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Yamana Y, Yamana S, Uchio E. JACQLQ subjective symptom questionnaire score and clinical test results for patients with allergic conjunctival disease. Sci Rep 2024; 14:16235. [PMID: 39004666 PMCID: PMC11247079 DOI: 10.1038/s41598-024-67117-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 07/08/2024] [Indexed: 07/16/2024] Open
Abstract
We investigated the relationship between subjective symptoms and objective findings in patients with allergic conjunctival diseases (ACD) and test results for tear total IgE (t-tIgE), conjunctival eosinophils (c-Eo), serum total IgE (s-tIgE), serum-antigen specific IgE (s-sIgE), and serum eosinophils (s-Eo). Subjective symptoms and objective findings of patients with ACD were evaluated using Japanese Allergic Conjunctival Disease Quality of Life Questionnaire (JACQLQ), which described disability score and emotional score written by patient and clinical findings score written by ophthalmologist. We investigated the relationship between questionnaire scores and laboratory data for t-tIgE, c-Eo, s-tIgE, s-sIgE, and s-Eo. Scores of impediments to life and of moods were highest in vernal keratoconjunctivitis among ACD. Cases with positive pollen-sIgE showed significantly more nasal symptom score than those with negative pollen-sIgE (P < 0.05). Cases with positive t-tIgE or c-Eo showed significantly more objective symptoms' JACQLQ score than those with negative t-tIgE or c-Eo (P < 0.05), respectively. Cases positive for house dust/mite-sIgE, showed significantly more objective symptoms' JACQLQ score than those without for house dust/mite-sIgE (P < 0.05). These results indicate that ACD could be analyzed more accurately by the combination of JACQLQ and laboratory data.
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Affiliation(s)
| | - Satoshi Yamana
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Eiichi Uchio
- Department of Ophthalmology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
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Mikhail E, Mohebbi M, Gokhale M, Azizoglu S, Suphioglu C. Development and validation of a health practitioner survey on ocular allergy. Sci Rep 2024; 14:9932. [PMID: 38689009 PMCID: PMC11061311 DOI: 10.1038/s41598-024-60837-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 04/28/2024] [Indexed: 05/02/2024] Open
Abstract
Survey studies have played a significant role in understanding the gaps in the knowledge and practices of health practitioners. However, there have been no such survey studies on Ocular Allergy (OA). Thus, the purpose of this study was to develop and validate a survey on OA to better understand the gaps in the diagnostic, treatment, and collaborative care approaches of health practitioners in OA. The survey is titled "Survey on Ocular Allergy for Health Practitioners (SOAHP)". SOAHP was developed in a five-stage process. First, item extraction via the use of a literature review, second, face and content validity, third, a pilot study, fourth, test-retest reliability, and fifth, finalisation of the survey. 65 items under 6 domains were initially generated in the item extraction phase. Content validity was conducted on 15 experts in the field. This was conducted twice to reach consensus whereby items and domains were added, edited, kept, or removed, resulting in 50 items under 7 domains. The pilot study was conducted on 15 participants from the five relevant health practitioner fields (Allergists/Immunologists, General Practitioners (GPs), Ophthalmologists, Optometrists and Pharmacists). This altered the survey further to 40 items under 7 domains. Test-retest reliability was conducted on 25 participants from the five health practitioner fields. Reliability was moderate to almost perfect for most (97%) investigated items. The finalised survey was 40 items under 7 domains. SOAHP is the first survey created to assess diagnostic, treatment and collaborative care approaches of Allergists/Immunologists, GPs, Ophthalmologists, Optometrists and Pharmacists on OA. SOAHP will be a useful tool in clinical research on OA.
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Affiliation(s)
- Ereeny Mikhail
- NeuroAllergy Research Laboratory (NARL), School of Life and Environmental Sciences, Deakin University, Waurn Ponds, Geelong, VIC, 3216, Australia.
- Deakin Optometry, School of Medicine, Deakin University, Waurn Ponds, Geelong, VIC, 3216, Australia.
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Waurn Ponds, Geelong, VIC, 3216, Australia.
| | - Mohammadreza Mohebbi
- Biostatistics Unit, Faculty of Health, Deakin University, Geelong, VIC, 3216, Australia
| | - Moneisha Gokhale
- Deakin Optometry, School of Medicine, Deakin University, Waurn Ponds, Geelong, VIC, 3216, Australia
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Waurn Ponds, Geelong, VIC, 3216, Australia
| | - Serap Azizoglu
- Deakin Optometry, School of Medicine, Deakin University, Waurn Ponds, Geelong, VIC, 3216, Australia
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Waurn Ponds, Geelong, VIC, 3216, Australia
| | - Cenk Suphioglu
- NeuroAllergy Research Laboratory (NARL), School of Life and Environmental Sciences, Deakin University, Waurn Ponds, Geelong, VIC, 3216, Australia
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Waurn Ponds, Geelong, VIC, 3216, Australia
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Mimura T, Ichinose T, Inoue KI, Yoshida Y, Fujishima H. Airborne Suspended Particulate Matter and the Prevalence of Allergic Conjunctivitis in Japan. Cureus 2024; 16:e53292. [PMID: 38435920 PMCID: PMC10906130 DOI: 10.7759/cureus.53292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2024] [Indexed: 03/05/2024] Open
Abstract
Background This study aimed to examine the association of suspended particulate matter (SPM) with outpatient attendance for allergic conjunctivitis. Methodology The information on air pollution, encompassing total hydrocarbons, non-methane hydrocarbons, methane, carbon monoxide, nitrogen oxide, nitric oxide, oxidants, and SPM alongside data concerning daily weather conditions such as temperature, wind speed, and humidity, was gathered. Subsequently, the weekly mean values for outpatient visits, air pollution, and weather parameters were computed. Results The number of outpatient visits for allergic conjunctivitis was significantly associated with SPM levels (r = 0.70, p = 0.0037), oxidant levels (r = 0.70, p = 0.0038), wind speed (r = 0.48, p = 0.0472), and humidity (r = 0.77, p = 0.0009) from January to March, as well as SPM levels (r = 0.53, p = 0.0309) and carbon monoxide (r = 0.56, p = 0.0230) from April to June. Multivariate analysis showed that SPM (odds ratio = 1.37, p = 0.0161) and wind velocity (odds ratio = 1.52, p = 0.0038) were significant predictors of the number of outpatient visits from January to December. Conclusions SPM levels were the only independent predictor of outpatient visits for allergic conjunctivitis, suggesting that SPM contributes to the pathophysiology of this condition.
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Affiliation(s)
- Tatsuya Mimura
- Ophthalmology, Teikyo University School of Medicine, Tokyo, JPN
| | - Takamichi Ichinose
- Department of Health Science, Oita University of Nursing and Health Sciences, Oita, JPN
| | - Ken-Ichiro Inoue
- Graduate School of Nursing, University of Shizuoka, Shizuoka, JPN
| | - Yasuhiro Yoshida
- Department of Immunology and Parasitology, School of Medicine, University of Occupational and Environmental Health, Fukuoka, JPN
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Wang H, Jiang X, Zhang P, Li Y, Wang Y, Li X. Allergen-specific IgE in the tear fluid of Chinese patients with common allergic conjunctivitis in autumn and winter. Int Ophthalmol 2023; 43:4541-4549. [PMID: 37668849 DOI: 10.1007/s10792-023-02854-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 08/05/2023] [Indexed: 09/06/2023]
Abstract
PURPOSE In this study, we determined the positive rates of allergen-specific immunoglobulin E (IgE) in the tear fluid of Chinese patients with common allergic conjunctivitis (AC) in autumn and winter, compared systemic and ocular allergen tests, and explored the correlation between the numbers and categories of allergens and clinical AC features. METHODS This cross-sectional study recruited 44 patients with AC (86 eyes). Specific IgEs for allergens common in China (house dust mite, cat/dog dander, mugwort/ragweed pollen, cottonwood/willow/elm pollen, milk, egg whites, soybeans) were measured in collected tears using kits for allergen-specific IgE antibodies. AC signs and symptoms were graded according to severity. RESULTS Specific IgE in tears was positive in 87.2% of eyes. House dust mite was the most common allergen (86.0%), followed by cat (24.4%) and dog (7.0%) dander; tree and grass pollen accounted for only 4.7% and 2.3%, respectively. Food allergens were not detected. The positive rates of the systemic allergen tests were lower than in tear fluid tests in both eyes, especially for house dust mites (P = 0.000). In patients with more allergens, itching was more severe (P = 0.035), while conjunctival hyperemia was milder (P = 0.002). CONCLUSION In autumn and winter, the most common AC allergen in Chinese patients was house dust mites. Compared with systemic allergen tests, measuring specific IgE in tears may be a non-invasive method to diagnose and evaluate AC severity, which may be more suitable to reflect the local conditions of ocular surface inflammation due to its high positive rate and convenience.
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Affiliation(s)
- Hongmei Wang
- Department of Ophthalmology, Peking University Third Hospital Eye Center, 49 North Garden Rd, Haidian District, Beijing, 100191, People's Republic of China
| | - Xiaodan Jiang
- Department of Ophthalmology, Peking University Third Hospital Eye Center, 49 North Garden Rd, Haidian District, Beijing, 100191, People's Republic of China
| | - Pei Zhang
- Department of Ophthalmology, Peking University Third Hospital Eye Center, 49 North Garden Rd, Haidian District, Beijing, 100191, People's Republic of China
| | - Yingyu Li
- Department of Ophthalmology, Peking University Third Hospital Eye Center, 49 North Garden Rd, Haidian District, Beijing, 100191, People's Republic of China
| | - Yiren Wang
- Department of Ophthalmology, Peking University Third Hospital Eye Center, 49 North Garden Rd, Haidian District, Beijing, 100191, People's Republic of China
| | - Xuemin Li
- Department of Ophthalmology, Peking University Third Hospital Eye Center, 49 North Garden Rd, Haidian District, Beijing, 100191, People's Republic of China.
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Relationship among total tear IgE, specific serum IgE, and total serum IgE levels in patients with pollen-induced allergic conjunctivitis. Graefes Arch Clin Exp Ophthalmol 2021; 260:281-287. [PMID: 34415364 PMCID: PMC8763815 DOI: 10.1007/s00417-021-05348-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 07/20/2021] [Accepted: 07/27/2021] [Indexed: 12/28/2022] Open
Abstract
Background Recently, the number of patients with pollinosis, particularly Japanese cedar pollinosis, has markedly increased. We previously reported about local allergic conjunctivitis, which is a phenotype of allergic conjunctivitis (AC). AC cases are often sensitized by various antigens. This study aimed to investigate the relationship among total tear IgE (t-tIgE), specific serum IgE (s-sIgE), and total serum IgE (t-sIgE) levels in patients with pollen-induced AC. Methods In 2019, 1372 patients were clinically diagnosed with AC at the Yamana Eye Clinic using t-tIgE, t-sIgE, and s-sIgE tests against 39 allergens. Among the pollen-induced AC patients who underwent allergen testing, 99 tested positives for s-sIgE against pollen. The subjects comprised 33 (33.3%) male and 66 (66.7%) female individuals aged 9–86 years. Results The t-tIgE test was positive in 68 (68.7%) patients and negative in 31 (31.3%) patients. In the t-sIgE test, 45 (45.5%) patients had t-sIgE levels above the reference value of 170 IU/mL. The higher the total score of the positive class value of each pollen-specific IgE (pollen-sIgE) antibody, the higher the positive rate of t-tIgE (p < 0.001). Of 32 patients in whom food-specific IgE (food-sIgE) was detected, 81.3% of the pollen-sIgE-positive and food-sIgE-positive cases were also positive for t-sIgE and t-tIgE. However, significant difference was not found between the total score of food-sIgE of the t-tIgE positive group and negative group. Conclusions Pollen-induced AC is caused by pollen sensitization of the conjunctiva. Food-induced AC might be induced by the different pathological mechanism involved in pollen-induced AC.
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Mimura T, Noma H, Mizota A. Specific Dog Allergen Immunoglobulin G Antibodies in Patients with Allergic Conjunctivitis. Open Ophthalmol J 2019. [DOI: 10.2174/1874364101913010076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Purpose:
The purpose of the study was to examine the role of total tear IgE, and specific serum dog IgG and IgE antibodies on the severity of allergic conjunctivitis.
Methods:
This study enrolled healthy subjects (control group, N=13), the patients with seasonal allergic conjunctivitis (seasonal group, N=13), and patients with perennial allergic conjunctivitis (perennial group, N=13). Skin prick test, tear IgE level, and serum specific dog IgE and IgG levels were examined. The severity of allergic conjunctivitis using a grading score (0-30) was also examined.
Results:
The levels of serum dog-specific IgE and IgG, and total tear IgE of the seasonal and perennial groups were higher as compared to those of the control group (all p<0.05). The levels of serum dog-specific IgG of the perennial group were higher than those of the seasonal group (0.4 ± 0.6 vs. 0.0 ± 0.0). Multivariate analysis confirmed that the skin prick test result for dog allergen was related to the serum dog-specific IgG levels, but not IgE levels (p<0.01). The severity of allergic conjunctivitis was related to the serum level of dog-specific IgG antibodies (p<0.01).
Conclusion:
It was concluded that dog-specific IgG antibodies level may be associated with the severity of dog-related perennial allergic conjunctivitis.
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Multiplex assay of specific IgE antibodies in tear fluids by means of microarray technology. J Fr Ophtalmol 2016; 39:e183-5. [DOI: 10.1016/j.jfo.2015.10.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 10/17/2015] [Accepted: 10/23/2015] [Indexed: 11/20/2022]
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Miyama A, Mimura T, Noma H, Goto M, Kamei Y, Kondo A, Saito Y, Okuma H, Matsubara M. Specific IgG for cat allergens in patients with allergic conjunctivitis. Int Ophthalmol 2014; 35:575-86. [PMID: 25189683 DOI: 10.1007/s10792-014-9987-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Accepted: 08/07/2014] [Indexed: 10/24/2022]
Abstract
Immunoglobulin G (IgG) antibodies are involved in type II and type III hypersensitivity. We evaluated the relation between perennial allergic conjunctivitis and serum levels of specific IgG for cat allergens. A prospective study was conducted in patients with seasonal allergic conjunctivitis (seasonal group, n = 10), patients with perennial allergic conjunctivitis (perennial group, n = 10), and healthy control subjects (control group, n = 10). Serum levels of specific IgE and IgG for cat allergens and total tear IgE were measured, and a skin prick test was also performed. In addition, a severity score associated with allergic conjunctivitis was calculated (0-30). The positive rates and scores of for total tear IgE, serum cat-specific IgE, and serum cat-specific IgG were all higher in the seasonal and perennial groups than in the control group (all p < 0.05). Serum cat-specific IgG levels were higher in the perennial group than in the seasonal group (p = 0.0156), but there was no significant difference in the grade of cat-specific IgE between the two groups (p = 0.3008). On multivariate analysis, the mean wheal diameter for cat allergen was associated with the serum level of cat-specific IgG (not IgE) in all patients [odds ratio (OR) = 31.979, p < 0.0001]. Multivariate analysis revealed that the total objective score was strongly associated with serum cat-specific IgG (OR = 23.015, p < 0.0001). These findings suggest that specific IgG antibodies may be involved in perennial allergic symptoms caused by indoor allergens such as cat allergens.
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Affiliation(s)
- Anri Miyama
- Department of Ophthalmology, Tokyo Women's Medical University Medical Center East, 2-1-10 Nishiogu, Arakawa-ku, Tokyo, 116-8567, Japan
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Mimura T, Ichinose T, Yamagami S, Fujishima H, Kamei Y, Goto M, Takada S, Matsubara M. Airborne particulate matter (PM2.5) and the prevalence of allergic conjunctivitis in Japan. THE SCIENCE OF THE TOTAL ENVIRONMENT 2014; 487:493-9. [PMID: 24802272 DOI: 10.1016/j.scitotenv.2014.04.057] [Citation(s) in RCA: 92] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Revised: 04/11/2014] [Accepted: 04/15/2014] [Indexed: 05/03/2023]
Abstract
OBJECTIVE Exposure to particulate matter less than 2.5 μm in diameter (PM2.5) is associated with asthma and respiratory symptoms, but little is known about the influence of PM2.5 on allergic conjunctivitis. The purpose of this study was to examine the association of PM2.5 with outpatient attendance for allergic conjunctivitis. METHODS We conducted a time-series analysis of the association between outpatient attendance for allergic conjunctivitis and PM2.5 levels from May to July (non-pollen season) and from August to October (the autumnal pollen season) in 2012. Air pollution data (including the levels of PM2.5, oxidants, nitric oxide, nitrogen dioxide, nitrogen oxide, carbon monoxide, methane, non-methane hydrocarbons, and total hydrocarbons) and data on the daily weather conditions (temperature, wind speed, and humidity) were collected at a centrally located monitoring station in Tokyo. We calculated weekly average values for the daily number of outpatient visits, as well as the air pollution and weather data, and used the weekly average values for analysis. RESULTS There was a significant association between the number of outpatient visits for allergic conjunctivitis and the PM2.5 level (r=0.62, p=0.0177) from May to July, while no correlation was found between the number of outpatient visits and any variable assessed from August to November. Multivariate analysis also showed that PM2.5 was a significant predictor of the number of outpatient visits from May to July (odds ratio=9.05, p=0.0463), while there were no significant predictors of the number of outpatient visits from August to October. From May to July, PM2.5 showed a negative correlation with humidity (r=-0.53, p=0.0499). CONCLUSIONS These findings suggest a possible role of PM2.5 in the development of allergic conjunctivitis during the non-pollen season. This association between PM2.5 and allergic conjunctivitis may have broad public health implications in relation to allergic diseases.
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Affiliation(s)
- Tatsuya Mimura
- Department of Ophthalmology, Tokyo Women's Medical University Medical Center East, Tokyo, Japan; Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Tokyo, Japan; Nerima West Eye Clinic, Tokyo, Japan.
| | - Takamichi Ichinose
- Department of Health Science, Oita University of Nursing and Health Science, Oita, Japan
| | - Satoru Yamagami
- Department of Ophthalmology, Tokyo Women's Medical University Medical Center East, Tokyo, Japan; Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Hiroshi Fujishima
- Department of Ophthalmology, Tsurumi University School of Dental Medicine, Kanagawa, Japan
| | - Yuko Kamei
- Department of Ophthalmology, Tokyo Women's Medical University Medical Center East, Tokyo, Japan
| | - Mari Goto
- Department of Ophthalmology, Tokyo Women's Medical University Medical Center East, Tokyo, Japan
| | - Sachiko Takada
- Department of Ophthalmology, Tokyo Women's Medical University Medical Center East, Tokyo, Japan; Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Masao Matsubara
- Department of Ophthalmology, Tokyo Women's Medical University Medical Center East, Tokyo, Japan
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Mimura T, Yamagami S, Noma H, Kamei Y, Goto M, Kondo A, Matsubara M. Specific IgE for wheat in tear fluid of patients with allergic conjunctivitis. Cutan Ocul Toxicol 2014; 34:25-34. [PMID: 24678747 DOI: 10.3109/15569527.2014.890938] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONTEXT Allergy to hydrolyzed wheat protein in facial soap has become a major social issue in Japan. It has been reported that the most frequent early symptoms of allergy to hydrolyzed wheat protein in soap are allergic conjunctivitis and rhinitis, while wheat-dependent exercise-induced anaphylaxis can be induced by long-term use. OBJECTIVE We evaluated the relation between tear fluid levels of specific IgE for wheat and the features of allergic conjunctivitis. METHODS A prospective, non-randomized, cross-sectional study was conducted in 103 patients with moderate to severe allergic conjunctivitis (allergic group) and 20 age- and sex-matched healthy control subjects (control group). Specific IgE for wheat was measured in tear fluid with an immunochromatography assay, and a skin prick test (SPT) was also performed. Symptoms (sneezing, rhinorrhea, nasal obstruction, ocular itching, and lacrimation) were assessed in each subject along with the activities of daily living (ADL) score and the total ocular symptom score for allergic conjunctivitis. A severity score (0, 1, 2, or 3) was assigned for various changes of the palpebral and bulbar conjunctiva, as well as for limbal and corneal lesions associated with allergic conjunctivitis. RESULTS The IgE positive rate and specific IgE score were both higher in the allergic group than in the control group (71.8% versus 40.0% and 1.9 ± 0.7 versus 1.4 ± 0.5). A positive SPT for wheat was also more frequent in the allergic group than in the control group (6.8% versus 0.0%). Within the allergic group, patients with a positive SPT had higher specific IgE scores than patients with a negative SPT (3.3 ± 0.5 versus 1.8 ± 0.6, p < 0.001). In the allergic group, the wheat IgE level in tear fluid was correlated with the severity of allergic conjunctivitis symptoms, including ocular itching (r = 0.665), tearing (r = 0.672), and the total ocular symptom score (r = 0.204). Wheat IgE in tear fluid was also correlated with the severity of rhinitis symptoms, including sneezing (r = 0.610), nose blowing (r = 0.640), and nasal obstruction (r = 0.677). Furthermore, the tear fluid wheat IgE score was correlated with five objective features of allergic conjunctivitis (p < 0.05). CONCLUSIONS These results suggest that wheat allergy may be involved in the development of allergic conjunctivitis.
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Affiliation(s)
- Tatsuya Mimura
- Department of Ophthalmology, University of Tokyo Graduate School of Medicine , Bunkyo-ku , Japan
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Mimura T, Yamagami S, Kamei Y, Goto M, Matsubara M. Specific IgE in Tear Fluid and Features of Allergic Conjunctivitis. Curr Eye Res 2013; 38:917-25. [DOI: 10.3109/02713683.2013.794248] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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