{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T18:57:36Z","timestamp":1789498656378,"version":"build-2803163510"},"reference-count":37,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,2,3]],"date-time":"2021-02-03T00:00:00Z","timestamp":1612310400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,2,3]],"date-time":"2021-02-03T00:00:00Z","timestamp":1612310400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Microbiol"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Clarithromycin resistant\n                      <jats:italic>Helicobacter pylori<\/jats:italic>\n                      (\n                      <jats:italic>H. pylori<\/jats:italic>\n                      ) strains represent a worldwide health problem. These stains are usually carrying mutations within the 23S rRNA gene associated with clarithromycin resistance. This study aimed to detect\n                      <jats:italic>H. pylori<\/jats:italic>\n                      and clarithromycin resistant associated mutations from Sudanese patients with gastritis symptoms.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>\n                      Two hundred and eighty-eight gastric biopsies were collected using gastrointestinal endoscopy from patients with gastritis symptoms in different hospitals in Khartoum state.\n                      <jats:italic>H. pylori<\/jats:italic>\n                      was detected by PCR using primer targeting 16S rRNA. Then allele-specific PCR and DNA sequencing were used to screen for the presence of A2142G and A2143G point mutations.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Out of 288 samples,\n                      <jats:italic>H. pylori<\/jats:italic>\n                      was detected in 88 (~\u200930.6%) samples by 16\u2009s RNA. Allele-specific PCR detected the variant A2142G in 9\/53 (~\u200917%) sample, while A2143G mutation was not found in any sample. The DNA sequencing revealed the presence of mutations associated with clarithromycin-resistance in 36% (9\/25) of samples; the A2142G was present in one sample, A2143G in 5 samples and T2182C in 4 samples. Additionally, another point mutation (C2195T) was detected in 3 samples. There was no association of 23S rRNA gene point mutations with gender, age group, and patients\u2019 geographical distribution.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study revealed a high frequency (36%) of mutations associated with clarithromycin resistance using DNA sequencing of the 23S rRNA gene\u2019s V domain. This information should be taken into consideration to avoid eradication therapy failing.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12866-021-02096-3","type":"journal-article","created":{"date-parts":[[2021,2,3]],"date-time":"2021-02-03T03:03:47Z","timestamp":1612321427000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Helicobacter pylori 23S rRNA gene A2142G, A2143G, T2182C, and C2195T mutations associated with clarithromycin resistance detected in Sudanese patients"],"prefix":"10.1186","volume":"21","author":[{"given":"Aalaa Mahgoub","family":"Albasha","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maram M.","family":"Elnosh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esraa Hassan","family":"Osman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duha M.","family":"Zeinalabdin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amira A. M.","family":"Fadl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Musa Abdalla","family":"Ali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hisham N.","family":"Altayb","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,2,3]]},"reference":[{"key":"2096_CR1","volume-title":"Medical microbiology: Elsevier health sciences","author":"PR Murray","year":"2015","unstructured":"Murray PR, Rosenthal KS, Pfaller MA. Medical microbiology: Elsevier health sciences; 2015."},{"key":"2096_CR2","volume-title":"Microbiolog\u00eda m\u00e9dica: McGraw-Hill Interamericana","author":"KC Carroll","year":"2016","unstructured":"Carroll KC, Hobden JA, Miller S, Morse S, Mietzner T, Detrick B, Mitchell TG, McKerrow JH, Sakanari JA. Microbiolog\u00eda m\u00e9dica: McGraw-Hill Interamericana; 2016."},{"issue":"10","key":"2096_CR3","doi-asserted-by":"publisher","first-page":"1261","DOI":"10.2217\/fmb-2016-0023","volume":"11","author":"B Hu","year":"2016","unstructured":"Hu B, Zhao F, Wang S, Olszewski MA, Bian H, Wu Y, Kong M, Xu L, Miao Y, Fang Y. A high-throughput multiplex genetic detection system for Helicobacter pylori identification, virulence and resistance analysis. Future Microbiol. 2016;11(10):1261\u201378.","journal-title":"Future Microbiol"},{"key":"2096_CR4","doi-asserted-by":"publisher","first-page":"1058","DOI":"10.1016\/j.dib.2018.05.022","volume":"19","author":"SX Dong","year":"2018","unstructured":"Dong SX, Chang CC, Rowe KJ. A collection of the etiological theories, characteristics, and observations\/phenomena of peptic ulcers in existing data. Data Brief. 2018;19:1058\u201367.","journal-title":"Data Brief"},{"issue":"40","key":"2096_CR5","doi-asserted-by":"publisher","first-page":"11221","DOI":"10.3748\/wjg.v21.i40.11221","volume":"21","author":"Y-K Wang","year":"2015","unstructured":"Wang Y-K, Kuo F-C, Liu C-J, Wu M-C, Shih H-Y, Wang SS, Wu J-Y, Kuo C-H, Huang Y-K, Wu D-C. Diagnosis of Helicobacter pylori infection: current options and developments. World J Gastroenterol: WJG. 2015;21(40):11221.","journal-title":"World J Gastroenterol: WJG"},{"issue":"5","key":"2096_CR6","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1111\/hel.12142","volume":"19","author":"F Rasheed","year":"2014","unstructured":"Rasheed F, Campbell BJ, Alfizah H, Varro A, Zahra R, Yamaoka Y, Pritchard DM. Analysis of clinical isolates of Helicobacter pylori in Pakistan reveals high degrees of pathogenicity and high frequencies of antibiotic resistance. Helicobacter. 2014;19(5):387\u201399.","journal-title":"Helicobacter"},{"issue":"16","key":"2096_CR7","doi-asserted-by":"publisher","first-page":"2854","DOI":"10.3748\/wjg.v23.i16.2854","volume":"23","author":"N Arslan","year":"2017","unstructured":"Arslan N, Y\u0131lmaz \u00d6, Demiray-G\u00fcrb\u00fcz E. Importance of antimicrobial susceptibility testing for the management of eradication in Helicobacter pylori infection. World J Gastroenterol. 2017;23(16):2854.","journal-title":"World J Gastroenterol"},{"issue":"3","key":"2096_CR8","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1155\/2015\/853287","volume":"26","author":"NF Eng","year":"2015","unstructured":"Eng NF, Ybazeta G, Chapman K, Fraleigh NL, Letto R, Altman E, Diaz-Mitoma F. Antimicrobial susceptibility of Canadian isolates of Helicobacter pylori in northeastern Ontario. Can J Infect Dis Med Microbiol. 2015;26(3):137\u201344.","journal-title":"Can J Infect Dis Med Microbiol"},{"issue":"9","key":"2096_CR9","first-page":"1584","volume":"18","author":"JM Kim","year":"2008","unstructured":"Kim JM, Kim J-S, Kim N, Kim Y-J, Kim IY, Chee YJ, Lee C-H, Jung HC. Gene mutations of 23S rRNA associated with clarithromycin resistance in Helicobacter pylori strains isolated from Korean patients. J Microbiol Biotechnol. 2008;18(9):1584\u20139.","journal-title":"J Microbiol Biotechnol"},{"issue":"2","key":"2096_CR10","first-page":"104","volume":"36","author":"H Abdollahi","year":"2011","unstructured":"Abdollahi H, Savari M, Zahedi MJ, Moghadam SD, Hayatbakhsh Abasi M. Detection of A2142C, A2142G, and A2143G mutations in 23s rRNA gene conferring resistance to clarithromycin among Helicobacter pylori isolates in Kerman, Iran. Iran J Med Sci. 2011;36(2):104\u201310.","journal-title":"Iran J Med Sci"},{"issue":"7","key":"2096_CR11","doi-asserted-by":"publisher","first-page":"1796","DOI":"10.1093\/jac\/dku050","volume":"69","author":"TT Binh","year":"2014","unstructured":"Binh TT, Shiota S, Suzuki R, Matsuda M, Trang TTH, Kwon DH, Iwatani S, Yamaoka Y. Discovery of novel mutations for clarithromycin resistance in Helicobacter pylori by using next-generation sequencing. J Antimicrob Chemother. 2014;69(7):1796\u2013803.","journal-title":"J Antimicrob Chemother"},{"key":"2096_CR12","unstructured":"De Francesco V, Giorgio F, Hassan C, Manes G, Vannella L, Panella C, Ierardi E, Zullo A, et al. J Gastrointestinal Liver Dis. 2010;19(4):409\u201314."},{"issue":"1","key":"2096_CR13","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1186\/s12866-019-1517-4","volume":"19","author":"D Wang","year":"2019","unstructured":"Wang D, Guo Q, Yuan Y, Gong Y. The antibiotic resistance of Helicobacter pylori to five antibiotics and influencing factors in an area of China with a high risk of gastric cancer. BMC Microbiol. 2019;19(1):152.","journal-title":"BMC Microbiol"},{"key":"2096_CR14","unstructured":"Megraud F, Coenen S, Versporten A, Kist M, Lopez-Brea M, Hirschl AM, Andersen LP, Goossens H, Glupczynski Y. Helicobacter pylori resistance to antibiotics in Europe and its relationship to antibiotic consumption. Gut. 2012;201(62):34\u201342"},{"key":"2096_CR15","unstructured":"Wahab H, Khan T, Ahmad I, Jan A, Younas M, Shah H, AbdEl-Salam NM, Ayaz S, Ullah R, Wasim MA. Detection of H. pylori by PCR method using ureA and ureC gene in gastric biopsy sample. 2015;9(3):2165\u201374"},{"issue":"2","key":"2096_CR16","doi-asserted-by":"publisher","first-page":"280","DOI":"10.1128\/CMR.00033-06","volume":"20","author":"F M\u00e9graud","year":"2007","unstructured":"M\u00e9graud F, Lehours P. Helicobacter pylori detection and antimicrobial susceptibility testing. Clin Microbiol Rev. 2007;20(2):280\u2013322.","journal-title":"Clin Microbiol Rev"},{"key":"2096_CR17","unstructured":"Abd Al Rahem SA, Elhag WI. Molecular Detection of Helicobacter pylori in Drinking Water in Khartoum State (Sudan). Afr J Med ences. 2018;3(5)."},{"issue":"9","key":"2096_CR18","doi-asserted-by":"publisher","first-page":"2295","DOI":"10.1128\/JCM.30.9.2295-2301.1992","volume":"30","author":"L Engstrand","year":"1992","unstructured":"Engstrand L, Nguyen A, Graham D, El-Zaatari F. Reverse transcription and polymerase chain reaction amplification of rRNA for detection of Helicobacter species. J Clin Microbiol. 1992;30(9):2295\u2013301.","journal-title":"J Clin Microbiol"},{"issue":"11","key":"2096_CR19","doi-asserted-by":"publisher","first-page":"1810","DOI":"10.1111\/j.1440-1746.2007.04919.x","volume":"22","author":"T Furuta","year":"2007","unstructured":"Furuta T, Soya Y, Sugimoto M, Shirai N, Nakamura A, Kodaira C, Nishino M, Okuda M, Okimoto T, Murakami K. Modified allele-specific primer\u2013polymerase chain reaction method for analysis of susceptibility of Helicobacter pylori strains to clarithromycin. J Gastroenterol Hepatol. 2007;22(11):1810\u20135.","journal-title":"J Gastroenterol Hepatol"},{"key":"2096_CR20","first-page":"95","volume-title":"Nucleic acids symposium series","author":"TA Hall","year":"1999","unstructured":"Hall TA. BioEdit: a user-friendly biological sequence alignment editor and analysis program for Windows 95\/98\/NT. In: Nucleic acids symposium series, vol. c1979-c2000. London: Information Retrieval Ltd; 1999. p. 95\u20138."},{"issue":"1","key":"2096_CR21","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1002\/jgh3.12208","volume":"4","author":"R Shoosanglertwijit","year":"2020","unstructured":"Shoosanglertwijit R, Kamrat N, Werawatganon D, Chatsuwan T, Chaithongrat S, Rerknimitr R. Real-world data of Helicobacter pylori prevalence, eradication regimens, and antibiotic resistance in Thailand, 2013\u20132018. JGH Open. 2020;4(1):49\u201353.","journal-title":"JGH Open"},{"issue":"1","key":"2096_CR22","doi-asserted-by":"publisher","first-page":"93","DOI":"10.5455\/ijmsph.2016.1305201517","volume":"5","author":"H Shah","year":"2016","unstructured":"Shah H, Shah P, Jarag M, Shah R, Shah P, Naik K. Prevalence of Helicobacter pylori infection in gastric and duodenal lesions as diagnosed by endoscopic biopsy. Int J Med Sci Public Health. 2016;5(1):93\u20137.","journal-title":"Int J Med Sci Public Health"},{"issue":"5","key":"2096_CR23","doi-asserted-by":"publisher","first-page":"367","DOI":"10.1179\/1973947815Y.0000000067","volume":"28","author":"D Ghaith","year":"2016","unstructured":"Ghaith D, Elzahry M, Mostafa G, Mostafa S, Elsherif R, Ramzy I. Mutations affecting domain V of the 23S rRNA gene in Helicobacter pylori from Cairo, Egypt. J Chemother. 2016;28(5):367\u201370.","journal-title":"J Chemother"},{"issue":"5","key":"2096_CR24","doi-asserted-by":"publisher","first-page":"646","DOI":"10.1136\/gutjnl-2012-302084","volume":"61","author":"P Malfertheiner","year":"2012","unstructured":"Malfertheiner P, Megraud F, O'Morain CA, Atherton J, Axon AT, Bazzoli F, Gensini GF, Gisbert JP, Graham DY, Rokkas T. Management of Helicobacter pylori infection\u2014the Maastricht IV\/Florence consensus report. Gut. 2012;61(5):646\u201364.","journal-title":"Gut"},{"issue":"5","key":"2096_CR25","first-page":"41","volume":"3","author":"ABM Rahama","year":"2014","unstructured":"Rahama ABM, Mohamed AE, Elgemaabia OM, Yassin ME, Enan KM, Ahmed WAE, Ahmed BSR. Molecular detection of helicobacter pylori among gastroduodenitis and peptic ulcer patients in khartoum state. J Biomed Pharma Res. 2014;3(5):41\u20134.","journal-title":"J Biomed Pharma Res"},{"issue":"2","key":"2096_CR26","first-page":"50","volume":"3","author":"M Mamoun","year":"2015","unstructured":"Mamoun M, Ek ME, Abdo A, Hassan M. Molecular identification 0f 16s ribosomal RNA gene of Helicobacter pylori isolated from gastric biopsies in Sudan. Am J Microbiol Res. 2015;3(2):50\u20134.","journal-title":"Am J Microbiol Res"},{"key":"2096_CR27","doi-asserted-by":"publisher","first-page":"19","DOI":"10.3389\/fmolb.2014.00019","volume":"1","author":"T Nishizawa","year":"2014","unstructured":"Nishizawa T, Suzuki H. Mechanisms of Helicobacter pylori antibiotic resistance and molecular testing. Front Mol Biosci. 2014;1:19.","journal-title":"Front Mol Biosci"},{"key":"2096_CR28","unstructured":"Tanih NF, Ndip RN. Molecular detection of antibiotic resistance in south African isolates of Helicobacter pylori. Gastroenterol Res Pract. 2013;2013:6."},{"issue":"11","key":"2096_CR29","doi-asserted-by":"publisher","first-page":"699","DOI":"10.1016\/S1473-3099(06)70627-2","volume":"6","author":"MM Gerrits","year":"2006","unstructured":"Gerrits MM, van Vliet AH, Kuipers EJ, Kusters JG. Helicobacter pylori and antimicrobial resistance: molecular mechanisms and clinical implications. Lancet Infect Dis. 2006;6(11):699\u2013709.","journal-title":"Lancet Infect Dis"},{"key":"2096_CR30","doi-asserted-by":"crossref","unstructured":"Jaka H, R\u00fcttgerodt N, Bohne W, Mueller A, Gross U, Kasang C, Mshana SE. Helicobacter pylori mutations conferring resistance to Fluoroquinolones and clarithromycin among dyspeptic patients attending a tertiary hospital, Tanzania. Can J Gastroenterol Hepatol. 2019;2019:7.","DOI":"10.1155\/2019\/8481375"},{"issue":"8","key":"2096_CR31","doi-asserted-by":"publisher","first-page":"2373","DOI":"10.1007\/s10620-016-4091-8","volume":"61","author":"JY Park","year":"2016","unstructured":"Park JY, Dunbar KB, Mitui M, Arnold CA, Lam-Himlin DM, Valasek MA, Thung I, Okwara C, Coss E, Cryer B. Helicobacter pylori clarithromycin resistance and treatment failure are common in the USA. Dig Dis Sci. 2016;61(8):2373\u201380.","journal-title":"Dig Dis Sci"},{"issue":"3","key":"2096_CR32","doi-asserted-by":"publisher","first-page":"484","DOI":"10.2144\/02333bm04","volume":"33","author":"E Imyanitov","year":"2002","unstructured":"Imyanitov E, Buslov K, Suspitsin E, Kuligina ES, Belogubova E, Grigoriev MY, Togo A, Hanson K. Improved reliability of allele-specific PCR. Biotechniques. 2002;33(3):484\u201390.","journal-title":"Biotechniques"},{"issue":"07","key":"2096_CR33","doi-asserted-by":"publisher","first-page":"526","DOI":"10.3855\/jidc.10000","volume":"12","author":"TMT Ha","year":"2018","unstructured":"Ha TMT, Le PTQ, Nguyen VN, Phan TN, Paglietti B. Helicobacter pylori 23S rRNA gene mutations associated with clarithromycin resistance in chronic gastritis in Vietnam. J Infect Dev Countries. 2018;12(07):526\u201332.","journal-title":"J Infect Dev Countries"},{"issue":"5","key":"2096_CR34","doi-asserted-by":"publisher","first-page":"270","DOI":"10.5483\/BMBRep.2013.46.5.155","volume":"46","author":"C Cheng","year":"2013","unstructured":"Cheng C, Zhou Y, Yang C, Chen J, Wang J, Zhang J, Zhao G. Detection of rare point mutation via allele-specific amplification in emulsion PCR. BMB Rep. 2013;46(5):270.","journal-title":"BMB Rep"},{"issue":"1","key":"2096_CR35","doi-asserted-by":"publisher","first-page":"381","DOI":"10.1128\/IAI.05472-11","volume":"80","author":"SW Jung","year":"2012","unstructured":"Jung SW, Sugimoto M, Shiota S, Graham DY, Yamaoka Y. The intact dupA cluster is a more reliable Helicobacter pylori virulence marker than dupA alone. Infect Immun. 2012;80(1):381\u20137.","journal-title":"Infect Immun"},{"issue":"9","key":"2096_CR36","doi-asserted-by":"publisher","first-page":"3567","DOI":"10.1128\/AAC.48.9.3567-3569.2004","volume":"48","author":"R Khan","year":"2004","unstructured":"Khan R, Nahar S, Sultana J, Ahmad MM, Rahman M. T2182C mutation in 23S rRNA is associated with clarithromycin resistance in Helicobacter pylori isolates obtained in Bangladesh. Antimicrob Agents Chemother. 2004;48(9):3567\u20139.","journal-title":"Antimicrob Agents Chemother"},{"issue":"11","key":"2096_CR37","doi-asserted-by":"publisher","first-page":"1408","DOI":"10.1099\/jmm.0.000163","volume":"64","author":"T Fasciana","year":"2015","unstructured":"Fasciana T, Cal\u00e0 C, Bonura C, Di Carlo E, Matranga D, Scarpulla G, Manganaro M, Camilleri S, Giammanco A. Resistance to clarithromycin and genotypes in Helicobacter pylori strains isolated in Sicily. J Med Microbiol. 2015;64(11):1408\u201314.","journal-title":"J Med Microbiol"}],"container-title":["BMC Microbiology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12866-021-02096-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12866-021-02096-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12866-021-02096-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,2,3]],"date-time":"2021-02-03T03:06:25Z","timestamp":1612321585000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcmicrobiol.biomedcentral.com\/articles\/10.1186\/s12866-021-02096-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,3]]},"references-count":37,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["2096"],"URL":"https:\/\/doi.org\/10.1186\/s12866-021-02096-3","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-87256\/v1","asserted-by":"object"}]},"ISSN":["1471-2180"],"issn-type":[{"value":"1471-2180","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,3]]},"assertion":[{"value":"17 October 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 January 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 February 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The research was approved by the Khartoum state Ministry of health research department on1\/3\/2018.All methods were carried out in accordance with relevant guidelines and regulations. Informed consent was obtained from all adult patients and parents of the adolescent.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"38"}}