Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Dr Mohan Z Mani

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Thiruvalla, Kerala
On Sep 2018

Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."

Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
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Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018

Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."

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Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
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Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
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Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
On Sep 2018

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Calcutta National Medical College & Hospital , Kolkata

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Muzaffarnagar Medical College,
On Aug 2018

Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".

Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
On Aug 2018

Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".

Dr. Mamta Gupta
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018

Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.

Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."

Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
On May 11,2011

Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."

Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
On April 2011

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.

Dr. Anuradha
On Jan 2020

Important Notice

Year : 2012 | Month : February | Volume : 6 | Issue : 1 | Page : 139 - 141

Biological Restoration of a Grossly Decayed Deciduous Mandibular Molar

Shivani Mathur, Rahul Chopra, I.K. Pandit, Nikhil Srivastava, Neeraj Gugnani

1. Senior resident,Department of Pedodontics and Preventive Dentistry, Government Dental College,Rohtak, Haryana ,India. 2. Senior resident, Department of Periodontics, Government Dental College, Rohtak, Haryana, India. 3. Professor and Head of the Department, Department of Pedodontics and Preventive dentistry D.A.V.(C) Dental College & Hospital, Yamunanagar, Haryana, India. 4. Professor, Department of Pedodontics and Preventive dentistry, D.A.V.(C) Dental College & Hospital, Yamunanagar, Haryana, India. 5. Professor, Department of Pedodontics and Preventive dentistry D.A.V.(C) Dental College & Hospital, Yamunanagar, Haryana, India.

Correspondence Address :
Dr. Shivani Mathur, M.D.S
Senior resident,
Department of Pedodontics and Preventive Dentistry,
Government Dental College,
Rohtak, Haryana.
Phone: 09354812365


This article reports a case of 7-year old child, in whom a severely damaged primary molar was biologically restored using a tooth obtained from another patient. After clinical evaluation, extracted tooth was adjusted to the prepared primary molar, it was autoclaved and bonded to the primary molar with dual cure resin cement. Occlusal adjustment was performed and periodic clinical follow up was carried out at 6 month and 12 month interval. In this case report, the use of biological restorations as a possible alternative treatment for rehabilitation of severely destroyed primary teeth is discussed.


Biological restoration, root canal therapy, paediatric dentistry

Dental caries is one of the most prevalent disease of mankind. It has affected human race since times immemorial, especially during early childhood. According to 1999-2004 National Health and Nutrition Examination Survey 42% of children in the age group of 2 to 11 years have had dental caries in their primary teeth. Primary molars with extensive carious lesions are routinely observed in clinical practice. Their loss at an early age may not only lead to establishment of neuro-muscular imbalance leading to decreased masticatory efficacy but also phonetic and esthetic problems, development of parafunctional, psychological problems. To restore them is thus a challenge for the clinician. Diverse treatment options are available today like stainless steel crowns, cheng crowns, dura crowns, strip crowns, glastech crowns, pedo jacket crowns etc. Out Of the various treatment options available to rehabilitate it severely destroyed tooth crowns, conservatively and biologically, several authors have suggested the use of tooth structure as a restorative material (1),(2),(3),(4),(5),(6)(7). Santos and Bianchi (8) in 1991 coined the term “biological restoration” while the first paper reporting the use of fragments of extracted teeth as dental restorative materials was published in 1964 by Chosak and Eidelman (9). Ramires-Romito et al used teeth from the human tooth bank of Sao Paulo University Dental School to be used as natural posts and crowns to fit into the roots and replace the crowns as well (10). Thereafter, several other reports have demonstrated the advantages of this technique, such as favorable esthetics, resulting from enamel’s natural surface smoothness, anatomic contouring and color match, functional and masticatory effectiveness, preservation of sound tooth structure, prevention of physiological wear, and no need of complex material resources (3),(5),(6),(8). The technique consists of bonding sterile dental fragments teeth with large coronal destruction. Adhesive materials retain the tooth fragment in the non-retentive cavity which is present as a result of extensive loss of tooth structure. Fragments obtained either from the patient or from a tooth bank may be used as a safe and reliable alternative to restore dental anatomy and function with excellent biomechanical properties (2), (8). Not only is the technique Dentistry Section simple, but it also allows the preservation of sound tooth structure and provides excellent esthetics compared to composite resins and stainless steel crowns, especially regarding translucency. In addition the clinical chair time for fragment bonding procedures is relatively short, which is very interesting when treating paediatric patients. This article describes a case in which a severely damaged primary molar due to extensive carious lesion was biologically restored using a tooth obtained from another patient.

Case Report

A 7-year-old patient reported to the department of pedodontics and preventive dentistry D.A.V (C ) Dental College and Hospital, Yamunanagar with extensive carious lesion in the primary mandibular left first and second molars. After clinical and radiographic examinations, local anesthesia was given and a rubber dam was placed for isolation of the operative field. Single sitting root canal therapy was performed thereafter in both the molars (Table/Fig 1). A stainless steel crown was adapted on the mandibular first molar since there was substantial tooth structure left for it to be restored using SS crown. For the mandibular second molar to be biologically restored, the steps, advantages as well as disadvantages of the technique were fully explained to the parents and a signed informed consent was obtained. The core of the tooth structure was built with composite resin since the amount of remaining tooth structure was not sufficient for adhesion (Table/Fig 2). Impressions of both the maxillary as well as the mandibular arches were then taken using alginate. Stone casts were obtained and the mesiodistal, cervico-occlusal and buccolingual dimensions of the tooth (mandibular left second molar) were measured using a compass, in order to select an extracted tooth, whose coronal dimensions best fitted the prepared tooth. Color matching was also taken into account. A tooth was selected (Table/Fig 3) which was stored previously at 4 degree centigrade in Hank’s balanced salt solution with donor identification (11),(12),(13),(14). It was scaled, polished and freed of soft tissues and periodontal remnants. Also, the pulp was removed. The coronal fragment was adjusted with diamond burs at high-speed under air/water spray coolant until it fitted the cavity. Articulating paper was interposed between the fragment and the cavity in the stone cast as well as the fragment and the maxillary cast to demarcate the areas that needed further adjustments. The prepared fragment was autoclaved at 121°C for 20 min. In a second clinical appointment, the adaptation of the fragment to the tooth was checked. The fragment was bonded with a dual-cure resin-based cement (Calibra, Dentsply York, PA, USA), according to the manufacturer’s instructions. The material was light cured on buccal and lingual surfaces for 40 s (Table/Fig 4). The fragment-tooth interface was sealed with composite resin (Esthet-X, Dentsply, York, PA, USA), light-cured for 40 s. Occlusion was checked with articulating paper. The parents were instructed to get the follow-up done periodically; at 6 month and 12 month interval (Table/Fig 5). Post-treatment course was uneventful.


The use of extracted teeth as biological restoration constitutes a viable restorative alternative for teeth with extensive coronal destruction. This technique is simple, provides excellent esthetics as well as preserves natural tooth colour compared to composite resins and stainless steel crowns, allows the preservation of sound tooth structure and has low cost (15). The enamel of the biologically restored tooth has physiologic wear and offers superficial smoothness and cervical adaptation compatible with those of surrounding teeth [6,9] . Biological restorations not only mimic the missing part of the oral structures, but are also biofunctional (16). The length of each appointment is reduced because natural teeth are prepared previously. Clinical chair time for fragment bonding procedures is relatively short, which is a merit especially while dealing with paediatric patients (2),(3),(5),(6),(16). Resin composite restorations do not present these advantages and can allow staining and plaque formation on their surfaces. However, biological restorations as any indirect restoration requires a laboratory phase that must be handled carefully. Collected samples should be scaled, polished and freed of soft tissues and periodontal remnants. Although a simple technique, it requires professional expertise to prepare and adapt the natural crowns in the cavity. Disadvantages of the biological restoration technique include the difficulty in obtaining teeth with the required coronal dimensions and characteristics, problems inherent to indirect restorations and matching fragment colour with tooth remnant colour. Also, having fragments from other people’s teeth in their mouth is not a pleasant idea for some patients and many of them refuse to receive this treatment (2). However, all these factors are not contraindications of the technique. It is important that the parents are informed that the tooth fragments used for biological restoration are previously submitted to a rigorous sterilization process that completely eliminates any risk of contamination or disease transmission to the child receiving the fragment. Presently, secure methods of sterilization and storage are available to ensure the safety of teeth or tooth fragments coming from tooth banks (2),(17). Several materials have been used for bonding dental fragments to cavities, e.g., adhesive systems, composite resins, glass ionomer cements and dual-cure resin cements (2). Since the Tooth fragment which was taken was large, it was concerned that optimal lightcuring would not be achieved at the cavity gingival margin. Thus, dual-cure resin-based cement was used to enhance polymerization at this region in addition to filling any possible gaps existing at tooth/fragment interface with composite resin only (7).


Based on the positive results in the literature and on our own clinical experience, it may be concluded that the biological restoration technique using tooth fragments has a practical clinical applicability and is a viable, cost-effective restorative procedure for primary teeth with severely damaged crowns. In the present case, the use of biological restoration with natural crown resulted in clinical success as well as recovered the proper functional anatomy of the tooth.


Andreasen FM, Noren JG, Andreasen JO, Engelhardtsen S, Lindh- Stromberg U. Long-term survival of fragment bonding in the treatment of fractured crowns: a multicenter clinical study. Quintessence Int 1995;26:669-81.
Busato ALS, Loguercio AD, Barbosa NA, Sanseverino MCS, Macedo RP, Baldissera RA. Biological restorations using tooth fragments. Am J Dent 1998;11:46-48.
Ramires-Romito ACD, Wanderley MT, Oliveira MDM, Imparato JCP, CĂ´rrea MSNP. Biologic restoration of primary anterior teeth. Quintessence Int 2000;31:405-11.
Olsburgh S, Jacoby T, Krejci I. Crown fractures in the permanent dentition: pulpal and restorative considerations. Dent Traumatol 2002;18:103-15.
Barcelos R, Neves AA, Primo L, Souza IPR. Biological restorations as an alternative treatment for primary posterior teeth. J Clin Paediatr Dent 2003;27:305-10.
Mandroli PS. Biologic restoration of primary anterior teeth: a case report. J Indian Soc Pedod Prev Dent 2003;21:95-97.
Terry DA. Adhesive reattachment of a tooth fragment: the biological restoration. Pract Proced Aesthet Dent 2003;15:403-09.
Santos J, Bianchi J. Restoration of severely damaged teeth with resin bonding systems: case reports. Quintessence Int 1991;22:611-15.
Chosack ABDS, Eidelman EDO. Rehabilitation of a fractured incisor using the patient’s natural crown-case report. J Dent Child 1964;31:19-21.
Ramires Romito ACD., Wanderley MT, Oliveira MDM, Imparto JCP, Pires Correa MSN. Biologic restoration of primary anterior teeth. Quint Int 2000; 31: 405-11.
Ahmed FIK, Russel C. Sterilization of teeth for homogeneous transplantation. British Journal of Oral Surgery 1976;14;143-49.
Nassif AC, Tieri F, Da Ana PA, et al. Structuralisation of Human Tooth Bank. Pesqui Odontol Bras 2003;17(1);70-74.
Habiltz S, et al. Nanoindentation and storage of teeth. J Biomech 2002;35(7):995-98.
Grewal N, Reeshu S. Biological Restorations: An Alternative Esthetic Treatment for Restoration of Severely Mutilated Primary Anterior Teeth. Jaypee’s Int J of Clin Pediatr Dent, September-December 2008;1(1);42-47.
Ehrmann EH. Restoration of a fractured incisor with exposed pulp using original tooth fragment: report of a case. J Am Dent Assoc 1989;118:183.
Kapur A, Chawla HS, Goyal A, Gaube K. An esthetic point of view in very young children. J Clin Pediatr Dent 2005;30:99-103.
Yang ZP, Chang CS. A 3-year follow-up of a homotransplanted tooth from a tooth bank. J Endod 1990;16:34-37.

DOI and Others

ID: JCDR/2012/3368:1851.1


Date of Submission: Sep 30, 2011
Date of Peer Review: Dec 22, 2011
Date of Acceptance: Jan 03, 2012
Date of Publishing: Feb 15, 2012

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