A bibliometric analysis of the top 50 most cited articles published in the Journal of Conservative Dentistry.

Background: Bibliometric analysis is the quantitative analysis of measurable citation information of a journal. It unveils research topics, publishing trends, assess research impact, and productivity. Aims: The purpose of this study was to conduct a bibliometric analysis to identify and analyze the top 50 most cited articles published in the Journal of Conservative Dentistry (JCD). Methodology: Clarivate Analytics' Web of Science was used to search and identify the 50 most cited scientific papers of JCD. Each article was then cross-matched with Google Scholar and PubMed databases and the mean citation was derived. In addition, citation density for each article was derived to negate the age of publication factor. Statistical Analysis: Shapiro-Wilk test and Kolmogorov-Smirnov test were done to detect departures from normality. For testing and determining correlations among several variables, the Spearman rank test was performed.
Results: The top 50 most-cited articles received a total of 6263 (Google Scholar), 323 (PubMed), and 2056 (Web of Science) citations. Major topics of interest in the top 50 most-cited articles were dental material science (n = 18) and carious and noncarious lesion management (n = 14). There was no significant association between mean citation count and time since publication (correlation coefficient = 0.273, P = 0.055). However, there was a significant negative association of citation density (correlation coefficient = -0.647, P < 0.01) with time since publication. Conclusions: Bibliometric analysis of top-cited articles gave valuable insights into journal's research history and progress of the journal concerning dissemination of scholarly work. Copyright:

INTRODUCTION

Scholarly journals provide a comprehensive idea of the trends and drifts of research in a particular discipline. Journals strive to maintain the highest quality to create high-impact publications to strengthen future research in the specialty.[1] The bibliometric analysis is the quantitative analysis of journals by retrieving measurable information in any published scientific article or journal.[2] Alan Pritchard is credited for introducing the term “Bibliometrics” to replace the earlier word “Statistical bibliography” used for the same concept.[3] It unveils research topics, publishing trends, assess research impact, and productivity. Bibliometric analyses have lately been firmly established as integral part for assessing research evolution, methodology and also been used to analyze and rank institutions, universities, and scientific journals.[2]

Citation data of articles in a journal provide a metric to gauge the journal's impact. The number of citations an article receives accord recognition to the researcher's work and the journal.[4] The top-cited articles may not be the milestone research of the field, and it may not necessarily claim with conviction the research quality.[5] Nevertheless, this does not undermine the significance of this bibliometric indicator and is used to evaluate the trends in research over a period and identifies research institutes and researchers who have contributed immensely.

Bibliometric analysis is relatively new to dentistry. Until now, it has evaluated the most cited articles in specific topics and top journals in dentistry.[678910111213] Such analysis has yielded thoughtful insights into how academic journals have performed over the years to disseminate knowledge among peers.[2] However, the true potential of bibliometric analysis is still unexploited with its seemingly high potential to empower a young brigade of researchers by seeding ideas for future research. Bibliometric indicators have gained increasing importance and use in science policy and management where it has been frequently used in the domain of research evaluation and assessment. There is a dedicated scientific journal in bibliometrics by the name “Scientometrics” which can enable researchers in identifying the potential research directions and status of journals by utilizing key principles of bibliometrics.

To the best of the authors' knowledge, this is the first study to conduct a bibliometric analysis of the Journal of Conservative Dentistry (JCD) – the official journal of the Indian Association of Conservative Dentistry and Endodontics published by Wolters Kluwer Medknow publications since 1998. This article aims to extract and analyze the top 50 cited articles of the JCD from the last 23 years of existence. The articles will be examined for research topics, contributing institutes, countries, and authors. This exercise will bring forth the scholarly work contributed by this journal that will form the tool for further research in the field of conservative dentistry and endodontics.

METHODOLOGY

For the study, Clarivate Analytics' Web of Science, PubMed, and Google Scholar databases were used for the electronic literature search on June 1, 2021. The search was conducted within the “source title” and subject as “Journal of Conservative Dentistry.” There was no restraint in the search concerning the publication year or study design of the articles. As the Scopus database did not provide article citation data before 2011, its total cites were omitted from the study. The list of the top 50 cited articles obtained from the Web of Sciences database was cross-matched with citation scores in the Google Scholar and PubMed databases. The articles obtained from all databases were categorized in descending order based on their mean number of citations.

Data pertaining to the article title, total citation score from all databases, publication year, article topic/theme, study design, name of the first author and co-authors, state and country of origin, and contributing institutions were extracted for the selected top 50 cited articles of JCD. From the data extracted, the mean citation score and citation density for each article were calculated. In addition, the country and institute of origin were determined by the address provided for the first author. Articles were also categorized based on the research topic into six groups; dental material science, dental caries and noncarious lesions management, esthetic dentistry, root canal therapy, regenerative endodontics, and reporting guidelines. The Shapiro–Wilk test and Kolmogorov–Smirnov test were used to test the distribution of individual variables for normality. Correlation between variables was performed using the Spearman rank test. A P < 0.05 was considered to be statistically significant. Analysis was performed using Statistical Package for the Social Sciences (SPSS) (SPSS software version 20.0; SPSS Inc., Chicago, IL, USA).

RESULTS

Based on the mean citation score calculated, the top 50 most-cited articles were analyzed for their various characteristics.

The top 50 most-cited articles received a total of 6263 (Google Scholar), 323 (PubMed), and 2056 (Web of Science) citations. The citation range was 34–272 (Google Scholar), 1–59 (PubMed), and 23–105 (Web of Science). According to Google Scholar citations, the top 6 articles were each cited more than 200 times. The most-cited article with 272 (Google Scholar), 50 (PubMed), 105 (Web of Science) citations was “Endodontic microbiology” a review by Narayanan et al. with a mean citation score of 142.3. The second most-cited article with 270 (Google Scholar), 59 (PubMed), and 68 (Web of Science) citations was “Remineralization potential of fluoride and amorphous calcium phosphate-casein phosphopeptide on enamel lesions: An in vitro comparative evaluation” by Lata S et al. with a mean citation score of 132.3. The third most-cited article with 259 (Google Scholar), 28 (PubMed), and 85 (Web of Science) citations was “Dental ceramics: An update” (Shenoy A et al.) with a mean citation score of 124. However, there was no significant correlation between the mean citation score of all top-cited articles and the article publication age (P = 0.055), while the citation density of the articles showed a significant negative correlation with the publication age of the articles (P < 0.01) [Figure 1]. The list of the top 50 most-cited articles in the JCD based on their mean citation score is shown in Table 1.

Figure 1

Association of mean citation count with age of publication and citation density with age of publication

Table 1

Top 50 most cited articles in the Journal of Conservative Dentistry

Title	Web of Science	PubMed	Google Scholar	Mean citation	Citation density
Narayanan LL, Vaishnavi C. Endodontic microbiology. J Conserv Dent. 2010 Oct;13(4):233-9.	105	50	272	142.3	14
Lata S, Varghese NO, Varughese JM. Remineralization potential of fluoride and amorphous calcium phosphate-casein phosphopeptide on enamel lesions: An in vitro comparative evaluation. J Conserv Dent. 2010 Jan;13(1):42-6.	68	59	270	132.3	13
Shenoy A, Shenoy N. Dental ceramics: An update. J Conserv Dent. 2010 Oct;13(4):195-203.	85	28	259	124.0	12
Naik B, Karunakar P, Jayadev M, Marshal VR. Role of Platelet rich fibrin in wound healing: A critical review. J Conserv Dent. 2013 Jul;16(4):284-93.	76	40	228	114.7	16
Miglani S, Aggarwal V, Ahuja B. Dentin hypersensitivity: Recent trends in management. J Conserv Dent. 2010 Oct;13(4):218-24.	81	43	219	114.3	11
Kandaswamy D, Venkateshbabu N. Root canal irrigants. J Conserv Dent. 2010 Oct;13(4):256-64.	45	31	218	98.0	9
Siddique R, Sureshbabu NM, Somasundaram J, Jacob B, Selvam D. Qualitative and quantitative analysis of precipitate formation following interaction of chlorhexidine with sodium hypochlorite, neem, and tulsi. J Conserv Dent. 2019 Jan-Feb;22(1):40-47.	64	3	198	88.3	88
Teja KV, Ramesh S, Priya V. Regulation of matrix metalloproteinase-3 gene expression in inflammation: A molecular study. J Conserv Dent. 2018 Nov-Dec;21(6):592-596.	63	3	176	80.7	40
Nandakumar M, Nasim I. Comparative evaluation of grape seed and cranberry extracts in preventing enamel erosion: An optical emission spectrometric analysis. J Conserv Dent. 2018 Sep-Oct;21(5):516-520.	62	1	179	80.7	40
Sirisha K, Rambabu T, Ravishankar Y, Ravikumar P. Validity of bond strength tests: A critical review-Part II. J Conserv Dent. 2014 Sep;17(5):420-6.	53	17	165	78.3	13
Sirisha K, Rambabu T, Shankar YR, Ravikumar P. Validity of bond strength tests: A critical review: Part I. J Conserv Dent. 2014 Jul;17(4):305-11	44	15	165	74.7	12
Shivashankar VY, Johns DA, Vidyanath S, Kumar MR. Platelet Rich Fibrin in the revitalization of tooth with necrotic pulp and open apex. J Conserv Dent. 2012 Oct;15(4):395-8	48	19	145	70.7	8
Aggarwal V, Singla M, Miglani S, Kohli S. Comparative evaluation of push-out bond strength of ProRoot MTA, Biodentine, and MTA Plus in furcation perforation repair. J Conserv Dent. 2013 Sep;16(5):462-5.	33	29	149	70.3	10
Principles of smile design. Bhuvaneswaran M. Principles of smile design. J Conserv Dent. 2010 Oct;13(4):225-32.	31	7	169	69.0	6
Nadig RR. Stem cell therapy - Hype or hope? A review. J Conserv Dent. 2009 Oct;12(4):131-8.	46	25	135	68.7	6
Nandini VV, Venkatesh KV, Nair KC. Alginate impressions: A practical perspective. J Conserv Dent. 2008 Jan;11(1):37-41.	47	9	149	68.3	5
Camilleri J. The chemical composition of mineral trioxide aggregate. J Conserv Dent 2008;11:141-3	49	30	122	67.0	5
Nandini S. Indirect resin composites. J Conserv Dent. 2010 Oct;13(4):184-94.	39	13	147	66.3	6
Sikri VK. Color: Implications in dentistry. J Conserv Dent. 2010 Oct;13(4):249-55.	28	15	152	65.0	6
Shenoy A. Is it the end of the road for dental amalgam? A critical review. J Conserv Dent. 2008 Jul;11(3):99-107.	36	23	125	61.3	5
M R, Sajjan GS, B N K, Mittal N. Effect of different placement techniques on marginal microleakage of deep class-II cavities restored with two composite resin formulations. J Conserv Dent. 2010 Jan;13(1):9-15	24	22	131	59.0	5
Shivakumar K, Prasad S, Chandu G. International Caries Detection and Assessment System: A new paradigm in detection of dental caries. J Conserv Dent. 2009 Jan;12(1):10-6.	28	14	131	57.7	5
Poggio C, Dagna A, Chiesa M, Colombo M, Scribante A. Surface roughness of flowable resin composites eroded by acidic and alcoholic drinks. J Conserv Dent. 2012 Apr;15(2):137-40	26	15	129	56.7	7
Patil N, Choudhari S, Kulkarni S, Joshi SR. Comparative evaluation of remineralizing potential of three agents on artificially demineralized human enamel: An in vitro study. J Conserv Dent. 2013 Mar;16(2):116-20.	29	29	111	56.3	8
Krithikadatta J, Gopikrishna V, Datta M. CRIS Guidelines (Checklist for Reporting in vitro Studies): A concept note on the need for standardized guidelines for improving quality and transparency in reporting in vitro studies in experimental dental research. J Conserv Dent. 2014 Jul;17(4):301-4.	49	25	93	55.7	9
Asgary S, Ehsani S. Permanent molar pulpotomy with a new endodontic cement: A case series. J Conserv Dent. 2009 Jan;12(1):31-6	36	32	98	55.3	5
Poggio C, Lombardini M, Gaviati S, Chiesa M. Evaluation of Vickers hardness and depth of cure of six composite resins photoactivated with different polymerization modes. J Conserv Dent. 2012 Jul;15(3):237-41.	33	18	113	54.7	6
Athiban PP, Borthakur BJ, Ganesan S, Swathika B. Evaluation of antimicrobial efficacy of Aloe vera and its effectiveness in decontaminating gutta percha cones. J Conserv Dent. 2012 Jul;15(3):246-8.	31	23	109	54.3	6
Bharti R, Wadhwani KK, Tikku AP, Chandra A. Dental amalgam: An update. J Conserv Dent. 2010 Oct;13(4):204-8.	32	13	117	54.0	5
Eskandarizadeh A, Shahpasandzadeh MH, Shahpasandzadeh M, Torabi M, Parirokh M. A comparative study on dental pulp response to calcium hydroxide, white and grey mineral trioxide aggregate as pulp capping agents. J Conserv Dent. 2011 Oct;14(4):351-5.	35	21	103	53.0	5
Murthy BV, Ramani N. Evaluation of natural smile: Golden proportion, RED or Golden percentage. J Conserv Dent. 2008 Jan;11(1):16-21.	30	13	110	51.0	4
Parolia A, Kundabala M, Dahal M, Mohan M, Thomas MS. Management of supernumerary teeth. J Conserv Dent. 2011 Jul;14(3):221-4.	24	20	102	48.7	5
Pawar SS, Pujar MA, Makandar SD. Evaluation of the apical sealing ability of bioceramic sealer, AH plus & epiphany: An in vitro study. J Conserv Dent. 2014 Nov;17(6):579-82.	27	21	95	47.7	7
Hegde MN, Moany A. Remineralization of enamel subsurface lesions with casein phosphopeptide-amorphous calcium phosphate: A quantitative energy dispersive X-ray analysis using scanning electron microscopy: An in vitro study. J Conserv Dent. 2012 Jan;15(1):61-7.	25	19	93	45.7	5
Shetty S, Hegde MN, Bopanna TP. Enamel remineralization assessment after treatment with three different remineralizing agents using surface microhardness: An in vitro study. J Conserv Dent. 2014 Jan;17(1):49-52.	24	26	83	44.3	7
Mehta AB, Kumari V, Jose R, Izadikhah V. Remineralization potential of bioactive glass and casein phosphopeptide-amorphous calcium phosphate on initial carious lesion: An in vitro pH-cycling study. J Conserv Dent. 2014 Jan;17(1):3-7.	30	17	85	44.0	7
Yap AU, Chua AP. Sleep bruxism: Current knowledge and contemporary management. J Conserv Dent. 2016 Sep-Oct;19(5):383-9.	31	8	90	43.0	10
Bhavana V, Chaitanya KP, Gandi P, Patil J, Dola B, Reddy RB. Evaluation of antibacterial and antifungal activity of new calcium-based cement (Biodentine) compared to MTA and glass ionomer cement. J Conserv Dent. 2015 Jan-Feb;18(1):44-6.	28	21	75	41.3	8
Agarwal RS, Hiremath H, Agarwal J, Garg A. Evaluation of cervical marginal and internal adaptation using newer bulk fill composites: An in vitro study. J Conserv Dent. 2015 Jan-Feb;18(1):56-61	23	9	90	40.7	8
Azeem RA, Sureshbabu NM. Clinical performance of direct versus indirect composite restorations in posterior teeth: A systematic review. J Conserv Dent. 2018 Jan-Feb;21(1):2-9	54	3	57	38.0	19
Somasundaram P, Vimala N, Mandke LG. Protective potential of casein phosphopeptide amorphous calcium phosphate containing paste on enamel surfaces. J Conserv Dent. 2013 Mar;16(2):152-6.	24	16	74	38.0	5
Aggarwal V, Miglani S, Singla M. Conventional apexification and revascularization induced maturogenesis of two nonvital, immature teeth in same patient: 24-month follow-up of a case. J Conserv Dent. 2012 Jan;15(1):68-72.	28	10	75	37.7	4
Usha C, R S. Dental caries - A complete changeover (Part I). J Conserv Dent. 2009 Apr;12(2):46-54.	25	7	81	37.7	3
Jadhav GR, Shah N, Logani A. Comparative outcome of revascularization in bilateral, nonvital, immature maxillary anterior teeth supplemented with or without platelet rich plasma: A case series. J Conserv Dent. 2013 Nov;16(6):568-72.	23	13	71	35.7	5
Preethee T, Kandaswamy D, Arathi G, Hannah R. Bactericidal effect of the 908 nm diode laser on Enterococcus faecalis in infected root canals. J Conserv Dent. 2012 Jan;15(1):46-50.	26	17	61	34.7	4
Siddique R, Nivedhitha MS. Effectiveness of rotary and reciprocating systems on microbial reduction: A systematic review. J Conserv Dent. 2019 Mar-Apr;22(2):114-122	50	3	49	34.0	34
Hegde V, Jadhav S, Aher GB. A clinical survey of the output intensity of 200 light curing units in dental offices across Maharashtra. J Conserv Dent. 2009 Jul;12(3):105-8.	27	11	64	34.0	3
Vishwanath VR, Nadig RR, Nadig R, Prasanna JS, Karthik J, Pai VS. Differentiation of isolated and characterized human dental pulp stem cells and stem cells from human exfoliated deciduous teeth: An in vitro study. J Conserv Dent. 2013 Sep;16(5):423-8.	30	15	54	33.0	4
Poorni S, Srinivasan MR, Nivedhitha MS. Probiotic Streptococcus strains in caries prevention: A systematic review. J Conserv Dent. 2019 Mar-Apr;22(2):123-128	49	1	43	31.0	31
Jenarthanan S, Subbarao C. Comparative evaluation of the efficacy of diclofenac sodium administered using different delivery routes in the management of endodontic pain: A randomized controlled clinical trial. J Conserv Dent. 2018 May-Jun;21(3):297-301	52	1	34	29.0	14

The top 50 most-cited papers in the JCD were published between 2008 and 2019. The maximum frequency of top-cited articles published in a single year was 10, which occurred in 2010. The number of articles published in the top 50 cited articles was 19 during 2006–2010, 23 during 2011–2015, and 8 during 2016–2020.

A total of 45 authors as first authors and 96 as co-authors have contributed to the top 50 most-cited papers in JCD. The maximum contributions were made by Malli Sureshbabu N (n = 4), followed by Aggarwal V (n = 3) and Miglani S (n = 3). 11 other authors made a total of 2 publications each in the top 50 [Table 2]. In this analysis, the percentage of position of the corresponding author in the byline as the first author was found to be at 76%.

Table 2

Authors with highest number of contributions

Authors	Number of articles
Nivedhitha Malli Sureshbabu	4
Vivek Aggarwal	3
Sanjay Miglani	3
Mithra N Hegde	2
Deivanayagam Kandaswamy	2
Claudio Poggio	2
Arvind Shenoy	2
Riluwan Siddique	2
Kantheti Sirisha	2
Roopa R Nadig	2
Marco Chiesa	2
Tankonda Rambabu	2
Pabbati Ravikumar	2
Mamta Singla	2

Based on the details gathered from the author's affiliation, 5 countries contributed to the top 50 most-cited articles. Among these, India had the most contribution (n = 44). Iran and Italy had 2 publications each, followed by Malta and Singapore with 1 publication each. The top 3 states of India contributing the maximum to the top 50-cited articles in JCD were Tamil Nadu (n = 14), Karnataka (n = 10), and Maharashtra (n = 5). 4 each contribution was seen from New Delhi and Andhra Pradesh [Table 3].

Table 3

Geographical distribution of article origin based on the first author affiliation

States	Number of articles
Tamil Nadu	14
Karnataka	10
Maharashtra	5
Andhra Pradesh	4
New Delhi	4
Kerala	2
Gujarat	1
Madhya Pradesh	1
Puducherry	1
Punjab	1
Uttar Pradesh	1

Major topics of interest in the top 50 most-cited articles were dental material science (n = 18), and Carious and noncarious lesion management (n = 14). Esthetic Dentistry, Root Canal Therapy, Regenerative Endodontics, and Reporting guidelines accounted for 3,86, and 1 publication, respectively [Figure 2].

Figure 2

Topic distribution of top 50 most cited articles

The majority of the articles were original research articles (n = 23) followed by review articles (n = 22), of which 15 were invited reviews. Other publications included case reports (n = 4) and concept note (n = 1).

Out of the 50 contributing institutions, private institutions accounted for maximum involvement (n = 36). In contrast, government institutions contributing to the top 50 cited articles were 6. Saveetha Dental College, Chennai, had the maximum articles (n = 7), followed by Bapuji Dental College and Hospital, Davangere (n = 4). A. B. Shetty Memorial Institute of Dental Sciences, Mangalore, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, Meenakshi Ammal Dental College and Hospitals, Chennai, and Vishnu Dental College and Hospital, Bhimavaram were associated with 3 publications each.

DISCUSSION

The bibliometric analysis enables the quality assessment of scholarly research work based on citation data and performance indicators. The introduction of the Science Citation Index (SCI) by Eugene Garfield in 1963 marked the emergence of a revolution in research evaluation.[14] Soon, journals and their impact on knowledge creation and dissemination were measured with citation data to enable researchers and readers to identify the most influential journals in specialties. With over 1633 articles published since its foundation, JCD currently ranks the best among all dental journals in India (2021) in the SCImago Journal and Country Rank portal.[15] Since its inception in 1998, JCD has published four issues annually till 2012 and six issues per annum after that.[16] JCD is currently indexed in Indian Science Abstracts, IndMed, PubMed Central, Scimago Journal Ranking, and Scopus. The bibliometric analysis of the journal can provide in-depth understandings of the journal's contributions, research history, and current trends.

Databases such as Web of Sciences, Google Scholar, and PubMed were used to extract the top-cited articles. The citation numbers showed variations between the various databases. Such differences have been attributed to the time frame of data extraction, coverage of the database, age of the article and to some fundamental problems of the citation process.[1718]

The citation number of 100 and above makes an article a “classic” in specialized research fields. Based on the mean citation score, 5 articles met the above criteria.[2] However, it is disputed that an article cannot be established as a “Classic article” based on citation numbers alone as it may not truly meet all the hallmarks of quality research, such as originality, scientific value, plausibility, and societal value.[14] An aphorism by Albert Einstein aptly defines the above phenomena as “Not everything that can be counted counts and not everything that counts can be counted.”

JCD is relatively a young journal with a maximum window of citation of about 23 years (1998–2021). However, the journal had articles with short-term (3–5 years) and long-term citation windows in the top 50 cited articles.[19] This indicated the journal's contribution in creating newer findings that have been well accepted and the journal publishing articles that have become benchmark with long-term impact. Delving the study design in the top-cited article revealed 23 original research articles, 22 reviews, 4 case reports, and 1 concept note. Review and invited reviews combined formed the major design group published. These findings indicated the preference of readers to compiled information. The results of this bibliometric study also concur with similar studies that show lesser citation to case reports and more to original research and reviews.[51012]

The top 50 cited articles from the JCD had maximum contribution from Indian authors, followed by Iran, Italy, Malta, and Singapore. In India, institutes from the state of Tamil Nadu and Karnataka contributed maximum top-cited articles. This distribution may be due to the more significant number of dental research institutes in these states with postgraduate programs. On the other hand, the higher distribution of postgraduate seats in private institutions may be why private institutes contribute three-fourth to the top-cited articles. The present analysis found that corresponding authors as first authors in 76% of articles. These findings were in agreement to the theory that corresponding author is the author contributing more to the article which aided in formulating International Committee of Medical Editors guidelines, i.e., the author contributing most to the article should be positioned first in the byline.[2021] According to earlier research the first author was twice as likely as the other contributors to have coordinated the study and the first and last contributors on the byline were also more likely to have written the paper, designed the study, and analyzed the data.[2223]

The results emanated the highest interest in research topics of dental material science with the composite material being the highest researched subject. Yet, another realm of research where the majority of the work concentrated was early caries remineralization, which is a topic of utmost scientific value in minimally-invasive conservative dentistry.[24]

The absence of legitimate information on self-citation counts, absence of Scopus data for information before 2011, and deficiency of quality assessment of cited references can be a limitation of this analysis. However, despite these drawbacks, the citation numbers can project the impact of a journal in a discipline.

CONCLUSIONS

JCD has established as an eminent journal in the field of conservative dentistry and endodontics. It is, therefore, reasonable that a bibliometric assessment of this journal would appropriately define directions of research. Furthermore, this analysis brings forth the progress of the journal concerning disseminating scholarly work. Future focus with dedicated sections on systematic reviews, meta-analysis, clinical tips and techniques, and monographs by specialists in each issue can propel journal reach and readership and eventually invite authors to choose the journal to author their high-impact findings. Such measures can widen and expand author contribution to strengthen the scientific content of journal that can lead to wider international visibility and acknowledgment through higher citations.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.