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|-
| Asthivaha srotasa <br/>(channels for fibrocartilaginous system)
| Asthivaha srotasa <br/>(channels for fibrocartilaginous system)
| Bone or adipose tissue (meda), <br/>thigh (jaghana)
| Bone or adipose tissue ([[Meda dhatu|meda]]), <br/>thigh (jaghana)
| -
| -
|-
|-
| Majjavaha srotasa <br/>(channels for locomotor system)
| Majjavaha srotasa <br/>(channels for locomotor system)
| Bones (asthi), <br/>joints (sandhi)
| Bones ([[Asthi dhatu|asthi]]), <br/>joints (sandhi)
| -
| -
|-
|-
|-
|-
| Mutravaha srotasa <br/>(channels for urinary system)
| Mutravaha srotasa <br/>(channels for urinary system)
| Urinary bladder (basti), groin region (vankshana)
| [[Basti|Urinary bladder (basti)]], groin region (vankshana)
| Urinary bladder (basti), <br/>the external genitalia (medhra)
| [[Basti|Urinary bladder (basti)]], <br/>the external genitalia (medhra)
|-
|-
| Purishavaha srotasa <br/>(defecatory channels)
| Purishavaha srotasa <br/>(defecatory channels)
|-
|-
| Swedavaha srotasa <br/>(perspiratory channels)
| Swedavaha srotasa <br/>(perspiratory channels)
| Fats (meda), <br/>hair follicles (lomakoopa)
| Fats ([[Meda|meda]]), <br/>hair follicles (lomakoopa)
| -
| -
|-
|-
</ol>
</ol>
These srotasa can be further divided into three subgroups for ease of understanding:
These srotasa can be further divided into three subgroups for ease of understanding:
<ol type="a"><li>Three intake channels or channels leading to the interior: Annavaha, pranavaha & udakavaha srotasa. These act as channels for the ingestion and transportation of solids (food), liquid & gases on a broader account. Hence, these will be considered as digestive, respiratory and electrolyte balancing systems. These channels form the main links of the [[Sharira|body's]] internal environment with the external environment. Further, these channels are more prone to disorders, as they serve as the first defence to the external foreign matter entering the [[Sharira|body]]. These are the first sites of ama production.</li>
<ol type="a"><li>Three intake channels or channels leading to the interior: Annavaha, pranavaha & udakavaha srotasa. These act as channels for the ingestion and transportation of solids (food), liquid & gases on a broader account. Hence, these will be considered as digestive, respiratory and electrolyte balancing systems. These channels form the main links of the [[Sharira|body's]] internal environment with the external environment. Further, these channels are more prone to disorders, as they serve as the first defence to the external foreign matter entering the [[Sharira|body]]. These are the first sites of [[Ama|ama]] production.</li>
<li>Seven processor channels or channels of maintenance: These are dhatuvaha srotasa. These act as the processors of the [[Sharira|body]] and maintain the equilibrium in their physiological states. In Ayurveda, dhatu is the [[Sharira|body's]] structural unit that sustain [[Sharira|sharira (body)]] and are responsible for its strength and immunity. These dhatuvaha channels provide the necessary nutrition for proper growth and development of the seven [[Dhatu|dhatus]] and the space for their transportation, digestion, and metabolism.These are the channels where ama is dislodged. </li>
<li>Seven processor channels or channels of maintenance: These are dhatuvaha srotasa. These act as the processors of the [[Sharira|body]] and maintain the equilibrium in their physiological states. In Ayurveda, dhatu is the [[Sharira|body's]] structural unit that sustain [[Sharira|sharira (body)]] and are responsible for its strength and immunity. These dhatuvaha channels provide the necessary nutrition for proper growth and development of the seven [[Dhatu|dhatus]] and the space for their transportation, digestion, and metabolism. These are the channels where [[Ama|ama]] is dislodged. </li>
<li>Three output channels or channels leading to the expulsion of metabolic wastes. These include purishavaha, mutravaha, and swedavaha srotasa (malavaha srotasa). These will act as channels for removing waste products and toxic substances. The metabolites formed during metabolism in dhatuvaha srotasa and three input channels are further transported to malavaha srotasa, according to ease of removal through different sites of elimination through the [[Sharira|body]], after being processed again for easy and smooth expulsion by natural orifices. </li></ol>
<li>Three output channels or channels leading to the expulsion of metabolic wastes. These include purishavaha, mutravaha, and swedavaha srotasa (malavaha srotasa). These will act as channels for removing waste products and toxic substances. The metabolites formed during metabolism in dhatuvaha srotasa and three input channels are further transported to malavaha srotasa, according to ease of removal through different sites of elimination through the [[Sharira|body]], after being processed again for easy and smooth expulsion by natural orifices. </li></ol>
<li style="font-weight: bold;">Sukshma (Micro channels): <span style="font-weight: normal;">The small orifices or microscopic pores of the [[Sharira|body]] are known as sukshma srotasa. The navel (nabhi) and tiny channels or orifice of the skin are understood as sukshma srotasa. </span></li></ol>
<li style="font-weight: bold;">Sukshma (Micro channels): <span style="font-weight: normal;">The small orifices or microscopic pores of the [[Sharira|body]] are known as sukshma srotasa. The navel (nabhi) and tiny channels or orifice of the skin are understood as sukshma srotasa. </span></li></ol>
<li>Eliminating waste products from the [[Sharira|body]] through urine, feces, sweat etc. </li>
<li>Eliminating waste products from the [[Sharira|body]] through urine, feces, sweat etc. </li>
<li>Responsible for nutrition, protection, and equilibrium of the structural entities in the [[Sharira|body]]. </li>
<li>Responsible for nutrition, protection, and equilibrium of the structural entities in the [[Sharira|body]]. </li>
<li>As per ancient science, srotasa are the supreme factor responsible for health and disease throughout [[Ayu|life]]. </li>
<li>As per ancient science, srotasa are the supreme factor responsible for health and [[Vyadhi|disease]] throughout [[Ayu|life]]. </li>
<li>Nadi is also one of the synonyms of srotasa, which signifies its function of control and transportation of sensory and motor reflexes in the whole [[Sharira|body]]. </li>
<li>Nadi is also one of the synonyms of srotasa, which signifies its function of control and transportation of sensory and motor reflexes in the whole [[Sharira|body]]. </li>
<li>Maintains homeostasis in various systems of the [[Sharira|body]]. All the [[Dosha|dosha]], [[Dhatu|dhatu]], and [[Mala|mala]] rely on srotasa for their development, conveyance, and expulsion. </li></ul>
<li>Maintains homeostasis in various systems of the [[Sharira|body]]. All the [[Dosha|dosha]], [[Dhatu|dhatu]], and [[Mala|mala]] rely on srotasa for their development, conveyance, and expulsion. </li></ul>
== Characteristics of vitiation of srotasa ==
== Characteristics of vitiation of srotasa ==
Vitiation of srotasa are classified into four categories as stated below: [Cha. Sa [[Vimana Sthana]] 5/24]
Vitiation of srotasa are classified into four categories as stated below: [Cha. Sa [[Vimana Sthana]] 5/24]
<ol style='text-align:justify;'><li style="font-weight: bold;">Excessive flow (atipravatti): <span style="font-weight: normal;">Excessive formation or elimination of [[Dosha|dosha]], [[Dhatu|dhatu]], [[Mala|mala]] e.g., excess urination (bahumutra) in prameha, diarrhea (atisara), hemorrhage, etc.</span></li>
<ol style='text-align:justify;'><li style="font-weight: bold;">Excessive flow (atipravatti): <span style="font-weight: normal;">Excessive formation or elimination of [[Dosha|dosha]], [[Dhatu|dhatu]], [[Mala|mala]] e.g., excess urination (bahumutra) in [[Prameha Nidana|prameha]], [[Atisara Chikitsa|diarrhea (atisara)]], hemorrhage, etc.</span></li>
<li style="font-weight: bold;">Accumulation or obstruction (sanga): <span style="font-weight: normal;">Sanga means block in the passages, e.g., obstruction of sweda (sweating) in fever, obstruction of vata dosha in gulma disease, obstruction of piita dosha due to kapha in jaundice (shakhashrita kamala), delayed digestion (alasaka), digestive disorders (grahani), cold, constipation, etc. </span></li>
<li style="font-weight: bold;">Accumulation or obstruction (sanga): <span style="font-weight: normal;">Sanga means block in the passages, e.g., obstruction of [[Sweda|sweda (sweating)]] in [[Jwara|fever]], obstruction of [[Vata dosha|vata dosha]] in [[Gulma Nidana|gulma]] [[Vyadhi|disease]], obstruction of [[Pitta dosha|pitta dosha]] due to [[Kapha dosha|kapha]] in jaundice (shakhashrita kamala), delayed digestion (alasaka), digestive disorders (grahani), cold, constipation, etc. </span></li>
<li style="font-weight: bold;">Siragranthi: <span style="font-weight: normal;">It denotes thickening or abnormal growth in the natural orifice of the [[Sharira|body]] e.g., granthi, aneurysm in the artery, splenomegaly, varicose vein, tumors, etc. </span></li>
<li style="font-weight: bold;">Siragranthi: <span style="font-weight: normal;">It denotes thickening or abnormal growth in the natural orifice of the [[Sharira|body]] e.g., granthi, aneurysm in the artery, splenomegaly, varicose vein, tumors, etc. </span></li>
<li style="font-weight: bold;">Deviated flow (vimarga gamana): <span style="font-weight: normal;">Diversion from natural passages e.g., movement of apana vata in udavarta, movement of food in the upward direction in vomiting (chhardi), abdominal diseases (udara roga), bleeding disorders (raktapitta), acute gastroenteritis (visuchika), fistula (bhagandara). </span></li></ol>
<li style="font-weight: bold;">Deviated flow (vimarga gamana): <span style="font-weight: normal;">Diversion from natural passages e.g., movement of apana [[Vata dosha|vata]] in udavarta, movement of food in the upward direction in vomiting (chhardi), abdominal [[Vyadhi|diseases]] (udara roga), bleeding disorders (raktapitta), acute gastroenteritis (visuchika), fistula (bhagandara). </span></li></ol>
== Clinical features of vitiation of each srotasa ==
== Clinical features of vitiation of each srotasa ==
| style="text-align:center;" | '''4'''
| style="text-align:center;" | '''4'''
| '''Rasavaha'''
| '''Rasavaha'''
| Anorexia (aruchi), lack of interest in the food (ashradha), tastelessness (asyavairasya), nausea (hrillasa), heaviness in [[Sharira|body]] (gaurav), fatigue (tandra), Fever (jwara), anemia (pandu), darkness in front of the eyes (tama), malnutrition (krishangata), premature aging (palita), loss of libido (klaibya), death (maranam)
| Anorexia (aruchi), lack of interest in the food (ashradha), tastelessness (asyavairasya), nausea (hrillasa), heaviness in [[Sharira|body]] (gaurav), fatigue (tandra), [[Jwara|Fever (jwara)]], anemia (pandu), darkness in front of the eyes (tama), malnutrition (krishangata), premature aging (palita), loss of libido (klaibya), death (maranam)
|-
|-
| style="text-align:center;" | '''5'''
| style="text-align:center;" | '''5'''
| '''Raktavaha'''
| '''Raktavaha'''
| Skin disorder (twak vikara ), like melasma (vyanga), obstinate skin diseases (kushtha), ringwarm or tines (dadru), bleeding from different part of the [[Sharira|body]] (raktapitta), Menorrhagia (asrigdara), anal & urogenital abscesses (gudamedrasyapaaka), jaundice (kamala), vitiligo (shvitra), fever (jwara), anemia (pandutva), conjunctivitis.
| Skin disorder (twak vikara ), like melasma (vyanga), obstinate skin [[Vyadhi|diseases]] (kushtha), ringwarm or tines (dadru), bleeding from different part of the [[Sharira|body]] (raktapitta), Menorrhagia (asrigdara), anal & urogenital abscesses (gudamedrasyapaaka), jaundice (kamala), vitiligo (shvitra), [[Jwara|fever (jwara)]], anemia (pandutva), conjunctivitis.
|-
|-
| style="text-align:center;" | '''6'''
| style="text-align:center;" | '''6'''
== General principles of treatment of vitiation of srotasa ==
== General principles of treatment of vitiation of srotasa ==
<p style="text-align:justify;">The features of srotodushti (vitiation of srotasa) should be first clinically identified by the physicians. After that, the treatment protocol is decided based on the principle of treatment of particular srotasa. The general line of treatment is similar to the line of treatment for selective diseases. [Ch. Sa [[Vimana Sthana]] 5/26-28]. </p>
<p style="text-align:justify;">The features of srotodushti (vitiation of srotasa) should be first clinically identified by the physicians. After that, the treatment protocol is decided based on the principle of treatment of particular srotasa. The general line of treatment is similar to the line of treatment for selective [[Vyadhi|diseases]]. [Ch. Sa [[Vimana Sthana]] 5/26-28]. </p>
{| class="wikitable"
{| class="wikitable"
! Srotasa
! Srotasa
|-
|-
| Pranavaha srotasa
| Pranavaha srotasa
| Treatment of respiratory disorders (shwasa) : <br/>In case of kapha pradhana: emesis (vamana), Purgation (virechana), healthy diet (pathya ashana), dhooma (medicated smoking) , linctus (leha) In case of vata pradhana: pacificatory (shamana) meat soup (mamsarasa) [Ch. Sa [[Chikitsa Sthana]] 17/88-90]
| Treatment of respiratory disorders (shwasa) : <br/>In case of [[Kapha dosha|kapha]] pradhana: emesis (vamana), Purgation (virechana), healthy diet (pathya ashana), dhooma (medicated smoking) , linctus (leha) In case of [[Vata dosha|vata]] pradhana: pacificatory (shamana) meat soup (mamsarasa) [Ch. Sa [[Chikitsa Sthana]] 17/88-90]
|-
|-
| Annavaha srotasa
| Annavaha srotasa
| Treatment of ama [[Dosha|dosha]]: <br/>deepana, pachana, massage (abhaynga), asthapana basti, anuvasana basti, snehapana [Ch. Sa [[Vimana Sthana]] 15/95,98]
| Treatment of [[Ama|ama]] [[Dosha|dosha]]: <br/>deepana, pachana, massage (abhaynga), asthapana [[Basti|basti]], anuvasana [[Basti|basti]], snehapana [Ch. Sa [[Vimana Sthana]] 15/95,98]
|-
|-
| Udakavaha srotasa
| Udakavaha srotasa
# Raktavaha srotasa: virechana, upavasa and bloodletting, light diet.
# Raktavaha srotasa: virechana, upavasa and bloodletting, light diet.
# Mamsavaha srotasa: samshodhana, kshara karma, agnikarma
# Mamsavaha srotasa: samshodhana, kshara karma, agnikarma
# Medovaha srotasa: by using various dravya having vata, kapha and meda nashaka properties, use of ruksha, ushna and tikshna dravya in basti.
# Medovaha srotasa: by using various dravya having [[Vata dosha|vata]], [[Kapha dosha|kapha]] and meda nashaka properties, use of ruksha, ushna and tikshna dravya in [[Basti|basti]].
# Asthivaha srotasa: panchakarma procedures, basti processed with milk (ksheera) and bitter (tikta aushadha).
# Asthivaha srotasa: panchakarma procedures, [[Basti|basti]] processed with milk (ksheera) and bitter (tikta aushadha).
# Majjavaha & shukravaha srotasa : Treated by madhura and tikta rasa pradhana anna, by vyayama and by vamana and virechana [Ch. Sa [[Sutra Sthana]] 28/25-28]
# Majjavaha & shukravaha srotasa : Treated by madhura and tikta rasa pradhana anna, by vyayama and by vamana and virechana [Ch. Sa [[Sutra Sthana]] 28/25-28]
|-
|-
|-
|-
| Purishavaha srotasa
| Purishavaha srotasa
| Treatment of diarrhea (atisara): <br/>basti, treatment is planned as per the stages of diarrhoea (avasthiki chikitsa) [Ch. Sa [[Chikitsa Sthana]] 19/19,123]
| Treatment of [[Atisara Chikitsa|diarrhea (atisara)]]: <br/>[[Basti|basti]], treatment is planned as per the stages of diarrhoea (avasthiki chikitsa) [Ch. Sa [[Chikitsa Sthana]] 19/19,123]
|-
|-
| Swedavaha srotasa
| Swedavaha srotasa
| Treatment of fever (jwara): <br/>fasting (langhana), steam (swedanam), time for natural recovery (kala), gruels (yavagu), bitter taste herbs for digestion (tikta rasa pachana) [Ch. Sa [[Chikitsa Sthana]] 3/140,42]
| Treatment of [[Jwara|fever (jwara)]]: <br/>fasting (langhana), steam (swedanam), time for natural recovery (kala), gruels (yavagu), bitter taste herbs for digestion (tikta rasa pachana) [Ch. Sa [[Chikitsa Sthana]] 3/140,42]
|-
|-
|}
|}
<p style="text-align:justify;">Clinical assessment of srotasa is done from the root level (mulasthana). It means the origin of strotasa is assessed through its functions. Therefore, vitiation of srotasa can be easily identified in various disorders related to the srotasa. Elaborated understanding of srotasa is necessary, because srotasa are the factors involved in the genesis of the entire [[Sharira|body]].
<p style="text-align:justify;">Clinical assessment of srotasa is done from the root level (mulasthana). It means the origin of strotasa is assessed through its functions. Therefore, vitiation of srotasa can be easily identified in various disorders related to the srotasa. Elaborated understanding of srotasa is necessary, because srotasa are the factors involved in the genesis of the entire [[Sharira|body]].
<br/>
<br/>
Pathogenesis or vitiation in the transport system leads to stagnation of unwanted things, depletion of essential nutrients, eredication of the [[Sharira|body]] tissue and cells, and imbalance in the [[Sharira|body]], [[Manas|mind]], and health. This leads to multiple diseases related to different channels of the [[Sharira|body]].<ref name="ref3">https://www.easyayurveda.com/2016/06/02/srotas-body-channels-and-duct.. </ref> <br/>
Pathogenesis or vitiation in the transport system leads to stagnation of unwanted things, depletion of essential nutrients, eredication of the [[Sharira|body]] tissue and cells, and imbalance in the [[Sharira|body]], [[Manas|mind]], and health. This leads to multiple [[Vyadhi|diseases]] related to different channels of the [[Sharira|body]].<ref name="ref3">https://www.easyayurveda.com/2016/06/02/srotas-body-channels-and-duct.. </ref> <br/>
Srotasa is the inner transport or circulatory system of the [[Sharira|body]]. These can be depicted on macroscopic (sthula) as well as microscopic (sukshama) level for the descriptions pertaining to the exchange of gases, transportation of various nutrients from the gastrointestinal tract to multiple parts of the [[Sharira|body]] and elimination of waste products (kitta bhaga) like urine & feces, from the [[Sharira|body]]. They are mainly structural and functional [[Sharira|body]] units and carry essential nutrients, transmitting sensory and motor reflexes throughout the [[Sharira|body]]. Sthula srotasa, along with their roots are emphasized for pathology & treatment. Srotasa play a prime role in understanding physiology, pathology, clinical medicine, etc. </p>
Srotasa is the inner transport or circulatory system of the [[Sharira|body]]. These can be depicted on macroscopic (sthula) as well as microscopic (sukshama) level for the descriptions pertaining to the exchange of gases, transportation of various nutrients from the gastrointestinal tract to multiple parts of the [[Sharira|body]] and elimination of waste products (kitta bhaga) like urine & feces, from the [[Sharira|body]]. They are mainly structural and functional [[Sharira|body]] units and carry essential nutrients, transmitting sensory and motor reflexes throughout the [[Sharira|body]]. Sthula srotasa, along with their roots are emphasized for pathology & treatment. Srotasa play a prime role in understanding physiology, pathology, clinical medicine, etc. </p>
== Future scope ==
== Future scope ==
<p style="text-align:justify;">It is necessary to probe into this important conventional concept scientifically. It may be significant to tackle comparative studies with the modern sciences' knowledge about membrane biology and systemic endothelial system. The concept of srotasa in ayurveda is a large area of molecular biology research. Vitiation of srotasa is the major cause of pathology in any disease. There is a requirement for clinical and molecular research on the nature of vitiation of srotasa occurring in different clinical situations to develop preventive and treatment modalities on the lines of purification therapies. </p>
<p style="text-align:justify;">It is necessary to probe into this important conventional concept scientifically. It may be significant to tackle comparative studies with the modern sciences' knowledge about membrane biology and systemic endothelial system. The concept of srotasa in ayurveda is a large area of molecular biology research. Vitiation of srotasa is the major cause of pathology in any [[Vyadhi|disease]]. There is a requirement for clinical and molecular research on the nature of vitiation of srotasa occurring in different clinical situations to develop preventive and treatment modalities on the lines of purification therapies. </p>
== Current researches ==
== Current researches ==
<ol style='text-align:justify;'><li style="font-weight: bold;">Review on the concept of srotas: <span style="font-weight: normal;">Srotasa acts as the inner transport system of the [[Sharira|body]]. These macro, micro level channels also include all range of structural and functional units designed to carry specific materials, molecules, messages, impulses, emotions, and thoughts and are typical for the substances they transport. The concept of receptor theory and their specificity and membrane biology is also indicated by the functional physiology of srotamsi, which has importance from the point of view of pathophysiology and pharmacophysiology.<ref name="ref2" />. </span></li>
<ol style='text-align:justify;'><li style="font-weight: bold;">Review on the concept of srotas: <span style="font-weight: normal;">Srotasa acts as the inner transport system of the [[Sharira|body]]. These macro, micro level channels also include all range of structural and functional units designed to carry specific materials, molecules, messages, impulses, emotions, and thoughts and are typical for the substances they transport. The concept of receptor theory and their specificity and membrane biology is also indicated by the functional physiology of srotamsi, which has importance from the point of view of pathophysiology and pharmacophysiology.<ref name="ref2" />. </span></li>
<li style="font-weight: bold;">Critical evaluation of srotas and their clinical Significance: <span style="font-weight: normal;">Srotasa plays an essential role in disease manifestation. Understanding the concept of srotasa and srotovaigunya are vital to prognosis and treatment.<ref name="ref5">Katwal Savita, Udainiya Neha, 2018. “Critical evaluation of srotas and its clinical significance” International Journal of Current Research in Life Sciences, 7, (03), 1407-1409.</ref> </span></li>
<li style="font-weight: bold;">Critical evaluation of srotas and their clinical Significance: <span style="font-weight: normal;">Srotasa plays an essential role in [[Vyadhi|disease]] manifestation. Understanding the concept of srotasa and srotovaigunya are vital to prognosis and treatment.<ref name="ref5">Katwal Savita, Udainiya Neha, 2018. “Critical evaluation of srotas and its clinical significance” International Journal of Current Research in Life Sciences, 7, (03), 1407-1409.</ref> </span></li>
<li style="font-weight: bold;">Ayurveda literary research study on some important aspects of srotas: <span style="font-weight: normal;">This study mainly focuses on understanding the srotas regarding microcirculation and exploration of minute aspects of microchannels.<ref name="ref6">Chouhan PK. Ayurveda Literary Research Study on Some Important Aspects of Srotas. Journal of drug delivery and therapeutics.10Sep.2018 ;8(5):280-3 </ref> </span></li>
<li style="font-weight: bold;">Ayurveda literary research study on some important aspects of srotas: <span style="font-weight: normal;">This study mainly focuses on understanding the srotas regarding microcirculation and exploration of minute aspects of microchannels.<ref name="ref6">Chouhan PK. Ayurveda Literary Research Study on Some Important Aspects of Srotas. Journal of drug delivery and therapeutics.10Sep.2018 ;8(5):280-3 </ref> </span></li>
<li style="font-weight: bold;">Critical appraisal of doshavaha srotas: <span style="font-weight: normal;">The study is based on the various synonyms described in classical texts, focusing on the sira (vein) and further divided into three categories like the division of sira as vatavaha, pittavaha, kaphavaha & sarvavaha srotas. It makes it easier to understand srotas in the context of tridosha for better and more systematic treatment protocol.<ref name="ref7">Byadgi PS. Critical appraisal of Doshavaha Srotas. Ayu. 2012 Jul;33(3):337-42. doi: 10.4103/0974- 8520.108819. PMID: 23723638; PMCID: PMC3665105.</ref> </span></li>
<li style="font-weight: bold;">Critical appraisal of doshavaha srotas: <span style="font-weight: normal;">The study is based on the various synonyms described in classical texts, focusing on the sira (vein) and further divided into three categories like the division of sira as vatavaha, pittavaha, kaphavaha & sarvavaha srotas. It makes it easier to understand srotas in the context of tridosha for better and more systematic treatment protocol.<ref name="ref7">Byadgi PS. Critical appraisal of Doshavaha Srotas. Ayu. 2012 Jul;33(3):337-42. doi: 10.4103/0974- 8520.108819. PMID: 23723638; PMCID: PMC3665105.</ref> </span></li>