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Original Investigation
Literature analysis of economic aspects of rheumatoid arthritis
Análisis bibliométrico de temas económicos en artritis reumatoide
Melany Santrich Sotomayora,
Corresponding author
melaniesantrich@hotmail.com

Corresponding author.
, María Eugenia Casanovab, José Mauricio Ocampob,c
a Facultad de Medicina, Pontificia Universidad Javeriana, Cali, Colombia
b Departamento Medicina Interna, Facultad de Salud, Grupo Interinstitucional de Medicina Interna (GIMI 1), Universidad Libre, Cali, Colombia
c Departamento de Medicina Familiar, Facultad de Salud, Universidad del Valle, Cali, Colombia
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is an inflammatory disease of the musculoskeletal system&#46; Its prevalence varies according to the study population&#44; but is estimated to be between 0&#46;2&#37; and 5&#37; worldwide<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">4</span></a>&#59; in addition&#44; it produces a significant affectation of the quality of life of the patients&#46; It is known that&#44; in the first 10 years of illness&#44; RA generates a complete loss of employment in 50&#37; of people suffering from this disease&#59; this percentage can reach 59&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">5</span></a> When reviewing the main databases&#44; we did not find bibliometric studies on the economic impact of RA&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">The field of rheumatology was selected because it represents high-cost medical conditions&#59; particularly in older adults&#44; in whom rheumatologic diseases&#44; and more specifically RA&#44; generate annual costs of up to &#36;4&#46;8 million dollars per year in the United States&#44; according to a study conducted in 2010&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">6</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">The evolution over time and the characteristics of the scientific literature regarding the economic impact of RA were evaluated through this bibliometric analysis&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Methods</span><p id="par0025" class="elsevierStylePara elsevierViewall">It was conducted a retrospective descriptive bibliometric analysis of literature concerning the economic aspects related to RA&#44; which include both the direct costs arising from medical care and treatment&#44; and the indirect costs related to the loss of labor activity and the disability-adjusted life years&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The literature indexed in the last 20 years &#40;1996&#8211;2016&#41; was evaluated&#44; and this period was chosen since it is in recent years in which the majority of advances in terms of knowledge&#44; diagnosis and management of this disease have been produced&#46; The year 2017 was not included in order to generate comparable full annual results&#46; The references derived from the Medline database were analyzed through PubMed<span class="elsevierStyleSup">&#174;</span>&#44; GoPubMed<span class="elsevierStyleSup">&#174;</span> and Fabumed<span class="elsevierStyleSup">&#174;</span> in May 2017&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">A theme filter was designed with the MeSH terms referring to RA and its economic impact&#44; constituting the following search strategy&#58; &#40;&#8220;Arthritis&#44; Rheumatoid&#8221; &#91;Majr&#93;&#41; AND &#40;&#8220;Costs and Cost Analysis&#8221; &#91;Majr&#93;&#41;&#46; &#8220;&#91;Majr&#93;&#8221; was used for the bibliographic search&#44; since the search with this method is much more specific&#44; with precise results and focused on the main objective&#44; thus excluding the terms that alter the number of articles found and that as a consequence could modify the direction of the search&#46; However&#44; when more specific results are generated&#44; a search bias may occur and possibly leave some economic aspects outside the goal&#46; As mentioned above&#44; the search results were limited by publication date to the period between 1996 and 2016 &#40;&#8220;1996&#8221;&#91;dp&#93;&#58;&#8220;2016&#8221;&#91;dp&#93;&#41;&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Through GoPubMed<span class="elsevierStyleSup">&#174;</span> and its statistics option&#44; the following variables were obtained&#58; total number of publications&#44; number and percentage of publications per year&#44; journal and country&#46; Prevalence&#44; follow-up and descriptive studies in populations were included for the selection of the literature&#46; All types of non-scientific information were omitted and only articles defined as Journal articles were taken into account&#59; these include original research articles&#44; reviews&#44; assays and other scientific reports&#46; The analysis of the results of the data was carried out by means of descriptive statistics and based on this information&#44; tables and graphs were prepared in the Microsoft Excel program&#44; version 2017 for Mac&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">In order to compare the scientific journals and evaluate the relative significance of each according to the citations received of the articles published&#44; the impact factor of the Journal Citation Reports 2015&#47;2016 was used&#46; At present&#44; despite having contradictors&#44; the impact factor is the most important bibliometric indicator used to estimate the scientific quality of a journal&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">7</span></a></p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Results</span><p id="par0050" class="elsevierStylePara elsevierViewall">A total of 350 references on RA and economic issues were found in the 1996&#8211;2016 period&#46; These references were published in 80 indexed journals&#44; of which&#44; 38 &#40;10&#37;&#41; references were published in the first half of the period &#40;1996&#8211;2006&#41; and 341 &#40;89&#46;9&#37;&#41; in the second decade &#40;2006&#8211;2016&#41;&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Of the studies found in the literature&#44; 83 &#40;23&#46;71&#37;&#41; deal with the topic of direct and indirect costs related to the disease and 44 &#40;12&#46;57&#37;&#41; are analyses of cost-effectiveness of the different treatment options&#59; biological vs&#46; conventional&#44; being the burden of the disease the most used clinical outcome&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">The journals with the greatest number of publications are <span class="elsevierStyleItalic">Rheumatology</span> with 6 publications &#40;1&#46;71&#37;&#41;&#44; followed by <span class="elsevierStyleItalic">Clinical and Experimental Rheumatology</span> and <span class="elsevierStyleItalic">Annals of Rheumatic Diseases</span> with 5 publications &#40;1&#46;42&#37;&#41;&#46; In <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> are found the 10 journals with the greatest number of publications related to this topic during the period studied&#44; including the number of articles published therein&#44; their publication language&#44; and the impact factor for the year 2016 according to the Journal Citation Reports&#46; No High Impact Journal appeared among the 20 journals with the greatest number of publications&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">The absolute number of publications increased from 2 &#40;0&#46;52&#37;&#41; in 1996 to 8 &#40;2&#46;11&#37;&#41; in 2016&#44; with corresponds to a growth rate of 41&#46;4&#37;&#46; However&#44; it can be observed a variable behavior in terms of the number of publications per year &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">The search presented a worldwide geographical distribution&#44; which included the participation of the 5 continents&#46; The continent with the highest number of publications was Europe with 54 references &#40;15&#46;4&#37;&#41;&#59; the countries within the European continent with greater scientific production&#44; contributing with 35 publications &#40;10&#37;&#41; in total&#44; were&#58; the United Kingdom &#40;10 references&#41;&#44; the Netherlands &#40;8 references&#41;&#44; Germany &#40;5 references&#41;&#44; Spain &#40;4 references&#41;&#44; Finland &#40;4 references&#41; and Sweden &#40;4 references&#41;&#46; In the second place is America with 44 publications &#40;12&#46;6&#37;&#41;&#46; North America contributed with a total of 37 publications &#40;10&#46;6&#37;&#41; from the USA&#44; Canada&#44; Mexico and Dominican Republic&#46; South America contributed with 7 publications &#40;2&#37;&#41; from Brazil&#44; Colombia and Argentina&#46; Asia published a total of 11 references &#40;3&#46;1&#37;&#41;&#44; from China&#44; Taiwan&#44; South Korea&#44; India and Japan&#46; The continents of Africa with one publication &#40;0&#46;28&#37;&#41; and Oceania with 4 publications &#40;1&#46;14&#37;&#41; are located in the last place&#46; The top 10 countries with the highest number of publications were&#58; the USA&#44; the United Kingdom&#44; the Netherlands&#44; China&#44; Germany&#44; Canada&#44; Spain&#44; Finland&#44; Sweden and Turkey&#44; contributing with 79 publications in total &#40;22&#46;5&#37;&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">A total of 480 authors were identified&#46; Saag&#44; who is part of the University of Alabama in Birmingham&#44; USA&#44; and Sokka&#44; from the Department of Medicine&#44; Central Hospital&#44; Jyvaskyla&#44; Finland&#44; were the authors with more publications&#44; each one contributing with 2 references&#46; Among the top 20 authors&#44; only one resides in the United States&#46; The main authors of research on this area&#44; with their country of residence and the total number of publications are shown in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Discussion</span><p id="par0080" class="elsevierStylePara elsevierViewall">Our study demonstrated a clear increase in the total number of publications dealing with the economic aspects of RA&#44; with a growth rate of 41&#46;4&#37; in the last 20 years&#46; The economic impact on the health care systems and the rapid increase in the global prevalence of RA&#44; in both developed and developing countries&#44; can justify the increase in scientific production&#44; as well as the costs associated with the burden of the disease&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">8</span></a> However&#44; despite the increase in the number of publications during the period studied&#44; the differences mediated by the economic development of the countries are still notable&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Bibliometric analysis is a tool of science that allows to study and characterize the scientific production around a specific topic&#46; In this way&#44; it manages to obtain a global overview of the performance and repercussion of the scientific activity in a specific region&#44; which facilitates decision making when establishing policies or allocating resources to research lines&#46;<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">9&#44;10</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">When analyzing the results of the geographical distribution&#44; it can be observed that the continent with the highest number of publications is Europe&#44; followed by America&#44; mainly because of the contribution of North America&#44; probably related to the high economic development&#46; In Latin America&#44; the average number of publications per country is one&#46; Colombia has 3 indexed publications&#44; one indexed in the journal <span class="elsevierStyleItalic">Biomedica</span> and 2 in the REVISTA COLOMBIANA DE RENUMATOLOG&#205;A &#40;Colombian Journal of Rheumatology&#41;&#44; contributing with less than 1&#37; of the world&#39;s scientific production&#46; We consider that this makes evident not only the scarce scientific production that exists around this topic&#44; but also that the little that has been published is not fully reflected&#44; since it has been published in non-indexed journals&#44; preventing it from being visible at the global level in this database&#44; and regarding Colombia&#44; the publication of the <span class="elsevierStyleItalic">Biom&#233;dica</span> journal is only found in Medline&#46; The foregoing demonstrates the need to promote research on the economic impact of RA&#44; among other pathologies with a high disease burden&#44; in order to develop applicable scientific products with the ability to guide decisions in the socioeconomic and resource fields&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">11</span></a></p><p id="par0095" class="elsevierStylePara elsevierViewall">The main limitation of this study is that through the bibliometric indicators&#44; only information about the number of publications is obtained&#44; and to be able to speak about the quality of the publications&#44; in this study was used the impact factor of the Journal Citation Reports&#44;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">12</span></a> which is limited in its essence&#44; since it is a global measure obtained from the number of citations that a journal receives during one year&#44; but this count of citations does not distinguish between those that are made to research articles and those that are made to other types of articles of less importance&#44; such as letters and editorials&#44; and this is the reason why it cannot be used as a single indicator of scientific quality&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Conclusions</span><p id="par0100" class="elsevierStylePara elsevierViewall">Based on the bibliometric analysis carried out on the scientific production during the period from 1996 to 2016&#44; it can be evidenced that there is a significant number of articles available and at the service of researchers&#46; The number of publications dealing with economic aspects in RA has steadily grown during the period studied according to the indicators of distribution by year&#44; authorial production and production by country&#44; showing promising the number of publications in the future&#46; However&#44; regarding Latin America&#44; Colombia has contributed with less than 1&#37; of the scientific production worldwide&#44; with the great limitation that in addition to having scarce scientific production regarding the topic under study&#44; not all publications are indexed in the Medline database&#46; Taking into account that economic analyzes cannot be extrapolated&#44; it is deemed necessary the development of new proposals and contributions that foster an increase in the activity in this area of research in our country&#46; Moreover&#44; through this type of analysis it is possible to know which is the global panorama in terms of clinical research around a topic as relevant as RA&#44; a disease that currently affects almost 1&#37; of the world population&#44; this being of great usefulness not only to generate proposals that seek to promote research&#44; but also to achieve significant advances in knowledge and treatment options for this disease in the medium and long term&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Funding</span><p id="par0105" class="elsevierStylePara elsevierViewall">None&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Conflict of interest</span><p id="par0110" class="elsevierStylePara elsevierViewall">The authors declare they do not have any conflict of interest in relation to the publication of this manuscript&#46;</p></span></span>"
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            0 => "Arthritis"
            1 => "Rheumatoid"
            2 => "Economy"
            3 => "Bibliometrics"
            4 => "Medline"
            5 => "Colombia"
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            1 => "Reumatoide"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Rheumatoid arthritis is an inflammatory disorder with a prevalence of up to 5&#37;&#44; and with a significant impact on the quality of life&#46; Rheumatoid arthritis is a high cost medical condition&#46; According to a study carried out in the United States by 2010 an annual expenditure of 4&#46;8 million dollars was estimated&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objective</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">To perform a descriptive analysis of the Medline-indexed biomedical literature on economic aspects of rheumatoid arthritis published between 1996 and 2016&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Materials and methods</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The design is retrospective descriptive literature analysis&#44; with a search performed in Medline using GoPubMed and Fabumed&#44; with the following search strategy&#58; &#40;&#8220;Arthritis&#44; Rheumatoid&#8221; &#91;Majr&#93;&#41; AND &#40;&#8220;Costs and Cost Analysis&#8221; &#91;Majr&#93;&#41; AND &#40;1996&#58;2016 &#91;dp&#93;&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">A total of 350 references were obtained on economic aspects of rheumatoid arthritis indexed in 80 different journals&#46; <span class="elsevierStyleItalic">Rheumatology</span>&#44; with 6 &#40;1&#46;71&#37;&#41; references was the top journal&#44; followed by <span class="elsevierStyleItalic">Clinical and Experimental Rheumatology</span> with 5 &#40;1&#46;42&#37;&#41;&#46; The United States was the most productive country with 30 &#40;8&#46;57&#37;&#41; publications&#46; In Latin America&#44; Brazil and Colombia each contributed with 3 &#40;0&#46;85&#37;&#41; references&#46; During the period studied&#44; there was a growth rate of 41&#46;4&#37;&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusions</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Colombia has contributed with less than 1&#37; of scientific production worldwide&#44; and taking into account that the economic analysis cannot be decontextualised&#44; the development of new proposals and contributions in this research area in our country is considered necessary&#46;</p></span>"
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        "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Introducci&#243;n</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">La artritis reumatoide es una enfermedad inflamatoria con una prevalencia de hasta el 5&#37; y con un impacto significativo sobre la calidad de vida&#46; La artritis reumatoide representa una condici&#243;n m&#233;dica de alto costo&#59; para el a&#241;o 2010 se estim&#243; un gasto anual de 4&#44;8 millones de d&#243;lares&#44; seg&#250;n un estudio realizado en Estados Unidos&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Objetivos</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Realizar el an&#225;lisis descriptivo de la literatura biom&#233;dica indexada en Medline entre 1996 y 2016 sobre temas relacionados con aspectos econ&#243;micos de la artritis reumatoide&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Materiales y m&#233;todos</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">El dise&#241;o es un an&#225;lisis bibliom&#233;trico retrospectivo&#44; de tipo descriptivo&#46; Se realiz&#243; una b&#250;squeda bibliogr&#225;fica en Medline utilizando GoPubMed y Fabumed&#44; y la siguiente estrategia de b&#250;squeda&#58; &#40;&#171;Arthritis&#44; Rheumatoid&#187; &#91;Majr&#93;&#41; AND &#40;&#171;Costs and Cost Analysis&#187; &#91;Majr&#93;&#41; AND &#40;1996&#58;2016 &#91;dp&#93;&#41;&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Resultados</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Se obtuvieron un total de 350 referencias indexadas en 80 revistas diferentes&#46; <span class="elsevierStyleItalic">Rheumatology</span> con 6 &#40;1&#44;71&#37;&#41; referencias fue la revista con mayor n&#250;mero de publicaciones&#44; seguida por <span class="elsevierStyleItalic">Clinical and Experimental Rheumatology</span> con 5 &#40;1&#44;42&#37;&#41;&#46; Estados Unidos fue el pa&#237;s m&#225;s productivo con 30 &#40;8&#44;57&#37;&#41; publicaciones&#46; En Latinoam&#233;rica&#44; Brasil aporta 3 publicaciones &#40;0&#44;85&#37;&#41;&#44; al igual que Colombia con 3 publicaciones &#40;0&#44;85&#37;&#41;&#46; A lo largo del periodo estudiado se observ&#243; una tasa de crecimiento de 41&#44;4&#37;&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conclusiones</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Colombia ha aportado menos del 1&#37; de la producci&#243;n cient&#237;fica a escala mundial&#59; teniendo en cuenta que los an&#225;lisis econ&#243;micos no son extrapolables&#44; consideramos necesario el desarrollo de nuevas propuestas y contribuciones en esta &#225;rea de investigaci&#243;n en nuestro pa&#237;s&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Please cite this article as&#58; Sotomayor MS&#44; Casanova ME&#44; Ocampo JM&#46; An&#225;lisis bibliom&#233;trico de temas econ&#243;micos en artritis reumatoide&#46; Rev Colomb Reumatol&#46; 2018&#59;25&#58;228&#8211;232&#46;</p>"
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Country&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">3&#46;630&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">The Netherlands&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Hiligsmann M&#46;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">The Netherlands&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">The Netherlands&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">The Netherlands&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Watson V&#46;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">The Netherlands&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Gong L&#46;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">China&nbsp;\t\t\t\t\t\t\n
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Article information
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