Anns Mahboob, Chehbin Shin, Shahd Almughanni, Lubica Hornakova, Peter Kubatka, Dietrich Büsselberg
Background/Objectives: Colorectal cancer (CRC) and type 2 diabetes mellitus (T2DM) are two of the most rapidly rising chronic diseases globally. Despite appearing distinct, an emerging body of literature identifies shared etiopathogenic mechanisms mediated by gut microbiota. This review synthesizes 38 peer-reviewed studies to evaluate the compositional, metabolic, immune, and translational intersections of gut dysbiosis in the pathogenesis of T2DM-associated CRC. Methods: This narrative literature review examined 38 primary research articles (human and animal studies) retrieved from PubMed, Scopus, and Embase. Studies were selected based on relevance to the microbiota-mediated mechanisms linking T2DM and CRC, with a focus on compositional analysis, metabolomic shifts, immune activation, and therapeutic interventions. Results: The findings highlight a mechanistically rich overlap between T2DM and CRC through shared dysbiosis, characterized by depletion of SCFA-producing taxa (e.g., Faecalibacterium, Roseburia, Butyricicoccus), enrichment of pathobionts (e.g., Fusobacterium nucleatum, Peptostreptococcus), and the disruption of mucosal immunity and epithelial integrity. Metabolic shifts include reduced butyrate and increased toxic bile acids (e.g., deoxycholic acid), TMAO, and oxidative metabolites, while immune dysregulation features elevated LPS, IL-1β, CXCL3, and NF-κB signaling. Therapeutically, microbiota modulation via diet, metformin, and probiotics shows promise. Conclusions: Gut microbiota lies at the nexus of T2DM and CRC, functioning as a modifiable mediator rather than a passive bystander. Future research should prioritize longitudinal, multi-omic, and intervention-driven studies to enable personalized prevention and treatment strategies.
{"title":"The Gut Nexus: Unraveling Microbiota-Mediated Links Between Type 2 Diabetes and Colorectal Cancer.","authors":"Anns Mahboob, Chehbin Shin, Shahd Almughanni, Lubica Hornakova, Peter Kubatka, Dietrich Büsselberg","doi":"10.3390/nu17233803","DOIUrl":"10.3390/nu17233803","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Colorectal cancer (CRC) and type 2 diabetes mellitus (T2DM) are two of the most rapidly rising chronic diseases globally. Despite appearing distinct, an emerging body of literature identifies shared etiopathogenic mechanisms mediated by gut microbiota. This review synthesizes 38 peer-reviewed studies to evaluate the compositional, metabolic, immune, and translational intersections of gut dysbiosis in the pathogenesis of T2DM-associated CRC. <b>Methods</b>: This narrative literature review examined 38 primary research articles (human and animal studies) retrieved from PubMed, Scopus, and Embase. Studies were selected based on relevance to the microbiota-mediated mechanisms linking T2DM and CRC, with a focus on compositional analysis, metabolomic shifts, immune activation, and therapeutic interventions. <b>Results</b>: The findings highlight a mechanistically rich overlap between T2DM and CRC through shared dysbiosis, characterized by depletion of SCFA-producing taxa (e.g., <i>Faecalibacterium</i>, <i>Roseburia</i>, <i>Butyricicoccus</i>), enrichment of pathobionts (e.g., <i>Fusobacterium nucleatum</i>, <i>Peptostreptococcus</i>), and the disruption of mucosal immunity and epithelial integrity. Metabolic shifts include reduced butyrate and increased toxic bile acids (e.g., deoxycholic acid), TMAO, and oxidative metabolites, while immune dysregulation features elevated LPS, IL-1β, CXCL3, and NF-κB signaling. Therapeutically, microbiota modulation via diet, metformin, and probiotics shows promise. <b>Conclusions</b>: Gut microbiota lies at the nexus of T2DM and CRC, functioning as a modifiable mediator rather than a passive bystander. Future research should prioritize longitudinal, multi-omic, and intervention-driven studies to enable personalized prevention and treatment strategies.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"17 23","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12694093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145725161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lucas John, Moritz Munk, Roman Bizjak, Sebastian V W Schulz, Jens Witzel, Harald Engler, Christoph Siebers, Michael Siebers, Johannes Kirsten, Marijke Grau, Daniel Alexander Bizjak
Background: Ultramarathon running represents an extreme physiological and metabolic challenge. Despite its growing popularity among recreational and competitive runners, evidence-based guidance for nutrition, energy balance, and recovery remains limited. Understanding metabolic response and hormonal regulation during such events is crucial for improving athletes' health and performance.
Methods: This prospective observational study examined participants of the 2024 TorTour de Ruhr® (100 km, 160.9 km, and 230 km). Pre- and post-race assessments included body composition, energy intake and expenditure, metabolic and hormonal biomarkers (leptin, ghrelin, insulin, glucagon, irisin, creatine kinase muscle type (CKM), lactate dehydrogenase (LDH)), and continuous glucose monitoring (CGM). Blood and saliva samples, bioimpedance analysis, and validated symptom questionnaires (General Assessment of Side Effects (GASE)) were used.
Results: Of the 43 ultra runners (16 women, 27 men), 39 finished the race: 19 participants of the 100 km group, 8 of the 160.9 km group, and 16 of the 230 km group. Mean energy deficit was 6797 kcal (range: 417-18,364 kcal) with carbohydrate-dominant fueling (79%). Significant reductions in leptin and insulin and increases in ghrelin, glucagon, CKM, and LDH were observed, indicating disrupted energy homeostasis and muscle damage. The 230 km subgroup showed the greatest changes. Gastrointestinal and musculoskeletal symptoms increased post-race, aligning with biomarker patterns.
Conclusions: Ultramarathon participation induces profound disturbances in metabolic and structural integrity, regardless of race distance. These findings underline the importance of developing individualized nutritional and recovery strategies and highlight the need for future research to investigate how energy deficit and macronutrient composition interact to influence metabolic strain and post-race recovery.
背景:超级马拉松跑步是一项极端的生理和代谢挑战。尽管它在休闲和竞技跑步者中越来越受欢迎,但关于营养、能量平衡和恢复的循证指导仍然有限。了解这些赛事中的代谢反应和激素调节对提高运动员的健康和表现至关重要。方法:这项前瞻性观察研究调查了2024年TorTour de Ruhr®(100公里,160.9公里和230公里)的参与者。赛前和赛后的评估包括身体成分、能量摄入和消耗、代谢和激素生物标志物(瘦素、生长素、胰岛素、胰高血糖素、鸢尾素、肌酸激酶肌肉类型(CKM)、乳酸脱氢酶(LDH))和连续血糖监测(CGM)。使用血液和唾液样本、生物阻抗分析和经过验证的症状问卷(一般副作用评估(GASE))。结果:43名超跑者(16名女性,27名男性)中,39人完成了比赛:100公里组19人,160.9公里组8人,230公里组16人。平均能量赤字为6797千卡(范围:417- 18364千卡),以碳水化合物为主的燃料(79%)。瘦素和胰岛素显著降低,胃饥饿素、胰高血糖素、CKM和LDH升高,表明能量稳态被破坏和肌肉损伤。230 km亚群变化最大。胃肠道和肌肉骨骼症状在比赛后增加,与生物标志物模式一致。结论:无论比赛距离如何,参加超级马拉松都会引起代谢和结构完整性的严重紊乱。这些发现强调了制定个性化营养和恢复策略的重要性,并强调了未来研究能量不足和宏量营养素组成如何相互作用以影响代谢应变和赛后恢复的必要性。
{"title":"Does Distance Matter? Metabolic and Muscular Challenges of a Non-Stop Ultramarathon with Sub-Analysis Depending on Running Distance.","authors":"Lucas John, Moritz Munk, Roman Bizjak, Sebastian V W Schulz, Jens Witzel, Harald Engler, Christoph Siebers, Michael Siebers, Johannes Kirsten, Marijke Grau, Daniel Alexander Bizjak","doi":"10.3390/nu17233801","DOIUrl":"10.3390/nu17233801","url":null,"abstract":"<p><strong>Background: </strong>Ultramarathon running represents an extreme physiological and metabolic challenge. Despite its growing popularity among recreational and competitive runners, evidence-based guidance for nutrition, energy balance, and recovery remains limited. Understanding metabolic response and hormonal regulation during such events is crucial for improving athletes' health and performance.</p><p><strong>Methods: </strong>This prospective observational study examined participants of the 2024 TorTour de Ruhr<sup>®</sup> (100 km, 160.9 km, and 230 km). Pre- and post-race assessments included body composition, energy intake and expenditure, metabolic and hormonal biomarkers (leptin, ghrelin, insulin, glucagon, irisin, creatine kinase muscle type (CKM), lactate dehydrogenase (LDH)), and continuous glucose monitoring (CGM). Blood and saliva samples, bioimpedance analysis, and validated symptom questionnaires (General Assessment of Side Effects (GASE)) were used.</p><p><strong>Results: </strong>Of the 43 ultra runners (16 women, 27 men), 39 finished the race: 19 participants of the 100 km group, 8 of the 160.9 km group, and 16 of the 230 km group. Mean energy deficit was 6797 kcal (range: 417-18,364 kcal) with carbohydrate-dominant fueling (79%). Significant reductions in leptin and insulin and increases in ghrelin, glucagon, CKM, and LDH were observed, indicating disrupted energy homeostasis and muscle damage. The 230 km subgroup showed the greatest changes. Gastrointestinal and musculoskeletal symptoms increased post-race, aligning with biomarker patterns.</p><p><strong>Conclusions: </strong>Ultramarathon participation induces profound disturbances in metabolic and structural integrity, regardless of race distance. These findings underline the importance of developing individualized nutritional and recovery strategies and highlight the need for future research to investigate how energy deficit and macronutrient composition interact to influence metabolic strain and post-race recovery.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"17 23","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12693733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145724972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zahra Maghsoudi, Saleh A Alsanie, Yohannes Adama Melaku, Aliakbar Sayyari, Mehran Nouri, Marzieh Shoja, Beheshteh Olang, Habib Yarizadeh, Behzad Zamani
Background/objectives: Several studies have suggested a contrasting link between a diabetes risk reduction diet (DRRD) pattern and cancer risk; however, their findings have been inconsistent. This study aims to systematically review observational studies and, where possible, quantify the overall effect through a meta-analysis.
Methods: Searches were conducted in PubMed, Scopus, and Web of Science through May 2025. Odds ratios (ORs), along with their confidence intervals, were extracted for meta-analysis. The random-effects model was used to combine the ORs.
Results: Nineteen studies met the inclusion criteria for the systematic review and meta-analysis. Of these, six reports examined the relationship between the DRRD and breast cancer risk, three assessed liver cancer incidence, two analyzed pancreatic cancer risk, and two focused on endometrial cancer. Additionally, seven studies explored the association with other cancers, including ovarian, colorectal, renal, head and neck, bladder, and lung cancers. The meta-analysis revealed that high adherence to the DRRD is associated with a decreased cancer risk (OR = 0.77, 95% confidence interval [95% CI]: 0.71-0.84, p < 0.001).
Conclusions: After stratifying by geographic region, gender, study design, and cancer site, the inverse relationship remained significant across all subgroups. DRRD can be viewed as a beneficial approach associated with a lower cancer risk.
背景/目的:几项研究表明,糖尿病风险降低饮食(DRRD)模式与癌症风险之间存在对比联系;然而,他们的发现并不一致。本研究旨在系统地回顾观察性研究,并在可能的情况下,通过荟萃分析量化总体效果。方法:到2025年5月在PubMed、Scopus和Web of Science中进行检索。比值比(ORs)及其置信区间被提取用于荟萃分析。随机效应模型用于合并ORs。结果:19项研究符合系统评价和荟萃分析的纳入标准。其中,6篇研究了DRRD与乳腺癌风险之间的关系,3篇评估了肝癌发病率,2篇分析了胰腺癌风险,2篇研究了子宫内膜癌。此外,还有7项研究探讨了它与其他癌症的关系,包括卵巢癌、结直肠癌、肾癌、头颈癌、膀胱癌和肺癌。荟萃分析显示,高依从性DRRD与癌症风险降低相关(OR = 0.77, 95%可信区间[95% CI]: 0.71-0.84, p < 0.001)。结论:在按地理区域、性别、研究设计和癌症部位进行分层后,所有亚组之间的负相关仍然显著。DRRD可被视为与较低癌症风险相关的有益方法。
{"title":"The Association of Dietary Diabetes Risk Reduction Score and the Risk of Cancer: A Systematic Review and Meta-Analysis of Observational Studies.","authors":"Zahra Maghsoudi, Saleh A Alsanie, Yohannes Adama Melaku, Aliakbar Sayyari, Mehran Nouri, Marzieh Shoja, Beheshteh Olang, Habib Yarizadeh, Behzad Zamani","doi":"10.3390/nu17233802","DOIUrl":"10.3390/nu17233802","url":null,"abstract":"<p><strong>Background/objectives: </strong>Several studies have suggested a contrasting link between a diabetes risk reduction diet (DRRD) pattern and cancer risk; however, their findings have been inconsistent. This study aims to systematically review observational studies and, where possible, quantify the overall effect through a meta-analysis.</p><p><strong>Methods: </strong>Searches were conducted in PubMed, Scopus, and Web of Science through May 2025. Odds ratios (ORs), along with their confidence intervals, were extracted for meta-analysis. The random-effects model was used to combine the ORs.</p><p><strong>Results: </strong>Nineteen studies met the inclusion criteria for the systematic review and meta-analysis. Of these, six reports examined the relationship between the DRRD and breast cancer risk, three assessed liver cancer incidence, two analyzed pancreatic cancer risk, and two focused on endometrial cancer. Additionally, seven studies explored the association with other cancers, including ovarian, colorectal, renal, head and neck, bladder, and lung cancers. The meta-analysis revealed that high adherence to the DRRD is associated with a decreased cancer risk (OR = 0.77, 95% confidence interval [95% CI]: 0.71-0.84, <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>After stratifying by geographic region, gender, study design, and cancer site, the inverse relationship remained significant across all subgroups. DRRD can be viewed as a beneficial approach associated with a lower cancer risk.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"17 23","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12693901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145725152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Teodoro Suárez-Diéguez, Mariza Olvera Nájera, Mariana Silva, Guadalupe López-Rodríguez, José Alberto Ariza-Ortega, Aurora García-Tejedor, Juan Antonio Nieto
Background: Resistant starch, and specially retrograded starches (RS), have been suggested as useful biological molecules to improve the glucose management in diabetic conditions. However, the influence of the botanical origin in the RS biological capacities make necessary its evaluation, where RS from legumes have been paid less attention compared to other sources as cereals.
Objectives: A RS product obtained from creole Faba beans (Vicia faba L. creole), was evaluated for the first time as a material capable of improving glucose homeostasis in diabetic conditions.
Methods: The RS ingredient investigated (with a reduced digestibility of 50%) was tested in a Wistar rat model with induced diabetes, fed with a 15 or 30% replacement of RS ingredient in the diet. Diverse nutritional and biomarkers were analysed.
Results: As a result of the reduced digestibility of the RS ingredient, diabetic animals fed with RS replacement (15% or 30%) showed attenuated postprandial hyperglycemia responses, reducing the hyperglycemic condition close to 29% compared to non-treated diabetic animals (24.56 ± 7.50 and 25.02 ± 3.54 vs. 34.65 ± 1.89 mmol/L, respectively). In addition, fasting serum glucose levels were significantly reduced (22%). Other biochemical parameters associated with glucose metabolism, such as glycosylated hemoglobin and AGEs levels, also improved. Furthermore, significant improvements in nutritional parameters (such as weight gain) and a lower insulin resistance index were determined. In contrast, no clear effects were observed in lipid metabolism and oxidative stress biomarkers in the treated group.
Conclusions: The results of this research suggest that the retrograded starch from creole beans evaluated could be a potential functional food ingredient capable of enhancing glucose homeostasis in diabetic conditions.
背景:抗性淀粉,特别是逆行淀粉(RS),已被认为是改善糖尿病患者葡萄糖管理的有用生物分子。然而,植物来源对RS生物学能力的影响使得有必要对其进行评估,其中来自豆类的RS与谷物等其他来源相比受到的关注较少。目的:从克里奥尔蚕豆(Vicia Faba L. creole)中获得的RS产品首次被评价为能够改善糖尿病患者葡萄糖稳态的材料。方法:将所研究的RS成分(消化率降低50%)在Wistar诱导糖尿病大鼠模型中进行测试,并在日粮中添加15%或30%的RS成分替代。分析了不同的营养和生物标志物。结果:由于RS成分的消化率降低,添加RS(15%或30%)的糖尿病动物的餐后高血糖反应减弱,与未添加RS的糖尿病动物相比,高血糖状况降低了近29%(分别为24.56±7.50和25.02±3.54∶34.65±1.89 mmol/L)。此外,空腹血糖水平显著降低(22%)。其他与葡萄糖代谢相关的生化参数,如糖化血红蛋白和AGEs水平也有所改善。此外,营养参数(如体重增加)的显著改善和胰岛素抵抗指数的降低被确定。相比之下,治疗组在脂质代谢和氧化应激生物标志物方面没有明显的影响。结论:本研究结果表明,从克里奥尔豆中提取的逆行淀粉可能是一种潜在的功能性食品成分,能够增强糖尿病患者的葡萄糖稳态。
{"title":"A New Resistant Starch Material Obtained from Faba Beans (<i>Vicia faba</i> L. Creole): Potential Modulation of the Diabetic Condition in Diabetic Wistar Rat Model.","authors":"Teodoro Suárez-Diéguez, Mariza Olvera Nájera, Mariana Silva, Guadalupe López-Rodríguez, José Alberto Ariza-Ortega, Aurora García-Tejedor, Juan Antonio Nieto","doi":"10.3390/nu17233807","DOIUrl":"10.3390/nu17233807","url":null,"abstract":"<p><strong>Background: </strong>Resistant starch, and specially retrograded starches (RS), have been suggested as useful biological molecules to improve the glucose management in diabetic conditions. However, the influence of the botanical origin in the RS biological capacities make necessary its evaluation, where RS from legumes have been paid less attention compared to other sources as cereals.</p><p><strong>Objectives: </strong>A RS product obtained from creole Faba beans (<i>Vicia faba</i> L. creole), was evaluated for the first time as a material capable of improving glucose homeostasis in diabetic conditions.</p><p><strong>Methods: </strong>The RS ingredient investigated (with a reduced digestibility of 50%) was tested in a Wistar rat model with induced diabetes, fed with a 15 or 30% replacement of RS ingredient in the diet. Diverse nutritional and biomarkers were analysed.</p><p><strong>Results: </strong>As a result of the reduced digestibility of the RS ingredient, diabetic animals fed with RS replacement (15% or 30%) showed attenuated postprandial hyperglycemia responses, reducing the hyperglycemic condition close to 29% compared to non-treated diabetic animals (24.56 ± 7.50 and 25.02 ± 3.54 vs. 34.65 ± 1.89 mmol/L, respectively). In addition, fasting serum glucose levels were significantly reduced (22%). Other biochemical parameters associated with glucose metabolism, such as glycosylated hemoglobin and AGEs levels, also improved. Furthermore, significant improvements in nutritional parameters (such as weight gain) and a lower insulin resistance index were determined. In contrast, no clear effects were observed in lipid metabolism and oxidative stress biomarkers in the treated group.</p><p><strong>Conclusions: </strong>The results of this research suggest that the retrograded starch from creole beans evaluated could be a potential functional food ingredient capable of enhancing glucose homeostasis in diabetic conditions.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"17 23","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12693899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145724865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Szilvia Racz, Miklos Emri, Ervin Berenyi, Laszlo Horvath, Bela E Toth, Sandor Barat, Edit Kalina, Luca Jozsa, Amrit Pal Bhattoa-Buzas, William B Grant, Harjit Pal Bhattoa
Background/objectives: Big data analysis has revolutionized medical research, making it possible to analyze vast amounts of data and gain valuable insights that were previously impossible to obtain. Our knowledge of the characteristics of vitamin D sufficiency is primarily based on data from a limited number of observations, generally spanning a few years at most.
Methods: Here at the Medical Faculty of the University of Debrecen, the big data approach has allowed us to analyze trends in vitamin D status using nearly 60,000 25-hydroxyvitamin D (25(OH)D) concentration results from 2000 onwards.
Results: Apart from analyzing the well-known phenomenon of seasonality in 25(OH)D concentration, we observed a trend in test requests, which increased from a few hundred in 2000 to almost 10,000 in 2020. Of particular interest is the change in the gender gap in test requests. In previous years, test requests were primarily from women, but by the end of the analysis period, a significant number of requests were from men as well. Since the data set includes all age groups, we analyzed 25(OH)D concentration for incremental age sets of five years, from a few months to 100 years old. The prevalence of vitamin D insufficiency (<75 nmol/L) was clearly demarcated among various years of observation, age groups, sexes, and seasons. Our data was particularly valuable for analyzing the effect of the methodology used for 25(OH)D determination. Three different methodologies were used during the study period, and clear, statistically significant bias was observed.
Conclusions: Our results clearly demonstrate the effect of the methodology used to determine 25(OH)D concentrations on vitamin D status, explicitly highlighting the urgent need to standardize the various platforms used to measure this important analyte and its consequences for public health.
{"title":"Exploring Vitamin D Trends Through Big Data Analysis.","authors":"Szilvia Racz, Miklos Emri, Ervin Berenyi, Laszlo Horvath, Bela E Toth, Sandor Barat, Edit Kalina, Luca Jozsa, Amrit Pal Bhattoa-Buzas, William B Grant, Harjit Pal Bhattoa","doi":"10.3390/nu17233808","DOIUrl":"10.3390/nu17233808","url":null,"abstract":"<p><strong>Background/objectives: </strong>Big data analysis has revolutionized medical research, making it possible to analyze vast amounts of data and gain valuable insights that were previously impossible to obtain. Our knowledge of the characteristics of vitamin D sufficiency is primarily based on data from a limited number of observations, generally spanning a few years at most.</p><p><strong>Methods: </strong>Here at the Medical Faculty of the University of Debrecen, the big data approach has allowed us to analyze trends in vitamin D status using nearly 60,000 25-hydroxyvitamin D (25(OH)D) concentration results from 2000 onwards.</p><p><strong>Results: </strong>Apart from analyzing the well-known phenomenon of seasonality in 25(OH)D concentration, we observed a trend in test requests, which increased from a few hundred in 2000 to almost 10,000 in 2020. Of particular interest is the change in the gender gap in test requests. In previous years, test requests were primarily from women, but by the end of the analysis period, a significant number of requests were from men as well. Since the data set includes all age groups, we analyzed 25(OH)D concentration for incremental age sets of five years, from a few months to 100 years old. The prevalence of vitamin D insufficiency (<75 nmol/L) was clearly demarcated among various years of observation, age groups, sexes, and seasons. Our data was particularly valuable for analyzing the effect of the methodology used for 25(OH)D determination. Three different methodologies were used during the study period, and clear, statistically significant bias was observed.</p><p><strong>Conclusions: </strong>Our results clearly demonstrate the effect of the methodology used to determine 25(OH)D concentrations on vitamin D status, explicitly highlighting the urgent need to standardize the various platforms used to measure this important analyte and its consequences for public health.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"17 23","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12693762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145724816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alex Pinto, Adam Gerrard, Suresh Vijay, Sharon Evans, Anne Daly, Catherine Ashmore, Maria Inês Gama, Júlio César Rocha, Rani Singh, Richard Jackson, Anita MacDonald
Background: In phenylketonuria (PKU) patients, dried blood spot (DBS) sampling remains the standard method for monitoring phenylalanine (Phe) levels. However, delays in reporting results can hinder timely dietary adjustments. Patients and caregivers have expressed a preference for point-of-care testing (POCT) devices that enable home-based monitoring. Objectives: Our aim was to compare blood Phe measurements in PKU patients and caregiver usability of a POCT system with DBS, which is the standard practice monitoring method. Methods: Twenty participants (eighteen children with PKU and two healthy controls) were recruited. Caregivers of children with PKU were asked to perform blood Phe measurements at home under the supervision of a researcher, using both the POCT device (Egoo Phe system) and DBS sampling. Healthy controls collected the same number of samples using both methods in a hospital setting. The POCT system required 40 µL of blood and used an enzymatic, bioluminescent detection system. DBS samples were analyzed by tandem mass spectrometry (TMS) and required two blood spots (approximately 100 µL of blood). The Egoo Connect App, linked via Bluetooth to the POCT device, displayed results after 29 min. Caregiver usability of the POCT system was assessed using questionnaires at each visit. Results: A total of 100 paired samples were collected. Median values were 274 μmol/L (range: 30-1039) for POCT and 270 μmol/L (range: 20-1190) for DBS. POCT readings were a mean of 4.6% higher than DBS with a noticeable strong correlation observed (y = 1.017x; R2 = 0.8450; p < 0.0001). The usability of the POCT system improved with caregiver practice, and all caregivers expressed a preference for POCT over DBS. Conclusions: The POCT system for blood Phe demonstrated strong concordance with DBS and high caregiver acceptance, highlighting its potential to transform PKU care through faster, patient-driven monitoring and more timely clinical decision-making.
{"title":"Point-of-Care Testing in PKU: A New ERA of Blood Phenylalanine Monitoring.","authors":"Alex Pinto, Adam Gerrard, Suresh Vijay, Sharon Evans, Anne Daly, Catherine Ashmore, Maria Inês Gama, Júlio César Rocha, Rani Singh, Richard Jackson, Anita MacDonald","doi":"10.3390/nu17233800","DOIUrl":"10.3390/nu17233800","url":null,"abstract":"<p><p><b>Background:</b> In phenylketonuria (PKU) patients, dried blood spot (DBS) sampling remains the standard method for monitoring phenylalanine (Phe) levels. However, delays in reporting results can hinder timely dietary adjustments. Patients and caregivers have expressed a preference for point-of-care testing (POCT) devices that enable home-based monitoring. <b>Objectives:</b> Our aim was to compare blood Phe measurements in PKU patients and caregiver usability of a POCT system with DBS, which is the standard practice monitoring method. <b>Methods:</b> Twenty participants (eighteen children with PKU and two healthy controls) were recruited. Caregivers of children with PKU were asked to perform blood Phe measurements at home under the supervision of a researcher, using both the POCT device (Egoo Phe system) and DBS sampling. Healthy controls collected the same number of samples using both methods in a hospital setting. The POCT system required 40 µL of blood and used an enzymatic, bioluminescent detection system. DBS samples were analyzed by tandem mass spectrometry (TMS) and required two blood spots (approximately 100 µL of blood). The Egoo Connect App, linked via Bluetooth to the POCT device, displayed results after 29 min. Caregiver usability of the POCT system was assessed using questionnaires at each visit. <b>Results:</b> A total of 100 paired samples were collected. Median values were 274 μmol/L (range: 30-1039) for POCT and 270 μmol/L (range: 20-1190) for DBS. POCT readings were a mean of 4.6% higher than DBS with a noticeable strong correlation observed (y = 1.017x; R<sup>2</sup> = 0.8450; <i>p</i> < 0.0001). The usability of the POCT system improved with caregiver practice, and all caregivers expressed a preference for POCT over DBS. <b>Conclusions:</b> The POCT system for blood Phe demonstrated strong concordance with DBS and high caregiver acceptance, highlighting its potential to transform PKU care through faster, patient-driven monitoring and more timely clinical decision-making.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"17 23","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12693881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145725242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background/Objectives: Aging-related cognitive decline, linked to oxidative stress and impaired hippocampal neurogenesis, is a major contributor to neurodegenerative disorders. In rodents, this condition can be modeled by D-galactose (D-gal) administration, which induces oxidative stress and recognition memory deficits. Prunus domestica L. (PD), rich in phenolic and flavonoid compounds with antioxidant properties, may counteract such impairments. This study evaluated the effects of PD extract on D-gal-induced memory decline by analyzing its phytochemical content, antioxidant activity, and neuroprotective potential. Methods: Phytochemicals were quantified by colorimetric and pH differential methods, and antioxidant capacity was determined using DPPH and FRAP assays. Male Sprague Dawley rats (12 weeks; n = 12/group) were assigned to 8 groups: vehicle, D-gal, PD (75, 100, or 150 mg/kg), and D-gal + PD (same respective doses). D-gal (50 mg/kg, i.p.) and/or PD were administered by oral gavage daily for 8 weeks. Recognition memory was assessed by the novel object recognition (NOR) test. Hippocampal tissues were processed for immunofluorescence staining of the proliferation marker Ki-67 and superoxide dismutase (SOD) activity using the cytochrome C reduction method. Results: PD extract contained abundant phenolics, tannins, flavonoids, and anthocyanins, and exhibited notable antioxidant activity. D-gal impaired recognition memory, reduced hippocampal cell proliferation, and decreased SOD activity. Co-treatment with PD improved memory performance, enhanced hippocampal neurogenesis, and restored antioxidant enzyme activity. Conclusions: PD extract may protect against D-gal-induced age-related cognitive decline through antioxidant effects and support of hippocampal neurogenesis.
{"title":"Oral Supplementation with <i>Prunus domestica</i> L. Extract Restores Recognition Memory Impairment Caused by D-Galactose in Rats.","authors":"Anusara Aranarochana, Puncharatsm Pannin, Papatchaya Sintow, Apiwat Sirichoat, Nataya Sritawan, Wanassanan Pannangrong, Rawiwan Charoensup, Wuttichai Jaidee, Piti Ungarreevittaya, Peter Wigmore, Jariya Umka Welbat","doi":"10.3390/nu17233804","DOIUrl":"10.3390/nu17233804","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Aging-related cognitive decline, linked to oxidative stress and impaired hippocampal neurogenesis, is a major contributor to neurodegenerative disorders. In rodents, this condition can be modeled by D-galactose (D-gal) administration, which induces oxidative stress and recognition memory deficits. <i>Prunus domestica</i> L. (PD), rich in phenolic and flavonoid compounds with antioxidant properties, may counteract such impairments. This study evaluated the effects of PD extract on D-gal-induced memory decline by analyzing its phytochemical content, antioxidant activity, and neuroprotective potential. <b>Methods:</b> Phytochemicals were quantified by colorimetric and pH differential methods, and antioxidant capacity was determined using DPPH and FRAP assays. Male Sprague Dawley rats (12 weeks; n = 12/group) were assigned to 8 groups: vehicle, D-gal, PD (75, 100, or 150 mg/kg), and D-gal + PD (same respective doses). D-gal (50 mg/kg, i.p.) and/or PD were administered by oral gavage daily for 8 weeks. Recognition memory was assessed by the novel object recognition (NOR) test. Hippocampal tissues were processed for immunofluorescence staining of the proliferation marker Ki-67 and superoxide dismutase (SOD) activity using the cytochrome C reduction method. <b>Results:</b> PD extract contained abundant phenolics, tannins, flavonoids, and anthocyanins, and exhibited notable antioxidant activity. D-gal impaired recognition memory, reduced hippocampal cell proliferation, and decreased SOD activity. Co-treatment with PD improved memory performance, enhanced hippocampal neurogenesis, and restored antioxidant enzyme activity. <b>Conclusions:</b> PD extract may protect against D-gal-induced age-related cognitive decline through antioxidant effects and support of hippocampal neurogenesis.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"17 23","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12693760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145725120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Iasmim Xisto Campos, Marcella Duarte Villas Mishima, Fermín I Milagro, Maria do Carmo Gouveia Peluzio
Background/Objectives: High-fat diets (HFDs) are widely used to induce obesity, but cost-effective and reproducible formulations remain challenging. Moreover, the reversibility of metabolic and gut microbiota alterations following HFD withdrawal is not fully understood. This study evaluated a low-cost HFD model in mice and investigated metabolic, oxidative, and gut microbiota changes during a subsequent 12-week dietary normalization phase. Methods: Male C57BL/6 mice were fed a standard diet (CTN) or a lard-supplemented HFD for 12 weeks (Phase 1), followed by 12 weeks dietary normalization to a standard diet (Phase 2). Body weight, adiposity, blood glucose, biochemical parameters, and oxidative markers were assessed. Fecal samples were analyzed for short-chain fatty acids (SCFAs), microbiota composition (16S rRNA sequencing), and predicted functions using FAPROTAX and PICRUSt2. Results: The HFD significantly increased body weight, abdominal circumference, the Lee index, and adipose tissue mass compared to CTN. Following diet normalization, both groups exhibited weight loss, but the previously obese mice maintained a higher Lee index and distinct lipid and uric acid profiles. No hepatic oxidative stress was detected after normalization. SCFA profiles underwent a temporal shift: CTN showed higher fecal acetate, while HFD mice exhibited elevated butyrate. Functional prediction revealed one pathway associated with an unclassified Rickettsiales bacterium that was exclusively found in HFD mice. The CTN group exhibited a higher abundance of the thiamine diphosphate formation pathway (PWY-7357), suggesting enhanced oxidative metabolism. Conclusions: This low-cost HFD successfully induced obesity and dysbiosis. Dietary normalization resulted in a partial modulation of metabolic and microbial balance, thereby highlighting host-microbe metabolic plasticity.
{"title":"A Low-Cost, High-Fat Diet Effectively Induces Obesity and Metabolic Alterations and Diet Normalization Modulates Microbiota in C57BL/6 Mice.","authors":"Iasmim Xisto Campos, Marcella Duarte Villas Mishima, Fermín I Milagro, Maria do Carmo Gouveia Peluzio","doi":"10.3390/nu17233806","DOIUrl":"10.3390/nu17233806","url":null,"abstract":"<p><p><b>Background/Objectives</b>: High-fat diets (HFDs) are widely used to induce obesity, but cost-effective and reproducible formulations remain challenging. Moreover, the reversibility of metabolic and gut microbiota alterations following HFD withdrawal is not fully understood. This study evaluated a low-cost HFD model in mice and investigated metabolic, oxidative, and gut microbiota changes during a subsequent 12-week dietary normalization phase. <b>Methods</b>: Male C57BL/6 mice were fed a standard diet (CTN) or a lard-supplemented HFD for 12 weeks (Phase 1), followed by 12 weeks dietary normalization to a standard diet (Phase 2). Body weight, adiposity, blood glucose, biochemical parameters, and oxidative markers were assessed. Fecal samples were analyzed for short-chain fatty acids (SCFAs), microbiota composition (16S rRNA sequencing), and predicted functions using FAPROTAX and PICRUSt2. <b>Results</b>: The HFD significantly increased body weight, abdominal circumference, the Lee index, and adipose tissue mass compared to CTN. Following diet normalization, both groups exhibited weight loss, but the previously obese mice maintained a higher Lee index and distinct lipid and uric acid profiles. No hepatic oxidative stress was detected after normalization. SCFA profiles underwent a temporal shift: CTN showed higher fecal acetate, while HFD mice exhibited elevated butyrate. Functional prediction revealed one pathway associated with an unclassified Rickettsiales bacterium that was exclusively found in HFD mice. The CTN group exhibited a higher abundance of the thiamine diphosphate formation pathway (PWY-7357), suggesting enhanced oxidative metabolism. <b>Conclusions</b>: This low-cost HFD successfully induced obesity and dysbiosis. Dietary normalization resulted in a partial modulation of metabolic and microbial balance, thereby highlighting host-microbe metabolic plasticity.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"17 23","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12693873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145724723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background/Objectives: Sarcopenia may be influenced by lifestyle and dietary factors. Emerging evidence suggests that certain foods such as sea vegetables and fruits contain bioactive compounds may help protect against muscle loss. This study investigated the association between sea vegetable and fruit intake and the risk of sarcopenia and physical performance in older adults in Taiwan. Methods: We conducted a cross-sectional study of 588 individuals aged ≥65 years recruited from three hospitals (outpatient and home-care settings) in southern Taiwan (2018-2020). Questionnaire, medical chart, and laboratory data were used to examine the associations between demographic characteristics, dietary intake, and nutritional status and sarcopenia, defined as low muscle mass plus reduced strength or poor physical performance. Sarcopenia was diagnosed using Asian Working Group for Sarcopenia 2019 criteria. The performance variables we measured were grip strength, gait speed, and chair stand time. Logistic regression was used to identify associated factors, and linear regression was used to assess the contributions of these factors to performance measures. Results: Sarcopenia was identified in 159 (27.0%) of the 588 participants. Those with sarcopenia had lower education levels, poorer nutritional status, weaker grip strength, and slower mobility. Daily intakes of sea vegetables (adjusted OR = 0.38, 95% CI: 0.20-0.74) and fresh fruits (adjusted OR = 0.28, 95% CI: 0.16-0.49) were independently associated with reduced risk of sarcopenia. Sea vegetable intake was positively associated with grip strength, while fruit intake was inversely associated with chair stand time. Conclusions: Dietary factors and nutritional status were significantly associated with sarcopenia risk and physical performance. Sarcopenia prevention strategies might want to include promoting the consumption of sea vegetables and fruits.
{"title":"Sea Vegetables and Fruits as Novel Dietary Protective Factors for Sarcopenia and Muscle Function in Taiwan: A Cross-Sectional Study.","authors":"Chi-Hsien Huang, Pei-Fang Li, Tzyh-Chyuan Hour, Huei-Mei Chen, Hsin-Yi Chang, Yu-Kuei Chen","doi":"10.3390/nu17233805","DOIUrl":"10.3390/nu17233805","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Sarcopenia may be influenced by lifestyle and dietary factors. Emerging evidence suggests that certain foods such as sea vegetables and fruits contain bioactive compounds may help protect against muscle loss. This study investigated the association between sea vegetable and fruit intake and the risk of sarcopenia and physical performance in older adults in Taiwan. <b>Methods:</b> We conducted a cross-sectional study of 588 individuals aged ≥65 years recruited from three hospitals (outpatient and home-care settings) in southern Taiwan (2018-2020). Questionnaire, medical chart, and laboratory data were used to examine the associations between demographic characteristics, dietary intake, and nutritional status and sarcopenia, defined as low muscle mass plus reduced strength or poor physical performance. Sarcopenia was diagnosed using Asian Working Group for Sarcopenia 2019 criteria. The performance variables we measured were grip strength, gait speed, and chair stand time. Logistic regression was used to identify associated factors, and linear regression was used to assess the contributions of these factors to performance measures. <b>Results:</b> Sarcopenia was identified in 159 (27.0%) of the 588 participants. Those with sarcopenia had lower education levels, poorer nutritional status, weaker grip strength, and slower mobility. Daily intakes of sea vegetables (adjusted OR = 0.38, 95% CI: 0.20-0.74) and fresh fruits (adjusted OR = 0.28, 95% CI: 0.16-0.49) were independently associated with reduced risk of sarcopenia. Sea vegetable intake was positively associated with grip strength, while fruit intake was inversely associated with chair stand time. <b>Conclusions:</b> Dietary factors and nutritional status were significantly associated with sarcopenia risk and physical performance. Sarcopenia prevention strategies might want to include promoting the consumption of sea vegetables and fruits.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"17 23","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12693737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145725115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alzheimer's disease (AD), the leading cause of dementia, has limited treatment options despite extensive pharmacological research. This has increased interest in dietary strategies that act across multiple pathological mechanisms. Beetroot (Beta vulgaris), known for its cardiovascular and metabolic benefits, contains a distinctive combination of bioactive compounds including inorganic nitrate, betalains, and polyphenols. Together these constituents influence vascular function, oxidative stress, mitochondrial efficiency, inflammation, and the microbiota. Previous reviews have typically focused on dietary nitrate in dementia prevention or have examined nitrate and betalains separately. In contrast, this review synthesises evidence on beetroot as a combined neuroprotective food. Preclinical data indicate that beetroot and its key constituents enhance antioxidant defences, support neuronal bioenergetics, and modulate cholinergic and inflammatory pathways. Human studies further suggest that nitrate-rich beetroot can improve cerebral blood flow and vascular responsiveness, and that higher intakes of plant-derived nitrate are associated with reduced cognitive decline. However, findings are inconsistent, most trials are small and short in duration, and research directly involving people with AD is scarce. By integrating vascular, antioxidant, and microbiome perspectives, this review identifies beetroot as a promising yet underexplored dietary candidate for AD management. Further mechanistic studies and multidomain approaches combining metagenomics, biomarkers, neuroimaging, and cognitive outcomes are needed.
{"title":"Can Beetroot (<i>Beta vulgaris</i>) Support Brain Health? A Perspective Review on Alzheimer's Disease.","authors":"Rachel Kimble, Oliver M Shannon","doi":"10.3390/nu17233790","DOIUrl":"10.3390/nu17233790","url":null,"abstract":"<p><p>Alzheimer's disease (AD), the leading cause of dementia, has limited treatment options despite extensive pharmacological research. This has increased interest in dietary strategies that act across multiple pathological mechanisms. Beetroot (<i>Beta vulgaris</i>), known for its cardiovascular and metabolic benefits, contains a distinctive combination of bioactive compounds including inorganic nitrate, betalains, and polyphenols. Together these constituents influence vascular function, oxidative stress, mitochondrial efficiency, inflammation, and the microbiota. Previous reviews have typically focused on dietary nitrate in dementia prevention or have examined nitrate and betalains separately. In contrast, this review synthesises evidence on beetroot as a combined neuroprotective food. Preclinical data indicate that beetroot and its key constituents enhance antioxidant defences, support neuronal bioenergetics, and modulate cholinergic and inflammatory pathways. Human studies further suggest that nitrate-rich beetroot can improve cerebral blood flow and vascular responsiveness, and that higher intakes of plant-derived nitrate are associated with reduced cognitive decline. However, findings are inconsistent, most trials are small and short in duration, and research directly involving people with AD is scarce. By integrating vascular, antioxidant, and microbiome perspectives, this review identifies beetroot as a promising yet underexplored dietary candidate for AD management. Further mechanistic studies and multidomain approaches combining metagenomics, biomarkers, neuroimaging, and cognitive outcomes are needed.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"17 23","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12693808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145725022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}