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Hector EC, Zhang D, Tian L, Feng J, Yin X, Xu T, Laakso M, Bai Y, Xiao J, Kang J, Yu T. Dissecting genetic regulation of metabolic coordination. Brief Bioinform 2025; 26:bbaf095. [PMID: 40067114 PMCID: PMC11894804 DOI: 10.1093/bib/bbaf095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2024] [Revised: 12/24/2024] [Accepted: 02/19/2025] [Indexed: 03/15/2025] Open
Abstract
Understanding genetic regulation of metabolism is critical for gaining insights into the causes of metabolic diseases. Traditional metabolome-based genome-wide association studies (mGWAS) focus on static associations between single nucleotide polymorphisms (SNPs) and metabolite levels, overlooking the changing relationships caused by genotypes within the metabolic network. Notably, some metabolites exhibit changes in correlation patterns with other metabolites under certain physiological conditions while maintaining their overall abundance level. In this manuscript, we develop Metabolic Differential-coordination GWAS (mdGWAS), an innovative framework that detects SNPs associated with the changing correlation patterns between metabolites and metabolic pathways. This approach transcends and complements conventional mean-based analyses by identifying latent regulatory factors that govern the system-level metabolic coordination. Through comprehensive simulation studies, mdGWAS demonstrated robust performance in detecting SNP-metabolite-metabolite associations. Applying mdGWAS to genotyping and mass spectrometry (MS)-based metabolomics data of the METabolic Syndrome In Men (METSIM) Study revealed novel SNPs and genes potentially involved in the regulation of the coordination between metabolic pathways.
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Affiliation(s)
- Emily C Hector
- Department of Statistics, North Carolina State University, Raleigh, NC 27695, United States
| | - Daiwei Zhang
- Department of Biostatistics, University of Michigan, Ann Arbor, MI 48109, United States
- Department of Biostatistics and Department of Genetics, University of North Carolina, Chapel Hill, NC 27599, United States
| | - Leqi Tian
- School of Data Science, the Chinese University of Hong Kong, Shenzhen, Guangdong 518172, P.R.China
| | - Junning Feng
- School of Data Science, the Chinese University of Hong Kong, Shenzhen, Guangdong 518172, P.R.China
| | - Xianyong Yin
- Department of Biostatistics, University of Michigan, Ann Arbor, MI 48109, United States
| | - Tianyi Xu
- School of Data Science, the Chinese University of Hong Kong, Shenzhen, Guangdong 518172, P.R.China
| | - Markku Laakso
- School of Medicine, University of Eastern Finland, FI-70211 Kuopio, Finland
| | - Yun Bai
- School of Medicine, the Chinese University of Hong Kong, Shenzhen, Guangdong 518172, P.R.China
| | - Jiashun Xiao
- Shenzhen Research Institute of Big Data, Shenzhen, Guangdong 518172, P.R.China
| | - Jian Kang
- Department of Biostatistics, University of Michigan, Ann Arbor, MI 48109, United States
| | - Tianwei Yu
- School of Data Science, the Chinese University of Hong Kong, Shenzhen, Guangdong 518172, P.R.China
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Jovicic N, Andjic M, Novakovic J, Jeremic N, Zivkovic V, Srejovic I, Stanojevic D, Ristic P, Bolevich S, Jakovljevic V. The еffects of low mineral content water on microbiota, metabolic, and oxidative stress parameters in patients with type 2 diabetes mellitus. Heliyon 2023; 9:e18725. [PMID: 37554803 PMCID: PMC10404784 DOI: 10.1016/j.heliyon.2023.e18725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 07/22/2023] [Accepted: 07/25/2023] [Indexed: 08/10/2023] Open
Abstract
Although scientific evidence has shown that natural mineral waters have potential beneficial metabolic effects, there is still very scarce data on their influence on type 2 diabetes mellitus (T2DM). The study was designed to investigate the effects of low mineral water from the "Sneznik-1/79″ source in Serbia on microbiota, metabolic, and oxidative stress parameters in patients with T2DM. In total, 60 patients with confirmed T2DM were included in the study, and they consumed "Sneznik-1/79″ water for 28 days. To examine the positive effects of "Sneznik-1/79″ water, we compared the results before and after the four weeks of "Sneznik-1/79″ water intake. Standard biochemical analyses were carried out, such as glucose level, lipid profile, and stool tests. The blood samples were collected to evaluate the effects of "Sneznik-1/79″ water on the redox status. At the end of the monitoring period, the total cholesterol concentration significantly dropped compared to the initial value. A significant improvement in intestinal peristalsis was observed, which was reflected in the fact that after four weeks, all patients established regular, daily bowel movements. Moreover, consumption of "Sneznik-1/79″ water eliminated the appearance of dysbiosis in 50% of patients. Additionally, the antioxidant capacity was improved by increasing the concentration of superoxide dismutase and reduced glutathione. The result of our study pointed out that the intake of "Sneznik-1/79″ water could be a promising adjuvant therapy for improving intestinal peristalsis as well as reducing the appearance of dysbiosis in T2DM patients.
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Affiliation(s)
- Nikola Jovicic
- Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Marijana Andjic
- Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
- Center of Excellence for Redox Balance Research in Cardiovascular and Metabolic Disorders; Kragujevac, Serbia
| | - Jovana Novakovic
- Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
- Center of Excellence for Redox Balance Research in Cardiovascular and Metabolic Disorders; Kragujevac, Serbia
| | - Nevena Jeremic
- Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
- Center of Excellence for Redox Balance Research in Cardiovascular and Metabolic Disorders; Kragujevac, Serbia
- 1st Moscow State Medical, University IM Sechenov, Moscow, Russia
| | - Vladimir Zivkovic
- Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
- Center of Excellence for Redox Balance Research in Cardiovascular and Metabolic Disorders; Kragujevac, Serbia
- Department of Pharmacology, Institute of Biodesign and Complex System Modelling, First Moscow State Medical University I.M. Sechenov, Moscow, Russia
| | - Ivan Srejovic
- Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
- Center of Excellence for Redox Balance Research in Cardiovascular and Metabolic Disorders; Kragujevac, Serbia
- Department of Pharmacology, Institute of Biodesign and Complex System Modelling, First Moscow State Medical University I.M. Sechenov, Moscow, Russia
| | | | - Petar Ristic
- Clinic of Endocrinology, Military Medical Academy, Belgrade, Serbia
| | - Sergey Bolevich
- Department of Human Pathology, 1st Moscow State Medical, University IM Sechenov, Moscow, Russia
| | - Vladimir Jakovljevic
- Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
- Center of Excellence for Redox Balance Research in Cardiovascular and Metabolic Disorders; Kragujevac, Serbia
- Department of Human Pathology, 1st Moscow State Medical, University IM Sechenov, Moscow, Russia
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Yousri NA, Suhre K, Yassin E, Al-Shakaki A, Robay A, Elshafei M, Chidiac O, Hunt SC, Crystal RG, Fakhro KA. Metabolic and Metabo-Clinical Signatures of Type 2 Diabetes, Obesity, Retinopathy, and Dyslipidemia. Diabetes 2022; 71:184-205. [PMID: 34732537 PMCID: PMC8914294 DOI: 10.2337/db21-0490] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 10/25/2021] [Indexed: 11/13/2022]
Abstract
Macro- and microvascular complications of type 2 diabetes (T2D), obesity, and dyslipidemia share common metabolic pathways. In this study, using a total of 1,300 metabolites from 996 Qatari adults (57% with T2D) and 1,159 metabolites from an independent cohort of 2,618 individuals from the Qatar BioBank (11% with T2D), we identified 373 metabolites associated with T2D, obesity, retinopathy, dyslipidemia, and lipoprotein levels, 161 of which were novel. Novel metabolites included phospholipids, sphingolipids, lysolipids, fatty acids, dipeptides, and metabolites of the urea cycle and xanthine, steroid, and glutathione metabolism. The identified metabolites enrich pathways of oxidative stress, lipotoxicity, glucotoxicity, and proteolysis. Second, we identified 15 patterns we defined as "metabo-clinical signatures." These are clusters of patients with T2D who group together based on metabolite levels and reveal the same clustering in two or more clinical variables (obesity, LDL, HDL, triglycerides, and retinopathy). These signatures revealed metabolic pathways associated with different clinical patterns and identified patients with extreme (very high/low) clinical variables associated with extreme metabolite levels in specific pathways. Among our novel findings are the role of N-acetylmethionine in retinopathy in conjunction with dyslipidemia and the possible roles of N-acetylvaline and pyroglutamine in association with high cholesterol levels and kidney function.
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Affiliation(s)
- Noha A. Yousri
- Genetic Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar
- Computer and Systems Engineering, Alexandria University, Alexandria, Egypt
- Corresponding author: Noha A. Yousri,
| | - Karsten Suhre
- Physiology and Biophysics, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Esraa Yassin
- Genetic Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar
| | | | - Amal Robay
- Genetic Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar
| | | | - Omar Chidiac
- Genetic Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Steven C. Hunt
- Genetic Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar
| | | | - Khalid A. Fakhro
- Genetic Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar
- Translational Research, Sidra Medical and Research Center, Doha, Qatar
- College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
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Abstract
Life expectancy, and longevity have been increasing in recent years. However, this is, in most cases, accompanied by age-related diseases. Thus, it became essential to better understand the mechanisms inherent to aging, and to establish biomarkers that characterize this physiological process. Among all biomolecules, lipids appear to be a good target for the study of these biomarkers. In fact, some lipids have already been associated with age-related diseases. With the development of analytical techniques such as Mass Spectrometry, and Nuclear Magnetic Resonance, Lipidomics has been increasingly used to study pathological, and physiological states of an organism. Thus, the study of serum, and plasma lipidome in centenarians, and elderly individuals without age-related diseases can be a useful tool for the identification of aging biomarkers, and to understand physiological aging, and longevity. This review focus on the importance of lipids as biomarkers of aging, and summarize the changes in the lipidome that have been associated with aging, and longevity.
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Hussein NA, Ebied SA, Nour HA, Zaki UK, El-Kotishy SM, Salem TM. Liraglutide treatment and acylcarnitine profiles in Egyptian obese insulin-resistant females. Eur J Pharmacol 2020; 891:173668. [PMID: 33098833 DOI: 10.1016/j.ejphar.2020.173668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 10/16/2020] [Accepted: 10/21/2020] [Indexed: 10/23/2022]
Abstract
Using metabolomics technique to investigate the response to liraglutide treatment produces helpful information regarding the effects of drug on metabolic regulation. This study tested whether loss of weight by liraglutide combined with decreasing acylcarnitines (AcylCNs) represent an effective strategy to improve insulin sensitivity in obese insulin-resistant females. AcylCN profiles by tandem mass spectrometry, plasma glycosylated hemoglobin, lactate, pyruvate, serum fasting glucose, creatinine, and insulin were assessed for obese insulin-resistant females before and after treatment with liraglutide for 3 months and non-obese females. All studied parameters in obese insulin-resistant females before treatment were significantly higher than control subjects except C0 and C3 levels which were significantly low. Liraglutide treatment was effective in weight loss, increased C0 and C3 levels and decreased values of all other studied parameters comparing with before treatment but still higher than control. However, creatinine level was unaffected by treatment. This study can conclude that circulating AcylCN profiles can reflect mitochondrial overload that happen in response to obesity. Also, AcylCNs can be used as markers for diagnosis of metabolic disorders. Liraglutide treatment leads to durable improvements in weight reduction and glycometabolic control and the utilization of intracellular glucose.
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Affiliation(s)
- Neveen A Hussein
- Applied Medical Chemistry Department, Medical Research Institute, Alexandria University, Alexandria, Egypt.
| | - Samia A Ebied
- Applied Medical Chemistry Department, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Hoda A Nour
- Physiology Department, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Usama K Zaki
- Clinical Genetics Department, Faculty of Medicine, Ain Shams University, Egypt
| | - Sahar M El-Kotishy
- Applied Medical Chemistry Department, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Tarek M Salem
- Internal Medicine Department, Endocrinology unit, Faculty of Medicine, Alexandria University, Alexandria, Egypt
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Hasanpour M, Iranshahy M, Iranshahi M. The application of metabolomics in investigating anti-diabetic activity of medicinal plants. Biomed Pharmacother 2020; 128:110263. [DOI: 10.1016/j.biopha.2020.110263] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 05/08/2020] [Accepted: 05/10/2020] [Indexed: 12/21/2022] Open
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New molecular biomarkers in precise diagnosis and therapy of Type 2 diabetes. HEALTH AND TECHNOLOGY 2019. [DOI: 10.1007/s12553-019-00385-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Yang L, Li M, Shan Y, Shen S, Bai Y, Liu H. Recent advances in lipidomics for disease research. J Sep Sci 2015; 39:38-50. [PMID: 26394722 DOI: 10.1002/jssc.201500899] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 09/14/2015] [Accepted: 09/15/2015] [Indexed: 12/15/2022]
Abstract
Lipidomics is an important branch of metabolomics, which aims at the detailed analysis of lipid species and their multiple roles in the living system. In recent years, the development of various analytical methods for effective identification and characterization of lipids has greatly promoted the process of lipidomics. Meanwhile, as many diseases demonstrate a remarkable alteration in lipid profiles compared with that of healthy people, lipidomics has been extensively introduced to disease research. The comprehensive lipid profiling provides a chance to discover novel biomarkers for specific disease. In addition, it plays a crucial role in the study of lipid metabolism, which could illuminate the pathogenesis of diseases. In this review, after brief discussion of analytical methods for lipidomics in clinical research, we focus on the recent advances of lipidomics related to four types of diseases, including cancer, atherosclerosis, diabetes mellitus, and Alzheimer's disease.
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Affiliation(s)
- Li Yang
- Beijing National Laboratory for Molecular Sciences, Key Laboratory of Bioorganic Chemistry and Molecular Engineering of Ministry of Education, Institute of Analytical Chemistry, College of Chemistry and Molecular Engineering, Peking University, Beijing, China
| | - Min Li
- Beijing National Laboratory for Molecular Sciences, Key Laboratory of Bioorganic Chemistry and Molecular Engineering of Ministry of Education, Institute of Analytical Chemistry, College of Chemistry and Molecular Engineering, Peking University, Beijing, China
| | - Yabing Shan
- Beijing National Laboratory for Molecular Sciences, Key Laboratory of Bioorganic Chemistry and Molecular Engineering of Ministry of Education, Institute of Analytical Chemistry, College of Chemistry and Molecular Engineering, Peking University, Beijing, China.,National Research Center for Geoanalysis, Beijing, China
| | - Sensen Shen
- Beijing National Laboratory for Molecular Sciences, Key Laboratory of Bioorganic Chemistry and Molecular Engineering of Ministry of Education, Institute of Analytical Chemistry, College of Chemistry and Molecular Engineering, Peking University, Beijing, China
| | - Yu Bai
- Beijing National Laboratory for Molecular Sciences, Key Laboratory of Bioorganic Chemistry and Molecular Engineering of Ministry of Education, Institute of Analytical Chemistry, College of Chemistry and Molecular Engineering, Peking University, Beijing, China
| | - Huwei Liu
- Beijing National Laboratory for Molecular Sciences, Key Laboratory of Bioorganic Chemistry and Molecular Engineering of Ministry of Education, Institute of Analytical Chemistry, College of Chemistry and Molecular Engineering, Peking University, Beijing, China
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Abu Bakar MH, Sarmidi MR, Cheng KK, Ali Khan A, Suan CL, Zaman Huri H, Yaakob H. Metabolomics – the complementary field in systems biology: a review on obesity and type 2 diabetes. MOLECULAR BIOSYSTEMS 2015; 11:1742-74. [DOI: 10.1039/c5mb00158g] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This paper highlights the metabolomic roles in systems biology towards the elucidation of metabolic mechanisms in obesity and type 2 diabetes.
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Affiliation(s)
- Mohamad Hafizi Abu Bakar
- Department of Bioprocess Engineering
- Faculty of Chemical Engineering
- Universiti Teknologi Malaysia
- 81310 Johor Bahru
- Malaysia
| | - Mohamad Roji Sarmidi
- Institute of Bioproduct Development
- Universiti Teknologi Malaysia
- 81310 Johor Bahru
- Malaysia
- Innovation Centre in Agritechnology for Advanced Bioprocessing (ICA)
| | - Kian-Kai Cheng
- Department of Bioprocess Engineering
- Faculty of Chemical Engineering
- Universiti Teknologi Malaysia
- 81310 Johor Bahru
- Malaysia
| | - Abid Ali Khan
- Institute of Bioproduct Development
- Universiti Teknologi Malaysia
- 81310 Johor Bahru
- Malaysia
- Department of Biosciences
| | - Chua Lee Suan
- Institute of Bioproduct Development
- Universiti Teknologi Malaysia
- 81310 Johor Bahru
- Malaysia
| | - Hasniza Zaman Huri
- Department of Pharmacy
- Faculty of Medicine
- University of Malaya
- 50603 Kuala Lumpur
- Malaysia
| | - Harisun Yaakob
- Institute of Bioproduct Development
- Universiti Teknologi Malaysia
- 81310 Johor Bahru
- Malaysia
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Jové M, Naudí A, Portero-Otin M, Cabré R, Rovira-Llopis S, Bañuls C, Rocha M, Hernández-Mijares A, Victor VM, Pamplona R. Plasma lipidomics discloses metabolic syndrome with a specific HDL phenotype. FASEB J 2014; 28:5163-5171. [PMID: 25169057 DOI: 10.1096/fj.14-253187] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2024]
Abstract
Lipidomics reveals a remarkable diversity of lipids in human plasma. In this study, we have performed an in-depth lipidomic analysis of human plasma from healthy individuals and subjects with metabolic syndrome (MetS) in order to determine the lipidomic profile that allows prognosis of a pathological subpopulation with altered high-density lipoprotein (HDL) metabolism. The MetS population was categorized as having pathological or nonpathological HDL. Anthropometric parameters, cardiovascular risk markers, and lipoprotein subclasses of HDL and low-density lipoproteins were also evaluated. Lipidomic analysis revealed 357 differential molecules that were clustered (k means) in the two groups. The molecules identified in the whole lipidome showed that MetS subjects presented lower levels of glycerolipids and higher levels of glycerophospholipids with respect to control subjects. In contrast, when only statistically differential lipids were taken into account, differences were found between the two groups in almost cases. Furthermore, levels of saturated fatty acids were higher in patients with pathological HDL levels than in controls, whereas levels of unsaturated fatty acids were lower. These results highlight the potential of lipidomics as a clinical tool for risk assessment and monitoring of disease.
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Affiliation(s)
- Mariona Jové
- Department of Experimental Medicine, University of Lleida-Biomedical Research Institute of Lleida, Lleida, Spain
| | - Alba Naudí
- Department of Experimental Medicine, University of Lleida-Biomedical Research Institute of Lleida, Lleida, Spain
| | - Manuel Portero-Otin
- Department of Experimental Medicine, University of Lleida-Biomedical Research Institute of Lleida, Lleida, Spain
| | - Rosanna Cabré
- Department of Experimental Medicine, University of Lleida-Biomedical Research Institute of Lleida, Lleida, Spain
| | - Susana Rovira-Llopis
- Foundation for the Promotion of Healthcare and Biomedical Research in the Valencian Community, Service of Endocrinology, Valencia, Spain; and Fundación para la Investigación del Hospital Clínico Universitario de Valencia (INCLIVA)
| | - Celia Bañuls
- Foundation for the Promotion of Healthcare and Biomedical Research in the Valencian Community, Service of Endocrinology, Valencia, Spain; and Fundación para la Investigación del Hospital Clínico Universitario de Valencia (INCLIVA)
| | - Milagros Rocha
- Foundation for the Promotion of Healthcare and Biomedical Research in the Valencian Community, Service of Endocrinology, Valencia, Spain; and Fundación para la Investigación del Hospital Clínico Universitario de Valencia (INCLIVA)
| | - Antonio Hernández-Mijares
- Foundation for the Promotion of Healthcare and Biomedical Research in the Valencian Community, Service of Endocrinology, Valencia, Spain; and Fundación para la Investigación del Hospital Clínico Universitario de Valencia (INCLIVA), Department of Medicine, and
| | - Victor M Victor
- Foundation for the Promotion of Healthcare and Biomedical Research in the Valencian Community, Service of Endocrinology, Valencia, Spain; and Fundación para la Investigación del Hospital Clínico Universitario de Valencia (INCLIVA), Department of Physiology, University of Valencia, Valencia, Spain
| | - Reinald Pamplona
- Department of Experimental Medicine, University of Lleida-Biomedical Research Institute of Lleida, Lleida, Spain;
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Lipidomics: Potential role in risk prediction and therapeutic monitoring for diabetes and cardiovascular disease. Pharmacol Ther 2014; 143:12-23. [DOI: 10.1016/j.pharmthera.2014.02.001] [Citation(s) in RCA: 117] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Accepted: 01/27/2014] [Indexed: 01/07/2023]
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12
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Lamaziere A, Wolf C, Quinn PJ. How lipidomics provides new insight into drug discovery. Expert Opin Drug Discov 2014; 9:819-36. [DOI: 10.1517/17460441.2014.914026] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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