Medical Cannabis and Cannabinoids最新文献

{"title":"Cannabidiol (CBD) Oil Does Not Display an Entourage Effect in Reducing Cancer Cell Viability in vitro.","authors":"Wesley M Raup-Konsavage,&nbsp;Nurgul Carkaci-Salli,&nbsp;Kelly Greenland,&nbsp;Robert Gearhart,&nbsp;Kent E Vrana","doi":"10.1159/000510256","DOIUrl":"https://doi.org/10.1159/000510256","url":null,"abstract":"<p><strong>Introduction: </strong>Several studies have found that cannabinoids, particularly delta-9-tetrahydrocannabinol and cannabidiol (CBD), have the ability to reduce cancer cell viability. An ongoing debate regarding the use of medical Cannabis revolves around the effectiveness of pure compounds versus intact plant material for treatment. Proponents for the use of intact plant material or botanical extracts argue that there is a synergistic effect between the different cannabinoids, terpenoids, and flavonoids; this is commonly referred to as the \"entourage effect.\" Our study was designed to test the validity of the proposed entourage effect in a narrow application using a cancer cell viability model.</p><p><strong>Materials and methods: </strong>Six cancer cell lines, from 3 different types of human cancer were treated with 10 μM pure CBD or 10 μM CBD from hemp (<i>Cannabis sativa</i>) oil (obtained from 3 different commercial sources) for 48 h, and cell viability was measured with the MTS assay. Dose-response curves were then performed to compare the potencies of pure CBD to CBD oils. CBD concentrations were independently confirmed in the commercial oils, and cannabinoid and terpene composition were also compared.</p><p><strong>Results: </strong>CBD (10 μM) was able to reduce cell viability in 3 of the 6 cell lines tested, and this was found to be cell line specific and not specific to select cancers. None of the CBD oils tested were able to reduce viability to a greater extent than that of pure CBD. Additionally, dose-response curves found lower IC₅₀ values for pure CBD compared to the most potent CBD oil tested. Interestingly, some oils actually appeared to protect cancer cells from the effects of CBD.</p><p><strong>Conclusions: </strong>We found that pure CBD was as potent or more potent at reducing cancer cell viability as the most potent oil tested, suggesting that there is no \"entourage\" effect under these specific in vitro conditions.</p>","PeriodicalId":18415,"journal":{"name":"Medical Cannabis and Cannabinoids","volume":"3 2","pages":"95-102"},"PeriodicalIF":0.0,"publicationDate":"2020-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000510256","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39539402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of Light Spectra on the Production of Cannabinoids.","authors":"Pascal Amrein, Stefan Rinner, Tindaro Pittorino, Joan Espel, David Schmidmayr","doi":"10.1159/000510146","DOIUrl":"10.1159/000510146","url":null,"abstract":"<p><p>In recent years, more attention has been paid to cannabis from both medical and political points of view. This study investigates the influence of 5 different light spectra on the active substance content in THC-poor hemp of the Alessia chemotype II variety. The focus is on comparing conventional growing under metal halide lamps with growing under high-pressure sodium (HPS) vapor lamps with regard to different spectra of LED lighting modules. Growing was carried out in 10 growing boxes under controlled and mostly identical conditions for all boxes. The photoperiod during the vegetative phase was 18 h light and photosynthetic photon flux density ∼520 μmol⋅m^-2 s^-1. The flowering phase was 12 h light and ∼540 μmol⋅m^-2 s^-1. During the experiment, CO₂, temperature, and humidity were measured and logged. Additionally, weekly measurements of chlorophyll, electric conductivity of the fertilizer, activity measurement (salt content) of the soil, and pH value of the soil were checked. The content of cannabinoids was measured by high-performance liquid chromatography (HPLC). Plant height and growth were monitored during the whole experiment by cameras taking pictures every 30 min and loading them onto a cloud storage platform. Cannabinoid content was measured using HPLC. Plant wet weight was determined at the end of the experiment and showed that plants under the high pressure lamp treatment had less flower weight than those under the LED treatment. In conclusion, it could be shown that certain LED spectra can considerably increase the amount of cannabinoids with respect to conventional illumination (HPS).</p>","PeriodicalId":18415,"journal":{"name":"Medical Cannabis and Cannabinoids","volume":"3 2","pages":"103-110"},"PeriodicalIF":0.0,"publicationDate":"2020-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8489333/pdf/mca-0003-0103.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39539403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cannabinoids and COVID-19.","authors":"Myriam El Biali,&nbsp;Barbara Broers,&nbsp;Marie Besson,&nbsp;Jules Demeules","doi":"10.1159/000510799","DOIUrl":"10.1159/000510799","url":null,"abstract":"<p><p>Since the endocannabinoid system is involved in immune function, the effect of cannabinoid intake on infectious conditions is questioned for several years and is of particular interest in the COVID 19 pandemia. Some data suggest that the immunomodulatory effect of cannabinoids may affect the course and severity of SARS-CoV-2 infection. Given the large number of cannabinoids consumers in the community, this commentary presents the current knowledge on the potential impact of cannabinoids and endocannabinoids on bacterial and viral infection courses namely SARS-CoV-2 disease. Practical recommendations, which can be drawn from the literature, are given.</p>","PeriodicalId":18415,"journal":{"name":"Medical Cannabis and Cannabinoids","volume":"3 2","pages":"111-115"},"PeriodicalIF":0.0,"publicationDate":"2020-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000510799","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39535230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of Cannabidiol, Δ⁹-Tetrahydrocannabinol, and Their Acids in CBD Oil/Hemp Oil Products.","authors":"Mahmoud A ElSohly,&nbsp;Timothy P Murphy,&nbsp;Ikhlas Khan,&nbsp;Larry W Walker,&nbsp;Waseem Gul","doi":"10.1159/000509550","DOIUrl":"https://doi.org/10.1159/000509550","url":null,"abstract":"<p><p>Hemp products are readily available and are aggressively marketed for their health and medicinal benefits. Most consumers of these products are interested because of cannabidiol (CBD), which has taken the natural products industry by storm. The CBD and Δ⁹-tetrahydrocannabinol (Δ⁹-THC) concentrations in these products are often absent, and even where labeled, the accuracy of the label amounts is often questionable. In order to gain a better understanding of the CBD content, fifty hemp products were analyzed by gas chromatography coupled with mass spectrometry (GC-MS) for CBD, Δ⁹-THC, tetrahydrocannabinolic acid (Δ⁹-THCAA), and cannabidiolic acid (CBDA). Δ⁹-THCAA and CBDA are the natural precursors of Δ⁹-THC and CBD in the plant material. Decarboxylation to Δ⁹-THC and CBD is essential to get the total benefit of the neutral cannabinoids. Therefore, analysis for the neutral and acid cannabinoids is important to get a complete picture of the chemical profile of the products. The GC-MS method used for the analysis of these products was developed and validated. A 10-m × 0.18-mm DB-1 (0.4 μ film) column was used for the analysis. The majority of the hemp products were oils, one of the products was hemp butter, one was a concentrated hemp powder capsule, and another was a hemp extract capsule. Most of the products contained less than 0.1% CBD and less than 0.01% Δ⁹-THC. Three products contained 0.1-1% CBD, and 2 products contained 0.1-0.9% Δ⁹-THC. All of the samples appeared to be decarboxylated since the CBDA and Δ⁹-THCAA results were less than 0.001%. The developed method is simple, sensitive, and reproducible for the detection of Δ⁹-THC, Δ⁹-THCAA, CBD, and CBDA in CBD oil/hemp products.</p>","PeriodicalId":18415,"journal":{"name":"Medical Cannabis and Cannabinoids","volume":"3 1","pages":"1-13"},"PeriodicalIF":0.0,"publicationDate":"2020-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000509550","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39539457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Terpenes/Terpenoids in <i>Cannabis</i>: Are They Important?","authors":"Lumír Ondřej Hanuš,&nbsp;Yotam Hod","doi":"10.1159/000509733","DOIUrl":"10.1159/000509733","url":null,"abstract":"<p><p><i>Cannabis sativa</i> plant has not only cannabinoids as crucial compounds but also the other compounds that play important role as synergistic and/or entourage compound. Cannabis/hemp plant materials and essential oils were analyzed with the help of gas chromatography/mass spectrometry detector for the content of terpenes and terpenoids. The main terpenes/terpenoids and their abundance in the samples were evaluated. Results of this study will be helpful in the next evaluation of these compound in mixture with cannabinoids and their importance in medical treatment.</p>","PeriodicalId":18415,"journal":{"name":"Medical Cannabis and Cannabinoids","volume":"3 1","pages":"25-60"},"PeriodicalIF":0.0,"publicationDate":"2020-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000509733","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39539459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delta-9-Tetrahydrocannabinol and Cannabidiol Drug-Drug Interactions.","authors":"Paul T Kocis, Kent E Vrana","doi":"10.1159/000507998","DOIUrl":"10.1159/000507998","url":null,"abstract":"<p><p>Although prescribing information (PI) is often the initial source of information when identifying potential drug-drug interactions, it may only provide a limited number of exemplars or only reference a class of medications without providing any specific medication examples. In the case of medical cannabis and medicinal cannabinoids, this is further complicated by the fact that the increased therapeutic use of marijuana extracts and cannabidiol oil will not have regulatory agency approved PI. The objective of this study was to provide a detailed and comprehensive drug-drug interaction list that is aligned with cannabinoid manufacturer PI. The cannabinoid drug-drug interaction information is listed in this article and online supplementary material as a PRECIPITANT (cannabinoid) medication that either INHIBITS/INDUCES the metabolism or competes for the same SUBSTRATE target (metabolic enzyme) of an OBJECT (OTHER) medication. In addition to a comprehensive list of drug-drug interactions, we also provide a list of 57 prescription medications displaying a narrow therapeutic index that are potentially impacted by concomitant cannabinoid use (whether through prescription use of cannabinoid medications or therapeutic/recreational use of cannabis and its extracts).</p>","PeriodicalId":18415,"journal":{"name":"Medical Cannabis and Cannabinoids","volume":"3 1","pages":"61-73"},"PeriodicalIF":0.0,"publicationDate":"2020-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8489344/pdf/mca-0003-0061.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39539461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential Treatment for Overdose with Synthetic Cannabinoids.","authors":"Grant Meredith,&nbsp;Michael DeLollis,&nbsp;Mujeeb U Shad","doi":"10.1159/000506635","DOIUrl":"https://doi.org/10.1159/000506635","url":null,"abstract":"Emergency departments are increasingly reporting overdoses with synthetic cannabinoids (SCs), such as K2 and Spice, presenting not only as agitation, paranoia, anxiety, and confusion, but also medical complications, such as palpitations, hypertension, nausea, vomiting, and seizures [1]. Multiple deaths have also been reported with SC overdoses [2]. One of the reasons for such high level of toxicity with SCs is their potent agonist activity at cannabinoid type-1 (CB1) receptor without any action on the cannabinoid type-2 (CB2) receptor, which further adds to the adverse effect profile of SCs, as CB2 receptors have been shown to neutralize some of the CB1 receptor activation. However, in contrast to SCs, delta-9-tetrahydrocannabinol (THC; primary psychoactive substance in botanical marijuana) is a partial agonist at CB1 and CB2 receptors. We believe that it is the difference between partial and full agonism at CB1 receptors that makes the SCs so much more toxic than botanical marijuana or THC. In addition, SCs have longer half-lives along with active metabolites, whereas THC is primarily metabolized into the inactive metabolite 11-nor-9-carboxy-9-tetrahydrocannabinol (THC-COOH). Additionally, the effects of THC in botanical marijuana may also be modified by the presence of other cannabinoids and terpenes within the plant [3]. Cannabidiol (CBD) is another important psychoactive agent in marijuana (usually present at much lower concentrations than THC), which is neither an agonist nor a partial agonist but modifies CB1 receptor activity via allosteric modulation [1]. It is shown to be nonaddictive and safe as reflected by LD50, which is more than 100 times greater than the oral dose [3]. More importantly, CBD has also been shown to have preliminary evidence in the management of atonic seizures [4], social anxiety [5], and psychosis in patients with Parkinson’s disease [6]. In addition, CBD is the only marijuana agent that has been approved by the FDA to manage treatment-refractory seizures in children. Although it is theoretically plausible that partial agonism with THC may neutralize some of the neurotoxic effects of SCs, CBD represents a safer and more acceptable approach to neutralize toxic effects of SCs due to its nonaddictive potential and selective allosteric modulation of CB1 receptors. In this context, CBD may provide a specific antidote to the neurotoxicity with SCs [7]. More importantly, approval of CBD formulation (i.e., EpidiolexTM) can ensure qualitative and quantitative monitoring by the FDA. Therefore, we propose to explore CBD treatment to manage overdose and toxicity with SCs, which is increasingly recognized as a life-threatening emergency, especially in the emergency settings across the United States.","PeriodicalId":18415,"journal":{"name":"Medical Cannabis and Cannabinoids","volume":"3 1","pages":"74-75"},"PeriodicalIF":0.0,"publicationDate":"2020-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000506635","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39539460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstracts - CannX: The International Medical Cannabis Conference Lisbon, Portugal, February 12-13, 2020","authors":"C. Rundle, S. Dercon, P. Lio, J. Fernandez, M. Fujita, R. Dellavalle","doi":"10.1159/000505827","DOIUrl":"https://doi.org/10.1159/000505827","url":null,"abstract":"Cancer is the second leading cause of death globally and is responsible for an estimated 9.6 million deaths in 2018. Reported cases of cancer in both genders are 18.78 million in 2018 with ap-proximately 70% of deaths occurring in low- and middle-income countries, including Pakistan. Breast cancer is the highest reported cancer in Pakistan while prostate cancer constitutes 6.7% of the total cancer burden. Anti-cancer activity of selected plant-derived cannabinoids has been studied in different cancer cell lines showing positive results by some investigators but there is no such report available from Pakistan and the therapeutic potential of Pakistani varieties of Cannabis Sativa remains unexplored. We infer that the variant of C. sativa cultivated in Pakistan is efficacious against human breast cancer and prostate cancer cell lines. This study is planned to evaluate the anticancer properties of different extracts (Flowers, leaves, stem, root, seeds and whole plant extracts) of Cannabis Sativa cultivated in Pakistan against human breast cancer cell lines (MCF-7 and MDA-MB-231) and prostate cancer cell lines (PC3 and LNCaP). All plant material will be dry and powdered in pharmacology laboratory. Each plant material will be soaked in aqueous methanol (30:70) for three days at room temperature and 1st, 2nd, and 3rd filtrates will be obtained using a muslin cloth and Whatman filter paper. The filtrates will be com-bined together and solvent will be removed using a rotary-evapo-rator under reduced pressure, to yield/obtained respective Cannabis sativa thick extract. An intramural grant has been procured for this study. Results will be shared during the research presentation. Delta-9-tetrahydrocannabinol (THC) is the main phytocan-nabinoid in “Cannabis sativa”. Cannabis use by pregnant women to relieve morning sickness has been increasing, as reported by various epidemiological studies. Diverse processes are involved in the remodelling of trophoblast cells, such as proliferation, differentiation, apoptosis and invasion, which are crucial for placental development. The consumption of cannabis during pregnancy is of much concern since it may disrupt the endocannabinoid system (ECS) which modulates several biological functions, including re-production. Our group demonstrated that THC has an impact on trophoblast turnover, through induction of apoptosis, as well as on the ECS homeostasis. Considering the relevance of cannabinoid signalling in reproductive tissues, women of child-bearing age may be a particularly sensitive group to cannabinoids exposure. Thus, it is important to understand the consequences of this exposure on reproductive health. The aim of this work was to study the effects of THC on trophoblast cells, using BeWo and HTR-8 (ATCC, USA) cell lines, well-accepted models of cytotrophoblasts (“stem cells”) and extravillous/invasive trophoblasts, respectively. It was observed that THC induces a dose-dependent decrease in cell vi-ability although ","PeriodicalId":18415,"journal":{"name":"Medical Cannabis and Cannabinoids","volume":"3 1","pages":"116 - 131"},"PeriodicalIF":0.0,"publicationDate":"2020-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000505827","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48610729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Evaluation of Regulatory Regimes of Medical Cannabis: What Lessons Can Be Learned for the UK?","authors":"Anne Katrin Schlag","doi":"10.1159/000505028","DOIUrl":"https://doi.org/10.1159/000505028","url":null,"abstract":"<p><p>This paper evaluates current regulatory regimes of medical cannabis using peer-reviewed and grey literature as well as personal communications. Despite the legalization of medical cannabis in the UK in November 2018, patients still lack access to the medicine, with fewer than 10 NHS prescriptions having been written to date. We look at six countries that have been at the forefront of prescribing medical cannabis, including case studies of the three largest medical cannabis markets in the EU: Germany, Italy, and the Netherlands. Canada, Israel and Australia add global examples. These countries have a more successful history of prescribing medical cannabis than the UK. Their legislations are outlined and numbers of medical cannabis prescriptions are provided to give an indication of how successful their regulatory regime has been in providing patient access. Evaluating countries' medical cannabis regulations allows us to offer implications for lessons to be learned for the development of a successful medical cannabis regime in the UK.</p>","PeriodicalId":18415,"journal":{"name":"Medical Cannabis and Cannabinoids","volume":"3 1","pages":"76-83"},"PeriodicalIF":0.0,"publicationDate":"2020-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000505028","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39539462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a Vaping Machine for the Sampling of THC and CBD Aerosols Generated by Two Portable Dry Herb Cannabis Vaporisers.","authors":"Laura Carrara,&nbsp;Christian Giroud,&nbsp;Nicolas Concha-Lozano","doi":"10.1159/000505027","DOIUrl":"10.1159/000505027","url":null,"abstract":"<p><p><i>Cannabis sativa</i> is known for its recreational use, but also for its therapeutic potential. There has been wide discussion over the use of cannabis for medical purposes in recent years, especially because a consensus has not been reached regarding its risk/benefit balance. Among the more common modes of administration, vaping with a vaporiser is most frequently used for self-medication. Vaping seems to be a better alternative to preventing adverse health effects due to toxic compounds produced during combustion when cannabis is smoked. However, the delivery kinetics and efficiency of most portable vaporisers are not fully characterised with an appropriate vaping regime. This determination requires a specific vaping machine operating under realistic puffing conditions. In this study, a vaping machine was conceived to fit with the common uses of portable vaporisers that requires conditions different from those used for electronic cigarettes. The experimental setup in this study was optimised to sample aerosolised cannabinoids. The delivery kinetics, efficiency, and decarboxylation yields of two commercially available vaporisers (DaVinci® and Mighty Medic®) were evaluated for delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD). Among all tested sampling supports, the glass fibre filter is the most efficient medium to collect mixed THC and CBD aerosols. From the delivery kinetics of cannabinoids, a single-parameter model was used to calculate the extraction coefficient of each vaporiser. The results show that the Mighty Medic® vaporiser had a higher extraction coefficient (0.39) and a more immediate release of cannabinoids than the DaVinci® vaporiser (0.16), which had a gradual and slower rate of vaporisation. This parameter could be a quantitative input in pharmacokinetic models of administration of volatile compounds using vaporisers and a useful tool for the comparison of vaporisers.</p>","PeriodicalId":18415,"journal":{"name":"Medical Cannabis and Cannabinoids","volume":"3 1","pages":"84-93"},"PeriodicalIF":0.0,"publicationDate":"2020-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000505027","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39539463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}