ToxiconPub Date : 2025-01-01DOI: 10.1016/j.toxicon.2024.108220
Sofiane Chaib , Corentin Grenier , Alexandr Gish , Florian Hakim , Axelle Balgairies , Jocelyn Pollard , Emmanuel Robin , Valéry Hédouin , Patrick Nisse , Delphine Allorge , Jean-Michel Gaulier
{"title":"Simultaneous death of two siblings, a Senna matter?","authors":"Sofiane Chaib , Corentin Grenier , Alexandr Gish , Florian Hakim , Axelle Balgairies , Jocelyn Pollard , Emmanuel Robin , Valéry Hédouin , Patrick Nisse , Delphine Allorge , Jean-Michel Gaulier","doi":"10.1016/j.toxicon.2024.108220","DOIUrl":"10.1016/j.toxicon.2024.108220","url":null,"abstract":"<div><div>Senna is a medicinal herb commonly used as a laxative and dietary aid for weight loss. Repeated consumption of Senna may lead to persistent diarrhea. Furthermore, cases of acute liver failure and hepato-encephalopathic syndrome after chronic Senna ingestion were reported in literature.</div><div>In this situation, this manuscript aims to report and discuss two simultaneous fatalities putatively related to Senna repeated ingestions with analytical documentation. Two siblings in their thirties, who had no notable medical history except being overweight, passed away within two days of each other. Their family revealed that they had been regularly consuming Senna for weight loss purposes. Samples of leaves, supposed to be Senna, were analyzed and the identification of Senna was confirmed by detecting its main component (sennosides). Moreover, analyses of samples from siblings confirmed the effectiveness of Senna consumption by detection of Senna related substances (rheinanthrone and aloe-emodine) in urine, bile and feces. In view of these results, rheinanthrone and aloe-emodin can be suggested as analytical targets, particularly in urine, as biomarkers of Senna exposure. In these two fatalities, analytical data and metabolism studies confirmed use, but not necessarily toxicity. However, on a forensic point of view, the similarities in symptoms and the surprising simultaneity of the clinical events leading to fatalities suggest Senna exposure as the main hypothesis to explain these simultaneous deaths.</div></div>","PeriodicalId":23289,"journal":{"name":"Toxicon","volume":"254 ","pages":"Article 108220"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ToxiconPub Date : 2025-01-01DOI: 10.1016/j.toxicon.2024.108211
Emiro G. Muniz , Ida S. Sano-Martins , Maria das Graças G. Saraiva , Evela S. Magno , Sâmella S. Oliveira
{"title":"Ability of brazilian Bothrops-Lachesis-Crotalus antivenom in neutralizing some biological activities of Crotalus durissus ruruima rattlesnake venom","authors":"Emiro G. Muniz , Ida S. Sano-Martins , Maria das Graças G. Saraiva , Evela S. Magno , Sâmella S. Oliveira","doi":"10.1016/j.toxicon.2024.108211","DOIUrl":"10.1016/j.toxicon.2024.108211","url":null,"abstract":"<div><div>We evaluated the efficacy of freeze-dried <em>Bothrops</em>-<em>Lachesis</em>-<em>Crotalus</em> antivenom and liquid <em>Crotalus</em> antivenoms to neutralize <em>Crotalus durissus ruruima</em> (<em>Cdr</em>) venom (Roraima, Brazil) comparing with <em>C. d. terrificus</em> (<em>Cdt</em>) venom. Lethal and phospholipase A<sub>2</sub> activities were similar between both spp. Crotamine was negative and individual <em>Cdr</em> venoms induced hemorrhage in mice. It was lower coagulant than <em>Cdt</em> venom. Only <em>Bothrops</em>-<em>Lachesis</em>-<em>Crotalus</em> antivenom neutralized all biological activities evaluated, suggesting that it could be used in snakebites in this region.</div></div>","PeriodicalId":23289,"journal":{"name":"Toxicon","volume":"254 ","pages":"Article 108211"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ToxiconPub Date : 2025-01-01DOI: 10.1016/j.toxicon.2024.108214
Shiyu Xue , Weilian Bao , Jiaren Lyu , Changyue Wang , Yunyi Zhang , Hong Li , Daofeng Chen , Yan Lu
{"title":"In vitro nephrotoxicity and structure-toxicity relationships of eight natural aristolactams","authors":"Shiyu Xue , Weilian Bao , Jiaren Lyu , Changyue Wang , Yunyi Zhang , Hong Li , Daofeng Chen , Yan Lu","doi":"10.1016/j.toxicon.2024.108214","DOIUrl":"10.1016/j.toxicon.2024.108214","url":null,"abstract":"<div><div>The structural similarity between aristolactams (ALs) and aristolochic acids (AAs) raises constant concerns about the safety of ALs-containing plants. Natural ALs are distributed more extensively than AAs, leading to a higher risk of ALs exposure in daily consumption. This study aimed to evaluate and compare the <em>in vitro</em> nephrotoxicity on human renal tubular epithelial cells (HK-2 cells) of eight natural ALs with different substituents on the phenanthrene ring and amide ring, including aristolactam Ⅰ (AL Ⅰ), AL BⅡ, velutinam, AL AⅡ, sauristolactam, AL AⅠa, AL FⅠ and <em>N</em>-methyl piperolactam A. Their IC<sub>50</sub> values of cell viability were tested by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, and enzyme-linked immunosorbent assay (ELISA) was used to determine the levels of kidney injury molecule-1 (KIM-1), transforming growth factor-β1 (TGF-β1) and fibronectin (FN). The reactive oxygen species (ROS) assay was used to detect the intracellular oxidative stress level. The results showed that the eight ALs all had specific nephrotoxicity on HK-2 cells. Particularly, AL Ⅰ, AL BⅡ and velutinam exhibited more potent cytotoxicity on HK-2 cells (IC<sub>50</sub> = 2.49–2.78 μM) than the other five ALs (IC<sub>50</sub> = 12.33–43.84 μM). The structure-toxicity relationships indicated that both methylenedioxy (-OCH<sub>2</sub>O-) and methoxy (-OCH<sub>3</sub>) were positively contributing functional groups of ALs on nephrotoxicity, while the hydroxy group (-OH) and methyl substitution on nitrogen (<em>N</em>-CH<sub>3</sub>) accounted for a detrimental effect conversely. Consistent with this structure-toxicity relationship, the eight ALs increased KIM-1 levels in the same trend as their cytotoxicity at the same concentration of 2.5 μg/mL, associating with different levels of ROS generation. And the four most toxic ALs, AL Ⅰ, AL BⅡ, velutinam and AL AⅡ, could also induce fibrosis by increasing TGF-β1 and FN levels.</div></div>","PeriodicalId":23289,"journal":{"name":"Toxicon","volume":"254 ","pages":"Article 108214"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ToxiconPub Date : 2025-01-01DOI: 10.1016/j.toxicon.2024.108216
Abhinandan Chowdhury , Bryan G. Fry , Stephen P. Samuel , Ashish Bhalla , Sakthivel Vaiyapuri , Parul Bhargava , Rebecca W. Carter , Matthew R. Lewin
{"title":"Corrigendum to “In vitro anticoagulant effects of Bungarus venoms on human plasma which are effectively neutralized by the PLA2-inhibitor varespladib” [Toxicon Volume 252, December 2024, 108178]","authors":"Abhinandan Chowdhury , Bryan G. Fry , Stephen P. Samuel , Ashish Bhalla , Sakthivel Vaiyapuri , Parul Bhargava , Rebecca W. Carter , Matthew R. Lewin","doi":"10.1016/j.toxicon.2024.108216","DOIUrl":"10.1016/j.toxicon.2024.108216","url":null,"abstract":"","PeriodicalId":23289,"journal":{"name":"Toxicon","volume":"254 ","pages":"Article 108216"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ToxiconPub Date : 2025-01-01DOI: 10.1016/j.toxicon.2024.108218
Kristian A. Torres-Bonilla , Juan D. Bayona-Serrano , Paula A. Sáenz-Suarez , Débora Andrade-Silva , Manuel H. Bernal-Bautista , Solange M.T. Serrano , Stephen Hyslop
{"title":"Venom proteomics and Duvernoy's venom gland histology of Pseudoboa neuwiedii (Neuwied's false boa; Dipsadidae, Pseudoboini)","authors":"Kristian A. Torres-Bonilla , Juan D. Bayona-Serrano , Paula A. Sáenz-Suarez , Débora Andrade-Silva , Manuel H. Bernal-Bautista , Solange M.T. Serrano , Stephen Hyslop","doi":"10.1016/j.toxicon.2024.108218","DOIUrl":"10.1016/j.toxicon.2024.108218","url":null,"abstract":"<div><div>The venom of Colombian specimens of the rear-fanged snake <em>Pseudoboa neuwiedii</em> contains proteolytic and phospholipase A<sub>2</sub> (PLA<sub>2</sub>) activities, but is devoid of esterases. Mass spectrometric analysis of electrophoretic bands indicated that this venom contains C-type lectins (CTL), cysteine-rich secretory proteins (CRiSP), PLA<sub>2</sub>, snake venom metalloproteinases (SVMP), and snake venom matrix metalloproteinases (svMMP). In this investigation, we extended our characterization of <em>P. neuwiedii</em> by undertaking a shotgun proteomic analysis of the venom and comparing the results with a transcriptomic database for Brazilian <em>P. neuwiedii</em>; proteomic data previously obtained by in-gel digestion of electrophoretic bands coupled with mass spectrometry were also reanalyzed by comparing them with the transcriptomic results. The histology of the Duvernoy's venom gland was also examined. Histological analysis revealed a structural organization similar to that of other colubrids that consisted of a serous venom gland and a mucous supralabial gland. When the shotgun proteomic data were run against a general UniProt database for serpents, only metalloproteinases were identified (99% SVMPs, 1% snake endogenous matrix metalloproteinases-9 or seMMP-9). In contrast, when run against a transcriptomic database derived from the venom gland of Brazilian <em>P. neuwiedii</em> that contains predominantly SVMP, CRiSP, type IIE PLA<sub>2</sub> (PLA<sub>2</sub>-IIE), CTL and seMMP-9, the main components identified were seMMP-9 (49%), SVMP (47%), CRiSP (3%) and minor components that included CTL and PLA<sub>2</sub>-IIE. These findings confirmed the previously reported general composition of <em>P. neuwiedii</em> venom, with metalloproteinases (SVMP and seMMP-9) being the major components, and refined the identification of certain components, e.g., type IIA PLA<sub>2</sub> now identified as PLA<sub>2</sub>-IIE and the detection of seMMP-9 rather than svMMP. The data also indicate compositional similarity between Brazilian and Colombian <em>P. neuwiedii</em> venoms, and stress the need for specific databases for non-front-fanged colubroid snakes to allow accurate and more comprehensive identification of the venom components of these snakes.</div></div>","PeriodicalId":23289,"journal":{"name":"Toxicon","volume":"254 ","pages":"Article 108218"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ToxiconPub Date : 2025-01-01DOI: 10.1016/j.toxicon.2024.108222
Danica Lennox-Bulow, Robert Courtney, Jamie Seymour
{"title":"Geographic variation in stonefish (Synanceia spp.) venom","authors":"Danica Lennox-Bulow, Robert Courtney, Jamie Seymour","doi":"10.1016/j.toxicon.2024.108222","DOIUrl":"10.1016/j.toxicon.2024.108222","url":null,"abstract":"<div><div>Stonefish (<em>Synanceia</em> spp.) possess a medically significant venom and are widely distributed throughout the Indo-Pacific. Yet, little is known about how the ecology of these animals may influence their venom. The aim of this study was to explore the effect of species and geographic location on stonefish venom composition. We collected the venom of <em>Synanceia horrida</em> (Estuarine Stonefish) and <em>Synanceia verrucosa</em> (Reef Stonefish) from various locations across Australia (Cairns, Brisbane, Caloundra, and Onslow), and Southeast Asia (Kota Kinabalu, and Cebu) and analysed these samples using SDS-PAGE, FPLC, and HPLC. Stonefish have a complex venom comprised of numerous components. Stonefish venom exhibited both similarities and variations in composition within species between geographically isolated populations, as well as between species in a single location. We speculate that the observed geographic and interspecific trends may be driven by similarities and differences in the selective pressures faced by these animals, particularly those associated with predator dynamics. The findings of this study have furthered our understanding of the ecology of stonefish and their toxins.</div></div>","PeriodicalId":23289,"journal":{"name":"Toxicon","volume":"254 ","pages":"Article 108222"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ToxiconPub Date : 2025-01-01DOI: 10.1016/j.toxicon.2024.108223
Elaine R.M. de Almeida , Silvana L. Górniak , Cláudia Momo , Vinicius L.S. Ferreira , Edimar C. Pereira , Isis M. Hueza
{"title":"Prenatal toxicity of L-mimosine in Wistar rats","authors":"Elaine R.M. de Almeida , Silvana L. Górniak , Cláudia Momo , Vinicius L.S. Ferreira , Edimar C. Pereira , Isis M. Hueza","doi":"10.1016/j.toxicon.2024.108223","DOIUrl":"10.1016/j.toxicon.2024.108223","url":null,"abstract":"<div><div>L-Mimosine is the main active component of the plant <em>Leucaena leucocephala</em>. Due to its metal-chelating mechanism, it interacts with various metabolic pathways in living organisms, making it a potential pharmacological target, although it also leads to toxicity. The present study aimed to investigate the transplacental passage of L-mimosine and its effects on embryofetal development. Pregnant Wistar rats were divided into control groups (CO2; n = 8 or CO3; n = 6, according to experimental design 2 or 3) that received only the vehicle, and groups that received doses of 60 (n = 9), 100 (n = 8), 140 (n = 9), and 240 (n = 7) mg/kg of L-mimosine from gestational day (GD) 6–19. For the transplacental analysis, five rats were used: two as controls and three treated with a dose of 140 mg/kg L-mimosine from GD12 to 14. All the animals received food and water <em>ad libitum</em>. The parameters analyzed were body weight gain; water and food consumption; serum biochemistry; blood cell counts; reproductive indices; and histopathological, visceral and skeletal analyses of the fetuses. In the groups that received doses of 60, 100, and 140 mg/kg, alterations (<em>P</em> < 0.05) in the skeletal development of the fetuses were observed. In the 240 mg/kg group, a decrease (<em>P</em> < 0.05) in total food consumption; a decrease (<em>P</em> < 0.05) in absolute leukocyte and neutrophil counts; alterations (<em>P</em> < 0.05) in the levels of ALT, GGT, and creatinine enzymes; a decrease (<em>P</em> < 0.05) in the relative weight of the thymus along with a loss of the corticomedullary distinction; coalescence of lymphoid follicles in the spleen; and skeletal and visceral alterations and alopecia were observed. L-Mimosine was detected in the amniotic fluid of the rats. These results demonstrate the complex action of L-mimosine, leading to toxic effects on both dams and fetuses, highlighting the risk of exposure to this substance during the perinatal period, which negatively impacts embryo/fetal and neonatal growth and development.</div></div>","PeriodicalId":23289,"journal":{"name":"Toxicon","volume":"254 ","pages":"Article 108223"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ToxiconPub Date : 2024-12-01DOI: 10.1016/j.toxicon.2024.108163
Peshala Gunasekara , S.M. Handunnetti , Sunil Premawansa , W.M.D.K. Dasanayake , Indra P. Ratnayake , R.K.S. Dias , G.A.S. Premakumara , Suranjith L. Seneviratne , Rajiva de Silva
{"title":"Impact of environmental factors on Apis dorsata (giant Asian honeybee) venom in Bandarawela, Sri Lanka","authors":"Peshala Gunasekara , S.M. Handunnetti , Sunil Premawansa , W.M.D.K. Dasanayake , Indra P. Ratnayake , R.K.S. Dias , G.A.S. Premakumara , Suranjith L. Seneviratne , Rajiva de Silva","doi":"10.1016/j.toxicon.2024.108163","DOIUrl":"10.1016/j.toxicon.2024.108163","url":null,"abstract":"<div><div><em>Apis dorsata</em> stings are amongst the most frequent insect-stings in Sri Lanka. <em>A. dorsata</em> venom consists of a mixture of components including PLA<sub>2</sub>, melittin, hyaluronidase and apamin. However, there are no studies done in Sri Lanka to evaluate the environmental influence in venom production. We, herein, tried to correlate the variations in those four venom components of <em>A. dorsata</em> with environmental factors (temperature, rainfall, wind speed and relative humidity). The venom components were analyzed using high-performance liquid chromatography (HPLC) and variations in environmental factors were gathered from the Department of Meteorology, Sri Lanka. Of the four components, PLA<sub>2</sub> (r = 0.718; p = 0.009 and r = 0.636; p = 0.026) and melittin r = 0.734; p = 0.007 and r = 0.582; p = 0.047) showed significant correlations with temperature and wind speed, respectively. Whilst relative humidity showed significant negative correlations with PLA<sub>2</sub> (r = - 0.634; p = 0.027) and melittin (r = −0.643; p = 0.024). There was no significant correlation of climatic parameters with hyaluronidase or apamin. The results indicated a variation in the composition of venom components with the month in which the venom was collected due to climatic influence and it should be considered when therapeutic grade venom preparations are produced.</div></div>","PeriodicalId":23289,"journal":{"name":"Toxicon","volume":"252 ","pages":"Article 108163"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142626538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Toxicological consequences of yellowjacket wasp and its larvae entomophagy in Himalayan region of Nepal; case report and review of literature","authors":"Aayush Adhikari , Rajesh Sharma , Ishwor Thapaliya , Resona Simkhada , Pratik Baral , Mahima Acharya , Sushil Kumar Yadav , Sishir Poudel , Sunil B.K.","doi":"10.1016/j.toxicon.2024.108153","DOIUrl":"10.1016/j.toxicon.2024.108153","url":null,"abstract":"<div><div>Entomophagy, or insect consumption, is a common traditional practice in Asia, Africa, and South America including Nepal. Despite its longstanding cultural presence, there is limited literature on the toxicological effects of ingesting wasp larvae. This case report describes seven individuals who experienced toxicity after consuming pan-fried yellowjacket wasp larvae in August 2023. Symptoms included seizures, nausea, dizziness, blurred vision, and cardiovascular instability. The cases varied in severity, with some patients exhibiting profound hypotension and neurological symptoms. The symptoms suggest possible neurotoxic effects of venom components in wasp larvae, though some studies indicate larvae may lack venom glands. The slow progression and severity of symptoms highlight the need for further investigation into the toxicological profile of wasp larvae. Future research should focus on identifying specific venom components of yellowjackets, examining cooking impacts on toxicity, and exploring venom variations across wasp species to improve treatment approaches and safety protocols.</div></div>","PeriodicalId":23289,"journal":{"name":"Toxicon","volume":"252 ","pages":"Article 108153"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Corrigendum to “Study repair function of mucin-2 on the tight junction protein of uterine epithelial cells under bacterial endotoxins” [Toxicon 252 (2024) 108162]","authors":"Dujian Yan , Mengru Zhou , Tian Tian , Chenchen Wu","doi":"10.1016/j.toxicon.2024.108189","DOIUrl":"10.1016/j.toxicon.2024.108189","url":null,"abstract":"","PeriodicalId":23289,"journal":{"name":"Toxicon","volume":"253 ","pages":"Article 108189"},"PeriodicalIF":2.6,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142756613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}