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A Single Arm Pilot Study of Effects of Berberine on the Menstrual Pattern, Ovulation Rate, Hormonal and Metabolic Profiles in Anovulatory Chinese Women with Polycystic Ovary Syndrome
To evaluate the effects of berberine on the menstrual pattern, ovulation rate, hormonal and metabolic profiles in anovulatory Chinese women with polycystic ovary syndrome. Berberine 0.4 g three times per day was given for four months to 102 anovulatory Chinese women with polycystic ovary syndrome. T...
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Published in: | PloS one 2015-12, Vol.10 (12), p.e0144072-e0144072 |
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description | To evaluate the effects of berberine on the menstrual pattern, ovulation rate, hormonal and metabolic profiles in anovulatory Chinese women with polycystic ovary syndrome.
Berberine 0.4 g three times per day was given for four months to 102 anovulatory Chinese women with polycystic ovary syndrome. The menstrual pattern, ovulation rate, hormonal and metabolic profiles were compared before and after the berberine treatment. Ovulation was confirmed by serum progesterone level ≥10 ng/ml.
A total of 98 of 102 subjects (96.1%) completed the four month treatment, including 69 (70.4%, 69/98) normal weight and 29 (29.6%, 29/98) overweight/obese. Fourteen women (14.3%, 14/98) had regained regular menses after berberine treatment and there was no significant difference between normal weight and overweight/obese groups. The ovulation rate was 25.0% over four months in the whole group, 22.5% in the normal weight group and 31.0% in the overweight/obese group. Sex hormone binding globulin, insulin resistance, total cholesterol, total triglyceride and low-density lipoprotein cholesterol decreased after berberine treatment in the normal weight group only.
Our study found that administration of berberine alone may improve the menstrual pattern and ovulation rate in anovulatory Chinese women with polycystic ovary syndrome. Berberine can also decrease sex hormone binding globulin, insulin resistance, total cholesterol, triglycerides and low-density lipoprotein cholesterol in normal weight polycystic ovary syndrome women.
Chictr.org ChiCTR-OO-13003943. |
doi_str_mv | 10.1371/journal.pone.0144072 |
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Berberine 0.4 g three times per day was given for four months to 102 anovulatory Chinese women with polycystic ovary syndrome. The menstrual pattern, ovulation rate, hormonal and metabolic profiles were compared before and after the berberine treatment. Ovulation was confirmed by serum progesterone level ≥10 ng/ml.
A total of 98 of 102 subjects (96.1%) completed the four month treatment, including 69 (70.4%, 69/98) normal weight and 29 (29.6%, 29/98) overweight/obese. Fourteen women (14.3%, 14/98) had regained regular menses after berberine treatment and there was no significant difference between normal weight and overweight/obese groups. The ovulation rate was 25.0% over four months in the whole group, 22.5% in the normal weight group and 31.0% in the overweight/obese group. Sex hormone binding globulin, insulin resistance, total cholesterol, total triglyceride and low-density lipoprotein cholesterol decreased after berberine treatment in the normal weight group only.
Our study found that administration of berberine alone may improve the menstrual pattern and ovulation rate in anovulatory Chinese women with polycystic ovary syndrome. Berberine can also decrease sex hormone binding globulin, insulin resistance, total cholesterol, triglycerides and low-density lipoprotein cholesterol in normal weight polycystic ovary syndrome women.
Chictr.org ChiCTR-OO-13003943.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0144072</identifier><identifier>PMID: 26645811</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adolescent ; Adult ; Anovulation ; Berberine ; Berberine - pharmacology ; Binding ; Birth rate ; Body mass index ; Body weight ; Care and treatment ; China ; Chinese medicine ; Cholesterol ; Complications and side effects ; Diabetes ; Female ; Globulins ; Gonadal Steroid Hormones - metabolism ; Gynecology ; Humans ; In vitro fertilization ; Infertility ; Influence ; Insulin ; Insulin resistance ; Menstruation ; Menstruation - drug effects ; Metabolism ; Obstetrics ; Overweight ; Ovulation ; Ovulation - drug effects ; Pilot Projects ; Polycystic ovary syndrome ; Polycystic Ovary Syndrome - metabolism ; Polycystic Ovary Syndrome - physiopathology ; Pregnancy ; Progesterone ; Prospective Studies ; Sex ; Sex hormones ; Triglycerides ; Ultrasonic imaging ; Young Adult</subject><ispartof>PloS one, 2015-12, Vol.10 (12), p.e0144072-e0144072</ispartof><rights>COPYRIGHT 2015 Public Library of Science</rights><rights>2015 Li et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2015 Li et al 2015 Li et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-a9a2bb14c3e78b53f93a6a72c89d6898cf152ced331338f58e0e660f4c873b493</citedby><cites>FETCH-LOGICAL-c692t-a9a2bb14c3e78b53f93a6a72c89d6898cf152ced331338f58e0e660f4c873b493</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/1746865496/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/1746865496?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,25733,27903,27904,36991,36992,44569,53769,53771,74872</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26645811$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Baak, Jan P. A.</contributor><creatorcontrib>Li, Lin</creatorcontrib><creatorcontrib>Li, Chengyan</creatorcontrib><creatorcontrib>Pan, Ping</creatorcontrib><creatorcontrib>Chen, Xiaoli</creatorcontrib><creatorcontrib>Wu, Xiaoke</creatorcontrib><creatorcontrib>Ng, Ernest Hung Yu</creatorcontrib><creatorcontrib>Yang, Dongzi</creatorcontrib><title>A Single Arm Pilot Study of Effects of Berberine on the Menstrual Pattern, Ovulation Rate, Hormonal and Metabolic Profiles in Anovulatory Chinese Women with Polycystic Ovary Syndrome</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>To evaluate the effects of berberine on the menstrual pattern, ovulation rate, hormonal and metabolic profiles in anovulatory Chinese women with polycystic ovary syndrome.
Berberine 0.4 g three times per day was given for four months to 102 anovulatory Chinese women with polycystic ovary syndrome. The menstrual pattern, ovulation rate, hormonal and metabolic profiles were compared before and after the berberine treatment. Ovulation was confirmed by serum progesterone level ≥10 ng/ml.
A total of 98 of 102 subjects (96.1%) completed the four month treatment, including 69 (70.4%, 69/98) normal weight and 29 (29.6%, 29/98) overweight/obese. Fourteen women (14.3%, 14/98) had regained regular menses after berberine treatment and there was no significant difference between normal weight and overweight/obese groups. The ovulation rate was 25.0% over four months in the whole group, 22.5% in the normal weight group and 31.0% in the overweight/obese group. Sex hormone binding globulin, insulin resistance, total cholesterol, total triglyceride and low-density lipoprotein cholesterol decreased after berberine treatment in the normal weight group only.
Our study found that administration of berberine alone may improve the menstrual pattern and ovulation rate in anovulatory Chinese women with polycystic ovary syndrome. Berberine can also decrease sex hormone binding globulin, insulin resistance, total cholesterol, triglycerides and low-density lipoprotein cholesterol in normal weight polycystic ovary syndrome women.
Chictr.org ChiCTR-OO-13003943.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Anovulation</subject><subject>Berberine</subject><subject>Berberine - pharmacology</subject><subject>Binding</subject><subject>Birth rate</subject><subject>Body mass index</subject><subject>Body weight</subject><subject>Care and treatment</subject><subject>China</subject><subject>Chinese medicine</subject><subject>Cholesterol</subject><subject>Complications and side effects</subject><subject>Diabetes</subject><subject>Female</subject><subject>Globulins</subject><subject>Gonadal Steroid Hormones - metabolism</subject><subject>Gynecology</subject><subject>Humans</subject><subject>In vitro fertilization</subject><subject>Infertility</subject><subject>Influence</subject><subject>Insulin</subject><subject>Insulin resistance</subject><subject>Menstruation</subject><subject>Menstruation - drug effects</subject><subject>Metabolism</subject><subject>Obstetrics</subject><subject>Overweight</subject><subject>Ovulation</subject><subject>Ovulation - drug effects</subject><subject>Pilot Projects</subject><subject>Polycystic ovary syndrome</subject><subject>Polycystic Ovary Syndrome - metabolism</subject><subject>Polycystic Ovary Syndrome - physiopathology</subject><subject>Pregnancy</subject><subject>Progesterone</subject><subject>Prospective Studies</subject><subject>Sex</subject><subject>Sex hormones</subject><subject>Triglycerides</subject><subject>Ultrasonic imaging</subject><subject>Young Adult</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNqNk99uFCEUxidGY7X6BkZJTIwm3XUYGIa5MVmbapvU7Kbrn0vCMGd2aRiowFT3xXw-mXbbdE0vDBcQ-H0f5xw4WfYC51NMKvz-3A3eSjO9cBamOaY0r4oH2RNck2LCipw8vLPey56GcJ7nJeGMPc72CsZoyTF-kv2ZoaW2KwNo5nu00MZFtIxDu0GuQ0ddByqGcfkRfANeW0DOorgG9AVsiH6QBi1kjODtAZpfDkZGnYAzGeEAHTvfuxQikrZNfJSNM1qhhXedNhCQtmhm3ZXI-Q06XCf7AOiH68GiXzqu0cKZjdqEmFTzS5mY5ca2Pp0_yx510gR4vp33s2-fjr4eHk9O559PDmenE8XqIk5kLYumwVQRqHhTkq4mksmqULxuGa-56nBZKGgJwYTwruSQA2N5RxWvSENrsp-9uva9MC6IbcmDwBVlnJW0Zok4uSZaJ8_Fhdd9ilM4qcXVhvMrIX1KwICgtOlk2TQqh4JWBTSclzWvFeO0Yx2rkteH7W1D00OrwEYvzY7p7onVa7Fyl4KyqkhmyeDt1sC7nwOEKHodFBgjLbjhKu6K4ALnI_r6H_T-7LbUSqYEtO1culeNpmJGSaKKiuFETe-h0mih1yr9z_G9dwXvdgSJifA7ruQQgjhZnv0_O_--y765w65BmrgOzgzjpwy7IL0GlXcheOhui4xzMbbXTTXE2F5i215J9vLuA92KbvqJ_AUwQSHV</recordid><startdate>20151208</startdate><enddate>20151208</enddate><creator>Li, Lin</creator><creator>Li, Chengyan</creator><creator>Pan, Ping</creator><creator>Chen, Xiaoli</creator><creator>Wu, Xiaoke</creator><creator>Ng, Ernest Hung Yu</creator><creator>Yang, Dongzi</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20151208</creationdate><title>A Single Arm Pilot Study of Effects of Berberine on the Menstrual Pattern, Ovulation Rate, Hormonal and Metabolic Profiles in Anovulatory Chinese Women with Polycystic Ovary Syndrome</title><author>Li, Lin ; Li, Chengyan ; Pan, Ping ; Chen, Xiaoli ; Wu, Xiaoke ; Ng, Ernest Hung Yu ; Yang, Dongzi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-a9a2bb14c3e78b53f93a6a72c89d6898cf152ced331338f58e0e660f4c873b493</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Anovulation</topic><topic>Berberine</topic><topic>Berberine - pharmacology</topic><topic>Binding</topic><topic>Birth rate</topic><topic>Body mass index</topic><topic>Body weight</topic><topic>Care and treatment</topic><topic>China</topic><topic>Chinese medicine</topic><topic>Cholesterol</topic><topic>Complications and side effects</topic><topic>Diabetes</topic><topic>Female</topic><topic>Globulins</topic><topic>Gonadal Steroid Hormones - metabolism</topic><topic>Gynecology</topic><topic>Humans</topic><topic>In vitro fertilization</topic><topic>Infertility</topic><topic>Influence</topic><topic>Insulin</topic><topic>Insulin resistance</topic><topic>Menstruation</topic><topic>Menstruation - drug effects</topic><topic>Metabolism</topic><topic>Obstetrics</topic><topic>Overweight</topic><topic>Ovulation</topic><topic>Ovulation - drug effects</topic><topic>Pilot Projects</topic><topic>Polycystic ovary syndrome</topic><topic>Polycystic Ovary Syndrome - metabolism</topic><topic>Polycystic Ovary Syndrome - physiopathology</topic><topic>Pregnancy</topic><topic>Progesterone</topic><topic>Prospective Studies</topic><topic>Sex</topic><topic>Sex hormones</topic><topic>Triglycerides</topic><topic>Ultrasonic imaging</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Li, Lin</creatorcontrib><creatorcontrib>Li, Chengyan</creatorcontrib><creatorcontrib>Pan, Ping</creatorcontrib><creatorcontrib>Chen, Xiaoli</creatorcontrib><creatorcontrib>Wu, Xiaoke</creatorcontrib><creatorcontrib>Ng, Ernest Hung Yu</creatorcontrib><creatorcontrib>Yang, Dongzi</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Li, Lin</au><au>Li, Chengyan</au><au>Pan, Ping</au><au>Chen, Xiaoli</au><au>Wu, Xiaoke</au><au>Ng, Ernest Hung Yu</au><au>Yang, Dongzi</au><au>Baak, Jan P. A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Single Arm Pilot Study of Effects of Berberine on the Menstrual Pattern, Ovulation Rate, Hormonal and Metabolic Profiles in Anovulatory Chinese Women with Polycystic Ovary Syndrome</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2015-12-08</date><risdate>2015</risdate><volume>10</volume><issue>12</issue><spage>e0144072</spage><epage>e0144072</epage><pages>e0144072-e0144072</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>To evaluate the effects of berberine on the menstrual pattern, ovulation rate, hormonal and metabolic profiles in anovulatory Chinese women with polycystic ovary syndrome.
Berberine 0.4 g three times per day was given for four months to 102 anovulatory Chinese women with polycystic ovary syndrome. The menstrual pattern, ovulation rate, hormonal and metabolic profiles were compared before and after the berberine treatment. Ovulation was confirmed by serum progesterone level ≥10 ng/ml.
A total of 98 of 102 subjects (96.1%) completed the four month treatment, including 69 (70.4%, 69/98) normal weight and 29 (29.6%, 29/98) overweight/obese. Fourteen women (14.3%, 14/98) had regained regular menses after berberine treatment and there was no significant difference between normal weight and overweight/obese groups. The ovulation rate was 25.0% over four months in the whole group, 22.5% in the normal weight group and 31.0% in the overweight/obese group. Sex hormone binding globulin, insulin resistance, total cholesterol, total triglyceride and low-density lipoprotein cholesterol decreased after berberine treatment in the normal weight group only.
Our study found that administration of berberine alone may improve the menstrual pattern and ovulation rate in anovulatory Chinese women with polycystic ovary syndrome. Berberine can also decrease sex hormone binding globulin, insulin resistance, total cholesterol, triglycerides and low-density lipoprotein cholesterol in normal weight polycystic ovary syndrome women.
Chictr.org ChiCTR-OO-13003943.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>26645811</pmid><doi>10.1371/journal.pone.0144072</doi><oa>free_for_read</oa></addata></record> |
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subjects | Adolescent Adult Anovulation Berberine Berberine - pharmacology Binding Birth rate Body mass index Body weight Care and treatment China Chinese medicine Cholesterol Complications and side effects Diabetes Female Globulins Gonadal Steroid Hormones - metabolism Gynecology Humans In vitro fertilization Infertility Influence Insulin Insulin resistance Menstruation Menstruation - drug effects Metabolism Obstetrics Overweight Ovulation Ovulation - drug effects Pilot Projects Polycystic ovary syndrome Polycystic Ovary Syndrome - metabolism Polycystic Ovary Syndrome - physiopathology Pregnancy Progesterone Prospective Studies Sex Sex hormones Triglycerides Ultrasonic imaging Young Adult |
title | A Single Arm Pilot Study of Effects of Berberine on the Menstrual Pattern, Ovulation Rate, Hormonal and Metabolic Profiles in Anovulatory Chinese Women with Polycystic Ovary Syndrome |
url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-28T00%3A08%3A32IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=A%20Single%20Arm%20Pilot%20Study%20of%20Effects%20of%20Berberine%20on%20the%20Menstrual%20Pattern,%20Ovulation%20Rate,%20Hormonal%20and%20Metabolic%20Profiles%20in%20Anovulatory%20Chinese%20Women%20with%20Polycystic%20Ovary%20Syndrome&rft.jtitle=PloS%20one&rft.au=Li,%20Lin&rft.date=2015-12-08&rft.volume=10&rft.issue=12&rft.spage=e0144072&rft.epage=e0144072&rft.pages=e0144072-e0144072&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0144072&rft_dat=%3Cgale_plos_%3EA436862761%3C/gale_plos_%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c692t-a9a2bb14c3e78b53f93a6a72c89d6898cf152ced331338f58e0e660f4c873b493%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=1746865496&rft_id=info:pmid/26645811&rft_galeid=A436862761&rfr_iscdi=true |