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Record Information
Version5.0
StatusDetected but not Quantified
Creation Date2021-08-31 18:52:33 UTC
Update Date2021-09-26 22:48:58 UTC
HMDB IDHMDB0242499
Secondary Accession NumbersNone
Metabolite Identification
Common Name(22E)-(24R)-1alpha,24-Dihydroxy-26,27-cyclo-22,23-didehydro-20-epivitamin D3/(22E)-(24R)-1alpha,24-dihydroxy-26,27-cyclo-22,23-didehydro-20-epicholecalciferol
Description5-{2-[1-(5-cyclopropyl-5-hydroxypent-3-en-2-yl)-7a-methyl-octahydro-1H-inden-4-ylidene]ethylidene}-4-methylidenecyclohexane-1,3-diol belongs to the class of organic compounds known as vitamin d and derivatives. Vitamin D and derivatives are compounds containing a secosteroid backbone, usually secoergostane or secocholestane. Based on a literature review very few articles have been published on 5-{2-[1-(5-cyclopropyl-5-hydroxypent-3-en-2-yl)-7a-methyl-octahydro-1H-inden-4-ylidene]ethylidene}-4-methylidenecyclohexane-1,3-diol. This compound has been identified in human blood as reported by (PMID: 31557052 ). (22e)-(24r)-1alpha,24-dihydroxy-26,27-cyclo-22,23-didehydro-20-epivitamin d3/(22e)-(24r)-1alpha,24-dihydroxy-26,27-cyclo-22,23-didehydro-20-epicholecalciferol is not a naturally occurring metabolite and is only found in those individuals exposed to this compound or its derivatives. Technically (22E)-(24R)-1alpha,24-Dihydroxy-26,27-cyclo-22,23-didehydro-20-epivitamin D3/(22E)-(24R)-1alpha,24-dihydroxy-26,27-cyclo-22,23-didehydro-20-epicholecalciferol is part of the human exposome. The exposome can be defined as the collection of all the exposures of an individual in a lifetime and how those exposures relate to health. An individual's exposure begins before birth and includes insults from environmental and occupational sources.
Structure
Thumb
Synonyms
ValueSource
(22E)-(24R)-1a,24-Dihydroxy-26,27-cyclo-22,23-didehydro-20-epivitamin D3/(22E)-(24R)-1a,24-dihydroxy-26,27-cyclo-22,23-didehydro-20-epicholecalciferolGenerator, HMDB
(22E)-(24R)-1Α,24-dihydroxy-26,27-cyclo-22,23-didehydro-20-epivitamin D3/(22E)-(24R)-1α,24-dihydroxy-26,27-cyclo-22,23-didehydro-20-epicholecalciferolGenerator, HMDB
Chemical FormulaC27H40O3
Average Molecular Weight412.614
Monoisotopic Molecular Weight412.297745148
IUPAC Name5-{2-[1-(5-cyclopropyl-5-hydroxypent-3-en-2-yl)-7a-methyl-octahydro-1H-inden-4-ylidene]ethylidene}-4-methylidenecyclohexane-1,3-diol
Traditional Name5-{2-[1-(5-cyclopropyl-5-hydroxypent-3-en-2-yl)-7a-methyl-hexahydro-1H-inden-4-ylidene]ethylidene}-4-methylidenecyclohexane-1,3-diol
CAS Registry NumberNot Available
SMILES
CC(C=CC(O)C1CC1)C1CCC2C(CCCC12C)=CC=C1CC(O)CC(O)C1=C
InChI Identifier
InChI=1S/C27H40O3/c1-17(6-13-25(29)20-8-9-20)23-11-12-24-19(5-4-14-27(23,24)3)7-10-21-15-22(28)16-26(30)18(21)2/h6-7,10,13,17,20,22-26,28-30H,2,4-5,8-9,11-12,14-16H2,1,3H3
InChI KeyLWQQLNNNIPYSNX-UHFFFAOYSA-N
Chemical Taxonomy
Description Belongs to the class of organic compounds known as vitamin d and derivatives. Vitamin D and derivatives are compounds containing a secosteroid backbone, usually secoergostane or secocholestane.
KingdomOrganic compounds
Super ClassLipids and lipid-like molecules
ClassSteroids and steroid derivatives
Sub ClassVitamin D and derivatives
Direct ParentVitamin D and derivatives
Alternative Parents
Substituents
  • Triterpenoid
  • Cyclic alcohol
  • Secondary alcohol
  • Organic oxygen compound
  • Hydrocarbon derivative
  • Organooxygen compound
  • Alcohol
  • Aliphatic homopolycyclic compound
Molecular FrameworkAliphatic homopolycyclic compounds
External DescriptorsNot Available
Ontology
Physiological effectNot Available
Disposition
ProcessNot Available
RoleNot Available
Physical Properties
StateNot Available
Experimental Molecular Properties
PropertyValueReference
Melting PointNot AvailableNot Available
Boiling PointNot AvailableNot Available
Water SolubilityNot AvailableNot Available
LogPNot AvailableNot Available
Experimental Chromatographic PropertiesNot Available
Predicted Molecular Properties
PropertyValueSource
logP4.63ALOGPS
logP3.84ChemAxon
logS-4.5ALOGPS
pKa (Strongest Acidic)14.39ChemAxon
pKa (Strongest Basic)-1.6ChemAxon
Physiological Charge0ChemAxon
Hydrogen Acceptor Count3ChemAxon
Hydrogen Donor Count3ChemAxon
Polar Surface Area60.69 ŲChemAxon
Rotatable Bond Count5ChemAxon
Refractivity125.45 m³·mol⁻¹ChemAxon
Polarizability49.23 ųChemAxon
Number of Rings4ChemAxon
BioavailabilityYesChemAxon
Rule of FiveYesChemAxon
Ghose FilterYesChemAxon
Veber's RuleNoChemAxon
MDDR-like RuleNoChemAxon
Predicted Chromatographic Properties

Predicted Collision Cross Sections

PredictorAdduct TypeCCS Value (Å2)Reference
DeepCCS[M-2H]-228.60730932474
DeepCCS[M+Na]+203.83530932474
AllCCS[M+H]+210.132859911
AllCCS[M+H-H2O]+207.732859911
AllCCS[M+NH4]+212.232859911
AllCCS[M+Na]+212.832859911
AllCCS[M-H]-206.332859911
AllCCS[M+Na-2H]-208.032859911
AllCCS[M+HCOO]-210.032859911

Predicted Kovats Retention Indices

Derivatized

Derivative Name / StructureSMILESKovats RI ValueColumn TypeReference
(22E)-(24R)-1alpha,24-Dihydroxy-26,27-cyclo-22,23-didehydro-20-epivitamin D3/(22E)-(24R)-1alpha,24-dihydroxy-26,27-cyclo-22,23-didehydro-20-epicholecalciferol,1TBDMS,isomer #2C=C1C(=CC=C2CCCC3(C)C2CCC3C(C)C=CC(O)C2CC2)CC(O[Si](C)(C)C(C)(C)C)CC1O3765.8Semi standard non polar33892256
(22E)-(24R)-1alpha,24-Dihydroxy-26,27-cyclo-22,23-didehydro-20-epivitamin D3/(22E)-(24R)-1alpha,24-dihydroxy-26,27-cyclo-22,23-didehydro-20-epicholecalciferol,1TBDMS,isomer #2C=C1C(=CC=C2CCCC3(C)C2CCC3C(C)C=CC(O)C2CC2)CC(O[Si](C)(C)C(C)(C)C)CC1O3556.9Standard non polar33892256
(22E)-(24R)-1alpha,24-Dihydroxy-26,27-cyclo-22,23-didehydro-20-epivitamin D3/(22E)-(24R)-1alpha,24-dihydroxy-26,27-cyclo-22,23-didehydro-20-epicholecalciferol,1TBDMS,isomer #2C=C1C(=CC=C2CCCC3(C)C2CCC3C(C)C=CC(O)C2CC2)CC(O[Si](C)(C)C(C)(C)C)CC1O4136.4Standard polar33892256
(22E)-(24R)-1alpha,24-Dihydroxy-26,27-cyclo-22,23-didehydro-20-epivitamin D3/(22E)-(24R)-1alpha,24-dihydroxy-26,27-cyclo-22,23-didehydro-20-epicholecalciferol,1TBDMS,isomer #3C=C1C(=CC=C2CCCC3(C)C2CCC3C(C)C=CC(O)C2CC2)CC(O)CC1O[Si](C)(C)C(C)(C)C3794.9Semi standard non polar33892256
(22E)-(24R)-1alpha,24-Dihydroxy-26,27-cyclo-22,23-didehydro-20-epivitamin D3/(22E)-(24R)-1alpha,24-dihydroxy-26,27-cyclo-22,23-didehydro-20-epicholecalciferol,1TBDMS,isomer #3C=C1C(=CC=C2CCCC3(C)C2CCC3C(C)C=CC(O)C2CC2)CC(O)CC1O[Si](C)(C)C(C)(C)C3557.6Standard non polar33892256
(22E)-(24R)-1alpha,24-Dihydroxy-26,27-cyclo-22,23-didehydro-20-epivitamin D3/(22E)-(24R)-1alpha,24-dihydroxy-26,27-cyclo-22,23-didehydro-20-epicholecalciferol,1TBDMS,isomer #3C=C1C(=CC=C2CCCC3(C)C2CCC3C(C)C=CC(O)C2CC2)CC(O)CC1O[Si](C)(C)C(C)(C)C4121.2Standard polar33892256
(22E)-(24R)-1alpha,24-Dihydroxy-26,27-cyclo-22,23-didehydro-20-epivitamin D3/(22E)-(24R)-1alpha,24-dihydroxy-26,27-cyclo-22,23-didehydro-20-epicholecalciferol,2TBDMS,isomer #1C=C1C(=CC=C2CCCC3(C)C2CCC3C(C)C=CC(O[Si](C)(C)C(C)(C)C)C2CC2)CC(O[Si](C)(C)C(C)(C)C)CC1O3993.5Semi standard non polar33892256
(22E)-(24R)-1alpha,24-Dihydroxy-26,27-cyclo-22,23-didehydro-20-epivitamin D3/(22E)-(24R)-1alpha,24-dihydroxy-26,27-cyclo-22,23-didehydro-20-epicholecalciferol,2TBDMS,isomer #1C=C1C(=CC=C2CCCC3(C)C2CCC3C(C)C=CC(O[Si](C)(C)C(C)(C)C)C2CC2)CC(O[Si](C)(C)C(C)(C)C)CC1O3890.3Standard non polar33892256
(22E)-(24R)-1alpha,24-Dihydroxy-26,27-cyclo-22,23-didehydro-20-epivitamin D3/(22E)-(24R)-1alpha,24-dihydroxy-26,27-cyclo-22,23-didehydro-20-epicholecalciferol,2TBDMS,isomer #1C=C1C(=CC=C2CCCC3(C)C2CCC3C(C)C=CC(O[Si](C)(C)C(C)(C)C)C2CC2)CC(O[Si](C)(C)C(C)(C)C)CC1O4041.9Standard polar33892256
(22E)-(24R)-1alpha,24-Dihydroxy-26,27-cyclo-22,23-didehydro-20-epivitamin D3/(22E)-(24R)-1alpha,24-dihydroxy-26,27-cyclo-22,23-didehydro-20-epicholecalciferol,2TBDMS,isomer #2C=C1C(=CC=C2CCCC3(C)C2CCC3C(C)C=CC(O[Si](C)(C)C(C)(C)C)C2CC2)CC(O)CC1O[Si](C)(C)C(C)(C)C3983.7Semi standard non polar33892256
(22E)-(24R)-1alpha,24-Dihydroxy-26,27-cyclo-22,23-didehydro-20-epivitamin D3/(22E)-(24R)-1alpha,24-dihydroxy-26,27-cyclo-22,23-didehydro-20-epicholecalciferol,2TBDMS,isomer #2C=C1C(=CC=C2CCCC3(C)C2CCC3C(C)C=CC(O[Si](C)(C)C(C)(C)C)C2CC2)CC(O)CC1O[Si](C)(C)C(C)(C)C3904.4Standard non polar33892256
(22E)-(24R)-1alpha,24-Dihydroxy-26,27-cyclo-22,23-didehydro-20-epivitamin D3/(22E)-(24R)-1alpha,24-dihydroxy-26,27-cyclo-22,23-didehydro-20-epicholecalciferol,2TBDMS,isomer #2C=C1C(=CC=C2CCCC3(C)C2CCC3C(C)C=CC(O[Si](C)(C)C(C)(C)C)C2CC2)CC(O)CC1O[Si](C)(C)C(C)(C)C4026.2Standard polar33892256
(22E)-(24R)-1alpha,24-Dihydroxy-26,27-cyclo-22,23-didehydro-20-epivitamin D3/(22E)-(24R)-1alpha,24-dihydroxy-26,27-cyclo-22,23-didehydro-20-epicholecalciferol,2TBDMS,isomer #3C=C1C(=CC=C2CCCC3(C)C2CCC3C(C)C=CC(O)C2CC2)CC(O[Si](C)(C)C(C)(C)C)CC1O[Si](C)(C)C(C)(C)C3991.4Semi standard non polar33892256
(22E)-(24R)-1alpha,24-Dihydroxy-26,27-cyclo-22,23-didehydro-20-epivitamin D3/(22E)-(24R)-1alpha,24-dihydroxy-26,27-cyclo-22,23-didehydro-20-epicholecalciferol,2TBDMS,isomer #3C=C1C(=CC=C2CCCC3(C)C2CCC3C(C)C=CC(O)C2CC2)CC(O[Si](C)(C)C(C)(C)C)CC1O[Si](C)(C)C(C)(C)C3894.2Standard non polar33892256
(22E)-(24R)-1alpha,24-Dihydroxy-26,27-cyclo-22,23-didehydro-20-epivitamin D3/(22E)-(24R)-1alpha,24-dihydroxy-26,27-cyclo-22,23-didehydro-20-epicholecalciferol,2TBDMS,isomer #3C=C1C(=CC=C2CCCC3(C)C2CCC3C(C)C=CC(O)C2CC2)CC(O[Si](C)(C)C(C)(C)C)CC1O[Si](C)(C)C(C)(C)C4113.4Standard polar33892256
Spectra

GC-MS Spectra

Spectrum TypeDescriptionSplash KeyDeposition DateSourceView
Predicted GC-MSPredicted GC-MS Spectrum - (22E)-(24R)-1alpha,24-Dihydroxy-26,27-cyclo-22,23-didehydro-20-epivitamin D3/(22E)-(24R)-1alpha,24-dihydroxy-26,27-cyclo-22,23-didehydro-20-epicholecalciferol GC-MS (Non-derivatized) - 70eV, Positivesplash10-00ke-2019000000-170f81c20329c724273c2021-09-23Wishart LabView Spectrum
Predicted GC-MSPredicted GC-MS Spectrum - (22E)-(24R)-1alpha,24-Dihydroxy-26,27-cyclo-22,23-didehydro-20-epivitamin D3/(22E)-(24R)-1alpha,24-dihydroxy-26,27-cyclo-22,23-didehydro-20-epicholecalciferol GC-MS (Non-derivatized) - 70eV, PositiveNot Available2021-10-12Wishart LabView Spectrum
Predicted GC-MSPredicted GC-MS Spectrum - (22E)-(24R)-1alpha,24-Dihydroxy-26,27-cyclo-22,23-didehydro-20-epivitamin D3/(22E)-(24R)-1alpha,24-dihydroxy-26,27-cyclo-22,23-didehydro-20-epicholecalciferol GC-MS (Non-derivatized) - 70eV, PositiveNot Available2021-10-12Wishart LabView Spectrum
Predicted GC-MSPredicted GC-MS Spectrum - (22E)-(24R)-1alpha,24-Dihydroxy-26,27-cyclo-22,23-didehydro-20-epivitamin D3/(22E)-(24R)-1alpha,24-dihydroxy-26,27-cyclo-22,23-didehydro-20-epicholecalciferol GC-MS (Non-derivatized) - 70eV, PositiveNot Available2021-10-12Wishart LabView Spectrum
Predicted GC-MSPredicted GC-MS Spectrum - (22E)-(24R)-1alpha,24-Dihydroxy-26,27-cyclo-22,23-didehydro-20-epivitamin D3/(22E)-(24R)-1alpha,24-dihydroxy-26,27-cyclo-22,23-didehydro-20-epicholecalciferol GC-MS (Non-derivatized) - 70eV, PositiveNot Available2021-10-12Wishart LabView Spectrum
Predicted GC-MSPredicted GC-MS Spectrum - (22E)-(24R)-1alpha,24-Dihydroxy-26,27-cyclo-22,23-didehydro-20-epivitamin D3/(22E)-(24R)-1alpha,24-dihydroxy-26,27-cyclo-22,23-didehydro-20-epicholecalciferol GC-MS (Non-derivatized) - 70eV, PositiveNot Available2021-10-12Wishart LabView Spectrum
Predicted GC-MSPredicted GC-MS Spectrum - (22E)-(24R)-1alpha,24-Dihydroxy-26,27-cyclo-22,23-didehydro-20-epivitamin D3/(22E)-(24R)-1alpha,24-dihydroxy-26,27-cyclo-22,23-didehydro-20-epicholecalciferol GC-MS (TMS_1_1) - 70eV, PositiveNot Available2021-11-03Wishart LabView Spectrum
Predicted GC-MSPredicted GC-MS Spectrum - (22E)-(24R)-1alpha,24-Dihydroxy-26,27-cyclo-22,23-didehydro-20-epivitamin D3/(22E)-(24R)-1alpha,24-dihydroxy-26,27-cyclo-22,23-didehydro-20-epicholecalciferol GC-MS (TMS_1_2) - 70eV, PositiveNot Available2021-11-03Wishart LabView Spectrum
Predicted GC-MSPredicted GC-MS Spectrum - (22E)-(24R)-1alpha,24-Dihydroxy-26,27-cyclo-22,23-didehydro-20-epivitamin D3/(22E)-(24R)-1alpha,24-dihydroxy-26,27-cyclo-22,23-didehydro-20-epicholecalciferol GC-MS (TMS_1_3) - 70eV, PositiveNot Available2021-11-03Wishart LabView Spectrum
Predicted GC-MSPredicted GC-MS Spectrum - (22E)-(24R)-1alpha,24-Dihydroxy-26,27-cyclo-22,23-didehydro-20-epivitamin D3/(22E)-(24R)-1alpha,24-dihydroxy-26,27-cyclo-22,23-didehydro-20-epicholecalciferol GC-MS (TMS_2_1) - 70eV, PositiveNot Available2021-11-03Wishart LabView Spectrum
Predicted GC-MSPredicted GC-MS Spectrum - (22E)-(24R)-1alpha,24-Dihydroxy-26,27-cyclo-22,23-didehydro-20-epivitamin D3/(22E)-(24R)-1alpha,24-dihydroxy-26,27-cyclo-22,23-didehydro-20-epicholecalciferol GC-MS (TMS_2_2) - 70eV, PositiveNot Available2021-11-03Wishart LabView Spectrum
Predicted GC-MSPredicted GC-MS Spectrum - (22E)-(24R)-1alpha,24-Dihydroxy-26,27-cyclo-22,23-didehydro-20-epivitamin D3/(22E)-(24R)-1alpha,24-dihydroxy-26,27-cyclo-22,23-didehydro-20-epicholecalciferol GC-MS (TMS_2_3) - 70eV, PositiveNot Available2021-11-03Wishart LabView Spectrum
Predicted GC-MSPredicted GC-MS Spectrum - (22E)-(24R)-1alpha,24-Dihydroxy-26,27-cyclo-22,23-didehydro-20-epivitamin D3/(22E)-(24R)-1alpha,24-dihydroxy-26,27-cyclo-22,23-didehydro-20-epicholecalciferol GC-MS (TMS_3_1) - 70eV, PositiveNot Available2021-11-03Wishart LabView Spectrum
Predicted GC-MSPredicted GC-MS Spectrum - (22E)-(24R)-1alpha,24-Dihydroxy-26,27-cyclo-22,23-didehydro-20-epivitamin D3/(22E)-(24R)-1alpha,24-dihydroxy-26,27-cyclo-22,23-didehydro-20-epicholecalciferol GC-MS (TBDMS_1_1) - 70eV, PositiveNot Available2021-11-03Wishart LabView Spectrum
Predicted GC-MSPredicted GC-MS Spectrum - (22E)-(24R)-1alpha,24-Dihydroxy-26,27-cyclo-22,23-didehydro-20-epivitamin D3/(22E)-(24R)-1alpha,24-dihydroxy-26,27-cyclo-22,23-didehydro-20-epicholecalciferol GC-MS (TBDMS_3_1) - 70eV, PositiveNot Available2021-11-03Wishart LabView Spectrum

MS/MS Spectra

Spectrum TypeDescriptionSplash KeyDeposition DateSourceView
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - (22E)-(24R)-1alpha,24-Dihydroxy-26,27-cyclo-22,23-didehydro-20-epivitamin D3/(22E)-(24R)-1alpha,24-dihydroxy-26,27-cyclo-22,23-didehydro-20-epicholecalciferol 10V, Positive-QTOFsplash10-03fs-0239300000-de857c9b206398f11d752021-10-12Wishart LabView Spectrum
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - (22E)-(24R)-1alpha,24-Dihydroxy-26,27-cyclo-22,23-didehydro-20-epivitamin D3/(22E)-(24R)-1alpha,24-dihydroxy-26,27-cyclo-22,23-didehydro-20-epicholecalciferol 20V, Positive-QTOFsplash10-082i-1389200000-3d3a453adeac5cda57142021-10-12Wishart LabView Spectrum
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - (22E)-(24R)-1alpha,24-Dihydroxy-26,27-cyclo-22,23-didehydro-20-epivitamin D3/(22E)-(24R)-1alpha,24-dihydroxy-26,27-cyclo-22,23-didehydro-20-epicholecalciferol 40V, Positive-QTOFsplash10-0229-2693100000-93d993956e3855e699982021-10-12Wishart LabView Spectrum
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - (22E)-(24R)-1alpha,24-Dihydroxy-26,27-cyclo-22,23-didehydro-20-epivitamin D3/(22E)-(24R)-1alpha,24-dihydroxy-26,27-cyclo-22,23-didehydro-20-epicholecalciferol 10V, Negative-QTOFsplash10-03di-0000900000-7b99a6057fb360e47d262021-10-12Wishart LabView Spectrum
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - (22E)-(24R)-1alpha,24-Dihydroxy-26,27-cyclo-22,23-didehydro-20-epivitamin D3/(22E)-(24R)-1alpha,24-dihydroxy-26,27-cyclo-22,23-didehydro-20-epicholecalciferol 20V, Negative-QTOFsplash10-03di-1403900000-4985fff979b17241ba812021-10-12Wishart LabView Spectrum
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - (22E)-(24R)-1alpha,24-Dihydroxy-26,27-cyclo-22,23-didehydro-20-epivitamin D3/(22E)-(24R)-1alpha,24-dihydroxy-26,27-cyclo-22,23-didehydro-20-epicholecalciferol 40V, Negative-QTOFsplash10-0a6r-2719700000-04b077ff056b66074e092021-10-12Wishart LabView Spectrum
Biological Properties
Cellular LocationsNot Available
Biospecimen Locations
  • Blood
Tissue LocationsNot Available
Pathways
Normal Concentrations
BiospecimenStatusValueAgeSexConditionReferenceDetails
BloodDetected but not QuantifiedNot QuantifiedNot SpecifiedNot SpecifiedNormal details
Abnormal Concentrations
Not Available
Associated Disorders and Diseases
Disease ReferencesNone
Associated OMIM IDsNone
DrugBank IDNot Available
Phenol Explorer Compound IDNot Available
FooDB IDNot Available
KNApSAcK IDNot Available
Chemspider ID2427
KEGG Compound IDNot Available
BioCyc IDNot Available
BiGG IDNot Available
Wikipedia LinkNot Available
METLIN IDNot Available
PubChem Compound2522
PDB IDNot Available
ChEBI ID125387
Food Biomarker OntologyNot Available
VMH IDNot Available
MarkerDB IDNot Available
Good Scents IDNot Available
References
Synthesis ReferenceNot Available
Material Safety Data Sheet (MSDS)Not Available
General References
  1. Barupal DK, Fiehn O: Generating the Blood Exposome Database Using a Comprehensive Text Mining and Database Fusion Approach. Environ Health Perspect. 2019 Sep;127(9):97008. doi: 10.1289/EHP4713. Epub 2019 Sep 26. [PubMed:31557052 ]