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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_6035_Библиотеки_им_академика_М_И_Перельмана.pdf
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both rats and humans by decreasing insulin resistance (Jiao et al., 2013).In addition, oligonol,
which is a low-molecular-weight polyphenol found in litchi fruit, has high bioavailability
and exhibits significant antioxidant properties. Furthermore, it demonstrated protective
impacts on the liver and kidneys in animal models with type 2 DM (Noh et al., 2011).
12.3.3 BIOACTIVE COMPOUNDS OF FENUGREEK
Trigonella foenum-graecum, a member of the Fabaceae family, is commonly referred
to as fenugreek. Its seeds are utilized as a dietary supplement in traditional medicine to
enhance overall well-being, facilitate digestion, and stimulate labor, as documented in the
literature (Wankhede et al., 2016). Studies conducted on animals have indicated that the
administration of fenugreek seed extract may lead to a decrease in blood glucose levels
(Kamble et al., 2013). According to research findings, the chemical analysis of fenugreek
has identified diosgenin, galactomannan, trigoneosides, and 4-hydroxyisoleucine as active
antidiabetic compounds (Arif et al., 2019). The antidiabetic properties of fenugreek seeds
may be attributed to their ability to stimulate insulin synthesis and release from pancreatic
beta cells, as suggested by previous studies (Klajnert and Przygodzki, 2003). Additionally,
a clinical investigation demonstrated that fenugreek’s antidiabetic properties were attributed
to its ability to enhance insulin sensitivity (Kassaian et al., n.d.).
12.3.4 BIOACTIVE COMPOUNDS OF CINNAMON
Cinnamomum zeylanicum, commonly known as cinnamon, has been utilized in traditional
medicine to address a range of health concerns such as colds, diarrhea, headaches, wounds,
rheumatism, and diabetes (Deyno et al., 2019). Additionally, it is utilized as a flavoring
agent in pharmaceuticals and beverages (Qin et al., 2010). The research findings indicate
that cinnamon has the potential to exhibit antidiabetic properties by enhancing hepatic
glycogenesis and decreasing insulin resistance (Couturier et al., 2011).
Additionally, the aqueous extract derived from cinnamon has demonstrated antidiabetic properties by augmenting the translocation of glucose transporter type 4 (GLUT4) in
adipose tissues and muscles, as well as inducing an upregulation of uncoupling protein-1
(Material et al., 2019). Phenolic compounds present in cinnamon are known to have a
signicant impact on enhancing insulin signaling, as indicated by studies (Magnuson et al.,
2012). Cinnamaldehyde is responsible for antihyperlipidemic and antihyperglycemic properties in diabetic rodents (Pathak and Sharma, 2021).
12.3.5 BIOACTIVE COMPOUNDS OF GASTRODIA ELATA
The extract of G. elata exhibited an antidiabetic effect through the enhancement of insulin
resistance (Yang et al., 2016). The observed activity was attributed to the existence of
active compounds, namely, 4-hydroxybenzaldehyde and vanillin. The active compounds
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in question act as antidiabetic agents by reducing insulin resistance through the promotion
of fat oxidation, the reduction of adipose tissue fat accumulation, and the enhancement of
leptin signaling in obese rats (Olatunde et al., 2021).
12.3.6 POLYSACCHARIDES OF DIOSCOREA
The rhizome of Dioscorea has been employed in traditional medicine for the treatment of
ulcers, asthma, chronic diarrhea, and abscesses (Ma
et al., 2020). Recent research findings
indicate that the administration of Dioscorea extract led to a reduction in blood glucose levels
in rats that were induced with a high-fat diet. Moreover, it was observed to have reduced
insulin resistance in diabetic rodents (Yaribeygi et al., 2018). In literature, the antidiabetic
effect of Dioscorea polysaccharides is noteworthy as they aid in reducing insulin resistance
(Lee et al., 2021). The capacity of Dioscorea extract and its polysaccharides to mitigate
insulin resistance is ascribed to their potential to augment GLUT4 and Akt phosphorylation,
which are pivotal proteins implicated in glucose metabolism, thereby conferring antidiabetic
properties. Furthermore, research has demonstrated that the extract and polysaccharides
possess the ability to reduce the phosphorylation of pS6K and extracellular signal-regulated
kinase (ERK), both of which belong to the ribosomal S6 kinase (S6K) family and extracellular
signal-regulated kinase, respectively (Gao et al., 2007).
Both phosphorylation of pS6K and ERK play important roles in carbohydrate metabolism. Hepatic ERK activity has been shown to suppress the expression of the glucose6-phosphatase (G6 phase) gene (Gao et al., 2007). ERK2 also mediates the metabolic
stress response to modulate cell fate. In contrast, phosphorylation of S6K1, which is
regulated by multiple-site phosphorylation events in response to diverse extracellular
stimuli, including growth factors, nutrients, and mitogens, determines substrate selection
via a kinase phosphocode (Grace et al., 2009). S6K1 phosphorylation regulates protein
synthesis, transcription, cell proliferation, cellular metabolism, and survival. In addition,
phosphorylation-regulated ribosomal protein S6 kinase (S6K) within mammalian or
mechanistic target of rapamycin signaling networks is involved in glucose homeostasis,
insulin sensitivity , adipocyte metabolism, body mass and energy balance, tissue and or gan
size, learning, memory, and aging (Les et al., 2021).
12.3.7 ANTHOCYANINS OF BLUEBERRIES
The consumption of blueberry (Vaccinium spp.) has been shown to have a positive effect
on diabetic complications, insulin resistance, lipid oxidation, and blood pressure reduction,
as reported during investigation. The active components of blueberry, known as anthocyanins, have been discovered to possess a strong antidiabetic effect by reducing insulin
resistance (Stote et al., 2020).
According to several researchers, the ingestion of 22.5 g of blueberries twice a day for
eight weeks resulted in a reduction of insulin resistance in patients with type 2 diabetes, as
compared to those who were administered a placebo (Manikandan et al., 2016). It can be
265
asserted that blueberry and its active constituents possess a strong antidiabetic impact by
decreasing insulin resistance (Wojcik et al., 2018).
12.3.8 BIOACTIVE COMPOUNDS OF PSIDIUM GUAJAVA
Psidium guajava, which belongs to the Myrtaceae family, is commonly referred to as
guava. The leaves of the plant were subjected to aqueous and methanol extraction and
subsequent testing on alloxan-induced diabetic rats revealed a significant antidiabetic
impact (Anand et al., 2016). Furthermore, the stem bark’s ethanol extract demonstrated a
significant antidiabetic impact by enhancing peripheral glucose metabolism. The flavonoid
glycosides strictinin and pedunculagin have been identified as the active constituents in
guava, exhibiting significant antidiabetic properties in a clinical trial by enhancing insulin
sensitivity (Poli et al., 2022).
12.4 NATURAL ANTIDIABETIC PRODUCTS WITH VARIOUS MECHANISMS OF
ACTION
In this section, natural compounds from various sources have been discussed that can be
used as antidiabetic medicines through multiple metabolic pathways.
12.4.1 GINGEROL FROM ZINGIBER OFFICINALE
Gingerol is the bioactive constituent derived from the rhizome of the ginger (Zingiber
officinale) plant belonging to Zingiberaceae family. According to a study, gingerol
exhibited a strong antidiabetic impact by enhancing insulin sensitivity and glucose uptake
(Aderonke Otunola and Jide Afolayan, 2020). The compound exhibits insulin tropic,
sensitizer, and hypoglycemic impacts in both animal models and healthy human subjects.
A recent study has demonstrated that the administration of ginger extract resulted in a
reduction of insulin resistance and an increase in insulin release (El Gayar et al., 2019).
According to a clinical study, the consumption of 3 g of ginger powder per day for 30
days resulted in a significant reduction in the levels of lipids and blood glucose in diabetic
patients (Mohammadi et al., 2021).
12.4.2 CURCUMIN FROM CURCUMA LONGA
Curcuma longa commonly known as turmeric belongs to the Zinberaceae family (Figure
12.1). Curcumin commonly referred to as diferuloylmethane, is the primary natural polyphenol present in C. longa and other Curcuma species. It is composed of 1,7-bis(4-hydroxy3-methoxyphenyl)-1,6-heptadiene-3,5-dione (Deokate and Upadhye, 2023). The ingestion
of curcumin supplements may result in a decrease in fasting blood glucose and glycosylated
hemoglobin levels among individuals diagnosed with type 2 DM, in comparison to those
who were administered a placebo (Poolsup et al., 2019).
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FIGURE 12.1 Curcumin’s major antidiabetic and glucose-lowering mechanisms.
Source: Reprinted with permission from Mohammadi et al. (2021). Copyright © 2021, The Editor(s) and The
Author(s), under exclusive license to Springer Nature Switzerland AG
⏎
Curcumin has gained considerable attention for its potential antidiabetic and glucoselowering mechanisms. Numerous studies have highlighted its multifaceted actions that
contribute to improved glycemic control. One of the primary mechanisms through which
curcumin exerts its antidiabetic impact is by enhancing insulin sensitivity. It interacts
with various cellular components involved in insulin signaling pathways, such as insulin
receptors and glucose transporter GLUT4 (Gautam et al., 2021). By enhancing insulin
receptor phosphorylation and translocation of GLUT4 to the cell membrane, curcumin
enhances efcient glucose uptake into cells, reducing hyperglycemia. Additionally,
curcumin can mitigate insulin resistance by modulating inammatory pathways like nuclear
factor kappa-light-chain-enhancer of activated B cells (NF-κB) and cytokine production,
which are known to play a role in insulin resistance (Gonzales and Orlando, 2008).
Curcumin has been found to reduce glucose concentrations by activating AMPactivated protein kinase and inhibiting phosphoenolpyruvate carboxykinase and glucose
6-phosphatase activities, while increasing insulin levels. It also has antioxidant and
anti-inammatory activities, causing decreased metabolic, inammation, and apoptosis
biomarkers. Curcumin also increases antioxidant biomarkers like superoxide dismutase
and glutathione. It has benecial effects on glucose metabolism, such as increased
glycolysis and glycogen synthesis, and decreased gluconeogenesis. However, recent
267
studies have revealed that curcumin has hypoglycemic activity through the regulation
of incretins, α-glucosidase, amylase, glucose transporters, and peroxisome proliferator-
activated receptor gamma.
Curcumin’s impact on pancreatic beta cells, responsible for insulin secretion, is another
crucial aspect of its antidiabetic mechanism. Curcumin has been shown to preserve beta-
cell function and viability. It helps counteract oxidative stress and inammation, which can
contribute to beta-cell dysfunction and apoptosis. By protecting beta cells from damage,
curcumin supports sustained insulin production, contributing to better glucose regulation.
Furthermore, curcumin exhibits antioxidant properties that combat oxidative stress, a
key factor in the development and progression of diabetes (Madiwalar et al., 2022). It
scavenges free radicals and enhances the activity of endogenous antioxidant enzymes,
reducing cellular damage and improving overall metabolic health. This antioxidant effect
also extends to its inuence on lipid metabolism. Curcumin can modulate lipid proles by
reducing triglyceride and cholesterol levels, mitigating the risk of cardiovascular complications often associated with diabetes.
Inammation plays a central role in diabetes, and curcumin’s potent anti-inammatory
properties are instrumental in its glucose-lowering effects. By inhibiting proinammatory
molecules and pathways like NF-κB, curcumin reduces chronic low-grade inammation
observed in metabolic disorders (El-Abhar and Schaalan, 2014). This anti-inammatory
action not only improves insulin sensitivity but also helps preserve insulin-secreting beta cells.
12.4.3 BERBERINE
Berberine is an isoquinoline alkaloid that was initially extracted from Berberis vulgaris,
a natural product. The antidiabetic effects of berberine were observed through various
mechanisms, including the reduction of lipid peroxidation, promotion of pancreatic betacell regeneration, mitigation of hyperglycemia, and enhancement of insulin resistance in
rats with diabetes (Leung et al., 2009). Furthermore, berberine exhibits various effects such
as amelioration of the metabolic syndrome, a mild antidyslipidemic impact, suppression of
cancer, and other activities (Liu et al., 2021).
12.4.4 CAPSAICIN OF PEPPER
Capsaicin, an organic compound with the chemical formula 8-methyl-N-vanillyl-6-none-
namide, is a significant naturally occurring substance derived from the fruits of capsicum
plants, commonly called as chili peppers. Chilli pepper has demonstrated potential antidiabetic, anticancer, and antiobesity properties in both animals and humans (Said et al., 2007).
Capsaicin is the primary bioactive component of pepper, known for its pungent properties.
The mechanism by which it operates involves the regulation of insulin resistance and the
preservation of pancreatic β-cells (Haghani et al., 2022). According to a recent study,
capsaicin’s spicy properties are believed to have a significant impact on reducing blood
glucose levels (Elshater et al., 2022).
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12.4.5 BIOACTIVE COMPOUNDS OF BITTER MELON
Momordica charantia is a perennial vine that bears oblong fruits with a distinct acrid
flavor, commonly referred to as bitter melon or bitter gourd (Campos-Florián et al., 2013).
The potential antidiabetic properties of this species have been investigated through various
in-vitro and in-vivo studies. Various parts of the plant, including seeds, fruit pulp, leaves,
and the whole plant containing the compound charantin have been tested at different doses
ranging from 400 mg to 6 g/day for their antidiabetic effects. The results of experiments
conducted on rats indicate that M. charantia has the potential to enhance insulin sensitivity ,
suppress postprandial hyperglycemia, and improve glucose tolerance. Various mechanisms
of action have been suggested, including the induction of glucose uptake and heightened
secretion of adiponectin, which is another name for body fat and is a protein hormone that
is mostly made and secreted by adipose tissue. Its wide-ranging effects on the body have
garnered substantial attention in the field of metabolic and endocrine research, since it
plays a critical part in different physiological processes (Sharma et al., 2022).
12.4.6 GINSENOSIDES OF GINSENG
Panax ginseng, a member of the Araliaceae family, is more often known as ginseng. Both
rodents and people responded favorably to the antidiabetic effects of leaves, berries, and
roots of P. ginseng (Ghosh and Saha, 2012). Several mechanisms were identified by which
ginseng roots exerted their powerful antidiabetic effect, including the inhibition of hepatic
glucose-6-phosphatase activity and the blockage of intestinal glucose absorption, both of
which slowed both carbohydrate absorption and the pace of meal digestion. Intraperitoneal
administration of P. ginseng berry extract resulted in a significant drop in serum insulin
level and increase in glucose tolerance. Bioactive ginsenosides found in ginseng roots are
effective in lowering blood sugar levels. They work by lowering blood sugar and liver
glycogen levels decreasing insulin resistance and preserving pancreatic β-cells (Ghosh and
Saha, 2012).
12.4.7 BIOACTIVE COMPOUNDS OF ALOE VERA
Aloe vera, a member of the Asphodelaceae family, has been utilized for therapeutic
purposes. The extract derived from A. vera demonstrated a significant antidiabetic effect
in animal models treated with STZ and alloxan. Furthermore, it was observed to decrease
elevated levels of blood glucose and cholesterol in individuals with diabetes (Paul, 2022).
The active compound of A. vera, specifically aloe resin A, exhibited significant antidiabetic
properties through the inhibition of α-glucosidase activity according to the research findings. The antidiabetic properties of A. vera and its active compound are attributed to their
ability to reduce intestinal glucose absorption by inhibiting α-glucosidase and improving
insulin resistance (Ahmad et al., 2022).
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12.4.8 QUINIDES OF COFFEE
Coffee is a widely consumed beverage that is produced by roasting coffee beans, the seeds
of Coffea arabica belonging to the family Rubiaceae. Coffee is considered as a significant
contributor to dietary antioxidants. Upon being roasted at high temperatures, chlorogenic
acid undergoes conversion to quinides, which have been observed to reduce blood glucose
levels in animal models (Sridhar et al., 2022). Numerous research studies have demonstrated that coffee consumption can enhance insulin sensitivity and glucose tolerance,
elevate glucagon-like peptide 1 (GLP-1) levels, and mitigate the complications associated
with type 2 DM. Furthermore, caffeine was found to enhance the functioning of the liver
and adipocytes (Nasser Singab and Youssef, 2014).
12.4.9 BIOACTIVE COMPOUNDS OF TINOSPORA CORDIFOLIA
Tinospora cordifolia commonly known as Gaduchi belongs to the family Menispermaceae.
It is a common antidiabetic drug used to treat diabetes. Numerous physiologically active
substances, including polysaccharides, sesquiterpenoids, phenolics, alkaloids, steroids,
and diterpenoids are responsible for its biological activity (Dhanabal et al., 2018). The
administration of either alcohol or aqueous extract derived from T. cordifolia roots yielded
a noteworthy antidiabetic outcome by inhibiting hepatic glucose-6-phosphatase, serum acid
phosphatase, alkaline and lactate dehydrogenase, and decreasing plasma glucose concentration, thereby enhancing glucose metabolism in diabetic rats (Krishnasamy et al., 2016).
12.4.10 BIOACTIVE COMPOUNDS OF PTEROCARPUS MARSUPIUM
Pterocarpus marsupium, belonging to the family Fabaceae, is commonly referred to as
Vijayasar. Bark extracts of P. marsupium exhibited a notable antidiabetic impact on rats
with alloxan-induced diabetes (Laha and Paul, 2019). The butanol extract exhibited a strong
antidiabetic impact by regulating body metabolism, which is comparable to the properties of
insulin. The heartwood of P. marsupium comprises biologically active phenolic compounds,
namely, marsupsin and pterostilbene. These compounds have been found to effectively
reduce blood glucose levels, comparable to the effects of metformin (Kanetkar et al., 2007).
12.4.11 EUGENOL OF OCIMUM SANCTUM
Ocimum sanctum, belonging to the family Labiatae, is commonly referred to as holy basil.
The oral administration of O. sanctum leaf powder resulted in a reduction of blood glucose
levels in both healthy and diabetic rats (Jn
et al., 2019). Furthermore, the alcohol-based
extract derived from O. sanctum demonstrated a significant increase in exogenous insulin
activity while concurrently reducing glycemia levels. The antidiabetic activity of O.
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sanctum is attributed to the primary active compound, that is, eugenol. Eugenol is known
to reduce the activity of various enzymes such as alkaline phosphatase, AST, ALT, and
lactate dehydrogenase. Additionally, it is also known to decrease cholesterol, triglycerides,
and blood glucose levels (Anand et al., 2017).
12.4.12 BIOACTIVE COMPOUNDS OF SYZYGIUM DENSIFLORUM
Syzygium densiflorum belonging to Myrtaceae family holds significant value as a medicinal
plant. According to a study, the leaves of S. densiflorum have been traditionally employed
to manage diabetes (Lopes et al., 2022). According to research findings, the ethanolic
extract derived from the fruits of S. densiflorum, containing the compound trigonelline,
exhibited antioxidant, antidiabetic, and hyperlipidemic properties in rats with STZ-induced
diabetes (Cano-Marquina et al., 2013).
12.5 CLINICAL TRIALS BASED ON ANTIDIABETIC EFFECTS OF NATURAL PRODUCTS DERIVED FROM PLANTS
12.5.1 GYMNEMA SYLVESTRE (GURMAR)
The antidiabetic properties of Gymnema sylvestre have been documented in conjunction
with its antioxidant potential, which can be attributed to the presence of flavonoids, phenols,
triterpenoids, gymnemic acid, gymnemagenin, saponins, and tannins. These secondary
metabolites exhibit antioxidant properties and demonstrate antidiabetic activity (van Dam
et al., 2006). The administration of the methanolic extract of G. sylvestr e leaves at a dosage
of 200 mg/kg demonstrated superior efficacy in comparison to the control group, that is,
diabetic rats. Therefore, it is plausible to utilize it as a therapeutic agent for antidiabetic
purposes or as an adjunct to current treatments for diabetes (Muley et al., 2012).
12.5.2 FENUGREEK (TRIGONELLA FOENUM-GRAECUM)
According to studies, extracts derived from fenugreek seeds have demonstrated potential as
antidiabetic agents by retarding the rate and duration of gastric emptying and glucose absorption. The observed effect of reduced glucose uptake in the small intestine can be attributed to
the high fiber content of fenugreek (Trigonella foenum-graecum), which is known to impede
carbohydrate metabolism and subsequently lower blood glucose levels (Vo
et al., 2022).
12.5.3 TEA CATECHINS
T ea catechins have been found to have potential benefits in the prevention and treatment of
diabetes through various mechanisms. These include the regulation of insulin secretion by
pancreatic β-cells, the control of blood glucose levels, the inhibition of insulin resistance,
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and the regulation of inflammation markers such as the expression of pro-inflammatory
cytokines and oxidative status (Naimi et al., 2017). Clinical trials have been conducted to
investigate the effect of catechins on the management of obesity and blood glucose levels
in individuals diagnosed with type 2 diabetes (Khalil, 2012).
12.5.4 COFFEE
The consumption of coffee is a prevalent practice globally and has garnered significant
interest with regard to its potential therapeutic benefits for various chronic ailments;
particularly type 2 DM (Escandón-Rivera et al., 2020). Increased coffee consumption is
associated with improved glucose tolerance and reduced risk of type 2 diabetes. Caffeine,
chlorogenic acid, and magnesium in coffee may influence glucose metabolism, as suggested
by various research (Golovinskaia and Wang, 2023).
12.5.5 ROSEMARY (ROSMARINUS OFFICINALIS)
Rosemary belongs to the Lamiaceae family and is characterized by its aromatic evergreen
nature. An investigation showed a significant antidiabetic impact attributed to the presence
of polyphenolic compounds such as rosmarinic acid, carnosol, and carnosic acid. The
study revealed that rosemary extract and its polyphenolic compounds exhibited noteworthy
antidiabetic properties in various animal models of type 2 DM in vivo and demonstrated
an insulin-like effect in insulin target cells in vitro
(Duarte et al., 2020). The extract of
Rosmarinus officinalis has been found to effectively restore blood glucose levels and elevate
antioxidant levels in rats during experimental trials (Christiansen et al., 2018). Table 12.1
summarizes some of the natural antidiabetic bioactive compounds derived from natural
sources along with their modes of action.
Table 12.2 summarizes the chemical structures of the bioactive compounds obtained
from various medicinal plants with antidiabetic properties.
12.6 CONCLUSION
Several novel therapeutic strategies have been presented for type 2 DM. Animal models of
diabetes and the screening of medicinal plants used to treat the disease are both common
preclinical research methods. However, systematic reviews of clinical trials published in
recent years may be of most relevance. They provide new opportunities in the natural
product and medicinal plant industries with a solid foundation of credibility. There are
various pharmacological antidiabetic medicines available in the market; however, they
all have numerous negative effects. Therefore, natural diabetes medications may offer
appealing alternatives to synthetic medications for the treatment of diabetes as they have
fewer side effects, are readily available, and cost-effective. The present chapter centers on
contemporary advancements in natural products of medicinal significance, specifically those
utilized in the management of diabetes. The discussion pertains to the structure–activity
TABLE 12.1 Summary of Some Natural Antidiabetic Products
Source of Natural Products Bioactive Compound Mode of Action Reference
Carthamus tinctorius
Glycine max
Ishige okamura
Various plant species Quercetin • Stimulation of GLP-1 secretion
Psidium guajava
Olive oil Monounsaturated fatty acid
Ervatamia microphylla
Camellia sinensis
Aspalathus linearis
Various plants species Resveratrol:
Momordica charantia
Serotonin derivatives
Glyceollin I, glyceollin II, glyceollin III • Stimulation of GLP-1 secretion in NCI H716 cells
Diphlorethohydroxycarmalol
Strictinin and pedunculagin • Regulating insulin resistance
Conophylline • Decreasing the fibrosis of pancreatic β cells Madiwalar et al. (2022)
Epigallocatechin-3-gallate • Decreasing gluconeogenesis
Aspalathin/Rutin • Increasing insulin secretion and glucose uptake Wu and Chen (2004)
(3,5,40-trihydroxy-trans-stilbene)
Momordicin, momorcharin, and vicine
⏎
• Inhibition of α-glucosidase activity
• Stimulation of insulin secretion
• Prevent dysfunction and apoptosis in β cells
• Stimulation of insulin secretion
• Regulation of the hepatic glucose metabolic enzymes
• Reduction of insulin resistance
• Reduction of intestinal glucose absorption
• Inhibition of DPP-4 activity and α-glucosidase activity
• Stimulating GLP-1 secretion Lee et al. (2021)
• Decreasing insulin tolerance
• Increasing insulin secretion
• Increasing insulin sensitivity
• Increasing glucose uptake, utilization, and storage
• Regulation of β-cell functions and insulin resistance
• Increasing insulin secretion
• Inhibition of glucose reabsorption
• Preservation of islet β cells
• Increasing peripheral glucose utilization
• Suppression of gluconeogenic enzymes
S. N. C et al. (2022)
Liu
Ajuwon
Patole
Gupta et al. (2017)
Zhao et al. (2012)
Kadam et al. (2019)
et al. (2017)
et al. (2023)
272
et al. (2018)