{ "document_id": "fresh-bethgelab-298331", "source_sha256": "b7eff773bb1f99e0ec70566688feff4ba5a0189784a14a115bf01994215833e7", "kind": "ku", "status": "generated", "result": { "schema_version": "1.0", "title": "A six-month periodic fasting reduces microalbuminuria and improves metabolic control in patients with type 2 diabetes and diabetic nephropathy: a randomized controlled study", "abstract_sha256": "", "mode": "sequential", "model": "trained", "config": { "mode": "sequential", "chunk_words": 1000, "context_words": 0, "previous_units": 10, "canonicalize": false, "minhash_permutations": 16, "canonicalization_max_tokens": 4096, "parse_retries": 0 }, "knowledge_units": [ { "chunk_index": 0, "context_summary": "A randomized controlled study evaluated the effects of a fasting-mimicking diet on patients with type 2 diabetes and diabetic nephropathy. The intervention aimed to reduce albuminuria and assess changes in metabolic markers like HOMA-IR and senescence indicators. Results showed significant improvements in microalbuminuria and HOMA-IR, though these effects were not sustained at the three-month follow-up.", "entities": [ { "name": "fasting-mimicking diet (FMD)", "entity_id": "fasting_mimicking_diet_fmd", "entity_type": "method", "aliases": [], "attributes": { "duration": "six months", "cycle_structure": "five-day diet intervention followed by refeeding", "adherence_monitoring": "dietary protocols and ketone body measurements" }, "relationships": [ { "predicate": "reduced", "target": "microalbuminuria", "attributes": { "magnitude": "-30.3 mg/g", "significance": "P ≤ 0.05" }, "target_id": null }, { "predicate": "reduced", "target": "HOMA-IR", "attributes": { "magnitude": "-3.8", "significance": "P ≤ 0.05" }, "target_id": null }, { "predicate": "reduced", "target": "suPAR", "attributes": { "magnitude": "-156.6 pg/ml", "significance": "P ≤ 0.05" }, "target_id": null }, { "predicate": "did_not_change", "target": "markers of dicarbonyl detoxification", "attributes": {}, "target_id": null }, { "predicate": "did_not_change", "target": "DNA-damage/repair markers", "attributes": {}, "target_id": null } ] }, { "name": "Mediterranean diet", "entity_id": "mediterranean_diet", "entity_type": "method", "aliases": [], "attributes": { "role": "control group", "duration": "six months" }, "relationships": [ { "predicate": "compared_to", "target": "fasting-mimicking diet (FMD)", "attributes": {}, "target_id": null } ] }, { "name": "type 2 diabetes and diabetic nephropathy patients", "entity_id": "type_2_diabetes_and_diabetic_nephropathy_patients", "entity_type": "other", "aliases": [], "attributes": { "sample_size": 40, "baseline_HbA1c": "7.8±0.2% [62.1±2.3 mmol/mol]", "inclusion_criteria": "Increased albumin-to-creatinine ratio (ACR), good blood sugar control, and blood pressure control ", "randomization": "21 to FMD, 19 to Mediterranean diet", "model_entity_type": "population" }, "relationships": [ { "predicate": "underwent", "target": "randomized controlled study", "attributes": {}, "target_id": null } ] }, { "name": "albuminuria reduction", "entity_id": "albuminuria_reduction", "entity_type": "other", "aliases": [], "attributes": { "primary_endpoint": "difference of change in ACR from baseline to six months", "microalbuminuria_change": "-30.3 mg/g", "macroalbuminuria_change": "434.0 mg/g", "overall_change_difference": "110.3 mg/g", "model_entity_type": "outcome" }, "relationships": [ { "predicate": "sustained_at_follow_up", "target": "false", "attributes": { "reason": "lack of changes in markers of dicarbonyl detoxification and DNA-damage/repair" }, "target_id": null } ] }, { "name": "HOMA-IR reduction", "entity_id": "homa_ir_reduction", "entity_type": "other", "aliases": [], "attributes": { "magnitude": "-3.8", "significance": "P ≤ 0.05", "model_entity_type": "outcome" }, "relationships": [ { "predicate": "sustained_at_follow_up", "target": "true", "attributes": { "magnitude": "-1.9", "significance": "P ≤ 0.05" }, "target_id": null } ] }, { "name": "suPAR", "entity_id": "supar", "entity_type": "measurement", "aliases": [], "attributes": { "description": "marker of senescence", "change_magnitude": "-156.6 pg/ml", "significance": "P ≤ 0.05" }, "relationships": [ { "predicate": "affected_by", "target": "fasting-mimicking diet (FMD)", "attributes": {}, "target_id": null } ] }, { "name": "dicarbonyl detoxification markers", "entity_id": "dicarbonyl_detoxification_markers", "entity_type": "measurement", "aliases": [], "attributes": { "components": "MG-H1, glyoxalase-1, hydroxyacetone", "change": "no change observed" }, "relationships": [ { "predicate": "associated_with", "target": "relapse of albuminuria at follow-up", "attributes": {}, "target_id": null } ] }, { "name": "DNA-damage/repair markers", "entity_id": "dna_damage_repair_markers", "entity_type": "measurement", "aliases": [], "attributes": { "components": "(yH2Ax)", "change": "no change observed" }, "relationships": [ { "predicate": "associated_with", "target": "relapse of albuminuria at follow-up", "attributes": {}, "target_id": null } ] }, { "name": "acylcarnitines", "entity_id": "acylcarnitines", "entity_type": "measurement", "aliases": [], "attributes": { "description": "markers of lipid oxidation", "finding": "change in profile related to patient responsiveness to ACR improvement" }, "relationships": [ { "predicate": "correlated_with", "target": "ACR improvement", "attributes": {}, "target_id": null } ] }, { "name": "University Hospital of Heidelberg", "entity_id": "university_hospital_of_heidelberg", "entity_type": "organization", "aliases": [], "attributes": { "location": "Germany", "ethics_approval": "Ethic-Nr. S-682/2016", "registration": "DRKS-ID: DRKS00014287" }, "relationships": [ { "predicate": "conducted", "target": "randomized controlled study", "attributes": {}, "target_id": null } ] } ], "source": { "chunk_index": 0, "start_word": 0, "end_word": 995, "word_count": 995, "sha256": "774d4d1f3bd8c4b93cef6c482e941d8ff21d509d4580a2017016ad70414abe37", "sentence_minhash": [ 6510041791773535, 7605519510423274, 12309405932600981, 61919449716151556, 31941388625203915, 62667647458868521, 23718652799488495, 83575544965282909, 130591936822558120, 2607707833378508, 6226213327830117, 95656761971753031, 21933493368060407, 906306679132868, 73860429008392155, 658790404649858 ] }, "extraction_warnings": [ "normalized unsupported entity type 'population' for 'type 2 diabetes and diabetic nephropathy patients'", "normalized unsupported entity type 'outcome' for 'albuminuria reduction'", "normalized unsupported entity type 'outcome' for 'HOMA-IR reduction'" ] }, { "chunk_index": 1, "context_summary": "The study utilized a stratified randomization procedure to assign patients to either a fasting-mimicking diet or a Mediterranean diet intervention. Participants followed the prescribed diets for five days each month, with specific caloric and macronutrient targets for the fasting-mimicking diet. The primary endpoint was the absolute difference in change of ACR from baseline to after six diet cycles between the two groups.", "entities": [ { "name": "stratified computed randomization procedure", "entity_id": "stratified_computed_randomization_procedure", "entity_type": "method", "aliases": [], "attributes": { "software_version": "2.0.3", "institution": "Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz", "stratification_factors": "BMI (cut-off 30.0 kg/m²) and HbA1c (cut-off 7.0%)" }, "relationships": [ { "predicate": "assigned_participants_to", "target": "intervention or control group", "attributes": {}, "target_id": null } ] }, { "name": "fasting-mimicking diet (FMD)", "entity_id": "fasting_mimicking_diet_fmd", "entity_type": "method", "aliases": [], "attributes": { "type": "plant-based", "day_1_energy": "4600 kJ", "day_1_macronutrients": "11% protein, 46% fat, 43% carbohydrates", "days_2_to_5_energy": "3000 kJ", "days_2_to_5_macronutrients": "9% protein, 44% fat, 47% carbohydrate" }, "relationships": [ { "predicate": "mimics_effects_on", "target": "glucose and ketone bodies", "attributes": {}, "target_id": null }, { "predicate": "requires_discontinuation_of", "target": "short-acting insulin", "attributes": {}, "target_id": null }, { "predicate": "requires_reduction_of", "target": "long-acting insulin by 50%", "attributes": {}, "target_id": null }, { "predicate": "requires_discontinuation_of", "target": "oral antidiabetic therapy", "attributes": {}, "target_id": null } ] }, { "name": "Mediterranean Diet (M-Diet)", "entity_id": "mediterranean_diet_m_diet", "entity_type": "method", "aliases": [], "attributes": { "caloric_change": "no change compared to baseline", "adaptation_standard": "Mediterranean Diet Score (MDS)" }, "relationships": [ { "predicate": "assigned_to", "target": "control group", "attributes": {}, "target_id": null } ] }, { "name": "primary endpoint", "entity_id": "primary_endpoint", "entity_type": "measurement", "aliases": [], "attributes": { "definition": "absolute difference of change of ACR from baseline to after six diet cycles between FMD and M-Diet group" }, "relationships": [ { "predicate": "includes_subgroup_analysis_for", "target": "micro-versus macroalbuminuria levels at baseline", "attributes": {}, "target_id": null } ] }, { "name": "secondary endpoints", "entity_id": "secondary_endpoints", "entity_type": "measurement", "aliases": [], "attributes": { "time_points": "after three diet cycles and after six diet cycles", "markers": "HOMA-IR, plasma MG-H1, plasma MG, Glo-1 activity, expression of pGlo-1 in WBC, hydroxyacetone in RBC, plasma AC profile, yH2Ax expression in WBC, suPAR" }, "relationships": [ { "predicate": "uses_hierarchical_test_procedure_to_account_for", "target": "multiple testing", "attributes": {}, "target_id": null } ] }, { "name": "sample size calculation", "entity_id": "sample_size_calculation", "entity_type": "method", "aliases": [], "attributes": { "software": "PASS 16.0.12", "required_n": 34, "estimated_dropout_rate": "15%", "final_n": 40, "significance_level": "alpha=5%", "power": "at least 80%", "standard_deviation_assumption": "30% for both groups" }, "relationships": [ { "predicate": "based_on_clinically_relevant_reduction_of", "target": "albuminuria by at least 30%", "attributes": {}, "target_id": null } ] }, { "name": "statistical analysis", "entity_id": "statistical_analysis", "entity_type": "method", "aliases": [], "attributes": { "population": "intention-to-treat", "missing_value_handling": "not imputed", "analysis_type": "available-case analysis", "comparison_method": "ANCOVA was adjusted to account for age, gender, weight loss, and the initial value. ", "software": "R (version 3.6.1 2019-07-05)", "visualization_tools": "R core packages, tiduverse, pheatmap, GraphPad Prism version 5.00" }, "relationships": [] }, { "name": "patient characteristics", "entity_id": "patient_characteristics", "entity_type": "event", "aliases": [], "attributes": { "study_period": "March 2018 to May 2020", "total_randomized": 41, "fmd_group_n": 21, "m_diet_group_n": 20, "discontinued_immediately": 1, "reason_for_discontinuation": "erysipelas", "completed_three_cycles": 38, "completed_study": 33, "seen_at_follow_up": 31, "follow_up_time": "112±31 days", "main_reason_for_withdrawal": "Covid-19 pandemic restrictions" }, "relationships": [ { "predicate": "baseline_measures_comparable_between", "target": "study groups", "attributes": {}, "target_id": null } ] } ], "source": { "chunk_index": 1, "start_word": 995, "end_word": 1975, "word_count": 980, "sha256": "fb3400d72cb091e8e4496d43483baa8fbffcf160f6a9c4938c617dfebaae5dc8", "sentence_minhash": [ 78394354238995921, 18551641988871988, 13745959893517690, 61919449716151556, 31941388625203915, 62667647458868521, 22742697865333914, 40361113771795953, 64333332902950267, 9462436175016187, 10770288728711951, 95656761971753031, 38129318889309710, 906306679132868, 29116561381011342, 3126852891561233 ] }, "extraction_warnings": [] }, { "chunk_index": 2, "context_summary": "The study compared a fasting-mimicking diet (FMD) to a Mediterranean diet (M-Diet) in patients with type 2 diabetes and diabetic nephropathy, finding significant reductions in microalbuminuria, HOMA-IR, and suPAR levels. Weight loss was greater in the FMD group, but body composition remained unchanged between groups when adjusted for weight. Most metabolic improvements, including ACR reduction and MG-H1 changes, reversed at follow-up, while HOMA-IR reduction was sustained.", "entities": [ { "name": "fasting-mimicking diet (FMD)", "entity_id": "fasting_mimicking_diet_fmd", "entity_type": "method", "aliases": [], "attributes": { "tolerance": "well tolerated", "adverse_effects": "71-95% reported no adverse effects", "common_symptoms": "weakness, muscle pain, dizziness, headache", "severe_adverse_effects": "none reported" }, "relationships": [ { "predicate": "reduced_acr_in_microalbuminuria_patients", "target": "54% reduction after six cycles", "attributes": { "p_value": "<=0.05" }, "target_id": null }, { "predicate": "reduced_acr_in_macroalbuminuria_patients", "target": "434.0 mg/g difference after six cycles", "attributes": { "p_value": "0.23" }, "target_id": null }, { "predicate": "reduced_urea_levels", "target": "11.8 mg/dl after three cycles; 17.9 mg/dl after six cycles", "attributes": { "p_value": "<=0.01 for three cycles; <=0.05 for six cycles" }, "target_id": null }, { "predicate": "preserved_egfr_more_than_m_diet", "target": "8.3 ml/min/1.73m² difference after six cycles", "attributes": { "p_value": "<=0.05" }, "target_id": null }, { "predicate": "reduced_supar_levels", "target": "214.8 pg/ml after three cycles; 156.6 pg/ml after six cycles", "attributes": { "p_value": "<=0.05 for both" }, "target_id": null }, { "predicate": "reduced_hba1c_levels", "target": "17% reduction after six cycles", "attributes": { "p_value": "<=0.05" }, "target_id": null }, { "predicate": "reduced_homa_ir_in_non_insulin_treated", "target": "60% reduction after six cycles", "attributes": { "p_value": "<=0.05" }, "target_id": null }, { "predicate": "caused_weight_loss", "target": "5.6 kg after three cycles; 7.2 kg after six cycles", "attributes": { "p_value": "<=0.001" }, "target_id": null }, { "predicate": "reduced_mg_h1_levels", "target": "62% reduction after three cycles", "attributes": {}, "target_id": null } ] }, { "name": "Mediterranean diet (M-Diet)", "entity_id": "mediterranean_diet_m_diet", "entity_type": "method", "aliases": [], "attributes": {}, "relationships": [ { "predicate": "caused_weight_loss", "target": "0.7 kg after three cycles; 1.1 kg after six cycles", "attributes": { "p_value": "<=0.001" }, "target_id": null } ] }, { "name": "ACR (Albumin-to-Creatinine Ratio)", "entity_id": "acr_albumin_to_creatinine_ratio", "entity_type": "measurement", "aliases": [], "attributes": { "baseline_fmd_responders": "85.7 mg/g", "baseline_fmd_non_responders": "271 mg/g", "baseline_m_diet_responders": "55.5 mg/g", "baseline_m_diet_non_responders": "563.0 mg/g" }, "relationships": [ { "predicate": "difference_in_change_after_six_cycles_all_patients", "target": "110.3 mg/g", "attributes": { "p_value": "0.45" }, "target_id": null }, { "predicate": "difference_in_change_after_three_cycles_all_patients", "target": "-62.5 mg/g", "attributes": { "p_value": "0.45" }, "target_id": null }, { "predicate": "reversed_at_follow_up", "target": "baseline values", "attributes": {}, "target_id": null } ] }, { "name": "HOMA-IR", "entity_id": "homa_ir", "entity_type": "measurement", "aliases": [], "attributes": {}, "relationships": [ { "predicate": "sustained_reduction_at_follow_up", "target": "-1.9", "attributes": { "p_value": "<=0.05" }, "target_id": null } ] }, { "name": "HbA1c", "entity_id": "hba1c", "entity_type": "measurement", "aliases": [], "attributes": {}, "relationships": [ { "predicate": "no_change_after_three_cycles", "target": "FMD group", "attributes": {}, "target_id": null }, { "predicate": "reversed_at_follow_up", "target": "baseline values", "attributes": {}, "target_id": null } ] }, { "name": "FPG (Fasting Plasma Glucose)", "entity_id": "fpg_fasting_plasma_glucose", "entity_type": "measurement", "aliases": [], "attributes": {}, "relationships": [ { "predicate": "no_change_after_six_cycles", "target": "between study groups", "attributes": {}, "target_id": null } ] }, { "name": "LDL, HDL, Triglycerides", "entity_id": "ldl_hdl_triglycerides", "entity_type": "measurement", "aliases": [], "attributes": {}, "relationships": [ { "predicate": "no_change_throughout_study", "target": "FMD group compared to M-Diet and baseline", "attributes": {}, "target_id": null } ] }, { "name": "Body Composition", "entity_id": "body_composition", "entity_type": "measurement", "aliases": [], "attributes": { "fat_mass": "no change", "fat_free_mass": "no change" }, "relationships": [ { "predicate": "no_change_between_groups", "target": "when adjusted for weight loss", "attributes": {}, "target_id": null } ] }, { "name": "MG-H1", "entity_id": "mg_h1", "entity_type": "measurement", "aliases": [], "attributes": {}, "relationships": [ { "predicate": "no_association_with_acr_change", "target": "in both M-Diet and FMD groups", "attributes": {}, "target_id": null }, { "predicate": "reversed_at_follow_up", "target": "baseline values", "attributes": {}, "target_id": null } ] }, { "name": "AC Profile (Acetylcarnitine)", "entity_id": "ac_profile_acetylcarnitine", "entity_type": "measurement", "aliases": [], "attributes": { "C2_level_change": "increased after three cycles in responders" }, "relationships": [ { "predicate": "distinct_response_in_responders", "target": "compared to non-responders", "attributes": {}, "target_id": null }, { "predicate": "reversed_at_follow_up", "target": "baseline values", "attributes": {}, "target_id": null } ] }, { "name": "Study Participants", "entity_id": "study_participants", "entity_type": "person", "aliases": [], "attributes": { "gender_distribution": "74% male in M-Diet, 71% male in FMD", "medication_change": "most increased antihyperglycemic medication except three FMD participants" }, "relationships": [ { "predicate": "no_difference_in_endpoints_by_gender", "target": "female and male participants", "attributes": {}, "target_id": null } ] } ], "source": { "chunk_index": 2, "start_word": 1975, "end_word": 2958, "word_count": 983, "sha256": "87b01caf118dbbec19a066af33c8354f121c997f8ce6ad6d776f9261a7323b00", "sentence_minhash": [ 6919897742352966, 60625189416255572, 40863640610520970, 10004148275772588, 31941388625203915, 39127440086368283, 89633613770379075, 85390325476433150, 34383880606747972, 2607707833378508, 104535835787444099, 95656761971753031, 38129318889309710, 906306679132868, 95169533629451962, 109206766937244242 ] }, "extraction_warnings": [] }, { "chunk_index": 3, "context_summary": "The study found that fasting-mimicking diet (FMD) cycles significantly reduced antihyperglycemic and antihypertensive medications compared to the Mediterranean diet (M-Diet). Blood ketones increased three-fold in the FMD group, while high MDS scores in the M-Diet group indicated good compliance. The intervention improved microalbuminuria and HOMA-IR, but these effects were largely transient and reversed after refeeding.", "entities": [ { "name": "fasting-mimicking diet (FMD)", "entity_id": "fasting_mimicking_diet_fmd", "entity_type": "method", "aliases": [], "attributes": { "safety": "safe and well tolerated", "effect_on_medication": "reduced antihyperglycemic and antihypertensive medications", "effect_on_ketones": "increased 3-fold after three and six cycles", "effect_on_albuminuria": "reduced ACR in patients with microalbuminuria, no effect in macroalbuminuria", "effect_on_homa_ir": "sustained improvement", "effect_on_mg_h1": "transient reduction", "effect_on_supar": "transient reduction", "effect_on_dna_damage_repair": "no change", "effect_on_dicarbonyl_detoxification": "no change", "effect_on_glycine": "increased in responders", "effect_on_acetylcarnitine": "increased in responders", "effect_on_glo_1": "no change in activity or expression" }, "relationships": [ { "predicate": "compared_to", "target": "Mediterranean diet (M-Diet)", "attributes": {}, "target_id": null }, { "predicate": "induced_by", "target": "prolonged fasting periods", "attributes": {}, "target_id": null } ] }, { "name": "Mediterranean diet (M-Diet)", "entity_id": "mediterranean_diet_m_diet", "entity_type": "method", "aliases": [], "attributes": { "compliance_indicator": "high MDS score (6.1)", "effect_on_medication": "increased antihyperglycemic and antihypertensive medications in some participants", "effect_on_ketones": "not reported as increased", "effect_on_albuminuria": "no reduction in ACR" }, "relationships": [ { "predicate": "compared_to", "target": "fasting-mimicking diet (FMD)", "attributes": {}, "target_id": null } ] }, { "name": "hypoglycemic episodes", "entity_id": "hypoglycemic_episodes", "entity_type": "measurement", "aliases": [], "attributes": { "grade_1_fmd": "10%", "grade_1_m_diet": "11%", "grade_2_fmd": "5%", "grade_2_m_diet": "11%", "difference_between_groups": "did not differ" }, "relationships": [ { "predicate": "occurred_during", "target": "diet intervention", "attributes": {}, "target_id": null } ] }, { "name": "antihyperglycemic medication", "entity_id": "antihyperglycemic_medication", "entity_type": "measurement", "aliases": [], "attributes": { "fmd_reduction_3_cycles": "57%", "m_diet_reduction_3_cycles": "32%", "m_diet_increase_3_cycles": "5%", "fmd_reduction_6_cycles": "67%", "m_diet_increase_6_cycles": "21%" }, "relationships": [ { "predicate": "reduced_by", "target": "fasting-mimicking diet (FMD)", "attributes": {}, "target_id": null } ] }, { "name": "antihypertensive medication", "entity_id": "antihypertensive_medication", "entity_type": "measurement", "aliases": [], "attributes": { "fmd_reduction_3_cycles": "10%", "m_diet_reduction_3_cycles": "5%", "m_diet_increase_3_cycles": "5%", "fmd_reduction_6_cycles": "10%", "m_diet_increase_6_cycles": "10%" }, "relationships": [ { "predicate": "reduced_by", "target": "fasting-mimicking diet (FMD)", "attributes": {}, "target_id": null } ] }, { "name": "blood ketones", "entity_id": "blood_ketones", "entity_type": "measurement", "aliases": [], "attributes": { "fmd_increase_3_cycles": "3-fold (0.50 mmol)", "fmd_increase_6_cycles": "3-fold (0.50 mmol)", "p_value": "P≤0.001" }, "relationships": [ { "predicate": "increased_in", "target": "fasting-mimicking diet (FMD) group", "attributes": {}, "target_id": null } ] }, { "name": "MDS score", "entity_id": "mds_score", "entity_type": "measurement", "aliases": [], "attributes": { "m_diet_3_cycles": "6.1", "m_diet_6_cycles": "6.1", "interpretation": "sign of good compliance" }, "relationships": [ { "predicate": "reported_in", "target": "Mediterranean diet (M-Diet) group", "attributes": {}, "target_id": null } ] }, { "name": "microalbuminuria", "entity_id": "microalbuminuria", "entity_type": "concept", "aliases": [], "attributes": { "pathogenesis": "pathogenic events targeting vasculature, glomerulus, and tubular cells", "fmd_effect": "reduced ACR levels", "fmd_effect_macroalbuminuria": "no change in ACR levels", "comparison": "comparable to reduction in SGLT-2 inhibitors", "refeeding_effect": "rapid increase at refeeding points" }, "relationships": [ { "predicate": "reduced_by", "target": "fasting-mimicking diet (FMD)", "attributes": {}, "target_id": null } ] }, { "name": "HOMA-IR", "entity_id": "homa_ir", "entity_type": "measurement", "aliases": [], "attributes": { "fmd_effect": "sustained improvement", "adjustment": "even if weight loss is taken into account " }, "relationships": [ { "predicate": "improved_by", "target": "fasting-mimicking diet (FMD)", "attributes": {}, "target_id": null } ] }, { "name": "acetylcarnitine", "entity_id": "acetylcarnitine", "entity_type": "measurement", "aliases": [], "attributes": { "fmd_effect": "increased in responders", "cause": "Strong activation of lipolysis during a prolonged fasting period ", "uncertainty": "unclear if marker of compliance or substrate for renal metabolism" }, "relationships": [ { "predicate": "discriminates", "target": "responders and non-responders with respect to ACR improvement", "attributes": {}, "target_id": null } ] }, { "name": "glycine", "entity_id": "glycine", "entity_type": "measurement", "aliases": [], "attributes": { "fmd_effect": "increased in responders", "protective_effect": "protective effects on renal tubular injury", "mechanism": "might enhance Glo-1 function and restore antioxidant defense" }, "relationships": [ { "predicate": "discriminates", "target": "responders and non-responders with respect to ACR improvement", "attributes": {}, "target_id": null } ] }, { "name": "suPAR", "entity_id": "supar", "entity_type": "measurement", "aliases": [], "attributes": { "fmd_effect": "transient reduction", "definition": "Indicator of accelerated aging and senescence ", "post_fmd_increase": "fast increase after FMD" }, "relationships": [ { "predicate": "reduced_by", "target": "fasting-mimicking diet (FMD)", "attributes": {}, "target_id": null } ] }, { "name": "SGLT-2 inhibitors", "entity_id": "sglt_2_inhibitors", "entity_type": "method", "aliases": [], "attributes": { "effect_on_albuminuria": "reduction in microalbuminuria", "mechanism": "induction of mild ketogenesis shifting energy metabolism to ketolysis" }, "relationships": [ { "predicate": "compared_to", "target": "fasting-mimicking diet (FMD)", "attributes": {}, "target_id": null } ] } ], "source": { "chunk_index": 3, "start_word": 2958, "end_word": 3938, "word_count": 980, "sha256": "b12b4a0b1ffe140fe04f24bcf1429f31e74241bb588853abea05b6c6fe51e3de", "sentence_minhash": [ 14279474218976588, 18551641988871988, 12309405932600981, 61919449716151556, 31941388625203915, 99436724310786061, 23718652799488495, 83575544965282909, 96635883400075078, 316267458192039586, 19416574622547768, 53801230756016856, 38129318889309710, 906306679132868, 95169533629451962, 109206766937244242 ] }, "extraction_warnings": [] }, { "chunk_index": 4, "context_summary": "The study concludes that fasting-mimicking diet cycles can be integrated into clinical practice to reduce albuminuria and insulin resistance in type 2 diabetes patients with microalbuminuria. It notes that the lack of activation in specific nephropathy defense pathways and absence of changes in dicarbonyl detoxification markers may explain the relapse of albuminuria after six cycles. The study shows that a significant weight loss was achieved, but the reduction in albuminuria was likely independent of the weight loss, as it continued even after re-feeding. ", "entities": [ { "name": "fasting-mimicking diet (FMD)", "entity_id": "fasting_mimicking_diet_fmd", "entity_type": "method", "aliases": [], "attributes": { "clinical_integration": "complementary to current guidelines", "effect_on_insulin_resistance": "sustained reduction even when adjusted for weight loss", "effect_on_albuminuria": "reduction in patients with microalbuminuria", "effect_on_metabolism": "sustained redirection of metabolism" }, "relationships": [ { "predicate": "requires_longer_period_for", "target": "nephropathy reversal", "attributes": {}, "target_id": null }, { "predicate": "shows_different_response_in", "target": "MG-H1 reduction after three vs six cycles", "attributes": {}, "target_id": null } ] }, { "name": "nephropathy defense pathways", "entity_id": "nephropathy_defense_pathways", "entity_type": "concept", "aliases": [], "attributes": { "activation_status": "not activated or newly combined in this study " }, "relationships": [ { "predicate": "control", "target": "nephropathy", "attributes": {}, "target_id": null } ] }, { "name": "MG-H1 reduction", "entity_id": "mg_h1_reduction", "entity_type": "measurement", "aliases": [], "attributes": { "response_pattern": "Different depending on three, but not on six, FMD cycles. " }, "relationships": [ { "predicate": "suggests_not_due_to", "target": "reduced energy intake during FMD", "attributes": {}, "target_id": null } ] }, { "name": "study limitations", "entity_id": "study_limitations", "entity_type": "concept", "aliases": [], "attributes": { "control_group_diet": "isocaloric", "fmd_group_diet": "caloric restriction", "sample_size": "small", "renal_cell_metabolism_exploration": "limited due to lack of kidney biopsies" }, "relationships": [ { "predicate": "adjusted_for", "target": "weight loss", "attributes": {}, "target_id": null } ] }, { "name": "albuminuria reduction", "entity_id": "albuminuria_reduction", "entity_type": "measurement", "aliases": [], "attributes": { "significance": "significant in subgroup analysis of patients with microalbuminuria", "independence_from_weight_loss": "likely independent as weight loss persists at refeeding while albuminuria increases" }, "relationships": [ { "predicate": "predictor_of", "target": "development of diabetic nephropathy", "attributes": {}, "target_id": null } ] }, { "name": "dicarbonyl detoxification markers", "entity_id": "dicarbonyl_detoxification_markers", "entity_type": "measurement", "aliases": [], "attributes": { "change_status": "no significant change" }, "relationships": [ { "predicate": "may_explain", "target": "relapse of albuminuria after six FMD cycles", "attributes": {}, "target_id": null } ] }, { "name": "DNA-damage/repair markers", "entity_id": "dna_damage_repair_markers", "entity_type": "measurement", "aliases": [], "attributes": { "change_status": "no significant change" }, "relationships": [ { "predicate": "may_explain", "target": "relapse of albuminuria after six FMD cycles", "attributes": {}, "target_id": null } ] }, { "name": "incomplete lipid oxidation markers", "entity_id": "incomplete_lipid_oxidation_markers", "entity_type": "measurement", "aliases": [], "attributes": { "effect_on_albuminuria": "distinct effects in patients showing improvement" }, "relationships": [ { "predicate": "may_help_develop", "target": "new therapeutic strategies", "attributes": {}, "target_id": null } ] } ], "source": { "chunk_index": 4, "start_word": 3938, "end_word": 4701, "word_count": 763, "sha256": "b66eb15556527f1d76e96d9703cb14bd56b4aa61742a03013ebd4efa05d7ef23", "sentence_minhash": [ 147519523736366927, 1306423125707224, 153262400589127199, 37498130448765965, 26384097017582652, 99436724310786061, 23718652799488495, 47615437990415314, 96635883400075078, 17444917348060025, 67831053780325945, 95656761971753031, 38129318889309710, 906306679132868, 196881419005778658, 285412106277652386 ] }, "extraction_warnings": [] } ], "canonical_entities": [] }, "chunks_expected": 5, "chunks_generated": 5, "failed_chunks": [], "repair": { "accepted_windows": 8, "rolled_back": false, "original_context_sha256": "4de4a7c7b86f6b81a5dac51af57052b5d81707be06085b63ede3c2e9a773ee37", "final_context_sha256": "0d4a4942c6b1b8994b907bc150bcead111e964705cf4416c914f3727b1e27704", "critical_values": { "passed": true, "checks": { "numbers": true, "quantities": true, "formulas": true, "mathematical_variables": true, "operators": true }, "before": { "numbers": [ "2", "-30.3", "0.05", "-3.8", "0.05", "-156.6", "0.05", "2", "4E+1", "7.8", "0.2", "62.1", "2.3", "21", "19", "-30.3", "434", "110.3", "-3.8", "0.05", "-1.9", "0.05", "-156.6", "0.05", "1", "682", "2016", "3E+1", "2", "7", "4.6E+3", "11", "46", "43", "3E+3", "9", "44", "47", "5E+1", "1", "1", "34", "15", "4E+1", "5", "8E+1", "3E+1", "3E+1", "2019", "7", "5", "5", "2018", "2.02E+3", "41", "21", "2E+1", "1", "38", "33", "31", "112", "31", "19", "2", "71", "95", "54", "0.05", "434", "0.23", "11.8", "17.9", "0.01", "0.05", "8.3", "1.73", "2", "0.05", "214.8", "156.6", "0.05", "17", "0.05", "6E+1", "0.05", "5.6", "7.2", "0.001", "62", "0.7", "1.1", "0.001", "85.7", "271", "55.5", "563", "110.3", "0.45", "-62.5", "0.45", "-1.9", "0.05", "74", "71", "3", "6.1", "1E+1", "11", "5", "11", "57", "32", "5", "67", "21", "1E+1", "5", "5", "1E+1", "1E+1", "3", "0.5", "3", "0.5", "0.001", "6.1", "6.1", "2", "1", "2", "2" ], "quantities": [ [ "-30.3", "mg/g" ], [ "0.2", "%" ], [ "2.3", "mmol/mol" ], [ "-30.3", "mg/g" ], [ "434", "mg/g" ], [ "110.3", "mg/g" ], [ "3E+1", "kg/m" ], [ "7", "%" ], [ "4.6E+3", "kJ" ], [ "11", "%" ], [ "46", "%" ], [ "43", "%" ], [ "3E+3", "kJ" ], [ "9", "%" ], [ "44", "%" ], [ "47", "%" ], [ "5E+1", "%" ], [ "15", "%" ], [ "5", "%" ], [ "8E+1", "%" ], [ "3E+1", "%" ], [ "3E+1", "%" ], [ "95", "%" ], [ "54", "%" ], [ "434", "mg/g" ], [ "11.8", "mg" ], [ "17.9", "mg" ], [ "1.73", "m^2" ], [ "17", "%" ], [ "6E+1", "%" ], [ "5.6", "kg" ], [ "7.2", "kg" ], [ "62", "%" ], [ "0.7", "kg" ], [ "1.1", "kg" ], [ "85.7", "mg/g" ], [ "271", "mg/g" ], [ "55.5", "mg/g" ], [ "563", "mg/g" ], [ "110.3", "mg/g" ], [ "-62.5", "mg/g" ], [ "74", "%" ], [ "71", "%" ], [ "1E+1", "%" ], [ "11", "%" ], [ "5", "%" ], [ "11", "%" ], [ "57", "%" ], [ "32", "%" ], [ "5", "%" ], [ "67", "%" ], [ "21", "%" ], [ "1E+1", "%" ], [ "5", "%" ], [ "5", "%" ], [ "1E+1", "%" ], [ "1E+1", "%" ], [ "0.5", "mmol" ], [ "0.5", "mmol" ] ], "formulas": [ "P≤0.001", "P≤0.05", "P≤0.05", "P≤0.05", "P≤0.05", "P≤0.05", "P≤0.05", "R(version3.60.12019to7to5)", "S-682/2016", "a=5", "chemical:DRKS00014287", "chemical:H1", "chemical:H1", "chemical:H1", "chemical:H1", "chemical:H1", "chemical:H1", "m^2", "m^2" ], "mathematical_variables": [ "a_change", "a_change", "c_change", "d_acr_in_macroalbuminuria_patients", "d_acr_in_microalbuminuria_patients", "d_at_follow_up", "d_at_follow_up", "d_at_follow_up", "d_at_follow_up", "d_at_follow_up", "d_at_follow_up", "d_by", "d_by", "d_by", "d_by", "d_by", "d_by", "d_by", "d_deviation_assumption", "d_dropout_rate", "d_during", "d_effect", "d_effect", "d_effect", "d_effect", "d_effect", "d_effect_macroalbuminuria", "d_egfr_more_than_m_diet", "d_for", "d_group_diet", "d_group_n", "d_hba1c_levels", "d_homa_ir_in_non_insulin_treated", "d_immediately", "d_in", "d_in", "d_increase_3_cycles", "d_increase_6_cycles", "d_mg_h1_levels", "d_n", "d_not_change", "d_not_change", "d_on_clinically_relevant_reduction_of", "d_participants_to", "d_reduction_3_cycles", "d_reduction_3_cycles", "d_reduction_6_cycles", "d_reduction_6_cycles", "d_reduction_at_follow_up", "d_study", "d_supar_levels", "d_three_cycles", "d_to", "d_to", "d_to", "d_to", "d_to", "d_urea_levels", "d_weight_loss", "d_weight_loss", "d_with", "d_with", "d_with", "e_1_fmd", "e_1_m_diet", "e_2_fmd", "e_2_m_diet", "e_HbA1c", "e_adverse_effects", "e_between_groups", "e_effect", "e_effects", "e_fmd_non_responders", "e_fmd_responders", "e_from_weight_loss", "e_in_change_after_six_cycles_all_patients", "e_in_change_after_three_cycles_all_patients", "e_indicator", "e_level", "e_m_diet_non_responders", "e_m_diet_responders", "e_magnitude", "e_measures_comparable_between", "e_monitoring", "e_pattern", "e_points", "e_size", "e_size", "e_status", "e_status", "e_structure", "e_version", "g_effect", "g_value_handling", "l_cell_metabolism_exploration", "l_change", "l_change_difference", "l_entity_type", "l_entity_type", "l_entity_type", "l_group_diet", "l_integration", "l_n", "l_randomized", "m_diet_3_cycles", "m_diet_6_cycles", "m_diet_group_n", "m_diet_increase_3_cycles", "m_diet_increase_3_cycles", "m_diet_increase_6_cycles", "m_diet_increase_6_cycles", "m_diet_reduction_3_cycles", "m_diet_reduction_3_cycles", "n_at_follow_up", "n_change", "n_criteria", "n_factors", "n_for_discontinuation", "n_method", "n_reason_for_withdrawal", "n_standard", "n_status", "n_symptoms", "n_tools", "o_association_with_acr_change", "o_change_after_six_cycles", "o_change_after_three_cycles", "o_change_between_groups", "o_change_throughout_study", "o_difference_in_endpoints_by_gender", "p_value", "p_value", "p_value", "p_value", "p_value", "p_value", "p_value", "p_value", "p_value", "p_value", "p_value", "p_value", "p_value", "r_distribution", "r_of", "s_2_to_5_energy", "s_2_to_5_macronutrients", "s_approval", "s_different_response_in", "s_discontinuation_of", "s_discontinuation_of", "s_effects_on", "s_hierarchical_test_procedure_to_account_for", "s_longer_period_for", "s_not_due_to", "s_reduction_of", "s_subgroup_analysis_for", "s_type", "t_fmd_increase", "t_free_mass", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_mass", "t_on_acetylcarnitine", "t_on_albuminuria", "t_on_albuminuria", "t_on_albuminuria", "t_on_albuminuria", "t_on_albuminuria", "t_on_dicarbonyl_detoxification", "t_on_dna_damage_repair", "t_on_glo_1", "t_on_glycine", "t_on_homa_ir", "t_on_insulin_resistance", "t_on_ketones", "t_on_ketones", "t_on_medication", "t_on_medication", "t_on_metabolism", "t_on_mg_h1", "t_on_supar", "t_response_in_responders", "t_summary", "t_summary", "t_summary", "t_summary", "t_summary", "w_up_time", "y_1_energy", "y_1_macronutrients", "y_endpoint", "y_explain", "y_explain", "y_help_develop", "y_period" ], "operators": [ "≤", "≤", "≤", "±", "±", "≤", "≤", "≤", "=", "±", "<=", "<=", "<=", "<=", "<=", "<=", "<=", "<=", "<=", "<=", "≤" ] }, "after": { "numbers": [ "2", "-30.3", "0.05", "-3.8", "0.05", "-156.6", "0.05", "2", "4E+1", "7.8", "0.2", "62.1", "2.3", "21", "19", "-30.3", "434", "110.3", "-3.8", "0.05", "-1.9", "0.05", "-156.6", "0.05", "1", "682", "2016", "3E+1", "2", "7", "4.6E+3", "11", "46", "43", "3E+3", "9", "44", "47", "5E+1", "1", "1", "34", "15", "4E+1", "5", "8E+1", "3E+1", "3E+1", "2019", "7", "5", "5", "2018", "2.02E+3", "41", "21", "2E+1", "1", "38", "33", "31", "112", "31", "19", "2", "71", "95", "54", "0.05", "434", "0.23", "11.8", "17.9", "0.01", "0.05", "8.3", "1.73", "2", "0.05", "214.8", "156.6", "0.05", "17", "0.05", "6E+1", "0.05", "5.6", "7.2", "0.001", "62", "0.7", "1.1", "0.001", "85.7", "271", "55.5", "563", "110.3", "0.45", "-62.5", "0.45", "-1.9", "0.05", "74", "71", "3", "6.1", "1E+1", "11", "5", "11", "57", "32", "5", "67", "21", "1E+1", "5", "5", "1E+1", "1E+1", "3", "0.5", "3", "0.5", "0.001", "6.1", "6.1", "2", "1", "2", "2" ], "quantities": [ [ "-30.3", "mg/g" ], [ "0.2", "%" ], [ "2.3", "mmol/mol" ], [ "-30.3", "mg/g" ], [ "434", "mg/g" ], [ "110.3", "mg/g" ], [ "3E+1", "kg/m" ], [ "7", "%" ], [ "4.6E+3", "kJ" ], [ "11", "%" ], [ "46", "%" ], [ "43", "%" ], [ "3E+3", "kJ" ], [ "9", "%" ], [ "44", "%" ], [ "47", "%" ], [ "5E+1", "%" ], [ "15", "%" ], [ "5", "%" ], [ "8E+1", "%" ], [ "3E+1", "%" ], [ "3E+1", "%" ], [ "95", "%" ], [ "54", "%" ], [ "434", "mg/g" ], [ "11.8", "mg" ], [ "17.9", "mg" ], [ "1.73", "m^2" ], [ "17", "%" ], [ "6E+1", "%" ], [ "5.6", "kg" ], [ "7.2", "kg" ], [ "62", "%" ], [ "0.7", "kg" ], [ "1.1", "kg" ], [ "85.7", "mg/g" ], [ "271", "mg/g" ], [ "55.5", "mg/g" ], [ "563", "mg/g" ], [ "110.3", "mg/g" ], [ "-62.5", "mg/g" ], [ "74", "%" ], [ "71", "%" ], [ "1E+1", "%" ], [ "11", "%" ], [ "5", "%" ], [ "11", "%" ], [ "57", "%" ], [ "32", "%" ], [ "5", "%" ], [ "67", "%" ], [ "21", "%" ], [ "1E+1", "%" ], [ "5", "%" ], [ "5", "%" ], [ "1E+1", "%" ], [ "1E+1", "%" ], [ "0.5", "mmol" ], [ "0.5", "mmol" ] ], "formulas": [ "P≤0.001", "P≤0.05", "P≤0.05", "P≤0.05", "P≤0.05", "P≤0.05", "P≤0.05", "R(version3.60.12019to7to5)", "S-682/2016", "a=5", "chemical:DRKS00014287", "chemical:H1", "chemical:H1", "chemical:H1", "chemical:H1", "chemical:H1", "chemical:H1", "m^2", "m^2" ], "mathematical_variables": [ "a_change", "a_change", "c_change", "d_acr_in_macroalbuminuria_patients", "d_acr_in_microalbuminuria_patients", "d_at_follow_up", "d_at_follow_up", "d_at_follow_up", "d_at_follow_up", "d_at_follow_up", "d_at_follow_up", "d_by", "d_by", "d_by", "d_by", "d_by", "d_by", "d_by", "d_deviation_assumption", "d_dropout_rate", "d_during", "d_effect", "d_effect", "d_effect", "d_effect", "d_effect", "d_effect_macroalbuminuria", "d_egfr_more_than_m_diet", "d_for", "d_group_diet", "d_group_n", "d_hba1c_levels", "d_homa_ir_in_non_insulin_treated", "d_immediately", "d_in", "d_in", "d_increase_3_cycles", "d_increase_6_cycles", "d_mg_h1_levels", "d_n", "d_not_change", "d_not_change", "d_on_clinically_relevant_reduction_of", "d_participants_to", "d_reduction_3_cycles", "d_reduction_3_cycles", "d_reduction_6_cycles", "d_reduction_6_cycles", "d_reduction_at_follow_up", "d_study", "d_supar_levels", "d_three_cycles", "d_to", "d_to", "d_to", "d_to", "d_to", "d_urea_levels", "d_weight_loss", "d_weight_loss", "d_with", "d_with", "d_with", "e_1_fmd", "e_1_m_diet", "e_2_fmd", "e_2_m_diet", "e_HbA1c", "e_adverse_effects", "e_between_groups", "e_effect", "e_effects", "e_fmd_non_responders", "e_fmd_responders", "e_from_weight_loss", "e_in_change_after_six_cycles_all_patients", "e_in_change_after_three_cycles_all_patients", "e_indicator", "e_level", "e_m_diet_non_responders", "e_m_diet_responders", "e_magnitude", "e_measures_comparable_between", "e_monitoring", "e_pattern", "e_points", "e_size", "e_size", "e_status", "e_status", "e_structure", "e_version", "g_effect", "g_value_handling", "l_cell_metabolism_exploration", "l_change", "l_change_difference", "l_entity_type", "l_entity_type", "l_entity_type", "l_group_diet", "l_integration", "l_n", "l_randomized", "m_diet_3_cycles", "m_diet_6_cycles", "m_diet_group_n", "m_diet_increase_3_cycles", "m_diet_increase_3_cycles", "m_diet_increase_6_cycles", "m_diet_increase_6_cycles", "m_diet_reduction_3_cycles", "m_diet_reduction_3_cycles", "n_at_follow_up", "n_change", "n_criteria", "n_factors", "n_for_discontinuation", "n_method", "n_reason_for_withdrawal", "n_standard", "n_status", "n_symptoms", "n_tools", "o_association_with_acr_change", "o_change_after_six_cycles", "o_change_after_three_cycles", "o_change_between_groups", "o_change_throughout_study", "o_difference_in_endpoints_by_gender", "p_value", "p_value", "p_value", "p_value", "p_value", "p_value", "p_value", "p_value", "p_value", "p_value", "p_value", "p_value", "p_value", "r_distribution", "r_of", "s_2_to_5_energy", "s_2_to_5_macronutrients", "s_approval", "s_different_response_in", "s_discontinuation_of", "s_discontinuation_of", "s_effects_on", "s_hierarchical_test_procedure_to_account_for", "s_longer_period_for", "s_not_due_to", "s_reduction_of", "s_subgroup_analysis_for", "s_type", "t_fmd_increase", "t_free_mass", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_id", "t_mass", "t_on_acetylcarnitine", "t_on_albuminuria", "t_on_albuminuria", "t_on_albuminuria", "t_on_albuminuria", "t_on_albuminuria", "t_on_dicarbonyl_detoxification", "t_on_dna_damage_repair", "t_on_glo_1", "t_on_glycine", "t_on_homa_ir", "t_on_insulin_resistance", "t_on_ketones", "t_on_ketones", "t_on_medication", "t_on_medication", "t_on_metabolism", "t_on_mg_h1", "t_on_supar", "t_response_in_responders", "t_summary", "t_summary", "t_summary", "t_summary", "t_summary", "w_up_time", "y_1_energy", "y_1_macronutrients", "y_endpoint", "y_explain", "y_explain", "y_help_develop", "y_period" ], "operators": [ "≤", "≤", "≤", "±", "±", "≤", "≤", "≤", "=", "±", "<=", "<=", "<=", "<=", "<=", "<=", "<=", "<=", "<=", "<=", "≤" ] }, "numeric_content_present": true, "formula_content_present": true, "exact_text_unchanged": false, "interpretation": "Conservative preservation filter; changed signatures require review and can include harmless reordering or equivalent unit/algebra conversions" } }, "condition": "gemma12_r128_ku1000_bt", "source_metadata": { "title": "A six-month periodic fasting reduces microalbuminuria and improves metabolic control in patients with type 2 diabetes and diabetic nephropathy: a randomized controlled study", "authors": [ "Alba Sulaj", "Stefan Kopf", "Ekaterina Von Rauchhaupt", "Elisabeth Kliemank", "Maik Brune", "Zoltan Kender", "Hannelore Bartl", "Fabiola Garcia Cortizo", "Katarina Klepac", "Zhe Han", "Varun Kumar", "Valter Longo", "Aurelio Teleman", "Jürgen G Okun", "Jakob Morgenstern", "Thomas Fleming", "Julia Szendroedi", "Stephan Herzig", "Peter P Nawroth" ], "doi": "", "year": "", "openalex_id": "", "origin": "Existing disjoint 20-paper benchmark cohort", "metadata_added_for_attribution_only": true, "metadata_not_used_to_change_QA_context": true } }