Page last updated: 2024-12-06

chromates

Description Research Excerpts Clinical Trials Roles Classes Pathways Study Profile Bioassays Related Drugs Related Conditions Protein Interactions Research Growth Market Indicators

Description

Chromates: Salts of chromic acid containing the CrO(2-)4 radical. [Medical Subject Headings (MeSH), National Library of Medicine, extracted Dec-2023]

chromate(2-) : A chromium oxoanion resulting from the removal of two protons from chromic acid. [Chemical Entities of Biological Interest (ChEBI), Hastings J, Owen G, Dekker A, Ennis M, Kale N, Muthukrishnan V, Turner S, Swainston N, Mendes P, Steinbeck C. (2016). ChEBI in 2016: Improved services and an expanding collection of metabolites. Nucleic Acids Res]

Cross-References

ID SourceID
PubMed CID24461
CHEBI ID35404
MeSH IDM0004367

Synonyms (33)

Synonym
[cro4](2-)
tetraoxidochromate(vi)
tetraoxochromate(vi)
CHEBI:35404 ,
chromate(vi)
tetraoxidochromate(2-)
13907-45-4
tetraoxochromate(2-)
chromate(2-)
cro4(2-)
11104-59-9
chromate
chromate, wood preservative
NCGC00161828-01
cro42-
ccris 6173
chromate ions
chromate (cro42-)
chromates
dioxido(dioxo)chromium
9s2y101d6m ,
unii-9s2y101d6m
ZCDOYSPFYFSLEW-UHFFFAOYSA-N
chromate (cro42-) ion
chromate anion
chromate anion (cro42-)
chromate ion
DTXSID7065675
diketo(dioxido)chromium
Q26840817
chromate standard: cro4(-2) @ 10000 microg/ml in h2o
cro42?
chromate standard: cro4(-2) @ 1000 microg/ml in h2o

Research Excerpts

Toxicity

ExcerptReferenceRelevance
" The two trivalent compounds (chromium potassium sulfate and chromic chloride), with or without the microsomal fraction, were neither toxic nor mutagenic for the bacterial tester strains."( Toxicity and mutagenicity of hexavalent chromium on Salmonella typhimurium.
De Flora, S; Petrilli, FL, 1977
)
0.26
" At the same time, with the development of its uses, the adverse effects of chromium compounds in human health were being defined."( Toxic effects of chromium and its compounds.
Baruthio, F,
)
0.13
" Intraperitoneal injection of Cr(VI) did not inhibit hepatic glutathione reductase activity, even at toxic doses."( Possible role of glutathione in chromium(VI) metabolism and toxicity in rats.
Standeven, AM; Wetterhahn, KE, 1991
)
0.28
"Although chromium and compounds containing it have been recognized as having potential severe adverse effects on health for more than 160 years, understanding of the systemic toxicology and true hazard of these compounds is still not complete."( Acute and chronic systemic chromium toxicity.
Gad, SC, 1989
)
0.28
" Mutagenic and toxic effects of hexavalent chromium were more expressed in vitamin C-deficient guinea pigs administered K2Cr2O7 in drinking water: the number of micronuclei in polychromatic erythrocytes of bone marrow was increased, and the activity of O-demethylase and the levels of cytochromes P-450 and b5 in liver microsomes were decreased."( Vitamin C lowers mutagenic and toxic effect of hexavalent chromium in guinea pigs.
Chorvatovicová, D; Ginter, E; Kosinová, A, 1989
)
0.28
" These results demonstrate differences in the sensitivity of human, hamster, and mouse cells to CaCrO4 and suggest that the repair-resistant DNA-protein cross-link may be important in mediating the long term toxic and carcinogenic effects of CaCrO4."( Comparison of DNA lesions and cytotoxicity induced by calcium chromate in human, mouse, and hamster cell lines.
Costa, M; Sugiyama, M; Wang, XW, 1986
)
0.27
" Lead nitrate was the most toxic salt but was genetically inactive."( Genotoxic effects of potassium dichromate, sodium arsenite, cobalt chloride and lead nitrate in diploid yeast.
Kharab, P; Singh, I, 1985
)
0.27
" In vivo exposure of the macrophage to either chromium compound showed no toxic effects at a 2-micrograms dose."( Toxicity of hexavalent chromium to the alveolar macrophage in vivo and in vitro.
Galvin, JB; Oberg, SG, 1984
)
0.27
"Stable mutants resistant to the toxic anion chromate have been isolated from a variety of Chinese hamster cell lines."( Isolation and characterization of Chinese hamster cell mutants resistant to the cytotoxic effects of chromate.
Campbell, CE; Gravel, RA; Worton, RG, 1981
)
0.26
" CHOR cells were also found to be cross-resistant to the cytotoxicity and DNA breaks caused by other toxic metals such as CdCl2 and HgCl2."( DNA single-strand breaks and cytotoxicity induced by sodium chromate(VI) in hydrogen peroxide-resistant cell lines.
Haramaki, N; Sugiyama, M; Tsuzuki, K, 1993
)
0.29
" The dose necessary for protection against toxic Cr action in adult rats was not tolerated by young rats."( Vitamin E and C in the prevention of metal nephrotoxicity in developing rats.
Appenroth, D; Winnefeld, K, 1998
)
0.3
" Chromium and their compounds are toxic to both invertebrates and vertebrates and, for this reason, there has been a search for suitable and less toxic alternatives."( Toxicity of sodium molybdate and sodium dichromate to Daphnia magna straus evaluated in acute, chronic, and acetylcholinesterase inhibition tests.
Almeida, E; Diamantino, TC; Guilhermino, L; Soares, AM, 2000
)
0.31
"Some general principles regarding oxidative stress and molecular responses to toxic metals are presented in this manuscript."( The role of oxidative stress in nickel and chromate genotoxicity.
Broday, L; Costa, M; Kluz, T; Peng, W; Salnikow, K; Sutherland, JE; Zhang, Q,
)
0.13
" NER deficiency created by the loss of XPA in fibroblasts or by knockdown of this protein by stable expression of small interfering RNA in H460 cells increased apoptosis and clonogenic death by Cr(VI), providing genetic evidence for the role of monofunctional chromium-DNA adducts in the toxic effects of this metal."( Human nucleotide excision repair efficiently removes chromium-DNA phosphate adducts and protects cells against chromate toxicity.
Peterson, E; Quievryn, G; Reynolds, M; Zhitkovich, A, 2004
)
0.32
" Based on acute toxicity tests, cadmium was nearly 100 times more toxic than chromium for both the rotifer species."( Effect of cadmium and chromium toxicity on the demography and population growth of Brachionus calyciflonrs and Brachionus patulus (Rotifera).
Maríinez-Jerónimo, F; Nandini, S; Ramírez-Pérez, T; Sarma, SS, 2006
)
0.33
"Chromium, a major environmental pollutant, is known for its wide toxic manifestations."( Effects of selenium on chromium (VI)-induced hepatotoxicity in adult rats.
Ben Amara, I; Boudawara, T; Sefi, M; Soudani, N; Zeghal, N, 2011
)
0.37
"The molecular mode(s)-of-action of the toxic metal chromium has yet to be fully resolved."( Chromate toxicity and the role of sulfur.
Avery, SV; Holland, SL, 2011
)
0.37
" TT also showed a reduced ability to transform toxic high valence chromium ions into non-toxic low valence ions."( The protective and toxic effects of rhubarb tannins and anthraquinones in treating hexavalent chromium-injured rats: the Yin/Yang actions of rhubarb.
Jiang, BQ; Li, Q; Li, RS; Lü, Y; Ma, ZJ; Pu, SB; Wang, JB; Xiao, XH; Yan, D; Zeng, LN; Zhang, LD; Zhang, P; Zhao, YL, 2013
)
0.39
" To evaluate whether the nutrient supply may affect the endogenous level of Cr in plants grown under toxic Cr(VI) levels, the contents of Cr were measured (by ICP-MS analyses) in seedlings treated with Cr and with or without Pi, sulfate or nitrate."( Phosphate relieves chromium toxicity in Arabidopsis thaliana plants by interfering with chromate uptake.
Carreón-Abud, Y; Cervantes, C; Hernández-Madrigal, F; López-Bucio, J; Martínez-Trujillo, M; Ortiz-Castro, R, 2014
)
0.4
" Oregano in the peat-amended soil exhibited significantly less toxic effects, due to the role of organic matter in reducing toxic Cr(VI) to Cr(III) and boosted plant vigour in this treatment."( Modulation of hexavalent chromium toxicity on Οriganum vulgare in an acidic soil amended with peat, lime, and zeolite.
Antoniadis, V; Bolan, N; Dimirkou, A; Levizou, E; Rinklebe, J; Shaheen, SM; Zanni, AA, 2018
)
0.48
" Compared to lactate, Cr(VI) was at least 30-fold and 10-fold more toxic when ethanol or butyrate was the sole carbon source, respectively."( Carbon-dependent chromate toxicity mechanism in an environmental Arthrobacter isolate.
Blaskovich, JP; Field, EK; Gerlach, R; Peyton, BM, 2018
)
0.48
"Research over the last three decades showed that chromium, particularly the oxyanion chromate Cr(VI) behaves as a toxic environmental pollutant that strongly damages plants due to oxidative stress, disruption of nutrient uptake, photosynthesis and metabolism, and ultimately, represses growth and development."( Chromium in plant growth and development: Toxicity, tolerance and hormesis.
López-Bucio, J; López-Bucio, JS; Ravelo-Ortega, G, 2022
)
0.72

Pharmacokinetics

ExcerptReferenceRelevance
"The blood level and the basic pharmacokinetic parameters (kel, Cop, T 1/2, AUC) of amoxicillin trihydrate were studied following its oral application to albino rats with experimentally injured kidneys (potassium chromate) and liver (tetrachloromethane)."( [Changes in amoxicillin pharmacokinetics in white rats with experimentally damaged kidneys and liver].
Fink-Gremels, J; Lashev, L, 1987
)
0.27
"A pharmacokinetic model of chromium depuration in the rat has been developed under subchronic exposure conditions."( Development of a pharmacokinetic model for chromium in the rat following subchronic exposure. I. The importance of incorporating long-term storage compartment.
Snyder, CA; Squibb, KS; Thomann, RV, 1994
)
0.29

Compound-Compound Interactions

ExcerptReferenceRelevance
" In order to remove the oxyanions from aqueous stream effectively, surfactant-modified powdered activated carbon (SM-PAC) combined with ultrafiltration (UF) was proposed in this study."( Removal of anionic contaminants by surfactant modified powdered activated carbon (SM-PAC) combined with ultrafiltration.
Hong, HJ; Kim, H; Lee, YJ; Yang, JW, 2009
)
0.35
" This case reminds that clinicians shall strengthen the understanding of chromic acid burns, especially for the patient combined with thermal burns, timely and effective treatment of wounds after burns, close monitoring of liver and kidney function and blood chromium concentration, and early application of antidote are necessary."( [Early debridement combined with antidote in the treatment of one patient with chromic acid burn and acute kidney injury].
Jin, JJ; Luo, Y; Xu, G; Zhang, Y, 2020
)
0.56

Bioavailability

ExcerptReferenceRelevance
" DNA adduct formation was monitored as a marker for bioavailability of genotoxic chromium."( Apoptosis and P53 induction in human lung fibroblasts exposed to chromium (VI): effect of ascorbate and tocopherol.
Blankenship, LJ; Carlisle, DL; Orenstein, JM; Owens, BM; Patierno, SR; Pritchard, DE; Singh, J, 2000
)
0.31
" The absorption rate of chromic oxide, which is considered a nonabsorbable compound, was 14."( Absorption of inorganic, trivalent and hexavalent chromium following oral and intrajejunal doses in rats.
Fébel, H; Huszár, S; Szegedi, B, 2001
)
0.31
" Their potential carcinogenicity is affected by toxicokinetic patterns restricting bioavailability to certain targets, and by metabolic pathways affecting interaction of chromate-derived reactive species with DNA."( Oral chromium(VI) does not affect the frequency of micronuclei in hematopoietic cells of adult mice and of transplacentally exposed fetuses.
Balansky, RM; De Flora, S; Iltcheva, M, 2006
)
0.33
"Chromate mobility, reactivity, and bioavailability in soil environments are affected by adsorption reactions on iron oxide minerals, but the adsorption mechanisms remain controversial."( Investigation of chromate coordination on ferrihydrite by in situ ATR-FTIR spectroscopy and theoretical frequency calculations.
Chrysochoou, M; Johnston, CP, 2012
)
0.38
" The bioavailability of Cr(VI) in soil and its uptake by the plant reduced significantly in SUCR140-treated plants; the effects of AMF, however, either alone or in presence of SUCR140 were not significant."( A Cr(VI)-reducing Microbacterium sp. strain SUCR140 enhances growth and yield of Zea mays in Cr(VI) amended soil through reduced chromium toxicity and improves colonization of arbuscular mycorrhizal fungi.
Awasthi, A; Kalra, A; Singh, R; Soni, SK, 2014
)
0.4
" The bioavailability of Cr(VI) decreased significantly in soil (61 %) and in uptake (36 %) in SUCR140-treated plants; the effects of Rhizobium, however, either alone or in the presence of SUCR140, were not significant."( Pretreatment of Cr(VI)-amended soil with chromate-reducing rhizobacteria decreases plant toxicity and increases the yield of Pisum sativum.
Awasthi, A; Kalra, A; Singh, M; Singh, R; Soni, SK; Wasnik, K, 2014
)
0.4
" The application of biochar to Cr(VI) and As(V) spiked and field contaminated soils was evaluated on the reduction processes [(Cr(VI) to Cr(III)] and [As(V) to As(III))], and subsequent mobility and bioavailability of both As(V) and Cr(VI)."( Differential effect of biochar upon reduction-induced mobility and bioavailability of arsenate and chromate.
Bolan, N; Bush, R; Choppala, G; Kunhikrishnan, A, 2016
)
0.43
"In this work, the effects of various wastewater sources (storm water, sewage effluent, piggery effluent, and dairy effluent) on the reduction, and subsequent mobility and bioavailability of arsenate [As(V)] and chromate [Cr(VI)] were compared using both spiked and field contaminated soils."( Impact of wastewater derived dissolved organic carbon on reduction, mobility, and bioavailability of As(V) and Cr(VI) in contaminated soils.
Bolan, NS; Choppala, G; Kim, WI; Kunhikrishnan, A; Mbene, K; Seshadri, B; Wijesekara, H, 2017
)
0.46
" Blood-based biomarkers may prove useful when more specific information on systemic and intracellular bioavailability is necessary."( HBM4EU chromates study - Usefulness of measurement of blood chromium levels in the assessment of occupational Cr(VI) exposure.
Bocca, B; Bousoumah, R; Duca, RC; Godderis, L; Hardy, E; Iavicoli, I; Janasik, B; Leso, V; Ndaw, S; Pinhal, H; Poels, K; Porras, SP; Rémy, A; Ruggieri, F; Santonen, T; Santos, SR; Scheepers, PTJ; Silva, MJ; van Nieuwenhuyse, A; Verdonck, J; Viegas, S; Wasowicz, W, 2022
)
1.18

Dosage Studied

ExcerptRelevanceReference
" Single administration of potassium dichromate or glycerol is followed by a marked decrease of renal PAH excretion in dependence on the time after the administration as well as on the dosage used."( Stimulation of kidney function in rats of different ages injured by nephrotoxic agents.
Bräunlich, H; Fleck, C; Stopp, M; Weise, C, 1979
)
0.26
" A clear dose-response relationship was observed for the induction of morphological transformation for each compound, either previously solubilized or in suspension."( Role of solubilized chromium in the induction of morphological transformation of Syrian hamster embryo (SHE) cells by particulate chromium(VI) compounds.
Baruthio, F; Danière, MC; Elias, Z; Poirot, O, 1991
)
0.28
" The earliest and most sensitive non-invasive functional change in the dose-response and time-response studies was an elevation in the rate of urinary excretion of protein."( Dose-response and time-response biochemical and histological study of potassium dichromate-induced nephrotoxicity in the rat.
Gumbleton, M; Nicholls, PJ, 1988
)
0.27
" Urine was collected for up to 48 hr after dosing and was analyzed by 1H NMR spectroscopy (400 MHz) and conventional biochemical methods to provide biochemical fingerprints of urine in various site-specific nephrotoxic states."( Investigations into the biochemical effects of region-specific nephrotoxins.
Bonner, FW; Gartland, KP; Nicholson, JK, 1989
)
0.28
" Soluble hexavalent CaCrO4, administered in either acute (5-h) or subacute (24-h) dosing regimens, induced dose-dependent cytotoxicity and mutation to 6-thioguanine resistance in Chinese hamster ovary cells but no mutation to ouabain resistance or focus formation in transformation assays, although the acute treatment induced a high frequency of conversion of 10T1/2 cells to adipocytes."( Transformation of C3H/10T1/2 mouse embryo cells to focus formation and anchorage independence by insoluble lead chromate but not soluble calcium chromate: relationship to mutagenesis and internalization of lead chromate particles.
Banh, D; Landolph, JR; Patierno, SR, 1988
)
0.27
" This inference was supported by the finding that hypoferremic tolerance did not occur when the hypoferremia-provoking dosage of endotoxin (100 mug) was given intravenously to mice pretreated intraperitoneally."( Distribution of chromate-labeled Brucella abortus endoxin in tolerant mice.
Leong, D; Wilson, JB, 1969
)
0.25
" With limitations, the guinea pig model may be helpful in screening the hyposensitization capacity of different haptens dosed orally."( Flare-up reactions and desensitization from oral dosing in chromate-sensitive guinea pigs.
Christensen, MB; Christensen, OB; Maibach, HI, 1984
)
0.27
" The pattern of duration of exposure indicates that the lung-cancer risk does not show a clear dose-response effect with time of employment."( Lung cancer mortality of workers employed in chromate pigment factories. A multicentric European epidemiological study.
Frentzel-Beyme, R, 1983
)
0.27
" The number of ova recovered from superovulated chromium (VI)-treated animals showed significant decreases in the 500 and 750 ppm dosed groups compared to lower dosed (250 ppm) and control groups."( Ovarian dysfunction in mice following chromium (VI) exposure.
Junaid, M; Murthy, RC; Saxena, DK, 1996
)
0.29
" This assumption should be supported by further dose-response studies."( Carcinogenicity assays of wood dust and wood additives in rats exposed by long-term inhalation.
Amelung, F; Klein, RG; Schmezer, P; Schroeder, HG; Woeste, W; Wolf, J, 2001
)
0.31
" Analyses of the dose-response relationships for mwh clones recorded in the two wing genotypes demonstrated that all four compounds are recombinagenic."( Recombinagenic activity of four compounds in the standard and high bioactivation crosses of Drosophila melanogaster in the wing spot test.
Frei, H; Graf, U; Spanó, MA; Würgler, FE, 2001
)
0.31
" The length of comet tail of DNA strand-broken cells increased in a dose-response relation with the increase of K2Cr2O7, whereas, the apoptotic index increased with the dosage of dexamethasone."( [Distinguishing apoptotic cells from DNA strand-broken cells by comet assay].
Heng, Z; Li, R; Zhang, Z, 2001
)
0.31
"This study evaluates the dose-response relationship for inhalation exposure to hexavalent chromium [Cr(VI)] and lung cancer mortality for workers of a chromate production facility, and provides estimates of the carcinogenic potency."( Dose-response and risk assessment of airborne hexavalent chromium and lung cancer mortality.
Crump, C; Crump, K; Hack, E; Liebig, E; Luippold, R; Mundt, K; Panko, J; Paustenbach, D; Proctor, D, 2003
)
0.32
" The contact time, particle size, biosorbent dosage and optimum pH range were investigated to optimize the sorption condition."( Application of a by-product of Lentinus edodes to the bioremediation of chromate contaminated water.
Chen, GQ; Huang, GH; Jiang, W; Niu, CG; Tu, X; Zeng, GM, 2006
)
0.33
"We conducted a mortality study of two German chromate production facilities and evaluated possible dose-response relationships between hexavalent chromium exposure and lung cancer."( Lung cancer mortality in the German chromate industry, 1958 to 1998.
Birk, T; Dell, LD; Luippold, RS; Miksche, L; Mundt, DJ; Mundt, KA; Steinmann-Steiner-Haldenstaett, W, 2006
)
0.33
" No clear dose-response was found in stratified analyses by duration of employment and time since hire."( Lung cancer mortality in the German chromate industry, 1958 to 1998.
Birk, T; Dell, LD; Luippold, RS; Miksche, L; Mundt, DJ; Mundt, KA; Steinmann-Steiner-Haldenstaett, W, 2006
)
0.33
" (2) There existed a dose-response relationship between the personal airborne chromate concentration and the chromium content in erythrocytes."( [Chromium content in erythrocytes serving as the exposure biomarker for workers exposed to soluble chromate].
Jia, G; Li, GR; Liu, LZ; Wang, TC; Wang, X; Yan, L; Zhang, J; Zhang, N, 2006
)
0.33
" The lower body weights were partly attributed to poor palatability of the dosed water and consequent reductions in water consumption."( Toxicology and carcinogenesis studies of sodium dichromate dihydrate (Cas No. 7789-12-0) in F344/N rats and B6C3F1 mice (drinking water studies).
, 2008
)
0.35
" The ion exchange behavior of two alkaline-earth metals on the resin, depending on contact time, pH, temperature and resin dosage was studied."( Removal of Ca(II) and Mg(II) from potassium chromate solution on Amberlite IRC 748 synthetic resin by ion exchange.
Chu, J; Qi, T; Qu, J; Wang, L; Yu, Z, 2009
)
0.35
" Dose-response relationship was observed among rats exposed to Cr(VI)."( Multi-element distribution profile in Sprague-Dawley rats: effects of intratracheal instillation of Cr(VI) and Zn intervention.
Chen, Z; Guo, J; Jia, G; Pu, J; Song, Y; Wang, T; Wang, Y, 2014
)
0.4
" In this study, a microbial consortium was enriched via switching nitrate dosing to chromate feeding as the sole electron acceptor under anaerobic condition in a membrane biofilm reactor (MBfR), in which methane was continuously provided as the electron donor through bubble-less hollow fiber membranes."( Microbial chromate reduction coupled with anaerobic oxidation of methane in a membrane biofilm reactor.
Guo, J; Liu, J; Luo, JH; Qian, G; Wu, M; Yuan, Z, 2019
)
0.51
[information is derived through text-mining from research data collected from National Library of Medicine (NLM), extracted Dec-2023]

Roles (1)

RoleDescription
oxidising agentA substance that removes electrons from another reactant in a redox reaction.
[role information is derived from Chemical Entities of Biological Interest (ChEBI), Hastings J, Owen G, Dekker A, Ennis M, Kale N, Muthukrishnan V, Turner S, Swainston N, Mendes P, Steinbeck C. (2016). ChEBI in 2016: Improved services and an expanding collection of metabolites. Nucleic Acids Res]

Drug Classes (2)

ClassDescription
chromium oxoanion
divalent inorganic anionAny inorganic anion with a valency of two.
[compound class information is derived from Chemical Entities of Biological Interest (ChEBI), Hastings J, Owen G, Dekker A, Ennis M, Kale N, Muthukrishnan V, Turner S, Swainston N, Mendes P, Steinbeck C. (2016). ChEBI in 2016: Improved services and an expanding collection of metabolites. Nucleic Acids Res]

Protein Targets (1)

Potency Measurements

ProteinTaxonomyMeasurementAverage (µ)Min (ref.)Avg (ref.)Max (ref.)Bioassay(s)
DNA polymerase kappa isoform 1Homo sapiens (human)Potency29.93490.031622.3146100.0000AID588579
[prepared from compound, protein, and bioassay information from National Library of Medicine (NLM), extracted Dec-2023]

Research

Studies (2,376)

TimeframeStudies, This Drug (%)All Drugs %
pre-19901291 (54.34)18.7374
1990's287 (12.08)18.2507
2000's382 (16.08)29.6817
2010's324 (13.64)24.3611
2020's92 (3.87)2.80
[information is prepared from research data collected from National Library of Medicine (NLM), extracted Dec-2023]

Market Indicators

Research Demand Index: 82.52

According to the monthly volume, diversity, and competition of internet searches for this compound, as well the volume and growth of publications, there is estimated to be very strong demand-to-supply ratio for research on this compound.

MetricThis Compound (vs All)
Research Demand Index82.52 (24.57)
Research Supply Index7.84 (2.92)
Research Growth Index4.44 (4.65)
Search Engine Demand Index167.63 (26.88)
Search Engine Supply Index2.23 (0.95)

This Compound (82.52)

All Compounds (24.57)

Study Types

Publication TypeThis drug (%)All Drugs (%)
Trials12 (0.47%)5.53%
Reviews52 (2.05%)6.00%
Case Studies96 (3.78%)4.05%
Observational1 (0.04%)0.25%
Other2,376 (93.65%)84.16%
[information is prepared from research data collected from National Library of Medicine (NLM), extracted Dec-2023]