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            <front>

                <journal-meta>
                                    <journal-id></journal-id>
            <journal-title-group>
                                                                                    <journal-title>Erciyes Üniversitesi Fen Bilimleri Enstitüsü Fen Bilimleri Dergisi</journal-title>
            </journal-title-group>
                            <issn pub-type="ppub">1012-2354</issn>
                                                                                                        <publisher>
                    <publisher-name>Erciyes Üniversitesi</publisher-name>
                </publisher>
                    </journal-meta>
                <article-meta>
                                        <article-id/>
                                                                <article-categories>
                                            <subj-group  xml:lang="en">
                                                            <subject>Systems Biology</subject>
                                                    </subj-group>
                                            <subj-group  xml:lang="tr">
                                                            <subject>Sistem Biyolojisi</subject>
                                                    </subj-group>
                                    </article-categories>
                                                                                                                                                        <title-group>
                                                                                                                        <trans-title-group xml:lang="tr">
                                    <trans-title>Vasküler Yaşlanmada Bağırsak Mikrobiyotası Kaynaklı Metabolitlerin Entegrasyonu İçin Sistem Biyolojisi Temelli Hesaplamalı Bir Çerçeve: MCAS Modeli</trans-title>
                                </trans-title-group>
                                                                                                                                                                                                <article-title>A Systems Biology-Based Computational Framework for Integrating Gut Microbiota-Derived Metabolites in Vascular Aging: The MCAS Model</article-title>
                                                                                                    </title-group>
            
                                                    <contrib-group content-type="authors">
                                                                        <contrib contrib-type="author">
                                                                    <contrib-id contrib-id-type="orcid">
                                        https://orcid.org/0000-0002-8781-3877</contrib-id>
                                                                <name>
                                    <surname>Özbay</surname>
                                    <given-names>Erkan</given-names>
                                </name>
                                                                    <aff>Karamanoğlu Mehmetbey Üniversitesi</aff>
                                                            </contrib>
                                                    <contrib contrib-type="author">
                                                                    <contrib-id contrib-id-type="orcid">
                                        https://orcid.org/0000-0001-9905-2908</contrib-id>
                                                                <name>
                                    <surname>Örücü</surname>
                                    <given-names>Serkan</given-names>
                                </name>
                                                                    <aff>Karamanoğlu Mehmetbey Üniversitesi</aff>
                                                            </contrib>
                                                    <contrib contrib-type="author">
                                                                    <contrib-id contrib-id-type="orcid">
                                        https://orcid.org/0000-0003-4602-1061</contrib-id>
                                                                <name>
                                    <surname>Karagöz</surname>
                                    <given-names>Sami</given-names>
                                </name>
                                                                    <aff>Karamanoğlu Mehmetbey Üniversitesi</aff>
                                                            </contrib>
                                                    <contrib contrib-type="author">
                                                                    <contrib-id contrib-id-type="orcid">
                                        https://orcid.org/0000-0001-6231-886X</contrib-id>
                                                                <name>
                                    <surname>Gülbay</surname>
                                    <given-names>Sait Ramazan</given-names>
                                </name>
                                                                    <aff>Karaman Halk Sağlığı Laboratuvarı</aff>
                                                            </contrib>
                                                    <contrib contrib-type="author">
                                                                    <contrib-id contrib-id-type="orcid">
                                        https://orcid.org/0000-0001-8953-8302</contrib-id>
                                                                <name>
                                    <surname>Işık</surname>
                                    <given-names>Bülent</given-names>
                                </name>
                                                                    <aff>Karamanoğlu Mehmetbey Üniversitesi</aff>
                                                            </contrib>
                                                                                </contrib-group>
                        
                                        <pub-date pub-type="pub" iso-8601-date="20260323">
                    <day>03</day>
                    <month>23</month>
                    <year>2026</year>
                </pub-date>
                                        <volume>42</volume>
                                        <issue>1</issue>
                                                
                        <history>
                                    <date date-type="received" iso-8601-date="20260126">
                        <day>01</day>
                        <month>26</month>
                        <year>2026</year>
                    </date>
                                                    <date date-type="accepted" iso-8601-date="20260318">
                        <day>03</day>
                        <month>18</month>
                        <year>2026</year>
                    </date>
                            </history>
                                        <permissions>
                    <copyright-statement>Copyright © 1985, Erciyes Üniversitesi Fen Bilimleri Enstitüsü Fen Bilimleri Dergisi</copyright-statement>
                    <copyright-year>1985</copyright-year>
                    <copyright-holder>Erciyes Üniversitesi Fen Bilimleri Enstitüsü Fen Bilimleri Dergisi</copyright-holder>
                </permissions>
            
                                                                                                <trans-abstract xml:lang="tr">
                            <p>Yaşlanma, enerji metabolizmasındaki, epigenomik düzenlemedeki ve kronik düşük dereceli inflamasyondaki birbiriyle bağlantılı değişiklikler tarafından şekillendirilen çok faktörlü bir süreçtir. Burada, mikrobiyom kaynaklı metabolitleri vasküler yaşlanma ile ilişkili biyolojik özelliklerle sistem biyolojisi yaklaşımını kullanarak bütünleştirmek için çok katmanlı bir hesaplamalı model tanımlanmaktadır. Mikrobiyal, metabolik ve epigenomik bileşenleri birleştiren bileşik bir indeks oluşturulmuş ve herkese açık veri kümelerine dayanarak analiz edilmiştir. İç içe geçmiş çapraz doğrulama şeması içinde uygulanan L2-düzenlileştirilmiş bir lojistik regresyon modeli, genel model davranışını değerlendirmek için kullanılmıştır. Entegre model, ortalama AUC değeri 0.893 (95% GA: 0.787-0.959), PR-AUC değeri 0.913 ve Brier skoru 0.147 olmak üzere tutarlı biçimde kararlı bir performans göstermiştir. Ablasyon analizleri ayrıca mikrobiyal özelliklerin model ayrım gücüne en güçlü katkıyı sağladığını, metabolik ve epigenomik bileşenlerin ise esas olarak model kararlılığına katkıda bulunduğunu göstermiştir. Tüm bunlar birlikte ele alındığında, bu model mikrobiyota ile ilişkili biyolojik örüntülerin vasküler yaşlanma ile ilişkili olarak yorumlanması için bütünleştirici bir hesaplamalı yaklaşım sunmaktadır.</p></trans-abstract>
                                                                                                                                    <abstract><p>Aging is a multifactorial process that is shaped by interconnected alterations in energy metabolism, epigenomic regulation, and chronic low-grade inflammation. Here, a multilayered computational model is described to integrate microbiome-derived metabolites with vascular aging-related biological features using a systems biology approach. A composite index that combines microbial, metabolic, and epigenomic components was constructed and analyzed based on publicly available datasets. An L2-regularized logistic regression model implemented with in a nested cross-validation scheme was employed to evaluate overall model behavior. The integrated model demonstrated consistently stable performance, with a mean AUC of 0.893 (95% CI: 0.787-0.959), a PR-AUC of 0.913, and a Brier score of 0.147. Ablation analyses further showed that microbial features contributed most strongly to model discrimination, while metabolic and epigenomic components mainly contributed to model stability. Taken together, this model provides an integrative computational approach for interpreting microbiota-associated biological patterns in relation to vascular aging.</p></abstract>
                                                            
            
                                                                                        <kwd-group>
                                                    <kwd>Gut microbiota</kwd>
                                                    <kwd>  Vascular Aging</kwd>
                                                    <kwd>  Systems Biology</kwd>
                                                    <kwd>  Trimethylamine N-Oxide</kwd>
                                                    <kwd>  Short-Chain Fatty Acids</kwd>
                                            </kwd-group>
                            
                                                <kwd-group xml:lang="tr">
                                                    <kwd>Bağırsak Mikrobiyotası</kwd>
                                                    <kwd>  Vasküler Yaşlanma</kwd>
                                                    <kwd>  Sistem Biyolojisi</kwd>
                                                    <kwd>  Trimetilamin N-Oksit</kwd>
                                                    <kwd>  Kısa Zincirli Yağ Asitleri</kwd>
                                            </kwd-group>
                                                                                                                                        </article-meta>
    </front>
    <back>
                            <ref-list>
                                    <ref id="ref1">
                        <label>1</label>
                        <mixed-citation publication-type="journal">Galkin, F., Mamoshina, P., Aliper, A., Putin, E., Moskalev, V., Gladyshev, V. N., Zhavoronkov, A. 2020. Human Gut Microbiome Aging Clock Based on Taxonomic Profiling and Deep Learning. iScience, 23(6), 101199.</mixed-citation>
                    </ref>
                                    <ref id="ref2">
                        <label>2</label>
                        <mixed-citation publication-type="journal">Guedj, A., Volman, Y., Geiger-Maor, A., Bolik, J., Schumacher, N., Künzel, S., Baines, J. F., Nevo, Y., Elgavish, S., Galun, E., Amsalem, H., Schmidt-Arras, D., Rachmilewitz, J. 2020. Gut microbiota shape &#039;inflamm-ageing&#039; cytokines and account for age-dependent decline in DNA damage repair. Gut, 69(6), 1064-1075.</mixed-citation>
                    </ref>
                                    <ref id="ref3">
                        <label>3</label>
                        <mixed-citation publication-type="journal">Agnoletti, D., Piani, F., Cicero, A. F. G., Borghi, C. 2022. The Gut Microbiota and Vascular Aging: A State-of-the-Art and Systematic Review of the Literature. Journal of clinical medicine, 11(12), 3557.</mixed-citation>
                    </ref>
                                    <ref id="ref4">
                        <label>4</label>
                        <mixed-citation publication-type="journal">Behringer E. J. 2023. Impact of aging on vascular ion channels: perspectives and knowledge gaps across major organ systems. American journal of physiology. Heart and circulatory physiology, 325(5), H1012-H1038.</mixed-citation>
                    </ref>
                                    <ref id="ref5">
                        <label>5</label>
                        <mixed-citation publication-type="journal">Li, T., Chen, Y., Gua, C., Li, X. 2017. Elevated Circulating Trimethylamine N-Oxide Levels Contribute to Endothelial Dysfunction in Aged Rats through Vascular Inflammation and Oxidative Stress. Frontiers in physiology, 8, 350.</mixed-citation>
                    </ref>
                                    <ref id="ref6">
                        <label>6</label>
                        <mixed-citation publication-type="journal">Claesson, M. J., Jeffery, I. B., Conde, S., Power, S. E., O&#039;Connor, E. M., Cusack, S., Harris, H. M., Coakley, M., Lakshminarayanan, B., O&#039;Sullivan, O., Fitzgerald, G. F., Deane, J., O&#039;Connor, M., Harnedy, N., O&#039;Connor, K., O&#039;Mahony, D., van Sinderen, D., Wallace, M., Brennan, L., Stanton, C., … O&#039;Toole, P. W. 2012. Gut microbiota composition correlates with diet and health in the elderly. Nature, 488(7410), 178-184.</mixed-citation>
                    </ref>
                                    <ref id="ref7">
                        <label>7</label>
                        <mixed-citation publication-type="journal">Yatsunenko, T., Rey, F. E., Manary, M. J., Trehan, I., Dominguez-Bello, M. G., Contreras, M., Magris, M., Hidalgo, G., Baldassano, R. N., Anokhin, A. P., Heath, A. C., Warner, B., Reeder, J., Kuczynski, J., Caporaso, J. G., Lozupone, C. A., Lauber, C., Clemente, J. C., Knights, D., Knight, R., … Gordon, J. I. 2012. Human gut microbiome viewed across age and geography. Nature, 486(7402), 222-227.</mixed-citation>
                    </ref>
                                    <ref id="ref8">
                        <label>8</label>
                        <mixed-citation publication-type="journal">Chen, W., Zhang, S., Wu, J., Ye, T., Wang, S., Wang, P., Xing, D. 2020. Butyrate-producing bacteria and the gut-heart axis in atherosclerosis. Clinica chimica acta; international journal of clinical chemistry, 507, 236-241.</mixed-citation>
                    </ref>
                                    <ref id="ref9">
                        <label>9</label>
                        <mixed-citation publication-type="journal">Zhang D, Jian YP, Zhang YN, et al. Short-chain fatty acids in diseases. Cell Commun Signal. 2023;21(1):212.</mixed-citation>
                    </ref>
                                    <ref id="ref10">
                        <label>10</label>
                        <mixed-citation publication-type="journal">Mariat, D., Firmesse, O., Levenez, F., Guimarăes, V., Sokol, H., Doré, J., Corthier, G.,  Furet, J. P. 2009. The Firmicutes/Bacteroidetes ratio of the human microbiota changes with age. BMC microbiology, 9, 123</mixed-citation>
                    </ref>
                                    <ref id="ref11">
                        <label>11</label>
                        <mixed-citation publication-type="journal">Lu, Y., Zhang, Y., Zhao, X., Shang, C., Xiang, M., Li, L., Cui, X. 2022. Microbiota-derived short-chain fatty acids: Implications for cardiovascular and metabolic disease. Frontiers in cardiovascular medicine, 9, 900381.</mixed-citation>
                    </ref>
                                    <ref id="ref12">
                        <label>12</label>
                        <mixed-citation publication-type="journal">Wang, Z., Klipfell, E., Bennett, B. J., Koeth, R., Levison, B. S., Dugar, B., Feldstein, A. E., Britt, E. B., Fu, X., Chung, Y. M., Wu, Y., Schauer, P., Smith, J. D., Allayee, H., Tang, W. H., DiDonato, J. A., Lusis, A. J., Hazen, S. L. 2011. Gut flora metabolism of phosphatidylcholine promotes cardiovascular disease. Nature, 472(7341), 57-63.</mixed-citation>
                    </ref>
                                    <ref id="ref13">
                        <label>13</label>
                        <mixed-citation publication-type="journal">Sun, X., Jiao, X., Ma, Y., Liu, Y., Zhang, L., He, Y., Chen, Y. 2016. Trimethylamine N-oxide induces inflammation and endothelial dysfunction in human umbilical vein endothelial cells via activating ROS-TXNIP-NLRP3 inflammasome. Biochemical and biophysical research communications, 481(1-2), 63-70.</mixed-citation>
                    </ref>
                                    <ref id="ref14">
                        <label>14</label>
                        <mixed-citation publication-type="journal">Yao, Y., Xu, Y., Wang, W., Zhang, J., Li, Q. 2017. Glucagon-like peptide-1 improves β-cell dysfunction by suppressing the miR-27a-induced downregulation of ATP-binding cassette transporter A1. Biomedicine &amp; pharmacotherapy = Biomedecine &amp; pharmacotherapie, 96, 497-502.</mixed-citation>
                    </ref>
                                    <ref id="ref15">
                        <label>15</label>
                        <mixed-citation publication-type="journal">Alsulami, M., Alamri, H., Barhoumi, T., Munawar, N., Alghanem, B. 2025. The effect of TMAO on aging-associated cardiovascular and metabolic pathways and emerging therapies. Molecular and cellular biochemistry, 480(11), 5659-5669.</mixed-citation>
                    </ref>
                                    <ref id="ref16">
                        <label>16</label>
                        <mixed-citation publication-type="journal">Du, Y., Li, X., Su, C., Xi, M., Zhang, X., Jiang, Z., Wang, L., Hong, B. 2020. Butyrate protects against high-fat diet-induced atherosclerosis via up-regulating ABCA1 expression in apolipoprotein E-deficiency mice. British journal of pharmacology, 177(8), 1754-1772.</mixed-citation>
                    </ref>
                                    <ref id="ref17">
                        <label>17</label>
                        <mixed-citation publication-type="journal">Fellows, R., Denizot, J., Stellato, C., Cuomo, A., Jain, P., Stoyanova, E., Balázsi, S., Hajnády, Z., Liebert, A., Kazakevych, J., Blackburn, H., Corrêa, R. O., Fachi, J. L., Sato, F. T., Ribeiro, W. R., Ferreira, C. M., Perée, H., Spagnuolo, M., Mattiuz, R., Matolcsi, C., … Varga-Weisz, P. 2018. Microbiota derived short chain fatty acids promote histone crotonylation in the colon through histone deacetylases. Nature communications, 9(1), 105.</mixed-citation>
                    </ref>
                                    <ref id="ref18">
                        <label>18</label>
                        <mixed-citation publication-type="journal">Shapiro, H., Thaiss, C. A., Levy, M., Elinav, E. 2014. The cross talk between microbiota and the immune system: metabolites take center stage. Current opinion in immunology, 30, 54-62.</mixed-citation>
                    </ref>
                                    <ref id="ref19">
                        <label>19</label>
                        <mixed-citation publication-type="journal">Robles-Vera, I., Toral, M., de la Visitación, N., Aguilera-Sánchez, N., Redondo, J. M., Duarte, J. 2020. Protective Effects of Short-Chain Fatty Acids on Endothelial Dysfunction Induced by Angiotensin II. Frontiers in physiology, 11, 277.</mixed-citation>
                    </ref>
                                    <ref id="ref20">
                        <label>20</label>
                        <mixed-citation publication-type="journal">Davie J. R. 2003. Inhibition of histone deacetylase activity by butyrate. The Journal of nutrition, 133(7 Suppl), 2485S-2493S.</mixed-citation>
                    </ref>
                                    <ref id="ref21">
                        <label>21</label>
                        <mixed-citation publication-type="journal">Saeedi Saravi, S. S., Pugin, B., Constancias, F., Shabanian, K., Spalinger, M., Thomas, A., Le Gludic, S., Shabanian, T., Karsai, G., Colucci, M., Menni, C., Attaye, I., Zhang, X., Allemann, M. S., Lee, P., Visconti, A., Falchi, M., Alimonti, A., Ruschitzka, F., Paneni, F., … Beer, J. H. 2025. Gut microbiota-dependent increase in phenylacetic acid induces endothelial cell senescence during aging. Nature aging, 5(6), 1025-1045.</mixed-citation>
                    </ref>
                                    <ref id="ref22">
                        <label>22</label>
                        <mixed-citation publication-type="journal">Zhang, M., Wu, J. F., Chen, W. J., Tang, S. L., Mo, Z. C., Tang, Y. Y., Li, Y., Wang, J. L., Liu, X. Y., Peng, J., Chen, K., He, P. P., Lv, Y. C., Ouyang, X. P., Yao, F., Tang, D. P., Cayabyab, F. S., Zhang, D. W., Zheng, X. L., Tian, G. P., … Tang, C. K. 2014. MicroRNA-27a/b regulates cellular cholesterol efflux, influx and esterification/hydrolysis in THP-1 macrophages. Atherosclerosis, 234(1), 54-64.</mixed-citation>
                    </ref>
                                    <ref id="ref23">
                        <label>23</label>
                        <mixed-citation publication-type="journal">Yue, R., Dutta, A. 2022. Computational systems biology in disease modeling and control, review and perspectives. NPJ systems biology and applications, 8(1), 37.</mixed-citation>
                    </ref>
                                    <ref id="ref24">
                        <label>24</label>
                        <mixed-citation publication-type="journal">Pedregosa, F., Varoquaux, G., Gramfort, A., Michel, V., Thirion, B., Grisel, O., Blondel, M., Prettenhofer, P., Weiss, R., Dubourg, V., Vanderplas, J., Passos, A., Duchesnay, É. 2011. Scikit-learn: Machine learning in Python. the Journal of machine Learning research, 12, 2825-2830.</mixed-citation>
                    </ref>
                                    <ref id="ref25">
                        <label>25</label>
                        <mixed-citation publication-type="journal">DeGroat, W., Abdelhalim, H., Peker, E., Sheth, N., Narayanan, R., Zeeshan, S., Liang, B. T., Ahmed, Z. 2024. Multimodal AI/ML for discovering novel biomarkers and predicting disease using multi-omics profiles of patients with cardiovascular diseases. Scientific reports, 14(1), 26503.</mixed-citation>
                    </ref>
                                    <ref id="ref26">
                        <label>26</label>
                        <mixed-citation publication-type="journal">Barabási, A. L., Oltvai, Z. N. 2004. Network biology: understanding the cell&#039;s functional organization. Nature reviews. Genetics, 5(2), 101-113.</mixed-citation>
                    </ref>
                                    <ref id="ref27">
                        <label>27</label>
                        <mixed-citation publication-type="journal">Chen, Y., Wang, H., Lu, W., Wu, T., Yuan, W., Zhu, J., Lee, Y. K., Zhao, J., Zhang, H., Chen, W. 2022. Human gut microbiome aging clocks based on taxonomic and functional signatures through multi-view learning. Gut microbes, 14(1), 2025016.</mixed-citation>
                    </ref>
                                    <ref id="ref28">
                        <label>28</label>
                        <mixed-citation publication-type="journal">Stebegg, M., Silva-Cayetano, A., Innocentin, S., Jenkins, T. P., Cantacessi, C., Gilbert, C., Linterman, M. A. 2019. Heterochronic faecal transplantation boosts gut germinal centres in aged mice. Nature communications, 10(1), 2443.</mixed-citation>
                    </ref>
                                    <ref id="ref29">
                        <label>29</label>
                        <mixed-citation publication-type="journal">Ren, J., Li, H., Zeng, G., Pang, B., Wang, Q., Wei, J. 2023. Gut microbiome-mediated mechanisms in aging-related diseases: are probiotics ready for prime time?. Frontiers in pharmacology, 14, 1178596.</mixed-citation>
                    </ref>
                                    <ref id="ref30">
                        <label>30</label>
                        <mixed-citation publication-type="journal">Turkish Statistical Institute. Causes of Death Statistics, 2023 - Table 2: Classification by cause of death (ICD-10) Dataset. Ankara: Turkish Statistical Institute. https://data.tuik.gov.tr/Bulten/Index?p=Olum-ve-Olum-Nedeni-İstatistikleri-2023-53709. (Access Date, 21.10.2025).</mixed-citation>
                    </ref>
                                    <ref id="ref31">
                        <label>31</label>
                        <mixed-citation publication-type="journal">Efron, B., Tibshirani, R. J. 1994. An introduction to the bootstrap. pp 168-195. New York, NY: Chapman &amp; Hall/CRC, 456p</mixed-citation>
                    </ref>
                                    <ref id="ref32">
                        <label>32</label>
                        <mixed-citation publication-type="journal">Guyon I, Elisseeff, A. 2003. An Introduction to Variable and Feature Selection. Journal of Machine Learning Research, 3, 1157-1182.</mixed-citation>
                    </ref>
                                    <ref id="ref33">
                        <label>33</label>
                        <mixed-citation publication-type="journal">Hoyles, L., Fernández-Real, J. M., Federici, M., Serino, M., Abbott, J., Charpentier, J., Heymes, C., Luque, J. L., Anthony, E., Barton, R. H., Chilloux, J., Myridakis, A., Martinez-Gili, L., Moreno-Navarrete, J. M., Benhamed, F., Azalbert, V., Blasco-Baque, V., Puig, J., Xifra, G., Ricart, W., … Dumas, M. E. 2018. Molecular phenomics and metagenomics of hepatic steatosis in non-diabetic obese women. Nature medicine, 24(7), 1070-1080.</mixed-citation>
                    </ref>
                                    <ref id="ref34">
                        <label>34</label>
                        <mixed-citation publication-type="journal">Yang, R., Pang, J., Zhong, X., Pang, S., Hu, X., Wei, C., Yan, W., Chen, X., Zhao, R., Xu, B., Cao, Z. 2025. Molecular mechanisms of aberrant fatty acids metabolism in driving cardiovascular diseases: key regulatory targets and dietary interventions. Food &amp; function, 16(15), 5961-5993.</mixed-citation>
                    </ref>
                                    <ref id="ref35">
                        <label>35</label>
                        <mixed-citation publication-type="journal">Budoff, M. J., de Oliveira Otto, M. C., Li, X. S., Lee, Y., Wang, M., Lai, H. T. M., Lemaitre, R. N., Pratt, A., Tang, W. H. W., Psaty, B. M., Siscovick, D. S., Hazen, S. L., Mozaffarian, D. 2025. Trimethylamine-N-oxide (TMAO) and risk of incident cardiovascular events in the multi ethnic study of Atherosclerosis. Scientific reports, 15(1), 23362.</mixed-citation>
                    </ref>
                                    <ref id="ref36">
                        <label>36</label>
                        <mixed-citation publication-type="journal">Steyerberg, E. W., Vergouwe, Y. 2014. Towards better clinical prediction models: seven steps for development and an ABCD for validation. European heart journal, 35(29), 1925-1931.</mixed-citation>
                    </ref>
                                    <ref id="ref37">
                        <label>37</label>
                        <mixed-citation publication-type="journal">Pencina, M. J., D&#039;Agostino, R. B., Sr, Steyerberg, E. W. 2011. Extensions of net reclassification improvement calculations to measure usefulness of new biomarkers. Statistics in medicine, 30(1), 11-21.</mixed-citation>
                    </ref>
                                    <ref id="ref38">
                        <label>38</label>
                        <mixed-citation publication-type="journal">Chen, K., Zheng, X., Feng, M., Li, D., Zhang, H. 2017. Gut Microbiota-Dependent Metabolite Trimethylamine N-Oxide Contributes to Cardiac Dysfunction in Western Diet-Induced Obese Mice. Frontiers in physiology, 8, 139.</mixed-citation>
                    </ref>
                                    <ref id="ref39">
                        <label>39</label>
                        <mixed-citation publication-type="journal">Montero-Melendez, T., Dalli, J., Perretti, M. 2013. Gene expression signature-based approach identifies a pro-resolving mechanism of action for histone deacetylase inhibitors. Cell death and differentiation, 20(4), 567-575.</mixed-citation>
                    </ref>
                                    <ref id="ref40">
                        <label>40</label>
                        <mixed-citation publication-type="journal">Tang, W. H., Kitai, T., Hazen, S. L. 2017. Gut Microbiota in Cardiovascular Health and Disease. Circulation research, 120(7), 1183-1196.</mixed-citation>
                    </ref>
                                    <ref id="ref41">
                        <label>41</label>
                        <mixed-citation publication-type="journal">Canfora, E. E., Meex, R. C. R., Venema, K., Blaak, E. E. 2019. Gut microbial metabolites in obesity, NAFLD and T2DM. Nature reviews. Endocrinology, 15(5), 261-273.</mixed-citation>
                    </ref>
                                    <ref id="ref42">
                        <label>42</label>
                        <mixed-citation publication-type="journal">Zhu, W., Gregory, J. C., Org, E., Buffa, J. A., Gupta, N., Wang, Z., Li, L., Fu, X., Wu, Y., Mehrabian, M., Sartor, R. B., McIntyre, T. M., Silverstein, R. L., Tang, W. H. W., DiDonato, J. A., Brown, J. M., Lusis, A. J., Hazen, S. L. (2016). Gut Microbial Metabolite TMAO Enhances Platelet Hyperreactivity and Thrombosis Risk. Cell, 165(1), 111-124.</mixed-citation>
                    </ref>
                                    <ref id="ref43">
                        <label>43</label>
                        <mixed-citation publication-type="journal">Kurilshikov, A., van den Munckhof, I. C. L., Chen, L., Bonder, M. J., Schraa, K., Rutten, J. H. W., Riksen, N. P., de Graaf, J., Oosting, M., Sanna, S., Joosten, L. A. B., van der Graaf, M., Brand, T., Koonen, D. P. Y., van Faassen, M., LifeLines DEEP Cohort Study, BBMRI Metabolomics Consortium, Slagboom, P. E., Xavier, R. J., Kuipers, F., Hofker, M. H., … Fu, J. 2019. Gut Microbial Associations to Plasma Metabolites Linked to Cardiovascular Phenotypes and Risk. Circulation research, 124(12), 1808-1820.</mixed-citation>
                    </ref>
                            </ref-list>
                    </back>
    </article>
