{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T14:37:26Z","timestamp":1787582246599,"version":"build-2736575974"},"reference-count":48,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","license":[{"start":{"date-parts":[[2021,2,27]],"date-time":"2021-02-27T00:00:00Z","timestamp":1614384000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatol Commun"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:p>Persons with human immunodeficiency virus (PWH) have subcutaneous adipose tissue (SAT) dysfunction related to antiretroviral therapy and direct viral effects, which may contribute to a higher risk of nonalcoholic fatty liver disease compared with human immunodeficiency virus\u2013negative individuals. We assessed relationships between SAT expression of major adipocyte regulatory and lipid storage genes with hepatic and other ectopic lipid deposits in PWH. We enrolled 97 PWH on long\u2010term antiretroviral therapy with suppressed plasma viremia and performed computed tomography measurements of liver attenuation, a measure of hepatic steatosis, skeletal muscle (SM) attenuation, and the volume of abdominal subcutaneous, visceral, and pericardial adipose tissue. Whole SAT gene expression was measured using the Nanostring platform, and relationships with computed tomography imaging and fasting lipids were assessed using multivariable linear regression and network mapping. The cohort had a mean age of 47\u00a0years, body mass index of 33.4\u00a0kg\/m<jats:sup>2<\/jats:sup>, and CD4 count of 492\u00a0cells\/mm<jats:sup>3<\/jats:sup>. Lower liver attenuation, a marker of greater steatosis, was associated with differences in SAT gene expression, including lower lipoprotein lipase and acyl\u2010CoA dehydrogenase, and higher phospholipid transfer protein. Lower liver attenuation clustered with lower visceral adipose tissue (VAT) attenuation and greater VAT volume, pericardial fat volume and triglycerides, but no relationship was observed between liver attenuation and SAT volume, SM attenuation, or low\u2010density lipoprotein. <jats:italic toggle=\"yes\">Conclusion:<\/jats:italic> Liver attenuation was associated with altered SAT expression of genes regulating lipid metabolism and storage, suggesting that SAT dysfunction may contribute to nonalcoholic fatty liver disease in PWH. SAT gene\u2010expression relationships were similar for VAT volume and attenuation, but not SM, indicating that ectopic lipid deposition may involve multiple pathways.<\/jats:p>","DOI":"10.1002\/hep4.1695","type":"journal-article","created":{"date-parts":[[2021,2,27]],"date-time":"2021-02-27T09:39:49Z","timestamp":1614418789000},"page":"1224-1237","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":14,"title":["Hepatic Steatosis and Ectopic Fat Are Associated With Differences in Subcutaneous Adipose Tissue Gene Expression in People With HIV"],"prefix":"10.1097","volume":"5","author":[{"given":"Curtis L.","family":"Gabriel","sequence":"first","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition,Vanderbilt University Medical Center,Nashville,TN,USA"},{"name":"Tennessee Center for AIDS Research,Vanderbilt University Medical Center,Nashville,TN,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fei","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Biostatistics,Vanderbilt University Medical Center,Nashville,TN,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Run","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Biostatistics,Vanderbilt University Medical Center,Nashville,TN,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sangeeta","family":"Nair","sequence":"additional","affiliation":[{"name":"Department of Radiology and Radiological Sciences,Vanderbilt University Medical Center,Nashville,TN,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James G.","family":"Terry","sequence":"additional","affiliation":[{"name":"Department of Radiology and Radiological Sciences,Vanderbilt University Medical Center,Nashville,TN,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John Jeffrey","family":"Carr","sequence":"additional","affiliation":[{"name":"Department of Radiology and Radiological Sciences,Vanderbilt University Medical Center,Nashville,TN,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi","family":"Silver","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition,Vanderbilt University Medical Center,Nashville,TN,USA"},{"name":"Veterans Affairs Tennessee Valley Healthcare System,Nashville,TN,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paxton","family":"Baker","sequence":"additional","affiliation":[{"name":"Vanderbilt Technologies for Advanced Genomics,Vanderbilt University Medical Center,Nashville,TN,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"LaToya","family":"Hannah","sequence":"additional","affiliation":[{"name":"Division of Diabetes, Endocrinology and Metabolism,Vanderbilt University Medical Center,Nashville,TN,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celestine","family":"Wanjalla","sequence":"additional","affiliation":[{"name":"Tennessee Center for AIDS Research,Vanderbilt University Medical Center,Nashville,TN,USA"},{"name":"Division of Infectious Diseases,Vanderbilt University Medical Center,Nashville,TN,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mona","family":"Mashayekhi","sequence":"additional","affiliation":[{"name":"Division of Diabetes, Endocrinology and Metabolism,Vanderbilt University Medical Center,Nashville,TN,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sam","family":"Bailin","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases,Vanderbilt University Medical Center,Nashville,TN,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morgan","family":"Lima","sequence":"additional","affiliation":[{"name":"Tennessee Center for AIDS Research,Vanderbilt University Medical Center,Nashville,TN,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beverly","family":"Woodward","sequence":"additional","affiliation":[{"name":"Tennessee Center for AIDS Research,Vanderbilt University Medical Center,Nashville,TN,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6402-5333","authenticated-orcid":false,"given":"Manhal","family":"Izzy","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition,Vanderbilt University Medical Center,Nashville,TN,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane F.","family":"Ferguson","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine,Vanderbilt University Medical Center,Nashville,TN,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John R.","family":"Koethe","sequence":"additional","affiliation":[{"name":"Tennessee Center for AIDS Research,Vanderbilt University Medical Center,Nashville,TN,USA"},{"name":"Veterans Affairs Tennessee Valley Healthcare System,Nashville,TN,USA"},{"name":"Division of Infectious Diseases,Vanderbilt University Medical Center,Nashville,TN,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,2,27]]},"reference":[{"key":"hep41695-bib-0001-20241015","doi-asserted-by":"crossref","first-page":"1632","DOI":"10.1001\/archinte.166.15.1632","article-title":"Liver\u2010related deaths in persons infected with the human immunodeficiency virus: the D:A: D study","volume":"166","year":"2006","journal-title":"Arch Intern Med"},{"key":"hep41695-bib-0002-20241015","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1097\/EDE.0000000000000815","article-title":"Incidence and risk factors for prediabetes and diabetes mellitus among HIV\u2010infected adults on antiretroviral therapy: a systematic review and meta\u2010analysis","volume":"29","year":"2018","journal-title":"Epidemiology"},{"key":"hep41695-bib-0003-20241015","first-page":"e29","article-title":"Epidemiological evidence for cardiovascular disease in HIV\u2010infected patients and relationship to highly active antiretroviral therapy","volume":"118","year":"2008","journal-title":"Circulation"},{"key":"hep41695-bib-0004-20241015","doi-asserted-by":"crossref","first-page":"1621","DOI":"10.1097\/QAD.0000000000001504","article-title":"Prevalence and risk factors of nonalcoholic fatty liver disease in HIV\u2010monoinfection","volume":"31","year":"2017","journal-title":"AIDS"},{"key":"hep41695-bib-0005-20241015","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1111\/apt.13702","article-title":"Liver fibrosis and fatty liver in Asian HIV\u2010infected patients","volume":"44","year":"2016","journal-title":"Aliment Pharmacol Ther"},{"key":"hep41695-bib-0006-20241015","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1111\/apt.13052","article-title":"Clinical, biochemical and histological differences between HIV\u2010associated NAFLD and primary NAFLD: a case\u2010control study","volume":"41","year":"2015","journal-title":"Aliment Pharmacol Ther"},{"key":"hep41695-bib-0007-20241015","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1002\/hep.28431","article-title":"Global epidemiology of nonalcoholic fatty liver disease\u2014meta\u2010analytic assessment of prevalence, incidence, and outcomes","volume":"64","year":"2016","journal-title":"Hepatology"},{"key":"hep41695-bib-0008-20241015","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1097\/QAI.0b013e318074efe3","article-title":"HIV\u2010positive patients with nonalcoholic fatty liver disease have a lower body mass index and are more physically active than HIV\u2010negative patients","volume":"45","year":"2007","journal-title":"J Acquir Immune Defic Syndr"},{"key":"hep41695-bib-0009-20241015","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1038\/nrd.2016.75","article-title":"Targeting adipose tissue in the treatment of obesity\u2010associated diabetes","volume":"15","year":"2016","journal-title":"Nat Rev Drug Discov"},{"key":"hep41695-bib-0010-20241015","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1093\/cid\/cir324","article-title":"Peripheral and central fat changes in subjects randomized to abacavir\u2010lamivudine or tenofovir\u2010emtricitabine with atazanavir\u2010ritonavir or efavirenz: ACTG Study A5224s","volume":"53","year":"2011","journal-title":"Clin Infect Dis"},{"key":"hep41695-bib-0011-20241015","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1038\/s41572-020-0181-1","article-title":"HIV and antiretroviral therapy\u2010related fat alterations","volume":"6","year":"2020","journal-title":"Nat Rev Dis Primers"},{"key":"hep41695-bib-0012-20241015","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1097\/QAI.0b013e31829bdb67","article-title":"Differentially altered molecular signature of visceral adipose tissue in HIV\u20101\u2010associated lipodystrophy","volume":"64","year":"2013","journal-title":"J Acquir Immune Defic Syndr"},{"key":"hep41695-bib-0013-20241015","first-page":"104","article-title":"Skeletal muscle attenuation determined by computed tomography is associated with skeletal muscle lipid content","volume":"2000","year":"1985","journal-title":"J Appl Physiol"},{"key":"hep41695-bib-0014-20241015","doi-asserted-by":"crossref","first-page":"1307","DOI":"10.2214\/AJR.06.0992","article-title":"Comparison of CT methods for determining the fat content of the liver","volume":"188","year":"2007","journal-title":"AJR Am J Roentgenol"},{"key":"hep41695-bib-0015-20241015","article-title":"Body fat distribution and risk of incident and regressed nonalcoholic fatty liver disease","volume":"14","year":"2016","journal-title":"Clin Gastroenterol Hepatol"},{"key":"hep41695-bib-0016-20241015","article-title":"Visceral adipose tissue area as an independent risk factor for elevated liver enzyme in nonalcoholic fatty liver disease","volume":"94","year":"2015","journal-title":"Medicine (Baltimore)"},{"key":"hep41695-bib-0017-20241015","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1080\/21623945.2015.1106057","article-title":"Computed tomography\u2010measured adipose tissue attenuation and area both predict adipocyte size and cardiometabolic risk in women","volume":"5","year":"2016","journal-title":"Adipocyte"},{"key":"hep41695-bib-0018-20241015","doi-asserted-by":"crossref","first-page":"4677","DOI":"10.1038\/s41598-018-22962-x","article-title":"Abdominal subcutaneous and visceral adipocyte size, lipolysis and inflammation relate to insulin resistance in male obese humans","volume":"8","year":"2018","journal-title":"Sci Rep"},{"key":"hep41695-bib-0019-20241015","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.metabol.2019.05.001","article-title":"Fatty liver in lipodystrophy: a review with a focus on therapeutic perspectives of adiponectin and\/or leptin replacement","volume":"96","year":"2019","journal-title":"Metabolism"},{"key":"hep41695-bib-0020-20241015","first-page":"91","article-title":"Autologous fat grafting: use of closed syringe microcannula system for enhanced autologous structural grafting","volume":"6","year":"2013","journal-title":"Clin Cosmet Investig Dermatol"},{"key":"hep41695-bib-0021-20241015","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1016\/j.atherosclerosis.2014.05.962","article-title":"Associations between nonalcoholic fatty liver disease and subclinical atherosclerosis in middle\u2010aged adults: the Coronary Artery Risk Development in Young Adults Study","volume":"235","year":"2014","journal-title":"Atherosclerosis"},{"key":"hep41695-bib-0022-20241015","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1148\/radiol.2341040439","article-title":"Calcified coronary artery plaque measurement with cardiac CT in population\u2010based studies: standardized protocol of Multi\u2010Ethnic Study of Atherosclerosis (MESA) and Coronary Artery Risk Development in Young Adults (CARDIA) study","volume":"234","year":"2005","journal-title":"Radiology"},{"key":"hep41695-bib-0023-20241015","doi-asserted-by":"crossref","first-page":"2370","DOI":"10.1161\/ATVBAHA.117.309633","article-title":"Intermuscular adipose tissue and subclinical coronary artery calcification in midlife: the CARDIA Study (Coronary Artery Risk Development in Young Adults)","volume":"37","year":"2017","journal-title":"Arterioscler Thromb Vasc Biol"},{"key":"hep41695-bib-0025-20241015","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1089\/met.2019.0097","article-title":"Hepatic and skeletal muscle adiposity are associated with diabetes independent of visceral adiposity in nonobese African\u2010Caribbean men","volume":"18","year":"2020","journal-title":"Metab Syndr Relat Disord"},{"key":"hep41695-bib-0026-20241015","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1016\/j.numecd.2015.12.011","article-title":"Higher pericardial adiposity is associated with prevalent diabetes: the Coronary Artery Risk Development in Young Adults study","volume":"26","year":"2016","journal-title":"Nutr Metab Cardiovasc Dis"},{"key":"hep41695-bib-0027-20241015","doi-asserted-by":"crossref","first-page":"2498","DOI":"10.1101\/gr.1239303","article-title":"Cytoscape: a software environment for integrated models of biomolecular interaction networks","volume":"13","year":"2003","journal-title":"Genome Res"},{"key":"hep41695-bib-0029-20241015","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/j.1463-1326.2006.00590.x","article-title":"Ectopic fat accumulation and metabolic syndrome","volume":"9","year":"2007","journal-title":"Diabetes Obes Metab"},{"key":"hep41695-bib-0030-20241015","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1007\/s11904-020-00483-5","article-title":"Obesity and weight gain in persons with HIV","volume":"17","year":"2020","journal-title":"Curr HIV\/AIDS Rep"},{"key":"hep41695-bib-0031-20241015","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1097\/01.qai.0000182230.47819.aa","article-title":"Fat distribution in men with HIV infection","volume":"40","year":"2005","journal-title":"J Acquir Immune Defic Syndr"},{"key":"hep41695-bib-0032-20241015","doi-asserted-by":"crossref","first-page":"1509","DOI":"10.1016\/j.jacc.2016.06.067","article-title":"Association of changes in abdominal fat quantity and quality with incident cardiovascular disease risk factors","volume":"68","year":"2016","journal-title":"J Am Coll Cardiol"},{"key":"hep41695-bib-0033-20241015","article-title":"Adipose tissue depots and their cross\u2010sectional associations with circulating biomarkers of metabolic regulation","volume":"5","year":"2016","journal-title":"J Am Heart Assoc"},{"key":"hep41695-bib-0034-20241015","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1186\/s12977-016-0260-2","article-title":"Infectious SIV resides in adipose tissue and induces metabolic defects in chronically infected rhesus macaques","volume":"13","year":"2016","journal-title":"Retrovirology"},{"key":"hep41695-bib-0035-20241015","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1177\/135965350601100610","article-title":"HIV\u20101 infection alters gene expression in adipose tissue, which contributes to HIV\u2010 1\/HAART\u2010associated lipodystrophy","volume":"11","year":"2006","journal-title":"Antivir Ther"},{"key":"hep41695-bib-0036-20241015","doi-asserted-by":"crossref","first-page":"953","DOI":"10.1097\/QAD.0000000000002168","article-title":"Impact of HIV\/simian immunodeficiency virus infection and viral proteins on adipose tissue fibrosis and adipogenesis","volume":"33","year":"2019","journal-title":"AIDS"},{"key":"hep41695-bib-0037-20241015","doi-asserted-by":"crossref","first-page":"2127","DOI":"10.1097\/00002030-200411050-00004","article-title":"The HIV\u20101 nucleoside reverse transcriptase inhibitors stavudine and zidovudine alter adipocyte functions in vitro","volume":"18","year":"2004","journal-title":"AIDS"},{"key":"hep41695-bib-0038-20241015","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1111\/j.1365-201X.2004.01383.x","article-title":"Cellular mechanisms of insulin resistance, lipodystrophy and atherosclerosis induced by HIV protease inhibitors","volume":"183","year":"2005","journal-title":"Acta Physiol Scand"},{"key":"hep41695-bib-0039-20241015","article-title":"The integrase inhibitors dolutegravir and raltegravir exert pro\u2010adipogenic and profibrotic effects and induce insulin resistance in human\/simian adipose tissue and human adipocytes","year":"2020","journal-title":"Clin Infect Dis"},{"key":"hep41695-bib-0040-20241015","doi-asserted-by":"crossref","first-page":"1026","DOI":"10.1016\/S0140-6736(02)08094-7","article-title":"Association between altered expression of adipogenic factor SREBP1 in lipoatrophic adipose tissue from HIV\u20101\u2010infected patients and abnormal adipocyte differentiation and insulin resistance","volume":"359","year":"2002","journal-title":"Lancet"},{"key":"hep41695-bib-0041-20241015","doi-asserted-by":"crossref","first-page":"4857","DOI":"10.1210\/jc.2018-02785","article-title":"CT fat density accurately reflects histologic fat quality in adults with HIV on and off antiretroviral therapy","volume":"104","year":"2019","journal-title":"J Clin Endocrinol Metab"},{"key":"hep41695-bib-0042-20241015","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1186\/s12879-019-4347-y","article-title":"Long\u2010lasting alterations in adipose tissue density and adiponectin production in people living with HIV after thymidine analogues exposure","volume":"19","year":"2019","journal-title":"BMC Infect Dis"},{"key":"hep41695-bib-0043-20241015","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1530\/EJE-19-0296","article-title":"Associations between subcutaneous fat density and systemic inflammation differ by HIV serostatus and are independent of fat quantity","volume":"181","year":"2019","journal-title":"Eur J Endocrinol"},{"key":"hep41695-bib-0044-20241015","article-title":"Antiretroviral therapy initiation is associated with decreased visceral and subcutaneous adipose tissue density in people living with HIV","year":"2020","journal-title":"Clin Infect Dis"},{"key":"hep41695-bib-0045-20241015","doi-asserted-by":"crossref","first-page":"770","DOI":"10.1016\/j.cmet.2016.04.011","article-title":"Adiponectin, leptin, and fatty acids in the maintenance of metabolic homeostasis through adipose tissue crosstalk","volume":"23","year":"2016","journal-title":"Cell Metab"},{"key":"hep41695-bib-0046-20241015","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1007\/s00109-002-0384-9","article-title":"Lipoprotein lipase: structure, function, regulation, and role in disease","volume":"80","year":"2002","journal-title":"J Mol Med (Berl)"},{"key":"hep41695-bib-0047-20241015","doi-asserted-by":"crossref","first-page":"1383","DOI":"10.3390\/nu10101383","article-title":"Regulation and metabolic significance of de novo lipogenesis in adipose tissues","volume":"10","year":"2018","journal-title":"Nutrients"},{"key":"hep41695-bib-0048-20241015","doi-asserted-by":"crossref","first-page":"882","DOI":"10.1089\/aid.2015.0061","article-title":"Polymorphisms in LPL, CETP, and HL protect HIV\u2010infected patients from atherogenic dyslipidemia in an allele\u2010dose\u2010dependent manner","volume":"31","year":"2015","journal-title":"AIDS Res Hum Retroviruses"},{"key":"hep41695-bib-0049-20241015","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.atherosclerosis.2007.10.018","article-title":"HIV infection and high density lipoprotein metabolism","volume":"199","year":"2008","journal-title":"Atherosclerosis"},{"key":"hep41695-bib-0050-20241015","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1186\/s12977-017-0368-z","article-title":"Cellular fatty acid synthase is required for late stages of HIV\u20101 replication","volume":"14","year":"2017","journal-title":"Retrovirology"}],"container-title":["Hepatology Communications"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hep4.1695","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/hep4.1695","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/10.1002\/hep4.1695","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,15]],"date-time":"2024-10-15T22:22:33Z","timestamp":1729030953000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1002\/hep4.1695"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,27]]},"references-count":48,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.1002\/hep4.1695","relation":{},"ISSN":["2471-254X","2471-254X"],"issn-type":[{"value":"2471-254X","type":"print"},{"value":"2471-254X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,27]]},"assertion":[{"value":"2020-09-29","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-01-29","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}