{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,21]],"date-time":"2025-12-21T23:41:57Z","timestamp":1766360517091,"version":"3.48.0"},"reference-count":48,"publisher":"Walter de Gruyter GmbH","issue":"1","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>To investigate the clinicopathological features of three patients with Merkel cell carcinoma (MCC). The clinicopathological features, immunophenotypes, diagnosis and differential diagnosis, treatment, and prognosis of the three patients with MCC were analyzed retrospectively. Among the three patients, two were male and one was female. The age range of the patients was 55\u201379 years, while their mean age was 66.6 years. The maximum and mean tumor diameters were 1.8\u20132.5\u2009cm and 2.1\u2009cm, respectively. The tumors were located in surface areas such as the face and forearm. The tumor masses were mostly round, with a gray, solid appearance and qualitative sections. Microscopic examination revealed that the MCCs of the three patients had roughly the same morphology. Light microscopy indicated that the MCCs appeared as an intradermal mass with a narrow \u201cGrenz band\u201d separated from the epidermis, often accompanied by necrosis (apoptotic bodies) and patchy lymphocyte infiltration. Histological assessment of the MCCs showed monomorphic cell hyperplasia with cables, trabeculae, or sheet formation, hyperchromatic nuclei, vacuoles, cytoplasm with a \u201csalt and pepper\u201d appearance, and nuclear division. Immunophenotyping found tumor cells that were CK (+), CD56 (+), Syn (+), EMA (+), \u03b2-catenin (membrane +), LCA (\u2212), CD99 (\u2212), S100 (\u2212), HMB-45 (\u2212), SOX-10 (\u2212), TTF-1 (\u2212), CDX-2 (\u2212), and CD34 (\u2212), along with a Ki-67 proliferation index of 60\u201370%. Of the three patients with MCC, two were immunophenotypic CgA negative and one was positive. Additionally, two immunophenotypes exhibited CK20 negativity, and one showed paranuclear punctate positivity for CK20. MCC is a highly malignant cutaneous neuroendocrine carcinoma, requiring the combination of pathological morphology examination and immunophenotyping to confirm the diagnosis. Moreover, the primary MCC treatment of surgical treatment should be supplemented with chemotherapy and\/or local radiotherapy to alleviate its poor prognosis, easy recurrence or metastasis, and high mortality.<\/jats:p>","DOI":"10.1515\/biol-2025-1168","type":"journal-article","created":{"date-parts":[[2025,11,15]],"date-time":"2025-11-15T00:05:13Z","timestamp":1763165113000},"source":"Crossref","is-referenced-by-count":0,"title":["Merkel cell carcinoma: Clinicopathological analysis of three patients and literature review"],"prefix":"10.1515","volume":"20","author":[{"given":"Ting","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Pathology, Zhejiang Provincial People\u2019s Hospital Bijie Hospital , Bijie , Guizhou , P.R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xue","family":"Meng","sequence":"additional","affiliation":[{"name":"Department of Pathology, Zhejiang Provincial People\u2019s Hospital Bijie Hospital , Bijie , Guizhou , P.R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuai","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Pathology, Affiliated Hospital of Zunyi Medical University , Zunyi , Guizhou , P.R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Pathology, Affiliated Hospital of Zunyi Medical University , Zunyi , Guizhou , P.R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinjing","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pathology, Affiliated Hospital of Zunyi Medical University , Zunyi , Guizhou , P.R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2025,11,7]]},"reference":[{"key":"2025122123391346561_j_biol-2025-1168_ref_001","doi-asserted-by":"crossref","unstructured":"Toker C. Trabecular carcinoma of the skin. Arch Dermatol. 1972;105:107\u201310.","DOI":"10.1001\/archderm.1972.01620040075020"},{"key":"2025122123391346561_j_biol-2025-1168_ref_002","doi-asserted-by":"crossref","unstructured":"Becker JC, Stang A, DeCaprio JA, Cerroni L, Lebb\u00e9 C, Veness M, et al. Merkel cell carcinoma. Nat Rev Dis Primers. 2017;3:17077. 10.1038\/nrdp.2017.77.","DOI":"10.1038\/nrdp.2017.77"},{"key":"2025122123391346561_j_biol-2025-1168_ref_003","doi-asserted-by":"crossref","unstructured":"Frigerio B, Capella C, Eusebi V, Tenti P, Azzopardi JG. Merkel cell carcinoma of the skin: the structure and origin of normal Merkel cells. Histopathology. 1983;7:229\u201349.","DOI":"10.1111\/j.1365-2559.1983.tb02238.x"},{"key":"2025122123391346561_j_biol-2025-1168_ref_004","doi-asserted-by":"crossref","unstructured":"Nirenberg A, Steinman H, Dixon J, Dixon A. Merkel cell carcinoma update: the case for two tumours. J Eur Acad Dermatol Venereol. 2020;34:1425\u201331.","DOI":"10.1111\/jdv.16158"},{"key":"2025122123391346561_j_biol-2025-1168_ref_005","doi-asserted-by":"crossref","unstructured":"Zur Hausen A, Rennspiess D, Winnepenninckx V, Speel E-J, Kurz AK. Early B-cell differentiation in Merkel cell carcinomas: clues to cellular ancestry. Cancer Res. 2013;73:4982\u20137.","DOI":"10.1158\/0008-5472.CAN-13-0616"},{"key":"2025122123391346561_j_biol-2025-1168_ref_006","doi-asserted-by":"crossref","unstructured":"Pulitzer M. Merkel cell carcinoma. Surg Pathol Clin. 2017;10:399\u2013408. 10.1016\/j.path.2017.01.013.","DOI":"10.1016\/j.path.2017.01.013"},{"key":"2025122123391346561_j_biol-2025-1168_ref_007","doi-asserted-by":"crossref","unstructured":"Hodgson NC. Merkel cell carcinoma: changing incidence trends. J Surg Oncol. 2005;89:1\u20134.","DOI":"10.1002\/jso.20167"},{"key":"2025122123391346561_j_biol-2025-1168_ref_008","doi-asserted-by":"crossref","unstructured":"Heath M, Jaimes N, Lemos B, Mostaghimi A, Wang LC, Pe\u00f1as PF, et al. Clinical characteristics of merkel cell carcinoma at diagnosis in 195 patients: the AEIOU features. J Am Acad Dermatol. 2008;58(3):375\u201381.","DOI":"10.1016\/j.jaad.2007.11.020"},{"key":"2025122123391346561_j_biol-2025-1168_ref_009","doi-asserted-by":"crossref","unstructured":"Wong HH, Wang J. Merkel cell carcinoma. Arch Pathol Lab Med. 2010;134(11):1711\u20136.","DOI":"10.5858\/2009-0165-RSR2.1"},{"key":"2025122123391346561_j_biol-2025-1168_ref_010","doi-asserted-by":"crossref","unstructured":"Liang E, Brower JV, Rice SR, Buehler DG, Saha S, Kimple RJ. Merkel cell carcinoma analysis of outcomes: a 30-year experience. PLoS One. 2015;10(6):e0129476.","DOI":"10.1371\/journal.pone.0129476"},{"key":"2025122123391346561_j_biol-2025-1168_ref_011","doi-asserted-by":"crossref","unstructured":"Harms KL, Healy MA, Nghiem P, Sober AJ, Johnson TM, Bichakjian CK, et al. Analysis of prognostic factors from 9387 Merkel cell carcinoma cases forms the basis for the new 8th edition AJCC staging system. Ann Surg Oncol. 2016;23(11):3564\u201371.","DOI":"10.1245\/s10434-016-5266-4"},{"key":"2025122123391346561_j_biol-2025-1168_ref_012","unstructured":"Kohler S, Kerl H. Merkel cell carcinoma. In: LeBoit PE, Burg G, Weedon D, Sarasin A, editors. Pathology and genetics of skin tumours. Vol. 1, Lyon, France: IARC Press; 2006. p. 272\u20133. World Health Organization Classification of Tumours."},{"key":"2025122123391346561_j_biol-2025-1168_ref_013","unstructured":"LeBoit PE, Burg G, Weedon D, Sarasin A, eds. Pathology and genetics of skin tumours. Lyon, France: IARC Press; 2006. p. 272\u20133. World Health Organization Classification of."},{"key":"2025122123391346561_j_biol-2025-1168_ref_014","doi-asserted-by":"crossref","unstructured":"Nakano E, Ogata D, Namikawa K, Yamazaki N. Merkel cell carcinoma: a review of clinical management with focus on Asian patients. Japanese J Clin Oncol. 2023;53(8):673\u20139.","DOI":"10.1093\/jjco\/hyad059"},{"key":"2025122123391346561_j_biol-2025-1168_ref_015","doi-asserted-by":"crossref","unstructured":"Sarnaik AA, Lien MH, Nghiem P, Bichakjian CK. Clinical recognition, diagnosis, and staging of merkel cell carcinoma, and the role of the multidisciplinary management team. Curr Probl Cancer. 2010;34:38\u201346.","DOI":"10.1016\/j.currproblcancer.2010.01.002"},{"key":"2025122123391346561_j_biol-2025-1168_ref_016","doi-asserted-by":"crossref","unstructured":"Goessling W, McKee PH, Mayer RJ. Merkel cell carcinoma. J Clin Oncol. 2002;20:588\u201398.","DOI":"10.1200\/JCO.2002.20.2.588"},{"key":"2025122123391346561_j_biol-2025-1168_ref_017","doi-asserted-by":"crossref","unstructured":"Schrama D, Sarosi EM, Adam C, Ritter C, Kaemmerer U, Klopocki E, et al. Characterization of six polyomavirus-positive Merkel cell carcinoma cell lines: Integration pattern suggest that large T antigen truncating events occur before or during integration. Int J Cancer. 2019;145(4):1020\u201332.","DOI":"10.1002\/ijc.32280"},{"key":"2025122123391346561_j_biol-2025-1168_ref_018","doi-asserted-by":"crossref","unstructured":"Tang CK, Toker C. Trabecular carcinoma of the skin: an ultrastructural study. Cancer. 1978;42:2311\u201321.","DOI":"10.1002\/1097-0142(197811)42:5<2311::AID-CNCR2820420531>3.0.CO;2-L"},{"key":"2025122123391346561_j_biol-2025-1168_ref_019","doi-asserted-by":"crossref","unstructured":"Richardson WM, Hohmann A, Usmani H, Lozeau D, Huston TL. CK20\/CK7 double\u2010negative Merkel cell carcinoma in situ: A case report. J Cutan Pathol. 2022;49:947\u201356. 10.1111\/cup.14284.","DOI":"10.1111\/cup.14284"},{"key":"2025122123391346561_j_biol-2025-1168_ref_020","doi-asserted-by":"crossref","unstructured":"Liu Y, Mangini J, Saad R, Silverman AR, Abell E, Tung MY, et al. Diagnostic value of microtubule-associated protein-2 in Merkel cell carcinoma. Appl Immunohistochem Mol Morphol. 2003;11(4):326\u20139.","DOI":"10.1097\/00129039-200312000-00008"},{"key":"2025122123391346561_j_biol-2025-1168_ref_021","doi-asserted-by":"crossref","unstructured":"Asioli S, Righi A, Volante M, Eusebi V, Bussolati G. p63 expression as a new prognostic marker in Merkel cell carcinoma. Cancer. 2007;110:640\u20137.","DOI":"10.1002\/cncr.22828"},{"key":"2025122123391346561_j_biol-2025-1168_ref_022","unstructured":"Majewska H, Biernat W. Merkel cell carcinoma Pathological and molecular aspects of diagnosis and clinical features. Pol J Pathol. 2010;61(3):117\u201323."},{"key":"2025122123391346561_j_biol-2025-1168_ref_023","doi-asserted-by":"crossref","unstructured":"Shuda M, Feng H, Kwun HJ, Rosen ST, Gjoerup O, Moore PS, et al. T antigen mutations are a human tumor-specific signature for Merkel cell polyomavirus. Proc Natl Acad Sci U S A. 2008;105:16272\u20137.","DOI":"10.1073\/pnas.0806526105"},{"key":"2025122123391346561_j_biol-2025-1168_ref_024","doi-asserted-by":"crossref","unstructured":"Paulson KG, Lemos BD, Feng B, Jaimes N, Pe\u00f1as PF, Bi X, et al. Array-CGH reveals recurrent genomic changes in Merkel cell carcinoma including amplification of L-Myc. J Invest Dermatol. 2009;129:1547\u201355.","DOI":"10.1038\/jid.2008.365"},{"key":"2025122123391346561_j_biol-2025-1168_ref_025","doi-asserted-by":"crossref","unstructured":"Van Gele M, Leonard JH, Van Roy N, Cook AL, De Paepe A, Speleman F. Frequent allelic loss at 10q23 but low incidence of PTEN mutations in Merkel cell carcinoma. Int J Cancer. 2001;92:409\u201313.","DOI":"10.1002\/ijc.1209"},{"key":"2025122123391346561_j_biol-2025-1168_ref_026","doi-asserted-by":"crossref","unstructured":"Kytola S, Nord B, Elder EE, Carling T, Kjellman M, Cedermark B, et al. Alterations of the SDHD gene locus in midgut carcinoids, Merkel cell carcinomas, pheochromocytomas, and abdominal paragangliomas. Genes Chromosomes Cancer. 2002;34:325\u201332.","DOI":"10.1002\/gcc.10081"},{"key":"2025122123391346561_j_biol-2025-1168_ref_027","doi-asserted-by":"crossref","unstructured":"Poulsen M. Merkel cell carcinoma of skin: diagnosis and management strategies. Drugs Aging. 2005;22:219\u201329.","DOI":"10.2165\/00002512-200522030-00004"},{"key":"2025122123391346561_j_biol-2025-1168_ref_028","doi-asserted-by":"crossref","unstructured":"Eftekhari F, Wallace S, Silva EG, Lenzi R. Merkel cell carcinoma of the skin: imaging and clinical features in 93 cases. Br J Radiol. 1996;69(819):226\u201333.","DOI":"10.1259\/0007-1285-69-819-226"},{"key":"2025122123391346561_j_biol-2025-1168_ref_029","doi-asserted-by":"crossref","unstructured":"Zager JS, Brodsky S, Berman CG. Imaging of Merkel cell carcinoma. Curr Probl Cancer. 2010;34:65\u201376.","DOI":"10.1016\/j.currproblcancer.2010.01.003"},{"key":"2025122123391346561_j_biol-2025-1168_ref_030","doi-asserted-by":"crossref","unstructured":"Buder K, Lapa C, Kreissl MC, Schirbel A, Herrmann K, Schnack A, et al. Somatostatin receptor expression in Merkel cell carcinoma as target for molecular imaging. BMC Cancer. 2014;14:268.","DOI":"10.1186\/1471-2407-14-268"},{"key":"2025122123391346561_j_biol-2025-1168_ref_031","doi-asserted-by":"crossref","unstructured":"Concannon R, Larcos GS, Veness M. The impact of 18F-FDG PET-CT scanning for staging and management of Merkel cell carcinoma: results from Westmead Hospital, Sydney, Australia. J Am Acad Dermatol. 2010;62:76\u201384.","DOI":"10.1016\/j.jaad.2009.06.021"},{"key":"2025122123391346561_j_biol-2025-1168_ref_032","doi-asserted-by":"crossref","unstructured":"Nyrud MK, Bratland \u00c5, Landr\u00f8 L, Brevig T, Ryder T, Hermann R, et al. Merkel cell carcinoma. Tidsskr Nor Laegeforen. 2022;142(9). 10.4045\/tidsskr.21.0693.","DOI":"10.4045\/tidsskr.21.0693"},{"key":"2025122123391346561_j_biol-2025-1168_ref_033","doi-asserted-by":"crossref","unstructured":"Erickson LA, Papouchado B, Dimashkieh H, Zhang S, Nakamura N, Lloyd RV. Cdx2 as a marker for neuroendocrine tumors of unknown primary sites. Endocr Pathol. 2004;15(3):247\u201352.","DOI":"10.1385\/EP:15:3:247"},{"key":"2025122123391346561_j_biol-2025-1168_ref_034","doi-asserted-by":"crossref","unstructured":"Gnepp DR, Corio RL, Brannon RB. Small cell carcinoma of the major salivary glands. Cancer. 1986;58:705\u201314.","DOI":"10.1002\/1097-0142(19860801)58:3<705::AID-CNCR2820580318>3.0.CO;2-T"},{"key":"2025122123391346561_j_biol-2025-1168_ref_035","doi-asserted-by":"crossref","unstructured":"Hui KK, Luna MA, Batsakis JG, Ord\u00f3\u00f1ez NG, Weber R. Undifferentiated carcinomas of the major salivary glands. Oral Surg Oral Med Oral Pathol. 1990;69:76\u201383.","DOI":"10.1016\/0030-4220(90)90271-S"},{"key":"2025122123391346561_j_biol-2025-1168_ref_036","doi-asserted-by":"crossref","unstructured":"Jorcano S, Casado A, Berenguer J. Primary neuroendocrine small cell undifferentiated carcinoma of the parotid gland. Clin Transl Oncol. 2008;10:303\u20136. 10.1007\/s12094-008-0203-z.","DOI":"10.1007\/s12094-008-0203-z"},{"key":"2025122123391346561_j_biol-2025-1168_ref_037","doi-asserted-by":"crossref","unstructured":"Patel P, Hussain K. Merkel cell carcinoma. Clin Exp Dermatol. 2021 Jul;46(5):814\u20139.","DOI":"10.1111\/ced.14530"},{"key":"2025122123391346561_j_biol-2025-1168_ref_038","doi-asserted-by":"crossref","unstructured":"Hanna GJ, Kacew AJ, Tanguturi AR, Grote HJ, Vergara V, Brunkhorst B, et al. Association of programmed death 1 protein ligand (PD-L1) expression with prognosis in merkel cell carcinoma. Front Med. 2020;7:198.","DOI":"10.3389\/fmed.2020.00198"},{"key":"2025122123391346561_j_biol-2025-1168_ref_039","doi-asserted-by":"crossref","unstructured":"Lemos BD, Storer BE, Iyer JG, Phillips JL, Bichakjian CK, Fang LC, et al. Pathologic nodal evaluation improves prognostic accuracy in Merkel cell carcinoma: analysis of 5823 cases as the basis of the first consensus staging system. J Am Acad Dermatol. 2010;63(5):751\u201361.","DOI":"10.1016\/j.jaad.2010.02.056"},{"key":"2025122123391346561_j_biol-2025-1168_ref_040","doi-asserted-by":"crossref","unstructured":"Allen PJ, Bowne WB, Jaques DP, Brennan MF, Busam K, Coit DG. Merkel cell carcinoma: Prognosis and treatment of patients from a single institution. J Clin Oncol. 2005;23:2300\u20139.","DOI":"10.1200\/JCO.2005.02.329"},{"key":"2025122123391346561_j_biol-2025-1168_ref_041","doi-asserted-by":"crossref","unstructured":"Iyer JG, Blom A, Doumani R, Lewis C, Tarabadkar ES, Anderson A, et al. Response rates and durability of chemotherapy among 62 patients with metastatic Merkel cell carcinoma. Cancer Med. 2016;5:2294\u2013301.","DOI":"10.1002\/cam4.815"},{"key":"2025122123391346561_j_biol-2025-1168_ref_042","doi-asserted-by":"crossref","unstructured":"Lebbe C, Becker JC, Grob JJ, Malvehy J, Del Marmol V, Pehamberger H, et al. Diagnosis and treatment of Merkel cell carcinoma. European consensus\u2010based interdisciplinary guideline. Eur J Cancer. 2015;51:2396\u2013403.","DOI":"10.1016\/j.ejca.2015.06.131"},{"key":"2025122123391346561_j_biol-2025-1168_ref_043","doi-asserted-by":"crossref","unstructured":"Garcia-Carbonero R, Marquez-Rodas I, De La Cruz-Merino L, Martinez-Trufero J, Cabrera MA, Piulats JM, et al. Recent therapeutic advances and change in treatment paradigm of patients with Merkel cell carcinoma. The Oncologist. 2019;24:1375\u201383. 10.1634\/theoncologist.2018-0718.","DOI":"10.1634\/theoncologist.2018-0718"},{"key":"2025122123391346561_j_biol-2025-1168_ref_044","doi-asserted-by":"crossref","unstructured":"Nghiem PT, Bhatia S, Lipson EJ, Kudchadkar RR, Miller NJ, Annamalai L, et al. PD\u20101 blockade with pembrolizumab in advanced Merkel\u2010cell carcinoma. N Engl J Med. 2016;374:2542\u201352.","DOI":"10.1056\/NEJMoa1603702"},{"key":"2025122123391346561_j_biol-2025-1168_ref_045","doi-asserted-by":"crossref","unstructured":"Boyerinas B, Jochems C, Fantini M, Heery CR, Gulley JL, Tsang KY, et al. Antibody\u2010dependent cellular cytotoxicity activity of a novel anti\u2010PD\u2010L1 antibody avelumab (MSB0010718C) on human tumor cells. Cancer Immunol Res. 2015;3:1148\u201357.","DOI":"10.1158\/2326-6066.CIR-15-0059"},{"key":"2025122123391346561_j_biol-2025-1168_ref_046","doi-asserted-by":"crossref","unstructured":"D\u2019Angelo SP, Russell J, Lebb\u00e9 C, Chmielowski B, Gambichler T, Grob JJ, et al. Efficacy and safety of first-line avelumab treatment in patients with stage IV metastatic Merkel cell carcinoma: A preplanned interim analysis of a clinical trial. JAMA Oncol. 2018;4:e180077.","DOI":"10.1001\/jamaoncol.2018.0077"},{"key":"2025122123391346561_j_biol-2025-1168_ref_047","unstructured":"Nghiem P, Bhatia S, Lipson EJ, Sharfman WH, Kudchadkar RR, Brohl AS, et al. Durable tumor regression and overall survival in patients with advanced Merkel Cell carcinoma receiving pembrolizumab as first-line therapy. JCO. 2019;37:693\u2013702. 10.1200\/JCO.18.01896."},{"key":"2025122123391346561_j_biol-2025-1168_ref_048","doi-asserted-by":"crossref","unstructured":"Cassler NM, Merrill D, Bichakjian CK, Brownell I. Merkel cell carcinoma therapeutic update. Curr Treat Options Oncol. 2016;17(7):36.","DOI":"10.1007\/s11864-016-0409-1"}],"container-title":["Open Life Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/biol-2025-1168\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/biol-2025-1168\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,21]],"date-time":"2025-12-21T23:40:57Z","timestamp":1766360457000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/biol-2025-1168\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,1]]},"references-count":48,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,8,20]]},"published-print":{"date-parts":[[2025,8,20]]}},"alternative-id":["10.1515\/biol-2025-1168"],"URL":"https:\/\/doi.org\/10.1515\/biol-2025-1168","relation":{},"ISSN":["2391-5412"],"issn-type":[{"type":"electronic","value":"2391-5412"}],"subject":[],"published":{"date-parts":[[2025,1,1]]},"article-number":"20251168"}}