{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T13:02:33Z","timestamp":1785416553139,"version":"3.56.0"},"reference-count":43,"publisher":"IMR Press","issue":"7","license":[{"start":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T00:00:00Z","timestamp":1784160000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"NIH\/NIAID\/AFRRI Interagency Agreement","award":["AAI26003-001-00000"],"award-info":[{"award-number":["AAI26003-001-00000"]}]},{"name":"AFRRI intramural grant","award":["AFR-B2-13613"],"award-info":[{"award-number":["AFR-B2-13613"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Front. Biosci. (Landmark Ed)"],"abstract":"<jats:p>Background:Exposure to ionizing radiation (IR), particularly when combined with additional trauma such as skin wounding (referred to as radiation combined injury, RCI), results in a synergistic pathology that significantly increases morbidity and mortality compared to isolated radiation injury (RI). While Nplate (romiplostim), a thrombopoietin (TPO) receptor agonist, is a Food and Drug Administration (FDA)-approved medical countermeasure for haematopoietic acute radiation syndrome (H-ARS), its efficacy on RCI is unclear. This study evaluated the mitigative effects of Nplate on 30-day survival, wound healing, and haematopoietic recovery following RCI.Methods:Fourteen-week-old female B6D2F1\/J mice were exposed to 60Co \u03b3-radiation (9.0 or 9.5 Gy at 0.4 Gy\/min) followed by a full-thickness skin wound within one to two h. A single dose of Nplate (30 \u00b5g\/kg) or vehicle was administered subcutaneously 24 h post-IR. Survival, body weight, and wound closure were monitored for 30 days. On day 30, survivors were euthanized for blood and tissue analysis, including bone marrow histology, colony-forming unit (CFU) assays, complete blood count (CBC), and splenic assessment.Results:Nplate significantly improved 30-day survival following 9.5 Gy RI, increasing survival from 30% to 75% (p = 0.0071). In contrast, Nplate provided no significant survival improvement in the RCI groups, with 30-day survival rates of 65% at 9.0 Gy (p = 0.5485) and 15% at 9.5 Gy (p = 0.6044) compared to 75% and 20% in their respective vehicle controls. Despite the lack of survival improvement after RCI, Nplate significantly accelerated wound closure on day 14 after RCI at 9.5 Gy. During the acute phase (Days 1\u201314), Nplate treatment significantly accelerated healing kinetics, increasing the linear wound healing rate by 54% from 0.124 mm\/day to 0.192 mm\/day (p = 0.0205). Histological analysis revealed that Nplate enhanced bone marrow cellularity, increased megakaryocyte counts, and suppressed IR-induced adipocyte formation. Furthermore, Nplate treatment significantly strengthened functional haematopoiesis, particularly after 9.0 Gy RCI, and stimulated recovery of the splenic lymphoid compartment after both RI and RCI at 9.5 Gy.Conclusions:Nplate is a potent mitigator of H-ARS and a stimulator of multi-lineage haematopoietic and tissue regeneration. However, its efficacy in improving survival is limited in RCI, potentially due to exacerbated systemic physiological stress. These results suggest that while Nplate promotes haematopoietic recovery, managing RCI may require a multi-modal approach to address the unique complexities of combined injury, including gastrointestinal (GI)-ARS, systemic inflammation and endothelial dysfunction.<\/jats:p>","DOI":"10.31083\/fbl52437","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T12:17:49Z","timestamp":1785413869000},"source":"Crossref","is-referenced-by-count":0,"title":["Nplate (Romiplostim) Restores Blood Counts and Accelerates Wound Healing Following Radiation Combined Injury in Mice"],"prefix":"10.31083","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4700-989X","authenticated-orcid":true,"given":"Li","family":"Wang","sequence":"first","affiliation":[{"name":"Radiation Combined Injury Program, Armed Forces Radiobiology Research Institute, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA"},{"name":"Henry M Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD 20817, USA"},{"name":"Department of Pathology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Lin","sequence":"additional","affiliation":[{"name":"Radiation Combined Injury Program, Armed Forces Radiobiology Research Institute, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA"},{"name":"Henry M Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD 20817, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Zhai","sequence":"additional","affiliation":[{"name":"Radiation Combined Injury Program, Armed Forces Radiobiology Research Institute, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA"},{"name":"Henry M Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD 20817, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanchang","family":"Cui","sequence":"additional","affiliation":[{"name":"Radiation Combined Injury Program, Armed Forces Radiobiology Research Institute, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA"},{"name":"Department of Pharmacology and Molecular Therapeutics, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Hull","sequence":"additional","affiliation":[{"name":"Radiation Combined Injury Program, Armed Forces Radiobiology Research Institute, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA"},{"name":"Henry M Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD 20817, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Zizzo","sequence":"additional","affiliation":[{"name":"Radiation Combined Injury Program, Armed Forces Radiobiology Research Institute, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgetta","family":"Cannon","sequence":"additional","affiliation":[{"name":"Radiation Combined Injury Program, Armed Forces Radiobiology Research Institute, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mang","family":"Xiao","sequence":"additional","affiliation":[{"name":"Radiation Combined Injury Program, Armed Forces Radiobiology Research Institute, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3904-2350","authenticated-orcid":true,"given":"Juliann G.","family":"Kiang","sequence":"additional","affiliation":[{"name":"Radiation Combined Injury Program, Armed Forces Radiobiology Research Institute, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA"},{"name":"Department of Pharmacology and Molecular Therapeutics, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA"},{"name":"Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"16242","published-online":{"date-parts":[[2026,7,16]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Wu W, Wu Y, Yang Z, Chen M, Hu J, Qu K, et al. Radiation-induced intestinal injury: from molecular mechanisms to clinical translation. Oncology Reviews. 2025; 19: 1613704.","DOI":"10.3389\/or.2025.1613704"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Zhang Y, Chen X, Wang X, Chen J, Du C, Wang J, et al. Insights into ionizing radiation-induced bone marrow hematopoietic stem cell injury. Stem Cell Research & Therapy. 2024; 15: 222.","DOI":"10.1186\/s13287-024-03853-7"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"DiCarlo AL, Ramakrishnan N, Hatchett RJ. Radiation combined injury: overview of NIAID research. Health Physics. 2010; 98: 863\u2013867.","DOI":"10.1097\/HP.0b013e3181a6ee32"},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"Messerschmidt O. Combined effects of radiation and trauma. Advances in Space Research : the Official Journal of the Committee on Space Research (COSPAR). 1989; 9: 197\u2013201.","DOI":"10.1016\/0273-1177(89)90438-9"},{"key":"ref5","unstructured":"Ledney GD, Elliott TB, Moore MM. Modulation of mortality by tissue trauma and sepsis in mice after radiation injury. (AFRRI Special Report No. 92-18). Bethesda, MD: Armed Forces Radiobiology Research Institute. 1992."},{"key":"ref6","unstructured":"U.S. Department of Health and Human Services. Radiation Emergency Medical Management (REMM). Combined Injury. 2024. Available at: https:\/\/remm.hhs.gov\/radtrauma.htm (Accessed: 3 May 2026)."},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"Hay Q, Jennings R, Creel A, Gaffney K, Wagner C, Maxwell K, et al. Mathematical modeling of the combined effects of thermal burn and local irradiation. PloS One. 2026; 21: e0341595.","DOI":"10.1371\/journal.pone.0341595"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"Wang L, Lin B, Zhai M, Hull L, Cui W, Xiao M. Endothelial Dysfunction and Impaired Wound Healing Following Radiation Combined Skin Wound Injury. International Journal of Molecular Sciences. 2024; 25: 12498.","DOI":"10.3390\/ijms252312498"},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"Kiang JG, Jiao W, Cary LH, Mog SR, Elliott TB, Pellmar TC, et al. Wound trauma increases radiation-induced mortality by activation of iNOS pathway and elevation of cytokine concentrations and bacterial infection. Radiation Research. 2010; 173: 319\u2013332.","DOI":"10.1667\/RR1892.1"},{"key":"ref10","doi-asserted-by":"publisher","unstructured":"Ince C, Mayeux PR, Nguyen T, Gomez H, Kellum JA, Ospina-Tasc\u00f3n GA, et al. THE ENDOTHELIUM IN SEPSIS. Shock (Augusta, Ga.). 2016; 45: 259\u2013270.","DOI":"10.1097\/SHK.0000000000000473"},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"Tang F, Zhao XL, Xu LY, Zhang JN, Ao H, Peng C. Endothelial dysfunction: Pathophysiology and therapeutic targets for sepsis-induced multiple organ dysfunction syndrome. Biomedicine & Pharmacotherapy = Biomedecine & Pharmacotherapie. 2024; 178: 117180.","DOI":"10.1016\/j.biopha.2024.117180"},{"key":"ref12","doi-asserted-by":"publisher","unstructured":"Wang Y, Guan QN, Zhang ZJ, Zhang YM. Interaction between endothelial injury and immune response in septic shock: from basic research to clinical applications. Frontiers in Physiology. 2025; 16: 1627008.","DOI":"10.3389\/fphys.2025.1627008"},{"key":"ref13","doi-asserted-by":"publisher","unstructured":"DiCarlo AL, Maher C, Hick JL, Hanfling D, Dainiak N, Chao N, et al. Radiation injury after a nuclear detonation: medical consequences and the need for scarce resources allocation. Disaster Medicine and Public Health Preparedness. 2011; 5 Suppl 1: S32\u201344.","DOI":"10.1001\/dmp.2011.17"},{"key":"ref14","doi-asserted-by":"publisher","unstructured":"Rojavin Y, Seamon MJ, Tripathi RS, Papadimos TJ, Galwankar S, Kman N, et al. Civilian nuclear incidents: An overview of historical, medical, and scientific aspects. Journal of Emergencies, Trauma, and Shock. 2011; 4: 260\u2013272.","DOI":"10.4103\/0974-2700.82219"},{"key":"ref15","doi-asserted-by":"publisher","unstructured":"Singh VK, Seed TM. Cutting-edge animal models for radiation combined injury drug development. Expert Opinion on Drug Discovery. 2025; 20: 1573\u20131588.","DOI":"10.1080\/17460441.2025.2584319"},{"key":"ref16","doi-asserted-by":"publisher","unstructured":"Singh VK, Seed TM. An update on romiplostim for treatment of acute radiation syndrome. Drugs of Today (Barcelona, Spain: 1998). 2022; 58: 133\u2013145.","DOI":"10.1358\/dot.2022.58.3.3367994"},{"key":"ref17","doi-asserted-by":"publisher","unstructured":"Bunin DI, Bakke J, Green CE, Javitz HS, Fielden M, Chang PY. Romiplostim (Nplate\u00ae) as an effective radiation countermeasure to improve survival and platelet recovery in mice. International Journal of Radiation Biology. 2020; 96: 145\u2013154.","DOI":"10.1080\/09553002.2019.1605465"},{"key":"ref18","doi-asserted-by":"publisher","unstructured":"Yamaguchi M, Hirouchi T, Yokoyama K, Nishiyama A, Murakami S, Kashiwakura I. The thrombopoietin mimetic romiplostim leads to the complete rescue of mice exposed to lethal ionizing radiation. Scientific Reports. 2018; 8: 10659.","DOI":"10.1038\/s41598-018-29013-5"},{"key":"ref19","doi-asserted-by":"publisher","unstructured":"Bunin DI, Javitz HS, Gahagen J, Bakke J, Lane JH, Andrews DA, et al. Survival and Hematologic Benefits of Romiplostim After Acute Radiation Exposure Supported FDA Approval Under the Animal Rule. International Journal of Radiation Oncology, Biology, Physics. 2023; 117: 705\u2013717.","DOI":"10.1016\/j.ijrobp.2023.05.008"},{"key":"ref20","doi-asserted-by":"publisher","unstructured":"Silverman TA, Shadiack AM, Hofmeyer KA, Cecere AE, Eisnor DL, Hoffman CM, et al. Blood product use for radiological\/nuclear trauma: product development and US regulatory considerations. Trauma Surgery & Acute Care Open. 2024; 9: e001123.","DOI":"10.1136\/tsaco-2023-001123"},{"key":"ref21","doi-asserted-by":"publisher","unstructured":"Bortolotti M, Pettine L, Zaninoni A, Croci GA, Barcellini W, Fattizzo B. Efficacy and Immunomodulating Properties of Eltrombopag in Aplastic Anemia following Autologous Stem Cell Transplant: Case Report and Review of the Literature. Pharmaceuticals (Basel, Switzerland). 2022; 15: 419.","DOI":"10.3390\/ph15040419"},{"key":"ref22","doi-asserted-by":"publisher","unstructured":"Ghanima W, Cooper N, Rodeghiero F, Godeau B, Bussel JB. Thrombopoietin receptor agonists: ten years later. Haematologica. 2019; 104: 1112\u20131123.","DOI":"10.3324\/haematol.2018.212845"},{"key":"ref23","doi-asserted-by":"publisher","unstructured":"G\u00f3mez-Almaguer D. Eltrombopag-based combination treatment for immune thrombocytopenia. Therapeutic Advances in Hematology. 2018; 9: 309\u2013317.","DOI":"10.1177\/2040620718798798"},{"key":"ref24","doi-asserted-by":"publisher","unstructured":"Alizadeh M, Momeny M, Khodadoust E, Mahmoudi SM, Abolghasemi-Dehaghani S, Zarrabi M, et al. Platelet-Rich Fibrin (PRF)-Polymer Composites for Wound Healing: Macromolecular Synergies, Structural Design, and Therapeutic Efficacy. ACS Applied Bio Materials. 2025; 8: 8449\u20138466.","DOI":"10.1021\/acsabm.5c01083"},{"key":"ref25","doi-asserted-by":"publisher","unstructured":"Doi T, Hori T, Onuma T, Mizutani D, Ueda K, Enomoto Y, et al. Thrombopoietin and collagen in low doses cooperatively induce human platelet activation. Acute Medicine & Surgery. 2022; 9: e769.","DOI":"10.1002\/ams2.769"},{"key":"ref26","doi-asserted-by":"publisher","unstructured":"Ledney GD, Stewart DA, Exum ED, Sheehy PA, et al. Skin wound-enhanced survival and myelocytopoiesis in mice after whole-body irradiation. Acta radiologica. Oncology. 1981; 20: 29\u201338.","DOI":"10.3109\/02841868109130187"},{"key":"ref27","doi-asserted-by":"publisher","unstructured":"Wang L, Zhai M, Lin B, Cui W, Hull L, Li X, et al. PEG-G-CSF and L-Citrulline Combination Therapy for Mitigating Skin Wound Combined Radiation Injury in a Mouse Model. Radiation Research. 2021; 196: 113\u2013127.","DOI":"10.1667\/RADE-20-00151.1"},{"key":"ref28","doi-asserted-by":"publisher","unstructured":"Gilman T. Wound outcomes: the utility of surface measures. The International Journal of Lower Extremity Wounds. 2004; 3: 125\u2013132.","DOI":"10.1177\/1534734604264419"},{"key":"ref29","doi-asserted-by":"publisher","unstructured":"Gorin DR, Cordts PR, LaMorte WW, Manzoian JO. The influence of wound geometry on the measurement of wound healing rates in clinical trials. Journal of Vascular Surgery. 1996; 23: 524\u2013528.","DOI":"10.1016\/s0741-5214(96)80021-8"},{"key":"ref30","doi-asserted-by":"publisher","unstructured":"Kumar VP, Holmes-Hampton GP, Biswas S, Stone S, Sharma NK, Hritzo B, et al. Mitigation of total body irradiation-induced mortality and hematopoietic injury of mice by a thrombopoietin mimetic (JNJ-26366821). Scientific Reports. 2022; 12: 3485.","DOI":"10.1038\/s41598-022-07426-7"},{"key":"ref31","doi-asserted-by":"publisher","unstructured":"Kiang JG, Zhai M, Bolduc DL, Smith JT, Anderson MN, Ho C, et al. Combined Therapy of Pegylated G-CSF and Alxn4100TPO Improves Survival and Mitigates Acute Radiation Syndrome after Whole-Body Ionizing Irradiation Alone and Followed by Wound Trauma. Radiation Research. 2017; 188: 476\u2013490.","DOI":"10.1667\/RR14647.1"},{"key":"ref32","doi-asserted-by":"publisher","unstructured":"Mytych DT, Park JK, Kim J, Barger TE, Boshier A, Jawa V, et al. Assessment of romiplostim immunogenicity in adult patients in clinical trials and in a global postmarketing registry. British Journal of Haematology. 2020; 190: 923\u2013932.","DOI":"10.1111\/bjh.16658"},{"key":"ref33","doi-asserted-by":"publisher","unstructured":"Satyamitra M, Lombardini E, Peng T 3rd, Devore D, Graves J, 3rd Mullaney C, et al. Preliminary nonclinical toxicity, pharmacokinetics, and pharmacodynamics of ALXN4100TPO, a thrombopoietin receptor agonist, in CD2F1 mice. Radiation Research. 2013; 32: 100\u2013112.","DOI":"10.1177\/1091581813482336"},{"key":"ref34","doi-asserted-by":"publisher","unstructured":"Kiang JG, Zhai M, Liao PJ, Ho C, Gorbunov NV, Elliott TB. Thrombopoietin Receptor Agonist Mitigates Hematopoietic Radiation Syndrome and Improves Survival after Whole-Body Ionizing Irradiation Followed by Wound Trauma. Mediators of Inflammation. 2017; 2017: 7582079.","DOI":"10.1155\/2017\/7582079"},{"key":"ref35","doi-asserted-by":"publisher","unstructured":"Vercellino J, Ma\u0142achowska B, Kulkarni S, Bell BI, Shajahan S, Shinoda K, et al. Thrombopoietin mimetic stimulates bone marrow vascular and stromal niches to mitigate acute radiation syndrome. Stem Cell Research & Therapy. 2024; 15: 123.","DOI":"10.1186\/s13287-024-03734-z"},{"key":"ref36","unstructured":"Neelis KJ, Dubbelman YD, Qingliang L, Thomas GR, Eaton DL, Wagemaker G. Simultaneous administration of TPO and G-CSF after cytoreductive treatment of rhesus monkeys prevents thrombocytopenia, accelerates platelet and red cell reconstitution, alleviates neutropenia, and promotes the recovery of immature bone marrow cells. Experimental Hematology. 1997; 25: 1084\u20131093."},{"key":"ref37","doi-asserted-by":"crossref","unstructured":"Neelis KJ, Hartong SC, Egeland T, Thomas GR, Eaton DL, Wagemaker G. The efficacy of single-dose administration of thrombopoietin with coadministration of either granulocyte\/macrophage or granulocyte colony-stimulating factor in myelosuppressed rhesus monkeys. Blood. 1997; 90: 2565\u20132573.","DOI":"10.1182\/blood.V90.7.2565.2565_2565_2573"},{"key":"ref38","doi-asserted-by":"publisher","unstructured":"Opneja A, Kapoor S, Stavrou EX. Contribution of platelets, the coagulation and fibrinolytic systems to cutaneous wound healing. Thrombosis Research. 2019; 179: 56\u201363.","DOI":"10.1016\/j.thromres.2019.05.001"},{"key":"ref39","doi-asserted-by":"publisher","unstructured":"Locatelli L, Colciago A, Castiglioni S, Maier JA. Platelets in Wound Healing: What Happens in Space? Frontiers in Bioengineering and Biotechnology. 2021; 9: 716184.","DOI":"10.3389\/fbioe.2021.716184"},{"key":"ref40","doi-asserted-by":"publisher","unstructured":"Kumar R, Sharma AK, Bajaj S, Kalonia A, Shaw P, Yashavarddhan MH, et al. Developing a Murine Model for Radiation Combined Burn Injury Through Preliminary Assessment of Hematopoietic and Inflammatory Mediators. Radiation Research. 2025; 204: 449\u2013466.","DOI":"10.1667\/RADE-25-00002.1"},{"key":"ref41","doi-asserted-by":"publisher","unstructured":"Williams JP, McBride WH. After the bomb drops: a new look at radiation-induced multiple organ dysfunction syndrome (MODS). International Journal of Radiation biology. 2011; 87: 851\u2013868.","DOI":"10.3109\/09553002.2011.560996"},{"key":"ref42","doi-asserted-by":"publisher","unstructured":"Holmes-Hampton GP, Soni DK, Kumar VP, Biswas S, Wuddie K, Biswas R, et al. Time- and sex-dependent delayed effects of acute radiation exposure manifest via miRNA dysregulation. iScience. 2024; 27: 108867.","DOI":"10.1016\/j.isci.2024.108867"},{"key":"ref43","doi-asserted-by":"publisher","unstructured":"Krukowski K, Grue K, Frias ES, Pietrykowski J, Jones T, Nelson G, et al. Female mice are protected from space radiation-induced maladaptive responses. Brain, Behavior, and Immunity. 2018; 74: 106\u2013120.","DOI":"10.1016\/j.bbi.2018.08.008"}],"container-title":["Frontiers in Bioscience-Landmark"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.imrpress.com\/journal\/FBL\/31\/7\/10.31083\/FBL52437","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T12:19:26Z","timestamp":1785413966000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.imrpress.com\/journal\/FBL\/31\/7\/10.31083\/FBL52437"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,16]]},"references-count":43,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026]]}},"alternative-id":["S2768-6701(26)03260-0"],"URL":"https:\/\/doi.org\/10.31083\/fbl52437","relation":{},"ISSN":["2768-6701","2768-6698"],"issn-type":[{"value":"2768-6701","type":"print"},{"value":"2768-6698","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,16]]},"article-number":"52437"}}