{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T08:52:50Z","timestamp":1791276770339,"version":"4.1.0"},"reference-count":58,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Traditional CHA\u2082DS\u2082-VASc scoring has well-recognized limitations in thromboembolic risk assessment for atrial fibrillation (AF), particularly in low-score patients who nevertheless thrombose, high-score event-free individuals, cancer patients, and post-ablation cohorts. The left atrial appendage (LAA) is the source of 98% of thrombi in non-valvular AF and exhibits marked inter-individual morphological and hemodynamic variability that traditional scores completely ignore.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This narrative review critically evaluates current evidence on LAA morphology, hemodynamics, computational fluid dynamics\/fluid-structure interaction (CFD\/FSI) studies, and digital twin technology, and proposes a mechanism-driven, individualized risk assessment framework for AF-related thromboembolism.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A literature search was conducted in PubMed\/MEDLINE and Web of Science (1990\u2013May 2026) using combinations of keywords related to LAA morphology, hemodynamics, AF, and thromboembolism. Priority was given to landmark original studies, high-quality observational studies with multivariable adjustment, meta-analyses, and contemporary CFD\/digital twin studies. A narrative synthesis was adopted owing to heterogeneity in study designs and outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      LAA morphological subtypes are associated with long-term stroke risk, with chicken-wing being protective (OR 0.21, 95% CI 0.05\u20130.91) and cauliflower carrying the highest risk (OR 8.02, 95% CI 0.92\u201327.86). However, risk is highly context-dependent, with chicken-wing unexpectedly increasing peri-ablation thromboembolic risk (OR 7.2, 95% CI 1.35\u201338.33) and windsock morphology independently predicting post-ablation AF recurrence (OR 2.72, 95% CI 1.21\u20136.12). Importantly, traditional morphological classification does not correlate directly with blood stasis (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.365), whereas quantitative geometric parameters such as trabecular number, normalized stroke volume, and ostial area are far more sensitive predictors (R\u00b2\u2009=\u200974%). Digital twins integrating multimodal clinical, morphological, and hemodynamic data identify a high-risk phenogroup with a 70% thrombus history rate.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Based on these findings, we propose a practical two-tier assessment framework combining basic morphological classification with multimodal refined evaluation (digital twin) for intermediate-\/high-risk or clinically challenging cases. This framework represents a paradigm shift from static clinical scores toward mechanism-driven, individualized risk management. Prospective validation of this approach is now warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1924120","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T08:24:11Z","timestamp":1791275051000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Left atrial appendage morphology and hemodynamics: potential new markers for individualized thromboembolic risk assessment in atrial fibrillation"],"prefix":"10.3389","volume":"13","author":[{"given":"Bingxin","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Joint and Sports Medicine, The Second Hospital of Dalian Medical University","place":["Dalian, Liaoning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xianyong","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Xinhua Hospital Affiliated to Dalian University","place":["Dalian, Liaoning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changlin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Xinhua Hospital Affiliated to Dalian University","place":["Dalian, Liaoning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henan","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology, College of Basic Medical Sciences, Dalian Medical University","place":["Dalian, Liaoning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,10,6]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1080\/14779072.2023.2160319","article-title":"Atrial fibrillation and stroke","volume":"21","author":"Choi","year":"2023","journal-title":"Expert Rev Cardiovasc Ther"},{"key":"B2","doi-asserted-by":"publisher","first-page":"e70526","DOI":"10.1111\/ene.70526","article-title":"Screening of atrial fibrillation in cryptogenic ischemic stroke\u2014does timing make the difference?","volume":"33","author":"Suomalainen","year":"2026","journal-title":"Eur J Neurol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1016\/j.hrthm.2025.05.021","article-title":"Ablation of atrial fibrillation and risk of stroke: a meta-analysis","volume":"23","author":"Providencia","year":"2026","journal-title":"Heart Rhythm"},{"key":"B4","doi-asserted-by":"publisher","first-page":"3314","DOI":"10.1093\/eurheartj\/ehae176","article-title":"2024 ESC guidelines for the management of atrial fibrillation developed in collaboration with the European association for cardio-thoracic surgery (EACTS)","volume":"45","author":"Van Gelder","year":"2024","journal-title":"Eur Heart J"},{"key":"B5","doi-asserted-by":"publisher","first-page":"955","DOI":"10.1016\/s0140-6736(13)62343-0","article-title":"Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials","volume":"383","author":"Ruff","year":"2014","journal-title":"Lancet"},{"key":"B6","doi-asserted-by":"publisher","first-page":"200","DOI":"10.2459\/jcm.0000000000000930","article-title":"CHA2DS2-VASc and SAMe-TT2R2 scores as predictors of recurrence for nonvalvular atrial fibrillation patients on vitamin K antagonists after radiofrequency catheter ablation","volume":"21","author":"Zhao","year":"2020","journal-title":"J Cardiovasc Med"},{"key":"B7","doi-asserted-by":"publisher","first-page":"681","DOI":"10.1016\/j.hrthm.2014.12.034","article-title":"The impact of risk score (CHADS2 versus CHA2DS2-VASc) on long-term outcomes after atrial fibrillation ablation","volume":"12","author":"Jacobs","year":"2015","journal-title":"Heart Rhythm"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1277","DOI":"10.1056\/NEJMoa2408308","article-title":"Left atrial appendage closure after ablation for atrial fibrillation","volume":"392","author":"Wazni","year":"2025","journal-title":"N Engl J Med"},{"key":"B9","doi-asserted-by":"publisher","first-page":"531","DOI":"10.1016\/j.jacc.2012.04.032","article-title":"Does the left atrial appendage morphology correlate with the risk of stroke in patients with atrial fibrillation?","volume":"60","author":"Di Biase","year":"2012","journal-title":"J Am Coll Cardiol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"7753","DOI":"10.3390\/jcm13247753","article-title":"Atrial fibrillation and cancer\u2014epidemiology, mechanisms, and management","volume":"13","author":"Davis","year":"2024","journal-title":"J Clin Med"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1071","DOI":"10.1007\/s11864-023-01110-2","article-title":"Interventional cardio-oncology: unique challenges and considerations in a high-risk population","volume":"24","author":"Leiva","year":"2023","journal-title":"Curr Treat Options Oncol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"1045","DOI":"10.1007\/s11239-025-03098-y","article-title":"Left atrial appendage occlusion in patients with cancer","volume":"58","author":"Davis","year":"2025","journal-title":"J Thromb Thrombolysis"},{"key":"B13","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1016\/j.amjcard.2022.06.044","article-title":"Validation of embolic and bleeding risk scores in patients with atrial fibrillation and cancer","volume":"180","author":"Raposeiras-Roubin","year":"2022","journal-title":"Am J Cardiol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1009494","DOI":"10.3389\/fcvm.2022.1009494","article-title":"Left atrial appendage function and structure predictors of recurrent atrial fibrillation after catheter ablation: a meta-analysis of observational studies","volume":"9","author":"Han","year":"2022","journal-title":"Front Cardiovasc Med"},{"key":"B15","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1186\/s43044-023-00356-3","article-title":"Left atrial appendage morphofunctional indices could be predictive of arrhythmia recurrence post-atrial fibrillation ablation: a meta-analysis","volume":"75","author":"Papathanasiou","year":"2023","journal-title":"Egypt Heart J"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1364","DOI":"10.1161\/strokeaha.115.012609","article-title":"Ischemic stroke risk in patients with atrial fibrillation and CHA2DS2-VASc score of 1","volume":"47","author":"Joundi","year":"2016","journal-title":"Stroke"},{"key":"B17","doi-asserted-by":"publisher","first-page":"1299","DOI":"10.1007\/s11739-025-04006-1","article-title":"The 2024 ESC guidelines on atrial fibrillation: essential updates for everyday clinical practice","volume":"20","author":"Boriani","year":"2025","journal-title":"Intern Emerg Med"},{"key":"B18","doi-asserted-by":"publisher","first-page":"S33","DOI":"10.4103\/jcecho.jcecho_8_19","article-title":"Atrial fibrillation, cancer and echocardiography","volume":"30","author":"Galderisi","year":"2020","journal-title":"J Cardiovasc Echogr"},{"key":"B19","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1038\/s41746-025-01676-1","article-title":"Digital twin integrating clinical, morphological and hemodynamic data to identify stroke risk factors","volume":"8","author":"Saiz-Viv\u00f3","year":"2025","journal-title":"NPJ Digit Med"},{"key":"B20","doi-asserted-by":"publisher","first-page":"1712","DOI":"10.1111\/jce.15583","article-title":"Left atrial appendage emptying velocity as a predictor of recurrence of atrial fibrillation post-ablation","volume":"33","author":"Ezzeddine","year":"2022","journal-title":"J Cardiovasc Electrophysiol"},{"key":"B21","doi-asserted-by":"publisher","first-page":"e086485","DOI":"10.1136\/bmjopen-2024-086485","article-title":"Association between left atrial appendage volume and atrial fibrillation recurrence after catheter ablation: a systematic review and meta-analysis","volume":"15","author":"Chen","year":"2025","journal-title":"BMJ Open"},{"key":"B22","doi-asserted-by":"publisher","first-page":"755","DOI":"10.1016\/0735-1097(94)90025-6","article-title":"Prognostic implications of left artial spontaneous echo contrast in nonvalvular atrial fibrillation","volume":"24","author":"Leung","year":"1994","journal-title":"J Am Coll Cardiol"},{"key":"B23","doi-asserted-by":"publisher","first-page":"1152","DOI":"10.1111\/jce.15889","article-title":"Incidental left atrial appendage isolation after catheter ablation of persistent atrial fibrillation: mechanisms and long-term risk of thromboembolism","volume":"34","author":"Ghannam","year":"2023","journal-title":"J Cardiovasc Electrophysiol"},{"key":"B24","doi-asserted-by":"publisher","first-page":"1522","DOI":"10.1016\/j.hrthm.2014.05.022","article-title":"Impact of left atrial appendage morphology on peri-interventional thromboembolic risk during catheter ablation of atrial fibrillation","volume":"11","author":"Kosiuk","year":"2014","journal-title":"Heart Rhythm"},{"key":"B25","doi-asserted-by":"publisher","first-page":"817","DOI":"10.7326\/0003-4819-123-11-199512010-00001","article-title":"Accuracy of transesophageal echocardiography for identifying left atrial thrombi: a prospective, intraoperative study","volume":"123","author":"Manning","year":"1995","journal-title":"Ann Intern Med"},{"key":"B26","doi-asserted-by":"publisher","first-page":"1402","DOI":"10.1016\/j.hrthm.2016.03.042","article-title":"Left atrial appendage morphology assessment for risk stratification of embolic stroke in patients with atrial fibrillation: a meta-analysis","volume":"13","author":"Lupercio","year":"2016","journal-title":"Heart Rhythm"},{"key":"B27","doi-asserted-by":"publisher","first-page":"2642","DOI":"10.3390\/diagnostics15202642","article-title":"Left atrial appendage morphology predicts atrial fibrillation recurrence: the hidden risks of windsock anatomy","volume":"15","author":"Lin","year":"2025","journal-title":"Diagnostics"},{"key":"B28","doi-asserted-by":"publisher","first-page":"108056","DOI":"10.1016\/j.cmpb.2024.108056","article-title":"Fluid-structure interaction analysis of the thromboembolic risk in the left atrial appendage under atrial fibrillation: effect of hemodynamics and morphological features","volume":"246","author":"Musotto","year":"2024","journal-title":"Comput Methods Programs Biomed"},{"key":"B29","doi-asserted-by":"publisher","first-page":"1938","DOI":"10.3389\/fphys.2018.01938","article-title":"The impact of left atrium appendage morphology on stroke risk assessment in atrial fibrillation: a computational fluid dynamics study","volume":"9","author":"Masci","year":"2019","journal-title":"Front Physiol"},{"key":"B30","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1186\/s41073-019-0064-8","article-title":"SANRA\u2014a scale for the quality assessment of narrative review articles","volume":"4","author":"Baethge","year":"2019","journal-title":"Res Integr Peer Rev"},{"key":"B31","doi-asserted-by":"publisher","first-page":"103475","DOI":"10.1016\/j.media.2025.103475","article-title":"MRI-based modelling of left atrial flow and coagulation to predict risk of thrombogenesis in atrial fibrillation","volume":"101","author":"Qureshi","year":"2025","journal-title":"Med Image Anal"},{"key":"B32","doi-asserted-by":"publisher","first-page":"761","DOI":"10.4022\/jafib.761","article-title":"The prevalence of low left atrial appendage emptying velocity and thrombus in patients undergoing catheter ablation for atrial fibrillation on uninterrupted peri-procedural warfarin therapy","volume":"5","author":"Herring","year":"2013","journal-title":"J Atr Fibrillation"},{"key":"B33","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1136\/hrt.82.5.547","article-title":"Left atrial appendage: structure, function, and role in thromboembolism","volume":"82","author":"Al-Saady","year":"1999","journal-title":"Heart"},{"key":"B34","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1093\/ejcts\/ezw313","article-title":"2016 ESC guidelines for the management of atrial fibrillation developed in collaboration with EACTS","volume":"50","author":"Kirchhof","year":"2016","journal-title":"Eur J Cardiothorac Surg"},{"key":"B35","doi-asserted-by":"publisher","first-page":"e020406","DOI":"10.1161\/jaha.120.020406","article-title":"Left atrial appendage morphology and local thrombogenesis-related blood parameters in patients with atrial fibrillation","volume":"10","author":"Xu","year":"2021","journal-title":"J Am Heart Assoc"},{"key":"B36","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1016\/j.ijcard.2019.09.053","article-title":"Coagulation factors and fibrinolytic activity in the left atrial appendage and other heart chambers in patients with atrial fibrillation: is there a local intracardiac prothrombotic state? (HEART-CLOT study)","volume":"301","author":"Bartus","year":"2020","journal-title":"Int J Cardiol"},{"key":"B37","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1161\/cir.0000000000001193","article-title":"2023 ACC\/AHA\/ACCP\/HRS guideline for the diagnosis and management of atrial fibrillation: a report of the American College of Cardiology\/American Heart Association Joint Committee on clinical practice guidelines","volume":"149","author":"Joglar","year":"2024","journal-title":"Circulation"},{"key":"B38","doi-asserted-by":"publisher","first-page":"1468379","DOI":"10.3389\/fcvm.2024.1468379","article-title":"Influencing factors and predictive model for left atrial appendage emptying velocity in nonvalvular AF patients","volume":"11","author":"He","year":"2024","journal-title":"Front Cardiovasc Med"},{"key":"B39","doi-asserted-by":"publisher","first-page":"586041","DOI":"10.3389\/fbioe.2021.586041","article-title":"Effect of the alterations in contractility and morphology produced by atrial fibrillation on the thrombosis potential of the left atrial appendage","volume":"9","author":"Vella","year":"2021","journal-title":"Front Bioeng Biotechnol"},{"key":"B40","doi-asserted-by":"publisher","first-page":"894187","DOI":"10.3389\/fcvm.2022.894187","article-title":"The role of patient-specific morphological features of the left atrial appendage on the thromboembolic risk under atrial fibrillation","volume":"9","author":"Musotto","year":"2022","journal-title":"Front Cardiovasc Med"},{"key":"B41","doi-asserted-by":"publisher","first-page":"e26629","DOI":"10.1016\/j.heliyon.2024.e26629","article-title":"Left atrial appendage inversion: first computational study to shed light on the phenomenon","volume":"10","author":"Vella","year":"2024","journal-title":"Heliyon"},{"key":"B42","doi-asserted-by":"publisher","first-page":"110134","DOI":"10.1016\/j.compbiomed.2025.110134","article-title":"Modelling of thrombus formation, growth and embolisation in the left atrial appendage under atrial fibrillation","volume":"191","author":"Lo Presti","year":"2025","journal-title":"Comput Biol Med"},{"key":"B43","doi-asserted-by":"publisher","first-page":"977","DOI":"10.1016\/j.jacep.2024.12.013","article-title":"Causal machine learning for left atrial appendage occlusion in patients with atrial fibrillation","volume":"11","author":"Ngufor","year":"2025","journal-title":"JACC Clin Electrophysiol"},{"key":"B44","doi-asserted-by":"publisher","first-page":"921","DOI":"10.1016\/j.hrthm.2013.01.036","article-title":"Anatomical characteristics of the left atrial appendage in cardiogenic stroke with low CHADS2 scores","volume":"10","author":"Kimura","year":"2013","journal-title":"Heart Rhythm"},{"key":"B45","doi-asserted-by":"publisher","first-page":"e13036","DOI":"10.1111\/anec.13036","article-title":"Predictors of stroke or systemic embolism in patients with non-valvular atrial fibrillation with CHA2DS2-VASc score of 0","volume":"28","author":"Choi","year":"2023","journal-title":"Ann Noninvasive Electrocardiol"},{"key":"B46","doi-asserted-by":"publisher","first-page":"961","DOI":"10.1016\/0735-1097(94)90644-0","article-title":"Relations between left atrial appendage blood flow velocity, spontaneous echocardiographic contrast and thromboembolic risk in vivo","volume":"23","author":"Fatkin","year":"1994","journal-title":"J Am Coll Cardiol"},{"key":"B47","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2020\/3501749","article-title":"Left ventricular ejection fraction is associated with the risk of thrombus in the left atrial appendage in patients with atrial fibrillation","volume":"2020","author":"Uzi\u0119b\u0142o-\u017byczkowska","year":"2020","journal-title":"Cardiovasc Ther"},{"key":"B48","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1159\/000176661","article-title":"Left atrial appendage function determined by transesophageal echocardiography in patients with rheumatic mitral valve disease","volume":"85","author":"Hwang","year":"1994","journal-title":"Cardiology"},{"key":"B49","doi-asserted-by":"publisher","first-page":"840","DOI":"10.1378\/chest.120.3.840","article-title":"A transesophageal echocardiographic study on risk factors for stroke in elderly patients with atrial fibrillation","volume":"120","author":"Shinokawa","year":"2001","journal-title":"Chest"},{"key":"B50","doi-asserted-by":"publisher","first-page":"834","DOI":"10.1161\/01.Str.30.4.834","article-title":"Aortic plaque in atrial fibrillation","volume":"30","author":"Blackshear","year":"1999","journal-title":"Stroke"},{"key":"B51","doi-asserted-by":"publisher","first-page":"776","DOI":"10.5551\/jat.58339","article-title":"Complex aortic arch atherosclerosis in acute ischemic stroke patients with non-valvular atrial fibrillation","volume":"28","author":"Suzuki","year":"2021","journal-title":"J Atheroscler Thromb"},{"key":"B52","doi-asserted-by":"publisher","first-page":"10760296261429249","DOI":"10.1177\/10760296261429249","article-title":"Left atrial appendage occlusion in cancer-associated atrial fibrillation: who, when, and how to manage antithrombotic therapy","volume":"32","author":"Awashra","year":"2026","journal-title":"Clin Appl Thromb Hemost"},{"key":"B53","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1016\/j.thromres.2024.01.012","article-title":"Anticoagulation in cancer patients with atrial fibrillation and grade 3\u20134 thrombocytopenia","volume":"235","author":"Drozdinsky","year":"2024","journal-title":"Thromb Res"},{"key":"B54","doi-asserted-by":"publisher","first-page":"101585","DOI":"10.1016\/j.ijcha.2024.101585","article-title":"Short- and long-term outcomes of percutaneous left atrial appendage occlusion in cancer patients","volume":"56","author":"Tinoco","year":"2025","journal-title":"IJC Heart & Vasculature"},{"key":"B55","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1016\/j.jaccao.2022.10.016","article-title":"Left atrial appendage occlusion in patients with atrial fibrillation and cancer","volume":"5","author":"Shabtaie","year":"2023","journal-title":"JACC: CardioOncology"},{"key":"B56","doi-asserted-by":"publisher","first-page":"6514","DOI":"10.3390\/jcm13216514","article-title":"Left atrial appendage closure in atrial fibrillation patients with cancer","volume":"13","author":"Zweiker","year":"2024","journal-title":"J Clin Med"},{"key":"B57","doi-asserted-by":"publisher","first-page":"1331","DOI":"10.3390\/cancers17081331","article-title":"In-hospital outcomes of left atrial appendage occlusion among cancer patients with atrial fibrillation: a nationwide U.S","volume":"17","author":"Margolis","year":"2025","journal-title":"Study. Cancers"},{"key":"B58","doi-asserted-by":"publisher","first-page":"2683","DOI":"10.1093\/ckj\/sfad221","article-title":"Long-term safety and efficacy of left atrial appendage occlusion in dialysis patients with atrial fibrillation: a multi-center, prospective, open label, observational study","volume":"16","author":"Genovesi","year":"2023","journal-title":"Clin Kidney J"}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2026.1924120\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T08:24:12Z","timestamp":1791275052000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2026.1924120\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,6]]},"references-count":58,"alternative-id":["10.3389\/fcvm.2026.1924120"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2026.1924120","relation":{},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,6]]},"article-number":"1924120"}}