{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T05:02:04Z","timestamp":1784523724113,"version":"3.55.0"},"reference-count":53,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100008781","name":"Pomorski Uniwersytet Medyczny W Szczecinie","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008781","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:p>\n                    Xp21 contiguous gene deletion syndrome is a rare X-linked disorder caused by interstitial deletions involving neighboring genes such as\n                    <jats:italic>NR0B1<\/jats:italic>\n                    ,\n                    <jats:italic>GK<\/jats:italic>\n                    ,\n                    <jats:italic>DMD<\/jats:italic>\n                    , and\n                    <jats:italic>IL1RAPL1<\/jats:italic>\n                    , and is clinically associated with primary adrenal insufficiency, glycerol kinase deficiency, Duchenne muscular dystrophy, and neurodevelopmental delay. The phenotype depends on deletion size and gene content. We report a male child with a 4.5 Mb hemizygous deletion at Xp21.3-p21.2 encompassing\n                    <jats:italic>IL1RAPL1<\/jats:italic>\n                    ,\n                    <jats:italic>NR0B1<\/jats:italic>\n                    ,\n                    <jats:italic>GK<\/jats:italic>\n                    , and exons 61 to 79 of\n                    <jats:italic>DMD<\/jats:italic>\n                    , confirmed by exome sequencing and shown to be maternally inherited. The presented patient was admitted at 8\n                    <jats:sup>th<\/jats:sup>\n                    day of life due to concerns for primary muscular or metabolic disease. During the second week of life, the patient developed salt-wasting primary adrenal insufficiency with hyponatremia and hyperkalemia. Persistently elevated creatine kinase exceeding 3000 U\/L and markedly elevated cardiac biomarkers were observed in the absence of structural and functional cardiac abnormalities. Urinary organic acid analysis demonstrated significant glyceroluria, and severe serum hypertriglyceridemia was attributed to pseudo-hypertriglyceridemia consistent with glycerol kinase deficiency. Early visual impairment with nystagmus and pale optic discs were noted, and by 15 months the child exhibited global developmental delay, most pronounced in gross motor and language domains. This case illustrates the diagnostic challenges and clinical complexity of Xp21 contiguous gene deletion syndromes. In patients with Xp21 deletion syndrome, early molecular diagnosis enables timely hormone replacement, metabolic surveillance, cardiologic follow-up, and structured neurodevelopmental care.\n                  <\/jats:p>","DOI":"10.3389\/fendo.2026.1858779","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T04:20:48Z","timestamp":1784521248000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical challenges of an Xp21 contiguous gene deletion syndrome in a newborn and 15 months of follow-up - case report"],"prefix":"10.3389","volume":"17","author":[{"given":"Ignacy","family":"Frulenko","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Pomeranian Medical University in Szczecin","place":["Szczecin, Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iwona","family":"Ostrowska","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Rare Diseases and Metabolic Medicine, Pomeranian Medical University in Szczecin","place":["Szczecin, Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Micha\u0142","family":"Patalan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Rare Diseases and Metabolic Medicine, Pomeranian Medical University in Szczecin","place":["Szczecin, Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aida","family":"Bertoli-Avella","sequence":"additional","affiliation":[{"name":"Centogene GmbH","place":["Rostock, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nayla Y.","family":"Le\u00f3n","sequence":"additional","affiliation":[{"name":"Centogene GmbH","place":["Rostock, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreia","family":"Pinto","sequence":"additional","affiliation":[{"name":"Centogene GmbH","place":["Rostock, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Bauer","sequence":"additional","affiliation":[{"name":"Centogene GmbH","place":["Rostock, Germany"]},{"name":"Pomeranian Medical University in Szczecin","place":["Szczecin, Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alicja","family":"Le\u015bniak","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Rare Diseases and Metabolic Medicine, Pomeranian Medical University in Szczecin","place":["Szczecin, Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daria","family":"Katuszonek","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Rare Diseases and Metabolic Medicine, Pomeranian Medical University in Szczecin","place":["Szczecin, Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Gli\u0144ska","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Endocrinology, Diabetology, Metabolic Diseases and Cardiology of the Developmental Age, Prof. Tadeusz Soko\u0142owski University Teaching Hospital No. 1","place":["Szczecin, Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monika","family":"Modrzejewska","sequence":"additional","affiliation":[{"name":"2nd Department of Ophthalmology, Pomeranian Medical University in Szczecin","place":["Szczecin, Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"\u015amigiel","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Endocrinology, Diabetology and Metabolic Diseases, Wroc\u0142aw Medical University","place":["Wroc\u0142aw, Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Gi\u017cewska","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Rare Diseases and Metabolic Medicine, Pomeranian Medical University in Szczecin","place":["Szczecin, Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,20]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"24","DOI":"10.36185\/2532-1900-246","article-title":"Xp21 contiguous gene deletion syndrome presenting as Duchenne muscular dystrophy and glycerol kinase deficiency associated with intellectual disability: case report and review literature","volume":"42","author":"Pizza","year":"2023","journal-title":"Acta Myol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1507\/endocrj.EJ25-0265","article-title":"Congenital adrenal hypoplasia with neurodevelopmental delay due to contiguous Xp21 deletion: a case series with review of literature","volume":"73","author":"Gau","year":"2026","journal-title":"Endocr J"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.4274\/jcrpe.2539","article-title":"Complex glycerol kinase deficiency and adrenocortical insufficiency in two neonates","volume":"8","author":"Korkut","year":"2016","journal-title":"J Clin Res Pediatr Endocrinol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1515\/jpem.2011.350","article-title":"A neonate with contiguous deletion syndrome in XP21","volume":"24","author":"Sevim","year":"2011","journal-title":"J Pediatr Endocrinol Metab"},{"key":"B5","doi-asserted-by":"crossref","DOI":"10.33588\/rn.4909.2009408","article-title":"Contiguous gene deletion syndrome in Xp21: an unusual form of presentation","volume":"49","author":"Sanz-Ruiz","year":"2009","journal-title":"Rev Neurol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1080\/13816810.2025.2505914","article-title":"land Island eye disease in two patients harboring novel CACNA1F variants","volume":"46","author":"Duemler","year":"2025","journal-title":"Ophthalmic Genet"},{"key":"B7","doi-asserted-by":"publisher","first-page":"699","DOI":"10.1016\/j.oret.2024.01.012","article-title":"Spectrum of genetic variants in the most common genes causing inherited retinal disease in a large molecularly characterized United Kingdom cohort","volume":"8","author":"Lin","year":"2024","journal-title":"Ophthalmol Retina"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcjo.2023.11.022","article-title":"CACNA1F-related synaptic dysfunction: challenges diagnosing congenital stationary night blindness presenting without night blindness","volume":"59","author":"Dumitrescu","year":"2024","journal-title":"Can J Ophthalmol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.a.33656","article-title":"Intragenic deletions of IL1RAPL1: Report of two cases and review of the literature","volume":"155","author":"Behnecke","year":"2011","journal-title":"Am J Med Genet Part A"},{"key":"B10","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1186\/s13039-025-00729-0","article-title":"Genetic analysis of an asymptomatic female with a large Xp deletion revealed insights into the X chromosome inactivation pattern: a case report","volume":"18","author":"Zhang","year":"2025","journal-title":"Mol Cytogenet"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejmg.2015.04.003","article-title":"Xp21 deletion in female patients with intellectual disability: Two new cases and a review of the literature","volume":"58","author":"Heide","year":"2015","journal-title":"Eur J Med Genet"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1136\/jmg.2007.055129","article-title":"Skewed X inactivation is associated with phenotype in a female with adrenal hypoplasia congenita","volume":"45","author":"Shaikh","year":"2008","journal-title":"J Med Genet"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgg.2021.08.019","article-title":"nr0b1 (DAX1) loss of function in zebrafish causes hypothalamic defects via abnormal progenitor proliferation and differentiation","volume":"49","author":"Zhang","year":"2022","journal-title":"J Genet Genomics"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1210\/jendso\/bvab086","article-title":"Genetic analysis of pediatric primary adrenal insufficiency of unknown etiology: 25 years\u2019 Experience in the UK","volume":"5","author":"Buonocore","year":"2021","journal-title":"J Endocr Soc"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1007\/s11033-019-04758-y","article-title":"Gene dosage of DAX-1, determining in sexual differentiation: duplication of DAX-1 in two sisters with gonadal dysgenesis","volume":"46","author":"Garc\u00eda-Acero","year":"2019","journal-title":"Mol Biol Rep"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.21037\/tp-24-327","article-title":"46,XY disorders of sex development and muscular dystrophy caused by Xp21 duplication: a case report and literature review","volume":"13","author":"Zheng","year":"2024","journal-title":"Transl Pediatr"},{"key":"B17","doi-asserted-by":"publisher","first-page":"392","DOI":"10.1002\/jmd2.12452","article-title":"In vivo glycerol metabolism in patients with glycerol kinase deficiency","volume":"65","author":"Shah","year":"2024","journal-title":"JIMD Rep"},{"key":"B18","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1016\/j.atherosclerosis.2020.10.897","article-title":"Glycerol kinase deficiency in adults: Description of 4 novel cases, systematic review and development of a clinical diagnostic score","volume":"315","author":"Lamiquiz-Moneo","year":"2020","journal-title":"Atherosclerosis"},{"key":"B19","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1007\/s10545-014-9767-7","article-title":"Inborn errors of cytoplasmic triglyceride metabolism","volume":"38","author":"Wu","year":"2015","journal-title":"J Inherit Metab Dis"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.2217\/clp.14.52","article-title":"Identifying pseudohypertriglyceridemia in clinical practice","volume":"9","author":"Backes","year":"2014","journal-title":"Clin Lipidology"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2021-248251","article-title":"Pseudo-hypertriglyceridaemia in glycerol kinase deficiency misdiagnosed and treated as true hypertriglyceridaemia","volume":"15","author":"Pant","year":"2022","journal-title":"BMJ Case Rep"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacl.2024.10.006","article-title":"Falsely elevated triglyceride and lipase levels due to hyperglycerolemia in a burn patient treated with topical silver sulfadiazine","volume":"19","author":"Sriphrapradang","year":"2024","journal-title":"J Clin Lipidology"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmsacl.2024.02.004","article-title":"Pseudo-hypertriglyceridemia in a 2-year-old male with global developmental delay, myopathy and adrenal hypoplasia","volume":"32","author":"Fu","year":"2024","journal-title":"J Mass Spectrom Adv Clin Lab"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-024-08324-w","article-title":"Native DGC structure rationalizes muscular dystrophy-causing mutations","volume":"637","author":"Liu","year":"2024","journal-title":"Nature"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1002\/mus.28431","article-title":"Serum creatine kinase and transaminase levels in duchenne and becker muscular dystrophies","volume":"72","author":"Rohlenov\u00e1","year":"2025","journal-title":"Muscle Nerve"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1002\/brb3.3331","article-title":"Natural history of Duchenne muscular dystrophy in the United Kingdom: A descriptive study using the Clinical Practice Research Datalink","volume":"13","author":"Broomfield","year":"2023","journal-title":"Brain Behav"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.13411","article-title":"Ryanodine receptor dysfunction causes senescence and fibrosis in Duchenne dilated cardiomyopathy","volume":"15","author":"Souidi","year":"2024","journal-title":"J Cachexia Sarcopenia Muscle"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.29273","article-title":"Association between myocardial oxygenation and fibrosis in duchenne muscular dystrophy: analysis by rest oxygenation-sensitive magnetic resonance imaging","volume":"60","author":"Zhou","year":"2024","journal-title":"J Magn Reson Imaging"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1038\/s44319-024-00249-9","article-title":"Progressive cardiomyopathy with intercalated disc disorganization in a rat model of Becker dystrophy","volume":"25","author":"Taglietti","year":"2024","journal-title":"EMBO Rep"},{"key":"B30","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1186\/s13395-018-0177-7","article-title":"Muscle membrane integrity in Duchenne muscular dystrophy: recent advances in copolymer-based muscle membrane stabilizers","volume":"8","author":"Houang","year":"2018","journal-title":"Skeletal Muscle"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1111\/bcp.13437","article-title":"Short\u2010 and long\u2010term complications of in utero exposure to lamotrigine","volume":"84","author":"Cohen\u2010Israel","year":"2018","journal-title":"Brit J Clin Pharma"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2005.074203","article-title":"Malformation risks of antiepileptic drugs in pregnancy: a prospective study from the UK Epilepsy and Pregnancy Register","volume":"77","author":"Morrow","year":"2006","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.5543\/tkda.2012.70268","article-title":"Lamotrigine related myocarditis: case report","volume":"40","author":"Bayhan","year":"2012","journal-title":"Arch Turkish Soc Cardiol"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2007.07050728","article-title":"Acute hepatotoxicity associated with lamotrigine","volume":"165","author":"Moeller","year":"2008","journal-title":"AJP"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.64719\/pb.4421","article-title":"Myotoxicity Induced by Antiepileptic Drugs: Could be a Rare but Serious Adverse Event","volume":"51","author":"Siniscalchi","year":"2021","journal-title":"Psychopharmacol Bull"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-021-02807-7","article-title":"Current practices in treating cardiomyopathy and heart failure in duchenne muscular dystrophy (DMD): understanding care practices in order to optimize DMD heart failure through ACTION","volume":"43","author":"Villa","year":"2022","journal-title":"Pediatr Cardiol"},{"key":"B37","doi-asserted-by":"publisher","first-page":"192","DOI":"10.1016\/j.hrthm.2024.07.008","article-title":"Electrophysiologic and cardiovascular manifestations of Duchenne and Becker muscular dystrophies","volume":"22","author":"Hakimi","year":"2025","journal-title":"Heart Rhythm"},{"key":"B38","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1186\/s13023-024-03372-x","article-title":"Predictors of cardiac disease in duchenne muscular dystrophy: a systematic review and evidence grading","volume":"19","author":"Landfeldt","year":"2024","journal-title":"Orphanet J Rare Dis"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951125000587","article-title":"Cardiac treatment for Duchenne muscular dystrophy: consensus recommendations from the ACTION muscular dystrophy committee","volume":"35","author":"Esteso","year":"2025","journal-title":"Cardiol Young"},{"key":"B40","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1002\/dneu.22657","article-title":"The synaptic and neuronal functions of the X-linked intellectual disability protein interleukin-1 receptor accessory protein like 1 (IL1RAPL1)","volume":"79","author":"Montani","year":"2019","journal-title":"Dev Neurobiol"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1093\/hmg\/ddr418","article-title":"The X-linked intellectual disability protein IL1RAPL1 regulates excitatory synapse formation by binding PTP\u03b4 and RhoGAP2","volume":"20","author":"Valnegri","year":"2011","journal-title":"Hum Mol Genet"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1007\/s12035-019-01845-w","article-title":"Dystrophin dp71 and the neuropathophysiology of duchenne muscular dystrophy","volume":"57","author":"Naidoo","year":"2020","journal-title":"Mol Neurobiol"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1016\/j.preteyeres.2022.101137","article-title":"Retinal dystrophins and the retinopathy of Duchenne muscular dystrophy","volume":"95","author":"Barboni","year":"2023","journal-title":"Prog Retin Eye Res"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.1093\/hmg\/ddac236","article-title":"Tissue- and cell-specific whole-transcriptome meta-analysis from brain and retina reveals differential expression of dystrophin complexes and new dystrophin spliced isoforms","volume":"32","author":"Garc\u00eda-Cruz","year":"2023","journal-title":"Hum Mol Genet"},{"key":"B45","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1186\/s40478-025-01996-z","article-title":"A comprehensive spatiotemporal map of dystrophin isoform expression in the developing and adult human brain","volume":"13","author":"Catapano","year":"2025","journal-title":"Acta Neuropathol Commun"},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.1111\/dmcn.16282","article-title":"Dystrophin isoform deficiency and upper-limb and respiratory function in Duchenne muscular dystrophy","volume":"67","author":"Chesshyre","year":"2025","journal-title":"Dev Med Child Neurol"},{"key":"B47","doi-asserted-by":"publisher","DOI":"10.1002\/acn3.70097","article-title":"Influence of dystrophin isoform deficiency on motor development in duchenne muscular dystrophy","volume":"12","author":"Chesshyre","year":"2025","journal-title":"Ann Clin Transl Neurol"},{"key":"B48","doi-asserted-by":"publisher","first-page":"671\u2013","DOI":"10.1007\/s12098-026-06148-2","article-title":"Complex glycerol kinase deficiency: A case of segmental loss of xp chromosome","volume":"93","author":"Manisha","year":"2026","journal-title":"Indian J Pediatr"},{"key":"B49","doi-asserted-by":"publisher","first-page":"109","DOI":"10.36185\/2532-1900-1417","article-title":"The Severe neonatal presentation of Xp21 contiguous gene deletion: adrenal crisis and neuromuscular involvement","volume":"44","author":"Stankovic","year":"2025","journal-title":"Acta Myologica"},{"key":"B50","doi-asserted-by":"publisher","first-page":"83","DOI":"10.4274\/jcrpe.galenos.2025.2024-12-4","article-title":"Xp21 contiguous gene deletion syndrome: diagnosis, treatment, and a review of the literature on a rare genetic disorder","volume":"18","author":"Singin","year":"2025","journal-title":"J Clin Res Pediatr Endocrinol"},{"key":"B51","doi-asserted-by":"publisher","DOI":"10.1007\/s11055-025-01875-z","article-title":"Xp21 contiguous gene deletion syndrome","volume":"55","author":"Kalashnikova","year":"2025","journal-title":"Neurosci Behav Physi"},{"key":"B52","doi-asserted-by":"publisher","DOI":"10.5114\/pedm.2021.109681","article-title":"Complex glycerol kinase deficiency - long-term follow-up of two patients","volume":"27","author":"Wikiera","year":"2021","journal-title":"Pediatr Endocrinol Diabetes Metab"},{"key":"B53","doi-asserted-by":"publisher","DOI":"10.1177\/11795514251317419","article-title":"Genetic and clinical characterization of complex glycerol kinase deficiency in two male siblings: a case report","volume":"18","author":"Bregvadze","year":"2025","journal-title":"Clin Med Insights Endocrinol Diabetes"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1858779\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T04:20:50Z","timestamp":1784521250000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1858779\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,20]]},"references-count":53,"alternative-id":["10.3389\/fendo.2026.1858779"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2026.1858779","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,20]]},"article-number":"1858779"}}