{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T05:19:35Z","timestamp":1789103975878,"version":"build-2803163510"},"reference-count":64,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T00:00:00Z","timestamp":1750204800000},"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. Med."],"abstract":"<jats:p>Therapeutic plasma exchange (TPE) is widely used in various fields of clinical practice. There are two main modes of TPE: centrifugal TPE (cTPE) and membrane TPE (mTPE). No matter which mode of TPE, anticoagulant therapy is essential to prevent clotting in the extracorporeal circuit. Therefore, selecting a suitable and safe anticoagulant is crucial. Currently, heparin and citrate are the most commonly used anticoagulants. Different anticoagulant regimens have varying advantages, disadvantages, and associated complications, making them suitable for different TPE modes. This review aims to summarize relevant research findings to provide clinicians with evidence to guide their selection of appropriate anticoagulants during TPE.<\/jats:p>","DOI":"10.3389\/fmed.2025.1568333","type":"journal-article","created":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T05:41:35Z","timestamp":1750225295000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Anticoagulant regimens for different therapeutic plasma exchange modes"],"prefix":"10.3389","volume":"12","author":[{"given":"Ruishan","family":"Yao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiyan","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaohui","family":"Ming","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huiling","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lingli","family":"Miao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Su","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Wan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaofang","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanli","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaowen","family":"Yuan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruiting","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,6,18]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1002\/jca.22043","article-title":"Guidelines on the use of therapeutic apheresis in clinical practice - Evidence-based approach from the writing committee of the American society for apheresis: The ninth special issue.","volume":"38","author":"Connelly-Smith","year":"2023","journal-title":"J Clin Apher."},{"key":"B2","doi-asserted-by":"publisher","first-page":"728","DOI":"10.1111\/1744-9987.13749","article-title":"The Japanese society for apheresis clinical practice guideline for therapeutic apheresis.","volume":"25","author":"Abe","year":"2021","journal-title":"Ther Apher Dial."},{"key":"B3","doi-asserted-by":"publisher","first-page":"842","DOI":"10.1080\/0886022X.2022.2073892","article-title":"Therapeutic apheresis in kidney diseases: An updated review.","volume":"44","author":"Chen","year":"2022","journal-title":"Ren Fail."},{"key":"B4","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1111\/j.1744-9987.2009.00716.x","article-title":"Apheresis technologies and clinical applications: The 2007 International apheresis registry.","volume":"14","author":"Malchesky","year":"2010","journal-title":"Ther Apher Dial."},{"key":"B5","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1002\/jca.21391","article-title":"Experience in therapeutic plasma exchange by membrane filtration at an academic center in Colombia: Registry of the first 500 sessions.","volume":"30","author":"C\u00f3rdoba","year":"2015","journal-title":"J Clin Apher."},{"key":"B6","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1002\/jca.21561","article-title":"Membrane-based therapeutic plasma exchange (mTPE): Technical and clinical experience.","volume":"33","author":"Gashti","year":"2018","journal-title":"J Clin Apher."},{"key":"B7","doi-asserted-by":"publisher","first-page":"2379","DOI":"10.1007\/s11255-020-02581-0","article-title":"Application of regional citrate anticoagulation in membrane therapeutic plasma exchange.","volume":"52","author":"Yuan","year":"2020","journal-title":"Int Urol Nephrol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1007\/s11255-015-1137-3","article-title":"Membrane versus centrifuge-based therapeutic plasma exchange: A randomized prospective crossover study.","volume":"48","author":"Hafer","year":"2016","journal-title":"Int Urol Nephrol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"479","DOI":"10.1002\/jca.21544","article-title":"Membrane therapeutic plasma exchange with and without heparin anticoagulation.","volume":"32","author":"Brunetta Gavrani\u0107","year":"2017","journal-title":"J Clin Apher."},{"key":"B10","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1186\/s12882-017-0494-9","article-title":"A new prescription model for regional citrate anticoagulation in therapeutic plasma exchanges.","volume":"18","author":"Kissling","year":"2017","journal-title":"BMC Nephrol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"475","DOI":"10.1053\/j.ajkd.2022.10.017","article-title":"Therapeutic plasma exchange: Core curriculum 2023.","volume":"81","author":"Cervantes","year":"2023","journal-title":"Am J Kidney Dis."},{"key":"B12","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1159\/000534455","article-title":"Divide et Vinces, therapeutic apheresis in nephrological clinical practice.","volume":"53","author":"Mantilla","year":"2024","journal-title":"Blood Purif."},{"key":"B13","doi-asserted-by":"publisher","first-page":"155","DOI":"10.3760\/cma.j.cn441217-20220809-00815","article-title":"Chinese expert consensus on the application of anticoagulant technology in renal replacement therapy for critical patients.","volume":"39","year":"2023","journal-title":"Chinese J Nephrol."},{"key":"B14","doi-asserted-by":"publisher","first-page":"416","DOI":"10.1111\/sdi.12959","article-title":"Anticoagulation strategies in continuous renal replacement therapy.","volume":"34","author":"Legrand","year":"2021","journal-title":"Semin Dial."},{"key":"B15","doi-asserted-by":"publisher","first-page":"64S","DOI":"10.1378\/chest.119.1_suppl.64s","article-title":"Heparin and low-molecular-weight heparin: Mechanisms of action, pharmacokinetics, dosing, monitoring, efficacy, and safety.","volume":"119","author":"Hirsh","year":"2001","journal-title":"Chest."},{"key":"B16","doi-asserted-by":"publisher","first-page":"789","DOI":"10.1053\/j.ajkd.2007.12.040","article-title":"Pharmacodynamics of unfractionated heparin during and after a hemodialysis session.","volume":"51","author":"Brunet","year":"2008","journal-title":"Am J Kidney Dis."},{"key":"B17","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1053\/j.ajkd.2012.03.017","article-title":"Use and safety of unfractionated heparin for anticoagulation during maintenance hemodialysis.","volume":"60","author":"Shen","year":"2012","journal-title":"Am J Kidney Dis."},{"key":"B18","doi-asserted-by":"publisher","first-page":"188","DOI":"10.1007\/s00134-005-0044-y","article-title":"Anticoagulation strategies in continuous renal replacement therapy: Can the choice be evidence based?","volume":"32","author":"Oudemans-van Straaten","year":"2006","journal-title":"Intensive Care Med."},{"key":"B19","doi-asserted-by":"publisher","first-page":"1601","DOI":"10.1345\/aph.1G033","article-title":"Argatroban anticoagulation in patients with heparin-induced thrombocytopenia requiring renal replacement therapy.","volume":"39","author":"Reddy","year":"2005","journal-title":"Ann Pharmacother."},{"key":"B20","doi-asserted-by":"publisher","first-page":"1117","DOI":"10.1592\/phco.30.11.1117","article-title":"Bivalirudin versus unfractionated heparin for prevention of hemofilter occlusion during continuous renal replacement therapy.","volume":"30","author":"Kiser","year":"2010","journal-title":"Pharmacotherapy."},{"key":"B21","doi-asserted-by":"publisher","first-page":"483","DOI":"10.1046\/j.1526-0968.2003.00088.x","article-title":"Pharmacokinetics of nafamostat mesilate during continuous hemodiafiltration with a polyacrylonitrile membrane.","volume":"7","author":"Nakae","year":"2003","journal-title":"Ther Apher Dial."},{"key":"B22","doi-asserted-by":"publisher","first-page":"129","DOI":"10.19842\/j.cnki.issn.0253-9934.2024.03.001","article-title":"Society of nephrology, shanghai medical association, expert consensus on application of nafamostat mesilate in anticoagulation for blood purification writing group. expert consensus on application of nafamostat mesilate in anticoagulation for blood purification.","volume":"47","author":"Hu","year":"2024","journal-title":"SMJ."},{"key":"B23","doi-asserted-by":"publisher","first-page":"1148156","DOI":"10.1155\/2021\/1148156","article-title":"Anaphylactic reactions caused by nafamostat mesylate during hemodialysis before surgery for carpal tunnel syndrome.","volume":"29","author":"Nakamura","year":"2021","journal-title":"Case Rep Nephrol."},{"key":"B24","doi-asserted-by":"publisher","first-page":"2861","DOI":"10.21037\/jtd.2019.06.30","article-title":"Single-center experience of extracorporeal membrane oxygenation mainly anticoagulated with nafamostat mesilate.","volume":"11","author":"Han","year":"2019","journal-title":"J Thorac Dis."},{"key":"B25","doi-asserted-by":"publisher","first-page":"100855","DOI":"10.1016\/j.accpm.2021.100855","article-title":"Regional citrate anticoagulation for CRRT: Still hesitating?","volume":"40","author":"Schneider","year":"2021","journal-title":"Anaesth Crit Care Pain Med."},{"key":"B26","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1186\/s40779-023-00457-9","article-title":"Emergency Medical Doctor Branch of the Chinese Medical Doctor Association. Management of regional citrate anticoagulation for continuous renal replacement therapy: Guideline recommendations from Chinese emergency medical doctor consensus.","volume":"10","author":"Liu","year":"2023","journal-title":"Mil Med Res."},{"key":"B27","doi-asserted-by":"publisher","first-page":"1629","DOI":"10.1001\/jama.2020.18618","article-title":"Effect of regional citrate anticoagulation vs systemic heparin anticoagulation during continuous kidney replacement therapy on dialysis filter life span and mortality among critically ill patients with acute kidney injury: A randomized clinical trial.","volume":"324","author":"Zarbock","year":"2020","journal-title":"JAMA."},{"key":"B28","doi-asserted-by":"publisher","first-page":"1382","DOI":"10.1007\/s00134-022-06793-z","article-title":"Plasma exchange in the intensive care unit: A narrative review.","volume":"48","author":"Bauer","year":"2022","journal-title":"Intensive Care Med."},{"key":"B29","doi-asserted-by":"publisher","first-page":"103831","DOI":"10.1016\/j.transci.2023.103831","article-title":"The world apheresis association registry, 2023 update.","volume":"62","author":"Vrielink","year":"2023","journal-title":"Transfus Apher Sci."},{"key":"B30","doi-asserted-by":"publisher","first-page":"1371","DOI":"10.1055\/s-0040-1715460","article-title":"The anticoagulant and nonanticoagulant properties of heparin.","volume":"120","author":"Beurskens","year":"2020","journal-title":"Thromb Haemos."},{"key":"B31","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1159\/000515827","article-title":"Efficacy, safety, and calcium balance of an accelerated citrate anticoagulated membrane-based plasma exchange algorithm.","volume":"51","author":"Halpin","year":"2022","journal-title":"Blood Purif."},{"key":"B32","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1016\/j.bpa.2017.08.005","article-title":"Renal replacement therapy and anticoagulation.","volume":"31","author":"Brandenburger","year":"2017","journal-title":"Best Pract Res Clin Anaesthesiol."},{"key":"B33","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1002\/jca.21950","article-title":"Tolerance and complications of therapeutic plasma exchange by centrifugation: A single center experience.","volume":"37","author":"Coirier","year":"2022","journal-title":"J Clin Apher."},{"key":"B34","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1002\/jca.21961","article-title":"Comparison of centrifugal and membrane filtration modalities on therapeutic plasma exchange.","volume":"37","author":"Keklik","year":"2022","journal-title":"J Clin Apher."},{"key":"B35","doi-asserted-by":"publisher","first-page":"2210691","DOI":"10.1080\/0886022X.2023.2210691","article-title":"Heparin anticoagulation versus regional citrate anticoagulation for membrane therapeutic plasma exchange in patients with increased bleeding risk.","volume":"45","author":"Jiao","year":"2023","journal-title":"Ren Fail."},{"key":"B36","doi-asserted-by":"publisher","first-page":"e24S","DOI":"10.1378\/chest.11-2291","article-title":"Parenteral anticoagulants: Antithrombotic therapy and prevention of thrombosis, 9th ed: American college of chest physicians evidence-based clinical practice guidelines.","volume":"141","author":"Garcia","year":"2012","journal-title":"Chest."},{"key":"B37","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1002\/jca.21222","article-title":"Anticoagulation techniques in apheresis: From heparin to citrate and beyond.","volume":"27","author":"Lee","year":"2012","journal-title":"J Clin Apher."},{"key":"B38","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1002\/jca.21519","article-title":"The impact of citrate concentration on adhesion of platelets and leukocytes to adsorbents in whole blood lipoprotein apheresis.","volume":"32","author":"Weiss","year":"2017","journal-title":"J Clin Apher."},{"key":"B39","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1159\/000500408","article-title":"Safety and efficacy of regional citrate anticoagulation during plasma adsorption plus plasma exchange therapy for patients with acute-on-chronic liver failure: A pilot study.","volume":"48","author":"Ma","year":"2019","journal-title":"Blood Purif."},{"key":"B40","doi-asserted-by":"publisher","first-page":"542","DOI":"10.1159\/000505613","article-title":"Anticoagulation effect and safety observation of regional citrate anticoagulation for double-filtration plasmapheresis in critical patients.","volume":"49","author":"Peng","year":"2020","journal-title":"Blood Purif."},{"key":"B41","doi-asserted-by":"publisher","first-page":"2710","DOI":"10.1182\/blood-2005-04-1546","article-title":"Risk for heparin-induced thrombocytopenia with unfractionated and low-molecular-weight heparin thromboprophylaxis: A meta-analysis.","volume":"106","author":"Martel","year":"2005","journal-title":"Blood."},{"key":"B42","doi-asserted-by":"publisher","first-page":"253","DOI":"10.1016\/j.transci.2018.02.001","article-title":"Therapeutic plasma exchange: A prospective randomized trial to evaluate 2 strategies in patients with liver failure.","volume":"57","author":"Yuan","year":"2018","journal-title":"Transfus Apher Sci."},{"key":"B43","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1002\/jca.21592","article-title":"Therapeutic Apheresis Subsection of the AABB. The management of anticoagulation in patients undergoing therapeutic plasma exchange: A concise review.","volume":"33","author":"Shunkwiler","year":"2018","journal-title":"J Clin Apher."},{"key":"B44","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1186\/s13054-017-1880-1","article-title":"Complications of regional citrate anticoagulation: Accumulation or overload?","volume":"21","author":"Schneider","year":"2017","journal-title":"Crit Care."},{"key":"B45","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1053\/j.ackd.2021.03.005","article-title":"Therapeutic plasma exchange in the critically Ill patient: Technology and indications.","volume":"28","author":"Sanchez","year":"2021","journal-title":"Adv Chronic Kidney Dis."},{"key":"B46","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1002\/jca.21854","article-title":"Description of parallel and sequential configurations for concurrent therapeutic plasma exchange and continuous kidney replacement therapy in adults.","volume":"36","author":"Kaushik","year":"2021","journal-title":"J Clin Apher."},{"key":"B47","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1002\/jca.21301","article-title":"An international survey of pediatric apheresis practice.","volume":"29","author":"Delaney","year":"2014","journal-title":"J Clin Apher."},{"key":"B48","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1186\/cc11645","article-title":"Bench-to-bedside review: Citrate for continuous renal replacement therapy, from science to practice.","volume":"16","author":"Oudemans-van Straaten","year":"2012","journal-title":"Crit Care."},{"key":"B49","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1159\/000342378","article-title":"Advances in continuous renal replacement therapy: Citrate anticoagulation update.","volume":"34","author":"Tolwani","year":"2012","journal-title":"Blood Purif."},{"key":"B50","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1016\/j.jcrc.2013.10.015","article-title":"Incidence and outcome of metabolic disarrangements consistent with citrate accumulation in critically ill patients undergoing continuous venovenous hemodialysis with regional citrate anticoagulation.","volume":"29","author":"Khadzhynov","year":"2014","journal-title":"J Crit Care."},{"key":"B51","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1002\/jca.20303","article-title":"Therapeutic apheresis: A review of complications and recommendations for prevention and management.","volume":"26","author":"Mokrzycki","year":"2011","journal-title":"J Clin Apher."},{"key":"B52","doi-asserted-by":"publisher","first-page":"382","DOI":"10.1111\/sdi.12506","article-title":"Membrane-based therapeutic plasma exchange: A new frontier for nephrologists.","volume":"29","author":"Gashti","year":"2016","journal-title":"Semin Dial."},{"key":"B53","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1002\/jca.20142","article-title":"Continuous infusion of calcium gluconate in 5% albumin is safe and prevents most hypocalcemic reactions during therapeutic plasma exchange.","volume":"22","author":"Kankirawatana","year":"2007","journal-title":"J Clin Apher."},{"key":"B54","doi-asserted-by":"publisher","first-page":"1061","DOI":"10.1016\/j.jceh.2023.06.002","article-title":"Growing evidence for survival benefit with plasma exchange to treat liver failure.","volume":"13","author":"Goel","year":"2023","journal-title":"J Clin Exp Hepatol."},{"key":"B55","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1097\/LVT.0000000000000231","article-title":"Plasma exchange for acute and acute-on-chronic liver failure: A systematic review and meta-analysis.","volume":"30","author":"Mhanna","year":"2024","journal-title":"Liver Transpl."},{"key":"B56","doi-asserted-by":"publisher","first-page":"1047","DOI":"10.1016\/j.jhep.2016.12.003","article-title":"EASL clinical practical guidelines on the management of acute (fulminant) liver failure.","volume":"66","author":"Wendon","year":"2017","journal-title":"J Hepatol."},{"key":"B57","doi-asserted-by":"publisher","first-page":"904","DOI":"10.4254\/wjh.v13.i8.904","article-title":"Therapeutic plasma exchange in liver failure.","volume":"13","author":"Chris-Olaiya","year":"2021","journal-title":"World J Hepatol."},{"key":"B58","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1186\/s13054-017-1870-3","article-title":"Long-term continuous renal replacement therapy and anticoagulation with citrate in critically ill patients with severe liver dysfunction.","volume":"21","author":"Klingele","year":"2017","journal-title":"Crit Care."},{"key":"B59","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1186\/s13054-019-2317-9","article-title":"Safety and efficacy of regional citrate anticoagulation for continuous renal replacement therapy in liver failure patients: A systematic review and meta-analysis.","volume":"23","author":"Zhang","year":"2019","journal-title":"Crit Care."},{"key":"B60","doi-asserted-by":"publisher","first-page":"10760296231174001","DOI":"10.1177\/10760296231174001","article-title":"Regional citrate anticoagulation or heparin anticoagulation for renal replacement therapy in patients with liver failure: A systematic review and meta-analysis.","volume":"29","author":"Qi","year":"2023","journal-title":"Clin Appl Thromb Hemost."},{"key":"B61","doi-asserted-by":"publisher","first-page":"1870","DOI":"10.1111\/trf.15191","article-title":"Effects of therapeutic plasma exchange on anticoagulants in patients receiving therapeutic anticoagulation: A systematic review.","volume":"59","author":"Hodulik","year":"2019","journal-title":"Transfusion."},{"key":"B62","doi-asserted-by":"publisher","first-page":"507","DOI":"10.1002\/jca.21441","article-title":"Management of systemic unfractionated heparin anticoagulation during therapeutic plasma exchange.","volume":"31","author":"Kaplan","year":"2016","journal-title":"J Clin Apher."},{"key":"B63","doi-asserted-by":"publisher","first-page":"624","DOI":"10.1111\/j.1537-2995.2006.00755.x","article-title":"Anticoagulation with low-molecular-weight heparin (dalteparin) in plasmapheresis therapy: Initial experience.","volume":"46","author":"Schinzel","year":"2006","journal-title":"Transfusion."},{"key":"B64","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1002\/jca.21294","article-title":"Effect of therapeutic plasma exchange on coagulation parameters in patients on warfarin.","volume":"29","author":"Zantek","year":"2014","journal-title":"J Clin Apher."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1568333\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T05:41:37Z","timestamp":1750225297000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1568333\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,18]]},"references-count":64,"alternative-id":["10.3389\/fmed.2025.1568333"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2025.1568333","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,18]]},"article-number":"1568333"}}