{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T07:13:54Z","timestamp":1771485234086,"version":"3.50.1"},"reference-count":64,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:00:00Z","timestamp":1771459200000},"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:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Depression is highly prevalent among patients with systemic lupus erythematosus (SLE) and is associated with adverse clinical outcomes. However, evidence on its risk factors remains inconsistent, limiting early identification and targeted intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a systematic review and meta-analysis in accordance with PRISMA and MOOSE guidelines. Eight databases were searched from inception to May 2024 for observational studies reporting risk factors for depression in adult SLE patients assessed by validated scales. Study quality was evaluated using the Newcastle\u2013Ottawa Scale or AHRQ criteria. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using random-effects models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 26 studies (\n                      <jats:italic>n<\/jats:italic>\n                      = 8,960 patients) were included. Significant risk factors for depression included economic hardship (OR = 6.05, 95% CI: 3.64\u201310.07), high-dose glucocorticoid use (OR = 7.72, 95% CI: 4.62\u201312.90), higher disease activity (OR = 3.15, 95% CI: 2.95\u20133.37), unemployment (OR = 3.06, 95% CI: 1.48\u20136.32), lower academic qualifications (OR = 2.21, 95% CI: 1.45\u20133.36), presence of comorbidities (OR = 2.20, 95% CI: 1.45\u20133.34), smoking (OR = 3.17, 95% CI: 1.44\u20136.99), and greater fatigue severity (per unit increase: OR = 1.23, 95% CI: 1.08\u20131.40). Younger age was also associated with higher depression risk (OR = 1.97, 95% CI: 1.41\u20132.76). Subgroup and meta-regression analyses revealed substantial heterogeneity across studies, partially explained by geographic region and depression assessment tools. Publication bias was detected but did not alter core findings in sensitivity analyses.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This meta-analysis identifies key clinical, demographic, and psychosocial risk factors for depression in SLE. Findings support integrating routine depression screening with holistic assessments of disease burden and social context in clinical practice, particularly within nursing-led care models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/prospero\/display_record.php?ID=CRD42024557892<\/jats:ext-link>\n                      , identifier CRD42024557892.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1751870","type":"journal-article","created":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T06:41:10Z","timestamp":1771483270000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk factors for depression in systemic lupus erythematosus: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"13","author":[{"given":"Linling","family":"Zhu","sequence":"first","affiliation":[{"name":"School of Medicine, Tongji University","place":["Shanghai, China"]},{"name":"Department of Nursing, Renji Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinju","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Nursing, Renji Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yaping","family":"Sha","sequence":"additional","affiliation":[{"name":"Department of Nursing, Renji Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huiren","family":"Zhuang","sequence":"additional","affiliation":[{"name":"Shanghai East Hospital, School of Medicine, Tongji University","place":["Shanghai, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chunhua","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Nursing, Renji Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,19]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"2332","DOI":"10.1016\/S0140-6736(19)30237-5","article-title":"Management strategies and future directions for systemic lupus erythematosus in adults.","volume":"393","author":"Durcan","year":"2019","journal-title":"Lancet."},{"key":"B2","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1136\/ard-2022-223035","article-title":"Global epidemiology of systemic lupus erythematosus: a comprehensive systematic analysis and modelling study.","volume":"82","author":"Tian","year":"2023","journal-title":"Ann Rheum Dis."},{"key":"B3","doi-asserted-by":"publisher","first-page":"R17","DOI":"10.1186\/ar2368","article-title":"Rheumatic diseases in China.","volume":"10","author":"Zeng","year":"2008","journal-title":"Arthritis Res Ther."},{"key":"B4","doi-asserted-by":"publisher","first-page":"515","DOI":"10.1038\/s41584-021-00668-1","article-title":"Global epidemiology of systemic lupus erythematosus.","volume":"17","author":"Barber","year":"2021","journal-title":"Nat Rev Rheumatol."},{"key":"B5","doi-asserted-by":"publisher","first-page":"2009","DOI":"10.1136\/annrheumdis-2017-211663","article-title":"Survival in adults and children with systemic lupus erythematosus: a systematic review and Bayesian meta-analysis of studies from 1950 to 2016.","volume":"76","author":"Tektonidou","year":"2017","journal-title":"Ann Rheum Dis."},{"key":"B6","doi-asserted-by":"publisher","first-page":"e794","DOI":"10.1097\/MD.0000000000000794","article-title":"Long-term survival and death causes of systemic lupus erythematosus in China: a systemic review of observational studies.","volume":"94","author":"Wang","year":"2015","journal-title":"Medicine."},{"key":"B7","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1186\/s12888-017-1234-1","article-title":"Prevalence of depression and anxiety in systemic lupus erythematosus: a systematic review and meta-analysis.","volume":"17","author":"Zhang","year":"2017","journal-title":"BMC Psychiatry."},{"key":"B8","doi-asserted-by":"publisher","first-page":"795","DOI":"10.1007\/s10067-010-1651-8","article-title":"Damage accrual, cumulative glucocorticoid dose and depression predict anxiety in patients with systemic lupus erythematosus.","volume":"30","author":"Mak","year":"2011","journal-title":"Clin Rheumatol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"262","DOI":"10.3899\/jrheum.110327","article-title":"Association between depression and vascular disease in systemic lupus erythematosus.","volume":"39","author":"Greco","year":"2012","journal-title":"J Rheumatol."},{"key":"B10","doi-asserted-by":"publisher","first-page":"151997","DOI":"10.1016\/j.semarthrit.2022.151997","article-title":"Suicidal behavior in patients with systematic lupus erythematosus: systematic literature review and genetic linkage disequilibrium analysis.","volume":"54","author":"Parperis","year":"2022","journal-title":"Semin Arthritis Rheum."},{"key":"B11","doi-asserted-by":"publisher","first-page":"e068683","DOI":"10.1136\/bmjopen-2022-068683","article-title":"Association between depression and pain, functional disability, disease activity and health-related quality of life in patients with systemic lupus erythematosus: a meta-analysis.","volume":"13","author":"Zhao","year":"2023","journal-title":"BMJ Open."},{"key":"B12","doi-asserted-by":"publisher","first-page":"5369","DOI":"10.1093\/rheumatology\/keab123","article-title":"Association of clinical characteristics, disease activity and health-related quality of life in SLE patients with major depressive disorder.","volume":"60","author":"Parperis","year":"2021","journal-title":"Rheumatology."},{"key":"B13","doi-asserted-by":"publisher","first-page":"1207","DOI":"10.1007\/s00296-011-2043-3","article-title":"Prevalence and correlates of suicidal ideation in SLE inpatients: Chinese experience.","volume":"32","author":"Xie","year":"2011","journal-title":"Rheumatol Int."},{"key":"B14","doi-asserted-by":"publisher","first-page":"822","DOI":"10.1002\/art.24519","article-title":"Prevalence of mood and anxiety disorders in women with systemic lupus erythematosus.","volume":"61","author":"Bachen","year":"2009","journal-title":"Arthritis Rheum."},{"key":"B15","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1016\/j.comppsych.2006.04.002","article-title":"Major depressive disorder and disease activity in systemic lupus erythematosus.","volume":"48","author":"Nery","year":"2007","journal-title":"Compr Psychiatry."},{"key":"B16","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1177\/0961203310381773","article-title":"Common mental disorders and psychological distress in systemic lupus erythematosus are not associated with disease activity.","volume":"20","author":"Jarpa","year":"2011","journal-title":"Lupus."},{"key":"B17","first-page":"S40","article-title":"Fibromyalgia prevalence and related factors in a large registry of patients with systemic lupus erythematosus.","volume":"34","author":"Torrente-Segarra","year":"2016","journal-title":"Clin Exp Rheumatol."},{"key":"B18","first-page":"10","article-title":"[Prevalence of mental disorders in SLE patients: correlations with the disease activity and comorbid chronic conditions].","volume":"81","author":"Lisitsyna","year":"2009","journal-title":"Ter Arkh."},{"key":"B19","doi-asserted-by":"publisher","first-page":"e1000097","DOI":"10.1371\/journal.pmed.1000097","article-title":"Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.","volume":"6","author":"Moher","year":"2009","journal-title":"PLoS Med."},{"key":"B20","doi-asserted-by":"publisher","first-page":"2008","DOI":"10.1001\/jama.283.15.2008","article-title":"Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis of observational studies in epidemiology (MOOSE) group.","volume":"283","author":"Stroup","year":"2000","journal-title":"JAMA."},{"key":"B21","doi-asserted-by":"publisher","first-page":"603","DOI":"10.1007\/s10654-010-9491-z","article-title":"Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses.","volume":"25","author":"Stang","year":"2010","journal-title":"Eur J Epidemiol."},{"key":"B22","doi-asserted-by":"publisher","first-page":"1106","DOI":"10.1136\/bmj.39500.677199.AE","article-title":"Grading quality of evidence and strength of recommendations for diagnostic tests and strategies.","volume":"336","author":"Sch\u00fcnemann","year":"2008","journal-title":"BMJ."},{"key":"B23","first-page":"133","article-title":"The relationship between family function and depression in female patients with systemic lupus erythematosus.","volume":"48","author":"Chen","year":"2013","journal-title":"Chin J Nurs."},{"key":"B24","volume-title":"The Study of Base on Zangfu-Emotion Correlation theory to Discuss Relativity and Factor Analysis of SLE and Depressive Disorders.","author":"Yan","year":"2013"},{"key":"B25","first-page":"718","article-title":"Correlation study between pressure source and depression in female patients with systemic lupus erythematosus.","volume":"30","author":"Zhou","year":"2016","journal-title":"Chin Nurs Res."},{"key":"B26","first-page":"58","article-title":"Correlation between stressors and anxiety and depression in patients with systemic lupus erythematosus.","volume":"25","author":"Shen","year":"2018","journal-title":"Capital Food Med."},{"key":"B27","volume-title":"Effect of Social Media use Degree on Mental Health of Systemic Lupus erythematosus Patients.","author":"Yi","year":"2018"},{"key":"B28","doi-asserted-by":"publisher","first-page":"3311","DOI":"10.13241\/j.cnki.pmb.2019.17.023","article-title":"High-dose prednisone is an independent risk factor for depression in patients with systemic lupus erythematosus.","volume":"19","author":"Liu","year":"2019","journal-title":"Prog Mod Biomed."},{"key":"B29","first-page":"304","article-title":"Comparison of the reliability and validity of depression scales for systemic lupus erythematosus and analysis of depression-related risk factors.","volume":"39","author":"Li","year":"2019","journal-title":"J Shanghai Jiaotong Univ."},{"key":"B30","doi-asserted-by":"publisher","first-page":"3913","DOI":"10.3760\/cma.j.cn221370-20190718-01200","article-title":"Relationship between stressors and psychological depression in women with systemic lupus erythematosus.","volume":"39","author":"Chou","year":"2020","journal-title":"Int J Nurs."},{"key":"B31","first-page":"590","article-title":"Construction of risk prediction model for the occurrence of depression in patients with systemic lupus erythematosus during glucocorticoid maintenance therapy.","volume":"51","author":"Chen","year":"2022","journal-title":"Chongqing Med J."},{"key":"B32","doi-asserted-by":"publisher","first-page":"1309","DOI":"10.13898\/j.cnki.issn.1000-2200.2023.09.030","article-title":"Anxiety and depression in patients with systemic lupus erythematosus and its related factors.","volume":"48","author":"Tian","year":"2023","journal-title":"J Bengbu Med Coll."},{"key":"B33","doi-asserted-by":"publisher","first-page":"542","DOI":"10.1002\/acr.20426","article-title":"Cardiovascular and disease-related predictors of depression in systemic lupus erythematosus.","volume":"63","author":"Julian","year":"2011","journal-title":"Arthritis Care Res."},{"key":"B34","doi-asserted-by":"publisher","first-page":"1823","DOI":"10.3899\/jrheum.140111","article-title":"Predictors of incident depression in systemic lupus erythematosus.","volume":"41","author":"Huang","year":"2014","journal-title":"J Rheumatol."},{"key":"B35","doi-asserted-by":"publisher","first-page":"2829018","DOI":"10.1155\/2016\/2829018","article-title":"Depressive and anxiety disorders in systemic Lupus Erythematosus patients without major neuropsychiatric manifestations.","volume":"2016","author":"Bai","year":"2016","journal-title":"J Immunol Res."},{"key":"B36","doi-asserted-by":"publisher","first-page":"1705","DOI":"10.1007\/s00296-016-3559-3","article-title":"Prevalence and risk factors of anxiety and depression in patients with systemic lupus erythematosus in Southwest China.","volume":"36","author":"Xie","year":"2016","journal-title":"Rheumatol Int."},{"key":"B37","doi-asserted-by":"publisher","first-page":"2045","DOI":"10.1111\/1756-185X.12331","article-title":"Association of perceived neighborhood characteristics, socioeconomic status and rural residency with health outcomes in Egyptian patients with systemic lupus erythematosus: one center study.","volume":"20","author":"Abdul-Sattar","year":"2017","journal-title":"Int J Rheum Dis."},{"key":"B38","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1002\/acr.23247","article-title":"Socioeconomic predictors of incident depression in systemic Lupus Erythematosus.","volume":"70","author":"Mccormick","year":"2018","journal-title":"Arthritis Care Res."},{"key":"B39","doi-asserted-by":"publisher","first-page":"e11376","DOI":"10.1097\/MD.0000000000011376","article-title":"Depression and anxiety in systemic lupus erythematosus: the crosstalk between immunological, clinical, and psychosocial factors.","volume":"97","author":"Figueiredo-Braga","year":"2018","journal-title":"Medicine."},{"key":"B40","first-page":"627","article-title":"Association of depression with socioeconomic status, anticardiolipin antibodies, and organ damage in patients with systemic lupus erythematosus: results from the KORNET registry.","volume":"36","author":"Park","year":"2018","journal-title":"Clin Exp Rheumatol."},{"key":"B41","doi-asserted-by":"publisher","first-page":"e202101173","DOI":"10.37689\/acta-ape\/2021AO01173","article-title":"Factors influencing quality of life in people with systemic lupus erythematosus.","volume":"34","author":"De Souza","year":"2021","journal-title":"Acta Paul Enferm."},{"key":"B42","doi-asserted-by":"publisher","first-page":"951431","DOI":"10.3389\/fpsyg.2022.951431","article-title":"Development of a nomogram prediction model for depression in patients with systemic lupus erythematosus.","volume":"13","author":"Chen","year":"2022","journal-title":"Front Psychol."},{"key":"B43","doi-asserted-by":"publisher","first-page":"e689","DOI":"10.1002\/iid3.689","article-title":"Anxiety and depression prevalence and their risk factors in lupus nephritis patients: a case-control study.","volume":"10","author":"Hu","year":"2022","journal-title":"Immun Inflamm Dis."},{"key":"B44","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1186\/s12888-022-03739-z","article-title":"Prevalence and biopsychosocial factors associated with depressive symptoms among patients living with systemic lupus erythematosus in clinical settings in urban Thailand.","volume":"22","author":"Narupan","year":"2022","journal-title":"BMC Psychiatry."},{"key":"B45","doi-asserted-by":"publisher","first-page":"1098","DOI":"10.1002\/acr.24555","article-title":"Physical inactivity and incident depression in a multiracial, multiethnic systemic lupus erythematosus cohort.","volume":"74","author":"Patterson","year":"2022","journal-title":"Arthritis Care Res."},{"key":"B46","doi-asserted-by":"publisher","first-page":"676","DOI":"10.1093\/rheumatology\/keac333","article-title":"Trajectories of depressive symptoms in systemic lupus erythematosus over time.","volume":"62","author":"Chawla","year":"2023","journal-title":"Rheumatology."},{"key":"B47","doi-asserted-by":"publisher","first-page":"486","DOI":"10.3390\/clinpract14020037","article-title":"Anxiety and depression and associated risk factors among outpatients with systemic lupus erythematosus: Eastern Province, Saudi Arabia.","volume":"14","author":"Hasan","year":"2024","journal-title":"Clin Pract."},{"key":"B48","doi-asserted-by":"publisher","first-page":"995","DOI":"10.4103\/indianjpsychiatry.indianjpsychiatry_667_23","article-title":"Stigma towards mental illness in Asian nations and low-and-middle-income countries, and comparison with high-income countries: a literature review and practice implications.","volume":"65","author":"Vaishnav","year":"2023","journal-title":"Indian J Psychiatry."},{"key":"B49","doi-asserted-by":"publisher","first-page":"1315","DOI":"10.1177\/0961203316638934","article-title":"Gender differences in systemic lupus erythematosus concerning anxiety, depression and quality of life.","volume":"25","author":"Mac\u00eado","year":"2016","journal-title":"Lupus."},{"key":"B50","first-page":"1022","article-title":"Association between social support and depression in patients with systemic lupus erythematosus.","volume":"9","author":"Yue","year":"2011","journal-title":"Chinese General Pract Nurs."},{"key":"B51","doi-asserted-by":"publisher","first-page":"i10","DOI":"10.1093\/rheumatology\/keac613","article-title":"The impact of social determinants of health on the presentation, management and outcomes of systemic lupus erythematosus.","volume":"62","author":"Williams","year":"2011","journal-title":"Rheumatology."},{"key":"B52","first-page":"389","article-title":"Association of depressive\/anxiety symptoms with quality of life and work ability in patients with systemic lupus erythematosus.","volume":"34","author":"Mok","year":"2016","journal-title":"Clin Exp Rheumatol."},{"key":"B53","doi-asserted-by":"publisher","first-page":"405","DOI":"10.3109\/14397595.2014.962241","article-title":"Prevalence and severity of depression and anxiety in patients with systemic lupus erythematosus: an epidemiologic study in Iranian patients.","volume":"25","author":"Kheirandish","year":"2015","journal-title":"Mod Rheumatol."},{"key":"B54","doi-asserted-by":"publisher","first-page":"1179","DOI":"10.1007\/s00127-022-02240-y","article-title":"Functional status and return to work in people with major depression: a 3-year national follow-up study.","volume":"57","author":"Hong","year":"2022","journal-title":"Soc Psychiatry Psychiatr Epidemiol."},{"key":"B55","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hcaa052.066","article-title":"The association of tumor necrosis factor alpha levels with depression symptoms in systemic lupus erythematosus patients.","volume":"113","author":"Souza","year":"2020","journal-title":"QJM Int J Med."},{"key":"B56","doi-asserted-by":"publisher","first-page":"398","DOI":"10.1177\/0091217415612735","article-title":"Sustained corticosteroid- induced mania and psychosis despite cessation: a case study and brief literature review.","volume":"50","author":"Gable","year":"2015","journal-title":"Int J Psychiatry Med."},{"key":"B57","doi-asserted-by":"publisher","first-page":"644","DOI":"10.1016\/0002-9343(75)90500-8","article-title":"Central nervous system disease in systemic lupus erythematosus. Therapy and prognosis.","volume":"58","author":"Sergent","year":"1975","journal-title":"Am J Med."},{"key":"B58","doi-asserted-by":"crossref","first-page":"2987","DOI":"10.1001\/jama.1982.03330220031031","article-title":"Relationship between alternate-day corticosteroid therapy and behavioral abnormalities.","volume":"248","author":"Sharfstein","year":"1982","journal-title":"JAMA."},{"key":"B59","doi-asserted-by":"publisher","first-page":"827","DOI":"10.1177\/09612033231173510","article-title":"Depression and anxiety in systemic lupus erythematosus: a case-control study on prevalence and associated factors in a single-center cohort.","volume":"32","author":"Le\u00f3n-Su\u00e1rez","year":"2023","journal-title":"Lupus."},{"key":"B60","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1016\/j.jpsychires.2010.06.006","article-title":"Tobacco smoking as a risk factor for depression. A 26-year population-based follow-up study.","volume":"45","author":"Flensborg-Madsen","year":"2011","journal-title":"J Psychiatr Res."},{"key":"B61","doi-asserted-by":"publisher","first-page":"1656","DOI":"10.2105\/AJPH.2012.300911","article-title":"Cigarette smoking and onset of mood and anxiety disorders.","volume":"103","author":"Mojtabai","year":"2013","journal-title":"Am J Public Health."},{"key":"B62","doi-asserted-by":"publisher","first-page":"987","DOI":"10.1093\/rheumatology\/key398","article-title":"Predictors of fatigue and severe fatigue in a large international cohort of patients with systemic lupus erythematosus and a systematic review of the literature.","volume":"58","author":"Arnaud","year":"2019","journal-title":"Rheumatology."},{"key":"B63","first-page":"1282","article-title":"Dimensions of fatigue in systemic lupus erythematosus: relationship to disease status and behavioral and psychosocial factors.","volume":"33","author":"Da Costa","year":"2006","journal-title":"J Rheumatol."},{"key":"B64","doi-asserted-by":"publisher","first-page":"204","DOI":"10.1016\/j.semarthrit.2017.04.003","article-title":"Exercise and physical activity in systemic lupus erythematosus: a systematic review with meta-analyses.","volume":"47","author":"O\u2019Dwyer","year":"2017","journal-title":"Semin Arthritis Rheum."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1751870\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T06:41:15Z","timestamp":1771483275000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1751870\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,19]]},"references-count":64,"alternative-id":["10.3389\/fmed.2026.1751870"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1751870","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,19]]},"article-number":"1751870"}}