{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T17:04:07Z","timestamp":1794330247382,"version":"4.9.0"},"reference-count":68,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,8,31]],"date-time":"2025-08-31T00:00:00Z","timestamp":1756598400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bioengineering"],"abstract":"<jats:p>The effectiveness of breathing interventions on postural alignment, pain reduction, and functional improvement in patients with forward head posture (FHP) and chronic neck pain remains uncertain. Previously conducted randomized controlled trials (RCTs) that involved breathing interventions were identified through searches of the PubMed, Cochrane Library, Web of Science, and Scopus databases. Studies were included if they applied diaphragmatic breathing, breathing muscle training, or feedback breathing exercises for at least 2 weeks to chronic neck pain (duration \u2265 3 months) and\/or forward head posture. The craniovertebral angle (CVA), the visual analog scale (VAS), and the neck disability index (NDI) were the primary outcome measures. The results showed that breathing interventions had a moderate effect size in terms of improving the CVA. Limited effects were observed for pain reduction, and improvements in neck disability approached statistical significance. However, despite these positive findings, the overall evidence was rated as \u2018very low certainty\u2019 in the GRADE assessment, primarily due to high heterogeneity among studies, limited sample sizes, and the potential for unit-of-analysis errors in diagnosis-based subgroup analyses. Consequently, their overall effectiveness in chronic neck pain was limited. Future research is needed to explore a multidisciplinary approach to neck pain using standardized protocols and larger samples.<\/jats:p>","DOI":"10.3390\/bioengineering12090947","type":"journal-article","created":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T16:05:22Z","timestamp":1756829122000},"page":"947","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["The Effects of Rehabilitation Programs Incorporating Breathing Interventions on Chronic Neck Pain Among Patients with Forward Head Posture: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-1156-515X","authenticated-orcid":false,"given":"Seri","family":"Park","sequence":"first","affiliation":[{"name":"Seri Park Pilates Studio, 10, Teheran-ro 88-gil, Gangnam-gu, Seoul 06179, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4961-9685","authenticated-orcid":false,"given":"Kihyun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, KyungWoon University, Gumi 39160, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7852-6887","authenticated-orcid":false,"given":"Minbong","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Musculoskeletal Center, Daegu Medical Foundation K Hospital, 357, Chilgokjungang-daero, Buk-gu, Daegu 41452, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"309","DOI":"10.24171\/j.phrp.2018.9.6.04","article-title":"Neck pain in adults with forward head posture: Effects of craniovertebral angle and cervical range of motion","volume":"9","author":"Kim","year":"2018","journal-title":"Osong Public Health Res. Perspect."},{"key":"ref_2","first-page":"1717","article-title":"Head posture and neck pain of chronic nontraumatic origin: A comparison between patients and control persons","volume":"102","author":"Silva","year":"2021","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_3","first-page":"E803","article-title":"Respiratory dysfunction in chronic neck pain patients: A systematic review","volume":"19","author":"Dimitriadis","year":"2016","journal-title":"Pain Physician"},{"key":"ref_4","first-page":"1737","article-title":"The relationship between forward head posture and neck pain: A systematic review and meta-analysis","volume":"8","author":"Park","year":"2019","journal-title":"J. Clin. Med."},{"key":"ref_5","first-page":"28","article-title":"Neck pain causes respiratory dysfunction","volume":"72","author":"Kapreli","year":"2009","journal-title":"Med. Hypotheses"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1016\/j.math.2014.04.011","article-title":"Respiratory dysfunction in patients with chronic neck pain\u2014Influence of thoracic spine and chest mobility","volume":"19","author":"Wirth","year":"2014","journal-title":"Man. Ther."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Zafar, H., Albarrati, A., Alghadir, A.H., and Iqbal, Z.A. (2018). Effect of different head-neck postures on the respiratory function in healthy males. Biomed. Res. Int., 2018.","DOI":"10.1155\/2018\/4518269"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2422","DOI":"10.1080\/09638288.2022.2096126","article-title":"Respiratory dysfunction in patients with chronic neck pain: Systematic review and meta-analysis","volume":"45","year":"2023","journal-title":"Disabil. Rehabil."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1589\/jpts.30.132","article-title":"Correlation between pulmonary functions and respiratory muscle activity in patients with forward head posture","volume":"30","author":"Kang","year":"2018","journal-title":"J. Phys. Ther. Sci."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"995","DOI":"10.1097\/j.pain.0000000000000865","article-title":"Pain and respiration: A systematic review","volume":"158","author":"Jafari","year":"2017","journal-title":"Pain"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1016\/j.neuron.2022.02.003","article-title":"Taking a deep breath: How a brainstem pathway integrates pain and breathing","volume":"110","author":"Burdge","year":"2022","journal-title":"Neuron"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Anwar, S., Arsalan, A., Zafar, H., Ahmad, A., and Hanif, A. (2022). Effects of breathing reeducation on cervical and pulmonary outcomes in patients with non specific chronic neck pain: A double blind randomized controlled trial. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0273471"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"An, H.J., Kim, A.Y., and Park, S.J. (2021). Immediate effects of diaphragmatic breathing with cervical spine mobilization on the pulmonary function and craniovertebral angle in patients with chronic stroke. Medicina, 57.","DOI":"10.3390\/medicina57080826"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Cefal\u00ec, A., Santini, D., Lopez, G., Maselli, F., Rossettini, G., Crestani, M., Lullo, G., Young, I., Dunning, J., and de Abreu, R.M. (2025). Effects of breathing exercises on neck pain management: A systematic review with meta-analysis. J. Clin. Med., 14.","DOI":"10.3390\/jcm14030709"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"121","DOI":"10.13066\/kspm.2018.13.3.121","article-title":"Effects of exercise type on neck disability, pain, and postural changes in subjects with forward head posture: Systematic review and meta-analysis","volume":"13","author":"Na","year":"2018","journal-title":"J. Korean Soc. Phys. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1016\/j.jmpt.2018.02.002","article-title":"Effectiveness of therapeutic exercise on forward head posture: A systematic review and meta-analysis","volume":"41","author":"Sheikhhoseini","year":"2018","journal-title":"J. Manip. Physiol. Ther."},{"key":"ref_17","first-page":"e123","article-title":"Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement","volume":"3","author":"Moher","year":"2009","journal-title":"Open Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1660","DOI":"10.1097\/BRS.0000000000001061","article-title":"2015 updated method guideline for systematic reviews in the Cochrane Back and Neck Group","volume":"40","author":"Furlan","year":"2015","journal-title":"Spine"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2477","DOI":"10.1589\/jpts.28.2477","article-title":"The effect of feedback respiratory exercise on muscle activity, craniovertebral angle, and neck disability index of the neck flexors of patients with forward head posture","volume":"28","author":"Kang","year":"2016","journal-title":"J. Phys. Ther. Sci."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"23","DOI":"10.3233\/BMR-160709","article-title":"Effect of a stress management program on subjects with neck pain: A pilot randomized controlled trial","volume":"30","author":"Metikaridis","year":"2017","journal-title":"J. Back Musculoskelet. Rehabil."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Dareh-Deh, H.R., Hadadnezhad, M., Letafatkar, A., and Peolsson, A. (2022). Therapeutic routine with respiratory exercises improves posture, muscle activity, and respiratory pattern of patients with neck pain: A randomized controlled trial. Sci. Rep., 12.","DOI":"10.1038\/s41598-022-08128-w"},{"key":"ref_22","first-page":"45","article-title":"Effects of combining diaphragmatic exercise with physiotherapy on chronic neck pain: A randomized clinical trial","volume":"16","author":"Mosallaiezadeh","year":"2022","journal-title":"J. Mod. Rehabil."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Jeong, G.H., and Lee, B.H. (2024). Effects of telerehabilitation combining diaphragmatic breathing re-education and shoulder stabilization exercises on neck pain, posture, and function in young adult men with upper crossed syndrome: A randomized controlled trial. J. Clin. Med., 13.","DOI":"10.3390\/jcm13061612"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"678","DOI":"10.12688\/f1000research.24469.1","article-title":"The use of \u2018PICO for synthesis\u2019 and methods for synthesis without meta-analysis: Protocol for a survey of current practice in systematic reviews of health interventions","volume":"9","author":"Cumpston","year":"2020","journal-title":"F1000Research"},{"key":"ref_25","first-page":"ED000142","article-title":"Updated guidance for trusted systematic reviews: A new edition of the Cochrane Handbook for Systematic Reviews of Interventions","volume":"10","author":"Cumpston","year":"2019","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_26","unstructured":"Schwarzer, G. (2025, January 21). Meta: General Package for Meta-Analysis. R Package Version 6.5-0. Available online: https:\/\/cran.r-project.org\/package=meta."},{"key":"ref_27","unstructured":"Cohen, J. (1988). Statistical Power Analysis for the Behavioural Sciences, Erlbaum."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1539","DOI":"10.1002\/sim.1186","article-title":"Quantifying heterogeneity in a meta-analysis","volume":"21","author":"Higgins","year":"2002","journal-title":"Stat. Med."},{"key":"ref_29","unstructured":"Higgins, J.P.T., Thomas, J., Chandler, J., Cumpston, M., Li, T., Page, M.J., and Welch, V.A. (2024). Cochrane Handbook for Systematic Reviews of Interventions Version 6.5, Cochrane. Available online: https:\/\/www.cochrane.org\/authors\/handbooks-and-manuals\/handbook."},{"key":"ref_30","first-page":"409","article-title":"The Neck Disability Index: A study of reliability and validity","volume":"14","author":"Vernon","year":"1991","journal-title":"J. Manip. Physiol. Ther."},{"key":"ref_31","unstructured":"Workers\u2019 Compensation Board of Saskatchewan (2025, January 21). Neck Pain\u2013Clinical Practice Guidelines. Available online: https:\/\/www.wcbsask.com."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"A1","DOI":"10.2519\/jospt.2017.0302","article-title":"Neck pain: Revision 2017: Clinical practice guidelines linked to the International Classification of Functioning, Disability and Health","volume":"47","author":"Blanpied","year":"2017","journal-title":"J. Orthop. Sports Phys. Ther."},{"key":"ref_33","first-page":"8858305","article-title":"Predictive factors for therapeutic outcomes of chronic neck pain: A prospective cohort study","volume":"2021","author":"Cha","year":"2021","journal-title":"Pain Res. Manag."},{"key":"ref_34","first-page":"567","article-title":"Predictors of persistent neck pain after whiplash injury","volume":"65","author":"Atherton","year":"2006","journal-title":"Ann. Rheum. Dis."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1007\/s00586-004-0677-5","article-title":"Whiplash injuries in Finland: The situation 3 years later","volume":"13","author":"Miettinen","year":"2004","journal-title":"Eur. Spine J."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1152\/japplphysiol.00443.2021","article-title":"Impact of aging on the work of breathing during exercise in healthy men","volume":"132","author":"Weavil","year":"2022","journal-title":"J. Appl. Physiol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1842","DOI":"10.1152\/jappl.1985.59.6.1842","article-title":"Rib cage and diaphragm-abdomen compliance in humans: Effects of age and posture","volume":"59","author":"Estenne","year":"1985","journal-title":"J. Appl. Physiol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1539","DOI":"10.1359\/jbmr.1997.12.10.1539","article-title":"On our age-related bone loss: Insights from a new paradigm","volume":"12","author":"Frost","year":"1997","journal-title":"J. Bone Miner. Res."},{"key":"ref_39","first-page":"230","article-title":"Aspects physiologiques du vieillissement respiratoire Physiological aspects of the decline of pulmonary function with age","volume":"19","author":"Rouatbi","year":"2002","journal-title":"Rev. Mal. Respir."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Mitchell, W.K., Atherton, P.J., Williams, J., Larvin, M., Lund, J.N., and Narici, M. (2012). Sarcopenia, dynapenia, and the impact of advancing age on human skeletal muscle size and strength; a quantitative review. Front. Physiol., 3.","DOI":"10.3389\/fphys.2012.00260"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"GRADE Working Group (2004). Grading quality of evidence and strength of recommendations. BMJ, 328, 1490.","DOI":"10.1136\/bmj.328.7454.1490"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1136\/bmj.39489.470347.AD","article-title":"GRADE: An emerging consensus on rating quality of evidence and strength of recommendations","volume":"336","author":"Guyatt","year":"2008","journal-title":"BMJ"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1303","DOI":"10.1016\/j.jclinepi.2011.04.014","article-title":"GRADE guidelines: 8. Rating the quality of evidence\u2014Indirectness","volume":"64","author":"Guyatt","year":"2011","journal-title":"J. Clin. Epidemiol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1589\/jpts.31.63","article-title":"Effect of forward head posture on thoracic shape and respiratory function","volume":"31","author":"Koseki","year":"2019","journal-title":"J. Phys. Ther. Sci."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"711","DOI":"10.3233\/BMR-140253","article-title":"Correlation between forward head posture, respiratory functions, and respiratory accessory muscles in young adults","volume":"30","author":"Kim","year":"2017","journal-title":"J. Back Musculoskelet. Rehabil."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1179\/crn.2004.019","article-title":"Electromyographic muscle EMG activity in mouth and nasal breathing children","volume":"22","author":"Ribeiro","year":"2004","journal-title":"Cranio"},{"key":"ref_47","first-page":"378","article-title":"The role of the scalene and sternomastoid muscles in breathing in normal subjects; an electromyographic study","volume":"89","author":"Campbell","year":"1955","journal-title":"J. Anat."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Liu, F., Jones, A.Y.M., Tsang, R.C.C., Yam, T.T.T., and Tsang, W.W.N. (2025). Recruitment of the diaphragm and sternocleidomastoid muscle during increasing inspiratory pressure loads in healthy young adults. Respir. Physiol. Neurobiol., 331.","DOI":"10.1016\/j.resp.2024.104365"},{"key":"ref_49","first-page":"221","article-title":"Effects of diaphragmatic training on posture and stability in asymptomatic subjects: A randomized clinical trial","volume":"14","author":"Menon","year":"2020","journal-title":"Int. J. Physiother. Occup. Ther."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1111\/j.1469-7793.1997.539bb.x","article-title":"Contraction of the human diaphragm during rapid postural adjustments","volume":"505","author":"Hodges","year":"1997","journal-title":"J. Physiol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1016\/j.jcm.2023.07.001","article-title":"Effect of adding diaphragmatic breathing exercises to core stabilization exercises on pain, muscle activity, disability, and sleep quality in patients with chronic low back pain: A randomized control trial","volume":"22","author":"Masroor","year":"2023","journal-title":"J. Chiropr. Med."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Vostatek, P., Nov\u00e1k, D., Rychnovsk\u00fd, T., and Rychnovsk\u00e1, S. (2013). Diaphragm postural function analysis using magnetic resonance imaging. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0056724"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/j.wneu.2022.09.009","article-title":"Phrenic nerve dysfunction secondary to cervical neuroforaminal stenosis: A literature review","volume":"167","author":"Yekzaman","year":"2022","journal-title":"World Neurosurg."},{"key":"ref_54","first-page":"86","article-title":"Added value of diaphragm myofascial release on forward head posture and chest expansion in patients with neck pain: A randomized controlled trial","volume":"24","author":"Haghighat","year":"2020","journal-title":"J. Bodyw. Mov. Ther."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1007\/s40122-020-00230-z","article-title":"Cervical proprioception impairment in neck pain-pathophysiology, clinical evaluation, and management: A narrative review","volume":"10","author":"Peng","year":"2021","journal-title":"Pain Ther."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1093\/pm\/pnx207","article-title":"International consensus on diagnostic criteria and clinical considerations of myofascial trigger points: A Delphi study","volume":"19","author":"Dommerholt","year":"2018","journal-title":"Pain Med."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"797","DOI":"10.3233\/BMR-150587","article-title":"Do psychological states associate with pain and disability in chronic neck pain patients?","volume":"28","author":"Dimitriadis","year":"2015","journal-title":"J. Back Musculoskelet. Rehabil."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"46","DOI":"10.11604\/pamj.2016.24.89.8831","article-title":"Chronic neck pain and anxiety-depression: Prevalence and associated risk factors","volume":"24","author":"Elbinoune","year":"2016","journal-title":"Pan Afr. Med. J."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1288","DOI":"10.1016\/j.jpain.2015.09.002","article-title":"Psychosocial, physical, and neurophysiological risk factors for chronic neck pain: A prospective inception cohort study","volume":"16","author":"Shahidi","year":"2015","journal-title":"J. Pain"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/0304-3959(83)90088-X","article-title":"Assessment of chronic pain. I. Aspects of the reliability and validity of the visual analogue scale","volume":"16","author":"Carlsson","year":"1983","journal-title":"Pain"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"53","DOI":"10.14444\/7007","article-title":"Is the Neck Disability Index an appropriate measure for changes in physical function after surgery for cervical spondylotic myelopathy?","volume":"14","author":"Goyal","year":"2020","journal-title":"Int. J. Spine Surg."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1097\/01.BRS.0000092368.90019.D8","article-title":"The effects of breath control on intra-abdominal pressure during lifting tasks","volume":"29","author":"Hagins","year":"2004","journal-title":"Spine"},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Kang, E.S., Yook, J.S., and Ha, M.S. (2022). Breathing exercises for improving cognitive function in patients with stroke. J. Clin. Med., 11.","DOI":"10.3390\/jcm11102888"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"400","DOI":"10.2519\/jospt.2009.2930","article-title":"Measurement properties of the neck disability index: A systematic review","volume":"39","author":"MacDermid","year":"2009","journal-title":"J. Orthop. Sports Phys. Ther."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1016\/j.jmpt.2016.08.007","article-title":"The treatment of neck pain-associated disorders and whiplash-associated disorders: A clinical practice guideline","volume":"39","author":"Stewart","year":"2016","journal-title":"J. Manip. Physiol. Ther."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"3387","DOI":"10.14260\/jemds\/2020\/744","article-title":"Great awakening-telerehabilitation in physiotherapy during pandemic and impact of COVID-19","volume":"9","author":"Jachak","year":"2020","journal-title":"J. Evol. Med. Dent. Sci."},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Tatsios, P.I., Grammatopoulou, E., Dimitriadis, Z., Papandreou, M., Paraskevopoulos, E., Spanos, S., Karakasidou, P., and Koumantakis, G.A. (2022). The effectiveness of spinal, diaphragmatic, and specific stabilization exercise manual therapy and respiratory-related interventions in patients with chronic nonspecific neck pain: Systematic review and meta-analysis. Diagnostics, 12.","DOI":"10.3390\/diagnostics12071598"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"500","DOI":"10.23736\/S1973-9087.17.05024-9","article-title":"Manual therapy RCTs: Should we control placebo in placebo control?","volume":"54","author":"Rossettini","year":"2018","journal-title":"Eur. J. Phys. Rehabil. Med."}],"container-title":["Bioengineering"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2306-5354\/12\/9\/947\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:36:38Z","timestamp":1760034998000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2306-5354\/12\/9\/947"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,31]]},"references-count":68,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025,9]]}},"alternative-id":["bioengineering12090947"],"URL":"https:\/\/doi.org\/10.3390\/bioengineering12090947","relation":{},"ISSN":["2306-5354"],"issn-type":[{"value":"2306-5354","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,31]]}}}