{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T17:50:13Z","timestamp":1767203413195,"version":"build-2238731810"},"reference-count":34,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2024,9,4]],"date-time":"2024-09-04T00:00:00Z","timestamp":1725408000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Italian Ministry of Health","doi-asserted-by":"crossref","award":["Ricerca Corrente 2024"],"award-info":[{"award-number":["Ricerca Corrente 2024"]}],"id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100003196","name":"Italian Ministry of Health","doi-asserted-by":"crossref","award":["PRIN 2022AJT27Y"],"award-info":[{"award-number":["PRIN 2022AJT27Y"]}],"id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100003196","name":"Italian Ministry of Health","doi-asserted-by":"crossref","award":["CUP J53D23002030006"],"award-info":[{"award-number":["CUP J53D23002030006"]}],"id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"crossref"}]},{"name":"LILT\u2014Metropolitan City of Turin","award":["Ricerca Corrente 2024"],"award-info":[{"award-number":["Ricerca Corrente 2024"]}]},{"name":"LILT\u2014Metropolitan City of Turin","award":["PRIN 2022AJT27Y"],"award-info":[{"award-number":["PRIN 2022AJT27Y"]}]},{"name":"LILT\u2014Metropolitan City of Turin","award":["CUP J53D23002030006"],"award-info":[{"award-number":["CUP J53D23002030006"]}]},{"name":"Italian Ministry of Education and Research","award":["Ricerca Corrente 2024"],"award-info":[{"award-number":["Ricerca Corrente 2024"]}]},{"name":"Italian Ministry of Education and Research","award":["PRIN 2022AJT27Y"],"award-info":[{"award-number":["PRIN 2022AJT27Y"]}]},{"name":"Italian Ministry of Education and Research","award":["CUP J53D23002030006"],"award-info":[{"award-number":["CUP J53D23002030006"]}]},{"DOI":"10.13039\/501100012306","name":"University of Trieste","doi-asserted-by":"crossref","award":["Ricerca Corrente 2024"],"award-info":[{"award-number":["Ricerca Corrente 2024"]}],"id":[{"id":"10.13039\/501100012306","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100012306","name":"University of Trieste","doi-asserted-by":"crossref","award":["PRIN 2022AJT27Y"],"award-info":[{"award-number":["PRIN 2022AJT27Y"]}],"id":[{"id":"10.13039\/501100012306","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100012306","name":"University of Trieste","doi-asserted-by":"crossref","award":["CUP J53D23002030006"],"award-info":[{"award-number":["CUP J53D23002030006"]}],"id":[{"id":"10.13039\/501100012306","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.mdpi.com"],"crossmark-restriction":true},"short-container-title":["Cancers"],"abstract":"<jats:p>Multiple myeloma (MM) affects a population with a high prevalence of cardiovascular (CV) disease. These patients benefit from an accurate CV risk evaluation in order to choose the safest drug regimen. Haemodynamic forces (HDFs) analysis allows for the earlier detection of myocardial damage compared with standard markers; the role played by MM in HDFs alteration, with or without the influence of hypertension, is yet to be studied. Therefore, we aimed to identify differences in HDFs analysis in patients with MM, hypertension or both versus normotensive non-oncologic subjects. A total of 173 patients (MM hypertensive patients, MMHT; MM normotensive patients, MMNT; non-oncologic hypertensive patients, CoHT; and non-oncologic normotensive patients, CoNT) underwent transthoracic echocardiography for HDFs analysis and pulse wave velocity (PWV) assessment. Hypertensive patients (MMHT, CoHT) showed decreased ejection fraction (EF), global longitudinal strain (GLS) and HDFs values compared with CoNT, whereas ventricular mass (LVMi) and PWV increased. MMNT displayed a significant reduction in systolic HDFs (p &lt; 0.006) and systolic ejection HDFs (p &lt; 0.008) compared with CoNT, without significant change in EF, GLS, LVMi or PWV. In conclusion, MM leads to ventricular remodelling regardless of hypertension; HDFs application for MM patients could help detect early myocardial damage, especially in patients receiving cardiotoxic drugs.<\/jats:p>","DOI":"10.3390\/cancers16173081","type":"journal-article","created":{"date-parts":[[2024,9,4]],"date-time":"2024-09-04T10:58:46Z","timestamp":1725447526000},"page":"3081","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Haemodynamic Forces: Emerging Markers of Ventricular Remodelling in Multiple Myeloma Cardiovascular Baseline Risk Assessment"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-2675-8015","authenticated-orcid":false,"given":"Anna","family":"Colomba","sequence":"first","affiliation":[{"name":"Candiolo Cancer Institute, FPO\u2014IRCCS, 10060 Candiolo, TO, Italy"},{"name":"Department of Medical Sciences, University of Turin, 10126 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Astarita","sequence":"additional","affiliation":[{"name":"Hypertension Unit, Department of Medical Sciences, Division of Internal Medicine, AOU Citt\u00e0 della Salute e della Scienza University Hospital, 10126 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7360-728X","authenticated-orcid":false,"given":"Giulia","family":"Mingrone","sequence":"additional","affiliation":[{"name":"Candiolo Cancer Institute, FPO\u2014IRCCS, 10060 Candiolo, TO, Italy"},{"name":"Department of Medical Sciences, University of Turin, 10126 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5407-5188","authenticated-orcid":false,"given":"Lorenzo","family":"Airale","sequence":"additional","affiliation":[{"name":"Hypertension Unit, Department of Medical Sciences, Division of Internal Medicine, AOU Citt\u00e0 della Salute e della Scienza University Hospital, 10126 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cinzia","family":"Catarinella","sequence":"additional","affiliation":[{"name":"Hypertension Unit, Department of Medical Sciences, Division of Internal Medicine, AOU Citt\u00e0 della Salute e della Scienza University Hospital, 10126 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4628-6767","authenticated-orcid":false,"given":"Fabrizio","family":"Vallelonga","sequence":"additional","affiliation":[{"name":"Candiolo Cancer Institute, FPO\u2014IRCCS, 10060 Candiolo, TO, Italy"},{"name":"Department of Medical Sciences, University of Turin, 10126 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2904-3130","authenticated-orcid":false,"given":"Dario","family":"Leone","sequence":"additional","affiliation":[{"name":"Candiolo Cancer Institute, FPO\u2014IRCCS, 10060 Candiolo, TO, Italy"},{"name":"Department of Medical Sciences, University of Turin, 10126 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5459-9942","authenticated-orcid":false,"given":"Marco","family":"Cesareo","sequence":"additional","affiliation":[{"name":"Hypertension Unit, Department of Medical Sciences, Division of Internal Medicine, AOU Citt\u00e0 della Salute e della Scienza University Hospital, 10126 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arianna","family":"Paladino","sequence":"additional","affiliation":[{"name":"Candiolo Cancer Institute, FPO\u2014IRCCS, 10060 Candiolo, TO, Italy"},{"name":"Department of Medical Sciences, University of Turin, 10126 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4539-6363","authenticated-orcid":false,"given":"Sara","family":"Bringhen","sequence":"additional","affiliation":[{"name":"SSD Clinical Trial in Oncoematologia e Mieloma Multiplo, Division of Hematology, AOU Citt\u00e0 della Salute e della Scienza University Hospital, 10126 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8619-412X","authenticated-orcid":false,"given":"Francesca","family":"Gay","sequence":"additional","affiliation":[{"name":"SSD Clinical Trial in Oncoematologia e Mieloma Multiplo, Division of Hematology, AOU Citt\u00e0 della Salute e della Scienza University Hospital, 10126 Turin, Italy"},{"name":"Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Torino, 10124 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2886-7653","authenticated-orcid":false,"given":"Gianni","family":"Pedrizzetti","sequence":"additional","affiliation":[{"name":"Department of Engineering and Architecture, University of Trieste, 34127 Trieste, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Franco","family":"Veglio","sequence":"additional","affiliation":[{"name":"Hypertension Unit, Department of Medical Sciences, Division of Internal Medicine, AOU Citt\u00e0 della Salute e della Scienza University Hospital, 10126 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8863-8572","authenticated-orcid":false,"given":"Alberto","family":"Milan","sequence":"additional","affiliation":[{"name":"Candiolo Cancer Institute, FPO\u2014IRCCS, 10060 Candiolo, TO, Italy"},{"name":"Department of Medical Sciences, University of Turin, 10126 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,9,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2197","DOI":"10.1016\/S0140-6736(14)60493-1","article-title":"Multiple myeloma","volume":"385","author":"Knop","year":"2015","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1845","DOI":"10.1093\/ageing\/afab083","article-title":"Burden of cardiovascular diseases in older adults using aged care services","volume":"50","author":"Hsu","year":"2021","journal-title":"Age Ageing"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"3154","DOI":"10.18632\/oncotarget.26872","article-title":"Prevalence of cardiovascular risk factors and diseases in patients with multiple myeloma undergoing autologous peripheral blood stem cell transplantation","volume":"10","author":"Backs","year":"2019","journal-title":"Oncotarget"},{"key":"ref_4","first-page":"1774","article-title":"Optimising cardiovascular care of patients with multiple myeloma","volume":"107","author":"Naaktgeboren","year":"2021","journal-title":"Heart Br. Card. Soc."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1753","DOI":"10.3324\/haematol.2013.089334","article-title":"Integrated safety profile of single-agent carfilzomib: Experience from 526 patients enrolled in 4 phase II clinical studies","volume":"98","author":"Siegel","year":"2013","journal-title":"Haematologica"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1327","DOI":"10.1016\/S1470-2045(17)30578-8","article-title":"Carfilzomib or bortezomib in relapsed or refractory multiple myeloma (ENDEAVOR): An interim overall survival analysis of an open-label, randomised, phase 3 trial","volume":"18","author":"Dimopoulos","year":"2017","journal-title":"Lancet Oncol."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Mingrone, G., Astarita, A., Colomba, A., Catarinella, C., Cesareo, M., Airale, L., Paladino, A., Leone, D., Vallelonga, F., and Bringhen, S. (2023). Patients with Very High Risk of Cardiovascular Adverse Events during Carfilzomib Therapy: Prevention and Management of Events in a Single Center Experience. Cancers, 15.","DOI":"10.3390\/cancers15041149"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.clml.2016.11.009","article-title":"Incidence and Risk of Cardiac Events in Patients with Previously Treated Multiple Myeloma Versus Matched Patients without Multiple Myeloma: An Observational, Retrospective, Cohort Study","volume":"17","author":"Kistler","year":"2017","journal-title":"Clin. Lymphoma Myeloma Leuk."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1874","DOI":"10.1097\/HJH.0000000000003480","article-title":"2023 ESH Guidelines for the management of arterial hypertension the Task Force for the management of arterial hypertension of the European Society of Hypertension: Endorsed by the International Society of Hypertension (ISH) and the European Renal Association (ERA)","volume":"41","author":"Mancia","year":"2023","journal-title":"J. Hypertens."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"47","DOI":"10.2174\/1573402114666180611110547","article-title":"Arterial Hypertension and Multiple Myeloma: Physiopathology and Cardiovascular Risk and \u201cPractical\u201d Indications in Patients Receiving Carfilzomib","volume":"15","author":"Milan","year":"2019","journal-title":"Curr. Hypertens. Rev."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Mucherino, S., Gimeno-Miguel, A., Carmona-Pirez, J., Gonzalez-Rubio, F., Ioakeim-Skoufa, I., Moreno-Juste, A., Orlando, V., Aza-Pascual-Salcedo, M., Poblador-Plou, B., and Menditto, E. (2021). Changes in Multimorbidity and Polypharmacy Patterns in Young and Adult Population over a 4-Year Period: A 2011\u20132015 Comparison Using Real-World Data. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18094422"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1945","DOI":"10.1002\/ejhf.1920","article-title":"Baseline cardiovascular risk assessment in cancer patients scheduled to receive cardiotoxic cancer therapies: A position statement and new risk assessment tools from the Cardio-Oncology Study Group of the Heart Failure Association of the European Society of Cardiology in collaboration with the International Cardio-Oncology Society","volume":"22","author":"Lyon","year":"2020","journal-title":"Eur. J. Heart Fail."},{"key":"ref_13","first-page":"695","article-title":"Detection of Subclinical Cardiovascular Disease by Cardiovascular Magnetic Resonance in Lymphoma Survivors","volume":"3","author":"Janus","year":"2021","journal-title":"Cardio Oncol."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Mingrone, G., Astarita, A., Airale, L., Maffei, I., Cesareo, M., Crea, T., Bruno, G., Leone, D., Avenatti, E., and Catarinella, C. (2021). Effects of Carfilzomib Therapy on Left Ventricular Function in Multiple Myeloma Patients. Front. Cardiovasc. Med., 8.","DOI":"10.3389\/fcvm.2021.645678"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"229","DOI":"10.2147\/VHRM.S206747","article-title":"Prognostic implications of left ventricular strain by speckle-tracking echocardiography in the general population: A meta-analysis","volume":"15","author":"Park","year":"2019","journal-title":"Vasc. Health Risk Manag."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1016\/j.jcmg.2017.11.017","article-title":"Assessment of Left Ventricular Function by Echocardiography","volume":"11","author":"Potter","year":"2018","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1016\/j.jbiomech.2014.11.049","article-title":"Cardiac fluid dynamics anticipates heart adaptation","volume":"48","author":"Pedrizzetti","year":"2015","journal-title":"J. Biomech."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Matsuura, K., Shiraishi, K., Mandour, A.S., Sato, K., Shimada, K., Goya, S., Yoshida, T., Kitpipatkun, P., Hamabe, L., and Uemura, A. (2021). The Utility of Intraventricular Pressure Gradient for Early Detection of Chemotherapy-Induced Subclinical Cardiac Dysfunction in Dogs. Animals, 11.","DOI":"10.3390\/ani11041122"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/j.jbiomech.2017.06.046","article-title":"On estimating intraventricular hemodynamic forces from endocardial dynamics: A comparative study with 4D flow MRI","volume":"60","author":"Pedrizzetti","year":"2017","journal-title":"J. Biomech."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1016\/j.ijcard.2022.11.019","article-title":"Introduction to hemodynamic forces by echocardiography","volume":"370","author":"Laenens","year":"2023","journal-title":"Int. J. Cardiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1016\/j.echo.2018.10.018","article-title":"Intracardiac Flow Analysis: Techniques and Potential Clinical Applications","volume":"32","author":"Mele","year":"2019","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1093\/ehjci\/jev137","article-title":"Changes in electrical activation modify the orientation of left ventricular flow momentum: Novel observations using echocardiographic particle image velocimetry","volume":"17","author":"Pedrizzetti","year":"2016","journal-title":"Eur. Heart J. Cardiovasc. Imaging"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"3021","DOI":"10.1093\/eurheartj\/ehy339","article-title":"2018 ESC\/ESH Guidelines for the management of arterial hypertension","volume":"39","author":"Williams","year":"2018","journal-title":"Eur. Heart J."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1254","DOI":"10.3324\/haematol.2014.117176","article-title":"European Myeloma Network guidelines for the management of multiple myeloma-related complications","volume":"100","author":"Terpos","year":"2015","journal-title":"Haematologica"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Astarita, A., Mingrone, G., Airale, L., Vallelonga, F., Covella, M., Catarinella, C., Cesareo, M., Bruno, G., Leone, D., and Giordana, C. (2021). Multiple Myeloma Patients Undergoing Carfilzomib: Development and Validation of a Risk Score for Cardiovascular Adverse Events Prediction. Cancers, 13.","DOI":"10.3390\/cancers13071631"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1016\/j.echo.2014.11.003","article-title":"Definitions for a Common Standard for 2D Speckle Tracking Echocardiography: Consensus Document of the EACVI\/ASE\/Industry Task Force to Standardize Deformation Imaging","volume":"28","author":"Voigt","year":"2015","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Airale, L., Vallelonga, F., Forni, T., Leone, D., Magnino, C., Avenatti, E., Iannaccone, A., Astarita, A., Mingrone, G., and Cesareo, M. (2021). A Novel Approach to Left Ventricular Filling Pressure Assessment: The Role of Hemodynamic Forces Analysis. Front. Cardiovasc. Med., 8.","DOI":"10.3389\/fcvm.2021.704909"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e023417","DOI":"10.1161\/JAHA.121.023417","article-title":"Introduction to Hemodynamic Forces Analysis: Moving into the New Frontier of Cardiac Deformation Analysis","volume":"10","author":"Vallelonga","year":"2021","journal-title":"J. Am. Heart Assoc."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1229","DOI":"10.1242\/dev.073593","article-title":"Fluid flows and forces in development: Functions, features and biophysical principles","volume":"139","author":"Freund","year":"2012","journal-title":"Development"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1919","DOI":"10.1111\/echo.14477","article-title":"Intracardiac flow analysis in cardiac resynchronization therapy: A new challenge?","volume":"36","author":"Mele","year":"2019","journal-title":"Echocardiography"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"4229","DOI":"10.1093\/eurheartj\/ehac244","article-title":"2022 ESC Guidelines on cardio-oncology developed in collaboration with the European Hematology Association (EHA), the European Society for Therapeutic Radiology and Oncology (ESTRO) and the International Cardio-Oncology Society (IC-OS)","volume":"43","author":"Lyon","year":"2022","journal-title":"Eur. Heart J."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1007\/s10549-021-06192-w","article-title":"Incidence of cardiotoxicity and validation of the Heart Failure Association-International Cardio-Oncology Society risk stratification tool in patients treated with trastuzumab for HER2-positive early breast cancer","volume":"188","author":"Battisti","year":"2021","journal-title":"Breast Cancer Res. Treat."},{"key":"ref_33","unstructured":"L\u00f3pez-Fernandez, T., and Dent, S.F. (2024, March 30). Strategies for Risk Stratification and Cardiovascular Toxicity Prevention in Patients with Cancer. Available online: https:\/\/www.escardio.org\/Councils\/Council-for-Cardiology-Practice-(CCP)\/Cardiopractice\/strategies-for-risk-stratification-and-cardiovascular-toxicity-prevention-in-pat."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Astarita, A., Mingrone, G., Airale, L., Cesareo, M., Colomba, A., Catarinella, C., Leone, D., Gay, F., Bringhen, S., and Veglio, F. (2023). Carfilzomib-Based Regimen and Cardiotoxicity in Multiple Myeloma: Incidence of Cardiovascular Events and Organ Damage in Carfilzomib-Dexamethasone versus Carfilzomib-Lenalidomide-Dexamethasone. A Real-Life Prospective Study. Cancers, 15.","DOI":"10.3390\/cancers15030955"}],"updated-by":[{"DOI":"10.3390\/cancers16233891","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2024,9,4]],"date-time":"2024-09-04T00:00:00Z","timestamp":1725408000000}}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/16\/17\/3081\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,3]],"date-time":"2025-08-03T14:50:55Z","timestamp":1754232655000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/16\/17\/3081"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,4]]},"references-count":34,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2024,9]]}},"alternative-id":["cancers16173081"],"URL":"https:\/\/doi.org\/10.3390\/cancers16173081","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,4]]}}}