{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T20:14:11Z","timestamp":1793996051919,"version":"4.8.0"},"reference-count":51,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2024,3,21]],"date-time":"2024-03-21T00:00:00Z","timestamp":1710979200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Infectious and inflammatory dermatoses featuring skin lesions with loss of tissue expose skin layers to microbial invasions, disrupt the normal skin microbiome, and potentially lead to sepsis. However, literature data on the incidence of cutaneous-onset sepsis are scarce. This retrospective observational study assessed hospital admissions for primary skin lesions without bacterial infections and sepsis during 2020\u20132022 in the largest emergency hospital in NE Romania. Of 509 patients, 441 had infected lesions, 78 had sepsis caused by venous ulcers from microbial eczema cellulitis, superinfected bullous dermatoses, erysipelas, and erythroderma. Cultured samples revealed S. aureus, P. aeruginosa, and E. coli; and K. pneumoniae and S. \u03b2-hemolytic associated with sepsis, even if this was rarer. Clinical manifestations included ulcerations, erosions, fissures, excoriations, bullae, vesicles, pruritus, tumefaction, edema, fever, chills, pain, adenopathy, and mildly altered mental status. Underlying chronic heart failure, atrial fibrillation, anemia, and type-1 diabetes mellitus were comorbidities associated with infection and sepsis. Significant associations and risk factors, including their combined effects, are discussed to draw attention to the need for further research and adequate management to prevent sepsis in adult patients of any age presenting with infected skin lesions (especially cellulitis) and comorbidities (especially type 1 diabetes mellitus and anemia).<\/jats:p>","DOI":"10.3390\/diagnostics14060659","type":"journal-article","created":{"date-parts":[[2024,3,21]],"date-time":"2024-03-21T06:35:30Z","timestamp":1711002930000},"page":"659","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Skin Lesions with Loss of Tissue and Cutaneous-Onset Sepsis: The Skin Infection\u2013Sepsis Relationship"],"prefix":"10.3390","volume":"14","author":[{"given":"Adriana-Ionela","family":"P\u0103tra\u0219cu","sequence":"first","affiliation":[{"name":"Clinic of Dermatology-Venereology, \u201cSaint Spiridon\u201d Emergency County Clinical Hospital, 700111 Ia\u0219i, Romania"},{"name":"Discipline of Dermatology-Venereology, Department of Medical Sciences III, Faculty of Medicine \u201cGrigore T. Popa\u201d, University of Medicine and Pharmacy, 700115 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2755-6004","authenticated-orcid":false,"given":"Dan","family":"V\u00e2\u021b\u0103","sequence":"additional","affiliation":[{"name":"Clinic of Dermatology-Venereology, \u201cSaint Spiridon\u201d Emergency County Clinical Hospital, 700111 Ia\u0219i, Romania"},{"name":"Discipline of Dermatology-Venereology, Department of Medical Sciences III, Faculty of Medicine \u201cGrigore T. Popa\u201d, University of Medicine and Pharmacy, 700115 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doini\u021ba","family":"Temelie-Olinici","sequence":"additional","affiliation":[{"name":"Clinic of Dermatology-Venereology, \u201cSaint Spiridon\u201d Emergency County Clinical Hospital, 700111 Ia\u0219i, Romania"},{"name":"Discipline of Cellular and Molecular Biology, Department of Morpho-Functional Sciences II, Faculty of Medicine \u201cGrigore T. Popa\u201d, University of Medicine and Pharmacy, 700115 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u0103d\u0103lina","family":"Mocanu","sequence":"additional","affiliation":[{"name":"Clinic of Dermatology-Venereology, \u201cSaint Spiridon\u201d Emergency County Clinical Hospital, 700111 Ia\u0219i, Romania"},{"name":"Discipline of Dermatology-Venereology, Department of Medical Sciences III, Faculty of Medicine \u201cGrigore T. Popa\u201d, University of Medicine and Pharmacy, 700115 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dumitri\u021ba-Lenu\u021ba","family":"Gugulu\u0219","sequence":"additional","affiliation":[{"name":"Discipline of Dermatology-Venereology, Department of Medical Sciences III, Faculty of Medicine \u201cGrigore T. Popa\u201d, University of Medicine and Pharmacy, 700115 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u0103d\u0103lina","family":"Marinescu","sequence":"additional","affiliation":[{"name":"Discipline of Dermatology-Venereology, Department of Medical Sciences III, Faculty of Medicine \u201cGrigore T. Popa\u201d, University of Medicine and Pharmacy, 700115 Ia\u0219i, Romania"},{"name":"Clinic of Diabetes Mellitus and Nutrition, \u201cSf. Spiridon\u201d Emergency County Clinical Hospital, 700111 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liviu","family":"Stafie","sequence":"additional","affiliation":[{"name":"Discipline of Public Health and Management, Department of Preventive Medicine and Interdisciplinarity, Faculty of Medicine \u201cGrigore T. Popa\u201d, University of Medicine and Pharmacy, 700115 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4075-5451","authenticated-orcid":false,"given":"Bogdan-Marian","family":"Tarc\u0103u","sequence":"additional","affiliation":[{"name":"Clinic of Dermatology-Venereology, \u201cSaint Spiridon\u201d Emergency County Clinical Hospital, 700111 Ia\u0219i, Romania"},{"name":"Discipline of Dermatology-Venereology, Department of Medical Sciences III, Faculty of Medicine \u201cGrigore T. Popa\u201d, University of Medicine and Pharmacy, 700115 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioana","family":"Cre\u0163u","sequence":"additional","affiliation":[{"name":"Cre\u021bu R. Ioana Persoan\u0103 Fizic\u0103 Autorizat\u0103, 707020 Aroneanu, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0447-3625","authenticated-orcid":false,"given":"Ioana-Adriana","family":"Popescu","sequence":"additional","affiliation":[{"name":"Clinic of Dermatology-Venereology, \u201cSaint Spiridon\u201d Emergency County Clinical Hospital, 700111 Ia\u0219i, Romania"},{"name":"Discipline of Dermatology-Venereology, Department of Medical Sciences III, Faculty of Medicine \u201cGrigore T. Popa\u201d, University of Medicine and Pharmacy, 700115 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0609-3773","authenticated-orcid":false,"given":"Carmen-Diana","family":"Cimpoe\u0219u","sequence":"additional","affiliation":[{"name":"Discipline of Emergency, Medicine Department of Surgery II, Faculty of Medicine \u201cGrigore T. Popa\u201d, University of Medicine and Pharmacy, 700115 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Gheuc\u0103-Solov\u0103stru","sequence":"additional","affiliation":[{"name":"Clinic of Dermatology-Venereology, \u201cSaint Spiridon\u201d Emergency County Clinical Hospital, 700111 Ia\u0219i, Romania"},{"name":"Discipline of Dermatology-Venereology, Department of Medical Sciences III, Faculty of Medicine \u201cGrigore T. Popa\u201d, University of Medicine and Pharmacy, 700115 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,3,21]]},"reference":[{"key":"ref_1","first-page":"35","article-title":"Diagnostic and Treatment Strategies in Cutaneous Sepsis","volume":"66","author":"Patrascu","year":"2021","journal-title":"Dermato. Venerol."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Pant, A., Mackraj, I., and Govender, T. (2021). Advances in sepsis diagnosis and management: A paradigm shift towards nanotechnology. J. Biomed. Sci., 28.","DOI":"10.1186\/s12929-020-00702-6"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e22996","DOI":"10.1002\/jcla.22996","article-title":"Procalcitonin as a prognostic marker for sepsis based on SEPSIS-3","volume":"33","author":"Jeakrl","year":"2019","journal-title":"J. Clin. Lab. Anal."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1016\/j.ejim.2020.12.025","article-title":"Validity of \u201cSEPSIS-3\u201d criteria in identifying patients with community-onset sepsis in Internal Medicine wards; a prospective, multicenter study","volume":"85","author":"Fortini","year":"2021","journal-title":"Eur. J. Intern. Med."},{"key":"ref_5","first-page":"75","article-title":"Development of the Definition of Sepsis","volume":"4","author":"Dimic","year":"2023","journal-title":"Serbian J. Med. Chamb."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1016\/S1473-3099(12)70239-6","article-title":"Outcomes of the surviving sepsis campaign in intensive care units in the USA and Europe: A prospective cohort study","volume":"12","author":"Levy","year":"2012","journal-title":"Lancet Infect. Dis."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/S0140-6736(19)32989-7","article-title":"Global, regional and national sepsis incidence and mortality, 1990-2017: Analysis of the global burden of disease study","volume":"395","author":"Rudd","year":"2020","journal-title":"Lancet"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1007\/s15010-021-01608-7","article-title":"Skin and sepsis: Contribution of dermatology to a rapid diagnosis","volume":"49","author":"Bouza","year":"2021","journal-title":"Infection"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1093\/cid\/ciz004","article-title":"Current treatment options for acute skin and skin-structure infections","volume":"68","author":"Golan","year":"2019","journal-title":"Clin. Infect. Dis."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"854","DOI":"10.1007\/s00134-020-06022-5","article-title":"Surviving Sepsis Campaign: Guidelines on the management of critically ill adults with coronavirus disease COVID-19","volume":"46","author":"Alhazzani","year":"2020","journal-title":"Intensive Care Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1007\/s00134-017-4683-6","article-title":"Surviving sepsis campaign: International guidelines for management of sepsis and septic shock: 2016","volume":"43","author":"Rhodes","year":"2017","journal-title":"Intensive Care Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1097\/CCM.0000000000003119","article-title":"The Surviving Sepsis Campaign Bundle: 2018 Update","volume":"46","author":"Levy","year":"2018","journal-title":"Crit. Care Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1585","DOI":"10.1001\/archinte.168.14.1585","article-title":"National trends in ambulatory visits and antibiotic prescribing for skin and soft-tissue infections","volume":"168","author":"Hersh","year":"2008","journal-title":"Arch. Intern. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1516","DOI":"10.3201\/eid1509.081228","article-title":"Trends in US hospital admissions for skin and soft tissue infections","volume":"9","author":"Edelsberg","year":"2009","journal-title":"Emerg. Infect. Dis."},{"key":"ref_15","first-page":"115","article-title":"An\u00e1lisis de 1.250 episodios de infecci\u00f3n de piel y partes blandas registrados en 49 servicios de Urgencias hospitalarios [Review of 1.250 episodes of skin and soft tissue infections attended at 49 hospital emergency departments]","volume":"27","author":"Llopis","year":"2014","journal-title":"Rev. Esp. Quimioter."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.diagmicrobio.2006.05.009","article-title":"Contemporary causes of skin and soft tissue infections in North America, Latin America, and Europe: Report from the SENTRY Antimicrobial Surveillance Program (1998\u20132004)","volume":"57","author":"Moet","year":"2007","journal-title":"Diagn. Microbiol. Infect. Dis."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1016\/j.jcrc.2020.12.015","article-title":"Age-related incidence and outcomes of sepsis in California, 2008\u20132015","volume":"62","author":"Wardi","year":"2021","journal-title":"J. Crit. Care."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Bouza, C., and Lopez-Cuadrado, T. (2020). Epidemiology and Trends of Sepsis in Young Adults Aged 20-44 Years: A Nationwide Population-Based Study. J. Clin. Med., 9.","DOI":"10.3390\/jcm9010077"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Matthaeus-Kraemer, C.T., Norman, R., Spoden, M., Pletz, M.W., Reinhart, K., and Fleischmann-Struzek, C. (2023). Urban-Rural Disparities in Case Fatality of Community-acquired sepsis in Germany: A retrospective cohort study. Int. J. Environ. Res. Public Health., 20.","DOI":"10.3390\/ijerph20105867"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1111\/bjd.19803","article-title":"Cellulitis in chronic oedema of the lower leg: An international cross-sectional study","volume":"185","author":"Burian","year":"2021","journal-title":"Br. J. Dermatol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"157","DOI":"10.2165\/00128071-200304030-00002","article-title":"Erysipelas","volume":"4","author":"Bonnetblanc","year":"2003","journal-title":"Am. J. Clin. Dermatol."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Burgdorf, W.H.C., Plewig, G., Wolff, H.H., and Landthaler, M. (2009). Braun-Falco\u2019s Dermatology, Springer. [3rd ed.].","DOI":"10.1007\/978-3-540-29316-3"},{"key":"ref_23","unstructured":"P\u0103tra\u015fcu, A.I., Gheuc\u0103-Solov\u0103stru, L., V\u00e2\u0163\u0103, D., Zbranca, A., St\u0103tescu, L., Botnariu, G., Temelie-Olinici, D., Halip, I.A., St\u00eencanu, A., and Dobre, C. (2022). Dermatologia pas cu pas. Urgen\u0163e Cutaneo-Mucoase, \u201cGr. T. Popa\u201d Publishing House."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1016\/j.clindermatol.2013.01.004","article-title":"Pemphigus: Etiology, pathogenesis, and inducing or triggering factors: Facts and controversies","volume":"31","author":"Ruocco","year":"2013","journal-title":"Clin. Dermatol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.2340\/00015555-2706","article-title":"Pemphigus vulgaris and pemphigus foliaceus:differences in epidemiology and mortality","volume":"97","author":"Kridin","year":"2017","journal-title":"Acta Derm. Venereol."},{"key":"ref_26","unstructured":"Baigrie, D., and Nookala, V. (2023, December 04). Bullous Pemphigoid, StatPearls [Internet], Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK535374."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Rose, E. (2018). Life-Threatening Rashes. An Illustrated Practical Guide, Springer. [1st ed.]. Available online: https:\/\/link.springer.com\/chapter\/10.1007\/978-3-319-75623-3_19.","DOI":"10.1007\/978-3-319-75623-3"},{"key":"ref_28","first-page":"777","article-title":"A Practical Approach to the Diagnosis and Treatment of Adult Erythroderma","volume":"109","year":"2018","journal-title":"Actas Dermosifiliogr."},{"key":"ref_29","unstructured":"Goldsmith, L.A., Katz, S.I., Gilchrest, B.A., Paller, A.S., Leffell, D.J., and Wolff, K. (2012). Fitzpatrick\u2019s Dermatology in General Medicine, McGraw Hill. [8th ed.]. Available online: https:\/\/accessmedicine.mhmedical.com\/book.aspx?bookid=392#41138703."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Buka, B., Uliasz, A., and Krishnamurthy, K. (2013). Buka\u2019s Emergencies in Dermatology, Springer.","DOI":"10.1007\/978-1-4614-5031-3"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"517999","DOI":"10.3389\/fmed.2020.517999","article-title":"Clinical outcome of septic patients with heart failure with preserved ejection fraction presenting to the Emergency Department of a tertiary hospital: A retrospective cohort study","volume":"7","author":"Chebl","year":"2020","journal-title":"Front. Med."},{"key":"ref_32","first-page":"e19159","article-title":"Outcome of Atrial Fibrillation in Patients WithSepsis","volume":"13","author":"Afzal","year":"2021","journal-title":"Cureus"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Neri, V., Huang, L., and Li, J. (2021). Infections and Sepsis Development, IntechOpen.","DOI":"10.5772\/intechopen.94701"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"805","DOI":"10.5114\/aoms\/161802","article-title":"Iron deficiency in sepsis patients based on reticulocyte hemoglobin and hepcidin concentration: A prospective cohort study","volume":"19","author":"Piotr","year":"2023","journal-title":"Arch. Med. Sci."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"11198","DOI":"10.1038\/s41598-018-29558-5","article-title":"Relationship between Anaemia, Haemolysis, Inflammation and Haem Oxygenase-1 at Admission with Sepsis: A pilot study","volume":"8","author":"Ekregbesi","year":"2018","journal-title":"Sci. Rep."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1007\/s00592-021-01728-4","article-title":"Type 2 diabetes mellitus and sepsis: State of the art, certainties and missing evidence","volume":"58","author":"Constantin","year":"2021","journal-title":"Acta Diabetol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"108732","DOI":"10.1016\/j.diabres.2021.108732","article-title":"Diabetes and acute bacterial skin and skin structure infections","volume":"174","author":"Falcone","year":"2021","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1186\/s13098-022-00803-2","article-title":"Impact of diabetes mellitus on outcomes of patients with sepsis: An updated systematic review and meta-analysis","volume":"14","author":"Jiang","year":"2022","journal-title":"Diabetol. Metab. Syndr."},{"key":"ref_39","unstructured":"Willis, A. (2023, December 04). Altered Mental Status and Coma. Available online: https:\/\/www.amboss.com\/us\/knowledge\/altered-mental-status-and-coma."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1097\/MCC.0000000000001022","article-title":"Neurological complications of sepsis","volume":"29","author":"Piva","year":"2023","journal-title":"Curr. Opin. Crit. Care"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1075","DOI":"10.1007\/s00134-017-4807-z","article-title":"Potentially modifiable factors contributing to sepsis-associated encephalopathy","volume":"43","author":"Sonneville","year":"2017","journal-title":"Intensive Care Med."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1186\/s10020-019-0132-z","article-title":"Post-sepsis syndrome-an evolving entity that afflicts survivors of sepsis","volume":"26","author":"Mostel","year":"2019","journal-title":"Mol. Med."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1038\/nrneurol.2012.183","article-title":"Sepsis associated encephalopathy","volume":"8","author":"Gofton","year":"2012","journal-title":"Nat. Rev. Neurol."},{"key":"ref_44","first-page":"297","article-title":"The encephalopaty associated with septic illness","volume":"13","author":"Young","year":"1990","journal-title":"Clin. Investig. Med."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1753","DOI":"10.1001\/jama.291.14.1753","article-title":"Delirium as predictor of mortality in mechanically ventilated patients in the intensive care unit","volume":"291","author":"Ely","year":"2004","journal-title":"JAMA"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1007\/s12035-018-1048-2","article-title":"Long-term cognitive outcomes after sepsis: A translational systematic review","volume":"56","author":"Barichello","year":"2019","journal-title":"Mol. Neurobiol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1136\/jnnp-2012-302883","article-title":"Persistent cognitive impairment, hippocampal atrophy and EEG changes in sepsis survivors","volume":"84","author":"Semmler","year":"2013","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Henriquez-Camacho, C., and Losa, J. (2014). Biomarkers for sepsis. Review article. BioMed Res. Int., 7.","DOI":"10.1155\/2014\/547818"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"40","DOI":"10.5152\/eurasianjmed.2021.20081","article-title":"Comparison of Sofa Score, SIRS, q SOF and qSOFA + L Criteria in the Diagnosis and Prognosis of Sepsis","volume":"53","author":"Toker","year":"2021","journal-title":"Eurasian J. Med."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"2663","DOI":"10.12816\/0042245","article-title":"Glasgow Coma Scale in Anticipation of Sepsis and Septic Shock: Review Article","volume":"69","author":"Alalawi","year":"2017","journal-title":"Egypt. J. Hosp. Med."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Atterton, B., Paulino, M.C., Povoa, P., and Martin-Loeches, I. (2020). Sepsis associated delirum. Medicina, 56.","DOI":"10.3390\/medicina56050240"}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/14\/6\/659\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:17:14Z","timestamp":1760105834000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/14\/6\/659"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,21]]},"references-count":51,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2024,3]]}},"alternative-id":["diagnostics14060659"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics14060659","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,21]]}}}