{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T05:12:40Z","timestamp":1773465160314,"version":"3.50.1"},"reference-count":61,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,4,22]],"date-time":"2025-04-22T00:00:00Z","timestamp":1745280000000},"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>Background: This study aimed to investigate the presence of emotional disorders, the risk factors associated with these disorders, and the level of sexual function observed after childbirth. Additionally, the study aimed to explore how sexual function affects post-partum depression and Post-Traumatic Stress Disorder (PTSD), as well as how these emotional disorders, in turn, impact sexual function. Methodology: A total of 336 women participated in the study, who were asked to complete four questionnaires: a general women\u2019s personal information questionnaire, the Edinburgh Postnatal Depression Scale (EPDS), the PTSD Scale (PCL-5), and the Female Sexual Functioning Index (FSFI). Results: The results showed that 33% of mothers scored on the EPDS above 14 points, which was considered a threshold value for the prognosis of post-partum depression. In addition, the women scored an average of 20.8 points on the FSFI, and thus, their level of sexual functioning was characterized as moderate. According to the total score of the PCL-5 scale, it was observed that 17.6% of the mothers show post-traumatic stress after childbirth and satisfy all four criteria of this scale. Lastly, multiple regression analysis showed that factors such as annual family income and negative body image had a significant contribution to the models. Conclusions: Finally, it was observed that reduced sexual functionality in women is linked to post-partum depression and post-traumatic stress after childbirth. In conclusion, our research emphasizes the need for further exploration of the psychological and emotional challenges women face during the puerperium, which can negatively affect sexual health.<\/jats:p>","DOI":"10.3390\/diagnostics15091065","type":"journal-article","created":{"date-parts":[[2025,4,22]],"date-time":"2025-04-22T20:11:48Z","timestamp":1745352708000},"page":"1065","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Emotional Disorders, Risk Factors, and Correlations of Post-Partum Depression and Post-Traumatic Stress Disorder with Sexual Function During Post-Partum Period"],"prefix":"10.3390","volume":"15","author":[{"given":"Panagiotis","family":"Eskitzis","sequence":"first","affiliation":[{"name":"Department of Midwifery, School of Healthcare Sciences, University of Western Macedonia, Keptse, 50200 Ptolemaida, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7097-2927","authenticated-orcid":false,"given":"Vasiliki","family":"Michou","sequence":"additional","affiliation":[{"name":"Department of Midwifery, School of Healthcare Sciences, University of Western Macedonia, Keptse, 50200 Ptolemaida, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christiana","family":"Arampatzi","sequence":"additional","affiliation":[{"name":"Department of Midwifery, School of Healthcare Sciences, University of Western Macedonia, Keptse, 50200 Ptolemaida, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4337-7871","authenticated-orcid":false,"given":"Ioannis","family":"Tsakiridis","sequence":"additional","affiliation":[{"name":"3rd Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Ippokrateio General Hospital of Thessaloniki, Kostantinoupoleos Street 49, 54642 Thessalon\u00edki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dimitrios","family":"Papoutsis","sequence":"additional","affiliation":[{"name":"Department of Midwifery, School of Healthcare Sciences, University of Western Macedonia, Keptse, 50200 Ptolemaida, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,22]]},"reference":[{"key":"ref_1","unstructured":"Cunningham, F.G., Leveno, K.J., Bloom, S.L., Dashe, J.S., Hoffman, B.L., Casey, B.M., and Spong, C.Y. (2022). Williams Obstetrics. 1st Greek 2022, Paschalidis Publications."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"S24","DOI":"10.1186\/1472-6874-4-S1-S24","article-title":"Sexual Health","volume":"4","author":"Hansen","year":"2004","journal-title":"BMC Womens Health"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.5603\/GP.a2020.0162","article-title":"The impact of motherhood on sexuality","volume":"92","author":"Fuchs","year":"2021","journal-title":"Ginekol. Pol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1097\/AOG.0b013e3182479611","article-title":"Sex After Childbirth","volume":"119","author":"Leeman","year":"2012","journal-title":"Obstet. Gynecol."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Rahmani, A., Fallahi, A., Allahqoli, L., Grylka-Baeschlin, S., and Alkatout, I. (2023). How do new mothers describe their postpartum sexual quality of life? a qualitative study. BMC Womens Health, 23.","DOI":"10.1186\/s12905-023-02619-2"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e13047","DOI":"10.1111\/jne.13047","article-title":"Allopregnanolone and neuroHIV: Potential benefits of neuroendocrine modulation in the era of antiretroviral therapy","volume":"34","author":"Salahuddin","year":"2022","journal-title":"J. Neuroendocr."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Paris, J.J., Liere, P., Kim, S., Mahdi, F., Buchanan, M.E., Nass, S.R., Qrareya, A.N., Salahuddin, M.F., Pianos, A., and Fernandez, N. (2020). Pregnane steroidogenesis is altered by HIV-1 Tat and morphine: Physiological allopregnanolone is protective against neurotoxic and psychomotor effects. Neurobiol. Stress., 12.","DOI":"10.1016\/j.ynstr.2020.100211"},{"key":"ref_8","first-page":"e30898","article-title":"Risk Factors of Postpartum Depression","volume":"14","author":"Agrawal","year":"2022","journal-title":"Cureus"},{"key":"ref_9","first-page":"1745506519844044","article-title":"Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes","volume":"15","author":"Slomian","year":"2019","journal-title":"Women\u2019s Health"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1521\/psyc.2013.76.2.150","article-title":"Hospitalization-Based Treatment for Postpartum Depressed Mothers and Their Babies: Rationale, Principles, and Preliminary Follow-Up Data","volume":"76","author":"Vliegen","year":"2013","journal-title":"Psychiatry Interpers. Biol. Process."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1002\/da.22040","article-title":"Postpartum Gad Is a Risk Factor for Postpartum Mdd: The Course and Longitudinal Relationships of Postpartum Gad and Mdd","volume":"30","author":"Prenoveau","year":"2013","journal-title":"Depress. Anxiety"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.earlhumdev.2018.03.009","article-title":"Maternal mental health during the neonatal period: Relationships to the occupation of parenting","volume":"120","author":"Harris","year":"2018","journal-title":"Early Hum. Dev."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Qi, W., Liu, Y., Lv, H., Ge, J., Meng, Y., Zhao, N., Zhao, F., Guo, Q., and Hu, J. (2022). Effects of family relationship and social support on the mental health of Chinese postpartum women. BMC Pregnancy Childbirth, 22.","DOI":"10.1186\/s12884-022-04392-w"},{"key":"ref_14","first-page":"115","article-title":"Postpartum Sexuality Concerns Among First-Time Parents from One U.S","volume":"4","author":"Pastore","year":"2007","journal-title":"Acad. Hospital. J. Sex. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1455","DOI":"10.1016\/j.jsxm.2016.08.006","article-title":"A New Baby in the Bedroom: Frequency and Severity of Postpartum Sexual Concerns and Their Associations with Relationship Satisfaction in New Parent Couples","volume":"13","author":"Schlagintweit","year":"2016","journal-title":"J. Sex. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"700","DOI":"10.1037\/hea0000861","article-title":"Biopsychosocial predictors of trajectories of postpartum sexual function in first-time mothers","volume":"39","author":"Dawson","year":"2020","journal-title":"Health Psychol."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Grisbrook, M.A., Dewey, D., Cuthbert, C., McDonald, S., Ntanda, H., and Letourneau, N. (2024). The Association between Cesarean Section Delivery and Child Behavior: Is It Mediated by Maternal Post-Traumatic Stress Disorder and Maternal Postpartum Depression?. Behav. Sci., 14.","DOI":"10.3390\/bs14010061"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1055\/s-0031-1280408","article-title":"Post-traumatic Stress Disorder Post Partum","volume":"72","author":"Schwab","year":"2012","journal-title":"Geburtshilfe Frauenheilkd."},{"key":"ref_19","first-page":"111","article-title":"Do Women Get Posttraumatic Stress Disorder as a Result of Childbirth?","volume":"28","author":"Ayers","year":"2001","journal-title":"Prospect. Study Incid. Birth."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Arampatzi, C., Michou, V., Eskitzis, P., Andreou, K., and Papoutsis, D. (2025). Factors Associated with Postpartum Sexual Function During the Puerperium Period: A Cross-Sectional Study in Greece. Nurs. Rep., 15.","DOI":"10.3390\/nursrep15030086"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Al-Garni, A.M., Shati, A.A., Almonawar, N.A., Alamri, G.M., Alasmre, L.A., Saad, T.N., Alshehri, F.M., Hammouda, E.A., and Ghazy, R.M. (2025). Prevalence of depression, anxiety, and stress among students enrolled at King Khalid University: A cross-sectional study. BMC Public Health, 25.","DOI":"10.1186\/s12889-025-21277-7"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1192\/bjp.150.6.782","article-title":"Detection of Postnatal Depression","volume":"150","author":"Cox","year":"1987","journal-title":"Br. J. Psychiatry"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1080\/02646830802004909","article-title":"Validation of the Edinburgh Postnatal Depression Scale and prevalence of postnatal depression at two months postpartum in a sample of Greek mothers","volume":"27","author":"Leonardou","year":"2009","journal-title":"J. Reprod. Infant. Psychol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1111\/j.1524-4733.2005.04054.x","article-title":"Principles of Good Practice for the Translation and Cultural Adaptation Process for Patient-Reported Outcomes (PRO) Measures: Report of the ISPOR Task Force for Translation and Cultural Adaptation","volume":"8","author":"Wild","year":"2005","journal-title":"Value Health"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1002\/jts.22059","article-title":"The Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5): Development and Initial Psychometric Evaluation","volume":"28","author":"Blevins","year":"2015","journal-title":"J. Trauma. Stress"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1186\/s12955-017-0692-y","article-title":"Post-traumatic stress disorder in parturients delivering by caesarean section and the implication of anaesthesia: A prospective cohort study","volume":"15","author":"Lopez","year":"2017","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_27","unstructured":"National Center for Post-Traumatic Stress Disorder (2024, November 12). Post-Traumatic Stress Disorder Checklist for DSM-5 (PCL-5)\u2014Post-Traumatic Stress Disorder, Available online: https:\/\/www.ptsd.va.gov\/professional\/assessment\/adult-sr\/ptsd-checklist.asp."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1016\/j.jpsychires.2014.10.012","article-title":"Dimensional structure of DSM-5 posttraumatic stress symptoms: Support for a hybrid Anhedonia and Externalizing Behaviors model","volume":"61","author":"Armour","year":"2015","journal-title":"J. Psychiatr. Res."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"26406","DOI":"10.3402\/ejpt.v6.26406","article-title":"Latent profile analysis and principal axis factoring of the DSM-5 dissociative subtype","volume":"6","author":"Frewen","year":"2015","journal-title":"Eur. J. Psychotraumatol."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Orovou, E., Theodoropoulou, I.M., and Antoniou, E. (2021). Psychometric properties of the Post Traumatic Stress Disorder Checklist for DSM-5 (PCL-5) in Greek women after cesarean section. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0255689"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1080\/009262300278597","article-title":"The Female Sexual Function Index (FSFI): A Multidimensional Self-Report Instrument for the Assessment of Female Sexual Function","volume":"26","author":"Rosen","year":"2000","journal-title":"J. Sex. Marital. Ther."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/00926230590475206","article-title":"The Female Sexual Function Index (FSFI): Cross-Validation and Development of Clinical Cutoff Scores","volume":"31","author":"Wiegel","year":"2005","journal-title":"J. Sex. Marital. Ther."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1038\/ijir.2017.18","article-title":"Translation and validation of the Greek version of the female sexual function index questionnaire","volume":"29","author":"Zachariou","year":"2017","journal-title":"Int. J. Impot. Res."},{"key":"ref_34","first-page":"1","article-title":"Translation and Validity of the Female Sexual Function Index Filipino Version (FSFI-Fil)","volume":"51","year":"2013","journal-title":"Phil J Intern Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"365","DOI":"10.4103\/0253-7176.108222","article-title":"Nature of sexual dysfunctions in major depressive disorder and its impact on quality of life","volume":"34","author":"Thakurta","year":"2012","journal-title":"Indian J. Psychol. Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.pneurobio.2012.05.004","article-title":"The human sexual response cycle: Brain imaging evidence linking sex to other pleasures","volume":"98","author":"Georgiadis","year":"2012","journal-title":"Prog. Neurobiol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1016\/j.psyneuen.2008.03.008","article-title":"The link between childhood trauma and depression: Insights from HPA axis studies in humans","volume":"33","author":"Heim","year":"2008","journal-title":"Psychoneuroendocrinology"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1007\/s11930-017-0116-3","article-title":"Sex After Baby: Women\u2019s Sexual Function in the Postpartum Period","volume":"9","author":"McBride","year":"2017","journal-title":"Curr. Sex. Health Rep."},{"key":"ref_39","first-page":"54","article-title":"Sexual Dysfunction in Postpartum Turkish Women: It\u2019s Relationship with Depression and Some Risk Factors","volume":"22","author":"Avci","year":"2018","journal-title":"Afr. J. Reprod. Health"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1111\/ppc.12583","article-title":"Sexual dysfunction in the postpartum period: Its relationship with postpartum depression and certain other factors","volume":"57","year":"2021","journal-title":"Perspect. Psychiatr. Care"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1007\/s11930-023-00372-z","article-title":"Postpartum Sexual Function and Depression: A Review of Recent Literature","volume":"15","author":"Kelley","year":"2023","journal-title":"Curr. Sex. Health Rep."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1016\/j.genhosppsych.2004.02.006","article-title":"Antenatal risk factors for postpartum depression: A synthesis of recent literature","volume":"26","author":"Robertson","year":"2004","journal-title":"Gen. Hosp. Psychiatry"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"162","DOI":"10.12968\/bjom.2017.25.3.162","article-title":"Exploring postnatal depression, sexual dysfunction and relationship dissatisfaction in Australian women","volume":"25","author":"Khajehei","year":"2017","journal-title":"Br. J. Midwifery"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"938","DOI":"10.1080\/0092623X.2024.2397409","article-title":"Risk of Postpartum Sexual Dysfunction: A Link to Posttraumatic Stress Disorder Symptoms and Depression Symptoms","volume":"50","author":"Bal","year":"2024","journal-title":"J. Sex. Marital. Ther."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1038\/nrn3339","article-title":"Biological studies of post-traumatic stress disorder","volume":"13","author":"Pitman","year":"2012","journal-title":"Nat. Rev. Neurosci."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Toledo, F., and Carson, F. (2022). Neurobiological Features of Posttraumatic Stress Disorder (PTSD) and Their Role in Understanding Adaptive Behavior and Stress Resilience. Int. J. Env. Res. Public Health, 19.","DOI":"10.3390\/ijerph191610258"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1196\/annals.1364.022","article-title":"Clinical Implications of Neuroscience Research in PTSD","volume":"1071","year":"2006","journal-title":"Ann. N. Y Acad. Sci."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.copsyc.2016.11.006","article-title":"The innate alarm system in PTSD: Conscious and subconscious processing of threat","volume":"14","author":"Lanius","year":"2017","journal-title":"Curr. Opin. Psychol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1398","DOI":"10.1016\/j.jsxm.2021.05.011","article-title":"Relationship Between Posttraumatic Stress Disorder and Sexual Difficulties: A Systematic Review of Veterans and Military Personnel","volume":"18","author":"Bird","year":"2021","journal-title":"J. Sex. Med."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1348\/014466500163095","article-title":"Prevalence and predictors of post-traumatic stress symptoms following childbirth","volume":"39","author":"Czarnocka","year":"2000","journal-title":"Br. J. Clin. Psychol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1080\/13548500600708409","article-title":"The effects of childbirth-related post-traumatic stress disorder on women and their relationships: A qualitative study","volume":"11","author":"Ayers","year":"2006","journal-title":"Psychol. Health Med."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1728","DOI":"10.3389\/fpsyg.2018.01728","article-title":"The Impact of Postpartum Posttraumatic Stress and Depression Symptoms on Couples\u2019 Relationship Satisfaction: A Population-Based Prospective Study","volume":"9","author":"Horsch","year":"2018","journal-title":"Front Psychol."},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Geuens, S., Polona Miv\u0161ek, A., and Gianotten Woet, L. (2023). Midwifery and Sexuality, Springer International Publishing.","DOI":"10.1007\/978-3-031-18432-1"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1007\/s00737-015-0582-4","article-title":"A simple model for prediction postpartum PTSD in high-risk pregnancies","volume":"19","author":"Dulitzky","year":"2016","journal-title":"Arch. Womens Ment. Health"},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"van Heumen, M.A., Hollander, M.H., van Pampus, M.G., van Dillen, J., and Stramrood, C.A. (2018). Psychosocial Predictors of Postpartum Posttraumatic Stress Disorder in Women With a Traumatic Childbirth Experience. Front. Psychiatry, 9.","DOI":"10.3389\/fpsyt.2018.00348"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1016\/j.jpsychores.2012.07.010","article-title":"PTSD following childbirth: A prospective study of incidence and risk factors in Canadian women","volume":"73","author":"Verreault","year":"2012","journal-title":"J. Psychosom. Res."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1111\/j.1471-0528.2009.02493.x","article-title":"Prevalence and risk factors for postpartum depression among women with preterm and low-birth-weight infants: A systematic review","volume":"117","author":"Vigod","year":"2010","journal-title":"BJOG"},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Antoniou, E., Stamoulou, P., Tzanoulinou, M.D., and Orovou, E. (2021). Perinatal Mental Health; The Role and the Effect of the Partner: A Systematic Review. Healthcare, 9.","DOI":"10.3390\/healthcare9111572"},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Ginja, S., Coad, J., Bailey, E., Kendall, S., Goodenough, T., Nightingale, S., Smiddy, J., Day, C., Deave, T., and Lingam, R. (2018). Associations between social support, mental wellbeing, self-efficacy and technology use in first-time antenatal women: Data from the BaBBLeS cohort study. BMC Pregnancy Childbirth, 18.","DOI":"10.1186\/s12884-018-2049-x"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1097\/00006199-200109000-00004","article-title":"Predictors of Postpartum Depression","volume":"50","author":"Beck","year":"2001","journal-title":"Nurs. Res."},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Priddis, H., Schmied, V., and Dahlen, H. (2014). Women\u2019s experiences following severe perineal trauma: A qualitative study. BMC Womens Health, 14.","DOI":"10.1186\/1472-6874-14-32"}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/9\/1065\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:19:36Z","timestamp":1760030376000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/9\/1065"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,22]]},"references-count":61,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025,5]]}},"alternative-id":["diagnostics15091065"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics15091065","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,22]]}}}