{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T16:17:45Z","timestamp":1790785065333,"version":"4.1.0"},"reference-count":50,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2024,12,11]],"date-time":"2024-12-11T00:00:00Z","timestamp":1733875200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Genes"],"abstract":"<jats:p>Background: Chromosomal numerical and structural alterations are significant causes of various developmental disorders in foetuses. Non-invasive prenatal testing (NIPT) has emerged as an effective screening tool for detecting common aneuploidies, aiding in the identification of individuals who may require further diagnostic work-up. Methods: This retrospective, monocentric observational study evaluates the usage patterns, test choices, turnaround times (TAT), and outcomes of NIPT between 2013 and 2023 on a sample of 2431 pregnant women at a special hospital offering outpatient services and comprehensive gynaecological\/obstetric inpatient care. We analysed the trends in NIPT usage, high-risk results, prior screening procedures, as well as factors such as age, gestational age and in vitro fertilisation (IVF) status. NIPT was performed using cell-free foetal DNA (cffDNA) extracted from maternal plasma, followed by library construction, sequencing and result analysis. The sequencing results were aligned with reference genomes, and z-scores were calculated to assess the likelihood of aneuploidy. Statistical significance was set at p &lt; 0.05. Results: The average age of women undergoing NIPT decreased from 36.1 years in 2013 to 33.01 years in 2023 (p = 0.0287), and mean TAT dropped from 12.44 days in 2013 to 7.08 days in 2023 (p = 0.0121), with the most substantial reduction occurring between 2013 and 2019. The study identified a stable rate of women who underwent IVF seeking prenatal testing, with no statistically significant difference between the first half and the second half of the analysed period (p = 0.2659). Among high-risk results, there were 39 chromosomal abnormalities detected, most of them belonging to trisomy 21 (59%). Conclusions: Our findings demonstrate the increasing efficiency and accessibility of NIPT in prenatal care in Croatia, while the significant reduction in TAT and the decreasing age of women undergoing NIPT reflect enhanced operational practices and broader acceptance. Introducing NIPT into the public healthcare system in the Republic of Croatia could improve equitable access to advanced prenatal care and enhance pregnancy outcomes. Future advancements in technology and genetic counselling will further enhance its role, requiring careful attention to ethical and regulatory considerations.<\/jats:p>","DOI":"10.3390\/genes15121590","type":"journal-article","created":{"date-parts":[[2024,12,11]],"date-time":"2024-12-11T12:58:49Z","timestamp":1733921929000},"page":"1590","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["A Decade of Non-Invasive Prenatal Testing (NIPT) for Chromosomal Abnormalities in Croatia: First National Monocentric Study to Inform Country\u2019s Future Prenatal Care Strategy"],"prefix":"10.3390","volume":"15","author":[{"given":"Petra","family":"Podobnik","sequence":"first","affiliation":[{"name":"Podobnik Special Hospital, Ul. Sveti Duh 112, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8751-8149","authenticated-orcid":false,"given":"Tomislav","family":"Me\u0161trovi\u0107","sequence":"additional","affiliation":[{"name":"DA VINCI Polyclinic, Petrovaradinska ulica 110, 10000 Zagreb, Croatia"},{"name":"University Centre Vara\u017edin, University North, 42000 Vara\u017edin, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aida","family":"\u0110or\u0111evi\u0107","sequence":"additional","affiliation":[{"name":"GenePlanet, Cesta na Poljane 3A, 1210 Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristian","family":"Kurdija","sequence":"additional","affiliation":[{"name":"Podobnik Special Hospital, Ul. Sveti Duh 112, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D\u017eenis","family":"Jel\u010di\u0107","sequence":"additional","affiliation":[{"name":"Podobnik Special Hospital, Ul. Sveti Duh 112, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina","family":"Ogrin","sequence":"additional","affiliation":[{"name":"GenePlanet, Cesta na Poljane 3A, 1210 Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivan","family":"Bertovi\u0107-\u017dunec","sequence":"additional","affiliation":[{"name":"Podobnik Special Hospital, Ul. Sveti Duh 112, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beata","family":"Gebauer-Vukovi\u0107","sequence":"additional","affiliation":[{"name":"Podobnik Special Hospital, Ul. Sveti Duh 112, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grega","family":"Ho\u010devar","sequence":"additional","affiliation":[{"name":"GenePlanet, Cesta na Poljane 3A, 1210 Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Igor","family":"Lon\u010dar","sequence":"additional","affiliation":[{"name":"Podobnik Special Hospital, Ul. Sveti Duh 112, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zlata","family":"Srebrenikovi\u0107","sequence":"additional","affiliation":[{"name":"Podobnik Special Hospital, Ul. Sveti Duh 112, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petra","family":"Trobina","sequence":"additional","affiliation":[{"name":"GenePlanet, Cesta na Poljane 3A, 1210 Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marko","family":"Bitenc","sequence":"additional","affiliation":[{"name":"GenePlanet, Cesta na Poljane 3A, 1210 Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2005-6402","authenticated-orcid":false,"given":"Ivo","family":"Dumi\u0107-\u010cule","sequence":"additional","affiliation":[{"name":"DA VINCI Polyclinic, Petrovaradinska ulica 110, 10000 Zagreb, Croatia"},{"name":"University Centre Vara\u017edin, University North, 42000 Vara\u017edin, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3233","DOI":"10.1038\/s41591-023-02645-5","article-title":"Prevalence of chromosomal alterations in first-trimester spontaneous pregnancy loss","volume":"29","author":"Essers","year":"2023","journal-title":"Nat. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2556","DOI":"10.1056\/NEJMcp0900134","article-title":"Clinical practice. Prenatal screening for aneuploidy","volume":"360","author":"Driscoll","year":"2009","journal-title":"N. Engl. J. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1097\/01.AOG.0000278820.54029.e3","article-title":"Procedure-related complications of amniocentesis and chorionic villous sampling: A systematic review","volume":"110","author":"Mujezinovic","year":"2007","journal-title":"Obstet. Gynecol."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Jiang, F., Ren, J., Chen, F., Zhou, Y., Xie, J., Dan, S., Su, Y., Xie, J., Yin, B., and Su, W. (2012). Noninvasive Fetal Trisomy (NIFTY) test: An advanced noninvasive prenatal diagnosis methodology for fetal autosomal and sex chromosomal aneuploidies. BMC Med. Genomics, 5.","DOI":"10.1186\/1755-8794-5-57"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e33437","DOI":"10.1016\/j.heliyon.2024.e33437","article-title":"Performance analysis of non-invasive prenatal testing for trisomy 13, 18, and 21: A large-scale retrospective study (2018\u20132021)","volume":"10","author":"Lu","year":"2024","journal-title":"Heliyon"},{"key":"ref_6","first-page":"CD011767","article-title":"Genomics-based non-invasive prenatal testing for detection of fetal chromosomal aneuploidy in pregnant women","volume":"11","author":"Badeau","year":"2017","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1016\/S0140-6736(97)02174-0","article-title":"Presence of fetal DNA in maternal plasma and serum","volume":"350","author":"Lo","year":"1997","journal-title":"Lancet"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1097\/GIM.0b013e3182368a0e","article-title":"DNA sequencing of maternal plasma to detect Down syndrome: An international clinical validation study","volume":"13","author":"Palomaki","year":"2011","journal-title":"Genet. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"319.e1","DOI":"10.1016\/j.ajog.2012.01.030","article-title":"Noninvasive prenatal detection and selective analysis of cell-free DNA obtained from maternal blood: Evaluation for trisomy 21 and trisomy 18","volume":"206","author":"Sparks","year":"2012","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"890","DOI":"10.1097\/AOG.0b013e31824fb482","article-title":"Genome-wide fetal aneuploidy detection by maternal plasma DNA sequencing","volume":"119","author":"Bianchi","year":"2012","journal-title":"Obstet. Gynecol."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Abedalthagafi, M., Bawazeer, S., Fawaz, R.I., Heritage, A.M., Alajaji, N.M., and Faqeih, E. (2023). Non-invasive prenatal testing: A revolutionary journey in prenatal testing. Front. Med., 10.","DOI":"10.3389\/fmed.2023.1265090"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1615","DOI":"10.1042\/CS20210380","article-title":"Non-invasive prenatal diagnosis (NIPD): How analysis of cell-free DNA in maternal plasma has changed prenatal diagnosis for monogenic disorders","volume":"136","author":"Hanson","year":"2022","journal-title":"Clin. Sci."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Sorbini, M., Carradori, T., Togliatto, G.M., Vaisitti, T., and Deaglio, S. (2024). Technical Advances in Circulating Cell-Free DNA Detection and Analysis for Personalized Medicine in Patients\u2019 Care. Biomolecules, 14.","DOI":"10.20944\/preprints202403.1530.v1"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"224","DOI":"10.21860\/medflum2022_280997","article-title":"Molecular diagnostic methods in prenatal medicine","volume":"58","year":"2022","journal-title":"Med. Flum."},{"key":"ref_15","first-page":"53","article-title":"Current view of the application of non-invasive prenatal testing of cell-free circulating fetal DNA from maternal blood","volume":"145","year":"2023","journal-title":"Lije\u010d. Vjesn."},{"key":"ref_16","unstructured":"Rambousek, L. (2022). Genetic Testing Directly Offered to Consumers in the Republic of Croatia. [Master\u2019s Thesis, University of Rijeka, Faculty of Medicine]."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"722","DOI":"10.1111\/aogs.13841","article-title":"Current use of noninvasive prenatal testing in Europe, Australia and the USA: A graphical presentation","volume":"99","author":"Petersen","year":"2020","journal-title":"Acta. Obstet. Gynecol. Scand."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1080\/14737159.2022.2049245","article-title":"Retrospective analysis of the risk factors associated with failure in obtaining effective noninvasive prenatal test results and pregnancy outcomes: A case-control study","volume":"22","author":"Lu","year":"2022","journal-title":"Expert Rev. Mol. Diagn."},{"key":"ref_19","unstructured":"R Core Team (2021). R: A Language and Environment for Statistical Computing, R Foundation for Statistical Computing. Available online: https:\/\/www.R-project.org\/."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"303","DOI":"10.2174\/1389201017666160118103147","article-title":"Ovarian Stimulation Protocol in IVF: An Up-to-Date Review of the Literature","volume":"17","author":"Pacchiarotti","year":"2016","journal-title":"Curr. Pharm. Biotechnol."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Kadoura, S., Alhalabi, M., and Nattouf, A.H. (2022). Conventional GnRH antagonist protocols versus long GnRH agonist protocol in IVF\/ICSI cycles of polycystic ovary syndrome women: A systematic review and meta-analysis. Sci. Rep., 12.","DOI":"10.1038\/s41598-022-08400-z"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"6505","DOI":"10.1080\/14767058.2021.1916910","article-title":"Prenatal screening for Down syndrome: Popularity, perceptions and factors associated with acceptance or refusal of testing","volume":"35","author":"Armean","year":"2022","journal-title":"J. Matern. Fetal Neonatal Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1080\/14737159.2019.1571912","article-title":"The importance of pre- and post-test counseling for prenatal cell-free DNA screening for common fetal aneuploidies","volume":"19","author":"Stefanovic","year":"2019","journal-title":"Expert. Rev. Mol. Diagn."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1002\/pd.4579","article-title":"NIPT-based screening for Down syndrome and beyond: What do pregnant women think?","volume":"35","author":"Dondorp","year":"2015","journal-title":"Prenat. Diagn."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1038\/s41431-023-01504-8","article-title":"Psychological impact of additional findings detected by genome-wide Non-Invasive Prenatal Testing (NIPT): TRIDENT-2 study","volume":"32","author":"Bakkeren","year":"2024","journal-title":"Eur. J. Hum. Genet."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1505","DOI":"10.1111\/aogs.14631","article-title":"A decade of change-lessons learned from prenatal diagnostics in Central Denmark region in 2008-2018","volume":"102","author":"Lildballe","year":"2023","journal-title":"Acta. Obstet. Gynecol. Scand."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e2351","DOI":"10.1002\/mgg3.2351","article-title":"Reasons for failure of noninvasive prenatal test for cell-free fetal DNA in maternal peripheral blood","volume":"12","author":"Kong","year":"2024","journal-title":"Mol. Genet. Genomic. Med."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Demko, Z., Prigmore, B., and Benn, P. (2022). A Critical Evaluation of Validation and Clinical Experience Studies in Non-Invasive Prenatal Testing for Trisomies 21, 18, and 13 and Monosomy, X. J. Clin. Med., 11.","DOI":"10.3390\/jcm11164760"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1002\/pd.4069","article-title":"Discordant results between fetal karyotyping and non-invasive prenatal testing by maternal plasma sequencing in a case of uniparental disomy 21 due to trisomic rescue","volume":"33","author":"Pan","year":"2013","journal-title":"Prenat. Diagn."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"100844","DOI":"10.1016\/j.ajogmf.2022.100844","article-title":"The accuracy of prenatal cell-free DNA screening for sex chromosome abnormalities: A systematic review and meta-analysis","volume":"5","author":"Bussolaro","year":"2023","journal-title":"Am. J. Obstet. Gynecol. MFM"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1287","DOI":"10.1002\/pd.6028","article-title":"Association between low fetal fraction in cell-free DNA testing and adverse pregnancy outcome: A systematic review","volume":"41","author":"Scheffer","year":"2021","journal-title":"Prenat. Diagn."},{"key":"ref_32","first-page":"65","article-title":"Introduction of noninvasive prenatal testing for fetal trisomies: Preliminary results and consequences on invasive samplings","volume":"1","author":"Gilson","year":"2015","journal-title":"Bull. Soc. Sci. Med. Grand Duche Luxemb"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1127","DOI":"10.1007\/s10897-016-9945-x","article-title":"NIPT and Informed Consent: An Assessment of Patient Understanding of a Negative NIPT Result","volume":"25","author":"Piechan","year":"2016","journal-title":"J. Genet. Couns."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Bowman-Smart, H., Perrot, A., and Horn, R. (2024). Supporting patient decision-making in non-invasive prenatal testing: A comparative study of professional values and practices in England and France. BMC Med. Ethics, 25.","DOI":"10.1186\/s12910-024-01032-0"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1007\/s12687-022-00596-x","article-title":"Multisite assessment of the impact of a prenatal testing educational App on patient knowledge and preparedness for prenatal testing decision making","volume":"13","author":"Winters","year":"2022","journal-title":"J. Community Genet."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1141","DOI":"10.1007\/s00439-019-02061-1","article-title":"Noninvasive prenatal testing: From aneuploidy to single genes","volume":"139","author":"Guseh","year":"2020","journal-title":"Hum. Genet."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1002\/pd.4123","article-title":"Initial clinical laboratory experience in noninvasive prenatal testing for fetal aneuploidy from maternal plasma DNA samples","volume":"33","author":"Futch","year":"2013","journal-title":"Prenat. Diagn."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1002\/pd.5022","article-title":"Confined placental mosaicism for 22q11.2 deletion as the etiology for discordant positive NIPT results","volume":"37","author":"Bunnell","year":"2017","journal-title":"Prenat. Diagn."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1093\/humupd\/dmu016","article-title":"The origin, mechanisms, incidence and clinical consequences of chromosomal mosaicism in humans","volume":"20","author":"Taylor","year":"2014","journal-title":"Hum. Reprod. Update"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"994","DOI":"10.1002\/pd.4659","article-title":"The type of feto-placental aneuploidy detected by cfDNA testing may influence the choice of confirmatory diagnostic procedure","volume":"35","author":"Grati","year":"2015","journal-title":"Prenat. Diagn."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1002\/pd.5609","article-title":"Cell-free DNA fetal fraction in twin gestations in single-nucleotide polymorphism-based noninvasive prenatal screening","volume":"40","author":"Hedriana","year":"2020","journal-title":"Prenat. Diagn."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1002\/uog.14690","article-title":"Performance of screening for aneuploidies by cell-free DNA analysis of maternal blood in twin pregnancies","volume":"45","author":"Bevilacqua","year":"2015","journal-title":"Ultrasound Obstet. Gynecol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1016\/j.ajog.2014.09.012","article-title":"Noninvasive prenatal testing: Need for informed enthusiasm","volume":"211","author":"Han","year":"2014","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1016\/j.ajog.2017.01.005","article-title":"The role of ultrasound in women who undergo cell-free DNA screening","volume":"216","author":"Norton","year":"2017","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1016\/j.tjog.2024.03.003","article-title":"Genetic counseling of non-invasive prenatal testing (NIPT) trisomy 7-positive pregnancies","volume":"63","author":"Chen","year":"2024","journal-title":"Taiwan J. Obstet. Gynecol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1002\/pd.6278","article-title":"Issues associated with possible implementation of Non-Invasive Prenatal Testing (NIPT) in first-tier screening: A rapid scoping review","volume":"43","author":"Ghiasi","year":"2023","journal-title":"Prenat. Diagn."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Baranova, E.E., Sagaydak, O.V., Galaktionova, A.M., Kuznetsova, E.S., Kaplanova, M.T., Makarova, M.V., Belenikin, M.S., Olenev, A.S., and Songolova, E.N. (2022). Whole genome non-invasive prenatal testing in prenatal screening algorithm: Clinical experience from 12,700 pregnancies. BMC Pregnancy Childbirth, 22.","DOI":"10.1186\/s12884-022-04966-8"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1002\/pd.5114","article-title":"Opening Pandora\u2019s box?: Ethical issues in prenatal whole genome and exome sequencing","volume":"38","author":"Horn","year":"2018","journal-title":"Prenat. Diagn."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"DiNonno, W., Demko, Z., Martin, K., Billings, P., Egbert, M., Zneimer, S., Keen-Kim, D., and Benn, P. (2019). Quality Assurance of Non-Invasive Prenatal Screening (NIPS) for Fetal Aneuploidy Using Positive Predictive Values as Outcome Measures. J. Clin. Med., 8.","DOI":"10.3390\/jcm8091311"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1395","DOI":"10.1002\/pd.6043","article-title":"Dutch NIPT Consortium. Non-invasive prenatal test uptake in socioeconomically disadvantaged neighborhoods","volume":"41","author":"Kooij","year":"2021","journal-title":"Prenat. Diagn."}],"container-title":["Genes"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2073-4425\/15\/12\/1590\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:52:51Z","timestamp":1760115171000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2073-4425\/15\/12\/1590"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,11]]},"references-count":50,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["genes15121590"],"URL":"https:\/\/doi.org\/10.3390\/genes15121590","relation":{},"ISSN":["2073-4425"],"issn-type":[{"value":"2073-4425","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,11]]}}}