{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T22:52:46Z","timestamp":1773442366907,"version":"3.50.1"},"reference-count":54,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2021,8,31]],"date-time":"2021-08-31T00:00:00Z","timestamp":1630368000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Sociedad Espa\u00f1ola de Reumatolog\u00eda Pediatrica","award":["Grant for medical researchers of the \u201cSociedad Espa\u00f1ola de Reumatolog\u00eda Pediatrica\u201d"],"award-info":[{"award-number":["Grant for medical researchers of the \u201cSociedad Espa\u00f1ola de Reumatolog\u00eda Pediatrica\u201d"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Objective: To identify factors associated with the higher proportion of fatty tissue and overweight\/obesity observed in patients with juvenile idiopathic arthritis (JIA). Patients and methods: We performed a cross-sectional study of 80 JIA patients aged 4\u201315 years with 80 age- and sex-matched healthy controls. Body composition was assessed using dual-energy x-ray absorptiometry. The 27-joint Juvenile Arthritis Disease Activity score (JADAS27) was calculated. Two multivariate models were constructed to identify factors associated with overweight\/obesity and fat mass index (FMI). Results: No differences were found between cases and controls in body mass index (BMI) or body composition. However, compared with controls, patients with a high inflammatory activity (JADAS27 &gt; 4.2 for oligoarticular JIA or &gt;8.5 for polyarticular disease) had higher values for BMI (p = 0.006); total fat mass (p = 0.003); FMI (p = 0.001); and fat in the legs (p = 0.001), trunk (p = 0.001), and arms (p = 0.002). The factors associated with overweight\/obesity in patients were the duration of therapy with biological drugs, measured in months (OR [95% CI] = 1.12 [1.02\u20131.04]; p = 0.037), and physical activity (OR [95% CI] = 0.214 [0.07\u20130.68]; p = 0.010), while the factors associated with FMI were age (\u03b2 [95% CI] = 0.30 [0.17\u20131.41]; p = 0.014), JADAS27 (\u03b2 [95% CI] = 0.45 [0.16\u20131.08]; p = 0.009), and physical activity (\u03b2 [95% CI] = \u22120.22 [\u22125.76 to 0.29]; p = 0.031). Conclusion: Our study revealed no differences between JIA patients with well-controlled disease and low disability and the healthy population in BMI or body composition. Furthermore, the association observed between inflammatory activity and adiposity could be responsible for poorer clinical course.<\/jats:p>","DOI":"10.3390\/jcm10173949","type":"journal-article","created":{"date-parts":[[2021,8,31]],"date-time":"2021-08-31T08:42:32Z","timestamp":1630399352000},"page":"3949","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Adiposity Is Related to Inflammatory Disease Activity in Juvenile Idiopathic Arthritis"],"prefix":"10.3390","volume":"10","author":[{"given":"Gisela","family":"Diaz-Cordov\u00e9s Rego","sequence":"first","affiliation":[{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga (IBIMA), 29010 M\u00e1laga, Spain"},{"name":"UGC de Reumatolog\u00eda, Hospital Regional Universitario de M\u00e1laga, 29009 M\u00e1laga, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esmeralda","family":"N\u00fa\u00f1ez-Cuadros","sequence":"additional","affiliation":[{"name":"UGC de Pediatr\u00eda, Hospital Regional Universitario de M\u00e1laga, 29009 M\u00e1laga, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6173-2051","authenticated-orcid":false,"given":"Natalia","family":"Mena-V\u00e1zquez","sequence":"additional","affiliation":[{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga (IBIMA), 29010 M\u00e1laga, Spain"},{"name":"UGC de Reumatolog\u00eda, Hospital Regional Universitario de M\u00e1laga, 29009 M\u00e1laga, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Soledad","family":"Aguado Henche","sequence":"additional","affiliation":[{"name":"Departamento de Anatom\u00eda y Embriolog\u00eda Humana, Facultad de Medicina, Universidad de Alcal\u00e1 de Henares, 29009 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roc\u00edo","family":"Galindo-Zavala","sequence":"additional","affiliation":[{"name":"UGC de Pediatr\u00eda, Hospital Regional Universitario de M\u00e1laga, 29009 M\u00e1laga, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2284-7846","authenticated-orcid":false,"given":"Sara","family":"Manrique-Arija","sequence":"additional","affiliation":[{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga (IBIMA), 29010 M\u00e1laga, Spain"},{"name":"UGC de Reumatolog\u00eda, Hospital Regional Universitario de M\u00e1laga, 29009 M\u00e1laga, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Mart\u00edn-Pedraz","sequence":"additional","affiliation":[{"name":"UGC de Pediatr\u00eda, Hospital Regional Universitario de M\u00e1laga, 29009 M\u00e1laga, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rocio","family":"Redondo-Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga (IBIMA), 29010 M\u00e1laga, Spain"},{"name":"UGC de Reumatolog\u00eda, Hospital Regional Universitario de M\u00e1laga, 29009 M\u00e1laga, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisco Javier","family":"Godoy-Navarrete","sequence":"additional","affiliation":[{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga (IBIMA), 29010 M\u00e1laga, Spain"},{"name":"UGC de Reumatolog\u00eda, Hospital Regional Universitario de M\u00e1laga, 29009 M\u00e1laga, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2962-9844","authenticated-orcid":false,"given":"Antonio","family":"Fern\u00e1ndez-Nebro","sequence":"additional","affiliation":[{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga (IBIMA), 29010 M\u00e1laga, Spain"},{"name":"UGC de Reumatolog\u00eda, Hospital Regional Universitario de M\u00e1laga, 29009 M\u00e1laga, Spain"},{"name":"Departamento de Medicina, Universidad de M\u00e1laga, 29010 M\u00e1laga, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,8,31]]},"reference":[{"key":"ref_1","first-page":"390","article-title":"International League of Associations for Rheumatology classification of juvenile idiopathic arthritis: Second revision, Edmonton, 2001","volume":"31","author":"Petty","year":"2004","journal-title":"J. Rheumatol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1016\/S0140-6736(07)60363-8","article-title":"Juvenile idiopathic arthritis","volume":"369","author":"Ravelli","year":"2007","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"190","DOI":"10.3899\/jrheum.180168","article-title":"Toward new classification criteria for juvenile idiopathic arthritis: First steps, pediatric rheumatology international trials organization international consensus","volume":"46","author":"Martini","year":"2019","journal-title":"J. Rheumatol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1789","DOI":"10.1002\/acr.23229","article-title":"Impact of Obesity and Adiposity on Inflammatory Markers in Patients With Rheumatoid Arthritis","volume":"69","author":"George","year":"2017","journal-title":"Arthritis Care Res."},{"key":"ref_5","first-page":"505","article-title":"Adipocytokines\u2014Novel link between inflammation and vascular function?","volume":"57","author":"Guzik","year":"2006","journal-title":"J. Physiol. Pharmacol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1483","DOI":"10.1007\/s00296-014-3022-2","article-title":"Growth abnormalities in children and adolescents with juvenile idiopathic arthritis","volume":"34","author":"Bechtold","year":"2014","journal-title":"Rheumatol. Int."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"14","DOI":"10.3109\/03009749709065658","article-title":"Growth retardation and bone loss as determinants of axial osteopenia in juvenile chronic arthritis","volume":"26","author":"Kotaniemi","year":"1997","journal-title":"Scand. J. Rheumatol."},{"key":"ref_8","first-page":"1296","article-title":"Linear growth and final height in patients with systemic juvenile idiopathic arthritis treated with longterm glucocorticoids","volume":"29","author":"Simon","year":"2002","journal-title":"J. Rheumatol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2214","DOI":"10.1002\/art.11097","article-title":"Frequency of osteopenia in adolescents with early-onset juvenile idiopathic arthritis: A long-term outcome study of one hundred five patients","volume":"48","author":"Lien","year":"2003","journal-title":"Arthritis Rheum."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1210\/jc.2009-0979","article-title":"Dynamics of Body Composition and Bone in Patients with Juvenile Idiopathic Arthritis Treated with Growth Hormone","volume":"95","author":"Bechtold","year":"2010","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1002\/art.20963","article-title":"A two-year prospective controlled study of bone mass and bone turnover in children with early juvenile idiopathic arthritis","volume":"52","author":"Lien","year":"2005","journal-title":"Arthritis Rheum."},{"key":"ref_12","first-page":"227","article-title":"Relationship between bone mineral content and growth disorders in children with juvenile idiopathic arthritis","volume":"24","author":"Urban","year":"2008","journal-title":"Pol. Merkur. Lekarski"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Brabnikova Maresova, K., Jarosova, K., Pavelka, K., and Stepan, J.J. (2014). The association between lean mass and bone mineral content in the high disease activity group of adult patients with juvenile idiopathic arthritis. BMC Musculoskelet. Disord., 15.","DOI":"10.1186\/1471-2474-15-51"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"165","DOI":"10.3109\/03009749209099216","article-title":"Nutrient intake and nutritional status in children with juvenile chronic arthritis","volume":"21","author":"Haugen","year":"1992","journal-title":"Scand. J. Rheumatol."},{"key":"ref_15","first-page":"637","article-title":"Dietary intake and serum concentrations of antioxidants in children with juvenile arthritis","volume":"18","author":"Helgeland","year":"2000","journal-title":"Clin. Exp. Rheumatol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1172","DOI":"10.1093\/rheumatology\/41.10.1172","article-title":"Measuring the nutritional status of children with juvenile idiopathic arthritis using the bioelectrical impedance method","volume":"41","author":"Lofthouse","year":"2002","journal-title":"Rheumatology"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1186\/s12969-018-0297-y","article-title":"Body composition and phase angle as an indicator of nutritional status in children with juvenile idiopathic arthritis","volume":"16","year":"2018","journal-title":"Pediatr. Rheumatol."},{"key":"ref_18","first-page":"13","article-title":"Natural history of growth and body composition in juvenile idiopathic arthritis","volume":"72","author":"Bechtold","year":"2009","journal-title":"Horm. Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1186\/s12969-017-0196-7","article-title":"Growth and weight gain in children with juvenile idiopathic arthritis: Results from the ReACCh-Out cohort","volume":"15","author":"Guzman","year":"2017","journal-title":"Pediatr. Rheumatol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1569","DOI":"10.1093\/rheumatology\/keh387","article-title":"Nutritional impairment in juvenile idiopathic arthritis","volume":"43","author":"Cleary","year":"2004","journal-title":"Rheumatology"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1002\/art.10799","article-title":"Minor impact of juvenile arthritis on nutritional status in young adult patients","volume":"47","author":"Haugen","year":"2002","journal-title":"Arthritis Care Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1550","DOI":"10.1093\/rheumatology\/keq123","article-title":"Etanercept improves linear growth and bone mass acquisition in MTX-resistant polyarticular-course juvenile idiopathic arthritis","volume":"49","author":"Billiau","year":"2010","journal-title":"Rheumatology"},{"key":"ref_23","first-page":"1110","article-title":"Disease activity, overweight, physical activity and screen time in a cohort of patients with juvenile idiopathic arthritis","volume":"36","author":"Sherman","year":"2018","journal-title":"Clin. Exp. Rheumatol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1186\/1546-0096-10-3","article-title":"Obesity and disease activity in juvenile idiopathic arthritis","volume":"10","author":"Pelajo","year":"2012","journal-title":"Pediatr. Rheumatol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"488","DOI":"10.3109\/03009742.2014.918171","article-title":"Juvenile idiopathic arthritis patients with low inflammatory activity have increased adiposity","volume":"43","author":"Kaartoaho","year":"2014","journal-title":"Scand. J. Rheumatol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"288","DOI":"10.3109\/03009742.2014.999351","article-title":"Prevalence of overweight in children and adolescents with juvenile idiopathic arthritis","volume":"44","author":"Schenck","year":"2015","journal-title":"Scand. J. Rheumatol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"967","DOI":"10.1007\/s10067-012-1947-y","article-title":"Excess of adiposity in female children and adolescents with juvenile idiopathic arthritis","volume":"31","author":"Caetano","year":"2012","journal-title":"Clin. Rheumatol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1590\/S0021-75572009000600007","article-title":"Inadequate dietary intake of children and adolescents with juvenile idiopathic arthritis and systemic lupus erythematosus","volume":"85","author":"Caetano","year":"2009","journal-title":"J. Pediatr."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1016\/j.jbspin.2011.02.001","article-title":"Prevalence of overweight among Moroccan children and adolescents with juvenile idiopathic arthritis","volume":"78","author":"Amine","year":"2011","journal-title":"Jt. Bone Spine"},{"key":"ref_30","first-page":"190","article-title":"Association between body composition and disease activity in rheumatoid arthritis. A systematic review","volume":"12","year":"2016","journal-title":"Reumatol. Clin."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"411","DOI":"10.3899\/jrheum.170598","article-title":"Adiposity in juvenile psoriatic arthritis","volume":"45","author":"Samad","year":"2018","journal-title":"J. Rheumatol."},{"key":"ref_32","first-page":"307","article-title":"Is obesity in psoriatic arthritis associated with a poorer therapeutic response and more adverse effects of treatment with an anchor drug?","volume":"12","author":"Carmona","year":"2016","journal-title":"Reumatol. Clin."},{"key":"ref_33","first-page":"462","article-title":"Association between Overweight\/Obesity and Clinical Activity in Rheumatoid Arthritis","volume":"16","year":"2020","journal-title":"Reumatol. Clin."},{"key":"ref_34","first-page":"17","article-title":"Value of body mass index in the diagnosis of obesity according to DEXA in well-controlled RA patients","volume":"13","year":"2017","journal-title":"Reumatol. Clin."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1002\/jcsm.12320","article-title":"Prevalence of rheumatoid cachexia in rheumatoid arthritis: A systematic review and meta-analysis","volume":"9","author":"Santo","year":"2018","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1186\/ar2658","article-title":"Rheumatoid cachexia: A complication of rheumatoid arthritis moves into the 21st century","volume":"11","author":"Roubenoff","year":"2009","journal-title":"Arthritis Res. Ther."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1316","DOI":"10.1136\/ard.2006.060319","article-title":"Redefining overweight and obesity in rheumatoid arthritis patients","volume":"66","author":"Metsios","year":"2007","journal-title":"Ann. Rheum. Dis."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1111\/j.1475-097X.1991.tb00662.x","article-title":"Validation of body composition by dual energy X-ray absorptiometry (DEXA)","volume":"11","author":"Haarbo","year":"1991","journal-title":"Clin. Physiol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1440","DOI":"10.1038\/sj.ejcn.1602883","article-title":"An evaluation of patterns of change in total and regional body fat mass in healthy Spanish subjects using dual-energy X-ray absorptiometry (DXA)","volume":"62","author":"Henche","year":"2008","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1240","DOI":"10.1136\/bmj.320.7244.1240","article-title":"Establishing a standard definition for child overweight and obesity worldwide: International survey","volume":"320","author":"Cole","year":"2000","journal-title":"BMJ"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Taylor, A.E., Kuper, H., Varma, R.D., Wells, J.C., Bell, J.D., V Radhakrishna, K., Kulkarni, B., Kinra, S., Timpson, N.J., and Ebrahim, S. (2012). Validation of dual energy X-ray absorptiometry measures of abdominal fat by comparison with magnetic resonance imaging in an Indian population. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0051042"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1596","DOI":"10.2214\/AJR.20.22934","article-title":"Paravertebral Muscles as Indexes of Sarcopenia and Sarcopenic Obesity: Comparison With Imaging and Muscle Function Indexes and Impact on Cardiovascular and Metabolic Disorders","volume":"216","author":"Seo","year":"2021","journal-title":"Am. J. Roentgenol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1007\/s00198-005-1900-x","article-title":"Sarcopenia in premenopausal and postmenopausal women with osteopenia, osteoporosis and normal bone mineral density","volume":"17","author":"Walsh","year":"2006","journal-title":"Osteoporos. Int."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1186\/s12969-016-0085-5","article-title":"Clinical outcome measures in juvenile idiopathic arthritis","volume":"14","author":"Consolaro","year":"2016","journal-title":"Pediatr. Rheumatol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1002\/art.24516","article-title":"Development and validation of a composite disease activity score for juvenile idiopathic arthritis","volume":"61","author":"Consolaro","year":"2009","journal-title":"Arthritis Rheum."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1093\/rheumatology\/ket310","article-title":"Interpretation of the Juvenile Arthritis Disease Activity Score: Responsiveness, clinically important differences and levels of disease activity in prospective cohorts of patients with juvenile idiopathic arthritis","volume":"53","author":"Vastert","year":"2014","journal-title":"Rheumatology"},{"key":"ref_47","first-page":"S1","article-title":"Cross-cultural adaptation and psychometric evaluation of the Childhood Health Assessment Questionnaire (CHAQ) and the Child Health Questionnaire (CHQ) in 32 countries. Review of the general methodology","volume":"19","author":"Ruperto","year":"2001","journal-title":"Clin. Exp. Rheumatol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1123\/pes.9.4.342","article-title":"Convergent validity of the Physical Activity Questionnaire for Adolescents","volume":"9","author":"Kowalski","year":"1997","journal-title":"Pediatr. Exerc. Sci."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"e044749","DOI":"10.1136\/bmjopen-2020-044749","article-title":"Cumulative inflammatory burden and obesity as determinants of insulin resistance in patients with established rheumatoid arthritis: Cross-sectional study","volume":"11","author":"Rioja","year":"2021","journal-title":"BMJ Open"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3389\/fphar.2019.00637","article-title":"The Influence of Overweight and Obesity on Treatment Response in Juvenile Idiopathic Arthritis","volume":"10","author":"Giani","year":"2019","journal-title":"Front. Pharmacol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1152\/japplphysiol.01234.2003","article-title":"Validity and reliability of dual-energy X-ray absorptiometry for the assessment of abdominal adiposity","volume":"97","author":"Glickman","year":"2004","journal-title":"J. Appl. Physiol."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"de Bont, J., Bennett, M., Le\u00f3n-Mu\u00f1oz, L.M., and Duarte-Salles, T. (2021). The prevalence and incidence rate of overweight and obesity among 2.5 million children and adolescents in Spain. Rev. Espa\u00f1ola Cardiol. (Engl. Ed.).","DOI":"10.1016\/j.rec.2021.07.002"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1007\/s12098-017-2292-6","article-title":"Inflammatory Markers and Disease Activity in Juvenile Idiopathic Arthritis","volume":"84","author":"Sarkar","year":"2017","journal-title":"Indian J. Pediatr."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1186\/s12969-020-00448-3","article-title":"Subclinical cardiovascular risk signs in adults with juvenile idiopathic arthritis in sustained remission","volume":"18","year":"2020","journal-title":"Pediatric Rheumatol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/17\/3949\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:53:34Z","timestamp":1760165614000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/17\/3949"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,31]]},"references-count":54,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2021,9]]}},"alternative-id":["jcm10173949"],"URL":"https:\/\/doi.org\/10.3390\/jcm10173949","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,31]]}}}