{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T19:03:22Z","timestamp":1784919802143,"version":"3.55.0"},"reference-count":53,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,2,1]],"date-time":"2023-02-01T00:00:00Z","timestamp":1675209600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>This study was aimed at evaluating knee stabilizer (quadriceps and hamstring) muscle strength and the medio-lateral symmetry of hamstring fatigue in football players after ACL reconstruction and with mild lower extremity injuries. The study comprised 65 professional football players who were divided into three groups: Group 1 (n = 24; 22.7 \u00b1 3.6 years; 175 \u00b1 4 cm; 77.3 \u00b1 7.6 kg) after ACL reconstruction, Group 2 (n = 21; 20.5 \u00b1 3.7 years; 177 \u00b1 6 cm; 74.3 \u00b1 9.1 kg) with mild lower-limb injuries (grade 1 muscle strains) and Group 3 (n = 20; 23.1 \u00b1 2.8 years; 178 \u00b1 6 cm; 75.8 \u00b1 8.8 kg) without injuries in the past 3 years. The concentric isokinetic test (10 knee flexions and extensions at 60, 180 and 300\u00b0\/s with a 30 s interval for rest) was performed on both limbs. Fatigue symmetry between the medial and lateral hamstrings was measured with sEMG during 60 s of isometric contractions. In comparison to the other groups, the injured leg demonstrated significantly lower values of peak torque for the quadriceps (G1\u2013G2 = 48%, 38%, 14%; G1\u2013G3 = 49%, 25%, 14%) and hamstring muscles (G1\u2013G2 = 36%, 35%, 18%; G1\u2013G3 = 64%, 28%, 17%) as well as lower values of hamstring muscle work (G1\u2013G2 = 262 J, 157 J; G1\u2013G3 = 219 J, 179 J) and power (G1\u2013G2 = 34 W; 11 W; G1\u2013G3 = 29 W, 12 W). No significant differences were noted in strength between Groups 2 and 3. The significantly higher fatigue of the BF compared to the SEM muscle was seen in Group 1 for the involved (mean difference = 0.12) and uninvolved limbs (mean difference = \u22120.10), but in Group 2, a non-significant trend towards asymmetry was also noted. No asymmetry in hamstring muscle fatigue was determined in Group 3. The results of our study allow us to indicate that active football players who previously met the RTS criteria, had deficits in lower-limb muscle performance 2\u20133 years after reconstruction, which could lead to ACL re-injury. This observation is potentially of importance because these deficits may not be subjectively reported by such athletes and also may not be visible in regular orthopedic and physiotherapeutic assessment.<\/jats:p>","DOI":"10.3390\/jcm12031144","type":"journal-article","created":{"date-parts":[[2023,2,1]],"date-time":"2023-02-01T04:27:02Z","timestamp":1675225622000},"page":"1144","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["The Evaluation of Asymmetry in Isokinetic and Electromyographic Activity (sEMG) of the Knee Flexor and Extensor Muscles in Football Players after ACL Rupture Reconstruction and in the Athletes following Mild Lower-Limb Injuries"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0589-0554","authenticated-orcid":false,"given":"\u0141ukasz","family":"Oleksy","sequence":"first","affiliation":[{"name":"Faculty of Health Sciences, Department of Physiotherapy, Jagiellonian University Medical College Krakow, 31-008 Krakow, Poland"},{"name":"Oleksy Medical & Sports Sciences, 37-100 \u0141a\u0144cut, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4366-5091","authenticated-orcid":false,"given":"Anna","family":"Mika","sequence":"additional","affiliation":[{"name":"Institute of Clinical Rehabilitation, University of Physical Education in Krak\u00f3w, al. Jana Paw\u0142a II 78, 31-571 Krak\u00f3w, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1025-0508","authenticated-orcid":false,"given":"Iwona","family":"Sulowska-Daszyk","sequence":"additional","affiliation":[{"name":"Institute of Clinical Rehabilitation, University of Physical Education in Krak\u00f3w, al. Jana Paw\u0142a II 78, 31-571 Krak\u00f3w, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renata","family":"Kielnar","sequence":"additional","affiliation":[{"name":"Institute of Health Sciences, Medical College of Rzesz\u00f3w University, 35-315 Rzesz\u00f3w, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zofia","family":"Dzi\u0119cio\u0142-Anikiej","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Medical University of Bialystok, 24A M. Sk\u0142odowskiej-Curie St, 15-276 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3044-3422","authenticated-orcid":false,"given":"Joanna","family":"Zyznawska","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Department of Physiotherapy, Jagiellonian University Medical College Krakow, 31-008 Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1875-2510","authenticated-orcid":false,"given":"Olga","family":"Adamska","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Rehabilitation, Medical Faculty, Medical University of Warsaw, 02-091 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5633-8153","authenticated-orcid":false,"given":"Artur","family":"Stolarczyk","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Rehabilitation, Medical Faculty, Medical University of Warsaw, 02-091 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Theisen, D., Rada, I., Brau, A., Gette, P., and Seil, R. (2016). Muscle Activity Onset Prior to Landing in Patients after Anterior Cruciate Ligament Injury: A Systematic Review and Meta-Analysis. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0155277"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/j.knee.2015.07.007","article-title":"Different roles of the medial and lateral hamstrings in unloading the anterior cruciate ligament","volume":"23","author":"Guelich","year":"2016","journal-title":"Knee"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1136\/bjsports-2015-095908","article-title":"Likelihood of ACL graft rupture: Not meeting six clinical discharge criteria before return to sport is associated with a four times greater risk of rupture","volume":"50","author":"Kyritsis","year":"2016","journal-title":"Br. J. Sport. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1697","DOI":"10.1016\/j.arthro.2011.09.009","article-title":"Factors used to determine return to unrestricted sports activities after anterior cruciate ligament reconstruction","volume":"27","author":"Noyes","year":"2011","journal-title":"Arthroscopy"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1861","DOI":"10.1177\/0363546515621554","article-title":"Risk of Secondary Injury in Younger Athletes After Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis","volume":"44","author":"Wiggins","year":"2016","journal-title":"Am. J. Sport. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1177\/0363546506298277","article-title":"A 6-year follow-up of the effect of graft site on strength, stability, range of motion, function, and joint degeneration after anterior cruciate ligament reconstruction: Patellar tendon versus semitendinosus and Gracilis tendon graft","volume":"35","author":"Keays","year":"2007","journal-title":"Am. J. Sport. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1305","DOI":"10.1136\/bjsports-2014-093962","article-title":"Isokinetic muscle strength and readiness to return to sport following anterior cruciate ligament reconstruction: Is there an association? A systematic review and a protocol recommendation","volume":"49","author":"Undheim","year":"2015","journal-title":"Br. J. Sport. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1177\/0363546512459638","article-title":"Current concepts for injury prevention in athletes after anterior cruciate ligament reconstruction","volume":"41","author":"Hewett","year":"2013","journal-title":"Am. J. Sport. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1136\/bjsports-2012-091786","article-title":"Variables associated with return to sport following anterior cruciate ligament reconstruction: A systematic review","volume":"48","author":"Czuppon","year":"2014","journal-title":"Br. J. Sport. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"334","DOI":"10.2519\/jospt.2017.7285","article-title":"Limb Symmetry Indexes Can Overestimate Knee Function After Anterior Cruciate Ligament Injury","volume":"47","author":"Wellsandt","year":"2017","journal-title":"J. Orthop. Sport. Phys. Ther."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Kim, H.J., Lee, J.H., Ahn, S.E., Park, M.J., and Lee, D.H. (2016). Influence of Anterior Cruciate Ligament Tear on Thigh Muscle Strength and Hamstring-to-Quadriceps Ratio: A Meta-Analysis. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0146234"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1662","DOI":"10.1177\/0363546515578252","article-title":"Quadriceps Strength Asymmetry After Anterior Cruciate Ligament Reconstruction Alters Knee Joint Biomechanics and Functional Performance at Time of Return to Activity","volume":"43","author":"Lepley","year":"2015","journal-title":"Am. J. Sport. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"804","DOI":"10.1136\/bjsports-2016-096031","article-title":"Simple decision rules can reduce reinjury risk by 84% after ACL reconstruction: The Delaware-Oslo ACL cohort study","volume":"50","author":"Grindem","year":"2016","journal-title":"Br. J. Sport. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1016\/j.apmr.2013.07.028","article-title":"Is there a potential relationship between prior hamstring strain injury and increased risk for future anterior cruciate ligament injury?","volume":"95","author":"Opar","year":"2014","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1007\/s00256-003-0674-5","article-title":"Evaluation of the hamstring muscle complex following acute injury","volume":"32","author":"Koulouris","year":"2003","journal-title":"Skelet. Radiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1177\/0363546505284183","article-title":"Anterior cruciate ligament injuries in female athletes: Part 1, mechanisms and risk factors","volume":"34","author":"Hewett","year":"2006","journal-title":"Am. J. Sport. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"39","DOI":"10.11138\/jts\/2016.4.1.039","article-title":"An update on the grading of muscle injuries: A narrative review from clinical to comprehensive systems","volume":"4","author":"Grassi","year":"2016","journal-title":"Joints"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1016\/j.nmd.2007.03.014","article-title":"Isokinetic muscle testing for weak patients suffering from neuromuscular disorders: A reliability study","volume":"17","author":"Tiffreau","year":"2007","journal-title":"Neuromuscul. Disord."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1016\/S1050-6411(03)00022-1","article-title":"Test-retest reliability of EMG and peak torque during repetitive maximum concentric knee extensions","volume":"13","author":"Larsson","year":"2003","journal-title":"J. Electromyogr. Kinesiol."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Merletti, R., and Parker, P. (2004). Electromyography: Physiology, Engineering, and Non-Invasive Applications, Wiley-IEEE Press.","DOI":"10.1002\/0471678384"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1016\/S1050-6411(00)00027-4","article-title":"Development of recommendations for SEMG sensors and sensor placement procedures","volume":"10","author":"Hermens","year":"2000","journal-title":"J. Electromyogr. Kinesiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1016\/j.clinbiomech.2009.01.010","article-title":"Surface EMG based muscle fatigue evaluation in biomechanics","volume":"24","author":"Cifrek","year":"2009","journal-title":"Clin. Biomech."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1016\/j.jelekin.2007.01.006","article-title":"Correlations between short-time Fourier- and continuous wavelet transforms in the analysis of localized back and hip muscle fatigue during isometric contractions","volume":"18","author":"Coorevits","year":"2008","journal-title":"J. Electromyogr. Kinesiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"863","DOI":"10.3389\/fpsyg.2013.00863","article-title":"Calculating and reporting effect sizes to facilitate cumulative science: A practical primer for t-tests and ANOVAs","volume":"4","author":"Lakens","year":"2013","journal-title":"Front. Psychol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1177\/0363546510384798","article-title":"Return to the preinjury level of competitive sport after anterior cruciate ligament reconstruction surgery: Two-thirds of patients have not returned by 12 months after surgery","volume":"39","author":"Ardern","year":"2011","journal-title":"Am. J. Sport. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1136\/bjsm.2010.076364","article-title":"Return to sport following anterior cruciate ligament reconstruction surgery: A systematic review and meta-analysis of the state of play","volume":"45","author":"Ardern","year":"2011","journal-title":"Br. J. Sport. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1798","DOI":"10.1007\/s00167-011-1669-8","article-title":"Muscle strength and hop performance criteria prior to return to sports after ACL reconstruction","volume":"19","author":"Kaplan","year":"2011","journal-title":"Knee Surg. Sport. Traumatol. Arthrosc."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1007\/s00167-010-1357-0","article-title":"The influence of graft choice on isokinetic muscle strength 4-24 months after anterior cruciate ligament reconstruction","volume":"19","author":"Xergia","year":"2011","journal-title":"Knee Surg. Sport. Traumatol. Arthrosc."},{"key":"ref_29","first-page":"262","article-title":"Strength, Functional Outcome, and Postural Stability After Anterior Cruciate Ligament Reconstruction","volume":"37","author":"Mattacola","year":"2002","journal-title":"J. Athl. Train."},{"key":"ref_30","first-page":"352","article-title":"Rationale and Clinical Techniques for Anterior Cruciate Ligament Injury Prevention Among Female Athletes","volume":"39","author":"Myer","year":"2004","journal-title":"J. Athl. Train."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1128","DOI":"10.1007\/s00167-009-1027-2","article-title":"Evidence-based rehabilitation following anterior cruciate ligament reconstruction","volume":"18","author":"Holla","year":"2010","journal-title":"Knee Surg. Sport. Traumatol. Arthrosc."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"396","DOI":"10.4085\/1062-6050-47.4.01","article-title":"Quadriceps and hamstrings coactivation during common therapeutic exercises","volume":"47","author":"Begalle","year":"2012","journal-title":"J. Athl. Train."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1002\/jor.1100080107","article-title":"An in vitro study of anterior cruciate ligament strain induced by quadriceps and hamstrings forces","volume":"8","author":"Draganich","year":"1990","journal-title":"J. Orthop. Res."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1177\/036354659202000311","article-title":"Anterior-posterior and rotational displacement of the tibia elicited by quadriceps contraction","volume":"20","author":"Hirokawa","year":"1992","journal-title":"Am. J. Sport. Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1016\/S0021-9290(98)00181-X","article-title":"The importance of quadriceps and hamstring muscle loading on knee kinematics and in-situ forces in the ACL","volume":"32","author":"Li","year":"1999","journal-title":"J. Biomech."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"557","DOI":"10.2106\/00004623-199072040-00014","article-title":"Direct measurement of resultant forces in the anterior cruciate ligament. An in vitro study performed with a new experimental technique","volume":"72","author":"Markolf","year":"1990","journal-title":"J. Bone Jt. Surg. Am."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"396","DOI":"10.4085\/1062-6050-43.4.396","article-title":"Mechanisms of noncontact anterior cruciate ligament injury","volume":"43","author":"Shimokochi","year":"2008","journal-title":"J. Athl. Train."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"815","DOI":"10.2106\/JBJS.F.01352","article-title":"Effect of varying hamstring tension on anterior cruciate ligament strain during in vitro impulsive knee flexion and compression loading","volume":"90","author":"Withrow","year":"2008","journal-title":"J. Bone Jt. Surg. Am."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1417","DOI":"10.1007\/s00402-014-1992-x","article-title":"Return to play following ACL reconstruction: A systematic review about strength deficits","volume":"134","author":"Petersen","year":"2014","journal-title":"Arch. Orthop. Trauma. Surg."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1177\/03635465980260021201","article-title":"A new concept for isokinetic hamstring: Quadriceps muscle strength ratio","volume":"26","author":"Aagaard","year":"1998","journal-title":"Am. J. Sport. Med."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"2230","DOI":"10.1177\/0363546512457348","article-title":"The Swedish National Anterior Cruciate Ligament Register: A report on baseline variables and outcomes of surgery for almost 18,000 patients","volume":"40","author":"Samuelsson","year":"2012","journal-title":"Am. J. Sport. Med."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1500","DOI":"10.1177\/0363546507301258","article-title":"Magnetic resonance imaging parameters for assessing risk of recurrent hamstring injuries in elite athletes","volume":"35","author":"Koulouris","year":"2007","journal-title":"Am. J. Sport. Med."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"930","DOI":"10.1002\/jor.1100130618","article-title":"Combined knee loading states that generate high anterior cruciate ligament forces","volume":"13","author":"Markolf","year":"1995","journal-title":"J. Orthop. Res."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1177\/036354659302100212","article-title":"Hamstrings--an anterior cruciate ligament protagonist. An in vitro study","volume":"21","author":"More","year":"1993","journal-title":"Am. J. Sport. Med."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1177\/036354658601400114","article-title":"Strain within the anterior cruciate ligament during hamstring and quadriceps activity","volume":"14","author":"Arms","year":"1986","journal-title":"Am. J. Sport. Med."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1249\/MSS.0000000000001076","article-title":"Asymmetry and Thigh Muscle Coactivity in Fatigued Anterior Cruciate Ligament-Reconstructed Elite Skiers","volume":"49","author":"Jordan","year":"2017","journal-title":"Med. Sci. Sport. Exerc."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1177\/03635465990270030801","article-title":"Knee joint laxity and neuromuscular characteristics of male and female soccer and basketball players","volume":"27","author":"Rozzi","year":"1999","journal-title":"Am. J. Sport. Med."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1177\/0363546516664705","article-title":"Hamstring Strength Asymmetry at 3 Years After Anterior Cruciate Ligament Reconstruction Alters Knee Mechanics During Gait and Jogging","volume":"45","author":"Abourezk","year":"2017","journal-title":"Am. J. Sport. Med."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"444","DOI":"10.2519\/jospt.2015.5040","article-title":"Performance on the modified star excursion balance test at the time of return to sport following anterior cruciate ligament reconstruction","volume":"45","author":"Clagg","year":"2015","journal-title":"J. Orthop. Sport. Phys. Ther."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"2325967113518305","DOI":"10.1177\/2325967113518305","article-title":"Functional Performance Testing After Anterior Cruciate Ligament Reconstruction: A Systematic Review","volume":"2","author":"Abrams","year":"2014","journal-title":"Orthop. J. Sport. Med."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"911","DOI":"10.2519\/jospt.2006.2244","article-title":"Star excursion balance test as a predictor of lower extremity injury in high school basketball players","volume":"36","author":"Plisky","year":"2006","journal-title":"J. Orthop. Sport. Phys. Ther."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1177\/1941738113498703","article-title":"Dynamic balance performance and noncontact lower extremity injury in college football players: An initial study","volume":"5","author":"Butler","year":"2013","journal-title":"Sport. Health"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1773","DOI":"10.1002\/art.24066","article-title":"Muscle strength and functional performance in patients with anterior cruciate ligament injury treated with training and surgical reconstruction or training only: A two to five-year followup","volume":"59","author":"Ageberg","year":"2008","journal-title":"Arthritis Rheum."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/3\/1144\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:20:51Z","timestamp":1760120451000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/3\/1144"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,1]]},"references-count":53,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,2]]}},"alternative-id":["jcm12031144"],"URL":"https:\/\/doi.org\/10.3390\/jcm12031144","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,1]]}}}