{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:31:36Z","timestamp":1760149896456,"version":"build-2065373602"},"reference-count":58,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T00:00:00Z","timestamp":1695945600000},"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>The aim of this work was to investigate the relationship foot pain and foot disability have with HRQoL in groups of women with RA, SLE and EDS, in comparison with a control group. A cross-sectional study was carried out with females with one of these conditions and a control group. The SF-12 questionnaire was used to collect data about quality of life. The type of foot was classified according to the footprint and the foot posture index. A total of 156 patients and 47 controls participated in the study (N = 203). Neither pain nor foot posture were different between groups. The physical and mental components of SF-12 were worse in rheumatoid arthritis and Ehlers\u2013Danlos syndrome patients, and the physical component was worse in systemic lupus erythematosus patients, compared to controls. A significant difference was also observed in the mental component between systemic lupus erythematosus and Ehlers\u2013Danlos syndrome patients, the latter having the lowest values among the groups. We can conclude that women with rheumatoid arthritis, Ehlers\u2013Danlos syndrome, systemic lupus erythematosus and foot pain perceive a worse quality of life. There are no significant changes in foot posture. Pain and health-related quality of life are independent of foot posture.<\/jats:p>","DOI":"10.3390\/jcm12196284","type":"journal-article","created":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T05:48:13Z","timestamp":1695966493000},"page":"6284","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Foot Pain and Disability in Women with Rheumatoid Arthritis, Ehlers\u2013Danlos Syndrome and Systemic Lupus Erythematosus: Relationship with Quality of Life"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9901-8937","authenticated-orcid":false,"given":"Inmaculada C.","family":"Palomo-Toucedo","sequence":"first","affiliation":[{"name":"Department of Podiatry, University of Seville, Calle Avicena, s\/n., 41009 Seville, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8549-7703","authenticated-orcid":false,"given":"Gabriel","family":"Dom\u00ednguez-Maldonado","sequence":"additional","affiliation":[{"name":"Department of Podiatry, University of Seville, Calle Avicena, s\/n., 41009 Seville, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9316-8942","authenticated-orcid":false,"given":"Mar\u00eda","family":"Reina-Bueno","sequence":"additional","affiliation":[{"name":"Department of Podiatry, University of Seville, Calle Avicena, s\/n., 41009 Seville, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8217-7664","authenticated-orcid":false,"given":"Mar\u00eda del Carmen","family":"V\u00e1zquez-Bautista","sequence":"additional","affiliation":[{"name":"Department of Podiatry, University of Seville, Calle Avicena, s\/n., 41009 Seville, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7859-1849","authenticated-orcid":false,"given":"Javier","family":"Ramos-Ortega","sequence":"additional","affiliation":[{"name":"Department of Podiatry, University of Seville, Calle Avicena, s\/n., 41009 Seville, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 Manuel","family":"Castillo-L\u00f3pez","sequence":"additional","affiliation":[{"name":"Department of Podiatry, University of Seville, Calle Avicena, s\/n., 41009 Seville, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5708-4178","authenticated-orcid":false,"given":"Pedro V.","family":"Munuera-Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Department of Podiatry, University of Seville, Calle Avicena, s\/n., 41009 Seville, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,9,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1002\/acr.24526","article-title":"Altered Multisegment Ankle and Foot Kinematics During Gait in Patients With Hypermobile Ehlers-Danlos Syndrome\/Hypermobility Spectrum Disorder: A Case-Control Study","volume":"74","author":"Vermeulen","year":"2022","journal-title":"Arthritis Care Res."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"363","DOI":"10.3109\/03009742.2015.1110198","article-title":"Effectiveness of insole use in rheumatoid feet: A randomized controlled trial","volume":"45","author":"Moreira","year":"2016","journal-title":"Scand. J. Rheumatol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1177\/0961203316670730","article-title":"The prevalence of self-reported lower limb and foot health problems experienced by participants with systemic lupus erythematosus: Results of a UK national survey","volume":"26","author":"Cherry","year":"2017","journal-title":"Lupus"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1186\/s13047-017-0229-y","article-title":"Prevalence, impact and care of foot problems in people with rheumatoid arthritis: Results from a United Kingdom based cross-sectional survey","volume":"10","author":"Wilson","year":"2017","journal-title":"J. Foot Ankle Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/s13047-016-0143-8","article-title":"Patterns of foot complaints in systemic lupus erythematosus: A cross sectional survey","volume":"9","author":"Otter","year":"2016","journal-title":"J. Foot Ankle Res."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Reina-Bueno, M., V\u00e1zquez-Bautista, C., Palomo-Toucedo, I.C., Dom\u00ednguez-Maldonado, G., Castillo-L\u00f3pez, J.M., and Munuera-Mart\u00ednez, P.V. (2020). Custom-Made Foot Orthoses Reduce Pain and Fatigue in Patients with Ehlers-Danlos Syndrome. A Pilot Study. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17041359"},{"key":"ref_7","first-page":"1555","article-title":"PARE0010 Significance of foot problems for patients with rheumatoid arthritis: A patient-led qualitative study","volume":"76","author":"Lempp","year":"2017","journal-title":"Ann. Reum. Dis."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"3720","DOI":"10.1016\/j.ridd.2013.07.040","article-title":"Research in Developmental Disabilities Plantar pressure patterns in women affected by Ehlers\u2014Danlos syndrome while standing and walking","volume":"34","author":"Pau","year":"2013","journal-title":"Res. Dev. Disabil."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"751768","DOI":"10.5402\/2012\/751768","article-title":"Ehlers-Danlos Syndrome, Hypermobility Type: An Underdiagnosed Hereditary Connective Tissue Disorder with Mucocutaneous, Articular, and Systemic Manifestations","volume":"2012","author":"Castori","year":"2012","journal-title":"ISRN Dermatol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1174","DOI":"10.1177\/0961203317696590","article-title":"Patients\u2019 experiences of lupus-related foot problems: A qualitative investigation","volume":"26","author":"Williams","year":"2017","journal-title":"Lupus"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1177\/0961203306071710","article-title":"A review of health related quality of life in systemic lupus erythematosus","volume":"15","author":"McElhone","year":"2006","journal-title":"Lupus"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1186\/s13047-019-0335-0","article-title":"Work participation, mobility and foot symptoms in people with systemic lupus erythematosus: Findings of a UK national survey","volume":"12","author":"Stevens","year":"2019","journal-title":"J. Foot Ankle Res."},{"key":"ref_13","first-page":"165","article-title":"The Effects of off-the-Shelf Foot Orthoses on the Quality of Life of Patients Diagnosed with Early Rheumatoid Arthritis","volume":"3","author":"Santos","year":"2015","journal-title":"Clin. Res. Foot Ankle"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1007\/s00296-018-4014-4","article-title":"The effectiveness of therapeutic shoes in patients with rheumatoid arthritis: A systematic review and meta-analysis","volume":"38","year":"2018","journal-title":"Rheumatol. Int."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1080\/09638280802239441","article-title":"Influence of foot orthoses on plantar pressures, foot pain and walking ability of rheumatoid arthritis patients\u2014A randomised controlled study","volume":"31","author":"Novak","year":"2009","journal-title":"Disabil. Rehabil."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e12380","DOI":"10.1111\/opn.12380","article-title":"Self-assessed foot health in older people with rheumatoid arthritis\u2014A cross-sectional study","volume":"16","author":"Stolt","year":"2021","journal-title":"Int. J. Older People Nurs."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Perisano, C., Cannella, A., Polichetti, C., Mascio, A., Comisi, C., De Santis, V., Caravelli, S., Mosca, M., Spedicato, G.A., and Maccauro, G. (2023). Tibiotalar and Tibiotalocalcaneal Arthrodesis with Paragon28 SilverbackTM Plating System in Patients with Severe Ankle and Hindfoot Deformity. Medicina, 59.","DOI":"10.3390\/medicina59020344"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1080\/14397595.2019.1589921","article-title":"Relationship of callosities of the forefoot with foot deformity, Health Assessment Questionnaire Disability Index, and joint damage score in patients with rheumatoid arthritis","volume":"30","author":"Mochizuki","year":"2020","journal-title":"Mod. Rheumatol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"610","DOI":"10.7547\/8750-7315-104.6.610","article-title":"Effects of Off-the-Shelf Foot Orthoses on Plantar Foot Pressures in Patients with Early Rheumatoid Arthritis","volume":"104","author":"Santos","year":"2014","journal-title":"J. Am. Podiatr. Med. Assoc."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1016\/j.jpainsymman.2009.12.026","article-title":"Pain in Ehlers-Danlos Syndrome is common, severe, and associated with functional impairment","volume":"40","author":"Voermans","year":"2010","journal-title":"J. Pain Symptom Manag."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1080\/09638280400009352","article-title":"Foot pain and disability in individuals with Ehlers-Danlos syndrome (EDS): Impact on daily life activities","volume":"27","author":"Berglund","year":"2005","journal-title":"Disabil. Rehabil."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1339","DOI":"10.3109\/09638280903514739","article-title":"Musculoskeletal complaints, physical activity and health-related quality of life among patients with the EhlersDanlos syndrome hypermobility type","volume":"32","author":"Rombaut","year":"2010","journal-title":"Disabil. Rehabil."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"588","DOI":"10.7547\/8750-7315-104.6.588","article-title":"Foot type analysis based on electronic pedobarography data in individuals with joint hypermobility syndrome\/Ehlers-Danlos syndrome hypermobility type during upright standing","volume":"104","author":"Cimolin","year":"2014","journal-title":"J. Am. Podiatr. Med. Assoc."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/S0020-7489(99)00067-X","article-title":"Living a restricted life with Ehlers-Danlos Syndrome (EDS)","volume":"37","author":"Berglund","year":"2000","journal-title":"Int. J. Nurs. Stud."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1093\/rheumatology\/ket376","article-title":"Ultrasound evaluation of hand, wrist and foot joint synovitis in systemic lupus erythematosus","volume":"53","author":"Iagnocco","year":"2014","journal-title":"Rheumatology"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1016\/j.semarthrit.2018.07.002","article-title":"Foot and ankle characteristics in systemic lupus erythematosus: A systematic review and meta-analysis","volume":"48","author":"Stewart","year":"2019","journal-title":"Semin. Arthritis Rheum."},{"key":"ref_27","first-page":"609","article-title":"The feet in systemic lupus erythematosus; are we underestimating their involvement and functional impact?","volume":"34","author":"Valor","year":"2016","journal-title":"Clin. Exp. Rheumatol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1186\/s13047-016-0158-1","article-title":"A pilot investigation of the prevalence of US-detectable forefoot joint pathology and reported foot-related disability in participants with systemic lupus erythematosus","volume":"9","author":"Mukherjee","year":"2016","journal-title":"J. Foot Ankle Res."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1002\/art.1780310302","article-title":"The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis","volume":"31","author":"Arnett","year":"1988","journal-title":"Arthritis Rheum."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1002\/(SICI)1096-8628(19980428)77:1<31::AID-AJMG8>3.0.CO;2-O","article-title":"Ehlers-Danlos syndromes: Revised nosology, Villefranche, 1997. Ehlers-Danlos National Foundation (USA) and Ehlers-Danlos Support Group (UK)","volume":"77","author":"Beighton","year":"1998","journal-title":"Am. J. Med. Genet."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1725","DOI":"10.1002\/art.1780400928","article-title":"Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus","volume":"40","author":"Hochberg","year":"1997","journal-title":"Arthritis Rheum."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.clinbiomech.2005.08.002","article-title":"Development and validation of a novel rating system for scoring standing foot posture: The Foot Posture Index","volume":"21","author":"Redmond","year":"2006","journal-title":"Clin. Biomech."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.foot.2007.06.006","article-title":"Minimal important difference: Values for the Foot Health Status Questionnaire, Foot Function Index and Visual Analogue Scale","volume":"18","author":"Landorf","year":"2008","journal-title":"Foot"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.fas.2013.09.005","article-title":"Cross-cultural adaptation and validation of the Foot Function Index to Spanish","volume":"20","year":"2014","journal-title":"Foot Ankle Surg."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1007\/s11136-013-0507-5","article-title":"Cross-cultural adaptation and validation of the Manchester Foot Pain and Disability Index into Spanish","volume":"23","author":"Ndosi","year":"2014","journal-title":"Qual. Life Res."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1275","DOI":"10.4067\/S0034-98872014001000007","article-title":"Evaluaci\u00f3n del cuestionario SF-12: Verificaci\u00f3n de la utilidad de la escala de salud mental","volume":"142","author":"Silva","year":"2014","journal-title":"Rev. Med. Chil."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1177\/0309364612447097","article-title":"Effect of custom-made foot orthoses in female hallux valgus after one-year follow up","volume":"37","author":"Reina","year":"2013","journal-title":"Prosthet. Orthot. Int."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1016\/0021-9290(87)90255-7","article-title":"The arch index: A useful measure from footprints","volume":"20","author":"Cavanagh","year":"1987","journal-title":"J. Biomech."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.repod.2017.03.008","article-title":"Relaci\u00f3n de la calidad de vida y los autocuidados podol\u00f3gicos con las complicaciones asociadas a la diabetes. Estudio descriptivo","volume":"28","year":"2017","journal-title":"Rev. Espa\u00f1ola Podol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1177\/107110070402500105","article-title":"Health-Related Quality of Life for Patients with Rheumatoid Arthritis Foot Involvement","volume":"25","author":"Wickman","year":"2004","journal-title":"Foot Ankle Int."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1186\/1471-2474-10-67","article-title":"The impact of rheumatoid foot on disability in Colombian patients with rheumatoid arthritis","volume":"10","author":"Bayona","year":"2009","journal-title":"BMC Musculoskelet. Disord."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"e036903","DOI":"10.1136\/bmjopen-2020-036903","article-title":"Foot health and quality of life in patients with rheumatoid arthritis: A cross-sectional study","volume":"10","year":"2020","journal-title":"BMJ Open"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1979","DOI":"10.1002\/art.30337","article-title":"Impairment and impact of pain in female patients with Ehlers-Danlos syndrome: A comparative study with fibromyalgia and rheumatoid arthritis","volume":"63","author":"Rombaut","year":"2011","journal-title":"Arthritis Rheum."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1515","DOI":"10.1007\/s00296-010-1700-2","article-title":"Comparison of foot pain and foot care among rheumatoid arthritis patients taking and not taking anti-TNFalpha therapy: An epidemiological study","volume":"31","author":"Otter","year":"2011","journal-title":"Rheumatol. Int."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/1757-1146-6-5","article-title":"A review of the foot function index and the foot function index\u2014Revised","volume":"6","author":"Conrad","year":"2013","journal-title":"J. Foot Ankle Res."},{"key":"ref_46","first-page":"1377","article-title":"A randomized controlled trial of foot orthoses in rheumatoid arthritis","volume":"2929","author":"Woodburn","year":"2002","journal-title":"J. Rheumatol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1093\/rheumatology\/kei186","article-title":"Forefoot joint damage, pain and disability in rheumatoid arthritis patients with foot complaints: The role of plantar pressure and gait characteristics","volume":"45","author":"Steultjens","year":"2006","journal-title":"Rheumatology"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1011","DOI":"10.1177\/0269215521993316","article-title":"The effect of foot orthoses on balance, foot function, and mobility in rheumatoid arthritis: A randomized controlled clinical trial","volume":"35","author":"Gaino","year":"2021","journal-title":"Clin. Rehabil."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1641","DOI":"10.1002\/acr.21794","article-title":"Quantitative assessment of foot structure in rheumatoid arthritis by a foot digitizer: Detection of deformities even in the absence of erosions","volume":"64","author":"Mielants","year":"2012","journal-title":"Arthritis Care Res."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1080\/03009742.2016.1196500","article-title":"Clinical effectiveness and cost-effectiveness of foot orthoses for people with established rheumatoid arthritis: An exploratory clinical trial","volume":"46","author":"Rome","year":"2017","journal-title":"Scand. J. Rheumatol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1177\/0309364613498537","article-title":"Effect of rocker shoes on pain, disability and activity limitation in patients with rheumatoid arthritis","volume":"38","author":"Ghasemi","year":"2014","journal-title":"Prosthet. Orthot. Int."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1093\/rheumatology\/ket337","article-title":"Kinematic, kinetic and electromyographic response to customized foot orthoses in patients with tibialis posterior tenosynovitis, pes plano valgus and rheumatoid arthritis","volume":"53","author":"Barn","year":"2014","journal-title":"Rheumatology"},{"key":"ref_53","first-page":"480","article-title":"To what extent is foot pain related to biomechanical changes and ultrasound-detected abnormalities in rheumatoid arthritis?","volume":"34","author":"Valor","year":"2016","journal-title":"Clin. Exp. Rheumatol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1002\/acr.23832","article-title":"Objectively Assessed Foot and Ankle Characteristics in Patients With Systemic Lupus Erythematosus: A Comparison with Age- and Sex-Matched Controls","volume":"72","author":"Stewart","year":"2020","journal-title":"Arthritis Care Res."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1007\/s10067-005-0115-z","article-title":"Foot deformities in rheumatoid arthritis and relevance of foot function index","volume":"25","author":"Bal","year":"2006","journal-title":"Clin. Rheumatol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1111\/j.1756-185X.2010.01465.x","article-title":"Foot deformities in patients with rheumatoid arthritis: The relationship with foot functions","volume":"13","author":"Adibelli","year":"2010","journal-title":"Int. J. Rheum. Dis."},{"key":"ref_57","first-page":"48","article-title":"Analysis of Foot Structural Damage in Rheumatoid Arthritis: Clinical Evaluation by Validated Measures and Serological Correlations","volume":"61","author":"Biscontini","year":"2009","journal-title":"Reumatismo"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1186\/s13047-019-0328-z","article-title":"\u00abcome and live with my feet and you\u2019ll understand\u00bb\u2014A qualitative study exploring the experiences of retail footwear in women with rheumatoid arthritis","volume":"12","author":"Tehan","year":"2019","journal-title":"J. Foot Ankle Res."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/19\/6284\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:01:46Z","timestamp":1760130106000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/19\/6284"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,29]]},"references-count":58,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2023,10]]}},"alternative-id":["jcm12196284"],"URL":"https:\/\/doi.org\/10.3390\/jcm12196284","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2023,9,29]]}}}