{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T12:41:38Z","timestamp":1790685698626,"version":"4.1.0"},"reference-count":62,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2024,4,8]],"date-time":"2024-04-08T00:00:00Z","timestamp":1712534400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Chiropractic BioPhysics, NonProfit, Inc"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Forward head posture (FHP) and altered cervical lordotic curvatures are common spine displacements often associated with neck pain and disability. Two primary categories for determining FHP exist: radiographic and postural measurements. Methods: This study investigated the correlation between the craniovertebral angle (CVA), the radiographically measured C2\u2013C7 sagittal vertical axis (SVA), and cervical lordosis (absolute rotation angle: ARA C2\u2013C7) in a sample of participants with chronic myofascial pain (CMP). In 120 participants, we performed both a postural measurement of the CVA and a lateral cervical radiograph, where the C2\u2013C7 SVA and ARA C2\u2013C7 were measured. A linear-regression R2 value to assess the correlation between the CVA, C2\u2013C7 SVA, and ARA C2\u2013C7 was sought. Results: A statistically significant weak linear fit was identified (Spearman\u2019s r = 0.549; R2 = 0.30, p &lt; 0.001) between the CVA and C2\u2013C7 SVA, having considerable variation between the two measures. A statistically significant linear fit (very weak) was identified for the lordosis ARA C2\u2013C7 and the CVA: Spearman\u2019s r = 0.524; R2 = 0.275; p &lt; 0.001. A value of 50\u00b0 for the CVA corresponded to a value of 20 mm for the C2\u2013C7 SVA on an X-ray. Conclusion: While the CVA and radiographic C2\u2013C7 SVA are weakly correlated in an individual, they seem to represent different aspects of sagittal cervical balance. The CVA cannot replace radiographically measured cervical lordosis. We recommend that more emphasis be given to radiographic measures of sagittal cervical alignment than the CVA when considering patient interventions.<\/jats:p>","DOI":"10.3390\/jcm13072149","type":"journal-article","created":{"date-parts":[[2024,4,8]],"date-time":"2024-04-08T10:11:55Z","timestamp":1712571115000},"page":"2149","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Two Methods of Forward Head Posture Assessment: Radiography vs. Posture and Their Clinical Comparison"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3117-7330","authenticated-orcid":false,"given":"Paul A.","family":"Oakley","sequence":"first","affiliation":[{"name":"CBP Nonprofit (A Spine Research Foundation), Eagle, ID 83616, USA"},{"name":"Private Practice, Newmarket, ON L3Y 8Y8, Canada"},{"name":"Kinesiology and Health Science, York University, Toronto, ON M3J 1P3, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4859-1490","authenticated-orcid":false,"given":"Ibrahim M.","family":"Moustafa","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates"},{"name":"Neuromusculoskeletal Rehabilitation Research Group, RIMHS\u2013Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0901-9608","authenticated-orcid":false,"given":"Jason W.","family":"Haas","sequence":"additional","affiliation":[{"name":"CBP Nonprofit (A Spine Research Foundation), Eagle, ID 83616, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph W.","family":"Betz","sequence":"additional","affiliation":[{"name":"CBP Nonprofit (A Spine Research Foundation), Eagle, ID 83616, USA"},{"name":"Private Practice, Boise, ID 83709, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6671-7106","authenticated-orcid":false,"given":"Deed E.","family":"Harrison","sequence":"additional","affiliation":[{"name":"CBP Nonprofit (A Spine Research Foundation), Eagle, ID 83616, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,4,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1179\/106698105790824888","article-title":"Effectiveness of an Exercise Program to Improve Forward Head Posture in Normal Adults: A Randomized, Controlled 10-Week Trial","volume":"13","author":"Harman","year":"2005","journal-title":"J. Man. Manip. Ther."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1093\/ptj\/72.6.425","article-title":"Incidence of Common Postural Abnormalities in the Cervical, Shoulder, and Thoracic Regions and Their Association with Pain in Two Age Groups of Healthy Subjects","volume":"72","author":"Larson","year":"1992","journal-title":"Proc. Phys. Ther."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1007\/s12178-019-09594-y","article-title":"The Relationship Between Forward Head Posture and Neck Pain: A Systematic Review and Meta-Analysis","volume":"12","author":"Mahmoud","year":"2019","journal-title":"Curr. Rev. Musculoskelet. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.math.2012.07.005","article-title":"Effects of thoracic kyphosis and forward head posture on cervical range of motion in older adults","volume":"18","author":"Quek","year":"2013","journal-title":"Man. Ther."},{"key":"ref_5","first-page":"543","article-title":"Effect of Forward Head Posture on Dynamic Balance Based on the Biodex Balance System","volume":"12","author":"Ahmadipoor","year":"2022","journal-title":"J. Biomed. Phys. Eng."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1589\/jpts.28.274","article-title":"Effects of Forward Head Posture on Static and Dynamic Balance Control","volume":"28","author":"Lee","year":"2016","journal-title":"J. Phys. Ther. Sci."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1589\/jpts.31.63","article-title":"Effect of Forward Head Posture on Thoracic Shape and Respiratory Function","volume":"31","author":"Koseki","year":"2019","journal-title":"J. Phys. Ther. Sci."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1007\/s00586-017-5367-1","article-title":"Cervical sagittal balance: A biomechanical perspective can help clinical practice","volume":"27","author":"Patwardhan","year":"2018","journal-title":"Eur. Spine J."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1007\/s00586-018-5462-y","article-title":"Which parameters are relevant in sagittal balance analysis of the cervical spine? A literature review","volume":"27","author":"Ling","year":"2018","journal-title":"Eur. Spine J."},{"key":"ref_10","unstructured":"Harrison, D.D. CBP Technique: The Physics of Spinal Correction. National Library of Medicine #WE 725 4318C, 1982\u20131997."},{"key":"ref_11","first-page":"384","article-title":"Chiropractic biophysics lateral cervical film analysis reliability","volume":"16","author":"Jackson","year":"1993","journal-title":"J. Manip. Physiol. Ther."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1097\/00007632-199603150-00002","article-title":"Comparisons of lordotic cervical spine curvatures to a theoretical ideal model of the static sagittal cervical spine","volume":"21","author":"Harrison","year":"1996","journal-title":"Spine"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1227\/NEU.0b013e31826100c9","article-title":"The impact of standing regional cervical sagittal alignment on outcomes in posterior cervical fusion surgery","volume":"71","author":"Tang","year":"2012","journal-title":"Neurosurgery"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Norton, T.C., Oakley, P.A., Haas, J.W., and Harrison, D.E. (2023). Positive Outcomes Following Cervical Acceleration-Deceleration (CAD) Injury Using Chiropractic BioPhysics\u00ae Methods: A Pre-Auto Injury and Post-Auto Injury Case Series. J. Clin. Med., 12.","DOI":"10.3390\/jcm12196414"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1111\/os.13951","article-title":"Comparison of Cervical Sagittal Parameters among Patients with Neck Pain and Patients with Cervical Spondylotic Radiculopathy and Cervical Spondylotic Myelopathy","volume":"16","author":"Liu","year":"2024","journal-title":"Orthop. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1016\/j.gaitpost.2020.12.033","article-title":"Radiography and photogrammetry-based methods of assessing cervical spine posture in the sagittal plane: A systematic review with meta-analysis","volume":"84","author":"Pivotto","year":"2021","journal-title":"Gait Posture"},{"key":"ref_17","first-page":"e27696","article-title":"Reliability and Validity of Non-radiographic Methods of Forward Head Posture Measurement: A Systematic Review","volume":"14","author":"Mylonas","year":"2022","journal-title":"Cureus"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"15379","DOI":"10.1038\/s41598-021-94548-z","article-title":"Demonstration of Central Conduction Time and Neuroplastic Changes after Cervical Lordosis Rehabilitation in Asymptomatic Subjects: A Randomized, Placebo-Controlled Trial","volume":"11","author":"Moustafa","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"427","DOI":"10.4085\/1062-6050-0481.19","article-title":"Demonstration of Autonomic Nervous Function and Cervical Sensorimotor Control After Cervical Lordosis Rehabilitation: A Randomized Controlled Trial","volume":"56","author":"Moustafa","year":"2021","journal-title":"J. Athl. Train."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"van Niekerk, S.M., Louw, Q., Vaughan, C., Grimmer-Somers, K., and Schreve, K. (2008). Photographic measurement of upper-body sitting posture of high school students: A reliability and validity study. BMC Musculoskelet. Disord., 9.","DOI":"10.1186\/1471-2474-9-113"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Moustafa, I.M., Diab, A.A., Hegazy, F., and Harrison, D.E. (2018). Does Improvement towards a Normal Cervical Sagittal Configuration Aid in the Management of Cervical Myofascial Pain Syndrome: A 1- Year Randomized Controlled Trial. BMC Musculoskelet. Disord., 19.","DOI":"10.1186\/s12891-018-2317-y"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/j.math.2006.11.002","article-title":"The relationship between head posture and severity and disability of patients with neck pain","volume":"13","author":"Yip","year":"2008","journal-title":"Man. Ther."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.jcm.2017.01.005","article-title":"Photogrammetric Assessment of Upper Body Posture Using Postural Angles: A Literature Review","volume":"16","author":"Singla","year":"2017","journal-title":"J. Chiropr. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"408","DOI":"10.2522\/ptj.20060009","article-title":"Effect of Neck Exercise on Sitting Posture in Patients with Chronic Neck Pain","volume":"87","author":"Falla","year":"2007","journal-title":"Phys. Ther."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1177\/0269215511419536","article-title":"The efficacy of forward head correction on nerve root function and pain in cervical spondylotic radiculopathy: A randomized trial","volume":"26","author":"Diab","year":"2012","journal-title":"Clin. Rehabil."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1067\/mmt.2002.121411","article-title":"Further reliability analysis of the Harrison radiographic line-drawing methods: Crossed ICCs for lateral posterior tangents and modified Risser-Ferguson method on AP views","volume":"25","author":"Harrison","year":"2002","journal-title":"J. Manip. Physiol. Ther."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1007\/s00586-014-3525-2","article-title":"Does whole-spine lateral radiograph with clavicle positioning reflect the correct cervical sagittal alignment?","volume":"24","author":"Park","year":"2015","journal-title":"Eur. Spine J."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1097\/00007632-198607000-00003","article-title":"Roentgenographic findings of the cervical spine in asymptomatic people","volume":"11","author":"Gore","year":"1986","journal-title":"Spine"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"2070","DOI":"10.1097\/BRS.0000000000000641","article-title":"Postoperative cervical sagittal imbalance negatively affects outcomes after surgery for cervical spondylotic myelopathy","volume":"39","author":"Roguski","year":"2014","journal-title":"Spine"},{"key":"ref_30","unstructured":"Moore, D.S., Notz, W.I., and Flinger, M.A. (2013). The Basic Practice of Statistics, W. H. Freeman and Company. [6th ed.]."},{"key":"ref_31","unstructured":"Tafti, A., and Byerly, D.W. (2024, February 19). X-Ray Image Acquisition, StatPearls, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK563236\/."},{"key":"ref_32","first-page":"e2023006","article-title":"Assessment of Forward Head. Posture and Ergonomics in Young IT Professionals\u2014Reasons to Worry?","volume":"114","author":"Stincel","year":"2023","journal-title":"Med. Lav."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"559","DOI":"10.13075\/ijomeh.1896.01585","article-title":"The impact of the position of the head on the functioning of the human body: A systematic review","volume":"33","author":"Fudacz","year":"2020","journal-title":"Int. J. Occup. Med. Environ. Health"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"3398","DOI":"10.1589\/jpts.28.3398","article-title":"Inter- and intra-rater agreement of static posture analysis using a mobile application","volume":"28","author":"Boland","year":"2016","journal-title":"J. Phys. Ther. Sci."},{"key":"ref_35","unstructured":"Kan, S., Fortuna, J., and Nur, S. (2016). Can a Mobile Application Be Used to Assess Postural Alignment in Clinic?, Canadian Society for Biomechanics."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/j.jmpt.2019.02.003","article-title":"Validity and Reliability of Standing Posture Measurements Using a Mobile Application","volume":"42","author":"Hopkins","year":"2019","journal-title":"J. Manip. Physiol. Ther."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1221","DOI":"10.3233\/WOR-213451","article-title":"Correlation between craniovertebral angle in the sagittal plane and angles and indices measured in the frontal plane at the moment of inducing forward head posture","volume":"68","author":"Molaeifar","year":"2021","journal-title":"Work"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Cote, R., Vietas, C., Kolakowski, M., Lombardo, K., Prete, J., and Dashottar, A. (2021). Inter and intra-rater reliability of measuring photometric craniovertebral angle using a cloud-based video communication platform. Int. J. Telerehabil., 13.","DOI":"10.5195\/ijt.2021.6346"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1080\/09593985.2022.2117581","article-title":"Examining accuracy of and determining the best cutoff point for photographic-based postural angles to discriminate between slight and moderate-to-severe forward head posture","volume":"40","author":"Mostafaee","year":"2024","journal-title":"Physiother. Theory Pract."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"55","DOI":"10.4329\/wjr.v11.i4.55","article-title":"Imaging of the spine: Where do we stand?","volume":"11","author":"Nouh","year":"2019","journal-title":"World J. Radiol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"2052","DOI":"10.1097\/00007632-200008150-00009","article-title":"Breast cancer mortality after diagnostic radiography: Findings from the U.S. Scoliosis Cohort Study","volume":"25","author":"Doody","year":"2000","journal-title":"Spine"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1148\/68.4.572","article-title":"Comparative roentgen findings in symptomatic and asymptomatic backs","volume":"68","author":"Fullenlove","year":"1957","journal-title":"Radiology"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1016\/j.math.2015.11.004","article-title":"Differences in body posture, strength and flexibility in schoolchildren with overweight and obesity: A quasi-experimental study","volume":"22","author":"Schwanke","year":"2016","journal-title":"Man. Ther."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"e36845","DOI":"10.1097\/MD.0000000000036845","article-title":"Effects of cervical stabilization with visual feedback on craniovertebral angle and proprioception for the subjects with forward head posture","volume":"103","author":"Goo","year":"2024","journal-title":"Medicine"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1016\/S0021-9290(99)00156-6","article-title":"Inertial properties and loading rates affect buckling modes and injury mechanisms in the cervical spine","volume":"33","author":"Nightingale","year":"2000","journal-title":"J. Biomech."},{"key":"ref_46","unstructured":"Chen, W.F., and Lui, E.M. (1987). Structural Instability: Theory and Implementation, Elsevier."},{"key":"ref_47","unstructured":"Oakley, P.O.A., Moustafa, I.M., and Harrison, D.E. (2021). Spinal Deformities in Adolescents, Adults and Older Adults, IntechOpen."},{"key":"ref_48","unstructured":"Frane, N., and Bitterman, A. (2024, February 19). Radiation Safety and Protection, StatPearls, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK557499\/."},{"key":"ref_49","unstructured":"Tafti, D., and Maani, C.V. (2024, February 19). X-ray Production, StatPearls, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK537046\/."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1417","DOI":"10.1589\/jpts.30.1417","article-title":"Reliability of sagittal vertical axis measurement and association with measures of age-related hyperkyphosis","volume":"30","author":"Katzman","year":"2018","journal-title":"J. Phys. Ther. Sci."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1097\/00024720-200302000-00008","article-title":"Sagittal profile of the elderly","volume":"16","author":"Hammerberg","year":"2003","journal-title":"J. Spinal Disord. Tech."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Asai, Y., Tsutsui, S., Oka, H., Yoshimura, N., Hashizume, H., Yamada, H., Akune, T., Muraki, S., Matsudaira, K., and Kawaguchi, H. (2017). Sagittal spino-pelvic alignment in adults: The Wakayama Spine Study. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0178697"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"673","DOI":"10.3171\/2014.12.SPINE14780","article-title":"Reliability assessment of a novel cervical spine deformity classification system","volume":"23","author":"Ames","year":"2015","journal-title":"J. Neurosurg. Spine"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"169","DOI":"10.31616\/asj.2019.0069","article-title":"Accuracy and Reliability of X-ray Measurements in the Cervical Spine","volume":"14","author":"Marques","year":"2020","journal-title":"Asian Spine J."},{"key":"ref_55","first-page":"460","article-title":"Further analysis of the reliability of the posterior tangent lateral lumbar radiographic mensuration procedure: Concurrent validity of computer-aided X-ray digitization","volume":"21","author":"Troyanovich","year":"1998","journal-title":"J. Manip. Physiol. Ther."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1307","DOI":"10.1177\/2192568220972076","article-title":"Cervical Spine Alignment in the Sagittal Axis: A Review of the Best Validated Measures in Clinical Practice","volume":"11","author":"Martini","year":"2021","journal-title":"Global Spine J."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1177\/2192568217694011","article-title":"Effect of Cervical Sagittal Balance on Laminoplasty in Patients with Cervical Myelopathy","volume":"7","author":"Kato","year":"2017","journal-title":"Global Spine J."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"e752","DOI":"10.1016\/j.wneu.2019.08.022","article-title":"Anterior cervical discectomy and fusion versus hybrid decompression and fusion for the treatment of 3-level cervical spondylotic myelopathy: A comparative analysis of cervical sagittal balance and outcomes","volume":"132","author":"Xu","year":"2019","journal-title":"World Neurosurg."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1186\/s13018-019-1504-3","article-title":"The change of cervical sagittal parameters plays an important role in clinical outcomes of cervical spondylotic myelopathy after multi-level anterior cervical discectomy and fusion","volume":"14","author":"Fan","year":"2019","journal-title":"J. Orthop. Surg. Res."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"2485","DOI":"10.1097\/01.brs.0000144449.90741.7c","article-title":"Modeling of the sagittal cervical spine as a method to discriminate hypolordosis: Results of elliptical and circular modeling in 72 asymptomatic subjects, 52 acute neck pain subjects, and 70 chronic neck pain subjects","volume":"29","author":"Harrison","year":"2004","journal-title":"Spine"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/j.jmpt.2005.02.015","article-title":"Determining the relationship between cervical lordosis and neck complaints","volume":"28","author":"McAviney","year":"2005","journal-title":"J. Manip. Physiol. Ther."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1017\/S1049023X1900520X","article-title":"The Risk of Cancer from CT Scans and Other Sources of Low-Dose Radiation: A Critical Appraisal of Methodologic Quality","volume":"35","author":"Schultz","year":"2020","journal-title":"Prehosp. Disaster Med."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/7\/2149\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:25:03Z","timestamp":1760106303000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/7\/2149"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,8]]},"references-count":62,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2024,4]]}},"alternative-id":["jcm13072149"],"URL":"https:\/\/doi.org\/10.3390\/jcm13072149","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,8]]}}}