{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T14:41:05Z","timestamp":1785508865538,"version":"3.56.0"},"reference-count":53,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2024,8,28]],"date-time":"2024-08-28T00:00:00Z","timestamp":1724803200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Bayer AG"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: In the phase 3 clinical trials FIGARO-DKD and FIDELIO-DKD, finerenone reduced the risk of cardiovascular and kidney events among people with chronic kidney disease (CKD) and type 2 diabetes (T2D). Evidence regarding finerenone use in real-world settings is limited. Methods: A retrospective cohort study (NCT06278207) using two Japanese nationwide hospital-based databases provided by Medical Data Vision (MDV) and Real World Data Co., Ltd. (RWD Co., Kyoto Japan), converted to the OMOP common data model, was conducted. Persons with CKD and T2D initiating finerenone from 1 July 2021, to 30 August 2023, were included. Baseline characteristics were described. The occurrence of hyperkalemia after finerenone initiation was assessed. Results: 1029 new users of finerenone were included (967 from MDV and 62 from RWD Co.). Mean age was 69.5 and 72.4 years with 27.3% and 27.4% being female in the MDV and RWD Co. databases, respectively. Hypertension (92 and 95%), hyperlipidemia (59 and 71%), and congestive heart failure (60 and 66%) were commonly observed comorbidities. At baseline, 80% of persons were prescribed angiotensin-converting-enzyme inhibitors or angiotensin-receptor blockers. Sodium\u2013glucose cotransporter 2 inhibitors and glucagon-like peptide 1 receptor agonists were prescribed in 72% and 30% of the study population, respectively. The incidence proportions of hyperkalemia were 2.16 and 2.70 per 100 persons in the MDV and RWD Co. databases, respectively. There were no hospitalizations associated with hyperkalemia observed in either of the two datasets. Conclusions: For the first time, we report the largest current evidence on the clinical use of finerenone in real-world settings early after the drug authorization in Japan. This early evidence from clinical practice suggests that finerenone is used across comorbidities and comedications.<\/jats:p>","DOI":"10.3390\/jcm13175107","type":"journal-article","created":{"date-parts":[[2024,8,28]],"date-time":"2024-08-28T07:52:08Z","timestamp":1724831528000},"page":"5107","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Early Clinical Experience of Finerenone in People with Chronic Kidney Disease and Type 2 Diabetes in Japan\u2014A Multi-Cohort Study from the FOUNTAIN (FinerenOne mUltidatabase NeTwork for Evidence generAtIoN) Platform"],"prefix":"10.3390","volume":"13","author":[{"given":"Atsuhisa","family":"Sato","sequence":"first","affiliation":[{"name":"Department of Nephrology and Hypertension, International University of Health and Welfare Shioya Hospital, Yaita 329-2145, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daloha","family":"Rodriguez-Molina","sequence":"additional","affiliation":[{"name":"Integrated Evidence Generation & Business Innovation, Bayer AG, 13342 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanae","family":"Yoshikawa-Ryan","sequence":"additional","affiliation":[{"name":"Medical Affairs & Pharmacovigilance, Bayer Yakuhin Ltd., Breeze Tower, 2-4-9 Umeda, Kita-ku, Osaka 530-0001, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6600-4261","authenticated-orcid":false,"given":"Satoshi","family":"Yamashita","sequence":"additional","affiliation":[{"name":"Medical Affairs & Pharmacovigilance, Bayer Yakuhin Ltd., Breeze Tower, 2-4-9 Umeda, Kita-ku, Osaka 530-0001, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4402-0209","authenticated-orcid":false,"given":"Suguru","family":"Okami","sequence":"additional","affiliation":[{"name":"Medical Affairs & Pharmacovigilance, Bayer Yakuhin Ltd., Breeze Tower, 2-4-9 Umeda, Kita-ku, Osaka 530-0001, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fangfang","family":"Liu","sequence":"additional","affiliation":[{"name":"Integrated Evidence Generation & Business Innovation, Bayer AG, 13342 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfredo","family":"Farjat","sequence":"additional","affiliation":[{"name":"Integrated Evidence Generation & Business Innovation, Bayer AG, 13342 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaus G.","family":"Oberprieler","sequence":"additional","affiliation":[{"name":"Integrated Evidence Generation & Business Innovation, Bayer AG, 13342 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8204-911X","authenticated-orcid":false,"given":"Csaba P.","family":"Kovesdy","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9563-502X","authenticated-orcid":false,"given":"Keizo","family":"Kanasaki","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine 1, Faculty of Medicine, Shimane University, 89-1 Enya-cho, Izumo 693-8501, Japan"},{"name":"Center for Integrated Kidney Research and Advance, Faculty of Medicine, Shimane University, 89-1 Enya-cho, Izumo 693-8501, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0248-7636","authenticated-orcid":false,"given":"David","family":"Vizcaya","sequence":"additional","affiliation":[{"name":"Integrated Evidence Generation & Business Innovation, Bayer AG, 13342 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,8,28]]},"reference":[{"key":"ref_1","unstructured":"International Diabetes Federation (2021). IDF Diabetes Atlas, International Diabetes Federation. [10th ed.]."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e000154","DOI":"10.1136\/bmjdrc-2015-000154","article-title":"Understanding CKD among patients with T2DM: Prevalence, temporal trends, and treatment patterns\u2013NHAINES 2007\u20132012","volume":"4","author":"Wu","year":"2016","journal-title":"BMJ Open Diabetes Res. Care"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e065927","DOI":"10.1136\/bmjopen-2022-065927","article-title":"Characterising the burden of chronic kidney disease among people with type 2 diabetes in England: A cohort study using the Clinical Practice Research Datalink","volume":"13","author":"Cook","year":"2023","journal-title":"BMJ Open"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1681\/ASN.2012070718","article-title":"Kidney disease and increased mortality risk in type 2 diabetes","volume":"24","author":"Afkarian","year":"2013","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Sawaf, H., Thomas, G., Taliercio, J.J., Nakhoul, G., Vachharajani, T.J., and Mehdi, A. (2022). Therapeutic advances in diabetic nephropathy. J. Clin. Med., 11.","DOI":"10.3390\/jcm11020378"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1436","DOI":"10.1056\/NEJMoa2024816","article-title":"Dapagliflozin in patients with chronic kidney disease","volume":"383","author":"Heerspink","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"The EMPA-KIDNEY Collaborative Group (2023). Empagliflozin in patients with chronic kidney disease. N. Engl. J. Med., 388, 117\u2013127.","DOI":"10.1056\/NEJMoa2204233"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2295","DOI":"10.1056\/NEJMoa1811744","article-title":"Canagliflozin and renal outcomes in type 2 diabetes and nephropathy","volume":"380","author":"Perkovic","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1056\/NEJMoa2403347","article-title":"Effects of semaglutide on chronic kidney disease in patients with type 2 diabetes","volume":"391","author":"Perkovic","year":"2024","journal-title":"N. Engl. J. Med."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"The American Diabetes Association Professional Practice Committee (2024). Standard of care in diabetes\u20132024. Diabetes Care, 47, S295\u2013S306.","DOI":"10.2337\/dc24-S016"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"111136","DOI":"10.1016\/j.diabres.2024.111136","article-title":"Cardiorenal events in medication-initiator cohorts of patients with chronic kidney disease and type 2 diabetes in Japan","volume":"209","author":"Kashihara","year":"2024","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2925","DOI":"10.1681\/ASN.2020050723","article-title":"Early change in albuminuria with canagliflozin predicts kidney and cardiovascular outcomes: A post hoc analysis from the CREDENCE trial","volume":"31","author":"Oshima","year":"2020","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e016976","DOI":"10.1161\/JAHA.120.016976","article-title":"Short-term changes in albuminuria and risk of cardiovascular and renal outcomes in type 2 diabetes mellitus: A post hoc analysis of the EMPA-REG OUTCOME trial","volume":"9","author":"Waijer","year":"2020","journal-title":"J. Am. Heart Assoc."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1016\/j.mayocpiqo.2022.09.002","article-title":"Evolution of mineralocorticoid receptor antagonists in the treatment of chronic kidney disease associated with type 2 diabetes mellitus","volume":"6","author":"Wish","year":"2022","journal-title":"Mayo Clin. Proc. Innov. Qual. Outcomes"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1574","DOI":"10.2337\/dci23-0030","article-title":"Diabetic nephropathy: Update on pillars of therapy slowing progression","volume":"46","author":"Naaman","year":"2023","journal-title":"Diabetes Care."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"758","DOI":"10.1016\/j.jdiacomp.2016.11.021","article-title":"A randomized controlled study of finerenone versus placebo in Japanese patients with type 2 diabetes mellitus and diabetic nephropathy","volume":"31","author":"Katayama","year":"2017","journal-title":"J. Diabetes Complicat."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2219","DOI":"10.1056\/NEJMoa2025845","article-title":"Effect of finerenone on chronic kidney disease outcomes in type 2 diabetes","volume":"383","author":"Bakris","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2252","DOI":"10.1056\/NEJMoa2110956","article-title":"Cardiovascular events with finerenone in kidney disease and type 2 diabetes","volume":"385","author":"Pitt","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_19","unstructured":"U.S. Food and Drug Administration (FDA) (2024, June 24). Prescribing Information for KERENDIA, Available online: https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2021\/215341s000lbl.pdf."},{"key":"ref_20","unstructured":"Pharmaceutical and Medical Devices Agency in Japan (2024, June 24). KERENDIA Package Insert. Available online: https:\/\/www.pmda.go.jp\/PmdaSearch\/iyakuDetail\/ResultDataSetPDF\/630004_2190044F1020_1_06."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"4043","DOI":"10.1093\/eurheartj\/ehad192","article-title":"2023 ESC guidelines for the management of cardiovascular disease in patients with diabetes","volume":"44","author":"Marx","year":"2023","journal-title":"Eur. Heart J."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1874","DOI":"10.1097\/HJH.0000000000003480","article-title":"2023 ESH guidelines for the management of arterial hypertension. The task force for the management of arterial hypertension of the European Society of Hypertension","volume":"41","author":"Mancia","year":"2023","journal-title":"J. Hypertens."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Oberprieler, N.G., Pladevall-Vila, M., Johannes, C.B., Layton, J.B., Golozar, A., Lavallee, M., Kubin, M., and Vizcaya, D. (2023, January 23\u201327). FOUNTAIN: A modular research platform for integrated real-world evidence generation [Poster 186]. Proceedings of the 39th International Conference on Pharmacoepidemiology & Therapeutic Risk Management, Halifax, NS, Canada.","DOI":"10.1186\/s12874-024-02344-w"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1","DOI":"10.2188\/jea.JE20200288","article-title":"History and profile of diagnosis procedure combination (DPC): Development of a real data collection system for acute inpatient care in Japan","volume":"31","author":"Hayashida","year":"2021","journal-title":"J. Epidemiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e5680","DOI":"10.1002\/pds.5680","article-title":"Inventory of real-world data sources in Japan: Annual survey conducted by the Japanese Society for Pharmacoepidemiology Task Force","volume":"33","author":"Kumamaru","year":"2024","journal-title":"Pharmacoepidemiol. Drug Saf."},{"key":"ref_26","unstructured":"Observational Health Data Sciences and Informatics (OHDSI) (2024, January 30). OMOP Common Data Model. Available online: https:\/\/ohdsi.github.io\/CommonDataModel\/index.html."},{"key":"ref_27","unstructured":"The European Network of Centres for Pharmacoepidemiology and Pharmacovigilance (ENCePP) (2020). Guide on Methodological Standards in Pharmacoepidemiology, The European Network of Centres for Pharmacoepidemiology and Pharmacovigilance (ENCePP). Report No.EMA\/95098\/2010."},{"key":"ref_28","unstructured":"International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH) (2024, January 30). E2A Clinical Safety Data Management: Definition and Standards for Expedited Reporting. Available online: https:\/\/www.ema.europa.eu\/en\/ich-e2a-clinical-safety-data-management-definitions-and-standards-expedited-reporting-scientific-guideline."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1159\/000521288","article-title":"Charlson Comorbidity Index: A critical review of clinimetric properties","volume":"91","author":"Charlson","year":"2022","journal-title":"Psychother. Psychosom."},{"key":"ref_30","first-page":"15","article-title":"Diabetes complications severity index and risk of mortality, hospitalization, and healthcare utilization","volume":"14","author":"Young","year":"2008","journal-title":"Am. J. Manag. Care"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.1016\/j.jdiacomp.2017.02.018","article-title":"Diabetes complication severity index (DSCI)\u2014Update and ICD-10 translation","volume":"31","author":"Glasheen","year":"2017","journal-title":"J. Diabetes Complicat."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"657","DOI":"10.2147\/CEOR.S267063","article-title":"A model to predict risk of hyperkalemia in patients with chronic kidney disease using a large administrative claims database","volume":"12","author":"Sharma","year":"2020","journal-title":"Clinicoecon Outcomes Res."},{"key":"ref_33","unstructured":"Observational Health Data Sciences and Informatics (OHDSI) (2024, January 31). The Book of OHDSI. Available online: https:\/\/ohdsi.github.io\/TheBookOfOhdsi\/."},{"key":"ref_34","unstructured":"R Development Core Team (2005). R: A Language and Environment for Statistical Computing, R Foundation for Statistical Computing."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"573","DOI":"10.7326\/0003-4819-147-8-200710160-00010","article-title":"The strengthening the reporting of observational studies in epidemiology (STROBE) statement: Guidelines for reporting observational studies","volume":"147","author":"Altman","year":"2007","journal-title":"Ann. Int. Med."},{"key":"ref_36","unstructured":"Ministry of Labour, Health and Welfare of Japan (2023, December 27). Ethical Guidelines for Medical and Health Research Involving Human Subjects. Available online: https:\/\/www.mhlw.go.jp\/file\/06-Seisakujouhou-10600000-Daijinkanboukouseikagakuka\/0000080278.pdf."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"309","DOI":"10.14740\/cr1424","article-title":"Chronic kidney disease stage G4 in a diabetic patient improved by multi-disciplinary treatments based upon literature search for therapeutic evidence","volume":"13","author":"Yanai","year":"2022","journal-title":"Cardiol. Res."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"100251","DOI":"10.1016\/j.metop.2023.100251","article-title":"Effect of finerenone on diabetic kidney outcomes with estimated glomerular filtration rate below 25 mL\/min\/1.73m2","volume":"19","author":"Mima","year":"2023","journal-title":"Metabol. Open."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"100294","DOI":"10.1016\/j.metop.2024.100294","article-title":"Effect of finerenone on nephrotic syndrome patients with diabetic kidney disease","volume":"22","author":"Mima","year":"2024","journal-title":"Metabol. Open"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1093\/eurheartj\/ehab777","article-title":"Cardiovascular and kidney outcomes with finerenone in patients with type 2 diabetes and chronic kidney disease: The FIDELITY pooled analysis","volume":"43","author":"Agarwal","year":"2022","journal-title":"Eur. Heart J."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"e230076","DOI":"10.57264\/cer-2023-0076","article-title":"Characteristics of patients with chronic kidney disease and type 2 diabetes initiating Finerenone in the USA: A multi-database, cross-sectional study","volume":"12","author":"Vizcaya","year":"2023","journal-title":"J. Comp. Eff. Res."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group (2024). KDIGO 2024 clinical practice guideline for evaluation and management of chronic kidney disease. Kidney Int., 105, S117\u2013S314.","DOI":"10.1016\/j.kint.2023.10.018"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"102426","DOI":"10.1016\/j.eclinm.2024.102426","article-title":"Implementation of chronic kidney disease guidelines for sodium-glucose co-transporter-2 inhibitor use in primary care in the UK: A cross-sectional study","volume":"68","author":"Forbes","year":"2024","journal-title":"eClinicalMedicine"},{"key":"ref_44","unstructured":"Japanese Diabetes Society (2024). Japanese Clinical Practice Guideline for Diabetes, Japanese Diabetes Society."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1681\/ASN.2021070942","article-title":"Hyperkalemia risk with finerenone: Results from the FIDELIO-DKD trial","volume":"33","author":"Agarwal","year":"2022","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1038\/nrneph.2012.217","article-title":"Management of hyperkalemia to mineralocorticoid-receptor antagonist therapy","volume":"8","author":"Roscioni","year":"2012","journal-title":"Nat. Rev. Nephrol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1093\/ckj\/sfab243","article-title":"How common is hyperkalemia? A systematic review and meta-analysis of the prevalence and incidence of hyperkalemia reported in observational studies","volume":"15","author":"Humphrey","year":"2022","journal-title":"Clin. Kidney J."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1080\/00325481.2021.2009726","article-title":"Management of chronic kidney disease in type 2 diabetes: Screening, diagnosis and treatment goals, and recommendations","volume":"134","author":"Shubrook","year":"2022","journal-title":"Postgrad. Med."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Oberprieler, N.G., Kovesdy, C.P., Layton, J.B., Thapa, B., Curhan, G., E Farjat, A., Liu, F., Johannes, C., and Vizcaya, D. (2024, January 23\u201326). Clinical outcomes in US patients initiating finerenone\u2014A report from the FOUNTAIN platform. Proceedings of the Poster presented at the 61st European Renal Association (ERA) Congress, Stockholm, Sweden.","DOI":"10.1093\/ndt\/gfae069.1416"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1159\/000503712","article-title":"Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial","volume":"50","author":"Ruilope","year":"2019","journal-title":"Am. J. Nephrol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"e012832","DOI":"10.1136\/bmjopen-2016-012817","article-title":"Positive predictive value of cardiovascular diagnoses in the Danish National Patient Registry: A validation study","volume":"6","author":"Adelborg","year":"2016","journal-title":"BMJ Open"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"20","DOI":"10.2337\/diacare.28.1.20","article-title":"Antidiabetic drugs and heart failure risk in patients with type 2 diabetes in the U.K. primary care setting","volume":"28","author":"Maru","year":"2005","journal-title":"Diabetes Care."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1002\/pds.2313","article-title":"A systematic review of validated methods for identifying heart failure using administrative data","volume":"21","author":"Saczynski","year":"2012","journal-title":"Pharmacoepidemiol. Drug Saf."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/17\/5107\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:44:14Z","timestamp":1760111054000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/17\/5107"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,28]]},"references-count":53,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2024,9]]}},"alternative-id":["jcm13175107"],"URL":"https:\/\/doi.org\/10.3390\/jcm13175107","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,28]]}}}