{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T01:24:49Z","timestamp":1792805089047,"version":"4.5.0"},"reference-count":52,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2024,11,21]],"date-time":"2024-11-21T00:00:00Z","timestamp":1732147200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"\u201cVictor Babes\u201dUniversity of Medicine and Pharmacy, Timisoara","id":[{"id":"https:\/\/ror.org\/00afdp487","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Diabetes mellitus (DM) is one of the most impactful health problems worldwide. It affects ocular health in multiple ways and is one of the leading causes of vision loss. Our study aimed to evaluate the most important systemic risk factors related to the occurrence of cataracts in patients with DM. Method: This study evaluated a final number of 319 participants who were previously diagnosed with DM. For all patients, we retrieved data regarding DM status, metabolic control, demographic and anthropometric indices, and generally associated comorbidities from their medical charts. A comprehensive eye examination was performed on all patients. Results: The main studied risk factors were hypertension, cardiovascular disease (CVD), chronic kidney disease (CKD), diabetic polyneuropathy (DPN), dyslipidemia, and hepatic steatosis, which were present among the entire population. Hypertension (67.6%), DPN (53.3%), and dyslipidemia (46.6%) were highly prevalent in the cataract subgroup, and CKD (p &lt; 0.001) and DPN (p = 0.019) were found to be predictive factors for the probability of cataract occurrence. Ophthalmologic evaluation was used to assess the presence of ocular complications, such as diabetic retinopathy (DR) and diabetic maculopathy. DR reached statistically significant values in the occurence of cataracts. Patients\u2019 age and DM-related factors, such as disease duration (p &lt; 0.001) and HbA1c values (p = 0.029), significantly increased the risk of cataracts. Smoking was self-reported by 24.8% of the patients, with a significant impact on the occurrence of cataracts (p = 0.04). Conclusions: Patients with DM who exhibit a longer disease duration and poor glycemic control in conjunction with systemic comorbidities present a higher risk of developing cataracts; consequently, a strict therapeutic approach regarding these risk factors is needed.<\/jats:p>","DOI":"10.3390\/jcm13237005","type":"journal-article","created":{"date-parts":[[2024,11,21]],"date-time":"2024-11-21T06:57:54Z","timestamp":1732172274000},"page":"7005","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Risk Factors for Cataracts in Patients with Diabetes Mellitus"],"prefix":"10.3390","volume":"13","author":[{"given":"Adriana","family":"Ivanescu","sequence":"first","affiliation":[{"name":"Department of Second Internal Medicine Diabetes, Nutrition, Metabolic Diseases, and Systemic Rheumatology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Opticlass Ophtalmology Clinic, 300012 Timisoara, Romania"},{"name":"Doctoral School, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Popescu","sequence":"additional","affiliation":[{"name":"Department of Second Internal Medicine Diabetes, Nutrition, Metabolic Diseases, and Systemic Rheumatology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Department of Diabetes, Nutrition, and Metabolic Diseases Clinic, \u201cPius Br\u00eenzeu\u201d Emergency Clinical County University Hospital, 300723 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5204-6954","authenticated-orcid":false,"given":"Laura","family":"Gaita","sequence":"additional","affiliation":[{"name":"Department of Second Internal Medicine Diabetes, Nutrition, Metabolic Diseases, and Systemic Rheumatology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Department of Diabetes, Nutrition, and Metabolic Diseases Clinic, \u201cPius Br\u00eenzeu\u201d Emergency Clinical County University Hospital, 300723 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oana","family":"Albai","sequence":"additional","affiliation":[{"name":"Department of Second Internal Medicine Diabetes, Nutrition, Metabolic Diseases, and Systemic Rheumatology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Department of Diabetes, Nutrition, and Metabolic Diseases Clinic, \u201cPius Br\u00eenzeu\u201d Emergency Clinical County University Hospital, 300723 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7904-6073","authenticated-orcid":false,"given":"Adina","family":"Braha","sequence":"additional","affiliation":[{"name":"Department of Second Internal Medicine Diabetes, Nutrition, Metabolic Diseases, and Systemic Rheumatology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Department of Diabetes, Nutrition, and Metabolic Diseases Clinic, \u201cPius Br\u00eenzeu\u201d Emergency Clinical County University Hospital, 300723 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0792-9202","authenticated-orcid":false,"given":"Romulus","family":"Timar","sequence":"additional","affiliation":[{"name":"Department of Second Internal Medicine Diabetes, Nutrition, Metabolic Diseases, and Systemic Rheumatology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Department of Diabetes, Nutrition, and Metabolic Diseases Clinic, \u201cPius Br\u00eenzeu\u201d Emergency Clinical County University Hospital, 300723 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,11,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Sayin, N. (2015). Ocular Complications of Diabetes Mellitus. World J. Diabetes, 6.","DOI":"10.4239\/wjd.v6.i1.92"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"6","DOI":"10.2337\/db20191-6","article-title":"Cataracts and Their Treatment in People with Diabetes","volume":"2019","author":"Bixler","year":"2019","journal-title":"Compendia"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2010\/608751","article-title":"Diabetic Cataract\u2014Pathogenesis, Epidemiology and Treatment","volume":"2010","author":"Pollreisz","year":"2010","journal-title":"J. Ophthalmol."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Aldhabaan, W., Abdulrahman, M.A., Asiri, M.Y., Alshabab, M.Q., Alshahrani, M.Y., Alnakhli, G.R., Alasmari, F., Alharthi, A., and Al Zomia, A.S. (2022). Assessment of Knowledge Regarding Cataract Among Saudi Adult Population in Assir Region, Saudi Arabia. Cureus, 14.","DOI":"10.7759\/cureus.32703"},{"key":"ref_5","first-page":"52","article-title":"Cataracts in Diabetic Patients: A Review Article","volume":"3","author":"Javadi","year":"2008","journal-title":"J. Ophthalmic Vis. Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e32","DOI":"10.1111\/dme.12053","article-title":"Frequency and Risk Factors of Non-Retinopathy Ocular Conditions in People with Diabetes: The Singapore Malay Eye Study","volume":"30","author":"Chiang","year":"2013","journal-title":"Diabet. Med."},{"key":"ref_7","first-page":"1272","article-title":"Age-Related Cataract and Its Types in Patients with and without Type 2 Diabetes Mellitus: A Hospital-Based Comparative Study","volume":"66","author":"Memon","year":"2016","journal-title":"J. Pak. Med. Assoc."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.1097\/OPX.0b013e3182644cd1","article-title":"Age-Related Cataract Is Associated with Type 2 Diabetes and Statin Use","volume":"89","author":"Machan","year":"2012","journal-title":"Optom. Vis. Sci."},{"key":"ref_9","first-page":"589","article-title":"[Cataract types in diabetics and non-diabetics: A densitometric study with the Topcon-Scheimpflug camera]","volume":"223","author":"Struck","year":"2006","journal-title":"Klin. Monbl Augenheilkd."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1016\/j.ophtha.2011.09.005","article-title":"Los Angeles Latino Eye Study Group Risk Factors for Cortical, Nuclear, Posterior Subcapsular, and Mixed Lens Opacities: The Los Angeles Latino Eye Study","volume":"119","author":"Richter","year":"2012","journal-title":"Ophthalmology"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1016\/j.diabres.2008.08.023","article-title":"Cataract and Type 1 Diabetes Mellitus","volume":"82","author":"Esteves","year":"2008","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2457","DOI":"10.1016\/j.ophtha.2015.07.010","article-title":"Ocular Complications in Children with Diabetes Mellitus","volume":"122","author":"Geloneck","year":"2015","journal-title":"Ophthalmology"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1016\/j.jaapos.2005.10.005","article-title":"Cataract Associated with Type-1 Diabetes Mellitus in the Pediatric Population","volume":"11","author":"Wilson","year":"2007","journal-title":"J. Am. Assoc. Pediatr. Ophthalmol. Strabismus"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.3928\/01913913-20100719-12","article-title":"Acute Bilateral Cataract with Phacomorphic Glaucoma in a Girl with Newly Diagnosed Type 1 Diabetes Mellitus","volume":"47","author":"Skrabic","year":"2010","journal-title":"J. Pediatr. Ophthalmol. Strabismus"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Wang, Y.-H., Huang, C., Tseng, Y.-L., Zhong, J., and Li, X.-M. (2021). Refractive Error and Eye Health: An Umbrella Review of Meta-Analyses. Front. Med., 8.","DOI":"10.3389\/fmed.2021.759767"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1401","DOI":"10.4103\/ijo.IJO_1158_17","article-title":"Cataract Surgery in Diabetes Mellitus: A Systematic Review","volume":"66","author":"Kelkar","year":"2018","journal-title":"Indian. J. Ophthalmol."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Mrugacz, M., Pony-Uram, M., Bryl, A., and Zorena, K. (2023). Current Approach to the Pathogenesis of Diabetic Cataracts. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms24076317"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1016\/j.ophtha.2003.06.016","article-title":"Nine-Year Incidence of Lens Opacities in the Barbados Eye Studies","volume":"111","author":"Leske","year":"2004","journal-title":"Ophthalmology"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1512","DOI":"10.1136\/bjo.2004.045484","article-title":"Cataract Surgery and Subtype in a Defined, Older Population: The SEECAT Project","volume":"88","author":"Lewis","year":"2004","journal-title":"Br. J. Ophthalmol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/S0002-9394(02)01844-5","article-title":"Incidence and Progression of Cataract in the Melbourne Visual Impairment Project","volume":"136","author":"McCarty","year":"2003","journal-title":"Am. J. Ophthalmol."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Li, L., Wan, X., and Zhao, G. (2014). Meta-Analysis of the Risk of Cataract in Type 2 Diabetes. BMC Ophthalmol., 14.","DOI":"10.1186\/1471-2415-14-94"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1357","DOI":"10.1038\/s41433-020-0806-3","article-title":"Global and Regional Prevalence of Age-Related Cataract: A Comprehensive Systematic Review and Meta-Analysis","volume":"34","author":"Hashemi","year":"2020","journal-title":"Eye"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1097\/ICU.0b013e3282f154bd","article-title":"Cataract Surgery for the Developing World","volume":"19","author":"Tabin","year":"2008","journal-title":"Curr. Opin. Ophthalmol."},{"key":"ref_24","first-page":"209","article-title":"Cataract: Trends in Surgical Procedures and Visual Outcomes; a Study in a Tertiary Care Hospital","volume":"62","author":"Naeem","year":"2012","journal-title":"J. Pak. Med. Assoc."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Mukesh, B.N. (2006). Development of Cataract and Associated Risk Factors: The Visual Impairment Project. Arch. Ophthalmol., 124.","DOI":"10.1001\/archopht.124.1.79"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1111\/ceo.13892","article-title":"Cataract and Systemic Disease: A Review","volume":"49","author":"Ang","year":"2021","journal-title":"Clin. Exper Ophthalmol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1007\/BF00915959","article-title":"Systemic Diseases in Age Related Cataract Patients","volume":"18","author":"Ram","year":"1994","journal-title":"Int. Ophthalmol."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Zhang, J.H., Ramke, J., Lee, C.N., Gordon, I., Safi, S., Lingham, G., Evans, J.R., and Keel, S. (2022). A Systematic Review of Clinical Practice Guidelines for Cataract: Evidence to Support the Development of the WHO Package of Eye Care Interventions. Vision, 6.","DOI":"10.3390\/vision6020036"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1034\/j.1600-0420.1999.770615.x","article-title":"The Decrease of Visual Acuity in Cataract Patients Waiting for Surgery","volume":"77","author":"Leinonen","year":"1999","journal-title":"Acta Ophthalmol. Scand."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1002\/jbm.a.31619","article-title":"A Methodology Based on the \u201cAnterior Chamber of Rabbit Eyes\u201d Model for Noninvasively Determining the Biocompatibility of Biomaterials in an Immune Privileged Site","volume":"86A","author":"Lu","year":"2008","journal-title":"J. Biomed. Mater. Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1028","DOI":"10.1038\/s41433-017-0003-1","article-title":"Cataract in Patients with Diabetes Mellitus\u2014Incidence Rates in the UK and Risk Factors","volume":"32","author":"Becker","year":"2018","journal-title":"Eye"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2020\/8160256","article-title":"High Risk of Early Cataracts in Young Type 1 Diabetes Group: A Nationwide Cohort Study","volume":"2020","author":"Lu","year":"2020","journal-title":"Int. J. Endocrinol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1007\/s44197-021-00020-6","article-title":"Senile Cataract in Patients with Diabetes with and Without Diabetic Retinopathy: A Community-Based Comparative Study","volume":"12","author":"Alabdulwahhab","year":"2022","journal-title":"J. Epidemiol. Glob. Health"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1016\/S0002-9394(98)00280-3","article-title":"Diabetes, Cardiovascular Disease, Selected Cardiovascular Disease Risk Factors, and the 5-Year Incidence of Age-Related Cataract and Progression of Lens Opacities: The Beaver Dam Eye Study","volume":"126","author":"Klein","year":"1998","journal-title":"Am. J. Ophthalmol."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Srinivasan, S., Raman, R., Swaminathan, G., Ganesan, S., Kulothungan, V., and Sharma, T. (2017). Incidence, Progression, and Risk Factors for Cataract in Type 2 Diabetes. Investig. Ophthalmol. Vis. Sci., 58.","DOI":"10.1167\/iovs.17-22264"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"6253","DOI":"10.1167\/iovs.10-5414","article-title":"Prevalence and Risk Factors for Cataract in Diabetes: Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetics Study, Report No. 17","volume":"51","author":"Raman","year":"2010","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Ye, J., Lou, L.-X., He, J.-J., and Xu, Y.-F. (2014). Body Mass Index and Risk of Age-Related Cataract: A Meta-Analysis of Prospective Cohort Studies. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0089923"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Kulkarni, A., and Banait, S. (2023). Through the Smoke: An In-Depth Review on Cigarette Smoking and Its Impact on Ocular Health. Cureus, 15.","DOI":"10.7759\/cureus.47779"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"2395","DOI":"10.1016\/j.jcrs.2005.06.039","article-title":"Smoking and Cataract: Review of Causal Association","volume":"31","author":"Kelly","year":"2005","journal-title":"J. Cataract. Refract. Surg."},{"key":"ref_40","first-page":"317","article-title":"Cigarette Smoking, Body Mass Index Associated with the Risks of Age-Related Cataract in Male Patients in Northeast China","volume":"5","author":"Lu","year":"2012","journal-title":"Int. J. Ophthalmol."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Nien, C.-W., Lee, C.-Y., Chen, H.-C., Chao, S.-C., Hsu, H.-J., Tzeng, S.-H., Yang, S.-J., Huang, J.-Y., Yang, S.-F., and Lin, H.-Y. (2021). The Elevated Risk of Sight-Threatening Cataract in Diabetes with Retinopathy: A Retrospective Population-Based Cohort Study. BMC Ophthalmol., 21.","DOI":"10.1186\/s12886-021-02114-y"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Ivanescu, A., Popescu, S., Ivanescu, R., Potra, M., and Timar, R. (2024). Predictors of Diabetic Retinopathy in Type 2 Diabetes: A Cross-Sectional Study. Biomedicines, 12.","DOI":"10.3390\/biomedicines12081889"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1037\/hea0000739","article-title":"The Measurement of Multimorbidity","volume":"38","author":"Nicholson","year":"2019","journal-title":"Health Psychol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1016\/j.ecl.2021.05.012","article-title":"Characterizing Multimorbidity from Type 2 Diabetes","volume":"50","author":"Cicek","year":"2021","journal-title":"Endocrinol. Metab. Clin. North Am."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Mathebula, S.D. (2015). Polyol Pathway: A Possible Mechanism of Diabetes Complications in the Eye. Afr. Vis. Eye Health, 74.","DOI":"10.4102\/aveh.v74i1.13"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"943","DOI":"10.2147\/DMSO.S451628","article-title":"Gender Differences in the Incidence of Nephropathy and Changes in Renal Function in Patients with Type 2 Diabetes Mellitus: A Retrospective Cohort Study","volume":"17","author":"Zhang","year":"2024","journal-title":"Diabetes Metab. Syndr. Obes."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.1111\/dme.12478","article-title":"The Influence of Sex on Renal Function Decline in People with Type 2 Diabetes","volume":"31","author":"Ragot","year":"2014","journal-title":"Diabet. Med."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"630","DOI":"10.4093\/dmj.2021.0130","article-title":"Advanced Liver Fibrosis Is Associated with Chronic Kidney Disease in Patients with Type 2 Diabetes Mellitus and Nonalcoholic Fatty Liver Disease","volume":"46","author":"Seo","year":"2022","journal-title":"Diabetes Metab. J."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Chen, J., Xiao, H., Xue, R., Kumar, V., Aslam, R., Mehdi, S.F., Luo, H., Malhotra, A., Lan, X., and Singhal, P. (2023). Nicotine Exacerbates Diabetic Nephropathy through Upregulation of Grem1 Expression. Mol. Med., 29.","DOI":"10.1186\/s10020-023-00692-9"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1093\/ndt\/gfw452","article-title":"Cigarette Smoking and Chronic Kidney Disease in the General Population: A Systematic Review and Meta-Analysis of Prospective Cohort Studies","volume":"32","author":"Xia","year":"2017","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Tol, A., Baghbanian, A., Mohebbi, B., Shojaeizadeh, D., Azam, K., Shahmirzadi, S.E., and Asfia, A. (2013). Empowerment Assessment and Influential Factors among Patients with Type 2 Diabetes. J. Diabetes Metab. Disord., 12.","DOI":"10.1186\/2251-6581-12-6"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1080\/02713683.2017.1383443","article-title":"Glycemic Control and Quality of Life Following Cataract Surgery in Patients with Type 2 Diabetes and without Maculopathy","volume":"43","author":"Hecht","year":"2018","journal-title":"Curr. Eye Res."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/23\/7005\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:36:31Z","timestamp":1760114191000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/23\/7005"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,21]]},"references-count":52,"journal-issue":{"issue":"23","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["jcm13237005"],"URL":"https:\/\/doi.org\/10.3390\/jcm13237005","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,21]]}}}