{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T10:20:25Z","timestamp":1788517225543,"version":"build-2803163510"},"reference-count":59,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2024,12,12]],"date-time":"2024-12-12T00:00:00Z","timestamp":1733961600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"LMU Munich"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Before a cochlear implant is considered, patients undergo various audiological tests to assess their suitability. One key test measures the auditory brainstem response (ABR) to acoustic stimuli. However, in some cases, even with maximum sound stimulation, no response is detected. Methods: The promontory test involves electrical stimulation near the auditory nerve, allowing patients to associate the sensation. Ideally, the electrode is placed in the middle ear after opening the eardrum. This method, along with trans-tympanic electrically evoked ABR in local anesthesia (LA-TT-EABR) and the cortical equivalent (LA-TT-EALR), helps assess the auditory nerve\u2019s existence and excitability. The TympEALR test, utilizing a \u201ctympanic LA-TT-EALR\u201d, provides an alternative measurement. Previous research has shown the possibility of deriving brainstem and cortical potentials through trans-tympanic electrical stimulation, allowing for objective assessment of the auditory nerve\u2019s integrity and potentially objectifying patient sensations. Results: Sixteen patients have been tested using TympEALR. In seven of these, we found a positive response. The morphology was similar to other electrically evoked cortical auditory responses (EALR), e.g., using cochlear implants or trans-tympanic stimulation electrodes. We observed a higher influence of electrical artifacts than in other EALRs. Conclusions: TympEALR showed positive results in nearly half of the study participants, potentially avoiding invasive procedures. TympEALR can be a valuable alternative to trans-tympanic methods. More research is needed to determine if a negative result suggests against cochlear implantation.<\/jats:p>","DOI":"10.3390\/jcm13247573","type":"journal-article","created":{"date-parts":[[2024,12,12]],"date-time":"2024-12-12T10:53:27Z","timestamp":1734000807000},"page":"7573","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Tympanic Pre-Operative Electrically Evoked Auditory Late Response (TympEALR) as an Alternative to Trans-Tympanic Tests Using Anesthesia in Cochlear Implant Candidacy"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5008-7595","authenticated-orcid":false,"given":"Daniel","family":"Polterauer","sequence":"first","affiliation":[{"name":"Section Cochlear Implantation, Department of Otorhinolaryngology, University Hospital of Munich (LMU), 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maike","family":"Neuling","sequence":"additional","affiliation":[{"name":"Section Cochlear Implantation, Department of Otorhinolaryngology, University Hospital of Munich (LMU), 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Simon","sequence":"additional","affiliation":[{"name":"Section Cochlear Implantation, Department of Otorhinolaryngology, University Hospital of Munich (LMU), 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1967","DOI":"10.1002\/ar.22580","article-title":"The Cochlear Implant: Historical Aspects and Future Prospects","volume":"295","author":"Eshraghi","year":"2012","journal-title":"Anat. Rec."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1001\/archotol.1985.00800060079011","article-title":"Auditory Capabilities of Single-Channel Cochlear Implant Patients: Etiologic Considerations","volume":"111","author":"Edgerton","year":"1985","journal-title":"Arch. Otolaryngol."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"National Institutes of Health Consensus Development Conference Statement on Cochlear Implants (1989). Consensus Development Conference Statement. Arch. Otolaryngol. Head Neck Surg., 115, 31\u201336.","DOI":"10.1001\/archotol.1989.01860250033020"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1055\/a-2195-4886","article-title":"Aktuelle Trends und Entwicklungen bei der Cochlea-Implantat-Versorgung (Current Trends and Developments in Cochlear Implantation)","volume":"48","author":"Molenda","year":"2024","journal-title":"Sprache \u00b7 Stimme \u00b7 Geh\u00f6r"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1159\/000455058","article-title":"Towards a unified testing framework for single-sided deafness studies: A consensus paper","volume":"21","author":"Mertens","year":"2016","journal-title":"Audiol. Neurotol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1097\/00129492-200307000-00009","article-title":"Choice of ear for cochlear implantation: The effect of history and residual hearing on predicted postoperative performance","volume":"24","author":"Friedland","year":"2003","journal-title":"Otol. Neurotol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1159\/000095608","article-title":"Music Perception with Cochlear Implants and Residual Hearing","volume":"11","author":"Gfeller","year":"2006","journal-title":"Audiol. Neurotol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e40","DOI":"10.1097\/MAO.0b013e318291c66d","article-title":"Hearing Preservation With Full Insertion of the FLEXsoft Electrode","volume":"35","author":"Mick","year":"2013","journal-title":"Otol. Neurotol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"717","DOI":"10.3109\/00016489.2014.894254","article-title":"Hearing preservation and clinical outcome of 32 consecutive electric acoustic stimulation (EAS) surgeries","volume":"134","author":"Usami","year":"2014","journal-title":"Acta. Oto-Laryngol."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Schraivogel, S., Aebischer, P., Weder, S., Caversaccio, M., and Wimmer, W. (2023). Cochlear implant electrode impedance subcomponents as biomarker for residual hearing. Front. Neurol., 14.","DOI":"10.3389\/fneur.2023.1183116"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1097\/AUD.0000000000000400","article-title":"Using Neural Response Telemetry to Monitor Physiological Responses to Acoustic Stimulation in Hybrid Cochlear Implant Users","volume":"38","author":"Abbas","year":"2017","journal-title":"Ear Hear."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1097\/MAO.0000000000002996","article-title":"Clinical Utility of Intraoperative Electrocochleography (ECochG) During Cochlear Implantation: A Systematic Review and Quantitative Analysis","volume":"42","author":"Yin","year":"2020","journal-title":"Otol. Neurotol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"23312165241252240","DOI":"10.1177\/23312165241252240","article-title":"Does Intraoperative Extracochlear Electrocochleography Correlate With Postoperative Audiometric Hearing Thresholds in Cochlear Implant Surgery? A Retrospective Analysis of Cochlear Monitoring","volume":"28","author":"Haumann","year":"2024","journal-title":"Trends Hear."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"23312165231220997","DOI":"10.1177\/23312165231220997","article-title":"Classification of Acoustic Hearing Preservation After Cochlear Implantation Using Electrocochleography","volume":"27","author":"Sijgers","year":"2023","journal-title":"Trends Hear."},{"key":"ref_15","first-page":"358","article-title":"Monitoring Cochlear Health With Intracochlear Electrocochleography During Cochlear Implantation: Findings From an International Clinical Investigation","volume":"44","author":"Mylanus","year":"2022","journal-title":"Ear Hear."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e107","DOI":"10.1097\/MAO.0000000000001425","article-title":"Real-Time Intracochlear Electrocochleography Obtained Directly Through a Cochlear Implant","volume":"38","author":"Harris","year":"2017","journal-title":"Otol. Neurotol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"i","DOI":"10.1080\/00016489.2021.1918399","article-title":"Thirty Years of Translational Research Behind MED-EL","volume":"141","author":"Dhanasingh","year":"2021","journal-title":"Acta. Oto-Laryngol."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Schreier, A., Molenda, C., Draut, S., Hempel, J.-M., Volgger, V., Polterauer, D., Merz, L., and M\u00fcller, J. (2024). Individualized Cochlear Implantation\u2014First Experience with a New 34 Mm Electrode for Patients with Very Long Cochleae. Laryngo-Rhino-Otol., 103.","DOI":"10.1055\/s-0044-1784895"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1851","DOI":"10.1007\/s00405-021-06889-0","article-title":"Variation of the cochlear anatomy and cochlea duct length: Analysis with a new tablet-based software","volume":"279","author":"Spiegel","year":"2022","journal-title":"Eur. Arch. Otorhinolaryngol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1159\/000507975","article-title":"Acceptance and Benefits of Electro-Acoustic Stimulation for Conventional-Length Electrode Arrays","volume":"26","author":"Spitzer","year":"2020","journal-title":"Audiol. Neurotol."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Gadenstaetter, A.J., Auinger, A.B., Gerlitz, M., Riss, D., Yildiz, E., Roessler, K., Matula, C., Dahm, V., and Arnoldner, C. (2024). Long-Term Follow-Up After Translabyrinthine IAC Tumor Removal With Simultaneous Cochlear Implantation. Otol. Neurotol., 1\u20136.","DOI":"10.1097\/MAO.0000000000004313"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Dahm, V., Gadenstaetter, A.J., and Arnoldner, C. (2024). \u201cTo implant or not to implant\u201d: Electrically evoked auditory brainstem response audiometry for decision-making in vestibular schwannoma resection with CI. HNO, 1\u20137.","DOI":"10.1007\/s00106-024-01471-6"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1097\/MAO.0000000000001016","article-title":"Cochlear Implantation in Patients With Intracochlear and Intralabyrinthine Schwannomas","volume":"37","author":"Carlson","year":"2016","journal-title":"Otol. Neurotol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1097\/MAO.0b013e318254fba5","article-title":"Cochlear Implantation in Patients With Neurofibromatosis Type 2, Variables Affecting Auditory Performance","volume":"33","author":"Carlson","year":"2012","journal-title":"Otol. Neurotol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/EJA.0000000000002069","article-title":"Preoperative assessment of adults undergoing elective noncardiac surgery: Updated guidelines from the European Society of Anaesthesiology and Intensive Care","volume":"42","author":"Lamperti","year":"2025","journal-title":"Eur. J. Anaesthesiol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1097\/MAO.0000000000002055","article-title":"Extracochlear Stimulation of Electrically Evoked Auditory Brainstem Responses (eABRs) Remains the Preferred Pre-implant Auditory Nerve Function Test in an Assessor-blinded Comparison","volume":"40","author":"Causon","year":"2019","journal-title":"Otol. Neurotol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e413","DOI":"10.1097\/MAO.0000000000001584","article-title":"Usefulness of electrical auditory brainstem responses to assess the functionality of the cochlear nerve using an intracochlear test electrode","volume":"38","author":"Lassaletta","year":"2017","journal-title":"Otol. Neurotol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1186\/s40463-023-00671-4","article-title":"A novel intraoperative continuous monitoring method combining dorsal cochlear nucleus action potentials monitoring with auditory nerve test system","volume":"52","author":"Hosoya","year":"2023","journal-title":"J. Otolaryngol.\u2014Head Neck Surg."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"3315","DOI":"10.1007\/s00405-017-4643-3","article-title":"The role of eABR with intracochlear test electrode in decision making between cochlear and brainstem implants: Preliminary results","volume":"274","author":"Cinar","year":"2017","journal-title":"Eur. Arch. Oto-Rhino-Laryngol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1055\/s-0038-1673649","article-title":"Intraoperative Monitoring of the Cochlear Nerve during Neurofibromatosis Type-2 Vestibular Schwannoma Surgery and Description of a \u201cTest Intracochlear Electrode\u201d","volume":"80","author":"Kasbekar","year":"2019","journal-title":"J. Neurol. Surg. Rep."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1648","DOI":"10.1097\/AUD.0000000000000883","article-title":"Diagnostic Accuracy of Intracochlear Test Electrode for Acoustic Nerve Monitoring in Vestibular Schwannoma Surgery","volume":"41","author":"Medina","year":"2020","journal-title":"Ear Hear."},{"key":"ref_32","unstructured":"Polterauer, D. (2020). Intraoperative and postoperative measurement of brainstem responses through electrical stimulation of the auditory nerve via implantable neurostimulators. Path Med., 1\u201313."},{"key":"ref_33","first-page":"16","article-title":"Pre-perioperative, transtympanic electrically evoked auditory brainstem response in children","volume":"43","author":"Kileny","year":"2004","journal-title":"Int. J. Audiol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1072","DOI":"10.1001\/archotol.1987.01860100050020","article-title":"Electrically Evoked Middle-Latency Auditory Potentials in Cochlear Implant Candidates","volume":"113","author":"Kileny","year":"1987","journal-title":"Arch. Otolaryngol.\u2014Head Neck Surg."},{"key":"ref_35","first-page":"23","article-title":"An intrasubject comparison of electric and acoustic middle latency responses","volume":"10","author":"Kileny","year":"1989","journal-title":"Am. J. Otol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1080\/14670100.2020.1822643","article-title":"Use of auditory evoked potentials with electrical stimulation at the round window niche pre-operatively on a brain-injured patient: A case study","volume":"22","author":"Huen","year":"2020","journal-title":"Cochlear Implant. Int."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1176","DOI":"10.1080\/14992027.2022.2114024","article-title":"Evaluation of auditory pathway excitability using a pre-operative trans-tympanic electrically evoked auditory brainstem response under local anesthesia in cochlear implant candidates","volume":"62","author":"Polterauer","year":"2022","journal-title":"Int. J. Audiol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1017\/S0022215121001328","article-title":"Cochlear implantation in auditory neuropathy spectrum disorders: Role of transtympanic electrically evoked auditory brainstem responses and serial neural response telemetry","volume":"135","author":"Dutt","year":"2021","journal-title":"J. Laryngol. Otol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1179\/146701010X12671177818669","article-title":"The predictive value of transtympanic promontory EABR in congenital temporal bone malformations","volume":"11","author":"Kileny","year":"2010","journal-title":"Cochlear Implant. Int."},{"key":"ref_40","unstructured":"Polterauer, D., Mandruzzato, G., Neuling, M., Polak, M., M\u00fcller, J., and Hempel, J.-M. (2019, January 18\u201321). PromCERA: Praeoperative ECERA\u2014Erweiterter objektiver PromTest zur Integrit\u00e4tspr\u00fcfung des H\u00f6rnervs bei CI-Kandidaten. Proceedings of the 50 Jahrestagung der Deutschen Gesellschaft f\u00fcr Medizinische Physik, Stuttgart, Germany."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1515\/cdbme-2018-0135","article-title":"PromBERA: A preoperative eABR: An update","volume":"4","author":"Polterauer","year":"2018","journal-title":"Curr. Dir. Biomed. Eng."},{"key":"ref_42","unstructured":"Polterauer, D., and Neuling, M. (2023, January 15\u201319). Transtympanic Electrically Evoked Auditory Midbrain Response in Local Anesthesia (=LA-TT-EAMLR) as a Pre-Operative Tool for Checking Cochlear Implant (=CI) Candidacy in an Intrasubject Comparison to Established Equivalent Measurements of the Auditory Brainstem (=LA-TT-EABR) and Auditory Cortex (=LA-TT-EALR). Proceedings of the International Evoked Response Audiometry Study Group Biennial Symposium, Cologne, Germany."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1515\/cdbme-2022-1060","article-title":"LA-TT-EALR \/ PromCERA: Comparison of Preoperatively Performed Electrically Evoked Auditory Potentials at the Brainstem and Cortical Level during Local Anesthesia","volume":"8","author":"Polterauer","year":"2022","journal-title":"Curr. Dir. Biomed. Eng."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1179\/cim.2006.7.4.183","article-title":"Trans-tympanic electric auditory brainstem response (TT-EABR): The importance of the positioning of the stimulating electrode","volume":"7","author":"Pau","year":"2006","journal-title":"Cochlear Implant. Int."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s12070-019-01585-2","article-title":"The Methodology and Electro-physiological Classification of Pre-operative Trans-tympanic Electrically-Evoked Auditory Brainstem Response (TT-EABR)","volume":"71","author":"Dutt","year":"2019","journal-title":"Indian J. Otolaryngol. Head Neck Surg."},{"key":"ref_46","unstructured":"Neumann, K., Raab, P., Preibisch, C., Lanfermann, H., Reimold, I., and Kiefer, J. (2023, November 26). Aktivierung des Auditiven Cortex Durch Geh\u00f6rgangs-Elektrostimulation bei Geh\u00f6rlosen Erwachsenen\u2013eine fMRI-Studie. 5 DGA Jahrestagung. DGA. Available online: http:\/\/www.uzh.ch\/orl\/dga2002\/programm\/Neumann_a.pdf."},{"key":"ref_47","unstructured":"Neuling, M., Polterauer, D., Mandruzzato, G., M\u00fcller, J., and Hempel, J. (2020, January 3\u20134). PromCERA light (tympanale praeop. ECERA) vs. PromCERA (transtympanale praeop. ECERA in Lokalan\u00e4sthesie). Proceedings of the Jahrestagung der Deutschen Gesellschaft f\u00fcr Audiologie, Cologne, Germany."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1016\/j.ijporl.2018.02.033","article-title":"Clinically recorded cortical auditory evoked potentials from paediatric cochlear implant users fitted with electrically elicited stapedius reflex thresholds","volume":"108","author":"Kosaner","year":"2018","journal-title":"Int. J. Pediatr. Otorhinolaryngol."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Polterauer, D., Neuling, M., Stoecklein, S., and Mueller, J. (2024). Cochlear Implantation in a Patient with Implanted Trigeminus Stimulator\u2014Clinical Considerations for Using Two Different Electrical Stimulators in the Same Patient and Our Results. J. Otorhinolaryngol. Hear. Balance Med., 5.","DOI":"10.3390\/ohbm5010002"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1159\/000529797","article-title":"Direct Elicitation of Cortical Auditory Evoked Potentials by Electrical Stimulation and Their Use to Verify the Most Comfortable Level of Stimulation in Cochlear Implant Users","volume":"28","author":"Ffoulkes","year":"2023","journal-title":"Audiol. Neurotol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/j.bspc.2015.05.015","article-title":"Reduction of stimulation coherent artifacts in electrically evoked auditory brainstem responses","volume":"21","author":"Hu","year":"2015","journal-title":"Biomed. Signal Process. Control"},{"key":"ref_52","unstructured":"Hughes, M.L. (2012). Objective Measures in Cochlear Implants, Plural Publishing."},{"key":"ref_53","unstructured":"Lightfoot, G. (2024, November 15). Background information on Cortical ERA. October 2014. Available online: https:\/\/eratraining.co.uk\/onewebmedia\/CAEP%20Basics.pdf."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1097\/00003446-200212000-00002","article-title":"Neurophysiology of Cochlear Implant Users I: Effects of Stimulus Current Level and Electrode Site on the Electrical ABR, MLR, and N1-P2 Response","volume":"23","author":"Firszt","year":"2002","journal-title":"Ear Hear."},{"key":"ref_55","unstructured":"Eggermont, J.J. (2019). The Auditory Brain and Age-Related Hearing Impairment, Academic Press. Available online: https:\/\/shop.elsevier.com\/books\/the-auditory-brain-and-age-related-hearing-impairment\/eggermont\/978-0-12-815304-8."},{"key":"ref_56","first-page":"687","article-title":"Comprehensive literature review on the application of the otological-surgical planning software OTOPLAN\u00ae for cochlear implantation. German version","volume":"72","author":"Spahn","year":"2024","journal-title":"HNO"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1515\/cdbme-2023-1182","article-title":"Intra-operative test electrode and electrical auditory brainstem response after preoperative assessment in cochlear implant candidacy","volume":"9","author":"Polterauer","year":"2023","journal-title":"Curr. Dir. Biomed. Eng."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1055\/a-2195-4903","article-title":"Single-Sided Deafness\u2014Mit dem \u201eZweiten\u201c h\u00f6rt man besser","volume":"48","author":"Jakob","year":"2024","journal-title":"Sprache \u00b7 Stimme \u00b7 Geh\u00f6r"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1002\/lio2.288","article-title":"Auditory synaptopathy, auditory neuropathy, and cochlear implantation","volume":"4","author":"Shearer","year":"2019","journal-title":"Laryngoscope Investig. Otolaryngol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/24\/7573\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:53:48Z","timestamp":1760115228000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/24\/7573"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,12]]},"references-count":59,"journal-issue":{"issue":"24","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["jcm13247573"],"URL":"https:\/\/doi.org\/10.3390\/jcm13247573","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,12]]}}}