{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T05:58:48Z","timestamp":1790661528336,"version":"4.1.0"},"reference-count":48,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,2,7]],"date-time":"2025-02-07T00:00:00Z","timestamp":1738886400000},"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>Introduction: Comparative studies on Hounsfield units (HU) and bone volume fraction (BVF%) for the demonstration of cancellous bone density in the entire spine and in the various intravertebral regions are rare. The aim of the present study was to determine HU in various segments and sectional planes (sagittal, axial, coronary) of the spine and their description in the context of bone density measurement on micro-CT, as well as the significance of the values for bone loss and fracture risk. Materials\/Methods: The spines of 11 body donors were analyzed by means of high-resolution spiral CT and micro-CT. Vertebral deformities were identified on sagittal reformations and classified. Cancellous bone density in the individual vertebrae from C3 to L5, expressed in HU, was measured on CT images (in all 242 vertebral bodies). For this purpose, a manually positioned ROI was established in mid-vertebral cancellous bone in the axial, sagittal, and coronary planes. Using a Jamshidi\u00ae needle, we obtained 726 specimens from prepared vertebrae extracted from three quadrants (QI: right-sided edge, QII: central, QIII: left-sided edge) and analyzed these on a micro-CT device (SKYSCAN 1172, RJL Micro &amp; Analytic GmbH, Germany). The study design with multiple measurements was reflected by a General Linear Model Repeated Measures. The model was adjusted to the bone density values of both procedures (HU, BVF%) in the viewed sectional planes and quadrants for 22 vertebrae, with the predictors gender and fracture status, controlled for age and body mass index (BMI). Analysis of variance provided estimations of density values and comparisons of several subgroups. Results: All spines were osteoporotic. Both procedures revealed a significant reduction in cancellous bone density from C3 to L5 (p \u2264 0.018). Gender (p = 0.002) and fracture status (p = 0.001) have an impact on bone density: men have higher bone density values than women; cases with fewer fractures also have higher bone density values. CT revealed both effects (p = 0.002 for each) with greater clarity. HU on CT measurements in the axial plane showed higher density values than in the sagittal or coronary planes. CT measurement profiles along the spine as well as along the individual profiles of the 11 body donors were independent of the measured quadrants, but the micro-CT measurements were not. Discussion: The craniocaudal reduction in bone density was demonstrated in different degrees of clarity by the two procedures. Likewise, the procedure-related visualization of differences in cancellous bone density between genders, fracture groups, sectional planes, and quadrants indicates the need for a better understanding of the advantages of each procedure for patient-oriented approaches to the diagnosis of osteoporosis. Future research should be focused on the determination of standard values and their clinical application for the prevention and treatment of osteoporosis.<\/jats:p>","DOI":"10.3390\/jcm14041059","type":"journal-article","created":{"date-parts":[[2025,2,7]],"date-time":"2025-02-07T09:02:42Z","timestamp":1738918962000},"page":"1059","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Evaluation of Cancellous Bone Density from C3 to L5 in 11 Body Donors: CT Versus Micro-CT Measurements"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9953-3987","authenticated-orcid":false,"given":"Guido","family":"Schr\u00f6der","sequence":"first","affiliation":[{"name":"Clinic for Orthopaedics and Trauma Surgery, Sana Hospital Bad Doberan, Academic Teaching Hospital of the University of Rostock, 18209 Hohenfelde, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Estelle","family":"Akl","sequence":"additional","affiliation":[{"name":"Institute for Diagnostic and Interventional Radiology, Pediatric and Neuroradiology, Rostock University Medical Center, 18057 Rostock, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justus","family":"Hillebrand","sequence":"additional","affiliation":[{"name":"Institute for Diagnostic and Interventional Radiology, Pediatric and Neuroradiology, Rostock University Medical Center, 18057 Rostock, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0463-8741","authenticated-orcid":false,"given":"Andreas","family":"G\u00f6tz","sequence":"additional","affiliation":[{"name":"Institute for Biomedical Technology, Rostock University Medical Center, Warnem\u00fcnde, 18119 Rostock, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Mittlmeier","sequence":"additional","affiliation":[{"name":"Department of Trauma Surgery, Hand and Reconstructive Surgery, Rostock University Medical Center, 18057 Rostock, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0584-343X","authenticated-orcid":false,"given":"Steffi S. I.","family":"Falk","sequence":"additional","affiliation":[{"name":"Department of Trauma Surgery, Hand and Reconstructive Surgery, Rostock University Medical Center, 18057 Rostock, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8533-7486","authenticated-orcid":false,"given":"Laura","family":"Hiepe","sequence":"additional","affiliation":[{"name":"Institute of Anatomy, Rostock University Medical Center, 18057 Rostock, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1385-2793","authenticated-orcid":false,"given":"Julian Ramin","family":"Andresen","sequence":"additional","affiliation":[{"name":"Division of Trauma Surgery, Department of Orthopaedics and Trauma Surgery, Medical University of Vienna, W\u00e4hringer G\u00fcrtel 18\u201320, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1575-525X","authenticated-orcid":false,"given":"Reimer","family":"Andresen","sequence":"additional","affiliation":[{"name":"Institute of Diagnostic and Interventional Radiology\/Neuroradiology, Westk\u00fcstenklinikum Heide, Academic Teaching Hospital of the Universities of Kiel, L\u00fcbeck and Hamburg, 25746 Heide, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk","family":"Flachsmeyer-Blank","sequence":"additional","affiliation":[{"name":"Clinic for Orthopaedics and Trauma Surgery, Sana Hospital Bad Doberan, Academic Teaching Hospital of the University of Rostock, 18209 Hohenfelde, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans-Christof","family":"Schober","sequence":"additional","affiliation":[{"name":"OrthoCoast, Medical Office of Orthopedics and Osteology, 17438 Wolgast, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c4nne","family":"Glass","sequence":"additional","affiliation":[{"name":"Institute for Biostatistics and Informatics in Medicine and Ageing Research, Rostock University Medical Center, 18057 Rostock, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"(1993). Consensus development conference: Diagnosis, prophylaxis, and treatment of osteoporosis. Am. J. Med., 94, 646\u2013650.","DOI":"10.1016\/0002-9343(93)90218-E"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1007\/s11657-020-00871-9","article-title":"SCOPE 2021: A new scorecard for osteoporosis in Europe","volume":"16","author":"Kanis","year":"2021","journal-title":"Arch. Osteoporos."},{"key":"ref_3","first-page":"665","article-title":"The Incidence of Fractures Among the Adult Population of Germany\u2014An Analysis from 2009 through 2019","volume":"118","author":"Rupp","year":"2021","journal-title":"Dtsch. Arztebl. Int."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1111\/jgs.15716","article-title":"Osteoporosis in Older Persons: Old and New Players","volume":"67","author":"Zanker","year":"2019","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1007\/s00393-011-0753-2","article-title":"Radiologische Diagnostik der Osteoporose","volume":"70","author":"Issever","year":"2011","journal-title":"Z. Rheumatol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"654","DOI":"10.1007\/s00113-019-0658-0","article-title":"\u201cHounsfield units\u201d als Ma\u00df f\u00fcr die Knochendichte\u2014Anwendungsm\u00f6glichkeiten in der Wirbels\u00e4ulenchirurgie","volume":"122","author":"Scheyerer","year":"2019","journal-title":"Unfallchirurg"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2179","DOI":"10.1007\/s11999-010-1766-x","article-title":"High-resolution Computed Tomography for Clinical Imaging of Bone Microarchitecture","volume":"469","author":"Burghardt","year":"2011","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1080\/02841859809172221","article-title":"Bone mineral density and spongiosa architecture in correlation to vertebral body insufficiency fractures","volume":"39","author":"Andresen","year":"1998","journal-title":"Acta Radiol."},{"key":"ref_9","first-page":"547","article-title":"Insuffizienzfrakturen der Wirbels\u00e4ule in Abh\u00e4ngigkeit von der spongi\u00f6sen Knochendichte: Eine in-vitro-Studie","volume":"51","author":"Flachsmeyer","year":"2022","journal-title":"Orthopadie"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"25","DOI":"10.5115\/acb.20.269","article-title":"A comparison, using X-ray micro-computed tomography, of the architecture of cancellous bone from the cervical, thoracic and lumbar spine using 240 vertebral bodies from 10 body donors","volume":"54","author":"Jabke","year":"2021","journal-title":"Anat. Cell Biol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1055\/a-1647-3914","article-title":"Warum sich in der Halswirbels\u00e4ule auch bei Osteoporose nur selten Insuffizienzfrakturen finden","volume":"160","author":"Hiepe","year":"2022","journal-title":"Z. Orthop. Unfall."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Schr\u00f6der, G., Mittlmeier, T., Gahr, P., Ulusoy, S., Hiepe, L., Schulze, M., G\u00f6tz, A., Andresen, R., and Schober, H.-C. (2024). Regional Variations in the Intra- and Intervertebral Trabecular Microarchitecture of the Osteoporotic Axial Skeleton with Reference to the Direction of Puncture. Diagnostics, 14.","DOI":"10.3390\/diagnostics14050498"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1330","DOI":"10.1007\/s00198-004-1640-3","article-title":"Body mass index as a predictor of fracture risk: A meta-analysis","volume":"16","author":"Kanis","year":"2005","journal-title":"Osteoporos. Int."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/j.jocd.2007.12.010","article-title":"Clinical use of quantitative computed tomography and peripheral quantitative computed tomography in the management of osteoporosis in adults: The 2007 ISCD Official Positions","volume":"11","author":"Engelke","year":"2008","journal-title":"J. Clin. Densitom."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1007\/s00198-004-1780-5","article-title":"Assessment of fracture risk","volume":"16","author":"Kanis","year":"2005","journal-title":"Osteoporos. Int."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1007\/s00198-005-0009-6","article-title":"The long-term predictive value of bone mineral density measurements for fracture risk is independent of the site of measurement and the age at diagnosis: Results from the Prospective Epidemiological Risk Factors study","volume":"17","author":"Bagger","year":"2006","journal-title":"Osteoporos. Int."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1359\/jbmr.081244","article-title":"A simple risk score for the assessment of absolute fracture risk in general practice based on two longitudinal studies","volume":"24","author":"Pluijm","year":"2009","journal-title":"J. Bone Miner. Res."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1093\/pubmed\/fds076","article-title":"Population-based prospective study on the incidence of osteoporosis-associated fractures in a German population of 200,413 inhabitants","volume":"35","author":"Westphal","year":"2013","journal-title":"J. Public Health"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1007\/s11914-010-0031-2","article-title":"Biomechanics of vertebral fractures and the vertebral fracture cascade","volume":"8","author":"Christiansen","year":"2010","journal-title":"Curr. Osteoporos. Rep."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Montemurro, N., Cocciaro, A., Liberti, G., Cosottini, M., and Perrini, P. (2022). The internal trabecular bone structure of the odontoid process of the axis. A retrospective single-center comparative study in patients following cervical trauma. J. Neurol. Surg. A Cent. Eur. Neurosurg.","DOI":"10.1055\/a-1962-0181"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Shin, D.E., Lee, Y., An, H.-J., Hwang, T.-S., Cho, J.-W., Oh, J., Ahn, W., Lee, J., Hong, C.G., and Lee, Y. (2023). Trabecular structural difference between the superior and inferior regions of the vertebral body: A cadaveric and clinical study. Front. Endocrinol., 14.","DOI":"10.3389\/fendo.2023.1238654"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1416","DOI":"10.1016\/j.bone.2012.03.002","article-title":"Failure strength of human vertebrae: Prediction using bone mineral density measured by DXA and bone volume by micro-CT","volume":"50","author":"Perilli","year":"2012","journal-title":"Bone"},{"key":"ref_23","first-page":"724","article-title":"A comparison of lateral versus anterior-posterior spine dual energy x-ray absorptiometry for the diagnosis of osteopenia","volume":"78","author":"Finkelstein","year":"1994","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1007\/BF01622286","article-title":"Population-based geographic variations in DXA bone density in Europe: The EVOS Study. European Vertebral Osteoporosis","volume":"7","author":"Lunt","year":"1997","journal-title":"Osteoporos. Int."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1016\/j.bone.2008.10.048","article-title":"Vertebral fractures usually affect the cranial endplate because it is thinner and supported by less-dense trabecular bone","volume":"44","author":"Zhao","year":"2009","journal-title":"Bone"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.2106\/JBJS.J.00160","article-title":"Hounsfield units for assessing bone mineral density and strength: A tool for osteoporosis management","volume":"93","author":"Schreiber","year":"2011","journal-title":"J. Bone Jt. Surg. Am."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1871","DOI":"10.1185\/03007995.2015.1074892","article-title":"Use of routine thoracic and abdominal computed tomography scans for assessing bone mineral density and detecting osteoporosis","volume":"31","author":"Marinova","year":"2015","journal-title":"Curr. Med. Res. Opin."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1103","DOI":"10.1007\/s00256-023-04525-y","article-title":"Coronal plane in opportunistic screening of osteoporosis using computed tomography: Comparison with axial and sagittal planes","volume":"53","author":"Kim","year":"2024","journal-title":"Skelet. Radiol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1016\/j.crad.2023.07.006","article-title":"The axial and sagittal CT values of the 7th thoracic vertebrae in screening for osteoporosis and osteopenia","volume":"78","author":"Zhang","year":"2023","journal-title":"Clin. Radiol."},{"key":"ref_30","unstructured":"Kalender, W.A. (2000). Computertomographie: Grundlagen, Ger\u00e4tetechnologie, Bildqualit\u00e4t, Anwendungen; [mit Mehrschicht-Spiral-CT], Publicis-MCD-Verl."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1007\/s00586-020-06363-1","article-title":"Characteristics of vertebral CT Hounsfield units in elderly patients with acute vertebral fragility fractures","volume":"29","author":"Zou","year":"2020","journal-title":"Eur. Spine J."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"3221","DOI":"10.2147\/IJGM.S471770","article-title":"Diagnostic Value of Hounsfield Units for Osteoporotic Thoracolumbar Vertebral Non-Compression Fractures in Elderly Patients with Low-Energy Injuries","volume":"17","author":"Yu","year":"2024","journal-title":"Int. J. Gen. Med."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Yao, Y.-C., Chao, H., Kao, K.-Y., Lin, H.-H., Wang, S.-T., Chang, M.-C., Liu, C.-L., and Chou, P.-H. (2023). CT Hounsfield unit is a reliable parameter for screws loosening or cages subsidence in minimally invasive transforaminal lumbar interbody fusion. Sci. Rep., 13.","DOI":"10.1038\/s41598-023-28555-7"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"36S","DOI":"10.1177\/21925682221140831","article-title":"Treatment and Outcome of Osteoporotic Thoracolumbar Vertebral Body Fractures With Deformation of Both Endplates With or Without Posterior Wall Involvement (OF 4): Short-Term Results from the Prospective EOFTT Multicenter Study","volume":"13","author":"Spiegl","year":"2023","journal-title":"Glob. Spine J."},{"key":"ref_35","first-page":"E335","article-title":"Risk Factors for Refracture following Primary Osteoporotic Vertebral Compression Fractures","volume":"24","author":"Ji","year":"2021","journal-title":"Pain Physician"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Korovessis, P. (2022). Osteoporotic Vertebral Body Fractures: New Trends in Differential Diagnosis, Bracing and Surgery. J. Clin. Med., 11.","DOI":"10.3390\/jcm11175172"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1036","DOI":"10.21037\/qims-22-588","article-title":"The vertebral Hounsfield units can quantitatively predict the risk of adjacent vertebral fractures after percutaneous kyphoplasty","volume":"13","author":"Jiang","year":"2023","journal-title":"Quant. Imaging Med. Surg."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"232","DOI":"10.21037\/jss-23-121","article-title":"Side specific differences of Hounsfield-Units in the osteoporotic lumbar spine","volume":"10","author":"Metzner","year":"2024","journal-title":"J. Spine Surg."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Chen, J., Li, Y., Zheng, H., Li, H., Wang, H., and Ma, L. (2024). Hounsfield unit for assessing bone mineral density distribution within lumbar vertebrae and its clinical values. Front. Endocrinol., 15.","DOI":"10.3389\/fendo.2024.1398367"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"E10","DOI":"10.3171\/2020.5.FOCUS20249","article-title":"Hounsfield units of the vertebral body and pedicle as predictors of pedicle screw loosening after degenerative lumbar spine surgery","volume":"49","author":"Xu","year":"2020","journal-title":"Neurosurg. Focus"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1007\/s11657-022-01177-8","article-title":"Low vertebral CT Hounsfield units: A risk factor for new osteoporotic vertebral fractures after the treatment of percutaneous kyphoplasty","volume":"17","author":"Ye","year":"2022","journal-title":"Arch. Osteoporos."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1111\/clr.12315","article-title":"Bone quality evaluation at dental implant site using multislice CT, micro-CT, and cone beam CT","volume":"26","author":"Parsa","year":"2015","journal-title":"Clin. Oral Implants Res."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1473","DOI":"10.1007\/s00198-008-0593-3","article-title":"Regional variations of vertebral trabecular bone microstructure with age and gender","volume":"19","author":"Chen","year":"2008","journal-title":"Osteoporos. Int."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1007\/s00774-004-0557-4","article-title":"Regional variations in microstructural properties of vertebral trabeculae with aging","volume":"23","author":"Gong","year":"2005","journal-title":"J. Bone Miner. Metab."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1016\/S8756-3282(01)00425-2","article-title":"Inhomogeneity of human vertebral cancellous bone: Systematic density and structure patterns inside the vertebral body","volume":"28","author":"Banse","year":"2001","journal-title":"Bone"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"213234","DOI":"10.1155\/2013\/213234","article-title":"Age-related changes in trabecular and cortical bone microstructure","volume":"2013","author":"Chen","year":"2013","journal-title":"Int. J. Endocrinol."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Follet, H., Farlay, D., Bala, Y., Viguet-Carrin, S., Gineyts, E., Burt-Pichat, B., Wegrzyn, J., Delmas, P., Boivin, G., and Chapurlat, R. (2013). Determinants of Microdamage in Elderly Human Vertebral Trabecular Bone. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0055232"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1613","DOI":"10.1359\/jbmr.080517","article-title":"Microarchitecture influences microdamage accumulation in human vertebral trabecular bone","volume":"23","author":"Arlot","year":"2008","journal-title":"J. Bone Miner. Res."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/4\/1059\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:28:51Z","timestamp":1760027331000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/4\/1059"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,7]]},"references-count":48,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,2]]}},"alternative-id":["jcm14041059"],"URL":"https:\/\/doi.org\/10.3390\/jcm14041059","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,7]]}}}