{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T16:36:51Z","timestamp":1788367011517,"version":"build-2803163510"},"reference-count":54,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T00:00:00Z","timestamp":1757635200000},"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>Background\/Objectives: The advent of combination antiretroviral therapy has led to significant reductions in HIV-related morbidity and mortality and, conversely, an increasing incidence of chronic diseases, such as cancer. This study aimed to assess the incidence of skin malignancies in a cohort of people living with HIV (PLWH) compared to HIV-uninfected individuals (HUPs). Methods: Between April 2023 and April 2025, PLWH attending the Infectious Disease Unit at Policlinico of Foggia, Italy, were invited for skin cancer screening (cases). During the same period, patients visiting the Dermatology Unit were asked to undergo skin cancer screening and a rapid HIV test. Those who tested negative were included as controls. Suspicious lesions were surgically excised at the Plastic Surgery University Unit and examined by a dermatopathologist. Results: We enrolled 91 cases and 91 controls. Precancerous and cancerous skin lesions were detected at similar rates in PLWH and HUPs (12% vs. 13.2% and 7.6% vs. 8.7%). The total number of cancerous and precancerous lesions was higher in the PLWH group. In both groups, basal cell carcinoma was the most common tumor. Squamous cell carcinoma, basosquamous carcinoma, and dermatofibrosarcoma protuberans were found only in PLWH. Conclusions: The higher risk of multiple and rare skin cancers in PLWH should be recognized by healthcare providers and patients. PLWH should have regular skin cancer screenings, especially if they have additional risk factors such as a history of extensive ultraviolet radiation exposure.<\/jats:p>","DOI":"10.3390\/jcm14186447","type":"journal-article","created":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T13:43:02Z","timestamp":1757684582000},"page":"6447","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Skin Cancers in People Living with Human Immunodeficiency Virus (HIV) Infection"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8363-0195","authenticated-orcid":false,"given":"Giulia","family":"Ciccarese","sequence":"first","affiliation":[{"name":"Dermatology Unit, Department of Medical and Surgical Sciences, University of Foggia, Viale L. Pinto, 1, 71122 Foggia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liberato Roberto","family":"Cecchino","sequence":"additional","affiliation":[{"name":"Unit of Reconstructive and Plastic Surgery, Department of Clinical and Experimental Medicine, Ospedali Riuniti di Foggia and University of Foggia, Viale L. Pinto, 1, 71122 Foggia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fedele","family":"Lembo","sequence":"additional","affiliation":[{"name":"Unit of Reconstructive and Plastic Surgery, Department of Clinical and Experimental Medicine, Ospedali Riuniti di Foggia and University of Foggia, Viale L. Pinto, 1, 71122 Foggia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio","family":"Ferrara","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Department of Medical and Surgical Sciences, University of Foggia, Viale L. Pinto, 1, 71122 Foggia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Grillo","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Department of Medical and Surgical Sciences, University of Foggia, Viale L. Pinto, 1, 71122 Foggia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Pizzulli","sequence":"additional","affiliation":[{"name":"Unit of Pathology, Department of Clinical and Experimental Medicine, University of Foggia\u2014University Hospital \u201cPoliclinico Riuniti\u201d, Viale L. Pinto, 71122 Foggia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piergiorgio","family":"Di Tullio","sequence":"additional","affiliation":[{"name":"Unit of Medical Oncology and Biomolecular Therapy, Department of Medical and Surgical Sciences, University of Foggia, Viale L. Pinto, 1, 71122 Foggia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Romita","sequence":"additional","affiliation":[{"name":"Section of Dermatology, Department of Precision and Regenerative Medicine and Jonian Area, University Aldo Moro of Bari, Piazza G. Cesare, 11, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caterina","family":"Foti","sequence":"additional","affiliation":[{"name":"Section of Dermatology, Department of Precision and Regenerative Medicine and Jonian Area, University Aldo Moro of Bari, Piazza G. Cesare, 11, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Sanguedolce","sequence":"additional","affiliation":[{"name":"Unit of Pathology, Department of Clinical and Experimental Medicine, University of Foggia\u2014University Hospital \u201cPoliclinico Riuniti\u201d, Viale L. Pinto, 71122 Foggia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenico","family":"Parisi","sequence":"additional","affiliation":[{"name":"Unit of Reconstructive and Plastic Surgery, Department of Clinical and Experimental Medicine, Ospedali Riuniti di Foggia and University of Foggia, Viale L. Pinto, 1, 71122 Foggia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Drago","sequence":"additional","affiliation":[{"name":"Section of Dermatology, Casa di cura Villa Montallegro, Via Monte Zovetto, 16145 Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aurelio","family":"Portincasa","sequence":"additional","affiliation":[{"name":"Unit of Reconstructive and Plastic Surgery, Department of Clinical and Experimental Medicine, Ospedali Riuniti di Foggia and University of Foggia, Viale L. Pinto, 1, 71122 Foggia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4729-7548","authenticated-orcid":false,"given":"Sergio","family":"Lo Caputo","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Department of Medical and Surgical Sciences, University of Foggia, Viale L. Pinto, 1, 71122 Foggia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"McCusker, C., and Warrington, R. (2011). Primary immunodeficiency. Allergy Asthma Clin. Immunol., 7.","DOI":"10.1186\/1710-1492-7-S1-S11"},{"key":"ref_2","unstructured":"Daniels, P., Muse, M.E., Bebb, G., Jaskolka, M., Crane, J.S., and Bermudez, R. (2025). Evaluation and Treatment of Skin Cancer in Patients with Immunosuppression. StatPearls [Internet], StatPearls Publishing."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1111\/ijd.17061","article-title":"Skin cancer in renal transplant recipients: Outcomes from a safety net hospital in Boston","volume":"63","author":"Sachedina","year":"2024","journal-title":"Int. J. Dermatol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e36","DOI":"10.1111\/jdv.15153","article-title":"Dermatological infections in organ transplant recipients: A retrospective study on 222 patients","volume":"33","author":"Ciccarese","year":"2019","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"101896","DOI":"10.1016\/j.trim.2023.101896","article-title":"Skin cancers in solid organ transplant recipients: A retrospective study on 218 patients","volume":"80","author":"Trave","year":"2023","journal-title":"Transpl. Immunol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"155534","DOI":"10.1016\/j.prp.2024.155534","article-title":"Participation of T cells in generating immune protection against cancers","volume":"262","author":"Deo","year":"2024","journal-title":"Pathol. Res. Pract."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1143","DOI":"10.1007\/s00262-005-0702-5","article-title":"The interplay between innate and adaptive immunity regulates cancer development","volume":"54","author":"Coussens","year":"2005","journal-title":"Cancer Immunol. Immunother."},{"key":"ref_8","first-page":"375","article-title":"Anti-Herpes zoster vaccination in patients with dermatologic diseases: A position statement from the Italian SIDeMaST group of sexually transmitted, infectious and tropical diseases","volume":"159","author":"Ciccarese","year":"2024","journal-title":"Ital. J. Dermatol. Venerol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1848068","DOI":"10.1080\/2162402X.2020.1848068","article-title":"Cancer Risks in Solid Organ Transplant Recipients: Results from a Comprehensive Analysis of 72 Cohort Studies","volume":"9","author":"Huo","year":"2020","journal-title":"Oncoimmunology"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Dillibabu, T., Laprise, C., Nicolau, B., and Madathil, S. (2025). Risk of cancer among adult solid organ transplant recipients in Quebec, Canada: 1997\u20132016. BMC Cancer, 25.","DOI":"10.1186\/s12885-025-14349-9"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2509","DOI":"10.1111\/ajt.14382","article-title":"Skin Cancers in Organ Transplant Recipients","volume":"17","author":"Mittal","year":"2017","journal-title":"Am. J. Transplant."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Starace, M., Rapparini, L., and Cedirian, S. (2024). Skin Malignancies Due to Anti-Cancer Therapies. Cancers, 16.","DOI":"10.3390\/cancers16111960"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Karampinis, E., Koumaki, D., Sgouros, D., Nechalioti, P.M., Toli, O., Pappa, G., Papadakis, M., Georgopoulou, K.E., Schulze-Roussaki, A.V., and Kouretas, D. (2025). Non-Melanoma Skin Cancer: Assessing the Systemic Burden of the Disease. Cancers, 17.","DOI":"10.3390\/cancers17040703"},{"key":"ref_14","unstructured":"Coffin, J.M., Hughes, S.H., and Varmus, H.E. (2025, July 01). Immunopathogenic Mechanisms of HIV Infection, Retroviruses, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK19451\/."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1016\/j.ncrna.2022.07.003","article-title":"Long noncoding RNAs (lncRNAs) in HIV-mediated carcinogenesis: Role in cell homeostasis, cell survival processes and drug resistance","volume":"7","author":"Makgoo","year":"2022","journal-title":"Noncoding RNA Res."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Tolomeo, M., and Cascio, A. (2024). The Complex Dysregulations of CD4 T Cell Subtypes in HIV Infection. Int. J. Mol. Sci., 25.","DOI":"10.3390\/ijms25147512"},{"key":"ref_17","first-page":"686","article-title":"Study on the impact of sexually transmitted infections on Quality of Life, mood and sexual function","volume":"156","author":"Ciccarese","year":"2021","journal-title":"Ital. J. Dermatol. Venerol."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Omar, A., Marques, N., and Crawford, N. (2024). Cancer and HIV: The Molecular Mechanisms of the Deadly Duo. Cancers, 16.","DOI":"10.3390\/cancers16030546"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.1056\/NEJMra1615896","article-title":"HIV-Associated Cancers and Related Diseases","volume":"378","author":"Yarchoan","year":"2018","journal-title":"N. Engl. J. Med."},{"key":"ref_20","unstructured":"(2025, August 14). National Cancer Institute Dictionary, Available online: https:\/\/www.cancer.gov\/publications\/dictionaries\/cancer-terms\/def\/aids-defining-cancer."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/978-3-030-03502-0_1","article-title":"AIDS-Associated Malignancies","volume":"177","author":"Vangipuram","year":"2019","journal-title":"Cancer Treat. Res."},{"key":"ref_22","unstructured":"National Cancer Institute (2025, August 14). Non-AIDS-Defining Cancer, Available online: https:\/\/www.cancer.gov\/publications\/dictionaries\/cancer-terms\/def\/non-aids-defining-cancer."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e27924","DOI":"10.1002\/jmv.27924","article-title":"Oncoviruses and melanomas: A retrospective study and literature review","volume":"95","author":"Ciccarese","year":"2023","journal-title":"J. Med. Virol."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Bautista, J., and Lopez-Cortes, A. (2025). Oncogenic viruses rewire the epigenome in human cancer. Front. Cell. Infect. Microbiol., 15.","DOI":"10.3389\/fcimb.2025.1617198"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"4834","DOI":"10.1200\/JCO.2008.16.8252","article-title":"AIDS-related malignancies: State of the art and therapeutic challenges","volume":"26","author":"Spano","year":"2008","journal-title":"J. Clin. Oncol."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Mathoma, A., Sartorius, B., and Mahomed, S. (2024). The Trends and Risk Factors of AIDS- Defining Cancers and Non-AIDS-Defining Cancers in Adults Living with and without HIV: A Narrative Review. J. Cancer Epidemiol., 2024.","DOI":"10.1155\/2024\/7588928"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1142","DOI":"10.1002\/ijc.35493","article-title":"Cancer incidence in people with HIV in Italy: Comparison of the ICONA COHORT with general population data","volume":"157","author":"Piselli","year":"2025","journal-title":"Int. J. Cancer"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"860","DOI":"10.1634\/theoncologist.2014-0024","article-title":"The evolving scenario of non-AIDS-defining cancers: Challenges and opportunities of care","volume":"19","author":"Vaccher","year":"2014","journal-title":"Oncologist"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1177\/0956462415586316","article-title":"The risk of non-melanoma skin cancer in HIV-infected patients: New data and meta-analysis","volume":"27","author":"Zhao","year":"2016","journal-title":"Int. J. STD AIDS"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1570","DOI":"10.1097\/QAD.0000000000002600","article-title":"Nonmelanoma skin cancer and melanoma in HIV-1-infected patients","volume":"34","author":"Latini","year":"2020","journal-title":"AIDS"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"102661","DOI":"10.1016\/j.jiph.2025.102661","article-title":"Malignancies in people living with HIV: A 25-years observational study from a tertiary hospital in Italy","volume":"18","author":"Anastasia","year":"2025","journal-title":"J. Infect. Public Health"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e70044","DOI":"10.1002\/jmv.70044","article-title":"Fourth-Generation HIV Rapid Tests: Enhanced Sensitivity and Reduced Diagnostic Window for HIV-1 Primary Infection Screening","volume":"96","author":"Guiraud","year":"2024","journal-title":"J. Med. Virol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2416","DOI":"10.1097\/SCS.0000000000005717","article-title":"Integra in Scalp Reconstruction After Tumor Excision: Recommendations From a Multidisciplinary Advisory Board","volume":"30","author":"Magnoni","year":"2019","journal-title":"J. Craniofac. Surg."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1093\/jalm\/jfaa176","article-title":"Limits of Detection and Limits of Infection: Quantitative HIV Measurement in the Era of U = U","volume":"6","author":"Weld","year":"2021","journal-title":"J. Appl. Lab. Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1024","DOI":"10.1111\/jdv.19897","article-title":"European consensus-based interdisciplinary guideline for diagnosis, treatment and prevention of actinic keratoses, epithelial UV-induced dysplasia and field cancerization on behalf of European Association of Dermato-Oncology, European Dermatology Forum, European Academy of Dermatology and Venereology and Union of Medical Specialists (Union Europ\u00e9enne des M\u00e9decins Sp\u00e9cialistes)","volume":"38","author":"Kandolf","year":"2024","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1080\/14737140.2018.1489246","article-title":"The eighth edition American Joint Committee on Cancer (AJCC) melanoma staging system: Implications for melanoma treatment and care","volume":"18","author":"Keung","year":"2018","journal-title":"Expert. Rev. Anticancer Ther."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1016\/j.clindermatol.2024.09.006","article-title":"Melanoma in situ and low-risk pT1a melanoma: Need for new diagnostic terminology","volume":"43","author":"Elder","year":"2025","journal-title":"Clin. Dermatol."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"M\u00e5rdh, O., Quinten, C., Kuchukhidze, G., Seguy, N., Dara, M., Amato-Gauci, A.J., Pharris, A., and ECDC\/WHO HIV Surveillance network (2019). HIV among women in the WHO European Region\u2014Epidemiological trends and predictors of late diagnosis, 2009\u20132018. Euro. Surveill., 24.","DOI":"10.2807\/1560-7917.ES.2019.24.48.1900696"},{"key":"ref_39","first-page":"3","article-title":"Aggiornamento Delle Nuove Diagnosi di Infezione da Hiv e Dei Casi di Aids in Italia al 31 Dicembre 2023","volume":"37","author":"Regine","year":"2024","journal-title":"Not. Ist. Super. Sanit\u00e0"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1268","DOI":"10.1111\/tri.13520","article-title":"Initial skin cancer screening for solid organ transplant recipients in the United States: Delphi method development of expert consensus guidelines","volume":"32","author":"Crow","year":"2019","journal-title":"Transpl. Int."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1007\/s00403-024-03551-7","article-title":"Update on skin cancer prevention modalities and screening protocols in solid organ transplant recipients: A scoping review","volume":"317","author":"Korzeniowski","year":"2024","journal-title":"Arch. Dermatol. Res."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1684\/ejd.2020.3845","article-title":"Skin cancer screening in organ transplant centres in the United Kingdom: A national survey","volume":"30","author":"Cordaro","year":"2020","journal-title":"Eur. J. Dermatol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"892","DOI":"10.1001\/jamadermatol.2017.1716","article-title":"Association of Multiple Primary Skin Cancers With Human Immunodeficiency Virus Infection, CD4 Count, and Viral Load","volume":"153","author":"Asgari","year":"2017","journal-title":"JAMA Dermatol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1130","DOI":"10.1001\/archinternmed.2009.104","article-title":"Cutaneous malignancies among HIV-infected persons","volume":"169","author":"Hullsiek","year":"2009","journal-title":"Arch. Intern. Med."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1016\/j.jaad.2018.03.024","article-title":"Risk of skin cancer in patients with HIV: A Danish nationwide cohort study","volume":"79","author":"Omland","year":"2018","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1016\/j.jid.2022.09.008","article-title":"Risk of Nonkeratinocyte Skin Cancers in People Living with HIV during the Era of Antiretroviral Therapy","volume":"143","author":"Luu","year":"2023","journal-title":"J. Investig. Dermatol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"e60","DOI":"10.1016\/S2352-3018(23)00202-3","article-title":"Skin cancer risk in people living with HIV: A call for action","volume":"11","author":"Reinhart","year":"2024","journal-title":"Lancet HIV"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1093\/jnci\/djs529","article-title":"HIV infection status, immunodeficiency, and the incidence of non-melanoma skin cancer","volume":"105","author":"Silverberg","year":"2013","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Venanzi Rullo, E., Maimone, M.G., Fiorica, F., Ceccarelli, M., Guarneri, C., Berretta, M., and Nunnari, G. (2021). Non-Melanoma Skin Cancer in People Living with HIV: From Epidemiology to Clinical Management. Front. Oncol., 11.","DOI":"10.3389\/fonc.2021.689789"},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Dervenis, V. (2025). The Role of HPV in the Development of Cutaneous Squamous Cell Carcinoma-Friend or Foe?. Cancers, 17.","DOI":"10.3390\/cancers17071195"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1007\/978-3-030-46227-7_10","article-title":"Human Papillomaviruses and Skin Cancer","volume":"1268","author":"Smola","year":"2020","journal-title":"Adv. Exp. Med. Biol."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Kosche, C., Chio, M.T.W., and Arron, S.T. (Clin. Dermatol, 2023). Skin cancer and HIV, Clin. Dermatol, in press.","DOI":"10.1016\/j.clindermatol.2023.12.006"},{"key":"ref_53","first-page":"85","article-title":"Dermatofibrosarcoma protuberans in two patients with acquired immunodeficiency syndrome","volume":"65","author":"Sapadin","year":"2000","journal-title":"Cutis"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1111\/hiv.13022","article-title":"Multidisciplinary collaborative integrated management of increasingly prominent HIV complications in the post-cART era","volume":"21","author":"Lin","year":"2020","journal-title":"HIV. Med."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/18\/6447\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:44:49Z","timestamp":1760035489000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/18\/6447"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,12]]},"references-count":54,"journal-issue":{"issue":"18","published-online":{"date-parts":[[2025,9]]}},"alternative-id":["jcm14186447"],"URL":"https:\/\/doi.org\/10.3390\/jcm14186447","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,12]]}}}