{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:51:06Z","timestamp":1787028666110,"version":"build-2736575974"},"reference-count":59,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T00:00:00Z","timestamp":1767657600000},"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 most prevalent benign tumors in women are uterine fibroids. Most patients\u2014more than half\u2014do not exhibit any symptoms, but the most common clinical signs include irregular uterine bleeding, pelvic pain, gastrointestinal problems, increased frequency of urination, and, in some cases, infertility. Venous thromboembolism is a very rare consequence, especially when significant uterine fibroids are present. This syndrome usually develops because of pelvic vascular systems being compressed, which causes venous stasis. Pharmacological treatment, minimally invasive procedures, and surgical techniques are examples of therapy alternatives. The purpose of this study is to present, compare, and potentially elucidate the underlying mechanisms of VTE development in fibroids. Methods: we have synthesized findings from 24 documented instances of venous thromboembolism (VTE) linked to uterine fibroids. Results: the principal mechanism underlying thromboembolic events was identified as the mechanical compression of pelvic venous structures due to mass effect. Additionally, we recognized other pertinent risk factors, including oral contraceptive use, May-Thurner syndrome, myomatous erythrocytosis, and intravenous leiomyomatosis. None of the reviewed case reports provided evidence of confirmed inherited thrombophilia in the patients under investigation. The femoral and popliteal veins, primarily in the left leg, were most frequently impacted by thrombosis and the ensuing blockage. Imaging techniques confirmed that individuals suffered pulmonary embolisms in half of the cases. When the right treatment was given as soon as possible, most of VTEs had favorable outcome. In almost half of the cases examined, the patient had a hysterectomy. Since all symptoms were alleviated and the chance of additional thromboembolic consequences was reduced, this treatment strategy turned out to be the most successful. Conclusions: Clinicians should maintain a low threshold for venous imaging in women with large pelvic masses and unilateral limb symptoms. Despite being uncommon, VTE associated with UFs can cause serious morbidity. Mechanical venous compression is the main mechanism, which is often exacerbated by additional prothrombotic variables. Clinicians should maintain a low threshold for venous imaging in women with significant pelvic masses and unilateral limb symptoms, look for concurrent thrombophilia, and investigate early surgical consultation to address compressive etiologies when VTE is still unexplained. It would be simpler to ascertain the actual incidence and pinpoint risk variables that can be altered with standardized reporting of fibroid-associated VTE and prospective registries.<\/jats:p>","DOI":"10.3390\/jcm15020444","type":"journal-article","created":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T16:12:55Z","timestamp":1767715975000},"page":"444","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Venous Thromboembolism Associated with Uterine Fibroids: A Review of Reported Cases"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0515-1951","authenticated-orcid":false,"given":"Radmila","family":"Spari\u0107","sequence":"first","affiliation":[{"name":"Faculty of Medicine, University of Belgrade, Dr Suboti\u0107a 8, 11000 Belgrade, Serbia"},{"name":"Clinic for Gynecology and Obstetrics, University Clinical Centre of Serbia, Dr Koste Todorovi\u0107a 26, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9979-9287","authenticated-orcid":false,"given":"Marta","family":"Stojkovi\u0107","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Belgrade, Dr Suboti\u0107a 8, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Momir","family":"\u0160arac","sequence":"additional","affiliation":[{"name":"Faculty of Medicine of the Military Medical Academy, University of Defence, Crnotravska 17, 11000 Belgrade, Serbia"},{"name":"Clinic for Vascular and Endovascular Surgery, Military Medical Academy, Crnotravska 17, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5928-3565","authenticated-orcid":false,"given":"Giovanni","family":"Pecorella","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, and CERICSAL (CEntro di RIcerca Clinico SALentino), \u201cVeris delli Ponti Hospital\u201d, Via Giuseppina Delli Ponti, 73020 Scorrano, LE, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8242-9163","authenticated-orcid":false,"given":"Vladimir","family":"\u017divkovi\u0107","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Belgrade, Dr Suboti\u0107a 8, 11000 Belgrade, Serbia"},{"name":"Institute of Forensic Medicine, Faculty of Medicine, University of Belgrade, Deligradska 31a, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8859-0639","authenticated-orcid":false,"given":"Safak","family":"Hatirnaz","sequence":"additional","affiliation":[{"name":"School of Health Sciences, Kent University, Istanbul 34433, T\u00fcrkiye"},{"name":"Department of Obstetrics and Gynecology, Mediliv Medical Center, Samsun 55100, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8426-8490","authenticated-orcid":false,"given":"Andrea","family":"Tinelli","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, and CERICSAL (CEntro di RIcerca Clinico SALentino), \u201cVeris delli Ponti Hospital\u201d, Via Giuseppina Delli Ponti, 73020 Scorrano, LE, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,6]]},"reference":[{"key":"ref_1","unstructured":"Barjon, K., and Mikhail, L.N. (2024, July 23). Uterine Leiomyomata, StatPearls, Available online: http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK546680\/."},{"key":"ref_2","first-page":"424","article-title":"Epidemiology of Uterine Myomas: A Review","volume":"9","author":"Sparic","year":"2016","journal-title":"Int. J. Fertil. Steril."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1055\/s-0037-1599090","article-title":"Recent Advances in Uterine Fibroid Etiology","volume":"35","author":"McWilliams","year":"2017","journal-title":"Semin. Reprod. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1097\/01.EDE.0000054360.61254.27","article-title":"Why is Parity Protective for Uterine Fibroids?","volume":"14","author":"Dunson","year":"2003","journal-title":"Epidemiology"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Tinelli, A., Vinciguerra, M., Malvasi, A., Andji\u0107, M., Babovi\u0107, I., and Spari\u0107, R. (2021). Uterine Fibroids and Diet. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18031066"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1016\/j.bpobgyn.2008.01.008","article-title":"Clinical presentation of fibroids","volume":"22","author":"Gupta","year":"2008","journal-title":"Best Pract. Res. Clin. Obstet. Gynaecol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1002\/ijgo.13102","article-title":"Epidemiology and management of uterine fibroids","volume":"149","author":"Giuliani","year":"2020","journal-title":"Int. J. Gynecol. Obstet."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2045","DOI":"10.1093\/humrep\/dead194","article-title":"Infertility in patients with uterine fibroids: A debate about the hypothetical mechanisms","volume":"38","author":"Don","year":"2023","journal-title":"Human. Reprod."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1365","DOI":"10.1007\/s00404-024-07678-w","article-title":"Advanced maternal age (AMA) and pregnancy: A feasible but problematic event","volume":"310","author":"Pecorella","year":"2024","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"484","DOI":"10.3109\/14767058.2014.921675","article-title":"Number and size of uterine fibroids and obstetric outcomes","volume":"28","author":"Ciavattini","year":"2015","journal-title":"J. Matern. Fetal Neonatal Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1802","DOI":"10.5114\/aoms\/171786","article-title":"Global epidemiological characteristics of uterine fibroids","volume":"19","author":"Li","year":"2023","journal-title":"Arch. Med. Sci."},{"key":"ref_12","unstructured":"Florence, A.M., and Fatehi, M. (2024, July 23). Leiomyoma, StatPearls, Available online: http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK538273\/."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1097\/GRF.0000000000000164","article-title":"Epidemiology of Uterine Fibroids\u2014From Menarche to Menopause","volume":"59","author":"Wise","year":"2016","journal-title":"Clin. Obstet. Gynecol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"211.e1","DOI":"10.1016\/j.ajog.2011.12.002","article-title":"The estimated annual cost of uterine leiomyomata in the United States","volume":"206","author":"Cardozo","year":"2012","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1971","DOI":"10.1080\/03007995.2017.1372107","article-title":"Impact of uterine fibroid symptoms on health-related quality of life of US women: Evidence from a cross-sectional survey","volume":"33","author":"Soliman","year":"2017","journal-title":"Curr. Med. Res. Opin."},{"key":"ref_16","first-page":"1","article-title":"Case series of seven women with uterine fibroids associated with venous thromboembolism and chronic thromboembolic disease","volume":"9","author":"Raza","year":"2018","journal-title":"Pulm. Circ."},{"key":"ref_17","first-page":"e62436","article-title":"Uterine Fibroid-Associated Massive Pulmonary Embolism: A Report of Two Cases","volume":"16","author":"Brown","year":"2024","journal-title":"Cureus"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Yuk, J.S., and Kim, M. (2022). Incidence Rates of Myomectomy-Related Mortality and Venous Thromboembolism in South Korea: A Population-Based Study. Front. Med., 9.","DOI":"10.3389\/fmed.2022.849660"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e252906","DOI":"10.1136\/bcr-2022-252906","article-title":"Leiomyoma as a cause of thrombotic events in different vascular territories","volume":"15","author":"Sousa","year":"2022","journal-title":"BMJ Case Rep."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Alkhawam, M., Matthews, B., Chen, W., Sabouni, M.A., and McElwee, S.K. (Med. Pharmacol., 2024). Extensive Bilateral Pulmonary Embolism Secondary to Uterine Fibroid Induced Iliac Vein Compression; Case Report, Med. Pharmacol., preprint.","DOI":"10.20944\/preprints202409.2238.v1"},{"key":"ref_21","first-page":"306","article-title":"Portal Vein Thrombosis in a Woman with a Large Uterine Fibroma","volume":"7","author":"Almassinokiani","year":"2022","journal-title":"Case Rep. Clin. Pract."},{"key":"ref_22","first-page":"283","article-title":"May-Thurner Syndrome Variant\u2014Compression of the Iliac Vein Caused by Uterine Myoma","volume":"4","author":"Batista","year":"2022","journal-title":"Clin. Image Case Rep. J."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Dong, S., Sun, X., Yu, F., Wang, W., Zhang, L., Wang, Y., and Yu, X. (2024). Case report: A case of perineal prolapse of giant uterine fibroids complicated by multiple pulmonary embolisms and deep venous thrombosis. Front. Oncol., 14.","DOI":"10.3389\/fonc.2024.1415928"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"345","DOI":"10.36518\/2689-0216.1942","article-title":"A Complex Case of a Large Fibroid Uterus Compressing the Inferior Vena Cava Causing Recurrent Deep Vein Thrombosis and Pulmonary Embolisms","volume":"6","author":"Gil","year":"2025","journal-title":"HCA Healthc. J. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"rjac234","DOI":"10.1093\/jscr\/rjac234","article-title":"Vena cava balloon occlusion for pulmonary embolism prevention during resection of giant uterus fibroids","volume":"2022","author":"Kotsis","year":"2022","journal-title":"J. Surg. Case Rep."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1921","DOI":"10.1016\/j.radcr.2020.07.070","article-title":"Endovascular strategy for deep vein thrombosis caused by a huge uterine myoma accompanied by May\u2013Thurner syndrome: A case report","volume":"15","author":"Maruyama","year":"2020","journal-title":"Radiol. Case Rep."},{"key":"ref_27","first-page":"55","article-title":"Case report: A challenging case of bilateral pulmonary embolism, deep venous thrombosis and bleeding uterine fibroids in a resource poor setting in Ghana","volume":"2","author":"Nartey","year":"2020","journal-title":"PAMJ Clin. Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e40862","DOI":"10.1097\/MD.0000000000040862","article-title":"Large uterine fibroid causing DVT and PE: Successful management with mechanical aspiration thrombectomy and hysterectomy: A case report and literature review","volume":"103","author":"Qammar","year":"2024","journal-title":"Medicine"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"102022","DOI":"10.1016\/j.jvscit.2025.102022","article-title":"Phlegmasia Cerulea Dolens and Compartment Syndrome Secondary to Uterine Lipoleiomyoma","volume":"12","author":"Qureshy","year":"2025","journal-title":"J. Vasc. Surg. Cases Innov. Tech."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"27","DOI":"10.4038\/sljog.v45i1.8092","article-title":"Management of a case of large uterine leiomyoma with deep vein thrombosis","volume":"45","author":"Sangeethaa","year":"2023","journal-title":"Sri Lanka J. Obstet. Gynaecol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1016\/j.jvscit.2021.07.003","article-title":"Venous thromboembolism in a patient with an uncommon etiology of May-Thurner syndrome","volume":"7","author":"Speranza","year":"2021","journal-title":"J. Vasc. Surg. Cases Innov. Tech."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"69","DOI":"10.26502\/aimr.0024","article-title":"Massive Uterine Fibroid Resulting in Extensive Deep Venous Thrombosis, Compartment Syndrome and Rhabdomyolysis","volume":"3","author":"Tinawi","year":"2020","journal-title":"Arch. Intern. Med. Res."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"100340","DOI":"10.1016\/j.xagr.2024.100340","article-title":"A rare case of venous sinus thrombosis and pulmonary embolisms secondary to myomatous erythrocytosis syndrome","volume":"4","author":"Valente","year":"2024","journal-title":"AJOG Glob. Rep."},{"key":"ref_34","first-page":"891","article-title":"Benign gynaecological pathology causing vascular presentations: Three cases of women with peripheral thromboses","volume":"117","author":"Worrall","year":"2024","journal-title":"Ir. Med. J."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"101127","DOI":"10.1016\/j.gore.2022.101127","article-title":"Symptomatic uterine leiomyomatosis with intracaval and intracardiac invasion: Video case report","volume":"45","author":"Cassol","year":"2023","journal-title":"Gynecol. Oncol. Rep."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Khider, L., Gendron, N., and Mauge, L. (2022). Inherited Thrombophilia in the Era of Direct Oral Anticoagulants. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23031821"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"197","DOI":"10.4236\/ojog.2014.44033","article-title":"Uterine Fibromyoma and Intravascular Thrombosis\u2014Eight Cases","volume":"4","author":"Devabhaktuni","year":"2014","journal-title":"Open J. Obstet. Gynecol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1016\/j.ejvs.2006.10.006","article-title":"Obesity and Thrombosis","volume":"33","author":"Darvall","year":"2007","journal-title":"Eur. J. Vasc. Endovasc. Surg."},{"key":"ref_39","unstructured":"(2025, December 22). Overview of the Causes of Venous Thrombosis in Adults\u2014UpToDate. Available online: https:\/\/www.uptodate.com\/contents\/overview-of-the-causes-of-venous-thrombosis-in-adults."},{"key":"ref_40","unstructured":"Jameson, J.L., Fauci, A.S., Kasper, D.L., Hauser, S.L., Longo, D.L., and Loscalzo, J. (2020). Harrison\u2019s Manual of Medicine, McGraw-Hill Education. [20th ed.]."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"162","DOI":"10.15386\/mpr-1372","article-title":"Association between obesity and venous thromboembolism","volume":"93","author":"Hotoleanu","year":"2020","journal-title":"Med. Pharm. Rep."},{"key":"ref_42","first-page":"1","article-title":"Association between venous thrombosis and dyslipidemia","volume":"143","author":"Ene","year":"2014","journal-title":"Med. Clin."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Zawadzka, P.S., Imiela, A.M., and Pruszczyk, P. (2025). The Interplay Between Obesity and Venous Thromboembolism: From Molecular Aspects to Clinical Issue. Int. J. Mol. Sci., 26.","DOI":"10.3390\/ijms262110292"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1186\/s12959-025-00769-x","article-title":"Delayed diagnosis and treatment of deep vein thrombosis\u2014An underrecognized factor for its related outcomes?","volume":"23","author":"Puttarak","year":"2025","journal-title":"Thromb. J."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1177\/000331970005100210","article-title":"Deep Venous Thrombosis and Pulmonary Thromboembolism Associated with a Huge Uterine Myoma: A Case Report","volume":"51","author":"Nishikawa","year":"2000","journal-title":"Angiology"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1093\/humupd\/dmw023","article-title":"Uterine fibroid management: From the present to the future","volume":"22","author":"Donnez","year":"2016","journal-title":"Hum. Reprod. Update"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"e13","DOI":"10.1111\/ijlh.12020","article-title":"Is there an association between thrombosis and fibroids? A single centre experience and literature review","volume":"35","author":"Riat","year":"2013","journal-title":"Int. J. Lab. Hematol."},{"key":"ref_48","first-page":"e63129","article-title":"Pulmonary Embolism with Pulmonary Infarction in a Patient Using the Annovera\u00ae Segesterone Acetate and Ethinylestradiol Combined Vaginal Contraceptive Ring","volume":"16","author":"Mukherjee","year":"2024","journal-title":"Cureus"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"3146","DOI":"10.1097\/MS9.0000000000001985","article-title":"Intestinal obstruction induced by portal vein thrombosis in a female undergoing oral contraceptive therapy: A case report with comprehensive review","volume":"86","author":"William","year":"2024","journal-title":"Ann. Med. Surg."},{"key":"ref_50","first-page":"e32364","article-title":"Right Lower Extremity Phlegmasia Cerulea Dolens Due to Iliotibial Vein Thrombosis with Compartment Syndrome and Circulatory Shock: Case Report and Review","volume":"14","author":"Dah","year":"2022","journal-title":"Cureus"},{"key":"ref_51","first-page":"100","article-title":"Uterine Fibroids: Diagnosis and Treatment","volume":"95","author":"Buchanan","year":"2017","journal-title":"Am. Fam. Physician"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"192","DOI":"10.5468\/ogs.2018.61.2.192","article-title":"Current medical treatment of uterine fibroids","volume":"61","author":"Sohn","year":"2018","journal-title":"Obstet. Gynecol. Sci."},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Mici\u0107, J., Macura, M., Andji\u0107, M., Ivanovi\u0107, K., Dotli\u0107, J., Mici\u0107, D.D., Arsenijevi\u0107, V., Stojni\u0107, J., Bila, J., and Babi\u0107, S. (2024). Currently Available Treatment Modalities for Uterine Fibroids. Medicina, 60.","DOI":"10.3390\/medicina60060868"},{"key":"ref_54","unstructured":"Quintanilla Rodriguez, B.S., and Correa, R. (2025, February 05). Raloxifene, StatPearls, Available online: http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK544233\/."},{"key":"ref_55","unstructured":"Cooper, D.B., and Patel, P. (2025, February 05). Oral Contraceptive Pills, StatPearls, Available online: http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK430882\/."},{"key":"ref_56","first-page":"4169565","article-title":"Bleeding versus Clotting: A Complex Case of a Large Fibroid Uterus Causing Menorrhagia and a DVT","volume":"2016","author":"Ramanan","year":"2016","journal-title":"Case Rep. Obstet. Gynecol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1016\/j.bpobgyn.2009.01.012","article-title":"Acute complications of fibroids","volume":"23","author":"Gupta","year":"2009","journal-title":"Best Pract. Res. Clin. Obstet. Gynaecol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1275","DOI":"10.1097\/AOG.0000000000002918","article-title":"Incidence of Venous Thromboembolism After Different Modes of Gynecologic Surgery","volume":"132","author":"Jorgensen","year":"2018","journal-title":"Obstet. Gynecol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"956","DOI":"10.1097\/AOG.0b013e3181f240f7","article-title":"Risk of thromboembolic disease in patients undergoing laparoscopic gynecologic surgery","volume":"116","author":"Nick","year":"2010","journal-title":"Obstet. Gynecol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/2\/444\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T16:15:00Z","timestamp":1767716100000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/2\/444"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,6]]},"references-count":59,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["jcm15020444"],"URL":"https:\/\/doi.org\/10.3390\/jcm15020444","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,6]]}}}