{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T16:52:26Z","timestamp":1790614346047,"version":"4.1.0"},"reference-count":58,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"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>Sepsis remains a leading cause of global mortality, and early management in the emergency department (ED) is a key determinant of clinical outcomes. Among the earliest physiological derangements in sepsis are abnormalities in coagulation, which represent not merely laboratory disturbances but fundamental reflections of dysregulated host response, endothelial injury, and evolving microvascular thrombosis. Sepsis-induced coagulopathy (SIC) and disseminated intravascular coagulation (DIC) form a dynamic continuum that frequently begins before shock is clinically apparent. Despite their prognostic value and pathophysiologic significance, these abnormalities are often underrecognized in the ED, where coagulation tests are still commonly interpreted through the narrow lens of bleeding risk rather than as markers of systemic thromboinflammation. This narrative review synthesizes current understanding of the mechanisms linking sepsis, endothelial dysfunction, and coagulation abnormalities; outlines the distinction between SIC and overt DIC; and highlights why early identification of coagulopathy in the ED is essential. We discuss practical bedside approaches, including recommended laboratory testing, pattern recognition, and application of validated scores such as the SIC and ISTH DIC criteria. System-level strategies, such as embedding coagulation testing into sepsis bundles, automating score calculation, and enhancing communication between the ED and ICU teams, are explored as avenues to improve early detection. Evidence suggests that ED recognition of SIC\/DIC may refine risk stratification, guide triage decisions, and identify patients who may benefit from targeted anticoagulant strategies once stabilized. Ultimately, recognizing coagulation disorders in the ED reframes sepsis not solely as a hemodynamic crisis but as a complex, thromboinflammatory syndrome in which early intervention may alter trajectory and improve outcomes.<\/jats:p>","DOI":"10.3390\/jcm15020488","type":"journal-article","created":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T09:01:29Z","timestamp":1767862889000},"page":"488","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Recognizing Coagulation Disorders in Sepsis in the Emergency Room: A Narrative Review"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0255-4088","authenticated-orcid":false,"given":"Toshiaki","family":"Iba","sequence":"first","affiliation":[{"name":"Faculty of Medical Science, Juntendo University, Urayasu 279-0023, Japan"},{"name":"Department of Emergency and Disaster Medicine, Graduate School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4633-0041","authenticated-orcid":false,"given":"Tomoki","family":"Tanigawa","sequence":"additional","affiliation":[{"name":"Department of Emergency and Disaster Medicine, Graduate School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan"},{"name":"Medical Affairs Section, Research & Development Division, Japan Blood Products Organization, Tokyo 108-0023, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9021-8633","authenticated-orcid":false,"given":"Hideo","family":"Wada","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Mie Prefectural General Medical Center, Yokkaichi 510-8561, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenta","family":"Kondo","sequence":"additional","affiliation":[{"name":"Department of Emergency and Disaster Medicine, Graduate School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4859-4747","authenticated-orcid":false,"given":"Ricard","family":"Ferrer","sequence":"additional","affiliation":[{"name":"Intensive Care Department, Hospital Universitari Vall d\u2019Hebron, Universitat Aut\u00f2noma de Barcelona, 119-129 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3766-4962","authenticated-orcid":false,"given":"Jerrold H.","family":"Levy","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Critical Care, and Surgery, Duke University School of Medicine, Durham, NC 27710, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1001\/jama.2016.0287","article-title":"The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)","volume":"315","author":"Singer","year":"2016","journal-title":"JAMA"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/S0140-6736(19)32989-7","article-title":"Global, regional, and national sepsis incidence and mortality, 1990\u20132017: Analysis for the Global Burden of Disease Study","volume":"395","author":"Rudd","year":"2020","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1186\/s40560-020-00465-0","article-title":"Epidemiology of sepsis and septic shock in intensive care units between sepsis-2 and sepsis-3 populations: Sepsis prognostication in intensive care unit and emergency room (SPICE-ICU)","volume":"8","author":"Abe","year":"2020","journal-title":"J. Intensive Care"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.1007\/s00134-021-06506-y","article-title":"Surviving sepsis campaign: International guidelines for management of sepsis and septic shock 2021","volume":"47","author":"Evans","year":"2021","journal-title":"Intensive Care Med."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Jarczak, D., Kluge, S., and Nierhaus, A. (2021). Sepsis-Pathophysiology and Therapeutic Concepts. Front. Med., 8.","DOI":"10.3389\/fmed.2021.628302"},{"key":"ref_6","first-page":"e0414","article-title":"Diagnostic Potential of Coagulation-Related Biomarkers for Sepsis in the Emergency Department: Protocol for a Pilot Observational Cohort Study","volume":"3","author":"Arora","year":"2021","journal-title":"Crit. Care Explor."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.thromres.2016.11.007","article-title":"Coagulation and sepsis","volume":"149","author":"Levi","year":"2017","journal-title":"Thromb. Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"16037","DOI":"10.1038\/nrdp.2016.37","article-title":"Disseminated intravascular coagulation","volume":"2","author":"Gando","year":"2016","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"8694183","DOI":"10.1155\/2024\/8694183","article-title":"Are We Overusing Coagulation Studies in the Emergency Department?","volume":"2024","author":"Alyahya","year":"2024","journal-title":"Emerg. Med. Int."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1327","DOI":"10.1055\/s-0037-1616068","article-title":"Scientific Subcommittee on Disseminated Intravascular Coagulation (DIC) of the ISTH. Towards definition, clinical and laboratory criteria, and a scoring system for disseminated intravascular coagulation","volume":"86","author":"Taylor","year":"2001","journal-title":"Thromb. Haemost."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1186\/2052-0492-2-15","article-title":"Diagnosis and treatment of disseminated intravascular coagulation (DIC) according to four DIC guidelines","volume":"2","author":"Wada","year":"2014","journal-title":"J. Intensive Care"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e017046","DOI":"10.1136\/bmjopen-2017-017046","article-title":"New criteria for sepsis-induced coagulopathy (SIC) following the revised sepsis definition: A retrospective analysis of a nationwide survey","volume":"7","author":"Iba","year":"2017","journal-title":"BMJ Open"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1238","DOI":"10.1097\/ALN.0000000000003122","article-title":"Sepsis-induced coagulopathy and disseminated intravascular coagulation","volume":"132","author":"Iba","year":"2020","journal-title":"Anesthesiology"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Tsantes, A.G., Parastatidou, S., Tsantes, E.A., Bonova, E., Tsante, K.A., Mantzios, P.G., Vaiopoulos, A.G., Tsalas, S., Konstantinidi, A., and Houhoula, D. (2023). Sepsis-Induced Coagulopathy: An Update on Pathophysiology, Biomarkers, and Current Guidelines. Life, 13.","DOI":"10.3390\/life13020350"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1007\/s00281-011-0285-5","article-title":"Endothelium--role in regulation of coagulation and inflammation","volume":"34","year":"2012","journal-title":"Semin. Immunopathol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1291","DOI":"10.1089\/ars.2021.0027","article-title":"Oxidative Stress and Endothelial Dysfunction in Sepsis and Acute Inflammation","volume":"35","author":"Joffre","year":"2021","journal-title":"Antioxid. Redox Signal."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e00843","DOI":"10.1002\/ams2.843","article-title":"Sepsis-induced disseminated intravascular coagulation: An international estrangement of disease concept","volume":"10","author":"Ushio","year":"2023","journal-title":"Acute Med. Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1186\/s40560-023-00672-5","article-title":"The pathophysiology, diagnosis, and management of sepsis-associated disseminated intravascular coagulation","volume":"11","author":"Iba","year":"2023","journal-title":"J. Intensive Care"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2356","DOI":"10.1016\/j.jtha.2025.03.038","article-title":"Updated definition and scoring of disseminated intravascular coagulation in 2025: Communication from the ISTH SSC Subcommittee on Disseminated Intravascular Coagulation","volume":"23","author":"Iba","year":"2025","journal-title":"J. Thromb. Haemost."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"218","DOI":"10.14789\/ejmj.JMJ25-0011-P","article-title":"History of Disseminated Intravascular Coagulation (DIC) Research and My Personal Research History","volume":"71","author":"Iba","year":"2025","journal-title":"Juntendo Med. J."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e884","DOI":"10.1002\/ams2.884","article-title":"Anticoagulant therapies against sepsis-induced disseminated intravascular coagulation","volume":"10","author":"Umemura","year":"2023","journal-title":"Acute Med. Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/j.jemermed.2010.05.007","article-title":"Abnormal coagulation tests obtained in the emergency department are associated with mortality in patients with suspected infection","volume":"42","author":"Fischer","year":"2012","journal-title":"J. Emerg. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1007\/s11739-018-1990-z","article-title":"Prognostic value of sepsis-induced coagulation abnormalities: An early assessment in the emergency department","volume":"14","author":"Innocenti","year":"2019","journal-title":"Intern. Emerg. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1016\/j.thromres.2019.09.029","article-title":"The current status of viscoelastic testing in septic coagulopathy","volume":"183","author":"Scarlatescu","year":"2019","journal-title":"Thromb. Res."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1097\/SHK.0000000000000473","article-title":"The Endothelium in Sepsis","volume":"45","author":"Ince","year":"2016","journal-title":"Shock"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1869","DOI":"10.1001\/jama.286.15.1869","article-title":"Caring for the critically ill patient. High-dose antithrombin III in severe sepsis: A randomized controlled trial","volume":"286","author":"Warren","year":"2001","journal-title":"JAMA"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"R297","DOI":"10.1186\/cc13163","article-title":"A randomized, controlled, multicenter trial of the effects of antithrombin on disseminated intravascular coagulation in patients with sepsis","volume":"17","author":"Gando","year":"2013","journal-title":"Crit. Care"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1056\/NEJM200103083441001","article-title":"Efficacy and safety of recombinant human activated protein C for severe sepsis","volume":"344","author":"Bernard","year":"2001","journal-title":"N. Engl. J. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1332","DOI":"10.1056\/NEJMoa050935","article-title":"Drotrecogin alfa (activated) for adults with severe sepsis and a low risk of death","volume":"353","author":"Abraham","year":"2005","journal-title":"N. Engl. J. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2055","DOI":"10.1056\/NEJMoa1202290","article-title":"Drotrecogin alfa (activated) in adults with septic shock","volume":"366","author":"Ranieri","year":"2012","journal-title":"N. Engl. J. Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1001\/jama.290.2.238","article-title":"Efficacy and safety of tifacogin (recombinant tissue factor pathway inhibitor) in severe sepsis: A randomized controlled trial","volume":"290","author":"Abraham","year":"2003","journal-title":"JAMA"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2069","DOI":"10.1097\/CCM.0b013e31828e9b03","article-title":"A randomized, double-blind, placebo-controlled, Phase 2b study to evaluate the safety and efficacy of recombinant human soluble thrombomodulin, ART-123, in patients with sepsis and suspected disseminated intravascular coagulation","volume":"41","author":"Vincent","year":"2013","journal-title":"Crit. Care Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1993","DOI":"10.1001\/jama.2019.5358","article-title":"Effect of a Recombinant Human Soluble Thrombomodulin on Mortality in Patients With Sepsis-Associated Coagulopathy: The SCARLET Randomized Clinical Trial","volume":"321","author":"Vincent","year":"2019","journal-title":"JAMA"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1185","DOI":"10.1097\/CCM.0b013e31819c06bc","article-title":"Unfractioned heparin for treatment of sepsis: A randomized clinical trial (The HETRASE Study)","volume":"37","author":"Jaimes","year":"2009","journal-title":"Crit. Care Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"10760296231157766","DOI":"10.1177\/10760296231157766","article-title":"Effect of Anticoagulant Versus Non-Anticoagulant Therapy on Mortality of Sepsis-Induced Disseminated Intravascular Coagulation: A Systematic Review and Meta-Analysis","volume":"29","author":"Qi","year":"2023","journal-title":"Clin. Appl. Thromb. Hemost."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1186\/s12959-024-00653-0","article-title":"Heparin therapy in sepsis and sepsis-associated disseminated intravascular coagulation: A systematic review and meta-analysis","volume":"22","author":"Totoki","year":"2024","journal-title":"Thromb. J."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Chen, X., Liang, G., Zheng, Z., and Cao, Y. (2025). Association between early prophylactic heparin therapy and mortality in patients with septic shock secondary to respiratory infections: Analysis based on MIMIC-IV database. BMC Infect. Dis., 25.","DOI":"10.1186\/s12879-025-11963-7"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"10760296221077096","DOI":"10.1177\/10760296221077096","article-title":"Benefit Profile of Thrombomodulin Alfa Combined with Antithrombin Concentrate in Patients with Sepsis-Induced Disseminated Intravascular Coagulation","volume":"28","author":"Murao","year":"2022","journal-title":"Clin. Appl. Thromb. Hemost."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1186\/s13054-016-1415-1","article-title":"Benefit profile of anticoagulant therapy in sepsis: A nationwide multicentre registry in Japan","volume":"20","author":"Yamakawa","year":"2016","journal-title":"Crit. Care"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1076029619843338","DOI":"10.1177\/1076029619843338","article-title":"Markers of Inflammation and Infection in Sepsis and Disseminated Intravascular Coagulation","volume":"25","author":"Patel","year":"2019","journal-title":"Clin. Appl. Thromb. Hemost."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1093\/ajcp\/91.3.280","article-title":"Diagnosis of disseminated intravascular coagulation. Role of D-dimer","volume":"91","author":"Carr","year":"1989","journal-title":"Am. J. Clin. Pathol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"10760296221101386","DOI":"10.1177\/10760296221101386","article-title":"Decreasing Plasma Fibrinogen Levels in the Intensive Care Unit Are Associated with High Mortality Rates In Patients With Sepsis-Induced Coagulopathy","volume":"28","author":"Mori","year":"2022","journal-title":"Clin. Appl. Thromb. Hemost."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"180243","DOI":"10.1038\/sdata.2018.243","article-title":"Nationwide registry of sepsis patients in Japan focused on disseminated intravascular coagulation 2011\u20132013","volume":"5","author":"Hayakawa","year":"2018","journal-title":"Sci. Data"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1186\/s13613-017-0332-z","article-title":"Effects of combination therapy using antithrombin and thrombomodulin for sepsis-associated disseminated intravascular coagulation","volume":"7","author":"Iba","year":"2017","journal-title":"Ann. Intensive Care"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1186\/s40560-023-00656-5","article-title":"Sepsis-related coagulopathy treatment based on the disseminated intravascular coagulation diagnostic criteria: A post-hoc analysis of a prospective multicenter observational study","volume":"11","author":"Wada","year":"2023","journal-title":"J. Intensive Care"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1002\/ajh.10377","article-title":"Comparison of diagnostic criteria for disseminated intravascular coagulation (DIC): Diagnostic criteria of the International Society of Thrombosis and Hemostasis and of the Japanese Ministry of Health and Welfare for overt DIC","volume":"74","author":"Wada","year":"2003","journal-title":"Am. J. Hematol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"3360","DOI":"10.1016\/j.jtha.2023.05.028","article-title":"Mechanisms and management of the coagulopathy of trauma and sepsis: Trauma-induced coagulopathy, sepsis-induced coagulopathy, and disseminated intravascular coagulation","volume":"21","author":"Iba","year":"2023","journal-title":"J. Thromb. Haemost."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.jtha.2023.07.020","article-title":"Thromboinflammation in acute injury: Infections, heatstroke, and trauma","volume":"22","author":"Iba","year":"2024","journal-title":"J. Thromb. Haemost."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1056\/NEJMra1208626","article-title":"Bleeding and coagulopathies in critical care","volume":"370","author":"Hunt","year":"2014","journal-title":"N. Engl. J. Med."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1186\/s40560-024-00739-x","article-title":"Determining prognostic indicator for anticoagulant therapy in sepsis-induced disseminated intravascular coagulation","volume":"12","author":"Iba","year":"2024","journal-title":"J. Intensive Care"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1097\/SLA.0b013e318226113d","article-title":"A high admission syndecan-1 level as a marker of endothelial glycocalyx degradation is associated with increased mortality after trauma","volume":"254","author":"Johansson","year":"2011","journal-title":"Ann. Surg."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"2003","DOI":"10.1001\/jama.2019.5791","article-title":"Derivation, Validation, and Potential Treatment Implications of Novel Clinical Phenotypes for Sepsis","volume":"321","author":"Seymour","year":"2019","journal-title":"JAMA"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1164\/rccm.201806-1197OC","article-title":"Identifying Novel Sepsis Subphenotypes Using Temperature Trajectories","volume":"200","author":"Bhavani","year":"2019","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"e000234","DOI":"10.1136\/bmjresp-2017-000234","article-title":"Effect of a machine learning-based severe sepsis prediction algorithm on patient survival and hospital length of stay: A randomised clinical trial","volume":"4","author":"Shimabukuro","year":"2017","journal-title":"BMJ Open Respir. Res."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1136\/bmjqs-2018-008765","article-title":"Electronic health record-based clinical decision support alert for severe sepsis: A randomised evaluation","volume":"28","author":"Downing","year":"2019","journal-title":"BMJ Qual. Saf."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1186\/s40560-025-00776-0","article-title":"The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2024","volume":"13","author":"Shime","year":"2025","journal-title":"J. Intensive Care"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.1001\/jama.2017.13836","article-title":"Incidence and Trends of Sepsis in US Hospitals Using Clinical vs Claims Data, 2009\u20132014","volume":"318","author":"Rhee","year":"2017","journal-title":"JAMA"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"2450","DOI":"10.1016\/j.immuni.2021.10.012","article-title":"The immunology of sepsis","volume":"54","author":"Wiersinga","year":"2021","journal-title":"Immunity"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/2\/488\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T09:26:13Z","timestamp":1767864373000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/2\/488"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,8]]},"references-count":58,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["jcm15020488"],"URL":"https:\/\/doi.org\/10.3390\/jcm15020488","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,8]]}}}