{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T13:21:56Z","timestamp":1783344116517,"version":"3.54.6"},"reference-count":58,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Facial gender-confirmation surgery (FGCS) has expanded rapidly but remains uneven across procedures, specialties, and outcome domains, limiting clinically useful interpretation for surgeons. The aim is to characterize how FGCS evidence has developed and to identify gaps relevant to surgical reporting and patient-centered outcome evaluation. Materials and Methods: Systematic searches were conducted without date restriction in PubMed, Scopus, Web of Science, LiLACS, and EBSCOhost through June 2025. Eligible studies included original clinical research, systematic reviews (SR), technical notes, and economic evaluations. Two reviewers independently screened and extracted data. PROSPERO: CRD420251041192. Results: Among 338 included studies, the literature was concentrated on feminization procedures (78%) and hard-tissue interventions (51%). Outcome reporting was dominated by surgical technique (36%) and complications (29%); patient-centered domains were less represented, including satisfaction (25%), preferences (7%), recovery (2%), and ethics (3%). Masculinization and soft-tissue procedures were less frequently studied. Methodological quality of the 36 included SRs was predominantly critically low (72%) or low (28%). Conclusions: Procedural reporting in FGCS has developed asymmetrically relative to standardized patient-centered outcome measurement, a pattern consistent with the formative stages observed in other surgical fields. For surgeons, this limits comparability across procedures and weakens the evidence base for counseling, multidisciplinary planning, and postoperative evaluation. Future research should prioritize more consistent and validated patient-reporting frameworks.<\/jats:p>","DOI":"10.3390\/medicina62071303","type":"journal-article","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T10:43:11Z","timestamp":1783334591000},"page":"1303","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Facial Gender-Confirmation Surgery: A Systematic Mapping Review of Surgical Growth and Outcome Gaps"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8959-3989","authenticated-orcid":false,"given":"Gustavo","family":"S\u00e1enz-Ravello","sequence":"first","affiliation":[{"name":"School of Health and Wellbeing, Health Economics and Health Technology Assessment, University of Glasgow College of Medical Veterinary and Life Sciences, Glasgow G12 8QQ, UK"},{"name":"Servicio de Salud Tarapac\u00e1, Ministerio de Salud, Iquique 1130000, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Carrasco Garc\u00eda","sequence":"additional","affiliation":[{"name":"Servicio de Salud Tarapac\u00e1, Ministerio de Salud, Iquique 1130000, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3868-3532","authenticated-orcid":false,"given":"Shane D.","family":"Morrison","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Department of Surgery, Seattle Children\u2019s Hospital, Seattle, WA 98145, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8586-5251","authenticated-orcid":false,"given":"Alberto","family":"Inzulza Galdames","sequence":"additional","affiliation":[{"name":"Subsecretar\u00eda de Salud P\u00fablica, Gabinete, Ministerio de Salud, Santiago 8320064, Chile"},{"name":"Departamento de Tecnolog\u00edas de Gesti\u00f3n, Facultad Tecnol\u00f3gica, Universidad de Santiago de Chile, Santiago 9170022, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thais","family":"Calderon","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Department of Surgery, Seattle Children\u2019s Hospital, Seattle, WA 98145, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elie M.","family":"Ferneini","sequence":"additional","affiliation":[{"name":"Ferneini Maxillofacial Surgical Institute, Cheshire, CT 06410, USA"},{"name":"Beau Visage Med Spa, Cheshire, CT 06410, USA"},{"name":"Department of Surgery, Frank H. Netter MD School of Medicine, Quinnipiac University, North Haven, CT 06473, USA"},{"name":"Division of Oral and Maxillofacial Surgery, University of Connecticut School of Dental Medicine, Farmington, CT 06030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elda L.","family":"Fisher","sequence":"additional","affiliation":[{"name":"Division of Plastic, Maxillofacial, and Oral Surgery, Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1097\/NMD.0000000000001119","article-title":"The (Slow) Depathologizing of Gender Incongruence","volume":"208","author":"Davies","year":"2020","journal-title":"J. Nerv. Ment. Dis."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1016\/S0140-6736(16)00684-X","article-title":"Global health burden and needs of transgender populations: A review","volume":"388","author":"Reisner","year":"2016","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1080\/26895269.2022.2100644","article-title":"Standards of Care for the Health of Transgender and Gender Diverse People, Version 8","volume":"23","author":"Coleman","year":"2022","journal-title":"Int. J. Transgender Health"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"20210470","DOI":"10.1098\/rstb.2021.0470","article-title":"Face2face: Advancing the science of social interaction","volume":"378","author":"Hamilton","year":"2023","journal-title":"Philos. Trans. R. Soc. B Biol. Sci."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"766e","DOI":"10.1097\/PRS.0000000000003798","article-title":"Facial Gender Confirmation Surgery: A New Nomenclature","volume":"140","author":"Simon","year":"2017","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1186\/s40902-024-00424-x","article-title":"Exploring the evolution of facial feminization and masculinization surgery: A bibliometric analysis and visualization study","volume":"46","author":"Uranbey","year":"2024","journal-title":"Maxillofac. Plast. Reconstr. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1089\/trgh.2021.0033","article-title":"Factors Associated with Experiences of Gender-Affirming Health Care: A Systematic Review","volume":"8","author":"Howell","year":"2023","journal-title":"Transgender Health"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.otot.2023.01.002","article-title":"Gender-affirming facial surgery: Anatomy and fundamentals of care","volume":"34","author":"Benjamin","year":"2023","journal-title":"Oper. Tech. Otolaryngol. Head Neck Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1186\/s13643-023-02178-5","article-title":"Mapping reviews, scoping reviews, and evidence and gap maps (EGMs): The same but different\u2014The \u201cBig Picture\u201d review family","volume":"12","author":"Campbell","year":"2023","journal-title":"Syst. Rev."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1186\/s13643-016-0204-x","article-title":"What is an evidence map? A systematic review of published evidence maps and their definitions, methods, and products","volume":"5","author":"Hempel","year":"2016","journal-title":"Syst. Rev."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Bragge, P., Clavisi, O., Turner, T., Tavender, E., Collie, A., and Gruen, R.L. (2011). The Global Evidence Mapping Initiative: Scoping research in broad topic areas. BMC Med. Res. Methodol., 11.","DOI":"10.1186\/1471-2288-11-92"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_13","unstructured":"Li, Y., Ghogomu, E., Gaarder, M., Khalil, H., Li, X., Nduku, P.M., Campbell, F., White, H., Hou, L., and Hui, X. (2025, May 07). The Development of PRITEM Reporting Guideline for Mapping Reviews. Available online: https:\/\/osf.io\/6ysk8."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1186\/s13643-020-01542-z","article-title":"PRISMA-S: An extension to the PRISMA Statement for Reporting Literature Searches in Systematic Reviews","volume":"10","author":"Rethlefsen","year":"2021","journal-title":"Syst. Rev."},{"key":"ref_15","unstructured":"ASReview LAB Developers (2022). ASReview LAB\u2014A tool for AI-assisted systematic reviews. Zenodo."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1186\/s13643-016-0384-4","article-title":"Rayyan\u2014A web and mobile app for systematic reviews","volume":"5","author":"Ouzzani","year":"2016","journal-title":"Syst. Rev."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"l6890","DOI":"10.1136\/bmj.l6890","article-title":"Synthesis without meta-analysis (SWiM) in systematic reviews: Reporting guideline","volume":"368","author":"Campbell","year":"2020","journal-title":"BMJ"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"467","DOI":"10.7326\/M18-0850","article-title":"PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation","volume":"169","author":"Tricco","year":"2018","journal-title":"Ann. Intern. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/s41073-016-0007-6","article-title":"Sex and Gender Equity in Research: Rationale for the SAGER guidelines and recommended use","volume":"1","author":"Heidari","year":"2016","journal-title":"Res. Integr. Peer Rev."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"j4008","DOI":"10.1136\/bmj.j4008","article-title":"AMSTAR 2: A critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both","volume":"358","author":"Shea","year":"2017","journal-title":"BMJ"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Miller, M.N., Lin, D., Rabinovich, S., Airth, G., Rainsbury-Silva, S., Canfield, R., Fadich, S.K., Shariati, K., Bradley, J.P., and Lee, J.C. (2026). Defining Outcomes in Facial Gender-Affirming Surgery: A Systematic Review to Inform Core Outcome Set Development. J. Aesthetic Med., 2.","DOI":"10.3390\/jaestheticmed2010005"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2617","DOI":"10.1016\/j.jaip.2024.04.023","article-title":"Understanding Health Equity in Patient-Reported Outcomes","volume":"12","author":"Ramirez","year":"2024","journal-title":"J. Allergy Clin. Immunol. Pract."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e390678","DOI":"10.1200\/EDBK_390678","article-title":"Patient-Reported Outcomes, Digital Health, and the Quest to Improve Health Equity","volume":"43","author":"Pritchett","year":"2023","journal-title":"Am. Soc. Clin. Oncol. Educ. Book"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"864","DOI":"10.1111\/ans.70028","article-title":"Do hormones and surgery improve the health of adults with gender incongruence? A systematic review of patient reported outcomes","volume":"95","author":"Ireland","year":"2025","journal-title":"ANZ J. Surg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1177\/27325016251323096","article-title":"Evaluating Consistency in Reporting of Gender Dysphoria Before and After Facial Feminization Surgery: A Systematic Review","volume":"6","author":"Yanoshak","year":"2025","journal-title":"FACE"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2018","DOI":"10.1002\/ohn.1207","article-title":"Physical Features Contributing to Gender Dysphoria: The Role of Voice","volume":"172","author":"Pu","year":"2025","journal-title":"Otolaryngol.\u2013Head Neck Surg."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"906","DOI":"10.1002\/ohn.329","article-title":"Needs Assessment of Gender-Affirming Face, Neck, and Voice Procedures and the Role of Gender Dysphoria","volume":"169","author":"Ziltzer","year":"2023","journal-title":"Otolaryngol.\u2013Head Neck Surg."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1080\/26895269.2021.1919277","article-title":"The impact of living with transfeminine vocal gender dysphoria: Health utility outcomes assessment","volume":"24","author":"Nuyen","year":"2023","journal-title":"Int. J. Transgender Health"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1339","DOI":"10.1097\/SCS.0000000000005101","article-title":"Facial Masculinization Surgery and its Role in the Treatment of Gender Dysphoria","volume":"30","author":"Sayegh","year":"2019","journal-title":"J. Craniofacial Surg."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1573","DOI":"10.1007\/s10508-017-1012-7","article-title":"Craniofacial Reconstructive Surgery Improves Appearance Congruence in Male-to-Female Transsexual Patients","volume":"46","author":"Isung","year":"2017","journal-title":"Arch. Sex. Behav."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1080\/0092623X.2017.1326190","article-title":"Surgical Satisfaction, Quality of Life, and Their Association After Gender-Affirming Surgery: A Follow-up Study","volume":"44","author":"Elaut","year":"2018","journal-title":"J. Sex Marital Ther."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e1184\u201390","DOI":"10.1097\/SLA.0000000000005472","article-title":"Effect of Gender-affirming Facial Feminization Surgery on Psychosocial Outcomes","volume":"277","author":"Caprini","year":"2023","journal-title":"Ann. Surg."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1585","DOI":"10.1002\/ohn.1172","article-title":"Facial Feminization Surgery and Mental Health Resource Utilization: A Retrospective Institutional Review","volume":"172","author":"Huynh","year":"2025","journal-title":"Otolaryngol.\u2013Head Neck Surg."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1007\/s11136-010-9668-7","article-title":"Quality of life of individuals with and without facial feminization surgery or gender reassignment surgery","volume":"19","author":"Ainsworth","year":"2010","journal-title":"Qual. Life Res."},{"key":"ref_35","first-page":"1141.e1","article-title":"Voice Outcome of Glottoplasty in Trans Women","volume":"39","author":"Papeleu","year":"2023","journal-title":"J. Voice"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/j.bjorl.2021.06.010","article-title":"Effect of Wendler glottoplasty on voice and quality of life of transgender women","volume":"89","author":"Aires","year":"2023","journal-title":"Braz. J. Otorhinolaryngol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1080\/26895269.2022.2038334","article-title":"Surgical satisfaction and quality of life outcomes reported by transgender men and women at least one year post gender-affirming surgery: A systematic literature review","volume":"23","author":"Javier","year":"2022","journal-title":"Int. J. Transgender Health"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1080\/26895269.2023.2278736","article-title":"Quality of life outcomes in patients undergoing facial gender affirming surgery: A systematic review and meta-analysis","volume":"25","author":"Raner","year":"2024","journal-title":"Int. J. Transgender Health"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"S-44","DOI":"10.1089\/fpsam.2021.0373","article-title":"Quality of Life Outcomes After Facial Feminization Surgery","volume":"24","author":"Chou","year":"2022","journal-title":"Facial Plast. Surg. Aesthet. Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1089\/fpsam.2022.0264","article-title":"Satisfaction and Quality of Life Following Gender-Affirming Facial Surgery","volume":"25","author":"Gulati","year":"2023","journal-title":"Facial Plast. Surg. Aesthet. Med."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"e1877","DOI":"10.1097\/GOX.0000000000001877","article-title":"Patient Satisfaction after Aesthetic Chondrolaryngoplasty","volume":"6","author":"Cohen","year":"2018","journal-title":"Plast. Reconstr. Surg. Glob. Open"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1499","DOI":"10.1097\/PRS.0000000000006837","article-title":"Prospective Quality-of-Life Outcomes after Facial Feminization Surgery: An International Multicenter Study","volume":"145","author":"Morrison","year":"2020","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"e025435","DOI":"10.1136\/bmjopen-2018-025435","article-title":"International phase I study protocol to develop a patient-reported outcome measure for adolescents and adults receiving gender-affirming treatments (the GENDER-Q)","volume":"8","author":"Klassen","year":"2018","journal-title":"BMJ Open"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1186\/s41687-024-00785-x","article-title":"International study to develop a patient-reported outcome measure to evaluate outcomes of gender-affirming care\u2014The GENDER-Q","volume":"8","author":"Kaur","year":"2024","journal-title":"J. Patient Rep. Outcomes"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"e254708","DOI":"10.1001\/jamanetworkopen.2025.4708","article-title":"Development and Assessment of a Patient-Reported Outcome Instrument for Gender-Affirming Care","volume":"8","author":"Kaur","year":"2025","journal-title":"JAMA Netw. Open"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"103323","DOI":"10.1016\/j.eclinm.2025.103323","article-title":"The core outcome set for studies on feminizing genital gender-affirming surgery: Findings from the GenderCOS project","volume":"85","author":"Vallinga","year":"2025","journal-title":"EClinicalMedicine"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"103325","DOI":"10.1016\/j.eclinm.2025.103325","article-title":"A core outcome set for research on masculinizing genital gender-affirming surgery: International consensus results from the GenderCOS project","volume":"85","author":"Roijer","year":"2025","journal-title":"EClinicalMedicine"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1086","DOI":"10.1080\/26895269.2024.2429490","article-title":"Navigating toward standardization: A systematic review mapping outcome measures in masculinizing genital gender affirming surgery","volume":"27","author":"Roijer","year":"2026","journal-title":"Int. J. Transgender Health"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1097\/PRS.0000000000008668","article-title":"Facial Gender Surgery: Systematic Review and Evidence-Based Consensus Guidelines from the International Facial Gender Symposium","volume":"149","author":"Coon","year":"2022","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1351","DOI":"10.1016\/j.joms.2025.07.003","article-title":"Prevalence of body dysmorphic disorder in patients seeking orthognathic surgery: A systematic review and meta-analysis","volume":"83","author":"Fan","year":"2025","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1037\/sgd0000233","article-title":"A review of contemporary assessment tools for use with transgender and gender nonconforming adults","volume":"4","author":"Shulman","year":"2017","journal-title":"Psychol. Sex. Orientat. Gend. Divers."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1177\/1468794120965371","article-title":"\u2018A point of reference\u2019: The insider\/outsider research staircase and transgender people\u2019s experiences of participating in trans-led research","volume":"21","author":"Rosenberg","year":"2021","journal-title":"Qual. Res."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1177\/1476750318818875","article-title":"Lessons from a community-based participatory research study with transgender and gender nonconforming youth and their families","volume":"17","author":"Bogart","year":"2019","journal-title":"Action Res."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"114","DOI":"10.17294\/2330-0698.1137","article-title":"Embedding Patients, Providers, and Community Stakeholders in Research to Improve Transgender Health","volume":"2","author":"Quinn","year":"2015","journal-title":"J. Patient Cent. Res. Rev."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1186\/s13010-024-00157-9","article-title":"Epistemic appropriation and the ethics of engaging with trans community knowledge in the context of mental healthcare research","volume":"19","author":"Myerscough","year":"2024","journal-title":"Philos. Ethics Humanit. Med."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"e52","DOI":"10.1097\/SLA.0000000000004728","article-title":"Gender Affirming Surgery: A Comprehensive, Systematic Review of All Peer-reviewed Literature and Methods of Assessing Patient-centered Outcomes (Part 1: Breast\/Chest, Face, and Voice)","volume":"275","author":"Oles","year":"2022","journal-title":"Ann. Surg."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1080\/26895269.2022.2147117","article-title":"Outcome measures reported following feminizing genital gender affirmation surgery for transgender women and gender diverse individuals: A systematic review","volume":"24","author":"Pidgeon","year":"2023","journal-title":"Int. J. Transgender Health"},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Shah, V., Hassan, B., Hassan, R., Alexis, M., Bhoopalam, M., Agandi, L., and Liang, F. (2024). Gender-Affirming Surgery in Low- and Middle-Income Countries: A Systematic Review. J. Clin. Med., 13.","DOI":"10.3390\/jcm13123580"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/7\/1303\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T13:09:04Z","timestamp":1783343344000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/7\/1303"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,6]]},"references-count":58,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7]]}},"alternative-id":["medicina62071303"],"URL":"https:\/\/doi.org\/10.3390\/medicina62071303","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,6]]}}}