{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T17:45:17Z","timestamp":1774979117358,"version":"3.50.1"},"reference-count":49,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T00:00:00Z","timestamp":1774915200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Inflammatory myocardial involvement has been reported in canine leishmaniosis (CanL); however, studies evaluating the degree of myocardial dysfunction in affected dogs are limited. This prospective study aimed to investigate myocardial involvement in dogs with CanL using conventional and speckle-tracking echocardiography (STE), focusing on the assessment of left ventricular systolic function and myocardial strain. Symptomatic, initially untreated dogs with a diagnosis of leishmaniosis and free from other vector-borne diseases or underlying heart diseases were enrolled (Leish group). Healthy dogs matched for age, body weight, breed, and sex were selected for the control group (C group). At the time of inclusion (T0) and at each follow-up, laboratory tests as well as conventional echocardiographic examination and STE were performed. For strain analysis, apical longitudinal long-axis 4-chamber, 3-chamber, and 2-chamber views were used (2C, 3C, 4C, respectively) to obtain the average global longitudinal strain (GLSAV), which is recognised to have the maximum reliability as an indicator of left ventricular dysfunction in humans. The software obtains GLSAV by averaging the longitudinal strain values from all left-ventricular segments derived from the multiple apical views. After enrolment, dogs were treated with a combination of meglumine and allopurinol and were monitored for six months. Clinical-pathological and echocardiographic data were collected at follow-up at 1, 3, and 6 months after the start of treatment (T1, T2, T3) and compared between the two study groups using appropriate statistical tests. Sixteen dogs composed the C group and nine dogs the Leish group. At T0, none of these dogs had abnormalities in cardiac auscultation, plasma cardiac troponin concentration was within the reference range, and standard echocardiographic examination excluded underlying cardiac diseases. The comparison between C and Leish groups did not show a statistically significant difference in any of the strain parameters analysed (GLSAV, GLS4C, GLS3C, GLS2C). Moreover, strain values in the Leish group did not change significantly over time. In conclusion, in this preliminary study on a limited population of dogs with leishmaniosis, both conventional echocardiography and STE failed to reveal clear changes suggestive of left ventricular systolic dysfunction secondary to possible myocarditis or as a consequence of the systemic disease in dogs with active leishmaniosis. However, further STE studies in larger cohorts of dogs with leishmaniosis are needed to confirm and expand our findings.<\/jats:p>","DOI":"10.3390\/pathogens15040370","type":"journal-article","created":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T16:34:08Z","timestamp":1774974848000},"page":"370","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Longitudinal Myocardial Deformation Analysis of the Left Ventricle in Dogs with Leishmaniosis Investigated by Speckle-Tracking Echocardiography"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2722-4835","authenticated-orcid":false,"given":"Alessandra","family":"Recchia","sequence":"first","affiliation":[{"name":"Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J)\u2013Veterinary Section, University of Bari \u201cAldo Moro\u201d, Strada Provinciale Casamassima km3, Valenzano, 70010 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3259-9156","authenticated-orcid":false,"given":"Antonella","family":"Colella","sequence":"additional","affiliation":[{"name":"Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J)\u2013Veterinary Section, University of Bari \u201cAldo Moro\u201d, Strada Provinciale Casamassima km3, Valenzano, 70010 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8937-3860","authenticated-orcid":false,"given":"Maria","family":"Albrizio","sequence":"additional","affiliation":[{"name":"Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J)\u2013Veterinary Section, University of Bari \u201cAldo Moro\u201d, Strada Provinciale Casamassima km3, Valenzano, 70010 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8950-4074","authenticated-orcid":false,"given":"Fabrizio","family":"Iarussi","sequence":"additional","affiliation":[{"name":"Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J)\u2013Veterinary Section, University of Bari \u201cAldo Moro\u201d, Strada Provinciale Casamassima km3, Valenzano, 70010 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3927-1601","authenticated-orcid":false,"given":"Giovanni","family":"Romito","sequence":"additional","affiliation":[{"name":"Department of Veterinary Medical Sciences, University of Bologna, 40064 Ozzano dell\u2019 Emilia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5636-9163","authenticated-orcid":false,"given":"Aleksandra Domanjko","family":"Petri\u010d","sequence":"additional","affiliation":[{"name":"Veterinary Faculty, University of Ljubljana, 1000 Ljubljana, Slovenia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8820-1453","authenticated-orcid":false,"given":"Paola","family":"Paradies","sequence":"additional","affiliation":[{"name":"Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J)\u2013Veterinary Section, University of Bari \u201cAldo Moro\u201d, Strada Provinciale Casamassima km3, Valenzano, 70010 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"110388","DOI":"10.1016\/j.vetpar.2024.110388","article-title":"Leishmania sp. can affect the cardiovascular system of dogs\u2014A systematic review of over 80 years","volume":"334","author":"Queiroz","year":"2025","journal-title":"Vet. Parasitol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1111\/j.1748-5827.2005.tb00285.x","article-title":"Myocarditis and generalised vasculitis associated with leishmaniosis in a dog","volume":"46","author":"Torrent","year":"2005","journal-title":"J. Small Anim. Pract."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1177\/0300985813493914","article-title":"Cardiac lesions in 30 dogs naturally infected with Leishmania infantum chagasi","volume":"51","author":"Rosa","year":"2014","journal-title":"Vet. Pathol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1186\/1751-0147-51-20","article-title":"Visceral leishmaniasis with cardiac involvement in a dog: A case report","volume":"51","author":"Fondevila","year":"2009","journal-title":"Acta Vet. Scand."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1111\/j.1939-165X.2012.00467.x","article-title":"Serum cardiac troponin I concentrations in dogs with leishmaniasis: Correlation with age and clinicopathologic abnormalities","volume":"41","author":"Silvestrini","year":"2012","journal-title":"Vet. Clin. Pathol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1016\/j.nmd.2008.10.013","article-title":"Canine inflammatory myopathy associated with Leishmania Infantum infection","volume":"19","author":"Paciello","year":"2009","journal-title":"Neuromuscul. Disord."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"8016186","DOI":"10.1155\/2016\/8016186","article-title":"Immunopathological Features of Canine Myocarditis Associated with Leishmania infantum Infection","volume":"2016","author":"Costagliola","year":"2016","journal-title":"Biomed Res. Int."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e018223","DOI":"10.1590\/s1984-29612024023","article-title":"Ehrlichia spp. infection worsens cardiac damage in dogs with canine visceral leishmaniasis","volume":"33","author":"Zanfagnini","year":"2024","journal-title":"Rev. Bras. Parasitol. Vet."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.jvc.2019.01.004","article-title":"Canine leishmaniasis associated with pericardial effusion in a 4-year-old dog","volume":"23","author":"Santarelli","year":"2019","journal-title":"J. Vet. Cardiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1016\/j.jvc.2017.06.002","article-title":"Assessment of left ventricular function in healthy Great Danes and in Great Danes with dilated cardiomyopathy using speckle tracking echocardiography","volume":"19","author":"Pedro","year":"2017","journal-title":"J. Vet. Cardiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/ehjci\/jeu184","article-title":"Definitions for a common standard for 2D speckle tracking echocardiography: Consensus document of the EACVI\/ASE\/Industry Task Force to standardize deformation imaging","volume":"16","author":"Voigt","year":"2015","journal-title":"Eur. Heart J. Cardiovasc. Imaging"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1171","DOI":"10.1016\/j.echo.2015.06.011","article-title":"Head-to-Head Comparison of Global Longitudinal Strain Measurements among Nine Different Vendors: The EACVI\/ASE Inter-Vendor Comparison Study","volume":"28","author":"Farsalinos","year":"2015","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.jvc.2012.09.001","article-title":"Clinical assessment of systolic myocardial deformations in dogs with chronic mitral valve insufficiency using two-dimensional speckle-tracking echocardiography","volume":"15","author":"Suzuki","year":"2013","journal-title":"J. Vet. Cardiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/j.rvsc.2018.08.008","article-title":"Evaluation of the right parasternal four-chamber view for the assessment of left ventricular longitudinal strain and strain rate by two-dimensional speckle tracking echocardiography in dogs","volume":"120","author":"Santarelli","year":"2018","journal-title":"Res. Vet. Sci."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.jvc.2022.11.002","article-title":"Two-dimensional speckle tracking-derived global longitudinal strain in healthy Doberman Pinschers: Method evaluation, variability, and reference values","volume":"45","author":"Hertzsch","year":"2023","journal-title":"J. Vet. Cardiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1803","DOI":"10.1111\/jvim.15331","article-title":"ACVIM consensus statement: Guidelines for the identification, evaluation, and management of systemic hypertension in dogs and cats","volume":"32","author":"Acierno","year":"2018","journal-title":"J. Vet. Intern. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1111\/j.1939-1676.1993.tb01015.x","article-title":"Recommendations for standards in transthoracic two-dimensional echocardiography in the dog and cat. Echocardiography Committee of the Specialty of Cardiology, American College of Veterinary Internal Medicine","volume":"7","author":"Thomas","year":"1993","journal-title":"J. Vet. Intern. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.jvc.2021.08.004","article-title":"Echocardiographic assessment of dilated cardiomyopathy in dogs","volume":"40","author":"Bonagura","year":"2022","journal-title":"J. Vet. Cardiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1211","DOI":"10.2460\/ajvr.77.11.1211","article-title":"Assessment of left ventricular volume and function in healthy dogs by use of one-, two-, and three-dimensional echocardiography versus multidetector computed tomography","volume":"77","author":"Scollan","year":"2016","journal-title":"Am. J. Vet. Res."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Wang, Z.-Y., Huang, L., Li, L.-Q., Zhang, C.-Q., Guo, L.-Y., Liu, Y.-N., and Liao, L.-M. (2025). Quantitative evaluation of radiation-induced heart disease in beagle dogs by speckle tracking echocardiography. BMC Cardiovasc. Disord., 25.","DOI":"10.1186\/s12872-025-04636-5"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Mogensen, J.E., Bach, M.B.T., Bay, P.G., Varlik, T., Willesen, J.L., Gleerup, C.H., and Koch, J. (2025). Speckle-Tracking Echocardiography in Dogs: Evaluating Imaging Parameters and Methodological Variability in Global Longitudinal Strain Assessment. Animals, 15.","DOI":"10.3390\/ani15111523"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1186\/1756-3305-4-86","article-title":"LeishVet guidelines for the practical management of canine leishmaniosis","volume":"4","author":"Koutinas","year":"2011","journal-title":"Parasites Vectors"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1590\/S0100-879X2009007500037","article-title":"Cardiac and pulmonary alterations in symptomatic and asymptomatic dogs infectednaturally with Leishmania (Leishmania) chagasi","volume":"43","author":"Alves","year":"2010","journal-title":"Braz. J. Med. Biol. Res."},{"key":"ref_24","first-page":"1248","article-title":"Immunohistochemistry in Myocardium of Dogs Naturally Infected with Leishmania chagasi","volume":"42","author":"Soares","year":"2014","journal-title":"Acta Sci. Vet."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.tvjl.2016.11.015","article-title":"Comparison of myocardial damage among dogs at different stages of clinical leishmaniasis and dogs with idiopathic chronic kidney disease","volume":"221","year":"2017","journal-title":"Vet. J."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1136\/vr.105205","article-title":"Comparison of N-terminal proB-type natriuretic peptide levels at different stages of visceral leishmaniosis and in patients with chronic kidney disease","volume":"185","author":"Arroyo","year":"2019","journal-title":"Vet. Rec."},{"key":"ref_27","first-page":"115","article-title":"Evaluation of cardiovascular injury in dogs coinfected with visceral leishmaniasis and monocytic ehrlichiosis by echocardiographic examination and selected biomarker measurements","volume":"59","author":"Ural","year":"2023","journal-title":"Vet. Ital."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1016\/j.rvsc.2012.01.005","article-title":"Monitoring the reverse to normal of clinico-pathological findings and the disease free interval time using four different treatment protocols for canine leishmaniosis in an endemic area","volume":"93","author":"Paradies","year":"2012","journal-title":"Res. Vet. Sci."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.cyto.2018.08.019","article-title":"A Leishmania hypothetical protein-containing liposome-based formulation is highly immunogenic and induces protection against visceral leishmaniasis","volume":"111","author":"Ribeiro","year":"2018","journal-title":"Cytokine"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Digiaro, S., Recchia, A., Colella, A., Cucciniello, S., Greco, B., Buonfrate, D., and Paradies, P. (2024). Treatment of Canine Leishmaniasis with Meglumine Antimoniate: A Clinical Study of Tolerability and Efficacy. Animals, 14.","DOI":"10.3390\/ani14152244"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"231","DOI":"10.5326\/JAAHA-MS-5840","article-title":"Variation of proteinuria in dogs with leishmaniasis treated with meglumine antimoniate and allopurinol: A retrospective study","volume":"49","author":"Pierantozzi","year":"2013","journal-title":"J. Am. Anim. Hosp. Assoc."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.rvsc.2019.08.026","article-title":"Short term impacts of meglumine antimoniate treatment on kidney function in dogs with clinical leishmaniosis","volume":"126","year":"2019","journal-title":"Res. Vet. Sci."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/j.jvc.2020.05.003","article-title":"Clinical presentation, cardiovascular findings, etiology, and outcome of myocarditis in dogs: 64 cases with presumptive antemortem diagnosis (26 confirmed postmortem) and 137 cases with postmortem diagnosis only (2004\u20132017)","volume":"30","author":"Lakhdhir","year":"2020","journal-title":"J. Vet. Cardiol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.jvc.2024.03.004","article-title":"Myocardial injury in dogs: A retrospective analysis on etiological, echocardiographic, electrocardiographic, therapeutic, and outcome findings in 102 cases","volume":"53","author":"Romito","year":"2024","journal-title":"J. Vet. Cardiol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1292\/jvms.21-0571","article-title":"Reversible myocardial injury aggravated by complex arrhythmias in three Toxoplasma gondii-positive dogs","volume":"84","author":"Romito","year":"2022","journal-title":"J. Vet. Med. Sci."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/j.jvc.2016.07.005","article-title":"Bartonella-associated inflammatory cardiomyopathy in a dog","volume":"19","author":"Santilli","year":"2017","journal-title":"J. Vet. Cardiol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"909","DOI":"10.2460\/javma.249.8.909","article-title":"Epidemiological, clinical, and echocardiographic features and survival times of dogs and cats with tetralogy of Fallot: 31 cases (2003\u20132014)","volume":"249","author":"Chetboul","year":"2016","journal-title":"J. Am. Vet. Med. Assoc."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1222","DOI":"10.1111\/jvim.15464","article-title":"Clinical, epidemiological and echocardiographic features and prognostic factors in cats with restrictive cardiomyopathy: A retrospective study of 92 cases (2001\u20132015)","volume":"33","author":"Chetboul","year":"2019","journal-title":"J. Vet. Intern. Med."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1150","DOI":"10.2460\/javma.255.10.1150","article-title":"Prevalence of selected cardiotropic pathogens in the myocardium of adult dogs with unexplained myocardial and rhythm disorders or with congenital heart disease","volume":"255","author":"Santilli","year":"2019","journal-title":"J. Am. Vet. Med. Assoc."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1097\/HCO.0000000000000265","article-title":"Noninvasive imaging in acute myocarditis","volume":"31","author":"Bami","year":"2016","journal-title":"Curr. Opin. Cardiol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1161\/CIRCIMAGING.112.000162","article-title":"Prognostic significance of exercise-induced right ventricular dysfunction in asymptomatic degenerative mitral regurgitation","volume":"6","author":"Kusunose","year":"2013","journal-title":"Circ. Cardiovasc. Imaging"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1195","DOI":"10.1016\/j.echo.2012.08.007","article-title":"Variability of global left ventricular deformation analysis using vendor dependent and independent two-dimensional speckle-tracking software in adults","volume":"25","author":"Risum","year":"2012","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1673","DOI":"10.1136\/heartjnl-2014-305538","article-title":"Prognostic implications of global LV dysfunction: A systematic review and meta-analysis of global longitudinal strain and ejection fraction","volume":"100","author":"Kalam","year":"2014","journal-title":"Heart"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1111\/jvim.13938","article-title":"Echocardiographic Assessment of Cardiac Function by Conventional and Speckle-Tracking Echocardiography in Dogs with Patent Ductus Arteriosus","volume":"30","author":"Spalla","year":"2016","journal-title":"J. Vet. Intern. Med."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1186\/1751-0147-55-41","article-title":"Speckle tracking echocardiography in mature Irish Wolfhound dogs: Technical feasibility, measurement error and reference intervals","volume":"55","author":"Westrup","year":"2013","journal-title":"Acta Vet. Scand."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.jvc.2010.08.001","article-title":"Comparison of longitudinal myocardial tissue velocity, strain, and strain rate measured by two-dimensional speckle tracking and by color tissue Doppler imaging in healthy dogs","volume":"13","author":"Wess","year":"2011","journal-title":"J. Vet. Cardiol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.jvc.2021.01.006","article-title":"Systolic dysfunction by two-dimensional speckle tracking echocardiography in dogs with parvoviral enteritis","volume":"34","author":"Muzzi","year":"2021","journal-title":"J. Vet. Cardiol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1111\/jvim.15438","article-title":"Use of 2-dimensional speckle-tracking echocardiography to assess left ventricular systolic function in dogs with systemic inflammatory response syndrome","volume":"33","author":"Corda","year":"2019","journal-title":"J. Vet. Intern. Med."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1111\/jvim.13801","article-title":"Cardiac Troponins in Dogs and Cats","volume":"30","author":"Langhorn","year":"2016","journal-title":"J. Vet. Intern. Med."}],"container-title":["Pathogens"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-0817\/15\/4\/370\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T16:46:56Z","timestamp":1774975616000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-0817\/15\/4\/370"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,31]]},"references-count":49,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,4]]}},"alternative-id":["pathogens15040370"],"URL":"https:\/\/doi.org\/10.3390\/pathogens15040370","relation":{},"ISSN":["2076-0817"],"issn-type":[{"value":"2076-0817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,31]]}}}