{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T08:12:01Z","timestamp":1793175121123,"version":"4.5.0"},"reference-count":51,"publisher":"American Medical Association (AMA)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Objective<\/jats:title>To investigate the association between body composition parameters and breast cancer (BC) risk in premenopausal women.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>Prospective cohort study using data from the Kangbuk Samsung Cohort Study. Participants were women aged 20 to 54 years who were enrolled from 2011 to 2019 and followed up for BC development until December 31, 2020. Data were analyzed from June to August 2023.<\/jats:p><\/jats:sec>Exposures<\/jats:title>Trained nurses conducted anthropometric measurements and assessed body composition using segmental bioelectric impedance analysis. The analysis encompassed adiposity measures such as body mass index (BMI), waist circumference, and body composition parameters, including muscle mass, fat mass, ratio of muscle mass to weight, ratio of fat mass to weight, and fat mass index.<\/jats:p><\/jats:sec>Main outcomes and measures<\/jats:title>Adjusted hazard ratios (aHR) for BC during the follow-up period.<\/jats:p><\/jats:sec>Results<\/jats:title>Among 125\u202f188 premenopausal women, the mean (SD) age was 34.9 (6.3) years. During a mean (range) follow-up of 6.7 (0.5-9.9) years, 1110 incident BC cases were identified. The mean (SD) BMI and waist circumference were 21.6 (3.1) and 75.3 (8.2) cm, respectively. Higher BMI and waist circumference were associated with decreased risk, with an aHR of 0.89 (95% CI, 0.84-0.95) per SD increase in BMI and 0.92 (95% CI, 0.86-0.98) per SD increase in waist circumference. A higher ratio of fat mass to weight was associated with decreased BC risk (aHR, 0.92; 95% CI, 0.86-0.99 per SD increase), whereas the opposite trend was observed for the ratio of muscle mass to weight, with an aHR of 1.08 (95% CI, 1.02-1.15) per SD increase. The results remained consistent even after additional adjustments for height in the model. The fat mass index was also inversely associated with BC risk, with an HR of 0.90 (95% CI, 0.85-0.97) per SD increase.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>In this cohort study of premenopausal women, a higher level of adiposity, represented by increased BMI, waist circumference, and fat mass, was consistently associated with decreased breast cancer risk. Conversely, muscle mass and its ratio to weight displayed opposite or inconsistent patterns. These findings suggest an inverse association between excess adiposity and the risk of BC in premenopausal women, confirming earlier findings that BMI is an indirect measure of adiposity.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.5423","type":"journal-article","created":{"date-parts":[[2024,4,5]],"date-time":"2024-04-05T15:31:18Z","timestamp":1712331078000},"page":"e245423","source":"Crossref","is-referenced-by-count":21,"title":["Adiposity, Body Composition Measures, and Breast Cancer Risk in Korean Premenopausal Women"],"prefix":"10.1001","volume":"7","author":[{"given":"Thi Xuan Mai","family":"Tran","sequence":"first","affiliation":[{"name":"Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoosoo","family":"Chang","sequence":"additional","affiliation":[{"name":"Center for Cohort Studies, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea"},{"name":"Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea"},{"name":"Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hye Rin","family":"Choi","sequence":"additional","affiliation":[{"name":"Center for Cohort Studies, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea"},{"name":"Institute of Medical Research, Sungkyunkwan University, School of Medicine, Suwon, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ria","family":"Kwon","sequence":"additional","affiliation":[{"name":"Center for Cohort Studies, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea"},{"name":"Institute of Medical Research, Sungkyunkwan University, School of Medicine, Suwon, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ga-Young","family":"Lim","sequence":"additional","affiliation":[{"name":"Center for Cohort Studies, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea"},{"name":"Institute of Medical Research, Sungkyunkwan University, School of Medicine, Suwon, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eun Young","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seungho","family":"Ryu","sequence":"additional","affiliation":[{"name":"Center for Cohort Studies, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea"},{"name":"Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea"},{"name":"Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boyoung","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea"},{"name":"Hanyang Institute of Bioscience and Biotechnology, Hanyang University, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2024,4,5]]},"reference":[{"issue":"5","key":"zoi240218r1","doi-asserted-by":"publisher","first-page":"611","DOI":"10.1001\/jamaoncol.2015.1546","article-title":"Overweight, obesity, and postmenopausal invasive breast cancer risk: a secondary analysis of the women\u2019s health initiative randomized clinical trials.","volume":"1","author":"Neuhouser","year":"2015","journal-title":"JAMA Oncol"},{"issue":"12","key":"zoi240218r2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.39161","article-title":"Association of the interaction between mammographic breast density, body mass index, and menopausal status with breast cancer risk among Korean women.","volume":"4","author":"Tran","year":"2021","journal-title":"JAMA Netw Open"},{"issue":"11","key":"zoi240218r3","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2018.1771","article-title":"Association of body mass index and age with subsequent breast cancer risk in premenopausal women.","volume":"4","author":"Schoemaker","year":"2018","journal-title":"JAMA Oncol"},{"issue":"8","key":"zoi240218r4","doi-asserted-by":"publisher","first-page":"1554","DOI":"10.1002\/ijc.v142.8","article-title":"Waist circumference and risk of breast cancer in Korean women: a nationwide cohort study.","volume":"142","author":"Lee","year":"2018","journal-title":"Int J Cancer"},{"issue":"2","key":"zoi240218r5","doi-asserted-by":"publisher","first-page":"495","DOI":"10.1007\/s10549-020-05952-4","article-title":"Obesity and breast cancer risk for pre- and postmenopausal women among over 6 million Korean women.","volume":"185","author":"Park","year":"2021","journal-title":"Breast Cancer Res Treat"},{"issue":"20","key":"zoi240218r6","doi-asserted-by":"publisher","first-page":"3700","DOI":"10.1002\/cncr.v121.20","article-title":"Overall and central adiposity and breast cancer risk in the Sister Study.","volume":"121","author":"White","year":"2015","journal-title":"Cancer"},{"issue":"7","key":"zoi240218r7","doi-asserted-by":"publisher","first-page":"900","DOI":"10.1093\/jnci\/djaa197","article-title":"Central adiposity and subsequent risk of breast cancer by menopause status.","volume":"113","author":"Houghton","year":"2021","journal-title":"J Natl Cancer Inst"},{"issue":"10","key":"zoi240218r8","doi-asserted-by":"publisher","first-page":"1742","DOI":"10.1038\/s41366-022-01173-5","article-title":"Consecutive gain and loss in body weight and waist circumference with risk of subsequent breast cancer in Korean women.","volume":"46","author":"Tran","year":"2022","journal-title":"Int J Obes (Lond)"},{"issue":"1","key":"zoi240218r9","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1038\/s41574-020-00431-8","article-title":"Sexual dimorphism in cardiometabolic health: the role of adipose tissue, muscle and liver.","volume":"17","author":"Goossens","year":"2021","journal-title":"Nat Rev Endocrinol"},{"issue":"2","key":"zoi240218r10","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1001\/jamaoncol.2018.5327","article-title":"Association of body fat and risk of breast cancer in postmenopausal women with normal body mass index: a secondary analysis of a randomized clinical trial and observational study.","volume":"5","author":"Iyengar","year":"2019","journal-title":"JAMA Oncol"},{"issue":"4","key":"zoi240218r11","doi-asserted-by":"publisher","first-page":"356","DOI":"10.1159\/000529834","article-title":"Association of body fat distribution and risk of breast cancer in pre- and postmenopausal women.","volume":"16","author":"Cao","year":"2023","journal-title":"Obes Facts"},{"issue":"12","key":"zoi240218r12","doi-asserted-by":"publisher","first-page":"2117","DOI":"10.1158\/1055-9965.2117.13.12","article-title":"Body size and composition and risk of postmenopausal breast cancer.","volume":"13","author":"Macinnis","year":"2004","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"issue":"3","key":"zoi240218r13","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1046\/j.1467-789X.2002.00065.x","article-title":"Asians are different from Caucasians and from each other in their body mass index\/body fat per cent relationship.","volume":"3","author":"Deurenberg","year":"2002","journal-title":"Obes Rev"},{"issue":"4","key":"zoi240218r14","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1017\/S1368980008002802","article-title":"Are Asians at greater mortality risks for being overweight than Caucasians? Redefining obesity for Asians.","volume":"12","author":"Wen","year":"2009","journal-title":"Public Health Nutr"},{"issue":"5","key":"zoi240218r15","doi-asserted-by":"publisher","first-page":"305","DOI":"10.7326\/M15-1323","article-title":"Metabolically healthy obesity and development of chronic kidney disease: a cohort study.","volume":"164","author":"Chang","year":"2016","journal-title":"Ann Intern Med"},{"issue":"4","key":"zoi240218r16","doi-asserted-by":"publisher","first-page":"920","DOI":"10.1053\/j.gastro.2023.06.029","article-title":"Serum 25-Hydroxyvitamin D levels and risk of colorectal cancer: an age-stratified analysis.","volume":"165","author":"Kim","year":"2023","journal-title":"Gastroenterology"},{"issue":"5","key":"zoi240218r17","doi-asserted-by":"publisher","first-page":"610","DOI":"10.1016\/j.clnu.2011.04.001","article-title":"Accuracy of direct segmental multi-frequency bioimpedance analysis in the assessment of total body and segmental body composition in middle-aged adult population.","volume":"30","author":"Ling","year":"2011","journal-title":"Clin Nutr"},{"issue":"6","key":"zoi240218r18","doi-asserted-by":"publisher","first-page":"537","DOI":"10.1016\/S0261-5614(03)00048-7","article-title":"Validation of a bioelectrical impedance analysis equation to predict appendicular skeletal muscle mass (ASMM).","volume":"22","author":"Kyle","year":"2003","journal-title":"Clin Nutr"},{"issue":"4","key":"zoi240218r19","doi-asserted-by":"publisher","first-page":"621","DOI":"10.12965\/jer.1836284.142","article-title":"The reproducibility and validity verification for body composition measuring devices using bioelectrical impedance analysis in Korean adults.","volume":"14","author":"Yang","year":"2018","journal-title":"J Exerc Rehabil"},{"key":"zoi240218r20","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1186\/1471-2458-13-629","article-title":"The utility of fat mass index vs. body mass index and percentage of body fat in the screening of metabolic syndrome.","volume":"13","author":"Liu","year":"2013","journal-title":"BMC Public Health"},{"issue":"6","key":"zoi240218r21","doi-asserted-by":"publisher","first-page":"325","DOI":"10.4143\/crt.2005.37.6.325","article-title":"Nationwide cancer incidence in Korea, 1999~2001; first result using the national cancer incidence database.","volume":"37","author":"Shin","year":"2005","journal-title":"Cancer Res Treat"},{"issue":"2","key":"zoi240218r22","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1017\/S1368980012002741","article-title":"Measurement error of waist circumference: gaps in knowledge.","volume":"16","author":"Verweij","year":"2013","journal-title":"Public Health Nutr"},{"issue":"3","key":"zoi240218r23","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1016\/j.afos.2022.09.004","article-title":"Reply on \u201csignificant change for body composition data\u201d.","volume":"8","author":"Nascimento","year":"2022","journal-title":"Osteoporos Sarcopenia"},{"issue":"4","key":"zoi240218r24","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1158\/1940-6207.CAPR-17-0283","article-title":"Adiposity, inflammation, and breast cancer pathogenesis in Asian women.","volume":"11","author":"Iyengar","year":"2018","journal-title":"Cancer Prev Res (Phila)"},{"issue":"7","key":"zoi240218r25","doi-asserted-by":"publisher","first-page":"1067","DOI":"10.1001\/jamaoncol.2019.1091","article-title":"Accounting for height in an analysis of body fat and breast cancer risk.","volume":"5","author":"Lee","year":"2019","journal-title":"JAMA Oncol"},{"issue":"7","key":"zoi240218r26","doi-asserted-by":"publisher","first-page":"1068","DOI":"10.1001\/jamaoncol.2019.1103","article-title":"Accounting for height in an analysis of body fat and breast cancer risk-in reply.","volume":"5","author":"Iyengar","year":"2019","journal-title":"JAMA Oncol"},{"issue":"6","key":"zoi240218r27","doi-asserted-by":"publisher","first-page":"514","DOI":"10.1093\/aje\/152.6.514","article-title":"Pooled analysis of prospective cohort studies on height, weight, and breast cancer risk.","volume":"152","author":"van den Brandt","year":"2000","journal-title":"Am J Epidemiol"},{"issue":"1","key":"zoi240218r28","doi-asserted-by":"publisher","first-page":"2294","DOI":"10.1038\/s41598-020-59056-6","article-title":"Anthropometry, body shape in early-life and risk of premenopausal breast cancer among Latin American women: results from the PRECAMA study.","volume":"10","author":"His","year":"2020","journal-title":"Sci Rep"},{"issue":"5","key":"zoi240218r29","doi-asserted-by":"publisher","first-page":"762","DOI":"10.1002\/ijc.v111:5","article-title":"Body size and breast cancer risk: findings from the European Prospective Investigation into Cancer And Nutrition (EPIC).","volume":"111","author":"Lahmann","year":"2004","journal-title":"Int J Cancer"},{"issue":"1","key":"zoi240218r30","doi-asserted-by":"publisher","first-page":"475","DOI":"10.1186\/1471-2407-13-475","article-title":"Body fatness and breast cancer risk in women of African ancestry.","volume":"13","author":"Bandera","year":"2013","journal-title":"BMC Cancer"},{"issue":"12","key":"zoi240218r31","doi-asserted-by":"publisher","first-page":"1722","DOI":"10.1158\/1055-9965.EPI-17-0450","article-title":"Biology and etiology of young-onset breast cancers among premenopausal African American women: results from the AMBER Consortium.","volume":"26","author":"Chollet-Hinton","year":"2017","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"issue":"1","key":"zoi240218r32","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1186\/s13058-017-0931-5","article-title":"Body mass index at age 18 years and recent body mass index in relation to risk of breast cancer overall and ER\/PR\/HER2-defined subtypes in white women and African-American women: a pooled analysis.","volume":"20","author":"Ma","year":"2018","journal-title":"Breast Cancer Res"},{"key":"zoi240218r33","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1016\/j.annepidem.2023.01.014","article-title":"Associations of body fat mass and fat-free mass with breast cancer incidence in postmenopausal women: A Danish prospective cohort study.","volume":"80","author":"Gram","year":"2023","journal-title":"Ann Epidemiol"},{"issue":"3","key":"zoi240218r34","doi-asserted-by":"publisher","first-page":"S52","DOI":"10.1016\/j.amepre.2013.10.024","article-title":"Anthropometry, silhouette trajectory, and risk of breast cancer in Mexican women.","volume":"46","author":"Amadou","year":"2014","journal-title":"Am J Prev Med"},{"issue":"2","key":"zoi240218r35","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1093\/aje\/kwq345","article-title":"Adult body size, hormone receptor status, and premenopausal breast cancer risk in a multiethnic population: the San Francisco Bay Area breast cancer study.","volume":"173","author":"John","year":"2011","journal-title":"Am J Epidemiol"},{"issue":"3","key":"zoi240218r36","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1093\/jnci\/djq500","article-title":"Body fat distribution and risk of premenopausal breast cancer in the Nurses\u2019 Health Study II.","volume":"103","author":"Harris","year":"2011","journal-title":"J Natl Cancer Inst"},{"issue":"6","key":"zoi240218r37","doi-asserted-by":"publisher","first-page":"705","DOI":"10.1016\/j.ejca.2015.01.057","article-title":"Obesity in breast cancer\u2013what is the risk factor?","volume":"51","author":"James","year":"2015","journal-title":"Eur J Cancer"},{"issue":"1","key":"zoi240218r38","doi-asserted-by":"publisher","first-page":"16785","DOI":"10.1038\/s41598-021-96390-9","article-title":"Association between skeletal muscle mass and mammographic breast density.","volume":"11","author":"Lee","year":"2021","journal-title":"Sci Rep"},{"issue":"1","key":"zoi240218r39","doi-asserted-by":"publisher","first-page":"22224","DOI":"10.1038\/s41598-022-26839-y","article-title":"Association of body composition fat parameters and breast density in mammography by menopausal status.","volume":"12","author":"Chu","year":"2022","journal-title":"Sci Rep"},{"issue":"1","key":"zoi240218r40","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1186\/s13058-020-01332-4","article-title":"Hormonal determinants of mammographic density and density change.","volume":"22","author":"Gabrielson","year":"2020","journal-title":"Breast Cancer Res"},{"issue":"4","key":"zoi240218r41","doi-asserted-by":"publisher","first-page":"718","DOI":"10.1097\/gme.0b013e3181cec85d","article-title":"Obesity and reproductive hormone levels in the transition to menopause.","volume":"17","author":"Freeman","year":"2010","journal-title":"Menopause"},{"key":"zoi240218r42","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2021.705911","article-title":"Obesity and breast cancer: a paradoxical and controversial relationship influenced by menopausal status.","volume":"11","author":"Garc\u00eda-Est\u00e9vez","year":"2021","journal-title":"Front Oncol"},{"issue":"1","key":"zoi240218r43","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s10549-014-3211-4","article-title":"Reduced progesterone levels explain the reduced risk of breast cancer in obese premenopausal women: a new hypothesis.","volume":"149","author":"Dowsett","year":"2015","journal-title":"Breast Cancer Res Treat"},{"issue":"1","key":"zoi240218r44","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1186\/s13058-019-1129-9","article-title":"Body mass index, mammographic density, and breast cancer risk by estrogen receptor subtype.","volume":"21","author":"Shieh","year":"2019","journal-title":"Breast Cancer Res"},{"issue":"1","key":"zoi240218r45","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1007\/s10549-015-3286-6","article-title":"Mammographic breast density and breast cancer risk: interactions of percent density, absolute dense, and non-dense areas with breast cancer risk factors.","volume":"150","author":"Yaghjyan","year":"2015","journal-title":"Breast Cancer Res Treat"},{"issue":"27","key":"zoi240218r46","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000011345","article-title":"Association between serum leptin levels and breast cancer risk: an updated systematic review and meta-analysis.","volume":"97","author":"Pan","year":"2018","journal-title":"Medicine (Baltimore)"},{"issue":"4","key":"zoi240218r47","doi-asserted-by":"publisher","first-page":"1226","DOI":"10.1093\/ije\/dyu088","article-title":"Circulating adiponectin and breast cancer risk: a systematic review and meta-analysis.","volume":"43","author":"Macis","year":"2014","journal-title":"Int J Epidemiol"},{"issue":"9","key":"zoi240218r48","doi-asserted-by":"publisher","first-page":"1608","DOI":"10.1038\/bjc.2012.414","article-title":"Diabetes and breast cancer risk: a meta-analysis.","volume":"107","author":"Boyle","year":"2012","journal-title":"Br J Cancer"},{"issue":"2","key":"zoi240218r49","doi-asserted-by":"publisher","first-page":"123","DOI":"10.4048\/jbc.2021.24.e22","article-title":"Breast cancer statistics in Korea, 2018.","volume":"24","author":"Kang","year":"2021","journal-title":"J Breast Cancer"},{"issue":"6","key":"zoi240218r50","doi-asserted-by":"publisher","first-page":"438","DOI":"10.3322\/caac.v69.6","article-title":"Breast cancer statistics, 2019.","volume":"69","author":"DeSantis","year":"2019","journal-title":"CA Cancer J Clin"},{"issue":"5","key":"zoi240218r51","doi-asserted-by":"publisher","first-page":"433","DOI":"10.1177\/0115426504019005433","article-title":"The validity of bioelectrical impedance models in clinical populations.","volume":"19","author":"Buchholz","year":"2004","journal-title":"Nutr Clin Pract"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2817206\/tran_2024_oi_240218_1711636207.08807.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,5]],"date-time":"2024-04-05T15:31:23Z","timestamp":1712331083000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2817206"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,5]]},"references-count":51,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024,4,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2024.5423","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,5]]}}}