{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T07:10:06Z","timestamp":1778224206327,"version":"3.51.4"},"reference-count":54,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Reconstr Microsurg"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003When free tissue transfer is precluded or undesired, the pedicled trapezius flap is a viable alternative for adults requiring complex head and neck (H&amp;N) defect reconstruction. However, the application of this flap in pediatric reconstruction is underexplored. This systematic review aimed to describe the use of the pedicled trapezius flap and investigate its efficacy in pediatric H&amp;N reconstruction.<\/jats:p><jats:p>\n          Methods\u2003A systematic review was performed using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Articles describing the trapezius flap for H&amp;N reconstruction in pediatric patients were included. Patient demographics, surgical indications, wound characteristics, flap characteristics, complications, and functional outcomes were abstracted.<\/jats:p><jats:p>\n          Results\u2003A systematic review identified 22 articles for inclusion. Studies mainly consisted of case reports (n\u2009=\u200911) and case series (n\u2009=\u20098). In total, 67 pedicled trapezius flaps were successfully performed for H&amp;N reconstruction in 63 patients. The most common surgical indications included burn scar contractures (n\u2009=\u200946, 73.0%) and chronic wounds secondary to H&amp;N masses (n\u2009=\u20099, 14.3%). Defects were most commonly located in the neck (n\u2009=\u200928, 41.8%). The mean flap area and arc of rotation were 326.4\u2009\u00b1\u2009241.7\u2009cm2 and 157.6\u2009\u00b1\u200933.2\u2009degrees, respectively. Most flaps were myocutaneous (n\u2009=\u200948, 71.6%) and based on the dorsal scapular artery (n\u2009=\u200932, 47.8%). Complications occurred in 10 (14.9%) flaps. The flap's survival rate was 100% (n\u2009=\u200967). No instances of functional donor site morbidity were reported. The mean follow-up was 2.2\u2009\u00b1\u20091.8 years.<\/jats:p><jats:p>\n          Conclusion\u2003This systematic review demonstrated the reliability of the pedicled trapezius flap in pediatric H&amp;N reconstruction, with a low complication rate, no reports of functional donor site morbidity, and a 100% flap survival rate. The flap's substantial surface area, bulk, and arc of rotation contribute to its efficacy in covering soft tissue defects ranging from the proximal neck to the vertex of the scalp. The pedicled trapezius flap is a viable option for pediatric H&amp;N reconstruction.<\/jats:p>","DOI":"10.1055\/s-0044-1787741","type":"journal-article","created":{"date-parts":[[2024,6,25]],"date-time":"2024-06-25T22:51:47Z","timestamp":1719355907000},"page":"113-122","source":"Crossref","is-referenced-by-count":2,"title":["The Forgotten Flap: The Pedicled Trapezius Flap's Utility in Pediatric Head and Neck Reconstruction\u2014A Systematic Review"],"prefix":"10.1055","volume":"41","author":[{"given":"Tayla","family":"Moshal","sequence":"additional","affiliation":[{"name":"Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles, Los Angeles, California"},{"name":"Keck School of Medicine, University of Southern California, Los Angeles, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sasha","family":"Lasky","sequence":"additional","affiliation":[{"name":"Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles, Los Angeles, California"},{"name":"Keck School of Medicine, University of Southern California, Los Angeles, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Idean","family":"Roohani","sequence":"additional","affiliation":[{"name":"Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles, Los Angeles, California"},{"name":"Keck School of Medicine, University of Southern California, Los Angeles, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marah I.","family":"Jolibois","sequence":"additional","affiliation":[{"name":"Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles, Los Angeles, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Artur","family":"Manasyan","sequence":"additional","affiliation":[{"name":"Keck School of Medicine, University of Southern California, Los Angeles, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naikhoba C.O.","family":"Munabi","sequence":"additional","affiliation":[{"name":"Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles, Los Angeles, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Artur","family":"Fahradyan","sequence":"additional","affiliation":[{"name":"Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles, Los Angeles, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica A.","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles, Los Angeles, California"},{"name":"Division of Plastic and Reconstructive Surgery, Keck School of Medicine of USC, Los Angeles, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey A.","family":"Hammoudeh","sequence":"additional","affiliation":[{"name":"Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles, Los Angeles, California"},{"name":"Division of Plastic and Reconstructive Surgery, Keck School of Medicine of USC, Los Angeles, California"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,6,25]]},"reference":[{"issue":"03","key":"ref1","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1002\/hed.20512","article-title":"Infrahyoid fascio-myocutaneous flap as an alternative to free radial forearm flap in head and neck reconstruction","volume":"29","author":"A Deganello","year":"2007","journal-title":"Head Neck"},{"issue":"06","key":"ref2","doi-asserted-by":"crossref","first-page":"e532","DOI":"10.1097\/SCS.0000000000002033","article-title":"Use of pedicled trapezius myocutaneous flap for posterior skull reconstruction","volume":"26","author":"M Singh","year":"2015","journal-title":"J Craniofac Surg"},{"issue":"01","key":"ref3","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1097\/00006534-200007000-00012","article-title":"Factors affecting outcome in free-tissue transfer in the elderly","volume":"106","author":"J M Serletti","year":"2000","journal-title":"Plast Reconstr Surg"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1016\/j.bjps.2010.05.026","article-title":"Survival of pectoralis major flap after secondary myectomy of muscle pedicle including transection of thoracoacromial vessels: Does the flap remain dependent on its dominant?","volume":"64","author":"M EE van Rossen","year":"2011","journal-title":"J Plast Reconstr Aesthet Surg"},{"issue":"05","key":"ref5","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1177\/019459988409200509","article-title":"Extended latissimus dorsi myocutaneous flap reconstruction of major head and neck defects","volume":"92","author":"M D Maves","year":"1984","journal-title":"Otolaryngol Head Neck Surg"},{"issue":"05","key":"ref6","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1055\/s-0034-1544123","article-title":"Lower trapezius flap for reconstruction of posterior scalp and neck defects after complex occipital-cervical surgeries","volume":"76","author":"J Zenga","year":"2015","journal-title":"J Neurol Surg B Skull Base"},{"issue":"05","key":"ref7","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1016\/j.bjoms.2007.11.009","article-title":"Reconstruction of the tongue using an extended vertical lower trapezius island myocutaneous flap after removal of advanced tongue cancer","volume":"46","author":"W-L Chen","year":"2008","journal-title":"Br J Oral Maxillofac Surg"},{"key":"ref8","volume-title":"Grabb and Smith's Plastic Surgery","author":"W C Grabb","year":"2007"},{"issue":"06","key":"ref9","doi-asserted-by":"crossref","first-page":"529","DOI":"10.5999\/aps.2016.43.6.529","article-title":"The trapezius muscle flap: a viable alternative for posterior scalp and neck reconstruction","volume":"43","author":"H J Yang","year":"2016","journal-title":"Arch Plast Surg"},{"issue":"01","key":"ref10","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1097\/00006534-199007000-00005","article-title":"Superficial cervical artery skin flaps","volume":"86","author":"H Hyakusoku","year":"1990","journal-title":"Plast Reconstr Surg"},{"issue":"02","key":"ref11","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1016\/0305-4179(93)90044-9","article-title":"Versatility of the free or pedicled superficial cervical artery skin flaps in head and neck burns","volume":"19","author":"H Hyakusoku","year":"1993","journal-title":"Burns"},{"issue":"02","key":"ref12","doi-asserted-by":"crossref","first-page":"59","DOI":"10.2302\/kjm.33.59","article-title":"Island fasciocutaneous flaps of dorsal trunk and their application to myocutaneous flap","volume":"33","author":"H Nakajima","year":"1984","journal-title":"Keio J Med"},{"issue":"04","key":"ref13","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1016\/0002-9610(79)90414-8","article-title":"Trapezius myocutaneous flap in reconstructive surgery for head and neck cancer: an original technique","volume":"138","author":"F Demergasso","year":"1979","journal-title":"Am J Surg"},{"issue":"05","key":"ref14","doi-asserted-by":"crossref","first-page":"1224","DOI":"10.1016\/j.joms.2011.06.208","article-title":"Reconstruction of major full cheek defects with combined extensive pedicled supraclavicular fasciocutaneous island flaps and extended vertical lower trapezius island myocutaneous flaps after ablation of advanced oral cancer","volume":"70","author":"W-L Chen","year":"2012","journal-title":"J Oral Maxillofac Surg"},{"issue":"02","key":"ref15","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1097\/BCR.0b013e31816677d9","article-title":"Preexpanded vertical trapezius musculocutaneous flap for reconstruction of a severe neck contracture after burn injury","volume":"29","author":"D Ulrich","year":"2008","journal-title":"J Burn Care Res"},{"issue":"S 01","key":"ref16","first-page":"S48","article-title":"The lower trapezius musculocutaneous flap for head and neck reconstruction: two decades of clinical experience","volume":"71","author":"K-L Ou","year":"2013","journal-title":"Ann Plast Surg"},{"issue":"02","key":"ref17","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1097\/00006534-200202000-00005","article-title":"The lower trapezius musculocutaneous flap revisited: versatile coverage for complicated wounds to the posterior cervical and occipital regions based on the deep branch of the transverse cervical artery","volume":"109","author":"J R Lynch","year":"2002","journal-title":"Plast Reconstr Surg"},{"issue":"12","key":"ref18","doi-asserted-by":"crossref","first-page":"1295","DOI":"10.1007\/s00383-011-2948-7","article-title":"Extended lower trapezius myocutaneous flap in burn scar reconstruction of the face and neck of children","volume":"27","author":"X-Y Zheng","year":"2011","journal-title":"Pediatr Surg Int"},{"issue":"02","key":"ref19","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1097\/01.PRS.0000131984.55825.9D","article-title":"Extended vertical trapezius myocutaneous flap in head and neck reconstruction as a salvage procedure","volume":"114","author":"K U\u011furlu","year":"2004","journal-title":"Plast Reconstr Surg"},{"issue":"05","key":"ref20","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1016\/j.burns.2004.02.006","article-title":"Trapezius musculocutaneous flap in severe shoulder and neck burn","volume":"30","author":"S Motamed","year":"2004","journal-title":"Burns"},{"issue":"12","key":"ref21","doi-asserted-by":"crossref","first-page":"1852","DOI":"10.1016\/j.ijporl.2012.08.019","article-title":"Lower island trapezius myocutaneous flap reconstruction of a large neck defect in an infant","volume":"76","author":"A Parekh","year":"2012","journal-title":"Int J Pediatr Otorhinolaryngol"},{"issue":"04","key":"ref22","doi-asserted-by":"crossref","first-page":"e438","DOI":"10.1097\/SCS.0b013e3182942e74","article-title":"Orbitomaxillomandibular reconstruction with free osteomyocutaneous fibular flap and lower trapezius myocutaneous flap","volume":"24","author":"E Akbay","year":"2013","journal-title":"J Craniofac Surg"},{"issue":"12","key":"ref23","doi-asserted-by":"crossref","first-page":"1669","DOI":"10.1016\/j.bjps.2014.07.044","article-title":"The myocutaneous trapezius flap revisited: a treatment algorithm for optimal surgical outcomes based on 43 flap reconstructions","volume":"67","author":"A Can","year":"2014","journal-title":"J Plast Reconstr Aesthet Surg"},{"issue":"05","key":"ref24","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1016\/j.ijom.2013.11.011","article-title":"Second salvage surgery with extended vertical lower trapezius island myocutaneous flap reconstruction for advanced re-recurrent oral and oropharyngeal squamous cell carcinoma","volume":"43","author":"W Chen","year":"2014","journal-title":"Int J Oral Maxillofac Implants"},{"issue":"06","key":"ref25","doi-asserted-by":"crossref","first-page":"1635","DOI":"10.1007\/s00381-023-05941-0","article-title":"Efficacy of the pedicle trapezius muscle flap for the multisurgical removal of pediatric posterior fossa anaplastic ependymoma","volume":"39","author":"A Nakamura","year":"2023","journal-title":"Childs Nerv Syst"},{"issue":"04","key":"ref26","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1177\/014556139207100403","article-title":"The trapezius myocutaneous flap","volume":"71","author":"J T Wathne","year":"1992","journal-title":"Ear Nose Throat J"},{"issue":"03","key":"ref27","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1097\/00006534-198503000-00003","article-title":"The extended trapezius musculocutaneous flap for cranio-orbital facial reconstruction","volume":"75","author":"H M Rosen","year":"1985","journal-title":"Plast Reconstr Surg"},{"key":"ref28","first-page":"14","article-title":"Revisiting pedicled latissimus dorsi flaps in head and neck reconstruction: contrasting shoulder morbidities across myofascial flaps","volume":"8","author":"A L Feng","year":"2021","journal-title":"Plast Aesthet Res"},{"issue":"09","key":"ref29","doi-asserted-by":"crossref","first-page":"2539","DOI":"10.1007\/s00405-020-05952-6","article-title":"Utility and relevance of modified lateral trapezius myocutaneous flap as a locoregional reconstructive option for medium-sized ablative defects in head and neck cancer-our experience","volume":"277","author":"A Singh","year":"2020","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"ref30","volume-title":"Flaps and Reconstructive Surgery E-Book","author":"F-C Wei","year":"2016"},{"issue":"04","key":"ref31","doi-asserted-by":"crossref","first-page":"835","DOI":"10.5604\/12321966.1129943","article-title":"Biological psychological and social determinants of old age: bio-psycho-social aspects of human aging","volume":"21","author":"M Dziechcia\u017c","year":"2014","journal-title":"Ann Agric Environ Med"},{"issue":"09","key":"ref32","doi-asserted-by":"crossref","first-page":"1568","DOI":"10.1002\/jbmr.3564","article-title":"The spectrum of fundamental basic science discoveries contributing to organismal aging","volume":"33","author":"J N Farr","year":"2018","journal-title":"J Bone Miner Res"},{"issue":"01","key":"ref33","doi-asserted-by":"crossref","first-page":"28","DOI":"10.2174\/1874609812666190603165746","article-title":"An overview of neuromuscular junction aging findings in human and animal studies","volume":"12","author":"S Khosa","year":"2019","journal-title":"Curr Aging Sci"},{"key":"ref34","first-page":"105","article-title":"Proteomic profiling of fast-to-slow muscle transitions during aging","volume":"2","author":"K Ohlendieck","year":"2011","journal-title":"Front Physiol"},{"issue":"03","key":"ref35","doi-asserted-by":"crossref","first-page":"525","DOI":"10.3390\/jcm10030525","article-title":"Age differences in motor recruitment patterns of the shoulder in dynamic and isometric contractions. A cross-sectional study","volume":"10","author":"C Lirio-Romero","year":"2021","journal-title":"J Clin Med"},{"issue":"01","key":"ref36","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1152\/jn.00431.2018","article-title":"Aging changes in protective balance and startle responses to sudden drop perturbations","volume":"122","author":"O Sanders","year":"2019","journal-title":"J Neurophysiol"},{"issue":"05","key":"ref37","doi-asserted-by":"crossref","first-page":"1725","DOI":"10.1097\/PRS.0b013e31816c3b81","article-title":"Pediatric free tissue transfer: a 29-year experience with 433 transfers","volume":"121","author":"J Upton","year":"2008","journal-title":"Plast Reconstr Surg"},{"key":"ref38","doi-asserted-by":"crossref","first-page":"111974","DOI":"10.1016\/j.exger.2022.111974","article-title":"Aging is associated with an altered macrophage response during human skeletal muscle regeneration","volume":"169","author":"M Ahmadi","year":"2022","journal-title":"Exp Gerontol"},{"issue":"01","key":"ref39","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1053\/jhsu.1999.jhsu25a0016","article-title":"Primary epineural repair of the ulnar nerve in children","volume":"24","author":"D G Bolitho","year":"1999","journal-title":"J Hand Surg Am"},{"issue":"01","key":"ref40","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/0014-4886(80)90006-0","article-title":"Effects of aging on nerve sprouting and regeneration","volume":"70","author":"A Pestronk","year":"1980","journal-title":"Exp Neurol"},{"issue":"02","key":"ref41","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1016\/S0031-3955(16)33145-5","article-title":"Bone, nerve, and tendon injuries of the hand in children","volume":"22","author":"J W Strickland","year":"1975","journal-title":"Pediatr Clin North Am"},{"issue":"01","key":"ref42","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1097\/WNR.0b013e32835b6efd","article-title":"Poor electroneurography but excellent hand function 31 years after nerve repair in childhood","volume":"24","author":"A Chemnitz","year":"2013","journal-title":"Neuroreport"},{"issue":"01","key":"ref43","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1055\/s-0039-1692928","article-title":"Long-term outcomes following pediatric peripheral nerve injury repair","volume":"12","author":"B Langridge","year":"2020","journal-title":"J Hand Microsurg"},{"issue":"04","key":"ref44","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1016\/j.hansur.2022.04.003","article-title":"Peripheral nerve injuries of the upper extremity in a pediatric population: outcomes and prognostic factors","volume":"41","author":"J Fleurette","year":"2022","journal-title":"Hand Surg Rehabil"},{"issue":"05","key":"ref45","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1097\/BPB.0b013e32833ce404","article-title":"Congenital unilateral absence of sternocleidomastoid and trapezius muscles: a case report and literature review","volume":"19","author":"A Vajramani","year":"2010","journal-title":"J Pediatr Orthop B"},{"issue":"01","key":"ref46","doi-asserted-by":"crossref","first-page":"31","DOI":"10.26443\/mjm.v8i1.375","article-title":"Complete unilateral absence of trapezius muscle","volume":"8","author":"M Allouh","year":"2020","journal-title":"McGill J Med"},{"issue":"10","key":"ref47","doi-asserted-by":"crossref","first-page":"2563","DOI":"10.1245\/s10434-010-1157-2","article-title":"Outcomes of reconstructive surgery in pediatric oncology patients: review of 10-year experience","volume":"17","author":"L M Jacob","year":"2010","journal-title":"Ann Surg Oncol"},{"issue":"S 01","key":"ref48","doi-asserted-by":"crossref","first-page":"22","DOI":"10.2106\/JBJS.22.01049","article-title":"Pediatric and adult patients have similar functional improvement after endoprosthetic reconstruction of lower-extremity tumors","volume":"105","author":"T H Tran","year":"2023","journal-title":"J Bone Joint Surg Am"},{"issue":"03","key":"ref49","doi-asserted-by":"crossref","first-page":"e326","DOI":"10.3928\/01477447-20190321-01","article-title":"Preoperative patient functional status is an independent predictor of outcomes after primary total hip arthroplasty","volume":"42","author":"M Raad","year":"2019","journal-title":"Orthopedics"},{"key":"ref50","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.jbo.2018.01.003","article-title":"Healthcare-resource utilization associated with radiation to bone across eight European countries: results from a retrospective study","volume":"10","author":"R von Moos","year":"2018","journal-title":"J Bone Oncol"},{"issue":"05","key":"ref51","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1097\/SAP.0000000000003288","article-title":"Lower trapezius myocutaneous propeller flap based on dorsal scapular artery","volume":"89","author":"M Wang","year":"2022","journal-title":"Ann Plast Surg"},{"issue":"01","key":"ref52","doi-asserted-by":"crossref","first-page":"e3327","DOI":"10.1097\/GOX.0000000000003327","article-title":"Flap venous congestion and salvage techniques: a systematic literature review","volume":"9","author":"F Boissiere","year":"2021","journal-title":"Plast Reconstr Surg Glob Open"},{"issue":"05","key":"ref53","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1055\/a-1939-5606","article-title":"Utility of indocyanine green angiography for preventing pre-expanded extended lower trapezius myocutaneous flap necrosis: how to make the correct decision for hypoperfused areas","volume":"39","author":"M Wang","year":"2023","journal-title":"J Reconstr Microsurg"},{"issue":"01","key":"ref54","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1055\/s-0041-1740406","article-title":"First successful separation of craniopagus twins in India\u2013plastic surgical considerations","volume":"55","author":"M Singhal","year":"2022","journal-title":"Indian J Plast Surg"}],"container-title":["Journal of Reconstructive Microsurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0044-1787741.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,17]],"date-time":"2025-01-17T23:40:41Z","timestamp":1737157241000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0044-1787741"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,25]]},"references-count":54,"journal-issue":{"issue":"02","published-online":{"date-parts":[[2025,1,17]]},"published-print":{"date-parts":[[2025,2]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0044-1787741","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0743-684X","1098-8947"],"issn-type":[{"value":"0743-684X","type":"print"},{"value":"1098-8947","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,25]]}}}