{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T01:23:00Z","timestamp":1771550580794,"version":"3.50.1"},"reference-count":42,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2022,8,30]],"date-time":"2022-08-30T00:00:00Z","timestamp":1661817600000},"content-version":"unspecified","delay-in-days":29,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003593","name":"CNPq","doi-asserted-by":"crossref","award":["142306\/2020-7"],"award-info":[{"award-number":["142306\/2020-7"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100003593","name":"CNPq","doi-asserted-by":"crossref","award":["302917\/2019-5"],"award-info":[{"award-number":["302917\/2019-5"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"crossref"}]},{"name":"The Independent Research Fund Denmark","award":["0129-0003B"],"award-info":[{"award-number":["0129-0003B"]}]},{"DOI":"10.13039\/501100007436","name":"Torben og Alice Frimodts Fond","doi-asserted-by":"crossref","award":["TA250419"],"award-info":[{"award-number":["TA250419"]}],"id":[{"id":"10.13039\/501100007436","id-type":"DOI","asserted-by":"crossref"}]},{"name":"A. P. M\u00f8llers L\u00e6gefond","award":["18-L-0026"],"award-info":[{"award-number":["18-L-0026"]}]},{"DOI":"10.13039\/501100009938","name":"Knud H\u00f8jgaards Fond","doi-asserted-by":"crossref","award":["18-05-2487"],"award-info":[{"award-number":["18-05-2487"]}],"id":[{"id":"10.13039\/501100009938","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100009938","name":"Knud H\u00f8jgaards Fond","doi-asserted-by":"crossref","award":["20-01-1076"],"award-info":[{"award-number":["20-01-1076"]}],"id":[{"id":"10.13039\/501100009938","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001807","name":"FAPESP","doi-asserted-by":"crossref","award":["2020\/06747-4"],"award-info":[{"award-number":["2020\/06747-4"]}],"id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100007405","name":"Danish Heart Association","doi-asserted-by":"crossref","award":["20-R139-A9644-22165"],"award-info":[{"award-number":["20-R139-A9644-22165"]}],"id":[{"id":"10.13039\/100007405","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100009708","name":"Novo Nordisk Fonden","doi-asserted-by":"crossref","award":["NNF20OC0062782"],"award-info":[{"award-number":["NNF20OC0062782"]}],"id":[{"id":"10.13039\/501100009708","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Jette og Hans Henrik Jensen","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"DOI":"10.13039\/501100006426","name":"Eva og Henry Fr\u00e6nkels Mindefond","doi-asserted-by":"crossref","award":["NLA-080919"],"award-info":[{"award-number":["NLA-080919"]}],"id":[{"id":"10.13039\/501100006426","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Brorsons Fond","award":["12038-1-hh"],"award-info":[{"award-number":["12038-1-hh"]}]},{"DOI":"10.13039\/501100004954","name":"Augustinus Fonden","doi-asserted-by":"crossref","award":["18-3248"],"award-info":[{"award-number":["18-3248"]}],"id":[{"id":"10.13039\/501100004954","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Dansk Medicinsk Selskab K\u00f8benhavn","award":["120620-kms"],"award-info":[{"award-number":["120620-kms"]}]},{"name":"Julie von M\u00fcllens Fond","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"name":"Internal Funds at Herlev-Gentofte Hospital","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"name":"Astra Zeneca\/Danish Society of Cardiology","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"name":"William Demant","award":["20-1257"],"award-info":[{"award-number":["20-1257"]}]},{"DOI":"10.13039\/501100009099","name":"Reinholdt W. Jorck og Hustrus Fond","doi-asserted-by":"crossref","award":["18-JU-0485"],"award-info":[{"award-number":["18-JU-0485"]}],"id":[{"id":"10.13039\/501100009099","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100009099","name":"Reinholdt W. Jorck og Hustrus Fond","doi-asserted-by":"crossref","award":["20-JU-0145"],"award-info":[{"award-number":["20-JU-0145"]}],"id":[{"id":"10.13039\/501100009099","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100003554","name":"Lundbeckfonden","doi-asserted-by":"publisher","award":["R373-2021-1201"],"award-info":[{"award-number":["R373-2021-1201"]}],"id":[{"id":"10.13039\/501100003554","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2022,7,25]]},"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Prior studies have suggested that self-rated health may be a useful indicator of cardiovascular disease. Consequently, we aimed to assess the relationship between self-rated health, cardiovascular risk factors and subclinical cardiac disease in the Amazon Basin.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting, participants and interventions<\/jats:title>\n                    <jats:p>In participants from the Amazon Basin of Brazil we obtained self-rated health according to a Visual Analogue Scale, ranging from 0 (poor) to 100 (excellent). We performed questionnaires, physical examination and echocardiography. Logistic and linear regression models were applied to assess self-rated health, cardiac risk factors and cardiac disease by echocardiography. Multivariable models were mutually adjusted for other cardiovascular risk factors, clinical and socioeconomic data, and known cardiac disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>Cardiovascular risk factors and subclincial cardiac disease by echocardiography.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 574 participants (mean age 41 years, 61% female) provided information on self-rated health (mean 75\u00b121 (IQR 60\u201390) points). Self-rated health (per 10-point increase) was negatively associated with hypertension (OR 0.87 (95% CI 0.78 to 0.97), p=0.01), hypercholesterolaemia (OR 0.89 (95%CI 0.80 to 0.99), p=0.04) and positively with healthy diet (OR 1.13 (95%CI 1.04 to 1.24), p=0.004). Sex modified these associations (p-interaction &lt;0.05) such that higher self-rated health was associated with healthy diet and physical activity in men, and lower odds of hypertension and hypercholesterolaemia in women. No relationship was found with left ventricular ejection fraction &lt;45% (OR 0.97 (95% CI 0.77 to 1.23), p=0.8), left ventricular hypertrophy (OR 0.97 (95% CI 0.76 to 1.24), p=0.81) or diastolic dysfunction (OR 1.09 (95% CI 0.85 to 1.40), p=0.51).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Self-rated health was positively associated with health parameters in the Amazon Basin, but not with subclinical cardiac disease by echocardiography. Our findings are of hypothesis generating nature and future studies should aim to determine whether assessment of self-rated health may be useful for screening related to policy-making or lifestyle interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      Clinicaltrials.gov:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" specific-use=\"clinicaltrial post-results\" xlink:href=\"NCT04445103\">NCT04445103<\/jats:ext-link>\n                      ; Post-results\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-058277","type":"journal-article","created":{"date-parts":[[2022,8,30]],"date-time":"2022-08-30T11:45:17Z","timestamp":1661859917000},"page":"e058277","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Is self-rated health associated with cardiovascular risk factors and disease in a low-income setting? A cross-sectional study from the Amazon Basin of Brazil"],"prefix":"10.1136","volume":"12","clinical-trial-number":[{"clinical-trial-number":"nct04445103","registry":"10.18810\/clinical-trials-gov","type":"postResults"},{"clinical-trial-number":"nct04445103","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7959-6454","authenticated-orcid":false,"given":"Anna Engell","family":"Holm","sequence":"first","affiliation":[{"name":"Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Hellerup, Denmark"},{"name":"Multidisciplinary Center, Federal University of Acre, C\u00e2mpus Floresta, Cruzeiro do Sul, Acre, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura Cordeiro","family":"Gomes","sequence":"additional","affiliation":[{"name":"Department of Parasitology, University of S\u00e3o Paulo, Institute of Biomedical Sciences, S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alma","family":"Wegener","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Hellerup, Denmark"},{"name":"Multidisciplinary Center, Federal University of Acre, C\u00e2mpus Floresta, Cruzeiro do Sul, Acre, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karine O","family":"Lima","sequence":"additional","affiliation":[{"name":"Multidisciplinary Center, Federal University of Acre, C\u00e2mpus Floresta, Cruzeiro do Sul, Acre, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luan O","family":"Matos","sequence":"additional","affiliation":[{"name":"Multidisciplinary Center, Federal University of Acre, C\u00e2mpus Floresta, Cruzeiro do Sul, Acre, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabelle V M","family":"Vieira","sequence":"additional","affiliation":[{"name":"Multidisciplinary Center, Federal University of Acre, C\u00e2mpus Floresta, Cruzeiro do Sul, Acre, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Molly D","family":"Kaagaard","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Hellerup, Denmark"},{"name":"Multidisciplinary Center, Federal University of Acre, C\u00e2mpus Floresta, Cruzeiro do Sul, Acre, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manan","family":"Pareek","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Hellerup, Denmark"},{"name":"Department of Internal Medicine, Yale New Haven Hospital, Yale School of Medicine, New Haven, Connecticut, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7775-6901","authenticated-orcid":false,"given":"Rodrigo Medeiros","family":"de Souza","sequence":"additional","affiliation":[{"name":"Multidisciplinary Center, Federal University of Acre, C\u00e2mpus Floresta, Cruzeiro do Sul, Acre, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudio Romero Farias","family":"Marinho","sequence":"additional","affiliation":[{"name":"Department of Parasitology, University of S\u00e3o Paulo Institute of Biomedical Sciences, S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tor","family":"Biering-S\u00f8rensen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Hellerup, Denmark"},{"name":"Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Odilson M","family":"Silvestre","sequence":"additional","affiliation":[{"name":"Health and Sport Science Center, Federal University of Acre, Rio Branco, Acre, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6880-0424","authenticated-orcid":false,"given":"Philip","family":"Brainin","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Hellerup, Denmark"},{"name":"Multidisciplinary Center, Federal University of Acre, C\u00e2mpus Floresta, Cruzeiro do Sul, Acre, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,8,30]]},"reference":[{"key":"2025120518181997000_12.8.e058277.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.11.010"},{"key":"2025120518181997000_12.8.e058277.2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.008727"},{"key":"2025120518181997000_12.8.e058277.3","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0127382"},{"key":"2025120518181997000_12.8.e058277.4","unstructured":"Sa\u00fade Mda . Vigitel Brasil 2019, 2020. ISBN: 9788533427655."},{"key":"2025120518181997000_12.8.e058277.5","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0034799"},{"key":"2025120518181997000_12.8.e058277.6","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0053462"},{"key":"2025120518181997000_12.8.e058277.7","doi-asserted-by":"publisher","DOI":"10.1136\/jech.50.4.423"},{"key":"2025120518181997000_12.8.e058277.8","doi-asserted-by":"publisher","DOI":"10.2307\/2955359"},{"key":"2025120518181997000_12.8.e058277.9","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12955-021-01671-6","article-title":"EQ-5D Brazilian population norms","volume":"19","author":"Santos","year":"2021","journal-title":"Health Qual Life Outcomes"},{"key":"2025120518181997000_12.8.e058277.10","doi-asserted-by":"crossref","unstructured":"Gon\u00e7alves RPF , Haikal DS , Freitas MI . Self-Reported medical diagnosis of heart disease and associated risk factors: National health survey. Rev Bras Epidemiol 2019;22.doi:10.1590\/1980-549720190016.supl.2","DOI":"10.1590\/1980-549720190016.supl.2"},{"key":"2025120518181997000_12.8.e058277.11","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-016-3110-1"},{"key":"2025120518181997000_12.8.e058277.12","doi-asserted-by":"crossref","first-page":"308","DOI":"10.36660\/abc.20200812","article-title":"Cardiovascular statistics - Brazil 2020","volume":"115","author":"Oliveira","year":"2020","journal-title":"Arq Bras Cardiol"},{"key":"2025120518181997000_12.8.e058277.13","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)60054-8"},{"key":"2025120518181997000_12.8.e058277.14","unstructured":"EuroQol . EQ-5D-5L questionnaire in Brazilian Portuguese. Available: https:\/\/euroqol.org\/eq-5d-instruments\/ [Accessed 29 May 2022]."},{"key":"2025120518181997000_12.8.e058277.15","doi-asserted-by":"publisher","DOI":"10.2337\/dc20-S002"},{"key":"2025120518181997000_12.8.e058277.16","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1179\/102453310X12647083621128","article-title":"Manual and automated reticulocyte counts","volume":"15","author":"Simionatto","year":"2010","journal-title":"Hematology"},{"key":"2025120518181997000_12.8.e058277.17","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.echo.2014.10.003","article-title":"Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of echocardiography and the European association of cardiovascular imaging","volume":"28","author":"Lang","year":"2015","journal-title":"J Am Soc Echocardiogr"},{"key":"2025120518181997000_12.8.e058277.18","doi-asserted-by":"publisher","DOI":"10.1038\/nrcardio.2012.7"},{"key":"2025120518181997000_12.8.e058277.19","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jew082"},{"key":"2025120518181997000_12.8.e058277.20","doi-asserted-by":"publisher","DOI":"10.1002\/sim.4780040112"},{"key":"2025120518181997000_12.8.e058277.21","doi-asserted-by":"crossref","unstructured":"Gafarov V , Panov D , Gromova E , et al . Sex differences and trends of self-rated health in population aged 25-64 years from 1988 to 2017. Eur J Public Health 2021;31.doi:10.1093\/eurpub\/ckab165.231","DOI":"10.1093\/eurpub\/ckab165.231"},{"key":"2025120518181997000_12.8.e058277.22","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13584-019-0359-8","article-title":"Socio-economic status, self-rated health and mental health: the mediation effect of social participation on early-late midlife and older adults","volume":"9","author":"Achdut","year":"2020","journal-title":"Isr J Health Policy Res"},{"key":"2025120518181997000_12.8.e058277.23","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-017-4129-7"},{"key":"2025120518181997000_12.8.e058277.24","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1001\/jamanetworkopen.2018.8023","article-title":"Association between self-rated health, coronary artery calcium scores, and atherosclerotic cardiovascular disease risk: the multi-ethnic study of atherosclerosis (MESA)","volume":"2","author":"Orimoloye","year":"2019","journal-title":"JAMA Netw Open"},{"key":"2025120518181997000_12.8.e058277.25","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.117.006595","article-title":"Self-rated health status and risk of ischemic heart disease in the China Kadoorie Biobank study: a population-based cohort study","volume":"6","author":"Dong","year":"2017","journal-title":"J Am Heart Assoc"},{"key":"2025120518181997000_12.8.e058277.26","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp14X681769"},{"key":"2025120518181997000_12.8.e058277.27","doi-asserted-by":"publisher","DOI":"10.1097\/01.psy.0000130491.95823.94"},{"key":"2025120518181997000_12.8.e058277.28","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0117196"},{"key":"2025120518181997000_12.8.e058277.29","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-81132-8"},{"key":"2025120518181997000_12.8.e058277.30","doi-asserted-by":"crossref","first-page":"640","DOI":"10.21037\/atm-20-6845","article-title":"Right ventricular systolic function is associated with health-related quality of life: a cross-sectional study in community-dwelling populations","volume":"9","author":"Liu","year":"2021","journal-title":"Ann Transl Med"},{"key":"2025120518181997000_12.8.e058277.31","doi-asserted-by":"publisher","DOI":"10.1097\/PSY.0b013e3181dc0259"},{"key":"2025120518181997000_12.8.e058277.32","doi-asserted-by":"crossref","first-page":"2245","DOI":"10.4236\/health.2014.616260","article-title":"Self-rated health in university students from Rio Branco in the Western Brazilian Amazon","volume":"06","author":"de Mendon\u00e7a Freire","year":"2014","journal-title":"Health"},{"key":"2025120518181997000_12.8.e058277.33","doi-asserted-by":"crossref","first-page":"1","DOI":"10.5539\/gjhs.v4n4p1","article-title":"Predictors of self-rated health and lifestyle behaviours in Swedish university students","volume":"4","author":"Schmidt","year":"2012","journal-title":"Glob J Health Sci"},{"key":"2025120518181997000_12.8.e058277.34","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.87.6.951"},{"key":"2025120518181997000_12.8.e058277.35","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2015.01.027"},{"key":"2025120518181997000_12.8.e058277.36","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.37963.691632.44"},{"key":"2025120518181997000_12.8.e058277.37","doi-asserted-by":"crossref","first-page":"2761","DOI":"10.1007\/s11136-015-0994-7","article-title":"EQ-5D-3L as a health measure of Brazilian adult population","volume":"24","author":"Menezes","year":"2015","journal-title":"Qual Life Res"},{"key":"2025120518181997000_12.8.e058277.38","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(18)31221-2"},{"key":"2025120518181997000_12.8.e058277.39","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2005.085381"},{"key":"2025120518181997000_12.8.e058277.40","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.gheart.2014.12.007","article-title":"Changes in health behaviors and self-rated health of participants in meta Salud: a primary prevention intervention of ncd in Mexico","volume":"10","author":"Denman","year":"2015","journal-title":"Glob Heart"},{"key":"2025120518181997000_12.8.e058277.41","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-008-9262-2"},{"key":"2025120518181997000_12.8.e058277.42","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.88.4.1973"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2021-058277","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T02:18:34Z","timestamp":1764987514000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2021-058277"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8]]},"references-count":42,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2022,8,30]]},"published-print":{"date-parts":[[2022,8]]}},"alternative-id":["10.1136\/bmjopen-2021-058277"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2021-058277","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8]]}}}