{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:54:44Z","timestamp":1787774084465,"version":"build-2784847793"},"reference-count":50,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2024,1,19]],"date-time":"2024-01-19T00:00:00Z","timestamp":1705622400000},"content-version":"unspecified","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Dr Trygve Gythfeldt and Wife research fund","award":["June 2021, no grant number"],"award-info":[{"award-number":["June 2021, no grant number"]}]},{"DOI":"10.13039\/100009471","name":"EkstraStiftelsen Helse og Rehabilitering","doi-asserted-by":"publisher","award":["2021\/FO347439"],"award-info":[{"award-number":["2021\/FO347439"]}],"id":[{"id":"10.13039\/100009471","id-type":"DOI","asserted-by":"publisher"}]},{"name":"European Alliance of Associations for Rheumatology","award":["EULAR Research Voucher id Q223PV88"],"award-info":[{"award-number":["EULAR Research Voucher id Q223PV88"]}]},{"DOI":"10.13039\/501100013263","name":"Norwegian Health Association","doi-asserted-by":"crossref","award":["25576"],"award-info":[{"award-number":["25576"]}],"id":[{"id":"10.13039\/501100013263","id-type":"DOI","asserted-by":"crossref"}]},{"name":"REMEDY- Center for treatment of Rheumatic and Musculoskeletal Diseases","award":["Grant number 328657"],"award-info":[{"award-number":["Grant number 328657"]}]},{"DOI":"10.13039\/501100012266","name":"Norwegian Rheumatism Association","doi-asserted-by":"crossref","award":["November 2021, no grant number"],"award-info":[{"award-number":["November 2021, no grant number"]}],"id":[{"id":"10.13039\/501100012266","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2023,12,25]]},"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To assess the effect of high-intensity interval training (HIIT) delivered in physiotherapy primary care on the primary outcome of cardiorespiratory fitness (CRF) in patients with inflammatory arthritis (IA). Additionally, to explore the effects of HIIT on secondary outcomes, including cardiovascular disease (CVD) risk factors and disease activity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Single-blinded randomised controlled trial with 60 patients randomly assigned to either a control group receiving usual care or an exercise group receiving usual care and 12 weeks of individualised HIIT at 90%\u201395% peak heart rate. Outcomes were assessed at baseline, 3 months and 6 months post baseline and included CRF measured as peak oxygen uptake (VO<jats:sub>2peak<\/jats:sub>), classic CVD risk factors, disease activity, anthropometry and patient-reported physical activity, pain, fatigue, disease impact and exercise beliefs and self-efficacy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Intention-to-treat analysis demonstrated a significant between-group difference in VO<jats:sub>2peak<\/jats:sub> at 3 months (2.5 mL\/kg\/min, 95% CI 0.9 to 4.0) and 6 months (2.6 mL\/kg\/min, 95% CI 0.8 to 4.3) in favour of the exercise group. A beneficial change in self-reported physical activity in favour of the exercise group was observed at 3 and 6 months. The HIIT intervention was well-tolerated with minimal adverse events and no apparent impact on disease activity. Differences in secondary outcomes related to CVD risk factors, disease impact, pain, fatigue and exercise beliefs and self-efficacy were generally small and non-significant.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>After 12 weeks of supervised HIIT delivered in physiotherapy primary care, patients with IA demonstrated a favourable improvement in CRF, with sustained effects at 6-month follow-up.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration number<\/jats:title>\n                  <jats:p>\n                     <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT04922840\">NCT04922840<\/jats:ext-link>.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rmdopen-2023-003440","type":"journal-article","created":{"date-parts":[[2024,1,18]],"date-time":"2024-01-18T23:15:17Z","timestamp":1705619717000},"page":"e003440","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":25,"title":["Effect of high-intensity interval training in physiotherapy primary care for patients with inflammatory arthritis: the ExeHeart randomised controlled trial"],"prefix":"10.1136","volume":"10","clinical-trial-number":[{"clinical-trial-number":"nct04922840","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct04922840","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6664-7542","authenticated-orcid":false,"given":"Kristine R\u00f8ren","family":"Nord\u00e9n","sequence":"first","affiliation":[{"name":"Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway"},{"name":"Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Health Services Research and Innovation Unit, Diakonhjemmet Hospital, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2730-2853","authenticated-orcid":false,"given":"Anne Grete","family":"Semb","sequence":"additional","affiliation":[{"name":"Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7097-2962","authenticated-orcid":false,"given":"Hanne","family":"Dagfinrud","sequence":"additional","affiliation":[{"name":"Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway"},{"name":"Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Health Services Research and Innovation Unit, Diakonhjemmet Hospital, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0224-7854","authenticated-orcid":false,"given":"Jonny","family":"Hisdal","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Oslo University Hospital, Oslo, Norway"},{"name":"Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Sexton","sequence":"additional","affiliation":[{"name":"Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4109-3317","authenticated-orcid":false,"given":"Camilla","family":"Fongen","sequence":"additional","affiliation":[{"name":"Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Health Services Research and Innovation Unit, Diakonhjemmet Hospital, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilie","family":"Bakke","sequence":"additional","affiliation":[{"name":"Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Health Services Research and Innovation Unit, Diakonhjemmet Hospital, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sigrid","family":"\u00d8deg\u00e5rd","sequence":"additional","affiliation":[{"name":"Norwegian National Unit for Rehabilitation for Rheumatic Patients with Special Needs, Diakonhjemmet Hospital, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon","family":"Skandsen","sequence":"additional","affiliation":[{"name":"Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thalita","family":"Blanck","sequence":"additional","affiliation":[{"name":"Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5359-0436","authenticated-orcid":false,"given":"George S","family":"Metsios","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Dietetics, University of Thessaly, Volos, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1701-9835","authenticated-orcid":false,"given":"Anne Therese","family":"Tveter","sequence":"additional","affiliation":[{"name":"Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Health Services Research and Innovation Unit, Diakonhjemmet Hospital, Oslo, Norway"},{"name":"Faculty of Health Sciences, Institute of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Akershus, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,1,18]]},"reference":[{"key":"2025090313580426000_10.1.e003440.1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2016-209775"},{"key":"2025090313580426000_10.1.e003440.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)01349-6"},{"key":"2025090313580426000_10.1.e003440.3","doi-asserted-by":"crossref","first-page":"4656","DOI":"10.1093\/rheumatology\/keac210","article-title":"All-cause and cause-specific mortality in rheumatoid arthritis, psoriatic arthritis and axial spondyloarthritis: a nationwide Registry study","volume":"61","author":"Kerola","year":"2022","journal-title":"Rheumatology (Oxford)"},{"key":"2025090313580426000_10.1.e003440.4","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab484"},{"key":"2025090313580426000_10.1.e003440.5","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0000000000002454"},{"key":"2025090313580426000_10.1.e003440.6","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000461"},{"key":"2025090313580426000_10.1.e003440.7","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.pcad.2018.12.003","article-title":"The association between the change in directly measured cardiorespiratory fitness across time and mortality risk","volume":"62","author":"Imboden","year":"2019","journal-title":"Prog Cardiovasc Dis"},{"key":"2025090313580426000_10.1.e003440.8","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2021-104876"},{"key":"2025090313580426000_10.1.e003440.9","doi-asserted-by":"crossref","first-page":"1996","DOI":"10.1080\/02640414.2021.1912453","article-title":"Interval training versus moderate-intensity continuous training for cardiorespiratory fitness improvements in middle-aged and older adults: a systematic review and meta-analysis","volume":"39","author":"Poon","year":"2021","journal-title":"J Sports Sci"},{"key":"2025090313580426000_10.1.e003440.10","doi-asserted-by":"crossref","DOI":"10.3389\/fphys.2019.00019","article-title":"A multi-center comparison of O2Peak trainability between interval training and moderate intensity continuous training","volume":"10","author":"Williams","year":"2019","journal-title":"Front Physiol"},{"key":"2025090313580426000_10.1.e003440.11","doi-asserted-by":"publisher","DOI":"10.1007\/s40279-017-0807-y"},{"key":"2025090313580426000_10.1.e003440.12","doi-asserted-by":"crossref","DOI":"10.1007\/s11906-020-1030-z","article-title":"Effectiveness of high-intensity interval training versus moderate-intensity continuous training in hypertensive patients: a systematic review and meta-analysis","volume":"22","author":"Leal","year":"2020","journal-title":"Curr Hypertens Rep"},{"key":"2025090313580426000_10.1.e003440.13","doi-asserted-by":"crossref","first-page":"1753","DOI":"10.1007\/s40279-023-01863-8","article-title":"High-intensity interval training and Cardiometabolic health in the general population: a systematic review and meta-analysis of randomised controlled trials","volume":"53","author":"Edwards","year":"2023","journal-title":"Sports Med"},{"key":"2025090313580426000_10.1.e003440.14","doi-asserted-by":"crossref","DOI":"10.1186\/s12966-015-0254-9","article-title":"High-intensity interval exercise training for public health: a big HIT or shall we HIT it on the head","volume":"12","author":"Biddle","year":"2015","journal-title":"Int J Behav Nutr Phys Act"},{"key":"2025090313580426000_10.1.e003440.15","doi-asserted-by":"crossref","first-page":"101504","DOI":"10.1016\/j.berh.2020.101504","article-title":"Exercise and inflammation","volume":"34","author":"Metsios","year":"2020","journal-title":"Best Pract Res Clin Rheumatol"},{"key":"2025090313580426000_10.1.e003440.16","doi-asserted-by":"crossref","DOI":"10.3389\/fnagi.2019.00098","article-title":"Effect of aerobic exercise on inflammatory markers in healthy middle-aged and older adults: a systematic review and meta-analysis of randomized controlled trials","volume":"11","author":"Zheng","year":"2019","journal-title":"Front Aging Neurosci"},{"key":"2025090313580426000_10.1.e003440.17","doi-asserted-by":"crossref","DOI":"10.1136\/rmdopen-2019-000912","article-title":"Cardiorespiratory fitness in patients with rheumatoid arthritis is associated with the patient global assessment but not with objective measurements of disease activity","volume":"5","author":"Liff","year":"2019","journal-title":"RMD Open"},{"key":"2025090313580426000_10.1.e003440.18","doi-asserted-by":"crossref","first-page":"1863","DOI":"10.1007\/s00296-015-3339-5","article-title":"Decreased physical activity and cardiorespiratory fitness in adults with Ankylosing Spondylitis: a cross-sectional controlled study","volume":"35","author":"O\u2019Dwyer","year":"2015","journal-title":"Rheumatol Int"},{"key":"2025090313580426000_10.1.e003440.19","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2018-213585"},{"key":"2025090313580426000_10.1.e003440.20","doi-asserted-by":"publisher","DOI":"10.1038\/s41584-020-0428-y"},{"key":"2025090313580426000_10.1.e003440.21","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2018-099943"},{"key":"2025090313580426000_10.1.e003440.22","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1002\/acr.23614","article-title":"Impact of high-intensity interval training on disease activity and disease in patients with psoriatic arthritis: a randomized controlled trial","volume":"71","author":"Thomsen","year":"2019","journal-title":"Arthritis Care Res (Hoboken)"},{"key":"2025090313580426000_10.1.e003440.23","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1007\/s00296-019-04483-6","article-title":"The effects of exercise on cardiovascular disease risk factors and cardiovascular physiology in rheumatoid arthritis","volume":"40","author":"Metsios","year":"2020","journal-title":"Rheumatol Int"},{"key":"2025090313580426000_10.1.e003440.24","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2021-058634","article-title":"Effect of high-intensity exercise on cardiorespiratory fitness, cardiovascular disease risk and disease activity in patients with inflammatory joint disease: protocol for the Exeheart randomised controlled trial","volume":"12","author":"Nord\u00e9n","year":"2022","journal-title":"BMJ Open"},{"key":"2025090313580426000_10.1.e003440.25","doi-asserted-by":"publisher","DOI":"10.7326\/M17-0046"},{"key":"2025090313580426000_10.1.e003440.26","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2016-096651"},{"key":"2025090313580426000_10.1.e003440.27","doi-asserted-by":"crossref","first-page":"378","DOI":"10.31138\/mjr.32.4.378","article-title":"Position statement on exercise dosage in rheumatic and musculoskeletal diseases: the role of the IMPACT-RMD Toolkit","volume":"32","author":"Metsios","year":"2021","journal-title":"Mediterr J Rheumatol"},{"key":"2025090313580426000_10.1.e003440.28","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1249\/00005768-198205000-00012","article-title":"Psychophysical bases of perceived exertion","volume":"14","author":"Borg","year":"1982","journal-title":"Medicine & Science in Sports & Exercise"},{"key":"2025090313580426000_10.1.e003440.29","unstructured":"Liguori G . ACSM\u2019s guidelines for exercise testing and prescription. Lippincott Williams & Wilkins, 2020."},{"key":"2025090313580426000_10.1.e003440.30","doi-asserted-by":"crossref","DOI":"10.1136\/bmjresp-2021-001121","article-title":"ARTP statement on cardiopulmonary exercise testing 2021","volume":"8","author":"Pritchard","year":"2021","journal-title":"BMJ Open Respir Res"},{"key":"2025090313580426000_10.1.e003440.31","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1002\/1529-0131(199604)9:2<82::AID-ANR1790090203>3.0.CO;2-T","article-title":"A survey of exercise beliefs and exercise habits among people with arthritis","volume":"9","author":"Gecht","year":"1996","journal-title":"Arthritis Care Res"},{"key":"2025090313580426000_10.1.e003440.32","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0b013e31821d3f6f"},{"key":"2025090313580426000_10.1.e003440.33","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.681"},{"key":"2025090313580426000_10.1.e003440.34","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0000000000001474"},{"key":"2025090313580426000_10.1.e003440.35","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.211115"},{"key":"2025090313580426000_10.1.e003440.36","doi-asserted-by":"crossref","DOI":"10.3390\/diagnostics12102532","article-title":"Effects of high-intensity interval training (HIIT) on patients with musculoskeletal disorders: a systematic review and meta-analysis with a meta-regression and mapping report","volume":"12","author":"Cuenca-Mart\u00ednez","year":"2022","journal-title":"Diagnostics (Basel)"},{"key":"2025090313580426000_10.1.e003440.37","doi-asserted-by":"crossref","DOI":"10.1136\/rmdopen-2018-000729","article-title":"Effect of high-intensity interval training on cardiovascular disease risk factors and body composition in psoriatic arthritis: a randomised controlled trial","volume":"4","author":"Thomsen","year":"2018","journal-title":"RMD Open"},{"key":"2025090313580426000_10.1.e003440.38","doi-asserted-by":"crossref","DOI":"10.1186\/s13075-018-1624-x","article-title":"Ten weeks of high-intensity interval walk training is associated with reduced disease activity and improved innate immune function in older adults with rheumatoid arthritis: a pilot study","volume":"20","author":"Bartlett","year":"2018","journal-title":"Arthritis Res Ther"},{"key":"2025090313580426000_10.1.e003440.39","doi-asserted-by":"crossref","first-page":"2081","DOI":"10.1007\/s00421-015-3186-9","article-title":"The effects of high intensity interval training in women with rheumatic disease: a pilot study","volume":"115","author":"Sandstad","year":"2015","journal-title":"Eur J Appl Physiol"},{"key":"2025090313580426000_10.1.e003440.40","doi-asserted-by":"crossref","first-page":"1740","DOI":"10.1249\/MSS.0000000000001634","article-title":"Short-term (<8 wk) high-intensity interval training in diseased cohorts","volume":"50","author":"Blackwell","year":"2018","journal-title":"Med Sci Sports Exerc"},{"key":"2025090313580426000_10.1.e003440.41","doi-asserted-by":"crossref","first-page":"1991","DOI":"10.1249\/MSS.0000000000002993","article-title":"Change in central cardiovascular function in response to intense interval training: a systematic review and meta-analysis","volume":"54","author":"Astorino","year":"2022","journal-title":"Med Sci Sports Exerc"},{"key":"2025090313580426000_10.1.e003440.42","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.2825"},{"key":"2025090313580426000_10.1.e003440.43","doi-asserted-by":"crossref","DOI":"10.2196\/28124","article-title":"Smartphone-assisted high-intensity interval training in inflammatory rheumatic disease patients: randomized controlled trial","volume":"9","author":"Haglo","year":"2021","journal-title":"JMIR Mhealth Uhealth"},{"key":"2025090313580426000_10.1.e003440.44","doi-asserted-by":"crossref","first-page":"3725","DOI":"10.1007\/s10067-022-06343-4","article-title":"Exercise intervention on cardiorespiratory fitness in rheumatoid arthritis patients with high cardiovascular disease risk: a single-arm pilot study","volume":"41","author":"Sobejana","year":"2022","journal-title":"Clin Rheumatol"},{"key":"2025090313580426000_10.1.e003440.45","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2012-202075"},{"key":"2025090313580426000_10.1.e003440.46","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-203291"},{"key":"2025090313580426000_10.1.e003440.47","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2016-097149"},{"key":"2025090313580426000_10.1.e003440.48","doi-asserted-by":"crossref","first-page":"1370","DOI":"10.1016\/j.semarthrit.2021.11.001","article-title":"Composite outcomes at OMERACT: multi-outcome domains and composite outcome domains","volume":"51","author":"Wells","year":"2021","journal-title":"Semin Arthritis Rheum"},{"key":"2025090313580426000_10.1.e003440.49","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1093\/eurjpc\/zwac309","article-title":"High intensity interval training induces beneficial effects on coronary atheromatous plaques - a randomized trial","volume":"30","author":"Vesterbekkmo","year":"2023","journal-title":"Eur J Prev Cardiol"},{"key":"2025090313580426000_10.1.e003440.50","doi-asserted-by":"crossref","DOI":"10.1155\/2019\/3548284","article-title":"Assessment of body composition in health and disease using bioelectrical impedance analysis (BIA) and dual energy X-ray Absorptiometry (DXA): a critical overview","volume":"2019","author":"Marra","year":"2019","journal-title":"Contrast Media Mol Imaging"}],"container-title":["RMD Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/rmdopen-2023-003440","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T20:58:20Z","timestamp":1756933100000},"score":1,"resource":{"primary":{"URL":"https:\/\/rmdopen.bmj.com\/lookup\/doi\/10.1136\/rmdopen-2023-003440"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1]]},"references-count":50,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,1,18]]},"published-print":{"date-parts":[[2024,1]]}},"alternative-id":["10.1136\/rmdopen-2023-003440"],"URL":"https:\/\/doi.org\/10.1136\/rmdopen-2023-003440","relation":{},"ISSN":["2056-5933"],"issn-type":[{"value":"2056-5933","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1]]}}}