{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T02:59:08Z","timestamp":1772593148561,"version":"3.50.1"},"reference-count":56,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2019,3,1]],"date-time":"2019-03-01T00:00:00Z","timestamp":1551398400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>Epidemiologic research strongly supports an association between air pollution and chronic obstructive pulmonary disease exacerbations. Numerous mechanisms may underlie any association because pollutants are toxic to pulmonary cells and may increase susceptibility to respiratory infections. The relationship between ambient pollution and exacerbation etiology has not been studied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the characteristics of pollution-associated exacerbations and whether the association is specific to exacerbations of infective or noninfective etiology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed the effect of preceding ambient particulate matter less than or equal to 10 \u03bcm in aerodynamic diameter, oxides of nitrogen (NOx), and ozone on characterized chronic obstructive pulmonary disease exacerbations in a regression model adjusted for temperature, seasonality, and long-term trend. We specifically examined associations with exacerbations of suspected viral and\/or bacterial, or noninfective etiology. For the associations identified we further examined the characteristics of pollution-associated exacerbations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>A total of 4,173 exacerbations occurred over the 20-year study period. Higher ambient NOx was consistently associated with increased viral-type exacerbations at 2\u20134 days lag (P\u2009=\u20090.010). Recovery for viral-type exacerbations after higher ambient NOx was significantly prolonged. These findings were consistent in the subset of 2,841 exacerbations treated with oral corticosteroids or antibiotics, with recovery 1.29 (95% confidence interval, 1.17\u20131.42; P\u2009&amp;lt;\u20090.001) times longer with viral-type exacerbations of onset 3 days after above- versus below-median ambient NOx. A likely bimodal association of particulate matter less than or equal to 10 \u03bcm in aerodynamic diameter with infective exacerbations was also evident and supported by a daily time-series analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Higher levels of ambient NOx are associated with prolonged exacerbations of likely viral etiology, supporting toxicologic effects of air pollution that increase susceptibility to, and severity of, infection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1164\/rccm.201712-2506oc","type":"journal-article","created":{"date-parts":[[2018,8,29]],"date-time":"2018-08-29T17:01:30Z","timestamp":1535562090000},"page":"581-591","source":"Crossref","is-referenced-by-count":41,"title":["Increased Chronic Obstructive Pulmonary Disease Exacerbations of Likely Viral Etiology Follow Elevated Ambient Nitrogen Oxides"],"prefix":"10.1093","volume":"199","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0369-2885","authenticated-orcid":false,"given":"Paul E.","family":"Pfeffer","sequence":"first","affiliation":[{"name":"William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gavin C.","family":"Donaldson","sequence":"additional","affiliation":[{"name":"Respiratory Division, National Heart and Lung Institute, Imperial College London, London, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex J.","family":"Mackay","sequence":"additional","affiliation":[{"name":"Respiratory Division, National Heart and Lung Institute, Imperial College London, London, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jadwiga A.","family":"Wedzicha","sequence":"additional","affiliation":[{"name":"Respiratory Division, National Heart and Lung Institute, Imperial College London, London, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2019,3,1]]},"reference":[{"key":"2026030321254224200_bib1","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1289\/ehp.6539","article-title":"A retrospective assessment of mortality from the London smog episode of 1952: the role of influenza and pollution","volume":"112","author":"Bell","year":"2004","journal-title":"Environ Health Perspect"},{"key":"2026030321254224200_bib2","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.1111\/j.1365-2222.2011.03776.x","article-title":"Air pollution and airway disease","volume":"41","author":"Kelly","year":"2011","journal-title":"Clin Exp Allergy"},{"key":"2026030321254224200_bib3","doi-asserted-by":"crossref","first-page":"1618","DOI":"10.1164\/ajrccm.164.9.2105011","article-title":"Respiratory viruses, symptoms, and inflammatory markers in acute exacerbations and stable chronic obstructive pulmonary disease","volume":"164","author":"Seemungal","year":"2001","journal-title":"Am J Respir Crit Care Med"},{"key":"2026030321254224200_bib4","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1183\/09031936.00223113","article-title":"Human rhinovirus infection during naturally occurring COPD exacerbations","volume":"44","author":"George","year":"2014","journal-title":"Eur Respir J"},{"key":"2026030321254224200_bib5","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1007\/s00281-016-0554-4","article-title":"TRP channels and traffic-related environmental pollution-induced pulmonary disease","volume":"38","author":"Akopian","year":"2016","journal-title":"Semin Immunopathol"},{"key":"2026030321254224200_bib6","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1165\/rcmb.2015-0084OC","article-title":"Urban particulate matter-activated human dendritic cells induce the expansion of potent inflammatory Th1, Th2, and Th17 effector cells","volume":"54","author":"Matthews","year":"2016","journal-title":"Am J Respir Cell Mol Biol"},{"key":"2026030321254224200_bib7","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1136\/thx.2010.155358","article-title":"Outdoor air pollution and respiratory health in patients with COPD","volume":"66","author":"Peacock","year":"2011","journal-title":"Thorax"},{"key":"2026030321254224200_bib8","doi-asserted-by":"crossref","first-page":"3079","DOI":"10.2147\/COPD.S122282","article-title":"Major air pollutants and risk of COPD exacerbations: a systematic review and meta-analysis","volume":"11","author":"Li","year":"2016","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"key":"2026030321254224200_bib9","doi-asserted-by":"crossref","first-page":"1814","DOI":"10.1513\/AnnalsATS.201601-064OC","article-title":"Global associations between air pollutants and chronic obstructive pulmonary disease hospitalizations. A systematic review","volume":"13","author":"Moore","year":"2016","journal-title":"Ann Am Thorac Soc"},{"key":"2026030321254224200_bib10","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1164\/rccm.201104-0597OC","article-title":"Acute exacerbations of chronic obstructive pulmonary disease: identification of biologic clusters and their biomarkers","volume":"184","author":"Bafadhel","year":"2011","journal-title":"Am J Respir Crit Care Med"},{"key":"2026030321254224200_bib11","first-page":"A3557","article-title":"Ambient particulate matter and oxides of nitrogen are associated with an increased incidence of COPD exacerbations with symptoms of infective etiology [abstract]","volume":"197","author":"Donaldson","year":"2018","journal-title":"Am J Respir Crit Care Med"},{"key":"2026030321254224200_bib12","doi-asserted-by":"crossref","first-page":"1418","DOI":"10.1164\/ajrccm.157.5.9709032","article-title":"Effect of exacerbation on quality of life in patients with chronic obstructive pulmonary disease","volume":"157","author":"Seemungal","year":"1998","journal-title":"Am J Respir Crit Care Med"},{"key":"2026030321254224200_bib13","first-page":"S77","article-title":"Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease","volume":"152","author":"American Thoracic Society","year":"1995","journal-title":"Am J Respir Crit Care Med"},{"key":"2026030321254224200_bib14","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1136\/thx.52.2008.S1.5","article-title":"BTS guidelines for the management of chronic obstructive pulmonary disease","volume":"52","author":"The COPD Guidelines Group of the Standards of Care Committee of the BTS","year":"1997","journal-title":"Thorax"},{"key":"2026030321254224200_bib15","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1038\/jes.2015.65","article-title":"Short-term exposure to traffic-related air pollution and daily mortality in London, UK","volume":"26","author":"Atkinson","year":"2016","journal-title":"J Expo Sci Environ Epidemiol"},{"key":"2026030321254224200_bib16","doi-asserted-by":"crossref","first-page":"2718","DOI":"10.1039\/c2em30469d","article-title":"Within-city contrasts in PM composition and sources and their relationship with nitrogen oxides","volume":"14","author":"Minguill\u00f3n","year":"2012","journal-title":"J Environ Monit"},{"key":"2026030321254224200_bib17","doi-asserted-by":"crossref","first-page":"1449","DOI":"10.1289\/ehp.11463","article-title":"Climate change, tropospheric ozone and particulate matter, and health impacts","volume":"116","author":"Ebi","year":"2008","journal-title":"Environ Health Perspect"},{"key":"2026030321254224200_bib18","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S0098-2997(00)00003-0","article-title":"Ozone and the lung: a sensitive issue","volume":"21","author":"Mudway","year":"2000","journal-title":"Mol Aspects Med"},{"key":"2026030321254224200_bib19","doi-asserted-by":"crossref","first-page":"1608","DOI":"10.1164\/ajrccm.161.5.9908022","article-title":"Time course and recovery of exacerbations in patients with chronic obstructive pulmonary disease","volume":"161","author":"Seemungal","year":"2000","journal-title":"Am J Respir Crit Care Med"},{"key":"2026030321254224200_bib20","doi-asserted-by":"crossref","first-page":"1075","DOI":"10.1136\/thoraxjnl-2012-201924","article-title":"Changes in prevalence and load of airway bacteria using quantitative PCR in stable and exacerbated COPD","volume":"67","author":"Garcha","year":"2012","journal-title":"Thorax"},{"key":"2026030321254224200_bib21","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1007\/BF03654838","article-title":"The influence of age and gender on antioxidant enzyme activities in humans and laboratory animals","volume":"24","author":"Giergiel","year":"2012","journal-title":"Aging Clin Exp Res"},{"key":"2026030321254224200_bib22","doi-asserted-by":"crossref","first-page":"2193","DOI":"10.1158\/1055-9965.EPI-12-0820","article-title":"Gender difference in systemic oxidative stress and antioxidant capacity in current and former heavy smokers","volume":"21","author":"Hakim","year":"2012","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"key":"2026030321254224200_bib23","doi-asserted-by":"crossref","first-page":"w13681","DOI":"10.4414\/smw.2012.13681","article-title":"Acute respiratory health effects of urban air pollutants in adults with different patterns of underlying respiratory disease","volume":"142","author":"Mehta","year":"2012","journal-title":"Swiss Med Wkly"},{"key":"2026030321254224200_bib24","doi-asserted-by":"crossref","first-page":"1939","DOI":"10.1016\/S0140-6736(03)13582-9","article-title":"Personal exposure to nitrogen dioxide (NO2) and the severity of virus-induced asthma in children","volume":"361","author":"Chauhan","year":"2003","journal-title":"Lancet"},{"key":"2026030321254224200_bib25","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1136\/oem.56.10.679","article-title":"Air pollution and hospital admissions for respiratory and cardiovascular diseases in Hong Kong","volume":"56","author":"Wong","year":"1999","journal-title":"Occup Environ Med"},{"key":"2026030321254224200_bib26","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1016\/0300-483X(94)90102-3","article-title":"Human exposure to oxides of nitrogen at ambient and supra-ambient concentrations","volume":"89","author":"Mohsenin","year":"1994","journal-title":"Toxicology"},{"key":"2026030321254224200_bib27","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1165\/ajrcmb.18.3.2882","article-title":"The effect of diesel exhaust particles on cell function and release of inflammatory mediators from human bronchial epithelial cells in vitro","volume":"18","author":"Bayram","year":"1998","journal-title":"Am J Respir Cell Mol Biol"},{"key":"2026030321254224200_bib28","doi-asserted-by":"crossref","first-page":"1194","DOI":"10.1016\/j.jaci.2013.06.048","article-title":"Diesel exhaust particle induction of IL-17A contributes to severe asthma","volume":"132","author":"Brandt","year":"2013","journal-title":"J Allergy Clin Immunol"},{"key":"2026030321254224200_bib29","doi-asserted-by":"crossref","first-page":"2778","DOI":"10.4049\/jimmunol.1101380","article-title":"Suppression of the NF-\u03baB pathway by diesel exhaust particles impairs human antimycobacterial immunity","volume":"188","author":"Sarkar","year":"2012","journal-title":"J Immunol"},{"key":"2026030321254224200_bib30","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1080\/08958370601052121","article-title":"Effects of nitrogen dioxide on the expression of intercellular adhesion molecule-1, neutrophil adhesion, and cytotoxicity: studies in human bronchial epithelial cells","volume":"19","author":"Ayyagari","year":"2007","journal-title":"Inhal Toxicol"},{"key":"2026030321254224200_bib31","doi-asserted-by":"crossref","first-page":"27843","DOI":"10.1007\/s11356-017-0402-7","article-title":"NO2 inhalation enhances asthma susceptibility in a rat model","volume":"24","author":"Han","year":"2017","journal-title":"Environ Sci Pollut Res Int"},{"key":"2026030321254224200_bib32","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1016\/0092-8674(89)90688-0","article-title":"The major human rhinovirus receptor is ICAM-1","volume":"56","author":"Greve","year":"1989","journal-title":"Cell"},{"key":"2026030321254224200_bib33","doi-asserted-by":"crossref","first-page":"e1003520","DOI":"10.1371\/journal.ppat.1003520","article-title":"An anti-human ICAM-1 antibody inhibits rhinovirus-induced exacerbations of lung inflammation","volume":"9","author":"Traub","year":"2013","journal-title":"PLoS Pathog"},{"key":"2026030321254224200_bib34","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1289\/ehp.02110665","article-title":"Synergism between rhinovirus infection and oxidant pollutant exposure enhances airway epithelial cell cytokine production","volume":"110","author":"Spannhake","year":"2002","journal-title":"Environ Health Perspect"},{"key":"2026030321254224200_bib35","doi-asserted-by":"crossref","first-page":"3089","DOI":"10.1099\/jgv.0.000627","article-title":"Viral-bacterial interactions in the respiratory tract","volume":"97","author":"Bellinghausen","year":"2016","journal-title":"J Gen Virol"},{"key":"2026030321254224200_bib36","doi-asserted-by":"crossref","first-page":"2121","DOI":"10.1096\/fj.06-5806fje","article-title":"H. influenzae potentiates airway epithelial cell responses to rhinovirus by increasing ICAM-1 and TLR3 expression","volume":"20","author":"Sajjan","year":"2006","journal-title":"FASEB J"},{"key":"2026030321254224200_bib37","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1378\/chest.11-0281","article-title":"Influence of season on exacerbation characteristics in patients with COPD","volume":"141","author":"Donaldson","year":"2012","journal-title":"Chest"},{"key":"2026030321254224200_bib38","doi-asserted-by":"crossref","first-page":"780","DOI":"10.1136\/thx.2006.076166","article-title":"Temporal relationship between air pollutants and hospital admissions for chronic obstructive pulmonary disease in Hong Kong","volume":"62","author":"Ko","year":"2007","journal-title":"Thorax"},{"key":"2026030321254224200_bib39","doi-asserted-by":"crossref","first-page":"6351","DOI":"10.5194\/acp-15-6351-2015","article-title":"Investigating the annual behaviour of submicron secondary inorganic and organic aerosols in London","volume":"15","author":"Young","year":"2015","journal-title":"Atmos Chem Phys"},{"key":"2026030321254224200_bib40","doi-asserted-by":"crossref","first-page":"860","DOI":"10.1093\/ajcn\/85.3.860","article-title":"Hypovitaminosis D in British adults at age 45 y: nationwide cohort study of dietary and lifestyle predictors","volume":"85","author":"Hypp\u00f6nen","year":"2007","journal-title":"Am J Clin Nutr"},{"key":"2026030321254224200_bib41","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1039\/C5FD00180C","article-title":"Twenty years of ambient observations of nitrogen oxides and specified hydrocarbons in air masses dominated by traffic emissions in Germany","volume":"189","author":"Ehlers","year":"2016","journal-title":"Faraday Discuss"},{"key":"2026030321254224200_bib42","first-page":"5","article-title":"The impact of the congestion charging scheme on air quality in London. Part 1. Emissions modeling and analysis of air pollution measurements","volume":"155","author":"Kelly","year":"2011","journal-title":"Res Rep Health Eff Inst"},{"key":"2026030321254224200_bib43","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1080\/08958370801903784","article-title":"Effects of particulate matter on cytokine production in vitro: a comparative analysis of published studies","volume":"20","author":"Mitschik","year":"2008","journal-title":"Inhal Toxicol"},{"key":"2026030321254224200_bib44","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1165\/rcmb.2012-0052OC","article-title":"Radical-containing ultrafine particulate matter initiates epithelial-to-mesenchymal transitions in airway epithelial cells","volume":"48","author":"Thevenot","year":"2013","journal-title":"Am J Respir Cell Mol Biol"},{"key":"2026030321254224200_bib45","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1016\/0272-0590(88)90284-9","article-title":"Possible mechanisms to explain dust overloading of the lungs","volume":"10","author":"Morrow","year":"1988","journal-title":"Fundam Appl Toxicol"},{"key":"2026030321254224200_bib46","doi-asserted-by":"crossref","first-page":"20140049","DOI":"10.1098\/rstb.2014.0049","article-title":"Nanoparticles modulate surfactant protein A and D mediated protection against influenza A infection in vitro","volume":"370","author":"McKenzie","year":"2015","journal-title":"Philos Trans R Soc Lond B Biol Sci"},{"key":"2026030321254224200_bib47","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1165\/rcmb.2012-0465OC","article-title":"Urban particulate matter suppresses priming of Th1 cells by GM-CSF-activated human dendritic cells","volume":"50","author":"Matthews","year":"2014","journal-title":"Am J Respir Cell Mol Biol"},{"key":"2026030321254224200_bib48","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1111\/imm.12852","article-title":"Urban particulate matter stimulation of human dendritic cells enhances priming of naive CD8 T lymphocytes","volume":"153","author":"Pfeffer","year":"2018","journal-title":"Immunology"},{"key":"2026030321254224200_bib49","doi-asserted-by":"crossref","first-page":"943","DOI":"10.1164\/rccm.201412-2269OC","article-title":"Impact of prolonged exacerbation recovery in chronic obstructive pulmonary disease","volume":"192","author":"Donaldson","year":"2015","journal-title":"Am J Respir Crit Care Med"},{"key":"2026030321254224200_bib50","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1289\/ehp.00108419","article-title":"Exposure measurement error in time-series studies of air pollution: concepts and consequences","volume":"108","author":"Zeger","year":"2000","journal-title":"Environ Health Perspect"},{"key":"2026030321254224200_bib51","doi-asserted-by":"crossref","first-page":"1081","DOI":"10.1080\/10473289.2000.10464166","article-title":"Exposure of chronic obstructive pulmonary disease patients to particulate matter: relationships between personal and ambient air concentrations","volume":"50","author":"Ebelt","year":"2000","journal-title":"J Air Waste Manag Assoc"},{"key":"2026030321254224200_bib52","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1289\/ehp.8422","article-title":"Factors affecting the association between ambient concentrations and personal exposures to particles and gases","volume":"114","author":"Sarnat","year":"2006","journal-title":"Environ Health Perspect"},{"key":"2026030321254224200_bib53","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1164\/rccm.200408-1054OC","article-title":"Exacerbations and time spent outdoors in chronic obstructive pulmonary disease","volume":"171","author":"Donaldson","year":"2005","journal-title":"Am J Respir Crit Care Med"},{"key":"2026030321254224200_bib54","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.envint.2016.10.011","article-title":"Acute respiratory response to traffic-related air pollution during physical activity performance","volume":"97","author":"Matt","year":"2016","journal-title":"Environ Int"},{"key":"2026030321254224200_bib55","doi-asserted-by":"crossref","first-page":"1638","DOI":"10.1378\/chest.117.6.1638","article-title":"Relationship of sputum color to nature and outpatient management of acute exacerbations of COPD","volume":"117","author":"Stockley","year":"2000","journal-title":"Chest"},{"key":"2026030321254224200_bib56","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1186\/s12931-017-0570-5","article-title":"Blood and sputum eosinophils in COPD; relationship with bacterial load","volume":"18","author":"Kolsum","year":"2017","journal-title":"Respir Res"}],"container-title":["American Journal of Respiratory and Critical Care Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ajrccm\/article-pdf\/199\/5\/581\/67121040\/ajrccm_199_5_581.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajrccm\/article-pdf\/199\/5\/581\/67121040\/ajrccm_199_5_581.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T02:25:53Z","timestamp":1772591153000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ajrccm\/article\/199\/5\/581\/8497832"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3,1]]},"references-count":56,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2019,3,1]]},"published-print":{"date-parts":[[2019,3,1]]}},"URL":"https:\/\/doi.org\/10.1164\/rccm.201712-2506oc","relation":{},"ISSN":["1073-449X","1535-4970"],"issn-type":[{"value":"1073-449X","type":"print"},{"value":"1535-4970","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2019,3]]},"published":{"date-parts":[[2019,3,1]]}}}