{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T22:55:58Z","timestamp":1790808958478,"version":"4.1.0"},"reference-count":62,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T00:00:00Z","timestamp":1747353600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosglobalpublichealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Glob Public Health"],"abstract":"<jats:p>Cataracts are a leading cause of global blindness, with many low-resource populations having poor access to eye care. While much is known regarding surgical access and outcomes, less is understood about the initial detection of operable cataracts in low-resource settings. We performed a comprehensive literature review on existing and emerging cataract screening methods in low- and middle-income countries (LMICs). The search keywords were \u201ccataract detection, diagnosis, assessment, and evaluation in low- and middle- income countries\u201d. 1,825 articles were identified and 62 were selected for final inclusion comprising reviews, meta-analyses, and original research studies. Only 12 studies proposed new cataract screening methods for low-income settings. We extracted data on the efficacy and cost-efficiency of these novel methods and compared them to existing conventional cataract diagnosis methods. 8 out of 12 original research works developed novel devices or imaging modalities such as low-cost ophthalmoscopes and retinal cameras for cataract detection. 7 studies leveraged non-ophthalmologist staff to test their methods, suggesting a potential benefit of employing additional personnel for cataract screening. 8 studies utilized tele-ophthalmology and artificial intelligence (AI) platforms with high cataract detection accuracy. Overall, rates of cataract diagnosis in LMICs can be increased through a multifaceted strategy involving low-cost, portable devices operated by local healthcare workers and augmented by telehealth or AI approaches. Such efforts can aid in addressing the disparity between cataract diagnosis and surgical intervention in low-resource environments. However, improvements in research infrastructure are needed to support such efforts and the ability to thoroughly evaluate new innovations.<\/jats:p>","DOI":"10.1371\/journal.pgph.0004619","type":"journal-article","created":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T17:26:00Z","timestamp":1747416360000},"page":"e0004619","update-policy":"https:\/\/doi.org\/10.1371\/journal.pgph.corrections_policy","source":"Crossref","is-referenced-by-count":9,"title":["Tools and methods for cataract recognition in low-resource settings: A narrative review"],"prefix":"10.1371","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9635-1790","authenticated-orcid":true,"given":"Paulina N.","family":"Truong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth A.","family":"Merlinsky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas C.","family":"Maamari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3135-1922","authenticated-orcid":true,"given":"Christina Y.","family":"Weng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew G.","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,5,16]]},"reference":[{"issue":"2","key":"pgph.0004619.ref001","doi-asserted-by":"crossref","DOI":"10.1016\/S2214-109X(20)30489-7","article-title":"Causes of blindness and vision impairment in 2020 and trends over 30 years, and prevalence of avoidable blindness in relation to VISION 2020: the right to sight: an analysis for the Global Burden of Disease Study","volume":"9","author":"JD Steinmetz","year":"2021","journal-title":"Lancet Glob Health"},{"issue":"4","key":"pgph.0004619.ref002","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1111\/cxo.12142","article-title":"Investigating cataract referral practices used by Australian optometrists","volume":"97","author":"V Quang Do","year":"2014","journal-title":"Clin Exp Optom"},{"issue":"1","key":"pgph.0004619.ref003","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1186\/s12913-022-08144-6","article-title":"Evaluating eye health care services progress towards VISION 2020 goals in Gurage Zone, Ethiopia","volume":"22","author":"JG Soboka","year":"2022","journal-title":"BMC Health Serv Res"},{"issue":"2","key":"pgph.0004619.ref004","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1111\/j.1442-9071.1992.tb00717.x","article-title":"Present challenges in the global prevention of blindness","volume":"20","author":"B Thylefors","year":"1992","journal-title":"Aust N Z J Ophthalmol"},{"issue":"14","key":"pgph.0004619.ref005","doi-asserted-by":"crossref","first-page":"5872","DOI":"10.1167\/iovs.16-19894","article-title":"Cataract surgical rate and socioeconomics: a global study","volume":"57","author":"W Wang","year":"2017","journal-title":"Invest Ophthalmol Vis Sci"},{"issue":"10","key":"pgph.0004619.ref006","doi-asserted-by":"crossref","first-page":"4299","DOI":"10.1167\/iovs.17-21459","article-title":"Variations and Trends in Health Burden of Visual Impairment Due to Cataract: A Global Analysis","volume":"58","author":"M He","year":"2017","journal-title":"Invest Ophthalmol Vis Sci"},{"issue":"9","key":"pgph.0004619.ref007","doi-asserted-by":"crossref","first-page":"1784","DOI":"10.2105\/AJPH.2009.187930","article-title":"Global inequality in eye health: country-level analysis from the Global Burden of Disease Study","volume":"100","author":"K Ono","year":"2010","journal-title":"Am J Public Health"},{"issue":"4","key":"pgph.0004619.ref008","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1111\/ceo.13725","article-title":"Cataract surgery and Indigenous eye care: A review","volume":"48","author":"HR Taylor","year":"2020","journal-title":"Clin Exp Ophthalmol"},{"issue":"2","key":"pgph.0004619.ref009","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1093\/oxfordjournals.epirev.a036197","article-title":"Risk factors for age-related cataracts","volume":"17","author":"WG Hodge","year":"1995","journal-title":"Epidemiol Rev"},{"issue":"6","key":"pgph.0004619.ref010","doi-asserted-by":"crossref","first-page":"3660","DOI":"10.1167\/iovs.13-13695","article-title":"Association between dietary carbohydrate intake and dietary glycemic index and risk of age-related cataract: a meta-analysis","volume":"55","author":"H Wu","year":"2014","journal-title":"Invest Ophthalmol Vis Sci"},{"issue":"1","key":"pgph.0004619.ref011","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/09286586.2023.2183513","article-title":"Air Pollution and Chronic Eye Disease in Adults: A Scoping Review","volume":"31","author":"AE Millen","year":"2024","journal-title":"Ophthalmic Epidemiol"},{"issue":"5","key":"pgph.0004619.ref012","first-page":"681","article-title":"Strategic issues in preventing cataract blindness in developing countries","volume":"73","author":"LB Ellwein","year":"1995","journal-title":"Bull World Health Organ"},{"issue":"1","key":"pgph.0004619.ref013","doi-asserted-by":"crossref","DOI":"10.1016\/S2666-7568(21)00302-0","article-title":"Grand challenges in global eye health: a global prioritisation process using Delphi method","volume":"3","author":"J Ramke","year":"2022","journal-title":"Lancet Healthy Longev"},{"issue":"1","key":"pgph.0004619.ref014","doi-asserted-by":"crossref","first-page":"2068","DOI":"10.1186\/s12889-022-14491-0","article-title":"Global, regional, national burden and gender disparity of cataract: findings from the global burden of disease study 2019","volume":"22","author":"R Fang","year":"2022","journal-title":"BMC Public Health"},{"issue":"1","key":"pgph.0004619.ref015","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1038\/eye.2012.214","article-title":"Catatrac: a novel red light-emitting diode device for screening cataracts in the developing world","volume":"27","author":"MQ Rahman","year":"2013","journal-title":"Eye (Lond)"},{"issue":"1","key":"pgph.0004619.ref016","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1097\/ICU.0b013e3282f154bd","article-title":"Cataract surgery for the developing world","volume":"19","author":"G Tabin","year":"2008","journal-title":"Curr Opin Ophthalmol"},{"issue":"5","key":"pgph.0004619.ref017","first-page":"316","article-title":"First Rapid Assessment of Avoidable Blindness Survey in the Maldives: Prevalence and Causes of Blindness and Cataract Surgery","volume":"7","author":"U Thoufeeq","year":"2018","journal-title":"Asia Pac J Ophthalmol (Phila)"},{"issue":"4","key":"pgph.0004619.ref018","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1111\/ceo.13430","article-title":"Longitudinal changes in global cataract surgery rate inequality and associations with socioeconomic indices","volume":"47","author":"W Yan","year":"2019","journal-title":"Clin Exp Ophthalmol"},{"issue":"3","key":"pgph.0004619.ref019","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1080\/09286586.2019.1702217","article-title":"Primary Eye Care in Eastern Nepal","volume":"27","author":"H Burn","year":"2020","journal-title":"Ophthalmic Epidemiol"},{"issue":"2","key":"pgph.0004619.ref020","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/j.ajo.2010.04.003","article-title":"Screening and managing eye disease in 2010: an Asian perspective","volume":"150","author":"NG Congdon","year":"2010","journal-title":"Am J Ophthalmol"},{"issue":"8","key":"pgph.0004619.ref021","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2019-036413","article-title":"Interventions to improve the quality of cataract services: protocol for a global scoping review","volume":"10","author":"M Yoshizaki","year":"2020","journal-title":"BMJ Open"},{"issue":"5","key":"pgph.0004619.ref022","first-page":"338","article-title":"Cost-effectiveness analysis of cataract surgery: a global and regional analysis","volume":"82","author":"R Baltussen","year":"2004","journal-title":"Bull World Health Organ"},{"issue":"6","key":"pgph.0004619.ref023","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1016\/j.jcrs.2017.05.020","article-title":"Results and methodology of cost-utility evaluation of cataract surgery in developed countries: Quality-adjusted life years and cataract","volume":"43","author":"U Hahn","year":"2017","journal-title":"J Cataract Refract Surg"},{"issue":"9","key":"pgph.0004619.ref024","doi-asserted-by":"crossref","first-page":"1670","DOI":"10.1016\/j.ophtha.2006.12.013","article-title":"Global cost-effectiveness of cataract surgery","volume":"114","author":"VC Lansingh","year":"2007","journal-title":"Ophthalmology"},{"key":"pgph.0004619.ref025","doi-asserted-by":"crossref","first-page":"101354","DOI":"10.1016\/j.eclinm.2022.101354","article-title":"The economics of vision impairment and its leading causes: A systematic review","volume":"46","author":"AP Marques","year":"2022","journal-title":"EClinicalMedicine"},{"issue":"5","key":"pgph.0004619.ref026","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1007\/s00417-018-04210-0","article-title":"Do we need day-1 postoperative follow-up after cataract surgery?","volume":"257","author":"A Grzybowski","year":"2019","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"pgph.0004619.ref027","doi-asserted-by":"crossref","DOI":"10.1093\/inthealth\/ihab072","article-title":"Evidence on cataract in low- and middle-income countries: an updated review of reviews using the evidence gap maps approach","volume":"14","author":"E Jolley","year":"2022","journal-title":"Int Health"},{"issue":"5","key":"pgph.0004619.ref028","doi-asserted-by":"crossref","first-page":"464","DOI":"10.4103\/0301-4738.100552","article-title":"The challenges in improving outcome of cataract surgery in low and middle income countries","volume":"60","author":"R Lindfield","year":"2012","journal-title":"Indian J Ophthalmol"},{"issue":"5","key":"pgph.0004619.ref029","doi-asserted-by":"crossref","first-page":"438","DOI":"10.4103\/0301-4738.100545","article-title":"Elimination of avoidable blindness due to cataract: where do we prioritize and how should we monitor this decade?","volume":"60","author":"GVS Murthy","year":"2012","journal-title":"Indian J Ophthalmol"},{"issue":"1","key":"pgph.0004619.ref030","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1111\/j.1475-1313.2006.00428.x","article-title":"Technical Note: A comparison of a novel direct ophthalmoscope, the Optyse, to conventional direct ophthalmoscopes","volume":"27","author":"DE Harle","year":"2007","journal-title":"Ophthalmic Physiol Opt"},{"issue":"3","key":"pgph.0004619.ref031","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1111\/j.1444-0938.2005.tb06689.x","article-title":"A novel instrument for assessing the retinal red reflex for non-ophthalmic health professionals","volume":"88","author":"J-AMC Pon","year":"2005","journal-title":"Clin Exp Optom"},{"key":"pgph.0004619.ref032","doi-asserted-by":"crossref","first-page":"1182388","DOI":"10.3389\/fnins.2023.1182388","article-title":"Application of artificial intelligence for automatic cataract staging based on anterior segment images: comparing automatic segmentation approaches to manual segmentation","volume":"17","author":"F Gan","year":"2023","journal-title":"Front Neurosci"},{"issue":"16","key":"pgph.0004619.ref033","doi-asserted-by":"crossref","first-page":"23355","DOI":"10.1007\/s11042-022-12544-5","article-title":"Development of portable and robust cataract detection and grading system by analyzing multiple texture features for Tele-Ophthalmology","volume":"81","author":"S Pathak","year":"2022","journal-title":"Multimed Tools Appl"},{"issue":"2","key":"pgph.0004619.ref034","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1089\/tmj.2011.0067","article-title":"Ocular telehealth screenings in an urban community","volume":"18","author":"K Shahid","year":"2012","journal-title":"Telemed J E Health"},{"key":"pgph.0004619.ref035","doi-asserted-by":"crossref","first-page":"906042","DOI":"10.3389\/fcell.2022.906042","article-title":"Artificial Intelligence Model for Antiinterference Cataract Automatic Diagnosis: A Diagnostic Accuracy Study","volume":"10","author":"X Wu","year":"2022","journal-title":"Front Cell Dev Biol"},{"issue":"6","key":"pgph.0004619.ref036","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1080\/09286586.2020.1768552","article-title":"Eye Care Utilization in A Community-oriented Mobile Screening Programme for Improving Eye Health in Iran: A Cluster Randomized Trial","volume":"27","author":"M Katibeh","year":"2020","journal-title":"Ophthalmic Epidemiol"},{"issue":"5","key":"pgph.0004619.ref037","doi-asserted-by":"crossref","first-page":"100094","DOI":"10.1016\/j.apjo.2024.100094","article-title":"Development and Testing of Artificial Intelligence-Based Mobile Application to Achieve Cataract Backlog-Free Status in Uttar Pradesh, India","volume":"13","author":"M Devaraj","year":"2024","journal-title":"Asia Pac J Ophthalmol (Phila)"},{"key":"pgph.0004619.ref038","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/s12960-016-0107-x","article-title":"Setting targets for human resources for eye health in sub-Saharan Africa: what evidence should be used?","volume":"14","author":"P Courtright","year":"2016","journal-title":"Hum Resour Health"},{"issue":"3","key":"pgph.0004619.ref039","doi-asserted-by":"crossref","first-page":"149","DOI":"10.3109\/09286589409047223","article-title":"Eye care delivery in developing nations: paradigms, paradoxes, and progress","volume":"1","author":"L Schwab","year":"1994","journal-title":"Ophthalmic Epidemiol"},{"key":"pgph.0004619.ref040","first-page":"139","article-title":"A Pilot Study to Improve Access to Eye Care Services for Patients in Rural India by Implementing Community Ophthalmology through Innovative Telehealth Technology.","volume-title":"Driving Reform: Digital Health is Everyone&#39;s Business [Internet]","author":"S John","year":"2015"},{"key":"pgph.0004619.ref041","first-page":"20552076221090042","article-title":"Portable hardware & software technologies for addressing ophthalmic health disparities: A systematic review","volume":"8","author":"M Labkovich","year":"2022","journal-title":"Digit Health"},{"issue":"11","key":"pgph.0004619.ref042","doi-asserted-by":"crossref","first-page":"714","DOI":"10.21037\/atm-20-976","article-title":"Application of artificial intelligence in anterior segment ophthalmic diseases: diversity and standardization","volume":"8","author":"X Wu","year":"2020","journal-title":"Ann Transl Med"},{"issue":"7","key":"pgph.0004619.ref043","doi-asserted-by":"crossref","first-page":"792","DOI":"10.1136\/bjo.83.7.792","article-title":"Creation and testing of a practical visual function assessment for use in Africa: correlation with visual acuity, contrast sensitivity, and near vision in Malawian adults","volume":"83","author":"K van Dijk","year":"1999","journal-title":"Br J Ophthalmol"},{"issue":"2","key":"pgph.0004619.ref044","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1089\/tmj.2023.0041","article-title":"Smartphone eye examination: artificial intelligence and telemedicine","volume":"30","author":"MAP Vilela","year":"2024","journal-title":"Telemed E-Health"},{"issue":"5","key":"pgph.0004619.ref045","first-page":"799","article-title":"International applicability of the VF-14. An index of visual function in patients with cataracts","volume":"104","author":"J Alonso","year":"1997","journal-title":"Ophthalmology"},{"issue":"6","key":"pgph.0004619.ref046","doi-asserted-by":"crossref","first-page":"1084","DOI":"10.1038\/s41433-023-02846-9","article-title":"Developing ophthalmology in Cambodia","author":"P Mandal","year":"2024","journal-title":"Eye"},{"issue":"2","key":"pgph.0004619.ref047","doi-asserted-by":"crossref","first-page":"52","DOI":"10.3109\/09286586.2011.645108","article-title":"prevalence and causes of blindness and low vision revisited after 5 years of eye care in Timor-Leste","volume":"19","author":"J Ramke","year":"2012","journal-title":"Ophthalmic Epidemiol"},{"issue":"5","key":"pgph.0004619.ref048","doi-asserted-by":"crossref","first-page":"416","DOI":"10.4103\/0301-4738.100539","article-title":"Rapid assessment methods in eye care: an overview","volume":"60","author":"S Marmamula","year":"2012","journal-title":"Indian J Ophthalmol"},{"issue":"4","key":"pgph.0004619.ref049","doi-asserted-by":"crossref","first-page":"164","DOI":"10.3109\/09286586.2011.594205","article-title":"Cataract prevalence varies substantially with assessment systems: comparison of clinical and photographic grading in a population-based study","volume":"18","author":"ACS Tan","year":"2011","journal-title":"Ophthalmic Epidemiol"},{"issue":"11","key":"pgph.0004619.ref050","doi-asserted-by":"crossref","first-page":"1184","DOI":"10.1097\/j.jcrs.0000000000001538","article-title":"Global review of publicly available image datasets for the anterior segment of the eye","volume":"50","author":"M Niestrata","year":"2024","journal-title":"J Cataract Refract Surg"},{"issue":"11","key":"pgph.0004619.ref051","doi-asserted-by":"crossref","first-page":"1553","DOI":"10.1136\/bjophthalmol-2019-314729","article-title":"Universal artificial intelligence platform for collaborative management of cataracts","volume":"103","author":"X Wu","year":"2019","journal-title":"Br J Ophthalmol"},{"key":"pgph.0004619.ref052","doi-asserted-by":"crossref","first-page":"100900","DOI":"10.1016\/j.preteyeres.2020.100900","article-title":"Digital technology, tele-medicine and artificial intelligence in ophthalmology: A global perspective","volume":"82","author":"J-PO Li","year":"2021","journal-title":"Prog Retin Eye Res"},{"issue":"3","key":"pgph.0004619.ref053","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1038\/s41433-019-0566-0","article-title":"Artificial intelligence for diabetic retinopathy screening: a review","volume":"34","author":"A Grzybowski","year":"2020","journal-title":"Eye (Lond)"},{"issue":"7981","key":"pgph.0004619.ref054","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1038\/s41586-023-06555-x","article-title":"A foundation model for generalizable disease detection from retinal images","volume":"622","author":"Y Zhou","year":"2023","journal-title":"Nature"},{"issue":"11","key":"pgph.0004619.ref055","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1016\/j.diii.2024.06.002","article-title":"Climate change and artificial intelligence in healthcare: Review and recommendations towards a sustainable future","volume":"105","author":"D Ueda","year":"2024","journal-title":"Diagn Interv Imaging"},{"key":"pgph.0004619.ref056","doi-asserted-by":"crossref","first-page":"3650","DOI":"10.1038\/s41467-024-47211-w","article-title":"Cost-effectiveness and cost-utility of a digital technology-driven hierarchical healthcare screening pattern in China","volume":"15","author":"X Wu","year":"2024","journal-title":"Nat Commun"},{"issue":"10","key":"pgph.0004619.ref057","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.1038\/sj.eye.6701966","article-title":"High-volume surgery in developing countries","volume":"19","author":"D Yorston","year":"2005","journal-title":"Eye (Lond)"},{"issue":"6","key":"pgph.0004619.ref058","doi-asserted-by":"crossref","first-page":"329","DOI":"10.3109\/09286586.2012.717674","article-title":"How to achieve universal coverage of cataract surgical services in developing countries: lessons from systematic reviews of other services","volume":"19","author":"K Blanchet","year":"2012","journal-title":"Ophthalmic Epidemiol"},{"issue":"11","key":"pgph.0004619.ref059","article-title":"Interventions to improve access to cataract surgical services and their impact on equity in low\u2010 and middle\u2010income countries","volume":"2017","author":"J Ramke","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"pgph.0004619.ref060","volume-title":"Vision for Everyone: accelerating action to achieve the Sustainable Development Goals","author":"United Nations General Assembly (UNGA)","year":"2021"},{"issue":"7","key":"pgph.0004619.ref061","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0235699","article-title":"Factors associated with the uptake of cataract surgery and interventions to improve uptake in low- and middle-income countries: A systematic review","volume":"15","author":"EW Mailu","year":"2020","journal-title":"PLoS One"},{"issue":"8","key":"pgph.0004619.ref062","doi-asserted-by":"crossref","first-page":"780","DOI":"10.1111\/j.1442-9071.2009.02152.x","article-title":"Cataract in central Sri Lanka: cataract surgical coverage and self-reported barriers to cataract surgery","volume":"37","author":"PA Athanasiov","year":"2009","journal-title":"Clin Exp Ophthalmol"}],"container-title":["PLOS Global Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pgph.0004619","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T17:26:09Z","timestamp":1747416369000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pgph.0004619"}},"subtitle":[],"editor":[{"given":"Dhananjaya","family":"Sharma","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,5,16]]},"references-count":62,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,5,16]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pgph.0004619","relation":{},"ISSN":["2767-3375"],"issn-type":[{"value":"2767-3375","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,16]]}}}