{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T20:16:49Z","timestamp":1791231409195,"version":"4.1.0"},"reference-count":62,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2021,6,24]],"date-time":"2021-06-24T00:00:00Z","timestamp":1624492800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Like many other women in the developing world, the practice of breast cancer screening among Ghanaian women is unsatisfactory. As a result, many cases are diagnosed at advanced stages leading to poor outcomes including mortalities. An understanding of the awareness and predictors of breast examination is an important first step that may guide the design of interventions aimed at raising awareness across the general population. This study aimed to explore the awareness, risk factors, and self-reported screening practices of breast cancer among female undergraduate students at the University of Health and Allied Sciences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross-sectional study was conducted among 385 female undergraduate students using a pre-tested questionnaire. Data were analysed using Stata Version 13.1 and presented using descriptive and inferential statistics comprising frequency, percentage, chi-square, and binary logistic regression. Odds ratios and 95% confidence intervals were computed to quantify the association between regular Breast-Self Examination (BSE) and socio-demographic characteristics of respondents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Seventy-three per cent of the students were aware of breast cancer, with social media being the most important source of information (64.4%). The prevalence of breast cancer risk factors varied from 1% of having a personal history of breast cancer to 14.3% for positive family history of breast cancer. Current use of oral pills\/injectable contraceptives was confirmed by 13.2% of participants; 20% were current alcohol users and10.1% were physically inactive. Regarding breast examination, 42.6% performed BSE; 10.1% had Clinical Breast Examination (CBE), while 2.3% had undergone mammography in the three years preceding the study. Women who did not believe to be susceptible to breast cancer (AOR: 0.04; 95%CI: 0.02\u20130.09) and those who did not know their risk status (AOR: 0.02; 95%CI: 0.005\u20130.57) were less likely to perform regular BSE compared to those who displayed pessimism. Further, women with no religious affiliation had 0.11 (95%CI: 0.02\u20130.55) odds of examining their breast regularly compared to Christians.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study demonstrated moderate awareness of the modalities of breast cancer screening and the risk factors of breast cancer among the students. However, there exists a gap between awareness and practice of breast cancer screening, which was influenced by optimism in breast cancer risk perception and religion. Awareness campaigns and education should be intensified in the University to bridge this gap.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0253373","type":"journal-article","created":{"date-parts":[[2021,6,24]],"date-time":"2021-06-24T13:41:32Z","timestamp":1624542092000},"page":"e0253373","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":88,"title":["Breast cancer awareness, risk factors and screening practices among future health professionals in Ghana: A cross-sectional study"],"prefix":"10.1371","volume":"16","author":[{"given":"Sandra","family":"Osei-Afriyie","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert Kwesi","family":"Addae","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Oppong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0218-3843","authenticated-orcid":true,"given":"Hubert","family":"Amu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Ampofo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6567-1591","authenticated-orcid":true,"given":"Eric","family":"Osei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,6,24]]},"reference":[{"key":"pone.0253373.ref001","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1016\/S1470-2045(10)70273-4","article-title":"Breast-cancer early detection in low-income and middle-income countries: Do what you can versus one size fits all","volume":"12","author":"JB Harford","year":"2011","journal-title":"Lancet Oncol"},{"key":"pone.0253373.ref002","unstructured":"World Health Organization, \u201cCancer,\u201d retrieved from http:\/\/www.who.int\/topics\/cancer\/en\/ on February 10, 2019."},{"key":"pone.0253373.ref003","doi-asserted-by":"crossref","first-page":"394","DOI":"10.3322\/caac.21492","article-title":"Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"68","author":"Freddie Bray","year":"2018","journal-title":"CA Cancer J cLin."},{"issue":"4","key":"pone.0253373.ref004","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1097\/GRF.0000000000000239","article-title":"Breast Cancer Epidemiology and Risk Factors","volume":"59","author":"K Rojas","year":"2016","journal-title":"Clin Obstet Gynecol"},{"key":"pone.0253373.ref005","first-page":"8","article-title":"Breast cancer in Kumasi, Ghana","volume":"46","author":"M Ohene-Yeboah","year":"2012","journal-title":"Ghana Med J."},{"key":"pone.0253373.ref006","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1186\/s12885-019-5480-0","article-title":"Malignant tumours in urban Ghana: evidence from the city of Kumasi","volume":"19","author":"Baffour Awuah Yaw Ampem Amoako","year":"2019","journal-title":"BMC Cancer"},{"issue":"3","key":"pone.0253373.ref007","doi-asserted-by":"crossref","DOI":"10.4314\/gmj.v43i3.55338","article-title":"Why do breast cancer patients report late or abscond during treatment in Ghana? A pilot study","volume":"43","author":"J Clegg-Lamptey","year":"2009","journal-title":"Ghana medical journal"},{"key":"pone.0253373.ref008","first-page":"9","article-title":"Pattern of Breast Cancer Distribution in Ghana: A Survey to Enhance Early Detection, Diagnosis, and Treatment","volume":"2016","author":"Jnr Naku Frank Ghartey","journal-title":"Hindawi Publishing Corporation International Journal of Breast Cancer"},{"key":"pone.0253373.ref009","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1016\/j.breast.2014.08.014","article-title":"Factors related to incomplete treatment of breast cancer in Kumasi, Ghana","volume":"23","author":"M Obrist","year":"2014","journal-title":"Breast"},{"key":"pone.0253373.ref010","doi-asserted-by":"crossref","first-page":"139","DOI":"10.3233\/BD-140372","article-title":"Characterizing breast cancer treatment pathways in Kumasi, Ghana from onset of symptoms to final outcome: Outlook towards cancer control","volume":"34","author":"S Scherber","year":"2014","journal-title":"Breast Dis."},{"key":"pone.0253373.ref011","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1007\/s10549-014-2868-z","article-title":"Breast cancer in sub-Saharan Africa: Opportunities for prevention","volume":"144","author":"LA Brinton","year":"2014","journal-title":"Breast Cancer Res Treat"},{"issue":"1","key":"pone.0253373.ref012","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s10549-014-2852-7","article-title":"Reproductive risk factors and breast cancer subtypes: a review of the literature","volume":"144","author":"KN Anderson","year":"2014","journal-title":"Breast Cancer Res Treat"},{"issue":"Suppl 2","key":"pone.0253373.ref013","doi-asserted-by":"crossref","first-page":"S30","DOI":"10.1016\/j.breast.2013.07.006","article-title":"Nutrition and physical activity influence on breast cancer incidence and outcome","volume":"22","author":"RT Chlebowski","year":"2013","journal-title":"Breast. Aug"},{"issue":"11","key":"pone.0253373.ref014","doi-asserted-by":"crossref","first-page":"e0140904","DOI":"10.1371\/journal.pone.0140904","article-title":"Knowledge and Beliefs of Breast Self- Examination and Breast Cancer among Market Women in Ibadan, South West, Nigeria","volume":"10","author":"K Oladimeji","year":"2015","journal-title":"PLoS ONE"},{"key":"pone.0253373.ref015","first-page":"29","article-title":"Evaluation of breast cancer awareness among female University students in Malaysia","volume":"8","author":"M Hadi","year":"2010","journal-title":"Pharm Pract (Internet)"},{"key":"pone.0253373.ref016","unstructured":"American Cancer Society, \u201cAmerican Cancer Society recommendations for the early detection of breast cancer\u201d. https:\/\/www.cancer.org\/cancer\/breast-cancer\/screening-tests-and-early-detection\/american-cancer-society-recommendations-for-the-early-detection-of-breast-cancer.html. On February 12 2020."},{"key":"pone.0253373.ref017","volume-title":"In Abellof\u2019s Clinical Oncology","author":"T Bevers","year":"2020","edition":"6"},{"key":"pone.0253373.ref018","doi-asserted-by":"crossref","first-page":"1540","DOI":"10.1002\/cncr.20978","article-title":"Breast cancer in sub-Saharan Africa: How does it relate to breast cancer in African-American women?","volume":"103","author":"A Fregene","year":"2015","journal-title":"Cancer"},{"key":"pone.0253373.ref019","unstructured":"The University of Health and Allied Sciences, Ghana. http:\/\/www.uhas.du.gh."},{"key":"pone.0253373.ref020","first-page":"1","author":"G.E. Merdiemah","year":"2016","journal-title":"Breast Cancer screening among female Personnel of the Ghana Armed Forces, Accra"},{"key":"pone.0253373.ref021","volume-title":"International Guide for Monitoring Alcohol Consumption and Related Harm","author":"World Health Organization","year":"2000"},{"key":"pone.0253373.ref022","unstructured":"Global Physical Activity Questionnaire (GPAQ) Analysis Guide. https:\/\/www.who.int\/ncds\/surveillance\/steps\/resources\/GPAQ_Analysis_Guide.pdf (accessed April 20, 2020)."},{"issue":"2","key":"pone.0253373.ref023","first-page":"109","article-title":"Breast Cancer Awareness and Practice of Breast Self-Examination among Female Medical Students at Haramaya University, Harar, Ethiopia","volume":"2","author":"K Ameer","year":"2014","journal-title":"IJIMS"},{"issue":"Suppl 3","key":"pone.0253373.ref024","first-page":"400","article-title":"Knowledge, Attitude and Practice of self-breast examination among the female students of the University of Ibadan, Nigeria","volume":"4","author":"C Chioma","year":"2007","journal-title":"Pakistan J Social Sci."},{"key":"pone.0253373.ref025","first-page":"395","article-title":"Knowledge, attitude, and practice of self-breast examination among female university students at Presbyterian University College, Ghana","volume":"1","author":"LA Sarfo","year":"2013","journal-title":"American Journal of Research Communication"},{"key":"pone.0253373.ref026","first-page":"91","article-title":"Awareness of breast cancer and breast self-examination among female undergraduate students in a higher teacher training college in Cameroon","volume":"28","author":"Carlson-Babila Sama","year":"2017","journal-title":"Pan African Medical Journal"},{"key":"pone.0253373.ref027","doi-asserted-by":"crossref","first-page":"501","DOI":"10.3389\/fonc.2018.00501","article-title":"Evaluation of Knowledge, Perception, and Risk Awareness About Breast Cancer and its Treatment Outcome Among the University of Gondar Students, Northwest Ethiopia","volume":"8","author":"BM Gebresillassie","year":"2018","journal-title":"Front. Oncol."},{"key":"pone.0253373.ref028","first-page":"4","article-title":"Knowledge and awareness of breast cancer among university students in South-South Nigeria","volume":"6","author":"OO Deborah","year":"2017","journal-title":"Sch. Acad. J. Pharm"},{"key":"pone.0253373.ref029","doi-asserted-by":"crossref","first-page":"159","DOI":"10.11648\/j.ajns.20150404.13","article-title":"Effect of a Breast-Self Examination (BSE) educational intervention among female university students","volume":"4","author":"GM Doaa","year":"2015","journal-title":"Am J Nurs Sci."},{"key":"pone.0253373.ref030","first-page":"70","article-title":"Breast cancer knowledge and awareness among university students in Angola","volume":"11","author":"M Sambanje","year":"2012","journal-title":"Pan Afr Med J"},{"issue":"1","key":"pone.0253373.ref031","first-page":"133","article-title":"Breast cancer knowledge, risk factors and screening among adult Saudi women in a primary health care setting","volume":"10","author":"T Amin","year":"2009","journal-title":"Asian Pacific J Cancer Prev."},{"key":"pone.0253373.ref032","first-page":"2531","article-title":"Awareness and Knowledge of Breast Cancer and Mammography among a Group of Malaysian Women in Shah Alam","volume":"12","author":"S Al-Dubai","year":"2011","journal-title":"Asian Pacific J Cancer Prev"},{"key":"pone.0253373.ref033","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1186\/1756-0500-5-627","article-title":"Breast Self-Examination and breast cancer awareness in women in developing countries: a survey of women in Buea, Cameroon","volume":"5","author":"M Suh","year":"2012","journal-title":"BMC Research Notes"},{"issue":"2013","key":"pone.0253373.ref034","first-page":"8","article-title":"Assessment of Knowledge of Breast Cancer and Screening Methods among Nurses in University Hospitals in Addis Ababa, Ethiopia, 2011","volume":"2013","author":"S Lemlem","year":"2013","journal-title":"ISRN Oncology"},{"issue":"4","key":"pone.0253373.ref035","doi-asserted-by":"crossref","first-page":"792","DOI":"10.5604\/12321966.1129935","article-title":"Selected breast cancer risk factors and early detection of the neoplasm in women from Lublin region attending screening program in St. John\u2019s Cancer Center, years 2005\u20132006","volume":"21","author":"Dariusz Surdyka Jolanta Anna Surdyka","year":"2014","journal-title":"Annals of Agricultural and Environmental Medicine"},{"issue":"11","key":"pone.0253373.ref036","doi-asserted-by":"crossref","first-page":"1234","DOI":"10.1038\/sj.bjc.6600596","article-title":"Collaborative Group on Hormonal Factors in Breast Cancer. Alcohol, tobacco and breast cancer: collaborative reanalysis of individual data from 53 epidemiological studies, including 58,515 women with breast cancer and 95,067 women without the disease","volume":"87","author":"N Hamajima","year":"2002","journal-title":"Br J Cancer"},{"key":"pone.0253373.ref037","doi-asserted-by":"crossref","first-page":"2228","DOI":"10.1056\/NEJMoa1700732","article-title":"Contemporary Hormonal Contraception and the Risk of Breast Cancer","volume":"377","author":"Lina S. M\u00f8rch","year":"2017","journal-title":"N Engl J Med"},{"key":"pone.0253373.ref038","volume-title":"Breast cancer risk factors: a review of the evidence","author":"National Breast and Ovarian Cancer Centre","year":"2009"},{"issue":"S1","key":"pone.0253373.ref039","first-page":"S72","article-title":"Breast self-examination practice and breast cancer risk perception among female university students in Ajman, UAE","volume":"1","author":"Shatha Al-Sharbatti","year":"2012","journal-title":"GMJ, ASM"},{"issue":"17","key":"pone.0253373.ref040","doi-asserted-by":"crossref","first-page":"1884","DOI":"10.1001\/jama.2011.1590","article-title":"Moderate alcohol consumption during adult life, drinking patterns, and breast cancer risk","volume":"306","author":"WY Chen","year":"2011","journal-title":"JAMA"},{"key":"pone.0253373.ref041","doi-asserted-by":"crossref","first-page":"213","DOI":"10.5040\/9798400671340.ch-020","volume-title":"International handbook on alcohol and culture","author":"OG Oshodin","year":"1995","edition":"1"},{"key":"pone.0253373.ref042","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1186\/1471-2458-11-160","article-title":"Alcohol abstinence and drinking among African women: data from the World Health Surveys","volume":"11","author":"P Martinez","year":"2011","journal-title":"BMC Public Health"},{"issue":"1","key":"pone.0253373.ref043","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1111\/tmi.12618","article-title":"The impact of alcohol consumption on African people in 2012: an analysis of burden of disease","volume":"21","author":"C Ferreira-Borges","year":"2016","journal-title":"Trop Med Int Health"},{"issue":"2","key":"pone.0253373.ref044","article-title":"Predominant lifestyle risk factors associated with Breast Cancer: A 5-Year Review of Breast Cancer Patients from Accra, Ghana","volume":"3","author":"KA Kyei","year":"2014","journal-title":"World Journal of Epidemiology and Cancer Prevention"},{"key":"pone.0253373.ref045","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1016\/j.canep.2010.04.004","article-title":"Does consanguinity lead to decreased incidence of breast cancer?","volume":"34","author":"B Abdulbari","year":"2010","journal-title":"Cancer Epidemiol."},{"key":"pone.0253373.ref046","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1007\/s10552-009-9471-3","article-title":"Breastfeeding reduces breast cancer risk: a case-control study in Tunisia","volume":"21","author":"M Awatef","year":"2010","journal-title":"Cancer Causes Control"},{"key":"pone.0253373.ref047","doi-asserted-by":"crossref","first-page":"4429","DOI":"10.7314\/APJCP.2014.15.11.4429","article-title":"Association between vegetable, fruit and carbohydrate intake and breast cancer risk in relation to physical activity","volume":"15","author":"J Kruk","year":"2014","journal-title":"Asian Pac J Cancer Prev"},{"key":"pone.0253373.ref048","doi-asserted-by":"crossref","first-page":"1823","DOI":"10.1249\/01.MSS.0000093620.27893.23","article-title":"Physical activity and cancer prevention: data from epidemiologic studies","volume":"35","author":"IM Lee","year":"2003","journal-title":"Med Sci Sports Exerc"},{"key":"pone.0253373.ref049","volume-title":"Weight control and physical activity","author":"H Vainio","year":"2002"},{"key":"pone.0253373.ref050","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1097\/00008469-200102000-00003","article-title":"Review of anthropometric factors and breast cancer risk","volume":"10","author":"CM Friedenreich","year":"2001","journal-title":"Eur J Cancer Prev"},{"key":"pone.0253373.ref051","article-title":"Knowledge, attitudes, beliefs, behaviour and breast cancer screening practices in Ghana, West Africa","author":"Martin Benwell Samuel Yaw Opoku","journal-title":"The Pan African Medical Journal"},{"issue":"4","key":"pone.0253373.ref052","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1016\/S2305-0500(13)60098-6","article-title":"Knowledge, attitude & practice towards breast cancer & breast self-examination in Kirkuk University, Iraq","volume":"1","author":"ASA Nada","year":"2012","journal-title":"Asian Pacific Journal of Reproduction."},{"key":"pone.0253373.ref053","first-page":"4","article-title":"Breast Self-examination: Knowledge, Attitude, and Practice among Female Health Science Students at Adama Science and Technology University, Ethiopia","volume":"6","author":"Segni Mesfin Tafa","year":"2016","journal-title":"Gynecol Obstet (Sunnyvale)"},{"key":"pone.0253373.ref054","first-page":"805","article-title":"Knowledge and practice of breast self-examination among undergraduate students in Bahir Dar University, North-West Ethiopia, 2016: a cross-sectional study","volume":"10","author":"Tilahum Tewabe","year":"2019","journal-title":"Journal of Public Health in Africa"},{"key":"pone.0253373.ref055","doi-asserted-by":"crossref","first-page":"32","DOI":"10.4236\/ojpm.2014.41006","article-title":"Knowledge on breast cancer and its prevention among women household heads in Northern Ethiopia","volume":"4","author":"B Legesse","year":"2014","journal-title":"Open Journal of Preventive Medicine"},{"key":"pone.0253373.ref056","doi-asserted-by":"crossref","first-page":"69","DOI":"10.4236\/ojpm.2014.42011","article-title":"Knowledge, attitude and practice of breast self-examination and breast cancer among female medical students in Taif, Saudi Arabia","volume":"4","author":"Dalal Nemenqani","year":"2014","journal-title":"Open Journal of Preventive Medicine"},{"issue":"20","key":"pone.0253373.ref057","doi-asserted-by":"crossref","first-page":"8637","DOI":"10.7314\/APJCP.2014.15.20.8637","article-title":"Knowledge, Attitude and Practice of Breast Self-examination Among Female University Students from 24 Low and Middle-Income and Emerging Economy Countries","volume":"15","author":"Supa Pengpid","year":"2014","journal-title":"Asian Pac J Cancer Prev"},{"key":"pone.0253373.ref058","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1186\/s13104-015-1004-4","article-title":"Knowledge, Attitude and Practise of breast self-examination among female undergraduate students in the University of Buea","volume":"8","author":"Nde Fon Peter","year":"2015","journal-title":"BMC Res Notes"},{"key":"pone.0253373.ref059","doi-asserted-by":"crossref","first-page":"142","DOI":"10.4103\/LJMS.LJMS_21_18","article-title":"Knowledge, Attitude, and Practice regarding breast cancer among female students at college of medical technology\/Derna","volume":"2","author":"RA Elzahaf","year":"2018","journal-title":"Libyan J Med Sci"},{"key":"pone.0253373.ref060","first-page":"1","article-title":"Health belief model and practice of breast self-examination and breast cancer screening in Iranian women","author":"K Hajian-Tilaki","year":"2012","journal-title":"Breast cancer"},{"key":"pone.0253373.ref061","doi-asserted-by":"crossref","first-page":"6525","DOI":"10.7314\/APJCP.2014.15.16.6525","article-title":"Health beliefs and breast self-examination among female university nursing students in Turkey","volume":"15","author":"N Erbil","year":"2014","journal-title":"Asian Pac J Cancer Prev"},{"issue":"2009","key":"pone.0253373.ref062","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.pec.2008.12.015","article-title":"Big gap between risk perception for breast cancer and risk factors: Nationwide survey in Korea","volume":"76","author":"Park Keeho","year":"2009","journal-title":"Patient Education and Counseling."}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0253373","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,2]],"date-time":"2024-09-02T11:54:35Z","timestamp":1725278075000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0253373"}},"subtitle":[],"editor":[{"given":"Antonio Simone","family":"Lagan\u00e0","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2021,6,24]]},"references-count":62,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2021,6,24]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0253373","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,24]]}}}