{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T14:51:30Z","timestamp":1780584690747,"version":"3.54.1"},"reference-count":54,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2023,6,22]],"date-time":"2023-06-22T00:00:00Z","timestamp":1687392000000},"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>Purpose<\/jats:title>\n<jats:p>To evaluate the differences in structural parameters in patients with open-angle glaucoma (OAG), high myopia (M), and both diseases (OAG-M) concurrently.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>42 subjects with OAG (n = 14), M (n = 14) and OAG-M (n = 14) were included in a prospective pilot study. Mean peripapillary retinal nerve fiber layer (RNFL) thickness, RNFL in superior, temporal, inferior, nasal quadrants, macular ganglion cell complex (GCC) and its\u2019 layers, vessel density (VD) of optic nerve head (ONH) and macula were evaluated.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>The OAG-M group showed significantly lowest thickness of mean peripapillary RNFL 89 (49\u2013103) \u03bcm (p = 0.021), temporal quadrant 64.5 (51\u2013109) \u03bcm (p = 0.001) and inferior quadrant 107 (64\u2013124) \u03bcm (p = 0.025). The macular RNFL was thinnest in the OAG-M group (p &lt;0.001). Macular VD in inferior quadrant was lowest in OAG-M group at superficial capillary plexus 45.92 (40.39\u201351.72) % (p = 0.014) and choriocapillaris 51.62 (49.87\u201356.63) % (p = 0.035). The lowest ONH VD of temporal quadrant was found in the OAG-M group 52.15 (35.73\u201359.53) % (p = 0.001) in the superficial capillary plexus. Similarly, the lowest VD of inferior quadrant was found in OAG-M group in the choriocapillaris 54.42 (46.31\u201364.64) % (p&lt;0.001).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The M group showed the least thinning in the peripapillary RNFL thickness in the temporal quadrant and macular RNFL compared to other two groups. The highest macular VD in the inferior quadrant was in the M group in the superficial capillary plexus, deep capillary plexus and choriocapillaris. The M group showed highest VD in the temporal quadrant and in total VD of ONH at the superficial capillary plexus and in total VD of ONH at the deep capillary plexus.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Practical recommendations<\/jats:title>\n<jats:p>The observed decrease in peripapillary RNFL thickness of the temporal quadrant, macular RNFL thickness, the decrease of macular VD at the inferior quadrant and decrease in VD of the ONH temporal quadrant in deep capillary plexus could be beneficial for diagnosing glaucoma in high myopia.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0286019","type":"journal-article","created":{"date-parts":[[2023,6,23]],"date-time":"2023-06-23T13:16:18Z","timestamp":1687526178000},"page":"e0286019","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":8,"title":["Differences in structural parameters in patients with open-angle glaucoma, high myopia and both diseases concurrently. A pilot study"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0153-0081","authenticated-orcid":true,"given":"Agne","family":"Markeviciute","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingrida","family":"Januleviciene","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9897-4676","authenticated-orcid":true,"given":"Gal","family":"Antman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brent","family":"Siesky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alon","family":"Harris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,6,22]]},"reference":[{"issue":"5","key":"pone.0286019.ref001","doi-asserted-by":"crossref","first-page":"1036","DOI":"10.1016\/j.ophtha.2016.01.006","article-title":"Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050","volume":"123","author":"BA Holden","year":"2016","journal-title":"Ophthalmology"},{"key":"pone.0286019.ref002","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.cobme.2020.01.001","article-title":"Connective Tissue Remodeling in Myopia and its Potential Role in Increasing Risk of Glaucoma.","volume":"15","author":"R Grytz","year":"2020","journal-title":"Curr Opin Biomed Eng."},{"key":"pone.0286019.ref003","volume-title":"In: StatPearls [Internet].","author":"N Mahabadi","year":"2022"},{"key":"pone.0286019.ref004","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1016\/j.ophtha.2012.07.065","article-title":"Differential associations of myopia with major age-related eye diseases: the Singapore Indian eye study","volume":"120","author":"CW Pan","year":"2013","journal-title":"Ophthalmology"},{"issue":"11","key":"pone.0286019.ref005","doi-asserted-by":"crossref","first-page":"2081","DOI":"10.1016\/j.ophtha.2014.05.013","article-title":"Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systematic review and meta-analysis","volume":"121","author":"YC Tham","year":"2014","journal-title":"Ophthalmology"},{"key":"pone.0286019.ref006","doi-asserted-by":"crossref","first-page":"1537","DOI":"10.1016\/j.ophtha.2018.04.031","article-title":"Detection of Bruch\u2019s Membrane Opening in Healthy Individuals and Glaucoma Patients with and without High Myopia","volume":"125","author":"F Zheng","year":"2018","journal-title":"Ophthalmology"},{"issue":"10","key":"pone.0286019.ref007","doi-asserted-by":"crossref","first-page":"1347","DOI":"10.1136\/bjophthalmol-2018-313530","article-title":"Glaucoma in myopia: diagnostic dilemmas","volume":"103","author":"NYQ Tan","year":"2019","journal-title":"Br J Ophthalmol"},{"issue":"6","key":"pone.0286019.ref008","doi-asserted-by":"crossref","first-page":"391","DOI":"10.5455\/medarh.2019.73.391-393","article-title":"Tilted Optic Disc Frequency in Myopia of Different Degree.","volume":"73","author":"E Dervisevic","year":"2019","journal-title":"Med Arch."},{"issue":"8","key":"pone.0286019.ref009","first-page":"100933","article-title":"Optic nerve head anatomy in myopia and glaucoma. including parapapillary zones alpha. beta. gamma and delta: Histology and clinical features","volume":"83","author":"YX Wang","year":"2020","journal-title":"Prog Retin Eye Res"},{"key":"pone.0286019.ref010","doi-asserted-by":"crossref","first-page":"19320","DOI":"10.1038\/srep19320","article-title":"Joint Effects of Intraocular Pressure and Myopia on Risk of Primary Open-Angle Glaucoma: The Singapore Epidemiology of Eye Diseases Study.","volume":"6","author":"YC Tham","year":"2016","journal-title":"Sci Rep."},{"issue":"1","key":"pone.0286019.ref011","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1167\/iovs.06-0410","article-title":"Relationship between visual field sensitivity and retinal nerve fiber layer thickness as measured by optical coherence tomography","volume":"48","author":"C Ajtony","year":"2007","journal-title":"Invest Ophthalmol Vis Sci"},{"issue":"18","key":"pone.0286019.ref012","doi-asserted-by":"crossref","first-page":"1901","DOI":"10.1001\/jama.2014.3192","article-title":"The pathophysiology and treatment of glaucoma: a review","volume":"311","author":"RN Weinreb","year":"2014","journal-title":"JAMA"},{"issue":"4","key":"pone.0286019.ref013","doi-asserted-by":"crossref","first-page":"511","DOI":"10.4103\/ijo.IJO_1039_17","article-title":"Evaluation of macular ganglion cell analysis compared to retinal nerve fiber layer thickness for preperimetric glaucoma diagnosis","volume":"66","author":"S Kaushik","year":"2018","journal-title":"Indian J Ophthalmol"},{"key":"pone.0286019.ref014","article-title":"Macular OCT imaging in glaucoma","author":"AA Aref","year":"2022","journal-title":"American Academy of Ophthalmology"},{"issue":"2","key":"pone.0286019.ref015","doi-asserted-by":"crossref","first-page":"204","DOI":"10.4103\/0974-9233.95251","article-title":"Macular retinal and nerve fiber layer thickness in early glaucoma: clinical correlations.","volume":"19","author":"V Arvanitaki","year":"2012","journal-title":"Middle East Afr J Ophthalmol"},{"key":"pone.0286019.ref016","author":"C Saini","year":"2020","journal-title":"Monitoring Glaucoma Progression with OCT."},{"issue":"3","key":"pone.0286019.ref017","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1097\/APO.0000000000000288","article-title":"High Myopia and Glaucoma-Like Optic Neuropathy.","volume":"9","author":"JB Jonas","year":"2020","journal-title":"Asia-Pacific Journal of Ophthalmology"},{"issue":"2","key":"pone.0286019.ref018","doi-asserted-by":"crossref","first-page":"e46","DOI":"10.1097\/IJG.0000000000000536","article-title":"Repeatability and Agreement of Swept Source and Spectral Domain Optical Coherence Tomography Evaluations of Thickness Sectors in Normal Eyes","volume":"26","author":"SY Lee","year":"2017","journal-title":"Journal of Glaucoma"},{"issue":"12","key":"pone.0286019.ref019","doi-asserted-by":"crossref","first-page":"3914","DOI":"10.1167\/iovs.19-27652","article-title":"Longitudinal Changes in the Peripapillary Retinal Nerve Fiber Layer Thickness in Hypertension: 4-Year Prospective Observational Study","volume":"60","author":"MW Lee","year":"2019","journal-title":"Invest. Ophthalmol. Vis. Sci"},{"issue":"3","key":"pone.0286019.ref020","doi-asserted-by":"crossref","first-page":"2716","DOI":"10.3892\/etm.2017.4820","article-title":"Evaluation of myopia on retinal nerve fiber layer thickness measured by Spectralis optical coherence tomography.","volume":"14","author":"Y Zha","year":"2017","journal-title":"Exp Ther Med"},{"issue":"8","key":"pone.0286019.ref021","doi-asserted-by":"crossref","first-page":"5134","DOI":"10.1167\/iovs.14-14303","article-title":"Age-associated changes in the retinal nerve fiber layer and optic nerve head","volume":"55","author":"NB Patel","year":"2014","journal-title":"Invest Ophthalmol Vis Sci"},{"issue":"12","key":"pone.0286019.ref022","doi-asserted-by":"crossref","first-page":"2485","DOI":"10.1016\/j.ophtha.2013.07.021","article-title":"Impact of age-related change of retinal nerve fiber layer and macular thicknesses on evaluation of glaucoma progression","volume":"120","author":"CKS Leung","year":"2013","journal-title":"Ophthalmology"},{"issue":"6","key":"pone.0286019.ref023","first-page":"1046","article-title":"Determinants of normal retinal nerve fiber layer thickness measured by Stratus OCT [published correction appears in Ophthalmology.","volume":"114","author":"DL Budenz","year":"2007","journal-title":"2008 Mar;115(3):472]. Ophthalmology."},{"key":"pone.0286019.ref024","doi-asserted-by":"crossref","first-page":"1839","DOI":"10.1097\/IAE.0000000000001786","article-title":"Temporal vascular ARCADE width and angle inhigh axial myopia.","volume":"38","author":"JB Jonas","year":"2018","journal-title":"Retina"},{"issue":"1","key":"pone.0286019.ref025","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1186\/s12886-017-0419-1","article-title":"Ganglion cell-inner plexiform layer and retinal nerve fiber layer thickness according to myopia and optic disc area: a quantitative and three-dimensional analysis.","volume":"17","author":"S Seo","year":"2017","journal-title":"BMC Ophthalmol."},{"issue":"1","key":"pone.0286019.ref026","article-title":"Ganglion Cell Complex thickness as an early predictor of microstructural changes in varying degrees of myopia in comparison with Retinal Nerve Fiber Layer (RNFL) thickness.","volume":"7","author":"M Andi","year":"2018","journal-title":"Bali Medical Journal."},{"issue":"1","key":"pone.0286019.ref027","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1186\/s12886-020-01616-5","article-title":"Diagnostic ability of OCT parameters and retinal ganglion cells count in identification of glaucoma in myopic preperimetric eyes.","volume":"20","author":"T Rolle","year":"2020","journal-title":"BMC Ophthalmol"},{"issue":"2","key":"pone.0286019.ref028","doi-asserted-by":"crossref","first-page":"1098","DOI":"10.1167\/iovs.10-5922","article-title":"Assessment of glaucomatous changes in subjects with high myopia using spectral domain optical coherence tomography","volume":"52","author":"T Shoji","year":"2011","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"pone.0286019.ref029","doi-asserted-by":"crossref","first-page":"6025","DOI":"10.1167\/iovs.13-12630","article-title":"The ability of macular parameters and circumpapillary retinal nerve fiber layer by three SD-OCT instruments to diagnose highly myopic glaucoma","volume":"54","author":"A Akashi","year":"2013","journal-title":"Invest Ophthalmol Vis Sci"},{"issue":"11","key":"pone.0286019.ref030","doi-asserted-by":"crossref","first-page":"4910","DOI":"10.1167\/iovs.16-19104","article-title":"Comparison of several parameters in two optical coherence tomography systems for detecting glaucomatous defects in high myopia","volume":"57","author":"Y Zhang","year":"2016","journal-title":"Invest Ophthalmol Vis Sci"},{"issue":"12","key":"pone.0286019.ref031","doi-asserted-by":"crossref","first-page":"1843","DOI":"10.1007\/s00417-012-1994-8","article-title":"Impact of high myopia on the performance of SD-OCT parameters to detect glaucoma","volume":"250","author":"T Shoji","year":"2012","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"issue":"3","key":"pone.0286019.ref032","doi-asserted-by":"crossref","first-page":"2296","DOI":"10.1167\/iovs.12-10530","article-title":"Glaucoma detection ability of ganglion cell-inner plexiform layer thickness by spectral-domain optical coherence tomography in high myopia","volume":"54","author":"YJ Choi","year":"2013","journal-title":"Invest Ophthalmol Vis Sci"},{"issue":"12","key":"pone.0286019.ref033","doi-asserted-by":"crossref","first-page":"2498","DOI":"10.1016\/j.ophtha.2016.08.041","article-title":"Relationship between Optical Coherence Tomography Angiography Vessel Density and Severity of Visual Field Loss in Glaucoma","volume":"123","author":"A Yarmohammadi","year":"2016","journal-title":"Ophthalmology"},{"issue":"5","key":"pone.0286019.ref034","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1001\/jamaophthalmol.2018.0776","article-title":"Association of Myopia With Peripapillary Perfused Capillary Density in Patients With Glaucoma: An Optical Coherence Tomography Angiography Study","volume":"136","author":"Y Suwan","year":"2018","journal-title":"JAMA Ophthalmol"},{"issue":"3","key":"pone.0286019.ref035","doi-asserted-by":"crossref","first-page":"e010791","DOI":"10.1136\/bmjopen-2015-010791","article-title":"Is the peripapillary retinal perfusion related to myopia in healthy eyes? A prospective comparative study","volume":"6","author":"X Wang","year":"2016","journal-title":"BMJ Open"},{"issue":"1","key":"pone.0286019.ref036","doi-asserted-by":"crossref","first-page":"3027","DOI":"10.1038\/s41598-020-60051-0","article-title":"Diagnostic ability of vessel density measured by spectral-domain optical coherence tomography angiography for glaucoma in patients with high myopia.","volume":"10","author":"K Lee","year":"2020","journal-title":"Sci Rep"},{"issue":"5","key":"pone.0286019.ref037","article-title":"Relationship between vessel density and visual field sensitivity in glaucomatous eyes with high myopia","volume":"103","author":"JW Shin","year":"2018","journal-title":"Br J Ophthalmol"},{"issue":"8","key":"pone.0286019.ref038","doi-asserted-by":"crossref","first-page":"3655","DOI":"10.1167\/iovs.18-24283","article-title":"Diagnostic Accuracy of Three-Dimensional Neuroretinal Rim Thickness for Differentiation of Myopic Glaucoma From Myopia","volume":"59","author":"Y Kim","year":"2018","journal-title":"Invest Ophthalmol Vis Sci"},{"issue":"8","key":"pone.0286019.ref039","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1097\/IJG.0b013e31827b155b","article-title":"Diagnostic specificities of retinal nerve fiber layer optic nerve head. and macular ganglion cell-inner plexiform layer measurements in myopic eyes","volume":"23","author":"AA Aref","year":"2014","journal-title":"J Glaucoma"},{"issue":"8","key":"pone.0286019.ref040","doi-asserted-by":"crossref","first-page":"2660","DOI":"10.1167\/iovs.03-1363","article-title":"Lamina cribrosa thickness and spatial relationships between intraocular space and cerebrospinal fluid space in highly myopic eyes","volume":"45","author":"JB Jonas","year":"2004","journal-title":"Invest Ophthalmol Vis Sci"},{"issue":"5","key":"pone.0286019.ref041","doi-asserted-by":"crossref","first-page":"335","DOI":"10.3341\/kjo.2016.30.5.335","article-title":"Influence of Myopia on Size of Optic Nerve Head and Retinal Nerve Fiber Layer Thickness Measured by Spectral Domain Optical Coherence Tomography.","volume":"30","author":"SH Bae","year":"2016","journal-title":"Korean J Ophthalmol."},{"issue":"5","key":"pone.0286019.ref042","first-page":"791","article-title":"Diagnostic ability of ganglion cell complex thickness to detect glaucoma in high myopia eyes by Fourier domain optical coherence tomography","volume":"11","author":"WW Wang","year":"2018","journal-title":"Int J Ophthalmol"},{"key":"pone.0286019.ref043","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1016\/j.ophtha.2007.08.011","article-title":"Advanced Imaging for Glaucoma Study Group. Mapping of macular substructures with optical coherence tomography for glaucoma diagnosis","volume":"115","author":"O Tan","year":"2008","journal-title":"Ophthalmology"},{"issue":"5","key":"pone.0286019.ref044","doi-asserted-by":"crossref","first-page":"e213","DOI":"10.1097\/IJG.0000000000001834","article-title":"Evaluation of Retinal Nerve Fiber Layer, Ganglion Cell-Inner Plexiform Layer, and Optic Nerve Head in Glaucoma Suspects With Varying Myopia","volume":"30","author":"GD Miller","year":"2021","journal-title":"J Glaucoma"},{"issue":"2","key":"pone.0286019.ref045","first-page":"274","article-title":"Comparison of peripapillary retinal nerve fiber layer thickness between myopia severity groups and controls.","volume":"11","author":"ELM Tai","year":"2018","journal-title":"Int J Ophthalmol"},{"key":"pone.0286019.ref046","doi-asserted-by":"crossref","first-page":"33","DOI":"10.2147\/EB.S226319","article-title":"Ganglion Cell Complex Analysis in Glaucoma Patients: What Can It Tell Us?","volume":"12","author":"G Scuderi","year":"2020","journal-title":"Eye Brain."},{"issue":"3","key":"pone.0286019.ref047","doi-asserted-by":"crossref","first-page":"e010791","DOI":"10.1136\/bmjopen-2015-010791","article-title":"Is the peripapillary retinal perfusion related to myopia in healthy eyes? A prospective comparative study","volume":"6","author":"X Wang","year":"2016","journal-title":"BMJ Open"},{"key":"pone.0286019.ref048","doi-asserted-by":"crossref","first-page":"1587","DOI":"10.1007\/s00417-010-1407-9","article-title":"Ocular blood flow measurements in healthy human myopic eyes","volume":"248","author":"A Benavente-Perez","year":"2010","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol"},{"key":"pone.0286019.ref049","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.ajo.2016.10.018","article-title":"Retinal Microvascular Network and Microcirculation Assessments in High Myopia","volume":"174","author":"M Li","year":"2017","journal-title":"Am J Ophthalmol"},{"issue":"14","key":"pone.0286019.ref050","doi-asserted-by":"crossref","first-page":"6020","DOI":"10.1167\/iovs.16-19542","article-title":"Retinal Microvasculature Alteration in High Myopia","volume":"57","author":"Y Yang","year":"2016","journal-title":"Invest Ophthalmol Vis Sci"},{"issue":"2","key":"pone.0286019.ref051","doi-asserted-by":"crossref","first-page":"e013571","DOI":"10.1136\/bmjopen-2016-013571","article-title":"Vascular flow density in pathological myopia: an optical coherence tomography angiography study","volume":"7","author":"J Mo","year":"2017","journal-title":"BMJ Open"},{"issue":"10","key":"pone.0286019.ref052","doi-asserted-by":"crossref","first-page":"e0187160","DOI":"10.1371\/journal.pone.0187160","article-title":"Clinical features of superficial and deep peripapillary microvascular density in healthy myopic eyes.","volume":"12","author":"MS Sung","year":"2017","journal-title":"PLoS One"},{"issue":"1","key":"pone.0286019.ref053","doi-asserted-by":"crossref","first-page":"17866","DOI":"10.1038\/s41598-018-36279-2","article-title":"Repeatability and Reproducibility of Quantification of Superficial Peri-papillary Capillaries by four Different Optical Coherence Tomography Angiography Devices.","volume":"8","author":"J Lei","year":"2018","journal-title":"Sci Rep."},{"key":"pone.0286019.ref054","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1016\/j.ajo.2016.06.009","article-title":"Microvascular Density in Glaucomatous Eyes With Hemifield Visual Field Defects: An Optical Coherence Tomography Angiography Study","volume":"168","author":"T Akagi","year":"2016","journal-title":"Am J Ophthalmol"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0286019","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,6,23]],"date-time":"2023-06-23T13:16:57Z","timestamp":1687526217000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0286019"}},"subtitle":[],"editor":[{"given":"Sanjoy","family":"Bhattacharya","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2023,6,22]]},"references-count":54,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2023,6,22]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0286019","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,22]]}}}