{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T10:10:45Z","timestamp":1781518245907,"version":"3.54.1"},"reference-count":59,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2024,5,7]],"date-time":"2024-05-07T00:00:00Z","timestamp":1715040000000},"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>Diabetes mellitus continues to be a significant global public health concern, and it is currently a public health issue in developing nations. In Ethiopia, about three fourth of adult population with diabetes are unaware of their diabetic condition. However, there is a limited research on this specific topic particularly in the study area.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Objective<\/jats:title>\n<jats:p>To assess prevalence of undiagnosed diabetes mellitus and its associated factor among adult residents of Mizan Aman town, south West Ethiopia.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Methods and material<\/jats:title>\n<jats:p>A community-based cross-sectional study was conducted from May 23 to July 7, 2022, on 627 adult residents of Mizan Aman town. A multi stage sampling technique was used to obtain 646 study units. Interviewer-administered structured questionnaires were employed to gather socio-demographic and behavioral data. Anthropometric measurements were obtained and blood samples were taken from each participants. The fasting blood glucose level was measured after an 8-hour gap following a meal, using a digital glucometer to analyze a blood sample. Data were cleaned and entered into Epi-data v 3.1 and exported to SPSS v. 26 for analysis. Bi-variable analysis was done to select candidate variables and multivariable logistic regression model was fitted to identify independent predictors of undiagnosed diabetes mellitus. Adjusted odds ratio (AOR) with 95% CI was computed and variables with p-value &lt; 0.05 were declared to be predictors of undiagnosed diabetes mellitus.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Results<\/jats:title>\n<jats:p>The study revealed that, the overall magnitude of undiagnosed diabetes mellitus was 8.13% (95% CI: 6.1, 10.6). Predictors of undiagnosed diabetes mellitus were; physical activity level less than 600 Metabolic equivalent\/min per week (AOR = 3.39, 95%CI 1.08 to 10.66), family history of diabetes mellitus (AOR = 2.87, 95% CI 1.41, 5.85), current hypertension(AOR = 2.9, 95% CI 1.26, 6.69), fruit consumption of fewer than three servings per week(AOR = 2.64, 95% CI 1.18 to 5.92), and sedentary life(AOR = 3.33, 95% CI 1.63 to 6.79).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>The prevalence of undiagnosed diabetes mellitus was 8.13%. Physical inactivity, family history of diabetes mellitus, current hypertension, sedentary life, and fruit servings fewer than three per week were independent predictors of undiagnosed diabetes mellitus.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0302167","type":"journal-article","created":{"date-parts":[[2024,5,7]],"date-time":"2024-05-07T17:22:20Z","timestamp":1715102540000},"page":"e0302167","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":9,"title":["Prevalence of undiagnosed diabetes mellitus and associated factors among adult residents of Mizan Aman town, Southwest Ethiopia: Community-based cross-sectional study"],"prefix":"10.1371","volume":"19","author":[{"given":"Tsegaye","family":"Atrese","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lata","family":"Fekadu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7641-0151","authenticated-orcid":true,"given":"Guta","family":"Kune","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abel","family":"Shita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kifle","family":"Woldemikael","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,5,7]]},"reference":[{"issue":"Suppl 1","key":"pone.0302167.ref001","first-page":"224102","article-title":"Diabetes Mellitus and Other Categories of Description of Diabetes","volume":"28","author":"World Health Organisation (WHO)","year":"2005","journal-title":"World Health"},{"issue":"2","key":"pone.0302167.ref002","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1089\/pop.2009.12202","article-title":"The economic costs of undiagnosed diabetes","volume":"12","author":"Y. Zhang","year":"2009","journal-title":"Popul. Health Manag."},{"issue":"1","key":"pone.0302167.ref003","first-page":"6","volume":"164","author":"T. K. Young","year":"2001","journal-title":"Undiagnosed diabetes: Does it matter?"},{"key":"pone.0302167.ref004","unstructured":"IDF, IDF Diabetes Atlas 6th. 2021."},{"key":"pone.0302167.ref005","doi-asserted-by":"crossref","DOI":"10.1016\/j.diabres.2021.109118","article-title":"IDF diabetes Atlas: Global estimates of undiagnosed diabetes in adults for 2021","volume":"183","author":"K. Ogurtsova","year":"2022","journal-title":"Diabetes Res. Clin. Pract."},{"key":"pone.0302167.ref006","doi-asserted-by":"crossref","first-page":"107843","DOI":"10.1016\/j.diabres.2019.107843","article-title":"Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9th edition","volume":"157","author":"P. Saeedi","year":"2019","journal-title":"Diabetes Res. Clin. Pract."},{"issue":"4","key":"pone.0302167.ref007","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1016\/j.gheart.2017.11.001","article-title":"The Burden of Heart, Lung, and Blood Diseases in the United States, 1990 to 2016: Perspectives from the National Heart, Lung, and Blood Institute","volume":"12","author":"E. Coles","year":"2017","journal-title":"Glob. Heart"},{"key":"pone.0302167.ref008","doi-asserted-by":"crossref","first-page":"109118","DOI":"10.1016\/j.diabres.2021.109118","article-title":"IDF diabetes Atlas: Global estimates of undiagnosed diabetes in adults for 2021","volume":"183","author":"K. Ogurtsova","year":"2022","journal-title":"Diabetes Res. Clin. Pract."},{"key":"pone.0302167.ref009","unstructured":"N. H. (chair) et al. Cho, Eighth Edition 2017. 2017. [Online]. https:\/\/www.idf.org\/aboutdiabetes\/type-2-diabetes.html"},{"issue":"3","key":"pone.0302167.ref010","first-page":"250","article-title":"Complications and the time of diagnosis of diabetes mellitus in primary care","volume":"28","author":"D. N. Cortez","year":"2015","journal-title":"ACTA Paul. Enferm."},{"issue":"4","key":"pone.0302167.ref011","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1370\/afm.1816","article-title":"Erectile dysfunction and undiagnosed diabetes, hypertension, and hypercholesterolemia","volume":"13","author":"S. C. Skeldon","year":"2015","journal-title":"Ann. Fam. Med."},{"key":"pone.0302167.ref012","doi-asserted-by":"crossref","DOI":"10.1155\/2019\/4134937","article-title":"The burden of undiagnosed diabetes mellitus in adult african population: A systematic review and meta-analysis","volume":"2019","author":"D. Asmelash","year":"2019","journal-title":"J. Diabetes Res."},{"issue":"3","key":"pone.0302167.ref013","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1016\/j.diabres.2010.01.026","article-title":"Global healthcare expenditure on diabetes for 2010 and 2030","volume":"87","author":"P. Zhang","year":"2010","journal-title":"Diabetes Res. Clin. Pract."},{"key":"pone.0302167.ref014","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1471-2458-10-679","article-title":"Assessment of the direct medical costs of diabetes mellitus and its complications in the United Arab Emirates","volume":"10","author":"F. Al-Maskari","year":"2010","journal-title":"BMC Public Health"},{"key":"pone.0302167.ref015","unstructured":"R. B. Johnston, \u201c2030 Agenda for sustainable development,\u201d Arsen. Res. Glob. Sustain.\u2014Proc. 6th Int. Congr. Arsen. Environ. AS 2016, pp. 12\u201314, 2016."},{"key":"pone.0302167.ref016","unstructured":"\u201cNoncommunicable diseases.\u201d Accessed: Mar. 07, 2022. [Online]. https:\/\/www.who.int\/teams\/surveillance-of-noncommunicable-diseases\/about\/ncds"},{"key":"pone.0302167.ref017","unstructured":"World Health Organization, \u201cPrevention and control of noncommunicable diseases: implementation of the global strategy Report by the Secretariat- Sixty-First World Health Assembly,\u201d World Heal. Assem., no. April 2009, pp. 1\u201321, 2010, [Online]. http:\/\/apps.who.int\/gb\/ebwha\/pdf_files\/A61\/A61_8-en.pdf?ua=1"},{"key":"pone.0302167.ref018","unstructured":"WHO, Draft Updated Appendix 3 To the Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013\u20132020, vol. 300, no. October 2016. 2017. [Online]. http:\/\/apps.who.int\/gb\/ebwha\/pdf_files\/EB140\/B140_27-en.pdf?ua=1%0Ahttp:\/\/apps.who.int\/gb\/ebwha\/pdf_files\/EB140\/B140_27-en.pdf"},{"key":"pone.0302167.ref019","unstructured":"WHO, \u201cMonitoring noncommunicable disease commitments in Europe,\u201d World Heal. Organ., 2017, [Online]. https:\/\/www.euro.who.int\/__data\/assets\/pdf_file\/0005\/351518\/Monitoring-NCD.pdf?ua=1"},{"key":"pone.0302167.ref020","unstructured":"FMOH, \u201cEthiopian Health Sector Transformation Plan.2015\/16\u20132019\/20,\u201d Fed. Democr. Repub. Ethiop. Minist. Heal., vol. 20, no. May, p. 50, 2015."},{"key":"pone.0302167.ref021","unstructured":"Vladislav Dombrovskiy, A. Workneh, F. Shiferaw, R. Small, and N. Banatvala, \u201cPrevention and control of noncommunicable diseases in Ethiopia: The case for investment, including considerations on the impact of khat,\u201d 2019."},{"issue":"1","key":"pone.0302167.ref022","first-page":"677","article-title":"Undiagnosed Type 2 Diabetes Mellitus and Its Risk Factors Among Malaysians: National Health and Morbidity Survey, 2011","volume":"6","author":"H. Ismail","year":"2016","journal-title":"Int. J. Public Health"},{"key":"pone.0302167.ref023","first-page":"4","volume":"6","author":"A. T. Wondemagegn","year":"2017","journal-title":"Undiagnosed diabetes mellitus and related factors in East Gojjam (NW Ethiopia) in 2016: a community-based study"},{"issue":"1","key":"pone.0302167.ref024","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13104-017-2571-3","article-title":"The prevalence of impaired fasting glucose and undiagnosed diabetes mellitus and associated risk factors among adults living in a rural Koladiba town, northwest Ethiopia","volume":"10","author":"A. Worede","year":"2017","journal-title":"BMC Res. Notes"},{"key":"pone.0302167.ref025","doi-asserted-by":"crossref","first-page":"2925","DOI":"10.2147\/DMSO.S269386","article-title":"The hidden burden of diabetes mellitus in an urban community of southwest ethiopia","volume":"13","author":"T. T. Yunka","year":"2020","journal-title":"Diabetes, Metab. Syndr. Obes. Targets Ther"},{"key":"pone.0302167.ref026","unstructured":"\u201cS\/N\/N\/P\/R\/Government Bench Sheko Zone Health Department, Mizan Aman Health Office 2014 plan, June, 2013.\u201d"},{"issue":"10","key":"pone.0302167.ref027","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1136\/bmjopen-2019-030158","article-title":"Prevalence of undiagnosed diabetes mellitus and associated factors among adult residents of Bahir Dar city, northwest Ethiopia: a community-based cross-sectional study","volume":"9","author":"G. M. Bantie","year":"2019","journal-title":"BMJ Open"},{"issue":"1","key":"pone.0302167.ref028","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/0304-3835(93)90215-U","article-title":"The cellular composition in the peritoneal cavity and the cytotoxic function of the peritoneal cells from patients with ovarian cancer; effect of tumor necrosis factor-\u03b1 treatment","volume":"68","author":"C. D. Richters","year":"1993","journal-title":"Cancer Lett."},{"key":"pone.0302167.ref029","unstructured":"C. B. Weir and A. Jan, \u201cBMI Classification Percentile And Cut Off Points,\u201d StatPearls, no. November, 2019, [Online]. http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/31082114"},{"issue":"1","key":"pone.0302167.ref030","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13104-018-3136-9","article-title":"Optimal waist circumference cut-off points for predicting metabolic syndrome among low-income black South African adults","volume":"11","author":"E. O. Owolabi","year":"2018","journal-title":"BMC Res. Notes"},{"issue":"C","key":"pone.0302167.ref031","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/S0167-7306(09)60009-0","article-title":"Membrane-bound enzymes","volume":"1","author":"R. B. Freedman","year":"1981","journal-title":"New Compr. Biochem."},{"issue":"2","key":"pone.0302167.ref032","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1007\/s00125-002-1025-0","article-title":"High prevalence of undiagnosed diabetes mellitus in Southern Germany: Target populations for efficient screening. The KORA survey 2000","volume":"46","author":"W. Rathmann","year":"2003","journal-title":"Diabetologia"},{"issue":"2","key":"pone.0302167.ref033","doi-asserted-by":"crossref","first-page":"1931","DOI":"10.1007\/s40200-020-00635-9","article-title":"A systematic analysis on prevalence and sub-regional distribution of undiagnosed diabetes mellitus among adults in African countries","volume":"19","author":"G. Dessie","year":"2020","journal-title":"J. Diabetes Metab. Disord."},{"key":"pone.0302167.ref034","doi-asserted-by":"crossref","first-page":"205031212097523","DOI":"10.1177\/2050312120975235","article-title":"Prevalent, uncontrolled, and undiagnosed diabetes mellitus among urban adults in Dire Dawa, Eastern Ethiopia: A population-based cross-sectional study","volume":"8","author":"B. H. Ayele","year":"2020","journal-title":"SAGE Open Med."},{"issue":"1","key":"pone.0302167.ref035","first-page":"1","article-title":"Magnitude of undiagnosed diabetes mellitus and Associated Factors among Middle Aged Urban Residents of West Ethiopia","volume":"7","author":"A. Alemu","year":"2021","journal-title":"J. Obes. Weight. Medicat."},{"issue":"1","key":"pone.0302167.ref036","first-page":"677","article-title":"Undiagnosed Type 2 Diabetes Mellitus and Its Risk Factors Among Malaysians: National Health and Morbidity Survey, 2011","volume":"6","author":"H. Ismail","year":"2016","journal-title":"Int. J. Public Heal. Res."},{"key":"pone.0302167.ref037","first-page":"1","article-title":"Prevalence of Undiagnosed Diabetes Mellitus and its Risk Factors in Selected Institutions at Bishoftu Town, East Shoa, Ethiopia","author":"Y. C. M. Mistire Wolde Gebre","year":"2013","journal-title":"J. Diabetes Metab."},{"issue":"1","key":"pone.0302167.ref038","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41598-021-03669-y","article-title":"Undiagnosed diabetes mellitus and associated factors among adults in Ethiopia: a systematic review and meta-analysis","volume":"11","author":"G. Y. Yitbarek","year":"2021","journal-title":"Sci. Rep."},{"issue":"May","key":"pone.0302167.ref039","doi-asserted-by":"crossref","first-page":"139","DOI":"10.2147\/DMSO.S59652","article-title":"Prevalence of diagnosed and undiagnosed diabetes mellitus in adults aged 19 years and older in Basrah, Iraq","volume":"7","author":"A. A. Mansour","year":"2014","journal-title":"Diabetes, Metab. Syndr. Obes. Targets Ther."},{"issue":"1","key":"pone.0302167.ref040","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/j.diabres.2009.02.003","article-title":"Prevalence of diagnosed and undiagnosed diabetes mellitus and its risk factors in a population-based study of Qatar","volume":"84","author":"A. Bener","year":"2009","journal-title":"Diabetes Res. Clin. Pract."},{"key":"pone.0302167.ref041","unstructured":"A. Now and R. Course, \u201cThe Growing Danger of Non-Communicable Diseases Acting Now to Reverse Course,\u201d no. September, 2011."},{"issue":"2","key":"pone.0302167.ref042","first-page":"1","volume":"4","author":"S. Zenu","year":"2022","journal-title":"Prevalence of Undiagnosed Diabetes Mellitus and Associated Factors in Adults in Mettu Town, Southwest Ethiopia: Community Based Cross Sectional Study"},{"issue":"2","key":"pone.0302167.ref043","first-page":"222","article-title":"Prevalence of Undiagnosed Type 2 Diabetes and its Associated Risk Factors in Rural Population of Tamil Nadu","volume":"11","author":"R. Subramani","year":"2014","journal-title":"World J. Med. Sci."},{"issue":"1","key":"pone.0302167.ref044","doi-asserted-by":"crossref","first-page":"144","DOI":"10.26719\/1997.3.1.144","article-title":"Diabetes mellitus in Egypt: Risk factors, prevalence and future burden","volume":"3","author":"W. H. Herman","year":"1997","journal-title":"Eastern Mediterranean Health Journal"},{"key":"pone.0302167.ref045","doi-asserted-by":"crossref","first-page":"247","DOI":"10.2147\/DMSO.S126314","article-title":"Diabetes in sub-Saharan Africa\u2014from policy to practice to progress: Targeting the existing gaps for future care for diabetes","volume":"10","author":"S. D. Pastakia","year":"2017","journal-title":"Diabetes, Metab. Syndr. Obes. Targets Ther."},{"issue":"12","key":"pone.0302167.ref046","doi-asserted-by":"crossref","DOI":"10.2337\/dc10-1548","article-title":"Exercise and type 2 diabetes: The American College of Sports Medicine and the American Diabetes Association: Joint position statement","volume":"33","author":"S. R. Colberg","year":"2010","journal-title":"Diabetes Care"},{"issue":"11","key":"pone.0302167.ref047","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1046\/j.1464-5491.1999.00185.x","article-title":"Modifiable risk factors for Type 2 diabetes mellitus in a peri-urban community in South Africa","volume":"16","author":"N. S. Levitt","year":"1999","journal-title":"Diabet. Med."},{"issue":"5","key":"pone.0302167.ref048","first-page":"1","article-title":"Prevalence and Determinants of Modifiable Risk Factors for Chronic Non-Communicable Diseases among Adults in Mizan-Aman Town, Ethiopia: A Community Based Cross Sectional Study","volume":"3","author":"T. E. Yarinbab","year":"2018","journal-title":"Juniper Online J. Public Heal."},{"issue":"4","key":"pone.0302167.ref049","first-page":"379","article-title":"Association between time spent sitting and diabetes mellitus in older adults: A population-based study","volume":"17","author":"R. D. C. Da Silva","year":"2015","journal-title":"Rev. Bras. Cineantropometria e Desempenho Hum."},{"issue":"1","key":"pone.0302167.ref050","volume":"20","author":"E. Mutebi","year":"2012","journal-title":"Diabetes 2 in Uganda"},{"issue":"8","key":"pone.0302167.ref051","doi-asserted-by":"crossref","first-page":"1872","DOI":"10.2337\/dc05-2141","article-title":"A risk score for predicting incident diabetes in the Thai population","volume":"29","author":"W. Aekplakorn","year":"2006","journal-title":"Diabetes Care"},{"key":"pone.0302167.ref052","first-page":"2005","volume":"i","author":"C. O. Zein","journal-title":"Chronic Hepatitis C and Type II Diabetes Mellitus: A Prospective Cross-Sectional Study"},{"issue":"27","key":"pone.0302167.ref053","first-page":"3427","volume":"16","author":"S. Rouabhia","year":"2010","journal-title":"Prevalence of type 2 diabetes in Algerian patients with hepatitis C virus infection"},{"issue":"2","key":"pone.0302167.ref054","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1002\/(SICI)1096-9136(199802)15:2<164::AID-DIA536>3.0.CO;2-A","article-title":"A high prevalence of diabetes mellitus and impaired glucose tolerance in the Danagla community in Northern Sudan","volume":"15","author":"M. N. Elbagir","year":"1998","journal-title":"Diabet. Med"},{"issue":"4","key":"pone.0302167.ref055","first-page":"216","article-title":"Prevalence and predictors of undiagnosed diabetes mellitus in Indonesia","volume":"42","author":"L. A. Pramono","year":"2010","journal-title":"Acta Med. Indones."},{"issue":"6","key":"pone.0302167.ref056","first-page":"389","article-title":"Hypertension with diabetes mellitus: physiology and pathology","volume":"41","author":"M. Ohishi","year":"2018","journal-title":"Hypertens. Res. 2018 416"},{"key":"pone.0302167.ref057","unstructured":"Du H, Li L, Bennett D, Guo Y, Turnbull I, and Yang L, \u201cFresh fruit consumption in relation to incident diabetes and diabetic vascular complications. PLoS Med [revista en Internet] 2017 [acceso 2 de noviembre de 2021]; 14(4): 1\u201319.,\u201d vol. 300, pp. 1\u201319, 2017, [Online]. https:\/\/journals.plos.org\/plosmedicine\/article?id=10.1371\/journal.pmed.1002279"},{"issue":"3","key":"pone.0302167.ref058","article-title":"Health-promoting components of fruits and vegetables in the diet","volume":"4","author":"R. H. Liu","year":"2013","journal-title":"Adv. Nutr"},{"key":"pone.0302167.ref059","unstructured":"\u201cHealthy diet.\u201d Accessed: Jul. 28, 2022. [Online]. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/healthy-diet"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0302167","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,7]],"date-time":"2024-05-07T17:23:00Z","timestamp":1715102580000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0302167"}},"subtitle":[],"editor":[{"given":"Mohammed Hasen","family":"Badeso","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2024,5,7]]},"references-count":59,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2024,5,7]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0302167","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,7]]}}}