{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T21:52:38Z","timestamp":1790113958562,"version":"4.0.1"},"reference-count":60,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2024,11,25]],"date-time":"2024-11-25T00:00:00Z","timestamp":1732492800000},"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>Cognitive impairment (CI) in HIV is often of multifactorial causation, and remains a prominent issue in the age of effective combination antiretroviral therapy (cART), affecting approximately 14% of people living with HIV. Despite the 2018 BHIVA directive stating the importance of commencing rehabilitation strategies in people living with HIV with CI, no types of cognitive rehabilitations or other non-pharmaceutical interventions are specifically recommended. This scoping review aimed to describe the types of and evidence relating to the non-pharmaceutical interventions which have been examined in people living with HIV with CI.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Studies were identified from five electronic databases. Criteria for study inclusion were studies describing a non-pharmaceutical intervention published after 1st January 2000 in English, in a population of adults living with HIV with CI detected at baseline, without significant psychiatric or substance-misuse co-morbidity.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Fourteen studies met the criteria for inclusion, with the Frascati criteria most commonly used to define CI within participant populations. The median intervention length was 12 weeks (IQR = 6.5). Nine studies investigated interventions with some component of computerised cognitive training (CCT); other interventions included diet, exercise and goal management training. Studies most commonly examined neurocognitive outcomes, but also considered other outcomes including quality of life, depressive symptomatology, intervention acceptability and cART adherence. Eight studies observed improvement in cognition with CCT, with effects often maintained for several weeks post-intervention, however, results were not always statistically significant. Self-reported cognitive improvement and intervention acceptability was high amongst participants completing CCT.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>There was heterogeneity across studies not only in intervention type, but in diagnostic tools used, the chosen outcome measures and cognitive batteries, making comparison difficult. Findings, however, indicate that CCT interventions may produce benefits in cognition and are acceptable to patients. Further research is required in larger samples, alongside identifying specific intervention components that improve outcomes.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0314185","type":"journal-article","created":{"date-parts":[[2024,11,25]],"date-time":"2024-11-25T18:36:28Z","timestamp":1732559788000},"page":"e0314185","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":6,"title":["Non-pharmaceutical interventions for people living with HIV with cognitive impairment: A scoping review"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9612-0389","authenticated-orcid":true,"given":"Lucinda","family":"Stuart","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Alford","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie H.","family":"Vera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,11,25]]},"reference":[{"issue":"11","key":"pone.0314185.ref001","doi-asserted-by":"crossref","first-page":"1120","DOI":"10.1093\/cid\/cir627","article-title":"Premature age-related comorbidities among HIV-infected persons compared with the general population","volume":"53","author":"G. Guaraldi","year":"2011","journal-title":"Clinical infectious diseases"},{"issue":"2","key":"pone.0314185.ref002","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1007\/s13365-017-0556-6","article-title":"Changing clinical phenotypes of HIV-associated neurocognitive disorders","volume":"24","author":"N. Sacktor","year":"2018","journal-title":"Journal of neurovirology"},{"issue":"1","key":"pone.0314185.ref003","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1186\/s12879-016-1970-8","article-title":"Defining cognitive impairment in people-living-with-HIV: the POPPY study.","volume":"16","author":"D. De Francesco","year":"2016","journal-title":"BMC Infect Dis"},{"key":"pone.0314185.ref004","volume-title":"in Seminars in hearing.","author":"D.L. Murman","year":"2015"},{"issue":"5","key":"pone.0314185.ref005","first-page":"423","article-title":"Neurocognition and the aging brain in people with HIV: implications for screening.","volume":"29","author":"P. Chan","year":"2021","journal-title":"Topics in antiviral medicine"},{"issue":"7","key":"pone.0314185.ref006","doi-asserted-by":"crossref","first-page":"810","DOI":"10.1016\/S1473-3099(15)00056-0","article-title":"Future challenges for clinical care of an ageing population infected with HIV: a modelling study","volume":"15","author":"M. Smit","year":"2015","journal-title":"Lancet Infect Dis"},{"issue":"18","key":"pone.0314185.ref007","doi-asserted-by":"crossref","first-page":"1789","DOI":"10.1212\/01.WNL.0000287431.88658.8b","article-title":"Updated research nosology for HIV-associated neurocognitive disorders","volume":"69","author":"A. Antinori","year":"2007","journal-title":"Neurology"},{"key":"pone.0314185.ref008","article-title":"Cognitive impairment in people living with HIV: mechanisms, controversies, and future perspectives","author":"C.D. Moschopoulos","year":"2024","journal-title":"Trends in Molecular Medicine"},{"key":"pone.0314185.ref009","first-page":"1","article-title":"Cognitive impairment in people living with HIV: consensus recommendations for a new approach","author":"S. Nightingale","year":"2023","journal-title":"Nature Reviews Neurology"},{"issue":"2","key":"pone.0314185.ref010","doi-asserted-by":"crossref","DOI":"10.3390\/brainsci9020037","article-title":"Assessment and Management of HIV-Associated Cognitive Impairment: Experience from a Multidisciplinary Memory Service for People Living with HIV","volume":"9","author":"K. Alford","year":"2019","journal-title":"Brain Sci"},{"key":"pone.0314185.ref011","volume-title":"The CHARTER Group prevalence and predictors of neuro cognitive decline over 18 to 42 months: CHARTER Longitudinal Study","author":"R.D. Heaton","year":"2012"},{"key":"pone.0314185.ref012","unstructured":"Rhodes, S., et al., Cognitive trajectories among people living with HIV attending a dedicated memory clinic for people living with HIV, in European AIDS Clinical Society (EACS). 2023: Warsaw, Poland."},{"key":"pone.0314185.ref013","first-page":"517","article-title":"Clinical treatment options and randomized clinical trials for neurocognitive complications of HIV infection: combination antiretroviral therapy, central nervous system penetration effectiveness, and adjuvants.","author":"S.-P. Lin","year":"2021","journal-title":"Neurocognitive Complications of HIV-Infection: Neuropathogenesis to Implications for Clinical Practice"},{"issue":"1","key":"pone.0314185.ref014","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41746-023-00987-5","article-title":"Computerized cognitive training for memory functions in mild cognitive impairment or dementia: a systematic review and meta-analysis.","volume":"7","author":"A.T. Chan","year":"2024","journal-title":"NPJ Digital Medicine"},{"issue":"9","key":"pone.0314185.ref015","doi-asserted-by":"crossref","first-page":"1305","DOI":"10.1016\/j.jalz.2018.07.219","article-title":"Whitepaper: Defining and investigating cognitive reserve, brain reserve, and brain maintenance.","volume":"16","author":"Y. Stern","year":"2020","journal-title":"Alzheimer\u2019s & Dementia"},{"issue":"2","key":"pone.0314185.ref016","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1093\/cercor\/bht234","article-title":"Neural mechanisms of brain plasticity with complex cognitive training in healthy seniors","volume":"25","author":"S.B. Chapman","year":"2015","journal-title":"Cerebral cortex"},{"issue":"1","key":"pone.0314185.ref017","first-page":"2358724","article-title":"Understanding the lived experience research priorities for improving health-related quality of life in people living with HIV with cognitive impairment.","volume":"25","author":"K. Alford","year":"2024","journal-title":"HIV Research & Clinical Practice"},{"key":"pone.0314185.ref018","first-page":"1","article-title":"\u201cA fog that impacts everything\u201d: a qualitative study of health-related quality of life in people living with HIV who have cognitive impairment.","author":"K. Alford","year":"2022","journal-title":"Quality of Life Research"},{"issue":"5","key":"pone.0314185.ref019","doi-asserted-by":"crossref","first-page":"e0251944","DOI":"10.1371\/journal.pone.0251944","article-title":"Quality of life in people living with HIV-associated neurocognitive disorder: A scoping review study.","volume":"16","author":"K. Alford","year":"2021","journal-title":"PLoS One"},{"key":"pone.0314185.ref020","volume":"British","author":"BHIVA","year":"2018","journal-title":"HIV Association Standards of Care for People Living with HIV 2018"},{"key":"pone.0314185.ref021","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1007\/s11904-020-00515-0","article-title":"Cognitive and neurologic rehabilitation strategies for central nervous system HIV infection","volume":"17","author":"T. Chan","year":"2020","journal-title":"Current HIV\/AIDS Reports"},{"issue":"1","key":"pone.0314185.ref022","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1080\/1364557032000119616","article-title":"Scoping studies: towards a methodological framework.","volume":"8","author":"H Arksey","year":"2005","journal-title":"Int J Soc Res Methodol."},{"issue":"7","key":"pone.0314185.ref023","doi-asserted-by":"crossref","first-page":"467","DOI":"10.7326\/M18-0850","article-title":"PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation.","volume":"169","author":"AC Tricco","year":"2018","journal-title":"Ann Intern Med"},{"issue":"11","key":"pone.0314185.ref024","doi-asserted-by":"crossref","first-page":"1798","DOI":"10.3390\/pharmaceutics13111798","article-title":"Past HIV-1 medications and the current status of combined antiretroviral therapy options for HIV-1 patients.","volume":"13","author":"M Weichseldorfer","year":"2021","journal-title":"Pharmaceutics"},{"issue":"5","key":"pone.0314185.ref025","first-page":"581","article-title":"Perceived Improvement and Satisfaction With Training After Individualized-Targeted Computerized Cognitive Training in Adults With HIV-Associated Neurocognitive Disorder Living in Alabama: A Descriptive Cross-sectional Study.","volume":"33","author":"JY Byun","year":"2022","journal-title":"J Assoc Nurses AIDS Care"},{"issue":"11","key":"pone.0314185.ref026","doi-asserted-by":"crossref","first-page":"1269","DOI":"10.3390\/nu9111269","article-title":"Impact of high-dose multi-strain probiotic supplementation on neurocognitive performance and central nervous system immune activation of HIV-1 infected individuals.","volume":"9","author":"G Ceccarelli","year":"2017","journal-title":"Nutrients"},{"issue":"5","key":"pone.0314185.ref027","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1097\/JNC.0000000000000339","article-title":"Immediate and Long-Term Effects of a Computerized Cognitive Rehabilitation Therapy on Cognitive Function in People Living with HIV in Iran: A Single-Blind Two-Arm Parallel Randomized Controlled Trial.","volume":"33","author":"MS Etesami","year":"2022","journal-title":"J Assoc Nurses AIDS Care"},{"issue":"1","key":"pone.0314185.ref028","first-page":"19","article-title":"Examining the effectiveness of a cognitive intervention to improve cognitive function in a population of older adults living with HIV: a pilot study.","volume":"5","author":"JA Frain","year":"2018","journal-title":"Ther Adv Infect Dis.Jan"},{"issue":"4","key":"pone.0314185.ref029","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1016\/j.jana.2016.01.001","article-title":"Preliminary Findings Describing Participant Experience With iSTEP, an mHealth Intervention to Increase Physical Activity and Improve Neurocognitive Function in People Living With HIV.","volume":"27","author":"BL Henry","year":"2016","journal-title":"J Assoc Nurses AIDS Care"},{"issue":"6","key":"pone.0314185.ref030","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1016\/j.jana.2017.06.011","article-title":"The Potential of Computerized Cognitive Training on HIV-Associated Neurocognitive Disorder: A Case Comparison Study.","volume":"28","author":"S Hossain","year":"2017","journal-title":"J Assoc Nurses AIDS Care"},{"key":"pone.0314185.ref031","doi-asserted-by":"crossref","first-page":"101023","DOI":"10.1016\/j.conctc.2022.101023","article-title":"Efficacy potential of Goal Management Training to improve cognitive function in older people living with HIV.","volume":"30","author":"NE Mayo","year":"2022","journal-title":"Contemp Clin Trials Commun."},{"issue":"3","key":"pone.0314185.ref032","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1097\/JNC.0000000000000110","article-title":"Cognitive Effects of a Ketogenic Diet on Neurocognitive Impairment in Adults Aging With HIV: A Pilot Study.","volume":"31","author":"SA Morrison","year":"2020","journal-title":"J Assoc Nurses AIDS Care"},{"issue":"12","key":"pone.0314185.ref033","doi-asserted-by":"crossref","first-page":"1601","DOI":"10.1177\/02692155221114587","article-title":"Aerobic exercise for HIV-associated neurocognitive disorders in individuals on antiretroviral therapy: A randomised controlled trial.","volume":"36","author":"M Nweke","year":"2022","journal-title":"Clin Rehabil."},{"key":"pone.0314185.ref034","doi-asserted-by":"crossref","first-page":"2745","DOI":"10.2147\/NDT.S120282","article-title":"A pilot study of cognitive training with and without transcranial direct current stimulation to improve cognition in older persons with HIV-related cognitive impairment.","volume":"12","author":"RL Ownby","year":"2016","journal-title":"Neuropsychiatr Dis Treat."},{"key":"pone.0314185.ref035","doi-asserted-by":"crossref","first-page":"766311","DOI":"10.3389\/fnagi.2021.766311","article-title":"Computer-Delivered Cognitive Training and Transcranial Direct Current Stimulation in Patients With HIV-Associated Neurocognitive Disorder: A Randomized Trial.","volume":"13","author":"RL Ownby","year":"2021","journal-title":"Front Aging Neurosci."},{"issue":"4","key":"pone.0314185.ref036","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1016\/j.jana.2017.03.007","article-title":"The Acceptability and Potential Utility of Cognitive Training to Improve Working Memory in Persons Living With HIV: A Preliminary Randomized Trial.","volume":"28","author":"SL Towe","year":"2017","journal-title":"J Assoc Nurses AIDS Care"},{"issue":"12","key":"pone.0314185.ref037","doi-asserted-by":"crossref","first-page":"3898","DOI":"10.1007\/s10461-021-03230-y","article-title":"Can Individualized-Targeted Computerized Cognitive Training Benefit Adults with HIV-Associated Neurocognitive Disorder? The Training on Purpose Study (TOPS).","volume":"25","author":"DE Vance","year":"2021","journal-title":"AIDS Behav"},{"issue":"2","key":"pone.0314185.ref038","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1080\/13854046.2023.2212867","article-title":"A 2-year longitudinal randomized controlled trial examining the transfer of speed of processing training to secondary cognitive domains in middle-aged and older adults with HIV-associated neurocognitive disorder: Results of the think fast study.","volume":"38","author":"DE Vance","year":"2024","journal-title":"Clinical Neuropsychol."},{"issue":"3","key":"pone.0314185.ref039","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1007\/s41465-021-00209-4","article-title":"Computerized cognitive training: a review of mechanisms, methodological considerations, and application to research in depression.","volume":"5","author":"A Grinberg","year":"2021","journal-title":"J Cogn Enhanc."},{"issue":"3","key":"pone.0314185.ref040","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1097\/YCT.0000000000000510","article-title":"Physiology of transcranial direct current stimulation.","volume":"34","author":"CJ Stagg","year":"2018","journal-title":"J ECT."},{"issue":"10","key":"pone.0314185.ref041","doi-asserted-by":"crossref","first-page":"1569","DOI":"10.1080\/09602011.2018.1438294","article-title":"Effectiveness of goal management training\u00ae in improving executive functions: A meta-analysis.","volume":"29","author":"V Stamenova","year":"2019","journal-title":"Neuropsychol Rehabil."},{"issue":"9","key":"pone.0314185.ref042","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1016\/j.jagp.2020.05.023","article-title":"Targeting Cognitive Control Deficits With Neuroplasticity-Based Computerized Cognitive Remediation in Patients With Geriatric Major Depression: A Randomized, Double-Blind, Controlled Trial.","volume":"28","author":"SS Morimoto","year":"2020","journal-title":"Am J Geriatr Psychiatry."},{"issue":"4","key":"pone.0314185.ref043","first-page":"603","article-title":"Speed of processing training results in lower risk of dementia.","volume":"3","author":"JD Edwards","year":"2017","journal-title":"Alzheimers Dement."},{"key":"pone.0314185.ref044","doi-asserted-by":"crossref","first-page":"1287822","DOI":"10.3389\/fpsyt.2023.1287822","article-title":"Effect of computerized cognitive training on mood, cognition, and serum brain-derived neurotrophic factor level in late-life depression\u2014a pilot randomized controlled trial.","volume":"14","author":"SL Ma","year":"2024","journal-title":"Front Psychiatry."},{"issue":"1","key":"pone.0314185.ref045","article-title":"Computerized cognitive training for memory functions in mild cognitive impairment or dementia: a systematic review and meta-analysis.","volume":"7","author":"ATC Chan","year":"2024","journal-title":"NPJ Digit Med."},{"issue":"8 0","key":"pone.0314185.ref046","first-page":"3S","article-title":"The ACTIVE Study: Study Overview and Major Findings.","volume":"25","author":"S Tented","year":"2013","journal-title":"J Aging Health."},{"issue":"1","key":"pone.0314185.ref047","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s11920-014-0530-4","article-title":"Depression in HIV infected patients: a review.","volume":"17","author":"MG Nanni","year":"2015","journal-title":"Curr Psychiatry Rep."},{"issue":"8","key":"pone.0314185.ref048","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1080\/13803395.2014.943696","article-title":"Effects of information processing speed on learning, memory, and executive functioning in people living with HIV\/AIDS","volume":"36","author":"RP Fellows","year":"2014","journal-title":"J Clin Exp Neuropsychol"},{"issue":"3","key":"pone.0314185.ref049","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1007\/s13365-014-0240-z","article-title":"An active lifestyle is associated with better neurocognitive functioning in adults living with HIV infection","volume":"20","author":"PL Fazeli","year":"2014","journal-title":"J Neurovirol"},{"issue":"8","key":"pone.0314185.ref050","doi-asserted-by":"crossref","first-page":"1470","DOI":"10.1007\/s10461-015-1024-z","article-title":"Physical Activity is Associated with Better Neurocognitive and Everyday Functioning Among Older Adults with HIV Disease","volume":"19","author":"PL Fazeli","year":"2015","journal-title":"AIDS Behav"},{"issue":"5","key":"pone.0314185.ref051","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1007\/s13365-013-0184-8","article-title":"Physical exercise is associated with less neurocognitive impairment among HIV-infected adults","volume":"19","author":"CA Dufour","year":"2013","journal-title":"J Neurovirol"},{"issue":"6","key":"pone.0314185.ref052","doi-asserted-by":"crossref","first-page":"311","DOI":"10.14336\/AD.2013.0400311","article-title":"Poor Aerobic Fitness May Contribute to Cognitive Decline in HIV-infected Older Adults.","volume":"4","author":"M Mapstone","year":"2013","journal-title":"Aging Dis."},{"issue":"16","key":"pone.0314185.ref053","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1136\/bjsports-2021-104955","article-title":"Effects of exercise training on the cognitive function of older adults with different types of dementia: a systematic review and meta-analysis.","volume":"56","author":"GM Balbim","year":"2022","journal-title":"Br J Sports Med."},{"key":"pone.0314185.ref054","doi-asserted-by":"crossref","first-page":"1012076","DOI":"10.3389\/fnut.2022.1012076","article-title":"Can probiotics mitigate age-related neuroinflammation leading to improved cognitive outcomes?","volume":"9","author":"R. Anderson","year":"2022","journal-title":"Frontiers in Nutrition"},{"key":"pone.0314185.ref055","doi-asserted-by":"crossref","first-page":"102233","DOI":"10.1016\/j.arr.2024.102233","article-title":"Role of ketogenic diet in neurodegenerative diseases focusing on Alzheimer diseases: The guardian angle.","volume":"95","author":"HM Al-kuraishy","year":"2024","journal-title":"Ageing Res Rev."},{"issue":"6","key":"pone.0314185.ref056","doi-asserted-by":"crossref","first-page":"1352","DOI":"10.1080\/13854046.2020.1824280","article-title":"Objective and subjective sleep measures are associated with neurocognition in aging adults with and without HIV.","volume":"36","author":"LM Campbell","year":"2022","journal-title":"Clin Neuropsychol."},{"issue":"5","key":"pone.0314185.ref057","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1016\/j.jana.2017.06.002","article-title":"Feedback on a Multimodal Cognitive Intervention for Adults Aging With HIV: A Focus Group Study.","volume":"28","author":"DE Vance","year":"2017","journal-title":"J Assoc Nurses AIDS Care"},{"issue":"1","key":"pone.0314185.ref058","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1186\/s12916-016-0640-4","article-title":"Beyond viral suppression of HIV\u2014the new quality of life frontier","volume":"14","author":"J.V. Lazarus","year":"2016","journal-title":"BMC Med"},{"key":"pone.0314185.ref059","year":"2014","journal-title":"UNAIDS 90-90-90\u2014An ambitious treatment target to help end the AIDS epidemic"},{"key":"pone.0314185.ref060","author":"JBI Manual for Evidence Synthesis","journal-title":"Chapter 11: Scoping reviews [Internet]."}],"updated-by":[{"DOI":"10.1371\/journal.pone.0330546","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T00:00:00Z","timestamp":1755561600000}}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0314185","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,25]],"date-time":"2024-11-25T18:36:43Z","timestamp":1732559803000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0314185"}},"subtitle":[],"editor":[{"given":"Lucette A.","family":"Cysique","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2024,11,25]]},"references-count":60,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2024,11,25]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0314185","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,25]]}}}