{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T05:06:43Z","timestamp":1781586403281,"version":"3.54.5"},"reference-count":56,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T00:00:00Z","timestamp":1752710400000},"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=\"sec022\">\n<jats:title>Background<\/jats:title>\n<jats:p>Fatigue is a prevalent symptom in people with Multiple Sclerosis, but evidence for the effectiveness of telemedicine in treating this symptom remains incomplete. Despite favorable clinical trial results, its integration into practice and systematic evaluation is limited.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec023\">\n<jats:title>Objective<\/jats:title>\n<jats:p>The purpose of this research project is to carefully assess how well telemedicine works for managing fatigue in MS patients.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec024\">\n<jats:title>Methods<\/jats:title>\n<jats:p>This scoping review adhered to the Joanna Briggs Institute methodological framework and followed the preferred reporting items for systematic reviews and meta-Analyses extension for ccoping reviews (PRISMA-ScR) guidelines. reporting guidelines. A search covering literature in both English and Chinese up until December 2024 was carried out in the electronic databases of PubMed, Embase, Web of Science, CINAHL, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wan Fang, and VIP database. Studies that assessed telemedicine-based therapies for patients with multiple sclerosis and documented fatigue-related outcomes were eligible. The collected literature was compiled, examined, and pertinent information was extracted by two independent reviewers.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec025\">\n<jats:title>Results<\/jats:title>\n<jats:p>A total of 26 papers were included, all in English. Applications(n\u2009=\u200911), wearable devices(n\u2009=\u20098), teleconferences(n\u2009=\u200911), online platforms(n\u2009=\u20095), text messaging(n\u2009=\u20091), virtual reality(n\u2009=\u20091), and game consoles(n\u2009=\u20091) are some of the intervention forms of telemedicine. Remote monitoring(100% of studies), remote guidance(54%), and remote rehabilitation(58%) are some of the functional characteristics of telemedicine. Fatigue characteristics and its impact, health-related quality of life, physical activity, mental health, and the feasibility of remote interventions are among the outcome indicators. While 77% of studies reported statistically significant fatigue reduction, effect sizes varied from small to moderate.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec026\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Telemedicine demonstrates potential as a viable alternative to conventional rehabilitation for managing MS-related fatigue, particularly through multimodal interventions enabling personalized and real-time management. However, the heterogeneity in influencing factors and treatment effects warrants validation through large-scale trials. Future research should prioritize multimodal strategies, optimizing sample composition, extending follow-up periods, and integrating standardized assessment tools to enhance intervention precision.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0327563","type":"journal-article","created":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T17:24:42Z","timestamp":1752773082000},"page":"e0327563","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Application of telemedicine in fatigue management for patients with multiple sclerosis: A scoping review"],"prefix":"10.1371","volume":"20","author":[{"given":"Xiaoyan","family":"Gong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyu","family":"Xue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rong","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shengya","family":"Feng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyu","family":"Ji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7332-4837","authenticated-orcid":true,"given":"Jie","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bowen","family":"Xue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,7,17]]},"reference":[{"key":"pone.0327563.ref001","doi-asserted-by":"crossref","first-page":"17562864211039648","DOI":"10.1177\/17562864211039648","article-title":"Multiple Sclerosis Therapy Consensus Group (MSTCG): position statement on disease-modifying therapies for multiple sclerosis (white paper)","volume":"14","author":"H Wiendl","year":"2021","journal-title":"Ther Adv Neurol Disord"},{"issue":"10422","key":"pone.0327563.ref002","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1016\/S0140-6736(23)01473-3","article-title":"Multiple sclerosis","volume":"403","author":"D Jakimovski","year":"2024","journal-title":"Lancet"},{"issue":"10130","key":"pone.0327563.ref003","doi-asserted-by":"crossref","first-page":"1622","DOI":"10.1016\/S0140-6736(18)30481-1","article-title":"Multiple sclerosis","volume":"391","author":"AJ Thompson","year":"2018","journal-title":"Lancet"},{"issue":"12","key":"pone.0327563.ref004","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0314428","article-title":"Understanding the role of potential biomarkers in attenuating multiple sclerosis progression via multiomics and network-based approach","volume":"19","author":"N Shriwash","year":"2024","journal-title":"PLoS One"},{"issue":"6","key":"pone.0327563.ref005","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1136\/jnnp-2018-320050","article-title":"Pathophysiological and cognitive mechanisms of fatigue in multiple sclerosis","volume":"90","author":"Z-M Manjaly","year":"2019","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"pone.0327563.ref006","doi-asserted-by":"crossref","first-page":"105716","DOI":"10.1016\/j.msard.2024.105716","article-title":"Perspectives on fatigue management among veterans living with multiple sclerosis","volume":"88","author":"LM Knowles","year":"2024","journal-title":"Multiple Sclerosis Related Disorders"},{"issue":"9","key":"pone.0327563.ref007","doi-asserted-by":"crossref","first-page":"1247","DOI":"10.3390\/brainsci11091247","article-title":"Developing a digital solution for remote assessment in multiple sclerosis: from concept to software as a medical device","volume":"11","author":"A van der Walt","year":"2021","journal-title":"Brain Sci"},{"key":"pone.0327563.ref008","doi-asserted-by":"crossref","first-page":"104731","DOI":"10.1016\/j.msard.2023.104731","article-title":"Health related quality of life in the domain of physical activity predicts confirmed disability progression in people with relapsing remitting multiple sclerosis","volume":"75","author":"G Abbadessa","year":"2023","journal-title":"Mult Scler Relat Disord"},{"issue":"7","key":"pone.0327563.ref009","doi-asserted-by":"crossref","first-page":"3747","DOI":"10.3390\/ijerph19073747","article-title":"Mobile health (m-Health) in retrospect: the known unknowns","volume":"19","author":"RSH Istepanian","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"pone.0327563.ref010","volume-title":"Global strategy on digital health 2020-2025"},{"key":"pone.0327563.ref011","doi-asserted-by":"crossref","first-page":"787135","DOI":"10.3389\/fpubh.2022.787135","article-title":"The cost-effectiveness of digital health interventions: a systematic review of the literature","volume":"10","author":"A Gentili","year":"2022","journal-title":"Front Public Health"},{"key":"pone.0327563.ref012","doi-asserted-by":"crossref","first-page":"108233","DOI":"10.1016\/j.engappai.2024.108233","article-title":"Remote mobile health monitoring frameworks and mobile applications: Taxonomy, open challenges, motivation, and recommendations","volume":"133","author":"S Aziz Butt","year":"2024","journal-title":"Eng Applications Artificial Intelligence"},{"key":"pone.0327563.ref013","article-title":"Adapting telehealth to address health equity: Perspectives of primary care providers across the United States","author":"R Azar","year":"2024","journal-title":"J Telemed Telecare"},{"issue":"6","key":"pone.0327563.ref014","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1177\/1357633X241235701","article-title":"Managing pediatric-onset multiple sclerosis in an austere setting: A case report","volume":"31","author":"JU Pierce Pucci","year":"2025","journal-title":"J Telemed Telecare"},{"issue":"1","key":"pone.0327563.ref015","article-title":"Digitizing clinical trials","volume":"3","author":"OT Inan","year":"2020","journal-title":"npj Digit Med"},{"issue":"9","key":"pone.0327563.ref016","doi-asserted-by":"crossref","first-page":"2431","DOI":"10.1089\/tmj.2023.0188","article-title":"Types and effects of telenursing in home health care: a systematic review and meta-analysis","volume":"30","author":"M Mun","year":"2024","journal-title":"Telemed J E Health"},{"key":"pone.0327563.ref017","article-title":"Combined telemedicine-first and direct primary care as a promising model of healthcare delivery","author":"D Schlegel","year":"2024","journal-title":"J Telemed Telecare"},{"issue":"9","key":"pone.0327563.ref018","doi-asserted-by":"crossref","first-page":"1371","DOI":"10.1097\/CCM.0000000000005602","article-title":"Critical appraisal of a systematic review: a concise review","volume":"50","author":"JJ Patel","year":"2022","journal-title":"Crit Care Med"},{"issue":"12","key":"pone.0327563.ref019","doi-asserted-by":"crossref","first-page":"1291","DOI":"10.1016\/j.jclinepi.2014.03.013","article-title":"Scoping reviews: time for clarity in definition, methods, and reporting","volume":"67","author":"HL Colquhoun","year":"2014","journal-title":"J Clin Epidemiol"},{"issue":"10","key":"pone.0327563.ref020","doi-asserted-by":"crossref","first-page":"2119","DOI":"10.11124\/JBIES-20-00167","article-title":"Updated methodological guidance for the conduct of scoping reviews","volume":"18","author":"MDJ Peters","year":"2020","journal-title":"JBI Evid Synth"},{"issue":"7","key":"pone.0327563.ref021","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":"5","key":"pone.0327563.ref022","first-page":"287","article-title":"Practical guidance for knowledge synthesis: scoping review methods","volume":"13","author":"C Lockwood","year":"2019","journal-title":"Asian Nurs Res (Korean Soc Nurs Sci)"},{"issue":"2","key":"pone.0327563.ref023","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/j.apmr.2024.09.010","article-title":"Effects of a 6-week treadmill training with and without virtual reality on frailty in people with multiple sclerosis","volume":"106","author":"T Zanotto","year":"2025","journal-title":"Archives Physical Med Rehabilitation"},{"issue":"2","key":"pone.0327563.ref024","doi-asserted-by":"crossref","first-page":"101549","DOI":"10.1016\/j.dhjo.2023.101549","article-title":"Text messaging intervention for fatigue self-management in people with stroke, spinal cord injury, and multiple sclerosis: a pilot study","volume":"17","author":"AWK Wong","year":"2024","journal-title":"Disabil Health J"},{"issue":"4","key":"pone.0327563.ref025","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1037\/ccp0000086","article-title":"Improving fatigue and depression in individuals with multiple sclerosis using telephone-administered physical activity counseling","volume":"84","author":"AP Turner","year":"2016","journal-title":"J Consult Clin Psychol"},{"issue":"4","key":"pone.0327563.ref026","doi-asserted-by":"crossref","DOI":"10.2196\/19564","article-title":"Usability of a mobile app for real-time assessment of fatigue and related symptoms in patients with multiple sclerosis: observational study","volume":"9","author":"M Palotai","year":"2021","journal-title":"JMIR Mhealth Uhealth"},{"issue":"1","key":"pone.0327563.ref027","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1097\/NPT.0000000000000296","article-title":"Calling out MS fatigue: feasibility and preliminary effects of a pilot randomized telephone-delivered exercise intervention for multiple sclerosis fatigue","volume":"44","author":"AL Kratz","year":"2020","journal-title":"J Neurol Phys Ther"},{"issue":"7","key":"pone.0327563.ref028","doi-asserted-by":"crossref","first-page":"1265","DOI":"10.1016\/j.apmr.2017.12.012","article-title":"Moderators of treatment outcomes after telehealth self-management and education in adults with multiple sclerosis: a secondary analysis of a randomized controlled trial","volume":"99","author":"DM Ehde","year":"2018","journal-title":"Arch Phys Med Rehabil"},{"issue":"9","key":"pone.0327563.ref029","doi-asserted-by":"crossref","first-page":"1235","DOI":"10.3390\/brainsci11091235","article-title":"A mobile app for measuring real time fatigue in patients with multiple sclerosis: introducing the fimo health app","volume":"11","author":"J M\u00e4cken","year":"2021","journal-title":"Brain Sci"},{"issue":"12","key":"pone.0327563.ref030","doi-asserted-by":"crossref","first-page":"4544","DOI":"10.3390\/ijerph17124544","article-title":"Efficacy of an internet-based program to promote physical activity and exercise after inpatient rehabilitation in persons with multiple sclerosis: a randomized, single-blind, controlled study","volume":"17","author":"P Flachenecker","year":"2020","journal-title":"IJERPH"},{"issue":"10","key":"pone.0327563.ref031","doi-asserted-by":"crossref","first-page":"1667","DOI":"10.3390\/ijms17101667","article-title":"Internet-supported physical exercise training for persons with multiple sclerosis-a randomised, controlled study","volume":"17","author":"A Tallner","year":"2016","journal-title":"Int J Mol Sci"},{"issue":"9","key":"pone.0327563.ref032","doi-asserted-by":"crossref","first-page":"970","DOI":"10.1136\/jnnp-2017-317463","article-title":"Randomised controlled trial of a self-guided online fatigue intervention in multiple sclerosis","volume":"89","author":"J P\u00f6ttgen","year":"2018","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"pone.0327563.ref033","doi-asserted-by":"crossref","first-page":"103519","DOI":"10.1016\/j.msard.2022.103519","article-title":"Short inertial sensor-based gait tests reflect perceived state fatigue in multiple sclerosis","volume":"58","author":"AA Ibrahim","year":"2022","journal-title":"Mult Scler Relat Disord"},{"issue":"1","key":"pone.0327563.ref034","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1186\/s12883-021-02361-y","article-title":"Wearable inertial sensors are highly sensitive in the detection of gait disturbances and fatigue at early stages of multiple sclerosis","volume":"21","author":"R M\u00fcller","year":"2021","journal-title":"BMC Neurol"},{"issue":"6","key":"pone.0327563.ref035","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1016\/j.brat.2012.03.001","article-title":"A pilot randomised controlled trial of an Internet-based cognitive behavioural therapy self-management programme (MS Invigor8) for multiple sclerosis fatigue","volume":"50","author":"R Moss-Morris","year":"2012","journal-title":"Behav Res Ther"},{"issue":"9","key":"pone.0327563.ref036","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1177\/1357633X20964693","article-title":"Response heterogeneity in a randomized controlled trial of telerehabilitation interventions among adults with multiple sclerosis","volume":"28","author":"M Plow","year":"2022","journal-title":"J Telemed Telecare"},{"key":"pone.0327563.ref037","first-page":"20552076221117740","article-title":"Cognitive fatigability assessment test (cFAST): Development of a new instrument to assess cognitive fatigability and pilot study on its association to perceived fatigue in multiple sclerosis","volume":"8","author":"L Barrios","year":"2022","journal-title":"Digit Health"},{"issue":"2","key":"pone.0327563.ref038","doi-asserted-by":"crossref","first-page":"108965","DOI":"10.1016\/j.isci.2024.108965","article-title":"Meaningful digital biomarkers derived from wearable sensors to predict daily fatigue in multiple sclerosis patients and healthy controls","volume":"27","author":"M Moebus","year":"2024","journal-title":"iScience"},{"key":"pone.0327563.ref039","doi-asserted-by":"crossref","first-page":"6749951","DOI":"10.1155\/2021\/6749951","article-title":"A Smartphone-based application for self-management in multiple sclerosis","volume":"2021","author":"M Mokhberdezfuli","year":"2021","journal-title":"J Healthc Eng"},{"issue":"2","key":"pone.0327563.ref040","doi-asserted-by":"crossref","DOI":"10.5812\/msnj-144605","article-title":"Effect of mobile health self-care training on fatigue in multiple sclerosis patients","volume":"12","author":"S Roshanghiyas","year":"2024","journal-title":"Med Surg Nurs J"},{"key":"pone.0327563.ref041","doi-asserted-by":"crossref","first-page":"102067","DOI":"10.1016\/j.msard.2020.102067","article-title":"Feasibility study of a 10-week community-based program using the WalkWithMe application on physical activity, walking, fatigue and cognition in persons with Multiple Sclerosis","volume":"42","author":"F Van Geel","year":"2020","journal-title":"Mult Scler Relat Disord"},{"key":"pone.0327563.ref042","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.msard.2018.03.020","article-title":"Improving fatigue in multiple sclerosis by smartphone-supported energy management: The MS TeleCoach feasibility study","volume":"22","author":"M D\u2019hooghe","year":"2018","journal-title":"Mult Scler Relat Disord"},{"issue":"19","key":"pone.0327563.ref043","doi-asserted-by":"crossref","first-page":"6470","DOI":"10.3390\/s24196470","article-title":"STORMS: a pilot feasibility study for occupational TeleRehabilitation in multiple sclerosis","volume":"24","author":"L Vestito","year":"2024","journal-title":"Sensors"},{"key":"pone.0327563.ref044","doi-asserted-by":"crossref","first-page":"1394867","DOI":"10.3389\/fneur.2024.1394867","article-title":"Telerehabilitation and onsite rehabilitation effectively improve quality of life, fatigue, balance, and cognition in people with multiple sclerosis: an interventional study","volume":"15","author":"M Petracca","year":"2024","journal-title":"Front Neurol"},{"issue":"9","key":"pone.0327563.ref045","doi-asserted-by":"crossref","first-page":"1807","DOI":"10.1080\/09638288.2023.2205174","article-title":"Effects of Pilates-based telerehabilitation on physical performance and quality of life in patients with multiple sclerosis","volume":"46","author":"K Eldemir","year":"2024","journal-title":"Disabil Rehabil"},{"issue":"5","key":"pone.0327563.ref046","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1177\/1357633X18822355","article-title":"Physical, cognitive and psychosocial effects of telerehabilitation-based motor imagery training in people with multiple sclerosis: a randomized controlled pilot trial","volume":"26","author":"T Kahraman","year":"2019","journal-title":"J Telemed Telecare"},{"issue":"1","key":"pone.0327563.ref047","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1177\/13524585231213258","article-title":"Effectiveness of a blended booster programme for the long-term outcome of cognitive behavioural therapy for MS-related fatigue: a randomized controlled trial","volume":"30","author":"M de Gier","year":"2023","journal-title":"Mult Scler"},{"issue":"10","key":"pone.0327563.ref048","doi-asserted-by":"crossref","first-page":"4510","DOI":"10.4103\/jfmpc.jfmpc_204_24","article-title":"Can tele-physiotherapy help in filling treatment gaps during pandemics in multiple sclerosis?","volume":"13","author":"G Kumar","year":"2024","journal-title":"J Family Med Prim Care"},{"issue":"12","key":"pone.0327563.ref049","doi-asserted-by":"crossref","first-page":"2883","DOI":"10.1089\/tmj.2024.0249","article-title":"Associations between telemedicine use barriers, organizational factors, and physician perceptions of care quality","volume":"30","author":"K Wiley","year":"2024","journal-title":"Telemed J E Health"},{"key":"pone.0327563.ref050","article-title":"Telehealth utilization among patients with chronic disease: insights from the 2022 Health Information National Trends Survey","author":"M Lee","year":"2024","journal-title":"J Telemed Telecare"},{"issue":"14","key":"pone.0327563.ref051","doi-asserted-by":"crossref","first-page":"1709","DOI":"10.1177\/13524585231201089","article-title":"Mobile health interventions in multiple sclerosis: a systematic review","volume":"29","author":"C Heesen","year":"2023","journal-title":"Mult Scler"},{"issue":"10","key":"pone.0327563.ref052","doi-asserted-by":"crossref","first-page":"2527","DOI":"10.1089\/tmj.2024.0211","article-title":"The experiences and perceptions of older adults with multimorbidity toward E-Health Care: a qualitative evidence synthesis","volume":"30","author":"M Yi","year":"2024","journal-title":"Telemed J E Health"},{"issue":"11","key":"pone.0327563.ref053","doi-asserted-by":"crossref","first-page":"2328","DOI":"10.3390\/jcm10112328","article-title":"Digital technology in clinical trials for multiple sclerosis: systematic review","volume":"10","author":"M De Angelis","year":"2021","journal-title":"J Clin Med"},{"key":"pone.0327563.ref054","doi-asserted-by":"crossref","first-page":"104628","DOI":"10.1016\/j.msard.2023.104628","article-title":"Mobile apps used for people living with multiple sclerosis: a scoping review","volume":"73","author":"Z Howard","year":"2023","journal-title":"Mult Scler Relat Disord"},{"key":"pone.0327563.ref055","doi-asserted-by":"crossref","first-page":"1231321","DOI":"10.3389\/fnins.2023.1231321","article-title":"Management of multiple sclerosis fatigue in the digital age: from assessment to treatment","volume":"17","author":"C Pinarello","year":"2023","journal-title":"Front Neurosci"},{"issue":"2","key":"pone.0327563.ref056","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1089\/tmj.2019.0261","article-title":"Integration of telehealth education into the health care provider curriculum: a review","volume":"27","author":"KE Chike-Harris","year":"2021","journal-title":"Telemed J E Health"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0327563","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T17:24:51Z","timestamp":1752773091000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0327563"}},"subtitle":[],"editor":[{"given":"Gianmarco","family":"Abbadessa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,7,17]]},"references-count":56,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2025,7,17]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0327563","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,17]]}}}