{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T11:35:19Z","timestamp":1789472119621,"version":"build-2803163510"},"reference-count":55,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Aging"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Sexual response problems among older adults are not an inevitable consequence of aging but rather a response to sexual health. However, there is a lack of recent and multicenter data on this issue in China.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aims to assess the prevalence of sexual response problems and their correlates among older adults.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A multicenter cross-sectional study on sexual well-being was conducted among individuals aged more than 50 years in China between June 2020 and December 2022. Data on sociodemographics, physical health, psychological health, and sexual response problems were collected through face-to-face interviews. We included sexually active older adults who reported either vaginal, oral, or anal sex in the past 12 months for this study. Sexual response problems included a lack of interest or enjoyment in sex; feeling anxious, having pain, or no excitement during sex; no desire or orgasms; and the lack of lubrication in sex. The stepwise logistic regression models were used to examine the correlates of sexual response problems.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n A total of 1317 sexually active older adults (842 men, 475 women) were included. Older women reported a higher prevalence of sexual response problems than older men (52.0% [247\/475] vs 43.1% [363\/842]). Common factors associated with at least one of the sexual response problems included living in rural areas (men: adjusted odds ratio [aOR]=0.31, 95% CI 0.22\u20100.43; women: aOR=0.29, 95% CI 0.19\u20100.43) and abnormal BMI (aOR=men: 1.52, 95% CI1.11\u20102.07; women: aOR=2.19, 95% CI 1.47\u20103.28). Among older men, sleep quality (aOR=1.87, 95% CI 1.30\u20102.68), emotional connection with sex partners during sexual intercourse (aOR=0.69, 95% CI 0.50\u20100.96), frequently experienced fatigue (aOR=2.47, 95% CI 1.59\u20103.90), anxiety (aOR=4.26, 95% CI 1.12\u201021.27), and seeking professional help for sex life (aOR=1.58, 95% CI 1.14\u20102.21) were associated with sexual response problems. Among older women, sexual response problems were associated with a lack of physical exercise (aOR=1.69, 95% CI 1.13\u20102.54), poor sex-partner relationships (aOR=1.70, 95% CI 1.12\u20102.60), and depressive symptoms (aOR=3.18, 95% CI 1.18\u201010.24).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Sexual response problems are common among older adults. These problems were associated with adverse physical health, mental health, and poor sex-partner relationships. These findings highlight the importance for health care providers to take into account the physical and psychological health of older adults, as well as the quality of their relationships with sexual partners when diagnosing and addressing sexual response problems.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/66772","type":"journal-article","created":{"date-parts":[[2025,2,23]],"date-time":"2025-02-23T23:30:08Z","timestamp":1740353408000},"page":"e66772-e66772","source":"Crossref","is-referenced-by-count":5,"title":["Sexual Response Problems and Their Correlates Among Older Adults From the Sexual Well-Being (SWELL) Study in China: Multicenter Cross-Sectional Study"],"prefix":"10.2196","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9788-5826","authenticated-orcid":false,"given":"Bingyu","family":"Liang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7158-5402","authenticated-orcid":false,"given":"Chen","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3713-0488","authenticated-orcid":false,"given":"Bingyi","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2305-4757","authenticated-orcid":false,"given":"Xinyi","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5357-2503","authenticated-orcid":false,"given":"Xin","family":"Peng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6036-4135","authenticated-orcid":false,"given":"Ying","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2351-9377","authenticated-orcid":false,"given":"Hui","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5226-5113","authenticated-orcid":false,"given":"Yong","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1886-2148","authenticated-orcid":false,"given":"Xiaopei","family":"Shen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4109-9874","authenticated-orcid":false,"given":"Lin","family":"Ouyang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4140-7734","authenticated-orcid":false,"given":"Guohui","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7466-1624","authenticated-orcid":false,"given":"Maohe","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3721-4905","authenticated-orcid":false,"given":"Jiewei","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5201-0452","authenticated-orcid":false,"given":"Xiaojun","family":"Meng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5706-7906","authenticated-orcid":false,"given":"Yong","family":"Cai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8161-7576","authenticated-orcid":false,"given":"Huachun","family":"Zou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2025,5,1]]},"reference":[{"issue":"4","key":"R1","doi-asserted-by":"publisher","first-page":"1122","DOI":"10.1111\/jgs.18789","article-title":"Sexual function and correlates among adults aged 50+ years in China: findings from the sexual well-being (SWELL) study","volume":"72","author":"Wang","journal-title":"J Am Geriatr Soc"},{"issue":"5","key":"R2","doi-asserted-by":"publisher","first-page":"378","DOI":"10.1038\/s41371-019-0181-3","article-title":"Sexual\u0131ty and mar\u0131tal adjustment \u0131n women w\u0131th hypertens\u0131on \u0131n Turkey: how culture affects sex","volume":"33","author":"Ceyhan","journal-title":"J Hum Hypertens"},{"issue":"3","key":"R3","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1093\/jsxmed\/qdac004","article-title":"Sexual dysfunction, depression, and marital dissatisfaction among Brazilian couples","volume":"20","author":"Galati","journal-title":"J Sex Med"},{"key":"R4","doi-asserted-by":"publisher","DOI":"10.2147\/RRU.S283097","article-title":"The quality of life and economic burden of erectile dysfunction","volume":"13","author":"Elterman","journal-title":"Res Rep Urol"},{"issue":"4","key":"R5","doi-asserted-by":"publisher","first-page":"1031","DOI":"10.5114\/aoms.2019.86794","article-title":"Prevalence of sexual dysfunctions and associated risk factors in Poland","volume":"18","author":"Lew-Starowicz","journal-title":"Arch Med Sci"},{"issue":"6","key":"R6","doi-asserted-by":"publisher","first-page":"1497","DOI":"10.1111\/j.1743-6109.2012.02709.x","article-title":"Bidirectional association between depression and sexual dysfunction: a systematic review and meta-analysis","volume":"9","author":"Atlantis","journal-title":"J Sex Med"},{"issue":"8","key":"R7","doi-asserted-by":"publisher","first-page":"1212","DOI":"10.1016\/j.jsxm.2019.04.017","article-title":"Prevalence of sexual problems and associated distress in aging men across 4 European countries","volume":"16","author":"Hald","journal-title":"J Sex Med"},{"issue":"8","key":"R8","doi-asserted-by":"publisher","first-page":"2951","DOI":"10.1007\/s10508-020-01742-7","article-title":"Prevalence and predictors of sexual difficulties and associated distress among partnered, sexually active older women in Norway, Denmark, Belgium, and Portugal","volume":"49","author":"Graham","journal-title":"Arch Sex Behav"},{"issue":"6","key":"R9","doi-asserted-by":"publisher","first-page":"1559","DOI":"10.1111\/j.1743-6109.2007.00596.x","article-title":"Sexual dysfunctions in urban china: a population-based national survey of men and women","volume":"4","author":"Parish","journal-title":"J Sex Med"},{"key":"R10","doi-asserted-by":"publisher","DOI":"10.2147\/IJGM.S462124","article-title":"The prevalence and risk factors of sexual dysfunction in the elderly in Southern China","volume":"17","author":"Yu","journal-title":"Int J Gen Med"},{"issue":"6","key":"R11","doi-asserted-by":"publisher","first-page":"1096","DOI":"10.1097\/HJH.0b013e32835fdefa","article-title":"Sexual activity and function among middle-aged and older men and women with hypertension","volume":"31","author":"Spatz","journal-title":"J Hypertens"},{"issue":"9907","key":"R12","doi-asserted-by":"publisher","first-page":"1817","DOI":"10.1016\/S0140-6736(13)62366-1","article-title":"Sexual function in Britain: findings from the third national survey of sexual attitudes and lifestyles (Natsal-3)","volume":"382","author":"Mitchell","journal-title":"Lancet"},{"issue":"8","key":"R13","doi-asserted-by":"publisher","first-page":"3669","DOI":"10.1007\/s10508-022-02348-x","article-title":"Sexual inactivity and dysfunction in Denmark: a project SEXUS study","volume":"51","author":"Andresen","journal-title":"Arch Sex Behav"},{"issue":"1","key":"R14","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1080\/00224499.2012.744953","article-title":"Prevalence of sexual problems in Portugal: results of a population-based study using a stratified sample of men aged 18 to 70 years","volume":"51","author":"Quinta Gomes","journal-title":"J Sex Res"},{"issue":"2","key":"R15","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1093\/sxmrev\/qead058","article-title":"The problem of calculating the prevalence of sexual dysfunction: a meta-analysis attending gender","volume":"12","author":"Ram\u00edrez-Santos","journal-title":"Sex Med Rev"},{"issue":"1","key":"R16","doi-asserted-by":"publisher","first-page":"15","DOI":"10.6118\/jmm.2019.25.1.15","article-title":"Sexual function and factors affecting menopause: a systematic review","volume":"25","author":"Heidari","journal-title":"J Menopausal Med"},{"key":"R17","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2021.06.014","article-title":"Sexual dysfunction in young adult survivors of childhood cancer - a population-based study","volume":"154","author":"Hov\u00e9n","journal-title":"Eur J Cancer"},{"issue":"7","key":"R18","doi-asserted-by":"publisher","first-page":"1098","DOI":"10.1016\/j.jsxm.2022.03.614","article-title":"Sexual function and mood disorders among menopausal women: a systematic scoping review","volume":"19","author":"Rahmani","journal-title":"J Sex Med"},{"issue":"2","key":"R19","doi-asserted-by":"publisher","first-page":"539","DOI":"10.1097\/JU.0000000000001367","article-title":"Erectile dysfunction in a sample of sexually active young adult men from a U.S. cohort: demographic, metabolic and mental health correlates","volume":"205","author":"Calzo","journal-title":"J Urol"},{"issue":"1","key":"R20","doi-asserted-by":"publisher","DOI":"10.1186\/s12914-020-00245-9","article-title":"The correlation between sexual dysfunction and intimate partner violence in young women during pregnancy","volume":"20","author":"Bahrami Vazir","journal-title":"BMC Int Health Hum Rights"},{"issue":"2","key":"R21","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3494","article-title":"Erectile dysfunction and diabetes: a melting pot of circumstances and treatments","volume":"38","author":"Defeudis","journal-title":"Diabetes Metab Res Rev"},{"issue":"3","key":"R22","doi-asserted-by":"publisher","first-page":"929","DOI":"10.1007\/s10508-019-1443-4","article-title":"Declines in sexual activity and function predict incident health problems in older adults: prospective findings from the english longitudinal study of ageing","volume":"49","author":"Jackson","journal-title":"Arch Sex Behav"},{"issue":"9","key":"R23","doi-asserted-by":"publisher","DOI":"10.1002\/hsr2.1513","article-title":"Prevalence and predictors of sexual distress in married reproductive-age women: A cross-sectional study from Iran","volume":"6","author":"Hamzehgardeshi","journal-title":"Health Sci Rep"},{"issue":"1","key":"R24","doi-asserted-by":"publisher","first-page":"119","DOI":"10.3390\/ijerph19010119","article-title":"The influence of pension mode on the mental health of older adults\u2014evidence from older adults in China","volume":"19","author":"Li","journal-title":"IJERPH"},{"key":"R25","doi-asserted-by":"publisher","DOI":"10.1016\/j.arr.2020.101174","article-title":"A research agenda for ageing in China in the 21st century (2nd edition): Focusing on basic and translational research, long-term care, policy and social networks","volume":"64","author":"Fang","journal-title":"Ageing Res Rev"},{"issue":"1","key":"R26","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2022-067338","article-title":"Sexual well-being among older adults in China (SWELL): protocol for a multicenter cross-sectional study","volume":"13","author":"Wang","journal-title":"BMJ Open"},{"key":"R27","unstructured":"Laumann EO Gagnon JH Michael RT Michaels S . The Social Organization of Sexuality: Sexual Practices in the United States. University of Chicago press; 2000. ISBN: 0226470202"},{"key":"R28","doi-asserted-by":"publisher","DOI":"10.1016\/j.envint.2016.02.029","article-title":"Green spaces and General Health: roles of mental health status, social support, and physical activity","volume":"91","author":"Dadvand","journal-title":"Environ Int"},{"issue":"8","key":"R29","doi-asserted-by":"publisher","first-page":"1393","DOI":"10.1093\/jn\/nxz093","article-title":"Food insecurity is associated with anxiety, stress, and symptoms of posttraumatic stress disorder in a cohort of women with or at risk of HIV in the United States","volume":"149","author":"Whittle","journal-title":"J Nutr"},{"issue":"3","key":"R30","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1097\/IM9.0000000000000125","article-title":"Correlates of sexual lifestyles among older adults living with HIV in China: findings from the sexual well-being (SWELL) study","volume":"5","author":"Wang","journal-title":"Infect Microb Dis"},{"issue":"6","key":"R31","doi-asserted-by":"publisher","first-page":"1235","DOI":"10.1007\/s41999-022-00694-6","article-title":"Sexual activity and successful aging","volume":"13","author":"Soysal","journal-title":"Eur Geriatr Med"},{"issue":"8","key":"R32","doi-asserted-by":"publisher","first-page":"762","DOI":"10.1056\/NEJMoa067423","article-title":"A study of sexuality and health among older adults in the United States","volume":"357","author":"Lindau","journal-title":"N Engl J Med"},{"issue":"9907","key":"R33","doi-asserted-by":"publisher","first-page":"1830","DOI":"10.1016\/S0140-6736(13)62222-9","article-title":"Associations between health and sexual lifestyles in Britain: findings from the third national survey of sexual attitudes and lifestyles (Natsal-3)","volume":"382","author":"Field","journal-title":"Lancet"},{"issue":"1","key":"R34","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1007\/s10508-014-0465-1","article-title":"Sexual health and well-being among older men and women in England: Findings from the English longitudinal study of ageing","volume":"45","author":"Lee","journal-title":"Arch Sex Behav"},{"issue":"12","key":"R35","doi-asserted-by":"publisher","first-page":"2325","DOI":"10.1038\/oby.2012.104","article-title":"Sexual functioning and obesity: a review","volume":"20","author":"Kolotkin","journal-title":"Obesity (Silver Spring)"},{"issue":"1","key":"R36","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1186\/s12958-019-0557-9","article-title":"Lifestyles and sexuality in men and women: the gender perspective in sexual medicine","volume":"18","author":"Mollaioli","journal-title":"Reprod Biol Endocrinol"},{"issue":"10","key":"R37","doi-asserted-by":"publisher","first-page":"1971","DOI":"10.1016\/j.jsxm.2020.07.004","article-title":"Association between body mass index and female sexual dysfunction: a cross-sectional study from the data registry on experiences of aging, menopause, and sexuality","volume":"17","author":"Faubion","journal-title":"J Sex Med"},{"issue":"8","key":"R38","doi-asserted-by":"publisher","DOI":"10.1111\/obr.13757","article-title":"Effects of bariatric surgery on sexual function and fertility: a narrative review","volume":"25","author":"Law","journal-title":"Obes Rev"},{"issue":"1","key":"R39","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1055\/s-0043-117497","article-title":"Vigorous physical activity is associated with regular aerobic exercise-induced increased serum testosterone levels in overweight\/obese men","volume":"50","author":"Kumagai","journal-title":"Horm Metab Res"},{"issue":"11","key":"R40","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1007\/s11892-023-01523-1","article-title":"Sexual function and satisfaction in the context of obesity","volume":"23","author":"McNabney","journal-title":"Curr Diab Rep"},{"key":"R41","doi-asserted-by":"publisher","DOI":"10.1177\/17562872241279648","article-title":"Effect of surgical, medical, and behavioral weight loss on hormonal and sexual function in men: a contemporary narrative review","volume":"16","author":"Santamaria","journal-title":"Ther Adv Urol"},{"issue":"3","key":"R42","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1038\/nrurol.2010.6","article-title":"The effect of obesity on sperm disorders and male infertility","volume":"7","author":"Du Plessis","journal-title":"Nat Rev Urol"},{"issue":"3","key":"R43","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1016\/j.jsxm.2019.01.005","article-title":"Sleep quality, duration, and associated sexual function at older age: findings from the english longitudinal study of ageing","volume":"16","author":"Smith","journal-title":"J Sex Med"},{"issue":"3","key":"R44","doi-asserted-by":"publisher","first-page":"443","DOI":"10.1097\/01.JU.0000574448.61263.77","article-title":"Re: Sleep quality, duration, and associated sexual function at older age: findings from the english longitudinal study of ageing","volume":"202","author":"Seftel","journal-title":"Journal of Urology"},{"issue":"2","key":"R45","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1016\/j.sxmr.2021.12.001","article-title":"The association between sleep disturbances and erectile dysfunction during the COVID-19 pandemic","volume":"10","author":"Andersen","journal-title":"Sex Med Rev"},{"key":"R46","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2023.111534","article-title":"Relationship of insomnia to sexual function and sexual satisfaction: findings from the sleep and sex survey II","volume":"175","author":"Pigeon","journal-title":"J Psychosom Res"},{"key":"R47","doi-asserted-by":"publisher","DOI":"10.2147\/NSS.S375571","article-title":"Short sleep duration and erectile dysfunction: a review of the literature","volume":"14","author":"Zhang","journal-title":"Nat Sci Sleep"},{"issue":"4","key":"R48","doi-asserted-by":"publisher","first-page":"458","DOI":"10.1016\/j.jsxm.2018.02.008","article-title":"Health-related lifestyle factors and sexual dysfunction: a meta-analysis of population-based research","volume":"15","author":"Allen","journal-title":"J Sex Med"},{"issue":"1","key":"R49","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1038\/sj.ijir.3901250","article-title":"Sexual problems among women and men aged 40-80 y: prevalence and correlates identified in the Global Study of Sexual Attitudes and Behaviors","volume":"17","author":"Laumann","journal-title":"Int J Impot Res"},{"issue":"2","key":"R50","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1038\/s41443-020-00405-4","article-title":"Erectile dysfunction in patients with anxiety disorders: a systematic review","volume":"34","author":"Velurajah","journal-title":"Int J Impot Res"},{"issue":"S1","key":"R51","doi-asserted-by":"publisher","first-page":"s848","DOI":"10.1016\/j.eurpsy.2017.01.1681","article-title":"Sexual functioning in male patients suffering from depression and anxiety disorders","volume":"41","author":"Ciocca","journal-title":"Eur psychiatr"},{"key":"R52","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2016.3","article-title":"Erectile dysfunction","volume":"2","author":"Yafi","journal-title":"Nat Rev Dis Primers"},{"issue":"3","key":"R53","doi-asserted-by":"publisher","first-page":"738","DOI":"10.1111\/jsm.12791","article-title":"Sexual dysfunction among reproductive-aged Chinese married women in Hong Kong: prevalence, risk factors, and associated consequences","volume":"12","author":"Zhang","journal-title":"J Sex Med"},{"issue":"4","key":"R54","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1177\/0265407517743076","article-title":"The associations of intimacy and sexuality in daily life: Temporal dynamics and gender effects within romantic relationships","volume":"35","author":"van Lankveld","journal-title":"J Soc Pers Relat"},{"issue":"1","key":"R55","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1007\/s10433-019-00509-x","article-title":"Emotional intimacy and sexual well-being in aging European couples: a cross-cultural mediation analysis","volume":"17","author":"\u0160tulhofer","journal-title":"Eur J Ageing"}],"container-title":["JMIR Aging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aging.jmir.org\/2025\/1\/e66772","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T22:28:28Z","timestamp":1785536908000},"score":1,"resource":{"primary":{"URL":"https:\/\/aging.jmir.org\/2025\/1\/e66772"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,1]]},"references-count":55,"URL":"https:\/\/doi.org\/10.2196\/66772","relation":{},"ISSN":["2561-7605"],"issn-type":[{"value":"2561-7605","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,1]]},"article-number":"v8i4e66772"}}