{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T18:55:58Z","timestamp":1775069758993,"version":"3.50.1"},"reference-count":57,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2020,9,19]],"date-time":"2020-09-19T00:00:00Z","timestamp":1600473600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010665","name":"H2020 Marie Sk\u0142odowska-Curie Actions","doi-asserted-by":"publisher","award":["721577"],"award-info":[{"award-number":["721577"]}],"id":[{"id":"10.13039\/100010665","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000304","name":"Parkinson's UK","doi-asserted-by":"publisher","award":["J-0802, G-1301"],"award-info":[{"award-number":["J-0802, G-1301"]}],"id":[{"id":"10.13039\/501100000304","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003776","name":"Newcastle upon Tyne Hospitals NHS Foundation Trust","doi-asserted-by":"publisher","award":["REC number: 09\/H0906\/82"],"award-info":[{"award-number":["REC number: 09\/H0906\/82"]}],"id":[{"id":"10.13039\/501100003776","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Parkinson\u2019s disease (PD) is a common neurodegenerative disorder resulting in a range of mobility deficits affecting gait, balance and turning. In this paper, we present: (i) the development and validation of an algorithm to detect turns during gait; (ii) a method to extract turn characteristics; and (iii) the classification of PD using turn characteristics. Thirty-seven people with PD and 56 controls performed 180-degree turns during an intermittent walking task. Inertial measurement units were attached to the head, neck, lower back and ankles. A turning detection algorithm was developed and validated by two raters using video data. Spatiotemporal and signal-based characteristics were extracted and used for PD classification. There was excellent absolute agreement between the rater and the algorithm for identifying turn start and end (ICC \u2265 0.99). Classification modeling (partial least square discriminant analysis (PLS-DA)) gave the best accuracy of 97.85% when trained on upper body and ankle data. Balanced sensitivity (97%) and specificity (96.43%) were achieved using turning characteristics from the neck, lower back and ankles. Turning characteristics, in particular angular velocity, duration, number of steps, jerk and root mean square distinguished mild-moderate PD from controls accurately and warrant future examination as a marker of mobility impairment and fall risk in PD.<\/jats:p>","DOI":"10.3390\/s20185377","type":"journal-article","created":{"date-parts":[[2020,9,20]],"date-time":"2020-09-20T21:20:28Z","timestamp":1600636828000},"page":"5377","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["Turning Detection During Gait: Algorithm Validation and Influence of Sensor Location and Turning Characteristics in the Classification of Parkinson\u2019s Disease"],"prefix":"10.3390","volume":"20","author":[{"given":"Rana Zia Ur","family":"Rehman","sequence":"first","affiliation":[{"name":"Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE2 4HH, UK"},{"name":"Clinical Ageing Research Unit, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne NE4 5PL, UK"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0868-5270","authenticated-orcid":false,"given":"Philipp","family":"Klocke","sequence":"additional","affiliation":[{"name":"Clinical Ageing Research Unit, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne NE4 5PL, UK"},{"name":"Faculty of Medicine, University of Southampton, Southampton SO17 1BJ, UK"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5860-7986","authenticated-orcid":false,"given":"Sofia","family":"Hryniv","sequence":"additional","affiliation":[{"name":"Clinical Ageing Research Unit, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne NE4 5PL, UK"},{"name":"Department of Psychology, University of Cambridge, Cambridge CB2 3EB, UK"}]},{"given":"Brook","family":"Galna","sequence":"additional","affiliation":[{"name":"Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE2 4HH, UK"},{"name":"Clinical Ageing Research Unit, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne NE4 5PL, UK"},{"name":"School of Biomedical, Nutritional and Sport Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE2 4HH, UK"}]},{"given":"Lynn","family":"Rochester","sequence":"additional","affiliation":[{"name":"Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE2 4HH, UK"},{"name":"Clinical Ageing Research Unit, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne NE4 5PL, UK"},{"name":"The Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne NE1 1AA, UK"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1154-4751","authenticated-orcid":false,"given":"Silvia","family":"Del Din","sequence":"additional","affiliation":[{"name":"Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE2 4HH, UK"},{"name":"Clinical Ageing Research Unit, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne NE4 5PL, UK"}]},{"given":"Lisa","family":"Alcock","sequence":"additional","affiliation":[{"name":"Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE2 4HH, UK"},{"name":"Clinical Ageing Research Unit, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne NE4 5PL, UK"}]}],"member":"1968","published-online":{"date-parts":[[2020,9,19]]},"reference":[{"key":"ref_1","unstructured":"Parkinson\u2019s UK (2018). The Incidence and Prevalence of Parkinson\u2019s in the UK, Parkinson\u2019s UK. Available online: https:\/\/www.parkinsons.org.uk\/professionals\/resources\/incidence-and-prevalence-parkinsons-uk-report."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1016\/S1474-4422(18)30295-3","article-title":"Global, Regional, and National Burden of Parkinson\u2019s Disease, 1990\u20132016: A Systematic Analysis for the Global Burden of Disease Study 2016","volume":"17","author":"Dorsey","year":"2018","journal-title":"Lancet Neurol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1136\/jnnp.2007.131045","article-title":"Parkinson\u2019s Disease: Clinical Features and Diagnosis","volume":"79","author":"Jankovic","year":"2008","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"S28","DOI":"10.1016\/S1353-8020(09)70831-4","article-title":"The Clinical Progression of Parkinson\u2019s Disease","volume":"15","author":"Poewe","year":"2009","journal-title":"Parkinsonism Relat. Disord."},{"key":"ref_5","first-page":"356","article-title":"Continuous Monitoring of Turning in Patients with Movement Disability","volume":"14","author":"Pearson","year":"2014","journal-title":"Sensors"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1382","DOI":"10.3109\/09638288.2014.961661","article-title":"A Narrative Review of Turning deficits in people with parkinson\u2019s disease","volume":"37","author":"Hulbert","year":"2015","journal-title":"Disabil. Rehabil."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1002\/mds.25285","article-title":"Head-pelvis coupling is increased during turning in patients with parkinson\u2019s disease and freezing of gait","volume":"28","author":"Spildooren","year":"2013","journal-title":"Mov. Disord."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1186\/s12984-016-0147-4","article-title":"The quality of turning in parkinson\u2019s disease: A compensatory strategy to prevent postural instability?","volume":"13","author":"Mellone","year":"2016","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.parkreldis.2014.11.001","article-title":"Fall frequency, predicting falls and participating in falls research: Similarities among people with parkinson\u2019s disease with and without cognitive impairment","volume":"21","author":"Amar","year":"2015","journal-title":"Parkinsonism Relat. Disord."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/j.gaitpost.2019.09.001","article-title":"Objective measures to investigate turning impairments and freezing of gait in people with parkinson\u2019s disease","volume":"74","author":"Bertoli","year":"2019","journal-title":"Gait Posture"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"950","DOI":"10.1007\/s004150170047","article-title":"Prospective assessment of falls in parkinson\u2019s disease","volume":"248","author":"Bloem","year":"2001","journal-title":"J. Neurol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"78","DOI":"10.3389\/fnagi.2018.00078","article-title":"Effect of fear of falling on turning performance in parkinson\u2019s disease in the lab and at home","volume":"10","author":"Haertner","year":"2018","journal-title":"Front. Aging Neurosci."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1102","DOI":"10.1093\/gerona\/glw019","article-title":"Continuous monitoring of turning mobility and its association to falls and cognitive function: A pilot study","volume":"71","author":"Mancini","year":"2016","journal-title":"J. Gerontol. Ser. A Biomed. Sci. Med. Sci."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1097\/NPT.0b013e31824620d1","article-title":"Do clinical scales of balance reflect turning abnormalities in people with parkinson\u2019s disease?","volume":"36","author":"King","year":"2012","journal-title":"J. Neurol. Phys. Ther."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Buckley, C., Alcock, L., McArdle, R., Rehman, R.Z.U., Del Din, S., Mazz\u00e0, C., Yarnall, A.J., and Rochester, L. (2019). The role of movement analysis in diagnosing and monitoring neurodegenerative conditions: Insights from gait and postural control. Brain Sci., 9.","DOI":"10.3390\/brainsci9020034"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1016\/j.compbiomed.2017.08.026","article-title":"Fuzzy inference model evaluating turn for parkinson\u2019s disease patients","volume":"89","year":"2017","journal-title":"Comput. Biol. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1205","DOI":"10.1080\/09638280701828930","article-title":"The circumstances of falls among people with parkinson\u2019s disease and the use of falls diaries to facilitate reporting","volume":"30","author":"Ashburn","year":"2008","journal-title":"Disabil. Rehabil."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Cheng, F.-Y., Yang, Y.-R., Wang, C.-J., Wu, Y.-R., Cheng, S.-J., Wang, H.-C., and Wang, R.-Y. (2014). Factors influencing turning and its relationship with falls in individuals with parkinson\u2019s disease. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0093572"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"3","DOI":"10.3233\/NRE-151236","article-title":"Continuous monitoring of turning in parkinson\u2019s disease: Rehabilitation potential","volume":"37","author":"Mancini","year":"2015","journal-title":"NeuroRehabilitation"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Haji Ghassemi, N., Hannink, J., Roth, N., Ga\u00dfner, H., Marxreiter, F., Klucken, J., and Eskofier, B.M. (2019). Turning analysis during standardized test using on-shoe wearable sensors in parkinson\u2019s disease. Sensors, 19.","DOI":"10.3390\/s19143103"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1109\/TBME.2012.2227317","article-title":"On-shoe wearable sensors for gait and turning assessment of patients with parkinson\u2019s disease","volume":"60","author":"Mariani","year":"2012","journal-title":"IEEE Trans. Biomed. Eng."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2999","DOI":"10.1016\/j.jbiomech.2010.07.003","article-title":"3d gait assessment in young and elderly subjects using foot-worn inertial sensors","volume":"43","author":"Mariani","year":"2010","journal-title":"J. Biomech."},{"key":"ref_23","first-page":"135","article-title":"Algorithm for turning detection and analysis validated under home-like conditions in patients with parkinson\u2019s disease and older adults using a 6 degree-of-freedom inertial measurement unit at the lower back","volume":"8","author":"Pham","year":"2017","journal-title":"Front. Neurol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1186\/s12984-015-0026-4","article-title":"Auto detection and segmentation of physical activities during a timed-up-and-go (tug) task in healthy older adults using multiple inertial sensors","volume":"12","author":"Nguyen","year":"2015","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"18800","DOI":"10.3390\/s141018800","article-title":"Toward real-time automated detection of turns during gait using wearable inertial measurement units","volume":"14","author":"Novak","year":"2014","journal-title":"Sensors"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Fleury, A., Noury, N., and Vuillerme, N. (2007, January 22\u201326). A fast algorithm to track changes of direction of a person using magnetometers. Proceedings of the 2007 29th Annual International Conference of the IEEE Engineering in Medicine and Biology Society, Lyon, France.","DOI":"10.1109\/IEMBS.2007.4352788"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1099","DOI":"10.3233\/JPD-201914","article-title":"Digital biomarkers of mobility in parkinson\u2019s disease during daily living","volume":"10","author":"Shah","year":"2020","journal-title":"J. Parkinson\u2019s Dis."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Hasegawa, N., Shah, V.V., Carlson-Kuhta, P., Nutt, J.G., Horak, F.B., and Mancini, M. (2019). How to select balance measures sensitive to parkinson\u2019s disease from body-worn inertial sensors\u2014Separating the trees from the forest. Sensors, 19.","DOI":"10.3390\/s19153320"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/j.ctim.2017.03.012","article-title":"Dance for parkinson\u2019s\u2014The effects on whole body co-ordination during turning around","volume":"32","author":"Hulbert","year":"2017","journal-title":"Complement. Ther. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1109\/OJEMB.2020.2966295","article-title":"Accelerometry-based digital gait characteristics for classification of parkinson\u2019s disease: What counts?","volume":"1","author":"Rehman","year":"2020","journal-title":"IEEE Open J. Eng. Med. Biol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1212\/WNL.0b013e31827deb74","article-title":"The spectrum of nonmotor symptoms in early parkinson disease","volume":"80","author":"Khoo","year":"2013","journal-title":"Neurology"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1142","DOI":"10.1212\/WNL.42.6.1142","article-title":"What features improve the accuracy of clinical diagnosis in parkinson\u2019s disease: A clinicopathologic study","volume":"42","author":"Hughes","year":"1992","journal-title":"Neurology"},{"key":"ref_33","first-page":"373","article-title":"World medical association declaration of helsinki. Ethical principles for medical research involving human subjects","volume":"79","author":"Association","year":"2001","journal-title":"Bull. World Health Organ."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"922","DOI":"10.1111\/j.1532-5415.1992.tb01992.x","article-title":"The mini-mental state examination: A comprehensive review","volume":"40","author":"Tombaugh","year":"1992","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"M28","DOI":"10.1093\/gerona\/50A.1.M28","article-title":"The activities-specific balance confidence (abc) scale","volume":"50","author":"Powell","year":"1995","journal-title":"J. Gerontol. Ser. A Biol. Sci. Med. Sci."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1212\/WNL.50.2.318","article-title":"Parkinsonism: Onset, progression, and mortality","volume":"50","author":"Hoehn","year":"1998","journal-title":"Neurology"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"2129","DOI":"10.1002\/mds.22340","article-title":"Movement disorder society-sponsored revision of the unified parkinson\u2019s disease rating scale (mds-updrs): Scale presentation and clinimetric testing results","volume":"23","author":"Goetz","year":"2008","journal-title":"Mov. Disord. Off. J. Mov. Disord. Soc."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/j.parkreldis.2016.04.009","article-title":"Cognitive decline and quality of life in incident parkinson\u2019s disease: The role of attention","volume":"27","author":"Lawson","year":"2016","journal-title":"Parkinsonism Relat. Disord."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1016\/j.gaitpost.2009.07.108","article-title":"Reliability of the new freezing of gait questionnaire: Agreement between patients with parkinson\u2019s disease and their carers","volume":"30","author":"Nieuwboer","year":"2009","journal-title":"Gait Posture"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1016\/j.gaitpost.2012.09.025","article-title":"Is gait variability reliable in older adults and parkinson\u2019s disease? Towards an optimal testing protocol","volume":"37","author":"Galna","year":"2013","journal-title":"Gait Posture"},{"key":"ref_41","unstructured":"Jaiswal, R., Nair, R.C., Yarlagadda, N.K., Senapati, A.A.K., and Mulage, P. (2016, January 23\u201325). Adaptive gyroscope drift compensation based on temporal noise modelling. Proceedings of the 2016 International Conference on Microelectronics, Computing and Communications (MicroCom), Durgapur, India."},{"key":"ref_42","unstructured":"Fordellone, M., Bellincontro, A., and Mencarelli, F. (2018). Partial least squares discriminant analysis: A dimensionality reduction method to classify hyperspectral data. arXiv."},{"key":"ref_43","first-page":"79","article-title":"Principle component analysis and partial least squares: Two dimension reduction techniques for regression","volume":"79","author":"Maitra","year":"2008","journal-title":"Appl. Multivar. Stat. Models"},{"key":"ref_44","unstructured":"Eriksson, L., Johansson, E., Kettaneh-Wold, N., Trygg, J., Wikstr\u00f6m, C., and Wold, S. (2006). Multi-and Megavariate Data Analysis Part 1: Basic Principles and Applications, Umetrics."},{"key":"ref_45","first-page":"581","article-title":"Prediction of clinical outcome with microarray data: A partial least squares discriminant analysis (pls-da) approach","volume":"112","author":"Tenenhaus","year":"2003","journal-title":"Hum. Genet."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1016\/j.gaitpost.2008.11.003","article-title":"Concurrent validity of a trunk tri-axial accelerometer system for gait analysis in older adults","volume":"29","author":"Hartmann","year":"2009","journal-title":"Gait Posture"},{"key":"ref_47","unstructured":"Portney, L.G., and Watkins, M.P. (2009). Foundations of Clinical Research: Applications to Practice, Pearson\/Prentice Hall."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Rehman, R.Z.U., Del Din, S., Shi, J.Q., Galna, B., Lord, S., Yarnall, A.J., Guan, Y., and Rochester, L. (2019). Comparison of walking protocols and gait assessment systems for machine learning-based classification of parkinson\u2019s disease. Sensors, 19.","DOI":"10.3390\/s19245363"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41598-019-53656-7","article-title":"Selecting clinically relevant gait characteristics for classification of early parkinson\u2019s disease: A comprehensive machine learning approach","volume":"9","author":"Rehman","year":"2019","journal-title":"Sci. Rep."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1017\/S0317167100014591","article-title":"Parkinson\u2019s disease and segmental coordination during turning: I. Standing turns","volume":"40","author":"Akram","year":"2013","journal-title":"Can. J. Neurol. Sci."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1007\/s002210050932","article-title":"Online steering: Coordination and control of body center of mass, head and body reorientation","volume":"129","author":"Patla","year":"1999","journal-title":"Exp. Brain Res."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1002\/mds.21932","article-title":"Footstep adjustments used to turn during walking in parkinson\u2019s disease","volume":"23","author":"Huxham","year":"2008","journal-title":"Mov. Disord."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1016\/j.gaitpost.2007.04.010","article-title":"The association between impaired turning and normal straight walking in parkinson\u2019s disease","volume":"26","author":"Crenna","year":"2007","journal-title":"Gait Posture"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/j.parkreldis.2012.09.006","article-title":"Dynamics of turning sharpness influences freezing of gait in parkinson\u2019s disease","volume":"19","author":"Bhatt","year":"2013","journal-title":"Parkinsonism Relat. Disord."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1007\/s00221-008-1446-1","article-title":"Sudden turn during walking is impaired in people with parkinson\u2019s disease","volume":"190","author":"Mak","year":"2008","journal-title":"Exp. Brain Res."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1222","DOI":"10.1080\/09638280701829938","article-title":"Dysfunctional turning in parkinson\u2019s disease","volume":"30","author":"Stack","year":"2008","journal-title":"Disabil. Rehabil."},{"key":"ref_57","first-page":"S115","article-title":"Turning difficulties associated with parkinson\u2019s disease (pd)","volume":"17","author":"Stack","year":"2002","journal-title":"Mov. Disord."}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/20\/18\/5377\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T10:11:41Z","timestamp":1760177501000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/20\/18\/5377"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,19]]},"references-count":57,"journal-issue":{"issue":"18","published-online":{"date-parts":[[2020,9]]}},"alternative-id":["s20185377"],"URL":"https:\/\/doi.org\/10.3390\/s20185377","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9,19]]}}}