{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T17:26:06Z","timestamp":1785432366210,"version":"3.56.0"},"reference-count":43,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:00:00Z","timestamp":1777507200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004271","name":"Sapienza University of Rome","doi-asserted-by":"crossref","award":["AR120172B97AF626"],"award-info":[{"award-number":["AR120172B97AF626"]}],"id":[{"id":"10.13039\/501100004271","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100004271","name":"Sapienza University of Rome","doi-asserted-by":"crossref","award":["AR222181683A15AA"],"award-info":[{"award-number":["AR222181683A15AA"]}],"id":[{"id":"10.13039\/501100004271","id-type":"DOI","asserted-by":"crossref"}]},{"award":["AR120172B97AF626"],"award-info":[{"award-number":["AR120172B97AF626"]}],"id":[{"id":"https:\/\/ror.org\/02be6w209","id-type":"ROR","asserted-by":"publisher"}]},{"award":["AR222181683A15AA"],"award-info":[{"award-number":["AR222181683A15AA"]}],"id":[{"id":"https:\/\/ror.org\/02be6w209","id-type":"ROR","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001665","name":"French National Research Agency","doi-asserted-by":"crossref","award":["ANR-23-IACL-0006"],"award-info":[{"award-number":["ANR-23-IACL-0006"]}],"id":[{"id":"10.13039\/501100001665","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001665","name":"French National Research Agency","doi-asserted-by":"crossref","award":["ANR-10-AIRT-0005"],"award-info":[{"award-number":["ANR-10-AIRT-0005"]}],"id":[{"id":"10.13039\/501100001665","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001665","name":"French National Research Agency","doi-asserted-by":"crossref","award":["ANR-15-IDEX-0002"],"award-info":[{"award-number":["ANR-15-IDEX-0002"]}],"id":[{"id":"10.13039\/501100001665","id-type":"DOI","asserted-by":"crossref"}]},{"award":["ANR-23-IACL-0006"],"award-info":[{"award-number":["ANR-23-IACL-0006"]}],"id":[{"id":"https:\/\/ror.org\/00rbzpz17","id-type":"ROR","asserted-by":"publisher"}]},{"award":["ANR-10-AIRT-0005"],"award-info":[{"award-number":["ANR-10-AIRT-0005"]}],"id":[{"id":"https:\/\/ror.org\/00rbzpz17","id-type":"ROR","asserted-by":"publisher"}]},{"award":["ANR-15-IDEX-0002"],"award-info":[{"award-number":["ANR-15-IDEX-0002"]}],"id":[{"id":"https:\/\/ror.org\/00rbzpz17","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Background\/Objectives: Freezing of gait (FOG) and sleep disturbances are common in people with Parkinson\u2019s disease (PwPD). A bidirectional association between them has been suggested, but quantitative evaluations are scarce. This study aimed to compare sleep disturbances in mild-to-moderate PwPD with (PD+FOG) and without FOG (PD\u2212FOG), and to assess the association between FOG severity and sleep parameters. Methods: Data from 54 PwPD with disease stage &lt;4 and no severe cognitive decline were included (27 PD+FOG and 27 propensity score-matched for age, sex, and disease duration PD\u2212FOG). Demographics and clinical variables were collected. Clinical assessment included the new freezing of gait questionnaire (NFOG-Q), Parkinson\u2019s Disease Sleep Scale (PDSS-2), Epworth Sleepiness Scale (ESS) and Movement Disorder Society Unified Parkinson\u2019s Disease Rating Scale (MDS-UPDRS). Mann\u2013Whitney U, Fisher\u2019s exact and Spearman\u2019s tests were used for group comparisons and correlations, respectively. Results: Significant differences were observed between PD+FOG and PD\u2212FOG groups in MDS-UPDRS part II (p = 0.011) and part IV (p = 0.011), with higher scores in PD+FOG participants. No significant differences were found in PDSS-2 or ESS between the two groups. A significant moderate positive correlation was found between NFOG-Q score and PDSS-2 (\u03c1 = 0.416; p = 0.044) in PD+FOG participants. Conclusions: FOG severity was positively associated with sleep disturbances within the PD+FOG group. However, no significant difference in sleep quality or excessive daytime sleepiness was found between PD+FOG and PD\u2212FOG after propensity score matching. PD+FOG participants experienced more severe motor complications and greater impairment in daily activities compared to PD\u2212FOG.<\/jats:p>","DOI":"10.3390\/brainsci16050493","type":"journal-article","created":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T14:35:53Z","timestamp":1777559753000},"page":"493","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association Between Freezing of Gait and Sleep Quality in People with Parkinson\u2019s Disease"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-0030-9191","authenticated-orcid":false,"given":"Tracy","family":"Milane","sequence":"first","affiliation":[{"name":"Univ. Grenoble Alpes, CNRS, Grenoble INP, LIG Sangria, 38000 Grenoble, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7955-3369","authenticated-orcid":false,"given":"Edoardo","family":"Bianchini","sequence":"additional","affiliation":[{"name":"Univ. Grenoble Alpes, CNRS, Grenoble INP, LIG Sangria, 38000 Grenoble, France"},{"name":"Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0478-4523","authenticated-orcid":false,"given":"Lanfranco","family":"De Carolis","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, 00189 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9903-5550","authenticated-orcid":false,"given":"Antonio","family":"Suppa","sequence":"additional","affiliation":[{"name":"Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy"},{"name":"IRCCS Neuromed Institute, 86077 Pozzilli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0501-8803","authenticated-orcid":false,"given":"Marco","family":"Salvetti","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, 00189 Rome, Italy"},{"name":"IRCCS Neuromed Institute, 86077 Pozzilli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4813-3868","authenticated-orcid":false,"given":"Clint","family":"Hansen","sequence":"additional","affiliation":[{"name":"Department of Neurology, Kiel University, 24105 Kiel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9885-3666","authenticated-orcid":false,"given":"Massimo","family":"Marano","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128 Rome, Italy"},{"name":"Unit of Neurology, Neurophysiology, Neurobiology and Psychiatry, Department of Medicine, Campus Bio-Medico University of Rome, 00128 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domiziana","family":"Rinaldi","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, 00189 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3773-393X","authenticated-orcid":false,"given":"Nicolas","family":"Vuillerme","sequence":"additional","affiliation":[{"name":"Univ. Grenoble Alpes, CNRS, Grenoble INP, LIG Sangria, 38000 Grenoble, France"},{"name":"Institut Universitaire de France, 75005 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"17013","DOI":"10.1038\/nrdp.2017.13","article-title":"Parkinson Disease","volume":"3","author":"Poewe","year":"2017","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"734","DOI":"10.1016\/S1474-4422(11)70143-0","article-title":"Freezing of Gait: Moving Forward on a Mysterious Clinical Phenomenon","volume":"10","author":"Nutt","year":"2011","journal-title":"Lancet Neurol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1038\/s41582-025-01179-3","article-title":"An Updated Definition of Freezing of Gait","volume":"22","author":"Gilat","year":"2026","journal-title":"Nat. Rev. Neurol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1186\/s40035-020-00191-5","article-title":"Freezing of Gait in Parkinson\u2019s Disease: Pathophysiology, Risk Factors and Treatments","volume":"9","author":"Gao","year":"2020","journal-title":"Transl. Neurodegener."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1186\/s41016-020-00197-y","article-title":"The Prevalence of Freezing of Gait in Parkinson\u2019s Disease and in Patients with Different Disease Durations and Severities","volume":"6","author":"Ge","year":"2020","journal-title":"Chin. Neurosurg. J."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Conde, C.I., Lang, C., Baumann, C.R., Easthope, C.A., Taylor, W.R., and Ravi, D.K. (2023). Triggers for Freezing of Gait in Individuals with Parkinson\u2019s Disease: A Systematic Review. Front. Neurol., 14.","DOI":"10.3389\/fneur.2023.1326300"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1007\/s10072-018-3625-6","article-title":"Factors Associated with Freezing of Gait in Patients with Parkinson\u2019s Disease","volume":"40","author":"Choi","year":"2019","journal-title":"Neurol. Sci."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1038\/s41531-024-00642-0","article-title":"Sleep Disorders in Parkinson\u2019s Disease, an Early and Multiple Problem","volume":"10","author":"Dodet","year":"2024","journal-title":"npj Park. Dis."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1016\/S1474-4422(24)00170-4","article-title":"Sleep and Sleep Disorders in People with Parkinson\u2019s Disease","volume":"23","author":"Iranzo","year":"2024","journal-title":"Lancet Neurol."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Gjerstad, M.D., Alves, G., and Maple-Gr\u00f8dem, J. (2018). Excessive Daytime Sleepiness and REM Sleep Behavior Disorders in Parkinson\u2019s Disease: A Narrative Review on Early Intervention With Implications to Neuroprotection. Front. Neurol., 9.","DOI":"10.3389\/fneur.2018.00961"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/j.sleep.2023.11.021","article-title":"Comparison of Sleep Characteristics between Parkinson\u2019s Disease with and without Freezing of Gait: A Systematic Review","volume":"114","author":"Milane","year":"2024","journal-title":"Sleep Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.sleep.2024.06.001","article-title":"Comparison of Number of People with Freezing of Gait in Parkinson\u2019s Disease with and without Sleep Disturbances: A Systematic Review","volume":"121","author":"Milane","year":"2024","journal-title":"Sleep Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1591","DOI":"10.1002\/mds.26424","article-title":"MDS Clinical Diagnostic Criteria for Parkinson\u2019s Disease","volume":"30","author":"Postuma","year":"2015","journal-title":"Mov. Disord."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1020","DOI":"10.1002\/mds.20213","article-title":"Movement Disorder Society Task Force Report on the Hoehn and Yahr Staging Scale: Status and Recommendations the Movement Disorder Society Task Force on rating scales for Parkinson\u2019s disease","volume":"19","author":"Goetz","year":"2004","journal-title":"Mov. Disord."},{"key":"ref_15","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."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1002\/mds.23476","article-title":"Parkinson\u2019s Disease Sleep Scale\u2014Validation of the Revised Version PDSS-2","volume":"26","author":"Trenkwalder","year":"2011","journal-title":"Mov. Disord."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1093\/sleep\/14.6.540","article-title":"A New Method for Measuring Daytime Sleepiness: The Epworth Sleepiness Scale","volume":"14","author":"Johns","year":"1991","journal-title":"Sleep"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1111\/ane.12347","article-title":"Evaluation of Cutoff Scores for the Parkinson\u2019s Disease Sleep Scale-2","volume":"131","author":"Suzuki","year":"2015","journal-title":"Acta Neurol. Scand."},{"key":"ref_19","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_20","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/j.tjem.2018.08.001","article-title":"User\u2019s Guide to Correlation Coefficients","volume":"18","author":"Akoglu","year":"2018","journal-title":"Turk. J. Emerg. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.gaitpost.2021.01.026","article-title":"Poor Sleep Quality Is Associated with Cognitive, Mobility, and Anxiety Disability That Underlie Freezing of Gait in Parkinson\u2019s Disease","volume":"85","author":"Ugrinowitsch","year":"2021","journal-title":"Gait Posture"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"107342","DOI":"10.1016\/j.parkreldis.2025.107342","article-title":"Waking up to the Role of Sleep Disturbances in Freezing of Gait among People with Parkinson\u2019s Disease","volume":"133","author":"Zitser","year":"2025","journal-title":"Park. Relat. Disord."},{"key":"ref_23","first-page":"e12385","article-title":"The Relationship of Rapid Eye Movement Sleep Behavior Disorder and Freezing of Gait in Parkinson\u2019s Disease","volume":"12","author":"Nobleza","year":"2020","journal-title":"Cureus"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.nbd.2018.01.010","article-title":"Bottom-up Gamma Maintenance in Various Disorders","volume":"128","author":"Mahaffey","year":"2019","journal-title":"Neurobiol. Dis."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"219","DOI":"10.3934\/Neuroscience.2019.4.219","article-title":"The Pedunculopontine Nucleus: From Posture and Locomotion to Neuroepigenetics","volume":"6","author":"Virmani","year":"2019","journal-title":"AIMS Neurosci."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1148","DOI":"10.1212\/WNL.0b013e3182886a76","article-title":"Pedunculopontine Nucleus: Functional Organization and Clinical Implications","volume":"80","author":"Benarroch","year":"2013","journal-title":"Neurology"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1093\/brain\/awq324","article-title":"Gait-Related Cerebral Alterations in Patients with Parkinson\u2019s Disease with Freezing of Gait","volume":"134","author":"Snijders","year":"2011","journal-title":"Brain"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2405","DOI":"10.1093\/brain\/awt172","article-title":"Asymmetric Pedunculopontine Network Connectivity in Parkinsonian Patients with Freezing of Gait","volume":"136","author":"Fling","year":"2013","journal-title":"Brain"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"6452","DOI":"10.1007\/s00415-022-11294-6","article-title":"Associated Factors and Abnormal Dorsal Raphe Nucleus Connectivity Patterns of Freezing of Gait in Parkinson\u2019s Disease","volume":"269","author":"Lv","year":"2022","journal-title":"J. Neurol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1016\/j.gaitpost.2018.12.009","article-title":"Non-Motor Predictors of Freezing of Gait in Parkinson\u2019s Disease","volume":"68","author":"Banks","year":"2019","journal-title":"Gait Posture"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Xu, K., Zhou, X.-X., He, R.-C., Zhou, Z., Liu, Z.-H., Xu, Q., Sun, Q.-Y., Yan, X.-X., Wu, X.-Y., and Guo, J.-F. (2021). Constructing Prediction Models for Freezing of Gait by Nomogram and Machine Learning: A Longitudinal Study. Front. Neurol., 12.","DOI":"10.3389\/fneur.2021.684044"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"779","DOI":"10.5664\/jcsm.9022","article-title":"Association of Sleep Disturbance and Freezing of Gait in Parkinson Disease: Prevention\/Delay Implications","volume":"17","author":"Tang","year":"2021","journal-title":"J. Clin. Sleep. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e2359","DOI":"10.1002\/brb3.2359","article-title":"Clinical Features and Related Factors of Freezing of Gait in Patients with Parkinson\u2019s Disease","volume":"11","author":"Zhang","year":"2021","journal-title":"Brain Behav."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e01244","DOI":"10.1002\/brb3.1244","article-title":"Clinical Features of Freezing of Gait in Parkinson\u2019s Disease Patients","volume":"9","author":"Sawada","year":"2019","journal-title":"Brain Behav."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1007\/s13760-015-0478-0","article-title":"Effects of Various Factors on Sleep Disorders and Quality of Life in Parkinson\u2019s Disease","volume":"115","author":"Telarovic","year":"2015","journal-title":"Acta Neurol. Belg."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Landes, R.D., Glover, A., Pillai, L., Doerhoff, S., and Virmani, T. (2022). Levodopa ONOFF-State Freezing of Gait: Defining the Gait and Non-Motor Phenotype. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0269227"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1030","DOI":"10.1212\/WNL.0b013e3182a4a408","article-title":"Increased REM Sleep without Atonia in Parkinson Disease with Freezing of Gait","volume":"81","author":"Videnovic","year":"2013","journal-title":"Neurology"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1774","DOI":"10.1016\/j.jbmt.2024.10.043","article-title":"Motor and Non-Motor Predictors of Freezing of Gait in Parkinson\u2019s Disease: A Retrospective Cohort Study","volume":"40","author":"Sharafkhah","year":"2024","journal-title":"J. Bodyw. Mov. Ther."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1007\/s10072-024-07738-8","article-title":"Impact of Excessive Daytime Sleepiness on the Progression of Freezing of Gait in de Novo Parkinson\u2019s Disease: A Cohort Study","volume":"46","author":"Chen","year":"2025","journal-title":"Neurol. Sci."},{"key":"ref_40","first-page":"8857204","article-title":"Freezing of Gait in Parkinson\u2019s Disease: Risk Factors, Their Interactions, and Associated Nonmotor Symptoms","volume":"2021","author":"Lichter","year":"2021","journal-title":"Park. Dis."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1016\/j.parkreldis.2014.12.020","article-title":"A 12-Year Population-Based Study of Freezing of Gait in Parkinson\u2019s Disease","volume":"21","author":"Forsaa","year":"2015","journal-title":"Park. Relat. Disord."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1080\/00273171.2011.568786","article-title":"An Introduction to Propensity Score Methods for Reducing the Effects of Confounding in Observational Studies","volume":"46","author":"Austin","year":"2011","journal-title":"Multivar. Behav. Res."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.1093\/aje\/kwj149","article-title":"Variable Selection for Propensity Score Models","volume":"163","author":"Brookhart","year":"2006","journal-title":"Am. J. Epidemiol."}],"container-title":["Brain Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3425\/16\/5\/493\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T04:26:09Z","timestamp":1778905569000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3425\/16\/5\/493"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,30]]},"references-count":43,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,5]]}},"alternative-id":["brainsci16050493"],"URL":"https:\/\/doi.org\/10.3390\/brainsci16050493","relation":{},"ISSN":["2076-3425"],"issn-type":[{"value":"2076-3425","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,30]]}}}