{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:36:23Z","timestamp":1787027783666,"version":"build-2736575974"},"reference-count":70,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2022,11,25]],"date-time":"2022-11-25T00:00:00Z","timestamp":1669334400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Genital lymphedema may affect males and females after cancer treatment (gynecological, such as cervical, uterine or ovarian, melanoma, prostate, anus\u2026). It is frequently associated with lower limb lymphedema, and is responsible for discomfort, cosmetic disfigurement and functional disturbances. Impacts on body image, sexual function and quality of life are major, and difficult to explore because cancer treatment itself and lymphedema are so closely interwoven. Local complications, e.g., papillomatosis, warty growth, lymph vesicles with embarrassing lymph oozing and cellulitis, may occur. Usual lymphedema therapies, like bandaging and elastic compression, are poorly adapted to these sites. Surgery, essentially based on cutaneous resection techniques, is the primary symptomatic treatment; it achieves good efficacy, in adults and children, with possible recurrence requiring reintervention.<\/jats:p>","DOI":"10.3390\/cancers14235809","type":"journal-article","created":{"date-parts":[[2022,11,28]],"date-time":"2022-11-28T07:01:30Z","timestamp":1669618890000},"page":"5809","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Genital Lymphedema after Cancer Treatment: A Narrative Review"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6745-1469","authenticated-orcid":false,"given":"St\u00e9phane","family":"Vignes","sequence":"first","affiliation":[{"name":"Department of Lymphology, Centre National de R\u00e9f\u00e9rence des Maladies Vasculaires Rares (Lymphoed\u00e8mes Primaires), H\u00f4pital Cognacq-Jay, 15, rue Eug\u00e8ne-Millon, 75015 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1097\/PRS.0b013e3182450b2d","article-title":"Regulation of adipogenesis by lymphatic fluid stasis: Part I. Adipogenesis, fibrosis, and inflammation","volume":"129","author":"Zampell","year":"2012","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/S0151-9638(05)79190-0","article-title":"Lymphedema of male external genitalia: A retrospective study of 33 cases","volume":"132","author":"Vignes","year":"2005","journal-title":"Ann. Dermatol. Venereol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"836","DOI":"10.1111\/pde.15025","article-title":"Milroy disease with predominant preputial involvement","volume":"39","author":"Alonso","year":"2022","journal-title":"Pediatr. Dermatol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1136\/jmedgenet-2019-106084","article-title":"Update and audit of the St George\u2019s classification algorithm of primary lymphatic anomalies: A clinical and molecular approach to diagnosis","volume":"57","author":"Gordon","year":"2020","journal-title":"J. Med. Genet."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e203","DOI":"10.1542\/peds.2014-3673","article-title":"ISSVA Board and Scientific Committee. Vascular anomalies classification: Recommendations from the International Society for the Study of Vascular Anomalies","volume":"136","author":"Wassef","year":"2015","journal-title":"Pediatrics"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"119","DOI":"10.3347\/kjp.2008.46.3.119","article-title":"Clinical and pathological aspects of filarial lymphedema and its management","volume":"46","author":"Shenoy","year":"2008","journal-title":"Korean J. Parasitol."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Medeiros, Z.M., Vieira, A., Xavier, A.T., Bezerra, G., Lopes, M., Bonfim, C.V., and Aguiar-Santos, A.M. (2021). Lymphatic filariasis: A systematic review on morbidity and its repercussions in countries in the Americas. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19010316"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1196\/annals.1413.014","article-title":"Estimating the population burden of lymphedema","volume":"1131","author":"Rockson","year":"2008","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1007\/s10585-021-10096-w","article-title":"Secondary lymphedema from cancer therapy","volume":"39","author":"Bernas","year":"2022","journal-title":"Clin. Exp. Metastasis"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/1750-1172-3-5","article-title":"Primary intestinal lymphangiectasia (Waldmann\u2019s disease)","volume":"3","author":"Vignes","year":"2008","journal-title":"Orphanet J. Rare Dis."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1111\/j.1525-1470.2008.00861.x","article-title":"Metastatic cutaneous Crohn\u2019s disease in children: Case report and review of the literature","volume":"26","author":"Keiler","year":"2009","journal-title":"Pediatr. Dermatol."},{"key":"ref_12","first-page":"454","article-title":"Ano-genital granulomatosis and Crohn\u2019s disease: A case series of males presenting with genital lymphoedema","volume":"11","author":"Alexakis","year":"2017","journal-title":"J. Crohn\u2019s Colitis"},{"key":"ref_13","first-page":"84","article-title":"Penile and scrotal lymphedema associated with hidradenitis suppurativa: Case report and review of surgical options","volume":"86","author":"Pacheco","year":"2018","journal-title":"Cir. Cir."},{"key":"ref_14","first-page":"214","article-title":"Upper limb lymphatic function in inflammatory arthritis","volume":"22","author":"Kiely","year":"1995","journal-title":"J. Rheumatol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1007\/s002470050608","article-title":"Juvenile rheumatoid arthritis and lymphoedema: Lymphangiographic aspects","volume":"29","author":"Schmit","year":"1999","journal-title":"Pediatr. Radiol."},{"key":"ref_16","first-page":"566","article-title":"Oligoarthrite B27 avec \u0153d\u00e8mes et signes g\u00e9n\u00e9raux: Une forme atypique de spondylarthropathie \u00e0 d\u00e9but tardif","volume":"140","author":"Dubost","year":"1989","journal-title":"Ann. Med. Interne"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1297","DOI":"10.1046\/j.1365-2133.2000.03905.x","article-title":"Bilateral upper limb lymphoedema associated with psoriatic arthritis: A case report and review of the literature","volume":"143","author":"Riemann","year":"2000","journal-title":"Br. J. Dermatol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1452","DOI":"10.1001\/archderm.136.12.1452","article-title":"Clinical features and contribution of virological findings to the management of Kaposi sarcoma in organ-allograft recipients","volume":"136","author":"Barete","year":"2000","journal-title":"Arch. Dermatol."},{"key":"ref_19","first-page":"422","article-title":"Lymph\u0153d\u00e8me du membre inf\u00e9rieur r\u00e9v\u00e9lant une fibrose r\u00e9trop\u00e9riton\u00e9ale d\u2019origine m\u00e9tastatique","volume":"129","author":"Foureur","year":"2002","journal-title":"Ann. Dermatol. Venereol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2299","DOI":"10.1111\/j.1572-0241.1998.00647.x","article-title":"Primary amyloidosis of the mesentery and the retroperitoneum presenting with lymphedema","volume":"93","author":"Halm","year":"1998","journal-title":"Am. J. Gastroenterol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1322","DOI":"10.1111\/j.1365-2133.2009.09098.x","article-title":"Sirolimus-associated lymphoedema: Eight new cases and a proposed mechanism","volume":"160","author":"Desai","year":"2009","journal-title":"Br. J. Dermatol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"648","DOI":"10.1111\/j.1346-8138.1996.tb02672.x","article-title":"Lymphedema due to chronic penile strangulation: A case report","volume":"23","author":"Tanabe","year":"1996","journal-title":"J. Dermatol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1007\/s10508-011-9812-7","article-title":"Compulsive masturbation and chronic penile lymphedema","volume":"41","author":"Marino","year":"2012","journal-title":"Arch. Sex. Behav."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1590\/1516-3180.2016.0275251016","article-title":"Liquid silicone used for esthetic purposes as a potentiator for occurrence of post-radiotherapy genital lymphedema: Case report","volume":"135","author":"Antonelli","year":"2017","journal-title":"Sao Paulo Med. J."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1038\/modpathol.2015.135","article-title":"Massive localized lymphedema: A clinicopathologic study of 46 patients with an enrichment for multiplicity","volume":"29","author":"Kurt","year":"2016","journal-title":"Mod. Pathol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1016\/j.ucl.2022.04.009","article-title":"Adult-acquired buried penis classification and surgical management","volume":"49","author":"Flynn","year":"2022","journal-title":"Urol. Clin. N. Am."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1159\/000506045","article-title":"With bare feet in the soil: Podoconiosis, a neglected cause of tropical lymphoedema","volume":"237","author":"Chandler","year":"2021","journal-title":"Dermatology"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"102167","DOI":"10.1016\/j.eucr.2022.102167","article-title":"Sarcoidosis: A rare cause of penile edema","volume":"44","author":"Herodotou","year":"2022","journal-title":"Urol. Case Rep."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1016\/0741-5214(90)90247-8","article-title":"Edema after femoropopliteal bypass surgery: Lymphatic and venous theories of causation","volume":"11","author":"AbuRahma","year":"1990","journal-title":"J. Vasc. Surg."},{"key":"ref_30","first-page":"306","article-title":"Genital swelling as a surgical complication of continuous ambulatory peritoneal dialysis","volume":"170","author":"Abraham","year":"1990","journal-title":"Surg. Gynecol. Obstet."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Kuroda, K., Yamamoto, Y., Yanagisawa, M., Kawata, A., Akiba, N., Suzuki, K., and Naritaka, K. (2017). Risk factors and a prediction model for lower limb lymphedema following lymphadenectomy in gynecologic cancer: A hospital-based retrospective cohort study. BMC Women\u2019s Health, 17.","DOI":"10.1186\/s12905-017-0403-1"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1007\/s10147-019-01608-6","article-title":"Risk factors for lower limb lymphedema in gynecologic cancer patients after initial treatment","volume":"25","author":"Kunitake","year":"2020","journal-title":"Int. J. Clin. Oncol."},{"key":"ref_33","first-page":"S19","article-title":"An international investigation of the education needs of health professionals conservatively managing genital lymphoedema: Survey findings","volume":"30","author":"Thomas","year":"2021","journal-title":"J. Wound Care"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e56","DOI":"10.1111\/jdv.14497","article-title":"Vulvar lymphangioma circumscriptum: Comparison of primary and acquired forms in a cohort of 57 patients","volume":"32","author":"Simon","year":"2018","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"2607","DOI":"10.1002\/cncr.22684","article-title":"Lymphedema after gynecological cancer treatment: Prevalence, correlates, and supportive care needs","volume":"109","author":"Beesley","year":"2007","journal-title":"Cancer"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1089\/wound.2021.0149","article-title":"Guidelines relevant to diagnosis, assessment, and management of lymphedema: A systematic review","volume":"12","author":"Torgbenu","year":"2023","journal-title":"Adv. Wound Care"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1097\/SAP.0000000000000360","article-title":"Genital Lymphedema Score: Genital Lymphedema Severity scoring system based on subjective symptoms","volume":"77","author":"Yamamoto","year":"2016","journal-title":"Ann. Plast. Surg."},{"key":"ref_38","first-page":"261","article-title":"A clinical symptom for the early and differential diagnosis of lymphedema","volume":"5","author":"Stemmer","year":"1976","journal-title":"Vasa"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1186","DOI":"10.1097\/PRS.0b013e3181b5a37f","article-title":"Management of \u201cburied\u201d penis in adulthood: An overview","volume":"124","author":"Pestana","year":"2009","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1111\/j.1600-0560.1999.tb01820.x","article-title":"Acquired vulvar lymphangioma mimicking genital warts. A case report and review of the literature","volume":"26","author":"Mu","year":"1999","journal-title":"J. Cutan. Pathol"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1016\/j.jaad.2014.01.907","article-title":"Verrucous localized lymphedema of genital areas: Clinicopathologic report of 18 cases of this rare entity","volume":"71","author":"Plaza","year":"2014","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1591","DOI":"10.1136\/bmj.318.7198.1591","article-title":"Risk factors for erysipelas of the leg (cellulitis): Case-Control study","volume":"318","author":"Dupuy","year":"1999","journal-title":"BMJ"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1393","DOI":"10.1111\/jocn.14721","article-title":"Lived experiences and quality of life after gynaecological cancer\u2014An integrative review","volume":"28","author":"Sekse","year":"2019","journal-title":"J. Clin. Nurs."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"e1215","DOI":"10.1016\/j.clgc.2018.07.029","article-title":"Cross-sectional patient-reported outcome measuring of health-related quality of life with establishment of cancer- and treatment-specific functional and symptom scales in patients with penile cancer","volume":"16","author":"Draeger","year":"2018","journal-title":"Clin. Genitourin. Cancer"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"2959","DOI":"10.1007\/s00520-021-06595-x","article-title":"Changes in quality of life and lower urinary tract symptoms over time in cancer patients after a total prostatectomy: Systematic review and meta-analysis","volume":"30","author":"Amano","year":"2022","journal-title":"Support. Care Cancer"},{"key":"ref_46","first-page":"43","article-title":"The third circulation: Radionuclide lymphoscintigraphy in the evaluation of lymphedema","volume":"44","author":"Szuba","year":"2003","journal-title":"J. Nucl. Med."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"e3755","DOI":"10.1097\/MD.0000000000003755","article-title":"Assessment of the lymphatic system of the genitalia using magnetic resonance lymphography before and after treatment of male genital lymphedema","volume":"95","author":"Lu","year":"2016","journal-title":"Medicine"},{"key":"ref_48","first-page":"400","article-title":"Indocyanine green lymphography for evaluation of genital lymphedema in secondary lower extremity lymphedema patients","volume":"1","author":"Yamamoto","year":"2013","journal-title":"J. Vasc. Surg. Venous. Lymph. Dis."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1488","DOI":"10.1007\/s00270-012-0445-6","article-title":"Transnodal lymphangiography in the diagnosis and treatment of genital lymphedema","volume":"35","author":"Santos","year":"2012","journal-title":"Cardiovasc. Interv. Radiol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1016\/j.annder.2017.03.008","article-title":"Lymph\u0153d\u00e8me des membres inf\u00e9rieurs r\u00e9v\u00e9lant une linite gastrique","volume":"144","author":"Nguyen","year":"2017","journal-title":"Ann. Dermatol. Venereol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1016\/j.bjps.2014.10.003","article-title":"Treatment of male genital lymphedema: An integrated concept","volume":"68","author":"Stark","year":"2015","journal-title":"J. Plast. Reconstr. Aesthet. Surg."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1016\/j.pmrj.2012.05.003","article-title":"A systematic review of the evidence for complete decongestive therapy in the treatment of lymphedema from 2004 to 2011","volume":"4","author":"Lasinski","year":"2012","journal-title":"PM R"},{"key":"ref_53","first-page":"224","article-title":"Measurement of lower leg compression in vivo: Recommendations for the performance of measurements of interface pressure and stiffness: Consensus statement","volume":"32","author":"Partsch","year":"2006","journal-title":"Dermatol. Surg."},{"key":"ref_54","first-page":"15","article-title":"The risk of genital edema after external pump compression for lower limb lymphedema","volume":"31","author":"Boris","year":"1998","journal-title":"Lymphology"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1007\/s11764-020-00928-1","article-title":"Manual lymphatic drainage treatment for lymphedema: A systematic review of the literature","volume":"15","author":"Thompson","year":"2021","journal-title":"J. Cancer Surviv."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"975","DOI":"10.1097\/PRS.0000000000007783","article-title":"Surgical treatment of lymphedema: A systematic review and meta-analysis of controlled trials. Results of a Consensus Conference","volume":"147","author":"Chang","year":"2021","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1097\/01.ju.0000067625.45000.9e","article-title":"Lymphedema of the external genitalia","volume":"170","author":"McDougal","year":"2003","journal-title":"J. Urol."},{"key":"ref_58","first-page":"870","article-title":"Radical reduction and reconstruction for male genital elephantiasis: Superficial circumflex iliac artery perforator (SCIP) lymphatic flap transfer after elephantiasis tissue resection","volume":"75","author":"Yamamoto","year":"2022","journal-title":"JPRAS"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.1016\/j.eururo.2010.11.020","article-title":"Assessment and follow-up of patency after lymphovenous microsurgery for treatment of secondary lymphedema in external male genital organs","volume":"60","author":"Mukenge","year":"2011","journal-title":"Eur. Urol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.jpra.2019.01.007","article-title":"Ultramicrosurgery: A new approach to treat primary male genital lymphedema","volume":"20","author":"Gennaro","year":"2019","journal-title":"JPRAS Open"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1111\/j.1464-410X.2008.07559.x","article-title":"The management of genital lymphoedema","volume":"102","author":"Garaffa","year":"2008","journal-title":"BJU Int."},{"key":"ref_62","first-page":"1108","article-title":"Chronic penile lymphedema: A report of 6 cases","volume":"137","author":"Porter","year":"2001","journal-title":"Arch. Dermatol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1016\/j.urology.2015.07.005","article-title":"Utilities of split-thickness skin grafting for male genital reconstruction","volume":"86","author":"Alwaal","year":"2015","journal-title":"Urology"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1647","DOI":"10.1016\/j.jpedsurg.2014.05.031","article-title":"Male genital lymphedema: Clinical features and management in 25 pediatric patients","volume":"49","author":"Schook","year":"2014","journal-title":"J. Pediatr. Surg."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1883","DOI":"10.1016\/j.bjps.2009.11.019","article-title":"Surgical resection of vulva lymphoedema circumscriptum","volume":"63","author":"Vignes","year":"2010","journal-title":"J. Plast. Reconstr. Aesthet. Surg."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"3","DOI":"10.5999\/aps.2019.01123","article-title":"Surgical management of male genital lymphedema: A systematic review","volume":"47","author":"Aulia","year":"2020","journal-title":"Arch. Plast. Surg."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"e85","DOI":"10.1097\/SAP.0000000000001875","article-title":"A systematic review of outcomes after genital lymphedema surgery: Microsurgical reconstruction versus excisional procedures","volume":"83","author":"Guiotto","year":"2019","journal-title":"Ann. Plast. Surg."},{"key":"ref_68","first-page":"575","article-title":"CO2 laser therapy of vulva lymphangiectasia and lymphangioma circumscriptum","volume":"28","author":"Huilgol","year":"2002","journal-title":"Dermatol. Surg."},{"key":"ref_69","first-page":"946","article-title":"Lymphangioma circumscriptum of the vulva: A review of the literature","volume":"101","author":"Vlastos","year":"2003","journal-title":"Obstet. Gynecol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"e482","DOI":"10.1111\/ijd.13264","article-title":"Acquired lymphangiectasia (lymphangioma circumscriptum) of the vulva: Clinicopathologic study of 11 patients from a single institution and 67 from the literature","volume":"55","author":"Chang","year":"2016","journal-title":"Int. J. Dermatol."}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/14\/23\/5809\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:26:41Z","timestamp":1760146001000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/14\/23\/5809"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,25]]},"references-count":70,"journal-issue":{"issue":"23","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["cancers14235809"],"URL":"https:\/\/doi.org\/10.3390\/cancers14235809","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,25]]}}}