{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T00:24:32Z","timestamp":1772843072588,"version":"3.50.1"},"reference-count":53,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2023,1,2]],"date-time":"2023-01-02T00:00:00Z","timestamp":1672617600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>The early identification of modifiable risk factors and their monitoring, also within school physical education (PE) classes, are becoming indispensable in the context of public health. The aim of this study was to test whether making use of waist circumference (WC) measurements increases the possibility of predicting the results of cardiorespiratory fitness (CRF) in school-age children, as compared with body mass index (BMI) and other somatic indicators related to body fat. The cross-sectional study covered 190 children aged 10 to 15 years, participating in school PE classes. Body height (BH), body weight (BW), WC, hip circumference (HC) and percentage of body fat (BF%) were measured. BMI, waist to hip ratio (WHR) and waist to height ratio (WHtR) were calculated, and a CRF test was performed by means of a 20 m shuttle run test (20mSRT). The peak heart rate (HRpeak) of the children was also measured. The regression model that was developed showed that WC (R2 = 47.1%), beyond BF% (R2 = 50.3%) and WHtR (R2 = 50.0%), was a useful measure of CRF, and stronger than BMI (R2 = 45.8%) or WHR (R2 = 39.2%). The risk of obtaining the CRF result classified below a good level (below the percentile range of P60-P80) was significantly higher in children with a larger WC (odds ratio (OR) for the WC change of 1 cm equals 1.14 (95% CI: 1.09\u20131.20; p &lt; 0.001)). The simplicity of measuring WC and the possibility of using this measurement in the calculation of WHtR with reference to CRF indicate its usefulness in the prophylactic exams of school children.<\/jats:p>","DOI":"10.3390\/ijerph20010851","type":"journal-article","created":{"date-parts":[[2023,1,3]],"date-time":"2023-01-03T02:33:21Z","timestamp":1672713201000},"page":"851","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["An Investigation of the Utility of Waist Circumference Predicting Cardiorespiratory Fitness in School Children: A Cross-Sectional Study"],"prefix":"10.3390","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4330-3944","authenticated-orcid":false,"given":"Maria","family":"Zadarko-Domaradzka","sequence":"first","affiliation":[{"name":"Institute of Physical Culture Sciences, Medical College of Rzeszow University, 35-959 Rzeszow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marek","family":"Sobolewski","sequence":"additional","affiliation":[{"name":"Department of Quantitative Methods, Rzeszow University of Technology, 35-959 Rzeszow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edyta","family":"Nizio\u0142-Babiarz","sequence":"additional","affiliation":[{"name":"Department of Physical Education, Carpathian State College in Krosno, 38-400 Krosno, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zbigniew","family":"Barabasz","sequence":"additional","affiliation":[{"name":"Department of Physical Education, Carpathian State College in Krosno, 38-400 Krosno, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krzysztof","family":"Warcho\u0142","sequence":"additional","affiliation":[{"name":"Institute of Physical Culture Sciences, Medical College of Rzeszow University, 35-959 Rzeszow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Klaudia","family":"Niewczas-Czarna","sequence":"additional","affiliation":[{"name":"Institute of Physical Culture Sciences, Medical College of Rzeszow University, 35-959 Rzeszow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7423-1790","authenticated-orcid":false,"given":"Emilian","family":"Zadarko","sequence":"additional","affiliation":[{"name":"Institute of Physical Culture Sciences, Medical College of Rzeszow University, 35-959 Rzeszow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"75","DOI":"10.4103\/ijpvm.IJPVM_422_18","article-title":"Validity of Self-Reported Height, Weight, Body Mass Index, and Waist Circumference in Iranian Adults","volume":"12","author":"Aminianfar","year":"2021","journal-title":"Int. J. Prev. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"9524","DOI":"10.1038\/s41598-021-88951-9","article-title":"Distribution of Waist-to-Height Ratio and Cardiometabolic Risk in Children and Adolescents: A Population-Based Study","volume":"11","author":"Lee","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"43046","DOI":"10.1038\/srep43046","article-title":"Waist-to-Height Ratio Is an Effective Indicator for Comprehensive Cardiovascular Health","volume":"7","author":"Shen","year":"2017","journal-title":"Sci. Rep."},{"key":"ref_4","first-page":"557","article-title":"Waist Circumference as an Indicator of High Blood Pressure in Preschool Obese Children","volume":"20","author":"Chen","year":"2011","journal-title":"Asia Pac. J. Clin. Nutr."},{"key":"ref_5","first-page":"385","article-title":"Body Fat Measurements in Children as Predictors for the Metabolic Syndrome: Focus on Waist Circumference","volume":"65","author":"McCarthy","year":"2006","journal-title":"Proc. Nutr. Soc."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1038\/s41574-019-0310-7","article-title":"Waist Circumference as a Vital Sign in Clinical Practice: A Consensus Statement from the IAS and ICCR Working Group on Visceral Obesity","volume":"16","author":"Ross","year":"2020","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_7","unstructured":"Fija\u0142kowska, A., Oblaci\u0144ska, A., Dzielska, A., Na\u0142\u0119cz, H., Korzycka, M., Okulicz-Kozaryn, K., B\u00f3jko, M., and Radiukiewicz, K. (2022). Zdrowie dzieci w Pandemii COVID-19, Instytut Matki i Dziecka."},{"key":"ref_8","unstructured":"WHO (2017). Reducing Childhood Obesity in Poland by Effective Policies, World Health Organization, Regional Office for Europe. Available online: https:\/\/www.euro.who.int\/__data\/assets\/pdf_file\/0011\/350030\/Reducing-childhood-obesity-in-Poland_final_WEB.pdf."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Mazur, A., Zachurzok, A., Baran, J., Dere\u0144, K., \u0141uszczki, E., Weres, A., Wyszy\u0144ska, J., Dylczyk, J., Szczudlik, E., and Dro\u017cd\u017c, D. (2022). Childhood Obesity: Position Statement of Polish Society of Pediatrics, Polish Society for Pediatric Obesity, Polish Society of Pediatric Endocrinology and Diabetes, the College of Family Physicians in Poland and Polish Association for Study on Obesity. Nutrients, 14.","DOI":"10.3390\/nu14183806"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Herbert, J., Mat\u0142osz, P., Lenik, J., Szybisty, A., Baran, J., Przednowek, K., and Wyszy\u0144ska, J. (2020). Objectively Assessed Physical Activity of Preschool-Aged Children from Urban Areas. Int. J. Environ. Res. Public. Health, 17.","DOI":"10.3390\/ijerph17041375"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1111\/j.1467-789X.2009.00694.x","article-title":"Percentile Distributions of Waist Circumference for 7\u201319-Year-Old Polish Children and Adolescents","volume":"11","author":"Nawarycz","year":"2010","journal-title":"Obes. Rev."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1154","DOI":"10.1001\/jamapediatrics.2019.3310","article-title":"Global Prevalence of Hypertension in Children: A Systematic Review and Meta-Analysis","volume":"173","author":"Song","year":"2019","journal-title":"JAMA Pediatr."},{"key":"ref_13","unstructured":"Fija\u0142kowska, A., Oblaci\u0144ska, A., and Stalmach, M. (2017). Nadwaga i Oty\u0142o\u015b\u0107 u Polskich 8-latk\u00f3w w \u015awietle Uwarunkowa\u0144 Biologicznych, Behawioralnych i Spo\u0142ecznych Raport z Mi\u0119dzynarodowych Bada\u0144 WHO European Childhood Obesity Surveillance Initiative (COSI), Instytut Matki i Dziecka."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"340","DOI":"10.21101\/cejph.a4153","article-title":"Percentile Values of Physical Fitness Levels among Polish Children Aged 7 to 19 Years\u2014A Population-Based Study","volume":"23","author":"Dobosz","year":"2015","journal-title":"Cent. Eur. J. Public Health"},{"key":"ref_15","unstructured":"Wieczorek, M., Bronikowski, M., Groffik, D., and Kumala, R. (2017). Komentarz do podstawy programowej przedmiotu wychowanie fizyczne na II etapie edukacyjnym. Podstawa Programowa Kszta\u0142cenia Og\u00f3lnego z Komentarzem. Szko\u0142a Podstawowa. Wychowanie Fizyczne, O\u015brodek Rozwoju Edukacji."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/sj.ijo.0803774","article-title":"Physical Fitness in Childhood and Adolescence: A Powerful Marker of Health","volume":"32","author":"Ortega","year":"2008","journal-title":"Int. J. Obes."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1136\/bjsm.2008.056499","article-title":"Predictive Validity of Health-Related Fitness in Youth: A Systematic Review","volume":"43","author":"Ruiz","year":"2009","journal-title":"Br. J. Sports Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1016\/j.pcad.2019.01.002","article-title":"Cardiorespiratory Fitness and Cardiovascular Disease\u2014The Past, Present, and Future","volume":"62","author":"Kaminsky","year":"2019","journal-title":"Prog. Cardiovasc. Dis."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e653","DOI":"10.1161\/CIR.0000000000000461","article-title":"American Heart Association Physical Activity Committee of the Council on Lifestyle and Cardiometabolic Health; Council on Clinical Cardiology; Council on Epidemiology and Prevention; Council on Cardiovascular and Stroke Nursing; Council on Functional Genomics and Translational Biology; Stroke Council. Importance of Assessing Cardiorespiratory Fitness in Clinical Practice: A Case for Fitness as a Clinical Vital Sign: A Scientific Statement From the American Heart Association","volume":"134","author":"Ross","year":"2016","journal-title":"Circulation"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1093\/eurjpc\/zwab169","article-title":"Combinations of BMI and Cardiorespiratory Fitness Categories: Trends between 1995 and 2020 and Associations with CVD Incidence and Mortality and All-Cause Mortality in 471,216 Adults","volume":"29","author":"Hemmingsson","year":"2022","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e101","DOI":"10.1161\/CIR.0000000000000866","article-title":"Cardiorespiratory Fitness in Youth: An Important Marker of Health: A Scientific Statement from the American Heart Association","volume":"142","author":"Raghuveer","year":"2020","journal-title":"Circulation"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1016\/j.jpeds.2017.09.055","article-title":"Cardiorespiratory Fitness and Blood Pressure: A Longitudinal Analysis","volume":"192","author":"Ruiz","year":"2018","journal-title":"J. Pediatr."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1080\/02701367.2015.1124969","article-title":"Prediction of VO2max in Children and Adolescents Using Exercise Testing and Physical Activity Questionnaire Data","volume":"87","author":"Black","year":"2016","journal-title":"Res. Q. Exerc. Sport"},{"key":"ref_24","first-page":"536","article-title":"Criterion-Related Validity of the 20-M Shuttle Run Test for Estimating Cardiorespiratory Fitness: A Meta-Analysis","volume":"14","author":"Viciana","year":"2015","journal-title":"J. Sports Sci. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1624","DOI":"10.1249\/MSS.0000000000002637","article-title":"Predicting Cardiorespiratory Fitness Using the 20-m Shuttle Run Test: New Insights Using Nonlinear Allometry","volume":"53","author":"Nevill","year":"2021","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Silva, D.A.S., Lang, J.J., Barnes, J.D., Tomkinson, G.R., and Tremblay, M.S. (2018). Cardiorespiratory Fitness in Children: Evidence for Criterion-Referenced Cut-Points. PloS ONE, 13.","DOI":"10.1371\/journal.pone.0201048"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e000627","DOI":"10.1136\/bmjsem-2019-000627","article-title":"The 20 m Shuttle Run Is Not a Valid Test of Cardiorespiratory Fitness in Boys Aged 11\u201314 Years","volume":"5","author":"Welsman","year":"2019","journal-title":"BMJ Open Sport Exerc. Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1016\/j.jsams.2017.08.002","article-title":"Systematic Review of the Relationship between 20m Shuttle Run Performance and Health Indicators among Children and Youth","volume":"21","author":"Lang","year":"2018","journal-title":"J. Sci. Med. Sport"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1097\/HJR.0b013e328336975e","article-title":"Increased Body Fat Is Independently and Negatively Related with Cardiorespiratory Fitness Levels in Children and Adolescents with Normal Weight","volume":"17","author":"Marcelino","year":"2010","journal-title":"Eur. J. Cardiovasc. Prev. Rehabil."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"48","DOI":"10.17309\/tmfv.2022.1.07","article-title":"Cardiorespiratory Fitness Cut-Points Related to Body Adiposity Parameters in Macedonian Children","volume":"22","author":"Elezi","year":"2022","journal-title":"Teor\u00ec\u00e2 Ta Metod. F\u00eczi\u010dnogo Vihov."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"4091","DOI":"10.1007\/s00431-022-04623-4","article-title":"Cardiovascular Health Behavior and Cardiorespiratory Fitness in Adolescents: A Longitudinal Study","volume":"181","author":"Dubey","year":"2022","journal-title":"Eur. J. Pediatr."},{"key":"ref_32","unstructured":"Ministerswo Edukacji Narodowej (2017). Podstawa Programowa Kszta\u0142cenia Og\u00f3lnego z Komentarzem. Szko\u0142a Podstawowa. Wychowanie Fizyczne, O\u015brodek Rozwoju Edukacji."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"697437","DOI":"10.3389\/fendo.2021.697437","article-title":"Quotient of Waist Circumference and Body Mass Index: A Valuable Indicator for the High-Risk Phenotype of Obesity","volume":"12","author":"Liu","year":"2021","journal-title":"Front. Endocrinol."},{"key":"ref_34","unstructured":"WHO (2022, October 28). Growth Reference 5\u201319 years\u2014BMI-for-Age (5\u201319 years). Available online: https:\/\/www.who.int\/tools\/growth-reference-data-for-5to19-years\/indicators\/bmi-for-age."},{"key":"ref_35","unstructured":"World Health Organization (2011). Waist Circumference and Waist-Hip Ratio: Report of a WHO Expert Consultation, Geneva, 8\u201311 December 2008, World Health Organization. Available online: https:\/\/apps.who.int\/iris\/handle\/10665\/44583."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/BF00428958","article-title":"A Maximal Multistage 20-m Shuttle Run Test to Predict VO2 Max","volume":"49","author":"Lambert","year":"1982","journal-title":"Eur. J. Appl. Physiol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1545","DOI":"10.1136\/bjsports-2016-095987","article-title":"International Normative 20 m Shuttle Run Values from 1,142,026 Children and Youth Representing 50 Countries","volume":"51","author":"Tomkinson","year":"2017","journal-title":"Br. J. Sports Med."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1093\/eurpub\/ckr005","article-title":"Positive Health, Cardiorespiratory Fitness and Fatness in Children and Adolescents","volume":"22","author":"Ortega","year":"2012","journal-title":"Eur. J. Public Health"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/j.ypmed.2016.09.024","article-title":"Waist Circumference, Body Mass Index and Waist-Height Ratio: Are Two Indices Better than One for Identifying Hypertension Risk in Older Adults?","volume":"93","author":"Luz","year":"2016","journal-title":"Prev. Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"784787","DOI":"10.3389\/fphys.2022.784787","article-title":"Defining Optimal Cut-Points for Cardiorespiratory Fitness Associated With Overweight\/Obesity in Children: A School-Based Study","volume":"13","year":"2022","journal-title":"Front. Physiol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1093\/ajcn\/72.2.490","article-title":"Evaluation of Waist Circumference, Waist-to-Hip Ratio, and the Conicity Index as Screening Tools for High Trunk Fat Mass, as Measured by Dual-Energy X-Ray Absorptiometry, in Children Aged 3\u201319 y","volume":"72","author":"Taylor","year":"2000","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"e010159","DOI":"10.1136\/bmjopen-2015-010159","article-title":"Waist-to-Height Ratio as an Indicator of \u201cEarly Health Risk\u201d: Simpler and More Predictive than Using a \u201cmatrix\u201d Based on BMI and Waist Circumference","volume":"6","author":"Ashwell","year":"2016","journal-title":"BMJ Open"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"4250793","DOI":"10.1155\/2020\/4250793","article-title":"Waist-to-Height Ratio (WHtR) in Predicting Coronary Artery Disease Compared to Body Mass Index and Waist Circumference in a Single Center from Saudi Arabia","volume":"2020","author":"Alshamiri","year":"2020","journal-title":"Cardiol. Res. Pract."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"16228","DOI":"10.1038\/s41598-020-73224-8","article-title":"Waist-to-Height Ratio Is a Better Discriminator of Cardiovascular Disease than Other Anthropometric Indicators in Kurdish Adults","volume":"10","author":"Pasdar","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"5971030","DOI":"10.1155\/2019\/5971030","article-title":"Waist Circumference Measured by Bioelectrical Impedance Analysis Is Interchangeable with Manual Measurement: Increased Waist Circumference Is Associated with Locomotive Syndrome Risk","volume":"2019","author":"Tanaka","year":"2019","journal-title":"BioMed Res. Int."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"4019","DOI":"10.1590\/1413-812320182411.30182017","article-title":"Correlates of Body Fat and Waist Circumference in Children from S\u00e3o Caetano Do Sul, Brazil","volume":"24","author":"Pires","year":"2019","journal-title":"Cienc. Saude Coletiva"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1139\/apnm-2017-0728","article-title":"Exploring the Utility of Cardiorespiratory Fitness as a Population Health Surveillance Indicator for Children and Youth: An International Analysis of Results from the 20-m Shuttle Run Test","volume":"43","author":"Lang","year":"2018","journal-title":"Appl. Physiol. Nutr. Metab."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1080\/17477160802221101","article-title":"Eight-Year-Old Children with High Cardiorespiratory Fitness Have Lower Overall and Abdominal Fatness","volume":"4","author":"Stigman","year":"2009","journal-title":"Int. J. Pediatr. Obes."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"952","DOI":"10.1001\/jamapediatrics.2020.2400","article-title":"Association of Cardiorespiratory Fitness Levels During Youth With Health Risk Later in Life","volume":"174","author":"Izquierdo","year":"2020","journal-title":"JAMA Pediatr."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1007\/s40279-021-01537-3","article-title":"Health-Related Criterion-Referenced Cut-Points for Cardiorespiratory Fitness Among Youth: A Systematic Review","volume":"52","author":"Rollo","year":"2022","journal-title":"Sports Med."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Prieto-Benavides, D.H., Garc\u00eda-Hermoso, A., Izquierdo, M., Alonso-Mart\u00ednez, A.M., Agostinis-Sobrinho, C., Correa-Bautista, J.E., and Ram\u00edrez-V\u00e9lez, R. (2019). Cardiorespiratory Fitness Cut-Points Are Related to Body Adiposity Parameters in Latin American Adolescents. Medicina, 55.","DOI":"10.3390\/medicina55090508"},{"key":"ref_52","unstructured":"Dobosz, J. (2012). Kondycja Fizyczna Dzieci i M\u0142odzie\u017cy w Wieku Szkolnym, Siatki Centylowe [Growth and Physical Fitness of Children and Youth of School Age. Centile Charts], J\u00f3zef Pi\u0142sudski University of Physical Education in Warsaw."},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Dobrowolska, A., Domagalska-Szopa, M., Siwiec, A., and Szopa, A. (2022). Association between Cardiopulmonary Capacity and Body Mass Composition in Children and Adolescents with High Body Weight: A Cross-Sectional Study. Children, 9.","DOI":"10.3390\/children9050647"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/1\/851\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T17:56:32Z","timestamp":1760118992000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/1\/851"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,2]]},"references-count":53,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,1]]}},"alternative-id":["ijerph20010851"],"URL":"https:\/\/doi.org\/10.3390\/ijerph20010851","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,2]]}}}