{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T22:14:11Z","timestamp":1775772851779,"version":"3.50.1"},"reference-count":54,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2023,3,7]],"date-time":"2023-03-07T00:00:00Z","timestamp":1678147200000},"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>(1) Background: Myopia is one of the leading causes of visual impairment. Visual work and usage of electronic devices are known risk factors of myopia. Many education systems were forced to apply online and hybrid teaching methods, to reduce the number of new cases of COVID-19. Medical students are a population well-known for intense visual work in the form of learning; (2) Methods: Visual acuity and refractive error were measured in the population of medical students. Participants also filled out the survey that included their population characteristic and their habits related to the hygiene of vision; (3) Results: We found a correlation between the age of the first diagnosis of myopia and current values of refractive error. The majority of participants believe that the COVID-19 pandemic had an impact on the health of their vision. Among methods of studying, usage of the computer screen was less preferred by myopic students; (4) Conclusions: In the population of medical school students in Eastern Poland, visual acuity was lower than 1.0 in 232 (52.97%) in the right eye and 234 (53.42%) in the left eye. Early recognition of refractive error has influenced its current values. Among methods of studying, usage of the computer screen was less preferred by myopic students. More population-based studies should focus on the impact of the COVID-19 pandemic on the health of vision.<\/jats:p>","DOI":"10.3390\/ijerph20064699","type":"journal-article","created":{"date-parts":[[2023,3,8]],"date-time":"2023-03-08T02:30:23Z","timestamp":1678242623000},"page":"4699","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["The Incidence and Severity of Myopia in the Population of Medical Students and Its Dependence on Various Demographic Factors and Vision Hygiene Habits"],"prefix":"10.3390","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7406-550X","authenticated-orcid":false,"given":"Pawe\u0142","family":"Oszcz\u0119d\u0142owski","sequence":"first","affiliation":[{"name":"Students\u2019 Scientific Association at the Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20-079 Lublin, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Przemys\u0142aw","family":"Raczkiewicz","sequence":"additional","affiliation":[{"name":"Students\u2019 Scientific Association at the Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20-079 Lublin, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6785-6741","authenticated-orcid":false,"given":"Piotr","family":"Wi\u0119syk","sequence":"additional","affiliation":[{"name":"Students\u2019 Scientific Association at the Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20-079 Lublin, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3941-027X","authenticated-orcid":false,"given":"Kinga","family":"Brzuszkiewicz","sequence":"additional","affiliation":[{"name":"Students\u2019 Scientific Association at the Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20-079 Lublin, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Rapa","sequence":"additional","affiliation":[{"name":"Students\u2019 Scientific Association at the Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20-079 Lublin, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0865-6541","authenticated-orcid":false,"given":"Anna","family":"Matysik-Wo\u017aniak","sequence":"additional","affiliation":[{"name":"Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20-079 Lublin, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2849-0641","authenticated-orcid":false,"given":"Grzegorz","family":"Zieli\u0144ski","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine, Medical University of Lublin, 20-093 Lublin, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maksymilian","family":"Onyszkiewicz","sequence":"additional","affiliation":[{"name":"Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20-079 Lublin, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krzysztof Marek","family":"R\u0119kas","sequence":"additional","affiliation":[{"name":"Students\u2019 Scientific Association at the Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20-079 Lublin, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Inga","family":"Makosz","sequence":"additional","affiliation":[{"name":"Students\u2019 Scientific Association at the Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20-079 Lublin, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ma\u0142gorzata","family":"Latalska","sequence":"additional","affiliation":[{"name":"Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20-079 Lublin, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aleksandra","family":"Czarnek-Chudzik","sequence":"additional","affiliation":[{"name":"Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20-079 Lublin, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"Korulczyk","sequence":"additional","affiliation":[{"name":"Department of Didactics and Medical Simulation, Medical University of Lublin, 20-093 Lublin, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Rejdak","sequence":"additional","affiliation":[{"name":"Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20-079 Lublin, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e1221","DOI":"10.1016\/S2214-109X(17)30393-5","article-title":"Global Causes of Blindness and Distance Vision Impairment 1990\u20132020: A Systematic Review and Meta-Analysis","volume":"5","author":"Flaxman","year":"2017","journal-title":"Lancet Glob. Health"},{"key":"ref_2","first-page":"31","article-title":"Prevalence of Refractive Errors Among Students of Faculty of Medicine, Herat University, Afghanistan","volume":"1","author":"Hosaini","year":"2021","journal-title":"Afghanistan Res. J."},{"key":"ref_3","unstructured":"Holden, B., Davis, S., Jong, M., and Resnikoff, S. (2014). Journal and Proceedings of the Royal Society of New South Wales, Royal Society of New South Wales."},{"key":"ref_4","unstructured":"Riordan-Eva, P., and Cunningham, E.T. (2011). Vaughan & Asbury\u2019s General Ophthalmology, McGraw Hill."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1111\/cxo.12339","article-title":"Nearly 1 Billion Myopes at Risk of Myopia-Related Sight-Threatening Conditions by 2050\u2014Time to Act Now","volume":"98","author":"Holden","year":"2015","journal-title":"Clin. Exp. Optom."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"63","DOI":"10.2471\/BLT.07.041210","article-title":"Global Magnitude of Visual Impairment Caused by Uncorrected Refractive Errors in 2004","volume":"86","author":"Resnikoff","year":"2008","journal-title":"Bull. World Health Organ."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1001\/jama.2020.10834","article-title":"Effect of High Add Power, Medium Add Power, or Single-Vision Contact Lenses on Myopia Progression in Children: The BLINK Randomized Clinical Trial","volume":"324","author":"Walline","year":"2020","journal-title":"JAMA"},{"key":"ref_8","unstructured":"Bowling, B. (2016). Kanski\u2019s Clinical Opthalmology. A Systematic Aproach, Elsevier."},{"key":"ref_9","first-page":"6115782","article-title":"The Axial Length of the Eyeball and Bioelectrical Activity of Masticatory and Neck Muscles: A Preliminary Report","volume":"2022","author":"Baszczowski","year":"2022","journal-title":"Pain Res. Manag."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Zieli\u0144ski, G., W\u00f3jcicki, M., Rapa, M., Matysik-Wo\u017aniak, A., Baszczowski, M., Ginszt, M., Litko-Rola, M., Szkutnik, J., R\u00f3\u017cy\u0142o-Kalinowska, I., and Rejdak, R. (2022). Masticatory Muscle Thickness and Activity Correlates to Eyeball Length, Intraocular Pressure, Retinal and Choroidal Thickness in Healthy Women versus Women with Myopia. J. Pers. Med., 12.","DOI":"10.3390\/jpm12040626"},{"key":"ref_11","first-page":"19","article-title":"IMI Prevention of Myopia and Its Progression","volume":"62","author":"Jonas","year":"2021","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1034\/j.1600-0420.1999.770311.x","article-title":"Refractive Changes among Norwegian University Students\u2014A Three-Year Longitudinal Study","volume":"77","author":"Kinge","year":"1999","journal-title":"Acta Ophthalmol. Scand."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"101452","DOI":"10.1016\/j.eclinm.2022.101452","article-title":"Changes and Correlates of Screen Time in Adults and Children during the COVID-19 Pandemic: A Systematic Review and Meta-Analysis","volume":"48","author":"Trott","year":"2022","journal-title":"EClinicalMedicine"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2813","DOI":"10.1007\/s00417-021-05305-x","article-title":"Progression of Myopia in a Natural Cohort of Chinese Children during COVID-19 Pandemic","volume":"259","author":"Ma","year":"2021","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1016\/j.ajo.2020.07.034","article-title":"Digital Screen Time During the COVID-19 Pandemic: Risk for a Further Myopia Boom?","volume":"223","author":"Wong","year":"2021","journal-title":"Am. J. Ophthalmol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"820","DOI":"10.1136\/bjophthalmol-2020-316234","article-title":"Myopia Progression from Wearing First Glasses to Adult Age: The DREAM Study","volume":"106","author":"Polling","year":"2022","journal-title":"Br. J. Ophthalmol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"7871","DOI":"10.1167\/iovs.13-12403","article-title":"Myopia Stabilization and Associated Factors Among Participants in the Correction of Myopia Evaluation Trial (COMET)","volume":"54","author":"Hardy","year":"2013","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"5","DOI":"10.3389\/fpubh.2022.1008858","article-title":"Editorial: Myopia: Public Health Challenges and Interventions","volume":"10","author":"Iribarren","year":"2022","journal-title":"Front. Public Health"},{"key":"ref_19","unstructured":"Azzam, D., and Ronquillo, Y. (2022). A Compend. Tests, Scales Quest, StatPearls Publishing."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"146","DOI":"10.3928\/01913913-20200331-02","article-title":"Evaluation of the SPOT Vision Screener in School-Aged Children","volume":"57","author":"Peterseim","year":"2020","journal-title":"J. Pediatr. Ophthalmol. Strabismus"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1016\/j.jaapos.2014.07.176","article-title":"The Effectiveness of the Spot Vision Screener in Detecting Amblyopia Risk Factors","volume":"18","author":"Peterseim","year":"2014","journal-title":"J. Am. Assoc. Pediatr. Ophthalmol. Strabismus"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"153.e1","DOI":"10.1016\/j.jaapos.2018.09.012","article-title":"Evaluation of the Spot Vision Screener for Children with Limited Access to Ocular Health Care","volume":"23","author":"Barugel","year":"2019","journal-title":"J. Am. Assoc. Pediatr. Ophthalmol. Strabismus"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Matsuo, T., Matsuo, C., Kayano, M., Mitsufuji, A., Satou, C., and Matsuoka, H. (2022). Photorefraction with Spot Vision Screener versus Visual Acuity Testing as Community-Based Preschool Vision Screening at the Age of 3.5 Years in Japan. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19148655"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Maruyama, T., Yotsukura, E., Torii, H., Mori, K., Inokuchi, M., Tokumura, M., Hazra, D., Ogawa, M., Hanyuda, A., and Tsubota, K. (2022). Children in Tokyo Have a Long Sustained Axial Length from Age 3 Years: The Tokyo Myopia Study. J. Clin. Med., 11.","DOI":"10.3390\/jcm11154413"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Verkicharla, P.K., Kammari, P., and Das, A.V. (2020). Myopia Progression Varies with Age and Severity of Myopia. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0241759"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"861044","DOI":"10.3389\/fpubh.2022.861044","article-title":"Prevalence and Risk Factors of Myopia in Young Adults: Review of Findings From the Raine Study","volume":"10","author":"Lee","year":"2022","journal-title":"Front. Public Health"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1489","DOI":"10.1016\/j.ophtha.2015.03.018","article-title":"Increasing Prevalence of Myopia in Europe and the Impact of Education","volume":"122","author":"Williams","year":"2015","journal-title":"Ophthalmology"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Nowak, M.S., Jurowski, P., Grzybowski, A., and Smigielski, J. (2018). Characteristics of Refractive Errors in a Population of Adults in the Central Region of Poland. Int. J. Environ. Res. Public Health, 15.","DOI":"10.3390\/ijerph15010090"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1097\/00006324-199607000-00007","article-title":"Changes in Ocular Refraction and Its Components among Medical Students--a 5-Year Longitudinal Study","volume":"73","author":"Lin","year":"1996","journal-title":"Optom. Vis. Sci."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1097\/OPX.0b013e3180335c52","article-title":"Refractive Errors of Medical Students in Turkey: One Year Follow-up of Refraction and Biometry","volume":"84","author":"Onal","year":"2007","journal-title":"Optom. Vis. Sci."},{"key":"ref_31","first-page":"1698","article-title":"The Prevalence of Vision Impairment and Refractive Error in 3654 First Year Students at Tianjin Medical University","volume":"11","author":"Shi","year":"2018","journal-title":"Int. J. Ophthalmol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1111\/j.1755-3768.1992.tb08571.x","article-title":"Myopia among Medical Students in Norway","volume":"70","author":"Midelfart","year":"1992","journal-title":"Acta Ophthalmol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1322","DOI":"10.1167\/iovs.07-1144","article-title":"Does the Level of Physical Activity in University Students Influence Development and Progression of Myopia?--A 2-Year Prospective Cohort Study","volume":"49","author":"Jacobsen","year":"2008","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"210","DOI":"10.4103\/meajo.MEAJO_240_20","article-title":"Prevalence of Refractive Errors and Its Associated Risk Factors among Medical Students of Jazan University, Saudi Arabia: A Cross-Sectional Study","volume":"27","author":"Abuallut","year":"2020","journal-title":"Middle East Afr. J. Ophthalmol."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Wang, L., Du, M., Yi, H., Duan, S., Guo, W., Qin, P., Hao, Z., and Sun, J. (2017). Prevalence of and Factors Associated with Myopia in Inner Mongolia Medical Students in China, a Cross-Sectional Study. BMC Ophthalmol., 17.","DOI":"10.1186\/s12886-017-0446-y"},{"key":"ref_36","first-page":"892","article-title":"Prevalence of Myopia Among Medical Students From \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy","volume":"120","author":"Filimon","year":"2016","journal-title":"Rev. Med. Chir. Soc. Med. Nat. Iasi"},{"key":"ref_37","first-page":"472","article-title":"Refractive Errors in Singapore Medical Students","volume":"31","author":"Chow","year":"1990","journal-title":"Singapore Med. J."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1034\/j.1600-0420.2000.078005501.x","article-title":"Myopia Profile in Copenhagen Medical Students 1996-98. Refractive Stability over a Century Is Suggested","volume":"78","author":"Fledelius","year":"2000","journal-title":"Acta Ophthalmol. Scand."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1007\/s00417-012-2074-9","article-title":"Pattern of Myopia Progression in Chinese Medical Students: A Two-Year Follow-up Study","volume":"251","author":"Lv","year":"2013","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1080\/09286586.2019.1597899","article-title":"Choroidal Thickness and Associated Factors among Adult Myopia: A Baseline Report from a Medical University Student Cohort","volume":"26","author":"Duan","year":"2019","journal-title":"Ophthalmic Epidemiol."},{"key":"ref_41","first-page":"468","article-title":"Frequency and Incidence of Myopia among Medical Students","volume":"107","author":"Stepniewska","year":"2005","journal-title":"Klin. Oczna"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"65.e1","DOI":"10.1016\/j.jaapos.2021.11.014","article-title":"Rapid Progression of Myopia at Onset during Home Confinement","volume":"26","author":"Picotti","year":"2022","journal-title":"J. AAPOS"},{"key":"ref_43","first-page":"493","article-title":"Refractive Status of Medical Students of Mymensingh Medical College","volume":"19","author":"Akhanda","year":"2010","journal-title":"Mymensingh Med. J."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Grzybowski, A., Kanclerz, P., Tsubota, K., Lanca, C., and Saw, S.M. (2020). A Review on the Epidemiology of Myopia in School Children Worldwide. BMC Ophthalmol., 20.","DOI":"10.1186\/s12886-019-1220-0"},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Iyer, V., Enthoven, C.A., van Dommelen, P., van Samkar, A., Groenewoud, J.H., Jaddoe, V.V.W., Reijneveld, S.A., and Klaver, C.C.W. (2022). Rates of Spectacle Wear in Early Childhood in the Netherlands. BMC Pediatr., 22.","DOI":"10.1186\/s12887-022-03467-z"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1016\/j.ophtha.2020.10.040","article-title":"Reducing the Global Burden of Myopia by Delaying the Onset of Myopia and Reducing Myopic Progression in Children: The Academy\u2019s Task Force on Myopia","volume":"128","author":"Modjtahedi","year":"2021","journal-title":"Ophthalmology"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1758","DOI":"10.3389\/fpubh.2022.901480","article-title":"Prevalence of Myopia and Its Associated Factors Among Japanese Preschool Children","volume":"10","author":"Matsumura","year":"2022","journal-title":"Front. Public Health"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"704","DOI":"10.3389\/fmed.2022.831177","article-title":"Longitudinal Changes in Refractive Error Among Preschool Children Aged 1\u20136 Years: The Changsha Children Eye Study","volume":"9","author":"You","year":"2022","journal-title":"Front. Med."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"437","DOI":"10.2147\/OPTH.S193213","article-title":"Refractive Errors among Saudi College Students and Associated Risk Factors","volume":"13","author":"Alsaif","year":"2019","journal-title":"Clin. Ophthalmol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"678","DOI":"10.1016\/j.ophtha.2004.10.048","article-title":"Refractive Error and Visual Impairment in School-Age Children in Gombak District, Malaysia","volume":"112","author":"Goh","year":"2005","journal-title":"Ophthalmology"},{"key":"ref_51","first-page":"615","article-title":"Refractive Error in Children in a Rural Population in India","volume":"43","author":"Dandona","year":"2002","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_52","first-page":"53","article-title":"Myopia in Schoolchildren in a Rural Community in the State of Mexico, Mexico","volume":"8","year":"2016","journal-title":"Clin. Optom."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"314.e1","DOI":"10.1016\/j.jaapos.2022.08.525","article-title":"Role of Tutorial Classes and Full Day Schooling on Self-Reported Age of Myopia Onset: Findings in a Sample of Argentinian Adults","volume":"26","author":"Lanca","year":"2022","journal-title":"J. Am. Assoc. Pediatr. Ophthalmol. Strabismus"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"882","DOI":"10.1136\/bjophthalmol-2015-307724","article-title":"Global Variations and Time Trends in the Prevalence of Childhood Myopia, a Systematic Review and Quantitative Meta-Analysis: Implications for Aetiology and Early Prevention","volume":"100","author":"Rudnicka","year":"2016","journal-title":"Br. J. Ophthalmol."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/6\/4699\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:49:47Z","timestamp":1760122187000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/6\/4699"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,7]]},"references-count":54,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2023,3]]}},"alternative-id":["ijerph20064699"],"URL":"https:\/\/doi.org\/10.3390\/ijerph20064699","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,7]]}}}