{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,18]],"date-time":"2026-01-18T04:20:20Z","timestamp":1768710020006,"version":"3.49.0"},"reference-count":65,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2023,7,26]],"date-time":"2023-07-26T00:00:00Z","timestamp":1690329600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"R\u012bga Stradi\u0146\u0161 University doctoral"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Footwear usage could be a promising focus in reducing musculoskeletal injury risk in lower extremities commonly observed among the military. The goal of this research was to find potential gait-related risk factors for lower leg overuse injuries. Cases (n = 32) were active-duty infantry soldiers who had suffered an overuse injury in the previous six months of service before enrolling in the study. The control group (n = 32) included infantry soldiers of the same age and gender who did not have a history of lower leg overuse injury. In the gait laboratory, individuals were asked to walk on a 5-m walkway. Rearfoot eversion, ankle plantar\/dorsiflexion and stride parameters were evaluated for barefoot and shod conditions. Barefoot walking was associated with higher stride time variability among cases. According to the conditional regression analysis, stride time variability greater than 1.95% (AUC = 0.77, 95% CI (0.648 to 0.883), p &lt; 0.001) during barefoot gait could predict lower leg overuse injury. Increased barefoot gait variability should be considered as a possible predictive factor for lower leg overuse injury in the military, and gait with military boots masked stride-related differences between soldiers with and without lower leg overuse injury.<\/jats:p>","DOI":"10.3390\/ijerph20156449","type":"journal-article","created":{"date-parts":[[2023,7,27]],"date-time":"2023-07-27T02:14:48Z","timestamp":1690424088000},"page":"6449","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Increased Barefoot Stride Variability Might Be Predictor Rather than Risk Factor for Overuse Injury in the Military"],"prefix":"10.3390","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1344-0067","authenticated-orcid":false,"given":"Darja","family":"Nesterovica-Petrikova","sequence":"first","affiliation":[{"name":"Military Medicine Research and Study Center, R\u012bga Stradi\u0146\u0161 University, LV-1048 Riga, Latvia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Normunds","family":"Vaivads","sequence":"additional","affiliation":[{"name":"Joint Headquarters of the Latvian National Armed Forces Medical Service, LV-1006 Riga, Latvia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ain\u0101rs","family":"Stepens","sequence":"additional","affiliation":[{"name":"Military Medicine Research and Study Center, R\u012bga Stradi\u0146\u0161 University, LV-1048 Riga, Latvia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,7,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1097\/JSA.0000000000000246","article-title":"Combat and Noncombat Musculoskeletal Injuries in the US Military","volume":"27","author":"Grimm","year":"2019","journal-title":"Sports Med. Arthrosc."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e1140","DOI":"10.1093\/milmed\/usaa524","article-title":"Most Military Runners Report Recent Changes in Running Parameters Before Lower Limb Injury Onset","volume":"186","author":"Fredette","year":"2021","journal-title":"Mil. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1016\/j.jsams.2021.03.016","article-title":"Musculoskeletal Injuries in Military Personnel\u2014Descriptive Epidemiology, Risk Factor Identification, and Prevention","volume":"24","author":"Lovalekar","year":"2021","journal-title":"J. Sci. Med. Sport"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e480","DOI":"10.1093\/milmed\/usz328","article-title":"Epidemiology and Financial Burden of Musculoskeletal Injuries as the Leading Health Problem in the Military","volume":"185","author":"Dijksma","year":"2020","journal-title":"Mil. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"E196","DOI":"10.1093\/milmed\/usx055","article-title":"Overuse Injuries in the IDF\u2019s Combat Training Units: Rates, Types, and Mechanisms of Injury","volume":"183","author":"Schwartz","year":"2018","journal-title":"Mil. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"S3","DOI":"10.1016\/j.jsams.2017.09.014","article-title":"Mitigating the Risk of Musculoskeletal Injury: A Systematic Review of the Most Effective Injury Prevention Strategies for Military Personnel","volume":"20","author":"Wardle","year":"2017","journal-title":"J. Sci. Med. Sport"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e73","DOI":"10.1016\/j.amepre.2020.08.007","article-title":"Nonexercise Interventions for Prevention of Musculoskeletal Injuries in Armed Forces: A Systematic Review and Meta-Analysis","volume":"60","author":"Arslan","year":"2021","journal-title":"Am. J. Prev. Med."},{"key":"ref_8","first-page":"52","article-title":"Peak Plantar Pressure as a Risk Factor for Lower Extremity Overuse Injury Among Infantry Soldiers","volume":"75","author":"Stepens","year":"2021","journal-title":"Proc. Latv. Acad. Sci. Sect. B. Nat. Exact. Appl. Sci."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1186\/s40798-016-0046-z","article-title":"Musculoskeletal Lower Limb Injury Risk in Army Populations","volume":"2","author":"Andersen","year":"2016","journal-title":"Sport. Med. Open"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1136\/bjsports-2014-093494.137","article-title":"Subsequent injury during injury recovery in elite athletics: Cohort study in swedish male and female athletes","volume":"48","author":"Jacobsson","year":"2014","journal-title":"Br. J. Sports Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1320","DOI":"10.1111\/sms.13036","article-title":"Does the Amount of Lower Extremity Movement Variability Differ between Injured and Uninjured Populations? A Systematic Review","volume":"28","author":"Baida","year":"2018","journal-title":"Scand. J. Med. Sci. Sports"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1186\/1758-2555-4-45","article-title":"Coordinative Variability and Overuse Injury","volume":"4","author":"Hamill","year":"2012","journal-title":"Sport. Med. Arthrosc. Rehabil. Ther. Technol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1670","DOI":"10.1136\/bjsports-2017-097500","article-title":"Is Subsequent Lower Limb Injury Associated with Previous Injury? A Systematic Review and Meta-Analysis","volume":"51","author":"Toohey","year":"2017","journal-title":"Br. J. Sports Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1152\/jappl.1995.78.1.349","article-title":"Is Walking a Random Walk? Evidence for Long-Range Correlations in Stride Interval of Human Gait","volume":"78","author":"Hausdorff","year":"1995","journal-title":"J. Appl. Physiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/0167-9457(84)90005-8","article-title":"Kinematic and Kinetic Patterns in Human Gait: Variability and Compensating Effects","volume":"3","author":"Winter","year":"1984","journal-title":"Hum. Mov. Sci."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"101344","DOI":"10.1016\/j.cegh.2023.101344","article-title":"Determining the Characteristics of Gait Variability with a Preferred Walking Speed in Hypertensive and Normotensive Participants","volume":"23","author":"Ahsan","year":"2023","journal-title":"Clin. Epidemiol. Glob. Health"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"102562","DOI":"10.1016\/j.humov.2019.102562","article-title":"A Scoping Review of Non-Linear Analysis Approaches Measuring Variability in Gait Due to Lower Body Injury or Dysfunction","volume":"69","author":"Strongman","year":"2020","journal-title":"Hum. Mov. Sci."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1186\/s13047-022-00521-y","article-title":"Spatiotemporal Parameters and Gait Variability in People with Psoriatic Arthritis (PsA): A Cross-Sectional Study","volume":"15","author":"Walha","year":"2022","journal-title":"J. Foot Ankle Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.gaitpost.2006.01.002","article-title":"Changes in Gait Variability during Different Challenges to Mobility in Patients with Traumatic Brain Injury","volume":"25","author":"Inness","year":"2007","journal-title":"Gait Posture"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1016\/j.gaitpost.2009.12.003","article-title":"Variability and Fluctuation in Running Gait Cycle of Trained Runners and Non-Runners","volume":"31","author":"Nakayama","year":"2010","journal-title":"Gait Posture"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1016\/j.gaitpost.2023.01.018","article-title":"The Impact of Previous Musculoskeletal Injury on Running Gait Variability: A Systematic Review","volume":"101","author":"Blyton","year":"2023","journal-title":"Gait Posture"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Orr, R., Maupin, D., Palmer, R., Canetti, E.F.D., Simas, V., and Schram, B. (2022). The Impact of Footwear on Occupational Task Performance and Musculoskeletal Injury Risk: A Scoping Review to Inform Tactical Footwear. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph191710703"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1186\/s13018-015-0319-0","article-title":"Shoe Heel Abrasion and Its Possible Biomechanical Cause: A Transversal Study with Infantry Recruits","volume":"10","author":"Baumfeld","year":"2015","journal-title":"J. Orthop. Surg. Res."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1016\/j.gaitpost.2021.04.024","article-title":"Effects of Barefoot vs. Shod Walking during Indoor and Outdoor Conditions in Younger and Older Adults","volume":"95","author":"Hollander","year":"2022","journal-title":"Gait Posture"},{"key":"ref_25","unstructured":"Heidelbaugh, J.J., Jauniaux, E., and Landon, M.B. (2008). Clinical Men\u2019s Health, Elsevier."},{"key":"ref_26","unstructured":"WHO (2016). World Health Organization International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10), World Health Organization."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1176","DOI":"10.1097\/00005768-199908000-00015","article-title":"Epidemiological Patterns of Musculoskeletal Injuries and Physical Training","volume":"31","author":"Almeida","year":"1999","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12891-021-04839-9","article-title":"Relationship of Footwear Comfort, Selected Size, and Lower Leg Overuse Injuries among Infantry Soldiers","volume":"22","author":"Nesterovica","year":"2021","journal-title":"BMC Musculoskelet. Disord."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1016\/S0278-5919(03)00035-8","article-title":"The Painful Nonruptured Tendon: Clinical Aspects","volume":"22","author":"Khan","year":"2003","journal-title":"Clin. Sports Med."},{"key":"ref_30","first-page":"748","article-title":"Current concepts of muscle and tendon adaptation to strength and conditioning","volume":"10","author":"Brumitt","year":"2015","journal-title":"Int. J. Sports Phys. Ther."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1007\/s40520-016-0536-3","article-title":"Between-Day Test\u2013Retest Reliability of Gait Variability in Older Individuals Improves with a Familiarization Trial","volume":"29","author":"Hamacher","year":"2017","journal-title":"Aging Clin. Exp. Res."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1016\/j.gaitpost.2013.06.014","article-title":"Is Gait Variability Reliable? An Assessment of Spatio-Temporal Parameters of Gait Variability during Continuous Overground Walking","volume":"39","author":"Singh","year":"2014","journal-title":"Gait Posture"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"435","DOI":"10.3389\/fnagi.2018.00435","article-title":"Less Is More\u2014Estimation of the Number of Strides Required to Assess Gait Variability in Spatially Confined Settings","volume":"11","author":"Kroneberg","year":"2019","journal-title":"Front. Aging Neurosci."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Molina-Rueda, F., Fern\u00e1ndez-Gonz\u00e1lez, P., Cuesta-G\u00f3mez, A., Koutsou, A., Carratal\u00e1-Tejada, M., and Miangolarra-Page, J.C. (2021). Test-Retest Reliability of a Conventional Gait Model for Registering Joint Angles during Initial Contact and Toe-Off in Healthy Subjects. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18031343"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Peng, Y., Wong, D.W.C., Wang, Y., Chen, T.L.W., Tan, Q., Chen, Z., Jin, Z., and Zhang, M. (2020). Immediate Effects of Medially Posted Insoles on Lower Limb Joint Contact Forces in Adult Acquired Flatfoot: A Pilot Study. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17072226"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"824297","DOI":"10.3389\/fbioe.2022.824297","article-title":"Effects of Attrition Shoes on Kinematics and Kinetics of Lower Limb Joints During Walking","volume":"10","author":"Chen","year":"2022","journal-title":"Front. Bioeng. Biotechnol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"18385","DOI":"10.1038\/s41598-019-54913-5","article-title":"A Low-Cost 2-D Video System Can Accurately and Reliably Assess Adaptive Gait Kinematics in Healthy and Low Vision Subjects","volume":"9","author":"Zult","year":"2019","journal-title":"Sci. Rep."},{"key":"ref_38","first-page":"136","article-title":"Concurrent Validity and Reliability of 2d Kinematic Analysis of Frontal Plane Motion during Running","volume":"10","author":"Maykut","year":"2015","journal-title":"Int. J. Sports Phys. Ther."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"556","DOI":"10.2519\/jospt.2016.6280","article-title":"Reliability of a Qualitative Video Analysis for Running","volume":"46","author":"Pipkin","year":"2016","journal-title":"J. Orthop. Sports Phys. Ther."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2016\/5939164","article-title":"Spatiotemporal Gait Parameters as Predictors of Lower-Limb Overuse Injuries in Military Training","volume":"2016","author":"Springer","year":"2016","journal-title":"Sci. World J."},{"key":"ref_41","unstructured":"Kelsey, L., and Fleiss, K. (2019, February 10). Methods in Observational Epidemiology 2nd Edition, Statistical Methods for Rates and Proportion, Formulas 3.18 and 19. Available online: http:\/\/www.openepi.com\/SampleSize\/SSCohort.htm."},{"key":"ref_42","unstructured":"Breslow, N.E., and Day, N.E. (1980). Statistical Methods in Cancer Research, IARC Scientific Publications."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1111\/j.1469-185X.2007.00027.x","article-title":"Effect Size, Confidence Interval and Statistical Significance: A Practical Guide for Biologists","volume":"82","author":"Nakagawa","year":"2007","journal-title":"Biol. Rev."},{"key":"ref_44","unstructured":"Cohen, J. (2016). Methodological Issues and Strategies in Clinical Research, American Psychological Association. [4th ed.]."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1002\/bimj.200410135","article-title":"Estimation of the Youden Index and Its Associated Cutoff Point","volume":"47","author":"Fluss","year":"2005","journal-title":"Biom. J."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Hill, C.M., DeBusk, H., Knight, A.C., and Chander, H. (2020). Military-Type Workload and Footwear Alter Lower Extremity Muscle Activity during Unilateral Static Balance: Implications for Tactical Athletic Footwear Design. Sports, 8.","DOI":"10.3390\/sports8050058"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/j.ergon.2017.11.003","article-title":"Influence of Military Workload and Footwear on Static and Dynamic Balance Performance","volume":"64","author":"DeBusk","year":"2018","journal-title":"Int. J. Ind. Ergon."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1016\/j.gaitpost.2015.05.019","article-title":"Barefoot vs Common Footwear: A Systematic Review of the Kinematic, Kinetic and Muscle Activity Differences during Walking","volume":"42","author":"Franklin","year":"2015","journal-title":"Gait Posture"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1249\/01.mss.0000247001.94470.21","article-title":"Gait-Related Risk Factors for Exercise-Related Lower-Leg Pain during Shod Running","volume":"39","author":"Willems","year":"2007","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_50","first-page":"33","article-title":"Temporal Spatial Parameters of Gait with Barefoot, Bathroom Slippers and Military Boots","volume":"50","author":"Majumdar","year":"2006","journal-title":"Indian J. Physiol. Pharmacol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1016\/j.gaitpost.2018.06.162","article-title":"Lower Limb Angular Velocity during Walking at Various Speeds","volume":"65","author":"Mentiplay","year":"2018","journal-title":"Gait Posture"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1402","DOI":"10.1007\/s00167-014-3084-4","article-title":"Normative Rearfoot Motion during Barefoot and Shod Walking Using Biplane Fluoroscopy","volume":"24","author":"Campbell","year":"2016","journal-title":"Knee Surg. Sport. Traumatol. Arthrosc."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"105530","DOI":"10.1016\/j.clinbiomech.2021.105530","article-title":"Comparing the Applicability of Temporal Gait Symmetry, Variability and Laterality in Bilateral Gait Conditions: A Feasibility Study of Healthy Individuals and People with Diabetic Neuropathy","volume":"91","author":"Tan","year":"2022","journal-title":"Clin. Biomech."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1","DOI":"10.17159\/2078-516X\/2017\/v29i0a1923","article-title":"Gait Retraining as Part of the Treatment Programme for Soldiers with Exercise-Related Leg Pain: Preliminary Clinical Experiences and Retention","volume":"29","author":"Zimmermann","year":"2017","journal-title":"South African J. Sport. Med."},{"key":"ref_55","first-page":"23","article-title":"Muscle Strength as a Predictor of Gait Variability after Two Years in Community-Living Older Adults","volume":"9","author":"Bogen","year":"2020","journal-title":"J. Frailty Aging"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1016\/0966-6362(95)01057-2","article-title":"Scaling Gait Data to Body Size","volume":"4","author":"Hof","year":"1996","journal-title":"Gait Posture"},{"key":"ref_57","first-page":"241","article-title":"The Invariant Relationship between Step Length and Step Rate during Free Walking","volume":"30","author":"Sekiya","year":"1996","journal-title":"J. Hum. Mov. Stud."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1482","DOI":"10.1136\/bjsports-2017-099006","article-title":"So You Think You Can Return to Sport?","volume":"52","author":"Lentz","year":"2018","journal-title":"Br. J. Sports Med."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1177\/1941738116666813","article-title":"Fear of Reinjury in Athletes","volume":"9","author":"Hsu","year":"2017","journal-title":"Sport. Health A Multidiscip. Approach"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"2853","DOI":"10.1177\/0363546519870534","article-title":"Association Between Running Shoe Characteristics and Lower Extremity Injuries in United States Military Academy Cadets","volume":"47","author":"Helton","year":"2019","journal-title":"Am. J. Sports Med."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.gaitpost.2018.04.035","article-title":"Calcaneus Range of Motion Underestimated by Markers on Running Shoe Heel","volume":"63","author":"Alcantara","year":"2018","journal-title":"Gait Posture"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1016\/j.gaitpost.2005.04.012","article-title":"Effect of Skin Movement Artifact on Knee Kinematics during Gait and Cutting Motions Measured in Vivo","volume":"24","author":"Benoit","year":"2006","journal-title":"Gait Posture"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1186\/1757-1146-3-9","article-title":"Relationships between Foot Type and Dynamic Rearfoot Frontal Plane Motion","volume":"3","author":"Chuter","year":"2010","journal-title":"J. Foot Ankle Res."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"64","DOI":"10.2478\/humo-2013-0005","article-title":"Differences in Tibiocalcaneal Kinematics Measured with Skin- and Shoe-Mounted Markers","volume":"14","author":"Sinclair","year":"2013","journal-title":"Hum. Mov."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"S13","DOI":"10.1080\/19424280.2011.575873","article-title":"The Development of a Multi-Segment Kinematic Model of Footwear","volume":"3","author":"Bishop","year":"2011","journal-title":"Footwear Sci."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/15\/6449\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:19:22Z","timestamp":1760127562000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/15\/6449"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,26]]},"references-count":65,"journal-issue":{"issue":"15","published-online":{"date-parts":[[2023,8]]}},"alternative-id":["ijerph20156449"],"URL":"https:\/\/doi.org\/10.3390\/ijerph20156449","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,26]]}}}