{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T03:53:04Z","timestamp":1791431584393,"version":"4.3.3"},"reference-count":46,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T00:00:00Z","timestamp":1761264000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>COVID-19 is a public health issue with a significant mortality rate and potential long-lasting disabling symptoms responsible for the long-COVID syndrome. Mitochondrial dysfunction is a key mechanism but whether peripheral blood mononuclear cell (PBMC) mitochondrial respiration changes might be associated with mortality and\/or occurrence and severity of long-COVID syndrome remains to be investigated. We determined mitochondrial respiratory chain oxygen consumption in twenty COVID-19 patients hospitalized in the intensive care unit and analyzed their remaining symptoms at the third year after hospital release. PBMC mitochondrial respiration was decreased in COVID-19 patients compared to the control group (14.13 \u00b1 2.35 vs. 6.21 \u00b1 0.88 pmol\/s\/106 cell, p = 0.0006 for the OXPHOS state by CII). Considering COVID severity, such a decrease was greater in long-COVID patients and in patients who deceased (4.91 \u00b1 0.75, p = 0.008 and 4.94 \u00b1 1.11 pmol\/s\/106 cell, p = 0.04, respectively). PBMC markers of inflammation also increased with the severity of COVID (1.0 \u00b1 0.08 vs. 14.45 \u00b1 2.07, p = 0.02 for ISG15 in patients who died) and ISG15 negatively correlated with PBMC mitochondrial respiration (r = \u22120.67, p = 0.02 for CII). In conclusion, this study shows that the greater the impairment in PBMC mitochondrial respiration in patients hospitalized in the intensive care unit for COVID-19, the greater the mortality rate and the more severe the long-COVID symptoms\u2014three years after hospital discharge. Further, PBMC markers of inflammation also increased with the severity of COVID and ISG15 negatively correlated with PBMC mitochondrial respiration. These results support that PBMC mitochondrial respiration might be a biomarker of COVID severity and further studies investigating whether modulation of PBMC mitochondrial respiration might improve COVID-19 patients\u2019 prognosis.<\/jats:p>","DOI":"10.3390\/ijms262110377","type":"journal-article","created":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T00:51:42Z","timestamp":1761526302000},"page":"10377","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Impaired Peripheral Blood Mononuclear Cell (PBMC) Mitochondrial Respiration Is Associated with Mortality and Long COVID Syndrome Severity in COVID-19 Patients"],"prefix":"10.3390","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3557-2642","authenticated-orcid":false,"given":"Anne-Laure","family":"Charles","sequence":"first","affiliation":[{"name":"Biomedicine Research Center of Strasbourg (CRBS), UR 3072, \u201cMitochondria, Oxidative Stress and Muscle Plasticity\u201d, Faculty of Medicine, University of Strasbourg, 67081 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1534-8088","authenticated-orcid":false,"given":"L\u00e9a","family":"Debrut","sequence":"additional","affiliation":[{"name":"Biomedicine Research Center of Strasbourg (CRBS), UR 3072, \u201cMitochondria, Oxidative Stress and Muscle Plasticity\u201d, Faculty of Medicine, University of Strasbourg, 67081 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walid","family":"Oulehri","sequence":"additional","affiliation":[{"name":"Biomedicine Research Center of Strasbourg (CRBS), UR 3072, \u201cMitochondria, Oxidative Stress and Muscle Plasticity\u201d, Faculty of Medicine, University of Strasbourg, 67081 Strasbourg, France"},{"name":"Department of Anesthesia and Intensive Care, Strasbourg University Hospital, 67091 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V\u00e9ronique","family":"Vincent","sequence":"additional","affiliation":[{"name":"Department of Physiology and Functional Exploration, Strasbourg University Hospital, 67091 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H\u00e9loise","family":"Delagreverie","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, H\u00f4pital Avicenne AP-HP, 125 rue de Stalingrad, 93000 Bobigny, France"},{"name":"Facult\u00e9 de M\u00e9decine, INSERM U1137 IAME, Universit\u00e9 Sorbonne Paris Nord and Universit\u00e9 Paris Cit\u00e9, 16 rue Henri Huchard, 75018 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pauline","family":"Asael","sequence":"additional","affiliation":[{"name":"Biomedicine Research Center of Strasbourg (CRBS), UR 3072, \u201cMitochondria, Oxidative Stress and Muscle Plasticity\u201d, Faculty of Medicine, University of Strasbourg, 67081 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6807-8582","authenticated-orcid":false,"given":"Marianne","family":"Riou","sequence":"additional","affiliation":[{"name":"Biomedicine Research Center of Strasbourg (CRBS), UR 3072, \u201cMitochondria, Oxidative Stress and Muscle Plasticity\u201d, Faculty of Medicine, University of Strasbourg, 67081 Strasbourg, France"},{"name":"Department of Physiology and Functional Exploration, Strasbourg University Hospital, 67091 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margherita","family":"Giannini","sequence":"additional","affiliation":[{"name":"Biomedicine Research Center of Strasbourg (CRBS), UR 3072, \u201cMitochondria, Oxidative Stress and Muscle Plasticity\u201d, Faculty of Medicine, University of Strasbourg, 67081 Strasbourg, France"},{"name":"Department of Physiology and Functional Exploration, Strasbourg 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Respir. J."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1038\/s41586-020-2008-3","article-title":"A New Coronavirus Associated with Human Respiratory Disease in China","volume":"579","author":"Wu","year":"2020","journal-title":"Nature"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1126\/science.abp8715","article-title":"The Huanan Seafood Wholesale Market in Wuhan Was the Early Epicenter of the COVID-19 Pandemic","volume":"377","author":"Worobey","year":"2022","journal-title":"Science"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1038\/s41579-022-00846-2","article-title":"Long COVID: Major Findings, Mechanisms and Recommendations","volume":"21","author":"Davis","year":"2023","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_6","unstructured":"World Health Organization (2025, September 19). Coronavirus Disease (COVID-19). Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/coronavirus-disease-(Covid-19)."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1957","DOI":"10.1038\/s41467-022-29521-z","article-title":"Persistent COVID-19 Symptoms in a Community Study of 606,434 People in England","volume":"13","author":"Whitaker","year":"2022","journal-title":"Nat. Commun."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Tarazona, V., Kirouchena, D., Clerc, P., Pinsard-Laventure, F., and Bourrion, B. (2022). Quality of Life in COVID-19 Outpatients: A Long-Term Follow-Up Study. J. Clin. Med., 11.","DOI":"10.3390\/jcm11216478"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"101019","DOI":"10.1016\/j.eclinm.2021.101019","article-title":"Characterizing Long COVID in an International Cohort: 7 Months of Symptoms and Their Impact","volume":"38","author":"Davis","year":"2021","journal-title":"EClinicalMedicine"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Nikolic Turnic, T., Vasiljevic, I., Stanic, M., Jakovljevic, B., Mikerova, M., Ekkert, N., Reshetnikov, V., and Jakovljevic, V. (2022). Post-COVID-19 Status and Its Physical, Nutritional, Psychological, and Social Effects in Working-Age Adults-A Prospective Questionnaire Study. J. Clin. Med., 11.","DOI":"10.3390\/jcm11226668"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Van Wambeke, E., Bezler, C., Kasprowicz, A.-M., Charles, A.-L., Andres, E., and Geny, B. (2023). Two-Years Follow-Up of Symptoms and Return to Work in Complex Post-COVID-19 Patients. J. Clin. Med., 12.","DOI":"10.3390\/jcm12030741"},{"key":"ref_12","unstructured":"World Health Organization (2025, September 19). Post COVID-19 Condition (Long COVID). Available online: https:\/\/www.who.int\/europe\/news-room\/fact-sheets\/item\/post-COVID-19-condition."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1038\/s41467-021-27797-1","article-title":"Immunoglobulin Signature Predicts Risk of Post-Acute COVID-19 Syndrome","volume":"13","author":"Cervia","year":"2022","journal-title":"Nat. Commun."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Pinto, M.D., Downs, C.A., Huang, Y., El-Azab, S.A., Ramrakhiani, N.S., Barisano, A., Yu, L., Taylor, K., Esperanca, A., and Abrahim, H.L. (2022). A Distinct Symptom Pattern Emerges for COVID-19 Long-Haul: A Nationwide Study. Sci. Rep., 12.","DOI":"10.1038\/s41598-022-20214-7"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1016\/S0140-6736(22)01214-4","article-title":"Lifelines Corona Research Initiative Persistence of Somatic Symptoms after COVID-19 in the Netherlands: An Observational Cohort Study","volume":"400","author":"Ballering","year":"2022","journal-title":"Lancet Lond. Engl."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1235","DOI":"10.15585\/mmwr.mm7036a1","article-title":"Long-Term Symptoms Among Adults Tested for SARS-CoV-2\u2014United States, January 2020-April 2021","volume":"70","author":"Wanga","year":"2021","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Riou, M., Oulehri, W., Momas, C., Rouyer, O., Lebourg, F., Meyer, A., Enache, I., Pistea, C., Charloux, A., and Marcot, C. (2021). Reduced Flow-Mediated Dilatation Is Not Related to COVID-19 Severity Three Months after Hospitalization for SARS-CoV-2 Infection. J. Clin. Med., 10.","DOI":"10.3390\/jcm10061318"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Riou, M., Coste, F., Meyer, A., Enache, I., Talha, S., Charloux, A., Reboul, C., and Geny, B. (2024). Mechanisms of Pulmonary Vasculopathy in Acute and Long-Term COVID-19: A Review. Int. J. Mol. Sci., 25.","DOI":"10.3390\/ijms25094941"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"108697","DOI":"10.1016\/j.intimp.2022.108697","article-title":"Viral Load Is Associated with Mitochondrial Dysfunction and Altered Monocyte Phenotype in Acute Severe SARS-CoV-2 Infection","volume":"108","author":"Teixeira","year":"2022","journal-title":"Int. Immunopharmacol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e13001","DOI":"10.15252\/emmm.202013001","article-title":"Altered Bioenergetics and Mitochondrial Dysfunction of Monocytes in Patients with COVID-19 Pneumonia","volume":"12","author":"Gibellini","year":"2020","journal-title":"EMBO Mol. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"C57","DOI":"10.1152\/ajpcell.00426.2020","article-title":"Mitochondrial Metabolic Manipulation by SARS-CoV-2 in Peripheral Blood Mononuclear Cells of Patients with COVID-19","volume":"320","author":"Ajaz","year":"2021","journal-title":"Am. J. Physiol. Cell Physiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"982","DOI":"10.1080\/10715762.2021.2005247","article-title":"SARS-CoV-2 Induces Mitochondrial Dysfunction and Cell Death by Oxidative Stress\/Inflammation in Leukocytes of COVID-19 Patients","volume":"55","year":"2021","journal-title":"Free Radic. Res."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Bizjak, D.A., Ohmayer, B., Buhl, J.L., Schneider, E.M., Walther, P., Calzia, E., Jerg, A., Matits, L., and Steinacker, J.M. (2024). Functional and Morphological Differences of Muscle Mitochondria in Chronic Fatigue Syndrome and Post-COVID Syndrome. Int. J. Mol. Sci., 25.","DOI":"10.3390\/ijms25031675"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1080\/10715762.2021.1919304","article-title":"5Flavoenzyme-Catalyzed Single-Electron Reduction of Nitroaromatic Antiandrogens: Implications for Their Cytotoxicity","volume":"55","author":"Yantsevich","year":"2021","journal-title":"Free Radic. Res."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"De Vitis, C., Capalbo, C., Torsello, A., Napoli, C., Salvati, V., Loffredo, C., Blandino, G., Piaggio, G., Auciello, F.R., and Pelliccia, F. (2022). Opposite Effect of Thyroid Hormones on Oxidative Stress and on Mitochondrial Respiration in COVID-19 Patients. Antioxidants, 11.","DOI":"10.3390\/antiox11101998"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Alfatni, A., Riou, M., Charles, A.-L., Meyer, A., Barnig, C., Andres, E., Lejay, A., Talha, S., and Geny, B. (2020). Peripheral Blood Mononuclear Cells and Platelets Mitochondrial Dysfunction, Oxidative Stress, and Circulating mtDNA in Cardiovascular Diseases. J. Clin. Med., 9.","DOI":"10.3390\/jcm9020311"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"C258","DOI":"10.1152\/ajpcell.00224.2020","article-title":"Decoding SARS-CoV-2 Hijacking of Host Mitochondria in COVID-19 Pathogenesis","volume":"319","author":"Singh","year":"2020","journal-title":"Am. J. Physiol. Cell Physiol."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Liu, Y., Qin, C., Rao, Y., Ngo, C., Feng, J.J., Zhao, J., Zhang, S., Wang, T.-Y., Carriere, J., and Savas, A.C. (2021). SARS-CoV-2 Nsp5 Demonstrates Two Distinct Mechanisms Targeting RIG-I and MAVS To Evade the Innate Immune Response. mBio, 12.","DOI":"10.1128\/mBio.02335-21"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1038\/s41423-021-00807-4","article-title":"SARS-CoV-2 ORF10 Suppresses the Antiviral Innate Immune Response by Degrading MAVS through Mitophagy","volume":"19","author":"Li","year":"2022","journal-title":"Cell. Mol. Immunol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1038\/s41586-020-2286-9","article-title":"A SARS-CoV-2 Protein Interaction Map Reveals Targets for Drug Repurposing","volume":"583","author":"Gordon","year":"2020","journal-title":"Nature"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Huynh, T.V., Rethi, L., Lee, T.-W., Higa, S., Kao, Y.-H., and Chen, Y.-J. (2023). Spike Protein Impairs Mitochondrial Function in Human Cardiomyocytes: Mechanisms Underlying Cardiac Injury in COVID-19. Cells, 12.","DOI":"10.3390\/cells12060877"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1038\/s41392-023-01368-w","article-title":"SARS-CoV-2 Spike Protein Induces IL-18-Mediated Cardiopulmonary Inflammation via Reduced Mitophagy","volume":"8","author":"Liang","year":"2023","journal-title":"Signal Transduct. Target. Ther."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Lee, E., Ozigbo, A.A., Varon, J., Halma, M., Laezzo, M., Ang, S.P., and Iglesias, J. (2025). Mitochondrial Reactive Oxygen Species: A Unifying Mechanism in Long COVID and Spike Protein-Associated Injury: A Narrative Review. Biomolecules, 15.","DOI":"10.3390\/biom15091339"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Refrigeri, M., Tola, A., Mogavero, R., Pietracupa, M.M., Gionta, G., and Scatena, R. (2025). Mechanisms of Mitochondrial Impairment by SARS-CoV-2 Proteins: A Nexus of Pathogenesis with Significant Biochemical and Clinical Implications. Int. J. Mol. Sci., 26.","DOI":"10.3390\/ijms26209885"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"220098","DOI":"10.1183\/16000617.0098-2022","article-title":"Prognostic Factors for Mortality, Intensive Care Unit and Hospital Admission Due to SARS-CoV-2: A Systematic Review and Meta-Analysis of Cohort Studies in Europe","volume":"31","author":"Vardavas","year":"2022","journal-title":"Eur. Respir. Rev. Off. J. Eur. Respir. Soc."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Regolo, M., Vaccaro, M., Sorce, A., Stancanelli, B., Colaci, M., Natoli, G., Russo, M., Alessandria, I., Motta, M., and Santangelo, N. (2022). Neutrophil-to-Lymphocyte Ratio (NLR) Is a Promising Predictor of Mortality and Admission to Intensive Care Unit of COVID-19 Patients. J. Clin. Med., 11.","DOI":"10.3390\/jcm11082235"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1164\/rccm.202108-1903LE","article-title":"Decreased Fatty Acid Oxidation and Altered Lactate Production during Exercise in Patients with Post-Acute COVID-19 Syndrome","volume":"205","author":"Petrache","year":"2022","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"2528167","DOI":"10.1080\/07853890.2025.2528167","article-title":"Mitochondrial Function Is Impaired in Long COVID Patients","volume":"57","author":"Macnaughtan","year":"2025","journal-title":"Ann. Med."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Aminzadeh, A., Azmi-Naei, N., Teimouri, M., and Rohani-Rasaf, M. (2025). FIB-4, APRI, and ALRI as Predictors of COVID-19 Outcomes: Insights from a Large-Scale Study. Diagnostics, 15.","DOI":"10.3390\/diagnostics15161984"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1262","DOI":"10.1016\/j.tim.2023.07.006","article-title":"ISG15: Its Roles in SARS-CoV-2 and Other Viral Infections","volume":"31","author":"Sarkar","year":"2023","journal-title":"Trends Microbiol."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Riou, M., Charles, A.-L., Enache, I., Evrard, C., Pistea, C., Giannini, M., Charloux, A., and Geny, B. (2025). Acute Severe Hypoxia Decreases Mitochondrial Chain Complex II Respiration in Human Peripheral Blood Mononuclear Cells. Int. J. Mol. Sci., 26.","DOI":"10.3390\/ijms26020705"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Levy, D., Giannini, M., Oulehri, W., Riou, M., Marcot, C., Pizzimenti, M., Debrut, L., Charloux, A., Geny, B., and Meyer, A. (2022). Long Term Follow-Up of Sarcopenia and Malnutrition after Hospitalization for COVID-19 in Conventional or Intensive Care Units. Nutrients, 14.","DOI":"10.3390\/nu14040912"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"101849","DOI":"10.1016\/j.mito.2024.101849","article-title":"Altered Mitochondrial Respiration in Peripheral Blood Mononuclear Cells of Post-Acute Sequelae of SARS-CoV-2 Infection","volume":"75","author":"Maison","year":"2024","journal-title":"Mitochondrion"},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Marzetti, E., Coelho-J\u00fanior, H.J., Calvani, R., Girolimetti, G., Di Corato, R., Ciciarello, F., Galluzzo, V., Di Mario, C., Tolusso, B., and Santoro, L. (2025). Mitochondria-Derived Vesicles and Inflammatory Profiles of Adults with Long COVID Supplemented with Red Beetroot Juice: Secondary Analysis of a Randomized Controlled Trial. Int. J. Mol. Sci., 26.","DOI":"10.3390\/ijms26031224"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1186\/s12931-019-1139-2","article-title":"Systemic Immuno-Metabolic Alterations in Chronic Obstructive Pulmonary Disease (COPD)","volume":"20","author":"Agarwal","year":"2019","journal-title":"Respir. Res."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Riou, M., Alfatni, A., Charles, A.-L., Andr\u00e8s, E., Pistea, C., Charloux, A., and Geny, B. (2020). New Insights into the Implication of Mitochondrial Dysfunction in Tissue, Peripheral Blood Mononuclear Cells, and Platelets during Lung Diseases. J. Clin. Med., 9.","DOI":"10.3390\/jcm9051253"}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/26\/21\/10377\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T00:54:42Z","timestamp":1761526482000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/26\/21\/10377"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,24]]},"references-count":46,"journal-issue":{"issue":"21","published-online":{"date-parts":[[2025,11]]}},"alternative-id":["ijms262110377"],"URL":"https:\/\/doi.org\/10.3390\/ijms262110377","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,24]]}}}