{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T12:55:00Z","timestamp":1791204900824,"version":"4.1.0"},"reference-count":64,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T00:00:00Z","timestamp":1790985600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int. J. Mol. Sci.","IJMS"],"abstract":"<jats:p>Red blood cells (RBCs) have traditionally been regarded as passive carriers of respiratory gases. Increasing evidence, however, indicates that they are active participants in vascular homeostasis and respond to mechanical, metabolic, and oxidative stimuli. This narrative review examines the interconnected roles of RBCs as regulators of vascular physiology, indicators of hereditary and systemic disease, therapeutic targets, and delivery platforms. RBC deformability, membrane organization, ion-water balance, metabolism, and redox capacity support microcirculatory flow, while ATP release, nitric oxide handling, adhesion, and extracellular-vesicle formation influence vascular function. RBC morphology, mechanics, hydration, metabolism, oxidative status, and vesiculation can provide clinically relevant information, although emerging functional and molecular biomarkers require further standardization and validation. RBC-directed treatments and RBC-based carriers offer additional therapeutic opportunities. Automated image analysis and machine-learning-assisted microfluidic classification are the most substantiated artificial-intelligence applications; broader multimodal decision-support systems remain exploratory.<\/jats:p>","DOI":"10.3390\/ijms27198848","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T12:31:31Z","timestamp":1791203491000},"page":"8848","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Red Blood Cells Beyond Oxygen Transport: Dynamic Regulators, Disease Biomarkers and Therapeutic Platforms\u2014A Narrative Review"],"prefix":"10.3390","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-3035-8924","authenticated-orcid":false,"given":"Joan-Lluis","family":"Vives-Corrons","sequence":"first","affiliation":[{"name":"Rare Anemias Ektacytometry Unit, Josep Carreras Leukaemia Research Institute, Ctra. de Can Ruti, Cam\u00ed de les Escoles, 08916 Badalona, Catalonia, Spain"},{"name":"Medical Centre for Ambulatory Medicine, Carrer de C\u00f2rsega 209, 08036 Barcelona, Catalonia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,10,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1161\/01.RES.22.3.405","article-title":"Distribution of size and shape in populations of normal human red cells","volume":"22","author":"Canham","year":"1968","journal-title":"Circ. Res."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1351","DOI":"10.1182\/blood.V79.5.1351.1351","article-title":"Rheologic properties of senescent erythrocytes: Loss of surface area and volume with red blood cell age","volume":"79","author":"Waugh","year":"1992","journal-title":"Blood"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1172\/JCI109888","article-title":"Analysis of factors regulating erythrocyte deformability","volume":"66","author":"Mohandas","year":"1980","journal-title":"J. Clin. Investig."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/j.blre.2013.04.003","article-title":"Hereditary spherocytosis, elliptocytosis, and other red cell membrane disorders","volume":"27","author":"Galimand","year":"2013","journal-title":"Blood Rev."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"10731","DOI":"10.1074\/jbc.M610717200","article-title":"Roles of hemoglobin allostery in hypoxia-induced metabolic alterations in erythrocytes: Simulation and verification by metabolome analysis","volume":"282","author":"Kinoshita","year":"2007","journal-title":"J. Biol. Chem."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e07370","DOI":"10.7554\/eLife.07370","article-title":"Piezo1 links mechanical forces to red blood cell volume","volume":"4","author":"Cahalan","year":"2015","journal-title":"eLife"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1152\/physiol.00038.2008","article-title":"Erythrocytes: Oxygen sensors and modulators of vascular tone","volume":"24","author":"Ellsworth","year":"2009","journal-title":"Physiology"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2287","DOI":"10.1111\/jth.13482","article-title":"Erythrocyte oxidative stress is associated with cell deformability in patients with retinal vein occlusion","volume":"14","author":"Becatti","year":"2016","journal-title":"J. Thromb. Haemost."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"12086","DOI":"10.1038\/ncomms12086","article-title":"Sphingosine-1-phosphate promotes erythrocyte glycolysis and oxygen release for adaptation to high-altitude hypoxia","volume":"7","author":"Sun","year":"2016","journal-title":"Nat. Commun."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1908","DOI":"10.1182\/blood-2012-04-422253","article-title":"Mutations in the mechanotransduction protein PIEZO1 are associated with hereditary xerocytosis","volume":"120","author":"Zarychanski","year":"2012","journal-title":"Blood"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1016\/j.addr.2016.02.007","article-title":"Red blood cells: Supercarriers for drugs, biologicals, and nanoparticles and inspiration for advanced delivery systems","volume":"106","author":"Villa","year":"2016","journal-title":"Adv. Drug Deliv. Rev."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1161\/CIRCULATIONAHA.110.008698","article-title":"Nitric oxide scavenging by red blood cell microparticles and cell-free hemoglobin as a mechanism for the red cell storage lesion","volume":"124","author":"Donadee","year":"2011","journal-title":"Circulation"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1744","DOI":"10.1111\/trf.12008","article-title":"Red blood cell-derived microparticles isolated from blood units initiate and propagate thrombin generation","volume":"53","author":"Rubin","year":"2013","journal-title":"Transfusion"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2630","DOI":"10.1172\/JCI124566","article-title":"Erythrocyte-derived microvesicles induce arterial spasms in JAK2V617F myeloproliferative neoplasm","volume":"130","author":"Poisson","year":"2020","journal-title":"J. Clin. Investig."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Barshtein, G., Livshits, L., Gural, A., Arbell, D., Barkan, R., Pajic-Lijakovic, I., and Yedgar, S. (2024). Hemoglobin binding to the red blood cell (RBC) membrane is associated with decreased cell deformability. Int. J. Mol. Sci., 25.","DOI":"10.3390\/ijms25115814"},{"key":"ref_16","first-page":"165","article-title":"Shear stress-induced improvement of red blood cell deformability","volume":"50","author":"Meram","year":"2013","journal-title":"Biorheology"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1111\/trf.12291","article-title":"Nitroprusside inhibits calcium-induced impairment of red blood cell deformability","volume":"54","author":"Barodka","year":"2014","journal-title":"Transfusion"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Nader, E., Romana, M., and Connes, P. (2020). The red blood cell\u2013inflammation vicious circle in sickle cell disease. Front. Immunol., 11.","DOI":"10.3389\/fimmu.2020.00454"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1111\/j.1523-1755.2005.00082.x","article-title":"Association of reduced red blood cell deformability and diabetic nephropathy","volume":"67","author":"Brown","year":"2005","journal-title":"Kidney Int."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1227","DOI":"10.1016\/j.kint.2021.08.024","article-title":"Proteinuric chronic kidney disease is associated with altered red blood cell lifespan, deformability and metabolism","volume":"100","author":"Bissinger","year":"2021","journal-title":"Kidney Int."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Depond, M., Henry, B., Buffet, P., and Ndour, P.A. (2020). Methods to investigate the deformability of RBC during malaria. Front. Physiol., 10.","DOI":"10.3389\/fphys.2019.01613"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1767","DOI":"10.1016\/j.jbiomech.2014.03.038","article-title":"Microfluidic analysis of red blood cell deformability","volume":"47","author":"Guo","year":"2014","journal-title":"J. Biomech."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"H1146","DOI":"10.1152\/ajpheart.00301.2010","article-title":"Pannexin 1 is the conduit for low oxygen tension-induced ATP release from human erythrocytes","volume":"299","author":"Sridharan","year":"2010","journal-title":"Am. J. Physiol. Heart Circ. Physiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2150","DOI":"10.1182\/blood-2014-05-572024","article-title":"Hemolysis is a primary ATP-release mechanism in human erythrocytes","volume":"124","author":"Sikora","year":"2014","journal-title":"Blood"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1498","DOI":"10.1038\/nm954","article-title":"Nitrite reduction to nitric oxide by deoxyhemoglobin vasodilates the human circulation","volume":"9","author":"Cosby","year":"2003","journal-title":"Nat. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e12404","DOI":"10.1002\/jev2.12404","article-title":"Minimal information for studies of extracellular vesicles (MISEV2023): From basic to advanced approaches","volume":"13","author":"Welsh","year":"2024","journal-title":"J. Extracell. Vesicles"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1111\/ijlh.12746","article-title":"Osmotic gradient ektacytometry: A valuable screening test for hereditary spherocytosis and other red blood cell membrane disorders","volume":"40","author":"Rizzuto","year":"2018","journal-title":"Int. J. Lab. Hematol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1007\/s12185-020-03010-9","article-title":"Characterization of hereditary red blood cell membranopathies using combined targeted next-generation sequencing and osmotic gradient ektacytometry","volume":"113","author":"Krishnevskaya","year":"2021","journal-title":"Int. J. Hematol."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Sadaf, A., Seu, K.G., Thaman, E., Fessler, R., Konstantinidis, D.G., Bonar, H.A., Korpik, J., Ware, R.E., McGann, P.T., and Quinn, C.T. (2021). Automated oxygen gradient ektacytometry: A novel biomarker in sickle cell anemia. Front. Physiol., 12.","DOI":"10.3389\/fphys.2021.636609"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"E29","DOI":"10.1002\/ajh.26031","article-title":"Oxygen gradient ektacytometry-derived biomarkers are associated with vaso-occlusive crises and correlate with treatment response in sickle cell disease","volume":"96","author":"Rab","year":"2021","journal-title":"Am. J. Hematol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1111\/bjh.17975","article-title":"Oxygen gradient ektacytometry does not predict pain in children with sickle cell anaemia","volume":"197","author":"Petersen","year":"2022","journal-title":"Br. J. Haematol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1016\/j.ajem.2017.10.056","article-title":"Red blood cell distribution width is associated with mortality in elderly patients with sepsis","volume":"36","author":"Wang","year":"2018","journal-title":"Am. J. Emerg. Med."},{"key":"ref_33","first-page":"100452","article-title":"Red blood cells protein profile is modified in breast cancer patients","volume":"21","author":"Bravo","year":"2022","journal-title":"Mol. Cell Proteom."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1111\/ijlh.12327","article-title":"ICSH recommendations for the standardization of nomenclature and grading of peripheral blood cell morphological features","volume":"37","author":"Palmer","year":"2015","journal-title":"Int. J. Lab. Hematol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1111\/ejh.70204","article-title":"Evaluation of the eosin-5\u2032-maleimide flow cytometry test for the diagnosis of hereditary spherocytosis","volume":"117","author":"Biaggioni","year":"2026","journal-title":"Eur. J. Haematol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1002\/ajh.25325","article-title":"Addressing the diagnostic gaps in pyruvate kinase deficiency: Consensus recommendations on the diagnosis of pyruvate kinase deficiency","volume":"94","author":"Bianchi","year":"2019","journal-title":"Am. J. Hematol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1225","DOI":"10.1182\/blood.2019000944","article-title":"Glucose-6-phosphate dehydrogenase deficiency","volume":"136","author":"Luzzatto","year":"2020","journal-title":"Blood"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.ijcard.2017.01.045","article-title":"Red cell distribution width and risk of cardiovascular mortality: Insights from National Health and Nutrition Examination Survey III","volume":"232","author":"Shah","year":"2017","journal-title":"Int. J. Cardiol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"722","DOI":"10.1038\/s41597-024-03570-z","article-title":"One million segmented red blood cells with 240 K classified in nine shapes and 47 K patches of 25 manual blood smears","volume":"11","author":"Elsafty","year":"2024","journal-title":"Sci. Data"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"13553","DOI":"10.1038\/s41598-021-92747-2","article-title":"Combining microfluidics with machine learning algorithms for red blood cell classification in rare hereditary hemolytic anemia","volume":"11","author":"Rizzuto","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1274","DOI":"10.1182\/blood.2019000948","article-title":"Congenital dyserythropoietic anemias","volume":"136","author":"Iolascon","year":"2020","journal-title":"Blood"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1080\/14789450.2017.1291347","article-title":"Proteomic analysis of red. blood cells and the potential. for the clinic: What have we learned so far?","volume":"14","author":"Zolla","year":"2017","journal-title":"Expert. Rev. Proteom."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1111\/j.1365-2141.2010.08520.x","article-title":"Improvements in haemolysis and indicators of erythrocyte survival do not correlate with acute vaso-occlusive crises in patients with sickle cell disease: A phase III randomized, placebo-controlled, double-blind study of the Gardos channel blocker senicapoc (ICA-17043)","volume":"153","author":"Ataga","year":"2011","journal-title":"Br. J. Haematol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1317","DOI":"10.1056\/NEJM199505183322001","article-title":"Effect of hydroxyurea on the frequency of painful crises in sickle cell anemia","volume":"332","author":"Charache","year":"1995","journal-title":"N. Engl. J. Med."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"R630","DOI":"10.1152\/ajpregu.00205.2020","article-title":"Hydroxyurea improves nitric oxide bioavailability in humanized sickle cell mice","volume":"320","author":"Taylor","year":"2021","journal-title":"Am. J. Physiol. Regul. Integr. Comp. Physiol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1649","DOI":"10.1056\/NEJMoa2309676","article-title":"Exagamglogene autotemcel for severe sickle cell disease","volume":"390","author":"Frangoul","year":"2024","journal-title":"N. Engl. J. Med."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1432","DOI":"10.1056\/NEJMoa2116634","article-title":"Mitapivat versus placebo for pyruvate kinase deficiency","volume":"386","author":"Rothman","year":"2022","journal-title":"N. Engl. J. Med."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1233","DOI":"10.1056\/NEJMoa061648","article-title":"The complement inhibitor eculizumab in paroxysmal nocturnal hemoglobinuria","volume":"355","author":"Hillmen","year":"2006","journal-title":"N. Engl. J. Med."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1276","DOI":"10.1182\/blood-2012-11-451229","article-title":"Hemolysis and free hemoglobin revisited: Exploring haemoglobin and haemin scavengers as a novel class of therapeutic proteins","volume":"121","author":"Schaer","year":"2013","journal-title":"Blood"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1172","DOI":"10.1182\/blood.2021012070","article-title":"Treatment of sickle cell disease by increasing oxygen affinity of haemoglobin","volume":"138","author":"Henry","year":"2021","journal-title":"Blood"},{"key":"ref_51","unstructured":"European Medicines Agency (2026, August 29). EMA Recommends Suspension of Sickle Cell Disease Medicine Oxbryta. Available online: https:\/\/www.ema.europa.eu\/en\/news\/ema-recommends-suspension-sickle-cell-disease-medicine-oxbryta."},{"key":"ref_52","unstructured":"US Food and Drug Administration (2026, September 26). FDA is Alerting Patients and Health Care Professionals About the Voluntary Withdrawal of Oxbryta from the Market Due to Safety Concerns, Available online: https:\/\/www.fda.gov\/drugs\/drug-alerts-and-statements\/fda-alerting-patients-and-health-care-professionals-about-voluntary-withdrawal-oxbryta-market-due."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1028","DOI":"10.1056\/NEJMoa2029073","article-title":"Pegcetacoplan versus eculizumab in paroxysmal nocturnal hemoglobinuria","volume":"384","author":"Hillmen","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.tmrv.2016.08.004","article-title":"Erythrocytes as carriers for drug delivery in blood transfusion and beyond","volume":"31","author":"Villa","year":"2017","journal-title":"Transfus. Med. Rev."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"10980","DOI":"10.1073\/pnas.1106634108","article-title":"Erythrocyte membrane-camouflaged polymeric nanoparticles as a biomimetic delivery platform","volume":"108","author":"Hu","year":"2011","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"2684","DOI":"10.1038\/s41467-018-05079-7","article-title":"Red blood cell-hitchhiking boosts delivery of nanocarriers to chosen organs by orders of magnitude","volume":"9","author":"Brenner","year":"2018","journal-title":"Nat. Commun."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"14610","DOI":"10.1038\/s41598-024-65623-y","article-title":"Efficient and highly reproducible production of red blood cell-derived extracellular vesicle mimetics for the loading and delivery of RNA molecules","volume":"14","author":"Biagiotti","year":"2024","journal-title":"Sci. Rep."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"e011148","DOI":"10.1136\/jitc-2024-011148","article-title":"Engineered red blood cell extracellular vesicles for delivery of doxorubicin and siIDO1 enhance targeted chemo-immunotherapy of acute myeloid leukaemia","volume":"13","author":"Liu","year":"2025","journal-title":"J. Immunother. Cancer"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"2701","DOI":"10.1007\/s00262-021-03001-7","article-title":"Anti-tumor effects of RTX-240: An engineered red blood cell expressing 4-1BB ligand and interleukin-15","volume":"70","author":"McArdel","year":"2021","journal-title":"Cancer Immunol. Immunother."},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Mayers, S., Mo\u00e7o, P.D., Maqbool, T., Silva, P.N., Kilkenny, D.M., and Audet, J. (2019). Establishment of an erythroid progenitor cell line capable of enucleation achieved with an inducible c-Myc vector. BMC Biotechnol., 19.","DOI":"10.1186\/s12896-019-0515-9"},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Levene, M., Bain, M.D., Moran, N.F., Nirmalananthan, N., Poulton, J., Scarpelli, M., Filosto, M., Mandel, H., MacKinnon, A.D., and Fairbanks, L. (2019). Safety and efficacy of erythrocyte encapsulated thymidine phosphorylase in mitochondrial neurogastrointestinal encephalomyopathy. J. Clin. Med., 8.","DOI":"10.3390\/jcm8040457"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1515\/cclm-2016-0290","article-title":"Next-generation osmotic gradient ektacytometry for the diagnosis of hereditary spherocytosis: Interlaboratory method validation and experience","volume":"55","author":"Lazarova","year":"2017","journal-title":"Clin. Chem. Lab. Med."},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Makhro, A., Huisjes, R., Verhagen, L.P., Ma\u00f1\u00fa-Pereira, M.d.M., Llaudet-Planas, E., Petkova-Kirova, P., Wang, J., Eichler, H., Bogdanova, A., and van Wijk, R. (2016). Red cell properties after different modes of blood transportation. Front. Physiol., 7.","DOI":"10.3389\/fphys.2016.00288"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"110014","DOI":"10.1016\/j.compbiomed.2025.110014","article-title":"Patient-specific microvascular computational modeling for estimating radiotherapy outcomes","volume":"190","author":"Materne","year":"2025","journal-title":"Comput. Biol. Med."}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/27\/19\/8848\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T12:33:56Z","timestamp":1791203636000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/27\/19\/8848"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,3]]},"references-count":64,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2026,10]]}},"alternative-id":["ijms27198848"],"URL":"https:\/\/doi.org\/10.3390\/ijms27198848","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,3]]}}}