{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T07:51:51Z","timestamp":1784793111434,"version":"3.55.0"},"reference-count":55,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T00:00:00Z","timestamp":1772755200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Return to work (RTW) after acute coronary syndrome (ACS) or acute heart failure (HF) is a pivotal outcome reflecting functional recovery and quality of life (QoL). While survival after cardiac events has improved through reperfusion and guideline-directed pharmacotherapy, sustainable RTW depends on an integrated set of clinical, psychological, social, and occupational determinants. Objective: This study aimed to synthesize and expand the evidence on predictors of RTW, delineate practical workload-matching rules using METs and CPET, and position multidisciplinary cardiac rehabilitation (CR) as the bridge from clinical recovery to durable vocational reintegration. Key findings: Beyond left ventricular ejection fraction (LVEF), depression, anxiety, illness perceptions, and RTW self-efficacy are robust predictors of vocational outcomes. CPET-guided exercise prescriptions and MET-based job matching ensure adequate metabolic reserve; sustained task demand should remain at \u226435\u201340% of maximal capacity, with peak capacity \u22652\u00d7 average job demand. CR (Class IA in the 2023 ESC ACS Guidelines) improves exercise tolerance, medication adherence, psychosocial well-being, and deployment of vocational support, including stepwise reintegration plans and ergonomic adaptations. Telerehabilitation extends monitoring and counseling into the workplace and maintains adherence after RTW. Conclusions: Comprehensive CR that integrates exercise training, psychosocial counseling, lifestyle modification, and vocational interventions offers the most effective pathway to stable RTW, improved QoL, and reduced socio-economic burden. Early identification of vulnerable subgroups and personalized, digitally supported follow-up are essential for long-term job retention.<\/jats:p>","DOI":"10.3390\/jcm15052019","type":"journal-article","created":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T09:22:14Z","timestamp":1772788934000},"page":"2019","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Return to Work After a Cardiovascular Event: The Central Role of Cardiac Rehabilitation"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6330-1738","authenticated-orcid":false,"given":"Mario","family":"Pacileo","sequence":"first","affiliation":[{"name":"Cardiology and Intensive Care Unit, Department of Cardiology, \u201cUmberto I\u201d Hospital, 84014 Nocera Inferiore, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4119-9397","authenticated-orcid":false,"given":"Francesco","family":"Giallauria","sequence":"additional","affiliation":[{"name":"Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluigi","family":"Cuomo","sequence":"additional","affiliation":[{"name":"Department of General Medicine, \u201cOspedale del Mare\u201d, ASL Napoli 1Centro, 80147 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Vallefuoco","sequence":"additional","affiliation":[{"name":"Cardiology Unit, University of Campania \u201cLuigi Vanvitelli\u201d, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7060-6938","authenticated-orcid":false,"given":"Alfredo","family":"Mauriello","sequence":"additional","affiliation":[{"name":"Cardiology Unit, Institute National Cancer, IRCCS, Foundation \u201cG. Pascale\u201d, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9227-0360","authenticated-orcid":false,"given":"Vincenzo","family":"Russo","sequence":"additional","affiliation":[{"name":"Cardiology Unit, Monaldi Hospital, Department of Medical and Translational Sciences, University of Campania \u201cLuigi Vanvitelli\u201d, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9698-9145","authenticated-orcid":false,"given":"Antonello","family":"D\u2019Andrea","sequence":"additional","affiliation":[{"name":"Cardiology and Intensive Care Unit, Department of Cardiology, \u201cUmberto I\u201d Hospital, 84014 Nocera Inferiore, Italy"},{"name":"Cardiology Unit, Monaldi Hospital, Department of Medical and Translational Sciences, University of Campania \u201cLuigi Vanvitelli\u201d, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e006486","DOI":"10.1161\/JAHA.117.006486","article-title":"Return to Work and Risk of Subsequent Detachment from Employment After Myocardial Infarction: Insights from Danish Nationwide Registries","volume":"6","author":"Smedegaard","year":"2017","journal-title":"J. Am. Heart Assoc."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1358","DOI":"10.1177\/2047487319839263","article-title":"The importance of return to work: How to achieve optimal reintegration in ACS patients","volume":"26","author":"Reibis","year":"2019","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_3","first-page":"215","article-title":"Psychosocial\/vocational interventions and RTW post-MI","volume":"38","author":"Wallace","year":"2018","journal-title":"J. Cardiopulm. Rehabil. Prev."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1177\/2047487320913379","article-title":"Secondary prevention through comprehensive cardiovascular rehabilitation: From knowledge to implementation. 2020 update. A position paper from the Secondary Prevention and Rehabilitation Section of the European Association of Preventive Cardiology","volume":"28","author":"Ambrosetti","year":"2021","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"15348","DOI":"10.1038\/s41598-022-19467-z","article-title":"Prevalence and determinants of return to work after various coronary events: Meta-analysis of prospective studies","volume":"12","author":"Kai","year":"2022","journal-title":"Sci. Rep."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e069091","DOI":"10.1136\/bmjopen-2022-069091","article-title":"Barriers and facilitators to return to work following cardiovascular disease: A systematic review and meta-synthesis","volume":"13","author":"Andersen","year":"2023","journal-title":"BMJ Open"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Sun, W., Gholizadeh, L., Perry, L., and Kang, K. (2022). Predicting return to work following myocardial infarction. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19138032"},{"key":"ref_8","first-page":"e6226","article-title":"Prognostic value of ejection fraction in ACS","volume":"96","author":"Klempfner","year":"2017","journal-title":"Medicine"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"D\u2019Andrea, A., Sperlongano, S., Pacileo, M., Vitale, G., Maglione, M., Cice, G., Maria Sarullo, F., Di Lorenzo, A., Vigorito, C., and Giallauria, F. (2020). New Ultrasound Technologies for Ischemic Heart Disease Assessment and Monitoring in Cardiac Rehabilitation. J. Clin. Med., 9.","DOI":"10.3390\/jcm9103131"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1111\/echo.13879","article-title":"Speckle tracking analysis in intensive care unit: A toy or a tool?","volume":"35","author":"Radmilovic","year":"2018","journal-title":"Echocardiography"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1016\/j.amjcard.2011.03.052","article-title":"Prognostic value of serial global longitudinal strain measured by two-dimensional speckle tracking echocardiography in patients with ST-segment elevation myocardial infarction","volume":"108","author":"Woo","year":"2011","journal-title":"Am. J. Cardiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1404","DOI":"10.1016\/j.amjcard.2010.06.072","article-title":"Left ventricular muscle and fluid mechanics in acute myocardial infarction","volume":"106","author":"Nucifora","year":"2010","journal-title":"Am. J. Cardiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2640","DOI":"10.1253\/circj.CJ-12-0360","article-title":"Abnormal left ventricular vortex flow patterns in association with left ventricular apical thrombus formation in patients with anterior myocardial infarction: A quantitative analysis by contrast echocardiography","volume":"76","author":"Son","year":"2012","journal-title":"Circ. J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1515","DOI":"10.1592\/phco.24.16.1515.50946","article-title":"Work-related outcomes after a myocardial infarction","volume":"24","author":"McBurney","year":"2004","journal-title":"Pharmacotherapy"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1386","DOI":"10.1177\/2047487319843079","article-title":"Return to work and associations with psychosocial well-being and health-related quality of life in coronary heart disease patients: Results from EUROASPIRE IV","volume":"26","author":"Cauter","year":"2019","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Salzwedel, A., Koran, I., Langheim, E., Schlitt, A., Nothroff, J., Bongarth, C., Wrenger, M., Sehner, S., Reibis, R., and Wegscheider, K. (2020). Patient-reported outcomes predict return to work and health-related quality of life six months after cardiac rehabilitation: Results from a German multi-centre registry (OutCaRe). PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0232752"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"301","DOI":"10.2147\/VHRM.S216039","article-title":"Patients\u2019 expectations of returning to work, co-morbid disorders and work capacity at discharge from cardiac rehabilitation","volume":"15","author":"Salzwedel","year":"2019","journal-title":"Vasc. Health Risk Manag."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"3720","DOI":"10.1093\/eurheartj\/ehad191","article-title":"2023 ESC Guidelines for the management of acute coronary syndromes","volume":"44","author":"Byrne","year":"2023","journal-title":"Eur. Heart J."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1177\/2047487320924912","article-title":"Standardization and quality improvement of secondary prevention through cardiovascular rehabilitation programmes in Europe: The avenue towards EAPC accreditation programme: A position statement of the Secondary Prevention and Rehabilitation Section of the European Association of Preventive Cardiology (EAPC)","volume":"28","author":"Abreu","year":"2021","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"13429","DOI":"10.1038\/s41598-024-63988-8","article-title":"Predictors of work inability after acute myocardial infarction in Switzerland","volume":"14","author":"Barresi","year":"2024","journal-title":"Sci. Rep."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Stendardo, M., Bonci, M., Casillo, V., Miglio, R., Giovannini, G., Nardini, M., Campo, G., Fucili, A., and Boschetto, P. (2018). Predicting return to work after acute myocardial infarction: Socio-occupational factors overcome clinical conditions. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0208842"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/j.repc.2019.09.010","article-title":"Indirect costs of myocardial infarction in Portugal","volume":"39","author":"Gouveia","year":"2020","journal-title":"Rev. Port. Cardiol. Engl. Ed."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1186\/1477-7525-8-95","article-title":"Depression as a predictor of work resumption following myocardial infarction","volume":"8","author":"Sanderson","year":"2010","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Hu, Y., Zhou, T., Li, X., Chen, X., Wang, X., Xu, J., and Gu, D. (2023). Factors influencing return to work 3 months after percutaneous coronary intervention in young and middle-aged patients with coronary heart disease: A single-center, cross-sectional study. PLoS ONE, 18.","DOI":"10.1371\/journal.pone.0284100"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1007\/s10926-020-09942-7","article-title":"Effort-Reward Imbalance at Work and Overcommitment in Patients with Acute Myocardial Infarction (AMI): Associations with Return to Work 6 Months After AMI","volume":"31","author":"Ruile","year":"2021","journal-title":"J. Occup. Rehabil."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1007\/s10926-015-9588-z","article-title":"Longitudinal Associations Between Biopsychosocial Factors and Sustainable Return to Work of Sick-Listed Workers with a Depressive or Anxiety Disorder","volume":"26","author":"Lammerts","year":"2016","journal-title":"J. Occup. Rehabil."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1007\/s10926-022-10046-7","article-title":"Predictors of return to work for people with anxiety or depression in supported employment trials","volume":"33","author":"Christensen","year":"2023","journal-title":"J. Occup. Rehabil."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"101412","DOI":"10.1016\/j.physio.2024.07.003","article-title":"Psychologically-enhanced cardiac rehabilitation for psychological and functional improvement in patients with cardiovascular disease: A systematic review with meta-analysis and future research directions","volume":"125","author":"Wrzeciono","year":"2024","journal-title":"Physiotherapy"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"114560","DOI":"10.1016\/j.physbeh.2024.114560","article-title":"The psychological well-being index and quality of life after a cardiac rehabilitation program based on aerobic training and psychosocial support","volume":"280","author":"Villafaina","year":"2024","journal-title":"Physiol Behav."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/j.ajem.2010.10.011","article-title":"Killip classification in patients with acute coronary syndrome: Insight from a multicenter registry","volume":"30","author":"Zubaid","year":"2012","journal-title":"Am. J. Emerg. Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"3997","DOI":"10.1093\/eurheartj\/ehac262","article-title":"2022 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death","volume":"43","author":"Zeppenfeld","year":"2022","journal-title":"Eur. Heart J."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1185","DOI":"10.4244\/EIJ-D-17-00132","article-title":"Impact of residual SYNTAX score on clinical outcomes after incomplete revascularisation percutaneous coronary intervention: A large single-centre study","volume":"13","author":"Song","year":"2017","journal-title":"EuroIntervention"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1093\/eurheartj\/ehac747","article-title":"Exercise-based cardiac rehabilitation for coronary heart disease: A meta-analysis","volume":"44","author":"Dibben","year":"2023","journal-title":"Eur. Heart J."},{"key":"ref_34","first-page":"E428","article-title":"Emotional Distress in Younger (<55 Years) and Older (\u226555) Patients After a First-Time Myocardial Infarction and Its Prospective Associations With Working Status and Secondary Preventive Goals Among the Younger Cohort: Insights From the Swedish SWEDEHEART Registry Study","volume":"40","author":"Leissner","year":"2024","journal-title":"J. Cardiovasc. Nurs."},{"key":"ref_35","first-page":"397","article-title":"Return to work after acute myocardial infarction with cardiogenic shock: A Danish nationwide cohort study","volume":"11","author":"Lauridsen","year":"2022","journal-title":"Eur. Heart J. Acute Cardiovasc. Care"},{"key":"ref_36","unstructured":"World Health Organization (2002). Occupational Health: A Manual for Primary Health Care Workers, Regional Office for the Eastern Mediterranean. Available online: https:\/\/iris.who.int\/handle\/10665\/116326."},{"key":"ref_37","unstructured":"\u00c5strand, P.O., Rodahl, K., Dahl, H.A., and Stromme, S.B. (2003). Textbook of Work Physiology: Physiological Bases of Exercise, Human Kinetics Publishers. [4th ed.]."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1002\/clc.4960130809","article-title":"Metabolic equivalents (METS) in exercise testing, exercise prescription, and evaluation of functional capacity","volume":"13","author":"Sidney","year":"1990","journal-title":"Clin. Cardiol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1055\/s-0029-1241810","article-title":"Implementierung eines psychodiagnostischen Stufenplans in der medizinischen Rehabilitation\u2014Ergebnisse einer Pilotstudie [Implementation of a routine gradual psycho-diagnostic programme in somatic rehabilitation centres\u2014Results of a pilot study]","volume":"48","author":"Vogel","year":"2009","journal-title":"Die Rehabilitation"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1007\/BF02602324","article-title":"The Functional Status Questionnaire: Reliability and validity when used in primary care","volume":"1","author":"Jette","year":"1986","journal-title":"J. Gen. Intern. Med."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"649","DOI":"10.13075\/ijomeh.1896.00643","article-title":"Work-related outcome after acute coronary syndrome: Implications of complex cardiac rehabilitation in occupational medicine","volume":"29","author":"Lamberti","year":"2016","journal-title":"Int. J. Occup. Med. Environ. Health"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1177\/1357633X14562732","article-title":"A review of telerehabilitation for cardiac patients","volume":"21","author":"Frederix","year":"2015","journal-title":"J. Telemed. Telecare"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1166","DOI":"10.1177\/2047487319832394","article-title":"ESC e-Cardiology Working Group Position Paper: Overcoming challenges in digital health implementation in cardiovascular medicine","volume":"26","author":"Frederix","year":"2019","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1177\/2047487319892201","article-title":"Home-based exercise with telemonitoring guidance in patients with coronary artery disease: Does it improve long-term physical fitness?","volume":"27","author":"Avila","year":"2020","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_45","first-page":"e14221","article-title":"Feasibility, Acceptability, and Clinical Effectiveness of a Technology-Enabled Cardiac Rehabilitation Platform (Physical Activity Toward Health-I): Randomized Controlled Trial","volume":"22","author":"Claes","year":"2020","journal-title":"J. Med. Internet Res."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"3714","DOI":"10.1093\/eurheartj\/ehaf408","article-title":"Standards for cardiac telerehabilitation","volume":"46","author":"Scherrenberg","year":"2025","journal-title":"Eur. Heart J."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"e003480","DOI":"10.1161\/CIRCOUTCOMES.116.003480","article-title":"Young Women With Acute Myocardial Infarction: Current Perspectives","volume":"10","author":"Dreyer","year":"2017","journal-title":"Circ. Cardiovasc. Qual. Outcomes"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"e184831","DOI":"10.1001\/jamanetworkopen.2018.4831","article-title":"Factors Associated With Return to Work After Acute Myocardial Infarction in China","volume":"1","author":"Jiang","year":"2018","journal-title":"JAMA Netw. Open"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1159\/000081850","article-title":"Employment after first MI","volume":"103","author":"Drory","year":"2005","journal-title":"Cardiology"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1060","DOI":"10.1177\/2047487313486040","article-title":"Short-term comprehensive cardiac rehabilitation after AMI is associated with reduced 1-year mortality: Results from the OMEGA study","volume":"21","author":"Rauch","year":"2014","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"117","DOI":"10.5491\/SHAW.2012.3.2.117","article-title":"Return to work after an acute coronary syndrome: Patients\u2019 perspective","volume":"3","author":"Slebus","year":"2012","journal-title":"Saf. Health Work"},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Bernier, J., Breton, M., and Poitras, M.E. (2024). Co-designing a cardiac rehabilitation program with knowledge users for patients with cardiovascular disease from a remote area. BMC Health Serv. Res., 24.","DOI":"10.1186\/s12913-024-11321-4"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1016\/j.acvd.2010.04.007","article-title":"Return to work after acute ST-segment elevation myocardial infarction in the modern era of reperfusion by direct percutaneous coronary intervention","volume":"103","author":"Isaaz","year":"2010","journal-title":"Arch. Cardiovasc. Dis."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"e44318","DOI":"10.1097\/MD.0000000000044318","article-title":"Predictors of job maintenance in young and middle-aged patients after percutaneous coronary intervention: A retrospective cohort study","volume":"104","author":"Hua","year":"2025","journal-title":"Medicine"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1097\/HJR.0b013e3280128bde","article-title":"CR in Germany","volume":"14","author":"Karoff","year":"2007","journal-title":"Eur. J. Cardiovasc. Prev. Rehabil."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/5\/2019\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T09:56:50Z","timestamp":1772791010000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/5\/2019"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,6]]},"references-count":55,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["jcm15052019"],"URL":"https:\/\/doi.org\/10.3390\/jcm15052019","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,6]]}}}