{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T13:09:37Z","timestamp":1789132177803,"version":"build-2803163510"},"reference-count":50,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:00:00Z","timestamp":1789084800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background: Transfusion-transmitted infections (TTIs) continue to threaten the safety of blood supply systems worldwide. This study aimed to estimate the prevalence of malaria, HTLV I\/II, and syphilis among blood donors at the Riyadh Regional Laboratory and Blood Bank from 2018 to 2022, and to assess associations with gender, age, nationality, and the ABO\/RhD blood group. Methods: We conducted a retrospective analysis of 217,543 blood donations. Demographic and serological records were extracted from the blood bank\u2019s electronic database and analyzed in SPSS v28. Chi-square, Fisher\u2019s exact tests and multivariate logistic regression were used as appropriate, with significance set at p &lt; 0.05. Results: Male donors accounted for 97% of the cohort, and 52% were non-Saudi nationals. Malaria was rare (0.03%; n = 58); all 58 cases were detected in 2018, and none were recorded in subsequent years. HTLV I\/II antibodies were observed in 464 donors (0.21%), with the highest annual share in 2019 (39.7%). Syphilis was the most common TTI, identified in 1143 donors (0.52%), and showed a significant increasing trend over the study period (Cochran\u2013Armitage test p &lt; 0.001; Poisson regression IRR 1.21, 95% CI 1.15\u20131.28, p &lt; 0.001). In multivariable logistic regression, non-Saudi nationality was independently associated with syphilis positivity (aOR 1.48, 95% CI 1.31\u20131.67), and ages 46\u201365 was associated with higher odds of all three TTIs. ABO and RhD blood groups were not significantly associated with TTI positivity in univariate or multivariable analyses. Conclusions: Current screening practices appear to maintain low TTI prevalence in the central region, but the rising syphilis trend and the clustering of malaria positivity among non-Saudi donors point to the need for closer surveillance and targeted donor counseling. The study also highlights the need for more granular demographic data collection, including specific country of origin and duration of residence, to enable more effective risk stratification and intervention targeting.<\/jats:p>","DOI":"10.3390\/jcm15187058","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T12:24:33Z","timestamp":1789129473000},"page":"7058","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Prevalence of Syphilis, HTLV I\/II, and Malaria Among Blood Donors at the Riyadh Regional Laboratory: A Retrospective Study from Saudi Arabia"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-5864-9091","authenticated-orcid":false,"given":"Nouf Shawqi","family":"Alwaseah","sequence":"first","affiliation":[{"name":"College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"}]},{"given":"Abdulwahab","family":"Binjomah","sequence":"additional","affiliation":[{"name":"College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia"},{"name":"Bacterial Diseases and Special Pathogens Department, Public Health Authority, Riyadh 13351, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4654-245X","authenticated-orcid":false,"given":"Rimah Abdullah","family":"Saleem","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Molecular Medicine, College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"validation","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6082-3928","authenticated-orcid":false,"given":"Muhammad Raihan","family":"Sajid","sequence":"additional","affiliation":[{"name":"Department of Pathology, College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"data-curation","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Hani","family":"Tamim","sequence":"additional","affiliation":[{"name":"College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia"},{"name":"Department of Internal Medicine, Clinical Research Institute, American University of Beirut Medical Center, Beirut 1107 2020, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"formal-analysis","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-3944-1165","authenticated-orcid":false,"given":"Maria","family":"Imtiaz","sequence":"additional","affiliation":[{"name":"College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"visualization","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4549-9247","authenticated-orcid":false,"given":"Ashna","family":"Majid","sequence":"additional","affiliation":[{"name":"College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,11]]},"reference":[{"key":"ref_1","unstructured":"Myers, D.J., and Collins, R.A. (2026). Blood Donation. StatPearls, StatPearls Publishing."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1111\/vox.13001","article-title":"Evaluation of the WHO Global Database on Blood Safety","volume":"116","author":"Kanagasabai","year":"2021","journal-title":"Vox Sang."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"103450","DOI":"10.1016\/j.sjbs.2022.103450","article-title":"Demography and Blood Donation Trends in Saudi Arabia: A Nationwide Retrospective, Cross-Sectional Study","volume":"29","author":"Alsughayyir","year":"2022","journal-title":"Saudi J. Biol. Sci."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/voxs.12520","article-title":"Deferred and Deterred: A Review of Literature on the Impact of Deferrals on Blood Donors","volume":"15","author":"Davison","year":"2019","journal-title":"ISBT Sci. Ser."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1363","DOI":"10.15537\/smj.2022.43.12.20220634","article-title":"Prevalence of Transfusion-Transmitted Infections in Saudi Arabia Blood Donors: A Nationwide, Cross-Sectional Study","volume":"43","author":"Alsughayyir","year":"2022","journal-title":"Saudi Med. J."},{"key":"ref_6","unstructured":"(2026, May 08). Blood Donor Selection: Guidelines on Assessing Donor Suitability for Blood Donation. Available online: https:\/\/www.who.int\/publications\/i\/item\/9789241548519."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1128\/CMR.00109-14","article-title":"Blood Groups in Infection and Host Susceptibility","volume":"28","author":"Cooling","year":"2015","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e10568","DOI":"10.1016\/j.heliyon.2022.e10568","article-title":"Distribution Characteristics of ABO Blood Groups in China","volume":"8","author":"Sun","year":"2022","journal-title":"Heliyon"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1071\/SH14174","article-title":"Syphilis Transmission: A Review of the Current Evidence","volume":"12","author":"Stoltey","year":"2015","journal-title":"Sex. Health"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2275","DOI":"10.1128\/IAI.00360-15","article-title":"Transcription of TP0126, Treponema Pallidum Putative OmpW Homolog, Is Regulated by the Length of a Homopolymeric Guanosine Repeat","volume":"83","author":"Giacani","year":"2015","journal-title":"Infect. Immun."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"3181","DOI":"10.1111\/trf.16655","article-title":"Effect of Storage on Survival of Infectious Treponema Pallidum Spiked in Whole Blood and Platelets","volume":"61","author":"Tamrakar","year":"2021","journal-title":"Transfusion"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"103286","DOI":"10.1016\/j.transci.2021.103286","article-title":"Seropositivity for Syphilis among Brazilian Blood Donors. A Retrospective Study 2015\u20132020","volume":"61","author":"Kluppel","year":"2022","journal-title":"Transfus. Apher. Sci."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1668703","DOI":"10.1155\/2022\/1668703","article-title":"Prevalence of Treponema Pallidum Antibody among Volunteer Blood Donors in China","volume":"2022","author":"Zheng","year":"2022","journal-title":"Can. J. Infect. Dis. Med. Microbiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1195","DOI":"10.1111\/trf.17393","article-title":"Monitoring Syphilis Serology in Blood Donors: Is There Utility as a Surrogate Marker of Early Transfusion Transmissible Infection Behavioral Risk?","volume":"63","author":"Drews","year":"2023","journal-title":"Transfusion"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"6431","DOI":"10.2147\/IDR.S386495","article-title":"Prevalence of Syphilis Infections Among Volunteer Blood Donors in Jinan Blood Center, China: A 15-Year Retrospective Study","volume":"15","author":"Chen","year":"2022","journal-title":"Infect. Drug Resist."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"702","DOI":"10.1016\/j.jiph.2018.04.008","article-title":"The Prevalence of Transfusion-Transmitted Infections and Nucleic Acid Testing among Blood Donors in Majmaah, Saudi Arabia","volume":"11","author":"Alaidarous","year":"2018","journal-title":"J. Infect. Public Health"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2747","DOI":"10.19082\/2747","article-title":"Prevalence of Syphilis among Blood and Stem Cell Donors in Saudi Arabia: An Institutional Experience","volume":"8","author":"Elyamany","year":"2016","journal-title":"Electron. Physician"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1016\/j.jiph.2019.12.004","article-title":"Sero-Prevalence ABO and Rh Blood Groups and Their Associated Transfusion-Transmissible Infections among Blood Donors in the Central Region of Saudi Arabia","volume":"13","author":"Shariq","year":"2020","journal-title":"J. Infect. Public Health"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Altayar, M., Jalal, M., Kabrah, A., Qashqari, F., Jalal, N., Faidah, H., Baghdadi, M., and Kabrah, S. (2022). Prevalence and Association of Transfusion Transmitted Infections with ABO and Rh Blood Groups among Blood Donors in the Western Region of Saudi Arabia: A 7-Year Retrospective Analysis. Medicina, 58.","DOI":"10.3390\/medicina58070857"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"7415","DOI":"10.1073\/pnas.77.12.7415","article-title":"Detection and Isolation of Type C Retrovirus Particles from Fresh and Cultured Lymphocytes of a Patient with Cutaneous T-Cell Lymphoma","volume":"77","author":"Poiesz","year":"1980","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.antiviral.2016.10.015","article-title":"Reducing the Global Burden of HTLV-1 Infection: An Agenda for Research and Action","volume":"137","author":"Willems","year":"2017","journal-title":"Antivir. Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1126\/science.6981847","article-title":"A New Subtype of Human T-Cell Leukemia Virus (HTLV-II) Associated with a T-Cell Variant of Hairy Cell Leukemia","volume":"218","author":"Kalyanaraman","year":"1982","journal-title":"Science"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1186\/s12977-019-0483-0","article-title":"Comparative Virology of HTLV-1 and HTLV-2","volume":"16","author":"Martinez","year":"2019","journal-title":"Retrovirology"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Kalinichenko, S., Komkov, D., and Mazurov, D. (2022). HIV-1 and HTLV-1 Transmission Modes: Mechanisms and Importance for Virus Spread. Viruses, 14.","DOI":"10.3390\/v14010152"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1111\/bjh.19051","article-title":"HTLV-1 and Blood Donation","volume":"204","author":"Murphy","year":"2024","journal-title":"Br. J. Haematol."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Rosadas, C., Menezes, M.L.B., Galv\u00e3o-Castro, B., Assone, T., Miranda, A.E., Arag\u00f3n, M.G., Caterino-de-Araujo, A., Taylor, G.P., and Ishak, R. (2021). Blocking HTLV-1\/2 Silent Transmission in Brazil: Current Public Health Policies and Proposal for Additional Strategies. PLoS Negl. Trop. Dis., 15.","DOI":"10.1371\/journal.pntd.0009717"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1186\/s12936-022-04178-7","article-title":"Reflections on the 2021 World Malaria Report and the Future of Malaria Control","volume":"21","author":"Monroe","year":"2022","journal-title":"Malar. J."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"a025452","DOI":"10.1101\/cshperspect.a025452","article-title":"Biology of Malaria Transmission","volume":"7","author":"Meibalan","year":"2017","journal-title":"Cold Spring Harb. Perspect. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1128\/CMR.00051-10","article-title":"Epidemiology and Infectivity of Plasmodium falciparum and Plasmodium vivax Gametocytes in Relation to Malaria Control and Elimination","volume":"24","author":"Bousema","year":"2011","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"ofz283","DOI":"10.1093\/ofid\/ofz283","article-title":"Transfusion-Transmitted Malaria: A Systematic Review and Meta-Analysis","volume":"6","author":"Ahmadpour","year":"2019","journal-title":"Open Forum Infect. Dis."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1159\/000525414","article-title":"Transfusion-Transmitted Malaria and Mitigation Strategies in Nonendemic Regions","volume":"49","author":"Niederhauser","year":"2022","journal-title":"Transfus. Med. Hemother."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"3970370","DOI":"10.1155\/2021\/3970370","article-title":"Current Situation of Transfusion-Transmitted Malaria in China","volume":"2021","author":"Lin","year":"2021","journal-title":"J. Trop. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1186\/s12936-021-03846-4","article-title":"Residual Malaria in Jazan Region, Southwestern Saudi Arabia: The Situation, Challenges and Climatic Drivers of Autochthonous Malaria","volume":"20","author":"Madkhali","year":"2021","journal-title":"Malar. J."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Madkhali, A.M., Ghzwani, A.H., and Al-Mekhlafi, H.M. (2022). Comparison of Rapid Diagnostic Test, Microscopy, and Polymerase Chain Reaction for the Detection of Plasmodium falciparum Malaria in a Low-Transmission Area, Jazan Region, Southwestern Saudi Arabia. Diagnostics, 12.","DOI":"10.3390\/diagnostics12061485"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"667","DOI":"10.15537\/smj.2024.45.7.20240338","article-title":"Serological Markers of Transfusion Transmissible Infections and ABO Blood Groups in Najran, Saudi Arabia","volume":"45","author":"Alshehri","year":"2024","journal-title":"Saudi Med. J."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1016\/j.tracli.2020.06.005","article-title":"Measuring Public Awareness about Blood Donation in Assir, South-Western Saudi Arabia","volume":"27","author":"Otifi","year":"2020","journal-title":"Transfus. Clin. Biol."},{"key":"ref_37","unstructured":"MOH News (2026, September 03). MOH Reports First Case of Coronavirus Infection, Available online: https:\/\/www.moh.gov.sa\/en\/ministry\/mediacenter\/news\/pages\/news-2020-03-02-002.aspx?utm_source=chatgpt.com."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"102836","DOI":"10.1016\/j.transci.2020.102836","article-title":"Management of Blood Supply and Demand during the COVID-19 Pandemic in King Abdullah Hospital, Bisha, Saudi Arabia","volume":"59","author":"Yahia","year":"2020","journal-title":"Transfus. Apher. Sci."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1474426","DOI":"10.1155\/2022\/1474426","article-title":"Impact of COVID-19 on Blood Donation and Supply: A Multicenter Cross-Sectional Study from Saudi Arabia","volume":"2022","author":"Hakami","year":"2022","journal-title":"Biomed. Res. Int."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"3258","DOI":"10.1111\/trf.16661","article-title":"Blood Shortages Planning in Canada: The National Emergency Blood Management Committee Experience during the First 6 Months of the COVID-19 Pandemic","volume":"61","author":"Petraszko","year":"2021","journal-title":"Transfusion"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1111\/trf.17359","article-title":"Impact of the COVID-19 Pandemic on Blood Donation and Transfusions in the United States in 2020","volume":"63","author":"Basavaraju","year":"2023","journal-title":"Transfusion"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"WHO EMRO (2026, September 03). COVID-19-Related Challenges in Blood Donation in the United Arab Emirates. Available online: https:\/\/www.emro.who.int\/emhj-volume-30-2024\/volume-30-issue-7\/covid-19-related-challenges-in-blood-donation-in-the-united-arab-emirates.html?utm_source=chatgpt.com.","DOI":"10.26719\/2024.30.7.492"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1055\/s-0041-1729485","article-title":"Seroprevalence of Transfusion-Transmitted Infections among Voluntary and Replacement Blood Donors at the Peshawar Regional Blood Centre, Khyber Pakhtunkhwa, Pakistan","volume":"13","author":"Saba","year":"2021","journal-title":"J. Lab. Physicians"},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Aabdien, M., Selim, N., Himatt, S., Hmissi, S., Merenkov, Z., AlKubaisi, N., Abdel-Rahman, M.E., Abdelmola, A., Khelfa, S., and Farag, E. (2020). Prevalence and Trends of Transfusion Transmissible Infections among Blood Donors in the State of Qatar, 2013\u20132017. BMC Infect. Dis., 20.","DOI":"10.1186\/s12879-020-05344-5"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"551","DOI":"10.2147\/JBM.S316845","article-title":"ABO and Rhesus Blood Group Distribution and Blood Donation Willingness Among First-Year Health Students in a Saudi University","volume":"12","author":"AlShamlan","year":"2021","journal-title":"J. Blood Med."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Fambirai, T., Chimbari, M.J., and Ndarukwa, P. (2022). Global Cross-Border Malaria Control Collaborative Initiatives: A Scoping Review. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph191912216"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/s12977-020-00546-w","article-title":"Seroprevalence of Human T-Lymphotropic Virus Infection among Blood Donors in China: A First Nationwide Survey","volume":"18","author":"Chang","year":"2021","journal-title":"Retrovirology"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Rosadas, C., and Taylor, G.P. (2022). HTLV-1 and Co-Infections. Front. Med., 9.","DOI":"10.3389\/fmed.2022.812016"},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Miranda, C., Utsch-Gon\u00e7alves, D., Piassi, F.C.C., Loureiro, P., Gomes, I., Ribeiro, M.A., de Almeida-Neto, C., Blatyta, P., Amorim, L., and Garcia Mateos, S.O. (2022). Prevalence and Risk Factors for Human T-Cell Lymphotropic Virus (HTLV) in Blood Donors in Brazil-A 10-Year Study (2007\u20132016). Front. Med., 9.","DOI":"10.3389\/fmed.2022.844265"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.jgar.2015.12.006","article-title":"A New Enhanced Antibiotic Treatment for Early and Late Syphilis","volume":"5","author":"Drago","year":"2016","journal-title":"J. Glob. Antimicrob. Resist."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/18\/7058\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T12:34:28Z","timestamp":1789130068000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/18\/7058"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,11]]},"references-count":50,"journal-issue":{"issue":"18","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["jcm15187058"],"URL":"https:\/\/doi.org\/10.3390\/jcm15187058","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,11]]}}}