{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:15:26Z","timestamp":1760058926205,"version":"build-2065373602"},"reference-count":63,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,5,6]],"date-time":"2025-05-06T00:00:00Z","timestamp":1746489600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMAHP"],"abstract":"<jats:p>Dynamic transmission models (DTMs) have been used to estimate various aspects of the public health impact of varicella vaccination programs. The aim of this study was to validate the predictions of a DTM\u2014developed using the typical approach to varicella modeling\u2014using real-world data from a country with a long-term universal varicella vaccination (UVV) program and to assess the sensitivity of the predictions to changes in model input parameters. A compartmental, age-stratified DTM was developed using the settings corresponding to the existing UVV program in Germany. The model-predicted total number of varicella cases followed the same trend as observed in the reported data. The agreement between the simulations\u2019 results and the data was the highest for the age group most exposed to varicella (0\u20135 years old), while for other age groups, a decline in accuracy was observed. Sensitivity analyses identified the input parameters having a crucial impact on the model\u2019s long-term predictions. The results supported the reliability of the DTM for assessing the impact of varicella vaccination programs over the first decades after their introduction and provided an insight into how certain parameters and assumptions influence the model output and thus require careful evaluation in the studies of future varicella vaccination programs.<\/jats:p>","DOI":"10.3390\/jmahp13020020","type":"journal-article","created":{"date-parts":[[2025,5,6]],"date-time":"2025-05-06T09:08:56Z","timestamp":1746522536000},"page":"20","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Validating the Predictions of a Dynamic Transmission Model Using Real-World Data from a Universal Varicella Vaccination Program in Germany"],"prefix":"10.3390","volume":"13","author":[{"given":"Iwona","family":"\u017berda","sequence":"first","affiliation":[{"name":"Clever-Access, Wadowicka 8a, 30-415 Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomasz","family":"Stanisz","sequence":"additional","affiliation":[{"name":"Clever-Access, Wadowicka 8a, 30-415 Krakow, Poland"},{"name":"Complex Systems Theory Department, Institute of Nuclear Physics, Polish Academy of Sciences, Radzikowskiego 152, 31-342 Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomasz","family":"Fundament","sequence":"additional","affiliation":[{"name":"Clever-Access, Wadowicka 8a, 30-415 Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Filip","family":"Che\u0142mikowski","sequence":"additional","affiliation":[{"name":"Clever-Access, Wadowicka 8a, 30-415 Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wioletta","family":"K\u0142\u0119bczyk","sequence":"additional","affiliation":[{"name":"Clever-Access, Wadowicka 8a, 30-415 Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Micha\u0142","family":"Pochopie\u0144","sequence":"additional","affiliation":[{"name":"Clever-Access, Wadowicka 8a, 30-415 Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emilie","family":"Clay","sequence":"additional","affiliation":[{"name":"Clever-Access, 53 Avenue Montaigne, 75008 Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6037-2039","authenticated-orcid":false,"given":"Samuel","family":"Aball\u00e9a","sequence":"additional","affiliation":[{"name":"InovIntell, 3023GJ Rotterdam, Zuid-Holland, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mondher","family":"Toumi","sequence":"additional","affiliation":[{"name":"InovIntell, 215 rue du Faubourg St Honor\u00e9, 75008 Paris, France"},{"name":"CEReSS\/UR3279\u2014Health Services Research and Quality of Life Center, Aix-Marseille University, 13385 Marseille, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"828","DOI":"10.1016\/j.jval.2012.06.011","article-title":"Dynamic Transmission Modeling: A Report of the ISPOR-SMDM Modeling Good Research Practices Task Force-5","volume":"15","author":"Pitman","year":"2012","journal-title":"Value Health"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1002\/hec.3303","article-title":"Dynamic Transmission Economic Evaluation of Infectious Disease Interventions in Low- and Middle-Income Countries: A Systematic Literature Review","volume":"25","author":"Drake","year":"2016","journal-title":"Health Econ."},{"key":"ref_3","first-page":"60","article-title":"Dynamic transmission models and economic evaluations of pneumococcal conjugate vaccines: A quality appraisal and limitations","volume":"26","author":"Anderson","year":"2019","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_4","unstructured":"Advisory Committee on Immunization Practices (ACIP) (2024, May 20). Evidence to Recommendations for Use of Hepatitis A Vaccine Catch-Up, Available online: https:\/\/www.cdc.gov\/acip\/evidence-to-recommendations\/hep-a-catchup-etr.html."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1728","DOI":"10.1080\/21645515.2020.1769388","article-title":"Landscape of vaccine access and health technology assessment role in decision-making process in ASEAN countries","volume":"16","author":"Taychakhoonavudh","year":"2020","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_6","unstructured":"National Advisory Committee on Immunization (NACI) (2023). Guidelines for the Economic Evaluation of Vaccination Programs in Canada, Public Health Agency of Canada."},{"key":"ref_7","unstructured":"World Health Organization (2019). Who Guide for Standardization of Economic Evaluations of Immunization Programmes, World Health Organization."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"S97","DOI":"10.1016\/j.jval.2023.03.512","article-title":"EE211 Guidelines for the Economic Evaluation of Vaccination Programs in Canada","volume":"26","author":"Sander","year":"2023","journal-title":"Value Health"},{"key":"ref_9","unstructured":"Australian Technical Advisory Group on Immunisation (ATAGI) (2024, May 20). Guidelines for Preparing a Request for Advice from the Australian Technical Advisory Group on Immunisation (ATAGI) to Support Pharmaceutical Benefits Advisory Committee (PBAC) Consideration of Vaccines, Available online: https:\/\/www.health.gov.au\/resources\/publications\/atagi-pre-submission-advice-for-industry-sponsors-wishing-to-make-a-pbac-submission."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"S380","DOI":"10.1093\/infdis\/jiac390","article-title":"Clinical Manifestations of Varicella: Disease Is Largely Forgotten, but It\u2019s Not Gone","volume":"226","author":"Dooling","year":"2022","journal-title":"J. Infect. Dis."},{"key":"ref_11","first-page":"1","article-title":"Prevention of varicella: Recommendations of the Advisory Committee on Immunization Practices (ACIP)","volume":"56","author":"Marin","year":"2007","journal-title":"Morb. Mortal. Wkly. Report. Recomm. Rep."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"15016","DOI":"10.1038\/nrdp.2015.16","article-title":"Varicella zoster virus infection","volume":"2","author":"Gershon","year":"2015","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Kennedy, P.G.E., and Gershon, A.A. (2018). Clinical Features of Varicella-Zoster Virus Infection. Viruses, 10.","DOI":"10.3390\/v10110609"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Pawaskar, M., M\u00e9roc, E., Samant, S., Flem, E., Bencina, G., Riera-Montes, M., and Heininger, U. (2021). Economic burden of varicella in Europe in the absence of universal varicella vaccination. BMC Public Health, 21.","DOI":"10.1186\/s12889-021-12343-x"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"S463","DOI":"10.1093\/infdis\/jiac271","article-title":"Health and Economic Impact of the United States Varicella Vaccination Program, 1996\u20132020","volume":"226","author":"Zhou","year":"2022","journal-title":"J. Infect. Dis."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1080\/14760584.2017.1343669","article-title":"Varicella vaccination\u2014The global experience","volume":"16","author":"Wutzler","year":"2017","journal-title":"Expert Rev. Vaccines"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Moek, F., and Siedler, A. (2023). Trends in age-specific varicella incidences following the introduction of the general recommendation for varicella immunization in Germany, 2006\u20132022. BMC Public Health, 23.","DOI":"10.1186\/s12889-023-17098-1"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1017\/S0950268802006878","article-title":"Assessment of varicella underreporting in Italy","volume":"128","author":"Rota","year":"2002","journal-title":"Epidemiol. Infect."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1007\/s00431-005-1637-8","article-title":"Prospective surveillance of hospitalisations associated with varicella-zoster virus infections in children and adolescents","volume":"164","author":"Bonhoeffer","year":"2005","journal-title":"Eur. J. Pediatr."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"99","DOI":"10.21101\/cejph.a3572","article-title":"Evaluation of Mandatory Case-based Reporting System for Varicella in the Prevaccine Era","volume":"18","year":"2010","journal-title":"Central Eur. J. Public Health"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1256","DOI":"10.1016\/S0264-410X(02)00431-0","article-title":"The cost-effectiveness of routine childhood varicella vaccination in Germany","volume":"21","author":"Banz","year":"2002","journal-title":"Vaccine"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1007\/s10198-003-0200-7","article-title":"The burden of varicella in Germany","volume":"5","author":"Banz","year":"2004","journal-title":"Eur. J. Health Econ."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"7307","DOI":"10.1016\/j.vaccine.2007.08.017","article-title":"Universal mass vaccination against varicella in Germany using an MMRV combination vaccine with a two-dose schedule: An economic analysis","volume":"25","author":"Hammerschmidt","year":"2007","journal-title":"Vaccine"},{"key":"ref_24","first-page":"1766","article-title":"Current and future effects of varicella and herpes zoster vaccination in Germany\u2014Insights from a mathematical model in a country with universal varicella vaccination","volume":"12","author":"Horn","year":"2016","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Horn, J., Damm, O., Greiner, W., Hengel, H., Kretzschmar, M.E., Siedler, A., Ultsch, B., Weidemann, F., Wichmann, O., and Karch, A. (2018). Influence of demographic changes on the impact of vaccination against varicella and herpes zoster in Germany\u2014A mathematical modelling study. BMC Med., 16.","DOI":"10.1186\/s12916-017-0983-5"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1007\/s40273-024-01364-0","article-title":"Evaluating the Validation Process: Embracing Complexity and Transparency in Health Economic Modelling","volume":"42","author":"Ramos","year":"2024","journal-title":"PharmacoEconomics"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1093\/imammb\/1.2.169","article-title":"An Age-Structured Model of Pre- and Post-Vaccination Measles Transmission","volume":"1","author":"Schenzle","year":"1984","journal-title":"Math. Med. Biol. A J. IMA"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1098\/rspb.1993.0011","article-title":"Chaos and biological complexity in measles dynamics","volume":"251","author":"Bolker","year":"1993","journal-title":"Proc. R. Soc. B Biol. Sci."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1031","DOI":"10.1006\/bulm.1999.0126","article-title":"Modeling the Effects of Varicella Vaccination Programs on the Incidence of Chickenpox and Shingles","volume":"61","author":"Schuette","year":"1999","journal-title":"Bull. Math. Biol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1017\/S0950268800004714","article-title":"Modelling the impact of immunization on the epidemiology of varicella zoster virus","volume":"125","author":"Brisson","year":"2000","journal-title":"Epidemiol. Infect."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"3385","DOI":"10.1016\/j.vaccine.2010.02.079","article-title":"Modeling the impact of one- and two-dose varicella vaccination on the epidemiology of varicella and zoster","volume":"28","author":"Brisson","year":"2010","journal-title":"Vaccine"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1016\/j.clinthera.2014.12.017","article-title":"The Impact of 2-Dose Routine Measles, Mumps, Rubella, and Varicella Vaccination in France on the Epidemiology of Varicella and Zoster Using a Dynamic Model With an Empirical Contact Matrix","volume":"37","author":"Ouwens","year":"2015","journal-title":"Clin. Ther."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e3617","DOI":"10.1093\/cid\/ciaa1708","article-title":"Epidemiological Impact and Cost-Effectiveness of Varicella Vaccination Strategies in the United Kingdom","volume":"73","author":"Akpo","year":"2020","journal-title":"Clin. Infect. Dis."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1365","DOI":"10.1016\/S0140-6736(06)69561-5","article-title":"Varicella","volume":"368","author":"Heininger","year":"2006","journal-title":"Lancet"},{"key":"ref_35","unstructured":"Centers for Disease Control and Prevention (2024, February 06). Chickenpox (Varicella), Available online: https:\/\/www.cdc.gov\/chickenpox\/index.html."},{"key":"ref_36","unstructured":"United Nations, Department of Economic and Social Affairs, Population Division (2021, October 14). World Population Prospects 2022. Available online: https:\/\/www.un.org\/development\/desa\/pd\/."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Mossong, J., Hens, N., Jit, M., Beutels, P., Auranen, K., Mikolajczyk, R., Massari, M., Salmaso, S., Tomba, G.S., and Wallinga, J. (2008). Social Contacts and Mixing Patterns Relevant to the Spread of Infectious Diseases. PLoS Med., 5.","DOI":"10.1371\/journal.pmed.0050074"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Wiese-Posselt, M., Siedler, A., Mankertz, A., Sauerbrei, A., Hengel, H., Wichmann, O., and Poethko-M\u00fcller, C. (2017). Varicella-zoster virus seroprevalence in children and adolescents in the pre-varicella vaccine era, Germany. BMC Infect. Dis., 17.","DOI":"10.1186\/s12879-017-2461-2"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"2666","DOI":"10.1017\/S0950268817001546","article-title":"A systematic review of varicella seroprevalence in European countries before universal childhood immunization: Deriving incidence from seroprevalence data","volume":"145","author":"Bollaerts","year":"2017","journal-title":"Epidemiol. Infect."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/S0264-410X(01)00276-6","article-title":"Seroprevalence of varicella-zoster virus in the German population","volume":"20","author":"Wutzler","year":"2001","journal-title":"Vaccine"},{"key":"ref_41","unstructured":"(2024, February 08). RKI: Epidemiologisches Bulletin 3\/2020. Available online: https:\/\/www.rki.de\/DE\/Content\/Infekt\/EpidBull\/Archiv\/2020\/Ausgaben\/03_20."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"476","DOI":"10.4161\/hv.26986","article-title":"Vaccination coverage among children in Germany estimated by analysis of health insurance claims data","volume":"10","author":"Rieck","year":"2013","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_43","unstructured":"(2024, February 08). Das Informationssystem der Gesundheitsberichterstattung des Bundes. Available online: https:\/\/www.gbe-bund.de\/gbe\/."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"19530","DOI":"10.2807\/ese.15.13.19530-en","article-title":"Impact of the routine varicella vaccination programme on varicella epidemiology in Germany","volume":"15","author":"Siedler","year":"2010","journal-title":"Eurosurveillance"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"998","DOI":"10.1097\/INF.0b013e31829ae263","article-title":"The Effectiveness of Varicella Vaccination in Children in Germany: A Case-control Study","volume":"32","author":"Liese","year":"2013","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1016\/j.jpeds.2016.02.040","article-title":"Strong Additional Effect of a Second Varicella Vaccine Dose in Children in Germany, 2009-2014","volume":"173","author":"Siedler","year":"2016","journal-title":"J. Pediatr."},{"key":"ref_47","unstructured":"(2023, August 24). RKI: Impfquoten bei den Schuleingangs-Untersuchungen in Deutschland. Available online: https:\/\/www.rki.de\/DE\/Content\/Infekt\/Impfen\/Impfstatus\/schulanfaenger\/schuleingangsuntersuchungen_node."},{"key":"ref_48","unstructured":"(2024, February 19). Handbook Germany: School Entry Health Checks. Available online: https:\/\/handbookgermany.de\/en\/school-entry-health-checks."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"F\u00fchrer, A., Wienke, A., Wiermann, S., Gr\u00f6ger, C., and Tiller, D. (2019). Risk-based approach to school entry examinations in Germany\u2014A validation study. BMC Pediatr., 19.","DOI":"10.1186\/s12887-019-1825-8"},{"key":"ref_50","unstructured":"Vynnycky, E., and White, R.G. (2011). An Introduction to Infectious Disease Modelling, Oxford University Press. [Reprint]."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1016\/j.jval.2012.04.012","article-title":"Model Transparency and Validation: A Report of the ISPOR-SMDM Modeling Good Research Practices Task Force-7","volume":"15","author":"Eddy","year":"2012","journal-title":"Value Health"},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Wolfson, L.J., Daniels, V.J., Pillsbury, M., Kurug\u00f6l, Z., Yardimci, C., Kyle, J., and Dinleyici, E.C. (2019). Cost-effectiveness analysis of universal varicella vaccination in Turkey using a dynamic transmission model. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0220921"},{"key":"ref_53","first-page":"100639","article-title":"National and provincial burden of varicella disease and cost-effectiveness of childhood varicella vaccination in China from 2019 to 2049: A modelling analysis","volume":"32","author":"Feng","year":"2022","journal-title":"Lancet Reg. Health West. Pac."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1177\/2051013613515621","article-title":"Successes and challenges in varicella vaccine","volume":"2","author":"Papaloukas","year":"2014","journal-title":"Ther. Adv. Vaccines"},{"key":"ref_55","unstructured":"World Health Organization (1998). Weekly Epidemiological Record, 1998, vol. 73, 32. Wkly. Epidemiol. Rec. Relev. \u00c9pid\u00e9miologique Hebd., 73, 241\u2013248."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"2411","DOI":"10.1016\/j.vaccine.2011.01.037","article-title":"Modelling the impact of a combined varicella and zoster vaccination programme on the epidemiology of varicella zoster virus in England","volume":"29","author":"Melegaro","year":"2011","journal-title":"Vaccine"},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Burgess, C., Samant, S., Lefevre, T., Larsen, C.S., and Pawaskar, M. (2023). Universal varicella vaccination in Denmark: Modeling public health impact, age-shift, and cost-effectiveness. PLoS Glob. Public Health, 3.","DOI":"10.1371\/journal.pgph.0002407"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"e1134","DOI":"10.1542\/peds.2013-0863","article-title":"Impact of a Routine Two-Dose Varicella Vaccination Program on Varicella Epidemiology","volume":"132","author":"Bialek","year":"2013","journal-title":"Pediatrics"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1542\/peds.2013-4251","article-title":"Impact of Vaccination on the Epidemiology of Varicella: 1995\u20132009","volume":"134","author":"Baxter","year":"2014","journal-title":"Pediatrics"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1080\/21645515.2018.1546525","article-title":"Global impact of varicella vaccination programs","volume":"15","author":"Varela","year":"2019","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Poletti, P., Melegaro, A., Ajelli, M., del Fava, E., Guzzetta, G., Faustini, L., Tomba, G.S., Lopalco, P., Rizzo, C., and Merler, S. (2013). Perspectives on the Impact of Varicella Immunization on Herpes Zoster. A Model-Based Evaluation from Three European Countries. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0060732"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.epidem.2014.12.005","article-title":"The social contact hypothesis under the assumption of endemic equilibrium: Elucidating the transmission potential of VZV in Europe","volume":"11","author":"Santermans","year":"2015","journal-title":"Epidemics"},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Arregui, S., Aleta, A., Sanz, J., and Moreno, Y. (2018). Projecting social contact matrices to different demographic structures. PLoS Comput. Biol., 14.","DOI":"10.1101\/343491"}],"container-title":["Journal of Market Access &amp; Health Policy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2001-6689\/13\/2\/20\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:27:38Z","timestamp":1760030858000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2001-6689\/13\/2\/20"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,6]]},"references-count":63,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,6]]}},"alternative-id":["jmahp13020020"],"URL":"https:\/\/doi.org\/10.3390\/jmahp13020020","relation":{},"ISSN":["2001-6689"],"issn-type":[{"type":"electronic","value":"2001-6689"}],"subject":[],"published":{"date-parts":[[2025,5,6]]}}}