{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T05:40:56Z","timestamp":1778996456277,"version":"3.51.4"},"reference-count":59,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2023,11,28]],"date-time":"2023-11-28T00:00:00Z","timestamp":1701129600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Le Fonds de recherche du Qu\u00e9bec\u2014Sant\u00e9 (FRQS)"},{"name":"Otsuka Canada Pharmaceutical Inc."},{"name":"Chaire Eli Lilly Canada de recherche en schizophr\u00e9nie"},{"name":"MEI (Minist\u00e8re de l\u2019\u00c9conomie et de l\u2019Innovation)"},{"name":"Services et recherches psychiatriques AD"},{"name":"Fonds d\u2019excellence en recherche Apog\u00e9e Canada"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>(1) Background: Approximately 30% of schizophrenia patients are known to be treatment-resistant. For these cases, more personalized approaches must be developed. Virtual reality therapeutic approaches such as avatar therapy (AT) are currently undergoing investigations to address these patients\u2019 needs. To further tailor the therapeutic trajectory of patients presenting with this complex presentation of schizophrenia, quantitative insight about the therapeutic process is warranted. The aim of the study is to combine a classification model with a regression model with the aim of predicting the therapeutic outcomes of patients based on the interactions taking place during their first immersive session of virtual reality therapy. (2) Methods: A combination of a Linear Support Vector Classifier and logistic regression was conducted over a dataset comprising 162 verbatims of the immersive sessions of 18 patients who previously underwent AT. As a testing dataset, 17 participants, unknown to the dataset, had their first immersive session presented to the combinatory model to predict their clinical outcome. (3) Results: The model accurately predicted the clinical outcome for 15 out of the 17 participants. Classification of the therapeutic interactions achieved an accuracy of 63%. (4) Conclusion: To our knowledge, this is the first attempt to predict the outcome of psychotherapy patients based on the content of their interactions with their therapist. These results are important as they open the door to personalization of psychotherapy based on quantitative information about the interactions taking place during AT.<\/jats:p>","DOI":"10.3390\/jpm13121660","type":"journal-article","created":{"date-parts":[[2023,11,28]],"date-time":"2023-11-28T06:45:35Z","timestamp":1701153935000},"page":"1660","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Enhancing Predictive Power: Integrating a Linear Support Vector Classifier with Logistic Regression for Patient Outcome Prognosis in Virtual Reality Therapy for Treatment-Resistant Schizophrenia"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4868-0928","authenticated-orcid":false,"given":"Alexandre","family":"Hudon","sequence":"first","affiliation":[{"name":"Centre de Recherche de l\u2019Institut Universitaire en Sant\u00e9 Mentale de Montr\u00e9al, Montreal, QC H1N 3V2, Canada"},{"name":"Department of Psychiatry and Addictology, Faculty of Medicine, Universit\u00e9 de Montr\u00e9al, Montreal, QC H3T 1J4, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0169-8055","authenticated-orcid":false,"given":"M\u00e9lissa","family":"Beaudoin","sequence":"additional","affiliation":[{"name":"Centre de Recherche de l\u2019Institut Universitaire en Sant\u00e9 Mentale de Montr\u00e9al, Montreal, QC H1N 3V2, Canada"},{"name":"Department of Psychiatry and Addictology, Faculty of Medicine, Universit\u00e9 de Montr\u00e9al, Montreal, QC H3T 1J4, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3113-9104","authenticated-orcid":false,"given":"Kingsada","family":"Phraxayavong","sequence":"additional","affiliation":[{"name":"Services et Recherches Psychiatriques AD, Montreal, QC H1N 3V2, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1624-378X","authenticated-orcid":false,"given":"St\u00e9phane","family":"Potvin","sequence":"additional","affiliation":[{"name":"Centre de Recherche de l\u2019Institut Universitaire en Sant\u00e9 Mentale de Montr\u00e9al, Montreal, QC H1N 3V2, Canada"},{"name":"Department of Psychiatry and Addictology, Faculty of Medicine, Universit\u00e9 de Montr\u00e9al, Montreal, QC H3T 1J4, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4480-0064","authenticated-orcid":false,"given":"Alexandre","family":"Dumais","sequence":"additional","affiliation":[{"name":"Centre de Recherche de l\u2019Institut Universitaire en Sant\u00e9 Mentale de Montr\u00e9al, Montreal, QC H1N 3V2, Canada"},{"name":"Department of Psychiatry and Addictology, Faculty of Medicine, Universit\u00e9 de Montr\u00e9al, Montreal, QC H3T 1J4, Canada"},{"name":"Services et Recherches Psychiatriques AD, Montreal, QC H1N 3V2, Canada"},{"name":"Institut National de Psychiatrie L\u00e9gale Philippe-Pinel, Montreal, QC H1C 1H1, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"101675","DOI":"10.1016\/j.eclinm.2022.101675","article-title":"Quantifying the global burden of mental disorders and their economic value","volume":"54","author":"Arias","year":"2022","journal-title":"EClinicalMedicine"},{"key":"ref_2","first-page":"1","article-title":"Epidemiology and risk factors of schizophrenia","volume":"37","author":"Zeman","year":"2016","journal-title":"Neuroendocrinol. Lett."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2063","DOI":"10.1016\/S0140-6736(04)16458-1","article-title":"Schizophrenia","volume":"363","author":"Mueser","year":"2004","journal-title":"Lancet"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"95","DOI":"10.4103\/0019-5545.94660","article-title":"Paul Eugen Bleuler and the origin of the term schizophrenia (SCHIZOPRENIEGRUPPE)","volume":"54","author":"Ashok","year":"2012","journal-title":"Indian J. Psychiatry"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Orsolini, L., Pompili, S., and Volpe, U. (2022). Schizophrenia: A Narrative Review of Etiopathogenetic, Diagnostic and Treatment Aspects. J. Clin. Med., 11.","DOI":"10.3390\/jcm11175040"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"St\u0119pnicki, P., Kondej, M., and Kaczor, A.A. (2018). Current Concepts and Treatments of Schizophrenia. Molecules, 23.","DOI":"10.3390\/molecules23082087"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1016\/S2215-0366(20)30007-9","article-title":"Thinking, believing, and hallucinating self in schizophrenia","volume":"7","author":"Humpston","year":"2020","journal-title":"Lancet Psychiatry"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1016\/j.schres.2016.06.010","article-title":"Prevalence and classification of hallucinations in multiple sensory modalities in schizophrenia spectrum disorders","volume":"176","author":"Lim","year":"2016","journal-title":"Schizophr. Res."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1093\/schbul\/sbaa101","article-title":"A Review of Multimodal Hallucinations: Categorization, Assessment, Theoretical Perspectives, and Clinical Recommendations","volume":"47","author":"Montagnese","year":"2021","journal-title":"Schizophr. Bull."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1097\/YCO.0b013e32835035ca","article-title":"Life expectancy and cardiovascular mortality in persons with schizophrenia","volume":"25","author":"Laursen","year":"2012","journal-title":"Curr. Opin. Psychiatry"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1","DOI":"10.5498\/wjp.v12.i1.1","article-title":"Prevalence and correlates of aggressive behavior in psychiatric inpatient populations","volume":"12","author":"Girasek","year":"2022","journal-title":"World J. Psychiatry"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"475","DOI":"10.9758\/cpn.2019.17.4.475","article-title":"Biological Aspects of Aggression and Violence in Schizophrenia","volume":"17","author":"Cho","year":"2019","journal-title":"Clin. Psychopharmacol. Neurosci."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1176\/ajp.154.6.840","article-title":"Specific major mental disorders and criminality: A 26-year prospective study of the 1966 northern Finland birth cohort","volume":"154","author":"Tiihonen","year":"1997","journal-title":"Am. J. Psychiatry"},{"key":"ref_14","first-page":"333","article-title":"Substance Use Disorders and Schizophrenia","volume":"14","author":"Manseau","year":"2016","journal-title":"Focus (Am. Psychiatr. Publ.)"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1097\/NMD.0000000000001604","article-title":"Association Between Cannabis and Violence in Community-Dwelling Patients with Severe Mental Disorders: A Cross-sectional Study Using Machine Learning","volume":"211","author":"Hudon","year":"2023","journal-title":"J. Nerv. Ment. Dis."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2016","DOI":"10.1001\/jama.2009.675","article-title":"Schizophrenia, substance abuse, and violent crime","volume":"301","author":"Fazel","year":"2009","journal-title":"JAMA"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"990","DOI":"10.1176\/appi.ajp.2017.16091097","article-title":"Mortality and Self-Harm in Association with Clozapine in Treatment-Resistant Schizophrenia","volume":"174","author":"Wimberley","year":"2017","journal-title":"Am. J. Psychiatry"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"129","DOI":"10.2165\/11586450-000000000-00000","article-title":"Managing suicide risk in patients with schizophrenia","volume":"25","author":"Kasckow","year":"2011","journal-title":"CNS Drugs"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1006","DOI":"10.1016\/j.comppsych.2012.03.003","article-title":"Effects of antipsychotic medications on quality of life and psychosocial functioning in patients with early-stage schizophrenia: 1-year follow-up naturalistic study","volume":"53","author":"Guo","year":"2012","journal-title":"Compr. Psychiatry"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1080\/13651501.2021.1879157","article-title":"Treatment strategies in management of schizophrenia patients with persistent symptoms in daily practice: A retrospective study","volume":"25","author":"Kokurcan","year":"2021","journal-title":"Int. J. Psychiatry Clin. Pract."},{"key":"ref_21","unstructured":"National Collaborating Centre for Mental Health (UK) (2014). Psychosis and Schizophrenia in Adults: Treatment and Management, National Institute for Health and Care Excellence."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1038\/s41398-017-0071-9","article-title":"Dopamine, psychosis and schizophrenia: The widening gap between basic and clinical neuroscience","volume":"8","author":"Kesby","year":"2018","journal-title":"Transl. Psychiatry"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Novak, G., and Seeman, M.V. (2022). Dopamine, Psychosis, and Symptom Fluctuation: A Narrative Review. Healthcare, 10.","DOI":"10.3390\/healthcare10091713"},{"key":"ref_24","first-page":"638","article-title":"Schizophrenia: Overview and treatment options","volume":"39","author":"Patel","year":"2014","journal-title":"Pharm. Ther."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1097\/YCO.0000000000000871","article-title":"The ever-growing case for clozapine in the treatment of schizophrenia: An obligation for psychiatrists and psychiatry","volume":"36","author":"Bittner","year":"2023","journal-title":"Curr. Opin. Psychiatry"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"429","DOI":"10.5498\/wjp.v11.i8.429","article-title":"Clozapine resistant schizophrenia: Newer avenues of management","volume":"11","author":"Chakrabarti","year":"2021","journal-title":"World J. Psychiatry"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1007\/s00406-019-01053-6","article-title":"Clozapine response trajectories and predictors of non-response in treatment-resistant schizophrenia: A chart review study","volume":"270","author":"Shah","year":"2020","journal-title":"Eur. Arch Psychiatry Clin. Neurosci."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1097\/01.NAJ.0000854488.48801.59","article-title":"CE: Original Research: Cognitive Behavioral Therapy for Symptom Management in Treatment-Resistant Schizophrenia","volume":"122","author":"Ryan","year":"2022","journal-title":"Am. J. Nurs."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1016\/S2215-0366(18)30184-6","article-title":"Cognitive behavioural therapy in clozapine-resistant schizophrenia (FOCUS): An assessor-blinded, randomised controlled trial","volume":"5","author":"Morrison","year":"2018","journal-title":"Lancet Psychiatry"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1080\/17522439.2013.773457","article-title":"Avatar therapy for persecutory auditory hallucinations: What is it and how does it work?","volume":"6","author":"Leff","year":"2014","journal-title":"Psychosis"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/S2215-0366(17)30427-3","article-title":"AVATAR therapy for auditory verbal hallucinations in people with psychosis: A single-blind, randomised controlled trial","volume":"5","author":"Craig","year":"2018","journal-title":"Lancet Psychiatry"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1038\/s41537-021-00139-2","article-title":"One-year randomized trial comparing virtual reality-assisted therapy to cognitive-behavioral therapy for patients with treatment-resistant schizophrenia","volume":"7","author":"Dellazizzo","year":"2021","journal-title":"NPJ Schizophr."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Beaudoin, M., Potvin, S., Phraxayavong, K., and Dumais, A. (2023). Changes in Quality of Life in Treatment-Resistant Schizophrenia Patients Undergoing Avatar Therapy: A Content Analysis. J. Pers. Med., 13.","DOI":"10.3390\/jpm13030522"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"878","DOI":"10.1002\/cpp.2322","article-title":"Exploration of the dialogue components in Avatar Therapy for schizophrenia patients with refractory auditory hallucinations: A content analysis","volume":"25","author":"Dellazizzo","year":"2018","journal-title":"Clin. Psychol. Psychother."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1002\/cpp.2556","article-title":"The therapeutic processes of avatar therapy: A content analysis of the dialogue between treatment-resistant patients with schizophrenia and their avatar","volume":"28","author":"Beaudoin","year":"2021","journal-title":"Clin. Psychol. Psychother."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.3390\/make5030057","article-title":"Comparing the Performance of Machine Learning Algorithms in the Automatic Classification of Psychotherapeutic Interactions in Avatar Therapy","volume":"5","author":"Hudon","year":"2023","journal-title":"Mach. Learn. Knowl. Extr."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"14604582221142442","DOI":"10.1177\/14604582221142442","article-title":"Implementation of a machine learning algorithm for automated thematic annotations in avatar: A linear support vector classifier approach","volume":"28","author":"Hudon","year":"2022","journal-title":"Health Inform. J."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1038\/s41591-021-01614-0","article-title":"AI in health and medicine","volume":"28","author":"Rajpurkar","year":"2022","journal-title":"Nat. Med."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Al Kuwaiti, A., Nazer, K., Al-Reedy, A., Al-Shehri, S., Al-Muhanna, A., Subbarayalu, A.V., Al Muhanna, D., and Al-Muhanna, F.A. (2023). A Review of the Role of Artificial Intelligence in Healthcare. J. Pers. Med., 13.","DOI":"10.3390\/jpm13060951"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Kitsios, F., Kamariotou, M., Syngelakis, A.I., and Talias, M.A. (2023). Recent Advances of Artificial Intelligence in Healthcare: A Systematic Literature Review. Appl. Sci., 13.","DOI":"10.3390\/app13137479"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1007\/978-981-32-9721-0_6","article-title":"Artificial Intelligence in Psychiatry","volume":"1192","author":"Fakhoury","year":"2019","journal-title":"Adv. Exp. Med. Biol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1240","DOI":"10.1038\/s41591-022-01811-5","article-title":"Machine learning model to predict mental health crises from electronic health records","volume":"28","author":"Garriga","year":"2022","journal-title":"Nat. Med."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"2742","DOI":"10.1017\/S0033291721003871","article-title":"Machine learning in the prediction of depression treatment outcomes: A systematic review and meta-analysis","volume":"51","author":"Sajjadian","year":"2021","journal-title":"Psychol Med."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"100602","DOI":"10.1016\/j.patter.2022.100602","article-title":"Modern views of machine learning for precision psychiatry","volume":"3","author":"Chen","year":"2022","journal-title":"Patterns"},{"key":"ref_45","unstructured":"(2016). QDA Miner, Version 5, Provalis Research."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1007\/978-1-60327-241-4_13","article-title":"A user\u2019s guide to support vector machines","volume":"609","author":"Weston","year":"2010","journal-title":"Methods Mol. Biol."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Busagala, L.S.P., Ohyama, W., Wakabayashi, T., and Kimura, F. (2012, January 27\u201329). Multiple feature-classifier combination in automated text classification. Proceedings of the 2012 10th IAPR International Workshop on Document Analysis Systems (DAS), Gold Cost, QLD, Australia.","DOI":"10.1109\/DAS.2012.56"},{"key":"ref_48","first-page":"2825","article-title":"Scikit-learn: Machine learning in Python","volume":"12","author":"Pedregosa","year":"2011","journal-title":"J. Mach. Learn. Res."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1177\/1932296819838856","article-title":"Simple Linear Support Vector Machine Classifier Can Distinguish Impaired Glucose Tolerance Versus Type 2 Diabetes Using a Reduced Set of CGM-Based Glycemic Variability Indices","volume":"14","author":"Longato","year":"2020","journal-title":"J. Diabetes Sci. Technol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1109\/72.914517","article-title":"An introduction to kernel-based learning algorithms","volume":"12","author":"Mika","year":"2001","journal-title":"IEEE Trans. Neural Netw."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"S265","DOI":"10.1093\/schbul\/sbu014","article-title":"Symptom dimensions of the psychotic symptom rating scales in psychosis: A multisite study","volume":"40","author":"Woodward","year":"2014","journal-title":"Schizophr. Bull."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Wei, Q., and Dunbrack, R.L. (2013). The role of balanced training and testing data sets for binary classifiers in bioinformatics. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0067863"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"5979","DOI":"10.1038\/s41598-022-09954-8","article-title":"On evaluation metrics for medical applications of artificial intelligence","volume":"12","author":"Hicks","year":"2022","journal-title":"Sci. Rep."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"2582","DOI":"10.1080\/02664763.2020.1754360","article-title":"Reconceptualizing the p-value from a likelihood ratio test: A probabilistic pairwise comparison of models based on Kullback-Leibler discrepancy measures","volume":"47","author":"Riedle","year":"2020","journal-title":"J. Appl. Stat."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"94","DOI":"10.7861\/futurehosp.6-2-94","article-title":"The potential for artificial intelligence in healthcare","volume":"6","author":"Davenport","year":"2019","journal-title":"Future Healthc. J."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1109\/RBME.2020.3007816","article-title":"Machine Learning for Clinical Outcome Prediction","volume":"14","author":"Shamout","year":"2021","journal-title":"IEEE Rev. Biomed. Eng."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1080\/10503307.2015.1125546","article-title":"Predicting psychotherapy outcome based on therapist interpersonal skills: A five-year longitudinal study of a therapist assessment protocol","volume":"27","author":"Goldberg","year":"2017","journal-title":"Psychother. Res."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"e11821","DOI":"10.1016\/j.heliyon.2022.e11821","article-title":"Therapists and psychotherapy side effects in China: A machine learning-based study","volume":"8","author":"Yao","year":"2022","journal-title":"Heliyon"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"102193","DOI":"10.1016\/j.cpr.2022.102193","article-title":"Can we predict who will benefit from cognitive-behavioural therapy? A systematic review and meta-analysis of machine learning studies","volume":"97","author":"Vieira","year":"2022","journal-title":"Clin. Psychol. Rev."}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/13\/12\/1660\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:32:12Z","timestamp":1760131932000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/13\/12\/1660"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,28]]},"references-count":59,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["jpm13121660"],"URL":"https:\/\/doi.org\/10.3390\/jpm13121660","relation":{},"ISSN":["2075-4426"],"issn-type":[{"value":"2075-4426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,28]]}}}