{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T21:45:24Z","timestamp":1792532724872,"version":"4.5.0"},"reference-count":62,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2024,12,12]],"date-time":"2024-12-12T00:00:00Z","timestamp":1733961600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurology International"],"abstract":"<jats:p>The purpose of this review is to compile and discuss available evidence in humans on the efficacy of YHM supplementation on performance in different exercise modalities. Yohimbine (YHM) is a naturally occurring alkaloid that induces increases in sympathetic nervous system (SNS) activation effectively initiating \u201cfight or flight\u201d responses. In supplement form, YHM is commonly sold as an isolated product or combined into multi-ingredient exercise supplements and is widely consumed in fitness settings despite the lack of empirical support until recently. YHM primarily acts as an \u03b12-adrenergic receptor antagonist effectively increasing norepinephrine release from sympathetic neurons. YHM has been implicated in improving or altering cardiovascular function, blood flow, lactate metabolism, and muscle function. Emerging evidence has suggested that YHM may have the potential to improve performance in a wide range of exercise modes including endurance, sprint, and resistance exercise. Performance enhancement with YHM is mediated by mechanistic underpinnings of physiological and psychological alterations to exercise responses including increased sympathetic activation, adaptive hemodynamic changes, increased alertness, and decreased fatigue. However, YHM use is not without risk as it has high interindividual variability in bioavailability, can be deceptively potent, lacks widely accepted dosing recommendations, and, when taken in large doses, has been empirically documented to result in serious side effects. Despite this, the evidence presented in this review suggests low doses of YHM are tolerable and may serve as an ideal exercise training aid due to acute enhancement of physical performance. However, safety concerns remain outstanding and temperance should be used when using YHM and similar sympathomimetics.<\/jats:p>","DOI":"10.3390\/neurolint16060131","type":"journal-article","created":{"date-parts":[[2024,12,12]],"date-time":"2024-12-12T04:52:49Z","timestamp":1733979169000},"page":"1837-1848","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Ergogenic and Sympathomimetic Effects of Yohimbine: A Review"],"prefix":"10.3390","volume":"16","author":[{"given":"Sophia L.","family":"Porrill","sequence":"first","affiliation":[{"name":"Department of Human Studies, University of Alabama at Birmingham, Birmingham, AL 35294, USA"},{"name":"SHP Research Collaborative, University of Alabama at Birmingham, Birmingham, AL 35294, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2484-9311","authenticated-orcid":false,"given":"Rebecca R.","family":"Rogers","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7839-8894","authenticated-orcid":false,"given":"Christopher G.","family":"Ballmann","sequence":"additional","affiliation":[{"name":"Department of Human Studies, University of Alabama at Birmingham, Birmingham, AL 35294, USA"},{"name":"SHP Research Collaborative, University of Alabama at Birmingham, Birmingham, AL 35294, USA"},{"name":"Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL 35294, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1016\/S0163-7258(01)00156-5","article-title":"Yohimbine: A clinical review","volume":"91","author":"Tam","year":"2001","journal-title":"Pharmacol. Ther."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1016\/S0022-5347(01)64032-1","article-title":"Therapeutic effects of high dose yohimbine hydrochloride on organic erectile dysfunction","volume":"159","author":"Teloken","year":"1998","journal-title":"J. Urol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1080\/15438620600987106","article-title":"Yohimbine: The effects on body composition and exercise performance in soccer players","volume":"14","author":"Ostojic","year":"2006","journal-title":"Res. Sports Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"S70","DOI":"10.1038\/sj.ijir.3900508","article-title":"Yohimbine in erectile dysfunction: The facts","volume":"12","author":"Morales","year":"2000","journal-title":"Int. J. Impot. Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"67","DOI":"10.26444\/jpccr\/91404","article-title":"Yohimbine improves lipid and carbohydrate profiles without reduction in body weight in obese leptin-deficient ob\/ob mice","volume":"12","author":"Kotanska","year":"2018","journal-title":"J. Pre-Clin. Clin. Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1002\/dta.1849","article-title":"Pharmaceutical quantities of yohimbine found in dietary supplements in the USA","volume":"8","author":"Cohen","year":"2016","journal-title":"Drug Test. Anal."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1097\/00006842-200007000-00014","article-title":"Effects of yohimbine on cerebral blood flow, symptoms, and physiological functions in humans","volume":"62","author":"Cameron","year":"2000","journal-title":"Psychosom. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"82","DOI":"10.3390\/muscles1020009","article-title":"Effects of Acute Yohimbine Hydrochloride Ingestion on Bench Press Performance in Resistance-Trained Males","volume":"1","author":"Williams","year":"2022","journal-title":"Muscles"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"772","DOI":"10.1161\/01.HYP.5.5.772","article-title":"Influence of yohimbine on blood pressure, autonomic reflexes, and plasma catecholamines in humans","volume":"5","author":"Goldberg","year":"1983","journal-title":"Hypertension"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1210\/jcem-73-4-861","article-title":"Effects of yohimbine on human sympathetic nervous system function","volume":"73","author":"Murburg","year":"1991","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"R142","DOI":"10.1152\/ajpregu.1991.260.1.R142","article-title":"Yohimbine increases sympathetic nerve activity and norepinephrine spillover in normal volunteers","volume":"260","author":"Grossman","year":"1991","journal-title":"Am. J. Physiol. Regul. Integr. Comp. Physiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1054\/mehy.2001.1459","article-title":"Pre-exercise administration of yohimbine may enhance the efficacy of exercise training as a fat loss strategy by boosting lipolysis","volume":"58","author":"McCarty","year":"2002","journal-title":"Med. Hypotheses"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1093\/jat\/bkt057","article-title":"Case study: Two fatal case reports of acute yohimbine intoxication","volume":"37","author":"Anderson","year":"2013","journal-title":"J. Anal. Toxicol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"23","DOI":"10.3390\/nutraceuticals4010002","article-title":"Yohimbine Ingestion Mitigates Morning-Associated Decrements in High-Intensity Exercise Performance","volume":"4","author":"Ballmann","year":"2024","journal-title":"Nutraceuticals"},{"key":"ref_15","first-page":"1850","article-title":"Ergogenic Effects of Yohimbine: Standardized Cycling Clinical Study","volume":"7","year":"2014","journal-title":"Kerbala J. Med."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Barnes, M.E., Cowan, C.R., Boag, L.E., Hill, J.G., Jones, M.L., Nixon, K.M., Parker, M.G., Parker, S.K., Raymond, M.V., and Sternenberg, L.H. (2022). Effects of Acute Yohimbine Hydrochloride Supplementation on Repeated Supramaximal Sprint Performance. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19031316"},{"key":"ref_17","first-page":"1","article-title":"The Effects of Acute Rauwolscine (\u03b1-Yohimbine) Ingestion on Repeated Wingate Sprint Performance in Healthy Males","volume":"4","author":"Barnes","year":"2023","journal-title":"Top. Exerc. Sci. Kinesiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"783058","DOI":"10.1155\/2013\/783058","article-title":"Mechanism of selective inhibition of yohimbine and its derivatives in adrenoceptor \u03b12 subtypes","volume":"2013","author":"Yong","year":"2013","journal-title":"J. Chem."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"31","DOI":"10.2344\/0003-3006-62.1.31","article-title":"Alpha-2 adrenergic receptor agonists: A review of current clinical applications","volume":"62","author":"Giovannitti","year":"2015","journal-title":"Anesth. Prog."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1207","DOI":"10.1248\/bpb.18.1207","article-title":"Effects of yohimbine and desipramine on adrenal catecholamine release in response to splanchnic nerve stimulation in anesthetized dogs","volume":"18","author":"Koganei","year":"1995","journal-title":"Biol. Pharm. Bull."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1046\/j.1365-2281.1998.00075.x","article-title":"Cardiovascular effects of ephedrine, caffeine and yohimbine measured by thoracic electrical bioimpedance in obese women","volume":"18","author":"Waluga","year":"1998","journal-title":"Clin. Physiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1007\/BF02455991","article-title":"The pharmacokinetics of yohimbine in man","volume":"32","author":"Owen","year":"1987","journal-title":"Eur. J. Clin. Pharmacol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1038\/ijir.2009.41","article-title":"Yohimbine relaxes the human corpus cavernosum through a non-adrenergic mechanism involving the activation of K+ ATP-dependent channels","volume":"21","author":"Freitas","year":"2009","journal-title":"Int. J. Impot. Res."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"761","DOI":"10.2165\/00007256-200232120-00002","article-title":"Factors affecting the rate of phosphocreatine resynthesis following intense exercise","volume":"32","author":"McMahon","year":"2002","journal-title":"Sports Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2849","DOI":"10.1080\/07853890.2022.2131330","article-title":"A literature perspective on the pharmacological applications of yohimbine","volume":"54","author":"Jabir","year":"2022","journal-title":"Ann. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1111\/j.1365-2362.1988.tb01272.x","article-title":"\u03b12-Antagonist compounds and lipid mobilization: Evidence for a lipid mobilizing effect of oral yohimbine in healthy male volunteers","volume":"18","author":"Galitzky","year":"1988","journal-title":"Eur. J. Clin. Investig."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1783","DOI":"10.1007\/s00213-018-5160-9","article-title":"The impact of Yohimbine-induced arousal on facets of behavioural impulsivity","volume":"236","author":"Herman","year":"2019","journal-title":"Psychopharmacology"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.1016\/0024-3205(87)90625-4","article-title":"Learning enhancement and behavioral arousal induced by yohimbine","volume":"41","author":"Huang","year":"1987","journal-title":"Life Sci."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1007\/s00213-013-3088-7","article-title":"Norepinephrine and impulsivity: Effects of acute yohimbine","volume":"229","author":"Swann","year":"2013","journal-title":"Psychopharmacology"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/S0928-0987(99)00046-9","article-title":"Biopharmaceutics and metabolism of yohimbine in humans","volume":"9","author":"Dollo","year":"1999","journal-title":"Eur. J. Pharm. Sci."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1002\/(SICI)1098-2396(200002)35:2<79::AID-SYN1>3.0.CO;2-X","article-title":"Agonist and antagonist actions of yohimbine as compared to fluparoxan at \u03b12-adrenergic receptors (AR) s, serotonin (5-HT) 1A, 5-HT1B, 5-HT1D and dopamine D2 and D3 receptors. Significance for the modulation of frontocortical monoaminergic transmission and depressive states","volume":"35","author":"Millan","year":"2000","journal-title":"Synapse"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1007\/BF02284967","article-title":"Yohimbine pharmacokinetics and interaction with the sympathetic nervous system in normal volunteers","volume":"43","author":"Hedner","year":"1992","journal-title":"Eur. J. Clin. Pharmacol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1550-2783-6-1","article-title":"Examination of a pre-exercise, high energy supplement on exercise performance","volume":"6","author":"Hoffman","year":"2009","journal-title":"J. Int. Soc. Sports Nutr."},{"key":"ref_34","first-page":"200","article-title":"Thermogenic effect of a high energy, pre-exercise supplement","volume":"40","author":"Hoffman","year":"2008","journal-title":"Kinesiology"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Lutsch, D.J., Camic, C.L., Jagim, A.R., Stefan, R.R., Cox, B.J., Tauber, R.N., and Henert, S.E. (2020). Effects of a multi-ingredient preworkout supplement versus caffeine on energy expenditure and feelings of fatigue during low-intensity treadmill exercise in college-aged males. Sports, 8.","DOI":"10.3390\/sports8100132"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1152\/japplphysiol.00586.2006","article-title":"Anticipatory responses of catecholamines on muscle force production","volume":"102","author":"French","year":"2007","journal-title":"J. Appl. Physiol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1161\/HYPERTENSIONAHA.107.095984","article-title":"Yohimbine attenuates baroreflex-mediated bradycardia in humans","volume":"50","author":"Tank","year":"2007","journal-title":"Hypertension"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"H371","DOI":"10.1152\/ajpheart.1994.266.2.H371","article-title":"Effect of systemic yohimbine on the control of skin blood flow during local heating and dynamic exercise","volume":"266","author":"Kenney","year":"1994","journal-title":"Am. J. Physiol.-Heart Circ. Physiol."},{"key":"ref_39","first-page":"103","article-title":"Divergent effects of an \u03b12-adrenergic antagonist on lipolysis and thermogenesis: Interactions with a \u03b23-adrenergic agonist in rats","volume":"8","author":"Fruhbeck","year":"2001","journal-title":"Int. J. Mol. Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"219S","DOI":"10.1093\/ajcn\/55.1.219s","article-title":"Alpha-2 adrenoceptors in lipolysis: \u03b12 antagonists and lipid-mobilizing strategies","volume":"55","author":"Lafontan","year":"1992","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"141","DOI":"10.3177\/jnsv.62.141","article-title":"Nutrition supplements to stimulate lipolysis: A review in relation to endurance exercise capacity","volume":"62","author":"Kim","year":"2016","journal-title":"J. Nutr. Sci. Vitaminol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1007\/s00421-003-0988-y","article-title":"Estimation of \n\t\t  V.O2max from the ratio between HRmax and HRrest\u2013the Heart Rate Ratio Method","volume":"91","author":"Uth","year":"2004","journal-title":"Eur. J. Appl. Physiol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1177\/1087054707308484","article-title":"Exercise responses in boys with attention deficit\/hyperactivity disorder: Effects of stimulant medication","volume":"12","author":"Mahon","year":"2008","journal-title":"J. Atten. Disord."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1175","DOI":"10.1080\/00140138208925074","article-title":"Metabolic and cardiovascular responses to exercise with caffeine","volume":"25","author":"Toner","year":"1982","journal-title":"Ergonomics"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1007\/s004210050355","article-title":"Effects of caffeine, ephedrine and their combination on time to exhaustion during high-intensity exercise","volume":"77","author":"Bell","year":"1998","journal-title":"Eur. J. Appl. Physiol. Occup. Physiol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1081\/CBI-200041039","article-title":"Circadian rhythms in sports performance\u2014An update","volume":"22","author":"Drust","year":"2005","journal-title":"Chronobiol. Int."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1080\/02701367.2020.1751032","article-title":"Effects of time-of-day training preference on resistance-exercise performance","volume":"92","author":"Blazer","year":"2021","journal-title":"Res. Q. Exerc. Sport"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Dumar, A.M., Huntington, A.F., Rogers, R.R., Kopec, T.J., Williams, T.D., and Ballmann, C.G. (2021). Acute beetroot juice supplementation attenuates morning-associated decrements in supramaximal exercise performance in trained sprinters. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18020412"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"5561","DOI":"10.1113\/jphysiol.2008.160770","article-title":"Sympathetic-induced changes in discharge rate and spike-triggered average twitch torque of low-threshold motor units in humans","volume":"586","author":"Roatta","year":"2008","journal-title":"J. Physiol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1097\/JES.0b013e3181c5cde7","article-title":"Sympathetic actions on the skeletal muscle","volume":"38","author":"Roatta","year":"2010","journal-title":"Exerc. Sport Sci. Rev."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1152\/japplphysiol.01200.2007","article-title":"The cross-bridge cycle and skeletal muscle fatigue","volume":"104","author":"Fitts","year":"2008","journal-title":"J. Appl. Physiol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1016\/j.biopsych.2009.11.030","article-title":"Yohimbine increases impulsivity through activation of cAMP response element binding in the orbitofrontal cortex","volume":"67","author":"Sun","year":"2010","journal-title":"Biol. Psychiatry"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1161\/01.HYP.15.6.877","article-title":"Effect of the alpha 2-adrenergic antagonist yohimbine on orthostatic tolerance","volume":"15","author":"Farrow","year":"1990","journal-title":"Hypertension"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1016\/S0022-5347(01)63942-9","article-title":"Yohimbine for erectile dysfunction: A systematic review and meta-analysis of randomized clinical trials","volume":"159","author":"Ernst","year":"1998","journal-title":"J. Urol."},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"EFSA Panel on Food Additives and Nutrient Sources Added to Food (ANS) (2013). Scientific Opinion on the evaluation of the safety in use of Yohimbe (Pausinystalia yohimbe (K. Schum.) Pierre ex Beille). EFSA J., 11, 3302.","DOI":"10.2903\/j.efsa.2013.3302"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1022","DOI":"10.1345\/aph.1P060","article-title":"Adverse drug events associated with yohimbine-containing products: A retrospective review of the California Poison Control System reported cases","volume":"44","author":"Kearney","year":"2010","journal-title":"Ann. Pharmacother."},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Cimolai, N. (2017). An overview of yohimbine in sports medicine. Sustained Energy for Enhanced Human Functions and Activity, Academic Press.","DOI":"10.1016\/B978-0-12-805413-0.00015-6"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"110705","DOI":"10.1016\/j.forsciint.2021.110705","article-title":"Severe acute intoxication with yohimbine: Four simultaneous poisoning cases","volume":"320","author":"Zhu","year":"2021","journal-title":"Forensic Sci. Int."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1080\/15563650903081601","article-title":"Acute neurotoxicity after yohimbine ingestion by a body builder","volume":"47","author":"Giampreti","year":"2009","journal-title":"Clin. Toxicol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"e1857","DOI":"10.1093\/milmed\/usaa043","article-title":"Chest pain from supplement use in an active duty soldier: A case report","volume":"185","author":"Bridwell","year":"2020","journal-title":"Mil. Med."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1007\/s11419-019-00512-y","article-title":"A fatal case report of acute yohimbine intoxication","volume":"38","author":"Drevin","year":"2020","journal-title":"Forensic Toxicol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1038\/sj.ijir.3900271","article-title":"Double-blind, placebo-controlled safety and efficacy trial with yohimbine hydrochloride in the treatment of nonorganic erectile dysfunction","volume":"9","author":"Vogt","year":"1997","journal-title":"Int. J. Impot. Res."}],"container-title":["Neurology International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2035-8377\/16\/6\/131\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:53:13Z","timestamp":1760115193000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2035-8377\/16\/6\/131"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,12]]},"references-count":62,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["neurolint16060131"],"URL":"https:\/\/doi.org\/10.3390\/neurolint16060131","relation":{},"ISSN":["2035-8377"],"issn-type":[{"value":"2035-8377","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,12]]}}}