{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T04:33:47Z","timestamp":1791261227753,"version":"4.1.0"},"reference-count":59,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2024,10,28]],"date-time":"2024-10-28T00:00:00Z","timestamp":1730073600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: Numerous meta-analyses have assessed the efficacy of creatine supplementation in increasing muscle strength. However, most have not considered the effect of the participants\u2019 age, training duration, or other confounding variables on strength outcomes. Therefore, the purpose of this study was to consider the effect of these variables on the potential efficacy of creatine supplementation and resistance training for improving measures of muscle strength. Methods: Four databases were searched (MEDLINE, Scopus, Embase, and SPORTDiscus) with a search end date of 22 May 2024. Twenty-three studies were included, with 20 studies involving males (447 male participants), 2 studies involving females (40 female participants), and 1 study involving both males and females (13 male participants and 9 female participants). Results: In comparison with a placebo, creatine supplementation combined with resistance training significantly increased upper-body (WMD = 4.43 kg, p &lt; 0.001) and lower-body strength (WMD = 11.35 kg, p &lt; 0.001). Subgroup analyses showed a trend for greater upper-body strength improvements for males on creatine compared with females on creatine (p = 0.067, Q = 3.366). Additionally, males who consumed creatine combined with resistance training significantly increased both upper- and lower-body strength, whereas females showed no significant gains. There was a trend indicating greater lower-body strength gains from high-dose creatine compared with lower doses (p = 0.068, Q = 3.341). No other variables influenced the effect of creatine supplementation. In conclusions, creatine supplementation with resistance training enhances upper- and lower-body muscle strength in adults aged &lt; 50, with greater benefits likely to be seen in males than females.<\/jats:p>","DOI":"10.3390\/nu16213665","type":"journal-article","created":{"date-parts":[[2024,10,28]],"date-time":"2024-10-28T08:39:07Z","timestamp":1730104747000},"page":"3665","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Effects of Creatine Supplementation and Resistance Training on Muscle Strength Gains in Adults &lt;50 Years of Age: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8015-2279","authenticated-orcid":false,"given":"Ziyu","family":"Wang","sequence":"first","affiliation":[{"name":"China Swimming College, Beijing Sport University, Beijing 100084, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4028-0863","authenticated-orcid":false,"given":"Bopeng","family":"Qiu","sequence":"additional","affiliation":[{"name":"School of Strength and Conditioning Training, Beijing Sport University, Beijing 100084, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruoling","family":"Li","sequence":"additional","affiliation":[{"name":"China Swimming College, Beijing Sport University, Beijing 100084, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunzhi","family":"Han","sequence":"additional","affiliation":[{"name":"School of International Chinese Language Education, Beijing Normal University, Beijing 100875, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3872-914X","authenticated-orcid":false,"given":"Carl","family":"Petersen","sequence":"additional","affiliation":[{"name":"Faculty of Health, University of Canterbury, Christchurch 8041, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuting","family":"Liu","sequence":"additional","affiliation":[{"name":"School of Strength and Conditioning Training, Beijing Sport University, Beijing 100084, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-3778-6282","authenticated-orcid":false,"given":"Yinkai","family":"Zhang","sequence":"additional","affiliation":[{"name":"China Wushu School, Beijing Sport University, Beijing 100084, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7867-6807","authenticated-orcid":false,"given":"Chang","family":"Liu","sequence":"additional","affiliation":[{"name":"School of Sport Science, Beijing Sport University, Beijing 100084, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darren G.","family":"Candow","sequence":"additional","affiliation":[{"name":"Faculty of Kinesiology and Health Studies, University of Regina, Regina, SK S4S 0A2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5785-984X","authenticated-orcid":false,"given":"Juan","family":"Del Coso","sequence":"additional","affiliation":[{"name":"Sport Sciences Research Centre, Rey Juan Carlos University, 28943 Fuenlabrada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1177\/0363546509344071","article-title":"The use of drugs and nutritional supplements in top-level track and field athletes","volume":"38","author":"Tscholl","year":"2010","journal-title":"Am. J. Sports Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1186\/s41110-023-00193-z","article-title":"Prevalence of dietary supplement consumption among CrossFit practitioners","volume":"48","author":"Marques","year":"2023","journal-title":"Nutrire"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1186\/s12970-017-0173-z","article-title":"International Society of Sports Nutrition position stand: Safety and efficacy of creatine supplementation in exercise, sport, and medicine","volume":"14","author":"Kreider","year":"2017","journal-title":"J. Int. Soc. Sports Nutr."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Candow, D.G., Forbes, S.C., Chilibeck, P.D., Cornish, S.M., Antonio, J., and Kreider, R.B. (2019). Variables Influencing the Effectiveness of Creatine Supplementation as a Therapeutic Intervention for Sarcopenia. Front. Nutr., 6.","DOI":"10.3389\/fnut.2019.00124"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"29","DOI":"10.20463\/pan.2020.0006","article-title":"The effect of short-term creatine intake on blood lactic acid and muscle fatigue measured by accelerometer-based tremor response to acute resistance exercise","volume":"24","author":"Lee","year":"2020","journal-title":"Phys. Act. Nutr."},{"key":"ref_6","first-page":"945","article-title":"Does oral creatine supplementation improve strength? A meta-analysis","volume":"51","author":"Dempsey","year":"2002","journal-title":"J. Fam. Pract."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1152\/japplphysiol.00755.2002","article-title":"Effect of dietary supplements on lean mass and strength gains with resistance exercise: A meta-analysis","volume":"94","author":"Nissen","year":"2003","journal-title":"J. Appl. Physiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1123\/ijsnem.13.2.198","article-title":"Effect of creatine supplementation on body composition and performance: A meta-analysis","volume":"13","author":"Branch","year":"2003","journal-title":"Int. J. Sport. Nutr. Exerc. Metab."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1285","DOI":"10.1007\/s40279-015-0337-4","article-title":"Creatine Supplementation and Lower Limb Strength Performance: A Systematic Review and Meta-Analyses","volume":"45","author":"Lanhers","year":"2015","journal-title":"Sports Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1007\/s40279-016-0571-4","article-title":"Creatine Supplementation and Upper Limb Strength Performance: A Systematic Review and Meta-Analysis","volume":"47","author":"Lanhers","year":"2017","journal-title":"Sports Med."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Dos Santos, E.E.P., de Ara\u00fajo, R.C., Candow, D.G., Forbes, S.C., Guijo, J.A., de Almeida Santana, C.C., Prado, W.L.D., and Botero, J.P. (2021). Efficacy of Creatine Supplementation Combined with Resistance Training on Muscle Strength and Muscle Mass in Older Females: A Systematic Review and Meta-Analysis. Nutrients, 13.","DOI":"10.3390\/nu13113757"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"213","DOI":"10.2147\/OAJSM.S123529","article-title":"Effect of creatine supplementation during resistance training on lean tissue mass and muscular strength in older adults: A meta-analysis","volume":"8","author":"Chilibeck","year":"2017","journal-title":"Open Access J. Sports Med."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Candow, D.G., Prokopidis, K., Forbes, S.C., Rusterholz, F., Campbell, B.I., and Ostojic, S.M. (2023). Resistance Exercise and Creatine Supplementation on Fat Mass in Adults < 50 Years of Age: A Systematic Review and Meta-Analysis. Nutrients, 15.","DOI":"10.20944\/preprints202306.1334.v1"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1136\/bjsports-2021-103987","article-title":"Implementing the 27 PRISMA 2020 Statement items for systematic reviews in the sport and exercise medicine, musculoskeletal rehabilitation and sports science fields: The PERSiST (implementing Prisma in Exercise, Rehabilitation, Sport medicine and SporTs science) guidance","volume":"56","author":"Ardern","year":"2022","journal-title":"Br. J. Sports Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1093\/ptj\/83.8.713","article-title":"Reliability of the PEDro scale for rating quality of randomized controlled trials","volume":"83","author":"Maher","year":"2003","journal-title":"Phys. Ther."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.jphys.2019.08.005","article-title":"Clinimetrics: Physiotherapy Evidence Database (PEDro) Scale","volume":"66","author":"Cashin","year":"2020","journal-title":"J. Physiother."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1136\/bmj.327.7414.557","article-title":"Measuring inconsistency in meta-analyses","volume":"327","author":"Higgins","year":"2003","journal-title":"BMJ"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1007\/s40279-023-01943-9","article-title":"Concurrent Strength and Endurance Training: A Systematic Review and Meta-Analysis on the Impact of Sex and Training Status","volume":"54","author":"Huiberts","year":"2024","journal-title":"Sports Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2380058","DOI":"10.1080\/15502783.2024.2380058","article-title":"Creatine supplementation protocols with or without training interventions on body composition: A GRADE-assessed systematic review and dose-response meta-analysis","volume":"21","author":"Heidari","year":"2024","journal-title":"J. Int. Soc. Sports Nutr."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1136\/bmj.315.7109.629","article-title":"Bias in meta-analysis detected by a simple, graphical test","volume":"315","author":"Egger","year":"1997","journal-title":"BMJ"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1111\/j.0006-341X.2000.00455.x","article-title":"Trim and fill: A simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis","volume":"56","author":"Duval","year":"2000","journal-title":"Biometrics"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"158","DOI":"10.2478\/bhk-2019-0022","article-title":"Effect of creatine ethyl ester supplementation and resistance training on hormonal changes, body composition and muscle strength in underweight non-athlete men","volume":"11","author":"Arazi","year":"2019","journal-title":"Biomed. Hum. Kinet."},{"key":"ref_23","first-page":"1034","article-title":"Creatine supplementation improves performance, but is it safe? Double-blind placebo-controlled study","volume":"60","author":"Almeida","year":"2020","journal-title":"J. Sports Med. Phys. Fit."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1429","DOI":"10.1053\/meta.2001.28159","article-title":"Comparison of creatine ingestion and resistance training on energy expenditure and limb blood flow","volume":"50","author":"Arciero","year":"2001","journal-title":"Metab.-Clin. Exp."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1667","DOI":"10.1097\/00005768-200110000-00009","article-title":"Creatine supplementation during resistance training in college football athletes","volume":"33","author":"Bemben","year":"2001","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1249\/01.mss.0000247002.32589.ef","article-title":"Effects of whey isolate, creatine and resistance training on muscle hypertrophy","volume":"39","author":"Cribb","year":"2007","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_27","first-page":"939","article-title":"Effects of creatine monohydrate supplementation on body composition and strength indices in experienced resistance trained women","volume":"20","author":"Ferguson","year":"2006","journal-title":"J. Strength Cond. Res."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1123\/ijsnem.16.4.430","article-title":"Effect of creatine and beta-alanine supplementation on performance and endocrine responses in strength\/power athletes","volume":"16","author":"Hoffman","year":"2006","journal-title":"Int. J. Sport. Nutr. Exerc. Metab."},{"key":"ref_29","first-page":"608","article-title":"Creatine monohydrate supplementation during eight weeks of progressive resistance training increases strength in as little as two weeks without reducing markers of muscle damage","volume":"59","author":"Kaviani","year":"2018","journal-title":"J. Sports Med. Phys. Fit."},{"key":"ref_30","first-page":"109","article-title":"Effect of oral creatine supplementation on near-maximal strength and repeated sets of high-intensity bench press exercise","volume":"12","author":"Kelly","year":"1998","journal-title":"J. Strength Cond. Res."},{"key":"ref_31","first-page":"434","article-title":"The effect of creatine supplementation on muscle strength and body composition during off-season training in female soccer players","volume":"14","author":"Hunter","year":"2000","journal-title":"J. Strength Cond. Res."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Mills, S., Candow, D.G., Forbes, S.C., Neary, J.P., Ormsbee, M.J., and Antonio, J. (2020). Effects of creatine supplementation during resistance training sessions in physically active young adults. Nutrients, 12.","DOI":"10.3390\/nu12061880"},{"key":"ref_33","first-page":"104","article-title":"Effects of varying dosages of oral creatine relative to fat free body mass on strength and body composition","volume":"12","author":"Noonan","year":"1998","journal-title":"J. Strength Cond. Res."},{"key":"ref_34","first-page":"187","article-title":"Long-term effects of creatine monohydrate on strength and power","volume":"13","author":"Pearson","year":"1999","journal-title":"J. Strength Cond. Res."},{"key":"ref_35","first-page":"3","article-title":"Effect of oral creatine monohydrate and creatine phosphate supplementation on maximal strength indices, body composition, and blood pressure","volume":"13","author":"Peeters","year":"1999","journal-title":"J. Strength Cond. Res."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1186\/1550-2783-9-56","article-title":"Effects of creatine supplementation on oxidative stress profile of athletes","volume":"9","author":"Domingues","year":"2012","journal-title":"J. Int. Soc. Sports Nutr."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.mce.2009.12.019","article-title":"Effects of oral creatine and resistance training on serum myostatin and GASP-1","volume":"317","author":"Saremi","year":"2010","journal-title":"Mol. Cell. Endocrinol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1123\/ijsn.9.2.146","article-title":"Effects of in-season (5 weeks) creatine and pyruvate supplementation on anaerobic performance and body composition in American football players","volume":"9","author":"Stone","year":"1999","journal-title":"Int. J. Sport Nutr. Exerc. Metab."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/S0271-5317(98)00185-7","article-title":"Effects of 8 weeks of creatine supplementation on exercise performance and fat-free weight in football players during training","volume":"19","author":"Stout","year":"1999","journal-title":"Nutr. Res."},{"key":"ref_40","first-page":"182","article-title":"Absolute and relative strength performance following creatine monohydrate supplementation combined with periodized resistance training","volume":"14","author":"Syrotuik","year":"2000","journal-title":"J. Strength Cond. Res."},{"key":"ref_41","first-page":"254","article-title":"Effects of combined creatine plus fenugreek extract vs. creatine plus carbohydrate supplementation on resistance training adaptations","volume":"10","author":"Taylor","year":"2011","journal-title":"J. Sports Sci. Med."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.1097\/00005768-199908000-00011","article-title":"Performance and muscle fiber adaptations to creatine supplementation and heavy resistance training","volume":"31","author":"Volek","year":"1999","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Wang, C.C., Fang, C.C., Lee, Y.H., Yang, M.T., and Chan, K.H. (2018). Effects of 4-Week Creatine Supplementation Combined with Complex Training on Muscle Damage and Sport Performance. Nutrients, 10.","DOI":"10.3390\/nu10111640"},{"key":"ref_44","first-page":"343","article-title":"The effects of a 10-week, periodized, off-season resistance-training program and creatine supplementation among collegiate football players","volume":"16","author":"Wilder","year":"2002","journal-title":"J. Strength Cond. Res."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Forbes, S.C., Candow, D.G., Ostojic, S.M., Roberts, M.D., and Chilibeck, P.D. (2021). Meta-Analysis Examining the Importance of Creatine Ingestion Strategies on Lean Tissue Mass and Strength in Older Adults. Nutrients, 13.","DOI":"10.3390\/nu13061912"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"3127","DOI":"10.1113\/JP271259","article-title":"Modelling in vivo creatine\/phosphocreatine in vitro reveals divergent adaptations in human muscle mitochondrial respiratory control by ADP after acute and chronic exercise","volume":"594","author":"Ydfors","year":"2016","journal-title":"J. Physiol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1271","DOI":"10.1007\/s00726-011-0877-3","article-title":"The creatine kinase system and pleiotropic effects of creatine","volume":"40","author":"Wallimann","year":"2011","journal-title":"Amino Acids"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1751","DOI":"10.1007\/s00726-016-2267-3","article-title":"Cellular compartmentation of energy metabolism: Creatine kinase microcompartments and recruitment of B-type creatine kinase to specific subcellular sites","volume":"48","author":"Schlattner","year":"2016","journal-title":"Amino Acids"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1042\/CS20030116","article-title":"Creatine supplementation increases glycogen storage but not GLUT-4 expression in human skeletal muscle","volume":"106","author":"Loon","year":"2004","journal-title":"Clin. Sci."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1910","DOI":"10.1152\/japplphysiol.00977.2002","article-title":"Combined creatine and protein supplementation in conjunction with resistance training promotes muscle GLUT-4 content and glucose tolerance in humans","volume":"94","author":"Derave","year":"2003","journal-title":"J. Appl. Physiol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1042\/cs0830367","article-title":"Elevation of creatine in resting and exercised muscle of normal subjects by creatine supplementation","volume":"83","author":"Harris","year":"1992","journal-title":"Clin. Sci."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1152\/jappl.1996.81.1.232","article-title":"Muscle creatine loading in men","volume":"81","author":"Hultman","year":"1996","journal-title":"J. Appl. Physiol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1023\/A:1022465203458","article-title":"Effects of creatine supplementation on performance and training adaptations","volume":"244","author":"Kreider","year":"2003","journal-title":"Mol. Cell Biochem."},{"key":"ref_54","first-page":"E31","article-title":"Creatine ingestion favorably affects performance and muscle metabolism during maximal exercise in humans","volume":"271","author":"Casey","year":"1996","journal-title":"Am. J. Physiol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1042\/cs0810249","article-title":"Muscle composition in relation to age and sex","volume":"81","author":"Forsberg","year":"1991","journal-title":"Clin. Sci."},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Smith-Ryan, A.E., Cabre, H.E., Eckerson, J.M., and Candow, D.G. (2021). Creatine Supplementation in Women\u2019s Health: A Lifespan Perspective. Nutrients, 13.","DOI":"10.3390\/nu13030877"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.1152\/jappl.2001.91.3.1041","article-title":"Effects of acute creatine monohydrate supplementation on leucine kinetics and mixed-muscle protein synthesis","volume":"91","author":"Parise","year":"2001","journal-title":"J. Appl. Physiol."},{"key":"ref_58","first-page":"E821","article-title":"Carbohydrate ingestion augments skeletal muscle creatine accumulation during creatine supplementation in humans","volume":"271","author":"Green","year":"1996","journal-title":"Am. J. Physiol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1186\/1550-2783-10-36","article-title":"The effects of pre versus post workout supplementation of creatine monohydrate on body composition and strength","volume":"10","author":"Antonio","year":"2013","journal-title":"J. Int. Soc. Sports Nutr."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/16\/21\/3665\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:22:20Z","timestamp":1760113340000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/16\/21\/3665"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,28]]},"references-count":59,"journal-issue":{"issue":"21","published-online":{"date-parts":[[2024,11]]}},"alternative-id":["nu16213665"],"URL":"https:\/\/doi.org\/10.3390\/nu16213665","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,28]]}}}