{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:41:35Z","timestamp":1760146895311,"version":"build-2065373602"},"reference-count":55,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2024,12,30]],"date-time":"2024-12-30T00:00:00Z","timestamp":1735516800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Instituto Polit\u00e9cnico de Set\u00fabal"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Applied Sciences"],"abstract":"<jats:p>Parkinson\u2019s disease (PD) is a neurodegenerative disorder characterized by motor and non-motor symptoms. The MoveONParkinson project aims to enhance exercise engagement among people with Parkinson\u2019s Disease (PwPD) in the Portuguese context through the ONParkinson digital platform, which provides mobile and web interfaces. While the broader MoveONParkinson project has been previously described from a health-focused perspective, this study specifically focuses on the development and integration of an AI-driven conversational agent (CA) for the Portuguese language, called PANDORA, within the mobile interface of the solution to assist and motivate PwPD in their exercise routines. PANDORA (Parkinson Assistant in Natural Dialogue and Oriented by Rules and Assessments), designed based on Self-Determination Theory (SDT), addresses the psychological needs of autonomy, competence, and relatedness. A preliminary study involving 20 PwPD, 10 caregivers, and 5 healthcare professionals informed the design requirements for PANDORA. The development process involved four main phases: (1) Design of the Chatbot\u2019s Motivation Model, (2) Design and implementation of the conversational agent, (3) Technical Performance Evaluation, and (4) User Experience Evaluation. Technical Performance Evaluation, conducted with three physiotherapists, assessed domain coverage, coherence response capacity, and dialog management capacity, achieving 100% accuracy in domain coverage and coherence response capacity and 89% in dialog management capacity. The User Experience Study involved eight PwPD users recruited from Portuguese healthcare units performing predefined tasks, with user satisfaction scores ranging from 4.2 to 4.9 on a five-point Likert scale. The findings indicate that integrating a conversational agent with motivational cues tends to increase patient engagement. However, further studies are required to determine PANDORA\u2019s impact on exercise engagement in PwPD.<\/jats:p>","DOI":"10.3390\/app15010223","type":"journal-article","created":{"date-parts":[[2024,12,31]],"date-time":"2024-12-31T07:51:57Z","timestamp":1735631517000},"page":"223","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A Conversational Agent for Empowering People with Parkinson\u2019s Disease in Exercising Through Motivation and Support"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4333-6754","authenticated-orcid":false,"given":"Patricia","family":"Macedo","sequence":"first","affiliation":[{"name":"Departamento de Engenharia Inform\u00e1tica, Escola Superior de Tecnologia de Set\u00fabal, Instituto Polit\u00e9cnico de Set\u00fabal, Campus do IPS, 2910-761 Set\u00fabal, Portugal"},{"name":"Centro ALGORITMI, Universidade do Minho, Campus de Guimar\u00e3es, 4800-058 Guimar\u00e3es, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7360-3855","authenticated-orcid":false,"given":"Rui Neves","family":"Madeira","sequence":"additional","affiliation":[{"name":"Departamento de Engenharia Inform\u00e1tica, Escola Superior de Tecnologia de Set\u00fabal, Instituto Polit\u00e9cnico de Set\u00fabal, Campus do IPS, 2910-761 Set\u00fabal, Portugal"},{"name":"NOVA Laboratory of Computer Science and Informatics (NOVA LINCS), NOVA School of Science & Technology, NOVA University Lisbon, Campus de Caparica, 2829-516 Caparica, Portugal"},{"name":"Center for Regional Resilience and Sustainability (RESILIENCE), Instituto Polit\u00e9cnico de Set\u00fabal, Campus do IPS, 2910-761 Set\u00fabal, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8159-1364","authenticated-orcid":false,"given":"Pedro Albuquerque","family":"Santos","sequence":"additional","affiliation":[{"name":"NOVA Laboratory of Computer Science and Informatics (NOVA LINCS), NOVA School of Science & Technology, NOVA University Lisbon, Campus de Caparica, 2829-516 Caparica, Portugal"},{"name":"Center for Regional Resilience and Sustainability (RESILIENCE), Instituto Polit\u00e9cnico de Set\u00fabal, Campus do IPS, 2910-761 Set\u00fabal, Portugal"},{"name":"Departamento de Engenharia Eletr\u00f3nica e Telecomunica\u00e7\u00f5es e de Computadores, Instituto Superior de Engenharia de Lisboa, Instituto Polit\u00e9cnico de Lisboa, Rua Conselheiro Em\u00eddio Navarro 1, 1959-007 Lisboa, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5379-4455","authenticated-orcid":false,"given":"Pedro","family":"Mota","sequence":"additional","affiliation":[{"name":"Departamento de Engenharia Inform\u00e1tica, Escola Superior de Tecnologia de Set\u00fabal, Instituto Polit\u00e9cnico de Set\u00fabal, Campus do IPS, 2910-761 Set\u00fabal, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9127-2991","authenticated-orcid":false,"given":"Beatriz","family":"Alves","sequence":"additional","affiliation":[{"name":"Departamento de Fisioterapia, Escola Superior de Sa\u00fade, Instituto Polit\u00e9cnico de Set\u00fabal, Campus do IPS, 2910-761 Set\u00fabal, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2899-9640","authenticated-orcid":false,"given":"Carla Mendes","family":"Pereira","sequence":"additional","affiliation":[{"name":"Departamento de Fisioterapia, Escola Superior de Sa\u00fade, Instituto Polit\u00e9cnico de Set\u00fabal, Campus do IPS, 2910-761 Set\u00fabal, Portugal"},{"name":"Comprehensive Health Research Center (CHRC), NOVA Medical School, 1150-190 Lisboa, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2284","DOI":"10.1016\/S0140-6736(21)00218-X","article-title":"Parkinson\u2019s disease","volume":"397","author":"Bloem","year":"2021","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1055\/s-0041-1725133","article-title":"Evidence for early and regular physical therapy and exercise in Parkinson\u2019s disease","volume":"41","author":"Ellis","year":"2021","journal-title":"Semin. Neurol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"pzab302","DOI":"10.1093\/ptj\/pzab302","article-title":"Physical therapist management of Parkinson disease: A clinical practice guideline from the American Physical Therapy Association","volume":"102","author":"Osborne","year":"2022","journal-title":"Phys. Ther."},{"key":"ref_4","first-page":"S257","article-title":"Defining Parkinson\u2019s Disease: Past and Future","volume":"14","author":"Kulcsarova","year":"2024","journal-title":"J. Park. Dis."},{"key":"ref_5","first-page":"S3","article-title":"The emerging evidence of the Parkinson pandemic","volume":"8","author":"Dorsey","year":"2018","journal-title":"J. Park. Dis."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1093\/ptj\/pzz160","article-title":"Helping people with Parkinson disease build exercise self-efficacy","volume":"100","author":"Stevens","year":"2020","journal-title":"Phys. Ther."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Siegert, C., Hauptmann, B., Jochems, N., Schrader, A., and Deck, R. (2019). ParkProTrain: An individualized, tablet-based physiotherapy training programme aimed at improving quality of life and participation restrictions in PD patients\u2014A study protocol for a quasi-randomized, longitudinal and sequential multi-method study. BMC Neurol., 19.","DOI":"10.1186\/s12883-019-1355-x"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e18985","DOI":"10.2196\/18985","article-title":"A mobile app specifically designed to facilitate exercise in Parkinson disease: Single-cohort pilot study on feasibility, safety, and signal of efficacy","volume":"8","author":"Landers","year":"2020","journal-title":"JMIR mHealth uHealth"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e27662","DOI":"10.2196\/27662","article-title":"Exercise Management Using a Mobile App in Patients with Parkinsonism: Prospective, Open-Label, Single-Arm Pilot Study","volume":"9","author":"Kim","year":"2021","journal-title":"JMIR MHealth UHealth"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Madeira, R.N., Pereira, C.M., Clipei, S., and Macedo, P. (2018). ONParkinson\u2013Innovative mHealth to support the triad: Patient, carer and health professional. Pervasive Computing Paradigms for Mental Health: Selected Papers from MindCare 2016, Fabulous 2016, and IIoT 2015 3, Springer.","DOI":"10.1007\/978-3-319-74935-8_2"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Pinto, D., Pereira, B., Santos, P.A., and Madeira, R.N. (2022, January 27\u201330). Studying the Design of Pervasive Serious Games for Parkinson\u2019s Disease. Proceedings of the 21st International Conference on Mobile and Ubiquitous Multimedia, Lisbon, Portugal.","DOI":"10.1145\/3568444.3570594"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1248","DOI":"10.1093\/jamia\/ocy072","article-title":"Conversational agents in healthcare: A systematic review","volume":"25","author":"Laranjo","year":"2018","journal-title":"J. Am. Med. Inform. Assoc."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e17158","DOI":"10.2196\/17158","article-title":"Conversational agents in health care: Scoping review and conceptual analysis","volume":"22","author":"Dhinagaran","year":"2020","journal-title":"J. Med. Internet Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e20346","DOI":"10.2196\/20346","article-title":"The effectiveness of artificial intelligence conversational agents in health care: Systematic review","volume":"22","author":"Lim","year":"2020","journal-title":"J. Med. Internet Res."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Liu, S., Zheng, C., Demasi, O., Sabour, S., Li, Y., Yu, Z., Jiang, Y., and Huang, M. (2021). Towards emotional support dialog systems. arXiv.","DOI":"10.18653\/v1\/2021.acl-long.269"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Haque, A., Chowdhury, M.N.U.R., and Soliman, H. (July, January 30). Transforming chronic disease management with chatbots: Key use cases for personalized and cost-effective care. Proceedings of the 2023 Sixth International Symposium on Computer, Consumer and Control (IS3C), Taichung, Taiwan.","DOI":"10.1109\/IS3C57901.2023.00104"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"5990","DOI":"10.1245\/s10434-023-13888-4","article-title":"A randomized trial comparing the effectiveness of pre-test genetic counseling using an artificial intelligence automated chatbot and traditional in-person genetic counseling in women newly diagnosed with breast cancer","volume":"30","author":"Noss","year":"2023","journal-title":"Ann. Surg. Oncol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e15787","DOI":"10.2196\/15787","article-title":"A chatbot versus physicians to provide information for patients with breast cancer: Blind, randomized controlled noninferiority trial","volume":"21","author":"Bibault","year":"2019","journal-title":"J. Med. Internet Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1007\/s10916-021-01730-x","article-title":"TensioBot: A chatbot assistant for self-managed in-house blood pressure checking","volume":"45","author":"Echeazarra","year":"2021","journal-title":"J. Med. Syst."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e15806","DOI":"10.2196\/15806","article-title":"A smartphone-based health care chatbot to promote self-management of chronic pain (SELMA): Pilot randomized controlled trial","volume":"8","author":"Kowatsch","year":"2020","journal-title":"JMIR mHealth uHealth"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e26152","DOI":"10.2196\/26152","article-title":"Efficacy of Zemedy, a mobile digital therapeutic for the self-management of irritable bowel syndrome: Crossover randomized controlled trial","volume":"9","author":"Hunt","year":"2021","journal-title":"JMIR MHealth UHealth"},{"key":"ref_22","first-page":"613","article-title":"Revolutionizing healthcare platforms: The impact of AI on patient engagement and treatment efficacy","volume":"13","author":"Batra","year":"2024","journal-title":"Int. J. Sci. Res. (IJSR)"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Steg, L., Keizer, K., Buunk, A.P., and Rothengatter, T. (2017). Applied Social Psychology, Cambridge University Press.","DOI":"10.1017\/9781107358430"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2185","DOI":"10.1007\/s12652-017-0652-8","article-title":"Influence awareness: Considering motivation in computer-assisted rehabilitation","volume":"10","author":"Montero","year":"2019","journal-title":"J. Ambient Intell. Humaniz. Comput."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Yoshida, T., Otaka, Y., Osu, R., Kumagai, M., Kitamura, S., and Yaeda, J. (2021). Motivation for rehabilitation in patients with subacute stroke: A qualitative study. Front. Rehabilit. Sci., 2.","DOI":"10.3389\/fresc.2021.664758"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1038\/s43856-023-00308-7","article-title":"A multicenter explanatory survey of patients\u2019 and clinicians\u2019 perceptions of motivational factors in rehabilitation","volume":"3","author":"Oyake","year":"2023","journal-title":"Commun. Med."},{"key":"ref_27","unstructured":"Deci, E.L., and Ryan, R.M. (2013). Intrinsic Motivation and Self-Determination in Human Behavior, Springer Science & Business Media."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1145\/153571.255960","article-title":"Participatory design","volume":"36","author":"Muller","year":"1993","journal-title":"Commun. ACM"},{"key":"ref_29","unstructured":"Fuglerud, K.S., Halbach, T., and Snaprud, M. (2021, January 20\u201323). Involving Diverse Users for Inclusive Technology Development. Proceedings of the IADIS International Conference on Interfaces and Human Computer Interaction 2021 (Part of MCCSIS 2021), Online."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"105070","DOI":"10.1016\/j.ijmedinf.2023.105070","article-title":"A usability evaluation of the perceived user friendliness, accessibility, and inclusiveness of a personalized digital care pathway tool","volume":"175","author":"Heijsters","year":"2023","journal-title":"Int. J. Med. Inform."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Albouys-Perrois, J., Laviole, J., Briant, C., and Brock, A.M. (2018, January 21\u201326). Towards a multisensory augmented reality map for blind and low vision people: A participatory design approach. Proceedings of the 2018 CHI Conference on Human Factors in Computing Systems, Montreal, QC, Canada.","DOI":"10.1145\/3173574.3174203"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e548","DOI":"10.36367\/ntqr.11.2022.e548","article-title":"Health interventions for self-management: The role of qualitative approaches in mixed methods research","volume":"11","author":"Soares","year":"2022","journal-title":"New Trends Qual. Res."},{"key":"ref_33","first-page":"e25891","article-title":"Usability and acceptance of the embodied conversational agent Anne by people with dementia and their caregivers: Exploratory study in home environment settings","volume":"9","author":"Stara","year":"2021","journal-title":"JMIR mHealth uHealth"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e25381","DOI":"10.2196\/25381","article-title":"Embodied conversational agents for patients with dementia: Thematic literature analysis","volume":"9","author":"Rampioni","year":"2021","journal-title":"JMIR MHealth UHealth"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"836","DOI":"10.1037\/amp0000983","article-title":"Engagement in digital interventions","volume":"77","author":"Shaw","year":"2022","journal-title":"Am. Psychol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"20552076231155679","DOI":"10.1177\/20552076231155679","article-title":"An artificially intelligent, natural language processing chatbot designed to promote COVID-19 vaccination: A proof-of-concept pilot study","volume":"9","author":"Zhou","year":"2023","journal-title":"Digit. Health"},{"key":"ref_37","first-page":"100096","article-title":"Non-pharmacologic interventions to treat apathy in Parkinson\u2019s disease: A realist review","volume":"4","author":"Mele","year":"2021","journal-title":"Clin. Park. Relat. Disord."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1080\/17437199.2019.1706614","article-title":"Mediators of physical activity behaviour change interventions among adults: A systematic review and meta-analysis","volume":"15","author":"Rhodes","year":"2021","journal-title":"Health Psychol. Rev."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"e26315","DOI":"10.2196\/26315","article-title":"Smartphone-based interventions to reduce sedentary behavior and promote physical activity using integrated dynamic models: Systematic review","volume":"23","author":"Dunstan","year":"2021","journal-title":"J. Med. Internet Res."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Sabharwal, N., Agrawal, A., Sabharwal, N., and Agrawal, A. (2020). Introduction to Google dialogflow. Cognitive Virtual Assistants Using Google Dialogflow: Develop Complex Cognitive Bots Using the Google Dialogflow Platform, Apress.","DOI":"10.1007\/978-1-4842-5741-8"},{"key":"ref_41","unstructured":"Borghi, P.H., Teixeira, J.P., and Freitas, D.R. (2023). Automatic Speech Recognition for Portuguese: A Comparative Study. Proceedings of the Optimization, Learning Algorithms and Applications, Proceedings of the International Conference, OL2A 2023, Ponta Delgada, Portugal, 27\u201329 September 2023, Springer."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4017\/gt.2011.10.01.006.00","article-title":"A review of technology acceptance by older adults","volume":"10","author":"Chen","year":"2011","journal-title":"Gerontechnology"},{"key":"ref_43","unstructured":"Venkatesh, A., Khatri, C., Ram, A., Guo, F., Gabriel, R., Nagar, A., Prasad, R., Cheng, M., Hedayatnia, B., and Metallinou, A. (2017, January 4\u20139). On evaluating and comparing conversational agents. Proceedings of the 31st Conference on Neural Information Processing Systems (NIPS 2017), Long Beach, CA, USA."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"L\u00f3pez-C\u00f3zar, R., Callejas, Z., Espejo, G., and Griol, D. (2011). Enhancement of conversational agents by means of multimodal interaction. Conversational Agents and Natural Language Interaction: Techniques and Effective Practices, IGI Global.","DOI":"10.4018\/978-1-60960-617-6.ch010"},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Walker, M.A., Litman, D.J., Kamm, C.A., and Abella, A. (1997). PARADISE: A framework for evaluating spoken dialogue agents. arXiv.","DOI":"10.3115\/979617.979652"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"e27","DOI":"10.2196\/mhealth.3422","article-title":"Mobile App Rating Scale: A New Tool for Assessing the Quality of Health Mobile Apps","volume":"3","author":"Stoyanov","year":"2015","journal-title":"JMIR mHealth uHealth"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1212\/WNL.17.5.427","article-title":"Parkinsonism: Onset, progression, and mortality","volume":"17","author":"Hoehn","year":"1967","journal-title":"Neurology"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/j.invent.2017.10.002","article-title":"A fully automated conversational agent for promoting mental well-being: A pilot RCT using mixed methods","volume":"10","author":"Ly","year":"2017","journal-title":"Internet Interv."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"e7785","DOI":"10.2196\/mental.7785","article-title":"Delivering cognitive behavior therapy to young adults with symptoms of depression and anxiety using a fully automated conversational agent (Woebot): A randomized controlled trial","volume":"4","author":"Fitzpatrick","year":"2017","journal-title":"JMIR Ment. Health"},{"key":"ref_50","first-page":"214","article-title":"Telemedicine therapy for overweight adolescents: First results of a novel smartphone app intervention using a behavioural health platform","volume":"90","author":"Heldt","year":"2018","journal-title":"Obes. Facts"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"106722","DOI":"10.1016\/j.chb.2021.106722","article-title":"Emojis influence emotional communication, social attributions, and information processing","volume":"119","author":"Boutet","year":"2021","journal-title":"Comput. Hum. Behav."},{"key":"ref_52","unstructured":"Van Belle, G. (2011). Statistical Rules of Thumb, John Wiley & Sons."},{"key":"ref_53","unstructured":"World Health Organization (2016). Monitoring and Evaluating Digital Health Interventions: A Practical Guide to Conducting Research and Assessment, World Health Organization."},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Morales-de Jes\u00fas, V., G\u00f3mez-Adorno, H., Somodevilla-Garc\u00eda, M., and Vilari\u00f1o, D. (2021). Conversational System as Assistant Tool in Reminiscence Therapy for People with Early-Stage of Alzheimer\u2019s. Healthcare, 9.","DOI":"10.3390\/healthcare9081036"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"e12106","DOI":"10.2196\/12106","article-title":"An empathy-driven, conversational artificial intelligence agent (Wysa) for digital mental well-being: Real-world data evaluation mixed-methods study","volume":"6","author":"Inkster","year":"2018","journal-title":"JMIR mHealth uHealth"}],"container-title":["Applied Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3417\/15\/1\/223\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:56:37Z","timestamp":1760115397000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3417\/15\/1\/223"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,30]]},"references-count":55,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1]]}},"alternative-id":["app15010223"],"URL":"https:\/\/doi.org\/10.3390\/app15010223","relation":{},"ISSN":["2076-3417"],"issn-type":[{"type":"electronic","value":"2076-3417"}],"subject":[],"published":{"date-parts":[[2024,12,30]]}}}