{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T03:06:07Z","timestamp":1760238367176,"version":"build-2065373602"},"reference-count":56,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2022,7,19]],"date-time":"2022-07-19T00:00:00Z","timestamp":1658188800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001871","name":"APIMedOlder","doi-asserted-by":"publisher","award":["PTDC\/MED-FAR\/31598\/2017","POCI-01-0145-FEDER-031598"],"award-info":[{"award-number":["PTDC\/MED-FAR\/31598\/2017","POCI-01-0145-FEDER-031598"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]},{"name":"FEDER, through COMPETE2020\u2014Programa Operacional Competitividade e Internacionaliza\u00e7\u00e3o","award":["PTDC\/MED-FAR\/31598\/2017","POCI-01-0145-FEDER-031598"],"award-info":[{"award-number":["PTDC\/MED-FAR\/31598\/2017","POCI-01-0145-FEDER-031598"]}]},{"name":"national funds (OE), through FCT\/MCTES","award":["PTDC\/MED-FAR\/31598\/2017","POCI-01-0145-FEDER-031598"],"award-info":[{"award-number":["PTDC\/MED-FAR\/31598\/2017","POCI-01-0145-FEDER-031598"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Healthcare"],"abstract":"<jats:p>(1) Background: According to the World Health Organization (WHO), benzodiazepines (BZD) are considered essential medicines for the treatment of several mental disorders in older adults over 65 years old. However, the long-term use of BZD could present a harmful impact on this population, leading to cognitive deficits, drug dependence, falls, and fractures. This study aims to analyze trends of BZD prescription to Portuguese older adults in the primary care setting, and to analyze the change in the prescription rate of BZD over time, assessing the geographical variability in mainland Portugal. (2) Methods: A nationwide, retrospective ecological study was performed between January 2019 and December 2021 for BZD prescribing data reported in a national public database for all persons aged 65 and older in mainland Portugal (about 2.4 million). Trends of BZD by defined daily doses (DDD) and per 1000 older adults\u2019 inhabitants per day (DID) were analyzed. (3) Results: A total of 19 BZD were included in this study and more than 1 million BZD prescriptions were recorded in each year of this study period. BZD prescriptions were three times higher in females than in males. Alprazolam, lorazepam, diazepam, ethyl loflazepate, and bromazepam were the most prescribed BZD over the years, presenting the higher DDD and DID values. (4) Conclusions: Despite the DID value growth of several BZD, Portugal is now showing stable BZD prescriptions in older adults, between the years 2019 to 2021. More studies are needed to access if these results are a consequence of successful health programs or just a consequence of the pandemic context that we are facing, which limited older adults\u2019 clinical appointments.<\/jats:p>","DOI":"10.3390\/healthcare10071342","type":"journal-article","created":{"date-parts":[[2022,7,19]],"date-time":"2022-07-19T23:10:22Z","timestamp":1658272222000},"page":"1342","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Trends and Geographic Variabilities in Benzodiazepines Prescription in Primary Care to Older Adults: A 3-Year Population-Based Ecological Study in Portugal"],"prefix":"10.3390","volume":"10","author":[{"given":"Ana B\u00e1rbara","family":"Tavares","sequence":"first","affiliation":[{"name":"Research Unit for Inland Development, Polytechnic of Guarda (UDI-IPG), 6300-559 Guarda, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2316-6770","authenticated-orcid":false,"given":"Ana Isabel","family":"Placido","sequence":"additional","affiliation":[{"name":"Research Unit for Inland Development, Polytechnic of Guarda (UDI-IPG), 6300-559 Guarda, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4708-8965","authenticated-orcid":false,"given":"Daniela Almeida","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"Research Unit for Inland Development, Polytechnic of Guarda (UDI-IPG), 6300-559 Guarda, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2112-2835","authenticated-orcid":false,"given":"Manuel","family":"Morgado","sequence":"additional","affiliation":[{"name":"Research Unit for Inland Development, Polytechnic of Guarda (UDI-IPG), 6300-559 Guarda, Portugal"},{"name":"Health Sciences Research Centre, University of Beira Interior (CICS-UBI), 6200-506 Covilha, Portugal"},{"name":"Pharmaceutical Services of University Hospital Centre of Cova da Beira, Quinta do Alvito, 6200-251 Covilha, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5766-8672","authenticated-orcid":false,"given":"Adolfo","family":"Figueiras","sequence":"additional","affiliation":[{"name":"Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28001 Madrid, Spain"},{"name":"Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0500-4049","authenticated-orcid":false,"given":"Maria Teresa","family":"Herdeiro","sequence":"additional","affiliation":[{"name":"Institute of Biomedicine, Department of Medical Sciences, University of Aveiro, 3810-193 Aveiro, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0169-3788","authenticated-orcid":false,"given":"F\u00e1tima","family":"Roque","sequence":"additional","affiliation":[{"name":"Research Unit for Inland Development, Polytechnic of Guarda (UDI-IPG), 6300-559 Guarda, Portugal"},{"name":"Health Sciences Research Centre, University of Beira Interior (CICS-UBI), 6200-506 Covilha, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2022,7,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1097\/HRP.0000000000000190","article-title":"Prescription Benzodiazepine Use among Older Adults: A Critical Review","volume":"26","author":"Gerlach","year":"2018","journal-title":"Harv. Rev. Psychiatry"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1007\/s40266-018-0544-4","article-title":"Deprescribing Benzodiazepines in Older Patients: Impact of Interventions Targeting Physicians, Pharmacists, and Patients","volume":"35","author":"Ng","year":"2018","journal-title":"Drugs Aging"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1192\/bjp.bp.113.126003","article-title":"Interventions for Reducing Benzodiazepine Use in Older People: Meta-Analysis of Randomised Controlled Trials","volume":"204","author":"Gould","year":"2014","journal-title":"Br. J. Psychiatry"},{"key":"ref_4","unstructured":"Dire\u00e7\u00e3o-Geral da Sa\u00fade (2015). Tratamento Sintom\u00e1tico Da Ansiedade e Ins\u00f3nia Com Benzodiazepinas e F\u00e1rmacos An\u00e1logos. Anamnesis, 24, 15."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1007\/s00228-017-2257-8","article-title":"A Systematic Review of Interventions to Deprescribe Benzodiazepines and Other Hypnotics among Older People","volume":"73","author":"Reeve","year":"2017","journal-title":"Eur. J. Clin. Pharmacol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"825","DOI":"10.2165\/00023210-200317110-00004","article-title":"Benzodiazepines and Risk of Hip Fractures in Older People: A Review of the Evidence","volume":"17","author":"Cumming","year":"2003","journal-title":"CNS Drugs"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1007\/s00228-015-1860-9","article-title":"The EU(7)-PIM List: A List of Potentially Inappropriate Medications for Older People Consented by Experts from Seven European Countries","volume":"71","author":"Meyer","year":"2015","journal-title":"Eur. J. Clin. Pharmacol."},{"key":"ref_8","first-page":"194","article-title":"Operationalisation for Portugal of the EU(7)-PIM List for Identification of Potentially Inappropriate Medicines in Older Adults","volume":"33","author":"Rodrigues","year":"2020","journal-title":"Acta Med. Port."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1111\/jgs.15767","article-title":"American Geriatrics Society 2019 Updated AGS Beers Criteria\u00ae for Potentially Inappropriate Medication Use in Older Adults","volume":"67","author":"Fick","year":"2019","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1093\/ageing\/afu145","article-title":"STOPP\/START Criteria for Potentially Inappropriate Prescribing in Older People: Version 2","volume":"44","author":"Mahony","year":"2015","journal-title":"Age Ageing"},{"key":"ref_11","unstructured":"OECD\/European Union (2020). Health at a Glance: Europe 2020: State of Health in the EU Cycle, OECD Publishing."},{"key":"ref_12","unstructured":"Dire\u00e7\u00e3o-Geral da Sa\u00fade (2017). Programa Nacional Para a Sa\u00fade Mental, Sistema Nacional de Sa\u00fade (SNS)."},{"key":"ref_13","unstructured":"Administra\u00e7\u00e3o Central do Sistema de Sa\u00fade (2016). Protocolo de Desabitua\u00e7\u00e3o Do Uso Cr\u00f3nico de Benzodiazepinas, Administra\u00e7\u00e3o Central do Sistema de Sa\u00fade. Circular Informativa N. 8\/2016\/DPS\/ACSS 2016."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Pl\u00e1cido, A.I., Herdeiro, M.T., Sim\u00f5es, J.L., Amaral, O., Figueiras, A., and Roque, F. (2020). Voices of Polymedicated Older Patients: A Focus Group Approach. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17186443"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e21","DOI":"10.1002\/hpm.2695","article-title":"Reforms in the Portuguese Health Care Sector: Challenges and Proposals","volume":"34","author":"Nunes","year":"2019","journal-title":"Int. J. Health Plan. Manag."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1007\/s10198-020-01242-4","article-title":"Multi-Layer Health Insurance Coverage, Medical Services Use and Health in a Universal National Health System, the Case of Portugal","volume":"22","author":"Tavares","year":"2021","journal-title":"Eur. J. Health Econ."},{"key":"ref_17","unstructured":"Dire\u00e7\u00e3o de Informa\u00e7\u00e3o e Planeamento Estrat\u00e9gico (2017). Infarmed An\u00e1lise de Utiliza\u00e7\u00e3o de Benzodiazepinas e An\u00e1logos, Dire\u00e7\u00e3o de Informa\u00e7\u00e3o e Planeamento Estrat\u00e9gico (Infarmed). Vers\u00e3o 1.2 (2017\/06\/02)."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1016\/j.jagp.2016.06.003","article-title":"A Systematic Review of Opioid and Benzodiazepine Misuse in Older Adults","volume":"24","author":"Maree","year":"2016","journal-title":"Am. J. Geriatr. Psychiatry"},{"key":"ref_19","unstructured":"(2021, November 12). Servi\u00e7os Partilhados do Minist\u00e9rio da Sa\u00fade (SPMS) System of Information and Monitoring of the Portuguese National Health System (SIM@SNS). Available online: https:\/\/bicsp.min-saude.pt\/pt\/investigacao\/Paginas\/medicamentoprescritor_publico.aspx?isdlg=1."},{"key":"ref_20","unstructured":"(2021, September 30). Infarmed\u2013Autoridade Nacional do Medicamento e Produtos de Sa\u00fade, I.P. INFOMED. Available online: https:\/\/extranet.infarmed.pt\/INFOMED-fo\/."},{"key":"ref_21","unstructured":"(2022, March 04). Instituto Nacional de Estat\u00edstica Popula\u00e7\u00e3o Residente (N.o) Por Local de Resid\u00eancia, Sexo e Grupo Et\u00e1rio. Available online: https:\/\/www.ine.pt\/xportal\/xmain?xpid=INE&xpgid=ine_main."},{"key":"ref_22","unstructured":"(2022, March 05). World Health Organization ATC\/DDD Toolkit. Available online: https:\/\/www.who.int\/tools\/atc-ddd-toolkit."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1136\/jech-2021-216732","article-title":"Prescription of Anxiolytics, Sedatives, Hypnotics and Antidepressants in Outpatient, Universal Care during the COVID-19 Pandemic in Portugal: A Nationwide, Interrupted Time-Series Approach","volume":"76","author":"Estrela","year":"2022","journal-title":"J. Epidemiol. Community Health"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"693","DOI":"10.20344\/amp.13976","article-title":"Recommendations about the Use of Psychotropic Medications during the COVID-19 Pandemic","volume":"33","author":"Andrade","year":"2020","journal-title":"Acta Med. Port."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e031156","DOI":"10.1136\/bmjopen-2019-031156","article-title":"Patterns of Benzodiazepine Prescription among Older Adults in Switzerland: A Cross-Sectional Analysis of Claims Data","volume":"10","author":"Luta","year":"2020","journal-title":"BMJ Open"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"E124","DOI":"10.1016\/S2468-2667(20)30288-7","article-title":"Effects of the COVID-19 Pandemic on Primary Care-Recorded Mental Illness and Self-Harm Episodes in the UK: A Population-Based Cohort Study","volume":"6","author":"Carr","year":"2021","journal-title":"Lancet Public Health"},{"key":"ref_27","unstructured":"Dire\u00e7\u00e3o Geral de Sa\u00fade (DGS) (2020). Programas de Sa\u00fade Priorit\u00e1rios de Sa\u00fade 2020, Sistema Nacional de Sa\u00fade (SNS)."},{"key":"ref_28","unstructured":"Organisation for Economic Co-operation and Development (2021). Health at a Glance 2021: OECD Indicators, OECD."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"109176","DOI":"10.1016\/j.drugalcdep.2021.109176","article-title":"Prescription Fill Patterns for Benzodiazepine and Opioid Drugs during the COVID-19 Pandemic in the United States","volume":"229","author":"Fernandes","year":"2021","journal-title":"Drug Alcohol Depend."},{"key":"ref_30","unstructured":"(2022, April 26). Instituto Nacional de Estat\u00edstica Estat\u00edsticas Da Sa\u00fade: 2020. Available online: https:\/\/www.ine.pt\/xurl\/pub\/436989156."},{"key":"ref_31","unstructured":"International Narcotics Control Board, and United Nations (2022). Report of the International Narcotics Control Board for 2021, International Narcotics Control Board."},{"key":"ref_32","unstructured":"(2022, March 21). World Health Organization Collaborating Centre for Drug Statistics Methodology Anatomical Therapeutic Chemical (ATC) Classification Index. Available online: https:\/\/www.whocc.no\/atc_ddd_index\/."},{"key":"ref_33","unstructured":"Teixeira, I., and Furtado, C. (2006, January 24\u201327). Benzodiazepine\u2019s Utilization in Continental Portugal: Medicine and Health Products Observatory\/Medicine and Health Products Economics Department Institute of Pharmacy and Medicines. Proceedings of the 22nd International Conference on Pharmacoepidemiology & Therapeutic Risk Management, Lisbon, Portugal."},{"key":"ref_34","unstructured":"(2022, April 13). OECD OECD.Stat. Available online: https:\/\/stats.oecd.org\/."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Sanabria, E., Cuenca, R.E., Esteso, M.\u00c1., and Maldonado, M. (2021). Benzodiazepines: Their Use Either as Essential Medicines or as Toxics Substances. Toxics, 9.","DOI":"10.3390\/toxics9020025"},{"key":"ref_36","first-page":"239","article-title":"Utiliza\u00e7\u00e3o de benzodiazepinas em Portugal continental (1999\u20132003) [Benzodiazepine\u2019s utilization in continental Portugal (1999\u20132003)]","volume":"19","author":"Furtado","year":"2006","journal-title":"Acta Med. Port."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"196","DOI":"10.3389\/fmed.2017.00196","article-title":"Anxiety and Depression in the Portuguese Older Adults: Prevalence and Associated Factors","volume":"4","author":"Rodrigues","year":"2017","journal-title":"Front. Med."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Estrela, M., Herdeiro, M.T., Ferreira, P.L., and Roque, F. (2020). The Use of Antidepressants, Anxiolytics, Sedatives and Hypnotics in Europe: Focusing on Mental Health Care in Portugal and Prescribing in Older Patients. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17228612"},{"key":"ref_39","unstructured":"Instituto Nacional de Estat\u00edstica de Portugal, and Instituto Nacional de Sa\u00fade Doutor Ricardo Jorge (2009). Inqu\u00e9rito Nacional de Sa\u00fade, Instituto Nacional de Estat\u00edstica de Portugal."},{"key":"ref_40","unstructured":"Programa Nacional para a Sa\u00fade Mental (2016). PORTUGAL: Sa\u00fade Mental Em N\u00fameros-2015, Dire\u00e7\u00e3o-Geral da Sa\u00fade."},{"key":"ref_41","unstructured":"International Narcotics Control Board, and United Nations (2005). Report of the International Narcotics Control Board for 2004, International Narcotics Control Board."},{"key":"ref_42","unstructured":"International Narcotics Control Board, and United Nations (2012). Report of the International Narcotics Control Board for 2011, International Narcotics Control Board."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.eurpsy.2017.12.004","article-title":"Disability and Common Mental Disorders: Results from the World Mental Health Survey Initiative Portugal","volume":"49","author":"Antunes","year":"2018","journal-title":"Eur. Psychiatry"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"861","DOI":"10.20344\/amp.9135","article-title":"Limited Health Literacy in Portugal Assessed with the Newest Vital Sign Preval\u00eancia de Literacia Em Sa\u00fade Inadequada Em Portugal Medida Com o Newest Vital Sign","volume":"30","author":"Paiva","year":"2017","journal-title":"Acta Med. Port."},{"key":"ref_45","unstructured":"(2022, July 15). Medical Doctors per 1000 Inhabitants by Place of Residence. [Internet]. Available online: https:\/\/www.ine.pt\/xportal\/xmain?xpid=INE&xpgid=ine_indicadores&contecto=pi&indOcorrCod=0008356&selTab=tab0&xlang=en."},{"key":"ref_46","unstructured":"Sistema Nacional de Sa\u00fade (SNS) (2019). Relat\u00f3rio Anual Sobre o Acesso a Cuidados de Sa\u00fade Nos Estabelecimentos Do SNS e Entidades Convencionadas, Sistema Nacional de Sa\u00fade (SNS)."},{"key":"ref_47","unstructured":"(2022, July 15). Social Security Pensions by Place of Residence and Type of Pension. [Internet]. Available online: https:\/\/www.ine.pt\/xportal\/xmain?xpid=INE&xpgid=ine_indicadores&indOcorrCod=0010277&contexto=bd&selTab=tab2&xlang=pt."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Pl\u00e1cido, A.I., Herdeiro, M.T., Sim\u00f5es, J.L., Amaral, O., Figueiras, A., and Roque, F. (2021). Health Professionals Perception and Beliefs about Drug- Related Problems on Polymedicated Older Adults- a Focus Group Study. BMC Geriatr., 21.","DOI":"10.1186\/s12877-020-01972-3"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"698907","DOI":"10.3389\/fphar.2021.698907","article-title":"Drug-Related Problems of Patients in Primary Health Care Institutions: A Systematic Review","volume":"12","author":"Ni","year":"2021","journal-title":"Front. Pharmacol."},{"key":"ref_50","unstructured":"(2022, April 12). Eurostat Eurostat Data Browser: Persons Reporting a Chronic Disease, by Disease, Sex, Age and Educational Attainment Level. Available online: https:\/\/ec.europa.eu\/eurostat\/databrowser\/view\/HLTH_EHIS_CD1E__custom_2494696\/default\/table?lang=en."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"106608","DOI":"10.1016\/j.addbeh.2020.106608","article-title":"Sex Differences in Benzodiazepine Misuse among Adults with Substance Use Disorders","volume":"112","author":"McHugh","year":"2021","journal-title":"Addict. Behav."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"33","DOI":"10.3109\/13697137.2010.510912","article-title":"Prevalence of Depression among Postmenopausal Women and Related Characteristics","volume":"14","author":"Unsal","year":"2011","journal-title":"Climacteric"},{"key":"ref_53","unstructured":"European Monitoring Centre for Drugs and Drug Addiction (2022, July 17). The Misuse of Benzodiazepines among High-Risk Opioid Users in Europe. Available online: www.emcdda.europa.eu\/publications\/manuals\/tdi-."},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Vila\u00e7a, A., Vieira, A., Fernandes, A., Ribeiro, D., and Esteves, I. (2019). Characterisation of Benzodiazepine Use in an Older Population Registered in Family Health Units in the Region of Minho, Portugal. Geriatrics, 4.","DOI":"10.3390\/geriatrics4010027"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"102514","DOI":"10.1016\/j.ajp.2020.102514","article-title":"Prescription Pattern and Prevalence of Benzodiazepine Use among Elderly Patients","volume":"55","author":"Franceschi","year":"2021","journal-title":"Asian J. Psychiatry"},{"key":"ref_56","unstructured":"World Health Organization (2017). Integrated Care for Older People Guidelines on Community-Level Interventions to Manage Declines in Intrinsic Capacity, World Health Organization."}],"container-title":["Healthcare"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9032\/10\/7\/1342\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:54:10Z","timestamp":1760140450000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9032\/10\/7\/1342"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,19]]},"references-count":56,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2022,7]]}},"alternative-id":["healthcare10071342"],"URL":"https:\/\/doi.org\/10.3390\/healthcare10071342","relation":{},"ISSN":["2227-9032"],"issn-type":[{"type":"electronic","value":"2227-9032"}],"subject":[],"published":{"date-parts":[[2022,7,19]]}}}