{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T20:40:52Z","timestamp":1778618452823,"version":"3.51.4"},"reference-count":56,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2021,7,20]],"date-time":"2021-07-20T00:00:00Z","timestamp":1626739200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100017014","name":"Centro de Investiga\u00e7\u00e3o em Tecnologias e Servi\u00e7os de Sa\u00fade","doi-asserted-by":"publisher","award":["reference UIDB\/4255\/2020"],"award-info":[{"award-number":["reference UIDB\/4255\/2020"]}],"id":[{"id":"10.13039\/501100017014","id-type":"DOI","asserted-by":"publisher"}]},{"name":"North Portugal Regional Operational Programme (NORTE 2020), under the PORTUGAL 2020 Partnership Agreement, and through the European Regional Development Fund (ERDF).","award":["Project NORTE-01-0247-FEDER-033275"],"award-info":[{"award-number":["Project NORTE-01-0247-FEDER-033275"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Conventional lung auscultation is essential in the management of respiratory diseases. However, detecting adventitious sounds outside medical facilities remains challenging. We assessed the feasibility of lung auscultation using the smartphone built-in microphone in real-world clinical practice. We recruited 134 patients (median[interquartile range] 16[11\u201322.25]y; 54% male; 31% cystic fibrosis, 29% other respiratory diseases, 28% asthma; 12% no respiratory diseases) at the Pediatrics and Pulmonology departments of a tertiary hospital. First, clinicians performed conventional auscultation with analog stethoscopes at 4 locations (trachea, right anterior chest, right and left lung bases), and documented any adventitious sounds. Then, smartphone auscultation was recorded twice in the same four locations. The recordings (n = 1060) were classified by two annotators. Seventy-three percent of recordings had quality (obtained in 92% of the participants), with the quality proportion being higher at the trachea (82%) and in the children\u2019s group (75%). Adventitious sounds were present in only 35% of the participants and 14% of the recordings, which may have contributed to the fair agreement between conventional and smartphone auscultation (85%; k = 0.35(95% CI 0.26\u20130.44)). Our results show that smartphone auscultation was feasible, but further investigation is required to improve its agreement with conventional auscultation.<\/jats:p>","DOI":"10.3390\/s21144931","type":"journal-article","created":{"date-parts":[[2021,7,20]],"date-time":"2021-07-20T11:26:10Z","timestamp":1626780370000},"page":"4931","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Lung Auscultation Using the Smartphone\u2014Feasibility Study in Real-World Clinical Practice"],"prefix":"10.3390","volume":"21","author":[{"given":"Henrique","family":"Ferreira-Cardoso","sequence":"first","affiliation":[{"name":"Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1151-8791","authenticated-orcid":false,"given":"Cristina","family":"J\u00e1come","sequence":"additional","affiliation":[{"name":"MEDCIDS\u2014Department of Community Medicine, Health Information and Decision, Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal"},{"name":"CINTESIS\u2014Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal"}]},{"given":"S\u00f3nia","family":"Silva","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Centro Hospitalar Universit\u00e1rio de S\u00e3o Jo\u00e3o, 4200-319 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0357-8900","authenticated-orcid":false,"given":"Adelina","family":"Amorim","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"},{"name":"Department of Pulmonology, Centro Hospitalar Universit\u00e1rio de S\u00e3o Jo\u00e3o, 4200-319 Porto, Portugal"}]},{"given":"Margarida T.","family":"Redondo","sequence":"additional","affiliation":[{"name":"Department of Pulmonology, Centro Hospitalar Universit\u00e1rio de S\u00e3o Jo\u00e3o, 4200-319 Porto, Portugal"}]},{"given":"Jos\u00e9","family":"Fontoura-Matias","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Centro Hospitalar Universit\u00e1rio de S\u00e3o Jo\u00e3o, 4200-319 Porto, Portugal"}]},{"given":"Margarida","family":"Vicente-Ferreira","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Centro Hospitalar Universit\u00e1rio de S\u00e3o Jo\u00e3o, 4200-319 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4174-2820","authenticated-orcid":false,"given":"Pedro","family":"Vieira-Marques","sequence":"additional","affiliation":[{"name":"CINTESIS\u2014Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal"}]},{"given":"Jos\u00e9","family":"Valente","sequence":"additional","affiliation":[{"name":"MEDIDA\u2014Servi\u00e7os em Medicina, Educa\u00e7\u00e3o, Investiga\u00e7\u00e3o, Desenvolvimento e Avalia\u00e7\u00e3o, LDA, 4200-386 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7755-5002","authenticated-orcid":false,"given":"Rute","family":"Almeida","sequence":"additional","affiliation":[{"name":"MEDCIDS\u2014Department of Community Medicine, Health Information and Decision, Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal"},{"name":"CINTESIS\u2014Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0887-8796","authenticated-orcid":false,"given":"Jo\u00e3o Almeida","family":"Fonseca","sequence":"additional","affiliation":[{"name":"MEDCIDS\u2014Department of Community Medicine, Health Information and Decision, Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal"},{"name":"CINTESIS\u2014Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal"},{"name":"MEDIDA\u2014Servi\u00e7os em Medicina, Educa\u00e7\u00e3o, Investiga\u00e7\u00e3o, Desenvolvimento e Avalia\u00e7\u00e3o, LDA, 4200-386 Porto, Portugal"}]},{"given":"In\u00eas","family":"Azevedo","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Centro Hospitalar Universit\u00e1rio de S\u00e3o Jo\u00e3o, 4200-319 Porto, Portugal"},{"name":"Department of Obstetrics, Gynecology and Pediatrics, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"},{"name":"EpiUnit, Institute of Public Health, University of Porto, 4050-091 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2021,7,20]]},"reference":[{"key":"ref_1","unstructured":"European Respiratory Society (2021, March 01). 2017 Forum of International Respiratory Societies the Global Impact of Respiratory Disease. Available online: https:\/\/www.who.int\/gard\/publications\/The_Global_Impact_of_Respiratory_Disease.pdf."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1183\/09031936.00105513","article-title":"Respiratory health and disease in Europe: The new European Lung White Book","volume":"42","author":"Gibson","year":"2013","journal-title":"Eur. Respir. J."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1016\/S2213-2600(20)30105-3","article-title":"Prevalence and attributable health burden of chronic respiratory diseases, 1990\u20132017: A systematic analysis for the Global Burden of Disease Study 2017","volume":"8","author":"Soriano","year":"2020","journal-title":"Lancet Respir. Med."},{"key":"ref_4","unstructured":"WHO (2018). Global Asthma Network the Global Asthma Report, WHO. Available online: http:\/\/globalasthmareport.org\/."},{"key":"ref_5","first-page":"683","article-title":"Cost of asthma in children: A nationwide, population-based, cost-of-illness study. Pediatr","volume":"28","author":"Amaral","year":"2017","journal-title":"Allergy Immunol."},{"key":"ref_6","first-page":"323","article-title":"Cost of asthma in Portuguese adults: A population-based, cost-of-illness study","volume":"23","author":"Barbosa","year":"2017","journal-title":"Rev. Port. Pneumol. (Engl. Ed.)"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Scotet, V., L\u2019hostis, C., and F\u00e9rec, C. (2020). The changing epidemiology of cystic fibrosis: Incidence, survival and impact of the CFTRGene discovery. Genes, 11.","DOI":"10.3390\/genes11060589"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1016\/j.jcf.2016.11.002","article-title":"Environmental scan of cystic fibrosis research worldwide","volume":"16","author":"Kelly","year":"2017","journal-title":"J. Cyst. Fibros."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1007\/s00108-014-3646-z","article-title":"Zystische Fibrose und ihre Komplikationen","volume":"56","author":"Schwarz","year":"2015","journal-title":"Der Internist"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1016\/j.jval.2012.12.003","article-title":"Understanding the costs of care for cystic fibrosis: An analysis by age and health state","volume":"16","author":"Norman","year":"2013","journal-title":"Value Health"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Bilton, D., Canny, G., Conway, S., Dumcius, S., Hjelte, L., Proesmans, M., T\u00fcmmler, B., Vavrova, V., and De Boeck, K. (2011). Pulmonary exacerbation: Towards a definition for use in clinical trials. Report from the EuroCareCF Working Group on outcome parameters in clinical trials. J. Cyst. Fibros., 10.","DOI":"10.1016\/S1569-1993(11)60012-X"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1056\/NEJMra1302901","article-title":"Fundamentals of lung auscultation","volume":"370","author":"Bohadana","year":"2014","journal-title":"N. Engl. J. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"158","DOI":"10.4103\/1817-1737.160831","article-title":"Auscultation of the respiratory system","volume":"10","author":"Arkar","year":"2015","journal-title":"Ann. Thorac. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1109\/RBME.2020.3002970","article-title":"Methods for Adventitious Respiratory Sound Analyzing Applications Based on Smartphones: A Survey","volume":"14","author":"Tabatabaei","year":"2020","journal-title":"IEEE Rev. Biomed. Eng."},{"key":"ref_15","unstructured":"(2021, March 01). Global Initiative for Asthma Global Strategy for Asthma Management and Prevention Updated 2021. Available online: www.ginasthma.org."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1002\/ppul.22658","article-title":"Pulmonary exacerbations in cystic fibrosis: Young children with characteristic signs and symptoms","volume":"48","author":"Regelmann","year":"2013","journal-title":"Pediatr. Pulmonol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1082","DOI":"10.1093\/ptj\/75.12.1082","article-title":"Interrater reliability of auscultation of breath sounds among physical therapists","volume":"75","author":"Brooks","year":"1995","journal-title":"Phys. Ther."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2139","DOI":"10.1183\/09031936.95.08122139","article-title":"Crackles: Recording, analysis and clinical significance","volume":"8","author":"Piirila","year":"1995","journal-title":"Eur. Respir. J."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1007\/s11882-018-0808-4","article-title":"Telemedicine: A Primer","volume":"18","author":"Waller","year":"2018","journal-title":"Curr. Allergy Asthma Rep."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1132","DOI":"10.1093\/jamia\/ocaa072","article-title":"COVID-19 transforms health care through telemedicine: Evidence from the field","volume":"27","author":"Mann","year":"2020","journal-title":"J. Am. Med. Inform. Assoc."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1353\/hpu.2015.0078","article-title":"Expanding telemedicine to include primary care for the urban adult","volume":"26","author":"Markwick","year":"2015","journal-title":"J. Health Care Poor Underserved"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"McConnochie, K.M., Wood, N.E., Herendeen, N.E., Ng, P.K., Noyes, K., Wang, H., and Roghmann, K.J. (2009). Acute illness care patterns change with use of telemedicine. Pediatrics, 123.","DOI":"10.1542\/peds.2008-2698"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.mjafi.2013.02.013","article-title":"Are medical apps the future of medicine?","volume":"69","author":"Gupta","year":"2013","journal-title":"Med. J. Armed Forces India"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Ramos-Lacuey, B., Herranz Aguirre, M., Calder\u00f3n Gallego, C., Ilundain L\u00f3pez de Munain, A., Gembero Esarte, E., and Moreno-Galarraga, L. (2021). ECIEN-2020 study: The effect of COVID-19 on admissions for non-COVID-19 diseases. World J. Pediatr., 17.","DOI":"10.1007\/s12519-020-00406-9"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1202","DOI":"10.1089\/tmj.2020.0114","article-title":"Smartphone-based self-testing of COVID-19 using breathing sounds","volume":"26","author":"Faezipour","year":"2020","journal-title":"Telemed. e-Health"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Beaney, T., Salman, D., Samee, T., and Mak, V. (2020). Assessment and management of adults with asthma during the COVID-19 pandemic. BMJ, 369.","DOI":"10.1136\/bmj.m2092"},{"key":"ref_27","first-page":"625","article-title":"Basic techniques for respiratory sound analysis","volume":"10","author":"Charbonneau","year":"2000","journal-title":"Eur. Respir. Rev."},{"key":"ref_28","first-page":"611","article-title":"Environmental and subject conditions and breathing manoeuvres for respiratory sound recordings","volume":"10","author":"Rossi","year":"2000","journal-title":"Eur. Respir. Rev."},{"key":"ref_29","first-page":"597","article-title":"Definition of terms for applications of respiratory sounds","volume":"10","author":"Dalmasso","year":"2000","journal-title":"Eur. Respir. Rev."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1007\/s11325-018-1661-3","article-title":"Monitoring healthy and disturbed sleep through smartphone applications: A review of experimental evidence","volume":"23","author":"Fino","year":"2019","journal-title":"Sleep Breath."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"914","DOI":"10.1016\/j.compbiomed.2013.03.011","article-title":"Computerized analysis of respiratory sounds during COPD exacerbations","volume":"43","year":"2013","journal-title":"Comput. Biol. Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1111\/crj.12392","article-title":"Computerized respiratory sounds: A comparison between patients with stable and exacerbated COPD","volume":"11","author":"Oliveira","year":"2017","journal-title":"Clin. Respir. J."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1016\/j.jaip.2016.02.001","article-title":"Lung Sound Analysis and Airway Inflammation in Bronchial Asthma","volume":"4","author":"Shimoda","year":"2016","journal-title":"J. Allergy Clin. Immunol. Pract."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"99","DOI":"10.2147\/JAA.S125938","article-title":"Lung sound analysis helps localize airway inflammation in patients with bronchial asthma","volume":"10","author":"Shimoda","year":"2017","journal-title":"J. Asthma Allergy"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.alit.2016.05.002","article-title":"Lung sound analysis can be an index of the control of bronchial asthma","volume":"66","author":"Shimoda","year":"2017","journal-title":"Allergol. Int."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"989","DOI":"10.1007\/s00431-017-2929-5","article-title":"Digital stethoscopes compared to standard auscultation for detecting abnormal paediatric breath sounds","volume":"176","author":"Kevat","year":"2017","journal-title":"Eur. J. Pediatr."},{"key":"ref_37","unstructured":"Almeida, R., J\u00e1come, C., Martinho, D., Vieira-Marques, P., Jacinto, T., Ferreira, A., Almeida, A., Martins, C., Pereira, M., and Pereira, A. (2020, January 21\u201325). AIRDOC: Smart mobile application for individualized support and monitoring of respiratory function and sounds of patients with chronic obstructive disease. Proceedings of the 12th IADIS International Conference e-Health 2020, EH 2020\u2014Part of the 14th Multi Conference on Computer Science and Information Systems, MCCSIS 2020, Online."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"13830","DOI":"10.3390\/s140813830","article-title":"Tracheal sounds acquisition using smartphones","volume":"14","author":"Reyes","year":"2014","journal-title":"Sensors"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Von Elm, E., Altman, D.G., Egger, M., Pocock, S.J., G\u00f8tzsche, P.C., and Vandenbroucke, J.P. (2009). The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for reporting observational studies. UroToday Int. J., 2.","DOI":"10.1016\/j.jclinepi.2007.11.008"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Ferreira, A., Almeida, R., and Muchagata, J. (2020, January 26\u201328). How Secure Is Your Mobile Health?. Proceedings of the IFMBE Proceedings, Coimbra, Portugal.","DOI":"10.1007\/978-3-030-31635-8_168"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"e0162538","DOI":"10.1371\/journal.pone.0162538","article-title":"Lung sounds in children before and after respiratory physical therapy for right middle lobe atelectasis","volume":"11","author":"Adachi","year":"2016","journal-title":"PLoS ONE"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1183\/13993003.01132-2015","article-title":"Towards the standardisation of lung sound nomenclature","volume":"47","author":"Pasterkamp","year":"2016","journal-title":"Eur. Respir. J."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"159","DOI":"10.2307\/2529310","article-title":"The Measurement of Observer Agreement for Categorical Data","volume":"33","author":"Landis","year":"1977","journal-title":"Biometrics"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"e0177926","DOI":"10.1371\/journal.pone.0177926","article-title":"Automatic adventitious respiratory sound analysis: A systematic review","volume":"12","author":"Pramono","year":"2017","journal-title":"PLoS ONE"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"e000136","DOI":"10.1136\/bmjresp-2016-000136","article-title":"Wheezes, crackles and rhonchi: Simplifying description of lung sounds increases the agreement on their classification: A study of 12 physicians\u2019 classification of lung sounds from video recordings","volume":"3","author":"Melbye","year":"2016","journal-title":"BMJ Open Respir. Res."},{"key":"ref_46","first-page":"641","article-title":"Future perspectives for respiratory sound research","volume":"10","author":"Earis","year":"2000","journal-title":"Eur. Respir. Rev."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Aviles-Solis, J.C., J\u00e1come, C., Davidsen, A., Einarsen, R., Vanbelle, S., Pasterkamp, H., and Melbye, H. (2019). Prevalence and clinical associations of wheezes and crackles in the general population: The Troms\u00f8 study. BMC Pulm. Med., 19.","DOI":"10.1186\/s12890-019-0928-1"},{"key":"ref_48","first-page":"355","article-title":"In defense of the stethoscope","volume":"53","author":"Murphy","year":"2008","journal-title":"Respir. Care"},{"key":"ref_49","first-page":"1","article-title":"SARS-CoV-2 infection in patients with cystic fibrosi. An overwiew","volume":"91","author":"Fainardi","year":"2020","journal-title":"Acta Biomed."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"3378","DOI":"10.1016\/j.jaip.2020.07.057","article-title":"Pediatric Asthma Health Care Utilization, Viral Testing, and Air Pollution Changes During the COVID-19 Pandemic","volume":"8","author":"Taquechel","year":"2020","journal-title":"J. Allergy Clin. Immunol. Pract."},{"key":"ref_51","first-page":"1490","article-title":"Automated lung sound analysis in patients with pneumonia","volume":"49","author":"Murphy","year":"2004","journal-title":"Respir. Care"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1291","DOI":"10.1164\/ajrccm.150.5.7952555","article-title":"Clinical utility of chest auscultation in common pulmonary diseases","volume":"150","author":"Bettencourt","year":"1994","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1016\/S0140-6736(88)91613-3","article-title":"Reliability of eliciting physical signs in examination of the chest","volume":"331","author":"Spiteri","year":"1988","journal-title":"Lancet"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1007\/BF02599985","article-title":"Diagnosis of obstructive airways disease from the clinical examination","volume":"8","author":"Holleman","year":"1993","journal-title":"J. Gen. Intern. Med."},{"key":"ref_55","first-page":"1304","article-title":"Wheeze detection in the pediatric intensive care unit: Comparison among physician, nurses, respiratory therapists, and a computerized respiratory sound monitor","volume":"53","author":"Prodhan","year":"2008","journal-title":"Respir. Care"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1016\/0895-4356(96)00011-X","article-title":"The meaning of kappa: Probabilistic concepts of reliability and validity revisited","volume":"49","year":"1996","journal-title":"J. Clin. Epidemiol."}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/21\/14\/4931\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:32:13Z","timestamp":1760164333000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/21\/14\/4931"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,20]]},"references-count":56,"journal-issue":{"issue":"14","published-online":{"date-parts":[[2021,7]]}},"alternative-id":["s21144931"],"URL":"https:\/\/doi.org\/10.3390\/s21144931","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,20]]}}}