{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:33:45Z","timestamp":1787841225397,"version":"build-2784847793"},"reference-count":61,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2024,9,1]],"date-time":"2024-09-01T00:00:00Z","timestamp":1725148800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Polycystic ovarian syndrome (PCOS) is a metabolic and endocrinological condition that affects many women of reproductive age. Pathology manifests as the changes in reproductive functions, encompassing disorders such as hyperandrogenism, irregular menstrual cycles, and insulin resistance with oxidative stress. We investigated the effect of naturopathy and yoga interventions on oxidative stress and androgens with metabolic parameters in patients with PCOS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      We enrolled the 120 obese teenagers with PCOS, and we divided the patients into two groups as study (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 60) and control (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 60). In the study group, the patients were given 10 days of naturopathy and yoga interventions, whereas the other group was a waitlist control group. They were assessed for testosterone, lipid profile, malonaldehyde (MDA), total antioxidant capacity (TAC) with Hamilton Anxiety (HAM-A), and Depression (HAM-D) Scale at baseline and after 10 days of intervention.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>We found out that the study group exhibited a significant decrease in testosterone, MDA, HAM-A, HAM-D, body mass index (BMI), and lipid profile compared to the control group also with an effective improvement in the TAC. The stepwise multiple regression data highlight that BMI as a significant predictor for the reduction of testosterone in PCOS after taking naturopathy and yoga interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The results indicate that short-term integrated yoga and naturopathy interventions are effective in modifying the disease progression of PCOS through endocrinological and metabolic balance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijoy.ijoy_180_24","type":"journal-article","created":{"date-parts":[[2024,12,14]],"date-time":"2024-12-14T14:00:11Z","timestamp":1734184811000},"page":"195-202","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":6,"title":["A Randomized Controlled Trial in Obese Adults with Polycystic Ovarian Syndrome: Examining the Impact of Short-term Integrated Naturopathy and Yoga Interventions on Testosterone, Oxidative Stress, and Mental Health"],"prefix":"10.4103","volume":"17","author":[{"given":"Balakrishna","family":"Shetty","sequence":"first","affiliation":[{"name":"Department of Biochemistry, S.D.M. College of Naturopathy and Yogic Sciences, Ujire, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geetha Balakrishna","family":"Shetty","sequence":"additional","affiliation":[{"name":"Department of Acupuncture and Energy Medicine, S.D.M. College of Naturopathy and Yogic Sciences, Ujire, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. L.","family":"Nanjeshgowda","sequence":"additional","affiliation":[{"name":"Department of Natural Therapeutics, S.D.M. College of Naturopathy and Yogic Sciences, Ujire, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prashanth","family":"Shetty","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Dietetics, S.D.M. College of Naturopathy and Yogic Sciences, Ujire, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,12,14]]},"reference":[{"key":"R1-20260424","doi-asserted-by":"crossref","first-page":"4650","DOI":"10.1210\/jc.2005-0628","article-title":"Health care-related economic burden of the polycystic ovary syndrome during the reproductive life span","volume":"90","author":"Azziz","year":"2005","journal-title":"J Clin Endocrinol Metab"},{"key":"R2-20260424","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1093\/humupd\/dmm030","article-title":"Health-related quality of life measurement in women with polycystic ovary syndrome: A systematic review","volume":"14","author":"Jones","year":"2008","journal-title":"Hum Reprod Update"},{"key":"R3-20260424","first-page":"61","article-title":"The impact of polycystic ovary syndrome on the health-related quality of life: A systematic review and meta-analysis","volume":"13","author":"Bazarganipour","year":"2015","journal-title":"Iran J Reprod Med"},{"key":"R4-20260424","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1097\/AOG.0b013e318202b0a4","article-title":"Increased risk for abnormal depression scores in women with polycystic ovary syndrome: A systematic review and meta-analysis","volume":"117","author":"Dokras","year":"2011","journal-title":"Obstet Gynecol"},{"key":"R5-20260424","doi-asserted-by":"crossref","first-page":"2442","DOI":"10.1093\/humrep\/der197","article-title":"Anxiety and depression in polycystic ovary syndrome: A systematic review and meta-analysis","volume":"26","author":"Barry","year":"2011","journal-title":"Hum Reprod"},{"key":"R6-20260424","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1016\/j.fertnstert.2007.11.022","article-title":"Risk of depression and other mental health disorders in women with polycystic ovary syndrome: A longitudinal study","volume":"91","author":"Kerchner","year":"2009","journal-title":"Fertil Steril"},{"key":"R7-20260424","doi-asserted-by":"crossref","first-page":"e97041.","DOI":"10.1371\/journal.pone.0097041","article-title":"Risk of psychiatric disorders following polycystic ovary syndrome: A nationwide population-based cohort study","volume":"9","author":"Hung","year":"2014","journal-title":"PLoS One"},{"key":"R8-20260424","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1016\/S0006-3223(03)00608-5","article-title":"Depression and obesity","volume":"54","author":"Stunkard","year":"2003","journal-title":"Biol Psychiatry"},{"key":"R9-20260424","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1001\/archgenpsychiatry.2010.2","article-title":"Overweight, obesity, and depression: A systematic review and meta-analysis of longitudinal studies","volume":"67","author":"Luppino","year":"2010","journal-title":"Arch Gen Psychiatry"},{"key":"R10-20260424","doi-asserted-by":"crossref","first-page":"1375","DOI":"10.1089\/ars.2007.1964","article-title":"Redox considerations in female reproductive function and assisted reproduction: From molecular mechanisms to health implications","volume":"10","author":"Agarwal","year":"2008","journal-title":"Antioxid Redox Signal"},{"key":"R11-20260424","doi-asserted-by":"crossref","first-page":"I27","DOI":"10.1161\/01.CIR.0000131515.03336.f8","article-title":"Role of endothelial dysfunction in atherosclerosis","volume":"109","author":"Davignon","year":"2004","journal-title":"Circulation"},{"key":"R12-20260424","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1161\/01.ATV.15.7.821","article-title":"Coronary heart disease risk factors in women with polycystic ovary syndrome","volume":"15","author":"Talbott","year":"1995","journal-title":"Arterioscler Thromb Vasc Biol"},{"issue":"Suppl 1","key":"R13-20260424","doi-asserted-by":"crossref","first-page":"S25","DOI":"10.1038\/ijo.2013.93","article-title":"The impact of a primary care-based weight loss intervention on the quality of life","volume":"37","author":"Sarwer","year":"2013","journal-title":"Int J Obes (Lond)"},{"key":"R14-20260424","doi-asserted-by":"crossref","first-page":"e132.","DOI":"10.1038\/nutd.2014.29","article-title":"The effects of weight loss after bariatric surgery on health-related quality of life and depression","volume":"4","author":"Strain","year":"2014","journal-title":"Nutr Diabetes"},{"key":"R15-20260424","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1093\/humupd\/dms029","article-title":"Emotional distress is a common risk in women with polycystic ovary syndrome: A systematic review and meta-analysis of 28 studies","volume":"18","author":"Veltman-Verhulst","year":"2012","journal-title":"Hum Reprod Update"},{"key":"R16-20260424","doi-asserted-by":"crossref","first-page":"1470","DOI":"10.1016\/j.psyneuen.2011.04.001","article-title":"Sex steroids, insulin sensitivity and sympathetic nerve activity in relation to affective symptoms in women with polycystic ovary syndrome","volume":"36","author":"Jedel","year":"2011","journal-title":"Psychoneuroendocrinology"},{"key":"R17-20260424","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1016\/j.fertnstert.2015.05.019","article-title":"Putative role for insulin resistance in depression risk in polycystic ovary syndrome","volume":"104","author":"Greenwood","year":"2015","journal-title":"Fertil Steril"},{"key":"R18-20260424","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1016\/j.fertnstert.2018.05.004","article-title":"Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome","volume":"110","author":"Teede","year":"2018","journal-title":"Fertil Steril"},{"key":"R19-20260424","doi-asserted-by":"crossref","first-page":"1454.","DOI":"10.3390\/jcm12041454","article-title":"Polycystic ovary syndrome: Etiology, current management, and future therapeutics","volume":"12","author":"Singh","year":"2023","journal-title":"J Clin Med"},{"key":"R20-20260424","doi-asserted-by":"crossref","first-page":"916","DOI":"10.18203\/2320-1770.ijrcog20160612","article-title":"Naturopathy and yoga in ameliorating multiple hormonal imbalance: A single case report","volume":"5","author":"Nair","year":"2016","journal-title":"Int J Reprod Contracept Obstet Gynecol"},{"key":"R21-20260424","doi-asserted-by":"crossref","first-page":"49","DOI":"10.4103\/0973-6131.85485","article-title":"Exploring the therapeutic effects of yoga and its ability to increase quality of life","volume":"4","author":"Woodyard","year":"2011","journal-title":"Int J Yoga"},{"key":"R22-20260424","doi-asserted-by":"crossref","first-page":"139","DOI":"10.4103\/ijoy.IJOY_62_16","article-title":"Study to evaluate the changes in polycystic ovarian morphology after naturopathic and yogic interventions","volume":"11","author":"Ratnakumari","year":"2018","journal-title":"Int J Yoga"},{"key":"R23-20260424","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/S0140-6736(03)15268-3","article-title":"Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies","volume":"363","year":"2004","journal-title":"Lancet"},{"key":"R24-20260424","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.fertnstert.2003.10.004","article-title":"Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome","volume":"81","year":"2004","journal-title":"Fertil Steril"},{"key":"R25-20260424","doi-asserted-by":"crossref","first-page":"112","DOI":"10.4103\/0973-6131.98223","article-title":"Effect of holistic yoga program on anxiety symptoms in adolescent girls with polycystic ovarian syndrome: A randomized control trial","volume":"5","author":"Nidhi","year":"2012","journal-title":"Int J Yoga"},{"key":"R26-20260424","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/0891-5849(90)90139-A","article-title":"Increase in free radical generation and lipid peroxidation following chemotherapy in patients with cancer","volume":"8","author":"Sangeetha","year":"1990","journal-title":"Free Radic Biol Med"},{"key":"R27-20260424","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1006\/abio.1996.0292","article-title":"The ferric reducing ability of plasma (FRAP) as a measure of \u201cantioxidant power\u201d: The FRAP assay","volume":"239","author":"Benzie","year":"1996","journal-title":"Anal Biochem"},{"key":"R28-20260424","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1111\/j.2044-8341.1959.tb00467.x","article-title":"The assessment of anxiety states by rating","volume":"32","author":"Hamilton","year":"1959","journal-title":"Br J Med Psychol"},{"key":"R29-20260424","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1136\/jnnp.23.1.56","article-title":"A rating scale for depression","volume":"23","author":"Hamilton","year":"1960","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"R30-20260424","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1089\/acm.2011.0868","article-title":"Effects of a holistic yoga program on endocrine parameters in adolescents with polycystic ovarian syndrome: A randomized controlled trial","volume":"19","author":"Nidhi","year":"2013","journal-title":"J Altern Complement Med"},{"key":"R31-20260424","doi-asserted-by":"crossref","first-page":"1525","DOI":"10.4103\/jfmpc.jfmpc_651_21","article-title":"Effect of integrated approach of yoga and naturopathy on polycystic ovarian syndrome: A case study","volume":"11","author":"Shrivastava","year":"2022","journal-title":"J Family Med Prim Care"},{"key":"R32-20260424","doi-asserted-by":"crossref","first-page":"103","DOI":"10.4103\/ijoy.IJOY_46_16","article-title":"Yoga practice improves the body mass index and blood pressure: A randomized controlled trial","volume":"10","author":"Chauhan","year":"2017","journal-title":"Int J Yoga"},{"key":"R33-20260424","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1177\/15598276211029221","article-title":"Effect of yoga therapy on health outcomes in women with polycystic ovary syndrome: A systematic review and meta-analysis","volume":"17","author":"Verma","year":"2023","journal-title":"Am J Lifestyle Med"},{"key":"R34-20260424","first-page":"dgae446","article-title":"Causal association between BMI and polycystic ovarian syndrome: Bidirectional two-sample Mendelian randomization study","author":"Fang","year":"2024","journal-title":"J Clin Endocrinol Metab"},{"key":"R35-20260424","first-page":"622","article-title":"Polycystic ovary syndrome: A common reproductive syndrome with long-term metabolic consequences","volume":"23","author":"Yau","year":"2017","journal-title":"Hong Kong Med J"},{"key":"R36-20260424","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1055\/s-0030-1249020","article-title":"Very high frequency of the polymorphism for the insulin receptor substrate 1 (IRS-1) at codon 972 (glycine972arginine) in Southern Italian women with polycystic ovary syndrome","volume":"42","author":"Pappalardo","year":"2010","journal-title":"Horm Metab Res"},{"key":"R37-20260424","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1007\/s40618-016-0569-7","article-title":"Gly972Arg of IRS-1 and Lys121Gln of PC-1 polymorphisms act in opposite way in polycystic ovary syndrome","volume":"40","author":"Pappalardo","year":"2017","journal-title":"J Endocrinol Invest"},{"key":"R38-20260424","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1089\/acm.2010.0676","article-title":"Impact of yoga nidra on menstrual abnormalities in females of reproductive age","volume":"19","author":"Rani","year":"2013","journal-title":"J Altern Complement Med"},{"key":"R39-20260424","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1111\/j.1365-2265.1990.tb03887.x","article-title":"The prevalence of polycystic ovaries in patients with congenital adrenal hyperplasia and their close relatives","volume":"33","author":"Hague","year":"1990","journal-title":"Clin Endocrinol (Oxf)"},{"key":"R40-20260424","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1210\/mend.13.6.0311","article-title":"Augmented androgen production is a stable steroidogenic phenotype of propagated theca cells from polycystic ovaries","volume":"13","author":"Nelson","year":"1999","journal-title":"Mol Endocrinol"},{"key":"R41-20260424","doi-asserted-by":"crossref","first-page":"1238","DOI":"10.1007\/s12020-024-03726-2","article-title":"Increased oxidative stress is associated with hyperandrogenemia in polycystic ovary syndrome evidenced by oxidized lipoproteins stimulating rat ovarian androgen synthesis in vitro","volume":"84","author":"Zhang","year":"2024","journal-title":"Endocrine"},{"key":"R42-20260424","doi-asserted-by":"crossref","first-page":"869.","DOI":"10.3390\/metabo11120869","article-title":"Metabolic syndrome and PCOS: Pathogenesis and the role of metabolites","volume":"11","author":"Chen","year":"2021","journal-title":"Metabolites"},{"key":"R43-20260424","first-page":"32","article-title":"Narrative review of yoga intervention clinical trials including weight-related outcomes","volume":"19","author":"Rioux","year":"2013","journal-title":"Altern Ther Health Med"},{"key":"R44-20260424","doi-asserted-by":"crossref","first-page":"3115","DOI":"10.1210\/jc.2011-0651","article-title":"Induction of oxidative stress and human leukocyte\/endothelial cell interactions in polycystic ovary syndrome patients with insulin resistance","volume":"96","author":"Victor","year":"2011","journal-title":"J Clin Endocrinol Metab"},{"key":"R45-20260424","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1161\/01.RES.87.10.840","article-title":"Endothelial dysfunction in cardiovascular diseases: The role of oxidant stress","volume":"87","author":"Cai","year":"2000","journal-title":"Circ Res"},{"key":"R46-20260424","doi-asserted-by":"crossref","first-page":"1667.","DOI":"10.3390\/ijms22041667","article-title":"Oxidative stress and low-grade inflammation in polycystic ovary syndrome: Controversies and new insights","volume":"22","author":"Mancini","year":"2021","journal-title":"Int J Mol Sci"},{"key":"R47-20260424","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2016\/8589318","article-title":"Roles of oxidative stress in polycystic ovary syndrome and cancers","volume":"2016","author":"Zuo","year":"2016","journal-title":"Oxid Med Cell Longev"},{"key":"R48-20260424","doi-asserted-by":"crossref","first-page":"43.","DOI":"10.1186\/1477-7827-3-43","article-title":"Fundamental roles of reactive oxygen species and protective mechanisms in the female reproductive system","volume":"3","author":"Fujii","year":"2005","journal-title":"Reprod Biol Endocrinol"},{"key":"R49-20260424","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1016\/j.rbmo.2015.12.010","article-title":"Oxidative stress in follicular fluid of young women with low response compared with fertile oocyte donors","volume":"32","author":"Nu\u00f1ez-Calonge","year":"2016","journal-title":"Reprod Biomed Online"},{"key":"R50-20260424","doi-asserted-by":"crossref","first-page":"136","DOI":"10.5152\/jtgga.2013.53323","article-title":"Effect of follicular fluid NO, MDA and GSH levels on in vitro fertilization outcomes","volume":"14","author":"Yal\u00e7\u0131nkaya","year":"2013","journal-title":"J Turk Ger Gynecol Assoc"},{"key":"R51-20260424","first-page":"373","article-title":"Oxidative stress and anti-oxidant defense system in Iranian women with polycystic ovary syndrome","volume":"13","author":"Moti","year":"2015","journal-title":"Iran J Reprod Med"},{"key":"R52-20260424","doi-asserted-by":"crossref","first-page":"1561","DOI":"10.1517\/14728222.2015.1101067","article-title":"Targets to treat metabolic syndrome in polycystic ovary syndrome","volume":"19","author":"Mahalingaiah","year":"2015","journal-title":"Expert Opin Ther Targets"},{"key":"R53-20260424","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1042\/BJ20081386","article-title":"How mitochondria produce reactive oxygen species","volume":"417","author":"Murphy","year":"2009","journal-title":"Biochem J"},{"key":"R54-20260424","article-title":"Yogic practices on oxidative stress and of antioxidant level: A systematic review of randomized controlled trials","volume":"16","author":"Pal","year":"2017","journal-title":"J Complement Integr Med"},{"key":"R55-20260424","first-page":"115","article-title":"Effects of yoga on blood pressure and malondialdehyde (MDA) in mild hypertensive patients","author":"AYu","year":"2020","journal-title":"Adv Clin Med Res"},{"key":"R56-20260424","doi-asserted-by":"crossref","first-page":"1822","DOI":"10.1111\/1756-185X.13118","article-title":"Role of hydrotherapy in the amelioration of oxidant-antioxidant status in rheumatoid arthritis patients","volume":"21","author":"Mateen","year":"2018","journal-title":"Int J Rheum Dis"},{"key":"R57-20260424","doi-asserted-by":"crossref","first-page":"64.","DOI":"10.3390\/geriatrics7030064","article-title":"Impact of hydrotherapy on antioxidant enzyme activity in an elderly population","volume":"7","author":"Valado","year":"2022","journal-title":"Geriatrics (Basel)"},{"key":"R58-20260424","doi-asserted-by":"crossref","first-page":"915","DOI":"10.1016\/j.mayocp.2023.01.008","article-title":"Does the combination of Finnish sauna bathing and other lifestyle factors confer additional health benefits? A review of the evidence","volume":"98","author":"Kunutsor","year":"2023","journal-title":"Mayo Clin Proc"},{"key":"R59-20260424","doi-asserted-by":"crossref","first-page":"942.","DOI":"10.3390\/medicina58070942","article-title":"Anxiety and depression in women with polycystic ovary syndrome","volume":"58","author":"Dybciak","year":"2022","journal-title":"Medicina (Kaunas)"},{"key":"R60-20260424","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/j.fertnstert.2011.10.022","article-title":"Increased prevalence of anxiety symptoms in women with polycystic ovary syndrome: Systematic review and meta-analysis","volume":"97","author":"Dokras","year":"2012","journal-title":"Fertil Steril"},{"key":"R61-20260424","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1176\/appi.psy.49.1.23","article-title":"Which measures of obesity are related to depressive symptoms and in whom?","volume":"49","author":"Lim","year":"2008","journal-title":"Psychosomatics"}],"container-title":["International Journal of Yoga"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ijoy.ijoy_180_24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:44:42Z","timestamp":1787838282000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ijoy.ijoy_180_24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9]]},"references-count":61,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.4103\/ijoy.ijoy_180_24","relation":{},"ISSN":["0973-6131","2231-2714"],"issn-type":[{"value":"0973-6131","type":"print"},{"value":"2231-2714","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9]]},"assertion":[{"value":"2024-08-12","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-21","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}