{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T11:37:09Z","timestamp":1785411429785,"version":"3.56.0"},"reference-count":43,"publisher":"Open Medical Publishing","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec id=\"background\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Diabetic peripheral neuropathy (DPN) is a frequent and disabling complication of diabetes mellitus that impairs function, increases morbidity, and predisposes to orthopedic complications. Its relationship with physical activity in community dwelling patients with diabetes remains unclear, particularly in high burden settings such as Saudi Arabia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"objective\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine the association between physical activity level and reported peripheral neuropathy among adults with diabetes mellitus in the Northern Border Region of Saudi Arabia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A descriptive cross sectional study was conducted between November 2025 and February 2026 using an anonymous online questionnaire disseminated via social media. Adults aged \u226518 years with type 1 or type 2 diabetes residing in the Northern Border Region were eligible. Peripheral neuropathy was assessed using the Diabetic Neuropathy Symptom score, and physical activity was measured using the International Physical Activity Questionnaire\u2013Short Form. Participants were categorized into low, moderate, and high physical activity levels based on MET minutes\/week. Associations were examined using chi square tests and multivariable logistic regression, adjusting for demographic and clinical covariates, including metformin use and glycemic control.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 463 participants were analyzed; the prevalence of peripheral neuropathy was 78.6%. Neuropathy prevalence increased across physical activity levels (low: 66.7%; moderate: 78.2%; high: 84.3%; p = 0.040). High physical activity was associated with greater odds of neuropathy versus low activity (adjusted odds ratio 2.47, 95% confidence interval 1.07\u20135.70, p = 0.034). Metformin use was also independently associated with neuropathy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"conclusion\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>DPN was highly prevalent in this cohort. High physical activity and metformin use were independently associated with neuropathy, underscoring the need for neuropathy screening, individualized activity counseling, and consideration of vitamin B12 monitoring in metformin treated patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.52965\/001c.161807","type":"journal-article","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T20:06:09Z","timestamp":1780949169000},"source":"Crossref","is-referenced-by-count":0,"title":["Association between physical activity and peripheral neuropathy among patients with diabetes mellitus: A cross-sectional study"],"prefix":"10.52965","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2163-9132","authenticated-orcid":false,"given":"Raed","family":"AlRuwaili","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03j9tzj20","id-type":"ROR","asserted-by":"publisher"}],"name":"Northern Border University","department":["Department of Internal Medicine, Faculty of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rakan Nasser Abdullah","family":"Alruwaili","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03j9tzj20","id-type":"ROR","asserted-by":"publisher"}],"name":"Northern Border University","department":["Faculty of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aljawharah Mohammad H.","family":"Alshammari","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03j9tzj20","id-type":"ROR","asserted-by":"publisher"}],"name":"Northern Border University","department":["Faculty of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norah Khalid M.","family":"Alanazi","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03j9tzj20","id-type":"ROR","asserted-by":"publisher"}],"name":"Northern Border University","department":["Faculty of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusra R.","family":"Alruwaili","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03j9tzj20","id-type":"ROR","asserted-by":"publisher"}],"name":"Northern Border University","department":["Faculty of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mozon H.","family":"Alenzi","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03j9tzj20","id-type":"ROR","asserted-by":"publisher"}],"name":"Northern Border University","department":["Faculty of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bushra Aied H.","family":"Alenezi","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03j9tzj20","id-type":"ROR","asserted-by":"publisher"}],"name":"Northern Border University","department":["Faculty of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kadi Fahad","family":"Alfehaid","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03j9tzj20","id-type":"ROR","asserted-by":"publisher"}],"name":"Northern Border University","department":["Faculty of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3811-0822","authenticated-orcid":false,"given":"Baraah","family":"Abu Alsel","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01bazpc66","id-type":"ROR","asserted-by":"publisher"}],"name":"North Private College of Nursing","department":["Medical Sciences & Preparatory Year Department"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9313-2656","authenticated-orcid":false,"given":"Safya E.","family":"Esmaeel","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03j9tzj20","id-type":"ROR","asserted-by":"publisher"}],"name":"Northern Border University","department":["Department of Physiology, Faculty of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9039-8424","authenticated-orcid":false,"given":"Shereen Mohamed","family":"Olama","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03j9tzj20","id-type":"ROR","asserted-by":"publisher"}],"name":"Northern Border University","department":["Department of Internal Medicine, Faculty of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1994-2570","authenticated-orcid":false,"given":"Eslam K.","family":"Fahmy","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03j9tzj20","id-type":"ROR","asserted-by":"publisher"}],"name":"Northern Border University","department":["Department of Physiology, Faculty of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1252-8403","authenticated-orcid":true,"given":"Manal S.","family":"Fawzy","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03j9tzj20","id-type":"ROR","asserted-by":"publisher"}],"name":"Northern Border University","department":["Center for Health Research"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"30777","published-online":{"date-parts":[[2026,6,8]]},"reference":[{"issue":"2","key":"ref1","doi-asserted-by":"publisher","first-page":"e34504","DOI":"10.7759\/cureus.34504","article-title":"The Association Between Physical Activity and Peripheral Neuropathy in Diabetic Patients: A Cross-Sectional Multicenter Study From Saudi Arabia","volume":"15","author":"R. Y. AlKhotani","year":"2023","journal-title":"Cureus"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"15598276251372427","DOI":"10.1177\/15598276251372427","article-title":"The Role of Lifestyle Interventions for the Prevention and Treatment of Type 2 Diabetes: A Narrative Review","author":"O. P. Espinola","year":"2025","journal-title":"American journal of lifestyle medicine"},{"issue":"1","key":"ref3","doi-asserted-by":"publisher","first-page":"17","DOI":"10.3233\/BPL-180069","article-title":"The Neuroprotective Effects of Exercise: Maintaining a Healthy Brain Throughout Aging","volume":"4","author":"L. M. Vecchio","year":"2018","journal-title":"Brain plasticity"},{"issue":"16","key":"ref4","doi-asserted-by":"publisher","DOI":"10.3390\/ijms21165895","article-title":"Possible Neuroprotective Mechanisms of Physical Exercise in Neurodegeneration","volume":"21","author":"B. Mahalakshmi","year":"2020","journal-title":"Int J Mol Sci"},{"issue":"5","key":"ref5","doi-asserted-by":"publisher","first-page":"569","DOI":"10.60787\/nmj.v65i3.543","article-title":"Prevalence and Determinants of Diabetes in Saudi Arabia: A Cross-Sectional Analysis","volume":"65","author":"A. A. Alhur","year":"2024","journal-title":"Nigerian medical journal: journal of the Nigeria Medical Association"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1047","DOI":"10.2147\/jmdh.s401001","article-title":"A Systematic Review of Chronic Diseases and Their Prevalence Among the Population of Northern Borders Province (NBP) in Saudi Arabia","volume":"16","author":"E. O. Alenzi","year":"2023","journal-title":"Journal of multidisciplinary healthcare"},{"issue":"9","key":"ref7","doi-asserted-by":"publisher","first-page":"4897","DOI":"10.4103\/jfmpc.jfmpc_488_20","article-title":"Prevalence of painful diabetic peripheral neuropathy and its impact on quality of life among diabetic patients in Western region, Saudi Arabia","volume":"9","author":"M. H. AlSufyani","year":"2020","journal-title":"J Family Med Prim Care"},{"issue":"1","key":"ref8","doi-asserted-by":"publisher","first-page":"43","DOI":"10.4103\/jfcm.JFCM_145_16","article-title":"Painful Diabetic Peripheral Neuropathy among Saudi Diabetic Patients is Common but Under-recognized: Multicenter Cross-sectional study at primary health care setting","volume":"25","author":"M. A. Algeffari","year":"2018","journal-title":"Journal of family & community medicine"},{"issue":"11","key":"ref9","doi-asserted-by":"publisher","first-page":"e49317","DOI":"10.7759\/cureus.49317","article-title":"Prevalence of Painful Diabetic Peripheral Neuropathy Among Saudi Patients With Diabetes in Al Ahsa: A Cross-Sectional Study","volume":"15","author":"R. S. Alharajin","year":"2023","journal-title":"Cureus"},{"issue":"6","key":"ref10","doi-asserted-by":"publisher","first-page":"660","DOI":"10.1111\/j.1526-4637.2007.00347.x","article-title":"Painful diabetic neuropathy: epidemiology, natural history, early diagnosis, and treatment options","volume":"9","author":"A. Veves","year":"2008","journal-title":"Pain medicine"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"107843","DOI":"10.1016\/j.diabres.2019.107843","article-title":"Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9(th) edition","volume":"157","author":"P. Saeedi","year":"2019","journal-title":"Diabetes Res Clin Pract"},{"issue":"Suppl 1","key":"ref12","doi-asserted-by":"publisher","first-page":"S31","DOI":"10.4103\/sja.SJA_97_17","article-title":"Development and validation of Arabic version of the douleur neuropathique 4 questionnaire","volume":"11","author":"A. S. Terkawi","year":"2017","journal-title":"Saudi journal of anaesthesia"},{"issue":"5","key":"ref13","doi-asserted-by":"publisher","first-page":"578","DOI":"10.1111\/j.1464-5491.2011.03500.x","article-title":"Validation of DN4 as a screening tool for neuropathic pain in painful diabetic polyneuropathy","volume":"29","author":"V. Spallone","year":"2012","journal-title":"Diabetic medicine: a journal of the British Diabetic Association"},{"issue":"4","key":"ref14","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1016\/j.jtumed.2016.06.002","article-title":"Diabetic neuropathy and painful diabetic neuropathy in the Middle East and North Africa (MENA) region: Much work needs to be done","volume":"11","author":"I. N. Petropoulos","year":"2016","journal-title":"Journal of Taibah University Medical Sciences"},{"issue":"10","key":"ref15","doi-asserted-by":"publisher","first-page":"e011897","DOI":"10.1136\/bmjopen-2016-011897","article-title":"Prevalence, discomfort and self-relief behaviours of painful diabetic neuropathy in Taiwan: a cross-sectional study","volume":"6","author":"S.W. Jane","year":"2016","journal-title":"BMJ open"},{"issue":"10","key":"ref16","doi-asserted-by":"publisher","first-page":"2220","DOI":"10.2337\/dc11-1108","article-title":"Prevalence and characteristics of painful diabetic neuropathy in a large community-based diabetic population in the U.K.","volume":"34","author":"C. A. Abbott","year":"2011","journal-title":"Diabetes Care"},{"issue":"6","key":"ref17","doi-asserted-by":"publisher","first-page":"714","DOI":"10.1111\/jdi.12223","article-title":"Prevalence and risk factors of development of peripheral diabetic neuropathy in type 2 diabetes mellitus in a tertiary care setting","volume":"5","author":"D. Bansal","year":"2014","journal-title":"Journal of diabetes investigation"},{"issue":"1","key":"ref18","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1186\/s12889-018-6374-9","article-title":"A cross-sectional study to estimate the point prevalence of painful diabetic neuropathy in Eastern Libya","volume":"19","author":"S. Garoushi","year":"2019","journal-title":"BMC public health"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"534372","DOI":"10.3389\/fpubh.2020.534372","article-title":"Prevalence and Risk Factors for Diabetic Peripheral Neuropathy in Type 2 Diabetic Patients From 14 Countries: Estimates of the INTERPRET-DD Study","volume":"8","author":"Y. Lu","year":"2020","journal-title":"Frontiers in public health"},{"issue":"2","key":"ref20","doi-asserted-by":"publisher","first-page":"337","DOI":"10.1185\/03007990903471940","article-title":"Prevalence of painful diabetic peripheral neuropathy among patients suffering from diabetes mellitus in Saudi Arabia","volume":"26","author":"M. R. Halawa","year":"2010","journal-title":"Current Medical Research and Opinion"},{"issue":"1","key":"ref21","doi-asserted-by":"publisher","first-page":"197","DOI":"10.4103\/jfmpc.jfmpc_927_19","article-title":"Diabetic peripheral neuropathy among Saudi diabetic patients: A multicenter cross-sectional study at primary health care setting","volume":"9","author":"R. A. Sendi","year":"2020","journal-title":"J Family Med Prim Care"},{"issue":"1","key":"ref22","doi-asserted-by":"publisher","first-page":"136","DOI":"10.2337\/dc16-2042","article-title":"Diabetic Neuropathy: A Position Statement by the American Diabetes Association","volume":"40","author":"R. Pop-Busui","year":"2017","journal-title":"Diabetes Care"},{"issue":"9","key":"ref23","doi-asserted-by":"publisher","first-page":"1226","DOI":"10.2337\/dc17-0179","article-title":"Prevalence of and Risk Factors for Diabetic Peripheral Neuropathy in Youth With Type 1 and Type 2 Diabetes: SEARCH for Diabetes in Youth Study","volume":"40","author":"M. Jaiswal","year":"2017","journal-title":"Diabetes Care"},{"issue":"1 Suppl 1","key":"ref24","doi-asserted-by":"publisher","first-page":"S181","DOI":"10.2337\/dc25-S009","article-title":"9. Pharmacologic Approaches to Glycemic Treatment: Standards of Care in Diabetes-2025","volume":"48","author":"American Diabetes Association Professional Practice C","year":"2025","journal-title":"Diabetes Care"},{"issue":"1","key":"ref25","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1007\/s40520-025-03093-6","article-title":"Vigorous physical activity does not lower all-cause and cardio-cerebrovascular mortality more than moderate physical activity in aged hypertensive patients","volume":"37","author":"C. Li","year":"2025","journal-title":"Aging Clinical and Experimental Research"},{"issue":"6","key":"ref26","doi-asserted-by":"publisher","first-page":"e100379","DOI":"10.1371\/journal.pone.0100379","article-title":"Vitamin B12 status in metformin treated patients: systematic review","volume":"9","author":"Q. Liu","year":"2014","journal-title":"PloS one"},{"issue":"1","key":"ref27","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1007\/s11739-014-1157-5","article-title":"The role of metformin on vitamin B12 deficiency: a meta-analysis review","volume":"10","author":"M. Niafar","year":"2015","journal-title":"Internal and emergency medicine"},{"issue":"4","key":"ref28","doi-asserted-by":"publisher","first-page":"1754","DOI":"10.1210\/jc.2015-3754","article-title":"Long-term Metformin Use and Vitamin B12 Deficiency in the Diabetes Prevention Program Outcomes Study","volume":"101","author":"V. R. Aroda","year":"2016","journal-title":"The Journal of clinical endocrinology and metabolism"},{"issue":"9","key":"ref29","doi-asserted-by":"publisher","first-page":"e68550","DOI":"10.7759\/cureus.68550","article-title":"Vitamin B12 Deficiency in Patients Taking Metformin: Pathogenesis and Recommendations","volume":"16","author":"N. U. H. Ramzan","year":"2024","journal-title":"Cureus"},{"issue":"9","key":"ref30","doi-asserted-by":"publisher","first-page":"1227","DOI":"10.2337\/diacare.23.9.1227","article-title":"Increased intake of calcium reverses vitamin B12 malabsorption induced by metformin","volume":"23","author":"W. A. Bauman","year":"2000","journal-title":"Diabetes Care"},{"issue":"3","key":"ref31","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1097\/SMJ.0b013e3181ce0e4d","article-title":"Metformin-induced vitamin B12 deficiency presenting as a peripheral neuropathy","volume":"103","author":"D. S. Bell","year":"2010","journal-title":"Southern medical journal"},{"issue":"1","key":"ref32","doi-asserted-by":"publisher","first-page":"156","DOI":"10.2337\/dc09-0606","article-title":"Association of metformin, elevated homocysteine, and methylmalonic acid levels and clinically worsened diabetic peripheral neuropathy","volume":"33","author":"D. J. Wile","year":"2010","journal-title":"Diabetes Care"},{"issue":"6","key":"ref33","doi-asserted-by":"publisher","first-page":"1296","DOI":"10.1016\/j.neuron.2017.02.005","article-title":"New Horizons in Diabetic Neuropathy: Mechanisms, Bioenergetics, and Pain","volume":"93","author":"E. L. Feldman","year":"2017","journal-title":"Neuron"},{"issue":"11","key":"ref34","doi-asserted-by":"publisher","first-page":"1470","DOI":"10.1345\/aph.1R223","article-title":"Evaluation of vitamin B12 monitoring in a veteran population on long-term, high-dose metformin therapy","volume":"46","author":"S. A. Pierce","year":"2012","journal-title":"The Annals of pharmacotherapy"},{"issue":"3","key":"ref35","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1007\/s40801-022-00309-3","article-title":"Association Between HbA1c Levels and Diabetic Peripheral Neuropathy: A Case-Control Study of Patients with Type 2 Diabetes Using Claims Data","volume":"9","author":"K. Nozawa","year":"2022","journal-title":"Drugs - real world outcomes"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"313","DOI":"10.2147\/CIA.S97295","article-title":"Age as an independent factor for the development of neuropathy in diabetic patients","volume":"11","author":"S. Popescu","year":"2016","journal-title":"Clinical interventions in aging"},{"issue":"4","key":"ref37","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1056\/NEJMoa032782","article-title":"Vascular risk factors and diabetic neuropathy","volume":"352","author":"S. Tesfaye","year":"2005","journal-title":"The New England journal of medicine"},{"issue":"1","key":"ref38","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1038\/s41392-025-02175-1","article-title":"Diabetic neuropathy: cutting-edge research and future directions","volume":"10","author":"Y. Yang","year":"2025","journal-title":"Signal Transduct Target Ther"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"312","DOI":"10.1016\/j.bioactmat.2026.02.023","article-title":"Innovative strategies for diabetic peripheral neuropathy: From clinical management to emerging bioengineering solutions","volume":"61","author":"Z. He","year":"2026","journal-title":"Bioactive Materials"},{"issue":"4","key":"ref40","doi-asserted-by":"publisher","first-page":"542","DOI":"10.4093\/dmj.2025.0299","article-title":"Clinical Phenotypes of Diabetic Peripheral Neuropathy: Implications for Phenotypic-Based Therapeutics Strategies","volume":"49","author":"J. E. Lee","year":"2025","journal-title":"Diabetes & metabolism journal"},{"issue":"24","key":"ref41","doi-asserted-by":"publisher","first-page":"2367","DOI":"10.1056\/NEJMra1615439","article-title":"Diabetic Foot Ulcers and Their Recurrence","volume":"376","author":"D.G. Armstrong","year":"2017","journal-title":"The New England journal of medicine"},{"issue":"10","key":"ref42","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1007\/s11892-019-1212-8","article-title":"Epidemiology of Peripheral Neuropathy and Lower Extremity Disease in Diabetes","volume":"19","author":"C. W. Hicks","year":"2019","journal-title":"Current diabetes reports"},{"issue":"1","key":"ref43","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1186\/s13104-019-4088-4","article-title":"Factors associated with diabetic foot among type 2 diabetes in Northern area of Saudi Arabia: a descriptive study","volume":"12","author":"M. S. Fawzy","year":"2019","journal-title":"BMC research notes"}],"container-title":["Orthopedic Reviews"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/orthopedicreviews.openmedicalpublishing.org\/article\/161807-association-between-physical-activity-and-peripheral-neuropathy-among-patients-with-diabetes-mellitus-a-cross-sectional-study","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T20:06:10Z","timestamp":1780949170000},"score":1,"resource":{"primary":{"URL":"https:\/\/orthopedicreviews.openmedicalpublishing.org\/article\/161807-association-between-physical-activity-and-peripheral-neuropathy-among-patients-with-diabetes-mellitus-a-cross-sectional-study"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,8]]},"references-count":43,"URL":"https:\/\/doi.org\/10.52965\/001c.161807","relation":{},"ISSN":["2035-8164"],"issn-type":[{"value":"2035-8164","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,8]]}}}