{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T03:57:31Z","timestamp":1790740651570,"version":"4.1.0"},"reference-count":30,"publisher":"MDPI AG","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:p>Studies have been conducted to evaluate the efficacy of dehydrated human amnion chorion membrane (dHACM) in treating recalcitrant diabetic foot ulcers. A literature search was performed to review the data collected from the use of dHACM allografts. Two products were explicitly named in these publications, EpiFix and AmnioBand Membrane. Relevant results included the healing rate, number of wounds healed, and number of grafts used. Data had supported the potential of lowering the overall cost to manage a wound despite a relatively higher cost per dressing. However, discrepancy was observed in the rate of healing between several of the studies. Nonetheless, dHACM had demonstrated improvement in healing of recalcitrant diabetic foot ulcers compared to standard of care alone. These results provide grounds for more inclusive research on dHACM in the future.<\/jats:p>","DOI":"10.7547\/17-154","type":"journal-article","created":{"date-parts":[[2021,4,20]],"date-time":"2021-04-20T01:47:07Z","timestamp":1618883227000},"source":"Crossref","is-referenced-by-count":8,"title":["Efficacy of Dehydrated Human Amnion Chorion Membrane in the Treatment of Diabetic Foot Ulcers: A Review"],"prefix":"10.3390","volume":"111","author":[{"given":"Andrew S.","family":"Au","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wai Y.","family":"Leung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James W.","family":"Stavosky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","reference":[{"key":"i8750-7315-111-2-Article_13-b01","article-title":"National Diabetes Statistics Report, 2014: Estimates of Diabetes and Its Burden in the United States","year":"2014","unstructured":"Centers for Disease Control and Prevention:\n          \n            National Diabetes Statistics Report, 2014: Estimates of Diabetes and Its Burden in the United States\n          .\n\t\t\t\t\tAtlanta, GA:\n\t\t\t\t\tUS Department of Health and Human Services;\n\t\t\t\t\t2014.\n\t\t\t\t24789311"},{"key":"i8750-7315-111-2-Article_13-b02","series-title":"JAMA","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1001\/jama.293.2.217","article-title":"Preventing foot ulcers in patients with diabetes","volume":"293","author":"Singh","year":"2005","unstructured":"Singh\n              N\n            \n            \n              Armstrong\n              DG\n            \n            \n              Lipsky\n              BA:\n            \n          \n          Preventing foot ulcers in patients with diabetes.\n\t\t\t\t\tJAMA293: 217,\n\t\t\t\t\t2005.\n\t\t\t\t1564454910.1001\/jama.293.2.217"},{"key":"i8750-7315-111-2-Article_13-b03","series-title":"Pharmacol Ther","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.pharmthera.2008.05.005","article-title":"Diabetic neuropathy: mechanisms to management","volume":"120","author":"Edwards","year":"2008","unstructured":"Edwards\n              JL\n            \n            \n              Vincent\n              AM\n            \n            \n              Cheng\n              HT\n            \n            :\n          \n          Diabetic neuropathy: mechanisms to management.\n\t\t\t\t\tPharmacol Ther120: 1,\n\t\t\t\t\t2008.\n\t\t\t\t10.1016\/j.pharmthera.2008.05.00518616962"},{"key":"i8750-7315-111-2-Article_13-b04","series-title":"Diabetes Care","doi-asserted-by":"publisher","first-page":"692","DOI":"10.2337\/diacare.22.5.692","article-title":"Healing of neuropathic ulcers: results of a meta-analysis","volume":"22","author":"Margolis","year":"1999","unstructured":"Margolis\n              D\n            \n            \n              Kantor\n              J\n            \n            \n              Berlin\n              J:\n            \n          \n          Healing of neuropathic ulcers: results of a meta-analysis.\n\t\t\t\t\tDiabetes Care22: 692,\n\t\t\t\t\t1999.\n\t\t\t\t1033266710.2337\/diacare.22.5.692"},{"key":"i8750-7315-111-2-Article_13-b05","series-title":"Diabetes Care","doi-asserted-by":"publisher","first-page":"491","DOI":"10.2337\/diacare.26.2.491","article-title":"Amputation and mortality in new-onset diabetic foot ulcers stratified by etiology","volume":"26","author":"Moulik","year":"2003","unstructured":"Moulik\n              P\n            \n            \n              Gill\n              GV:\n            \n          \n          Amputation and mortality in new-onset diabetic foot ulcers stratified by etiology.\n\t\t\t\t\tDiabetes Care26: 491,\n\t\t\t\t\t2003.\n\t\t\t\t1254788710.2337\/diacare.26.2.491"},{"key":"i8750-7315-111-2-Article_13-b06","series-title":"Int Wound J","doi-asserted-by":"publisher","first-page":"632","DOI":"10.1111\/j.1742-481X.2011.00860.x","article-title":"Differentiating diabetic foot ulcers that are unlikely to heal by 12 weeks following achieving 50% percent area reduction at 4 weeks","volume":"8","author":"Warriner","year":"2011","unstructured":"Warriner\n              RA\n            \n            \n              Snyder\n              RJ\n            \n            \n              Cardinal\n              MH:\n            \n          \n          Differentiating diabetic foot ulcers that are unlikely to heal by 12 weeks following achieving 50% percent area reduction at 4 weeks.\n\t\t\t\t\tInt Wound J8: 632,\n\t\t\t\t\t2011.\n\t\t\t\t2195176310.1111\/j.1742-481X.2011.00860.x"},{"key":"i8750-7315-111-2-Article_13-b07","series-title":"Int Wound J","doi-asserted-by":"publisher","first-page":"272","DOI":"10.1111\/iwj.12566","article-title":"Treatment of chronic diabetic lower extremity ulcers with advanced therapies: a prospective, randomised, controlled, multi-centre comparative study examining clinical efficacy and cost","volume":"13","author":"Zelen","year":"2016","unstructured":"Zelen\n              CM\n            \n            \n              Serena\n              TE\n            \n            \n              Gould\n              L\n            \n            :\n          \n          Treatment of chronic diabetic lower extremity ulcers with advanced therapies: a prospective, randomised, controlled, multi-centre comparative study examining clinical efficacy and cost.\n\t\t\t\t\tInt Wound J13: 272,\n\t\t\t\t\t2016.\n\t\t\t\t10.1111\/iwj.1256626695998"},{"key":"i8750-7315-111-2-Article_13-b08","series-title":"Int Wound J","doi-asserted-by":"publisher","first-page":"493","DOI":"10.1111\/iwj.12140","article-title":"Biological properties of dehydrated human amnion\/chorion composite graft: implications for chronic wound healing","volume":"10","author":"Koob","year":"2013","unstructured":"Koob\n              TJ\n            \n            \n              Rennert\n              R\n            \n            \n              Zabek\n              N\n            \n            :\n          \n          Biological properties of dehydrated human amnion\/chorion composite graft: implications for chronic wound healing.\n\t\t\t\t\tInt Wound J10: 493,\n\t\t\t\t\t2013.\n\t\t\t\t2390252610.1111\/iwj.12140"},{"key":"i8750-7315-111-2-Article_13-b09","series-title":"J Biomed Mater Res B Appl Biomater","doi-asserted-by":"publisher","first-page":"1353","DOI":"10.1002\/jbm.b.33141","article-title":"Properties of dehydrated human amnion\/chorion composite grafts: implications for wound repair and soft tissue regeneration","volume":"102","author":"Koob","year":"2014","unstructured":"Koob\n              TJ\n            \n            \n              Lim\n              JJ\n            \n            \n              Massee\n              M\n            \n            :\n          \n          Properties of dehydrated human amnion\/chorion composite grafts: implications for wound repair and soft tissue regeneration.\n\t\t\t\t\tJ Biomed Mater Res B Appl Biomater102: 1353,\n\t\t\t\t\t2014.\n\t\t\t\t10.1002\/jbm.b.3314124664953"},{"key":"i8750-7315-111-2-Article_13-b10","series-title":"Eur Cell Mater","first-page":"88","article-title":"Properties of the amniotic membrane for potential use in tissue engineering","volume":"15","author":"Niknejad","year":"2008","unstructured":"Niknejad\n              H\n            \n            \n              Habibollah\n              P\n            \n            \n              Masoumeh\n              J\n            \n            :\n          \n          Properties of the amniotic membrane for potential use in tissue engineering.\n\t\t\t\t\tEur Cell Mater15: 88,\n\t\t\t\t\t2008.\n\t\t\t\t18446690"},{"key":"i8750-7315-111-2-Article_13-b11","series-title":"J Wound Care","doi-asserted-by":"publisher","first-page":"347","DOI":"10.12968\/jowc.2013.22.7.347","article-title":"An evaluation of dehydrated human amniotic membrane allografts in patients with DFUs","volume":"22","author":"Zelen","year":"2013","unstructured":"Zelen\n              CM:\n            \n          \n          An evaluation of dehydrated human amniotic membrane allografts in patients with DFUs.\n\t\t\t\t\tJ Wound Care22: 347,\n\t\t\t\t\t2013.\n\t\t\t\t2415965610.12968\/jowc.2013.22.7.347"},{"key":"i8750-7315-111-2-Article_13-b12","series-title":"Int Wound J","doi-asserted-by":"publisher","first-page":"502","DOI":"10.1111\/iwj.12097","article-title":"A prospective randomised comparative parallel study of amniotic membrane wound graft in the management of diabetic foot ulcers","volume":"10","author":"Zelen","year":"2013","unstructured":"Zelen\n              CM\n            \n            \n              Serena\n              TE\n            \n            \n              Denoziere\n              G\n            \n            :\n          \n          A prospective randomised comparative parallel study of amniotic membrane wound graft in the management of diabetic foot ulcers.\n\t\t\t\t\tInt Wound J10: 502,\n\t\t\t\t\t2013.\n\t\t\t\t10.1111\/iwj.1209723742102"},{"key":"i8750-7315-111-2-Article_13-b13","series-title":"Int Wound J","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1111\/iwj.12242","article-title":"A prospective, randomised comparative study of weekly versus biweekly application of dehydrated human amnion\/chorion membrane allograft in the management of diabetic foot ulcers","volume":"11","author":"Zelen","year":"2014","unstructured":"Zelen\n              CM\n            \n            \n              Serena\n              TE\n            \n            \n              Snyder\n              RJ:\n            \n          \n          A prospective, randomised comparative study of weekly versus biweekly application of dehydrated human amnion\/chorion membrane allograft in the management of diabetic foot ulcers.\n\t\t\t\t\tInt Wound J11: 122,\n\t\t\t\t\t2014.\n\t\t\t\t10.1111\/iwj.1224224618401"},{"key":"i8750-7315-111-2-Article_13-b14","series-title":"Int Wound J","first-page":"724","article-title":"A prospective, randomised, controlled, multi-centre comparative effectiveness study of healing using dehydrated human amnion\/chorion membrane allograft, bioengineered skin substitute or standard of care for treatment of chronic lower extremity diabetic ulcers","volume":"12","author":"Zelen","year":"2015","unstructured":"Zelen\n              CM\n            \n            \n              Gould\n              L\n            \n            \n              Serena\n              TE\n            \n            :\n          \n          A prospective, randomised, controlled, multi-centre comparative effectiveness study of healing using dehydrated human amnion\/chorion membrane allograft, bioengineered skin substitute or standard of care for treatment of chronic lower extremity diabetic ulcers.\n\t\t\t\t\tInt Wound J12: 724,\n\t\t\t\t\t2015."},{"key":"i8750-7315-111-2-Article_13-b15","series-title":"Wound Repair Regen","doi-asserted-by":"publisher","first-page":"737","DOI":"10.1111\/wrr.12332","article-title":"Comparative effectiveness of a bioengineered living cellular construct vs. a dehydrated human amniotic membrane allograft for the treatment of diabetic foot ulcers in a real-world setting","volume":"23","author":"Kirsner","year":"2015","unstructured":"Kirsner\n              RS\n            \n            \n              Sabolinski\n              ML\n            \n            \n              Parsons\n              NB\n            \n            :\n          \n          Comparative effectiveness of a bioengineered living cellular construct vs. a dehydrated human amniotic membrane allograft for the treatment of diabetic foot ulcers in a real-world setting.\n\t\t\t\t\tWound Repair Regen23: 737,\n\t\t\t\t\t2015.\n\t\t\t\t10.1111\/wrr.12332"},{"key":"i8750-7315-111-2-Article_13-b16","series-title":"Wounds","first-page":"125","article-title":"The comparative effectiveness of a human fibroblast dermal substitute versus a dehydrated human amnion\/chorion membrane allograft for the treatment of diabetic foot ulcers in a real-world setting","volume":"29","author":"Kraus","year":"2017","unstructured":"Kraus\n              I\n            \n            \n              Sabolinski\n              ML\n            \n            \n              Skornicki\n              M\n            \n            :\n          \n          The comparative effectiveness of a human fibroblast dermal substitute versus a dehydrated human amnion\/chorion membrane allograft for the treatment of diabetic foot ulcers in a real-world setting.\n\t\t\t\t\tWounds29: 125,\n\t\t\t\t\t2017."},{"key":"i8750-7315-111-2-Article_13-b17","series-title":"Plast Reconstr Surg Glob Open","doi-asserted-by":"publisher","first-page":"e1095","DOI":"10.1097\/GOX.0000000000001095","article-title":"Aseptically processed placental membrane improves healing of diabetic foot ulcerations: prospective, randomized clinical trial","volume":"4","author":"DiDomenico","year":"2016","unstructured":"DiDomenico\n              LA\n            \n            \n              Orgill\n              DP\n            \n            \n              Galiano\n              RD\n            \n            :\n          \n          Aseptically processed placental membrane improves healing of diabetic foot ulcerations: prospective, randomized clinical trial.\n\t\t\t\t\tPlast Reconstr Surg Glob Open4: e1095,\n\t\t\t\t\t2016.\n\t\t\t\t10.1097\/GOX.000000000000109527826487"},{"key":"i8750-7315-111-2-Article_13-b18","series-title":"Int Wound J","doi-asserted-by":"publisher","first-page":"950","DOI":"10.1111\/iwj.12954","article-title":"Use of an aseptically processed, dehydrated human amnion and chorion membrane improves likelihood and rate of healing in chronic diabetic foot ulcers: a prospective, randomised, multi-centre clinical trial in 80 patients","volume":"15","author":"DiDomenico","year":"2018","unstructured":"DiDomenico\n              LA\n            \n            \n              Orgill\n              DP\n            \n            \n              Galiano\n              RD\n            \n            :\n          \n          Use of an aseptically processed, dehydrated human amnion and chorion membrane improves likelihood and rate of healing in chronic diabetic foot ulcers: a prospective, randomised, multi-centre clinical trial in 80 patients.\n\t\t\t\t\tInt Wound J15: 950,\n\t\t\t\t\t2018.\n\t\t\t\t3001952810.1111\/iwj.12954"},{"key":"i8750-7315-111-2-Article_13-b19","series-title":"Int Wound J","first-page":"9","article-title":"A confirmatory study on the efficacy of dehydrated human amnion\/chorion membrane dHACM allograft in the management of diabetic foot ulcers: a prospective, multicentre, randomised, controlled study of 110 patients from 14 wound clinics","volume":"16","author":"Tettelbach","year":"2019","unstructured":"Tettelbach\n              W\n            \n            \n              Cazzell\n              S\n            \n            \n              Reyzelman\n              AM\n            \n            :\n          \n          A confirmatory study on the efficacy of dehydrated human amnion\/chorion membrane dHACM allograft in the management of diabetic foot ulcers: a prospective, multicentre, randomised, controlled study of 110 patients from 14 wound clinics.\n\t\t\t\t\tInt Wound J16: 9,\n\t\t\t\t\t2019."},{"key":"i8750-7315-111-2-Article_13-b20","series-title":"JAPMA","first-page":"84","article-title":"Use of dehydrated human amnion\/chorion membrane allografts in more than 100 patients with six major types of refractory nonhealing wounds","volume":"108","author":"Garoufalis","year":"2018","unstructured":"Garoufalis\n              M\n            \n            \n              Nagesh\n              D\n            \n            \n              Sanchez\n              PJ\n            \n            :\n          \n          Use of dehydrated human amnion\/chorion membrane allografts in more than 100 patients with six major types of refractory nonhealing wounds.\n\t\t\t\t\tJAPMA108: 84,\n\t\t\t\t\t2018."},{"key":"i8750-7315-111-2-Article_13-b21","series-title":"Wounds","first-page":"S19","article-title":"Clinical experience using a dehydrated amnion\/chorion membrane construct for the management of wounds","volume":"31","author":"Caporusso","year":"2019","unstructured":"Caporusso\n              J\n            \n            \n              Abdo\n              R\n            \n            \n              Karr\n              J\n            \n            :\n          \n          Clinical experience using a dehydrated amnion\/chorion membrane construct for the management of wounds.\n\t\t\t\t\tWounds31: S19,\n\t\t\t\t\t2019.\n\t\t\t\t30933904"},{"key":"i8750-7315-111-2-Article_13-b22","series-title":"Plast Reconstr Surg Glob Open","doi-asserted-by":"publisher","first-page":"e2371","DOI":"10.1097\/GOX.0000000000002371","article-title":"Placental membrane provides improved healing efficacy and lower cost versus a tissue-engineered human skin in the treatment of diabetic foot ulcerations","volume":"7","author":"Glat","year":"2019","unstructured":"Glat\n              P\n            \n            \n              Orgill\n              DP\n            \n            \n              Galiano\n              R\n            \n            :\n          \n          Placental membrane provides improved healing efficacy and lower cost versus a tissue-engineered human skin in the treatment of diabetic foot ulcerations.\n\t\t\t\t\tPlast Reconstr Surg Glob Open7: e2371,\n\t\t\t\t\t2019.\n\t\t\t\t10.1097\/GOX.000000000000237131592387"},{"key":"i8750-7315-111-2-Article_13-b23","series-title":"Can Med Assoc J","first-page":"1237","article-title":"Human amniotic membrane: a versatile wound dressing","volume":"118","author":"Gruss","year":"1978","unstructured":"Gruss\n              JS\n            \n            \n              Jirsch\n              DW:\n            \n          \n          Human amniotic membrane: a versatile wound dressing.\n\t\t\t\t\tCan Med Assoc J118: 1237,\n\t\t\t\t\t1978.\n\t\t\t\t647542"},{"key":"i8750-7315-111-2-Article_13-b24","series-title":"JAPMA","first-page":"180","article-title":"Characteristics predicting the outcome in individuals with diabetic foot ulcerations","volume":"107","author":"Vella","year":"2017","unstructured":"Vella\n              L\n            \n            \n              Formosa\n              C:\n            \n          \n          Characteristics predicting the outcome in individuals with diabetic foot ulcerations.\n\t\t\t\t\tJAPMA107: 180,\n\t\t\t\t\t2017."},{"key":"i8750-7315-111-2-Article_13-b25","series-title":"AACN Clin Issues Crit Care Nurs","first-page":"578","article-title":"The influence of tissue oxygen and perfusion on wound healing","volume":"1","author":"Whitney","year":"1990","unstructured":"Whitney\n              JD:\n            \n          \n          The influence of tissue oxygen and perfusion on wound healing.\n\t\t\t\t\tAACN Clin Issues Crit Care Nurs1: 578,\n\t\t\t\t\t1990.\n\t\t\t\t2223323"},{"key":"i8750-7315-111-2-Article_13-b26","series-title":"Diabet Med","doi-asserted-by":"publisher","first-page":"977","DOI":"10.1111\/j.1464-5491.2007.02189.x","article-title":"The association between baseline characteristics and the outcome of foot lesions in a UK population with diabetes","volume":"24","author":"Ince","year":"2007","unstructured":"Ince\n              P\n            \n            \n              Kendrick\n              D\n            \n            \n              Game\n              F\n            \n            :\n          \n          The association between baseline characteristics and the outcome of foot lesions in a UK population with diabetes.\n\t\t\t\t\tDiabet Med24: 977,\n\t\t\t\t\t2007.\n\t\t\t\t10.1111\/j.1464-5491.2007.02189.x"},{"key":"i8750-7315-111-2-Article_13-b27","series-title":"JAPMA","first-page":"198","article-title":"Using amniotic membrane allografts in the treatment of neuropathic foot ulcers","volume":"104","author":"Shah","year":"2014","unstructured":"Shah\n              AP:\n            \n          \n          Using amniotic membrane allografts in the treatment of neuropathic foot ulcers.\n\t\t\t\t\tJAPMA104: 198,\n\t\t\t\t\t2014."},{"key":"i8750-7315-111-2-Article_13-b28","series-title":"Int Wound J","doi-asserted-by":"publisher","first-page":"485","DOI":"10.1111\/iwj.12458","article-title":"Amniotic membrane is a potential regenerative option for chronic non-healing wounds: a report of five cases receiving dehydrated human amnion\/chorion membrane allograft","volume":"13","author":"Mrugala","year":"2016","unstructured":"Mrugala\n              A\n            \n            \n              Sui\n              A\n            \n            \n              Plummer\n              M\n            \n            :\n          \n          Amniotic membrane is a potential regenerative option for chronic non-healing wounds: a report of five cases receiving dehydrated human amnion\/chorion membrane allograft.\n\t\t\t\t\tInt Wound J13: 485,\n\t\t\t\t\t2016.\n\t\t\t\t10.1111\/iwj.1245825974156"},{"key":"i8750-7315-111-2-Article_13-b29","series-title":"J Wound Care","doi-asserted-by":"publisher","first-page":"104","DOI":"10.12968\/jowc.2015.24.3.104","article-title":"Dehydrated human amnion\/chorion tissue in difficult- to-heal DFUs: a case series","volume":"24","author":"Penny","year":"2015","unstructured":"Penny\n              H\n            \n            \n              Rifkah\n              M\n            \n            \n              Weaver\n              A\n            \n            :\n          \n          Dehydrated human amnion\/chorion tissue in difficult- to-heal DFUs: a case series.\n\t\t\t\t\tJ Wound Care24: 104,\n\t\t\t\t\t2015.\n\t\t\t\t10.12968\/jowc.2015.24.3.10425764954"},{"key":"i8750-7315-111-2-Article_13-b30","series-title":"Wounds","first-page":"152","article-title":"The use of micronized dehydrated human amnion\/chorion membrane allograft for the treatment of diabetic foot ulcers: a case series","volume":"28","author":"Hawkins","year":"2016","unstructured":"Hawkins\n              B:\n            \n          \n          The use of micronized dehydrated human amnion\/chorion membrane allograft for the treatment of diabetic foot ulcers: a case series.\n\t\t\t\t\tWounds28: 152,\n\t\t\t\t\t2016.\n\t\t\t\t27191173"}],"container-title":["Journal of the American Podiatric Medical Association"],"original-title":[],"link":[{"URL":"https:\/\/japmaonline.org\/view\/journals\/apms\/111\/2\/i8750-7315-111-2-article_13.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/meridian.allenpress.com\/japma\/article-pdf\/doi\/10.7547\/17-154\/2812766\/i8750-7315-111-2-article_13.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/japmaonline.org\/downloadpdf\/journals\/apms\/111\/2\/i8750-7315-111-2-article_13.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/japmaonline.org\/downloadpdf\/journals\/apms\/111\/2\/i8750-7315-111-2-article_13.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T10:18:10Z","timestamp":1783505890000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1930-8264\/111\/2\/17154"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3]]},"references-count":30,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.7547\/17-154","relation":{},"ISSN":["8750-7315"],"issn-type":[{"value":"8750-7315","type":"print"}],"subject":[],"published":{"date-parts":[[2021,3]]}}}