{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T18:54:28Z","timestamp":1768416868222,"version":"3.49.0"},"reference-count":58,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n            <jats:title>Objective:<\/jats:title>\n            <jats:p>The objective of this review was to examine the effectiveness of oral hygiene care for the management of oral symptoms in patients with cancer receiving specialist palliative care and the patients\u2019 experience of oral symptoms and oral hygiene care.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Introduction:<\/jats:title>\n            <jats:p>Oral symptoms, such as xerostomia, mouth pain, or dysgeusia, are highly prevalent in patients with cancer receiving specialist palliative care. These symptoms negatively affect patients\u2019 quality of life. Oral hygiene care can assist in the management of oral symptoms. This care could be improved with a more systematic approach, adequate guidelines, and training to properly integrate it into the care provided by specialist palliative care teams.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Eligibility criteria:<\/jats:title>\n            <jats:p>This review considered quantitative, qualitative, and mixed methods studies on oral hygiene care for the management of oral symptoms in adult patients with cancer, aged 18 years or older, diagnosed with any type of cancer, receiving specialist palliative care. For the quantitative component, eligible studies measured the effectiveness of oral hygiene care, of any frequency or duration, using any valid method, for the management of oral symptoms. Oral hygiene care interventions were compared with standard care, another experimental care, or there was no comparison. For the qualitative component, eligible studies explored participants\u2019 experiences of oral symptoms and the provision of oral hygiene care. Specialist palliative care was provided in several settings, including palliative care units, inpatient hospice, home palliative care teams, or day care centers.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>The search was conducted in PubMed (NLM), CINAHL Complete (EBSCOhost), Cochrane Central Register of Controlled Trials, Dentistry and Oral Sciences Source (EBSCOhost), and MedicLatina (EBSCOhost). Sources of unpublished studies and gray literature searched included Networked Digital Library of Theses and Dissertations and Reposit\u00f3rios Cient\u00edficos de Acesso Aberto de Portugal. Studies in English, Portuguese, and Spanish from 2000 to October 2023 were considered. Methodological quality was assessed and data were extracted by 2 reviewers. Synthesis and integration followed the JBI convergent segregated approach for mixed methods reviews. Meta-analysis of quantitative studies was not possible and findings were reported narratively. Meta-aggregation was used to pool findings of qualitative studies.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>Six studies (2 randomized controlled trials, 2 quasi-experimental studies, and 2 qualitative studies) were included, involving 451 participants. Studies that had a methodological quality of 75% or higher, based on affirmative answers in the respective critical assessment tool, were included in the review. Evidence indicated that oral hygiene care may be effective for the management of oral symptoms. Patients reported a reduction in oral symptoms, such as xerostomia, accompanied by a reduction of oral mucositis and retention of oral debris. One synthesized finding indicated that patients with cancer receiving specialist palliative care may experience oral symptoms that have detrimental effects on their physical and psychosocial well-being. Oral care may be performed by the patients themselves or by others, but is not seen as a priority by some patients. The integrated evidence supports that oral symptoms affect oral functions and that oral hygiene care may help manage several oral symptoms; however, due to the limited evidence, further integration was not possible.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Patients with cancer receiving specialist palliative care experience a wide variety of oral symptoms that affect oral functions, psychosocial well-being, and quality of life. Although more robust evidence is needed, the available evidence indicates that regular oral hygiene care may help manage oral symptoms.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Supplemental digital content:<\/jats:title>\n            <jats:p>Translations of the review abstract are available in Spanish http:\/\/links.lww.com\/SRX\/A105 and Portuguese http:\/\/links.lww.com\/SRX\/A106.<\/jats:p>\n          <\/jats:sec>","DOI":"10.11124\/jbies-24-00204","type":"journal-article","created":{"date-parts":[[2025,6,23]],"date-time":"2025-06-23T08:00:43Z","timestamp":1750665643000},"page":"1565-1601","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Oral hygiene care and the management of oral symptoms in patients with cancer in palliative care: a mixed methods systematic review"],"prefix":"10.11124","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4008-4547","authenticated-orcid":false,"given":"Ricardo","family":"Serra","sequence":"first","affiliation":[{"name":"Department of Health Sciences and Technologies, Polytechnic University of Portalegre, Portalegre, Portugal"},{"name":"University of Lisbon, Lisbon, Portugal"},{"name":"Lisbon School of Nursing, Lisbon, Portugal"},{"name":"CARE \u2013 Research Center on Health and Social Sciences, Portalegre, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5242-6167","authenticated-orcid":false,"given":"Sofia","family":"Roque","sequence":"additional","affiliation":[{"name":"Department of Health Sciences and Technologies, Polytechnic University of Portalegre, Portalegre, Portugal"},{"name":"CARE \u2013 Research Center on Health and Social Sciences, Portalegre, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7455-1081","authenticated-orcid":false,"given":"Helena","family":"Arco","sequence":"additional","affiliation":[{"name":"Department of Health Sciences and Technologies, Polytechnic University of Portalegre, Portalegre, Portugal"},{"name":"CARE \u2013 Research Center on Health and Social Sciences, Portalegre, Portugal"},{"name":"Comprehensive Health Research Center (CHRC), University of \u00c9vora, \u00c9vora, Portugal"}]}],"member":"276","published-online":{"date-parts":[[2025,8,8]]},"reference":[{"issue":"1","key":"R2-20250813","first-page":"278","article-title":"European Association for Palliative Care (EAPC). White Paper on standards and norms for hospice and palliative care in Europe: part 1","volume":"16","author":"Radbruch","year":"2009","journal-title":"Eur J Palliat Care"},{"issue":"3","key":"R3-20250813","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1038\/nrclinonc.2015.201","article-title":"Integrating palliative care into the trajectory of cancer care","volume":"13","author":"Hui","year":"2016","journal-title":"Nat Rev Clin Oncol"},{"issue":"11","key":"R4-20250813","doi-asserted-by":"crossref","first-page":"e588","DOI":"10.1016\/S1470-2045(18)30415-7","article-title":"Integration of oncology and palliative care: a Lancet Oncology Commission","volume":"19","author":"Kaasa","year":"2018","journal-title":"Lancet Oncol"},{"issue":"8","key":"R5-20250813","doi-asserted-by":"crossref","first-page":"e1004436","DOI":"10.1371\/journal.pmed.1004436","article-title":"Benefits of specialist palliative care by identifying active ingredients of service composition, structure, and delivery model: a systematic review with meta-analysis and meta-regression","volume":"21","author":"Johnson","year":"2024","journal-title":"PLoS Med"},{"issue":"4","key":"R7-20250813","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1055\/s-0037-1608702","article-title":"The role of palliative care in oncology","volume":"34","author":"Agarwal","journal-title":"Semin Intervent Radiol"},{"issue":"2","key":"R8-20250813","first-page":"1463","article-title":"Factors affecting the oral health of inpatients with advanced cancer in palliative care","volume":"30","author":"Furuya","year":"2022","journal-title":"Support Care Cancer"},{"issue":"9","key":"R9-20250813","first-page":"607","article-title":"Prevalence of oral diseases in patients under palliative care: a systematic review and meta-analysis","volume":"32","author":"Silva","year":"2024","journal-title":"Support Care Cancer"},{"issue":"8","key":"R10-20250813","first-page":"4357","article-title":"Oral symptoms in patients with advanced cancer: an observational study using a novel oral symptom assessment scale","volume":"29","author":"Davies","year":"2021","journal-title":"Support Care Cancer"},{"issue":"3","key":"R11-20250813","first-page":"881","article-title":"Systematic literature review: xerostomia in advanced cancer patients","volume":"23","author":"Hanchanale","year":"2015","journal-title":"Support Care Cancer"},{"issue":"12","key":"R12-20250813","doi-asserted-by":"crossref","first-page":"2918","DOI":"10.1002\/cam4.1221","article-title":"Common oral complications of head and neck cancer radiation therapy: mucositis, infections, saliva change, fibrosis, sensory dysfunctions, dental caries, periodontal disease, and osteoradionecrosis","volume":"6","author":"Sroussi","year":"2017","journal-title":"Cancer Med"},{"issue":"3","key":"R13-20250813","first-page":"803","article-title":"Oral health conditions affect functional and social activities of terminally ill cancer patients","volume":"22","author":"Fischer","year":"2014","journal-title":"Support Care Cancer"},{"issue":"11","key":"R14-20250813","first-page":"3249","article-title":"Prevalence of oral mucositis, dry mouth, and dysphagia in advanced cancer patients","volume":"23","author":"Mercadante","year":"2015","journal-title":"Support Care Cancer"},{"issue":"5","key":"R15-20250813","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1111\/scd.12316","article-title":"Oral health in end-of-life patients: a rapid review","volume":"38","author":"Fitzgerald","year":"2018","journal-title":"Spec Care Dentist"},{"issue":"18","key":"R16-20250813","doi-asserted-by":"crossref","first-page":"2387","DOI":"10.1001\/jama.289.18.2387","article-title":"Patterns of functional decline at the end of life","volume":"289","author":"Lunney","year":"2003","journal-title":"JAMA"},{"issue":"6","key":"R17-20250813","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1177\/0269216319839024","article-title":"The trajectory of functional decline over the last 4 months of life in a palliative care population: a prospective, consecutive cohort study","volume":"33","author":"Morgan","year":"2019","journal-title":"Palliat Med"},{"issue":"1","key":"R18-20250813","first-page":"157","article-title":"Associations between oral complications and days to death in palliative care patients","volume":"24","author":"Matsuo","year":"2016","journal-title":"Support Care Cancer"},{"issue":"10","key":"R20-20250813","doi-asserted-by":"crossref","first-page":"1138","DOI":"10.1177\/10499091231221204","article-title":"Association between oral health status and survival time in terminally ill cancer patients","volume":"41","author":"Lee","year":"2024","journal-title":"Am J Hosp Palliat Med"},{"issue":"10","key":"R21-20250813","doi-asserted-by":"crossref","first-page":"2360","DOI":"10.1111\/jan.12107","article-title":"A concept analysis of oral hygiene care in dependent older adults","volume":"69","author":"Coker","year":"2013","journal-title":"J Adv Nurs"},{"issue":"9","key":"R22-20250813","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1177\/1049909119829411","article-title":"Oral hygiene care in patients with advanced disease: an essential measure to improve oral cavity conditions and symptom management","volume":"36","author":"Magnani","year":"2019","journal-title":"Am J Hosp Palliat Med"},{"issue":"11","key":"R23-20250813","first-page":"8761","article-title":"MASCC\/ISOO expert opinion on the management of oral problems in patients with advanced cancer","volume":"30","author":"Jones","year":"2022","journal-title":"Support Care Cancer"},{"issue":"5","key":"R24-20250813","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1046\/j.1365-2648.2001.01697.x","article-title":"Advancing the science of symptom management","volume":"33","author":"Dodd","year":"2001","journal-title":"J Adv Nurs"},{"issue":"4","key":"R25-20250813","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1111\/ger.12198","article-title":"End-of-life palliative oral care in Norwegian health institutions. An exploratory study","volume":"33","author":"Kvalheim","year":"2016","journal-title":"Gerodontology"},{"issue":"5","key":"R26-20250813","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1016\/j.colegn.2020.04.001","article-title":"Perceptions of nurses towards oral health in palliative care: a qualitative study","volume":"27","author":"Kong","year":"2020","journal-title":"Collegian"},{"issue":"25","key":"R27-20250813","doi-asserted-by":"crossref","first-page":"2825","DOI":"10.1200\/JCO.21.01208","article-title":"Salivary gland hypofunction and\/or xerostomia induced by nonsurgical cancer therapies: ISOO\/MASCC\/ASCO Guideline","volume":"39","author":"Mercadante","year":"2021","journal-title":"J Clin Oncol"},{"issue":"10","key":"R28-20250813","first-page":"3949","article-title":"Systematic review of basic oral care for the management of oral mucositis in cancer patients and clinical practice guidelines","volume":"27","author":"Hong","year":"2019","journal-title":"Support Care Cancer"},{"issue":"19","key":"R29-20250813","doi-asserted-by":"crossref","first-page":"4423","DOI":"10.1002\/cncr.33100","article-title":"MASCC\/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy","volume":"126","author":"Elad","year":"2020","journal-title":"Cancer"},{"issue":"1","key":"R31-20250813","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1186\/s12903-020-01075-w","article-title":"Oral health problems among palliative and terminally ill patients: an integrated systematic review","volume":"20","author":"Venkatasalu","journal-title":"BMC Oral Health"},{"issue":"9","key":"R32-20250813","doi-asserted-by":"crossref","first-page":"2980","DOI":"10.21037\/apm-22-215","article-title":"A systematic review of interventional studies on oral care of palliative patients","volume":"11","author":"Dhaliwal","year":"2022","journal-title":"Ann Palliat Med"},{"issue":"1","key":"R33-20250813","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1177\/1466424006061174","article-title":"The assessment and implementation of mouth care in palliative care: a review","volume":"126","author":"Gillam","year":"2006","journal-title":"J R Soc Promot Health"},{"issue":"4","key":"R34-20250813","doi-asserted-by":"crossref","first-page":"673","DOI":"10.11124\/JBIES-23-00096","article-title":"Oral hygiene care and the management of oral symptoms in patients with cancer in palliative care: a mixed methods systematic review protocol","volume":"22","author":"Serra","year":"2024","journal-title":"JBI Evid Synth"},{"issue":"9","key":"R35-20250813","doi-asserted-by":"crossref","first-page":"1936","DOI":"10.11124\/JBIES-24-00382","article-title":"Erratum to: Oral hygiene care and the management of oral symptoms in patients with cancer in palliative care: a mixed methods systematic review protocol","volume":"22","year":"2024","journal-title":"JBI Evid Synth"},{"issue":"5","key":"R37-20250813","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1016\/S1470-2045(07)70138-9","article-title":"From margins to centre: a review of the history of palliative care in cancer","volume":"8","author":"Clark","year":"2007","journal-title":"Lancet Oncol"},{"issue":"1","key":"R38-20250813","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1097\/XEB.0000000000000152","article-title":"The development of software to support multiple systematic review types: the Joanna Briggs Institute System for the Unified Management, Assessment and Review of Information (JBI SUMARI)","volume":"17","author":"Munn","year":"2019","journal-title":"Int J Evid Based Healthc"},{"key":"R39-20250813","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"issue":"3","key":"R42-20250813","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1097\/XEB.0000000000000062","article-title":"Qualitative research synthesis: methodological guidance for systematic reviewers utilizing meta-aggregation","volume":"13","author":"Lockwood","year":"2015","journal-title":"Int J Evid Based Healthc"},{"issue":"3","key":"R43-20250813","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1097\/NJH.0000000000000745","article-title":"oral care experiences of palliative care patients, their relatives, and health care professionals: a qualitative study","volume":"23","author":"Bernardes Delgado","year":"2021","journal-title":"J Hosp Palliat Nurs"},{"key":"R44-20250813","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1191\/026921600672294077","article-title":"A comparison of artificial saliva and chewing gum in the management of xerostomia in patients with advanced cancer","volume":"14","author":"Davies","year":"2000","journal-title":"Palliat Med"},{"issue":"1","key":"R45-20250813","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1186\/s12904-020-00684-0","article-title":"Professional oral care in end-of-life patients with advanced cancers in a hospice ward: improvement of oral conditions","volume":"19","author":"Wu","year":"2020","journal-title":"BMC Palliat Care"},{"issue":"5","key":"R46-20250813","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1177\/1049909116633063","article-title":"Characteristics of oral problems and effects of oral care in terminally ill patients with cancer","volume":"34","author":"Nakajima","year":"2017","journal-title":"Am J Hosp Palliat Medicine"},{"issue":"9","key":"R47-20250813","first-page":"4997","article-title":"A mouth rinse based on a tea solution of Salvia officinalis for oral discomfort in palliative cancer care: a randomized controlled trial","volume":"29","author":"Monsen","year":"2021","journal-title":"Support Care Cancer"},{"issue":"7","key":"R49-20250813","doi-asserted-by":"crossref","first-page":"318","DOI":"10.12968\/ijpn.2002.8.7.10671","article-title":"Physical and psychosocial impact of xerostomia in palliative cancer care - a qualitative interview study","volume":"8","author":"Rydholm","year":"2002","journal-title":"Int J Palliat Nurs"},{"issue":"9","key":"R50-20250813","doi-asserted-by":"crossref","first-page":"439","DOI":"10.12968\/ijpn.2010.16.9.78638","article-title":"Oral discomfort in palliative care - results of an exploratory study of terminally ill","volume":"16","author":"Rohr","year":"2010","journal-title":"Int J Palliat Nurs"},{"issue":"5","key":"R51-20250813","doi-asserted-by":"crossref","first-page":"1330","DOI":"10.1002\/nop2.480","article-title":"Why oral palliative care takes a backseat? A national focus group study on experiences of palliative doctors, nurses and dentists","volume":"7","author":"Venkatasalu","year":"2020","journal-title":"Nurs Open"},{"issue":"1","key":"R52-20250813","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1186\/s12904-021-00859-3","article-title":"Oral health plays second fiddle in palliative care: an interview study with registered nurses in home healthcare","volume":"20","author":"Gustafsson","year":"2021","journal-title":"BMC Palliat Care"},{"issue":"2","key":"R53-20250813","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1002\/kjm2.12308","article-title":"Missed nursing care: an overview of reviews","volume":"37","author":"Chaboyer","year":"2021","journal-title":"Kaohsiung J Med Sci"},{"issue":"1","key":"R54-20250813","doi-asserted-by":"crossref","first-page":"e12257","DOI":"10.1111\/nup.12257","article-title":"Rationing of nursing care, a deviation from holistic nursing: a systematic review","volume":"21","author":"Mandal","year":"2020","journal-title":"Nurs Philos"},{"issue":"7","key":"R55-20250813","doi-asserted-by":"crossref","first-page":"1509","DOI":"10.1111\/j.1365-2648.2009.05027.x","article-title":"Missed nursing care: a concept analysis","volume":"65","author":"Kalisch","year":"2009","journal-title":"J Adv Nurs"},{"issue":"6","key":"R56-20250813","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.1016\/j.ijnurstu.2015.02.012","article-title":"Unfinished nursing care, missed care, and implicitly rationed care: state of the science review","volume":"52","author":"Jones","year":"2015","journal-title":"Int J Nurs Stud"},{"issue":"2","key":"R57-20250813","doi-asserted-by":"crossref","first-page":"224","DOI":"10.3390\/healthcare12020224","article-title":"Missed nursing care; prioritizing the patient\u2019s needs: an umbrella review","volume":"12","author":"Papathanasiou","year":"2024","journal-title":"Healthcare"},{"issue":"4","key":"R58-20250813","doi-asserted-by":"crossref","first-page":"820","DOI":"10.1016\/S0885-3924(01)00318-9","article-title":"Xerostomia in patients with advanced cancer","volume":"22","author":"Davies","year":"2001","journal-title":"J Pain Symptom Manage"},{"issue":"12","key":"R59-20250813","first-page":"3115","article-title":"Oral health is an important issue in end-of-life cancer care","volume":"20","author":"Wilberg","year":"2012","journal-title":"Support Care Cancer"},{"issue":"9","key":"R60-20250813","first-page":"7481","article-title":"Oral symptom assessment tools in patients with advanced cancer: a scoping review","volume":"30","author":"Cleary","year":"2022","journal-title":"Support Care Cancer"},{"issue":"3","key":"R61-20250813","first-page":"1121","article-title":"Palliative care assessment of dry mouth: what matters most to patients with advanced disease?","volume":"28","author":"Fleming","year":"2020","journal-title":"Support Care Cancer"},{"issue":"32","key":"R62-20250813","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1093\/jncimonographs\/lgh023","article-title":"Symptom clusters: the new frontier in symptom management research","author":"Miaskowski","year":"2004","journal-title":"J Natl Cancer Inst Monogr"},{"issue":"5","key":"R63-20250813","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1016\/j.jpainsymman.2023.08.005","article-title":"A novel approach to managing thirst and dry mouth in palliative care: a prospective randomized cross-over trial","volume":"66","author":"Phelan","year":"2023","journal-title":"J Pain Symptom Manage"},{"issue":"6","key":"R64-20250813","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1111\/eos.12655","article-title":"Randomized controlled trial of the effectiveness of three different oral moisturizers in palliative care patients","volume":"127","author":"Kvalheim","year":"2019","journal-title":"Eur J Oral Sci"},{"issue":"9","key":"R65-20250813","doi-asserted-by":"crossref","first-page":"418","DOI":"10.12968\/ijpn.2001.7.9.9300","article-title":"Oral care for people with advanced cancer: an evidence-based protocol","volume":"7","author":"Milligan","year":"2001","journal-title":"Int J Palliat Nurs"},{"issue":"1","key":"R66-20250813","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1186\/s12904-023-01276-4","article-title":"Xerostomia in patients with advanced cancer: a scoping review of clinical features and complications","volume":"22","author":"Walsh","year":"2023","journal-title":"BMC Palliat Care"}],"container-title":["JBI Evidence Synthesis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.11124\/JBIES-24-00204","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T19:00:34Z","timestamp":1755111634000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.11124\/JBIES-24-00204"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8]]},"references-count":58,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.11124\/jbies-24-00204","relation":{},"ISSN":["2689-8381"],"issn-type":[{"value":"2689-8381","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8]]}}}