{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T17:22:51Z","timestamp":1768584171877,"version":"3.49.0"},"reference-count":85,"publisher":"BMJ","issue":"11","license":[{"start":{"date-parts":[[2020,11,4]],"date-time":"2020-11-04T00:00:00Z","timestamp":1604448000000},"content-version":"unspecified","delay-in-days":3,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2020,7,20]]},"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>As a consequence of ovarian cancer and its treatment, many women with ovarian cancer have to deal with reduced physical function, fatigue, and loss of weight and\/or muscle mass, compromising quality of life. Exercise and dietary interventions can positively influence body composition, physical fitness and function, and fatigue in patients with cancer. However, there are no data from randomised controlled trials on the effectiveness of exercise and dietary interventions in patients with ovarian cancer. Due to a complex disease trajectory, a relatively poor survival and distinct disease-induced and treatment-induced side effects, it is unclear whether exercise and dietary interventions that were shown to be feasible and effective in other types of cancer produce comparable results in patients with ovarian cancer. The aim of this article is to present the design of the multicentre randomised controlled Physical Activity and Dietary intervention in OVArian cancer trial and to describe how the exercise and dietary intervention is tailored to specific comorbidities and disease-induced and treatment-induced adverse effects in patients with ovarian cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>Adult women with primary epithelial ovarian cancer who are scheduled to undergo first-line (neo)adjuvant chemotherapy (n=122) are randomly allocated to a combined exercise and dietary intervention or a usual care control group during chemotherapy. Primary outcomes are body composition, physical function and fatigue. Outcome measures will be assessed before the start of chemotherapy, 3\u2009weeks after completion of chemotherapy and 12 weeks later. The exercise and dietary intervention was tailored to ovarian cancer-specific comorbidities and adverse effects of ovarian cancer and its treatment following the i3-S strategy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>This study has been approved by the medical ethical committee of the Amsterdam UMC (reference: 018). Results of the study will be published in international peer-reviewed journals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>Netherlands Trial Registry (NTR6300).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-036854","type":"journal-article","created":{"date-parts":[[2020,11,4]],"date-time":"2020-11-04T16:37:52Z","timestamp":1604507872000},"page":"e036854","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":30,"title":["Rationale and study protocol of the Physical Activity and Dietary intervention in women with OVArian cancer (PADOVA) study: a randomised controlled trial to evaluate effectiveness of a tailored exercise and dietary intervention on body composition, physical function and fatigue in women with ovarian cancer undergoing chemotherapy"],"prefix":"10.1136","volume":"10","author":[{"given":"Stephanie","family":"Stelten","sequence":"first","affiliation":[{"name":"Epidemiology and Biostatistics, Amsterdam Public Health research institute, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands"},{"name":"Physiology, Radboud Institute of Health Sciences, Radboudumc, Nijmegen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meeke","family":"Hoedjes","sequence":"additional","affiliation":[{"name":"Medical and Clinical Psychology, Center of Research on Psychology in Somatic diseases, Tilburg University, Tilburg, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gemma G","family":"Kenter","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology, Cancer Center Amsterdam, Center for Gynaecologic Oncology Amsterdam (CGOA), Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands"},{"name":"Obstetrics and Gynaecology, Amsterdam UMC, Univ(ersity) of Amsterdam, Amsterdam, Netherlands"},{"name":"Gynaecology, Center for Gynaecologic Oncology Amsterdam (CGOA), The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ellen","family":"Kampman","sequence":"additional","affiliation":[{"name":"Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosalie J","family":"Huijsmans","sequence":"additional","affiliation":[{"name":"Rehabilitation Medicine, Amsterdam UMC, Vrije Universiteit van Amsterdam, Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luc RCW","family":"van Lonkhuijzen","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology, Amsterdam UMC, Univ(ersity) of Amsterdam, Amsterdam, Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8095-436X","authenticated-orcid":false,"given":"LM","family":"Buffart","sequence":"additional","affiliation":[{"name":"Epidemiology and Biostatistics, Amsterdam Public Health research institute, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands"},{"name":"Physiology, Radboud Institute of Health Sciences, Radboudumc, Nijmegen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,11,4]]},"reference":[{"key":"2025120600494737000_10.11.e036854.1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.29210"},{"key":"2025120600494737000_10.11.e036854.2","doi-asserted-by":"publisher","DOI":"10.20892\/j.issn.2095-3941.2016.0084"},{"key":"2025120600494737000_10.11.e036854.3","unstructured":"Netherlands CCCt . Epithelial ovarian carcinoma; national guidelines 2.0, 2012."},{"key":"2025120600494737000_10.11.e036854.4","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdt333"},{"key":"2025120600494737000_10.11.e036854.5","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.11253"},{"key":"2025120600494737000_10.11.e036854.6","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2407-12-77","article-title":"Monitoring physical and psychosocial symptom trajectories in ovarian cancer patients receiving chemotherapy","volume":"12","author":"Meraner","year":"2012","journal-title":"BMC Cancer"},{"key":"2025120600494737000_10.11.e036854.7","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.24520"},{"key":"2025120600494737000_10.11.e036854.8","doi-asserted-by":"publisher","DOI":"10.1097\/01.gco.0000192996.20040.24"},{"key":"2025120600494737000_10.11.e036854.9","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1002\/jcsm.12107","article-title":"Loss of skeletal muscle during neoadjuvant chemotherapy is related to decreased survival in ovarian cancer patients","volume":"7","author":"Rutten","year":"2016","journal-title":"J Cachexia Sarcopenia Muscle"},{"key":"2025120600494737000_10.11.e036854.10","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1016\/j.ygyno.2016.05.027","article-title":"Muscle composition measured by CT scan is a measurable predictor of overall survival in advanced ovarian cancer","volume":"142","author":"Kumar","year":"2016","journal-title":"Gynecol Oncol"},{"key":"2025120600494737000_10.11.e036854.11","first-page":"795","article-title":"Body weight changes in patients undergoing chemotherapy for ovarian cancer influence progression-free and overall survival","volume":"25","author":"Mardas","year":"2017","journal-title":"Support Care Cancer"},{"key":"2025120600494737000_10.11.e036854.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2006.01.059"},{"key":"2025120600494737000_10.11.e036854.13","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7525-5-25"},{"key":"2025120600494737000_10.11.e036854.14","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.08.147"},{"key":"2025120600494737000_10.11.e036854.15","first-page":"1015","article-title":"Dietary habits changes and quality of life in patients undergoing chemotherapy for epithelial ovarian cancer","volume":"23","author":"Mardas","year":"2015","journal-title":"Support Care Cancer"},{"key":"2025120600494737000_10.11.e036854.16","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1038\/sj.ejcn.1602540","article-title":"Malnutrition among gynaecological cancer patients","volume":"61","author":"Laky","year":"2007","journal-title":"Eur J Clin Nutr"},{"key":"2025120600494737000_10.11.e036854.17","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.ygyno.2014.07.103","article-title":"Impact of obesity on surgical and oncologic outcomes in ovarian cancer","volume":"135","author":"Kumar","year":"2014","journal-title":"Gynecol Oncol"},{"key":"2025120600494737000_10.11.e036854.18","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.22194"},{"key":"2025120600494737000_10.11.e036854.19","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0140403","article-title":"Skeletal muscle depletion and markers for cancer cachexia are strong prognostic factors in epithelial ovarian cancer","volume":"10","author":"Aust","year":"2015","journal-title":"PLoS One"},{"key":"2025120600494737000_10.11.e036854.20","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1001\/jamaoncol.2015.1796","article-title":"Impact of chemotherapy dosing on ovarian cancer survival according to body mass index","volume":"1","author":"Bandera","year":"2015","journal-title":"JAMA Oncol"},{"key":"2025120600494737000_10.11.e036854.21","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2014\/349546","article-title":"Impact of underweight after treatment on prognosis of advanced-stage ovarian cancer","volume":"2014","author":"Kim","year":"2014","journal-title":"J Immunol Res"},{"key":"2025120600494737000_10.11.e036854.22","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2007.06.010"},{"key":"2025120600494737000_10.11.e036854.23","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdu250"},{"key":"2025120600494737000_10.11.e036854.24","doi-asserted-by":"crossref","first-page":"1252","DOI":"10.1249\/MSS.0000000000001937","article-title":"Physical activity in cancer prevention and survival: a systematic review","volume":"51","author":"McTiernan","year":"2019","journal-title":"Med Sci Sports Exerc"},{"key":"2025120600494737000_10.11.e036854.25","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1007\/s11764-016-0592-x","article-title":"Evaluation of resistance training to improve muscular strength and body composition in cancer patients undergoing neoadjuvant and adjuvant therapy: a meta-analysis","volume":"11","author":"Padilha","year":"2017","journal-title":"J Cancer Surviv"},{"key":"2025120600494737000_10.11.e036854.26","doi-asserted-by":"crossref","first-page":"1253","DOI":"10.1093\/jn\/nxy119","article-title":"A ketogenic diet reduces central obesity and serum insulin in women with ovarian or endometrial cancer","volume":"148","author":"Cohen","year":"2018","journal-title":"J Nutr"},{"key":"2025120600494737000_10.11.e036854.27","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-015-0513-2"},{"key":"2025120600494737000_10.11.e036854.28","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.59.1081"},{"key":"2025120600494737000_10.11.e036854.29","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.40.0895"},{"key":"2025120600494737000_10.11.e036854.30","doi-asserted-by":"publisher","DOI":"10.1016\/j.jand.2014.07.005"},{"key":"2025120600494737000_10.11.e036854.31","doi-asserted-by":"crossref","DOI":"10.1186\/s12970-017-0177-8","article-title":"International society of sports nutrition position stand: protein and exercise","volume":"14","author":"J\u00e4ger","year":"2017","journal-title":"J Int Soc Sports Nutr"},{"key":"2025120600494737000_10.11.e036854.32","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1007\/978-3-642-04231-7_13","article-title":"Physical activity and gynecologic cancer survivorship","volume":"186","author":"Gil","year":"2011","journal-title":"Recent Results Cancer Res"},{"key":"2025120600494737000_10.11.e036854.33","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2407-11-389","article-title":"Safety, feasibility and effects of an individualised walking intervention for women undergoing chemotherapy for ovarian cancer: a pilot study","volume":"11","author":"Newton","year":"2011","journal-title":"BMC Cancer"},{"key":"2025120600494737000_10.11.e036854.34","doi-asserted-by":"publisher","DOI":"10.1097\/IGC.0000000000000460"},{"key":"2025120600494737000_10.11.e036854.35","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2011.04.043"},{"key":"2025120600494737000_10.11.e036854.36","unstructured":"Wereld Kanker Onderzoeks Fonds . Gezond leven Na kanker, 2017."},{"key":"2025120600494737000_10.11.e036854.37","unstructured":"Oncoline . Algemene voedings- en dieetbehandeling 2017, 2018. Available: https:\/\/www.oncoline.nl\/voedings-en-dieetbehandeling [Accessed 20 Aug 2018]."},{"key":"2025120600494737000_10.11.e036854.38","unstructured":"Oncoline . Eierstokkanker, 2017. Available: https:\/\/www.oncoline.nl\/voeding-eierstokkanker"},{"key":"2025120600494737000_10.11.e036854.39","unstructured":"Oncoline . Ondervoeding bij patienten Met kanker, 2012. Available: https:\/\/www.oncoline.nl\/ondervoeding-bij-patienten-met-kanker"},{"key":"2025120600494737000_10.11.e036854.40","unstructured":"World cancer research fund\/American Institute for cancer research . Diet, nutrition, physical activity and cancer: a global perspective continuous update project expert report, 2018."},{"key":"2025120600494737000_10.11.e036854.41","unstructured":"Arends J , Bachmann P , Baracos V , et al . ESPEN guidelines on nutrition in cancer patients. Clin Nutr 2016."},{"key":"2025120600494737000_10.11.e036854.42","doi-asserted-by":"crossref","first-page":"905","DOI":"10.3109\/09638288.2015.1066451","article-title":"Exercise and comorbidity: the i3-S strategy for developing comorbidity-related adaptations to exercise therapy","volume":"38","author":"Dekker","year":"2016","journal-title":"Disabil Rehabil"},{"key":"2025120600494737000_10.11.e036854.43","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/09638288.2016.1260647","article-title":"Tailoring exercise interventions to comorbidities and treatment-induced adverse effects in patients with early stage breast cancer undergoing chemotherapy: a framework to support clinical decisions","volume":"40","author":"van der Leeden","year":"2018","journal-title":"Disabil Rehabil"},{"key":"2025120600494737000_10.11.e036854.44","doi-asserted-by":"crossref","first-page":"829","DOI":"10.2147\/CIA.S55705","article-title":"Development of comorbidity-adapted exercise protocols for patients with knee osteoarthritis","volume":"9","author":"de Rooij","year":"2014","journal-title":"Clin Interv Aging"},{"key":"2025120600494737000_10.11.e036854.45","unstructured":"WHO . International statistical classification of diseases and related health problems (10th revision). Available: https:\/\/icd.who.int\/browse10\/2016\/en2019"},{"key":"2025120600494737000_10.11.e036854.46","unstructured":"Farmacotherapeutisch Kompas: Zorginstituut Nederland. Available: https:\/\/farmacotherapeutischkompas.nl [Accessed 20 Sept 2017]."},{"key":"2025120600494737000_10.11.e036854.47","unstructured":"Oncoline . Epitheliaal ovariumcarcinoom 2.1: Integraal Kankercentrum Nederland, 2018."},{"key":"2025120600494737000_10.11.e036854.48","unstructured":"Oncoline . Ascites, versie 2.0: Integraal Kankercentrum Nederland, 2010."},{"key":"2025120600494737000_10.11.e036854.49","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.678326"},{"key":"2025120600494737000_10.11.e036854.50","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2010-082719"},{"key":"2025120600494737000_10.11.e036854.51","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2007.02.013"},{"key":"2025120600494737000_10.11.e036854.52","unstructured":"Borg G . Borg\u2019s perceived exertion and pain scales. Champaign, IL: Human Kinetics, 1998."},{"key":"2025120600494737000_10.11.e036854.53","doi-asserted-by":"publisher","DOI":"10.1017\/S1352465809005128"},{"key":"2025120600494737000_10.11.e036854.54","doi-asserted-by":"publisher","DOI":"10.1016\/0306-4603(96)00044-5"},{"key":"2025120600494737000_10.11.e036854.55","unstructured":"Bandura A . Social foundations of thought and action: a social cognitive theory. Englewood Cliffs, NJ, 1986."},{"key":"2025120600494737000_10.11.e036854.56","doi-asserted-by":"publisher","DOI":"10.1007\/s11764-014-0413-z"},{"key":"2025120600494737000_10.11.e036854.57","doi-asserted-by":"publisher","DOI":"10.1007\/s12160-013-9486-6"},{"key":"2025120600494737000_10.11.e036854.58","doi-asserted-by":"publisher","DOI":"10.1016\/S1040-8428(00)00048-2"},{"key":"2025120600494737000_10.11.e036854.59","doi-asserted-by":"publisher","DOI":"10.1097\/MCO.0b013e32831cef8b"},{"key":"2025120600494737000_10.11.e036854.60","doi-asserted-by":"publisher","DOI":"10.1097\/SPC.0b013e328331124a"},{"key":"2025120600494737000_10.11.e036854.61","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00744.2004"},{"key":"2025120600494737000_10.11.e036854.62","first-page":"1029","article-title":"Assessment of human body composition using dual-energy X-ray absorptiometry and bioelectrical impedance analysis","volume":"7","author":"Bolanowski","year":"2001","journal-title":"Med Sci Monit"},{"key":"2025120600494737000_10.11.e036854.63","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/85.5.365"},{"key":"2025120600494737000_10.11.e036854.64","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3999(94)00125-O"},{"key":"2025120600494737000_10.11.e036854.65","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2004.01.003"},{"key":"2025120600494737000_10.11.e036854.66","doi-asserted-by":"crossref","first-page":"205510291773067","DOI":"10.1177\/2055102917730675","article-title":"Validation of the English and French versions of the brief health care climate questionnaire","volume":"4","author":"Czajkowska","year":"2017","journal-title":"Health Psychol Open"},{"key":"2025120600494737000_10.11.e036854.67","unstructured":"Boeije H . Analysis in qualitative research. Sage, 2009."},{"key":"2025120600494737000_10.11.e036854.68","unstructured":"Green J , Thorogood N . Qualitative methods for health research. Sage, 2013."},{"key":"2025120600494737000_10.11.e036854.69","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2001.19.9.2381"},{"key":"2025120600494737000_10.11.e036854.70","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2003-031874"},{"key":"2025120600494737000_10.11.e036854.71","doi-asserted-by":"publisher","DOI":"10.1016\/j.jada.2011.10.022"},{"key":"2025120600494737000_10.11.e036854.72","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2015.63.6043"},{"key":"2025120600494737000_10.11.e036854.73","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1590\/S1516-31802007000100005","article-title":"The effects of an individualized exercise intervention on body composition in breast cancer patients undergoing treatment","volume":"125","author":"Battaglini","year":"2007","journal-title":"Sao Paulo Med J"},{"key":"2025120600494737000_10.11.e036854.74","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2010-0197"},{"key":"2025120600494737000_10.11.e036854.75","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0181313","article-title":"Randomized controlled trial on the effects of a supervised high intensity exercise program in patients with a hematologic malignancy treated with autologous stem cell transplantation: results from the exist study","volume":"12","author":"Persoon","year":"2017","journal-title":"PLoS One"},{"key":"2025120600494737000_10.11.e036854.76","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.psych.58.110405.085542"},{"key":"2025120600494737000_10.11.e036854.77","unstructured":"Steckler A , Linnan L . Process evaluation for public health interventions and research. San Francisco, CA: Jossey-Bass, 2002."},{"key":"2025120600494737000_10.11.e036854.78","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1093\/geronb\/gbn032","article-title":"Assessing outcome expectations in older adults: the multidimensional outcome expectations for exercise scale","volume":"64","author":"W\u00f3jcicki","year":"2009","journal-title":"J Gerontol B Psychol Sci Soc Sci"},{"key":"2025120600494737000_10.11.e036854.79","doi-asserted-by":"publisher","DOI":"10.1016\/S0959-8049(03)00307-1"},{"key":"2025120600494737000_10.11.e036854.80","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2005.02.012"},{"key":"2025120600494737000_10.11.e036854.81","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.1983.tb09716.x"},{"key":"2025120600494737000_10.11.e036854.82","doi-asserted-by":"publisher","DOI":"10.1016\/0165-1781(89)90047-4"},{"key":"2025120600494737000_10.11.e036854.83","doi-asserted-by":"publisher","DOI":"10.4278\/0890-1171-12.1.38"},{"key":"2025120600494737000_10.11.e036854.84","doi-asserted-by":"publisher","DOI":"10.1093\/her\/cyl148"},{"key":"2025120600494737000_10.11.e036854.85","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1111\/cge.13076","article-title":"Increasing awareness and knowledge of lifestyle recommendations for cancer prevention in Lynch syndrome carriers: randomized controlled trial","volume":"93","author":"Vrieling","year":"2018","journal-title":"Clin Genet"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2020-036854","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T08:49:59Z","timestamp":1765010999000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2020-036854"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11]]},"references-count":85,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2020,11,4]]},"published-print":{"date-parts":[[2020,11]]}},"alternative-id":["10.1136\/bmjopen-2020-036854"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2020-036854","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,11]]}}}