{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T22:16:33Z","timestamp":1791497793262,"version":"4.3.4"},"reference-count":48,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,9,12]],"date-time":"2024-09-12T00:00:00Z","timestamp":1726099200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,9,12]],"date-time":"2024-09-12T00:00:00Z","timestamp":1726099200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Eat Disord"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Questions remain about the best approaches to treatment for the subset of patients with severe and long-standing Anorexia Nervosa, commonly described in the literature as \u201cSevere and Enduring Anorexia Nervosa.\u201d When discussing the optimal strategies and goals for treating this group, there is uncertainty over whether to focus on refining current treatment methods or exploring alternative approaches. One such alternative is \u201charm reduction,\u201d which has generated a wave of positive interest from patients and clinicians alike because of its emphasis on individual autonomy, personal goals and quality of life. While harm reduction can provide an attractive alternative to seemingly endless cycles of ineffective treatment, this narrative review builds on previous work to highlight the inadequate terminology and possible dangers of considering harm reduction as the endpoint of treatment. In conjunction with perspectives from a lived experience author, we consider wider contextual and ethical issues in the field of eating disorders, which should inform the role of harm-reduction approaches in this patient group.<\/jats:p>","DOI":"10.1186\/s40337-024-01063-3","type":"journal-article","created":{"date-parts":[[2024,9,12]],"date-time":"2024-09-12T09:06:09Z","timestamp":1726131969000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Harm reduction in severe and long-standing Anorexia Nervosa: part of the journey but not the destination\u2014a narrative review with lived experience"],"prefix":"10.1186","volume":"12","author":[{"given":"Edwin","family":"Birch","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Downs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnes","family":"Ayton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,9,12]]},"reference":[{"key":"1063_CR1","doi-asserted-by":"publisher","first-page":"1320","DOI":"10.1002\/eat.23295","volume":"53","author":"R Dalle Grave","year":"2020","unstructured":"Dalle Grave R. Severe and enduring anorexia nervosa: no easy solutions. Int J Eat Disorders. 2020;53:1320\u20131.","journal-title":"Int J Eat Disorders"},{"key":"1063_CR2","doi-asserted-by":"publisher","first-page":"603","DOI":"10.1016\/j.psc.2021.08.003","volume":"44","author":"P Westmoreland","year":"2021","unstructured":"Westmoreland P, Parks L, Lohse K, Mehler P. Severe and enduring Anorexia Nervosa and futility: a time for every purpose? Psychiatric Clin N Am. 2021;44:603\u201311.","journal-title":"Psychiatric Clin N Am"},{"issue":"1","key":"1063_CR3","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1097\/HRP.0000000000000355","volume":"31","author":"J Tumba","year":"2023","unstructured":"Tumba J, Smith M, Rodenbach KE. Clinical and ethical dilemmas in the involuntary treatment of Anorexia Nervosa. Harv Rev Psychiatry. 2023;31(1):14\u201321.","journal-title":"Harv Rev Psychiatry"},{"key":"1063_CR4","doi-asserted-by":"publisher","first-page":"1037","DOI":"10.1007\/s40519-020-01031-1","volume":"26","author":"AR Atti","year":"2021","unstructured":"Atti AR, Mastellari T, Valente S, Speciani M, Panariello F, De Ronchi D. Compulsory treatments in eating disorders: a systematic review and meta-analysis. Eat Weight Disorders. 2021;26:1037\u201348.","journal-title":"Eat Weight Disorders"},{"issue":"7","key":"1063_CR5","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1080\/15265161.2020.1863509","volume":"21","author":"A Bianchi","year":"2021","unstructured":"Bianchi A, Stanley K, Sutandar K. The ethical defensibility of harm reduction and eating disorders. Am J Bioeth. 2021;21(7):46\u201356.","journal-title":"Am J Bioeth"},{"issue":"1","key":"1063_CR6","doi-asserted-by":"publisher","first-page":"124","DOI":"10.1002\/wps.21182","volume":"23","author":"M Solmi","year":"2024","unstructured":"Solmi M, Monaco F, H\u00f8jlund M, Monteleone AM, Trott M, Firth J, et al. Outcomes in people with eating disorders: a transdiagnostic and disorder-specific systematic review, meta-analysis and multivariable meta-regression analysis. World Psychiatry. 2024;23(1):124\u201338.","journal-title":"World Psychiatry"},{"key":"1063_CR7","unstructured":"World Health Organisation (WHO) International classification of diseases, Eleventh Revision (ICD-11). 2021"},{"key":"1063_CR8","unstructured":"American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR\u00ae). 2022."},{"issue":"7","key":"1063_CR9","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1080\/15265161.2015.1039720","volume":"15","author":"CMA Geppert","year":"2015","unstructured":"Geppert CMA. Futility in chronic anorexia nervosa: a concept whose time has not yet come. Am J Bioeth. 2015;15(7):34\u201343.","journal-title":"Am J Bioeth"},{"key":"1063_CR10","doi-asserted-by":"publisher","first-page":"611","DOI":"10.1002\/eat.22715","volume":"50","author":"C Broomfield","year":"2017","unstructured":"Broomfield C, Stedal K, Touyz S, Rhodes P. Labeling and defining severe and enduring anorexia nervosa: a systematic review and critical analysis. Int J Eat Disorders. 2017;50:611\u201323.","journal-title":"Int J Eat Disorders"},{"issue":"1","key":"1063_CR11","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1186\/s40337-022-00648-0","volume":"10","author":"M Reay","year":"2022","unstructured":"Reay M, Holliday J, Stewart J, Adams J. Creating a care pathway for patients with longstanding, complex eating disorders. J Eat Disord. 2022;10(1):128.","journal-title":"J Eat Disord"},{"key":"1063_CR12","volume-title":"Severe and enduring eating disorder (SEED): Management of complex presentations of anorexia and bulimia nervosa","author":"P Robinson","year":"2009","unstructured":"Robinson P. Severe and enduring eating disorder (SEED): Management of complex presentations of anorexia and bulimia nervosa. Hoboken: Wiley; 2009."},{"issue":"8","key":"1063_CR13","doi-asserted-by":"publisher","first-page":"1303","DOI":"10.1002\/eat.23283","volume":"53","author":"SA Wonderlich","year":"2020","unstructured":"Wonderlich SA, Bulik CM, Schmidt U, Steiger H, Hoek HW. Severe and enduring anorexia nervosa: update and observations about the current clinical reality. Int J Eat Disord. 2020;53(8):1303\u201312.","journal-title":"Int J Eat Disord"},{"key":"1063_CR14","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1186\/s40337-018-0229-8","volume":"6","author":"P Hay","year":"2018","unstructured":"Hay P, Touyz S. Classification challenges in the field of eating disorders: can severe and enduring anorexia nervosa be better defined? J Eat Disord. 2018;6:41.","journal-title":"J Eat Disord"},{"issue":"1","key":"1063_CR15","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1186\/s40337-022-00598-7","volume":"10","author":"S G\u00f6ller","year":"2022","unstructured":"G\u00f6ller S, Nickel K, Horster I, Endres D, Zeeck A, Domschke K, et al. State or trait: the neurobiology of anorexia nervosa\u2014contributions of a functional magnetic resonance imaging study. J Eat Disord. 2022;10(1):77.","journal-title":"J Eat Disord"},{"issue":"4","key":"1063_CR16","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1080\/09540261.2019.1601073","volume":"31","author":"J Russell","year":"2019","unstructured":"Russell J, Mulvey B, Bennett H, Donnelly B, Frig E. Harm minimization in severe and enduring anorexia nervosa. Int Rev Psychiatry. 2019;31(4):391\u2013402.","journal-title":"Int Rev Psychiatry"},{"issue":"12","key":"1063_CR17","doi-asserted-by":"publisher","first-page":"1136","DOI":"10.1177\/0004867412450469","volume":"46","author":"PJ Hay","year":"2012","unstructured":"Hay PJ, Touyz S, Sud R. Treatment for severe and enduring anorexia nervosa: a review. Aust N Z J Psychiatry. 2012;46(12):1136\u201344.","journal-title":"Aust N Z J Psychiatry"},{"issue":"2","key":"1063_CR18","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1002\/erv.989","volume":"18","author":"KD Williams","year":"2010","unstructured":"Williams KD, Dobney T, Geller J. Setting the eating disorder aside: an alternative model of care. Eur Eat Disord Rev. 2010;18(2):90\u20136.","journal-title":"Eur Eat Disord Rev"},{"issue":"4","key":"1063_CR19","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1097\/NMD.0000000000001124","volume":"208","author":"J Yager","year":"2020","unstructured":"Yager J. Managing patients with severe and enduring Anorexia Nervosa: when is enough, enough? J Nervous Mental Disease. 2020;208(4):277\u201382.","journal-title":"J Nervous Mental Disease"},{"issue":"12","key":"1063_CR20","doi-asserted-by":"publisher","first-page":"2501","DOI":"10.1017\/S0033291713000949","volume":"43","author":"S Touyz","year":"2013","unstructured":"Touyz S, Le Grange D, Lacey H, Hay P, Smith R, Maguire S, et al. Treating severe and enduring anorexia nervosa: a randomized controlled trial. Psychol Med. 2013;43(12):2501\u201311.","journal-title":"Psychol Med"},{"issue":"1","key":"1063_CR21","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1159\/000355240","volume":"83","author":"AE Dingemans","year":"2014","unstructured":"Dingemans AE, Danner UN, Donker JM, Aardoom JJ, van Meer F, Tobias K, et al. The effectiveness of cognitive remediation therapy in patients with a severe or enduring eating disorder: a randomized controlled trial. Psychother Psychosom. 2014;83(1):29\u201336.","journal-title":"Psychother Psychosom"},{"issue":"1","key":"1063_CR22","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1186\/s40337-020-00306-3","volume":"8","author":"M Janse Van Rensburg","year":"2020","unstructured":"Janse Van Rensburg M. COVID19, the pandemic which may exemplify a need for harm-reduction approaches to eating disorders: a reflection from a person living with an eating disorder. J Eat Disord. 2020;8(1):26.","journal-title":"J Eat Disord"},{"key":"1063_CR23","doi-asserted-by":"crossref","unstructured":"Zhu J, Hay PJ, Yang Y, Le Grange D, Lacey JH, Lujic S, et al. Specific psychological therapies versus other therapies or no treatment for severe and enduring anorexia nervosa. Cochrane Database Syst Rev 2023;8(8).","DOI":"10.1002\/14651858.CD011570.pub2"},{"issue":"2","key":"1063_CR24","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1016\/j.drugpo.2010.01.004","volume":"21","author":"JR Ashton","year":"2010","unstructured":"Ashton JR, Seymour H. Public health and the origins of the mersey model of harm reduction. Int J Drug Policy. 2010;21(2):94\u20136.","journal-title":"Int J Drug Policy"},{"issue":"5","key":"1063_CR25","doi-asserted-by":"publisher","first-page":"1119","DOI":"10.1111\/adb.12414","volume":"22","author":"K Charlet","year":"2017","unstructured":"Charlet K, Heinz A. Harm reduction-a systematic review on effects of alcohol reduction on physical and mental symptoms. Addict Biol. 2017;22(5):1119\u201359.","journal-title":"Addict Biol"},{"issue":"6","key":"1063_CR26","doi-asserted-by":"publisher","first-page":"624","DOI":"10.7861\/clinmedicine.10-6-624","volume":"10","author":"J Saunders","year":"2010","unstructured":"Saunders J, Smith T. Malnutrition: causes and consequences. Clin Med (Lond). 2010;10(6):624\u20137.","journal-title":"Clin Med (Lond)"},{"issue":"3","key":"1063_CR27","doi-asserted-by":"publisher","first-page":"238","DOI":"10.1002\/eat.22481","volume":"49","author":"KV Sachs","year":"2016","unstructured":"Sachs KV, Harnke B, Mehler PS, Krantz MJ. Cardiovascular complications of anorexia nervosa: a systematic review. Int J Eat Disord. 2016;49(3):238\u201348.","journal-title":"Int J Eat Disord"},{"issue":"2","key":"1063_CR28","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1007\/s40519-018-0567-1","volume":"24","author":"S Giovinazzo","year":"2019","unstructured":"Giovinazzo S, Sukkar SG, Rosa GM, Zappi A, Bezante GP, Balbi M, et al. Anorexia nervosa and heart disease: a systematic review. Eat Weight Disord. 2019;24(2):199\u2013207.","journal-title":"Eat Weight Disord"},{"key":"1063_CR29","doi-asserted-by":"crossref","unstructured":"Jada K, Djossi SK, Khedr A, Neupane B, Proskuriakova E, Mostafa JA. The pathophysiology of Anorexia Nervosa in hypothalamic endocrine function and bone metabolism. Cureus. 2021; 13(12)","DOI":"10.7759\/cureus.20548"},{"issue":"1","key":"1063_CR30","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1186\/s40337-021-00466-w","volume":"9","author":"BB Brodrick","year":"2021","unstructured":"Brodrick BB, Adler-Neal AL, Palka JM, Mishra V, Aslan S, McAdams CJ. Structural brain differences in recovering and weight-recovered adult outpatient women with anorexia nervosa. J Eat Disord. 2021;9(1):108.","journal-title":"J Eat Disord"},{"issue":"9","key":"1063_CR31","doi-asserted-by":"publisher","first-page":"730","DOI":"10.1016\/j.biopsych.2022.04.022","volume":"92","author":"E Walton","year":"2022","unstructured":"Walton E, Bernardoni F, Batury VL, Bahnsen K, Larivi\u00e8re S, Abbate-Daga G, et al. Brain structure in acutely underweight and partially weight-restored individuals with Anorexia Nervosa: a coordinated analysis by the ENIGMA eating disorders working group. Biol Psychiatry. 2022;92(9):730\u20138.","journal-title":"Biol Psychiatry"},{"key":"1063_CR32","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1186\/s40337-022-00729-0","volume":"11","author":"R Elwyn","year":"2023","unstructured":"Elwyn R. A lived experience response to the proposed diagnosis of terminal anorexia nervosa: learning from iatrogenic harm, ambivalence and enduring hope. J Eat Disorders. 2023;11:2.","journal-title":"J Eat Disorders"},{"key":"1063_CR33","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1016\/j.ijlp.2018.02.001","volume":"58","author":"IFFM Elzakkers","year":"2018","unstructured":"Elzakkers IFFM, Danner UN, Grisso T, Hoek HW, van Elburg AA. Assessment of mental capacity to consent to treatment in anorexia nervosa: a comparison of clinical judgment and MacCAT-T and consequences for clinical practice. Int J Law Psychiatry. 2018;58:27\u201335.","journal-title":"Int J Law Psychiatry"},{"issue":"7","key":"1063_CR34","doi-asserted-by":"publisher","first-page":"1329","DOI":"10.1002\/eat.23957","volume":"56","author":"SJ Crow","year":"2023","unstructured":"Crow SJ. Terminal anorexia nervosa cannot currently be identified. Int J Eat Disord. 2023;56(7):1329\u201334.","journal-title":"Int J Eat Disord"},{"issue":"12","key":"1063_CR35","doi-asserted-by":"publisher","first-page":"2273","DOI":"10.1002\/eat.24058","volume":"56","author":"MP Cummings","year":"2023","unstructured":"Cummings MP, Alexander RK, Boswell RG. \u201cOrdinary days would be extraordinary\u201d: the lived experiences of severe and enduring anorexia nervosa. Int J Eat Disord. 2023;56(12):2273\u201382.","journal-title":"Int J Eat Disord"},{"key":"1063_CR36","first-page":"1","volume":"8","author":"J Downs","year":"2023","unstructured":"Downs J. Care pathways for longstanding eating disorders must offer paths to recovery, not managed decline. BJPsych Bull. 2023;8:1\u20135.","journal-title":"BJPsych Bull"},{"issue":"1","key":"1063_CR37","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1080\/21507740.2023.2292508","volume":"15","author":"DD Moseley","year":"2024","unstructured":"Moseley DD. What is futility in psychiatry? AJOB Neurosci. 2024;15(1):67\u20139.","journal-title":"AJOB Neurosci"},{"issue":"2","key":"1063_CR38","doi-asserted-by":"publisher","first-page":"184","DOI":"10.4088\/JCP.15m10393","volume":"78","author":"KT Eddy","year":"2017","unstructured":"Eddy KT, Tabri N, Thomas JJ, Murray HB, Keshaviah A, Hastings E, et al. Recovery from Anorexia Nervosa and bulimia nervosa at 22-year follow-up. J Clin Psychiatry. 2017;78(2):184\u20139.","journal-title":"J Clin Psychiatry"},{"issue":"8","key":"1063_CR39","doi-asserted-by":"publisher","first-page":"702","DOI":"10.1037\/ccp0000319","volume":"86","author":"BC Raykos","year":"2018","unstructured":"Raykos BC, Erceg-Hurn DM, McEvoy PM, Fursland A, Waller G. Severe and enduring anorexia nervosa? Illness severity and duration are unrelated to outcomes from cognitive behaviour therapy. J Consult Clin Psychol. 2018;86(8):702\u20139.","journal-title":"J Consult Clin Psychol"},{"key":"1063_CR40","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1016\/j.brat.2016.11.006","volume":"89","author":"S Calugi","year":"2017","unstructured":"Calugi S, El Ghoch M, Dalle GR. Intensive enhanced cognitive behavioural therapy for severe and enduring anorexia nervosa: a longitudinal outcome study. Behav Res Ther. 2017;89:41\u20138.","journal-title":"Behav Res Ther"},{"issue":"1","key":"1063_CR41","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1186\/s40337-022-00620-y","volume":"10","author":"A Ibrahim","year":"2022","unstructured":"Ibrahim A, Ryan S, Viljoen D, Tutisani E, Gardner L, Collins L, et al. Integrated enhanced cognitive behavioural (I-CBTE) therapy significantly improves effectiveness of inpatient treatment of anorexia nervosa in real life settings. J Eat Disord. 2022;10(1):98.","journal-title":"J Eat Disord"},{"issue":"4","key":"1063_CR42","doi-asserted-by":"publisher","first-page":"494","DOI":"10.1177\/1049732314524029","volume":"24","author":"L Dawson","year":"2014","unstructured":"Dawson L, Rhodes P, Touyz S. \u201cDoing the impossible\u201d: the process of recovery from chronic anorexia nervosa. Qual Health Res. 2014;24(4):494\u2013505.","journal-title":"Qual Health Res"},{"issue":"8","key":"1063_CR43","doi-asserted-by":"publisher","first-page":"1207","DOI":"10.1038\/s41588-019-0439-2","volume":"51","author":"HJ Watson","year":"2019","unstructured":"Watson HJ, Yilmaz Z, Thornton LM, H\u00fcbel C, Coleman JRI, Gaspar HA, et al. Genome-wide association study identifies eight risk loci and implicates metabo-psychiatric origins for anorexia nervosa. Nat Genet. 2019;51(8):1207\u201314.","journal-title":"Nat Genet"},{"key":"1063_CR44","doi-asserted-by":"publisher","first-page":"752","DOI":"10.1016\/j.tem.2021.07.010","volume":"32","author":"CM Bulik","year":"2021","unstructured":"Bulik CM, Carroll IM, Mehler P. Reframing Anorexia Nervosa as a metabo-psychiatric disorder. Trends Endocrinol Metab. 2021;32:752\u201361.","journal-title":"Trends Endocrinol Metab"},{"issue":"3","key":"1063_CR45","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1037\/abn0000912","volume":"133","author":"M Robison","year":"2024","unstructured":"Robison M, et al. \u201cTerminal anorexia nervosa\u201d may not be terminal: An empirical evaluation. J Psychopathol Clin Sci. 2024;133(3):285\u201396. https:\/\/doi.org\/10.1037\/abn0000912.","journal-title":"J Psychopathol Clin Sci"},{"issue":"4","key":"1063_CR46","doi-asserted-by":"publisher","first-page":"318","DOI":"10.1002\/erv.2367","volume":"23","author":"P Robinson","year":"2015","unstructured":"Robinson P, Kukucska R, Guidetti G, Leavey G. Severe and Enduring Anorexia Nervosa (SEED-AN): A Qualitative Study of Patients with 20+ Years of Anorexia Nervosa. Euro Eating Disorders Rev. 2015;23(4):318\u201326.","journal-title":"Euro Eating Disorders Rev."},{"issue":"7","key":"1063_CR47","doi-asserted-by":"publisher","first-page":"650","DOI":"10.1002\/eat.20546","volume":"41","author":"J Arkell","year":"2008","unstructured":"Arkell J, Robinson P. A pilot case series using qualitative and quantitative methods: Biological psychological and social outcome in severe and enduring eating disorder (anorexia nervosa). Int J Eating Disorders. 2008;41(7):650\u20136.","journal-title":"Int J Eating Disorders"},{"issue":"3","key":"1063_CR48","first-page":"290","volume":"31","author":"P Daansen","year":"2010","unstructured":"Daansen P, Haffmans J.  Reducing symptoms in women with chronic anorexia nervosa. A pilot study on the effects of bright light therapy . Neuro Endocrinol Lett. 2010;31(3):290\u20136.","journal-title":"Neuro Endocrinol Lett."}],"container-title":["Journal of Eating Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40337-024-01063-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40337-024-01063-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40337-024-01063-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,12]],"date-time":"2024-09-12T10:08:40Z","timestamp":1726135720000},"score":1,"resource":{"primary":{"URL":"https:\/\/jeatdisord.biomedcentral.com\/articles\/10.1186\/s40337-024-01063-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,12]]},"references-count":48,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["1063"],"URL":"https:\/\/doi.org\/10.1186\/s40337-024-01063-3","relation":{},"ISSN":["2050-2974"],"issn-type":[{"value":"2050-2974","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,12]]},"assertion":[{"value":"22 May 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 July 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 September 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"None required.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have NO affiliations with or involvement in any organization or entity with any financial interest in the subject matter or materials discussed in this manuscript.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interest"}}],"article-number":"140"}}