{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T06:56:34Z","timestamp":1790232994165,"version":"4.1.0"},"reference-count":138,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,1,25]],"date-time":"2025-01-25T00:00:00Z","timestamp":1737763200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Alberta Cancer Foundation RK Dixon Family Award","award":["27265"],"award-info":[{"award-number":["27265"]}]},{"name":"Canada Research Chairs Program","award":["27265"],"award-info":[{"award-number":["27265"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Symptom burden is known to be high in patients with hematologic malignancies and can adversely impact patients\u2019 quality of life. The aims of this retrospective observational cohort study were to explore symptoms in patients with hematologic malignancies, including during the last year of life, to explore symptom profiles in patients with hematologic malignancies, and to explore associations among symptoms\/symptom profiles and demographic, clinical, and treatment-related variables. Symptom prevalence and severity and symptom profiles were explored in patients with hematologic malignancies who completed patient-reported outcome measures (n = 6136) between October 2019 and April 2020. Emergency department visits and hospital admissions during the study period were reviewed. Chart audits were undertaken for patients who died within a year of completing patient-reported outcome measures (n = 432) to explore symptoms and healthcare utilization in the last year of life. Patients with hematologic malignancies in this study reported multiple symptoms co-occurring, with more than 50% of patients reporting four or more symptoms. Classes of co-occurring symptoms (symptom profiles) were associated with demographic and clinical factors as well as with healthcare utilization, particularly emergency department visits. The most reported symptoms were tiredness, impaired well-being, and drowsiness. The findings emphasize the need for more supports for patients with hematologic malignancies, particularly for symptom management.<\/jats:p>","DOI":"10.3390\/curroncol32020062","type":"journal-article","created":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T11:38:49Z","timestamp":1737977929000},"page":"62","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Symptoms, Symptom Profiles, and Healthcare Utilization in Patients with Hematologic Malignancies: A Retrospective Observational Cohort Study and Latent Class Analysis"],"prefix":"10.3390","volume":"32","author":[{"given":"Reanne","family":"Booker","sequence":"first","affiliation":[{"name":"Palliative Care, Arthur JE Child Comprehensive Cancer Centre, Calgary, AB T2N 4N1, Canada"},{"name":"School of Nursing, University of Victoria, Victoria, BC V8P 5C2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8042-190X","authenticated-orcid":false,"given":"Richard","family":"Sawatzky","sequence":"additional","affiliation":[{"name":"School of Nursing, Trinity Western University, Langley, BC V2Y 1Y1, Canada"},{"name":"Centre for Advancing Health Outcomes, St. Paul\u2019s Hospital, Vancouver, BC V6Z 1Y6, Canada"},{"name":"University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, SE-405 30 Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7967-159X","authenticated-orcid":false,"given":"Aynharan","family":"Sinnarajah","sequence":"additional","affiliation":[{"name":"Division of Palliative Medicine, Queen\u2019s University, Kingston, ON K7L 3J7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siwei","family":"Qi","sequence":"additional","affiliation":[{"name":"Surveillance & Reporting, Advanced Analytics, Cancer Research & Analytics, Cancer Care Alberta, Alberta Health Services, Calgary, AB T2N 2T9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6729-7898","authenticated-orcid":false,"given":"Claire","family":"Link","sequence":"additional","affiliation":[{"name":"Supportive Care Services and Patient Experience, Cancer Care Alberta, Alberta Health Services, Calgary, AB T2N 2T9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7802-0082","authenticated-orcid":false,"given":"Linda","family":"Watson","sequence":"additional","affiliation":[{"name":"Supportive Care Services and Patient Experience, Cancer Care Alberta, Alberta Health Services, Calgary, AB T2N 2T9, Canada"},{"name":"Faculty of Nursing, University of Calgary, Calgary, AB T2N 1N4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2381-4712","authenticated-orcid":false,"given":"Kelli","family":"Stajduhar","sequence":"additional","affiliation":[{"name":"School of Nursing, University of Victoria, Victoria, BC V8P 5C2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e432196","DOI":"10.1200\/EDBK_432196","article-title":"Integrating palliative care and hematologic malignancies: Bridging the gaps for our patients and their caregivers","volume":"44","author":"Webb","year":"2024","journal-title":"Am. Soc. Clin. Oncol. Educ. Book"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"944","DOI":"10.1200\/JCO.18.02386","article-title":"Palliative and end-of-life care for patients with hematologic malignancies","volume":"38","author":"Nelson","year":"2020","journal-title":"J. Clin. Oncol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1007\/s00432-024-05721-6","article-title":"Utilization and quality of palliative care in patients with hematological and solid cancers: A population-based study","volume":"150","author":"Gebel","year":"2024","journal-title":"J. Cancer Res. Clin. Oncol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1007\/s11864-023-01084-1","article-title":"Advancing palliative care integration in hematology: Building upon existing evidence","volume":"24","author":"Webb","year":"2023","journal-title":"Curr. Treat. Options Oncol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1093\/jncimonographs\/lgm005","article-title":"Symptom burden: Multiple symptoms and their impact as patient-reported outcomes","volume":"37","author":"Cleeland","year":"2007","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1188\/07.ONF.673-680","article-title":"Symptom burden: A concept analysis and implications for oncology nurses","volume":"34","author":"Gapstur","year":"2007","journal-title":"Oncol. Nurs. Forum"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1016\/j.jpainsymman.2017.08.030","article-title":"Comparing the palliative care needs of patients with hematologic and solid malignancies","volume":"55","author":"Hochman","year":"2018","journal-title":"J. Pain Symptom Manag."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1016\/j.jpainsymman.2010.12.008","article-title":"The symptom burden of patients with hematological malignancy: A cross-sectional observational study","volume":"42","author":"Manitta","year":"2011","journal-title":"J. Pain Symptom Manag."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"101182","DOI":"10.1016\/j.blre.2024.101182","article-title":"Depression in patients with hematologic malignancies: The current landscape and future directions","volume":"65","author":"Kuczmarski","year":"2024","journal-title":"Blood Rev."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1086","DOI":"10.1002\/ajh.26590","article-title":"Multiple myeloma: 2022 update on diagnosis, risk stratification, and management","volume":"97","author":"Rajkumar","year":"2022","journal-title":"Am. J. Hematol."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Howell, D.A., McCaughan, D., Smith, A.G., Patmore, R., and Roman, E. (2022). Incurable but treatable: Understanding, uncertainty and impact in chronic blood cancers\u2014A qualitative study from the UK\u2019s Haematological Malignancy Research Network. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0263672"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e152","DOI":"10.1093\/oncolo\/oyad211","article-title":"Symptom clusters in patients with advanced cancer: A prospective longitudinal cohort study to examine their stability and prognostic significance","volume":"29","author":"Simao","year":"2024","journal-title":"Oncologist"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1016\/j.leukres.2013.02.009","article-title":"Symptom burden and supportive care in patients with acute leukemia","volume":"37","author":"Zimmermann","year":"2013","journal-title":"Leuk. Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"3273","DOI":"10.21037\/apm-22-691","article-title":"Supportive care and symptom management in patients with advanced hematological malignancies: A literature review","volume":"11","author":"Chan","year":"2022","journal-title":"Ann. Palliat. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1111\/ejh.14285","article-title":"Health-related quality of life in older hematological cancer survivors (70+) compared to older general population\u2014A German cancer-register-based cross-sectional comparative study","volume":"113","author":"Schatz","year":"2024","journal-title":"Eur. J. Haematol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1016\/j.htct.2022.06.007","article-title":"Early integration of palliative care in hematology: An urgency for patients, a challenge for physicians","volume":"44","author":"Ferraz","year":"2022","journal-title":"Hematol. Transfus. Cell Ther."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2040620720955002","DOI":"10.1177\/2040620720955002","article-title":"Quality-of-life issues and symptoms reported by patients living with haematological malignancy: A qualitative study","volume":"11","author":"Goswami","year":"2020","journal-title":"Ther. Adv. Hematol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1038\/s41408-021-00602-4","article-title":"Patient-reported outcome measures are associated with health care utilization in patients with transplant ineligible multiple myeloma: A population-based study","volume":"12","author":"Mian","year":"2022","journal-title":"Blood Cancer J."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1111\/bjh.18286","article-title":"Early integration of palliative care for patients with haematological malignancies","volume":"199","author":"Shaulov","year":"2022","journal-title":"Br. J. Haematol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1186\/s12955-021-01887-6","article-title":"Patient-reported outcomes in patients with hematological relapse or progressive disease: A longitudinal observational study","volume":"19","author":"Sommer","year":"2021","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_21","first-page":"465","article-title":"Symptom clusters and their effect on the functional status of patients with cancer","volume":"28","author":"Dodd","year":"2001","journal-title":"Oncol. Nurs. Forum"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"djw253","DOI":"10.1093\/jnci\/djw253","article-title":"Advancing symptom science through symptom cluster research: Expert panel proceedings and recommendations","volume":"109","author":"Miaskowski","year":"2017","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1007\/s00520-024-08489-0","article-title":"Comparing symptom clusters in cancer survivors by cancer diagnosis: A latent class profile analysis","volume":"32","author":"Lee","year":"2024","journal-title":"Support. Care Cancer"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1016\/j.soncn.2016.08.002","article-title":"Biological basis for the clustering of symptoms","volume":"32","author":"Dickinson","year":"2016","journal-title":"Semin. Oncol. Nurs."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1016\/j.jpainsymman.2013.10.027","article-title":"Symptom clusters in patients with advanced cancer: A systematic review of observational studies","volume":"48","author":"Dong","year":"2014","journal-title":"J. Pain Symptom Manag."},{"key":"ref_26","first-page":"361","article-title":"Symptom clusters in lymphoma survivors before, during, and after chemotherapy: A prospective study","volume":"50","author":"Wu","year":"2023","journal-title":"Oncol. Nurs. Forum"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Fang, J., Wong, C.L., Liu, C.Q., Huang, H.Y., Qi, Y.S., Xu, L.L., Wang, M.X., and Lin, Y. (2023). Identifying central symptom clusters and correlates in children with acute leukemia undergoing chemotherapy: A network analysis. Front. Oncol., 13.","DOI":"10.3389\/fonc.2023.1236129"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1016\/j.jpainsymman.2018.12.329","article-title":"Consensus in identification and stability of symptom clusters using different symptom dimensions in newly diagnosed acute myeloid leukemia patients undergoing induction therapy","volume":"57","author":"Lin","year":"2019","journal-title":"J. Pain Symptom Manag."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1429","DOI":"10.1111\/bjh.19326","article-title":"Symptom clusters and their impact on quality of life in multiple myeloma survivors: Secondary analysis of BMT CTN 0702 trial","volume":"204","author":"Brazauskas","year":"2024","journal-title":"Br. J. Haematol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"4961","DOI":"10.1007\/s00520-022-06896-9","article-title":"Symptom clusters and quality of life in ambulatory patients with multiple myeloma","volume":"30","author":"Chen","year":"2022","journal-title":"Support. Care Cancer"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"7247","DOI":"10.1111\/jocn.16791","article-title":"Multiple myeloma patients undergoing chemotherapy: Which symptom clusters impact quality of life?","volume":"32","author":"Zeng","year":"2023","journal-title":"J. Clin. Nurs."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"507","DOI":"10.3109\/0284186X.2014.958527","article-title":"Prevalence and correlates of the unmet supportive care needs of individuals diagnosed with a haematological malignancy","volume":"54","author":"Boyes","year":"2015","journal-title":"Acta Oncol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"993","DOI":"10.1007\/s00277-011-1274-4","article-title":"The impact of treatment, socio-demographic and clinical characteristics on health-related quality of life among Hodgkin\u2019s and non-Hodgkin\u2019s lymphoma survivors: A systematic review","volume":"90","author":"Oerlemans","year":"2011","journal-title":"Ann. Hematol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1007\/s00277-017-3198-0","article-title":"Correlation of sociodemographic and clinical parameters with depression and distress in patients with hematologic malignancies","volume":"97","author":"Shreders","year":"2018","journal-title":"Ann. Hematol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/08964289.2013.833083","article-title":"Psychosocial predictors of quality of life in hematological cancer","volume":"41","author":"Pulgar","year":"2015","journal-title":"Behav. Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1111\/jrh.12774","article-title":"Rural-urban differences in distress, quality of life, and social support among Canadian young adult cancer survivors: A Young Adults with Cancer in Their Prime (YACPRIME) study","volume":"40","author":"Tulk","year":"2024","journal-title":"J. Rural Health"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Cerni, J., Rhee, J., and Hosseinzadeh, H. (2020). End-of-life cancer care resource utilisation in rural versus urban settings: A systematic review. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17144955"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"940","DOI":"10.1093\/jnci\/djac030","article-title":"Rural-urban disparities in cancer outcomes: Opportunities for future research","volume":"114","author":"Bhatia","year":"2022","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"157","DOI":"10.5737\/23688076252157166","article-title":"Supportive care needs of rural individuals living with cancer: A literature review","volume":"25","author":"Loughery","year":"2015","journal-title":"Can. Oncol. Nurs. J."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"173","DOI":"10.6004\/jnccn.2022.7087","article-title":"Patient-reported symptom complexity and acute care utilization among patients with cancer: A population-based study using a novel symptom complexity algorithm and observational data","volume":"21","author":"Watson","year":"2023","journal-title":"J. Natl. Compr. Canc. Netw."},{"key":"ref_41","unstructured":"Canadian Institute for Health Information (2024, October 21). Discharge Abstract Database Metadata. Available online: www.cihi.ca\/en\/discharge-abstract-database-dad-metadata."},{"key":"ref_42","unstructured":"Canadian Institute for Health Information (2024, October 21). National Ambulatory Care Reporting System Metadata. Available online: www.cihi.ca\/en\/national-ambulatory-care-reporting-system-nacrs-metadata."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1016\/S0885-3924(98)00102-X","article-title":"A Canadian survey of cancer patients\u2019 experiences: Are their needs being met?","volume":"16","author":"Ashbury","year":"1998","journal-title":"J. Pain Symptom Manag."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1002\/pon.1932","article-title":"Implementing screening for distress, the 6th vital sign: A Canadian strategy for changing practice","volume":"20","author":"Bultz","year":"2011","journal-title":"Psycho-Oncology"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"e503","DOI":"10.3747\/co.26.4919","article-title":"Patient-reported outcomes in Alberta: Rationale, scope, and design of a database initiative","volume":"26","author":"Cuthbert","year":"2019","journal-title":"Curr. Oncol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1177\/082585979100700202","article-title":"The Edmonton Symptom Assessment System (ESAS): A simple method for the assessment of palliative care patients","volume":"7","author":"Bruera","year":"1991","journal-title":"J. Palliat. Care"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1016\/j.jpainsymman.2016.10.370","article-title":"The Edmonton Symptom Assessment System 25 years later: Past, present, and future developments","volume":"53","author":"Hui","year":"2017","journal-title":"J. Pain Symptom Manag."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"977","DOI":"10.1002\/pon.1996","article-title":"The Edmonton Symptom Assessment System, a proposed tool for distress screening in cancer patients: Development and refinement","volume":"21","author":"Watanabe","year":"2012","journal-title":"Psycho-Oncology"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1130","DOI":"10.1097\/01.mlr.0000182534.19832.83","article-title":"Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data","volume":"43","author":"Quan","year":"2005","journal-title":"Med. Care"},{"key":"ref_50","unstructured":"World Health Organization (2024, October 21). Ageing and Health. Available online: www.who.int\/news-room\/fact-sheets\/detail\/ageing-and-health."},{"key":"ref_51","unstructured":"Varian Medical Services (2024, October 21). ARIA Oncology Information System. Available online: www.varian.com\/products\/software\/digital-oncology\/oncology-management-systems\/aria-oncology-information-system."},{"key":"ref_52","unstructured":"Muthen, L.K., and Muthen, B.O. (2024, October 21). MPlus Statistical Analysis with Latent Variables. User\u2019s Guide. Available online: www.statmodel.com\/download\/usersguide\/MplusUserGuideVer_8.pdf."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1016\/j.annemergmed.2012.10.010","article-title":"Do patient-reported symptoms predict emergency department visits in cancer patients? A population-based analysis","volume":"61","author":"Barbera","year":"2013","journal-title":"Ann. Emerg. Med."},{"key":"ref_54","unstructured":"(2024, October 25). IBM SPSS Statistics 29. Available online: www.ibm.com\/spss."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.1016\/j.jpainsymman.2012.06.007","article-title":"Cut points on 0\u201310 numeric rating scales for symptoms included in the Edmonton Symptom Assessment Scale in cancer patients: A systematic review","volume":"45","author":"Oldenmenger","year":"2013","journal-title":"J. Pain Symptom Manag."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1016\/j.jpainsymman.2019.07.007","article-title":"Patient-reported symptoms improve performance of risk prediction models for emergency department visits among patients with cancer: A population-wide study in Ontario using administrative data","volume":"58","author":"Sutradhar","year":"2019","journal-title":"J. Pain Symptom Manag."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.jpainsymman.2022.03.007","article-title":"Identification of distinct symptom profiles in cancer patients using a pre-specified symptom cluster","volume":"64","author":"Hammer","year":"2022","journal-title":"J. Pain Symptom Manag."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.jpainsymman.2014.12.011","article-title":"Latent class analysis reveals distinct subgroups of patients based on symptom occurrence and demographic and clinical characteristics","volume":"50","author":"Miaskowski","year":"2015","journal-title":"J. Pain Symptom Manag."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1676","DOI":"10.1016\/j.jid.2020.05.079","article-title":"Research techniques made simple: Latent class analysis","volume":"140","author":"Naldi","year":"2020","journal-title":"J. Investig. Dermatol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1177\/0095798420930932","article-title":"Latent class analysis: A guide to best practice","volume":"46","author":"Weller","year":"2020","journal-title":"J. Black Psychol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"e63","DOI":"10.1097\/CCM.0000000000004710","article-title":"Practitioner\u2019s guide to latent class analysis: Methodological considerations and common pitfalls","volume":"49","author":"Sinha","year":"2021","journal-title":"Crit. Care Med."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1080\/10705511.2014.915181","article-title":"Auxiliary variables in mixture modeling: Three-step approaches using Mplus","volume":"21","author":"Asparouhov","year":"2014","journal-title":"Struct. Equ. Model."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"967","DOI":"10.1080\/10705511.2019.1590146","article-title":"Prediction from latent classes: A demonstration of different approaches to include distal outcomes in mixture models","volume":"26","author":"Grimm","year":"2019","journal-title":"Struct. Equ. Model."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/10705511.2013.742377","article-title":"Latent class analysis with distal outcomes: A flexible model-based approach","volume":"20","author":"Lanza","year":"2013","journal-title":"Struct. Equ. Model."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"e334","DOI":"10.1016\/S2352-3026(15)00111-8","article-title":"Symptom burden of haematological malignancies as death approaches in a community palliative care service: A retrospective cohort study of a consecutive case series","volume":"2","author":"LeBlanc","year":"2015","journal-title":"Lancet Haematol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"E178","DOI":"10.1188\/16.ONF.E178-E187","article-title":"Signs, symptoms, and characteristics associated with end of life in people with a hematologic malignancy: A review of the literature","volume":"43","author":"Button","year":"2016","journal-title":"Oncol. Nurs. Forum"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"7107","DOI":"10.1002\/cam4.3374","article-title":"The impact of routine Edmonton Symptom Assessment System (ESAS) use on overall survival in cancer patients: Results of a population-based retrospective matched cohort analysis","volume":"9","author":"Barbera","year":"2020","journal-title":"Cancer Med."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"e685","DOI":"10.1016\/S1470-2045(19)30656-4","article-title":"Prognostic value of patient-reported outcomes from international randomised clinical trials on cancer: A systematic review","volume":"20","author":"Mierzynska","year":"2019","journal-title":"Lancet Oncol."},{"key":"ref_69","doi-asserted-by":"crossref","unstructured":"Caminiti, C., Maglietta, G., Diodati, F., Puntoni, M., Marcomini, B., Lazzarelli, S., Pinto, C., and Perrone, F. (2022). The effects of patient-reported outcome screening on the survival of people with cancer: A systematic review and meta-analysis. Cancers, 14.","DOI":"10.3390\/cancers14215470"},{"key":"ref_70","doi-asserted-by":"crossref","unstructured":"Lizan, L., Perez-Carbonell, L., and Comellas, M. (2021). Additional value of patient-reported symptom monitoring in cancer care: A systematic review of the literature. Cancers, 13.","DOI":"10.3390\/cancers13184615"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1200\/EDBK_200383","article-title":"Implementation of patient-reported outcomes in routine medical care","volume":"38","author":"Basch","year":"2018","journal-title":"Am. Soc. Clin. Oncol. Educ. Book"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1001\/jama.2017.7156","article-title":"Overall survival results of a trial assessing patient-reported outcomes for symptom monitoring during routine cancer treatment","volume":"318","author":"Basch","year":"2017","journal-title":"JAMA"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/j.radonc.2019.09.009","article-title":"Access to radiotherapy and its association with cancer outcomes in a high-income country: Addressing the inequity in Canada","volume":"141","author":"Chan","year":"2019","journal-title":"Radiother. Oncol."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"1248","DOI":"10.1158\/1055-9965.EPI-18-0807","article-title":"Rural cancer control: Bridging the chasm in geographic health inequity","volume":"27","author":"Henley","year":"2018","journal-title":"Cancer Epidemiol. Biomark. Prev."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1200\/OP.20.00174","article-title":"Closing the rural cancer care gap: Three institutional approaches","volume":"16","author":"Levit","year":"2020","journal-title":"JCO Oncol. Pract."},{"key":"ref_76","unstructured":"Canadian Medical Association (2024, December 29). Medical Oncology Profile. Available online: www.cma.ca\/sites\/default\/files\/2019-01\/medical-oncology-e.pdf."},{"key":"ref_77","first-page":"64","article-title":"The landscape of connected cancer symptom management in rural America: A narrative review of opportunities for launching connected health interventions","volume":"2","author":"Chih","year":"2020","journal-title":"J. Appalach. Health"},{"key":"ref_78","first-page":"CD007568","article-title":"Telephone interventions for symptom management in adults with cancer","volume":"6","author":"Ream","year":"2020","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"e432078","DOI":"10.1200\/EDBK_432078","article-title":"Revolutionizing rural oncology: Innovative models and global perspectives","volume":"44","author":"Munhoz","year":"2024","journal-title":"Am. Soc. Clin. Oncol. Educ. Book"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"m4087","DOI":"10.1136\/bmj.m4087","article-title":"Mortality due to cancer treatment delay: Systematic review and meta-analysis","volume":"371","author":"Hanna","year":"2020","journal-title":"BMJ"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1200\/OP.20.00352","article-title":"Rural cancer disparities in the United States: A multilevel framework to improve access to care and patient outcomes","volume":"16","author":"Yabroff","year":"2020","journal-title":"JCO Oncol. Pract."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1188\/20.CJON.S1.16-23","article-title":"Access to care: Using eHealth to limit location-based barriers for patients with cancer","volume":"24","author":"Holland","year":"2020","journal-title":"Clin. J. Oncol. Nurs."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1188\/22.CJON.224-227","article-title":"Virtual cancer care equity in Canada: Lessons from COVID-19","volume":"26","author":"Booker","year":"2022","journal-title":"Clin. J. Oncol. Nurs."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"2336","DOI":"10.1200\/JCO.24.00542","article-title":"Palliative care for patients with cancer: ASCO Guideline Update","volume":"42","author":"Sanders","year":"2024","journal-title":"J. Clin. Oncol."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"101005","DOI":"10.1016\/j.lanepe.2024.101005","article-title":"Implementation of a remote symptom monitoring pathway in oncology care: Analysis of real-world experience across 33 cancer centres in France and Belgium","volume":"44","author":"Franzoi","year":"2024","journal-title":"Lancet Reg. Health Eur."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"n1647","DOI":"10.1136\/bmj.n1647","article-title":"Real time remote symptom monitoring during chemotherapy for cancer: European multicentre randomised controlled trial (eSMART)","volume":"374","author":"Maguire","year":"2021","journal-title":"BMJ"},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"12000","DOI":"10.1200\/JCO.2021.39.15_suppl.12000","article-title":"Randomized trial of remote cancer symptom monitoring during COVID-19: Impact on symptoms, QoL, and unplanned health care utilization","volume":"39","author":"Mooney","year":"2021","journal-title":"J. Clin. Oncol."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"e46001","DOI":"10.2196\/46001","article-title":"Patient and provider perspectives on symptom monitoring during outpatient chemotherapy: Interview study","volume":"7","author":"Chen","year":"2023","journal-title":"JMIR Form. Res."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"10732748241297368","DOI":"10.1177\/10732748241297368","article-title":"Patient-perceived benefits and limitations of standard of care remote symptom monitoring during cancer treatment","volume":"31","author":"Smith","year":"2024","journal-title":"Cancer Control"},{"key":"ref_90","first-page":"299","article-title":"An integrative review of sex differences in quality of life and symptoms among survivors of hematologic malignancies","volume":"50","author":"Nodzon","year":"2023","journal-title":"Oncol. Nurs. Forum"},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"e714","DOI":"10.1016\/j.clml.2021.05.002","article-title":"Trajectory of symptoms in patients undergoing autologous stem cell transplant for multiple myeloma: A population-based cohort study of patient-reported outcomes","volume":"21","author":"Ebraheem","year":"2021","journal-title":"Clin. Lymphoma Myeloma Leuk."},{"key":"ref_92","doi-asserted-by":"crossref","unstructured":"Morse, L., Cooper, B.A., Ritchie, C.S., Wong, M.L., Kober, K.M., Harris, C., Shin, J., Oppegaard, K., Hammer, M.J., and Schimmel, A.C. (2024). Stability and consistency of symptom clusters in younger versus older patients receiving chemotherapy. BMC Geriatr., 24.","DOI":"10.1186\/s12877-024-04755-2"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"2150","DOI":"10.1200\/JCO.21.00195","article-title":"Understanding treatment tolerability in older adults with cancer","volume":"39","author":"Flannery","year":"2021","journal-title":"J. Clin. Oncol."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"102029","DOI":"10.1016\/j.ejon.2021.102029","article-title":"Symptom experience of older oncology patients with low versus high levels of multimorbidity prior to chemotherapy","volume":"54","author":"Gaudernack","year":"2021","journal-title":"Eur. J. Oncol. Nurs."},{"key":"ref_95","doi-asserted-by":"crossref","unstructured":"Cataldo, J.K., Paul, S., Cooper, B., Skerman, H., Alexander, K., Aouizerat, B., Blackman, V., Merriman, J., Dunn, L., and Ritchie, C. (2013). Differences in the symptom experience of older versus younger oncology outpatients: A cross-sectional study. BMC Cancer, 13.","DOI":"10.1186\/1471-2407-13-6"},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"103655","DOI":"10.1016\/j.esmoop.2024.103655","article-title":"Estimating the prevalence of mental disorders in patients with newly diagnosed cancer in relation to socioeconomic status: A multicenter prospective observational study","volume":"9","author":"Goerling","year":"2024","journal-title":"ESMO Open"},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"E29","DOI":"10.1097\/NCC.0000000000000135","article-title":"Symptom burden and quality of life in survivorship: A review of the literature","volume":"38","author":"Wu","year":"2015","journal-title":"Cancer Nurs."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"4720","DOI":"10.1002\/cncr.30912","article-title":"The relationship between physical and psychological symptoms and health care utilization in hospitalized patients with advanced cancer","volume":"123","author":"Nipp","year":"2017","journal-title":"Cancer"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"1572","DOI":"10.1002\/cncr.28614","article-title":"Quality of end-of-life care in patients with hematologic malignancies: A retrospective cohort study","volume":"120","author":"Hui","year":"2014","journal-title":"Cancer"},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"813","DOI":"10.6004\/jnccn.2023.7033","article-title":"Hematologic malignancy: Who cares in the end? A retrospective cohort study of markers of quality end-of-life care","volume":"21","author":"Shaw","year":"2023","journal-title":"J. Natl. Compr. Canc. Netw."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"93","DOI":"10.21037\/apm-23-80","article-title":"Characterizing after-hours hematology\/oncology clinic calls","volume":"13","author":"Phung","year":"2024","journal-title":"Ann. Palliat. Med."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"E496","DOI":"10.9778\/cmajo.20190198","article-title":"Outcomes after emergency department use in patients with cancer receiving chemotherapy in Ontario, Canada: A population-based cohort study","volume":"8","author":"Grewal","year":"2020","journal-title":"CMAJ Open"},{"key":"ref_103","first-page":"E180","article-title":"Meta-analysis of effects of early palliative care on health-related outcomes among advanced cancer patients","volume":"72","author":"Cui","year":"2023","journal-title":"Nurs. Res."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"1179554920915722","DOI":"10.1177\/1179554920915722","article-title":"Summarizing the evidence base for palliative oncology care: A critical evaluation of the meta-analyses","volume":"14","author":"Rogers","year":"2020","journal-title":"Clin. Med. Insights Oncol."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1016\/j.jpainsymman.2021.03.014","article-title":"Outcomes of specialty palliative care interventions for patients with hematologic malignancies: A systematic review","volume":"62","author":"Elliott","year":"2021","journal-title":"J. Pain Symptom Manag."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1177\/0269216318812633","article-title":"Integrated outpatient palliative care for patients with advanced cancer: A systematic review and meta-analysis","volume":"33","author":"Fulton","year":"2019","journal-title":"Palliat. Med."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"e183","DOI":"10.1200\/OP.21.00299","article-title":"Effect of early palliative care on end-of-life health care costs: A population-based, propensity score-matched cohort study","volume":"18","author":"Seow","year":"2022","journal-title":"JCO Oncol. Pract."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"3146","DOI":"10.1182\/bloodadvances.2022009039","article-title":"Value of embedded palliative care: Outpatient palliative care and health care utilization for patients with hematologic malignancies","volume":"7","author":"Tsang","year":"2023","journal-title":"Blood Adv."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"102941","DOI":"10.1016\/j.esmoop.2024.102941","article-title":"Under-reporting of subjective symptoms and its prognostic value: A pooled analysis of 12 cancer clinical trials","volume":"9","author":"Arenare","year":"2024","journal-title":"ESMO Open"},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1016\/j.jpainsymman.2014.10.013","article-title":"Modified Edmonton Symptom Assessment System including constipation and sleep: Validation in outpatients with cancer","volume":"49","author":"Hannon","year":"2015","journal-title":"J. Pain Symptom Manag."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.1007\/s11136-021-02966-3","article-title":"Willingness to report treatment-related symptoms of immunotherapy among patients with non-small cell lung cancer","volume":"31","author":"Martin","year":"2022","journal-title":"Qual. Life Res."},{"key":"ref_112","first-page":"313","article-title":"Integrating palliative care in hematopoietic stem cell transplantation: A qualitative study exploring patient, caregiver, and clinician perspectives","volume":"50","author":"Booker","year":"2023","journal-title":"Oncol. Nurs. Forum"},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1038\/nrclinonc.2015.222","article-title":"Patient-reported outcomes in the evaluation of toxicity of anticancer treatments","volume":"13","author":"Basch","year":"2016","journal-title":"Nat. Rev. Clin. Oncol."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"5835","DOI":"10.3390\/curroncol30060437","article-title":"The stigma surrounding opioid use as a barrier to cancer-pain management: An overview of experiences with fear, shame, and poorly controlled pain in the context of advanced cancer","volume":"30","author":"Harsanyi","year":"2023","journal-title":"Curr. Oncol."},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1007\/s13187-019-01548-9","article-title":"Managing pain in people with cancer-a systematic review of the attitudes and knowledge of professionals, patients, caregivers and public","volume":"35","author":"Makhlouf","year":"2020","journal-title":"J. Cancer Educ."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"3426","DOI":"10.1200\/JCO.23.00293","article-title":"Management of anxiety and depression in adult survivors of cancer: ASCO guideline update","volume":"41","author":"Andersen","year":"2023","journal-title":"J. Clin. Oncol."},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1016\/S2215-0366(14)70313-X","article-title":"Prevalence, associations, and adequacy of treatment of major depression in patients with cancer: A cross-sectional analysis of routinely collected clinical data","volume":"1","author":"Walker","year":"2014","journal-title":"Lancet Psychiatry"},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1002\/pon.3606","article-title":"Patterns and predictors of antidepressant use in ambulatory cancer patients with common solid tumors","volume":"24","author":"Fisch","year":"2015","journal-title":"Psychooncology"},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"23m03668","DOI":"10.4088\/PCC.23m03668","article-title":"Psychotropic medication prescriptions for home-based palliative care oncology patients","volume":"26","author":"Mohamed","year":"2024","journal-title":"Prim. Care Companion CNS Disord."},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"101155","DOI":"10.1016\/j.esmoop.2023.101155","article-title":"Anxiety and depression in adult cancer patients: ESMO clinical practice guideline","volume":"8","author":"Grassi","year":"2023","journal-title":"ESMO Open"},{"key":"ref_121","doi-asserted-by":"crossref","unstructured":"Perna, G., Pinto, E., Spiti, A., Torti, T., Cucchi, M., and Caldirola, D. (2024). Foundations for a personalized psycho-oncology: The state of the art. J. Pers. Med., 14.","DOI":"10.3390\/jpm14090892"},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"2413","DOI":"10.1001\/jama.2022.9265","article-title":"Effect of electronic symptom monitoring on patient-reported outcomes among patients with metastatic cancer: A randomized clinical trial","volume":"327","author":"Basch","year":"2020","journal-title":"JAMA"},{"key":"ref_123","doi-asserted-by":"crossref","first-page":"1537","DOI":"10.1016\/S0140-6736(22)00242-2","article-title":"Management of common clinical problems experienced by survivors of cancer","volume":"399","author":"Emery","year":"2022","journal-title":"Lancet"},{"key":"ref_124","doi-asserted-by":"crossref","unstructured":"Lewandowska, A., Rudzki, G., Lewandowski, T., Prochnicki, M., Rudzki, S., Laskowska, B., and Brudniak, J. (2020). Quality of life of cancer patients treated with chemotherapy. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17196938"},{"key":"ref_125","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1016\/j.annonc.2020.02.016","article-title":"Cancer-related fatigue: ESMO Clinical Practice Guidelines for diagnosis and treatment","volume":"31","author":"Fabi","year":"2020","journal-title":"Ann. Oncol."},{"key":"ref_126","doi-asserted-by":"crossref","first-page":"e2424793","DOI":"10.1001\/jamanetworkopen.2024.24793","article-title":"Patient-reported outcome measures in cancer care: An updated systematic review and meta-analysis","volume":"7","author":"Balitsky","year":"2024","journal-title":"JAMA Netw. Open"},{"key":"ref_127","first-page":"3353","article-title":"The pathophysiology of cancer-related fatigue: Current controversies","volume":"10","author":"Brady","year":"2018","journal-title":"Support. Care Cancer"},{"key":"ref_128","doi-asserted-by":"crossref","first-page":"1286","DOI":"10.1016\/j.jpainsymman.2018.01.008","article-title":"The role of inflammation in the pain, fatigue, and sleep disturbance symptom cluster in advanced cancer","volume":"55","author":"Kwekkeboom","year":"2018","journal-title":"J. Pain Symptom Manag."},{"key":"ref_129","doi-asserted-by":"crossref","first-page":"458","DOI":"10.21037\/apm-22-974","article-title":"Symptom clusters in palliative-stage cancer correlate with proinflammatory cytokine cluster","volume":"12","author":"Nilsberth","year":"2023","journal-title":"Ann. Palliat. Med."},{"key":"ref_130","doi-asserted-by":"crossref","unstructured":"Harmer, D., Falank, C., and Reagan, M.R. (2019). Interleukin-6 Interweaves the bone marrow microenvironment, bone loss, and multiple myeloma. Front. Endocrinol., 8.","DOI":"10.3389\/fendo.2018.00788"},{"key":"ref_131","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1188\/09.ONF.209-216","article-title":"The relationships among physiologic variables, quality of life, and fatigue in patients with multiple myeloma","volume":"36","author":"Booker","year":"2009","journal-title":"Oncol. Nurs. Forum"},{"key":"ref_132","doi-asserted-by":"crossref","first-page":"1476","DOI":"10.1002\/cncr.33397","article-title":"Systemic inflammation and symptomatology in patients with prostate cancer treated with androgen deprivation therapy: Preliminary findings","volume":"127","author":"Hoogland","year":"2021","journal-title":"Cancer"},{"key":"ref_133","doi-asserted-by":"crossref","first-page":"S129","DOI":"10.1016\/j.bbmt.2019.12.648","article-title":"Improved quality of life with interleukin-6 (IL-6) blockade with siltuximab peri-autologous hematopoietic stem cell transplantation (AHCT) in older patients with multiple myeloma (MM)","volume":"26","author":"Shah","year":"2020","journal-title":"Biol. Blood Marrow Transplant."},{"key":"ref_134","doi-asserted-by":"crossref","first-page":"103222","DOI":"10.1016\/j.critrevonc.2021.103222","article-title":"Relationship between cytokines and symptoms in people with incurable cancer: A systematic review","volume":"159","author":"Patton","year":"2021","journal-title":"Crit. Rev. Oncol. Hematol."},{"key":"ref_135","doi-asserted-by":"crossref","first-page":"100278","DOI":"10.1016\/j.ctarc.2020.100278","article-title":"Chemotherapy-induced nausea and vomiting: Pathogenesis, recommendations, and new trends","volume":"26","author":"Gupta","year":"2021","journal-title":"Cancer Treat. Res. Commun."},{"key":"ref_136","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1007\/s11864-020-0704-8","article-title":"Nausea and vomiting in advanced cancer","volume":"21","author":"Navari","year":"2020","journal-title":"Curr. Treat. Options Oncol."},{"key":"ref_137","unstructured":"Karstens-Smith, B. (2024, October 21). A Timeline of COVID-19 in Alberta. Global News. Available online: https:\/\/globalnews.ca\/news\/7538547\/covid-19-alberta-health-timeline\/."},{"key":"ref_138","doi-asserted-by":"crossref","first-page":"e1354","DOI":"10.1200\/OP.21.00144","article-title":"Virtual cancer care during the COVID-19 pandemic in Alberta: Evidence from a mixed methods evaluation and key learnings","volume":"17","author":"Watson","year":"2021","journal-title":"JCO Oncol. Pract."}],"container-title":["Current Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1718-7729\/32\/2\/62\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T10:36:17Z","timestamp":1759919777000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1718-7729\/32\/2\/62"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,25]]},"references-count":138,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,2]]}},"alternative-id":["curroncol32020062"],"URL":"https:\/\/doi.org\/10.3390\/curroncol32020062","relation":{},"ISSN":["1718-7729"],"issn-type":[{"value":"1718-7729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,25]]}}}