{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T11:24:35Z","timestamp":1783596275363,"version":"3.55.0"},"reference-count":62,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T00:00:00Z","timestamp":1783555200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Background: Lung cancer carries a high psychosocial burden. Tobacco use, the stigma attached to the disease, and coping strategies are thought to interact and shape psychological outcomes, yet they have rarely been examined together. This review aimed to synthesise the evidence on the relationship between tobacco use, lung cancer stigma, and coping, and how these factors interact and influence patients\u2019 psychological outcomes. Methods: Following the PRISMA 2020 guideline, PubMed\/MEDLINE and Dialnet were searched (window 2014\u2013April 2026) for empirical studies conducted in adults with lung cancer that addressed stigma, coping, or relevant psychological outcomes (e.g., anxiety, depression, distress, or quality of life). Study selection and data extraction were performed independently by two reviewers, with discrepancies resolved by consensus and, where needed, by a third reviewer. Methodological quality was appraised with design-specific tools (JBI for cross-sectional and cohort studies, CASP for qualitative studies, and COSMIN-oriented criteria for the psychometric study). Given the clinical and methodological heterogeneity, a structured narrative synthesis was conducted following the SWiM guideline. The protocol was registered in the Open Science Framework. Results: Twenty-four studies were included. Stigma was prevalent and consistently associated with depression, anxiety, distress, and poorer quality of life, with longitudinal evidence indicating that stigma precedes and predicts distress. Internalised stigma (guilt, shame, self-blame) was the facet most strongly linked to depression and anxiety. Smoking history graded stigma intensity (current &gt; former &gt; never smokers) but did not determine it, since clinically significant stigma also affected never-smokers. Adaptive coping (e.g., fighting spirit, positive reappraisal) and social support were consistently associated with better psychological adjustment and quality of life, while maladaptive coping (e.g., helplessness, avoidance, anxious preoccupation) was associated with worse outcomes; cross-sectional evidence further indicated that coping modes mediated the relationship between stigma and quality of life and that social support and self-compassion attenuated the impact of stigma on distress. Conclusions: Internalised stigma is a central, modifiable psychosocial stressor in lung cancer that affects smokers and never-smokers alike. Systematic screening for stigma, coping, and social support, together with non-stigmatising care, is warranted.<\/jats:p>","DOI":"10.3390\/curroncol33070408","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T10:16:22Z","timestamp":1783592182000},"page":"408","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Tobacco Use, Stigma, and Coping in Lung Cancer: A Systematic Review of Their Psychosocial Interactions and Clinical Implications"],"prefix":"10.3390","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-3274-5401","authenticated-orcid":false,"given":"Anais","family":"S\u00e1nchez-Ros","sequence":"first","affiliation":[{"name":"Doctoral School, Catholic University of Valencia San Vicente M\u00e1rtir, c\/Quevedo, 2, 46001 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9515-180X","authenticated-orcid":false,"given":"Francisco","family":"Tom\u00e1s-Aguirre","sequence":"additional","affiliation":[{"name":"SONEV Research Group, Faculty of Medicine and Health Sciences, Catholic University of Valencia San Vicente M\u00e1rtir, C\/Quevedo No. 2, 46001 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5027-4785","authenticated-orcid":false,"given":"Marcelino","family":"P\u00e9rez-Bermejo","sequence":"additional","affiliation":[{"name":"SONEV Research Group, Faculty of Medicine and Health Sciences, Catholic University of Valencia San Vicente M\u00e1rtir, C\/Quevedo No. 2, 46001 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9905-0443","authenticated-orcid":false,"given":"Mar\u00eda Teresa","family":"Murillo-Llorente","sequence":"additional","affiliation":[{"name":"SONEV Research Group, Faculty of Medicine and Health Sciences, Catholic University of Valencia San Vicente M\u00e1rtir, C\/Quevedo No. 2, 46001 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5468-4434","authenticated-orcid":false,"given":"Mar\u00eda Ester","family":"Legidos-Garc\u00eda","sequence":"additional","affiliation":[{"name":"SONEV Research Group, Faculty of Medicine and Health Sciences, Catholic University of Valencia San Vicente M\u00e1rtir, C\/Quevedo No. 2, 46001 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6426-2999","authenticated-orcid":false,"given":"Ignacio","family":"Ventura","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Sciences, Catholic University of Valencia San Vicente M\u00e1rtir, C\/Quevedo No. 2, 46001 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Mayordomo-Rodriguez","sequence":"additional","affiliation":[{"name":"Departamento Psicolog\u00eda de la Personalidad, Tratamientos y Metodolog\u00eda, Avda de la Ilustraci\u00f3n, 2, 46010 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,9]]},"reference":[{"key":"ref_1","first-page":"229","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA Cancer J. Clin."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ccm.2019.10.001","article-title":"Lung cancer 2020: Epidemiology, etiology, and prevention","volume":"41","author":"Bade","year":"2020","journal-title":"Clin. Chest Med."},{"key":"ref_3","unstructured":"Asociaci\u00f3n Espa\u00f1ola de Afectados de C\u00e1ncer de Pulm\u00f3n (AEACAP) (2026, June 02). Diagn\u00f3stico Precoz. Available online: https:\/\/afectadoscancerdepulmon.com\/diagnostico-precoz\/."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"746","DOI":"10.1038\/s41571-019-0249-6","article-title":"Comorbid chronic diseases and cancer diagnosis: Disease-specific effects and underlying mechanisms","volume":"16","author":"Renzi","year":"2019","journal-title":"Nat. Rev. Clin. Oncol."},{"key":"ref_5","unstructured":"Generalitat Valenciana, and Conselleria de Sanitat Universal i Salut P\u00fablica (2019). Estrategia Contra el C\u00e1ncer de la Comunitat Valenciana 2019\u20132022."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1002\/pon.5846","article-title":"Lung cancer symptom appraisal, help-seeking and diagnosis\u2014Rapid systematic review of differences between patients with and without a smoking history","volume":"31","author":"Syversen","year":"2022","journal-title":"Psychooncology"},{"key":"ref_7","unstructured":"World Health Organization (2026, June 02). Cancer, Available online: https:\/\/www.who.int\/es\/news-room\/fact-sheets\/detail\/cancer."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"102895","DOI":"10.1016\/j.critrevonc.2020.102895","article-title":"Lung cancer in never smokers: The role of different risk factors other than tobacco smoking","volume":"148","author":"Corrales","year":"2020","journal-title":"Crit. Rev. Oncol. Hematol."},{"key":"ref_9","unstructured":"Asociaci\u00f3n Espa\u00f1ola Contra el C\u00e1ncer (AECC) (2026, June 02). Factores de Riesgo del C\u00e1ncer de Pulm\u00f3n. Available online: https:\/\/www.contraelcancer.es\/es\/todo-sobre-cancer\/tipos-cancer\/cancer-pulmon\/factores-riesgo-cancer-pulmon."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1093\/ijnp\/pyaa015","article-title":"Neural basis of smoking-related difficulties in emotion regulation","volume":"23","author":"Faulkner","year":"2020","journal-title":"Int. J. Neuropsychopharmacol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"109416","DOI":"10.1016\/j.drugalcdep.2022.109416","article-title":"Cigarette smoking is associated with difficulties in the use of reappraisal for emotion regulation","volume":"234","author":"Faulkner","year":"2022","journal-title":"Drug Alcohol Depend."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/j.addbeh.2019.05.002","article-title":"Emotion dysregulation and cigarette dependence, perceptions of quitting, and problems during quit attempts among Spanish-speaking Latinx adult smokers","volume":"96","author":"Zvolensky","year":"2019","journal-title":"Addict. Behav."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1080\/07481180701603360","article-title":"Death anxiety and cancer-related stigma: A terror management analysis","volume":"31","author":"Mosher","year":"2007","journal-title":"Death Stud."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1016\/j.cnre.2017.10.002","article-title":"Perceived health-related stigma among patients with breast cancer","volume":"4","author":"Wang","year":"2017","journal-title":"Chin. Nurs. Res."},{"key":"ref_15","unstructured":"Jones, E.E., Farina, A., Hastorf, A.H., Markus, H., Miller, D.T., and Scott, R.A. (1984). Social Stigma: The Psychology of Marked Relationships, W.H. Freeman."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1093\/abm\/kaz063","article-title":"Lung cancer stigma: Does smoking history matter?","volume":"54","author":"Williamson","year":"2020","journal-title":"Ann. Behav. Med."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Chambers, S.K., Dunn, J., Occhipinti, S., Hughes, S., Baade, P., Sinclair, S., Aitken, J., Youl, P., and O\u2019connell, D.L. (2012). A systematic review of the impact of stigma and nihilism on lung cancer outcomes. BMC Cancer, 12.","DOI":"10.1186\/1471-2407-12-184"},{"key":"ref_18","unstructured":"National Institute on Drug Abuse (NIDA) (2026, June 02). Estigma y Discriminaci\u00f3n, Available online: https:\/\/nida.nih.gov\/es\/areas-de-investigacion\/estigma-y-discriminacion."},{"key":"ref_19","unstructured":"Delegaci\u00f3n del Gobierno para el Plan Nacional sobre Drogas (PNSD) (2026, June 02). Tabaco, Available online: https:\/\/pnsd.sanidad.gob.es."},{"key":"ref_20","first-page":"318","article-title":"Stigma and quality of life in patients with advanced lung cancer","volume":"46","author":"Johnson","year":"2019","journal-title":"Oncol. Nurs. Forum."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1037\/sah0000089","article-title":"Development and preliminary psychometric evaluation of a patient-reported outcome measure for lung cancer stigma: The Lung Cancer Stigma Inventory (LCSI)","volume":"3","author":"Hamann","year":"2018","journal-title":"Stigma Health"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1037\/hea0001156","article-title":"Facets of stigma, self-compassion, and health-related adjustment to lung cancer: A longitudinal study","volume":"41","author":"Williamson","year":"2022","journal-title":"Health Psychol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1011","DOI":"10.1002\/pon.5033","article-title":"Lung cancer stigma and depression: Validation of the Lung Cancer Stigma Inventory","volume":"28","author":"Ostroff","year":"2019","journal-title":"Psychooncology"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1002\/pon.4464","article-title":"One in two cancer patients is significantly distressed: Prevalence and indicators of distress","volume":"27","author":"Mehnert","year":"2018","journal-title":"Psychooncology"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1080\/07347332.2018.1521490","article-title":"Prevalence of psychosocial distress in cancer patients across 55 North American cancer centers","volume":"37","author":"Carlson","year":"2019","journal-title":"J. Psychosoc. Oncol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1016\/j.cllc.2017.02.008","article-title":"Emotional problems, quality of life, and symptom burden in patients with lung cancer","volume":"18","author":"Morrison","year":"2017","journal-title":"Clin. Lung Cancer"},{"key":"ref_27","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_28","doi-asserted-by":"crossref","first-page":"1310","DOI":"10.1200\/JCO.2011.38.3166","article-title":"Depression and survival in metastatic non-small-cell lung cancer: Effects of early palliative care","volume":"30","author":"Pirl","year":"2012","journal-title":"J. Clin. Oncol."},{"key":"ref_29","first-page":"57","article-title":"Influence of coping strategy on perception of anxiety and depression in patients with non-small cell lung cancer","volume":"1251","author":"Chabowski","year":"2020","journal-title":"Adv. Exp. Med. Biol."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Pola\u0144ski, J., Ta\u0144ski, W., Dudek, K., and Jankowska-Pola\u0144ska, B. (2024). Pain and coping strategies as determinants of malnutrition risk in lung cancer patients: A cross-sectional study. Nutrients, 16.","DOI":"10.3390\/nu16142193"},{"key":"ref_31","first-page":"16","article-title":"Estrategias de afrontamiento y calidad de vida en pacientes oncol\u00f3gicos y cuidadores primarios","volume":"12","year":"2019","journal-title":"Rev. Griot"},{"key":"ref_32","first-page":"73","article-title":"Reflexiones sobre el concepto de afrontamiento en psicooncolog\u00eda","volume":"75","author":"Soriano","year":"2002","journal-title":"Bol. Psicol."},{"key":"ref_33","unstructured":"Lazarus, R.S., and Folkman, S. (1984). Stress, Appraisal, and Coping, Springer."},{"key":"ref_34","unstructured":"Lazarus, R.S. (2000). Estr\u00e9s y Emoci\u00f3n: Manejo e Implicaciones en Nuestra Salud, Descl\u00e9e de Brouwer."},{"key":"ref_35","unstructured":"Moorey, S., and Greer, S. (1989). Psychological Therapy for Patients with Cancer: A New Approach, Heinemann Medical Books."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"4085","DOI":"10.2147\/CMAR.S175210","article-title":"The effect of coping strategy on quality of life in patients with NSCLC","volume":"10","author":"Chabowski","year":"2018","journal-title":"Cancer Manag. Res."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1137","DOI":"10.1002\/pon.5665","article-title":"Lung cancer stigma is a predictor for psychological distress: A longitudinal study","volume":"30","author":"Rose","year":"2021","journal-title":"Psychooncology"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1284","DOI":"10.1016\/j.jtho.2018.06.018","article-title":"A longitudinal investigation of internalized stigma, constrained disclosure, and quality of life across 12 weeks in lung cancer patients on active oncologic treatment","volume":"13","author":"Williamson","year":"2018","journal-title":"J. Thorac. Oncol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1017\/S147895152200116X","article-title":"Quality of life, anxiety, depression, and distress in patients with advanced and metastatic lung cancer","volume":"21","author":"Bello","year":"2023","journal-title":"Palliat. Support. Care"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"100483","DOI":"10.1016\/j.apjon.2024.100483","article-title":"Stigma and quality of life in lung cancer patients: The mediating effect of distress and the moderated mediating effect of social support","volume":"11","author":"Lim","year":"2024","journal-title":"Asia-Pac. J. Oncol. Nurs."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Ma, F., Zheng, W., Wang, W., Zhang, N., and Liu, Y. (2024). The mediating role of medical coping modes between stigma and quality of life in patients undergoing lung cancer surgery: A cross-sectional study. BMC Cancer, 24.","DOI":"10.1186\/s12885-024-13337-9"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1790","DOI":"10.1186\/s40064-016-3486-5","article-title":"Coping with stigma: The experiences of Chinese patients living with lung cancer","volume":"5","author":"Liu","year":"2016","journal-title":"SpringerPlus"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Ding, Y., Wang, X., Zhang, F., Yan, H., Liu, Y., and Zhang, L. (2024). The relationship between perceived social support, coping style, and the quality of life and psychological state of lung cancer patients. BMC Psychol., 12.","DOI":"10.1186\/s40359-024-01927-y"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"27253","DOI":"10.1038\/s41598-025-09847-6","article-title":"Exploring psychological distress among lung cancer patients through the stress system model","volume":"15","author":"Liu","year":"2025","journal-title":"Sci. Rep."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Xu, F., Xie, S., Li, Q., Zhong, X., and Zhang, J. (2025). The impact of depression on the quality of life of lung cancer patients undergoing chemotherapy: Mediating effects of perceived social support. Front. Psychiatry, 16.","DOI":"10.3389\/fpsyt.2025.1526217"},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Munn, Z., Peters, M.D.J., Stern, C., Tufanaru, C., McArthur, A., and Aromataris, E. (2018). Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC Med. Res. Methodol., 18.","DOI":"10.1186\/s12874-018-0611-x"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"l6890","DOI":"10.1136\/bmj.l6890","article-title":"Synthesis without meta-analysis (SWiM) in systematic reviews: Reporting guideline","volume":"368","author":"Campbell","year":"2020","journal-title":"BMJ"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1435","DOI":"10.1177\/1049732312452938","article-title":"Beyond PICO: The SPIDER tool for qualitative evidence synthesis","volume":"22","author":"Cooke","year":"2012","journal-title":"Qual. Health Res."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1186\/s13643-020-01542-z","article-title":"PRISMA-S: An extension to the PRISMA Statement for Reporting Literature Searches in Systematic Reviews","volume":"10","author":"Rethlefsen","year":"2021","journal-title":"Syst. Rev."},{"key":"ref_51","unstructured":"Wyman, O. (2020). El Impacto Econ\u00f3mico y Social del C\u00e1ncer en Espa\u00f1a, Asociaci\u00f3n Espa\u00f1ola Contra el C\u00e1ncer (AECC)."},{"key":"ref_52","unstructured":"Aromataris, E., and Munn, Z. (2020). JBI Manual for Evidence Synthesis, JBI."},{"key":"ref_53","unstructured":"Critical Appraisal Skills Programme (2018). CASP Qualitative Studies Checklist, CASP UK. Available online: https:\/\/casp-uk.net\/casp-tools-checklists\/."},{"key":"ref_54","first-page":"285","article-title":"The Mixed Methods Appraisal Tool (MMAT) version 2018 for information professionals and researchers","volume":"34","author":"Hong","year":"2018","journal-title":"Educ. Inf."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1037\/sah0000214","article-title":"Dispositional shame and guilt as predictors of depressive symptoms and anxiety among adults with lung cancer: The mediational role of internalized stigma","volume":"5","author":"Williamson","year":"2020","journal-title":"Stigma Health"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"E203","DOI":"10.1188\/14.ONF.E203-E210","article-title":"Lung cancer stigma predicts timing of medical help-seeking behavior","volume":"41","author":"Hermann","year":"2014","journal-title":"Oncol. Nurs. Forum."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1569","DOI":"10.1002\/pon.3829","article-title":"Psychological distress and quality of life in lung cancer: The role of health-related stigma, illness appraisals and social constraints","volume":"24","author":"Chambers","year":"2015","journal-title":"Psychooncology"},{"key":"ref_58","first-page":"2093","article-title":"Association between patient-provider communication and lung cancer stigma","volume":"24","author":"Shen","year":"2016","journal-title":"Support Care Cancer"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"e023934","DOI":"10.1136\/bmjopen-2018-023934","article-title":"Qualitative cross-country comparison of whether, when and how people diagnosed with lung cancer talk about cigarette smoking in narrative interviews","volume":"8","author":"Hajdarevic","year":"2018","journal-title":"BMJ Open"},{"key":"ref_60","first-page":"989","article-title":"Psychological distress and coping strategies among women with incurable lung cancer: A qualitative study","volume":"26","author":"Liao","year":"2018","journal-title":"Support Care Cancer"},{"key":"ref_61","first-page":"1359","article-title":"The relation between psychological profiles and quality of life in patients with lung cancer","volume":"28","author":"Arts","year":"2020","journal-title":"Support Care Cancer"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"2094","DOI":"10.1002\/pon.6041","article-title":"What are the similarities and differences in lung cancer symptom appraisal and help-seeking according to smoking status? A qualitative study with lung cancer patients","volume":"31","author":"Black","year":"2022","journal-title":"Psychooncology"}],"container-title":["Current Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1718-7729\/33\/7\/408\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T10:52:44Z","timestamp":1783594364000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1718-7729\/33\/7\/408"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,9]]},"references-count":62,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7]]}},"alternative-id":["curroncol33070408"],"URL":"https:\/\/doi.org\/10.3390\/curroncol33070408","relation":{},"ISSN":["1718-7729"],"issn-type":[{"value":"1718-7729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,9]]}}}