{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T12:23:43Z","timestamp":1783081423380,"version":"3.54.6"},"reference-count":62,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:00:00Z","timestamp":1783036800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: Problematic smartphone use may threaten student well-being, especially among nursing students who rely on smartphones for academic and clinical activities. This study estimated potential problematic smartphone use among Greek nursing students, examined its association with quality of life (QoL), and explored whether contextual factors modified these associations. Methods: A cross-sectional study was conducted among 331 nursing students in Greece from September to November 2025. Participants completed an anonymous online questionnaire including sociodemographic data, the Smartphone Addiction Scale\u2013Short Version (SAS-SV), and the World Health Organization Quality of Life\u2013BREF (WHOQOL-BREF). Results: The mean SAS-SV score was 29.30 \u00b1 9.69, and 18.9% of students screened positive for potential problematic smartphone use. Mean overall QoL and general health satisfaction were 3.80 \u00b1 0.78 and 3.97 \u00b1 0.88, respectively. Higher SAS-SV scores were associated with lower physical, psychological, and environmental QoL, but not with social QoL. Years of study moderated only the association with environmental QoL. Conclusions: Problematic smartphone use was associated with poorer physical, psychological, and environmental QoL among Greek nursing students. These domain-specific findings extend existing evidence and support integrating digital well-being, self-regulation, and sleep-hygiene strategies into nursing education and student-support services.<\/jats:p>","DOI":"10.3390\/ijerph23070870","type":"journal-article","created":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T11:39:11Z","timestamp":1783078751000},"page":"870","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Problematic Smartphone Use and Quality of Life Among Greek Nursing Students: A Cross-Sectional Study"],"prefix":"10.3390","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2481-4335","authenticated-orcid":false,"given":"Georgios","family":"Manomenidis","sequence":"first","affiliation":[{"name":"Department of Nursing, Democritus University of Thrace, 68100 Alexandroupolis, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0351-9970","authenticated-orcid":false,"given":"Vasiliki","family":"Georgousopoulou","sequence":"additional","affiliation":[{"name":"Department of Nursing, Democritus University of Thrace, 68100 Alexandroupolis, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Vasileiou","sequence":"additional","affiliation":[{"name":"Department of Occupational Health Services, University Hospital of Alexandroupolis, 68100 Alexandroupolis, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7086-9989","authenticated-orcid":false,"given":"Savvato","family":"Karavasileiadou","sequence":"additional","affiliation":[{"name":"Department of Community and Psychiatric Mental Health Nursing, College of Nursing, Princess Nourah Bint Abdulrahman University, Riyadh 11671, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikoletta T.","family":"Karavasili","sequence":"additional","affiliation":[{"name":"Department of Nursing, Democritus University of Thrace, 68100 Alexandroupolis, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4847-0437","authenticated-orcid":false,"given":"Stefanos","family":"Mavroudis","sequence":"additional","affiliation":[{"name":"Department of Nursing, Democritus University of Thrace, 68100 Alexandroupolis, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eman","family":"Atef","sequence":"additional","affiliation":[{"name":"Faculty of Nursing, Helwan University, Cairo 11795, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"104741","DOI":"10.1016\/j.nedt.2020.104741","article-title":"Smartphone addiction, risk factors and its adverse effects in nursing students: A systematic review and meta-analysis","volume":"98","year":"2021","journal-title":"Nurse Educ. Today"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1016\/j.dsx.2020.05.033","article-title":"COVID-19 and applications of smartphone technology in the current pandemic","volume":"14","author":"Iyengar","year":"2020","journal-title":"Diabetes Metab. Syndr."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1007\/s40211-019-00319-8","article-title":"Risk factors for problematic smartphone use in children and adolescents: A review of existing literature","volume":"33","author":"Kothgassner","year":"2019","journal-title":"Neuropsychiatrie"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Giansanti, D. (2025). Smartphone addiction in youth: A narrative review of systematic evidence and emerging strategies. Psychiatry Int., 6.","DOI":"10.3390\/psychiatryint6040118"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Tangmunkongvorakul, A., Musumari, P.M., Thongpibul, K., Srithanaviboonchai, K., Techasrivichien, T., Suguimoto, S.P., Ono-Kihara, M., and Kihara, M. (2019). Association of excessive smartphone use with psychological well-being among university students in Chiang Mai, Thailand. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0210294"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Syed-Abdul, S., and Li, Y.-C. (2023). Empowering patients and transforming healthcare in the post-COVID-19 era: The role of digital and wearable technologies. J. Pers. Med., 13.","DOI":"10.3390\/jpm13050722"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4018\/IJMBL.2021100101","article-title":"The use of mobile devices in university distance learning","volume":"13","author":"Eom","year":"2021","journal-title":"Int. J. Mob. Blended Learn."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.nepr.2018.11.010","article-title":"Comparative study of nomophobia among Spanish and Portuguese nursing students","volume":"34","year":"2019","journal-title":"Nurse Educ. Pract."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1016\/j.chb.2013.10.059","article-title":"A conceptual and methodological critique of internet addiction research: Towards a model of compensatory internet use","volume":"31","year":"2014","journal-title":"Comput. Hum. Behav."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"103478","DOI":"10.1016\/j.nepr.2022.103478","article-title":"Prevalence and predisposing factors of smartphone addiction, sleep quality and daytime sleepiness of nursing students: A cross-sectional design","volume":"65","author":"Akca","year":"2022","journal-title":"Nurse Educ. Pract."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1556\/2006.7.2018.49","article-title":"Is smartphone addiction really an addiction?","volume":"7","author":"Panova","year":"2018","journal-title":"J. Behav. Addctn."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1016\/j.chb.2015.02.059","article-title":"Exploring the dimensions of nomophobia: Development and validation of a self-reported questionnaire","volume":"49","author":"Yildirim","year":"2015","journal-title":"Comput. Hum. Behav."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"104909","DOI":"10.1016\/j.nedt.2021.104909","article-title":"The negative impact of smartphone usage on nursing students: An integrative literature review","volume":"102","author":"Ramjan","year":"2021","journal-title":"Nurse Educ. Today"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"103874","DOI":"10.1016\/j.nepr.2024.103874","article-title":"A model for risk factors harms and of smartphone addiction among nursing students: A scoping review","volume":"75","author":"Zhou","year":"2024","journal-title":"Nurse Educ. Pract."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"151405","DOI":"10.1016\/j.apnr.2021.151405","article-title":"Smartphone distraction during nursing care: Systematic literature review","volume":"58","author":"Fiorinelli","year":"2021","journal-title":"Appl. Nurs. Res."},{"key":"ref_16","first-page":"0272","article-title":"Smartphone addiction, insomnia, loneliness, and self-esteem among nursing students: A correlation study","volume":"33","author":"Yadav","year":"2025","journal-title":"Florence Nightingale J. Nurs."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"151958","DOI":"10.1016\/j.apnu.2025.151958","article-title":"Smartphone usage habits among French nursing students: A monocentric mixed-methods study","volume":"58","author":"Thebault","year":"2025","journal-title":"Arch. Psychiatr. Nurs."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"103025","DOI":"10.1016\/j.nepr.2021.103025","article-title":"Nomophobia and the influence of time to rest among nursing students: A descriptive, correlational and predictive research","volume":"52","year":"2021","journal-title":"Nurse Educ. Pract."},{"key":"ref_19","first-page":"355","article-title":"The effect of dependence on mobile phones and computers on the lifestyle and health of nursing students at the University of the Peloponnese","volume":"33","author":"Tahtsidou","year":"2016","journal-title":"Arch. Hell. Med."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"The WHOQOL Group (1995). The World Health Organization Quality of Life assessment (WHOQOL): Position paper from the World Health Organization. Soc. Sci. Med., 41, 1403\u20131409.","DOI":"10.1016\/0277-9536(95)00112-K"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"105374","DOI":"10.1016\/j.actpsy.2025.105374","article-title":"The impact of smartphone usage frequency on university students\u2019 academic performance: A meta-analysis of moderating factors","volume":"259","author":"Hsieh","year":"2025","journal-title":"Acta Psychol."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Lazo-Caparr\u00f3s, M.D., G\u00f3mez-Urquiza, J.L., Gonz\u00e1lez-D\u00edaz, A., P\u00e9rez-Conde, I., G\u00f3mez-Torres, P., and Membrive-Jim\u00e9nez, M.J. (2025). Assessment tools and psychosocial consequences of smartphone addiction in nursing students: A systematic review and meta-analysis. Healthcare, 13.","DOI":"10.3390\/healthcare13202639"},{"key":"ref_23","first-page":"e73666","article-title":"Measuring the quality of life and psychological distress of dormitory students at a university in Sharjah","volume":"16","author":"Youssef","year":"2024","journal-title":"Cureus"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"da-Silva-Domingues, H., Palomino-Moral, P.\u00c1., Guti\u00e9rrez-S\u00e1nchez, B., Moreno-C\u00e1mara, S., Macedo Loureiro, H.M.A., and del-Pino-Casado, R. (2024). Lifestyles of university students: Analyzing the role of social support and family dynamics. BMC Public Health, 24.","DOI":"10.1186\/s12889-024-21021-7"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"726","DOI":"10.1016\/j.appet.2011.02.010","article-title":"Impact of living arrangements and nationality on food habits and nutrient intakes in young adults","volume":"56","author":"Riddell","year":"2011","journal-title":"Appetite"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"104614","DOI":"10.1016\/j.nedt.2020.104614","article-title":"Nursing graduates lived experiences of anxiety during their final year at university: A phenomenological study","volume":"96","author":"Sun","year":"2021","journal-title":"Nurse Educ. Today"},{"key":"ref_27","first-page":"216","article-title":"The challenges of supporting nursing students in clinical education","volume":"9","author":"Zabihi","year":"2020","journal-title":"J. Educ. Health Promot."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"102744","DOI":"10.1016\/j.pmedr.2024.102744","article-title":"Could physical activity alleviate smartphone addiction in university students? A systematic literature review","volume":"42","author":"Pirwani","year":"2024","journal-title":"Prev. Med. Rep."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1775","DOI":"10.2147\/PRBM.S455955","article-title":"The impact of problematic smartphone use on sleep quality among Chinese young adults: Investigating anxiety and depression as mediators in a three-wave longitudinal study","volume":"17","author":"Wu","year":"2024","journal-title":"Psychol. Res. Behav. Manag."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"107715","DOI":"10.1016\/j.addbeh.2023.107715","article-title":"Longitudinal association between problematic smartphone use and sleep disorder among Chinese college students during the COVID-19 pandemic","volume":"144","author":"Zhang","year":"2023","journal-title":"Addctv. Behav."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"102196","DOI":"10.1016\/j.msksp.2020.102196","article-title":"A systematic review of musculoskeletal complaints, symptoms, and pathologies related to mobile phone usage","volume":"49","author":"Zirek","year":"2020","journal-title":"Musculoskelet. Sci. Pract."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Fabio, R.A., Stracuzzi, A., and Lo Faro, R. (2022). Problematic smartphone use leads to behavioral and cognitive self-control deficits. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19127445"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Teo, J.K.H., Chionh, I.Y.L., Bin Shaul Hamed, N.A., and Lai, C. (2023). Problematic smartphone usage in Singaporean university students: An analysis of self-reported versus objectively measured smartphone usage patterns. Healthcare, 11.","DOI":"10.3390\/healthcare11233033"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Park, J.H., and Choi, J.M. (2022). Smartphone overdependence and quality of life in college students: Focusing on the mediating effect of social withdrawal. Front. Public Health, 10.","DOI":"10.3389\/fpubh.2022.997682"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"27071","DOI":"10.1007\/s12144-022-03830-4","article-title":"Cell phone use distracts young adults from academic work with limited benefit to self-regulatory behavior","volume":"42","author":"Joshi","year":"2022","journal-title":"Curr. Psychol."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Tian, J., Zhao, J.Y., Xu, J.M., Li, Q.L., Sun, T., Zhao, C.X., Gao, R., Zhu, L.Y., Guo, H.C., and Yang, L.B. (2021). Mobile phone addiction and academic procrastination negatively impact academic achievement among Chinese medical students. Front. Psychol., 12.","DOI":"10.3389\/fpsyg.2021.758303"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Kwon, M., Kim, D.-J., Cho, H., and Yang, S. (2013). The Smartphone Addiction Scale: Development and Validation of a Short Version for Adolescents. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0083558"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"3186","DOI":"10.1097\/00007632-200012150-00014","article-title":"Guidelines for the process of cross-cultural adaptation of self-report measures","volume":"25","author":"Beaton","year":"2000","journal-title":"Spine"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"The WHOQOL Group (1998). Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychol. Med., 28, 551\u2013558.","DOI":"10.1017\/S0033291798006667"},{"key":"ref_40","first-page":"130","article-title":"Psychometric properties of WHOQOL-BREF in clinical and health Greek populations: Incorporating new culture-relevant items","volume":"23","author":"Triantafillou","year":"2012","journal-title":"Psychiatriki"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"a6120","DOI":"10.4102\/safp.v67i1.6120","article-title":"Measuring problematic smartphone use among students using the Smartphone Addiction Scale","volume":"67","author":"Mostert","year":"2025","journal-title":"S. Afr. Fam. Pract."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1515\/ijamh-2025-0105","article-title":"Pattern of smartphone use and its influence on psychosocial well-being among adolescent health professional students","volume":"38","author":"Deka","year":"2025","journal-title":"Int. J. Adolesc. Med. Health"},{"key":"ref_43","first-page":"93","article-title":"Screen time and university students\u2019 life: Exploring the impact of smartphone usage on sleep quality, well-being, social behavior, and academic performance","volume":"8","author":"Kee","year":"2025","journal-title":"Asia Pac. J. Manag. Educ."},{"key":"ref_44","first-page":"72","article-title":"Smartphone use: Implications for musculoskeletal symptoms and socio-demographic characteristics in students","volume":"4","author":"Leonel","year":"2024","journal-title":"Rehabil. Sports Med."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"650","DOI":"10.62617\/mcb650","article-title":"Understanding the biomechanics of smartphone addiction: The physical and cognitive impacts of prolonged device use on college students","volume":"22","author":"Sheng","year":"2025","journal-title":"Mol. Cell. Biomech."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Song, Y., Zhang, G., Liu, N., Zhang, Y., Zhai, J., Niu, X., and Liu, Y. (2024). Influence of physical activity on problematic smartphone use in medical students: Mediating effects of social anxiety and the moderating role of gender. Front. Psychol., 15.","DOI":"10.3389\/fpsyg.2024.1445847"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"2334","DOI":"10.1038\/s41390-025-04108-8","article-title":"Smartphone use, wellbeing, and their association in children","volume":"98","author":"Poulain","year":"2025","journal-title":"Pediatr. Res."},{"key":"ref_48","first-page":"210","article-title":"Exploring the relationship between smartphone addiction, quality of life, and personality traits in university students","volume":"19","author":"Demirkan","year":"2024","journal-title":"Iran. J. Psychiatry"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1080\/03069885.2024.2436030","article-title":"Let me check my phone: Smartphone addiction and its links to life satisfaction and psychological resilience in university students","volume":"53","author":"Kartol","year":"2025","journal-title":"Br. J. Guid. Couns."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1409","DOI":"10.1080\/13548506.2025.2478516","article-title":"The mediating effect of nomophobia in the relationship between problematic social media use\/problematic smartphone use and psychological distress among university students","volume":"30","author":"Tung","year":"2025","journal-title":"Psychol. Health Med."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"3355","DOI":"10.2147\/PRBM.S472299","article-title":"A longitudinal investigation on the reciprocal relationship of problematic smartphone use with bedtime procrastination, sleep quality, and mental health among university students","volume":"17","author":"Cemei","year":"2024","journal-title":"Psychol. Res. Behav. Manag."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"e70843","DOI":"10.1002\/hsr2.70843","article-title":"The psychopathology of problematic smartphone use (PSU): A narrative review of burden, mediating factors, and prevention","volume":"8","author":"Ndayambaje","year":"2025","journal-title":"Health Sci. Rep."},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Mayerhofer, D., Haider, K., Amon, M., G\u00e4chter, A., O\u2019Rourke, T., Dale, R., Humer, E., Probst, T., and Pieh, C. (2024). The association between problematic smartphone use and mental health in Austrian adolescents and young adults. Healthcare, 12.","DOI":"10.3390\/healthcare12060600"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1089\/cyber.2023.0548","article-title":"Trends and influencing factors in problematic smartphone use prevalence (2012\u20132022): A systematic review and meta-analysis","volume":"27","author":"Lu","year":"2024","journal-title":"Cyberpsychol. Behav. Soc. Netw."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"151","DOI":"10.3126\/ija.v3i1.76725","article-title":"Health-related quality of life among undergraduate students","volume":"3","author":"Paudel","year":"2025","journal-title":"Int. J. Atharva"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1177\/08901171241285094","article-title":"Exploring the Quality of Life of University Students in Egypt: A Cross-Sectional Survey Using the World Health Organization Quality of Life-BREF (WHOQOL-BREF) Assessment","volume":"39","author":"Ali","year":"2025","journal-title":"Am. J. Health Promot."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"429","DOI":"10.5565\/rev\/educar.1991","article-title":"Gender differences in the use of smartphones: A quantitative study among Mexican university students","volume":"60","year":"2024","journal-title":"Educar"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"518","DOI":"10.51380\/gujr-40-04-10","article-title":"Gender differences in smartphone addiction, problematic social media use, and problematic game use","volume":"40","author":"Ayan","year":"2024","journal-title":"Gomal Univ. J. Res."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"8","DOI":"10.47960\/2303-8616.2025.1.11.8","article-title":"Mental health and quality of life of students at the Faculty of Health Studies, University of Mostar","volume":"11","year":"2025","journal-title":"Zdr. Glas.\/Health Bull."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"e69320","DOI":"10.2196\/69320","article-title":"App-based ecological momentary assessment of problematic smartphone use during examination weeks in university students: 6-week observational study","volume":"27","author":"Ahn","year":"2025","journal-title":"J. Med. Internet Res."},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Barros, R., Ohnuma, A.A., and Manso, M.C. (2024). Self-perceived quality of life (WHOQOL-Bref), and self-reported health, social and environmental factors related to its improvement among residents of Anil, Rio de Janeiro: Cross-sectional study. Healthcare, 12.","DOI":"10.3390\/healthcare12151520"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"196","DOI":"10.59075\/rjs.v3i2.122","article-title":"Problematic smartphone usage and quality of life among adults","volume":"3","author":"Naeem","year":"2025","journal-title":"Res. J. Psychol."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/23\/7\/870\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T11:56:36Z","timestamp":1783079796000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/23\/7\/870"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,3]]},"references-count":62,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7]]}},"alternative-id":["ijerph23070870"],"URL":"https:\/\/doi.org\/10.3390\/ijerph23070870","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,3]]}}}