{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:27:47Z","timestamp":1760059667796,"version":"build-2065373602"},"reference-count":61,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2025,6,28]],"date-time":"2025-06-28T00:00:00Z","timestamp":1751068800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>This study aimed to investigate the effect of the number of adjuvant chemotherapy cycles on taste alteration, energy intake, and life quality. This study was conducted with 87 adult patients with newly diagnosed early-stage cancer, treated by surgery and receiving adjuvant chemotherapy (two groups received &lt;4 and \u22654 cycles). Taste alteration was assessed with the Chemotherapy-induced Taste Alteration Scale, and life quality with the Functional Assessment of Cancer Therapy. Patients who received \u22654 cycles showed significantly higher \u201cDecline in Basic Taste\u201d, \u201cPhantogeusia and Parageusia\u201d, and \u201cGeneral Taste Alterations\u201d subscale scores at the end of treatment (d = 0.945, d = 1.200, d = 0.928, respectively; p &lt; 0.001) and 3 months later (d = 0.515, d = 0.605, d = 0.985, respectively; p &lt; 0.05). Quality of life scale total score and \u201cphysical well-being\u201d and \u201cfunctional well-being\u201d subscale scores were significantly lower in patients received \u22654 cycle at the end of treatment (d = 0.590, d = 0.500, d = 0.621, respectively; p &lt; 0.05) and 3 months later (d = 0.500, d = 0.516, d = 0.562, respectively; p &lt; 0.05) but improved within 6 months. Significant correlations were found between taste alterations and recent weight loss, affordability of energy requirements, and decreased quality of life. A higher number of adjuvant chemotherapy cycles was associated with greater taste alterations, nutritional challenges and lower quality of life, especially in the early post-treatment. These changes are often transient and tend to return to baseline levels within 3\u20136 months after treatment.<\/jats:p>","DOI":"10.3390\/life15071031","type":"journal-article","created":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T03:54:28Z","timestamp":1751255668000},"page":"1031","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Effect of the Number of Adjuvant Chemotherapy Cycles Following Cancer Surgery on Taste Alteration, Energy Intake, and Life Quality: 6-Month Follow-Up Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7255-8036","authenticated-orcid":false,"given":"Can Selim","family":"Yilmaz","sequence":"first","affiliation":[{"name":"Department of Nutrition and Dietetic, Baskent University, Ankara 06790, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hilal","family":"Caliskan \u0130zgi","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Dietetic, Baskent University, Ankara 06790, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4254-3711","authenticated-orcid":false,"given":"Perim Fatma","family":"T\u00fcrker","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Dietetics, Acibadem Mehmet Ali Aydinlar University, Istanbul 34638, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Liu, H., Ma, X., Sun, C., Wu, M., Xu, Z., Zhou, S., Yao, N., Liu, S., Qin, X., and Han, Z. (2022). Concurrent chemoradiotherapy followed by adjuvant chemotherapy versus concurrent chemoradiotherapy alone in locally advanced cervical cancer: A systematic review and meta-analysis. Front. Oncol., 12.","DOI":"10.3389\/fonc.2022.997030"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"8588","DOI":"10.1200\/JCO.2004.00.5355","article-title":"Ototoxicity in children receiving platinum chemotherapy: Underestimating a commonly occurring toxicity that may influence academic and social development","volume":"23","author":"Knight","year":"2005","journal-title":"J. Clin. Oncol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1007\/PL00007853","article-title":"Chemotherapy-induced peripheral neuropathy","volume":"249","author":"Quasthoff","year":"2002","journal-title":"J. Neurol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1634\/theoncologist.2009-0333","article-title":"Taste alterations in cancer patients receiving chemotherapy: A neglected side effect?","volume":"15","author":"Zabernigg","year":"2010","journal-title":"Oncologist"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/j.tripleo.2008.04.003","article-title":"Oral mucosal lesions, microbial changes, and taste disturbances induced by adjuvant chemotherapy in breast cancer patients","volume":"106","author":"Jensen","year":"2008","journal-title":"Oral. Surg. Oral. Med. Oral. Pathol. Oral. Radiol. Endod."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1046\/j.1523-5394.1999.07205.x","article-title":"Perception of Chemotherapy Side Effects Cancer versus Noncancer Patients","volume":"7","author":"Lindley","year":"1999","journal-title":"Cancer Pract."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1007\/s00520-007-0319-7","article-title":"Self-reported taste and smell changes during cancer chemotherapy","volume":"16","author":"Bernhardson","year":"2008","journal-title":"Support. Care Cancer"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"E47","DOI":"10.1188\/09.ONF.E47-E56","article-title":"Self-care strategies to cope with taste changes after chemotherapy","volume":"36","author":"Rehwaldt","year":"2009","journal-title":"Oncol. Nurs. Forum."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1002\/hed.20221","article-title":"Impact of nutrition on outcome: A prospective randomized controlled trial in patients with head and neck cancer undergoing radiotherapy","volume":"27","author":"Ravasco","year":"2005","journal-title":"Head. Neck"},{"key":"ref_10","first-page":"81","article-title":"Talking about taste: How do oncology clinicians discuss and document taste problems?","volume":"35","author":"Boltong","year":"2011","journal-title":"Cancer Forum"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1016\/S0140-6736(80)92061-9","article-title":"Can a tumour cause the same appetite perversion or taste change as a pregnancy?","volume":"316","author":"Brewin","year":"1980","journal-title":"Lancet"},{"key":"ref_12","first-page":"447","article-title":"Changes in taste sensation and feeding behaviour in cancer patients: A review","volume":"32","author":"DeWys","year":"1978","journal-title":"J. Hum. Nutr."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1938","DOI":"10.1002\/(SICI)1097-0142(19980515)82:10<1938::AID-CNCR18>3.0.CO;2-U","article-title":"A randomized, controlled clinical trial to evaluate the effects of zinc sulfate on cancer patients with taste alterations caused by head and neck irradiation","volume":"82","author":"Ripamonti","year":"1998","journal-title":"Cancer"},{"key":"ref_14","first-page":"58","article-title":"Taste and odor abnormalities in cancer patients","volume":"7","author":"Hong","year":"2009","journal-title":"J. Support. Oncol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1007\/s005200100279","article-title":"Taste and smell dysfunction in patients receiving chemotherapy: A review of current knowledge","volume":"9","author":"Comeau","year":"2001","journal-title":"Support. Care Cancer"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1017\/S0029665107005599","article-title":"Critical illness and changes in sensory perception","volume":"66","author":"Schiffman","year":"2007","journal-title":"Proc. Nutr. Soc."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"199","DOI":"10.2165\/00002018-200831030-00002","article-title":"Drug-Induced Taste Disorders","volume":"31","author":"Doty","year":"2008","journal-title":"Drug Saf."},{"key":"ref_18","first-page":"439","article-title":"Combination of flavor enhancement and chemosensory education improves nutritional status in older cancer patients","volume":"11","author":"Schiffman","year":"2007","journal-title":"J. Nutr. Health Aging"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1038\/sj.ejcn.1601026","article-title":"Taste and smell perception affect appetite and immunity in the elderly","volume":"54","author":"Schiffman","year":"2000","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1136\/ebn.6.2.62","article-title":"5 themes described the experiences of patients with chemotherapy induced oral mucositis","volume":"6","author":"Bernhardson","year":"2003","journal-title":"Evid. Based Nurs."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1016\/j.jpainsymman.2006.12.010","article-title":"Chemosensory changes experienced by patients undergoing cancer chemotherapy: A qualitative interview study","volume":"34","author":"Bernhardson","year":"2007","journal-title":"J. Pain. Symptom Manag."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1634\/theoncologist.2007-0217","article-title":"Prevention of docetaxel-or paclitaxel-associated taste alterations in cancer patients with oral glutamine: A randomized, placebo-controlled, double-blind study","volume":"13","author":"Strasser","year":"2008","journal-title":"Oncologist"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Kim, T.H., Ahn, M.S., Choi, Y.W., Kang, S.Y., Choi, J.H., Lee, H.W., Park, M., and Kim, H. (2022). Analysis of treatment outcomes according to the cycles of adjuvant chemotherapy in gastric cancer: A retrospective nationwide cohort study. BMC Cancer, 22.","DOI":"10.1186\/s12885-022-10006-7"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"4458","DOI":"10.1245\/s10434-020-09504-4","article-title":"Appropriate Number of Adjuvant Chemotherapy Cycles for Patients with Stage 2 or 3 Gastric Cancer After Curative Gastrectomy: A Multicenter Cohort Study","volume":"28","author":"Jeong","year":"2021","journal-title":"Ann. Surg. Oncol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"E79","DOI":"10.1188\/13.ONF.E79-E85","article-title":"Development and validation of a chemotherapy-induced taste alteration scale","volume":"40","author":"Kano","year":"2013","journal-title":"Oncol. Nurs. Forum"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1177\/1054773816662436","article-title":"The Validity and Reliability of Turkish Version of the Chemotherapy-induced Taste Alteration Scale (CiTAS)","volume":"27","author":"Sozeri","year":"2018","journal-title":"Clin. Nurs. Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1200\/JCO.1993.11.3.570","article-title":"The Functional Assessment of Cancer Therapy scale: Development and validation of the general measure","volume":"11","author":"Cella","year":"1993","journal-title":"J. Clin. Oncol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"198","DOI":"10.34087\/cbusbed.692556","article-title":"The functional assessment of cancer therapy general FACT-G scale reliability and validity of a Turkish version","volume":"8","author":"Ay","year":"2021","journal-title":"Celal Bayar \u00dcniversitesi Sa\u011fl\u0131k Bilim. Enstit\u00fcs\u00fc Derg."},{"key":"ref_29","unstructured":"FAO\/WHO\/UNU Expert Consultation (2001). Nutrition Technical Report Series 1. Human Energy Requirements. Report of a Joint FAO\/WHO\/UNU Expert Consultation, FAO."},{"key":"ref_30","unstructured":"Harris, J.A., and Benedict, F.G. (1919). A Biometric Study of Basal Metabolism in Man, Carnegie institution of Washington."},{"key":"ref_31","unstructured":"Jan\u00e9, M., Xiao, Q., Yeung, S., Azevedo, F., Ben-Shachar, M.S., Caldwell, A.R., Cousineau, D., Dunleavy, D.J., Elsherif, M., and Harlow, T.J. (2024, December 17). Guide to Effect Sizes and Confidence Intervals. Available online: https:\/\/osf.io\/download\/87vke\/."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e12633","DOI":"10.1111\/ecc.12633","article-title":"Dysgeusia and health-related quality of life of cancer patients receiving chemotherapy: A cross-sectional study","volume":"26","author":"Ponticelli","year":"2017","journal-title":"Eur. J. Cancer Care"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"102735","DOI":"10.1016\/j.ejon.2024.102735","article-title":"Prevalence and risk factors of chemotherapy-induced taste alterations among cancer patients: A systematic review and meta-analysis","volume":"74","author":"Zhang","year":"2024","journal-title":"Eur. J. Oncol. Nurs."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Al-Amouri, F.M., and Badrasawi, M. (2024). Taste alteration and its relationship with nutritional status among cancer patients receiving chemotherapy, cross-sectional study. PLoS ONE, 19.","DOI":"10.1371\/journal.pone.0302990"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1016\/j.jand.2020.08.014","article-title":"Taste function in adults undergoing cancer radiotherapy or chemotherapy, and implications for nutrition management: A systematic review","volume":"121","author":"Kiss","year":"2021","journal-title":"J. Acad. Nutr. Diet."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"2573","DOI":"10.2217\/fon-2020-0871","article-title":"Altertaste: Improving Food Pleasure and Intake of Oncology Patients Receiving Chemotherapy","volume":"17","author":"Spinelli","year":"2021","journal-title":"Future Oncol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"2125","DOI":"10.1007\/s00520-020-05717-1","article-title":"Chemotherapy-induced taste and smell changes influence food perception in cancer patients","volume":"29","author":"Drareni","year":"2021","journal-title":"Support. Care Cancer"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1080\/01635581.2016.1144075","article-title":"Value: Changes in the Detection and Recognition Thresholds of Three Basic Tastes in Lung Cancer Patients Receiving Cisplatin and Paclitaxel and Its Association with Nutritional and Quality of Life Parameters","volume":"68","author":"Turcott","year":"2016","journal-title":"Nutr. Cancer"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1186\/1475-2891-9-15","article-title":"Influence of taste disorders on dietary behaviors in cancer patients under chemotherapy","volume":"9","author":"Laviano","year":"2010","journal-title":"Nutr. J."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1899","DOI":"10.1200\/JCO.2008.19.2690","article-title":"Qualitative and Quantitative Assessment of Taste and Smell Changes in Patients Undergoing Chemotherapy for Breast Cancer or Gynecologic Malignancies","volume":"27","author":"Steinbach","year":"2009","journal-title":"J. Clin. Oncol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1860","DOI":"10.21873\/invivo.12904","article-title":"Taste Alterations Do Not Affect Change in Food Habits and Body Weight in Breast Cancer Patients","volume":"36","author":"Pedersini","year":"2022","journal-title":"In Vivo"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"7431","DOI":"10.1007\/s00520-021-06316-4","article-title":"Taste alterations and oral discomfort in patients receiving chemotherapy","volume":"29","author":"Larsen","year":"2021","journal-title":"Support. Care Cancer"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1016\/j.clnesp.2021.03.006","article-title":"Association of xerostomia and taste alterations of patients receiving antineoplastic chemotherapy: A cause for nutritional concern","volume":"43","author":"Silva","year":"2021","journal-title":"Clin. Nutr. ESPEN"},{"key":"ref_44","first-page":"222","article-title":"Taste alteration in cancer patients receiving chemotherapy: A cross-sectional study","volume":"34","author":"Arikan","year":"2019","journal-title":"Turk. J. Oncol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1851","DOI":"10.2147\/DDDT.S64940","article-title":"Preclinical profile of cabazitaxel","volume":"8","author":"Vrignaud","year":"2014","journal-title":"Drug Des. Devel Ther."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Murtaza, B., Hichami, A., Khan, A.S., Ghiringhelli, F., and Khan, N.A. (2017). Alteration in taste perception in cancer: Causes and strategies of treatment. Front. Physiol., 8.","DOI":"10.3389\/fphys.2017.00134"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"5103","DOI":"10.1007\/s00520-021-06066-3","article-title":"Characteristics of taste alterations in people receiving taxane-based chemotherapy and their association with appetite, weight, and quality of life","volume":"29","author":"Kaizu","year":"2021","journal-title":"Support. Care Cancer"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Pellegrini, M., Merlo, F.D., Agnello, E., Monge, T., Devecchi, A., Casalone, V., Montemurro, F., Ghigo, E., Sapino, A., and Bo, S. (2023). Dysgeusia in Patients with Breast Cancer Treated with Chemotherapy\u2014A Narrative Review. Nutrients, 15.","DOI":"10.3390\/nu15010226"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1007\/s00520-021-06219-4","article-title":"Risk factors for dysgeusia during chemotherapy for solid tumors: A retrospective cross-sectional study","volume":"30","author":"Malta","year":"2022","journal-title":"Support. Care Cancer"},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Boltong, A., Aranda, S., Keast, R., Wynne, R., Francis, P.A., Chirgwin, J., and Gough, K. (2014). A prospective cohort study of the effects of adjuvant breast cancer chemotherapy on taste function, food liking, appetite and associated nutritional outcomes. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0103512"},{"key":"ref_51","first-page":"1684","article-title":"The factors influencing the taste alterations in patients receiving chemotherapy","volume":"12","year":"2019","journal-title":"Int. J. Caring Sci."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"954","DOI":"10.1007\/s12282-020-01089-w","article-title":"Taste alterations in patients with breast cancer following chemotherapy: A cohort study","volume":"27","author":"Denda","year":"2020","journal-title":"Breast Cancer"},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Bleumer, T., Abel, J., B\u00f6hmerle, W., Schr\u00f6der, S., Yap, S.A., Schaeper, N.D.E., Hummel, T., Stintzing, S., Stephan, L.U., and Pelzer, U. (2024). Smell and Taste Alterations in Patients Receiving Curative or Palliative Chemotherapy\u2014The CONKO 021\u2014ChemTox Trial. Cancers, 16.","DOI":"10.3390\/cancers16142495"},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Lewandowska, A., Rudzki, G., Lewandowski, T., Pr\u00f3chnicki, 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_55","first-page":"204","article-title":"Quality of life in cancer patients undergoing chemotherapy","volume":"24","author":"Dehkordi","year":"2009","journal-title":"Oman Med. J."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1111\/j.1447-0756.1997.tb00831.x","article-title":"The Effect of Prolonged Cycles of Chemotherapy on Quality of Life in Gynaecologic Cancer Patients","volume":"23","author":"Carter","year":"1997","journal-title":"J. Obstet. Gynaecol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"e018101","DOI":"10.1136\/bmjopen-2017-018101","article-title":"Quality of life of elderly patients with solid tumours undergoing adjuvant cancer therapy: A systematic review","volume":"8","author":"Cheng","year":"2018","journal-title":"BMJ Open"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"2613","DOI":"10.1016\/j.ejca.2005.05.017","article-title":"Quality of life among long-term breast cancer survivors: A systematic review","volume":"41","author":"Mols","year":"2005","journal-title":"Eur. J. Cancer"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"5052","DOI":"10.1200\/JCO.2007.12.6094","article-title":"Quality-of-Life Outcomes for Adjuvant Chemotherapy in Early-Stage Non\u2013Small-Cell Lung Cancer: Results From a Randomized Trial","volume":"26","author":"Bezjak","year":"2008","journal-title":"J. Clin. Oncol."},{"key":"ref_60","unstructured":"Mebis, J., Censabella, S., Engels, S., Van Marsenille, C., Orye, G., Marquette, S., Vansteelant, L., Luyten, D., Maes, A., and No\u00e9, L. (2025, February 15). Quality of Life, Fatigue, and Subjective Cognitive Functioning Immediately and 6 Months After Adjuvant Chemotherapy in Breast Cancer Patients. Available online: https:\/\/documentserver.uhasselt.be\/handle\/1942\/29208."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"E99","DOI":"10.1097\/NCC.0000000000001070","article-title":"Differences in quality of life and emotional well-being in breast, colon, and lung cancer patients during outpatient adjuvant chemotherapy: A longitudinal study","volume":"46","author":"Iraurgi","year":"2023","journal-title":"Cancer Nurs."}],"container-title":["Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-1729\/15\/7\/1031\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:00:39Z","timestamp":1760032839000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-1729\/15\/7\/1031"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,28]]},"references-count":61,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2025,7]]}},"alternative-id":["life15071031"],"URL":"https:\/\/doi.org\/10.3390\/life15071031","relation":{},"ISSN":["2075-1729"],"issn-type":[{"type":"electronic","value":"2075-1729"}],"subject":[],"published":{"date-parts":[[2025,6,28]]}}}