{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T10:33:54Z","timestamp":1763116434793,"version":"3.45.0"},"reference-count":59,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T00:00:00Z","timestamp":1762992000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Takeda Pharmaceuticals Korea Co., Ltd."}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background\/Objectives: Short bowel syndrome (SBS) is the leading cause of intestinal failure (IF) that often requires long-term parenteral nutrition (PN). Extended PN results in severe complications and reduced quality of life (QoL). This study aimed to evaluate the QoL utility weights associated with PN duration using vignettes. Methods: We developed detailed scenarios and descriptions to represent eight hypothetical health states, reflecting variations in PN frequency in both pediatric and adult patients. A cross-sectional survey was conducted among 359 Korean adults (aged 19\u201359 years) from the general population, assigned to evaluate adult (n = 179) or pediatric (n = 180) vignette groups. Health utility was measured using the EuroQol 5-Dimension (EQ-5D), visual analog scale (VAS), and time trade-off (TTO) methods. Multivariable regression analysis using a mixed-effects model was employed to manage repeated measures and control for sociodemographic variables. Results: Utility scores measured using the EQ-5D, VAS, and TTO were negatively correlated with increasing PN days in both adult and pediatric patients with SBS-IF. The highest mean utility values were \u201c0 days on PN\u201d (adults: EQ-5D 0.808, VAS 0.689, TTO 0.874; pediatric: EQ-5D 0.804, VAS 0.680, TTO 0.883), while the lowest were \u201c7 days on PN\u201d (adults: EQ-5D 0.117, VAS 0.180, TTO 0.272; pediatric: EQ-5D 0.070, VAS 0.178, TTO 0.291). These trends remained significant after covariate adjustment (p &lt; 0.001). Conclusions: The study revealed a steady decline in utility values with an increasing number of PN days. These findings highlight the importance of enhancing the QoL in patients with SBS-IF by supporting intestinal adaptation and reducing PN dependency.<\/jats:p>","DOI":"10.3390\/nu17223551","type":"journal-article","created":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T10:07:03Z","timestamp":1763114823000},"page":"3551","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Health State Utility Associated with Parenteral Nutrition Requirement in Patients with Short Bowel Syndrome and Intestinal Failure in Korea: A Vignette-Based Approach"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-2741-5904","authenticated-orcid":false,"given":"Hyewon","family":"Sim","sequence":"first","affiliation":[{"name":"NDnex, 462, Bongeunsa-ro, Gangnam-gu, Seoul 16154, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9760-297X","authenticated-orcid":false,"given":"Jin Soo","family":"Moon","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-Gu, 110-769, Seoul 03080, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6352-9759","authenticated-orcid":false,"given":"Young Suk","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Surgery, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eunji","family":"Heo","sequence":"additional","affiliation":[{"name":"Department of Industrial Pharmaceutical Science, Ewha Womans University, Seoul 03760, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4106-0849","authenticated-orcid":false,"given":"Yoon Soo","family":"Chun","sequence":"additional","affiliation":[{"name":"Market Access, Takeda Pharmaceuticals Korea Co., Ltd., Seoul 05551, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4920-0962","authenticated-orcid":false,"given":"Songhwa","family":"Choi","sequence":"additional","affiliation":[{"name":"Medical Affairs, Takeda Pharmaceuticals Korea Co., Ltd., Seoul 05551, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1699-5367","authenticated-orcid":false,"given":"Hyemin","family":"Ku","sequence":"additional","affiliation":[{"name":"NDnex, 462, Bongeunsa-ro, Gangnam-gu, Seoul 16154, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jae Hee","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Surgery, Seoul St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1016\/j.jviscsurg.2017.12.012","article-title":"Medical and surgical management of short bowel syndrome","volume":"155","author":"Billiauws","year":"2018","journal-title":"J. Visc. Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1016\/j.clnu.2012.08.007","article-title":"Determinants of home parenteral nutrition dependence and survival of 268 patients with non-malignant short bowel syndrome","volume":"32","author":"Amiot","year":"2013","journal-title":"Clin. Nutr."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1053\/spsu.2001.22382","article-title":"Short bowel syndrome in infants and children: An overview","volume":"10","author":"Sigalet","year":"2001","journal-title":"Semin. Pediatr. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1016\/j.dld.2019.11.013","article-title":"Understanding short bowel syndrome: Current status and future perspectives","volume":"52","author":"Massironi","year":"2020","journal-title":"Dig. Liver Dis."},{"key":"ref_5","first-page":"34","article-title":"Prevalence and disease burden of patients with short bowel syndrome in Korea","volume":"2","author":"Lee","year":"2018","journal-title":"Health Insur. Rev. Assess. Serv."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"iv1","DOI":"10.1136\/gut.2006.091108","article-title":"Guidelines for management of patients with a short bowel","volume":"55","author":"Nightingale","year":"2006","journal-title":"Gut"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1016\/j.clnesp.2021.07.004","article-title":"Characteristics of adult patients with chronic intestinal failure due to short bowel syndrome: An international multicenter survey","volume":"45","author":"Pironi","year":"2021","journal-title":"Clin. Nutr. ESPEN"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/j.mpmed.2023.12.004","article-title":"Intestinal failure and short bowel syndrome","volume":"52","author":"Woods","year":"2024","journal-title":"Medicine"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/j.cgh.2005.10.002","article-title":"Short bowel syndrome and intestinal failure: Consensus definitions and overview","volume":"4","author":"Buchman","year":"2006","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1097\/SGA.0000000000000324","article-title":"Treatment in a Tertiary Intestinal Rehabilitation Center Improves Outcome for Children With Short Bowel Syndrome","volume":"42","author":"Hojsak","year":"2019","journal-title":"Gastroenterol. Nurs."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1177\/0148607109348612","article-title":"The clinical and psychometric validation of a questionnaire to assess the quality of life of adult patients treated with long-term parenteral nutrition","volume":"34","author":"Baxter","year":"2010","journal-title":"JPEN J. Parenter. Enter. Nutr."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"32s","DOI":"10.1177\/0148607113517717","article-title":"Clinical, social, and economic impacts of home parenteral nutrition dependence in short bowel syndrome","volume":"38","author":"Winkler","year":"2014","journal-title":"JPEN J. Parenter. Enter. Nutr."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1007\/s12529-010-9116-7","article-title":"Predicting fatigue in patients using home parenteral nutrition: A longitudinal study","volume":"18","author":"Bazelmans","year":"2011","journal-title":"Int. J. Behav. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"844","DOI":"10.1136\/gut.44.6.844","article-title":"Quality of life in patients receiving home parenteral nutrition","volume":"44","author":"Jeppesen","year":"1999","journal-title":"Gut"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1016\/j.clnu.2004.12.009","article-title":"Impact of long-term HPN on daily life in adults","volume":"24","author":"Persoon","year":"2005","journal-title":"Clin. Nutr."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1878","DOI":"10.1016\/j.clinthera.2018.09.009","article-title":"Measurement of Utilities Associated with Parenteral Support Requirement in Patients with Short Bowel Syndrome and Intestinal Failure","volume":"40","author":"Ballinger","year":"2018","journal-title":"Clin. Ther."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"812","DOI":"10.1016\/j.jval.2020.12.017","article-title":"Vignette-Based Utilities: Usefulness, Limitations, and Methodological Recommendations","volume":"24","author":"Matza","year":"2021","journal-title":"Value Health"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.bpg.2016.02.011","article-title":"Definitions of intestinal failure and the short bowel syndrome","volume":"30","author":"Pironi","year":"2016","journal-title":"Best. Pract. Res. Clin. Gastroenterol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1007\/s40258-022-00721-4","article-title":"Korean Guidelines for Pharmacoeconomic Evaluations: Updates in the Third Version","volume":"20","author":"Bae","year":"2022","journal-title":"Appl. Health Econ. Health Policy"},{"key":"ref_20","unstructured":"Ha, B. (2013). Gang Survey. How to Investigate Ads., Communication Books."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"114523","DOI":"10.1016\/j.socscimed.2021.114523","article-title":"Sample sizes for saturation in qualitative research: A systematic review of empirical tests","volume":"292","author":"Hennink","year":"2022","journal-title":"Soc. Sci. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1016\/0021-9681(87)90019-1","article-title":"Utility approach to measuring health-related quality of life","volume":"40","author":"Torrance","year":"1987","journal-title":"J. Chronic Dis."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1186\/s13561-016-0094-6","article-title":"Patient- and person-reports on healthcare: Preferences, outcomes, experiences, and satisfaction\u2014An essay","volume":"6","author":"Klose","year":"2016","journal-title":"Health Econ. Rev."},{"key":"ref_24","unstructured":"Drummond, M.F., Sculpher, M.J., Claxton, K., Stoddart, G.L., and Torrance, G.W. (2015). Methods for the Economic Evaluation of Health Care Programmes, Oxford University Press."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1727","DOI":"10.1007\/s11136-011-9903-x","article-title":"Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L)","volume":"20","author":"Herdman","year":"2011","journal-title":"Qual. Life Res."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1845","DOI":"10.1007\/s11136-015-1205-2","article-title":"The EQ-5D-5L valuation study in Korea","volume":"25","author":"Kim","year":"2016","journal-title":"Qual. Life Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1002\/hec.1086","article-title":"Is there a case for using visual analogue scale valuations in cost-utility analysis?","volume":"15","author":"Parkin","year":"2006","journal-title":"Health Econ."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"700","DOI":"10.1016\/j.clinthera.2019.02.007","article-title":"Estimation of Health Utilities Based on the Response to Treatment in Atopic Dermatitis: A Population-based Study","volume":"41","author":"Song","year":"2019","journal-title":"Clin. Ther."},{"key":"ref_29","first-page":"118","article-title":"A utility maximization model for evaluation of health care programs","volume":"7","author":"Torrance","year":"1972","journal-title":"Health Serv. Res."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1080\/14737167.2020.1779062","article-title":"An overview of the time trade-off method: Concept, foundation, and the evaluation of distorting factors in putting a value on health","volume":"20","author":"Krabbe","year":"2020","journal-title":"Expert. Rev. Pharmacoecon Outcomes Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"S53","DOI":"10.1007\/s10198-013-0508-x","article-title":"Time trade-off: One methodology, different methods","volume":"14","author":"Attema","year":"2013","journal-title":"Eur. J. Health Econ."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1002\/hec.1385","article-title":"The influence of subjective life expectancy on health state valuations using a 10 year TTO","volume":"18","author":"Koolman","year":"2009","journal-title":"Health Econ."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1002\/jpen.1506","article-title":"Assessing Patient Preferences for Intestinal Failure Management Using the Time Trade-Off Methodology","volume":"43","author":"Carey","year":"2019","journal-title":"JPEN J. Parenter. Enter. Nutr."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1172\/JCI171058","article-title":"Guidelines for repeated measures statistical analysis approaches with basic science research considerations","volume":"133","author":"Muhammad","year":"2023","journal-title":"J. Clin. Investig."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1269","DOI":"10.3899\/jrheum.2022-1109","article-title":"Avoiding Blunders When Analyzing Correlated Data, Clustered Data, or Repeated Measures","volume":"50","author":"Chang","year":"2023","journal-title":"J. Rheumatol."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Fayers, P., and Hays, R. (2005). Preference-Based Measures: Utility And Quality-Adjusted Life Years. Assessing Quality of Life in Clinical Trials: Methods and Practice, Oxford University Press.","DOI":"10.1093\/oso\/9780198527695.001.0001"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1136","DOI":"10.3904\/kjim.2018.398","article-title":"The health-related quality-of-life of chronic obstructive pulmonary disease patients and disease-related indirect burdens","volume":"35","author":"Choi","year":"2020","journal-title":"Korean J. Intern. Med."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1007\/s40261-018-0659-8","article-title":"The Utility of 5 Hypothetical Health States in Heart Failure Using Time Trade-Off (TTO) and EQ-5D-5L in Korea","volume":"38","author":"Hong","year":"2018","journal-title":"Clin. Drug Investig."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"16","DOI":"10.15747\/jcn.2017.9.1.16","article-title":"Analysis of Adverse Reactions Associated with Parenteral Nutrition Use in Korea","volume":"9","author":"Sera","year":"2017","journal-title":"J. Clin. Nutr."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1016\/j.clnu.2012.05.004","article-title":"Outcome on home parenteral nutrition for benign intestinal failure: A review of the literature and benchmarking with the European prospective survey of ESPEN","volume":"31","author":"Pironi","year":"2012","journal-title":"Clin. Nutr."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1186\/s43162-024-00370-0","article-title":"An assessment of quality of life in ESRD patients undergoing hemodialysis","volume":"36","author":"Abbas","year":"2024","journal-title":"Egypt. J. Intern. Med."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1016\/j.clnu.2013.03.016","article-title":"Quality of life in patients with short bowel syndrome treated with the new glucagon-like peptide-2 analogue teduglutide--analyses from a randomised, placebo-controlled study","volume":"32","author":"Jeppesen","year":"2013","journal-title":"Clin. Nutr."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1002\/jpen.1588","article-title":"Impact of Teduglutide on Quality of Life Among Patients With Short Bowel Syndrome and Intestinal Failure","volume":"44","author":"Chen","year":"2020","journal-title":"JPEN J. Parenter. Enter. Nutr."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"112640","DOI":"10.1016\/j.nut.2024.112640","article-title":"Forty-eight months outcomes of teduglutide treatment in adult stable patients with short bowel syndrome and home parenteral nutrition dependence: A real-world Italian single-center observational cohort study","volume":"131","author":"Mazzuoli","year":"2025","journal-title":"Nutrition"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"e001818","DOI":"10.1136\/bmjgast-2025-001818","article-title":"Quality of life and lived experience of patients with short bowel syndrome treated with teduglutide and weaning off home parenteral nutrition: A qualitative analysis of patient diaries","volume":"12","author":"Jurewitsch","year":"2025","journal-title":"BMJ Open Gastroenterol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1433","DOI":"10.1016\/j.clnu.2018.06.964","article-title":"Needs-based quality of life in adults dependent on home parenteral nutrition","volume":"38","author":"Burden","year":"2019","journal-title":"Clin. Nutr."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1002\/jpen.2317","article-title":"Impact of infusion frequency on quality of life in patients receiving home parenteral nutrition","volume":"46","author":"Stanner","year":"2022","journal-title":"JPEN J. Parenter. Enter. Nutr."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1007\/s40273-020-00909-3","article-title":"International Valuation Protocol for the EQ-5D-Y-3L","volume":"38","author":"Oppe","year":"2020","journal-title":"Pharmacoeconomics"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"b2688","DOI":"10.1136\/bmj.b2688","article-title":"Comparison of direct and indirect methods of estimating health state utilities for resource allocation: Review and empirical analysis","volume":"339","author":"Arnold","year":"2009","journal-title":"BMJ"},{"key":"ref_50","unstructured":"Jo, M.W., Ahn, J.H., and Kim, S.H. (2014). The Valuation of EQ-5D-5L Health States in Korea, National Evidence-based Collaborating Agency (NECA)."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1111\/j.1524-4733.2007.00230.x","article-title":"Comparing the standard EQ-5D three-level system with a five-level version","volume":"11","author":"Janssen","year":"2008","journal-title":"Value Health"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1717","DOI":"10.1007\/s11136-012-0322-4","article-title":"Measurement properties of the EQ-5D-5L compared to the EQ-5D-3L across eight patient groups: A multi-country study","volume":"22","author":"Janssen","year":"2013","journal-title":"Qual. Life Res."},{"key":"ref_53","unstructured":"Brazier, J., and Rowen, D. (2011). NICE Decision Support Unit Technical Support Documents. NICE DSU Technical Support Document 11: Alternatives to EQ-5D for Generating Health State Utility Values, National Institute for Health and Care Excellence (NICE)."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1770","DOI":"10.1007\/s10620-024-08285-0","article-title":"Intestinal Rehabilitation Program for Adult Patients with Intestinal Failure: A 20-Year Analysis of Outcomes in the Single-Center Experience at a Tertiary Hospital","volume":"69","author":"Im","year":"2024","journal-title":"Dig. Dis. Sci."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1002\/jpen.2499","article-title":"Optimizing transition from pediatric to adult care in short bowel syndrome and intestinal failure","volume":"47","author":"Kinberg","year":"2023","journal-title":"JPEN J. Parenter. Enter. Nutr."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"44","DOI":"10.5223\/pghn.2016.19.1.44","article-title":"Poor Prognostic Factors in Patients with Parenteral Nutrition-Dependent Pediatric Intestinal Failure","volume":"19","author":"Choi","year":"2016","journal-title":"Pediatr. Gastroenterol. Hepatol. Nutr."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1007\/s10620-022-07760-w","article-title":"Management of Short Bowel Syndrome (SBS) and Intestinal Failure","volume":"68","author":"Radetic","year":"2023","journal-title":"Dig. Dis. Sci."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1159\/000538938","article-title":"Chronic Intestinal Failure and Short Bowel Syndrome in Adults: The State of the Art","volume":"31","author":"Mendes","year":"2024","journal-title":"GE Port. J. Gastroenterol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"241","DOI":"10.21032\/jhis.2022.47.4.241","article-title":"An Overview and Future Challenges of the WHO International Classification of Disease ICD-11","volume":"47","author":"Kim","year":"2022","journal-title":"J. Health Info Stat."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/22\/3551\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T10:23:39Z","timestamp":1763115819000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/22\/3551"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,13]]},"references-count":59,"journal-issue":{"issue":"22","published-online":{"date-parts":[[2025,11]]}},"alternative-id":["nu17223551"],"URL":"https:\/\/doi.org\/10.3390\/nu17223551","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,13]]}}}