{"id":"https://openalex.org/W4416630097","doi":"https://doi.org/10.1186/s40795-025-01190-3","title":"A systematic review and meta-analysis of household food safety and hygiene practices and their determinants in Africa","display_name":"A systematic review and meta-analysis of household food safety and hygiene practices and their determinants in Africa","publication_year":2025,"publication_date":"2025-11-25","ids":{"openalex":"https://openalex.org/W4416630097","doi":"https://doi.org/10.1186/s40795-025-01190-3","pmid":"https://pubmed.ncbi.nlm.nih.gov/41291953"},"language":"en","primary_location":{"id":"doi:10.1186/s40795-025-01190-3","doi":"https://doi.org/10.1186/s40795-025-01190-3","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s40795-025-01190-3","pdf_url":"https://link.springer.com/content/pdf/10.1186/s40795-025-01190-3.pdf","source":{"id":"https://openalex.org/S2765040563","display_name":"BMC Nutrition","issn_l":"2055-0928","issn":["2055-0928"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-d","jufo-1","ki-jl-1","norway-1","poland-20","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Nutrition","raw_type":"journal-article"},"volume":null,"type":"review","indexed_in":["crossref","doaj","pubmed"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://link.springer.com/content/pdf/10.1186/s40795-025-01190-3.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5034870533","display_name":"Negasa Eshete Soboksa","orcid":"https://orcid.org/0000-0003-3451-175X","observed_orcids":["https://orcid.org/0000-0003-3451-175X"]},"institutions":[{"id":"https://openalex.org/I26092322","display_name":"Stellenbosch University","ror":"https://ror.org/05bk57929","country_code":"ZA","type":"education","lineage":["https://openalex.org/I26092322"]},{"id":"https://openalex.org/I4210136909","display_name":"Dilla University","ror":"https://ror.org/04ahz4692","country_code":"ET","type":"education","lineage":["https://openalex.org/I4210136909"]}],"countries":["ET","ZA"],"is_corresponding":true,"raw_author_name":"Negasa Eshete Soboksa","raw_affiliation_strings":["Division Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, PO Box 241, 8000, South Africa. yeroosaa@gmail.com","School of Public Health, College of Health Sciences and Medicine, Dilla University, Dilla, PO Box 419, Ethiopia. yeroosaa@gmail.com","School of Public Health, College of Health Sciences and Medicine, Dilla University, Dilla, PO Box 419, Ethiopia"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Division Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, PO Box 241, 8000, South Africa. yeroosaa@gmail.com","institution_ids":["https://openalex.org/I26092322"]},{"raw_affiliation_string":"School of Public Health, College of Health Sciences and Medicine, Dilla University, Dilla, PO Box 419, Ethiopia. yeroosaa@gmail.com","institution_ids":["https://openalex.org/I4210136909"]},{"raw_affiliation_string":"School of Public Health, College of Health Sciences and Medicine, Dilla University, Dilla, PO Box 419, Ethiopia","institution_ids":["https://openalex.org/I4210136909"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5071748796","display_name":"Habtamu Endashaw Hareru","orcid":"https://orcid.org/0000-0002-0591-0893","observed_orcids":["https://orcid.org/0000-0002-0591-0893"]},"institutions":[{"id":"https://openalex.org/I4210136909","display_name":"Dilla University","ror":"https://ror.org/04ahz4692","country_code":"ET","type":"education","lineage":["https://openalex.org/I4210136909"]}],"countries":["ET"],"is_corresponding":false,"raw_author_name":"Habtamu Endashaw Hareru","raw_affiliation_strings":["School of Public Health, College of Health Sciences and Medicine, Dilla University, Dilla, PO Box 419, Ethiopia"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"School of Public Health, College of Health Sciences and Medicine, Dilla University, Dilla, PO Box 419, Ethiopia","institution_ids":["https://openalex.org/I4210136909"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5092059747","display_name":"Zoe Nomakhushe Nxusani","orcid":"https://orcid.org/0000-0002-2805-3820","observed_orcids":["https://orcid.org/0000-0002-2805-3820"]},"institutions":[{"id":"https://openalex.org/I26092322","display_name":"Stellenbosch University","ror":"https://ror.org/05bk57929","country_code":"ZA","type":"education","lineage":["https://openalex.org/I26092322"]}],"countries":["ZA"],"is_corresponding":false,"raw_author_name":"Zoe Nomakhushe Nxusani","raw_affiliation_strings":["Division Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, PO Box 241, 8000, South Africa"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Division Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, PO Box 241, 8000, South Africa","institution_ids":["https://openalex.org/I26092322"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5091973437","display_name":"Vhushavhelo Nedzingahe","orcid":"https://orcid.org/0000-0002-2528-7138","observed_orcids":["https://orcid.org/0000-0002-2528-7138"]},"institutions":[{"id":"https://openalex.org/I26092322","display_name":"Stellenbosch University","ror":"https://ror.org/05bk57929","country_code":"ZA","type":"education","lineage":["https://openalex.org/I26092322"]}],"countries":["ZA"],"is_corresponding":false,"raw_author_name":"Vhushavhelo Nedzingahe","raw_affiliation_strings":["Division Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, PO Box 241, 8000, South Africa"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Division Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, PO Box 241, 8000, South Africa","institution_ids":["https://openalex.org/I26092322"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5037457450","display_name":"Xikombiso Gertrude Mbhenyane","orcid":"https://orcid.org/0000-0003-0408-9586","observed_orcids":["https://orcid.org/0000-0003-0408-9586"]},"institutions":[{"id":"https://openalex.org/I26092322","display_name":"Stellenbosch University","ror":"https://ror.org/05bk57929","country_code":"ZA","type":"education","lineage":["https://openalex.org/I26092322"]}],"countries":["ZA"],"is_corresponding":false,"raw_author_name":"Xikombiso Gertrude Mbhenyane","raw_affiliation_strings":["Division Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, PO Box 241, 8000, South Africa"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Division Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, PO Box 241, 8000, South Africa","institution_ids":["https://openalex.org/I26092322"]}]}],"institutions":[],"countries_distinct_count":2,"institutions_distinct_count":2,"corresponding_author_ids":["https://openalex.org/A5034870533"],"corresponding_institution_ids":["https://openalex.org/I26092322","https://openalex.org/I4210136909"],"apc_list":{"value":2290,"currency":"USD","value_usd":2290},"apc_paid":{"value":2290,"currency":"USD","value_usd":2290},"fwci":0.4757,"has_fulltext":true,"cited_by_count":3,"citation_normalized_percentile":{"value":0.5215311,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":{"min":97,"max":98},"biblio":{"volume":"11","issue":"1","first_page":"220","last_page":"220"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11957","display_name":"Food Safety and Hygiene","score":1.0,"subfield":{"id":"https://openalex.org/subfields/1106","display_name":"Food Science"},"field":{"id":"https://openalex.org/fields/11","display_name":"Agricultural and Biological Sciences"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}},"topics":[{"id":"https://openalex.org/T11957","display_name":"Food Safety and Hygiene","score":1.0,"subfield":{"id":"https://openalex.org/subfields/1106","display_name":"Food Science"},"field":{"id":"https://openalex.org/fields/11","display_name":"Agricultural and Biological Sciences"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}},{"id":"https://openalex.org/T10486","display_name":"Salmonella and Campylobacter epidemiology","score":9.999999747378752e-05,"subfield":{"id":"https://openalex.org/subfields/1106","display_name":"Food Science"},"field":{"id":"https://openalex.org/fields/11","display_name":"Agricultural and Biological Sciences"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}},{"id":"https://openalex.org/T10596","display_name":"Child Nutrition and Water Access","score":0.0,"subfield":{"id":"https://openalex.org/subfields/2916","display_name":"Nutrition and Dietetics"},"field":{"id":"https://openalex.org/fields/29","display_name":"Nursing"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/food-hygiene-practices","display_name":"food hygiene practices","score":0.9369999766349792},{"id":"https://openalex.org/keywords/foodborne-illness","display_name":"food poisoning","score":0.7670000195503235},{"id":"https://openalex.org/keywords/disease-awareness","display_name":"disease awareness","score":0.8109999895095825},{"id":"https://openalex.org/keywords/sanitation-facilities","display_name":"sanitation facilities","score":0.8119999766349792},{"id":"https://openalex.org/keywords/handwashing","display_name":"hand washing","score":0.6380000114440918},{"id":"https://openalex.org/keywords/latrines","display_name":"latrines","score":0.6669999957084656},{"id":"https://openalex.org/keywords/household-workload","display_name":"household workload","score":0.7269999980926514},{"id":"https://openalex.org/keywords/educational-attainment","display_name":"educational attainment","score":0.5440000295639038},{"id":"https://openalex.org/keywords/wealth-status","display_name":"wealth status","score":0.7630000114440918},{"id":"https://openalex.org/keywords/africa","display_name":"Africa","score":0.5519999861717224}],"concepts":[{"id":"https://openalex.org/C547646559","wikidata":"https://www.wikidata.org/wiki/Q162297","display_name":"Hygiene","level":2,"score":0.8291000127792358},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.7896000146865845},{"id":"https://openalex.org/C99454951","wikidata":"https://www.wikidata.org/wiki/Q932068","display_name":"Environmental health","level":1,"score":0.7451000213623047},{"id":"https://openalex.org/C2780151969","wikidata":"https://www.wikidata.org/wiki/Q949149","display_name":"Sanitation","level":2,"score":0.7297000288963318},{"id":"https://openalex.org/C516717267","wikidata":"https://www.wikidata.org/wiki/Q909821","display_name":"Food safety","level":2,"score":0.6868000030517578},{"id":"https://openalex.org/C138816342","wikidata":"https://www.wikidata.org/wiki/Q189603","display_name":"Public health","level":2,"score":0.6033999919891357},{"id":"https://openalex.org/C97156103","wikidata":"https://www.wikidata.org/wiki/Q17072861","display_name":"Open defecation","level":3,"score":0.4609000086784363},{"id":"https://openalex.org/C2992475876","wikidata":"https://www.wikidata.org/wiki/Q909821","display_name":"Food hygiene","level":3,"score":0.4205000102519989},{"id":"https://openalex.org/C148257392","wikidata":"https://www.wikidata.org/wiki/Q2358629","display_name":"Clinical nutrition","level":2,"score":0.36059999465942383},{"id":"https://openalex.org/C2779134260","wikidata":"https://www.wikidata.org/wiki/Q12136","display_name":"Disease","level":2,"score":0.33799999952316284},{"id":"https://openalex.org/C107130276","wikidata":"https://www.wikidata.org/wiki/Q133805","display_name":"Epidemiology","level":2,"score":0.3325999975204468},{"id":"https://openalex.org/C2985496182","wikidata":"https://www.wikidata.org/wiki/Q1773974","display_name":"Disease prevention","level":2,"score":0.3109000027179718},{"id":"https://openalex.org/C2780877353","wikidata":"https://www.wikidata.org/wiki/Q2518253","display_name":"Health services research","level":3,"score":0.27320000529289246},{"id":"https://openalex.org/C83864248","wikidata":"https://www.wikidata.org/wiki/Q177323","display_name":"Developing country","level":2,"score":0.26589998602867126},{"id":"https://openalex.org/C78635009","wikidata":"https://www.wikidata.org/wiki/Q2109172","display_name":"Hygiene hypothesis","level":3,"score":0.2603999972343445},{"id":"https://openalex.org/C142052008","wikidata":"https://www.wikidata.org/wiki/Q954027","display_name":"Cross-sectional study","level":2,"score":0.2578999996185303},{"id":"https://openalex.org/C184356942","wikidata":"https://www.wikidata.org/wiki/Q830382","display_name":"Best practice","level":2,"score":0.25130000710487366}],"mesh":[],"locations_count":3,"locations":[{"id":"doi:10.1186/s40795-025-01190-3","doi":"https://doi.org/10.1186/s40795-025-01190-3","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s40795-025-01190-3","pdf_url":"https://link.springer.com/content/pdf/10.1186/s40795-025-01190-3.pdf","source":{"id":"https://openalex.org/S2765040563","display_name":"BMC Nutrition","issn_l":"2055-0928","issn":["2055-0928"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-d","jufo-1","ki-jl-1","norway-1","poland-20","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Nutrition","raw_type":"journal-article"},{"id":"pmid:41291953","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/41291953","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC nutrition","raw_type":"Journal Article"},{"id":"pmh:oai:doaj.org/article:7356822ee4df44479417b1a9e38ce5d4","doi":null,"is_oa":true,"landing_page_url":"https://doaj.org/article/7356822ee4df44479417b1a9e38ce5d4","pdf_url":null,"source":{"id":"https://openalex.org/S4306401280","display_name":"DOAJ (DOAJ: Directory of Open Access Journals)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-sa","license_id":"https://openalex.org/licenses/cc-by-sa","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"BMC Nutrition, Vol 11, Iss 1, Pp 1-16 (2025)","raw_type":"article"}],"best_oa_location":{"id":"doi:10.1186/s40795-025-01190-3","doi":"https://doi.org/10.1186/s40795-025-01190-3","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s40795-025-01190-3","pdf_url":"https://link.springer.com/content/pdf/10.1186/s40795-025-01190-3.pdf","source":{"id":"https://openalex.org/S2765040563","display_name":"BMC Nutrition","issn_l":"2055-0928","issn":["2055-0928"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-d","jufo-1","ki-jl-1","norway-1","poland-20","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Nutrition","raw_type":"journal-article"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being","score":0.9537000060081482},{"id":"https://metadata.un.org/sdg/2","display_name":"Zero hunger","score":0.9208999872207642},{"id":"https://metadata.un.org/sdg/1","display_name":"No poverty","score":0.41670000553131104}],"sustainable_development_goals_aurora":[],"study_designs":[{"id":"https://openalex.org/study-designs/systematic-review","display_name":"Systematic Review"},{"id":"https://openalex.org/study-designs/meta-analysis","display_name":"Meta-Analysis"}],"awards":[],"funders":[{"id":"https://openalex.org/F4320320671","display_name":"National Research Foundation","ror":"https://ror.org/05s0g1g46"},{"id":"https://openalex.org/F4320322663","display_name":"Universiteit Stellenbosch","ror":"https://ror.org/05bk57929"},{"id":"https://openalex.org/F4320337083","display_name":"Faculty of Medicine and Health, University of Sydney","ror":null}],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W4416630097.pdf","grobid_xml":"https://content.openalex.org/works/W4416630097.grobid-xml"},"referenced_works_count":37,"referenced_works":["https://openalex.org/W760861952","https://openalex.org/W1582175947","https://openalex.org/W2095051731","https://openalex.org/W2126930838","https://openalex.org/W2139905170","https://openalex.org/W2408140425","https://openalex.org/W2795843602","https://openalex.org/W2885382530","https://openalex.org/W2887760750","https://openalex.org/W2892516279","https://openalex.org/W2917951897","https://openalex.org/W2948562665","https://openalex.org/W2948983857","https://openalex.org/W3081497194","https://openalex.org/W3115997142","https://openalex.org/W3126498634","https://openalex.org/W3128252017","https://openalex.org/W3132417666","https://openalex.org/W3211520781","https://openalex.org/W3215635707","https://openalex.org/W4214917722","https://openalex.org/W4280503060","https://openalex.org/W4283269037","https://openalex.org/W4285742753","https://openalex.org/W4298122101","https://openalex.org/W4304084297","https://openalex.org/W4367353556","https://openalex.org/W4381051335","https://openalex.org/W4382468322","https://openalex.org/W4386565373","https://openalex.org/W4387667709","https://openalex.org/W4389284685","https://openalex.org/W4390500733","https://openalex.org/W4401590227","https://openalex.org/W4402645590","https://openalex.org/W4403344495","https://openalex.org/W4403583908"],"related_works":[],"abstract_inverted_index":{"BACKGROUND:":[0],"Food":[1],"safety":[2,28,64,158,221,231,270],"is":[3,33,48],"vital":[4],"for":[5,147,227,273],"public":[6],"health":[7],"in":[8,66,138,238],"Africa,":[9,67],"where":[10],"foodborne":[11],"diseases":[12],"pose":[13],"significant":[14],"risks.":[15],"Despite":[16],"the":[17,31,73,108,139,145,150,169,195,236],"importance":[18],"of":[19,153,171,197,235],"proper":[20,245],"food":[21,27,63,157,173,220,230,246,269],"handling,":[22],"comprehensive":[23],"data":[24],"on":[25,61,71],"household":[26,62,229],"practices":[29,65,159,175,253],"across":[30],"continent":[32],"scarce.":[34],"Various":[35],"socioeconomic,":[36],"cultural,":[37],"and":[38,55,90,96,102,120,205,216,248,261,265],"environmental":[39],"factors":[40,75,185,251],"may":[41],"influence":[42],"these":[43,77,190],"practices,":[44,191],"but":[45],"their":[46],"interplay":[47],"still":[49],"unclear.":[50],"AIM:":[51],"This":[52],"systematic":[53,140],"review":[54],"meta-analysis":[56,121],"sought":[57],"to":[58,107,165,181,224,258],"synthesize":[59],"evidence":[60],"with":[68,93,124,142],"a":[69,129],"focus":[70],"identifying":[72],"determinant":[74],"influencing":[76,189,252],"behaviors.":[78],"METHODS:":[79],"Literature":[80],"searches":[81],"were":[82,111,136,186,222,271],"conducted":[83,123],"using":[84,117,128],"PubMed,":[85],"Embase,":[86],"African":[87,240],"Journals":[88],"Online,":[89],"ScienceDirect,":[91],"along":[92],"Google":[94],"Scholar":[95],"citations":[97],"from":[98,179],"other":[99],"studies.":[100],"Keywords":[101],"medical":[103],"subject-heading":[104],"terms":[105],"related":[106],"study":[109],"title":[110],"used.":[112],"Data":[113],"extraction":[114],"was":[115,122,160],"performed":[116],"Microsoft":[118],"Excel,":[119],"Stata":[125],"version":[126],"18.0":[127],"random":[130],"effect":[131],"model.":[132],"RESULTS:":[133],"Nineteen":[134],"studies":[135],"included":[137,254],"review,":[141],"ten":[143],"meeting":[144],"criteria":[146],"meta-analysis.":[148],"Overall,":[149],"pooled":[151],"prevalence":[152,170],"respondents":[154],"showing":[155],"good":[156,172,214],"54%":[161],"(95%":[162],"CI:":[163],"46%":[164],"62%).":[166],"In":[167],"comparison,":[168],"hygiene":[174,247],"varied":[176],"widely,":[177],"ranging":[178],"17.6%":[180],"86.0%.":[182],"Several":[183],"key":[184],"identified":[187],"as":[188],"including":[192],"disease":[193,255],"awareness,":[194,256],"availability":[196],"latrines,":[198],"handwashing":[199],"facilities,":[200,260],"liquid":[201],"waste":[202],"disposal":[203],"pits,":[204],"workload.":[206],"Furthermore,":[207],"higher":[208],"education":[209],"levels,":[210],"improved":[211],"wealth":[212],"status,":[213],"knowledge,":[215],"positive":[217,266],"attitudes":[218,267],"towards":[219,268],"found":[223],"be":[225],"crucial":[226],"enhancing":[228],"practices.":[232],"CONCLUSION:":[233],"Half":[234],"households":[237],"seven":[239],"countries":[241],"did":[242],"not":[243],"practice":[244],"safety.":[249],"Key":[250],"access":[257],"sanitation":[259],"workload,":[262],"while":[263],"understanding":[264],"essential":[272],"improvement.":[274]},"counts_by_year":[{"year":2026,"cited_by_count":3}],"updated_date":"2026-10-13T10:08:12.033832","created_date":"2025-11-25T00:00:00"}
