Clinical Practice in Pediatric Psychology最新文献

{"title":"Development of the Diversity, Equity, and Inclusion Supervisor Self-Assessment Tool (DEI-SST).","authors":"Monique Germone, Brandon Matsumiya, Kristoffer S Berlin, Sobha Fritz, Ana Belen Goya Arce, Casie H Morgan, Elizabeth S Christofferson, Erica H Lee, Jessica M Valenzuela","doi":"10.1177/21694826261429709","DOIUrl":"10.1177/21694826261429709","url":null,"abstract":"<p><p>The Diversity, Equity, and Inclusion Supervisor Self-Assessment Tool (DEI-SST) was developed to help psychology supervisors reflect on their supervisory practices regarding diversity, equity, and inclusion. The Society of Pediatric Psychology's Anti-racism Workgroup, Training Subgroup, adapted a preexisting psychology course syllabus evaluation tool for self-assessment in supervision to include aspects of clinical training, the APA multicultural guidelines, and the domains from the APA Guidelines for Clinical Supervision in Health Service Psychology. Following an expert review of the modified tool, the tool was administered in three settings, and qualitative themes were extracted from participant feedback. All participants (<i>N</i> = 38) endorsed that the DEI-SST helped them reflect on their supervisory practice. No participants provided feedback on the wording of the tool. All participants identified at least one area of supervision they had not considered previously. Suggested improvements to the tool included reducing the length of the tool, expanding the examples provided within each developmental stage, and including resources to enhance supervision. The DEI-SST shows promise to help supervisors incorporate aspects of DEI into their supervision that they may not have previously done. It provides a starting point for further growth needed to improve their practice. Future directions include investigating best practices for tool administration and a continued review of tool content to reflect advances in equitable and inclusive supervisory practices.</p>","PeriodicalId":37641,"journal":{"name":"Clinical Practice in Pediatric Psychology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13015934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147522084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Item-Level Analysis of Patient Health Questionnaire (PHQ-9) Among Adolescents in Primary Care.","authors":"Leah LaLonde, Teryn Bruni, Chong Man Chow, Michelle Byrd, Joyce M Lee, Alexandros Maragakis","doi":"10.1177/21694826251323289","DOIUrl":"10.1177/21694826251323289","url":null,"abstract":"<p><strong>Objective: </strong>Adolescents are at increased risk for meeting diagnostic criteria for depression and chronic impairments in functioning. Despite the potential consequences, adolescents have poor access to mental health treatment. To increase access, professional organizations recommend pediatricians regularly screen for symptoms of depression with the goal of identifying, preventing, and treating depression. The Patient Health Questionnaire (PHQ-9) has become a frequently used screener in primary care due to its brevity and well-established psychometric properties among both adults and adolescents. The present study aims to expand on this research by examining the quality of individual PHQ-9 items in an ecologically valid sample of adolescents screened for depression during their well-child exams.</p><p><strong>Method: </strong>Participants include 11,058 adolescents who were screened using the PHQ-9 at a primary care clinic.</p><p><strong>Results: </strong>This retrospective chart review study demonstrated that all nine items discriminate moderate to severe depression severity. The PHQ-9 provides the most information about two standard deviations above the mean, indicating more error when measuring mild levels of depression. Some PHQ-9 items function best at lower levels of depression, whereas others function best at higher levels of depression. Four of the PHQ-9 items do not show evidence of equal interval response options.</p><p><strong>Conclusions: </strong>Individual symptoms of depression endorsed by adolescents should be considered when interpreting the overall depression scores. The clinical implications related to ultra-brief depression screening and suicidal ideation screening are discussed as well as limitations and future directions.</p>","PeriodicalId":37641,"journal":{"name":"Clinical Practice in Pediatric Psychology","volume":"14 1","pages":"42-52"},"PeriodicalIF":1.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Bedside Caregiver Distress Screening Following Pediatric Hospitalization for Traumatic Injury.","authors":"Emily C Hilton, Leigh E Ridings, Dulaney A Wilson, Tatiana M Davidson, Kenneth J Ruggiero, Hannah C Espeleta","doi":"10.1177/21694826251369455","DOIUrl":"10.1177/21694826251369455","url":null,"abstract":"<p><p>Youth hospitalized for traumatic injury have high risk of developing mental health concerns. As such, the American College of Surgeons guidelines require trauma centers to provide mental health screening to patients at risk. Evidence-based guidance is needed to inform screening tool selection and implementation. This study evaluated the utility of caregiver self-report on the Peritraumatic Distress Inventory (PDI) at bedside to predict mental health symptoms in caregivers and youth 30 days post-injury, using data collected 2015-2024. Caregivers completed the PDI at hospital bedside and self-reported on distress (Kessler-6) 30 days post-injury (<i>n</i> = 306). Youth self-reported symptoms of PTSD (<i>n</i> = 134) and depression (<i>n</i> = 160) post-injury. At 30 days, 10% of caregivers had clinically elevated distress scores, 34% of youth had elevated depression symptoms, and 37% of youth had elevated PTSD symptoms. Caregivers with elevated PDI at baseline were 8% more likely to have elevated 30-day distress; youth of caregivers with elevated PDI were 6% more likely to have elevated 30-day depression symptoms. Receiver operating characteristic (ROC) curves for the PDI suggested a cut-point of 28 to predict caregiver distress and 21 to predict youth depression symptoms following the acute post-trauma period. The PDI demonstrated low clinical utility for predicting later caregiver distress, but performed well as a screener of youth depressive symptoms. Caregiver self-report on the PDI was predictive of youth depression symptoms 30 days following injury. Including caregiver PDI in mental health screening protocols may improve trauma centers' ability to address the needs of youth and families after injury.</p>","PeriodicalId":37641,"journal":{"name":"Clinical Practice in Pediatric Psychology","volume":"13 4","pages":"390-398"},"PeriodicalIF":1.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13373907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148473319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lessons learned from mothers: Parenting perspectives for preventing pediatric unintentional injuries related to autism.","authors":"Alecia Mercier, Brianna Paquette, David C Schwebel, Kristi C Guest, Sarah E O'Kelley, Casie H Morgan","doi":"10.1177/21694826251374700","DOIUrl":"10.1177/21694826251374700","url":null,"abstract":"<p><strong>Objective: </strong>Autistic children have higher unintentional injury risk than typically developing children, but little is known about how parents struggle and succeed in keeping their autistic children safe from injury. Qualitative methods evaluated the concerns of unintentional injury prevention experienced by mothers of autistic children and the impact of these strategies on maternal quality of life.</p><p><strong>Methods: </strong>Fifteen mothers (<i>M</i> _<i>age</i> = 37.80 years) of autistic children participated in a semi-structured interview addressing child characteristics, injury concerns and experiences, and injury prevention strategies and resources. Interviews were transcribed and coded in NVivo following a systematic, inductive approach.</p><p><strong>Results: </strong>Mothers of autistic children have significant concerns regarding child injury prevention, leading to increased feelings of parental responsibility and need for constant supervision of their autistic child. The sustainability of safety strategies that encompass supervision, such as proximity and control, were concerning to mothers. The dominant role of supervision leads to reports of exhaustion and increased cognitive load. Despite this, the mothers reported these efforts were necessary to prevent injury in their child.</p><p><strong>Conclusions: </strong>By evaluating the lived experiences of mothers with autistic children, this study identified maternal responsibility and supervision as the most critical and most demanding aspects of child injury prevention. Clinicians working with families who have autistic children should consider encouraging parents to proactively develop effective and practical safety interventions to reduce child injury risk as well as reducing caregiver stress.</p>","PeriodicalId":37641,"journal":{"name":"Clinical Practice in Pediatric Psychology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12419536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coping and Meaning-Making Strategies Described by Parents of Children with Medical Complexity.","authors":"Julia B Tager, Ansley E Kenney, Paulina S Lim, Samantha A Everhart, Sarah Johaningsmeir, Kathryn A Balistreri, Amy Morgan-Tautges, K Jane Lee, Maura A Brophey, Matthew C Scanlon, Charles B Rothschild, W Hobart Davies, Jessica L Schnell","doi":"10.1177/21694826251322195","DOIUrl":"10.1177/21694826251322195","url":null,"abstract":"<p><strong>Objective: </strong>Parents of children with medical complexity (CMC) experience stressors related to caregiving, navigating the healthcare system, and managing their own well-being. There is a dearth of research examining parental coping strategies used in response to these challenges. Informed by the revised Transactional Model of Coping, the current study aimed to characterize coping among a sample of parents of CMC.</p><p><strong>Methods: </strong>Twenty parental caregivers of CMC served by the Complex Care Program at a large midwestern pediatric hospital participated in one-hour semi-structured qualitative interviews.</p><p><strong>Results: </strong>Participants described a breadth of ways of coping with challenges in their lives, including problem-focused and emotion-focused coping strategies. They also described a range of meaning-making strategies, represented by themes <i>celebration of child, maintaining</i> a <i>commitment to caregiving</i>, <i>striving to be a \"good parent</i>,\" and <i>recognizing gains from caregiving experiences.</i></p><p><strong>Conclusions: </strong>Parents of CMC described coping with their challenges in diverse ways, including using many meaning-making strategies. Future research should investigate coping strategies more systematically with representative samples to enable culturally informed intervention development to support parent and family well-being among those who care for CMC.</p>","PeriodicalId":37641,"journal":{"name":"Clinical Practice in Pediatric Psychology","volume":"13 3","pages":"247-258"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Not a Trainee, Not Yet Mid-Career: Navigating being an Early Career Pediatric Psychologist.","authors":"Colleen Stiles-Shields, Emily G Lattie, Kathryn Macapagal, Alexandra M Psihogios","doi":"10.1037/cpp0000546","DOIUrl":"10.1037/cpp0000546","url":null,"abstract":"<p><strong>Objective: </strong>The American Psychological Association (APA) defines early career (EC) status as occurring in the 10 years following earning a doctorate. As EC pediatric and behavioral health psychologists (ECPP) who work with and conduct research with adolescents and young adults (AYA), we have noted that our own and our peers' experiences during this career phase have mirrored that of our AYA research participants and patients. Namely, no longer scaffolded by training milestones and supervision, yet still often viewed as green, EC psychologists may often feel and be treated like they are experiencing a career-based emerging adulthood. Despite the presence of some institutional support during this career phase, we and our peers have found difficulty in navigating this career phase-something compounded by concurrent life events (e.g., parenting, pandemic).</p><p><strong>Method: </strong>Grounded in our own current and recent histories, this Commentary provides examples of common experiences across the EC--from fellowship to nearing mid-career.</p><p><strong>Results: </strong>To improve the EC experience for pediatric psychologists and beyond, recommendations are made at the institutional, mentor, and ECPP-levels.</p><p><strong>Conclusions: </strong>Given the risks for burnout during this phase of career, when workforce demands are at all-time high, this Commentary aims to draw attention to the developmental norms of EC and to improve the EC experience for pediatric psychologists and our peers. The hope is that in doing so, pediatric patients and their families may be better served via a well-supported EC workforce.</p>","PeriodicalId":37641,"journal":{"name":"Clinical Practice in Pediatric Psychology","volume":"13 3","pages":"327-333"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12377528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective Rates of Positive Depression Screens in Pediatric Diabetes Using Two PHQ-9 Cutoff Scores: A Brief Report.","authors":"Alexandra D Monzon, Susana R Patton, Shilpa Gurnurkar, Marisse Padron, Jessica Pierce","doi":"10.1177/21694826251353219","DOIUrl":"10.1177/21694826251353219","url":null,"abstract":"<p><strong>Objective: </strong>Compare two empirically supported cutoff scores for the Patient Health Questionnaire (PHQ-9) in a clinical sample of youth with type 1 diabetes (T1D).</p><p><strong>Methods: </strong>The sample comprises 212 youth with T1D aged 12-18. We retroactively collected PHQ-9 scores from electronic health records. We compared the normative cutoff score of 10 on the PHQ-9 to a newly modified score of 5.</p><p><strong>Results: </strong>Using the cutoff score of 5 on the PHQ-9, 44.3% of patients screened positive for symptoms of depression, while 22.6% of patients screened positive for symptoms of depression using the cutoff score of 10.</p><p><strong>Conclusions: </strong>The modified cutoff score of 5 on the PHQ-9 resulted in twice as many patients screening positive for symptoms of depression as the normative cutoff score of 10. However, it is important to consider these findings in the context of the healthcare system and the overall impact of false positives.</p>","PeriodicalId":37641,"journal":{"name":"Clinical Practice in Pediatric Psychology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13309205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148345650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community-Engaged, Multi-Method Needs Assessment to Improve Asthma Care Implementation: The Rhode Island Asthma Integrated Response (RI-AIR) Program.","authors":"Anna J Yeo, Elizabeth L McQuaid, Grace K Cushman, Sara E Vargas, Barbara Jandasek, Deborah N Pearlman, Daphne Koinis-Mitchell","doi":"10.1177/21694826251347980","DOIUrl":"10.1177/21694826251347980","url":null,"abstract":"<p><strong>Objective: </strong>Asthma disproportionately afflicts U.S. urban children, particularly those of Black and Latino backgrounds, and is highly prevalent in Rhode Island (RI). We collaborated with community partners to conduct a multi-level, theoretically supported needs assessment and used its findings to inform the development of the Rhode Island Asthma Integrated Response (RI-AIR) Program.</p><p><strong>Methods: </strong>To elucidate social, epidemiological, behavioral, environmental, educational, administrative, and policy-related factors contributing to gaps in asthma care in RI, we established the RI-AIR Collaborative with community partners; examined state- and hospital-level health care data; conducted in-depth interviews and focus groups with community partners; used geospatial mapping to identify high burden areas; and interpreted outcomes of our existing school- and home-based programs.</p><p><strong>Results: </strong>The Collaborative reviewed quantitative and qualitative data from multiple sources and identified gaps to address, and resources and strengths to utilize in the RI-AIR program. Findings highlighted the need to provide tailored interventions based on asthma control, and improve communication between families, schools, and health care providers to promote integrated care. Existing strengths included our guidelines-based school and home interventions, longstanding community collaborations, and technological resources.</p><p><strong>Conclusions: </strong>We developed RI-AIR, a coordinated system of asthma assessment and intervention, that provides school- and/or home-based interventions tailored to risk levels and facilitate communication across sectors of care. Our multi-method needs assessment and RI-AIR represent an innovative, community-engaged approach to building a program to address asthma disparities.</p>","PeriodicalId":37641,"journal":{"name":"Clinical Practice in Pediatric Psychology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12539642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145349027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mindfulness-Based Intervention for Adolescents With Type 1 Diabetes: A Case Series.","authors":"Francesca Lupini, Hailey Moore, Molly Basch, Jack Vagadori, Frances Cooke, Katherine Patterson Kelly, Randi Streisand, Lauren Shomaker, Mesgana Dagnachew, Daniel K Cooper, Eleanor R Mackey","doi":"10.1177/21694826251319328","DOIUrl":"10.1177/21694826251319328","url":null,"abstract":"<p><strong>Objective: </strong>Adolescents with type 1 diabetes (T1D) have risk for elevated negative affect, and mindfulness-based interventions (MBI) may be effective interventions. The aim of this case series was to (1) highlight individual changes in negative affect (depression, anxiety, and stress), mindfulness, and diabetes outcomes (diabetes distress, diabetes self-management, and HbA1c) after participating in an MBI and (2) highlight the utility of MBI in historically marginalized populations.</p><p><strong>Methods: </strong>Cases were chosen from a sample of adolescents with T1D and elevated negative affect who took part in a pilot randomized controlled trial of an MBI. Individuals were selected due to adherence to study protocol, similar baseline scores on target outcomes, and demographic similarities that indicate historical marginalization. The participants were two 12-14-year-old girls with T1D, one identifying as Black/African American, \"Jayla,\" and one identifying as biracial Latinx/Hispanic, \"Valerie\" who participated in a 6-7 session virtual group MBI. Participants completed surveys at baseline, post-intervention, and three months post-intervention.</p><p><strong>Results: </strong>Jayla and Valerie demonstrated improvements in multiple domains including depression, anxiety, stress, mindfulness, diabetes distress, and diabetes self-management. We observed small improvements in HbA1c and disordered eating in Valerie, but not in Jayla.</p><p><strong>Conclusions: </strong>This case series demonstrates the potential utility of MBI in adolescents with T1D and negative affect, particularly those experiencing increased burden of SDOH.</p>","PeriodicalId":37641,"journal":{"name":"Clinical Practice in Pediatric Psychology","volume":"13 2","pages":"189-198"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12456681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating Critical Moments: The Importance of Spiritual and Psychosocial Collaboration in Addressing Coping in the Pediatric ICU.","authors":"Madeline Johnson, Rev Ian R Butts, Rachel Ashworth, Jacquelyn Smith, Patricia Marik, W Hobart Davies, Charles Rothschild","doi":"10.1177/21694826251328954","DOIUrl":"10.1177/21694826251328954","url":null,"abstract":"<p><strong>Objective: </strong>To explore, by way of intentional, case-based reflection, the ways in which hospital-based chaplains and pediatric psychologists collaborate as key members of a patient/family's interdisciplinary care team to provide synergistic spiritual and psychosocial care.</p><p><strong>Methods: </strong>Intentional reflection and dialogue amongst co-authors with backgrounds in chaplaincy/spiritual care, pediatric intensive care medicine, pediatric palliative care medicine, and pediatric psychology. Co-authors took notes on the content of conversations they observed at a midwestern hospital. They then reviewed the content of these conversations for themes which might be applicable to interdisciplinary psychosocial and spiritual care.</p><p><strong>Results: </strong>While each case represents one specific situation, key concepts were identified and explored. These include: differences in timing of care and expertise among psychosocial team members can be leveraged to enhance the collective ability to support a family; spiritual and psychological distress can mirror one another, and even co-occur; a family's religious or cultural identity does not inherently predict the degree to which their distress has spiritual underpinnings; the collaborative nature of interdisciplinary team members can strengthen support to patients and families if they demonstrate partnership and consistent communication.</p><p><strong>Conclusions: </strong>Interdisciplinary teamwork involving collaboration between hospital chaplains and pediatric psychologists, both serving critical roles within the care team, can lead to unique and effective partnerships which enhance psychosocial and spiritual care for patients and families. While these reflections represent collaboration at a single hospital, further work should be done to better understand the current state of such teamwork more broadly, and to identify best practices to maximize the impact of these collaborations across institutions.</p>","PeriodicalId":37641,"journal":{"name":"Clinical Practice in Pediatric Psychology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12338377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}