Stigma and Health最新文献

{"title":"Social Perceptions of Weight Loss With Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists in Black and White Women With Obesity.","authors":"Stacy M Post, Michelle L Stock, Susan Persky","doi":"10.1037/sah0000689","DOIUrl":"10.1037/sah0000689","url":null,"abstract":"<p><p>Intersectionality theory suggests that because stigma arises from the interplay of multiple marginalized identities, Black women with obesity may face stronger negative attitudes than White women when using GLP-1 agonists, a newer class of obesity medications often perceived as an 'easy way out.' This experimental study tested how exposure to different weight loss methods affected stigma toward a Black or White woman with obesity, as well as the influence of participant race on stigma. A sample of 402 Black and White women with overweight or obesity were randomly assigned to read about a Black or White woman named Evette who lost 15% of her total body weight with either diet/exercise or a GLP-1. Participants reported stigmatizing attitudes toward Evette (fat phobia, dislike, desire for social distance, and blame) and beliefs that she took a weight loss shortcut. Stigma was higher when Evette lost weight with a GLP-1 (vs. diet/exercise) and, contrary to hypotheses, when Evette was depicted as White (vs. Black). Moderated mediation analyses demonstrated that GLP-1-assisted weight loss (vs. diet/exercise) led to higher fat phobia, dislike, desire for social distance, and blame via stronger shortcut beliefs and this effect was more pronounced when Evette was portrayed as White. Participant race did not influence how weight loss with a GLP-1 and Evette's race, together, affected stigma through shortcut beliefs. Findings highlight the importance of challenging societal narratives about what constitutes 'acceptable' weight loss strategies for women with obesity to reduce stigma and protect long-term health.</p>","PeriodicalId":53222,"journal":{"name":"Stigma and Health","volume":"11 2","pages":"303-315"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13196875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148018801","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":"Impact of policies on pregnant individuals using drugs: A narrative synthesis review of treatment, health care access, and outcomes.","authors":"Sugy Choi, Josh Aleksanyan, Elizabeth Knopf, Theresa Hwee, Leah Habersham, Brooke S West","doi":"10.1037/sah0000675","DOIUrl":"10.1037/sah0000675","url":null,"abstract":"<p><p>Amid the opioid epidemic and racial disparities in maternal and child health, there is increasing interest from clinicians, patients, and policymakers in understanding how state policies impact pregnant individuals using drugs, particularly regarding healthcare access and outcomes. This narrative synthesis examines the types of policies affecting this population and their consequences on maternal and child health. Following PRISMA guidelines, we reviewed 408 studies, selecting 28 relevant articles to assess the prevalence and effects of punitive laws targeting pregnant individuals using drugs. The review reveals an increase in punitive policies over time, such as considering substance use as child abuse, mandatory reporting with positive toxicology tests, and cannabis-related regulations, including restrictions on breastfeeding. However, the findings are mixed regarding neonatal abstinence syndrome (NAS) and mandatory reporting. Some studies show a rise or decrease in NAS following punitive policy changes, while others suggest that such policy changes may lead to lower rates of provider reporting. The fear of being reported may discourage some pregnant individuals from seeking prenatal care due to increased stigma. Other studies report confusion about mandatory reporting procedures and providers' concerns about damaging patient trust. Policies sanctioning incarceration of pregnant individuals using substances also increase out-of-state births, potentially endangering both mothers and infants. This study highlights the harmful, unintended consequences of various policies and discusses interventions and future research directions.</p>","PeriodicalId":53222,"journal":{"name":"Stigma and Health","volume":"11 1","pages":"61-74"},"PeriodicalIF":1.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13344196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413745","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":"Expressive Flexibility as a Buffer in the Association Between Substance Use Stigma and Drug Use Problems Among Substance-Using Individuals with Depression.","authors":"Katie Wang, Rachel Girard, Robert B Manning, Nicole H Weiss","doi":"10.1037/sah0000680","DOIUrl":"10.1037/sah0000680","url":null,"abstract":"<p><p>Prior research has linked stigma associated with substance use (e.g., encounters with and anticipation of discrimination, internalization of negative stereotypes) to increased drug use problems, yet little work has examined protective factors that mitigate this association. The current study examined expressive flexibility (i.e., the ability to flexibly enhance and suppress one's emotional expression in accordance with situational demands), an important component of emotion regulation and psychological flexibility, as a buffer in the relation between substance use stigma and drug use problems among individuals with depression, a population disproportionately impacted by substance use disorder. A community sample of U.S. adults diagnosed with major depressive disorder (<i>N</i> = 112) completed self-report measures of substance use stigma, expressive flexibility, and drug use problems. Moderation analyses showed that substance use stigma was significantly associated with drug use problems, but the association was attenuated for participants with high levels of expressive flexibility. These findings underscored the potential utility of fostering expressive flexibility as a stigma coping resource in substance use prevention and treatment interventions.</p>","PeriodicalId":53222,"journal":{"name":"Stigma and Health","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12807520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145999646","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":"\"Stigma's Every Day, All Day Long\": A Qualitative Exploration of Experiences of Overlapping Stigmas and HIV Prevention Service Use Among Women Who Use Drugs.","authors":"Stephanie A Meyers-Pantele, Ingrid Yu, Keith J Horvath, Lisa Eaton, Stefan Baral, Laramie R Smith, Jamila K Stockman","doi":"10.1037/sah0000678","DOIUrl":"10.1037/sah0000678","url":null,"abstract":"<p><p>In 2025, gendered inequities in HIV risk and harm remain for women who use drugs (WWUD). WWUD also have low levels of HIV prevention service engagement and likely experience intersectional stigma. The present study sought to explore WWUD's experiences with intersectional stigma and how those experiences shape HIV prevention service use to better inform the development of tailored intervention efforts. Individual in-depth interviews were conducted within the mHeaLth interventiOn To redUce Stigma study, a study to develop and pilot test an intervention to reduce intersectional stigma and improve HIV prevention service engagement among racially and ethnically diverse WWUD. Interviews elicited participants' experiences with stigma and perceived barriers and facilitators to HIV prevention services. Data were analyzed via thematic analysis. Intersectionality theory and the Health Stigma and Discrimination Framework were applied to emergent themes to conceptualize study findings. Narratives from 26 WWUD in San Diego County highlighted ubiquitous homelessness, drug use, misogyny, and/or other intersectional stigmas that were driven by structural-level factors (e.g., criminal justice environment, housing systems, local politics) and resulted in violence, health care avoidance, and receiving poor-quality care. Though most women reported not experiencing stigma within HIV prevention services, many still reported barriers to care (i.e., time, transportation, HIV stigma, shame/embarrassment, and lack of trustworthy information). Collectively, these findings highlight the pervasive nature of intersectional stigma in WWUD's lives, the detrimental impact that stigma has (i.e., violence and poor-quality care), and the need for flexible, mobile, and tailored HIV prevention interventions that target intersectional stigma.</p>","PeriodicalId":53222,"journal":{"name":"Stigma and Health","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13327734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377944","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":"\"They Call Us Amaphara (Junkies)\": Intersectional Tuberculosis, Alcohol, and Drug Stigma in South Africa.","authors":"Tara Carney, Noluthando Mpisane, Jessica F Magidson, Mari-Lynn Drainoni, Nandi Niemand, Sarah Weber, Christina S Meade, Karen R Jacobson, Bronwyn Myers","doi":"10.1037/sah0000670","DOIUrl":"10.1037/sah0000670","url":null,"abstract":"<p><p>Stigma acts as a barrier to the diagnosis and effective treatment of tuberculosis (TB). Individuals with TB who also use alcohol or drugs (AODs), including methamphetamine, may experience intersectional stigma. Further, the nature and intensity of these intersecting stigmas may be compounded by co-morbidities like HIV and marginalized social status. Despite this, AOD use stigma has rarely been studied in the context of TB and other co-occurring conditions. We examined the perceptions and experiences of AOD use-related stigma among individuals who were previously diagnosed with TB or were at increased risk of TB based on their close contacts, in a rural community in the Western Cape, South Africa. We analyzed qualitative data collected by two studies (study 1: five focus groups (n=34), study 2: ten focus groups (n=84)). Findings highlighted that study participants who use AODs experienced intersectional stigma from multiple sources. AOD use- and TB-related stigma were experienced from friends, family, healthcare providers, and the broader community, particularly for those who used illicit drugs. Participants discussed stigma's effects on their health and well-being. The negative effects of AOD use stigma were particularly salient among female participants. Findings indicate that intersecting stigmas exist at multiple levels for people who use AODs with/at risk of TB, and that these stigmas hinder healthcare utilization in this rural setting. Future interventions to improve TB service uptake need to address intersectional AOD use and TB stigma.</p>","PeriodicalId":53222,"journal":{"name":"Stigma and Health","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12900165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202901","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":"Interpersonal Health Care Discrimination and Delayed Alcohol Use Treatment Among Sexual Minority Adults With Multiple Stigmatized Identities.","authors":"Emily Pasman, Sean Esteban McCabe, Luisa Kcomt, Jessica M Mongilio, Marvin Schilt-Solberg, Rebecca J Evans-Polce","doi":"10.1037/sah0000674","DOIUrl":"10.1037/sah0000674","url":null,"abstract":"<p><p>Experiences of prejudice and discrimination contribute to heightened risk for alcohol use-related harm among sexual minority (SM) individuals. Discrimination in health care settings can also reduce help-seeking and treatment engagement. However, most research has focused on only one form of discrimination in isolation. This study used an intersectional stigma lens to examine associations between interpersonal health care discrimination and delayed alcohol use treatment among SM adults with multiple stigmatized identities. Interpersonal health care discrimination-based on one's sexual orientation, race-ethnicity, or both-and delayed treatment for alcohol use were examined among a nationally representative sample of SM adults from the 2012 to 2013 National Epidemiologic Survey on Alcohol and Related Conditions (<i>N</i> = 3,201), the only nationally representative survey that assesses multiple domains of sexual orientation, experiences of health care discrimination, and treatment intentions and utilization. Multivariable logistic regression was used to identify factors associated with delayed treatment for alcohol use. Approximately one in five (18.9%) SM adults experienced interpersonal health care discrimination and 9.2% delayed treatment for alcohol use. Delayed treatment was more prevalent among SM adults than the general population of adults with lifetime alcohol use. Those reporting both sexual orientation and racial-ethnic discrimination had more than double the odds of delayed treatment than those reporting neither (adjusted odds ratio = 2.38, 95% confidence interval [1.17, 4.85]). Findings highlight the compounding effect of intersectional stigma on treatment delay. Interventions are needed to address intersectional stigma in health care settings and engage particularly marginalized subpopulations of SM adults in alcohol use treatment.</p>","PeriodicalId":53222,"journal":{"name":"Stigma and Health","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12872057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146127538","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":"Exploring the Relationship Between Adverse Childhood Experiences and Internalized Substance Use Stigma: A Mediation Analysis Among Incarcerated Women.","authors":"Jaxin Annett, Marguerite Webster, Martha Tillson, J Matthew Webster, Megan F Dickson, Michele Staton","doi":"10.1037/sah0000663","DOIUrl":"10.1037/sah0000663","url":null,"abstract":"<p><p>While adverse childhood experiences (ACEs) and mental health (MH) may significantly influence internalized substance use stigma (ISUS), these relationships remain underexplored. This study addresses this gap by: (1) examining bivariate relationships between ACEs, MH, and ISUS, and (2) investigating the mediating role of MH-specifically anxiety, depression, and post-traumatic stress disorder (PTSD)-in this relationship. As part of the ongoing NIDA-funded Kentucky Justice Community Opioid Innovation Network (JCOIN) trial, 900 women with a history of opioid use disorder were randomly selected from nine Kentucky jails, consented, and interviewed on their substance use histories and related stigma, ACEs, and MH. Linear regression with mediation was used to analyze data. Women were an average age of 37 years and were predominantly non-Hispanic white (92.4%). ACEs and all MH variables were significantly associated with ISUS (<i>p</i><.001). Mediation models indicated that anxiety and depression partially mediated the relationship between ACEs and ISUS, each explaining about a third (anxiety=38%, depression=32%) of the total effect of this relationship. Additionally, PTSD fully mediated this relationship, highlighting that PTSD is a significant explanatory factor and accounts for about 69% of the relationship. Results suggest that ACEs among women who have been incarcerated are linked to MH issues, which may contribute to ISUS. Addressing MH may help mitigate ISUS, underscoring the need for integrated, trauma-informed treatment interventions targeting ACEs, MH, and ISUS to improve recovery outcomes.</p>","PeriodicalId":53222,"journal":{"name":"Stigma and Health","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12493996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234079","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":"Global Sleep Quality among Multiracial College Students in the United States: A Brief Report of Concurrent Associations with General and Multiracial Discrimination and Negative Affect.","authors":"Fatima Dobani, Patricia A Goodhines, Hana A Shroff, William J Salapow, Lila Ferrucci, Aesoon Park","doi":"10.1037/sah0000659","DOIUrl":"10.1037/sah0000659","url":null,"abstract":"<p><p>College environments confer risk for sleep health, with discrimination compounding this risk for marginalized college students, in line with the sociocultural determinants of health framework. Multiracial (alternatively, mixed-race or biracial) college students may be susceptible to poor sleep quality due to their unique experiences of Multiracial-specific discrimination as well as general, everyday discrimination. Further, negative affect may play a role in the discrimination-sleep association. The current cross-sectional study investigated the association of general and Multiracial discrimination and negative affect with global sleep quality among a convenience sample of 193 Multiracial college students. Participants were recruited from a predominantly White institution in 2021 and completed an online survey reporting lifetime discriminatory experiences (general and Multiracial-specific), negative affect (depressive and anxiety symptoms), and past-month global sleep quality (Pittsburgh Sleep Quality Index). Findings from a hierarchical linear regression model indicated that covariates (i.e., age and sex) accounted for 2% of the variance in sleep quality. General discrimination explained 11% of additional variance, and Multiracial discrimination accounted for a further 4% of variance and was associated with poor sleep quality (<i>ϐ</i>=.23, <i>p</i><.001) beyond general discrimination, age, and sex. Negative affect also significantly predicted poor sleep quality when added in the model (<i>ϐ</i>=.56, <i>p</i><.001), further accounting for 25% of variance. Exploratory ancillary analyses suggested that negative affect may account for the discrimination-sleep quality relation and sleep quality may account for the discrimination-negative affect relation. Findings extend limited research on Multiracial college student sleep health and its associations with both general and Multiracial-specific discrimination and negative affect.</p>","PeriodicalId":53222,"journal":{"name":"Stigma and Health","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12885241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158911","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":"Stigma Affects How Parents Respond to their Children's Mental Health, But Does Child Gender Complicate the Story?","authors":"Alice P Villatoro, Melissa J DuPont-Reyes, Jo C Phelan, Bruce G Link","doi":"10.1037/sah0000658","DOIUrl":"10.1037/sah0000658","url":null,"abstract":"<p><p>Parents are influential gatekeepers to mental health services for children struggling with mental health issues, and their stigmatizing attitudes and behaviors towards mental illness may hinder help-seeking. Parents' gendered expectations throughout the help-seeking process may influence whether they pursue formal or informal support for their children. We advance stigma research by examining how stigma affects a parent's decision to seek formal and informal mental health support for their child depending on the child's gender. Using longitudinal data from a school-based anti-stigma intervention study among sixth-grade students, we analyzed the subsample of children who reported high mental health symptoms (<i>n</i>=217). Regression models assessed the role of parental stigmatizing attitudes and behaviors and child gender on parental formal and informal help-seeking, including the child's use of psychiatric medications. To examine gendered patterns to stigma and help-seeking, we tested interactions between parental stigmatizing attitudes and the child's self-reported gender on help-seeking behaviors. Mental health labeling and literacy were associated with proactive parental help-seeking behaviors, while discriminatory stigma dimensions like social distance decreased help-seeking. These stigma effects varied by child gender, particularly when it came to formal avenues of care: Labeling enhanced parental help-seeking for girls in formal settings, while social distance deterred medication use among girls. The results of the study suggest that effective interventions targeting mental illness and help-seeking must actively incorporate parental perspectives, address gender biases in mental health, and consider the nuanced ways in which gender may complicate stigma processes when it comes to help-seeking decisions.</p>","PeriodicalId":53222,"journal":{"name":"Stigma and Health","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132599","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":"A Comprehensive Understanding of Global Female Genital Fistula and Stigma: A Systematic Scoping Review and Meta-Analysis.","authors":"Alison M El Ayadi, Analisa Conway, Masumi Padhye, Avni Mittal, Jia Nocon, Jill Barr-Walker, Ava Kennerly, Nessa E Ryan","doi":"10.1037/sah0000643","DOIUrl":"10.1037/sah0000643","url":null,"abstract":"<p><p>Female genital fistula, a debilitating birth injury frequently caused by prolonged obstructed labor or surgery in lower resource settings, leads to stigma and poor health, social, and economic outcomes. Fistula-related stigma evidence is lacking, including the nature, dimensions, sources, and influences on health and well-being. This systematic scoping review aimed to (a) examine fistula-related stigma experiences, (b) assess stigma and discrimination consequences, and (c) compare how stigma, its severity, and related stigma coping and resistance differ across contexts. We searched 10 scientific databases for original research on fistula-related stigma through June 8, 2021. Findings were thematically analyzed and summarized in table and narrative format. We calculated pooled prevalence for divorce/separation, anxiety, and depression. A total of 199 unique articles were identified across 41 countries, predominantly from sub-Saharan Africa. Findings highlight multiple manifestations of fistula stigma including enacted, internalized, anticipated, caregiver, and structural stigma. Fistula stigma intersected with infertility, gender, disability, and poverty stigma. Stigma consequences included mental health and psychological distress, lost employment/income, and limited social engagement. Pooled prevalence of divorce/separation was 35% (95% CI [30%, 41%]), depression 65% (95% CI [56%, 74%]), and anxiety 52% (95% CI [27%, 75%]). Common coping strategies included self-isolation or social withdrawal and keeping oneself clean; stigma resistance was rarely reported. Social support was protective of stigma. Few stigma interventions were identified; none evaluated implementation context or strategies to inform adoption and sustainability. Clinical interventions (e.g., counseling) addressed psychosocial and mental health consequences, and community-level interventions addressed community stigma. Assets-based or strengths-based framing was uncommon. Knowledge gaps impede theory- and evidence-based optimization of clinical and social services for fistula-related stigma prevention and mitigation, impacting quality of life.</p>","PeriodicalId":53222,"journal":{"name":"Stigma and Health","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12795582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145967904","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}