Frontiers in health services最新文献

{"title":"Complex inner and outer setting interactions determine feasibility and readiness of developing primary care registries in small island developing states: sequential mixed methods study.","authors":"Natasha P Sobers, Joeleita Agard, Jacqueline Campbell, Kia Lewis, S M Jeyaseelan","doi":"10.3389/frhs.2025.1593902","DOIUrl":"https://doi.org/10.3389/frhs.2025.1593902","url":null,"abstract":"<p><strong>Introduction: </strong>We assessed feasibility and readiness for registry development and sought to understand the factors likely to affect the implementation of a registry into health systems in small island developing states (SIDS).</p><p><strong>Methods: </strong>We conducted online quantitative surveys and focus groups among health managers in four SIDS. Both survey and focus group guides were developed primarily based on four domains (inner setting, outer setting, individual characteristics and implementation process) of the Consolidated Framework for Implementation Research (CFIR). Focus groups within each of four territories were recorded, transcribed verbatim and analyzed using thematic content analysis using a deductively derived coding framework. We synthesized our findings using a systems archetype informed by the common themes emerging from the dual methods.</p><p><strong>Findings: </strong>From the 37 respondents of the online survey, 40% and 16% identified diabetes and hypertension as the highest priority NCDs for registry development. Respondents were more concerned about monitoring and improving care for patients (65%) than about determining disease burden (16%) or outcomes monitoring (8%). Strong mission alignment, external pressure and support and emerging data protection laws were identified as potential facilitators. Participants reported lack of human resource capacity and funding to support NCD registry and poor information systems infrastructure. The emerging systems archetype indicated that lack of investment in human and systems infrastructure were significant threats to registry success.</p><p><strong>Discussion: </strong>Despite external interest in registry development, infrastructural and human resource capacity barriers are likely contribute to a sub-optimal implementation in SIDS. We recommend greater collaboration between countries and enhanced regional support to overcome the challenges.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1593902"},"PeriodicalIF":2.7,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12518279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145304845","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 the pre-implementation phase of a patient navigation intervention to increase patient portal enrollment in Federally Qualified Health Centers.","authors":"Alicia K Matthews, Safa Elkefi, Maureen George, Andrea Cassells, Jonathan N Tobin","doi":"10.3389/frhs.2025.1624032","DOIUrl":"https://doi.org/10.3389/frhs.2025.1624032","url":null,"abstract":"<p><strong>Objectives: </strong>To describe the pre-implementation phase of a patient navigator-led intervention to increase patient portal enrollment among adults receiving care within Federally Qualified Health Centers (FQHCs) in New York City.</p><p><strong>Methods: </strong>We conducted semi-structured in-depth interviews with fourteen key stakeholders (clinicians, nurses, patient navigators, and practice staff) in three FQHCs. Using the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework as a guide, the interviews focused on current patient portal education and enrollment procedures, establishing the workflow for the new patient navigator-led enrollment intervention, co-creation of low-health literacy educational materials, and identifying potential challenges and mitigation strategies. Thematic analysis was conducted to inform the development of a standardized patient portal enrollment protocol.</p><p><strong>Results: </strong>Findings revealed significant variability in support and educational procedures across the three FQHC locations. Strategies that emerged as potentially effective for integrating patient navigators into the center workflow included scheduling navigators during peak hours (Mondays to Thursdays, 10 AM to 4 PM) and positioning them in high-traffic areas such as waiting rooms. Customizing educational materials to meet linguistic and cultural needs was important for improving accessibility and relevance. Providing navigators with access to the appointment scheduling and Electronic Health Records (EHR) systems was viewed as enabling real-time identification and engagement of eligible patients, reducing missed enrollment opportunities. Proactive engagement methods, including in-lobby interactions, were viewed as essential in fostering sustained portal usage. Addressing technological barriers and language challenges through multilingual resources and hands-on demonstrations was also described as creating a more inclusive environment.</p><p><strong>Conclusions: </strong>The study results have implications for implementing and evaluating a patient navigator-led intervention to increase patient portal enrollment among patients in FQHCs. Hiring and training dedicated navigators, customizing educational materials, and integrating navigators into the practice's workflow are key strategies for improving the adoption of this intervention. The findings provide a foundation for future research to evaluate the effectiveness, sustainability and scalability of the intervention approach across diverse healthcare settings.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1624032"},"PeriodicalIF":2.7,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12518268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145304782","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":"Documenting adaptations across the Accelerating Colorectal Cancer Screening and follow-up through Implementation Science research programs: methods and adaptation examples.","authors":"Borsika A Rabin, Erin S Kenzie, Jill M Oliveri, Aaron J Kruse-Diehr, Sonja Hoover, Usha Menon, Mark P Doescher, Prajakta Adsul, Shiraz I Mishra, Kevin English, Jesse Nodora, Helen Lam, Karen Kim, Jennifer K Coury, Melinda M Davis, Teri Malo, Sarah Kobrin, Sujha Subramanian, Renée M Ferrari","doi":"10.3389/frhs.2025.1613925","DOIUrl":"10.3389/frhs.2025.1613925","url":null,"abstract":"<p><strong>Introduction: </strong>Adaptations are common, expected, and often imperative for successful uptake and sustained implementation of clinical or public health programs in real-world practice settings. Understanding which adaptations have been made to evidence-based interventions and subsequent implementation strategies throughout the life cycle of a project can contextualize findings and support future scale-up of the program. Systematic documentation of adaptations is rarely conducted or reported, and little guidance exists on approaches to documenting adaptations.</p><p><strong>Methods: </strong>Accelerating Colorectal Cancer Screening and follow-up through Implementation Science (ACCSIS) is a National Cancer Institute-funded Beau Biden Cancer Moonshot^SM Initiative developed to improve colorectal cancer screening, follow-up, and referral for care among underserved groups, including diverse racial and ethnic populations and people living in rural areas. Using an iterative data gathering approach-a survey, data abstraction, and data validation-we compiled information about adaptation documentation and analytic methods and intervention and implementation strategy adaptations from the eight funded ACCSIS research programs. An analytic team representing multiple ACCSIS programs reviewed, coded, and summarized the data using a rapid qualitative analytic approach.</p><p><strong>Results: </strong>ACCSIS programs varied substantially in how they defined and documented adaptations. Nine approaches were used to document adaptations; the most common were periodic reflections and review of meeting minutes and agendas. Nine analytic methods were reported to guide adaptation analysis; the most frequently mentioned were rapid qualitative methods, descriptive statistics, and mixed-methods analysis. A total of 96 adaptations were reported by the eight research programs, most of which occurred during the pre-implementation stage (68%) or were made to the program format (71%). Only 36% of the adaptations were due to the COVID-19 pandemic.</p><p><strong>Conclusions: </strong>Our multi-method, systematic approach allowed us to explore how sites document and analyze adaptations across eight ACCSIS Moonshot programs. Using a systematic approach allowed for comparisons of intervention and strategy adaptations within and across research programs and can inform the science of adaptations, while building a knowledge base of why such adaptations are needed and how they can inform implementation efforts across time. Methods described herein provide a template for similar assessment activities in other large, multi-site research initiatives.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1613925"},"PeriodicalIF":2.7,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12511014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145281967","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":"The experiences of patients who leave hospital against medical advice: analysis of survey data.","authors":"Kyle Kemp, Brian Steele, Paul Fairie, Maria Jose Santana","doi":"10.3389/frhs.2025.1620715","DOIUrl":"10.3389/frhs.2025.1620715","url":null,"abstract":"<p><strong>Background: </strong>Historically, when patients leave hospital against medical advice (LAMA), the focus has often been on non-compliance or other patient-level factors, rather than on how services may be designed to better support these patients. Efforts to better understand why patients LAMA could strengthen the provision of patient-centered care that is responsive to individual needs and values. This study aimed to explore the experiences of Albertan adults who LAMA by examining patient-centered quality indicators (PC-QIs) derived from survey data. We sought to identify actionable insights that may inform service improvements and reduce the risks associated with LAMA discharges.</p><p><strong>Methods: </strong>We analyzed seven years of survey data, encompassing hospital discharges from April 2016 to March 2023. A random sample of respondents completed the Canadian Patient Experiences - Inpatient Care (CPES-IC) instrument by telephone within six weeks of hospital discharge. From the data, we assessed ten patient-centred quality indicators (PC-QI) which were previously co-created with patient advisors, researchers, and health system administrators. Survey responses/PC-QIs were reported as percent in \"top box\", as represented by the most positive answer choice. Differences between patients who LAMA and other medical/surgical discharges were assessed.</p><p><strong>Results: </strong>A total of 144,480 surveys were successfully linked with inpatient records and included for analysis. This included 1,177 (0.9%) respondents who LAMA. In our sample, those who LAMA were predominantly male, younger, had a lower level of educational attainment, and were living with a greater number of comorbid health conditions. They also had lower self-reported levels of physical and mental health and had a longer average length of stay. The LAMA group had significantly lower top-box percentages on all ten of the PC-QIs which we examined. This difference ranged from 20.7% (communicating test results; 51.6% LAMA group vs. 71.3% others) to 29.2% (patient involvement in decisions about their care and treatment; 39.8% vs. 69.0% respectively).</p><p><strong>Conclusion: </strong>Patients who LAMA reported lower ratings of patient experience across all PC-QIs studied. Our findings may provide actionable, service-related insights into the reasons why patients LAMA. This is important as those who do so may place themselves at increased risk for future unplanned healthcare events, mortality, and morbidity.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1620715"},"PeriodicalIF":2.7,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12510932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145281931","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":"The guided understanding of implementation, development & education (GUIDE): a tool for implementation science instruction.","authors":"Laura Ellen Ashcraft, Meghan B Lane-Fall","doi":"10.3389/frhs.2025.1654516","DOIUrl":"10.3389/frhs.2025.1654516","url":null,"abstract":"<p><strong>Background: </strong>The use of implementation science in health research continues to increase, generating interest amongst those new to the field. However, conventional biomedical and health services research training does not necessarily equip scholars to incorporate theory-driven implementation science into their projects. Those new to IS may therefore struggle to apply abstract concepts from theory to their own work. In our teaching, we addressed this challenge by creating a practical teaching tool based on lessons from implementation mapping and the implementation research logic model (IRLM).</p><p><strong>The guide: </strong>The tool is inspired by implementation mapping, the Implementation Research Logic Model, the ERIC implementation strategies, and Proctor's Outcomes Framework amongst other innumerable lessons from our experience as implementation scientists. We included sections to prompt learners to articulate the evidence-based practice of interest (including core and adaptable components) and the evidence-practice gap. The Guided Understanding of Implementation, Development & Education-GUIDE-and its corresponding prompts may provide a useful teaching tool to guide new users on incorporating implementation science into their evaluations. It also may help instructors illustrate how related implementation science concepts relate to each other over successive lessons or class sessions.</p><p><strong>Conclusion: </strong>This tool was developed from our experiences in teaching implementation science courses and consultation with new users in conjunction with common practices in the field including implementation mapping and the IRLM.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1654516"},"PeriodicalIF":2.7,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12510919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145282008","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":"The broken care chain-report from a country with a low number of hospital beds.","authors":"Marie Jönsson, Peter Appelros, Marie Holmefur, Carin Fredriksson","doi":"10.3389/frhs.2025.1632220","DOIUrl":"10.3389/frhs.2025.1632220","url":null,"abstract":"<p><strong>Background: </strong>Approximately 30% of older adults admitted to hospital in Sweden are readmitted within three months. Short hospital stays and readmission can lead to further functional decline, as recovery appears to be poor at home after discharge.</p><p><strong>Aim: </strong>To explore healthcare professionals' experiences of transitional care in older adults in order to prevent readmission.</p><p><strong>Methods: </strong>Four focus group interviews were conducted with healthcare professionals (<i>n</i> = 29). Data were analyzed using a phenomenographic approach.</p><p><strong>Results: </strong>Healthcare professionals' perceptions were compiled into seven descriptive categories. Three of the categories, i.e., <i>resources</i>, <i>interprofessional coordination</i>, and <i>advanced care needs can be difficult to meet</i>, described healthcare professionals' perceptions of the current stage of older adults-the first-order perspective, i.e., <i>what something is</i>. The remaining categories described the meanings of the healthcare professionals' perceptions.</p><p><strong>Conclusion: </strong>Several interacting structural issues cause readmissions. These include premature discharge from hospital, poor hand-over between healthcare professionals, and a lack of qualified staff in the home-setting. To prevent readmission, medical competence and interprofessional teamwork must be improved in the home setting.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1632220"},"PeriodicalIF":2.7,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12507781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145281974","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":"Editorial: Overcoming challenges in health technology implementation to maximize patient safety.","authors":"Melissa T Baysari, Jane E Carland, Megan E Salwei","doi":"10.3389/frhs.2025.1692601","DOIUrl":"10.3389/frhs.2025.1692601","url":null,"abstract":"","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1692601"},"PeriodicalIF":2.7,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12507839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145281954","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":"Artificial intelligence in healthcare: rethinking doctor-patient relationship in megacities.","authors":"Qi Chen","doi":"10.3389/frhs.2025.1694139","DOIUrl":"10.3389/frhs.2025.1694139","url":null,"abstract":"<p><strong>Introduction: </strong>Artificial intelligence has been extensively applied in healthcare, offering significant potential to improve the quality of medical services. However, it also introduces critical challenges, such as privacy infringement, algorithmic discrimination, and ambiguous liability. The integration of artificial intelligence inevitably influences the doctor-patient relationship, which is pronounced in megacities. This study aims to explore the application of artificial intelligence in megacity healthcare system, exam the multidimensional transformation of the doctor-patient relationship and propose new governance frameworks.</p><p><strong>Methods: </strong>This study examines how artificial intelligence can effectively address systemic challenges within megacity healthcare systems while leveraging technological and institutional advantages to maximize its benefits, with a focus on Beijing as a primary case.</p><p><strong>Results: </strong>The integration of artificial intelligence inevitably influences the doctor-patient relationship, reducing information asymmetry, enhancing patient autonomy, and transforming the traditional doctor-patient dualistic interaction structure into a doctor-artificial intelligence-patient triad interaction structure. These effects are pronounced in megacities, presenting new challenges including crisis of trust, intensified disputes, and emotional and communication distance.</p><p><strong>Discussion: </strong>Given that the integration of artificial intelligence into healthcare is inevitable, especially for megacities like Beijing, proactive governance is essential. This includes institutionalizing the triad interaction model, deepening the integration of artificial intelligence in healthcare by leveraging the advantages of megacities, and establishing regulatory frameworks to mitigate risks while harnessing potential.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1694139"},"PeriodicalIF":2.7,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12504271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260108","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":"From symbolism to substance: evaluating state disclosure laws and the case for federal oversight.","authors":"Sherri Cheng, Wenjing Duan, Wenqi Zhou","doi":"10.3389/frhs.2025.1666949","DOIUrl":"10.3389/frhs.2025.1666949","url":null,"abstract":"<p><p>Pharmaceutical payments to physicians have long raised concerns about conflicts of interest and rising healthcare costs. While the Physician Payments Sunshine Act (PPSA) established federal transparency standards in 2013, several states had already enacted their own disclosure laws. This study evaluates the hypothesis that individual state policies varied in effectiveness at shaping corporate payment strategies. Specifically, we examined four state policies, Massachusetts (MA), Maine (ME), Minnesota (MN), and West Virginia (WV), using a difference-in-differences design, comparing the outcomes with matched control states before and after PPSA implementation. We analyzed meals and travel payments from four major pharmaceutical companies using ProPublica's Dollars for Docs (2012-2013) and Centers for Medicare & Medicaid Services' Open Payments (2014-2015) data. Results indicate that MA's comprehensive policy, featuring strict reporting requirements, public accessibility, and enforcement, yielded a significant 44% decline in travel payments. In contrast, ME, MN, and WV's policies showed negligible impacts. These findings suggest that disclosure laws exert real influence only when they are comprehensive, transparent, and backed by enforcement. This underscores the critical role of policy structure in addressing conflicts of interest and points to ways the PPSA framework could be strengthened. Based on our findings, we suggest that other nations could strengthen their systems by adopting centralized and standardized reporting systems, similar to the PPSA.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1666949"},"PeriodicalIF":2.7,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12504496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260092","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":"Improving cross-learning in clinical teams using daily on-site reflective meetings.","authors":"Nawal Khattabi, Ros Axel, Reem AlAbdulmalik, Amal Al-Ali, Erik Hollnagel","doi":"10.3389/frhs.2025.1630722","DOIUrl":"10.3389/frhs.2025.1630722","url":null,"abstract":"<p><strong>Introduction: </strong>Learning is fundamental for improving patient safety and quality. Historically, people have focused on learning from unsuccessful performances, such as accidents, incidents, or near-misses. Contemporary approaches to patient safety emphasize the importance of learning from successful everyday work. This approach to learning is less common in the healthcare system and does not carry the same sense of urgency as learning from work that does not go well. Broadening an organization's learning strategies to include learning from everyday work requires adopting new methods and mindsets.</p><p><strong>Methods: </strong>This study describes the experience of implementing the Resilient Performance Enhancement Toolkit (RPET) in a multisite primary care organization. RPET was introduced through structured daily reflective meetings aimed at fostering cross learning, team adaptation and real-time reflection. Qualitative feedback and thematic observations were collected to explore its impact.</p><p><strong>Results: </strong>The use of RPET varied across 27 Health Centers (HC), with seven early adopters (29 teams) maintaining consistent practices despite pandemic disruptions. By 2023, meeting frequency stabilized, ranging from daily to monthly. Teams reported improvements in patient safety, communication, and team learning, while identifying challenges such as time constraints and interdepartmental coordination. Key benefits included enhanced teamwork, increased risk identification and improved staff morale.</p><p><strong>Conclusion: </strong>Embedding reflective practices into daily routines through RPET can strengthen organizational learning and resilience. This approach offers a practical method for shifting healthcare systems toward proactive, Safety-II aligned strategies that support continuous improvement in dynamic clinical environments.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1630722"},"PeriodicalIF":2.7,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12504320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260139","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}