{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T16:08:18Z","timestamp":1787846898523,"version":"build-2784847793"},"reference-count":40,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T00:00:00Z","timestamp":1764288000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T00:00:00Z","timestamp":1764288000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100005902","name":"Institute for Clinical and Translational Research, University of Wisconsin, Madison","doi-asserted-by":"publisher","award":["TL1TR002375"],"award-info":[{"award-number":["TL1TR002375"]}],"id":[{"id":"10.13039\/100005902","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Institute of Health","award":["K01MH123914"],"award-info":[{"award-number":["K01MH123914"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eat Weight Disord"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Physicians can play a critical role in the early identification and treatment of eating disorders (EDs), yet many report low confidence in diagnosing and managing these illnesses. ED education during medical training has the potential to improve physician\u2019s competence in recognizing, diagnosing, and treating EDs. This study assessed the content of ED education in preclinical medical training to identify opportunities to strengthen curricula.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Slide content from 15 ED lecture presentations used between 2019 and 2024 in preclinical medical education at either Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) institutions in the United States was analyzed. Through a directed qualitative content analysis, the depth and breadth of textual content were examined and the use of visual aids in slide content was assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Slides often acknowledged the multifactorial nature of EDs. They primarily focused on anorexia nervosa and bulimia nervosa, but not other EDs. Images reinforced stereotypes about who develops EDs, and there was limited mention of weight stigma as a barrier to diagnosis and treatment. Furthermore, ED treatment options, including therapeutic modalities, pharmacotherapies, and levels of care, were introduced but not described in detail.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Physicians are well-positioned to identify and treat EDs. However, findings suggest that significant gaps exist in the coverage of EDs in preclinical medical education. Current preclinical education may inadvertently reinforce misconceptions that hinder the ability of physicians to detect diverse presentations of EDs early. Recommendations are offered to guide future lecture development and strengthen ED-related educational content.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of evidence<\/jats:title>\n                    <jats:p>Level V: Opinions of respected authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s40519-025-01799-0","type":"journal-article","created":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T12:05:03Z","timestamp":1764331503000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Assessing eating disorder education in U.S. medical schools: a qualitative content analysis of lecture slides"],"prefix":"10.1007","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5089-4087","authenticated-orcid":false,"given":"Agatha A.","family":"Laboe","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4356-6496","authenticated-orcid":false,"given":"Lauren E.","family":"Pictor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahathi","family":"Gavuji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9933-0883","authenticated-orcid":false,"given":"Samantha","family":"Temucin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Kreynin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5279-0716","authenticated-orcid":false,"given":"Elizabeth","family":"Sheil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brooke","family":"Jourdan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3193-2233","authenticated-orcid":false,"given":"Katherine","family":"Schaumberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3529-9175","authenticated-orcid":false,"given":"Heather","family":"Davis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0933-1098","authenticated-orcid":false,"given":"Erin N.","family":"Harrop","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,28]]},"reference":[{"key":"1799_CR1","unstructured":"Deloitte Access Economics (2020) The social and economic cost of eating disorders in the United States of America: a report for the strategic training initiative for the prevention of eating disorders and the academy for eating disorders. Boston: Harvard T.H. Chan School of Public Health. https:\/\/www.hsph.harvard.edu\/wp-content\/uploads\/sites\/1267\/2020\/07\/Social-Economic-Cost-of-Eating-Disorders-in-US.pdf. Accessed 31 Mar 2025."},{"issue":"2","key":"1799_CR2","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1016\/j.brat.2011.11.003","volume":"50","author":"D Le Grange","year":"2012","unstructured":"Le Grange D, Lock J, Agras WS et al (2012) Moderators and mediators of remission in family-based treatment and adolescent focused therapy for anorexia nervosa. Behav Res Ther 50(2):85\u201392","journal-title":"Behav Res Ther"},{"issue":"2","key":"1799_CR3","doi-asserted-by":"publisher","first-page":"130","DOI":"10.1002\/eat.20676","volume":"43","author":"GE van Son","year":"2009","unstructured":"van Son GE, van Hoeken D, van Furth EF, Donker GA, Hoek HW (2009) Course and outcome of eating disorders in a primary care-based cohort. Int J Eat Disord 43(2):130\u2013138","journal-title":"Int J Eat Disord"},{"issue":"1","key":"1799_CR4","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1016\/j.chc.2008.07.013","volume":"18","author":"HC Steinhausen","year":"2009","unstructured":"Steinhausen HC (2009) Outcome of eating disorders. Child Adolesc Psychiatr Clin N Am 18(1):225\u2013242","journal-title":"Child Adolesc Psychiatr Clin N Am"},{"issue":"4","key":"1799_CR5","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1097\/01.yco.0000228759.95237.78","volume":"19","author":"HW Hoek","year":"2006","unstructured":"Hoek HW (2006) Incidence, prevalence and mortality of anorexia nervosa and other eating disorders. Curr Opin Psychiatry 19(4):389\u2013394","journal-title":"Curr Opin Psychiatry"},{"issue":"1","key":"1799_CR6","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1186\/s40337-022-00570-5","volume":"10","author":"A Tse","year":"2022","unstructured":"Tse A, Xavier S, Trollope-Kumar K, Agarwal G, Lokker C (2022) Challenges in eating disorder diagnosis and management among family physicians and trainees: a qualitative study. J Eat Disord 10(1):45","journal-title":"J Eat Disord"},{"issue":"1169","key":"1799_CR7","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1136\/postgradmedj-2021-140253","volume":"99","author":"AJ Jafar","year":"2021","unstructured":"Jafar AJ, Jafar WJ, Everitt EK, Gill I, Sait HM, Tan J (2021) Recognising and managing eating disorders in the emergency department. Postgrad Med J 99(1169):101\u2013111","journal-title":"Postgrad Med J"},{"issue":"1","key":"1799_CR8","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s40337-020-00363-8","volume":"9","author":"J Lebow","year":"2021","unstructured":"Lebow J, Narr C, Mattke A et al (2021) Engaging primary care providers in managing pediatric eating disorders: a mixed methods study. J Eat Disord 9(1):1","journal-title":"J Eat Disord"},{"issue":"3","key":"1799_CR9","doi-asserted-by":"publisher","first-page":"381","DOI":"10.1007\/s40596-016-0578-z","volume":"41","author":"K Anderson","year":"2016","unstructured":"Anderson K, Accurso EC, Kinasz KR, Le Grange D (2016) Resident\u2019s and fellow\u2019s knowledge and attitudes about eating disorders at an academic medical center. Acad Psychiatry 41(3):381\u2013384","journal-title":"Acad Psychiatry"},{"issue":"1","key":"1799_CR10","doi-asserted-by":"publisher","first-page":"216","DOI":"10.1186\/s40337-024-01174-x","volume":"12","author":"TR Brown","year":"2024","unstructured":"Brown TR, Jansen MO, Hirsch D, Amir H, Duncan AE, Nicol GE (2024) Hiding in plain sight: eating disorders in diverse populations \u2013 a case for comprehensive medical education. J Eat Disord 12(1):216","journal-title":"J Eat Disord"},{"issue":"10","key":"1799_CR11","doi-asserted-by":"publisher","first-page":"978","DOI":"10.1177\/0009922812441667","volume":"51","author":"DW Davis","year":"2012","unstructured":"Davis DW, Honaker SM, Jones VF, Williams PG, Stocker F, Martin E (2012) Identification and management of behavioral\/mental health problems in primary care pediatrics: perceived strengths, challenges, and new delivery models. Clin Pediatr 51(10):978\u2013982","journal-title":"Clin Pediatr"},{"key":"1799_CR12","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1016\/j.bodyim.2023.04.008","volume":"46","author":"EN Harrop","year":"2023","unstructured":"Harrop EN, Hutcheson R, Harner V, Mensinger JL, Lindhorst T (2023) \u201cYou don\u2019t look anorexic\u201d: atypical anorexia patient experiences of weight stigma in medical care. Body Image 46:48\u201361","journal-title":"Body Image"},{"key":"1799_CR13","doi-asserted-by":"publisher","DOI":"10.1002\/eat.24374","author":"N Garcia Moreno","year":"2025","unstructured":"Garcia Moreno N, Walker DC, Gullo N, O\u2019Dea CJ (2025) Weight stigma\u2019s effects on misdiagnosis of eating disorders among laypeople and healthcare professionals. Int J Eat Disord. https:\/\/doi.org\/10.1002\/eat.24374","journal-title":"Int J Eat Disord"},{"issue":"4","key":"1799_CR14","doi-asserted-by":"publisher","first-page":"993","DOI":"10.1002\/eat.24095","volume":"57","author":"K Kons","year":"2023","unstructured":"Kons K, Essayli J, Shook J (2023) Comparing the knowledge, attitudes, and practices of pediatric and family medicine clinicians toward atypical anorexia nervosa versus anorexia nervosa. Int J Eat Disord 57(4):993\u20131001","journal-title":"Int J Eat Disord"},{"issue":"4","key":"1799_CR15","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2015-4080","volume":"137","author":"SM Sawyer","year":"2016","unstructured":"Sawyer SM, Whitelaw M, Le Grange D, Yeo M, Hughes EK (2016) Physical and psychological morbidity in adolescents with atypical anorexia nervosa. Pediatrics 137(4):e20154080","journal-title":"Pediatrics"},{"issue":"4","key":"1799_CR16","doi-asserted-by":"publisher","first-page":"798","DOI":"10.1002\/eat.23856","volume":"56","author":"BT Walsh","year":"2022","unstructured":"Walsh BT, Hagan KE, Lockwood C (2022) A systematic review comparing atypical anorexia nervosa and anorexia nervosa. Int J Eat Disord 56(4):798\u2013820","journal-title":"Int J Eat Disord"},{"issue":"8","key":"1799_CR17","doi-asserted-by":"publisher","first-page":"1328","DOI":"10.1002\/eat.23519","volume":"54","author":"EN Harrop","year":"2021","unstructured":"Harrop EN, Mensinger JL, Moore M, Lindhorst T (2021) Restrictive eating disorders in higher weight persons: a systematic review of atypical anorexia nervosa prevalence and consecutive admission literature. Int J Eat Disord 54(8):1328\u20131357","journal-title":"Int J Eat Disord"},{"key":"1799_CR18","doi-asserted-by":"publisher","DOI":"10.4088\/pcc.15r01905","author":"SG Kornstein","year":"2016","unstructured":"Kornstein SG, Kunovac JL, Herman BK, Culpepper L (2016) Recognizing binge-eating disorder in the clinical setting. Prim Care Companion CNS Disord. https:\/\/doi.org\/10.4088\/pcc.15r01905","journal-title":"Prim Care Companion CNS Disord"},{"issue":"1","key":"1799_CR19","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1002\/eat.22186","volume":"47","author":"RM Puhl","year":"2013","unstructured":"Puhl RM, Latner JD, King KM, Luedicke J (2013) Weight bias among professionals treating eating disorders: attitudes about treatment and perceived patient outcomes. Int J Eat Disord 47(1):65\u201375","journal-title":"Int J Eat Disord"},{"issue":"4","key":"1799_CR20","doi-asserted-by":"publisher","first-page":"1008","DOI":"10.1002\/oby.20637","volume":"22","author":"RM Puhl","year":"2013","unstructured":"Puhl RM, Luedicke J, Grilo CM (2013) Obesity bias in training: attitudes, beliefs, and observations among advanced trainees in professional health disciplines. Obesity 22(4):1008\u20131015","journal-title":"Obesity"},{"issue":"5","key":"1799_CR21","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1080\/10640266.2014.915692","volume":"22","author":"L Girz","year":"2014","unstructured":"Girz L, Robinson AL, Tessier C (2014) Is the next generation of physicians adequately prepared to diagnose and treat eating disorders in children and adolescents? Eat Disord 22(5):375\u2013385","journal-title":"Eat Disord"},{"issue":"4","key":"1799_CR22","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1177\/0009922813479157","volume":"52","author":"DA Banas","year":"2013","unstructured":"Banas DA, Redfern R, Wanjiku S, Lazebnik R, Rome ES (2013) Eating disorder training and attitudes among primary care residents. Clin Pediatr 52(4):355\u2013361","journal-title":"Clin Pediatr"},{"key":"1799_CR23","doi-asserted-by":"publisher","first-page":"443","DOI":"10.1002\/eat.22390","volume":"48","author":"F Mahr","year":"2014","unstructured":"Mahr F, Farahmand P, Bixler EO, Domen RE, Moser EM, Nadeem T, Levine RL, Halmi KA (2014) A national survey of eating disorder training. Int J Eat Disord 48:443\u2013445. https:\/\/doi.org\/10.1002\/eat.22390","journal-title":"Int J Eat Disord"},{"key":"1799_CR24","unstructured":"United States Medical Licensing Examination (2022) Public USMLE\u00ae content outline. https:\/\/www.usmle.org\/sites\/default\/files\/2022-01\/USMLE_Content_Outline_0.pdf. Accessed 5 Oct 2025"},{"key":"1799_CR25","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.52454","volume":"16","author":"R Mathai","year":"2024","unstructured":"Mathai R, Patel S, Littman ER, Lo A, Yitzhak B, Hirumi A (2024) Medical student\u2019s perceptions and use of formal and informal curriculum resources. Cureus 16:e52454. https:\/\/doi.org\/10.7759\/cureus.52454","journal-title":"Cureus"},{"key":"1799_CR26","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1096\/fba.2021-00128","volume":"4","author":"E Finn","year":"2022","unstructured":"Finn E, Ayres F, Goldberg S, Hortsch M (2022) Brave new e-world: medical student\u2019s preferences for and usage of electronic learning resources during two different phases of their education. FASEB BioAdv 4:298\u2013308. https:\/\/doi.org\/10.1096\/fba.2021-00128","journal-title":"FASEB BioAdv"},{"issue":"9","key":"1799_CR27","doi-asserted-by":"publisher","first-page":"1277","DOI":"10.1177\/1049732305276687","volume":"15","author":"HF Hsieh","year":"2005","unstructured":"Hsieh HF, Shannon SE (2005) Three approaches to qualitative content analysis. Qual Health Res 15(9):1277\u20131288","journal-title":"Qual Health Res"},{"issue":"1","key":"1799_CR28","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1007\/s10755-019-09488-4","volume":"45","author":"D Ch\u00e1vez Herting","year":"2019","unstructured":"Ch\u00e1vez Herting D, Cladellas Pros R, Castell\u00f3 Tarrida A (2019) Patterns of PowerPoint use in higher education: a comparison between the natural, medical, and social sciences. Innov High Educ 45(1):65\u201380","journal-title":"Innov High Educ"},{"key":"1799_CR29","unstructured":"International Medical Aid (2024) How many medical schools in US: the definitive guide (2024). https:\/\/medicalaid.org\/how-many-medical-schools-in-us-the-definitive-guide\/. Accessed 31 Mar 2025"},{"key":"1799_CR30","unstructured":"Medical School Headquarters (2024) Map of US med schools. https:\/\/medicalschoolhq.net\/map-of-medical-schools-in-the-us\/. Accessed 31 Mar 2025."},{"issue":"9","key":"1799_CR31","doi-asserted-by":"publisher","first-page":"1259","DOI":"10.1002\/eat.23732","volume":"55","author":"TD Wade","year":"2022","unstructured":"Wade TD, Johnson C, Cadman K, Cook L (2022) Turning eating disorders screening in primary practice into treatment: a clinical practice approach. Int J Eat Disord 55(9):1259\u20131263","journal-title":"Int J Eat Disord"},{"issue":"6","key":"1799_CR32","doi-asserted-by":"publisher","first-page":"362","DOI":"10.1097\/YCO.0000000000000818","volume":"35","author":"Y Sil\u00e9n","year":"2022","unstructured":"Sil\u00e9n Y, Keski-Rahkonen A (2022) Worldwide prevalence of DSM-5 eating disorders among young people. Curr Opin Psychiatry 35(6):362\u2013371","journal-title":"Curr Opin Psychiatry"},{"key":"1799_CR33","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1186\/s40337-017-0149-z","volume":"5","author":"P Hay","year":"2017","unstructured":"Hay P, Mitchison D, Collado AE, Gonz\u00e1lez-Chica DA, Stocks N, Touyz S (2017) Burden and health-related quality of life of eating disorders, including avoidant\/restrictive food intake disorder (ARFID), in the Australian population. J Eat Disord 5:21. https:\/\/doi.org\/10.1186\/s40337-017-0149-z","journal-title":"J Eat Disord"},{"key":"1799_CR34","doi-asserted-by":"publisher","DOI":"10.31076\/2023.p28","author":"K Mishra","year":"2023","unstructured":"Mishra K, Harrop E (2023) Teaching medical students how to avoid overreliance on BMI in diagnosing and caring for patients with eating disorders. 9th Annu Int Weight Stigma Conf. https:\/\/doi.org\/10.31076\/2023.p28","journal-title":"9th Annu Int Weight Stigma Conf"},{"key":"1799_CR35","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1016\/j.bodyim.2021.01.006","volume":"37","author":"KA Romano","year":"2021","unstructured":"Romano KA, Heron KE, Henson JM (2021) Examining associations among weight stigma, weight bias internalization, body dissatisfaction, and eating disorder symptoms: does weight status matter? Body Image 37:38\u201349","journal-title":"Body Image"},{"issue":"5","key":"1799_CR36","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1002\/eat.20636","volume":"42","author":"L Currin","year":"2008","unstructured":"Currin L, Waller G, Schmidt U (2008) Primary care physician\u2019s knowledge of and attitudes toward the eating disorders: do they affect clinical actions? Int J Eat Disord 42(5):453\u2013458","journal-title":"Int J Eat Disord"},{"issue":"2","key":"1799_CR37","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1080\/10640260903585532","volume":"18","author":"D Linville","year":"2010","unstructured":"Linville D, Benton A, O\u2019Neil M, Sturm K (2010) Medical provider\u2019s screening, training and intervention practices for eating disorders. Eat Disord 18(2):110\u2013131","journal-title":"Eat Disord"},{"issue":"9","key":"1799_CR38","doi-asserted-by":"publisher","first-page":"1332","DOI":"10.1097\/ACM.0000000000002670","volume":"94","author":"C Moriates","year":"2019","unstructured":"Moriates C, Valencia V, Stamets S et al (2019) Using interactive learning modules to teach value-based health care to health professions trainees across the United States. Acad Med 94(9):1332\u20131336","journal-title":"Acad Med"},{"issue":"1","key":"1799_CR39","doi-asserted-by":"publisher","first-page":"868","DOI":"10.1186\/s12909-023-04866-1","volume":"23","author":"DR Glasofer","year":"2023","unstructured":"Glasofer DR, Lemly DC, Lloyd C et al (2023) Evaluation of an online modular eating disorders training (PreparED) to prepare healthcare trainees: a survey study. BMC Med Educ 23(1):868","journal-title":"BMC Med Educ"},{"issue":"9","key":"1799_CR40","doi-asserted-by":"publisher","first-page":"1245","DOI":"10.1002\/eat.23766","volume":"55","author":"A Raffoul","year":"2022","unstructured":"Raffoul A, Vitagliano JA, Sarda V et al (2022) Evaluation of a one-hour asynchronous video training for eating disorder screening and referral in U.S. pediatric primary care: a pilot study. Int J Eat Disord 55(9):1245\u20131251","journal-title":"Int J Eat Disord"}],"container-title":["Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40519-025-01799-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s40519-025-01799-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40519-025-01799-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T12:05:06Z","timestamp":1764331506000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s40519-025-01799-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,28]]},"references-count":40,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["1799"],"URL":"https:\/\/doi.org\/10.1007\/s40519-025-01799-0","relation":{},"ISSN":["1590-1262"],"issn-type":[{"value":"1590-1262","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,28]]},"assertion":[{"value":"22 July 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 October 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 November 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This is an observational study. The University of Wisconsin-Madison IRB has confirmed that no ethical approval is required.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"91"}}