{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T12:36:06Z","timestamp":1768566966033,"version":"3.49.0"},"posted":{"date-parts":[[2025,1,28]]},"group-title":"Psychiatry and Clinical Psychology","reference-count":131,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2025,1,28]],"date-time":"2025-01-28T00:00:00Z","timestamp":1738022400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2025,1,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:p>Neurofibromatosis 1 (NF1) is a rare genetic condition, frequently associated with learning difficulties. Functional neuroimaging techniques have been used to investigate brain mechanisms underlying learning difficulties in NF1, but these remain poorly understood. We conducted a systematic review of functional neuroimaging studies in NF1 from 2000-2024 aiming to develop a neurobiological framework for understanding the NF1 cognitive phenotype. A total of 44 studies were identified as relevant across functional magnetic resonance imaging (fMRI), electroencephalography (EEG), magnetic resonance spectroscopy (MRS), positron emission topography (PET), transcranial magnetic stimulation (TMS) and arterial spin labelling (ASL) techniques. Findings suggest mechanisms underlying learning in NF1 may be characterised as excitation\/ inhibition imbalance, dysconnectivity between brain regions and perturbations in neural activation patterns. We suggest, disruptions in GABAergic signalling, beginning in early development, may alter the whole brain function, explaining the differential patterns of brain activity, connectivity, and brain chemistry. As most of the reviewed studies were cross-sectional in nature, future research should focus on longitudinal designs to better understand developmental changes in brain mechanisms and how these processes evolve over time. Finally, it is essential to explore environmental modifiers in shaping the cognitive phenotypes associated with NF1.<\/jats:p>","DOI":"10.1101\/2025.01.27.25321195","type":"posted-content","created":{"date-parts":[[2025,1,29]],"date-time":"2025-01-29T00:20:51Z","timestamp":1738110051000},"source":"Crossref","is-referenced-by-count":0,"title":["Examining the cognitive phenotype in Neurofibromatosis 1: a systematic review of functional imaging studies"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-4428-7252","authenticated-orcid":false,"given":"Anna","family":"Wild","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Tziraki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline","family":"Lea-Carnall","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shruti","family":"Garg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"54368","reference":[{"key":"2025013104150565000_2025.01.27.25321195v1.1","doi-asserted-by":"publisher","DOI":"10.3390\/children10091556"},{"key":"2025013104150565000_2025.01.27.25321195v1.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0896-6273(03)00851-1"},{"key":"2025013104150565000_2025.01.27.25321195v1.3","doi-asserted-by":"publisher","DOI":"10.1016\/0092-8674(90)90151-4"},{"key":"2025013104150565000_2025.01.27.25321195v1.4","doi-asserted-by":"publisher","DOI":"10.1186\/s11689-022-09428-y"},{"key":"2025013104150565000_2025.01.27.25321195v1.5","doi-asserted-by":"publisher","DOI":"10.1186\/s11689-021-09364-3"},{"key":"2025013104150565000_2025.01.27.25321195v1.6","doi-asserted-by":"publisher","DOI":"10.1523\/ENEURO.0356-20.2023"},{"key":"2025013104150565000_2025.01.27.25321195v1.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuropsychologia.2003.07.008"},{"key":"2025013104150565000_2025.01.27.25321195v1.8","doi-asserted-by":"publisher","DOI":"10.1177\/08830738030180110701"},{"key":"2025013104150565000_2025.01.27.25321195v1.9","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2020.00368"},{"key":"2025013104150565000_2025.01.27.25321195v1.10","doi-asserted-by":"publisher","DOI":"10.1038\/srep43929"},{"key":"2025013104150565000_2025.01.27.25321195v1.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.nicl.2017.02.014"},{"key":"2025013104150565000_2025.01.27.25321195v1.12","doi-asserted-by":"publisher","DOI":"10.1186\/s11689-023-09492-y"},{"key":"2025013104150565000_2025.01.27.25321195v1.13","doi-asserted-by":"publisher","DOI":"10.1097\/MNM.0b013e3282f1bbf5"},{"key":"2025013104150565000_2025.01.27.25321195v1.14","doi-asserted-by":"publisher","DOI":"10.1177\/17470218211008895"},{"key":"2025013104150565000_2025.01.27.25321195v1.15","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l6890"},{"key":"2025013104150565000_2025.01.27.25321195v1.16","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2017.00069"},{"key":"2025013104150565000_2025.01.27.25321195v1.17","doi-asserted-by":"publisher","DOI":"10.1186\/s13229-022-00526-1"},{"key":"2025013104150565000_2025.01.27.25321195v1.18","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2020.08.016"},{"key":"2025013104150565000_2025.01.27.25321195v1.19","doi-asserted-by":"publisher","DOI":"10.1016\/j.neulet.2012.03.009"},{"key":"2025013104150565000_2025.01.27.25321195v1.20","doi-asserted-by":"publisher","DOI":"10.1002\/dneu.22874"},{"key":"2025013104150565000_2025.01.27.25321195v1.21","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2012.05.003"},{"key":"2025013104150565000_2025.01.27.25321195v1.22","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuropsychologia.2007.09.013"},{"key":"2025013104150565000_2025.01.27.25321195v1.23","doi-asserted-by":"publisher","DOI":"10.1038\/nature711"},{"key":"2025013104150565000_2025.01.27.25321195v1.24","doi-asserted-by":"publisher","DOI":"10.1016\/j.conb.2005.03.001"},{"key":"2025013104150565000_2025.01.27.25321195v1.25","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2008.09.060"},{"key":"2025013104150565000_2025.01.27.25321195v1.26","doi-asserted-by":"publisher","DOI":"10.1002\/glia.24432"},{"key":"2025013104150565000_2025.01.27.25321195v1.27","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/noac165"},{"key":"2025013104150565000_2025.01.27.25321195v1.28","doi-asserted-by":"publisher","DOI":"10.1093\/cercor\/bhac027"},{"key":"2025013104150565000_2025.01.27.25321195v1.29","doi-asserted-by":"publisher","DOI":"10.3389\/fncir.2013.00018"},{"key":"2025013104150565000_2025.01.27.25321195v1.30","doi-asserted-by":"publisher","DOI":"10.1111\/ejn.13645"},{"key":"2025013104150565000_2025.01.27.25321195v1.31","doi-asserted-by":"publisher","DOI":"10.1016\/j.tins.2012.12.002"},{"key":"2025013104150565000_2025.01.27.25321195v1.32","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2023.02.014"},{"key":"2025013104150565000_2025.01.27.25321195v1.33","doi-asserted-by":"publisher","DOI":"10.1080\/00222895.2013.850401"},{"key":"2025013104150565000_2025.01.27.25321195v1.34","doi-asserted-by":"publisher","DOI":"10.7554\/eLife.73827"},{"key":"2025013104150565000_2025.01.27.25321195v1.35","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2017.03.011"},{"key":"2025013104150565000_2025.01.27.25321195v1.36","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-024-49140-0"},{"key":"2025013104150565000_2025.01.27.25321195v1.37","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.a.33139"},{"key":"2025013104150565000_2025.01.27.25321195v1.38","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2019.00585"},{"key":"2025013104150565000_2025.01.27.25321195v1.39","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2023.111692"},{"key":"2025013104150565000_2025.01.27.25321195v1.40","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2011.00154"},{"key":"2025013104150565000_2025.01.27.25321195v1.41","doi-asserted-by":"publisher","DOI":"10.1177\/0883073813517001"},{"key":"2025013104150565000_2025.01.27.25321195v1.42","doi-asserted-by":"publisher","DOI":"10.1111\/dmcn.12043"},{"key":"2025013104150565000_2025.01.27.25321195v1.43","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-022-21907-9"},{"key":"2025013104150565000_2025.01.27.25321195v1.44","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2021.06.002"},{"key":"2025013104150565000_2025.01.27.25321195v1.45","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2021.06.004"},{"key":"2025013104150565000_2025.01.27.25321195v1.46","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000007899"},{"key":"2025013104150565000_2025.01.27.25321195v1.47","doi-asserted-by":"publisher","DOI":"10.1186\/s13229-017-0166-4"},{"key":"2025013104150565000_2025.01.27.25321195v1.48","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2006.04.025"},{"key":"2025013104150565000_2025.01.27.25321195v1.49","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-444-64032-1.00036-9"},{"key":"2025013104150565000_2025.01.27.25321195v1.50","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijpsycho.2006.08.004"},{"key":"2025013104150565000_2025.01.27.25321195v1.51","doi-asserted-by":"publisher","DOI":"10.1007\/s10519-010-9430-5"},{"key":"2025013104150565000_2025.01.27.25321195v1.52","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000179303.72345.ce"},{"key":"2025013104150565000_2025.01.27.25321195v1.53","doi-asserted-by":"publisher","DOI":"10.1016\/j.nicl.2017.06.032"},{"key":"2025013104150565000_2025.01.27.25321195v1.54","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines10123189"},{"key":"2025013104150565000_2025.01.27.25321195v1.55","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.5253-10.2011"},{"key":"2025013104150565000_2025.01.27.25321195v1.56","doi-asserted-by":"publisher","DOI":"10.3389\/fnhum.2010.00186"},{"key":"2025013104150565000_2025.01.27.25321195v1.57","doi-asserted-by":"publisher","DOI":"10.1111\/jcpp.13372"},{"key":"2025013104150565000_2025.01.27.25321195v1.58","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpsc.2016.12.003"},{"key":"2025013104150565000_2025.01.27.25321195v1.59","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0047854"},{"key":"2025013104150565000_2025.01.27.25321195v1.60","doi-asserted-by":"publisher","DOI":"10.3934\/Neuroscience.2015.2.91"},{"key":"2025013104150565000_2025.01.27.25321195v1.61","doi-asserted-by":"publisher","DOI":"10.1111\/psyp.12147"},{"key":"2025013104150565000_2025.01.27.25321195v1.62","doi-asserted-by":"publisher","DOI":"10.1038\/s41386-021-01137-9"},{"key":"2025013104150565000_2025.01.27.25321195v1.63","doi-asserted-by":"publisher","DOI":"10.1016\/j.nbd.2022.105881"},{"key":"2025013104150565000_2025.01.27.25321195v1.64","doi-asserted-by":"publisher","DOI":"10.1016\/j.brainres.2023.148512"},{"key":"2025013104150565000_2025.01.27.25321195v1.65","doi-asserted-by":"publisher","DOI":"10.1186\/s11689-022-09452-y"},{"key":"2025013104150565000_2025.01.27.25321195v1.66","unstructured":"Li, T. , Higgins, J. P. T. , & Deeks, J. J. (2024a). Chapter 5: Collecting data. In J. P. T. Higgins , J. Thomas , J. Chandler , M. Cumpston , T. Li , M. J. Page , & V. A. Welch (Eds.), Cochrane Handbook for Systematic Reviews of Interventions version 6.5. www.training.cochrane.org\/handbook."},{"key":"2025013104150565000_2025.01.27.25321195v1.67","doi-asserted-by":"publisher","DOI":"10.1016\/j.cub.2005.09.043"},{"key":"2025013104150565000_2025.01.27.25321195v1.68","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2024.02.012"},{"key":"2025013104150565000_2025.01.27.25321195v1.69","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2012.04377.x"},{"key":"2025013104150565000_2025.01.27.25321195v1.70","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-444-64148-9.00019-3"},{"key":"2025013104150565000_2025.01.27.25321195v1.71","doi-asserted-by":"publisher","DOI":"10.1007\/s00406-022-01541-2"},{"key":"2025013104150565000_2025.01.27.25321195v1.72","doi-asserted-by":"publisher","DOI":"10.1002\/nbm.4484"},{"key":"2025013104150565000_2025.01.27.25321195v1.73","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2011.03.022"},{"key":"2025013104150565000_2025.01.27.25321195v1.74","doi-asserted-by":"publisher","DOI":"10.3390\/cancers12010114"},{"key":"2025013104150565000_2025.01.27.25321195v1.75","doi-asserted-by":"publisher","DOI":"10.1089\/brain.2014.0334"},{"key":"2025013104150565000_2025.01.27.25321195v1.76","doi-asserted-by":"publisher","DOI":"10.1016\/j.nicl.2019.101959"},{"key":"2025013104150565000_2025.01.27.25321195v1.77","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2377-13-131"},{"key":"2025013104150565000_2025.01.27.25321195v1.78","doi-asserted-by":"publisher","DOI":"10.1177\/1087054712450749"},{"key":"2025013104150565000_2025.01.27.25321195v1.79","doi-asserted-by":"publisher","DOI":"10.1126\/science.1254960"},{"key":"2025013104150565000_2025.01.27.25321195v1.80","doi-asserted-by":"publisher","DOI":"10.1016\/j.nicl.2019.101692"},{"key":"2025013104150565000_2025.01.27.25321195v1.81","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2020.12.003"},{"key":"2025013104150565000_2025.01.27.25321195v1.82","doi-asserted-by":"publisher","DOI":"10.1016\/s1556-0864(15)31506-9"},{"key":"2025013104150565000_2025.01.27.25321195v1.83","doi-asserted-by":"publisher","DOI":"10.1016\/bs.pbr.2018.09.014"},{"key":"2025013104150565000_2025.01.27.25321195v1.84","doi-asserted-by":"publisher","DOI":"10.1016\/j.dcn.2022.101067"},{"key":"2025013104150565000_2025.01.27.25321195v1.85","doi-asserted-by":"publisher","DOI":"10.11124\/JBISRIR-D-19-00099"},{"key":"2025013104150565000_2025.01.27.25321195v1.86","doi-asserted-by":"publisher","DOI":"10.1002\/hbm.24612"},{"key":"2025013104150565000_2025.01.27.25321195v1.87","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3182919029"},{"key":"2025013104150565000_2025.01.27.25321195v1.88","doi-asserted-by":"publisher","DOI":"10.1038\/nn.4500"},{"key":"2025013104150565000_2025.01.27.25321195v1.89","doi-asserted-by":"publisher","DOI":"10.1007\/s00381-013-2236-z"},{"key":"2025013104150565000_2025.01.27.25321195v1.90","doi-asserted-by":"publisher","DOI":"10.1038\/mp.2015.48"},{"key":"2025013104150565000_2025.01.27.25321195v1.91","doi-asserted-by":"publisher","DOI":"10.1111\/dmcn.16094"},{"key":"2025013104150565000_2025.01.27.25321195v1.92","doi-asserted-by":"publisher","DOI":"10.1038\/s41436-020-0752-2"},{"key":"2025013104150565000_2025.01.27.25321195v1.93","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"2025013104150565000_2025.01.27.25321195v1.94","doi-asserted-by":"publisher","DOI":"10.1038\/s41593-019-0582-1"},{"key":"2025013104150565000_2025.01.27.25321195v1.95","doi-asserted-by":"publisher","DOI":"10.1101\/2023.05.17.541109"},{"key":"2025013104150565000_2025.01.27.25321195v1.96","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.b.32414"},{"key":"2025013104150565000_2025.01.27.25321195v1.97","doi-asserted-by":"publisher","DOI":"10.1007\/s10803-021-05043-3"},{"key":"2025013104150565000_2025.01.27.25321195v1.98","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2007.11.048"},{"key":"2025013104150565000_2025.01.27.25321195v1.99","doi-asserted-by":"publisher","DOI":"10.7554\/eLife.62575"},{"key":"2025013104150565000_2025.01.27.25321195v1.100","doi-asserted-by":"publisher","DOI":"10.1016\/j.ridd.2013.07.011"},{"key":"2025013104150565000_2025.01.27.25321195v1.101","doi-asserted-by":"publisher","DOI":"10.1016\/j.cortex.2017.04.022"},{"key":"2025013104150565000_2025.01.27.25321195v1.102","doi-asserted-by":"publisher","DOI":"10.1007\/s11682-017-9717-8"},{"key":"2025013104150565000_2025.01.27.25321195v1.103","doi-asserted-by":"publisher","DOI":"10.1080\/87565641.2012.695831"},{"key":"2025013104150565000_2025.01.27.25321195v1.104","doi-asserted-by":"publisher","DOI":"10.1038\/nrc3911"},{"key":"2025013104150565000_2025.01.27.25321195v1.105","doi-asserted-by":"publisher","DOI":"10.1186\/1866-1955-6-1"},{"key":"2025013104150565000_2025.01.27.25321195v1.106","doi-asserted-by":"publisher","DOI":"10.1016\/j.cortex.2014.10.019"},{"key":"2025013104150565000_2025.01.27.25321195v1.107","doi-asserted-by":"publisher","DOI":"10.1186\/s13293-023-00509-8"},{"key":"2025013104150565000_2025.01.27.25321195v1.108","doi-asserted-by":"publisher","DOI":"10.1038\/mp.2014.147"},{"key":"2025013104150565000_2025.01.27.25321195v1.109","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0203520"},{"key":"2025013104150565000_2025.01.27.25321195v1.110","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1004829107"},{"key":"2025013104150565000_2025.01.27.25321195v1.111","doi-asserted-by":"publisher","DOI":"10.1016\/j.nbd.2019.104479"},{"key":"2025013104150565000_2025.01.27.25321195v1.112","doi-asserted-by":"publisher","DOI":"10.1186\/s11689-018-9230-4"},{"key":"2025013104150565000_2025.01.27.25321195v1.113","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0148600"},{"key":"2025013104150565000_2025.01.27.25321195v1.114","doi-asserted-by":"publisher","DOI":"10.1038\/s41386-021-01089-0"},{"key":"2025013104150565000_2025.01.27.25321195v1.115","doi-asserted-by":"publisher","DOI":"10.1016\/j.dcn.2024.101404"},{"key":"2025013104150565000_2025.01.27.25321195v1.116","doi-asserted-by":"publisher","DOI":"10.1002\/hbm.22937"},{"key":"2025013104150565000_2025.01.27.25321195v1.117","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000002118"},{"key":"2025013104150565000_2025.01.27.25321195v1.118","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000003044"},{"key":"2025013104150565000_2025.01.27.25321195v1.119","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0038785"},{"key":"2025013104150565000_2025.01.27.25321195v1.120","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/aws368"},{"key":"2025013104150565000_2025.01.27.25321195v1.121","doi-asserted-by":"publisher","DOI":"10.1186\/1866-1955-5-3"},{"key":"2025013104150565000_2025.01.27.25321195v1.122","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2011.09.003"},{"key":"2025013104150565000_2025.01.27.25321195v1.123","doi-asserted-by":"publisher","DOI":"10.1212\/NXG.0000000000000616"},{"key":"2025013104150565000_2025.01.27.25321195v1.124","doi-asserted-by":"publisher","DOI":"10.1002\/1531-8249(200004)47:4<477::AID-ANA11>3.0.CO;2-C"},{"key":"2025013104150565000_2025.01.27.25321195v1.125","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.027448"},{"key":"2025013104150565000_2025.01.27.25321195v1.126","doi-asserted-by":"crossref","unstructured":"Yeom, K. W. , Lober, R. M. , Barnes, P. D. , & Campen, C. J . (2013). Reduced cerebral arterial spin-labeled perfusion in children with neurofibromatosis type 1. American Journal of Neuroradiology,","DOI":"10.3174\/ajnr.A3649"},{"key":"2025013104150565000_2025.01.27.25321195v1.127","doi-asserted-by":"publisher","DOI":"10.1016\/j.pscychresns.2017.06.003"},{"key":"2025013104150565000_2025.01.27.25321195v1.128","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awy266"},{"key":"2025013104150565000_2025.01.27.25321195v1.129","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2014.08.028"},{"key":"2025013104150565000_2025.01.27.25321195v1.130","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebiom.2015.08.036"},{"key":"2025013104150565000_2025.01.27.25321195v1.131","doi-asserted-by":"publisher","DOI":"10.1016\/j.jneumeth.2008.04.012"}],"container-title":[],"original-title":[],"link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1101\/2025.01.27.25321195","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T20:26:32Z","timestamp":1768508792000},"score":1,"resource":{"primary":{"URL":"http:\/\/medrxiv.org\/lookup\/doi\/10.1101\/2025.01.27.25321195"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,28]]},"references-count":131,"URL":"https:\/\/doi.org\/10.1101\/2025.01.27.25321195","relation":{},"subject":[],"published":{"date-parts":[[2025,1,28]]},"subtype":"preprint"}}