{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T20:03:07Z","timestamp":1787688187883,"version":"build-2784847793"},"reference-count":88,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T00:00:00Z","timestamp":1748736000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T00:00:00Z","timestamp":1748736000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["R61DA059889"],"award-info":[{"award-number":["R61DA059889"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Substance Use: Research and Treatment"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The quality of methadone treatment for opioid use disorder varies across the U.S., affecting patient retention and overdose. Staff stress, trauma exposure, vicarious trauma (VT), burnout, and empowerment are important yet understudied factors that influence workforce well-being and performance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>This study aimed to characterize trauma-related well-being among staff in a national sample of opioid treatment programs (OTPs) and to explore potential correlates of resilience.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>A cross-sectional survey was conducted from June to August 2024 with OTP staff from clinics participating in a parent national study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The survey combined validated instruments and tailored questions to assess work experience, lifetime trauma exposure, trauma and stress-related symptoms, VT, burnout, and multiple dimensions of empowerment. Exploratory factor analysis was used to identify domains of staff well-being.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The sample (N\u2009=\u200986) included medical staff, counselors, and non-medical\/counseling staff from OTPs across 16 states. Thirteen percent of staff met preliminary criteria for posttraumatic stress disorder, 89.2% reported VT exposure at work, and 63.8% reported moderate to severe VT symptoms. Medical staff reported the highest VT and stress scores. Overall, 19.8% of staff met criteria for burnout, with counselors reporting the highest rates (30%). VT symptoms were positively correlated with burnout among counselors, medical, and other staff (\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      \u2009=\u20090.413-0.650,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.05). Empowerment subscales were strongly correlated. Two distinct, uncorrelated domains of staff well-being emerged: VT resilience (low VT symptoms and burnout) and empowerment (high perceived control and influence), reflecting distinct aspects of trauma-related functioning. Despite high exposure to lifetime trauma and VT, staff demonstrated moderate resilience and moderate-to-high levels of empowerment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Staff of OTPs experience high levels of trauma exposure and symptomatology, VT, and burnout, with notable differences by clinic role. Resilience and empowerment domains suggest opportunities to improve staff wellness.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/29768357251383239","type":"journal-article","created":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T06:05:44Z","timestamp":1760594744000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Trauma-Related Stress and Resilience in a Multistate Sample of Methadone Treatment Staff"],"prefix":"10.1177","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7957-6333","authenticated-orcid":false,"given":"Zhanette","family":"Coffee","sequence":"first","affiliation":[{"name":"Harm Reduction Research Lab, College of Nursing, Tucson, Arizona, USA"},{"name":"Comprehensive Center for Pain and Addiction, University of Arizona, Tucson, Arizona, USA"},{"name":"College of Nursing, University of Arizona, Tucson Arizona, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5881-5920","authenticated-orcid":false,"given":"Linnea","family":"Linde-Krieger","sequence":"additional","affiliation":[{"name":"Harm Reduction Research Lab, College of Nursing, Tucson, Arizona, USA"},{"name":"Comprehensive Center for Pain and Addiction, University of Arizona, Tucson, Arizona, USA"},{"name":"School of Social Work, Arizona State University, Phoenix, AZ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9974-5587","authenticated-orcid":false,"given":"Gregory A.","family":"Carter","sequence":"additional","affiliation":[{"name":"Harm Reduction Research Lab, College of Nursing, Tucson, Arizona, USA"},{"name":"School of Nursing, Indiana University, Indianapolis, Indiana, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin R.","family":"Brady","sequence":"additional","affiliation":[{"name":"Harm Reduction Research Lab, College of Nursing, Tucson, Arizona, USA"},{"name":"College of Health and Human Services, Western Michigan University, Kalamazoo, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alissa","family":"Davis","sequence":"additional","affiliation":[{"name":"Harm Reduction Research Lab, College of Nursing, Tucson, Arizona, USA"},{"name":"Columbia University School of Social Work, New York NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard A.","family":"Crosby","sequence":"additional","affiliation":[{"name":"Harm Reduction Research Lab, College of Nursing, Tucson, Arizona, USA"},{"name":"College of Public Health, University of Kentucky, Lexington, Kentucky, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Frank","sequence":"additional","affiliation":[{"name":"Harm Reduction Research Lab, College of Nursing, Tucson, Arizona, USA"},{"name":"School of Global Health, New York University, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8180-4040","authenticated-orcid":false,"given":"Arlene N.","family":"Mahoney","sequence":"additional","affiliation":[{"name":"Harm Reduction Research Lab, College of Nursing, Tucson, Arizona, USA"},{"name":"Southwest Recovery Alliance, Phoenix, Arizona, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8701-6843","authenticated-orcid":false,"given":"Sara M.","family":"Najar","sequence":"additional","affiliation":[{"name":"College of Education and Human Development, Western Michigan University, Kalamazoo Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1762-7179","authenticated-orcid":false,"given":"Beth E.","family":"Meyerson","sequence":"additional","affiliation":[{"name":"Harm Reduction Research Lab, College of Nursing, Tucson, Arizona, USA"},{"name":"Comprehensive Center for Pain and Addiction, University of Arizona, Tucson, Arizona, USA"},{"name":"College of Nursing, University of Arizona, Tucson Arizona, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,10,15]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2005.02.007"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2019.20622"},{"key":"e_1_3_3_4_2","unstructured":"Substance Abuse and Mental Health Services Administration. Approved accreditation bodies. 2025. Accessed April 1 2025 https:\/\/www.samhsa.gov\/substance-use\/treatment\/opioid-treatment-program\/accreditation-bodies"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2020.108146"},{"key":"e_1_3_3_6_2","unstructured":"Pew Charitable Trusts. Overview of opioid treatment program regulations bystate. 2025. Accessed April 1 2025. https:\/\/www.pew.org\/-\/media\/assets\/2022\/09\/overview-of-opioid-treatment-program-regulations-by-state.pdf"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2020.108197"},{"key":"e_1_3_3_8_2","unstructured":"U.S. Substance Abuse and Mental Health Services Administration (SAMHSA). Opioid treatment program directory. 2025. Accessed April 1 2025. https:\/\/dpt2.samhsa.gov\/treatment\/directory.aspx"},{"key":"e_1_3_3_9_2","unstructured":"Meyerson BE Davis A Brady BR et al. Methadone treatment practice in a changing landscape: National survey of U.S. opioid treatment programs. (In Review)."},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.5001\/omj.2020.07"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-021-01764-9"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13722-024-00501-6"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/sw\/52.1.63"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/jts.21998"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20311"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1002\/pon.3743"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1080\/13548506.2018.1475679"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1002\/pchj.583"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1521-0391.2012.00271.x"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00975140"},{"key":"e_1_3_3_21_2","volume-title":"Compassion Fatigue: Coping With Secondary Traumatic Stress Disorder in Those Who Treat the Traumatized","author":"Figley CR.","year":"1995","unstructured":"Figley CR. Compassion Fatigue: Coping With Secondary Traumatic Stress Disorder in Those Who Treat the Traumatized. Brunner\/Mazel; 1995."},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejon.2007.02.007"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1080\/15548732.2015.1021987"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1111\/inm.12953"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.16918"},{"key":"e_1_3_3_26_2","unstructured":"Pearlman LA. Trauma and the therapist : countertransference and vicarious traumatization in psychotherapy with incest survivors. Norton. 1995. Advance online publication. https:\/\/archive.org\/details\/traumatherapistc0000pear_q4x2"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1037\/tra0001277"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1177\/1078345820953219"},{"issue":"1","key":"e_1_3_3_29_2","first-page":"1","article-title":"An exploratory study of trauma histories, symptoms, and vicarious trauma among opioid treatment program staff: implications for provider functioning","volume":"31","author":"Linde-Krieger LB","year":"2025","unstructured":"Linde-Krieger LB, Meyerson BE, Huff AJ, Carter GA, Brady BR. An exploratory study of trauma histories, symptoms, and vicarious trauma among opioid treatment program staff: implications for provider functioning. Traumatol. 2025;31(1):1-9.","journal-title":"Traumatol"},{"issue":"2","key":"e_1_3_3_30_2","first-page":"65","article-title":"A systematic review exploring the presence of vicarious trauma, compassion fatigue, and secondary traumatic stress in alcohol and other drug clinicians","volume":"21","author":"Huggard P","year":"2017","unstructured":"Huggard P, Law J, Newcombe D. A systematic review exploring the presence of vicarious trauma, compassion fatigue, and secondary traumatic stress in alcohol and other drug clinicians. Australas J Disaster Trauma Stud. 2017;21(2):65-72.","journal-title":"Australas J Disaster Trauma Stud"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1080\/08897077.2016.1181695"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1002\/job.4030020205"},{"issue":"5","key":"e_1_3_3_33_2","first-page":"479","article-title":"Identifying, preventing, and addressing job burnout and vicarious burnout for social work professionals","volume":"13","author":"Wilson F.","year":"2016","unstructured":"Wilson F. Identifying, preventing, and addressing job burnout and vicarious burnout for social work professionals. J \u00c9vid Soc Work. 2016;13(5):479-483.","journal-title":"J \u00c9vid Soc Work"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1080\/10926771.2012.689422"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2022.108924"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2010.11.015"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.HMR.0000304493.87898.72"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.1080\/08897077.2018.1449051"},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.1097\/JAN.0000000000000434"},{"key":"e_1_3_3_40_2","doi-asserted-by":"publisher","DOI":"10.1111\/1467-8624.00164"},{"key":"e_1_3_3_41_2","doi-asserted-by":"publisher","DOI":"10.1080\/20008198.2020.1822064"},{"key":"e_1_3_3_42_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1545-5300.2007.00206.x"},{"key":"e_1_3_3_43_2","doi-asserted-by":"publisher","DOI":"10.70256\/607490pbruec"},{"key":"e_1_3_3_44_2","doi-asserted-by":"publisher","DOI":"10.1002\/smi.2905"},{"key":"e_1_3_3_45_2","doi-asserted-by":"publisher","DOI":"10.14195\/1647-8606_60-2_3"},{"issue":"6","key":"e_1_3_3_46_2","article-title":"Staff nurse empowerment and collective accountability: effect on perceived productivity and self-rated work effectiveness","volume":"17","author":"Laschinger HK","year":"1999","unstructured":"Laschinger HK, Wong C. Staff nurse empowerment and collective accountability: effect on perceived productivity and self-rated work effectiveness. Nurs Econ. 1999;17(6):308-316, 351.","journal-title":"Nurs Econ"},{"key":"e_1_3_3_47_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005110-199706000-00012"},{"key":"e_1_3_3_48_2","doi-asserted-by":"publisher","DOI":"10.1177\/001872679504800202"},{"key":"e_1_3_3_49_2","doi-asserted-by":"publisher","DOI":"10.1016\/0092-6566(84)90018-7"},{"key":"e_1_3_3_50_2","doi-asserted-by":"publisher","DOI":"10.1037\/0022-3514.56.5.805"},{"key":"e_1_3_3_51_2","doi-asserted-by":"publisher","DOI":"10.1002\/job.248"},{"key":"e_1_3_3_52_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2020.107968"},{"key":"e_1_3_3_53_2","doi-asserted-by":"publisher","DOI":"10.1353\/hpu.2022.0104"},{"key":"e_1_3_3_54_2","doi-asserted-by":"crossref","unstructured":"Brady BR Gildersleeve R Koch BD Campos-Outcalt DE Derksen DJ. Federally qualified health centers can expand rural access to buprenorphine for opioid use disorder in Arizona. Health Serv Insights. 2021;14:11786329211037502. https:\/\/doi.org\/10.1177\/11786329211037502","DOI":"10.1177\/11786329211037502"},{"key":"e_1_3_3_55_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2025.104799"},{"key":"e_1_3_3_56_2","unstructured":"Weathers FW Blake DD Schnurr PP Kaloupek DG Marx BP Keane TM. Life Events Checklist for DSM-5 (LEC-5). National Center for PTSD 2013. Accessed July 29 2024. https:\/\/www.ptsd.va.gov\/professional\/assessment\/te-measures\/life_events_checklist.asp"},{"key":"e_1_3_3_57_2","doi-asserted-by":"publisher","DOI":"10.1590\/2237-6089-2015-0074"},{"key":"e_1_3_3_58_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2016.03.014"},{"key":"e_1_3_3_59_2","doi-asserted-by":"publisher","DOI":"10.1002\/jts.22059"},{"key":"e_1_3_3_60_2","doi-asserted-by":"publisher","DOI":"10.1111\/hsc.12554"},{"key":"e_1_3_3_61_2","doi-asserted-by":"publisher","DOI":"10.1093\/hsw\/hlt017"},{"key":"e_1_3_3_62_2","doi-asserted-by":"publisher","DOI":"10.1002\/smi.2762"},{"key":"e_1_3_3_63_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-014-3112-6"},{"key":"e_1_3_3_64_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40596-017-0849-3"},{"key":"e_1_3_3_65_2","first-page":"153","article-title":"Employee empowerment: an integrative, psychological approach","volume":"50","author":"Menon S.","year":"2001","unstructured":"Menon S. Employee empowerment: an integrative, psychological approach. Appl Psychol Crim Justice. 2001;50:153-180.","journal-title":"Appl Psychol Crim Justice"},{"key":"e_1_3_3_66_2","doi-asserted-by":"publisher","DOI":"10.1177\/1470595802002002860"},{"key":"e_1_3_3_67_2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.publhealth.28.082206.094100"},{"key":"e_1_3_3_68_2","unstructured":"R Core Team. R: A Language and Environment for Statistical Computing. R Foundation for Statistical Computing 2025. https:\/\/www.R-project.org\/"},{"key":"e_1_3_3_69_2","doi-asserted-by":"publisher","DOI":"10.1080\/00273170903504810"},{"key":"e_1_3_3_70_2","doi-asserted-by":"publisher","DOI":"10.1037\/1082-989X.4.3.272"},{"key":"e_1_3_3_71_2","volume-title":"Principles and Practice of Structural Equation Modeling","author":"Kline RB","year":"2016","unstructured":"Kline RB, ed. Principles and Practice of Structural Equation Modeling. 4th ed. Methodology in the Social Sciences. Guilford Press; 2016.","edition":"4"},{"key":"e_1_3_3_72_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4614-6849-3"},{"key":"e_1_3_3_73_2","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1984.10478083"},{"key":"e_1_3_3_74_2","first-page":"369","volume":"2013","author":"Kuhn M","unstructured":"Kuhn M, Johnson K. Classification Trees and Rule-Based Models. Springer; 2013:369-413.","journal-title":"Classification Trees and Rule-Based Models"},{"key":"e_1_3_3_75_2","doi-asserted-by":"publisher","DOI":"10.1080\/10705519909540118"},{"key":"e_1_3_3_76_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10597-018-00364-7"},{"key":"e_1_3_3_77_2","doi-asserted-by":"publisher","DOI":"10.1111\/jonm.13420"},{"key":"e_1_3_3_78_2","doi-asserted-by":"publisher","DOI":"10.1002\/jclp.10090"},{"key":"e_1_3_3_79_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10488-011-0352-1"},{"key":"e_1_3_3_80_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eurpsy.2018.06.003"},{"key":"e_1_3_3_81_2","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201400430"},{"key":"e_1_3_3_82_2","doi-asserted-by":"publisher","DOI":"10.1111\/inm.13289"},{"key":"e_1_3_3_83_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nurpra.2024.105033"},{"key":"e_1_3_3_84_2","doi-asserted-by":"publisher","DOI":"10.1111\/jan.16694"},{"key":"e_1_3_3_85_2","doi-asserted-by":"publisher","DOI":"10.1177\/070674371105600504"},{"key":"e_1_3_3_86_2","doi-asserted-by":"publisher","DOI":"10.1097\/ACM.0b013e318280cff0"},{"key":"e_1_3_3_87_2","doi-asserted-by":"publisher","DOI":"10.1037\/1040-3590.8.4.412"},{"key":"e_1_3_3_88_2","doi-asserted-by":"publisher","DOI":"10.1037\/1040-3590.9.1.34"},{"key":"e_1_3_3_89_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291799002111"}],"container-title":["Substance Use: Research and Treatment"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/29768357251383239","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/29768357251383239","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/29768357251383239","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T01:53:24Z","timestamp":1777600404000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/29768357251383239"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6]]},"references-count":88,"alternative-id":["10.1177\/29768357251383239"],"URL":"https:\/\/doi.org\/10.1177\/29768357251383239","relation":{},"ISSN":["2976-8357","2976-8357"],"issn-type":[{"value":"2976-8357","type":"print"},{"value":"2976-8357","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6]]},"article-number":"29768357251383239"}}