{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T22:20:49Z","timestamp":1782858049696,"version":"3.54.5"},"reference-count":54,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:00:00Z","timestamp":1777939200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"CArdiovascular DiseasE National Collaborative Enterprise","award":["MOH-001277-01"],"award-info":[{"award-number":["MOH-001277-01"]}]},{"DOI":"10.13039\/501100001349","name":"National Medical Research Council","doi-asserted-by":"publisher","award":["NMRC CG21APR1006"],"award-info":[{"award-number":["NMRC CG21APR1006"]}],"id":[{"id":"10.13039\/501100001349","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001349","name":"National Medical Research Council","doi-asserted-by":"publisher","award":["NMRC\/CG21APRC006"],"award-info":[{"award-number":["NMRC\/CG21APRC006"]}],"id":[{"id":"10.13039\/501100001349","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001350","name":"Ministry of Health -Singapore","doi-asserted-by":"publisher","award":["MOH-STaR21jun-0003"],"award-info":[{"award-number":["MOH-STaR21jun-0003"]}],"id":[{"id":"10.13039\/501100001350","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Elevated low-density lipoprotein cholesterol is one of the major modifiable risk factors for cardiovascular disease. Lipid management is integral to primary and secondary prevention of cardiovascular disease, but undermined by high prevalence of non-adherence to lipid-lowering medications. Innovative, personalized multicomponent interventions may address the gaps in medication non-adherence. We aim to evaluate the effectiveness of a human coach-supported digital personal health assistant (mobile health app) intervention in improving adherence to statins in adults with hyperlipidaemia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>AdLip is a multicentre, open-label, parallel, two-arms, randomized controlled trial aiming to recruit a minimum of 376 adult participants who are non-adherent to statins from primary care ambulatory clinic setting in Singapore. Participants recruited will be randomly assigned (1:1) to human-coach supported mobile health app intervention or control group. The primary outcome will be adherence to statins at 6 months, measured by Medication Adherence Report Scale-5. Secondary outcomes will include change in serum low-density lipoprotein cholesterol levels, health motivation and attitudes, self-efficacy, self-care behaviours, quality of life, app acceptability, user engagement, and cost-effectiveness. Outcomes will be analysed using intention-to-treat approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>The AdLip trial will provide empirical evidence on a multicomponent approach to the long-standing challenge of suboptimal adherence to statins in a multi-ethnic Asian setting. Findings from this study may inform a more personalized approach to addressing non-adherence in the short term, and how it relates to cardiovascular disease prevention in the longer term.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Trial Registration:<\/jats:bold>\n                      ClinicalTrials.gov\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/NCT06614049\" xlink:type=\"simple\">NCT06614049<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0346509","type":"journal-article","created":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T17:24:20Z","timestamp":1778001860000},"page":"e0346509","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Health coach-supported mobile health intervention to improve adherence to lipid-lowering medications (AdLip): Design and rationale of a multicentre randomized controlled trial protocol"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-5621-5071","authenticated-orcid":true,"given":"Qi Chwen","family":"Ong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6846-7753","authenticated-orcid":true,"given":"Emina","family":"Obarcanin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iva","family":"Bojic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sock Hwee","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5606-2046","authenticated-orcid":true,"given":"Sameera","family":"Senanayake","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjeewa","family":"Kularatna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Graves","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siew Pang","family":"Chan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun Long Marvin","family":"Sim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derek","family":"Hausenloy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark Yan Yee","family":"Chan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andy Wai Hoong","family":"Khong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doreen Su-Yin","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0373-7043","authenticated-orcid":true,"given":"Andy Hau Yan","family":"Ho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,5,5]]},"reference":[{"issue":"25","key":"pone.0346509.ref001","first-page":"2982","article-title":"Global Burden of Cardiovascular Diseases and Risk Factors, 1990-2019: Update From the GBD 2019 Study","volume":"76","author":"GA Roth","year":"2020","journal-title":"J Am Coll Cardiol"},{"key":"pone.0346509.ref002","first-page":"100803","article-title":"Trends and predictions of metabolic risk factors for acute myocardial infarction: findings from a multiethnic nationwide cohort","volume":"37","author":"NWS Chew","year":"2023","journal-title":"Lancet Reg Health West Pac"},{"issue":"16","key":"pone.0346509.ref003","doi-asserted-by":"crossref","first-page":"1557","DOI":"10.1056\/NEJMra1806939","article-title":"Lipid Management for the Prevention of Atherosclerotic Cardiovascular Disease","volume":"381","author":"ED Michos","year":"2019","journal-title":"N Engl J Med"},{"key":"pone.0346509.ref004","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.ahj.2018.12.007","article-title":"Comparative effectiveness and safety of statins as a class and of specific statins for primary prevention of cardiovascular disease: A systematic review, meta-analysis, and network meta-analysis of randomized trials with 94,283 participants","volume":"210","author":"HG Yebyo","year":"2019","journal-title":"Am Heart J"},{"issue":"14","key":"pone.0346509.ref005","doi-asserted-by":"crossref","first-page":"1172","DOI":"10.1093\/eurheartj\/ehx566","article-title":"Effect of statins and non-statin LDL-lowering medications on cardiovascular outcomes in secondary prevention: a meta-analysis of randomized trials","volume":"39","author":"KC Koskinas","year":"2018","journal-title":"Eur Heart J"},{"issue":"9493","key":"pone.0346509.ref006","doi-asserted-by":"crossref","first-page":"1267","DOI":"10.1016\/S0140-6736(05)67394-1","article-title":"Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins","volume":"366","author":"C Baigent","year":"2005","journal-title":"Lancet"},{"issue":"3","key":"pone.0346509.ref007","doi-asserted-by":"crossref","first-page":"155","DOI":"10.11622\/smedj.2017018","article-title":"Ministry of Health Clinical Practice Guidelines: Lipids","volume":"58","author":"ES Tai","year":"2017","journal-title":"Singapore Med J"},{"issue":"8","key":"pone.0346509.ref008","doi-asserted-by":"crossref","DOI":"10.1002\/pds.5879","article-title":"Prevalence, Associated Risk Factors, and Adverse Cardiovascular Outcomes of Statins Discontinuation: A Systematic Review","volume":"33","author":"SA Ageeb","year":"2024","journal-title":"Pharmacoepidemiol Drug Safe"},{"issue":"6","key":"pone.0346509.ref009","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1517\/14740330802396984","article-title":"Compliance with lipid-lowering therapy and its impact on cardiovascular morbidity and mortality","volume":"7","author":"EN Liberopoulos","year":"2008","journal-title":"Expert Opin Drug Saf"},{"key":"pone.0346509.ref010","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1016\/j.ijcard.2016.09.075","article-title":"Statin non-adherence and residual cardiovascular risk: There is need for substantial improvement","volume":"225","author":"M Banach","year":"2016","journal-title":"Int J Cardiol"},{"issue":"4","key":"pone.0346509.ref011","doi-asserted-by":"crossref","first-page":"684","DOI":"10.1111\/bcp.12339","article-title":"Impact of statin adherence on cardiovascular disease and mortality outcomes: a systematic review","volume":"78","author":"MA De Vera","year":"2014","journal-title":"Br J Clin Pharmacol"},{"issue":"7","key":"pone.0346509.ref012","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1016\/j.cardfail.2008.02.011","article-title":"Predictors of medication adherence using a multidimensional adherence model in patients with heart failure","volume":"14","author":"J-R Wu","year":"2008","journal-title":"J Card Fail"},{"issue":"25","key":"pone.0346509.ref013","doi-asserted-by":"crossref","first-page":"2067","DOI":"10.1161\/CIRCULATIONAHA.119.041974","article-title":"Cost-Related Medication Nonadherence in Adults With Atherosclerotic Cardiovascular Disease in the United States, 2013 to 2017","volume":"140","author":"R Khera","year":"2019","journal-title":"Circulation"},{"key":"pone.0346509.ref014","article-title":"Adherence to statin therapy: it seems we know everything, yet we do nothing","author":"M Banach","year":"2022","journal-title":"Oxford Univ Press US"},{"key":"pone.0346509.ref015","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1186\/1472-6963-12-98","article-title":"Unintentional non-adherence to chronic prescription medications: how unintentional is it really?","volume":"12","author":"AS Gadkari","year":"2012","journal-title":"BMC Health Serv Res"},{"issue":"1","key":"pone.0346509.ref016","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.amjopharm.2011.02.004","article-title":"A systematic review of barriers to medication adherence in the elderly: looking beyond cost and regimen complexity","volume":"9","author":"WF Gellad","year":"2011","journal-title":"Am J Geriatr Pharmacother"},{"issue":"22","key":"pone.0346509.ref017","doi-asserted-by":"crossref","first-page":"2182","DOI":"10.1056\/NEJMc2031173","article-title":"N-of-1 Trial of a Statin, Placebo, or No Treatment to Assess Side Effects","volume":"383","author":"FA Wood","year":"2020","journal-title":"N Engl J Med"},{"issue":"4","key":"pone.0346509.ref018","doi-asserted-by":"crossref","first-page":"688","DOI":"10.1093\/eurpub\/ckab063","article-title":"Multicomponent intervention provided by GPs to reduce cardiovascular risk factors: evaluation in an Italian large sample","volume":"31","author":"A Colombo","year":"2021","journal-title":"Eur J Public Health"},{"key":"pone.0346509.ref019","doi-asserted-by":"crossref","first-page":"510339","DOI":"10.3389\/fphar.2020.510339","article-title":"Tailored Interventions to Improve Medication Adherence for Cardiovascular Diseases","volume":"11","author":"H-Y Xu","year":"2020","journal-title":"Front Pharmacol"},{"issue":"23","key":"pone.0346509.ref020","doi-asserted-by":"crossref","first-page":"2461","DOI":"10.1001\/jama.2018.19271","article-title":"Interventions to Improve Medication Adherence: A Review","volume":"320","author":"V Kini","year":"2018","journal-title":"JAMA"},{"key":"pone.0346509.ref021","volume-title":"Adherence to long-term therapies: evidence for action","author":"E Sabat\u00e9","year":"2003"},{"key":"pone.0346509.ref022","doi-asserted-by":"crossref","first-page":"103270","DOI":"10.1016\/j.eclinm.2025.103270","article-title":"Interventions to improve adherence to lipid-lowering drugs: a systematic review and meta-analysis","volume":"84","author":"DKW Yow","year":"2025","journal-title":"EClinicalMedicine"},{"issue":"11","key":"pone.0346509.ref023","article-title":"Mobile phone interventions to improve health outcomes among patients with chronic diseases: an umbrella review and evidence synthesis from 34 meta-analyses","volume":"6","author":"S Sun","year":"2024","journal-title":"Lancet Digit Health"},{"issue":"4","key":"pone.0346509.ref024","article-title":"Effectiveness of home-based cardiac rehabilitation interventions delivered via mHealth technologies: a systematic review and meta-analysis","volume":"7","author":"L Li","year":"2025","journal-title":"Lancet Digit Health"},{"issue":"1","key":"pone.0346509.ref025","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1007\/s10916-024-02135-2","article-title":"Effectiveness of Mobile Health Intervention in Medication Adherence: a Systematic Review and Meta-Analysis","volume":"49","author":"SK Kim","year":"2025","journal-title":"J Med Syst"},{"issue":"5","key":"pone.0346509.ref026","doi-asserted-by":"crossref","DOI":"10.2196\/24190","article-title":"Mobile Apps to Improve Medication Adherence in Cardiovascular Disease: Systematic Review and Meta-analysis","volume":"23","author":"S Al-Arkee","year":"2021","journal-title":"J Med Internet Res"},{"issue":"2","key":"pone.0346509.ref027","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1370\/afm.1768","article-title":"Health coaching by medical assistants to improve control of diabetes, hypertension, and hyperlipidemia in low-income patients: a randomized controlled trial","volume":"13","author":"R Willard-Grace","year":"2015","journal-title":"Ann Fam Med"},{"issue":"4","key":"pone.0346509.ref028","doi-asserted-by":"crossref","DOI":"10.2196\/35120","article-title":"Challenges in Participant Engagement and Retention Using Mobile Health Apps: Literature Review","volume":"24","author":"S Amagai","year":"2022","journal-title":"J Med Internet Res"},{"issue":"3","key":"pone.0346509.ref029","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1080\/14635240.2003.10806231","article-title":"Health coaching to facilitate the promotion of healthy behaviour and achievement of health-related goals","volume":"41","author":"S Palmer","year":"2003","journal-title":"Int J Health Promot Educ"},{"issue":"2","key":"pone.0346509.ref030","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/j.pec.2014.07.026","article-title":"The effects of health coaching on adult patients with chronic diseases: a systematic review","volume":"97","author":"K Kivel\u00e4","year":"2014","journal-title":"Patient Educ Couns"},{"issue":"4","key":"pone.0346509.ref031","doi-asserted-by":"crossref","first-page":"680","DOI":"10.1016\/j.pec.2020.10.026","article-title":"Combining mHealth and health-coaching for improving self-management in chronic care. A scoping review","volume":"104","author":"LF Obro","year":"2021","journal-title":"Patient Educ Couns"},{"key":"pone.0346509.ref032","doi-asserted-by":"crossref","first-page":"103593","DOI":"10.1016\/j.ebiom.2021.103593","article-title":"Outcomes of a smartphone-based application with live health-coaching post-percutaneous coronary intervention","volume":"72","author":"K Paruchuri","year":"2021","journal-title":"EBioMedicine"},{"issue":"1","key":"pone.0346509.ref033","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1186\/s12891-019-2454-y","article-title":"Integrating Mobile-health, health coaching, and physical activity to reduce the burden of chronic low back pain trial (IMPACT): a pilot randomised controlled trial","volume":"20","author":"AB Amorim","year":"2019","journal-title":"BMC Musculoskelet Disord"},{"issue":"10491","key":"pone.0346509.ref034","article-title":"SPIRIT 2025 statement: updated guideline for protocols of randomised trials","volume":"405","author":"AW Chan","year":"2025","journal-title":"Lancet"},{"issue":"1","key":"pone.0346509.ref035","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1007\/s12160-013-9486-6","article-title":"The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: building an international consensus for the reporting of behavior change interventions","volume":"46","author":"S Michie","year":"2013","journal-title":"Ann Behav Med"},{"issue":"1","key":"pone.0346509.ref036","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1177\/109019818401100101","article-title":"The Health Belief Model: a decade later","volume":"11","author":"NK Janz","year":"1984","journal-title":"Health Educ Q"},{"issue":"1","key":"pone.0346509.ref037","doi-asserted-by":"crossref","first-page":"38","DOI":"10.4278\/0890-1171-12.1.38","article-title":"The transtheoretical model of health behavior change","volume":"12","author":"JO Prochaska","year":"1997","journal-title":"Am J Health Promot"},{"key":"pone.0346509.ref038","author":"National Board for Health & Wellness Coaching"},{"key":"pone.0346509.ref039","author":"Centre for Professional and Continuing Education, Nanyang Technological University, Singapore"},{"issue":"1","key":"pone.0346509.ref040","doi-asserted-by":"crossref","DOI":"10.4278\/ajhp.090313-LIT-101","article-title":"Health coaching to improve healthy lifestyle behaviors: an integrative review","volume":"25","author":"JM Olsen","year":"2010","journal-title":"Am J Health Promot"},{"issue":"3","key":"pone.0346509.ref041","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1016\/j.sapharm.2018.04.012","article-title":"A systematic review of pharmacy health coaching and an evaluation of patient outcomes","volume":"15","author":"HK Singh","year":"2019","journal-title":"Res Social Adm Pharm"},{"key":"pone.0346509.ref042","unstructured":"Lim C, Hilal S, Ma S, Sim X, Shyong TE, Ying TY. Recalibrated Singapore-Modified framingham risk score 2023 (SG-FRS-2023)."},{"issue":"7","key":"pone.0346509.ref043","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1016\/j.jdiacomp.2018.04.009","article-title":"Motivation and attitudes toward changing health (MATCH): A new patient-reported measure to inform clinical conversations","volume":"32","author":"DM Hessler","year":"2018","journal-title":"J Diabetes Complications"},{"issue":"10","key":"pone.0346509.ref044","doi-asserted-by":"crossref","first-page":"1727","DOI":"10.1007\/s11136-011-9903-x","article-title":"Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L)","volume":"20","author":"M Herdman","year":"2011","journal-title":"Qual Life Res"},{"issue":"12","key":"pone.0346509.ref045","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.1097\/PHM.0000000000000298","article-title":"Correlates of a Single-Item Quality-of-Life Measure in People Aging with Disabilities","volume":"94","author":"HC Siebens","year":"2015","journal-title":"Am J Phys Med Rehabil"},{"issue":"1","key":"pone.0346509.ref046","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1207\/S15324796ABM2401_06","article-title":"Measuring spiritual well-being in people with cancer: the functional assessment of chronic illness therapy--Spiritual Well-being Scale (FACIT-Sp)","volume":"24","author":"AH Peterman","year":"2002","journal-title":"Ann Behav Med"},{"issue":"4","key":"pone.0346509.ref047","doi-asserted-by":"crossref","DOI":"10.2196\/11500","article-title":"The mHealth App Usability Questionnaire (MAUQ): Development and Validation Study","volume":"7","author":"L Zhou","year":"2019","journal-title":"JMIR Mhealth Uhealth"},{"key":"pone.0346509.ref048","first-page":"100861","article-title":"Healthier SG: Singapore\u2019s multi-year strategy to transform primary healthcare","volume":"37","author":"CD Foo","year":"2023","journal-title":"Lancet Reg Health West Pac"},{"issue":"9","key":"pone.0346509.ref049","doi-asserted-by":"crossref","first-page":"1490","DOI":"10.1097\/HJH.0000000000003793","article-title":"Effectiveness of digital health interventions on adherence and control of hypertension: a systematic review and meta-analysis","volume":"42","author":"HJ Yap","year":"2024","journal-title":"J Hypertens"},{"issue":"2","key":"pone.0346509.ref050","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1177\/1357633X231174933","article-title":"Effects of mobile apps intervention on medication adherence and type 2 diabetes mellitus control: a systematic review and meta-analysis","volume":"31","author":"CJ Chong","year":"2025","journal-title":"J Telemed Telecare"},{"issue":"6","key":"pone.0346509.ref051","doi-asserted-by":"crossref","DOI":"10.2196\/jmir.9275","article-title":"Beyond the Trial: Systematic Review of Real-World Uptake and Engagement With Digital Self-Help Interventions for Depression, Low Mood, or Anxiety","volume":"20","author":"T Fleming","year":"2018","journal-title":"J Med Internet Res"},{"issue":"9","key":"pone.0346509.ref052","doi-asserted-by":"crossref","DOI":"10.2196\/20283","article-title":"Rates of Attrition and Dropout in App-Based Interventions for Chronic Disease: Systematic Review and Meta-Analysis","volume":"22","author":"G Meyerowitz-Katz","year":"2020","journal-title":"J Med Internet Res"},{"issue":"5","key":"pone.0346509.ref053","doi-asserted-by":"crossref","DOI":"10.2196\/35371","article-title":"Factors Influencing Adherence to mHealth Apps for Prevention or Management of Noncommunicable Diseases: Systematic Review","volume":"24","author":"R Jakob","year":"2022","journal-title":"J Med Internet Res"},{"issue":"2","key":"pone.0346509.ref054","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.cvdhj.2021.01.003","article-title":"Why digital health trials can fail: Lessons learned from a randomized trial of health coaching and virtual cardiac rehabilitation","volume":"2","author":"CB Olivier","year":"2021","journal-title":"Cardiovasc Digit Health J"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0346509","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T17:24:34Z","timestamp":1778001874000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0346509"}},"subtitle":[],"editor":[{"given":"Jason","family":"Morgan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,5,5]]},"references-count":54,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,5,5]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0346509","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,5]]}}}