{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T14:56:58Z","timestamp":1788188218496,"version":"build-2803163510"},"reference-count":67,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T00:00:00Z","timestamp":1759881600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Reprod. Health"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The value of combining infertility research in the psychological and medical fields, i.e., by exploring psychological factors associated not only with emotional adjustment to infertility experiences but also with treatment outcomes, is well-recognized. However, research that bridges these fields\u2019 boundaries is still narrow, is featured by mixed evidence, and often lacks a valid theoretical framework to comprehensively explore and\/or identify the multiple psychological risk and protective factors associated with assisted reproductive technology (ART) treatment outcomes. Thus, there is a need for further research in this promising field of reproductive health to foster a high-quality standard of care for infertile couples.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>Based on the infertility-related stress model, this prospective study recruited a group of infertile women at the beginning of their infertility treatment (T1) to explore and identify the psychological variables (predictors and moderating and mediating variables) associated with their treatment outcome (Failure\/Success) at the 4-year follow-up (T2).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>At the beginning of their infertility treatments (T1, 2019), 120 women completed self-report measures that provided data on their background information (sociodemographic characteristics and type of diagnosis), infertility-related stressors, coping strategies, psychological health (State-Anxiety and depression), and the couple's dyadic adjustment. After 4\u2005years (T2, 2023), medical records were collected to provide data on their treatment outcome (failure or success), duration of infertility, and number of treatment cycles. The main, moderating, and mediating hypotheses were tested using correlational analyses, logistic regression analyses, and Hayes\u2019 PROCESS tool.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The couple's relationship concern stressor, the adoption of a positive attitude coping strategy, and a perceived couple's dyadic adjustment at T1 were significantly associated with treatment success at T2. Conversely, the social concern stressor, the adoption of an avoidant coping strategy, State-Anxiety, and depression at T1, along with a duration of infertility &amp;gt;3\u2005years and a number of treatment cycles &amp;gt;4 at T2, were significantly associated with treatment failure. Duration of infertility, number of treatment cycles, the couple's dyadic adjustment, and the positive attitude and avoiding coping strategies emerged as significant moderating variables. Depression was a significant mediator in the association between the social concern stressor and the treatment outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study\u2019s findings provide evidence on the key psychological dimensions that should be assessed and addressed within multidisciplinary counseling interventions to support ART-treated women effectively throughout their infertility path and reduce the risk of treatment failure.<\/jats:p><\/jats:sec>","DOI":"10.3389\/frph.2025.1665920","type":"journal-article","created":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T05:42:26Z","timestamp":1759902146000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Psychological predictors, moderators, and mediators of treatment outcome among ART-treated women: a prospective study"],"prefix":"10.3389","volume":"7","author":[{"given":"Maria Clelia","family":"Zurlo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Vallone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Francesca","family":"Cattaneo Della Volta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1833","DOI":"10.1007\/s00404-024-07444-y","article-title":"Global prevalence of major depressive disorder, generalized anxiety, stress, and depression among infertile women: a systematic review and meta-analysis","volume":"309","author":"Salari","year":"2024","journal-title":"Arch Gynecol Obstet"},{"key":"B2","doi-asserted-by":"publisher","first-page":"e70016","DOI":"10.1111\/jmft.70016","article-title":"Relevance of positive dyadic coping for couples undergoing assisted reproduction treatments: a systematic review","volume":"51","author":"Santamar\u00eda-Gutiez","year":"2025","journal-title":"J Marital Fam Ther"},{"key":"B3","doi-asserted-by":"publisher","first-page":"408","DOI":"10.1186\/s40359-024-01914-3","article-title":"The effect of supportive counseling on self-esteem of infertile women after in vitro fertilization (IVF) failure: a randomized controlled trial study","volume":"12","author":"Shafaghi","year":"2024","journal-title":"BMC Psychol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"hoaf001","DOI":"10.1093\/hropen\/hoaf001","article-title":"Now is the time to introduce new innovative assisted reproduction methods to implement accessible, affordable, and demonstrably successful advanced infertility services in resource-poor countries","volume":"2025","author":"Ombelet","year":"2025","journal-title":"Hum Reprod Open"},{"key":"B5","article-title":"Infertility","year":""},{"key":"B6","doi-asserted-by":"publisher","first-page":"110357","DOI":"10.1016\/j.jpsychores.2021.110357","article-title":"Trajectories and predictors of anxiety and depression amongst infertile women during their first IVF\/ICSI treatment cycle","volume":"142","author":"Li","year":"2021","journal-title":"J Psychosom Res"},{"key":"B7","doi-asserted-by":"publisher","first-page":"2027","DOI":"10.3389\/fpsyg.2020.02027","article-title":"Individual and relational well-being at the start of an ART treatment: a focus on partners\u2019 gender differences","volume":"11","author":"Molgora","year":"2020","journal-title":"Front Psychol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"662","DOI":"10.1007\/s10880-019-09653-z","article-title":"Infertility-related stress and psychological health outcomes in infertile couples undergoing medical treatments: testing a multi-dimensional model","volume":"27","author":"Zurlo","year":"2020","journal-title":"J Clin Psychol Med Settings"},{"key":"B9","doi-asserted-by":"publisher","first-page":"614887","DOI":"10.3389\/fpsyg.2020.614887","article-title":"Re-examining the role of coping strategies in the associations between infertility-related stress dimensions and state-anxiety: implications for clinical interventions with infertile couples","volume":"11","author":"Zurlo","year":"2020","journal-title":"Front Psychol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1147926","DOI":"10.3389\/fpsyg.2023.1147926","article-title":"Paths towards parenthood after repeated treatment failures: a comparative study on predictors of psychological health outcomes in infertile couples persisting in treatments or opting for adoption","volume":"14","author":"Zurlo","year":"2023","journal-title":"Front Psychol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"742","DOI":"10.1016\/j.fertnstert.2024.03.003","article-title":"Predictors of success after in vitro fertilization","volume":"121","author":"Shingshetty","year":"2024","journal-title":"Fertil Steril"},{"key":"B12","doi-asserted-by":"publisher","first-page":"e057132","DOI":"10.1136\/bmjopen-2021-057132","article-title":"Worldwide prevalence, risk factors and psychological impact of infertility among women: a systematic review and meta-analysis","volume":"12","author":"Hazlina","year":"2022","journal-title":"BMJ Open"},{"key":"B13","first-page":"344","article-title":"The integrated work between medicine and psychology with infertile couples at a public hospital in Rio de Janeiro\/Brazil","volume":"17","author":"Lopes","year":"2022","journal-title":"JBRA Assist Reprod"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1745","DOI":"10.1016\/j.fertnstert.2004.12.039","article-title":"Infertility-related stress in men and women predicts treatment outcome 1 year later","volume":"83","author":"Boivin","year":"2005","journal-title":"Fertil Steril"},{"key":"B15","doi-asserted-by":"publisher","first-page":"539","DOI":"10.18502\/ijrm.v20i7.11556","article-title":"The relationship between coping strategies and infertility self-efficacy with pregnancy outcomes of women undergoing in vitro fertilization: a prospective cohort study","volume":"20","author":"Mirzaasgari","year":"2022","journal-title":"Int J Reprod Biomed"},{"key":"B16","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1080\/14647273.2021.1957503","article-title":"Socioeconomic status and fertility treatment outcomes in high-income countries: a review of the current literature","volume":"26","author":"Imrie","year":"2023","journal-title":"Hum Fertil (Camb)"},{"key":"B17","doi-asserted-by":"publisher","first-page":"1185","DOI":"10.1111\/j.0001-6349.2005.00858.x","article-title":"In vitro fertilization in Sweden: maternal characteristics","volume":"84","author":"K\u00e4ll\u00e9n","year":"2005","journal-title":"Acta Obstet Gynecol Scand"},{"key":"B18","doi-asserted-by":"publisher","first-page":"3077","DOI":"10.1007\/s10815-021-02345-4","article-title":"Impact of maternal education level on live birth rate after in vitro fertilization in China: a retrospective cohort study","volume":"38","author":"Liu","year":"2021","journal-title":"J Assist Reprod Genet"},{"key":"B19","doi-asserted-by":"publisher","first-page":"2618","DOI":"10.1016\/j.fertnstert.2011.05.015","article-title":"Does a woman\u2019s Educational attainment influence in vitro fertilization outcomes?","volume":"95","author":"Mahalingaiah","year":"2011","journal-title":"Fertil Steril"},{"key":"B20","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1016\/j.fertnstert.2011.04.054","article-title":"Socioeconomic disparities in the use and success of fertility treatments: analysis of data from a prospective cohort in the United States","volume":"96","author":"Smith","year":"2011","journal-title":"Fertil Steril"},{"key":"B21","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1111\/ajo.12356","article-title":"The success rate of IVF has significantly improved over the last decade","volume":"55","author":"Wade","year":"2015","journal-title":"Aust N Z J Obstet Gynaecol"},{"key":"B22","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1080\/02646838.2015.1093613","article-title":"Stressful events and coping with infertility: factors determining pregnancy outcome among IVF couples in Jamaica","volume":"34","author":"Pottinger","year":"2016","journal-title":"J Reprod Infant Psychol"},{"key":"B23","doi-asserted-by":"publisher","first-page":"883","DOI":"10.1007\/s00404-018-5034-8","article-title":"Only women\u2019s age and the duration of infertility are the prognostic factors for the success rate of natural cycle IVF","volume":"299","author":"von Wolff","year":"2019","journal-title":"Arch Gynecol Obstet"},{"key":"B24","doi-asserted-by":"publisher","first-page":"179","DOI":"10.18502\/jfrh.v15i3.7136","article-title":"Estimation methods for infertility treatment success: comparison of four methods","volume":"15","author":"Zarinara","year":"2021","journal-title":"J Fam Reprod Health"},{"key":"B25","doi-asserted-by":"publisher","first-page":"1953","DOI":"10.1093\/humrep\/15.9.1953","article-title":"The prognostic power of the post-coital test for natural conception depends on duration of infertility","volume":"15","author":"Glazener","year":"2000","journal-title":"Hum Reprod"},{"key":"B26","doi-asserted-by":"publisher","first-page":"572","DOI":"10.1016\/j.rbmo.2014.01.002","article-title":"Cumulative success rates following mild IVF in unselected infertile patients: a 3-year, single-centre cohort study","volume":"28","author":"Bodri","year":"2014","journal-title":"Reprod Biomed Online"},{"key":"B27","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1056\/NEJMoa0803072","article-title":"Cumulative live-birth rates after in vitro fertilization","volume":"360","author":"Malizia","year":"2009","journal-title":"N Engl J Med"},{"key":"B28","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1016\/j.ejogrb.2016.09.017","article-title":"Effect of IVF failure on quality of life and emotional status in infertile couples","volume":"206","author":"Karaca","year":"2016","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"B29","doi-asserted-by":"publisher","first-page":"322","DOI":"10.1093\/humupd\/dmx001","article-title":"Long-term adjustment to unmet parenthood goals: systematic review of long-term adjustment after failed fertility treatment","volume":"23","author":"Gameiro","year":"2017","journal-title":"Hum Reprod Update"},{"key":"B30","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1186\/s12955-021-01666-3","article-title":"The analysis of fertility quality of life and the influencing factors of patients with repeated implantation failure","volume":"19","author":"Ni","year":"2021","journal-title":"Health Qual Life Outcomes"},{"key":"B31","doi-asserted-by":"publisher","first-page":"945","DOI":"10.1007\/s11136-017-1781-4","article-title":"Predictors of quality of life and psychological health in infertile couples: the moderating role of duration of infertility","volume":"27","author":"Zurlo","year":"2018","journal-title":"Qual Life Res"},{"key":"B32","doi-asserted-by":"publisher","first-page":"258","DOI":"10.1111\/aogs.13280","article-title":"A prospective investigation of perceived stress, infertility-related stress, and cortisol levels in women undergoing in vitro fertilization: influence on embryo quality and clinical pregnancy rate","volume":"97","author":"Cesta","year":"2018","journal-title":"Acta Obstet Gynecol Scand"},{"key":"B33","doi-asserted-by":"publisher","first-page":"714","DOI":"10.1016\/j.fertnstert.2006.11.158","article-title":"Perceived infertility-related stress correlates with in vitro fertilization outcome","volume":"88","author":"Cooper","year":"2007","journal-title":"Fertil Steril"},{"key":"B34","doi-asserted-by":"publisher","first-page":"475","DOI":"10.1111\/j.1542-2011.2011.00047.x","article-title":"Differences in women\u2019s psychological well-being based on infertility treatment choice and outcome","volume":"56","author":"McCarthy","year":"2011","journal-title":"J Midwifery Womens Health"},{"key":"B35","doi-asserted-by":"publisher","first-page":"S624","DOI":"10.1016\/j.eurpsy.2016.01.2342","article-title":"Women coping strategies to infertility stress can impact IVF outcome EV1357","volume":"33","author":"Kitanovic","year":"2016","journal-title":"Eur Psychiatry"},{"key":"B36","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1080\/02646838.2018.1560398","article-title":"Psychosocial predictors of IVF success after one year: a follow-up study","volume":"37","author":"McLaughlin","year":"2019","journal-title":"J Reprod Infant Psychol"},{"key":"B37","doi-asserted-by":"publisher","first-page":"1384","DOI":"10.1016\/j.fertnstert.2008.08.012","article-title":"\u201cLetting go\u201d coping is associated with successful IVF treatment outcome","volume":"92","author":"Rapoport-Hubschman","year":"2009","journal-title":"Fertil Steril"},{"key":"B38","doi-asserted-by":"publisher","first-page":"522","DOI":"10.2466\/PR0.105.2.522-532","article-title":"Alexithymia is positively associated with the outcome of in vitro fertilization (IVF) treatment","volume":"2","author":"Kakatsaki","year":"2009","journal-title":"Psychol Rep"},{"key":"B39","doi-asserted-by":"publisher","first-page":"718","DOI":"10.1080\/08870446.2019.1667500","article-title":"The effects of an expressive writing intervention on pregnancy rates, alexithymia and psychophysical health during an assisted reproductive treatment","volume":"35","author":"Renzi","year":"2020","journal-title":"Psychol Health"},{"key":"B40","doi-asserted-by":"publisher","first-page":"222","DOI":"10.1016\/j.apnr.2016.07.003","article-title":"Factors that influence in vitro fertilization treatment outcomes of Chinese men: a cross-sectional study","volume":"32","author":"Chen","year":"2016","journal-title":"Appl Nurs Res"},{"key":"B41","doi-asserted-by":"publisher","first-page":"2055102920933073","DOI":"10.1177\/2055102920933","article-title":"Success of assisted reproductive technology treatment and couple relationship: a pilot study on the role of romantic attachment","volume":"7","author":"Renzi","year":"2020","journal-title":"Health Psychol Open"},{"key":"B42","doi-asserted-by":"publisher","first-page":"e0242024","DOI":"10.1371\/journal.pone.0242024","article-title":"The effect of psychological distress on IVF outcomes: reality or speculations?","volume":"15","author":"Aimagambetova","year":"2020","journal-title":"PLoS One"},{"key":"B43","doi-asserted-by":"publisher","first-page":"937","DOI":"10.3390\/jcm10050937","article-title":"The effect of stress, anxiety and depression on in vitro fertilization outcome in Kazakhstani public clinical setting: a cross-sectional study","volume":"10","author":"Bapayeva","year":"2021","journal-title":"J Clin Med"},{"key":"B44","doi-asserted-by":"publisher","first-page":"e12832","DOI":"10.1111\/aji.12832","article-title":"Stress, anxiety, and depression of both partners in infertile couples are associated with cytokine levels and adverse IVF outcome","volume":"79","author":"Haimovici","year":"2018","journal-title":"Am J Reprod Immunol"},{"key":"B45","first-page":"55","article-title":"The influence of emotional distress on the outcome of in vitro fertilization (IVF) and\/or intracytoplasmic sperm injection (ICSI) treatment among infertile Turkish women","volume":"45","author":"Karlidere","year":"2008","journal-title":"Isr J Psychiatry Relat Sci"},{"key":"B46","doi-asserted-by":"publisher","first-page":"1092","DOI":"10.1093\/humrep\/dep093","article-title":"Anxiety and depression have no influence on the cancellation and pregnancy rates of a first IVF or ICSI treatment","volume":"24","author":"Lintsen","year":"2009","journal-title":"Hum Reprod"},{"key":"B47","doi-asserted-by":"publisher","first-page":"646","DOI":"10.1016\/j.rbmo.2018.03.010","article-title":"Depression and state anxiety scores during assisted reproductive treatment are associated with outcome: a meta-analysis","volume":"36","author":"Purewal","year":"2018","journal-title":"Reprod Biomed Online"},{"key":"B48","first-page":"89","article-title":"Effect of anxiety and depression on ART outcome","volume":"6","author":"Sohrabvand","year":"2008","journal-title":"Iran J Reprod Med"},{"key":"B49","doi-asserted-by":"publisher","first-page":"2055102917738657","DOI":"10.1177\/20551029177386","article-title":"Factor structure and psychometric properties of the Fertility Problem Inventory\u2013Short Form","volume":"4","author":"Zurlo","year":"2017","journal-title":"Health Psychol Open"},{"key":"B50","first-page":"27","article-title":"Coping Orientation to Problems Experienced-Nuova Versione Italiana (COPE-NVI): uno strumento per la misura degli stili di coping","volume":"14","author":"Sica","year":"2008","journal-title":"Psicoterapia Cogn Comportamentale"},{"key":"B51","doi-asserted-by":"publisher","first-page":"15","DOI":"10.2307\/350547","article-title":"Measuring dyadic adjustment: new scales for assessing the quality of marriage and similar dyads","volume":"38","author":"Spanier","year":"1976","journal-title":"J Marriage Fam"},{"key":"B52","first-page":"107","article-title":"La dyadic adjustment scale: una misura dell'adattamento di coppia","volume":"43","author":"Gentili","year":"2002","journal-title":"Minerva Psichiatr"},{"key":"B53","volume-title":"New Italian Version of the STAI-Form Y","author":"Pedrabissi","year":"1989"},{"key":"B54","volume-title":"Anxiety: Current Trends in Research","author":"Spielberger","year":"1972"},{"key":"B55","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1080\/02646839008403615","article-title":"Screening for depression during pregnancy with the Edinburgh Depression Scale (EDDS)","volume":"8","author":"Murray","year":"1990","journal-title":"J Reprod Infant Psychol"},{"key":"B56","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1016\/S0165-0327(98)00102-5","article-title":"The Edinburgh postnatal depression scale: validation for an Italian sample","volume":"53","author":"Benvenuti","year":"1999","journal-title":"J Affect Disord"},{"key":"B57","volume-title":"Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression-based Approach","author":"Hayes","year":"2017"},{"key":"B58","doi-asserted-by":"crossref","first-page":"13","DOI":"10.4135\/9781452272054.n2","article-title":"Contemporary approaches to assessing mediation in communication research","volume-title":"The Sage Sourcebook of Advanced Data Analysis Methods for Communication Research","author":"Preacher","year":"2008"},{"key":"B59","doi-asserted-by":"publisher","first-page":"290","DOI":"10.2307\/270723","article-title":"Asymptotic confidence intervals for indirect effects in structural equation models","volume":"1","author":"Sobel","year":"1982","journal-title":"Sociol Methodol"},{"key":"B60","doi-asserted-by":"publisher","first-page":"1918","DOI":"10.1177\/0956797613480187","article-title":"The relative trustworthiness of inferential tests of the indirect effect in statistical mediation analysis: does method really matter?","volume":"24","author":"Hayes","year":"2013","journal-title":"Psychol Sci"},{"key":"B61","doi-asserted-by":"publisher","first-page":"410","DOI":"10.17826\/cumj.456723","article-title":"Effects of infertility treatment on anxiety and depression levels","volume":"44","author":"Yassa","year":"2019","journal-title":"Cukurova Med J"},{"key":"B62","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1186\/s12884-024-06398-y","article-title":"The relationship between duration of infertility and clinical outcomes of intrauterine insemination for younger women: a retrospective clinical study","volume":"24","author":"Huang","year":"2024","journal-title":"BMC Pregnancy Childbirth"},{"key":"B63","doi-asserted-by":"publisher","first-page":"726","DOI":"10.3390\/ijms25020726","article-title":"Effect of stress on each of the stages of the IVF procedure: a systematic review","volume":"25","author":"Zanettoullis","year":"2024","journal-title":"Int J Mol Sci"},{"key":"B64","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1007\/BF01204110","article-title":"Motives for parenthood and response to failed in vitro fertilization: implications for counseling","volume":"9","author":"Newton","year":"1992","journal-title":"J Assist Reprod Genet"},{"key":"B65","doi-asserted-by":"publisher","first-page":"594","DOI":"10.1093\/humupd\/dmu010","article-title":"A systematic review of psychosocial factors associated with emotional adjustment in in vitro fertilization patients","volume":"20","author":"Rockliff","year":"2014","journal-title":"Hum Reprod Update"},{"key":"B66","doi-asserted-by":"publisher","first-page":"1548","DOI":"10.1186\/s12889-019-7925-4","article-title":"The association between stressful life events and perceived quality of life among women attending infertility treatments: the moderating role of coping strategies and perceived couple\u2019s dyadic adjustment","volume":"19","author":"Zurlo","year":"2019","journal-title":"BMC Public Health"},{"key":"B67","doi-asserted-by":"publisher","first-page":"00363","DOI":"10.15406\/jpcpy.2016.06.00363","article-title":"Distress and coping with in vitro fertilisation (IVF): the role of self-compassion, parenthood motivation and attachment","volume":"6","author":"Cassidy","year":"2016","journal-title":"J Psychol Clin Psychiatry"}],"container-title":["Frontiers in Reproductive Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/frph.2025.1665920\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T05:42:28Z","timestamp":1759902148000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/frph.2025.1665920\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,8]]},"references-count":67,"alternative-id":["10.3389\/frph.2025.1665920"],"URL":"https:\/\/doi.org\/10.3389\/frph.2025.1665920","relation":{},"ISSN":["2673-3153"],"issn-type":[{"value":"2673-3153","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,8]]},"article-number":"1665920"}}