{"id":"https://openalex.org/W4415819563","doi":"https://doi.org/10.1016/j.mehy.2025.111810","title":"Subclinical mastitis during lactation: A modifiable risk factor for breast cancer?","display_name":"Subclinical mastitis during lactation: A modifiable risk factor for breast cancer?","publication_year":2025,"publication_date":"2025-11-03","ids":{"openalex":"https://openalex.org/W4415819563","doi":"https://doi.org/10.1016/j.mehy.2025.111810","pmid":"https://pubmed.ncbi.nlm.nih.gov/41404433","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/12704944"},"language":"en","primary_location":{"id":"doi:10.1016/j.mehy.2025.111810","doi":"https://doi.org/10.1016/j.mehy.2025.111810","is_oa":true,"landing_page_url":"https://doi.org/10.1016/j.mehy.2025.111810","pdf_url":null,"source":{"id":"https://openalex.org/S27514295","display_name":"Medical Hypotheses","issn_l":"0306-9877","issn":["0306-9877","1532-2777"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","jufo-1","ki-jl-1","norway-1","poland-40","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320990","host_organization_name":"Elsevier BV","host_organization_lineage":["https://openalex.org/P4310320990"],"host_organization_lineage_names":["Elsevier BV"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Medical Hypotheses","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","pubmed"],"open_access":{"is_oa":true,"oa_status":"hybrid","oa_url":"https://doi.org/10.1016/j.mehy.2025.111810","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5012333995","display_name":"Sallie S. Schneider","orcid":"https://orcid.org/0000-0003-0093-4308","observed_orcids":["https://orcid.org/0000-0003-0093-4308"]},"institutions":[{"id":"https://openalex.org/I1338449461","display_name":"Baystate Medical Center","ror":"https://ror.org/01q2nz307","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1338449461"]},{"id":"https://openalex.org/I4210123955","display_name":"Baystate Health","ror":"https://ror.org/02x011m46","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I4210123955"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Sallie S. Schneider","raw_affiliation_strings":["Pioneer Valley Life Sciences Institute, Baystate Medical Center, Springfield, MA 01199, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Pioneer Valley Life Sciences Institute, Baystate Medical Center, Springfield, MA 01199, USA","institution_ids":["https://openalex.org/I1338449461","https://openalex.org/I4210123955"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5015422526","display_name":"Brian T. Pentecost","orcid":"https://orcid.org/0000-0003-1539-6848","observed_orcids":["https://orcid.org/0000-0003-1539-6848"]},"institutions":[{"id":"https://openalex.org/I24603500","display_name":"University of Massachusetts Amherst","ror":"https://ror.org/0072zz521","country_code":"US","type":"education","lineage":["https://openalex.org/I24603500"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Brian T. Pentecost","raw_affiliation_strings":["Department of Veterinary and Animal Sciences, University of Massachusetts, 240 Thatcher Road, Amherst, MA 01003, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Veterinary and Animal Sciences, University of Massachusetts, 240 Thatcher Road, Amherst, MA 01003, USA","institution_ids":["https://openalex.org/I24603500"]}]},{"author_position":"middle","author":{"id":null,"display_name":"Ashley R. Banas","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I24603500","display_name":"University of Massachusetts Amherst","ror":"https://ror.org/0072zz521","country_code":"US","type":"education","lineage":["https://openalex.org/I24603500"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Ashley R. Banas","raw_affiliation_strings":["Animal Biotechnology and Biomedical Sciences Graduate Program, University of Massachusetts, Amherst MA 01003, USA","Department of Veterinary and Animal Sciences, University of Massachusetts, 240 Thatcher Road, Amherst, MA 01003, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Animal Biotechnology and Biomedical Sciences Graduate Program, University of Massachusetts, Amherst MA 01003, USA","institution_ids":["https://openalex.org/I24603500"]},{"raw_affiliation_string":"Department of Veterinary and Animal Sciences, University of Massachusetts, 240 Thatcher Road, Amherst, MA 01003, USA","institution_ids":["https://openalex.org/I24603500"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5120235139","display_name":"Aliyah Dalier","orcid":"https://orcid.org/0000-0001-9713-4264","observed_orcids":["https://orcid.org/0000-0001-9713-4264"]},"institutions":[{"id":"https://openalex.org/I24603500","display_name":"University of Massachusetts Amherst","ror":"https://ror.org/0072zz521","country_code":"US","type":"education","lineage":["https://openalex.org/I24603500"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Aliyah Dalier","raw_affiliation_strings":["Department of Veterinary and Animal Sciences, University of Massachusetts, 240 Thatcher Road, Amherst, MA 01003, USA","Molecular and Cellular Biology Program, University of Massachusetts, Amherst MA 01003, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Veterinary and Animal Sciences, University of Massachusetts, 240 Thatcher Road, Amherst, MA 01003, USA","institution_ids":["https://openalex.org/I24603500"]},{"raw_affiliation_string":"Molecular and Cellular Biology Program, University of Massachusetts, Amherst MA 01003, USA","institution_ids":["https://openalex.org/I24603500"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5036969800","display_name":"Vignesh Narayanaswamy","orcid":"https://orcid.org/0000-0002-8562-7659","observed_orcids":["https://orcid.org/0000-0002-8562-7659"]},"institutions":[{"id":"https://openalex.org/I24603500","display_name":"University of Massachusetts Amherst","ror":"https://ror.org/0072zz521","country_code":"US","type":"education","lineage":["https://openalex.org/I24603500"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Vignesh Narayanaswamy","raw_affiliation_strings":["Department of Veterinary and Animal Sciences, University of Massachusetts, 240 Thatcher Road, Amherst, MA 01003, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Veterinary and Animal Sciences, University of Massachusetts, 240 Thatcher Road, Amherst, MA 01003, USA","institution_ids":["https://openalex.org/I24603500"]}]},{"author_position":"middle","author":{"id":null,"display_name":"Emma C. Gotschlich","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I24603500","display_name":"University of Massachusetts Amherst","ror":"https://ror.org/0072zz521","country_code":"US","type":"education","lineage":["https://openalex.org/I24603500"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Emma C. Gotschlich","raw_affiliation_strings":["Animal Biotechnology and Biomedical Sciences Graduate Program, University of Massachusetts, Amherst MA 01003, USA","Department of Veterinary and Animal Sciences, University of Massachusetts, 240 Thatcher Road, Amherst, MA 01003, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Animal Biotechnology and Biomedical Sciences Graduate Program, University of Massachusetts, Amherst MA 01003, USA","institution_ids":["https://openalex.org/I24603500"]},{"raw_affiliation_string":"Department of Veterinary and Animal Sciences, University of Massachusetts, 240 Thatcher Road, Amherst, MA 01003, USA","institution_ids":["https://openalex.org/I24603500"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5056163853","display_name":"Kathleen F. Arcaro","orcid":"https://orcid.org/0000-0002-2035-4098","observed_orcids":["https://orcid.org/0000-0002-2035-4098"]},"institutions":[{"id":"https://openalex.org/I24603500","display_name":"University of Massachusetts Amherst","ror":"https://ror.org/0072zz521","country_code":"US","type":"education","lineage":["https://openalex.org/I24603500"]}],"countries":["US"],"is_corresponding":true,"raw_author_name":"Kathleen F. Arcaro","raw_affiliation_strings":["Department of Veterinary and Animal Sciences, University of Massachusetts, 240 Thatcher Road, Amherst, MA 01003, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Veterinary and Animal Sciences, University of Massachusetts, 240 Thatcher Road, Amherst, MA 01003, USA","institution_ids":["https://openalex.org/I24603500"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":3,"corresponding_author_ids":["https://openalex.org/A5056163853"],"corresponding_institution_ids":["https://openalex.org/I24603500"],"apc_list":{"value":2820,"currency":"USD","value_usd":2820},"apc_paid":{"value":2820,"currency":"USD","value_usd":2820},"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"205","issue":null,"first_page":"111810","last_page":"111810"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11134","display_name":"Breast Lesions and Carcinomas","score":0.5400000214576721,"subfield":{"id":"https://openalex.org/subfields/2734","display_name":"Pathology and Forensic Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11134","display_name":"Breast Lesions and Carcinomas","score":0.5400000214576721,"subfield":{"id":"https://openalex.org/subfields/2734","display_name":"Pathology and Forensic Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11226","display_name":"Milk Quality and Mastitis in Dairy Cows","score":0.3707999885082245,"subfield":{"id":"https://openalex.org/subfields/1103","display_name":"Animal Science and Zoology"},"field":{"id":"https://openalex.org/fields/11","display_name":"Agricultural and Biological Sciences"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}},{"id":"https://openalex.org/T12103","display_name":"Cancer Risks and Factors","score":0.05510000139474869,"subfield":{"id":"https://openalex.org/subfields/2730","display_name":"Oncology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/subclinical-mastitis","display_name":"subclinical mastitis","score":1.0},{"id":"https://openalex.org/keywords/breast-cancer-risk","display_name":"breast cancer risk","score":0.9110000133514404},{"id":"https://openalex.org/keywords/lactation","display_name":"lactation","score":0.8550000190734863},{"id":"https://openalex.org/keywords/chronic-inflammation","display_name":"chronic inflammation","score":0.9710000157356262},{"id":"https://openalex.org/keywords/clinical-mastitis","display_name":"clinical mastitis","score":0.8690000176429749},{"id":"https://openalex.org/keywords/genomic-instability","display_name":"genomic instability","score":0.8899999856948853},{"id":"https://openalex.org/keywords/epigenetic-mechanisms","display_name":"epigenetic mechanisms","score":0.8410000205039978}],"concepts":[{"id":"https://openalex.org/C113280763","wikidata":"https://www.wikidata.org/wiki/Q2326546","display_name":"Subclinical infection","level":2,"score":0.8804000020027161},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.777899980545044},{"id":"https://openalex.org/C530470458","wikidata":"https://www.wikidata.org/wiki/Q128581","display_name":"Breast cancer","level":3,"score":0.7764999866485596},{"id":"https://openalex.org/C2776344049","wikidata":"https://www.wikidata.org/wiki/Q835061","display_name":"Mastitis","level":2,"score":0.6572999954223633},{"id":"https://openalex.org/C50440223","wikidata":"https://www.wikidata.org/wiki/Q1475848","display_name":"Risk factor","level":2,"score":0.5928999781608582},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.42399999499320984},{"id":"https://openalex.org/C143998085","wikidata":"https://www.wikidata.org/wiki/Q162555","display_name":"Oncology","level":1,"score":0.39800000190734863},{"id":"https://openalex.org/C121608353","wikidata":"https://www.wikidata.org/wiki/Q12078","display_name":"Cancer","level":2,"score":0.3330000042915344},{"id":"https://openalex.org/C2776914184","wikidata":"https://www.wikidata.org/wiki/Q101991","display_name":"Inflammation","level":2,"score":0.3230000138282776},{"id":"https://openalex.org/C2776601875","wikidata":"https://www.wikidata.org/wiki/Q1833750","display_name":"Risk factors for breast cancer","level":4,"score":0.3122999966144562},{"id":"https://openalex.org/C2780839634","wikidata":"https://www.wikidata.org/wiki/Q5922406","display_name":"Inflammatory breast cancer","level":4,"score":0.30889999866485596},{"id":"https://openalex.org/C2778001805","wikidata":"https://www.wikidata.org/wiki/Q189961","display_name":"Mammary gland","level":4,"score":0.2957000136375427},{"id":"https://openalex.org/C203014093","wikidata":"https://www.wikidata.org/wiki/Q101929","display_name":"Immunology","level":1,"score":0.2816999852657318}],"mesh":[],"locations_count":3,"locations":[{"id":"doi:10.1016/j.mehy.2025.111810","doi":"https://doi.org/10.1016/j.mehy.2025.111810","is_oa":true,"landing_page_url":"https://doi.org/10.1016/j.mehy.2025.111810","pdf_url":null,"source":{"id":"https://openalex.org/S27514295","display_name":"Medical Hypotheses","issn_l":"0306-9877","issn":["0306-9877","1532-2777"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","jufo-1","ki-jl-1","norway-1","poland-40","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320990","host_organization_name":"Elsevier BV","host_organization_lineage":["https://openalex.org/P4310320990"],"host_organization_lineage_names":["Elsevier BV"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Medical Hypotheses","raw_type":"journal-article"},{"id":"pmid:41404433","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/41404433","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Medical hypotheses","raw_type":"Journal Article"},{"id":"pmh:oai:pubmedcentral.nih.gov:12704944","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12704944/","pdf_url":null,"source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"acceptedVersion","is_accepted":true,"is_published":false,"raw_source_name":"Med Hypotheses","raw_type":"Text"}],"best_oa_location":{"id":"doi:10.1016/j.mehy.2025.111810","doi":"https://doi.org/10.1016/j.mehy.2025.111810","is_oa":true,"landing_page_url":"https://doi.org/10.1016/j.mehy.2025.111810","pdf_url":null,"source":{"id":"https://openalex.org/S27514295","display_name":"Medical Hypotheses","issn_l":"0306-9877","issn":["0306-9877","1532-2777"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","jufo-1","ki-jl-1","norway-1","poland-40","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320990","host_organization_name":"Elsevier BV","host_organization_lineage":["https://openalex.org/P4310320990"],"host_organization_lineage_names":["Elsevier BV"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Medical Hypotheses","raw_type":"journal-article"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","score":1.0,"display_name":"Good health and well-being"}],"study_designs":[],"awards":[{"id":"https://openalex.org/G3488869543","display_name":null,"funder_award_id":"R01HD11120","funder_id":"https://openalex.org/F4320337611","funder_display_name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development"},{"id":"https://openalex.org/G9000891845","display_name":"Mammary Epithelium Permeability, Lactation Outcomes, and Infant Health","funder_award_id":"R01HD111200","funder_id":"https://openalex.org/F4320337611","funder_display_name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development"}],"funders":[{"id":"https://openalex.org/F4320337364","display_name":"National Institute of Child Health and Human Development","ror":"https://ror.org/04byxyr05"},{"id":"https://openalex.org/F4320337611","display_name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","ror":"https://ror.org/04byxyr05"}],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":57,"referenced_works":["https://openalex.org/W152821195","https://openalex.org/W176198751","https://openalex.org/W1498921062","https://openalex.org/W1757383019","https://openalex.org/W1969887827","https://openalex.org/W1987699028","https://openalex.org/W2007043238","https://openalex.org/W2013558463","https://openalex.org/W2031633408","https://openalex.org/W2034621130","https://openalex.org/W2038302380","https://openalex.org/W2039299469","https://openalex.org/W2049521319","https://openalex.org/W2063114651","https://openalex.org/W2086564214","https://openalex.org/W2123105952","https://openalex.org/W2127225003","https://openalex.org/W2128624246","https://openalex.org/W2197135019","https://openalex.org/W2530667653","https://openalex.org/W2548158791","https://openalex.org/W2593439292","https://openalex.org/W2757570095","https://openalex.org/W2769082168","https://openalex.org/W2770851450","https://openalex.org/W2898596469","https://openalex.org/W2902950838","https://openalex.org/W2951770754","https://openalex.org/W2959497269","https://openalex.org/W2963141093","https://openalex.org/W2982369606","https://openalex.org/W2987494339","https://openalex.org/W2996776723","https://openalex.org/W3016073414","https://openalex.org/W3025504019","https://openalex.org/W3040325124","https://openalex.org/W3045331682","https://openalex.org/W3045876436","https://openalex.org/W3133159619","https://openalex.org/W3189199920","https://openalex.org/W3191720683","https://openalex.org/W4205328642","https://openalex.org/W4214936696","https://openalex.org/W4280511871","https://openalex.org/W4289884455","https://openalex.org/W4297186127","https://openalex.org/W4297259793","https://openalex.org/W4308517764","https://openalex.org/W4376106555","https://openalex.org/W4379741093","https://openalex.org/W4386465857","https://openalex.org/W4391784771","https://openalex.org/W4401913870","https://openalex.org/W4406543078","https://openalex.org/W4407445224","https://openalex.org/W4407870211","https://openalex.org/W4408884901"],"related_works":["https://openalex.org/W3040325124","https://openalex.org/W2049521319","https://openalex.org/W7153755692","https://openalex.org/W2982369606","https://openalex.org/W2038401127","https://openalex.org/W4312095446","https://openalex.org/W1436617570","https://openalex.org/W2316530266","https://openalex.org/W2038302380","https://openalex.org/W3045331682"],"abstract_inverted_index":{"\u2022":[0,10,27,44],"Chronic":[1,45,65],"inflammation":[2,66],"is":[3,13,159,173,210],"a":[4,14,38,174],"risk":[5,61,102,176],"factor":[6,177],"for":[7,24,104,165,178],"many":[8],"cancers.":[9],"Subclinical":[11],"mastitis":[12,31,47,91,108,131,158,172,209],"non-symptomatic":[15],"inflammatory":[16,81,113,184],"condition":[17],"of":[18,40,62,80,115,146],"breast":[19,63,70,84,105,117,179,187,213],"tissue":[20,188],"that":[21,118,156,170,207],"may":[22,138,189],"persist":[23,164],"long":[25],"periods.":[26,167],"During":[28],"lactation,":[29],"subclinical":[30,46,93,130,157,171,183,208],"can":[32,50,163],"be":[33,51,123],"identified":[34],"by":[35],"sodium":[36,147],"levels,":[37],"marker":[39],"mammary":[41],"epithelium":[42],"permeability.":[43],"during":[48],"lactation":[49],"easily":[52],"detected":[53],"in":[54,83,119,134,151,186],"milk":[55],"and":[56,92,126,137,149,162,193],"treated":[57,125],"to":[58,69,87,98,198,203],"reduce":[59],"the":[60,116,144,205],"cancer.":[64,106,180,199],"likely":[67],"contributes":[68],"cancer":[71,214],"risk,":[72],"but":[73],"epidemiologic":[74],"studies":[75,202],"are":[76],"inconclusive.":[77],"Two":[78],"types":[79],"episodes":[82],"tissue,":[85],"referred":[86],"here":[88],"as":[89,101],"clinical":[90],"mastitis,":[94],"have":[95],"received":[96],"little":[97],"no":[99],"attention":[100],"factors":[103],"Clinical":[107],"represents":[109],"an":[110],"acute":[111],"painful":[112],"state":[114],"most":[120,135],"cases":[121,136],"will":[122],"quickly":[124],"resolved.":[127],"In":[128],"contrast,":[129],"remains":[132],"undetected":[133],"represent":[139],"chronic":[140,182],"inflammation.":[141],"Based":[142],"on":[143],"concentration":[145],"(Na)":[148],"cytokines":[150],"milk,":[152],"several":[153],"publications":[154],"suggest":[155,201],"relatively":[160],"common":[161],"extended":[166],"We":[168,200],"propose":[169],"modifiable":[175],"This":[181],"profile":[185],"cause":[190],"genetic":[191],"instability":[192],"perturb":[194],"epigenetic":[195],"mechanisms":[196],"leading":[197],"determine":[204],"extent":[206],"associated":[211],"with":[212],"risk.":[215]},"counts_by_year":[],"updated_date":"2026-11-10T11:39:43.021295","created_date":"2025-11-03T00:00:00"}
