{"id":"https://openalex.org/W7124533709","doi":"https://doi.org/10.31435/ijitss.1(49).2026.4594","title":"CHRONIC STRESS AS A MODULATOR OF THE IMMUNE SYSTEM: NEUROENDOCRINE MECHANISMS, IMMUNOLOGICAL PATHWAYS AND CLINICAL CONSEQUENCES - A LITERATURE REVIEW","display_name":"CHRONIC STRESS AS A MODULATOR OF THE IMMUNE SYSTEM: NEUROENDOCRINE MECHANISMS, IMMUNOLOGICAL PATHWAYS AND CLINICAL CONSEQUENCES - A LITERATURE REVIEW","publication_year":2026,"publication_date":"2026-01-16","ids":{"openalex":"https://openalex.org/W7124533709","doi":"https://doi.org/10.31435/ijitss.1(49).2026.4594"},"language":"en","primary_location":{"id":"doi:10.31435/ijitss.1(49).2026.4594","doi":"https://doi.org/10.31435/ijitss.1(49).2026.4594","is_oa":true,"landing_page_url":"https://doi.org/10.31435/ijitss.1(49).2026.4594","pdf_url":null,"source":{"id":"https://openalex.org/S4210206754","display_name":"International Journal of Innovative Technologies in Social Science","issn_l":"2544-9338","issn":["2544-9338","2544-9435"],"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":["erih-plus","poland-20"],"host_organization":"https://openalex.org/I4210100292","host_organization_name":"RS Global (Poland)","host_organization_lineage":["https://openalex.org/I4210100292"],"host_organization_lineage_names":[],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"International Journal of Innovative Technologies in Social Science","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://doi.org/10.31435/ijitss.1(49).2026.4594","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5123283108","display_name":"Martyna Susek","orcid":"https://orcid.org/0009-0006-7383-8121","observed_orcids":["https://orcid.org/0009-0006-7383-8121"]},"institutions":[{"id":"https://openalex.org/I4210166750","display_name":"Beskidzkie Centrum Onkologii Szpital Miejski im. Jana Pawla II w Bielsku-Bialej","ror":"https://ror.org/05fy44g10","country_code":"PL","type":"healthcare","lineage":["https://openalex.org/I4210166750"]}],"countries":["PL"],"is_corresponding":false,"raw_author_name":"Martyna Susek","raw_affiliation_strings":["Beskidzkie Centrum Onkologii, Municipal Hospital of John Paul II in Bielsko-Bia\u0142a, Bielsko-Bia\u0142a, Poland"],"raw_orcid":"https://orcid.org/0009-0006-7383-8121","affiliations":[{"raw_affiliation_string":"Beskidzkie Centrum Onkologii, Municipal Hospital of John Paul II in Bielsko-Bia\u0142a, Bielsko-Bia\u0142a, Poland","institution_ids":["https://openalex.org/I4210166750"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5123259231","display_name":"Amadeusz Furmanek","orcid":"https://orcid.org/0009-0003-6839-2207","observed_orcids":["https://orcid.org/0009-0003-6839-2207"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Amadeusz Furmanek","raw_affiliation_strings":["Provincial Hospital in Bielsko-Bia\u0142a, Bielsko-Bia\u0142a, Poland"],"raw_orcid":"https://orcid.org/0009-0003-6839-2207","affiliations":[{"raw_affiliation_string":"Provincial Hospital in Bielsko-Bia\u0142a, Bielsko-Bia\u0142a, Poland","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5123262794","display_name":"Anna Wawrzeczko","orcid":"https://orcid.org/0009-0000-0329-150X","observed_orcids":["https://orcid.org/0009-0000-0329-150X"]},"institutions":[{"id":"https://openalex.org/I4210166750","display_name":"Beskidzkie Centrum Onkologii Szpital Miejski im. Jana Pawla II w Bielsku-Bialej","ror":"https://ror.org/05fy44g10","country_code":"PL","type":"healthcare","lineage":["https://openalex.org/I4210166750"]}],"countries":["PL"],"is_corresponding":false,"raw_author_name":"Anna Wawrzeczko","raw_affiliation_strings":["Beskidzkie Centrum Onkologii, Municipal Hospital of John Paul II in Bielsko-Bia\u0142a, Bielsko-Bia\u0142a, Poland"],"raw_orcid":"https://orcid.org/0009-0000-0329-150X","affiliations":[{"raw_affiliation_string":"Beskidzkie Centrum Onkologii, Municipal Hospital of John Paul II in Bielsko-Bia\u0142a, Bielsko-Bia\u0142a, Poland","institution_ids":["https://openalex.org/I4210166750"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5139585128","display_name":"Maciej Krzysztof Jakubiec","orcid":"https://orcid.org/0009-0009-3408-3354","observed_orcids":["https://orcid.org/0009-0009-3408-3354"]},"institutions":[{"id":"https://openalex.org/I4210166750","display_name":"Beskidzkie Centrum Onkologii Szpital Miejski im. Jana Pawla II w Bielsku-Bialej","ror":"https://ror.org/05fy44g10","country_code":"PL","type":"healthcare","lineage":["https://openalex.org/I4210166750"]}],"countries":["PL"],"is_corresponding":false,"raw_author_name":"Maciej Jakubiec","raw_affiliation_strings":["Beskidzkie Centrum Onkologii, Municipal Hospital of John Paul II in Bielsko-Bia\u0142a, Bielsko-Bia\u0142a, Poland"],"raw_orcid":"https://orcid.org/0009-0009-3408-3354","affiliations":[{"raw_affiliation_string":"Beskidzkie Centrum Onkologii, Municipal Hospital of John Paul II in Bielsko-Bia\u0142a, Bielsko-Bia\u0142a, Poland","institution_ids":["https://openalex.org/I4210166750"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5106319023","display_name":"Mariusz Suchcicki","orcid":"https://orcid.org/0009-0008-6988-4664","observed_orcids":["https://orcid.org/0009-0008-6988-4664"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Mariusz Suchcicki","raw_affiliation_strings":["Clinical Hospital of the Ministry of the Interior and Administration with the Warmia\u2013Mazury Oncology Centre in Olsztyn, Olsztyn, Poland"],"raw_orcid":"https://orcid.org/0009-0008-6988-4664","affiliations":[{"raw_affiliation_string":"Clinical Hospital of the Ministry of the Interior and Administration with the Warmia\u2013Mazury Oncology Centre in Olsztyn, Olsztyn, Poland","institution_ids":[]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":{"value":100,"currency":"USD","value_usd":100},"apc_paid":{"value":100,"currency":"USD","value_usd":100},"fwci":0.0,"has_fulltext":true,"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":null,"issue":"1(49)","first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10529","display_name":"Stress Responses and Cortisol","score":0.9994999766349792,"subfield":{"id":"https://openalex.org/subfields/2802","display_name":"Behavioral Neuroscience"},"field":{"id":"https://openalex.org/fields/28","display_name":"Neuroscience"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}},"topics":[{"id":"https://openalex.org/T10529","display_name":"Stress Responses and Cortisol","score":0.9994999766349792,"subfield":{"id":"https://openalex.org/subfields/2802","display_name":"Behavioral Neuroscience"},"field":{"id":"https://openalex.org/fields/28","display_name":"Neuroscience"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}},{"id":"https://openalex.org/T12626","display_name":"Cancer, Stress, Anesthesia, and Immune Response","score":0.00019999999494757503,"subfield":{"id":"https://openalex.org/subfields/1306","display_name":"Cancer Research"},"field":{"id":"https://openalex.org/fields/13","display_name":"Biochemistry, Genetics and Molecular Biology"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}},{"id":"https://openalex.org/T12580","display_name":"Vagus Nerve Stimulation Research","score":0.0,"subfield":{"id":"https://openalex.org/subfields/2808","display_name":"Neurology"},"field":{"id":"https://openalex.org/fields/28","display_name":"Neuroscience"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/chronic-stress","display_name":"chronic stress","score":0.9990000128746033},{"id":"https://openalex.org/keywords/immune-system","display_name":"immune system","score":0.6819999814033508},{"id":"https://openalex.org/keywords/hypothalamic-pituitary-adrenal-axis","display_name":"hypothalamic-pituitary-adrenal axis","score":0.9760000109672546},{"id":"https://openalex.org/keywords/sympathetic-nervous-system","display_name":"sympathetic nervous system","score":0.9470000267028809},{"id":"https://openalex.org/keywords/glucocorticoid-resistance","display_name":"glucocorticoid resistance","score":0.9589999914169312},{"id":"https://openalex.org/keywords/cytokine-dysregulation","display_name":"cytokine imbalance","score":0.8830000162124634},{"id":"https://openalex.org/keywords/chronic-low-grade-inflammation","display_name":"low-grade inflammation","score":0.8930000066757202},{"id":"https://openalex.org/keywords/innate-immunity","display_name":"innate immunity","score":0.8029999732971191},{"id":"https://openalex.org/keywords/adaptive-immunity","display_name":"adaptive immunity","score":1.0},{"id":"https://openalex.org/keywords/vaccine-response","display_name":"vaccine response","score":0.6520000100135803},{"id":"https://openalex.org/keywords/autoimmune-disease","display_name":"autoimmune disease","score":0.5379999876022339},{"id":"https://openalex.org/keywords/stress-management-strategies","display_name":"stress management strategies","score":0.4020000100135803},{"id":"https://openalex.org/keywords/exercise","display_name":"physical activity","score":0.9649999737739563},{"id":"https://openalex.org/keywords/cognitive-behavioral-therapy","display_name":"cognitive behavioral therapy","score":0.9700000286102295},{"id":"https://openalex.org/keywords/sleep-hygiene","display_name":"sleep hygiene","score":0.9919999837875366}],"concepts":[{"id":"https://openalex.org/C8891405","wikidata":"https://www.wikidata.org/wiki/Q1059","display_name":"Immune system","level":2,"score":0.7954000234603882},{"id":"https://openalex.org/C203014093","wikidata":"https://www.wikidata.org/wiki/Q101929","display_name":"Immunology","level":1,"score":0.6829000115394592},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.6624000072479248},{"id":"https://openalex.org/C2778690821","wikidata":"https://www.wikidata.org/wiki/Q212354","display_name":"Cytokine","level":2,"score":0.573199987411499},{"id":"https://openalex.org/C2778654844","wikidata":"https://www.wikidata.org/wiki/Q3305232","display_name":"Chronic stress","level":2,"score":0.527899980545044},{"id":"https://openalex.org/C2776914184","wikidata":"https://www.wikidata.org/wiki/Q101991","display_name":"Inflammation","level":2,"score":0.5016999840736389},{"id":"https://openalex.org/C193419808","wikidata":"https://www.wikidata.org/wiki/Q1645075","display_name":"Acquired immune system","level":3,"score":0.45590001344680786},{"id":"https://openalex.org/C136449434","wikidata":"https://www.wikidata.org/wiki/Q428253","display_name":"Innate immune system","level":3,"score":0.45089998841285706},{"id":"https://openalex.org/C38042653","wikidata":"https://www.wikidata.org/wiki/Q1500332","display_name":"Psychoneuroimmunology","level":3,"score":0.4269999861717224},{"id":"https://openalex.org/C2779341262","wikidata":"https://www.wikidata.org/wiki/Q182581","display_name":"Immunity","level":3,"score":0.4212999939918518},{"id":"https://openalex.org/C169760540","wikidata":"https://www.wikidata.org/wiki/Q207011","display_name":"Neuroscience","level":1,"score":0.4187000095844269},{"id":"https://openalex.org/C60644358","wikidata":"https://www.wikidata.org/wiki/Q128570","display_name":"Bioinformatics","level":1,"score":0.4004000127315521},{"id":"https://openalex.org/C71315377","wikidata":"https://www.wikidata.org/wiki/Q11364","display_name":"Hormone","level":2,"score":0.3668000102043152},{"id":"https://openalex.org/C116834253","wikidata":"https://www.wikidata.org/wiki/Q2039217","display_name":"Identification (biology)","level":2,"score":0.35839998722076416},{"id":"https://openalex.org/C2776533406","wikidata":"https://www.wikidata.org/wiki/Q187215","display_name":"Sympathetic nervous system","level":3,"score":0.3537999987602234},{"id":"https://openalex.org/C89611455","wikidata":"https://www.wikidata.org/wiki/Q6804646","display_name":"Mechanism (biology)","level":2,"score":0.3458999991416931},{"id":"https://openalex.org/C137858568","wikidata":"https://www.wikidata.org/wiki/Q7239","display_name":"Organism","level":2,"score":0.3379000127315521},{"id":"https://openalex.org/C46699223","wikidata":"https://www.wikidata.org/wiki/Q11078","display_name":"Endocrine system","level":3,"score":0.32679998874664307},{"id":"https://openalex.org/C2779134260","wikidata":"https://www.wikidata.org/wiki/Q12136","display_name":"Disease","level":2,"score":0.31369999051094055},{"id":"https://openalex.org/C2987552334","wikidata":"https://www.wikidata.org/wiki/Q383126","display_name":"Chronic disease","level":2,"score":0.3109000027179718},{"id":"https://openalex.org/C2777372248","wikidata":"https://www.wikidata.org/wiki/Q171064","display_name":"Autonomic nervous system","level":4,"score":0.3066999912261963},{"id":"https://openalex.org/C78635009","wikidata":"https://www.wikidata.org/wiki/Q2109172","display_name":"Hygiene hypothesis","level":3,"score":0.2964000105857849},{"id":"https://openalex.org/C2778329153","wikidata":"https://www.wikidata.org/wiki/Q1364801","display_name":"Sleep deprivation","level":3,"score":0.26600000262260437},{"id":"https://openalex.org/C201934248","wikidata":"https://www.wikidata.org/wiki/Q2492999","display_name":"Neuroimmunology","level":3,"score":0.26510000228881836},{"id":"https://openalex.org/C2777863537","wikidata":"https://www.wikidata.org/wiki/Q357896","display_name":"Adjuvant","level":2,"score":0.2615000009536743},{"id":"https://openalex.org/C3017875465","wikidata":"https://www.wikidata.org/wiki/Q189146","display_name":"Cellular immunity","level":3,"score":0.2583000063896179},{"id":"https://openalex.org/C2780194698","wikidata":"https://www.wikidata.org/wiki/Q6005429","display_name":"Immune dysregulation","level":3,"score":0.25619998574256897},{"id":"https://openalex.org/C2779146795","wikidata":"https://www.wikidata.org/wiki/Q1369123","display_name":"Hypothalamic\u2013pituitary\u2013adrenal axis","level":3,"score":0.2533999979496002}],"mesh":[],"locations_count":3,"locations":[{"id":"doi:10.31435/ijitss.1(49).2026.4594","doi":"https://doi.org/10.31435/ijitss.1(49).2026.4594","is_oa":true,"landing_page_url":"https://doi.org/10.31435/ijitss.1(49).2026.4594","pdf_url":null,"source":{"id":"https://openalex.org/S4210206754","display_name":"International Journal of Innovative Technologies in Social Science","issn_l":"2544-9338","issn":["2544-9338","2544-9435"],"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":["erih-plus","poland-20"],"host_organization":"https://openalex.org/I4210100292","host_organization_name":"RS Global (Poland)","host_organization_lineage":["https://openalex.org/I4210100292"],"host_organization_lineage_names":[],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"International Journal of Innovative Technologies in Social Science","raw_type":"journal-article"},{"id":"pmh:oai:rspublisher.org:article/4594","doi":null,"is_oa":true,"landing_page_url":"https://rspublisher.org/index.php/ijitss/article/view/4594","pdf_url":"https://rspublisher.org/index.php/ijitss/article/download/4594/3688","source":{"id":"https://openalex.org/S4306402503","display_name":"RS Global journals (RS Global Sp. z O.O.)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I4210100292","host_organization_name":"RS Global (Poland)","host_organization_lineage":["https://openalex.org/I4210100292"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"2544-9338","raw_type":"info:eu-repo/semantics/article"},{"id":"pmh:oai:ojs2.rsglobal.pl:article/4594","doi":null,"is_oa":true,"landing_page_url":"https://rsglobal.pl/index.php/ijitss/article/view/4594","pdf_url":null,"source":{"id":"https://openalex.org/S4306402503","display_name":"RS Global journals (RS Global Sp. z O.O.)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I4210100292","host_organization_name":"RS Global (Poland)","host_organization_lineage":["https://openalex.org/I4210100292"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"2544-9338","raw_type":"info:eu-repo/semantics/article"}],"best_oa_location":{"id":"doi:10.31435/ijitss.1(49).2026.4594","doi":"https://doi.org/10.31435/ijitss.1(49).2026.4594","is_oa":true,"landing_page_url":"https://doi.org/10.31435/ijitss.1(49).2026.4594","pdf_url":null,"source":{"id":"https://openalex.org/S4210206754","display_name":"International Journal of Innovative Technologies in Social Science","issn_l":"2544-9338","issn":["2544-9338","2544-9435"],"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":["erih-plus","poland-20"],"host_organization":"https://openalex.org/I4210100292","host_organization_name":"RS Global (Poland)","host_organization_lineage":["https://openalex.org/I4210100292"],"host_organization_lineage_names":[],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"International Journal of Innovative Technologies in Social Science","raw_type":"journal-article"},"sustainable_development_goals":[{"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3","score":1.0}],"study_designs":[],"awards":[],"funders":[],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7124533709.pdf","grobid_xml":"https://content.openalex.org/works/W7124533709.grobid-xml"},"referenced_works_count":17,"referenced_works":["https://openalex.org/W1520207918","https://openalex.org/W2025845020","https://openalex.org/W2051045609","https://openalex.org/W2107337543","https://openalex.org/W2116205810","https://openalex.org/W2122626461","https://openalex.org/W2293546053","https://openalex.org/W2900790963","https://openalex.org/W4220915433","https://openalex.org/W4386068432","https://openalex.org/W4386154638","https://openalex.org/W4396596934","https://openalex.org/W4403637571","https://openalex.org/W4403749058","https://openalex.org/W4404361035","https://openalex.org/W4406422463","https://openalex.org/W4415085468"],"related_works":["https://openalex.org/W4403749058","https://openalex.org/W4405089361","https://openalex.org/W2017820677","https://openalex.org/W4415369846","https://openalex.org/W4411179528","https://openalex.org/W4406422463","https://openalex.org/W4212828252","https://openalex.org/W4413761677","https://openalex.org/W4205699318","https://openalex.org/W7160448673"],"abstract_inverted_index":{"Chronic":[0],"stress":[1,138],"is":[2,47,130],"a":[3,54],"significant":[4],"factor":[5],"influencing":[6],"human":[7],"immune":[8,38,164],"system":[9,22],"functioning.":[10],"Prolonged":[11],"activation":[12],"of":[13,56,77,143,207,213],"the":[14,19,50,75,140,211],"hypothalamic-pituitary-adrenal":[15],"(HPA)":[16],"axis":[17,114],"and":[18,26,49,72,82,98,104,107,122,126,139,169,176,210],"sympathetic":[20,117],"nervous":[21],"leads":[23],"to":[24,43,64,132,136,161],"hormonal":[25],"immunological":[27,99],"dysregulation":[28],"(Glaser":[29],"&":[30,34,86,181,193],"Kiecolt-Glaser,":[31],"2005;":[32],"Segerstrom":[33],"Miller,":[35,87],"2004).":[36],"Consequently,":[37],"cells":[39],"become":[40],"less":[41],"sensitive":[42],"glucocorticoids,":[44],"cytokine":[45,119],"balance":[46],"disrupted,":[48],"organism":[51],"remains":[52],"in":[53,124],"state":[55],"chronic":[57,78,137],"low-grade":[58],"inflammation.":[59],"These":[60],"changes":[61,123],"increase":[62],"susceptibility":[63],"infections,":[65],"delay":[66],"wound":[67],"healing,":[68],"weaken":[69],"vaccine":[70],"responses,":[71],"may":[73,199],"exacerbate":[74],"course":[76],"diseases,":[79],"including":[80,112],"autoimmune":[81],"inflammatory":[83],"disorders":[84],"(Segerstrom":[85],"2004;":[88],"Alotiby,":[89],"2024).":[90,155],"This":[91],"review":[92,157],"presents":[93],"current":[94],"data":[95],"from":[96],"clinical":[97,141,201],"studies":[100],"published":[101],"between":[102],"2000":[103],"2025.":[105],"Molecular":[106],"cellular":[108],"mechanisms":[109,198],"are":[110],"discussed,":[111],"HPA":[113],"dysfunction,":[115],"excessive":[116],"activity,":[118,173],"profile":[120],"alterations,":[121],"innate":[125],"adaptive":[127],"immunity.":[128],"Attention":[129],"given":[131],"populations":[133],"particularly":[134],"vulnerable":[135],"consequences":[142],"these":[144,197],"dysregulations":[145],"(Katz":[146],"et":[147,151,185,189],"al.,":[148,152,186,190],"2025;":[149],"Chan":[150],"2023;":[153],"Bolton,":[154],"The":[156],"also":[158],"considers":[159],"strategies":[160],"mitigate":[162],"stress-related":[163],"impairment,":[165],"such":[166],"as":[167],"mindfulness":[168],"meditation,":[170],"regular":[171],"physical":[172],"cognitive-behavioral":[174],"therapy,":[175],"sleep":[177],"hygiene":[178],"improvement":[179],"(Black":[180],"Slavich,":[182],"2016;":[183],"Creswell":[184],"2012;":[187],"Carlson":[188],"2007;":[191],"Nieman":[192],"Wentz,":[194],"2019).":[195],"Understanding":[196],"support":[200],"practice":[202],"by":[203],"enabling":[204],"better":[205],"identification":[206],"high-risk":[208],"patients":[209],"implementation":[212],"effective":[214],"interventions.":[215]},"counts_by_year":[],"updated_date":"2026-11-06T12:05:46.655746","created_date":"2026-01-19T00:00:00"}
