{"id":"https://openalex.org/W7204452756","doi":"https://doi.org/10.48550/arxiv.2608.25236","title":"Rare Diseases, Common Dilemmas: LLMs Prioritize Equal Resource Distribution over Patient Benefit in Decision-Making","display_name":"Rare Diseases, Common Dilemmas: LLMs Prioritize Equal Resource Distribution over Patient Benefit in Decision-Making","publication_year":2026,"publication_date":"2026-08-25","ids":{"openalex":"https://openalex.org/W7204452756","doi":"https://doi.org/10.48550/arxiv.2608.25236"},"language":"en","primary_location":{"id":"pmh:oai:arXiv.org:2608.25236","doi":null,"is_oa":true,"landing_page_url":"https://arxiv.org/abs/2608.25236","pdf_url":"https://arxiv.org/pdf/2608.25236","source":{"id":"https://openalex.org/S4306400194","display_name":"arXiv (Cornell University)","issn_l":"2331-8422","issn":["2331-8422"],"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I205783295","host_organization_name":"Cornell University","host_organization_lineage":["https://openalex.org/I205783295"],"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":null,"raw_type":"text"},"volume":null,"type":"preprint","is_traditional":true,"indexed_in":["arxiv","datacite"],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://arxiv.org/pdf/2608.25236","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5076546551","display_name":"Minda Zhao","orcid":"https://orcid.org/0000-0002-8736-272X","observed_orcids":["https://orcid.org/0000-0002-8736-272X"]},"institutions":[{"id":"https://openalex.org/I136199984","display_name":"Harvard University","ror":"https://ror.org/03vek6s52","country_code":"US","type":"education","lineage":["https://openalex.org/I136199984"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Zhao, Minda","raw_affiliation_strings":["Department of Biostatistics , Harvard T.H. Chan School of Public Health , Boston , MA , USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Biostatistics , Harvard T.H. Chan School of Public Health , Boston , MA , USA","institution_ids":["https://openalex.org/I136199984"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5148434090","display_name":"Xu Han","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I136199984","display_name":"Harvard University","ror":"https://ror.org/03vek6s52","country_code":"US","type":"education","lineage":["https://openalex.org/I136199984"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Han, Xu","raw_affiliation_strings":["Department of Biostatistics , Harvard T.H. Chan School of Public Health , Boston , MA , USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Biostatistics , Harvard T.H. Chan School of Public Health , Boston , MA , USA","institution_ids":["https://openalex.org/I136199984"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5148424074","display_name":"Rishabh Goel","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I136199984","display_name":"Harvard University","ror":"https://ror.org/03vek6s52","country_code":"US","type":"education","lineage":["https://openalex.org/I136199984"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Goel, Rishabh","raw_affiliation_strings":["Department of Biomedical Informatics , Harvard Medical School , Boston , MA , USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Biomedical Informatics , Harvard Medical School , Boston , MA , USA","institution_ids":["https://openalex.org/I136199984"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5006871211","display_name":"Maya Dagan","orcid":"https://orcid.org/0000-0002-4192-7158","observed_orcids":["https://orcid.org/0000-0002-4192-7158"]},"institutions":[{"id":"https://openalex.org/I64767286","display_name":"Clalit Health Services","ror":"https://ror.org/04zjvnp94","country_code":"IL","type":"healthcare","lineage":["https://openalex.org/I64767286"]}],"countries":["IL"],"is_corresponding":false,"raw_author_name":"Dagan, Maya","raw_affiliation_strings":["Clalit Health Services , Tel Aviv , Israel"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Clalit Health Services , Tel Aviv , Israel","institution_ids":["https://openalex.org/I64767286"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5057364990","display_name":"Noa Dagan","orcid":"https://orcid.org/0000-0001-8811-7825","observed_orcids":["https://orcid.org/0000-0001-8811-7825","https://orcid.org/0009-0009-0378-545X"]},"institutions":[{"id":"https://openalex.org/I64767286","display_name":"Clalit Health Services","ror":"https://ror.org/04zjvnp94","country_code":"IL","type":"healthcare","lineage":["https://openalex.org/I64767286"]}],"countries":["IL"],"is_corresponding":false,"raw_author_name":"Dagan, Noa","raw_affiliation_strings":["Clalit Health Services , Tel Aviv , Israel"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Clalit Health Services , Tel Aviv , Israel","institution_ids":["https://openalex.org/I64767286"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5144349105","display_name":"Adithya V. Madduri","orcid":"https://orcid.org/0000-0002-2656-6331","observed_orcids":["https://orcid.org/0000-0002-2656-6331"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Madduri, Adithya","raw_affiliation_strings":["Harvard College , Cambridge , MA , USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Harvard College , Cambridge , MA , USA","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5037842761","display_name":"Payal Chandak","orcid":"https://orcid.org/0000-0003-1097-803X","observed_orcids":["https://orcid.org/0000-0003-1097-803X"]},"institutions":[{"id":"https://openalex.org/I136199984","display_name":"Harvard University","ror":"https://ror.org/03vek6s52","country_code":"US","type":"education","lineage":["https://openalex.org/I136199984"]},{"id":"https://openalex.org/I4210092658","display_name":"Harvard\u2013MIT Division of Health Sciences and Technology","ror":"https://ror.org/00jjeh629","country_code":"US","type":"education","lineage":["https://openalex.org/I4210092658"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Chandak, Payal","raw_affiliation_strings":["Department of Biomedical Informatics , Harvard Medical School , Boston , MA , USA","Harvard-MIT Program in Health Sciences and Technology , Cambridge , MA 02139 , USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Biomedical Informatics , Harvard Medical School , Boston , MA , USA","institution_ids":["https://openalex.org/I136199984"]},{"raw_affiliation_string":"Harvard-MIT Program in Health Sciences and Technology , Cambridge , MA 02139 , USA","institution_ids":["https://openalex.org/I4210092658"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5084028768","display_name":"Shilpa N. Kobren","orcid":"https://orcid.org/0000-0003-1264-6098","observed_orcids":["https://orcid.org/0000-0003-1264-6098"]},"institutions":[{"id":"https://openalex.org/I136199984","display_name":"Harvard University","ror":"https://ror.org/03vek6s52","country_code":"US","type":"education","lineage":["https://openalex.org/I136199984"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Kobren, Shilpa Nadimpalli","raw_affiliation_strings":["Department of Biomedical Informatics , Harvard Medical School , Boston , MA , USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Biomedical Informatics , Harvard Medical School , Boston , MA , USA","institution_ids":["https://openalex.org/I136199984"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5088509061","display_name":"Isaac S. Kohane","orcid":"https://orcid.org/0000-0003-2192-5160","observed_orcids":["https://orcid.org/0000-0003-2192-5160"]},"institutions":[{"id":"https://openalex.org/I136199984","display_name":"Harvard University","ror":"https://ror.org/03vek6s52","country_code":"US","type":"education","lineage":["https://openalex.org/I136199984"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Kohane, Isaac S.","raw_affiliation_strings":["Department of Biomedical Informatics , Harvard Medical School , Boston , MA , USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Biomedical Informatics , Harvard Medical School , Boston , MA , USA","institution_ids":["https://openalex.org/I136199984"]}]}],"institutions":[],"countries_distinct_count":2,"institutions_distinct_count":3,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":null,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11636","display_name":"Artificial Intelligence in Healthcare and Education","score":0.9932000041007996,"subfield":{"id":"https://openalex.org/subfields/2718","display_name":"Health Informatics"},"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/T11636","display_name":"Artificial Intelligence in Healthcare and Education","score":0.9932000041007996,"subfield":{"id":"https://openalex.org/subfields/2718","display_name":"Health Informatics"},"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/T10883","display_name":"Ethics and Social Impacts of AI","score":0.00430000014603138,"subfield":{"id":"https://openalex.org/subfields/1702","display_name":"Artificial Intelligence"},"field":{"id":"https://openalex.org/fields/17","display_name":"Computer Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}},{"id":"https://openalex.org/T13147","display_name":"Ethics and bioethics in healthcare","score":0.001500000013038516,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"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/large-language-models","display_name":"large language models","score":0.8930000066757202},{"id":"https://openalex.org/keywords/rare-diseases","display_name":"rare diseases","score":0.7639999985694885},{"id":"https://openalex.org/keywords/clinical-decision-making","display_name":"clinical decision-making","score":0.8130000233650208},{"id":"https://openalex.org/keywords/bioethical-principles","display_name":"bioethical principles","score":0.75},{"id":"https://openalex.org/keywords/justice","display_name":"justice","score":0.9259999990463257},{"id":"https://openalex.org/keywords/beneficence","display_name":"beneficence","score":0.8870000243186951},{"id":"https://openalex.org/keywords/patient-autonomy","display_name":"patient autonomy","score":0.7680000066757202},{"id":"https://openalex.org/keywords/nonmaleficence","display_name":"non-maleficence","score":0.9599999785423279},{"id":"https://openalex.org/keywords/ethical-conflicts","display_name":"ethical conflicts","score":0.5220000147819519},{"id":"https://openalex.org/keywords/clinical-vignettes","display_name":"clinical vignettes","score":0.6430000066757202},{"id":"https://openalex.org/keywords/decision-support-system","display_name":"decision support system","score":0.6499999761581421},{"id":"https://openalex.org/keywords/health-care-resource-allocation","display_name":"healthcare resource allocation","score":0.4790000021457672}],"concepts":[{"id":"https://openalex.org/C65414064","wikidata":"https://www.wikidata.org/wiki/Q484105","display_name":"Autonomy","level":2,"score":0.6668999791145325},{"id":"https://openalex.org/C117438556","wikidata":"https://www.wikidata.org/wiki/Q4887413","display_name":"Beneficence","level":3,"score":0.6290000081062317},{"id":"https://openalex.org/C139621336","wikidata":"https://www.wikidata.org/wiki/Q3190382","display_name":"Economic Justice","level":2,"score":0.5964999794960022},{"id":"https://openalex.org/C29202148","wikidata":"https://www.wikidata.org/wiki/Q287260","display_name":"Resource allocation","level":2,"score":0.5159000158309937},{"id":"https://openalex.org/C9114305","wikidata":"https://www.wikidata.org/wiki/Q1428317","display_name":"Situational ethics","level":2,"score":0.5066999793052673},{"id":"https://openalex.org/C206345919","wikidata":"https://www.wikidata.org/wiki/Q20380951","display_name":"Resource (disambiguation)","level":2,"score":0.5027999877929688},{"id":"https://openalex.org/C188084074","wikidata":"https://www.wikidata.org/wiki/Q194294","display_name":"Bioethics","level":2,"score":0.47369998693466187},{"id":"https://openalex.org/C2779134260","wikidata":"https://www.wikidata.org/wiki/Q12136","display_name":"Disease","level":2,"score":0.4471000134944916},{"id":"https://openalex.org/C18762648","wikidata":"https://www.wikidata.org/wiki/Q42213","display_name":"Work (physics)","level":2,"score":0.43630000948905945},{"id":"https://openalex.org/C15744967","wikidata":"https://www.wikidata.org/wiki/Q9418","display_name":"Psychology","level":0,"score":0.4320000112056732},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.4244999885559082},{"id":"https://openalex.org/C2776414048","wikidata":"https://www.wikidata.org/wiki/Q5690891","display_name":"Health care rationing","level":3,"score":0.4081999957561493},{"id":"https://openalex.org/C162118730","wikidata":"https://www.wikidata.org/wiki/Q1128453","display_name":"Actuarial science","level":1,"score":0.39309999346733093},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.3619000017642975},{"id":"https://openalex.org/C2777890144","wikidata":"https://www.wikidata.org/wiki/Q7315879","display_name":"Respect for persons","level":4,"score":0.3571000099182129},{"id":"https://openalex.org/C100001284","wikidata":"https://www.wikidata.org/wiki/Q2248246","display_name":"Public economics","level":1,"score":0.34929999709129333},{"id":"https://openalex.org/C2781175729","wikidata":"https://www.wikidata.org/wiki/Q7315823","display_name":"Resource distribution","level":3,"score":0.34869998693466187},{"id":"https://openalex.org/C144133560","wikidata":"https://www.wikidata.org/wiki/Q4830453","display_name":"Business","level":0,"score":0.3379000127315521},{"id":"https://openalex.org/C77805123","wikidata":"https://www.wikidata.org/wiki/Q161272","display_name":"Social psychology","level":1,"score":0.32690000534057617},{"id":"https://openalex.org/C2780129364","wikidata":"https://www.wikidata.org/wiki/Q552284","display_name":"Distributive justice","level":3,"score":0.3073999881744385},{"id":"https://openalex.org/C127454912","wikidata":"https://www.wikidata.org/wiki/Q942582","display_name":"Cost\u2013benefit analysis","level":2,"score":0.30649998784065247},{"id":"https://openalex.org/C110121322","wikidata":"https://www.wikidata.org/wiki/Q865811","display_name":"Distribution (mathematics)","level":2,"score":0.29269999265670776},{"id":"https://openalex.org/C39549134","wikidata":"https://www.wikidata.org/wiki/Q133080","display_name":"Public relations","level":1,"score":0.27889999747276306},{"id":"https://openalex.org/C2779701055","wikidata":"https://www.wikidata.org/wiki/Q929833","display_name":"Rare disease","level":3,"score":0.2786000072956085},{"id":"https://openalex.org/C2781118332","wikidata":"https://www.wikidata.org/wiki/Q430460","display_name":"Capability approach","level":2,"score":0.27480000257492065},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.26930001378059387},{"id":"https://openalex.org/C112930515","wikidata":"https://www.wikidata.org/wiki/Q4389547","display_name":"Risk analysis (engineering)","level":1,"score":0.2632000148296356},{"id":"https://openalex.org/C68122502","wikidata":"https://www.wikidata.org/wiki/Q764527","display_name":"Informed consent","level":3,"score":0.26179999113082886},{"id":"https://openalex.org/C59594135","wikidata":"https://www.wikidata.org/wiki/Q5249242","display_name":"Decision model","level":2,"score":0.2567000091075897}],"mesh":[],"locations_count":2,"locations":[{"id":"pmh:oai:arXiv.org:2608.25236","doi":null,"is_oa":true,"landing_page_url":"https://arxiv.org/abs/2608.25236","pdf_url":"https://arxiv.org/pdf/2608.25236","source":{"id":"https://openalex.org/S4306400194","display_name":"arXiv (Cornell University)","issn_l":"2331-8422","issn":["2331-8422"],"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I205783295","host_organization_name":"Cornell University","host_organization_lineage":["https://openalex.org/I205783295"],"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":null,"raw_type":"text"},{"id":"doi:10.48550/arxiv.2608.25236","doi":"https://doi.org/10.48550/arxiv.2608.25236","is_oa":true,"landing_page_url":"https://doi.org/10.48550/arxiv.2608.25236","pdf_url":null,"source":{"id":"https://openalex.org/S4306400194","display_name":"arXiv (Cornell University)","issn_l":"2331-8422","issn":["2331-8422"],"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I205783295","host_organization_name":"Cornell University","host_organization_lineage":["https://openalex.org/I205783295"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":null,"is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"Preprint"}],"best_oa_location":{"id":"pmh:oai:arXiv.org:2608.25236","doi":null,"is_oa":true,"landing_page_url":"https://arxiv.org/abs/2608.25236","pdf_url":"https://arxiv.org/pdf/2608.25236","source":{"id":"https://openalex.org/S4306400194","display_name":"arXiv (Cornell University)","issn_l":"2331-8422","issn":["2331-8422"],"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I205783295","host_organization_name":"Cornell University","host_organization_lineage":["https://openalex.org/I205783295"],"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":null,"raw_type":"text"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being","score":0.428600013256073},{"id":"https://metadata.un.org/sdg/10","display_name":"Reduced inequalities","score":0.4000000059604645}],"study_designs":[],"awards":[],"funders":[],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7204452756.pdf","grobid_xml":"https://content.openalex.org/works/W7204452756.grobid-xml"},"referenced_works_count":7,"referenced_works":["https://openalex.org/W4360891289","https://openalex.org/W4401306886","https://openalex.org/W4405903187","https://openalex.org/W6947991961","https://openalex.org/W6948369276","https://openalex.org/W7119523234","https://openalex.org/W7125099347"],"related_works":["https://openalex.org/W7166890109","https://openalex.org/W7201889733","https://openalex.org/W4413104119","https://openalex.org/W7162141491","https://openalex.org/W4402642451","https://openalex.org/W4409018247","https://openalex.org/W7131649944","https://openalex.org/W4392308586","https://openalex.org/W4414888078","https://openalex.org/W4414137684"],"abstract_inverted_index":{"Clinical":[0],"decision-making":[1,38],"often":[2],"involves":[3],"prioritizing":[4],"ethical":[5,45,190],"values,":[6],"such":[7,29],"as":[8,160],"beneficence,":[9],"non-maleficence,":[10],"respecting":[11],"a":[12,64,138],"patient's":[13],"autonomy,":[14],"and":[15,49,148,152],"justice.":[16],"Recent":[17],"work":[18,169],"has":[19],"begun":[20],"to":[21,85,127],"assess":[22],"how":[23],"large":[24],"language":[25],"models":[26,104,114,142],"(LLMs)":[27],"make":[28],"subjective,":[30],"value-laden":[31],"clinical":[32,130],"judgments.":[33],"However,":[34],"evaluations":[35],"of":[36,66,74],"LLM":[37,56],"in":[39,129,145,183],"rare":[40,70,175],"disease":[41,71,176],"care":[42],"contexts,":[43],"where":[44,50],"tensions":[46],"are":[47,58,158],"ubiquitous":[48],"scarce":[51],"prior":[52],"information":[53],"likely":[54],"impacts":[55],"behavior,":[57],"still":[59],"lacking.":[60],"Here,":[61],"we":[62,99],"present":[63],"benchmark":[65],"208":[67],"clinically":[68,88],"grounded":[69],"vignettes,":[72,98],"each":[73],"which":[75],"presents":[76],"genuine,":[77],"high-stakes":[78],"conflicts.":[79],"When":[80],"prompting":[81],"11":[82],"state-of-the-art":[83],"LLMs":[84],"choose":[86],"between":[87],"defensible":[89],"yet":[90],"ethically":[91],"conflicting":[92],"next":[93],"steps":[94],"embedded":[95],"within":[96],"these":[97],"found":[100],"that":[101,171],"all":[102],"evaluated":[103],"consistently":[105],"prioritized":[106],"justice":[107,144],"over":[108,120],"other":[109],"core":[110],"bioethical":[111],"principles.":[112],"Specifically,":[113],"overwhelmingly":[115],"favor":[116,143],"equal":[117],"resource":[118,177],"allocation":[119],"need-based":[121],"considerations,":[122],"indicating":[123],"LLMs'":[124],"limited":[125],"responsiveness":[126],"differences":[128],"severity":[131],"or":[132,165],"situational":[133],"context.":[134],"We":[135],"also":[136],"identify":[137],"strong":[139],"authority-framing":[140],"effect:":[141],"committee-based":[146],"contexts":[147],"shift":[149],"toward":[150],"beneficence":[151],"autonomy":[153],"only":[154],"when":[155],"final":[156],"decisions":[157],"framed":[159],"being":[161],"made":[162],"by":[163],"clinicians":[164],"patients":[166],"respectively.":[167],"Our":[168],"suggests":[170],"institutional":[172],"pressures":[173],"surrounding":[174],"utilization":[178],"may":[179],"be":[180],"silently":[181],"reflected":[182],"LLM-based":[184],"decision":[185],"support":[186],"systems,":[187],"with":[188],"finer":[189],"considerations":[191],"disregarded.":[192]},"counts_by_year":[],"updated_date":"2026-11-07T11:25:07.637180","created_date":"2026-08-28T00:00:00"}