{"id":"https://openalex.org/W7225736816","doi":"https://doi.org/10.21203/rs.3.rs-11338686/v1","title":"Patient-reported healthcare utilisation and economic burden among people with colorectal cancer in Kuwait: a cross-sectional study","display_name":"Patient-reported healthcare utilisation and economic burden among people with colorectal cancer in Kuwait: a cross-sectional study","publication_year":2026,"publication_date":"2026-11-10","ids":{"openalex":"https://openalex.org/W7225736816","doi":"https://doi.org/10.21203/rs.3.rs-11338686/v1"},"language":"en","primary_location":{"id":"doi:10.21203/rs.3.rs-11338686/v1","doi":"https://doi.org/10.21203/rs.3.rs-11338686/v1","is_oa":true,"landing_page_url":"https://doi.org/10.21203/rs.3.rs-11338686/v1","pdf_url":"https://www.researchsquare.com/article/rs-11338686/latest.pdf","source":{"id":"https://openalex.org/S4306525896","display_name":"Research Square","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"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":"Research Square","raw_type":"posted-content"},"volume":null,"type":"preprint","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://www.researchsquare.com/article/rs-11338686/latest.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5111911435","display_name":"Amrizal Muhd Nur","orcid":"https://orcid.org/0000-0001-7170-0918","observed_orcids":["https://orcid.org/0000-0001-7170-0918"]},"institutions":[{"id":"https://openalex.org/I189462010","display_name":"Universiti Brunei Darussalam","ror":"https://ror.org/02qnf3n86","country_code":"BN","type":"education","lineage":["https://openalex.org/I189462010"]}],"countries":["BN"],"is_corresponding":false,"raw_author_name":"Amrizal Muhammad Nur","raw_affiliation_strings":["Universiti Brunei Darussalam"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Universiti Brunei Darussalam","institution_ids":["https://openalex.org/I189462010"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5029961086","display_name":"Syed Mohamed Aljunid","orcid":"https://orcid.org/0000-0002-0380-1335","observed_orcids":["https://orcid.org/0000-0002-0380-1335"]},"institutions":[{"id":"https://openalex.org/I62370553","display_name":"IMU University","ror":"https://ror.org/04d4wjw61","country_code":"MY","type":"education","lineage":["https://openalex.org/I62370553"]}],"countries":["MY"],"is_corresponding":false,"raw_author_name":"Syed Mohamed Aljunid","raw_affiliation_strings":["IMU University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"IMU University","institution_ids":["https://openalex.org/I62370553"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5084978926","display_name":"Mohammad Almari","orcid":"https://orcid.org/0000-0002-9360-6444","observed_orcids":["https://orcid.org/0000-0002-9360-6444"]},"institutions":[{"id":"https://openalex.org/I36721946","display_name":"Kuwait University","ror":"https://ror.org/021e5j056","country_code":"KW","type":"education","lineage":["https://openalex.org/I36721946"]}],"countries":["KW"],"is_corresponding":false,"raw_author_name":"Mohammad Almari","raw_affiliation_strings":["Kuwait University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Kuwait University","institution_ids":["https://openalex.org/I36721946"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5161096785","display_name":"Mohd Hafiz Jaafar","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I112982808","display_name":"Universiti Sains Islam Malaysia","ror":"https://ror.org/020ast312","country_code":"MY","type":"education","lineage":["https://openalex.org/I112982808"]}],"countries":["MY"],"is_corresponding":false,"raw_author_name":"Mohd Hafiz Jaafar","raw_affiliation_strings":["Universiti Sains Islam Malaysia"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Universiti Sains Islam Malaysia","institution_ids":["https://openalex.org/I112982808"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5058682956","display_name":"Amirah binti Azzeri","orcid":"https://orcid.org/0000-0001-6261-1307","observed_orcids":["https://orcid.org/0000-0001-6261-1307"]},"institutions":[{"id":"https://openalex.org/I112982808","display_name":"Universiti Sains Islam Malaysia","ror":"https://ror.org/020ast312","country_code":"MY","type":"education","lineage":["https://openalex.org/I112982808"]}],"countries":["MY"],"is_corresponding":false,"raw_author_name":"Amirah Azzeri","raw_affiliation_strings":["Universiti Sains Islam Malaysia"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Universiti Sains Islam Malaysia","institution_ids":["https://openalex.org/I112982808"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5153605331","display_name":"Muhammad Fandy Osman","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I189462010","display_name":"Universiti Brunei Darussalam","ror":"https://ror.org/02qnf3n86","country_code":"BN","type":"education","lineage":["https://openalex.org/I189462010"]}],"countries":["BN"],"is_corresponding":false,"raw_author_name":"Muhammad Fandy Osman","raw_affiliation_strings":["Universiti Brunei Darussalam"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Universiti Brunei Darussalam","institution_ids":["https://openalex.org/I189462010"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5101177505","display_name":"Lin Naing","orcid":"https://orcid.org/0000-0003-1723-9854","observed_orcids":["https://orcid.org/0000-0003-1723-9854"]},"institutions":[{"id":"https://openalex.org/I189462010","display_name":"Universiti Brunei Darussalam","ror":"https://ror.org/02qnf3n86","country_code":"BN","type":"education","lineage":["https://openalex.org/I189462010"]}],"countries":["BN"],"is_corresponding":false,"raw_author_name":"Lin Naing","raw_affiliation_strings":["Universiti Brunei Darussalam"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Universiti Brunei Darussalam","institution_ids":["https://openalex.org/I189462010"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5161381088","display_name":"Syed Mohamad Hamzah Al-Junid Syed Abdul Rahman","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Syed Mohamad Hamzah Al-Junid Syed Abdul Rahman","raw_affiliation_strings":["Casemix Solutions Sdn. Bhd"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Casemix Solutions Sdn. Bhd","institution_ids":[]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5086685633","display_name":"Siti Athirah Zafirah Abdul Rashid","orcid":"https://orcid.org/0000-0003-0973-1945","observed_orcids":["https://orcid.org/0000-0003-0973-1945"]},"institutions":[{"id":"https://openalex.org/I55141112","display_name":"National Defence University of Malaysia","ror":"https://ror.org/00t53pv34","country_code":"MY","type":"education","lineage":["https://openalex.org/I55141112"]}],"countries":["MY"],"is_corresponding":false,"raw_author_name":"Siti Athirah Zafirah Abdul Rashid","raw_affiliation_strings":["National Defence University of Malaysia"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"National Defence University of Malaysia","institution_ids":["https://openalex.org/I55141112"]}]}],"institutions":[],"countries_distinct_count":3,"institutions_distinct_count":5,"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/T12708","display_name":"Economic and Financial Impacts of Cancer","score":1.0,"subfield":{"id":"https://openalex.org/subfields/2002","display_name":"Economics and Econometrics"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},"topics":[{"id":"https://openalex.org/T12708","display_name":"Economic and Financial Impacts of Cancer","score":1.0,"subfield":{"id":"https://openalex.org/subfields/2002","display_name":"Economics and Econometrics"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T10804","display_name":"Health Systems, Economic Evaluations, Quality of Life","score":0.00019999999494757503,"subfield":{"id":"https://openalex.org/subfields/2002","display_name":"Economics and Econometrics"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T10178","display_name":"Cancer survivorship and care","score":0.0,"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":[],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.8755999803543091},{"id":"https://openalex.org/C204983608","wikidata":"https://www.wikidata.org/wiki/Q2111958","display_name":"Productivity","level":2,"score":0.6547999978065491},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.6362000107765198},{"id":"https://openalex.org/C6964187","wikidata":"https://www.wikidata.org/wiki/Q659256","display_name":"Indirect costs","level":2,"score":0.5928999781608582},{"id":"https://openalex.org/C526805850","wikidata":"https://www.wikidata.org/wiki/Q188874","display_name":"Colorectal cancer","level":3,"score":0.5188999772071838},{"id":"https://openalex.org/C182299520","wikidata":"https://www.wikidata.org/wiki/Q1289588","display_name":"Total cost","level":2,"score":0.43939998745918274},{"id":"https://openalex.org/C512399662","wikidata":"https://www.wikidata.org/wiki/Q3505712","display_name":"Family medicine","level":1,"score":0.41530001163482666},{"id":"https://openalex.org/C2778137410","wikidata":"https://www.wikidata.org/wiki/Q2732820","display_name":"Government (linguistics)","level":2,"score":0.41370001435279846},{"id":"https://openalex.org/C524218345","wikidata":"https://www.wikidata.org/wiki/Q31218","display_name":"Health economics","level":3,"score":0.39879998564720154},{"id":"https://openalex.org/C195910791","wikidata":"https://www.wikidata.org/wiki/Q1324077","display_name":"Medical record","level":2,"score":0.3982999920845032},{"id":"https://openalex.org/C194828623","wikidata":"https://www.wikidata.org/wiki/Q2861470","display_name":"Emergency medicine","level":1,"score":0.39629998803138733},{"id":"https://openalex.org/C124306116","wikidata":"https://www.wikidata.org/wiki/Q2512965","display_name":"Ambulatory care","level":3,"score":0.38659998774528503},{"id":"https://openalex.org/C145096142","wikidata":"https://www.wikidata.org/wiki/Q5333450","display_name":"Economic cost","level":2,"score":0.3781999945640564},{"id":"https://openalex.org/C95821633","wikidata":"https://www.wikidata.org/wiki/Q973302","display_name":"Cost driver","level":2,"score":0.3537999987602234},{"id":"https://openalex.org/C15716912","wikidata":"https://www.wikidata.org/wiki/Q5174768","display_name":"Cost database","level":2,"score":0.34220001101493835},{"id":"https://openalex.org/C2780958618","wikidata":"https://www.wikidata.org/wiki/Q945621","display_name":"Average cost","level":2,"score":0.3402000069618225},{"id":"https://openalex.org/C2909321700","wikidata":"https://www.wikidata.org/wiki/Q181600","display_name":"Outpatient visits","level":3,"score":0.33889999985694885},{"id":"https://openalex.org/C2991842025","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Tertiary care","level":2,"score":0.3357999920845032},{"id":"https://openalex.org/C3018494286","wikidata":"https://www.wikidata.org/wiki/Q30587857","display_name":"Direct cost","level":3,"score":0.3336000144481659},{"id":"https://openalex.org/C3020110884","wikidata":"https://www.wikidata.org/wiki/Q695416","display_name":"Outpatient clinic","level":2,"score":0.3303000032901764},{"id":"https://openalex.org/C2988170871","wikidata":"https://www.wikidata.org/wiki/Q11000047","display_name":"Healthcare system","level":3,"score":0.3273000121116638},{"id":"https://openalex.org/C198531522","wikidata":"https://www.wikidata.org/wiki/Q485146","display_name":"Sample (material)","level":2,"score":0.3206999897956848},{"id":"https://openalex.org/C99454951","wikidata":"https://www.wikidata.org/wiki/Q932068","display_name":"Environmental health","level":1,"score":0.3131999969482422},{"id":"https://openalex.org/C188897","wikidata":"https://www.wikidata.org/wiki/Q5333508","display_name":"Economic impact analysis","level":2,"score":0.305400013923645},{"id":"https://openalex.org/C3018080189","wikidata":"https://www.wikidata.org/wiki/Q11000047","display_name":"Health care cost","level":3,"score":0.304500013589859},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.29589998722076416},{"id":"https://openalex.org/C2989236134","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Patient care","level":2,"score":0.2874000072479248},{"id":"https://openalex.org/C138816342","wikidata":"https://www.wikidata.org/wiki/Q189603","display_name":"Public health","level":2,"score":0.2870999872684479},{"id":"https://openalex.org/C121608353","wikidata":"https://www.wikidata.org/wiki/Q12078","display_name":"Cancer","level":2,"score":0.28619998693466187},{"id":"https://openalex.org/C149923435","wikidata":"https://www.wikidata.org/wiki/Q37732","display_name":"Demography","level":1,"score":0.27810001373291016},{"id":"https://openalex.org/C2992395903","wikidata":"https://www.wikidata.org/wiki/Q814232","display_name":"Telephone survey","level":2,"score":0.2761000096797943},{"id":"https://openalex.org/C2983335822","wikidata":"https://www.wikidata.org/wiki/Q942582","display_name":"Cost analysis","level":2,"score":0.26809999346733093},{"id":"https://openalex.org/C2775909303","wikidata":"https://www.wikidata.org/wiki/Q3259564","display_name":"Inpatient care","level":3,"score":0.25679999589920044},{"id":"https://openalex.org/C2776125615","wikidata":"https://www.wikidata.org/wiki/Q18391886","display_name":"Economic evaluation","level":2,"score":0.2540000081062317}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.21203/rs.3.rs-11338686/v1","doi":"https://doi.org/10.21203/rs.3.rs-11338686/v1","is_oa":true,"landing_page_url":"https://doi.org/10.21203/rs.3.rs-11338686/v1","pdf_url":"https://www.researchsquare.com/article/rs-11338686/latest.pdf","source":{"id":"https://openalex.org/S4306525896","display_name":"Research Square","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"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":"Research Square","raw_type":"posted-content"}],"best_oa_location":{"id":"doi:10.21203/rs.3.rs-11338686/v1","doi":"https://doi.org/10.21203/rs.3.rs-11338686/v1","is_oa":true,"landing_page_url":"https://doi.org/10.21203/rs.3.rs-11338686/v1","pdf_url":"https://www.researchsquare.com/article/rs-11338686/latest.pdf","source":{"id":"https://openalex.org/S4306525896","display_name":"Research Square","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"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":"Research Square","raw_type":"posted-content"},"sustainable_development_goals":[],"study_designs":[],"awards":[],"funders":[],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7225736816.pdf","grobid_xml":"https://content.openalex.org/works/W7225736816.grobid-xml"},"referenced_works_count":48,"referenced_works":["https://openalex.org/W2050056063","https://openalex.org/W2077299691","https://openalex.org/W2150459683","https://openalex.org/W2164631768","https://openalex.org/W2164862736","https://openalex.org/W2292373964","https://openalex.org/W2302003756","https://openalex.org/W2395213014","https://openalex.org/W2512774975","https://openalex.org/W2614393227","https://openalex.org/W2792953063","https://openalex.org/W2889646458","https://openalex.org/W2890076567","https://openalex.org/W2941974000","https://openalex.org/W2952316115","https://openalex.org/W2978644288","https://openalex.org/W3033718997","https://openalex.org/W3064526859","https://openalex.org/W3088608226","https://openalex.org/W3116326314","https://openalex.org/W3128646645","https://openalex.org/W3137861363","https://openalex.org/W3153373528","https://openalex.org/W3186797693","https://openalex.org/W3214242183","https://openalex.org/W4200584507","https://openalex.org/W4214927185","https://openalex.org/W4293537691","https://openalex.org/W4294343653","https://openalex.org/W4378781771","https://openalex.org/W4382197427","https://openalex.org/W4384626180","https://openalex.org/W4385564321","https://openalex.org/W4387580445","https://openalex.org/W4393935425","https://openalex.org/W4399741705","https://openalex.org/W4400808172","https://openalex.org/W4401723847","https://openalex.org/W4402616287","https://openalex.org/W4405221525","https://openalex.org/W4407706796","https://openalex.org/W4408076557","https://openalex.org/W4413286776","https://openalex.org/W4416336704","https://openalex.org/W4416380298","https://openalex.org/W7127052503","https://openalex.org/W7160326629","https://openalex.org/W7168102310"],"related_works":[],"abstract_inverted_index":{"Abstract":[0],"Background":[1],"Patient-reported":[2],"economic":[3,30],"consequences":[4],"of":[5,47,167,186,206],"colorectal":[6],"cancer":[7],"(CRC),":[8],"particularly":[9],"productivity":[10,77,261],"losses":[11,95],"and":[12,25,32,68,78,85,93,144,226,258,262,278,296],"caregiving":[13,263],"costs,":[14],"are":[15,268,299],"insufficiently":[16],"documented":[17],"in":[18,123,215],"Kuwait.":[19],"This":[20,241],"study":[21],"described":[22],"healthcare":[23,74],"use":[24],"quantified":[26],"direct":[27,154,256,286],"expenditure,":[28,76],"indirect":[29,88,173,283],"costs":[31,81,89,92,212,277,284,287],"their":[33],"combined":[34,192],"burden":[35,271],"among":[36,250],"patients":[37,49,251],"receiving":[38],"tertiary":[39],"oncology":[40],"care.":[41],"Methods":[42],"A":[43],"cross-sectional":[44],"telephone":[45],"survey":[46],"100":[48],"with":[50,114,164,183,203],"CRC":[51,304],"was":[52,128],"conducted":[53],"at":[54,97],"the":[55,124],"Kuwait":[56],"Cancer":[57],"Control":[58],"Center":[59],"from":[60,235],"6":[61],"June":[62],"through":[63],"December":[64],"2022.":[65],"The":[66,191,265],"EQ-5D-5L":[67],"Health":[69],"Care":[70],"Utilisation":[71],"questionnaires":[72],"captured":[73],"encounters,":[75,254],"caregiving.":[79],"Direct":[80],"comprised":[82],"reported":[83,129],"outpatient":[84,140],"inpatient":[86],"expenditure;":[87],"included":[90],"caregiver":[91,297],"time":[94],"valued":[96,260],"KD":[98,157,168,176,187,196,207,219],"33.56":[99],"per":[100],"day":[101],"using":[102,117],"a":[103,165,184,204],"2022":[104],"GDP-per-capita":[105],"proxy.":[106],"Skewed":[107],"monetary":[108],"outcomes":[109],"were":[110,136,213],"summarised":[111],"for":[112,288],"records":[113,217],"positive":[115,214],"values":[116],"response-specific":[118],"denominators.":[119],"Results":[120],"Outpatient":[121],"care":[122],"preceding":[125],"six":[126],"months":[127],"by":[130,138],"44/99":[131],"respondents":[132,142,148],"(44.4%);":[133],"government":[134],"hospitals":[135],"named":[137],"39/43":[139],"facility":[141,147],"(90.7%)":[143],"24/32":[145],"admission":[146],"(75.0%).":[149],"Among":[150],"positive-value":[151],"records,":[152],"total":[153],"expenditure":[155],"averaged":[156,175,195],"266.28":[158],"(SD":[159,178,198],"393.42;":[160],"n":[161,180,200],"=":[162,181,201],"48),":[163],"median":[166,185,205],"155.00":[169],"(IQR":[170,189,209],"47.50\u2013310.00).":[171],"Total":[172],"cost":[174,194,224,266],"1,714.29":[177],"2,441.86;":[179],"67),":[182],"1,074.97":[188],"301.05\u20132,020.32).":[190],"patient-level":[193],"1,636.40":[197],"2,475.83;":[199],"78),":[202],"1,003.40":[208],"253.75\u20132,062.50).":[210],"Caregiver":[211],"39":[216],"(median":[218],"900.00).":[220],"Denominators":[221],"differed":[222],"across":[223],"domains,":[225],"stored":[227],"zero":[228],"amounts":[229],"could":[230],"not":[231,280],"reliably":[232],"be":[233],"distinguished":[234],"non-applicability":[236],"or":[237],"missing":[238],"costs.":[239,264],"Conclusions":[240],"single-centre,":[242],"non-representative":[243],"sample":[244],"indicates":[245],"reliance":[246],"on":[247],"public-sector":[248],"services":[249],"reporting":[252],"relevant":[253],"alongside":[255],"expenditures":[257],"substantial":[259],"summaries":[267],"neither":[269],"national":[270],"estimates":[272],"nor":[273],"complete":[274],"annual":[275],"per-patient":[276],"do":[279],"establish":[281],"that":[282],"exceed":[285],"individual":[289],"patients.":[290],"Better":[291],"linked":[292],"clinical,":[293],"employment,":[294],"healthcare-expenditure":[295],"data":[298],"needed":[300],"to":[301],"inform":[302],"equitable":[303],"service":[305],"planning.":[306]},"counts_by_year":[],"updated_date":"2026-11-11T12:16:26.678958","created_date":"2026-11-11T00:00:00"}