{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T02:56:41Z","timestamp":1790823401487,"version":"4.1.0"},"reference-count":120,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000833","name":"Rosetrees Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000833","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Intramuscular fat (IMF), also known as myosteatosis, refers to the accumulation of lipids within and around skeletal muscle fibres. Excess IMF is increasingly recognised as a sign of poor muscle quality, linked to reductions in strength, power and mobility, and associated with adverse outcomes in metabolic disease, osteoarthritis, cardiovascular diseases and cancer. It is important to note that an increase in intramuscular fat is not always pathological. These associations and the ongoing uncertainty have sparked growing interest in IMF as a biomarker of muscle health beyond muscle mass and cross\u2010sectional area. This narrative review synthesises current evidence on IMF as a biomarker of muscle health, critically evaluating its definition, measurement, biological variability, responsiveness to intervention and ongoing challenges for clinical application. We first clarify terminology, distinguishing intramyocellular lipids, extramyocellular lipids, intermuscular adipose tissue and subcutaneous adipose tissue. Advances in imaging techniques are assessed: Magnetic resonance imaging and spectroscopy provide accurate compartmental lipid quantification; computed tomography offers practical, reproducible estimates of muscle density; and ultrasound presents an accessible, though operator\u2010dependent, alternative. Across populations, IMF shows considerable variability: Levels increase with age, differ by sex and ethnicity and have strong associations with adiposity and activity. Normative values are emerging but are lacking standardisation and population\u2010specific reference ranges. Interventional studies show that IMF is modifiable. Acute endurance exercise reduces intramyocellular lipid stores, while long\u2010term aerobic and resistance training prevent or lower fat infiltration but increase levels of intramyocellular lipids. Dietary restriction and bariatric surgery reliably decrease IMF but may also cause loss of lean mass without sufficient resistance training or protein intake. Pharmacological therapies, particularly glucagon\u2010like peptide\u20101 receptor agonists such as liraglutide and semaglutide, have recently been shown to lower IMF while enhancing muscle quality, despite some overall muscle reduction. These findings support IMF as a flexible biomarker that indicates intervention success and correlates with functional outcomes including strength, gait speed and insulin sensitivity. Key barriers remain: lack of standardised imaging protocols, no universally defined pathological thresholds and the complex challenge of interpreting IMF across different age groups, sexes and ethnicities. Overcoming these obstacles through consensus definitions, prospective multi\u2010ethnic research and the integration of advanced imaging with functional outcomes will be vital. If achieved, IMF could become a clinically important biomarker, complementing mass and strength\u2010based measures to guide treatments, assess risk and track muscle health throughout life.<\/jats:p>","DOI":"10.1002\/jcsm.70389","type":"journal-article","created":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T02:21:41Z","timestamp":1790821301000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Intramuscular Fat as a Biomarker of Muscle Health: Strengths, Limitations and Open Challenges"],"prefix":"10.1002","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3871-5637","authenticated-orcid":false,"given":"Christopher","family":"Spence","sequence":"first","affiliation":[{"name":"Department of Orthopaedics and MSK Science, Division of Surgery and Interventional Science, Faculty of Medical Sciences University College London  London UK"},{"name":"Cleveland Clinic London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin\u00a0Alberto","family":"Belzunce","sequence":"additional","affiliation":[{"name":"Royal National Orthopaedic Hospital  Stanmore UK"},{"name":"Centro Universitario de Im\u00e1genes M\u00e9dicas (CEUNIM), Instituto de Ciencias F\u00edsicas (ICIFI UNSAM\u2013CONICET), Escuela de Ciencia y Tecnolog\u00eda Universidad Nacional de San Mart\u00edn  San Mart\u00edn Buenos Aires Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Di\u00a0Laura","sequence":"additional","affiliation":[{"name":"Royal National Orthopaedic Hospital  Stanmore UK"},{"name":"Department of Mechanical Engineering University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johann","family":"Henckel","sequence":"additional","affiliation":[{"name":"Royal National Orthopaedic Hospital  Stanmore UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alister\u00a0J.","family":"Hart","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and MSK Science, Division of Surgery and Interventional Science, Faculty of Medical Sciences University College London  London UK"},{"name":"Cleveland Clinic London  London UK"},{"name":"Royal National Orthopaedic Hospital  Stanmore UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,30]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2020.00963"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehae827"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1152\/AJPENDO.00243.2018"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010020\u201079718\u20109"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinre.2025.102743"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2024.05.020"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440\u20101797.2009.01261.x"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.12039"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.70021"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.critrevonc.2019.102839"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40520\u2010020\u201001530\u20102"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2019.02.026"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.ACRA.2023.06.003"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.13243"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010021\u201000790\u2010w"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13395\u2010024\u201000364\u20100"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010024\u201065802\u2010x"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/AJCN\/85.2.377"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1152\/JAPPLPHYSIOL.90425.2008"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/S11357\u2010015\u20109798\u20105"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.JOT.2018.10.004"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jot.2023.07.005"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1210\/JC.2003\u2010031006"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/MRM.23255"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.12901"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.3389\/FENDO.2019.00577"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.2337\/DBI24\u20100030"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/nbm.4266"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.ARTH.2013.04.045"},{"key":"e_1_2_13_31_1","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1097\/00003086-199407000-00014","article-title":"Fatty Muscle Degeneration in Cuff Ruptures Pre\u2010 and Postoperative Evaluation by CT Scan","volume":"304","author":"Goutallier D.","year":"1994","journal-title":"Clinical Orthopaedics and Related Research"},{"key":"e_1_2_13_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1058\u20102746(03)00211\u20108"},{"issue":"6","key":"e_1_2_13_33_1","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1016\/S1058-2746(99)90097-6","article-title":"Fatty Degeneration of the Muscles of the Rotator Cuff: Assessment by Computed Tomography Versus Magnetic Resonance Imaging","volume":"8","author":"Fuchs B.","year":"1999","journal-title":"Journal of Shoulder and Elbow Surgery"},{"key":"e_1_2_13_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2015.02.011"},{"key":"e_1_2_13_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.acra.2005.01.019"},{"key":"e_1_2_13_36_1","doi-asserted-by":"publisher","DOI":"10.1148\/RADIOLOGY.153.1.6089263"},{"key":"e_1_2_13_37_1","doi-asserted-by":"publisher","DOI":"10.1002\/JMRI.21090"},{"key":"e_1_2_13_38_1","doi-asserted-by":"publisher","DOI":"10.1002\/MRM.21737"},{"key":"e_1_2_13_39_1","doi-asserted-by":"publisher","DOI":"10.1002\/MRM.1910400412"},{"key":"e_1_2_13_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.MRI.2007.08.012"},{"key":"e_1_2_13_41_1","doi-asserted-by":"publisher","DOI":"10.1002\/MRM.10675"},{"key":"e_1_2_13_42_1","doi-asserted-by":"publisher","DOI":"10.1002\/JMRI.23741"},{"key":"e_1_2_13_43_1","doi-asserted-by":"publisher","DOI":"10.5152\/DIR.2021.21845"},{"key":"e_1_2_13_44_1","doi-asserted-by":"publisher","DOI":"10.1259\/BJR.20130761"},{"key":"e_1_2_13_45_1","doi-asserted-by":"publisher","DOI":"10.1148\/RADIOL.2523082084"},{"key":"e_1_2_13_46_1","doi-asserted-by":"publisher","DOI":"10.1002\/nbm.4636"},{"key":"e_1_2_13_47_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjsem\u20102023\u2010001672"},{"key":"e_1_2_13_48_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI.INSIGHT.94278"},{"key":"e_1_2_13_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.NMD.2017.04.008"},{"key":"e_1_2_13_50_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.11.7113"},{"issue":"1","key":"e_1_2_13_51_1","first-page":"19","article-title":"Clinical Application of Diffusion Tensor Magnetic Resonance Imaging in Skeletal Muscle","volume":"2","author":"Longwei X.","year":"2012","journal-title":"Muscles, Ligaments and Tendons Journal"},{"key":"e_1_2_13_52_1","doi-asserted-by":"publisher","DOI":"10.1088\/0031\u20109155\/30\/4\/009"},{"key":"e_1_2_13_53_1","doi-asserted-by":"publisher","DOI":"10.1186\/S13244\u2010024\u201001800\u2010X"},{"key":"e_1_2_13_54_1","doi-asserted-by":"publisher","DOI":"10.1002\/MRM.1910370403"},{"key":"e_1_2_13_55_1","doi-asserted-by":"publisher","DOI":"10.1002\/MRM.1910290203"},{"key":"e_1_2_13_56_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.29368"},{"key":"e_1_2_13_57_1","doi-asserted-by":"publisher","DOI":"10.1007\/S001250051123"},{"key":"e_1_2_13_58_1","doi-asserted-by":"publisher","DOI":"10.14283\/JFA.2018.16"},{"key":"e_1_2_13_59_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.13635"},{"key":"e_1_2_13_60_1","doi-asserted-by":"publisher","DOI":"10.1210\/JC.2014\u20101532"},{"key":"e_1_2_13_61_1","doi-asserted-by":"publisher","DOI":"10.1002\/9780470034590.EMRSTM1496"},{"key":"e_1_2_13_62_1","doi-asserted-by":"publisher","DOI":"10.1371\/JOURNAL.PONE.0175174"},{"key":"e_1_2_13_63_1","doi-asserted-by":"publisher","DOI":"10.1093\/GERONA\/GLZ034"},{"key":"e_1_2_13_64_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.2000.89.1.104"},{"key":"e_1_2_13_65_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.ACRA.2023.06.009"},{"key":"e_1_2_13_66_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjr\/tqae191"},{"key":"e_1_2_13_67_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnesp.2025.08.024"},{"key":"e_1_2_13_68_1","doi-asserted-by":"publisher","DOI":"10.1016\/0720\u2010048X(92)90113\u2010N"},{"key":"e_1_2_13_69_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2024.07.003"},{"key":"e_1_2_13_70_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ultrasmedbio.2015.08.013"},{"key":"e_1_2_13_71_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.braindev.2011.05.013"},{"key":"e_1_2_13_72_1","doi-asserted-by":"publisher","DOI":"10.3233\/JND\u2010160145"},{"issue":"12","key":"e_1_2_13_73_1","doi-asserted-by":"crossref","first-page":"1539","DOI":"10.1200\/JCO.2012.45.2722","article-title":"Cancer Cachexia in the Age of Obesity: Skeletal Muscle Depletion Is a Powerful Prognostic Factor, Independent of Body Mass Index","volume":"31","author":"Martin L.","year":"2013","journal-title":"Journal of Clinical Oncology"},{"key":"e_1_2_13_74_1","doi-asserted-by":"publisher","DOI":"10.1371\/JOURNAL.PONE.0211629"},{"key":"e_1_2_13_75_1","doi-asserted-by":"publisher","DOI":"10.1111\/APHA.12224"},{"key":"e_1_2_13_76_1","doi-asserted-by":"publisher","DOI":"10.1259\/BJR.20211094"},{"key":"e_1_2_13_77_1","doi-asserted-by":"publisher","DOI":"10.1002\/MUS.27081"},{"key":"e_1_2_13_78_1","doi-asserted-by":"publisher","DOI":"10.3389\/FRESC.2022.896114"},{"key":"e_1_2_13_79_1","doi-asserted-by":"publisher","DOI":"10.1007\/S00421\u2010011\u20102099\u20105"},{"key":"e_1_2_13_80_1","doi-asserted-by":"publisher","DOI":"10.1007\/S41999\u2010020\u201000433\u20109"},{"key":"e_1_2_13_81_1","doi-asserted-by":"publisher","DOI":"10.3390\/S23104763"},{"key":"e_1_2_13_82_1","doi-asserted-by":"publisher","DOI":"10.1136\/RMDOPEN\u20102022\u2010002779"},{"key":"e_1_2_13_83_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ultrasmedbio.2008.09.016"},{"key":"e_1_2_13_84_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877\u2010023\u201004177\u20106"},{"key":"e_1_2_13_85_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.isci.2024.109221"},{"key":"e_1_2_13_86_1","doi-asserted-by":"publisher","DOI":"10.1093\/GERONA\/GLU086"},{"key":"e_1_2_13_87_1","doi-asserted-by":"publisher","DOI":"10.1038\/S41598\u2010024\u201075005\u2010Z"},{"key":"e_1_2_13_88_1","doi-asserted-by":"publisher","DOI":"10.3390\/DIAGNOSTICS14202260\/S1"},{"key":"e_1_2_13_89_1","doi-asserted-by":"publisher","DOI":"10.1093\/AJCN\/81.4.903"},{"key":"e_1_2_13_90_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41366\u2010019\u20100435\u20108"},{"key":"e_1_2_13_91_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2012.05.003"},{"key":"e_1_2_13_92_1","doi-asserted-by":"publisher","DOI":"10.1080\/22423982.2024.2312663"},{"key":"e_1_2_13_93_1","doi-asserted-by":"publisher","DOI":"10.2522\/PTJ.20100329"},{"key":"e_1_2_13_94_1","doi-asserted-by":"publisher","DOI":"10.1038\/IJO.2009.170"},{"key":"e_1_2_13_95_1","doi-asserted-by":"publisher","DOI":"10.1159\/000182084"},{"key":"e_1_2_13_96_1","doi-asserted-by":"publisher","DOI":"10.1210\/JC.2006\u20102113"},{"key":"e_1_2_13_97_1","doi-asserted-by":"publisher","DOI":"10.1038\/S41598\u2010021\u201099126\u2010X"},{"key":"e_1_2_13_98_1","doi-asserted-by":"publisher","DOI":"10.1210\/JCEM.86.12.8075"},{"key":"e_1_2_13_99_1","doi-asserted-by":"publisher","DOI":"10.1111\/CPF.12346"},{"key":"e_1_2_13_100_1","doi-asserted-by":"publisher","DOI":"10.1038\/OBY.2006.47"},{"key":"e_1_2_13_101_1","doi-asserted-by":"publisher","DOI":"10.1210\/JC.2002\u2010021674"},{"key":"e_1_2_13_102_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.MOLMET.2018.08.004"},{"key":"e_1_2_13_103_1","doi-asserted-by":"publisher","DOI":"10.1152\/JAPPLPHYSIOL.00637.2021"},{"key":"e_1_2_13_104_1","doi-asserted-by":"publisher","DOI":"10.1152\/JAPPLPHYSIOL.00738.2020"},{"key":"e_1_2_13_105_1","doi-asserted-by":"publisher","DOI":"10.2337\/DIACARE.26.11.2977"},{"key":"e_1_2_13_106_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40520\u2010025\u201003097\u20102"},{"key":"e_1_2_13_107_1","doi-asserted-by":"publisher","DOI":"10.1111\/OBR.13370"},{"key":"e_1_2_13_108_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.BONR.2023.101661"},{"key":"e_1_2_13_109_1","doi-asserted-by":"publisher","DOI":"10.1038\/S41598\u2010019\u201040107\u20106"},{"key":"e_1_2_13_110_1","doi-asserted-by":"publisher","DOI":"10.1007\/S00421\u2010022\u201004896\u20105"},{"key":"e_1_2_13_111_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.13445"},{"key":"e_1_2_13_112_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.24.31805"},{"key":"e_1_2_13_113_1","doi-asserted-by":"publisher","DOI":"10.1111\/DOM.15728"},{"key":"e_1_2_13_114_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajcnut.2025.04.023"},{"key":"e_1_2_13_115_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.13183"},{"key":"e_1_2_13_116_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.12525"},{"key":"e_1_2_13_117_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.25709"},{"key":"e_1_2_13_118_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.15938"},{"key":"e_1_2_13_119_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afy169"},{"key":"e_1_2_13_120_1","doi-asserted-by":"publisher","DOI":"10.1093\/bbb\/zbac037"},{"key":"e_1_2_13_121_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.13474"}],"container-title":["Journal of Cachexia, Sarcopenia and Muscle"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jcsm.70389","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jcsm.70389","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jcsm.70389","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T02:21:43Z","timestamp":1790821303000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jcsm.70389"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,30]]},"references-count":120,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1002\/jcsm.70389"],"URL":"https:\/\/doi.org\/10.1002\/jcsm.70389","archive":["Portico"],"relation":{},"ISSN":["2190-5991","2190-6009"],"issn-type":[{"value":"2190-5991","type":"print"},{"value":"2190-6009","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,30]]},"assertion":[{"value":"2025-11-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70389"}}