{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T23:41:04Z","timestamp":1793144464176,"version":"4.5.0"},"reference-count":40,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T00:00:00Z","timestamp":1779667200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T00:00:00Z","timestamp":1779667200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Rheumatol Int"],"DOI":"10.1007\/s00296-026-06127-y","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T11:48:00Z","timestamp":1779709680000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Systemic sclerosis and cardiovascular disease: an integrative perspective on immune\u2013vascular mechanisms and emerging risk stratification strategies"],"prefix":"10.1007","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8993-8155","authenticated-orcid":false,"given":"Filipe C.","family":"Marmelo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cl\u00e1udia","family":"Ribeiro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3653-0639","authenticated-orcid":false,"given":"Beatriz","family":"Almeida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00f3nia","family":"Borges","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catarina","family":"Gon\u00e7alves","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4566-5976","authenticated-orcid":false,"given":"Fernando","family":"Salvador","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,25]]},"reference":[{"key":"6127_CR1","unstructured":"Varga J (2022) Systemic sclerosis (Scleroderma) and Related Disorders. In: Harrison Internal Medicine, 21st ed. McGraw Hill, pp 2771\u20132787"},{"key":"6127_CR2","doi-asserted-by":"publisher","first-page":"1897","DOI":"10.1136\/annrheumdis-2017-211448","volume":"76","author":"M Elhai","year":"2017","unstructured":"Elhai M, Meune C, Boubaya M et al (2017) Mapping and predicting mortality from systemic sclerosis. Ann Rheum Dis 76:1897\u20131905. https:\/\/doi.org\/10.1136\/annrheumdis-2017-211448","journal-title":"Ann Rheum Dis"},{"key":"6127_CR3","doi-asserted-by":"publisher","DOI":"10.55563\/clinexprheumatol\/6pstix","author":"G Pellegrino","year":"2026","unstructured":"Pellegrino G, Mohammad Reza Beigi D, Varvaro A et al (2026) Risk of major cardiovascular events in patients with systemic sclerosis: insights into an underestimated concern from a systematic literature review and meta-analysis. Clin Exp Rheumatol. https:\/\/doi.org\/10.55563\/clinexprheumatol\/6pstix","journal-title":"Clin Exp Rheumatol"},{"key":"6127_CR4","doi-asserted-by":"publisher","unstructured":"Gerasimova EV, Shayakhmetova RU, Gerasimova DA et al (2023) Systemic Sclerosis and Atherosclerosis: Potential Cellular Biomarkers and Mechanisms. Front Bioscience-Scholar 15. https:\/\/doi.org\/10.31083\/j.fbs1504016","DOI":"10.31083\/j.fbs1504016"},{"key":"6127_CR5","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1007\/s00296-016-3530-3","volume":"37","author":"A Psarras","year":"2017","unstructured":"Psarras A, Soulaidopoulos S, Garyfallos A et al (2017) A critical view on cardiovascular risk in systemic sclerosis. Rheumatol Int 37:85\u201395","journal-title":"Rheumatol Int"},{"key":"6127_CR6","doi-asserted-by":"publisher","first-page":"1188","DOI":"10.1136\/annrheumdis","volume":"7","author":"A Man","year":"2013","unstructured":"Man A, Zhu Y, Zhang Y et al (2013) The risk of cardiovascular disease in systemic sclerosis: a population-based cohort study. Ann Rheum Dis 7:1188\u20131193. https:\/\/doi.org\/10.1136\/annrheumdis","journal-title":"Ann Rheum Dis"},{"key":"6127_CR7","doi-asserted-by":"publisher","unstructured":"Osgueritchian R, Mombeini H, Jani VP et al (2025) Myocardial Disease in Systemic Sclerosis: Recent Updates and Clinical Implications. Curr Cardiol Rep 27. https:\/\/doi.org\/10.1007\/s11886-024-02164-w","DOI":"10.1007\/s11886-024-02164-w"},{"key":"6127_CR8","doi-asserted-by":"publisher","first-page":"1809","DOI":"10.1136\/ard.2009.114264","volume":"69","author":"AJ Tyndall","year":"2010","unstructured":"Tyndall AJ, Bannert B, Vonk M et al (2010) Causes and risk factors for death in systemic sclerosis: a study from the EULAR Scleroderma Trials and Research (EUSTAR) database. Ann Rheum Dis 69:1809\u20131815. https:\/\/doi.org\/10.1136\/ard.2009.114264","journal-title":"Ann Rheum Dis"},{"key":"6127_CR9","doi-asserted-by":"publisher","first-page":"208","DOI":"10.1016\/j.semarthrit.2014.05.010","volume":"44","author":"M Rubio-Rivas","year":"2014","unstructured":"Rubio-Rivas M, Royo C, Sime\u00f3n CP et al (2014) Mortality and survival in systemic sclerosis: Systematic review and meta-analysis. Semin Arthritis Rheum 44:208\u2013219. https:\/\/doi.org\/10.1016\/j.semarthrit.2014.05.010","journal-title":"Semin Arthritis Rheum"},{"key":"6127_CR10","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1177\/23971983241313096","volume":"10","author":"XM Jones","year":"2025","unstructured":"Jones XM, Bottini N, Boin F, Marb\u00e1n E (2025) Cardiac involvement in systemic sclerosis: A critical review of knowledge gaps and opportunities. J Scleroderma Relat Disord 10:91\u2013100","journal-title":"J Scleroderma Relat Disord"},{"key":"6127_CR11","doi-asserted-by":"publisher","unstructured":"Butt SA, Jeppesen JL, Torp-Pedersen C et al (2019) Cardiovascular Manifestations of Systemic Sclerosis: A Danish Nationwide Cohort Study. J Am Heart Assoc 8. https:\/\/doi.org\/10.1161\/JAHA.119.013405","DOI":"10.1161\/JAHA.119.013405"},{"key":"6127_CR12","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2024.1446268","author":"U Heilmeier","year":"2024","unstructured":"Heilmeier U, Feldmann D, Leynes A et al (2024) Chronic low-grade inflammation in patients with systemic sclerosis is associated with increased risk for arteriosclerotic cardiovascular disease. Front Med (Lausanne). https:\/\/doi.org\/10.3389\/fmed.2024.1446268. 11:","journal-title":"Front Med (Lausanne)"},{"key":"6127_CR13","first-page":"16","volume":"3","author":"AGNR Dwivedi","year":"2025","unstructured":"Dwivedi AGNR K DE (2025) Systemic sclerosis and cardiovascular risk: a systemic review of its association with atherosclerosis. J Anal Inventions 3:16\u201323","journal-title":"J Anal Inventions"},{"key":"6127_CR14","doi-asserted-by":"publisher","first-page":"690","DOI":"10.1016\/j.autrev.2016.03.005","volume":"15","author":"O Cabral-Marques","year":"2016","unstructured":"Cabral-Marques O, Riemekasten G (2016) Vascular hypothesis revisited: Role of stimulating antibodies against angiotensin and endothelin receptors in the pathogenesis of systemic sclerosis. Autoimmun Rev 15:690\u2013694. https:\/\/doi.org\/10.1016\/j.autrev.2016.03.005","journal-title":"Autoimmun Rev"},{"key":"6127_CR15","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1007\/s11926-017-0630-3","volume":"19","author":"C Dowson","year":"2017","unstructured":"Dowson C, Simpson N, Duffy L, O\u2019Reilly S (2017) Innate Immunity in Systemic Sclerosis. Curr Rheumatol Rep 19:2. https:\/\/doi.org\/10.1007\/s11926-017-0630-3","journal-title":"Curr Rheumatol Rep"},{"key":"6127_CR16","doi-asserted-by":"publisher","first-page":"5291","DOI":"10.1038\/s41467-023-41117-9","volume":"14","author":"C Ortega-Ferreira","year":"2023","unstructured":"Ortega-Ferreira C, Soret P, Robin G et al (2023) Antibody-mediated neutralization of galectin-3 as a strategy for the treatment of systemic sclerosis. Nat Commun 14:5291. https:\/\/doi.org\/10.1038\/s41467-023-41117-9","journal-title":"Nat Commun"},{"key":"6127_CR17","doi-asserted-by":"publisher","first-page":"593","DOI":"10.7150\/thno.22196","volume":"8","author":"N Suthahar","year":"2018","unstructured":"Suthahar N, Meijers WC, Sillj\u00e9 HHW et al (2018) Galectin-3 Activation and Inhibition in Heart Failure and Cardiovascular Disease: An Update. Theranostics 8:593\u2013609. https:\/\/doi.org\/10.7150\/thno.22196","journal-title":"Theranostics"},{"key":"6127_CR18","doi-asserted-by":"publisher","first-page":"2213","DOI":"10.1016\/j.jacc.2018.08.2149","volume":"72","author":"KJ Lavine","year":"2018","unstructured":"Lavine KJ, Pinto AR, Epelman S et al (2018) The Macrophage in Cardiac Homeostasis and Disease. J Am Coll Cardiol 72:2213\u20132230. https:\/\/doi.org\/10.1016\/j.jacc.2018.08.2149","journal-title":"J Am Coll Cardiol"},{"key":"6127_CR19","doi-asserted-by":"publisher","first-page":"e268","DOI":"10.1093\/rheumatology\/keae199","volume":"63","author":"A Bhalodia","year":"2024","unstructured":"Bhalodia A, Bermea K, Schmidt J et al (2024) Increased risk of myocarditis and arrythmias in anti-Ku-positive scleroderma\u2013myositis overlap patients: a case series. Rheumatology 63:e268\u2013e269. https:\/\/doi.org\/10.1093\/rheumatology\/keae199","journal-title":"Rheumatology"},{"key":"6127_CR20","doi-asserted-by":"publisher","first-page":"849","DOI":"10.1002\/art.42054","volume":"74","author":"AM Hinze","year":"2022","unstructured":"Hinze AM, Perin J, Woods A et al (2022) Diastolic Dysfunction in Systemic Sclerosis: Risk Factors and Impact on Mortality. Arthritis Rheumatol 74:849\u2013859. https:\/\/doi.org\/10.1002\/art.42054","journal-title":"Arthritis Rheumatol"},{"key":"6127_CR21","doi-asserted-by":"publisher","first-page":"H1847","DOI":"10.1152\/ajpheart.00434.2006","volume":"292","author":"MR Bergman","year":"2007","unstructured":"Bergman MR, Teerlink JR, Mahimkar R et al (2007) Cardiac matrix metalloproteinase-2 expression independently induces marked ventricular remodeling and systolic dysfunction. Am J Physiol Heart Circ Physiol 292:H1847\u2013H1860. https:\/\/doi.org\/10.1152\/ajpheart.00434.2006","journal-title":"Am J Physiol Heart Circ Physiol"},{"key":"6127_CR22","doi-asserted-by":"publisher","first-page":"1804","DOI":"10.1016\/j.jacc.2018.07.068","volume":"72","author":"AH Tenn\u00f8e","year":"2018","unstructured":"Tenn\u00f8e AH, Murbr\u00e6ch K, Andreassen JC et al (2018) Left Ventricular Diastolic Dysfunction Predicts Mortality in Patients With Systemic Sclerosis. J Am Coll Cardiol 72:1804\u20131813. https:\/\/doi.org\/10.1016\/j.jacc.2018.07.068","journal-title":"J Am Coll Cardiol"},{"key":"6127_CR23","doi-asserted-by":"publisher","first-page":"268","DOI":"10.1093\/eurjhf\/hfp198","volume":"12","author":"R Mizuno","year":"2010","unstructured":"Mizuno R, Fujimoto S, Saito Y, Nakamura S (2010) Cardiac Raynaud\u2019s Phenomenon Induced by Cold Provocation as a Predictor of Long-Term Left Ventricular Dysfunction and Remodelling in Systemic Sclerosis: 7-Year Follow-Up Study. Eur J Heart Fail 12:268\u2013275. https:\/\/doi.org\/10.1093\/eurjhf\/hfp198","journal-title":"Eur J Heart Fail"},{"key":"6127_CR24","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1515\/rir-2024-0014","volume":"5","author":"J Werakiat","year":"2024","unstructured":"Werakiat J, Pussadhamma B, Mahakkanukrauh A et al (2024) Clinical courses and predictors of left ventricular systolic dysfunction in systemic sclerosis: A cohort study. Rheumatol Immunol Res 5:107\u2013116. https:\/\/doi.org\/10.1515\/rir-2024-0014","journal-title":"Rheumatol Immunol Res"},{"key":"6127_CR25","doi-asserted-by":"publisher","first-page":"309","DOI":"10.1016\/j.semarthrit.2015.06.011","volume":"45","author":"M Hinchcliff","year":"2015","unstructured":"Hinchcliff M, Khanna S, Hsu VM et al (2015) Survival in systemic sclerosis\u2013pulmonary arterial hypertension by serum autoantibody status in the Pulmonary Hypertension Assessment and Recognition of Outcomes in Scleroderma (PHAROS) Registry. Semin Arthritis Rheum 45:309\u2013314. https:\/\/doi.org\/10.1016\/j.semarthrit.2015.06.011","journal-title":"Semin Arthritis Rheum"},{"key":"6127_CR26","doi-asserted-by":"publisher","first-page":"953","DOI":"10.1161\/CIRCHEARTFAILURE.112.000008","volume":"6","author":"RJ Tedford","year":"2013","unstructured":"Tedford RJ, Mudd JO, Girgis RE et al (2013) Right Ventricular Dysfunction in Systemic Sclerosis\u2013Associated Pulmonary Arterial Hypertension. Circ Heart Fail 6:953\u2013963. https:\/\/doi.org\/10.1161\/CIRCHEARTFAILURE.112.000008","journal-title":"Circ Heart Fail"},{"key":"6127_CR27","doi-asserted-by":"publisher","first-page":"304","DOI":"10.1016\/S2213-2600(19)30480-1","volume":"8","author":"A Perelas","year":"2020","unstructured":"Perelas A, Silver RM, Arrossi AV, Highland KB (2020) Systemic sclerosis-associated interstitial lung disease. Lancet Respir Med 8:304\u2013320. https:\/\/doi.org\/10.1016\/S2213-2600(19)30480-1","journal-title":"Lancet Respir Med"},{"key":"6127_CR28","doi-asserted-by":"publisher","first-page":"1340","DOI":"10.1136\/annrheumdis-2013-203301","volume":"73","author":"JG Coghlan","year":"2014","unstructured":"Coghlan JG, Denton CP, Gr\u00fcnig E et al (2014) Evidence-based detection of pulmonary arterial hypertension in systemic sclerosis: the DETECT study. Ann Rheum Dis 73:1340\u20131349. https:\/\/doi.org\/10.1136\/annrheumdis-2013-203301","journal-title":"Ann Rheum Dis"},{"key":"6127_CR29","doi-asserted-by":"publisher","first-page":"4034","DOI":"10.3390\/jcm11144034","volume":"11","author":"V Mercurio","year":"2022","unstructured":"Mercurio V, Hassan HJ, Naranjo M et al (2022) Risk Stratification of Patients with Pulmonary Arterial Hypertension: The Role of Echocardiography. J Clin Med 11:4034. https:\/\/doi.org\/10.3390\/jcm11144034","journal-title":"J Clin Med"},{"key":"6127_CR30","first-page":"S81","volume":"30","author":"C Chighizola","year":"2012","unstructured":"Chighizola C, Meroni PL, Schreiber BE et al (2012) Role of N-terminal pro-brain natriuretic peptide in detecting clinically significant cardiac involvement in systemic sclerosis patients. Clin Exp Rheumatol 30:S81\u2013S85","journal-title":"Clin Exp Rheumatol"},{"key":"6127_CR31","doi-asserted-by":"publisher","first-page":"3388","DOI":"10.3390\/jcm9113388","volume":"9","author":"A Utsunomiya","year":"2020","unstructured":"Utsunomiya A, Oyama N, Hasegawa M (2020) Potential Biomarkers in Systemic Sclerosis: A Literature Review and Update. J Clin Med 9:3388. https:\/\/doi.org\/10.3390\/jcm9113388","journal-title":"J Clin Med"},{"key":"6127_CR32","doi-asserted-by":"publisher","first-page":"1154","DOI":"10.1002\/acr.23861","volume":"71","author":"DF Moore","year":"2019","unstructured":"Moore DF, Kramer E, Eltaraboulsi R, Steen VD (2019) Increased Morbidity and Mortality of Scleroderma in African Americans Compared to Non\u2013African Americans. Arthritis Care Res (Hoboken) 71:1154\u20131163. https:\/\/doi.org\/10.1002\/acr.23861","journal-title":"Arthritis Care Res (Hoboken)"},{"key":"6127_CR33","doi-asserted-by":"publisher","first-page":"448","DOI":"10.1016\/j.ijcard.2017.08.072","volume":"249","author":"M Hrom\u00e1dka","year":"2017","unstructured":"Hrom\u00e1dka M, Seidlerov\u00e1 J, Such\u00fd D et al (2017) Myocardial fibrosis detected by magnetic resonance in systemic sclerosis patients \u2013 Relationship with biochemical and echocardiography parameters. Int J Cardiol 249:448\u2013453. https:\/\/doi.org\/10.1016\/j.ijcard.2017.08.072","journal-title":"Int J Cardiol"},{"key":"6127_CR34","doi-asserted-by":"publisher","first-page":"412","DOI":"10.1007\/s12016-022-08946-w","volume":"64","author":"I Cavazzana","year":"2022","unstructured":"Cavazzana I, Vojinovic T, Airo\u2019 P et al (2022) Systemic Sclerosis-Specific Antibodies: Novel and Classical Biomarkers. Clin Rev Allergy Immunol 64:412\u2013430. https:\/\/doi.org\/10.1007\/s12016-022-08946-w","journal-title":"Clin Rev Allergy Immunol"},{"key":"6127_CR35","doi-asserted-by":"publisher","first-page":"2200879","DOI":"10.1183\/13993003.00879-2022","volume":"61","author":"M Humbert","year":"2023","unstructured":"Humbert M, Kovacs G, Hoeper MM et al (2023) 2022 ESC\/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Respir J 61:2200879. https:\/\/doi.org\/10.1183\/13993003.00879-2022","journal-title":"Eur Respir J"},{"key":"6127_CR36","doi-asserted-by":"publisher","unstructured":"Gremese E, Bruno D, Perniola S et al (2025) Autoimmune inflammation as a key risk factor for heart failure with preserved ejection fraction: the different types of inflammation driving to HFpEF. Front Med (Lausanne) 12. https:\/\/doi.org\/10.3389\/fmed.2025.1557312","DOI":"10.3389\/fmed.2025.1557312"},{"key":"6127_CR37","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1007\/s12265-020-10026-3","volume":"14","author":"EL Kessler","year":"2021","unstructured":"Kessler EL, Oerlemans MIFJ, van den Hoogen P et al (2021) Immunomodulation in Heart Failure with Preserved Ejection Fraction: Current State and Future Perspectives. J Cardiovasc Transl Res 14:63\u201374. https:\/\/doi.org\/10.1007\/s12265-020-10026-3","journal-title":"J Cardiovasc Transl Res"},{"key":"6127_CR38","doi-asserted-by":"publisher","first-page":"267","DOI":"10.2478\/sjecr-2018-0052","volume":"24","author":"JS Neskovic","year":"2023","unstructured":"Neskovic JS, Ristic A, Petronijevic M et al (2023) Electrocardiographic Findings in Systemic Sclerosis. Experimental Appl Biomedical Res (EABR) 24:267\u2013270. https:\/\/doi.org\/10.2478\/sjecr-2018-0052","journal-title":"Experimental Appl Biomedical Res (EABR)"},{"key":"6127_CR39","doi-asserted-by":"publisher","unstructured":"Bairkdar M, Dong Z, Andell P et al (2024) Arrhythmia in patients with systemic sclerosis: incidence, risk factors and impact on mortality in a Swedish register-based study. https:\/\/doi.org\/10.1136\/rmdopen-2024-004532. RMD Open 10:","DOI":"10.1136\/rmdopen-2024-004532"},{"key":"6127_CR40","doi-asserted-by":"publisher","first-page":"152229","DOI":"10.1016\/j.semarthrit.2023.152229","volume":"62","author":"JL Fairley","year":"2023","unstructured":"Fairley JL, Ross L, Quinlivan A et al (2023) Sudden cardiac death, arrhythmias and abnormal electrocardiography in systemic sclerosis: A systematic review and meta-analysis. Semin Arthritis Rheum 62:152229. https:\/\/doi.org\/10.1016\/j.semarthrit.2023.152229","journal-title":"Semin Arthritis Rheum"}],"container-title":["Rheumatology International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00296-026-06127-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00296-026-06127-y","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00296-026-06127-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T15:39:20Z","timestamp":1783525160000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00296-026-06127-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,25]]},"references-count":40,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["6127"],"URL":"https:\/\/doi.org\/10.1007\/s00296-026-06127-y","relation":{},"ISSN":["1437-160X"],"issn-type":[{"value":"1437-160X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,25]]},"assertion":[{"value":"28 March 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 April 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 May 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"ChatGPT (OpenAI) was used solely to assist with language editing and translation from the authors\u2019 native language into English. The tool was not used for the generation or interpretation of scientific content. All AI-assisted text was critically reviewed and edited by the authors and take full responsibility for its content. The figures were created with the assistance of purely graphical artificial intelligence tools; all content was entirely provided and curated by the authors. The authors confirm that this manuscript is original, has not been published or submitted elsewhere in whole or in part in any languages; has been approved by all authors and relevant authorities, and will not be published elsewhere in any form without prior written consent of the copyright holder.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"AI use statement"}}],"article-number":"110"}}