{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T10:05:46Z","timestamp":1779444346926,"version":"3.53.1"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T00:00:00Z","timestamp":1772582400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T00:00:00Z","timestamp":1772582400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100008386","name":"Marmara University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100008386","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Nephrol"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>\n                      We aimed to evaluate the clinical and genetic characteristics and clinical course of children with persistent proteinuria associated with\n                      <jats:italic>CUBN<\/jats:italic>\n                      variants.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Forty-eight children with\n                      <jats:italic>CUBN<\/jats:italic>\n                      variants from 15 pediatric nephrology centers were included. Patients\u2019 characteristics, serum creatinine, albumin, hemoglobin, vitamin B12 levels, urinalysis, spot urine protein\/creatinine (uPCR), microalbumin\/creatinine (uACR), beta-2 microglobulin\/creatinine (uBMCR) ratios, estimated glomerular filtration rates (eGFRs), treatments, kidney biopsies, and genetic findings were evaluated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      All patients had normal serum albumin and creatinine and preserved eGFR. There was no significant change in eGFR between the first and last visits (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.15), whereas uPCR was lower at the last visit (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001). Kidney biopsy was performed in 13 (27%); light microscopy was normal in all except one patient with focal segmental glomerulosclerosis (FSGS). Thirty-five patients (72.9%) had ACEi\/ARB therapy, which was discontinued in 21 patients without subsequent worsening of proteinuria. Overall, 26 distinct\n                      <jats:italic>CUBN<\/jats:italic>\n                      variants were identified, predominantly in the C-terminal region. The most frequent variant was c.10102A\u2009&gt;\u2009G (p.Met3368Val). Variant types included 15 (57.7%) missense, 7 (27%) nonsense, 3 (11.5%) splicing, and 1 (3.8%) frameshift variants.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      In this multicenter, large pediatric cohort, proteinuria associated with\n                      <jats:italic>CUBN<\/jats:italic>\n                      variants generally followed a benign course over short to mid-term follow-up even without sustained ACEi\/ARB therapy. Embedding targeted\n                      <jats:italic>CUBN<\/jats:italic>\n                      testing into the evaluation of children with asymptomatic proteinuria and normal kidney function may reduce unnecessary kidney biopsies and prolonged medication, while improving family counseling. We outline a stepwise care pathway\u2009\u2192\u2009early genetic screening\u2009\u2192\u2009conservative monitoring with periodic eGFR and proteinuria assessment\u2009\u2192\u2009consideration of ACEi\/ARB discontinuation and recommend prospective validation and cost-effectiveness studies.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00467-026-07227-4","type":"journal-article","created":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T21:31:37Z","timestamp":1772659897000},"page":"2089-2097","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical course of proteinuria due to cubilin variants: a large multicenter pediatric cohort"],"prefix":"10.1007","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5859-4177","authenticated-orcid":false,"given":"Neslihan","family":"Cicek","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7327-3849","authenticated-orcid":false,"given":"Ceren","family":"Alavanda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2443-4378","authenticated-orcid":false,"given":"Ayse Seda","family":"P\u0131narbas\u0131","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1164-734X","authenticated-orcid":false,"given":"Aylin","family":"Inal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1133-4845","authenticated-orcid":false,"given":"Bahriye","family":"Atm\u0131s","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5828-331X","authenticated-orcid":false,"given":"Secil","family":"Kezer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0790-323X","authenticated-orcid":false,"given":"Mehtap Akbalik","family":"Kara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2148-1160","authenticated-orcid":false,"given":"Okan","family":"Akaci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6896-404X","authenticated-orcid":false,"given":"Serim","family":"Pul","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6438-2015","authenticated-orcid":false,"given":"Sevcan","family":"Hatipoglu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2891-2231","authenticated-orcid":false,"given":"Zeynep Nagehan Yuruk","family":"Yildirim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3658-8622","authenticated-orcid":false,"given":"Ayse","family":"Agbas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0504-7911","authenticated-orcid":false,"given":"Emre","family":"Leventoglu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2617-4466","authenticated-orcid":false,"given":"Ilknur","family":"Girisgen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6750-5172","authenticated-orcid":false,"given":"Mehtap","family":"Kaya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8162-3677","authenticated-orcid":false,"given":"Nimet Sasmaz","family":"Nurdag","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3284-9204","authenticated-orcid":false,"given":"Sercin","family":"Guven","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2928-9031","authenticated-orcid":false,"given":"Ozde Nisa","family":"Turkkan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6805-5313","authenticated-orcid":false,"given":"Nurdan","family":"Yildiz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6688-2347","authenticated-orcid":false,"given":"Pinar","family":"Ata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0191-4344","authenticated-orcid":false,"given":"Ismail","family":"Dursun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6896-5162","authenticated-orcid":false,"given":"Ibrahim","family":"Gokce","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,4]]},"reference":[{"key":"7227_CR1","doi-asserted-by":"publisher","DOI":"10.1186\/1750-1172-1-17","volume":"1","author":"RN Gr\u00e4sbeck","year":"2006","unstructured":"Gr\u00e4sbeck RN (2006) Imerslund-Gr\u00e4sbeck syndrome (selective vitamin B(12) malabsorption with proteinuria). Orphanet J Rare Dis 1:17. https:\/\/doi.org\/10.1186\/1750-1172-1-17","journal-title":"Orphanet J Rare Dis"},{"key":"7227_CR2","doi-asserted-by":"publisher","first-page":"309","DOI":"10.1038\/6831","volume":"21","author":"M Aminoff","year":"1999","unstructured":"Aminoff M, Carter JE, Chadwick RB, Johnson C, Gr\u00e4sbeck R, Abdelaal MA, Broch H, Jenner LB, Verroust PJ, Moestrup SK, de la Chapelle A, Krahe R (1999) Mutations in CUBN, encoding the intrinsic factor-vitamin B12 receptor, cubilin, cause hereditary megaloblastic anaemia 1. Nat Genet 21:309\u2013313. https:\/\/doi.org\/10.1038\/6831","journal-title":"Nat Genet"},{"key":"7227_CR3","doi-asserted-by":"publisher","first-page":"3367","DOI":"10.1007\/s00467","volume":"40","author":"N Sakakibara","year":"2025","unstructured":"Sakakibara N, Nozu K (2025) Tubular proteinuria due to hereditary endocytic receptor disorder of the proximal tubule: Dent disease and chronic benign proteinuria. Pediatr Nephrol 40:3367\u20133377. https:\/\/doi.org\/10.1007\/s00467","journal-title":"Pediatr Nephrol"},{"key":"7227_CR4","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1172\/JCI129937","volume":"130","author":"M Bedin","year":"2020","unstructured":"Bedin M, Boyer O, Servais A, Li Y, Villoing-Gaud\u00e9 L, T\u00eate MJ et al (2020) Human C-terminal CUBN variants associate with chronic proteinuria and normal renal function. J Clin Invest 130:335\u2013344. https:\/\/doi.org\/10.1172\/JCI129937","journal-title":"J Clin Invest"},{"key":"7227_CR5","doi-asserted-by":"publisher","first-page":"663","DOI":"10.23876\/j.krcp.23.258","volume":"43","author":"YY Choi","year":"2024","unstructured":"Choi YY, Ahn YH, Park E, Kim JH, Kang HG, Lee HK (2024) To treat or not to treat: CUBN-associated persistent proteinuria. Kidney Res Clin Pract 43:663\u2013670. https:\/\/doi.org\/10.23876\/j.krcp.23.258","journal-title":"Kidney Res Clin Pract"},{"key":"7227_CR6","doi-asserted-by":"publisher","DOI":"10.1002\/ccr3.7502","volume":"11","author":"V Shi","year":"2023","unstructured":"Shi V, Stein Q, Clark D, Punj S, Kremsdorf R, Faizan M (2023) Isolated benign persistent proteinuria with novel association of CUBN (cubilin) variants. Clin Case Rep 11:e7502. https:\/\/doi.org\/10.1002\/ccr3.7502","journal-title":"Clin Case Rep"},{"key":"7227_CR7","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1159\/000530466","volume":"13","author":"J Ran","year":"2023","unstructured":"Ran J, Chen Q, Hu Y, Yang P, Yu G, Liao X, Lei J (2023) Isolated proteinuria caused by CUBN gene mutations: a case report and review of the literature. Case Rep Nephrol Dial 13:27\u201335. https:\/\/doi.org\/10.1159\/000530466","journal-title":"Case Rep Nephrol Dial"},{"key":"7227_CR8","doi-asserted-by":"publisher","first-page":"1381","DOI":"10.1007\/s00467-022-05730-y","volume":"38","author":"N Cicek","year":"2023","unstructured":"Cicek N, Alpay H, Guven S, Alavanda C, T\u00fcrkkan \u00d6N, Pul S, Demirci E, Y\u0131ld\u0131z N, Ata P, Gokce I (2023) Clinical and genetic characterization of children with cubilin variants. Pediatr Nephrol 38:1381\u20131385. https:\/\/doi.org\/10.1007\/s00467-022-05730-y","journal-title":"Pediatr Nephrol"},{"key":"7227_CR9","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1681\/ASN.2008030287","volume":"20","author":"GJ Schwartz","year":"2009","unstructured":"Schwartz GJ, Munoz A, Schneider MF, Mak RH, Kaskel F, Warady BA, Furth SL (2009) New equations to estimate GFR in children with CKD. J Am Soc Nephrol 20:629\u2013637. https:\/\/doi.org\/10.1681\/ASN.2008030287","journal-title":"J Am Soc Nephrol"},{"key":"7227_CR10","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1038\/gim.2015.30","volume":"17","author":"S Richards","year":"2015","unstructured":"Richards S, Aziz N, Bale S, Bick D, Das S, Gastier-Foster J, Grody WW, Hegde M, Lyon E, Spector E, Voelkerding K, Rehm HL, ACMG Laboratory Quality Assurance Committee (2015) Standards and guidelines for the interpretation of sequence variants: a joint consensus recommendation of the American College of Medical Genetics and Genomics and the Association for Molecular Pathology. Genet Med 17:405\u2013424. https:\/\/doi.org\/10.1038\/gim.2015.30","journal-title":"Genet Med"},{"key":"7227_CR11","doi-asserted-by":"publisher","first-page":"1906","DOI":"10.1093\/ndt\/gfab285","volume":"37","author":"A Domingo-Gallego","year":"2022","unstructured":"Domingo-Gallego A, Pybus M, Madariaga L, Pi\u00f1ero-Fern\u00e1ndez JA, Gonz\u00e1lez-Pastor S, L\u00f3pez-Gonz\u00e1lez M, Simarro-Rueda E, Quintanilla-Mata ML, Matoses-Ruip\u00e9rez ML, Ejarque-Vila L, Cornec-Le Gall E, Guirado L, Torra R, Ariceta G, Ars E (2022) Clinical and genetic characterization of a cohort of proteinuric patients with biallelic CUBN variants. Nephrol Dial Transplant 37:1906\u20131915. https:\/\/doi.org\/10.1093\/ndt\/gfab285","journal-title":"Nephrol Dial Transplant"},{"key":"7227_CR12","doi-asserted-by":"publisher","first-page":"1353","DOI":"10.1172\/JCI8862","volume":"105","author":"H Birn","year":"2000","unstructured":"Birn H, Fyfe JC, Jacobsen C, Mounier F, Verroust PJ, Orskov H, Willnow TE, Moestrup SK, Christensen EI (2000) Cubilin is an albumin binding protein important for renal tubular albumin reabsorption. J Clin Invest 105:1353\u20131361. https:\/\/doi.org\/10.1172\/JCI8862","journal-title":"J Clin Invest"},{"key":"7227_CR13","doi-asserted-by":"publisher","first-page":"1859","DOI":"10.1681\/ASN.2010050492","volume":"21","author":"S Amsellem","year":"2010","unstructured":"Amsellem S, Gburek J, Hamard G, Nielsen R, Willnow TE, Devuyst O, Nexo E, Verroust PJ, Christensen EI, Kozyraki R (2010) Cubilin is essential for albumin reabsorption in the renal proximal tubule. J Am Soc Nephrol 21:1859\u20131867. https:\/\/doi.org\/10.1681\/ASN.2010050492","journal-title":"J Am Soc Nephrol"},{"key":"7227_CR14","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-017-13789-z","volume":"7","author":"L Gianesello","year":"2017","unstructured":"Gianesello L, Priante G, Ceol M, Radu CM, Saleem MA, Simioni P, Terrin L, Anglani F, Del Prete D (2017) Albumin uptake in human podocytes: a possible role for the cubilin-amnionless (CUBAM) complex. Sci Rep 7:13705. https:\/\/doi.org\/10.1038\/s41598-017-13789-z","journal-title":"Sci Rep"},{"key":"7227_CR15","doi-asserted-by":"publisher","first-page":"710","DOI":"10.1681\/ASN.2017111197","volume":"29","author":"M Simons","year":"2018","unstructured":"Simons M (2018) The benefits of tubular proteinuria: an evolutionary perspective. J Am Soc Nephrol 29:710\u2013712. https:\/\/doi.org\/10.1681\/ASN.2017111197","journal-title":"J Am Soc Nephrol"},{"key":"7227_CR16","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfaf320","volume":"18","author":"FF Alkaff","year":"2025","unstructured":"Alkaff FF, Lammerts RGM, Tiller G, van den Heuvel MC, Bajema IM, Daha MR, van den Born J, Berger SP (2025) Alternative pathway-mediated tubular complement activation in human proteinuric kidney diseases: a proof-of-concept study. Clin Kidney J 18:sfaf320. https:\/\/doi.org\/10.1093\/ckj\/sfaf320","journal-title":"Clin Kidney J"},{"key":"7227_CR17","doi-asserted-by":"publisher","unstructured":"Ishola DA Jr, Post JA, van Timmeren MM, Bakker SJ, Goldschmeding R, Koomans HA, Braam B, Joles JA (2006) Albumin-bound fatty acids induce mitochondrial oxidant stress and impair antioxidant responses in proximal tubular cells. Kidney Int 70:724\u2013731. https:\/\/doi.org\/10.1038\/sj.ki.5001629","DOI":"10.1038\/sj.ki.5001629"},{"key":"7227_CR18","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1016\/j.kint.2024.04.011","volume":"106","author":"Y Feng","year":"2024","unstructured":"Feng Y, Sun Z, Fu J, Zhong F, Zhang W, Wei C, Chen A, Liu BC, He JC, Lee K (2024) Podocyte-derived soluble RARRES1 drives kidney disease progression through direct podocyte and proximal tubular injury. Kidney Int 106:50\u201366. https:\/\/doi.org\/10.1016\/j.kint.2024.04.011","journal-title":"Kidney Int"},{"key":"7227_CR19","doi-asserted-by":"publisher","first-page":"1815","DOI":"10.1681\/ASN.2011040337","volume":"22","author":"B Ovunc","year":"2011","unstructured":"Ovunc B, Otto EA, Vega-Warner V, Saisawat P, Ashraf S, Ramaswami G, Fathy HM, Schoeb D, Chernin G, Lyons RH, Yilmaz E, Hildebrandt F (2011) Exome sequencing reveals cubilin mutation as a single-gene cause of proteinuria. J Am Soc Nephrol 22:1815\u20131820. https:\/\/doi.org\/10.1681\/ASN.2011040337","journal-title":"J Am Soc Nephrol"},{"key":"7227_CR20","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1007\/s13730-024-00919-6","volume":"14","author":"N Yamamura-Miyazaki","year":"2025","unstructured":"Yamamura-Miyazaki N, Sakakibara N, Nozu K, Shima Y, Satomura K, Yamamoto S, Baba M, Fujiwara K, Yamamoto K, Michigami T (2025) Identification of CUBN variants in triplets with a 20-year history of proteinuria. CEN Case Rep 14:145\u2013150. https:\/\/doi.org\/10.1007\/s13730-024-00919-6","journal-title":"CEN Case Rep"},{"key":"7227_CR21","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.34730","volume":"15","author":"S Madureira Gomes","year":"2023","unstructured":"Madureira Gomes S, Igreja AI, Silva R, Oliveira JP, Pinto H (2023) Podocytopathy and glomerular basement membrane anomalies in two patients with cubilin gene mutations. Cureus 15:e34730. https:\/\/doi.org\/10.7759\/cureus.34730","journal-title":"Cureus"},{"key":"7227_CR22","doi-asserted-by":"publisher","DOI":"10.1186\/s12882-021-02654-x","volume":"23","author":"J Yang","year":"2022","unstructured":"Yang J, Xu Y, Deng L, Zhou L, Qiu L, Zhang Y, Zhou J (2022) CUBN gene mutations may cause focal segmental glomerulosclerosis (FSGS) in children. BMC Nephrol 23:15. https:\/\/doi.org\/10.1186\/s12882-021-02654-x","journal-title":"BMC Nephrol"},{"key":"7227_CR23","doi-asserted-by":"publisher","first-page":"3156","DOI":"10.1093\/ndt\/gfr794","volume":"27","author":"T Prabakaran","year":"2012","unstructured":"Prabakaran T, Christensen EI, Nielsen R, Verroust PJ (2012) Cubilin is expressed in rat and human glomerular podocytes. Nephrol Dial Transplant 27:3156\u20133159. https:\/\/doi.org\/10.1093\/ndt\/gfr794","journal-title":"Nephrol Dial Transplant"}],"container-title":["Pediatric Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00467-026-07227-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00467-026-07227-4","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00467-026-07227-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T09:27:20Z","timestamp":1779442040000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00467-026-07227-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,4]]},"references-count":23,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["7227"],"URL":"https:\/\/doi.org\/10.1007\/s00467-026-07227-4","relation":{},"ISSN":["0931-041X","1432-198X"],"issn-type":[{"value":"0931-041X","type":"print"},{"value":"1432-198X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,4]]},"assertion":[{"value":"14 November 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 January 2026","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 February 2026","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 March 2026","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Informed consents from the parents were obtained.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent to participate"}},{"value":"Ethics statement is approved by the local Marmara University School of Medicine committee of ethics (09.2025.25\u20130110).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Ethics statement is approved by the local Marmara University School of Medicine committee of ethics (09.2022.21). All procedures performed in studies involving human participants were in accordance with the ethical standards Helsinki declaration.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"The authors declare no conflicts of interest.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of\/Competing \u0131nterest"}}]}}