{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T17:12:27Z","timestamp":1790010747977,"version":"4.0.1"},"reference-count":51,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"funder":[{"DOI":"10.13039\/501100004410","name":"T\u00fcrkiye Bilimsel ve Teknolojik Ara\u015ft\u0131rma Kurumu","doi-asserted-by":"publisher","award":["121S210"],"award-info":[{"award-number":["121S210"]}],"id":[{"id":"10.13039\/501100004410","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Reprod. Sci."],"DOI":"10.1007\/s43032-026-02210-8","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T16:41:00Z","timestamp":1790008860000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sperm tRNA-Derived Fragment-36 Expression in Varicocele: Associations with Disease Severity, Semen Parameters and Reproductive Hormones"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6213-6286","authenticated-orcid":false,"given":"Asli","family":"Metin Mahmutoglu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2216-5677","authenticated-orcid":false,"given":"Mehmet","family":"Caniklioglu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8128-6044","authenticated-orcid":false,"given":"Aysen","family":"Caniklioglu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3818-2693","authenticated-orcid":false,"given":"Emin","family":"Kaymak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4966-8450","authenticated-orcid":false,"given":"Yuksel","family":"Terzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"issue":"2","key":"2210_CR1","doi-asserted-by":"publisher","first-page":"276","DOI":"10.4103\/1008-682X.167724","volume":"18","author":"K Chiba","year":"2016","unstructured":"Chiba K, et al. The varicocele: diagnostic dilemmas, therapeutic challenges and future perspectives. Asian J Androl. 2016;18(2):276\u201381.","journal-title":"Asian J Androl"},{"issue":"9","key":"2210_CR2","doi-asserted-by":"publisher","first-page":"523","DOI":"10.1038\/nrurol.2017.98","volume":"14","author":"CFS Jensen","year":"2017","unstructured":"Jensen CFS, et al. Varicocele and male infertility. Nat Rev Urol. 2017;14(9):523\u201333.","journal-title":"Nat Rev Urol"},{"issue":"3","key":"2210_CR3","doi-asserted-by":"publisher","first-page":"613","DOI":"10.1016\/S0015-0282(16)55809-9","volume":"59","author":"JI Gorelick","year":"1993","unstructured":"Gorelick JI, Goldstein M. Loss of fertility in men with varicocele. Fertil Steril. 1993;59(3):613\u20136.","journal-title":"Fertil Steril"},{"issue":"1","key":"2210_CR4","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1016\/S0090-4295(99)80385-9","volume":"47","author":"JP Jarow","year":"1996","unstructured":"Jarow JP, Coburn M, Sigman M. Incidence of varicoceles in men with primary and secondary infertility. Urology. 1996;47(1):73\u20136.","journal-title":"Urology"},{"key":"2210_CR5","doi-asserted-by":"crossref","unstructured":"Zylbersztejn DS, Esteves SC. Varicocele. In: Male infertility: contemporary clinical approaches, andrology, ART and antioxidants. Springer; 2020. p. 391\u2013407.","DOI":"10.1007\/978-3-030-32300-4_31"},{"key":"2210_CR6","doi-asserted-by":"publisher","DOI":"10.1080\/14647273.2020.1785117","author":"A Maheshwari","year":"2020","unstructured":"Maheshwari A, et al. A review of varicocele treatment and fertility outcomes. Hum Fertil (Camb). 2020. https:\/\/doi.org\/10.1080\/14647273.2020.1785117.","journal-title":"Hum Fertil (Camb)"},{"issue":"4","key":"2210_CR7","doi-asserted-by":"publisher","first-page":"770","DOI":"10.1016\/j.fertnstert.2020.04.045","volume":"114","author":"VP Santana","year":"2020","unstructured":"Santana VP, et al. Differential DNA methylation pattern and sperm quality in men with varicocele. Fertil Steril. 2020;114(4):770\u20138.","journal-title":"Fertil Steril"},{"issue":"2","key":"2210_CR8","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1016\/j.fertnstert.2020.08.004","volume":"115","author":"B Yang","year":"2021","unstructured":"Yang B, et al. Molecular characteristics of varicocele: integration of whole-exome and transcriptome sequencing. Fertil Steril. 2021;115(2):363\u201372.","journal-title":"Fertil Steril"},{"issue":"9","key":"2210_CR9","doi-asserted-by":"publisher","DOI":"10.1111\/and.13598","volume":"52","author":"AM Ashrafzade","year":"2020","unstructured":"Ashrafzade AM, et al. Oxidative stress-related miRNAs in spermatozoa may reveal the severity of damage in grade III varicocele. Andrologia. 2020;52(9):e13598.","journal-title":"Andrologia"},{"issue":"4","key":"2210_CR10","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0232357","volume":"15","author":"NS Ata-Abadi","year":"2020","unstructured":"Ata-Abadi NS, et al. Hypoxia-related long noncoding RNAs are associated with varicocele-related male infertility. PLoS ONE. 2020;15(4):e0232357.","journal-title":"PLoS ONE"},{"key":"2210_CR11","doi-asserted-by":"publisher","first-page":"4302754","DOI":"10.1155\/2016\/4302754","volume":"2016","author":"T Mostafa","year":"2016","unstructured":"Mostafa T, et al. Seminal miRNA relationship with apoptotic markers and oxidative stress in infertile men with varicocele. Biomed Res Int. 2016;2016:4302754.","journal-title":"Biomed Res Int"},{"key":"2210_CR12","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1016\/j.reprotox.2020.09.012","volume":"98","author":"N Ou","year":"2020","unstructured":"Ou N, et al. Identification and verification of hub microRNAs in varicocele rats through high-throughput sequencing and bioinformatics analysis. Reprod Toxicol. 2020;98:189\u201399.","journal-title":"Reprod Toxicol"},{"issue":"4","key":"2210_CR13","doi-asserted-by":"publisher","first-page":"5105","DOI":"10.18632\/oncotarget.23696","volume":"9","author":"J Zhao","year":"2018","unstructured":"Zhao J, et al. LncRNA gadd7, increased in varicocele patients, suppresses cell proliferation and promotes cell apoptosis. Oncotarget. 2018;9(4):5105\u201310.","journal-title":"Oncotarget"},{"issue":"1","key":"2210_CR14","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1038\/s41392-020-00217-4","volume":"5","author":"Y Xie","year":"2020","unstructured":"Xie Y, et al. Action mechanisms and research methods of tRNA-derived small RNAs. Signal Transduct Target Ther. 2020;5(1):109.","journal-title":"Signal Transduct Target Ther"},{"issue":"8","key":"2210_CR15","doi-asserted-by":"publisher","first-page":"679","DOI":"10.1016\/j.tibs.2016.05.004","volume":"41","author":"P Kumar","year":"2016","unstructured":"Kumar P, Kuscu C, Dutta A. Biogenesis and function of transfer RNA-related fragments (tRFs). Trends Biochem Sci. 2016;41(8):679\u201389.","journal-title":"Trends Biochem Sci"},{"key":"2210_CR16","doi-asserted-by":"publisher","DOI":"10.1093\/molehr\/gaab026","author":"HM Li","year":"2021","unstructured":"Li HM, et al. Transfer- or \u2019transmission\u2019-RNA fragments? The roles of tsRNAs in the reproductive system. Mol Hum Reprod. 2021. https:\/\/doi.org\/10.1093\/molehr\/gaab026.","journal-title":"Mol Hum Reprod"},{"issue":"11","key":"2210_CR17","doi-asserted-by":"publisher","first-page":"3007","DOI":"10.1002\/ijc.33107","volume":"147","author":"T Zeng","year":"2020","unstructured":"Zeng T, et al. Relationship between tRNA-derived fragments and human cancers. Int J Cancer. 2020;147(11):3007\u201318.","journal-title":"Int J Cancer"},{"issue":"2","key":"2210_CR18","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1530\/REP-20-0415","volume":"161","author":"X Chen","year":"2021","unstructured":"Chen X, et al. Human sperm tsRNA as potential biomarker and therapy target for male fertility. Reproduction. 2021;161(2):111\u201322.","journal-title":"Reproduction"},{"issue":"4","key":"2210_CR19","first-page":"3191","volume":"20","author":"C Yu","year":"2019","unstructured":"Yu C, et al. Expression profile of tRNA-derived fragments and their potential roles in human varicose veins. Mol Med Rep. 2019;20(4):3191\u2013201.","journal-title":"Mol Med Rep"},{"issue":"1","key":"2210_CR20","doi-asserted-by":"publisher","first-page":"20251075","DOI":"10.1515\/biol-2025-1075","volume":"20","author":"G Chen","year":"2025","unstructured":"Chen G, et al. Transfer RNA-derived fragment tRF-36 modulates varicose vein progression via human vascular smooth muscle cell Notch signaling. Open Life Sci. 2025;20(1):20251075.","journal-title":"Open Life Sci"},{"issue":"10","key":"2210_CR21","doi-asserted-by":"publisher","first-page":"972","DOI":"10.1111\/iju.12843","volume":"22","author":"YW Lai","year":"2015","unstructured":"Lai YW, et al. Varicocele is associated with varicose veins: a population-based case-control study. Int J Urol. 2015;22(10):972\u20135.","journal-title":"Int J Urol"},{"issue":"8","key":"2210_CR22","doi-asserted-by":"publisher","first-page":"409","DOI":"10.1258\/phleb.2011.011051","volume":"27","author":"JD Lee","year":"2012","unstructured":"Lee JD, et al. Increased expression of hypoxia-inducible factor-1\u03b1 and metallothionein in varicocele and varicose veins. Phlebology. 2012;27(8):409\u201315.","journal-title":"Phlebology"},{"issue":"6","key":"2210_CR23","doi-asserted-by":"publisher","first-page":"768","DOI":"10.1016\/j.avsg.2010.02.018","volume":"24","author":"JD Lee","year":"2010","unstructured":"Lee JD, Yang WK, Lai CH. Involved intrinsic apoptotic pathway in the varicocele and varicose veins. Ann Vasc Surg. 2010;24(6):768\u201374.","journal-title":"Ann Vasc Surg"},{"key":"2210_CR24","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1016\/j.avsg.2016.05.105","volume":"38","author":"P Qiu","year":"2017","unstructured":"Qiu P, et al. Association between clinical and ultrasonic characteristics of varicocele and lower extremity varicose vein in men. Ann Vasc Surg. 2017;38:298\u2013304.","journal-title":"Ann Vasc Surg"},{"issue":"1","key":"2210_CR25","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1038\/s41421-020-00212-7","volume":"6","author":"W Cui","year":"2020","unstructured":"Cui W, et al. CARF promotes spermatogonial self-renewal and proliferation through Wnt signaling pathway. Cell Discov. 2020;6(1):85.","journal-title":"Cell Discov"},{"issue":"4","key":"2210_CR26","doi-asserted-by":"publisher","first-page":"1305","DOI":"10.1152\/physrev.00028.2010","volume":"91","author":"A Darszon","year":"2011","unstructured":"Darszon A, et al. Calcium channels in the development, maturation, and function of spermatozoa. Physiol Rev. 2011;91(4):1305\u201355.","journal-title":"Physiol Rev"},{"key":"2210_CR27","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1016\/S0074-7696(05)43002-8","volume":"243","author":"A Darszon","year":"2005","unstructured":"Darszon A, et al. Calcium channels and Ca2+ fluctuations in sperm physiology. Int Rev Cytol. 2005;243:79\u2013172.","journal-title":"Int Rev Cytol"},{"issue":"5","key":"2210_CR28","doi-asserted-by":"publisher","first-page":"1225","DOI":"10.1016\/j.cell.2015.10.029","volume":"163","author":"S Koch","year":"2015","unstructured":"Koch S, et al. Post-transcriptional Wnt signaling governs epididymal sperm maturation. Cell. 2015;163(5):1225\u201336.","journal-title":"Cell"},{"issue":"4","key":"2210_CR29","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1016\/j.molmed.2009.02.002","volume":"15","author":"MW Li","year":"2009","unstructured":"Li MW, Mruk DD, Cheng CY. Mitogen-activated protein kinases in male reproductive function. Trends Mol Med. 2009;15(4):159\u201368.","journal-title":"Trends Mol Med"},{"key":"2210_CR30","doi-asserted-by":"publisher","DOI":"10.1155\/2011\/821615","volume":"2011","author":"PR Manna","year":"2011","unstructured":"Manna PR, Stocco DM. The role of specific mitogen-activated protein kinase signaling cascades in the regulation of steroidogenesis. J Signal Transduct. 2011;2011:821615.","journal-title":"J Signal Transduct"},{"issue":"8","key":"2210_CR31","doi-asserted-by":"publisher","first-page":"541","DOI":"10.1038\/s41419-019-1782-z","volume":"10","author":"FD Ni","year":"2019","unstructured":"Ni FD, Hao SL, Yang WX. Multiple signaling pathways in Sertoli cells: recent findings in spermatogenesis. Cell Death Dis. 2019;10(8):541.","journal-title":"Cell Death Dis"},{"issue":"11","key":"2210_CR32","doi-asserted-by":"publisher","first-page":"1609","DOI":"10.1038\/cr.2012.141","volume":"22","author":"H Peng","year":"2012","unstructured":"Peng H, et al. A novel class of tRNA-derived small RNAs extremely enriched in mature mouse sperm. Cell Res. 2012;22(11):1609\u201312.","journal-title":"Cell Res"},{"issue":"1","key":"2210_CR33","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1186\/s41544-020-00058-x","volume":"2","author":"SJ Stanger","year":"2020","unstructured":"Stanger SJ, et al. The abundance of a transfer RNA-derived RNA fragment small RNA subpopulation is enriched in cauda spermatozoa. ExRNA. 2020;2(1):17.","journal-title":"ExRNA"},{"key":"2210_CR34","doi-asserted-by":"publisher","DOI":"10.1093\/molehr\/gaab017","author":"JB Grosso","year":"2021","unstructured":"Grosso JB, et al. Levels of seminal tRNA-derived fragments from normozoospermic men correlate with the success rate of ART. Mol Hum Reprod. 2021. https:\/\/doi.org\/10.1093\/molehr\/gaab017.","journal-title":"Mol Hum Reprod"},{"issue":"1","key":"2210_CR35","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1186\/s12958-022-00978-3","volume":"20","author":"X Han","year":"2022","unstructured":"Han X, et al. Seminal plasma extracellular vesicles tRF-Val-AAC-010 can serve as a predictive factor of successful microdissection testicular sperm extraction in patients with non-obstructive azoospermia. Reprod Biol Endocrinol. 2022;20(1):106.","journal-title":"Reprod Biol Endocrinol"},{"key":"2210_CR36","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1016\/j.trsl.2022.12.006","volume":"256","author":"HM Li","year":"2023","unstructured":"Li HM, et al. Promising novel biomarkers and therapy targets: the application of cell-free seminal nucleotides in male reproduction research. Transl Res. 2023;256:73\u201386.","journal-title":"Transl Res"},{"issue":"6271","key":"2210_CR37","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1126\/science.aad7977","volume":"351","author":"Q Chen","year":"2016","unstructured":"Chen Q, et al. Sperm tsRNAs contribute to intergenerational inheritance of an acquired metabolic disorder. Science. 2016;351(6271):397\u2013400.","journal-title":"Science"},{"issue":"21","key":"2210_CR38","doi-asserted-by":"publisher","first-page":"10547","DOI":"10.1073\/pnas.1820810116","volume":"116","author":"G Sarker","year":"2019","unstructured":"Sarker G, et al. Maternal overnutrition programs hedonic and metabolic phenotypes across generations through sperm tsRNAs. Proc Natl Acad Sci U S A. 2019;116(21):10547\u201356.","journal-title":"Proc Natl Acad Sci U S A"},{"issue":"6271","key":"2210_CR39","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1126\/science.aad6780","volume":"351","author":"U Sharma","year":"2016","unstructured":"Sharma U, et al. Biogenesis and function of tRNA fragments during sperm maturation and fertilization in mammals. Science. 2016;351(6271):391\u20136.","journal-title":"Science"},{"key":"2210_CR40","unstructured":"Organization WH. WHO laboratory manual for the examination and processing of human semen. In: WHO laboratory manual for the examination and processing of human semen. 2021."},{"key":"2210_CR41","doi-asserted-by":"publisher","DOI":"10.1111\/and.12903","author":"S Gunes","year":"2018","unstructured":"Gunes S, et al. Association between promoter methylation of MLH1 and MSH2 and reactive oxygen species in oligozoospermic men-A pilot study. Andrologia. 2018. https:\/\/doi.org\/10.1111\/and.12903.","journal-title":"Andrologia"},{"issue":"2","key":"2210_CR42","doi-asserted-by":"publisher","DOI":"10.1111\/and.13925","volume":"53","author":"A Metin Mahmutoglu","year":"2021","unstructured":"Metin Mahmutoglu A, et al. Association of XRCC1 and ERCC2 promoters\u2019 methylation with chromatin condensation and sperm DNA fragmentation in idiopathic oligoasthenoteratozoospermic men. Andrologia. 2021;53(2):e13925.","journal-title":"Andrologia"},{"issue":"4","key":"2210_CR43","doi-asserted-by":"publisher","first-page":"402","DOI":"10.1006\/meth.2001.1262","volume":"25","author":"KJ Livak","year":"2001","unstructured":"Livak KJ, Schmittgen TD. Analysis of relative gene expression data using real-time quantitative PCR and the 2(-Delta Delta C(T)) method. Methods. 2001;25(4):402\u20138.","journal-title":"Methods"},{"key":"2210_CR44","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1038\/s41421-019-0087-9","volume":"5","author":"M Hua","year":"2019","unstructured":"Hua M, et al. Identification of small non-coding RNAs as sperm quality biomarkers for in vitro fertilization. Cell Discov. 2019;5:20.","journal-title":"Cell Discov"},{"issue":"6","key":"2210_CR45","doi-asserted-by":"publisher","first-page":"1019","DOI":"10.1016\/j.eururo.2016.06.044","volume":"70","author":"J Damsgaard","year":"2016","unstructured":"Damsgaard J, et al. Varicocele is associated with impaired semen quality and reproductive hormone levels: a study of 7035 healthy young men from six European countries. Eur Urol. 2016;70(6):1019\u201329.","journal-title":"Eur Urol"},{"key":"2210_CR46","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinsp.2024.100339","volume":"79","author":"L Liu","year":"2024","unstructured":"Liu L, et al. Relationship between semen parameters, serum InhB, and INSL-3 levels, and the degree of varicocele. Clinics (Sao Paulo). 2024;79:100339.","journal-title":"Clinics (Sao Paulo)"},{"issue":"2","key":"2210_CR47","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1038\/nrg3861","volume":"16","author":"S Kirchner","year":"2015","unstructured":"Kirchner S, Ignatova Z. Emerging roles of tRNA in adaptive translation, signalling dynamics and disease. Nat Rev Genet. 2015;16(2):98\u2013112.","journal-title":"Nat Rev Genet"},{"key":"2210_CR48","doi-asserted-by":"publisher","DOI":"10.3389\/fcell.2021.642352","volume":"9","author":"A Akil","year":"2021","unstructured":"Akil A, et al. Notch signaling in vascular endothelial cells, angiogenesis, and tumor progression: an update and prospective. Front Cell Dev Biol. 2021;9:642352.","journal-title":"Front Cell Dev Biol"},{"issue":"1","key":"2210_CR49","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1016\/j.fertnstert.2004.09.006","volume":"83","author":"Z Sahin","year":"2005","unstructured":"Sahin Z, et al. Effect of experimental varicocele on the expressions of Notch 1, 2, and 3 in rat testes: an immunohistochemical study. Fertil Steril. 2005;83(1):86\u201394.","journal-title":"Fertil Steril"},{"issue":"1","key":"2210_CR50","doi-asserted-by":"publisher","DOI":"10.1002\/jcb.30702","volume":"126","author":"J Shen","year":"2025","unstructured":"Shen J, et al. Recent insights into Wnt-related tRNA-derived fragments (tRFs) in human diseases. J Cell Biochem. 2025;126(1):e30702.","journal-title":"J Cell Biochem"},{"key":"2210_CR51","doi-asserted-by":"publisher","DOI":"10.3389\/fgene.2024.1346852","volume":"15","author":"Q Wang","year":"2024","unstructured":"Wang Q, et al. Unveiling the role of tRNA-derived small RNAs in MAPK signaling pathway: implications for cancer and beyond. Front Genet. 2024;15:1346852.","journal-title":"Front Genet"}],"container-title":["Reproductive Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s43032-026-02210-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s43032-026-02210-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s43032-026-02210-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T16:41:03Z","timestamp":1790008863000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s43032-026-02210-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,21]]},"references-count":51,"alternative-id":["2210"],"URL":"https:\/\/doi.org\/10.1007\/s43032-026-02210-8","relation":{},"ISSN":["1933-7191","1933-7205"],"issn-type":[{"value":"1933-7191","type":"print"},{"value":"1933-7205","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,21]]},"assertion":[{"value":"10 November 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 September 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 September 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This study was conducted in accordance with the principles outlined in the Declaration of Helsinki. The ethical approval of the study was received from the Local Ethics Committee of Yozgat Bozok University (Approval No: 2017_KAEK 189_2021.04.14_07).","order":1,"name":"Ethics","label":"Ethics Approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Written informed consent for publication was obtained from all participants involved in the study.","order":2,"name":"Ethics","label":"Consent to Participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no conflicts of interest regarding this study.","order":3,"name":"Ethics","label":"Competing Interests","group":{"name":"EthicsHeading","label":"Declarations"}}]}}