{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T15:07:52Z","timestamp":1787238472252,"version":"build-2736575974"},"reference-count":39,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,9,27]],"date-time":"2022-09-27T00:00:00Z","timestamp":1664236800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,9,27]],"date-time":"2022-09-27T00:00:00Z","timestamp":1664236800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The HIV\/AIDS cases and proportion in older people are continuously and rapidly increasing in China, especially in males. However, the transmission mechanism is not well understood. This study aims to explore the transmission mechanism of HIV\/AIDS and potential ways to prevent or control HIV\/AIDS transmission in a city in southwestern China. Data from multiple sources, including HIV\/AIDS case reports in 2010\u20132020, a survey of HIV\/AIDS cases in 2020, and sentinel surveillance data of female sex workers (FSWs) in 2016\u20132020 were analyzed. We explored the transmission mechanism of HIV\/AIDS cases aged 50\u00a0years and older. In this city, the number of newly reported HIV\/AIDS cases aged 50\u00a0years and older increased from 2010 to 2019, and decreased in 2020. The number of male and female cases aged 50\u00a0years and older both increased rapidly in 2017\u20132019, though the number of male cases was larger than that of female. The survey data showed that 84.7% of older male cases reported commercial sexual behavior, among whom 87.7% reported never using condom and 37.6% reported more than 10 times of commercial sexual behaviors in 1\u00a0year. In terms of price of sexual behavior, 68.3% of older male cases sought low-tier FSWs among whom the HIV\/AIDS positive rate was 5.4% from the sentinel surveillance data. These results suggested HIV transmission between older men and low-tier FSWs through commercial sexual behavior. Among female cases aged 50\u00a0years and older, most reported non-marital and non-commercial heterosexual (60.5%) or regular sexual partner (31.4%) transmission, suggesting that they were infected by their spouse\/regular sexual partner. Data of matched couples showed that most male cases had both marital sexual behavior and commercial sexual behavior, or acquired HIV through commercial sexual behavior, while most female cases had only marital sexual behavior. Based on these findings, we proposed a transmission mode of that local older male people and FSWs are transmitting bilaterally through commercial sexual behavior, and local older male people are spreading to local older female people through spouse or regular sexual partner route. By studying data from multiple sources, we explored the HIV transmission mode among older people. In the meantime, we found that marital status had a different impact on male and female old people in their sex behaviors.<\/jats:p>","DOI":"10.1038\/s41598-022-20146-2","type":"journal-article","created":{"date-parts":[[2022,9,27]],"date-time":"2022-09-27T06:06:22Z","timestamp":1664258782000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["An exploratory transmission mode of HIV\/AIDS among older people based on data from multiple sources in China"],"prefix":"10.1038","volume":"12","author":[{"given":"Xiwei","family":"Sun","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caibi","family":"Feng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liao","family":"Feng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ticheng","family":"Xiao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinran","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiqiu","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shoulin","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dinglun","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,9,27]]},"reference":[{"key":"20146_CR1","doi-asserted-by":"publisher","first-page":"1052","DOI":"10.1016\/S0140-6736(16)31541-0","volume":"388","author":"SW Pan","year":"2016","unstructured":"Pan, S. W., Li, D. L., Carpiano, R. M., Spittal, P. M. & Ruan, Y. H. Ethnicity and HIV epidemiology research in China. Lancet 388, 1052\u20131053. https:\/\/doi.org\/10.1016\/S0140-6736(16)31541-0 (2016).","journal-title":"Lancet"},{"key":"20146_CR2","unstructured":"UNAIDS. Global HIV & AIDS Statistics\u2014Fact Sheet. https:\/\/www.unaids.org\/en\/resources\/fact-sheet. (2021)."},{"key":"20146_CR3","doi-asserted-by":"publisher","first-page":"1191","DOI":"10.3760\/cma.j.issn.0254-6450.2019.10.004","volume":"40","author":"P Lyu","year":"2019","unstructured":"Lyu, P. & Chen, F. F. National HIV\/AIDS epidemic estimation and interpretation in China. Zhonghua Liu Xing Bing Xue Za Zhi 40, 1191\u20131196. https:\/\/doi.org\/10.3760\/cma.j.issn.0254-6450.2019.10.004 (2019).","journal-title":"Zhonghua Liu Xing Bing Xue Za Zhi"},{"key":"20146_CR4","doi-asserted-by":"publisher","first-page":"Iii10","DOI":"10.1136\/sti.2005.019471","volume":"82","author":"C Aceijas","year":"2006","unstructured":"Aceijas, C. et al. Estimates of injecting drug users at the national and local level in developing and transitional countries, and gender and age distribution. Sex. Trans. Inf. 82, Iii10\u2013Iii17. https:\/\/doi.org\/10.1136\/sti.2005.019471 (2006).","journal-title":"Sex. Trans. Inf."},{"key":"20146_CR5","doi-asserted-by":"publisher","first-page":"729","DOI":"10.1093\/ije\/dyn127","volume":"37","author":"FI Bastos","year":"2008","unstructured":"Bastos, F. I., Caceres, C., Galvao, J., Veras, M. A. & Castilho, E. A. AIDS in Latin America: Assessing the current status of the epidemic and the ongoing response. Int. J. Epidemiol. 37, 729\u2013737. https:\/\/doi.org\/10.1093\/ije\/dyn127 (2008).","journal-title":"Int. J. Epidemiol."},{"key":"20146_CR6","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1111\/add.12779","volume":"110","author":"L Wang","year":"2015","unstructured":"Wang, L. et al. HIV epidemic among drug users in China: 1995\u20132011. Addiction 110, 20\u201328. https:\/\/doi.org\/10.1111\/add.12779 (2015).","journal-title":"Addiction"},{"key":"20146_CR7","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-79951-2","author":"XW Pang","year":"2021","unstructured":"Pang, X. W. et al. Patterns and risk of HIV-1 transmission network among men who have sex with men in Guangxi, China. Sci. Rep. https:\/\/doi.org\/10.1038\/s41598-020-79951-2 (2021).","journal-title":"Sci. Rep."},{"key":"20146_CR8","doi-asserted-by":"publisher","first-page":"e18776","DOI":"10.1097\/MD.0000000000018776","volume":"99","author":"CH Xiao","year":"2020","unstructured":"Xiao, C. H. et al. The changing modes of human immunodeficiency virus transmission and spatial variations among women in a minority prefecture in southwest China: An exploratory study. Medicine 99, e18776. https:\/\/doi.org\/10.1097\/MD.0000000000018776 (2020).","journal-title":"Medicine"},{"key":"20146_CR9","doi-asserted-by":"publisher","first-page":"769","DOI":"10.1016\/j.ijid.2021.02.077","volume":"105","author":"FS Yuan","year":"2021","unstructured":"Yuan, F. S. et al. Epidemiological and spatiotemporal analyses of HIV\/AIDS prevalence among older adults in Sichuan, China between 2008 and 2019: A population-based study. Int. J. Infect. Dis. 105, 769\u2013775. https:\/\/doi.org\/10.1016\/j.ijid.2021.02.077 (2021).","journal-title":"Int. J. Infect. Dis."},{"key":"20146_CR10","doi-asserted-by":"publisher","first-page":"r53","DOI":"10.1093\/cid\/ciu214","volume":"59","author":"JN Xing","year":"2014","unstructured":"Xing, J. N. et al. HIV\/AIDS epidemic among older adults in China during 2005\u20132012: Results from trend and spatial analysis. Clin. Infect. Dis. 59, r53-e60. https:\/\/doi.org\/10.1093\/cid\/ciu214 (2014).","journal-title":"Clin. Infect. Dis."},{"key":"20146_CR11","first-page":"1075","volume":"24","author":"CC National Center for AIDS\/STD Contro","year":"2018","unstructured":"National Center for AIDS\/STD Control and Prevention, C. C. update on the AIDS\/STD epidemic in China the third quarter of 2018. Chin. J. AIDS STD 24, 1075 (2018).","journal-title":"Chin. J. AIDS STD"},{"key":"20146_CR12","doi-asserted-by":"publisher","first-page":"1145","DOI":"10.1080\/09540121.2012.752565","volume":"25","author":"KJ O'Keefe","year":"2013","unstructured":"O\u2019Keefe, K. J., Scheer, S., Chen, M. J., Hughes, A. J. & Pipkin, S. People fifty years or older now account for the majority of AIDS cases in San Francisco, California, 2010. AIDS Care 25, 1145\u20131148. https:\/\/doi.org\/10.1080\/09540121.2012.752565 (2013).","journal-title":"AIDS Care"},{"key":"20146_CR13","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-018-3551-5","author":"ZQ Liu","year":"2018","unstructured":"Liu, Z. Q. et al. Changing epidemiological patterns of HIV and AIDS in China in the post-SARS era identified by the nationwide surveillance system. BMC Infect. Dis. https:\/\/doi.org\/10.1186\/s12879-018-3551-5 (2018).","journal-title":"BMC Infect. Dis."},{"key":"20146_CR14","doi-asserted-by":"publisher","first-page":"847","DOI":"10.2471\/Blt.10.076349","volume":"88","author":"J Negin","year":"2010","unstructured":"Negin, J. & Cumming, R. G. HIV infection in older adults in sub-Saharan Africa: Extrapolating prevalence from existing data. Bull. W.H.O. 88, 847\u2013853. https:\/\/doi.org\/10.2471\/Blt.10.076349 (2010).","journal-title":"Bull. W.H.O."},{"key":"20146_CR15","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b1460","author":"KA Gebo","year":"2009","unstructured":"Gebo, K. A. HIV infection in older people. BMJ https:\/\/doi.org\/10.1136\/bmj.b1460 (2009).","journal-title":"BMJ"},{"key":"20146_CR16","doi-asserted-by":"publisher","first-page":"479","DOI":"10.1111\/j.1468-1293.2009.00810.x","volume":"11","author":"JV Lazarus","year":"2010","unstructured":"Lazarus, J. V. & Nielsen, K. K. HIV and people over 50 years old in Europe. HIV Med. 11, 479\u2013481. https:\/\/doi.org\/10.1111\/j.1468-1293.2009.00810.x (2010).","journal-title":"HIV Med."},{"key":"20146_CR17","first-page":"222","volume":"37","author":"LY Wang","year":"2016","unstructured":"Wang, L. Y., Qin, Q. Q., Ge, L., Ding, Z. W. & Cui, Y. Characteristics of HIV infections among over 50-year-olds population in China. Zhonghua Liu Xing Bing Xue Za Zhi 37, 222\u2013226 (2016).","journal-title":"Zhonghua Liu Xing Bing Xue Za Zhi"},{"key":"20146_CR18","doi-asserted-by":"publisher","first-page":"712","DOI":"10.1089\/aid.2019.0293","volume":"36","author":"J Jiang","year":"2020","unstructured":"Jiang, J., Fan, Q., Zhang, J., Luo, M. & Qiu, L. A geographic hotspot and emerging transmission cluster of the HIV-1 epidemic among older adults in a rural area of eastern China. AIDS Res. Hum. Retrovir. 36, 712\u2013720 (2020).","journal-title":"AIDS Res. Hum. Retrovir."},{"key":"20146_CR19","doi-asserted-by":"publisher","first-page":"85","DOI":"10.2174\/1570162X17666190703163838","volume":"17","author":"H Chen","year":"2019","unstructured":"Chen, H. et al. HIV epidemiology and prevention in southwestern China: Trends from 1996\u20132017. Curr. HIV Res. 17, 85\u201393. https:\/\/doi.org\/10.2174\/1570162X17666190703163838 (2019).","journal-title":"Curr. HIV Res."},{"key":"20146_CR20","unstructured":"UNAIDS. 2025 AIDS Targets: The Next Generation of Goals for the Global AIDS response. https:\/\/www.unaids.org\/en\/resources\/presscentre\/featurestories\/2021\/july\/20210721_2025-aids-targets (2021)."},{"key":"20146_CR21","doi-asserted-by":"publisher","first-page":"875","DOI":"10.3390\/ijerph17030875","volume":"17","author":"YJ Wang","year":"2020","unstructured":"Wang, Y. J. et al. Changing trends of HIV, syphilis, and hepatitis C among male migrant workers in Chongqing, China: Nine consecutive cross-sectional surveys, 2010\u20132018. Int. J. Environ. Res. Public Health 17, 875. https:\/\/doi.org\/10.3390\/ijerph17030875 (2020).","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"20146_CR22","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12879-020-05757-2","volume":"21","author":"ZL Dong","year":"2021","unstructured":"Dong, Z. L., Ma, L. Y., Cai, C., Gao, G. F. & Lyu, F. Demographic features of identified PLWHA infected through commercial and nonmarital noncommercial heterosexual contact in China from 2015 to 2018: A retrospective cross-sectional study. BMC Infect. Dis. 21, 1\u201311. https:\/\/doi.org\/10.1186\/s12879-020-05757-2 (2021).","journal-title":"BMC Infect. Dis."},{"key":"20146_CR23","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1080\/19317611.2016.1223249","volume":"29","author":"XH Wu","year":"2017","unstructured":"Wu, X. H. et al. HIV infections among older male clients of low-cost commercial sex venues in southern China. Int. J. Sex. Health 29, 48\u201354. https:\/\/doi.org\/10.1080\/19317611.2016.1223249 (2017).","journal-title":"Int. J. Sex. Health"},{"key":"20146_CR24","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12879-019-4187-9","volume":"19","author":"JJ Wu","year":"2019","unstructured":"Wu, J. J. et al. Phylogenetic analysis highlights the role of older people in the transmission of HIV-1 in Fuyang, Anhui Province, China. BMC Infect. Dis. 19, 1\u20139. https:\/\/doi.org\/10.1186\/s12879-019-4187-9 (2019).","journal-title":"BMC Infect. Dis."},{"key":"20146_CR25","doi-asserted-by":"publisher","first-page":"707","DOI":"10.3760\/cma.j.issn.0254-6450.2018.06.002","volume":"39","author":"ZY Wu","year":"2018","unstructured":"Wu, Z. Y. Characteristics of HIV sexually transmission and challenges for controlling the epidemic in China. Zhonghua Liu Xing Bing Xue Za Zhi 39, 707\u2013709. https:\/\/doi.org\/10.3760\/cma.j.issn.0254-6450.2018.06.002 (2018).","journal-title":"Zhonghua Liu Xing Bing Xue Za Zhi"},{"key":"20146_CR26","doi-asserted-by":"publisher","first-page":"698","DOI":"10.1016\/S0140-6736(18)31439-9","volume":"392","author":"K Shannon","year":"2018","unstructured":"Shannon, K. et al. The global response and unmet actions for HIV and sex workers. Lancet 392, 698\u2013710. https:\/\/doi.org\/10.1016\/S0140-6736(18)31439-9 (2018).","journal-title":"Lancet"},{"key":"20146_CR27","doi-asserted-by":"publisher","first-page":"719","DOI":"10.1097\/01.olq.0000218881.01437.99","volume":"33","author":"YH Ruan","year":"2006","unstructured":"Ruan, Y. H. et al. Syphilis among female sex workers in southwestern China: Potential for HIV transmission. Sex. Transm. Dis. 33, 719\u2013723. https:\/\/doi.org\/10.1097\/01.olq.0000218881.01437.99 (2006).","journal-title":"Sex. Transm. Dis."},{"key":"20146_CR28","doi-asserted-by":"publisher","first-page":"538","DOI":"10.1016\/S1473-3099(12)70066-X","volume":"12","author":"S Baral","year":"2012","unstructured":"Baral, S. et al. Burden of HIV among female sex workers in low-income and middle-income countries: A systematic review and meta-analysis. Lancet Infect. Dis. 12, 538\u2013549. https:\/\/doi.org\/10.1016\/S1473-3099(12)70066-X (2012).","journal-title":"Lancet Infect. Dis."},{"key":"20146_CR29","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1016\/j.ijid.2015.08.014","volume":"39","author":"L Zhang","year":"2015","unstructured":"Zhang, L. et al. A systematic review and meta-analysis of the prevalence, trends, and geographical distribution of HIV among Chinese female sex workers (2000\u20132011): Implications for preventing sexually transmitted HIV. Int. J. Infect. Dis. 39, 76\u201386. https:\/\/doi.org\/10.1016\/j.ijid.2015.08.014 (2015).","journal-title":"Int. J. Infect. Dis."},{"key":"20146_CR30","doi-asserted-by":"publisher","first-page":"202","DOI":"10.4111\/icu.2019.60.3.202","volume":"60","author":"HY Kim","year":"2019","unstructured":"Kim, H. Y., Choe, H. S., Lee, D. S., Yoo, J. M. & Lee, S. J. Sexual behavior and sexually transmitted infection in the elderly population of South Korea. Investig. Clin. Urol. 60, 202\u2013209. https:\/\/doi.org\/10.4111\/icu.2019.60.3.202 (2019).","journal-title":"Investig. Clin. Urol."},{"key":"20146_CR31","doi-asserted-by":"publisher","first-page":"e109452","DOI":"10.1371\/journal.pone.0109452","volume":"9","author":"ZZ Tang","year":"2014","unstructured":"Tang, Z. Z. et al. Aphrodisiac use associated with HIV infection in elderly male clients of low-cost commercial sex venues in Guangxi, China: A matched case-control study. PLoS ONE 9, e109452. https:\/\/doi.org\/10.1371\/journal.pone.0109452 (2014).","journal-title":"PLoS ONE"},{"key":"20146_CR32","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1016\/j.ijid.2008.05.1229","volume":"13","author":"HB Wang","year":"2009","unstructured":"Wang, H. B. et al. Prevalence and predictors of HIV infection among female sex workers in Kaiyuan City, Yunnan Province, China. Int. J. Infect. Dis. 13, 162\u2013169. https:\/\/doi.org\/10.1016\/j.ijid.2008.05.1229 (2009).","journal-title":"Int. J. Infect. Dis."},{"key":"20146_CR33","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1080\/09540121.2010.507759","volume":"23","author":"ZJ Huang","year":"2011","unstructured":"Huang, Z. J. et al. \u201cBridge population\u201d: Sex workers or their clients?\u2014STI prevalence and risk behaviors of clients of female sex workers in China. AIDS Care 23, 45\u201353. https:\/\/doi.org\/10.1080\/09540121.2010.507759 (2011).","journal-title":"AIDS Care"},{"key":"20146_CR34","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1097\/QAI.0b013e3181b3552a","volume":"53","author":"X Jin","year":"2010","unstructured":"Jin, X. et al. HIV prevalence and risk behaviors among male clients of female sex workers in Yunnan, China. J. Acquir. Immune Defic. Syndr. 53, 131\u2013135. https:\/\/doi.org\/10.1097\/QAI.0b013e3181b3552a (2010).","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"20146_CR35","doi-asserted-by":"publisher","first-page":"S1211","DOI":"10.1093\/infdis\/jir537","volume":"204","author":"SM Pan","year":"2011","unstructured":"Pan, S. M., Parish, W. L. & Huang, Y. Y. Clients of female sex workers: A population-based survey of China. J. Infect. Dis. 204, S1211\u2013S1217. https:\/\/doi.org\/10.1093\/infdis\/jir537 (2011).","journal-title":"J. Infect. Dis."},{"key":"20146_CR36","doi-asserted-by":"publisher","first-page":"20225072","DOI":"10.1371\/journal.pone.0225072","volume":"14","author":"J Zhu","year":"2019","unstructured":"Zhu, J. et al. HIV prevalence and correlated factors among male clients of female sex workers in a border region of China. PLoS ONE 14, 20225072. https:\/\/doi.org\/10.1371\/journal.pone.0225072 (2019).","journal-title":"PLoS ONE"},{"key":"20146_CR37","doi-asserted-by":"publisher","first-page":"1230","DOI":"10.1097\/00029330-200807010-00016","volume":"121","author":"L Sheng","year":"2008","unstructured":"Sheng, L. & Cao, W. K. HIV\/AIDS epidemiology and prevention in China. Chin. Med. J. 121, 1230\u20131236. https:\/\/doi.org\/10.1097\/00029330-200807010-00016 (2008).","journal-title":"Chin. Med. J."},{"key":"20146_CR38","doi-asserted-by":"publisher","first-page":"490","DOI":"10.1177\/0733464805279155","volume":"24","author":"NA Orel","year":"2005","unstructured":"Orel, N. A., Spence, M. & Steele, J. Getting the message out to older adults: Effective HIV health education risk reduction publications. J. Appl. Gerontol. 24, 490\u2013508. https:\/\/doi.org\/10.1177\/0733464805279155 (2005).","journal-title":"J. Appl. Gerontol."},{"key":"20146_CR39","doi-asserted-by":"publisher","first-page":"570","DOI":"10.1016\/j.physa.2019.01.121","volume":"523","author":"XL Dong","year":"2019","unstructured":"Dong, X. L., Wang, J. G., Hu, B. B. & Liu, X. Y. Female sex workers in HIV\/AIDS prevention: A social network analysis perspective. Physica A Stat. Mech. Appl. 523, 570\u2013582. https:\/\/doi.org\/10.1016\/j.physa.2019.01.121 (2019).","journal-title":"Physica A Stat. Mech. Appl."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-022-20146-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-022-20146-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-022-20146-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,27]],"date-time":"2022-09-27T06:13:17Z","timestamp":1664259197000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-022-20146-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,27]]},"references-count":39,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["20146"],"URL":"https:\/\/doi.org\/10.1038\/s41598-022-20146-2","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,27]]},"assertion":[{"value":"2 April 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 September 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 September 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"16077"}}