{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T14:50:19Z","timestamp":1790607019383,"version":"4.1.0"},"reference-count":62,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T00:00:00Z","timestamp":1747353600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T00:00:00Z","timestamp":1747353600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"DOI":"10.13039\/501100009053","name":"The Wellcome Trust DBT India Alliance","doi-asserted-by":"publisher","award":["IA\/CPHI\/16\/1\/502653"],"award-info":[{"award-number":["IA\/CPHI\/16\/1\/502653"]}],"id":[{"id":"10.13039\/501100009053","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"DOI":"10.1038\/s41598-024-70628-8","type":"journal-article","created":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T16:48:59Z","timestamp":1747414139000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Sex differences in disease burden, utilization, and expenditure on primary health care services in Kerala, India"],"prefix":"10.1038","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0332-8154","authenticated-orcid":false,"given":"Jaison","family":"Joseph","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hari","family":"Sankar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santosh Kumar","family":"Sharma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Devaki","family":"Nambiar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,5,16]]},"reference":[{"key":"70628_CR1","volume-title":"A discussion paper","author":"W Gender","year":"2010","unstructured":"Gender, W. & Renewal, P. H. C. A discussion paper (World Health Organisation, 2010)."},{"key":"70628_CR2","doi-asserted-by":"publisher","unstructured":"Matud, M. P. Gender and health. Gender differences in different contexts (IntechOpen, 2017). https:\/\/doi.org\/10.5772\/65410.","DOI":"10.5772\/65410"},{"key":"70628_CR3","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1007\/978-3-319-72356-3_5","volume-title":"A demographic perspective on gender Family and Health in Europe","author":"A Oksuzyan","year":"2018","unstructured":"Oksuzyan, A., Gum\u00e0, J. & Doblhammer, G. Sex differences in health and survival. In A demographic perspective on gender Family and Health in Europe (eds Doblhammer, G. & Gum\u00e0, J.) 65\u2013100 (Springer International Publishing, Cham, 2018). https:\/\/doi.org\/10.1007\/978-3-319-72356-3_5."},{"key":"70628_CR4","first-page":"85","volume-title":"Equity and access: Health care studies in India","author":"S Nandraj","year":"2020","unstructured":"Nandraj, S. & Nambiar, D. Kerala\u2019s early experience: Moving towards Universal health coverage moving towards universal health coverage. In Equity and access: Health care studies in India 85\u201396 (Oxford University Press, Oxford, 2020)."},{"key":"70628_CR5","doi-asserted-by":"publisher","first-page":"e027880","DOI":"10.1136\/bmjopen-2018-027880","volume":"9","author":"PS Sarma","year":"2019","unstructured":"Sarma, P. S. et al. Prevalence of risk factors of non-communicable diseases in Kerala, India: Results of a cross-sectional study. BMJ Open 9, e027880 (2019).","journal-title":"BMJ Open"},{"key":"70628_CR6","doi-asserted-by":"publisher","unstructured":"Ottapura Prabhakaran, A. Burden of noncommunicable disease in Kerala. in (Trivandrum, 2015). https:\/\/doi.org\/10.13140\/RG.2.1.3672.1684.","DOI":"10.13140\/RG.2.1.3672.1684"},{"key":"70628_CR7","doi-asserted-by":"publisher","first-page":"e027880","DOI":"10.1136\/bmjopen-2018-027880","volume":"9","author":"PS Sarma","year":"2019","unstructured":"Sarma, P. S. et al. Prevalence of risk factors of non-communicable diseases in Kerala, India: Results of a cross-sectional study. BMJ Open 9, e027880 (2019).","journal-title":"BMJ Open"},{"key":"70628_CR8","doi-asserted-by":"publisher","first-page":"19","DOI":"10.12927\/whp.2018.25482","volume":"17","author":"GS Ramanathan","year":"2018","unstructured":"Ramanathan, G. S. & Varma, R. P. Gender differences in self-reported heart disease and multiple risk factors in India: Evidence from the 71st round of the national sample survey Office, 2014. World Health Popul. 17, 19\u201329 (2018).","journal-title":"World Health Popul."},{"key":"70628_CR9","unstructured":"Ministry of statistics and programme implementation. Key Indicators of Social Consumption in India: Health. http:\/\/mospi.nic.in\/sites\/default\/files\/publication_reports\/KI_Health_75th_Final.pdf (2017)."},{"key":"70628_CR10","unstructured":"Economic Review 2018 | State Planning Board, Thiruvananthapuram, Kerala, India. http:\/\/spb.kerala.gov.in\/ER2018\/index.php."},{"key":"70628_CR11","unstructured":"Department of Health Services Govt. of Kerala. Data on Non-Communicable Diseases 2019. https:\/\/dhs.kerala.gov.in\/wp-content\/uploads\/2020\/03\/data_29022020.pdf (2019)."},{"key":"70628_CR12","doi-asserted-by":"publisher","first-page":"12","DOI":"10.2307\/3343116","volume":"23","author":"J Church","year":"2002","unstructured":"Church, J. et al. Citizen participation in health decision-making: Past experience and future prospects. J. Public Health Policy 23, 12\u201332 (2002).","journal-title":"J. Public Health Policy"},{"key":"70628_CR13","unstructured":"Closing the gap in a generation: Health equity through action on the social determinants of health - final report of the commission on social determinants of health. https:\/\/www.who.int\/publications-detail-redirect\/WHO-IER-CSDH-08.1 (2008)."},{"key":"70628_CR14","unstructured":"National Academies of Sciences, E., Division, H. and M., Services, B. on H. C. & Disabilities, C. on H. C. U. and A. with. Factors That Affect Health-Care Utilization. Health-care utilization as a proxy in disability determination (National Academies Press (US), 2018)."},{"key":"70628_CR15","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1016\/j.healthpol.2005.02.005","volume":"75","author":"C Fern\u00e1ndez-Olano","year":"2006","unstructured":"Fern\u00e1ndez-Olano, C. et al. Factors associated with health care utilization by the elderly in a public health care system. Health Policy 75, 131\u2013139 (2006).","journal-title":"Health Policy"},{"key":"70628_CR16","first-page":"95","volume":"51","author":"R Andersen","year":"1973","unstructured":"Andersen, R. & Newman, J. F. Societal and individual determinants of medical care utilization in the United States. The Milbank memorial fund quarterly. Health Soc. 51, 95\u2013124 (1973).","journal-title":"Health Soc."},{"key":"70628_CR17","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1093\/pubmed\/fdh207","volume":"27","author":"BT Shaikh","year":"2005","unstructured":"Shaikh, B. T. & Hatcher, J. Health seeking behaviour and health service utilization in Pakistan: Challenging the policy makers. J. Public Health 27, 49\u201354 (2005).","journal-title":"J. Public Health"},{"key":"70628_CR18","volume-title":"Equity, social determinants and public health programmes","author":"B Erik","year":"2020","unstructured":"Erik, B. & Anand, S. K. Equity, social determinants and public health programmes (World Health Organization, 2020)."},{"key":"70628_CR19","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-026850","volume":"9","author":"M Kapoor","year":"2019","unstructured":"Kapoor, M. et al. Missing female patients: an observational analysis of sex ratio among outpatients in a referral tertiary care public hospital in India. BMJ Open 9, e026850 (2019).","journal-title":"BMJ Open"},{"key":"70628_CR20","unstructured":"Jain Kalra, R. Access to health care a distant dream for most Indian women. DW.COM (2019)."},{"key":"70628_CR21","doi-asserted-by":"publisher","first-page":"463","DOI":"10.4103\/2249-4863.192376","volume":"5","author":"S Oberoi","year":"2016","unstructured":"Oberoi, S., Chaudhary, N., Patnaik, S. & Singh, A. Understanding health seeking behavior. J. Family Med. Prim. Care 5, 463\u2013464 (2016).","journal-title":"J. Family Med. Prim. Care"},{"key":"70628_CR22","unstructured":"Tipping, G. & Segall, M. Health care seeking behaviour in developing countries: An annotated bibliography and literature review. Institute of Development Studies https:\/\/www.ids.ac.uk\/publications\/health-care-seeking-behaviour-in-developing-countries-an-annotated-bibliography-and-literature-review\/."},{"key":"70628_CR23","doi-asserted-by":"publisher","unstructured":"Babitsch, B., Gohl, D. & von Lengerke, T. Re-revisiting Andersen\u2019s behavioral model of health services use: A systematic review of studies from 1998\u20132011. Psychosoc Med 9, https:\/\/doi.org\/10.3205\/psm000089(2012). Epub 2012 Oct 25. PMID: 23133505; PMCID: PMC3488807.","DOI":"10.3205\/psm000089"},{"key":"70628_CR24","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-020-09107-4","author":"G Samir","year":"2020","unstructured":"Samir, G., Bebarta, K. K. & Tripathi, N. Performance of India\u2019s national publicly funded health insurance scheme, Pradhan Mantri Jan Arogaya Yojana (PMJAY), in improving access and financial protection for hospital care: Findings from household surveys in Chhattisgarh state. BMC Public Health https:\/\/doi.org\/10.1186\/s12889-020-09107-4 (2020).","journal-title":"BMC Public Health"},{"key":"70628_CR25","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12913-021-06777-7","volume":"21","author":"S Garg","year":"2021","unstructured":"Garg, S., Narayan, T., Ranjan, A. & Kumar Bebarta, K. Comparing the average cost of outpatient care of public and for-profit private providers in India. BMC Health Services Res. 21, 1\u20139 (2021).","journal-title":"BMC Health Services Res."},{"key":"70628_CR26","unstructured":"Batra, A., Gupta, I. & Mukhopadhyay, A. Does Discrimination Drive Gender Differences in Health Expenditure on Adults: Evidence from Cancer Patients in Rural India. Indian Statistical Institute, Planning Unit, New Delhi Discussion Papers https:\/\/ideas.repec.org\/p\/ind\/isipdp\/14-03.html (2014)."},{"key":"70628_CR27","doi-asserted-by":"publisher","first-page":"e0158332","DOI":"10.1371\/journal.pone.0158332","volume":"11","author":"N Saikia","year":"2016","unstructured":"Saikia, N., Moradhvaj, N. & Bora, J. K. Gender difference in health-care expenditure: Evidence from India human development survey. PLoS One 11, e0158332 (2016).","journal-title":"PLoS One"},{"key":"70628_CR28","unstructured":"Patient Satisfaction Survey as a Tool Towards Quality Improvement. https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3910415\/."},{"key":"70628_CR29","doi-asserted-by":"publisher","first-page":"196","DOI":"10.5539\/gjhs.v6n5p196","volume":"6","author":"A Pini","year":"2014","unstructured":"Pini, A. et al. Assessment of patient satisfaction of the quality of health care provided by outpatient services of an oncology hospital. Glob. J. Health Sci. 6, 196\u2013203 (2014).","journal-title":"Glob. J. Health Sci."},{"key":"70628_CR30","doi-asserted-by":"publisher","first-page":"e367","DOI":"10.1016\/j.crohns.2013.02.012","volume":"7","author":"A Vasudevan","year":"2013","unstructured":"Vasudevan, A., Arachchi, A. & van Langenberg, D. R. Assessing patient satisfaction in inflammatory bowel disease using the QUOTE-IBD survey: A small step for clinicians, a potentially large step for improving quality of care. J. Crohns. Colitis. 7, e367-374 (2013).","journal-title":"J. Crohns. Colitis."},{"key":"70628_CR31","unstructured":"Aardram - Government of Kerala, India. https:\/\/kerala.gov.in\/aardram."},{"key":"70628_CR32","unstructured":"Aardram \u2013 National Health Mission. \/2020\/04\/01\/aardram\/."},{"key":"70628_CR33","doi-asserted-by":"publisher","first-page":"747","DOI":"10.2471\/BLT.19.249565","volume":"98","author":"D Nambiar","year":"2020","unstructured":"Nambiar, D., Sankar, H., Negi, J., Nair, A. & Sadanandan, R. Field-testing of primary health-care indicators India. Bull. World Health Organ 98, 747\u2013753 (2020).","journal-title":"Bull. World Health Organ"},{"key":"70628_CR34","doi-asserted-by":"publisher","first-page":"544","DOI":"10.1186\/s12889-022-12956-w","volume":"22","author":"J Negi","year":"2022","unstructured":"Negi, J., Sankar, D. H., Nair, A. B. & Nambiar, D. Intersecting sex-related inequalities in self-reported testing for and prevalence of Non-Communicable Disease (NCD) risk factors in Kerala. BMC Public Health 22, 544 (2022).","journal-title":"BMC Public Health"},{"key":"70628_CR35","unstructured":"The DHS Program - Service Provision Assessments (SPA). https:\/\/dhsprogram.com\/methodology\/Survey-Types\/SPA.cfm."},{"key":"70628_CR36","unstructured":"Stata 12 | Archive. https:\/\/www.stata.com\/stata12\/."},{"key":"70628_CR37","unstructured":"Karan, A., Srivastava, S., Chakraborty, A. & Matela, H. Key Indicators of Health and Morbidity - Kerala 2014. (2016)."},{"key":"70628_CR38","doi-asserted-by":"publisher","first-page":"3654","DOI":"10.18203\/2394-6040.ijcmph20203939","volume":"7","author":"T George","year":"2020","unstructured":"George, T. & Mankara Valsan, S. Clinical and epidemiological profile of patients admitted with dengue fever in a tertiary care hospital, Thrissur, Kerala, India. Int. J. Commun. Med. Public Health 7, 3654 (2020).","journal-title":"Int. J. Commun. Med. Public Health"},{"key":"70628_CR39","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1093\/heapol\/czl013","volume":"21","author":"J-F Levesque","year":"2006","unstructured":"Levesque, J.-F., Haddad, S., Narayana, D. & Fournier, P. Outpatient care utilization in urban Kerala India. Health Policy Plann. 21, 289\u2013301 (2006).","journal-title":"Health Policy Plann."},{"key":"70628_CR40","doi-asserted-by":"publisher","first-page":"67","DOI":"10.12688\/wellcomeopenres.17674.2","volume":"7","author":"S Ismail","year":"2022","unstructured":"Ismail, S., Stanley, A. & Jeemon, P. Prevalence of multimorbidity and associated treatment burden in primary care settings in Kerala: A cross-sectional study in Malappuram District, Kerala India. Wellcome Open Res 7, 67 (2022).","journal-title":"Wellcome Open Res"},{"key":"70628_CR41","first-page":"115","volume":"1","author":"S Malla","year":"2024","unstructured":"Malla, S., Agiwal, V. & Chaudhuri, S. Multimorbidity among pregnant women in India: National and state-level burden and socio-demographic variations. Prevent. Med.: Res. Rev. 1, 115 (2024).","journal-title":"Prevent. Med.: Res. Rev."},{"key":"70628_CR42","unstructured":"Puthenparambil, S. & Krishnapriya, K. A study on risk factors of road traffic accidents in Kottayam District, Kerala State.|International Journal of Development Research (IJDR) 08, (2018)."},{"key":"70628_CR43","unstructured":"World Health Organization, Management of Substance Abuse Team, & World Health Organization. Global Status Report on Alcohol and Health 2018. (2018)."},{"key":"70628_CR44","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1177\/0018720811410057","volume":"54","author":"XS Dong","year":"2012","unstructured":"Dong, X. S., Wang, X. & Daw, C. Fatal falls among older construction workers. Hum. Factors 54, 303\u2013315 (2012).","journal-title":"Hum. Factors"},{"key":"70628_CR45","unstructured":"Bureau, T. H. Trauma care training for doctors and nurses. The Hindu (2023). https:\/\/www.thehindu.com\/news\/national\/kerala\/trauma-care-training-for-doctors-andnurses\/article67446814.ece"},{"key":"70628_CR46","unstructured":"Operational Framework for Primary Health Care. https:\/\/www.who.int\/publications-detail-redirect\/9789240017832."},{"key":"70628_CR47","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1093\/heapol\/czh005","volume":"19","author":"D Varatharajan","year":"2004","unstructured":"Varatharajan, D., Thankappan, R. & Jayapalan, S. Assessing the performance of primary health centres under decentralized government in Kerala India. Health Policy Plan 19, 41\u201351 (2004).","journal-title":"Health Policy Plan"},{"key":"70628_CR48","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1093\/heapol\/15.1.103","volume":"15","author":"VR Kutty","year":"2000","unstructured":"Kutty, V. R. Historical analysis of the development of health care facilities in Kerala State India. Health Policy Plan 15, 103\u2013109 (2000).","journal-title":"Health Policy Plan"},{"key":"70628_CR49","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1186\/s12875-023-02000-0","volume":"24","author":"DH Sankar","year":"2023","unstructured":"Sankar, D. H., Joseph, J., Benny, G. & Nambiar, D. Of primary health care reforms and pandemic responses: Understanding perspectives of health system actors in Kerala before and during COVID-19. BMC Primary Care 24, 59 (2023).","journal-title":"BMC Primary Care"},{"key":"70628_CR50","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-018020","volume":"8","author":"S Selvaraj","year":"2018","unstructured":"Selvaraj, S., Farooqui, H. H. & Karan, A. Quantifying the financial burden of households\u2019 out-of-pocket payments on medicines in India: a repeated cross-sectional analysis of National Sample Survey data, 1994\u20132014. BMJ Open 8, e018020 (2018).","journal-title":"BMJ Open"},{"key":"70628_CR51","doi-asserted-by":"publisher","DOI":"10.1007\/s12098-020-03359-z","author":"C Lahariya","year":"2020","unstructured":"Lahariya, C. Health & wellness centers to strengthen primary health care in India: Concept, progress and ways forward. Indian J. Pediatr. https:\/\/doi.org\/10.1007\/s12098-020-03359-z (2020).","journal-title":"Indian J. Pediatr."},{"key":"70628_CR52","unstructured":"Data on Communicable Diseases in Kerala. https:\/\/dhs.kerala.gov.in\/wp-content\/uploads\/2020\/03\/data_29022020.pdf (2019)."},{"key":"70628_CR53","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1186\/s41256-017-0026-y","volume":"2","author":"A Jana","year":"2017","unstructured":"Jana, A. & Basu, R. Examining the changing health care seeking behavior in the era of health sector reforms in India: Evidences from the national sample surveys 2004 & 2014. Global Health Res. Policy 2, 6 (2017).","journal-title":"Global Health Res. Policy"},{"key":"70628_CR54","doi-asserted-by":"publisher","first-page":"3081","DOI":"10.18203\/2394-6040.ijcmph20203381","volume":"7","author":"S Mathumkunnath Vijayan","year":"2020","unstructured":"Mathumkunnath Vijayan, S., Puliyakkadi, S. & Chalil, S. Health care utilization and out of pocket expenditure in a rural area of Kerala: A cross sectional study. Int. J. Commun. Med. Public Health 7, 3081 (2020).","journal-title":"Int. J. Commun. Med. Public Health"},{"key":"70628_CR55","doi-asserted-by":"publisher","first-page":"526","DOI":"10.1016\/j.cegh.2019.11.007","volume":"8","author":"R Patel","year":"2020","unstructured":"Patel, R. & Chauhan, S. Gender differential in health care utilisation in India. Clin. Epidemiol. Global Health 8, 526\u2013530 (2020).","journal-title":"Clin. Epidemiol. Global Health"},{"key":"70628_CR56","doi-asserted-by":"publisher","first-page":"5872","DOI":"10.4103\/jfmpc.jfmpc_1574_20","volume":"9","author":"C Lahariya","year":"2020","unstructured":"Lahariya, C. Access, utilization, perceived quality, and satisfaction with health services at Mohalla (Community) Clinics of Delhi India. J. Family Med. Prim. Care 9, 5872\u20135880 (2020).","journal-title":"J. Family Med. Prim. Care"},{"key":"70628_CR57","doi-asserted-by":"publisher","first-page":"29","DOI":"10.15171\/ijhpm.2014.06","volume":"2","author":"S Ghosh","year":"2014","unstructured":"Ghosh, S. Equity in the utilization of healthcare services in India: Evidence from national sample survey. Int. J. Health Policy Manag. 2, 29\u201338 (2014).","journal-title":"Int. J. Health Policy Manag."},{"key":"70628_CR58","doi-asserted-by":"publisher","first-page":"162","DOI":"10.4103\/PMRR.PMRR_60_23","volume":"1","author":"R Kumar","year":"2024","unstructured":"Kumar, R. Health equity monitoring to achieve social justice: A preventive medicine perspective. Prevent. Med. Res. Rev. 1, 162 (2024).","journal-title":"Prevent. Med. Res. Rev."},{"key":"70628_CR59","doi-asserted-by":"publisher","unstructured":"George, A. K. & Sanda, M. G. Measuring patient satisfaction. In Clinical Research Methods for Surgeons. (eds Penson, D.F. & Wei, J.T.) (Humana Press, 2006). https:\/\/doi.org\/10.1007\/978-1-59745-230-4_14","DOI":"10.1007\/978-1-59745-230-4_14"},{"key":"70628_CR60","doi-asserted-by":"publisher","first-page":"41","DOI":"10.4103\/PMRR.PMRR_77_23","volume":"1","author":"S Saxena","year":"2024","unstructured":"Saxena, S., Bhan, A., Fleming, W. O., Singh, A. & Tugnawat, D. Acceptability, feasibility and appropriateness of care of patients with depression at health and wellness centre in a district of India. Prevent. Med. Res. Rev. 1, 41\u201346 (2024).","journal-title":"Prevent. Med. Res. Rev."},{"key":"70628_CR61","unstructured":"KASH \u2013 National Health Mission. https:\/\/arogyakeralam.gov.in\/2020\/04\/23\/kash\/."},{"key":"70628_CR62","unstructured":"National Health Systems Resource Centre. National Quality Assurance Standards. http:\/\/qi.nhsrcindia.org\/national-quality-assurance-standards."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-024-70628-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-024-70628-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-024-70628-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T16:49:07Z","timestamp":1747414147000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-024-70628-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,16]]},"references-count":62,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["70628"],"URL":"https:\/\/doi.org\/10.1038\/s41598-024-70628-8","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-3404039\/v1","asserted-by":"object"}]},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,16]]},"assertion":[{"value":"2 October 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 August 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 May 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors of this paper do not have any conflicts of interest.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interest"}}],"article-number":"17116"}}