{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,12]],"date-time":"2026-11-12T08:03:46Z","timestamp":1794470626533,"version":"4.9.1"},"reference-count":42,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T00:00:00Z","timestamp":1755561600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T00:00:00Z","timestamp":1755561600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Research on the Association between Hearing Loss and Other Health Problems, China.","award":["2024003"],"award-info":[{"award-number":["2024003"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>Hearing loss (HL) is a prevalent health issue, and identifying noninvasive biomarkers for early detection is crucial. This study investigates the association between retinal vascular fractal dimension (FD) and HL in a health checkup population. A retrospective cross-sectional study was conducted with 575 participants who underwent ophthalmological and audiological assessments at Shanghai Health and Medical Center CN between October 2014 and January 2024. Retinal FD was measured using nonmydriatic fundus photography and analyzed using Singapore I Vessel Assessment software. Hearing thresholds were assessed by air-conduction pure-tone audiometry, with the high Fletcher index (hFI) used to evaluate hearing acuity. Results showed that higher retinal FD values were significantly associated with better hearing acuity. Specifically, each 1-SD increase in arteriolar FD (FDa) was correlated with a 2.85 dB decrease in the hearing threshold at 1\u00a0kHz (\u03b2 = \u22122.85, 95% CI \u2212\u20094.47 to \u2212\u20091.23, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001), and each 1-SD increase in venular FD (FDv) was correlated with a 2.61 dB decrease at 2\u00a0kHz (\u03b2 = \u22122.61, 95% CI \u2212\u20094.42 to \u2212\u20090.80, <jats:italic>p<\/jats:italic>\u2009=\u2009.005). The study suggests that retinal FD may serve as a noninvasive biomarker for early detection of HL and could assist in the development of preventive strategies.<\/jats:p>","DOI":"10.1038\/s41598-025-16451-1","type":"journal-article","created":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T15:48:39Z","timestamp":1755618519000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Association between retinal vascular fractal dimension and hearing loss: a cross-sectional study"],"prefix":"10.1038","volume":"15","author":[{"given":"Rui","family":"Xu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xing","family":"Qi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yihan","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiyun","family":"Bian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaowei","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tingli","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8250-9887","authenticated-orcid":false,"given":"Xiangming","family":"Meng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,8,19]]},"reference":[{"key":"16451_CR1","doi-asserted-by":"publisher","first-page":"996","DOI":"10.1016\/s0140-6736(21)00516-x","volume":"407","author":"GHL Collaborators","year":"2021","unstructured":"Collaborators, G. H. L. Hearing loss prevalence and years lived with disability, 1990\u20132019: findings from the global burden of disease study 2019. Lancet 407, 996\u20131009. https:\/\/doi.org\/10.1016\/s0140-6736(21)00516-x (2021).","journal-title":"Lancet"},{"key":"16451_CR2","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1037\/a0029558","volume":"49","author":"AR Lederberg","year":"2013","unstructured":"Lederberg, A. R., Schick, B. & Spencer, P. E. Language and literacy development of deaf and hard-of-hearing children: successes and challenges. Dev. Psychol. 49, 15\u201330. https:\/\/doi.org\/10.1037\/a0029558 (2013).","journal-title":"Dev. Psychol."},{"key":"16451_CR3","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1016\/s0140-6736(20)30367-6","volume":"396","author":"G Livingston","year":"2020","unstructured":"Livingston, G. et al. Dementia prevention, intervention, and care: 2020 report of the lancet commission. Lancet 396, 413\u2013446. https:\/\/doi.org\/10.1016\/s0140-6736(20)30367-6 (2020).","journal-title":"Lancet"},{"key":"16451_CR4","doi-asserted-by":"publisher","first-page":"101521","DOI":"10.1016\/j.bjorl.2024.101521","volume":"91","author":"P de Ara\u00fajo","year":"2024","unstructured":"de Ara\u00fajo, P. et al. Impact of hearing impairment on cognitive performance. Braz J. Otorhinolaryngol. 91, 101521. https:\/\/doi.org\/10.1016\/j.bjorl.2024.101521 (2024).","journal-title":"Braz J. Otorhinolaryngol."},{"key":"16451_CR5","doi-asserted-by":"publisher","first-page":"1443","DOI":"10.1056\/nejm198012183032503","volume":"303","author":"SB Arnold","year":"1980","unstructured":"Arnold, S. B. et al. Long-term digitalis therapy improves left ventricular function in heart failure. N Engl. J. Med. 303, 1443\u20131448. https:\/\/doi.org\/10.1056\/nejm198012183032503 (1980).","journal-title":"N Engl. J. Med."},{"key":"16451_CR6","doi-asserted-by":"publisher","first-page":"1063","DOI":"10.1124\/pharmrev.124.001195","volume":"76","author":"CR Cederroth","year":"2024","unstructured":"Cederroth, C. R., Dyhrfjeld-Johnsen, J. & Canlon, B. Pharmacological approaches to hearing loss. Pharmacol. Rev. 76, 1063\u20131088. https:\/\/doi.org\/10.1124\/pharmrev.124.001195 (2024).","journal-title":"Pharmacol. Rev."},{"key":"16451_CR7","doi-asserted-by":"publisher","first-page":"49","DOI":"10.20960\/nh.05458","volume":"41","author":"J Almaz\u00e1n-Catal\u00e1n","year":"2024","unstructured":"Almaz\u00e1n-Catal\u00e1n, J., Morais-Moreno, C. & Puga Gim\u00e9nez de Azc\u00e1rate, A. M. Partearroyo cediel, T. Impact of nutrition on hearing loss. Nutr. Hosp. 41, 49\u201351. https:\/\/doi.org\/10.20960\/nh.05458 (2024).","journal-title":"Nutr. Hosp."},{"key":"16451_CR8","doi-asserted-by":"publisher","first-page":"340","DOI":"10.1186\/s12944-024-02331-6","volume":"23","author":"Z Peng","year":"2024","unstructured":"Peng, Z., Wu, Q., Zhao, C. L. & Gong, S. S. Lipid metabolism and hearing loss: association of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) with adolescent hearing health. Lipids Health Dis. 23, 340. https:\/\/doi.org\/10.1186\/s12944-024-02331-6 (2024).","journal-title":"Lipids Health Dis."},{"key":"16451_CR9","doi-asserted-by":"publisher","first-page":"2382943","DOI":"10.1080\/13510002.2024.2382943","volume":"29","author":"TF Shi","year":"2024","unstructured":"Shi, T. F. et al. Hyperglycemia-induced oxidative stress exacerbates mitochondrial apoptosis damage to cochlear stria vascularis pericytes via the ROS-mediated Bcl-2\/CytC\/AIF pathway. Redox Rep. 29, 2382943. https:\/\/doi.org\/10.1080\/13510002.2024.2382943 (2024).","journal-title":"Redox Rep."},{"key":"16451_CR10","doi-asserted-by":"publisher","unstructured":"Cohen, B. E., Durstenfeld, A. & Roehm, P. C. Viral causes of hearing loss: a review for hearing health professionals. Trends Hear. 18 https:\/\/doi.org\/10.1177\/2331216514541361 (2014).","DOI":"10.1177\/2331216514541361"},{"key":"16451_CR11","doi-asserted-by":"publisher","first-page":"104229","DOI":"10.1016\/j.amjoto.2024.104229","volume":"45","author":"C Han","year":"2024","unstructured":"Han, C. et al. The silent reservoir? SARS-CoV-2 detection in the middle ear effusion of patients with otitis media with effusion after Omicron infection. Am. J. Otolaryngol. 45, 104229. https:\/\/doi.org\/10.1016\/j.amjoto.2024.104229 (2024).","journal-title":"Am. J. Otolaryngol."},{"key":"16451_CR12","doi-asserted-by":"publisher","first-page":"883749","DOI":"10.3389\/fneur.2022.883749","volume":"13","author":"X Meng","year":"2022","unstructured":"Meng, X., Wang, J., Sun, J. & Zhu, K. COVID-19 and sudden sensorineural hearing loss: A systematic review. Front. Neurol. 13, 883749. https:\/\/doi.org\/10.3389\/fneur.2022.883749 (2022).","journal-title":"Front. Neurol."},{"key":"16451_CR13","doi-asserted-by":"publisher","first-page":"1028","DOI":"10.17305\/bb.2024.10239","volume":"24","author":"X Meng","year":"2024","unstructured":"Meng, X. et al. Clinical manifestations and outcomes of otitis media with effusion in adult patients following Omicron infection in China. Biomol. Biomed. 24, 1028\u20131034. https:\/\/doi.org\/10.17305\/bb.2024.10239 (2024).","journal-title":"Biomol. Biomed."},{"key":"16451_CR14","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1016\/j.cophys.2020.09.004","volume":"18","author":"L Neng","year":"2020","unstructured":"Neng, L. & Shi, X. Vascular pathology and hearing disorders. Curr. Opin. Physiol. 18, 79\u201384. https:\/\/doi.org\/10.1016\/j.cophys.2020.09.004 (2020).","journal-title":"Curr. Opin. Physiol."},{"key":"16451_CR15","doi-asserted-by":"publisher","first-page":"108877","DOI":"10.1016\/j.heares.2023.108877","volume":"438","author":"X Shi","year":"2023","unstructured":"Shi, X. Research advances in cochlear pericytes and hearing loss. Hear. Res. 438, 108877. https:\/\/doi.org\/10.1016\/j.heares.2023.108877 (2023).","journal-title":"Hear. Res."},{"key":"16451_CR16","doi-asserted-by":"publisher","first-page":"774585","DOI":"10.3389\/fnins.2021.774585","volume":"15","author":"W Yu","year":"2021","unstructured":"Yu, W. et al. Role of the stria vascularis in the pathogenesis of sensorineural hearing loss: A narrative review. Front. Neurosci. 15, 774585. https:\/\/doi.org\/10.3389\/fnins.2021.774585 (2021).","journal-title":"Front. Neurosci."},{"key":"16451_CR17","doi-asserted-by":"publisher","unstructured":"Bovee, S., Klump, G. M., K\u00f6ppl, C. & Pyott, S. J. The stria vascularis: renewed attention on a key player in age-related hearing loss. Int. J. Mol. Sci. 25 https:\/\/doi.org\/10.3390\/ijms25105391 (2024).","DOI":"10.3390\/ijms25105391"},{"key":"16451_CR18","doi-asserted-by":"publisher","first-page":"479","DOI":"10.5664\/jcsm.10370","volume":"19","author":"J Wang","year":"2023","unstructured":"Wang, J. et al. Retinal vascular fractal dimension measurements in patients with obstructive sleep apnea syndrome: a retrospective case-control study. J. Clin. Sleep. Med. 19, 479\u2013490. https:\/\/doi.org\/10.5664\/jcsm.10370 (2023).","journal-title":"J. Clin. Sleep. Med."},{"key":"16451_CR19","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1001\/jamaoto.2019.4484","volume":"146","author":"J Wang","year":"2020","unstructured":"Wang, J. et al. Associations of retinal vessel caliber with hearing status in childhood and midlife: A Cross-Generational Population-Based study. JAMA Otolaryngol. Head Neck Surg. 146, 323\u2013330. https:\/\/doi.org\/10.1001\/jamaoto.2019.4484 (2020).","journal-title":"JAMA Otolaryngol. Head Neck Surg."},{"key":"16451_CR20","doi-asserted-by":"publisher","first-page":"100903","DOI":"10.1016\/j.preteyeres.2020.100903","volume":"82","author":"S Roy","year":"2021","unstructured":"Roy, S. & Kim, D. Retinal capillary basement membrane thickening: role in the pathogenesis of diabetic retinopathy. Prog Retin Eye Res. 82, 100903. https:\/\/doi.org\/10.1016\/j.preteyeres.2020.100903 (2021).","journal-title":"Prog Retin Eye Res."},{"key":"16451_CR21","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.3474","author":"A Abdin","year":"2024","unstructured":"Abdin, A. et al. Cardio-ocular syndrome: retinal microvascular changes in acutely decompensated heart failure. Eur. J. Heart Fail. https:\/\/doi.org\/10.1002\/ejhf.3474 (2024).","journal-title":"Eur. J. Heart Fail."},{"key":"16451_CR22","doi-asserted-by":"publisher","unstructured":"Curro, K. R. et al. Longitudinal assessment of retinal microvasculature in preclinical Alzheimer\u2019s disease. Invest. Ophthalmol. Vis. Sci. 65 https:\/\/doi.org\/10.1167\/iovs.65.12.2 (2024).","DOI":"10.1167\/iovs.65.12.2"},{"key":"16451_CR23","doi-asserted-by":"publisher","first-page":"394","DOI":"10.1097\/AUD.0b013e3180479388","volume":"28","author":"G Liew","year":"2007","unstructured":"Liew, G. et al. Retinal microvascular abnormalities and age-related hearing loss: the blue mountains hearing study. Ear Hear. 28, 394\u2013401. https:\/\/doi.org\/10.1097\/AUD.0b013e3180479388 (2007).","journal-title":"Ear Hear."},{"key":"16451_CR24","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1001\/jamaoto.2019.3987","volume":"146","author":"SJ Kim","year":"2020","unstructured":"Kim, S. J. et al. Association between microvascular retinal signs and Age-Related hearing loss in the atherosclerosis risk in communities neurocognitive study (ARIC-NCS). JAMA Otolaryngol. Head Neck Surg. 146, 152\u2013159. https:\/\/doi.org\/10.1001\/jamaoto.2019.3987 (2020).","journal-title":"JAMA Otolaryngol. Head Neck Surg."},{"key":"16451_CR25","doi-asserted-by":"publisher","first-page":"2169","DOI":"10.1093\/gerona\/glaa269","volume":"76","author":"R Sardone","year":"2021","unstructured":"Sardone, R. et al. Retinal vascular density on optical coherence tomography angiography and Age-Related central and peripheral hearing loss in a Southern Italian older population. J. Gerontol. Biol. Sci. Med. Sci. 76, 2169\u20132177. https:\/\/doi.org\/10.1093\/gerona\/glaa269 (2021).","journal-title":"J. Gerontol. Biol. Sci. Med. Sci."},{"key":"16451_CR26","doi-asserted-by":"publisher","first-page":"1276","DOI":"10.1161\/strokeaha.120.031886","volume":"52","author":"G Liew","year":"2021","unstructured":"Liew, G. et al. Retinal vasculature fractal and stroke mortality. Stroke 52, 1276\u20131282. https:\/\/doi.org\/10.1161\/strokeaha.120.031886 (2021).","journal-title":"Stroke"},{"key":"16451_CR27","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1136\/bmjopen-2018-022399","volume":"9","author":"J Dascalu","year":"2019","unstructured":"Dascalu, J. et al. Retinal microvasculature: population epidemiology and concordance in Australian children aged 11\u201312 years and their parents. BMJ Open. 9, 44\u201352. https:\/\/doi.org\/10.1136\/bmjopen-2018-022399 (2019).","journal-title":"BMJ Open."},{"key":"16451_CR28","doi-asserted-by":"publisher","first-page":"330","DOI":"10.1044\/jshd.2404.330","volume":"24","author":"R Carhart","year":"1959","unstructured":"Carhart, R. & Jerger, J. F. Preferred method for clinical determination of pure-tone thresholds. J. Speech Hear. Disorders. 24, 330\u2013345 (1959).","journal-title":"J. Speech Hear. Disorders"},{"key":"16451_CR29","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1097\/aud.0000000000001420","volume":"45","author":"LM Haile","year":"2024","unstructured":"Haile, L. M. et al. Hearing loss prevalence, years lived with disability, and hearing aid use in the united States from 1990 to 2019: findings from the global burden of disease study. Ear Hear. 45, 257\u2013267. https:\/\/doi.org\/10.1097\/aud.0000000000001420 (2024).","journal-title":"Ear Hear."},{"key":"16451_CR30","doi-asserted-by":"publisher","first-page":"1075","DOI":"10.1097\/JGP.0b013e31823e31c4","volume":"20","author":"RJ Teunisse","year":"2012","unstructured":"Teunisse, R. J. & Olde Rikkert, M. G. Prevalence of musical hallucinations in patients referred for audiometric testing. Am. J. Geriatr. Psychiatry. 20, 1075\u20131077. https:\/\/doi.org\/10.1097\/JGP.0b013e31823e31c4 (2012).","journal-title":"Am. J. Geriatr. Psychiatry"},{"key":"16451_CR31","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1016\/j.preteyeres.2003.12.001","volume":"23","author":"NN Osborne","year":"2004","unstructured":"Osborne, N. N. et al. Retinal ischemia: mechanisms of damage and potential therapeutic strategies. Prog Retin Eye Res. 23, 91\u2013147. https:\/\/doi.org\/10.1016\/j.preteyeres.2003.12.001 (2004).","journal-title":"Prog Retin Eye Res."},{"key":"16451_CR32","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1111\/j.1749-6632.1999.tb08644.x","volume":"884","author":"MD Seidman","year":"1999","unstructured":"Seidman, M. D., Quirk, W. S. & Shirwany, N. A. Mechanisms of alterations in the microcirculation of the cochlea. Ann. N Y Acad. Sci. 884, 226\u2013232. https:\/\/doi.org\/10.1111\/j.1749-6632.1999.tb08644.x (1999).","journal-title":"Ann. N Y Acad. Sci."},{"key":"16451_CR33","doi-asserted-by":"publisher","DOI":"10.1016\/S2665-9913(24)00220-0","author":"A Kachaner","year":"2024","unstructured":"Kachaner, A. et al. Immunosuppressive agents or intravenous Immunoglobulin in addition to glucocorticoids in the treatment of Susac syndrome: a French National cohort study. Lancet Rheumatol. https:\/\/doi.org\/10.1016\/S2665-9913(24)00220-0 (2024).","journal-title":"Lancet Rheumatol."},{"key":"16451_CR34","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1146\/annurev-physiol-042022-030946","volume":"86","author":"XR Lim","year":"2024","unstructured":"Lim, X. R. & Harraz, O. F. Mechanosensing by vascular endothelium. Annu. Rev. Physiol. 86, 71\u201397. https:\/\/doi.org\/10.1146\/annurev-physiol-042022-030946 (2024).","journal-title":"Annu. Rev. Physiol."},{"key":"16451_CR35","doi-asserted-by":"publisher","first-page":"112623","DOI":"10.1016\/j.celrep.2023.112623","volume":"42","author":"WH van der Valk","year":"2023","unstructured":"van der Valk, W. H. et al. A single-cell level comparison of human inner ear organoids with the human cochlea and vestibular organs. Cell. Rep. 42, 112623. https:\/\/doi.org\/10.1016\/j.celrep.2023.112623 (2023).","journal-title":"Cell. Rep."},{"key":"16451_CR36","doi-asserted-by":"publisher","first-page":"121","DOI":"10.4103\/bc.bc_8_23","volume":"9","author":"Y Gao","year":"2023","unstructured":"Gao, Y. et al. A narrative review of retinal vascular parameters and the applications (Part I): measuring methods. Brain Circ. 9, 121\u2013128. https:\/\/doi.org\/10.4103\/bc.bc_8_23 (2023).","journal-title":"Brain Circ."},{"key":"16451_CR37","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1161\/circulationaha.121.057709","volume":"145","author":"SM Zekavat","year":"2022","unstructured":"Zekavat, S. M. et al. Deep learning of the retina enables Phenome- and Genome-Wide analyses of the microvasculature. Circulation 145, 134\u2013150. https:\/\/doi.org\/10.1161\/circulationaha.121.057709 (2022).","journal-title":"Circulation"},{"key":"16451_CR38","doi-asserted-by":"publisher","first-page":"406","DOI":"10.1038\/nn.4489","volume":"20","author":"K Kisler","year":"2017","unstructured":"Kisler, K. et al. Pericyte degeneration leads to neurovascular uncoupling and limits oxygen supply to brain. Nat. Neurosci. 20, 406\u2013416. https:\/\/doi.org\/10.1038\/nn.4489 (2017).","journal-title":"Nat. Neurosci."},{"key":"16451_CR39","doi-asserted-by":"publisher","first-page":"e14846","DOI":"10.1111\/cns.14846","volume":"30","author":"Y Bi","year":"2024","unstructured":"Bi, Y., Yang, Y., Zhang, G., Wang, H. & Dong, R. From hearing loss to neurological complications: is there an ear glymphatic system? CNS Neurosci. Ther. 30, e14846. https:\/\/doi.org\/10.1111\/cns.14846 (2024).","journal-title":"CNS Neurosci. Ther."},{"key":"16451_CR40","doi-asserted-by":"publisher","first-page":"845","DOI":"10.2147\/cia.S458869","volume":"19","author":"Y Hou","year":"2024","unstructured":"Hou, Y. & Liu, B. Relationship between hypertension and hearing loss: analysis of the related factors. Clin. Interv Aging. 19, 845\u2013856. https:\/\/doi.org\/10.2147\/cia.S458869 (2024).","journal-title":"Clin. Interv Aging"},{"key":"16451_CR41","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1186\/s10020-023-00737-z","volume":"29","author":"Y Deng","year":"2023","unstructured":"Deng, Y., Chen, S. & Hu, J. Diabetes mellitus and hearing loss. Mol. Med. 29, 141. https:\/\/doi.org\/10.1186\/s10020-023-00737-z (2023).","journal-title":"Mol. Med."},{"key":"16451_CR42","doi-asserted-by":"publisher","first-page":"432","DOI":"10.1136\/bjo-2022-321399","volume":"108","author":"J Xie","year":"2024","unstructured":"Xie, J. et al. Deep segmentation of OCTA for evaluation and association of changes of retinal microvasculature with alzheimer\u2019s disease and mild cognitive impairment. Br. J. Ophthalmol. 108, 432\u2013439. https:\/\/doi.org\/10.1136\/bjo-2022-321399 (2024).","journal-title":"Br. J. Ophthalmol."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-16451-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-16451-1","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-16451-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T07:27:45Z","timestamp":1757402865000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-16451-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,19]]},"references-count":42,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["16451"],"URL":"https:\/\/doi.org\/10.1038\/s41598-025-16451-1","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,19]]},"assertion":[{"value":"27 November 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 August 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 August 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"30425"}}