{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T14:17:36Z","timestamp":1778595456973,"version":"3.51.4"},"reference-count":49,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:00:00Z","timestamp":1778544000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:00:00Z","timestamp":1778544000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Medizinische Hochschule Hannover (MHH)"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Many patients with coronary artery disease are eligible for either percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). Technical and clinical aspects influence the decision for either treatment. However, biological effects of PCI and CABG on long-term coronary artery anatomy and physiology should be considered but are largely unknown. Eight German landrace swine were used in this study. An artificial atherosclerotic plaque (AAP) was implanted into the left anterior descending coronary artery (LAD) to simulate coronary atherosclerosis. Physiological changes of PCI and surgical CABG in vascular and perivascular tissue were assessed in an ex vivo setting (organ care system OCS). Furthermore, radiological and nuclear imaging was performed using single photon emission computed tomography (SPECT) and computed tomography (CT). Furthermore, interventional (PCI) and surgical (CABG) treatment was evaluated using an ex-vivo setting. Lymphatic flow and myocardial perfusion were improved in pigs in the CABG group compared to the PCI group. The PCI group showed a significantly higher mean count number proximal to the intervention in the LAD area. Stenting experiments showed a significantly higher mean count number proximal to the intervention in the LAD area. This effect could also be demonstrated macroscopically, as myocardial infarct areas were smaller and myocardial function was better after defibrillation in the OCS (organ care system) in the CABG treated hearts. The artificial atherosclerotic plaque model in porcine hearts is a new valuable tool to simulate coronary artery stenosis without damaging other organs. It may serve as a tool for future medical testing and for further specific research on coronary artery physiology. Our data suggest that the cardiac lymphatic vascular system and perfusion capability are partly restricted after PCI as compared to CABG.<\/jats:p>","DOI":"10.1038\/s41598-026-50599-8","type":"journal-article","created":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T05:15:37Z","timestamp":1778562937000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative analysis of bypass vs. stent for coronary revascularization using an ex-vivo organ care system in an animal model"],"prefix":"10.1038","volume":"16","author":[{"given":"Philipp","family":"Lindenhahn","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rabea","family":"Hinkel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L. Christian","family":"Napp","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johanna","family":"Diekmann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jens P.","family":"Bankstahl","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frank M.","family":"Bengel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Holger","family":"Volk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernhard","family":"Hiebl","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan B.","family":"Hinrichs","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lena S.","family":"Becker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jannik","family":"Richter","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iliyana","family":"Pepelanova","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danny","family":"Jonigk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Klaus","family":"H\u00f6ffler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Axel","family":"Haverich","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tim","family":"Kaufeld","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,5,12]]},"reference":[{"key":"50599_CR1","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1016\/S0140-6736(14)61682-2","volume":"385","author":"M Naghavi","year":"2015","unstructured":"Naghavi, M. et al. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990\u20132013: A systematic analysis for the Global Burden of Disease Study 2013. Lancet 385, 117\u2013171 (2015).","journal-title":"Lancet"},{"key":"50599_CR2","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1111\/j.1442-2018.2011.00627.x","volume":"13","author":"N Oba","year":"2011","unstructured":"Oba, N., Mccaffrey, R., Choonhapran, P., Chutug, P. & Rueangram, S. Development of a community participation program for diabetes mellitus prevention in a primary care unit, Thailand. Nurs. Health Sci. 13, 352\u2013359 (2011).","journal-title":"Nurs. Health Sci."},{"key":"50599_CR3","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1016\/j.acvd.2009.11.006","volume":"103","author":"M Grau","year":"2010","unstructured":"Grau, M. et al. Prevalence of cardiovascular risk factors in men with stable coronary heart disease in France and Spain. Arch. Cardiovasc. Dis. 103, 80\u201389 (2010).","journal-title":"Arch. Cardiovasc. Dis."},{"key":"50599_CR4","doi-asserted-by":"publisher","first-page":"276","DOI":"10.1038\/nrcardio.2014.26","volume":"11","author":"ND Wong","year":"2014","unstructured":"Wong, N. D. Epidemiological studies of CHD and the evolution of preventive cardiology. Nat. Rev. Cardiol. 11, 276\u2013289 (2014).","journal-title":"Nat. Rev. Cardiol."},{"key":"50599_CR5","doi-asserted-by":"publisher","first-page":"284","DOI":"10.4065\/mcp.2009.0560","volume":"85","author":"MC Kontos","year":"2010","unstructured":"Kontos, M. C., Diercks, D. B. & Kirk, J. D. Emergency Department and office-based evaluation of patients with chest pain. Mayo Clin. Proc. 85, 284\u2013299 (2010).","journal-title":"Mayo Clin. Proc."},{"key":"50599_CR6","unstructured":"Kaukola, S. The diagonal ear-lobe crease, a physical sign associated with coronary heart disease. Acta Med. Scand. 204, (1978)."},{"key":"50599_CR7","first-page":"341","volume":"61","author":"A Vaidya","year":"2009","unstructured":"Vaidya, A. et al. Prevalence of coronary heart disease in the urban adult males of eastern Nepal: a population-based analytical cross-sectional study. Indian Heart J. 61, 341\u2013347 (2009).","journal-title":"Indian Heart J."},{"key":"50599_CR8","doi-asserted-by":"crossref","unstructured":"Albarrati, A. M. et al. Effectiveness of low to moderate physical exercise training on the level of low-density lipoproteins: A systematic review. Biomed Res Int. (2018). (2018).","DOI":"10.1155\/2018\/5982980"},{"key":"50599_CR9","doi-asserted-by":"publisher","first-page":"27","DOI":"10.31083\/j.rcm.2019.01.53","volume":"20","author":"Y Tian","year":"2019","unstructured":"Tian, Y. et al. Treatment models of cardiac rehabilitation in patients with coronary heart disease and related factors affecting patient compliance. Rev. Cardiovasc. Med. 20, 27\u201333 (2019).","journal-title":"Rev. Cardiovasc. Med."},{"key":"50599_CR10","doi-asserted-by":"publisher","first-page":"3232","DOI":"10.1093\/eurheartj\/ehw334","volume":"37","author":"N Townsend","year":"2016","unstructured":"Townsend, N. et al. Cardiovascular disease in Europe: Epidemiological update 2016. Eur. Heart J. 37, 3232\u20133245 (2016).","journal-title":"Eur. Heart J."},{"key":"50599_CR11","unstructured":"Tsao, C. W. et al. Heart disease and stroke statistics-2022 update: A report from the American Heart Association. Circulation145 (2022)."},{"key":"50599_CR12","first-page":"21","volume":"20","author":"A Milutinovi\u0107","year":"2020","unstructured":"Milutinovi\u0107, A., \u0160uput, D. & Zorc-Pleskovi\u010d, R. Pathogenesis of atherosclerosis in the tunica intima, media, and adventitia of coronary arteries: An updated review. Bosn J. Basic. Med. Sci. 20, 21\u201330 (2020).","journal-title":"Bosn J. Basic. Med. Sci."},{"key":"50599_CR13","doi-asserted-by":"publisher","first-page":"0","DOI":"10.1016\/j.jacc.2005.09.068","volume":"47","author":"E Falk","year":"2006","unstructured":"Falk, E. Pathogenesis of Atherosclerosis. J. Am. Coll. Cardiol. 47, 0\u20135 (2006).","journal-title":"J. Am. Coll. Cardiol."},{"key":"50599_CR14","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3390\/biom8030080","volume":"8","author":"Y Zhu","year":"2018","unstructured":"Zhu, Y. et al. Research progress on the relationship between atherosclerosis and inflammation. Biomolecules 8, 1\u201311 (2018).","journal-title":"Biomolecules"},{"key":"50599_CR15","unstructured":"Zipes, D. P., Libby, P. & Bonow, R. O. B. E. Braunwald\u2019s heart disease - A textbook of cardiovascular medicine. In A Textbook of Cardiovascular Medicine 2183 (2005)."},{"key":"50599_CR16","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1016\/j.vph.2017.08.003","volume":"96\u201398","author":"EC Boyle","year":"2017","unstructured":"Boyle, E. C., Sedding, D. G. & Haverich, A. Targeting vasa vasorum dysfunction to prevent atherosclerosis. Vascul. Pharmacol. 96\u201398, 5\u201310 (2017).","journal-title":"Vascul Pharmacol."},{"key":"50599_CR17","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1161\/CIRCULATIONAHA.116.025407","volume":"135","author":"AA Haverich","year":"2017","unstructured":"Haverich, A. A. Surgeon\u2019s view on the pathogenesis of atherosclerosis. Circulation 135, 205\u2013207 (2017).","journal-title":"Circulation"},{"key":"50599_CR18","doi-asserted-by":"publisher","first-page":"2813","DOI":"10.1016\/j.jacc.2018.09.012","volume":"72","author":"DW Park","year":"2018","unstructured":"Park, D. W. et al. 10-year outcomes of stents versus coronary artery bypass grafting for left main coronary artery disease. J. Am. Coll. Cardiol. 72, 2813\u20132822 (2018).","journal-title":"J. Am. Coll. Cardiol."},{"key":"50599_CR19","doi-asserted-by":"publisher","first-page":"939","DOI":"10.1016\/S0140-6736(18)30423-9","volume":"391","author":"SJ Head","year":"2018","unstructured":"Head, S. J. et al. Mortality after coronary artery bypass grafting versus percutaneous coronary intervention with stenting for coronary artery disease: a pooled analysis of individual patient data. Lancet 391, 939\u2013948 (2018).","journal-title":"Lancet"},{"key":"50599_CR20","first-page":"8","volume":"12","author":"G Giustino","year":"2015","unstructured":"Giustino, G. & Mehran, R. PCI AND CABG surgery in 2014: CABG surgery versus PCI in CAD-surgery strikes again! Nat. Rev. Gastroenterol. Hepatol. 12, 8\u201310 (2015).","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"50599_CR21","doi-asserted-by":"publisher","first-page":"964","DOI":"10.1016\/j.jacc.2018.11.053","volume":"73","author":"T Doenst","year":"2019","unstructured":"Doenst, T. et al. PCI and CABG for treating stable coronary artery disease: JACC review topic of the week. J. Am. Coll. Cardiol. 73, 964\u2013976 (2019).","journal-title":"J. Am. Coll. Cardiol."},{"key":"50599_CR22","unstructured":"Deutsche Herzstiftung e.V. Deutscher Herzbericht. 33, 182 (2021)."},{"key":"50599_CR23","doi-asserted-by":"crossref","unstructured":"Dahme, E. G. Atherosclerosis and arteriosclerosis in domestic animals. Annals of the New York Academy of Sciences. 127 (1965).","DOI":"10.1111\/j.1749-6632.1965.tb49433.x"},{"key":"50599_CR24","doi-asserted-by":"publisher","first-page":"372","DOI":"10.1111\/j.1469-185X.1964.tb01163.x","volume":"39","author":"CW ADAMS","year":"1964","unstructured":"ADAMS, C. W. Arteriosclerosis in man, other mammals and birds. Biol. Rev. Camb. Philos. Soc. 39, 372\u2013423 (1964).","journal-title":"Biol. Rev. Camb. Philos. Soc."},{"key":"50599_CR25","doi-asserted-by":"publisher","first-page":"197","DOI":"10.3390\/biomimetics9040197","volume":"9","author":"P Lindenhahn","year":"2024","unstructured":"Lindenhahn, P. et al. A novel artificial coronary plaque to model coronary heart disease. Biomimetics 9, 197 (2024).","journal-title":"Biomimetics"},{"key":"50599_CR26","doi-asserted-by":"publisher","first-page":"2760","DOI":"10.1016\/j.jbiomech.2009.07.032","volume":"42","author":"E Maher","year":"2009","unstructured":"Maher, E. et al. Tensile and compressive properties of fresh human carotid atherosclerotic plaques. J. Biomech. 42, 2760\u20132767 (2009).","journal-title":"J. Biomech."},{"key":"50599_CR27","doi-asserted-by":"publisher","first-page":"378","DOI":"10.1161\/01.RES.84.4.378","volume":"5","author":"C Rogers","year":"1999","unstructured":"Rogers, C., Tseng, D. Y., Squire, J. C. & Edelman, E. R. A finite element analysis approach to pressure, compliance, and stent design as contributors to vascular injury. Circ. Res. 5, 378\u2013383 (1999).","journal-title":"Circ. Res."},{"key":"50599_CR28","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1007\/s10237-004-0039-6","volume":"2","author":"F Migliavacca","year":"2004","unstructured":"Migliavacca, F. et al. Stainless and shape memory alloy coronary stents: A computational study on the interaction with the vascular wall. Biomech. Model. Mechanobiol. 2, 205\u2013217 (2004).","journal-title":"Biomech. Model. Mechanobiol."},{"key":"50599_CR29","doi-asserted-by":"publisher","first-page":"1574","DOI":"10.1016\/j.jbiomech.2004.07.022","volume":"38","author":"C Lally","year":"2005","unstructured":"Lally, C., Dolan, F. & Prendergast, P. J. Cardiovascular stent design and vessel stresses: A finite element analysis. J. Biomech. 38, 1574\u20131581 (2005).","journal-title":"J. Biomech."},{"key":"50599_CR30","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1080\/10255840802136135","volume":"12","author":"M Early","year":"2009","unstructured":"Early, M., Lally, C., Prendergast, P. J. & Kelly, D. J. Stresses in peripheral arteries following stent placement: a finite element analysis. Comput. Methods Biomech. Biomed. Engin. 12, 25\u201333 (2009).","journal-title":"Comput. Methods Biomech. Biomed. Engin"},{"key":"50599_CR31","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1016\/S0924-0136(03)00435-7","volume":"143\u2013144","author":"D Chua","year":"2003","unstructured":"Chua, D., Donald, S. N., Hashmi, M. S. & B. J. & J. Finite element simulation of stent and balloon interaction. J. Mater. Process. Technol. 143\u2013144, 591\u2013597 (2003).","journal-title":"J. Mater. Process. Technol."},{"key":"50599_CR32","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1080\/10255840108908007","volume":"4","author":"F Auricchio","year":"2001","unstructured":"Auricchio, F., di Loreto, M. & Sacco, E. Finite-element analysis of a stenotic artery revascularization through a stent insertion. Comput. Methods Biomech. Biomed. Engin. 4, 249\u2013263 (2001).","journal-title":"Comput. Methods Biomech. Biomed. Engin"},{"key":"50599_CR33","doi-asserted-by":"publisher","first-page":"757","DOI":"10.1115\/1.2246236","volume":"128","author":"J Bedoya","year":"2006","unstructured":"Bedoya, J., Meyer, C. A., Timmins, L. H., Moreno, M. R. & Moore, J. E. Effects of stent design parameters on normal artery wall mechanics. J. Biomech. Eng. 128, 757\u2013765 (2006).","journal-title":"J. Biomech. Eng."},{"key":"50599_CR34","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1016\/0021-9150(71)90014-1","volume":"13","author":"HL Ratcliffe","year":"1971","unstructured":"Ratcliffe, H. L. & Luginb\u00fchl, H. The domestic pig: A model for experimental atherosclerosis. Atherosclerosis 13, 133\u2013136 (1971).","journal-title":"Atherosclerosis"},{"key":"50599_CR35","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1136\/heart.89.2.133","volume":"89","author":"R Virmani","year":"2003","unstructured":"Virmani, R., Kolodgie, F. D., Farb, A. & Lafont, A. Drug eluting stents: Are human and animal studies comparable? Heart 89, 133\u2013138 (2003).","journal-title":"Heart"},{"key":"50599_CR36","doi-asserted-by":"publisher","first-page":"788","DOI":"10.1111\/jocs.14144","volume":"34","author":"NJ Smith","year":"2019","unstructured":"Smith, N. J. et al. Minimally invasive single-vessel left internal mammary to left anterior descending artery bypass grafting improves outcomes over conventional sternotomy: A single-institution retrospective cohort study. J. Card Surg. 34, 788\u2013795 (2019).","journal-title":"J. Card Surg."},{"key":"50599_CR37","first-page":"515","volume":"60","author":"HC Lowe","year":"2003","unstructured":"Lowe, H. C. et al. The porcine coronary model of in-stent restenosis: Current status in the era of drug-eluting stents. Catheter. Cardiovasc. Interv. 60, 515\u2013523 (2003).","journal-title":"Catheter Cardiovasc. Interv."},{"key":"50599_CR38","doi-asserted-by":"publisher","first-page":"1286","DOI":"10.1093\/eurheartj\/ehz552","volume":"41","author":"MB Bastos","year":"2020","unstructured":"Bastos, M. B. et al. Invasive left ventricle pressure-volume analysis: Overview and practical clinical implications. Eur. Heart J. 41, 1286\u20131297 (2020).","journal-title":"Eur. Heart J."},{"key":"50599_CR39","doi-asserted-by":"crossref","unstructured":"Lyhne, M. D. et al. Closed chest biventricular pressure-volume loop recordings with admittance catheters in a porcine model. J. Visualized Exp. 1\u201320 (2021).","DOI":"10.3791\/62661"},{"key":"50599_CR40","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1016\/j.jvssci.2021.12.003","volume":"3","author":"DP Stonko","year":"2022","unstructured":"Stonko, D. P. et al. A technical and data analytic approach to pressure-volume loops over numerous cardiac cycles. JVS Vasc Sci. 3, 73\u201384 (2022).","journal-title":"JVS Vasc Sci."},{"key":"50599_CR41","doi-asserted-by":"crossref","unstructured":"Rojas, S. V. et al. Ex-vivo preservation with the organ care system in high risk heart transplantation. Life 12, 1\u201311 (2022).","DOI":"10.3390\/life12020247"},{"key":"50599_CR42","doi-asserted-by":"publisher","first-page":"67","DOI":"10.21037\/acs.2018.01.06","volume":"7","author":"MM Vela","year":"2018","unstructured":"Vela, M. M., S\u00e1ez, D. G. & Simon, A. R. Current approaches in retrieval and heart preservation. Ann. Cardiothorac. Surg. 7, 67\u201374 (2018).","journal-title":"Ann. Cardiothorac. Surg."},{"key":"50599_CR43","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1007\/s10456-022-09860-7","volume":"26","author":"C Werlein","year":"2023","unstructured":"Werlein, C. et al. Inflammation and vascular remodeling in COVID-19 hearts. Angiogenesis 26, 233\u2013248 (2023).","journal-title":"Angiogenesis"},{"key":"50599_CR44","unstructured":"Schmidt, M. et al. Verfahrensanweisung f\u00fcr die technische Durchf\u00fchrung der nuklearmedizinischen W\u00e4chter-Lymphknoten-Diagnostik. Dtsch. Gesellschaft f\u00fcr Nuklearmedizin e V 1\u201314 (2014)."},{"key":"50599_CR45","doi-asserted-by":"publisher","first-page":"1932","DOI":"10.1007\/s00259-013-2544-2","volume":"40","author":"F Giammarile","year":"2013","unstructured":"Giammarile, F. et al. The EANM and SNMMI practice guideline for lymphoscintigraphy and sentinel node localization in breast cancer. Eur. J. Nucl. Med. Mol. Imaging. 40, 1932\u20131947 (2013).","journal-title":"Eur. J. Nucl. Med. Mol. Imaging"},{"key":"50599_CR46","first-page":"883","volume":"23","author":"MD Osbakken","year":"1982","unstructured":"Osbakken, M. D. et al. Investigative nuclear medicine. J. Nucl. Med. 23, 883\u2013889 (1982).","journal-title":"J. Nucl. Med."},{"key":"50599_CR47","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1111\/j.1600-6143.2010.03388.x","volume":"11","author":"K Brown","year":"2011","unstructured":"Brown, K. et al. SPECT\/CT lymphoscintigraphy of heterotopic cardiac grafts reveals novel sites of lymphatic drainage and T cell priming. Am. J. Transplant. 11, 225\u2013234 (2011).","journal-title":"Am. J. Transplant."},{"key":"50599_CR48","doi-asserted-by":"publisher","first-page":"488","DOI":"10.1161\/CIRCULATIONAHA.117.028533","volume":"137","author":"LA Edwards","year":"2018","unstructured":"Edwards, L. A. et al. Chronic rejection of cardiac allografts is associated with increased lymphatic flow and cellular trafficking. Circulation 137, 488\u2013503 (2018).","journal-title":"Circulation"},{"key":"50599_CR49","first-page":"351","volume":"94","author":"JJ Castronuovo","year":"1983","unstructured":"Castronuovo, J. J., Lopez-Majano, V., Flanigan, D. P., Schuler, J. J. & Jonasson, O. Cardiovascular lymphoscintigraphy. Surgery 94, 351\u2013357 (1983).","journal-title":"Cardiovasc. lymphoscintigraphy Surgery"}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-50599-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-50599-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-50599-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T13:27:14Z","timestamp":1778592434000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-50599-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,12]]},"references-count":49,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["50599"],"URL":"https:\/\/doi.org\/10.1038\/s41598-026-50599-8","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,12]]},"assertion":[{"value":"4 December 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 April 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 May 2026","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":"14762"}}