{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T23:19:07Z","timestamp":1787872747082,"version":"build-2784847793"},"reference-count":44,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T00:00:00Z","timestamp":1779408000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"vor","delay-in-days":98,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"DOI":"10.1038\/s41598-026-53281-1","type":"journal-article","created":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T08:46:42Z","timestamp":1779439602000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Reliability of methods in assessing proximal femur bone quality for hip prosthesis selection"],"prefix":"10.1038","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6547-6419","authenticated-orcid":false,"given":"Marcos","family":"Del Carmen-Rodr\u00edguez","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleix","family":"Agelet-Pueyo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreu","family":"Triguero-Espinosa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Rodriguez-P\u00e9rez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose Luis","family":"Agull\u00f3-Ferr\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"G\u00f3mez-Vaquero","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,22]]},"reference":[{"issue":"5","key":"53281_CR1","doi-asserted-by":"publisher","first-page":"591","DOI":"10.5312\/wjo.v5.i5.591","volume":"5","author":"M Wyatt","year":"2014","unstructured":"Wyatt, M., Hooper, G., Frampton, C. & Rothwell, A. Survival outcomes of cemented compared to uncemented stems in primary total hip replacement. World J. Orthop. 5 (5), 591\u2013596. https:\/\/doi.org\/10.5312\/wjo.v5.i5.591 (2014).","journal-title":"World J. Orthop."},{"issue":"9214","key":"53281_CR2","doi-asserted-by":"publisher","first-page":"1499","DOI":"10.1016\/S0140-6736(00)02164-4","volume":"355","author":"S Kobayashi","year":"2000","unstructured":"Kobayashi, S., Saito, N., Horiuchi, H., Iorio, R. & Takaoka, K. Poor bone quality or hip structure as risk factors affecting survival of total-hip arthroplasty. Lancet 355 (9214), 1499\u20131504. https:\/\/doi.org\/10.1016\/S0140-6736(00)02164-4 (2000).","journal-title":"Lancet"},{"issue":"5","key":"53281_CR3","doi-asserted-by":"publisher","first-page":"413","DOI":"10.5301\/hipint.5000423","volume":"26","author":"DE Giebaly","year":"2016","unstructured":"Giebaly, D. E., Twaij, H., Ibrahim, M. & Haddad, F. S. Cementless hip implants: an expanding choice. Hip Int. 26 (5), 413\u2013423. https:\/\/doi.org\/10.5301\/hipint.5000423 (2016).","journal-title":"Hip Int."},{"issue":"11","key":"53281_CR4","doi-asserted-by":"publisher","first-page":"1024","DOI":"10.2106\/JBJS.21.00853","volume":"104","author":"HS Khanuja","year":"2022","unstructured":"Khanuja, H. S. et al. Revisiting Cemented Femoral Fixation in Hip Arthroplasty. J. Bone Joint Surg. Am. 104 (11), 1024\u20131033. https:\/\/doi.org\/10.2106\/JBJS.21.00853 (2022).","journal-title":"J. Bone Joint Surg. Am."},{"key":"53281_CR5","unstructured":"American Joint Replacement Registry. AJRR 2024 Annual Report. Rosemont, IL: American Academy of Orthopaedic Surgeons; (2024)."},{"issue":"1","key":"53281_CR6","first-page":"1","volume":"68","author":"EW Morscher","year":"2002","unstructured":"Morscher, E. W. & Wirz, D. Current state of cement fixation in THR. Acta Orthop. Belg. 68 (1), 1\u201312 (2002).","journal-title":"Acta Orthop. Belg."},{"issue":"3","key":"53281_CR7","doi-asserted-by":"publisher","first-page":"231","DOI":"10.1016\/8756-3282(93)90146-2","volume":"14","author":"LD Dorr","year":"1993","unstructured":"Dorr, L. D. et al. Structural and cellular assessment of bone quality of proximal femur. Bone 14 (3), 231\u2013242. (1993).","journal-title":"Bone"},{"issue":"8","key":"53281_CR8","doi-asserted-by":"publisher","first-page":"1939","DOI":"10.1097\/CORR.0000000000001295","volume":"478","author":"J Wilkerson","year":"2020","unstructured":"Wilkerson, J. & Fernando, N. D. Classifications in Brief: The Dorr Classification of Femoral Bone. Clin. Orthop. Relat. Res. 478 (8), 1939\u20131944. https:\/\/doi.org\/10.1097\/CORR.0000000000001295 (2020).","journal-title":"Clin. Orthop. Relat. Res."},{"key":"53281_CR9","doi-asserted-by":"publisher","first-page":"12","DOI":"10.5005\/jp-journals-10017-1063","volume":"6","author":"JM Jennings","year":"2016","unstructured":"Jennings, J. M. et al. Independent analysis of the dorr classification of proximal femoral morphology: a reliability study. Duke Orthop. J. 6, 12\u201316 (2016). https:\/\/doi.org\/10.5005\/jp-journals-10017-1063","journal-title":"Duke Orthop. J."},{"key":"53281_CR10","doi-asserted-by":"publisher","first-page":"e64801","DOI":"10.5812\/soj.64801.","volume":"5","author":"FN Mazhar","year":"2018","unstructured":"Mazhar, F. N., Jafari, D., Nojoomi, M., Mirzaei, A. & Tayebi, H. Inter and intra-observer reliability of Dorr classification in proximal femur morphology. Shafa Ortho J. 5, e64801 (2018). https:\/\/doi.org\/10.5812\/soj.64801.","journal-title":"Shafa Ortho J."},{"issue":"1","key":"53281_CR11","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1016\/j.otsr.2018.11.008","volume":"105","author":"R Nakaya","year":"2019","unstructured":"Nakaya, R., Takao, M., Hamada, H., Sakai, T. & Sugano, N. Reproducibility of the Dorr classification and its quantitative indices on plain radiographs. Orthop. Traumatol. Surg. Res. 105 (1), 17\u201321. https:\/\/doi.org\/10.1016\/j.otsr.2018.11.008 (2019).","journal-title":"Orthop. Traumatol. Surg. Res."},{"issue":"11","key":"53281_CR12","doi-asserted-by":"publisher","first-page":"3204","DOI":"10.1016\/j.arth.2020.05.066","volume":"35","author":"PN Karayiannis","year":"2020","unstructured":"Karayiannis, P. N., Cassidy, R. S., Hill, J. C., Dorr, L. D. & Beverland, D. E. The relationship between canal diameter and the dorr classification. J. Arthroplasty. 35 (11), 3204\u20133207. https:\/\/doi.org\/10.1016\/j.arth.2020.05.066 (2020).","journal-title":"J. Arthroplasty"},{"issue":"12","key":"53281_CR13","doi-asserted-by":"publisher","first-page":"604","DOI":"10.1302\/2046-3758.812.BJR-2019-0337","volume":"8","author":"S Konan","year":"2020","unstructured":"Konan, S., Abdel, M. P. & Haddad, F. S. Cemented versus uncemented hip implant fixation: Should there be age thresholds? Bone Joint Res. 8 (12), 604\u2013607. https:\/\/doi.org\/10.1302\/2046-3758.812.BJR-2019-0337 (2020).","journal-title":"Bone Joint Res."},{"issue":"10","key":"53281_CR14","doi-asserted-by":"publisher","first-page":"1108","DOI":"10.1001\/archinte.164.10.1108","volume":"164","author":"ES Siris","year":"2004","unstructured":"Siris, E. S. et al. Bone Mineral density thresholds for pharmacological intervention to prevent fractures. Arch. Intern. Med. 164 (10), 1108 (2004).\u00a0https:\/\/doi.org\/10.1001\/archinte.164.10.1108","journal-title":"Arch. Intern. Med."},{"issue":"2","key":"53281_CR15","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1016\/S2213-8587(13)70183-9","volume":"2","author":"EM Stein","year":"2014","unstructured":"Stein, E. M. & Silverberg, S. J. Bone loss after bariatric surgery: causes, consequences, and management. Lancet Diabetes Endocrinol. 2 (2), 165\u2013174 (2014).\u00a0https:\/\/doi.org\/10.1016\/S2213-8587(13)70183-9","journal-title":"Lancet Diabetes Endocrinol."},{"issue":"1","key":"53281_CR16","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1109\/TMI.2016.2593346","volume":"36","author":"L Humbert","year":"2017","unstructured":"Humbert, L. et al. 3D-DXA: Assessing the Femoral Shape, the Trabecular Macrostructure and the Cortex in 3D from DXA images. IEEE Trans. Med. Imaging. 36 (1), 27\u201339 (2017).\u00a0https:\/\/doi.org\/10.1109\/TMI.2016.2593346","journal-title":"IEEE Trans. Med. Imaging"},{"issue":"4","key":"53281_CR17","doi-asserted-by":"publisher","first-page":"550","DOI":"10.1016\/j.jocd.2017.05.002","volume":"21","author":"J Clotet","year":"2018","unstructured":"Clotet, J., Martelli, Y., Di Gregorio, S., del R\u00edo Barquero, L. M. & Humbert, L. structural parameters of the proximal femur by 3-dimensional dual-energy x-ray absorptiometry software: comparison with quantitative computed tomography. J. Clin. Densitom. 21 (4), 550\u2013562 (2018).\u00a0https:\/\/doi.org\/10.1016\/j.jocd.2017.05.002","journal-title":"J. Clin. Densitom"},{"key":"53281_CR18","doi-asserted-by":"publisher","first-page":"116005","DOI":"10.1016\/j.bone.2021.116005","volume":"150","author":"L Ma\u00efmoun","year":"2021","unstructured":"Ma\u00efmoun, L. et al. Modification of bone mineral density, bone geometry and volumetric BMD in young women with obesity. Bone 150, 116005 (2021).\u00a0https:\/\/doi.org\/10.1016\/j.bone.2021.116005","journal-title":"Bone"},{"issue":"8","key":"53281_CR19","doi-asserted-by":"publisher","first-page":"1119","DOI":"10.1007\/s00198-007-0348-6","volume":"18","author":"AP Sah","year":"2007","unstructured":"Sah, A. P., Thornhill, T. S., LeBoff, M. S. & Glowacki, J. Correlation of plain radiographic indices of the hip with quantitative bone mineral density. Osteoporos. Int. 18 (8), 1119\u20131126. https:\/\/doi.org\/10.1007\/s00198-007-0348-6 (2007).","journal-title":"Osteoporos. Int."},{"issue":"1","key":"53281_CR20","doi-asserted-by":"publisher","first-page":"9","DOI":"10.3390\/osteology5010009","volume":"5","author":"K Oe","year":"2025","unstructured":"Oe, K. et al. Association Between Bone Mineral Density Around the Stem, Morphology of the Proximal Femur, and Effects of Osteoporosis Treatment in Patients with Femoral Neck Fracture. Osteology 5 (1), 9. https:\/\/doi.org\/10.3390\/osteology5010009 (2025).","journal-title":"Osteology"},{"issue":"2","key":"53281_CR21","doi-asserted-by":"publisher","first-page":"149","DOI":"10.4055\/cios.2018.10.2.149","volume":"10","author":"BN Nguyen","year":"2018","unstructured":"Nguyen, B. N., Hoshino, H., Togawa, D. & Matsuyama, Y. Cortical Thickness Index of the Proximal Femur: A Radiographic Parameter for Preliminary Assessment of Bone Mineral Density and Osteoporosis Status. Clin. Orthop. Surg. 10 (2), 149\u2013156. https:\/\/doi.org\/10.4055\/cios.2018.10.2.149 (2018).","journal-title":"Clin. Orthop. Surg."},{"key":"53281_CR22","doi-asserted-by":"publisher","first-page":"871","DOI":"10.1007\/s00198-021-06231-8","volume":"33","author":"Y Liu","year":"2022","unstructured":"Liu, Y. et al. Radiographic indexes in AP hip radiographs prior to total hip arthroplasty reveal candidates with low BMD. Osteoporos. Int. 33, 871\u2013879. https:\/\/doi.org\/10.1007\/s00198-021-06231-8 (2022).","journal-title":"Osteoporos. Int."},{"issue":"1","key":"53281_CR23","doi-asserted-by":"publisher","first-page":"19886","DOI":"10.1038\/s41598-023-47247-w","volume":"13","author":"S Rohe","year":"2023","unstructured":"Rohe, S. et al. Plain radiographic indices are reliable indicators for quantitative bone mineral density before THA. Sci. Rep. 13 (1), 19886. https:\/\/doi.org\/10.1038\/s41598-023-47247-w (2023).","journal-title":"Sci. Rep."},{"issue":"3","key":"53281_CR24","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1093\/ptj\/85.3.257","volume":"85","author":"J Sim","year":"2005","unstructured":"Sim, J. & Wright, C. C. The kappa statistic in reliability studies: use, interpretation, and sample size requirements. Phys. Ther. 85 (3), 257\u2013268. https:\/\/doi.org\/10.1093\/ptj\/85.3.257 (2005).","journal-title":"Phys. Ther."},{"issue":"1","key":"53281_CR25","doi-asserted-by":"publisher","first-page":"159","DOI":"10.2307\/2529310","volume":"33","author":"JR Landis","year":"1977","unstructured":"Landis, J. R. & Koch, G. G. The measurement of observer agreement for categorical data. Biometrics 33 (1), 159\u2013174. https:\/\/doi.org\/10.2307\/2529310 (1977).","journal-title":"Biometrics"},{"issue":"7","key":"53281_CR26","doi-asserted-by":"publisher","first-page":"e0219854","DOI":"10.1371\/journal.pone.0219854","volume":"14","author":"D Liljequist","year":"2019","unstructured":"Liljequist, D., Elfving, B. & Roaldsen, K. S. Intraclass correlation \u2013 A discussion and demonstration of basic features. PLoS One. 14 (7), e0219854. https:\/\/doi.org\/10.1371\/journal.pone.0219854 (2019).","journal-title":"PLoS One"},{"issue":"2","key":"53281_CR27","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1016\/j.jcm.2016.02.012","volume":"15","author":"TK Koo","year":"2016","unstructured":"Koo, T. K. & Li, M. Y. A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J. Chiropr. Med. 15 (2), 155\u2013163. https:\/\/doi.org\/10.1016\/j.jcm.2016.02.012 (2016).","journal-title":"J. Chiropr. Med."},{"key":"53281_CR28","unstructured":"Portney, L. G. & Watkins, M. P. Foundations of clinical research: applications to practice (Prentice Hall, 2000)."},{"key":"53281_CR29","doi-asserted-by":"publisher","unstructured":"Giavarina, D. Understanding Bland Altman analysis. Biochem Med (Zagreb). Jun 5. (2015). https:\/\/doi.org\/10.11613\/BM.2015.015","DOI":"10.11613\/BM.2015.015"},{"issue":"7","key":"53281_CR30","doi-asserted-by":"publisher","first-page":"1348","DOI":"10.1016\/j.arth.2022.03.062","volume":"37","author":"IE Kacmaz","year":"2022","unstructured":"Kacmaz, I. E. et al. Comparison of the reliability of three scoring systems used to decide whether to apply cement in hip arthroplasty among fracture patients and the effect of surgical experience. J. Arthroplasty. 37 (7), 1348\u20131353. https:\/\/doi.org\/10.1016\/j.arth.2022.03.062 (2022).","journal-title":"J. Arthroplasty"},{"issue":"2","key":"53281_CR31","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1016\/j.arth.2023.08.037","volume":"39","author":"J Faundez","year":"2024","unstructured":"Faundez, J. et al. Radiographic Assessment of Bone Quality Using 4 Radiographic Indexes: Canal Diaphysis Ratio Is Superior. J. Arthroplasty. 39 (2), 427\u2013432. https:\/\/doi.org\/10.1016\/j.arth.2023.08.037 (2024).","journal-title":"J. Arthroplasty"},{"issue":"6","key":"53281_CR32","doi-asserted-by":"publisher","first-page":"e62428","DOI":"10.7759\/cureus.62428","volume":"16","author":"RW Lutz Jr","year":"2024","unstructured":"Lutz, R. W. Jr et al. Medial calcar density measured via opportunistic computed tomography is well represented by the Dorr C classification. Cureus 16 (6), e62428. https:\/\/doi.org\/10.7759\/cureus.62428 (2024).","journal-title":"Cureus"},{"issue":"4","key":"53281_CR33","doi-asserted-by":"publisher","first-page":"981","DOI":"10.3390\/jcm13040981","volume":"13","author":"F Guyan","year":"2024","unstructured":"Guyan, F., Gianduzzo, E., Waltensp\u00fcl, M., Dietrich, M. & Kabelitz, M. Cortical thickness index and canal calcar ratio: a comparison of proximal femoral fractures and non-fractured femora in octogenarians to centenarians. J. Clin. Med. 13 (4), 981. https:\/\/doi.org\/10.3390\/jcm13040981 (2024).","journal-title":"J. Clin. Med."},{"issue":"2","key":"53281_CR34","doi-asserted-by":"publisher","first-page":"214","DOI":"10.1016\/j.jocd.2018.05.001","volume":"22","author":"L Humbert","year":"2019","unstructured":"Humbert, L. et al. Del R\u00edo Barquero LM. 3D analysis of cortical and trabecular bone from hip DXA: precision and trend assessment interval in postmenopausal women. J. Clin. Densitom. 22 (2), 214\u2013218. https:\/\/doi.org\/10.1016\/j.jocd.2018.05.001 (2019).","journal-title":"J. Clin. Densitom"},{"issue":"1","key":"53281_CR35","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1109\/TMI.2016.2593346","volume":"36","author":"L Humbert","year":"2017","unstructured":"Humbert, L. et al. 3D-DXA: assessing the femoral shape, the trabecular macrostructure and the cortex in 3D from DXA images. IEEE Trans. Med. Imaging. 36 (1), 27\u201339. https:\/\/doi.org\/10.1109\/TMI.2016.2593346 (2017).","journal-title":"IEEE Trans. Med. Imaging"},{"key":"53281_CR36","doi-asserted-by":"publisher","first-page":"1111020","DOI":"10.3389\/fbioe.2023.1111020","volume":"11","author":"A Dudle","year":"2023","unstructured":"Dudle, A. et al. 2D-3D reconstruction of the proximal femur from DXA scans: evaluation of the 3D-Shaper software. Front. Bioeng. Biotechnol. 11, 1111020. https:\/\/doi.org\/10.3389\/fbioe.2023.1111020 (2023).","journal-title":"Front. Bioeng. Biotechnol."},{"issue":"9","key":"53281_CR37","doi-asserted-by":"publisher","first-page":"ziaf075","DOI":"10.1093\/jbmrpl\/ziaf075","volume":"9","author":"T Whitmarsh","year":"2025","unstructured":"Whitmarsh, T. Critical evaluation of 3D-DXA and 3D-Shaper: methodological limitations and their implications. JBMR Plus. 9 (9), ziaf075. https:\/\/doi.org\/10.1093\/jbmrpl\/ziaf075 (2025).","journal-title":"JBMR Plus"},{"issue":"5","key":"53281_CR38","doi-asserted-by":"publisher","first-page":"1191","DOI":"10.1016\/j.arth.2023.11.021","volume":"39","author":"SJ Jang","year":"2024","unstructured":"Jang, S. J. et al. Deep-learning automation of preoperative radiographic parameters associated with early periprosthetic femur fracture after total hip arthroplasty. J. Arthroplasty. 39 (5), 1191\u20131198e2. https:\/\/doi.org\/10.1016\/j.arth.2023.11.021 (2024).","journal-title":"J. Arthroplasty"},{"issue":"9","key":"53281_CR39","doi-asserted-by":"publisher","first-page":"2438","DOI":"10.1016\/j.arth.2020.04.033","volume":"35","author":"KC Bigart","year":"2020","unstructured":"Bigart, K. C., Beaulieu-Jones, B. R. & Kamath, A. F. Does femoral morphology predict the risk of periprosthetic fracture after cementless total hip arthroplasty? J. Arthroplasty. 35 (9), 2438\u20132444. https:\/\/doi.org\/10.1016\/j.arth.2020.04.033 (2020).","journal-title":"J. Arthroplasty"},{"issue":"12","key":"53281_CR40","doi-asserted-by":"publisher","first-page":"2381","DOI":"10.1016\/j.arth.2022.06.015","volume":"37","author":"Z Wang","year":"2022","unstructured":"Wang, Z. et al. Fracture risk assessment tool scores and radiographical bone measurements in total hip arthroplasty patients. J. Arthroplasty. 37 (12), 2381\u20132386. https:\/\/doi.org\/10.1016\/j.arth.2022.06.015 (2022).","journal-title":"J. Arthroplasty"},{"issue":"5","key":"53281_CR41","doi-asserted-by":"publisher","first-page":"484","DOI":"10.3390\/bioengineering11050484","volume":"11","author":"RW Liu","year":"2024","unstructured":"Liu, R. W. et al. Application of artificial intelligence methods on osteoporosis classification with radiographs: a systematic review. Bioeng. (Basel). 11 (5), 484. https:\/\/doi.org\/10.3390\/bioengineering11050484 (2024).","journal-title":"Bioeng. (Basel)"},{"key":"53281_CR42","doi-asserted-by":"publisher","first-page":"1417729","DOI":"10.3389\/frai.2024.1417729","volume":"7","author":"JK Mozafari","year":"2024","unstructured":"Mozafari, J. K. et al. The role of artificial intelligence in preoperative planning for total hip arthroplasty: a systematic review. Front. Artif. Intell. 7, 1417729. https:\/\/doi.org\/10.3389\/frai.2024.1417729 (2024).","journal-title":"Front. Artif. Intell."},{"key":"53281_CR43","doi-asserted-by":"publisher","first-page":"2145","DOI":"10.1007\/s00198-024-07244-9","volume":"35","author":"DP Martin","year":"2024","unstructured":"Martin, D. P. et al. Intraoperative physician assessment during total hip arthroplasty correlates with DXA parameters. Osteoporos. Int. 35, 2145\u20132151. https:\/\/doi.org\/10.1007\/s00198-024-07244-9 (2024).","journal-title":"Osteoporos. Int."},{"issue":"12","key":"53281_CR44","doi-asserted-by":"publisher","first-page":"604","DOI":"10.1302\/2046-3758.812.BJR-2019-0337","volume":"8","author":"S Konan","year":"2019","unstructured":"Konan, S., Abdel, M. P. & Haddad, F. S. Cemented versus uncemented hip implant fixation: Should there be age thresholds? Bone Joint Res. 8 (12), 604\u2013607. https:\/\/doi.org\/10.1302\/2046-3758.812.BJR-2019-0337 (2019).","journal-title":"Bone Joint Res."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-53281-1","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-53281-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-53281-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T22:51:57Z","timestamp":1787871117000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-53281-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,22]]},"references-count":44,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["53281"],"URL":"https:\/\/doi.org\/10.1038\/s41598-026-53281-1","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,22]]},"assertion":[{"value":"5 January 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 May 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 May 2026","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","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was approved by the Ethics Committee of Hospital Universitari de Bellvitge (21 November 2019, code: PR217\/19) and conducted in accordance with the Declaration of Helsinki.","order":2,"name":"Ethics","label":"Ethics approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All participants provided written informed consent.","order":3,"name":"Ethics","label":"Consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"26984"}}