{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T06:49:08Z","timestamp":1787986148712,"version":"build-2784847793"},"reference-count":44,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Matrouh University"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Vitamin D is essential for calcium absorption, bone mineralization, and immunological function; nonetheless, vitamin D deficiency (VDD) continues to be a significant health issue in children under five years. In Egypt, VDD is highly prevalent among preschool children, with maternal awareness and nursing practices playing significant roles in its occurrence. This study aimed to identify the relationship between maternal awareness and practices regarding vitamin D and their impact on health outcomes in children under five years. A cross-sectional, correlational, descriptive, and quantitative study was employed. Data collection occurred over eight months throughout three governorates in Egypt, involving 300 mothers and their children under five years of age. Children\u2019s health status outcomes were assessed and linked with their mothers\u2019 awareness and practice scores regarding vitamin D supplementation. It was found that two-thirds of mothers had satisfactory knowledge about vitamin D deficiency, but more than half showed unsatisfactory practice scores. A moderate positive correlation was found between maternal practices and children\u2019s health outcomes as height (r\u2009=\u20090.301,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001), and weight (0.242,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001), as well as between mothers\u2019 practices and knowledge scores (\n                    <jats:italic>r<\/jats:italic>\n                    \u2009=\u20090.323,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). Additionally, maternal practices were significantly influenced by both age and educational level. Maternal practices emerged as a more convincing and coherent associated with child health outcomes than awareness alone. The findings underscore revealed that although over two-thirds of mothers had satisfactory knowledge about VDD, more than half showed unsatisfactory practices. Mothers of children without VDD, and those whose primary teeth erupted before one year demonstrated significantly higher practice scores. A moderate positive correlation was found between maternal practices and children\u2019s health outcomes (weight, and height), as well as between mothers\u2019 practices and awareness scores. Additionally, maternal practices were significantly influenced by both age and educational level.\n                  <\/jats:p>","DOI":"10.1038\/s41598-026-54282-w","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T14:44:27Z","timestamp":1781707467000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Maternal awareness and practices regarding vitamin D and their impact on health outcomes in children under five years in Egypt"],"prefix":"10.1038","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2098-4660","authenticated-orcid":false,"given":"Seham El-Sayed","family":"Saleh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdelaziz","family":"Hendy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rasha Kadri","family":"Ibrahim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2952-0301","authenticated-orcid":false,"given":"Eman Arafa","family":"Badr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,17]]},"reference":[{"issue":"1","key":"54282_CR1","doi-asserted-by":"publisher","first-page":"429","DOI":"10.1186\/s12889-020-08557-0","volume":"20","author":"H Zhang","year":"2020","unstructured":"Zhang, H. et al. Status and influential factors of vitamin D among children aged 0 to 6 years in a Chinese population. BMC Public Health 20(1), 429 (2020).","journal-title":"BMC Public Health"},{"issue":"2","key":"54282_CR2","doi-asserted-by":"publisher","first-page":"946","DOI":"10.4103\/1110-2098.352452","volume":"35","author":"M Al-Mendalawi","year":"2022","unstructured":"Al-Mendalawi, M. Status of vitamin-D deficiency among preschool children and associated factors in a rural area in Upper Egypt. Menoufia Med. J. 35(2), 946 (2022).","journal-title":"Menoufia Med. J."},{"key":"54282_CR3","doi-asserted-by":"crossref","unstructured":"van Schoor, N., Lips, P. Chapter 59\u2014Worldwide Vitamin D Status. In: Feldman D, editor. Vitamin D (Fourth Edition) 15\u201340 (Academic Press, 2018) [cited 2025 Aug 23]. https:\/\/www.sciencedirect.com\/science\/article\/pii\/B9780128099636000596","DOI":"10.1016\/B978-0-12-809963-6.00059-6"},{"issue":"13","key":"54282_CR4","doi-asserted-by":"publisher","first-page":"1727","DOI":"10.1080\/14767058.2017.1326897","volume":"31","author":"A\u00d6 K\u0131l\u0131caslan","year":"2018","unstructured":"K\u0131l\u0131caslan, A. \u00d6., Kutlu, R., Kilinc, I. & Ozberk, D. I. The effects of vitamin D supplementation during pregnancy and maternal vitamin D levels on neonatal vitamin D levels and birth parameters. J. Matern-Fetal Neonatal Med. 31(13), 1727\u20131734 (2018).","journal-title":"J. Matern-Fetal Neonatal Med."},{"issue":"1","key":"54282_CR5","doi-asserted-by":"publisher","first-page":"1162","DOI":"10.1186\/s12889-022-13465-6","volume":"22","author":"N SaeidiFard","year":"2022","unstructured":"SaeidiFard, N. et al. Association of health literacy and nutritional literacy with sun exposure in adults using structural equation modelling. BMC Public Health 22(1), 1162 (2022).","journal-title":"BMC Public Health"},{"key":"54282_CR6","volume":"70","author":"LK Midtb\u00f8","year":"2020","unstructured":"Midtb\u00f8, L. K. et al. Vitamin D status in preschool children and its relations to vitamin D sources and body mass index-fish intervention studies-KIDS (FINS-KIDS). Nutr. Burbank Los Angel Cty Calif. 70, 110595 (2020).","journal-title":"Nutr. Burbank Los Angel Cty Calif."},{"issue":"4","key":"54282_CR7","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1007\/s42000-019-00155-z","volume":"18","author":"D Zisi","year":"2019","unstructured":"Zisi, D., Challa, A. & Makis, A. The association between vitamin D status and infectious diseases of the respiratory system in infancy and childhood. Horm. Athens Greece 18(4), 353\u2013363 (2019).","journal-title":"Horm. Athens Greece"},{"issue":"9","key":"54282_CR8","doi-asserted-by":"publisher","first-page":"911","DOI":"10.2174\/0929867323666161202153028","volume":"24","author":"Z Luan","year":"2017","unstructured":"Luan, Z., Ma, Y., Xin, Y., Qian, J. & Wang, H. Possible molecular mechanisms by which vitamin D prevents inflammatory bowel disease and colitis-associated colorectal cancer. Curr. Med. Chem. 24(9), 911\u2013917 (2017).","journal-title":"Curr. Med. Chem."},{"issue":"12","key":"54282_CR9","first-page":"8208","volume":"12","author":"E Dogan","year":"2020","unstructured":"Dogan, E. & Sevinc, E. The vitamin D status and serum eosinophilic cationic protein levels in infants with cow\u2019s milk protein allergy. Am. J. Transl. Res. 12(12), 8208\u20138215 (2020).","journal-title":"Am. J. Transl. Res."},{"issue":"6","key":"54282_CR10","doi-asserted-by":"publisher","first-page":"928","DOI":"10.3109\/14767058.2015.1023710","volume":"29","author":"N Dinlen","year":"2016","unstructured":"Dinlen, N. et al. Association of vitamin D deficiency with acute lower respiratory tract infections in newborns. J. Matern-Fetal. Neonatal. Med. 29(6), 928\u2013932 (2016).","journal-title":"J. Matern-Fetal. Neonatal. Med."},{"issue":"6","key":"54282_CR11","doi-asserted-by":"publisher","first-page":"553","DOI":"10.4162\/nrp.2020.14.6.553","volume":"14","author":"H Nimitphong","year":"2020","unstructured":"Nimitphong, H., Park, E. & Lee, M. J. Vitamin D regulation of adipogenesis and adipose tissue functions. Nutr. Res. Pract. 14(6), 553\u2013567 (2020).","journal-title":"Nutr. Res. Pract."},{"issue":"5","key":"54282_CR12","doi-asserted-by":"publisher","first-page":"1142","DOI":"10.1542\/peds.2008-1862","volume":"122","author":"CL Wagner","year":"2008","unstructured":"Wagner, C. L. & Greer, F. R. The section on breastfeeding and committee on nutrition. Prevention of rickets and vitamin D deficiency in infants, children, and adolescents. Pediatrics 122(5), 1142\u20131152 (2008).","journal-title":"Pediatrics"},{"key":"54282_CR13","unstructured":"Vitamin D Deficiency in Children and Its Management: Review of Current Knowledge and Recommendations\u2014Pediatric Endocrine Society [Internet]. 2020 [cited 2025 Aug 23]. https:\/\/pedsendo.org\/clinical-resource\/vitamin-d-deficiency-in-children-and-its-management-review-of-current-knowledge-and-recommendations\/, https:\/\/pedsendo.org\/clinical-resource\/vitamin-d-deficiency-in-children-and-its-management-review-of-current-knowledge-and-recommendations\/"},{"issue":"3","key":"54282_CR14","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1016\/j.pedneo.2019.04.007","volume":"60","author":"SW Chang","year":"2019","unstructured":"Chang, S. W. & Lee, H. C. Vitamin D and health\u2014The missing vitamin in humans. Pediatr. Neonatol. 60(3), 237\u2013244 (2019).","journal-title":"Pediatr. Neonatol."},{"issue":"6","key":"54282_CR15","first-page":"1938","volume":"13","author":"V Crincoli","year":"2021","unstructured":"Crincoli, V. et al. Evaluation of vitamin D (25OHD), bone alkaline phosphatase (BALP), serum calcium, serum phosphorus, ionized calcium in patients with mandibular third molar impaction. An. Observ. Study. Nutr. 13(6), 1938 (2021).","journal-title":"An. Observ. Study. Nutr."},{"issue":"1","key":"54282_CR16","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1016\/j.cnur.2020.10.004","volume":"56","author":"DL Ellison","year":"2021","unstructured":"Ellison, D. L. & Moran, H. R. Vitamin D: Vitamin or hormone?. Nurs. Clin. N. Am. 56(1), 47\u201357 (2021).","journal-title":"Nurs. Clin. N. Am."},{"issue":"12","key":"54282_CR17","doi-asserted-by":"publisher","first-page":"1584","DOI":"10.1530\/EC-21-0341","volume":"10","author":"M Amaya-Montoya","year":"2021","unstructured":"Amaya-Montoya, M. et al. 100 YEARS OF VITAMIN D: Dietary intake and main food sources of vitamin D and calcium in Colombian urban adults. Endocr. Connect. 10(12), 1584\u20131593 (2021).","journal-title":"Endocr. Connect."},{"issue":"4","key":"54282_CR18","doi-asserted-by":"publisher","first-page":"1842","DOI":"10.21608\/ejhc.2021.279303","volume":"12","author":"H K. Ghazy","year":"2021","unstructured":"K. Ghazy, H., Reafaat Abdelkader Atia, R., Abdelhamid Deyab, B. & M. Fathy, D. Effect of webinar teaching program on mothers\u2019 knowledge and practices regarding vitamin D deficiency among their children. Egypt J. Health Care 12(4), 1842\u20131858 (2021).","journal-title":"Egypt J. Health Care"},{"key":"54282_CR19","doi-asserted-by":"crossref","unstructured":"Botros, R., Al, S. H., Mansour, H. & Guirgis, M. High prevalence of severe vitamin D deficiency in Egyptian females. In Endocrine Abstracts. Bioscientifica; 2019 [cited 2025 Aug 23]. Available from: https:\/\/www.endocrine-abstracts.org\/ea\/0063\/ea0063p473","DOI":"10.1530\/endoabs.63.P473"},{"key":"54282_CR20","doi-asserted-by":"crossref","unstructured":"Ahmed, S. Effect of Educational program on women knowledge regarding vitamin D deficiency at Assiut City. Assiut Sci. Nurs. J. 2022.","DOI":"10.21608\/asnj.2022.135812.1373"},{"issue":"149","key":"54282_CR21","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268821001825","volume":"10","author":"A Alpcan","year":"2021","unstructured":"Alpcan, A., Tursun, S. & Kandur, Y. Vitamin D levels in children with COVID-19: A report from Turkey. Epidemiol. Infect. 10(149), e180 (2021).","journal-title":"Epidemiol. Infect."},{"issue":"9","key":"54282_CR22","doi-asserted-by":"publisher","first-page":"1100","DOI":"10.25122\/jml-2021-0384","volume":"15","author":"SEA Bassam","year":"2022","unstructured":"Bassam, S. E. A. & Abd-Elmageed, F. N. M. Mothers\u2019 knowledge, practice, and attitudes toward Vitamin D deficiency among children in the Qassim region, Kingdom of Saudi Arabia. J. Med. Life. 15(9), 1100\u20131104. https:\/\/doi.org\/10.25122\/jml-2021-0384 (2022).","journal-title":"J. Med. Life."},{"issue":"4","key":"54282_CR23","doi-asserted-by":"publisher","first-page":"378","DOI":"10.1177\/1010539518768034","volume":"30","author":"Y Liang","year":"2018","unstructured":"Liang, Y., Ren, H. Y. & Zuo, P. X. Associations between maternal nutrition knowledge, attitude, and practice and 25-Hydroxyvitamin D levels and rickets in children in Xinjiang Province, People\u2019s Republic of China. Asia Pac. J. Public Health. 30(4), 378\u2013386 (2018).","journal-title":"Asia Pac. J. Public Health."},{"key":"54282_CR24","doi-asserted-by":"publisher","DOI":"10.4103\/2277-9531.131915","volume":"3","author":"OM Rezaei","year":"2014","unstructured":"Rezaei, O. M., Moodi, M. & Moazam, N. Analyzing the level of knowledge and attitude of the mothers referring the urban health centers of Birjand about nutritional behaviors. J. Educ. Health Promot. 3, 37 (2014).","journal-title":"J. Educ. Health Promot."},{"issue":"2","key":"54282_CR25","doi-asserted-by":"publisher","first-page":"398","DOI":"10.1542\/peds.2007-1894","volume":"122","author":"M Misra","year":"2008","unstructured":"Misra, M., Pacaud, D., Petryk, A., Collett-Solberg, P. F. & Kappy, M. Drug and therapeutics committee of the Lawson Wilkins pediatric endocrine society vitamin D deficiency in children and its management: Review of current knowledge and recommendations. Pediatrics 122(2), 398\u2013417 (2008).","journal-title":"Pediatrics"},{"issue":"2","key":"54282_CR26","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3310\/hta23020","volume":"23","author":"AR Martineau","year":"2019","unstructured":"Martineau, A. R. et al. Vitamin D supplementation to prevent acute respiratory infections: Individual participant data meta-analysis. Health Technol. Assess. 23(2), 1\u201344 (2019).","journal-title":"Health Technol. Assess."},{"issue":"3","key":"54282_CR27","first-page":"916","volume":"11","author":"AS Hussein","year":"2018","unstructured":"Hussein, A. S. et al. Parental awareness and knowledge of vitamin D and its health benefits for children. J. Int. Dental Med. Res. 11(3), 916\u2013924 (2018).","journal-title":"J. Int. Dental Med. Res."},{"issue":"4","key":"54282_CR28","doi-asserted-by":"publisher","first-page":"62","DOI":"10.21608\/ejcm.2020.119419","volume":"38","author":"NS Soliman","year":"2020","unstructured":"Soliman, N. S., Wahdan, M. M., Abouelezz, N. F. & Sabbour, S. M. Knowledge, attitude and practice towards Vitamin D importance and supplementation among mothers of under five children in a primary health care center in Cairo. Egypt. J. Community Med. 38(4), 62\u201375 (2020).","journal-title":"Egypt. J. Community Med."},{"key":"54282_CR29","doi-asserted-by":"publisher","DOI":"10.1155\/2019\/4138187","volume":"2019","author":"LH Alamoudi","year":"2019","unstructured":"Alamoudi, L. H. et al. Awareness of vitamin D deficiency among the general population in Jeddah, Saudi Arabia. J. Nutr. Metab. 2019, 4138187 (2019).","journal-title":"J. Nutr. Metab."},{"issue":"1","key":"54282_CR30","first-page":"1","volume":"2","author":"W Kamal","year":"2018","unstructured":"Kamal, W. Mothers\u2019 awareness regarding vitamin D deficiency among their infants in Kalyobia governorate. Menoufia Nurs. J. 2(1), 1\u201320 (2018).","journal-title":"Menoufia Nurs. J."},{"issue":"19","key":"54282_CR31","doi-asserted-by":"publisher","first-page":"12","DOI":"10.25259\/GJMPBU_3_2024","volume":"28","author":"N Fatima","year":"2024","unstructured":"Fatima, N. et al. Maternal nutritional knowledge and nutritional outcome of children: A cross-sectional study from a developing country. Glob. J. Med. Pharmac. Biomed. Update. 28(19), 12 (2024).","journal-title":"Glob. J. Med. Pharmac. Biomed. Update."},{"issue":"12","key":"54282_CR32","doi-asserted-by":"publisher","DOI":"10.1016\/j.heliyon.2022.e12330","volume":"8","author":"G Forh","year":"2022","unstructured":"Forh, G., Apprey, C. & Frimpomaa Agyapong, N. A. Nutritional knowledge and practices of mothers\/caregivers and its impact on the nutritional status of children 6-59 months in Sefwi Wiawso Municipality, Western-North Region, Ghana. Heliyon 8(12), e12330 (2022).","journal-title":"Heliyon"},{"issue":"1","key":"54282_CR33","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1186\/s13690-017-0176-x","volume":"75","author":"KZ Ahsan","year":"2017","unstructured":"Ahsan, K. Z., Arifeen, S. E., Al-Mamun, M. D. A., Khan, S. H. & Chakraborty, N. Effects of individual, household and community characteristics on child nutritional status in the slums of urban Bangladesh. Arch Public Health. 75(1), 9 (2017).","journal-title":"Arch Public Health."},{"key":"54282_CR34","doi-asserted-by":"publisher","DOI":"10.1177\/11795565211041348","volume":"15","author":"AS Bezabih","year":"2021","unstructured":"Bezabih, A. S., Eshetu, D., Yohanis, N. & Hirigo, A. T. Knowledge and practice of infants exposure to sunlight among lactating mothers attending at Yirgalem Hospital, Sidama Regional State. Clin. Med. Insights Pediatr. 15, 11795565211041348 (2021).","journal-title":"Clin. Med. Insights Pediatr."},{"issue":"1","key":"54282_CR35","first-page":"1","volume":"10","author":"AH Alharbi","year":"2022","unstructured":"Alharbi, A. H., Albarakati, A. F. & Alqurashi, J. H. Knowledge, attitude and practice of mothers attending Kudai and Al-Hijrah primary health care center in Makkah towards vitamin D supplementation to their infants 2021. Am. J. Med. Sci. Med. 10(1), 1\u201310 (2022).","journal-title":"Am. J. Med. Sci. Med."},{"issue":"7","key":"54282_CR36","doi-asserted-by":"publisher","first-page":"1911","DOI":"10.1210\/jc.2011-0385","volume":"96","author":"MF Holick","year":"2011","unstructured":"Holick, M. F. et al. Evaluation, treatment, and prevention of vitamin D deficiency: An endocrine society clinical practice guideline. J. Clin. Endocrinol. Metab. 96(7), 1911\u20131930 (2011).","journal-title":"J. Clin. Endocrinol. Metab."},{"issue":"8","key":"54282_CR37","doi-asserted-by":"publisher","first-page":"600","DOI":"10.1080\/00016357.2021.1918762","volume":"79","author":"TA Xavier","year":"2021","unstructured":"Xavier, T. A. et al. Vitamin D deficiency is a risk factor for delayed tooth eruption associated with persistent primary tooth. Acta Odontol. Scand. 79(8), 600\u2013605 (2021).","journal-title":"Acta Odontol. Scand."},{"key":"54282_CR38","unstructured":"Improving nutrition outcomes with better water, sanitation and hygiene [Internet]. [cited 2025 Aug 23]. Available from: https:\/\/www.who.int\/publications\/i\/item\/9789241565103"},{"key":"54282_CR39","unstructured":"Health behavior: Theory, research, and practice, 5th ed. Hoboken, NJ, US: Jossey-Bass\/Wiley; 2015. xxv, 485 p. (Glanz K, Rimer BK, Viswanath K \u201cVish,\u201d editors. Health behavior: Theory, research, and practice, 5th ed)."},{"key":"54282_CR40","unstructured":"Improving Young Children\u2019s Diets During the Complementary Feeding Period\u2014UNICEF Programming Guidance, 2020 | UNICEF [Internet]. [cited 2025 Aug 23]. Available from: https:\/\/www.unicef.org\/documents\/improving-young-childrens-diets-during-complementary-feeding-period-unicef-programming"},{"issue":"Suppl 1","key":"54282_CR41","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1111\/mcn.12283","volume":"12","author":"VM Aguayo","year":"2016","unstructured":"Aguayo, V. M. & Menon, P. Stop stunting: Improving child feeding, women\u2019s nutrition and household sanitation in South Asia. Matern. Child Nutr. 12(Suppl 1), 3\u201311 (2016).","journal-title":"Matern. Child Nutr."},{"issue":"3","key":"54282_CR42","first-page":"16460","volume":"32","author":"HF Abbas","year":"2021","unstructured":"Abbas, H. F., Kassim, N. M., Hameed, I. H. & Danook, A. S. Assessment of knowledge, attitudes, and traditional preventive practices of the mothers toward vitamin (D) deficiency among children in the middle Euphrates pediatric teaching hospitals. Turk. J. Physiother. Rehabil. 32(3), 16460 (2021).","journal-title":"Turk. J. Physiother. Rehabil."},{"issue":"4","key":"54282_CR43","first-page":"43","volume":"5","author":"WH Shakir","year":"2024","unstructured":"Shakir, W. H., Al Abedi, N. F. H., Abdulhussein, T. A. & Al-Hussien, I. Q. K. Evaluation of mothers\u2019 awareness and perceptions about vitamin D deficiency among young children. CAJMNS. 5(4), 43\u201352 (2024).","journal-title":"CAJMNS."},{"key":"54282_CR44","doi-asserted-by":"publisher","first-page":"39","DOI":"10.22159\/ijcpr.2019v11i6.36339","volume":"15","author":"SJ Al-Ghraibawi","year":"2019","unstructured":"Al-Ghraibawi, S. J., Al-Ghabban, S. I. & Al-Zubaidy, R. D. Knowledge and practices regarding vitamin D deficiency among women attending imam Hussein medical city in Karbala 2018. Int. J. Curr. Pharm. Res. 15, 39\u201343 (2019).","journal-title":"Int. J. Curr. Pharm. Res."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-54282-w","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-54282-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-54282-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T15:02:45Z","timestamp":1781708565000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-54282-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,17]]},"references-count":44,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["54282"],"URL":"https:\/\/doi.org\/10.1038\/s41598-026-54282-w","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,17]]},"assertion":[{"value":"10 April 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 May 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 June 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 Faculty of Nursing at Alexandria University gave the study [AU-20-4-182], IRB00013620 (9\/19\/2025] ethical approval. The study followed the rules set out in the Declaration of Helsinki. Everyone who took part was given information about their rights and the rules for protecting their data. The poll does not collect personal information, and all replies will be kept safe for research purposes only. All participants in the study gave their informed consent. All procedures were carried out in accordance with relevant rules and regulations.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval and consent to participate"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"18869"}}