{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:37:47Z","timestamp":1792787867148,"version":"4.5.0"},"reference-count":36,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"vor","delay-in-days":59,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"name":"Key Scientific and Technological Projects in Henan Province","award":["LHGJ20240046"],"award-info":[{"award-number":["LHGJ20240046"]}]},{"name":"National Natural Science Foundation of China","award":["82002840"],"award-info":[{"award-number":["82002840"]}],"id":[{"id":"https:\/\/ror.org\/01h0zpd94","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Key Research Projects of Henan Provincial Colleges and Universities","award":["26A320039"],"award-info":[{"award-number":["26A320039"]}]},{"name":"Henan Provincial and Ministry Co-construction Project","award":["SBGJ202102031"],"award-info":[{"award-number":["SBGJ202102031"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Surg"],"DOI":"10.1186\/s12893-026-04060-2","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:34:18Z","timestamp":1785717258000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Tranexamic acid in primary total knee arthroplasty: a systematic review and meta-analysis of blood loss, transfusion, and deep vein thrombosis"],"prefix":"10.1186","volume":"26","author":[{"given":"Jiawei","family":"Feng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuhui","family":"Liang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liyang","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jincheng","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Jin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,3]]},"reference":[{"key":"4060_CR1","unstructured":"Varacallo MA, Luo TD, Mabrouk A, Johanson NA. Total Knee Arthroplasty Techniques. StatPearls. Treasure Island (FL): StatPearls Publishing Copyright \u00a9 2026. StatPearls Publishing LLC; 2026."},{"issue":"6","key":"4060_CR2","doi-asserted-by":"publisher","first-page":"361","DOI":"10.5435\/jaaos-22-06-361","volume":"22","author":"BR Levine","year":"2014","unstructured":"Levine BR, Haughom B, Strong B, Hellman M, Frank RM. Blood management strategies for total knee arthroplasty. J Am Acad Orthop Surg. 2014;22(6):361\u201371. https:\/\/doi.org\/10.5435\/jaaos-22-06-361.","journal-title":"J Am Acad Orthop Surg"},{"issue":"15","key":"4060_CR3","doi-asserted-by":"publisher","first-page":"2503","DOI":"10.2106\/jbjs.I.01518","volume":"92","author":"J Wong","year":"2010","unstructured":"Wong J, Abrishami A, El Beheiry H, Mahomed NN, Roderick Davey J, Gandhi R, et al. Topical application of tranexamic acid reduces postoperative blood loss in total knee arthroplasty: a randomized, controlled trial. J Bone Joint Surg Am. 2010;92(15):2503\u201313. https:\/\/doi.org\/10.2106\/jbjs.I.01518.","journal-title":"J Bone Joint Surg Am"},{"issue":"12","key":"4060_CR4","doi-asserted-by":"publisher","first-page":"1577","DOI":"10.1302\/0301-620x.93b12.26989","volume":"93","author":"S Alshryda","year":"2011","unstructured":"Alshryda S, Sarda P, Sukeik M, Nargol A, Blenkinsopp J, Mason JM. Tranexamic acid in total knee replacement: a systematic review and meta-analysis. J Bone Joint Surg Br. 2011;93(12):1577\u201385. https:\/\/doi.org\/10.1302\/0301-620x.93b12.26989.","journal-title":"J Bone Joint Surg Br"},{"issue":"4","key":"4060_CR5","doi-asserted-by":"publisher","first-page":"202","DOI":"10.11138\/jts\/2016.4.4.202","volume":"4","author":"F Marra","year":"2016","unstructured":"Marra F, Rosso F, Bruzzone M, Bonasia DE, Dettoni F, Rossi R. Use of tranexamic acid in total knee arthroplasty. Joints. 2016;4(4):202\u201313. https:\/\/doi.org\/10.11138\/jts\/2016.4.4.202.","journal-title":"Joints"},{"issue":"1","key":"4060_CR6","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1186\/s12891-018-2181-9","volume":"19","author":"H Xiong","year":"2018","unstructured":"Xiong H, Liu Y, Zeng Y, Wu Y, Shen B. The efficacy and safety of combined administration of intravenous and topical tranexamic acid in primary total knee arthroplasty: a meta-analysis of randomized controlled trials. BMC Musculoskelet Disord. 2018;19(1):321. https:\/\/doi.org\/10.1186\/s12891-018-2181-9.","journal-title":"BMC Musculoskelet Disord"},{"issue":"1","key":"4060_CR7","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1016\/j.knee.2015.09.004","volume":"23","author":"JY Chen","year":"2016","unstructured":"Chen JY, Chin PL, Moo IH, Pang HN, Tay DK, Chia SL, et al. Intravenous versus intra-articular tranexamic acid in total knee arthroplasty: A double-blinded randomised controlled noninferiority trial. Knee. 2016;23(1):152\u20136. https:\/\/doi.org\/10.1016\/j.knee.2015.09.004.","journal-title":"Knee"},{"issue":"11","key":"4060_CR8","doi-asserted-by":"publisher","first-page":"2458","DOI":"10.1016\/j.arth.2016.04.034","volume":"31","author":"J Xie","year":"2016","unstructured":"Xie J, Ma J, Yao H, Yue C, Pei F. Multiple Boluses of Intravenous Tranexamic Acid to Reduce Hidden Blood Loss After Primary Total Knee Arthroplasty Without Tourniquet: A Randomized Clinical Trial. J Arthroplasty. 2016;31(11):2458\u201364. https:\/\/doi.org\/10.1016\/j.arth.2016.04.034.","journal-title":"J Arthroplasty"},{"key":"4060_CR9","doi-asserted-by":"publisher","first-page":"n71","DOI":"10.1136\/bmj.n71","volume":"372","author":"MJ Page","year":"2021","unstructured":"Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. https:\/\/doi.org\/10.1136\/bmj.n71.","journal-title":"BMJ"},{"key":"4060_CR10","doi-asserted-by":"publisher","first-page":"l4898","DOI":"10.1136\/bmj.l4898","volume":"366","author":"JAC Sterne","year":"2019","unstructured":"Sterne JAC, Savovi\u0107 J, Page MJ, Elbers RG, Blencowe NS, Boutron I, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ. 2019;366:l4898. https:\/\/doi.org\/10.1136\/bmj.l4898.","journal-title":"BMJ"},{"issue":"7","key":"4060_CR11","doi-asserted-by":"publisher","first-page":"1936","DOI":"10.1111\/os.70077","volume":"17","author":"N Ramadanov","year":"2025","unstructured":"Ramadanov N, Voss M, Diallo RM, Lettner J, Hakam HT, Prill R, et al. Do Meta-Analyses of Total Hip Arthroplasty Produce Reliable Results? A Systematic Review and Meta-Epidemiological Study of Statistical Methods. Orthop Surg. 2025;17(7):1936\u201355. https:\/\/doi.org\/10.1111\/os.70077.","journal-title":"Orthop Surg"},{"issue":"7414","key":"4060_CR12","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1136\/bmj.327.7414.557","volume":"327","author":"JP Higgins","year":"2003","unstructured":"Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ. 2003;327(7414):557\u201360. https:\/\/doi.org\/10.1136\/bmj.327.7414.557.","journal-title":"BMJ"},{"issue":"7109","key":"4060_CR13","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1136\/bmj.315.7109.629","volume":"315","author":"M Egger","year":"1997","unstructured":"Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315(7109):629\u201334. https:\/\/doi.org\/10.1136\/bmj.315.7109.629.","journal-title":"BMJ"},{"issue":"5","key":"4060_CR14","doi-asserted-by":"publisher","first-page":"590","DOI":"10.4103\/njcp.njcp_57_24","volume":"28","author":"ME Ugbeye","year":"2025","unstructured":"Ugbeye ME, Alatishe KA, Olanrewaju SO, Lawal WO, Akpan IJ, Nwose UC. Intravenous Tranexamic Acid Reduces Blood Loss and Transfusion Requirements in Total Knee Replacement Surgery: A Double-Blind Controlled Study in a Regional Hospital, Southwest, Nigeria. Niger J Clin Pract. 2025;28(5):590\u20134. https:\/\/doi.org\/10.4103\/njcp.njcp_57_24.","journal-title":"Niger J Clin Pract"},{"issue":"3","key":"4060_CR15","doi-asserted-by":"publisher","first-page":"733","DOI":"10.1111\/os.14317","volume":"17","author":"S Ye","year":"2025","unstructured":"Ye S, Luo Y, Li Q, Cai L, Kang P. Efficacy of Different Doses of Intra-Articular Tranexamic Acid for Reducing Blood Loss and Lower Limb Swelling After Total Knee Arthroplasty: A Prospective, Randomized, Controlled Trial. Orthop Surg. 2025;17(3):733\u201343. https:\/\/doi.org\/10.1111\/os.14317.","journal-title":"Orthop Surg"},{"key":"4060_CR16","doi-asserted-by":"publisher","unstructured":"Jovanovic G, Lukic-Sarkanovic M, Lazetic F, Tubic T, Lendak D, Uvelin A. The Effect of Intravenous Tranexamic Acid on Perioperative Blood Loss, Transfusion Requirements, Verticalization, and Ambulation in Total Knee Arthroplasty: A Randomized Double-Blind Study. Med (Kaunas). 2024;60(7). https:\/\/doi.org\/10.3390\/medicina60071183.","DOI":"10.3390\/medicina60071183"},{"issue":"18","key":"4060_CR17","doi-asserted-by":"publisher","first-page":"6127","DOI":"10.26355\/eurrev_201809_15952","volume":"22","author":"A Arslan","year":"2018","unstructured":"Arslan A, G\u00f6rmeli G. Using intra-articular tranexamic acid in total knee replacement surgery with and without bleeding control: a prospective randomized double blind study. Eur Rev Med Pharmacol Sci. 2018;22(18):6127\u201332. https:\/\/doi.org\/10.26355\/eurrev_201809_15952.","journal-title":"Eur Rev Med Pharmacol Sci"},{"issue":"7","key":"4060_CR18","doi-asserted-by":"publisher","first-page":"1181","DOI":"10.1007\/s00590-015-1664-8","volume":"25","author":"G Digas","year":"2015","unstructured":"Digas G, Koutsogiannis I, Meletiadis G, Antonopoulou E, Karamoulas V, Bikos C. Intra-articular injection of tranexamic acid reduce blood loss in cemented total knee arthroplasty. Eur J Orthop Surg Traumatol. 2015;25(7):1181\u20138. https:\/\/doi.org\/10.1007\/s00590-015-1664-8.","journal-title":"Eur J Orthop Surg Traumatol"},{"issue":"4","key":"4060_CR19","first-page":"484","volume":"85","author":"\u0130G \u015eahin","year":"2019","unstructured":"\u015eahin \u0130G, Akalin Y, \u00c7evik N, Otuzbir A, \u00d6zkan Y, \u00d6zt\u00fcrk A. Tranexamic acid in total knee replacement which protocol? which application form? A prospective randomised study. Acta Orthop Belg. 2019;85(4):484\u201393.","journal-title":"Acta Orthop Belg"},{"issue":"3","key":"4060_CR20","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1055\/s-0037-1602248","volume":"31","author":"W Liu","year":"2018","unstructured":"Liu W, Yang C, Huang X, Liu R. Tranexamic Acid Reduces Occult Blood Loss, Blood Transfusion, and Improves Recovery of Knee Function after Total Knee Arthroplasty: A Comparative Study. J Knee Surg. 2018;31(3):239\u201346. https:\/\/doi.org\/10.1055\/s-0037-1602248.","journal-title":"J Knee Surg"},{"key":"4060_CR21","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.ijsu.2015.05.045","volume":"20","author":"CG Wang","year":"2015","unstructured":"Wang CG, Sun ZH, Liu J, Cao JG, Li ZJ. Safety and efficacy of intra-articular tranexamic acid injection without drainage on blood loss in total knee arthroplasty: A randomized clinical trial. Int J Surg. 2015;20:1\u20137. https:\/\/doi.org\/10.1016\/j.ijsu.2015.05.045.","journal-title":"Int J Surg"},{"issue":"1","key":"4060_CR22","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1007\/s00590-014-1461-9","volume":"25","author":"Y Yang","year":"2015","unstructured":"Yang Y, Lv YM, Ding PJ, Li J, Ying-Ze Z. The reduction in blood loss with intra-articular injection of tranexamic acid in unilateral total knee arthroplasty without operative drains: a randomized controlled trial. Eur J Orthop Surg Traumatol. 2015;25(1):135\u20139. https:\/\/doi.org\/10.1007\/s00590-014-1461-9.","journal-title":"Eur J Orthop Surg Traumatol"},{"issue":"7","key":"4060_CR23","doi-asserted-by":"publisher","first-page":"1017","DOI":"10.1007\/s00402-015-2232-8","volume":"135","author":"X Aguilera","year":"2015","unstructured":"Aguilera X, Mart\u00ednez-Zapata MJ, Hinarejos P, Jord\u00e1n M, Leal J, Gonz\u00e1lez JC, et al. Topical and intravenous tranexamic acid reduce blood loss compared to routine hemostasis in total knee arthroplasty: a multicenter, randomized, controlled trial. Arch Orthop Trauma Surg. 2015;135(7):1017\u201325. https:\/\/doi.org\/10.1007\/s00402-015-2232-8.","journal-title":"Arch Orthop Trauma Surg"},{"issue":"3","key":"4060_CR24","doi-asserted-by":"publisher","first-page":"254","DOI":"10.1016\/j.bjane.2014.11.004","volume":"66","author":"D Volquind","year":"2016","unstructured":"Volquind D, Zardo RA, Winkler BC, Londero BB, Zanelatto N, Leichtweis GP. Use of tranexamic acid in primary total knee replacement: effects on perioperative blood loss. Braz J Anesthesiol. 2016;66(3):254\u20138. https:\/\/doi.org\/10.1016\/j.bjane.2014.11.004.","journal-title":"Braz J Anesthesiol"},{"key":"4060_CR25","doi-asserted-by":"publisher","first-page":"576","DOI":"10.12659\/msm.892768","volume":"21","author":"PF Shen","year":"2015","unstructured":"Shen PF, Hou WL, Chen JB, Wang B, Qu YX. Effectiveness and safety of tranexamic acid for total knee arthroplasty: a prospective randomized controlled trial. Med Sci Monit. 2015;21:576\u201381. https:\/\/doi.org\/10.12659\/msm.892768.","journal-title":"Med Sci Monit"},{"issue":"11","key":"4060_CR26","doi-asserted-by":"publisher","first-page":"3379","DOI":"10.1016\/j.arth.2017.05.058","volume":"32","author":"MDJ Stowers","year":"2017","unstructured":"Stowers MDJ, Aoina J, Vane A, Poutawera V, Hill AG, Munro JT. Tranexamic Acid in Knee Surgery Study-A Multicentered, Randomized, Controlled Trial. J Arthroplasty. 2017;32(11):3379\u201384. https:\/\/doi.org\/10.1016\/j.arth.2017.05.058.","journal-title":"J Arthroplasty"},{"issue":"2","key":"4060_CR27","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1055\/s-0036-1583270","volume":"30","author":"M U\u011furlu","year":"2017","unstructured":"U\u011furlu M, Aksekili MA, \u00c7a\u011flar C, Y\u00fcksel K, \u015eahin E, Akyol M. Effect of Topical and Intravenously Applied Tranexamic Acid Compared to Control Group on Bleeding in Primary Unilateral Total Knee Arthroplasty. J Knee Surg. 2017;30(2):152\u20137. https:\/\/doi.org\/10.1055\/s-0036-1583270.","journal-title":"J Knee Surg"},{"issue":"1","key":"4060_CR28","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1007\/s00590-025-04174-y","volume":"35","author":"S Sa\u011flam","year":"2025","unstructured":"Sa\u011flam S, Karaduman ZO, Ar\u0131can M, Y\u00fccel MO, Dalaslan RE, Cangur S, et al. The role of tranexamic acid and cryotherapy on acute postoperative pain and blood loss: a randomized controlled study following total knee arthroplasty. Eur J Orthop Surg Traumatol. 2025;35(1):58. https:\/\/doi.org\/10.1007\/s00590-025-04174-y.","journal-title":"Eur J Orthop Surg Traumatol"},{"issue":"1","key":"4060_CR29","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1016\/j.otsr.2014.10.013","volume":"101","author":"LH Carvalho Jr","year":"2015","unstructured":"Carvalho LH Jr., Frois Temponi E, Machado Soares LF, Gon\u00e7alves MB, Paiva Costa L, Tavares de Souza ML. Bleeding reduction after topical application of tranexamic acid together with Betadine solution in total knee arthroplasty. A randomised controlled study. Orthop Traumatol Surg Res. 2015;101(1):83\u20137. https:\/\/doi.org\/10.1016\/j.otsr.2014.10.013.","journal-title":"Orthop Traumatol Surg Res"},{"key":"4060_CR30","doi-asserted-by":"publisher","first-page":"9105645","DOI":"10.1155\/2017\/9105645","volume":"2017","author":"SH Yen","year":"2017","unstructured":"Yen SH, Lin PC, Chen B, Huang CC, Wang JW. Topical Tranexamic Acid Reduces Blood Loss in Minimally Invasive Total Knee Arthroplasty Receiving Rivaroxaban. Biomed Res Int. 2017;2017:9105645. https:\/\/doi.org\/10.1155\/2017\/9105645.","journal-title":"Biomed Res Int"},{"issue":"4","key":"4060_CR31","doi-asserted-by":"publisher","first-page":"839","DOI":"10.1097\/00000539-199704000-00026","volume":"84","author":"ST Hiippala","year":"1997","unstructured":"Hiippala ST, Strid LJ, Wennerstrand MI, Arvela JV, Niemel\u00e4 HM, M\u00e4ntyl\u00e4 SK, et al. Tranexamic acid radically decreases blood loss and transfusions associated with total knee arthroplasty. Anesth Analg. 1997;84(4):839\u201344. https:\/\/doi.org\/10.1097\/00000539-199704000-00026.","journal-title":"Anesth Analg"},{"issue":"3","key":"4060_CR32","first-page":"83","volume":"8","author":"LT Goodnough","year":"1995","unstructured":"Goodnough LT, Verbrugge D, Marcus RE. The relationship between hematocrit, blood lost, and blood transfused in total knee replacement. Implications for postoperative blood salvage and reinfusion. Am J Knee Surg. 1995;8(3):83\u20137.","journal-title":"Am J Knee Surg"},{"issue":"3","key":"4060_CR33","doi-asserted-by":"publisher","first-page":"576","DOI":"10.1111\/os.70270","volume":"18","author":"N Ramadanov","year":"2026","unstructured":"Ramadanov N, Fuchs D, Heinz M, Prill R, Becker R. Perioperative Factors Associated With Allogeneic Blood Transfusion in Elective THA. Orthop Surg. 2026;18(3):576\u201386. https:\/\/doi.org\/10.1111\/os.70270.","journal-title":"Orthop Surg"},{"key":"4060_CR34","doi-asserted-by":"publisher","unstructured":"Ramadanov N, Voss M, Heinz M, Fuchs D, Prill R, Becker R. A multivariable model for perioperative transfusion risk in elective primary THA. BMC Musculoskelet Disord. 2026;27(1). https:\/\/doi.org\/10.1186\/s12891-026-09979-4.","DOI":"10.1186\/s12891-026-09979-4"},{"issue":"13","key":"4060_CR35","doi-asserted-by":"publisher","first-page":"1153","DOI":"10.2106\/jbjs.K.00873","volume":"94","author":"ZG Yang","year":"2012","unstructured":"Yang ZG, Chen WP, Wu LD. Effectiveness and safety of tranexamic acid in reducing blood loss in total knee arthroplasty: a meta-analysis. J Bone Joint Surg Am. 2012;94(13):1153\u20139. https:\/\/doi.org\/10.2106\/jbjs.K.00873.","journal-title":"J Bone Joint Surg Am"},{"issue":"4","key":"4060_CR36","doi-asserted-by":"publisher","first-page":"e70568","DOI":"10.1002\/jeo2.70568","volume":"12","author":"N Ramadanov","year":"2025","unstructured":"Ramadanov N. MCID normalization: A methodological framework for harmonizing heterogeneous PROMs in hip arthroscopy research. J Exp Orthop. 2025;12(4):e70568. https:\/\/doi.org\/10.1002\/jeo2.70568.","journal-title":"J Exp Orthop"}],"container-title":["BMC Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12893-026-04060-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12893-026-04060-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12893-026-04060-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T03:20:55Z","timestamp":1790824855000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12893-026-04060-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,3]]},"references-count":36,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["4060"],"URL":"https:\/\/doi.org\/10.1186\/s12893-026-04060-2","relation":{},"ISSN":["1471-2482"],"issn-type":[{"value":"1471-2482","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,3]]},"assertion":[{"value":"31 May 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 July 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 August 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Not applicable.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"660"}}