{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T21:45:19Z","timestamp":1790891119389,"version":"4.1.0"},"reference-count":48,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T00:00:00Z","timestamp":1770595200000},"content-version":"vor","delay-in-days":28,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"name":"Anusandhan National Research Foundation, India","award":["ANRF\/PAIR\/2025\/000008\/PAIR"],"award-info":[{"award-number":["ANRF\/PAIR\/2025\/000008\/PAIR"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Endocr Disord"],"DOI":"10.1186\/s12902-026-02166-5","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T06:33:43Z","timestamp":1768199623000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Investigating the impact of phthalate exposure on endocrine function in women with polycystic ovary syndrome"],"prefix":"10.1186","volume":"26","author":[{"given":"Jalpa","family":"Patel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiral","family":"Chaudhary","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonal","family":"Panchal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiransinh","family":"Rajput","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rushikesh","family":"Joshi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,12]]},"reference":[{"key":"2166_CR1","doi-asserted-by":"publisher","unstructured":"Chang WH, Herianto S, Lee CC, Hung H, Chen HL. The effects of phthalate ester exposure on human health: a review. Sci Total Environ [Internet]. 2021;786:147371. Available from: https:\/\/doi.org\/10.1016\/j.scitotenv.2021.147371.","DOI":"10.1016\/j.scitotenv.2021.147371"},{"issue":"11","key":"2166_CR2","doi-asserted-by":"publisher","first-page":"1530","DOI":"10.1289\/ehp.8083","volume":"113","author":"SM Duty","year":"2005","unstructured":"Duty SM, Ackerman RM, Calafat AM, Hauser R. Personal care product use predicts urinary concentrations of some phthalate monoesters. Environ Health Perspect. 2005;113(11):1530\u20135.","journal-title":"Environ Health Perspect"},{"key":"2166_CR3","doi-asserted-by":"publisher","unstructured":"Koniecki D, Wang R, Moody RP, Zhu J. Phthalates in cosmetic and personal care products: concentrations and possible dermal exposure. Environ Res [Internet]. 2011;111(3):329\u201336. Available from: https:\/\/doi.org\/10.1016\/j.envres.2011.01.013.","DOI":"10.1016\/j.envres.2011.01.013"},{"issue":"1","key":"2166_CR4","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1111\/j.1365-2605.2005.00567.x","volume":"29","author":"T Schettler","year":"2006","unstructured":"Schettler T, Skakkeb\u00e6k NE, De Kretser D, Leffers H. Human exposure to phthalates via consumer products. Int J Androl. 2006;29(1):134\u20139.","journal-title":"Int J Androl"},{"issue":"1","key":"2166_CR5","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1289\/ehp.10498","volume":"116","author":"B Kolarik","year":"2008","unstructured":"Kolarik B, Naydenov K, Larsson M, Bornehag CG, Sundell J. The association between phthalates in dust and allergic diseases among Bulgarian children. Environ Health Perspect. 2008;116(1):98\u2013103.","journal-title":"Environ Health Perspect"},{"key":"2166_CR6","doi-asserted-by":"publisher","unstructured":"Xu S, Li C. Phthalates in house and dormitory dust: occurrence, human exposure and risk assessment. Bull Environ Contam Toxicol [Internet]. 2021;106(2):393\u20138. Available from: https:\/\/doi.org\/10.1007\/s00128-020-03058-7.","DOI":"10.1007\/s00128-020-03058-7"},{"issue":"5","key":"2166_CR7","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1210\/er.2015-1018","volume":"36","author":"DA Dumesic","year":"2015","unstructured":"Dumesic DA, Oberfield SE, Stener-Victorin E, Marshall JC, Laven JS, Legro RS. Scientific statement on the diagnostic criteria, epidemiology, pathophysiology, and molecular genetics of polycystic ovary syndrome. Endocr Rev. 2015;36(5):487\u2013525.","journal-title":"Endocr Rev"},{"key":"2166_CR8","doi-asserted-by":"crossref","unstructured":"Papadakis G, Kandaraki EA, Tseniklidi E, Papalou O, Diamanti-Kandarakis E. Polycystic ovary syndrome and NC-CAH: distinct characteristics and common findings: a systematic review. Front Endocrinol (Lausanne). 2019;10.","DOI":"10.3389\/fendo.2019.00388"},{"key":"2166_CR9","doi-asserted-by":"publisher","unstructured":"Chaudhary H, Patel J, Jain NK, Joshi R. The role of polymorphism in various potential genes on polycystic ovary syndrome susceptibility and pathogenesis. J Ovarian Res [Internet]. 2021;14(1):1\u201321. Available from: https:\/\/doi.org\/10.1186\/s13048-021-00879-w.","DOI":"10.1186\/s13048-021-00879-w"},{"key":"2166_CR10","doi-asserted-by":"publisher","unstructured":"Gene H, Chaudhary H, Patel J, Jain NK, Panchal S, Laddha N. Investigating the interplay between AMH gene polymorphism rs10407022 and clinical indicators in polycystic ovary syndrome. Hum Gene [Internet]. 2024;40:201279. Available from: https:\/\/doi.org\/10.1016\/j.humgen.2024.201279.","DOI":"10.1016\/j.humgen.2024.201279"},{"issue":"1","key":"2166_CR11","doi-asserted-by":"publisher","first-page":"278","DOI":"10.1111\/j.1365-2605.2005.00623.x","volume":"29","author":"S Franks","year":"2006","unstructured":"Franks S, McCarthy MI, Hardy K, Skakkeb\u00e6k NE, Aitken RJ, Swan S, et al. Development of polycystic ovary syndrome: involvement of genetic and environmental factors. Int J Androl. 2006;29(1):278\u201385.","journal-title":"Int J Androl"},{"key":"2166_CR12","doi-asserted-by":"publisher","unstructured":"Chaudhary H, Patel J, Jain NK, et al. Impact of CYP19A1 genetic variations on polycystic ovary syndrome: findings from a case-control study. Fertil Steril Sci [Internet]. 2025; Available from: https:\/\/doi.org\/10.1016\/j.xfss.2025.03.005.","DOI":"10.1016\/j.xfss.2025.03.005"},{"issue":"1","key":"2166_CR13","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1002\/j.1839-4655.2008.tb00093.x","volume":"43","author":"E Baker","year":"2008","unstructured":"Baker E, Tually S. Women, health and housing assistance: implications in an emerging era of housing provision. Aust J Soc Issues. 2008;43(1):123\u201338.","journal-title":"Aust J Soc Issues"},{"issue":"6","key":"2166_CR14","doi-asserted-by":"publisher","first-page":"1018","DOI":"10.1095\/biolreprod.107.065649","volume":"78","author":"M Culty","year":"2008","unstructured":"Culty M, Thuillier R, Li W, Wang Y, Martinez-Arguelles DB, Gesteira Benjamin C, et al. In utero exposure to di-(2-ethylhexyl) phthalate exerts both short-term and long-lasting suppressive effects on testosterone production in the rat. Biol Reprod. 2008;78(6):1018\u201328.","journal-title":"Biol Reprod"},{"issue":"1","key":"2166_CR15","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1093\/toxsci\/kfv317","volume":"150","author":"PR Hannon","year":"2016","unstructured":"Hannon PR, Niermann S, Flaws JA. Acute exposure to Di(2-Ethylhexyl) phthalate in adulthood causes adverse reproductive outcomes later in life and accelerates reproductive aging in female mice. Toxicol Sci. 2016;150(1):97\u2013108.","journal-title":"Toxicol Sci"},{"issue":"6","key":"2166_CR16","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1095\/biolreprod.114.119032","volume":"90","author":"PR Hannon","year":"2014","unstructured":"Hannon PR, Peretz J, Flaws JA. Daily exposure to di(2-ethylhexyl) phthalate alters estrous Cyclicity and accelerates primordial follicle recruitment potentially via dysregulation of the phosphatidylinositol 3-kinase signaling pathway in adult mice. Biol Reprod. 2014;90(6):1\u201311.","journal-title":"Biol Reprod"},{"issue":"3","key":"2166_CR17","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1006\/taap.2001.9156","volume":"172","author":"TN Lovekamp","year":"2001","unstructured":"Lovekamp TN, Davis BJ. Mono-(2-ethylhexyl) phthalate suppresses aromatase transcript levels and estradiol production in cultured rat granulosa cells. Toxicol Appl Pharmacol. 2001;172(3):217\u201324.","journal-title":"Toxicol Appl Pharmacol"},{"issue":"4","key":"2166_CR18","first-page":"719","volume":"20","author":"PC Huang","year":"2012","unstructured":"Huang PC, Liou SH, Ho IK, Chiang HC, Huang HI, Wang SL. Phthalates exposure and endocrinal effects: an epidemiological review. J Food Drug Anal. 2012;20(4):719\u201333.","journal-title":"J Food Drug Anal"},{"key":"2166_CR19","doi-asserted-by":"publisher","first-page":"216","DOI":"10.1006\/taap.1994.1200","volume":"128","author":"B Davis","year":"1994","unstructured":"Davis B, Maronpot R, Heindel J. DEHP suppresses estradioland ovuation in cycling rats. Toxicol Appl Pharmcol. 1994;128:216\u201323.","journal-title":"Toxicol Appl Pharmcol"},{"issue":"3","key":"2166_CR20","doi-asserted-by":"publisher","first-page":"958","DOI":"10.1002\/pmic.200401344","volume":"6","author":"N Hirosawa","year":"2006","unstructured":"Hirosawa N, Yano K, Suzuki Y, Sakamoto Y. Endocrine disrupting effect of di-(2-ethylhexyl)phthalate on female rats and proteome analyses of their pituitaries. Proteomics. 2006;6(3):958\u201371.","journal-title":"Proteomics"},{"issue":"4","key":"2166_CR21","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1371\/journal.pone.0010201","volume":"5","author":"O Carnevali","year":"2010","unstructured":"Carnevali O, Tosti L, Speciale C, Peng C, Zhu Y, Maradonna F. DEHP impairs zebrafish reproduction by affecting critical factors in oogenesis. PLoS ONE. 2010;5(4):1\u20137.","journal-title":"PLoS ONE"},{"key":"2166_CR22","doi-asserted-by":"publisher","unstructured":"Park CB, Kim GE, Kim YJ, On J, Park CG, Kwon YS, et al. Reproductive dysfunction linked to alteration of endocrine activities in zebrafish exposed to mono-(2-ethylhexyl) phthalate (MEHP). Environ Pollut [Internet]. 2020;265:114362. Available from: https:\/\/doi.org\/10.1016\/j.envpol.2020.114362.","DOI":"10.1016\/j.envpol.2020.114362"},{"key":"2166_CR23","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1016\/j.reprotox.2014.03.006","volume":"46","author":"T Liu","year":"2014","unstructured":"Liu T, Li N, Zhu J, Yu G, Guo K, Zhou L, et al. Effects of di-(2-ethylhexyl) phthalate on the hypothalamus-pituitary-ovarian axis in adult female rats. Reprod Toxicol. 2014;46:141\u20137.","journal-title":"Reprod Toxicol"},{"issue":"FEB","key":"2166_CR24","first-page":"1","volume":"6","author":"PR Hannon","year":"2015","unstructured":"Hannon PR, Flaws JA. The effects of phthalates on the ovary. Front Endocrinol (Lausanne). 2015;6(FEB):1\u201319.","journal-title":"Front Endocrinol (Lausanne)"},{"issue":"5","key":"2166_CR25","first-page":"1057","volume":"6","author":"C Xu","year":"2011","unstructured":"Xu C, Lin H, Zhao Y, Zhang Y. Determination of serum levels of three phthalate esters in patients with polycystic ovary syndrome. Sci Res Essays. 2011;6(5):1057\u201362.","journal-title":"Sci Res Essays"},{"issue":"4","key":"2166_CR26","doi-asserted-by":"publisher","first-page":"393","DOI":"10.4274\/jcrpe.galenos.2020.2020.0037","volume":"12","author":"L Ak\u0131n","year":"2020","unstructured":"Ak\u0131n L, Kendirci M, Narin F, Kurto\u011flu S, Hatipo\u011flu N, Elmal\u0131 F. Endocrine disruptors and polycystic ovary syndrome: phthalates. JCRPE J Clin Res Pediatr Endocrinol. 2020;12(4):393\u2013400.","journal-title":"JCRPE J Clin Res Pediatr Endocrinol"},{"key":"2166_CR27","doi-asserted-by":"publisher","unstructured":"Akg\u00fcl S, Sur \u00dc, D\u00fcz\u00e7eker Y, Balc\u0131 A, K\u0131z\u0131lkan MP, Kanbur N, et al. Bisphenol A and phthalate levels in adolescents with polycystic ovary syndrome. Gynecol Endocrinol [Internet]. 2019;35(12):1084\u20137. Available from: https:\/\/doi.org\/10.1080\/09513590.2019.1630608.","DOI":"10.1080\/09513590.2019.1630608"},{"issue":"1","key":"2166_CR28","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1093\/humrep\/deh098","volume":"19","author":"BCJM Fauser","year":"2004","unstructured":"Fauser BCJM, Tarlatzis, Fauser C, Aziz L, et al. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Hum Reprod. 2004;19(1):41\u20137.","journal-title":"Hum Reprod"},{"key":"2166_CR29","doi-asserted-by":"publisher","unstructured":"Patel J, Chaudhary H, Panchal S, Joshi T, Joshi R. Endocrine-disrupting chemicals and hormonal profiles in PCOS women: a comparative study between urban and rural environment. Reprod Toxicol [Internet]. 2024;125:108562. Available from: https:\/\/doi.org\/10.1016\/j.reprotox.2024.108562.","DOI":"10.1016\/j.reprotox.2024.108562"},{"issue":"1","key":"2166_CR30","first-page":"68","volume":"29","author":"SI Pak","year":"2012","unstructured":"Pak SI, Oh TH. Sample size calculation in medical research. J Vet Clin. 2012;29(1):68\u201377.","journal-title":"J Vet Clin"},{"issue":"1","key":"2166_CR31","first-page":"1","volume":"18","author":"RJ Green","year":"2015","unstructured":"Green RJ, Samy G, Saleh MM, Salah M. Search Synapse Search. 2015;18(1):1\u201313.","journal-title":"Search Synapse Search"},{"key":"2166_CR32","unstructured":"Vera P, Marie M, Gaviria JA, Miroslav T, Petr H, Esther B, et al. Preprint not peer reviewed. 2020;1\u201324."},{"key":"2166_CR33","doi-asserted-by":"publisher","unstructured":"Patel J, Chaudhary H, Panchal S, Joshi R. Plasticizer exposure and reproductive dysfunction: assessing bisphenol A and phthalate esters impact on ovarian reserve in women with PCOS-associated infertility. Reprod Toxicol [Internet]. 2025;135(February):108949. Available from: https:\/\/doi.org\/10.1016\/j.reprotox.2025.108949.","DOI":"10.1016\/j.reprotox.2025.108949"},{"key":"2166_CR34","doi-asserted-by":"publisher","unstructured":"Patel J, Chaudhary H, Panchal S, Parekh B, Joshi R. Connecting bisphenol A exposure to PCOS: findings from a case-control investigation. Reprod Sci [Internet]. 2024;(0123456789). Available from: https:\/\/doi.org\/10.1007\/s43032-024-01548-1.","DOI":"10.1007\/s43032-024-01548-1"},{"key":"2166_CR35","doi-asserted-by":"publisher","unstructured":"Tabassum F, Jyoti C, Sinha HH, Dhar K, Akhtar MS. Impact of polycystic ovary syndrome on quality of life of women in correlation to age, basal metabolic index, education and marriage. PLoS One [Internet]. 2021;16(3):1\u201313. Available from: https:\/\/doi.org\/10.1371\/journal.pone.0247486.","DOI":"10.1371\/journal.pone.0247486"},{"issue":"6","key":"2166_CR36","doi-asserted-by":"publisher","first-page":"618","DOI":"10.1093\/humupd\/dms030","volume":"18","author":"SS Lim","year":"2012","unstructured":"Lim SS, Davies MJ, Norman RJ, Moran LJ. Overweight, obesity and central obesity in women with polycystic ovary syndrome: A systematic review and meta-analysis. Hum Reprod Update. 2012;18(6):618\u201337.","journal-title":"Hum Reprod Update"},{"key":"2166_CR37","doi-asserted-by":"publisher","unstructured":"Dadachanji R, Patil A, Joshi B, Mukherjee S. Elucidating the impact of obesity on hormonal and metabolic perturbations in polycystic ovary syndrome phenotypes in Indian women. PLoS One [Internet]. 2021;16(2):1\u201319. Available from: https:\/\/doi.org\/10.1371\/journal.pone.0246862.","DOI":"10.1371\/journal.pone.0246862"},{"key":"2166_CR38","doi-asserted-by":"crossref","unstructured":"Joshi R, Patel J, Chaudhary H. Comparing the metabolomic landscape of polycystic ovary syndrome within urban and rural environments [Internet]. 2025. Available from: https:\/\/figshare.com\/articles\/dataset\/_b_Comparing_the_Metabolomic_Landscape_of_Polycystic_Ovary_Syndrome_within_Urban_and_Rural_Environments_b_\/28891628.","DOI":"10.1038\/s43856-025-00985-6"},{"issue":"1","key":"2166_CR39","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12920-023-01654-0","volume":"16","author":"H Chaudhary","year":"2023","unstructured":"Chaudhary H, Patel J, Jain NK, Panchal S, Laddha N, Joshi R. Association of FTO gene variant rs9939609 with polycystic ovary syndrome from Gujarat, India. BMC Med Genomics. 2023;16(1):1\u20139.","journal-title":"BMC Med Genomics"},{"key":"2166_CR40","doi-asserted-by":"publisher","unstructured":"Patel J, Chaudhary H, Rajput K, Parekh B, Joshi R. Assessment of gut microbial \u03b2-glucuronidase and \u03b2-glucosidase activity in women with polycystic ovary syndrome. Sci Rep [Internet]. 2023;13(1):1\u20138. Available from: https:\/\/doi.org\/10.1038\/s41598-023-39168-5.","DOI":"10.1038\/s41598-023-39168-5"},{"key":"2166_CR41","doi-asserted-by":"publisher","unstructured":"Singh S, Kaur M, Kaur R, Beri A, Kaur A. Association analysis of LHCGR variants and polycystic ovary syndrome in Punjab: a case\u2013control approach. BMC Endocr Disord [Internet]. 2022;22(1):1\u20139. Available from: https:\/\/doi.org\/10.1186\/s12902-022-01251-9.","DOI":"10.1186\/s12902-022-01251-9"},{"key":"2166_CR42","doi-asserted-by":"crossref","unstructured":"Vagi SJ, Azziz-Baumgartner E, Sj\u00f6din A, Calafat AM, Dumesic D, Gonzalez L, et al. Exploring the potential association between brominated diphenyl ethers, polychlorinated biphenyls, organochlorine pesticides, perfluorinated compounds, phthalates, and bisphenol A in polycystic ovary syndrome: a case-control study. BMC Endocr Disord. 2014;14(1).","DOI":"10.1186\/1472-6823-14-86"},{"key":"2166_CR43","doi-asserted-by":"crossref","unstructured":"Sehgal M, Rizwan SA, Krishnan A. Disease burden due to biomass cooking-fuel-related household air pollution among women in India. Glob Health Action. 2014;7(1).","DOI":"10.3402\/gha.v7.25326"},{"key":"2166_CR44","doi-asserted-by":"publisher","unstructured":"Parlett LE, Calafat AM, Swan SH. Women\u2019s exposure to phthalates in relation to use of personal care products. J Expo Sci Environ Epidemiol [Internet]. 2013;23(2):197\u2013206. Available from: https:\/\/doi.org\/10.1038\/jes.2012.105.","DOI":"10.1038\/jes.2012.105"},{"key":"2166_CR45","doi-asserted-by":"publisher","unstructured":"Merkin SS, Phy JL, Sites CK, Yang D. Environmental determinants of polycystic ovary syndrome. Fertil Steril [Internet]. 2016;106(1):16\u201324. Available from: https:\/\/doi.org\/10.1016\/j.fertnstert.2016.05.011.","DOI":"10.1016\/j.fertnstert.2016.05.011"},{"issue":"12","key":"2166_CR46","doi-asserted-by":"publisher","first-page":"6278","DOI":"10.1177\/0300060519876467","volume":"47","author":"Y Jin","year":"2019","unstructured":"Jin Y, Zhang Q, Pan JX, Wang FF, Qu F. The effects of di(2-ethylhexyl) phthalate exposure in women with polycystic ovary syndrome undergoing in vitro fertilization. J Int Med Res. 2019;47(12):6278\u201393.","journal-title":"J Int Med Res"},{"key":"2166_CR47","doi-asserted-by":"publisher","unstructured":"Niermann S, Rattan S, Brehm E, Flaws JA. Prenatal exposure to di-(2-ethylhexyl) phthalate (DEHP) affects reproductive outcomes in female mice. Reprod Toxicol [Internet]. 2015;53:23\u201332. Available from: https:\/\/doi.org\/10.1016\/j.reprotox.2015.02.013.","DOI":"10.1016\/j.reprotox.2015.02.013"},{"issue":"1","key":"2166_CR48","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1530\/JOE-14-0111","volume":"223","author":"P Rajesh","year":"2014","unstructured":"Rajesh P, Balasubramanian K. Phthalate exposure in utero causes epigenetic changes and impairs insulin signalling. J Endocrinol. 2014;223(1):47\u201366.","journal-title":"J Endocrinol"}],"container-title":["BMC Endocrine Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12902-026-02166-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12902-026-02166-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12902-026-02166-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T13:26:40Z","timestamp":1770643600000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12902-026-02166-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,12]]},"references-count":48,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["2166"],"URL":"https:\/\/doi.org\/10.1186\/s12902-026-02166-5","relation":{},"ISSN":["1472-6823"],"issn-type":[{"value":"1472-6823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,12]]},"assertion":[{"value":"31 January 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 January 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 January 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 Institutional Ethics Committee (IEC) (GU-IEC(NIV)\/02\/Ph.D.\/007) of the University School of Sciences, Gujarat University, approved this study. All participants gave informed consent. All research work was performed in accordance with relevant guidelines and regulations. These guidelines and considerations align with the ethical approval requirements of the Helsinki Declaration, which emphasizes the protection of human subjects in research.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"42"}}