{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T19:59:35Z","timestamp":1790193575706,"version":"4.1.0"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"vor","delay-in-days":7,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"name":"Shenzhen Basic Research Special Fund Project for Natural Science Research","award":["Grant No. JCYJ20250604143739051"],"award-info":[{"award-number":["Grant No. JCYJ20250604143739051"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Women's Health"],"DOI":"10.1186\/s12905-026-04890-5","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T06:05:16Z","timestamp":1789538716000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Female sexual dysfunction is independently associated with depressive symptom burden in premenopausal pelvic floor clinic patients: a cross-sectional analysis"],"prefix":"10.1186","volume":"26","author":[{"given":"Mengxiong","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Mo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juanhua","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tian","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,16]]},"reference":[{"key":"4890_CR1","doi-asserted-by":"publisher","unstructured":"Geiss IM, Umek WH, Dungl A, Sam C, Riss P, Hanzal E. Prevalence of female sexual dysfunction in gynecologic and urogynecologic patients according to the international consensus classification. Urology. 2003;62(3):514-8. https:\/\/doi.org\/10.1016\/s0090-4295(03)00487-4. PMID: 12946757.","DOI":"10.1016\/s0090-4295(03)00487-4"},{"issue":"2","key":"4890_CR2","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1016\/j.jsxm.2016.11.323","volume":"14","author":"RJ Li-Yun-Fong","year":"2017","unstructured":"Li-Yun-Fong RJ, Larouche M, Hyakutake M, Koenig N, Lovatt C, Geoffrion R, Brotto LA, Lee T, Cundiff GW. Is Pelvic Floor Dysfunction an Independent Threat to Sexual Function? A Cross-Sectional Study in Women With Pelvic Floor Dysfunction. J Sex Med. 2017;14(2):226\u201337. https:\/\/doi.org\/10.1016\/j.jsxm.2016.11.323.\u00a0 Epub 2016 Dec 29. PMID: 28041844.","journal-title":"J Sex Med"},{"issue":"7","key":"4890_CR3","doi-asserted-by":"publisher","first-page":"1816","DOI":"10.1002\/nau.23186","volume":"36","author":"D Vrijens","year":"2017","unstructured":"Vrijens D, Berghmans B, Nieman F, van Os J, van Koeveringe G, Leue C. Prevalence of anxiety and depressive symptoms and their association with pelvic floor dysfunctions-A cross sectional cohort study at a Pelvic Care Centre. Neurourol Urodyn. 2017;36(7):1816\u201323. https:\/\/doi.org\/10.1002\/nau.23186 . Epub 2017 Feb 21. PMID: 28220586.","journal-title":"Neurourol Urodyn"},{"issue":"6","key":"4890_CR4","doi-asserted-by":"publisher","first-page":"1497","DOI":"10.1111\/j.1743-6109.2012.02709.x","volume":"9","author":"E Atlantis","year":"2012","unstructured":"Atlantis E, Sullivan T. Bidirectional association between depression and sexual dysfunction: a systematic review and meta-analysis. J Sex Med. 2012;9(6):1497\u2013507. https:\/\/doi.org\/10.1111\/j.1743-6109.2012.02709.x. Epub 2012 Mar 29. PMID: 22462756.","journal-title":"J Sex Med"},{"issue":"4","key":"4890_CR5","doi-asserted-by":"publisher","first-page":"287","DOI":"10.4274\/tjod.galenos.2025.88949","volume":"22","author":"C Karada\u011f","year":"2025","unstructured":"Karada\u011f C, Kara SMG, G\u00fcner G, Da\u011fdeviren E, Pota A, Tercan E, \u0130nal MM. The impact of human papillomavirus positivity and genotype on sexual dysfunction and psychosexual stress. Turk J Obstet Gynecol. 2025;22(4):287\u201391. https:\/\/doi.org\/10.4274\/tjod.galenos.2025.88949 . Epub 2025 Oct 27. PMID: 41140103; PMCID: PMC12671457.","journal-title":"Turk J Obstet Gynecol"},{"key":"4890_CR6","doi-asserted-by":"publisher","unstructured":"Erkok U, Barut A, Saglik B, Hassan HB, Guner G, Kablan G, Ertok C, Omer Z. Impact of female genital mutilation on sexual function and psychosocial wellbeing among Somali women: a cross-sectional study. BMC Womens Health. 2026 May 11. https:\/\/doi.org\/10.1186\/s12905-026-04529-5. Epub ahead of print. PMID: 42116011.","DOI":"10.1186\/s12905-026-04529-5"},{"key":"4890_CR7","doi-asserted-by":"publisher","first-page":"1697957","DOI":"10.3389\/fmed.2025.1697957","volume":"12","author":"G G\u00fcner","year":"2025","unstructured":"G\u00fcner G, Tercan C, Dagdeviren E, Bacaks\u0131z A, Kiray E, Erdo\u011fmu\u015f SN, \u00d6ner Y\u00d6, K\u0131l\u0131\u00e7 S\u00d6, Sat\u0131lm\u0131\u015fo\u011flu ZZ, Ertok \u00c7, Tercan E, Efe \u00c7amili F, Vural NA, Yentek Balkanay A, Temel Y\u00fcksel \u0130, Erk\u0131l\u0131n\u00e7 S. Comparison of sexual function in women with endometrial cancer and their partners following surgery versus surgery additional brachytherapy: a cross-sectional study from a tertiary care center. Front Med (Lausanne). 2025;12:1697957. https:\/\/doi.org\/10.3389\/fmed.2025.1697957 . PMID: 41393143; PMCID: PMC12698566.","journal-title":"Front Med (Lausanne)"},{"issue":"6","key":"4890_CR8","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1007\/s00345-002-0301-4","volume":"20","author":"WF Stewart","year":"2003","unstructured":"Stewart WF, Van Rooyen JB, Cundiff GW, Abrams P, Herzog AR, Corey R, Hunt TL, Wein AJ. Prevalence and burden of overactive bladder in the United States. World J Urol. 2003;20(6):327\u201336. https:\/\/doi.org\/10.1007\/s00345-002-0301-4 . Epub 2002 Nov 15. PMID: 12811491.","journal-title":"World J Urol"},{"key":"4890_CR9","doi-asserted-by":"publisher","unstructured":"Coyne KS, Sexton CC, Irwin DE, Kopp ZS, Kelleher CJ, Milsom I. The impact of overactive bladder, incontinence and other lower urinary tract symptoms on quality of life, work productivity, sexuality and emotional well-being in men and women: results from the EPIC study. BJU Int. 2008;101(11):1388-95. https:\/\/doi.org\/10.1111\/j.1464-410X.2008.07601.x. PMID: 18454794.","DOI":"10.1111\/j.1464-410X.2008.07601.x"},{"key":"4890_CR10","doi-asserted-by":"publisher","unstructured":"Stach-Lempinen B, Kujansuu E, Laippala P, Mets\u00e4noja R. Visual analogue scale, urinary incontinence severity score and 15 D\u2013psychometric testing of three different health-related quality-of-life instruments for urinary incontinent women. Scand J Urol Nephrol. 2001;35(6):476\u2009\u2013\u200983. https:\/\/doi.org\/10.1080\/003655901753367587. PMID: 11848427.","DOI":"10.1080\/003655901753367587"},{"issue":"3","key":"4890_CR11","doi-asserted-by":"publisher","first-page":"1141","DOI":"10.1002\/ijgo.15189","volume":"164","author":"JM Mart\u00ednez-Galiano","year":"2024","unstructured":"Mart\u00ednez-Galiano JM, Peinado-Molina RA, Mart\u00ednez-Vazquez S, Hita-Contreras F, Delgado-Rodr\u00edguez M, Hern\u00e1ndez-Mart\u00ednez A. Influence of pelvic floor disorders on sexuality in women. Int J Gynaecol Obstet. 2024;164(3):1141\u201350. https:\/\/doi.org\/10.1002\/ijgo.15189. Epub 2023 Oct 13. PMID: 37830235.","journal-title":"Int J Gynaecol Obstet"},{"key":"4890_CR12","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1016\/j.ejogrb.2017.11.017","volume":"220","author":"YM Lim","year":"2018","unstructured":"Lim YM, Lee SR, Choi EJ, Jeong K, Chung HW. Urinary incontinence is strongly associated with depression in middle-aged and older Korean women: Data from the Korean longitudinal study of ageing. Eur J Obstet Gynecol Reprod Biol. 2018;220:69\u201373. https:\/\/doi.org\/10.1016\/j.ejogrb.2017.11.017.\u00a0Epub 2017 Nov 22. PMID: 29175130.","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"4890_CR13","doi-asserted-by":"publisher","unstructured":"Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsigh R, Ferguson D, D\u2019Agostino R Jr. The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther. 2000 Apr-Jun;26(2):191\u2013208. https:\/\/doi.org\/10.1080\/009262300278597.\u00a0PMID: 10782451.","DOI":"10.1080\/009262300278597"},{"key":"4890_CR14","doi-asserted-by":"publisher","unstructured":"Wiegel M, Meston C, Rosen R. The female sexual function index (FSFI): cross-validation and development of clinical cutoff scores. J Sex Marital Ther. 2005 Jan-Feb;31(1):1\u201320. https:\/\/doi.org\/10.1080\/00926230590475206.\u00a0PMID: 15841702.","DOI":"10.1080\/00926230590475206"},{"key":"4890_CR15","doi-asserted-by":"publisher","unstructured":"Zung WW. A self-rating depression, scale. Arch Gen Psychiatry. 1965;12:63\u201370. https:\/\/doi.org\/10.1001\/archpsyc.1965.01720310065008. PMID: 14221692.","DOI":"10.1001\/archpsyc.1965.01720310065008"},{"key":"4890_CR16","doi-asserted-by":"publisher","unstructured":"Biggs JT, Wylie LT, Ziegler VE. Validity of the Zung Self-rating Depression Scale. Br J Psychiatry. 1978;132:381-5. https:\/\/doi.org\/10.1192\/bjp.132.4.381. PMID: 638392.","DOI":"10.1192\/bjp.132.4.381"},{"key":"4890_CR17","doi-asserted-by":"publisher","unstructured":"Barber MD, Walters MD, Bump RC. Short forms of two condition-specific quality-of-life questionnaires for women with pelvic floor disorders (PFDI-20 and PFIQ-7). Am J Obstet Gynecol. 2005;193(1):103\u2009\u2013\u200913. https:\/\/doi.org\/10.1016\/j.ajog.2004.12.025. PMID: 16021067.","DOI":"10.1016\/j.ajog.2004.12.025"},{"key":"4890_CR18","doi-asserted-by":"publisher","unstructured":"Barber MD, Kuchibhatla MN, Pieper CF, Bump RC. Psychometric evaluation of 2 comprehensive condition-specific quality of life instruments for women with pelvic floor disorders. Am J Obstet Gynecol. 2001;185(6):1388-95. https:\/\/doi.org\/10.1067\/mob.2001.118659. PMID: 11744914.","DOI":"10.1067\/mob.2001.118659"},{"key":"4890_CR19","doi-asserted-by":"publisher","unstructured":"Wagner TH, Patrick DL, Bavendam TG, Martin ML, Buesching DP. Quality of life of persons with urinary incontinence: development of a new measure. Urology. 1996;47(1):67\u201371; discussion 71\u2009\u2013\u20092. https:\/\/doi.org\/10.1016\/s0090-4295(99)80384-7. PMID: 8560665.","DOI":"10.1016\/s0090-4295(99)80384-7"},{"issue":"5","key":"4890_CR20","doi-asserted-by":"publisher","first-page":"100417","DOI":"10.1016\/j.esxm.2021.100417","volume":"9","author":"J Du","year":"2021","unstructured":"Du J, Ye J, Fei H, Li M, He J, Liu L, Liu Y, Li T. Effect of Epidural Analgesia on Pelvic Floor Dysfunction at 6 Months Postpartum in Primiparous Women: A Prospective Cohort Study. Sex Med. 2021;9(5):100417. https:\/\/doi.org\/10.1016\/j.esxm.2021.100417 . Epub 2021 Aug 19. PMID: 34419692; PMCID: PMC8498962.","journal-title":"Sex Med"},{"issue":"3","key":"4890_CR21","doi-asserted-by":"publisher","first-page":"282","DOI":"10.1159\/000519818","volume":"106","author":"N d\u2019Altilia","year":"2022","unstructured":"d\u2019Altilia N, Mancini V, Falagario U, Chirico M, Illiano E, Balzarro M, Annese P, Busetto GM, Bettocchi C, Cormio L, Sanguedolce F, Schiavina R, Brunocilla E, Costantini E, Carrieri G. Are Two Meshes Better than One in Sacrocolpopexy for Pelvic Organ Prolapse? Comparison of Single Anterior versus Anterior and Posterior Vaginal Mesh Procedures. Urol Int. 2022;106(3):282\u201390. https:\/\/doi.org\/10.1159\/000519818 . Epub 2021 Nov 26. PMID: 34839298.","journal-title":"Urol Int"},{"key":"4890_CR22","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.euros.2026.03.019","volume":"88","author":"N d\u2019Altilia","year":"2026","unstructured":"d'Altilia N, Finati M, Ninivaggi A, Falagario UG, Guzzi F, Liuzzi G, Ciavarella G, Staffieri S, Busetto GM, Bettocchi C, Annese P, Cormio L, Carrieri G. Trifecta Outcomes after Robotic Sacrocolpopexy with Dual Mesh in Single-center Cohort. Eur Urol Open Sci. 2026;88:1\u20138. https:\/\/doi.org\/10.1016\/j.euros.2026.03.019. PMID: 42037645; PMCID: PMC13103591.","journal-title":"Eur Urol Open Sci"},{"issue":"10","key":"4890_CR23","doi-asserted-by":"publisher","first-page":"1270","DOI":"10.1111\/j.1471-0528.2012.03426.x","volume":"119","author":"SN Stafne","year":"2012","unstructured":"Stafne SN, Salvesen K\u00c5, Romundstad PR, Torjusen IH, M\u00f8rkved S. Does regular exercise including pelvic floor muscle training prevent urinary and anal incontinence during pregnancy? A randomised controlled trial. BJOG. 2012;119(10):1270\u201380. https:\/\/doi.org\/10.1111\/j.1471-0528.2012.03426.x . Epub 2012 Jul 17. PMID: 22804796.","journal-title":"BJOG"},{"issue":"2","key":"4890_CR24","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1007\/s10067-011-1870-7","volume":"31","author":"RP Campos","year":"2012","unstructured":"Campos RP, V\u00e1zquez Rodr\u00edguez MI. Health-related quality of life in women with fibromyalgia: clinical and psychological factors associated. Clin Rheumatol. 2012;31(2):347\u201355. https:\/\/doi.org\/10.1007\/s10067-011-1870-7. Epub 2011 Oct 7. Erratum in: Clin Rheumatol. 2012;31(2):401. V\u00e1zquez, Maria Isabel Rodr\u00edguez [corrected to V\u00e1zquez Rodr\u00edguez, Maria Isabel]. PMID: 21979445.","journal-title":"Clin Rheumatol"},{"key":"4890_CR25","doi-asserted-by":"publisher","first-page":"9250972","DOI":"10.1155\/2018\/9250972","volume":"2018","author":"DA Dunstan","year":"2018","unstructured":"Dunstan DA, Scott N. Assigning Clinical Significance and Symptom Severity Using the Zung Scales: Levels of Misclassification Arising from Confusion between Index and Raw Scores. Depress Res Treat. 2018;2018:9250972. https:\/\/doi.org\/10.1155\/2018\/9250972 . PMID: 29610683; PMCID: PMC5828114.","journal-title":"Depress Res Treat"},{"key":"4890_CR26","doi-asserted-by":"publisher","first-page":"143","DOI":"10.2147\/IJWH.S187417","volume":"11","author":"B Mazi","year":"2019","unstructured":"Mazi B, Kaddour O, Al-Badr A. Depression symptoms in women with pelvic floor dysfunction: a case-control study. Int J Womens Health. 2019;11:143\u20138. https:\/\/doi.org\/10.2147\/IJWH.S187417 . PMID: 30863189; PMCID: PMC6390859.","journal-title":"Int J Womens Health"},{"issue":"9","key":"4890_CR27","doi-asserted-by":"publisher","first-page":"e101517","DOI":"10.1136\/bmjopen-2025-101517","volume":"15","author":"E Mooren","year":"2025","unstructured":"Mooren E, Posthumus AG, Steensma A, van der Kooy J, Speksnijder L. Impact of postpartum urinary and anal incontinence on patient-reported quality of life and risk of depressive disorder in women receiving primary and secondary care in the Netherlands: a prospective cohort study. BMJ Open. 2025;15(9):e101517. https:\/\/doi.org\/10.1136\/bmjopen-2025-101517 . PMID: 40976659; PMCID: PMC12458654.","journal-title":"BMJ Open"},{"issue":"3","key":"4890_CR28","doi-asserted-by":"publisher","first-page":"541","DOI":"10.3390\/medicina62030541","volume":"62","author":"A Boarta","year":"2026","unstructured":"Boarta A, Gluhovschi A, Craina ML, Marta CI, Dumitriu B, Socol ID, Sorop MI, Sorop B. Longitudinal Trajectories and Psychosocial Predictors of Postpartum Sexual Dysfunction from Early Pregnancy to 12 Months Postpartum. Medicina (Kaunas). 2026;62(3):541. https:\/\/doi.org\/10.3390\/medicina62030541. PMID: 41901622; PMCID: PMC13028179.","journal-title":"Med (Kaunas)"},{"issue":"13","key":"4890_CR29","doi-asserted-by":"publisher","first-page":"1581","DOI":"10.3390\/healthcare13131581","volume":"13","author":"D Brezeanu","year":"2025","unstructured":"Brezeanu D, Brezeanu AM, Chirila SI, Tica V. A Preliminary Study of Intravaginal Lactic Acid Gel (Canesbalance\u00ae) for Post-Episiotomy Healing: A Randomized Clinical Trial. Healthcare (Basel). 2025;13(13):1581. https:\/\/doi.org\/10.3390\/healthcare13131581. PMID: 40648604; PMCID: PMC12249008.","journal-title":"Healthc (Basel)"},{"issue":"1","key":"4890_CR30","doi-asserted-by":"publisher","first-page":"20","DOI":"10.3390\/clinpract15010020","volume":"15","author":"L \u0218erb\u0103nescu","year":"2025","unstructured":"\u0218erb\u0103nescu L, Rotar V, Brezeanu D, Mirea S, Ionescu EV, Ionescu P. Evaluating the Efficacy of Combined Intravaginal Estriol Therapy and Kegel Exercises in Managing Menopausal Atrophic Vulvovaginitis. Clin Pract. 2025;15(1):20.PMID: 39851803; PMCID: PMC11763434. https:\/\/doi.org\/10.3390\/clinpract15010020","journal-title":"Clin Pract"},{"key":"4890_CR31","doi-asserted-by":"publisher","unstructured":"ter Kuile MM, Both S, van Lankveld JJ. Cognitive behavioral therapy for sexual dysfunctions in women. Psychiatr Clin North Am. 2010;33(3):595\u2013610. https:\/\/doi.org\/10.1016\/j.psc.2010.04.010. PMID: 20599135.","DOI":"10.1016\/j.psc.2010.04.010"},{"issue":"3","key":"4890_CR32","doi-asserted-by":"publisher","first-page":"348","DOI":"10.3934\/medsci.2024024","volume":"11","author":"V-S L\u00f3pez-L\u00f3pez Laura","year":"2024","unstructured":"L\u00f3pez-L\u00f3pez L, Villalobos-Santos L, Del Castillo-Mat\u00edas R, Torres-S\u00e1nchez I, D\u00edaz-Mohedo E. Transcutaneous electrical nerve stimulation in the treatment of women with genito-pelvic pain penetration disorders: a systematic review. AIMS Med Sci. 2024;11(3):348\u201360. https:\/\/doi.org\/10.3934\/medsci.2024024.","journal-title":"AIMS Med Sci"},{"issue":"4","key":"4890_CR33","doi-asserted-by":"publisher","first-page":"430","DOI":"10.1016\/j.ajog.2017.06.016","volume":"217","author":"CS Bradley","year":"2017","unstructured":"Bradley CS, Nygaard IE, Hillis SL, Torner JC, Sadler AG. Longitudinal associations between mental health conditions and overactive bladder in women veterans. Am J Obstet Gynecol. 2017;217(4):430.e1-430.e8.https:\/\/doi.org\/10.1016\/j.ajog.2017.06.016.Epub 2017 Jun 20. PMID: 28645572.","journal-title":"Am J Obstet Gynecol"}],"container-title":["BMC Women's Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12905-026-04890-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12905-026-04890-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12905-026-04890-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T19:03:23Z","timestamp":1790190203000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12905-026-04890-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,16]]},"references-count":33,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["4890"],"URL":"https:\/\/doi.org\/10.1186\/s12905-026-04890-5","relation":{},"ISSN":["1472-6874"],"issn-type":[{"value":"1472-6874","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,16]]},"assertion":[{"value":"11 May 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 September 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 September 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The study was conducted in accordance with the Declaration of Helsinki. The study was approved by the Ethics Committee of The Seventh Affiliated Hospital, Sun Yat-sen University (approval number: KY-2026-002-01). Due to the retrospective nature of the study, the requirement for written informed consent was waived by the ethics committee.","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":"473"}}