{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T00:18:45Z","timestamp":1793837925026,"version":"4.6.1"},"reference-count":37,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,4,11]],"date-time":"2025-04-11T00:00:00Z","timestamp":1744329600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,4,11]],"date-time":"2025-04-11T00:00:00Z","timestamp":1744329600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Hereditas"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Mitochondrial oxidative stress (ROS) is a crucial factor in the pathogenesis of dilated cardiomyopathy (DCM). Despite its significance, robust biomarkers for assessing its role remain scarce. This study investigates ROS mechanisms in DCM and identifies associated biomarkers, offering fresh insights into diagnosis and treatment.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>We sourced transcriptomic data from the GEO database and mitochondrial oxidative stress-related genes from GeneCards. Using consensus clustering, we identified 64 genes associated with mitochondrial oxidative stress in DCM and further isolated five hub genes through protein\u2013protein interaction and machine learning techniques. These genes were analyzed for functions related to immunity, drug sensitivity, and single-cell localization. Concurrently, we collected blood samples from DCM patients to validate the hub genes' expression.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The study identified five hub genes related to mitochondrial oxidative stress: VCL, ABCB1, JAK2, KDR, and NGF. Expression analysis revealed high levels of VCL, ABCB1, KDR, and NGF in the non-failing (NF) group, while JAK2 was elevated in the DCM group (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Diagnostic efficacy, measured by area under the curve (AUC), was significant for VCL (76.4), ABCB1 (80.1), JAK2 (68.2), KDR (78.1), and NGF (71.8). Moreover, several drugs were identified as potential regulators of these hub genes, including Topotecan, CDK9_5576, Acetalax, Afatinib, and GSK591. Notably, VCL showed increased expression in DCM patient blood samples, consistent with transcriptomic and single-cell findings.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>This research highlights key genes associated with mitochondrial oxidative stress\u2014VCL, ABCB1, JAK2, KDR, NGF\u2014that show differential expression in DCM and myocardial infarction. These findings underscore their diagnostic potential and pave the way for new therapeutic strategies.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s41065-025-00399-3","type":"journal-article","created":{"date-parts":[[2025,4,11]],"date-time":"2025-04-11T08:09:48Z","timestamp":1744358988000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Decoding mitochondrial stress genes in DCM: towards precision diagnosis and therapy"],"prefix":"10.1186","volume":"162","author":[{"given":"Bingbing","family":"Zhu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hai","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiawei","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yangyang","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoning","family":"Ge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,4,11]]},"reference":[{"key":"399_CR1","doi-asserted-by":"publisher","first-page":"270","DOI":"10.1093\/eurheartj\/ehm342","volume":"29","author":"P Elliott","year":"2008","unstructured":"Elliott P, Andersson B, Arbustini E, Bilinska Z, Cecchi F, Charron P, Dubourg O, K\u00fchl U, Maisch B, McKenna WJ, Monserrat L, Pankuweit S, Rapezzi C, Seferovic P, Tavazzi L, Keren A. Classification of the cardiomyopathies: a position statement from the European Society Of Cardiology Working Group on Myocardial and Pericardial Diseases. Eur Heart J. 2008;29:270\u20136.","journal-title":"Eur Heart J"},{"key":"399_CR2","doi-asserted-by":"publisher","first-page":"769","DOI":"10.1016\/j.healun.2007.06.004","volume":"26","author":"DO Taylor","year":"2007","unstructured":"Taylor DO, Edwards LB, Boucek MM, Trulock EP, Aurora P, Christie J, Dobbels F, Rahmel AO, Keck BM, Hertz MI. Registry of the International Society for Heart and Lung Transplantation: twenty-fourth official adult heart transplant report\u20132007. J Heart Lung Transplant. 2007;26:769\u201381.","journal-title":"J Heart Lung Transplant"},{"key":"399_CR3","doi-asserted-by":"publisher","first-page":"1077","DOI":"10.1056\/NEJM200004133421502","volume":"342","author":"GM Felker","year":"2000","unstructured":"Felker GM, Thompson RE, Hare JM, Hruban RH, Clemetson DE, Howard DL, Baughman KL, Kasper EK. Underlying causes and long-term survival in patients with initially unexplained cardiomyopathy. N Engl J Med. 2000;342:1077\u201384.","journal-title":"N Engl J Med"},{"key":"399_CR4","doi-asserted-by":"publisher","first-page":"400","DOI":"10.1016\/S0140-6736(16)31713-5","volume":"390","author":"RG Weintraub","year":"2017","unstructured":"Weintraub RG, Semsarian C, Macdonald P. Dilated cardiomyopathy. Lancet. 2017;390:400\u201314.","journal-title":"Lancet"},{"key":"399_CR5","doi-asserted-by":"publisher","first-page":"531","DOI":"10.1038\/nrcardio.2013.105","volume":"10","author":"RE Hershberger","year":"2013","unstructured":"Hershberger RE, Hedges DJ, Morales A. Dilated cardiomyopathy: the complexity of a diverse genetic architecture. Nat Rev Cardiol. 2013;10:531\u201347.","journal-title":"Nat Rev Cardiol"},{"key":"399_CR6","doi-asserted-by":"publisher","first-page":"1564","DOI":"10.1056\/NEJM199412083312307","volume":"331","author":"GW Dec","year":"1994","unstructured":"Dec GW, Fuster V. Idiopathic dilated cardiomyopathy. N Engl J Med. 1994;331:1564\u201375.","journal-title":"N Engl J Med"},{"key":"399_CR7","doi-asserted-by":"publisher","first-page":"553","DOI":"10.1002\/ejhf.1461","volume":"21","author":"PM Seferovi\u0107","year":"2019","unstructured":"Seferovi\u0107 PM, Polovina M, Bauersachs J, Arad M, Ben Gal T, Lund LH, Felix SB, Arbustini E, Caforio ALP, Farmakis D, Filippatos GS. Heart failure in cardiomyopathies: a position paper from the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail. 2019;21:553\u201376.","journal-title":"Eur J Heart Fail"},{"issue":"25","key":"399_CR8","doi-asserted-by":"publisher","first-page":"2996","DOI":"10.1016\/j.jacc.2016.03.590","volume":"67","author":"AG Japp","year":"2016","unstructured":"Japp AG, Gulati A, Cook SA, Cowie MR, Prasad SK. The Diagnosis and Evaluation of Dilated Cardiomyopathy. J Am Coll Cardiol. 2016;67(25):2996\u20133010.","journal-title":"J Am Coll Cardiol."},{"key":"399_CR9","doi-asserted-by":"publisher","first-page":"731","DOI":"10.1161\/CIRCRESAHA.116.309396","volume":"121","author":"EM McNally","year":"2017","unstructured":"McNally EM, Mestroni L. Dilated Cardiomyopathy: Genetic Determinants and Mechanisms. Circ Res. 2017;121:731\u201348.","journal-title":"Circ Res"},{"key":"399_CR10","doi-asserted-by":"publisher","first-page":"750","DOI":"10.1126\/science.280.5364.750","volume":"280","author":"TM Olson","year":"1998","unstructured":"Olson TM, Michels VV, Thibodeau SN, Tai YS, Keating MT. Actin mutations in dilated cardiomyopathy, a heritable form of heart failure. Science. 1998;280:750\u20132.","journal-title":"Science"},{"key":"399_CR11","doi-asserted-by":"publisher","first-page":"909","DOI":"10.1152\/physrev.00026.2013","volume":"94","author":"DB Zorov","year":"2014","unstructured":"Zorov DB, Juhaszova M, Sollott SJ. Mitochondrial reactive oxygen species (ROS) and ROS-induced ROS release. Physiol Rev. 2014;94:909\u201350.","journal-title":"Physiol Rev"},{"key":"399_CR12","doi-asserted-by":"publisher","first-page":"e2309714120","DOI":"10.1073\/pnas.2309714120","volume":"120","author":"WQ Zheng","year":"2023","unstructured":"Zheng WQ, Zhang JH, Li ZH, Liu X, Zhang Y, Huang S, Li J, Zhou B, Eriani G, Wang ED, Zhou XL. Mammalian mitochondrial translation infidelity leads to oxidative stress-induced cell cycle arrest and cardiomyopathy. Proc Natl Acad Sci U S A. 2023;120:e2309714120.","journal-title":"Proc Natl Acad Sci U S A"},{"key":"399_CR13","doi-asserted-by":"publisher","first-page":"1383","DOI":"10.3390\/molecules18021383","volume":"18","author":"H Koyama","year":"2013","unstructured":"Koyama H, Nojiri H, Kawakami S, Sunagawa T, Shirasawa T, Shimizu T. Antioxidants improve the phenotypes of dilated cardiomyopathy and muscle fatigue in mitochondrial superoxide dismutase-deficient mice. Molecules. 2013;18:1383\u201393.","journal-title":"Molecules"},{"key":"399_CR14","doi-asserted-by":"publisher","first-page":"619","DOI":"10.1016\/j.jchf.2023.03.011","volume":"11","author":"AS Desai","year":"2023","unstructured":"Desai AS, Lam CSP, McMurray JJV, Redfield MM. How to Manage Heart Failure With Preserved Ejection Fraction: Practical Guidance for Clinicians. JACC Heart Fail. 2023;11:619\u201336.","journal-title":"JACC Heart Fail"},{"key":"399_CR15","doi-asserted-by":"publisher","first-page":"H2181","DOI":"10.1152\/ajpheart.00554.2011","volume":"301","author":"H Tsutsui","year":"2011","unstructured":"Tsutsui H, Kinugawa S, Matsushima S. Oxidative stress and heart failure. Am J Physiol Heart Circ Physiol. 2011;301:H2181\u201390.","journal-title":"Am J Physiol Heart Circ Physiol"},{"key":"399_CR16","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1016\/j.toxlet.2019.02.013","volume":"307","author":"M Songbo","year":"2019","unstructured":"Songbo M, Lang H, Xinyong C, Bin X, Ping Z, Liang S. Oxidative stress injury in doxorubicin-induced cardiotoxicity. Toxicol Lett. 2019;307:41\u20138.","journal-title":"Toxicol Lett"},{"key":"399_CR17","doi-asserted-by":"publisher","first-page":"812","DOI":"10.1186\/s12864-018-5213-9","volume":"19","author":"ME Sweet","year":"2018","unstructured":"Sweet ME, Cocciolo A, Slavov D, Jones KL, Sweet JR, Graw SL, Reece TB, Ambardekar AV, Bristow MR, Mestroni L, Taylor MRG. Transcriptome analysis of human heart failure reveals dysregulated cell adhesion in dilated cardiomyopathy and activated immune pathways in ischemic heart failure. BMC Genomics. 2018;19:812.","journal-title":"BMC Genomics"},{"key":"399_CR18","doi-asserted-by":"publisher","first-page":"4364","DOI":"10.1038\/s41467-020-18128-x","volume":"11","author":"T Yamaguchi","year":"2020","unstructured":"Yamaguchi T, Sumida TS, Nomura S, Satoh M, Higo T, Ito M, Ko T, Fujita K, Sweet ME, Sanbe A, Yoshimi K, Manabe I, Sasaoka T, Taylor MRG, Toko H, Takimoto E, Naito AT, Komuro I. Cardiac dopamine D1 receptor triggers ventricular arrhythmia in chronic heart failure. Nat Commun. 2020;11:4364.","journal-title":"Nat Commun"},{"key":"399_CR19","doi-asserted-by":"publisher","first-page":"180","DOI":"10.1136\/gutjnl-2020-320646","volume":"70","author":"Y Tanaka","year":"2021","unstructured":"Tanaka Y, Shimanaka Y, Caddeo A, Kubo T, Mao Y, Kubota T, Kubota N, Yamauchi T, Mancina RM, Baselli G, Luukkonen P, Pihlajam\u00e4ki J, Yki-J\u00e4rvinen H, Valenti L, Arai H, Romeo S, Kono N. LPIAT1\/MBOAT7 depletion increases triglyceride synthesis fueled by high phosphatidylinositol turnover. Gut. 2021;70:180\u201393.","journal-title":"Gut"},{"key":"399_CR20","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1038\/s41556-019-0446-7","volume":"22","author":"L Wang","year":"2020","unstructured":"Wang L, Yu P, Zhou B, Song J, Li Z, Zhang M, Guo G, Wang Y, Chen X, Han L, Hu S. Single-cell reconstruction of the adult human heart during heart failure and recovery reveals the cellular landscape underlying cardiac function. Nat Cell Biol. 2020;22:108\u201319.","journal-title":"Nat Cell Biol"},{"key":"399_CR21","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1038\/s41587-023-01767-y","volume":"42","author":"Y Hao","year":"2024","unstructured":"Hao Y, Stuart T, Kowalski MH, Choudhary S, Hoffman P, Hartman A, Srivastava A, Molla G, Madad S, Fernandez-Granda C, Satija R. Dictionary learning for integrative, multimodal and scalable single-cell analysis. Nat Biotechnol. 2024;42:293\u2013304.","journal-title":"Nat Biotechnol"},{"key":"399_CR22","doi-asserted-by":"publisher","first-page":"D607","DOI":"10.1093\/nar\/gky1131","volume":"47","author":"D Szklarczyk","year":"2019","unstructured":"Szklarczyk D, Gable AL, Lyon D, Junge A, Wyder S, Huerta-Cepas J, Simonovic M, Doncheva NT, Morris JH, Bork P, Jensen LJ, Mering CV. STRING v11: protein-protein association networks with increased coverage, supporting functional discovery in genome-wide experimental datasets. Nucleic Acids Res. 2019;47:D607\u201313.","journal-title":"Nucleic Acids Res"},{"key":"399_CR23","doi-asserted-by":"publisher","first-page":"2498","DOI":"10.1101\/gr.1239303","volume":"13","author":"P Shannon","year":"2003","unstructured":"Shannon P, Markiel A, Ozier O, Baliga NS, Wang JT, Ramage D, Amin N, Schwikowski B, Ideker T. Cytoscape: a software environment for integrated models of biomolecular interaction networks. Genome Res. 2003;13:2498\u2013504.","journal-title":"Genome Res"},{"key":"399_CR24","doi-asserted-by":"publisher","first-page":"1305656","DOI":"10.3389\/fimmu.2023.1305656","volume":"14","author":"L Li","year":"2023","unstructured":"Li L, Wang S, Zhang T, Lv B, Jin Y, Wang Y, Chen X, Li N, Han N, Wu Y, Yuan J. Walnut peptide alleviates obesity, inflammation and dyslipidemia in mice fed a high-fat diet by modulating the intestinal flora and metabolites. Front Immunol. 2023;14:1305656.","journal-title":"Front Immunol"},{"key":"399_CR25","doi-asserted-by":"publisher","first-page":"e47","DOI":"10.1093\/nar\/gkv007","volume":"43","author":"ME Ritchie","year":"2015","unstructured":"Ritchie ME, Phipson B, Wu D, Hu Y, Law CW, Shi W, Smyth GK. limma powers differential expression analyses for RNA-sequencing and microarray studies. Nucleic Acids Res. 2015;43:e47.","journal-title":"Nucleic Acids Res."},{"key":"399_CR26","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1089\/omi.2011.0118","volume":"16","author":"G Yu","year":"2012","unstructured":"Yu G, Wang LG, Han Y, He QY. clusterProfiler: an R package for comparing biological themes among gene clusters. OMICS. 2012;16:284\u20137.","journal-title":"OMICS"},{"key":"399_CR27","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1186\/1471-2105-14-7","volume":"14","author":"S H\u00e4nzelmann","year":"2013","unstructured":"H\u00e4nzelmann S, Castelo R, Guinney J. GSVA: gene set variation analysis for microarray and RNA-seq data. BMC Bioinformatics. 2013;14:7.","journal-title":"BMC Bioinformatics"},{"key":"399_CR28","doi-asserted-by":"publisher","first-page":"687975","DOI":"10.3389\/fimmu.2021.687975","volume":"12","author":"D Zeng","year":"2021","unstructured":"Zeng D, Ye Z, Shen R, Yu G, Wu J, Xiong Y, Zhou R, Qiu W, Huang N, Sun L, Li X, Bin J, Liao Y, Shi M, Liao W. IOBR: Multi-Omics Immuno-Oncology Biological Research to Decode Tumor Microenvironment and Signatures. Front Immunol. 2021;12:687975.","journal-title":"Front Immunol."},{"key":"399_CR29","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1038\/nmeth.3337","volume":"12","author":"AM Newman","year":"2015","unstructured":"Newman AM, Liu CL, Green MR, Gentles AJ, Feng W, Xu Y, Hoang CD, Diehn M, Alizadeh AA. Robust enumeration of cell subsets from tissue expression profiles. Nat Methods. 2015;12:453\u20137.","journal-title":"Nat Methods"},{"key":"399_CR30","doi-asserted-by":"publisher","first-page":"bbab260","DOI":"10.1093\/bib\/bbab260","volume":"22","author":"D Maeser","year":"2021","unstructured":"Maeser D, Gruener RF, Huang RS. oncoPredict: an R package for predicting in vivo or cancer patient drug response and biomarkers from cell line screening data. Brief Bioinform. 2021;22:bbab260.","journal-title":"Brief Bioinform"},{"key":"399_CR31","doi-asserted-by":"publisher","first-page":"527","DOI":"10.1111\/j.1365-2362.2010.02441.x","volume":"41","author":"D Alexander","year":"2011","unstructured":"Alexander D, Lombardi R, Rodriguez G, Mitchell MM, Marian AJ. Metabolomic distinction and insights into the pathogenesis of human primary dilated cardiomyopathy. Eur J Clin Invest. 2011;41:527\u201338.","journal-title":"Eur J Clin Invest"},{"key":"399_CR32","first-page":"774","volume":"169","author":"W Goossen","year":"2011","unstructured":"Goossen W. Representing knowledge, data and concepts for EHRS using DCM. Stud Health Technol Inform. 2011;169:774\u20138.","journal-title":"Stud Health Technol Inform"},{"key":"399_CR33","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1161\/CIRCULATIONAHA.119.037661","volume":"141","author":"F Mazzarotto","year":"2020","unstructured":"Mazzarotto F, Tayal U, Buchan RJ, Midwinter W, Wilk A, Whiffin N, Govind R, Mazaika E, de Marvao A, Dawes TJW, Felkin LE, Ahmad M, Theotokis PI, Edwards E, Ing AY, Thomson KL, Chan LLH, Sim D, Baksi AJ, Pantazis A, Roberts AM, Watkins H, Funke B, O\u2019Regan DP, Olivotto I, Barton PJR, Prasad SK, Cook SA, Ware JS, Walsh R. Reevaluating the Genetic Contribution of Monogenic Dilated Cardiomyopathy. Circulation. 2020;141:387\u201398.","journal-title":"Circulation"},{"issue":"1","key":"399_CR34","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1016\/j.tcm.2005.10.001","volume":"16","author":"TF Solbach","year":"2006","unstructured":"Solbach TF, K\u00f6nig J, Fromm MF, Zolk O. ATP-binding cassette transporters in the heart. Trends Cardiovasc Med. 2006;16(1):7\u201315.","journal-title":"Trends Cardiovasc Med"},{"key":"399_CR35","doi-asserted-by":"publisher","first-page":"194","DOI":"10.1186\/s13287-020-01713-8","volume":"11","author":"G Crist\u00f3v\u00e3o","year":"2020","unstructured":"Crist\u00f3v\u00e3o G, Milner J, Sousa P, Ventura M, Crist\u00f3v\u00e3o J, Elvas L, Paiva A, Gon\u00e7alves L, Ribeiro CF, Ant\u00f3nio N. Improvement in circulating endothelial progenitor cells pool after cardiac resynchronization therapy: increasing the list of benefits. Stem Cell Res Ther. 2020;11:194.","journal-title":"Stem Cell Res Ther"},{"key":"399_CR36","doi-asserted-by":"publisher","first-page":"798","DOI":"10.1161\/01.CIR.0000057545.82749.FF","volume":"107","author":"EK Podewski","year":"2003","unstructured":"Podewski EK, Hilfiker-Kleiner D, Hilfiker A, Morawietz H, Lichtenberg A, Wollert KC, Drexler H. Alterations in Janus kinase (JAK)-signal transducers and activators of transcription (STAT) signaling in patients with end-stage dilated cardiomyopathy. Circulation. 2003;107:798\u2013802.","journal-title":"Circulation"},{"key":"399_CR37","doi-asserted-by":"publisher","first-page":"e12657","DOI":"10.1111\/micc.12657","volume":"28","author":"Y Hu","year":"2021","unstructured":"Hu Y, Xiong J, Wen H, Wei H, Zeng X. MiR-98-5p promotes ischemia\/reperfusion-induced microvascular dysfunction by targeting NGF and is a potential biomarker for microvascular reperfusion. Microcirculation. 2021;28:e12657.","journal-title":"Microcirculation"}],"container-title":["Hereditas"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s41065-025-00399-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s41065-025-00399-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s41065-025-00399-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,11]],"date-time":"2025-04-11T08:09:49Z","timestamp":1744358989000},"score":1,"resource":{"primary":{"URL":"https:\/\/hereditasjournal.biomedcentral.com\/articles\/10.1186\/s41065-025-00399-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,11]]},"references-count":37,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["399"],"URL":"https:\/\/doi.org\/10.1186\/s41065-025-00399-3","relation":{},"ISSN":["1601-5223"],"issn-type":[{"value":"1601-5223","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,11]]},"assertion":[{"value":"7 October 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 February 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 April 2025","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 study was approved by the Ethics Committee of the Suzhou Kowloon Hospital, Shanghai Jiao Tong University School of Medicine and conducted in accordance with the Declaration of Helsinki.","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":"57"}}