{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T19:58:54Z","timestamp":1793044734625,"version":"4.5.0"},"reference-count":43,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T00:00:00Z","timestamp":1752451200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T00:00:00Z","timestamp":1752451200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"National High Level Hospital Clinical Research Funding","award":["BJ-2022-143"],"award-info":[{"award-number":["BJ-2022-143"]}]},{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2022YFC3602900"],"award-info":[{"award-number":["2022YFC3602900"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Trop Med Health"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Benign prostatic hyperplasia (BPH) is a prevalent condition among older men that significantly reduces quality of life. Despite its global impact, comprehensive estimates of lifetime risk remain limited. This study aims to quantify the lifetime risk of BPH at both global and regional levels using data from the Global Burden of Disease (GBD) 2021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>We estimated the lifetime risk of developing BPH in men aged over 40 using the \u201cadjusted for multiple primaries (AMP)\u201d method, derived from age-specific incidence rates provided by GBD. The analysis included data from 204 countries and regions covering the period from 1990 to 2021, stratified by age, region, and sociodemographic index (SDI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In 2021, the global lifetime risk of BPH from age 40 to death was estimated at 27.29% (95% CI 27.26\u201327.31), with significant regional and socioeconomic inequalities. Eastern Europe exhibited the highest risk (37.57%), while Central Sub-Saharan Africa had the lowest (13.66%). When stratified by SDI, lifetime risk increased from 19.46% in low SDI regions to 31.51% in high-middle SDI regions but declined to 24.71% in high SDI settings. Across all regions, most cases were observed in individuals aged 50\u201370. Furthermore, between 1990 and 2021, the global lifetime risk of BPH showed a gradual increase. Projections indicate that this risk will remain stable over the next 30\u00a0years, with pronounced regional disparities expected to persist.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study offers a comprehensive assessment of the global lifetime risk of BPH, revealing significant regional variations and age-related trends. These findings underscore the need for targeted prevention and management strategies, particularly for high-risk regions and men aged 50\u201370, to reduce the global burden of BPH.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s41182-025-00770-0","type":"journal-article","created":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T03:52:27Z","timestamp":1752465147000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Global, regional, and national lifetime risks of developing benign prostatic hyperplasia in men aged over 40: a population-based cross-sectional study from 1990 to 2021"],"prefix":"10.1186","volume":"53","author":[{"given":"Yongming","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuhao","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lingfeng","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miao","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhengtong","family":"Lv","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shengjie","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huimin","family":"Hou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shengfeng","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,7,14]]},"reference":[{"key":"770_CR1","doi-asserted-by":"crossref","unstructured":"Safiri S MAK, Sullman MJM: The Global Burden of Diseases and Injuries Among Older Adults. Int J Aging 2023, 1.","DOI":"10.34172\/ija.2023.e16"},{"key":"770_CR2","doi-asserted-by":"publisher","first-page":"16031","DOI":"10.1038\/nrdp.2016.31","volume":"2","author":"B Chughtai","year":"2016","unstructured":"Chughtai B, Forde JC, Thomas DD, et al. Benign prostatic hyperplasia. Nat Rev Dis Primers. 2016;2:16031.","journal-title":"Nat Rev Dis Primers"},{"issue":"Suppl 1","key":"770_CR3","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1159\/000049872","volume":"40","author":"A Bertaccini","year":"2001","unstructured":"Bertaccini A, Vassallo F, Martino F, et al. Symptoms, bothersomeness and quality of life in patients with LUTS suggestive of BPH. Eur Urol. 2001;40(Suppl 1):13\u20138.","journal-title":"Eur Urol"},{"issue":"1","key":"770_CR4","first-page":"64","volume":"8","author":"C Zhu","year":"2021","unstructured":"Zhu C, Wang DQ, Zi H, et al. Epidemiological trends of urinary tract infections, urolithiasis and benign prostatic hyperplasia in 203 countries and territories from 1990 to 2019. Mil Med Res. 2021;8(1):64.","journal-title":"Mil Med Res"},{"issue":"1","key":"770_CR5","first-page":"64","volume":"11","author":"H Zi","year":"2024","unstructured":"Zi H, Liu MY, Luo LS, et al. Global burden of benign prostatic hyperplasia, urinary tract infections, urolithiasis, bladder cancer, kidney cancer, and prostate cancer from 1990 to 2021. Mil Med Res. 2024;11(1):64.","journal-title":"Mil Med Res"},{"issue":"21","key":"770_CR6","doi-asserted-by":"publisher","first-page":"2620","DOI":"10.1016\/j.scib.2023.09.041","volume":"68","author":"R Zheng","year":"2023","unstructured":"Zheng R, Wang S, Zhang S, et al. Global, regional, and national lifetime probabilities of developing cancer in 2020. Sci Bull. 2023;68(21):2620\u20138.","journal-title":"Sci Bull"},{"issue":"1","key":"770_CR7","doi-asserted-by":"publisher","first-page":"7984","DOI":"10.1038\/s41598-017-06628-8","volume":"7","author":"SWH Lee","year":"2017","unstructured":"Lee SWH, Chan EMC, Lai YK. The global burden of lower urinary tract symptoms suggestive of benign prostatic hyperplasia: a systematic review and meta-analysis. Sci Rep. 2017;7(1):7984.","journal-title":"Sci Rep"},{"issue":"10","key":"770_CR8","doi-asserted-by":"publisher","first-page":"2019","DOI":"10.1038\/s41591-022-01990-1","volume":"28","author":"CJL Murray","year":"2022","unstructured":"Murray CJL. The global burden of disease study at 30 years. Nat Med. 2022;28(10):2019\u201326.","journal-title":"Nat Med"},{"issue":"3","key":"770_CR9","doi-asserted-by":"publisher","first-page":"474","DOI":"10.1016\/S0022-5347(17)49698-4","volume":"132","author":"SJ Berry","year":"1984","unstructured":"Berry SJ, Coffey DS, Walsh PC, Ewing LL. The development of human benign prostatic hyperplasia with age. J Urol. 1984;132(3):474\u20139.","journal-title":"J Urol"},{"issue":"2","key":"770_CR10","doi-asserted-by":"publisher","first-page":"710","DOI":"10.1016\/j.juro.2008.10.025","volume":"181","author":"ET Kok","year":"2009","unstructured":"Kok ET, Schouten BW, Bohnen AM, et al. Risk factors for lower urinary tract symptoms suggestive of benign prostatic hyperplasia in a community based population of healthy aging men: the Krimpen Study. J Urol. 2009;181(2):710\u20136.","journal-title":"J Urol"},{"issue":"6","key":"770_CR11","doi-asserted-by":"publisher","first-page":"1221","DOI":"10.1007\/s11154-022-09730-z","volume":"23","author":"K Wel\u00e9n","year":"2022","unstructured":"Wel\u00e9n K, Damber JE. Androgens, aging, and prostate health. Rev Endocr Metab Disord. 2022;23(6):1221\u201331.","journal-title":"Rev Endocr Metab Disord"},{"key":"770_CR12","unstructured":"Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990\u20132021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet 2024, 403(10440):2133\u20132161."},{"issue":"1","key":"770_CR13","first-page":"60","volume":"8","author":"H Zi","year":"2021","unstructured":"Zi H, He SH, Leng XY, et al. Global, regional, and national burden of kidney, bladder, and prostate cancers and their attributable risk factors, 1990\u20132019. Mil Med Res. 2021;8(1):60.","journal-title":"Mil Med Res"},{"issue":"2","key":"770_CR14","doi-asserted-by":"publisher","first-page":"446","DOI":"10.1016\/j.chest.2023.09.028","volume":"165","author":"Y Liu","year":"2024","unstructured":"Liu Y, Wen H, Bai J, et al. Disease burden and prediction analysis of tracheal, bronchus, and lung cancer attributable to residential radon, solid fuels, and particulate matter pollution under different sociodemographic transitions from 1990 to 2030. Chest. 2024;165(2):446\u201360.","journal-title":"Chest"},{"key":"770_CR15","unstructured":"Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990\u20132017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018, 392(10159):1789\u20131858."},{"issue":"5","key":"770_CR16","doi-asserted-by":"publisher","first-page":"943","DOI":"10.1038\/bjc.2014.606","volume":"112","author":"AS Ahmad","year":"2015","unstructured":"Ahmad AS, Ormiston-Smith N, Sasieni PD. Trends in the lifetime risk of developing cancer in great Britain: comparison of risk for those born from 1930 to 1960. Br J Cancer. 2015;112(5):943\u20137.","journal-title":"Br J Cancer"},{"issue":"3","key":"770_CR17","doi-asserted-by":"publisher","first-page":"460","DOI":"10.1038\/bjc.2011.250","volume":"105","author":"PD Sasieni","year":"2011","unstructured":"Sasieni PD, Shelton J, Ormiston-Smith N, Thomson CS, Silcocks PB. What is the lifetime risk of developing cancer?: the effect of adjusting for multiple primaries. Br J Cancer. 2011;105(3):460\u20135.","journal-title":"Br J Cancer"},{"key":"770_CR18","doi-asserted-by":"publisher","first-page":"e073043","DOI":"10.1136\/bmj-2022-073043","volume":"381","author":"W Yan","year":"2023","unstructured":"Yan W, Qin C, Tao L, et al. Association between inequalities in human resources for health and all cause and cause specific mortality in 172 countries and territories, 1990\u20132019: observational study. BMJ. 2023;381:e073043.","journal-title":"BMJ"},{"key":"770_CR19","doi-asserted-by":"publisher","first-page":"117667","DOI":"10.1016\/j.socscimed.2024.117667","volume":"366","author":"J Qi","year":"2024","unstructured":"Qi J, Chen C, Zhang S, et al. The impacts of the COVID-19 pandemic on the burden of maternal and neonatal disorders: a counterfactual modeling based on the global burden of disease study (2021). Soc Sci Med. 2024;366:117667.","journal-title":"Soc Sci Med"},{"key":"770_CR20","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hcaf002","author":"D Jena","year":"2025","unstructured":"Jena D, Padhi BK. Global and regional burden of cardiovascular diseases due to non-optimal temperature exposure: a systematic analysis with forecasts to 2050. QJM. 2025. https:\/\/doi.org\/10.1093\/qjmed\/hcaf002.","journal-title":"QJM"},{"issue":"3","key":"770_CR21","doi-asserted-by":"publisher","first-page":"560","DOI":"10.1016\/j.eururo.2011.11.013","volume":"61","author":"C De Nunzio","year":"2012","unstructured":"De Nunzio C, Aronson W, Freedland SJ, Giovannucci E, Parsons JK. The correlation between metabolic syndrome and prostatic diseases. Eur Urol. 2012;61(3):560\u201370.","journal-title":"Eur Urol"},{"issue":"2","key":"770_CR22","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1038\/nrurol.2015.301","volume":"13","author":"L Vignozzi","year":"2016","unstructured":"Vignozzi L, Gacci M, Maggi M. Lower urinary tract symptoms, benign prostatic hyperplasia and metabolic syndrome. Nat Rev Urol. 2016;13(2):108\u201319.","journal-title":"Nat Rev Urol"},{"key":"770_CR23","doi-asserted-by":"publisher","first-page":"329456","DOI":"10.1155\/2014\/329456","volume":"2014","author":"G Corona","year":"2014","unstructured":"Corona G, Vignozzi L, Rastrelli G, et al. Benign prostatic hyperplasia: a new metabolic disease of the aging male and its correlation with sexual dysfunctions. Int J Endocrinol. 2014;2014:329456.","journal-title":"Int J Endocrinol"},{"issue":"4","key":"770_CR24","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1159\/000020162","volume":"37","author":"G Haidinger","year":"2000","unstructured":"Haidinger G, Temml C, Schatzl G, et al. Risk factors for lower urinary tract symptoms in elderly men. For the prostate study group of the Austrian society of urology. Eur Urol. 2000;37(4):413\u201320.","journal-title":"Eur Urol"},{"issue":"3","key":"770_CR25","doi-asserted-by":"publisher","first-page":"310","DOI":"10.1038\/sj.ijo.0802881","volume":"29","author":"S Rohrmann","year":"2005","unstructured":"Rohrmann S, Smit E, Giovannucci E, Platz EA. Association between markers of the metabolic syndrome and lower urinary tract symptoms in the third national health and nutrition examination survey (NHANES III). Int J Obes. 2005;29(3):310\u20136.","journal-title":"Int J Obes"},{"key":"770_CR26","doi-asserted-by":"crossref","unstructured":"Safiri S DSA, Aletaha R, Hamidi S, Motlagh Asghari K, Sarkesh A, et al: Obesity: global epidemiology, trends, risk factors, and clinical aspects. Int J Aging 2024, 2.","DOI":"10.34172\/ija.2024.e19"},{"issue":"6","key":"770_CR27","doi-asserted-by":"publisher","first-page":"1228","DOI":"10.1016\/j.eururo.2008.02.019","volume":"53","author":"JK Parsons","year":"2008","unstructured":"Parsons JK, Kashefi C. Physical activity, benign prostatic hyperplasia, and lower urinary tract symptoms. Eur Urol. 2008;53(6):1228\u201335.","journal-title":"Eur Urol"},{"issue":"10","key":"770_CR28","doi-asserted-by":"publisher","first-page":"2632","DOI":"10.1002\/ijc.21668","volume":"118","author":"L Dal Maso","year":"2006","unstructured":"Dal Maso L, Zucchetto A, Tavani A, et al. Lifetime occupational and recreational physical activity and risk of benign prostatic hyperplasia. Int J Cancer. 2006;118(10):2632\u20135.","journal-title":"Int J Cancer"},{"issue":"1","key":"770_CR29","doi-asserted-by":"publisher","first-page":"495","DOI":"10.1186\/s12967-022-03722-y","volume":"20","author":"YB Wang","year":"2022","unstructured":"Wang YB, Yang L, Deng YQ, et al. Causal relationship between obesity, lifestyle factors and risk of benign prostatic hyperplasia: a univariable and multivariable Mendelian randomization study. J Transl Med. 2022;20(1):495.","journal-title":"J Transl Med"},{"issue":"1","key":"770_CR30","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1186\/s12967-024-05212-9","volume":"22","author":"X Fei","year":"2024","unstructured":"Fei X, Liu J, Xu J, et al. Integrating spatial transcriptomics and single-cell RNA-sequencing reveals the alterations in epithelial cells during nodular formation in benign prostatic hyperplasia. J Transl Med. 2024;22(1):380.","journal-title":"J Transl Med"},{"key":"770_CR31","unstructured":"Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990\u20132021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet 2024, 403(10440):2100\u20132132."},{"issue":"1","key":"770_CR32","doi-asserted-by":"publisher","first-page":"31556","DOI":"10.1038\/s41598-024-83483-4","volume":"14","author":"T Tiruneh","year":"2024","unstructured":"Tiruneh T, Getachew T, Getahun F, Gebreyesus T, Meskele S. Magnitude and factors associated with benign prostatic hyperplasia among adult male patients visiting Wolaita Sodo University comprehensive specialized hospital southern Ethiopia. Sci Rep. 2024;14(1):31556.","journal-title":"Sci Rep"},{"issue":"1","key":"770_CR33","doi-asserted-by":"publisher","first-page":"31123","DOI":"10.1038\/s41598-024-82443-2","volume":"14","author":"H Wu","year":"2024","unstructured":"Wu H, Wang Y, Zhang H, et al. An investigation into the health status of the elderly population in China and the obstacles to achieving healthy aging. Sci Rep. 2024;14(1):31123.","journal-title":"Sci Rep"},{"issue":"1","key":"770_CR34","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1186\/s12889-025-21306-5","volume":"25","author":"AEN Mouteyica","year":"2025","unstructured":"Mouteyica AEN, Ngepah N. Exploring health outcome disparities in African regional economics communities: a multilevel linear mixed-effect analysis. BMC Public Health. 2025;25(1):175.","journal-title":"BMC Public Health"},{"key":"770_CR35","unstructured":"Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021. Lancet 2023, 402(10397):203\u2013234."},{"issue":"2","key":"770_CR36","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1136\/tobaccocontrol-2021-056535","volume":"31","author":"X Dai","year":"2022","unstructured":"Dai X, Gakidou E, Lopez AD. Evolution of the global smoking epidemic over the past half century: strengthening the evidence base for policy action. Tob Control. 2022;31(2):129\u201337.","journal-title":"Tob Control"},{"issue":"1","key":"770_CR37","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1056\/NEJMoa1614362","volume":"377","author":"A Afshin","year":"2017","unstructured":"Afshin A, Forouzanfar MH, Reitsma MB, et al. Health effects of overweight and obesity in 195 countries over 25 years. N Engl J Med. 2017;377(1):13\u201327.","journal-title":"N Engl J Med"},{"key":"770_CR38","doi-asserted-by":"publisher","DOI":"10.2373\/S2724-6051.24.05957-3","author":"C Re","year":"2025","unstructured":"Re C, Longoni M, Rosiello G, et al. Current management of patients affected by benign prostatic hyperplasia: a multi-institutional study from a contemporary large Italian cohort. Minerva Urol Nephrol. 2025. https:\/\/doi.org\/10.2373\/S2724-6051.24.05957-3.","journal-title":"Minerva Urol Nephrol"},{"issue":"1","key":"770_CR39","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1097\/JU.0000000000003698","volume":"211","author":"JS Sandhu","year":"2024","unstructured":"Sandhu JS, Bixler BR, Dahm P, et al. Management of lower urinary tract symptoms attributed to benign prostatic hyperplasia (BPH): AUA guideline amendment 2023. J Urol. 2024;211(1):11\u20139.","journal-title":"J Urol"},{"issue":"3","key":"770_CR40","doi-asserted-by":"publisher","first-page":"163","DOI":"10.3949\/ccjm.91a.23027","volume":"91","author":"ES Haile","year":"2024","unstructured":"Haile ES, Sotimehin AE, Gill BC. Medical management of benign prostatic hyperplasia. Cleve Clin J Med. 2024;91(3):163\u201370.","journal-title":"Cleve Clin J Med"},{"issue":"4","key":"770_CR41","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1016\/j.eururo.2024.04.031","volume":"86","author":"M Creta","year":"2024","unstructured":"Creta M, Russo GI, Bhojani N, et al. Bladder outlet obstruction relief and symptom improvement following medical and surgical therapies for lower urinary tract symptoms suggestive of benign prostatic hyperplasia: a systematic review. Eur Urol. 2024;86(4):315\u201326.","journal-title":"Eur Urol"},{"key":"770_CR42","unstructured":"Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950-2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021. Lancet 2024, 403(10440):1989-2056."},{"key":"770_CR43","unstructured":"Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990\u20132021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet 2024, 403(10440):2162\u20132203."}],"container-title":["Tropical Medicine and Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s41182-025-00770-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s41182-025-00770-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s41182-025-00770-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,7]],"date-time":"2025-09-07T07:22:38Z","timestamp":1757229758000},"score":1,"resource":{"primary":{"URL":"https:\/\/tropmedhealth.biomedcentral.com\/articles\/10.1186\/s41182-025-00770-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,14]]},"references-count":43,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["770"],"URL":"https:\/\/doi.org\/10.1186\/s41182-025-00770-0","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-6617584\/v1","asserted-by":"object"}]},"ISSN":["1349-4147"],"issn-type":[{"value":"1349-4147","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,14]]},"assertion":[{"value":"8 May 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 June 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 July 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 September 2025","order":4,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Update","order":5,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The first author affiliation has been updated","order":6,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study does not involve any personal or sensitive information and therefore does not require ethical approval.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"93"}}