{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T00:50:15Z","timestamp":1793407815088,"version":"4.5.0"},"reference-count":61,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      As the principal cause of cervical cancer, human papillomavirus (HPV) infection is linked to vaginal infections such as bacterial vaginosis (BV), vulvovaginal candidiasis (VVC), aerobic vaginitis (AV), and\n                      <jats:italic>Trichomonas vaginalis<\/jats:italic>\n                      (TV); however, the exact relationship remains controversial.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this study, we performed a cross-sectional analysis of 10,104 women in Jinan, China, to establish a detailed association between HPV and vaginal infections.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Our analysis showed that the HPV infection rate in Jinan was 21.84% of which the high-risk HPV (HR-HPV) infection rate was 84.32%. Although HR-HPV, low-risk HPV, BV, VVC, and TV prevalence rates across seasons were not statistically significant, we discerned significance for AV. In addition, while there was no difference between the prevalence of HPV and VVC, women with BV, AV, TV, or any vaginal infection manifested a higher risk of HPV infection. As for HR-HPV, our results showed statistically significant differences in HR-HPV infection rates between patients with BV, AV, TV, or any type of vaginal infection and the control group; however, VVC cases and cases without VVC did not differ. Furthermore, our correlation analysis among different HR-HPV genotypes and vaginal infections revealed an elevated incidence of BV in individuals with HPV45, HPV51, HPV52, HPV58, HPV66, and HPV68. AV exhibited an elevated infection rate in women with HPV16, HPV33, and HPV68; while TV demonstrated an increased infection risk in women with HPV52.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We hereby explored the complex relationship between HPV infection and vaginal infections and provided information on early-detection, preventive, and therapeutic strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcimb.2026.1775865","type":"journal-article","created":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T06:51:22Z","timestamp":1772175082000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical epidemiology and associations between HPV infection and vaginal infections in Jinan, China: a cross-sectional analysis"],"prefix":"10.3389","volume":"16","author":[{"given":"Xiaodi","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Clinical Laboratory, Jinan Maternity and Child Care Hospital Affiliated to Shandong First Medical University","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiyan","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Jinan Maternity and Child Care Hospital Affiliated to Shandong First Medical University","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruotong","family":"Li","sequence":"additional","affiliation":[{"name":"Neonatal Disease Screening Center, Jinan Maternity and Child Care Hospital Affiliated to Shandong First Medical University","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rongguo","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Jinan Maternity and Child Care Hospital Affiliated to Shandong First Medical University","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Jinan Maternity and Child Care Hospital Affiliated to Shandong First Medical University","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,27]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1038\/s41572-025-00626-1","article-title":"Bacterial vaginosis","volume":"11","author":"Bradshaw","year":"2025","journal-title":"Nat. Rev. Dis. Primers."},{"key":"B2","doi-asserted-by":"publisher","first-page":"229","DOI":"10.3322\/caac.21834","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA Cancer J. Clin."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1281","DOI":"10.1002\/jmv.24748","article-title":"Prevalence of high-risk human papillomavirus infection among women in Shaanxi province of China: a hospital-based investigation","volume":"89","author":"Cao","year":"2017","journal-title":"J. Med. Virol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1186\/s12985-019-1239-0","article-title":"Characteristics of human papillomaviruses distribution in Guizhou Province, China","volume":"16","author":"Chen","year":"2019","journal-title":"Virol. J."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1966","DOI":"10.1002\/jmv.24248","article-title":"Prevalence and genotype distribution of cervical human papillomavirus (HPV) among women in urban Tianjin, China","volume":"87","author":"Chen","year":"2015","journal-title":"J. Med. Virol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"795656","DOI":"10.1155\/2015\/795656","article-title":"Analysis of the oxidative stress status in nonspecific vaginitis and its role in vaginal epithelial cells apoptosis","volume":"2015","author":"Chen","year":"2015","journal-title":"BioMed. Res. Int."},{"key":"B7","doi-asserted-by":"publisher","first-page":"1961","DOI":"10.1016\/j.jiph.2020.05.024","article-title":"The correlation between the determination of vaginal micro-ecological composition and the outcome of HPV infection by high-throughput metagene sequencing information technology on the illumina platform","volume":"13","author":"Cheng","year":"2020","journal-title":"J. Infect. Public Health"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2025.1608195","article-title":"Advances in the interrelated nature of vaginal microecology, HPV infection, and cervical lesions","volume":"15","author":"Cui","year":"2025","journal-title":"Front. Cell Infect. Microbiol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1159\/000314017","article-title":"Epidemiology of trichomonas vaginalis and human papillomavirus infection detected by real-time PCR in Flanders","volume":"70","author":"Depuydt","year":"2010","journal-title":"Gynecol. Obstet. Invest."},{"key":"B10","doi-asserted-by":"publisher","first-page":"e86266","DOI":"10.1371\/journal.pone.0086266","article-title":"Association of Trichomonas vaginalis and cytological abnormalities of the cervix in low risk women","volume":"8","author":"Donders","year":"2013","journal-title":"PloS One"},{"key":"B11","doi-asserted-by":"publisher","first-page":"574","DOI":"10.3390\/jcm11030574","article-title":"Lab-based retrospective 10-Year analysis shows seasonal variation of vaginal candida infection rates in Belgium","volume":"11","author":"Donders","year":"2022","journal-title":"J. Clin. Med."},{"key":"B12","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1111\/j.1471-0528.2002.00432.x","article-title":"Definition of a type of abnormal vaginal flora that is distinct from bacterial vaginosis: aerobic vaginitis","volume":"109","author":"Donders","year":"2002","journal-title":"BJOG: Int. J. Obstet. Gynaecol."},{"key":"B13","doi-asserted-by":"publisher","first-page":"374","DOI":"10.1002\/cam4.2697","article-title":"Cancer burden attributable to human papillomavirus infection by sex, cancer site, age, and geographical area in China","volume":"9","author":"Duan","year":"2020","journal-title":"Cancer Med."},{"key":"B14","doi-asserted-by":"publisher","first-page":"3911","DOI":"10.3390\/cells11233911","article-title":"Reduced MHC Class I and II expression in HPV-negative vs. HPV-positive cervical cancers","volume":"11","author":"Evans","year":"2022","journal-title":"Cells"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2023.1138507","article-title":"Correlation analysis of vaginal microecology and different types of human papillomavirus infection: a study conducted at a hospital in northwest China","volume":"10","author":"Feng","year":"2023","journal-title":"Front. Med."},{"key":"B16","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1016\/j.jcv.2017.12.015","article-title":"Risk of high-risk human papillomavirus infection and cervical precancerous lesions with past or current trichomonas infection: a pooled analysis of 25,054 women in rural China","author":"Feng","year":"2018","journal-title":"J. Clin. Virol."},{"key":"B17","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1186\/s12916-025-03975-6","article-title":"Prevalence, trends, and geographic distribution of human papillomavirus infection in Chinese women: a summative analysis of 2,728,321 cases","volume":"23","author":"Han","year":"2025","journal-title":"BMC Med."},{"key":"B18","doi-asserted-by":"publisher","first-page":"105250","DOI":"10.1016\/j.ebiom.2024.105250","article-title":"Epidemiology of Trichomonas vaginalis infection in the Middle East and North Africa: systematic review, meta-analyses, and meta-regressions","volume":"106","author":"Harfouche","year":"2024","journal-title":"eBioMedicine"},{"key":"B19","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1002\/rmv.488","article-title":"Human papillomaviruses: basic mechanisms of pathogenesis and oncogenicity","volume":"16","author":"Hebner","year":"2006","journal-title":"Rev. Med. Virol."},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2023.1210253","article-title":"Cervical HPV infection in Yueyang, China: a cross-sectional study of 125,604 women from 2019 to 2022","volume":"11","author":"Hou","year":"2023","journal-title":"Front. Public Health"},{"key":"B21","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1093\/infdis\/jiaa384","article-title":"Association between common vaginal infections and cervical Non\u2013human papillomavirus (HPV) 16\/18 infection in HPV-Vaccinated women","volume":"223","author":"Hu","year":"2021","journal-title":"J. Infect. Dis."},{"key":"B22","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1097\/OLQ.0000000000000124","article-title":"Bacterial vaginosis and season, a proxy for vitamin D status","volume":"41","author":"Klebanoff","year":"2014","journal-title":"Sex Transm. Dis."},{"key":"B23","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1016\/j.clinthera.2013.11.009","article-title":"An association between trichomonas vaginalis and high-risk human papillomavirus in rural Tanzanian women undergoing cervical cancer screening","volume":"36","author":"Lazenby","year":"2014","journal-title":"Clin. Ther."},{"key":"B24","doi-asserted-by":"publisher","first-page":"2183","DOI":"10.1038\/s41564-023-01500-0","article-title":"A citizen-science-enabled catalogue of the vaginal microbiome and associated factors","volume":"8","author":"Lebeer","year":"2023","journal-title":"Nat. Microbiol."},{"key":"B25","doi-asserted-by":"publisher","first-page":"356","DOI":"10.1016\/j.tim.2022.09.011","article-title":"New perspectives into the vaginal microbiome with systems biology","volume":"31","author":"Lee","year":"2023","journal-title":"Trends Microbiol."},{"key":"B26","doi-asserted-by":"publisher","first-page":"12067","DOI":"10.1074\/jbc.M113.453654","article-title":"Degradation, foraging, and depletion of mucus sialoglycans by the vagina-adapted Actinobacterium Gardnerella vaginalis","volume":"288","author":"Lewis","year":"2013","journal-title":"J. Biol. Chem."},{"key":"B27","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1186\/s12985-020-01352-8","article-title":"Prevalence characteristics of cervical human papillomavirus (HPV) infection in the Zhoupu District, Shanghai City, China","volume":"17","author":"Li","year":"2020","journal-title":"Virol. J."},{"key":"B28","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1186\/s13027-019-0243-8","article-title":"A meta-analysis of the relationship between vaginal microecology, human papillomavirus infection and cervical intraepithelial neoplasia","volume":"14","author":"Liang","year":"2019","journal-title":"Infect. Agent Cancer"},{"key":"B29","doi-asserted-by":"publisher","first-page":"2812","DOI":"10.1038\/s41598-022-06731-5","article-title":"Changes of the vaginal microbiota in HPV infection and cervical intraepithelial neoplasia: a cross-sectional analysis","volume":"12","author":"Lin","year":"2022","journal-title":"Sci. Rep."},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2023.1153894","article-title":"Use of probiotic lactobacilli in the treatment of vaginal infections: In vitro and in vivo investigations","volume":"13","author":"Liu","year":"2023","journal-title":"Front. Cell Infect. Microbiol."},{"key":"B31","doi-asserted-by":"publisher","first-page":"1765","DOI":"10.2147\/IJWH.S479836","article-title":"Cross-sectional study on the correlation between vaginal microecology and high-risk human papillomavirus infection: establishment of a clinical prediction model","volume":"16","author":"Liu","year":"2024","journal-title":"Int. J. Women\u2019s Health"},{"key":"B32","doi-asserted-by":"publisher","first-page":"e073332","DOI":"10.1136\/bmjopen-2023-073332","article-title":"HPV prevalence and genotype distribution among 38\u2013056 women in Weifang, China: a cross-sectional study","volume":"13","author":"Liu","year":"2023","journal-title":"BMJ Open"},{"key":"B33","doi-asserted-by":"publisher","first-page":"1017","DOI":"10.20892\/j.issn.2095-3941.2025.0386","article-title":"Cervical cancer burden and trends in China, 2000-2020: Asia-Pacific international comparisons and insights for elimination goals","volume":"22","author":"Ma","year":"2025","journal-title":"Cancer Biol. Med."},{"key":"B34","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1038\/s41579-021-00617-5","article-title":"Human papillomaviruses: diversity, infection and host interactions","volume":"20","author":"McBride","year":"2022","journal-title":"Nat. Rev. Microbiol."},{"key":"B35","doi-asserted-by":"publisher","first-page":"2567","DOI":"10.1016\/j.clinthera.2016.10.005","article-title":"Associations between vaginal infections and potential high-risk and high-risk human papillomavirus genotypes in female sex workers in Western Kenya","volume":"38","author":"Menon","year":"2016","journal-title":"Clin. Ther."},{"key":"B36","doi-asserted-by":"publisher","first-page":"e00837","DOI":"10.1128\/jcm.00837-22","article-title":"State of the art for diagnosis of bacterial vaginosis","volume":"61","author":"Muzny","year":"2023","journal-title":"J. Clin. Microbiol."},{"key":"B37","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1111\/1471-0528.15854","article-title":"The vaginal microbiota, human papillomavirus and cervical dysplasia: a systematic review and network meta-analysis","volume":"127","author":"Norenhag","year":"2020","journal-title":"BJOG: Int. J. Obstet. Gynaecol."},{"key":"B38","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1128\/jcm.29.2.297-301.1991","article-title":"Reliability of diagnosing bacterial vaginosis is improved by a standardized method of gram stain interpretation","volume":"29","author":"Nugent","year":"1991","journal-title":"J. Clin. Microbiol."},{"key":"B39","doi-asserted-by":"publisher","first-page":"97","DOI":"10.3390\/diagnostics11010097","article-title":"Aerobic vaginitis-underestimated risk factor for cervical intraepithelial neoplasia","volume":"11","author":"Plisko","year":"2021","journal-title":"Diagnostics"},{"key":"B40","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1016\/j.ygyno.2009.05.003","article-title":"Association between high risk papillomavirus DNA and nitric oxide release in the human uterine cervix","volume":"114","author":"Rahkola","year":"2009","journal-title":"Gynecol. Oncol."},{"key":"B41","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.medcli.2018.01.027","article-title":"Vaginosis-associated bacteria and its association with HPV infection","volume":"152","author":"Romero-Morelos","year":"2019","journal-title":"Med. Clin. (Barc)."},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2023.1130226","article-title":"Prevalence and genotype distribution of HPV infection among women in Xiamen, China","volume":"14","author":"Shen","year":"2023","journal-title":"Front. Microbiol."},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2021.710209","article-title":"HPV prevalence and genotype distribution among women from Hengyang District of Hunan Province, China","volume":"9","author":"Tang","year":"2021","journal-title":"Front. Public Health"},{"key":"B44","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1186\/s12985-017-0751-3","article-title":"Epidemiology and genotype distribution of human papillomavirus (HPV) in Southwest China: a cross-sectional five years study in non-vaccinated women","volume":"14","author":"Tang","year":"2017","journal-title":"Virol. J."},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.1093\/femsre\/fuaf013","article-title":"Vaginal Candida albicans infections: host\u2013pathogen\u2013microbiome interactions","volume":"49","author":"Valentine","year":"2025","journal-title":"FEMS Microbiol. Rev."},{"key":"B46","doi-asserted-by":"publisher","first-page":"D499","DOI":"10.1093\/nar\/gkw879","article-title":"The Papillomavirus Episteme: a major update to the papillomavirus sequence database","volume":"45","author":"Van Doorslaer","year":"2017","journal-title":"Nucleic Acids Res."},{"key":"B47","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1186\/1471-2334-9-16","article-title":"Human Papillomaviruses and genital co-infections in gynaecological outpatients","volume":"9","author":"Verteramo","year":"2009","journal-title":"BMC Infect. Dis."},{"key":"B48","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1186\/s12985-022-01759-5","article-title":"Prevalence and distribution of human papillomavirus (HPV) in Luoyang city of Henan province during 2015\u20132021 and the genetic variability of HPV16 and 52","volume":"19","author":"Wang","year":"2022","journal-title":"Virol. J."},{"key":"B49","doi-asserted-by":"publisher","first-page":"16538","DOI":"10.1038\/s41598-021-96131-y","article-title":"Prevalence characteristics of human papillomavirus (HPV) infection among women receiving physical examinations in the Shangcheng District, Hangzhou city, China","volume":"11","author":"Wang","year":"2021","journal-title":"Sci. Rep."},{"key":"B50","doi-asserted-by":"publisher","first-page":"1129","DOI":"10.1086\/427777","article-title":"Effects of bacterial vaginosis and other genital infections on the natural history of human papillomavirus infection in HIV-1-infected and high-risk HIV-1-uninfected women","volume":"191","author":"Watts","year":"2005","journal-title":"J. Infect. Dis."},{"key":"B51","doi-asserted-by":"publisher","first-page":"435","DOI":"10.1016\/S0140-6736(24)01097-3","article-title":"Causal attribution of human papillomavirus genotypes to invasive cervical cancer worldwide: a systematic analysis of the global literature","volume":"404","author":"Wei","year":"2024","journal-title":"Lancet"},{"key":"B52","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1097\/LGT.0000000000000243","article-title":"Analysis of human papillomavirus infection in 16,320 patients from a gynecology clinic in Central South China","volume":"20","author":"Xiao","year":"2016","journal-title":"J. Low Genit. Tract. Dis."},{"key":"B53","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1002\/cac2.12629","article-title":"Advances in cervical cancer: current insights and future directions","volume":"45","author":"Xu","year":"2024","journal-title":"Cancer Commun."},{"key":"B54","doi-asserted-by":"publisher","first-page":"642","DOI":"10.1186\/s12879-020-05349-0","article-title":"Co-infection with trichomonas vaginalis increases the risk of cervical intraepithelial neoplasia grade 2\u20133 among HPV16 positive female: a large population-based study","volume":"20","author":"Yang","year":"2020","journal-title":"BMC Infect. Dis."},{"key":"B55","doi-asserted-by":"publisher","first-page":"e2176009","DOI":"10.1080\/22221751.2023.2176009","article-title":"Cervical HPV infection in Guangzhou, China: an epidemiological study of 198,111 women from 2015 to 2021","volume":"12","author":"Yang","year":"2023","journal-title":"Emerg. Microbes Infect."},{"key":"B56","first-page":"744","article-title":"To determine of the prevalence of Bacterial Vaginosis, Candida sp, mixed infections (Bacterial Vaginosis+Candida sp), Trichomonas Vaginalis, Actinomyces sp in Turkish women from Ankara, Turkey","volume":"83","author":"Yenidunya","year":"2012","journal-title":"Ginekol. Pol."},{"key":"B57","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2024.1325500","article-title":"Human papillomavirus and cervical cancer in the microbial world: exploring the vaginal microecology","volume":"14","author":"Zhang","year":"2024","journal-title":"Front. Cell Infect. Microbiol."},{"key":"B58","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2025.1724735","article-title":"The dual role of vulvovaginal candidiasis in HPV infection: implications for vaginal microecology and cervical lesions","volume":"16","author":"Zhang","year":"2026","journal-title":"Front. Microbiol."},{"key":"B59","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1186\/s12985-024-02317-x","article-title":"Prevalence and genotype distribution of HPV infections among women in Chengdu,China","volume":"21","author":"Zhang","year":"2024","journal-title":"Virol. J."},{"key":"B60","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1001\/jamaoncol.2020.6575","article-title":"Effectiveness of high-risk human papillomavirus testing for cervical cancer screening in China","volume":"7","author":"Zhang","year":"2021","journal-title":"JAMA Oncol."},{"key":"B61","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2022.1077651","article-title":"Prevention and treatment of human papillomavirus in men benefits both men and women","volume":"12","author":"Zou","year":"2022","journal-title":"Front. Cell Infect. Microbiol."}],"container-title":["Frontiers in Cellular and Infection Microbiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2026.1775865\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T06:51:24Z","timestamp":1772175084000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2026.1775865\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,27]]},"references-count":61,"alternative-id":["10.3389\/fcimb.2026.1775865"],"URL":"https:\/\/doi.org\/10.3389\/fcimb.2026.1775865","relation":{},"ISSN":["2235-2988"],"issn-type":[{"value":"2235-2988","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,27]]},"article-number":"1775865"}}