{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T15:16:37Z","timestamp":1786115797226,"version":"build-2736575974"},"reference-count":62,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"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. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Polycystic ovary syndrome (PCOS) commonly causes infertility in women of reproductive age. Integrated Chinese\u2013Western medicine is used to improve reproductive outcomes and reduce adverse effects, but its reliability remains uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Efficacy and safety meta-analyses of integrated traditional Chinese medicine (TCM) and Western medicine for PCOS-related infertility were synthesized. PubMed, Embase, Web of Science, the Cochrane Library, the China National Knowledge Infrastructure (CNKI), Wanfang, and the Chinese Science and Technology Periodical Database (VIP) were searched from inception to November 2025. A Measurement Tool to Assess Systematic Reviews (AMSTAR) and Grading of Recommendations Assessment, Development and Evaluation (GRADE) assessed quality and certainty. Outcomes were classified by significance and evidence strength.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty meta-analyses included 39 intervention types and 153 outcomes, 135 outcomes (36 interventions) favored integrated treatment, and 18 (13 interventions) were non-significant. Heterogeneity and publication bias affected 33 and 48.4%, respectively. AMSTAR scores were 4\u20139. Four outcomes from two interventions met Class I-III criteria. Chinese medicine plus Western medicine using the TCM Cycle Method showed Class I evidence for pregnancy rate (OR: 2.76, 95% CI: 2.43, 3.13) and Class II evidence for total clinical efficiency (OR: 3.78, 95% CI: 3.29, 4.34) and ovulation rate (OR: 2.90, 95% CI: 2.39, 3.50). TCM cycle therapy plus ovulation induction showed Class III evidence for ovulation rate (RR: 1.10, 95% CI: 1.06, 1.14). GRADE ratings were high for 45, moderate for 92, and low for 16 outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Integrated therapy showed promising associations, but robust evidence remains limited; only four of 153 outcomes met Class I-III criteria. Rigorous randomized trials are required.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD420251275827<\/jats:ext-link>\n                      , Identifier: CRD420251275827.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1877844","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T05:31:20Z","timestamp":1785994280000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The efficacy and safety of combined traditional Chinese and Western medicine treatment for PCOS-related infertility: an umbrella meta-analysis"],"prefix":"10.3389","volume":"13","author":[{"given":"Hongwen","family":"Li","sequence":"first","affiliation":[{"name":"College of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine","place":["Jinan, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Acupuncture and Tuina, Qilu Hospital of Shandong University","place":["Jinan, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingchen","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Acupuncture and Tuina, Qilu Hospital of Shandong University","place":["Jinan, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guangzhong","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Acupuncture and Tuina, Qilu Hospital of Shandong University","place":["Jinan, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,6]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"2745","DOI":"10.1210\/jc.2003-032046","article-title":"The prevalence and features of the polycystic ovary syndrome in an unselected population","volume":"89","author":"Azziz","year":"2004","journal-title":"J Clin Endocrinol Metab"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"668","DOI":"10.1016\/S2213-8587(22)00163-2","article-title":"Polycystic ovary syndrome","volume":"10","author":"Joham","year":"2022","journal-title":"Lancet Diabetes Endocrinol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1303","DOI":"10.1007\/s00404-024-07607-x","article-title":"Global prevalence of polycystic ovary syndrome in women worldwide: a comprehensive systematic review and meta-analysis","volume":"310","author":"Salari","year":"2024","journal-title":"Arch Gynecol Obstet"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"516","DOI":"10.3389\/fendo.2020.00516","article-title":"Fundamental concepts and novel aspects of polycystic ovarian syndrome: expert consensus resolutions","volume":"11","author":"Aversa","year":"2020","journal-title":"Front Endocrinol (Lausanne)"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1038\/s41572-024-00511-3","article-title":"Polycystic ovary syndrome","volume":"10","author":"Stener-Victorin","year":"2024","journal-title":"Nat Rev Dis Primers"},{"key":"ref6","volume-title":"Infertility Prevalence Estimates, 1990\u20132021","year":"2023"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"2447","DOI":"10.1210\/clinem\/dgad463","article-title":"Recommendations from the 2023 international evidence-based guideline for the assessment and Management of Polycystic Ovary Syndrome","volume":"108","author":"Teede","year":"2023","journal-title":"J Clin Endocrinol Metab"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1186\/s12958-025-01372-5","article-title":"Diagnosis and management of infertility in patients with polycystic ovary syndrome (PCOS): guidelines from the Italian Society of Human Reproduction (SIRU) and the Italian centers for the study and conservation of eggs and sperm (CECOS Italy)","volume":"23","author":"Palomba","year":"2025","journal-title":"Reprod Biol Endocrinol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"Cd010287","DOI":"10.1002\/14651858.cd010287.pub4","article-title":"Aromatase inhibitors (letrozole) for ovulation induction in infertile women with polycystic ovary syndrome","volume":"2022","author":"Franik","year":"2022","journal-title":"Cochrane Database Syst Rev"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"257","DOI":"10.22074\/ijfs.2020.5608","article-title":"Medical and surgical treatment of reproductive outcomes in polycystic ovary syndrome: an overview of systematic reviews","volume":"13","author":"Gadalla","year":"2020","journal-title":"Int J Fertil Steril"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"2051","DOI":"10.3390\/biomedicines13092051","article-title":"Letrozole at the crossroads of efficacy and fetal safety in ovulation induction: a narrative review","volume":"13","author":"Kaltsas","year":"2025","journal-title":"Biomedicine"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"584","DOI":"10.1093\/humupd\/dmaa051","article-title":"Endometrial function in women with polycystic ovary syndrome: a comprehensive review","volume":"27","author":"Palomba","year":"2021","journal-title":"Hum Reprod Update"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"e38912","DOI":"10.1097\/MD.0000000000038912","article-title":"Combined traditional Chinese medicine therapy for the treatment of infertility with polycystic ovary syndrome: a network meta-analysis of randomized controlled trials","volume":"103","author":"Deng","year":"2024","journal-title":"Medicine (Baltimore)"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"657889","DOI":"10.3389\/fendo.2021.657889","article-title":"Improvement of insulin sensitivity increases pregnancy rate in infertile PCOS women: a systemic review","volume":"12","author":"Liu","year":"2021","journal-title":"Front Endocrinol (Lausanne)"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1016\/j.joim.2022.12.002","article-title":"Efficacy and safety of acupuncture for polycystic ovary syndrome: an overview of systematic reviews","volume":"21","author":"Yang","year":"2023","journal-title":"J Integr Med"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2021\/9935536","article-title":"An overview of systematic reviews of using Chinese medicine to treat polycystic ovary syndrome","volume":"2021","author":"Wang","year":"2021","journal-title":"Evid Based Complement Alternat Med"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"e000071","DOI":"10.1136\/bmjmed-2021-000071","article-title":"Conducting umbrella reviews","volume":"1","author":"Belbasis","year":"2022","journal-title":"BMJ Med"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"e070849","DOI":"10.1136\/bmj-2022-070849","article-title":"Reporting guideline for overviews of reviews of healthcare interventions: development of the PRIOR statement","volume":"378","author":"Gates","year":"2022","journal-title":"BMJ"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"10","author":"Page","year":"2021","journal-title":"Syst Rev"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"196","DOI":"10.1016\/j.jclinepi.2022.04.006","article-title":"JBI series paper 2: tailored evidence synthesis approaches are required to answer diverse questions: a pragmatic evidence synthesis toolkit from JBI","volume":"150","author":"Aromataris","year":"2022","journal-title":"J Clin Epidemiol"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"ED000142","DOI":"10.1002\/14651858.ED000142","article-title":"Updated guidance for trusted systematic reviews: a new edition of the Cochrane handbook for systematic reviews of interventions","volume":"10","author":"Cumpston","year":"2019","journal-title":"Cochrane Database Syst Rev"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"e18715303297819","DOI":"10.2174\/0118715303297819240826065755","article-title":"Effectiveness of acupuncture for infertility in patients with polycystic ovary syndrome: a systematic review and network meta-analysis","volume":"26","author":"Wu","year":"2026","journal-title":"Endocr Metab Immune Disord Drug Targets"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"e250108","DOI":"10.1530\/REP-25-0108","article-title":"Polycystic ovary syndrome: origins and implications: maternal complications of pregnancy in polycystic ovary syndrome","volume":"170","author":"Wegrzynowicz","year":"2025","journal-title":"Reproduction"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"459","DOI":"10.3390\/cells10020459","article-title":"Estrogen receptors in polycystic ovary syndrome","volume":"10","author":"Xu","year":"2021","journal-title":"Cells"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"1661806","DOI":"10.3389\/fphar.2025.1661806","article-title":"Research progress on the pathogenesis, clinical impact, and traditional Chinese medicine treatment of polycystic ovary syndrome complicated by insulin resistance","volume":"16","author":"Sun","year":"2025","journal-title":"Front Pharmacol"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"j5024","DOI":"10.1136\/bmj.j5024","article-title":"Coffee consumption and health: umbrella review of meta-analyses of multiple health outcomes","volume":"359","author":"Poole","year":"2017","journal-title":"BMJ"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1186\/1471-2288-7-10","article-title":"Development of AMSTAR: a measurement tool to assess the methodological quality of systematic reviews","volume":"7","author":"Shea","year":"2007","journal-title":"BMC Med Res Methodol"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1016\/j.jclinepi.2010.04.026","article-title":"GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables","volume":"64","author":"Guyatt","year":"2011","journal-title":"J Clin Epidemiol"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"1212","DOI":"10.16448\/j.cjtcm.2016.0428","article-title":"Meta-analysis of integrated traditional Chinese and Western medicine in the treatment of infertility caused by polycystic ovary syndrome","volume":"28","author":"Shu","year":"2016","journal-title":"Chin Med Clin J"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"1032","DOI":"10.31083\/j.ceog4805166","article-title":"The effects of Chinese herbal medicine on the pregnancy outcomes of infertile women with polycystic ovary syndrome undergoing in vitro fertilization-embryo transfer: a systematic review and meta-analysis","volume":"48","author":"Liu","year":"2021","journal-title":"Clin Exp Obstet Gynecol"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"271","DOI":"10.21203\/rs.3.rs-1038721\/v1","article-title":"Treatment of polycystic ovary syndrome-related infertility using a combination of compound Xuanju capsules and hormones: a meta-analysis","volume":"29","author":"Ma","year":"2023","journal-title":"Altern Ther Health Med"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"352","DOI":"10.21037\/apm-21-3638","article-title":"Clinical efficacy and safety of the Jinfeng pill in the adjuvant treatment of infertility in patients with polycystic ovary syndrome: a systematic review and meta-analysis of randomized controlled trial","volume":"11","author":"Xu","year":"2022","journal-title":"Ann Palliative Med"},{"key":"ref33","first-page":"1417","article-title":"Meta-analysis of the therapeutic effect of traditional Chinese medicine \"adjusting the cycle\" on infertility caused by PCOS","volume":"23","author":"Jie","year":"2017","journal-title":"Zhongguo Zhong Yi Ji Chu Yi Xue Za Zhi"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"3037","DOI":"10.7501\/j.issn.0253-2670.2021.10.021","article-title":"A systematic review on the efficacy and safety of the kidney-regulating and meridian-adjusting therapy in treating infertility caused by polycystic ovary syndrome","volume":"52","author":"Jing","year":"2021","journal-title":"Chinese Traditional and Herbal Drugs"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"775","DOI":"10.3969\/j.issn.1004-3845.2024.06.012","article-title":"Meta-analysis of the treatment of polycystic ovary syndrome infertility with Dingkundan combined with Western medicine","volume":"33","author":"Kefan","year":"2024","journal-title":"Reproduct Med J"},{"key":"ref36","first-page":"465","article-title":"Meta-analysis of compound Xuanju capsules in treating infertility in patients with polycystic ovary syndrome","volume":"32","author":"Xiu","year":"2020","journal-title":"Chin Med Clin J"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"431","DOI":"10.7507\/1672-2531.202009166","article-title":"Systematic review on the effectiveness of acupuncture in treating infertility caused by polycystic ovary syndrome","volume":"21","author":"Shouqiang","year":"2021","journal-title":"Chin J Evid Based Med"},{"key":"ref38","first-page":"59","article-title":"Systematic review of Kuntai capsule in the treatment of infertility caused by polycystic ovary syndrome","volume":"42","author":"Ying","year":"2019","journal-title":"Guangxi Tradit Chin Med"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"181","DOI":"10.13457\/j.cnki.jncm.2024.22.035","article-title":"Meta-analysis of the treatment of polycystic ovary syndrome infertility with traditional Chinese medicine cycle therapy combined with ovulation induction regimen","volume":"56","author":"Huimin","year":"2024","journal-title":"New Tradit Chin Med"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"134","DOI":"10.16808\/j.cnki.issn1003-7705.2017.03.062","article-title":"Meta-analysis of the treatment of polycystic ovary syndrome infertility with integrated traditional Chinese and Western medicine","volume":"33","author":"Nan","year":"2017","journal-title":"Hunan J Tradit Chin Med"},{"key":"ref41","first-page":"53","article-title":"Meta-analysis of the therapeutic effect of traditional Chinese medicine for kidney-tonifying and blood-activating combined with letrozole in the treatment of PCOS-induced infertility","volume":"30","author":"Nan","year":"2021","journal-title":"Chin Ethn Folk Med"},{"key":"ref42","author":"Haiyan","year":"2019"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"2141","DOI":"10.3969\/j.issn.1004-7484(x).2013.04.635","article-title":"Meta-analysis of the treatment of polycystic ovary syndrome infertility with integrated traditional Chinese and Western medicine","author":"W","year":"2013","journal-title":"Chin Health Nutr"},{"key":"ref44","first-page":"145","article-title":"Meta-analysis of traditional Chinese medicine for kidney-tonifying and blood-activating in the treatment of infertility caused by polycystic ovary syndrome","volume":"16","author":"Xu","year":"2018","journal-title":"Modern Distance Education of Traditional Chinese Medicine in China"},{"key":"ref45","author":"Zhu","year":"2022"},{"key":"ref46","author":"Ting","year":"2022"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"130","DOI":"10.3969\/j.issn.1674-7860.2022.28.034","article-title":"Meta-analysis of traditional Chinese medicine in the treatment of infertility caused by polycystic ovary syndrome (kidney Yang deficiency syndrome)","volume":"14","author":"Shuai","year":"2022","journal-title":"Clin Res TCM"},{"key":"ref48","first-page":"800","article-title":"Systematic review of compound Xuanju capsules in the treatment of infertility caused by polycystic ovary syndrome","volume":"6","author":"Kunyan","year":"2014","journal-title":"Chin J Tradit Med"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"e1558","DOI":"10.1002\/wsbm.1558","article-title":"Hyperandrogenism and polycystic ovary syndrome: effects in pregnancy and offspring development","volume":"14","author":"Abruzzese","year":"2022","journal-title":"WIREs Mech Dis"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1186\/s12958-023-01159-6","article-title":"A review of nitric oxide and oxidative stress in typical ovulatory women and in the pathogenesis of ovulatory dysfunction in PCOS","volume":"21","author":"Awonuga","year":"2023","journal-title":"Reprod Biol Endocrinol"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"e2695","DOI":"10.1210\/clinem\/dgaa285","article-title":"Obesity, polycystic ovary syndrome, and infertility: a new avenue for GLP-1 receptor agonists","volume":"105","author":"Cena","year":"2020","journal-title":"J Clin Endocrinol Metab"},{"key":"ref52","doi-asserted-by":"publisher","first-page":"1705","DOI":"10.3390\/biomedicines10071705","article-title":"Sex steroid receptors in polycystic ovary syndrome and endometriosis: insights from laboratory studies to clinical trials","volume":"10","author":"Abdul Hamid","year":"2022","journal-title":"Biomedicine"},{"key":"ref53","doi-asserted-by":"publisher","first-page":"956772","DOI":"10.3389\/fendo.2023.956772","article-title":"Effects of TCM on polycystic ovary syndrome and its cellular endocrine mechanism","volume":"14","author":"Chen","year":"2023","journal-title":"Front Endocrinol (Lausanne)"},{"key":"ref54","doi-asserted-by":"publisher","first-page":"5869","DOI":"10.1002\/fsn3.2523","article-title":"Female infertility and herbal medicine: an overview of the new findings","volume":"9","author":"Akbaribazm","year":"2021","journal-title":"Food Sci Nutr"},{"key":"ref55","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1186\/s12958-021-00802-4","article-title":"Research progress of endometrial receptivity in patients with polycystic ovary syndrome: a systematic review","volume":"19","author":"Bai","year":"2021","journal-title":"Reprod Biol Endocrinol"},{"key":"ref56","doi-asserted-by":"publisher","first-page":"2872","DOI":"10.3390\/ijms22062872","article-title":"Therapeutic potentials of low-dose tacrolimus for aberrant endometrial features in polycystic ovary syndrome","volume":"22","author":"Albaghdadi","year":"2021","journal-title":"Int J Mol Sci"},{"key":"ref57","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1186\/s13048-025-01638-x","article-title":"Enhancing understanding of endometrial function in patients with PCOS: clinical and immunological insights","volume":"18","author":"Guo","year":"2025","journal-title":"J Ovarian Res"},{"key":"ref58","doi-asserted-by":"publisher","first-page":"R81","DOI":"10.1530\/JME-21-0238","article-title":"Female reproductive dysfunctions and the gut microbiota","volume":"69","author":"Chadchan","year":"2022","journal-title":"J Mol Endocrinol"},{"key":"ref59","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1186\/s13048-023-01331-x","article-title":"Association between maternal polycystic ovarian syndrome undergoing assisted reproductive technology and pregnancy complications and neonatal outcomes: a systematic review and meta-analysis","volume":"17","author":"Ban","year":"2024","journal-title":"J Ovarian Res"},{"key":"ref60","doi-asserted-by":"publisher","first-page":"935","DOI":"10.1016\/j.jmpt.2025.10.059","article-title":"Meta-analysis of the effects of acupuncture combined with letrozole on ovulation induction and pregnancy outcomes in patients with polycystic ovary syndrome","volume":"48","author":"He","year":"2025","journal-title":"J Manip Physiol Ther"},{"key":"ref61","doi-asserted-by":"publisher","first-page":"123221","DOI":"10.1016\/j.lfs.2024.123221","article-title":"Polycystic ovary syndrome: recent research and therapeutic advancements","volume":"359","author":"Dilliyappan","year":"2024","journal-title":"Life Sci"},{"key":"ref62","doi-asserted-by":"publisher","first-page":"1358755","DOI":"10.3389\/fcell.2024.1358755","article-title":"PCOS stratification for precision diagnostics and treatment","volume":"12","author":"Joshi","year":"2024","journal-title":"Front Cell Dev Biol"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1877844\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T05:31:33Z","timestamp":1785994293000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1877844\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,6]]},"references-count":62,"alternative-id":["10.3389\/fmed.2026.1877844"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1877844","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,6]]},"article-number":"1877844"}}