{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T15:44:16Z","timestamp":1785426256915,"version":"3.56.0"},"reference-count":61,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T00:00:00Z","timestamp":1748476800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004731","name":"Natural Science Foundation of Zhejiang Province","doi-asserted-by":"publisher","award":["LHZQN25C010004"],"award-info":[{"award-number":["LHZQN25C010004"]}],"id":[{"id":"10.13039\/501100004731","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Microbiol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Exercise therapy can reduce insulin resistance during pregnancy and improve glucose tolerance in women with gestational diabetes mellitus (GDM), leading to better pregnancy outcomes. This study aimed to investigate the effects of different exercise levels on GDM from the perspective of gut microbiota.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Ninety patients with GDM were enrolled and divided into two groups: the L (<jats:italic>n<\/jats:italic>\u202f=\u202f50) and the M (<jats:italic>n<\/jats:italic>\u202f=\u202f40) groups. The L group performed 150\u202fmin of aerobic exercise per week, while the M group exercised for 200\u202fmin per week. After 8\u202fweeks of intervention, fecal samples from each subject were collected for 16S rRNA gene sequencing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Different exercise levels significantly affected membrane rupture and gestational weight gain in GDM patients (<jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.05), but these effects were not significantly correlated by logistic regression analysis (<jats:italic>p<\/jats:italic>\u202f&amp;gt;\u202f0.05). After sequencing, 4,712 OTUs and 3,483 OTUs were identified in the M and L groups, respectively, with 2,643 OTUs overlapping between both groups. Compared to the L group, the \u03b1-diversity in the M group was significantly increased (<jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.05). The dominant phyla were <jats:italic>Firmicutes<\/jats:italic>, <jats:italic>Actinobacteriota<\/jats:italic>, and <jats:italic>Bacteroidota<\/jats:italic>. Compared to the L group, the M group had a significantly higher abundance of <jats:italic>Firmicutes<\/jats:italic> and a significantly lower abundance of <jats:italic>Actinobacteriota<\/jats:italic>. At the genus level, LEfSe analysis revealed that moderate-intensity exercise increased the levels of <jats:italic>Faecalibacterium<\/jats:italic>, <jats:italic>Agathobacter<\/jats:italic>, <jats:italic>Roseburia<\/jats:italic>, and <jats:italic>Osillospira<\/jats:italic>, but decreased the abundance of <jats:italic>Bifidobacterium<\/jats:italic> and <jats:italic>Coprobacillus<\/jats:italic>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>There were significant differences in the composition and structure of the gut microbiota of patients with GDM with different exercise levels.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmicb.2025.1526714","type":"journal-article","created":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T05:24:10Z","timestamp":1748496250000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Increased maternal exercise of moderate intensity improves pregnancy outcomes of gestational diabetes mellitus patients through maintaining the balance of the gut microbiota"],"prefix":"10.3389","volume":"16","author":[{"given":"Mengyan","family":"Xu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinru","family":"Ye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fengcheng","family":"Cai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingying","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,5,29]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"S114","DOI":"10.2337\/dc17-S016","article-title":"Management of diabetes in pregnancy","volume":"40","year":"2017","journal-title":"Diabetes Care"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"323","DOI":"10.22122\/ijbmc.v9i4.404","article-title":"Effects of a continuous and periodic aerobic exercise rehabilitation program on depression and anxiety in hypertension patients","volume":"9","author":"Ai-Sadi","year":"2022","journal-title":"Int. J. Body Mind Cult."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"5003","DOI":"10.3390\/ijms21145003","article-title":"Gestational diabetes mellitus: a harbinger of the vicious cycle of diabetes","volume":"21","author":"Alejandro","year":"2020","journal-title":"Int. J. Mol. Sci."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"399","DOI":"10.15537\/smj.2015.4.10307","article-title":"Gestational diabetes mellitus","volume":"36","author":"Alfadhli","year":"2015","journal-title":"Saudi Med. J."},{"key":"ref5","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.1152\/japplphysiol.01077.2014","article-title":"Voluntary and forced exercise differentially alters the gut microbiome in C57BL\/6J mice","volume":"118","author":"Allen","year":"1985","journal-title":"J. Appl. Physiol."},{"key":"ref6","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1016\/j.bjpt.2018.11.005","article-title":"Exercise during pregnancy has a preventative effect on excessive maternal weight gain and gestational diabetes. A randomized controlled trial","volume":"23","author":"Barakat","year":"2019","journal-title":"Braz. J. Phys. Ther."},{"key":"ref7","doi-asserted-by":"publisher","first-page":"j1631","DOI":"10.1136\/bmj.j1631","article-title":"Obesity and pregnancy: mechanisms of short term and long term adverse consequences for mother and child","volume":"356","author":"Catalano","year":"2017","journal-title":"BMJ"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"e0267045","DOI":"10.1371\/journal.pone.0267045","article-title":"Relationship between gut microbiome characteristics and the effect of nutritional therapy on glycemic control in pregnant women with gestational diabetes mellitus","volume":"17","author":"Chen","year":"2022","journal-title":"PLoS One"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"725","DOI":"10.1289\/ehp.1306534","article-title":"Exercise attenuates PCB-induced changes in the mouse gut microbiome","volume":"121","author":"Choi","year":"2013","journal-title":"Environ. Health Perspect."},{"key":"ref10","doi-asserted-by":"publisher","first-page":"9083264","DOI":"10.1155\/2020\/9083264","article-title":"Early pregnancy screening for women at high-risk of GDM results in reduced neonatal morbidity and similar maternal outcomes to routine screening","volume":"2020","author":"Clarke","year":"2020","journal-title":"J. Pregnancy"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1128\/mSystems.00044-18","article-title":"A prospective metagenomic and Metabolomic analysis of the impact of exercise and\/or whey protein supplementation on the gut microbiome of sedentary adults","volume":"3","author":"Cronin","year":"2018","journal-title":"mSystems"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"129","DOI":"10.3390\/antiox11010129","article-title":"Gestational diabetes mellitus: the crosslink among inflammation, nitroxidative stress, intestinal microbiota and alternative therapies","volume":"11","author":"de Mendon\u00e7a","year":"2022","journal-title":"Antioxidants (Basel)"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"2315804","DOI":"10.3390\/ijerph192315804","article-title":"Evolution of gestational diabetes mellitus across continents in 21st century","volume":"19","author":"D\u0142uski","year":"2022","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"20499361211027067","DOI":"10.1177\/20499361211027067","article-title":"An exercise intervention alters stool microbiota and metabolites among older, sedentary adults","volume":"8","author":"Erlandson","year":"2021","journal-title":"Therap. Adv. Infect. Dis."},{"key":"ref15","doi-asserted-by":"publisher","first-page":"e92193","DOI":"10.1371\/journal.pone.0092193","article-title":"Exercise prevents weight gain and alters the gut microbiota in a mouse model of high fat diet-induced obesity","volume":"9","author":"Evans","year":"2014","journal-title":"PLoS One"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"13212","DOI":"10.1038\/srep13212","article-title":"The stool microbiota of insulin resistant women with recent gestational diabetes, a high risk group for type 2 diabetes","volume":"5","author":"Fugmann","year":"2015","journal-title":"Sci. Rep."},{"key":"ref17","doi-asserted-by":"publisher","first-page":"188","DOI":"10.1016\/j.jphys.2016.08.003","article-title":"Exercise improves glycaemic control in women diagnosed with gestational diabetes mellitus: a systematic review","volume":"62","author":"Harrison","year":"2016","journal-title":"J. Physiother."},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1725","DOI":"10.3390\/microorganisms11071725","article-title":"Gut microbiota and critical metabolites: potential target in preventing gestational diabetes mellitus?","volume":"11","author":"Hu","year":"2023","journal-title":"Microorganisms"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"2839","DOI":"10.3390\/ijms232112839","article-title":"Gut microbiome changes in gestational diabetes","volume":"23","author":"Ionescu","year":"2022","journal-title":"Int. J. Mol. Sci."},{"key":"ref20","doi-asserted-by":"publisher","first-page":"249517","DOI":"10.3390\/ijerph17249517","article-title":"Prevalence, prevention, and lifestyle intervention of gestational diabetes mellitus in China","volume":"17","author":"Juan","year":"2020","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1186\/s40168-023-01694-9","article-title":"Maternal microbiota communicates with the fetus through microbiota-derived extracellular vesicles","volume":"11","author":"Kaisanlahti","year":"2023","journal-title":"Microbiome"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"79","DOI":"10.2174\/187152812800392832","article-title":"Probiotics as an alternative strategy for prevention and treatment of human diseases: a review","volume":"11","author":"Khani","year":"2012","journal-title":"Inflamm. Allergy Drug Targets"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1093\/gigascience\/gix058","article-title":"Connections between the human gut microbiome and gestational diabetes mellitus","volume":"6","author":"Kuang","year":"2017","journal-title":"GigaScience"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"2528","DOI":"10.1007\/s00125-018-4736-6","article-title":"The impact of restricted gestational weight gain by dietary intervention on fetal growth in women with gestational diabetes mellitus","volume":"61","author":"Kurtzhals","year":"2018","journal-title":"Diabetologia"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"e0178150","DOI":"10.1371\/journal.pone.0178150","article-title":"Preeclampsia: a risk factor for gestational diabetes mellitus in subsequent pregnancy","volume":"12","author":"Lee","year":"2017","journal-title":"PLoS One"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"9573","DOI":"10.3390\/ijerph17249573","article-title":"Gestational diabetes: overview with emphasis on medical management","volume":"17","author":"Lende","year":"2020","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"763","DOI":"10.1530\/EJE-15-1103","article-title":"Physical activity, sedentary behaviors and risk of gestational diabetes mellitus: a population-based cross-sectional study in Tianjin, China","volume":"174","author":"Leng","year":"2016","journal-title":"Eur. J. Endocrinol."},{"key":"ref28","doi-asserted-by":"publisher","first-page":"104344","DOI":"10.1016\/j.micpath.2020.104344","article-title":"The critical role of Faecalibacterium prausnitzii in human health: an overview","volume":"149","author":"Leylabadlo","year":"2020","journal-title":"Microb. Pathog."},{"key":"ref29","doi-asserted-by":"publisher","first-page":"861","DOI":"10.4239\/wjd.v13.i10.861","article-title":"Correlation between gut microbiota and glucagon-like peptide-1 in patients with gestational diabetes mellitus","volume":"13","author":"Liang","year":"2022","journal-title":"World J. Diabetes"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"740636","DOI":"10.3389\/fphar.2021.740636","article-title":"Possible benefits of Faecalibacterium prausnitzii for obesity-associated gut disorders","volume":"12","author":"Maioli","year":"2021","journal-title":"Front. Pharmacol."},{"key":"ref31","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1093\/femsre\/fuad039","article-title":"Faecalibacterium: a bacterial genus with promising human health applications","volume":"47","author":"Mart\u00edn","year":"2023","journal-title":"FEMS Microbiol. Rev."},{"key":"ref32","doi-asserted-by":"publisher","first-page":"1214","DOI":"10.1177\/1535370217708188","article-title":"Butyrate reduces high-fat diet-induced metabolic alterations, hepatic steatosis and pancreatic beta cell and intestinal barrier dysfunctions in prediabetic mice","volume":"242","author":"Matheus","year":"2017","journal-title":"Exp. Biol. Med. (Maywood)"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"109078","DOI":"10.1016\/j.diabres.2021.109078","article-title":"Gut microbiota and gestational diabetes mellitus: a systematic review","volume":"180","author":"Medici Dualib","year":"2021","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref34","doi-asserted-by":"publisher","first-page":"676","DOI":"10.2337\/dc09-1848","article-title":"International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy","volume":"33","author":"Metzger","year":"2010","journal-title":"Diabetes Care"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"698","DOI":"10.3390\/nu10060698","article-title":"Associations of diet and physical activity with risk for gestational diabetes mellitus: a systematic review and Meta-analysis","volume":"10","author":"Mijatovic-Vukas","year":"2018","journal-title":"Nutrients"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1186\/s10020-021-00371-7","article-title":"A higher bacterial inward BCAA transport driven by Faecalibacterium prausnitzii is associated with lower serum levels of BCAA in early adolescents","volume":"27","author":"Moran-Ramos","year":"2021","journal-title":"Molecul. Med."},{"key":"ref37","first-page":"1837","article-title":"The effects of different exercise intensity on gut microbiota of female swimmers","volume":"38","author":"Pan","year":"2019","journal-title":"Genom. Appl. Biol."},{"key":"ref38","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1186\/s40168-017-0320-4","article-title":"Community characteristics of the gut microbiomes of competitive cyclists","volume":"5","author":"Petersen","year":"2017","journal-title":"Microbiome"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"3342","DOI":"10.3390\/ijms19113342","article-title":"The pathophysiology of gestational diabetes mellitus","volume":"19","author":"Plows","year":"2018","journal-title":"Int. J. Mol. Sci."},{"key":"ref40","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/19490976.2021.1894070","article-title":"The impact of the gut microbiota on the reproductive and metabolic endocrine system","volume":"13","author":"Qi","year":"2021","journal-title":"Gut Microbes"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"415","DOI":"10.1136\/gutjnl-2014-307649","article-title":"Identification of an anti-inflammatory protein from Faecalibacterium prausnitzii, a commensal bacterium deficient in Crohn's disease","volume":"65","author":"Qu\u00e9vrain","year":"2016","journal-title":"Gut"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"3050","DOI":"10.3390\/nu12103050","article-title":"Diet and healthy lifestyle in the Management of Gestational Diabetes Mellitus","volume":"12","author":"Rasmussen","year":"2020","journal-title":"Nutrients"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"e0284972","DOI":"10.1371\/journal.pone.0284972","article-title":"Intestinal permeability and peripheral immune cell composition are altered by pregnancy and adiposity at mid-and late-gestation in the mouse","volume":"18","author":"Ribeiro","year":"2023","journal-title":"PLoS One"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"Cd010443","DOI":"10.1002\/14651858.CD010443.pub3","article-title":"Combined diet and exercise interventions for preventing gestational diabetes mellitus","volume":"11","author":"Shepherd","year":"2017","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref45","doi-asserted-by":"publisher","first-page":"5677073","DOI":"10.1155\/2022\/5677073","article-title":"An investigation into the correlation of intestinal Flora with obesity and gestational diabetes mellitus","volume":"2022","author":"Song","year":"2022","journal-title":"Comput. Math. Methods Med."},{"key":"ref46","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1159\/000439413","article-title":"Gestational diabetes mellitus","volume":"31","author":"Spaight","year":"2016","journal-title":"Endocr. Dev."},{"key":"ref47","doi-asserted-by":"publisher","first-page":"763","DOI":"10.1210\/endrev\/bnac003","article-title":"A clinical update on gestational diabetes mellitus","volume":"43","author":"Sweeting","year":"2022","journal-title":"Endocr. Rev."},{"key":"ref48","doi-asserted-by":"publisher","first-page":"479","DOI":"10.1016\/j.ecl.2019.05.001","article-title":"Gestational diabetes mellitus","volume":"48","author":"Szmuilowicz","year":"2019","journal-title":"Endocrinol. Metab. Clin. N. Am."},{"key":"ref49","doi-asserted-by":"publisher","first-page":"e1373208","DOI":"10.1080\/21688370.2017.1373208","article-title":"Intestinal barrier and gut microbiota: shaping our immune responses throughout life","volume":"5","author":"Takiishi","year":"2017","journal-title":"Tissue Barr."},{"key":"ref50","doi-asserted-by":"publisher","first-page":"252","DOI":"10.1016\/j.chom.2019.07.004","article-title":"Obese individuals with and without type 2 diabetes show different gut microbial functional capacity and composition","volume":"26","author":"Thingholm","year":"2019","journal-title":"Cell Host Microbe"},{"key":"ref51","first-page":"84","article-title":"Exercise and immune system as modulators of intestinal microbiome: implications for the gut-muscle axis hypothesis","volume":"25","author":"Ticinesi","year":"2019","journal-title":"Exerc. Immunol. Rev."},{"key":"ref52","doi-asserted-by":"publisher","first-page":"2679","DOI":"10.3390\/nu13082679","article-title":"Gut microbiota and subclinical cardiovascular disease in patients with type 2 diabetes mellitus","volume":"13","author":"Tsai","year":"2021","journal-title":"Nutrients"},{"key":"ref53","doi-asserted-by":"publisher","first-page":"32","DOI":"10.61838\/kman.hn.1.1.6","article-title":"Strength exercises with blood flow restriction promotes hypotensive and hypoglycemic effects in women with mellitus type 2 diabetes?: randomized crossover study","volume":"1","author":"Wagner","year":"2023","journal-title":"Health Nexus"},{"key":"ref54","doi-asserted-by":"publisher","first-page":"e163","DOI":"10.2337\/dc16-1320","article-title":"Effect of regular exercise commenced in early pregnancy on the incidence of gestational diabetes mellitus in overweight and obese pregnant women: a randomized controlled trial","volume":"39","author":"Wang","year":"2016","journal-title":"Diabetes Care"},{"key":"ref55","doi-asserted-by":"publisher","first-page":"598672","DOI":"10.3389\/fcimb.2021.598672","article-title":"The fecal microbiota is already altered in Normoglycemic individuals who go on to have type 2 diabetes","volume":"11","author":"Wang","year":"2021","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"ref56","doi-asserted-by":"publisher","first-page":"5001","DOI":"10.1080\/14767058.2021.1874340","article-title":"Application of diversified and quantitative management model of exercise intervention in patients with gestational diabetes mellitus","volume":"35","author":"Wu","year":"2022","journal-title":"J. Matern. Fetal Neonatal Med."},{"key":"ref57","doi-asserted-by":"publisher","first-page":"e002622","DOI":"10.1136\/bmjdrc-2021-002622","article-title":"Effects of resistance exercise on blood glucose level and pregnancy outcome in patients with gestational diabetes mellitus: a randomized controlled trial","volume":"10","author":"Xie","year":"2022","journal-title":"BMJ Open Diabetes Res. Care"},{"key":"ref58","doi-asserted-by":"publisher","first-page":"224","DOI":"10.1111\/1753-0407.12986","article-title":"Faecalibacterium prausnitzii-derived microbial anti-inflammatory molecule regulates intestinal integrity in diabetes mellitus mice via modulating tight junction protein expression","volume":"12","author":"Xu","year":"2020","journal-title":"J. Diabetes"},{"key":"ref59","doi-asserted-by":"publisher","first-page":"1987783","DOI":"10.1080\/19490976.2021.1987783","article-title":"Oscillospira - a candidate for the next-generation probiotics","volume":"13","author":"Yang","year":"2021","journal-title":"Gut Microbes"},{"key":"ref60","doi-asserted-by":"publisher","first-page":"2154552","DOI":"10.1080\/19490976.2022.2154552","article-title":"Integrative metagenomic and metabolomic analyses reveal gut microbiota-derived multiple hits connected to development of gestational diabetes mellitus in humans","volume":"15","author":"Ye","year":"2023","journal-title":"Gut Microbes"},{"key":"ref61","doi-asserted-by":"publisher","first-page":"e0038223","DOI":"10.1128\/spectrum.00382-23","article-title":"The intestinal microbiota composition in early and late stages of diabetic kidney disease","volume":"11","author":"Zhang","year":"2023","journal-title":"Microbiol. Spect."}],"container-title":["Frontiers in Microbiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmicb.2025.1526714\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T05:24:11Z","timestamp":1748496251000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmicb.2025.1526714\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,29]]},"references-count":61,"alternative-id":["10.3389\/fmicb.2025.1526714"],"URL":"https:\/\/doi.org\/10.3389\/fmicb.2025.1526714","relation":{},"ISSN":["1664-302X"],"issn-type":[{"value":"1664-302X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,29]]},"article-number":"1526714"}}