{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T06:15:10Z","timestamp":1783318510754,"version":"3.54.6"},"reference-count":71,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"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. Pediatr."],"abstract":"<jats:p>Osteopetrosis is a heterogeneous group of inherited bone disorders, where increased bone density and brittleness are associated with pathological fractures and osseous deformities. Treating patients with osteopetrosis is a significant challenge for orthopaedic surgeons. Altered bone characteristics affect the surgical care of fractures and impending fractures and complicate the correction of deformities, non-union and malunion. This review aims to summarise the existing literature on osteopetrosis and guide orthopaedic surgeons wishing to establish treatment protocols for paediatric patients.<\/jats:p>","DOI":"10.3389\/fped.2026.1846893","type":"journal-article","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T05:36:54Z","timestamp":1783316214000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The orthopaedic management of osteopetrosis in paediatric populations: a narrative review of the literature"],"prefix":"10.3389","volume":"14","author":[{"given":"Antoine","family":"Chemtob","sequence":"first","affiliation":[{"name":"Faculty of Medicine, University of Geneva","place":["Geneva, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elio","family":"Paris","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Geneva","place":["Geneva, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giacomo","family":"De Marco","sequence":"additional","affiliation":[{"name":"Paediatric Orthopaedics Unit, Paediatric Surgery Service, Geneva University Hospitals","place":["Geneva, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oscar","family":"Vazquez","sequence":"additional","affiliation":[{"name":"Paediatric Orthopaedics Unit, Paediatric Surgery Service, Geneva University Hospitals","place":["Geneva, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Steiger","sequence":"additional","affiliation":[{"name":"Paediatric Orthopaedics Unit, Paediatric Surgery Service, Geneva University Hospitals","place":["Geneva, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sana","family":"Boudabbous","sequence":"additional","affiliation":[{"name":"Radiology Department, Geneva University Hospitals","place":["Geneva, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romain","family":"Dayer","sequence":"additional","affiliation":[{"name":"Paediatric Orthopaedics Unit, Paediatric Surgery Service, Geneva University Hospitals","place":["Geneva, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitri","family":"Ceroni","sequence":"additional","affiliation":[{"name":"Paediatric Orthopaedics Unit, Paediatric Surgery Service, Geneva University Hospitals","place":["Geneva, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,6]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"110206","DOI":"10.1016\/j.ijscr.2024.110206","article-title":"Malignant osteopetrosis of infancy: a case report","volume":"123","author":"Avijgan","year":"2024","journal-title":"Int J Surg Case Rep"},{"key":"B2","doi-asserted-by":"publisher","first-page":"e21648","DOI":"10.1097\/MD.0000000000021648","article-title":"Intramedullary nailing for subtrochanteric fracture in autosomal dominant type II osteopetrosis: case report of 2 patients","volume":"99","author":"Kim","year":"2020","journal-title":"Medicine (Baltimore)"},{"key":"B3","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1186\/1750-1172-4-5","article-title":"Osteopetrosis","volume":"4","author":"Stark","year":"2009","journal-title":"Orphanet J Rare Dis"},{"key":"B4","doi-asserted-by":"publisher","first-page":"717","DOI":"10.5005\/jp-journals-10005-1835","article-title":"A rare case of osteoclast-poor osteopetrosis (RANKL mutation) with recurrent osteomyelitis of mandible: a case report","volume":"13","author":"Sharma","year":"2020","journal-title":"Int J Clin Pediatr Dent"},{"key":"B5","doi-asserted-by":"publisher","first-page":"30","DOI":"10.11604\/pamj.2022.43.30.36827","article-title":"Malignant infantile osteopetrosis in a 3-year-old Yemeni child: a case report","volume":"43","author":"Thabet","year":"2022","journal-title":"Pan Afr Med J"},{"key":"B6","doi-asserted-by":"publisher","first-page":"e6725","DOI":"10.7759\/cureus.6725","article-title":"Malignant infantile osteopetrosis: a case report","volume":"12","author":"Bubshait","year":"2020","journal-title":"Cureus"},{"key":"B7","doi-asserted-by":"publisher","first-page":"522","DOI":"10.1038\/nrendo.2013.137","article-title":"Osteopetrosis: genetics, treatment and new insights into osteoclast function","volume":"9","author":"Sobacchi","year":"2013","journal-title":"Nat Rev Endocrinol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1016\/j.bone.2007.08.029","article-title":"Genetics, pathogenesis and complications of osteopetrosis","volume":"42","author":"Del Fattore","year":"2008","journal-title":"Bone"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1047","DOI":"10.1007\/s00198-015-3320-x","article-title":"Novel mutations of CLCN7 cause autosomal dominant osteopetrosis type II (ADO-II) and intermediate autosomal recessive osteopetrosis (IARO) in Chinese patients","volume":"27","author":"Pang","year":"2016","journal-title":"Osteoporos Int"},{"key":"B10","doi-asserted-by":"publisher","first-page":"912","DOI":"10.2106\/00004623-198264060-00016","article-title":"Osteopetrosis. A morphological study of twenty-one cases","volume":"64","author":"Milgram","year":"1982","journal-title":"J Bone Joint Surg Am"},{"key":"B11","first-page":"365","article-title":"Rntgenbilder einer seltenen knochenkrankung","volume":"51","author":"Albers-Schonberg","year":"1904","journal-title":"M\u00fcnch Med Wochenschr"},{"key":"B12","article-title":"\u00dcber drei f\u00e4lle einer seltenen skeletterkrankung (marmorknochen nach albers-sch\u00f6nberg)","volume-title":"Festschrift dem Eppendorfer Krankenhause zur Feier Seines 25-j\u00e4hrigen Bestehens","author":"Sick","year":"1914"},{"key":"B13","first-page":"232","article-title":"Report of a case of so-called \u201cmarble bones\u201d with a review of the literature","volume":"10","author":"Alexander","year":"1923","journal-title":"Am J Roentgenol Radium Ther"},{"key":"B14","first-page":"405","article-title":"Osteopetrosis","volume":"16","author":"Karshner","year":"1926","journal-title":"Am J Roentgenol Radium Ther"},{"key":"B15","first-page":"1143","article-title":"Osteopetrosis (\u201cmarble bones\u201d)","volume":"52","author":"Wortis","year":"1936","journal-title":"Am J Dis Children"},{"key":"B16","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1136\/adc.13.74.161","article-title":"Osteopetrosis","volume":"13","author":"Nussey","year":"1938","journal-title":"Arch Dis Child"},{"key":"B17","doi-asserted-by":"publisher","first-page":"116737","DOI":"10.1016\/j.bone.2023.116737","article-title":"Osteopetrosis: discovery and early history of \u201cmarble bone disease\u201d","volume":"171","author":"Whyte","year":"2023","journal-title":"Bone"},{"key":"B18","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1136\/adc.40.209.7","article-title":"Studies in osteopetrosis","volume":"40","author":"Dent","year":"1965","journal-title":"Arch Dis Child"},{"key":"B19","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1016\/j.abb.2008.03.027","article-title":"Osteoclast-osteoblast communication","volume":"473","author":"Matsuo","year":"2008","journal-title":"Arch Biochem Biophys"},{"key":"B20","doi-asserted-by":"publisher","first-page":"308","DOI":"10.1177\/0004563218759371","article-title":"The bone remodelling cycle","volume":"55","author":"Kenkre","year":"2018","journal-title":"Ann Clin Biochem"},{"key":"B21","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1359\/jbmr.2000.15.2.352","article-title":"Study of the nonresorptive phenotype of osteoclast-like cells from patients with malignant osteopetrosis: a new approach to investigating pathogenesis","volume":"15","author":"Flanagan","year":"2000","journal-title":"J Bone Miner Res"},{"key":"B22","doi-asserted-by":"publisher","first-page":"514","DOI":"10.1002\/jemt.10375","article-title":"Osteoclast diseases","volume":"61","author":"Helfrich","year":"2003","journal-title":"Microsc Res Tech"},{"key":"B23","first-page":"222","article-title":"Osteopetrosis","volume":"32","author":"Kocher","year":"2003","journal-title":"Am J Orthop (Belle Mead NJ)"},{"key":"B24","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1007\/s00223-005-0027-6","article-title":"A clinical and molecular overview of the human osteopetroses","volume":"77","author":"Balemans","year":"2005","journal-title":"Calcif Tissue Int"},{"key":"B25","doi-asserted-by":"publisher","first-page":"342","DOI":"10.1002\/jbmr.559","article-title":"RANK-dependent autosomal recessive osteopetrosis: characterization of five new cases with novel mutations","volume":"27","author":"Pangrazio","year":"2012","journal-title":"J Bone Miner Res"},{"key":"B26","doi-asserted-by":"publisher","first-page":"2861","DOI":"10.1093\/hmg\/10.25.2861","article-title":"Albers-Sch\u00f6nberg disease (autosomal dominant osteopetrosis, type II) results from mutations in the ClCN7 chloride channel gene","volume":"10","author":"Cleiren","year":"2001","journal-title":"Hum Mol Genet"},{"key":"B27","doi-asserted-by":"publisher","first-page":"1726","DOI":"10.1210\/clinem\/dgae040","article-title":"Autosomal dominant osteopetrosis (ADO) caused by a missense variant in the TCIRG1 gene","volume":"109","author":"Jodeh","year":"2024","journal-title":"J Clin Endocrinol Metab"},{"key":"B28","doi-asserted-by":"publisher","first-page":"1036","DOI":"10.2174\/1573405617666210129111339","article-title":"An extremely rare, atypical and genetically-undetermined form of osteopetrosis","volume":"17","author":"Tetta","year":"2021","journal-title":"Curr Med Imaging"},{"key":"B29","doi-asserted-by":"publisher","first-page":"2839","DOI":"10.1056\/NEJMra040952","article-title":"Osteopetrosis","volume":"351","author":"Tolar","year":"2004","journal-title":"N Engl J Med"},{"key":"B30","doi-asserted-by":"publisher","first-page":"771","DOI":"10.1210\/jc.2006-1986","article-title":"Autosomal dominant osteopetrosis: clinical severity and natural history of 94 subjects with a chloride channel 7 gene mutation","volume":"92","author":"Waguespack","year":"2007","journal-title":"J Clin Endocrinol Metab"},{"key":"B31","doi-asserted-by":"publisher","first-page":"216","DOI":"10.1002\/ajmg.a.30490","article-title":"Intrafamilial phenotypic variability of osteopetrosis due to chloride channel 7 (CLCN7) mutations","author":"Campos-Xavier","year":"2005","journal-title":"Am J Med Genet A"},{"key":"B32","doi-asserted-by":"publisher","first-page":"116723","DOI":"10.1016\/j.bone.2023.116723","article-title":"Autosomal dominant osteopetrosis","volume":"170","author":"Polgreen","year":"2023","journal-title":"Bone"},{"key":"B33","doi-asserted-by":"publisher","first-page":"63","DOI":"10.11604\/pamj.2014.17.63.3759","article-title":"Malignant infantile osteopetrosis: case report with review of literature","volume":"17","author":"Essabar","year":"2014","journal-title":"Pan Afr Med J"},{"key":"B34","doi-asserted-by":"publisher","first-page":"103","DOI":"10.3171\/PED-08\/01\/103","article-title":"Patients with autosomal-recessive osteopetrosis presenting with hydrocephalus and hindbrain posterior fossa crowding","volume":"1","author":"Al-Tamimi","year":"2008","journal-title":"J Neurosurg Pediatr"},{"key":"B35","doi-asserted-by":"publisher","first-page":"689","DOI":"10.1001\/archotol.124.6.689","article-title":"Malignant infantile osteopetrosis: otolaryngological complications and management","volume":"124","author":"Stocks","year":"1998","journal-title":"Arch Otolaryngol Head Neck Surg"},{"key":"B36","doi-asserted-by":"publisher","first-page":"116577","DOI":"10.1016\/j.bone.2022.116577","article-title":"Phenotype-autosomal recessive osteopetrosis","volume":"165","author":"Pillai","year":"2022","journal-title":"Bone"},{"key":"B37","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1542\/peds.93.2.247","article-title":"Autosomal recessive osteopetrosis: variability of findings at diagnosis and during the natural course","volume":"93","author":"Gerritsen","year":"1994","journal-title":"Pediatrics"},{"key":"B38","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1007\/s00277-002-0578-9","article-title":"Malignant infantile osteopetrosis initially presenting with neonatal hypocalcemia: case report","volume":"82","author":"Chen","year":"2003","journal-title":"Ann Hematol"},{"key":"B39","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1055\/s-2002-36728","article-title":"Osteopetrosis","volume":"6","author":"Stoker","year":"2002","journal-title":"Semin Musculoskelet Radiol"},{"key":"B40","doi-asserted-by":"publisher","first-page":"1965","DOI":"10.3390\/genes13111965","article-title":"Spectrum of skeletal imaging features in osteopetrosis: inheritance pattern and radiological associations","volume":"13","author":"Spinnato","year":"2022","journal-title":"Genes (Basel)"},{"key":"B41","doi-asserted-by":"publisher","first-page":"116560","DOI":"10.1016\/j.bone.2022.116560","article-title":"Imaging in osteopetrosis","volume":"165","author":"Calder","year":"2022","journal-title":"Bone"},{"key":"B42","doi-asserted-by":"publisher","first-page":"1733","DOI":"10.1007\/s00247-015-3381-1","article-title":"A review of imaging protocols for suspected skeletal dysplasia and a proposal for standardisation","volume":"45","author":"Watson","year":"2015","journal-title":"Pediatr Radiol"},{"key":"B43","doi-asserted-by":"publisher","first-page":"656","DOI":"10.1111\/ocr.12782","article-title":"Pycnodysostosis: characteristics of teeth, mouth and jaws","volume":"27","author":"Ferlias","year":"2024","journal-title":"Orthod Craniofac Res"},{"key":"B44","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1016\/s0009-9260(03)00337-4","article-title":"Bone within a bone","volume":"59","author":"Williams","year":"2004","journal-title":"Clin Radiol"},{"key":"B45","doi-asserted-by":"publisher","first-page":"654","DOI":"10.5435\/00124635-200711000-00004","article-title":"Orthopaedic management of the patient with osteopetrosis","volume":"15","author":"Landa","year":"2007","journal-title":"J Am Acad Orthop Surg"},{"key":"B46","doi-asserted-by":"publisher","first-page":"3111","DOI":"10.1210\/jc.2017-01127","article-title":"Diagnosis and management of osteopetrosis: consensus guidelines from the osteopetrosis working group","volume":"102","author":"Wu","year":"2017","journal-title":"J Clin Endocrinol Metab"},{"key":"B47","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1186\/s40246-015-0031-5","article-title":"Clinical application of next-generation sequencing for Mendelian diseases","volume":"9","author":"Jamuar","year":"2015","journal-title":"Hum Genomics"},{"key":"B48","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1007\/s11914-018-0415-2","article-title":"Genetics of osteopetrosis","volume":"16","author":"Palagano","year":"2018","journal-title":"Curr Osteoporos Rep"},{"key":"B49","doi-asserted-by":"publisher","first-page":"110","DOI":"10.3109\/17453678909150106","article-title":"Fracture patterns in two types of autosomal-dominant osteopetrosis","volume":"60","author":"Bollerslev","year":"1989","journal-title":"Acta Orthop Scand"},{"key":"B50","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1007\/BF00443478","article-title":"Fracture patterns in malignant osteopetrosis (albers-sch\u00f6nberg disease)","volume":"111","author":"Dahl","year":"1992","journal-title":"Arch Orthop Trauma Surg"},{"key":"B51","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1530\/eje.0.1340143","article-title":"Recent developments in the understanding of the pathophysiology of osteopetrosis","volume":"134","author":"Felix","year":"1996","journal-title":"Eur J Endocrinol"},{"key":"B52","doi-asserted-by":"publisher","first-page":"1167","DOI":"10.1016\/j.injury.2009.02.009","article-title":"Challenges in the management of fractures in osteopetrosis\u201d! review of literature and technical tips learned from long-term management of seven patients","volume":"40","author":"Bhargava","year":"2009","journal-title":"Injury"},{"key":"B53","doi-asserted-by":"publisher","first-page":"399","DOI":"10.3389\/fendo.2020.00399","article-title":"A clinical perspective on advanced developments in bone biopsy assessment in rare bone disorders","volume":"11","author":"Treurniet","year":"2020","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B54","doi-asserted-by":"publisher","first-page":"155","DOI":"10.5005\/jp-journals-10080-1424","article-title":"Intramedullary canal-creation technique for patients with osteopetrosis","volume":"14","author":"Kent","year":"2019","journal-title":"Strateg Trauma Limb Reconstr"},{"key":"B55","doi-asserted-by":"publisher","first-page":"111592","DOI":"10.1016\/j.ijscr.2025.111592","article-title":"Treatment of subtrochantric femur fracture with intra-medullary nailing (IMN) in a patient with osteopetrosis: a case report and literature review","volume":"133","author":"Alajlan","year":"2025","journal-title":"Int J Surg Case Rep"},{"key":"B56","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1016\/j.amsu.2018.10.038","article-title":"Inheritance patterns, challenges, and outcomes of fracture management in osteopetrosis patients. CASE series and review of pertinent literature","volume":"36","author":"Hasan","year":"2018","journal-title":"Ann Med Surg (Lond)"},{"key":"B57","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1097\/01241398-199901000-00026","article-title":"Orthopedic management of osteopetrosis: results of a survey and review of the literature","volume":"19","author":"Armstrong","year":"1999","journal-title":"J Pediatr Orthop"},{"key":"B58","doi-asserted-by":"publisher","first-page":"308","DOI":"10.12688\/f1000research.161715.1","article-title":"Osteopetrosis and fracture: planning and management","volume":"14","author":"Chabchoub","year":"2025","journal-title":"F1000Res"},{"key":"B59","doi-asserted-by":"publisher","first-page":"565","DOI":"10.1016\/j.injury.2019.11.032","article-title":"Open reduction and internal fixation using a locking compression plate as treatment for subtrochanteric fracture in two patients with osteopetrosis","volume":"51","author":"Hiyama","year":"2020","journal-title":"Injury"},{"key":"B60","doi-asserted-by":"publisher","first-page":"64","DOI":"10.5704\/MOJ.1703.007","article-title":"Use of an industrial tungsten carbide drill in the treatment of a Complex fracture in a patient with severe osteopetrosis: a case report","volume":"11","author":"Kunnasegaran","year":"2017","journal-title":"Malays Orthop J"},{"key":"B61","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1007\/s12306-012-0222-3","article-title":"Simple reproducible technique in treatment for osteopetrotic fractures","volume":"97","author":"Sen","year":"2013","journal-title":"Musculoskelet Surg"},{"key":"B62","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1007\/s00402-014-2144-z","article-title":"Recommendations for fracture management in patients with osteopetrosis: case report","volume":"135","author":"Farf\u00e1n","year":"2015","journal-title":"Arch Orthop Trauma Surg"},{"key":"B63","first-page":"488","article-title":"Fracture management in osteopetrosis\u202f: an intriguing Enigma A guide for surgeons","volume":"83","author":"Dawar","year":"2017","journal-title":"Acta Orthop Belg"},{"key":"B64","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1016\/j.clinbiomech.2011.10.010","article-title":"Cortical bone drilling and thermal osteonecrosis","volume":"27","author":"Augustin","year":"2012","journal-title":"Clin Biomech (Bristol)"},{"key":"B65","first-page":"186","article-title":"Heat generation during implant site preparation: an in vitro study","volume":"12","author":"Cordioli","year":"1997","journal-title":"Int J Oral Maxillofac Implants"},{"key":"B66","doi-asserted-by":"publisher","first-page":"5271","DOI":"10.3390\/ma16155271","article-title":"Influence of multiple used implant drills on their cutting performance and fracture resistance","volume":"16","author":"Alevizakos","year":"2023","journal-title":"Materials (Basel)"},{"key":"B67","first-page":"1","article-title":"Heat and bone tissue. An experimental investigation of the thermal properties of bone and threshold levels for thermal injury","volume":"9","author":"Lundskog","year":"1972","journal-title":"Scand J Plast Reconstr Surg"},{"key":"B68","doi-asserted-by":"publisher","first-page":"657","DOI":"10.1038\/sj.bmt.1704194","article-title":"Long-term outcome of haematopoietic stem cell transplantation in autosomal recessive osteopetrosis: an EBMT report","volume":"32","author":"Driessen","year":"2003","journal-title":"Bone Marrow Transplant"},{"key":"B69","doi-asserted-by":"publisher","first-page":"116634","DOI":"10.1016\/j.bone.2022.116634","article-title":"Hematopoietic stem cell transplantation, a curative approach in infantile osteopetrosis","volume":"167","author":"Schulz","year":"2023","journal-title":"Bone"},{"key":"B70","doi-asserted-by":"publisher","first-page":"1594","DOI":"10.1056\/NEJM199506153322402","article-title":"Long-term treatment of osteopetrosis with recombinant human interferon gamma","volume":"332","author":"Key","year":"1995","journal-title":"N Engl J Med"},{"key":"B71","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1016\/j.bone.2017.02.002","article-title":"Osteopetroses, emphasizing potential approaches to treatment","volume":"102","author":"Teti","year":"2017","journal-title":"Bone"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2026.1846893\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T05:36:56Z","timestamp":1783316216000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2026.1846893\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,6]]},"references-count":71,"alternative-id":["10.3389\/fped.2026.1846893"],"URL":"https:\/\/doi.org\/10.3389\/fped.2026.1846893","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,6]]},"article-number":"1846893"}}