A joinpoint regression analysis of Malaria epidemiological Indicators progression in Mizoram from 2000 to 2024

A joinpoint regression analysis of Malaria epidemiological Indicators progression in Mizoram from 2000 to 2024 | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article A joinpoint regression analysis of Malaria epidemiological Indicators progression in Mizoram from 2000 to 2024 Mukesh Ranjan, Samuel Vanlalruata, Vanlaldiki -, Ashutosh Singh This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7093691/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Malaria remains a persistent public health burden in Mizoram, India, which accounts for a disproportionately high share of national cases. This study employs Joinpoint Regression Analysis to examine the temporal trends in key malaria epidemiological indicators—API, ABER, Pf%, SFR, SPR, total cases, and malarial deaths—from 2000 to 2024 across nine districts of Mizoram. The analysis identifies statistically significant shifts in malaria trends and quantifies the Annual Percent Change (APC) and Average Annual Percent Change (AAPC) to assess intervention impact and surveillance dynamics. Results show substantial heterogeneity: districts like Aizawl East, Kolasib, and Serchhip exhibited marked declines in Pf cases, API, and mortality, while others like Champhai and Saiha experienced recent upsurges or fluctuating trends. Declines in ABER until 2010 followed by resurgence indicate evolving diagnostic strategies. Despite national elimination initiatives, border proximity, terrain, and sociocultural factors contribute to transmission persistence in specific districts. The study underscores the need for district-specific strategies, improved surveillance, and cross-border coordination. Joinpoint analysis proves valuable in detecting epidemiological shifts that basic models may overlook. The findings offer actionable insights for optimizing malaria control efforts and accelerating elimination in Mizoram and similar high-risk, ecologically complex regions. Annual Percent Change Average Annual Percent Change ABER percent pf API Malarial deaths SPR SFR Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7093691","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":554893800,"identity":"a6074b58-2e4a-43d7-8406-0326e8345b6a","order_by":0,"name":"Mukesh Ranjan","email":"data:image/png;base64,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","orcid":"","institution":"Mizoram University","correspondingAuthor":true,"prefix":"","firstName":"Mukesh","middleName":"","lastName":"Ranjan","suffix":""},{"id":554893802,"identity":"f4c06512-b9ba-4ac7-8f62-16485409fdf1","order_by":1,"name":"Samuel Vanlalruata","email":"","orcid":"","institution":"Mizoram University","correspondingAuthor":false,"prefix":"","firstName":"Samuel","middleName":"","lastName":"Vanlalruata","suffix":""},{"id":554893803,"identity":"22ed46ac-5c47-4ba8-9513-e5b144b0a67d","order_by":2,"name":"Vanlaldiki -","email":"","orcid":"","institution":"Mizoram University","correspondingAuthor":false,"prefix":"","firstName":"Vanlaldiki","middleName":"","lastName":"-","suffix":""},{"id":554893804,"identity":"4091f569-6188-400f-9060-2112a8e4d3d0","order_by":3,"name":"Ashutosh Singh","email":"","orcid":"","institution":"HNB Garhwal University","correspondingAuthor":false,"prefix":"","firstName":"Ashutosh","middleName":"","lastName":"Singh","suffix":""}],"badges":[],"createdAt":"2025-07-10 13:53:10","currentVersionCode":1,"declarations":{"humanSubjects":false,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":false,"humanSubjectConsent":false,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-7093691/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7093691/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":97530889,"identity":"2b6ceaef-7740-448b-b85b-526336778477","added_by":"auto","created_at":"2025-12-05 13:21:31","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":1536332,"visible":true,"origin":"","legend":"","description":"","filename":"FullPaper.docx","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/f34e91f65ae14c8947bd7346.docx"},{"id":97530887,"identity":"6943e8ad-05ac-420a-b161-3c59135512a8","added_by":"auto","created_at":"2025-12-05 13:21:31","extension":"json","order_by":1,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":5892,"visible":true,"origin":"","legend":"","description":"","filename":"12ec9c76d9e446d9bec79b76b65e5a6a.json","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/ffa8df1065d29256ddc7a3fb.json"},{"id":97530909,"identity":"675a6eee-3f5c-4996-88a2-057bffbb7f45","added_by":"auto","created_at":"2025-12-05 13:21:32","extension":"xml","order_by":2,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":172645,"visible":true,"origin":"","legend":"","description":"","filename":"12ec9c76d9e446d9bec79b76b65e5a6a1enriched.xml","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/4867f5da5ad561ab10ae10b4.xml"},{"id":97672674,"identity":"7e212c9a-2d6f-4402-9f48-b064224e16cc","added_by":"auto","created_at":"2025-12-08 09:38:33","extension":"png","order_by":3,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":26690,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/18c70e96dc08617c031fee37.png"},{"id":97672259,"identity":"d43e7f9c-1e9f-4457-aacc-bb4fa3129830","added_by":"auto","created_at":"2025-12-08 09:34:56","extension":"jpeg","order_by":4,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":105362,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage10.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/41fce9e7a796cecbbca92b60.jpeg"},{"id":97530885,"identity":"88c11be3-a0b8-431f-acc0-85d6a414daec","added_by":"auto","created_at":"2025-12-05 13:21:31","extension":"png","order_by":5,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":22378,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage11.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/2e6b87d2716c9953e45d0121.png"},{"id":97672721,"identity":"008f5f3c-a31a-4781-ad1e-fa7e26a40b40","added_by":"auto","created_at":"2025-12-08 09:38:39","extension":"png","order_by":6,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":28139,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage12.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/d95f6711aeb2f27aa2255d26.png"},{"id":97530890,"identity":"28d04547-0a58-4b4e-8476-65f7462f5f62","added_by":"auto","created_at":"2025-12-05 13:21:31","extension":"png","order_by":7,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":15917,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage13.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/8c7f9676f1969f0ded1f60be.png"},{"id":97671550,"identity":"2021c6fb-fe72-4804-ae3c-2c3a31341bd4","added_by":"auto","created_at":"2025-12-08 09:32:43","extension":"png","order_by":8,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":13552,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage14.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/63ee4b2bef47257778573c38.png"},{"id":97670605,"identity":"cc0a1c9e-7c71-46cd-ae88-e21ed23d9a2a","added_by":"auto","created_at":"2025-12-08 09:31:01","extension":"png","order_by":9,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":24370,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage15.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/26eacce70b3d385beccb1d51.png"},{"id":97670990,"identity":"3ce971c3-325c-4271-b56f-d7da2d9e1132","added_by":"auto","created_at":"2025-12-08 09:31:41","extension":"png","order_by":10,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":13617,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage16.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/05e32c561ba11a3a2f93d14d.png"},{"id":97530897,"identity":"d1cc9aa0-4758-44ff-9c48-2b77d49b2fea","added_by":"auto","created_at":"2025-12-05 13:21:31","extension":"png","order_by":11,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":27969,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage17.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/b1dc83bcc8e033796b10a8dd.png"},{"id":97530919,"identity":"44057071-a06d-4ab9-a79e-df55e3c19166","added_by":"auto","created_at":"2025-12-05 13:21:32","extension":"png","order_by":12,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":22420,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage18.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/57b3c4ddb84f839a0cc59a1d.png"},{"id":97530914,"identity":"e85d6852-7006-4b68-b441-01e9a7c7e163","added_by":"auto","created_at":"2025-12-05 13:21:32","extension":"png","order_by":13,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":22749,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage19.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/cdd5fd1eb4b66adc276d37da.png"},{"id":97670812,"identity":"be0f252e-64e0-445c-b753-608adcb264a9","added_by":"auto","created_at":"2025-12-08 09:31:22","extension":"png","order_by":14,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":29862,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/f7de7a643d6cdd857989299f.png"},{"id":97530902,"identity":"9a69dba3-a8c1-4a43-96c3-c8b98bf2695e","added_by":"auto","created_at":"2025-12-05 13:21:31","extension":"png","order_by":15,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":15483,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage20.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/6f0b0d16b6f212a4e090ab26.png"},{"id":97530917,"identity":"790da21b-42f9-4ede-8847-eb0fd5f10463","added_by":"auto","created_at":"2025-12-05 13:21:32","extension":"png","order_by":16,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":15164,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage21.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/517170d1068dbb4e4490c5db.png"},{"id":97670985,"identity":"c04f609c-5c23-477f-87f9-a9be4070dce9","added_by":"auto","created_at":"2025-12-08 09:31:41","extension":"png","order_by":17,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":15700,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage22.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/4efc023234fcbf2df7a4010d.png"},{"id":97671397,"identity":"d99e05c6-2376-4c4a-a027-5c3eae28d0c1","added_by":"auto","created_at":"2025-12-08 09:32:34","extension":"png","order_by":18,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":21544,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage23.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/683fa50eefa2edb99002c0eb.png"},{"id":97671415,"identity":"6fdace52-6a9b-4da4-9641-4d5c7822bf48","added_by":"auto","created_at":"2025-12-08 09:32:36","extension":"png","order_by":19,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":15146,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage24.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/93dd6f5b86e6691590c1a279.png"},{"id":97530892,"identity":"2353676f-4ad6-4f17-92ca-288e12bf77f8","added_by":"auto","created_at":"2025-12-05 13:21:31","extension":"png","order_by":20,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":13954,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage25.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/4b6b33cb09378ec9011599ee.png"},{"id":97671653,"identity":"8dfa47cf-f5c9-4074-ac70-568e8dd679ed","added_by":"auto","created_at":"2025-12-08 09:32:53","extension":"png","order_by":21,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":14133,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage26.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/fcec65117633f3f906e9b0e6.png"},{"id":97672275,"identity":"beacdbaa-00b3-466d-b2d4-2ffe4c058193","added_by":"auto","created_at":"2025-12-08 09:35:00","extension":"png","order_by":22,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":14424,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage27.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/6a8933c519b769166e01b9f5.png"},{"id":97530928,"identity":"076942b4-04da-459d-b37f-acb93a458b8c","added_by":"auto","created_at":"2025-12-05 13:21:33","extension":"png","order_by":23,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":22290,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage28.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/7ba7182ffb768d9ba2f06455.png"},{"id":97670655,"identity":"96c56969-ef61-42e6-82f6-7a3db7da46e7","added_by":"auto","created_at":"2025-12-08 09:31:08","extension":"png","order_by":24,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":15488,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage29.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/a10751ec4c80ef957882cb4e.png"},{"id":97671484,"identity":"47c7efe1-fd2d-4cad-adce-a1a011ca67e4","added_by":"auto","created_at":"2025-12-08 09:32:39","extension":"png","order_by":25,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":15707,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage3.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/a2d138dee64efb73612618ee.png"},{"id":97530920,"identity":"8fcdaaac-9889-47d3-b1e6-9bd5a09331dc","added_by":"auto","created_at":"2025-12-05 13:21:33","extension":"png","order_by":26,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":12627,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage30.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/5aba4f32efb5aa48d1ba437c.png"},{"id":97671926,"identity":"569cfd6d-d918-4797-9797-4c4918b2964b","added_by":"auto","created_at":"2025-12-08 09:33:23","extension":"png","order_by":27,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":13530,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage31.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/317c115a4ae4ebbc4ff50dbc.png"},{"id":97670523,"identity":"03ca8f93-70bc-4ac2-aeaf-671bfe6ae317","added_by":"auto","created_at":"2025-12-08 09:30:50","extension":"png","order_by":28,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":22525,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage32.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/f9e2c6a38f78309ae5253c51.png"},{"id":97530895,"identity":"17a70eda-cc29-4bea-98be-2bb1c9441783","added_by":"auto","created_at":"2025-12-05 13:21:31","extension":"png","order_by":29,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":21734,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage33.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/b744691779f9462342108dd0.png"},{"id":97530910,"identity":"36e7e24a-960e-4c96-8232-b62435909c1c","added_by":"auto","created_at":"2025-12-05 13:21:32","extension":"png","order_by":30,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":23375,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage34.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/8c21554644f4951e8c5c2d71.png"},{"id":97530904,"identity":"9078bafb-e737-4418-aec9-5153d6b3cd55","added_by":"auto","created_at":"2025-12-05 13:21:31","extension":"png","order_by":31,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":28490,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage35.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/338df14416dab6626076bbfc.png"},{"id":97530899,"identity":"c0b8173b-0705-4001-a37a-87e8859fe5a3","added_by":"auto","created_at":"2025-12-05 13:21:31","extension":"png","order_by":32,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":15896,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage36.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/1da1d7e1543373df0b4dd422.png"},{"id":97530942,"identity":"56c8fe4a-ff81-47cc-bf56-62795f845841","added_by":"auto","created_at":"2025-12-05 13:21:34","extension":"png","order_by":33,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":13247,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage37.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/28a539fd9b136d3974280497.png"},{"id":97530939,"identity":"cc4f8289-5b90-447c-a66a-8be6a9eb4802","added_by":"auto","created_at":"2025-12-05 13:21:33","extension":"png","order_by":34,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":27650,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage38.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/a2da7c041093a2b07a723d30.png"},{"id":97672202,"identity":"02f8ff5c-734c-4566-b4da-7e3efe1ef9ac","added_by":"auto","created_at":"2025-12-08 09:34:39","extension":"png","order_by":35,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":24404,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage39.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/882a1dc268d4b0c82093e1c4.png"},{"id":97530929,"identity":"fad1241c-d85b-434a-b7f4-5aab171cfc8d","added_by":"auto","created_at":"2025-12-05 13:21:33","extension":"png","order_by":36,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":15295,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage4.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/91cdb30479292b7286e7a062.png"},{"id":97530915,"identity":"1627dbe7-7483-45cb-9001-3f843a3ce27b","added_by":"auto","created_at":"2025-12-05 13:21:32","extension":"png","order_by":37,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":15808,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage40.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/517d4793abbd98910e915b8b.png"},{"id":97530948,"identity":"88d4e15b-08f8-4f54-9efd-4502aeca75eb","added_by":"auto","created_at":"2025-12-05 13:21:34","extension":"png","order_by":38,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":12968,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage41.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/9d6ff05bc1b39cda5df9075c.png"},{"id":97530905,"identity":"eb2e0397-c2bd-4f75-87eb-a0858aeabe8d","added_by":"auto","created_at":"2025-12-05 13:21:32","extension":"png","order_by":39,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":14726,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage42.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/1918acbdb8255d0cd06199d8.png"},{"id":97530923,"identity":"d6f02d34-c014-4443-b914-8b1b59e62d19","added_by":"auto","created_at":"2025-12-05 13:21:33","extension":"png","order_by":40,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":14004,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage43.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/99d73da0c8ee39bda0ef50b2.png"},{"id":97670661,"identity":"18796ffd-2127-4603-b37e-89caf0dab424","added_by":"auto","created_at":"2025-12-08 09:31:08","extension":"png","order_by":41,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":14549,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage44.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/330067f2aa443a85bc6e453d.png"},{"id":97530922,"identity":"756c3daf-a78e-489d-951d-4e9bc15bfc2f","added_by":"auto","created_at":"2025-12-05 13:21:33","extension":"png","order_by":42,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":11725,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage45.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/6391d3f1b03c87d01d652d2c.png"},{"id":97530912,"identity":"abc7a2a9-7abb-4bd1-b479-334fb0232996","added_by":"auto","created_at":"2025-12-05 13:21:32","extension":"png","order_by":43,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":13974,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage46.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/8f39450f9c9e27980974f5f1.png"},{"id":97530930,"identity":"bf683c5f-715a-400e-8891-59b68912e778","added_by":"auto","created_at":"2025-12-05 13:21:33","extension":"png","order_by":44,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":12896,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage47.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/74789254eefa850a35943b0e.png"},{"id":97530941,"identity":"da3fceba-cbb2-412f-a80a-6d62f848fe8f","added_by":"auto","created_at":"2025-12-05 13:21:34","extension":"png","order_by":45,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":13362,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage48.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/80a0e318906e5f70052dafd1.png"},{"id":97672472,"identity":"274f11b6-adda-4d6c-a5cf-70e164798884","added_by":"auto","created_at":"2025-12-08 09:38:05","extension":"png","order_by":46,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":14518,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage49.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/9d66d60a65ab3c29ad9d36ca.png"},{"id":97893019,"identity":"6ed18fb1-ef2a-4b97-86b4-2d3ca854c24f","added_by":"auto","created_at":"2025-12-10 15:25:41","extension":"png","order_by":47,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":16110,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage5.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/d65782dda21ff6023cb57bc0.png"},{"id":97671175,"identity":"d2aaf629-863f-40ac-bc89-04d714edb3a4","added_by":"auto","created_at":"2025-12-08 09:32:05","extension":"png","order_by":48,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":23542,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage50.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/d5ffa564d0daff6e96d78070.png"},{"id":97530984,"identity":"783a18c0-a035-4a8f-ac21-aa0e17fe7940","added_by":"auto","created_at":"2025-12-05 13:21:36","extension":"png","order_by":49,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":13087,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage51.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/7a8107df410067307b7a211d.png"},{"id":97671176,"identity":"c5e60384-84ae-4297-9d38-ec3230a5e53d","added_by":"auto","created_at":"2025-12-08 09:32:05","extension":"png","order_by":50,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":19579,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage52.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/b1741f07f4a42ddd229ce683.png"},{"id":97672384,"identity":"d84f139d-cd83-4d89-bc86-a568e5dff6f2","added_by":"auto","created_at":"2025-12-08 09:37:01","extension":"png","order_by":51,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":18819,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage53.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/291644c7ee1b94d66d3eeecc.png"},{"id":97530987,"identity":"177fd97e-3200-46bf-b2aa-aa8642996c34","added_by":"auto","created_at":"2025-12-05 13:21:36","extension":"png","order_by":52,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":19190,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage54.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/4c3211ad7493758efd6be45e.png"},{"id":97530947,"identity":"2a37c14d-d6bd-4f71-9654-0c39a9e2137e","added_by":"auto","created_at":"2025-12-05 13:21:34","extension":"png","order_by":53,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":24413,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage55.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/368be1c69615526cd25fb06d.png"},{"id":97530907,"identity":"e20b0d5f-8956-45ce-b82a-44d44be0e718","added_by":"auto","created_at":"2025-12-05 13:21:32","extension":"png","order_by":54,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":14475,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage56.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/d9507be03a4e6bd02a3579df.png"},{"id":97530989,"identity":"b78e73a5-f71e-4be3-be5c-7c57d5b0155b","added_by":"auto","created_at":"2025-12-05 13:21:36","extension":"png","order_by":55,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":12651,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage57.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/f819100348d55653a016cb6b.png"},{"id":97530960,"identity":"2ea19490-cb3a-4496-a6b9-19a295042961","added_by":"auto","created_at":"2025-12-05 13:21:35","extension":"png","order_by":56,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":18804,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage58.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/8dd266ba440fc5031aa245c2.png"},{"id":97671737,"identity":"3d7a1814-93f3-46b9-b4d5-3c2d12203625","added_by":"auto","created_at":"2025-12-08 09:33:01","extension":"png","order_by":57,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":22509,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage59.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/99520980f96b7c4c3f20df60.png"},{"id":97530962,"identity":"bab104b2-712e-4dbd-aae8-c0c55a325e03","added_by":"auto","created_at":"2025-12-05 13:21:35","extension":"png","order_by":58,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":25454,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage6.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/34ef2384d56b7d6c406284c2.png"},{"id":97671405,"identity":"298e5a5a-1c39-42e0-a71e-6da626ee5921","added_by":"auto","created_at":"2025-12-08 09:32:34","extension":"png","order_by":59,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":21981,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage60.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/3bb070b1c6f7127ea8134954.png"},{"id":97530924,"identity":"bba9ca07-6b8d-4cf3-883a-4b005e571023","added_by":"auto","created_at":"2025-12-05 13:21:33","extension":"png","order_by":60,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":13469,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage61.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/515b745f2a02495fb8b7cc83.png"},{"id":97671112,"identity":"f88aa39a-658d-419e-8afb-c05119f86b59","added_by":"auto","created_at":"2025-12-08 09:31:56","extension":"png","order_by":61,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":13318,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage62.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/0caf91ab6c711a54a76882ed.png"},{"id":97530981,"identity":"973321cd-a706-4b2d-82f0-a881294f0277","added_by":"auto","created_at":"2025-12-05 13:21:36","extension":"png","order_by":62,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":19583,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage63.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/e6cb7eb28945fa251d019fea.png"},{"id":97530940,"identity":"af929bae-6d2a-4d7e-9ab9-bdd85ea44267","added_by":"auto","created_at":"2025-12-05 13:21:34","extension":"png","order_by":63,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":13922,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage64.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/bc1999c0e9ba219277dcc76c.png"},{"id":97672722,"identity":"09d7d9c4-5e83-492e-9067-956ffaa13cc9","added_by":"auto","created_at":"2025-12-08 09:38:39","extension":"png","order_by":64,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":13083,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage65.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/9d0d6bb38e7a3d6b59b4b32b.png"},{"id":97671766,"identity":"7412f222-2b9e-464c-b74e-44be44bb6d58","added_by":"auto","created_at":"2025-12-08 09:33:03","extension":"png","order_by":65,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":13055,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage66.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/c25f65c2cceb49e8fd6854a0.png"},{"id":97530953,"identity":"3ee26b2d-eead-43ee-bdd0-3f2cb40e52ca","added_by":"auto","created_at":"2025-12-05 13:21:34","extension":"png","order_by":66,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":20647,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage67.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/f06ccb948ca53d85b91bb78c.png"},{"id":97531007,"identity":"89abd0ff-4f91-472c-bcfb-ea697a14ced4","added_by":"auto","created_at":"2025-12-05 13:21:37","extension":"png","order_by":67,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":13225,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage68.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/59c395109d6319ce29cd5460.png"},{"id":97530995,"identity":"b068b193-1472-4521-a22f-9045b1c55df4","added_by":"auto","created_at":"2025-12-05 13:21:36","extension":"png","order_by":68,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":21953,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage69.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/d371872a4c68351cd4b9b8b5.png"},{"id":97530959,"identity":"c262d58e-99de-401a-bcd4-3dfea5203b7a","added_by":"auto","created_at":"2025-12-05 13:21:35","extension":"png","order_by":69,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":48137,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage7.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/2c876e41a3ba75c5a3f99f74.png"},{"id":97530991,"identity":"12df7cd5-08e8-4b59-a34c-2dd768af81e3","added_by":"auto","created_at":"2025-12-05 13:21:36","extension":"png","order_by":70,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":21340,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage70.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/5267c4d837f72b28c0a16a08.png"},{"id":97671150,"identity":"a8224820-87fc-41e0-a7db-36beb0c10837","added_by":"auto","created_at":"2025-12-08 09:32:00","extension":"png","order_by":71,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":44703,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage8.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/c869a17a6966f42deb44be58.png"},{"id":97671754,"identity":"22b52823-5cc4-4528-86ad-baa442fd68b4","added_by":"auto","created_at":"2025-12-08 09:33:03","extension":"png","order_by":72,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":46459,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage9.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/a6e5b2b592605b1473b33f54.png"},{"id":97670654,"identity":"8fef5345-90bd-4596-91e8-540aae5a0aae","added_by":"auto","created_at":"2025-12-08 09:31:08","extension":"png","order_by":73,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":13911,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/fdfa9b1a9d107cd97657cd33.png"},{"id":97530994,"identity":"0477a953-973f-4f75-874c-8c600ffae85e","added_by":"auto","created_at":"2025-12-05 13:21:36","extension":"png","order_by":74,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":20060,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage10.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/22e4f39cd407ee46882bc3a0.png"},{"id":97670642,"identity":"c2e91f64-dbc4-4eac-9c73-1acc033091bd","added_by":"auto","created_at":"2025-12-08 09:31:04","extension":"png","order_by":75,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":12054,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage11.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/683a1430f389d2400a2e75d9.png"},{"id":97530955,"identity":"38f3ae01-1aa8-4522-949e-8fa25c60505e","added_by":"auto","created_at":"2025-12-05 13:21:35","extension":"png","order_by":76,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":14875,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage12.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/42c23473c006609c4aafc968.png"},{"id":97530932,"identity":"b1c02f14-4852-4037-a220-849562157797","added_by":"auto","created_at":"2025-12-05 13:21:33","extension":"png","order_by":77,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":12526,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage13.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/fa1662f80499b1c93a7c348b.png"},{"id":97530944,"identity":"60274e6b-a94c-4308-a409-4de62ab341bd","added_by":"auto","created_at":"2025-12-05 13:21:34","extension":"png","order_by":78,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":11908,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage14.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/2524f18562ef7d5da484f365.png"},{"id":97531010,"identity":"6c80a5ae-970a-4e49-859f-366189df8cda","added_by":"auto","created_at":"2025-12-05 13:21:37","extension":"png","order_by":79,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":13293,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage15.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/215594c38339806c0c9e3e1a.png"},{"id":97671014,"identity":"19b40d9c-d06a-4c3c-b190-8951dbc83350","added_by":"auto","created_at":"2025-12-08 09:31:44","extension":"png","order_by":80,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":11073,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage16.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/cfa42676422739dd47941c3a.png"},{"id":97531026,"identity":"cf10c1f8-97d0-4f40-a2ac-5136a424ec2c","added_by":"auto","created_at":"2025-12-05 13:21:38","extension":"png","order_by":81,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":15045,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage17.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/bb491b892417a46687000fb0.png"},{"id":97672715,"identity":"20df310f-2233-4f84-b7e8-e13207481bbc","added_by":"auto","created_at":"2025-12-08 09:38:38","extension":"png","order_by":82,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":11907,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage18.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/486c07a7be836f1a1ec34d3e.png"},{"id":97531009,"identity":"6faca188-840a-4271-aa76-87679f071092","added_by":"auto","created_at":"2025-12-05 13:21:37","extension":"png","order_by":83,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":11880,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage19.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/43fd73acaf882d1eaeff0307.png"},{"id":97531006,"identity":"f2c0133f-678f-471e-99da-7132cbf4733e","added_by":"auto","created_at":"2025-12-05 13:21:37","extension":"png","order_by":84,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":16011,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/8c2adf1216837e2eb92d768b.png"},{"id":97671632,"identity":"e318cd4c-8ee1-4cfc-a31d-91c14bbedbbd","added_by":"auto","created_at":"2025-12-08 09:32:51","extension":"png","order_by":85,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":13498,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage20.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/059bfa5339d784c0c3f98417.png"},{"id":97530957,"identity":"68f72567-aeac-494e-b333-4084231ab95b","added_by":"auto","created_at":"2025-12-05 13:21:35","extension":"png","order_by":86,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":12835,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage21.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/e677a66e9548d59e46d161cb.png"},{"id":97530967,"identity":"81a8b81f-282d-4dd0-83b1-68ec511a66be","added_by":"auto","created_at":"2025-12-05 13:21:35","extension":"png","order_by":87,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":13238,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage22.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/6764989d5c78bcd9b25260dc.png"},{"id":97531013,"identity":"7497b60c-cfda-466a-a028-600b44ebcfbc","added_by":"auto","created_at":"2025-12-05 13:21:37","extension":"png","order_by":88,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":12046,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage23.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/2bcf76d76245efa794a78a00.png"},{"id":97671563,"identity":"4229f919-07e2-418d-8351-11cf03e56e77","added_by":"auto","created_at":"2025-12-08 09:32:45","extension":"png","order_by":89,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":12094,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage24.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/bbc708b81d2de5df6b4c6936.png"},{"id":97669994,"identity":"e074dded-57b0-4a35-9a5e-4bc86593b98f","added_by":"auto","created_at":"2025-12-08 09:29:32","extension":"png","order_by":90,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":11422,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage25.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/a5e73be9a4ab8194f6a8d3a5.png"},{"id":97530938,"identity":"cb1da7b0-241e-4b51-a441-b7ff8d71c812","added_by":"auto","created_at":"2025-12-05 13:21:33","extension":"png","order_by":91,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":12271,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage26.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/e637901d48bfa2ad39570302.png"},{"id":97670693,"identity":"315ec502-1902-4879-8faa-c0d16d0ffd00","added_by":"auto","created_at":"2025-12-08 09:31:11","extension":"png","order_by":92,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":11856,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage27.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/14bff40401857c916a16a98c.png"},{"id":97530976,"identity":"a0757e48-cd55-4949-8121-d4f84eecf7b3","added_by":"auto","created_at":"2025-12-05 13:21:36","extension":"png","order_by":93,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":12658,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage28.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/f32a5c5cf661e4246159b14b.png"},{"id":97530965,"identity":"75c1883a-a450-4138-9932-1db7a0b4a396","added_by":"auto","created_at":"2025-12-05 13:21:35","extension":"png","order_by":94,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":12799,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage29.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/06207bbe0899326bbc50e842.png"},{"id":97530964,"identity":"1798e0f8-f6c4-4507-8a6a-ecec21a1046c","added_by":"auto","created_at":"2025-12-05 13:21:35","extension":"png","order_by":95,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":12947,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage3.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/8456a1b08eb885b2ee3e09fb.png"},{"id":97530979,"identity":"812dd001-2082-49b8-b1e7-27e6a33a8afc","added_by":"auto","created_at":"2025-12-05 13:21:36","extension":"png","order_by":96,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":9334,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage30.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/3b2a7ef017be89a86f3e6e40.png"},{"id":97671833,"identity":"2da2d898-aad7-4f18-a71c-8520fa9ae893","added_by":"auto","created_at":"2025-12-08 09:33:09","extension":"png","order_by":97,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":11399,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage31.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/13160cb87679edc05877dd67.png"},{"id":97672828,"identity":"97c0e795-e61f-4638-9383-64cc93026846","added_by":"auto","created_at":"2025-12-08 09:38:51","extension":"png","order_by":98,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":12301,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage32.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/e1017095dd524ce3b329e8ec.png"},{"id":97670696,"identity":"d0cf75a1-c7c7-4876-855d-e6e988766f59","added_by":"auto","created_at":"2025-12-08 09:31:11","extension":"png","order_by":99,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":11764,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage33.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/ef9e02089ab9fb490000f475.png"},{"id":97531023,"identity":"d8e5adec-8ce0-406b-8297-1b8fa8fb4268","added_by":"auto","created_at":"2025-12-05 13:21:38","extension":"png","order_by":100,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":12183,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage34.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/5db35b4149c841d1cc2c57e5.png"},{"id":97672624,"identity":"52c25da4-a9e4-449b-86a9-1b2e3d33bceb","added_by":"auto","created_at":"2025-12-08 09:38:29","extension":"png","order_by":101,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":14221,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage35.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/a8a6083532d00068b9d40088.png"},{"id":97531033,"identity":"d6bc0a73-71ba-4cc6-833f-ed68e4f462c9","added_by":"auto","created_at":"2025-12-05 13:21:38","extension":"png","order_by":102,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":13289,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage36.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/6cdca0f063f621b64c78e90d.png"},{"id":97531021,"identity":"ba9bde6d-cd82-4eb9-b7ff-ed92f7de7913","added_by":"auto","created_at":"2025-12-05 13:21:37","extension":"png","order_by":103,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":10713,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage37.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/3c438f147a5a540406202cf1.png"},{"id":97530934,"identity":"84aa28c8-2b83-4086-8409-dc89c29d30f6","added_by":"auto","created_at":"2025-12-05 13:21:33","extension":"png","order_by":104,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":14641,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage38.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/33f3f3cf3664e3d8aa9f6d70.png"},{"id":97672723,"identity":"c749156f-edf0-4e80-8179-dc6ce2ea1e48","added_by":"auto","created_at":"2025-12-08 09:38:39","extension":"png","order_by":105,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":12461,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage39.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/7e6d950ec8a3eea8547bcc3c.png"},{"id":97530974,"identity":"02079304-7c32-4bbd-b7c3-d7c24c18e3de","added_by":"auto","created_at":"2025-12-05 13:21:36","extension":"png","order_by":106,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":12160,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage4.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/18508ef19deff57b35b1b7ca.png"},{"id":97530927,"identity":"c77377f4-951a-44b2-bc2f-e93e1d097dd4","added_by":"auto","created_at":"2025-12-05 13:21:33","extension":"png","order_by":107,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":12758,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage40.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/a5b5f9996d9ddf08fc241c39.png"},{"id":97530950,"identity":"aa3d18a4-36db-4c4d-bd1a-f7a3478c7257","added_by":"auto","created_at":"2025-12-05 13:21:34","extension":"png","order_by":108,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":10299,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage41.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/fe936ff370e0ff552105a74b.png"},{"id":97670704,"identity":"6ec58851-6a43-4294-9dda-de36631645a0","added_by":"auto","created_at":"2025-12-08 09:31:11","extension":"png","order_by":109,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":12240,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage42.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/230083322d9e0e0bd4d24226.png"},{"id":97530945,"identity":"23714c66-72f5-453b-a2d2-de661652b727","added_by":"auto","created_at":"2025-12-05 13:21:34","extension":"png","order_by":110,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":10325,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage43.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/3ef1b24a8946e5238628ce6b.png"},{"id":97531004,"identity":"822aac1e-27ff-40ba-b9f3-578f8d8a8f69","added_by":"auto","created_at":"2025-12-05 13:21:37","extension":"png","order_by":111,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":11722,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage44.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/21ccf6682047dac99e36f533.png"},{"id":97531038,"identity":"f88963c9-671d-45af-815c-39e8fea0be44","added_by":"auto","created_at":"2025-12-05 13:21:38","extension":"png","order_by":112,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":10058,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage45.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/1d2b04dfd535d2745fac167f.png"},{"id":97530933,"identity":"14dc6425-7561-4cf6-9354-5ac1d08407b0","added_by":"auto","created_at":"2025-12-05 13:21:33","extension":"png","order_by":113,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":10959,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage46.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/1a90d27f7de897752ae75bcc.png"},{"id":97530971,"identity":"b7745547-436e-460d-a366-39b013085031","added_by":"auto","created_at":"2025-12-05 13:21:36","extension":"png","order_by":114,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":10453,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage47.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/9c647b4049a7c67507db9366.png"},{"id":97530982,"identity":"bd4caa5c-bf6a-4865-b7ea-ad10b6552274","added_by":"auto","created_at":"2025-12-05 13:21:36","extension":"png","order_by":115,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":11082,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage48.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/37456d143743f363c1fe1fa0.png"},{"id":97531020,"identity":"fe6b4fc5-1bae-495e-b4d3-8a5614340091","added_by":"auto","created_at":"2025-12-05 13:21:37","extension":"png","order_by":116,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":10690,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage49.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/bceb13c3060e14f9b0f49ebf.png"},{"id":97530985,"identity":"c1dde3a1-f0eb-4c14-9419-d9ff5f711d39","added_by":"auto","created_at":"2025-12-05 13:21:36","extension":"png","order_by":117,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":13388,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage5.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/e24a3c02acf279eae6b82374.png"},{"id":97531035,"identity":"4cb25071-ddf5-45fe-b295-6809707e7295","added_by":"auto","created_at":"2025-12-05 13:21:38","extension":"png","order_by":118,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":13101,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage50.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/dfc919714e99224023ac38a9.png"},{"id":97671080,"identity":"4f172908-e8dc-4c04-9c1e-f5fa9564771b","added_by":"auto","created_at":"2025-12-08 09:31:51","extension":"png","order_by":119,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":10383,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage51.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/018771d7f4dc631488926ad5.png"},{"id":97670711,"identity":"83f5ef92-8601-4416-bcb4-cb28914234cc","added_by":"auto","created_at":"2025-12-08 09:31:12","extension":"png","order_by":120,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":10796,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage52.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/a3ad52f7e3a993c508e7ffd5.png"},{"id":97671543,"identity":"46bb5278-0474-4e87-a5d7-82ebf906f374","added_by":"auto","created_at":"2025-12-08 09:32:42","extension":"png","order_by":121,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":10333,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage53.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/230ed237c043578b9d6e08bf.png"},{"id":97531030,"identity":"7ece97d3-1812-4abc-969f-d1fab71aad48","added_by":"auto","created_at":"2025-12-05 13:21:38","extension":"png","order_by":122,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":10608,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage54.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/5fb254a0c4d2ecb0154412df.png"},{"id":97530943,"identity":"a9f49900-0875-44f0-b20b-ca2041a29e0a","added_by":"auto","created_at":"2025-12-05 13:21:34","extension":"png","order_by":123,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":13111,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage55.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/56462377237aef531c51f397.png"},{"id":97530977,"identity":"14284393-3d6e-4a02-8365-ed8866aa6a75","added_by":"auto","created_at":"2025-12-05 13:21:36","extension":"png","order_by":124,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":12523,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage56.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/f9e0316dfbb1d9973d47289c.png"},{"id":97531005,"identity":"27c4af22-0682-41a5-a0b2-314f4243de94","added_by":"auto","created_at":"2025-12-05 13:21:37","extension":"png","order_by":125,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":10411,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage57.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/25fb04f80e9c9135f29bf00c.png"},{"id":97530986,"identity":"fa984945-c3b4-4f91-8d3b-83e1b2954b71","added_by":"auto","created_at":"2025-12-05 13:21:36","extension":"png","order_by":126,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":10445,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage58.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/c02ebd60ea355b4ff29715ad.png"},{"id":97530961,"identity":"b8158dc6-2a80-4abd-90aa-5bb5b35756a0","added_by":"auto","created_at":"2025-12-05 13:21:35","extension":"png","order_by":127,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":12042,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage59.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/feeef9b72c61dfb890b0d5e8.png"},{"id":97531041,"identity":"2e9107ad-af1b-4436-b134-bdd09a5510af","added_by":"auto","created_at":"2025-12-05 13:21:38","extension":"png","order_by":128,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":13618,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage6.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/c1343188d1fd60598982b194.png"},{"id":97671419,"identity":"8f429799-dbae-4c20-b6ad-f01a25d73f5b","added_by":"auto","created_at":"2025-12-08 09:32:36","extension":"png","order_by":129,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":12407,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage60.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/e3f3db93caed279bcce722d7.png"},{"id":97531028,"identity":"fdf52cce-5ada-4b05-bc10-89cca11f7167","added_by":"auto","created_at":"2025-12-05 13:21:38","extension":"png","order_by":130,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":10544,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage61.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/8169ccbc224c07e7ee9d8dff.png"},{"id":97530973,"identity":"ee6da341-a404-4a19-b752-59255c0ae58c","added_by":"auto","created_at":"2025-12-05 13:21:36","extension":"png","order_by":131,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":11279,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage62.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/e56075b664b7f48311f759b6.png"},{"id":97530952,"identity":"097f4075-7b50-4e1a-aa55-01cdd48a374e","added_by":"auto","created_at":"2025-12-05 13:21:34","extension":"png","order_by":132,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":10617,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage63.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/b04e16d11470595831199375.png"},{"id":97531047,"identity":"c70a1b26-1f76-4f77-bd9b-516e9a9d3876","added_by":"auto","created_at":"2025-12-05 13:21:39","extension":"png","order_by":133,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":11435,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage64.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/57135c978cc31ad34bb43d92.png"},{"id":97672123,"identity":"fa7640d5-2f37-45cf-929e-257fdf97a941","added_by":"auto","created_at":"2025-12-08 09:34:19","extension":"png","order_by":134,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":10405,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage65.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/7c4df79e4df61275bfc2237b.png"},{"id":97531017,"identity":"b27d3917-4ed4-4c2d-a1f6-0cffc6a7ce4f","added_by":"auto","created_at":"2025-12-05 13:21:37","extension":"png","order_by":135,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":11247,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage66.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/f32af27b4c0be5400eecbc3b.png"},{"id":97530970,"identity":"92aef92a-f65d-4847-9cab-2f7ce6865b52","added_by":"auto","created_at":"2025-12-05 13:21:35","extension":"png","order_by":136,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":11237,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage67.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/83d6f764833c6f122809dc19.png"},{"id":97531042,"identity":"cbd9d5fb-c169-43a6-a8f9-d697d5c11e69","added_by":"auto","created_at":"2025-12-05 13:21:38","extension":"png","order_by":137,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":10533,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage68.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/121891c48827e2c21e5fb18c.png"},{"id":97530999,"identity":"3cd374ff-532f-4830-94a4-0533d0bcd18a","added_by":"auto","created_at":"2025-12-05 13:21:37","extension":"png","order_by":138,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":11194,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage69.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/4b74e08178c74eb9c3c5fe11.png"},{"id":97671081,"identity":"a2eefb6c-68de-4e3c-ab3e-d5e3145fdd71","added_by":"auto","created_at":"2025-12-08 09:31:51","extension":"png","order_by":139,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":16894,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage7.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/e7408bec5cfac31a6ffa5011.png"},{"id":97531001,"identity":"31f61f52-e99d-4275-b27c-b781b27c8f67","added_by":"auto","created_at":"2025-12-05 13:21:37","extension":"png","order_by":140,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":12036,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage70.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/fa0b8dd45540ac7c33f05334.png"},{"id":97531048,"identity":"d1d30b92-f9cc-4ec9-80ed-67111c94439a","added_by":"auto","created_at":"2025-12-05 13:21:39","extension":"png","order_by":141,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":15139,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage8.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/3fa07ea5289609e1502b436b.png"},{"id":97531044,"identity":"842d524f-af4b-470a-8787-856be8317e13","added_by":"auto","created_at":"2025-12-05 13:21:38","extension":"png","order_by":142,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":16867,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage9.png","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/0054028b9af2ebb07cbbb09c.png"},{"id":97671177,"identity":"9464c001-36b8-43d7-b9b0-55aa1031080c","added_by":"auto","created_at":"2025-12-08 09:32:05","extension":"xml","order_by":143,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":169712,"visible":true,"origin":"","legend":"","description":"","filename":"12ec9c76d9e446d9bec79b76b65e5a6a1structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/6fc50f777d476d8b3236bd8d.xml"},{"id":97672028,"identity":"619aec6a-c789-4a2f-89b5-cef000830755","added_by":"auto","created_at":"2025-12-08 09:33:48","extension":"html","order_by":144,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":181717,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1/1463d4b9ced9a3bcfc40af3c.html"},{"id":101204634,"identity":"9344b667-485a-4959-814b-3482c8e5515c","added_by":"auto","created_at":"2026-01-27 09:43:36","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1825330,"visible":true,"origin":"","legend":"","description":"","filename":"FullPaper.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7093691/v1_covered_c4974f13-18c2-4bdb-8ead-77d1e3fe58e5.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"A joinpoint regression analysis of Malaria epidemiological Indicators progression in Mizoram from 2000 to 2024","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":true,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Annual Percent Change, Average Annual Percent Change, ABER, percent pf, API, Malarial deaths, SPR, SFR","lastPublishedDoi":"10.21203/rs.3.rs-7093691/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7093691/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cem\u003eMalaria remains a persistent public health burden in Mizoram, India, which accounts for a disproportionately high share of national cases. This study employs Joinpoint Regression Analysis to examine the temporal trends in key malaria epidemiological indicators—API, ABER, Pf%, SFR, SPR, total cases, and malarial deaths—from 2000 to 2024 across nine districts of Mizoram. The analysis identifies statistically significant shifts in malaria trends and quantifies the Annual Percent Change (APC) and Average Annual Percent Change (AAPC) to assess intervention impact and surveillance dynamics. Results show substantial heterogeneity: districts like Aizawl East, Kolasib, and Serchhip exhibited marked declines in Pf cases, API, and mortality, while others like Champhai and Saiha experienced recent upsurges or fluctuating trends. Declines in ABER until 2010 followed by resurgence indicate evolving diagnostic strategies. Despite national elimination initiatives, border proximity, terrain, and sociocultural factors contribute to transmission persistence in specific districts. The study underscores the need for district-specific strategies, improved surveillance, and cross-border coordination. Joinpoint analysis proves valuable in detecting epidemiological shifts that basic models may overlook. The findings offer actionable insights for optimizing malaria control efforts and accelerating elimination in Mizoram and similar high-risk, ecologically complex regions.\u003c/em\u003e\u003c/p\u003e","manuscriptTitle":"A joinpoint regression analysis of Malaria epidemiological Indicators progression in Mizoram from 2000 to 2024","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-12-05 13:21:25","doi":"10.21203/rs.3.rs-7093691/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"9077608f-1e85-4fb8-9e39-330116ea1ed3","owner":[],"postedDate":"December 5th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-01-24T16:39:07+00:00","versionOfRecord":[],"versionCreatedAt":"2025-12-05 13:21:25","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7093691","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7093691","identity":"rs-7093691","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}