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. 2026 Jan 7;6:105928. doi: 10.1016/j.bas.2026.105928

Swiss national spinal implant registry SIRIS Spine: methods and first results

Thorsten Jentzsch a,b, David Bellut a,c, Ralph T Schär a,d, Daniel Haschtmann a,e, Emin Aghayev a,f,g,∗
PMCID: PMC12830243  PMID: 41584995

Abstract

Introduction

Spine registries are important for advancing the field to provide evidence for clinical and health policy decision-making.

Research question

The objective is to introduce the Swiss Implant Registry "SIRIS Spine" as one of the world's first mandatory nationwide spinal implant registries for selected spinal surgeries.

Material and methods

SIRIS Spine is governed by the SIRIS Foundation, Switzerland. EUROSPINE is commissioned to operate the registry. Collected patient data includes demographic, clinical, and implant information and may additionally include electronic patient-reported outcome measures. Inclusion criteria are growing stepwise.

Results

Between the years 2021–2023, 12,815 surgeries for 11,789 patients from 91 hospitals were registered. This includes 75,522 implants from 40 manufactures. Reoperations and revisions were registered in 6.9 %. The most frequent pathology was degenerative disease (61.6 %), followed by osteoporotic fractures (12.4 %), and non-degenerative spondylolisthesis (5.4 %). The mean age was 66.8 (standard deviation (SD) 13.7) years. Women (58.7 %) were slightly more frequently included than men. Almost half of the surgeries were preceded by one or several prior surgeries at the same or adjacent segment (49.6 %), after excluding 1′367 patients with missing information.

Discussion and conclusion

The SIRIS Spine registry has successfully captured initial data from the involved Swiss hospitals. Involvement of all key stakeholders including specialist societies has proven to be important and a clear success factor. The primary challenge identified was the complexity of inclusion criteria, which has impeded data validation. Future efforts will focus on simplifying criteria, rigorously validating data completeness and accuracy, and leveraging data for quality improvement and comparative analyses.

Keywords: Spine surgery, Registry, SIRIS spine, Spine implant, Fusion, Complication, Outcome, Reoperation, Revision

Highlights

  • •

    This is the first publication of the mandatory Swiss National Implant Registry SIRIS Spine.

  • •

    In the first four years of registration 12′815 surgeries with 75′522 implants from 91 hospitals were captured.

  • •

    Appropriate organisation with involvement of all key stakeholders was identified as an important success factor.

  • •

    The missed simplicity of inclusion criteria for a practicable inclusion and validation of surgeries was the learning point.

  • •

    The data are highly demanded by all involved stakeholder including MedTech, clinicians and their organisation and public.

1. Introduction

Spinal surgery has undergone significant advancements in recent years. Nevertheless, the field remains characterized by substantial variability in treatment practices. This variability arises from differences in surgeon training and treatment philosophies, ongoing debates regarding the effectiveness and safety of certain surgical techniques and implant types, heterogeneity in patient characteristics and expectations, an aging patient population, disparities in resource availability, as well as variations in healthcare regulations, insurance policies, and financial incentives.

There is a growing need within spinal surgery to generate robust evidence on the safety and effectiveness of spinal implants. This need is driven not only by the aforementioned complexities of the field but also by evolving regulatory requirements, particularly following the enforcement of the new Medical Device Regulation (MDR) in Europe.

Spine registries play a critical role in addressing this evidence gap. By systematically collecting real-world, structured data across diverse patient populations, they facilitate quality assurance, support continuous improvement in patient care and surgical outcomes, and provide statistically sound evidence to inform both clinical practice and health policy. Several spine registries are currently active (Pascucci et al., 2023) such as SweSpine in Sweden (Strömqvist et al., 2013), North American Spine Society (NASS) registry (NASS Registry), Spine Tango from EUROSPINE (Neukamp et al., 2013), Australian Spine Registry (ASR) (ASR - the Australian Spine Registry), DaneSpine in Denmark (Pedersen et al., 2023), NORspine in Norway (Mikkelsen et al., 2023), FinSpine in Finland (Marjamaa et al., 2023), British Spine Registry in the UK (Knight et al., 2023), Canadian Spine Outcome and Research Network (CSORN) (Power et al., 2023), and German Spine Registry (DWG) (Vinas et al., 2024). These registries along with the Swiss Implant Registry SIRIS Spine (Swiss Implant Registry, 2024) were included in the scoping review published by Pascucci et al. and compared in term of different characteristics (Pascucci et al., 2023). In addition, there is the Belgian Spine Registry, which is a government-mandated registry that includes registration of spinal implants and is operating since 2023 (Belgium Spine Registry, 2025).

The objective of this article is to describe the organization and methodology of SIRIS Spine, to present preliminary exploratory (non-generalizable) analyses of data collected between 2021 and 2023, to discuss encountered challenges, and to outline future directions for the registry's continued development.

2. Materials and methods

2.1. Organisation of SIRIS spine

SIRIS Spine is governed by the SIRIS Foundation. EUROSPINE is commissioned to operate the registry, while the IT and data management services are provided by NEC Software Solutions subcontracted by EUROSPINE. The registry is supported by national professional associations (i.e. swiss orthopaedics (SO), Swiss Society for Neurosurgery (SGNC), and Swiss Society for Spinal Surgery (SGSC), who delegate their representatives to the scientific advisory board (SSAB) in addition to the delegates from EUROSPINE and from the SIRIS foundation. With its five delegate members, the SSAB ensures scientific integrity of the registry, its documents, development and output. A steering committee is composed of representatives from the SSAB, the SIRIS Foundation, EUROSPINE, and the Swiss National Association for Quality Development in Hospitals and Clinics (ANQ), ensuring smooth registry operations and strategical development of the registry. The steering committee and the SSAB hold monthly meetings.

The registry is incorporated into the acute care measurement plan of the ANQ after approval of its partners (insurers, cantons, hospitals, and clinics) since January 2021. As such, hospitals are responsible to comply with registration requirements and to cover associated registration cost (which was CHF 50 per registered case in 2025).

2.2. Data registration

Each patient must provide written informed consent before their data can be registered in SIRIS Spine. Data registration takes place via a web-application (SIRIS Spine, 2024), which is derived from the international Spine Tango registry, and is based on the principle of "develop once and share". Collected patient data includes demographic, clinical, and implant information (Supplement 1) (as found on the SIRIS web page) (Swiss Implant Registry, 2024). Implant data can be either scanned directly from implant labels using implant code readers or found in the implant catalogue using unique article number or other search terms. The implant catalogue is fed by the manufacturers to ensure high data quality of implant data. In 2025 the catalogue included specifications of >205,000 implants from 75 manufacturers.

The registered data is hosted on a cloud server in Switzerland. Patient identifiable data stay within Switzerland, while aggregated data may be used in international research publications and/or reports.

2.3. Voluntary electronic patient-reported outcome measures (ePROMs)

Hospitals may opt in for their patients to receive patient-reported outcome measures. In such a case patient receives a link to the questionnaire via e-mail and/or text message. This electronic questionnaire is distributed by the registry application pre- and postoperatively (at three and twelve months) as per standard protocol. The ePROMs questionnaire includes 14 questions preoperatively and 19 questions postoperatively and incorporates three instruments: Core Outcome Measures Index (COMI) instrument with the Spine-Tango supplement (Mannion et al., 2009), the EuroQol-5D-5L with 5 domains and 5 answer levels (Van et al., 2015), and the Minimal Dataset from Swiss Orthopaedics (SO MDS) (Jentzsch et al., 2020). Among other questions, the patient states the extent of back and leg pain on a numeric rating scale (Supplement 2) (as found on the SIRIS web page) (Swiss Implant Registry, 2024). The use of ePROMs requires hospitals to inform their patients accordingly, and to capture the patient's email address and/or mobile phone number in the application, if the patient consents. The ePROMs function has been available since 2024 and is voluntary.

2.4. Quarterly hospital reports, aggregated annual reports and analysis methods

In return for their data registration, hospitals receive quarterly reports describing their registered data and comparing them with the pooled data of all other hospitals. Additionally, the registry publishes annual reports with aggregated data from all participating hospitals. The first such annual report included data of the first three years (2021–2023) and was published in September 2024 (Swiss Implant Registry, 2024). Reported data is presented in a descriptive manner. For the analysis of revision/reoperation rates, only revisions and reoperations that were linked to a registered primary surgery were taken into the account. We use a combined term “reoperation/revision” and define it as a secondary surgery when the initial surgery does not achieve its technical or clinical objectives. Technical objectives may not be met due to factors such as an incorrectly placed screw, screw breakage, insufficient decompression or lack of fusion. Clinical objectives may not be met when technical objectives are met but symptoms persist, for example, when fusion is successful, but pain persists. Elective reoperations are also included (e.g. for metal removal).

Kaplan-Meier curves are generated to visualise cumulative reoperation and revision rates stratified by age group, gender, BMI, and ASA category. The time-zero was defined as the surgery date. Right-censoring is used in the Kaplan-Meier analyses, as mortality data are not currently available. A log-rank test was used to determine whether at least two of the analysed stratification groups are statistically different, calculating a corresponding p-value (with p < 0.05 considered statistically significant). The current analysis was univariate. Multivariate analyses are planned in the future.

Missing data for smoking status (“unknown” answer option), for ASA category, and for the question on prior surgery (which was not asked in patients with osteoporotic fractures) were not missing at random as the probability of being missing was associated with main pathology. The number of surgeries with missing data were reported, while these sergeries were excluded from the univariate subgroup percentage calculations presented.

The registry data can be used for research purposes based on relevant provisions of the local Human Research Act.

2.5. Inclusion criteria

The inclusion criteria are supposed to grow in a stepwise fashion to ensure smooth implementation of the registry in hospitals.

Starting from 2021 they included lumbar posterior 1–2 segment fusion surgeries for degenerative disease and non-degenerative spondylolisthesis in patients ≥18 years of age as well as any reoperation/revision thereof at the same or adjacent segment.

Starting from 2022, thoracic and lumbar kypho-/vertebroplasties for osteoporotic fractures within 28 days of their occurrence or radiological diagnosis as well as any reoperation/revision thereof at the same or adjacent segment were added to the inclusion criteria.

Further expansion of the inclusion criteria is anticipated in the future.

2.6. Data validation

The registered primary and revision/reoperation surgeries that are reported in this article have been validated against the procedure (CHOP) codes of the “Swiss Surgical Classification” ("Schweizerische Operationsklassifikation") from the Federal Office of Statistics (Jentzsch et al., 2016; Moos et al., 2016).

Starting from 2025, the data validation will include hospital audits on sites, with a detailed assessment of capture rate, data completeness and accuracy. This detailed data validation just started and will require another 1.5 years to be carried out in all involved Swiss hospitals. Due to that limitation of the data validation, the first results presented in this article have a preliminary explorative character, even though some interferential statistic is included to describe the first registry cohort. Data shown in this article, especially regarding reoperations/revisions should be interpreted with caution. It is expected that this data may change in the coming years, due to the ongoing data validation and increasing registration capture rate.

2.7. Ethics

The local ethics committee has granted exemption from ethics approval due to the use of anonymous data for quality control (Req-2025-0072).

3. Results

3.1. Surgeries, institutions, and implants

Between the years 2021–2023, 12,815 surgeries for 11,789 patients were registered from 91 hospitals. The registration number varied substantially between individual hospitals. In 2023, approximately two thirds of hospital registered <50 surgeries (Fig. 1). At the same time, 75,522 implants from 40 manufactures (i.e. 5.9 implants on average per surgery) were registered.

Fig. 1.

Fig. 1

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Case numbers by hospital and clinic in 2023.

3.2. Main pathology, patient age and gender

The main pathology was degenerative disease (61.6 %) followed by osteoporotic fractures (12.4 %), and non-degenerative spondylolisthesis (5.4 %) (Fig. 2). The mean age was 66.8 (standard deviation (SD) 13.7, 95 % confidence intervals [CI] 66.5–67.0) years, median age was 68.9 years. Most patients (87.5 %) were above 50 years of age (Table 1). There were slightly more women (58.7 %) than men in the registry.

Fig. 2.

Fig. 2

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Main pathology (diagnosis).

Table 1.

Patient characteristics.

Patient characteristic Subcategories N of surgeries % of surgeries
Age groups 18–29 years 124 1.0
30–39 years 457 3.6
40–49 years 1′006 7.9
50–59 years 2′212 17.3
60–69 years 2′952 23.0
70–79 years 3′973 31.0
≥80 years 2′091 16.3
Body Mass Index (BMI) categories <18.5 kg/m2 (underweight) 321 2.5
18.5–24.9 kg/m2 (normal weight) 4′629 36.1
25.0–29.9 kg/m2 (overweight) 4′675 36.5
30.0–34.9 kg/m2 (obesity class 1) 2′246 17.5
35.0–39.9 kg/m2 (obesity class 2) 707 5.5
40+ kg/m2 (obesity class 3) 237 1.9
American Society of Anesthesiologists (ASA) categories 1 (healthy) 1′015 8.2
2 (mild systemic disease) 6′560 53.1
3 (severe systemic disease) 4′609 37.3
4 (severe systemic disease) 172 1.4
unknown 459 –
Number of previous surgeries none 5′775 50.4
1 3′400 29.7
2 1′331 11.6
3 537 4.7
4 199 1.7
>4 206 1.8
unknown 1′367 –
TOTAL – 12′815 100.0
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3.3. Smoking, obesity, morbidity, and prior surgery

Most patients were non-smokers (76.6 %), while smoking status was unknown in 3920 patients. The mean body mass index (BMI) was 27.3 (SD 11.4, 95 % CI 27.1–27.5) kilograms per square meter (kg/m2), with a median of 26.3 kg/m2. Overweight was observed in 19.9 % of the patients (Table 1). Category 2 (mild systemic disease) of the ASA was registered most commonly (53.1 %) (Table 1). Almost half of the surgeries were preceded by one or several prior surgeries at the same or adjacent segment (Table 1), after excluding 1′367 patients with missing information.

3.4. Surgical approach and fusion

The most common surgical approach was midline (74.8 %), followed by paramedian (14.9 %) and others (11.2 %), while in 2.4 % a combination of approaches was captured. A transforaminal lumbar interbody fusion (TLIF) was performed most commonly (56.7 %), followed by posterolateral fusion (26.4 %), posterior fusion (15.8 %), posterior lumbar interbody fusion (PLIF) (9.1 %), and others (6.3 %), while in 21 % of the patients more than one type of fusion was specified. Reoperations and revisions were registered in 6.9 %.

3.5. Reoperation and revision

We observed the following associations, which warrant further investigation as soon as full data validation is completed. First, reoperation and revision rates appeared to be significantly higher for older patients compared to younger patients (p < 0.001) (Fig. 3). For example, the revision rate for patients aged 70–79, or those over 80, was approximately 8 %, whereas the rate for patients under 40, was around 4 %. Second, reoperation and revision rates appeared to be similar for genders (p = 0.19) (Fig. 4). Third, reoperation and revision rates seemed to be significantly higher for patients with overweight and obesity (p < 0.001) (Fig. 5). The observed trends suggest that the reoperation and revision rates increase almost proportionally with higher BMI levels. For example, the reoperation and revision rate for patients with a BMI of at least 35 kg/m2, was approximately 12 %, whereas for normal-weight patients with a BMI between 20 and 25 kg/m2, it was only about half of that, around 6 %. Fourth, higher reoperation and revision rates were observed in patients with a higher perioperative risk as classified by the ASA category (p < 0.001) (Fig. 6). For example, reoperation and revision rate for ASA-3 and ASA-4 patients, was approximately 9 %, whereas the rate for ASA-2 patients, was about 7 %, and for ASA-1 patients, shown in red, it was around 3 %. Relatively few outlier hospitals or clinics were observed in terms of the dura lesion rate (see Fig. 7).

Fig. 3.

Fig. 3

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Kaplan-Meier curve for reoperation and revision rate for lumbar mono- and bisegmental fusion surgeries, kypho-/vertebroplasties by age group (N = 12′815).

Fig. 4.

Fig. 4

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Kaplan-Meier curve for reoperation and revision rate for lumbar mono- and bisegmental fusion surgeries, kypho-/vertebroplasties by gender (N = 12′815).

Fig. 5.

Fig. 5

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Kaplan-Meier curve for reoperation and revision rate for lumbar mono- and bisegmental fusion surgeries, kypho-/vertebroplasties by body mass index (BMI) (N = 12,815).

Fig. 6.

Fig. 6

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Kaplan-Meier curve for reoperation and revision rate for lumbar mono- and bisegmental fusion surgeries, kypho-/vertebroplasties by American Society of Anesthesiologists (ASA) category (N = 12′815).

Fig. 7.

Fig. 7

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Dural lesion rate for lumbar mono- and bisegmental fusion surgeries, kypho-/vertebroplasties by hospital. Rate of observed/expected dural lesions adjusted for age, gender, smoking status, body mass index, American Society of Anesthesiologists (ASA) category, and number of previous surgeries.

3.6. Data validation

Comparison of the registered surgeries in the years between 2021 and 2023 in the registry versus procedure codes in the Federal Office of Public Health showed a completeness rate of 53 %.

4. Discussion

4.1. Experience with setting up the Swiss Implant Registry SIRIS spine

Healthcare actors and ANQ partners agreed and approved incorporation of the spine implant registration into the acute care measurement plan of the ANQ. The consequence of this incorporation was the establishment of the SIRIS Spine registry by the SIRIS foundation. As the registry service provider EUROSPINE with its subcontractor NEC Software Solutions has been chosen, which is also running the international spine registry Spine Tango. Their matured registry application and service supported smooth start of the Swiss registry.

However, a registration of multiple implants in spine surgery on a mandatory basis is a complex and time-consuming task for hospitals, which requires a rich implant catalogue, personal resources and efficient processes within hospitals, implant labels on products, etc. To ensure smooth implementation, the involved national stakeholders agreed on limited inclusion criteria to be stepwise expanded over time. Retrospectively, this was one of the key success factors for the hospital compliance and practicability of the implementation. However, initial experience has shown that the selected inclusion criteria were very complex to handle in everyday clinical practice, which stems from various aspects of those criteria, including specific pathologies (e.g. spinal fusions are excluded for fractures but included for vertebroplasties), symptom duration (e.g. no time limitation applies to spinal fusions, but ≤28 days is required for kypho- and vertebroplasties), segments (e.g. primary spinal fusions are limited to 1–2 segments, whereas kypho- and vertebroplasties and reoperations/revisions have no segment limitation), implantation requirements (e.g. primary spinal fusions and kypho-/vertebroplasties require an implant, but no new implant is needed for decompressions during reoperations/revisions).

4.2. Lack of full data validation as the current key limitation

The key limitation of the current registry data is the lack of full data validation. The highly complex inclusion criteria applied between 2021 and 2023 make it extremely difficult to retrospectively verify case numbers both at the hospital and national levels. This is the main reason for the challenges and the current lack of confirmation regarding the completeness and accuracy of the registered data.

A first partial validation of data from 2021 to 2023 was performed by comparing registry entries with the procedure codes from the Federal Office of Statistics (Jentzsch et al., 2016; Moos et al., 2016). In the first three years only ca. 53 % of surgeries have been registered based on this comparison.

Some proportion of surgeries may have been lost for the registry due to a delayed start with the registration in some hospitals. Also, the logic of procedure codes, which are primarily used for financial settlement and done by medical coders, may differ from the logic of clinicians who are deciding about in- and exclusion of a surgery in the registry. This may have lowered the completeness rate. Thus, this validation against procedure codes is an approximation, while a higher completeness rate is expected in the coming years supported by data validation on sites and other supportive measures.

To address the key limitation of complex inclusion criteria, new simplified inclusion criteria were implemented from 2025 onward. They require registration of all lumbar spine surgeries where an implant is: a) newly inserted, b) already in situ, or c) explanted. With this substantial simplification of inclusion criteria and the introduction of targeted measures to externally monitor data completeness on sites, registration rates are expected to improve significantly.

Because of the lacking full data validation, so far, caution is advised when interpreting the presented results. Additionally, further development and precision of the used metrics is needed. A reoperation or revision is not always related to the quality of care since it may include a planned hardware removal or a natural progression of disease. The presented results may change over time therefore, and, in particularly, the reoperation and revision rate. This is expected, at least in part, due to the planned measures aiming at validation and steadily improvement of the quality of the data.

4.3. Feasibility of data analysis

Our registered data during the initial three years between 2021 and 2023 includes a large number of surgeries (N = 12,815) from 91 hospitals with many implants (N = 75,522) from 40 manufactures. While most data is for degenerative disease (61.6 %), the large number of osteoporotic fractures (12.4 %) may be able in the future, after full data validation, to provide insights into the clinical outcomes of vertebro-/kyphoplasties once revision rates become more apparent and ePROMS can be linked to the clinical outcome (Pourtaheri et al., 2018). Our observed preliminary trend that most patients undergoing spine surgery are older (mean age of 66.8 years), appears to be in line with a study from the Canadian Spine Outcomes and Research Netweork by Ells et al., who reported that 36.1 % of 3421 patients were aged 65 years and older (Ells et al., 2025). Most patients were non-smokers (76.6 %), pre-adipose (BMI 26.3 kg/m2), had mild systemic disease, and at least one prior surgery at the same or adjacent segment. A TLIF was performed most commonly (56.7 %). This may be associated with the relatively frequent rate of reoperations and revisions in 6.9 % within the 3-year time frame. In our exploratory analysis, trends were seen for higher reoperation/revision rates in patients, who were older, overweight/obese, and at higher perioperative risk according to ASA category. Similarly, a study by Kia et al. reported that 13,678 patients from a national Surgical Quality Improvement Program database had a 30-day complication rate of 6.8 % (Kia et al., 2022). They identified age, female gender, obesity, hypertension, and smoking to be risk factors for these complications.

The missing data (smoking status, ASA category, and prior surgeries) were not missing at random, as their absence was associated with the main pathology. The number of operations with missing information was reported; however, these cases were excluded from the univariate subgroup percentage calculations. Missing information for these three variables may have influenced the proportions of related patient characteristics. No further impact of the missing data on the analysis is expected, as the analysis was univariate only.

In the future, comparisons will be possible for reoperation/revision rates between hospitals. Furthermore, data analysis will also consist of pre- and postoperative ePROMs.

4.4. Outlook

A national registry promises multiple benefits for monitoring and improving surgical treatment quality. Registration of implant data in SIRIS Spine will allow for implant data analysis and will support post-market surveillance of medical devises. Spine device market health policy demands good real-life clinical data, and this is one of the current priorities in the spinal care, as devices without reliable clinical data risk to be taken from the marked (Bisschop et al., 2016). The registry will service for timely detection of poor performing implants and thus support patient safety. A systematic undesirable outcome may be observed in a registry, and it may have different causes including, but not limited to wrong indication, surgeon's technical error, patient-related risk factors, natural course of disease, and implant-related issues. Various national hip and knee joint replacement registries, cancer registries and other medical registries have been going this way in the past decades.

However, further efforts have to be invested in the harmonisation of spinal registries to enable data comparisons across countries and in the further development of reliable national comparative metrics including revision/reoperations rates. The vast majority of the spinal registries mentioned in the introduction have joined the International Spine Registry (ISR) working group, which is focusing on their harmonisation. The third annual meeting of the ISR group was held during the Eurospine's annual meeting in Copenhagen in 2025. One of the group's and member registrie's findings was that only the Belgian Spine Registry (Belgium Spine Registry, 2025) and the Swiss SIRIS Spine Implant Registry (Swiss Implant Registry, 2024) capture implant data on a mandatory national basis and at product level.

5. Conclusions

The SIRIS Spine registry has successfully captured initial data from the involved Swiss hospitals. The primary challenge identified was the complexity of inclusion criteria, which has impeded data validation. Future efforts will focus on simplifying criteria, rigorously validating data completeness and accuracy, and leveraging this mandatory national resource for quality improvement and comparative analyses.

Funding

This work was not funded.

Declaration of competing interest

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: The authors of the article are members of the SIRIS Spine Advisory Board (SSAB) of the registry.

Acknowledgment

We would like to thank Prof. Dr. Norbert Boos and PD Dr. Anne Mannion for their valuable advisory role during the initial stages of the SIRIS Spine registry, and the SIRIS foundation, including Prof. Dr. Claudio Dora, Andreas Mischler (including his company Conidea in Thun, Switzerland), as well as Jasmin Vonlanthen for their ongoing support. We would also like to thank EUROSPINE, including Christian Hermann for project management; NEC Software Solutions, for data and registry application management; the Swiss National Association for Quality Development in Hospitals and Clinics (ANQ), including Regula Heller, for their support in the development and implementation of the registry; and the national professional societies (swiss orthopaedics [SO], the Swiss Society for Neurosurgery [SGNC], and the Swiss Society for Spinal Surgery (SGSC). Finally, we would like to thank the spine surgeons, hospitals, and patients for their valuable contributions of data.

Footnotes

Appendix A

Supplementary data to this article can be found online at https://doi.org/10.1016/j.bas.2026.105928.

Appendix A. Supplementary data

The following are the Supplementary data to this article:

Multimedia component 1
mmc1.pdf (259.4KB, pdf)
Multimedia component 2
mmc2.pdf (329.6KB, pdf)

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