{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T16:12:47Z","timestamp":1784995967619,"version":"3.55.0"},"reference-count":56,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2022,4,9]],"date-time":"2022-04-09T00:00:00Z","timestamp":1649462400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,4,9]],"date-time":"2022-04-09T00:00:00Z","timestamp":1649462400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100010669","name":"H2020 LEIT Information and Communication Technologies","doi-asserted-by":"publisher","award":["780572"],"award-info":[{"award-number":["780572"]}],"id":[{"id":"10.13039\/100010669","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Empir Software Eng"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Architectural smells (AS) are notorious for their long-term impact on the Maintainability and Evolvability of software systems. The majority of research work has investigated this topic by mining software repositories of open source Java systems, making it hard to generalise and apply them to an industrial context and other programming languages. To address this research gap, we conducted an embedded multiple-case case study, in collaboration with a large industry partner, to study how AS evolve in industrial embedded systems. We detect and track AS in 9 C\/C++ projects with over 30 releases for each project that span over two years of development, with over 20 millions lines of code in the last release only. In addition to these quantitative results, we also interview 12 among the developers and architects working on these projects, collecting over six hours of qualitative data about the usefulness of AS analysis and the issues they experienced while maintaining and evolving artefacts affected by AS. Our quantitative findings show how individual smell instances evolve over time, how long they typically survive within the system, how they overlap with instances of other smell types, and finally what the introduction order of smell types is when they overlap. Our qualitative findings, instead, provide insights on the effects of AS on the long-term maintainability and evolvability of the system, supported by several excerpts from our interviews. Practitioners also mention what parts of the AS analysis actually provide actionable insights that they can use to plan refactoring activities.<\/jats:p>","DOI":"10.1007\/s10664-022-10132-7","type":"journal-article","created":{"date-parts":[[2022,4,9]],"date-time":"2022-04-09T10:02:50Z","timestamp":1649498570000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["On the evolution and impact of architectural smells\u2014an industrial case study"],"prefix":"10.1007","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3383-3298","authenticated-orcid":false,"given":"Darius","family":"Sas","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paris","family":"Avgeriou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umut","family":"Uyumaz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,4,9]]},"reference":[{"key":"10132_CR1","doi-asserted-by":"crossref","unstructured":"Abdeen H, Ducasse S, Sahraoui H (2011) Modularization metrics: assessing package organization in legacy large object-oriented software. In: 2011 18th Working conference on reverse engineering. IEEE, pp 394\u2013398","DOI":"10.1109\/WCRE.2011.55"},{"key":"10132_CR2","doi-asserted-by":"crossref","unstructured":"Al-Mutawa H A, Dietrich J, Marsland S, McCartin C (2014) On the shape of circular dependencies in java programs. In: Proceedings of the Australian software engineering conference, ASWEC. IEEE, pp 48\u201357","DOI":"10.1109\/ASWEC.2014.15"},{"key":"10132_CR3","doi-asserted-by":"crossref","unstructured":"Arcelli Fontana F, Ferme V, Zanoni M, Yamashita A (2015) Automatic metric thresholds derivation for code smell detection. In: International workshop on emerging trends in software metrics, WETSoM, pp 44\u201353","DOI":"10.1109\/WETSoM.2015.14"},{"key":"10132_CR4","doi-asserted-by":"crossref","unstructured":"Arcelli Fontana F, Pigazzini I, Roveda R, Tamburri D, Zanoni M, Nitto ED (2017a) Arcan: a tool for architectural smells detection. In: Proceedings\u20142017 IEEE international conference on software architecture workshops, ICSAW 2017: side track proceedings, pp 282\u2013285","DOI":"10.1109\/ICSAW.2017.16"},{"key":"10132_CR5","doi-asserted-by":"crossref","unstructured":"Arcelli Fontana F, Pigazzini I, Roveda R, Zanoni M (2017b) Automatic detection of instability architectural smells. In: Proceedings\u20142016 IEEE international conference on software maintenance and evolution, ICSME 2016, pp 433\u2013437","DOI":"10.1109\/ICSME.2016.33"},{"key":"10132_CR6","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1016\/j.jss.2019.04.066","volume":"154","author":"F Arcelli Fontana","year":"2019","unstructured":"Arcelli Fontana F, Lenarduzzi V, Roveda R, Taibi D (2019) Are architectural smells independent from code smells? An empirical study. J Syst Softw 154:139\u2013156","journal-title":"J Syst Softw"},{"key":"10132_CR7","unstructured":"Arcelli Fontana F, Locatelli F, Pigazzini I, Mereghetti P (2020) An architectural smell evaluation in an industrial context, pp 68\u201374"},{"key":"10132_CR8","doi-asserted-by":"crossref","unstructured":"Azadi U, Arcelli Fontana F, Taibi D (2019) Architectural smells detected by tools : a catalogue proposal architectural smells detected by tools : a catalogue proposal. In: International conference on technical debt (TechDebt 2019)","DOI":"10.1109\/TechDebt.2019.00027"},{"key":"10132_CR9","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.jss.2015.05.024","volume":"107","author":"G Bavota","year":"2015","unstructured":"Bavota G, De Lucia A, Di Penta M, Oliveto R, Palomba F (2015) An experimental investigation on the innate relationship between quality and refactoring. J Syst Softw 107:1\u201314","journal-title":"J Syst Softw"},{"key":"10132_CR10","doi-asserted-by":"crossref","unstructured":"Biaggi A, Arcelli Fontana F, Roveda R (2018) An architectural smells detection tool for C and C++ projects. In: 2018 44th Euromicro conference on software engineering and advanced applications (SEAA). IEEE, pp 417\u2013420","DOI":"10.1109\/SEAA.2018.00074"},{"key":"10132_CR11","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1023\/A:1020909529486","volume":"36","author":"H Boeije","year":"2002","unstructured":"Boeije H (2002) A purposeful approach to the constant comparative method in the analysis of qualitative interviews. Qual Quant 36:391\u2013409","journal-title":"Qual Quant"},{"key":"10132_CR12","doi-asserted-by":"crossref","unstructured":"Brereton P, Kitchenham B, Budgen D, Li Z (2008) Using a protocol template for case study planning. In: Proceedings of the 12th international conference on evaluation and assessment in software engineering, number 2006, p 8","DOI":"10.14236\/ewic\/EASE2008.5"},{"key":"10132_CR13","doi-asserted-by":"crossref","unstructured":"Cedrim D, Garcia A, Mongiovi M, Gheyi R, Sousa L, de Mello R, Fonseca B, Ribeiro M, Ch\u00e1vez A (2017) Understanding the impact of refactoring on smells: a longitudinal study of 23 software projects. In: Proceedings of the 2017 11th joint meeting on foundations of software engineering, ESEC\/FSE 2017. Association for Computing Machinery, New York, pp 465\u2013475","DOI":"10.1145\/3106237.3106259"},{"issue":"1","key":"10132_CR14","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1007\/s11334-013-0205-z","volume":"10","author":"A Chatzigeorgiou","year":"2014","unstructured":"Chatzigeorgiou A, Manakos A (2014) Investigating the evolution of code smells in object-oriented systems. Innov Syst Softw Eng 10(1):3\u201318","journal-title":"Innov Syst Softw Eng"},{"key":"10132_CR15","doi-asserted-by":"crossref","unstructured":"De Andrade H S, Almeida E, Crnkovic I (2014) Architectural bad smells in software product lines: an exploratory study. In: ACM International conference proceeding series. Association for Computing Machinery, New York, pp 1\u20136","DOI":"10.1145\/2578128.2578237"},{"key":"10132_CR16","doi-asserted-by":"crossref","unstructured":"Ernst N A, Bellomo S, Ozkaya I, Nord R L, Gorton I (2015) Measure it? Manage it? Ignore it? Software practitioners and technical debt. In: Proceedings of the 2015 10th joint meeting on foundations of software engineering\u2014ESEC\/FSE 2015. ACM Press, New York, pp 50\u201360","DOI":"10.1145\/2786805.2786848"},{"key":"10132_CR17","doi-asserted-by":"crossref","unstructured":"Feng Q, Cai Y, Kazman R, Cui D, Liu T, Fang H (2019) Active hotspot: an issue-oriented model to monitor software evolution and degradation. In: Proceedings\u20142019 34th IEEE\/ACM international conference on automated software engineering, ASE, 2019, pp 986\u2013997","DOI":"10.1109\/ASE.2019.00095"},{"key":"10132_CR18","doi-asserted-by":"publisher","DOI":"10.1145\/581441.581453","volume-title":"Refactoring: improving the design of existing code, 1st edn","author":"M Fowler","year":"2002","unstructured":"Fowler M, Beck K (2002) Refactoring: improving the design of existing code, 1st edn. Addison-Wesley Professional, Boston"},{"key":"10132_CR19","doi-asserted-by":"crossref","unstructured":"Garcia J, Popescu D, Edwards G, Medvidovic N (2009) Identifying architectural bad smells. In: Proceedings of the European conference on software maintenance and reengineering, CSMR, pp 255\u2013258","DOI":"10.1109\/CSMR.2009.59"},{"key":"10132_CR20","doi-asserted-by":"publisher","DOI":"10.4324\/9780203793206","volume-title":"Discovery of grounded theory: strategies for qualitative research","author":"BG Glaser","year":"2017","unstructured":"Glaser B G, Strauss A L (2017) Discovery of grounded theory: strategies for qualitative research. Routledge, New York"},{"issue":"4","key":"10132_CR21","doi-asserted-by":"publisher","first-page":"364","DOI":"10.1097\/00006199-196807000-00014","volume":"17","author":"BG Glaser","year":"1968","unstructured":"Glaser B G, Strauss A L, Strutzel E (1968) The discovery of grounded theory; strategies for qualitative research. Nurs Res 17(4):364","journal-title":"Nurs Res"},{"issue":"282","key":"10132_CR22","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1080\/01621459.1958.10501452","volume":"53","author":"EL Kaplan","year":"1958","unstructured":"Kaplan E L, Meier P (1958) Nonparametric estimation from incomplete observations. J Am Stat Assoc 53(282):457\u2013481","journal-title":"J Am Stat Assoc"},{"key":"10132_CR23","doi-asserted-by":"crossref","unstructured":"Kruskal J, Liberman M (1983) The symmetric time-warping problem: from continuous to discrete. In: Time warps, string edits, and macromolecules: the theory and practice of sequence comparison","DOI":"10.1137\/1025045"},{"key":"10132_CR24","doi-asserted-by":"crossref","unstructured":"Le D M, Carrillo C, Capilla R, Medvidovic N (2016) Relating architectural decay and sustainability of software systems. In: Proceedings\u20142016 13th working IEEE\/IFIP conference on software architecture, WICSA 2016. Institute of Electrical and Electronics Engineers Inc, pp 178\u2013181","DOI":"10.1109\/WICSA.2016.15"},{"key":"10132_CR25","doi-asserted-by":"crossref","unstructured":"Le D M, Link D, Shahbazian A, Medvidovic N (2018) An empirical study of architectural decay in open-source software. In: Proceedings\u20142018 IEEE 15th international conference on software architecture, ICSA 2018. IEEE, pp 176\u2013185","DOI":"10.1109\/ICSA.2018.00027"},{"key":"10132_CR26","doi-asserted-by":"crossref","unstructured":"Lefever J, Cai Y, Cervantes H, Kazman R, Fang H (2021) On the lack of consensus among technical debt detection tools. In: Proceedings\u2014international conference on software engineering. IEEE Computer Society, pp 121\u2013130","DOI":"10.1109\/ICSE-SEIP52600.2021.00021"},{"issue":"9","key":"10132_CR27","doi-asserted-by":"publisher","first-page":"1060","DOI":"10.1109\/PROC.1980.11805","volume":"68","author":"M Lehman","year":"1980","unstructured":"Lehman M (1980) Programs, life cycles, and laws of software evolution. Proc IEEE 68(9):1060\u20131076","journal-title":"Proc IEEE"},{"key":"10132_CR28","volume-title":"Refactoring in large software projects: performing complex restructurings successfully","author":"M Lippert","year":"2006","unstructured":"Lippert M, Roock S (2006) Refactoring in large software projects: performing complex restructurings successfully. Wiley, New York"},{"key":"10132_CR29","unstructured":"Martin R (1994) Oo design quality metrics. An analysis of dependencies 12:151\u2013170"},{"key":"10132_CR30","volume-title":"Clean architecture: a craftsman\u2019s guide to software structure and design, 1st edn","author":"RC Martin","year":"2017","unstructured":"Martin R C (2017) Clean architecture: a craftsman\u2019s guide to software structure and design, 1st edn. Prentice Hall Press, Upper Saddle River"},{"key":"10132_CR31","unstructured":"Martin R (2000) Design principles and design patterns. Object Mentor"},{"key":"10132_CR32","first-page":"320","volume-title":"Identifying and prioritizing architectural debt through architectural smells: a case study in a large software company","author":"A Martini","year":"2018","unstructured":"Martini A, Arcelli Fontana F, Biaggi A, Roveda R (2018) Identifying and prioritizing architectural debt through architectural smells: a case study in a large software company. Springer, Cham, pp 320\u2013335"},{"key":"10132_CR33","doi-asserted-by":"crossref","unstructured":"Mathison S (2005) Constant comparative method. Encyclopedia of evaluation 1:0","DOI":"10.4135\/9781412950558"},{"key":"10132_CR34","doi-asserted-by":"crossref","unstructured":"Mo R, Cai Y, Kazman R, Xiao L (2015) Hotspot patterns: the formal definition and automatic detection of architecture smells. In: Proceedings\u201412th working IEEE\/IFIP conference on software architecture, WICSA 2015, pp 51\u201360","DOI":"10.1109\/WICSA.2015.12"},{"key":"10132_CR35","doi-asserted-by":"crossref","unstructured":"Mo R, Ramaswamy S, Snipes W, Kazman R, Cai Y, Naedele M (2018) Experiences applying automated architecture analysis tool suites. In: ASE 2018\u2014proceedings of the 33rd ACM\/IEEE international conference on automated software engineering. Association for Computing Machinery, Inc, pp 779\u2013789","DOI":"10.1145\/3238147.3240467"},{"key":"10132_CR36","doi-asserted-by":"crossref","unstructured":"Nayebi M, Cai Y, Kazman R, Ruhe G, Feng Q, Carlson C, Chew F (2019) A longitudinal study of identifying and paying down architecture debt. In: Proceedings\u20142019 IEEE\/ACM 41st international conference on software engineering: software engineering in practice, ICSE-SEIP 2019, pp 171\u2013180","DOI":"10.1109\/ICSE-SEIP.2019.00026"},{"key":"10132_CR37","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1016\/j.jss.2017.03.044","volume":"128","author":"AS Nu\u00f1ez-Varela","year":"2017","unstructured":"Nu\u00f1ez-Varela A S, P\u00e9rez-Gonzalez H G, Mart\u00ednez-Perez F E, Soubervielle-Montalvo C (2017) Source code metrics: a systematic mapping study. J Syst Softw 128:164\u2013197","journal-title":"J Syst Softw"},{"key":"10132_CR38","doi-asserted-by":"crossref","unstructured":"Oyetoyan T D, Falleri J R, Dietrich J, Jezek K (2015) Circular dependencies and change-proneness: an empirical study. In: 2015 IEEE 22nd international conference on software analysis, evolution, and reengineering, SANER 2015\u2014proceedings. Institute of Electrical and Electronics Engineers Inc, pp 241\u2013250","DOI":"10.1109\/SANER.2015.7081834"},{"key":"10132_CR39","unstructured":"Page L, Brin S, Motwani R, Winograd T (1999) The pagerank citation ranking: bringing order to the web. Technical report, Stanford InfoLab"},{"key":"10132_CR40","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.infsof.2018.02.004","volume":"99","author":"F Palomba","year":"2018","unstructured":"Palomba F, Bavota G, Di Penta M, Fasano F, Oliveto R, De Lucia A (2018) A large-scale empirical study on the lifecycle of code smell co-occurrences. Inf Softw Technol 99:1\u201310. https:\/\/doi.org\/10.1016\/j.infsof.2018.02.004","journal-title":"Inf Softw Technol"},{"key":"10132_CR41","doi-asserted-by":"crossref","unstructured":"Parnas D L (1979) Designing software for ease of extension and contraction. IEEE Trans Softw Eng (2):128\u2013138","DOI":"10.1109\/TSE.1979.234169"},{"issue":"4","key":"10132_CR42","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1145\/141874.141884","volume":"17","author":"DE Perry","year":"1992","unstructured":"Perry D E, Wolf A L (1992) Foundations for the study of software architecture. SIGSOFT Softw Eng Notes 17(4):40\u201352","journal-title":"SIGSOFT Softw Eng Notes"},{"key":"10132_CR43","doi-asserted-by":"crossref","unstructured":"Pruijt L, K\u00f6ppe C, van der Werf J M, Brinkkemper S (2017) The accuracy of dependency analysis in static architecture compliance checking. In: Software\u2014practice and experience, vol 47. Wiley, pp 273\u2013309","DOI":"10.1002\/spe.2421"},{"key":"10132_CR44","doi-asserted-by":"crossref","unstructured":"Roveda R, Arcelli Fontana F, Pigazzini I, Zanoni M (2018) Towards an architectural debt index. In: 2018 44th Euromicro conference on software engineering and advanced applications (SEAA). IEEE, pp 408\u2013416","DOI":"10.1109\/SEAA.2018.00073"},{"key":"10132_CR45","doi-asserted-by":"publisher","DOI":"10.1002\/9781118181034","volume-title":"Case study research in software engineering\u2014guidelines and examples","author":"P Runeson","year":"2012","unstructured":"Runeson P, H\u00f6st M, Rainer A, Regnell B (2012) Case study research in software engineering\u2014guidelines and examples. Wiley, New York"},{"issue":"2002","key":"10132_CR46","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1109\/MS.2002.1003450","volume":"19.3","author":"I Rus","year":"2002","unstructured":"Rus I, Lindvall M (2002) Knowledge management in software engineering. IEEE Softw 19.3(2002):26\u201338","journal-title":"IEEE Softw"},{"key":"10132_CR47","doi-asserted-by":"crossref","unstructured":"Samarthyam G, Suryanarayana G, Sharma T (2016) Refactoring for software architecture smells. In: Proceedings of the 1st international workshop on software refactoring\u2014IWoR 2016. ACM Press, New York, pp 1\u20134","DOI":"10.1145\/2975945.2975946"},{"key":"10132_CR48","doi-asserted-by":"crossref","unstructured":"Sas D, Avgeriou P, Arcelli Fontana F (2019) Investigating instability architectural smells evolution: an exploratory case study. In: 35th International conference on software maintenance and evolution. IEEE, pp 557\u2013567","DOI":"10.1109\/ICSME.2019.00090"},{"issue":"2","key":"10132_CR49","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1147\/sj.132.0115","volume":"13","author":"WP Stevens","year":"1974","unstructured":"Stevens W P, Myers G J, Constantine L L (1974) Structured design. IBM Syst J 13(2):115\u2013139","journal-title":"IBM Syst J"},{"key":"10132_CR50","unstructured":"TIOBE (2021) The TIOBE programming community index. https:\/\/www.tiobe.com\/tiobe-index\/. Accessed: 30 Mar 2021"},{"key":"10132_CR51","doi-asserted-by":"crossref","unstructured":"Tufano M, Palomba F, Bavota G, Olivetox R, Di Penta M, De Lucia A, Poshyvanyk D (2015) When and why your code starts to smell bad. In: Proceedings\u2014international conference on software engineering, vol 1. IEEE Press, pp 403\u2013414","DOI":"10.1109\/ICSE.2015.59"},{"key":"10132_CR52","doi-asserted-by":"crossref","unstructured":"van Solingen R, Basili V, Caldiera G, Rombach H D (2002) Goal question metric (GQM) approach. In: Encyclopedia of software engineering. Wiley","DOI":"10.1002\/0471028959.sof142"},{"key":"10132_CR53","unstructured":"van Vliet H (2008) Software engineering: principles and practice, p 713"},{"key":"10132_CR54","doi-asserted-by":"crossref","unstructured":"Vaucher S, Khomh F, Moha N, Gu\u00e9h\u00e9neuc Y G (2009) Tracking design smells: lessons from a study of God classes. In: Proceedings\u2014working conference on reverse engineering, WCRE. IEEE, pp 145\u2013154","DOI":"10.1109\/WCRE.2009.23"},{"key":"10132_CR55","doi-asserted-by":"crossref","unstructured":"Verdecchia R, Malavolta I, Lago P (2018) Architectural technical debt identification: the research landscape. In: 2018 ACM\/IEEE international conference on technical debt","DOI":"10.1145\/3194164.3194176"},{"key":"10132_CR56","doi-asserted-by":"crossref","unstructured":"Xiao L, Cai Y, Kazman R, Mo R, Feng Q (2016) Identifying and quantifying architectural debt. In: Proceedings\u2014international conference on software engineering, vol 14. IEEE Computer Society, pp 488\u2013498","DOI":"10.1145\/2884781.2884822"}],"container-title":["Empirical Software Engineering"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10664-022-10132-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10664-022-10132-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10664-022-10132-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,6,9]],"date-time":"2022-06-09T20:58:17Z","timestamp":1654808297000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10664-022-10132-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,9]]},"references-count":56,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2022,7]]}},"alternative-id":["10132"],"URL":"https:\/\/doi.org\/10.1007\/s10664-022-10132-7","relation":{},"ISSN":["1382-3256","1573-7616"],"issn-type":[{"value":"1382-3256","type":"print"},{"value":"1573-7616","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,9]]},"assertion":[{"value":"11 February 2022","order":1,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 April 2022","order":2,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All subjects of our interviews were asked whether they would agree taking part in the interview beforehand. Interviewees were also informed of the possibility that excerpts from the interviews may be used in a published version of the manuscript.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"<!--Emphasis Type='Bold' removed-->Consent to Participate"}}],"article-number":"86"}}