{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T23:47:47Z","timestamp":1794008867347,"version":"4.8.0"},"reference-count":34,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T00:00:00Z","timestamp":1750896000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T00:00:00Z","timestamp":1750896000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Neurol"],"published-print":{"date-parts":[[2025,7]]},"DOI":"10.1007\/s00415-025-13192-z","type":"journal-article","created":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T02:40:28Z","timestamp":1750905628000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Mitochondrial pathology in inflammatory myopathies: a marker of worse clinical outcome"],"prefix":"10.1007","volume":"272","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8853-7280","authenticated-orcid":false,"given":"Antonio","family":"Lauletta","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Bosco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gioia","family":"Merlonghi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuri Matteo","family":"Falzone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Cheli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta Piera","family":"Bencivenga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dario","family":"Zoppi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Ceccanti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Kleefeld","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"L\u00e9onard-Louis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Werner","family":"Stenzel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Benveniste","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Maggi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano Carlo","family":"Previtali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Garibaldi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,6,26]]},"reference":[{"key":"13192_CR1","doi-asserted-by":"publisher","first-page":"1734","DOI":"10.1056\/NEJMra1402225","volume":"372","author":"MC Dalakas","year":"2015","unstructured":"Dalakas MC (2015) Inflammatory muscle diseases. N Engl J Med 372:1734\u20131747. https:\/\/doi.org\/10.1056\/NEJMra1402225","journal-title":"N Engl J Med"},{"key":"13192_CR2","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1038\/s41572-021-00321-x","volume":"7","author":"IE Lundberg","year":"2021","unstructured":"Lundberg IE, Fujimoto M, Vencovsky J, Aggarwal R, Holmqvist M, Christopher-Stine L et al (2021) Idiopathic inflammatory myopathies. Nat Rev Dis Primers 7:86. https:\/\/doi.org\/10.1038\/s41572-021-00321-x","journal-title":"Nat Rev Dis Primers"},{"key":"13192_CR3","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1016\/j.jns.2008.11.010","volume":"278","author":"P Temiz","year":"2009","unstructured":"Temiz P, Weihl CC, Pestronk A (2009) Inflammatory myopathies with mitochondrial pathology and protein aggregates. J Neurol Sci 278:25\u201329. https:\/\/doi.org\/10.1016\/j.jns.2008.11.010","journal-title":"J Neurol Sci"},{"issue":"Pt 1","key":"13192_CR4","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1093\/brain\/120.1.39","volume":"120","author":"G Blume","year":"1997","unstructured":"Blume G, Pestronk A, Frank B, Johns DR (1997) Polymyositis with cytochrome oxidase negative muscle fibres. Early quadriceps weakness and poor response to immunosuppressive therapy. Brain 120(Pt 1):39\u201345. https:\/\/doi.org\/10.1093\/brain\/120.1.39","journal-title":"Brain"},{"key":"13192_CR5","doi-asserted-by":"publisher","first-page":"620","DOI":"10.1016\/S1474-4422(07)70171-0","volume":"6","author":"M Needham","year":"2007","unstructured":"Needham M, Mastaglia FL (2007) Inclusion body myositis: current pathogenetic concepts and diagnostic and therapeutic approaches. Lancet Neurol 6:620\u2013631. https:\/\/doi.org\/10.1016\/S1474-4422(07)70171-0","journal-title":"Lancet Neurol"},{"key":"13192_CR6","doi-asserted-by":"publisher","first-page":"441","DOI":"10.1016\/j.nmd.2022.03.005","volume":"32","author":"IJ Acosta","year":"2022","unstructured":"Acosta IJ, Hofer M, Brady S (2022) Mitochondrial dysfunction in anti-3-hydroxy-3-methylglutaryl-CoA reductase (HMGCR) immune-mediated necrotising myopathy. Neuromuscul Disord 32:441\u2013444. https:\/\/doi.org\/10.1016\/j.nmd.2022.03.005","journal-title":"Neuromuscul Disord"},{"key":"13192_CR7","doi-asserted-by":"publisher","first-page":"4525","DOI":"10.1007\/s10072-023-07035-w","volume":"44","author":"A Lauletta","year":"2023","unstructured":"Lauletta A, De Carolis L, Teresi V, Fionda L, Leonardi L, Ceccanti M et al (2023) Prominent mitochondrial pathology in a case of refractory dermatomyositis: coincidence or concause? Neurol Sci 44:4525\u20134529. https:\/\/doi.org\/10.1007\/s10072-023-07035-w","journal-title":"Neurol Sci"},{"key":"13192_CR8","doi-asserted-by":"publisher","first-page":"615","DOI":"10.1007\/s10735-004-2194-6","volume":"35","author":"MI Alhatou","year":"2004","unstructured":"Alhatou MI, Sladky JT, Bagasra O, Glass JD (2004) Mitochondrial abnormalities in dermatomyositis: characteristic pattern of neuropathology. J Mol Histol 35:615\u2013619. https:\/\/doi.org\/10.1007\/s10735-004-2194-6","journal-title":"J Mol Histol"},{"key":"13192_CR9","doi-asserted-by":"publisher","first-page":"651","DOI":"10.1097\/BOR.0b013e32833f108a","volume":"22","author":"AS Varadhachary","year":"2010","unstructured":"Varadhachary AS, Weihl CC, Pestronk A (2010) Mitochondrial pathology in immune and inflammatory myopathies. Curr Opin Rheumatol 22:651\u2013657. https:\/\/doi.org\/10.1097\/BOR.0b013e32833f108a","journal-title":"Curr Opin Rheumatol"},{"key":"13192_CR10","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1016\/j.anndiagpath.2012.10.004","volume":"17","author":"T Siepmann","year":"2013","unstructured":"Siepmann T, Tesch M, Krause F, Illigens BM-W, Stoltenburg-Didinger G (2013) Polymyositis with cytochrome C oxidase negative fibers\u2013a pathological and clinical challenge. Ann Diagn Pathol 17:183\u20136. https:\/\/doi.org\/10.1016\/j.anndiagpath.2012.10.004","journal-title":"Ann Diagn Pathol"},{"key":"13192_CR11","doi-asserted-by":"publisher","first-page":"1459","DOI":"10.1007\/s00296-019-04314-8","volume":"39","author":"GK Papadimas","year":"2019","unstructured":"Papadimas GK, Kokkinis C, Xirou S, Chrysanthou M, Kararizou E, Papadopoulos C (2019) Polymyositis with mitochondrial pathology or atypical form of sporadic inclusion body myositis: case series and review of the literature. Rheumatol Int 39:1459\u20131466. https:\/\/doi.org\/10.1007\/s00296-019-04314-8","journal-title":"Rheumatol Int"},{"key":"13192_CR12","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000201103","author":"F Kleefeld","year":"2022","unstructured":"Kleefeld F, Uruha A, Sch\u00e4nzer A, Nishimura A, Roos A, Schneider U et al (2022) Morphological and molecular patterns of polymyositis with mitochondrial pathology and inclusion body myositis. Neurology. https:\/\/doi.org\/10.1212\/WNL.0000000000201103","journal-title":"Neurology"},{"key":"13192_CR13","doi-asserted-by":"publisher","first-page":"1060","DOI":"10.1093\/jnen\/nlab101","volume":"80","author":"M Winkler","year":"2021","unstructured":"Winkler M, von Landenberg C, Kappes-Horn K, Neudecker S, Kornblum C, Reimann J (2021) Diagnosis and clinical development of sporadic inclusion body myositis and polymyositis with mitochondrial pathology: a single-center retrospective analysis. J Neuropathol Exp Neurol 80:1060\u20131067. https:\/\/doi.org\/10.1093\/jnen\/nlab101","journal-title":"J Neuropathol Exp Neurol"},{"key":"13192_CR14","doi-asserted-by":"publisher","first-page":"1955","DOI":"10.1136\/annrheumdis-2017-211468","volume":"76","author":"IE Lundberg","year":"2017","unstructured":"Lundberg IE, Tj\u00e4rnlund A, Bottai M, Werth VP, Pilkington C, de Visser M et al (2017) 2017 European League Against Rheumatism\/American College of Rheumatology classification criteria for adult and juvenile idiopathic inflammatory myopathies and their major subgroups. Ann Rheum Dis 76:1955\u20131964. https:\/\/doi.org\/10.1136\/annrheumdis-2017-211468","journal-title":"Ann Rheum Dis"},{"key":"13192_CR15","doi-asserted-by":"publisher","first-page":"483","DOI":"10.1016\/j.nmd.2019.03.002","volume":"29","author":"B Udd","year":"2019","unstructured":"Udd B, Stenzel W, Oldfors A, Oliv\u00e9 M, Romero N, Lammens M et al (2019) 1st ENMC European meeting: The EURO-NMD pathology working group Recommended Standards for Muscle Pathology Amsterdam, The Netherlands, 7 December 2018. Neuromuscul Disord 29:483\u2013485. https:\/\/doi.org\/10.1016\/j.nmd.2019.03.002","journal-title":"Neuromuscul Disord"},{"key":"13192_CR16","doi-asserted-by":"publisher","unstructured":"Allenbach Y, Mammen AL, Benveniste O, Stenzel W, Immune-Mediated Necrotizing Myopathies Working Group. 224th ENMC International Workshop:: Clinico-sero-pathological classification of immune-mediated necrotizing myopathies Zandvoort, The Netherlands, 14\u201316 October 2016. Neuromuscul Disord 2018;28:87\u201399. https:\/\/doi.org\/10.1016\/j.nmd.2017.09.016.","DOI":"10.1016\/j.nmd.2017.09.016"},{"key":"13192_CR17","doi-asserted-by":"publisher","first-page":"344","DOI":"10.1056\/NEJM197502132920706","volume":"292","author":"A Bohan","year":"1975","unstructured":"Bohan A, Peter JB (1975) Polymyositis and dermatomyositis (first of two parts). N Engl J Med 292:344\u2013347. https:\/\/doi.org\/10.1056\/NEJM197502132920706","journal-title":"N Engl J Med"},{"key":"13192_CR18","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1056\/NEJM197502202920807","volume":"292","author":"A Bohan","year":"1975","unstructured":"Bohan A, Peter JB (1975) Polymyositis and dermatomyositis (second of two parts). N Engl J Med 292:403\u2013407. https:\/\/doi.org\/10.1056\/NEJM197502202920807","journal-title":"N Engl J Med"},{"key":"13192_CR19","doi-asserted-by":"publisher","unstructured":"Mammen AL, Allenbach Y, Stenzel W, Benveniste O, ENMC 239th Workshop Study Group. 239th ENMC International Workshop: Classification of dermatomyositis, Amsterdam, the Netherlands, 14\u201316 December 2018. Neuromuscul Disord 2020;30:70\u201392. https:\/\/doi.org\/10.1016\/j.nmd.2019.10.005.","DOI":"10.1016\/j.nmd.2019.10.005"},{"key":"13192_CR20","doi-asserted-by":"publisher","DOI":"10.1016\/j.nmd.2024.104453","volume":"2014","author":"W Stenzel","year":"2024","unstructured":"Stenzel W, Mammen AL, Gallay L, Holzer M-T, Kleefeld F, Benveniste O et al (2024) 273rd ENMC International workshop: Clinico-Sero-Morphological Classification of the Antisynthetase Syndrome, Amsterdam, The Netherlands, 27\u201329 October 2023. Neuromuscul Disord 2014:104453. https:\/\/doi.org\/10.1016\/j.nmd.2024.104453","journal-title":"Neuromuscul Disord"},{"key":"13192_CR21","doi-asserted-by":"publisher","first-page":"662","DOI":"10.1097\/WCO.0000000000000376","volume":"29","author":"O Benveniste","year":"2016","unstructured":"Benveniste O, Stenzel W, Allenbach Y (2016) Advances in serological diagnostics of inflammatory myopathies. Curr Opin Neurol 29:662\u2013673. https:\/\/doi.org\/10.1097\/WCO.0000000000000376","journal-title":"Curr Opin Neurol"},{"key":"13192_CR22","doi-asserted-by":"publisher","first-page":"1240","DOI":"10.1136\/jnnp-2013-305690","volume":"84","author":"S Brady","year":"2013","unstructured":"Brady S, Squier W, Hilton-Jones D (2013) Clinical assessment determines the diagnosis of inclusion body myositis independently of pathological features. J Neurol Neurosurg Psychiatry 84:1240\u20131246. https:\/\/doi.org\/10.1136\/jnnp-2013-305690","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"13192_CR23","doi-asserted-by":"publisher","DOI":"10.1093\/braincomms\/fcaa181","volume":"2","author":"S Shelly","year":"2020","unstructured":"Shelly S, Triplett JD, Pinto MV, Milone M, Diehn FE, Zekeridou A et al (2020) Immune checkpoint inhibitor-associated myopathy: a clinicoseropathologically distinct myopathy. Brain Commun 2:fcaa181. https:\/\/doi.org\/10.1093\/braincomms\/fcaa181","journal-title":"Brain Commun"},{"key":"13192_CR24","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1007\/s00415-024-12748-9","volume":"272","author":"A Lauletta","year":"2025","unstructured":"Lauletta A, de Le HL, Leonard-Louis S, Garibaldi M, Allenbach Y, Benveniste O (2025) Refining the clinical and therapeutic spectrum of granulomatous myositis from a large cohort of patients. J Neurol 272:123. https:\/\/doi.org\/10.1007\/s00415-024-12748-9","journal-title":"J Neurol"},{"key":"13192_CR25","doi-asserted-by":"publisher","first-page":"597","DOI":"10.1002\/mus.10194","volume":"26","author":"S DiMauro","year":"2002","unstructured":"DiMauro S, Tanji K, Bonilla E, Pallotti F, Schon EA (2002) Mitochondrial abnormalities in muscle and other aging cells: classification, causes, and effects. Muscle Nerve 26:597\u2013607. https:\/\/doi.org\/10.1002\/mus.10194","journal-title":"Muscle Nerve"},{"key":"13192_CR26","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1016\/j.nmd.2024.03.001","volume":"37","author":"JB Lilleker","year":"2024","unstructured":"Lilleker JB, Naddaf E, Saris CGJ, Schmidt J, de Visser M, Weihl CC et al (2024) 272nd ENMC international workshop: 10 Years of progress - revision of the ENMC 2013 diagnostic criteria for inclusion body myositis and clinical trial readiness. 16\u201318 June 2023, Hoofddorp, The Netherlands. Neuromuscul Disord 37:36\u201351. https:\/\/doi.org\/10.1016\/j.nmd.2024.03.001","journal-title":"Neuromuscul Disord"},{"key":"13192_CR27","doi-asserted-by":"publisher","first-page":"581","DOI":"10.1097\/00005072-199507000-00012","volume":"54","author":"A Oldfors","year":"1995","unstructured":"Oldfors A, Moslemi AR, Fyhr IM, Holme E, Larsson NG, Lindberg C (1995) Mitochondrial DNA deletions in muscle fibers in inclusion body myositis. J Neuropathol Exp Neurol 54:581\u2013587. https:\/\/doi.org\/10.1097\/00005072-199507000-00012","journal-title":"J Neuropathol Exp Neurol"},{"key":"13192_CR28","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1186\/s40478-022-01389-6","volume":"10","author":"C Nelke","year":"2022","unstructured":"Nelke C, Kleefeld F, Preusse C, Ruck T, Stenzel W (2022) Inclusion body myositis and associated diseases: an argument for shared immune pathologies. Acta Neuropathol Commun 10:84. https:\/\/doi.org\/10.1186\/s40478-022-01389-6","journal-title":"Acta Neuropathol Commun"},{"key":"13192_CR29","doi-asserted-by":"publisher","first-page":"1635","DOI":"10.1093\/brain\/awf163","volume":"125","author":"G Cea","year":"2002","unstructured":"Cea G, Bendahan D, Manners D, Hilton-Jones D, Lodi R, Styles P et al (2002) Reduced oxidative phosphorylation and proton efflux suggest reduced capillary blood supply in skeletal muscle of patients with dermatomyositis and polymyositis: a quantitative 31P-magnetic resonance spectroscopy and MRI study. Brain 125:1635\u20131645. https:\/\/doi.org\/10.1093\/brain\/awf163","journal-title":"Brain"},{"key":"13192_CR30","doi-asserted-by":"publisher","first-page":"5403","DOI":"10.1038\/s41467-024-49460-1","volume":"15","author":"C Abad","year":"2024","unstructured":"Abad C, Pinal-Fernandez I, Guillou C, Bourdenet G, Drouot L, Cosette P et al (2024) IFN\u03b3 causes mitochondrial dysfunction and oxidative stress in myositis. Nat Commun 15:5403. https:\/\/doi.org\/10.1038\/s41467-024-49460-1","journal-title":"Nat Commun"},{"key":"13192_CR31","doi-asserted-by":"publisher","first-page":"e1193","DOI":"10.1212\/WNL.0000000000008128","volume":"93","author":"I Pinal-Fernandez","year":"2019","unstructured":"Pinal-Fernandez I, Casal-Dominguez M, Derfoul A, Pak K, Plotz P, Miller FW et al (2019) Identification of distinctive interferon gene signatures in different types of myositis. Neurology 93:e1193\u2013e1204. https:\/\/doi.org\/10.1212\/WNL.0000000000008128","journal-title":"Neurology"},{"key":"13192_CR32","doi-asserted-by":"publisher","first-page":"655","DOI":"10.1007\/s00401-017-1731-9","volume":"134","author":"A Meyer","year":"2017","unstructured":"Meyer A, Laverny G, Allenbach Y, Grelet E, Ueberschlag V, Echaniz-Laguna A et al (2017) IFN-\u03b2-induced reactive oxygen species and mitochondrial damage contribute to muscle impairment and inflammation maintenance in dermatomyositis. Acta Neuropathol 134:655\u2013666. https:\/\/doi.org\/10.1007\/s00401-017-1731-9","journal-title":"Acta Neuropathol"},{"key":"13192_CR33","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1002\/path.5309","volume":"249","author":"JF Boehler","year":"2019","unstructured":"Boehler JF, Horn A, Novak J, Li N, Ghimbovschi S, Lundberg IE et al (2019) Mitochondrial dysfunction and role of harakiri in the pathogenesis of myositis. J Pathol 249:215. https:\/\/doi.org\/10.1002\/path.5309","journal-title":"J Pathol"},{"key":"13192_CR34","doi-asserted-by":"publisher","first-page":"12926","DOI":"10.3390\/ijms232112926","volume":"23","author":"T-H Chen","year":"2022","unstructured":"Chen T-H, Koh K-Y, Lin KM-C, Chou C-K (2022) Mitochondrial dysfunction as an underlying cause of skeletal muscle disorders. Int J Mol Sci 23:12926. https:\/\/doi.org\/10.3390\/ijms232112926","journal-title":"Int J Mol Sci"}],"container-title":["Journal of Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00415-025-13192-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00415-025-13192-z\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00415-025-13192-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,12]],"date-time":"2025-07-12T06:26:08Z","timestamp":1752301568000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00415-025-13192-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,26]]},"references-count":34,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["13192"],"URL":"https:\/\/doi.org\/10.1007\/s00415-025-13192-z","relation":{},"ISSN":["0340-5354","1432-1459"],"issn-type":[{"value":"0340-5354","type":"print"},{"value":"1432-1459","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,26]]},"assertion":[{"value":"22 January 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 May 2025","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 June 2025","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 June 2025","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"On behalf of all the authors, Antonio Lauletta states that there is no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}},{"value":"The study obtained the institutional review board\/ethical approval and has, therefore, been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. All patients gave their informed consent to participate in this study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}],"article-number":"480"}}