{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T13:01:20Z","timestamp":1788181280975,"version":"build-2803163510"},"reference-count":73,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2022,3,8]],"date-time":"2022-03-08T00:00:00Z","timestamp":1646697600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,3,8]],"date-time":"2022-03-08T00:00:00Z","timestamp":1646697600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100009473","name":"Universidad de M\u00e1laga","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100009473","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Pediatr"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>This study provides practical recommendations on infection screening in pediatric patients with immune-mediated rheumatic diseases and immunosuppressive therapies. For this reason, a qualitative approach was applied. A narrative literature review was performed via Medline. Primary searches were conducted using Mesh and free texts to identify articles that analyzed data on infections and vaccinations in pediatric patients with immune-mediated rheumatic diseases and immunosuppressive therapies. The results were presented and discussed in a nominal group meeting, comprising a committee of 12 pediatric rheumatologists from the infections prevention and treatment working group of the Spanish Society of Pediatric Rheumatology. Several recommendations were generated. A consensus procedure was implemented via a Delphi process that was extended to members of the Spanish Society of Pediatric Rheumatology and Vaccine Advisory Committee of the Spanish Association of Pediatrics. Participants to the process produced a score ranging from 0\u2009=\u2009totally disagree to 10\u2009=\u2009totally agree. Agreement was considered if at least 70% of participants voted\u2009\u2265\u20097. The literature review included more than 400 articles. Overall, 63 recommendations were generated (21 on infection screening) voted by 59 pediatric rheumatologists and other pediatric specialists, all of them achieving the pre-established agreement level. The recommendations on screening cover all the procedures (serology, assessment of risk factors, and other clinical activities) connected with the screening for infections including tuberculosis; hepatitis A, B, and C viruses; measles; mumps; rubella; diphtheria; and other infections.\u00a0<\/jats:p><jats:p><jats:italic>Conclusion<\/jats:italic>: Screening for infections is an essential part of risk management in pediatric patients with immune-mediated rheumatic diseases and immunosuppressive therapies.<jats:table-wrap><jats:table><jats:tbody>\n                    <jats:tr>\n                      <jats:td align=\"left\"><jats:bold>What is Known:<\/jats:bold><\/jats:td>\n                    <\/jats:tr>\n                    <jats:tr>\n                      <jats:td align=\"left\">\u2022 <jats:italic>Infectious diseases and related complications are a major cause of morbidity and mortality in patients with immune-mediated rheumatic diseases.<\/jats:italic><\/jats:td>\n                    <\/jats:tr>\n                    <jats:tr>\n                      <jats:td align=\"left\">\u2022 <jats:italic>At present, practical information on infectious prophylaxis in children with rheumatic diseases is limited, and often extrapolated from children with cancer.<\/jats:italic><\/jats:td>\n                    <\/jats:tr>\n                    <jats:tr>\n                      <jats:td align=\"left\"><jats:bold>What is New:<\/jats:bold><\/jats:td>\n                    <\/jats:tr>\n                    <jats:tr>\n                      <jats:td align=\"left\">\u2022 <jats:italic>In the absence of evidence, a literature review and a Delphi survey were conducted to establish a series of expert recommendations that would be useful in clinical practice, providing a practical and simple day-to-day approach to be used by pediatric rheumatologists.<\/jats:italic><\/jats:td>\n                    <\/jats:tr>\n                  <\/jats:tbody><\/jats:table><\/jats:table-wrap><\/jats:p>","DOI":"10.1007\/s00431-022-04418-7","type":"journal-article","created":{"date-parts":[[2022,3,8]],"date-time":"2022-03-08T08:02:38Z","timestamp":1646726558000},"page":"2343-2354","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Position statement of the Spanish Society of Pediatric Rheumatology on infection screening, prophylaxis, and vaccination of pediatric patients with rheumatic diseases and immunosuppressive therapies: Part 1 (screening)"],"prefix":"10.1007","volume":"181","author":[{"given":"Esmeralda N\u00fa\u00f1ez","family":"Cuadros","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joan","family":"Calzada-Hern\u00e1ndez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Clemente","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara Guill\u00e9n","family":"Mart\u00edn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura Fern\u00e1ndez","family":"Silveira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Jos\u00e9","family":"Lirola-Cruz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfredo","family":"Tagarro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marisol Camacho","family":"Lovillo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa Mar\u00eda Alcobendas","family":"Rueda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agust\u00edn L\u00f3pez","family":"L\u00f3pez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miren Satrustegi","family":"Aritziturri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Calvo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,3,8]]},"reference":[{"issue":"2","key":"4418_CR1","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen-2019-001041","volume":"5","author":"V Furer","year":"2019","unstructured":"Furer V, Rondaan C, Heijstek M, van Assen S, Bijl M, Agmon-Levin N et al (2019) Incidence and prevalence of vaccine preventable infections in adult patients with autoimmune inflammatory rheumatic diseases (AIIRD): a systemic literature review informing the 2019 update of the EULAR recommendations for vaccination in adult patients with AIIRD. RMD Open 5(2):e001041. https:\/\/doi.org\/10.1136\/rmdopen-2019-001041","journal-title":"RMD Open"},{"key":"4418_CR2","doi-asserted-by":"publisher","unstructured":"Heijstek MW, Ott de Bruin LM, Bijl M, Borrow R, van der Klis F, Kon\u00e9-Paut I et al (2011) EULAR recommendations for vaccination in paediatric patients with rheumatic diseases. Ann Rheum Dis 70(10):1704\u201312.\u00a0https:\/\/doi.org\/10.1136\/ard.2011.150193","DOI":"10.1136\/ard.2011.150193"},{"issue":"4","key":"4418_CR3","doi-asserted-by":"publisher","first-page":"751","DOI":"10.1007\/s00296-020-04774-3","volume":"41","author":"F Thiele","year":"2021","unstructured":"Thiele F, Klein A, Windschall D, Hospach A, Foeldvari I, Minden K et al (2021) Comparative risk of infections among real-world users of biologics for juvenile idiopathic arthritis: data from the German BIKER registry. Rheumatol Int 41(4):751\u2013762. https:\/\/doi.org\/10.1007\/s00296-020-04774-3","journal-title":"Rheumatol Int"},{"key":"4418_CR4","unstructured":"CEBM Medicine (2011) CfEB: CEBM levels of evidence 2011. http:\/\/www.cebm.net\/index.aspx?o=1025. Accessed 11\/04\/2013 2013"},{"key":"4418_CR5","unstructured":"Prevention (2016)\u00a0CfDCa: who should be tested"},{"issue":"10","key":"4418_CR6","doi-asserted-by":"publisher","first-page":"e486","DOI":"10.1016\/j.crohns.2013.03.004","volume":"7","author":"C Abreu","year":"2013","unstructured":"Abreu C, Magro F, Santos-Antunes J, Pilao A, Rodrigues-Pinto E, Bernardes J et al (2013) Tuberculosis in anti-TNF-alpha treated patients remains a problem in countries with an intermediate incidence: analysis of 25 patients matched with a control population. J Crohns Colitis 7(10):e486\u2013e492. https:\/\/doi.org\/10.1016\/j.crohns.2013.03.004","journal-title":"J Crohns Colitis"},{"issue":"7","key":"4418_CR7","doi-asserted-by":"publisher","first-page":"1884","DOI":"10.1002\/art.24632","volume":"60","author":"F Tubach","year":"2009","unstructured":"Tubach F, Salmon D, Ravaud P, Allanore Y, Goupille P, Breban M et al (2009) Risk of tuberculosis is higher with anti-tumor necrosis factor monoclonal antibody therapy than with soluble tumor necrosis factor receptor therapy: the three-year prospective French Research Axed on Tolerance of Biotherapies registry. Arthritis Rheum 60(7):1884\u20131894. https:\/\/doi.org\/10.1002\/art.24632","journal-title":"Arthritis Rheum"},{"issue":"5","key":"4418_CR8","doi-asserted-by":"publisher","first-page":"1185","DOI":"10.1183\/09031936.00028510","volume":"36","author":"I Solovic","year":"2010","unstructured":"Solovic I, Sester M, Gomez-Reino JJ, Rieder HL, Ehlers S, Milburn HJ et al (2010) The risk of tuberculosis related to tumour necrosis factor antagonist therapies: a TBNET consensus statement. Eur Respir J 36(5):1185\u20131206. https:\/\/doi.org\/10.1183\/09031936.00028510","journal-title":"Eur Respir J"},{"issue":"43\u201344","key":"4418_CR9","first-page":"620","volume":"137","author":"C Beglinger","year":"2007","unstructured":"Beglinger C, Dudler J, Mottet C, Nicod L, Seibold F, Villiger PM et al (2007) Screening for tuberculosis infection before the initiation of an anti-TNF-alpha therapy. Swiss Med Wkly 137(43\u201344):620\u2013622","journal-title":"Swiss Med Wkly"},{"issue":"3","key":"4418_CR10","first-page":"247","volume":"31","author":"JE Fonseca","year":"2006","unstructured":"Fonseca JE, Canhao H, Silva C, Miguel C, Mediavilla MJ, Teixeira A et al (2006) Tuberculosis in rheumatic patients treated with tumour necrosis factor alpha antagonists: the Portuguese experience. Acta Reumatol Port 31(3):247\u2013253","journal-title":"Acta Reumatol Port"},{"issue":"8","key":"4418_CR11","doi-asserted-by":"publisher","first-page":"2122","DOI":"10.1002\/art.11137","volume":"48","author":"Gomez-Reino JJ, Carmona L, Valverde VR, Mola EM, Montero MD, Group B","year":"2003","unstructured":"Gomez-Reino JJ, Carmona L, Valverde VR, Mola EM, Montero MD, Group B (2003) Treatment of rheumatoid arthritis with tumor necrosis factor inhibitors may predispose to significant increase in tuberculosis risk: a multicenter active-surveillance report. Arthritis Rheum 48(8):2122\u20132127. https:\/\/doi.org\/10.1002\/art.11137","journal-title":"Arthritis Rheum"},{"issue":"6","key":"4418_CR12","doi-asserted-by":"publisher","first-page":"1766","DOI":"10.1002\/art.21043","volume":"52","author":"L Carmona","year":"2005","unstructured":"Carmona L, Gomez-Reino JJ, Rodriguez-Valverde V, Montero D, Pascual-Gomez E, Mola EM et al (2005) Effectiveness of recommendations to prevent reactivation of latent tuberculosis infection in patients treated with tumor necrosis factor antagonists. Arthritis Rheum 52(6):1766\u20131772. https:\/\/doi.org\/10.1002\/art.21043","journal-title":"Arthritis Rheum"},{"key":"4418_CR13","doi-asserted-by":"publisher","unstructured":"British Thoracic Society Standards of Care C (2005) BTS recommendations for assessing risk and for managing Mycobacterium tuberculosis infection and disease in patients due to start anti-TNF-alpha treatment. Thorax 60(10):800\u20135.\u00a0https:\/\/doi.org\/10.1136\/thx.2005.046797","DOI":"10.1136\/thx.2005.046797"},{"issue":"1","key":"4418_CR14","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1016\/j.arbres.2015.04.016","volume":"52","author":"I Mir Viladrich","year":"2016","unstructured":"Mir Viladrich I, Dauden Tello E, Solano-Lopez G, Lopez Longo FJ, Taxonera Samso C, Sanchez Martinez P et al (2016) Consensus document on prevention and treatment of tuberculosis in patients for biological treatment. Arch Bronconeumol 52(1):36\u201345. https:\/\/doi.org\/10.1016\/j.arbres.2015.04.016","journal-title":"Arch Bronconeumol"},{"key":"4418_CR15","unstructured":"Excellence (2011) NIfHaC: Tuberculosis: clinical diagnosis and management of tuberculosis, and measures for its prevention and control. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK97852\/pdf\/Bookshelf_NBK97852.pdf. Accessed March 2011"},{"issue":"12","key":"4418_CR16","doi-asserted-by":"publisher","first-page":"2102","DOI":"10.1128\/CVI.05299-11","volume":"18","author":"D Vassilopoulos","year":"2011","unstructured":"Vassilopoulos D, Tsikrika S, Hatzara C, Podia V, Kandili A, Stamoulis N et al (2011) Comparison of two gamma interferon release assays and tuberculin skin testing for tuberculosis screening in a cohort of patients with rheumatic diseases starting anti-tumor necrosis factor therapy. Clin Vaccine Immunol 18(12):2102\u20132108. https:\/\/doi.org\/10.1128\/CVI.05299-11","journal-title":"Clin Vaccine Immunol"},{"key":"4418_CR17","doi-asserted-by":"publisher","unstructured":"Behar SM, Shin DS, Maier A, Coblyn J, Helfgott S, Weinblatt ME (2009) Use of the T-SPOT.TB assay to detect latent tuberculosis infection among rheumatic disease patients on immunosuppressive therapy. J Rheumato 36(3):546\u201351.\u00a0https:\/\/doi.org\/10.3899\/jrheum.080854","DOI":"10.3899\/jrheum.080854"},{"issue":"3","key":"4418_CR18","doi-asserted-by":"publisher","first-page":"322","DOI":"10.1086\/519266","volume":"45","author":"AK Detjen","year":"2007","unstructured":"Detjen AK, Keil T, Roll S, Hauer B, Mauch H, Wahn U et al (2007) Interferon-gamma release assays improve the diagnosis of tuberculosis and nontuberculous mycobacterial disease in children in a country with a low incidence of tuberculosis. Clin Infect Dis 45(3):322\u2013328. https:\/\/doi.org\/10.1086\/519266","journal-title":"Clin Infect Dis"},{"key":"4418_CR19","doi-asserted-by":"publisher","unstructured":"Kay AW, Islam SM, Wendorf K, Westenhouse J, Barry PM (2018) Interferon-gamma release assay performance for tuberculosis in childhood. Pediatrics 141(6).\u00a0https:\/\/doi.org\/10.1542\/peds.2017-3918","DOI":"10.1542\/peds.2017-3918"},{"issue":"2","key":"4418_CR20","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1093\/cid\/ciw694","volume":"64","author":"DM Lewinsohn","year":"2017","unstructured":"Lewinsohn DM, Leonard MK, LoBue PA, Cohn DL, Daley CL, Desmond E et al (2017) Official American Thoracic Society\/Infectious Diseases Society of America\/Centers for Disease Control and Prevention Clinical Practice Guidelines: diagnosis of tuberculosis in adults and children. Clin Infect Dis 64(2):e1\u2013e33. https:\/\/doi.org\/10.1093\/cid\/ciw694","journal-title":"Clin Infect Dis"},{"issue":"12","key":"4418_CR21","doi-asserted-by":"publisher","first-page":"1291","DOI":"10.1097\/INF.0000000000000432","volume":"33","author":"E Chiappini","year":"2014","unstructured":"Chiappini E, Bonsignori F, Mazzantini R, Sollai S, Venturini E, Mangone G et al (2014) Interferon-gamma release assay sensitivity in children younger than 5 years is insufficient to replace the use of tuberculin skin test in western countries. Pediatr Infect Dis J 33(12):1291\u20131293. https:\/\/doi.org\/10.1097\/INF.0000000000000432","journal-title":"Pediatr Infect Dis J"},{"issue":"11","key":"4418_CR22","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0188631","volume":"12","author":"TN Doan","year":"2017","unstructured":"Doan TN, Eisen DP, Rose MT, Slack A, Stearnes G, McBryde ES (2017) Interferon-gamma release assay for the diagnosis of latent tuberculosis infection: a latent-class analysis. PLoS One 12(11):e0188631. https:\/\/doi.org\/10.1371\/journal.pone.0188631","journal-title":"PLoS ONE"},{"key":"4418_CR23","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/381929","volume":"2012","author":"E Tavast","year":"2012","unstructured":"Tavast E, Tuuminen T, Pakkanen SH, Eriksson M, Kantele A, Jarvinen A et al (2012) Immunosuppression adversely affects TST but not IGRAs in patients with psoriasis or inflammatory musculoskeletal diseases. Int J Rheumatol 2012:381929. https:\/\/doi.org\/10.1155\/2012\/381929","journal-title":"Int J Rheumatol"},{"key":"4418_CR24","doi-asserted-by":"publisher","unstructured":"Sargin G, Senturk T, Ceylan E, Telli M, Cildag S, Dogan H (2018) TST, QuantiFERON-TB Gold test and T-SPOT.TB test for detecting latent tuberculosis infection in patients with rheumatic disease prior to anti-TNF therapy. Tuberk Toraks 66(2):136\u201343.\u00a0https:\/\/doi.org\/10.5578\/tt.66444","DOI":"10.5578\/tt.66444"},{"issue":"5","key":"4418_CR25","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1111\/ped.12885","volume":"58","author":"T Nozawa","year":"2016","unstructured":"Nozawa T, Mori M, Nishimura K, Sakurai N, Kikuchi M, Hara R et al (2016) Usefulness of two interferon-gamma release assays for rheumatic disease. Pediatr Int 58(5):347\u2013352. https:\/\/doi.org\/10.1111\/ped.12885","journal-title":"Pediatr Int"},{"issue":"12","key":"4418_CR26","doi-asserted-by":"publisher","first-page":"1986","DOI":"10.3899\/jrheum.130303","volume":"40","author":"F Costantino","year":"2013","unstructured":"Costantino F, de Carvalho BM, Rat AC, Loeuille D, Dintinger H, Bene MC et al (2013) Screening for latent tuberculosis infection in patients with chronic inflammatory arthritis: discrepancies between tuberculin skin test and interferon-gamma release assay results. J Rheumatol 40(12):1986\u20131993. https:\/\/doi.org\/10.3899\/jrheum.130303","journal-title":"J Rheumatol"},{"issue":"3","key":"4418_CR27","doi-asserted-by":"publisher","first-page":"320","DOI":"10.1097\/MPG.0000000000000205","volume":"58","author":"O Hradsky","year":"2014","unstructured":"Hradsky O, Ohem J, Zarubova K, Mitrova K, Durilova M, Kotalova R et al (2014) Disease activity is an important factor for indeterminate interferon-gamma release assay results in children with inflammatory bowel disease. J Pediatr Gastroenterol Nutr 58(3):320\u2013324. https:\/\/doi.org\/10.1097\/MPG.0000000000000205","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"4418_CR28","doi-asserted-by":"publisher","unstructured":"Chikura B, Sadananda V, Usman-Saeed M (2009) Comment on: Screening for Mycobacterium tuberculosis prior to anti-TNF therapy--an audit of impact of the British Thoracic Society guidelines on rheumatology practice in an area of low Mycobacterium tuberculosis prevalence. Rheumatology (Oxford) 48(10):1331\u20132; author reply 2.\u00a0https:\/\/doi.org\/10.1093\/rheumatology\/kep181","DOI":"10.1093\/rheumatology\/kep181"},{"key":"4418_CR29","doi-asserted-by":"publisher","unstructured":"Du F, Xie L, Zhang Y, Gao F, Zhang H, Chen W et al (2018) Prospective comparison of QFT-GIT and T-SPOT.TB assays for diagnosis of active tuberculosis. Sci Rep 8(1):5882. https:\/\/doi.org\/10.1038\/s41598-018-24285-3","DOI":"10.1038\/s41598-018-24285-3"},{"key":"4418_CR30","doi-asserted-by":"publisher","unstructured":"Matsumura R, Igari H, Nakazawa T, Ishikawa S, Tsuyuzaki M, Suzuki K et al (2016) Comparative utility of interferon-gamma release assay, QuantiFERON((R)) TB-GIT and T-SPOT((R)).TB in rheumatoid arthritis. Int J Tuberc Lung Dis 20(11):1546\u201353.\u00a0https:\/\/doi.org\/10.5588\/ijtld.16.0038","DOI":"10.5588\/ijtld.16.0038"},{"issue":"1","key":"4418_CR31","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1136\/ard.2008.101857","volume":"69","author":"J Martin","year":"2010","unstructured":"Martin J, Walsh C, Gibbs A, McDonnell T, Fearon U, Keane J et al (2010) Comparison of interferon gamma release assays and conventional screening tests before tumour necrosis factor alpha blockade in patients with inflammatory arthritis. Ann Rheum Dis 69(1):181\u2013185. https:\/\/doi.org\/10.1136\/ard.2008.101857","journal-title":"Ann Rheum Dis"},{"key":"4418_CR32","doi-asserted-by":"publisher","unstructured":"Starke JR (2014) Committee On Infectious D. Interferon-gamma release assays for diagnosis of tuberculosis infection and disease in children. Pediatrics 134(6):e1763\u201373. https:\/\/doi.org\/10.1542\/peds.2014-2983","DOI":"10.1542\/peds.2014-2983"},{"key":"4418_CR33","doi-asserted-by":"publisher","unstructured":"Moreno-Perez D, Andres Martin A, Altet Gomez N, Baquero-Artigao F, Escribano Montaner A, Gomez-Pastrana Duran D et al (2010) Diagnosis of tuberculosis in pediatrics. Consensus document of the Spanish Society of Pediatric Infectology (SEIP) and the Spanish Society of Pediatric Pneumology (SENP). An Pediatr (Barc) 73(3):143 e1- 14. https:\/\/doi.org\/10.1016\/j.anpedi.2009.12.017","DOI":"10.1016\/j.anpedi.2009.12.017"},{"issue":"9","key":"4418_CR34","doi-asserted-by":"publisher","first-page":"858","DOI":"10.1111\/apt.12037","volume":"36","author":"P Papay","year":"2012","unstructured":"Papay P, Primas C, Eser A, Novacek G, Winkler S, Frantal S et al (2012) Retesting for latent tuberculosis in patients with inflammatory bowel disease treated with TNF-alpha inhibitors. Aliment Pharmacol Ther 36(9):858\u2013865. https:\/\/doi.org\/10.1111\/apt.12037","journal-title":"Aliment Pharmacol Ther"},{"issue":"4","key":"4418_CR35","doi-asserted-by":"publisher","first-page":"450","DOI":"10.1097\/QCO.0b013e328354f179","volume":"25","author":"C Bern","year":"2012","unstructured":"Bern C (2012) Chagas disease in the immunosuppressed host. Curr Opin Infect Dis 25(4):450\u2013457. https:\/\/doi.org\/10.1097\/QCO.0b013e328354f179","journal-title":"Curr Opin Infect Dis"},{"issue":"10115","key":"4418_CR36","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1016\/S0140-6736(17)31612-4","volume":"391","author":"JA Perez-Molina","year":"2018","unstructured":"Perez-Molina JA, Molina I (2018) Chagas disease. Lancet 391(10115):82\u201394. https:\/\/doi.org\/10.1016\/S0140-6736(17)31612-4","journal-title":"Lancet"},{"issue":"6","key":"4418_CR37","doi-asserted-by":"publisher","first-page":"e84","DOI":"10.1097\/DAD.0b013e318257f9e2","volume":"34","author":"LG Burgos","year":"2012","unstructured":"Burgos LG, Ortiz BD, Canese A, Ojeda A, Melo M (2012) Reactivation of Chagas disease by immunosuppressive therapy in a patient with systemic lupus erythematosus: report of an exceptional case. Am J Dermatopathol 34(6):e84\u2013e89. https:\/\/doi.org\/10.1097\/DAD.0b013e318257f9e2","journal-title":"Am J Dermatopathol"},{"key":"4418_CR38","doi-asserted-by":"publisher","unstructured":"Roca Saumell C, Soriano-Arandes A, Solsona Diaz L, Gascon Brustenga J, Grupo de consenso Chagas APS (2015) Consensus document for the detection and management of Chagas disease in primary health care in a non-endemic areas. Aten Primaria 47(5):308\u201317. https:\/\/doi.org\/10.1016\/j.aprim.2015.01.002","DOI":"10.1016\/j.aprim.2015.01.002"},{"issue":"32","key":"4418_CR39","doi-asserted-by":"publisher","first-page":"5130","DOI":"10.1016\/j.vaccine.2011.05.046","volume":"29","author":"M Paulke-Korinek","year":"2011","unstructured":"Paulke-Korinek M, Fischmeister G, Grac A, Rendi-Wagner P, Kundi M, Mohsenzadeh-Rabbani A et al (2011) Persistence of antibodies in 4\u20138 year old Austrian children after vaccination with hexavalent DTaP-HBV-IPV\/Hib and MMR vaccines. Vaccine 29(32):5130\u20135136. https:\/\/doi.org\/10.1016\/j.vaccine.2011.05.046","journal-title":"Vaccine"},{"key":"4418_CR40","doi-asserted-by":"publisher","unstructured":"Saffar MJ, Fathpour GR, Parsaei MR, Ajami A, Khalilian AR, Shojaei J et al (2011) Measles-mumps-rubella revaccination; 18 months vs. 4\u20136 years of age: potential impacts of schedule changes. J Trop Pediatr 57(5):347\u201351.\u00a0https:\/\/doi.org\/10.1093\/tropej\/fmq102","DOI":"10.1093\/tropej\/fmq102"},{"issue":"7\u20138","key":"4418_CR41","doi-asserted-by":"publisher","first-page":"1134","DOI":"10.1016\/s0264-410x(01)00435-2","volume":"20","author":"RG Pebody","year":"2002","unstructured":"Pebody RG, Gay NJ, Hesketh LM, Vyse A, Morgan-Capner P, Brown DW et al (2002) Immunogenicity of second dose measles-mumps-rubella (MMR) vaccine and implications for serosurveillance. Vaccine 20(7\u20138):1134\u20131140. https:\/\/doi.org\/10.1016\/s0264-410x(01)00435-2","journal-title":"Vaccine"},{"issue":"19\u201320","key":"4418_CR42","doi-asserted-by":"publisher","first-page":"2580","DOI":"10.1016\/s0264-410x(03)00053-7","volume":"21","author":"B Rager-Zisman","year":"2003","unstructured":"Rager-Zisman B, Bazarsky E, Skibin A, Chamney S, Belmaker I, Shai I et al (2003) The effect of measles-mumps-rubella (MMR) immunization on the immune responses of previously immunized primary school children. Vaccine 21(19\u201320):2580\u20132588. https:\/\/doi.org\/10.1016\/s0264-410x(03)00053-7","journal-title":"Vaccine"},{"issue":"6","key":"4418_CR43","doi-asserted-by":"publisher","first-page":"818","DOI":"10.1016\/j.vaccine.2017.12.075","volume":"36","author":"EE Seagle","year":"2018","unstructured":"Seagle EE, Bednarczyk RA, Hill T, Fiebelkorn AP, Hickman CJ, Icenogle JP et al (2018) Measles, mumps, and rubella antibody patterns of persistence and rate of decline following the second dose of the MMR vaccine. Vaccine 36(6):818\u2013826. https:\/\/doi.org\/10.1016\/j.vaccine.2017.12.075","journal-title":"Vaccine"},{"issue":"7","key":"4418_CR44","doi-asserted-by":"publisher","first-page":"950","DOI":"10.1086\/528993","volume":"197","author":"I Davidkin","year":"2008","unstructured":"Davidkin I, Jokinen S, Broman M, Leinikki P, Peltola H (2008) Persistence of measles, mumps, and rubella antibodies in an MMR-vaccinated cohort: a 20-year follow-up. J Infect Dis 197(7):950\u2013956. https:\/\/doi.org\/10.1086\/528993","journal-title":"J Infect Dis"},{"issue":"6","key":"4418_CR45","doi-asserted-by":"publisher","first-page":"948","DOI":"10.1136\/annrheumdis-2011-200637","volume":"71","author":"MW Heijstek","year":"2012","unstructured":"Heijstek MW, van Gageldonk PG, Berbers GA, Wulffraat NM (2012) Differences in persistence of measles, mumps, rubella, diphtheria and tetanus antibodies between children with rheumatic disease and healthy controls: a retrospective cross-sectional study. Ann Rheum Dis 71(6):948\u2013954. https:\/\/doi.org\/10.1136\/annrheumdis-2011-200637","journal-title":"Ann Rheum Dis"},{"issue":"32","key":"4418_CR46","doi-asserted-by":"publisher","first-page":"3988","DOI":"10.1016\/j.vaccine.2015.06.036","volume":"33","author":"V Gajdos","year":"2015","unstructured":"Gajdos V, Vidor E, Richard P, Tran C, Sadorge C (2015) Diphtheria, tetanus and poliovirus antibody persistence 5 years after vaccination of pre-schoolers with two different diphtheria, tetanus and inactivated poliomyelitis vaccines (Td-IPV or DT-IPV) and immune responses to a booster dose of DTaP-IPV. Vaccine 33(32):3988\u20133996. https:\/\/doi.org\/10.1016\/j.vaccine.2015.06.036","journal-title":"Vaccine"},{"key":"4418_CR47","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1186\/1471-2334-8-100","volume":"8","author":"C Giambi","year":"2008","unstructured":"Giambi C, Bella A, Barale A, Montu D, Marchisio M, Oddone M et al (2008) A cohort study to evaluate persistence of hepatitis B immunogenicity after administration of hexavalent vaccines. BMC Infect Dis 8:100. https:\/\/doi.org\/10.1186\/1471-2334-8-100","journal-title":"BMC Infect Dis"},{"key":"4418_CR48","doi-asserted-by":"publisher","unstructured":"Ward JW (2018) VDP. Hepatitis B vaccines. Singapore: Springer.\u00a0https:\/\/doi.org\/10.1007\/978-981-10-4843-2_5","DOI":"10.1007\/978-981-10-4843-2_5"},{"issue":"9","key":"4418_CR49","doi-asserted-by":"publisher","first-page":"1140","DOI":"10.1016\/j.cmi.2019.02.003","volume":"25","author":"MW Lai","year":"2019","unstructured":"Lai MW, Liang KH, Yeh CT (2019) Diverse immune responses to HBV surface epitope variants after vaccine booster in adolescents immunized in infancy. Clin Microbiol Infect 25(9):1140\u20131146. https:\/\/doi.org\/10.1016\/j.cmi.2019.02.003","journal-title":"Clin Microbiol Infect"},{"issue":"9","key":"4418_CR50","doi-asserted-by":"publisher","DOI":"10.5812\/hepatmon.22223","volume":"14","author":"H Saffar","year":"2014","unstructured":"Saffar H, Saffar MJ, Ajami A, Khalilian AR, Shams-Esfandabad K, Mirabi AM (2014) Long-term T-cell-mediated immunologic memory to hepatitis B vaccine in young adults following neonatal vaccination. Hepat Mon 14(9):e22223. https:\/\/doi.org\/10.5812\/hepatmon.22223","journal-title":"Hepat Mon"},{"issue":"1","key":"4418_CR51","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1093\/cid\/cir270","volume":"53","author":"E Leuridan","year":"2011","unstructured":"Leuridan E, Van Damme P (2011) Hepatitis B and the need for a booster dose. Clin Infect Dis 53(1):68\u201375. https:\/\/doi.org\/10.1093\/cid\/cir270","journal-title":"Clin Infect Dis"},{"issue":"9494","key":"4418_CR52","doi-asserted-by":"publisher","first-page":"1379","DOI":"10.1016\/s0140-6736(05)67568-x","volume":"366","author":"AR Zanetti","year":"2005","unstructured":"Zanetti AR, Mariano A, Roman\u00f2 L, D\u2019Amelio R, Chironna M, Coppola RC et al (2005) Long-term immunogenicity of hepatitis B vaccination and policy for booster: an Italian multicentre study. Lancet 366(9494):1379\u20131384. https:\/\/doi.org\/10.1016\/s0140-6736(05)67568-x","journal-title":"Lancet"},{"key":"4418_CR53","unstructured":"Agency (2005) EM: European Medicines Agency recommends suspension of Hexavac. https:\/\/www.ema.europa.eu\/en\/documents\/press-release\/european-medicines-agency-recommends-suspension-hexavac_en.pdf. Accessed 01 febrero 2021"},{"issue":"2","key":"4418_CR54","doi-asserted-by":"publisher","first-page":"119","DOI":"10.14218\/jcth.2016.00067","volume":"5","author":"MG Mavilia","year":"2017","unstructured":"Mavilia MG, Wu GY (2017) Mechanisms and prevention of vertical transmission in chronic viral hepatitis. J Clin Transl Hepatol 5(2):119\u2013129. https:\/\/doi.org\/10.14218\/jcth.2016.00067","journal-title":"J Clin Transl Hepatol"},{"issue":"5","key":"4418_CR55","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1007\/s15010-010-0039-7","volume":"38","author":"L Roznovsky","year":"2010","unstructured":"Roznovsky L, Orsagova I, Kloudova A, Tvrdik J, Kabieszova L, Lochman I et al (2010) Long-term protection against hepatitis B after newborn vaccination: 20-year follow-up. Infection 38(5):395\u2013400. https:\/\/doi.org\/10.1007\/s15010-010-0039-7","journal-title":"Infection"},{"issue":"9","key":"4418_CR56","doi-asserted-by":"publisher","first-page":"1644","DOI":"10.1016\/j.vaccine.2011.12.106","volume":"30","author":"SS Chaves","year":"2012","unstructured":"Chaves SS, Fischer G, Groeger J, Patel PR, Thompson ND, Teshale EH et al (2012) Persistence of long-term immunity to hepatitis B among adolescents immunized at birth. Vaccine 30(9):1644\u20131649. https:\/\/doi.org\/10.1016\/j.vaccine.2011.12.106","journal-title":"Vaccine"},{"key":"4418_CR57","unstructured":"(CAV-AEP) CAdV (2020) Vacunaci\u00f3n en ni\u00f1os inmunodeprimidos o con tratamiento inmunosupresor. In: Pediatr\u00eda AEd, editor. Manual de vacunas en l\u00ednea de la AEP. Madrid: AEP. http:\/\/vacunasaep.org\/documentos\/manual\/cap-14. Accessed 21 enero 2021"},{"issue":"1","key":"4418_CR58","doi-asserted-by":"publisher","first-page":"25","DOI":"10.5152\/eurjrheum.2015.150072","volume":"3","author":"O Karadag","year":"2016","unstructured":"Karadag O, Kasifoglu T, Ozer B, Kaymakoglu S, Kus Y, Inanc M et al (2016) Viral hepatitis screening guideline before biological drug use in rheumatic patients. Eur J Rheumatol 3(1):25\u201328. https:\/\/doi.org\/10.5152\/eurjrheum.2015.150072","journal-title":"Eur J Rheumatol"},{"issue":"1","key":"4418_CR59","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1016\/j.eimc.2015.01.012","volume":"34","author":"L Garcia-Comas","year":"2016","unstructured":"Garcia-Comas L, Ordobas M, Sanz JC, Ramos B, Arce A, Barranco D (2016) Population study of seroprevalence of antibodies against hepatitis A virus in the Community of Madrid, 2008\u20132009. Enferm Infecc Microbiol Clin 34(1):33\u201338. https:\/\/doi.org\/10.1016\/j.eimc.2015.01.012","journal-title":"Enferm Infecc Microbiol Clin"},{"issue":"1","key":"4418_CR60","first-page":"166","volume":"35","author":"RA Russo","year":"2008","unstructured":"Russo RA, Rosenzweig SD, Katsicas MM (2008) Hepatitis A-associated macrophage activation syndrome in children with systemic juvenile idiopathic arthritis: report of 2 cases. J Rheumatol 35(1):166\u2013168","journal-title":"J Rheumatol"},{"issue":"3","key":"4418_CR61","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1016\/j.rbre.2016.02.011","volume":"56","author":"NE Aikawa","year":"2016","unstructured":"Aikawa NE, Nascimento AP, Hayata AL, Bonf\u00e1 E, Goldenstein-Schainberg C (2016) Hepatitis C virus antibodies in high risk juvenile onset systemic lupus erythematosus. Rev Bras Reumatol Engl Ed 56(3):235\u2013239. https:\/\/doi.org\/10.1016\/j.rbre.2016.02.011","journal-title":"Rev Bras Reumatol Engl Ed"},{"issue":"12","key":"4418_CR62","doi-asserted-by":"publisher","first-page":"1649","DOI":"10.1093\/cid\/ciu185","volume":"58","author":"IS Kourbeti","year":"2014","unstructured":"Kourbeti IS, Ziakas PD, Mylonakis E (2014) Biologic therapies in rheumatoid arthritis and the risk of opportunistic infections: a meta-analysis. Clin Infect Dis 58(12):1649\u20131657. https:\/\/doi.org\/10.1093\/cid\/ciu185","journal-title":"Clin Infect Dis"},{"issue":"12","key":"4418_CR63","doi-asserted-by":"publisher","first-page":"533","DOI":"10.1016\/j.medcli.2010.11.032","volume":"137","author":"MJ Perez-Sola","year":"2011","unstructured":"Perez-Sola MJ, Torre-Cisneros J, Perez-Zafrilla B, Carmona L, Descalzo MA, Gomez-Reino JJ et al (2011) Infections in patients treated with tumor necrosis factor antagonists: incidence, etiology and mortality in the BIOBADASER registry. Med Clin (Barc) 137(12):533\u2013540. https:\/\/doi.org\/10.1016\/j.medcli.2010.11.032","journal-title":"Med Clin (Barc)"},{"issue":"11","key":"4418_CR64","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1007\/s11926-015-0542-z","volume":"17","author":"G Horneff","year":"2015","unstructured":"Horneff G (2015) Biologic-associated infections in pediatric rheumatology. Curr Rheumatol Rep 17(11):66. https:\/\/doi.org\/10.1007\/s11926-015-0542-z","journal-title":"Curr Rheumatol Rep"},{"issue":"6","key":"4418_CR65","doi-asserted-by":"publisher","first-page":"830","DOI":"10.1097\/MPG.0b013e31824d1438","volume":"54","author":"G Veereman-Wauters","year":"2012","unstructured":"Veereman-Wauters G, de Ridder L, Veres G, Kolacek S, Fell J, Malmborg P et al (2012) Risk of infection and prevention in pediatric patients with IBD: ESPGHAN IBD Porto Group commentary. J Pediatr Gastroenterol Nutr 54(6):830\u2013837. https:\/\/doi.org\/10.1097\/MPG.0b013e31824d1438","journal-title":"J Pediatr Gastroenterol Nutr"},{"issue":"3","key":"4418_CR66","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1097\/BOR.0000000000000272","volume":"28","author":"R Kado","year":"2016","unstructured":"Kado R, Sanders G, McCune WJ (2016) Suppression of normal immune responses after treatment with rituximab. Curr Opin Rheumatol 28(3):251\u2013258. https:\/\/doi.org\/10.1097\/BOR.0000000000000272","journal-title":"Curr Opin Rheumatol"},{"issue":"1","key":"4418_CR67","doi-asserted-by":"publisher","first-page":"305","DOI":"10.3390\/cancers7010305","volume":"7","author":"J Worch","year":"2015","unstructured":"Worch J, Makarova O, Burkhardt B (2015) Immunreconstitution and infectious complications after rituximab treatment in children and adolescents: what do we know and what can we learn from adults? Cancers (Basel) 7(1):305\u2013328. https:\/\/doi.org\/10.3390\/cancers7010305","journal-title":"Cancers (Basel)"},{"issue":"10","key":"4418_CR68","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1007\/s11926-015-0539-7","volume":"17","author":"MY Md Yusof","year":"2015","unstructured":"Md Yusof MY, Vital EM, Buch MH (2015) B cell therapies, approved and emerging: a review of infectious risk and prevention during use. Curr Rheumatol Rep 17(10):65. https:\/\/doi.org\/10.1007\/s11926-015-0539-7","journal-title":"Curr Rheumatol Rep"},{"issue":"Suppl 2","key":"4418_CR69","doi-asserted-by":"publisher","first-page":"S71","DOI":"10.1016\/j.cmi.2018.02.003","volume":"24","author":"M Mikulska","year":"2018","unstructured":"Mikulska M, Lanini S, Gudiol C, Drgona L, Ippolito G, Fernandez-Ruiz M et al (2018) ESCMID Study Group for Infections in Compromised Hosts (ESGICH) consensus document on the safety of targeted and biological therapies: an infectious diseases perspective (agents targeting lymphoid cells surface antigens [I]: CD19, CD20 and CD52). Clin Microbiol Infect 24(Suppl 2):S71\u2013S82. https:\/\/doi.org\/10.1016\/j.cmi.2018.02.003","journal-title":"Clin Microbiol Infect"},{"issue":"3","key":"4418_CR70","doi-asserted-by":"publisher","first-page":"228","DOI":"10.1097\/BOR.0000000000000377","volume":"29","author":"R Kado","year":"2017","unstructured":"Kado R, Sanders G, McCune WJ (2017) Diagnostic and therapeutic considerations in patients with hypogammaglobulinemia after rituximab therapy. Curr Opin Rheumatol 29(3):228\u2013233. https:\/\/doi.org\/10.1097\/BOR.0000000000000377","journal-title":"Curr Opin Rheumatol"},{"issue":"2","key":"4418_CR71","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.36321","volume":"4","author":"CL McAtee","year":"2021","unstructured":"McAtee CL, Lubega J, Underbrink K, Curry K, Msaouel P, Barrow M et al (2021) Association of rituximab use with adverse events in children, adolescents, and young adults. JAMA Netw Open 4(2):e2036321. https:\/\/doi.org\/10.1001\/jamanetworkopen.2020.36321","journal-title":"JAMA Netw Open"},{"issue":"Suppl 2","key":"4418_CR72","doi-asserted-by":"publisher","first-page":"S10","DOI":"10.1016\/j.cmi.2017.12.025","volume":"24","author":"JW Baddley","year":"2018","unstructured":"Baddley JW, Cantini F, Goletti D, Gomez-Reino JJ, Mylonakis E, San-Juan R et al (2018) ESCMID Study Group for Infections in Compromised Hosts (ESGICH) consensus document on the safety of targeted and biological therapies: an infectious diseases perspective (soluble immune effector molecules [I]: anti-tumor necrosis factor-alpha agents). Clin Microbiol Infect 24(Suppl 2):S10\u2013S20. https:\/\/doi.org\/10.1016\/j.cmi.2017.12.025","journal-title":"Clin Microbiol Infect"},{"key":"4418_CR73","doi-asserted-by":"publisher","unstructured":"Sanchez-Moya AI, Garcia-Doval I, Carretero G, Sanchez-Carazo J, Ferrandiz C, Herrera Ceballos E et al (2013) Latent tuberculosis infection and active tuberculosis in patients with psoriasis: a study on the incidence of tuberculosis and the prevalence of latent tuberculosis disease in patients with moderate-severe psoriasis in Spain. BIOBADADERM registry. J Eur Acad Dermatol Venereol 27(11):1366\u201374.\u00a0https:\/\/doi.org\/10.1111\/jdv.12011","DOI":"10.1111\/jdv.12011"}],"updated-by":[{"DOI":"10.1007\/s00431-022-04448-1","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2022,3,21]],"date-time":"2022-03-21T00:00:00Z","timestamp":1647820800000}}],"container-title":["European Journal of Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00431-022-04418-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00431-022-04418-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00431-022-04418-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,16]],"date-time":"2022-05-16T12:14:24Z","timestamp":1652703264000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00431-022-04418-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,8]]},"references-count":73,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2022,6]]}},"alternative-id":["4418"],"URL":"https:\/\/doi.org\/10.1007\/s00431-022-04418-7","relation":{"correction":[{"id-type":"doi","id":"10.1007\/s00431-022-04448-1","asserted-by":"object"}]},"ISSN":["1432-1076"],"issn-type":[{"value":"1432-1076","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,8]]},"assertion":[{"value":"13 September 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"31 January 2022","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 February 2022","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 March 2022","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 March 2022","order":5,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Correction","order":6,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"A Correction to this paper has been published:","order":7,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"https:\/\/doi.org\/10.1007\/s00431-022-04448-1","URL":"https:\/\/doi.org\/10.1007\/s00431-022-04448-1","order":8,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"N\/A.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"N\/A.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"N\/A.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}