{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T18:27:51Z","timestamp":1773080871843,"version":"3.50.1"},"reference-count":46,"publisher":"Springer Science and Business Media LLC","issue":"9","license":[{"start":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T00:00:00Z","timestamp":1750809600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T00:00:00Z","timestamp":1750809600000},"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":["Eur Spine J"],"published-print":{"date-parts":[[2025,9]]},"DOI":"10.1007\/s00586-025-09029-y","type":"journal-article","created":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T21:24:03Z","timestamp":1750800243000},"page":"3863-3875","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Machine learning-driven national analysis for predicting adverse outcomes in intramedullary spinal cord tumor surgery"],"prefix":"10.1007","volume":"34","author":[{"given":"Marc","family":"Ghanem","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdul Karim","family":"Ghaith","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6993-5416","authenticated-orcid":false,"given":"Sung Huang Laurent","family":"Tsai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu-Cheng","family":"Yeh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oluwaseun O.","family":"Akinduro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Loizos","family":"Michaelides","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victor Gabriel","family":"El-Hajj","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hassan","family":"Saad","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali","family":"Tfaily","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio Bon","family":"Nieves","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alfredo","family":"Qui\u00f1ones-Hinojosa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kingsley","family":"Abode-Iyamah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamad","family":"Bydon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,6,25]]},"reference":[{"key":"9029_CR1","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1007\/s10143-018-0957-x","volume":"42","author":"M Ottenhausen","year":"2019","unstructured":"Ottenhausen M, Ntoulias G, Bodhinayake I et al (2019) Intradural spinal tumors in adults\u2014update on management and outcome. Neurosurg Rev 42:371\u2013388","journal-title":"Neurosurg Rev"},{"key":"9029_CR2","doi-asserted-by":"crossref","first-page":"149","DOI":"10.4103\/joss.joss_21_22","volume":"9","author":"K Das","year":"2022","unstructured":"Das K, Pattankar S, Sardhara J et al (2022) Management of intramedullary spinal cord tumors: an updated review. J Spinal Surg 9:149","journal-title":"J Spinal Surg"},{"key":"9029_CR3","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/j.anclin.2020.11.012","volume":"39","author":"S Walha","year":"2021","unstructured":"Walha S, Fairbanks SL (2021) Spinal cord tumor surgery. Anesthesiol Clin 39:139\u2013149","journal-title":"Anesthesiol Clin"},{"key":"9029_CR4","first-page":"20","volume":"5","author":"S Sasikala","year":"2019","unstructured":"Sasikala S (2019) An expert system of MRI spinal cord tumor types using GLCM features for classification techniques. J Sci Technol 5:20\u201334","journal-title":"J Sci Technol"},{"key":"9029_CR5","doi-asserted-by":"crossref","first-page":"S53","DOI":"10.1016\/j.otsr.2019.05.028","volume":"106","author":"G Missenard","year":"2020","unstructured":"Missenard G, Bouthors C, Fadel E et al (2020) Surgical strategies for primary malignant tumors of the thoracic and lumbar spine. Orthop Traumatol Surg Res 106:S53-62","journal-title":"Orthop Traumatol Surg Res"},{"key":"9029_CR6","doi-asserted-by":"crossref","first-page":"9","DOI":"10.21037\/jss.2018.03.18","volume":"4","author":"AD Bhimani","year":"2018","unstructured":"Bhimani AD, Sadeh M, Esfahani DR et al (2018) Preoperative steroids do not improve outcomes for intramedullary spinal tumors: a NSQIP analysis of 30-day reoperation and readmission rates. J Spine Surg 4:9\u201316","journal-title":"J Spine Surg"},{"key":"9029_CR7","doi-asserted-by":"crossref","first-page":"1941","DOI":"10.1016\/j.spinee.2019.07.003","volume":"19","author":"DL Kerr","year":"2019","unstructured":"Kerr DL, Dial BL, Lazarides AL et al (2019) Epidemiologic and survival trends in adult primary bone tumors of the spine. Spine J 19:1941\u20131949","journal-title":"Spine J"},{"key":"9029_CR8","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/j.jocn.2016.02.017","volume":"31","author":"R De la Garza-Ramos","year":"2016","unstructured":"De la Garza-Ramos R, Goodwin CR, Abu-Bonsrah N et al (2016) Prolonged length of stay after posterior surgery for cervical spondylotic myelopathy in patients over 65 years of age. J Clin Neurosci 31:137\u2013141","journal-title":"J Clin Neurosci"},{"key":"9029_CR9","doi-asserted-by":"crossref","first-page":"807","DOI":"10.3171\/2015.3.SPINE14318","volume":"23","author":"S Yadla","year":"2015","unstructured":"Yadla S, Ghobrial GM, Campbell PG et al (2015) Identification of complications that have a significant effect on length of stay after spine surgery and predictive value of 90-day readmission rate. J Neurosurg Spine 23:807\u2013811","journal-title":"J Neurosurg Spine"},{"key":"9029_CR10","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.ejca.2018.08.028","volume":"104","author":"L Bollen","year":"2018","unstructured":"Bollen L, Dijkstra SPD, Bartels RHM et al (2018) Clinical management of spinal metastases\u2014The Dutch national guideline. Eur J Cancer 104:81\u201390","journal-title":"Eur J Cancer"},{"key":"9029_CR11","doi-asserted-by":"crossref","first-page":"1345","DOI":"10.1016\/j.spinee.2022.03.005","volume":"22","author":"AM Hersh","year":"2022","unstructured":"Hersh AM, Patel J, Pennington Z et al (2022) A novel online calculator to predict nonroutine discharge, length of stay, readmission, and reoperation in patients undergoing surgery for intramedullary spinal cord tumors. Spine J 22:1345\u20131355","journal-title":"Spine J"},{"key":"9029_CR12","doi-asserted-by":"crossref","first-page":"241","DOI":"10.3171\/2022.1.SPINE21987","volume":"37","author":"AA Elsamadicy","year":"2022","unstructured":"Elsamadicy AA, Koo AB, Reeves BC et al (2022) Hospital Frailty Risk Score and healthcare resource utilization after surgery for metastatic spinal column tumors. J Neurosurg Spine 37:241\u2013251","journal-title":"J Neurosurg Spine"},{"key":"9029_CR13","doi-asserted-by":"crossref","first-page":"1495","DOI":"10.1016\/j.ijsu.2014.07.013","volume":"12","author":"E von Elm","year":"2014","unstructured":"von Elm E, Altman DG, Egger M et al (2014) The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. Int J Surg 12:1495\u20131499","journal-title":"Int J Surg"},{"key":"9029_CR14","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.ins.2019.07.070","volume":"505","author":"D Elreedy","year":"2019","unstructured":"Elreedy D, Atiya AF (2019) A Comprehensive Analysis of Synthetic Minority Oversampling Technique (SMOTE) for handling class imbalance. Inf Sci 505:32\u201364","journal-title":"Inf Sci"},{"key":"9029_CR15","doi-asserted-by":"crossref","unstructured":"Agrawal T (2021) Optuna and AutoML. In: Hyperparameter optimization in machine learning, pp 109\u2013129","DOI":"10.1007\/978-1-4842-6579-6_5"},{"key":"9029_CR16","unstructured":"Lundberg S, Lee S-I (2017) A unified approach to interpreting model predictions. arXiv [cs.AI]. Available at http:\/\/arxiv.org\/abs\/1705.07874"},{"key":"9029_CR17","doi-asserted-by":"publisher","unstructured":"Lanitis A, Taylor CJ, Cootes TF (1995) A unified approach to coding and interpreting face images. In: Proceedings of IEEE international conference on computer vision. https:\/\/doi.org\/10.1109\/iccv.1995.466919","DOI":"10.1109\/iccv.1995.466919"},{"key":"9029_CR18","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1038\/s41551-018-0304-0","volume":"2","author":"SM Lundberg","year":"2018","unstructured":"Lundberg SM, Nair B, Vavilala MS et al (2018) Explainable machine-learning predictions for the prevention of hypoxaemia during surgery. Nat Biomed Eng 2:749\u2013760","journal-title":"Nat Biomed Eng"},{"key":"9029_CR19","doi-asserted-by":"crossref","first-page":"921","DOI":"10.1093\/neuonc\/not038","volume":"15","author":"S-H Lee","year":"2013","unstructured":"Lee S-H, Chung CK, Kim CH et al (2013) Long-term outcomes of surgical resection with or without adjuvant radiation therapy for treatment of spinal ependymoma: a retrospective multicenter study by the Korea Spinal Oncology Research Group. Neuro Oncol 15:921\u2013929","journal-title":"Neuro Oncol"},{"key":"9029_CR20","doi-asserted-by":"crossref","first-page":"492","DOI":"10.3171\/jns.1985.63.4.0492","volume":"63","author":"PR Cooper","year":"1985","unstructured":"Cooper PR, Epstein F (1985) Radical resection of intramedullary spinal cord tumors in adults. Recent experience in 29 patients. J Neurosurg 63:492\u2013429","journal-title":"J Neurosurg"},{"key":"9029_CR21","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1007\/BF01541785","volume":"119","author":"L Ferrante","year":"1992","unstructured":"Ferrante L, Mastronardi L, Celli P et al (1992) Intramedullary spinal cord ependymomas\u2013a study of 45 cases with long-term follow-up. Acta Neurochir 119:74\u201379","journal-title":"Acta Neurochir"},{"key":"9029_CR22","doi-asserted-by":"crossref","first-page":"654","DOI":"10.3171\/2017.9.SPINE17494","volume":"28","author":"M Wostrack","year":"2018","unstructured":"Wostrack M, Ringel F, Eicker SO et al (2018) Spinal ependymoma in adults: a multicenter investigation of surgical outcome and progression-free survival. J Neurosurg Spine 28:654\u2013662","journal-title":"J Neurosurg Spine"},{"key":"9029_CR23","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1016\/j.jocn.2008.08.016","volume":"16","author":"J Sun","year":"2009","unstructured":"Sun J, Wang Z, Li Z et al (2009) Microsurgical treatment and functional outcomes of multi-segment intramedullary spinal cord tumors. J Clin Neurosci 16:666\u2013671","journal-title":"J Clin Neurosci"},{"key":"9029_CR24","doi-asserted-by":"crossref","first-page":"1390","DOI":"10.1016\/j.jocn.2012.12.010","volume":"20","author":"MC Oh","year":"2013","unstructured":"Oh MC, Tarapore PE, Kim JM et al (2013) Spinal ependymomas: benefits of extent of resection for different histological grades. J Clin Neurosci 20:1390\u20131397","journal-title":"J Clin Neurosci"},{"key":"9029_CR25","doi-asserted-by":"crossref","first-page":"754","DOI":"10.1097\/WCO.0b013e328317efe8","volume":"21","author":"R Rud\u00e0","year":"2008","unstructured":"Rud\u00e0 R, Gilbert M, Soffietti R (2008) Ependymomas of the adult: molecular biology and treatment. Curr Opin Neurol 21:754\u2013761","journal-title":"Curr Opin Neurol"},{"key":"9029_CR26","doi-asserted-by":"crossref","first-page":"260","DOI":"10.3171\/2014.1.SPINE13866","volume":"21","author":"X Deng","year":"2014","unstructured":"Deng X, Wang K, Wu L et al (2014) Intraspinal hemangioblastomas: analysis of 92 cases in a single institution: clinical article. J Neurosurg Spine 21:260\u2013269","journal-title":"J Neurosurg Spine"},{"key":"9029_CR27","doi-asserted-by":"crossref","first-page":"814","DOI":"10.3389\/fneur.2019.00814","volume":"10","author":"O Persson","year":"2019","unstructured":"Persson O, Fletcher-Sandersj\u00f6\u00f6 A, Burstr\u00f6m G et al (2019) Surgical treatment of intra- and juxtamedullary spinal cord tumors: a population based observational cohort study. Front Neurol 10:814","journal-title":"Front Neurol"},{"key":"9029_CR28","doi-asserted-by":"crossref","first-page":"E13","DOI":"10.3171\/2011.7.FOCUS11158","volume":"31","author":"DT Nagasawa","year":"2011","unstructured":"Nagasawa DT, Smith ZA, Cremer N et al (2011) Complications associated with the treatment for spinal ependymomas. Neurosurg Focus 31:E13","journal-title":"Neurosurg Focus"},{"key":"9029_CR29","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1097\/BRS.0000000000000190","volume":"39","author":"R Babu","year":"2014","unstructured":"Babu R, Karikari IO, Owens TR et al (2014) Spinal cord astrocytomas: a modern 20-year experience at a single institution. Spine 39:533\u2013540","journal-title":"Spine"},{"key":"9029_CR30","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1215\/S1152851704001231","volume":"7","author":"DR Gomez","year":"2005","unstructured":"Gomez DR, Missett BT, Wara WM et al (2005) High failure rate in spinal ependymomas with long-term follow-up. Neuro Oncol 7:254\u2013259","journal-title":"Neuro Oncol"},{"key":"9029_CR31","doi-asserted-by":"crossref","first-page":"570103","DOI":"10.3389\/fonc.2020.570103","volume":"10","author":"X Yin","year":"2020","unstructured":"Yin X, Duan H, Yi Z et al (2020) Incidence, prognostic factors and survival for hemangioblastoma of the central nervous system: analysis based on the surveillance, epidemiology, and end results database. Front Oncol 10:570103","journal-title":"Front Oncol"},{"key":"9029_CR32","doi-asserted-by":"crossref","first-page":"441","DOI":"10.14245\/ns.2244156.078","volume":"19","author":"T Endo","year":"2022","unstructured":"Endo T, Inoue T, Mizuno M et al (2022) Current trends in the surgical management of intramedullary tumors: a multicenter study of 1,033 patients by the Neurospinal Society of Japan. Neurospine 19:441\u2013452","journal-title":"Neurospine"},{"key":"9029_CR33","doi-asserted-by":"crossref","first-page":"1622","DOI":"10.1227\/NEU.0b013e3181f96d41","volume":"67","author":"CM Halvorsen","year":"2010","unstructured":"Halvorsen CM, Kolstad F, Hald J et al (2010) Long-term outcome after resection of intraspinal ependymomas: report of 86 consecutive cases. Neurosurgery 67:1622\u20131631","journal-title":"Neurosurgery"},{"key":"9029_CR34","first-page":"3761","volume":"19","author":"H Mao","year":"2020","unstructured":"Mao H, Li X, Mao W (2020) Advantages of gross total resection in patients with astrocytoma: a population-based study. Oncol Lett 19:3761\u20133774","journal-title":"Oncol Lett"},{"key":"9029_CR35","doi-asserted-by":"crossref","first-page":"404","DOI":"10.3171\/2018.4.PEDS17587","volume":"22","author":"TD Azad","year":"2018","unstructured":"Azad TD, Pendharkar AV, Pan J et al (2018) Surgical outcomes of pediatric spinal cord astrocytomas: systematic review and meta-analysis. J Neurosurg Pediatr 22:404\u2013410","journal-title":"J Neurosurg Pediatr"},{"key":"9029_CR36","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1038\/sj.sc.3101932","volume":"44","author":"M Nakamura","year":"2006","unstructured":"Nakamura M, Chiba K, Ishii K et al (2006) Surgical outcomes of spinal cord astrocytomas. Spinal Cord 44:740\u2013745","journal-title":"Spinal Cord"},{"key":"9029_CR37","first-page":"55","volume":"63","author":"MJ McGirt","year":"2008","unstructured":"McGirt MJ, Goldstein IM, Chaichana KL et al (2008) Extent of surgical resection of malignant astrocytomas of the spinal cord: outcome analysis of 35 patients. Neurosurgery 63:55\u201360","journal-title":"Neurosurgery"},{"key":"9029_CR38","doi-asserted-by":"crossref","first-page":"404","DOI":"10.3171\/2009.2.SPINE08698","volume":"10","author":"Y Matsuyama","year":"2009","unstructured":"Matsuyama Y, Sakai Y, Katayama Y et al (2009) Surgical results of intramedullary spinal cord tumor with spinal cord monitoring to guide extent of resection. J Neurosurg Spine 10:404\u2013413","journal-title":"J Neurosurg Spine"},{"key":"9029_CR39","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1016\/j.neucli.2007.10.003","volume":"37","author":"KF Kothbauer","year":"2007","unstructured":"Kothbauer KF (2007) Intraoperative neurophysiologic monitoring for intramedullary spinal-cord tumor surgery. Neurophysiol Clin 37:407\u2013414","journal-title":"Neurophysiol Clin"},{"key":"9029_CR40","doi-asserted-by":"crossref","first-page":"12","DOI":"10.3171\/2013.3.SPINE121063","volume":"19","author":"J Klekamp","year":"2013","unstructured":"Klekamp J (2013) Treatment of intramedullary tumors: analysis of surgical morbidity and long-term results. J Neurosurg Spine 19:12\u201326","journal-title":"J Neurosurg Spine"},{"key":"9029_CR41","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1038\/sj.sc.3102130","volume":"46","author":"M Nakamura","year":"2008","unstructured":"Nakamura M, Ishii K, Watanabe K et al (2008) Surgical treatment of intramedullary spinal cord tumors: prognosis and complications. Spinal Cord 46:282\u2013286","journal-title":"Spinal Cord"},{"key":"9029_CR42","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1007\/s00586-007-0423-x","volume":"16","author":"F Sala","year":"2007","unstructured":"Sala F, Bricolo A, Faccioli F et al (2007) Surgery for intramedullary spinal cord tumors: the role of intraoperative (neurophysiological) monitoring. Eur Spine J 16:130\u2013139","journal-title":"Eur Spine J"},{"key":"9029_CR43","doi-asserted-by":"crossref","first-page":"591","DOI":"10.3171\/2014.2.PEDS1392","volume":"13","author":"JS Cheng","year":"2014","unstructured":"Cheng JS, Ivan ME, Stapleton CJ et al (2014) Intraoperative changes in transcranial motor evoked potentials and somatosensory evoked potentials predicting outcome in children with intramedullary spinal cord tumors. J Neurosurg Pediatr 13:591\u2013599","journal-title":"J Neurosurg Pediatr"},{"key":"9029_CR44","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1093\/neuros\/nyx303","volume":"82","author":"BJ Neuman","year":"2018","unstructured":"Neuman BJ, Ailon T, Scheer JK et al (2018) Development and validation of a novel adult spinal deformity surgical invasiveness score: analysis of 464 patients. Neurosurgery 82:847\u2013853","journal-title":"Neurosurgery"},{"key":"9029_CR45","doi-asserted-by":"crossref","first-page":"E2","DOI":"10.3171\/2017.9.FOCUS17494","volume":"43","author":"T Oh","year":"2017","unstructured":"Oh T, Scheer JK, Smith JS et al (2017) Potential of predictive computer models for preoperative patient selection to enhance overall quality-adjusted life years gained at 2-year follow-up: a simulation in 234 patients with adult spinal deformity. Neurosurg Focus 43:E2","journal-title":"Neurosurg Focus"},{"key":"9029_CR46","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1016\/j.wneu.2022.12.087","volume":"171","author":"VG El-Hajj","year":"2023","unstructured":"El-Hajj VG, Gharios M, Edstr\u00f6m E et al (2023) Artificial intelligence in neurosurgery: a bibliometric analysis. World Neurosurg 171:152\u2013158","journal-title":"World Neurosurg"}],"container-title":["European Spine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00586-025-09029-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00586-025-09029-y\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00586-025-09029-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T16:19:26Z","timestamp":1757953166000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00586-025-09029-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,25]]},"references-count":46,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["9029"],"URL":"https:\/\/doi.org\/10.1007\/s00586-025-09029-y","relation":{},"ISSN":["0940-6719","1432-0932"],"issn-type":[{"value":"0940-6719","type":"print"},{"value":"1432-0932","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,25]]},"assertion":[{"value":"25 April 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 October 2024","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"31 May 2025","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 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":"The authors declares that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The authors received no financial assistance.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Funding"}}]}}