{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T19:30:23Z","timestamp":1769715023421,"version":"3.49.0"},"reference-count":40,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T00:00:00Z","timestamp":1763510400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T00:00:00Z","timestamp":1763510400000},"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":["Clin Rheumatol"],"published-print":{"date-parts":[[2026,1]]},"DOI":"10.1007\/s10067-025-07811-3","type":"journal-article","created":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T08:34:30Z","timestamp":1763541270000},"page":"5-12","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Avascular necrosis in antiphospholipid syndrome: pathophysiology, risk factors, and management"],"prefix":"10.1007","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-5091-6635","authenticated-orcid":false,"given":"Reine","family":"Zankar","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5823-8811","authenticated-orcid":false,"given":"Reem El","family":"Jamal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2571-1450","authenticated-orcid":false,"given":"Georges El","family":"Hasbani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8285-6483","authenticated-orcid":false,"given":"Imad","family":"Uthman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,11,19]]},"reference":[{"key":"7811_CR1","doi-asserted-by":"publisher","unstructured":"Thrombosis, abortion, cerebral disease and the lupus anticoagulant. (2001). In CRC Press eBooks (pp. 184\u2013185). https:\/\/doi.org\/10.3109\/9780203214237-90","DOI":"10.3109\/9780203214237-90"},{"issue":"1","key":"7811_CR2","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2019.101463","volume":"34","author":"LR Sammaritano","year":"2020","unstructured":"Sammaritano LR (2020) Antiphospholipid syndrome. Best Pract Res Clin Rheumatol 34(1):101463","journal-title":"Best Pract Res Clin Rheumatol"},{"key":"7811_CR3","doi-asserted-by":"crossref","unstructured":"Schreiber K, Sciascia S, De Groot PG, Devreese K, Jacobsen S, Ruiz-Irastorza G, ... Hunt BJ (2018) Antiphospholipid syndrome. Nature reviews Disease primers, 4(1), 1\u201320","DOI":"10.1038\/nrdp.2017.103"},{"issue":"6","key":"7811_CR4","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1177\/1759720X13502919","volume":"5","author":"CL Aguiar","year":"2013","unstructured":"Aguiar CL, Erkan D (2013) Catastrophic antiphospholipid syndrome: how to diagnose a rare but highly fatal disease. Ther Adv Musculoskelet Dis 5(6):305\u2013314","journal-title":"Ther Adv Musculoskelet Dis"},{"key":"7811_CR5","doi-asserted-by":"crossref","unstructured":"Barbhaiya M, Zuily S, Naden R, Hendry A, Manneville F, Amigo MC, ... Fortin P (2023) The 2023 ACR\/EULAR antiphospholipid syndrome classification criteria. Arthritis & Rheumatology, 75(10), 1687\u20131702","DOI":"10.1002\/art.42624"},{"key":"7811_CR6","doi-asserted-by":"publisher","unstructured":"Bouomrani S, Ayed MB (2019) Isolated osteonecrosis revealing primary antiphospholipid syndrome. MOJ Orthopedics & Rheumatology, 11(1). https:\/\/doi.org\/10.15406\/mojor.2019.11.00469","DOI":"10.15406\/mojor.2019.11.00469"},{"issue":"1","key":"7811_CR7","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1177\/0961203317722850","volume":"27","author":"MHA Noureldine","year":"2018","unstructured":"Noureldine MHA, Uthman I (2018) Antiphospholipid (Hughes) syndrome: insights for orthopedics. Lupus 27(1):3\u20135. https:\/\/doi.org\/10.1177\/0961203317722850","journal-title":"Lupus"},{"issue":"3","key":"7811_CR8","doi-asserted-by":"publisher","first-page":"732","DOI":"10.1002\/art.10835","volume":"48","author":"MG Tektonidou","year":"2003","unstructured":"Tektonidou MG, Malagari K, Vlachoyiannopoulos PG, Kelekis DA, Moutsopoulos HM (2003) Asymptomatic avascular necrosis in patients with primary antiphospholipid syndrome in the absence of corticosteroid use: a prospective study by magnetic resonance imaging. Arthritis Rheum 48(3):732\u2013736. https:\/\/doi.org\/10.1002\/art.10835","journal-title":"Arthritis Rheum"},{"key":"7811_CR9","doi-asserted-by":"crossref","unstructured":"Chang C, Greenspan A, Gershwin ME (2013) Osteonecrosis. Kelley\u2019s textbook of rheumatology, 9th edition. W.B. Saunders, Philadelphia","DOI":"10.1016\/B978-1-4377-1738-9.00103-1"},{"key":"7811_CR10","unstructured":"Matthews AH, Davis DD, Fish MJ, Stitson D (2023) Avascular necrosis. In: StatPearls[Internet]. StatPearls Publishing"},{"issue":"3","key":"7811_CR11","doi-asserted-by":"publisher","first-page":"1255","DOI":"10.1007\/s40744-021-00333-9","volume":"8","author":"JF De Carvalho","year":"2021","unstructured":"De Carvalho JF, De Araujo RPC, Skare TL (2021) Osteonecrosis in primary antiphospholipid syndrome is associated with previous glucocorticoid use and thrombocytopenia. Rheumatol Ther 8(3):1255\u20131261. https:\/\/doi.org\/10.1007\/s40744-021-00333-9","journal-title":"Rheumatol Ther"},{"issue":"3","key":"7811_CR12","doi-asserted-by":"publisher","first-page":"523","DOI":"10.1016\/j.rdc.2006.05.003","volume":"32","author":"MG Tektonidou","year":"2006","unstructured":"Tektonidou MG, Moutsopoulos HM (2006) Osteoarticular manifestations of antiphospholipid syndrome. Rheum Dis Clin North Am 32(3):523\u2013535. https:\/\/doi.org\/10.1016\/j.rdc.2006.05.003","journal-title":"Rheum Dis Clin North Am"},{"issue":"2","key":"7811_CR13","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1007\/s12016-007-0006-y","volume":"32","author":"A Gorshtein","year":"2007","unstructured":"Gorshtein A, Levy Y (2007) Orthopedic involvement in antiphospholipid syndrome. Clin Rev Allergy Immunol 32(2):167\u2013171. https:\/\/doi.org\/10.1007\/s12016-007-0006-y","journal-title":"Clin Rev Allergy Immunol"},{"issue":"6","key":"7811_CR14","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1097\/MD.0000000000000007","volume":"92","author":"JA G\u00f3mez-Puerta","year":"2013","unstructured":"G\u00f3mez-Puerta JA, Peris P, Reverter JC, Espinosa G, Martinez-Ferrer A, Monegal A, Gua\u00f1abens N (2013) High prevalence of prothrombotic abnormalities in multifocal osteonecrosis: description of a series and review of the literature. Medicine (Baltimore) 92(6):295\u2013304","journal-title":"Medicine (Baltimore)"},{"issue":"2","key":"7811_CR15","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1007\/s10067-007-0716-9","volume":"27","author":"S Rostom","year":"2007","unstructured":"Rostom S, Bahiri R, Hajjaj-Hassouni N (2007) Multifocal avascular necrosis revealing antiphospholipid syndrome. Clin Rheumatol 27(2):271\u2013272. https:\/\/doi.org\/10.1007\/s10067-007-0716-9","journal-title":"Clin Rheumatol"},{"issue":"9","key":"7811_CR16","doi-asserted-by":"publisher","first-page":"737","DOI":"10.2169\/internalmedicine.48.2063","volume":"48","author":"S Sciascia","year":"2009","unstructured":"Sciascia S, Bertero MT (2009) Osteonecrosis and antiphospholipid antibodies. Intern Med 48(9):737\u2013738. https:\/\/doi.org\/10.2169\/internalmedicine.48.2063","journal-title":"Intern Med"},{"issue":"4","key":"7811_CR17","doi-asserted-by":"publisher","first-page":"214","DOI":"10.1097\/01.rhu.0000135559.95451.b2","volume":"10","author":"A Zonana-Nacach","year":"2004","unstructured":"Zonana-Nacach A, Jim\u00e9nez-Balderas FJ (2004) Avascular necrosis of bone associated with primary antiphospholipid syndrome: case report and literature review. JCR J Clin Rheumatol 10(4):214\u2013217","journal-title":"JCR J Clin Rheumatol"},{"issue":"5","key":"7811_CR18","doi-asserted-by":"publisher","first-page":"647","DOI":"10.1007\/s00296-009-1346-0","volume":"31","author":"JF De Carvalho","year":"2010","unstructured":"De Carvalho JF (2010) Influence of gender on the clinical and laboratory spectra of patients with primary antiphospholipid syndrome. Rheumatol Int 31(5):647\u2013650. https:\/\/doi.org\/10.1007\/s00296-009-1346-0","journal-title":"Rheumatol Int"},{"key":"7811_CR19","doi-asserted-by":"publisher","unstructured":"Lykissas MG, Gelalis ID, Kostas-Agnantis IP, Vozonelos G, Korompilias AV (2012) The role of hypercoagulability in the development of osteonecrosis of the femoral head. Orthopedic Reviews, 4(2). https:\/\/doi.org\/10.4081\/or.2012.e17","DOI":"10.4081\/or.2012.e17"},{"key":"7811_CR20","doi-asserted-by":"publisher","DOI":"10.1186\/s43166-022-00122-4","author":"AE Shintenawy","year":"2022","unstructured":"Shintenawy AE, Khallaf S, Shentenawy EE, Deeb AE (2022) A case of completed course multifocal osteonecrosis (MFON) during pregnancy due to primary antiphospholipid syndrome. Egypt Rheumatol Rehabil. https:\/\/doi.org\/10.1186\/s43166-022-00122-4","journal-title":"Egypt Rheumatol Rehabil"},{"issue":"5","key":"7811_CR21","doi-asserted-by":"publisher","first-page":"304","DOI":"10.1191\/0961203306lu2301cr","volume":"15","author":"J Mundo","year":"2006","unstructured":"Mundo J, Peris P, Monegal A, Navasa M, Cervera R, Guaniabens N (2006) Multifocal avascular necrosis after liver transplantation: an unusual presentation of the antiphospholipid syndrome. Lupus 15(5):304\u2013307. https:\/\/doi.org\/10.1191\/0961203306lu2301cr","journal-title":"Lupus"},{"issue":"3","key":"7811_CR22","doi-asserted-by":"publisher","first-page":"130","DOI":"10.1097\/RHU.0b013e31819dbd20","volume":"15","author":"JC Rueda","year":"2009","unstructured":"Rueda JC, Duque MAQ, Mantilla RD, Iglesias-Gamarra A (2009) Osteonecrosis and antiphospholipid syndrome. JCR J Clin Rheumatol 15(3):130\u2013132","journal-title":"JCR J Clin Rheumatol"},{"issue":"4","key":"7811_CR23","doi-asserted-by":"publisher","first-page":"638","DOI":"10.1111\/j.1365-2141.2008.07228.x","volume":"142","author":"CP Despujol","year":"2008","unstructured":"Despujol CP, Michel M, Khellaf M, Gouault M, Intrator L, Bierling P, Godeau B (2008) Antiphospholipid antibodies in adults with immune thrombocytopenic purpura. Br J Haematol 142(4):638\u2013643. https:\/\/doi.org\/10.1111\/j.1365-2141.2008.07228.x","journal-title":"Br J Haematol"},{"issue":"5","key":"7811_CR24","doi-asserted-by":"publisher","first-page":"664","DOI":"10.1080\/09537104.2018.1535701","volume":"30","author":"H El-Gendy","year":"2019","unstructured":"El-Gendy H, El-Gohary RM, Mahfouz S, Ahmed HMA, El Demerdash DM, Ragab G (2019) Multifocal avascular necrosis in a patient with refractory immune thrombocytopenia and antiphospholipid antibodies; case report and review of literature. Platelets 30(5):664\u2013671. https:\/\/doi.org\/10.1080\/09537104.2018.1535701","journal-title":"Platelets"},{"issue":"4","key":"7811_CR25","doi-asserted-by":"publisher","first-page":"374","DOI":"10.3109\/s10165-003-0239-4","volume":"13","author":"M Nishikai","year":"2003","unstructured":"Nishikai M, Ichihara N, Bito S, Akiya K (2003) Nondiabetic thigh muscle infarction presenting as a possible primary antiphospholipid syndrome. Mod Rheumatol 13(4):374\u2013375. https:\/\/doi.org\/10.3109\/s10165-003-0239-4","journal-title":"Mod Rheumatol"},{"issue":"4","key":"7811_CR26","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1182\/blood.2019003863","volume":"135","author":"S Chaturvedi","year":"2019","unstructured":"Chaturvedi S, Braunstein EM, Yuan X, Yu J, Alexander A, Chen H, Gavriilaki E, Alluri R, Streiff MB, Petri M, Crowther MA, McCrae KR, Brodsky RA (2019) Complement activity and complement regulatory gene mutations are associated with thrombosis in APS and CAPS. Blood 135(4):239\u2013251. https:\/\/doi.org\/10.1182\/blood.2019003863","journal-title":"Blood"},{"key":"7811_CR27","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2012-006731","author":"CR Crome","year":"2012","unstructured":"Crome CR, Rajagopalan S, Kuhan G, Fluck N (2012) Antiphospholipid syndrome presenting with acute digital ischaemia, avascular necrosis of the femoral head and superior mesenteric artery thrombus. BMJ Case Rep. https:\/\/doi.org\/10.1136\/bcr-2012-006731","journal-title":"BMJ Case Rep"},{"issue":"10","key":"7811_CR28","doi-asserted-by":"publisher","first-page":"2914","DOI":"10.1002\/art.38712","volume":"66","author":"SM Jung","year":"2014","unstructured":"Jung SM, Ju JH, Kwok SK, Park KS, Park SH (2014) Multiple osteonecrotic lesions mimicking a piano keyboard in the spine of a patient with catastrophic antiphospholipid syndrome. Arthritis Rheumatol 66(10):2914. https:\/\/doi.org\/10.1002\/art.38712","journal-title":"Arthritis Rheumatol"},{"issue":"4","key":"7811_CR29","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1136\/ard.2003.006197","volume":"63","author":"WH Yoo","year":"2004","unstructured":"Yoo WH (2004) Multiple rib infarcts: a rare form of osteonecrosis in antiphospholipid syndrome. Ann Rheum Dis 63(4):457\u2013458. https:\/\/doi.org\/10.1136\/ard.2003.006197","journal-title":"Ann Rheum Dis"},{"issue":"3","key":"7811_CR30","doi-asserted-by":"publisher","first-page":"228","DOI":"10.1007\/s12178-015-9280-0","volume":"8","author":"TP Pierce","year":"2015","unstructured":"Pierce TP, Jauregui JJ, Elmallah RK, Lavernia CJ, Mont MA, Nace J (2015) A current review of core decompression in the treatment of osteonecrosis of the femoral head. Curr Rev Musculoskelet Med 8(3):228\u2013324","journal-title":"Curr Rev Musculoskelet Med"},{"issue":"23","key":"7811_CR31","doi-asserted-by":"publisher","first-page":"6984","DOI":"10.3390\/jcm11236984","volume":"11","author":"M Capecchi","year":"2022","unstructured":"Capecchi M, Abbattista M, Ciavarella A, Uhr M, Novembrino C, Martinelli I (2022) Anticoagulant therapy in patients with antiphospholipid syndrome. J Clin Med 11(23):6984","journal-title":"J Clin Med"},{"issue":"SI","key":"7811_CR32","doi-asserted-by":"publisher","first-page":"SI96","DOI":"10.1093\/rheumatology\/kead538","volume":"63","author":"G Ruiz-Irastorza","year":"2024","unstructured":"Ruiz-Irastorza G, Tektonidou MG, Khamashta M (2024) Anticoagulant and non-anticoagulant therapy in thrombotic antiphospholipid syndrome: old drugs and new treatment targets. Rheumatology 63(SI):SI96\u2013SI106","journal-title":"Rheumatology"},{"issue":"4","key":"7811_CR33","doi-asserted-by":"publisher","first-page":"222","DOI":"10.1007\/s003930050095","volume":"57","author":"HP Justen","year":"1998","unstructured":"Justen HP, Muller-Ladner U, Leeb I, Lang B, Wessinghage D (1998) Surgical treatment of aseptic bone necroses of both knee joints in antiphospholipid antibody syndrome (APL) by synovectomy, arthrolysis and arthroplasty. Z Rheumatol 57(4):222\u2013226. https:\/\/doi.org\/10.1007\/s003930050095","journal-title":"Z Rheumatol"},{"issue":"5","key":"7811_CR34","first-page":"232","volume":"72","author":"S Legreve","year":"2017","unstructured":"Legreve S, Brands G (2017) Multifocal osteonecrosis revealing an antiphospholipid syndrome: case report. Rev Med Liege 72(5):232\u2013236","journal-title":"Rev Med Liege"},{"issue":"10","key":"7811_CR35","doi-asserted-by":"publisher","first-page":"1296","DOI":"10.1136\/annrheumdis-2019-215213","volume":"78","author":"MG Tektonidou","year":"2019","unstructured":"Tektonidou MG, Andreoli L, Limper M, Amoura Z, Cervera R, Costedoat-Chalumeau N, Cuadrado MJ, D\u00f6rner T, Ferrer-Oliveras R, Hambly K, Khamashta MA, King J, Marchiori F, Meroni PL, Mosca M, Pengo V, Raio L, Ruiz-Irastorza G, Shoenfeld Y, Ward MM (2019) EULAR recommendations for the management of antiphospholipid syndrome in adults. Ann Rheum Dis 78(10):1296\u20131304. https:\/\/doi.org\/10.1136\/annrheumdis-2019-215213","journal-title":"Ann Rheum Dis"},{"key":"7811_CR36","doi-asserted-by":"crossref","unstructured":"Piotrowski M, Majdan M, Jablonski M & Gorzelak M (2007) Orthopedic complications of antiphospholipid syndrome: presentation of two cases. Polskie Archiwum Medycyny Wewnetrznej, 117 Suppl, 73\u20135. Retrieved from https:\/\/ovidsp.ovid.com\/ovidweb.cgi?T=JS&PAGE=reference&D=med6&NEWS=N&AN=18778027","DOI":"10.20452\/pamw.284"},{"issue":"2","key":"7811_CR37","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1093\/rheumatology\/ket313","volume":"53","author":"MJ Cuadrado","year":"2013","unstructured":"Cuadrado MJ, Bertolaccini ML, Seed PT, Tektonidou MG, Aguirre A, Mico L, Gordon C, Ruiz-Irastorza G, Egurbide MV, Gil A, Espinosa G, Houssiau F, Rahman A, Martin H, McHugh N, Galindo M, Akil M, Amigo MC, Murru V, Khamashta MA (2013) Low-dose aspirin vs low-dose aspirin plus low-intensity warfarin in thromboprophylaxis: a prospective, multicentre, randomized, open, controlled trial in patients positive for antiphospholipid antibodies (ALIWAPAS). Lara D Veeken 53(2):275\u2013284. https:\/\/doi.org\/10.1093\/rheumatology\/ket313","journal-title":"Lara D Veeken"},{"key":"7811_CR38","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2018-225532","author":"I Cecchi","year":"2018","unstructured":"Cecchi I, Perez Sanchez L, Sciascia S, Roccatello D (2018) Multifocal avascular osteonecrosis despite appropriate anticoagulation therapy in a patient with systemic lupus erythematosus and antiphospholipid syndrome. BMJ Case Rep. https:\/\/doi.org\/10.1136\/bcr-2018-225532","journal-title":"BMJ Case Rep"},{"issue":"6","key":"7811_CR39","doi-asserted-by":"publisher","first-page":"719","DOI":"10.1007\/s00296-009-1269-9","volume":"30","author":"W Haque","year":"2010","unstructured":"Haque W, Kadikoy H, Pacha O, Maliakkal J, Hoang V, Abdellatif A (2010) Osteonecrosis secondary to antiphospholipid syndrome: a case report, review of the literature, and treatment strategy. Rheumatol Int 30(6):719\u2013723. https:\/\/doi.org\/10.1007\/s00296-009-1269-9","journal-title":"Rheumatol Int"},{"issue":"5","key":"7811_CR40","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1191\/0961203305lu2146rr","volume":"14","author":"S Vasoo","year":"2005","unstructured":"Vasoo S, Sangle S, Zain M, D\u2019Cruz D, Hughes G (2005) Orthopaedic manifestations of the antiphospholipid (Hughes) syndrome. Lupus 14(5):339\u2013345. https:\/\/doi.org\/10.1191\/0961203305lu2146rr","journal-title":"Lupus"}],"container-title":["Clinical Rheumatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10067-025-07811-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10067-025-07811-3","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10067-025-07811-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T09:41:50Z","timestamp":1769679710000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10067-025-07811-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,19]]},"references-count":40,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["7811"],"URL":"https:\/\/doi.org\/10.1007\/s10067-025-07811-3","relation":{},"ISSN":["0770-3198","1434-9949"],"issn-type":[{"value":"0770-3198","type":"print"},{"value":"1434-9949","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,19]]},"assertion":[{"value":"22 June 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 November 2025","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 November 2025","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 November 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":"None.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosures"}}]}}