{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T16:34:19Z","timestamp":1788885259468,"version":"build-2803163510"},"reference-count":40,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:00:00Z","timestamp":1778544000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:00:00Z","timestamp":1778544000000},"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":["Neurol Sci"],"published-print":{"date-parts":[[2026,6]]},"DOI":"10.1007\/s10072-026-09090-5","type":"journal-article","created":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T05:17:42Z","timestamp":1778563062000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Oral antipyretics for fatigue alleviation and exercise enhancement in adults with multiple sclerosis: a systematic review and meta-analysis"],"prefix":"10.1007","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0805-8181","authenticated-orcid":false,"given":"Ismail A.","family":"Ibrahim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed Mohamed","family":"Hamdy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mazen Momtaz","family":"Shehata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mandy","family":"Elewa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara Wael","family":"Elmandrawi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed Mahmoud Elsayed","family":"Elemam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaimaa","family":"Ibrahim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Nezar","family":"Abohalawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Liaquat","family":"Raza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,12]]},"reference":[{"issue":"2","key":"9090_CR1","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1016\/j.jns.2003.06.001","volume":"206","author":"H Lassmann","year":"2003","unstructured":"Lassmann H (2003) Inflammation and degeneration in multiple sclerosis. J Neurol Sci 206(2):181\u2013185. https:\/\/doi.org\/10.1016\/j.jns.2003.06.001","journal-title":"J Neurol Sci"},{"key":"9090_CR2","doi-asserted-by":"publisher","unstructured":"Diaz-Quiroz M, Chicue-Cuervo PC, Garcia-Moreno L, Gaviria-Carrillo M, Talero-Gutierrez C, Palacios-Espinosa X (2025) Fatigue in multiple sclerosis: a scoping review of pharmacological and nonpharmacological interventions. Mult Scler J Exp Transl Clin 11(1):20552173241312527. https:\/\/doi.org\/10.1177\/20552173241312527","DOI":"10.1177\/20552173241312527"},{"issue":"20","key":"9090_CR3","doi-asserted-by":"publisher","first-page":"1430","DOI":"10.1056\/NEJM200011163432001","volume":"343","author":"C Confavreux","year":"2000","unstructured":"Confavreux C, Vukusic S, Moreau T, Adeleine P (2000) Relapses and progression of disability in multiple sclerosis. N Engl J Med 343(20):1430\u20131438","journal-title":"N Engl J Med"},{"key":"9090_CR4","unstructured":"Freal J, Kraft G, Jk C (1984) Symptomatic fatigue in multiple sclerosis. Arch Phys Med Rehabil"},{"issue":"1","key":"9090_CR5","doi-asserted-by":"publisher","first-page":"468","DOI":"10.1186\/s12883-021-02396-1","volume":"21","author":"A Oliva Ramirez","year":"2021","unstructured":"Oliva Ramirez A, Keenan A, Kalau O, Worthington E, Cohen L, Singh S (2021) Prevalence and burden of multiple sclerosis-related fatigue: a systematic literature review. BMC Neurol 21(1):468. https:\/\/doi.org\/10.1186\/s12883-021-02396-1","journal-title":"BMC Neurol"},{"issue":"8","key":"9090_CR6","doi-asserted-by":"publisher","first-page":"1061","DOI":"10.1093\/sleep\/33.8.1061","volume":"33","author":"TJ Braley","year":"2010","unstructured":"Braley TJ, Chervin RD (2010) Fatigue in multiple sclerosis: mechanisms, evaluation, and treatment. Sleep 33(8):1061\u20137. https:\/\/doi.org\/10.1093\/sleep\/33.8.1061","journal-title":"Sleep"},{"key":"9090_CR7","doi-asserted-by":"crossref","unstructured":"Zimek D, Miklusova M, Mares J (2023) Overview of the Current Pathophysiology of Fatigue in Multiple Sclerosis, Its Diagnosis and Treatment Options - Review Article. Neuropsychiatr Dis Treat [Internet]. [cited 2025 Feb 27];19:2485-97. Available from: https:\/\/www.tandfonline.com\/action\/journalInformation?journalCode=dndt20","DOI":"10.2147\/NDT.S429862"},{"key":"9090_CR8","doi-asserted-by":"publisher","first-page":"102799","DOI":"10.1016\/j.msard.2021.102799","volume":"50","author":"S Johansson","year":"2021","unstructured":"Johansson S, Skjerb\u00e6k AG, N\u00f8rgaard M, Boesen F, Hvid LG, Dalgas U (2021) Associations between fatigue impact and lifestyle factors in people with multiple sclerosis - The Danish MS hospitals rehabilitation study. Mult Scler Relat Disord 50:102799","journal-title":"Mult Scler Relat Disord"},{"key":"9090_CR9","doi-asserted-by":"publisher","unstructured":"White AT, VanHaitsma TA, Vener J, Davis SL (2013) Effect of passive whole body heating on central conduction and cortical excitability in multiple sclerosis patients and healthy controls. J Appl Physiol [Internet]. Jun 15 [cited 2025 Feb 27];114(12):1697\u2009\u2013\u2009704. Available from: https:\/\/doi.org\/10.1152\/japplphysiol.01119.2012","DOI":"10.1152\/japplphysiol.01119.2012"},{"issue":"7","key":"9090_CR10","doi-asserted-by":"publisher","first-page":"1298","DOI":"10.1016\/j.apmr.2014.02.004","volume":"95","author":"JF Sumowski","year":"2014","unstructured":"Sumowski JF, Leavitt VM (2014) Body temperature is elevated and linked to fatigue in Relapsing-Remitting Multiple Sclerosis, even without heat exposure. Arch Phys Med Rehabil 95(7):1298\u20131302","journal-title":"Arch Phys Med Rehabil"},{"key":"9090_CR11","doi-asserted-by":"publisher","unstructured":"Marrie RA, Horwitz R, Cutter G, Tyry T, Campagnolo D, Vollmer T (2009) High frequency of adverse health behaviors in multiple sclerosis. Mult Scler J 15(1):105\u201313. https:\/\/doi.org\/10.1177\/1352458508096680","DOI":"10.1177\/1352458508096680"},{"issue":"2","key":"9090_CR12","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1016\/j.neucli.2017.02.004","volume":"47","author":"SS Ayache","year":"2017","unstructured":"Ayache SS, Chalah MA (2017) Fatigue in multiple sclerosis - insights into evaluation and management. Neurophysiol Clin 47(2):139\u2013171","journal-title":"Neurophysiol Clin"},{"key":"9090_CR13","doi-asserted-by":"publisher","unstructured":"Lewis HDJr, Davis JW, Archibald DG, Steinke WE, Smitherman TC, Doherty JEI et al Protective Effects of Aspirin against Acute Myocardial Infarction and Death in Men with Unstable Angina. New England Journal of Medicine [Internet]. 1983 Aug 18 [cited 2025 Feb 27];309(7):396\u2013403. Available from: https:\/\/www.nejm.org\/doi\/abs\/https:\/\/doi.org\/10.1056\/NEJM198308183090703","DOI":"10.1056\/NEJM198308183090703"},{"key":"9090_CR14","doi-asserted-by":"publisher","unstructured":"Simes J, Becattini C, Agnelli G, Eikelboom JW, Kirby AC, Mister R et al (2014) Aspirin for the prevention of recurrent venous thromboembolism the INSPIRE collaboration. Circulation [Internet]. [cited 2025 Feb 27];130(13):1062-71. Available from: https:\/\/www.ahajournals.org\/doi\/https:\/\/doi.org\/10.1161\/CIRCULATIONAHA.114.008828","DOI":"10.1161\/CIRCULATIONAHA.114.008828"},{"key":"9090_CR15","doi-asserted-by":"publisher","first-page":"424","DOI":"10.1016\/j.msard.2018.10.008","volume":"27","author":"O Ahmed","year":"2019","unstructured":"Ahmed O, Geraldes R, DeLuca GC, Palace J (2019) Multiple sclerosis and the risk of systemic venous thrombosis: a systematic review. Mult Scler Relat Disord 27:424\u2013430","journal-title":"Mult Scler Relat Disord"},{"key":"9090_CR16","doi-asserted-by":"crossref","unstructured":"Sumowski JF, Leavitt VM (2014) Body temperature is elevated and linked to fatigue in relapsing-remitting multiple sclerosis, even without heat exposure. Arch Phys Med Rehabil [Internet]. [cited 2025 Feb 27];95(7):1298\u2009\u2013\u2009302.Available from: https:\/\/www.researchgate.net\/publication\/260296390_Body_Temperature_Is_Elevated_and_Linked_to_Fatigue_in_Relapsing-Remitting_Multiple_Sclerosis_Even_Without_Heat_Exposure","DOI":"10.1016\/j.apmr.2014.02.004"},{"key":"9090_CR17","doi-asserted-by":"publisher","unstructured":"Tsau S, Emerson MR, Lynch SG, LeVine SM (2015) Aspirin and multiple sclerosis. BMC Med [Internet]. Jun 29 [cited 2025 Feb 27];13(1):1\u201316. Available from: https:\/\/link.springer.com\/articles\/https:\/\/doi.org\/10.1186\/s12916-015-0394-4","DOI":"10.1186\/s12916-015-0394-4"},{"issue":"7","key":"9090_CR18","doi-asserted-by":"publisher","first-page":"1267","DOI":"10.1212\/01.WNL.0000156803.23698.9A","volume":"64","author":"DM Wingerchuk","year":"2005","unstructured":"Wingerchuk DM, Benarroch EE, O\u2019Brien PC, Keegan BM, Lucchinetti CF, Noseworthy JH, Weinshenker BG, Rodriguez M (2005) A randomized controlled crossover trial of aspirin for fatigue in multiple sclerosis. Neurology 64(7):1267\u20131269","journal-title":"Neurology"},{"issue":"9","key":"9090_CR19","doi-asserted-by":"publisher","first-page":"126","DOI":"10.3390\/sports9090126","volume":"9","author":"J Grgic","year":"2021","unstructured":"Grgic J, Mikulic P (2021) Effects of paracetamol (acetaminophen) ingestion on endurance performance: a systematic review and meta-analysis. Sports 9(9):126","journal-title":"Sports"},{"key":"9090_CR20","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000097","volume":"6","author":"D Moher","year":"2009","unstructured":"Moher D, Liberati A, Tetzlaff J, Altman DG (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 6:e1000097. https:\/\/doi.org\/10.1371\/journal.pmed.1000097","journal-title":"PLoS Med"},{"issue":"6","key":"9090_CR21","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1136\/emermed-2020-209567","volume":"37","author":"M Amir-Behghadami","year":"2020","unstructured":"Amir-Behghadami M, Janati A (2020) Population, intervention, comparison, outcomes and study (PICOS) design as a framework to formulate eligibility criteria in systematic reviews. Emerg Med J 37:387. https:\/\/doi.org\/10.1136\/emermed-2020-209567","journal-title":"Emerg Med J"},{"issue":"2","key":"9090_CR22","doi-asserted-by":"publisher","first-page":"266","DOI":"10.1097\/00005768-199602000-00017","volume":"28","author":"AE Jeukendrup","year":"1996","unstructured":"Jeukendrup AE, Saris WHM, Brouns F, Kester ADM (1996) A new validated endurance performance test. Med Sci Sports Exerc 28(2):266\u2013270","journal-title":"Med Sci Sports Exerc"},{"issue":"10","key":"9090_CR23","doi-asserted-by":"publisher","first-page":"1121","DOI":"10.1001\/archneur.1989.00520460115022","volume":"46","author":"LB Krupp","year":"1989","unstructured":"Krupp LB, LaRocca NG, Muir-Nash J, Steinberg AD (1989) The fatigue severity scale: application to patients with multiple sclerosis and systemic lupus erythematosus. Arch Neurol 46(10):1121\u20133. https:\/\/doi.org\/10.1001\/archneur.1989.00520460115022","journal-title":"Arch Neurol"},{"key":"9090_CR24","volume-title":"Fatigue and multiple sclerosis: Evidence-based management strategies for fatigue in multiple sclerosis","author":"Multiple Sclerosis Council for Clinical Practice Guidelines","year":"1998","unstructured":"Multiple Sclerosis Council for Clinical Practice Guidelines (1998) Fatigue and multiple sclerosis: Evidence-based management strategies for fatigue in multiple sclerosis. Paralyzed Veterans of America, Washington, DC"},{"key":"9090_CR25","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1136\/bmjebm-2022-112102","volume":"28","author":"E Flemyng","year":"2023","unstructured":"Flemyng E, Moore TH, Boutron I, Higgins JP, Hrobjartsson A, Nejstgaard CH, Dwan K (2023) Using risk of bias 2 to assess results from randomised controlled trials: guidance from Cochrane. BMJ Evid Based Med 28:260\u2013266. https:\/\/doi.org\/10.1136\/bmjebm-2022-112102","journal-title":"BMJ Evid Based Med"},{"issue":"2","key":"9090_CR26","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1037\/a0027890","volume":"57","author":"D Amtmann","year":"2012","unstructured":"Amtmann D, Bamer AM, Noonan V, Lang N, Kim J, Cook KF (2012) Comparison of the psychometric properties of two fatigue scales in multiple sclerosis. Rehabil Psychol 57(2):159\u201366. https:\/\/doi.org\/10.1037\/a0027890","journal-title":"Rehabil Psychol"},{"key":"9090_CR27","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1186\/1471-2377-6-27","volume":"6","author":"D Kos","year":"2006","unstructured":"Kos D, Nagels G, D\u2019Hooghe MB, Duportail M, Kerckhofs E (2006) A rapid screening tool for fatigue impact in multiple sclerosis. BMC Neurol 6:27","journal-title":"BMC Neurol"},{"key":"9090_CR28","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1016\/j.pmr.2008.12.003","volume":"20","author":"A Shah","year":"2009","unstructured":"Shah A (2009) Fatigue in multiple sclerosis. Phys Med Rehabil Clin N Am 20:363\u2013372","journal-title":"Phys Med Rehabil Clin N Am"},{"key":"9090_CR29","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1093\/qjmed\/hcm122","volume":"101","author":"RJ Mills","year":"2007","unstructured":"Mills RJ, Young CA (2007) A medical definition of fatigue in multiple sclerosis. QJM Int J Med 101:49\u201360","journal-title":"QJM Int J Med"},{"key":"9090_CR30","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1016\/j.annrmp.2006.04.023","volume":"49","author":"F B\u00e9thoux","year":"2006","unstructured":"B\u00e9thoux F (2006) Fatigue and multiple sclerosis. Ann Readapt Med Phys 49:265\u2013271","journal-title":"Ann Readapt Med Phys"},{"key":"9090_CR31","doi-asserted-by":"publisher","first-page":"xxx","DOI":"10.1016\/j.npbr.2016.11.002","volume":"201","author":"M Sadeghi-Naini","year":"2016","unstructured":"Sadeghi-Naini M, Ghazi-zadeh Esslami G, Fayyazi S, Nabavi SM, Morsali D, Ghaffarpour M (2016) Low dose aspirin for MS-related fatigue: results of a pilot, double-blind, randomized trial. Neurol Psychiatry Brain Res 201:xxx\u2013xxx. https:\/\/doi.org\/10.1016\/j.npbr.2016.11.002","journal-title":"Neurol Psychiatry Brain Res"},{"key":"9090_CR32","doi-asserted-by":"crossref","unstructured":"Shuster E et al (2014) Aspirin is unlikely to have a clinically meaningful effect on multiple sclerosis-related fatigue: data from a randomized controlled trial (P7. 245)[J], Neurology 82 (10 Supplement) P7. 245","DOI":"10.1212\/WNL.82.10_supplement.P7.245"},{"key":"9090_CR33","doi-asserted-by":"crossref","unstructured":"Shuster E et al (2014) Aspirin is unlikely to have a clinically meaningful effect on multiple sclerosis-related fatigue: data from a randomized controlled trial (P7. 245)[J], Neurology 82 (10 Supplement) P7. 245. ClinicalTrials.gov. (2014, May 20). Aspirin for treatment of multiple sclerosis-related fatigue (NCT00467584) [Clinical trial protocol]. from https:\/\/clinicaltrials.gov\/study NCT00467584cond=multiple%20sclerosis intr=aspirin%20&rank\u2009=\u20092","DOI":"10.1212\/WNL.82.10_supplement.P7.245"},{"key":"9090_CR34","unstructured":"ClinicalTrials.gov. (2014), May 20 Aspirin for treatment of multiple sclerosis-related fatigue (NCT00467584) [Clinical trial protocol]. from https:\/\/clinicaltrials.gov\/study NCT00467584cond=multiple%20sclerosis intr=aspirin%20&rank\u2009=\u20092"},{"issue":"11","key":"9090_CR35","doi-asserted-by":"publisher","first-page":"1511","DOI":"10.1177\/1352458517739138","volume":"24","author":"VM Leavitt","year":"2017","unstructured":"Leavitt VM, Blanchard AR, Guo C-Y, Gelernt E, Sumowski JF, Stein J (2017) Aspirin is an effective pretreatment for exercise in multiple sclerosis: a double-blind randomized controlled pilot trial. Mult Scler J 24(11):1511\u20131513. https:\/\/doi.org\/10.1177\/1352458517739138","journal-title":"Mult Scler J"},{"key":"9090_CR36","doi-asserted-by":"publisher","first-page":"2207","DOI":"10.1007\/s00415-023-12147-6","volume":"271","author":"VM Leavitt","year":"2024","unstructured":"Leavitt VM, Tozlu C, Nelson KE, Boehme AK, Donnelly JE, Aguerre I, Spinner M, Riley CS, Stein J, Onomichi K (2024) A randomized controlled trial of oral antipyretic treatment to reduce overheating during exercise in adults with multiple sclerosis. J Neurol 271:2207\u20132215. https:\/\/doi.org\/10.1007\/s00415-023-12147-6","journal-title":"J Neurol"},{"key":"9090_CR37","unstructured":"Moghaddam, A. H., Sedighi, B., Iranmanesh, F., & Abdi, M. H. (2011). Therapeutic effect of co-administration of amantadine and aspirin on fatigue in patients with multiple sclerosis: A randomized placebo-controlled double-blind study. Iranian Journal of Pharmacology & Therapeutics, 10(2), 71\u201375. http:\/\/ijpt.iums.ac.ir:contentReference[oaicite:2]{index=2}"},{"issue":"9","key":"9090_CR38","doi-asserted-by":"publisher","first-page":"854","DOI":"10.1179\/1743132812Y.0000000081","volume":"34","author":"V Shaygannejad","year":"2012","unstructured":"Shaygannejad V, Janghorbani M, Ashtari F, Zakeri H (2012) Comparison of the effect of aspirin and amantadine for the treatment of fatigue in multiple sclerosis: a randomized, blinded, crossover study. Neurol Res 34(9):854\u2013858. https:\/\/doi.org\/10.1179\/1743132812Y.0000000081","journal-title":"Neurol Res"},{"key":"9090_CR39","doi-asserted-by":"publisher","first-page":"256","DOI":"10.1016\/j.jns.2017.07.042","volume":"380","author":"T Yang","year":"2017","unstructured":"Yang T, Wang L, Deng X, Yu G (2017) Pharmacological treatments for fatigue in patients with multiple sclerosis: a systematic review and meta-analysis. J Neurol Sci 380:256\u2013261. https:\/\/doi.org\/10.1016\/j.jns.2017.07.042","journal-title":"J Neurol Sci"},{"issue":"3","key":"9090_CR40","doi-asserted-by":"publisher","first-page":"176","DOI":"10.1177\/135245850000600307","volume":"6","author":"AT White","year":"2000","unstructured":"White AT, Wilson TE, Davis SL et al (2000) Effect of precooling on physical performance in multiple sclerosis. Mult Scler 6(3):176\u2013180","journal-title":"Mult Scler"}],"container-title":["Neurological Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10072-026-09090-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10072-026-09090-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10072-026-09090-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T07:05:53Z","timestamp":1780988753000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10072-026-09090-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,12]]},"references-count":40,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["9090"],"URL":"https:\/\/doi.org\/10.1007\/s10072-026-09090-5","relation":{},"ISSN":["1590-1874","1590-3478"],"issn-type":[{"value":"1590-1874","type":"print"},{"value":"1590-3478","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,12]]},"assertion":[{"value":"7 October 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 April 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 May 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics, consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to publish"}},{"value":"Not applicable.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Clinical trial number"}},{"value":"In preparing this work, the author utilized ChatGPT 3.5 to enhance the clarity and readability of the English text. After employing the ChatGPT 3.5, the author carefully reviewed and edited the content as necessary. The author assumes full accountability for the publication's content.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Use of generative AI tool"}},{"value":"The authors declare no conflicts of interest.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}],"article-number":"487"}}