{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T14:18:28Z","timestamp":1790518708291,"version":"4.1.0"},"reference-count":39,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2021,2,1]],"date-time":"2021-02-01T00:00:00Z","timestamp":1612137600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2021,2,1]],"date-time":"2021-02-01T00:00:00Z","timestamp":1612137600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Clin Microbiol Infect Dis"],"published-print":{"date-parts":[[2021,7]]},"DOI":"10.1007\/s10096-021-04172-y","type":"journal-article","created":{"date-parts":[[2021,2,1]],"date-time":"2021-02-01T18:03:22Z","timestamp":1612202602000},"page":"1419-1426","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Community-acquired versus nosocomial Legionella pneumonia: factors associated with Legionella-related mortality"],"prefix":"10.1007","volume":"40","author":[{"given":"Avner","family":"Dagan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7032-7007","authenticated-orcid":false,"given":"Danny","family":"Epstein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad","family":"Mahagneh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeries","family":"Nashashibi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuval","family":"Geffen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ami","family":"Neuberger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asaf","family":"Miller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,2,1]]},"reference":[{"key":"4172_CR1","doi-asserted-by":"publisher","first-page":"1011","DOI":"10.1016\/S1473-3099(14)70713-3","volume":"14","author":"N Phin","year":"2014","unstructured":"Phin N, Parry-Ford F, Harrison T, Stagg HR, Zhang N, Kumar K et al (2014) Epidemiology and clinical management of Legionnaires\u2019 disease. Lancet Infect Dis 14:1011\u20131021. https:\/\/doi.org\/10.1016\/S1473-3099(14)70713-3","journal-title":"Lancet Infect Dis"},{"key":"4172_CR2","doi-asserted-by":"publisher","first-page":"1190","DOI":"10.15585\/mmwr.mm6442a2","volume":"64","author":"KL Dooling","year":"2015","unstructured":"Dooling KL, Toews K-A, Hicks LA, Garrison LE, Bachaus B, Zansky S et al (2015) Active bacterial core surveillance for legionellosis - United States, 2011-2013. MMWR Morb Mortal Wkly Rep 64:1190\u20131193. https:\/\/doi.org\/10.15585\/mmwr.mm6442a2","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"4172_CR3","unstructured":"Legionnaires\u2019 disease - Annual epidemiological report for 2015. [cited 2020 7]. https:\/\/www.ecdc.europa.eu\/en\/publications-data\/legionnaires-disease-annual-epidemiological-report-2015"},{"key":"4172_CR4","first-page":"E48","volume":"40","author":"NNDSS Annual Report Working Group","year":"2016","unstructured":"NNDSS Annual Report Working Group (2016) Australia\u2019s notifiable disease status, 2014: annual report of the National Notifiable Diseases Surveillance System: Part 1. Commun Dis Intell Q Rep 40:E48\u2013E145","journal-title":"Commun Dis Intell Q Rep"},{"key":"4172_CR5","doi-asserted-by":"publisher","first-page":"770","DOI":"10.1016\/S1473-3099(19)30113-6","volume":"19","author":"PC Priest","year":"2019","unstructured":"Priest PC, Slow S, Chambers ST, Cameron CM, Balm MN, Beale MW et al (2019) The burden of Legionnaires\u2019 disease in New Zealand (LegiNZ): a national surveillance study. Lancet Infect Dis 19:770\u2013777. https:\/\/doi.org\/10.1016\/S1473-3099(19)30113-6","journal-title":"Lancet Infect Dis"},{"key":"4172_CR6","first-page":"32","volume":"4","author":"RR Muder","year":"1989","unstructured":"Muder RR, Yu VL, Fang GD (1989) Community-acquired Legionnaires\u2019 disease. Semin Respir Infect 4:32\u201339","journal-title":"Semin Respir Infect"},{"key":"4172_CR7","doi-asserted-by":"publisher","first-page":"794","DOI":"10.1086\/428059","volume":"40","author":"A Mykietiuk","year":"2005","unstructured":"Mykietiuk A, Carratal\u00e0 J, Fern\u00e1ndez-Sab\u00e9 N, Dorca J, Verdaguer R, Manresa F et al (2005) Clinical outcomes for hospitalized patients with Legionella pneumonia in the antigenuria era: the influence of levofloxacin therapy. Clin Infect Dis 40:794\u2013799. https:\/\/doi.org\/10.1086\/428059","journal-title":"Clin Infect Dis"},{"key":"4172_CR8","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.jinf.2007.09.010","volume":"56","author":"BMW Diederen","year":"2008","unstructured":"Diederen BMW (2008) Legionella spp. and Legionnaires\u2019 disease. J Inf Secur 56:1\u201312. https:\/\/doi.org\/10.1016\/j.jinf.2007.09.010","journal-title":"J Inf Secur"},{"key":"4172_CR9","doi-asserted-by":"publisher","first-page":"320","DOI":"10.1016\/j.medin.2012.05.010","volume":"37","author":"J Rello","year":"2013","unstructured":"Rello J, Gattarello S, Souto J, Sole-Violan J, Valles J, Peredo R et al (2013) Community-acquired Legionella pneumonia in the intensive care unit: impact on survival of combined antibiotic therapy. Med Int 37:320\u2013326. https:\/\/doi.org\/10.1016\/j.medin.2012.05.010","journal-title":"Med Int"},{"key":"4172_CR10","doi-asserted-by":"publisher","first-page":"2215","DOI":"10.1111\/ajt.14407","volume":"17","author":"EA Soda","year":"2017","unstructured":"Soda EA, Barskey AE, Shah PP, Schrag S, Whitney CG, Arduino MJ et al (2017) Vital Signs: Health care-associated Legionnaires\u2019 disease surveillance data from 20 states and a large metropolitan area-United States, 2015. Am J Transplant 17:2215\u20132220. https:\/\/doi.org\/10.1111\/ajt.14407","journal-title":"Am J Transplant"},{"key":"4172_CR11","doi-asserted-by":"publisher","first-page":"e61","DOI":"10.1093\/cid\/ciw353","volume":"63","author":"AC Kalil","year":"2016","unstructured":"Kalil AC, Metersky ML, Klompas M, Muscedere J, Sweeney DA, Palmer LB et al (2016) Management of adults with hospital-acquired and ventilator-associated pneumonia: 2016 Clinical Practice Guidelines by the Infectious Diseases Society of America and the American Thoracic Society. Clin Infect Dis 63:e61\u2013e111. https:\/\/doi.org\/10.1093\/cid\/ciw353","journal-title":"Clin Infect Dis"},{"key":"4172_CR12","doi-asserted-by":"publisher","first-page":"2417","DOI":"10.1001\/archinte.154.21.2417","volume":"154","author":"BJ Marston","year":"1994","unstructured":"Marston BJ, Lipman HB, Breiman RF (1994) Surveillance for Legionnaires\u2019 disease: risk factors for morbidity and mortality. Arch Intern Med 154:2417\u20132422. https:\/\/doi.org\/10.1001\/archinte.154.21.2417","journal-title":"Arch Intern Med"},{"key":"4172_CR13","first-page":"407","volume":"13","author":"A Dominguez","year":"2009","unstructured":"Dominguez A, Alvarez J, Sabria M, Carmona G, Torner N, Oviedo M et al (2009) Factors influencing the case-fatality rate of Legionnaires\u2019 disease. Int J Tuberc Lung Dis 13:407\u2013412","journal-title":"Int J Tuberc Lung Dis"},{"key":"4172_CR14","doi-asserted-by":"publisher","first-page":"1929","DOI":"10.1183\/09031936.95.08111929","volume":"8","author":"ML Pedro-Botet","year":"1995","unstructured":"Pedro-Botet ML, Sabria-Leal M, Haro M, Rubio C, Gimenez G, Sopena N et al (1995) Nosocomial and community-acquired Legionella pneumonia: clinical comparative analysis. Eur Respir J 8:1929\u20131933. https:\/\/doi.org\/10.1183\/09031936.95.08111929","journal-title":"Eur Respir J"},{"key":"4172_CR15","doi-asserted-by":"publisher","first-page":"1467","DOI":"10.1164\/ajrccm.156.5.97-04039","volume":"156","author":"M El-Ebiary","year":"1997","unstructured":"El-Ebiary M, Sarmiento X, Torres A, Nogu\u00e9 S, Mesalles E, Bod\u00ed M et al (1997) Prognostic factors of severe Legionella pneumonia requiring admission to ICU. Am J Respir Crit Care Med 156:1467\u20131472. https:\/\/doi.org\/10.1164\/ajrccm.156.5.97-04039","journal-title":"Am J Respir Crit Care Med"},{"key":"4172_CR16","doi-asserted-by":"publisher","first-page":"1479","DOI":"10.1086\/515040","volume":"27","author":"LS Tkatch","year":"1998","unstructured":"Tkatch LS, Kusne S, Irish WD, Krystofiak S, Wing E (1998) Epidemiology of Legionella pneumonia and factors associated with Legionella-related mortality at a tertiary care center. Clin Infect Dis 27:1479\u20131486. https:\/\/doi.org\/10.1086\/515040","journal-title":"Clin Infect Dis"},{"key":"4172_CR17","doi-asserted-by":"publisher","first-page":"1709","DOI":"10.1128\/jcm.38.5.1709-1712.2000","volume":"38","author":"JL Cloud","year":"2000","unstructured":"Cloud JL, Carroll KC, Pixton P, Erali M, Hillyard DR (2000) Detection of Legionella species in respiratory specimens using PCR with sequencing confirmation. J Clin Microbiol 38:1709\u20131712. https:\/\/doi.org\/10.1128\/jcm.38.5.1709-1712.2000","journal-title":"J Clin Microbiol"},{"key":"4172_CR18","doi-asserted-by":"publisher","first-page":"292","DOI":"10.1016\/j.annemergmed.2014.03.025","volume":"64","author":"AH Kaji","year":"2014","unstructured":"Kaji AH, Schriger D, Green S (2014) Looking through the retrospectoscope: reducing bias in emergency medicine chart review studies. Ann Emerg Med 64:292\u2013298. https:\/\/doi.org\/10.1016\/j.annemergmed.2014.03.025","journal-title":"Ann Emerg Med"},{"key":"4172_CR19","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1016\/0196-6553(88)90053-3","volume":"16","author":"JS Garner","year":"1988","unstructured":"Garner JS, Jarvis WR, Emori TG, Horan TC, Hughes JM (1988) CDC definitions for nosocomial infections, 1988. AJIC Am J Infect Control 16:128\u2013140. https:\/\/doi.org\/10.1016\/0196-6553(88)90053-3","journal-title":"AJIC Am J Infect Control"},{"key":"4172_CR20","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1056\/NEJM199701233360402","volume":"336","author":"MJ Fine","year":"1997","unstructured":"Fine MJ, Auble TE, Yealy DM, Hanusa BH, Weissfeld LA, Singer DE et al (1997) A prediction rule to identify low-risk patients with community-acquired pneumonia. N Engl J Med 336:243\u2013250. https:\/\/doi.org\/10.1056\/NEJM199701233360402","journal-title":"N Engl J Med"},{"key":"4172_CR21","unstructured":"NHIS - Adult tobacco use - Glossary. [cited 2020 6]. https:\/\/www.cdc.gov\/nchs\/nhis\/tobacco\/tobacco_glossary.htm"},{"key":"4172_CR22","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1038\/kisup.2012.6","volume":"2","author":"KDIGO","year":"2012","unstructured":"KDIGO (2012) Kidney International Supplements: KDIGO Clinical Practice Guideline for Acute Kidney Injury. Kidney Int Suppl 2:6. https:\/\/doi.org\/10.1038\/kisup.2012.6","journal-title":"Kidney Int Suppl"},{"issue":"337","key":"4172_CR23","doi-asserted-by":"publisher","first-page":"682","DOI":"10.1056\/NEJM199709043371006","volume":"4","author":"JE Stout","year":"1997","unstructured":"Stout JE, Yu VL (1997) Legionnellosis. N Engl J Med 4(337):682\u2013687. https:\/\/doi.org\/10.1056\/NEJM199709043371006","journal-title":"N Engl J Med"},{"key":"4172_CR24","doi-asserted-by":"publisher","first-page":"376","DOI":"10.1016\/S0140-6736(15)60078-2","volume":"387","author":"BA Cunha","year":"2016","unstructured":"Cunha BA, Burillo A, Bouza E (2016) Legionnaires\u2019 disease. Lancet 387:376\u2013385. https:\/\/doi.org\/10.1016\/S0140-6736(15)60078-2","journal-title":"Lancet"},{"key":"4172_CR25","doi-asserted-by":"publisher","first-page":"990","DOI":"10.1378\/chest.12-2820","volume":"144","author":"F Lanternier","year":"2013","unstructured":"Lanternier F, Tubach F, Ravaud P, Salmon D, Dellamonica P, Bretagne S et al (2013) Incidence and risk factors of Legionella pneumophila pneumonia during anti-tumor necrosis factor therapy: a prospective French study. Chest 144:990\u2013998. https:\/\/doi.org\/10.1378\/chest.12-2820","journal-title":"Chest"},{"key":"4172_CR26","doi-asserted-by":"publisher","first-page":"1138","DOI":"10.1001\/archinte.1985.00360060206034","volume":"145","author":"PA Sheldon","year":"1985","unstructured":"Sheldon PA, Tight RR, Renner ED (1985) Fatal Legionnaires\u2019 disease coincident with initiation of immunosuppressive therapy. Arch Intern Med 145:1138\u20131139","journal-title":"Arch Intern Med"},{"key":"4172_CR27","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1089\/apc.2007.0111","volume":"22","author":"U Sandkovsky","year":"2008","unstructured":"Sandkovsky U, Sandkovsky G, Suh J, Smith B, Sharp V, Polsky B (2008) Legionella pneumonia and HIV: case reports and review of the literature. AIDS Patient Care STDs 22:473\u2013481. https:\/\/doi.org\/10.1089\/apc.2007.0111","journal-title":"AIDS Patient Care STDs"},{"key":"4172_CR28","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1097\/00000441-198807000-00002","volume":"296","author":"LL Schulman","year":"1988","unstructured":"Schulman LL, Smith CR, Drusin R, Rose EA, Enson Y, Reemtsma K (1988) Respiratory complications of cardiac transplantation. Am J Med Sci 296:1\u201310. https:\/\/doi.org\/10.1097\/00000441-198807000-00002","journal-title":"Am J Med Sci"},{"key":"4172_CR29","doi-asserted-by":"publisher","first-page":"164","DOI":"10.7326\/0003-4819-94-2-164","volume":"94","author":"AC England 3rd","year":"1981","unstructured":"England AC 3rd, Fraser DW, Plikaytis BD, Tsai TF, Storch G, Broome CV (1981) Sporadic legionellosis in the United States: the first thousand cases. Ann Intern Med 94:164\u2013170. https:\/\/doi.org\/10.7326\/0003-4819-94-2-164","journal-title":"Ann Intern Med"},{"key":"4172_CR30","doi-asserted-by":"publisher","first-page":"286","DOI":"10.1007\/BF01695659","volume":"15","author":"CH Heath","year":"1996","unstructured":"Heath CH, Grove DI, Looke DF (1996) Delay in appropriate therapy of Legionella pneumonia associated with increased mortality. Eur J Clin Microbiol Infect Dis Off Publ Eur Soc Clin Microbiol 15:286\u2013290. https:\/\/doi.org\/10.1007\/BF01695659","journal-title":"Eur J Clin Microbiol Infect Dis Off Publ Eur Soc Clin Microbiol"},{"key":"4172_CR31","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1186\/s12879-016-1374-9","volume":"16","author":"A Levcovich","year":"2016","unstructured":"Levcovich A, Lazarovitch T, Moran-Gilad J, Peretz C, Yakunin E, Valinsky L et al (2016) Complex clinical and microbiological effects on Legionnaires\u2019 disease outcome; a retrospective cohort study. BMC Infect Dis 16:75. https:\/\/doi.org\/10.1186\/s12879-016-1374-9","journal-title":"BMC Infect Dis"},{"key":"4172_CR32","doi-asserted-by":"publisher","first-page":"1039","DOI":"10.1086\/342903","volume":"35","author":"AL Benin","year":"2002","unstructured":"Benin AL, Benson RF, Besser RE (2002) Trends in Legionnaires disease, 1980-1998: declining mortality and new patterns of diagnosis. Clin Infect Dis 35:1039\u20131046. https:\/\/doi.org\/10.1086\/342903","journal-title":"Clin Infect Dis"},{"key":"4172_CR33","doi-asserted-by":"publisher","first-page":"625","DOI":"10.1055\/s-2005-925526","volume":"26","author":"ML Pedro-Botet","year":"2005","unstructured":"Pedro-Botet ML, Sabri\u00e0 M (2005) Legionellosis. Semin Respir Crit Care Med 26:625\u2013634. https:\/\/doi.org\/10.1055\/s-2005-925526","journal-title":"Semin Respir Crit Care Med"},{"key":"4172_CR34","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1016\/j.idc.2016.10.004","volume":"31","author":"S Mittal","year":"2017","unstructured":"Mittal S, Singh AP, Gold M, Leung AN, Haramati LB, Katz DS (2017) Thoracic imaging features of Legionnaire\u2019s disease. Infect Dis Clin N Am 31:43\u201354. https:\/\/doi.org\/10.1016\/j.idc.2016.10.004","journal-title":"Infect Dis Clin N Am"},{"key":"4172_CR35","doi-asserted-by":"publisher","first-page":"124","DOI":"10.1186\/1471-2334-10-124","volume":"10","author":"S Jespersen","year":"2010","unstructured":"Jespersen S, S\u00f8gaard OS, Sch\u00f8nheyder HC, Fine MJ, Ostergaard L (2010) Clinical features and predictors of mortality in admitted patients with community- and hospital-acquired legionellosis: a Danish historical cohort study. BMC Infect Dis 10:124. https:\/\/doi.org\/10.1186\/1471-2334-10-124","journal-title":"BMC Infect Dis"},{"key":"4172_CR36","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1183\/09031936.00077206","volume":"29","author":"N Sopena","year":"2007","unstructured":"Sopena N, Force L, Pedro-Botet ML, Barrufet P, Sauca G, Garc\u00eda-N\u00fa\u00f1ez M et al (2007) Sporadic and epidemic community legionellosis: two faces of the same illness. Eur Respir J 29:138\u2013142. https:\/\/doi.org\/10.1183\/09031936.00077206","journal-title":"Eur Respir J"},{"key":"4172_CR37","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1097\/00005792-199009000-00004","volume":"69","author":"GD Fang","year":"1990","unstructured":"Fang GD, Fine M, Orloff J, Arisumi D, Yu VL, Kapoor W et al (1990) New and emerging etiologies for community-acquired pneumonia with implications for therapy. A prospective multicenter study of 359 cases. Medicine (Baltimore) 69:307\u2013316. https:\/\/doi.org\/10.1097\/00005792-199009000-00004","journal-title":"Medicine (Baltimore)"},{"key":"4172_CR38","doi-asserted-by":"publisher","first-page":"625","DOI":"10.1164\/ajrccm.149.3.8118629","volume":"149","author":"J Carratala","year":"1994","unstructured":"Carratala J, Gudiol F, Pallares R, Dorca J, Verdaguer R, Ariza J et al (1994) Risk factors for nosocomial Legionella pneumophila pneumonia. Am J Respir Crit Care Med 149:625\u2013629. https:\/\/doi.org\/10.1164\/ajrccm.149.3.8118629","journal-title":"Am J Respir Crit Care Med"},{"key":"4172_CR39","doi-asserted-by":"publisher","first-page":"1201","DOI":"10.1183\/09031936.00187811","volume":"40","author":"M Carrabba","year":"2012","unstructured":"Carrabba M, Zarantonello M, Bonara P, Hu C, Minonzio F, Cortinovis I et al (2012) Severity assessment of healthcare-associated pneumonia and pneumonia in immunosuppression. Eur Respir J 40:1201\u20131210. https:\/\/doi.org\/10.1183\/09031936.00187811","journal-title":"Eur Respir J"}],"container-title":["European Journal of Clinical Microbiology & Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10096-021-04172-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10096-021-04172-y\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10096-021-04172-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,6,15]],"date-time":"2021-06-15T09:05:39Z","timestamp":1623747939000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10096-021-04172-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,1]]},"references-count":39,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2021,7]]}},"alternative-id":["4172"],"URL":"https:\/\/doi.org\/10.1007\/s10096-021-04172-y","relation":{},"ISSN":["0934-9723","1435-4373"],"issn-type":[{"value":"0934-9723","type":"print"},{"value":"1435-4373","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,1]]},"assertion":[{"value":"16 November 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 January 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 February 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was approved by the Institutional Review Board at Rambam Health Care Campus (approval number RMB-0593-19).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"The need for written informed consent was waived due to the retrospective study design.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"None.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"All authors report no conflicts of interest relevant to this article.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}