{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T15:28:24Z","timestamp":1786980504419,"version":"build-2736575974"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2023,1,10]],"date-time":"2023-01-10T00:00:00Z","timestamp":1673308800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,1,10]],"date-time":"2023-01-10T00:00:00Z","timestamp":1673308800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Southwest Finland Cultural Foundation"},{"DOI":"10.13039\/501100011797","name":"Turun Yliopistollinen Keskussairaala","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100011797","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006081","name":"Lounais-Suomen Sy\u00f6p\u00e4yhdistys","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006081","id-type":"DOI","asserted-by":"publisher"}]},{"name":"University of Helsinki including Helsinki University Central Hospital"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Clin Microbiol Infect Dis"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Next-generation sequencing-based microbiological analysis is a complex way to profile vaginal microbiome samples since each step affects the results gained. Methodologies for sample collection lack golden standards. We compared Puritan DNA\/RNA swab (PS) and Copan FLOQ swab (CS) and provided consistent and reliable microbiome profiles analyzed by 16S rRNA gene sequencing. We collected two consecutive vaginal samples utilizing PS with room temperature storing and CS with instant freezing from 26 women. Variable region 4 of bacterial 16S rRNA gene was amplified with single PCR by custom-designed dual-indexed primers and sequenced with Illumina MiSeq system. Read quality control, operational taxonomic unit tables, and alpha and beta diversities analysis were performed, and community richness, diversity, and evenness were evaluated and compared between the two samplings and tests. Nineteen sample pairs produced detectable, intact DNA during the extraction protocol and\/or further microbial profiles. Alpha bacterial diversity indices were independent on the collection protocol. No significant statistical differences were found in the measured beta diversity metrics between the collection methods. Of the women, 43% had\n                    <jats:italic>Lactobacillus<\/jats:italic>\n                    -dominated vaginal microbiome profile despite of collection method. Previously reported important vaginal microbiome phyla\n                    <jats:italic>Actinobacteria, Bacteroidetes, Firmicutes, Fusobacteria,<\/jats:italic>\n                    and\n                    <jats:italic>Proteobacteria<\/jats:italic>\n                    were present in the sample set although their relative abundances varied among individuals. PS and CS enable constant vaginal microbiota sampling. The PS method with no need for instant freezing is suitable for on-site collections at clinics. Furthermore, it seems to be possible to take two samples instead of one with constant microbiological results.\n                  <\/jats:p>","DOI":"10.1007\/s10096-022-04545-x","type":"journal-article","created":{"date-parts":[[2023,1,9]],"date-time":"2023-01-09T22:02:57Z","timestamp":1673301777000},"page":"201-208","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Optimal sampling and analysis methods for clinical diagnostics of vaginal microbiome"],"prefix":"10.1007","volume":"42","author":[{"given":"Katja","family":"Kero","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niina","family":"Hieta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teemu","family":"Kallonen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Ahtikoski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8156-6820","authenticated-orcid":false,"given":"Hanna K.","family":"Laine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaana","family":"Rautava","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eveliina","family":"Munukka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,1,10]]},"reference":[{"issue":"3","key":"4545_CR1","doi-asserted-by":"publisher","first-page":"367","DOI":"10.1038\/s41564-022-01083-2","volume":"7","author":"M France","year":"2022","unstructured":"France M, Alizadeh M, Brown S, Ma B, Ravel J (2022) Towards a deeper understanding of the vaginal microbiota. Nat Microbiol 7(3):367\u2013378. https:\/\/doi.org\/10.1038\/s41564-022-01083-2","journal-title":"Nat Microbiol"},{"key":"4545_CR2","doi-asserted-by":"publisher","first-page":"e00487","DOI":"10.1128\/IAI.00487-20","volume":"89","author":"S Dabee","year":"2021","unstructured":"Dabee S, Passmore JS, Heffron R, Jaspan HB (2021) The complex link between the female genital microbiota, genital infections, and inflammation. Infect Immun 89:e00487-e520. https:\/\/doi.org\/10.1128\/IAI.00487-20","journal-title":"Infect Immun"},{"key":"4545_CR3","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1186\/s12941-020-0347-4","volume":"19","author":"N Kalia","year":"2020","unstructured":"Kalia N, Singh J, Kaur M (2020) Microbiota in vaginal health and pathogenesis of recurrent vulvovaginal infections: a critical review. Ann Clin Microbiol Antimicrob 19:5. https:\/\/doi.org\/10.1186\/s12941-020-0347-4","journal-title":"Ann Clin Microbiol Antimicrob"},{"issue":"18","key":"4545_CR4","doi-asserted-by":"publisher","first-page":"1501","DOI":"10.2217\/fmb-2022-0112","volume":"17","author":"C Chopra","year":"2022","unstructured":"Chopra C, Bhushan I, Mehta M, Koushal T, Gupta A, Sharma S et al (2022) Vaginal microbiome: considerations for reproductive health. Fut Microbiol 17(18):1501\u20131513. https:\/\/doi.org\/10.2217\/fmb-2022-0112","journal-title":"Fut Microbiol"},{"key":"4545_CR5","doi-asserted-by":"publisher","unstructured":"Lehtoranta L, Ala-Jaakkola R, Laitila A, Maukonen J (2022) Healthy vaginal microbiota and influence of probiotics across the female life span. Front Microbiol 787. https:\/\/doi.org\/10.3389\/fmicb.2022.819958","DOI":"10.3389\/fmicb.2022.819958"},{"key":"4545_CR6","doi-asserted-by":"publisher","first-page":"569","DOI":"10.1007\/s00404-020-05675-3","volume":"302","author":"X Hong","year":"2020","unstructured":"Hong X, Ma J, Yin J, Fang S, Geng J, Zhao H et al (2020) The association between vaginal microbiota and female infertility: a systematic review and meta-analysis. Arch Gynecol Obstet 302:569\u2013578. https:\/\/doi.org\/10.1007\/s00404-020-05675-3","journal-title":"Arch Gynecol Obstet"},{"key":"4545_CR7","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1016\/j.cmi.2018.04.019","volume":"25","author":"J Tamarelle","year":"2019","unstructured":"Tamarelle J, Thi\u00e9baut ACM, de Barbeyrac B, B\u00e9b\u00e9ar C, Ravel J, Delarocque-Astagneau E (2019) The vaginal microbiota and its association with human papillomavirus, Chlamydia trachomatis, Neisseria gonorrhoeae and Mycoplasma genitalium infections: a systematic review and meta-analysis. Clin Microbiol Infect 25:35\u201347. https:\/\/doi.org\/10.1016\/j.cmi.2018.04.019","journal-title":"Clin Microbiol Infect"},{"key":"4545_CR8","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1016\/j.trsl.2016.07.004","volume":"179","author":"M Kyrgiou","year":"2017","unstructured":"Kyrgiou M, Mitra A, Moscicki AB (2017) Does the vaginal microbiota play a role in the development of cervical cancer? Transl Res 179:168\u2013182. https:\/\/doi.org\/10.1016\/j.trsl.2016.07.004","journal-title":"Transl Res"},{"issue":"1","key":"4545_CR9","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1097\/LGT.0000000000000644","volume":"26","author":"A Lev-Sagie","year":"2022","unstructured":"Lev-Sagie A, De Seta F, Verstraelen H, Ventolini G, Lonnee-Hoffmann R, Vieira-Baptista P (2022) The vaginal microbiome: II. Vaginal dysbiotic conditions. J Low Genit Tract Dis 26(1):79\u201384. https:\/\/doi.org\/10.1097\/LGT.0000000000000644","journal-title":"J Low Genit Tract Dis"},{"issue":"8","key":"4545_CR10","doi-asserted-by":"publisher","first-page":"1948","DOI":"10.3390\/diagnostics12081948","volume":"12","author":"V G\u00fcnther","year":"2022","unstructured":"G\u00fcnther V, Allahqoli L, Watrowski R, Maass N, Ackermann J, von Otte S, Alkatout I (2022) Vaginal microbiome in reproductive medicine. Diagnostics 12(8):1948. https:\/\/doi.org\/10.3390\/diagnostics12081948","journal-title":"Diagnostics"},{"key":"4545_CR11","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1016\/j.chom.2018.01.013","volume":"23","author":"MN Anahtar","year":"2018","unstructured":"Anahtar MN, Gootenberg DB, Mitchell CM, Kwon DS (2018) Cervicovaginal microbiota and reproductive health: the virtue of simplicity. Cell Host Microbe 23:159\u2013168. https:\/\/doi.org\/10.1016\/j.chom.2018.01.013","journal-title":"Cell Host Microbe"},{"key":"4545_CR12","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1186\/s13073-016-0291-2","volume":"8","author":"J Ravel","year":"2016","unstructured":"Ravel J, Brotman RM (2016) Translating the vaginal microbiome: gaps and challenges. Genome Med 8:35. https:\/\/doi.org\/10.1186\/s13073-016-0291-2","journal-title":"Genome Med"},{"key":"4545_CR13","doi-asserted-by":"publisher","first-page":"180","DOI":"10.1186\/s12879-016-1513-3","volume":"16","author":"JA Dols","year":"2016","unstructured":"Dols JA, Molenaar D, van der Helm JJ, Caspers MP, de Kat A-B, Schuren FH et al (2016) Molecular assessment of bacterial vaginosis by Lactobacillus abundance and species diversity. BMC Infect Dis 16:180. https:\/\/doi.org\/10.1186\/s12879-016-1513-3","journal-title":"BMC Infect Dis"},{"key":"4545_CR14","doi-asserted-by":"publisher","first-page":"S222","DOI":"10.1093\/infdis\/jiaa762","volume":"223","author":"S Tuddenham","year":"2021","unstructured":"Tuddenham S, Ravel J, Marrazzo JM (2021) Protection and risk: male and female genital microbiota and sexually transmitted infections. J Infect Dis 223:S222\u2013S235. https:\/\/doi.org\/10.1093\/infdis\/jiaa762","journal-title":"J Infect Dis"},{"key":"4545_CR15","doi-asserted-by":"publisher","first-page":"264","DOI":"10.1111\/1471-0528.15972","volume":"127","author":"M Al-Memar","year":"2020","unstructured":"Al-Memar M, Bobdiwala S, Fourie H, Mannino R, Lee YS, Smith A et al (2020) The association between vaginal bacterial composition and miscarriage: a nested case-control study. BJOG 127:264\u2013274. https:\/\/doi.org\/10.1111\/1471-0528.15972","journal-title":"BJOG"},{"key":"4545_CR16","doi-asserted-by":"publisher","first-page":"16865","DOI":"10.1038\/srep16865","volume":"5","author":"A Mitra","year":"2015","unstructured":"Mitra A, MacIntyre DA, Lee YS, Smith A, Marchesi JR, Lehne B et al (2015) Cervical intraepithelial neoplasia disease progression is associated with increased vaginal microbiome diversity. Sci Rep 5:16865. https:\/\/doi.org\/10.1038\/srep16865","journal-title":"Sci Rep"},{"key":"4545_CR17","doi-asserted-by":"publisher","first-page":"410","DOI":"10.1038\/s41579-018-0029-9","volume":"16","author":"R Knight","year":"2018","unstructured":"Knight R, Vrbanac A, Taylor BC, Aksenov A, Callewaert C, Debelius J et al (2018) Best practices for analysing microbiomes. Nat Rev Microbiol 16:410\u2013422. https:\/\/doi.org\/10.1038\/s41579-018-0029-9","journal-title":"Nat Rev Microbiol"},{"issue":"1","key":"4545_CR18","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1097\/LGT.0000000000000643","volume":"26","author":"H Verstraelen","year":"2022","unstructured":"Verstraelen H, Vieira-Baptista P, De Seta F, Ventolini G, Lonnee-Hoffmann R, Lev-Sagie A (2022) The vaginal microbiome: I. Research development, lexicon, defining \u201cNormal\u201d and the dynamics throughout women\u2019s lives. J Low Genit Tract Dis 26(1):73\u201378. https:\/\/doi.org\/10.1097\/LGT.0000000000000643","journal-title":"J Low Genit Tract Dis"},{"key":"4545_CR19","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1186\/s12866-021-02149-7","volume":"21","author":"M Singer","year":"2021","unstructured":"Singer M, Koedooder R, Bos MP, Poort L, Schoenmakers S, Savelkoul PHM et al (2021) The profiling of microbiota in vaginal swab samples using 16S rRNA gene sequencing and IS-pro analysis. BMC Microbiol 21:100. https:\/\/doi.org\/10.1186\/s12866-021-02149-7","journal-title":"BMC Microbiol"},{"key":"4545_CR20","doi-asserted-by":"publisher","first-page":"191","DOI":"10.3390\/diagnostics11020191","volume":"11","author":"G Campisciano","year":"2021","unstructured":"Campisciano G, Zanotta N, Petix V, Giangreco M, Ricci G, Maso G et al (2021) Vaginal dysbiosis and partial bacterial vaginosis: the interpretation of the \u201cGrey Zones\u201d of clinical practice. Diagnostics (Basel) 11:191. https:\/\/doi.org\/10.3390\/diagnostics11020191","journal-title":"Diagnostics (Basel)"},{"key":"4545_CR21","doi-asserted-by":"publisher","first-page":"e01329","DOI":"10.1128\/mSystems.01329-20","volume":"6","author":"C Marotz","year":"2021","unstructured":"Marotz C, Cavagnero KJ, Song SJ, McDonald D, Wandro S, Humphrey G et al (2021) Evaluation of the effect of storage methods on fecal, saliva, and skin microbiome composition. mSystems 6:e01329-20. https:\/\/doi.org\/10.1128\/mSystems.01329-20","journal-title":"mSystems"},{"key":"4545_CR22","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1186\/s40168-021-01059-0","volume":"9","author":"JT Nearing","year":"2021","unstructured":"Nearing JT, Comeau AM, Langille MG (2021) Identifying biases and their potential solutions in human microbiome studies. Microbiome 9:113. https:\/\/doi.org\/10.1186\/s40168-021-01059-0","journal-title":"Microbiome"},{"key":"4545_CR23","doi-asserted-by":"publisher","first-page":"e0181477","DOI":"10.1371\/journal.pone.0181477","volume":"12","author":"S Virtanen","year":"2017","unstructured":"Virtanen S, Kalliala I, Nieminen P, Salonen A (2017) Comparative analysis of vaginal microbiota sampling using 16S rRNA gene analysis. PLoS ONE 12:e0181477. https:\/\/doi.org\/10.1371\/journal.pone.0181477","journal-title":"PLoS ONE"},{"issue":"11","key":"4545_CR24","doi-asserted-by":"publisher","first-page":"1229","DOI":"10.3390\/life11111229","volume":"11","author":"M Sharma","year":"2021","unstructured":"Sharma M, Chopra C, Mehta M, Sharma V, Mallubhotla S, Sistla S et al (2021) An insight into vaginal microbiome techniques. Life (Basel) 11(11):1229. https:\/\/doi.org\/10.3390\/life11111229","journal-title":"Life (Basel)"},{"key":"4545_CR25","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1080\/00365521.2018.1444788","volume":"53","author":"A Rintala","year":"2018","unstructured":"Rintala A, Riikonen I, Toivonen A, Pietil\u00e4 S, Munukka E, Pursiheimo JP et al (2018) Early fecal microbiota composition in children who later develop celiac disease and associated autoimmunity. Scand J Gastroenterol 53:403\u2013409. https:\/\/doi.org\/10.1080\/00365521.2018.1444788","journal-title":"Scand J Gastroenterol"},{"issue":"Database issue","key":"4545_CR26","doi-asserted-by":"publisher","first-page":"D590","DOI":"10.1093\/nar\/gks1219","volume":"41","author":"C Quast","year":"2013","unstructured":"Quast C, Pruesse E, Yilmaz P, Gerken J, Schweer T, Yarza P et al (2013) The SILVA ribosomal RNA gene database project: improved data processing and web-based tools. Nucleic Acids Res 41(Database issue):D590-596. https:\/\/doi.org\/10.1093\/nar\/gks1219","journal-title":"Nucleic Acids Res"},{"key":"4545_CR27","doi-asserted-by":"publisher","first-page":"D643","DOI":"10.1093\/nar\/gkt1209","volume":"42","author":"P Yilmaz","year":"2014","unstructured":"Yilmaz P, Parfrey LW, Yarza P, Gerken J, Pruesse E, Quast C et al (2014) The SILVA and \u201cAll-species Living Tree Project (LTP)\u201d taxonomic frameworks. Nucleic Acids Res 42:D643\u2013D648. https:\/\/doi.org\/10.1093\/nar\/gkt1209","journal-title":"Nucleic Acids Res"},{"key":"4545_CR28","doi-asserted-by":"publisher","first-page":"602","DOI":"10.1089\/omi.2020.0096","volume":"24","author":"I Mohamed","year":"2020","unstructured":"Mohamed I, Zakeer S, Azab M, Hanora A (2020) Changes in vaginal microbiome in pregnant and nonpregnant women with bacterial vaginosis: toward microbiome diagnostics? OMICS 24:602\u2013614. https:\/\/doi.org\/10.1089\/omi.2020.0096","journal-title":"OMICS"},{"key":"4545_CR29","doi-asserted-by":"publisher","first-page":"327","DOI":"10.3389\/fcimb.2019.00327","volume":"9","author":"G Reid","year":"2019","unstructured":"Reid G (2019) The need to focus on therapy instead of associations. Front Cell Infect Microbiol 9:327. https:\/\/doi.org\/10.3389\/fcimb.2019.00327","journal-title":"Front Cell Infect Microbiol"},{"key":"4545_CR30","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.semcancer.2018.02.003","volume":"52","author":"M Rajpoot","year":"2018","unstructured":"Rajpoot M, Sharma AK, Sharma A, Gupta GK (2018) Understanding the microbiome: emerging biomarkers for exploiting the microbiota for personalized medicine against cancer. Semin Cancer Biol 52:1\u20138. https:\/\/doi.org\/10.1016\/j.semcancer.2018.02.003","journal-title":"Semin Cancer Biol"},{"key":"4545_CR31","doi-asserted-by":"publisher","first-page":"e1002533","DOI":"10.1371\/journal.pbio.1002533","volume":"14","author":"R Sender","year":"2016","unstructured":"Sender R, Fuchs S, Milo R (2016) Revised estimates for the number of human and bacteria cells in the body. PLoS Biol 14:e1002533. https:\/\/doi.org\/10.1371\/journal.pbio.1002533","journal-title":"PLoS Biol"},{"key":"4545_CR32","doi-asserted-by":"publisher","first-page":"471.e1","DOI":"10.1016\/j.ajog.2019.10.008","volume":"222","author":"BA Tortelli","year":"2020","unstructured":"Tortelli BA, Lewis WG, Allsworth JE, Member-Meneh N, Foster LR, Reno E et al (2020) Associations between the vaginal microbiome and Candida colonization in women of reproductive age. Am J Obstet Gynecol 222:471.e1-471.e9. https:\/\/doi.org\/10.1016\/j.ajog.2019.10.008","journal-title":"Am J Obstet Gynecol"},{"issue":"Suppl 1","key":"4545_CR33","doi-asserted-by":"publisher","first-page":"4680","DOI":"10.1073\/pnas.1002611107","volume":"108","author":"J Ravel","year":"2011","unstructured":"Ravel J, Gajer P, Abdo Z, Schneider GM, Koenig SS, McCulle SL et al (2011) Vaginal microbiome of reproductive-age women. Proc Natl Acad Sci U S A 108(Suppl 1):4680\u20134687. https:\/\/doi.org\/10.1073\/pnas.1002611107","journal-title":"Proc Natl Acad Sci U S A"},{"key":"4545_CR34","doi-asserted-by":"publisher","first-page":"406","DOI":"10.1093\/infdis\/175.2.406","volume":"175","author":"V Pybus","year":"1997","unstructured":"Pybus V, Onderdonk AB (1997) Evidence for a commensal, symbiotic relationship between Gardnerella vaginalis and Prevotella bivia involving ammonia: potential significance for bacterial vaginosis. J Infect Dis 175:406\u2013413. https:\/\/doi.org\/10.1093\/infdis\/175.2.406","journal-title":"J Infect Dis"},{"key":"4545_CR35","doi-asserted-by":"publisher","first-page":"481","DOI":"10.1007\/s10096-015-2564-x","volume":"35","author":"C Cox","year":"2016","unstructured":"Cox C, Watt AP, McKenna JP, Coyle PV (2016) Mycoplasma hominis and Gardnerella vaginalis display a significant synergistic relationship in bacterial vaginosis. Eur J Clin Microbiol Infect Dis 35:481\u2013487. https:\/\/doi.org\/10.1007\/s10096-015-2564-x","journal-title":"Eur J Clin Microbiol Infect Dis"}],"container-title":["European Journal of Clinical Microbiology &amp; Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10096-022-04545-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10096-022-04545-x\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10096-022-04545-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,12]],"date-time":"2023-01-12T07:35:46Z","timestamp":1673508946000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10096-022-04545-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,10]]},"references-count":35,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2023,2]]}},"alternative-id":["4545"],"URL":"https:\/\/doi.org\/10.1007\/s10096-022-04545-x","relation":{},"ISSN":["0934-9723","1435-4373"],"issn-type":[{"value":"0934-9723","type":"print"},{"value":"1435-4373","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,10]]},"assertion":[{"value":"30 June 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 December 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 January 2023","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 Ethics Committee of the Hospital District of Southwest Finland (nro 97\/1801\/2016).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"EM is currently working as full-time Medical Advisor for Biocodex Nordics.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}