{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T09:27:05Z","timestamp":1781083625101,"version":"3.54.1"},"reference-count":37,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2025,2,10]],"date-time":"2025-02-10T00:00:00Z","timestamp":1739145600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2025,2,10]],"date-time":"2025-02-10T00:00:00Z","timestamp":1739145600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Clin Microbiol Infect Dis"],"published-print":{"date-parts":[[2025,4]]},"DOI":"10.1007\/s10096-025-05053-4","type":"journal-article","created":{"date-parts":[[2025,2,10]],"date-time":"2025-02-10T21:02:02Z","timestamp":1739221322000},"page":"923-932","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Evaluation of the Allplex NG & DR assay for molecular prediction of ciprofloxacin and azithromycin resistance in Neisseria gonorrhoeae"],"prefix":"10.1007","volume":"44","author":[{"given":"Anna","family":"Roditscheff","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konrad","family":"Egli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9j","family":"Vianin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabian","family":"L\u00f6rtscher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrgen","family":"Reidla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faina","family":"Wehrli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Risch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenz","family":"Risch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sven N.","family":"Hobbie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadia","family":"Wohlwend","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Bodmer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,2,10]]},"reference":[{"key":"5053_CR1","doi-asserted-by":"publisher","unstructured":"Unemo M, del Rio C, Shafer WM (2016) Antimicrobial resistance expressed by Neisseria gonorrhoeae: a major global public health problem in the 21st century. Microbiol Spectr 4. https:\/\/doi.org\/10.1128\/microbiolspec.ei10-0009-2015","DOI":"10.1128\/microbiolspec.ei10-0009-2015"},{"key":"5053_CR2","doi-asserted-by":"publisher","first-page":"374","DOI":"10.1093\/jac\/dku396","volume":"70","author":"SA Buono","year":"2015","unstructured":"Buono SA, Watson TD, Borenstein LA, Klausner JD, Pandori MW, Godwin HA (2015) Stemming the tide of drug-resistant Neisseria gonorrhoeae: the need for an individualized approach to treatment. J Antimicrob Chemother 70:374\u2013381. https:\/\/doi.org\/10.1093\/jac\/dku396","journal-title":"J Antimicrob Chemother"},{"key":"5053_CR3","doi-asserted-by":"publisher","unstructured":"Sadiq ST, Mazzaferri F, Unemo M (2017) Rapid accurate point-of-care tests combining diagnostics and antimicrobial resistance prediction for Neisseria gonorrhoeae and Mycoplasma genitalium. Sex Transm Infect [Internet] [cited 2023 18];93:S65\u201368. http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/28684610, https:\/\/doi.org\/10.1136\/SEXTRANS-2016-053072","DOI":"10.1136\/SEXTRANS-2016-053072"},{"key":"5053_CR4","doi-asserted-by":"publisher","unstructured":"Fingerhuth SM, Low N, Bonhoeffer S, Althaus CL (2017) Detection of antibiotic resistance is essential for gonorrhoea point-of-care testing: a mathematical modelling study. BMC Med 26:15. https:\/\/doi.org\/10.1186\/s12916-017-0881-x","DOI":"10.1186\/s12916-017-0881-x"},{"key":"5053_CR5","doi-asserted-by":"publisher","unstructured":"Tuite AR, Gift TL, Chesson HW, Hsu K, Salomon JA, Grad YH (2017) Impact of rapid susceptibility testing and antibiotic selection strategy on the emergence and spread of antibiotic resistance in Gonorrhea. J Infect Dis [Internet] [cited 2023 18];216:1141. https:\/\/doi.org\/10.1093\/INFDIS\/JIX450","DOI":"10.1093\/INFDIS\/JIX450"},{"key":"5053_CR6","doi-asserted-by":"publisher","first-page":"479","DOI":"10.1071\/SH18225","volume":"16","author":"CL Hall","year":"2019","unstructured":"Hall CL, Harrison MA, Pond MJ, Chow C, Harding-Esch EM, Sadiq ST (2019) Genotypic determinants of fluoroquinolone and macrolide resistance in Neisseria gonorrhoeae. Sex Health 16:479\u2013487. https:\/\/doi.org\/10.1071\/SH18225","journal-title":"Sex Health"},{"key":"5053_CR7","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1097\/OLQ.0000000000000591","volume":"44","author":"LT Allan-Blitz","year":"2017","unstructured":"Allan-Blitz LT, Wang X, Klausner JD (2017) Wild-type gyrase a genotype of neisseria gonorrhoeae predicts in vitro susceptibility to ciprofloxacin: a systematic review of the literature and meta-analysis. Sex Transm Dis 44:261\u2013265. https:\/\/doi.org\/10.1097\/OLQ.0000000000000591","journal-title":"Sex Transm Dis"},{"key":"5053_CR8","doi-asserted-by":"publisher","unstructured":"Peterson SW, Martin I, Demczuk W, Bharat A, Hoang L, Wylie J et al (2015) Molecular assay for detection of ciprofloxacin resistance in Neisseria gonorrhoeae isolates from cultures and clinical nucleic acid amplification test specimens. J Clin Microbiol [Internet] [cited 2023 4] 53:3606\u20133608. https:\/\/pubmed.ncbi.nlm.nih.gov\/26292300\/, https:\/\/doi.org\/10.1128\/JCM.01632-15","DOI":"10.1128\/JCM.01632-15"},{"key":"5053_CR9","doi-asserted-by":"publisher","unstructured":"Unemo M, Shafer WM (2014) Antimicrobial resistance in Neisseria gonorrhoeae in the 21st century: past, evolution, and future. Clin Microbiol Rev [Internet] [cited 2023 5];27:587\u2013613. https:\/\/journals.asm.org\/doi\/10.1128\/cmr.00010-14, https:\/\/doi.org\/10.1128\/CMR.00010-14\/ASSET\/26C663A0-41F4-48E5-BF7D-B0DCD0E0C4AB\/ASSETS\/GRAPHIC\/ZCM9990924720002.JPEG","DOI":"10.1128\/CMR.00010-14\/ASSET\/26C663A0-41F4-48E5-BF7D-B0DCD0E0C4AB\/ASSETS\/GRAPHIC\/ZCM9990924720002.JPEG"},{"key":"5053_CR10","doi-asserted-by":"publisher","first-page":"e452","DOI":"10.1016\/S2666-5247(22)00044-1","volume":"3","author":"L S\u00e1nchez-Bus\u00f3","year":"2022","unstructured":"S\u00e1nchez-Bus\u00f3 L, Cole MJ, Spiteri G, Day M, Jacobsson S, Golparian D et al (2022) Europe-wide expansion and eradication of multidrug-resistant Neisseria gonorrhoeae lineages: a genomic surveillance study. Lancet Microbe 3:e452\u2013e463. https:\/\/doi.org\/10.1016\/S2666-5247(22)00044-1","journal-title":"Lancet Microbe"},{"key":"5053_CR11","doi-asserted-by":"publisher","first-page":"e18","DOI":"10.1097\/OLQ.0000000000000758","volume":"45","author":"LT Allan-Blitz","year":"2018","unstructured":"Allan-Blitz LT, Hemarajata P, Humphries RM, Kimble M, Elias S, Klausner JD (2018) Ciprofloxacin may be efficacious in treating wild-type gyrase a genotype neisseria gonorrhoeae infections. Sex Transm Dis 45:e18. https:\/\/doi.org\/10.1097\/OLQ.0000000000000758","journal-title":"Sex Transm Dis"},{"key":"5053_CR12","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1093\/cid\/ciaa596","volume":"73","author":"JD Klausner","year":"2021","unstructured":"Klausner JD, Bristow CC, Soge OO, Shahkolahi A, Waymer T, Bolan RK et al (2021) Resistance-guided treatment of Gonorrhea: a prospective clinical study. Clin Infect Dis 73:298\u2013303. https:\/\/doi.org\/10.1093\/cid\/ciaa596","journal-title":"Clin Infect Dis"},{"key":"5053_CR13","doi-asserted-by":"publisher","DOI":"10.1177\/0956462420949126","author":"M Unemo","year":"2020","unstructured":"Unemo M, Ross JDC, Serwin AB, Gomberg M, Cusini M, Jensen JS (2020) 2020 European guideline for the diagnosis and treatment of gonorrhoea in adults. Int J STD AIDS. https:\/\/doi.org\/10.1177\/0956462420949126","journal-title":"Int J STD AIDS"},{"key":"5053_CR14","unstructured":"Gonorrhoea - STI Guidelines Australia [Internet]. [cited 2024 14]. https:\/\/sti.guidelines.org.au\/sexually-transmissible-infections\/gonorrhoea\/"},{"key":"5053_CR15","unstructured":"Diagnostik und Therapie der Gonorrhoe [cited 2024 14]. www.awmf.org\/leitlinien\/detail\/ll\/059-004.html"},{"key":"5053_CR16","doi-asserted-by":"publisher","unstructured":"(2024) Updated recommendations for the treatment of Neisseria gonorrhoeae, Chlamydia trachomatis, and Treponema pallidum (syphilis) and new recommendations on syphilis testing and partner services [Internet]. World Health Organization. https:\/\/iris.who.int\/handle\/10665\/378228, https:\/\/doi.org\/10.2471\/B09099","DOI":"10.2471\/B09099"},{"key":"5053_CR17","unstructured":"Low N. Textbox Antimicrobial resistance in Neisseria gonorrhoeae in Switzerland"},{"key":"5053_CR18","unstructured":"EUCAST Breakpoint Tables [cited 2023 18]. http:\/\/www.eucast.org"},{"key":"5053_CR19","doi-asserted-by":"publisher","first-page":"3812","DOI":"10.1128\/AAC.00309-10","volume":"54","author":"SA Chisholm","year":"2010","unstructured":"Chisholm SA, Dave J, Ison CA (2010) High-level azithromycin resistance occurs in Neisseria gonorrhoeae as a result of a single point mutation in the 23S rRNA genes. Antimicrob Agents Chemother 54:3812\u20133816. https:\/\/doi.org\/10.1128\/AAC.00309-10","journal-title":"Antimicrob Agents Chemother"},{"key":"5053_CR20","doi-asserted-by":"publisher","first-page":"3020","DOI":"10.1128\/AAC.46.9.3020-3025.2002","volume":"46","author":"LK Ng","year":"2002","unstructured":"Ng LK, Martin I, Liu G, Bryden L (2002) Mutation in 23S rRNA associated with macrolide resistance in Neisseria gonorrhoeae. Antimicrob Agents Chemother 46:3020\u20133025. https:\/\/doi.org\/10.1128\/AAC.46.9.3020-3025.2002","journal-title":"Antimicrob Agents Chemother"},{"key":"5053_CR21","doi-asserted-by":"publisher","unstructured":"Pham CD, Nash E, Liu H, Schmerer MW, Sharpe S, Woods G et al (2021) Atypical mutation in neisseria gonorrhoeae 23S rRNA associated with high-level azithromycin resistance. Antimicrob Agents Chemother 1:65.\u00a0https:\/\/doi.org\/10.1128\/AAC.00885-20","DOI":"10.1128\/AAC.00885-20"},{"key":"5053_CR22","doi-asserted-by":"publisher","unstructured":"Wadsworth CB, Arnold BJ, Sater MRA, Grad YH (2018) Azithromycin resistance through interspecific acquisition of an epistasis-dependent efflux pump component and transcriptional regulator in Neisseria gonorrhoeae. mBio [Internet] [cited 2023 17] 9.\u00a0https:\/\/pubmed.ncbi.nlm.nih.gov\/30087172\/, https:\/\/doi.org\/10.1128\/MBIO.01419-18","DOI":"10.1128\/MBIO.01419-18"},{"key":"5053_CR23","doi-asserted-by":"publisher","unstructured":"S\u00e1nchez-Bus\u00f3 L, Yeats CA, Taylor B, Goater RJ, Underwood A, Abudahab K et al (2021) A community-driven resource for genomic epidemiology and antimicrobial resistance prediction of Neisseria gonorrhoeae at Pathogenwatch. Genome Med 113. https:\/\/doi.org\/10.1186\/s13073-021-00858-2","DOI":"10.1186\/s13073-021-00858-2"},{"key":"5053_CR24","doi-asserted-by":"publisher","first-page":"436","DOI":"10.1101\/gr.2754005","volume":"15","author":"S Weckx","year":"2005","unstructured":"Weckx S, Del-Favero J, Rademakers R, Claes L, Cruts M, De Jonghe P et al (2005) novoSNP, a novel computational tool for sequence variation discovery. Genome Res 15:436\u2013442. https:\/\/doi.org\/10.1101\/gr.2754005","journal-title":"Genome Res"},{"key":"5053_CR25","doi-asserted-by":"publisher","unstructured":"Nadal-Baron P, Salmer\u00f3n P, Garc\u00eda JN, Trejo-Zahinos J, Sulleiro E, Lopez L et al (2022) Neisseria gonorrhoeae culture growth rates from asymptomatic individuals with a positive nucleic acid amplification test. Lett Appl Microbiol [ Internet] [cited 2023 3];75:1215\u20131224. https:\/\/pubmed.ncbi.nlm.nih.gov\/35861027\/, https:\/\/doi.org\/10.1111\/LAM.13789","DOI":"10.1111\/LAM.13789"},{"key":"5053_CR26","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1080\/14737159.2022.2015329","volume":"22","author":"D Golparian","year":"2022","unstructured":"Golparian D, Unemo M (2022) Antimicrobial resistance prediction in Neisseria gonorrhoeae: current status and future prospects. Expert Rev Mol Diagn 22:29\u201348. https:\/\/doi.org\/10.1080\/14737159.2022.2015329","journal-title":"Expert Rev Mol Diagn"},{"key":"5053_CR27","doi-asserted-by":"publisher","unstructured":"Darren YJ, Lee MM, Ashcroft, Eric PF, Chow M, Sait VD, Petra M, Tschaepe et al (2021) Reflex detection of ciprofloxacin resistance in Neisseria gonorrhoeae by use of the SpeeDx ResistancePlus GC assay. J Clin Microbiol 159. https:\/\/doi.org\/10.1128\/JCM.00089-21","DOI":"10.1128\/JCM.00089-21"},{"key":"5053_CR28","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1093\/JAC\/DKAA381","volume":"76","author":"R Hadad","year":"2021","unstructured":"Hadad R, Cole MJ, Ebeyan S, Jacobsson S, Tan LY, Golparian D et al (2021) Evaluation of the SpeeDx ResistancePlusVR GC and SpeeDx GC 23S 2611 (beta) molecular assays for prediction of antimicrobial resistance\/susceptibility to ciprofloxacin and azithromycin in Neisseria gonorrhoeae. J Antimicrob Chemother 76:84\u201390. https:\/\/doi.org\/10.1093\/JAC\/DKAA381","journal-title":"J Antimicrob Chemother"},{"key":"5053_CR29","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1097\/QCO.0000000000000230","volume":"29","author":"N Low","year":"2016","unstructured":"Low N, Unemo M (2016) Molecular tests for the detection of antimicrobial resistant Neisseria gonorrhoeae: when, where, and how to use? Curr Opin Infect Dis 29:45\u201351. https:\/\/doi.org\/10.1097\/QCO.0000000000000230","journal-title":"Curr Opin Infect Dis"},{"key":"5053_CR30","doi-asserted-by":"publisher","unstructured":"Bissessor M, Tabrizi SN, Fairley CK, Danielewski J, Whitton B, Bird S et al (2011) Differing Neisseria gonorrhoeae bacterial loads in the pharynx and rectum in men who have sex with men: implications for gonococcal detection, transmission, and control. J Clin Microbiol [Internet] [cited 2023 2];49:4304\u20134306. https:\/\/pubmed.ncbi.nlm.nih.gov\/21956992\/, https:\/\/doi.org\/10.1128\/JCM.05341-11","DOI":"10.1128\/JCM.05341-11"},{"key":"5053_CR31","doi-asserted-by":"publisher","first-page":"1009","DOI":"10.1007\/s10096-024-04786-y","volume":"43","author":"A Maldonado-Barrueco","year":"2024","unstructured":"Maldonado-Barrueco A, Sanz-Gonz\u00e1lez C, Falces-Romero I, Garc\u00eda-Clemente P, Cacho-Calvo J, Quiles-Melero I (2024) Comparison of gradient diffusion and molecular methods using Allplex\u2122 NG&DR assay (Seegene\u00ae) for macrolide and fluoroquinolone screening resistance in Neisseria gonorrhoeae. Eur J Clin Microbiol Infect Dis 43:1009\u20131012. https:\/\/doi.org\/10.1007\/s10096-024-04786-y","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"5053_CR32","doi-asserted-by":"publisher","unstructured":"Rubin DHF, Mortimer TD, Grad YH (2023) Neisseria gonorrhoeae diagnostic escape from a gyra-based test for ciprofloxacin susceptibility and the effect on zoliflodacin resistance: a bacterial genetics and experimental evolution study. Lancet Microbe [Internet] [cited 2023 17];4:e247. https:\/\/doi.org\/10.1016\/S2666-5247(22)00356-1","DOI":"10.1016\/S2666-5247(22)00356-1"},{"key":"5053_CR33","doi-asserted-by":"publisher","unstructured":"Zhou Q, Liu J, Chen S, Xu W, Han Y, Yin Y (2021) The accuracy of molecular detection targeting the mutation C2611T for detecting moderate-level azithromycin resistance in neisseria gonorrhoeae: A systematic review and meta-analysis. Antibiotics 1:10. https:\/\/doi.org\/10.3390\/antibiotics10091027","DOI":"10.3390\/antibiotics10091027"},{"key":"5053_CR34","doi-asserted-by":"publisher","unstructured":"Salmeron P, Moreno-Mingorance A, Trejo J, Amado R, Vinado B, Cornejo-Sanchez T et al (2021) Emergence and dissemination of three mild outbreaks of Neisseria gonorrhoeae with high-level resistance to azithromycin in Barcelona, 2016-18. J Antimicrob Chemother [Internet] [cited 2023 3];76:930\u2013935. https:\/\/pubmed.ncbi.nlm.nih.gov\/33367806\/, https:\/\/doi.org\/10.1093\/JAC\/DKAA536","DOI":"10.1093\/JAC\/DKAA536"},{"key":"5053_CR35","doi-asserted-by":"publisher","unstructured":"Fifer H, Cole M, Hughes G, Padfield S, Smolarchuk C, Woodford N et al (2018) Sustained transmission of high-level azithromycin-resistant Neisseria gonorrhoeae in England: an observational study. Lancet Infect Dis [Internet] [cited 2023 3];18:573\u2013581. https:\/\/pubmed.ncbi.nlm.nih.gov\/29523496\/, https:\/\/doi.org\/10.1016\/S1473-3099(18)30122-1","DOI":"10.1016\/S1473-3099(18)30122-1"},{"key":"5053_CR36","doi-asserted-by":"publisher","unstructured":"Wan C, Li Y, Le WJ, Liu YR, Li S, Wang BX et al (2018) Increasing resistance to azithromycin in Neisseria gonorrhoeae in Eastern Chinese cities: Resistance mechanisms and genetic diversity among isolates from Nanjing. Antimicrob Agents Chemother [Internet] [cited 2023 3]:62. https:\/\/pubmed.ncbi.nlm.nih.gov\/29530847\/, https:\/\/doi.org\/10.1128\/AAC.02499-17","DOI":"10.1128\/AAC.02499-17"},{"key":"5053_CR37","doi-asserted-by":"publisher","first-page":"758","DOI":"10.1016\/S1473-3099(18)30225-1","volume":"1;18","author":"SR Harris","year":"2018","unstructured":"Harris SR, Cole MJ, Spiteri G, S\u00e1nchez-Bus\u00f3 L, Golparian D, Jacobsson S et al (2018) Public health surveillance of multidrug-resistant clones of Neisseria gonorrhoeae in Europe: a genomic survey. Lancet Infect Dis 18:758\u2013768. https:\/\/doi.org\/10.1016\/S1473-3099(18)30225-1","journal-title":"Lancet Infect Dis"}],"container-title":["European Journal of Clinical Microbiology & Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10096-025-05053-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10096-025-05053-4\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10096-025-05053-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,29]],"date-time":"2025-03-29T17:12:41Z","timestamp":1743268361000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10096-025-05053-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,10]]},"references-count":37,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,4]]}},"alternative-id":["5053"],"URL":"https:\/\/doi.org\/10.1007\/s10096-025-05053-4","relation":{},"ISSN":["0934-9723","1435-4373"],"issn-type":[{"value":"0934-9723","type":"print"},{"value":"1435-4373","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,10]]},"assertion":[{"value":"4 July 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 January 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 February 2025","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 protocol was approved by the Swiss ethics committee in Bern (BASEC-Nr: Req-2024-00208).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"We are grateful to Seegene Inc. for providing the reagents for the NG & DR assay and the kits used for DNA extraction for this study. They did not participate in the study design, data interpretation, or the writing of the manuscript.Funding for this study was provided by Dr. Risch.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}