{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T23:53:33Z","timestamp":1790985213858,"version":"4.1.0"},"reference-count":46,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T00:00:00Z","timestamp":1781827200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T00:00:00Z","timestamp":1781827200000},"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":["Emerg Radiol"],"DOI":"10.1007\/s10140-026-02507-w","type":"journal-article","created":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T03:12:35Z","timestamp":1781838755000},"page":"1075-1087","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["First nationwide clinical indication-based diagnostic reference levels incorporating size-specific dose estimates for adult chest CT in Morocco"],"prefix":"10.1007","volume":"33","author":[{"given":"Youssef","family":"Madkouri","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamza","family":"Sekkat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oussama El","family":"Mouden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farida","family":"Bentayeb","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Youssef El","family":"Merabet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdellah","family":"Khallouqi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdellah","family":"Halimi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar El","family":"Rhazouani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,19]]},"reference":[{"key":"2507_CR1","doi-asserted-by":"publisher","first-page":"1178","DOI":"10.1080\/10420150.2024.2332208","volume":"179","author":"M El Mansouri","year":"2024","unstructured":"El Mansouri M, Talbi M, Khatar Z et al (2024) Assessing the influence of X-ray spectrum on image quality in abdominal computed tomography scans. Radiat Eff Defects Solids 179:1178\u20131187. https:\/\/doi.org\/10.1080\/10420150.2024.2332208","journal-title":"Radiat Eff Defects Solids"},{"key":"2507_CR2","doi-asserted-by":"publisher","first-page":"125012","DOI":"10.1088\/1402-4896\/ad8b86","volume":"99","author":"H Sekkat","year":"2024","unstructured":"Sekkat H, Khallouqi A, Madkouri Y et al (2024) Development of a novel automated algorithm for patient dosimetry in computed tomography: a step towards the facilitation of size-specific dose estimates and organs dosimetry estimations in a busy clinical workflow. Phys Scr 99:125012. https:\/\/doi.org\/10.1088\/1402-4896\/ad8b86","journal-title":"Phys Scr"},{"key":"2507_CR3","doi-asserted-by":"publisher","first-page":"112388","DOI":"10.1016\/j.radphyschem.2024.112388","volume":"227","author":"H Sekkat","year":"2025","unstructured":"Sekkat H, Khallouqi A, El Rhazouani O et al (2025) HeadCTDosi: A python-based automated calculation of head water equivalent diameter and size specific dose estimate based on AAPM 220 report. Radiat Phys Chem 227:112388. https:\/\/doi.org\/10.1016\/j.radphyschem.2024.112388","journal-title":"Radiat Phys Chem"},{"key":"2507_CR4","doi-asserted-by":"publisher","first-page":"015031","DOI":"10.1088\/2057-1976\/ad992e","volume":"11","author":"A Khallouqi","year":"2025","unstructured":"Khallouqi A, Sekkat H, El Rhazouani O, Halimi A (2025) Investigation of organs dosimetry precision using ATOM phantom and optically stimulated luminescence detectors in computed tomography. Biomed Phys Eng Express 11:015031. https:\/\/doi.org\/10.1088\/2057-1976\/ad992e","journal-title":"Biomed Phys Eng Express"},{"key":"2507_CR5","doi-asserted-by":"publisher","first-page":"236","DOI":"10.4103\/ijri.IJRI_34_19","volume":"29","author":"AS Bhalla","year":"2019","unstructured":"Bhalla AS, Das A, Naranje P et al (2019) Imaging protocols for CT chest: A recommendation. Indian J Radiol Imaging 29:236\u2013246. https:\/\/doi.org\/10.4103\/ijri.IJRI_34_19","journal-title":"Indian J Radiol Imaging"},{"key":"2507_CR6","doi-asserted-by":"publisher","first-page":"2277","DOI":"10.1056\/NEJMra072149","volume":"357","author":"DJ Brenner","year":"2007","unstructured":"Brenner DJ, Hall EJ (2007) Computed tomography \u2014 an increasing source of radiation exposure. N Engl J Med 357:2277\u20132284. https:\/\/doi.org\/10.1056\/NEJMra072149","journal-title":"N Engl J Med"},{"key":"2507_CR7","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2009.427","author":"R Smith-Bindman","year":"2009","unstructured":"Smith-Bindman R (2009) Radiation dose associated with common computed tomography examinations and the associated lifetime attributable risk of cancer. Arch Intern Med. . 169:2078 https:\/\/doi.org\/10.1001\/archinternmed.2009.427. 169:2078","journal-title":"Arch Intern Med"},{"key":"2507_CR8","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1016\/j.ejmp.2016.07.331","volume":"32","author":"AE Papadakis","year":"2016","unstructured":"Papadakis AE (2016) CT dose optimization. Physica Med 32:189. https:\/\/doi.org\/10.1016\/j.ejmp.2016.07.331","journal-title":"Physica Med"},{"key":"2507_CR9","doi-asserted-by":"publisher","first-page":"921","DOI":"10.1007\/s10140-025-02382-x","volume":"32","author":"Y Madkouri","year":"2025","unstructured":"Madkouri Y, Sekkat H, Khallouqi A (2025) Establishment of the first National diagnostic reference levels by clinical indication for adult head computed tomography in morocco: A baseline study. Emerg Radiol 32:921\u2013929. https:\/\/doi.org\/10.1007\/s10140-025-02382-x","journal-title":"Emerg Radiol"},{"key":"2507_CR10","doi-asserted-by":"publisher","first-page":"849","DOI":"10.1007\/s10140-025-02409-3","volume":"32","author":"H Sekkat","year":"2025","unstructured":"Sekkat H, Khallouqi A, Halimi A et al (2025) Setting the benchmark : morocco\u2019s first local diagnostic reference levels by clinical indication for pediatric computed tomography across all protocols. Emerg Radiol 32:849\u2013860. https:\/\/doi.org\/10.1007\/s10140-025-02409-3","journal-title":"Emerg Radiol"},{"key":"2507_CR11","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1177\/0146645317717209","volume":"46","author":"E Va\u00f1\u00f3","year":"2017","unstructured":"Va\u00f1\u00f3 E, Miller DL, Martin CJ et al (2017) ICRP Publication 135: Diagnostic reference levels in medical imaging. Ann ICRP 46:1\u2013144. https:\/\/doi.org\/10.1177\/0146645317717209","journal-title":"Ann ICRP"},{"key":"2507_CR12","unstructured":"Commission E, Energy D-G (2021) for European study on clinical diagnostic reference levels for X-ray medical imaging \u2013 EUCLID. Publications Office of the European Union"},{"key":"2507_CR13","volume-title":"Radiation protection and safety of radiation sources: international basic safety standards; general safety requirements","author":"IAEA","year":"2014","unstructured":"IAEA (2014) Radiation protection and safety of radiation sources: international basic safety standards; general safety requirements. Internat. Atomic Energy Agency, Vienna"},{"key":"2507_CR14","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1007\/s13244-015-0410-4","volume":"6","author":"European Society of Radiology (ESR)","year":"2015","unstructured":"European Society of Radiology (ESR) (2015) Summary of the European Directive 2013\/59\/Euratom: essentials for health professionals in radiology. Insights Imaging 6:411\u2013417. https:\/\/doi.org\/10.1007\/s13244-015-0410-4","journal-title":"Insights Imaging"},{"key":"2507_CR15","unstructured":"EUROPEAN COMMISSION (2014) Radiation protection N\u00b0 180. Diagnostic reference levels in thirty-six European countries"},{"key":"2507_CR16","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1186\/s13244-020-00899-y","volume":"11","author":"G Paulo","year":"2020","unstructured":"Paulo G, Damilakis J, Tsapaki V et al (2020) Diagnostic Reference Levels based on clinical indications in computed tomography: a literature review. Insights Imaging 11:96. https:\/\/doi.org\/10.1186\/s13244-020-00899-y","journal-title":"Insights Imaging"},{"key":"2507_CR17","doi-asserted-by":"publisher","first-page":"6794","DOI":"10.1007\/s00330-019-06257-x","volume":"29","author":"H Brat","year":"2019","unstructured":"Brat H, Zanca F, Montandon S et al (2019) Local clinical diagnostic reference levels for chest and abdomen CT examinations in adults as a function of body mass index and clinical indication: a prospective multicenter study. Eur Radiol 29:6794\u20136804. https:\/\/doi.org\/10.1007\/s00330-019-06257-x","journal-title":"Eur Radiol"},{"key":"2507_CR18","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1186\/s13244-020-00949-5","volume":"12","author":"G Frija","year":"2021","unstructured":"the European Society of Radiology, Frija G, Hoeschen C et al (2021) ESR EuroSafe Imaging and its role in promoting radiation protection \u2013 6 years of success. Insights Imaging 12:3. https:\/\/doi.org\/10.1186\/s13244-020-00949-5","journal-title":"Insights Imaging"},{"key":"2507_CR19","doi-asserted-by":"publisher","first-page":"4459","DOI":"10.1007\/s00330-020-07652-5","volume":"31","author":"V Tsapaki","year":"2021","unstructured":"Tsapaki V, Damilakis J, Paulo G et al (2021) CT diagnostic reference levels based on clinical indications: results of a large-scale European survey. Eur Radiol 31:4459\u20134469. https:\/\/doi.org\/10.1007\/s00330-020-07652-5","journal-title":"Eur Radiol"},{"key":"2507_CR20","doi-asserted-by":"publisher","first-page":"1971","DOI":"10.1007\/s00330-021-08266-1","volume":"32","author":"D Bos","year":"2022","unstructured":"Bos D, Yu S, Luong J et al (2022) Diagnostic reference levels and median doses for common clinical indications of CT: findings from an international registry. Eur Radiol 32:1971\u20131982. https:\/\/doi.org\/10.1007\/s00330-021-08266-1","journal-title":"Eur Radiol"},{"key":"2507_CR21","doi-asserted-by":"publisher","first-page":"e104530","DOI":"10.1136\/bmjopen-2025-104530","volume":"16","author":"A Alim","year":"2026","unstructured":"Alim A, Leong SS, Thomas Sudin AEL, Awla DH (2026) Clinical indication-based diagnostic reference levels in CT: a systematic review. BMJ Open 16:e104530. https:\/\/doi.org\/10.1136\/bmjopen-2025-104530","journal-title":"BMJ Open"},{"key":"2507_CR22","doi-asserted-by":"publisher","first-page":"400","DOI":"10.1093\/raddos\/ncaa170","volume":"191","author":"M Benmessaoud","year":"2020","unstructured":"Benmessaoud M, Dadouch A, Talbi M et al (2020) Diagnostic reference levels for paediatric head computed tomography in Morocco: a nationwide survey. Radiat Prot Dosimetry 191:400\u2013408. https:\/\/doi.org\/10.1093\/raddos\/ncaa170","journal-title":"Radiat Prot Dosimetry"},{"key":"2507_CR23","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1051\/radiopro\/2022007","volume":"57","author":"Z Tahiri","year":"2022","unstructured":"Tahiri Z, Talbi M, El Mansouri M (2022) Evaluation of Moroccan physician\u2019s knowledge about radiation doses and risks from pediatric computed tomography. Radioprotection 57:123\u2013126. https:\/\/doi.org\/10.1051\/radiopro\/2022007","journal-title":"Radioprotection"},{"key":"2507_CR24","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1051\/radiopro\/2022008","volume":"57","author":"M Talbi","year":"2022","unstructured":"Talbi M, Tahiri Z, Eddaoui K et al (2022) Local diagnostic reference levels (LDRLs) for routine X-ray examinations in Morocco. Radioprotection 57:149\u2013155. https:\/\/doi.org\/10.1051\/radiopro\/2022008","journal-title":"Radioprotection"},{"key":"2507_CR25","doi-asserted-by":"publisher","first-page":"1552","DOI":"10.1021\/ci500161d","volume":"54","author":"E Seifert","year":"2014","unstructured":"Seifert E (2014) OriginPro 9.1: Scientific data analysis and graphing software\u2014software review. J Chem Inf Model 54:1552\u20131552. https:\/\/doi.org\/10.1021\/ci500161d","journal-title":"J Chem Inf Model"},{"key":"2507_CR26","doi-asserted-by":"publisher","first-page":"881","DOI":"10.2214\/AJR.09.3462","volume":"194","author":"JA Christner","year":"2010","unstructured":"Christner JA, Kofler JM, McCollough CH (2010) Estimating effective dose for CT using dose\u2013length product compared with using organ doses: consequences of adopting international commission on radiological protection publication 103 or dual-energy scanning. Am J Roentgenol 194:881\u2013889. https:\/\/doi.org\/10.2214\/AJR.09.3462","journal-title":"Am J Roentgenol"},{"key":"2507_CR27","doi-asserted-by":"publisher","first-page":"228","DOI":"10.1002\/acm2.12223","volume":"19","author":"CS Burton","year":"2018","unstructured":"Burton CS, Szczykutowicz TP (2018) Evaluation of AAPM Reports 204 and 220: Estimation of effective diameter, water-equivalent diameter, and ellipticity ratios for chest, abdomen, pelvis, and head CT scans. J Appl Clin Med Phys 19:228\u2013238. https:\/\/doi.org\/10.1002\/acm2.12223","journal-title":"J Appl Clin Med Phys"},{"key":"2507_CR28","doi-asserted-by":"publisher","first-page":"268","DOI":"10.1016\/j.jcct.2017.05.002","volume":"11","author":"IA Castellano","year":"2017","unstructured":"Castellano IA, Nicol ED, Bull RK et al (2017) A prospective national survey of coronary CT angiography radiation doses in the United Kingdom. J Cardiovasc Comput Tomogr 11:268\u2013273. https:\/\/doi.org\/10.1016\/j.jcct.2017.05.002","journal-title":"J Cardiovasc Comput Tomogr"},{"key":"2507_CR29","doi-asserted-by":"publisher","first-page":"1390","DOI":"10.1259\/bjr\/15839549","volume":"85","author":"SJ Foley","year":"2012","unstructured":"Foley SJ, McEntee MF, Rainford LA (2012) Establishment of CT diagnostic reference levels in Ireland. BJR 85:1390\u20131397. https:\/\/doi.org\/10.1259\/bjr\/15839549","journal-title":"BJR"},{"key":"2507_CR30","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1093\/rpd\/ncr441","volume":"151","author":"Y Fukushima","year":"2012","unstructured":"Fukushima Y, Tsushima Y, Takei H et al (2012) Diagnostic reference level of computed tomography (CT) in japan. Radiat Prot Dosimetry 151:51\u201357. https:\/\/doi.org\/10.1093\/rpd\/ncr441","journal-title":"Radiat Prot Dosimetry"},{"key":"2507_CR31","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1016\/j.ejmp.2019.04.004","volume":"61","author":"B Habib Geryes","year":"2019","unstructured":"Habib Geryes B, Hornbeck A, Jarrige V et al (2019) Patient dose evaluation in computed tomography: A French national study based on clinical indications. Physica Med 61:18\u201327. https:\/\/doi.org\/10.1016\/j.ejmp.2019.04.004","journal-title":"Physica Med"},{"key":"2507_CR32","doi-asserted-by":"publisher","first-page":"500","DOI":"10.1001\/jama.2009.54","volume":"301","author":"J Hausleiter","year":"2009","unstructured":"Hausleiter J (2009) Estimated radiation dose associated with cardiac CT angiography. JAMA 301:500. https:\/\/doi.org\/10.1001\/jama.2009.54","journal-title":"JAMA"},{"key":"2507_CR33","unstructured":"Japan Network for Research and Information on Medical Exposures (2015) Diagnostic reference levels based on latest surveys in Japan \u2014 Japan DRLs 2015"},{"key":"2507_CR34","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1148\/radiol.2017161911","volume":"284","author":"KM Kanal","year":"2017","unstructured":"Kanal KM, Butler PF, Sengupta D et al (2017) U.S. Diagnostic reference levels and achievable doses for 10 adult CT examinations. Radiology 284:120\u2013133. https:\/\/doi.org\/10.1148\/radiol.2017161911","journal-title":"Radiology"},{"key":"2507_CR35","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1093\/rpd\/ncu317","volume":"164","author":"F Mafalanka","year":"2015","unstructured":"Mafalanka F, Etard C, Rehel JL et al (2015) Establishment of diagnostic reference levels in cardiac CT in France: a need for patient dose optimisation. Radiat Prot Dosimetry 164:116\u2013119. https:\/\/doi.org\/10.1093\/rpd\/ncu317","journal-title":"Radiat Prot Dosimetry"},{"key":"2507_CR36","unstructured":"MERU (2017) National survey on population dose from computed tomography 2017, Dublin"},{"key":"2507_CR37","doi-asserted-by":"publisher","first-page":"469","DOI":"10.1007\/s00330-013-3031-7","volume":"24","author":"F Palorini","year":"2014","unstructured":"Palorini F, Origgi D, Granata C et al (2014) Adult exposures from MDCT including multiphase studies: first Italian nationwide survey. Eur Radiol 24:469\u2013483. https:\/\/doi.org\/10.1007\/s00330-013-3031-7","journal-title":"Eur Radiol"},{"key":"2507_CR38","unstructured":"Public Health England (2018) National diagnostic reference levels (NDRLs): 15 November 2018 onwards"},{"key":"2507_CR39","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1016\/j.ejmp.2017.05.050","volume":"39","author":"DH Salama","year":"2017","unstructured":"Salama DH, Vassileva J, Mahdaly G et al (2017) Establishing national diagnostic reference levels (DRLs) for computed tomography in Egypt. Physica Med 39:16\u201324. https:\/\/doi.org\/10.1016\/j.ejmp.2017.05.050","journal-title":"Physica Med"},{"key":"2507_CR40","doi-asserted-by":"publisher","first-page":"739","DOI":"10.1055\/a-0824-7603","volume":"191","author":"A Schegerer","year":"2019","unstructured":"Schegerer A, Loose R, Heuser LJ, Brix G (2019) Diagnostic reference levels for diagnostic and interventional x-ray procedures in Germany: Update and handling. Fortschr R\u00f6ntgenstr 191:739\u2013751. https:\/\/doi.org\/10.1055\/a-0824-7603","journal-title":"Fortschr R\u00f6ntgenstr"},{"key":"2507_CR41","unstructured":"SRPA (2019) Diagnostic reference levels in the Swedish legislation"},{"key":"2507_CR42","unstructured":"STUK (2013) Reference levels for patient radiation exposure in computed tomography examinations of adults"},{"key":"2507_CR43","doi-asserted-by":"publisher","first-page":"244","DOI":"10.1093\/rpd\/ncq279","volume":"142","author":"R Treier","year":"2010","unstructured":"Treier R, Aroua A, Verdun FR et al (2010) Patient doses in CT examinations in Switzerland: implementation of national diagnostic reference levels. Radiat Prot Dosimetry 142:244\u2013254. https:\/\/doi.org\/10.1093\/rpd\/ncq279","journal-title":"Radiat Prot Dosimetry"},{"key":"2507_CR44","unstructured":"Widmark A (2018) Diagnostic reference level (DRL) in Norway 2017"},{"key":"2507_CR45","doi-asserted-by":"publisher","first-page":"390","DOI":"10.1148\/radiol.2021212624","volume":"302","author":"M Mahesh","year":"2022","unstructured":"Mahesh M (2022) Benchmarking CT radiation doses based on clinical indications. Is subjective image qual enough? Radiol 302:390\u2013391. https:\/\/doi.org\/10.1148\/radiol.2021212624","journal-title":"Is Subjective Image Qual Enough? Radiol"},{"key":"2507_CR46","doi-asserted-by":"publisher","first-page":"111191","DOI":"10.1016\/j.ejrad.2023.111191","volume":"169","author":"M Oliveira Bernardo","year":"2023","unstructured":"Oliveira Bernardo M, Karout L, Morgado F et al (2023) Establishing national clinical diagnostic reference levels and achievable doses for CT examinations in Brazil: A prospective study. Eur J Radiol 169:111191. https:\/\/doi.org\/10.1016\/j.ejrad.2023.111191","journal-title":"Eur J Radiol"}],"container-title":["Emergency Radiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10140-026-02507-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10140-026-02507-w","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10140-026-02507-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T23:03:00Z","timestamp":1790982180000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10140-026-02507-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,19]]},"references-count":46,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,10]]}},"alternative-id":["2507"],"URL":"https:\/\/doi.org\/10.1007\/s10140-026-02507-w","relation":{},"ISSN":["1438-1435"],"issn-type":[{"value":"1438-1435","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,19]]},"assertion":[{"value":"20 March 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 June 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 June 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This retrospective multicenter study was based exclusively on anonymized dosimetric data extracted from routine adult chest CT examination reports. No identifiable patient information, diagnostic images, clinical follow-up data, or additional patient intervention were collected. Therefore, formal informed consent was waived\/not required according to the retrospective and anonymized nature of the study.","order":1,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"None.","order":2,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}]}}