{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T23:48:51Z","timestamp":1790380131407,"version":"4.1.0"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,6,26]],"date-time":"2023-06-26T00:00:00Z","timestamp":1687737600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,6,26]],"date-time":"2023-06-26T00:00:00Z","timestamp":1687737600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100012940","name":"Universit\u00e4tsklinikum T\u00fcbingen","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100012940","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Neurosurg Rev"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Spinal arachnoid web (SAW) is a rare disease entity characterized as band-like arachnoid tissue that can cause spinal cord compression and syringomyelia. This study aimed to analyze the surgical management of the spinal arachnoid web in patients with syringomyelia, focusing on surgical strategies and outcomes.\u00a0A total of 135 patients with syringomyelia underwent surgery at our department between November 2003 and December 2022. All patients underwent magnetic resonance imaging (MRI), with a special syringomyelia protocol (including TrueFISP and CINE), and electrophysiology. Among these patients, we searched for patients with SAW with syringomyelia following careful analysis of neuroradiological data and surgical reports. The criteria for SAW were as follows: displacement of the spinal cord, disturbed but preserved CSF flow, and intraoperative arachnoid web. Patients were evaluated for initial symptoms, surgical strategies, and complications by reviewing surgical reports, patient documents, neuroradiological data, and follow-up data.\u00a0Of the 135 patients, 3 (2.22%) fulfilled the SAW criteria. The mean patient age was 51.67 \u00b1 8.33 years. Two patients were male, and one was female. The affected levels were T2\/3, T6, and T8. Excision of the arachnoid web was performed in all cases. No significant change in intraoperative monitoring was noted. Postoperatively, none of the patients presented new neurological symptoms. The MRI 3 months after surgery revealed that the syringomyelia improved in all cases, and caliber variation of the spinal cord could not be detected anymore. All clinical symptoms improved.\u00a0In summary, SAW can be safely treated by surgery. Even though syringomyelia usually improves on MRI and symptoms also improve, residual symptoms might be observed. We advocate for clear criteria for the diagnosis of SAW and a standardized diagnostic (MRI including TrueFISP and CINE).<\/jats:p>","DOI":"10.1007\/s10143-023-02071-8","type":"journal-article","created":{"date-parts":[[2023,6,26]],"date-time":"2023-06-26T08:02:26Z","timestamp":1687766546000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Surgical management of syringomyelia associated with spinal arachnoid web: strategies and outcomes"],"prefix":"10.1007","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1879-8490","authenticated-orcid":false,"given":"Sasan Darius","family":"Adib","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens","family":"Schittenhelm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Kurucz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Till-Karsten","family":"Hauser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcos","family":"Tatagiba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,6,26]]},"reference":[{"key":"2071_CR1","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1177\/1971400916656488","volume":"29","author":"R Aiyer","year":"2016","unstructured":"Aiyer R, El-Sherif Y, Voutsinas L (2016) Dorsal thoracic arachnoid web presenting as neuropathic pain: \u201cscalpel\u201d sign found on MRI. Neuroradiol J 29:393\u2013395. https:\/\/doi.org\/10.1177\/1971400916656488","journal-title":"Neuroradiol J"},{"key":"2071_CR2","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1186\/s43055-022-00847-4","volume":"53","author":"V Arora","year":"2022","unstructured":"Arora V, Verma H, Kamal R, Lone NA (2022) Dorsal arachnoid web: the \u2018scalpel\u2019 sign\u2014a case report and differential diagnosis. Egypt J Radiol Nucl Med 53:163. https:\/\/doi.org\/10.1186\/s43055-022-00847-4","journal-title":"Egypt J Radiol Nucl Med"},{"key":"2071_CR3","doi-asserted-by":"publisher","first-page":"446","DOI":"10.21037\/jss.2018.05.08","volume":"4","author":"H Ben Ali","year":"2018","unstructured":"Ben Ali H, Hamilton P, Zygmunt S, Yakoub KM (2018) Spinal arachnoid web-a review article. J Spine Surg 4:446\u2013450. https:\/\/doi.org\/10.21037\/jss.2018.05.08","journal-title":"J Spine Surg"},{"key":"2071_CR4","doi-asserted-by":"publisher","first-page":"96","DOI":"10.3174\/ng.1900037","volume":"10","author":"PM Brasil","year":"2020","unstructured":"Brasil PM, Pereira LP, T\u00e1vora DGF, Camara ACF, Macedo Filho CL, Coimbra PPA (2020) Imaging findings in dorsal thoracic arachnoid web and the differential diagnosis of \u201cscalpel sign\u201d. Neurograph 10:96\u2013102. https:\/\/doi.org\/10.3174\/ng.1900037","journal-title":"Neurograph"},{"key":"2071_CR5","doi-asserted-by":"publisher","first-page":"88","DOI":"10.5334\/jbsr.2592","volume":"105","author":"A Buttiens","year":"2021","unstructured":"Buttiens A, Feyen B, Dekeyzer S (2021) Dorsal arachnoid web: a rare cause of myelopathy. J Belg Soc Radiol 105:88. https:\/\/doi.org\/10.5334\/jbsr.2592","journal-title":"J Belg Soc Radiol"},{"key":"2071_CR6","doi-asserted-by":"publisher","first-page":"227","DOI":"10.3171\/2013.10.SPINE13395","volume":"20","author":"HS Chang","year":"2014","unstructured":"Chang HS, Nagai A, Oya S, Matsui T (2014) Dorsal spinal arachnoid web diagnosed with the quantitative measurement of cerebrospinal fluid flow on magnetic resonance imaging. J Neurosurg Spine 20:227\u2013233. https:\/\/doi.org\/10.3171\/2013.10.SPINE13395","journal-title":"J Neurosurg Spine"},{"key":"2071_CR7","doi-asserted-by":"publisher","first-page":"224","DOI":"10.4184\/asj.2018.12.2.224","volume":"12","author":"A Chellathurai","year":"2018","unstructured":"Chellathurai A, Balasubramaniam S, Gnanasihamani S, Ramasamy S, Durairajan J (2018) Pathophysiology and grading of the ventral displacement of dorsal spinal cord spectrum. Asian Spine J 12:224\u2013231. https:\/\/doi.org\/10.4184\/asj.2018.12.2.224","journal-title":"Asian Spine J"},{"key":"2071_CR8","doi-asserted-by":"publisher","first-page":"E4","DOI":"10.3171\/foc.2000.8.3.4","volume":"8","author":"NJ Fischbein","year":"2000","unstructured":"Fischbein NJ, Dillon WP, Cobbs C, Weinstein PR (2000) The \u201cpresyrinx\u201d state: is there a reversible myelopathic condition that may precede syringomyelia? Neurosurg Focus 8:E4. https:\/\/doi.org\/10.3171\/foc.2000.8.3.4","journal-title":"Neurosurg Focus"},{"key":"2071_CR9","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1097\/BSD.0000000000000569","volume":"31","author":"Y Fujiwara","year":"2018","unstructured":"Fujiwara Y, Manabe H, Izumi B, Shima T, Adachi N (2018) Microscope and fiberscope-assisted subarachnoid-subarachnoid (S-S) bypass: a novel surgical technique to reestablish cerebrospinal fluid flow in treating dorsal spinal arachnoid webs, diagnosed by cine-MRI. Clin Spine Surg 31:58\u201364. https:\/\/doi.org\/10.1097\/BSD.0000000000000569","journal-title":"Clin Spine Surg"},{"key":"2071_CR10","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1007\/s10143-006-0029-5","volume":"29","author":"D Greitz","year":"2006","unstructured":"Greitz D (2006) Unraveling the riddle of syringomyelia. Neurosurg Rev 29:251\u2013263. https:\/\/doi.org\/10.1007\/s10143-006-0029-5","journal-title":"Neurosurg Rev"},{"key":"2071_CR11","doi-asserted-by":"publisher","first-page":"101276","DOI":"10.1016\/j.inat.2021.101276","volume":"25","author":"P Hamilton","year":"2021","unstructured":"Hamilton P, Bartley J, Lawrence P, Eisenring CV (2021) Dorsal thoracic arachnoid web \u2013 confounders of a rare entity in the developing setting. Interdisciplinary Neurosurgery 25:101276. https:\/\/doi.org\/10.1016\/j.inat.2021.101276","journal-title":"Interdisciplinary Neurosurgery"},{"key":"2071_CR12","doi-asserted-by":"publisher","first-page":"367","DOI":"10.3171\/2012.8.SPINE111059","volume":"17","author":"JD Heiss","year":"2012","unstructured":"Heiss JD, Snyder K, Peterson MM, Patronas NJ, Butman JA, Smith RK, Devroom HL, Sansur CA, Eskioglu E, Kammerer WA, Oldfield EH (2012) Pathophysiology of primary spinal syringomyelia. J Neurosurg Spine 17:367\u2013380. https:\/\/doi.org\/10.3171\/2012.8.SPINE111059","journal-title":"J Neurosurg Spine"},{"key":"2071_CR13","doi-asserted-by":"publisher","first-page":"323","DOI":"10.25259\/SNI_339_2021","volume":"12","author":"T Hines","year":"2021","unstructured":"Hines T, Wang C, Duttlinger C, Thompson J, Watford K, Motley B, Wheeler G (2021) Thoracic dorsal arachnoid web with rapid onset of symptoms: a report of two cases and brief review of the literature. Surg Neurol Int 12:323. https:\/\/doi.org\/10.25259\/SNI_339_2021","journal-title":"Surg Neurol Int"},{"key":"2071_CR14","doi-asserted-by":"publisher","first-page":"8816598","DOI":"10.1155\/2020\/8816598","volume":"2020","author":"J Inoue","year":"2020","unstructured":"Inoue J, Miyakoshi N, Hongo M, Kobayashi T, Abe T, Kikuchi K, Abe E, Kasukawa Y, Ishikawa Y, Kudo D, Kinoshita H, Kimura R, Shimada Y (2020) Diagnosis and surgical treatment of thoracic dorsal arachnoid web: a report of two cases. Case Rep Orthop 2020:8816598. https:\/\/doi.org\/10.1155\/2020\/8816598","journal-title":"Case Rep Orthop"},{"key":"2071_CR15","doi-asserted-by":"publisher","first-page":"233","DOI":"10.3171\/jns.1997.86.2.0233","volume":"86","author":"J Klekamp","year":"1997","unstructured":"Klekamp J, Batzdorf U, Samii M, Bothe HW (1997) Treatment of syringomyelia associated with arachnoid scarring caused by arachnoiditis or trauma. J Neurosurg 86:233\u2013240. https:\/\/doi.org\/10.3171\/jns.1997.86.2.0233","journal-title":"J Neurosurg"},{"key":"2071_CR16","doi-asserted-by":"publisher","first-page":"917","DOI":"10.1093\/neuros\/nyab321","volume":"89","author":"N Laxpati","year":"2021","unstructured":"Laxpati N, Malcolm JG, Tsemo GB, Mustroph C, Saindane AM, Ahmad F, Refai D, Gary MF (2021) Spinal arachnoid webs: presentation, natural history, and outcomes in 38 patients. Neurosurgery 89:917\u2013927. https:\/\/doi.org\/10.1093\/neuros\/nyab321","journal-title":"Neurosurgery"},{"key":"2071_CR17","doi-asserted-by":"publisher","first-page":"306","DOI":"10.1080\/02688699746087","volume":"11","author":"CL Mallucci","year":"1997","unstructured":"Mallucci CL, Stacey RJ, Miles JB, Williams B (1997) Idiopathic syringomyelia and the importance of occult arachnoid webs, pouches and cysts. Br J Neurosurg 11:306\u2013309. https:\/\/doi.org\/10.1080\/02688699746087","journal-title":"Br J Neurosurg"},{"key":"2071_CR18","doi-asserted-by":"publisher","first-page":"1139","DOI":"10.1227\/01.NEU.0000334411.93870.45","volume":"63","author":"UM Mauer","year":"2008","unstructured":"Mauer UM, Freude G, Danz B, Kunz U (2008) Cardiac-gated phase-contrast magnetic resonance imaging of cerebrospinal fluid flow in the diagnosis of idiopathic syringomyelia. Neurosurgery 63:1139\u20131144. https:\/\/doi.org\/10.1227\/01.NEU.0000334411.93870.45","journal-title":"Neurosurgery"},{"key":"2071_CR19","doi-asserted-by":"publisher","unstructured":"Morrison T, Datta R, Masters L, Boggild M, Reddel S, Brennan J (2022) MR \u2018scalpel sign\u2019 of spinal arachnoid web. Pract Neurol Practneurol. https:\/\/doi.org\/10.1136\/practneurol-2021-003293","DOI":"10.1136\/practneurol-2021-003293"},{"key":"2071_CR20","doi-asserted-by":"publisher","first-page":"276","DOI":"10.3171\/jns.1988.69.2.0276","volume":"69","author":"DS Nicholas","year":"1988","unstructured":"Nicholas DS, Weller RO (1988) The fine anatomy of the human spinal meninges. A light and scanning electron microscopy study. J Neurosurg 69:276\u2013282. https:\/\/doi.org\/10.3171\/jns.1988.69.2.0276","journal-title":"J Neurosurg"},{"key":"2071_CR21","doi-asserted-by":"publisher","unstructured":"Nisson PL, Hussain I, H\u00e4rtl R, Kim S, Baaj AA (2019) Arachnoid web of the spine: a systematic literature review. J Neurosurg Spine 1\u201310. https:\/\/doi.org\/10.3171\/2019.1.SPINE181371","DOI":"10.3171\/2019.1.SPINE181371"},{"key":"2071_CR22","doi-asserted-by":"publisher","first-page":"287","DOI":"10.3171\/spi.2000.93.2.0287","volume":"93","author":"CG Paramore","year":"2000","unstructured":"Paramore CG (2000) Dorsal arachnoid web with spinal cord compression: variant of an arachnoid cyst? Report of two cases. J Neurosurg 93:287\u2013290. https:\/\/doi.org\/10.3171\/spi.2000.93.2.0287","journal-title":"J Neurosurg"},{"key":"2071_CR23","doi-asserted-by":"publisher","first-page":"25","DOI":"10.51638\/jksgn.2021.00052","volume":"17","author":"G-O Park","year":"2021","unstructured":"Park G-O, Kim D-Y, Jang H-J, Kim K-H, Park J-Y, Chin D-K, Kim K-S, Cho Y-E (2021) Diagnosis and surgical treatment of arachnoid web. J Korean Soc Geriatr Neurosurg 17:25\u201330. https:\/\/doi.org\/10.51638\/jksgn.2021.00052","journal-title":"J Korean Soc Geriatr Neurosurg"},{"key":"2071_CR24","doi-asserted-by":"publisher","first-page":"498","DOI":"10.1002\/aja.1001920414","volume":"192","author":"D Parkinson","year":"1991","unstructured":"Parkinson D (1991) Human spinal arachnoid septa, trabeculae, and \u201crogue strands\u201d. Am J Anat 192:498\u2013509. https:\/\/doi.org\/10.1002\/aja.1001920414","journal-title":"Am J Anat"},{"key":"2071_CR25","doi-asserted-by":"publisher","first-page":"CASE2142","DOI":"10.3171\/CASE2142","volume":"1","author":"N Pham","year":"2021","unstructured":"Pham N, Ebinu JO, Karnati T, Hacein-Bey L (2021) Neuroimaging findings and pathophysiology of dorsal spinal arachnoid webs: illustrative case. J Neurosurg Case Lessons 1:CASE2142. https:\/\/doi.org\/10.3171\/CASE2142","journal-title":"J Neurosurg Case Lessons"},{"key":"2071_CR26","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1016\/j.wneu.2020.06.119","volume":"142","author":"AI Qureshi","year":"2020","unstructured":"Qureshi AI, Bains NK, Balasetti VKS, Salame K, Gomez CR, Siddiq F, Cousins JP (2020) Percutaneous fenestration of a spinal arachnoid web using an intrathecal catheter: effect on cerebrospinal fluid flow and clinical status. World Neurosurg 142:17\u201323. https:\/\/doi.org\/10.1016\/j.wneu.2020.06.119","journal-title":"World Neurosurg"},{"key":"2071_CR27","doi-asserted-by":"publisher","first-page":"101","DOI":"10.4103\/0974-8237.181862","volume":"7","author":"PP Sayal","year":"2016","unstructured":"Sayal PP, Zafar A, Carroll TA (2016) Syringomyelia secondary to \u201coccult\u201d dorsal arachnoid webs: report of two cases with review of literature. J Craniovertebr Junction Spine 7:101\u2013104. https:\/\/doi.org\/10.4103\/0974-8237.181862","journal-title":"J Craniovertebr Junction Spine"},{"key":"2071_CR28","doi-asserted-by":"publisher","first-page":"754","DOI":"10.3171\/2016.11.SPINE16696","volume":"26","author":"R Schultz","year":"2017","unstructured":"Schultz R, Steven A, Wessell A, Fischbein N, Sansur CA, Gandhi D, Ibrahimi D, Raghavan P (2017) Differentiation of idiopathic spinal cord herniation from dorsal arachnoid webs on MRI and CT myelography. J Neurosurg Spine 26:754\u2013759. https:\/\/doi.org\/10.3171\/2016.11.SPINE16696","journal-title":"J Neurosurg Spine"},{"key":"2071_CR29","doi-asserted-by":"publisher","first-page":"E216","DOI":"10.1227\/01.NEU.0000348007.84175.FA","volume":"65","author":"A Sridharan","year":"2009","unstructured":"Sridharan A, Heilman CB (2009) Transverse dorsal arachnoid web and syringomyelia: case report. Neurosurgery 65:E216\u2013E217. https:\/\/doi.org\/10.1227\/01.NEU.0000348007.84175.FA","journal-title":"Neurosurgery"},{"key":"2071_CR30","doi-asserted-by":"publisher","first-page":"e81","DOI":"10.1016\/j.wneu.2017.09.107","volume":"109","author":"P Vergara","year":"2018","unstructured":"Vergara P, Barone DG (2018) Minimally invasive excision of thoracic arachnoid web. World Neurosurg 109:e81\u2013e87. https:\/\/doi.org\/10.1016\/j.wneu.2017.09.107","journal-title":"World Neurosurg"},{"key":"2071_CR31","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1016\/j.spinee.2021.06.018","volume":"22","author":"S Voglis","year":"2022","unstructured":"Voglis S, Romagna A, Germans MR, Carreno I, Stienen MN, Henzi A, Frauenknecht K, Rushing E, Molliqaj G, Tung K, Tessitore E, Ginsberg HJ, Bellut D (2022) Spinal arachnoid web-a distinct entity of focal arachnopathy with favorable long-term outcome after surgical resection: analysis of a multicenter patient population. Spine J 22:126\u2013135. https:\/\/doi.org\/10.1016\/j.spinee.2021.06.018","journal-title":"Spine J"},{"key":"2071_CR32","doi-asserted-by":"publisher","first-page":"554","DOI":"10.3171\/2014.10.SPINE1446","volume":"22","author":"S Yamaguchi","year":"2015","unstructured":"Yamaguchi S, Hida K, Takeda M, Mitsuhara T, Morishige M, Yamada N, Kurisu K (2015) Visualization of regional cerebrospinal fluid flow with a dye injection technique in focal arachnoid pathologies. J Neurosurg Spine 22:554\u2013557. https:\/\/doi.org\/10.3171\/2014.10.SPINE1446","journal-title":"J Neurosurg Spine"},{"key":"2071_CR33","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1016\/j.wneu.2016.12.015","volume":"99","author":"D Zhang","year":"2017","unstructured":"Zhang D, Papavassiliou E (2017) Spinal intradural arachnoid webs causing spinal cord compression with inconclusive preoperative imaging: a report of 3 cases and a review of the literature. World Neurosurg 99:251\u2013258. https:\/\/doi.org\/10.1016\/j.wneu.2016.12.015","journal-title":"World Neurosurg"}],"container-title":["Neurosurgical Review"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10143-023-02071-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10143-023-02071-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10143-023-02071-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,22]],"date-time":"2024-01-22T13:09:43Z","timestamp":1705928983000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10143-023-02071-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,26]]},"references-count":33,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["2071"],"URL":"https:\/\/doi.org\/10.1007\/s10143-023-02071-8","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-2631537\/v1","asserted-by":"object"}]},"ISSN":["1437-2320"],"issn-type":[{"value":"1437-2320","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,26]]},"assertion":[{"value":"26 February 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 May 2023","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 June 2023","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 June 2023","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and\/or national research committee (ethics committee of the University Hospital Tuebingen, Germany; reference number 036\/2023BO2) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent For this type of study (retrospective design, anonymized data), formal consent was not required.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"For this type of study (retrospective design, anonymized data), formal consent was not required.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"For this type of study (retrospective design, anonymized data), formal consent was not required.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"152"}}