{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T16:26:52Z","timestamp":1786984012804,"version":"build-2736575974"},"reference-count":34,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100016003","name":"Mie University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100016003","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Cardiovasc Interv and Ther"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Iliofemoral deep vein thrombosis (DVT) is associated with an increased risk of post-thrombotic syndrome (PTS), despite anticoagulant therapy. However, since the coronavirus disease 2019 pandemic, no thrombolytic agent has been available under the national health insurance system for catheter-directed thrombolysis (CDL) of DVT in Japan. To evaluate the clinical outcomes of CDL using monteplase in patients with acute iliofemoral DVT and severe symptoms. Among 1,437 consecutive patients with lower-extremity DVT from August 2022 to December 2024 at a single center, 11 consecutive patients with acute symptomatic iliofemoral DVT treated with CDL using monteplase were retrospectively analyzed. The median age was 51\u00a0years, 64% of patients were male, and the median Villalta score at diagnosis was 8.5. The median duration from symptom onset to therapy was 7\u00a0days. The median total dose of monteplase was 3.55 million IU, and the median duration of therapy was 4.5\u00a0days. Patency of the treated iliac vein immediately after CDL was achieved in all lesions. Treatment-related adverse events occurred in 1 patient (9.1%), consisting of a subcutaneous hematoma, and no patients required blood transfusion. At 1\u00a0year after CDL, the Villalta scores ranged from 0 to 3 in all patients, and no patients developed PTS. Although 1 patient showed a mild decline in quality of life, no clinically significant deterioration was observed overall. CDL using monteplase may represent a feasible treatment option for carefully selected patients with acute symptomatic iliofemoral DVT in Japan. Larger studies are warranted to confirm these findings.<\/jats:p>\n                  <jats:p>\n                    <jats:bold>Graphical abstract<\/jats:bold>\n                  <\/jats:p>\n                  <jats:p>In this retrospective single-center analysis including 11 patients (12 lesions), catheter-directed thrombolysis using monteplase achieved favorable short- and long-term clinical outcomes and no major bleeding events during the 1-year follow-up period. CDL, Catheter-directed Thrombolysis; DVT, deep vein thrombosis; IVC, inferior vena cava; PTS, post-thrombotic syndrome; UFH, unfractionated heparin.<\/jats:p>","DOI":"10.1007\/s12928-026-01335-6","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T15:26:11Z","timestamp":1786980371000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical experience and safety of catheter-directed thrombolysis using monteplase for acute iliofemoral deep vein thrombosis: a retrospective single-center analysis"],"prefix":"10.1007","author":[{"given":"Soichiro","family":"Kobayashi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6659-4660","authenticated-orcid":false,"given":"Yoshito","family":"Ogihara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toru","family":"Sato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihiro","family":"Tsuji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norikazu","family":"Yamada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaoru","family":"Dohi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,17]]},"reference":[{"issue":"4","key":"1335_CR1","doi-asserted-by":"publisher","first-page":"756","DOI":"10.1160\/TH07-03-0212","volume":"98","author":"AT Cohen","year":"2007","unstructured":"Cohen AT, Agnelli G, Anderson FA, et al. Venous thromboembolism (VTE) in Europe. The number of VTE events and associated morbidity and mortality. Thromb Haemost. 2007;98(4):756\u201364. https:\/\/doi.org\/10.1160\/TH07-03-0212.","journal-title":"Thromb Haemost"},{"issue":"18","key":"1335_CR2","doi-asserted-by":"publisher","first-page":"1636","DOI":"10.1161\/CIR.0000000000000130","volume":"130","author":"SR Kahn","year":"2014","unstructured":"Kahn SR, Comerota AJ, Cushman M, et al. The postthrombotic syndrome: evidence-based prevention, diagnosis, and treatment strategies: a scientific statement from the American Heart Association. Circulation. 2014;130(18):1636\u201361. https:\/\/doi.org\/10.1161\/CIR.0000000000000130.","journal-title":"Circulation"},{"issue":"7","key":"1335_CR3","doi-asserted-by":"publisher","first-page":"1105","DOI":"10.1111\/j.1538-7836.2008.03002.x","volume":"6","author":"SR Kahn","year":"2008","unstructured":"Kahn SR, Shbaklo H, Lamping DL, et al. Determinants of health-related quality of life during the 2 years following deep vein thrombosis. J Thromb Haemost. 2008;6(7):1105\u201312.","journal-title":"J Thromb Haemost"},{"issue":"1","key":"1335_CR4","doi-asserted-by":"publisher","first-page":"118","DOI":"10.1097\/01.sla.0000103067.10695.74","volume":"239","author":"KT Delis","year":"2004","unstructured":"Delis KT, Bountouroglou D, Mansfield AO. Venous claudication in iliofemoral thrombosis: long-term effects on venous hemodynamics, clinical status, and quality of life. Ann Surg. 2004;239(1):118\u201326. https:\/\/doi.org\/10.1097\/01.sla.0000103067.10695.74.","journal-title":"Ann Surg"},{"issue":"5","key":"1335_CR5","doi-asserted-by":"publisher","first-page":"565","DOI":"10.1016\/j.ejvs.2014.05.001","volume":"48","author":"SK Kakkos","year":"2014","unstructured":"Kakkos SK, Kirkilesis GI, Tsolakis IA. Editor\u2019s choice - efficacy and safety of the new oral anticoagulants dabigatran, rivaroxaban, apixaban, and edoxaban in the treatment and secondary prevention of venous thromboembolism: a systematic review and meta-analysis of phase III trials. Eur J Vasc Endovasc Surg. 2014;48(5):565\u201375. https:\/\/doi.org\/10.1016\/j.ejvs.2014.05.001.","journal-title":"Eur J Vasc Endovasc Surg"},{"issue":"3Part A","key":"1335_CR6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jscai.2024.101307","volume":"3","author":"MB Bisharat","year":"2024","unstructured":"Bisharat MB, Ichinose EJ, Veerina KK, et al. One-year clinical outcomes following mechanical thrombectomy for deep vein thrombosis: a CLOUT registry analysis. J Soc Cardiovasc Angiogr Interv. 2024;3(3Part A):101307. https:\/\/doi.org\/10.1016\/j.jscai.2024.101307.","journal-title":"J Soc Cardiovasc Angiogr Interv"},{"issue":"2","key":"1335_CR7","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1016\/j.jvsv.2018.09.015","volume":"7","author":"R Lopez","year":"2019","unstructured":"Lopez R, DeMartino R, Fleming M, Bjarnason H, Neisen M. Aspiration thrombectomy for acute iliofemoral or central deep venous thrombosis. J Vasc Surg Venous Lymphat Disord. 2019;7(2):162\u20138. https:\/\/doi.org\/10.1016\/j.jvsv.2018.09.015.","journal-title":"J Vasc Surg Venous Lymphat Disord"},{"issue":"23","key":"1335_CR8","doi-asserted-by":"publisher","first-page":"2240","DOI":"10.1056\/NEJMoa1615066","volume":"377","author":"S Vedantham","year":"2017","unstructured":"Vedantham S, Goldhaber SZ, Julian JA, et al. Pharmacomechanical catheter-directed thrombolysis for deep-vein thrombosis. N Engl J Med. 2017;377(23):2240\u201352. https:\/\/doi.org\/10.1056\/NEJMoa1615066.","journal-title":"N Engl J Med"},{"issue":"1","key":"1335_CR9","doi-asserted-by":"publisher","first-page":"e40","DOI":"10.1016\/S2352-3026(19)30209-1","volume":"7","author":"P Notten","year":"2020","unstructured":"Notten P, Ten Cate-Hoek AJ, Arnoldussen C, et al. Ultrasound-accelerated catheter-directed thrombolysis versus anticoagulation for the prevention of post-thrombotic syndrome (CAVA): a single-blind, multicentre, randomised trial. Lancet Haematol. 2020;7(1):e40\u20139. https:\/\/doi.org\/10.1016\/S2352-3026(19)30209-1.","journal-title":"Lancet Haematol"},{"issue":"9810","key":"1335_CR10","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1016\/S0140-6736(11)61753-4","volume":"379","author":"T Enden","year":"2012","unstructured":"Enden T, Haig Y, Klow NE, et al. Long-term outcome after additional catheter-directed thrombolysis versus standard treatment for acute iliofemoral deep vein thrombosis (the CaVenT study): a randomised controlled trial. Lancet. 2012;379(9810):31\u20138. https:\/\/doi.org\/10.1016\/S0140-6736(11)61753-4.","journal-title":"Lancet"},{"issue":"2","key":"1335_CR11","doi-asserted-by":"publisher","first-page":"e64","DOI":"10.1016\/S2352-3026(15)00248-3","volume":"3","author":"Y Haig","year":"2016","unstructured":"Haig Y, Enden T, Grotta O, et al. Post-thrombotic syndrome after catheter-directed thrombolysis for deep vein thrombosis (CaVenT): 5-year follow-up results of an open-label, randomised controlled trial. Lancet Haematol. 2016;3(2):e64-71. https:\/\/doi.org\/10.1016\/S2352-3026(15)00248-3.","journal-title":"Lancet Haematol"},{"key":"1335_CR12","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-25-1144","author":"Y Tamura","year":"2025","unstructured":"Tamura Y, Kusunose K, Yamashita Y, et al. JCS\/JPCPHS 2025 guideline on pulmonary hypertension and pulmonary embolism\/deep vein thrombosis. Circ J. 2025. https:\/\/doi.org\/10.1253\/circj.CJ-25-1144.","journal-title":"Circ J"},{"issue":"10","key":"1335_CR13","doi-asserted-by":"publisher","first-page":"2471","DOI":"10.1253\/circj.cj-12-0091","volume":"76","author":"A Niwa","year":"2012","unstructured":"Niwa A, Nakamura M, Harada N, Musha T. Observational investigation of thrombolysis with the tissue-type plasminogen activator monteplase for acute pulmonary embolism in Japan. Circ J. 2012;76(10):2471\u201380. https:\/\/doi.org\/10.1253\/circj.cj-12-0091.","journal-title":"Circ J"},{"issue":"16","key":"1335_CR14","doi-asserted-by":"publisher","first-page":"1788","DOI":"10.1161\/CIR.0b013e318214914f","volume":"123","author":"MR Jaff","year":"2011","unstructured":"Jaff MR, McMurtry MS, Archer SL, et al. Management of massive and submassive pulmonary embolism, iliofemoral deep vein thrombosis, and chronic thromboembolic pulmonary hypertension: a scientific statement from the American Heart Association. Circulation. 2011;123(16):1788\u2013830. https:\/\/doi.org\/10.1161\/CIR.0b013e318214914f.","journal-title":"Circulation"},{"issue":"3","key":"1335_CR15","doi-asserted-by":"publisher","first-page":"534","DOI":"10.1111\/jth.14707","volume":"18","author":"MM Harbin","year":"2020","unstructured":"Harbin MM, Lutsey PL. May-Thurner syndrome: history of understanding and need for defining population prevalence. J Thromb Haemost. 2020;18(3):534\u201342. https:\/\/doi.org\/10.1111\/jth.14707.","journal-title":"J Thromb Haemost"},{"key":"1335_CR16","unstructured":"Eisai Co. L. Cleactor for i.v. Inj 400,000 and Cleactor for i.v. Inj 800,000 (Monteplase (genetical recombination) preparation). Eisai Co., Ltd. Updated Sep 2019. Accessed July 23, 2026. https:\/\/medical2.eisai.jp\/fileviewer\/pdf_downloader.php?access_key=36iif7ueoy#toolbar=0"},{"issue":"3","key":"1335_CR17","doi-asserted-by":"publisher","first-page":"551","DOI":"10.3999\/jscpt.25.551","volume":"25","author":"A Ohnishi","year":"1994","unstructured":"Ohnishi A, Takazawa K, Fujita M, et al. Phase I Study of the Modified Tissue Plasminogen Activator E 6010 [in Japanese]. J Clin Pharmacol Ther. 1994;25(3):551\u201362. https:\/\/doi.org\/10.3999\/jscpt.25.551.","journal-title":"J Clin Pharmacol Ther"},{"issue":"6","key":"1335_CR18","doi-asserted-by":"publisher","first-page":"e545","DOI":"10.1016\/j.chest.2021.07.055","volume":"160","author":"SM Stevens","year":"2021","unstructured":"Stevens SM, Woller SC, Kreuziger LB, et al. Antithrombotic Therapy for VTE Disease: Second Update of the CHEST Guideline and Expert Panel Report. Chest. 2021;160(6):e545\u2013608. https:\/\/doi.org\/10.1016\/j.chest.2021.07.055.","journal-title":"Chest"},{"key":"1335_CR19","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01647-2019","author":"SV Konstantinides","year":"2019","unstructured":"Konstantinides SV, Meyer G, Becattini C, et al. 2019 ESC guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS): the task force for the diagnosis and management of acute pulmonary embolism of the European Society of Cardiology (ESC). Eur Respir J. 2019. https:\/\/doi.org\/10.1183\/13993003.01647-2019.","journal-title":"Eur Respir J"},{"key":"1335_CR20","unstructured":"Villalta S BP, Piccioli A, Lensing A, Prins M, Prandoni P. Assessment of validity and reproducibility of a clinical scale for the post-thrombotic syndrome. Haemostasis. 1994;24(supple 1):158a."},{"issue":"5","key":"1335_CR21","doi-asserted-by":"publisher","first-page":"879","DOI":"10.1111\/j.1538-7836.2009.03294.x","volume":"7","author":"SR Kahn","year":"2009","unstructured":"Kahn SR, Partsch H, Vedantham S, et al. Definition of post-thrombotic syndrome of the leg for use in clinical investigations: a recommendation for standardization. J Thromb Haemost. 2009;7(5):879\u201383.","journal-title":"J Thromb Haemost"},{"issue":"5","key":"1335_CR22","doi-asserted-by":"publisher","first-page":"1387","DOI":"10.1016\/j.jvs.2010.06.161","volume":"52","author":"MA Vasquez","year":"2010","unstructured":"Vasquez MA, Rabe E, McLafferty RB, et al. Revision of the venous clinical severity score: venous outcomes consensus statement: special communication of the American Venous Forum Ad Hoc Outcomes Working Group. J Vasc Surg. 2010;52(5):1387\u201396. https:\/\/doi.org\/10.1016\/j.jvs.2010.06.161.","journal-title":"J Vasc Surg"},{"key":"1335_CR23","doi-asserted-by":"crossref","unstructured":"Schulman S, Kearon C, Subcommittee on Control of Anticoagulation of the S, Standardization Committee of the International Society on T, Haemostasis. Definition of major bleeding in clinical investigations of antihemostatic medicinal products in non-surgical patients. J Thromb Haemost. Apr 2005;3(4):692\u20134","DOI":"10.1111\/j.1538-7836.2005.01204.x"},{"issue":"8","key":"1335_CR24","doi-asserted-by":"publisher","first-page":"1115","DOI":"10.1007\/s00270-016-1367-5","volume":"39","author":"VY Tichelaar","year":"2016","unstructured":"Tichelaar VY, Brodin EE, Vik A, et al. A retrospective comparison of ultrasound-assisted catheter-directed thrombolysis and catheter-directed thrombolysis alone for treatment of proximal deep vein thrombosis. Cardiovasc Intervent Radiol. 2016;39(8):1115\u201321. https:\/\/doi.org\/10.1007\/s00270-016-1367-5.","journal-title":"Cardiovasc Intervent Radiol"},{"issue":"5","key":"1335_CR25","first-page":"1018","volume":"89","author":"VJ Marder","year":"1977","unstructured":"Marder VJ, Soulen RL, Atichartakarn V, et al. Quantitative venographic assessment of deep vein thrombosis in the evaluation of streptokinase and heparin therapy. J Lab Clin Med. 1977;89(5):1018\u201329.","journal-title":"J Lab Clin Med"},{"issue":"2","key":"1335_CR26","doi-asserted-by":"publisher","first-page":"410","DOI":"10.1067\/mva.2003.152","volume":"37","author":"DL Lamping","year":"2003","unstructured":"Lamping DL, Schroter S, Kurz X, Kahn SR, Abenhaim L. Evaluation of outcomes in chronic venous disorders of the leg: development of a scientifically rigorous, patient-reported measure of symptoms and quality of life. J Vasc Surg. 2003;37(2):410\u20139. https:\/\/doi.org\/10.1067\/mva.2003.152.","journal-title":"J Vasc Surg"},{"issue":"1","key":"1335_CR27","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1016\/s0002-9343(00)00380-6","volume":"109","author":"M Verstraete","year":"2000","unstructured":"Verstraete M. Third-generation thrombolytic drugs. Am J Med. 2000;109(1):52\u20138. https:\/\/doi.org\/10.1016\/s0002-9343(00)00380-6.","journal-title":"Am J Med"},{"issue":"7","key":"1335_CR28","doi-asserted-by":"publisher","first-page":"1447","DOI":"10.1016\/S0735-1097(97)00074-0","volume":"29","author":"C Kawai","year":"1997","unstructured":"Kawai C, Yui Y, Hosoda S, et al. A prospective, randomized, double-blind multicenter trial of a single bolus injection of the novel modified t-PA E6010 in the treatment of acute myocardial infarction: comparison with native t-PA. E6010 study group. J Am Coll Cardiol. 1997;29(7):1447\u201353.","journal-title":"J Am Coll Cardiol."},{"issue":"2","key":"1335_CR29","doi-asserted-by":"publisher","first-page":"184","DOI":"10.1016\/s0002-9149(97)00315-9","volume":"80","author":"LB Daniels","year":"1997","unstructured":"Daniels LB, Parker JA, Patel SR, Grodstein F, Goldhaber SZ. Relation of duration of symptoms with response to thrombolytic therapy in pulmonary embolism. Am J Cardiol. 1997;80(2):184\u20138. https:\/\/doi.org\/10.1016\/s0002-9149(97)00315-9.","journal-title":"Am J Cardiol"},{"issue":"2","key":"1335_CR30","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1016\/j.amjcard.2012.09.027","volume":"111","author":"M Sharifi","year":"2013","unstructured":"Sharifi M, Bay C, Skrocki L, Rahimi F, Mehdipour M, Investigators M. Moderate pulmonary embolism treated with thrombolysis (from the \u201cMOPETT\u201d Trial). Am J Cardiol. 2013;111(2):273\u20137. https:\/\/doi.org\/10.1016\/j.amjcard.2012.09.027.","journal-title":"Am J Cardiol"},{"issue":"2","key":"1335_CR31","doi-asserted-by":"publisher","first-page":"254","DOI":"10.1378\/chest.09-0765","volume":"137","author":"C Wang","year":"2010","unstructured":"Wang C, Zhai Z, Yang Y, et al. Efficacy and safety of low dose recombinant tissue-type plasminogen activator for the treatment of acute pulmonary thromboembolism: a randomized, multicenter, controlled trial. Chest. 2010;137(2):254\u201362. https:\/\/doi.org\/10.1378\/chest.09-0765.","journal-title":"Chest"},{"issue":"2","key":"1335_CR32","doi-asserted-by":"publisher","first-page":"204","DOI":"10.1016\/j.ejvs.2005.08.010","volume":"31","author":"N Yamada","year":"2006","unstructured":"Yamada N, Ishikura K, Ota S, et al. Pulse-spray pharmacomechanical thrombolysis for proximal deep vein thrombosis. Eur J Vasc Endovasc Surg. 2006;31(2):204\u201311. https:\/\/doi.org\/10.1016\/j.ejvs.2005.08.010.","journal-title":"Eur J Vasc Endovasc Surg"},{"issue":"6","key":"1335_CR33","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1024\/0301-1526\/a001211","volume":"54","author":"O Schlager","year":"2025","unstructured":"Schlager O, Campello E, Madaric J, et al. 2025 ESVM Guidelines on interventional treatment of venous thromboembolism. Vasa. 2025;54(6):365\u201381. https:\/\/doi.org\/10.1024\/0301-1526\/a001211.","journal-title":"Vasa"},{"key":"1335_CR34","unstructured":"Japanese Society of Interventional Radiology, Japanese Association of Cardiovascular Intervention and Therapeutics, Japanese Society for Vascular Surgery, Japanese Society of Phlebology. Appropriate Use Guidance for Thrombectomy Devices for Deep Vein Thrombosis [in Japanese]. Updated Jan 1, 2026. Accessed July 23, 2026. https:\/\/www.cvit.jp\/docs\/about\/committee\/device\/index\/guideline-thrombus_removal.pdf?ver=260121"}],"container-title":["Cardiovascular Intervention and Therapeutics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12928-026-01335-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s12928-026-01335-6","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12928-026-01335-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T15:26:12Z","timestamp":1786980372000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s12928-026-01335-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,17]]},"references-count":34,"alternative-id":["1335"],"URL":"https:\/\/doi.org\/10.1007\/s12928-026-01335-6","relation":{},"ISSN":["1868-4300","1868-4297"],"issn-type":[{"value":"1868-4300","type":"print"},{"value":"1868-4297","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,17]]},"assertion":[{"value":"27 June 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 August 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 August 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"All authors declare that they have no conflicts of interest relevant to the content of this article.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}}]}}