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Natalie Patzlaff, Scott Seaman, and Meredith Broderick are employees of United Therapeutics Corporation. Daniel Lachant is a site PI for ADVANCE (United Therapeutics Corporation) and reports financial support from Merck and Co. Inc. George Giannakoulas reports personal lecture\/advisory fees from Actelion\/Janssen, ELPEN Pharmaceuticals, Ferrer, Galenica, GossamerBio, GlaxoSmithKline, MSD, and United Therapeutics Corporation. Zeenat Safdar is a speaker and consultant for United Therapeutics Corporation, Johnson & Johnson, Boehringer Ingelheim,\u00a0and Merck.","order":1,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"An independent ethics committee (Office for Research Ethics Committees Northern Ireland) approved the study protocol (EudraCT Number:\u00a02017-002639-40). 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