{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T03:57:37Z","timestamp":1769227057182,"version":"3.49.0"},"reference-count":40,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2024,11,15]],"date-time":"2024-11-15T00:00:00Z","timestamp":1731628800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,11,15]],"date-time":"2024-11-15T00:00:00Z","timestamp":1731628800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100006752","name":"Universidade do Porto","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100006752","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Public Health (Berl.)"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n              <jats:title>Background<\/jats:title>\n              <jats:p>Stone quarry workers and others exposed to silica are especially vulnerable to tuberculosis (TB). Silicosis is a known risk factor for TB disease, but other common comorbidities and habits such as diabetes and alcohol and tobacco consumption may increase risk. We aimed to estimate the risk of TB infection among stone quarry workers and to identify associated factors.<\/jats:p>\n            <\/jats:sec><jats:sec>\n              <jats:title>Methods<\/jats:title>\n              <jats:p>An annual TB infection screening strategy using interferon-gamma release assay (IGRA) was implemented in 2018 for quarry workers in two high-incidence municipalities in Portugal. Workers with a first negative IGRA test were followed up and stratified by age group, preconditions including silicosis, diabetes and hypertension, and alcohol and tobacco abuse. Incidence rates and adjusted risks for TB infection were quantified using Cox regression hazard rates.<\/jats:p>\n            <\/jats:sec><jats:sec>\n              <jats:title>Result<\/jats:title>\n              <jats:p>From 2018 to 2022, 997 stone quarry workers were screened for TB. Of those, 347 were negative in their first and performed at least one additional IGRA test, being included in the analysis. The overall rate of infection was 3.2 per 100 person-year. Silicosis, diabetes, and age above 45\u00a0years were independent risk factors for TB infection [adjusted hazard ratio (aHR) 2.9 (95% CI: 1.4\u20135.9), 2.9 (1.1\u20137.7), and 2.73 (1.1\u20136.6) respectively].<\/jats:p>\n            <\/jats:sec><jats:sec>\n              <jats:title>Conclusions<\/jats:title>\n              <jats:p>Silicosis and diabetes seem to be independent risk factors for TB infection and should be targeted to reduce the burden of TB further. We suggest periodic screening of TB infection in people with silicosis, but more broadly in all those exposed to silica, especially if they also have other comorbidities such as diabetes.<\/jats:p>\n            <\/jats:sec>","DOI":"10.1007\/s10389-024-02367-z","type":"journal-article","created":{"date-parts":[[2024,11,15]],"date-time":"2024-11-15T01:37:16Z","timestamp":1731634636000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Enhancing tuberculosis surveillance in quarry workers: identifying vulnerable subgroups"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1178-693X","authenticated-orcid":false,"given":"Sofia","family":"Sousa","sequence":"first","affiliation":[]},{"given":"Carlos","family":"Carvalho","sequence":"additional","affiliation":[]},{"given":"Catarina Magalh\u00e3es","family":"Alves","sequence":"additional","affiliation":[]},{"given":"Sofia","family":"Santos","sequence":"additional","affiliation":[]},{"given":"Guilherme","family":"Gon\u00e7alves","sequence":"additional","affiliation":[]},{"given":"Raquel","family":"Duarte","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2024,11,15]]},"reference":[{"issue":"2","key":"2367_CR1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1136\/bmjopen-2017-016961","volume":"8","author":"A Ahmed","year":"2018","unstructured":"Ahmed A, Mekonnen D, Shiferaw AM, Belayneh F, Yenit MK (2018) Incidence and determinants of tuberculosis infection among adult patients with HIV attending HIV care in north-east Ethiopia: a retrospective cohort study. BMJ Open 8(2):1\u201314. https:\/\/doi.org\/10.1136\/bmjopen-2017-016961","journal-title":"BMJ Open"},{"issue":"11","key":"2367_CR2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1371\/journal.pone.0187967","volume":"12","author":"RH Al-Rifai","year":"2017","unstructured":"Al-Rifai RH, Pearson F, Critchley JA, Abu-Raddad LJ (2017) Association between diabetes mellitus and active tuberculosis: a systematic review and meta-analysis. PLoS ONE 12(11):1\u201326. https:\/\/doi.org\/10.1371\/journal.pone.0187967","journal-title":"PLoS ONE"},{"issue":"2","key":"2367_CR3","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1164\/rccm.202011-4239PP","volume":"204","author":"MA Behr","year":"2021","unstructured":"Behr MA, Kaufmann E, Duffin J, Edelstein PH, Ramakrishnan L (2021) Latent tuberculosis: two centuries of confusion. Am J Respir Crit Care Med 204(2):142\u2013148. https:\/\/doi.org\/10.1164\/rccm.202011-4239PP","journal-title":"Am J Respir Crit Care Med"},{"key":"2367_CR4","doi-asserted-by":"publisher","unstructured":"Chen C, Martinez L, Xu B (2023) Factors for the progression from latent tuberculosis infection to tuberculosis disease. Front Cell Infect Microbiol 13:1225259. https:\/\/doi.org\/10.3389\/fcimb.2023.1225259","DOI":"10.3389\/fcimb.2023.1225259"},{"issue":"4","key":"2367_CR5","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1056\/nejmoa1214289","volume":"370","author":"GJ Churchyard","year":"2014","unstructured":"Churchyard GJ, Fielding KL, Lewis JJ, Coetzee L, Corbett EL, Godfrey-Faussett P, Hayes RJ, Chaisson RE, Grant AD (2014) A trial of mass isoniazid preventive therapy for tuberculosis control. N Engl J Med 370(4):301\u2013310. https:\/\/doi.org\/10.1056\/nejmoa1214289","journal-title":"N Engl J Med"},{"issue":"7","key":"2367_CR6","doi-asserted-by":"publisher","first-page":"820","DOI":"10.1016\/j.ajic.2022.01.021","volume":"50","author":"EH da Silva","year":"2022","unstructured":"da Silva EH, Lima E, Dos Santos TR, Padoveze MC (2022) Prevalence and incidence of tuberculosis in health workers: a systematic review of the literature. Am J Infect Control 50(7):820\u2013827. https:\/\/doi.org\/10.1016\/j.ajic.2022.01.021","journal-title":"Am J Infect Control"},{"key":"2367_CR7","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1016\/j.ijid.2022.05.029","volume":"122","author":"C Ding","year":"2022","unstructured":"Ding C, Hu M, Guo W, Hu W, Li X, Wang S, Shangguan Y, Zhang Y, Yang S, Xu K (2022) Prevalence trends of latent tuberculosis infection at the global, regional, and country levels from 1990\u20132019. Int J Infect Dis 122:46\u201362. https:\/\/doi.org\/10.1016\/j.ijid.2022.05.029","journal-title":"Int J Infect Dis"},{"key":"2367_CR8","unstructured":"Dire\u00e7\u00e3o-Geral da Sa\u00fade (2023) Relat\u00f3rio de vigil\u00e2ncia e monitoriza\u00e7\u00e3o da tuberculose em Portugal \u2014 dados definitivos 2021. Minist\u00e9rio da Sa\u00fade, Lisbon"},{"issue":"1","key":"2367_CR9","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/2193-1801-2-222","volume":"2","author":"Y Dong","year":"2013","unstructured":"Dong Y, Peng CYJ (2013) Principled missing data methods for researchers. Springerplus 2(1):1\u201317. https:\/\/doi.org\/10.1186\/2193-1801-2-222","journal-title":"Springerplus"},{"issue":"2","key":"2367_CR10","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1016\/j.rppnen.2017.11.003","volume":"24","author":"R Duarte","year":"2018","unstructured":"Duarte R, L\u00f6nnroth K, Carvalho C, Lima F, Carvalho ACC, Mu\u00f1oz-Torrico M, Centis R (2018) Tuberculosis, social determinants and co-morbidities (including HIV). Pulmonology 24(2):115\u2013119. https:\/\/doi.org\/10.1016\/j.rppnen.2017.11.003","journal-title":"Pulmonology"},{"issue":"1","key":"2367_CR11","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12889-021-10711-1","volume":"21","author":"R Ehrlich","year":"2021","unstructured":"Ehrlich R, Akugizibwe P, Siegfried N, Rees D (2021) The association between silica exposure, silicosis and tuberculosis: a systematic review and meta-analysis. BMC Public Health 21(1):1\u201318. https:\/\/doi.org\/10.1186\/s12889-021-10711-1","journal-title":"BMC Public Health"},{"key":"2367_CR12","doi-asserted-by":"publisher","unstructured":"European Centre for Disease Prevention and Control, Cai R, Vanhommerig J, Vonk Noordegraaf-Schouten M (2018) Mathematical modelling of programmatic screening strategies for latent tuberculosis infection in countries with low tuberculosis incidence. European Centre for Disease Prevention and Control, Stockholm. https:\/\/doi.org\/10.2900\/303841","DOI":"10.2900\/303841"},{"issue":"12","key":"2367_CR13","doi-asserted-by":"publisher","first-page":"e1274","DOI":"10.1016\/S2214-109X(18)30313-9","volume":"6","author":"P Gottesfeld","year":"2018","unstructured":"Gottesfeld P, Reid M, Goosby E (2018) Preventing tuberculosis among high-risk workers. Lancet Glob Health 6(12):e1274\u2013e1275. https:\/\/doi.org\/10.1016\/S2214-109X(18)30313-9","journal-title":"Lancet Glob Health"},{"key":"2367_CR14","doi-asserted-by":"publisher","unstructured":"Jamshidi P, Danaei B, Arbabi M, Mohammadzadeh B, Khelghati F, Akbari Aghababa A, Nayebzade A, Shahidi Bonjar AH, Centis R, Sotgiu G, Nasiri MJ, Migliori GB (2023) Silicosis and tuberculosis: a systematic review and meta-analysis. Pulmonology June 2023:S2531-0437(23)00092-2. https:\/\/doi.org\/10.1016\/j.pulmoe.2023.05.001","DOI":"10.1016\/j.pulmoe.2023.05.001"},{"key":"2367_CR15","doi-asserted-by":"publisher","unstructured":"Kawatsu L, Yoshiyama T, Kato S (2021) Tuberculosis in the elderly. In Migliori GB, Raviglione MC (eds.) Essential tuberculosis. Springer, Cham, pp 253\u2013258. https:\/\/doi.org\/10.1007\/978-3-030-66703-0_28","DOI":"10.1007\/978-3-030-66703-0_28"},{"key":"2367_CR16","doi-asserted-by":"publisher","unstructured":"Kone\u010dn\u00fd P, Ehrlich R, Gulumian M, Jacobs M (2019) Immunity to the dual threat of silica exposure and mycobacterium tuberculosis. Front Immunol 9:3069. https:\/\/doi.org\/10.3389\/fimmu.2018.03069","DOI":"10.3389\/fimmu.2018.03069"},{"key":"2367_CR17","unstructured":"Krishna S, Jacob JJ, Feingold KR, et al (2000) Diabetes mellitus and tuberculosis. Endotext: MDText.com, Inc., South Dartmouth, MA"},{"issue":"6","key":"2367_CR18","doi-asserted-by":"publisher","first-page":"719","DOI":"10.1093\/cid\/ciw836","volume":"64","author":"MR Lee","year":"2017","unstructured":"Lee MR, Huang YP, Kuo YT, Luo CH, Shih YJ, Shu CC, Wang JY, Ko JC, Yu CJ, Lin HH (2017) Diabetes mellitus and latent tuberculosis infection: a systemic review and metaanalysis. Clin Infect Dis 64(6):719\u2013727. https:\/\/doi.org\/10.1093\/cid\/ciw836","journal-title":"Clin Infect Dis"},{"issue":"1","key":"2367_CR19","doi-asserted-by":"publisher","first-page":"340","DOI":"10.1186\/1471-2334-14-340","volume":"14","author":"JS Lopes","year":"2014","unstructured":"Lopes JS, Rodrigues P, Pinho ST, Andrade RF, Duarte R, Gomes MGM (2014) Interpreting measures of tuberculosis transmission: a case study on the Portuguese population. BMC Infect Dis 14(1):340. https:\/\/doi.org\/10.1186\/1471-2334-14-340","journal-title":"BMC Infect Dis"},{"issue":"24","key":"2367_CR20","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1161\/JAHA.120.019144","volume":"9","author":"E Mandieka","year":"2020","unstructured":"Mandieka E, Saleh D, Chokshi AK, Rivera AS, Feinstein MJ (2020) Latent tuberculosis infection and elevated incidence of hypertension. J Am Heart Assoc 9(24):9\u201311. https:\/\/doi.org\/10.1161\/JAHA.120.019144","journal-title":"J Am Heart Assoc"},{"key":"2367_CR21","doi-asserted-by":"publisher","unstructured":"Nagao T, Nogawa K, Sakata K, Morimoto H, Morita K, Watanabe Y, Suwazono Y (2021) Effects of alcohol consumption and smoking on the onset of hypertension in a long-term longitudinal study in a male workers\u2019 cohort. Int J Environ Res Public Health 18(22). https:\/\/doi.org\/10.3390\/ijerph182211781","DOI":"10.3390\/ijerph182211781"},{"issue":"8","key":"2367_CR22","doi-asserted-by":"publisher","first-page":"818","DOI":"10.1016\/j.jiac.2020.03.020","volume":"26","author":"T Nishimura","year":"2020","unstructured":"Nishimura T, Ota M, Mori M, Takano Y, Fujiwara H, Uwamino Y, Uno S, Hasegawa N (2020) The annual risk of tuberculosis infection in newly hired researchers and healthcare workers using interferon-gamma release assay in Japan. J Infect Chemother 26(8):818\u2013822. https:\/\/doi.org\/10.1016\/j.jiac.2020.03.020","journal-title":"J Infect Chemother"},{"key":"2367_CR23","unstructured":"Programa Nacional para a Tuberculose (2020) Manual de Tuberculose e Micobact\u00e9rias n\u00e3o tuberculosas. Minist\u00e9rio da Sa\u00fade, Lisbon"},{"key":"2367_CR24","unstructured":"Programa Nacional para a Tuberculose (2021) Relat\u00f3rio de Vigil\u00e2ncia e Monitoriza\u00e7\u00e3o da Tuberculose em Portugal - Dados definitivos 2020. Dire\u00e7\u00e3o-Geral Da Sa\u00fade, Lisbon, pp 1\u201352.\u00a0Available at: https:\/\/www.dgs.pt\/portal-da-estatistica-dasaude\/diretorio-de-informacao\/diretorio-de-informacao\/por-serie-1252619-pdf.aspx?v=%3d%3dDwAAAB%2bLCAAAAAAABAArySzItzVUy81MsTU1MDAFAHzFEfkPAAAA. Accessed June 2024"},{"issue":"1","key":"2367_CR25","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12889-022-12799-5","volume":"22","author":"Z Qin","year":"2022","unstructured":"Qin Z, Li C, Qi S, Zhou H, Wu J, Wang W, Ye Q, Yang H, Wang C, Hong X (2022) Association of socioeconomic status with hypertension prevalence and control in Nanjing: a cross-sectional study. BMC Public Health 22(1):1\u20139. https:\/\/doi.org\/10.1186\/s12889-022-12799-5","journal-title":"BMC Public Health"},{"issue":"1","key":"2367_CR26","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12889-017-4471-9","volume":"17","author":"L Raposo","year":"2017","unstructured":"Raposo L, Severo M, Barros H, Santos AC (2017) The prevalence of the metabolic syndrome in Portugal: The PORMETS study. BMC Public Health 17(1):1\u20139. https:\/\/doi.org\/10.1186\/s12889-017-4471-9","journal-title":"BMC Public Health"},{"issue":"1","key":"2367_CR27","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s13690-023-01189-x","volume":"81","author":"MP Rupani","year":"2023","unstructured":"Rupani MP (2023) Silicosis as a predictor of tuberculosis mortality and treatment failure and need for incorporation in differentiated TB care models in India. Archives of Public Health 81(1):1\u20139. https:\/\/doi.org\/10.1186\/s13690-023-01189-x","journal-title":"Archives of Public Health"},{"issue":"April","key":"2367_CR28","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1016\/j.abst.2023.04.001","volume":"5","author":"B Sarkar","year":"2023","unstructured":"Sarkar B, Sarkar K, Sarkar R (2023) Potential consequences of screening of occupational silica dust exposed workers for early detection of silicosis\/silico-tuberculosis using a novel biomarker, club cell protein-16, with possible intervention by repurposing metformin. Adv Biomarker Sci Technol 5(April):33\u201337. https:\/\/doi.org\/10.1016\/j.abst.2023.04.001","journal-title":"Adv Biomarker Sci Technol"},{"key":"2367_CR29","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1016\/j.ijid.2016.12.016","volume":"56","author":"AB Seegert","year":"2017","unstructured":"Seegert AB, Rudolf F, Wejse C, Neupane D (2017) Tuberculosis and hypertension\u2014a systematic review of the literature. Int J Infect Dis 56:54\u201361. https:\/\/doi.org\/10.1016\/j.ijid.2016.12.016","journal-title":"Int J Infect Dis"},{"key":"2367_CR31","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1016\/j.pulmoe.2023.04.007","volume":"30","author":"S Sousa","year":"2024","unstructured":"Sousa S, Macedo R, Alves CM, Carvalho C, Gon\u00e7alves G, Duarte R (2024) Coffee shops, a hub for TB clusters? Pulmonology 30:71\u201374. https:\/\/doi.org\/10.1016\/j.pulmoe.2023.04.007","journal-title":"Pulmonology"},{"key":"2367_CR32","unstructured":"Sousa S, Alves CM, Carvalho C, Marques F, Correia AM, Duarte R (2019) Compendium of good practices in the implementation of the Tuberculosis Action Plan for the WHO European Region 2016\u20132020. World Health Organization, Geneva, pp 7\u201311"},{"key":"2367_CR33","doi-asserted-by":"publisher","unstructured":"World Health Organization (2020) WHO consolidated guidelines on tuberculosis. Module 1: Prevention. Tuberculosis preventive treatment. World Health Organization, Geneva. https:\/\/doi.org\/10.30978\/tb2021-2-86.\u00a0Accessed June 2024","DOI":"10.30978\/tb2021-2-86"},{"key":"2367_CR34","unstructured":"World Health Organization (2021a) WHO consolidated guidelines on tuberculosis. Module 2: Systematic screening for tuberculosis. World Health Organization, Geneva"},{"key":"2367_CR35","unstructured":"World Health Organization (2021b) Operational handbook on tuberculosis. In Module 2: Systematic screening for tuberculosis disease.World Health Organization, Geneva. https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/340256\/9789240022614-eng.pdf.\u00a0Accessed June 2024"},{"key":"2367_CR36","unstructured":"World Health Organization (2022) Global tuberculosis report 2022 (Vol. 4, Issue 1). World Health Organization, Geneva"},{"issue":"1","key":"2367_CR37","doi-asserted-by":"publisher","first-page":"1657","DOI":"10.1080\/07853890.2022.2085318","volume":"54","author":"Q Wu","year":"2022","unstructured":"Wu Q, Liu Y, Ma YB, Liu K, Chen SH (2022) Incidence and prevalence of pulmonary tuberculosis among patients with type 2 diabetes mellitus: a systematic review and meta-analysis. Ann Med 54(1):1657\u20131666. https:\/\/doi.org\/10.1080\/07853890.2022.2085318","journal-title":"Ann Med"},{"key":"2367_CR38","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1016\/j.ijid.2019.11.023","volume":"91","author":"Q Yang","year":"2020","unstructured":"Yang Q, Ruan Q, Liu X, Shen Y, Jiang T, Wu J, Cai L, Pan K, Lin M, Huang X, Shao L, Zhang W (2020) Preventive tuberculosis treatment effect on QuantiFERON TB-Gold in-tube testing in a high tuberculosis-endemic country: a clinical trial. Int J Infect Dis 91:182\u2013187. https:\/\/doi.org\/10.1016\/j.ijid.2019.11.023","journal-title":"Int J Infect Dis"},{"key":"2367_CR39","doi-asserted-by":"publisher","unstructured":"Yang Q, Lin M, He Z, Liu X, Xu Y, Wu J, Sun F, Jiang T, Gao Y, Huang X, Zhang W, Ruan Q, Shao L (2022) Mycobacterium tuberculosis Infection among 1,659 Silicosis Patients in Zhejiang Province, China. Microbiol Spectr 10(6):e0145122. https:\/\/doi.org\/10.1128\/spectrum.01451-22","DOI":"10.1128\/spectrum.01451-22"},{"issue":"2","key":"2367_CR40","first-page":"34","volume":"12","author":"A Yarahmadi","year":"2013","unstructured":"Yarahmadi A, Zahmatkesh MM, Ghaffari M, Mohammadi S, Labbafinejad Y, Seyedmehdi SM, Nojomi M, Attarchi M (2013) Correlation between silica exposure and risk of tuberculosis in Lorestan Province of Iran. Tanaffos 12(2):34\u201340","journal-title":"Tanaffos"},{"key":"2367_CR41","doi-asserted-by":"publisher","unstructured":"Yew WW, Leung CC, Chang KC, Zhang Y, Chan DP (2019) Can treatment outcomes of latent TB infection and TB in silicosis be improved? J Thoracic Dis 11(1):E8\u2013E10. https:\/\/doi.org\/10.21037\/jtd.2018.12.113","DOI":"10.21037\/jtd.2018.12.113"}],"container-title":["Journal of Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10389-024-02367-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10389-024-02367-z\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10389-024-02367-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,15]],"date-time":"2024-11-15T02:03:47Z","timestamp":1731636227000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10389-024-02367-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,15]]},"references-count":40,"alternative-id":["2367"],"URL":"https:\/\/doi.org\/10.1007\/s10389-024-02367-z","relation":{},"ISSN":["2198-1833","1613-2238"],"issn-type":[{"value":"2198-1833","type":"print"},{"value":"1613-2238","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,15]]},"assertion":[{"value":"22 July 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 November 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 November 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethical approval for this study was granted by the Ethics Boards of the Northern Regional Health Administration (41\/2018). Participants have given consent for their data to be used in the research.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors have no conflicts of interest to declare.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}