{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T12:46:20Z","timestamp":1792673180722,"version":"4.5.0"},"reference-count":88,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"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":["Nat Rev Rheumatol"],"published-print":{"date-parts":[[2026,11]]},"DOI":"10.1038\/s41584-026-01438-7","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T09:34:56Z","timestamp":1791192896000},"page":"719-731","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Antiphospholipid syndrome: epidemiology and outcomes in the evolving criteria era"],"prefix":"10.1038","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2571-1450","authenticated-orcid":false,"given":"Georges","family":"El Hasbani","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Schreiber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6193-6396","authenticated-orcid":false,"given":"Ignasi","family":"Rodr\u00edguez-Pint\u00f3","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7559-2579","authenticated-orcid":false,"given":"Katrien M. J.","family":"Devreese","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danieli","family":"Andrade","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1749-5719","authenticated-orcid":false,"given":"Al\u00ed","family":"Duarte-Garc\u00eda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"key":"1438_CR1","doi-asserted-by":"publisher","first-page":"1156","DOI":"10.7326\/0003-4819-37-6-1156","volume":"37","author":"JE Moore","year":"1952","unstructured":"Moore, J. E. & Mohr, C. F. The incidence and etiologic background of chronic biologic false-positive reactions in serologic tests for syphilis. Ann. Intern. Med. 37, 1156\u20131161 https:\/\/doi.org\/10.7326\/0003-4819-37-6-1156 (1952).","journal-title":"Ann. Intern. Med."},{"key":"1438_CR2","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1055\/s-0042-1760333","volume":"49","author":"DRJ Arachchillage","year":"2023","unstructured":"Arachchillage, D. R. J. & Pericleous, C. Evolution of antiphospholipid syndrome. Semin. Thromb. Hemost. 49, 295\u2013304 https:\/\/doi.org\/10.1055\/s-0042-1760333 (2023).","journal-title":"Semin. Thromb. Hemost."},{"key":"1438_CR3","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2018.5","volume":"4","author":"K Schreiber","year":"2018","unstructured":"Schreiber, K. et al. Antiphospholipid syndrome. Nat. Rev. Dis. Primers 4, 18005 https:\/\/doi.org\/10.1038\/nrdp.2018.5 (2018).","journal-title":"Nat. Rev. Dis. Primers"},{"key":"1438_CR4","doi-asserted-by":"publisher","first-page":"214","DOI":"10.1182\/hematology.2024000544","volume":"2024","author":"BM Salter","year":"2024","unstructured":"Salter, B. M. & Crowther, M. A. Catastrophic antiphospholipid syndrome: a CAPS-tivating hematologic disease. Hematol. Am. Soc. Hematol Educ. Program. 2024, 214\u2013221 https:\/\/doi.org\/10.1182\/hematology.2024000544 (2024).","journal-title":"Hematol. Am. Soc. Hematol Educ. Program."},{"key":"1438_CR5","doi-asserted-by":"publisher","first-page":"1687","DOI":"10.1002\/art.42624","volume":"75","author":"M Barbhaiya","year":"2023","unstructured":"Barbhaiya, M. et al. The 2023 ACR\/EULAR antiphospholipid syndrome classification criteria. Arthritis Rheumatol. 75, 1687\u20131702 https:\/\/doi.org\/10.1002\/art.42624 (2023).","journal-title":"Arthritis Rheumatol."},{"key":"1438_CR6","doi-asserted-by":"publisher","first-page":"324","DOI":"10.1093\/rheumatology\/26.5.324","volume":"26","author":"EN Harris","year":"1987","unstructured":"Harris, E. N. Syndrome of the black swan. Br. J. Rheumatol. 26, 324\u2013326 https:\/\/doi.org\/10.1093\/rheumatology\/26.5.324 (1987).","journal-title":"Br. J. Rheumatol."},{"key":"1438_CR7","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1016\/0049-0172(92)90021-5","volume":"21","author":"D Alarcon-Segovia","year":"1992","unstructured":"Alarcon-Segovia, D., Perez-Vazquez, M. E., Villa, A. R., Drenkard, C. & Cabiedes, J. Preliminary classification criteria for the antiphospholipid syndrome within systemic lupus erythematosus. Semin. Arthritis Rheum. 21, 275\u2013286 https:\/\/doi.org\/10.1016\/0049-0172(92)90021-5 (1992).","journal-title":"Semin. Arthritis Rheum."},{"key":"1438_CR8","doi-asserted-by":"publisher","first-page":"1309","DOI":"10.1002\/1529-0131(199907)42:7<1309::AID-ANR1>3.0.CO;2-F","volume":"42","author":"WA Wilson","year":"1999","unstructured":"Wilson, W. A. et al. International consensus statement on preliminary classification criteria for definite antiphospholipid syndrome: report of an international workshop. Arthritis Rheum. 42, 1309\u20131311 (1999).","journal-title":"Arthritis Rheum."},{"key":"1438_CR9","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1111\/j.1538-7836.2006.01753.x","volume":"4","author":"S Miyakis","year":"2006","unstructured":"Miyakis, S. et al. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J. Thromb. Haemost. 4, 295\u2013306 https:\/\/doi.org\/10.1111\/j.1538-7836.2006.01753.x (2006).","journal-title":"J. Thromb. Haemost."},{"key":"1438_CR10","doi-asserted-by":"publisher","first-page":"1545","DOI":"10.1002\/art.40901","volume":"71","author":"A Duarte-Garcia","year":"2019","unstructured":"Duarte-Garcia, A. et al. The epidemiology of antiphospholipid syndrome: a population-based study. Arthritis Rheumatol. 71, 1545\u20131552 https:\/\/doi.org\/10.1002\/art.40901 (2019).","journal-title":"Arthritis Rheumatol."},{"key":"1438_CR11","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2025.103956","volume":"25","author":"J Alijotas-Reig","year":"2026","unstructured":"Alijotas-Reig, J. et al. Are the 2023 ACR\/EULAR classification criteria a step forward in the management of antiphospholipid syndrome? A literature-based and clinical practice appraisal. Autoimmun. Rev. 25, 103956 https:\/\/doi.org\/10.1016\/j.autrev.2025.103956 (2026).","journal-title":"Autoimmun. Rev."},{"key":"1438_CR12","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1111\/ijlh.14416","volume":"47","author":"A Aiello","year":"2025","unstructured":"Aiello, A. et al. Impact of the 2023 ACR\/EULAR classification criteria on START2 antiphospholipid registry. Int. J. Lab. Hematol. 47, 313\u2013317 https:\/\/doi.org\/10.1111\/ijlh.14416 (2025).","journal-title":"Int. J. Lab. Hematol."},{"key":"1438_CR13","doi-asserted-by":"publisher","first-page":"2770","DOI":"10.1093\/rheumatology\/keae058","volume":"63","author":"SG Foddai","year":"2024","unstructured":"Foddai, S. G. et al. 2023 ACR\/EULAR classification criteria in existing research cohorts: an international study. Rheumatology 63, 2770\u20132775 https:\/\/doi.org\/10.1093\/rheumatology\/keae058 (2024).","journal-title":"Rheumatology"},{"key":"1438_CR14","doi-asserted-by":"publisher","first-page":"e368","DOI":"10.1016\/S2665-9913(24)00396-5","volume":"7","author":"K Schreiber","year":"2025","unstructured":"Schreiber, K. et al. Diagnostic, research, and real-life effect of the 2023 EULAR-ACR classification criteria for antiphospholipid syndrome. Lancet Rheumatol. 7, e368\u2013e376 https:\/\/doi.org\/10.1016\/S2665-9913(24)00396-5 (2025).","journal-title":"Lancet Rheumatol."},{"key":"1438_CR15","doi-asserted-by":"publisher","first-page":"1660","DOI":"10.1016\/j.jtha.2024.02.019","volume":"22","author":"Y Zhao","year":"2024","unstructured":"Zhao, Y. et al. Performance validation of the 2023 American College of Rheumatology\/European League against Rheumatism antiphospholipid syndrome classification criteria in an antiphospholipid syndrome cohort. J. Thromb. Haemost. 22, 1660\u20131674 https:\/\/doi.org\/10.1016\/j.jtha.2024.02.019 (2024).","journal-title":"J. Thromb. Haemost."},{"key":"1438_CR16","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1515\/cclm-2024-0570","volume":"63","author":"P Zigon","year":"2025","unstructured":"Zigon, P. et al. Establishment of ELISA-comparable moderate and high thresholds for anticardiolipin and anti-beta2 glycoprotein I chemiluminescent immunoassays according to the 2023 ACR\/EULAR APS classification criteria and evaluation of their diagnostic performance. Clin. Chem. Lab. Med. 63, 164\u2013176 https:\/\/doi.org\/10.1515\/cclm-2024-0570 (2025).","journal-title":"Clin. Chem. Lab. Med."},{"key":"1438_CR17","doi-asserted-by":"publisher","first-page":"1774","DOI":"10.1002\/art.41401","volume":"72","author":"M Radin","year":"2020","unstructured":"Radin, M. et al. Antiphospholipid syndrome is still a rare disease-estimated prevalence in the Piedmont and Aosta Valley regions of northwest Italy: comment on the article by Duarte-Garcia et al. Arthritis Rheumatol. 72, 1774\u20131776 https:\/\/doi.org\/10.1002\/art.41401 (2020).","journal-title":"Arthritis Rheumatol."},{"key":"1438_CR18","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1186\/s12959-022-00409-8","volume":"20","author":"WC Yao","year":"2022","unstructured":"Yao, W. C. et al. The trends in the incidence and thrombosis-related comorbidities of antiphospholipid syndrome: a 14-year nationwide population-based study. Thromb. J. 20, 50 https:\/\/doi.org\/10.1186\/s12959-022-00409-8 (2022).","journal-title":"Thromb. J."},{"key":"1438_CR19","doi-asserted-by":"publisher","first-page":"1019","DOI":"10.1002\/art.10187","volume":"46","author":"R Cervera","year":"2002","unstructured":"Cervera, R. et al. Antiphospholipid syndrome: clinical and immunologic manifestations and patterns of disease expression in a cohort of 1,000 patients. Arthritis Rheum. 46, 1019\u20131027 https:\/\/doi.org\/10.1002\/art.10187 (2002).","journal-title":"Arthritis Rheum."},{"key":"1438_CR20","doi-asserted-by":"publisher","first-page":"889","DOI":"10.1177\/0961203309106832","volume":"18","author":"R Cervera","year":"2009","unstructured":"Cervera, R., Boffa, M. C., Khamashta, M. A. & Hughes, G. R. The Euro-Phospholipid project: epidemiology of the antiphospholipid syndrome in Europe. Lupus 18, 889\u2013893 https:\/\/doi.org\/10.1177\/0961203309106832 (2009).","journal-title":"Lupus"},{"key":"1438_CR21","doi-asserted-by":"publisher","first-page":"183","DOI":"10.3390\/jcdd12050183","volume":"12","author":"P Evangelidis","year":"2025","unstructured":"Evangelidis, P. et al. Prevalence and risk factors of acute ischemic stroke in patients with antiphospholipid syndrome: a retrospective monocenter analysis. J. Cardiovasc. Dev. Dis. 12, 183 https:\/\/doi.org\/10.3390\/jcdd12050183 (2025).","journal-title":"J. Cardiovasc. Dev. Dis."},{"key":"1438_CR22","doi-asserted-by":"publisher","first-page":"e084563","DOI":"10.1136\/bmjopen-2024-084563","volume":"14","author":"M Khellaf","year":"2024","unstructured":"Khellaf, M. et al. Incidence and prevalence of antiphospholipid syndrome (APS) in the USA (2016\u20132019): a retrospective database study. BMJ Open. 14, e084563 https:\/\/doi.org\/10.1136\/bmjopen-2024-084563 (2024).","journal-title":"BMJ Open."},{"key":"1438_CR23","doi-asserted-by":"publisher","first-page":"548","DOI":"10.1038\/nrrheum.2017.124","volume":"13","author":"S Sciascia","year":"2017","unstructured":"Sciascia, S., Amigo, M. C., Roccatello, D. & Khamashta, M. Diagnosing antiphospholipid syndrome: \u2018extra-criteria\u2019 manifestations and technical advances. Nat. Rev. Rheumatol. 13, 548\u2013560 https:\/\/doi.org\/10.1038\/nrrheum.2017.124 (2017).","journal-title":"Nat. Rev. Rheumatol."},{"key":"1438_CR24","doi-asserted-by":"publisher","first-page":"1609","DOI":"10.3389\/fimmu.2019.01609","volume":"10","author":"A Martirosyan","year":"2019","unstructured":"Martirosyan, A., Aminov, R. & Manukyan, G. Environmental triggers of autoreactive responses: induction of antiphospholipid antibody formation. Front. Immunol. 10, 1609 https:\/\/doi.org\/10.3389\/fimmu.2019.01609 (2019).","journal-title":"Front. Immunol."},{"key":"1438_CR25","doi-asserted-by":"publisher","first-page":"2298","DOI":"10.1056\/NEJMc1713797","volume":"377","author":"JM Connors","year":"2017","unstructured":"Connors, J. M. Thrombophilia testing and venous thrombosis. N. Engl. J. Med. 377, 2298 https:\/\/doi.org\/10.1056\/NEJMc1713797 (2017).","journal-title":"N. Engl. J. Med."},{"key":"1438_CR26","doi-asserted-by":"publisher","DOI":"10.1002\/rth2.12676","volume":"6","author":"EJ Favaloro","year":"2022","unstructured":"Favaloro, E. J. & Pasalic, L. Lupus anticoagulant testing during anticoagulation, including direct oral anticoagulants. Res. Pract. Thromb. Haemost. 6, e12676 https:\/\/doi.org\/10.1002\/rth2.12676 (2022).","journal-title":"Res. Pract. Thromb. Haemost."},{"key":"1438_CR27","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1007\/s11926-021-01038-2","volume":"23","author":"JY Dabit","year":"2022","unstructured":"Dabit, J. Y., Valenzuela-Almada, M. O., Vallejo-Ramos, S. & Duarte-Garcia, A. Epidemiology of antiphospholipid syndrome in the general population. Curr. Rheumatol. Rep. 23, 85 https:\/\/doi.org\/10.1007\/s11926-021-01038-2 (2022).","journal-title":"Curr. Rheumatol. Rep."},{"key":"1438_CR28","doi-asserted-by":"publisher","first-page":"1732","DOI":"10.1016\/j.jtha.2025.02.018","volume":"23","author":"KMJ Devreese","year":"2025","unstructured":"Devreese, K. M. J. et al. An update on laboratory detection and interpretation of antiphospholipid antibodies for diagnosis of antiphospholipid syndrome: guidance from the ISTH-SSC Subcommittee on Lupus Anticoagulant\/Antiphospholipid Antibodies: reply. J. Thromb. Haemost. 23, 1732\u20131734 https:\/\/doi.org\/10.1016\/j.jtha.2025.02.018 (2025).","journal-title":"J. Thromb. Haemost."},{"key":"1438_CR29","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1111\/ijlh.14268","volume":"46","author":"KMJ Devreese","year":"2024","unstructured":"Devreese, K. M. J. Noncriteria antiphospholipid antibodies in antiphospholipid syndrome. Int. J. Lab. Hematol. 46, 34\u201342 https:\/\/doi.org\/10.1111\/ijlh.14268 (2024).","journal-title":"Int. J. Lab. Hematol."},{"key":"1438_CR30","doi-asserted-by":"publisher","first-page":"1220","DOI":"10.1055\/a-1344-4271","volume":"121","author":"D Yin","year":"2021","unstructured":"Yin, D., de Groot, P. G., Ninivaggi, M., Devreese, K. M. J. & de Laat, B. Clinical relevance of isolated lupus anticoagulant positivity in patients with thrombotic antiphospholipid syndrome. Thromb. Haemost. 121, 1220\u20131227 https:\/\/doi.org\/10.1055\/a-1344-4271 (2021).","journal-title":"Thromb. Haemost."},{"key":"1438_CR31","doi-asserted-by":"publisher","first-page":"508","DOI":"10.1111\/jth.15585","volume":"20","author":"A Vandevelde","year":"2022","unstructured":"Vandevelde, A. et al. Semiquantitative interpretation of anticardiolipin and antibeta2glycoprotein I antibodies measured with various analytical platforms: communication from the ISTH SSC subcommittee on Lupus Anticoagulant\/Antiphospholipid Antibodies. J. Thromb. Haemost. 20, 508\u2013524 https:\/\/doi.org\/10.1111\/jth.15585 (2022).","journal-title":"J. Thromb. Haemost."},{"key":"1438_CR32","doi-asserted-by":"publisher","first-page":"998","DOI":"10.1016\/S1474-4422(09)70239-X","volume":"8","author":"RT Urbanus","year":"2009","unstructured":"Urbanus, R. T. et al. Antiphospholipid antibodies and risk of myocardial infarction and ischaemic stroke in young women in the RATIO study: a case\u2013control study. Lancet Neurol. 8, 998\u20131005 https:\/\/doi.org\/10.1016\/S1474-4422(09)70239-X (2009).","journal-title":"Lancet Neurol."},{"key":"1438_CR33","doi-asserted-by":"publisher","first-page":"1993","DOI":"10.1111\/j.1538-7836.2005.01485.x","volume":"3","author":"PG de Groot","year":"2005","unstructured":"de Groot, P. G. et al. Lupus anticoagulants and the risk of a first episode of deep venous thrombosis. J. Thromb. Haemost. 3, 1993\u20131997 https:\/\/doi.org\/10.1111\/j.1538-7836.2005.01485.x (2005).","journal-title":"J. Thromb. Haemost."},{"key":"1438_CR34","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1055\/s-0038-1648840","volume":"72","author":"P Vila","year":"1994","unstructured":"Vila, P., Hernandez, M. C., Lopez-Fernandez, M. F. & Batlle, J. Prevalence, follow-up and clinical significance of the anticardiolipin antibodies in normal subjects. Thromb. Haemost. 72, 209\u2013213 (1994).","journal-title":"Thromb. Haemost."},{"key":"1438_CR35","doi-asserted-by":"publisher","first-page":"1663","DOI":"10.1515\/cclm-2016-0014","volume":"54","author":"D Manukyan","year":"2016","unstructured":"Manukyan, D. et al. Distribution of antiphospholipid antibodies in a large population-based German cohort. Clin. Chem. Lab. Med. 54, 1663\u20131670 https:\/\/doi.org\/10.1515\/cclm-2016-0014 (2016).","journal-title":"Clin. Chem. Lab. Med."},{"key":"1438_CR36","doi-asserted-by":"publisher","first-page":"e236530","DOI":"10.1001\/jamanetworkopen.2023.6530","volume":"6","author":"Y Zuo","year":"2023","unstructured":"Zuo, Y. et al. Prevalence of antiphospholipid antibodies and association with incident cardiovascular events. JAMA Netw. Open. 6, e236530 https:\/\/doi.org\/10.1001\/jamanetworkopen.2023.6530 (2023).","journal-title":"JAMA Netw. Open."},{"key":"1438_CR37","doi-asserted-by":"publisher","first-page":"404","DOI":"10.1136\/ard-2023-224952","volume":"83","author":"CM Yelnik","year":"2024","unstructured":"Yelnik, C. M. et al. Prevalence of clinically meaningful antiphospholipid antibodies in patients with systemic lupus erythematosus varies by race and ethnicity. Ann. Rheum. Dis. 83, 404\u2013406 https:\/\/doi.org\/10.1136\/ard-2023-224952 (2024).","journal-title":"Ann. Rheum. Dis."},{"key":"1438_CR38","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1006\/jaut.2000.0409","volume":"15","author":"M Petri","year":"2000","unstructured":"Petri, M. Epidemiology of the antiphospholipid antibody syndrome. J. Autoimmun. 15, 145\u2013151 https:\/\/doi.org\/10.1006\/jaut.2000.0409 (2000).","journal-title":"J. Autoimmun."},{"key":"1438_CR39","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1007\/BF02208692","volume":"10","author":"GD Sebastiani","year":"1991","unstructured":"Sebastiani, G. D., Passiu, G., Galeazzi, M., Porzio, F. & Carcassi, U. Prevalence and clinical associations of anticardiolipin antibodies in systemic lupus erythematosus: a prospective study. Clin. Rheumatol. 10, 289\u2013293 https:\/\/doi.org\/10.1007\/BF02208692 (1991).","journal-title":"Clin. Rheumatol."},{"key":"1438_CR40","doi-asserted-by":"publisher","first-page":"2480","DOI":"10.1002\/art.24684","volume":"60","author":"F Boin","year":"2009","unstructured":"Boin, F. et al. Independent association of anti-beta(2)-glycoprotein I antibodies with macrovascular disease and mortality in scleroderma patients. Arthritis Rheum. 60, 2480\u20132489 https:\/\/doi.org\/10.1002\/art.24684 (2009).","journal-title":"Arthritis Rheum."},{"key":"1438_CR41","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3109\/08916939508993333","volume":"20","author":"U Picillo","year":"1995","unstructured":"Picillo, U., Migliaresi, S., Marcialis, M. R., Ferruzzi, A. M. & Tirri, G. Clinical significance of anticardiolipin antibodies in patients with systemic sclerosis. Autoimmunity 20, 1\u20137 https:\/\/doi.org\/10.3109\/08916939508993333 (1995).","journal-title":"Autoimmunity"},{"key":"1438_CR42","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1093\/rheumatology\/40.1.111","volume":"40","author":"A Parodi","year":"2001","unstructured":"Parodi, A., Drosera, M., Barbieri, L. & Rebora, A. Antiphospholipid antibody system in systemic sclerosis. Rheumatology 40, 111\u2013112 https:\/\/doi.org\/10.1093\/rheumatology\/40.1.111 (2001).","journal-title":"Rheumatology"},{"key":"1438_CR43","doi-asserted-by":"publisher","first-page":"540","DOI":"10.1136\/ard.53.8.540","volume":"53","author":"AL Herrick","year":"1994","unstructured":"Herrick, A. L., Heaney, M., Hollis, S. & Jayson, M. I. Anticardiolipin, anticentromere and anti-Scl-70 antibodies in patients with systemic sclerosis and severe digital ischaemia. Ann. Rheum. Dis. 53, 540\u2013542 https:\/\/doi.org\/10.1136\/ard.53.8.540 (1994).","journal-title":"Ann. Rheum. Dis."},{"key":"1438_CR44","doi-asserted-by":"publisher","first-page":"1331","DOI":"10.1007\/s10067-012-2019-z","volume":"31","author":"SG Pasoto","year":"2012","unstructured":"Pasoto, S. G. et al. Lupus anticoagulant: a marker for stroke and venous thrombosis in primary Sj\u00f6gren\u2019s syndrome. Clin. Rheumatol. 31, 1331\u20131338 https:\/\/doi.org\/10.1007\/s10067-012-2019-z (2012).","journal-title":"Clin. Rheumatol."},{"key":"1438_CR45","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1191\/0961203304lu1006oa","volume":"13","author":"AL Fauchais","year":"2004","unstructured":"Fauchais, A. L. et al. Antiphospholipid antibodies in primary Sjogren\u2019s syndrome: prevalence and clinical significance in a series of 74 patients. Lupus 13, 245\u2013248 https:\/\/doi.org\/10.1191\/0961203304lu1006oa (2004).","journal-title":"Lupus"},{"key":"1438_CR46","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1177\/0961203316658557","volume":"26","author":"KJ Kim","year":"2017","unstructured":"Kim, K. J., Baek, I. W., Park, K. S., Kim, W. U. & Cho, C. S. Association between antiphospholipid antibodies and arterial thrombosis in patients with rheumatoid arthritis. Lupus 26, 88\u201394 https:\/\/doi.org\/10.1177\/0961203316658557 (2017).","journal-title":"Lupus"},{"key":"1438_CR47","doi-asserted-by":"publisher","first-page":"480","DOI":"10.20452\/pamw.1415","volume":"122","author":"R Jeleniewicz","year":"2012","unstructured":"Jeleniewicz, R., Majdan, M., Targonska-Stepniak, B. & Dryglewska, M. Prevalence of antiphospholipid antibodies in rheumatoid arthritis patients and relationship with disease activity. Pol. Arch. Med. Wewn. 122, 480\u2013486 https:\/\/doi.org\/10.20452\/pamw.1415 (2012).","journal-title":"Pol. Arch. Med. Wewn."},{"key":"1438_CR48","doi-asserted-by":"publisher","first-page":"256","DOI":"10.1053\/sarh.2002.28303","volume":"31","author":"IW Uthman","year":"2002","unstructured":"Uthman, I. W. & Gharavi, A. E. Viral infections and antiphospholipid antibodies. Semin. Arthritis Rheum. 31, 256\u2013263 https:\/\/doi.org\/10.1053\/sarh.2002.28303 (2002).","journal-title":"Semin. Arthritis Rheum."},{"key":"1438_CR49","doi-asserted-by":"publisher","first-page":"982","DOI":"10.1007\/s11239-025-03116-z","volume":"58","author":"M Rostami","year":"2025","unstructured":"Rostami, M., Parsa-Kondelaji, M., Bos, M. H. A. & Mansouritorghabeh, H. Antiphospholipid antibodies in patients with COVID-19: a systematic review and meta-analysis. J. Thromb. Thrombolysis 58, 982\u20131001 https:\/\/doi.org\/10.1007\/s11239-025-03116-z (2025).","journal-title":"J. Thromb. Thrombolysis"},{"key":"1438_CR50","doi-asserted-by":"publisher","first-page":"1746","DOI":"10.1182\/bloodadvances.2020001557","volume":"4","author":"N Abdel-Wahab","year":"2020","unstructured":"Abdel-Wahab, N. et al. Systematic review of observational studies reporting antiphospholipid antibodies in patients with solid tumors. Blood Adv. 4, 1746\u20131755 https:\/\/doi.org\/10.1182\/bloodadvances.2020001557 (2020).","journal-title":"Blood Adv."},{"key":"1438_CR51","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2022.103060","volume":"21","author":"C Gerardin","year":"2022","unstructured":"Gerardin, C. et al. Drug-induced antiphospholipid syndrome: analysis of the WHO international database. Autoimmun. Rev. 21, 103060 https:\/\/doi.org\/10.1016\/j.autrev.2022.103060 (2022).","journal-title":"Autoimmun. Rev."},{"key":"1438_CR52","doi-asserted-by":"publisher","unstructured":"Rodziewicz, M., D\u2019Cruz, D. P. & Gulliford, M. O30 The epidemiology of antiphospholipid syndrome in the UK, 1990\u20132016. Rheumatology https:\/\/doi.org\/10.1093\/rheumatology\/kez105.029 (2019).","DOI":"10.1093\/rheumatology\/kez105.029"},{"key":"1438_CR53","doi-asserted-by":"publisher","DOI":"10.1016\/j.clim.2024.109905","volume":"260","author":"L Andreoli","year":"2024","unstructured":"Andreoli, L. et al. The prevalence and incidence of thrombotic primary antiphospholipid syndrome in adults aged 18\u201349 years: a population-based study in a mountain community in northern Italy. Clin. Immunol. 260, 109905 https:\/\/doi.org\/10.1016\/j.clim.2024.109905 (2024).","journal-title":"Clin. Immunol."},{"key":"1438_CR54","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2020.35.e35","volume":"35","author":"JJ Hwang","year":"2020","unstructured":"Hwang, J. J. et al. Epidemiology of antiphospholipid syndrome in Korea: a nationwide population-based study. J. Korean Med. Sci. 35, e35 https:\/\/doi.org\/10.3346\/jkms.2020.35.e35 (2020).","journal-title":"J. Korean Med. Sci."},{"key":"1438_CR55","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2019.102448","volume":"19","author":"A Siso-Almirall","year":"2020","unstructured":"Siso-Almirall, A. et al. The prevalence of 78 autoimmune diseases in Catalonia (MASCAT-PADRIS Big Data Project). Autoimmun. Rev. 19, 102448 https:\/\/doi.org\/10.1016\/j.autrev.2019.102448 (2020).","journal-title":"Autoimmun. Rev."},{"key":"1438_CR56","doi-asserted-by":"publisher","first-page":"1011","DOI":"10.1136\/annrheumdis-2013-204838","volume":"74","author":"R Cervera","year":"2015","unstructured":"Cervera, R. et al. Morbidity and mortality in the antiphospholipid syndrome during a 10-year period: a multicentre prospective study of 1000 patients. Ann. Rheum. Dis. 74, 1011\u20131018 https:\/\/doi.org\/10.1136\/annrheumdis-2013-204838 (2015).","journal-title":"Ann. Rheum. Dis."},{"key":"1438_CR57","doi-asserted-by":"publisher","first-page":"760","DOI":"10.1002\/acr.25503","volume":"77","author":"Y Ahmadzadeh","year":"2025","unstructured":"Ahmadzadeh, Y. et al. Predictors of mortality in antiphospholipid antibody-positive patients: prospective results from antiphospholipid syndrome alliance for clinical trials and international networking clinical database and repository. Arthritis Care Res. 77, 760\u2013766 https:\/\/doi.org\/10.1002\/acr.25503 (2025).","journal-title":"Arthritis Care Res."},{"key":"1438_CR58","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1186\/s42358-026-00536-0","volume":"66","author":"E Gkrouzman","year":"2026","unstructured":"Gkrouzman, E. et al. Do ethnoracial differences exist among antiphospholipid antibody-positive patients with no other systemic autoimmune diseases: results from the APS ACTION registry. Adv. Rheumatol. 66, 40 https:\/\/doi.org\/10.1186\/s42358-026-00536-0 (2026).","journal-title":"Adv. Rheumatol."},{"key":"1438_CR59","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1055\/s-0043-1764472","volume":"50","author":"M Radin","year":"2024","unstructured":"Radin, M. et al. Pediatric presentation of antiphospholipid syndrome: a review of recent literature with estimation of local prevalence. Semin. Thromb. Hemost. 50, 182\u2013187 https:\/\/doi.org\/10.1055\/s-0043-1764472 (2024).","journal-title":"Semin. Thromb. Hemost."},{"key":"1438_CR60","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2020.102693","volume":"19","author":"AG Islabao","year":"2020","unstructured":"Islabao, A. G. et al. Childhood-onset systemic lupus erythematosus-related antiphospholipid syndrome: a multicenter study with 1519 patients. Autoimmun. Rev. 19, 102693 https:\/\/doi.org\/10.1016\/j.autrev.2020.102693 (2020).","journal-title":"Autoimmun. Rev."},{"key":"1438_CR61","doi-asserted-by":"publisher","first-page":"206","DOI":"10.1002\/art.23334","volume":"59","author":"T Avcin","year":"2008","unstructured":"Avcin, T., Benseler, S. M., Tyrrell, P. N., Cucnik, S. & Silverman, E. D. A followup study of antiphospholipid antibodies and associated neuropsychiatric manifestations in 137 children with systemic lupus erythematosus. Arthritis Rheum. 59, 206\u2013213 https:\/\/doi.org\/10.1002\/art.23334 (2008).","journal-title":"Arthritis Rheum."},{"key":"1438_CR62","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1002\/acr.23584","volume":"71","author":"O Unlu","year":"2019","unstructured":"Unlu, O. et al. The impact of systemic lupus erythematosus on the clinical phenotype of antiphospholipid antibody-positive patients: results from the antiphospholipid syndrome alliance for clinical trials and international clinical database and repository. Arthritis Care Res. 71, 134\u2013141 https:\/\/doi.org\/10.1002\/acr.23584 (2019).","journal-title":"Arthritis Care Res."},{"key":"1438_CR63","doi-asserted-by":"publisher","first-page":"1082","DOI":"10.1177\/09612033241266989","volume":"33","author":"P Mittal","year":"2024","unstructured":"Mittal, P. et al. Comparison of clinical and serological features in thrombotic antiphospholipid syndrome patients, with and without associated systemic lupus erythematosus, followed for up to 42 years: a single centre retrospective study. Lupus 33, 1082\u20131088 https:\/\/doi.org\/10.1177\/09612033241266989 (2024).","journal-title":"Lupus"},{"key":"1438_CR64","doi-asserted-by":"publisher","first-page":"918","DOI":"10.1177\/09612033261449991","volume":"35","author":"R Meidan","year":"2026","unstructured":"Meidan, R. et al. Morbidity and mortality in primary versus secondary antiphospholipid syndrome: a single-center study using the 2023 ACR\/EULAR criteria. Lupus 35, 918\u2013926 https:\/\/doi.org\/10.1177\/09612033261449991 (2026).","journal-title":"Lupus"},{"key":"1438_CR65","doi-asserted-by":"publisher","first-page":"530","DOI":"10.1191\/0961203303lu394oa","volume":"12","author":"RA Asherson","year":"2003","unstructured":"Asherson, R. A. et al. Catastrophic antiphospholipid syndrome: international consensus statement on classification criteria and treatment guidelines. Lupus 12, 530\u2013534 https:\/\/doi.org\/10.1191\/0961203303lu394oa (2003).","journal-title":"Lupus"},{"key":"1438_CR66","doi-asserted-by":"publisher","first-page":"1120","DOI":"10.1016\/j.autrev.2016.09.010","volume":"15","author":"I Rodriguez-Pinto","year":"2016","unstructured":"Rodriguez-Pinto, I. et al. Catastrophic antiphospholipid syndrome (CAPS): descriptive analysis of 500 patients from the International CAPS Registry. Autoimmun. Rev. 15, 1120\u20131124 https:\/\/doi.org\/10.1016\/j.autrev.2016.09.010 (2016).","journal-title":"Autoimmun. Rev."},{"key":"1438_CR67","doi-asserted-by":"publisher","first-page":"1264","DOI":"10.1093\/rheumatology\/key082","volume":"57","author":"I Rodriguez-Pinto","year":"2018","unstructured":"Rodriguez-Pinto, I. et al. The effect of triple therapy on the mortality of catastrophic anti-phospholipid syndrome patients. Rheumatology 57, 1264\u20131270 https:\/\/doi.org\/10.1093\/rheumatology\/key082 (2018).","journal-title":"Rheumatology"},{"key":"1438_CR68","doi-asserted-by":"publisher","first-page":"530","DOI":"10.1136\/ard.62.6.530","volume":"62","author":"D Erkan","year":"2003","unstructured":"Erkan, D. et al. Long term outcome of catastrophic antiphospholipid syndrome survivors. Ann. Rheum. Dis. 62, 530\u2013533 https:\/\/doi.org\/10.1136\/ard.62.6.530 (2003).","journal-title":"Ann. Rheum. Dis."},{"key":"1438_CR69","doi-asserted-by":"publisher","first-page":"1869","DOI":"10.1002\/acr.22066","volume":"65","author":"L Andreoli","year":"2013","unstructured":"Andreoli, L. et al. Estimated frequency of antiphospholipid antibodies in patients with pregnancy morbidity, stroke, myocardial infarction, and deep vein thrombosis: a critical review of the literature. Arthritis Care Res. 65, 1869\u20131873 https:\/\/doi.org\/10.1002\/acr.22066 (2013).","journal-title":"Arthritis Care Res."},{"key":"1438_CR70","doi-asserted-by":"publisher","first-page":"926","DOI":"10.1111\/jth.14720","volume":"18","author":"S Miranda","year":"2020","unstructured":"Miranda, S. et al. Prevalence of confirmed antiphospholipid syndrome in 18-50 years unselected patients with first unprovoked venous thromboembolism. J. Thromb. Haemost. 18, 926\u2013930 https:\/\/doi.org\/10.1111\/jth.14720 (2020).","journal-title":"J. Thromb. Haemost."},{"key":"1438_CR71","doi-asserted-by":"publisher","first-page":"2151","DOI":"10.1182\/blood-2017-09-805689","volume":"131","author":"C Kearon","year":"2018","unstructured":"Kearon, C. et al. Antiphospholipid antibodies and recurrent thrombosis after a first unprovoked venous thromboembolism. Blood 131, 2151\u20132160 https:\/\/doi.org\/10.1182\/blood-2017-09-805689 (2018).","journal-title":"Blood"},{"key":"1438_CR72","doi-asserted-by":"publisher","DOI":"10.1016\/j.rpth.2025.102864","volume":"9","author":"S Najaf Zadeh","year":"2025","unstructured":"Najaf Zadeh, S. et al. Prevalence and factors associated with high-risk thrombophilia: a single-center cross-sectional study of 3550 patients at a tertiary Thrombosis Centre in Switzerland. Res. Pract. Thromb. Haemost. 9, 102864 https:\/\/doi.org\/10.1016\/j.rpth.2025.102864 (2025).","journal-title":"Res. Pract. Thromb. Haemost."},{"key":"1438_CR73","doi-asserted-by":"publisher","first-page":"3264","DOI":"10.1182\/bloodadvances.2025019447","volume":"10","author":"C Crossette-Thambiah","year":"2026","unstructured":"Crossette-Thambiah, C. et al. Anticoagulation, recurrent thrombosis, and major bleeding in antiphospholipid syndrome: UK multicenter observational study. Blood Adv. 10, 3264\u20133275 https:\/\/doi.org\/10.1182\/bloodadvances.2025019447 (2026).","journal-title":"Blood Adv."},{"key":"1438_CR74","doi-asserted-by":"publisher","first-page":"1195","DOI":"10.1161\/STROKEAHA.108.529883","volume":"40","author":"J Putaala","year":"2009","unstructured":"Putaala, J. et al. Analysis of 1008 consecutive patients aged 15 to 49 with first-ever ischemic stroke: the Helsinki Young Stroke Registry. Stroke 40, 1195\u20131203 https:\/\/doi.org\/10.1161\/STROKEAHA.108.529883 (2009).","journal-title":"Stroke"},{"key":"1438_CR75","doi-asserted-by":"publisher","first-page":"e2444","DOI":"10.1212\/WNL.0000000000007533","volume":"92","author":"MS Ekker","year":"2019","unstructured":"Ekker, M. S. et al. Stroke incidence in young adults according to age, subtype, sex, and time trends. Neurology 92, e2444\u2013e2454 https:\/\/doi.org\/10.1212\/WNL.0000000000007533 (2019).","journal-title":"Neurology"},{"key":"1438_CR76","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1001\/jamaneurol.2013.575","volume":"70","author":"R Ji","year":"2013","unstructured":"Ji, R., Schwamm, L. H., Pervez, M. A. & Singhal, A. B. Ischemic stroke and transient ischemic attack in young adults: risk factors, diagnostic yield, neuroimaging, and thrombolysis. JAMA Neurol. 70, 51\u201357 https:\/\/doi.org\/10.1001\/jamaneurol.2013.575 (2013).","journal-title":"JAMA Neurol."},{"key":"1438_CR77","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1136\/jnnp-2019-322424","volume":"91","author":"E Boot","year":"2020","unstructured":"Boot, E. et al. Ischaemic stroke in young adults: a global perspective. J. Neurol. Neurosurg. Psychiatry 91, 411\u2013417 https:\/\/doi.org\/10.1136\/jnnp-2019-322424 (2020).","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"1438_CR78","doi-asserted-by":"publisher","first-page":"39","DOI":"10.5152\/eurjrheum.2023.22012","volume":"10","author":"Y Ioannou","year":"2023","unstructured":"Ioannou, Y., Beukelman, T., Murray, M. & Erkan, D. Incidence of antiphospholipid syndrome: is estimation currently possible? Eur. J. Rheumatol. 10, 39\u201344 (2023).","journal-title":"Eur. J. Rheumatol."},{"key":"1438_CR79","doi-asserted-by":"publisher","first-page":"449","DOI":"10.1007\/s11940-000-0043-9","volume":"2","author":"BS Jacobs","year":"2000","unstructured":"Jacobs, B. S. & Levine, S. R. Antiphospholipid antibody syndrome. Curr. Treat. Options Neurol. 2, 449\u2013457 https:\/\/doi.org\/10.1007\/s11940-000-0043-9 (2000).","journal-title":"Curr. Treat. Options Neurol."},{"key":"1438_CR80","doi-asserted-by":"publisher","unstructured":"The Antiphospholipid Antibodies in Stroke Study (APASS) Group. Anticardiolipin antibodies are an independent risk factor for first ischemic stroke. Neurology 43, 2069\u20132073 https:\/\/doi.org\/10.1212\/wnl.43.10.2069 (1993).","DOI":"10.1212\/wnl.43.10.2069"},{"key":"1438_CR81","doi-asserted-by":"publisher","first-page":"324","DOI":"10.1002\/acr.24468","volume":"74","author":"E Sevim","year":"2022","unstructured":"Sevim, E. et al. Characteristics of patients with antiphospholipid antibody positivity in the APS ACTION international clinical database and repository. Arthritis Care Res. 74, 324\u2013335 https:\/\/doi.org\/10.1002\/acr.24468 (2022).","journal-title":"Arthritis Care Res."},{"key":"1438_CR82","first-page":"2214","volume":"33","author":"L Opatrny","year":"2006","unstructured":"Opatrny, L., David, M., Kahn, S. R., Shrier, I. & Rey, E. Association between antiphospholipid antibodies and recurrent fetal loss in women without autoimmune disease: a metaanalysis. J. Rheumatol. 33, 2214\u20132221 (2006).","journal-title":"J. Rheumatol."},{"key":"1438_CR83","doi-asserted-by":"publisher","first-page":"7698","DOI":"10.3390\/jcm13247698","volume":"13","author":"M Mercier","year":"2024","unstructured":"Mercier, M. et al. Prevalence of antiphospholipid antibody syndrome among patients with recurrent pregnancy loss: impact of the revised 2023 ACR\/EULAR antiphospholipid syndrome criteria. J. Clin. Med. 13, 7698 https:\/\/doi.org\/10.3390\/jcm13247698 (2024).","journal-title":"J. Clin. Med."},{"key":"1438_CR84","doi-asserted-by":"publisher","first-page":"1903","DOI":"10.1177\/0961203318787035","volume":"27","author":"KJ Gibbins","year":"2018","unstructured":"Gibbins, K. J., Tebo, A. E., Nielsen, S. K. & Branch, D. W. Antiphospholipid antibodies in women with severe preeclampsia and placental insufficiency: a case-control study. Lupus 27, 1903\u20131910 https:\/\/doi.org\/10.1177\/0961203318787035 (2018).","journal-title":"Lupus"},{"key":"1438_CR85","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1186\/s13075-021-02518-7","volume":"23","author":"M Larosa","year":"2021","unstructured":"Larosa, M. et al. Evaluation of the severe preeclampsia classification criterion for antiphospholipid syndrome in a study of 40 patients. Arthritis Res. Ther. 23, 134 https:\/\/doi.org\/10.1186\/s13075-021-02518-7 (2021).","journal-title":"Arthritis Res. Ther."},{"key":"1438_CR86","doi-asserted-by":"publisher","first-page":"1523","DOI":"10.1111\/aogs.13665","volume":"98","author":"J Xu","year":"2019","unstructured":"Xu, J. et al. The association between antiphospholipid antibodies and late fetal loss: a systematic review and meta-analysis. Acta Obstet. Gynecol. Scand. 98, 1523\u20131533 https:\/\/doi.org\/10.1111\/aogs.13665 (2019).","journal-title":"Acta Obstet. Gynecol. Scand."},{"key":"1438_CR87","doi-asserted-by":"publisher","first-page":"e0260759","DOI":"10.1371\/journal.pone.0260759","volume":"17","author":"E Papadimitriou","year":"2022","unstructured":"Papadimitriou, E. et al. Presence of antiphospholipid antibodies is associated with increased implantation failure following in vitro fertilization technique and embryo transfer: a systematic review and meta-analysis. PLoS ONE 17, e0260759 https:\/\/doi.org\/10.1371\/journal.pone.0260759 (2022).","journal-title":"PLoS ONE"},{"key":"1438_CR88","doi-asserted-by":"publisher","first-page":"S31","DOI":"10.1016\/j.medcli.2024.02.011","volume":"163","author":"I Rodriguez-Pinto","year":"2024","unstructured":"Rodriguez-Pinto, I., Espinosa, G. & Cervera, R. Catastrophic antiphospholipid syndrome: lessons from the \u201cCAPS Registry\u201d. Med. Clin. 163, S31\u2013S35 https:\/\/doi.org\/10.1016\/j.medcli.2024.02.011 (2024).","journal-title":"Med. Clin."}],"container-title":["Nature Reviews Rheumatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41584-026-01438-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41584-026-01438-7","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41584-026-01438-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T12:05:13Z","timestamp":1792670713000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41584-026-01438-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,5]]},"references-count":88,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["1438"],"URL":"https:\/\/doi.org\/10.1038\/s41584-026-01438-7","relation":{},"ISSN":["1759-4790","1759-4804"],"issn-type":[{"value":"1759-4790","type":"print"},{"value":"1759-4804","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,5]]},"assertion":[{"value":"2 September 2026","order":1,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 October 2026","order":2,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Ethics"}}]}}