{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T09:44:36Z","timestamp":1781343876174,"version":"3.54.1"},"reference-count":41,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2019,12,20]],"date-time":"2019-12-20T00:00:00Z","timestamp":1576800000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2019,12,20]],"date-time":"2019-12-20T00:00:00Z","timestamp":1576800000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The aim of this study was to assess the association between the shoulder tenderness and the inflammatory changes on magnetic resonance imaging (MRI) in the rheumatoid shoulder. Forty-one shoulders of 41 patients with rheumatoid arthritis (RA) were examined. We evaluated synovitis, erosion and bone marrow\u00a0edema, by counting the numbers of each positive site, and rotator cuff tears on shoulder MRI. The association between the shoulder tenderness and the MRI findings were statistically analyzed. Twenty-three of 41 patients had tenderness in the shoulder joints. There were 20 shoulders (48.8%) with rotator cuff tear, and no significant difference was observed in the prevalence of rotator cuff tear between the tenderness group and non-tenderness group (p\u2009=\u20090.080). There were no significant differences in the demographic data between these two groups. In MRI findings, we found significant difference for the synovitis (p\u2009=\u20090.001) and bone marrow edema (p\u2009=\u20090.021). Synovitis was strongly associated with the shoulder tenderness (OR: 3.996, 95% CI: 1.651\u20139.671). Synovitis was the factor most associated with shoulder tenderness.<\/jats:p>","DOI":"10.1038\/s41598-019-55938-6","type":"journal-article","created":{"date-parts":[[2019,12,20]],"date-time":"2019-12-20T11:03:50Z","timestamp":1576839830000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Shoulder tenderness was associated with the inflammatory changes on magnetic resonance imaging in patients with rheumatoid arthritis"],"prefix":"10.1038","volume":"9","author":[{"given":"Satoshi","family":"Shinagawa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4523-7514","authenticated-orcid":false,"given":"Koichi","family":"Okamura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukio","family":"Yonemoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3547-0718","authenticated-orcid":false,"given":"Hitoshi","family":"Shitara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahito","family":"Suto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideo","family":"Sakane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trang Thuy","family":"Dam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsuyoshi","family":"Tajika","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshito","family":"Tsushima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenji","family":"Takagishi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirotaka","family":"Chikuda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,12,20]]},"reference":[{"key":"55938_CR1","doi-asserted-by":"publisher","first-page":"864","DOI":"10.1002\/art.1780270805","volume":"27","author":"T Pincus","year":"1984","unstructured":"Pincus, T. et al. Severe functional declines, work disability, and increased mortality in seventy-five rheumatoid arthritis patients studied over nine years. Arthritis Rheum. 27, 864\u2013872 (1984).","journal-title":"Arthritis Rheum."},{"key":"55938_CR2","doi-asserted-by":"publisher","first-page":"1108","DOI":"10.1016\/S0140-6736(87)91672-2","volume":"1","author":"DL Scott","year":"1987","unstructured":"Scott, D. L., Symmons, D. P., Coulton, B. L. & Popert, A. J. Long-term outcome of treating rheumatoid arthritis: results after 20 years. Lancet 1, 1108\u20131111 (1987).","journal-title":"Lancet"},{"key":"55938_CR3","unstructured":"Gardner, D. L. Rheumatoid arthritis: cell and tissue pathology in Pathological basis of connective tissue disease (ed. Gardner, D. L.) 444\u2013526 (Edward,Arnold, 1992)."},{"key":"55938_CR4","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1080\/03009740310000364","volume":"32","author":"Y Olofsson","year":"2003","unstructured":"Olofsson, Y., Book, C. & Jacobsson, L. Shoulder joint involvement in patients with newly diagnosed rheumatoid arthritis. Prevalence and associations. Scandinavian Journal of Rheumatology 32, 25\u201332, https:\/\/doi.org\/10.1080\/03009740310000364 (2003).","journal-title":"Prevalence and associations. Scandinavian Journal of Rheumatology"},{"key":"55938_CR5","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1038\/ncprheum0407","volume":"3","author":"J Goldhahn","year":"2007","unstructured":"Goldhahn, J., Kolling, C., Gay, S. & Simmen, B. R. Functional staging and surgical intervention of the elbow and shoulder joints in a patient with rheumatoid arthritis. Nat Clin Pract Rheumatol 3, 112\u2013117 (2007).","journal-title":"Nat Clin Pract Rheumatol"},{"key":"55938_CR6","doi-asserted-by":"publisher","first-page":"275","DOI":"10.3109\/03009748609092592","volume":"15","author":"CJ Petersson","year":"1986","unstructured":"Petersson, C. J. Painful shoulders in patients with rheumatoid arthritis. Prevalence, clinical and radiological features. Scand J Rheumatol. 15, 275\u2013279 (1986).","journal-title":"Scand J Rheumatol."},{"key":"55938_CR7","doi-asserted-by":"publisher","first-page":"481","DOI":"10.1177\/028418517701800415","volume":"18","author":"A Larsen","year":"1977","unstructured":"Larsen, A., Dale, K. & Eek, M. Radiographic evaluation of rheumatoid arthritis and related conditions by standard reference films. Acta Radiol Diagn (Stockh). 18, 481\u2013491 (1977).","journal-title":"Acta Radiol Diagn (Stockh)."},{"key":"55938_CR8","doi-asserted-by":"publisher","first-page":"683","DOI":"10.1016\/j.jse.2007.02.135","volume":"16","author":"JW Sperling","year":"2007","unstructured":"Sperling, J. W., Cofield, R. H., Schleck, C. D. & Harmsen, W. S. Total shoulder arthroplasty versus hemiarthroplasty for rheumatoid arthritis of the shoulder: results of 303 consecutive cases. J Shoulder Elbow Surg. 16, 683\u2013690 (2007).","journal-title":"J Shoulder Elbow Surg."},{"key":"55938_CR9","doi-asserted-by":"publisher","first-page":"224","DOI":"10.1186\/ar4035","volume":"14","author":"FM McQueen","year":"2012","unstructured":"McQueen, F. M. Bone marrow edema and osteitis in rheumatoid arthritis: the imaging perspective. Arthritis Res Ther. 14, 224 (2012).","journal-title":"Arthritis Res Ther."},{"key":"55938_CR10","doi-asserted-by":"publisher","first-page":"693","DOI":"10.1016\/j.acra.2012.02.010","volume":"19","author":"MF Amin","year":"2012","unstructured":"Amin, M. F., Ismail, F. M. & El Shereef, R. R. The role of ultrasonography in early detection and monitoring of shoulder erosions, and disease activity in rheumatoid arthritis patients; comparison with MRI examination. Acad Radiol. 19, 693\u2013700 (2012).","journal-title":"Acad Radiol."},{"key":"55938_CR11","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1016\/j.jbspin.2005.03.013","volume":"73","author":"T Thomas","year":"2006","unstructured":"Thomas, T. et al. The rheumatoid shoulder: current consensus on diagnosis and treatment. Joint Bone Spine 73, 139\u2013143 (2006).","journal-title":"Joint Bone Spine"},{"key":"55938_CR12","doi-asserted-by":"publisher","first-page":"1053","DOI":"10.3109\/s10165-012-0823-6","volume":"23","author":"A Kaneko","year":"2013","unstructured":"Kaneko, A. et al. Development and validation of a new radiographic scoring system to evaluate bone and cartilage destruction and healing of large joints with rheumatoid arthritis: ARASHI (Assessment of rheumatoid arthritis by scoring of large joint destruction and healing in radiographic imaging) study. Mod Rheumatol. 23, 1053\u20131062 (2013).","journal-title":"Mod Rheumatol."},{"key":"55938_CR13","doi-asserted-by":"publisher","first-page":"962","DOI":"10.1093\/rheumatology\/keq415","volume":"50","author":"SY Kawashiri","year":"2011","unstructured":"Kawashiri, S. Y. et al. The power Doppler ultrasonography score from 24 synovial sites or 6 simplified synovial sites, including the metacarpophalangeal joints, reflects the clinical disease activity and level of serum biomarkers in patients with rheumatoid arthritis. Rheumatology (Oxford) 50, 962\u2013965 (2011).","journal-title":"Rheumatology (Oxford)"},{"key":"55938_CR14","doi-asserted-by":"publisher","first-page":"1079","DOI":"10.1002\/acr.20175","volume":"62","author":"GA Bruyn","year":"2010","unstructured":"Bruyn, G. A. et al. Validity of ultrasonography and measures of adult shoulder function and reliability of ultrasonography in detecting shoulder synovitis in patients with rheumatoid arthritis using magnetic resonance imaging as a gold standard. Arthritis Care Res (Hoboken). 62, 1079\u20131086 (2010).","journal-title":"Arthritis Care Res (Hoboken)."},{"key":"55938_CR15","doi-asserted-by":"publisher","first-page":"350","DOI":"10.1136\/ard.57.6.350","volume":"57","author":"FM McQueen","year":"1998","unstructured":"McQueen, F. M. et al. Magnetic resonance imaging of the wrist in early rheumatoid arthritis reveals a high prevalence of erosions at four months after symptom onset. Ann Rheum Dis. 57, 350\u2013356 (1998).","journal-title":"Ann Rheum Dis."},{"key":"55938_CR16","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1097\/00003086-199104000-00010","volume":"265","author":"DM Murakami","year":"1991","unstructured":"Murakami, D. M., Bassett, L. W. & Seeger, L. L. Advances in imaging of rheumatoid arthritis. Clin Orthop Relat Res. 265, 83\u201395 (1991).","journal-title":"Clin Orthop Relat Res."},{"key":"55938_CR17","doi-asserted-by":"publisher","first-page":"1484","DOI":"10.1093\/rheumatology\/kes064","volume":"51","author":"K Okamura","year":"2012","unstructured":"Okamura, K. et al. The assessment of biologic treatment in patients with rheumatoid arthritis using FDG-PET\/CT. Rheumatology (Oxford) 51, 1484\u20131491 (2012).","journal-title":"Rheumatology (Oxford)"},{"key":"55938_CR18","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-15-393","volume":"15","author":"K Okamura","year":"2014","unstructured":"Okamura, K. et al. Evaluation of tocilizumab therapy in patients with rheumatoid arthritis based on FDG-PET\/CT. BMC Musculoskelet Disord. 15, 393, https:\/\/doi.org\/10.1186\/1471-2474-15-393 (2014).","journal-title":"BMC Musculoskelet Disord."},{"key":"55938_CR19","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1007\/s00296-015-3331-0","volume":"36","author":"Y Yonemoto","year":"2016","unstructured":"Yonemoto, Y. et al. [(18)F]fluorodeoxyglucose uptake as a predictor of large joint destruction in patients with rheumatoid arthritis. Rheumatol Int. 36, 109, https:\/\/doi.org\/10.1007\/s00296-015-3331-0 (2016).","journal-title":"Rheumatol Int."},{"key":"55938_CR20","doi-asserted-by":"publisher","first-page":"801","DOI":"10.1002\/acr.23006","volume":"69","author":"A Hirata","year":"2017","unstructured":"Hirata, A. et al. Concordance of Patient-Reported Joint Symptoms, Physician-Examined Arthritic Signs, and Ultrasound-Detected Synovitis in Rheumatoid Arthritis. Arthritis Care Res (Hoboken). 69, 801\u2013806 (2017).","journal-title":"Arthritis Care Res (Hoboken)."},{"key":"55938_CR21","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1002\/art.1780310302","volume":"31","author":"FC Arnett","year":"1988","unstructured":"Arnett, F. C. et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum. 31, 315\u2013324 (1988).","journal-title":"Arthritis Rheum."},{"key":"55938_CR22","doi-asserted-by":"publisher","first-page":"659","DOI":"10.1001\/jama.1949.02900430001001","volume":"140","author":"O Steinbrocker","year":"1949","unstructured":"Steinbrocker, O., Traeger, C. H. & Batterman, R. C. Therapeutic criteria in rheumatoid arthritis. JAMA. 140, 659\u2013662 (1949).","journal-title":"JAMA."},{"key":"55938_CR23","unstructured":"The DAS-score website. http:\/\/www.das-score.nl\/."},{"key":"55938_CR24","doi-asserted-by":"publisher","first-page":"1706","DOI":"10.3899\/jrheum.161433","volume":"44","author":"M \u00d8stergaard","year":"2017","unstructured":"\u00d8stergaard, M. et al. The OMERACT Rheumatoid Arthritis Magnetic Resonance Imaging (MRI) Scoring System: Updated Recommendations by the OMERACT MRI in Arthritis Working Group. J Rheumatol. 44, 1706\u20131712 (2017).","journal-title":"J Rheumatol."},{"key":"55938_CR25","doi-asserted-by":"publisher","first-page":"587","DOI":"10.1080\/14397595.2016.1245125","volume":"27","author":"Y Yonemoto","year":"2017","unstructured":"Yonemoto, Y. et al. Predictive factors related to shoulder joint destruction in rheumatoid arthritis patients treated with biologics: A prospective study. Mod Rheumatol. 27, 587\u2013592 (2017).","journal-title":"Mod Rheumatol."},{"key":"55938_CR26","doi-asserted-by":"publisher","first-page":"1451","DOI":"10.2214\/ajr.164.6.7754891","volume":"164","author":"WR Reinus","year":"1995","unstructured":"Reinus, W. R., Shady, K. L., Mirowitz, S. A. & Totty, W. G. MR diagnosis of rotator cuff tears of the shoulder: value of using T2-weighted fat-saturated images. Am J Roentgenol. 164, 1451\u20131455 (1995).","journal-title":"Am J Roentgenol."},{"key":"55938_CR27","doi-asserted-by":"publisher","first-page":"708","DOI":"10.2106\/00004623-200404000-00007","volume":"86","author":"SA Teefey","year":"2004","unstructured":"Teefey, S. A. et al. Detection and quantification of rotator cuff tears. Comparison of ultrasonographic, magnetic resonance imaging, and arthroscopic findings in seventy-one consecutive cases. J Bone Joint Surg Am. 86, 708\u2013716 (2004).","journal-title":"J Bone Joint Surg Am."},{"key":"55938_CR28","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1136\/ard.2005.043075","volume":"65","author":"M Tamai","year":"2006","unstructured":"Tamai, M. et al. Early prediction of rheumatoid arthritis by serological variables and magnetic resonance imaging of the wrists and finger joints: results from prospective clinical examination. Ann Rheum Dis. 65, 134\u2013135 (2006).","journal-title":"Ann Rheum Dis."},{"key":"55938_CR29","doi-asserted-by":"publisher","first-page":"772","DOI":"10.1002\/art.24711","volume":"61","author":"M Tamai","year":"2009","unstructured":"Tamai, M. et al. A prediction rule for disease outcome in patients with undifferentiated arthritis using magnetic resonance imaging of the wrists and finger joints and serologic autoantibodies. Arthritis Rheum. 61, 772\u2013778 (2009).","journal-title":"Arthritis Rheum."},{"key":"55938_CR30","doi-asserted-by":"publisher","first-page":"1152","DOI":"10.1093\/rheumatology\/37.11.1152","volume":"37","author":"E Alasaarela","year":"1998","unstructured":"Alasaarela, E. et al. Evaluation of humeral head erosions in rheumatoid arthritis: a comparison of ultrasonography, magnetic resonance imaging, computed tomography and plain radiography. Br J Rheumatol. 37, 1152\u20131156 (1998).","journal-title":"Br J Rheumatol."},{"key":"55938_CR31","doi-asserted-by":"publisher","first-page":"1789","DOI":"10.1136\/ard.2009.125534","volume":"69","author":"ML Hetland","year":"2010","unstructured":"Hetland, M. L. et al. CIMESTRA study group: Radiographic progression and remission rates in early rheumatoid arthritis - MRI bone oedema and anti-CCP predicted radiographic progression in the 5-year extension of the double-blind randomised CIMESTRA trial. Ann Rheum Dis. 69, 1789\u20131795 (2010).","journal-title":"Ann Rheum Dis."},{"key":"55938_CR32","doi-asserted-by":"publisher","first-page":"794","DOI":"10.1136\/ard.2007.071977","volume":"67","author":"EA Haavardsholm","year":"2008","unstructured":"Haavardsholm, E. A., B\u00f8yesen, P., \u00d8stergaard, M., Schildvold, A. & Kvien, T. K. Magnetic resonance imaging findings in 84 patients with early rheumatoid arthritis: bone marrow oedema predicts erosive progression. Ann Rheum Dis. 67, 794\u2013800 (2008).","journal-title":"Ann Rheum Dis."},{"key":"55938_CR33","doi-asserted-by":"publisher","first-page":"428","DOI":"10.1136\/ard.2009.123950","volume":"70","author":"P B\u00f8yesen","year":"2011","unstructured":"B\u00f8yesen, P. et al. MRI in early rheumatoid arthritis: synovitis and bone marrow oedema are independent predictors of subsequent radiographic progression. Ann Rheum Dis. 70, 428\u2013433 (2011).","journal-title":"Ann Rheum Dis."},{"key":"55938_CR34","doi-asserted-by":"publisher","first-page":"384","DOI":"10.1136\/ard.2008.088245","volume":"68","author":"ML Hetland","year":"2009","unstructured":"Hetland, M. L. et al. CIMESTRA study group: MRI bone oedema is the strongest predictor of subsequent radiographic progression in early rheumatoid arthritis. Results from a 2-year randomised controlled trial (CIMESTRA). Ann Rheum Dis. 68, 384\u2013390 (2009).","journal-title":"Ann Rheum Dis."},{"key":"55938_CR35","doi-asserted-by":"publisher","first-page":"319","DOI":"10.2106\/00004623-198264030-00001","volume":"64","author":"CS Neer 2nd","year":"1982","unstructured":"Neer, C. S. 2nd, Watson, K. C. & Stanton, F. J. Recent experience in total shoulder replacement. J Bone Joint Surg Am. 64, 319\u2013337 (1982).","journal-title":"J Bone Joint Surg Am."},{"key":"55938_CR36","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1016\/j.jse.2009.04.006","volume":"19","author":"A Yamamoto","year":"2010","unstructured":"Yamamoto, A. et al. Prevalence and risk factors of a rotator cuff tear in the general population. J Shoulder Elbow Surg. 19, 116\u2013120 (2010).","journal-title":"J Shoulder Elbow Surg."},{"key":"55938_CR37","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1067\/mse.2000.105446","volume":"9","author":"JT Lehtinen","year":"2000","unstructured":"Lehtinen, J. T. et al. Subacromial space in the rheumatoid shoulder: a radiographic 15-year follow-up study of 148 shoulders. J Shoulder Elbow Surg. 9, 183\u2013187 (2000).","journal-title":"J Shoulder Elbow Surg."},{"key":"55938_CR38","doi-asserted-by":"publisher","first-page":"521","DOI":"10.1001\/archinte.1975.00330040033005","volume":"135","author":"JJ Weiss","year":"1975","unstructured":"Weiss, J. J., Thompson, G. R., Doust, V. & Burgener, F. Rotator cuff tears in rheumatoid arthritis. Arch Intern Med. 135, 521\u2013525 (1975).","journal-title":"Arch Intern Med."},{"key":"55938_CR39","doi-asserted-by":"publisher","first-page":"434","DOI":"10.1080\/02841850410005354","volume":"45","author":"I Soini","year":"2004","unstructured":"Soini, I., Belt, E. A., Niemitukia, L., M\u00e4enp\u00e4\u00e4, H. M. & Kautiainen, H. J. Magnetic resonance imaging of the rotator cuff in destroyed rheumatoid shoulder: comparison with findings during shoulder replacement. Acta Radiol. 45, 434\u2013439 (2004).","journal-title":"Acta Radiol."},{"key":"55938_CR40","doi-asserted-by":"publisher","first-page":"274","DOI":"10.1097\/00124743-199510000-00004","volume":"1","author":"A Kavanaugh","year":"1995","unstructured":"Kavanaugh, A., Eshaghi, N., Cush, J. & Awad, R. Rotator cuff dysfunction in patients with rheumatoid arthritis. J Clin Rheumatol. 1, 274\u2013279 (1995).","journal-title":"J Clin Rheumatol."},{"key":"55938_CR41","doi-asserted-by":"publisher","first-page":"1520","DOI":"10.1302\/0301-620X.96B11.34133","volume":"96","author":"P van der Zwaal","year":"2014","unstructured":"van der Zwaal, P. et al. The natural history of the rheumatoid shoulder: a prospective long-term follow-up study. Bone Joint J. 96, 1520\u20131524 (2014).","journal-title":"Bone Joint J."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-019-55938-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-019-55938-6","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-019-55938-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,17]],"date-time":"2022-12-17T17:46:25Z","timestamp":1671299185000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-019-55938-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,12,20]]},"references-count":41,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2019,12]]}},"alternative-id":["55938"],"URL":"https:\/\/doi.org\/10.1038\/s41598-019-55938-6","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,12,20]]},"assertion":[{"value":"24 April 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 December 2019","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 December 2019","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"19599"}}