{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T19:49:19Z","timestamp":1792784959258,"version":"4.5.0"},"reference-count":38,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,11,10]],"date-time":"2020-11-10T00:00:00Z","timestamp":1604966400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,11,10]],"date-time":"2020-11-10T00:00:00Z","timestamp":1604966400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Malaysia One Health University Network","award":["GL00164-AK-2016"],"award-info":[{"award-number":["GL00164-AK-2016"]}]},{"DOI":"10.13039\/501100006242","name":"Universiti Malaysia Sabah","doi-asserted-by":"crossref","award":["SDN0067-2019"],"award-info":[{"award-number":["SDN0067-2019"]}],"id":[{"id":"10.13039\/501100006242","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100006242","name":"Universiti Malaysia Sabah","doi-asserted-by":"crossref","award":["AM 18006"],"award-info":[{"award-number":["AM 18006"]}],"id":[{"id":"10.13039\/501100006242","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Leptospirosis is a public health challenge in Sabah State of Malaysian Borneo. Rapid urbanization, rural-to-urban migration, and undocumented immigration in Sabah have increased the pressure on the urban garbage disposal system. Rodents and other small animals thrive under these conditions. We hypothesized that urban sanitation workers would be at risk of developing leptospirosis. In total, 303 urban sanitation workers with a mean age of 42.6\u00a0years were enrolled in this study. The serum samples collected from these workers were subjected to the microscopic agglutination test (MAT), PCR and nucleotide sequencing of the amplicons to confirm the presence of\n                    <jats:italic>Leptospira.<\/jats:italic>\n                    The phylogenetic analysis using the neighbor joining method was performed to assess whether they were pathogenic. In this study 43.8% (133\/303) of the samples were MAT-seropositive and among them, 29 (21.8%) were positive by PCR. Nucleotide sequencing of the amplicons confirmed the presence of\n                    <jats:italic>Leptospira.<\/jats:italic>\n                    Phylogenetic analysis showed that our strains belonged to the pathogenic group of\n                    <jats:italic>Leptospira.<\/jats:italic>\n                    A high proportion of urban sanitation workers were seropositive for leptospirosis, and a considerable number were PCR positive for\n                    <jats:italic>Leptospira,<\/jats:italic>\n                    thereby indicating asymptomatic infections. Further research is needed to confirm whether this is a transient phenomenon or antibiotic therapy is required.\n                  <\/jats:p>","DOI":"10.1038\/s41598-020-76595-0","type":"journal-article","created":{"date-parts":[[2020,11,10]],"date-time":"2020-11-10T06:02:41Z","timestamp":1604988161000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["High incidence of asymptomatic leptospirosis among urban sanitation workers from Kota Kinabalu, Sabah, Malaysian Borneo"],"prefix":"10.1038","volume":"10","author":[{"given":"Mohammad Saffree","family":"Jeffree","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisuke","family":"Mori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nur Athirah","family":"Yusof","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Azman Bin","family":"Atil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khamisah Awang","family":"Lukman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafidah","family":"Othman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohd Rohaizat","family":"Hassan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lela","family":"Suut","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamruddin","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,11,10]]},"reference":[{"key":"76595_CR1","doi-asserted-by":"publisher","first-page":"e0007374","DOI":"10.1371\/journal.pntd.0007374","volume":"13","author":"J Guglielmini","year":"2019","unstructured":"Guglielmini, J. et al. Genus-wide Leptospira core genome multilocus sequence typing for strain taxonomy and global surveillance. PLoS Negl. Trop. Dis. 13, e0007374. https:\/\/doi.org\/10.1371\/journal.pntd.0007374 (2019).","journal-title":"PLoS Negl. Trop. Dis."},{"key":"76595_CR2","doi-asserted-by":"publisher","first-page":"e0003898","DOI":"10.1371\/journal.pntd.0003898","volume":"9","author":"F Costa","year":"2015","unstructured":"Costa, F. et al. Global morbidity and mortality of leptospirosis: a systematic review. PLoS Negl. Trop. Dis. 9, e0003898. https:\/\/doi.org\/10.1371\/journal.pntd.0003898 (2015).","journal-title":"PLoS Negl. Trop. Dis."},{"key":"76595_CR3","doi-asserted-by":"publisher","first-page":"494","DOI":"10.1111\/j.1469-0691.2011.03474.x","volume":"17","author":"RA Hartskeerl","year":"2011","unstructured":"Hartskeerl, R. A., Collares-Pereira, M. & Ellis, W. A. Emergence, control and re-emerging Leptospirosis: dynamics of infection in the changing world. Clin Microbiol. Infect. 17, 494\u2013501. https:\/\/doi.org\/10.1111\/j.1469-0691.2011.03474.x (2011).","journal-title":"Clin Microbiol. Infect."},{"key":"76595_CR4","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1007\/s10393-017-1234-0","volume":"14","author":"B Garba","year":"2017","unstructured":"Garba, B., Bahaman, A. R., Khairani-Bejo, S., Zakaria, Z. & Mutalib, A. R. Retrospective study of leptospirosis in Malaysia. EcoHealth 14, 389\u2013398. https:\/\/doi.org\/10.1007\/s10393-017-1234-0 (2017).","journal-title":"EcoHealth"},{"key":"76595_CR5","doi-asserted-by":"publisher","first-page":"7229","DOI":"10.3390\/ijerph10127229","volume":"10","author":"MC Schneider","year":"2013","unstructured":"Schneider, M. C. et al. Leptospirosis: a silent epidemic disease. Int. J. Environ. Res. Public Health 10, 7229\u20137234. https:\/\/doi.org\/10.3390\/ijerph10127229 (2013).","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"76595_CR6","first-page":"455","volume":"59","author":"TK Koay","year":"2004","unstructured":"Koay, T. K., Nirmal, S., Noitie, L. & Tan, E. An epidemiological investigation of an outbreak of leptospirosis associated with swimming, Beaufort, Sabah. Med. J. Malaysia 59, 455\u2013459 (2004).","journal-title":"Med. J. Malaysia"},{"key":"76595_CR7","doi-asserted-by":"publisher","first-page":"334","DOI":"10.1179\/2047773214Y.0000000156","volume":"108","author":"SJ Wynwood","year":"2014","unstructured":"Wynwood, S. J. et al. Leptospirosis from water sources. Pathog. Glob. Health 108, 334\u2013338. https:\/\/doi.org\/10.1179\/2047773214Y.0000000156 (2014).","journal-title":"Pathog. Glob. Health"},{"key":"76595_CR8","first-page":"113","volume":"21","author":"IM El Jalii","year":"2004","unstructured":"El Jalii, I. M. & Bahaman, A. R. A review of human leptospirosis in Malaysia. Trop. Biomed. 21, 113\u2013119 (2004).","journal-title":"Trop. Biomed."},{"key":"76595_CR9","doi-asserted-by":"publisher","first-page":"e0007141","DOI":"10.1371\/journal.pntd.0007141","volume":"13","author":"KR Blasdell","year":"2019","unstructured":"Blasdell, K. R., Morand, S., Perera, D. & Firth, C. Association of rodent-borne Leptospira spp. with urban environments in Malaysian Borneo. PLoS Negl. Trop. Dis. 13, e0007141. https:\/\/doi.org\/10.1371\/journal.pntd.0007141 (2019).","journal-title":"PLoS Negl. Trop. Dis."},{"key":"76595_CR10","doi-asserted-by":"publisher","first-page":"468","DOI":"10.7589\/2014-10-245","volume":"52","author":"EU Andersen-Ranberg","year":"2016","unstructured":"Andersen-Ranberg, E. U., Pipper, C. & Jensen, P. M. Global patterns of Leptospira prevalence in vertebrate reservoir hosts. J. Wildlife Dis. 52, 468\u2013477. https:\/\/doi.org\/10.7589\/2014-10-245 (2016).","journal-title":"J. Wildlife Dis."},{"key":"76595_CR11","unstructured":"Prevention, C. f. D. C. a. Leptospirosis: Risk of Exposure, https:\/\/www.cdc.gov\/leptospirosis\/exposure\/index.html (2015)."},{"key":"76595_CR12","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17020427","author":"A Atil","year":"2020","unstructured":"Atil, A. et al. Occupational determinants of leptospirosis among urban service workers. Int. J. Environ. Res. Public Health https:\/\/doi.org\/10.3390\/ijerph17020427 (2020).","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"76595_CR13","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1007\/978-3-662-45059-8_5","volume":"387","author":"DA Haake","year":"2015","unstructured":"Haake, D. A. & Levett, P. N. Leptospirosis in humans. Curr. Top. Microbiol. Immunol. 387, 65\u201397. https:\/\/doi.org\/10.1007\/978-3-662-45059-8_5 (2015).","journal-title":"Curr. Top. Microbiol. Immunol."},{"key":"76595_CR14","doi-asserted-by":"publisher","first-page":"630","DOI":"10.1099\/jmm.0.050039-0","volume":"62","author":"N Koizumi","year":"2013","unstructured":"Koizumi, N. et al. Molecular and serological investigation of Leptospira and leptospirosis in dogs in Japan. J. Med. Microbiol. 62, 630\u2013636. https:\/\/doi.org\/10.1099\/jmm.0.050039-0 (2013).","journal-title":"J. Med. Microbiol."},{"key":"76595_CR15","doi-asserted-by":"publisher","first-page":"e0007270","DOI":"10.1371\/journal.pntd.0007270","volume":"13","author":"AT Vincent","year":"2019","unstructured":"Vincent, A. T. et al. Revisiting the taxonomy and evolution of pathogenicity of the genus Leptospira through the prism of genomics. PLoS Negl. Trop. Dis. 13, e0007270. https:\/\/doi.org\/10.1371\/journal.pntd.0007270 (2019).","journal-title":"PLoS Negl. Trop. Dis."},{"key":"76595_CR16","doi-asserted-by":"publisher","first-page":"2947","DOI":"10.1093\/bioinformatics\/btm404","volume":"23","author":"MA Larkin","year":"2007","unstructured":"Larkin, M. A. et al. Clustal W and Clustal X version 2.0. Bioinformatics 23, 2947\u20132948. https:\/\/doi.org\/10.1093\/bioinformatics\/btm404 (2007).","journal-title":"Bioinformatics"},{"key":"76595_CR17","first-page":"1222","volume":"48","author":"MA Zainuddin","year":"1917","unstructured":"Zainuddin, M. A. et al. Seroprevalence of leptospirosis among town service workers in Kelantan, Malaysia. Southeast Asian J. Trop. Med. Public Health 48, 1222\u20131229 (1917).","journal-title":"Southeast Asian J. Trop. Med. Public Health"},{"key":"76595_CR18","first-page":"6","volume":"208145","author":"S Samsudin","year":"2015","unstructured":"Samsudin, S. et al. Seroprevalence of leptospiral antibodies among healthy municipal service workers in Selangor. Adv. Public Health 208145, 6 (2015).","journal-title":"Adv. Public Health"},{"key":"76595_CR19","doi-asserted-by":"publisher","first-page":"e0132988","DOI":"10.1371\/journal.pone.0132988","volume":"10","author":"JJ Waggoner","year":"2015","unstructured":"Waggoner, J. J. et al. Reverse-transcriptase PCR detection of Leptospira: absence of agreement with single-specimen microscopic agglutination testing. PLoS ONE 10, e0132988. https:\/\/doi.org\/10.1371\/journal.pone.0132988 (2015).","journal-title":"PLoS ONE"},{"key":"76595_CR20","doi-asserted-by":"publisher","DOI":"10.1128\/AEM.01190-17","author":"V Barragan","year":"2017","unstructured":"Barragan, V., Olivas, S., Keim, P. & Pearson, T. Critical knowledge gaps in our understanding of environmental cycling and transmission of Leptospira spp. Appl. Environ. Microbiol. https:\/\/doi.org\/10.1128\/AEM.01190-17 (2017).","journal-title":"Appl. Environ. Microbiol."},{"key":"76595_CR21","doi-asserted-by":"publisher","first-page":"e308","DOI":"10.1371\/journal.pmed.0030308","volume":"3","author":"CA Ganoza","year":"2006","unstructured":"Ganoza, C. A. et al. Determining risk for severe leptospirosis by molecular analysis of environmental surface waters for pathogenic Leptospira. PLoS Med. 3, e308. https:\/\/doi.org\/10.1371\/journal.pmed.0030308 (2006).","journal-title":"PLoS Med."},{"key":"76595_CR22","doi-asserted-by":"publisher","first-page":"309","DOI":"10.4269\/ajtmh.2012.11-0398","volume":"86","author":"CL Lau","year":"2012","unstructured":"Lau, C. L. et al. Leptospirosis in American Samoa 2010: epidemiology, environmental drivers, and the management of emergence. Am. J. Trop. Med. Hyg. 86, 309\u2013319. https:\/\/doi.org\/10.4269\/ajtmh.2012.11-0398 (2012).","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"76595_CR23","doi-asserted-by":"publisher","first-page":"1309","DOI":"10.1099\/mic.0.2007\/014746-0","volume":"154","author":"P Ristow","year":"2008","unstructured":"Ristow, P. et al. Biofilm formation by saprophytic and pathogenic leptospires. Microbiology 154, 1309\u20131317. https:\/\/doi.org\/10.1099\/mic.0.2007\/014746-0 (2008).","journal-title":"Microbiology"},{"key":"76595_CR24","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1016\/j.tim.2004.11.004","volume":"13","author":"L Hall-Stoodley","year":"2005","unstructured":"Hall-Stoodley, L. & Stoodley, P. Biofilm formation and dispersal and the transmission of human pathogens. Trends Microbiol. 13, 7\u201310. https:\/\/doi.org\/10.1016\/j.tim.2004.11.004 (2005).","journal-title":"Trends Microbiol."},{"key":"76595_CR25","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1186\/s12866-018-1206-8","volume":"18","author":"T Yamaguchi","year":"2018","unstructured":"Yamaguchi, T. et al. Characterizing interactions of Leptospira interrogans with proximal renal tubule epithelial cells. BMC Microbiol 18, 64. https:\/\/doi.org\/10.1186\/s12866-018-1206-8 (2018).","journal-title":"BMC Microbiol"},{"key":"76595_CR26","first-page":"35","volume":"7","author":"G Trueba","year":"2004","unstructured":"Trueba, G., Zapata, S., Madrid, K., Cullen, P. & Haake, D. Cell aggregation: a mechanism of pathogenic Leptospira to survive in fresh water. Int. Microbiol. 7, 35\u201340 (2004).","journal-title":"Int. Microbiol."},{"key":"76595_CR27","doi-asserted-by":"publisher","first-page":"249","DOI":"10.4269\/ajtmh.2000.63.249","volume":"63","author":"DA Ashford","year":"2000","unstructured":"Ashford, D. A. et al. Asymptomatic infection and risk factors for leptospirosis in Nicaragua. Am. J. Trop. Med. Hyg. 63, 249\u2013254 (2000).","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"76595_CR28","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1016\/j.rvsc.2017.03.017","volume":"115","author":"A Kurilung","year":"2017","unstructured":"Kurilung, A. et al. Molecular detection and isolation of pathogenic Leptospira from asymptomatic humans, domestic animals and water sources in Nan province, a rural area of Thailand. Res. Vet. Sci. 115, 146\u2013154. https:\/\/doi.org\/10.1016\/j.rvsc.2017.03.017 (2017).","journal-title":"Res. Vet. Sci."},{"key":"76595_CR29","doi-asserted-by":"publisher","first-page":"583","DOI":"10.1093\/ije\/28.3.583","volume":"28","author":"P Bovet","year":"1999","unstructured":"Bovet, P., Yersin, C., Merien, F., Davis, C. E. & Perolat, P. Factors associated with clinical leptospirosis: a population-based case-control study in the Seychelles (Indian Ocean). Int. J. Epidemiol. 28, 583\u2013590 (1999).","journal-title":"Int. J. Epidemiol."},{"key":"76595_CR30","doi-asserted-by":"publisher","first-page":"1894","DOI":"10.1128\/JCM.32.8.1894-1898.1994","volume":"32","author":"AE Bal","year":"1994","unstructured":"Bal, A. E. et al. Detection of leptospires in urine by PCR for early diagnosis of leptospirosis. J. Clin. Microbiol. 32, 1894\u20131898 (1994).","journal-title":"J. Clin. Microbiol."},{"key":"76595_CR31","doi-asserted-by":"publisher","first-page":"e612","DOI":"10.1371\/journal.pntd.0000612","volume":"4","author":"CA Ganoza","year":"2010","unstructured":"Ganoza, C. A. et al. Asymptomatic renal colonization of humans in the peruvian Amazon by Leptospira. PLoS. Trop. Dis. 4, e612. https:\/\/doi.org\/10.1371\/journal.pntd.0000612 (2010).","journal-title":"PLoS. Trop. Dis."},{"key":"76595_CR32","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1080\/20477724.2016.1222054","volume":"110","author":"K Sivasankari","year":"2016","unstructured":"Sivasankari, K., Shanmughapriya, S. & Natarajaseenivasan, K. Leptospiral renal colonization status in asymptomatic rural population of Tiruchirapalli district, Tamilnadu, India. Pathog. Glob. Health 110, 209\u2013215. https:\/\/doi.org\/10.1080\/20477724.2016.1222054 (2016).","journal-title":"Pathog. Glob. Health"},{"key":"76595_CR33","doi-asserted-by":"publisher","first-page":"296","DOI":"10.1128\/CMR.14.2.296-326.2001","volume":"14","author":"PN Levett","year":"2001","unstructured":"Levett, P. N. Leptospirosis. Clin. Microbiol. Rev. 14, 296\u2013326. https:\/\/doi.org\/10.1128\/CMR.14.2.296-326.2001 (2001).","journal-title":"Clin. Microbiol. Rev."},{"key":"76595_CR34","doi-asserted-by":"publisher","first-page":"523","DOI":"10.1007\/s10096-018-03450-6","volume":"38","author":"VK Neela","year":"2019","unstructured":"Neela, V. K. et al. An outbreak of leptospirosis among reserve military recruits, Hulu Perdik, Malaysia. Eur. J. Clin. Microbiol. Infect. Dis. 38, 523\u2013528. https:\/\/doi.org\/10.1007\/s10096-018-03450-6 (2019).","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"76595_CR35","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1016\/j.phrp.2016.04.006","volume":"7","author":"JM Ridzuan","year":"2016","unstructured":"Ridzuan, J. M., Aziah, B. D. & Zahiruddin, W. M. Study on seroprevalence and leptospiral antibody distribution among high-risk planters in Malaysia. Osong Public Health Res. Perspect. 7, 168\u2013171. https:\/\/doi.org\/10.1016\/j.phrp.2016.04.006 (2016).","journal-title":"Osong Public Health Res. Perspect."},{"key":"76595_CR36","first-page":"395","volume":"4","author":"MN Shafei","year":"2012","unstructured":"Shafei, M. N. et al. Seroprevalence of leptospirosis among town service workers on northeastern state of Malaysia. Int. J. Collab. Res. Intern. Med. Public Health 4, 395\u2013403 (2012).","journal-title":"Int. J. Collab. Res. Intern. Med. Public Health"},{"key":"76595_CR37","doi-asserted-by":"publisher","DOI":"10.1016\/j.jiph.2019.02.001","author":"M Fernandes","year":"2019","unstructured":"Fernandes, M., Vieira, M. L., Carreira, T. & Teodosio, R. Sanitation workers from Portugal: Is there evidence of Leptospira spp?. J. Infect. Public Health. https:\/\/doi.org\/10.1016\/j.jiph.2019.02.001 (2019).","journal-title":"J. Infect. Public Health"},{"key":"76595_CR38","doi-asserted-by":"publisher","first-page":"6575","DOI":"10.1038\/s41598-019-42978-1","volume":"9","author":"Y Sato","year":"2019","unstructured":"Sato, Y. et al. Environmental DNA metabarcoding to detect pathogenic Leptospira and associated organisms in leptospirosis-endemic areas of Japan. Sci. Rep. 9, 6575. https:\/\/doi.org\/10.1038\/s41598-019-42978-1 (2019).","journal-title":"Sci. Rep."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-020-76595-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-020-76595-0","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-020-76595-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,6]],"date-time":"2022-12-06T17:35:43Z","timestamp":1670348143000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-020-76595-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11,10]]},"references-count":38,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2020,12]]}},"alternative-id":["76595"],"URL":"https:\/\/doi.org\/10.1038\/s41598-020-76595-0","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,11,10]]},"assertion":[{"value":"7 June 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 October 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 November 2020","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":"19442"}}