{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T21:44:57Z","timestamp":1778276697889,"version":"3.51.4"},"reference-count":44,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T00:00:00Z","timestamp":1754438400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T00:00:00Z","timestamp":1754438400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100002386","name":"Cairo University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100002386","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>This research assessed the effectiveness of <jats:italic>Sambucus nigra<\/jats:italic> (SN) in alleviating hepatorenal injury caused by fenpropathrin (FNP) in rodents. Six equal groups were created from the 30 Wistar rats: Group 1 was the negative control, Groups 2 and 3 were the SN control groups, Group 4 was the FNP group, and Groups 5 and 6 were the FNP\u2009+\u2009SN combination groups. The hepatoprotective and renoprotective effects of SN were assessed by quantifying serum enzyme markers, including ALT, AST, ALP, blood urea nitrogen, and creatinine. Oxidative stress indicators, RT-PCR analysis, histological examination, and immunohistochemistry studies were conducted on the liver and kidneys to confirm the previously indicated parameters. The rats administered FNP injections displayed increased blood marker enzyme levels, altered oxidant-antioxidant equilibrium, and significant pathogenic changes in hepatic and renal tissues. Furthermore, these rats exhibited elevated levels of caspase-3 and iNOS, linked to the triggered expression of TNF-\u03b1 and NF-\u03baB genes in these tissues. Administering SN enhanced all the aforementioned toxicological parameters. The prospective hepato-renal therapeutic benefits of SN against impairment of the liver and kidneys induced by FNP have been evidenced through its anti-inflammatory, antioxidant, and anti-apoptotic pathways.<\/jats:p>","DOI":"10.1038\/s41598-025-13653-5","type":"journal-article","created":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T11:03:51Z","timestamp":1754478231000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Sambucus nigra alleviates fenpropathrin-induced hepatorenal toxicity in rats via modulation of NF-\u03baB\/TNF-\u03b1 axis"],"prefix":"10.1038","volume":"15","author":[{"given":"Adel F.","family":"Tohamy","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marwa H.","family":"Hassan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdelbary M.","family":"Prince","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marsail S.","family":"Nashed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eman I.","family":"Hassanen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maher M.","family":"Soliman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,8,6]]},"reference":[{"key":"13653_CR1","doi-asserted-by":"publisher","unstructured":"Zaller, J. G. & Zaller, J. G. Pesticide impacts on the environment and humans. Daily Poison: pesticides-an Underestimated Danger 127\u2013221. https:\/\/doi.org\/10.1007\/978-3-030-50530-1 (2020).","DOI":"10.1007\/978-3-030-50530-1"},{"key":"13653_CR2","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1002\/fes3.108","volume":"6","author":"FP Carvalho","year":"2017","unstructured":"Carvalho, F. P. Pesticides, environment, and food safety. Food Energy Secur. 6, 48\u201360 (2017).","journal-title":"Food Energy Secur."},{"key":"13653_CR3","first-page":"147","volume":"247","author":"JE Woodrow","year":"2019","unstructured":"Woodrow, J. E., Gibson, K. A. & Seiber, J. N. Pesticides and related toxicants in the atmosphere. Reviews Environ. Contam. Toxicol. Volume. 247, 147\u2013196 (2019).","journal-title":"Reviews Environ. Contam. Toxicol. Volume"},{"key":"13653_CR4","doi-asserted-by":"publisher","first-page":"116007","DOI":"10.1016\/j.ecoenv.2024.116007","volume":"271","author":"W Wang","year":"2024","unstructured":"Wang, W. et al. Fenpropathrin disrupted the gills of common carp (Cyprinus Carpio L.) through oxidative stress, inflammatory responses, apoptosis, and transcriptional alterations. Ecotoxicol. Environ. Saf. 271, 116007 (2024).","journal-title":"Ecotoxicol. Environ. Saf."},{"key":"13653_CR5","doi-asserted-by":"crossref","unstructured":"Nashed, M. S. et al. The mollifying effect of Sambucus Nigra extract on star gene expression, oxidative stress, and apoptosis induced by fenpropathrin in male rats. Food Chem. Toxicology 189, 114744 (2024).","DOI":"10.1016\/j.fct.2024.114744"},{"key":"13653_CR6","doi-asserted-by":"crossref","unstructured":"Abd-Elhakim, Y. M. et al. Fenpropathrin provoked kidney damage via controlling the NLRP3\/Caspase-1\/GSDMD\u2013mediated pyroptosis: the palliative role of curcumin-loaded Chitosan nanoparticles. Toxicol Appl. Pharmacol 484, 116869 (2024).","DOI":"10.1016\/j.taap.2024.116869"},{"key":"13653_CR7","doi-asserted-by":"publisher","first-page":"111296","DOI":"10.1016\/j.ecoenv.2020.111296","volume":"207","author":"EHA Zeid","year":"2021","unstructured":"Zeid, E. H. A., Sharkawy, E., Moustafa, N. I., Anwer, G. G., Al Nady, A. G. & A. M. & The palliative effect of camel milk on hepatic CYP1A1 gene expression and DNA damage induced by fenpropathrin oral intoxication in male rats. Ecotoxicol. Environ. Saf. 207, 111296 (2021).","journal-title":"Ecotoxicol. Environ. Saf."},{"key":"13653_CR8","first-page":"1","volume":"19","author":"ALR Merc\u00e9","year":"2024","unstructured":"Merc\u00e9, A. L. R. Contaminated waters and depleted soils: impact in nutrition II biochemical detoxification pathways. EC Nutr. 19, 1\u201329 (2024).","journal-title":"EC Nutr."},{"key":"13653_CR9","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1016\/j.jep.2003.08.006","volume":"89","author":"R Chattopadhyay","year":"2003","unstructured":"Chattopadhyay, R. Possible mechanism of hepatoprotective activity of Azadirachta indica leaf extract: part II. J. Ethnopharmacol. 89, 217\u2013219 (2003).","journal-title":"J. Ethnopharmacol."},{"key":"13653_CR10","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1016\/S1043-6618(02)00121-4","volume":"46","author":"HG Jeong","year":"2002","unstructured":"Jeong, H. G. et al. Hepatoprotective effects of 18\u03b2-glycyrrhetinic acid on carbon tetrachloride-induced liver injury: Inhibition of cytochrome P450 2E1 expression. Pharmacol. Res. 46, 221\u2013227 (2002).","journal-title":"Pharmacol. Res."},{"key":"13653_CR11","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1016\/j.phytol.2019.01.030","volume":"30","author":"J Basas-Jaumandreu","year":"2019","unstructured":"Basas-Jaumandreu, J. & de Las Heras, F. X. C. Allelochemicals and esters from leaves and inflorescences of Sambucus Nigra L. Phytochem Lett. 30, 107\u2013115 (2019).","journal-title":"Phytochem Lett."},{"key":"13653_CR12","doi-asserted-by":"publisher","first-page":"618","DOI":"10.3390\/ph17050618","volume":"17","author":"E Studzi\u0144ska-Sroka","year":"2024","unstructured":"Studzi\u0144ska-Sroka, E. et al. Elderberry leaves with antioxidant and Anti-Inflammatory properties as a valuable plant material for wound healing. Pharmaceuticals 17, 618 (2024).","journal-title":"Pharmaceuticals"},{"key":"13653_CR13","doi-asserted-by":"crossref","unstructured":"Neekhra, S., Awasthi, H. & Singh, D. P. Beneficial effects of Sambucus Nigra in chronic stress-induced neurobehavioral and biochemical perturbation in rodents. Pharmacognosy Journal 13, 1 (2021).","DOI":"10.5530\/pj.2021.13.22"},{"key":"13653_CR14","first-page":"55","volume":"94","author":"P Manual","year":"2004","unstructured":"Manual, P. The British crop protection Council (BCPC) puplications sales. Bear. Farm. Binfield Bracknell Berks. UK Phys. 94, 55\u201359 (2004).","journal-title":"Bear. Farm. Binfield Bracknell Berks. UK Phys."},{"key":"13653_CR15","first-page":"882","volume":"61","author":"E Beutler","year":"1963","unstructured":"Beutler, E., Duron, O. & Kelly, B. M. Improved method for the determination of blood glutathione. J. Lab. Clin. Med. 61, 882\u2013888 (1963).","journal-title":"J. Lab. Clin. Med."},{"key":"13653_CR16","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/0009-8981(78)90081-5","volume":"90","author":"K Satoh","year":"1978","unstructured":"Satoh, K. Calorimetric determination of glutathione reduced. Clin. Chim. Acta. 90, 37 (1978).","journal-title":"Clin. Chim. Acta"},{"key":"13653_CR17","first-page":"2768","volume":"7","author":"JD Bancroft","year":"2013","unstructured":"Bancroft, J. D. & Gamble, M. Theories and practice of histological techniques. New. York Lond. Madrid: Churchil Livingstone. 7, 2768\u20132773 (2013).","journal-title":"New. York Lond. Madrid: Churchil Livingstone"},{"key":"13653_CR18","doi-asserted-by":"publisher","first-page":"123925","DOI":"10.1007\/s11356-023-31016-3","volume":"30","author":"EI Hassanen","year":"2023","unstructured":"Hassanen, E. I., Ahmed, L. I., Fahim, K. M., Shehata, M. G. & Badr, A. N. Chitosan nanoparticle encapsulation increased the prophylactic efficacy of Lactobacillus plantarum RM1 against AFM1-induced hepatorenal toxicity in rats. Environ. Sci. Pollut. Res. 30, 123925\u2013123938 (2023).","journal-title":"Environ. Sci. Pollut. Res."},{"key":"13653_CR19","doi-asserted-by":"crossref","unstructured":"Kolawole, A. S. & Iyiola, A. O. Environmental pollution: threats, impact on biodiversity, and protection strategies. in Sustainable utilization and conservation of Africa\u2019s biological resources and environment 377\u2013409Springer, (2023).","DOI":"10.1007\/978-981-19-6974-4_14"},{"key":"13653_CR20","first-page":"817","volume":"15","author":"MR McGill","year":"2016","unstructured":"McGill, M. R. The past and present of serum aminotransferases and the future of liver injury biomarkers. EXCLI J. 15, 817 (2016).","journal-title":"EXCLI J."},{"key":"13653_CR21","unstructured":"Lala, V., Zubair, M. & Minter, D. Liver function tests. StatPearls (2023)."},{"key":"13653_CR22","doi-asserted-by":"publisher","first-page":"767","DOI":"10.1007\/s11096-019-00811-9","volume":"41","author":"RN Okoro","year":"2019","unstructured":"Okoro, R. N. & Farate, V. T. The use of nephrotoxic drugs in patients with chronic kidney disease. Int. J. Clin. Pharm. 41, 767\u2013775 (2019).","journal-title":"Int. J. Clin. Pharm."},{"key":"13653_CR23","doi-asserted-by":"crossref","unstructured":"Hassanen, E. I. et al. Pomegranate juice diminishes the mitochondria-dependent cell death and NF-kB signaling pathway induced by copper oxide nanoparticles on liver and kidneys of rats. Int J. Nanomedicine, 14, 8905\u20138922 (2019).","DOI":"10.2147\/IJN.S229461"},{"key":"13653_CR24","doi-asserted-by":"publisher","first-page":"322","DOI":"10.1039\/D2AY01573K","volume":"15","author":"P Lu","year":"2023","unstructured":"Lu, P. et al. CNN-assisted SERS enables ultra-sensitive and simultaneous detection of Scr and BUN for rapid kidney function assessment. Anal. Methods. 15, 322\u2013332 (2023).","journal-title":"Anal. Methods"},{"key":"13653_CR25","first-page":"165","volume":"59","author":"B Nieradko-Iwanicka","year":"2015","unstructured":"Nieradko-Iwanicka, B. & Borz\u0119cki, A. Effect of 28-day exposure to fenpropathrin on the activities of serum Alanine transaminase and liver antioxidant enzymes in mice. J. Vet. Res. 59, 165\u2013169 (2015).","journal-title":"J. Vet. Res."},{"key":"13653_CR26","doi-asserted-by":"publisher","first-page":"3723","DOI":"10.1007\/s11356-018-3908-8","volume":"26","author":"R Timoumi","year":"2019","unstructured":"Timoumi, R. et al. Acute triflumuron exposure induces oxidative stress responses in liver and kidney of balb\/c mice. Environ. Sci. Pollut. Res. 26, 3723\u20133730 (2019).","journal-title":"Environ. Sci. Pollut. Res."},{"key":"13653_CR27","doi-asserted-by":"publisher","first-page":"e70020","DOI":"10.1002\/jbt.70020","volume":"38","author":"MM Soliman","year":"2024","unstructured":"Soliman, M. M., Tohamy, A. F., Prince, A. M., Hussien, A. M. & Nashed, M. S. The mechanistic pathway induced by fenpropathrin toxicity: oxidative stress, signaling pathway, and mitochondrial damage. J. Biochem. Mol. Toxicol. 38, e70020 (2024).","journal-title":"J. Biochem. Mol. Toxicol."},{"key":"13653_CR28","doi-asserted-by":"crossref","unstructured":"Sule, R. O., Condon, L. & Gomes, A. V. A common feature of pesticides: oxidative stress\u2014the role of oxidative stress in pesticide-induced toxicity. Oxid Med Cell Longev 5563759 (2022). (2022).","DOI":"10.1155\/2022\/5563759"},{"key":"13653_CR29","doi-asserted-by":"publisher","first-page":"1838","DOI":"10.3390\/cells13221838","volume":"13","author":"M Mustafa","year":"2024","unstructured":"Mustafa, M. et al. Apoptosis: A comprehensive overview of signaling pathways, morphological changes, and physiological significance and therapeutic implications. Cells 13, 1838 (2024).","journal-title":"Cells"},{"key":"13653_CR30","doi-asserted-by":"publisher","first-page":"119730","DOI":"10.1016\/j.lfs.2021.119730","volume":"281","author":"C Caglayan","year":"2021","unstructured":"Caglayan, C., Kandemir, F. M., Darendelio\u011flu, E., K\u00fc\u00e7\u00fckler, S. & Ayna, A. Hesperidin protects liver and kidney against sodium fluoride-induced toxicity through anti-apoptotic and anti-autophagic mechanisms. Life Sci. 281, 119730 (2021).","journal-title":"Life Sci."},{"key":"13653_CR31","doi-asserted-by":"publisher","first-page":"2339","DOI":"10.1016\/j.celrep.2018.10.103","volume":"25","author":"JE Vince","year":"2018","unstructured":"Vince, J. E. et al. The mitochondrial apoptotic effectors BAX\/BAK activate caspase-3 and-7 to trigger NLRP3 inflammasome and caspase-8 driven IL-1\u03b2 activation. Cell. Rep. 25, 2339\u20132353 (2018).","journal-title":"Cell. Rep."},{"key":"13653_CR32","doi-asserted-by":"publisher","first-page":"1633","DOI":"10.1002\/bab.2233","volume":"69","author":"M Asadi","year":"2022","unstructured":"Asadi, M. et al. Caspase-3: structure, function, and biotechnological aspects. Biotechnol. Appl. Biochem. 69, 1633\u20131645 (2022).","journal-title":"Biotechnol. Appl. Biochem."},{"key":"13653_CR33","doi-asserted-by":"publisher","first-page":"e21960","DOI":"10.1002\/jbt.21960","volume":"31","author":"E Eldutar","year":"2017","unstructured":"Eldutar, E., Kandemir, F. M., Kucukler, S. & Caglayan, C. Restorative effects of Chrysin pretreatment on oxidant\u2013antioxidant status, inflammatory cytokine production, and apoptotic and autophagic markers in acute paracetamol-induced hepatotoxicity in rats: an experimental and biochemical study. J. Biochem. Mol. Toxicol. 31, e21960 (2017).","journal-title":"J. Biochem. Mol. Toxicol."},{"key":"13653_CR34","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1038\/s41419-024-06712-8","volume":"15","author":"Y Chen","year":"2024","unstructured":"Chen, Y., Li, X., Yang, M. & Liu, S. B. Research progress on morphology and mechanism of programmed cell death. Cell. Death Dis. 15, 327 (2024).","journal-title":"Cell. Death Dis."},{"key":"13653_CR35","doi-asserted-by":"publisher","first-page":"2303259","DOI":"10.1002\/advs.202303259","volume":"10","author":"SM Andrabi","year":"2023","unstructured":"Andrabi, S. M. et al. Nitric oxide: physiological functions, delivery, and biomedical applications. Adv. Sci. 10, 2303259 (2023).","journal-title":"Adv. Sci."},{"key":"13653_CR36","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1002\/med.21599","volume":"40","author":"MA Cinelli","year":"2020","unstructured":"Cinelli, M. A., Do, H. T., Miley, G. P. & Silverman, R. B. Inducible nitric oxide synthase: regulation, structure, and Inhibition. Med. Res. Rev. 40, 158\u2013189 (2020).","journal-title":"Med. Res. Rev."},{"key":"13653_CR37","doi-asserted-by":"publisher","first-page":"113068","DOI":"10.1016\/j.fct.2022.113068","volume":"164","author":"M Coremen","year":"2022","unstructured":"Coremen, M. et al. Lupeol inhibits pesticides induced hepatotoxicity via reducing oxidative stress and inflammatory markers in rats. Food Chem. Toxicol. 164, 113068 (2022).","journal-title":"Food Chem. Toxicol."},{"key":"13653_CR38","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1016\/j.neuro.2023.03.004","volume":"96","author":"O Habotta","year":"2023","unstructured":"Habotta, O., Ateya, A., Saleh, R. M. & El-Ashry, E. S. Thiamethoxam evoked neural oxido-inflammatory stress in male rats through modulation of Nrf2\/NF-kB\/iNOS signaling and inflammatory cytokines: neuroprotective effect of Silymarin. Neurotoxicology 96, 28\u201336 (2023).","journal-title":"Neurotoxicology"},{"key":"13653_CR39","doi-asserted-by":"publisher","first-page":"675","DOI":"10.1002\/fsn3.3784","volume":"12","author":"A Rauf","year":"2024","unstructured":"Rauf, A. et al. Reactive oxygen species in biological systems: pathways, associated diseases, and potential inhibitors\u2014A review. Food Sci. Nutr. 12, 675\u2013693 (2024).","journal-title":"Food Sci. Nutr."},{"key":"13653_CR40","doi-asserted-by":"publisher","first-page":"353","DOI":"10.4292\/wjgpt.v7.i3.353","volume":"7","author":"I Soufli","year":"2016","unstructured":"Soufli, I., Toumi, R., Rafa, H. & Touil-Boukoffa, C. Overview of cytokines and nitric oxide involvement in immuno-pathogenesis of inflammatory bowel diseases. World J. Gastrointest. Pharmacol. Ther. 7, 353 (2016).","journal-title":"World J. Gastrointest. Pharmacol. Ther."},{"key":"13653_CR41","doi-asserted-by":"publisher","first-page":"117423","DOI":"10.1016\/j.jep.2023.117423","volume":"320","author":"W Skowro\u0144ska","year":"2024","unstructured":"Skowro\u0144ska, W. et al. Wound healing potential of extract from Sambucus Nigra L. leaves and its fractions. J. Ethnopharmacol. 320, 117423 (2024).","journal-title":"J. Ethnopharmacol."},{"key":"13653_CR42","doi-asserted-by":"crossref","unstructured":"Nyarko, K. Investigating the Antioxidant Properties of Quercetin. in Quercetin-Effects on Human HealthIntechOpen, (2024).","DOI":"10.5772\/intechopen.1004648"},{"key":"13653_CR43","doi-asserted-by":"crossref","first-page":"127","DOI":"10.3390\/met9020127","volume":"9","author":"R Tundis","year":"2019","unstructured":"Tundis, R. et al. Flower and leaf extracts of Sambucus Nigra L.: application of membrane processes to obtain fractions with antioxidant and antityrosinase properties. Membr. (Basel). 9, 127 (2019).","journal-title":"Membr. (Basel)"},{"key":"13653_CR44","doi-asserted-by":"crossref","unstructured":"Uhl, K., Mitchell, A. E. & Elderberry An ancient remedy: A comprehensive study of the bioactive compounds in three Sambucus Nigra L. Subspecies. Annu Rev. Food Sci. Technol 15, 27\u201351 (2024).","DOI":"10.1146\/annurev-food-072023-034423"}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-13653-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-13653-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-13653-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T21:23:29Z","timestamp":1757366609000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-13653-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,6]]},"references-count":44,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["13653"],"URL":"https:\/\/doi.org\/10.1038\/s41598-025-13653-5","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,6]]},"assertion":[{"value":"23 February 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 July 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 August 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"Our study was performed in accordance with the regulations of the Veterinary Medicine Cairo. University Institutional Animal Care and Use Committee (Vet- CU- IACUC) with approval. number) Vet CU 13\/\/10\/2024\/980. The paper was read and approved by all writers.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}}],"article-number":"28741"}}