{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T23:07:49Z","timestamp":1784070469735,"version":"3.55.0"},"reference-count":46,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:00:00Z","timestamp":1779321600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"vor","delay-in-days":55,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"name":"National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases","award":["R01DK113295, R01DK132569-01"],"award-info":[{"award-number":["R01DK113295, R01DK132569-01"]}]},{"name":"University of Illinois Urbana-Champaign, Health Care Engineering Systems Center JUMP ARCHES"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med Inform Decis Mak"],"DOI":"10.1186\/s12911-026-03539-5","type":"journal-article","created":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T02:24:44Z","timestamp":1779330284000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Analyzing longitudinal antidiabetic medication patterns: a data-driven clustering framework"],"prefix":"10.1186","volume":"26","author":[{"given":"Peng","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer Mason","family":"Lobo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min-Woong","family":"Sohn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro Curi","family":"Hallal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7429-1101","authenticated-orcid":false,"given":"Hyojung","family":"Kang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,21]]},"reference":[{"key":"3539_CR1","unstructured":"National Center for Chronic Disease Prevention and Health Promotion. A Report Card: Diabetes in the United States Infographic. https:\/\/www.cdc.gov\/diabetes\/communication-resources\/diabetes-statistics.html. Accessed 6 Jan 2025."},{"key":"3539_CR2","doi-asserted-by":"publisher","first-page":"1699","DOI":"10.1001\/archinte.168.15.1699","volume":"168","author":"HC Gerstein","year":"2008","unstructured":"Gerstein HC, Swedberg K, Carlsson J, McMurray JJV, Michelson EL, Olofsson B, et al. The hemoglobin A1c level as a progressive risk factor for cardiovascular death, hospitalization for heart failure, or death in patients with chronic heart failure: an analysis of the Candesartan in Heart failure: Assessment of Reduction in Mortality and Morbidity (CHARM) program. Arch Intern Med. 2008;168:1699\u2013704.","journal-title":"Arch Intern Med"},{"key":"3539_CR3","doi-asserted-by":"publisher","first-page":"90","DOI":"10.3389\/fnins.2019.00090","volume":"13","author":"Y-R Lai","year":"2019","unstructured":"Lai Y-R, Chiu W-C, Huang C-C, Tsai N-W, Wang H-C, Lin W-C, et al. HbA1C variability is strongly associated with the severity of peripheral neuropathy in patients with type 2 diabetes. Front Neurosci. 2019;13:90.","journal-title":"Front Neurosci"},{"key":"3539_CR4","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1186\/s12933-023-02118-6","volume":"23","author":"R Marfella","year":"2024","unstructured":"Marfella R, Prattichizzo F, Sardu C, Rambaldi PF, Fumagalli C, Marfella LV, et al. GLP-1 receptor agonists-SGLT-2 inhibitors combination therapy and cardiovascular events after acute myocardial infarction: an observational study in patients with type 2 diabetes. Cardiovasc Diabetol. 2024;23:10.","journal-title":"Cardiovasc Diabetol"},{"key":"3539_CR5","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1210\/10.1210\/er.2006-0038","volume":"28","author":"BL Wajchenberg","year":"2007","unstructured":"Wajchenberg BL. \u03b2-cell failure in diabetes and preservation by clinical treatment. Endocr Rev. 2007;28:187\u2013218.","journal-title":"Endocr Rev"},{"key":"3539_CR6","doi-asserted-by":"publisher","first-page":"S140","DOI":"10.2337\/dc23-S009","volume":"46","author":"NA Elsayed","year":"2023","unstructured":"Elsayed NA, Aleppo G, Aroda VR, Bannuru RR, Brown FM, Bruemmer D, et al. 9. Pharmacologic Approaches to Glycemic Treatment: Standards of Care in Diabetes\u20142023. Diabetes Care. 2023;46:S140\u201357. https:\/\/doi.org\/10.2337\/dc23-S009.","journal-title":"Diabetes Care"},{"key":"3539_CR7","doi-asserted-by":"crossref","unstructured":"Truong B, Li Y, Zheng J, Qian J. Use of second-generation antidiabetic medication among a nationally representative sample. Am J Managed Care. 2023;29.","DOI":"10.37765\/ajmc.2023.89445"},{"key":"3539_CR8","doi-asserted-by":"publisher","first-page":"e13997","DOI":"10.1111\/eci.13997","volume":"53","author":"F Mahmoud","year":"2023","unstructured":"Mahmoud F, Mullen A, Sainsbury C, Rushworth GF, Yasin H, Abutheraa N, et al. Meta-analysis of factors associated with antidiabetic drug prescribing for type 2 diabetes mellitus. Eur J Clin Invest. 2023;53:e13997.","journal-title":"Eur J Clin Invest"},{"key":"3539_CR9","doi-asserted-by":"publisher","first-page":"2293","DOI":"10.2337\/dc21-0529","volume":"44","author":"ST Harris","year":"2021","unstructured":"Harris ST, Patorno E, Zhuo M, Kim SC, Paik JM. Prescribing trends of antidiabetes medications in patients with type 2 diabetes and diabetic kidney disease: a cohort study. Diabetes Care. 2021;44:2293\u2013301.","journal-title":"Diabetes Care"},{"key":"3539_CR10","doi-asserted-by":"publisher","first-page":"69","DOI":"10.2337\/dc17-1414","volume":"41","author":"O Montvida","year":"2018","unstructured":"Montvida O, Shaw J, Atherton JJ, Stringer F, Paul SK. Long-term trends in antidiabetes drug usage in the US: real-world evidence in patients newly diagnosed with type 2 diabetes. Diabetes Care. 2018;41:69\u201378.","journal-title":"Diabetes Care"},{"key":"3539_CR11","doi-asserted-by":"publisher","first-page":"2293","DOI":"10.2337\/DC21-0529","volume":"44","author":"ST Harris","year":"2021","unstructured":"Harris ST, Patorno E, Zhuo M, Kim SC, Paik JM. Prescribing Trends of Antidiabetes Medications in Patients With Type 2 Diabetes and Diabetic Kidney Disease: A Cohort Study. Diabetes Care. 2021;44:2293\u2013301. https:\/\/doi.org\/10.2337\/DC21-0529.","journal-title":"Diabetes Care"},{"key":"3539_CR12","doi-asserted-by":"publisher","first-page":"661","DOI":"10.37765\/ajmc.2023.89466","volume":"29","author":"DT Liss","year":"2023","unstructured":"Liss DT, Cherupally M, O\u2019Brien MJ, Kang RH, Aikman C, Wallia A, et al. Treatment Modification After Initiating Second-Line Medication for Type 2 Diabetes. Am J Managed Care. 2023;29:661\u20138. https:\/\/doi.org\/10.37765\/ajmc.2023.89466.","journal-title":"Am J Managed Care"},{"key":"3539_CR13","doi-asserted-by":"publisher","first-page":"477","DOI":"10.1007\/s40265-020-01279-y","volume":"80","author":"DN Koye","year":"2020","unstructured":"Koye DN, Montvida O, Paul SK. Third-line antidiabetic therapy intensification patterns and glycaemic control in patients with type 2 diabetes in the USA: a real-world study. Drugs. 2020;80:477\u201387. https:\/\/doi.org\/10.1007\/s40265-020-01279-y.","journal-title":"Drugs"},{"key":"3539_CR14","unstructured":"Chronic Conditions. https:\/\/www2.ccwdata.org\/web\/guest\/condition-categories-chronic. Accessed 6 Nov 2023."},{"key":"3539_CR15","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1016\/j.clinthera.2011.01.024","volume":"33","author":"J Voorham","year":"2011","unstructured":"Voorham J, Haaijer-Ruskamp FM, Wolffenbuttel BHR, Stolk RP, Denig P. Medication adherence affects treatment modifications in patients with type 2 diabetes. Clin Ther. 2011;33:121\u201334.","journal-title":"Clin Ther"},{"key":"3539_CR16","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1177\/0145721710388427","volume":"37","author":"RW Grant","year":"2011","unstructured":"Grant RW, Pabon-Nau L, Ross KM, Youatt EJ, Pandiscio JC, Park ER. Diabetes Oral Medication Initiation and Intensification. Diabetes Educ. 2011;37:78\u201384.","journal-title":"Diabetes Educ"},{"key":"3539_CR17","doi-asserted-by":"publisher","first-page":"e56","DOI":"10.1111\/dme.12061","volume":"30","author":"NJ Wei","year":"2013","unstructured":"Wei NJ, Wexler DJ, Nathan DM, Grant RW. Intensification of diabetes medication and risk for 30-day readmission. Diabet Med. 2013;30:e56\u201362.","journal-title":"Diabet Med"},{"key":"3539_CR18","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1002\/jppr.1812","volume":"52","author":"JA Wong","year":"2022","unstructured":"Wong JA, Young I, Sim R, Kua KP, Lee SWH. Type 2 Diabetes mellitus treatment intensification and deintensification in primary care: a retrospective cohort study. J Pharm Pract Res. 2022;52:311\u20137.","journal-title":"J Pharm Pract Res"},{"key":"3539_CR19","doi-asserted-by":"publisher","first-page":"1317","DOI":"10.4158\/EP-2019-0303","volume":"25","author":"DV Pirela","year":"2019","unstructured":"Pirela DV, Garg R. De-intensification of diabetes treatment in elderly patients with type 2 diabetes mellitus. Endocr Pract. 2019;25:1317\u201322.","journal-title":"Endocr Pract"},{"key":"3539_CR20","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1472-6823-13-20","volume":"13","author":"M Pawaskar","year":"2013","unstructured":"Pawaskar M, Bonafede M, Johnson B, Fowler R, Lenhart G, Hoogwerf B. Medication utilization patterns among type 2 diabetes patients initiating Exenatide BID or insulin glargine: a retrospective database study. BMC Endocr Disord. 2013;13:1\u20138.","journal-title":"BMC Endocr Disord"},{"key":"3539_CR21","doi-asserted-by":"publisher","unstructured":"Horsburgh S, Sharples K, Barson D, Zeng J, Parkin L. Patterns of metformin monotherapy discontinuation and reinitiation in people with type 2 diabetes mellitus in New Zealand. PLoS ONE. 2021;16. https:\/\/doi.org\/10.1371\/journal.pone.0250289.","DOI":"10.1371\/journal.pone.0250289"},{"key":"3539_CR22","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1007\/s00592-014-0692-x","volume":"52","author":"P Simard","year":"2015","unstructured":"Simard P, Presse N, Roy L, Dorais M, White-Guay B, R\u00e4kel A, et al. Persistence and adherence to oral antidiabetics: a population-based cohort study. Acta Diabetol. 2015;52:547\u201356.","journal-title":"Acta Diabetol"},{"key":"3539_CR23","doi-asserted-by":"crossref","unstructured":"M\u00fcller M. Dynamic time warping. Inform Retr Music Motion. 2007:69\u201384.","DOI":"10.1007\/978-3-540-74048-3_4"},{"key":"3539_CR24","doi-asserted-by":"publisher","first-page":"575","DOI":"10.1080\/0094965031000136012","volume":"73","author":"M n der Laan","year":"2003","unstructured":"n der Laan M, Pollard K, Bryan J. A new partitioning around medoids algorithm. J Stat Comput Simul. 2003;73:575\u201384.","journal-title":"J Stat Comput Simul"},{"key":"3539_CR25","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1016\/0377-0427(87)90125-7","volume":"20","author":"PJ Rousseeuw","year":"1987","unstructured":"Rousseeuw PJ. Silhouettes: a graphical aid to the interpretation and validation of cluster analysis. J Comput Appl Math. 1987;20:53\u201365.","journal-title":"J Comput Appl Math"},{"key":"3539_CR26","unstructured":"Yurtman A, Robberechts P, Vohl D, Ma E, Verbruggen G, Rossi M et al. Wannesm\/dtaidistance: v2. 3.5. Zenodo. 2021."},{"key":"3539_CR27","doi-asserted-by":"publisher","first-page":"4183","DOI":"10.21105\/joss.04183","volume":"7","author":"E Schubert","year":"2022","unstructured":"Schubert E, Lenssen L. Fast k-medoids Clustering in Rust and Python. J Open Source Softw. 2022;7:4183.","journal-title":"J Open Source Softw"},{"key":"3539_CR28","doi-asserted-by":"crossref","unstructured":"Elixhauser A, Steiner C, Harris DR, Coffey RM. Comorbidity measures for use with administrative data. Med Care. 1998:8\u201327.","DOI":"10.1097\/00005650-199801000-00004"},{"key":"3539_CR29","doi-asserted-by":"publisher","first-page":"107946","DOI":"10.1016\/j.diabres.2019.107946","volume":"159","author":"G Schernthaner","year":"2020","unstructured":"Schernthaner G, Schernthaner G-H. The right place for metformin today. Diabetes Res Clin Pract. 2020;159:107946. https:\/\/doi.org\/10.1016\/j.diabres.2019.107946.","journal-title":"Diabetes Res Clin Pract"},{"key":"3539_CR30","doi-asserted-by":"publisher","first-page":"268","DOI":"10.1080\/10810730.2011.604388","volume":"16","author":"CY Osborn","year":"2011","unstructured":"Osborn CY, Cavanaugh K, Wallston KA, Kripalani S, Elasy TA, Rothman RL, et al. Health literacy explains racial disparities in diabetes medication adherence. J Health Commun. 2011;16:268\u201378.","journal-title":"J Health Commun"},{"key":"3539_CR31","doi-asserted-by":"crossref","unstructured":"Shahin W, Kennedy GA, Stupans I. The impact of personal and cultural beliefs on medication adherence of patients with chronic illnesses: a systematic review. Patient Prefer Adherence. 2019;13:1019\u201335.","DOI":"10.2147\/PPA.S212046"},{"key":"3539_CR32","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1186\/s12877-017-0574-5","volume":"17","author":"L Schlender","year":"2017","unstructured":"Schlender L, Martinez YV, Adeniji C, Reeves D, Faller B, Sommerauer C, et al. Efficacy and safety of metformin in the management of type 2 diabetes mellitus in older adults: a systematic review for the development of recommendations to reduce potentially inappropriate prescribing. BMC Geriatr. 2017;17:99\u2013117.","journal-title":"BMC Geriatr"},{"key":"3539_CR33","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1016\/j.amjms.2016.01.010","volume":"351","author":"MT Brown","year":"2016","unstructured":"Brown MT, Bussell J, Dutta S, Davis K, Strong S, Mathew S. Medication adherence: truth and consequences. Am J Med Sci. 2016;351:387\u201399.","journal-title":"Am J Med Sci"},{"key":"3539_CR34","doi-asserted-by":"publisher","first-page":"927","DOI":"10.1007\/s40615-020-00850-3","volume":"8","author":"GL Hall","year":"2021","unstructured":"Hall GL, Heath M. Poor medication adherence in African Americans is a matter of trust. J Racial Ethn Health Disparities. 2021;8:927\u201342.","journal-title":"J Racial Ethn Health Disparities"},{"key":"3539_CR35","doi-asserted-by":"publisher","first-page":"1588","DOI":"10.2337\/dc16-1925","volume":"40","author":"K Khunti","year":"2017","unstructured":"Khunti K, Seidu S, Kunutsor S, Davies M. Association between adherence to pharmacotherapy and outcomes in type 2 diabetes: a meta-analysis. Diabetes Care. 2017;40:1588\u201396.","journal-title":"Diabetes Care"},{"key":"3539_CR36","doi-asserted-by":"publisher","first-page":"258","DOI":"10.2337\/dc15-1194","volume":"39","author":"AJ Farmer","year":"2016","unstructured":"Farmer AJ, Rodgers LR, Lonergan M, Shields B, Weedon MN, Donnelly L, et al. Adherence to oral glucose-lowering therapies and associations with 1-year HbA1c: a retrospective cohort analysis in a large primary care database. Diabetes Care. 2016;39:258\u201363.","journal-title":"Diabetes Care"},{"key":"3539_CR37","doi-asserted-by":"publisher","first-page":"e205411","DOI":"10.1001\/jamanetworkopen.2020.5411","volume":"3","author":"LG Gilstrap","year":"2020","unstructured":"Gilstrap LG, Blair RA, Huskamp HA, Zelevinsky K, Normand S-L. Assessment of second-generation diabetes medication initiation among Medicare enrollees from 2007 to 2015. JAMA Netw Open. 2020;3:e205411.","journal-title":"JAMA Netw Open"},{"key":"3539_CR38","doi-asserted-by":"publisher","first-page":"e2020969","DOI":"10.1001\/jamanetworkopen.2020.20969","volume":"3","author":"J Luo","year":"2020","unstructured":"Luo J, Feldman R, Rothenberger SD, Hernandez I, Gellad WF. Coverage, formulary restrictions, and out-of-pocket costs for sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide 1 receptor agonists in the Medicare Part D program. JAMA Netw Open. 2020;3:e2020969.","journal-title":"JAMA Netw Open"},{"key":"3539_CR39","doi-asserted-by":"publisher","first-page":"471","DOI":"10.1007\/s11606-018-4310-4","volume":"33","author":"BE Landon","year":"2018","unstructured":"Landon BE, Zaslavsky AM, Souza J, Ayanian JZ. Trends in diabetes treatment and monitoring among Medicare beneficiaries. J Gen Intern Med. 2018;33:471\u201380.","journal-title":"J Gen Intern Med"},{"key":"3539_CR40","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1517\/14740338.2015.977863","volume":"14","author":"SH Tella","year":"2015","unstructured":"Tella SH, Rendell MS. DPP-4 inhibitors: focus on safety. Expert Opin Drug Saf. 2015;14:127\u201340.","journal-title":"Expert Opin Drug Saf"},{"key":"3539_CR41","first-page":"840","volume":"11","author":"S Daniele","year":"2015","unstructured":"Daniele S, Luca R, Gian P, Pamela M, Marcello B, Roberto M. Sulfonylureas and their use in clinical practice. Arch Med Sci. 2015;11:840\u20138.","journal-title":"Arch Med Sci"},{"key":"3539_CR42","doi-asserted-by":"publisher","first-page":"S125","DOI":"10.2337\/dc08-s231","volume":"31 Supplement2","author":"MC Riddle","year":"2008","unstructured":"Riddle MC. Combined therapy with insulin plus oral agents: is there any advantage? An argument in favor. Diabetes Care. 2008;31 Supplement2:S125\u201330.","journal-title":"Diabetes Care"},{"key":"3539_CR43","doi-asserted-by":"publisher","first-page":"1395","DOI":"10.1002\/pds.5672","volume":"32","author":"MP Oktora","year":"2023","unstructured":"Oktora MP, de Vos S, de Vries ST, Hak E, Denig P. Sex disparities in treatment patterns after metformin initiation among patients with type 2 diabetes mellitus. Pharmacoepidemiol Drug Saf. 2023;32:1395\u2013405. https:\/\/doi.org\/10.1002\/pds.5672.","journal-title":"Pharmacoepidemiol Drug Saf"},{"key":"3539_CR44","doi-asserted-by":"publisher","first-page":"5416","DOI":"10.18632\/oncotarget.23387","volume":"9","author":"W-H Hsu","year":"2017","unstructured":"Hsu W-H, Hsiao P-J, Lin P-C, Chen S-C, Lee M-Y, Shin S-J. Effect of metformin on kidney function in patients with type 2 diabetes mellitus and moderate chronic kidney disease. Oncotarget. 2017;9:5416.","journal-title":"Oncotarget"},{"key":"3539_CR45","first-page":"243","volume":"60","author":"JA Spoelstra","year":"2002","unstructured":"Spoelstra JA, Stol RP, De Bruyne MC, Erkens JA, Herings RM, Leufkens HG, et al. Factors associated with switching from oral hypoglycaemic agents to insulin therapy. Neth J Med. 2002;60:243\u20138.","journal-title":"Neth J Med"},{"key":"3539_CR46","doi-asserted-by":"publisher","first-page":"109855","DOI":"10.1016\/j.diabres.2022.109855","volume":"187","author":"J Luo","year":"2022","unstructured":"Luo J, Gabriel N, Korytkowski M, Hernandez I, Gellad WF. Association of formulary restrictions and initiation of an SGLT2i or GLP1-RA among Medicare beneficiaries with type 2 diabetes. Diabetes Res Clin Pract. 2022;187:109855.","journal-title":"Diabetes Res Clin Pract"}],"container-title":["BMC Medical Informatics and Decision Making"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12911-026-03539-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12911-026-03539-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12911-026-03539-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T22:29:09Z","timestamp":1784068149000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12911-026-03539-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,21]]},"references-count":46,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["3539"],"URL":"https:\/\/doi.org\/10.1186\/s12911-026-03539-5","relation":{},"ISSN":["1472-6947"],"issn-type":[{"value":"1472-6947","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,21]]},"assertion":[{"value":"14 July 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 April 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 May 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The study was conducted in accordance with the ethical standards of the Declaration of Helsinki and approved by the University of Virginia Health Sciences Research institutional review board (IRB-HSR #21127). Given the retrospective nature of the study, the requirement for informed consent was waived by the University of Virginia Health Sciences Research institutional review board (IRB-HSR #21127).","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"267"}}