{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T04:12:58Z","timestamp":1772165578512,"version":"3.50.1"},"reference-count":43,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T00:00:00Z","timestamp":1745971200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T00:00:00Z","timestamp":1745971200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"DOI":"10.13039\/501100004748","name":"Mashhad University of Medical Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004748","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Anesthesiol"],"DOI":"10.1186\/s12871-025-03099-7","type":"journal-article","created":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T02:58:23Z","timestamp":1745981903000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Investigating the effect of ondansetron in reducing myoclonic movements caused by intravenous administration of etomidate"],"prefix":"10.1186","volume":"25","author":[{"given":"Mohammad","family":"Alipour","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seyed Javad Purafzali","family":"Firuzabadi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,4,30]]},"reference":[{"issue":"2","key":"3099_CR1","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1097\/AIA.0000000000000050","volume":"53","author":"DE Raines","year":"2015","unstructured":"Raines DE. The Pharmacology of etomidate and etomidate derivatives. Int Anesthesiol Clin. 2015;53(2):63\u201375.","journal-title":"Int Anesthesiol Clin"},{"issue":"5","key":"3099_CR2","doi-asserted-by":"publisher","first-page":"1689","DOI":"10.1213\/ane.0b013e3181852595","volume":"107","author":"LJ Voss","year":"2008","unstructured":"Voss LJ, Sleigh JW, Barnard JP, Kirsch HE. The howling cortex: seizures and general anesthetic drugs. Anesth Analg. 2008;107(5):1689\u2013703. https:\/\/doi.org\/10.1213\/ane.0b013e3181852595. PMID: 18931234.","journal-title":"Anesth Analg"},{"issue":"1","key":"3099_CR3","first-page":"283","volume":"3","author":"B Nazemroaya","year":"2017","unstructured":"Nazemroaya B, Babaei E. Comparison of recovery time and complications during the use of etomidate and thiopental sodium in anesthesia in children for electroconvulsive therapy; a double blind randomized clinical trial. Archives Anesthesiology Crit Care. 2017;3(1):283\u201390.","journal-title":"Archives Anesthesiology Crit Care"},{"key":"3099_CR4","doi-asserted-by":"publisher","unstructured":"He L, Ding Y, Chen H, Qian Y, Li Z. Butorphanol pre-treatment prevents myoclonus induced by etomidate: a randomised, double-blind, controlled clinical trial. Swiss Med Wkly. 2014;144:w14042. https:\/\/doi.org\/10.4414\/smw.2014.14042. PMID: 25317545.","DOI":"10.4414\/smw.2014.14042"},{"issue":"2","key":"3099_CR5","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1177\/0300060516682882","volume":"45","author":"C Zhou","year":"2017","unstructured":"Zhou C, Zhu Y, Liu Z, Ruan L. Effect of pretreatment with Midazolam on etomidate-induced myoclonus: A meta-analysis. J Int Med Res. 2017;45(2):399\u2013406.","journal-title":"J Int Med Res"},{"key":"3099_CR6","doi-asserted-by":"publisher","unstructured":"Feng Y, Chen XB, Zhang YL, Chang P, Zhang WS. Propofol decreased the etomidate-induced myoclonus in adult patients: a meta-analysis and systematic review. Eur Rev Med Pharmacol Sci. 2023;27(4):1322\u20131335. https:\/\/doi.org\/10.26355\/eurrev_202302_31366. PMID: 36876671.","DOI":"10.26355\/eurrev_202302_31366"},{"issue":"9","key":"3099_CR7","doi-asserted-by":"publisher","first-page":"815","DOI":"10.4103\/ija.ija_414_23","volume":"67","author":"RS Rautela","year":"2023","unstructured":"Rautela RS, Gulabani M, Kumar P, Salhotra R, Mohta M, Verma K. Comparative assessment of Dexmedetomidine and Butorphanol for Attenuation of etomidate-induced myoclonus: A double-blind, randomised controlled study. Indian J Anaesth. 2023;67(9):815\u201320. https:\/\/doi.org\/10.4103\/ija.ija_414_23. Epub 2023 Sep 6. PMID: 37829775; PMCID: PMC10566664.","journal-title":"Indian J Anaesth"},{"key":"3099_CR8","unstructured":"Abdollahi MH, Forouzannia SK, Bagherinasab M, Barzegar K, Fekri A, Sarebanhassanabadi M et al. The effect of Ondansetron and meperedin on preventing shivering after off-pump coronary artery bypass graft. Acta Medica Iranica. 2012:395\u20138."},{"key":"3099_CR9","doi-asserted-by":"crossref","unstructured":"Kelsaka E, Baris S, Karakaya D, Sar\u0131hasan B. Comparison of Ondansetron and Meperidinefor Prevention of Shivering in Patients Undergoing Spinal Anesthesia. Regional Anesthesia& Pain Medicine. 2006;31(1):40\u2013\u20095.","DOI":"10.1016\/j.rapm.2005.10.010"},{"key":"3099_CR10","doi-asserted-by":"publisher","unstructured":"Doenicke AW, Roizen MF, Kugler J, Kroll H, Foss J, Ostwald P. Reducing myoclonus after etomidate. Anesthesiology. 1999;90(1):113-9. https:\/\/doi.org\/10.1097\/00000542-199901000-00017. PMID: 9915320.","DOI":"10.1097\/00000542-199901000-00017"},{"issue":"6","key":"3099_CR11","doi-asserted-by":"publisher","first-page":"e2701","DOI":"10.1097\/MD.0000000000002701","volume":"95","author":"GN Wu","year":"2016","unstructured":"Wu GN, Xu HJ, Liu FF, Wu X, Zhou H. Low-Dose ketamine pretreatment reduces the incidence and severity of myoclonus induced by etomidate: A randomized, Double-Blinded, controlled clinical trial. Med (Baltim). 2016;95(6):e2701. https:\/\/doi.org\/10.1097\/MD.0000000000002701. PMID: 26871805; PMCID: PMC4753901.","journal-title":"Med (Baltim)"},{"issue":"2","key":"3099_CR12","doi-asserted-by":"publisher","first-page":"e35333","DOI":"10.5812\/aapm.35333","volume":"6","author":"A Sedighinejad","year":"2016","unstructured":"Sedighinejad A, Naderi Nabi B, Haghighi M, Biazar G, Imantalab V, Rimaz S, Zaridoost Z. Comparison of the effects of Low-Dose Midazolam, magnesium sulfate, remifentanil and Low-Dose etomidate on prevention of etomidate-Induced myoclonus in orthopedic surgeries. Anesth Pain Med. 2016;6(2):e35333. https:\/\/doi.org\/10.5812\/aapm.35333. PMID: 27247915; PMCID: PMC4885461.","journal-title":"Anesth Pain Med"},{"issue":"2","key":"3099_CR13","doi-asserted-by":"publisher","first-page":"114","DOI":"10.5152\/eajem.2016.29392","volume":"15","author":"O Eray","year":"2016","unstructured":"Eray O. Comments on etomidate usage in the emergency department. Eurasian J Emerg Med. 2016;15(2):114\u20136. https:\/\/doi.org\/10.5152\/eajem.2016.29392.","journal-title":"Eurasian J Emerg Med"},{"issue":"3","key":"3099_CR14","doi-asserted-by":"publisher","first-page":"305","DOI":"10.4097\/kjae.2008.55.3.305","volume":"55","author":"SH Do","year":"2008","unstructured":"Do SH, Han SH, Park SH, Kim JH, Hwang JY, Son IS, et al. The effect of injection rate on etomidate-induced myoclonus. Korean J Anesthesiol. 2008;55(3):305.","journal-title":"Korean J Anesthesiol"},{"issue":"26","key":"3099_CR15","doi-asserted-by":"publisher","first-page":"e7212","DOI":"10.1097\/MD.0000000000007212","volume":"96","author":"J Liu","year":"2017","unstructured":"Liu J, Liu R, Meng C, Cai Z, Dai X, Deng C, et al. Propofol decreases etomidate-related myoclonus in gastroscopy. Medicine. 2017;96(26):e7212\u2013e.","journal-title":"Medicine"},{"issue":"6","key":"3099_CR16","doi-asserted-by":"publisher","first-page":"e94388","DOI":"10.5812\/aapm.94388","volume":"9","author":"B Nazemroaya","year":"2019","unstructured":"Nazemroaya B, Mousavi SM. Comparison of premedication with Low-Dose Midazolam versus etomidate for reduction of etomidate-Induced myoclonus during general anesthesia for electroconvulsive therapy: A randomized clinical trial. Anesth Pain Med. 2019;9(6):e94388. https:\/\/doi.org\/10.5812\/aapm.94388. PMID: 32280614; PMCID: PMC7118685.","journal-title":"Anesth Pain Med"},{"key":"3099_CR17","doi-asserted-by":"publisher","unstructured":"H\u00fcter L, Schreiber T, Gugel M, Schwarzkopf K. Low-dose intravenous midazolam reduces etomidate-induced myoclonus: a prospective, randomized study in patients undergoing elective cardioversion. Anesth Analg. 2007;105(5):1298\u2013\u2009302, table of contents. https:\/\/doi.org\/10.1213\/01.ane.0000287248.25610.c0. PMID: 17959958.","DOI":"10.1213\/01.ane.0000287248.25610.c0"},{"issue":"1","key":"3099_CR18","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1177\/147323000803600103","volume":"36","author":"J Hwang","year":"2008","unstructured":"Hwang J, Kim J, Oh AY, Do S, Jeon YT, Han SH. A comparison of Midazolam with remifentanil for the prevention of myoclonic movements following etomidate injection. J Int Med Res. 2008;36(1):17\u201322.","journal-title":"J Int Med Res"},{"issue":"1","key":"3099_CR19","first-page":"1","volume":"29","author":"W Wasinwong","year":"2011","unstructured":"Wasinwong W, n Uakritdathikar T, Kovitwanawong N, Pakam P. Prevention of etomidate-induced myoclonic movement after Midazolam co-induction with low-dose etomidate. Songklanagarind Med J. 2011;29(1):1\u20139.","journal-title":"Songklanagarind Med J"},{"key":"3099_CR20","doi-asserted-by":"publisher","unstructured":"Alipour M, Tabari M, Azad AM. Comparative study evaluating efficacy of sufentanil versus Midazolam in preventing myoclonic movements following etomidate. J Anaesthesiol Clin Pharmacol 2016 Jan-Mar;32(1):29\u201332. https:\/\/doi.org\/10.4103\/0970-9185.173382. PMID: 27006537; PMCID: PMC4784209.","DOI":"10.4103\/0970-9185.173382"},{"issue":"2","key":"3099_CR21","first-page":"88","volume":"47","author":"P Bhattacharya","year":"2003","unstructured":"Bhattacharya P, Bhattacharya L, Jain R, Agarwal RC. Post anaesthesia shivering (PAS): A review. Indian J Anaesth. 2003;47(2):88\u201393.","journal-title":"Indian J Anaesth"},{"issue":"1","key":"3099_CR22","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1213\/01.ane.0000296458.16313.7c","volume":"106","author":"EA Kose","year":"2008","unstructured":"Kose EA, Dal D, Akinci SB, Saricaoglu F, Aypar U. The efficacy of ketamine for the treatment of postoperative shivering. Anesth Analgesia. 2008;106(1):120\u20132.","journal-title":"Anesth Analgesia"},{"issue":"6","key":"3099_CR23","doi-asserted-by":"publisher","first-page":"732","DOI":"10.1093\/bja\/ael101","volume":"96","author":"R Komatsu","year":"2006","unstructured":"Komatsu R, Orhan-Sungur M, In J, Podranski T, Bouillon T, Lauber R, et al. Ondansetron does not reduce the shivering threshold in healthy volunteers. BJA: Br J Anaesth. 2006;96(6):732\u20137.","journal-title":"BJA: Br J Anaesth"},{"issue":"3","key":"3099_CR24","doi-asserted-by":"publisher","first-page":"452","DOI":"10.1016\/j.gie.2017.02.033","volume":"86","author":"MG Kim","year":"2017","unstructured":"Kim MG, Park SW, Kim JH, Lee J, Kae SH, Jang HJ, et al. Etomidate versus Propofol sedation for complex upper endoscopic procedures: a prospective double-blinded randomized controlled trial. Gastrointest Endosc. 2017;86(3):452\u201361.","journal-title":"Gastrointest Endosc"},{"issue":"3","key":"3099_CR25","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1097\/ALN.0b013e3181ff72b5","volume":"114","author":"SA Forman","year":"2011","unstructured":"Forman SA. Clinical and molecular Pharmacology of etomidate. Anesthesiology: J Am Soc Anesthesiologists. 2011;114(3):695\u2013707.","journal-title":"Anesthesiology: J Am Soc Anesthesiologists"},{"key":"3099_CR26","doi-asserted-by":"crossref","unstructured":"Renner RM, Jensen JT, Nichols MD, Edelman A. Pain control in first trimester surgical abortion. Cochrane Database Syst Reviews. 2009(2).","DOI":"10.1002\/14651858.CD006712.pub2"},{"key":"3099_CR27","doi-asserted-by":"publisher","unstructured":"Shah SB, Chowdhury I, Bhargava AK, Sabbharwal B. Comparison of hemodynamic effects of intravenous etomidate versus Propofol during induction and intubation using entropy guided hypnosis levels. J Anaesthesiol Clin Pharmacol. 2015 Apr-Jun;31(2):180\u20135. https:\/\/doi.org\/10.4103\/0970-9185.155145. PMID: 25948897; PMCID: PMC4411830.","DOI":"10.4103\/0970-9185.155145"},{"issue":"2","key":"3099_CR28","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1111\/j.1533-2500.2011.00475.x","volume":"12","author":"M Forero","year":"2012","unstructured":"Forero M, Chan PS, Restrepo-Garces CE. Successful reversal of hyperalgesia\/myoclonus complex with low-dose ketamine infusion. Pain Pract. 2012;12(2):154\u20138.","journal-title":"Pain Pract"},{"issue":"2","key":"3099_CR29","doi-asserted-by":"publisher","first-page":"378","DOI":"10.4103\/0976-9668.160012","volume":"6","author":"S Kaur","year":"2015","unstructured":"Kaur S, Saroa R, Aggarwal S. Effect of intraoperative infusion of low-dose ketamine on management of postoperative analgesia. J Nat Sci Biology Med. 2015;6(2):378\u201382.","journal-title":"J Nat Sci Biology Med"},{"issue":"3","key":"3099_CR30","doi-asserted-by":"publisher","first-page":"348","DOI":"10.1016\/j.ajem.2010.10.018","volume":"29","author":"TY Lin","year":"2011","unstructured":"Lin TY, Lee WC, Wu CY. Low-dose ketamine for analgesia in the ED: a retrospective case series. Am J Emerg Med. 2011;29(3):348.","journal-title":"Am J Emerg Med"},{"issue":"3","key":"3099_CR31","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1007\/s00406-013-0420-5","volume":"264","author":"C Hoyer","year":"2014","unstructured":"Hoyer C, Kranaster L, Janke C, Sartorius A. Impact of the anesthetic agents ketamine, etomidate, thiopental, and Propofol on seizure parameters and seizure quality in electroconvulsive therapy: a retrospective study. Eur Arch Psychiatry Clin NeuroSci. 2014;264(3):255\u201361.","journal-title":"Eur Arch Psychiatry Clin NeuroSci"},{"issue":"2","key":"3099_CR32","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1007\/s00540-010-0869-6","volume":"24","author":"F Gultop","year":"2010","unstructured":"Gultop F, Akkaya T, Bedirli N, Gumus H. Lidocaine pretreatment reduces the frequency and severity of myoclonus induced by etomidate. J Anesth. 2010;24(2):300\u20132.","journal-title":"J Anesth"},{"issue":"1","key":"3099_CR33","doi-asserted-by":"publisher","first-page":"e11","DOI":"10.1016\/j.jss.2009.07.031","volume":"159","author":"A Mizrak","year":"2010","unstructured":"Mizrak A, Koruk S, Bilgi M, Kocamer B, Erkutlu I, Ganidagli S, et al. Pretreatment with Dexmedetomidine or thiopental decreases myoclonus after etomidate: A randomized, Double-Blind controlled trial. J Surg Res. 2010;159(1):e11\u20136.","journal-title":"J Surg Res"},{"issue":"4","key":"3099_CR34","first-page":"356","volume":"66","author":"M Y\u0131lmaz \u00c7akirg\u00f6z","year":"2016","unstructured":"Y\u0131lmaz \u00c7akirg\u00f6z M, Demirel \u0130, Duran E, \u00d6zer AB, Hanc\u0131 V, T\u00fcrkmen \u00dcA, et al. Effect of Gabapentin pretreatment on myoclonus after etomidate: a randomized, double-blind, placebo-controlled study. Revista Brasileira De Anestesiologia. 2016;66(4):356\u201362.","journal-title":"Revista Brasileira De Anestesiologia"},{"issue":"5","key":"3099_CR35","doi-asserted-by":"publisher","first-page":"e517","DOI":"10.1097\/MJT.0000000000000404","volume":"25","author":"J Wang","year":"2018","unstructured":"Wang J, Li Q-B, Wu Y-Y, Wang B-N, Kang J-L, Xu X-W. Efficacy and safety of opioids for the prevention of etomidate-induced myoclonus: a meta-analysis. Am J Ther. 2018;25(5):e517\u201323.","journal-title":"Am J Ther"},{"issue":"11","key":"3099_CR36","first-page":"1325","volume":"35","author":"J Zhang","year":"2015","unstructured":"Zhang J, Liu L, Liu H, Lyu G. Comparison of Butorphanol or Midazolam alone and combination of the two drugs in preventing etomidate-induced myoclonus during anesthesia induction. Chin J Anesthesiology. 2015;35(11):1325\u20137.","journal-title":"Chin J Anesthesiology"},{"issue":"2","key":"3099_CR37","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1177\/0310057X8801600207","volume":"16","author":"R Stockham","year":"1988","unstructured":"Stockham R, Stanley T, Pace N, Gillmor S, Groen F, Hilkens P. Fentanyl pretreatment modifies anaesthetic induction with etomidate. Anaesth Intensive Care. 1988;16(2):171\u20136.","journal-title":"Anaesth Intensive Care"},{"key":"3099_CR38","unstructured":"Prakash S, Mullick P, Virmani P, Talwar V, Singh R. Effect of Pre-Treatment with a combination of Fentanyl and Midazolam for prevention of Etomidate-Induced myoclonus. 2019."},{"issue":"1","key":"3099_CR39","doi-asserted-by":"publisher","first-page":"119","DOI":"10.4103\/aer.AER_188_18","volume":"13","author":"M Bisht","year":"2019","unstructured":"Bisht M, Pokhriyal AS, Khurana G, Sharma JP. Effect of Fentanyl and Nalbuphine for prevention of etomidate-induced myoclonus. Anesth Essays Researches. 2019;13(1):119.","journal-title":"Anesth Essays Researches"},{"issue":"1","key":"3099_CR40","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1007\/s00540-014-1854-2","volume":"29","author":"L He","year":"2015","unstructured":"He L, Ding Y, Chen H, Qian Y, Li Z. Dezocine pretreatment prevents myoclonus induced by etomidate: a randomized, double-blinded controlled trial. J Anesth. 2015;29(1):143\u20135.","journal-title":"J Anesth"},{"key":"3099_CR41","doi-asserted-by":"publisher","first-page":"2163","DOI":"10.2147\/DDDT.S137464","volume":"11","author":"Y Zhu","year":"2017","unstructured":"Zhu Y, Yang Y, Zhou C, Bao Z. Using Dezocine to prevent etomidate-induced myoclonus: a meta-analysis of randomized trials. Drug Des Devel Ther. 2017;11:2163.","journal-title":"Drug Des Devel Ther"},{"issue":"2","key":"3099_CR42","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1590\/1414-431x20144100","volume":"48","author":"H Luan","year":"2015","unstructured":"Luan H, Zhao Z, Feng J, Cui J, Zhang X, Zhu P, et al. Prevention of etomidate-induced myoclonus during anesthetic induction by pretreatment with Dexmedetomidine. Braz J Med Biol Res. 2015;48(2):186\u201390.","journal-title":"Braz J Med Biol Res"},{"key":"3099_CR43","doi-asserted-by":"publisher","first-page":"365","DOI":"10.2147\/DDDT.S121979","volume":"11","author":"X Du","year":"2017","unstructured":"Du X, Zhou C, Pan L, Li C. Effect of Dexmedetomidine in preventing etomidate-induced myoclonus: a meta-analysis. Drug Des Devel Ther. 2017;11:365\u201370.","journal-title":"Drug Des Devel Ther"}],"container-title":["BMC Anesthesiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12871-025-03099-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12871-025-03099-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12871-025-03099-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T02:58:26Z","timestamp":1745981906000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03099-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,30]]},"references-count":43,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["3099"],"URL":"https:\/\/doi.org\/10.1186\/s12871-025-03099-7","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-4663885\/v1","asserted-by":"object"}]},"ISSN":["1471-2253"],"issn-type":[{"value":"1471-2253","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,30]]},"assertion":[{"value":"30 June 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 April 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 April 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 proposed study plan was approved by the ethics committee of Mashhad University of Medical Sciences. (IR.MUMS.MEDICAL.REC.1400.234). Prior to study entrance the study protocol was fully explained and an informed consent was obtained from each participant. The participants were assured that all information will remain confidential.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"224"}}