{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T11:44:59Z","timestamp":1777463099110,"version":"3.51.4"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2019,9,18]],"date-time":"2019-09-18T00:00:00Z","timestamp":1568764800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2019,9,18]],"date-time":"2019-09-18T00:00:00Z","timestamp":1568764800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100011438","name":"State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics","doi-asserted-by":"publisher","award":["SKLVD2018KF001, SKLVD2018KF002"],"award-info":[{"award-number":["SKLVD2018KF001, SKLVD2018KF002"]}],"id":[{"id":"10.13039\/501100011438","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Detecting avian influenza virus has become an important public health strategy for controlling the emerging infectious disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The HIS (hospital information system) modified influenza surveillance system (ISS) and a newly built pneumonia surveillance system (PSS) were used to monitor the influenza viruses in Changsha City, China. The ISS was used to monitor outpatients in two sentinel hospitals and to detect mild influenza and avian influenza cases, and PSS was used to monitor inpatients in 49 hospitals and to detect severe and death influenza cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>From 2005 to 2016, there were 3,551,917 outpatients monitored by the ISS system, among whom 126,076 were influenza-like illness (ILI) cases, with the ILI proportion (ILI%) of 3.55%. After the HIS was used, the reported incident cases of ILI and ILI% were increased significantly. From March, 2009 to September, 2016, there were 5,491,560 inpatient cases monitored by the PSS system, among which 362,743 were pneumonia cases, with a proportion of 6.61%. Among pneumonia cases, about 10.55% (38,260\/362,743) of cases were severe or death cases. The pneumonia incidence increased each year in the city. Among 15 avian influenza cases reported from January, 2005 to September, 2016, there were 26.7% (4\/15) mild cases detected by the HIS-modified ISS system, while 60.0% (9\/15) were severe or death cases detected by the PSS system. Two H5N1 severe cases were missed by the ISS system in January, 2009 when the PSS system was not available.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The HIS was able to improve the efficiency of the ISS for monitoring ILI and emerging avian influenza virus. However, the efficiency of the system needs to be verified in a wider area for a longer time span in China.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12879-019-4405-5","type":"journal-article","created":{"date-parts":[[2019,9,18]],"date-time":"2019-09-18T10:07:31Z","timestamp":1568801251000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Detecting influenza and emerging avian influenza virus by influenza and pneumonia surveillance systems in a large city in China, 2005 to 2016"],"prefix":"10.1186","volume":"19","author":[{"given":"Xiaorong","family":"Guo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dong","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruchun","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yaman","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qingqing","family":"Hu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinrui","family":"Ma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yelan","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heng","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xixing","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benhua","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0710-5086","authenticated-orcid":false,"given":"Tianmu","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2019,9,18]]},"reference":[{"issue":"9918","key":"4405_CR1","doi-asserted-by":"publisher","first-page":"714","DOI":"10.1016\/S0140-6736(14)60111-2","volume":"383","author":"H Chen","year":"2014","unstructured":"Chen H, Yuan H, Gao R, Zhang J, Wang D, Xiong Y, Fan G, Yang F, Li X, Zhou J, et al. Clinical and epidemiological characteristics of a fatal case of avian influenza a H10N8 virus infection: a descriptive study. Lancet. 2014;383(9918):714\u201321.","journal-title":"Lancet"},{"issue":"6","key":"4405_CR2","doi-asserted-by":"publisher","first-page":"702","DOI":"10.1016\/j.jinf.2015.09.004","volume":"71","author":"T Chen","year":"2015","unstructured":"Chen T, Zhang R. Symptoms seem to be mild in children infected with avian influenza a (H5N6) and other subtypes. J Infec. 2015;71(6):702\u20133.","journal-title":"J Infec"},{"issue":"6","key":"4405_CR3","doi-asserted-by":"publisher","first-page":"964","DOI":"10.3201\/eid2206.151752","volume":"22","author":"P Wu","year":"2016","unstructured":"Wu P, Peng Z, Fang VJ, Feng L, Tsang TK, Jiang H, Lau EH, Yang J, Zheng J, Qin Y, et al. Human infection with influenza a(H7N9) virus during 3 major epidemic waves, China, 2013-2015. Emerg Infect Dis. 2016;22(6):964\u201372.","journal-title":"Emerg Infect Dis"},{"issue":"7","key":"4405_CR4","doi-asserted-by":"publisher","first-page":"e108","DOI":"10.1016\/S1473-3099(16)00153-5","volume":"16","author":"S Lai","year":"2016","unstructured":"Lai S, Qin Y, Cowling BJ, Ren X, Wardrop NA, Gilbert M, Tsang TK, Wu P, Feng L, Jiang H, et al. Global epidemiology of avian influenza a H5N1 virus infection in humans, 1997-2015: a systematic review of individual case data. Lancet Infect Dis. 2016;16(7):e108\u201318.","journal-title":"Lancet Infect Dis"},{"key":"4405_CR5","doi-asserted-by":"publisher","first-page":"43566","DOI":"10.1038\/srep43566","volume":"7","author":"Y Peng","year":"2017","unstructured":"Peng Y, Li X, Zhou H, Wu A, Dong L, Zhang Y, Gao R, Bo H, Yang L, Wang D, et al. Continual antigenic diversification in China leads to global antigenic complexity of avian influenza H5N1 viruses. Sci Rep. 2017;7:43566.","journal-title":"Sci Rep"},{"issue":"13","key":"4405_CR6","doi-asserted-by":"publisher","first-page":"1374","DOI":"10.1056\/NEJMra052211","volume":"353","author":"JH Beigel","year":"2005","unstructured":"Beigel JH, Farrar J, Han AM, Hayden FG, Hyer R, de Jong MD, Lochindarat S, Nguyen TK, Nguyen TH, Tran TH, et al. Avian influenza a (H5N1) infection in humans. N Engl J Med. 2005;353(13):1374\u201385.","journal-title":"N Engl J Med"},{"issue":"3","key":"4405_CR7","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1056\/NEJMra0707279","volume":"358","author":"AN Abdel-Ghafar","year":"2008","unstructured":"Writing Committee of the Second World Health Organization Consultation on Clinical Aspects of Human Infection with Avian Influenza AV, Abdel-Ghafar AN, Chotpitayasunondh T, Gao Z, Hayden FG, Nguyen DH, de Jong MD, Naghdaliyev A, Peiris JS, Shindo N, et al. Update on avian influenza A (H5N1) virus infection in humans. N Engl J Med. 2008;358(3):261\u201373.","journal-title":"N Engl J Med"},{"issue":"21","key":"4405_CR8","doi-asserted-by":"publisher","first-page":"2179","DOI":"10.1056\/NEJMoa060601","volume":"355","author":"AF Oner","year":"2006","unstructured":"Oner AF, Bay A, Arslan S, Akdeniz H, Sahin HA, Cesur Y, Epcacan S, Yilmaz N, Deger I, Kizilyildiz B, et al. Avian influenza a (H5N1) infection in eastern Turkey in 2006. N Engl J Med. 2006;355(21):2179\u201385.","journal-title":"N Engl J Med"},{"issue":"5","key":"4405_CR9","doi-asserted-by":"publisher","first-page":"122","DOI":"10.2807\/esm.11.05.00620-en","volume":"11","author":"A Gilsdorf","year":"2006","unstructured":"Gilsdorf A, Boxall N, Gasimov V, Agayev I, Mammadzade F, Ursu P, Gasimov E, Brown C, Mardel S, Jankovic D, et al. Two clusters of human infection with influenza a\/H5N1 virus in the republic of Azerbaijan, February-march 2006. Euro Surveill. 2006;11(5):122\u20136.","journal-title":"Euro Surveill"},{"issue":"4","key":"4405_CR10","doi-asserted-by":"publisher","first-page":"542","DOI":"10.3201\/eid2004.131295","volume":"20","author":"G Kayali","year":"2014","unstructured":"Kayali G, Kandeil A, El-Shesheny R, Kayed AS, Gomaa MM, Maatouq AM, Shehata MM, Moatasim Y, Bagato O, Cai Z, et al. Active surveillance for avian influenza virus, Egypt, 2010-2012. Emerg Infect Dis. 2014;20(4):542\u201351.","journal-title":"Emerg Infect Dis"},{"issue":"20","key":"4405_CR11","doi-asserted-by":"publisher","first-page":"1888","DOI":"10.1056\/NEJMoa1304459","volume":"368","author":"R Gao","year":"2013","unstructured":"Gao R, Cao B, Hu Y, Feng Z, Wang D, Hu W, Chen J, Jie Z, Qiu H, Xu K, et al. Human infection with a novel avian-origin influenza a (H7N9) virus. N Engl J Med. 2013;368(20):1888\u201397.","journal-title":"N Engl J Med"},{"key":"4405_CR12","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1016\/j.meegid.2016.03.010","volume":"40","author":"R Zhang","year":"2016","unstructured":"Zhang R, Chen T, Ou X, Liu R, Yang Y, Ye W, Chen J, Yao D, Sun B, Zhang X, et al. Clinical, epidemiological and virological characteristics of the first detected human case of avian influenza a(H5N6) virus. Infect Genet Evol. 2016;40:236\u201342.","journal-title":"Infect Genet Evol"},{"issue":"12","key":"4405_CR13","doi-asserted-by":"publisher","first-page":"2268","DOI":"10.3201\/eid2112.150809","volume":"21","author":"CK Mok","year":"2015","unstructured":"Mok CK, Da Guan W, Liu XQ, Lamers MM, Li XB, Wang M, Zhang TJ, Zhang QL, Li ZT, Huang JC, et al. Genetic characterization of highly pathogenic avian influenza a(H5N6) virus, Guangdong, China. Emerg Infect Dis. 2015;21(12):2268\u201371.","journal-title":"Emerg Infect Dis"},{"issue":"5","key":"4405_CR14","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1056\/NEJMc1502983","volume":"373","author":"ZF Yang","year":"2015","unstructured":"Yang ZF, Mok CK, Peiris JS, Zhong NS. Human infection with a novel avian influenza a(H5N6) virus. N Engl J Med. 2015;373(5):487\u20139.","journal-title":"N Engl J Med"},{"issue":"1","key":"4405_CR15","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1016\/j.jinf.2015.06.009","volume":"72","author":"M Pan","year":"2016","unstructured":"Pan M, Gao R, Lv Q, Huang S, Zhou Z, Yang L, Li X, Zhao X, Zou X, Tong W, et al. Human infection with a novel, highly pathogenic avian influenza a (H5N6) virus: Virological and clinical findings. J Infect. 2016;72(1):52\u20139.","journal-title":"J Infect"},{"issue":"11","key":"4405_CR16","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0142584","volume":"10","author":"Y Huang","year":"2015","unstructured":"Huang Y, Zhang H, Li X, Hu S, Cai L, Sun Q, Li W, Deng Z, Xiang X, Zhang H, et al. Detection and genetic characteristics of H9N2 avian influenza viruses from live poultry Markets in Hunan Province, China. PloS one. 2015;10(11):e0142584.","journal-title":"PloS one"},{"key":"4405_CR17","doi-asserted-by":"publisher","first-page":"f3693","DOI":"10.1136\/bmj.f3693","volume":"346","author":"DK Ip","year":"2013","unstructured":"Ip DK, Liao Q, Wu P, Gao Z, Cao B, Feng L, Xu X, Jiang H, Li M, Bao J, et al. Detection of mild to moderate influenza a\/H7N9 infection by China's national sentinel surveillance system for influenza-like illness: case series. Bmj. 2013;346:f3693.","journal-title":"Bmj"},{"issue":"11","key":"4405_CR18","doi-asserted-by":"publisher","first-page":"1784","DOI":"10.3201\/eid1911.130865","volume":"19","author":"N Xiang","year":"2013","unstructured":"Xiang N, Havers F, Chen T, Song Y, Tu W, Li L, Cao Y, Liu B, Zhou L, Meng L, et al. Use of National Pneumonia Surveillance to Describe Influenza A(H7N9) Virus Epidemiology, China, 2004\u20132013. Emerg Infect Dis. 2013;19(11):1784\u201390.","journal-title":"Emerg Infect Dis"},{"issue":"4","key":"4405_CR19","doi-asserted-by":"publisher","first-page":"279","DOI":"10.2471\/BLT.11.096958","volume":"90","author":"L Feng","year":"2012","unstructured":"Feng L, Shay DK, Jiang Y, Zhou H, Chen X, Zheng Y, Jiang L, Zhang Q, Lin H, Wang S, et al. Influenza-associated mortality in temperate and subtropical Chinese cities, 2003\u20132008. Bull World Health Organ. 2012;90(4):279\u2013288B.","journal-title":"Bull World Health Organ"},{"issue":"5","key":"4405_CR20","first-page":"650","volume":"116","author":"Q Guo","year":"2003","unstructured":"Guo Q, Hao F, Duan X, Xie X, Liao W. Multi personal computer storage system: solution of sea capacity PACS storage. Chin Med J. 2003;116(5):650\u20133.","journal-title":"Chin Med J"},{"issue":"15","key":"4405_CR21","first-page":"2372","volume":"124","author":"P Li","year":"2011","unstructured":"Li P, Wu T, Chen M, Zhou B, Xu WG. A study on building data warehouse of hospital information system. Chin Med J. 2011;124(15):2372\u20137.","journal-title":"Chin Med J"},{"issue":"11","key":"4405_CR22","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0166180","volume":"11","author":"T Chen","year":"2016","unstructured":"Chen T, Chen T, Liu R, Xu C, Wang D, Chen F, Zhu W, Zhang X, Yang J, Wang L, et al. Transmissibility of the influenza virus during influenza outbreaks and related asymptomatic infection in mainland China, 2005-2013. PLoS One. 2016;11(11):e0166180.","journal-title":"PLoS One"},{"issue":"3","key":"4405_CR23","doi-asserted-by":"publisher","first-page":"424","DOI":"10.1017\/S0950268816002508","volume":"145","author":"TM Chen","year":"2017","unstructured":"Chen TM, Chen QP, Liu RC, Szot A, Chen SL, Zhao J, Zhou SS. The transmissibility estimation of influenza with early stage data of small-scale outbreaks in Changsha, China, 2005-2013. Epidemiol Infect. 2017;145(3):424\u201333.","journal-title":"Epidemiol Infect"},{"issue":"6","key":"4405_CR24","doi-asserted-by":"publisher","first-page":"842","DOI":"10.1097\/EDE.0b013e3181f20977","volume":"21","author":"BJ Cowling","year":"2010","unstructured":"Cowling BJ, Lau MS, Ho LM, Chuang SK, Tsang T, Liu SH, Leung PY, Lo SV, Lau EH. The effective reproduction number of pandemic influenza: prospective estimation. Epidemiology. 2010;21(6):842\u20136.","journal-title":"Epidemiology"},{"issue":"8","key":"4405_CR25","doi-asserted-by":"publisher","first-page":"1313","DOI":"10.1093\/aje\/kwt120","volume":"178","author":"Y Zhou","year":"2013","unstructured":"Zhou Y, Lau EH, Ip DK, Nishiura H, Leung GM, Seto WH, Cowling BJ. Years of life lost in the first wave of the 2009 influenza a(H1N1) pandemic in Hong Kong. Am J Epidemiol. 2013;178(8):1313\u20138.","journal-title":"Am J Epidemiol"},{"issue":"4","key":"4405_CR26","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1056\/NEJMoa044021","volume":"352","author":"K Ungchusak","year":"2005","unstructured":"Ungchusak K, Auewarakul P, Dowell SF, Kitphati R, Auwanit W, Puthavathana P, Uiprasertkul M, Boonnak K, Pittayawonganon C, Cox NJ, et al. Probable person-to-person transmission of avian influenza a (H5N1). N Engl J Med. 2005;352(4):333\u201340.","journal-title":"N Engl J Med"},{"issue":"12","key":"4405_CR27","doi-asserted-by":"publisher","first-page":"1841","DOI":"10.3201\/eid1212.060829","volume":"12","author":"PN Dinh","year":"2006","unstructured":"Dinh PN, Long HT, Tien NT, Hien NT, le TQ M, Phong le H, Tuan le V, Van Tan H, Nguyen NB, Van Tu P, et al. Risk factors for human infection with avian influenza a H5N1, Vietnam, 2004. Emerg Infect Dis. 2006;12(12):1841\u20137.","journal-title":"Emerg Infect Dis"},{"issue":"12","key":"4405_CR28","doi-asserted-by":"publisher","first-page":"1744","DOI":"10.1086\/599208","volume":"199","author":"S Vong","year":"2009","unstructured":"Vong S, Ly S, Van Kerkhove MD, Achenbach J, Holl D, Buchy P, Sorn S, Seng H, Uyeki TM, Sok T, et al. Risk factors associated with subclinical human infection with avian influenza a (H5N1) virus--Cambodia, 2006. J Infect Dis. 2009;199(12):1744\u201352.","journal-title":"J Infect Dis"},{"issue":"2","key":"4405_CR29","doi-asserted-by":"publisher","first-page":"258","DOI":"10.1016\/j.virol.2006.03.048","volume":"350","author":"GJ Smith","year":"2006","unstructured":"Smith GJ, Naipospos TS, Nguyen TD, de Jong MD, Vijaykrishna D, Usman TB, Hassan SS, Nguyen TV, Dao TV, Bui NA, et al. Evolution and adaptation of H5N1 influenza virus in avian and human hosts in Indonesia and Vietnam. Virology. 2006;350(2):258\u201368.","journal-title":"Virology"},{"issue":"12","key":"4405_CR30","doi-asserted-by":"publisher","first-page":"2171","DOI":"10.3201\/eid2112.150885","volume":"21","author":"S Refaey","year":"2015","unstructured":"Refaey S, Azziz-Baumgartner E, Amin MM, Fahim M, Roguski K, Elaziz HA, Iuliano AD, Salah N, Uyeki TM, Lindstrom S, et al. Increased number of human cases of influenza virus a(H5N1) infection, Egypt, 2014-15. Emerg Infect Dis. 2015;21(12):2171\u20133.","journal-title":"Emerg Infect Dis"},{"issue":"2","key":"4405_CR31","doi-asserted-by":"publisher","first-page":"202","DOI":"10.3201\/eid2102.140877","volume":"21","author":"LO Durand","year":"2015","unstructured":"Durand LO, Glew P, Gross D, Kasper M, Trock S, Kim IK, Bresee JS, Donis R, Uyeki TM, Widdowson M-A, et al. Timing of influenza a(H5N1) in poultry and humans and seasonal influenza activity worldwide, 2004\u20132013. Emerg Infect Dis. 2015;21(2):202\u20138.","journal-title":"Emerg Infect Dis"}],"container-title":["BMC Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-019-4405-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12879-019-4405-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-019-4405-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,9,17]],"date-time":"2020-09-17T08:13:34Z","timestamp":1600330414000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcinfectdis.biomedcentral.com\/articles\/10.1186\/s12879-019-4405-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,9,18]]},"references-count":31,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2019,12]]}},"alternative-id":["4405"],"URL":"https:\/\/doi.org\/10.1186\/s12879-019-4405-5","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.2.1751\/v1","asserted-by":"object"},{"id-type":"doi","id":"10.21203\/rs.2.1751\/v2","asserted-by":"object"},{"id-type":"doi","id":"10.21203\/rs.2.1751\/v3","asserted-by":"object"},{"id-type":"doi","id":"10.21203\/rs.2.1751\/v4","asserted-by":"object"}]},"ISSN":["1471-2334"],"issn-type":[{"value":"1471-2334","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,9,18]]},"assertion":[{"value":"28 March 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 August 2019","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 September 2019","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This effort of outbreak control and investigation was part of CDC\u2019s routine responsibility in Changsha City; therefore, institutional review and informed consent were waived by Medical Ethics Committee of Changsha Center for Disease Control and Prevention on the following grounds: (1) all data analyzed were anonymized.; (2) neither medical intervention nor biological samples were involved; (3) study procedures and results would not affect clinical management of patients in any form.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"No authors declare a conflict of interest.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"825"}}