{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:06:59Z","timestamp":1779062819038,"version":"3.51.4"},"reference-count":39,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T00:00:00Z","timestamp":1775260800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:00:00Z","timestamp":1779062400000},"content-version":"vor","delay-in-days":44,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"DOI":"10.1186\/s12879-026-12702-2","type":"journal-article","created":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T10:16:18Z","timestamp":1775297778000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical impact of metagenomic next-generation sequencing on pathogen detection and outcomes in non-immunocompromised patients with severe pneumonia supported by veno-venous extracorporeal membrane oxygenation"],"prefix":"10.1186","volume":"26","author":[{"given":"Xing-Xing","family":"Li","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bo-Yan","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guo-Wei","family":"Fu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi-Heng","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yang-Chao","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,4,4]]},"reference":[{"issue":"1","key":"12702_CR1","first-page":"35","volume":"24","author":"T Bein","year":"2018","unstructured":"Bein T, Weber-Carstens S, Apfelbacher C. Long-term outcome after the acute respiratory distress syndrome: different from general critical illness? Curr Opin Crit Care. 2018;24(1):35\u201340.","journal-title":"Curr Opin Crit Care"},{"issue":"12","key":"12702_CR2","doi-asserted-by":"publisher","first-page":"e0243762","DOI":"10.1371\/journal.pone.0243762","volume":"15","author":"F Sangla","year":"2020","unstructured":"Sangla F, Legouis D, Marti PE, Sgardello SD, Brebion A, Saint-Sardos P, et al. One year after ICU admission for severe community-acquired pneumonia of bacterial, viral or unidentified etiology. What Are outcomes? PLoS One. 2020;15(12):e0243762.","journal-title":"What Are outcomes? PLoS One"},{"issue":"Suppl 2","key":"12702_CR3","doi-asserted-by":"publisher","first-page":"S27","DOI":"10.1086\/511159","volume":"44","author":"LA Mandell","year":"2007","unstructured":"Mandell LA, Wunderink RG, Anzueto A, Bartlett JG, Campbell GD, Dean NC, et al. Infectious diseases society of America\/American thoracic society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis. 2007;44(Suppl 2):S27\u201372.","journal-title":"Clin Infect Dis"},{"issue":"3","key":"12702_CR4","doi-asserted-by":"publisher","first-page":"157","DOI":"10.3904\/kjim.2007.22.3.157","volume":"22","author":"JH Lee","year":"2007","unstructured":"Lee JH, Ryu YJ, Chun EM, Chang JH. Outcomes and prognostic factors for severe community-acquired pneumonia that requires mechanical ventilation. Korean J Intern Med. 2007;22(3):157\u201363.","journal-title":"Korean J Intern Med"},{"issue":"6","key":"12702_CR5","doi-asserted-by":"publisher","first-page":"1493","DOI":"10.1097\/01.CCM.0000266755.75844.05","volume":"35","author":"A Rodr\u00edguez","year":"2007","unstructured":"Rodr\u00edguez A, Mendia A, Sirvent JM, Barcenilla F, de la Torre-Prados MV, Sol\u00e9-Viol\u00e1n J, et al. Combination antibiotic therapy improves survival in patients with community-acquired pneumonia and shock. Crit Care Med. 2007;35(6):1493\u20138.","journal-title":"Crit Care Med"},{"issue":"3","key":"12702_CR6","doi-asserted-by":"publisher","first-page":"563","DOI":"10.1016\/j.ccc.2013.03.009","volume":"29","author":"WI Sligl","year":"2013","unstructured":"Sligl WI, Marrie TJ. Severe community-acquired pneumonia. Crit Care Clin. 2013;29(3):563\u2013601.","journal-title":"Crit Care Clin"},{"issue":"7","key":"12702_CR7","doi-asserted-by":"publisher","first-page":"e45","DOI":"10.1164\/rccm.201908-1581ST","volume":"200","author":"JP Metlay","year":"2019","unstructured":"Metlay JP, Waterer GW, Long AC, Anzueto A, Brozek J, Crothers K, et al. Diagnosis and treatment of adults with Community-acquired Pneumonia. An official clinical practice guideline of the American thoracic society and infectious diseases society of America. Am J Respir Crit Care Med. 2019;200(7):e45\u201367.","journal-title":"Am J Respir Crit Care Med"},{"key":"12702_CR8","doi-asserted-by":"crossref","unstructured":"Torres A, Niederman MS, Chastre J, Ewig S, Fernandez-Vandellos P, Hanberger H et al. International ERS\/ESICM\/ESCMID\/ALAT guidelines for the management of hospital-acquired pneumonia and ventilator-associated pneumonia: guidelines for the management of hospital-acquired pneumonia (HAP)\/ventilator-associated pneumonia (VAP) of the European respiratory society (ERS), European society of intensive care medicine (ESICM), European society of clinical microbiology and infectious diseases (ESCMID) and Asociaci\u00f3n Latinoamericana Del T\u00f3rax (ALAT). Eur Respir J. 2017;50(3).","DOI":"10.1183\/13993003.00582-2017"},{"issue":"3","key":"12702_CR9","doi-asserted-by":"publisher","first-page":"332","DOI":"10.1007\/s00134-022-06635-y","volume":"48","author":"M Kochanek","year":"2022","unstructured":"Kochanek M, Kochanek J, B\u00f6ll B, Eichenauer DA, Beutel G, Bracht H, et al. Veno-venous extracorporeal membrane oxygenation (vv-ECMO) for severe respiratory failure in adult cancer patients: a retrospective multicenter analysis. Intensive Care Med. 2022;48(3):332\u201342.","journal-title":"Intensive Care Med"},{"issue":"1","key":"12702_CR10","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1186\/s12931-021-01796-8","volume":"22","author":"TK Oh","year":"2021","unstructured":"Oh TK, Cho HW, Lee HT, Song IA. Chronic respiratory disease and survival outcomes after extracorporeal membrane oxygenation. Respir Res. 2021;22(1):195.","journal-title":"Respir Res"},{"issue":"10","key":"12702_CR11","doi-asserted-by":"publisher","first-page":"1726","DOI":"10.1097\/CCM.0000000000002652","volume":"45","author":"G Grasselli","year":"2017","unstructured":"Grasselli G, Scaravilli V, Di Bella S, Biffi S, Bombino M, Patroniti N, et al. Nosocomial infections during extracorporeal membrane oxygenation: Incidence, Etiology, and impact on patients\u2019 outcome. Crit Care Med. 2017;45(10):1726\u201333.","journal-title":"Crit Care Med"},{"issue":"suppl2","key":"12702_CR12","doi-asserted-by":"publisher","first-page":"S231","DOI":"10.1093\/cid\/ciy693","volume":"67","author":"Q Miao","year":"2018","unstructured":"Miao Q, Ma Y, Wang Q, Pan J, Zhang Y, Jin W, et al. Microbiological diagnostic performance of metagenomic Next-generation sequencing when applied to clinical practice. Clin Infect Dis. 2018;67(suppl2):S231\u201340.","journal-title":"Clin Infect Dis"},{"issue":"2","key":"12702_CR13","doi-asserted-by":"publisher","first-page":"396","DOI":"10.1039\/C8AN01488D","volume":"144","author":"P Rajapaksha","year":"2019","unstructured":"Rajapaksha P, Elbourne A, Gangadoo S, Brown R, Cozzolino D, Chapman J. A review of methods for the detection of pathogenic microorganisms. Analyst. 2019;144(2):396\u2013411.","journal-title":"Analyst"},{"issue":"9","key":"12702_CR14","doi-asserted-by":"publisher","first-page":"3256","DOI":"10.1128\/JCM.40.9.3256-3260.2002","volume":"40","author":"E Spackman","year":"2002","unstructured":"Spackman E, Senne DA, Myers TJ, Bulaga LL, Garber LP, Perdue ML, et al. Development of a real-time reverse transcriptase PCR assay for type A influenza virus and the avian H5 and H7 hemagglutinin subtypes. J Clin Microbiol. 2002;40(9):3256\u201360.","journal-title":"J Clin Microbiol"},{"issue":"10224","key":"12702_CR15","doi-asserted-by":"publisher","first-page":"565","DOI":"10.1016\/S0140-6736(20)30251-8","volume":"395","author":"R Lu","year":"2020","unstructured":"Lu R, Zhao X, Li J, Niu P, Yang B, Wu H, et al. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet. 2020;395(10224):565\u201374.","journal-title":"Lancet"},{"issue":"25","key":"12702_CR16","doi-asserted-by":"publisher","first-page":"2408","DOI":"10.1056\/NEJMoa1401268","volume":"370","author":"MR Wilson","year":"2014","unstructured":"Wilson MR, Naccache SN, Samayoa E, Biagtan M, Bashir H, Yu G, et al. Actionable diagnosis of neuroleptospirosis by next-generation sequencing. N Engl J Med. 2014;370(25):2408\u201317.","journal-title":"N Engl J Med"},{"issue":"6","key":"12702_CR17","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1038\/s41576-019-0113-7","volume":"20","author":"CY Chiu","year":"2019","unstructured":"Chiu CY, Miller SA. Clinical metagenomics. Nat Rev Genet. 2019;20(6):341\u201355.","journal-title":"Nat Rev Genet"},{"key":"12702_CR18","doi-asserted-by":"publisher","first-page":"696403","DOI":"10.3389\/fimmu.2021.696403","volume":"12","author":"W Tang","year":"2021","unstructured":"Tang W, Zhang Y, Luo C, Zhou L, Zhang Z, Tang X, et al. Clinical application of metagenomic Next-Generation sequencing for suspected infections in patients with primary immunodeficiency disease. Front Immunol. 2021;12:696403.","journal-title":"Front Immunol"},{"key":"12702_CR19","doi-asserted-by":"publisher","first-page":"661589","DOI":"10.3389\/fcimb.2021.661589","volume":"11","author":"T Sun","year":"2021","unstructured":"Sun T, Wu X, Cai Y, Zhai T, Huang L, Zhang Y, et al. Metagenomic Next-Generation sequencing for pathogenic diagnosis and antibiotic management of severe Community-Acquired pneumonia in immunocompromised adults. Front Cell Infect Microbiol. 2021;11:661589.","journal-title":"Front Cell Infect Microbiol"},{"issue":"1","key":"12702_CR20","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1186\/s12931-019-1218-4","volume":"20","author":"L Yang","year":"2019","unstructured":"Yang L, Haidar G, Zia H, Nettles R, Qin S, Wang X, et al. Metagenomic identification of severe pneumonia pathogens in mechanically-ventilated patients: a feasibility and clinical validity study. Respir Res. 2019;20(1):265.","journal-title":"Respir Res"},{"issue":"10","key":"12702_CR21","doi-asserted-by":"publisher","first-page":"1259","DOI":"10.1016\/j.jmoldx.2021.06.007","volume":"23","author":"H Zhou","year":"2021","unstructured":"Zhou H, Larkin PMK, Zhao D, Ma Q, Yao Y, Wu X, et al. Clinical impact of metagenomic Next-Generation sequencing of Bronchoalveolar lavage in the diagnosis and management of pneumonia: A multicenter prospective observational study. J Mol Diagn. 2021;23(10):1259\u201368.","journal-title":"J Mol Diagn"},{"issue":"6","key":"12702_CR22","doi-asserted-by":"publisher","first-page":"601","DOI":"10.1097\/MAT.0000000000001432","volume":"67","author":"JE Tonna","year":"2021","unstructured":"Tonna JE, Abrams D, Brodie D, Greenwood JC, Rubio Mateo-Sidron JA, Usman A, et al. Management of adult patients supported with venovenous extracorporeal membrane oxygenation (VV ECMO): guideline from the extracorporeal life support organization (ELSO). Asaio J. 2021;67(6):601\u201310.","journal-title":"Asaio J"},{"key":"12702_CR23","doi-asserted-by":"publisher","first-page":"g5493","DOI":"10.1136\/bmj.g5493","volume":"349","author":"CJ Currie","year":"2014","unstructured":"Currie CJ, Berni E, Jenkins-Jones S, Poole CD, Ouwens M, Driessen S, et al. Antibiotic treatment failure in four common infections in UK primary care 1991\u20132012: longitudinal analysis. BMJ. 2014;349:g5493.","journal-title":"BMJ"},{"issue":"5","key":"12702_CR24","doi-asserted-by":"publisher","first-page":"415","DOI":"10.1056\/NEJMoa1500245","volume":"373","author":"S Jain","year":"2015","unstructured":"Jain S, Self WH, Wunderink RG, Fakhran S, Balk R, Bramley AM, et al. Community-Acquired pneumonia requiring hospitalization among U.S. Adults. N Engl J Med. 2015;373(5):415\u201327.","journal-title":"N Engl J Med"},{"key":"12702_CR25","doi-asserted-by":"publisher","first-page":"877205","DOI":"10.3389\/fcimb.2022.877205","volume":"12","author":"YC Zhao","year":"2022","unstructured":"Zhao YC, Ding YZ, Zhao X, Fu GW, Huang MJ, Li XX, et al. Role and clinical application of metagenomic Next-Generation sequencing in immunocompromised patients with acute respiratory failure during Veno-Venous extracorporeal membrane oxygenation. Front Cell Infect Microbiol. 2022;12:877205.","journal-title":"Front Cell Infect Microbiol"},{"key":"12702_CR26","doi-asserted-by":"publisher","first-page":"567615","DOI":"10.3389\/fcimb.2020.567615","volume":"10","author":"YY Qian","year":"2020","unstructured":"Qian YY, Wang HY, Zhou Y, Zhang HC, Zhu YM, Zhou X, et al. Improving pulmonary infection diagnosis with metagenomic next generation sequencing. Front Cell Infect Microbiol. 2020;10:567615.","journal-title":"Front Cell Infect Microbiol"},{"issue":"4","key":"12702_CR27","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1016\/j.jinf.2021.01.029","volume":"82","author":"JM Peng","year":"2021","unstructured":"Peng JM, Du B, Qin HY, Wang Q, Shi Y. Metagenomic next-generation sequencing for the diagnosis of suspected pneumonia in immunocompromised patients. J Infect. 2021;82(4):22\u20137.","journal-title":"J Infect"},{"issue":"1","key":"12702_CR28","doi-asserted-by":"publisher","first-page":"252","DOI":"10.1186\/s12890-019-1022-4","volume":"19","author":"J Wang","year":"2019","unstructured":"Wang J, Han Y, Feng J. Metagenomic next-generation sequencing for mixed pulmonary infection diagnosis. BMC Pulm Med. 2019;19(1):252.","journal-title":"BMC Pulm Med"},{"key":"12702_CR29","doi-asserted-by":"publisher","first-page":"749905","DOI":"10.3389\/fcimb.2021.749905","volume":"11","author":"Z Zhao","year":"2021","unstructured":"Zhao Z, Song J, Yang C, Yang L, Chen J, Li X, et al. Prevalence of fungal and bacterial Co-Infection in pulmonary fungal infections: A metagenomic next generation Sequencing-Based study. Front Cell Infect Microbiol. 2021;11:749905.","journal-title":"Front Cell Infect Microbiol"},{"key":"12702_CR30","doi-asserted-by":"publisher","first-page":"5884568","DOI":"10.1155\/2022\/5884568","volume":"2022","author":"J Li","year":"2022","unstructured":"Li J, Zhou CE, Wei SC, Wang LN, Shi MW, Sun CP, et al. Diagnostic value of metagenomic Next-Generation sequencing for pneumonia in immunocompromised patients. Can J Infect Dis Med Microbiol. 2022;2022:5884568.","journal-title":"Can J Infect Dis Med Microbiol"},{"key":"12702_CR31","doi-asserted-by":"crossref","unstructured":"Wilden JJ, Jacob JC, Ehrhardt C, Ludwig S, Boergeling Y. Altered signal transduction in the immune response to influenza virus and S. pneumoniae or S. aureus Co-Infections. Int J Mol Sci. 2021;22(11).","DOI":"10.3390\/ijms22115486"},{"key":"12702_CR32","doi-asserted-by":"publisher","first-page":"105","DOI":"10.3389\/fimmu.2020.00105","volume":"11","author":"ER Aguilera","year":"2020","unstructured":"Aguilera ER, Lenz LL. Inflammation as a modulator of host susceptibility to pulmonary Influenza, Pneumococcal, and Co-Infections. Front Immunol. 2020;11:105.","journal-title":"Front Immunol"},{"issue":"2","key":"12702_CR33","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1016\/j.jinf.2018.09.004","volume":"78","author":"Y Xie","year":"2019","unstructured":"Xie Y, Du J, Jin W, Teng X, Cheng R, Huang P, et al. Next generation sequencing for diagnosis of severe pneumonia: China, 2010\u20132018. J Infect. 2019;78(2):158\u201369.","journal-title":"J Infect"},{"issue":"9","key":"12702_CR34","doi-asserted-by":"publisher","first-page":"1242","DOI":"10.1086\/496927","volume":"41","author":"J Maertens","year":"2005","unstructured":"Maertens J, Theunissen K, Verhoef G, Verschakelen J, Lagrou K, Verbeken E, et al. Galactomannan and computed tomography-based preemptive antifungal therapy in neutropenic patients at high risk for invasive fungal infection: a prospective feasibility study. Clin Infect Dis. 2005;41(9):1242\u201350.","journal-title":"Clin Infect Dis"},{"issue":"2","key":"12702_CR35","doi-asserted-by":"publisher","first-page":"212","DOI":"10.1086\/512174","volume":"28","author":"PM Polgreen","year":"2007","unstructured":"Polgreen PM, Chen YY, Cavanaugh JE, Ward M, Coffman S, Hornick DB, et al. An outbreak of severe clostridium difficile-associated disease possibly related to inappropriate antimicrobial therapy for community-acquired pneumonia. Infect Control Hosp Epidemiol. 2007;28(2):212\u20134.","journal-title":"Infect Control Hosp Epidemiol"},{"issue":"10","key":"12702_CR36","doi-asserted-by":"publisher","first-page":"2922","DOI":"10.1093\/jac\/dkv200","volume":"70","author":"M Tumbarello","year":"2015","unstructured":"Tumbarello M, Viale P, Bassetti M, De Rosa FG, Spanu T, Viscoli C. Infections caused by KPC-producing Klebsiella pneumoniae: differences in therapy and mortality in a multicentre study\u2013authors\u2019 response. J Antimicrob Chemother. 2015;70(10):2922.","journal-title":"J Antimicrob Chemother"},{"issue":"5","key":"12702_CR37","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1007\/BF01712153","volume":"22","author":"F Alvarez-Lerma","year":"1996","unstructured":"Alvarez-Lerma F. Modification of empiric antibiotic treatment in patients with pneumonia acquired in the intensive care unit. ICU-Acquired pneumonia study group. Intensive Care Med. 1996;22(5):387\u201394.","journal-title":"Intensive Care Med"},{"issue":"2","key":"12702_CR38","doi-asserted-by":"publisher","first-page":"412","DOI":"10.1378\/chest.113.2.412","volume":"113","author":"MH Kollef","year":"1998","unstructured":"Kollef MH, Ward S. The influence of mini-BAL cultures on patient outcomes: implications for the antibiotic management of ventilator-associated pneumonia. Chest. 1998;113(2):412\u201320.","journal-title":"Chest"},{"issue":"5","key":"12702_CR39","doi-asserted-by":"publisher","first-page":"778","DOI":"10.1093\/cid\/cix881","volume":"66","author":"PJ Simner","year":"2018","unstructured":"Simner PJ, Miller S, Carroll KC. Understanding the promises and hurdles of metagenomic Next-Generation sequencing as a diagnostic tool for infectious diseases. Clin Infect Dis. 2018;66(5):778\u201388.","journal-title":"Clin Infect Dis"}],"container-title":["BMC Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12879-026-12702-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-026-12702-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-026-12702-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T23:44:56Z","timestamp":1779061496000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12879-026-12702-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,4]]},"references-count":39,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["12702"],"URL":"https:\/\/doi.org\/10.1186\/s12879-026-12702-2","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-7229208\/v1","asserted-by":"object"}]},"ISSN":["1471-2334"],"issn-type":[{"value":"1471-2334","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,4]]},"assertion":[{"value":"28 July 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 January 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 April 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the Ethics Committee of the First Affiliated Hospital of Zhengzhou University (Title: Application of mNGS in patients with ECMO; Date of approval: May 4, 2022; Ethics Number: 2022-KY-0272).","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":"This retrospective study was approved by the Ethics Committee of the First Affiliated Hospital of Zhengzhou University, and the requirement to obtain informed written consent was waived.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"The informed consent waiver statement"}},{"value":"The authors declare no competing interests.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"964"}}