{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T18:54:23Z","timestamp":1781636063089,"version":"3.54.5"},"reference-count":37,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T00:00:00Z","timestamp":1770854400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T00:00:00Z","timestamp":1773964800000},"content-version":"vor","delay-in-days":36,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"the scientific research project of Jiangsu Health Commission","award":["Y12023009"],"award-info":[{"award-number":["Y12023009"]}]},{"name":"the scientific research project of Jiangsu Health Commission","award":["Y12023009"],"award-info":[{"award-number":["Y12023009"]}]},{"name":"the scientific research project of Jiangsu Health Commission","award":["Y12023009"],"award-info":[{"award-number":["Y12023009"]}]},{"name":"the scientific research project of Jiangsu Health Commission","award":["Y12023009"],"award-info":[{"award-number":["Y12023009"]}]},{"name":"the scientific research project of Jiangsu Health Commission","award":["Y12023009"],"award-info":[{"award-number":["Y12023009"]}]},{"name":"the scientific research project of Jiangsu Health Commission","award":["Y12023009"],"award-info":[{"award-number":["Y12023009"]}]},{"name":"the scientific research project of Jiangsu Health Commission","award":["Y12023009"],"award-info":[{"award-number":["Y12023009"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>China experienced its worst pertussis epidemic in 30 years during 2024, and Wujin District faced the same challenge. This study aims to investigate the epidemiological characteristics of pertussis and the immune status of the healthy population in Wujin District, Changzhou City.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The study employed descriptive epidemiology for pertussis case analysis and a serological survey for population antibody assessment in Wujin District, 2024. The level of pertussis toxin (PT) IgG antibody was measured by the Enzyme-Linked Immunosorbent Assay (ELISA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 28 pertussis cases were reported in 2024 in Wujin District, with an incidence rate of 2.15 per 100,000 population. Although infants\u2009&lt;\u20091 year had the peak incidence (84.02 per 100,000), the 5\u20139 year age group accounted for the largest proportion of cases (67.86%) with an incidence rate of 28.70 per 100,000. 521 participants were included in the serological survey. Anti-PT IgG levels were undetectable (&lt;\u20095 IU\/ml) in 49.52% of the participants. The overall positivity (\u2265\u200920 IU\/mL) rate and antibody concentration were 17.27% and 5.17 IU\/mL, respectively. The antibody positive rate was highest in the 1.5\u20133 years age group (30.00%) and lowest in the 20\u201329 years age group (7.89%). The recent infection (\u2265\u200980 IU\/mL) rate was 2.11%, with the top two observed in the 6\u20139 years old group (7.69%) and the 10\u201314 years old group (5.88%). The seropositivity rates and antibody concentrations of vaccinated individuals were higher than those of unvaccinated subjects or those with unknown vaccination history (all\n                      <jats:italic>P<\/jats:italic>\n                      -values\u2009&lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Wujin District saw a striking predominance of pertussis cases in school-aged children (5\u20139 years) in 2024. The antibody levels against pertussis in the healthy population were generally low, especially among adolescents and adults, calling for reinforced active surveillance targeting these age groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial number<\/jats:title>\n                    <jats:p>Not applicable.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12879-026-12799-5","type":"journal-article","created":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T13:35:35Z","timestamp":1770903335000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pertussis epidemiology and seroprevalence in Wujin District, Changzhou, China, 2024"],"prefix":"10.1186","volume":"26","author":[{"given":"Chunyan","family":"Yuan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lingyan","family":"Tang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cong","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiyi","family":"Zhuang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qin","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingzi","family":"Pan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,12]]},"reference":[{"key":"12799_CR1","doi-asserted-by":"publisher","first-page":"722","DOI":"10.1038\/s41579-024-01064-8","volume":"22","author":"M Domenech de Cell`es","year":"2024","unstructured":"Domenech de Cell`es M, Rohani P. Pertussis vaccines, epidemiology and evolution. Nat Rev Microbiol. 2024;22:722\u201335.","journal-title":"Nat Rev Microbiol"},{"issue":"5","key":"12799_CR2","doi-asserted-by":"publisher","first-page":"378","DOI":"10.2500\/aap.2021.42.210065","volume":"42","author":"Frenkel","year":"2021","unstructured":"Frenkel LD. The global burden of vaccine-preventable infectious diseases in children less than 5 years of age: implications for COVID-19 vaccination. How can we do better? Allergy Asthma Proc. 2021;42(5):378\u201385.","journal-title":"Allergy Asthma Proc"},{"issue":"4","key":"12799_CR3","doi-asserted-by":"publisher","first-page":"106140","DOI":"10.1016\/j.jinf.2024.106140","volume":"88","author":"MY Guo","year":"2024","unstructured":"Guo MY, Hu YH, Meng QH, Shi W, Yao KH. Resurgence and atypical patterns of pertussis in China. J Infect. 2024;88(4):106140.","journal-title":"J Infect"},{"key":"12799_CR4","doi-asserted-by":"crossref","unstructured":"Smout E, Mellon D. Maggie Rae. Whooping cough rises sharply in UK and Europe. BMJ. 2024 Apr;2:385q736.","DOI":"10.1136\/bmj.q736"},{"issue":"2","key":"12799_CR5","doi-asserted-by":"publisher","first-page":"e77","DOI":"10.1016\/S1473-3099(23)00757-0","volume":"24","author":"T Dalby","year":"2024","unstructured":"Dalby T. Clarifying pertussis in Denmark. Lancet Infect Dis. 2024;24(2):e77.","journal-title":"Lancet Infect Dis"},{"key":"12799_CR6","unstructured":"National Disease Control and Prevention Administration. Overview of the national epidemic situation of notifiable infectious diseases. https:\/\/www.ndcpa.gov.cn\/jbkzzx\/c100016\/common\/list.html."},{"key":"12799_CR7","unstructured":"European Center for Disease Prevention and Control. Surveillance and updates for pertussis. https:\/\/www.ecdc.europa.eu\/en\/pertussis\/threats-and-outbreaks."},{"issue":"14","key":"12799_CR8","doi-asserted-by":"publisher","first-page":"2400160","DOI":"10.2807\/1560-7917.ES.2024.29.14.2400160","volume":"29","author":"AC Nordholm","year":"2024","unstructured":"Nordholm AC, Emborg HA, Norgaard SK, Nygaard U, Ronayne A, Nielsen LB, et al. Pertussis epidemic in Denmark, August 2023 to February 2024. Euro Surveill. 2024;29(14):2400160.","journal-title":"Euro Surveill"},{"issue":"02","key":"12799_CR9","first-page":"54","volume":"3","author":"LY Tang","year":"2023","unstructured":"Tang LY, Pan YZ, Yuan CY, Ji X. Epidemiological characteristics analysis of pertussis in Wujin District, Changzhou City from 2012 to 2022. Disease Prev Control Bull (in Chinese). 2023;3(02):54\u20137.","journal-title":"Disease Prev Control Bull (in Chinese)"},{"issue":"12","key":"12799_CR10","doi-asserted-by":"publisher","first-page":"2130","DOI":"10.3390\/vaccines10122130","volume":"10","author":"T Grassi","year":"2022","unstructured":"Grassi T, Bagordo F, Savio M, Rota MC, Vitale F, Arghittu A, et al. Sero-Epidemiological study of Bordetella pertussis infection in the Italian general population. Vaccines (Basel). 2022;10(12):2130.","journal-title":"Vaccines (Basel)"},{"issue":"4","key":"12799_CR11","doi-asserted-by":"publisher","first-page":"2071","DOI":"10.1007\/s40121-021-00520-9","volume":"10","author":"D Macina","year":"2021","unstructured":"Macina D, Evans KE. Bordetella pertussis in school-age children, adolescents and adults: a systematic review of epidemiology and mortality in Europe. Infect Dis Ther. 2021;10(4):2071\u2013118.","journal-title":"Infect Dis Ther"},{"issue":"1","key":"12799_CR12","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.jinf.2019.04.011","volume":"79","author":"YX Zhang","year":"2019","unstructured":"Zhang YX, Chen ZY, Zhao JH, Zhang N, Chen N, Zhang J, et al. Increased susceptibility to pertussis in adults at childbearing age as determined by comparative Seroprevalence study, China 2010\u20132016. J Infect. 2019;79(1):1\u20136.","journal-title":"J Infect"},{"issue":"1","key":"12799_CR13","doi-asserted-by":"publisher","first-page":"E70","DOI":"10.1503\/cmaj.110506","volume":"184","author":"SE Wilson","year":"2012","unstructured":"Wilson SE, Deeks SL, Hatchette TF, Crowcroft NS. The role of seroepidemiology in the comprehensive surveillance of vaccine-preventable diseases. CMAJ. 2012;184(1):E70\u201376.","journal-title":"CMAJ"},{"issue":"09","key":"12799_CR14","first-page":"68","volume":"16","author":"JQ Li","year":"2024","unstructured":"Li JQ, Zhang HJ, Sai JY. Analysis of the epidemic characteristics of pertussis in Weihai City from 2018 to 2023. China Rural Health (in Chinese). 2024;16(09):68\u201370.","journal-title":"China Rural Health (in Chinese)"},{"key":"12799_CR15","unstructured":"Shen C, Chen M, Xu L, Sun JN, Huang QM, Wang J, et al. Epidemiological characteristics of pertussis in Nanjing City 2013\u20132023. J Prev Med Inf. 2025 Jan 21. Online ahead of print. https:\/\/link.cnki.net\/urlid\/51.1276.R.20250121.1138.003."},{"key":"12799_CR16","unstructured":"National Disease Control and Prevention Administration. 2023 National Report on Statutory Notifiable Infectious Diseases in China. https:\/\/www.ndcpa.gov.cn\/jbkzzx\/c100016\/common\/content\/content_1836299733133275136.html."},{"issue":"1","key":"12799_CR17","doi-asserted-by":"publisher","first-page":"2513729","DOI":"10.1080\/21645515.2025.2513729","volume":"21","author":"S Wanga","year":"2025","unstructured":"Wanga S, Zhanga S, Liu J. Resurgence of pertussis: epidemiological trends, contributing factors, challenges, and recommendations for vaccination and surveillance. Hum Vaccin Immunother. 2025;21(1):2513729.","journal-title":"Hum Vaccin Immunother"},{"issue":"01","key":"12799_CR18","first-page":"34","volume":"30","author":"Q Zhang","year":"2024","unstructured":"Zhang Q, Wu D, Zheng W, Li MS, Yan TT, Dong ZD, et al. Epidemiological characteristics of pertussis in China in 2022. Chin J Vaccines Immun (in Chinese). 2024;30(01):34\u20138.","journal-title":"Chin J Vaccines Immun (in Chinese)"},{"issue":"6","key":"12799_CR19","doi-asserted-by":"publisher","first-page":"106170","DOI":"10.1016\/j.jinf.2024.106170","volume":"88","author":"Y Hu","year":"2024","unstructured":"Hu Y, Guo M, Yao K. Infections in preschool and school-aged children are driving the recent rise in pertussis in China. J Infect. 2024;88(6):106170.","journal-title":"J Infect"},{"issue":"2","key":"12799_CR20","doi-asserted-by":"publisher","first-page":"106194","DOI":"10.1016\/j.jinf.2024.106194","volume":"89","author":"Y Liu","year":"2024","unstructured":"Liu Y, Ye Q. Resurgence and the shift in the age of peak onset of pertussis in Southern China. J Infect. 2024;89(2):106194.","journal-title":"J Infect"},{"key":"12799_CR21","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1016\/j.ijid.2023.01.005","volume":"128","author":"P Fu","year":"2023","unstructured":"Fu P, Zhou J, Meng J, Liu Z, Nijiati Y, He L, et al. Emergence and spread of MT28 ptxP3 allele macrolide-resistant Bordetella pertussis from 2021 to 2022 in China. Int J Infect Dis. 2023;128:205\u201311.","journal-title":"Int J Infect Dis"},{"issue":"02","key":"12799_CR22","first-page":"173","volume":"26","author":"Y Wu","year":"2020","unstructured":"Wu Y, Chen Q, Leng HY, Guo HX. IgG antibody levels against pertussis toxin and filamentous hemagglutinin among healthy people of Jiangsu Province in 2018. Chin J Vaccines Lmmunization (in Chinese). 2020;26(02):173\u20136.","journal-title":"Chin J Vaccines Lmmunization (in Chinese)"},{"issue":"7","key":"12799_CR23","first-page":"983","volume":"58","author":"Q Liu","year":"2024","unstructured":"Liu Q, Dou QH, Zhang L, Kong JN, Guo YH, Wei DX, et al. Sero-epidemiological study and infection rate evaluation of pertussis in Henan Province. Chin J Prev Med (in Chinese). 2024;58(7):983\u201391.","journal-title":"Chin J Prev Med (in Chinese)"},{"issue":"48","key":"12799_CR24","doi-asserted-by":"publisher","first-page":"6956","DOI":"10.1016\/j.vaccine.2022.10.020","volume":"40","author":"HQ He","year":"2022","unstructured":"He HQ, Zhu Y, Jin MG, Zhou Y, Tang XW, Yan R, et al. The decline in immunity and circulation of pertussis among Chinese population during the COVID-19 pandemic: A cross-sectional seroepidemiological study. Vaccine. 2022;40(48):6956\u201362.","journal-title":"Vaccine"},{"issue":"21","key":"12799_CR25","doi-asserted-by":"publisher","first-page":"e39889","DOI":"10.1016\/j.heliyon.2024.e39889","volume":"10","author":"N Wanlapakorn","year":"2024","unstructured":"Wanlapakorn N, Suntronwong N, Kanokudom S, Assawakosri S, Vichaiwattana P, Klinfueng S, et al. Seroprevalence of antibodies against diphtheria, tetanus, and pertussis across various age groups during the post-COVID-19 pandemic period in Chonburi Province, Thailand. Heliyon. 2024;10(21):e39889.","journal-title":"Heliyon"},{"issue":"12 Suppl 2","key":"12799_CR26","doi-asserted-by":"publisher","first-page":"S310","DOI":"10.1093\/infdis\/jiaa469","volume":"224","author":"MD Decker","year":"2021","unstructured":"Decker MD, Edwards KM. Pertussis (Whooping Cough). J Infect Dis. 2021;224(12 Suppl 2):S310\u201320.","journal-title":"J Infect Dis"},{"issue":"7","key":"12799_CR27","doi-asserted-by":"publisher","first-page":"1159","DOI":"10.3201\/eid1407.071246","volume":"14","author":"N Guiso","year":"2008","unstructured":"Guiso N, Rocque FDL, Njamkepo E, L\u00e9cuyer A, Levy C, Romain O, et al. Pertussis surveillance in private pediatric practices, France, 2002\u20132006. Emerg Infect Dis. 2008;14(7):1159\u201361.","journal-title":"Emerg Infect Dis"},{"issue":"8","key":"12799_CR28","doi-asserted-by":"publisher","first-page":"1336","DOI":"10.3390\/vaccines11081336","volume":"11","author":"W Wang","year":"2023","unstructured":"Wang W, Wang ZG, Chen Q, Li M, Jia CM, Xu Y, et al. The decay of pertussis antibodies in children aged 0\u201314 years in Jiangsu Province, China. Vaccines (Basel). 2023;11(8):1336.","journal-title":"Vaccines (Basel)"},{"issue":"1","key":"12799_CR29","doi-asserted-by":"publisher","first-page":"2341454","DOI":"10.1080\/21645515.2024.2341454","volume":"20","author":"Y Zhu","year":"2024","unstructured":"Zhu Y, Zhang WT, Hu J, Luo SY, Zhou Y, Tang XW, et al. Seroprevalence of IgG antibodies against pertussis toxin in the Chinese population: A systematic review and meta-analysis. Hum Vaccin Immunother. 2024;20(1):2341454.","journal-title":"Hum Vaccin Immunother"},{"issue":"15","key":"12799_CR30","doi-asserted-by":"publisher","first-page":"1555","DOI":"10.1056\/NEJMoa050824","volume":"353","author":"JI Ward","year":"2005","unstructured":"Ward JI, Cherry JD, Chang SJ, Keitel W, Barenkamp S, Bernstein DI, et al. Efficacy of an acellular pertussis vaccine among adolescents and adults. N Engl J Med. 2005;353(15):1555\u201363.","journal-title":"N Engl J Med"},{"issue":"12","key":"12799_CR31","doi-asserted-by":"publisher","first-page":"2351","DOI":"10.1007\/s10096-024-04952-2","volume":"43","author":"JS Zhang","year":"2024","unstructured":"Zhang JS, Wei XG, Luan Y, Zhang DQ, Shan GD, Wang XQ, et al. Laboratory, epidemiological and clinical characteristics of pertussis in children and close contacts: a cross-sectional study. Eur J Clin Microbiol Infect Dis. 2024;43(12):2351\u20139.","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"12799_CR32","doi-asserted-by":"crossref","unstructured":"Son S, Thamlikitkul V, Chokephaibulkit K, Perera J, Jayatilleke K, Hsueh PR, et al. Prospective multinational serosurveillance study of Bordetella pertussis infection among 10- to 18-year-old Asian children and adolescents. Clin Microbiol Infect. 2019;25(2):250.e1-250.e7.","DOI":"10.1016\/j.cmi.2018.04.013"},{"issue":"2","key":"12799_CR33","doi-asserted-by":"publisher","first-page":"e111","DOI":"10.1016\/j.ijid.2009.03.026","volume":"14","author":"PN Baptista","year":"2010","unstructured":"Baptista PN, Magalh\u00e3es VS, Rodrigues LC. The role of adults in household outbreaks of pertussis. Int J Infect Dis. 2010;14(2):e111\u2013114.","journal-title":"Int J Infect Dis"},{"issue":"1","key":"12799_CR34","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1186\/s12879-019-4680-1","volume":"20","author":"K Katfy","year":"2020","unstructured":"Katfy K, Diawara I, Maaloum F, Aziz S, Guiso N, Fellah H, et al. Pertussis in infants, in their mothers and other contacts in Casablanca, Morocco. BMC Infect Dis. 2020;20(1):43.","journal-title":"BMC Infect Dis"},{"issue":"6","key":"12799_CR35","doi-asserted-by":"publisher","first-page":"872","DOI":"10.3390\/vaccines10060872","volume":"10","author":"ZY Chen","year":"2022","unstructured":"Chen ZY, Pang J, Zhang YX, Ding YW, Chen N, Zhang N, et al. Seroprevalence of pertussis in adults at childbearing age Pre-and Post-COVID-19 in Beijing, China. Vaccines (Basel). 2022;10(6):872.","journal-title":"Vaccines (Basel)"},{"key":"12799_CR36","volume-title":"Vaccines[M]","author":"SA Plotkin","year":"2018","unstructured":"Plotkin SA, Orenstein WA, Offit PA. Vaccines[M]. 7th ed. Philadelphia, PA: Elsevier; 2018.","edition":"7"},{"issue":"6","key":"12799_CR37","doi-asserted-by":"publisher","first-page":"1989","DOI":"10.1086\/315509","volume":"181","author":"CM Ausiello","year":"2000","unstructured":"Ausiello CM, Lande R, Urbani F, Carlo BD, Stefanelli P, Salmaso S, et al. Cell-mediated immunity and antibody responses to Bordetella pertussis antigens in children with a history of pertussis infection and in recipients of an acellular pertussis vaccine. J Infect Dis. 2000;181(6):1989\u201395.","journal-title":"J Infect Dis"}],"container-title":["BMC Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12879-026-12799-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-026-12799-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-026-12799-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T18:11:00Z","timestamp":1781633460000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12879-026-12799-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,12]]},"references-count":37,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["12799"],"URL":"https:\/\/doi.org\/10.1186\/s12879-026-12799-5","relation":{},"ISSN":["1471-2334"],"issn-type":[{"value":"1471-2334","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,12]]},"assertion":[{"value":"19 May 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 February 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 February 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 adheres to the principles of the Declaration of Helsinki. Approval for the study was obtained from the Ethics Committee of Jiangsu Provincial Center for Disease Control and Prevention (approval number: JSJK2023-B027-02). All the survey subjects or parents of the children signed the informed consent forms. Personal information including age and gender were collected. Immunization histories were retrieved from the Jiangsu Province vaccination integrated service management information system. All methods conformed to the approved guidelines.","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":"588"}}