{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T01:08:37Z","timestamp":1781658517879,"version":"3.54.5"},"reference-count":37,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,4,19]],"date-time":"2023-04-19T00:00:00Z","timestamp":1681862400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,4,19]],"date-time":"2023-04-19T00:00:00Z","timestamp":1681862400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Minufiya University"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Pulm Med"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Autoimmune rheumatic diseases (ARD) are groups of diseases that are commonly associated with cardiac and pulmonary manifestations and may affect the morbidity and mortality of the patients. The study aimed to the assessment of cardiopulmonary manifestations and their correlation with the semi-quantitative scoring of high-resolution computed tomography (HRCT) in ARD patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and patients<\/jats:title>\n                    <jats:p>30 patients with ARD were included in the study (mean age 42.2\u2009\u00b1\u20099.76 years) [10 patients were scleroderma (SSc), 10 patients were rheumatoid arthritis (RA), and 10 patients were systemic lupus erythematosus (SLE)]. They all met the diagnostic criteria of the American College of Rheumatology and underwent spirometry, echocardiography, and chest HRCT. The HRCT was assessed by a semi-quantitative score for parenchymal abnormalities. Correlation between HRCT lung scores and: inflammatory markers, lung volumes in spirometry, and echocardiographic indices has been performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The total lung score (TLS) by HRCT was 14.8\u2009\u00b1\u20098.78 (mean\u2009\u00b1\u2009SD), ground glass opacity score (GGO) was 7.20\u2009\u00b1\u20095.79 (mean\u2009\u00b1\u2009SD) and fibrosis lung score (F) was 7.63\u2009\u00b1\u20096.05 (mean\u2009\u00b1\u2009SD). TLS correlated significantly with ESR (r 0.528, p 0.003), CRP (r 0.439, p 0.015), PaO2 (r -0.395, P 0.031) FVC% (r -0.687, p 0.001), and echocardiographic Tricuspid E (r -0.370, p 0.044), Tricuspid E\/\u00e8 (r -0.397,p 0.03), ESPAP (r 0.459,p 0.011), TAPSE (r -0.405, p 0.027), MPI-TDI (r -0.428, p 0.018) and RV Global strain(r -0.567, p 0.001). GGO score correlated significantly with ESR (r 0.597, p 0.001), CRP (r 0.473, p 0.008), FVC% (r -0.558, p 0.001), and RV Global strain(r -0.496, p 0.005). F score correlated significantly with FVC% (r -0.397, p 0.030), Tricuspid E\/\u00e8 (r -0.445, p 0.014), ESPAP (r 0.402, p 0.028), and MPI-TDI (r -0.448, p 0.013).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The total lung score and GGO score in ARD were found to be consistently significantly correlated with FVC% predicted, PaO2, inflammatory markers, and RV functions. Fibrotic score correlated with ESPAP. Therefore, in a clinical setting, most clinicians who monitor patients suffering from ARD should concern with the applicability of semiquantitative HRCT scoring in clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12890-023-02404-9","type":"journal-article","created":{"date-parts":[[2023,4,19]],"date-time":"2023-04-19T07:02:18Z","timestamp":1681887738000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Assessment of cardiopulmonary manifestations and its correlation with semi-quantitative scoring of high-resolution computed tomography in patients with autoimmune rheumatic diseases"],"prefix":"10.1186","volume":"23","author":[{"given":"Mai M.","family":"El-Kalashy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samah A.","family":"Elbeltagy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enas S.","family":"Zahran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maha M.","family":"Salman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shrief R. Abd","family":"Elrahman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mai M.","family":"Abdalraouf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amal A.","family":"El-Koa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,4,19]]},"reference":[{"issue":"11","key":"2404_CR1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s11926-017-0697-x","volume":"19","author":"H Jawad","year":"2017","unstructured":"Jawad H, McWilliams SR, Bhalla S. Cardiopulmonary manifestations of collagen vascular diseases. Curr Rheumatol Rep. 2017;19(11):1\u201310.","journal-title":"Curr Rheumatol Rep"},{"issue":"1","key":"2404_CR2","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1097\/01.cpm.0000197403.64631.de","volume":"13","author":"SK Frankel","year":"2006","unstructured":"Frankel SK, Brown KK. Collagen vascular diseases of the lung. Clin Pulmonary Med. 2006;13(1):25\u201336.","journal-title":"Clin Pulmonary Med"},{"issue":"1","key":"2404_CR3","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1186\/s12890-016-0269-2","volume":"16","author":"HM Nurmi","year":"2016","unstructured":"Nurmi HM, et al. Variable course of disease of rheumatoid arthritis-associated usual interstitial pneumonia compared to other subtypes. BMC Pulm Med. 2016;16(1):107.","journal-title":"BMC Pulm Med"},{"key":"2404_CR4","doi-asserted-by":"crossref","unstructured":"Ruaro B et al. High-Resolution Computed Tomography: Lights and Shadows in Improving Care for SSc-ILD Patients. Diagnostics (Basel), 2021. 11(11).","DOI":"10.3390\/diagnostics11111960"},{"issue":"4","key":"2404_CR5","doi-asserted-by":"publisher","first-page":"465","DOI":"10.1007\/BF02283100","volume":"11","author":"A Pignone","year":"1992","unstructured":"Pignone A, et al. High resolution computed tomography in systemic sclerosis. Real diagnostic utilities in the assessment of pulmonary involvement and comparison with other modalities of lung investigation. Clin Rheumatol. 1992;11(4):465\u201372.","journal-title":"Clin Rheumatol"},{"issue":"2","key":"2404_CR6","first-page":"229","volume":"18","author":"G Sergiacomi","year":"2004","unstructured":"Sergiacomi G, et al. Non-invasive diagnostic and functional evaluation of cardiac and pulmonary involvement in systemic sclerosis. in vivo. 2004;18(2):229\u201336.","journal-title":"in vivo"},{"issue":"9","key":"2404_CR7","first-page":"1789","volume":"33","author":"D Launay","year":"2006","unstructured":"Launay D, et al. High resolution computed tomography in fibrosing alveolitis associated with systemic sclerosis. J Rhuematol. 2006;33(9):1789\u2013801.","journal-title":"J Rhuematol"},{"key":"2404_CR8","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1016\/j.ejrad.2019.01.024","volume":"112","author":"FS van Royen","year":"2019","unstructured":"van Royen FS, et al. Automated CT quantification methods for the assessment of interstitial lung disease in collagen vascular diseases: a systematic review. Eur J Radiol. 2019;112:200\u20136.","journal-title":"Eur J Radiol"},{"issue":"10","key":"2404_CR9","first-page":"1520","volume":"18","author":"JH Warrick","year":"1991","unstructured":"Warrick JH, et al. High resolution computed tomography in early scleroderma lung disease. J Rhuematol. 1991;18(10):1520\u20138.","journal-title":"J Rhuematol"},{"issue":"3","key":"2404_CR10","first-page":"258","volume":"44","author":"G Ooi","year":"2003","unstructured":"Ooi G, et al. Interstitial lung disease in systemic sclerosis: an HRCT-clinical correlative study. Acta Radiol. 2003;44(3):258\u201364.","journal-title":"Acta Radiol"},{"key":"2404_CR11","doi-asserted-by":"crossref","unstructured":"Assayag D et al. High Resolution Computed Tomography Scoring Systems for Evaluating Interstitial Lung Disease in Systemic Sclerosis Patients. Rheumatology, 2012. 2012: p.\u00a01\u20136.","DOI":"10.4172\/2161-1149.S1-003"},{"issue":"1","key":"2404_CR12","doi-asserted-by":"publisher","first-page":"430","DOI":"10.1186\/s12890-022-02212-7","volume":"22","author":"\u00d6I Emilsson","year":"2022","unstructured":"Emilsson \u00d6I, et al. Different chest HRCT scan protocols change the extent of ground glass opacities. BMC Pulm Med. 2022;22(1):430.","journal-title":"BMC Pulm Med"},{"issue":"5","key":"2404_CR13","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1016\/j.carj.2010.02.006","volume":"61","author":"AK Pandey","year":"2010","unstructured":"Pandey AK, et al. Predictors of pulmonary hypertension on high-resolution computed tomography of the chest in systemic sclerosis: a retrospective analysis. Can Assoc Radiol J. 2010;61(5):291\u20136.","journal-title":"Can Assoc Radiol J"},{"issue":"2","key":"2404_CR14","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1097\/01.rti.0000213572.16904.40","volume":"22","author":"RM Shah","year":"2007","unstructured":"Shah RM, Jimenez S, Wechsler R. Significance of ground-glass opacity on HRCT in long-term follow-up of patients with systemic sclerosis. J Thorac Imaging. 2007;22(2):120\u20134.","journal-title":"J Thorac Imaging"},{"issue":"3","key":"2404_CR15","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1002\/art.1780310302","volume":"31","author":"FC Arnett","year":"1988","unstructured":"Arnett FC, et al. The american Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis & Rheumatism: Official Journal of the American College of Rheumatology. 1988;31(3):315\u201324.","journal-title":"Arthritis & Rheumatism: Official Journal of the American College of Rheumatology"},{"issue":"11","key":"2404_CR16","doi-asserted-by":"publisher","first-page":"2737","DOI":"10.1002\/art.38098","volume":"65","author":"F Van Den Hoogen","year":"2013","unstructured":"Van Den Hoogen F, et al. 2013 classification criteria for systemic sclerosis: an American College of Rheumatology\/European League against Rheumatism collaborative initiative. Arthr Rhuem. 2013;65(11):2737\u201347.","journal-title":"Arthr Rhuem"},{"issue":"11","key":"2404_CR17","doi-asserted-by":"publisher","first-page":"1271","DOI":"10.1002\/art.1780251101","volume":"25","author":"EM Tan","year":"1982","unstructured":"Tan EM, et al. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis & Rheumatism: Official Journal of the American College of Rheumatology. 1982;25(11):1271\u20137.","journal-title":"Arthritis & Rheumatism: Official Journal of the American College of Rheumatology"},{"issue":"1","key":"2404_CR18","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1183\/09031936.05.00034505","volume":"26","author":"MR Miller","year":"2005","unstructured":"Miller MR, et al. General considerations for lung function testing. Eur Respir J. 2005;26(1):153\u201361.","journal-title":"Eur Respir J"},{"issue":"7","key":"2404_CR19","doi-asserted-by":"publisher","first-page":"685","DOI":"10.1016\/j.echo.2010.05.010","volume":"23","author":"LG Rudski","year":"2010","unstructured":"Rudski LG, et al. Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography: endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the canadian society of Echocardiography. J Am Soc Echocardiogr. 2010;23(7):685\u2013713.","journal-title":"J Am Soc Echocardiogr"},{"issue":"2","key":"2404_CR20","doi-asserted-by":"publisher","first-page":"358","DOI":"10.1378\/chest.07-2444","volume":"134","author":"JG Goldin","year":"2008","unstructured":"Goldin JG, et al. High-resolution CT scan findings in patients with symptomatic scleroderma-related interstitial lung disease. Chest. 2008;134(2):358\u201367.","journal-title":"Chest"},{"issue":"3","key":"2404_CR21","doi-asserted-by":"publisher","first-page":"773","DOI":"10.1378\/chest.07-0116","volume":"132","author":"DA Zisman","year":"2007","unstructured":"Zisman DA, et al. High-resolution chest CT findings do not predict the presence of pulmonary hypertension in advanced idiopathic pulmonary fibrosis. Chest. 2007;132(3):773\u20139.","journal-title":"Chest"},{"key":"2404_CR22","doi-asserted-by":"publisher","first-page":"977","DOI":"10.2214\/ajr.169.4.9308447","volume":"169","author":"EA Kazerooni","year":"1997","unstructured":"Kazerooni EA, et al. Thin-section CT obtained at 10-mm increments versus limited three-level thin-section CT for idiopathic pulmonary fibrosis: correlation with pathologic scoring. Am J Roentgenol. 1997;169:977\u201384.","journal-title":"Am J Roentgenol"},{"key":"2404_CR23","doi-asserted-by":"publisher","first-page":"1206","DOI":"10.1164\/ajrccm\/142.5.1206","volume":"142","author":"NL Muller","year":"1990","unstructured":"Muller NL, Miller RR. Computed tomography of chronic diffuse infiltrative lung disease. Am Rev Respir Dis. 1990;142:1206\u201315.","journal-title":"Am Rev Respir Dis"},{"issue":"2","key":"2404_CR24","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1148\/radiology.188.2.8327704","volume":"188","author":"M Remy-Jardin","year":"1993","unstructured":"Remy-Jardin M, et al. Pulmonary involvement in progressive systemic sclerosis: sequential evaluation with CT, pulmonary function tests, and bronchoalveolar lavage. Radiology. 1993;188(2):499\u2013506.","journal-title":"Radiology"},{"issue":"2","key":"2404_CR25","doi-asserted-by":"publisher","first-page":"266","DOI":"10.1097\/RCT.0b013e31820ccf18","volume":"35","author":"KE Shin","year":"2011","unstructured":"Shin KE, et al. Quantitative computed tomographic indexes in diffuse interstitial lung disease: correlation with physiologic tests and computed tomography visual scores. J Comput Assist Tomogr. 2011;35(2):266\u201371.","journal-title":"J Comput Assist Tomogr"},{"issue":"5 Suppl 62","key":"2404_CR26","first-page":"S26","volume":"28","author":"H Kim","year":"2010","unstructured":"Kim H, et al. A computer-aided diagnosis system for quantitative scoring of extent of lung fibrosis in scleroderma patients. Clin Exp Rheumatol. 2010;28(5 Suppl 62):S26.","journal-title":"Clin Exp Rheumatol"},{"issue":"3","key":"2404_CR27","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1007\/s10278-013-9670-z","volume":"27","author":"A Kazantzi","year":"2014","unstructured":"Kazantzi A, et al. Automated 3D \u03b9nterstitial lung disease \u03b5xtent quantification: performance evaluation and correlation to PFTs. J Digit Imaging. 2014;27(3):380\u201391.","journal-title":"J Digit Imaging"},{"issue":"11","key":"2404_CR28","doi-asserted-by":"publisher","first-page":"1248","DOI":"10.1164\/rccm.200706-877OC","volume":"177","author":"NS Goh","year":"2008","unstructured":"Goh NS, et al. Interstitial lung disease in systemic sclerosis: a simple staging system. Am J Respir Crit Care Med. 2008;177(11):1248\u201354.","journal-title":"Am J Respir Crit Care Med"},{"issue":"10","key":"2404_CR29","doi-asserted-by":"publisher","first-page":"1794","DOI":"10.3390\/diagnostics11101794","volume":"11","author":"N Mena-V\u00e1zquez","year":"2021","unstructured":"Mena-V\u00e1zquez N, et al. Characteristics and predictors of Progression interstitial lung Disease in Rheumatoid Arthritis compared with other Autoimmune Disease: a retrospective cohort study. Diagnostics. 2021;11(10):1794.","journal-title":"Diagnostics"},{"issue":"2","key":"2404_CR30","doi-asserted-by":"publisher","first-page":"324","DOI":"10.1007\/s00330-008-1152-1","volume":"19","author":"K Marten","year":"2009","unstructured":"Marten K, et al. Interstitial lung disease associated with collagen vascular disorders: disease quantification using a computer-aided diagnosis tool. Eur Radiol. 2009;19(2):324\u201332.","journal-title":"Eur Radiol"},{"issue":"6","key":"2404_CR31","doi-asserted-by":"publisher","first-page":"1623","DOI":"10.1378\/chest.114.6.1623","volume":"114","author":"E Diot","year":"1998","unstructured":"Diot E, et al. Relationship between abnormalities on high-resolution CT and pulmonary function in systemic sclerosis. Chest. 1998;114(6):1623\u20139.","journal-title":"Chest"},{"issue":"3","key":"2404_CR32","doi-asserted-by":"publisher","first-page":"672","DOI":"10.1378\/chest.06-1401","volume":"131","author":"G Camiciottoli","year":"2007","unstructured":"Camiciottoli G, et al. Lung CT densitometry in systemic sclerosis: correlation with lung function, exercise testing, and quality of life. Chest. 2007;131(3):672\u201381.","journal-title":"Chest"},{"issue":"2","key":"2404_CR33","doi-asserted-by":"publisher","first-page":"190","DOI":"10.1007\/s11547-009-0367-9","volume":"114","author":"M Bellia","year":"2009","unstructured":"Bellia M, et al. HRCT and scleroderma: semiquantitative evaluation of lung damage and functional abnormalities. Radiol Med. 2009;114(2):190\u2013203.","journal-title":"Radiol Med"},{"key":"2404_CR34","doi-asserted-by":"publisher","first-page":"035","DOI":"10.29328\/journal.jro.1001036","volume":"5","author":"Z Zexuan","year":"2021","unstructured":"Zexuan Z, et al. HRCT imaging features of systemic sclerosis-associated interstitial lung disease. J Radiol Oncol. 2021;5:035\u201341.","journal-title":"J Radiol Oncol"},{"issue":"4","key":"2404_CR35","doi-asserted-by":"publisher","first-page":"381","DOI":"10.21037\/qims.2016.08.08","volume":"6","author":"S Wangkaew","year":"2016","unstructured":"Wangkaew S, et al. Correlation of delta high-resolution computed tomography (HRCT) score with delta clinical variables in early systemic sclerosis (SSc) patients. Quant imaging Med Surg. 2016;6(4):381.","journal-title":"Quant imaging Med Surg"},{"issue":"4","key":"2404_CR36","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1093\/rheumatology\/keh067","volume":"43","author":"D Mukerjee","year":"2004","unstructured":"Mukerjee D, et al. Echocardiography and pulmonary function as screening tests for pulmonary arterial hypertension in systemic sclerosis. Rheumatology. 2004;43(4):461\u20136.","journal-title":"Rheumatology"},{"issue":"3","key":"2404_CR37","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1016\/j.ejr.2017.10.009","volume":"40","author":"MA Mohammed","year":"2018","unstructured":"Mohammed MA, et al. Echocardiographic findings in systemic lupus erythematosus and its relation to disease activity and damage index. Egypt Rheumatologist. 2018;40(3):173\u20138.","journal-title":"Egypt Rheumatologist"}],"updated-by":[{"DOI":"10.1186\/s12890-024-03111-9","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2024,6,25]],"date-time":"2024-06-25T00:00:00Z","timestamp":1719273600000}}],"container-title":["BMC Pulmonary Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12890-023-02404-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12890-023-02404-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12890-023-02404-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,26]],"date-time":"2024-06-26T02:02:54Z","timestamp":1719367374000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcpulmmed.biomedcentral.com\/articles\/10.1186\/s12890-023-02404-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,19]]},"references-count":37,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["2404"],"URL":"https:\/\/doi.org\/10.1186\/s12890-023-02404-9","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-1994622\/v1","asserted-by":"object"}]},"ISSN":["1471-2466"],"issn-type":[{"value":"1471-2466","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,19]]},"assertion":[{"value":"24 August 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 March 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 April 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 June 2024","order":4,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Correction","order":5,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"A Correction to this paper has been published:","order":6,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"https:\/\/doi.org\/10.1186\/s12890-024-03111-9","URL":"https:\/\/doi.org\/10.1186\/s12890-024-03111-9","order":7,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The Menoufia University Hospital Research Ethical Committee gave its approval to the study, which adhered to the Declaration of Helsinki\u2019s guidelines (IRB: 6\/2022CHES4-2). Following the guidelines of the Menoufia University Hospital\u2019s local research ethical committee, written informed consent was obtained from each participant.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"The ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors confirm that they do not have any competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"131"}}