{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T18:01:34Z","timestamp":1783620094889,"version":"3.55.0"},"reference-count":38,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,4,12]],"date-time":"2021-04-12T00:00:00Z","timestamp":1618185600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,4,12]],"date-time":"2021-04-12T00:00:00Z","timestamp":1618185600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Endocr Disord"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>The main purpose is to investigate the effect of LiCO3 as an add-on therapy with radioactive iodine in increasing the cure and decreasing the T4 level compared to radioactive iodine alone. The primary outcome is the cure rate as defined by the number of hyperthyroid patients who became euthyroid or hypothyroid. The secondary outcome is the T4 level.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Four databases were searched (PubMed, Scopus, Web of Science, and Cochrane central library). The inclusion criteria were randomized and non-randomized clinical trials of hyperthyroidism patients receiving LiCO3 with radioiodine compared with hyperthyroidism patients receiving radioactive iodine alone. Included studies were appraised with the risk of bias version 2 tool, according to the Cochrane Handbook for Systematic Reviews of Interventions 5.1.0.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Nine studies were eligible for inclusion in the study, six randomized control trials and three non-randomized control trials. There were 477 patients in the intervention group and 451 patients in the control group. The cure rate was not significantly different between the two groups, while it was significantly increased with 5000 to 6500\u2009mg optimized cumulative dose of LiCO3 compared with the control group<jats:italic>, P<\/jats:italic>\u2009=\u20090.0001. The T4 level showed no significant difference between the two groups, <jats:italic>P<\/jats:italic>\u2009=\u20090.13.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>LiCO3 adjunct to radioactive iodine did not show significant differences compared with radioactive iodine alone in terms of cure rate or decreasing T4 level. However, the dose of 5000 to 6000\u2009mg of LiCO3 may increase the cure rate.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12902-021-00729-2","type":"journal-article","created":{"date-parts":[[2021,4,12]],"date-time":"2021-04-12T02:02:43Z","timestamp":1618192963000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Lithium carbonate as add-on therapy to radioiodine in the treatment on hyperthyroidism: a systematic review and meta-analysis"],"prefix":"10.1186","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4120-9161","authenticated-orcid":false,"given":"Mohamed","family":"Abd-ElGawad","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Abdelmonem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed Eissa","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar Magdy","family":"Mohammed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Sayed","family":"Zaazouee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Assar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Gadelkarim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed M.","family":"Afifi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,4,12]]},"reference":[{"issue":"9382","key":"729_CR1","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1016\/S0140-6736(03)14073-1","volume":"362","author":"DS Cooper","year":"2003","unstructured":"Cooper DS. Hyperthyroidism. Lancet. 2003;362(9382):459\u201368. https:\/\/doi.org\/10.1016\/S0140-6736(03)14073-1.","journal-title":"Lancet."},{"issue":"2","key":"729_CR2","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1016\/j.autrev.2014.10.016","volume":"14","author":"A Antonelli","year":"2015","unstructured":"Antonelli A, Ferrari SM, Corrado A, Di Domenicantonio A, Fallahi P. Autoimmune thyroid disorders. Autoimmun Rev. 2015;14(2):174\u201380. https:\/\/doi.org\/10.1016\/j.autrev.2014.10.016.","journal-title":"Autoimmun Rev"},{"issue":"4\u20135","key":"729_CR3","doi-asserted-by":"publisher","first-page":"398","DOI":"10.1016\/j.autrev.2014.01.013","volume":"13","author":"F Menconi","year":"2014","unstructured":"Menconi F, Marcocci C, Marin\u00f2 M. Diagnosis and classification of Graves' disease. Autoimmun Rev. 2014;13(4\u20135):398\u2013402. https:\/\/doi.org\/10.1016\/j.autrev.2014.01.013.","journal-title":"Autoimmun Rev"},{"issue":"23","key":"729_CR4","doi-asserted-by":"publisher","first-page":"2544","DOI":"10.1001\/jama.2015.16535","volume":"314","author":"HB Burch","year":"2015","unstructured":"Burch HB, Cooper DS. Management of Graves Disease. Jama. 2015;314(23):2544. https:\/\/doi.org\/10.1001\/jama.2015.16535.","journal-title":"Jama."},{"issue":"3","key":"729_CR5","doi-asserted-by":"publisher","first-page":"447","DOI":"10.1111\/j.1365-2125.2009.03474.x","volume":"68","author":"C van Noord","year":"2009","unstructured":"van Noord C, Sturkenboom MC, Straus SM, Hofman A, Witteman JC, Stricker BH. Population-based studies of antithyroid drugs and sudden cardiac death. Br J Clin Pharmacol. 2009;68(3):447\u201354. https:\/\/doi.org\/10.1111\/j.1365-2125.2009.03474.x.","journal-title":"Br J Clin Pharmacol"},{"issue":"331","key":"729_CR6","first-page":"559","volume":"25","author":"JA Franklyn","year":"1994","unstructured":"Franklyn JA. The management of hyperthyroidism. N Engl J Med. 1994;25(331):559.","journal-title":"N Engl J Med"},{"key":"729_CR7","first-page":"1","volume":"2017","author":"J Liu","year":"2017","unstructured":"Liu J, Jing F, Xu Y, Wang G. Antithyroid drug therapy for graves\u2019 disease and implications for recurrence. Int J Endocrinol. 2017;2017:1\u20138.","journal-title":"Int J Endocrinol"},{"key":"729_CR8","doi-asserted-by":"publisher","first-page":"2218","DOI":"10.1007\/s00259-010-1536-8","volume":"37","author":"MPM Stokkel","year":"2010","unstructured":"Stokkel MPM, Junak DH, Lassmann M, Dietlein M, Luster M. EANM procedure guidelines for therapy of benign thyroid disease. Eur J Nucl Med Mol Imaging. 2010;37:2218\u201328.","journal-title":"Eur J Nucl Med Mol Imaging"},{"issue":"3","key":"729_CR9","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1016\/S0001-2998(96)80020-1","volume":"26","author":"DV Becker","year":"1996","unstructured":"Becker DV, Sawin CT. Radioiodine and thyroid disease: the beginning. Semin Nucl Med. 1996;26(3):155\u201364.","journal-title":"Semin Nucl Med"},{"issue":"2","key":"729_CR10","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1089\/thy.1997.7.163","volume":"7","author":"CT Sawin","year":"1997","unstructured":"Sawin CT, Becker DV. Radioiodine and the treatment of hyperthyroidism: the early history. Thyroid. 1997;7(2):163\u201376.","journal-title":"Thyroid"},{"key":"729_CR11","doi-asserted-by":"publisher","unstructured":"Ron E, Doody MM, Becker DV, et al. Cancer Mortality Following Treatment for Adult Hyperthyroidism. JAMA. 1998;280(4):347\u201355. https:\/\/doi.org\/10.1001\/jama.280.4.347","DOI":"10.1001\/jama.280.4.347"},{"key":"729_CR12","doi-asserted-by":"publisher","unstructured":"Bartalena L, Marcocci C, Bogazzi F, Manetti L, Tanda ML, Dell'Unto E, Bruno-Bossio G, Nardi M, Bartolomei MP, Lepri A, Rossi G, Martino E, Pinchera A. Relation between therapy for hyperthyroidism and the course of Graves' ophthalmopathy. N Engl J Med. 1998;338(2):73\u20138. https:\/\/doi.org\/10.1056\/NEJM199801083380201. PMID: 9420337.","DOI":"10.1056\/NEJM199801083380201"},{"key":"729_CR13","doi-asserted-by":"publisher","unstructured":"Shafer RB, Nuttall FQ. Acute changes in thyroid function in patients treated with radioactive iodine. Lancet. 1975;2(7936):635\u20137. https:\/\/doi.org\/10.1016\/s0140-6736(75)90117-8. PMID: 52005.","DOI":"10.1016\/s0140-6736(75)90117-8"},{"issue":"2","key":"729_CR14","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1210\/jcem.84.2.5446","volume":"84","author":"F Bogazzi","year":"1999","unstructured":"Bogazzi F, Bartalena L, Brogioni S, Scarcello G, Burelli A, Campomori A, et al. Comparison of radioiodine with radioiodine plus Lithium in the treatment of graves\u2019 hyperthyroidism. J Clin Endocrinol Metab. 1999;84(2):499\u2013503. https:\/\/doi.org\/10.1210\/jcem.84.2.5446.","journal-title":"J Clin Endocrinol Metab"},{"issue":"4","key":"729_CR15","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1136\/jnnp.17.4.250","volume":"17","author":"M Schou","year":"1954","unstructured":"Schou M, Juel-Nielsen N, Stromgren E, Voldby H. The treatment of manic psychoses by the administration of lithium salts. J Neurol Neurosurg Psychiatry. 1954;17(4):250\u201360. https:\/\/doi.org\/10.1136\/jnnp.17.4.250.","journal-title":"J Neurol Neurosurg Psychiatry"},{"issue":"5","key":"729_CR16","doi-asserted-by":"publisher","first-page":"647","DOI":"10.1210\/jcem-32-5-647","volume":"32","author":"GN Burrow","year":"1971","unstructured":"Burrow GN, Burke WR, Himmelhoch JM, Spencer RP, Hershman JM. Effect of Lithium on thyroid function. J Clin Endocrinol Metab. 1971;32(5):647\u201352. https:\/\/doi.org\/10.1210\/jcem-32-5-647.","journal-title":"J Clin Endocrinol Metab"},{"issue":"6","key":"729_CR17","doi-asserted-by":"publisher","first-page":"905","DOI":"10.1210\/jcem-35-6-905","volume":"35","author":"SW Spaulding","year":"1972","unstructured":"Spaulding SW, Burrow GN, Bermudez F, Himmelhoch JM. The inhibitory effect of Lithium on thyroid hormone release in both Euthyroid and Thyrotoxic patients. J Clin Endocrinol Metab. 1972;35(6):905\u201311. https:\/\/doi.org\/10.1210\/jcem-35-6-905.","journal-title":"J Clin Endocrinol Metab"},{"issue":"2","key":"729_CR18","first-page":"499","volume":"84","author":"F Bogazzi","year":"1999","unstructured":"Bogazzi F, Bartalena L, Brogioni S, Scarcello G, Burelli A, Campomori A, et al. Comparison of radioiodine with radioiodine plus Lithium in the treatment of graves\u2019 Hyperthyroidism1. J Clin Endocrinol Metab. 1999;84(2):499\u2013503.","journal-title":"J Clin Endocrinol Metab"},{"key":"729_CR19","doi-asserted-by":"crossref","unstructured":"Atmaca A, Dogan S, Dagdelen S, Gurlek A, Bayraktar M, Adalar N. Symptomatic Treatment of Graves Hyperthyroidism With Lithium in States of Thionamide Adverse Reactions: A Retrospective Analysis. The Endocrinol. 2004;14(6).","DOI":"10.1097\/01.ten.0000146399.37196.12"},{"issue":"1","key":"729_CR20","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1210\/jc.2009-1655","volume":"95","author":"F Bogazzi","year":"2010","unstructured":"Bogazzi F, Giovannetti C, Fessehatsion R, Tanda ML, Campomori A, Compri E, et al. Impact of Lithium on efficacy of radioactive iodine therapy for graves\u2019 disease: a cohort study on cure rate, time to cure, and frequency of increased serum Thyroxine after Antithyroid drug withdrawal. J Clin Endocrinol Metab. 2010;95(1):201\u20138. https:\/\/doi.org\/10.1210\/jc.2009-1655.","journal-title":"J Clin Endocrinol Metab"},{"issue":"5","key":"729_CR21","doi-asserted-by":"publisher","first-page":"669","DOI":"10.4103\/2230-8210.139230","volume":"18","author":"B Lingudu","year":"2014","unstructured":"Lingudu B, Bongi V, Ayyagari M, Venkata SK. Impact of lithium on radioactive iodine therapy for hyperthyroidism. Indian J Endocrinol Metab. 2014;18(5):669\u201375. https:\/\/doi.org\/10.4103\/2230-8210.139230.","journal-title":"Indian J Endocrinol Metab"},{"issue":"5","key":"729_CR22","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1089\/105072502760043486","volume":"12","author":"C Bal","year":"2002","unstructured":"Bal C, Kumar A, Pandey RM. A randomized controlled trial to evaluate the adjuvant effect of Lithium on radioiodine treatment of hyperthyroidism. Thyroid. 2002;12(5):399\u2013405. https:\/\/doi.org\/10.1089\/105072502760043486.","journal-title":"Thyroid"},{"issue":"7","key":"729_CR23","doi-asserted-by":"publisher","first-page":"e1000097-e","DOI":"10.1371\/journal.pmed.1000097","volume":"6","author":"D Moher","year":"2009","unstructured":"Moher D, Liberati A, Tetzlaff J, Altman DG, Group P. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097-e.","journal-title":"PLoS Med"},{"issue":"7","key":"729_CR24","doi-asserted-by":"publisher","first-page":"769","DOI":"10.1016\/0895-4356(92)90054-Q","volume":"45","author":"DEP Follmann","year":"1992","unstructured":"Follmann DEP, Suh I, Cutler J. Variance imputation for overviews of clinical trials with continuous response. J Clin Epidemiol. 1992;45(7):769\u201373. https:\/\/doi.org\/10.1016\/0895-4356(92)90054-Q.","journal-title":"J Clin Epidemiol"},{"issue":"24","key":"729_CR25","doi-asserted-by":"publisher","first-page":"3823","DOI":"10.1002\/sim.2423","volume":"24","author":"KR Abrams","year":"2005","unstructured":"Abrams KR, Gillies CL, Lambert PC. Meta-analysis of heterogeneously reported trials assessing change from baseline. Stat Med. 2005;24(24):3823\u201344. https:\/\/doi.org\/10.1002\/sim.2423.","journal-title":"Stat Med"},{"key":"729_CR26","unstructured":"AD HJPT, JAC S. Chapter 8: assessing risk of bias in included studies. In: JPT H, Green S, editors. Cochrane handbook for systematic reviews of interventions version 5.1.0 (updated March 2011): The Cochrane Collaboration; 2011."},{"key":"729_CR27","first-page":"i4919","volume":"355","author":"JA Sterne","year":"2016","unstructured":"Sterne JA, Hern\u00e1n MA, Reeves BC, Savovi\u0107 J, Berkman ND, Viswanathan M, et al. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ (Clinical research ed). 2016;355:i4919.","journal-title":"BMJ (Clinical research ed)"},{"issue":"10","key":"729_CR28","doi-asserted-by":"publisher","first-page":"4490","DOI":"10.1210\/jc.2002-020580","volume":"87","author":"F Bogazzi","year":"2002","unstructured":"Bogazzi F, Bartalena L, Campomori A, Brogioni S, Traino C, De Martino F, et al. Treatment with lithium prevents serum thyroid hormone increase after thionamide withdrawal and radioiodine therapy in patients with Graves' disease. J Clin Endocrinol Metab. 2002;87(10):4490\u20135. https:\/\/doi.org\/10.1210\/jc.2002-020580.","journal-title":"J Clin Endocrinol Metab"},{"issue":"3","key":"729_CR29","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1080\/16089677.2016.1228745","volume":"21","author":"ENB Hammond","year":"2016","unstructured":"Hammond ENB, Vangu M-D-THW. Lithium-enhanced radioactive iodine ablation of hyperthyroid patients. J Endocrinol Metab Diabetes S Afr. 2016;21(3):51\u20135. https:\/\/doi.org\/10.1080\/16089677.2016.1228745.","journal-title":"J Endocrinol Metab Diabetes S Afr"},{"issue":"10","key":"729_CR30","doi-asserted-by":"publisher","first-page":"744","DOI":"10.1007\/s12149-017-1206-z","volume":"31","author":"V Sekulic","year":"2017","unstructured":"Sekulic V, Rajic M, Vlajkovic M, Ilic S, Stevic M, Kojic M. The effect of short-term treatment with lithium carbonate on the outcome of radioiodine therapy in patients with long-lasting Graves' hyperthyroidism. Ann Nucl Med. 2017;31(10):744\u201351. https:\/\/doi.org\/10.1007\/s12149-017-1206-z.","journal-title":"Ann Nucl Med"},{"issue":"19","key":"729_CR31","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000015573","volume":"98","author":"S Thamcharoenvipas","year":"2019","unstructured":"Thamcharoenvipas S, Kerr SJ, Tepmongkol S. Finding the best effective way of treatment for rapid I-131 turnover Graves' disease patients: a randomized clinical trial. Medicine (Baltimore). 2019;98(19):e15573. https:\/\/doi.org\/10.1097\/MD.0000000000015573.","journal-title":"Medicine (Baltimore)"},{"key":"729_CR32","doi-asserted-by":"crossref","unstructured":"JGT BEWB, Ovenden BM, Rogers TGH. Results of lithium-1311 treatment of thyrotoxicosis. J Endocrinol Invest. 1979;2(303).","DOI":"10.1007\/BF03350422"},{"issue":"1","key":"729_CR33","first-page":"56","volume":"61","author":"L Oszukowska","year":"2010","unstructured":"Oszukowska L, Knapska-Kucharska M, Makarewicz J, Lewi\u0144ski A. The influence of thiamazole, lithium carbonate, or prednisone administration on the efficacy of radioiodine treatment (131I) in hyperthyroid patients. Endokrynologia Polska\/Polish J Endocrinols. 2010;61(1):56\u201361.","journal-title":"Endokrynologia Polska\/Polish J Endocrinols"},{"issue":"1","key":"729_CR34","first-page":"56","volume":"61","author":"L Oszukowska","year":"2010","unstructured":"Oszukowska L, Knapska-Kucharska M, Makarewicz J, Lewi\u0144ski A. The influence of thiamazole, lithium carbonate, or prednisone administration on the efficacy of radioiodine treatment ((131) I) in hyperthyroid patients. Endokrynologia Polska. 2010;61(1):56\u201361.","journal-title":"Endokrynologia Polska"},{"issue":"3","key":"729_CR35","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1007\/BF03350422","volume":"2","author":"BE Brownlie","year":"1979","unstructured":"Brownlie BE, Turner JG, Ovenden BM, Rogers TG. Results of lithium- 131I treatment of thyrotoxicosis. J Endocrinol Investig. 1979;2(3):303\u20134. https:\/\/doi.org\/10.1007\/BF03350422.","journal-title":"J Endocrinol Investig"},{"key":"729_CR36","doi-asserted-by":"publisher","first-page":"464","DOI":"10.1016\/j.ejphar.2014.06.042","volume":"740","author":"R Oruch","year":"2014","unstructured":"Oruch R, Elderbi MA, Khattab HA, Pryme IF, Lund A. Lithium: a review of pharmacology, clinical uses, and toxicity. Eur J Pharmacol. 2014;740:464\u201373. https:\/\/doi.org\/10.1016\/j.ejphar.2014.06.042.","journal-title":"Eur J Pharmacol"},{"issue":"6","key":"729_CR37","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1097\/RLU.0b013e3182817c78","volume":"38","author":"JA de Jong","year":"2013","unstructured":"de Jong JA, Verkooijen HM, Valk GD, Zelissen PM, de Keizer B. High failure rates after (131) I therapy in graves hyperthyroidism patients with large thyroid volumes, high iodine uptake, and high iodine turnover. Clin Nucl Med. 2013;38(6):401\u20136. https:\/\/doi.org\/10.1097\/RLU.0b013e3182817c78.","journal-title":"Clin Nucl Med"},{"issue":"7960","key":"729_CR38","doi-asserted-by":"publisher","first-page":"614","DOI":"10.1016\/S0140-6736(76)90419-0","volume":"307","author":"JG Turner","year":"1976","unstructured":"Turner JG, Brownlie BE, Rogers TG. Lithium as an adjunct to radioiodine therapy for thyrotoxicosis. Lancet. 1976;307(7960):614\u20135. https:\/\/doi.org\/10.1016\/S0140-6736(76)90419-0.","journal-title":"Lancet"}],"container-title":["BMC Endocrine Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12902-021-00729-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12902-021-00729-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12902-021-00729-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,4,12]],"date-time":"2021-04-12T02:02:56Z","timestamp":1618192976000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcendocrdisord.biomedcentral.com\/articles\/10.1186\/s12902-021-00729-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,12]]},"references-count":38,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["729"],"URL":"https:\/\/doi.org\/10.1186\/s12902-021-00729-2","relation":{},"ISSN":["1472-6823"],"issn-type":[{"value":"1472-6823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,12]]},"assertion":[{"value":"21 October 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 March 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 April 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Not applicable.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Dr. Abd-ElGawad has nothing to disclose. All the authors also declare no conflict of interest.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"64"}}