{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T16:36:55Z","timestamp":1781627815776,"version":"3.54.5"},"reference-count":39,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T00:00:00Z","timestamp":1775433600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T00:00:00Z","timestamp":1779148800000},"content-version":"vor","delay-in-days":43,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP22K15674"],"award-info":[{"award-number":["JP22K15674"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100016573","name":"Japan Association for Diabetes Education and Care","doi-asserted-by":"publisher","award":["2023-FND-012"],"award-info":[{"award-number":["2023-FND-012"]}],"id":[{"id":"10.13039\/100016573","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Endocr Disord"],"DOI":"10.1186\/s12902-026-02261-7","type":"journal-article","created":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T08:47:24Z","timestamp":1775465244000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Continuous glucose monitoring reveals distinct clinical implications of glucose levels at the start and end of hemodialysis in people with type 2 diabetes"],"prefix":"10.1186","volume":"26","author":[{"given":"Akinori","family":"Hayashi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rihito","family":"Takaesu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haruna","family":"Sogabe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuiko","family":"Tani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nagisa","family":"Aoki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiki","family":"Ko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Tsuji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibuki","family":"Moriguchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoyuki","family":"Kobayashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Miyatsuka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,6]]},"reference":[{"issue":"8","key":"2261_CR1","doi-asserted-by":"publisher","first-page":"1018","DOI":"10.1111\/dme.13676","volume":"35","author":"AH Frankel","year":"2018","unstructured":"Frankel AH, Kazempour-Ardebili S, Bedi R, et al. Management of adults with diabetes on the haemodialysis unit: summary of guidance from the Joint British Diabetes Societies and the Renal Association. Diabet Med. 2018;35(8):1018\u201326.","journal-title":"Diabet Med"},{"issue":"3","key":"2261_CR2","doi-asserted-by":"publisher","first-page":"385","DOI":"10.7326\/M20-5938","volume":"174","author":"SD Navaneethan","year":"2021","unstructured":"Navaneethan SD, Zoungas S, Caramori ML, et al. Diabetes management in chronic kidney disease: synopsis of the 2020 KDIGO clinical practice guideline. Ann Intern Med. 2021;174(3):385\u2013.","journal-title":"Ann Intern Med"},{"issue":"4","key":"2261_CR3","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1053\/j.ajkd.2021.09.010","volume":"79","author":"AK Mottl","year":"2022","unstructured":"Mottl AK, Alicic R, Argyropoulos C, et al. KDOQI US commentary on the KDIGO 2020 clinical practice guideline for diabetes management in CKD. Am J Kidney Dis. 2022;79(4):457\u201379.","journal-title":"Am J Kidney Dis"},{"issue":"5S","key":"2261_CR4","first-page":"S1","volume":"102","author":"Kidney Disease: Improving Global Outcomes Diabetes Work G","year":"2022","unstructured":"Kidney disease: improving global outcomes diabetes work G. KDIGO 2022 clinical practice guideline for diabetes management in chronic kidney disease. Kidney Int. 2022;102(5S):S1\u2013127.","journal-title":"Kidney Int"},{"issue":"1","key":"2261_CR5","doi-asserted-by":"publisher","first-page":"130","DOI":"10.2215\/CJN.04510422","volume":"18","author":"RJ Galindo","year":"2023","unstructured":"Galindo RJ, de Boer IH, Neumiller JJ, Tuttle KR. Continuous glucose monitoring to optimize management of diabetes in patients with advanced CKD. Clin J Am Soc Nephrol. 2023;18(1):130\u201345.","journal-title":"Clin J Am Soc Nephrol"},{"issue":"4","key":"2261_CR6","doi-asserted-by":"publisher","first-page":"e15027","DOI":"10.1111\/dme.15027","volume":"40","author":"AH Frankel","year":"2023","unstructured":"Frankel AH, Wahba M, Ashworth V, et al. Management of adults with diabetes on dialysis: Summary of recommendations of the Joint British Diabetes Societies guidelines 2022. Diabet Med. 2023;40(4):e15027.","journal-title":"Diabet Med"},{"issue":"10","key":"2261_CR7","doi-asserted-by":"publisher","first-page":"2129","DOI":"10.1007\/s00125-024-06244-y","volume":"67","author":"RJ Galindo","year":"2024","unstructured":"Galindo RJ, Soliman D, Chernavvsky D, Rhee CM. Diabetes technology in people with diabetes and advanced chronic kidney disease. Diabetologia. 2024;67(10):2129\u201342.","journal-title":"Diabetologia"},{"key":"2261_CR8","doi-asserted-by":"crossref","unstructured":"Rhee CM, Gianchandani RY, Kerr D et al. Consensus report on the use of continuous glucose monitoring in chronic kidney disease and diabetes. J Diabetes Sci Technol 2024:19322968241292041.","DOI":"10.1177\/19322968241292041"},{"issue":"5","key":"2261_CR9","doi-asserted-by":"publisher","first-page":"302","DOI":"10.1038\/nrneph.2015.38","volume":"11","author":"M Abe","year":"2015","unstructured":"Abe M, Kalantar-Zadeh K. Haemodialysis-induced hypoglycaemia and glycaemic disarrays. Nat Rev Nephrol. 2015;11(5):302\u201313.","journal-title":"Nat Rev Nephrol"},{"issue":"7","key":"2261_CR10","doi-asserted-by":"publisher","first-page":"1647","DOI":"10.2337\/dc21-0269","volume":"44","author":"A Hayashi","year":"2021","unstructured":"Hayashi A, Shimizu N, Suzuki A, et al. Hemodialysis-related glycemic disarray proven by continuous glucose monitoring: glycemic markers and hypoglycemia. Diabetes Care. 2021;44(7):1647\u201356.","journal-title":"Diabetes Care"},{"issue":"2","key":"2261_CR11","doi-asserted-by":"publisher","first-page":"267","DOI":"10.2337\/dc23-1276","volume":"47","author":"CY Kaminski","year":"2024","unstructured":"Kaminski CY, Galindo RJ, Navarrete JE, et al. Assessment of Glycemic Control by Continuous Glucose Monitoring, Hemoglobin A1c, Fructosamine, and Glycated Albumin in Patients With End-Stage Kidney Disease and Burnt-Out Diabetes. Diabetes Care. 2024;47(2):267\u201371.","journal-title":"Diabetes Care"},{"issue":"6","key":"2261_CR12","doi-asserted-by":"publisher","first-page":"1354","DOI":"10.1016\/j.ekir.2022.03.029","volume":"7","author":"J Ling","year":"2022","unstructured":"Ling J, Ng J, Lau ESH, et al. Continuous Glucose Monitoring Metrics in the Assessment of Glycemia in Moderate-to-Advanced CKD in Diabetes. Kidney Int Rep. 2022;7(6):1354\u201363.","journal-title":"Kidney Int Rep"},{"issue":"8","key":"2261_CR13","doi-asserted-by":"publisher","first-page":"1494","DOI":"10.1016\/j.jdiacomp.2016.08.015","volume":"30","author":"A Hayashi","year":"2016","unstructured":"Hayashi A, Takano K, Masaki T, Yoshino S, Ogawa A, Shichiri M. Distinct biomarker roles for HbA1c and glycated albumin in patients with type 2 diabetes on hemodialysis. J Diabetes Complications. 2016;30(8):1494\u20139.","journal-title":"J Diabetes Complications"},{"issue":"Suppl 1","key":"2261_CR14","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1111\/1744-9987.12299","volume":"19","author":"T Nakao","year":"2015","unstructured":"Nakao T, Inaba M, Abe M, et al. Best practice for diabetic patients on hemodialysis 2012. Ther Apher Dial. 2015;19(Suppl 1):40\u201366.","journal-title":"Ther Apher Dial"},{"key":"2261_CR15","doi-asserted-by":"crossref","unstructured":"Yajima T, Yajima K, Hayashi M, Yasuda K, Takahashi H, Yamakita N. Serum albumin-adjusted glycated albumin is a better predictor of mortality in diabetic patients with end-stage renal disease on hemodialysis. J Diabetes Complications 2016.","DOI":"10.1016\/j.jdiacomp.2016.02.021"},{"issue":"6","key":"2261_CR16","doi-asserted-by":"publisher","first-page":"1389","DOI":"10.2337\/dc09-2082","volume":"33","author":"CV Desouza","year":"2010","unstructured":"Desouza CV, Bolli GB, Fonseca V. Hypoglycemia, diabetes, and cardiovascular events. Diabetes Care. 2010;33(6):1389\u201394.","journal-title":"Diabetes Care"},{"issue":"4","key":"2261_CR17","doi-asserted-by":"publisher","first-page":"107549","DOI":"10.1016\/j.jdiacomp.2020.107549","volume":"34","author":"C Shi","year":"2020","unstructured":"Shi C, Liu S, Yu HF, Han B. Glycemic variability and all-cause mortality in patients with diabetes receiving hemodialysis: a prospective cohort study. J Diabetes Complications. 2020;34(4):107549.","journal-title":"J Diabetes Complications"},{"issue":"10","key":"2261_CR18","doi-asserted-by":"publisher","first-page":"801","DOI":"10.1089\/dia.2010.0067","volume":"12","author":"HS Jung","year":"2010","unstructured":"Jung HS, Kim HI, Kim MJ, et al. Analysis of hemodialysis-associated hypoglycemia in patients with type 2 diabetes using a continuous glucose monitoring system. Diabetes Technol Ther. 2010;12(10):801\u20137.","journal-title":"Diabetes Technol Ther"},{"issue":"8","key":"2261_CR19","doi-asserted-by":"publisher","first-page":"1593","DOI":"10.2337\/dci19-0028","volume":"42","author":"T Battelino","year":"2019","unstructured":"Battelino T, Danne T, Bergenstal RM, et al. Clinical targets for continuous glucose monitoring data interpretation: recommendations from the international consensus on time in range. Diabetes Care. 2019;42(8):1593\u2013603.","journal-title":"Diabetes Care"},{"issue":"5","key":"2261_CR20","doi-asserted-by":"publisher","first-page":"1738","DOI":"10.2337\/db13-0468","volume":"63","author":"E Chow","year":"2014","unstructured":"Chow E, Bernjak A, Williams S, et al. Risk of cardiac arrhythmias during hypoglycemia in patients with type 2 diabetes and cardiovascular risk. Diabetes. 2014;63(5):1738\u201347.","journal-title":"Diabetes"},{"issue":"7","key":"2261_CR21","doi-asserted-by":"publisher","first-page":"1137","DOI":"10.2337\/dc08-1688","volume":"32","author":"S Kazempour-Ardebili","year":"2009","unstructured":"Kazempour-Ardebili S, Lecamwasam VL, Dassanyake T, et al. Assessing glycemic control in maintenance hemodialysis patients with type 2 diabetes. Diabetes Care. 2009;32(7):1137\u201342.","journal-title":"Diabetes Care"},{"issue":"10","key":"2261_CR22","doi-asserted-by":"publisher","first-page":"749","DOI":"10.1089\/dia.2010.0052","volume":"12","author":"M Mirani","year":"2010","unstructured":"Mirani M, Berra C, Finazzi S, et al. Inter-day glycemic variability assessed by continuous glucose monitoring in insulin-treated type 2 diabetes patients on hemodialysis. Diabetes Technol Ther. 2010;12(10):749\u201353.","journal-title":"Diabetes Technol Ther"},{"issue":"9","key":"2261_CR23","doi-asserted-by":"publisher","first-page":"2866","DOI":"10.1093\/ndt\/gfp181","volume":"24","author":"JP Riveline","year":"2009","unstructured":"Riveline JP, Teynie J, Belmouaz S, et al. Glycaemic control in type 2 diabetic patients on chronic haemodialysis: use of a continuous glucose monitoring system. Nephrol Dial Transpl. 2009;24(9):2866\u201371.","journal-title":"Nephrol Dial Transpl"},{"issue":"3","key":"2261_CR24","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1016\/j.jdiacomp.2014.12.015","volume":"29","author":"YP Jin","year":"2015","unstructured":"Jin YP, Su XF, Yin GP, et al. Blood glucose fluctuations in hemodialysis patients with end stage diabetic nephropathy. J Diabetes Complications. 2015;29(3):395\u20139.","journal-title":"J Diabetes Complications"},{"issue":"1","key":"2261_CR25","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1159\/000362863","volume":"38","author":"M Gai","year":"2014","unstructured":"Gai M, Merlo I, Dellepiane S, et al. Glycemic pattern in diabetic patients on hemodialysis: continuous glucose monitoring (CGM) analysis. Blood Purif. 2014;38(1):68\u201373.","journal-title":"Blood Purif"},{"issue":"3","key":"2261_CR26","doi-asserted-by":"publisher","first-page":"348","DOI":"10.1016\/j.diabres.2015.01.026","volume":"107","author":"M Joubert","year":"2015","unstructured":"Joubert M, Fourmy C, Henri P, Ficheux M, Lobbedez T, Reznik Y. Effectiveness of continuous glucose monitoring in dialysis patients with diabetes: the DIALYDIAB pilot study. Diabetes Res Clin Pract. 2015;107(3):348\u201354.","journal-title":"Diabetes Res Clin Pract"},{"issue":"11","key":"2261_CR27","doi-asserted-by":"publisher","first-page":"810","DOI":"10.1055\/s-0034-1370963","volume":"46","author":"F Chantrel","year":"2014","unstructured":"Chantrel F, Sissoko H, Kepenekian L, et al. Influence of dialysis on the glucose profile in patients with diabetes: usefulness of continuous glucose monitoring. Horm Metab Res. 2014;46(11):810\u20133.","journal-title":"Horm Metab Res"},{"key":"2261_CR28","doi-asserted-by":"crossref","unstructured":"Habte-Asres HH, Jiang Y, Rosenthal M, Wheeler DC. Burden of impaired awareness of hypoglycemia in people with diabetes undergoing hemodialysis. BMJ Open Diabetes Res Care 2024;12(1).","DOI":"10.1136\/bmjdrc-2023-003730"},{"issue":"1","key":"2261_CR29","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1186\/s41100-022-00429-0","volume":"8","author":"A Hayashi","year":"2022","unstructured":"Hayashi A, Matoba K, Ohata Y, et al. Evaluation of the relationship between hemodialysis-related glycemic variability and hormonal profiles in patients with type 2 diabetes on hemodialysis: a pilot study. Ren Replace Therapy. 2022;8(1):43.","journal-title":"Ren Replace Therapy"},{"issue":"12","key":"2261_CR30","doi-asserted-by":"publisher","first-page":"2845","DOI":"10.1007\/s13300-020-00928-5","volume":"11","author":"T Ishikawa-Tanaka","year":"2020","unstructured":"Ishikawa-Tanaka T, Hosojima M, Kabasawa H, et al. Effects of DPP-4 inhibitors on blood glucose variability in Japanese patients with type 2 diabetes on maintenance hemodialysis: a prospective observational exploratory study. Diabetes therapy. 2020;11(12):2845\u201361.","journal-title":"Diabetes therapy"},{"issue":"3","key":"2261_CR31","doi-asserted-by":"publisher","first-page":"483","DOI":"10.2337\/dc25-2353","volume":"49","author":"E Montaser","year":"2026","unstructured":"Montaser E, Williams C, Shah VN. Assessing time below range as a predictor of severe hypoglycemia: insights from six clinical trials. Diabetes Care. 2026;49(3):483\u20139.","journal-title":"Diabetes Care"},{"issue":"11","key":"2261_CR32","doi-asserted-by":"publisher","first-page":"107680","DOI":"10.1016\/j.jdiacomp.2020.107680","volume":"34","author":"K Matoba","year":"2020","unstructured":"Matoba K, Hayashi A, Shimizu N, Moriguchi I, Kobayashi N, Shichiri M. Comparison of accuracy between flash glucose monitoring and continuous glucose monitoring in patients with type 2 diabetes mellitus undergoing hemodialysis. J Diabetes Complications. 2020;34(11):107680.","journal-title":"J Diabetes Complications"},{"key":"2261_CR33","doi-asserted-by":"crossref","unstructured":"Yajima T, Takahashi H, Yasuda K. Comparison of interstitial fluid glucose levels obtained by continuous glucose monitoring and flash glucose monitoring in patients with type 2 diabetes mellitus undergoing hemodialysis. J Diabetes Sci Technol 2019:1932296819882690.","DOI":"10.1177\/1932296819882690"},{"issue":"7","key":"2261_CR34","doi-asserted-by":"publisher","first-page":"447","DOI":"10.1089\/dia.2023.0013","volume":"25","author":"P Avari","year":"2023","unstructured":"Avari P, Tang W, Jugnee N, et al. The accuracy of continuous glucose sensors in people with diabetes undergoing hemodialysis (ALPHA Study). Diabetes Technol Ther. 2023;25(7):447\u201356.","journal-title":"Diabetes Technol Ther"},{"issue":"4","key":"2261_CR35","doi-asserted-by":"publisher","first-page":"971","DOI":"10.1177\/19322968231173447","volume":"17","author":"C Horne","year":"2023","unstructured":"Horne C, Cranston I, Amos M, Flowers K. Accuracy of continuous glucose monitoring in an insulin-treated population requiring haemodialysis. J Diabetes Sci Technol. 2023;17(4):971\u20135.","journal-title":"J Diabetes Sci Technol"},{"issue":"5","key":"2261_CR36","doi-asserted-by":"publisher","first-page":"586","DOI":"10.1111\/1744-9987.13618","volume":"25","author":"M Toyoda","year":"2021","unstructured":"Toyoda M, Murata T, Saito N, et al. Assessment of the accuracy of an intermittent-scanning continuous glucose monitoring device in patients with type 2 diabetes mellitus undergoing hemodialysis (AIDT2H) study. Ther Apher Dial. 2021;25(5):586\u201394.","journal-title":"Ther Apher Dial"},{"issue":"7","key":"2261_CR37","doi-asserted-by":"publisher","first-page":"1666","DOI":"10.2337\/dc22-0073","volume":"45","author":"O Villard","year":"2022","unstructured":"Villard O, Breton MD, Rao S, et al. Accuracy of a factory-calibrated continuous glucose monitor in individuals with diabetes on hemodialysis. Diabetes Care. 2022;45(7):1666\u20139.","journal-title":"Diabetes Care"},{"issue":"4","key":"2261_CR38","doi-asserted-by":"publisher","first-page":"292","DOI":"10.1089\/dia.2024.0496","volume":"27","author":"E Montaser","year":"2025","unstructured":"Montaser E, Farhy LS, Rich SS. Enhancing type 1 diabetes immunological risk prediction with continuous glucose monitoring and genetic profiling. Diabetes Technol Ther. 2025;27(4):292\u2013300.","journal-title":"Diabetes Technol Ther"},{"issue":"4","key":"2261_CR39","doi-asserted-by":"publisher","first-page":"1109","DOI":"10.1177\/19322968251333441","volume":"19","author":"JK Mader","year":"2025","unstructured":"Mader JK, Wong JC, Freckmann G, et al. The use of continuous glucose monitoring to diagnose stage 2 type 1 diabetes. J Diabetes Sci Technol. 2025;19(4):1109\u201327.","journal-title":"J Diabetes Sci Technol"}],"container-title":["BMC Endocrine Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12902-026-02261-7","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12902-026-02261-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12902-026-02261-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T16:36:12Z","timestamp":1779208572000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12902-026-02261-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,6]]},"references-count":39,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["2261"],"URL":"https:\/\/doi.org\/10.1186\/s12902-026-02261-7","relation":{},"ISSN":["1472-6823"],"issn-type":[{"value":"1472-6823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,6]]},"assertion":[{"value":"23 January 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 April 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 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 Kitasato University Hospital (B23-108). All study methods adhered to the relevant guidelines and regulations of Kitasato University Hospital, as well as\n                      the Ethical Guidelines for Medical and Health Research Involving Human Participants in Japan and under the Code of Ethics of the Helsinki Declaration\n                      . Given the retrospective study, informed consent was obtained using an opt-out approach.","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":"A.H. reports receiving speaker honoraria from Medtronic, Abbott, Dexcom, Terumo, Roche DC, and Sanwa Kagaku Kenkyusho, as well as grants from Abbott outside the submitted work. T.M. reports receiving speaker honoraria from Abbott, Sanwa Kagaku Kenkyusho, as well as grants from Abbott, Sanwa Kagaku Kenkyusho outside the submitted work. No other potential conflicts of interest relevant to this study were reported.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"154"}}