{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T05:44:48Z","timestamp":1790401488513,"version":"4.1.0"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,11,15]],"date-time":"2021-11-15T00:00:00Z","timestamp":1636934400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,11,15]],"date-time":"2021-11-15T00:00:00Z","timestamp":1636934400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Health Serv Res"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Although HIV continues to have a high prevalence among adults in sub-Saharan Africa (SSA), the burden of noncommunicable diseases (NCD) such as diabetes and hypertension is increasing rapidly. There is an urgent need to expand the capacity of healthcare systems in SSA to provide NCD services and scale up existing chronic care management pathways. The aim of this study was to identify key components, outcomes, and best practice in integrated service provision for the prevention, identification and treatment of HIV, hypertension and diabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An international, multi stakeholder e-Delphi consensus study was conducted over two successive rounds. In Round 1, 24 participants were asked to score 27 statements, under the headings \u2018Service Provision\u2019 and \u2018Benefits of Integration\u2019, by importance. In Round 2, the 16 participants who completed Round 1 were shown the distribution of scores from other participants along with the score that they attributed to an outcome and were asked to reflect on the score they gave, based on the scores of the other participants and then to rescore if they wished to. Nine participants completed Round 2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Based on the Round 1 ranking, 19 of the 27 outcomes met the 70% threshold for consensus. Four additional outcomes suggested by participants in Round 1 were added to Round 2, and upon review by participants, 22 of the 31 outcomes met the consensus threshold. The five items participants scored from 7 to 9 in both rounds as essential for effective integrated healthcare delivery of health services for chronic conditions were improved data collection and surveillance of NCDs among people living with HIV to inform integrated NCD\/HIV programme management, strengthened drug procurement systems, availability of equipment and access to relevant blood tests, health education for all chronic conditions, and enhanced continuity of care for patients with multimorbidity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study highlights the outcomes which may form key components of future complex interventions to define a model of integrated healthcare delivery for diabetes, hypertension and HIV in sub-Saharan Africa.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12913-021-07073-0","type":"journal-article","created":{"date-parts":[[2021,11,15]],"date-time":"2021-11-15T00:04:52Z","timestamp":1636934692000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Integrating diabetes, hypertension and HIV care in sub-Saharan Africa: a Delphi consensus study on international best practice"],"prefix":"10.1186","volume":"21","author":[{"given":"Geoff","family":"McCombe","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Murtagh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey V.","family":"Lazarus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie Claire","family":"Van Hout","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Max","family":"Bachmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shabbar","family":"Jaffar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anupam","family":"Garrib","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaushik","family":"Ramaiya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nelson K.","family":"Sewankambo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sayoki","family":"Mfinanga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter","family":"Cullen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,11,15]]},"reference":[{"issue":"10","key":"7073_CR1","doi-asserted-by":"publisher","first-page":"e1375","DOI":"10.1016\/S2214-109X(19)30374-2","volume":"7","author":"HN Gouda","year":"2019","unstructured":"Gouda HN, Charlson F, Sorsdahl K, Ahmadzada S, Ferrari AJ, Erskine H, et al. Burden of non-communicable diseases in sub-Saharan Africa, 1990\u20132017: results from the global burden of disease study 2017. Lancet Glob Health. 2019;7(10):e1375\u2013e87. https:\/\/doi.org\/10.1016\/S2214-109X(19)30374-2.","journal-title":"Lancet Glob Health"},{"key":"7073_CR2","volume-title":"Noncommunicable diseases: progress monitor 2020: World Health Organization","author":"Organization WH","year":"2020","unstructured":"Organization WH. Noncommunicable diseases: progress monitor 2020: World Health Organization; 2020."},{"key":"7073_CR3","volume-title":"Diabetes atlas international diabetes federation","author":"R Sicree","year":"2006","unstructured":"Sicree R, Shaw J, Zimmet P. Diabetes atlas international diabetes federation. Belgium: International Diabetes Federation; 2006."},{"issue":"10","key":"7073_CR4","doi-asserted-by":"publisher","first-page":"e1295","DOI":"10.1016\/S2214-109X(19)30370-5","volume":"7","author":"JJ Bigna","year":"2019","unstructured":"Bigna JJ, Noubiap JJ. The rising burden of non-communicable diseases in sub-Saharan Africa. Lancet Glob Health. 2019;7(10):e1295\u2013e6. https:\/\/doi.org\/10.1016\/S2214-109X(19)30370-5.","journal-title":"Lancet Glob Health"},{"issue":"1","key":"7073_CR5","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1186\/s12872-019-01273-7","volume":"19","author":"I Desormais","year":"2019","unstructured":"Desormais I, Amidou SA, Houehanou YC, Houinato SD, Gbagouidi GN, Preux PM, et al. The prevalence, awareness, management and control of hypertension in men and women in Benin, West Africa: the TAHES study. BMC Cardiovasc Disord. 2019;19(1):303. https:\/\/doi.org\/10.1186\/s12872-019-01273-7.","journal-title":"BMC Cardiovasc Disord"},{"key":"7073_CR6","volume-title":"The global burden of disease: 2004 update","author":"World Health Organization","year":"2008","unstructured":"World Health Organization. The global burden of disease: 2004 update. Geneva: World Health Organization; 2008."},{"key":"7073_CR7","unstructured":"World Health Organization. Global status report on noncommunicable diseases 2014. World Health Organization; 2014. https:\/\/apps.who.int\/iris\/handle\/10665\/148114."},{"issue":"1","key":"7073_CR8","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1744-8603-4-8","volume":"4","author":"D Yu","year":"2008","unstructured":"Yu D, Souteyrand Y, Banda MA, Kaufman J, Perri\u00ebns JH. Investment in HIV\/AIDS programs: does it help strengthen health systems in developing countries? Glob Health. 2008;4(1):1\u201310. https:\/\/doi.org\/10.1186\/1744-8603-4-8.","journal-title":"Glob Health"},{"issue":"Suppl 2","key":"7073_CR9","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/S2055-6640(20)30340-X","volume":"4","author":"D Nash","year":"2018","unstructured":"Nash D, Yotebieng M, Sohn AH. Treating all people living with HIV in sub-Saharan Africa: a new era calling for new approaches. J Virus Erad. 2018;4(Suppl 2):1\u20134. https:\/\/doi.org\/10.1016\/S2055-6640(20)30340-X.","journal-title":"J Virus Erad"},{"key":"7073_CR10","doi-asserted-by":"crossref","unstructured":"Medlock J, Pandey A, Parpia AS, Tang A, Skrip LA, Galvani AP. Effectiveness of UNAIDS targets and HIV vaccination across 127 countries. Proc Natl Acad Sci. 2017;114(15):4017\u201322.","DOI":"10.1073\/pnas.1620788114"},{"issue":"1","key":"7073_CR11","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1093\/ije\/dys135","volume":"42","author":"JV Remais","year":"2012","unstructured":"Remais JV, Zeng G, Li G, Tian L, Engelgau MM. Convergence of non-communicable and infectious diseases in low-and middle-income countries. Int J Epidemiol. 2012;42(1):221\u20137. https:\/\/doi.org\/10.1093\/ije\/dys135.","journal-title":"Int J Epidemiol"},{"issue":"8","key":"7073_CR12","doi-asserted-by":"publisher","first-page":"622","DOI":"10.1016\/S2213-8587(17)30181-X","volume":"5","author":"R Atun","year":"2017","unstructured":"Atun R, Davies JI, Gale EAM, B\u00e4rnighausen T, Beran D, Kengne AP, et al. Diabetes in sub-Saharan Africa: from clinical care to health policy. Lancet Diabetes Endocrinol. 2017;5(8):622\u201367. https:\/\/doi.org\/10.1016\/S2213-8587(17)30181-X.","journal-title":"Lancet Diabetes Endocrinol"},{"key":"7073_CR13","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2012\/137460","volume":"2012","author":"M Rabkin","year":"2012","unstructured":"Rabkin M, Melaku Z, Bruce K, Reja A, Koler A, Tadesse Y, et al. Strengthening health systems for chronic care: leveraging HIV programs to support diabetes services in Ethiopia and Swaziland. J Trop Med. 2012;2012:1\u20136. https:\/\/doi.org\/10.1155\/2012\/137460.","journal-title":"J Trop Med"},{"issue":"10","key":"7073_CR14","doi-asserted-by":"publisher","first-page":"e039237","DOI":"10.1136\/bmjopen-2020-039237","volume":"10","author":"M-C Van Hout","year":"2020","unstructured":"Van Hout M-C, Bachmann M, Lazarus JV, Shayo EH, Bukenya D, Picchio CA, et al. Strengthening integration of chronic care in Africa: protocol for the qualitative process evaluation of integrated HIV, diabetes and hypertension care in a cluster randomised controlled trial in Tanzania and Uganda. BMJ Open. 2020;10(10):e039237. https:\/\/doi.org\/10.1136\/bmjopen-2020-039237.","journal-title":"BMJ Open"},{"issue":"8","key":"7073_CR15","doi-asserted-by":"publisher","first-page":"926","DOI":"10.1111\/tmi.12901","volume":"22","author":"M Duffy","year":"2017","unstructured":"Duffy M, Ojikutu B, Andrian S, Sohng E, Minior T, Hirschhorn LR. Non-communicable diseases and HIV care and treatment: models of integrated service delivery. Tropical Med Int Health. 2017;22(8):926\u201337. https:\/\/doi.org\/10.1111\/tmi.12901.","journal-title":"Tropical Med Int Health"},{"issue":"1","key":"7073_CR16","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1471-2458-14-904","volume":"14","author":"GB Kagaruki","year":"2014","unstructured":"Kagaruki GB, Mayige MT, Ngadaya ES, Kimaro GD, Kalinga AK, Kilale AM, et al. Magnitude and risk factors of non-communicable diseases among people living with HIV in Tanzania: a cross sectional study from Mbeya and Dar Es Salaam regions. BMC Public Health. 2014;14(1):1\u20139. https:\/\/doi.org\/10.1186\/1471-2458-14-904.","journal-title":"BMC Public Health"},{"issue":"Suppl 1","key":"7073_CR17","doi-asserted-by":"publisher","first-page":"S33","DOI":"10.1097\/QAD.0000000000001887","volume":"32","author":"B Njuguna","year":"2018","unstructured":"Njuguna B, Vorkoper S, Patel P, Reid MJA, Vedanthan R, Pfaff C, et al. Models of integration of HIV and noncommunicable disease care in sub-Saharan Africa: lessons learned and evidence gaps. Aids. 2018;32(Suppl 1):S33\u2013s42. https:\/\/doi.org\/10.1097\/QAD.0000000000001887.","journal-title":"Aids"},{"issue":"4","key":"7073_CR18","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1016\/j.jclinepi.2013.12.002","volume":"67","author":"IR Diamond","year":"2014","unstructured":"Diamond IR, Grant RC, Feldman BM, Pencharz PB, Ling SC, Moore AM, et al. Defining consensus: a systematic review recommends methodologic criteria for reporting of Delphi studies. J Clin Epidemiol. 2014;67(4):401\u20139. https:\/\/doi.org\/10.1016\/j.jclinepi.2013.12.002.","journal-title":"J Clin Epidemiol"},{"issue":"2","key":"7073_CR19","first-page":"65","volume":"9","author":"L Giannarou","year":"2014","unstructured":"Giannarou L, Zervas E. Using Delphi technique to build consensus in practice. Int J Bus Sci Appl Manag. 2014;9(2):65\u201382.","journal-title":"Int J Bus Sci Appl Manag"},{"issue":"4","key":"7073_CR20","doi-asserted-by":"crossref","first-page":"1008","DOI":"10.1046\/j.1365-2648.2000.t01-1-01567.x","volume":"32","author":"F Hasson","year":"2000","unstructured":"Hasson F, Keeney S, McKenna H. Research guidelines for the Delphi survey technique. J Adv Nurs. 2000;32(4):1008\u201315.","journal-title":"J Adv Nurs"},{"issue":"1","key":"7073_CR21","first-page":"10","volume":"12","author":"C-C Hsu","year":"2007","unstructured":"Hsu C-C, Sandford BA. The Delphi technique: making sense of consensus. Pract Assess Res Eval. 2007;12(1):10.","journal-title":"Pract Assess Res Eval"},{"key":"7073_CR22","unstructured":"INTE-AFRICA trial. Available from: https:\/\/inteafrica.org\/."},{"issue":"1","key":"7073_CR23","doi-asserted-by":"publisher","first-page":"368","DOI":"10.1186\/s13063-015-0905-9","volume":"16","author":"B Blackwood","year":"2015","unstructured":"Blackwood B, Ringrow S, Clarke M, Marshall J, Rose L, Williamson P, et al. Core outcomes in ventilation trials (COVenT): protocol for a core outcome set using a Delphi survey with a nested randomised trial and observational cohort study. Trials. 2015;16(1):368. https:\/\/doi.org\/10.1186\/s13063-015-0905-9.","journal-title":"Trials."},{"key":"7073_CR24","volume-title":"The RAND\/UCLA appropriateness method user's manual","author":"K Fitch","year":"2001","unstructured":"Fitch K, Bernstein SJ, Aguilar MD, Burnand B, JR LC. The RAND\/UCLA appropriateness method user's manual. SANTA MONICA: RAND CORP; 2001."},{"issue":"3","key":"7073_CR25","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1111\/pcmr.12354","volume":"28","author":"V Eleftheriadou","year":"2015","unstructured":"Eleftheriadou V, Thomas K, van Geel N, Hamzavi I, Lim H, Suzuki T, et al. Developing core outcome set for vitiligo clinical trials: international e-Delphi consensus. Pigment Cell Melanoma Res. 2015;28(3):363\u20139. https:\/\/doi.org\/10.1111\/pcmr.12354.","journal-title":"Pigment Cell Melanoma Res"},{"key":"7073_CR26","doi-asserted-by":"crossref","unstructured":"Sinha IP, Smyth RL, Williamson PR. Using the Delphi technique to determine which outcomes to measure in clinical trials: recommendations for the future based on a systematic review of existing studies. PLoS Med. 2011;8(1):e1000393.","DOI":"10.1371\/journal.pmed.1000393"},{"issue":"7","key":"7073_CR27","doi-asserted-by":"publisher","first-page":"e019664","DOI":"10.1136\/bmjopen-2017-019664","volume":"8","author":"UE Ekrikpo","year":"2018","unstructured":"Ekrikpo UE, Akpan EE, Ekott JU, Bello AK, Okpechi IG, Kengne AP. Prevalence and correlates of traditional risk factors for cardiovascular disease in a Nigerian ART-naive HIV population: a cross-sectional study. BMJ Open. 2018;8(7):e019664. https:\/\/doi.org\/10.1136\/bmjopen-2017-019664.","journal-title":"BMJ Open"},{"issue":"1","key":"7073_CR28","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1186\/s40200-017-0310-x","volume":"16","author":"P Shankalala","year":"2017","unstructured":"Shankalala P, Jacobs C, Bosomprah S, Vinikoor M, Katayamoyo P, Michelo C. Risk factors for impaired fasting glucose or diabetes among HIV infected patients on ART in the Copperbelt Province of Zambia. J Diabetes Metab Disord. 2017;16(1):29. https:\/\/doi.org\/10.1186\/s40200-017-0310-x.","journal-title":"J Diabetes Metab Disord"},{"issue":"1","key":"7073_CR29","doi-asserted-by":"publisher","first-page":"1243","DOI":"10.1186\/s12889-016-3916-x","volume":"16","author":"OH Divala","year":"2016","unstructured":"Divala OH, Amberbir A, Ismail Z, Beyene T, Garone D, Pfaff C, et al. The burden of hypertension, diabetes mellitus, and cardiovascular risk factors among adult Malawians in HIV care: consequences for integrated services. BMC Public Health. 2016;16(1):1243. https:\/\/doi.org\/10.1186\/s12889-016-3916-x.","journal-title":"BMC Public Health"},{"issue":"1","key":"7073_CR30","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.4102\/phcfm.v9i1.1151","volume":"9","author":"C Pfaff","year":"2017","unstructured":"Pfaff C, Scott V, Hoffman R, Mwagomba B. You can treat my HIV - but can you treat my blood pressure? Availability of integrated HIV and non-communicable disease care in northern Malawi. Afr J Prim Health Care Fam Med. 2017;9(1):e1\u20138. https:\/\/doi.org\/10.4102\/phcfm.v9i1.1151.","journal-title":"Afr J Prim Health Care Fam Med"},{"issue":"Suppl 1","key":"7073_CR31","doi-asserted-by":"publisher","first-page":"S5","DOI":"10.1097\/QAD.0000000000001888","volume":"32","author":"P Patel","year":"2018","unstructured":"Patel P, Rose CE, Collins PY, Nuche-Berenguer B, Sahasrabuddhe VV, Peprah E, et al. Noncommunicable diseases among HIV-infected persons in low-income and middle-income countries: a systematic review and meta-analysis. Aids. 2018;32(Suppl 1):S5\u2013s20. https:\/\/doi.org\/10.1097\/QAD.0000000000001888.","journal-title":"Aids"},{"issue":"7","key":"7073_CR32","doi-asserted-by":"publisher","first-page":"440","DOI":"10.1093\/trstmh\/trv038","volume":"109","author":"JK Edwards","year":"2015","unstructured":"Edwards JK, Bygrave H, Van den Bergh R, Kizito W, Cheti E, Kosgei RJ, et al. HIV with non-communicable diseases in primary care in Kibera, Nairobi, Kenya: characteristics and outcomes 2010-2013. Trans R Soc Trop Med Hyg. 2015;109(7):440\u20136. https:\/\/doi.org\/10.1093\/trstmh\/trv038.","journal-title":"Trans R Soc Trop Med Hyg"},{"issue":"Suppl 1","key":"7073_CR33","doi-asserted-by":"publisher","first-page":"S63","DOI":"10.1097\/QAD.0000000000001879","volume":"32","author":"K Juma","year":"2018","unstructured":"Juma K, Reid M, Roy M, Vorkoper S, Temu TM, Levitt NS, et al. From HIV prevention to non-communicable disease health promotion efforts in sub-Saharan Africa: a narrative review. Aids. 2018;32(Suppl 1):S63\u2013s73. https:\/\/doi.org\/10.1097\/QAD.0000000000001879.","journal-title":"Aids"},{"issue":"4","key":"7073_CR34","doi-asserted-by":"publisher","first-page":"701","DOI":"10.1086\/676145","volume":"62","author":"V Hoffmann","year":"2014","unstructured":"Hoffmann V, Fooks JR, Messer KD. Measuring and mitigating HIV stigma: a framed field experiment. Econ Dev Cult Chang. 2014;62(4):701\u201326. https:\/\/doi.org\/10.1086\/676145.","journal-title":"Econ Dev Cult Chang"},{"key":"7073_CR35","doi-asserted-by":"crossref","unstructured":"Boulkedid R, Abdoul H, Loustau M, Sibony O, Alberti C. Using and reporting the Delphi method for selecting healthcare quality indicators: a systematic review. PloS one. 2011;6(6):e20476.","DOI":"10.1371\/journal.pone.0020476"}],"container-title":["BMC Health Services Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12913-021-07073-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12913-021-07073-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12913-021-07073-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,12]],"date-time":"2023-11-12T11:31:28Z","timestamp":1699788688000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmchealthservres.biomedcentral.com\/articles\/10.1186\/s12913-021-07073-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,15]]},"references-count":35,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["7073"],"URL":"https:\/\/doi.org\/10.1186\/s12913-021-07073-0","relation":{},"ISSN":["1472-6963"],"issn-type":[{"value":"1472-6963","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,15]]},"assertion":[{"value":"7 March 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 September 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 November 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":"Ethical approval for the study was granted by the human research ethics committee at University College Dublin (LS-19-91-Cullen) and all methods were performed in accordance with the relevant guidelines and regulations. All participants were briefed fully on the aims and objectives of the study and informed consent was obtained from all participants prior to taking part.","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 that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"1235"}}