{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T05:35:56Z","timestamp":1791005756427,"version":"4.1.0"},"reference-count":45,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,3,31]],"date-time":"2025-03-31T00:00:00Z","timestamp":1743379200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2025,3,31]],"date-time":"2025-03-31T00:00:00Z","timestamp":1743379200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med Genomics"],"DOI":"10.1186\/s12920-025-02127-2","type":"journal-article","created":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T11:41:47Z","timestamp":1744285307000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Severe traumatic brain injury and risk for osteoporosis: a Mendelian randomization study"],"prefix":"10.1186","volume":"18","author":[{"given":"Guoqiang","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiachen","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dinglong","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,3,31]]},"reference":[{"key":"2127_CR1","unstructured":"Cooper C, Dennison EM, Fuggle NR, Curtis EM, Harvey NC, Clynes MA. The epidemiology of osteoporosis. Br Med Bull. 2020."},{"issue":"1","key":"2127_CR2","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1007\/s11657-013-0136-1","volume":"8","author":"E Hernlund","year":"2013","unstructured":"Hernlund E, Svedbom A, Iverg\u00e5rd M, Compston J, Cooper C, Stenmark J, McCloskey EV, J\u00f6nsson B, Kanis JA. Osteoporosis in the European union: medical management, epidemiology and economic burden. A report prepared in collaboration with the international osteoporosis foundation (IOF) and the European federation of pharmaceutical industry associations (EFPIA). Arch Osteoporos. 2013;8(1):136.","journal-title":"Arch Osteoporos"},{"key":"2127_CR3","doi-asserted-by":"crossref","unstructured":"Srivastava RK, Sapra L, Mishra PK. Osteometabolism: metabolic alterations in bone pathologies. Cells 2022, 11(23).","DOI":"10.3390\/cells11233943"},{"issue":"10169","key":"2127_CR4","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1016\/S0140-6736(18)32112-3","volume":"393","author":"JE Compston","year":"2019","unstructured":"Compston JE, McClung MR, Leslie WD, Osteoporosis. Lancet. 2019;393(10169):364\u201376.","journal-title":"Lancet"},{"issue":"12","key":"2127_CR5","doi-asserted-by":"crossref","first-page":"1914","DOI":"10.1016\/j.cmet.2022.09.025","volume":"34","author":"X Lv","year":"2022","unstructured":"Lv X, Gao F, Cao X. Skeletal interoception in bone homeostasis and pain. Cell Metab. 2022;34(12):1914\u201331.","journal-title":"Cell Metab"},{"issue":"1","key":"2127_CR6","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1111\/nyas.13915","volume":"1428","author":"L Quadt","year":"2018","unstructured":"Quadt L, Critchley HD, Garfinkel SN. The neurobiology of interoception in health and disease. Ann N Y Acad Sci. 2018;1428(1):112\u201328.","journal-title":"Ann N Y Acad Sci"},{"issue":"5","key":"2127_CR7","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.tics.2019.02.002","volume":"23","author":"HD Park","year":"2019","unstructured":"Park HD, Blanke O. Coupling inner and outer body for Self-Consciousness. Trends Cogn Sci. 2019;23(5):377\u201388.","journal-title":"Trends Cogn Sci"},{"issue":"2","key":"2127_CR8","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1016\/j.neuron.2015.01.026","volume":"86","author":"M Hanoun","year":"2015","unstructured":"Hanoun M, Maryanovich M, Arnal-Estape A, Frenette PS. Neural regulation of hematopoiesis, inflammation, and cancer. Neuron. 2015;86(2):360\u201373.","journal-title":"Neuron"},{"issue":"2","key":"2127_CR9","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.jdsr.2011.12.002","volume":"48","author":"A Togari","year":"2012","unstructured":"Togari A, Arai M, Kondo H, Kodama D, Niwa Y. The neuro-osteogenic network: the sympathetic regulation of bone resorption. Japanese Dent Sci Rev. 2012;48(2):61\u201370.","journal-title":"Japanese Dent Sci Rev"},{"key":"2127_CR10","doi-asserted-by":"crossref","unstructured":"Chen H, Hu B, Lv X, Zhu S, Zhen G, Wan M, Jain A, Gao B, Chai Y, Yang M et al. Prostaglandin E2 mediates sensory nerve regulation of bone homeostasis. Nat Commun. 2019;10(1).","DOI":"10.1038\/s41467-018-08097-7"},{"issue":"3","key":"2127_CR11","doi-asserted-by":"crossref","first-page":"1044","DOI":"10.1007\/s12028-021-01428-5","volume":"36","author":"MD Karagianni","year":"2022","unstructured":"Karagianni MD, Brotis AG, Gatos C, Kalamatianos T, Vrettou C, Stranjalis G, Fountas KN. Neuromonitoring in severe traumatic brain injury: A bibliometric analysis. Neurocrit Care. 2022;36(3):1044\u201352.","journal-title":"Neurocrit Care"},{"issue":"2","key":"2127_CR12","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/j.mcna.2019.11.001","volume":"104","author":"A Capizzi","year":"2020","unstructured":"Capizzi A, Woo J, Verduzco-Gutierrez M. Traumatic brain injury an overview of epidemiology, pathophysiology, and medical management. Med Clin N Am. 2020;104(2):213\u2013.","journal-title":"Med Clin N Am"},{"issue":"2","key":"2127_CR13","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1007\/s11845-016-1399-5","volume":"185","author":"E Smith","year":"2016","unstructured":"Smith E, Comiskey C, Carroll A. Prevalence of and risk factors for osteoporosis in adults with acquired brain injury. Ir J Med Sci. 2016;185(2):473\u201381.","journal-title":"Ir J Med Sci"},{"key":"2127_CR14","doi-asserted-by":"crossref","unstructured":"Otto E, Knapstein PR, Jahn D, Appelt J, Frosch KH, Tsitsilonis S, Keller J. Crosstalk of brain and Bone-Clinical observations and their molecular bases. Int J Mol Sci. 2020;21(14).","DOI":"10.3390\/ijms21144946"},{"key":"2127_CR15","doi-asserted-by":"crossref","first-page":"115","DOI":"10.3389\/fneur.2018.00115","volume":"9","author":"NM Bajwa","year":"2018","unstructured":"Bajwa NM, Kesavan C, Mohan S. Long-term consequences of traumatic brain injury in bone metabolism. Front Neurol. 2018;9:115.","journal-title":"Front Neurol"},{"issue":"1","key":"2127_CR16","doi-asserted-by":"crossref","first-page":"1636","DOI":"10.1080\/07853890.2022.2085883","volume":"54","author":"Z Cao","year":"2022","unstructured":"Cao Z, Wu Y, Li Q, Li Y, Wu J. A causal relationship between childhood obesity and risk of osteoarthritis: results from a two-sample Mendelian randomization analysis. Ann Med. 2022;54(1):1636\u201345.","journal-title":"Ann Med"},{"issue":"19","key":"2127_CR17","doi-asserted-by":"crossref","first-page":"1925","DOI":"10.1001\/jama.2017.17219","volume":"318","author":"CA Emdin","year":"2017","unstructured":"Emdin CA, Khera AV, Kathiresan S. Mendelian randomization. JAMA. 2017;318(19):1925\u20136.","journal-title":"JAMA"},{"issue":"16","key":"2127_CR18","doi-asserted-by":"crossref","first-page":"1614","DOI":"10.1001\/jama.2021.18236","volume":"326","author":"VW Skrivankova","year":"2021","unstructured":"Skrivankova VW, Richmond RC, Woolf BAR, Yarmolinsky J, Davies NM, Swanson SA, VanderWeele TJ, Higgins JPT, Timpson NJ, Dimou N, et al. Strengthening the reporting of observational studies in epidemiology using Mendelian randomization: the STROBE-MR statement. JAMA. 2021;326(16):1614\u201321.","journal-title":"JAMA"},{"issue":"7944","key":"2127_CR19","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1038\/s41586-022-05473-8","volume":"613","author":"MI Kurki","year":"2023","unstructured":"Kurki MI, Karjalainen J, Palta P, Sipila TP, Kristiansson K, Donner KM, Reeve MP, Laivuori H, Aavikko M, Kaunisto MA, et al. FinnGen provides genetic insights from a well-phenotyped isolated population. Nature. 2023;613(7944):508\u201318.","journal-title":"Nature"},{"key":"2127_CR20","doi-asserted-by":"crossref","first-page":"727475","DOI":"10.3389\/fgene.2021.727475","volume":"12","author":"XL Zou","year":"2021","unstructured":"Zou XL, Wang S, Wang LY, Xiao LX, Yao TX, Zeng Y, Zhang L. Childhood obesity and risk of stroke: A Mendelian randomisation analysis. Front Genet. 2021;12:727475.","journal-title":"Front Genet"},{"issue":"23","key":"2127_CR21","doi-asserted-by":"crossref","first-page":"9160","DOI":"10.1002\/cam4.3493","volume":"9","author":"X Chen","year":"2020","unstructured":"Chen X, Kong J, Diao X, Cai J, Zheng J, Xie W, Qin H, Huang J, Lin T. Depression and prostate cancer risk: A Mendelian randomization study. Cancer Med. 2020;9(23):9160\u20137.","journal-title":"Cancer Med"},{"key":"2127_CR22","doi-asserted-by":"crossref","unstructured":"Hemani G, Zheng J, Elsworth B, Wade KH, Haberland V, Baird D, Laurin C, Burgess S, Bowden J, Langdon R et al. The MR-Base platform supports systematic causal inference across the human phenome. Elife. 2018;7.","DOI":"10.7554\/eLife.34408"},{"issue":"6","key":"2127_CR23","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1002\/gepi.22207","volume":"43","author":"JS Ong","year":"2019","unstructured":"Ong JS, MacGregor S. Implementing MR-PRESSO and GCTA\u2010GSMR for Pleiotropy assessment in Mendelian randomization studies from a practitioner\u2019s perspective. Genet Epidemiol. 2019;43(6):609\u201316.","journal-title":"Genet Epidemiol"},{"issue":"4","key":"2127_CR24","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1002\/gepi.21965","volume":"40","author":"J Bowden","year":"2016","unstructured":"Bowden J, Davey Smith G, Haycock PC, Burgess S. Consistent Estimation in Mendelian randomization with some invalid instruments using a weighted median estimator. Genet Epidemiol. 2016;40(4):304\u201314.","journal-title":"Genet Epidemiol"},{"issue":"7","key":"2127_CR25","doi-asserted-by":"crossref","first-page":"1251","DOI":"10.1016\/j.ajhg.2021.05.014","volume":"108","author":"H Xue","year":"2021","unstructured":"Xue H, Shen X, Pan W. Constrained maximum likelihood-based Mendelian randomization robust to both correlated and uncorrelated pleiotropic effects. Am J Hum Genet. 2021;108(7):1251\u201369.","journal-title":"Am J Hum Genet"},{"issue":"5","key":"2127_CR26","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1007\/s10654-017-0255-x","volume":"32","author":"S Burgess","year":"2017","unstructured":"Burgess S, Thompson SG. Interpreting findings from Mendelian randomization using the MR-Egger method. Eur J Epidemiol. 2017;32(5):377\u201389.","journal-title":"Eur J Epidemiol"},{"issue":"5","key":"2127_CR27","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1038\/s41588-018-0099-7","volume":"50","author":"M Verbanck","year":"2018","unstructured":"Verbanck M, Chen C-Y, Neale B, Do R. Detection of widespread horizontal Pleiotropy in causal relationships inferred from Mendelian randomization between complex traits and diseases. Nat Genet. 2018;50(5):693\u20138.","journal-title":"Nat Genet"},{"issue":"6","key":"2127_CR28","doi-asserted-by":"crossref","first-page":"1111","DOI":"10.1007\/s00198-023-06734-6","volume":"34","author":"Y Tang","year":"2023","unstructured":"Tang Y, Zhang L, Ye D, Zhao A, Liu Y, Zhang M. Causal relationship between type 1 diabetes and osteoporosis and fracture occurrence: a two-sample Mendelian randomization analysis. Osteoporos Int. 2023;34(6):1111\u20137.","journal-title":"Osteoporos Int"},{"issue":"4","key":"2127_CR29","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1016\/j.physio.2012.12.009","volume":"99","author":"N Banham-Hall","year":"2013","unstructured":"Banham-Hall N, Kothwal K, Pipkin J, Bentley J, Dickens GL. Prevalence of low bone mineral density in inpatients with traumatic brain injury receiving neurobehavioural rehabilitation: a postoperative, observational study. Physiotherapy. 2013;99(4):328\u201334.","journal-title":"Physiotherapy"},{"issue":"23","key":"2127_CR30","doi-asserted-by":"crossref","first-page":"2154","DOI":"10.1089\/neu.2014.3836","volume":"33","author":"RD Brady","year":"2016","unstructured":"Brady RD, Shultz SR, Sun M, Romano T, van der Poel C, Wright DK, Wark JD, O\u2019Brien TJ, Grills BL, McDonald SJ. Experimental traumatic brain injury induces bone loss in rats. J Neurotrauma. 2016;33(23):2154\u201360.","journal-title":"J Neurotrauma"},{"issue":"7","key":"2127_CR31","doi-asserted-by":"crossref","first-page":"3483","DOI":"10.1172\/JCI131554","volume":"130","author":"B Hu","year":"2020","unstructured":"Hu B, Lv X, Chen H, Xue P, Gao B, Wang X, Zhen G, Crane JL, Pan D, Liu S, et al. Sensory nerves regulate mesenchymal stromal cell lineage commitment by tuning sympathetic tones. J Clin Invest. 2020;130(7):3483\u201398.","journal-title":"J Clin Invest"},{"key":"2127_CR32","doi-asserted-by":"crossref","unstructured":"Lv X, Gao F, Li TP, Xue P, Wang X, Wan M, Hu B, Chen H, Jain A, Shao Z et al. Skeleton interoception regulates bone and fat metabolism through hypothalamic neuroendocrine NPY. Elife. 2021;10.","DOI":"10.7554\/eLife.70324"},{"issue":"1","key":"2127_CR33","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1038\/s41392-023-01457-w","volume":"8","author":"W Liu","year":"2023","unstructured":"Liu W, Chen W, Xie M, Chen C, Shao Z, Zhang Y, Zhao H, Song Q, Hu H, Xing X, et al. Traumatic brain injury stimulates sympathetic tone-mediated bone marrow myelopoiesis to favor fracture healing. Signal Transduct Target Ther. 2023;8(1):260.","journal-title":"Signal Transduct Target Ther"},{"issue":"4","key":"2127_CR34","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1556\/APhysiol.97.2010.4.8","volume":"97","author":"T Mano","year":"2010","unstructured":"Mano T, Nishimura N, Iwase S. Sympathetic neural influence on bone metabolism in microgravity (Review). Acta Physiol Hung. 2010;97(4):354\u201361.","journal-title":"Acta Physiol Hung"},{"issue":"6","key":"2127_CR35","doi-asserted-by":"crossref","first-page":"772","DOI":"10.4103\/2230-8210.192917","volume":"20","author":"KV Hari Kumar","year":"2016","unstructured":"Hari Kumar KV, Swamy MN, Khan MA. Prevalence of hypothalamo pituitary dysfunction in patients of traumatic brain injury. Indian J Endocrinol Metab. 2016;20(6):772\u20138.","journal-title":"Indian J Endocrinol Metab"},{"issue":"2","key":"2127_CR36","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1530\/eje.1.02071","volume":"154","author":"HJ Schneider","year":"2006","unstructured":"Schneider HJ, Schneider M, Saller B, Petersenn S, Uhr M, Husemann B, von Rosen F, Stalla GK. Prevalence of anterior pituitary insufficiency 3 and 12 months after traumatic brain injury. Eur J Endocrinol. 2006;154(2):259\u201365.","journal-title":"Eur J Endocrinol"},{"issue":"5","key":"2127_CR37","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1111\/cen.13161","volume":"85","author":"M Mormando","year":"2016","unstructured":"Mormando M, Chiloiro S, Bianchi A, Giampietro A, Angelini F, Tartaglione L, Nasto L, Milardi D, Formenti AM, Giustina A, et al. Growth hormone receptor isoforms and fracture risk in adult-onset growth hormone-deficient patients. Clin Endocrinol (Oxf). 2016;85(5):717\u201324.","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"10","key":"2127_CR38","doi-asserted-by":"crossref","first-page":"3737","DOI":"10.1172\/JCI63948","volume":"122","author":"R Baliram","year":"2012","unstructured":"Baliram R, Sun L, Cao J, Li J, Latif R, Huber AK, Yuen T, Blair HC, Zaidi M, Davies TF. Hyperthyroid-associated osteoporosis is exacerbated by the loss of TSH signaling. J Clin Invest. 2012;122(10):3737\u201341.","journal-title":"J Clin Invest"},{"issue":"2","key":"2127_CR39","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1002\/msj.20104","volume":"76","author":"MW Greve","year":"2009","unstructured":"Greve MW, Zink BJ. Pathophysiology of traumatic brain injury. Mt Sinai J Med. 2009;76(2):97\u2013104.","journal-title":"Mt Sinai J Med"},{"issue":"10","key":"2127_CR40","doi-asserted-by":"crossref","first-page":"3795","DOI":"10.2741\/3489","volume":"14","author":"J Lu","year":"2009","unstructured":"Lu J, Goh SJ, Tng PY, Deng YY, Ling EA, Moochhala S. Systemic inflammatory response following acute traumatic brain injury. Front Biosci (Landmark Ed). 2009;14(10):3795\u2013813.","journal-title":"Front Biosci (Landmark Ed)"},{"key":"2127_CR41","doi-asserted-by":"crossref","unstructured":"Sorby-Adams AJ, Marcoionni AM, Dempsey ER, Woenig JA, Turner RJ. The role of neurogenic inflammation in Blood-Brain barrier disruption and development of cerebral oedema following acute central nervous system (CNS) injury. Int J Mol Sci. 2017;18(8).","DOI":"10.3390\/ijms18081788"},{"key":"2127_CR42","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.biocel.2016.08.003","volume":"79","author":"NA Sims","year":"2016","unstructured":"Sims NA. Cell-specific paracrine actions of IL-6 family cytokines from bone, marrow and muscle that control bone formation and resorption. Int J Biochem Cell Biol. 2016;79:14\u201323.","journal-title":"Int J Biochem Cell Biol"},{"key":"2127_CR43","doi-asserted-by":"crossref","unstructured":"Singleton Q, Vaibhav K, Braun M, Patel C, Khayrullin A, Mendhe B, Lee BR, Kolhe R, Kaiser H, Awad ME et al. Bone marrow derived extracellular vesicles activate osteoclast differentiation in traumatic brain injury induced bone loss. Cells. 2019;8(1).","DOI":"10.3390\/cells8010063"},{"issue":"11","key":"2127_CR44","doi-asserted-by":"crossref","first-page":"e1009922","DOI":"10.1371\/journal.pgen.1009922","volume":"17","author":"Z Lin","year":"2021","unstructured":"Lin Z, Deng Y, Pan W. Combining the strengths of inverse-variance weighting and Egger regression in Mendelian randomization using a mixture of regressions model. PLoS Genet. 2021;17(11):e1009922.","journal-title":"PLoS Genet"},{"key":"2127_CR45","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.eurpsy.2019.05.004","volume":"60","author":"X Gao","year":"2019","unstructured":"Gao X, Meng LX, Ma KL, Liang J, Wang H, Gao Q, Wang T. The bidirectional causal relationships of insomnia with five major psychiatric disorders: A Mendelian randomization study. Eur Psychiatry. 2019;60:79\u201385.","journal-title":"Eur Psychiatry"}],"container-title":["BMC Medical Genomics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12920-025-02127-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12920-025-02127-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12920-025-02127-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T12:53:50Z","timestamp":1744289630000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcmedgenomics.biomedcentral.com\/articles\/10.1186\/s12920-025-02127-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,31]]},"references-count":45,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["2127"],"URL":"https:\/\/doi.org\/10.1186\/s12920-025-02127-2","relation":{},"ISSN":["1755-8794"],"issn-type":[{"value":"1755-8794","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,31]]},"assertion":[{"value":"23 February 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 March 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"31 March 2025","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":"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":"61"}}