{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T21:54:03Z","timestamp":1783547643022,"version":"3.55.0"},"reference-count":36,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2019,11,4]],"date-time":"2019-11-04T00:00:00Z","timestamp":1572825600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2019,11,4]],"date-time":"2019-11-04T00:00:00Z","timestamp":1572825600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100006676","name":"Lilly Deutschland","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006676","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002957","name":"Technische Universit\u00e4t Dresden","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002957","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int J Bipolar Disord"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Despite various pharmacological and psychological treatment interventions, bipolar disorders rank among the leading causes of global disease burden. Group psychoeducation has been demonstrated an effective add-on to pharmacotherapy, but it may be difficult to implement in practice depending on the clinical setting and available human resources.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Multicenter, rater-blind, randomized controlled trial to investigate the efficacy of a new intervention program consisting of an initial 6-week psychoeducation protocol plus a subsequent structured daily computer-based self-charting program (ChronoRecord) over 54\u00a0weeks in remitted patients with bipolar disorders. The control condition included non-structured group sessions followed by daily computer-based self-reports (unstructured like a diary). Both groups received treatment-as-usual.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Over 2\u00a0years, 41 mood episodes occurred in the experimental group (<jats:italic>n<\/jats:italic>\u2009=\u200939) compared to 27 in the control group (<jats:italic>n<\/jats:italic>\u2009=\u200934), without reaching statistical significance. Time to recurrence did not significantly differ between the experimental and control group (25% relapsed after 112 and 273\u00a0days, respectively). There were no significant group-by-time interactions in mood symptoms, quality of life, self-efficacy expectations or perceived involvement in care.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Six weekly psychoeducational group sessions followed by daily self-monitoring via ChronoRecord for 54\u00a0weeks may not be superior to non-structured group meetings followed by unstructured self-reporting. Other psychotherapeutic interventions may be needed to optimize the treatment of patients with bipolar disorders, especially for those at later disease stages.<\/jats:p>\n                <jats:p><jats:italic>Trial registration<\/jats:italic> Retrospectively registered at German Clinical Trials Register on May 24, 2019; DRKS00017319<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s40345-019-0158-8","type":"journal-article","created":{"date-parts":[[2019,11,4]],"date-time":"2019-11-04T04:56:48Z","timestamp":1572843408000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Short group psychoeducation followed by daily electronic self-monitoring in the long-term treatment of bipolar disorders: a multicenter, rater-blind, randomized controlled trial"],"prefix":"10.1186","volume":"7","clinical-trial-number":[{"clinical-trial-number":"drks00017319","registry":"10.18810\/drks"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4163-9014","authenticated-orcid":false,"given":"Johannes","family":"Petzold","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ren\u00e9","family":"Mayer-Pelinski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximilian","family":"Pilhatsch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Luthe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Barth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Bauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuel","family":"Severus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,11,4]]},"reference":[{"key":"158_CR1","unstructured":"Bates D, Kliegl R, Vasishth S, Baayen H. Parsimonious mixed models. ArXiv e-prints; 2015."},{"issue":"1","key":"158_CR2","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1046\/j.1399-5618.2003.00085.x","volume":"6","author":"M Bauer","year":"2004","unstructured":"Bauer M, Grof P, Gyulai L, Rasgon N, Glenn T, Whybrow PC. Using technology to improve longitudinal studies: self-reporting with ChronoRecord in bipolar disorder. Bipolar Disord. 2004;6(1):67\u201374.","journal-title":"Bipolar Disord"},{"issue":"3","key":"158_CR3","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1016\/j.psychres.2007.04.013","volume":"159","author":"M Bauer","year":"2008","unstructured":"Bauer M, Wilson T, Neuhaus K, Sasse J, Pfennig A, Lewitzka U, et al. Self-reporting software for bipolar disorder: validation of ChronoRecord by patients with mania. Psychiatry Res. 2008;159(3):359\u201366.","journal-title":"Psychiatry Res"},{"issue":"4","key":"158_CR4","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1111\/bdi.12287","volume":"17","author":"K Bond","year":"2015","unstructured":"Bond K, Anderson IM. Psychoeducation for relapse prevention in bipolar disorder: a systematic review of efficacy in randomized controlled trials. Bipolar Disord. 2015;17(4):349\u201362.","journal-title":"Bipolar Disord"},{"issue":"10","key":"158_CR5","doi-asserted-by":"publisher","first-page":"1359","DOI":"10.1016\/0277-9536(95)00115-N","volume":"41","author":"M Bullinger","year":"1995","unstructured":"Bullinger M. German translation and psychometric testing of the SF-36 Health Survey: preliminary results from the IQOLA Project. International Quality of Life Assessment. Soc Sci Med. 1995;41(10):1359\u201366.","journal-title":"Soc Sci Med."},{"issue":"11","key":"158_CR6","doi-asserted-by":"publisher","first-page":"1337","DOI":"10.1016\/j.euroneuro.2013.04.001","volume":"23","author":"F Catala-Lopez","year":"2013","unstructured":"Catala-Lopez F, Genova-Maleras R, Vieta E, Tabares-Seisdedos R. The increasing burden of mental and neurological disorders. Eur Neuropsychopharmacol. 2013;23(11):1337\u20139.","journal-title":"Eur Neuropsychopharmacol"},{"issue":"1","key":"158_CR7","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1111\/bdi.12642","volume":"21","author":"R Chen","year":"2018","unstructured":"Chen R, Zhu X, Capitao LP, Zhang H, Luo J, Wang X, et al. Psychoeducation for psychiatric inpatients following remission of a manic episode in bipolar I disorder: a randomized controlled trial. Bipolar Disord. 2018;21(1):76\u201385.","journal-title":"Bipolar Disord"},{"key":"158_CR8","doi-asserted-by":"publisher","DOI":"10.1017\/CBO9780511543685","volume-title":"Psychoeducation manual for bipolar disorder","author":"F Colom","year":"2006","unstructured":"Colom F, Vieta E. Psychoeducation manual for bipolar disorder. 1st ed. New York: Cambridge University Press; 2006.","edition":"1"},{"issue":"4","key":"158_CR9","doi-asserted-by":"publisher","first-page":"402","DOI":"10.1001\/archpsyc.60.4.402","volume":"60","author":"F Colom","year":"2003","unstructured":"Colom F, Vieta E, Martinez-Aran A, Reinares M, Goikolea JM, Benabarre A, et al. A randomized trial on the efficacy of group psychoeducation in the prophylaxis of recurrences in bipolar patients whose disease is in remission. Arch Gen Psychiatry. 2003a;60(4):402\u20137.","journal-title":"Arch Gen Psychiatry"},{"issue":"9","key":"158_CR10","doi-asserted-by":"publisher","first-page":"1101","DOI":"10.4088\/JCP.v64n0917","volume":"64","author":"F Colom","year":"2003","unstructured":"Colom F, Vieta E, Reinares M, Martinez-Aran A, Torrent C, Goikolea JM, et al. Psychoeducation efficacy in bipolar disorders: beyond compliance enhancement. J Clin Psychiatry. 2003b;64(9):1101\u20135.","journal-title":"J Clin Psychiatry"},{"issue":"1\u20133","key":"158_CR11","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1016\/j.jad.2008.03.023","volume":"112","author":"F Colom","year":"2009","unstructured":"Colom F, Vieta E, Sanchez-Moreno J, Goikolea JM, Popova E, Bonnin CM, et al. Psychoeducation for bipolar II disorder: an exploratory, 5-year outcome subanalysis. J Affect Disord. 2009a;112(1\u20133):30\u20135.","journal-title":"J Affect Disord"},{"issue":"3","key":"158_CR12","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1192\/bjp.bp.107.040485","volume":"194","author":"F Colom","year":"2009","unstructured":"Colom F, Vieta E, Sanchez-Moreno J, Palomino-Otiniano R, Reinares M, Goikolea JM, et al. Group psychoeducation for stabilised bipolar disorders: 5-year outcome of a randomised clinical trial. Br J Psychiatry. 2009b;194(3):260\u20135.","journal-title":"Br J Psychiatry"},{"issue":"2","key":"158_CR13","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1111\/j.1601-5215.2010.00450.x","volume":"22","author":"F Colom","year":"2010","unstructured":"Colom F, Reinares M, Pacchiarotti I, Popovic D, Mazzarini L, Martinez-Aran A, et al. Has number of previous episodes any effect on response to group psychoeducation in bipolar patients? A 5-year follow-up post hoc analysis. Acta Neuropsychiatr. 2010;22(2):50\u20133.","journal-title":"Acta Neuropsychiatr."},{"issue":"2","key":"158_CR14","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1111\/acps.12007","volume":"127","author":"Pellegrinelli K de Barros","year":"2013","unstructured":"de Barros Pellegrinelli K, de Costa OLF, Silval KI, Dias VV, Roso MC, Bandeira M, et al. Efficacy of psychoeducation on symptomatic and functional recovery in bipolar disorder. Acta Psychiatr Scand. 2013;127(2):153\u20138.","journal-title":"Acta Psychiatr Scand."},{"key":"158_CR15","volume-title":"KurzPsychoEdukation f\u00fcr Bipolare Patienten: Das einfache Kurzprogramm in 6 Modulen","author":"A Erfurth","year":"2005","unstructured":"Erfurth A, Dobmeier M, Zechendorff M. KurzPsychoEdukation f\u00fcr Bipolare Patienten: Das einfache Kurzprogramm in 6 Modulen. 1st ed. Stuttgart: Thieme; 2005.","edition":"1"},{"key":"158_CR16","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1186\/s12888-016-0713-0","volume":"16","author":"M Faurholt-Jepsen","year":"2016","unstructured":"Faurholt-Jepsen M, Munkholm K, Frost M, Bardram JE, Kessing LV. Electronic self-monitoring of mood using IT platforms in adult patients with bipolar disorder: a systematic review of the validity and evidence. BMC Psychiatry. 2016;16:7.","journal-title":"BMC Psychiatry."},{"issue":"3","key":"158_CR17","first-page":"285","volume":"18","author":"D Ferring","year":"1989","unstructured":"Ferring D, Filipp S-H. Der Fragebogen zur Erfassung gesundheitsbezogener Kontroll\u00fcberzeugungen (FEGK). Kurzbericht. Zeitschrift f\u00fcr Klinische Psychologie. 1989;18(3):285\u20139.","journal-title":"Zeitschrift f\u00fcr Klinische Psychologie."},{"issue":"3","key":"158_CR18","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1111\/acps.12275","volume":"130","author":"TA Furukawa","year":"2014","unstructured":"Furukawa TA, Noma H, Caldwell DM, Honyashiki M, Shinohara K, Imai H, et al. Waiting list may be a nocebo condition in psychotherapy trials: a contribution from network meta-analysis. Acta Psychiatr Scand. 2014;130(3):181\u201392.","journal-title":"Acta Psychiatr Scand"},{"key":"158_CR19","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1136\/jnnp.23.1.56","volume":"23","author":"M Hamilton","year":"1960","unstructured":"Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatry. 1960;23:56\u201362.","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"158_CR20","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4757-3462-1","volume-title":"Regression modeling strategies","author":"FE Harrell","year":"2001","unstructured":"Harrell FE. Regression modeling strategies. 1st ed. New York: Springer; 2001.","edition":"1"},{"key":"158_CR21","doi-asserted-by":"publisher","first-page":"436","DOI":"10.1016\/j.jad.2018.08.048","volume":"241","author":"D Hidalgo-Mazzei","year":"2018","unstructured":"Hidalgo-Mazzei D, Reinares M, Mateu A, Nikolova VL, Bonn\u00edn CDM, Samalin L, et al. OpenSIMPLe: a real-world implementation feasibility study of a smartphone-based psychoeducation programme for bipolar disorder. J Affect Disord. 2018;241:436\u201345.","journal-title":"J Affect Disord."},{"key":"158_CR22","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291719001053","author":"E Joas","year":"2019","unstructured":"Joas E, Backman K, Karanti A, Sparding T, Colom F, Palsson E, et al. Psychoeducation for bipolar disorder and risk of recurrence and hospitalization\u2014a within-individual analysis using registry data. Psychol Med. 2019. https:\/\/doi.org\/10.1017\/S0033291719001053.","journal-title":"Psychol Med."},{"issue":"1","key":"158_CR23","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1007\/BF02602306","volume":"5","author":"CE Lerman","year":"1990","unstructured":"Lerman CE, Brody DS, Caputo GC, Smith DG, Lazaro CG, Wolfson HG. Patients\u2019 Perceived Involvement in Care Scale: relationship to attitudes about illness and medical care. J Gen Intern Med. 1990;5(1):29\u201333.","journal-title":"J Gen Intern Med"},{"key":"158_CR24","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1016\/j.jad.2017.06.057","volume":"222","author":"T Macheiner","year":"2017","unstructured":"Macheiner T, Skavantzos A, Pilz R, Reininghaus EZ. A meta-analysis of adjuvant group-interventions in psychiatric care for patients with bipolar disorders. J Affect Disord. 2017;222:28\u201331.","journal-title":"J Affect Disord"},{"key":"158_CR25","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1186\/s12991-015-0057-z","volume":"14","author":"S Miziou","year":"2015","unstructured":"Miziou S, Tsitsipa E, Moysidou S, Karavelas V, Dimelis D, Polyzoidou V, et al. Psychosocial treatment and interventions for bipolar disorder: a systematic review. Ann Gen Psychiatry. 2015;14:19.","journal-title":"Ann Gen Psychiatry"},{"issue":"11","key":"158_CR26","doi-asserted-by":"publisher","first-page":"1029","DOI":"10.1016\/S2215-0366(16)30302-9","volume":"3","author":"R Morriss","year":"2016","unstructured":"Morriss R, Lobban F, Riste L, Davies L, Holland F, Long R, et al. Clinical effectiveness and acceptability of structured group psychoeducation versus optimised unstructured peer support for patients with remitted bipolar disorder (PARADES): a pragmatic, multicentre, observer-blind, randomised controlled superiority trial. Lancet Psychiatry. 2016;3(11):1029\u201338.","journal-title":"Lancet Psychiatry."},{"key":"158_CR27","volume-title":"The NICE Guideline on the Assessment and Management of Bipolar Disorder in Adults, Children and Young People in Primary and Secondary Care. updated ed","author":"National Collaborating Centre for Mental Health","year":"2018","unstructured":"National Collaborating Centre for Mental Health. The NICE Guideline on the Assessment and Management of Bipolar Disorder in Adults, Children and Young People in Primary and Secondary Care. updated ed. Leicester: The British Psychological Society & The Royal College of Psychiatrists; 2018."},{"issue":"10","key":"158_CR28","doi-asserted-by":"publisher","first-page":"1058","DOI":"10.1001\/archgenpsychiatry.2011.113","volume":"68","author":"M Nordentoft","year":"2011","unstructured":"Nordentoft M, Mortensen PB, Pedersen CB. Absolute risk of suicide after first hospital contact in mental disorder. Arch Gen Psychiatry. 2011;68(10):1058\u201364.","journal-title":"Arch Gen Psychiatry"},{"issue":"6","key":"158_CR29","doi-asserted-by":"publisher","first-page":"803","DOI":"10.4088\/JCP.11m07343","volume":"73","author":"SV Parikh","year":"2012","unstructured":"Parikh SV, Zaretsky A, Beaulieu S, Yatham LN, Young LT, Patelis-Siotis I, et al. A randomized controlled trial of psychoeducation or cognitive-behavioral therapy in bipolar disorder: a Canadian Network for Mood and Anxiety treatments (CANMAT) study [CME]. J Clin Psychiatry. 2012;73(6):803\u201310.","journal-title":"J Clin Psychiatry"},{"issue":"6","key":"158_CR30","first-page":"92","volume":"110","author":"A Pfennig","year":"2013","unstructured":"Pfennig A, Bschor T, Falkai P, Bauer M. The diagnosis and treatment of bipolar disorder: recommendations from the current s3 guideline. Dtsch Arztebl Int. 2013;110(6):92\u2013100.","journal-title":"Dtsch Arztebl Int."},{"key":"158_CR31","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1016\/j.jad.2016.05.018","volume":"201","author":"S Salcedo","year":"2016","unstructured":"Salcedo S, Gold AK, Sheikh S, Marcus PH, Nierenberg AA, Deckersbach T, et al. Empirically supported psychosocial interventions for bipolar disorder: current state of the research. J Affect Disord. 2016;201:203\u201314.","journal-title":"J Affect Disord"},{"issue":"2","key":"158_CR32","first-page":"105","volume":"40","author":"R Schwarzer","year":"1994","unstructured":"Schwarzer R. Optimistische Kompetenzerwartung: zur Erfassung einer personellen Bew\u00e4ltigungsressource [Generalized self-efficacy: assessment of a personal coping resource]. Diagnostica. 1994;40(2):105\u201323.","journal-title":"Diagnostica."},{"issue":"3","key":"158_CR33","doi-asserted-by":"publisher","first-page":"17r11750","DOI":"10.4088\/JCP.17r11750","volume":"79","author":"SA Soo","year":"2018","unstructured":"Soo SA, Zhang ZW, Khong SJ, Low JEW, Thambyrajah VS, Alhabsyi S, et al. Randomized controlled trials of psychoeducation modalities in the management of bipolar disorder: a systematic review. J Clin Psychiatry. 2018;79(3):17r11750.","journal-title":"J Clin Psychiatry."},{"issue":"6","key":"158_CR34","doi-asserted-by":"publisher","first-page":"328","DOI":"10.1016\/j.eurpsy.2009.11.012","volume":"25","author":"T Treuer","year":"2010","unstructured":"Treuer T, Tohen M. Predicting the course and outcome of bipolar disorder: a review. Eur Psychiatry. 2010;25(6):328\u201333.","journal-title":"Eur Psychiatry."},{"key":"158_CR35","volume-title":"Strukturiertes Klinisches Interview f\u00fcr DSM-IV","author":"H-U Wittchen","year":"1997","unstructured":"Wittchen H-U, Zaudig M, Fydrich T. Strukturiertes Klinisches Interview f\u00fcr DSM-IV. 1st ed. G\u00f6ttingen: Hogrefe Verlag; 1997.","edition":"1"},{"key":"158_CR36","doi-asserted-by":"publisher","first-page":"429","DOI":"10.1192\/bjp.133.5.429","volume":"133","author":"RC Young","year":"1978","unstructured":"Young RC, Biggs JT, Ziegler VE, Meyer DA. A rating scale for mania: reliability, validity and sensitivity. Br J Psychiatry. 1978;133:429\u201335.","journal-title":"Br J Psychiatry"}],"container-title":["International Journal of Bipolar Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40345-019-0158-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40345-019-0158-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40345-019-0158-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,8,10]],"date-time":"2021-08-10T17:43:23Z","timestamp":1628617403000},"score":1,"resource":{"primary":{"URL":"https:\/\/journalbipolardisorders.springeropen.com\/articles\/10.1186\/s40345-019-0158-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,11,4]]},"references-count":36,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2019,12]]}},"alternative-id":["158"],"URL":"https:\/\/doi.org\/10.1186\/s40345-019-0158-8","relation":{},"ISSN":["2194-7511"],"issn-type":[{"value":"2194-7511","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,11,4]]},"assertion":[{"value":"24 May 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 August 2019","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 November 2019","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"All participants signed the informed consent form approved by the institutional review board of the Charit\u00e9, Berlin University of Medicine, Germany (EA1\/256\/05).","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"MB is on the advisory boards of Allergan, Janssen, Lundbeck and Neuraxpharm. MB has received lecture fees from Lilly and Neuraxpharm. All other authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"23"}}