{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T05:08:15Z","timestamp":1772168895431,"version":"3.50.1"},"update-to":[{"DOI":"10.12688\/f1000research.161758.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T00:00:00Z","timestamp":1759449600000}},{"DOI":"10.12688\/f1000research.161758.2","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T00:00:00Z","timestamp":1759449600000}},{"DOI":"10.12688\/f1000research.161758.3","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T00:00:00Z","timestamp":1759449600000}}],"reference-count":23,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T00:00:00Z","timestamp":1759449600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"None"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns3:p>\n                    Background Standard multi-drug therapy (MDT) with duration of 6-12 months is generally effective for treating leprosy. However, in cases of lepromatous (LL) and borderline lepromatous (BL) patients with high bacterial loads and complicated circumstances\n                    <ns3:bold>often faces non-adherence.<\/ns3:bold>\n                    Ofloxacin, a fluoroquinolone, has shown promising efficacy against\n                    <ns3:italic>Mycobacterium leprae<\/ns3:italic>\n                    in in-vitro and in-vivo studies, therefore accelerates bacterial clearance. Methods This\n                    <ns3:bold>\n                      <ns3:italic>single-center<\/ns3:italic>\n                    <\/ns3:bold>\n                    retrospective cohort study investigated the effects of adding ofloxacin to MDT in 21 patients diagnosed with LL or BL leprosy at Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia. Bacterial load and viability were tracked using the Bacteriological Index (BI) and Morphological Index (MI), and were compared before and after the patients were given ofloxacin. Findings Adding ofloxacin to MDT led to a significant reductions in both BI and MI. The median MI dropped to zero after six months of combined treatment (p&lt;0.001), with significant differences between baseline and 6, 9, and 12-months. BI also significantly declined (p=0.007), with significant reductions between baseline and 3, 6, 9, and 12-month assessments. The proportion of patients reaching an MI of zero also steadily increased. Interpretation Ofloxacin as an adjunctive therapy to MDT substantially improves treatment of leprosy with high bacterial and morphological index. Faster bacterial clearance prevent prolonged treatment duration, potentially improving adherence, outcomes and reducing relapse risk. Ofloxacin is the only second-line leprosy treatment covered by the national health insurance in Indonesia. Earlier initiation of this adjunctive therapy may offer greater benefits.\n                  <\/ns3:p>","DOI":"10.12688\/f1000research.161758.4","type":"journal-article","created":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T14:30:06Z","timestamp":1759501806000},"page":"252","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Optimizing treatment of lepromatous form of leprosy using ofloxacin on top of standard multi-drug therapy in National Referral Hospital, Jakarta, Indonesia"],"prefix":"10.12688","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9838-6623","authenticated-orcid":false,"given":"Mufqi Handaru","family":"Priyanto","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Malika Sabrina","family":"Yunifananda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sri Linuwih SW","family":"Menaldi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erni Juwita","family":"Nelwan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melani","family":"Marissa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2560","published-online":{"date-parts":[[2025,10,3]]},"reference":[{"key":"ref1","first-page":"501-521","article-title":"Global leprosy (Hansen disease) update, 2023: Elimination of leprosy disease is possible - Time to act!","volume":"1","year":"2024","journal-title":"Wkly Epidemiol. Rec."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"554-563","DOI":"10.1016\/j.adengl.2012.03.028","volume":"104","author":"K Eichelmann","year":"2013","journal-title":"Actas Dermo-Sifiliogr\u00e1ficas (English Edition)."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1186\/s12879-019-4665-0","article-title":"World Health Organization (WHO) antibiotic regimen against other regimens for the treatment of leprosy: A systematic review and meta-analysis.","volume":"20","author":"M Lazo-Porras","year":"2020","journal-title":"BMC Infect. Dis."},{"key":"ref5","doi-asserted-by":"publisher","first-page":"45-52","DOI":"10.1177\/1203475420952437","article-title":"Ofloxacin-containing multidrug therapy in ambulatory leprosy patients: a case series.","volume":"25","author":"L Faust","year":"2020","journal-title":"J. Cutan. Med. Surg."},{"key":"ref6","doi-asserted-by":"publisher","first-page":"96-99","DOI":"10.18689\/mjdr-1000125","article-title":"Treatment of leprosy with ofloxacin - containing combined drug regimens in vietnam.","volume":"4","author":"T Khang","year":"2019 May 20","journal-title":"Madridge J. Dermatology Res."},{"key":"ref7","doi-asserted-by":"publisher","first-page":"671-672","DOI":"10.1128\/AAC.31.4.671","article-title":"Activity of ofloxacin and pefloxacin against mycobacterium leprae in mice.","volume":"31","author":"S Pattyn","year":"1987","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"24-30","DOI":"10.4269\/ajtmh.18-0256","article-title":"Alternate anti-leprosy regimen for multidrug therapy refractory leprosy: A retrospective study from a tertiary care center in North India.","volume":"100","author":"T Narang","year":"2019","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref9","doi-asserted-by":"publisher","first-page":"295-309","DOI":"10.1111\/j.1365-3156.2008.02003.x","article-title":"Relapses vs. reactions in multibacillary leprosy: Proposal of new relapse criteria.","volume":"13","author":"K Linder","year":"2008 Mar","journal-title":"Trop. Med. Int. Health."},{"key":"ref10","first-page":"255-273","article-title":"Classification of leprosy according to immunity. A five-group system.","volume":"34","author":"D Ridley","year":"1966","journal-title":"Int. J. Lepr. Other Mycobact. Dis."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"89-93","DOI":"10.2478\/sjdv-2019-0013","article-title":"Alternative leprosy treatment using rifampicin ofloxacin minocycline (rom) regimen \u2013 two case reports.","volume":"11","author":"Y Widjaja","year":"2019 Sep 1","journal-title":"Serb. J. Dermatol. Venerol."},{"key":"ref13","first-page":"261-268","article-title":"Ofloxacin multicentre trial in MB leprosy FUAM-Manaus and ILSL-Bauru, Brazil.","volume":"1","author":"A Cunha","year":"2012","journal-title":"Lepr. Rev."},{"key":"ref14","doi-asserted-by":"publisher","first-page":"46-54","DOI":"10.47276\/lr.82.1.46","article-title":"A randomised controlled trial assessing the effect of adding clarithromycin to rifampicin, ofloxacin and minocycline in the treatment of single lesion paucibacillary leprosy in Agra District, India.","volume":"82","author":"A Girdhar","year":"2011","journal-title":"Lepr. Rev."},{"key":"ref15","doi-asserted-by":"publisher","first-page":"356-362","DOI":"10.4103\/0378-6323.159929","article-title":"A randomized controlled trial to compare cure and relapse rate of paucibacillary multidrug therapy with monthly rifampicin, ofloxacin, and minocycline among paucibacillary leprosy patients in Agra District, India.","volume":"81","author":"A Kumar","year":"2015","journal-title":"Indian J. Dermatol. Venereol. Leprol."},{"key":"ref16","first-page":"27-33","article-title":"The efficacy of a four-week, ofloxacin-containing regimen compared with standard WHO-MDT in PB leprosy.","volume":"1","author":"M Balagon","year":"2010","journal-title":"Lepr. Rev."},{"key":"ref17","first-page":"181-189","article-title":"Ofloxacin-containing combined drug regimens in the treatment of lepromatous leprosy.","volume":"65","author":"P Rao","year":"1994","journal-title":"Lepr. Rev."},{"key":"ref18","doi-asserted-by":"publisher","first-page":"662-667","DOI":"10.1128\/AAC.38.4.662","article-title":"Clinical trial of ofloxacin alone and in combination with dapsone plus clofazimine for treatment of lepromatous leprosy.","volume":"38","author":"B Ji","year":"1994","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref19","first-page":"259-264","article-title":"Activity of ofloxacin against mycobacterium leprae in the mouse.","volume":"56","author":"J Grosset","year":"1988","journal-title":"Int. J. Lepr."},{"key":"ref20","doi-asserted-by":"publisher","first-page":"661-665","DOI":"10.15850\/amj.v3n4.955","article-title":"Comparison of effectiveness between rifampicin ofloxin-minocycline regimen and multidrug therapy-world health organization in multibacillary leprosy patients.","volume":"3","author":"O Moestopo","year":"2016","journal-title":"Althea Med. J."},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1-3","DOI":"10.4172\/2376-0427.1000267","article-title":"Relapse of multibacillary leprosy treated with rifampicin and ofloxacin: a case report.","volume":"04","author":"S Basuki","year":"2017","journal-title":"J. Pigment Disord."},{"key":"ref23","doi-asserted-by":"publisher","first-page":"55-65","DOI":"10.1016\/j.clindermatol.2014.07.007","article-title":"Treatment of leprosy.","volume":"33","author":"H Kar","year":"2015","journal-title":"Clin. Dermatol."},{"key":"ref24","doi-asserted-by":"publisher","first-page":"1-11","DOI":"10.1371\/journal.pntd.0008746","article-title":"Validation study of hla-b* 13:01 as a biomarker of dapsone hypersensitivity syndrome in leprosy patients in Indonesia.","volume":"14","author":"H Krismawati","year":"2020","journal-title":"PLoS Negl. Trop. Dis."},{"key":"ref25","doi-asserted-by":"publisher","first-page":"1-8","DOI":"10.1002\/ski2.5","article-title":"Leprosy patients with deformities at post-elimination stage: The Bangladesh experience.","volume":"1","author":"M Mowla","year":"2021","journal-title":"Skin Health Dis."},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.6084\/m9.figshare.28331675.v1","author":"M Handaru Priyanto","year":"2025","journal-title":"figshare."}],"container-title":["F1000Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/f1000research.com\/articles\/14-252\/v4\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/14-252\/v4\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/14-252\/v4\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T14:30:07Z","timestamp":1759501807000},"score":1,"resource":{"primary":{"URL":"https:\/\/f1000research.com\/articles\/14-252\/v4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,3]]},"references-count":23,"URL":"https:\/\/doi.org\/10.12688\/f1000research.161758.4","relation":{"has-version":[{"id-type":"doi","id":"10.12688\/f1000research.161758.3","asserted-by":"subject"},{"id-type":"doi","id":"10.12688\/f1000research.161758.2","asserted-by":"subject"},{"id-type":"doi","id":"10.12688\/f1000research.161758.1","asserted-by":"subject"}],"has-review":[{"id-type":"doi","id":"10.5256\/f1000research.188786.r421045","asserted-by":"object"},{"id-type":"doi","id":"10.5256\/f1000research.188786.r421040","asserted-by":"object"},{"id-type":"doi","id":"10.5256\/f1000research.188786.r421048","asserted-by":"object"}]},"ISSN":["2046-1402"],"issn-type":[{"value":"2046-1402","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,3]]},"assertion":[{"value":"Approved with reservations, Not Approved, Approved","URL":"https:\/\/f1000research.com\/articles\/14-252\/v4#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.5256\/f1000research.177837.r369473, Maria T Ochoa, Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, Southern California, 02 Apr 2025, version 1, 1 approved with reservations","URL":"https:\/\/f1000research.com\/articles\/14-252\/v1#referee-response-369473","order":0,"name":"referee-response-369473","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Mufqi Handaru Priyanto<\/b>; \n<i>Posted: 17 Apr 2025<\/i>; We sincerely appreciate the reviewer\u2019s constructive feedback on our manuscript. Below, we address each of the points raised:  1. Regarding the suggestion to include a cohort treated without ofloxacin: We acknowledge the importance of this comparison. However, as this is a preliminary study, our aim was to analyze treatment outcomes before and after the addition of ofloxacin within the same patient group. Should the current findings prove promising, a subsequent study involving a direct comparison between ofloxacin and non-ofloxacin groups will be conducted to strengthen this finding&nbsp;  2. Regarding the clarification of \u201chigh initial viable infection load, evidenced by a high MI\u201d: A high MI (Morphological Index) was not the sole criterion for patient recruitment in this study. While there is currently no universally accepted threshold in the international literature defining what constitutes a &quot;high&quot; MI, we based our observations on patient data from our center. In addition to elevated MI values, other factors such as persistent positivity, relapse, and re-positivity were also considered in selecting subjects for inclusion.  3. Regarding the main dose and side effects of ofloxacin: We have now included a description of the dose of ofloxacin along with its commonly reported side effects  4. Regarding the discussion section: We have revised the discussion section to make it more concise  Thank you so much for your time","URL":"https:\/\/f1000research.com\/articles\/14-252\/v4#referee-comment-13757","order":1,"name":"referee-comment-13757","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.180812.r384857, Brandon L Adler, Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California, 13 Jun 2025, version 2, 1 approved with reservations, 1 not approved","URL":"https:\/\/f1000research.com\/articles\/14-252\/v2#referee-response-384857","order":2,"name":"referee-response-384857","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Mufqi Handaru Priyanto<\/b>; \n<i>Posted: 04 Aug 2025<\/i>; Thank you for this study evaluating the impact of addition of ofloxacin to MDT for lepromatous leprosy, conducted in a single center. &nbsp;  \u201cAt our center, slit-skin smear examinations are routinely performed from six sites (both earlobes and four lesions) every three months in patients with positive initial MI or in cases requiring close monitoring.\u201d Accordingly, there seems to be no reason that a cohort of patients receiving MDT without ofloxacin from your center could be compared to those receiving ofloxacin with regard to the BI and MI. &nbsp;That is what is missing for this study to be truly clinically meaningful.  Thank you for this observation. We acknowledge that the inclusion of a control group receiving standard MDT without ofloxacin would indeed strengthen the study's design and enhance its clinical meaningfulness, allowing for a more direct comparison of bacteriological indices (BI) and morphological indices (MI) changes. However, it is crucial to clarify the ethical and practical considerations at our center that led to the current study design. Our institution, as a national referral hospital, primarily manages complex and challenging cases of leprosy, including those with high initial MI, persistent positivity, relapse, or re-positivity, where the standard MDT alone might be insufficient to achieve optimal clinical and bacteriological clearance within the conventional timeframe. The decision to add ofloxacin in these specific cases is a clinical judgment made in accordance with the severity of the disease and the need for more aggressive bacteriological clearance to prevent further complications and transmission. Therefore, withholding an additional, potentially beneficial, antimicrobial agent from these high-risk patients solely for research comparison was considered as ethically unfeasible, given the established clinical practice and patient well-being priorities. While a concurrent control group was not feasible, we aimed to demonstrate the efficacy of ofloxacin-added regimens within this cohort by observing significant reductions in MI and BI over time, and by comparing these outcomes against the expected prolonged treatment durations typically observed in such cases under standard MDT alone. We agree that future multi-center studies, perhaps with different patient populations or in settings where such a comparative arm is ethically permissible, would be invaluable to further validate our findings. &nbsp;  In the abstract you state, \u201cAs prolonged duration may affect patient adherence negatively, adding ofloxacin to MDT is a promising approach to prevent prolonged treatment.\u201d In the discussion: \u201cThough the treatment duration remains similar to standard MDT, ofloxacin-added regimens may offer enhanced efficacy, particularly in lepromatous cases.\u201d These statements seem contradictory, and maybe the one in the abstract should be toned down?  We appreciate you highlighting this discrepancy. You are correct that the statements regarding treatment duration could appear contradictory. We have revised the abstract to better reflect the findings and align with the discussion. In the abstract, our initial \n<i>statement 'As prolonged duration may affect patient adherence negatively, adding ofloxacin to MDT is a promising approach to prevent prolonged treatment'<\/i> was an initial hypothesis and a general clinical rationale. However, as revealed in our results and discussed in detail, the addition of ofloxacin did not, in this specific cohort, \n<i>shorten<\/i> the overall treatment duration compared to the \n<i>minimum<\/i> standard MDT for lepromatous leprosy. Instead, its benefit lies in \n<i>accelerating bacteriological clearance<\/i> within that standard duration, which is crucial for preventing relapse and reducing transmission, especially in difficult-to-treat cases. Therefore, we have revised the abstract statement on the newest version.   2. Statistical methods (non-parametric Friedman test) can be deleted from the study abstract. We concur with your suggestion. The specific mention of 'non-parametric Friedman test' in the abstract is indeed overly detailed for this section. We have removed it from the abstract to maintain conciseness and focus on the primary findings, while ensuring the full details of our statistical analysis remain in the Methods section.  3.&nbsp;Methods: \u201cThe most common adverse effect of this drug is tendinopathy, and there may be hypersensitivity reactions, central nervous system adverse drug reactions, peripheral neuropathy, though uncommon.\u201d This is not a study method and does not belong in this section of the paper. It can go in the introduction (assuming you report the numbers of patients developing side effects to ofloxacin) or in the discussion (since it seems side effects were not evaluated- which is another limitation). We appreciate this astute observation regarding the placement of the adverse effect description. You are absolutely correct that this information does not belong in the Methods section, which should be reserved for how the study was conducted. We have moved the description of ofloxacin's common adverse effects, including tendinopathy, hypersensitivity reactions, CNS adverse drug reactions, and peripheral neuropathy, to the \n<b>Introduction section<\/b>. This provides essential background information for readers regarding the drug's safety profile before they delve into our findings. Regarding the evaluation of side effects in our study, we acknowledge this as a limitation. While we did not conduct a systematic, pre-specified evaluation of all potential adverse effects, any reported side effects during treatment were documented in patient medical records. However, due to the retrospective nature of some data collection and the primary focus on bacteriological outcomes, a comprehensive analysis of adverse events was beyond the scope of this particular study. We have explicitly stated this as a limitation in the Discussion section, consistent with your feedback.   4. In figure 1, I don\u2019t understand how 3 patients were excluded due to not having BL\/LL leprosy, if the initial N=43 includes only lepromatous patients. Also in figure 1, we can see that nearly half of patients were excluded due to missing data or not returning for follow up, a major limitation.&nbsp;  Thank you for pointing out the inconsistencies in Figure 1. We apologize for the confusion. Regarding the initial cohort of 43 patients and the subsequent exclusions, it is important to clarify our patient selection process. The initial N=43 represents all leprosy patients who received ofloxacin in addition to standard MDT at our center during the study period, as identified from our pharmacy records. From this initial pool, patients were then filtered based on our specific inclusion criteria for this study, which required a diagnosis of lepromatous leprosy (BL\/LL). During a re-review of their detailed clinical and histopathological records for this specific study, 3 patients, despite an initial classification, were found to have clinical features and biopsy results that did not unequivocally meet the criteria for the lepromatous (BL\/LL) spectrum as defined for our study's inclusion. We have revised the flowchart to clarify this specific reason for exclusion. We fully agree with your observation that the exclusion of nearly half of the patients due to missing data or not returning for follow-up represents a significant limitation. We have acknowledged and emphasized this point more strongly in our Discussion section. This high reduction rate is indeed a challenge inherent to real-world clinical data collection in a referral setting, particularly for chronic diseases requiring long-term follow-up. While regrettable, we believe the remaining robust dataset still provides valuable insights into the efficacy of ofloxacin in the responsive patients within this challenging group. We are actively working on strategies to improve patient retention and data completeness in future studies.  5. Figure 2 showing the map of patients\u2019 domiciles is extraneous to the study aims and can be deleted.  We concur with your assessment that Figure 2 is extraneous to the core aims of this study, which primarily focus on the clinical and bacteriological outcomes of the treatment regimen. We have removed Figure 2 from the manuscript.","URL":"https:\/\/f1000research.com\/articles\/14-252\/v4#referee-comment-14319","order":3,"name":"referee-comment-14319","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.186135.r407739, Fifa Argentina, Universitas Sriwijaya, Palembang, South Sumatra, 03 Sep 2025, version 3, 1 approved, 1 approved with reservations, 1 not approved","URL":"https:\/\/f1000research.com\/articles\/14-252\/v3#referee-response-407739","order":4,"name":"referee-response-407739","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Mufqi Handaru Priyanto<\/b>; \n<i>Posted: 25 Sep 2025<\/i>; We thank the reviewer for the constructive comments. Concerning the absence of a control group and the retrospective single-center design, we acknowledge that this limits the generalizability of the findings; this has already been addressed in the Limitations section, and we have strengthened our interpretation by referencing comparable published studies. Regarding adverse event monitoring, we would like to clarify that side effects were monitored through patient medical records during follow-up visits. Any adverse events related to treatment would have been documented in the patient\u2019s status notes, while the absence of such documentation indicated no adverse events. To make this explicit, we have added a statement in the Methods section specifying that adverse event monitoring was integrated into clinical follow-up and recorded accordingly. In addition, the Discussion section has been revised to reduce repetition and improve clarity while maintaining alignment with the cited literature. We believe these revisions address the reviewer\u2019s concerns and strengthen the manuscript","URL":"https:\/\/f1000research.com\/articles\/14-252\/v4#referee-comment-14660","order":5,"name":"referee-comment-14660","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"The author(s) declared that no grants were involved in supporting this work","order":6,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}