{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:30:47Z","timestamp":1787167847769,"version":"build-2736575974"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T00:00:00Z","timestamp":1773273600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Addressing disparities in ovarian cancer care between sub-Saharan Africa and other regions begins with the fundamental question, \u201cWho gets ovarian cancer?\u201d This study aimed to identify the demographic and clinical predictors of cancer among women with ovarian tumours.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a cross-sectional analysis of women with histology-confirmed ovarian tumour discussed at a multidisciplinary tumour board in a tertiary hospital in Ghana between 2013 and 2024. Descriptive statistics were used to summarise the characteristics of the women, and logistic regression was performed to identify predictors of ovarian cancer. P\u22640.05 was considered statistically significant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 496 women whose data were analysed, 74.4% (n=369) had ovarian cancer. Women diagnosed with ovarian cancer were older than those without cancer (median age 50 years (36-60) vs 39 years (26-55), p&amp;lt;0.001). Most women (274, 55.3%) were married; 297 (59.9%) were multiparous; 291 (58.7%) were urbanites; and more women with cancer were unemployed (93 vs 8, p=0.023). Most women (281, 56.7%) reported abdominal distension. Women with cancer had anaemia (p&amp;lt;0.001), hypertension, diabetes, or other comorbidities (p=0.012). Of the 127 benign tumours, mature cystic teratomas (50, 39.4%), mucinous tumours (28, 22.0%), serous tumours (20, 15.7%), and ovarian fibromas (12, 12.9%) were common. Few (30, 7.5%) and 3 (0.8%) had immunohistochemical and genetic tests, respectively. Travel distance of 100 km or more, (aOR 2.82; 95% CI: 1.21\u20136.56) postmenopausal status (aOR 6.43; 95% CI: 1.98\u201320.92), symptom duration of 3\u20136 months (aOR 2.85; 95% CI: 1.36\u20135.95), anaemia (aOR 3.74; 95% CI: 1.93\u20137.25) and hypertension, diabetes, or other comorbidities (aOR 3.74; 95% CI: 1.93\u20137.25) were predictors of ovarian cancer. Other predictors were tumours with a solid component (aOR 12.97; 95% CI: 3.16\u201353.18), vascular flow on imaging (aOR 9.53; 95% CI: 4.63\u201319.65), ascites (aOR 3.62; 95% CI: 1.84\u20137.14) and elevated serum CA-125 levels (aOR 4.48; 95% CI: 2.32\u20138.62).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Most women with ovarian tumours were young, and a significant proportion had benign tumours, highlighting the need for a more thorough diagnostic assessment. Improved gynaecological ultrasound scanning, access to intraoperative pathology consultation and molecular testing will be essential for guiding ovarian cancer care in Ghana.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1771387","type":"journal-article","created":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T07:20:23Z","timestamp":1773300023000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Women with suspected diagnosis of ovarian cancer in Ghana: how much do we know about them?"],"prefix":"10.3389","volume":"16","author":[{"given":"Kwabena","family":"Amo-Antwi","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology, School of Medical Sciences, Kwame Nkrumah University of Science and Technology","place":["Kumasi, Ghana"]},{"name":"Walter Aiden Specialist Clinic","place":["Asokwa-Kumasi, Ghana"]},{"name":"Department of Obstetrics and Gynaecology, Komfo Anokye Teaching Hospital","place":["Kumasi, Ghana"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yvonne","family":"Nartey","sequence":"additional","affiliation":[{"name":"Department of Adult Health, School of Nursing and Midwifery, University of Ghana","place":["Accra, Ghana"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramatu","family":"Agambire","sequence":"additional","affiliation":[{"name":"Walter Aiden Specialist Clinic","place":["Asokwa-Kumasi, Ghana"]},{"name":"Department of Nursing and Midwifery, Garden City University College","place":["Kumasi, Ghana"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Davis-Rivera","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Weill Cornell Medical Centre, New York-Presbyterian","place":["New York, NY, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roxanna","family":"Haghighat","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Weill Cornell Medical Centre, New York-Presbyterian","place":["New York, NY, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard Worlasi","family":"Ocloo","sequence":"additional","affiliation":[{"name":"Biostatics Unit, Komfo Anokye Teaching Hospital","place":["Kumasi, Ghana"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adu","family":"Appiah-Kubi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, School of Medicine, University of Health and Allied Sciences","place":["Ho, Ghana"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Agyemang-Prempeh","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Komfo Anokye Teaching Hospital","place":["Kumasi, Ghana"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George Osei","family":"Prempeh","sequence":"additional","affiliation":[{"name":"Walter Aiden Specialist Clinic","place":["Asokwa-Kumasi, Ghana"]},{"name":"Department of Obstetrics and Gynaecology, Komfo Anokye Teaching Hospital","place":["Kumasi, Ghana"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kofi","family":"Dekyi","sequence":"additional","affiliation":[{"name":"Walter Aiden Specialist Clinic","place":["Asokwa-Kumasi, Ghana"]},{"name":"Department of Obstetrics and Gynaecology, Komfo Anokye Teaching Hospital","place":["Kumasi, Ghana"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ama Yeboah","family":"Boakye","sequence":"additional","affiliation":[{"name":"Walter Aiden Specialist Clinic","place":["Asokwa-Kumasi, Ghana"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward Tieru","family":"Dassah","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Komfo Anokye Teaching Hospital","place":["Kumasi, Ghana"]},{"name":"Department of Population, Family and Reproductive Health, School of Public Health, Kwame Nkrumah University of Science and Technology","place":["Kumasi, Ghana"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elliot Koranteng","family":"Tannor","sequence":"additional","affiliation":[{"name":"Department of Medicine, School of Medical Sciences, Kwame Nkrumah University of Science and Technology","place":["Kumasi, Ghana"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mavis Bobie","family":"Ansah","sequence":"additional","affiliation":[{"name":"Walter Aiden Specialist Clinic","place":["Asokwa-Kumasi, Ghana"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick Kafui","family":"Akakpo","sequence":"additional","affiliation":[{"name":"Department of Pathology, School of Medical Sciences, University of Cape Coast, Cape Coast Teaching Hospital","place":["Cape Coast, Ghana"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernest","family":"Adjei","sequence":"additional","affiliation":[{"name":"Department of Pathology, Komfo Anokye Teaching Hospital","place":["Kumasi, Ghana"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nana Addo","family":"Boateng","sequence":"additional","affiliation":[{"name":"Walter Aiden Specialist Clinic","place":["Asokwa-Kumasi, Ghana"]},{"name":"Department of Pathology, Komfo Anokye Teaching Hospital","place":["Kumasi, Ghana"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kofi Nti","family":"Maxwell","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Komfo Anokye Teaching Hospital","place":["Kumasi, Ghana"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kwabena Oppong","family":"Adutwum","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Komfo Anokye Teaching Hospital","place":["Kumasi, Ghana"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kwasi","family":"Ampem-Darkwa","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Komfo Anokye Teaching Hospital","place":["Kumasi, Ghana"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bismark Dwobeng","family":"Amo","sequence":"additional","affiliation":[{"name":"Department of Oncology, Komfo Anokye Teaching Hospital","place":["Kumasi, Ghana"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akwasi","family":"Antwi-Kusi","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care, Komfo Anokye Teaching Hospital","place":["Kumasi, Ghana"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eloise","family":"Chapman-Davis","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Weill Cornell Medical Centre, New York-Presbyterian","place":["New York, NY, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,12]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1186\/s12905-025-03904-y","article-title":"Analysis of global ovarian cancer disease burden and its changing trend from 1990 to 2021","volume":"25","author":"Gui","year":"2025","journal-title":"BMC Womens Health"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2407-14\u2013362","article-title":"Cancer incidence in Ghana, 2012: evidence from a population-based cancer registry","volume":"14","author":"Laryea","year":"2014","journal-title":"BMC Cancer"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.2147\/IJWH.S473381","article-title":"Identifying factors contributing to delayed diagnosis of ovarian cancer: A comprehensive analysis","volume":"16","author":"Hong","year":"2024","journal-title":"Int J Womens Health"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1007\/s13224-023-01890\u20135","article-title":"Comparison of simple ultrasound rules by international ovarian tumor analysis (IOTA) with RMI-1 and RMI-4 (Risk of Malignancy index) in preoperative differentiation of benign and Malignant adnexal masses","volume":"74","author":"Dewangan","year":"2024","journal-title":"J Obstet Gynaecol India"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2021.732443","article-title":"An assessment of ovarian cancer histotypes across the african diaspora","volume":"11","author":"George","year":"2021","journal-title":"Front Oncol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1186\/s12905-017-0389-8","article-title":"A pathological and clinical study of 706 primary tumours of the ovary in the largest tertiary hospital in Ghana","volume":"17","author":"Akakpo","year":"2017","journal-title":"BMC Womens Health"},{"key":"B7","doi-asserted-by":"publisher","first-page":"61","DOI":"10.4103\/2277-9175.179183","article-title":"Ovarian tumors among Nigerian females: A private practice experience in Benin-City, Nigeria","volume":"5","author":"Forae","year":"2016","journal-title":"Adv BioMed Res"},{"key":"B8","article-title":"Ovarian cancer in Ghana, a 10 year histopathological review of cases at korle bu teaching hospital","volume":"19","author":"Akakpo","year":"2015","journal-title":"Afr J Reprod Health"},{"key":"B9","doi-asserted-by":"publisher","first-page":"e0205000","DOI":"10.1371\/journal.pone.0205000","article-title":"Familial risks of ovarian cancer by age at diagnosis, proband type and histology","volume":"13","author":"Zheng","year":"2018","journal-title":"PloS One"},{"key":"B10","doi-asserted-by":"publisher","first-page":"93","DOI":"10.5114\/pm.2023.128661","article-title":"Epidemiology and risk factors for ovarian cancer","volume":"22","author":"Ali","year":"2023","journal-title":"Przegl\u0105d Menopauzalny Menopause Rev"},{"key":"B11","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1097\/00001648-200201000\u201300011","article-title":"Association of parity and ovarian cancer risk by family history of breast or ovarian cancer in a population-based study of postmenopausal women","volume":"13","author":"Vachon","year":"2002","journal-title":"Epidemiology"},{"key":"B12","doi-asserted-by":"publisher","first-page":"e065153","DOI":"10.1136\/bmjopen-2022\u2013065153","article-title":"What influences cancer treatment service access in Ghana? A critical interpretive synthesis","volume":"12","author":"Tuck","year":"2022","journal-title":"BMJ Open"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.5003","article-title":"Marital status and survival in cancer patients: A systematic review and meta-analysis","volume":"12","author":"Krajc","year":"2022","journal-title":"Cancer Med"},{"key":"B14","doi-asserted-by":"publisher","first-page":"127","DOI":"10.4103\/jehp.jehp_65_18","article-title":"Investigating the effect of education on health literacy and its relation to health-promoting behaviors in health center","volume":"7","author":"Bayati","year":"2018","journal-title":"J Educ Health Promot"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1001\/jama.291.22.2705","article-title":"Frequency of symptoms of ovarian cancer in women presenting to primary care clinics","volume":"291","author":"Goff","year":"2004","journal-title":"JAMA"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.22371","article-title":"Development of an ovarian cancer symptom index: possibilities for earlier detection","volume":"109","author":"Goff","year":"2007","journal-title":"Cancer"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1002\/uog.9012","article-title":"GI-RADS reporting system for ultrasound evaluation of adnexal masses in clinical practice: a prospective multicenter study","volume":"38","author":"Amor","year":"2011","journal-title":"Ultrasound Obstet Gynecol Off J Int Soc Ultrasound Obstet Gynecol"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2008.08.031","article-title":"A novel multiple marker bioassay utilizing HE4 and CA125 for the prediction of ovarian cancer in patients with a pelvic mass","volume":"112","author":"Moore","year":"2009","journal-title":"Gynecol Oncol"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2020.04.700","article-title":"Cardiometabolic comorbidities and epithelial ovarian cancer risk among African-American women in the African-American Cancer Epidemiology Study (AACES)","volume":"158","author":"Staples","year":"2020","journal-title":"Gynecol Oncol"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2010\u20130236","article-title":"The prognostic impact of duration of anemia during chemotherapy in advanced epithelial ovarian cancer","volume":"16","author":"Kim","year":"2011","journal-title":"Oncologist"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.3390\/cancers17081314","article-title":"Enhancing prognosis in advanced ovarian cancer: primary cytoreductive surgery and adjuvant chemotherapy or neoadjuvant chemotherapy and interval cytoreduction\u2014A single-center retrospective observational study","volume":"17","author":"Gheorghe","year":"2025","journal-title":"Cancers"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.3390\/proteomes12010008","article-title":"Biomarkers in ovarian cancer: towards personalized medicine","volume":"12","author":"L\u00f3pez-Portugu\u00e9s","year":"2024","journal-title":"Proteomes"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2012\u20130139","article-title":"Diagnosis, treatment, and follow-up of borderline ovarian tumors","volume":"17","author":"Fischerova","year":"2012","journal-title":"Oncologist"},{"key":"B24","doi-asserted-by":"publisher","first-page":"e0204428","DOI":"10.1371\/journal.pone.0204428","article-title":"The ties that bind: Cradling in Tajikistan","volume":"13","author":"Karasik","year":"2018","journal-title":"PloS One"},{"key":"B25","doi-asserted-by":"publisher","first-page":"e0268831","DOI":"10.1371\/journal.pone.0268831","article-title":"Health-related quality of life among cervical cancer survivors at a tertiary hospital in Ghana","volume":"17","author":"Amo-Antwi","year":"2022","journal-title":"PloS One"},{"key":"B26","doi-asserted-by":"publisher","first-page":"16061","DOI":"10.1038\/nrdp.2016.61","article-title":"Ovarian cancer","volume":"2","author":"Matulonis","year":"2016","journal-title":"Nat Rev Dis Primer"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2020.603391","article-title":"Gynecologic oncology sub-specialty training in Ghana: A model for sustainable impact on gynecologic cancer care in sub-saharan africa","volume":"8","author":"Erem","year":"2020","journal-title":"Front Public Health"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwn006","article-title":"Hormonal risk factors for ovarian cancer in premenopausal and postmenopausal women","volume":"167","author":"Moorman","year":"2008","journal-title":"Am J Epidemiol"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.34335","article-title":"Trends in the incidence of ovarian cancer in sub-Saharan Africa","volume":"152","author":"Gizaw","year":"2023","journal-title":"Int J Cancer"},{"key":"B30","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1186\/s12939-023-01962-y","article-title":"Addressing cancer care inequities in sub-Saharan Africa: current challenges and proposed solutions","volume":"22","author":"Omotoso","year":"2023","journal-title":"Int J Equity Health"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgc.2025.101679","article-title":"Controversies in the management of mucinous ovarian tumors","volume":"35","author":"Blanc-Durand","year":"2025","journal-title":"Int J Gynecol Cancer Off J Int Gynecol Cancer Soc"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-200307000\u201300014","article-title":"Primary and metastatic mucinous adenocarcinomas in the ovaries: incidence in routine practice with a new approach to improve intraoperative diagnosis","volume":"27","author":"Seidman","year":"2003","journal-title":"Am J Surg Pathol"},{"key":"B33","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1007\/s10350-003-0006\u20139","article-title":"Primary sphincter repair: are the results of the operation good enough","volume":"47","author":"Pinta","year":"2004","journal-title":"Dis Colon Rectum"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1016\/j.mpdhp.2022.05.012","article-title":"Frozen section diagnosis of ovarian epithelial tumours: a practical guide for pathologists","volume":"28","author":"Ralte","year":"2022","journal-title":"Diagn Histopathol"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.3332\/ecancer.2019.945","article-title":"Pathology and cancer in africa","volume":"13","author":"Fleming","year":"2019","journal-title":"ecancermedicalscience"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e318195ad17","article-title":"The accuracy of risk scores in predicting ovarian Malignancy: a systematic review","volume":"113","author":"Geomini","year":"2009","journal-title":"Obstet Gynecol"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.7863\/jum.2009.28.3.285","article-title":"Gynecologic imaging reporting and data system: a new proposal for classifying adnexal masses on the basis of sonographic findings","volume":"28","author":"Amor","year":"2009","journal-title":"J Ultrasound Med Off J Am Inst Ultrasound Med"},{"key":"B38","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1159\/000083128","article-title":"Cancer-related anemia: pathogenesis, prevalence and treatment","volume":"68","author":"Birgeg\u00e5rd","year":"2005","journal-title":"Oncology"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)61863\u20138","article-title":"Multimorbidity: another key issue for cardiovascular medicine","volume":"374","author":"Glynn","year":"2009","journal-title":"Lancet Lond Engl"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.563452","article-title":"Risk factors associated with myocardial infarction in Africa: the INTERHEART Africa study","volume":"112","author":"Steyn","year":"2005","journal-title":"Circulation"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.22034\/APJCP.2018.19.2.357","article-title":"Characteristics of women diagnosed with invasive cervical cancer in Ghana","volume":"19","author":"Nartey","year":"2018","journal-title":"Asian Pac J Cancer Prev APJCP"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1771387\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T07:20:25Z","timestamp":1773300025000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1771387\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,12]]},"references-count":41,"alternative-id":["10.3389\/fonc.2026.1771387"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2026.1771387","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,12]]},"article-number":"1771387"}}