{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T23:51:21Z","timestamp":1794268281487,"version":"4.9.0"},"reference-count":44,"publisher":"Springer Science and Business Media LLC","issue":"12","license":[{"start":{"date-parts":[[2025,11,8]],"date-time":"2025-11-08T00:00:00Z","timestamp":1762560000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2025,11,8]],"date-time":"2025-11-08T00:00:00Z","timestamp":1762560000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"funder":[{"name":"Medical Expert Team Program of Wuxi Taihu Talent Plan","award":["THRC-TD-YXYXK-2021"],"award-info":[{"award-number":["THRC-TD-YXYXK-2021"]}]},{"name":"Wuxi Medical Innovation Team Program","award":["CXTD2021002"],"award-info":[{"award-number":["CXTD2021002"]}]},{"DOI":"10.13039\/501100004608","name":"Natural Science Foundation of Jiangsu Province","doi-asserted-by":"publisher","award":["BK20191143"],"award-info":[{"award-number":["BK20191143"]}],"id":[{"id":"10.13039\/501100004608","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81271629"],"award-info":[{"award-number":["81271629"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Neuroradiology"],"published-print":{"date-parts":[[2025,12]]},"DOI":"10.1007\/s00234-025-03836-2","type":"journal-article","created":{"date-parts":[[2025,11,8]],"date-time":"2025-11-08T06:12:40Z","timestamp":1762582360000},"page":"3599-3612","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["MRI-based glymphatic markers and composite scoring for the discrimination of mild cognitive impairment in cerebral small vessel disease"],"prefix":"10.1007","volume":"67","author":[{"given":"Min","family":"Xu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boyu","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haixia","family":"Mao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yachen","family":"Shi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiayi","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingyu","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"He","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangming","family":"Fang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,8]]},"reference":[{"issue":"3","key":"3836_CR1","doi-asserted-by":"publisher","first-page":"1075","DOI":"10.1152\/physrev.00028.2024","volume":"105","author":"HS Markus","year":"2025","unstructured":"Markus HS, Joutel A (2025) The pathogenesis of cerebral small vessel disease and vascular cognitive impairment. Physiol Rev 105(3):1075\u20131171","journal-title":"Physiol Rev"},{"issue":"24","key":"3836_CR2","doi-asserted-by":"publisher","first-page":"1146","DOI":"10.1212\/WNL.0000000000007654","volume":"92","author":"RJ Cannistraro","year":"2019","unstructured":"Cannistraro RJ, Badi M, Eidelman BH et al (2019) CNS small vessel disease: a clinical review. Neurology 92(24):1146\u20131156","journal-title":"Neurology"},{"key":"3836_CR3","doi-asserted-by":"crossref","unstructured":"Rensma SP, van Sloten TT, Launer LJ et al (2018) Cerebral small vessel disease and risk of incident stroke, dementia and depression, and all-cause mortality: a systematic review and meta-analysis[J], vol 90. Neuroscience & Biobehavioral Reviews, pp 164\u2013173","DOI":"10.1016\/j.neubiorev.2018.04.003"},{"issue":"4","key":"3836_CR4","doi-asserted-by":"publisher","first-page":"822","DOI":"10.1161\/STROKEAHA.123.044174","volume":"55","author":"BYM Ip","year":"2024","unstructured":"Ip BYM, Ko H, Lam BYK et al (2024) Current and future treatments of vascular cognitive impairment. Stroke 55(4):822\u2013839","journal-title":"Stroke"},{"issue":"7","key":"3836_CR5","doi-asserted-by":"publisher","first-page":"689","DOI":"10.1016\/S1474-4422(10)70104-6","volume":"9","author":"L Pantoni","year":"2010","unstructured":"Pantoni L (2010) Cerebral small vessel disease: from pathogenesis and clinical characteristics to therapeutic challenges. Lancet Neurol 9(7):689\u2013701","journal-title":"Lancet Neurol"},{"issue":"8","key":"3836_CR6","doi-asserted-by":"publisher","first-page":"822","DOI":"10.1016\/S1474-4422(13)70124-8","volume":"12","author":"JM Wardlaw","year":"2013","unstructured":"Wardlaw JM, Smith EE, Biessels GJ et al (2013) Neuroimaging standards for research into small vessel disease and its contribution to ageing and neurodegeneration. Lancet Neurol 12(8):822\u2013838","journal-title":"Lancet Neurol"},{"key":"3836_CR7","doi-asserted-by":"publisher","DOI":"10.1016\/j.nbd.2022.105750","volume":"170","author":"Q Yang","year":"2022","unstructured":"Yang Q, Wei X, Deng B et al (2022) Cerebral small vessel disease alters neurovascular unit regulation of microcirculation integrity involved in vascular cognitive impairment. Neurobiol Dis 170:105750","journal-title":"Neurobiol Dis"},{"issue":"2","key":"3836_CR8","doi-asserted-by":"publisher","first-page":"405","DOI":"10.14336\/AD.2019.0521","volume":"11","author":"L Ma","year":"2020","unstructured":"Ma L, Chan P (2020) Understanding the physiological links between physical frailty and cognitive decline[J]. Aging Disease 11(2):405","journal-title":"Aging Disease"},{"issue":"7","key":"3836_CR9","doi-asserted-by":"publisher","first-page":"684","DOI":"10.1016\/S1474-4422(19)30079-1","volume":"18","author":"JM Wardlaw","year":"2019","unstructured":"Wardlaw JM, Smith C, Dichgans M (2019) Small vessel disease: mechanisms and clinical implications. Lancet Neurol 18(7):684\u2013696","journal-title":"Lancet Neurol"},{"issue":"12","key":"3836_CR10","doi-asserted-by":"publisher","first-page":"e661","DOI":"10.1016\/S2468-2667(20)30185-7","volume":"5","author":"L Jia","year":"2020","unstructured":"Jia L, Du Y, Chu L et al (2020) Prevalence, risk factors, and management of dementia and mild cognitive impairment in adults aged 60 years or older in China: a cross-sectional study. Lancet Public Health 5(12):e661\u2013e671","journal-title":"Lancet Public Health"},{"key":"3836_CR11","doi-asserted-by":"crossref","unstructured":"Shi Y, Wardlaw JM (2016) Update on cerebral small vessel disease: a dynamic whole-brain disease[J]. Stroke Vascular Neurol, 1(3)","DOI":"10.1136\/svn-2016-000035"},{"issue":"2","key":"3836_CR12","doi-asserted-by":"publisher","first-page":"622","DOI":"10.1002\/hbm.23857","volume":"39","author":"SJ Wiseman","year":"2018","unstructured":"Wiseman SJ, Booth T, Ritchie SJ et al (2018) Cognitive abilities, brain white matter hyperintensity volume, and structural network connectivity in older age[J]. Hum Brain Mapp 39(2):622\u2013632","journal-title":"Hum Brain Mapp"},{"issue":"2","key":"3836_CR13","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1038\/s44161-021-00014-4","volume":"1","author":"G Barisano","year":"2022","unstructured":"Barisano G, Montagne A, Kisler K et al (2022) Blood\u2013brain barrier link to human cognitive impairment and Alzheimer\u2019s disease. Nat Cardiovasc Res 1(2):108\u2013115","journal-title":"Nat Cardiovasc Res"},{"issue":"147","key":"3836_CR14","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.3003748","volume":"4","author":"JJ Iliff","year":"2012","unstructured":"Iliff JJ, Wang M, Liao Y et al (2012) A paravascular pathway facilitates CSF flow through the brain parenchyma and the clearance of interstitial solutes, including amyloid \u03b2. Sci Transl Med 4(147):111ra147","journal-title":"Sci Transl Med"},{"issue":"2","key":"3836_CR15","doi-asserted-by":"publisher","first-page":"1025","DOI":"10.1152\/physrev.00031.2020","volume":"102","author":"MK Rasmussen","year":"2022","unstructured":"Rasmussen MK, Mestre H (2022) Fluid transport in the brain. Physiol Rev 102(2):1025\u20131151","journal-title":"Physiol Rev"},{"issue":"11","key":"3836_CR16","doi-asserted-by":"publisher","first-page":"1016","DOI":"10.1016\/S1474-4422(18)30318-1","volume":"17","author":"MK Rasmussen","year":"2018","unstructured":"Rasmussen MK, Mestre H, Nedergaard M (2018) The glymphatic pathway in neurological disorders[J]. Lancet Neurol 17(11):1016\u20131024","journal-title":"Lancet Neurol"},{"issue":"1","key":"3836_CR17","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1146\/annurev-pathol-051217-111018","volume":"13","author":"BA Plog","year":"2018","unstructured":"Plog BA, Nedergaard M (2018) The glymphatic system in central nervous system health and disease: past, present, and future. Annu Rev Pathol 13(1):379\u2013394","journal-title":"Annu Rev Pathol"},{"key":"3836_CR18","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2021.118257","volume":"238","author":"W Zhang","year":"2021","unstructured":"Zhang W, Zhou Y, Wang J et al (2021) Glymphatic clearance function in patients with cerebral small vessel disease. Neuroimage 238:118257","journal-title":"Neuroimage"},{"issue":"24","key":"3836_CR19","doi-asserted-by":"publisher","first-page":"e2648","DOI":"10.1212\/WNL.0000000000201300","volume":"99","author":"K Kamagata","year":"2022","unstructured":"Kamagata K, Andica C, Takabayashi K et al (2022) Association of MRI indices of glymphatic system with amyloid deposition and cognition in mild cognitive impairment and Alzheimer disease. Neurology 99(24):e2648\u2013e2660","journal-title":"Neurology"},{"issue":"4","key":"3836_CR20","doi-asserted-by":"publisher","first-page":"672","DOI":"10.1002\/ana.26729","volume":"94","author":"P He","year":"2023","unstructured":"He P, Shi L, Li Y et al (2023) The association of the glymphatic function with Parkinson\u2019s disease symptoms: neuroimaging evidence from longitudinal and cross-sectional studies. Ann Neurol 94(4):672\u2013683","journal-title":"Ann Neurol"},{"issue":"1","key":"3836_CR21","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1002\/jmri.26892","volume":"51","author":"T Taoka","year":"2020","unstructured":"Taoka T, Naganawa S (2020) Glymphatic imaging using MRI[J]. J Magn Reson Imaging 51(1):11\u201324","journal-title":"J Magn Reson Imaging"},{"key":"3836_CR22","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1016\/j.neuroscience.2020.11.014","volume":"474","author":"H Benveniste","year":"2021","unstructured":"Benveniste H, Lee H, Ozturk B et al (2021) Glymphatic cerebrospinal fluid and solute transport quantified by MRI and PET imaging. Neuroscience 474:63\u201379","journal-title":"Neuroscience"},{"issue":"3","key":"3836_CR23","doi-asserted-by":"publisher","first-page":"516","DOI":"10.1148\/radiol.2021204088","volume":"301","author":"JM KLOSTRANEC","year":"2021","unstructured":"KLOSTRANEC JM, BHATIA K D VUCEVICD et al (2021) Current concepts in intracranial interstitial fluid transport and the glymphatic system: part II-Imaging techniques and clinical applications [J]. Radiology 301(3):516\u2013532","journal-title":"Radiology"},{"key":"3836_CR24","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1007\/s11604-017-0617-z","volume":"35","author":"T Taoka","year":"2017","unstructured":"Taoka T, Masutani Y, Kawai H et al (2017) Evaluation of glymphatic system activity with the diffusion MR technique: diffusion tensor image analysis along the perivascular space (DTI-ALPS) in Alzheimer\u2019s disease cases. Jpn J Radiol 35:172\u2013178","journal-title":"Jpn J Radiol"},{"key":"3836_CR25","doi-asserted-by":"publisher","DOI":"10.1016\/j.nicl.2022.103229","volume":"36","author":"Y Zhang","year":"2022","unstructured":"Zhang Y, Zhang R, Wang S et al (2022) Reduced coupling between the global blood-oxygen-level-dependent signal and cerebrospinal fluid inflow is associated with the severity of small vessel disease. NeuroImage: Clinical 36:103229","journal-title":"NeuroImage: Clinical"},{"issue":"3","key":"3836_CR26","doi-asserted-by":"publisher","first-page":"635","DOI":"10.1148\/radiol.212400","volume":"304","author":"JD Choi","year":"2022","unstructured":"Choi JD, Moon Y, Kim HJ et al (2022) Choroid plexus volume and permeability at brain MRI within the alzheimer disease clinical spectrum[J]. Radiology 304(3):635\u2013645","journal-title":"Radiology"},{"issue":"13","key":"3836_CR27","doi-asserted-by":"publisher","first-page":"1272","DOI":"10.1212\/WNL.0b013e318230208a","volume":"77","author":"HC Rossetti","year":"2011","unstructured":"Rossetti HC, Lacritz LH, Cullum CM et al (2011) Normative data for the Montreal cognitive assessment (MoCA) in a population-based sample. Neurology 77(13):1272\u20131275","journal-title":"Neurology"},{"issue":"7","key":"3836_CR28","doi-asserted-by":"publisher","first-page":"602","DOI":"10.1016\/S1474-4422(23)00131-X","volume":"22","author":"M Duering","year":"2023","unstructured":"Duering M, Biessels GJ, Brodtmann A et al (2023) Neuroimaging standards for research into small vessel disease\u2014advances since 2013. Lancet Neurol 22(7):602\u2013618","journal-title":"Lancet Neurol"},{"key":"3836_CR29","unstructured":"Potter G, Morris Z, Wardlaw J (2015) Enlarged perivascular spaces (EPVS): a visual rating scale and user guide[J]. Guide prepared by Gillian Potter, Zoe Morris and Prof Joanna Wardlaw (University of Edinburgh)"},{"key":"3836_CR30","doi-asserted-by":"publisher","first-page":"782","DOI":"10.1016\/j.neuroimage.2011.09.015","volume":"62","author":"M Jenkinson","year":"2012","unstructured":"Jenkinson M, Beckmann CF, Behrens TEJ, Woolrich MW, Smith SM (2012) FSL. Neuroimage 62:782\u2013790. https:\/\/doi.org\/10.1016\/j.neuroimage.2011.09.015","journal-title":"Neuroimage"},{"issue":"6465","key":"3836_CR31","doi-asserted-by":"publisher","first-page":"628","DOI":"10.1126\/science.aax5440","volume":"366","author":"NE Fultz","year":"2019","unstructured":"Fultz NE, Bonmassar G, Setsompop K et al (2019) Coupled electrophysiological, hemodynamic, and cerebrospinal fluid oscillations in human sleep. Science 366(6465):628\u2013631","journal-title":"Science"},{"key":"3836_CR32","doi-asserted-by":"publisher","first-page":"11050","DOI":"10.1073\/pnas.200033797","volume":"97","author":"B Fischl","year":"2000","unstructured":"Fischl B, Dale AM (2000) Measuring the thickness of the human cerebral cortex from magnetic resonance images. Proc Natl Acad Sci USA 97:11050\u201311055","journal-title":"Proc Natl Acad Sci USA"},{"key":"3836_CR33","doi-asserted-by":"publisher","first-page":"774","DOI":"10.1016\/j.neuroimage.2012.01.021","volume":"62","author":"B Fischl","year":"2012","unstructured":"Fischl B (2012) FreeSurfer. Neuroimage 62:774\u2013781. https:\/\/doi.org\/10.1016\/j.neuroimage.2012.01.021","journal-title":"Neuroimage"},{"issue":"4","key":"3836_CR34","doi-asserted-by":"publisher","first-page":"1057","DOI":"10.3233\/JAD-190706","volume":"74","author":"E Tadayon","year":"2020","unstructured":"Tadayon E, Moret B, Sprugnoli G et al (2020) Improving choroid plexus segmentation in the healthy and diseased brain: relevance for tau-PET imaging in dementia. J Alzheimers Dis 74(4):1057\u20131068","journal-title":"J Alzheimers Dis"},{"key":"3836_CR35","doi-asserted-by":"publisher","first-page":"268","DOI":"10.2463\/mrms.rev.2023-0175","volume":"23","author":"Toshiaki Taoka","year":"2024","unstructured":"Taoka Toshiaki, Ito Rintaro, Nakamichi Rei (2024) Diffusion tensor image analysis along the perivascular space (DTI-ALPS): revisiting the meaning and significance of the method. Magn Reson Med Sci 23:268\u2013290","journal-title":"Magn Reson Med Sci"},{"issue":"12","key":"3836_CR36","doi-asserted-by":"publisher","DOI":"10.3390\/brainsci12121611","volume":"12","author":"Z Ke","year":"2022","unstructured":"Ke Z, Mo Y, Li J et al (2022) Glymphatic dysfunction mediates the influence of white matter hyperintensities on episodic memory in cerebral small vessel disease. Brain Sci 12(12):1611","journal-title":"Brain Sci"},{"issue":"4","key":"3836_CR37","doi-asserted-by":"publisher","first-page":"1635","DOI":"10.1007\/s11357-021-00361-x","volume":"43","author":"B Sabayan","year":"2021","unstructured":"Sabayan B, Westendorp RGJ (2021) Neurovascular-glymphatic dysfunction and white matter lesions. Geroscience 43(4):1635\u20131642","journal-title":"Geroscience"},{"key":"3836_CR38","doi-asserted-by":"publisher","DOI":"10.3389\/fnagi.2022.916633","volume":"14","author":"J Tang","year":"2022","unstructured":"Tang J, Zhang M, Liu N et al (2022) The association between glymphatic system dysfunction and cognitive impairment in cerebral small vessel disease. Front Aging Neurosci 14:916633","journal-title":"Front Aging Neurosci"},{"key":"3836_CR39","doi-asserted-by":"crossref","unstructured":"Han F et al (2024) Lee JiaQie,Chen Xi. Global brain activity and its coupling with cerebrospinal fluid flow is related to tau pathology.[J].Alzheimers Dement, 20: 8541\u20138555","DOI":"10.1002\/alz.14296"},{"issue":"9","key":"3836_CR40","doi-asserted-by":"publisher","first-page":"2066","DOI":"10.1002\/mds.28643","volume":"36","author":"F Han","year":"2021","unstructured":"Han F, Brown GL, Zhu Y et al (2021) Decoupling of global brain activity and cerebrospinal fluid flow in Parkinson\u2019s disease cognitive decline. Mov Disord 36(9):2066\u20132076","journal-title":"Mov Disord"},{"key":"3836_CR41","doi-asserted-by":"crossref","unstructured":"Roefs ECA, Eiling I, de Bresser J et al (2024) BOLD-CSF dynamics assessed using real-time phase contrast CSF flow interleaved with cortical BOLD MRI[J], vol 21. Fluids and Barriers of the CNS, p 107. 1","DOI":"10.1186\/s12987-024-00607-8"},{"key":"3836_CR42","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1016\/j.neurobiolaging.2020.01.005","volume":"89","author":"E Tadayon","year":"2020","unstructured":"Tadayon E, Pascual-Leone A, Press D, Santarnecchi E (2020) Alzheimer\u2019s disease neuroimaging Initiative. Choroid plexus volume is associated with levels of CSF proteins: relevance for alzheimer\u2019s and parkinson\u2019s disease. Neurobiol Aging 89:108\u2013117","journal-title":"Neurobiol Aging"},{"key":"3836_CR43","doi-asserted-by":"crossref","unstructured":"Liang P, Li M, Chen Y et al (2025) Associations of choroid plexus volume with white matter hyperintensity volume and susceptibility and plasma amyloid markers in cerebral small vessel disease[J], vol 17. Alzheimer\u2019s Research & Therapy, p 90. 1","DOI":"10.1186\/s13195-025-01740-8"},{"issue":"1","key":"3836_CR44","doi-asserted-by":"publisher","DOI":"10.1111\/ene.16533","volume":"32","author":"H Jokinen","year":"2025","unstructured":"Jokinen H, Laakso HM, Arola A et al (2025) Executive functions and processing speed in covert cerebral small vessel disease. Eur J Neurol 32(1):e16533","journal-title":"Eur J Neurol"}],"container-title":["Neuroradiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00234-025-03836-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00234-025-03836-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00234-025-03836-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T06:14:40Z","timestamp":1769494480000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00234-025-03836-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,8]]},"references-count":44,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["3836"],"URL":"https:\/\/doi.org\/10.1007\/s00234-025-03836-2","relation":{},"ISSN":["0028-3940","1432-1920"],"issn-type":[{"value":"0028-3940","type":"print"},{"value":"1432-1920","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,8]]},"assertion":[{"value":"4 July 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"31 October 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 November 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":"This study was approved by the authorized local ethical committee.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"All patients provided informed consent.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}