{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T12:08:01Z","timestamp":1787314081964,"version":"build-2736575974"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T00:00:00Z","timestamp":1747958400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T00:00:00Z","timestamp":1747958400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["International Orthopaedics (SICOT)"],"published-print":{"date-parts":[[2025,8]]},"DOI":"10.1007\/s00264-025-06561-w","type":"journal-article","created":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T01:30:07Z","timestamp":1747963807000},"page":"1953-1961","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Clinical outcomes after medial patellofemoral complex reconstruction using allografts in children and adolescents: a preliminary report"],"prefix":"10.1007","volume":"49","author":[{"given":"Florencia","family":"Turazza","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Masquijo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,5,23]]},"reference":[{"issue":"4","key":"6561_CR1","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1097\/01241398-199407000-00018","volume":"14","author":"Y Nietosvaara","year":"1994","unstructured":"Nietosvaara Y, Aalto K, Kallio PE (1994) Acute patellar dislocation in children: incidence and associated osteochondral fractures. J Pediatr Orthop 14(4):513\u2013515. https:\/\/doi.org\/10.1097\/01241398-199407000-00018","journal-title":"J Pediatr Orthop"},{"issue":"1","key":"6561_CR2","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1055\/s-0031-1286199","volume":"25","author":"BR Waterman","year":"2012","unstructured":"Waterman BR, Belmont PJ Jr, Owens BD (2012) Patellar dislocation in the united States: role of sex, age, race, and athletic participation. J Knee Surg 25(1):51\u201357. https:\/\/doi.org\/10.1055\/s-0031-1286199","journal-title":"J Knee Surg"},{"issue":"5","key":"6561_CR3","doi-asserted-by":"publisher","first-page":"1114","DOI":"10.1177\/0363546503260788","volume":"32","author":"DC Fithian","year":"2004","unstructured":"Fithian DC, Paxton EW, Stone ML, Silva P, Davis DK, Elias DA, White LM (2004) Epidemiology and natural history of acute patellar dislocation. Am J Sports Med 32(5):1114\u20131121. https:\/\/doi.org\/10.1177\/0363546503260788","journal-title":"Am J Sports Med"},{"issue":"4","key":"6561_CR4","doi-asserted-by":"publisher","first-page":"472","DOI":"10.1177\/03635465000280040601","volume":"28","author":"DM Atkin","year":"2000","unstructured":"Atkin DM, Fithian DC, Marangi KS, Stone ML, Dobson BE, Mendelsohn C (2000) Characteristics of patients with primary acute lateral patellar dislocation and their recovery within the first 6 months of injury. Am J Sports Med 28(4):472\u2013479. https:\/\/doi.org\/10.1177\/03635465000280040601","journal-title":"Am J Sports Med"},{"issue":"8","key":"6561_CR5","doi-asserted-by":"publisher","first-page":"2453","DOI":"10.1007\/s00167-015-3934-8","volume":"25","author":"JC Monllau","year":"2017","unstructured":"Monllau JC, Masferrer-Pino \u00c0, Ginovart G, P\u00e9rez-Prieto D, Gelber PE, Sanchis-Alfonso V (2017) Clinical and radiological outcomes after a quasi-anatomical reconstruction of medial patellofemoral ligament with gracilis tendon autograft. Knee Surg Sports Traumatol Arthrosc 25(8):2453\u20132459. https:\/\/doi.org\/10.1007\/s00167-015-3934-8","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"6561_CR6","doi-asserted-by":"publisher","unstructured":"Sidharthan S, Wang G, Schlichte LM, Fulkerson JP, Green DW (2020) Medial patellofemoral ligament reconstruction in skeletally immature patients. JBJS Essent Surg Tech 10(1). https:\/\/doi.org\/10.2106\/JBJS.ST.18.00110.;e0110:1\u20133","DOI":"10.2106\/JBJS.ST.18.00110"},{"issue":"5","key":"6561_CR7","doi-asserted-by":"publisher","first-page":"508","DOI":"10.1007\/s00167-008-0713-9","volume":"17","author":"PJ Sillanp\u00e4\u00e4","year":"2009","unstructured":"Sillanp\u00e4\u00e4 PJ, M\u00e4enp\u00e4\u00e4 HM, Mattila VM, Visuri T, Pihlajam\u00e4ki H (2009) A mini-invasive adductor Magnus tendon transfer technique for medial patellofemoral ligament reconstruction: a technical note. Knee Surg Sports Traumatol Arthrosc 17(5):508\u2013512. https:\/\/doi.org\/10.1007\/s00167-008-0713-9","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"5","key":"6561_CR8","doi-asserted-by":"publisher","first-page":"e1281","DOI":"10.1016\/j.eats.2021.01.025","volume":"10","author":"ER Floyd","year":"2021","unstructured":"Floyd ER, Ebert NJ, Carlson GB, Monson JK, LaPrade RF (2021) Medial patellofemoral ligament reconstruction using a quadriceps tendon autograft in a patient with open physes. Arthrosc Tech 10(5):e1281\u2013e1286. https:\/\/doi.org\/10.1016\/j.eats.2021.01.025","journal-title":"Arthrosc Tech"},{"issue":"1","key":"6561_CR9","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1016\/j.arthro.2021.05.005","volume":"38","author":"S Allahabadi","year":"2022","unstructured":"Allahabadi S, Pandya NK (2022) Allograft medial patellofemoral ligament reconstruction in adolescent patients results in a low recurrence rate of patellar dislocation or subluxation at midterm Follow-Up. Arthroscopy 38(1):128\u2013138. https:\/\/doi.org\/10.1016\/j.arthro.2021.05.005","journal-title":"Arthroscopy"},{"issue":"6","key":"6561_CR10","doi-asserted-by":"publisher","first-page":"1513","DOI":"10.1177\/03635465231164400","volume":"51","author":"M Husen","year":"2023","unstructured":"Husen M, Milbrandt TA, Shah V, Krych AJ, Stuart MJ, Saris DBF (2023) Medial patellofemoral ligament reconstruction using allografts in skeletally immature patients. Am J Sports Med 51(6):1513\u20131524. https:\/\/doi.org\/10.1177\/03635465231164400","journal-title":"Am J Sports Med"},{"issue":"5","key":"6561_CR11","doi-asserted-by":"publisher","first-page":"232596711877427","DOI":"10.1177\/2325967118774272","volume":"6","author":"N Kumar","year":"2018","unstructured":"Kumar N, Bastrom TP, Dennis MM, Pennock AT, Edmonds EW (2018) Adolescent medial patellofemoral ligament reconstruction: A comparison of the use of autograft versus allograft hamstring. Orthop J Sports Med 6(5):2325967118774272. https:\/\/doi.org\/10.1177\/2325967118774272","journal-title":"Orthop J Sports Med"},{"issue":"4","key":"6561_CR12","doi-asserted-by":"publisher","first-page":"75","DOI":"10.3390\/medsci11040075","volume":"11","author":"P Tanos","year":"2023","unstructured":"Tanos P, Neo C, Tong E, Volpin A (2023) The use of synthetic graft for MPFL reconstruction surgery: A systematic review of the clinical outcomes. Med Sci (Basel) 11(4):75. https:\/\/doi.org\/10.3390\/medsci11040075","journal-title":"Med Sci (Basel)"},{"issue":"1","key":"6561_CR13","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1186\/s43019-019-0008-0","volume":"31","author":"KW Nha","year":"2019","unstructured":"Nha KW, Bae JH, Hwang SC, Nam YJ, Shin MJ, Bhandare NN, Kumar A, Kang DG, Lee DY (2019) Medial patellofemoral ligament reconstruction using an autograft or allograft for patellar dislocation: a systematic review. Knee Surg Relat Res 31(1):8. https:\/\/doi.org\/10.1186\/s43019-019-0008-0","journal-title":"Knee Surg Relat Res"},{"issue":"10","key":"6561_CR14","doi-asserted-by":"publisher","first-page":"232596712110466","DOI":"10.1177\/23259671211046639","volume":"9","author":"GM Aliberti","year":"2021","unstructured":"Aliberti GM, Kraeutler MJ, Miskimin C, Scillia AJ, Belk JW, Mulcahey MK (2021) Autograft versus allograft for medial patellofemoral ligament reconstruction: A systematic review. Orthop J Sports Med 9(10):23259671211046639. https:\/\/doi.org\/10.1177\/23259671211046639","journal-title":"Orthop J Sports Med"},{"issue":"2","key":"6561_CR15","doi-asserted-by":"publisher","first-page":"108","DOI":"10.3928\/01477447-20221031-07","volume":"46","author":"J Masquijo","year":"2023","unstructured":"Masquijo J, Parikh SN, Kothari A (2023) Evaluation of the optimal femoral fixation site for medial patellofemoral ligament reconstruction in the skeletally immature patient. Orthopedics 46(2):108\u2013113. https:\/\/doi.org\/10.3928\/01477447-20221031-07","journal-title":"Orthopedics"},{"key":"6561_CR16","first-page":"1466","volume":"56","author":"D Dejour","year":"1998","unstructured":"Dejour D, Reynaud P, Lecoultre B (1998) Pain and patellar instability classification. Med Hyg 56:1466\u20131471","journal-title":"Med Hyg"},{"issue":"5","key":"6561_CR17","first-page":"317","volume":"68","author":"J Caton","year":"1982","unstructured":"Caton J, Deschamps G, Chambat P, Lerat JL, Dejour H (1982) Les rotules basses. A Propos de 128 observations [Patella infera. Apropos of 128 cases]. Rev Chir Orthop Reparatrice Appar Mot 68(5):317\u2013325","journal-title":"Rev Chir Orthop Reparatrice Appar Mot"},{"issue":"1","key":"6561_CR18","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1016\/j.knee.2005.06.003","volume":"13","author":"PB Schoettle","year":"2006","unstructured":"Schoettle PB, Zanetti M, Seifert B, Pfirrmann CW, Fucentese SF, Romero J (2006) The tibial tuberosity\u2013trochlear groove distance; a comparative study between CT and MRI scanning. Knee 13(1):26\u201331. https:\/\/doi.org\/10.1016\/j.knee.2005.06.003","journal-title":"Knee"},{"issue":"5","key":"6561_CR19","doi-asserted-by":"publisher","first-page":"933","DOI":"10.1177\/0363546510383002","volume":"39","author":"MS Kocher","year":"2011","unstructured":"Kocher MS, Smith JT, Iversen MD, Brustowicz K, Ogunwole O, Andersen J, Yoo WJ, McFeely ED, Anderson AF, Zurakowski D (2011) Reliability, validity, and responsiveness of a modified international knee Documentation committee subjective knee form (Pedi-IKDC) in children with knee disorders. Am J Sports Med 39(5):933\u2013939","journal-title":"Am J Sports Med"},{"issue":"2","key":"6561_CR20","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1016\/s0749-8063(05)80366-4","volume":"9","author":"UM Kujala","year":"1993","unstructured":"Kujala UM, Jaakkola LH, Koskinen SK, Taimela S, Hurme M, Nelimarkka O (1993) Scoring of patellofemoral disorders. Arthroscopy 9(2):159\u2013163. https:\/\/doi.org\/10.1016\/s0749-8063(05)80366-4","journal-title":"Arthroscopy"},{"key":"6561_CR21","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1097\/00003086-198509000-00007","volume":"198","author":"Y Tegner","year":"1985","unstructured":"Tegner Y, Lysholm J (1985) Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res 198:43\u201349","journal-title":"Clin Orthop Relat Res"},{"issue":"3","key":"6561_CR22","first-page":"227","volume":"28","author":"JJ Masquijo","year":"2021","unstructured":"Masquijo JJ (2021) Transferencia subperi\u00f3stica Del tend\u00f3n Rotuliano Para Realineaci\u00f3n distal En Pacientes Esquel\u00e9ticamente inmaduros Con inestabilidad patelofemoral: nota t\u00e9cnica. Artrosc (B Aires) 28(3):227\u2013231","journal-title":"Artrosc (B Aires)"},{"issue":"7","key":"6561_CR23","doi-asserted-by":"publisher","first-page":"232596712412569","DOI":"10.1177\/23259671241256983","volume":"12","author":"J Henstenburg","year":"2024","unstructured":"Henstenburg J, Pezzulo JD, Farronato DM, Johnson EB, Bodnar J, Petrucelli P, Dodson C, Freedman KB, Cohen SB, Hammoud S (2024) Comparison of clinical outcomes after medial patellofemoral ligament reconstruction with allograft versus autograft: A Matched-Cohort analysis. Orthop J Sports Med 12(7):23259671241256983. https:\/\/doi.org\/10.1177\/23259671241256983","journal-title":"Orthop J Sports Med"},{"issue":"6","key":"6561_CR24","doi-asserted-by":"publisher","first-page":"571","DOI":"10.1302\/1863-2548.15.210084","volume":"15","author":"CD VandenBerg","year":"2021","unstructured":"VandenBerg CD, Sarkisova N, Lee Pace J, Rhodes J, Hidalgo Perea S, PRiSM Patellofemoral Instability RIG Study Group, Green DW (2021) Current practice trends in the surgical management of patellofemoral instability: a survey of the paediatric research in sports medicine (PRiSM) society. J Child Orthop 15(6):571\u2013576. https:\/\/doi.org\/10.1302\/1863-2548.15.210084","journal-title":"J Child Orthop"},{"issue":"2","key":"6561_CR25","doi-asserted-by":"publisher","first-page":"e144","DOI":"10.1097\/BPO.0000000000002582","volume":"44","author":"CA Perkins","year":"2024","unstructured":"Perkins CA, Egger AC, Busch MT, Murata A, Willimon SC (2024) Medial patellofemoral ligament reconstruction with or without tibial tubercle osteotomy in carefully selected patients results in a 5% revision rate: A preliminary analysis. J Pediatr Orthop 44(2):e144\u2013e150. https:\/\/doi.org\/10.1097\/BPO.0000000000002582","journal-title":"J Pediatr Orthop"},{"issue":"6","key":"6561_CR26","doi-asserted-by":"publisher","first-page":"232596712412410","DOI":"10.1177\/23259671241241096","volume":"12","author":"SN Parikh","year":"2024","unstructured":"Parikh SN, Nemunaitis J, Wall EJ, Cabatu C, Gupta R, Veerkamp MW (2024) Midterm outcomes of isolated medial patellofemoral ligament reconstruction for patellar instability in Ehlers-Danlos syndrome. Orthop J Sports Med 12(6):23259671241241096. https:\/\/doi.org\/10.1177\/23259671241241096","journal-title":"Orthop J Sports Med"},{"issue":"5","key":"6561_CR27","doi-asserted-by":"publisher","first-page":"840","DOI":"10.3390\/children10050840","volume":"10","author":"F Migliorini","year":"2023","unstructured":"Migliorini F, Maffulli N, S\u00f6llner S, Pasurka M, Kubach J, Bell A, Betsch M (2023) Allografts for medial patellofemoral ligament (MPFL) reconstruction in adolescent patients with recurrent patellofemoral instability: A systematic review. Child (Basel) 10(5):840. https:\/\/doi.org\/10.3390\/children10050840","journal-title":"Child (Basel)"},{"issue":"3","key":"6561_CR28","doi-asserted-by":"publisher","first-page":"161","DOI":"10.4103\/ijabmr.ijabmr_25_22","volume":"12","author":"G Reddy","year":"2022","unstructured":"Reddy G, Hayer PS, UlIslam S, Mehta NJ, Iqbal HJ, Stables G, Barton-Hanson NG (2022) Outcomes of allograft medial patellofemoral ligament reconstruction in children and adolescents with hypermobility. Int J Appl Basic Med Res 12(3):161\u2013166. https:\/\/doi.org\/10.4103\/ijabmr.ijabmr_25_22","journal-title":"Int J Appl Basic Med Res"},{"key":"6561_CR29","doi-asserted-by":"publisher","first-page":"e1589","DOI":"10.1016\/j.asmr.2022.05.007","volume":"4","author":"NJ Quinlan","year":"2022","unstructured":"Quinlan NJ, Tomasevich KM, Mortensen AJ, Hobson TE, Adeyemi T, Metz AK, Aoki SK (2022) Medial patellofemoral ligament reconstruction in the pediatric population: skeletal immaturity does not affect functional outcomes but demonstrates increased rate of subsequent knee injury. Arthrosc Sports Med Rehabil 4:e1589\u2013e1599. https:\/\/doi.org\/10.1016\/j.asmr.2022.05.007","journal-title":"Arthrosc Sports Med Rehabil"},{"key":"6561_CR30","doi-asserted-by":"publisher","first-page":"e54","DOI":"10.1097\/BPO.0000000000001259","volume":"39","author":"RC Spang","year":"2019","unstructured":"Spang RC, Tepolt FA, Paschos NK, Redler LH, Davis EA, Kocher MS (2019) Combined reconstruction of the medial patellofemoral ligament (MPFL) and medial quadriceps Tendon-Femoral ligament (MQTFL) for patellar instability in children and adolescents: surgical technique and outcomes. J Pediatr Orthop 39:e54\u2013e61. https:\/\/doi.org\/10.1097\/BPO.0000000000001259","journal-title":"J Pediatr Orthop"},{"issue":"2","key":"6561_CR31","doi-asserted-by":"publisher","first-page":"96","DOI":"10.31486\/toj.18.0081","volume":"19","author":"T Hendawi","year":"2019","unstructured":"Hendawi T, Godshaw B, Flowers C, Stephens I, Haber L, Waldron S (2019) Autograft vs allograft comparison in pediatric medial patellofemoral ligament reconstruction. Ochsner J 19(2):96\u2013101. https:\/\/doi.org\/10.31486\/toj.18.0081","journal-title":"Ochsner J"},{"issue":"50","key":"6561_CR32","doi-asserted-by":"publisher","first-page":"e13605","DOI":"10.1097\/MD.0000000000013605","volume":"97","author":"\u0141 Matuszewski","year":"2018","unstructured":"Matuszewski \u0141, Tram\u015b M, Ciszewski A, Wilczy\u0144ski M, Tram\u015b E, Jakubowski P, Matuszewska A, John K (2018) Medial patellofemoral ligament reconstruction in children: A comparative randomized short-term study of fascia Lata allograft and gracilis tendon autograft reconstruction. Medicine 97(50):e13605. https:\/\/doi.org\/10.1097\/MD.0000000000013605","journal-title":"Medicine"},{"issue":"6","key":"6561_CR33","doi-asserted-by":"publisher","first-page":"1563","DOI":"10.1007\/s11999-016-5060-4","volume":"475","author":"E Hohn","year":"2017","unstructured":"Hohn E, Pandya NK (2017) Does the utilization of allograft tissue in medial patellofemoral ligament reconstruction in pediatric and adolescent patients restore patellar stability?? Clin Orthop Relat Res 475(6):1563\u20131569. https:\/\/doi.org\/10.1007\/s11999-016-5060-4","journal-title":"Clin Orthop Relat Res"},{"issue":"8","key":"6561_CR34","doi-asserted-by":"publisher","first-page":"103530","DOI":"10.1016\/j.otsr.2022.103530","volume":"109","author":"N Bremond","year":"2023","unstructured":"Bremond N, Prima R, Rabattu PY, Accadbled F, Chotel F, Konkel M, Eid A, Philippe C, Godinho A, Turati M, Cruz ES (2023) Isolated MPFL reconstruction with soft tissue femoral fixation technique in 54 skeletally immature patients: clinical outcomes at 2 years follow-up. A French multicenter retrospective study. Orthop Traumatol Surg Research: OTSR 109(8):103530. https:\/\/doi.org\/10.1016\/j.otsr.2022.103530","journal-title":"Orthop Traumatol Surg Research: OTSR"},{"issue":"8","key":"6561_CR35","doi-asserted-by":"publisher","first-page":"103515","DOI":"10.1016\/j.otsr.2022.103515","volume":"109","author":"A Zampieri","year":"2023","unstructured":"Zampieri A, Girardin C, Hocquet B, Coursier R, Fournier A, Martin C, Nectoux E, Canavese F (2023) Patellar dislocation recurrence after pediatric MPFL reconstruction: bone tunnels and soft tissues versus suture anchors and interference screw. Orthop Traumatol Surg Research: OTSR 109(8):103515. https:\/\/doi.org\/10.1016\/j.otsr.2022.103515","journal-title":"Orthop Traumatol Surg Research: OTSR"}],"container-title":["International Orthopaedics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00264-025-06561-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00264-025-06561-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00264-025-06561-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,6]],"date-time":"2025-09-06T15:18:43Z","timestamp":1757171923000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00264-025-06561-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,23]]},"references-count":35,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2025,8]]}},"alternative-id":["6561"],"URL":"https:\/\/doi.org\/10.1007\/s00264-025-06561-w","relation":{},"ISSN":["0341-2695","1432-5195"],"issn-type":[{"value":"0341-2695","type":"print"},{"value":"1432-5195","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,23]]},"assertion":[{"value":"22 November 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 May 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 May 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":"Approval was obtained from the Ethics Committee of our institution. The procedures used in this study adhere to the principles of the Declaration of Helsinki and its later amendments or comparable ethical standards.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent was obtained from all individual participants and their parents included in the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"The research participants and their parents provided informed consent for publication of the images in Fig\u00a0\n                      \n                      .","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}