{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T18:51:50Z","timestamp":1770835910511,"version":"3.50.1"},"reference-count":40,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2025,1,4]],"date-time":"2025-01-04T00:00:00Z","timestamp":1735948800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2025,1,4]],"date-time":"2025-01-04T00:00:00Z","timestamp":1735948800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"funder":[{"name":"the establishment and application of a detection method for minimal residual disease in multiple myeloma based on second-generation sequencing technology","award":["YGLX202309"],"award-info":[{"award-number":["YGLX202309"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Ann Hematol"],"DOI":"10.1007\/s00277-024-06164-2","type":"journal-article","created":{"date-parts":[[2025,1,4]],"date-time":"2025-01-04T02:51:20Z","timestamp":1735959080000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The prognostic impact of 1q21 gain\/amplification in newly diagnosed multiple myeloma: a retrospective study based on a single center in China"],"prefix":"10.1007","author":[{"given":"Ye","family":"Li","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingjing","family":"Deng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenming","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,1,4]]},"reference":[{"key":"6164_CR1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.27422","author":"SV Rajkumar","year":"2024","unstructured":"Rajkumar SV (2024) Multiple myeloma: 2024 update on diagnosis, risk-stratification, and management. Am J Hematol. https:\/\/doi.org\/10.1002\/ajh.27422","journal-title":"Am J Hematol"},{"key":"6164_CR2","doi-asserted-by":"publisher","first-page":"410","DOI":"10.1016\/S0140-6736(21)00135-5","volume":"397","author":"N van de Donk","year":"2021","unstructured":"van de Donk N, Pawlyn C, Yong KL (2021) Multiple myeloma. Lancet 397:410\u2013427. https:\/\/doi.org\/10.1016\/S0140-6736(21)00135-5","journal-title":"Lancet"},{"key":"6164_CR3","doi-asserted-by":"publisher","first-page":"3412","DOI":"10.1200\/JCO.2005.04.242","volume":"23","author":"PR Greipp","year":"2005","unstructured":"Greipp PR, San Miguel J, Durie BG et al (2005) International staging system for multiple myeloma. J Clin Oncol 23:3412\u20133420. https:\/\/doi.org\/10.1200\/JCO.2005.04.242","journal-title":"J Clin Oncol"},{"key":"6164_CR4","doi-asserted-by":"publisher","first-page":"3406","DOI":"10.1200\/jco.21.02614","volume":"40","author":"M D\u2019Agostino","year":"2022","unstructured":"D\u2019Agostino M, Cairns DA, Lahuerta JJ et al (2022) Second revision of the International Staging System (R2-ISS) for overall survival in multiple myeloma: a European Myeloma Network (EMN) Report within the HARMONY Project. J Clin Oncol 40:3406\u20133418. https:\/\/doi.org\/10.1200\/jco.21.02614","journal-title":"J Clin Oncol"},{"key":"6164_CR5","doi-asserted-by":"publisher","first-page":"2863","DOI":"10.1200\/JCO.2015.61.2267","volume":"33","author":"A Palumbo","year":"2015","unstructured":"Palumbo A, Avet-Loiseau H, Oliva S et al (2015) Revised International Staging System for multiple myeloma: a Report from International Myeloma Working Group. J Clin Oncol 33:2863\u20132869. https:\/\/doi.org\/10.1200\/JCO.2015.61.2267","journal-title":"J Clin Oncol"},{"key":"6164_CR6","doi-asserted-by":"publisher","first-page":"269","DOI":"10.1038\/leu.2013.247","volume":"28","author":"WJ Chng","year":"2014","unstructured":"Chng WJ, Dispenzieri A, Chim CS et al (2014) IMWG consensus on risk stratification in multiple myeloma. Leukemia 28:269\u2013277. https:\/\/doi.org\/10.1038\/leu.2013.247","journal-title":"Leukemia"},{"key":"6164_CR7","doi-asserted-by":"publisher","first-page":"e24375","DOI":"10.1002\/jcla.24375","volume":"36","author":"YT Wang","year":"2022","unstructured":"Wang YT, Bao L, Chu B et al (2022) Amp 1q21 is more predictable with dismal survival than gain 1q21 of newly diagnosed multiple myeloma in real-world analysis. J Clin Lab Anal 36:e24375. https:\/\/doi.org\/10.1002\/jcla.24375","journal-title":"J Clin Lab Anal"},{"key":"6164_CR8","doi-asserted-by":"publisher","first-page":"1142","DOI":"10.1002\/ajh.26639","volume":"97","author":"E Kastritis","year":"2022","unstructured":"Kastritis E, Migkou M, Dalampira D et al (2022) Chromosome 1q21 aberrations identify ultra high-risk myeloma with prognostic and clinical implications. Am J Hematol 97:1142\u20131149. https:\/\/doi.org\/10.1002\/ajh.26639","journal-title":"Am J Hematol"},{"key":"6164_CR9","doi-asserted-by":"publisher","first-page":"e1132","DOI":"10.1634\/theoncologist.2019-0132","volume":"24","author":"X Li","year":"2019","unstructured":"Li X, Chen W, Wu Y et al (2019) 1q21 gain combined with high-risk factors is a heterogeneous prognostic factor in newly diagnosed multiple myeloma: a Multicenter Study in China. Oncologist 24:e1132\u2013e1140. https:\/\/doi.org\/10.1634\/theoncologist.2019-0132","journal-title":"Oncologist"},{"key":"6164_CR10","doi-asserted-by":"publisher","DOI":"10.1038\/s41408-021-00474-8","author":"TM Schmidt","year":"2021","unstructured":"Schmidt TM, Fonseca R, Usmani SZ (2021) Chromosome 1q21 abnormalities in multiple myeloma. Blood Cancer J. https:\/\/doi.org\/10.1038\/s41408-021-00474-8","journal-title":"Blood Cancer J"},{"key":"6164_CR11","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1038\/s41408-022-00611-x","volume":"12","author":"NH Abdallah","year":"2022","unstructured":"Abdallah NH, Binder M, Rajkumar SV et al (2022) A simple additive staging system for newly diagnosed multiple myeloma. Blood Cancer J 12:21. https:\/\/doi.org\/10.1038\/s41408-022-00611-x","journal-title":"Blood Cancer J"},{"key":"6164_CR12","doi-asserted-by":"publisher","first-page":"204062072210820","DOI":"10.1177\/20406207221082043","volume":"13","author":"HKK Tang","year":"2022","unstructured":"Tang HKK, Fung CY, Morgan GJ et al (2022) The impact of bortezomib-based induction in newly diagnosed multiple myeloma with chromosome 1q21 gain. Ther Adv Hematol 13:20406207221082043. https:\/\/doi.org\/10.1177\/20406207221082043","journal-title":"Ther Adv Hematol"},{"key":"6164_CR13","first-page":"4438","volume":"11","author":"A Minguela","year":"2021","unstructured":"Minguela A, Vasco-Mogorr\u00f3n MA, Campillo JA et al (2021) Predictive value of 1q21 gain in multiple myeloma is strongly dependent on concurrent cytogenetic abnormalities and first-line treatment. Am J Cancer Res 11:4438\u20134454","journal-title":"Am J Cancer Res"},{"key":"6164_CR14","doi-asserted-by":"publisher","first-page":"7819","DOI":"10.1002\/cam4.3254","volume":"9","author":"W Gao","year":"2020","unstructured":"Gao W, Jian Y, Du J et al (2020) Gain of 1q21 is an adverse prognostic factor for multiple myeloma patients treated by autologous stem cell transplantation: a multicenter study in China. Cancer Med 9:7819\u20137829. https:\/\/doi.org\/10.1002\/cam4.3254","journal-title":"Cancer Med"},{"key":"6164_CR15","doi-asserted-by":"publisher","first-page":"3509","DOI":"10.1182\/bloodadvances.2020002218","volume":"4","author":"N Abdallah","year":"2020","unstructured":"Abdallah N, Greipp P, Kapoor P et al (2020) Clinical characteristics and treatment outcomes of newly diagnosed multiple myeloma with chromosome 1q abnormalities. Blood Adv 4:3509\u20133519. https:\/\/doi.org\/10.1182\/bloodadvances.2020002218","journal-title":"Blood Adv"},{"key":"6164_CR16","doi-asserted-by":"publisher","first-page":"938392","DOI":"10.3389\/fonc.2022.938392","volume":"12","author":"H You","year":"2022","unstructured":"You H, Jin S, Wu C et al (2022) The independent adverse prognostic significance of 1q21 gain\/amplification in newly diagnosed multiple myeloma patients. Front Oncol 12:938392. https:\/\/doi.org\/10.3389\/fonc.2022.938392","journal-title":"Front Oncol"},{"key":"6164_CR17","doi-asserted-by":"publisher","first-page":"535","DOI":"10.1016\/j.clml.2022.01.013","volume":"22","author":"L Gao","year":"2022","unstructured":"Gao L, Liu Y, Li Y et al (2022) The importance of FISH Signal Cut-off Value and Copy Number Variation for 1q21 in newly diagnosed multiple myeloma: is it underestimated? Clin Lymphoma Myeloma Leuk 22:535\u2013544. https:\/\/doi.org\/10.1016\/j.clml.2022.01.013","journal-title":"Clin Lymphoma Myeloma Leuk"},{"key":"6164_CR18","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1038\/s41379-020-00669-7","volume":"34","author":"S Hao","year":"2021","unstructured":"Hao S, Lu X, Gong Z et al (2021) The survival impact of CKS1B gains or amplification is dependent on the background karyotype and TP53 deletion status in patients with myeloma. Mod Pathol 34:327\u2013335. https:\/\/doi.org\/10.1038\/s41379-020-00669-7","journal-title":"Mod Pathol"},{"key":"6164_CR19","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1002\/ajh.27207","volume":"1","author":"X Mao","year":"2024","unstructured":"Mao X, Yan W, Mery D et al (2024) Development and validation of an individualized and weighted myeloma prognostic score system (MPSS) in patients with newly diagnosed multiple myeloma. Am J Hematol 1:11. https:\/\/doi.org\/10.1002\/ajh.27207","journal-title":"Am J Hematol"},{"key":"6164_CR20","doi-asserted-by":"publisher","first-page":"1142168","DOI":"10.3389\/fonc.2023.1142168","volume":"13","author":"G Wenpei","year":"2023","unstructured":"Wenpei G, Yuan L, Liangbo L et al (2023) Predictive value of preoperative inflammatory indexes for postoperative early recurrence of hepatitis B-related hepatocellular carcinoma. Front Oncol 13:1142168. https:\/\/doi.org\/10.3389\/fonc.2023.1142168","journal-title":"Front Oncol"},{"key":"6164_CR21","doi-asserted-by":"publisher","first-page":"2177979","DOI":"10.1080\/16078454.2023.2177979","volume":"28","author":"H Chen","year":"2023","unstructured":"Chen H, Zhou N, Shi H, Yu W, Wu L, Zhou F (2023) Presentation and outcomes of patients with multiple myeloma harboring gain or amplification of 1q21 and receiving novel agent therapies: results from a single-center study. Hematology 28:2177979. https:\/\/doi.org\/10.1080\/16078454.2023.2177979","journal-title":"Hematology"},{"key":"6164_CR22","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1038\/leu.2017.179","volume":"32","author":"V Shah","year":"2018","unstructured":"Shah V, Sherborne AL, Walker BA et al (2018) Prediction of outcome in newly diagnosed myeloma: a meta-analysis of the molecular profiles of 1905 trial patients. Leukemia 32:102\u2013110. https:\/\/doi.org\/10.1038\/leu.2017.179","journal-title":"Leukemia"},{"key":"6164_CR23","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1111\/ejh.12546","volume":"96","author":"H Nahi","year":"2016","unstructured":"Nahi H, Vatsveen TK, Lund J et al (2016) Proteasome inhibitors and IMiDs can overcome some high-risk cytogenetics in multiple myeloma but not gain 1q21. Eur J Haematol 96:46\u201354. https:\/\/doi.org\/10.1111\/ejh.12546","journal-title":"Eur J Haematol"},{"key":"6164_CR24","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1002\/ajh.26774","volume":"98","author":"P Yang","year":"2023","unstructured":"Yang P, Chen H, Liang X et al (2023) Proposed risk-scoring model for estimating the prognostic impact of 1q gain in patients with newly diagnosed multiple myeloma. Am J Hematol 98:251\u2013263. https:\/\/doi.org\/10.1002\/ajh.26774","journal-title":"Am J Hematol"},{"key":"6164_CR25","doi-asserted-by":"publisher","first-page":"1979","DOI":"10.1007\/s00277-023-05588-6","volume":"103","author":"S Gao","year":"2024","unstructured":"Gao S, Dong F, Yang P et al (2024) 1q21\u2009+\u2009is associated with poor prognosis in newly diagnosed multiple myeloma patients with extramedullary disease: a retrospective study. Ann Hematol 103:1979\u20131987. https:\/\/doi.org\/10.1007\/s00277-023-05588-6","journal-title":"Ann Hematol"},{"key":"6164_CR26","doi-asserted-by":"publisher","first-page":"e70193","DOI":"10.1002\/cam4.70193","volume":"13","author":"Y Xiong","year":"2024","unstructured":"Xiong Y, Liang S, Tang W et al (2024) A predictive risk-scoring model for survival prognosis of multiple myeloma based on gain\/amplification of 1q21: experience in a tertiary hospital in South-Western China. Cancer Med 13:e70193. https:\/\/doi.org\/10.1002\/cam4.70193","journal-title":"Cancer Med"},{"key":"6164_CR27","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1080\/14712598.2024.2357382","volume":"24","author":"E Barbieri","year":"2024","unstructured":"Barbieri E, Martino EA, Rivolti E et al (2024) Anti-CD38 monoclonal antibodies in multiple myeloma with gain\/amplification of chromosome arm 1q: a review of the literature. Expert Opin Biol Ther 24:365\u2013381. https:\/\/doi.org\/10.1080\/14712598.2024.2357382","journal-title":"Expert Opin Biol Ther"},{"key":"6164_CR28","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1038\/s41408-023-00973-w","volume":"14","author":"O Pasvolsky","year":"2024","unstructured":"Pasvolsky O, Ghanem S, Milton DR et al (2024) Outcomes of patients with multiple myeloma and 1q gain\/amplification receiving autologous hematopoietic stem cell transplant: the MD Anderson cancer center experience. Blood Cancer J 14:4. https:\/\/doi.org\/10.1038\/s41408-023-00973-w","journal-title":"Blood Cancer J"},{"key":"6164_CR29","doi-asserted-by":"publisher","first-page":"2754","DOI":"10.3324\/haematol.2021.278888","volume":"106","author":"N Weinhold","year":"2021","unstructured":"Weinhold N, Salwender HJ, Cairns DA et al (2021) Chromosome 1q21 abnormalities refine outcome prediction in patients with multiple myeloma - a meta-analysis of 2,596 trial patients. Haematologica 106:2754\u20132758. https:\/\/doi.org\/10.3324\/haematol.2021.278888","journal-title":"Haematologica"},{"key":"6164_CR30","doi-asserted-by":"publisher","first-page":"e70270","DOI":"10.1002\/cam4.70270","volume":"13","author":"D Liang","year":"2024","unstructured":"Liang D, Li X, Bai S et al (2024) Clinical outcome of induction treatment in the era of Novel agents and the impact of the number of high-risk cytogenetic abnormalities (HRA) on prognosis of patients with newly diagnosed multiple myeloma (NDMM): insights from a Multicenter Study. Cancer Med 13:e70270. https:\/\/doi.org\/10.1002\/cam4.70270","journal-title":"Cancer Med"},{"key":"6164_CR31","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1038\/s41408-024-00985-0","volume":"14","author":"K Neupane","year":"2024","unstructured":"Neupane K, Fortuna GG, Dahal R et al (2024) Alterations in chromosome 1q in multiple myeloma randomized clinical trials: a systematic review. Blood Cancer J 14:20. https:\/\/doi.org\/10.1038\/s41408-024-00985-0","journal-title":"Blood Cancer J"},{"key":"6164_CR32","doi-asserted-by":"publisher","first-page":"938550","DOI":"10.3389\/fonc.2022.938550","volume":"12","author":"X Liu","year":"2022","unstructured":"Liu X, Jia S, Chu Y et al (2022) Chromosome 1q21 gain is an adverse prognostic factor for newly diagnosed multiple myeloma patients treated with bortezomib-based regimens. Front Oncol 12:938550. https:\/\/doi.org\/10.3389\/fonc.2022.938550","journal-title":"Front Oncol"},{"key":"6164_CR33","doi-asserted-by":"publisher","first-page":"18","DOI":"10.3892\/ol.2024.14764","volume":"29","author":"X Zheng","year":"2025","unstructured":"Zheng X, Lin S, Lu K, Hou J, Liu T (2025) Impact of bortezomib on 1q21\u2009+\u2009in multiple myeloma: a meta-analysis of treatment outcomes and prognostic implications. Oncol Lett 29:18. https:\/\/doi.org\/10.3892\/ol.2024.14764","journal-title":"Oncol Lett"},{"key":"6164_CR34","doi-asserted-by":"publisher","first-page":"295","DOI":"10.2147\/OTT.S95381","volume":"9","author":"W Yu","year":"2016","unstructured":"Yu W, Guo R, Qu X et al (2016) The amplification of 1q21 is an adverse prognostic factor in patients with multiple myeloma in a Chinese population. Onco Targets Ther 9:295\u2013302. https:\/\/doi.org\/10.2147\/OTT.S95381","journal-title":"Onco Targets Ther"},{"key":"6164_CR35","doi-asserted-by":"publisher","first-page":"353","DOI":"10.3324\/haematol.2013.088211","volume":"99","author":"G An","year":"2014","unstructured":"An G, Xu Y, Shi L et al (2014) Chromosome 1q21 gains confer inferior outcomes in multiple myeloma treated with bortezomib but copy number variation and percentage of plasma cells involved have no additional prognostic value. Haematologica 99:353\u2013359. https:\/\/doi.org\/10.3324\/haematol.2013.088211","journal-title":"Haematologica"},{"key":"6164_CR36","doi-asserted-by":"publisher","first-page":"153303382412526","DOI":"10.1177\/15330338241252605","volume":"23","author":"Q Zhou","year":"2024","unstructured":"Zhou Q, Wen J, Xu F et al (2024) Efficacy Analysis of Bortezomib Combined with Lenalidomide in newly diagnosed multiple myeloma with 1q21 Gain\/Amp. Technol Cancer Res Treat 23:15330338241252605. https:\/\/doi.org\/10.1177\/15330338241252605","journal-title":"Technol Cancer Res Treat"},{"key":"6164_CR37","doi-asserted-by":"publisher","first-page":"2485","DOI":"10.3324\/haematol.2022.280660","volume":"107","author":"T Martin","year":"2022","unstructured":"Martin T, Richardson PG, Facon T et al (2022) Primary outcomes by 1q21\u2009+\u2009status for isatuximab-treated patients with relapsed\/refractory multiple myeloma: subgroup analyses from ICARIA-MM and IKEMA. Haematologica 107:2485\u20132491. https:\/\/doi.org\/10.3324\/haematol.2022.280660","journal-title":"Haematologica"},{"key":"6164_CR38","doi-asserted-by":"publisher","first-page":"1705","DOI":"10.1016\/s1470-2045(21)00535-0","volume":"22","author":"F Gay","year":"2021","unstructured":"Gay F, Musto P, Rota-Scalabrini D et al (2021) Carfilzomib with cyclophosphamide and dexamethasone or lenalidomide and dexamethasone plus autologous transplantation or carfilzomib plus lenalidomide and dexamethasone, followed by maintenance with carfilzomib plus lenalidomide or lenalidomide alone for patients with newly diagnosed multiple myeloma (FORTE): a randomised, open-label, phase 2 trial. Lancet Oncol 22:1705\u20131720. https:\/\/doi.org\/10.1016\/s1470-2045(21)00535-0","journal-title":"Lancet Oncol"},{"key":"6164_CR39","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1007\/s00277-021-04704-8","volume":"101","author":"X Hu","year":"2022","unstructured":"Hu X, Wu CH, Cowan JM, Comenzo RL, Varga C (2022) Outcomes of patients with multiple myeloma harboring chromosome 1q gain\/amplification in the era of modern therapy. Ann Hematol 101:369\u2013378. https:\/\/doi.org\/10.1007\/s00277-021-04704-8","journal-title":"Ann Hematol"},{"key":"6164_CR40","doi-asserted-by":"publisher","first-page":"1657","DOI":"10.1200\/jco.18.00776","volume":"37","author":"A Perrot","year":"2019","unstructured":"Perrot A, Lauwers-Cances V, Tournay E et al (2019) Development and validation of a Cytogenetic Prognostic Index Predicting Survival in multiple myeloma. J Clin Oncol 37:1657\u20131665. https:\/\/doi.org\/10.1200\/jco.18.00776","journal-title":"J Clin Oncol"}],"container-title":["Annals of Hematology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00277-024-06164-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00277-024-06164-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00277-024-06164-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,12]],"date-time":"2025-02-12T11:08:35Z","timestamp":1739358515000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00277-024-06164-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,4]]},"references-count":40,"alternative-id":["6164"],"URL":"https:\/\/doi.org\/10.1007\/s00277-024-06164-2","relation":{},"ISSN":["0939-5555","1432-0584"],"issn-type":[{"value":"0939-5555","type":"print"},{"value":"1432-0584","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,4]]},"assertion":[{"value":"28 October 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 December 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 January 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 has been approved by the Medical Ethics Committee of Beijing Chaoyang Hospital. We followed the patients through the electronic medical record system without disturbing the patients in any way or interfering with the treatment of the patients. No informed consent was required because the data are anonymized.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}