{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T18:19:19Z","timestamp":1788373159408,"version":"build-2803163510"},"reference-count":43,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T00:00:00Z","timestamp":1778889600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T00:00:00Z","timestamp":1778889600000},"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":["Eur J Appl Physiol"],"published-print":{"date-parts":[[2026,8]]},"DOI":"10.1007\/s00421-026-06247-0","type":"journal-article","created":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T09:32:26Z","timestamp":1778923946000},"page":"4269-4280","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Caffeinated chewing gum improves military performances in special forces soldiers"],"prefix":"10.1007","volume":"126","clinical-trial-number":[{"clinical-trial-number":"nct06638372","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Yi-Jie","family":"Shiu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Che-Hsiu","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hung-Yu","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chia-Cheng","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi-Wen","family":"Yen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han-Yuan","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsuan-Ta","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0739-874X","authenticated-orcid":false,"given":"Chih-Hui","family":"Chiu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,16]]},"reference":[{"issue":"3","key":"6247_CR1","doi-asserted-by":"publisher","first-page":"749","DOI":"10.1007\/s00421-020-04571-7","volume":"121","author":"G Barreto","year":"2021","unstructured":"Barreto G, Grecco B, Merola P, Reis CEG, Gualano B, Saunders B (2021) Novel insights on caffeine supplementation, CYP1A2 genotype, physiological responses and exercise performance. Eur J Appl Physiol 121(3):749\u2013769","journal-title":"Eur J Appl Physiol"},{"issue":"5","key":"6247_CR2","doi-asserted-by":"publisher","first-page":"714","DOI":"10.1080\/17461391.2022.2049885","volume":"23","author":"G Barreto","year":"2023","unstructured":"Barreto G, Loureiro L, Reis C, Saunders B (2023) Effects of caffeine chewing gum supplementation on exercise performance: A systematic review and meta-analysis. Eur J Sport Sci 23(5):714\u2013725","journal-title":"Eur J Sport Sci"},{"issue":"1","key":"6247_CR3","doi-asserted-by":"publisher","first-page":"22016","DOI":"10.1038\/s41598-023-49453-y","volume":"13","author":"C-H Chen","year":"2023","unstructured":"Chen C-H, Wu S-H, Shiu Y-J, Yu S-Y, Chiu C-H (2023) Acute enhancement of Romanian deadlift performance after consumption of caffeinated chewing gum. Sci Rep 13(1):22016","journal-title":"Sci Rep"},{"issue":"1","key":"6247_CR4","doi-asserted-by":"publisher","first-page":"543","DOI":"10.1080\/15502783.2022.2113339","volume":"19","author":"HP Cintineo","year":"2022","unstructured":"Cintineo HP, Bello ML, Chandler AJ, Cardaci TD, McFadden BA, Arent SM (2022) Effects of caffeine, methylliberine, and theacrine on vigilance, marksmanship, and hemodynamic responses in tactical personnel: a double-blind, randomized, placebo-controlled trial. J Int Soc Sports Nutr 19(1):543\u2013564","journal-title":"J Int Soc Sports Nutr"},{"issue":"2","key":"6247_CR5","doi-asserted-by":"publisher","first-page":"R399","DOI":"10.1152\/ajpregu.00386.2002","volume":"284","author":"JM Davis","year":"2003","unstructured":"Davis JM, Zhao Z, Stock HS, Mehl KA, Buggy J, Hand GA (2003) Central nervous system effects of caffeine and adenosine on fatigue. Am J Physiology-Regulatory Integr Comp Physiol 284(2):R399\u2013R404","journal-title":"Am J Physiology-Regulatory Integr Comp Physiol"},{"issue":"2","key":"6247_CR6","doi-asserted-by":"publisher","first-page":"175","DOI":"10.3758\/BF03193146","volume":"39","author":"F Faul","year":"2007","unstructured":"Faul F, Erdfelder E, Lang A-G, Buchner A (2007) G* Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 39(2):175\u2013191","journal-title":"Behav Res Methods"},{"key":"6247_CR7","doi-asserted-by":"publisher","first-page":"1035","DOI":"10.1007\/s00421-009-1310-4","volume":"108","author":"E Filaire","year":"2010","unstructured":"Filaire E, Portier H, Massart A, Ramat L, Teixeira A (2010) Effect of lecturing to 200 students on heart rate variability and alpha-amylase activity. Eur J Appl Physiol 108:1035\u20131043","journal-title":"Eur J Appl Physiol"},{"issue":"1","key":"6247_CR8","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12970-020-00383-4","volume":"18","author":"NS Guest","year":"2021","unstructured":"Guest NS, VanDusseldorp TA, Nelson MT, Grgic J, Schoenfeld BJ, Jenkins ND, Arent SM, Antonio J, Stout JR, Trexler ET (2021) International society of sports nutrition position stand: caffeine and exercise performance. J Int Soc Sports Nutr 18(1):1","journal-title":"J Int Soc Sports Nutr"},{"key":"6247_CR9","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1016\/j.ijpsycho.2023.08.001","volume":"192","author":"N Gullett","year":"2023","unstructured":"Gullett N, Zajkowska Z, Walsh A, Harper R, Mondelli V (2023) Heart rate variability (HRV) as a way to understand associations between the autonomic nervous system (ANS) and affective states: A critical review of the literature. Int J Psychophysiol 192:35\u201342","journal-title":"Int J Psychophysiol"},{"issue":"4","key":"6247_CR10","first-page":"181","volume":"63","author":"AL Hansen","year":"2012","unstructured":"Hansen AL, Murison R, Eid J, Thayer JF (2012) Heart rate variability and cortisol responses during attentional and working memory tasks in naval cadets. Int maritime health 63(4):181\u2013187","journal-title":"Int maritime health"},{"issue":"411","key":"6247_CR11","first-page":"321","volume":"502","author":"WG Hopkins","year":"2002","unstructured":"Hopkins WG (2002) A scale of magnitudes for effect statistics. new view Stat 502(411):321","journal-title":"new view Stat"},{"issue":"6","key":"6247_CR12","doi-asserted-by":"publisher","first-page":"648","DOI":"10.1016\/j.numecd.2013.12.013","volume":"24","author":"C Huang","year":"2014","unstructured":"Huang C, Niu K, Momma H, Kobayashi Y, Guan L, Chujo M, Otomo A, Cui Y, Nagatomi R (2014) Breakfast consumption frequency is associated with grip strength in a population of healthy Japanese adults. Nutr Metabolism Cardiovasc Dis 24(6):648\u2013655","journal-title":"Nutr Metabolism Cardiovasc Dis"},{"key":"6247_CR13","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12970-021-00413-9","volume":"18","author":"B-L Hung","year":"2021","unstructured":"Hung B-L, Chen L-J, Chen Y-Y, Ou J-B, Fang S-H (2021) Nicotine supplementation enhances simulated game performance of archery athletes. J Int Soc Sports Nutr 18:1\u20139","journal-title":"J Int Soc Sports Nutr"},{"key":"6247_CR14","doi-asserted-by":"publisher","DOI":"10.1007\/s11896-024-09699-2","author":"F Ibrahim","year":"2024","unstructured":"Ibrahim F, Feildboy E, Huber Y, Nagy D, Hennig J, Herzberg P (2024a) Enhancing Close Quarters Battle Performance-The Effect of a Compact Training on the Tactical Performance and Stress Response of Non-Specialized and Special Forces. J Police Criminal Psychol. https:\/\/doi.org\/10.1007\/s11896-024-09699-2","journal-title":"J Police Criminal Psychol"},{"key":"6247_CR15","doi-asserted-by":"crossref","unstructured":"Ibrahim F, Feildboy E, Huber Y, Nagy D, Hennig J, Herzberg PY (2024b) Enhancing close quarters battle performance\u2014The effect of a compact training on the tactical performance and stress response of non-specialized and special forces. J Police Criminal Psychol :1\u201310","DOI":"10.1007\/s11896-024-09699-2"},{"issue":"4","key":"6247_CR16","doi-asserted-by":"publisher","first-page":"468","DOI":"10.1002\/ajhb.22247","volume":"24","author":"N Iizuka","year":"2012","unstructured":"Iizuka N, Awano S, Ansai T (2012) Salivary alpha-amylase activity and stress in Japan air self\u2010defense force cargo pilots involved in Iraq reconstruction. Am J Hum Biology 24(4):468\u2013472","journal-title":"Am J Hum Biology"},{"issue":"12","key":"6247_CR17","doi-asserted-by":"publisher","first-page":"2113","DOI":"10.1249\/01.mss.0000178219.18086.9e","volume":"37","author":"JM Kalmar","year":"2005","unstructured":"Kalmar JM (2005) The influence of caffeine on voluntary muscle activation. Med Sci Sports Exerc 37(12):2113\u20132119","journal-title":"Med Sci Sports Exerc"},{"issue":"1\u20132","key":"6247_CR18","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1016\/S0378-5173(01)00958-9","volume":"234","author":"GH Kamimori","year":"2002","unstructured":"Kamimori GH, Karyekar CS, Otterstetter R, Cox DS, Balkin TJ, Belenky GL, Eddington ND (2002) The rate of absorption and relative bioavailability of caffeine administered in chewing gum versus capsules to normal healthy volunteers. Int J Pharm 234(1\u20132):159\u2013167","journal-title":"Int J Pharm"},{"issue":"1","key":"6247_CR19","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1080\/01402390.2021.1991797","volume":"45","author":"A King","year":"2022","unstructured":"King A (2022) Will inter-state war take place in cities? J Strategic Stud 45(1):69\u201395","journal-title":"J Strategic Stud"},{"issue":"1","key":"6247_CR20","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1186\/s12937-022-00774-0","volume":"21","author":"JJ Knapik","year":"2022","unstructured":"Knapik JJ, Steelman RA, Trone DW, Farina EK, Lieberman HR (2022) Prevalence of caffeine consumers, daily caffeine consumption, and factors associated with caffeine use among active duty United States military personnel. Nutr J 21(1):22","journal-title":"Nutr J"},{"key":"6247_CR21","doi-asserted-by":"publisher","first-page":"238557","DOI":"10.3389\/fpsyg.2017.00213","volume":"8","author":"S Laborde","year":"2017","unstructured":"Laborde S, Mosley E, Thayer JF (2017) Heart rate variability and cardiac vagal tone in psychophysiological research\u2013recommendations for experiment planning, data analysis, and data reporting. Front Psychol 8:238557","journal-title":"Front Psychol"},{"issue":"3","key":"6247_CR22","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1007\/s00213-002-1217-9","volume":"164","author":"HR Lieberman","year":"2002","unstructured":"Lieberman HR, Tharion WJ, Shukitt-Hale B, Speckman KL, Tulley R (2002) Effects of caffeine, sleep loss, and stress on cognitive performance and mood during US Navy SEAL training. Psychopharmacology 164(3):250\u2013261","journal-title":"Psychopharmacology"},{"issue":"9","key":"6247_CR23","doi-asserted-by":"publisher","first-page":"1256","DOI":"10.3390\/nu16091256","volume":"16","author":"H-S Liu","year":"2024","unstructured":"Liu H-S, Liu C-C, Shiu Y-J, Lan P-T, Wang A-Y, Chiu C-H (2024) Caffeinated chewing gum improves basketball shooting accuracy and physical performance indicators of trained basketball players: a double-blind crossover trial. Nutrients 16(9):1256","journal-title":"Nutrients"},{"key":"6247_CR24","doi-asserted-by":"crossref","unstructured":"Liu H-S, Okada T, Mitsuya H, Hsieh M-H, Hou C-W, Chang C-C, Chiu C-H (2025) Effects of caffeinated chewing gum-induced sympathetic activation and diuretic effect on the rapid rate of weight loss in bodybuilders: a double-blind crossover study. BMC Sports Science, Medicine and Rehabilitation 17 (1):98","DOI":"10.1186\/s13102-025-01144-z"},{"issue":"1","key":"6247_CR25","doi-asserted-by":"publisher","first-page":"2237952","DOI":"10.1080\/15502783.2023.2237952","volume":"20","author":"LM Lowery","year":"2023","unstructured":"Lowery LM, Anderson DE, Scanlon KF, Stack A, Escalante G, Campbell SC, Kerksick CM, Nelson MT, Ziegenfuss TN, VanDusseldorp TA (2023) International society of sports nutrition position stand: coffee and sports performance. J Int Soc Sports Nutr 20(1):2237952","journal-title":"J Int Soc Sports Nutr"},{"key":"6247_CR26","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1016\/j.neubiorev.2016.09.001","volume":"71","author":"TM McLellan","year":"2016","unstructured":"McLellan TM, Caldwell JA, Lieberman HR (2016) A review of caffeine\u2019s effects on cognitive, physical and occupational performance. Neurosci Biobehavioral Reviews 71:294\u2013312","journal-title":"Neurosci Biobehavioral Reviews"},{"key":"6247_CR27","unstructured":"Miller NL, Matsangas P, Shattuck L (2018) Fatigue and its effect on performance in military environments. Performance under stress. CRC, pp 247\u2013266"},{"issue":"1","key":"6247_CR28","doi-asserted-by":"publisher","first-page":"13795","DOI":"10.1038\/s41598-023-40365-5","volume":"13","author":"I Ouergui","year":"2023","unstructured":"Ouergui I, Delleli S, Bridge CA, Messaoudi H, Chtourou H, Ballmann CG, Ardig\u00f2 LP, Franchini E (2023) Acute effects of caffeine supplementation on taekwondo performance: the influence of competition level and sex. Sci Rep 13(1):13795","journal-title":"Sci Rep"},{"key":"6247_CR29","doi-asserted-by":"crossref","unstructured":"Peinado AB, Rojo JJ, Calder\u00f3n FJ, Maffulli N (2014) Responses to increasing exercise upon reaching the anaerobic threshold, and their control by the central nervous system. BMC sports science, medicine and rehabilitation 6:1\u20137","DOI":"10.1186\/2052-1847-6-17"},{"issue":"7","key":"6247_CR30","doi-asserted-by":"publisher","first-page":"1007","DOI":"10.1007\/s40279-019-01101-0","volume":"49","author":"C Pickering","year":"2019","unstructured":"Pickering C, Grgic J (2019) Caffeine and exercise: what next? Sports Med 49(7):1007\u20131030","journal-title":"Sports Med"},{"issue":"2","key":"6247_CR31","doi-asserted-by":"publisher","first-page":"545","DOI":"10.3390\/nu12020545","volume":"12","author":"DE Pomeroy","year":"2020","unstructured":"Pomeroy DE, Tooley KL, Probert B, Wilson A, Kemps E (2020) A systematic review of the effect of dietary supplements on cognitive performance in healthy young adults and military personnel. Nutrients 12(2):545","journal-title":"Nutrients"},{"issue":"6","key":"6247_CR32","doi-asserted-by":"publisher","first-page":"1235","DOI":"10.1128\/CDLI.9.6.1235-1239.2002","volume":"9","author":"GF Reed","year":"2002","unstructured":"Reed GF, Lynn F, Meade BD (2002) Use of coefficient of variation in assessing variability of quantitative assays. Clin Vaccine Immunol 9(6):1235\u20131239","journal-title":"Clin Vaccine Immunol"},{"issue":"4","key":"6247_CR33","doi-asserted-by":"publisher","first-page":"469","DOI":"10.1016\/j.psyneuen.2008.12.004","volume":"34","author":"N Rohleder","year":"2009","unstructured":"Rohleder N, Nater UM (2009) Determinants of salivary \u03b1-amylase in humans and methodological considerations. Psychoneuroendocrinology 34(4):469\u2013485","journal-title":"Psychoneuroendocrinology"},{"key":"6247_CR34","doi-asserted-by":"publisher","first-page":"113031","DOI":"10.1016\/j.physbeh.2020.113031","volume":"224","author":"I Sainz","year":"2020","unstructured":"Sainz I, Collado-Mateo D, Del Coso J (2020) Effect of acute caffeine intake on hit accuracy and reaction time in professional e-sports players. Physiol Behav 224:113031","journal-title":"Physiol Behav"},{"issue":"6","key":"6247_CR36","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1080\/08995605.2019.1654293","volume":"31","author":"J S\u00e1nchez-Molina","year":"2019","unstructured":"S\u00e1nchez-Molina J, Robles-P\u00e9rez JJ, Clemente-Su\u00e1rez VJ (2019) Psychophysiological and fine motor skill differences of elite and non-elite soldiers in an urban combat simulation. Military Psychol 31(6):425\u2013432","journal-title":"Military Psychol"},{"issue":"1","key":"6247_CR35","doi-asserted-by":"publisher","first-page":"2414871","DOI":"10.1080\/15502783.2024.2414871","volume":"21","author":"Y-J Shiu","year":"2024","unstructured":"Shiu Y-J, Chen C-H, Tao W-S, Nai H-F, Yu C-Y, Chiu C-H (2024) Acute ingestion of caffeinated chewing gum reduces fatigue index and improves 400-meter performance in trained sprinters: a double-blind crossover trial. J Int Soc Sports Nutr 21(1):2414871","journal-title":"J Int Soc Sports Nutr"},{"issue":"1","key":"6247_CR37","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1177\/0098628316677643","volume":"44","author":"G Stoet","year":"2017","unstructured":"Stoet G (2017) PsyToolkit: A novel web-based method for running online questionnaires and reaction-time experiments. Teach Psychol 44(1):24\u201331","journal-title":"Teach Psychol"},{"issue":"1","key":"6247_CR38","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1016\/j.cmpb.2013.07.024","volume":"113","author":"MP Tarvainen","year":"2014","unstructured":"Tarvainen MP, Niskanen J-P, Lipponen JA, Ranta-Aho PO, Karjalainen PA (2014) Kubios HRV\u2013heart rate variability analysis software. Comput Methods Programs Biomed 113(1):210\u2013220","journal-title":"Comput Methods Programs Biomed"},{"issue":"4","key":"6247_CR39","first-page":"309","volume":"74","author":"WJ Tharion","year":"2003","unstructured":"Tharion WJ, Shukitt-Hale B, Lieberman HR (2003) Caffeine effects on marksmanship during high-stress military training with 72 hour sleep deprivation. Aviat Space Environ Med 74(4):309\u2013314","journal-title":"Aviat Space Environ Med"},{"issue":"1","key":"6247_CR40","doi-asserted-by":"publisher","first-page":"2074","DOI":"10.1038\/s41598-024-52599-y","volume":"14","author":"S-H Wu","year":"2024","unstructured":"Wu S-H, Chen Y-C, Chen C-H, Liu H-S, Liu Z-X, Chiu C-H (2024) Caffeine supplementation improves the cognitive abilities and shooting performance of elite e-sports players: a crossover trial. Sci Rep 14(1):2074","journal-title":"Sci Rep"},{"issue":"1","key":"6247_CR41","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1186\/s40798-016-0057-9","volume":"2","author":"T Wyss","year":"2016","unstructured":"Wyss T, Boesch M, Roos L, Tschopp C, Frei KM, Annen H, La Marca R (2016) Aerobic fitness level affects cardiovascular and salivary alpha amylase responses to acute psychosocial stress. Sports medicine-open 2(1):33","journal-title":"Sports medicine-open"},{"issue":"1","key":"6247_CR42","first-page":"164","volume":"2","author":"FH Yagin","year":"2024","unstructured":"Yagin FH, Pinar A, de Sousa Fernandes MS (2024) Statistical effect sizes in sports science. J Exerc Sci Phys Activity Reviews 2(1):164\u2013171","journal-title":"J Exerc Sci Phys Activity Reviews"},{"key":"6247_CR43","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1752-4458-8-19","volume":"8","author":"Z Yang","year":"2014","unstructured":"Yang Z, Cao F, Lu H, Zhu X, Miao D (2014) Changes of anxiety in Chinese military personnels over time: a cross-temporal meta-analysis. Int J Mental Health Syst 8:1\u20139","journal-title":"Int J Mental Health Syst"}],"container-title":["European Journal of Applied Physiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00421-026-06247-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00421-026-06247-0","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00421-026-06247-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T12:22:05Z","timestamp":1786105325000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00421-026-06247-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,16]]},"references-count":43,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["6247"],"URL":"https:\/\/doi.org\/10.1007\/s00421-026-06247-0","relation":{},"ISSN":["1439-6319","1439-6327"],"issn-type":[{"value":"1439-6319","type":"print"},{"value":"1439-6327","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,16]]},"assertion":[{"value":"22 December 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 April 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 May 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Yi-Jie Shiu, Che-Hsiu Chen, Hung-Yu Lin, Chia-Cheng Yang, Chi-Wen Yen, Han-Yuan Chang, Hsuan-Ta Chen and Chih-Hui Chiu declare that they have no competing interests.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}}]}}