{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T11:21:00Z","timestamp":1791285660282,"version":"4.1.0"},"reference-count":40,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2024,7,5]],"date-time":"2024-07-05T00:00:00Z","timestamp":1720137600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,7,5]],"date-time":"2024-07-05T00:00:00Z","timestamp":1720137600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Anesth"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>Combined spinal-epidural analgesia (CSEA) is effective but not sufficient for labor pain. This study was conducted to assess the real-time analgesic efficacy, side effects of anesthetic drug dosage, and maternal satisfaction in labor to provide reference for the optimization of labor analgesia.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This was a prospective, cohort, single-center study that included 3020 women who received CSEA for labor analgesia. The visual analogue scale (VAS) for labor pain, real-time anesthetic drug dosage, side effects, adverse labor outcomes, factors influencing average drug dosage, and maternal satisfaction with CSEA were assessed.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Overall, the VAS labor pain score was lowest at the first hour after the anesthesia was given. After 4\u00a0h for primiparas and 3\u00a0h for multiparas, the VAS score was greater than 3 but the anesthetic drug dosage did not reach the maximum allowed dosage at the same time. The average anesthetic drug dosage was positively correlated with fever, urinary retention, uterine atony, prolonged active phase, prolonged second stage, assisted vaginal delivery, and postpartum hemorrhage. The average anesthetic drug dosage was the highest in women\u2009\u2264\u200920\u00a0years old, those with a body mass index (BMI)\u2009\u2265\u200924.9\u00a0kg\/m<jats:sup>2<\/jats:sup>, and those with a primary or secondary education level.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Appropriate age guidance and emphasis on education of labor analgesia, weight management during pregnancy, and real-time anesthetic dosage adjustment during labor based on VAS pain score may have positive effects on the satisfaction of labor analgesia.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Clinical trial number and registry<\/jats:title>\n                <jats:p>Clinicaltrials.gov (ChiCTR2100051809).<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00540-024-03368-8","type":"journal-article","created":{"date-parts":[[2024,7,5]],"date-time":"2024-07-05T08:02:22Z","timestamp":1720166542000},"page":"656-665","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Real-time analgesic efficacy and factors determining drug requirements of combined spinal-epidural analgesia for labor: a prospective cohort study"],"prefix":"10.1007","volume":"38","clinical-trial-number":[{"clinical-trial-number":"chictr2100051809","registry":"10.18810\/chictr"}],"author":[{"given":"Shuzhen","family":"Wu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaxin","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zijing","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linjia","family":"Zhong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongfei","family":"Dai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changping","family":"Fang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minli","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zifeng","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4995-1790","authenticated-orcid":false,"given":"Lingling","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,7,5]]},"reference":[{"issue":"4","key":"3368_CR1","doi-asserted-by":"publisher","first-page":"318","DOI":"10.1111\/birt.12009","volume":"39","author":"JP Rooks","year":"2012","unstructured":"Rooks JP. Labor pain management other than neuraxial: what do we know and where do we go next? Birth. 2012;39(4):318\u201322.","journal-title":"Birth"},{"issue":"3","key":"3368_CR2","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1007\/s00540-022-03061-8","volume":"36","author":"H Yin","year":"2022","unstructured":"Yin H, Tong X, Huang H. Dural puncture epidural versus conventional epidural analgesia for labor: a systematic review and meta-analysis of randomized controlled studies. J Anesth. 2022;36(3):413\u201327.","journal-title":"J Anesth"},{"key":"3368_CR3","doi-asserted-by":"crossref","unstructured":"American College of Obstetricians and Gynecologists\u2019 Committee on Practice Bulletins\u2014Obstetrics. ACOG Practice Bulletin No. 209: Obstetric Analgesia and Anesthesia. Obstet Gynecol. 2019;133(3): e208-e225.","DOI":"10.1097\/AOG.0000000000003132"},{"issue":"5","key":"3368_CR4","first-page":"413","volume":"26","author":"KK Lam","year":"2020","unstructured":"Lam KK, Leung MKM, Irwin MG. Labour analgesia: update and literature review. Hong Kong Med J. 2020;26(5):413\u201320.","journal-title":"Hong Kong Med J"},{"issue":"1","key":"3368_CR5","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1097\/AAP.0000000000000517","volume":"42","author":"MP Bonnet","year":"2017","unstructured":"Bonnet MP, Prunet C, Baillard C, Kp\u00e9a L, Blondel B, Le Ray C. Anesthetic and obstetrical factors associated with the effectiveness of epidural analgesia for labor pain relief: an observational population-based study. Reg Anesth Pain Med. 2017;42(1):109\u201316.","journal-title":"Reg Anesth Pain Med"},{"issue":"1","key":"3368_CR6","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1007\/s00404-018-4777-6","volume":"298","author":"Q Wang","year":"2018","unstructured":"Wang Q, Zheng SX, Ni YF, Lu YY, Zhang B, Lian QQ, Hu MP. The effect of labor epidural analgesia on maternal-fetal outcomes: a retrospective cohort study. Arch Gynecol Obstet. 2018;298(1):89\u201396.","journal-title":"Arch Gynecol Obstet"},{"issue":"6","key":"3368_CR7","doi-asserted-by":"publisher","first-page":"437","DOI":"10.1097\/AJP.0000000000000928","volume":"37","author":"X Sun","year":"2021","unstructured":"Sun X, Zhou Q, Zhou M, Cao R, Chen Z, Tang S, Huang S. The effect of epidural nalbuphine combined with ropivacaine on epidural analgesia during labor: a multicenter, randomized, double-blind, controlled study. Clin J Pain. 2021;37(6):437\u201342.","journal-title":"Clin J Pain"},{"issue":"4","key":"3368_CR8","first-page":"971","volume":"132","author":"Y Song","year":"2021","unstructured":"Song Y, Du W, Zhou S, Zhou Y, Yu Y, Xu Z, Liu Z. Effect of dural puncture epidural technique combined with programmed intermittent epidural bolus on labor analgesia onset and maintenance: a randomized controlled trial. AnesthAnalg. 2021;132(4):971\u20138.","journal-title":"AnesthAnalg"},{"key":"3368_CR9","first-page":"1228006","volume":"2022","author":"L Mao","year":"2022","unstructured":"Mao L, Zhang X, Zhu J. Analgesic effects, birth process, and prognosis of pregnant women in normal labor by epidural analgesia using sufentanil in combination with ropivacaine: a retrospective cohort study. ComputIntellNeurosci. 2022;2022:1228006.","journal-title":"ComputIntellNeurosci"},{"issue":"3","key":"3368_CR10","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-037251","volume":"10","author":"L Jibb","year":"2020","unstructured":"Jibb L, Nathan PC, Breakey V, Fernandez C, Johnston D, Lewis V, McKillop S, Patel S, Sabapathy C, Strahlendorf C, Victor JC, Moretti ME, Nguyen C, Hundert A, Cassiani C, El-KhechenRichandi G, Insull H, Hamilton R, Fang G, Kuczynski S, Stinson J. Pain Squad+ smartphone app to support real-time pain treatment for adolescents with cancer: protocol for a randomised controlled trial. BMJ Open. 2020;10(3): e037251.","journal-title":"BMJ Open"},{"key":"3368_CR11","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1016\/j.contraception.2022.03.003","volume":"110","author":"EB Friedlander","year":"2022","unstructured":"Friedlander EB, Raidoo S, Soon R, Salcedo J, Davis J, Tschann M, Fontanilla T, Horiuchi W, Kaneshiro B. The experience of pain in real-time during medication abortion. Contraception. 2022;110:71\u20135.","journal-title":"Contraception"},{"issue":"4","key":"3368_CR12","doi-asserted-by":"publisher","first-page":"496","DOI":"10.4103\/0970-9185.142842","volume":"30","author":"BL Sng","year":"2014","unstructured":"Sng BL, Woo D, Leong WL, Wang H, Assam PN, Sia AT. Comparison of computer-integrated patient-controlled epidural analgesia with no initial basal infusion versus moderate basal infusion for labor and delivery: a randomized controlled trial. J Anaesthesiol Clin Pharmacol. 2014;30(4):496\u2013501.","journal-title":"J Anaesthesiol Clin Pharmacol"},{"issue":"1","key":"3368_CR13","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12871-019-0855-y","volume":"20","author":"Y Wang","year":"2020","unstructured":"Wang Y, Xu M. Comparison of ropivacaine combined with sufentanil for epidural anesthesia and spinal-epidural anesthesia in labor analgesia. BMC Anesthesiol. 2020;20(1):1.","journal-title":"BMC Anesthesiol"},{"key":"3368_CR14","doi-asserted-by":"crossref","unstructured":"Anim-Somuah M, Smyth RM, Cyna AM, Cuthbert A. Epidural versus non-epidural or no analgesia for pain management in labour. Cochrane Database Syst Rev. 2018;5(5):CD000331.","DOI":"10.1002\/14651858.CD000331.pub4"},{"issue":"9237","key":"3368_CR15","doi-asserted-by":"publisher","first-page":"1255","DOI":"10.1016\/S0140-6736(00)02799-9","volume":"356","author":"IR Edwards","year":"2000","unstructured":"Edwards IR, Aronson JK. Adverse drug reactions: definitions, diagnosis, and management. Lancet. 2000;356(9237):1255\u20139.","journal-title":"Lancet"},{"issue":"2","key":"3368_CR16","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1159\/000030425","volume":"63","author":"AS Salinas","year":"1999","unstructured":"Salinas AS, Lorenzo-Romero J, Segura M, Calero MR, Hern\u00e1ndez-Mill\u00e1n I, Mart\u00ednez-Mart\u00edn M, Virseda JA. Factors determining analgesic and sedative drug requirements during extracorporeal shock wave lithotripsy. Urol Int. 1999;63(2):92\u2013101.","journal-title":"Urol Int"},{"issue":"4","key":"3368_CR17","doi-asserted-by":"publisher","first-page":"247","DOI":"10.5055\/jom.2020.0578","volume":"16","author":"M Hashimoto","year":"2020","unstructured":"Hashimoto M, Aogaki K, Numata C, Moriwaki K, Matsuda Y, Ishii R, Tanaka I, Okamoto Y. Factors influencing the prescribed dose of opioid analgesics in cancer patients. J Opioid Manag. 2020;16(4):247\u201352.","journal-title":"J Opioid Manag"},{"issue":"2","key":"3368_CR18","doi-asserted-by":"publisher","first-page":"e118","DOI":"10.1016\/j.wombi.2020.02.009","volume":"34","author":"A Westergren","year":"2021","unstructured":"Westergren A, Edin K, Lindkvist M, Christianson M. Exploring the medicalisation of childbirth through women\u2019s preferences for and use of pain relief. Women Birth. 2021;34(2):e118\u201327.","journal-title":"Women Birth"},{"key":"3368_CR19","unstructured":"Expert consensus on new labor standards and management [J]. Chinese J Obstet Gynecol 2014:49(07):486."},{"key":"3368_CR20","doi-asserted-by":"crossref","unstructured":"Thorburn PT, Monteiro R, Chakladar A, Cochrane A, Roberts J. South East Anaesthetic Research Chain (SEARCH), Mark Harper C. Maternal temperature in emergency caesarean section (MATES): an observational multicentre study. Int J ObstetAnesth. 2021;46:102963.","DOI":"10.1016\/j.ijoa.2021.102963"},{"issue":"1","key":"3368_CR21","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1515\/sjpain-2018-0012","volume":"18","author":"ISK Thong","year":"2018","unstructured":"Thong ISK, Jensen MP, Mir\u00f3 J, Tan G. The validity of pain intensity measures: what do the NRS, VAS, VRS, and FPS-R measure? Scand J Pain. 2018;18(1):99\u2013107.","journal-title":"Scand J Pain"},{"key":"3368_CR22","unstructured":"Wang Fen, LI Yan, Chen Feng-Ren, et al. Effect of maternal satisfaction with labor analgesia on postpartum depression. Modern Preventive Medicine, 2020;47(06):1028\u20131031+1051."},{"issue":"5","key":"3368_CR23","first-page":"458","volume":"9","author":"PAN Yue-song","year":"2018","unstructured":"Yue-song PAN. Data management and quality control for clinical research. Med J Pumch. 2018;9(5):458\u201362.","journal-title":"Med J Pumch"},{"key":"3368_CR24","doi-asserted-by":"crossref","unstructured":"Zhang J, Landy HJ, Ware Branch D, Burkman R, Haberman S, Gregory KD, Hatjis CG, Ramirez MM, Bailit JL, Gonzalez-Quintero VH, Hibbard JU, Hoffman MK, Kominiarek M, Learman LA, Van Veldhuisen P, Troendle J, Reddy UM. Consortium on Safe Labor. Contemporary patterns of spontaneous labor with normal neonatal outcomes. Obstet Gynecol. 2010;116(6):1281\u20131287.","DOI":"10.1097\/AOG.0b013e3181fdef6e"},{"issue":"3","key":"3368_CR25","doi-asserted-by":"publisher","first-page":"267.e1","DOI":"10.1016\/j.ajog.2019.09.035","volume":"222","author":"E Ashwal","year":"2020","unstructured":"Ashwal E, Livne MY, Benichou JIC, Unger R, Hiersch L, Aviram A, Mani A, Yogev Y. Contemporary patterns of labor in nulliparous and multiparous women. Am J Obstet Gynecol. 2020;222(3):267.e1-267.e9.","journal-title":"Am J Obstet Gynecol"},{"issue":"8","key":"3368_CR26","doi-asserted-by":"publisher","first-page":"696","DOI":"10.2174\/138945009788982441","volume":"10","author":"E Congedo","year":"2009","unstructured":"Congedo E, Sgreccia M, De Cosmo G. New drugs for epidural analgesia. Curr Drug Targets. 2009;10(8):696\u2013706.","journal-title":"Curr Drug Targets"},{"issue":"1","key":"3368_CR27","doi-asserted-by":"publisher","first-page":"619","DOI":"10.1186\/s13104-019-4645-x","volume":"12","author":"M Siyoum","year":"2019","unstructured":"Siyoum M, Mekonnen S. Labor pain control and associated factors among women who gave birth at Leku primary hospital, southern Ethiopia. BMC Res Notes. 2019;12(1):619.","journal-title":"BMC Res Notes"},{"issue":"10180","key":"3368_CR28","doi-asserted-by":"publisher","first-page":"1558","DOI":"10.1016\/S0140-6736(19)30430-1","volume":"393","author":"LA Colvin","year":"2019","unstructured":"Colvin LA, Bull F, Hales TG. Perioperative opioid analgesia-when is enough too much? A review of opioid-induced tolerance and hyperalgesia. Lancet. 2019;393(10180):1558\u201368.","journal-title":"Lancet"},{"issue":"1","key":"3368_CR29","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000018673","volume":"99","author":"Q Peng","year":"2020","unstructured":"Peng Q, Yang Z, Zhang W, Wu X. Comparison of median effective concentration of ropivacaine in multiparas or primiparas during epidural labor analgesia: STROBE compliant. Medicine (Baltimore). 2020;99(1): e18673.","journal-title":"Medicine (Baltimore)"},{"key":"3368_CR30","first-page":"9973001","volume":"2021","author":"R Gido","year":"2021","unstructured":"Gido R, Yadeta TA, Tura AK. Utilization of obstetric analgesia for labor pain management and associated factors among obstetric care providers in public hospitals of addis ababa, ethiopia: a cross-sectional study. ObstetGynecol Int. 2021;2021:9973001.","journal-title":"ObstetGynecol Int"},{"key":"3368_CR31","doi-asserted-by":"crossref","unstructured":"Ali Alahmari SS, ALmetrek M, Alzillaee AY, Hassan WJ, Ali Alamry SM. Knowledge, attitude, and practice of childbearing women toward epidural anesthesia during normal vaginal delivery in Alsanayeah Primary Health Care in Khamis Mushait. J Family Med Prim Care. 2020;9(1):99\u2013104.","DOI":"10.4103\/jfmpc.jfmpc_530_19"},{"issue":"3","key":"3368_CR32","first-page":"1631","volume":"17","author":"X Zhou","year":"2019","unstructured":"Zhou X, Li J, Deng S, Xu Z, Liu Z. Ropivacaine at different concentrations on intrapartum fever, IL-6 and TNF-\u03b1 in parturient with epidural labor analgesia. Exp Ther Med. 2019;17(3):1631\u20136.","journal-title":"Exp Ther Med"},{"issue":"5","key":"3368_CR33","first-page":"334","volume":"6","author":"F Tian","year":"2013","unstructured":"Tian F, Wang K, Hu J, Xie Y, Sun S, Zou Z, Huang S. Continuous spinal anesthesia with sufentanil in labor analgesia can induce maternal febrile responses in puerperas. Int J Clin Exp Med. 2013;6(5):334\u201341.","journal-title":"Int J Clin Exp Med"},{"issue":"5","key":"3368_CR34","doi-asserted-by":"publisher","first-page":"381","DOI":"10.1007\/s40264-015-0386-5","volume":"39","author":"S Armstrong","year":"2016","unstructured":"Armstrong S, Fernando R. Side effects and efficacy of neuraxial opioids in pregnant patients at delivery: a comprehensive review. Drug Saf. 2016;39(5):381\u201399.","journal-title":"Drug Saf"},{"issue":"3","key":"3368_CR35","doi-asserted-by":"publisher","first-page":"288","DOI":"10.1111\/1471-0528.12966","volume":"122","author":"EN Grant","year":"2015","unstructured":"Grant EN, Tao W, Craig M, McIntire D, Leveno K. Neuraxial analgesia effects on labour progression: facts, fallacies, uncertainties and the future. BJOG. 2015;122(3):288\u201393.","journal-title":"BJOG"},{"issue":"9","key":"3368_CR36","doi-asserted-by":"publisher","first-page":"840","DOI":"10.1007\/s12630-013-9981-z","volume":"60","author":"P Sultan","year":"2013","unstructured":"Sultan P, Murphy C, Halpern S, Carvalho B. The effect of low concentrations versus high concentrations of local anesthetics for labour analgesia on obstetric and anesthetic outcomes: a meta-analysis. Can J Anaesth. 2013;60(9):840\u201354.","journal-title":"Can J Anaesth"},{"issue":"1","key":"3368_CR37","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1186\/s12884-020-2719-3","volume":"20","author":"L Hawker","year":"2020","unstructured":"Hawker L, Weeks A. Postpartum haemorrhage (PPH) rates in randomized trials of PPH prophylactic interventions and the effect of underlying participant PPH risk: a meta-analysis. BMC Pregnancy Childbirth. 2020;20(1):107.","journal-title":"BMC Pregnancy Childbirth"},{"issue":"1","key":"3368_CR38","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1007\/s00404-018-4955-6","volume":"299","author":"J Xiao","year":"2019","unstructured":"Xiao J, Yi W, Wu L. Effects of electroacupuncture on reducing labor pain and complications in the labor analgesia process of combined spinal-epidural analgesia with patient-controlled epidural analgesia. Arch Gynecol Obstet. 2019;299(1):123\u20138.","journal-title":"Arch Gynecol Obstet"},{"key":"3368_CR39","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1016\/j.jclinane.2019.05.023","volume":"59","author":"TJ Vernon","year":"2020","unstructured":"Vernon TJ, Vogel TM, Dalby PL, Mandell G, Lim G. Ultrasound-assisted epidural labor analgesia for landmark identification in morbidly obese pregnant women: a preliminary investigation. J Clin Anesth. 2020;59:53\u20134.","journal-title":"J Clin Anesth"},{"issue":"4","key":"3368_CR40","doi-asserted-by":"publisher","first-page":"469","DOI":"10.1111\/birt.12349","volume":"45","author":"C Junge","year":"2018","unstructured":"Junge C, von Soest T, Weidner K, Seidler A, Eberhard-Gran M, Garthus-Niegel S. Labor pain in women with and without severe fear of childbirth: a population-based, longitudinal study. Birth. 2018;45(4):469\u201377.","journal-title":"Birth"}],"container-title":["Journal of Anesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00540-024-03368-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00540-024-03368-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00540-024-03368-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,20]],"date-time":"2024-09-20T11:03:28Z","timestamp":1726830208000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00540-024-03368-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,5]]},"references-count":40,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,10]]}},"alternative-id":["3368"],"URL":"https:\/\/doi.org\/10.1007\/s00540-024-03368-8","relation":{},"ISSN":["0913-8668","1438-8359"],"issn-type":[{"value":"0913-8668","type":"print"},{"value":"1438-8359","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,5]]},"assertion":[{"value":"9 May 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 June 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 July 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no conflicts of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}