{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,3,5]],"date-time":"2025-03-05T05:39:04Z","timestamp":1741153144714,"version":"3.38.0"},"reference-count":41,"publisher":"Springer Science and Business Media LLC","issue":"3","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":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["No. 81872705, No. 81473060"],"award-info":[{"award-number":["No. 81872705, No. 81473060"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Clin Microbiol Infect Dis"],"published-print":{"date-parts":[[2025,3]]},"DOI":"10.1007\/s10096-024-05036-x","type":"journal-article","created":{"date-parts":[[2025,1,4]],"date-time":"2025-01-04T05:42:45Z","timestamp":1735969365000},"page":"671-679","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Dynamic characteristics of high-risk HPV infection in women with low-grade cervical intraepithelial neoplasia, based on a community longitudinal study"],"prefix":"10.1007","volume":"44","author":[{"given":"Kailu","family":"Zhao","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huimin","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meng","family":"Cui","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Song","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuanjing","family":"Lyu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ling","family":"Ding","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5958-1194","authenticated-orcid":false,"given":"Jintao","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,1,4]]},"reference":[{"issue":"3","key":"5036_CR1","doi-asserted-by":"publisher","first-page":"229","DOI":"10.3322\/caac.21834","volume":"74","author":"F Bray","year":"2024","unstructured":"Bray F et al (2024) Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA-Cancer J Clin 74(3):229\u2013263. https:\/\/doi.org\/10.3322\/caac.21834","journal-title":"CA-Cancer J Clin"},{"key":"5036_CR2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jncc.2024.01.006","author":"B Han","year":"2024","unstructured":"Han B et al (2024) Cancer incidence and mortality in China, 2022. J Natl Cancer Cent. https:\/\/doi.org\/10.1016\/j.jncc.2024.01.006","journal-title":"J Natl Cancer Cent"},{"issue":"12","key":"5036_CR3","doi-asserted-by":"publisher","first-page":"2929","DOI":"10.1002\/ijc.27571","volume":"131","author":"FH Zhao","year":"2012","unstructured":"Zhao FH et al (2012) Prevalence of human papillomavirus and cervical intraepithelial neoplasia in China: a pooled analysis of 17 population-based studies. Int J Cancer 131(12):2929\u20132938. https:\/\/doi.org\/10.1002\/ijc.27571","journal-title":"Int J Cancer"},{"issue":"3","key":"5036_CR4","doi-asserted-by":"publisher","first-page":"616","DOI":"10.1016\/j.ygyno.2019.12.027","volume":"156","author":"SY Hu","year":"2020","unstructured":"Hu SY et al (2020) Outcomes in women with biopsy-confirmed cervical intraepithelial neoplasia grade 1 or normal cervix and related cofactors: a 15-year population-based cohort study from China. Gynecol Oncol 156(3):616\u2013623. https:\/\/doi.org\/10.1016\/j.ygyno.2019.12.027","journal-title":"Gynecol Oncol"},{"issue":"7","key":"5036_CR5","doi-asserted-by":"publisher","first-page":"1298","DOI":"10.1158\/1055-9965.Epi-13-0846","volume":"23","author":"S-K Zhang","year":"2014","unstructured":"Zhang S-K et al (2014) The natural history of cervical cancer in chinese women: results from an 11-year follow-up study in China using a multistate model. Cancer Epidemiol Biomarkers Prev 23(7):1298\u20131305. https:\/\/doi.org\/10.1158\/1055-9965.Epi-13-0846","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"key":"5036_CR6","doi-asserted-by":"publisher","unstructured":"Loopik DLB, Heidi AE, Maria NIH, JoannaBekkers RLM (2021) The natural history of cervical intraepithelial neoplasia grades 1, 2, and 3: a systematic review and meta-analysis. J Low Genit Tract Di 25(3). https:\/\/doi.org\/10.1097\/LGT.0000000000000604","DOI":"10.1097\/LGT.0000000000000604"},{"key":"5036_CR7","doi-asserted-by":"publisher","unstructured":"Crosbie EJ et al (2013) Human papillomavirus and cervical cancer. Lancet 382(9895):889\u2009\u2013\u200999. https:\/\/doi.org\/10.1016\/S0140-6736(13)60022-7","DOI":"10.1016\/S0140-6736(13)60022-7"},{"issue":"10","key":"5036_CR8","doi-asserted-by":"publisher","first-page":"2349","DOI":"10.1002\/ijc.27485","volume":"131","author":"P Guan","year":"2012","unstructured":"Guan P et al (2012) Human papillomavirus types in 115,789 HPV-positive women: a meta-analysis from cervical infection to cancer. Int J Cancer 131(10):2349\u20132359. https:\/\/doi.org\/10.1002\/ijc.27485","journal-title":"Int J Cancer"},{"issue":"7","key":"5036_CR9","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1093\/jnci\/djn044","volume":"100","author":"AC Rodriguez","year":"2008","unstructured":"Rodriguez AC et al (2008) Rapid clearance of human papillomavirus and implications for clinical focus on persistent infections. J Natl Cancer Inst 100(7):513\u2013517. https:\/\/doi.org\/10.1093\/jnci\/djn044","journal-title":"J Natl Cancer Inst"},{"issue":"2","key":"5036_CR10","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1016\/j.ijgo.2010.03.021","volume":"110","author":"Yl Guo","year":"2010","unstructured":"Guo Yl et al (2010) Natural history of infections with high-risk HPV in Chinese women with abnormal cervical cytology findings at baseline. Int J Gynecol Obstet 110(2):137\u2013140. https:\/\/doi.org\/10.1016\/j.ijgo.2010.03.021","journal-title":"Int J Gynecol Obstet"},{"issue":"6","key":"5036_CR11","doi-asserted-by":"publisher","first-page":"941","DOI":"10.1111\/j.1469-0691.2010.03387.x","volume":"17","author":"A Pista","year":"2011","unstructured":"Pista A et al (2011) Single and multiple human papillomavirus infections in cervical abnormalities in Portuguese women. Clin Microbiol Infect 17(6):941\u2013946. https:\/\/doi.org\/10.1111\/j.1469-0691.2010.03387.x","journal-title":"Clin Microbiol Infect"},{"key":"5036_CR12","doi-asserted-by":"publisher","unstructured":"Sahlgren H et al (2020) Colposcopic and histopathologic evaluation of women with HPV persistence exiting an organized screening program. Am J Obstet Gynecol 222(3):253.e1-253.e. https:\/\/doi.org\/10.1016\/j.ajog.2019.09.039","DOI":"10.1016\/j.ajog.2019.09.039"},{"key":"5036_CR13","doi-asserted-by":"publisher","unstructured":"Zhang Q et al (2015) Natural outcome of genital tract high-risk human papillomavirus infection and associated factors among 760 women. Zhongguo Yi Xue Ke Xue Yuan Xue Bao, 37(5): 534\u2009\u2013\u2009540. https:\/\/doi.org\/10.3881\/j.issn.1000-503X.2015.05.008","DOI":"10.3881\/j.issn.1000-503X.2015.05.008"},{"issue":"4","key":"5036_CR14","doi-asserted-by":"publisher","first-page":"616","DOI":"10.1002\/jmv.21750","volume":"82","author":"A Nielsen","year":"2010","unstructured":"Nielsen A et al (2010) Persistence of high-risk human papillomavirus infection in a population-based cohort of Danish women. J Med Virol 82(4):616\u2013623. https:\/\/doi.org\/10.1002\/jmv.21750","journal-title":"J Med Virol"},{"issue":"9","key":"5036_CR15","doi-asserted-by":"publisher","first-page":"2406","DOI":"10.1002\/ijc.32562","volume":"146","author":"X Li","year":"2019","unstructured":"Li X et al (2019) Effects of exposure to polycyclic aromatic hydrocarbons combined with high-risk human papillomavirus infection on cervical intraepithelial neoplasia: a population study in Shanxi Province, China. Int J Cancer 146(9):2406\u20132412. https:\/\/doi.org\/10.1002\/ijc.32562","journal-title":"Int J Cancer"},{"key":"5036_CR16","doi-asserted-by":"publisher","unstructured":"Song L et al (2020) Prevalence and genotype distribution of high-risk human papillomavirus infection in women with abnormal cervical cytology: a population-based study in Shanxi Province, China. Cancer Manage Res.\u00a0https:\/\/doi.org\/10.2147\/CMAR.S269050","DOI":"10.2147\/CMAR.S269050"},{"issue":"11","key":"5036_CR17","doi-asserted-by":"publisher","first-page":"5373","DOI":"10.1002\/cam4.2017","volume":"8","author":"B Zhu","year":"2019","unstructured":"Zhu B et al (2019) The prevalence, trends, and geographical distribution of human papillomavirus infection in China: the pooled analysis of 1.7 million women. Cancer Med 8(11):5373\u20135385. https:\/\/doi.org\/10.1002\/cam4.2017","journal-title":"Cancer Med"},{"issue":"12","key":"5036_CR18","doi-asserted-by":"publisher","first-page":"1789","DOI":"10.1086\/657321","volume":"202","author":"L Bruni","year":"2010","unstructured":"Bruni L et al (2010) Cervical human papillomavirus prevalence in 5 continents: meta-analysis of 1 million women with normal cytological findings. J Infect Dis 202(12):1789\u20131799. https:\/\/doi.org\/10.1086\/657321","journal-title":"J Infect Dis"},{"issue":"1","key":"5036_CR19","doi-asserted-by":"publisher","first-page":"e28302","DOI":"10.1002\/jmv.28302","volume":"95","author":"X Tang","year":"2023","unstructured":"Tang X et al (2023) Extended human papillomavirus genotype distribution in cervical intraepithelial neoplasia and cancer: analysis of 40 352 cases from a large academic gynecologic center in China. J Med Virol 95(1):e28302. https:\/\/doi.org\/10.1002\/jmv.28302","journal-title":"J Med Virol"},{"issue":"7","key":"5036_CR20","doi-asserted-by":"publisher","first-page":"782","DOI":"10.1134\/s0006297919070095","volume":"84","author":"M Vonsky","year":"2019","unstructured":"Vonsky M et al (2019) Carcinogenesis associated with human papillomavirus infection. mechanisms and potential for immunotherapy. Biochem (Moscow) 84(7):782\u2013799. https:\/\/doi.org\/10.1134\/s0006297919070095","journal-title":"Biochem (Moscow)"},{"key":"5036_CR21","doi-asserted-by":"publisher","unstructured":"Della Fera AN et al (2021) Persistent human papillomavirus infection. Viruses 13(2). https:\/\/doi.org\/10.3390\/v13020321","DOI":"10.3390\/v13020321"},{"issue":"18","key":"5036_CR22","doi-asserted-by":"publisher","first-page":"1387","DOI":"10.1093\/jnci\/djr283","volume":"103","author":"HC Chen","year":"2011","unstructured":"Chen HC et al (2011) Persistence of type-specific human papillomavirus infection and increased long-term risk of cervical cancer. J Natl Cancer Inst 103(18):1387\u20131396. https:\/\/doi.org\/10.1093\/jnci\/djr283","journal-title":"J Natl Cancer Inst"},{"key":"5036_CR23","doi-asserted-by":"publisher","unstructured":"Ferreccio C et al (2011) High-risk HPV infection after five years in a population-based cohort of Chilean women. Infect Agents Cancer 6(1):21.\u00a0https:\/\/doi.org\/10.1186\/1750-9378-6-21","DOI":"10.1186\/1750-9378-6-21"},{"issue":"12","key":"5036_CR24","doi-asserted-by":"publisher","first-page":"862","DOI":"10.1016\/s1473-3099(10)70190-0","volume":"10","author":"NJ Veldhuijzen","year":"2010","unstructured":"Veldhuijzen NJ et al (2010) Factors affecting transmission of mucosal human papillomavirus. Lancet Infect Dis 10(12):862\u2013874. https:\/\/doi.org\/10.1016\/s1473-3099(10)70190-0","journal-title":"Lancet Infect Dis"},{"key":"5036_CR25","doi-asserted-by":"publisher","first-page":"1248","DOI":"10.1186\/1471-2458-14-1248","volume":"14","author":"C Remschmidt","year":"2014","unstructured":"Remschmidt C et al (2014) Sexual behavior and factors associated with young age at first intercourse and HPV vaccine uptake among young women in Germany: implications for HPV vaccination policies. BMC Public Health 14:1248. https:\/\/doi.org\/10.1186\/1471-2458-14-1248","journal-title":"BMC Public Health"},{"issue":"8685","key":"5036_CR26","doi-asserted-by":"publisher","first-page":"338","DOI":"10.1016\/0140-6736(90)90617-e","volume":"335","author":"ME Duncan","year":"1990","unstructured":"Duncan ME et al (1990) First coitus before menarche and risk of sexually transmitted disease. Lancet 335(8685):338\u2013340. https:\/\/doi.org\/10.1016\/0140-6736(90)90617-e","journal-title":"Lancet"},{"issue":"3","key":"5036_CR27","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1016\/s0022-3476(89)80863-7","volume":"115","author":"AB Moscicki","year":"1989","unstructured":"Moscicki AB et al (1989) Differences in biologic maturation, sexual behavior, and sexually transmitted disease between adolescents with and without cervical intraepithelial neoplasia. J Pediatr 115(3):487\u2013493. https:\/\/doi.org\/10.1016\/s0022-3476(89)80863-7","journal-title":"J Pediatr"},{"issue":"7","key":"5036_CR28","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1016\/S1473-3099(07)70158-5","volume":"7","author":"S de Sanjose","year":"2007","unstructured":"de Sanjose S et al (2007) Worldwide prevalence and genotype distribution of cervical human papillomavirus DNA in women with normal cytology: a meta-analysis. Lancet Infect Dis 7(7):453\u2013459. https:\/\/doi.org\/10.1016\/S1473-3099(07)70158-5","journal-title":"Lancet Infect Dis"},{"issue":"5","key":"5036_CR29","doi-asserted-by":"publisher","first-page":"718","DOI":"10.1067\/mpd.2002.128893","volume":"141","author":"JA Kahn","year":"2002","unstructured":"Kahn JA et al (2002) The interval between menarche and age of first sexual intercourse as a risk factor for subsequent HPV infection in adolescent and young adult women. J Pediatr 141(5):718\u2013723. https:\/\/doi.org\/10.1067\/mpd.2002.128893","journal-title":"J Pediatr"},{"issue":"3","key":"5036_CR30","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1080\/14760584.2022.2021077","volume":"21","author":"S Welby","year":"2022","unstructured":"Welby S et al (2022) Progression from human papillomavirus (HPV) infection to cervical lesion or clearance in women (18\u201325 years): natural history study in the control arm subjects of AS04-HPV-16\/18 vaccine efficacy study in China between 2008 and 2016. Expert Rev Vaccines 21(3):407\u2013413. https:\/\/doi.org\/10.1080\/14760584.2022.2021077","journal-title":"Expert Rev Vaccines"},{"key":"5036_CR31","doi-asserted-by":"publisher","unstructured":"Shen Y et al (2021) Human papillomavirus infection rate, distribution characteristics, and risk of age in pre- and postmenopausal women. BMC Womens Health 21(1). https:\/\/doi.org\/10.1186\/s12905-021-01217-4","DOI":"10.1186\/s12905-021-01217-4"},{"key":"5036_CR32","doi-asserted-by":"publisher","unstructured":"Althoff KN et al (2009) Correlates of cervicovaginal human papillomavirus detection in perimenopausal women. J Women\\s Health 18(9):1341\u20131346.\u00a0https:\/\/doi.org\/10.1089\/jwh.2008.1223","DOI":"10.1089\/jwh.2008.1223"},{"issue":"2","key":"5036_CR33","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1016\/j.ygyno.2019.05.026","volume":"154","author":"W Li","year":"2019","unstructured":"Li W et al (2019) Association of age and viral factors with high-risk HPV persistence: a retrospective follow-up study. Gynecol Oncol 154(2):345\u2013353. https:\/\/doi.org\/10.1016\/j.ygyno.2019.05.026","journal-title":"Gynecol Oncol"},{"issue":"5","key":"5036_CR34","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1093\/jnci\/djq001","volume":"102","author":"AC Rodriguez","year":"2010","unstructured":"Rodriguez AC et al (2010) Longitudinal study of human papillomavirus persistence and cervical intraepithelial neoplasia grade 2\/3: critical role of duration of infection. J Natl Cancer Inst 102(5):315\u2013324. https:\/\/doi.org\/10.1093\/jnci\/djq001","journal-title":"J Natl Cancer Inst"},{"issue":"2","key":"5036_CR35","doi-asserted-by":"publisher","first-page":"394","DOI":"10.1016\/j.vaccine.2012.10.087","volume":"31","author":"M Mollers","year":"2013","unstructured":"Mollers M et al (2013) Prevalence, incidence and persistence of genital HPV infections in a large cohort of sexually active young women in the Netherlands. Vaccine 31(2):394\u2013401. https:\/\/doi.org\/10.1016\/j.vaccine.2012.10.087","journal-title":"Vaccine"},{"issue":"7","key":"5036_CR36","doi-asserted-by":"publisher","first-page":"4015","DOI":"10.7314\/apjcp.2013.14.7.4015","volume":"14","author":"J Li","year":"2013","unstructured":"Li J et al (2013) Epidemiological features of human papillomavirus (HPV) infection among women living in Mainland China. Asian Pac J Cancer Prev 14(7):4015\u20134023. https:\/\/doi.org\/10.7314\/apjcp.2013.14.7.4015","journal-title":"Asian Pac J Cancer Prev"},{"issue":"3","key":"5036_CR37","doi-asserted-by":"publisher","first-page":"436","DOI":"10.1086\/653826","volume":"202","author":"K Louvanto","year":"2010","unstructured":"Louvanto K et al (2010) Genotype-specific persistence of genital human papillomavirus (HPV) infections in women followed for 6 years in the Finnish Family HPV Study. J Infect Dis 202(3):436\u2013444. https:\/\/doi.org\/10.1086\/653826","journal-title":"J Infect Dis"},{"issue":"5","key":"5036_CR38","doi-asserted-by":"publisher","first-page":"486","DOI":"10.1093\/aje\/kwg171","volume":"158","author":"M Molano","year":"2003","unstructured":"Molano M et al (2003) Determinants of clearance of human papillomavirus infections in Colombian women with normal cytology: a population-based, 5-year follow-up study. Am J Epidemiol 158(5):486\u2013494. https:\/\/doi.org\/10.1093\/aje\/kwg171","journal-title":"Am J Epidemiol"},{"key":"5036_CR39","doi-asserted-by":"publisher","unstructured":"Yang X et al (2023) Cervical HPV infection in Guangzhou, China: an epidemiological study of 198,111 women from 2015 to 2021. Emerg Microbes Infect 12(1). https:\/\/doi.org\/10.1080\/22221751.2023.2176009","DOI":"10.1080\/22221751.2023.2176009"},{"issue":"2","key":"5036_CR40","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1002\/1097-0142(19900115)65:2","volume":"65","author":"R Herrero","year":"1990","unstructured":"Herrero R et al (1990) Sexual behavior, venereal diseases, hygiene practices, and invasive cervical cancer in a high-risk population. Cancer 65(2):380\u2013386. https:\/\/doi.org\/10.1002\/1097-0142(19900115)65:2","journal-title":"Cancer"},{"key":"5036_CR41","doi-asserted-by":"publisher","unstructured":"Li L et al Association between vaginal micro-environment disorder and cervical intraepithelial neoplasia in a community based population in China. J Cancer 11(2):284\u2013291. https:\/\/doi.org\/10.7150\/jca.35022","DOI":"10.7150\/jca.35022"}],"container-title":["European Journal of Clinical Microbiology &amp; Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10096-024-05036-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10096-024-05036-x\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10096-024-05036-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,4]],"date-time":"2025-03-04T14:23:17Z","timestamp":1741098197000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10096-024-05036-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,4]]},"references-count":41,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,3]]}},"alternative-id":["5036"],"URL":"https:\/\/doi.org\/10.1007\/s10096-024-05036-x","relation":{},"ISSN":["0934-9723","1435-4373"],"issn-type":[{"type":"print","value":"0934-9723"},{"type":"electronic","value":"1435-4373"}],"subject":[],"published":{"date-parts":[[2025,1,4]]},"assertion":[{"value":"18 September 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 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":"All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and\/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This study has been approved by the Institutional Review Board of Shanxi Medical University (No: 2013-003). Written and informed consent from every participant was obtained in this study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval and consent to participate"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}