{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T01:19:34Z","timestamp":1792718374033,"version":"4.5.0"},"reference-count":42,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T00:00:00Z","timestamp":1753315200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T00:00:00Z","timestamp":1753315200000},"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":["Dig Dis Sci"],"published-print":{"date-parts":[[2025,11]]},"DOI":"10.1007\/s10620-025-09228-z","type":"journal-article","created":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T14:29:24Z","timestamp":1753367364000},"page":"3705-3715","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Alterations in Gut Microbiota and Stool Properties Following Treatment with Potassium-Competitive Acid Blocker and Proton Pump Inhibitor"],"prefix":"10.1007","volume":"70","author":[{"given":"Osamu","family":"Dohi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Yasuda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomohisa","family":"Takagi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoto","family":"Iwai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhiko","family":"Uchiyama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsura","family":"Mizushima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryo","family":"Inoue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuji","family":"Naito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshito","family":"Itoh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,7,24]]},"reference":[{"key":"9228_CR1","doi-asserted-by":"publisher","first-page":"1818","DOI":"10.1001\/jama.2015.13766","volume":"314","author":"ED Kantor","year":"2015","unstructured":"Kantor ED, Rehm CD, Haas JS et al. Trends in prescription drug use among adults in the United States from 1999\u20132012. JAMA 2015;314:1818\u20131831.","journal-title":"JAMA"},{"key":"9228_CR2","doi-asserted-by":"publisher","first-page":"706","DOI":"10.1053\/j.gastro.2017.01.031","volume":"152","author":"DE Freedberg","year":"2017","unstructured":"Freedberg DE, Kim LS, Yang YX. The risks and benefits of long-term use of proton pump inhibitors: Expert review and best practice advice from the American Gastroenterological Association. Gastroenterology 2017;152:706\u2013715.","journal-title":"Gastroenterology"},{"key":"9228_CR3","doi-asserted-by":"publisher","first-page":"238","DOI":"10.1001\/jamainternmed.2015.7193","volume":"176","author":"B Lazarus","year":"2016","unstructured":"Lazarus B, Chen Y, Wilson FP et al. Proton pump inhibitor use and the risk of chronic kidney disease. JAMA Intern Med 2016;176:238\u2013246.","journal-title":"JAMA Intern Med"},{"key":"9228_CR4","doi-asserted-by":"crossref","unstructured":"Kahrilas PJ, Shaheen NJ, Vaezi MF, et al. American Gastroenterological Association. American Gastroenterological Association Medical Position Statement on the management of gastroesophageal reflux disease. Gastroenterology. 2008. 1391.e1\u20135; 135:1383\u201391.","DOI":"10.1053\/j.gastro.2008.08.045"},{"key":"9228_CR5","doi-asserted-by":"publisher","first-page":"419","DOI":"10.1007\/s00406-014-0554-0","volume":"265","author":"B Haenisch","year":"2015","unstructured":"Haenisch B, von Holt K, Wiese B et al. Risk of dementia in elderly patients with the use of proton pump inhibitors. Eur Arch Psychiatry Clin Neurosci 2015;265:419\u2013428.","journal-title":"Eur Arch Psychiatry Clin Neurosci"},{"key":"9228_CR6","doi-asserted-by":"crossref","unstructured":"Katz PO, Gerson LB, Vela MF. Guidelines for the diagnosis and management of gastroesophageal reflux disease. Am J Gastroenterol 2013;108:308\u2013328; quiz 329.","DOI":"10.1038\/ajg.2012.444"},{"key":"9228_CR7","doi-asserted-by":"publisher","first-page":"2947","DOI":"10.1001\/jama.296.24.2947","volume":"296","author":"YX Yang","year":"2006","unstructured":"Yang YX, Lewis JD, Epstein S et al. Long-term proton pump inhibitor therapy and risk of hip fracture. JAMA 2006;296:2947\u20132953.","journal-title":"JAMA"},{"key":"9228_CR8","doi-asserted-by":"publisher","first-page":"682","DOI":"10.1053\/j.gastro.2019.05.056","volume":"157","author":"P Moayyedi","year":"2019","unstructured":"Moayyedi P, Eikelboom JW, Bosch J et al. Safety of proton pump inhibitors based on a large, multi-year, randomized trial of patients receiving Rivaroxaban or aspirin. Gastroenterology 2019;157:682-691.e2.","journal-title":"Gastroenterology"},{"key":"9228_CR9","doi-asserted-by":"publisher","first-page":"1334","DOI":"10.1053\/j.gastro.2021.12.247","volume":"162","author":"LE Targownik","year":"2022","unstructured":"Targownik LE, Fisher DA, Saini SD. AGA clinical practice update on de-prescribing of proton pump inhibitors: Expert Review [Review]. Gastroenterology 2022;162:1334\u20131342.","journal-title":"Gastroenterology"},{"key":"9228_CR10","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1111\/j.1365-2036.2012.05133.x","volume":"36","author":"K Sugano","year":"2012","unstructured":"Sugano K, Kinoshita Y, Miwa H et al. Randomised clinical trial: Esomeprazole for the prevention of nonsteroidal anti-inflammatory drug-related peptic ulcers in Japanese patients. Aliment Pharmacol Ther 2012;36:115\u2013125.","journal-title":"Aliment Pharmacol Ther"},{"key":"9228_CR11","doi-asserted-by":"publisher","first-page":"409","DOI":"10.1007\/s40262-015-0326-7","volume":"55","author":"H Echizen","year":"2016","unstructured":"Echizen H. The first-in-class potassium-competitive acid blocker, vonoprazan fumarate: Pharmacokinetic and pharmacodynamic considerations. Clin Pharmacokinet 2016;55:409\u2013418.","journal-title":"Clin Pharmacokinet"},{"key":"9228_CR12","doi-asserted-by":"publisher","first-page":"100","DOI":"10.3164\/jcbn.17-78","volume":"62","author":"T Takagi","year":"2018","unstructured":"Takagi T, Naito Y, Inoue R et al. The influence of long-term use of proton pump inhibitors on the gut microbiota: An age-sex-matched case-control study. J Clin Biochem Nutr 2018;62:100\u2013105.","journal-title":"J Clin Biochem Nutr"},{"key":"9228_CR13","doi-asserted-by":"publisher","first-page":"1723","DOI":"10.1136\/gutjnl-2016-313312","volume":"66","author":"T Otsuka","year":"2017","unstructured":"Otsuka T, Sugimoto M, Inoue R et al. Influence of potassium-competitive acid blocker on the gut microbiome of Helicobacter pylori-negative healthy individuals. Gut 2017;66:1723\u20131725.","journal-title":"Gut"},{"key":"9228_CR14","doi-asserted-by":"publisher","first-page":"920","DOI":"10.3109\/00365529709011203","volume":"32","author":"SJ Lewis","year":"1997","unstructured":"Lewis SJ, Heaton KW. Stool form scale as a useful guide to intestinal transit time. Scand J Gastroenterol 1997;32:920\u2013924.","journal-title":"Scand J Gastroenterol"},{"key":"9228_CR15","doi-asserted-by":"publisher","first-page":"693","DOI":"10.1111\/apt.13746","volume":"44","author":"MR Blake","year":"2016","unstructured":"Blake MR, Raker JM, Whelan K. Validity and reliability of the Bristol Stool Form Scale in healthy adults and patients with diarrhoea-predominant irritable bowel syndrome. Aliment Pharmacol Ther 2016;44:693\u2013703.","journal-title":"Aliment Pharmacol Ther"},{"key":"9228_CR16","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1097\/00002820-198906000-00012","volume":"12","author":"SC McMillan","year":"1989","unstructured":"McMillan SC, Williams FA. Validity and reliability of the Constipation Assessment Scale. Cancer Nurs 1989;12:183\u2013188.","journal-title":"Cancer Nurs"},{"key":"9228_CR17","doi-asserted-by":"publisher","first-page":"1257","DOI":"10.1053\/j.gastro.2016.03.035","volume":"150","author":"DA Drossman","year":"2016","unstructured":"Drossman DA, Hasler WL. Rome IV\u2014Functional GI Disorders: Disorders of Gut-Brain Interaction. Gastroenterology 2016;150:1257\u20131261.","journal-title":"Gastroenterology"},{"key":"9228_CR18","doi-asserted-by":"publisher","first-page":"2111","DOI":"10.1007\/s10815-019-01564-0","volume":"36","author":"A Bernabeu","year":"2019","unstructured":"Bernabeu A, Lledo B, D\u00edaz MC et al. Effect of the vaginal microbiome on the pregnancy rate in women receiving assisted reproductive treatment. J Assist Reprod Genet 2019;36:2111\u20132119.","journal-title":"J Assist Reprod Genet"},{"key":"9228_CR19","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1007\/s00535-018-1488-5","volume":"54","author":"T Takagi","year":"2019","unstructured":"Takagi T, Naito Y, Inoue R et al. Differences in gut microbiota associated with age, sex, and stool consistency in healthy Japanese subjects. J Gastroenterol 2019;54:53\u201363.","journal-title":"J Gastroenterol"},{"key":"9228_CR20","doi-asserted-by":"publisher","first-page":"852","DOI":"10.1038\/s41587-019-0209-9","volume":"37","author":"E Bolyen","year":"2019","unstructured":"Bolyen E, Rideout JR, Dillon MR et al. Reproducible, interactive, scalable and extensible microbiome data science using QIIME 2. Nat Biotechnol 2019;37:852\u2013857.","journal-title":"Nat Biotechnol"},{"key":"9228_CR21","doi-asserted-by":"publisher","first-page":"581","DOI":"10.1038\/nmeth.3869","volume":"13","author":"BJ Callahan","year":"2016","unstructured":"Callahan BJ, McMurdie PJ, Rosen MJ et al. DADA2: High-resolution sample inference from Illumina amplicon data. Nat Methods 2016;13:581\u2013583.","journal-title":"Nat Methods"},{"key":"9228_CR22","doi-asserted-by":"publisher","first-page":"R60","DOI":"10.1186\/gb-2011-12-6-r60","volume":"12","author":"N Segata","year":"2011","unstructured":"Segata N, Izard J, Waldron L et al. Metagenomic biomarker discovery and explanation. Genome Biol 2011;12:R60.","journal-title":"Genome Biol"},{"key":"9228_CR23","doi-asserted-by":"publisher","first-page":"6484","DOI":"10.1080\/21655979.2021.1973356","volume":"12","author":"R Fu","year":"2021","unstructured":"Fu R, Li Z, Zhou R et al. The mechanism of intestinal flora dysregulation mediated by intestinal bacterial biofilm to induce constipation. Bioengineered 2021;12:6484\u20136498.","journal-title":"Bioengineered"},{"key":"9228_CR24","doi-asserted-by":"publisher","first-page":"654074","DOI":"10.3389\/fcimb.2021.654074","volume":"11","author":"R Tan","year":"2021","unstructured":"Tan R, Dong H, Chen Z et al. Intestinal microbiota mediates high-fructose and high-fat diets to induce chronic intestinal inflammation. Front Cell Infect Microbiol 2021;11:654074.","journal-title":"Front Cell Infect Microbiol"},{"key":"9228_CR25","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1136\/gutjnl-2015-309618","volume":"65","author":"D Vandeputte","year":"2016","unstructured":"Vandeputte D, Falony G, Vieira-Silva S et al. Stool consistency is strongly associated with gut microbiota richness and composition, enterotypes and bacterial growth rates. Gut 2016;65:57\u201362.","journal-title":"Gut"},{"key":"9228_CR26","doi-asserted-by":"publisher","first-page":"679","DOI":"10.1152\/physiolgenomics.00082.2014","volume":"46","author":"L Zhu","year":"2014","unstructured":"Zhu L, Liu W, Alkhouri R et al. Structural changes in the gut microbiome of constipated patients. Physiol Genomics 2014;46:679\u2013686.","journal-title":"Physiol Genomics"},{"key":"9228_CR27","first-page":"e114","volume":"22","author":"C Tana","year":"2010","unstructured":"Tana C, Umesaki Y, Imaoka A et al. Altered profiles of intestinal microbiota and organic acids may be the origin of symptoms in irritable bowel syndrome. Neurogastroenterol Motil 2010;22:e114\u2013e115.","journal-title":"Neurogastroenterol Motil"},{"key":"9228_CR28","doi-asserted-by":"publisher","first-page":"fuad039","DOI":"10.1093\/femsre\/fuad039","volume":"47","author":"R Mart\u00edn","year":"2023","unstructured":"Mart\u00edn R, Rios-Covian D, Huillet E et al. Faecalibacterium: A bacterial genus with promising human health applications. FEMS Microbiol Rev 2023;47:fuad039.","journal-title":"FEMS Microbiol Rev"},{"key":"9228_CR29","doi-asserted-by":"publisher","first-page":"2438","DOI":"10.2337\/db22-0168","volume":"71","author":"J Cui","year":"2022","unstructured":"Cui J, Ramesh G, Wu M et al. Butyrate-producing bacteria and insulin homeostasis: The microbiome and insulin longitudinal evaluation study (MILES). Diabetes 2022;71:2438\u20132446.","journal-title":"Diabetes"},{"key":"9228_CR30","doi-asserted-by":"publisher","first-page":"4477","DOI":"10.1038\/s41467-022-32015-7","volume":"13","author":"K Hosomi","year":"2022","unstructured":"Hosomi K, Saito M, Park J et al. Oral administration of Blautia wexlerae ameliorates obesity and type 2 diabetes via metabolic remodeling of the gut microbiota. Nat Commun 2022;13:4477.","journal-title":"Nat Commun"},{"key":"9228_CR31","doi-asserted-by":"publisher","first-page":"433","DOI":"10.3390\/ijms20020433","volume":"20","author":"J Jalanka","year":"2019","unstructured":"Jalanka J, Major G, Murray K et al. The Effect of Psyllium Husk on Intestinal Microbiota in Constipated Patients and Healthy Controls. Int J Mol Sci 2019;20:433. https:\/\/doi.org\/10.3390\/ijms20020433.","journal-title":"Int J Mol Sci"},{"key":"9228_CR32","doi-asserted-by":"publisher","first-page":"e1801187","DOI":"10.1002\/mnfr.201801187","volume":"63","author":"M Zhuang","year":"2019","unstructured":"Zhuang M, Shang W, Ma Q et al. Abundance of Probiotics and Butyrate-Production Microbiome Manages Constipation via Short-Chain Fatty Acids Production and Hormones Secretion. Mol Nutr Food Res 2019;63:e1801187. https:\/\/doi.org\/10.1002\/mnfr.201801187.","journal-title":"Mol Nutr Food Res"},{"key":"9228_CR33","doi-asserted-by":"publisher","first-page":"1117905","DOI":"10.3389\/fmicb.2023.1117905","volume":"9","author":"L Wang","year":"2023","unstructured":"Wang L, Lv WQ, Yang JT et al. Enteric nervous system damage caused by abnormal intestinal butyrate metabolism may lead to functional constipation. Front Microbiol 2023;9:1117905. https:\/\/doi.org\/10.3389\/fmicb.2023.1117905.","journal-title":"Front Microbiol"},{"key":"9228_CR34","doi-asserted-by":"publisher","first-page":"242","DOI":"10.1111\/j.1758-2229.2012.00327.x","volume":"4","author":"A Durb\u00e1n","year":"2012","unstructured":"Durb\u00e1n A, Abell\u00e1n JJ, Jim\u00e9nez-Hern\u00e1ndez N et al. Structural alterations of faecal and mucosa-associated bacterial communities in irritable bowel syndrome. Environ Microbiol Rep 2012;4:242\u2013247.","journal-title":"Environ Microbiol Rep"},{"key":"9228_CR35","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1038\/nrmicro3161","volume":"12","author":"TJ Foster","year":"2014","unstructured":"Foster TJ, Geoghegan JA, Ganesh VK et al. Adhesion, invasion and evasion: the many functions of the surface proteins of Staphylococcus aureus. Nat Rev Microbiol 2014;12:49\u201362.","journal-title":"Nat Rev Microbiol"},{"key":"9228_CR36","doi-asserted-by":"publisher","first-page":"eaat9076","DOI":"10.1126\/science.aat9076","volume":"362","author":"Y Litvak","year":"2018","unstructured":"Litvak Y, Byndloss MX, B\u00e4umler AJ. Colonocyte metabolism shapes the gut microbiota. Science 2018;362:eaat9076. https:\/\/doi.org\/10.1126\/science.aat9076.","journal-title":"Science"},{"key":"9228_CR37","doi-asserted-by":"publisher","first-page":"1761","DOI":"10.2337\/db06-1491","volume":"56","author":"PD Cani","year":"2007","unstructured":"Cani PD, Amar J, Iglesias MA et al. Metabolic endotoxemia initiates obesity and insulin resistance. Diabetes 2007;56:1761\u20131772.","journal-title":"Diabetes"},{"key":"9228_CR38","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1016\/j.atherosclerosis.2018.12.021","volume":"281","author":"K Sumida","year":"2019","unstructured":"Sumida K, Molnar MZ, Potukuchi PK et al. Constipation and risk of death and cardiovascular events. Atherosclerosis 2019;281:114\u2013120.","journal-title":"Atherosclerosis"},{"key":"9228_CR39","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1016\/j.puhe.2023.05.019","volume":"221","author":"Y Shimizu","year":"2023","unstructured":"Shimizu Y, Inoue M, Yasuda N et al. Bowel movement frequency, stool consistency, and risk of disabling dementia: A population-based cohort study in Japan. Public Health 2023;221:31\u201338.","journal-title":"Public Health"},{"key":"9228_CR40","doi-asserted-by":"publisher","first-page":"1964","DOI":"10.1111\/cns.13940","volume":"28","author":"T Nakase","year":"2022","unstructured":"Nakase T, Tatewaki Y, Thyreau B et al. Impact of constipation on progression of Alzheimer\u2019s disease: A retrospective study. CNS Neurosci Ther 2022;28:1964\u20131973.","journal-title":"CNS Neurosci Ther"},{"key":"9228_CR41","first-page":"358","volume":"58","author":"M Kato","year":"2023","unstructured":"Kato M, Hosoe N, Gotoda T et al. Treatment with vonoprazan for 3 weeks is not inferior to 8 weeks for the management of gastric ESD: A multicenter noninferiority randomized study. J Gastroenterol 2023;58:358\u2013366.","journal-title":"J Gastroenterol"},{"key":"9228_CR42","doi-asserted-by":"publisher","first-page":"386","DOI":"10.1159\/000507807","volume":"102","author":"T Ishida","year":"2021","unstructured":"Ishida T, Dohi O, Yamada S et al. Clinical outcomes of vonoprazan-treated patients after endoscopic submucosal dissection for gastric neoplasms: A prospective multicenter observation study. Digestion 2021;102:386\u2013396.","journal-title":"Digestion"}],"updated-by":[{"DOI":"10.1007\/s10620-026-09810-z","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:00Z","timestamp":1773878400000}}],"container-title":["Digestive Diseases and Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10620-025-09228-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10620-025-09228-z","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10620-025-09228-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T04:55:58Z","timestamp":1773896158000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10620-025-09228-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,24]]},"references-count":42,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["9228"],"URL":"https:\/\/doi.org\/10.1007\/s10620-025-09228-z","relation":{},"ISSN":["0163-2116","1573-2568"],"issn-type":[{"value":"0163-2116","type":"print"},{"value":"1573-2568","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,24]]},"assertion":[{"value":"15 February 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 June 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 July 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 March 2026","order":5,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Update","order":6,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The original online version of this article was revised to update Figure 2.","order":7,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 March 2026","order":8,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Correction","order":9,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"A Correction to this paper has been published:","order":10,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"https:\/\/doi.org\/10.1007\/s10620-026-09810-z","URL":"https:\/\/doi.org\/10.1007\/s10620-026-09810-z","order":11,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Tomohisa Takagi received collaborative research funds from Fujifilm Medical Co., Ltd. and lecture fees from Mochida Pharmaceutical Co., Ltd. and Janssen Pharmaceutical K.K. Yuji Naito received scholarship funds from EA Pharma Co., Ltd, collaboration research funds from Taiyo Kagaku Co., Ltd, and lecture fees from Mylan EPD Kft, Takeda Pharmaceutical Co., Ltd, Mochida Pharmaceutical Co., Ltd, EA Pharma Co., Ltd, Otsuka Pharmaceutical Co., Ltd, and Miyarisan Pharmaceutical Co., Ltd. Yoshito Itoh is affiliated to a department funded by donations from Nichinichi Pharmaceutical Co., Ltd. Neither the funding agencies nor any outside organizations participated in the study design nor had any competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}