{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T10:57:01Z","timestamp":1785322621985,"version":"3.55.0"},"reference-count":41,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2024,2,21]],"date-time":"2024-02-21T00:00:00Z","timestamp":1708473600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,2,21]],"date-time":"2024-02-21T00:00:00Z","timestamp":1708473600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Dipro Medical Research Fund","award":["DiPRO\/2021\/11\/H311"],"award-info":[{"award-number":["DiPRO\/2021\/11\/H311"]}]},{"name":"Scientific Research Project of Sichuan Maternal and Child Health Care Association","award":["22FXYB15"],"award-info":[{"award-number":["22FXYB15"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Braz J Microbiol"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Functional constipation (FC) can seriously affect the physical and mental health of children. The goal of this study is to assess the efficacy and safety of <jats:italic>Bifidobacterium animalis<\/jats:italic> subsp. <jats:italic>lactis<\/jats:italic> XLTG11 in treating FC in children through a randomized, double-blinded, placebo-controlled approach. Eligible children were randomized into either the intervention group (IG, <jats:italic>n<\/jats:italic>\u2009=\u200965, receiving conventional treatment with probiotics) or the control group (CG, <jats:italic>n<\/jats:italic>\u2009=\u200966, receiving conventional treatment without probiotics). The primary outcome measure was fecal frequency. Fecal gut microbiota analysis and PICRUSt (Phylogenetic Investigation of Communities by Reconstruction of Unobserved States) were used to predict gene family abundances based on 16S information. Over the course of treatment, the weekly frequency of feces within each group increased significantly (<jats:italic>F<\/jats:italic>\u2009=\u200941.97, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). The frequency of feces (times\/week (t\/w)) in the IG was significantly higher than that in the CG (3.69\u2009\u00b1\u20092.62 t\/w vs.3.18\u2009\u00b1\u20091.43 t\/w, 4.03\u2009\u00b1\u20092.54 t\/w vs. 2.89\u2009\u00b1\u20091.39 t\/w and 3.74\u2009\u00b1\u20092.36 t\/w vs. 2.94\u2009\u00b1\u20091.18 t\/w and 3.45\u2009\u00b1\u20091.98 vs. 3.17\u2009\u00b1\u20091.41 t\/w for the 1st, 2nd, 3rd, and 4th week after intervention, respectively) (<jats:italic>F<\/jats:italic>\u2009=\u20097.60, <jats:italic>p<\/jats:italic>\u2009=\u20090.0067). After the intervention, dominate species shifted to <jats:italic>Bifidobacterium longum<\/jats:italic>, <jats:italic>Bifidobacterium breve<\/jats:italic>, and <jats:italic>Escherichia coli<\/jats:italic> in the IG. Additionally, genes related to short-chain fatty acid (SCF) metabolism were upregulated, while methane metabolism was downregulated. Administration of XLTG11 at a dose of 1\u2009\u00d7\u200910<jats:sup>10<\/jats:sup>\u00a0CFU\/day to children increased fecal frequency, induced beneficial changes in gut microbiota, and regulated SCFs and methane metabolism\u2013related genes.<\/jats:p>","DOI":"10.1007\/s42770-024-01276-3","type":"journal-article","created":{"date-parts":[[2024,2,21]],"date-time":"2024-02-21T08:03:52Z","timestamp":1708502632000},"page":"1317-1330","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Adjunctive efficacy of Bifidobacterium animalis subsp. lactis XLTG11 for functional constipation in children"],"prefix":"10.1007","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7216-3165","authenticated-orcid":false,"given":"Ke","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zengyuan","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Nie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanmei","family":"Cao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qinghua","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Shen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiwei","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanshan","family":"Jin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changqi","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,2,21]]},"reference":[{"issue":"2","key":"1276_CR1","doi-asserted-by":"publisher","first-page":"63","DOI":"10.11622\/smedj.2020014","volume":"61","author":"JMD Ho","year":"2020","unstructured":"Ho JMD, How CH (2020) Chronic constipation in infants and children. Singapore Med J 61(2):63\u201368","journal-title":"Singapore Med J"},{"issue":"1","key":"1276_CR2","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1186\/s12887-021-02610-6","volume":"21","author":"Y Huang","year":"2021","unstructured":"Huang Y, Tan SY, Parikh P et al (2021) Prevalence of functional gastrointestinal disorders in infants and young children in China. BMC Pediatr 21(1):131","journal-title":"BMC Pediatr"},{"key":"1276_CR3","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1016\/j.jpeds.2019.06.059","volume":"214","author":"MH Vriesman","year":"2019","unstructured":"Vriesman MH, Rajindrajith S, Koppen IJN et al (2019) Quality of life in children with functional constipation: a systematic review and meta-analysis. J Pediatr 214:141\u201350","journal-title":"J Pediatr"},{"issue":"6","key":"1276_CR4","doi-asserted-by":"publisher","first-page":"465","DOI":"10.5152\/tjg.2017.17216","volume":"28","author":"Y \u00c7a\u011fan Appak","year":"2017","unstructured":"\u00c7a\u011fan Appak Y, Yalin Sapmaz \u015e, Do\u011fan G et al (2017) Clinical findings, child and mother psychosocial status in functional constipation. Turkish J Gastroenterol Off J Turkish Soc Gastroenterol 28(6):465\u2013470","journal-title":"Turkish J Gastroenterol Off J Turkish Soc Gastroenterol"},{"issue":"5","key":"1276_CR5","doi-asserted-by":"publisher","first-page":"1232","DOI":"10.1053\/j.gastro.2019.12.034","volume":"158","author":"AE Bharucha","year":"2020","unstructured":"Bharucha AE, Lacy BE (2020) Mechanisms, evaluation, and management of chronic constipation. Gastroenterology 158(5):1232\u201349.e3","journal-title":"Gastroenterology"},{"issue":"3","key":"1276_CR6","doi-asserted-by":"publisher","first-page":"484","DOI":"10.3945\/an.116.014407","volume":"8","author":"E Dimidi","year":"2017","unstructured":"Dimidi E, Christodoulides S, Scott SM et al (2017) Mechanisms of action of probiotics and the gastrointestinal microbiota on gut motility and constipation. Advances in nutrition (Bethesda, Md) 8(3):484\u2013494","journal-title":"Advances in nutrition (Bethesda, Md)"},{"key":"1276_CR7","doi-asserted-by":"crossref","unstructured":"Pan R, Wang L, Xu X et al (2022) Crosstalk between the gut microbiome and colonic motility in chronic constipation: potential mechanisms and microbiota modulation. Nutrients 14(18):3407","DOI":"10.3390\/nu14183704"},{"issue":"9","key":"1276_CR8","doi-asserted-by":"publisher","first-page":"435","DOI":"10.1111\/1751-2980.12797","volume":"20","author":"CJ Martoni","year":"2019","unstructured":"Martoni CJ, Evans M, Chow CT et al (2019) Impact of a probiotic product on bowel habits and microbial profile in participants with functional constipation: a randomized controlled trial. J Dig Dis 20(9):435\u2013446","journal-title":"J Dig Dis"},{"issue":"3","key":"1276_CR9","doi-asserted-by":"publisher","first-page":"228","DOI":"10.1001\/jamapediatrics.2013.4367","volume":"168","author":"F Indrio","year":"2014","unstructured":"Indrio F, Di Mauro A, Riezzo G et al (2014) Prophylactic use of a probiotic in the prevention of colic, regurgitation, and functional constipation: a randomized clinical trial. JAMA Pediatr 168(3):228\u2013233","journal-title":"JAMA Pediatr"},{"issue":"1","key":"1276_CR10","doi-asserted-by":"publisher","first-page":"e0210064","DOI":"10.1371\/journal.pone.0210064","volume":"14","author":"MR Sanctuary","year":"2019","unstructured":"Sanctuary MR, Kain JN, Chen SY et al (2019) Pilot study of probiotic\/colostrum supplementation on gut function in children with autism and gastrointestinal symptoms. PLoS One 14(1):e0210064","journal-title":"PLoS ONE"},{"key":"1276_CR11","doi-asserted-by":"crossref","unstructured":"Kubota M, Ito K, Tomimoto K et al (2020) Lactobacillus reuteri DSM 17938 and magnesium oxide in children with functional chronic constipation: a double-blind and randomized clinical trial. Nutrients 12(1):225","DOI":"10.3390\/nu12010225"},{"key":"1276_CR12","doi-asserted-by":"crossref","unstructured":"Mcfarland LV, Evans CT, Goldstein EJC (2018) Strain-specificity and disease-specificity of probiotic efficacy: a systematic review and meta-analysis. Front Med 5:124","DOI":"10.3389\/fmed.2018.00124"},{"key":"1276_CR13","doi-asserted-by":"crossref","unstructured":"Chapman C M C, Gibson G R, Rowland I (2011) Health benefits of probiotics: are mixtures more effective than single strains? Eur J Nutr 50(1):1\u201317","DOI":"10.1007\/s00394-010-0166-z"},{"issue":"1","key":"1276_CR14","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1111\/j.1574-6968.2008.01211.x","volume":"285","author":"MC Collado","year":"2008","unstructured":"Collado MC, Isolauri E, Salminen S (2008) Specific probiotic strains and their combinations counteract adhesion of Enterobacter sakazakii to intestinal mucus. FEMS Microbiol Lett 285(1):58\u201364","journal-title":"FEMS Microbiol Lett"},{"issue":"4","key":"1276_CR15","doi-asserted-by":"publisher","first-page":"409","DOI":"10.4168\/aair.2015.7.4.409","volume":"7","author":"L Drago","year":"2015","unstructured":"Drago L, De Vecchi E, Gabrieli A et al (2015) Immunomodulatory effects of Lactobacillus salivarius LS01 and Bifidobacterium breve BR03, alone and in combination, on peripheral blood mononuclear cells of allergic asthmatics. Allergy Asthma Immunol Res 7(4):409\u2013413","journal-title":"Allergy Asthma Immunol Res"},{"issue":"2","key":"1276_CR16","doi-asserted-by":"publisher","first-page":"455","DOI":"10.1111\/j.1574-6968.1997.tb12610.x","volume":"153","author":"L Drago","year":"1997","unstructured":"Drago L, Gismondo MR, Lombardi A et al (1997) Inhibition of in vitro growth of enteropathogens by new Lactobacillus isolates of human intestinal origin. FEMS Microbiol Lett 153(2):455\u2013463","journal-title":"FEMS Microbiol Lett"},{"issue":"3","key":"1276_CR17","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1080\/19490976.2017.1412908","volume":"9","author":"A Ibarra","year":"2018","unstructured":"Ibarra A, Latreille-Barbier M, Donazzolo Y et al (2018) Effects of 28-day Bifidobacterium animalis subsp. lactis HN019 supplementation on colonic transit time and gastrointestinal symptoms in adults with functional constipation: a double-blind, randomized, placebo-controlled, and dose-ranging trial. Gut Microbes 9(3):236\u201351","journal-title":"Gut Microbes"},{"issue":"1","key":"1276_CR18","doi-asserted-by":"publisher","first-page":"31","DOI":"10.3920\/BM2020.0023","volume":"12","author":"R Wang","year":"2021","unstructured":"Wang R, Sun J, Li G et al (2021) Effect of Bifidobacterium animalis subsp. lactis MN-Gup on constipation and the composition of gut microbiota. Benefic Microbes 12(1):31\u201342","journal-title":"Benefic Microbes"},{"issue":"1","key":"1276_CR19","first-page":"16","volume":"38","author":"JA De Paula","year":"2008","unstructured":"De Paula JA, Carmuega E, Weill R (2008) Effect of the ingestion of a symbiotic yogurt on the bowel habits of women with functional constipation. Acta Gastroenterol Latinoam 38(1):16\u201325","journal-title":"Acta Gastroenterol Latinoam"},{"key":"1276_CR20","unstructured":"Hyams JS, Di Lorenzo C, Saps M et al (2016) Functional disorders: children and adolescents. Gastroenterology S0016-5085(16):00181\u201300185"},{"issue":"5","key":"1276_CR21","first-page":"469","volume":"105","author":"E Mulhem","year":"2022","unstructured":"Mulhem E, Khondoker F, Kandiah S (2022) Constipation in children and adolescents: evaluation and treatment. Am Fam Physician 105(5):469\u2013478","journal-title":"Am Fam Physician"},{"issue":"2","key":"1276_CR22","doi-asserted-by":"publisher","first-page":"258","DOI":"10.1097\/MPG.0000000000000266","volume":"58","author":"MM Tabbers","year":"2014","unstructured":"Tabbers MM, Dilorenzo C, Berger MY et al (2014) Evaluation and treatment of functional constipation in infants and children: evidence-based recommendations from ESPGHAN and NASPGHAN. J Pediatr Gastroenterol Nutr 58(2):258\u2013274","journal-title":"J Pediatr Gastroenterol Nutr"},{"issue":"10","key":"1276_CR23","doi-asserted-by":"publisher","first-page":"996","DOI":"10.1038\/nmeth.2604","volume":"10","author":"RC Edgar","year":"2013","unstructured":"Edgar RC (2013) UPARSE: highly accurate OTU sequences from microbial amplicon reads. Nat Methods 10(10):996\u2013998","journal-title":"Nat Methods"},{"key":"1276_CR24","doi-asserted-by":"crossref","unstructured":"Kuczynski J, Stombaugh J, Walters WA et al (2012) Using QIIME to analyze 16S rRNA gene sequences from microbial communities. Curr Protoc Microbiol Chapter 1:Unit 1E.5","DOI":"10.1002\/9780471729259.mc01e05s27"},{"issue":"3","key":"1276_CR25","doi-asserted-by":"publisher","first-page":"239","DOI":"10.4161\/rna.28306","volume":"11","author":"JR Cole","year":"2014","unstructured":"Cole JR, Tiedje JM (2014) History and impact of RDP: a legacy from Carl Woese to microbiology. RNA Biol 11(3):239\u2013243","journal-title":"RNA Biol"},{"issue":"9","key":"1276_CR26","doi-asserted-by":"publisher","first-page":"814","DOI":"10.1038\/nbt.2676","volume":"31","author":"MG Langille","year":"2013","unstructured":"Langille MG, Zaneveld J, Caporaso JG et al (2013) Predictive functional profiling of microbial communities using 16S rRNA marker gene sequences. Nat Biotechnol 31(9):814\u2013821","journal-title":"Nat Biotechnol"},{"key":"1276_CR27","doi-asserted-by":"crossref","unstructured":"Wang N, Wang S, Xu B et al (2021) Alleviation effects of Bifidobacterium animalis subsp. lactis XLTG11 on dextran sulfate sodium-induced colitis in mice. Microorganisms 9(10):2093","DOI":"10.3390\/microorganisms9102093"},{"issue":"11","key":"1276_CR28","doi-asserted-by":"publisher","first-page":"6404","DOI":"10.1039\/D1FO04305F","volume":"13","author":"B Xu","year":"2022","unstructured":"Xu B, Liang S, Zhao J et al (2022) subsp XLTG11 improves antibiotic-related diarrhea by alleviating inflammation, enhancing intestinal barrier function and regulating intestinal flora. Food Funct 13(11):6404\u201318","journal-title":"Food Funct"},{"issue":"13","key":"1276_CR29","first-page":"103","volume":"48","author":"W Ma","year":"2022","unstructured":"Ma W, Li W, Ma Q et al (2022) Effects of Bifidobacterium lactis XLTG11 on immune function in mice. Food Fermentation Ind 48(13):103\u2013107","journal-title":"Food Fermentation Ind"},{"issue":"06","key":"1276_CR30","first-page":"610","volume":"23","author":"Xu Du Juan","year":"2021","unstructured":"Du Juan Xu, Li M-N et al (2021) Effects of Bifidobacterium lactis Bb12 in the adjuvant treatment of functional constipation in children. Mil Med J Southeast China 23(06):610\u2013613","journal-title":"Mil Med J Southeast China"},{"issue":"3","key":"1276_CR31","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1080\/17474124.2020.1733974","volume":"14","author":"BR Southwell","year":"2020","unstructured":"Southwell BR (2020) Treatment of childhood constipation: a synthesis of systematic reviews and meta-analyses. Expert Rev Gastroenterol Hepatol 14(3):163\u2013174","journal-title":"Expert Rev Gastroenterol Hepatol"},{"issue":"03","key":"1276_CR32","first-page":"174","volume":"2","author":"J Wang","year":"2014","unstructured":"Wang J, Chen T, Li F et al (2014) Efficacy of probiotic supplementation for treatment of functional constipation in children and adolescents: Meta-analysis. J Bio- education 2(03):174\u2013179","journal-title":"J Bio- education"},{"issue":"1","key":"1276_CR33","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1111\/apt.15561","volume":"51","author":"R Nocerino","year":"2020","unstructured":"Nocerino R, De Filippis F, Cecere G et al (2020) The therapeutic efficacy of Bifidobacterium animalis subsp. lactis BB-12 in infant colic: a randomised, double blind, placebo-controlled trial. Aliment Pharmacol Ther 51(1):110\u201320","journal-title":"Aliment Pharmacol Ther"},{"key":"1276_CR34","doi-asserted-by":"crossref","unstructured":"Merenstein D, Fraser CM, Roberts RF et al (2021) subsp. BB-12 protects against antibiotic-induced functional and compositional changes in human fecal microbiome. Nutrients 13(8):2814","DOI":"10.3390\/nu13082814"},{"issue":"2","key":"1276_CR35","doi-asserted-by":"publisher","first-page":"e0085921","DOI":"10.1128\/Spectrum.00859-21","volume":"9","author":"A Liu","year":"2021","unstructured":"Liu A, Ma T, Xu N et al (2021) Adjunctive probiotics alleviates asthmatic symptoms via modulating the gut microbiome and serum metabolome. Microbiol Spectr 9(2):e0085921","journal-title":"Microbiol Spectr"},{"key":"1276_CR36","doi-asserted-by":"crossref","unstructured":"Grubb DS, Wrigley SD, Freedman KE et al (2020) PHAGE-2 study: supplemental bacteriophages extend subsp. BL04 benefits on gut health and microbiota in healthy adults. Nutrients 12(8):2474","DOI":"10.3390\/nu12082474"},{"issue":"5","key":"1276_CR37","doi-asserted-by":"publisher","first-page":"392","DOI":"10.1093\/gastro\/goab035","volume":"9","author":"S Zhang","year":"2021","unstructured":"Zhang S, Wang R, Li D et al (2021) Role of gut microbiota in functional constipation. Gastroenterol Rep 9(5):392\u2013401","journal-title":"Gastroenterol Rep"},{"key":"1276_CR38","doi-asserted-by":"publisher","first-page":"790561","DOI":"10.3389\/fnut.2021.790561","volume":"8","author":"J Cheng","year":"2021","unstructured":"Cheng J, Laitila A, Ouwehand AC (2021) Bifidobacterium animalis subsp lactis HN019 effects on gut health: a review. Front Nutr 8:790561","journal-title":"Front Nutr"},{"key":"1276_CR39","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1038\/msb4100166","volume":"3","author":"SV Rajagopala","year":"2007","unstructured":"Rajagopala SV, Titz B, Goll J et al (2007) The protein network of bacterial motility. Mol Syst Biol 3:128","journal-title":"Mol Syst Biol"},{"issue":"1","key":"1276_CR40","doi-asserted-by":"publisher","first-page":"1834","DOI":"10.1038\/s41598-017-02079-3","volume":"7","author":"NN Al-Hebshi","year":"2017","unstructured":"Al-Hebshi NN, Nasher AT, Maryoud MY et al (2017) Inflammatory bacteriome featuring Fusobacterium nucleatum and Pseudomonas aeruginosa identified in association with oral squamous cell carcinoma. Sci Rep 7(1):1834","journal-title":"Sci Rep"},{"issue":"5","key":"1276_CR41","first-page":"e4764","volume":"11","author":"SH Bin Waqar","year":"2019","unstructured":"Bin Waqar SH, Rehan A (2019) Methane and constipation-predominant irritable bowel syndrome: entwining pillars of emerging neurogastroenterology. Cureus 11(5):e4764","journal-title":"Cureus"}],"container-title":["Brazilian Journal of Microbiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s42770-024-01276-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s42770-024-01276-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s42770-024-01276-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,6]],"date-time":"2024-06-06T02:08:57Z","timestamp":1717639737000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s42770-024-01276-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,21]]},"references-count":41,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,6]]}},"alternative-id":["1276"],"URL":"https:\/\/doi.org\/10.1007\/s42770-024-01276-3","relation":{},"ISSN":["1517-8382","1678-4405"],"issn-type":[{"value":"1517-8382","type":"print"},{"value":"1678-4405","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,21]]},"assertion":[{"value":"12 August 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 February 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 February 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 competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}