{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T22:08:01Z","timestamp":1757628481910,"version":"3.44.0"},"reference-count":46,"publisher":"Springer Science and Business Media LLC","issue":"9","license":[{"start":{"date-parts":[[2025,5,12]],"date-time":"2025-05-12T00:00:00Z","timestamp":1747008000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2025,5,12]],"date-time":"2025-05-12T00:00:00Z","timestamp":1747008000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["2021R1A2C2008439","2021R1A2C2008439","2021R1A2C2008439","2021R1A2C2008439"],"award-info":[{"award-number":["2021R1A2C2008439","2021R1A2C2008439","2021R1A2C2008439","2021R1A2C2008439"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003645","name":"National Cancer Center","doi-asserted-by":"publisher","award":["2310470","2210990","2210990"],"award-info":[{"award-number":["2310470","2210990","2210990"]}],"id":[{"id":"10.13039\/501100003645","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Clin Nutr"],"published-print":{"date-parts":[[2025,9]]},"DOI":"10.1038\/s41430-025-01612-2","type":"journal-article","created":{"date-parts":[[2025,5,12]],"date-time":"2025-05-12T03:59:59Z","timestamp":1747022399000},"page":"921-927","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The association of diet-dependent acid load with gastrointestinal cancer risk in the Cancer Screenee Cohort in Korea"],"prefix":"10.1038","volume":"79","author":[{"given":"Tao","family":"Thi Tran","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Madhawa","family":"Gunathilake","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeonghee","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0889-2686","authenticated-orcid":false,"given":"Jeongseon","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,5,12]]},"reference":[{"key":"1612_CR1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2022.942035","volume":"12","author":"MZ Hong","year":"2022","unstructured":"Hong MZ, Li JM, Chen ZJ, Lin XY, Pan JS, Gong LL. Global burden of major gastrointestinal cancers and its association with socioeconomics, 1990\u20132019. Front Oncol. 2022;12:942035.","journal-title":"Front Oncol"},{"key":"1612_CR2","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1038\/s41575-022-00726-3","volume":"20","author":"J Huang","year":"2023","unstructured":"Huang J, Lucero-Prisno DE, Zhang L, Xu W, Wong SH, Ng SC, et al. Updated epidemiology of gastrointestinal cancers in East Asia. Nat Rev Gstroentarol Hepatol. 2023;20:271\u201387.","journal-title":"Nat Rev Gstroentarol Hepatol"},{"key":"1612_CR3","doi-asserted-by":"publisher","DOI":"10.1038\/s41419-021-03929-9","volume":"12","author":"R Imbroisi Filho","year":"2021","unstructured":"Imbroisi Filho R, Ochioni AC, Esteves AM, Leandro JGB, Demaria TM, Sola-Penna M, et al. Western diet leads to aging-related tumorigenesis via activation of the inflammatory, UPR, and EMT pathways. Cell Death Dis. 2021;12:643.","journal-title":"Cell Death Dis"},{"key":"1612_CR4","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1186\/1743-7075-9-72","volume":"9","author":"IF Robey","year":"2012","unstructured":"Robey IF. Examining the relationship between diet-induced acidosis and cancer. Nutr Metab. 2012;9:72.","journal-title":"Nutr Metab"},{"doi-asserted-by":"crossref","unstructured":"Carnauba RA, Baptistella AB, Paschoal V, H\u00fcbscher GH. Diet-induced low-grade metabolic acidosis and clinical outcomes: a review. Nutrients. 2017;9:538.","key":"1612_CR5","DOI":"10.3390\/nu9060538"},{"key":"1612_CR6","doi-asserted-by":"publisher","DOI":"10.1186\/s12937-020-00653-6","volume":"19","author":"KW Lee","year":"2020","unstructured":"Lee KW, Shin D. Positive association between dietary acid load and future insulin resistance risk: findings from the Korean Genome and Epidemiology Study. Nutr J. 2020;19:137.","journal-title":"Nutr J"},{"key":"1612_CR7","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1016\/j.nefro.2018.10.005","volume":"39","author":"IA Osuna-Padilla","year":"2019","unstructured":"Osuna-Padilla IA, Leal-Escobar G, Garza-Garc\u00eda CA, Rodr\u00edguez-Castellanos FE. Dietary acid load: mechanisms and evidence of its health repercussions. Nefrologia. 2019;39:343\u201354.","journal-title":"Nefrologia"},{"key":"1612_CR8","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1053\/j.jrn.2016.11.006","volume":"27","author":"C Passey","year":"2017","unstructured":"Passey C. Reducing the dietary acid load: how a more alkaline diet benefits patients with chronic kidney disease. J Ren Nutr. 2017;27:151\u201360.","journal-title":"J Ren Nutr"},{"key":"1612_CR9","doi-asserted-by":"publisher","first-page":"4474","DOI":"10.1017\/S1368980020003420","volume":"24","author":"S Jafari Nasab","year":"2021","unstructured":"Jafari Nasab S, Rafiee P, Bahrami A, Rezaeimanesh N, Rashidkhani B, Sohrab G, et al. Diet-dependent acid load and the risk of colorectal cancer and adenoma: a case\u2013control study. Public Health Nutr. 2021;24:4474\u201381.","journal-title":"Public Health Nutr"},{"doi-asserted-by":"crossref","unstructured":"Herter J, Lederer AK, Ronco AL, Hannibal L, Huber R, Storz MA. Dietary acid load correlates with serum amino acid concentrations after a four-week intervention with vegan vs. meat-rich diets: a secondary data analysis. Nutrients. 2023;15:2942.","key":"1612_CR10","DOI":"10.3390\/nu15132942"},{"key":"1612_CR11","volume":"7","author":"A Ronco","year":"2020","unstructured":"Ronco A, Mart\u00ednez-L\u00f3pez W, Calder\u00f3n J, Mendoza B. Dietary acid load and colorectal cancer risk: a case-control study. World Cancer Res J. 2020;7:e1750.","journal-title":"World Cancer Res J"},{"doi-asserted-by":"crossref","unstructured":"Tran TT, Gunathilake M, Lee J, Oh JH, Chang HJ, Sohn DK, et al. The association of diet-dependent acid load with colorectal cancer risk: a case\u2013control study in Korea. Br J Nutr. 2023;131:333\u201342.","key":"1612_CR12","DOI":"10.1017\/S0007114523001691"},{"key":"1612_CR13","volume":"9","author":"A Ronco","year":"2022","unstructured":"Ronco A, Mart\u00ednez-L\u00f3pez W, Calder\u00f3n J, Mendoza B, Storz MA. Dietary acid load and risk of gastric cancer: a case-control study. World Cancer Res J. 2022;9:e2403.","journal-title":"World Cancer Res J"},{"key":"1612_CR14","first-page":"100382","volume":"28","author":"AL Ronco","year":"2021","unstructured":"Ronco AL, Mart\u00ednez-L\u00f3pez W, Calder\u00f3n JM, Golomar W. Dietary acid load and lung cancer risk: a case-control study in men. Cancer Treat Res Commun. 2021;28:100382.","journal-title":"Cancer Treat Res Commun"},{"unstructured":"Ronco A, Storz M, Mart\u00ednez-L\u00f3pez W, Calderon J, Golomar W. Dietary acid load and bladder cancer risk. An epidemiologic case-control study. Multidiscip Cancer Investig. 2022;15:3098.","key":"1612_CR15"},{"key":"1612_CR16","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1002\/osi2.1150","volume":"20","author":"AL Ronco","year":"2023","unstructured":"Ronco AL, Mart\u00ednez-L\u00f3pez W, Calder\u00f3n JM, Storz MA. Dietary acid load and risk of head and neck and oral cavity cancers: an epidemiologic study. Oral Sci Int. 2023;20:78\u20137.","journal-title":"Oral Sci Int"},{"key":"1612_CR17","doi-asserted-by":"publisher","first-page":"2759","DOI":"10.1111\/1759-7714.14612","volume":"13","author":"AL Ronco","year":"2022","unstructured":"Ronco AL, Mart\u00ednez-L\u00f3pez W, Calder\u00f3n JM, Storz MA. Dietary acid load and esophageal cancer risk: a case-control study. Thoracic Cancer. 2022;13:2759\u201366.","journal-title":"Thoracic Cancer"},{"key":"1612_CR18","doi-asserted-by":"publisher","first-page":"1834","DOI":"10.1002\/ijc.31889","volume":"144","author":"Y-MM Park","year":"2019","unstructured":"Park Y-MM, Steck SE, Fung TT, Merchant AT, Elizabeth Hodgson M, Keller JA, et al. Higher diet-dependent acid load is associated with risk of breast cancer: findings from the sister study. Int J Cancer. 2019;144:1834\u201343.","journal-title":"Int J Cancer"},{"key":"1612_CR19","doi-asserted-by":"publisher","first-page":"1009","DOI":"10.1158\/1055-9965.EPI-20-1293","volume":"30","author":"LW Shi","year":"2021","unstructured":"Shi LW, Wu YL, Hu JJ, Yang PF, Sun WP, Gao J, et al. Dietary acid load and the risk of pancreatic cancer: a prospective cohort study. Cancer Epidemiol Biomark Prev. 2021;30:1009\u201319.","journal-title":"Cancer Epidemiol Biomark Prev"},{"key":"1612_CR20","first-page":"1117","volume":"16","author":"ME Wright","year":"2005","unstructured":"Wright ME, Michaud DS, Pietinen P, Taylor PR, Virtamo J, Albanes D. Estimated urine pH and bladder cancer risk in a cohort of male smokers (Finland). Cancer Causes Control. 2005;16:1117\u201323.","journal-title":"Cancer Causes Control"},{"key":"1612_CR21","first-page":"e1687","volume":"7","author":"A Ronco","year":"2021","unstructured":"Ronco A, Mart\u00ednez-L\u00f3pez W, Calderon J, Golomar W, Storz M. Dietary acid load and risk of kidney cancer: an epidemiologic case-control study. World Cancer Res J. 2021;7:e1687.","journal-title":"World Cancer Res J"},{"key":"1612_CR22","first-page":"440","volume":"13","author":"FK Tabung","year":"2017","unstructured":"Tabung FK, Brown LS, Fung TT. Dietary patterns and colorectal cancer risk: a review of 17 years of evidence (2000-2016). Curr Colorectal Cancer Rep. 2017;13:440\u201354.","journal-title":"Curr Colorectal Cancer Rep"},{"key":"1612_CR23","doi-asserted-by":"publisher","first-page":"e2014013","DOI":"10.4178\/epih\/e2014013","volume":"36","author":"J Kim","year":"2014","unstructured":"Kim J. Cancer screenee cohort study of the National Cancer Center in South Korea. Epidemiol Health. 2014;36:e2014013.","journal-title":"Epidemiol Health"},{"key":"1612_CR24","doi-asserted-by":"publisher","first-page":"1356","DOI":"10.1093\/ajcn\/59.6.1356","volume":"59","author":"T Remer","year":"1994","unstructured":"Remer T, Manz F. Estimation of the renal net acid excretion by adults consuming diets containing variable amounts of protein. Am J Clin Nutr. 1994;59:1356\u201361.","journal-title":"Am J Clin Nutr"},{"key":"1612_CR25","doi-asserted-by":"publisher","first-page":"576","DOI":"10.1093\/ajcn\/68.3.576","volume":"68","author":"LA Frassetto","year":"1998","unstructured":"Frassetto LA, Todd KM, Morris RC Jr, Sebastian A. Estimation of net endogenous noncarbonic acid production in humans from diet potassium and protein contents. Am J Clin Nutr. 1998;68:576\u201383.","journal-title":"Am J Clin Nutr"},{"key":"1612_CR26","doi-asserted-by":"publisher","first-page":"1435","DOI":"10.1038\/sj.ejcn.1602657","volume":"61","author":"Y Ahn","year":"2007","unstructured":"Ahn Y, Kwon E, Shim JE, Park MK, Joo Y, Kimm K, et al. Validation and reproducibility of food frequency questionnaire for Korean genome epidemiologic study. Eur J Clin Nutr. 2007;61:1435\u201341.","journal-title":"Eur J Clin Nutr"},{"key":"1612_CR27","doi-asserted-by":"publisher","first-page":"e234680","DOI":"10.1001\/jamanetworkopen.2023.4680","volume":"6","author":"S Jun","year":"2023","unstructured":"Jun S, Lee J, Kim J. Association of dietary fiber intake with gastrointestinal tract cancer among Korean adults. JAMA Netw Open. 2023;6:e234680.","journal-title":"JAMA Netw Open"},{"key":"1612_CR28","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1093\/oxfordjournals.aje.a114366","volume":"124","author":"W Willett","year":"1986","unstructured":"Willett W, Stampfer MJ. Total energy intake: implications for epidemiologic analyses. Am J Epidemiol. 1986;124:17\u201327.","journal-title":"Am J Epidemiol"},{"key":"1612_CR29","doi-asserted-by":"publisher","first-page":"1220S","DOI":"10.1093\/ajcn\/65.4.1220S","volume":"65","author":"WC Willett","year":"1997","unstructured":"Willett WC, Howe GR, Kushi LH. Adjustment for total energy intake in epidemiologic studies. Am J Clin Nutr. 1997;65:1220S\u20138S.","journal-title":"Am J Clin Nutr"},{"key":"1612_CR30","doi-asserted-by":"publisher","first-page":"2091","DOI":"10.1002\/fsn3.2825","volume":"10","author":"MA Storz","year":"2022","unstructured":"Storz MA, Ronco AL. Reduced dietary acid load in U.S. vegetarian adults: results from the National Health and Nutrition Examination Survey. Food Sci Nutr. 2022;10:2091\u2013100.","journal-title":"Food Sci Nutr"},{"key":"1612_CR31","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1016\/j.clnesp.2021.05.015","volume":"44","author":"H Kahleova","year":"2021","unstructured":"Kahleova H, McCann J, Alwarith J, Rembert E, Tura A, Holubkov R, et al. A plant-based diet in overweight adults in a 16-week randomized clinical trial: the role of dietary acid load. Clin Nutr Espen. 2021;44:150\u20138.","journal-title":"Clin Nutr Espen"},{"key":"1612_CR32","doi-asserted-by":"publisher","first-page":"308","DOI":"10.1007\/s11130-017-0620-7","volume":"72","author":"K Cosgrove","year":"2017","unstructured":"Cosgrove K, Johnston CS. Examining the impact of adherence to a vegan diet on acid-base balance in healthy adults. Plant Foods Hum Nutr. 2017;72:308\u201313.","journal-title":"Plant Foods Hum Nutr"},{"doi-asserted-by":"crossref","unstructured":"Keramati M, Kheirouri S, Musazadeh V, Alizadeh M. Association of high dietary acid load with the risk of cancer: a systematic review and meta-analysis of observational studies. Front Nutr. 2022:9:816797.","key":"1612_CR33","DOI":"10.3389\/fnut.2022.816797"},{"key":"1612_CR34","first-page":"982769","volume":"2012","author":"V Izadi","year":"2012","unstructured":"Izadi V, Farabad E, Azadbakht L. Serum adiponectin level and different kinds of cancer: a review of recent evidence. ISRN Oncol. 2012;2012:982769.","journal-title":"ISRN Oncol"},{"key":"1612_CR35","doi-asserted-by":"publisher","first-page":"308","DOI":"10.1016\/j.clnesp.2022.01.029","volume":"48","author":"E Hatami","year":"2022","unstructured":"Hatami E, Abbasi K, Salehi-Sahlabadi A, Beigrezaei S, Bahrami A, Ghiasvand R, et al. Dietary acid load and risk of type 2 diabetes mellitus: a case-control study. Clin Nutr ESPEN. 2022;48:308\u201312.","journal-title":"Clin Nutr ESPEN"},{"key":"1612_CR36","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1186\/s13098-019-0447-5","volume":"11","author":"M Abshirini","year":"2019","unstructured":"Abshirini M, Bagheri F, Mahaki B, Siassi F, Koohdani F, Safabakhsh M, et al. The dietary acid load is higher in subjects with prediabetes who are at greater risk of diabetes: a case-control study. Diabetol Metab Syndr. 2019;11:52.","journal-title":"Diabetol Metab Syndr"},{"key":"1612_CR37","doi-asserted-by":"publisher","first-page":"e0188465","DOI":"10.1371\/journal.pone.0188465","volume":"12","author":"H Park","year":"2017","unstructured":"Park H, Cho S, Woo H, Park SK, Shin HR, Chang SH, et al. Fasting glucose and risk of colorectal cancer in the Korean Multi-center Cancer Cohort. PLoS ONE. 2017;12:e0188465.","journal-title":"PLoS ONE"},{"key":"1612_CR38","doi-asserted-by":"publisher","first-page":"1230","DOI":"10.1002\/cncr.34027","volume":"128","author":"TT Tran","year":"2022","unstructured":"Tran TT, Gunathilake M, Lee J, Kim J. Association between metabolic syndrome and its components and incident colorectal cancer in a prospective cohort study. Cancer. 2022;128:1230\u201341.","journal-title":"Cancer"},{"key":"1612_CR39","doi-asserted-by":"publisher","first-page":"254","DOI":"10.1158\/1055-9965.EPI-21-0670","volume":"31","author":"TT Tran","year":"2022","unstructured":"Tran TT, Lee J, Gunathilake M, Cho H, Kim J. Influence of fasting glucose level on gastric cancer incidence in a prospective cohort study. Cancer Epidemiol Biomark Prev. 2022;31:254\u201361.","journal-title":"Cancer Epidemiol Biomark Prev"},{"key":"1612_CR40","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2023.1049787","volume":"13","author":"TT Tran","year":"2023","unstructured":"Tran TT, Lee J, Gunathilake M, Kim J, Kim SY, Cho H, et al. A comparison of machine learning models and Cox proportional hazards models regarding their ability to predict the risk of gastrointestinal cancer based on metabolic syndrome and its components. Front Oncol. 2023;13:1049787.","journal-title":"Front Oncol"},{"doi-asserted-by":"crossref","unstructured":"Ronco AL, Storz MA. Dietary acid load and cancer risk: a review of the Uruguayan experience. Nutrients. 2023;15:3098.","key":"1612_CR41","DOI":"10.3390\/nu15143098"},{"key":"1612_CR42","doi-asserted-by":"publisher","first-page":"514","DOI":"10.21037\/atm.2020.01.23","volume":"8","author":"RC Harris","year":"2020","unstructured":"Harris RC, Zhang MZ. The role of gender disparities in kidney injury. Ann Transl Med. 2020;8:514.","journal-title":"Ann Transl Med"},{"key":"1612_CR43","doi-asserted-by":"publisher","first-page":"F623","DOI":"10.1152\/ajprenal.00494.2017","volume":"314","author":"EM Worcester","year":"2018","unstructured":"Worcester EM, Bergsland KJ, Gillen DL, Coe FL. Mechanism for higher urine pH in normal women compared with men. Am J Physiol Ren Physiol. 2018;314:F623\u201329.","journal-title":"Am J Physiol Ren Physiol"},{"key":"1612_CR44","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1177\/1756283X13501786","volume":"7","author":"CL Donohoe","year":"2014","unstructured":"Donohoe CL, O\u2019Farrell NJ, Doyle SL, Reynolds JV. The role of obesity in gastrointestinal cancer: evidence and opinion. Therap Adv Gastroenterol. 2014;7:38\u201350.","journal-title":"Therap Adv Gastroenterol"},{"key":"1612_CR45","doi-asserted-by":"publisher","first-page":"2740","DOI":"10.1007\/s10620-019-05603-9","volume":"64","author":"J Karczewski","year":"2019","unstructured":"Karczewski J, Begier-Krasi\u0144ska B, Staszewski R, Pop\u0142awska E, Gulczynska-Elhadi K, Dobrowolska A. Obesity and the risk of gastrointestinal cancers. Dig Dis Sci. 2019;64:2740\u20139.","journal-title":"Dig Dis Sci"},{"key":"1612_CR46","doi-asserted-by":"publisher","first-page":"1255","DOI":"10.1093\/ajcn\/77.5.1255","volume":"77","author":"T Remer","year":"2003","unstructured":"Remer T, Dimitriou T, Manz F. Dietary potential renal acid load and renal net acid excretion in healthy, free-living children and adolescents. Am J Clin Nutr. 2003;77:1255\u201360.","journal-title":"Am J Clin Nutr"}],"container-title":["European Journal of Clinical Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41430-025-01612-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41430-025-01612-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41430-025-01612-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T07:39:14Z","timestamp":1757489954000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41430-025-01612-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,12]]},"references-count":46,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["1612"],"URL":"https:\/\/doi.org\/10.1038\/s41430-025-01612-2","relation":{},"ISSN":["0954-3007","1476-5640"],"issn-type":[{"type":"print","value":"0954-3007"},{"type":"electronic","value":"1476-5640"}],"subject":[],"published":{"date-parts":[[2025,5,12]]},"assertion":[{"value":"7 December 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 December 2024","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 March 2025","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 May 2025","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"This research was performed in accordance with the Declaration of Helsinki. We obtained written informed consent from all participants and approval for the study protocol from the institutional review board of the National Cancer Center (No. NCCNCS-07-077).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}}]}}