{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T06:05:37Z","timestamp":1770271537730,"version":"3.49.0"},"reference-count":46,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2022,8,8]],"date-time":"2022-08-08T00:00:00Z","timestamp":1659916800000},"content-version":"unspecified","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Amsterdam Reproduction & Development (AR&D) research institute","award":["n\/a"],"award-info":[{"award-number":["n\/a"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2022,7,6]]},"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The use of low-dose aspirin by pregnant women to prevent preterm pre-eclampsia is gradually increasing. The administration of aspirin during pregnancy improves perinatal outcome, which could translate into improved child outcome in the long term. However, antenatal exposure to aspirin could have adverse effects on child development that may manifest later in life. The aim of this follow-up study is to assess the long-term effects of antenatal exposure to low-dose aspirin compared with placebo on survival, (neuro)development, behaviour and general health at 4 years corrected age.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This is a follow-up study of the Dutch double-blind randomised controlled APRIL trial which assessed the effectiveness of treatment with aspirin (80\u2009mg daily) compared with placebo for the prevention of preterm birth in women with a previous spontaneous preterm birth. Treatment was initiated before 16 weeks of gestation and continued until 36 weeks or birth. We aim to follow-up all 379 children born to women who participated in the APRIL trial and survived the neonatal period, at the corrected age of 4 years. The main outcomes are (neuro)development as assessed by the Ages and Stages Questionnaire, and behaviour as assessed by the Strength and Difficulties Questionnaire. Additional outcomes include mortality, growth and general health from birth up to 4 years, and a composite outcome including mortality, abnormal (neuro)development and problem behaviour. Analyses will be performed by intention-to-treat using a superiority design.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Institutional Review Board approval was obtained from the Medical Research Ethics Committee from Amsterdam Medical Center (no. W20 289#20.325). The results will be published in a peer-reviewed journal and presented at conferences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>The APRIL trial (NTR5675, NL5553; EudraCT number 2015-003220-31) and the APRIL follow-up study (NL8950) are registered in the Dutch trial register. The study is funded by the Amsterdam Reproduction &amp; Development research institute.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-060632","type":"journal-article","created":{"date-parts":[[2022,8,8]],"date-time":"2022-08-08T12:45:34Z","timestamp":1659962734000},"page":"e060632","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Long-term outcomes following antenatal exposure to low-dose aspirin: study protocol for the 4-year follow-up of the APRIL randomised controlled trial"],"prefix":"10.1136","volume":"12","clinical-trial-number":[{"clinical-trial-number":"nct04888377","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6354-3489","authenticated-orcid":false,"given":"Anadeijda J E M C","family":"Landman","sequence":"first","affiliation":[{"name":"Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Obstetrics and Gynaecology, De Boelelaan 1117, Amsterdam, The Netherlands"},{"name":"Amsterdam Reproduction and Development, Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2381-0332","authenticated-orcid":false,"given":"Emilie V J","family":"van Limburg Stirum","sequence":"additional","affiliation":[{"name":"Amsterdam Reproduction and Development, Amsterdam, The Netherlands"},{"name":"Amsterdam UMC location location University of Amsterdam, Department of Obstetrics and Gynaecology, Meibergdreef 9, Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5303-1503","authenticated-orcid":false,"given":"Janneke","family":"van 't Hooft","sequence":"additional","affiliation":[{"name":"Amsterdam Reproduction and Development, Amsterdam, The Netherlands"},{"name":"Amsterdam UMC location location University of Amsterdam, Department of Obstetrics and Gynaecology, Meibergdreef 9, Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4414-9451","authenticated-orcid":false,"given":"Aleid G","family":"Leemhuis","sequence":"additional","affiliation":[{"name":"Amsterdam UMC location University of Amsterdam, Emma Children\u2019s Hospital, Department of Neonatology and Paediatrics, Meibergdreef 9, Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6589-9788","authenticated-orcid":false,"given":"Martijn J J","family":"Finken","sequence":"additional","affiliation":[{"name":"Amsterdam UMC location Vrije Universiteit Amsterdam, Emma Children\u2019s Hospital, Department of Paediatric Endocrinology, De Boelelaan 1117, Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3498-9019","authenticated-orcid":false,"given":"Anneloes L","family":"van Baar","sequence":"additional","affiliation":[{"name":"Utrecht University, Department of Child and Adolescent Studies, Utrecht, The Netherlands, Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0564-5994","authenticated-orcid":false,"given":"Tessa J","family":"Roseboom","sequence":"additional","affiliation":[{"name":"Amsterdam Reproduction and Development, Amsterdam, The Netherlands"},{"name":"Amsterdam UMC location location University of Amsterdam, Department of Obstetrics and Gynaecology, Meibergdreef 9, Amsterdam, The Netherlands"},{"name":"Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3447-8286","authenticated-orcid":false,"given":"Anita C J","family":"Ravelli","sequence":"additional","affiliation":[{"name":"Department of Medical Informatics, Amsterdam UMC location University of Amsterdam, Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Meibergdreef 9, Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8263-213X","authenticated-orcid":false,"given":"Madelon","family":"van Wely","sequence":"additional","affiliation":[{"name":"Amsterdam Reproduction and Development, Amsterdam, The Netherlands"},{"name":"Amsterdam UMC location location University of Amsterdam, Department of Obstetrics and Gynaecology, Meibergdreef 9, Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0218-5630","authenticated-orcid":false,"given":"Jaap","family":"Oosterlaan","sequence":"additional","affiliation":[{"name":"Amsterdam Reproduction and Development, Amsterdam, The Netherlands"},{"name":"Amsterdam UMC location University of Amsterdam, Emma Children\u2019s Hospital, Department of Neonatology and Paediatrics, Meibergdreef 9, Amsterdam, The Netherlands"},{"name":"Amsterdam UMC location University of Amsterdam, Amsterdam UMC Follow-Me program & Emma Neuroscience Group, Meibergdreef 9, Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9336-6033","authenticated-orcid":false,"given":"Rebecca C","family":"Painter","sequence":"additional","affiliation":[{"name":"Amsterdam Reproduction and Development, Amsterdam, The Netherlands"},{"name":"Amsterdam UMC location location University of Amsterdam, Department of Obstetrics and Gynaecology, Meibergdreef 9, Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4432-3691","authenticated-orcid":false,"given":"Eva","family":"Pajkrt","sequence":"additional","affiliation":[{"name":"Amsterdam Reproduction and Development, Amsterdam, The Netherlands"},{"name":"Amsterdam UMC location location University of Amsterdam, Department of Obstetrics and Gynaecology, Meibergdreef 9, Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8672-4365","authenticated-orcid":false,"given":"Martijn A","family":"Oudijk","sequence":"additional","affiliation":[{"name":"Amsterdam Reproduction and Development, Amsterdam, The Netherlands"},{"name":"Amsterdam UMC location location University of Amsterdam, Department of Obstetrics and Gynaecology, Meibergdreef 9, Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9386-649X","authenticated-orcid":false,"given":"Marjon A","family":"de Boer","sequence":"additional","affiliation":[{"name":"Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Obstetrics and Gynaecology, De Boelelaan 1117, Amsterdam, The Netherlands"},{"name":"Amsterdam Reproduction and Development, Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,8,8]]},"reference":[{"key":"2025121407004474000_12.8.e060632.1","doi-asserted-by":"crossref","unstructured":"Duley L , Meher S , Hunter KE , et al . Antiplatelet agents for preventing pre-eclampsia and its complications. Cochrane Database Syst Rev 2019;2019.doi:10.1002\/14651858.CD004659.pub3","DOI":"10.1002\/14651858.CD004659.pub3"},{"key":"2025121407004474000_12.8.e060632.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)32973-3"},{"key":"2025121407004474000_12.8.e060632.3","unstructured":"National Institute for Health and Care Excellence . Hypertension in pregnancy: diagnosis and management (NICE guideline 133, 2011. Available: https:\/\/www.nice.org.uk\/guidance\/ng133"},{"key":"2025121407004474000_12.8.e060632.4","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1097\/AOG.0000000000003167","article-title":"A Nudge toward universal aspirin for preeclampsia prevention","volume":"133","author":"Ayala","year":"2019","journal-title":"Obstet Gynecol"},{"key":"2025121407004474000_12.8.e060632.5","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1016\/0002-9378(91)90444-V","article-title":"Transfer of aspirin across the perfused human placental cotyledon","volume":"165","author":"Jacobson","year":"1991","journal-title":"Am J Obstet Gynecol"},{"key":"2025121407004474000_12.8.e060632.6","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1542\/peds.53.2.201","article-title":"Kinetics of salicylate elimination by newborn infants of mothers who ingested aspirin before delivery","volume":"53","author":"Levy","year":"1974","journal-title":"Pediatrics"},{"key":"2025121407004474000_12.8.e060632.7","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1002\/cpt1975182210","article-title":"Distribution of salicylate between neonatal and maternal serum at diffusion equilibrium","volume":"18","author":"Levy","year":"1975","journal-title":"Clinical pharmacology and therapeutics"},{"key":"2025121407004474000_12.8.e060632.8","doi-asserted-by":"publisher","DOI":"10.1007\/s00702-010-0411-x"},{"key":"2025121407004474000_12.8.e060632.9","doi-asserted-by":"publisher","DOI":"10.1002\/ana.22620"},{"key":"2025121407004474000_12.8.e060632.10","doi-asserted-by":"publisher","DOI":"10.1038\/nrneurol.2015.13"},{"key":"2025121407004474000_12.8.e060632.11","doi-asserted-by":"publisher","DOI":"10.1002\/glia.23212"},{"key":"2025121407004474000_12.8.e060632.12","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-0994"},{"key":"2025121407004474000_12.8.e060632.13","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1093\/ije\/dyx235","article-title":"Use of paracetamol, ibuprofen or aspirin in pregnancy and risk of cerebral palsy in the child","volume":"47","author":"Petersen","year":"2018","journal-title":"Int J Epidemiol"},{"key":"2025121407004474000_12.8.e060632.14","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1111\/1471-0528.15561","article-title":"Association of intrauterine exposure to aspirin and blood pressure at 7 years of age: a secondary analysis","volume":"126","author":"Chen","year":"2019","journal-title":"BJOG"},{"key":"2025121407004474000_12.8.e060632.15","doi-asserted-by":"crossref","first-page":"726","DOI":"10.1097\/EDE.0000000000000519","article-title":"In utero exposure to aspirin and risk of asthma in childhood","volume":"27","author":"Chu","year":"2016","journal-title":"Epidemiology"},{"key":"2025121407004474000_12.8.e060632.16","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/j.ejogrb.2021.11.010","article-title":"Long-term health and neurodevelopment in children after antenatal exposure to low-dose aspirin for the prevention of preeclampsia and fetal growth restriction: a systematic review of randomized controlled trials","volume":"267","author":"Landman","year":"2021","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"2025121407004474000_12.8.e060632.17","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1111\/j.1471-0528.1995.tb10872.x","article-title":"Low dose aspirin in pregnancy and early childhood development: follow up of the Collaborative low dose aspirin study in pregnancy","volume":"102","year":"1995","journal-title":"BJOG: An International Journal of Obstetrics & Gynaecology"},{"key":"2025121407004474000_12.8.e060632.18","doi-asserted-by":"crossref","first-page":"1235","DOI":"10.1016\/S0140-6736(94)92452-X","article-title":"Follow-up of children in the Italian study of aspirin in pregnancy","volume":"343","author":"Parazzini","year":"1994","journal-title":"The Lancet"},{"key":"2025121407004474000_12.8.e060632.19","doi-asserted-by":"crossref","DOI":"10.1186\/s12884-017-1338-0","article-title":"Low dose aspirin in the prevention of recurrent spontaneous preterm labour \u2013 the April study: a multicenter randomized placebo controlled trial","volume":"17","author":"Visser","year":"2017","journal-title":"BMC Pregnancy Childbirth"},{"key":"2025121407004474000_12.8.e060632.20","unstructured":"AJEMC L , De Boer MA , Visser L . Evaluation of low-dose aspirin for the prevention of recurrent spontaneous preterm labour (the April study): a multicentre, randomised, double-blinded, placebo-controlled trial. PLoS Med 2021."},{"key":"2025121407004474000_12.8.e060632.21","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-158-3-201302050-00583"},{"key":"2025121407004474000_12.8.e060632.22","unstructured":"Squires JBD . Ages & stages questionnaires\u00ae. In: (ASQ\u00ae-3): a Parent-Completed child monitoring system. 3rd edn. Baltimore: Brookes Publishing Co., Inc, 2009."},{"key":"2025121407004474000_12.8.e060632.23","doi-asserted-by":"publisher","DOI":"10.1016\/j.earlhumdev.2009.03.001"},{"key":"2025121407004474000_12.8.e060632.24","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-7610.1997.tb01545.x"},{"key":"2025121407004474000_12.8.e060632.25","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/s40359-015-0061-8","article-title":"The strengths and difficulties questionnaire: psychometric properties of the parent and teacher version in children aged 4-7","volume":"3","author":"Stone","year":"2015","journal-title":"BMC Psychol"},{"key":"2025121407004474000_12.8.e060632.26","unstructured":"TheunissenMHCdWM , van Grieken A , Mieloo C . Handleiding voor Het gebruik van de strengths and difficulties questionnaire binnen de Jeugdgezondheidszorg. TNO: Leiden, 2016."},{"key":"2025121407004474000_12.8.e060632.27","doi-asserted-by":"crossref","DOI":"10.1186\/s12955-018-0948-1","article-title":"Dutch norms for the Strengths and Difficulties Questionnaire (SDQ) \u2013 parent form for children aged 2\u201318\u00a0years","volume":"16","author":"Maurice-Stam","year":"2018","journal-title":"Health Qual Life Outcomes"},{"key":"2025121407004474000_12.8.e060632.28","unstructured":"Cuijpers CJJ , van 't Hooft J , Schneeberger C . Progesterone for preterm birth prevention in women with short cervical length: outcomes in children at 2 years. Ultrasound Obstet Gynecol 2020 (published Online First: 2020\/09\/23)."},{"key":"2025121407004474000_12.8.e060632.29","unstructured":"de Ruigh AA , Simons NE , van 't Hooft J . Child outcomes after amnioinfusion compared with no intervention in women with second-trimester rupture of membranes: a long-term follow-up study of the PROMEXIL-III trial. BJOG 2020 (published Online First: 2020\/01\/28)."},{"key":"2025121407004474000_12.8.e060632.30","doi-asserted-by":"crossref","first-page":"1292","DOI":"10.1111\/aogs.13630","article-title":"Child outcomes after placement of a cervical pessary in women with a multiple pregnancy: a 4\u2010year follow\u2010up of the ProTWIN trial","volume":"98","author":"Simons","year":"2019","journal-title":"Acta Obstet Gynecol Scand"},{"key":"2025121407004474000_12.8.e060632.31","unstructured":"Netherlands Organisation for applied scientific research (TNO) . JGZ-Richtlijn Lengtegroei [Dutch], 2019. Available: https:\/\/www.ncj.nl\/richtlijnen\/alle-richtlijnen\/richtlijn\/lengtegroei-2019 [Accessed Cited 2021 Mar 24]."},{"key":"2025121407004474000_12.8.e060632.32","doi-asserted-by":"crossref","first-page":"38","DOI":"10.3109\/03014460.2014.926988","article-title":"Height of South Asian children in the Netherlands aged 0\u201320 years: secular trends and comparisons with current Asian Indian, Dutch and who references","volume":"42","author":"de Wilde","year":"2015","journal-title":"Ann Hum Biol"},{"key":"2025121407004474000_12.8.e060632.33","doi-asserted-by":"publisher","DOI":"10.1038\/pr.2012.189"},{"key":"2025121407004474000_12.8.e060632.34","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0124686","article-title":"Trend in height of Turkish and Moroccan children living in the Netherlands","volume":"10","author":"Sch\u00f6nbeck","year":"2015","journal-title":"PLoS One"},{"key":"2025121407004474000_12.8.e060632.35","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.320.7244.1240"},{"key":"2025121407004474000_12.8.e060632.36","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39238.399444.55"},{"key":"2025121407004474000_12.8.e060632.37","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1007\/s00787-015-0791-4","article-title":"Effect of socioeconomic status on psychosocial problems in 5- to 6-year-old preterm- and term-born children: the ABCD study","volume":"25","author":"de Laat","year":"2016","journal-title":"Eur Child Adolesc Psychiatry"},{"key":"2025121407004474000_12.8.e060632.38","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1038\/s41390-019-0526-1","article-title":"Assessment of long-term neurodevelopmental outcome following trials of medicinal products in newborn infants","volume":"86","author":"Marlow","year":"2019","journal-title":"Pediatr Res"},{"key":"2025121407004474000_12.8.e060632.39","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1111\/j.1471-0528.2012.03465.x","article-title":"Long-term child follow-up after large obstetric randomised controlled trials for the evaluation of perinatal interventions: a systematic review of the literature","volume":"120","author":"Teune","year":"2013","journal-title":"BJOG"},{"key":"2025121407004474000_12.8.e060632.40","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000001195"},{"key":"2025121407004474000_12.8.e060632.41","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2393-14-199","article-title":"The CROWN initiative: journal editors invite researchers to develop core outcomes in women\u2019s health","volume":"14","author":"Khan","year":"2014","journal-title":"BMC Pregnancy Childbirth"},{"key":"2025121407004474000_12.8.e060632.42","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1515\/jpm-2019-0302","article-title":"Variations in long-term outcome reporting among offspring followed up after lifestyle interventions in pregnancy: a systematic review","volume":"48","author":"Olmedo-Requena","year":"2020","journal-title":"J Perinat Med"},{"key":"2025121407004474000_12.8.e060632.43","doi-asserted-by":"crossref","DOI":"10.1186\/1745-6215-12-S1-A70","article-title":"The comet (core outcome measures in effectiveness trials) initiative","volume":"12","author":"Williamson","year":"2011","journal-title":"Trials"},{"key":"2025121407004474000_12.8.e060632.44","unstructured":"National Institute for Health and Care Excellence . Developmental follow-up of children and young people born preterm quality standard NICE, 2011. NICE Quality Standard [QS169]. Available: https:\/\/www.nice.org.uk\/guidance\/qs169 [Accessed 24 Jun 2021]."},{"key":"2025121407004474000_12.8.e060632.45","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2016-2828C"},{"key":"2025121407004474000_12.8.e060632.46","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2016-2828E"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2021-060632","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T15:00:55Z","timestamp":1765724455000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2021-060632"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8]]},"references-count":46,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2022,8,8]]},"published-print":{"date-parts":[[2022,8]]}},"alternative-id":["10.1136\/bmjopen-2021-060632"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2021-060632","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8]]}}}