{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,3,19]],"date-time":"2024-03-19T16:26:47Z","timestamp":1710865607603},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,5,24]],"date-time":"2021-05-24T00:00:00Z","timestamp":1621814400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,5,24]],"date-time":"2021-05-24T00:00:00Z","timestamp":1621814400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Headache Pain"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>There is currently a wide therapeutic arsenal for migraine patients, without a single first-line preventive drug and we choose the different available alternatives taking into account comorbidities, national guidelines, previous treatments and personal experiences.<\/jats:p><jats:p>Our objective was to evaluate the differences in the use of migraine treatments between neurologists from different countries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a multi-centre observational study carried out by neurologists from specialized headache units in seven countries, retrospective with consecutive inclusion of all patients presenting with a migraine diagnosis, over a period of three months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 734 patients were recruited but only 600 were considered in the analysis in order to homogenize the patient cohorts from countries: 200 Spain (ES), 100 Italy (IT), 85 Russia (RUS), 80 Germany (DE), 60 Portugal (PT), 45 Poland (PL) and 30 Australia (AU). 85.4\u2009% of patients were women with a mean age of 42.6\u2009\u00b1\u200911.8 years. Considering previous and current preventive treatment, the order of use was: antidepressants (69.3\u2009%), antiepileptic drugs (54.7\u2009%), beta-blockers and antihypertensive drugs (49.7\u2009%), OnabotulinumtoxinA (44.0\u2009%) and others (36.2\u2009%).<\/jats:p><jats:p>Statistically significant differences were found between all pharmacological classes: antidepressants were commonly used in all countries, with the exception of Poland (AU: 76.7\u2009%, IT: 71.0\u2009%, DE: 60.0\u2009%, PL: 31.1\u2009%, PT: 71.7\u2009%, RUS: 70.6\u2009%, ES: 78.5\u2009%;<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001); antiepileptic drugs were more frequently prescribed in Portugal, Australia and Spain (AU: 73.3\u2009%, IT: 40.0\u2009%, DE: 37.5\u2009%, PL: 48.9\u2009%, PT: 85.0\u2009%, RUS: 29.4\u2009% and ES: 69.0\u2009%;<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001); beta-blockers and antihypertensive drugs were frequently used in all countries except Italy (AU: 60.0\u2009%, IT: 14.0\u2009%, DE: 53.8\u2009%, PL: 48.9\u2009%, PT: 68.3\u2009%, RUS: 49.4\u2009% and ES: 59.0\u2009%;<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001); BTX-A were predominately used in Spain, Italy and Australia (AU:56.7\u2009%, IT:58.0\u2009%, DE:20.0\u2009%, PL: 42.2\u2009%, PT: 26.7\u2009%, RUS: 24.7\u2009% and ES: 58.5\u2009%;<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001) and others were most frequently used in Poland (AU: 0.0\u2009%, IT: 19.0\u2009%, DE: 42.5\u2009%, PL: 95.6\u2009%, PT: 31.7\u2009%, RUS: 3.5\u2009% and ES: 49.5\u2009%;<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). If only patients without comorbidities are considered (200\/600), statistically differences between countries persist in all preventive treatments.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>There is heterogeneity in the choice of preventive treatment between different countries. Prospective comparative studies of the different oral and subcutaneous alternatives would help to create a global therapeutic algorithm that would guarantee the best option for our patients.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s10194-021-01258-y","type":"journal-article","created":{"date-parts":[[2021,5,24]],"date-time":"2021-05-24T09:03:12Z","timestamp":1621846992000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["InterMiG: international differences in the therapeutic approach to migraine patients in specialized headache centers"],"prefix":"10.1186","volume":"22","author":[{"given":"AB","family":"Gago-Veiga","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J-I","family":"Huhn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N","family":"Latysheva","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Vieira Campos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Torres-Ferrus","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Alpuente Ruiz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S","family":"Sacco","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I","family":"Frattale","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R","family":"Ornello","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R","family":"Ruscheweyh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"IB","family":"Marques","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Gryglas-Dworak","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C","family":"Stark","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"VJ","family":"Gallardo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P","family":"Pozo-Rosich","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,5,24]]},"reference":[{"key":"1258_CR1","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1186\/s10194-020-01208-0","volume":"21","author":"TJ Steiner","year":"2020","unstructured":"Steiner TJ, Stovner LJ, Jensen R et al (2020) Migraine remains second among the worlds-s causes of disability, and first among young women: findings from GBD2019. J Headache Pain 21:137","journal-title":"J Headache Pain"},{"key":"1258_CR2","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1212\/01.wnl.0000252808.97649.21","volume":"68","author":"RB Lipton","year":"2007","unstructured":"Lipton RB, Bigal ME, Diamond M, Freitag F, Reed ML, Stewart WF, AMPP Advisory Group (2007) Migraine prevalence, disease burden, and the need for preventive therapy. Neurology 68:343\u2013349","journal-title":"Neurology"},{"key":"1258_CR3","doi-asserted-by":"publisher","first-page":"930","DOI":"10.1111\/j.1526-4610.2012.02185.x","volume":"52","author":"E Loder","year":"2012","unstructured":"Loder E, Burch R, Rizzoli P (2012) The 2012 AHS\/AAN guidelines for prevention of episodic migraine: a summary and comparison with other recent clinical practice guidelines. Headache 52:930\u2013945","journal-title":"Headache"},{"key":"1258_CR4","doi-asserted-by":"publisher","first-page":"968","DOI":"10.1111\/j.1468-1331.2009.02748.x","volume":"16","author":"S Evers","year":"2009","unstructured":"Evers S, Afra J, Frese A (2009) EFNS guideline on the drug treatment of migraine \u2013 revised report of an EFNS task force. Eur J Neurol 16:968\u2013981","journal-title":"Eur J Neurol"},{"key":"1258_CR5","doi-asserted-by":"crossref","unstructured":"Diener H-C, Holle-Lee D, N\u00e4gel S et al. Treatment of migraine attacks and prevention of migraine: Guidelines by the German Migraine and Headache Society and the German Society of Neurology. Clinical and Translational Neuroscience. 2019","DOI":"10.1177\/2514183X18823377"},{"key":"1258_CR6","unstructured":"Ezpeleta d, Pozo-Rosich P. Gu\u00edas diagn\u00f3sticas y terap\u00e9uticas de la Sociedad Espa\u00f1ola de Neurolog\u00eda. Gu\u00eda oficial de pr\u00e1ctica cl\u00ednica en Cefaleas. Ed. Luz\u00e1n 5, Madrid. 2015"},{"key":"1258_CR7","doi-asserted-by":"crossref","unstructured":"Headache Classification Committee of the International Headache Society (HIS). The International Classification of Headache Disorders, 3rd edition. Cephalalgia 2018; 38: 1-211","DOI":"10.1177\/0333102417738202"},{"key":"1258_CR8","doi-asserted-by":"publisher","first-page":"753","DOI":"10.1016\/j.ncl.2019.07.004","volume":"37","author":"SD Parikh Sk, Silverstein","year":"2019","unstructured":"Parikh Sk, Silverstein SD (2019) Preventive treatment for episodic migraine. Neurol Clin 37:753\u2013770","journal-title":"Neurol Clin"},{"key":"1258_CR9","first-page":"1052","volume":"24","author":"TJ Schwedt","year":"2018","unstructured":"Schwedt TJ (2018) Preventive therapy of migraine. Continuum 24:1052\u20131065","journal-title":"Continuum"},{"key":"1258_CR10","doi-asserted-by":"publisher","first-page":"364","DOI":"10.1111\/head.12273","volume":"54","author":"P Rizzoli","year":"2014","unstructured":"Rizzoli P (2014) Preventive pharmacotherapy in migraine. Headache 54:364\u2013369","journal-title":"Headache"},{"key":"1258_CR11","doi-asserted-by":"crossref","unstructured":"Lipton R, Silberstein S (2015) Episodic and chronic migraine headache: Episodic and chronic migraine headache: breaking down barriers to optimal treatment and prevention. Headache 55:103\u2013122","DOI":"10.1111\/head.12505_2"},{"key":"1258_CR12","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/head.13456","volume":"59","author":"The American Headache Society","year":"2019","unstructured":"The American Headache Society (2019) Position Statement on Integrating new migraine treatments into clinical practice. Headache 59:1\u201318","journal-title":"Headache"},{"key":"1258_CR13","doi-asserted-by":"crossref","unstructured":"Sarchielli P, Granella F, Prudenzano MP, Pini LA, Guidetti V, Bono G, Pinessi L, Alessandri M, Antonaci F, Fanciullacci M, Ferrari A, Guazzelli M, Nappi G, Sances G, Sandrini G, Savi L, Tassorelli C, Zanchin G. Italian guidelines for primary headaches: 2012 revised version. J Headache Pain 2012; Suppl2: S31-70","DOI":"10.1007\/s10194-012-0437-6"},{"key":"1258_CR14","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1016\/j.neurol.2013.09.006","volume":"170","author":"M Lant\u00e9ri-Minet","year":"2014","unstructured":"Lant\u00e9ri-Minet M, Demarquay G, Alchaar H, Bonnin J, Cornet P, Douay X, Dousset V, G\u00e9raud G, Guillouf V, Navez M, Radat F, Radenne S, Revol A, Valade D, Donnet A (2014) Management of chronic daily headache in migraine patients: medication overuse headache and chronic migraine. French guidelines. Rev Neurol (Paris) 170:162\u2013176","journal-title":"Rev Neurol (Paris)"},{"key":"1258_CR15","doi-asserted-by":"publisher","first-page":"e0130733","DOI":"10.1371\/journal.pone.0130733","volume":"10","author":"J Jackson","year":"2015","unstructured":"Jackson J, Cogbill E, Santana-Davila R, Eldredge C, Collier W, Gradall A, Sehgal N, Kuester J (2015) A comparative effectiveness meta-analysis of drugs for prophylaxis of migraine. PloS One 10:e0130733","journal-title":"PloS One"},{"key":"1258_CR16","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1111\/j.1600-0404.2008.01087.x","volume":"118","author":"F Ashtari","year":"2008","unstructured":"Ashtari F, Shaygannejad V, Akbari M (2008) A double-blind, randomized trial of low-dose topiramate vs propanolol in migraine prophylaxis. Acta Neurol Scand 118:301\u2013305","journal-title":"Acta Neurol Scand"},{"key":"1258_CR17","doi-asserted-by":"publisher","first-page":"1700","DOI":"10.1111\/head.13653","volume":"59","author":"JF Rothrock","year":"2019","unstructured":"Rothrock JF, Adams AM, Lipton RB, Silberstein SD, Jo E, Zhao X, Blumenfeld AM (2019) FORWARD Study investigative group. FORWARD Study: Evaluating the Comparative Effectiveness of OnabotulinumtoxinA and Topiramate for Headache Prevention in Adults with Chronic Migraine. Headache 59:1700\u20131713","journal-title":"Headache"},{"key":"1258_CR18","doi-asserted-by":"publisher","first-page":"1668","DOI":"10.1016\/S0140-6736(01)06711-3","volume":"358","author":"MD Ferrari","year":"2001","unstructured":"Ferrari MD, Roon KI, Lipton RB, Goadsby PJ (2001) Oral triptans (serotonin 5-HT (1b\/1d) agonist) in acute migraine treatment: a meta-analysis of 53 trials. Lancet 358:1668\u20131675","journal-title":"Lancet"},{"key":"1258_CR19","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1111\/head.12499","volume":"55","author":"MJ Marmura","year":"2015","unstructured":"Marmura MJ, Silberstein S, Schwedt T (2015) The acute treatment of migraine in adults: the american headache society evidence assessment of migraine pharmacotherapies. Headache 55:3\u201320","journal-title":"Headache"},{"issue":"Suppl4","key":"1258_CR20","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1111\/head.12601","volume":"55","author":"C Cameron","year":"2015","unstructured":"Cameron C, Kelly S, Hsieh SC, Murphy M, Chen L, Kotb A, Peterson J, Coyle D, Skidmore B, Gomes T, Clifford T, Wells G (2015) Triptans in the acute theatment of migraine: A systematic Review and Network Meta-analysis. Headache 55(Suppl4):221\u2013235","journal-title":"Headache"},{"key":"1258_CR21","doi-asserted-by":"publisher","first-page":"793","DOI":"10.1177\/0333102410364676","volume":"30","author":"SK Aurora","year":"2010","unstructured":"Aurora SK, Dodick DW, Turkel CC, DeGryse RE, Silberstein SD, Lipton RB, Diener HC, Brin MF (2010) PREEMPT 1 Chronic Migraine Study Group. Cephalalgia 30:793\u2013803","journal-title":"Cephalalgia"},{"key":"1258_CR22","first-page":"129","volume":"50","author":"J Pascual-G\u00f3mez","year":"2010","unstructured":"Pascual-G\u00f3mez J, Garc\u00eda-Naya M, Leira R. Mateos V, Alvaro-Gonzalez C, Hernando I (2010) Et al. Zonisamide in the preventive treatment of refractory migraine. Rev Neurol 50:129\u2013132","journal-title":"Rev Neurol"},{"key":"1258_CR23","doi-asserted-by":"publisher","first-page":"500","DOI":"10.1136\/jnnp.35.4.500","volume":"35","author":"H Jacobs","year":"1972","unstructured":"Jacobs H (1972) A trial of opipramol in the treatment of migraine. J Neurol Neurosurg Psychiatry 35:500\u2013504","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"1258_CR24","doi-asserted-by":"crossref","unstructured":"Schrader H, Stovner LJ, Helde G et al. Prophylactic treatment of migraine with an angiotensin converting enzyme inhibitor (Lisinopril): randomised, placebo controlled, crossover study. BMJ 322: 19\u201322","DOI":"10.1136\/bmj.322.7277.19"},{"key":"1258_CR25","doi-asserted-by":"publisher","first-page":"396","DOI":"10.1111\/jep.12869","volume":"24","author":"E Kuipers","year":"2018","unstructured":"Kuipers E, Wensing M, De Smet, Teicher M (2018) Considerations of prescribers and pharmacists for the use of non-selective B-Blockers in asthma and COPD patients. J Eval Clin Pract 24:396\u2013402","journal-title":"J Eval Clin Pract"},{"key":"1258_CR26","doi-asserted-by":"crossref","unstructured":"Lugaresi A, Montagna P, Gallasi R, Lugaresi E. Extrapyramidal syndrome and depression induced by flunarizine. Eur Neurol 188; 28: 208\u201311","DOI":"10.1159\/000116268"},{"key":"1258_CR27","doi-asserted-by":"publisher","first-page":"1069","DOI":"10.1016\/j.clinthera.2008.06.005","volume":"30","author":"F Taylor","year":"2008","unstructured":"Taylor F (2008) Weight change associated with the use of migraine-preventive medications. Clin Ther 30:1069\u20131080","journal-title":"Clin Ther"},{"key":"1258_CR28","doi-asserted-by":"crossref","unstructured":"Dekker F, Knuistingh A, Andriesse B, Kernick D, Reis R, Ferrari M et al (2012) Prophylactic treatment of migraine; the patient\u00b4s view, a qualitative study. BMC Fam Pract 9:13:13","DOI":"10.1186\/1471-2296-13-13"},{"key":"1258_CR29","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1186\/s10194-018-0955-y","volume":"20","author":"S Sacco","year":"2019","unstructured":"Sacco S, Bendtsen L, Ashina M, Reuter U, Terwindt G, Mitsikostas DD, Martelletti P (2019) European headache federation guideline on the use of monoclonal antibodies acting on the calcitonin gene related peptide or its receptor for migraine prevention. J Headache Pain 20:6","journal-title":"J Headache Pain"}],"container-title":["The Journal of Headache and Pain"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s10194-021-01258-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s10194-021-01258-y\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s10194-021-01258-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,4]],"date-time":"2023-11-04T02:35:49Z","timestamp":1699065349000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejournalofheadacheandpain.biomedcentral.com\/articles\/10.1186\/s10194-021-01258-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,24]]},"references-count":29,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["1258"],"URL":"https:\/\/doi.org\/10.1186\/s10194-021-01258-y","relation":{},"ISSN":["1129-2369","1129-2377"],"issn-type":[{"value":"1129-2369","type":"print"},{"value":"1129-2377","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,24]]},"assertion":[{"value":"4 February 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 May 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 May 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by Hospital de la Princesa\u00b4s Ethics Committee (register number: 3477). Patient data were anonymised for data analysis.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"All authors gave their consent for publication.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Gago-Veiga AB has received honoraria as a consultant and speaker for: AbbVie-Allergan, Chiesi, Exeltis, Novartis, Eli Lilly and Teva.Huhn J-I has received honaria as speaker or travel grants for: AbbVie-Allergan,\u00a0Novartis, Teva, Eli-Lilly and md-hoizonte.Latysheva N has received honoraria as a consultant and speaker for: AbbVie-Allergan and Novartis.Torres-Ferrus M has received honoraria as consultant or speaker for Allergan-Abbvie, Almirall, Chiesi, Eli Lilly, Novartis and Teva.Alpuente A has received honoraria as speaker for Allergan-Abbvie, Eli Lilly and eductation for Chiesi, Novartis and Teva.Sacco S has received honoraria as a consultant and speaker for: Abbot, Allergan-Abbvie, AstraZeneca, Eli Lilly, Novartis and Teva. Her research group has received\u00a0research grants from Allergan-Abbvie and Novartis and has received funding for clinical trials from Allergan-Abbvie, Novartis and Teva. She is a member of the Council of the European Headache Society and co-chair of the guideline board of the European Stroke Organization. She is the Specialty Chief Editor in Headache Medicine and Facial Pain in Frontiers in Neurology, associate editor for The Journal of Headache and Pain and for Stroke in Frontiers in Neurology, assistant editor for Stroke and member of the editorial board of Neurological Sciences, International Journal of Stroke, European Stroke Journal.Ornello R has received personal fees from Novartis and Ei Lilly, funding for publication fees from Allergan and Novartis, and travel grants from Novartis and Teva.Ruscheweyh R has received honoraria for talks and\/or advisory boards from Allergan, Hormosan, Lilly, Novartis and Teva.Marques IB has received honoraria as speaker and\/or advisory board for: AbbVie-Allergan, Sanofi and Novartis.Gryglas-Dworak A. has received honoraria as a consultant or speaker for AbbVie-Allergan and Novartis.Pozo-Rosich P has received honoraria as a consultant and speaker for: Allergan-Abbvie, Almirall, Amgen, Biohaven, Chiesi, Eli Lilly, Medscape, Neurodiem, Novartis and Teva. Her research group has received research grants from Allergan, and has received funding for clinical trials from Alder, Allergan-Abbvie, Electrocore, Eli Lilly, Novartis and Teva. She is a trustee member of the board of the International Headache Society, member of the Council of the European Headache Society. She is in the editorial board of Revista de Neurologia, associate editor for Cephalalgia, Headache, Neurologia, Frontiers of Neurology and The Journal of Headache and Pain. She is a member of the Clinical Trials Guidelines Committee of the International Headache Society. She has edited the Guidelines for the Diagnosis and Treatment of Headache of the Spanish Neurological Society. She is the founder ofExternalRef removed. Pozo-Rosich P does not own stocks from any pharmaceutical company.Vieira-Campos A, Frattale I, Stark C and Gallardo VJ report no disclosures","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"43"}}