{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T02:14:45Z","timestamp":1788401685069,"version":"build-2803163510"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":72,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Yunnan Major Scientific and Technological Projects","award":["202405AJ310002"],"award-info":[{"award-number":["202405AJ310002"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Microbiol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>To characterize HIV-1 molecular epidemiology and identify novel circulating recombinant forms (CRFs) among antiretroviral therapy (ART)-na\u00efve heterosexuals in Yunnan, China, and evaluate their clinical impact.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This study examined 636 HIV-1\n                      <jats:italic>pol<\/jats:italic>\n                      sequences to analyze genetic diversity, pretreatment drug resistance (PDR), and transmission networks. Near full-length genomes were obtained to identify and characterize novel recombinants, with their evolutionary history inferred by Bayesian analysis. Co-receptor tropism was predicted, and the five-year clinical outcomes (including immune reconstitution and virologic response) of patients infected with the novel CRFs were compared.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The most prevalent type identified was CRF08_BC, accounting for 50.16% of cases. The prevalence of drug resistance was 5.97% (38\/636), with the K103N mutation being the most common. An analysis of transmission networks revealed that 52.2% (272\/521) of clusters were associated with CRF07_BC and CRF08_BC. Two novel second-generation CRFs were identified: CRF190_0708, with an estimated time to the most recent common ancestor (tMRCA) of 1998.9, and CRF191_0708, with a more recent tMRCA ranging from 2009.5 to 2011.6. During the five-year follow-up period, viral rebound was observed in 7 patients in the CRF190_0708 group and in 1 patient in the CRF191_0708 group. Drug-resistance mutations (M184V and K103N) were detected in a subset of rebound cases in the CRF190_0708 group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study identifies two novel HIV-1 recombinants, CRF190_0708 and CRF191_0708, highlighting ongoing viral evolution in Yunnan. Preliminary findings suggest possible clinical differences, warranting further investigation. Continued molecular surveillance is needed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>The clinical study was registered at ClinicalTrials.gov under the identifier NCT03852849. The date of registration was March 22, 2019.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12866-026-05323-x","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T02:15:57Z","timestamp":1782180957000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Emergence of two novel HIV-1 Circulating Recombinant Forms (CRF190_0708 and CRF191_0708): molecular characterization and clinical insights from a five-year study in Yunnan, China"],"prefix":"10.1186","volume":"26","author":[{"given":"Li","family":"Gao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanlu","family":"Shu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mi","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianjian","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"HongYe","family":"Pai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lingling","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongjiao","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiqing","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fei","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xingqi","family":"Dong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Feng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xueshan","family":"Xia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,23]]},"reference":[{"key":"5323_CR1","unstructured":"UNAIDS. AIDS, crisis and the power to transform: Global AIDS Update 2025. Available at: https:\/\/www.unaids.org\/en\/resources\/documents\/2025\/2025-global-aids-update. Accessed Mar 2026."},{"issue":"1","key":"5323_CR2","doi-asserted-by":"publisher","first-page":"21133","DOI":"10.7448\/IAS.19.1.21133","volume":"19","author":"M Sidib\u00e9","year":"2016","unstructured":"Sidib\u00e9 M, Loures L, Samb B. The UNAIDS 90-90-90 target: a clear choice for ending AIDS and for sustainable health and development. J Int AIDS Soc. 2016;19(1):21133.","journal-title":"J Int AIDS Soc"},{"issue":"6","key":"5323_CR3","first-page":"501","volume":"33","author":"ZR Chuai","year":"2020","unstructured":"Chuai ZR, Zhang YH, Zhao YL, Yan JJ, Sun ZJ, Wang YY, et al. Latest AIDS epidemic in global and China. Infect Dis Info. 2020;33(6):501\u20133.","journal-title":"Infect Dis Info"},{"issue":"Suppl 1","key":"5323_CR4","doi-asserted-by":"publisher","first-page":"S34","DOI":"10.1097\/QAI.0b013e3181c7d6ff","volume":"53","author":"M Jia","year":"2010","unstructured":"Jia M, Luo H, Ma Y, Wang N, Smith K, Mei J, et al. The HIV epidemic in Yunnan Province, China, 1989\u20132007. J Acquir Immune Defic Syndr. 2010;53(Suppl 1):S34\u201340.","journal-title":"J Acquir Immune Defic Syndr"},{"key":"5323_CR5","unstructured":"HIV databases. Available at: https:\/\/www.hiv.lanl.gov\/content\/index. Accessed June 2025."},{"issue":"10","key":"5323_CR6","doi-asserted-by":"publisher","first-page":"e46777","DOI":"10.1371\/journal.pone.0046777","volume":"7","author":"L Li","year":"2012","unstructured":"Li L, Chen L, Yang S, Li T, Li J, Liu Y, et al. Recombination form and epidemiology of HIV-1 unique recombinant strains identified in Yunnan, China. PLoS ONE. 2012;7(10):e46777.","journal-title":"PLoS ONE"},{"issue":"1","key":"5323_CR7","doi-asserted-by":"publisher","first-page":"1919","DOI":"10.1080\/22221751.2021.1978822","volume":"10","author":"Z Ge","year":"2021","unstructured":"Ge Z, Feng Y, Zhang H, Rashid A, Zaongo SD, Li K, et al. HIV-1 CRF07_BC transmission dynamics in China: two decades of national molecular surveillance. Emerg Microbes Infect. 2021;10(1):1919\u201330.","journal-title":"Emerg Microbes Infect"},{"issue":"1","key":"5323_CR8","doi-asserted-by":"publisher","first-page":"669","DOI":"10.1186\/s12879-019-4276-9","volume":"19","author":"M Chen","year":"2019","unstructured":"Chen M, Ma Y, Chen H, Dai J, Luo H, Yang C, et al. Spatial clusters of HIV-1 genotypes in a recently infected population in Yunnan, China. BMC Infect Dis. 2019;19(1):669.","journal-title":"BMC Infect Dis"},{"key":"5323_CR9","doi-asserted-by":"publisher","first-page":"1624996","DOI":"10.3389\/fcimb.2025.1624996","volume":"15","author":"Y Liu","year":"2025","unstructured":"Liu Y, Yang C, Chang W, Fu X, Zhang M, Gao L, et al. Rapid circulation of HIV-1 CRF85_BC in Southwest China: its geographic origins and molecular transmission networks analysis. Front Cell Infect Microbiol. 2025;15:1624996.","journal-title":"Front Cell Infect Microbiol"},{"issue":"2","key":"5323_CR10","doi-asserted-by":"publisher","first-page":"106383","DOI":"10.1016\/j.jinf.2024.106383","volume":"90","author":"M Chen","year":"2025","unstructured":"Chen M, Ma Y, Chen H, Dai J, Dong L, Jia M, et al. Characterization of the first unambiguous HIV-1 CRF07_BC\/CRF08_BC circulating recombinant form (CRF160_0708) in Yunnan, China. J Infect. 2025;90(2):106383.","journal-title":"J Infect"},{"issue":"6","key":"5323_CR11","doi-asserted-by":"publisher","first-page":"322","DOI":"10.1089\/aid.2025.0022","volume":"41","author":"M Chen","year":"2025","unstructured":"Chen M, Chen H, Dai J, Dong L, Ma Y, Jia M, et al. Identification of a Novel Second-Generation HIV-1 Circulating Recombinant Form (CRF174_0708) Arising from CRF07_BC and CRF08_BC in Yunnan, China. AIDS Res Hum Retroviruses. 2025;41(6):322\u20136.","journal-title":"AIDS Res Hum Retroviruses"},{"issue":"1","key":"5323_CR12","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1186\/s12879-019-3927-1","volume":"19","author":"Z Wang","year":"2019","unstructured":"Wang Z, Zhang M, Zhang R, Liu L, Shen Y, Wang J, et al. Diversity of HIV-1 genotypes and high prevalence of pretreatment drug resistance in newly diagnosed HIV-infected patients in Shanghai, China. BMC Infect Dis. 2019;19(1):313.","journal-title":"BMC Infect Dis"},{"issue":"1","key":"5323_CR13","doi-asserted-by":"publisher","first-page":"20035","DOI":"10.7448\/IAS.18.1.20035","volume":"18","author":"S Grossmann","year":"2015","unstructured":"Grossmann S, Nowak P, Neogi U. Subtype-independent near full-length HIV-1 genome sequencing and assembly to be used in large molecular epidemiological studies and clinical management. J Int AIDS Soc. 2015;18(1):20035.","journal-title":"J Int AIDS Soc"},{"issue":"1","key":"5323_CR14","doi-asserted-by":"publisher","first-page":"1331","DOI":"10.1080\/21505594.2022.2106021","volume":"13","author":"C Topcu","year":"2022","unstructured":"Topcu C, Georgiou V, Rodosthenous JH, Demetriades I, Foley BT, Kostrikis G. Characterization of a novel HIV-1 circulating recombinant form, CRF91_cpx, comprising CRF02_AG, G, J, and U, mostly among men who have sex with men. Virulence. 2022;13(1):1331\u201348.","journal-title":"Virulence"},{"issue":"3","key":"5323_CR15","doi-asserted-by":"publisher","first-page":"e4724","DOI":"10.1371\/journal.pone.0004724","volume":"4","author":"DE Bennett","year":"2009","unstructured":"Bennett DE, Camacho RJ, Otelea D, Kuritzkes DR, Fleury H, Kiuchi M, et al. Drug resistance mutations for surveillance of transmitted HIV-1 drug-resistance: 2009 update. PLoS ONE. 2009;4(3):e4724.","journal-title":"PLoS ONE"},{"issue":"7","key":"5323_CR16","doi-asserted-by":"publisher","first-page":"1812","DOI":"10.1093\/molbev\/msy016","volume":"35","author":"SL Kosakovsky Pond","year":"2018","unstructured":"Kosakovsky Pond SL, Weaver S, Leigh Brown AJ, Wertheim JO. HIV-TRACE (TRAnsmission Cluster Engine): a Tool for Large Scale Molecular Epidemiology of HIV-1 and Other Rapidly Evolving Pathogens. Mol Biol Evol. 2018;35(7):1812\u20139.","journal-title":"Mol Biol Evol"},{"issue":"1","key":"5323_CR17","doi-asserted-by":"publisher","first-page":"vey016","DOI":"10.1093\/ve\/vey016","volume":"4","author":"MA Suchard","year":"2018","unstructured":"Suchard MA, Lemey P, Baele G, Ayres DL, Drummond AJ, Rambaut A. Bayesian phylogenetic and phylodynamic data integration using BEAST 1.10. Virus Evol. 2018;4(1):vey016.","journal-title":"Virus Evol"},{"issue":"12","key":"5323_CR18","doi-asserted-by":"publisher","first-page":"1407","DOI":"10.1038\/nbt1371","volume":"25","author":"T Lengauer","year":"2007","unstructured":"Lengauer T, Sander O, Sierra S, Thielen A, Kaiser R. Bioinformatics prediction of HIV coreceptor usage. Nat Biotechnol. 2007;25(12):1407\u201310.","journal-title":"Nat Biotechnol"},{"issue":"23","key":"5323_CR19","doi-asserted-by":"publisher","first-page":"11367","DOI":"10.1128\/JVI.74.23.11367-11376.2000","volume":"74","author":"L Su","year":"2000","unstructured":"Su L, Graf M, Zhang Y, von Briesen H, Xing H, K\u00f6stler J, et al. Characterization of a virtually full-length human immunodeficiency virus type 1 genome of a prevalent intersubtype (C\/B\u2019) recombinant strain in China. J Virol. 2000;74(23):11367\u201376.","journal-title":"J Virol"},{"issue":"23","key":"5323_CR20","doi-asserted-by":"publisher","first-page":"11286","DOI":"10.1128\/JVI.74.23.11286-11295.2000","volume":"74","author":"S Piyasirisilp","year":"2000","unstructured":"Piyasirisilp S, McCutchan FE, Carr JK, Sanders-Buell E, Liu W, Chen J, et al. A recent outbreak of human immunodeficiency virus type 1 infection in southern China was initiated by two highly homogeneous, geographically separated strains, circulating recombinant form AE and a novel BC recombinant. J Virol. 2000;74(23):11286\u201395.","journal-title":"J Virol"},{"key":"5323_CR21","unstructured":"Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents With HIV. Department of Health and Human Services. Available at: https:\/\/clinicalinfo.hiv.gov\/en\/guidelines\/adult-and-adolescent-arv. Accessed June 2025."},{"issue":"6","key":"5323_CR22","doi-asserted-by":"publisher","first-page":"775","DOI":"10.1017\/S0950268818000389","volume":"146","author":"M Chen","year":"2018","unstructured":"Chen M, Jia MH, Ma YL, Luo HB, Chen HC, Yang CJ, et al. The changing HIV-1 genetic characteristics and transmitted drug resistance among recently infected population in Yunnan, China. Epidemiol Infect. 2018;146(6):775\u201381.","journal-title":"Epidemiol Infect"},{"issue":"1","key":"5323_CR23","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1080\/22221751.2021.1899056","volume":"10","author":"K Li","year":"2021","unstructured":"Li K, Liu M, Chen H, Li J, Liang Y, Feng Y, et al. Using molecular transmission networks to understand the epidemic characteristics of HIV-1 CRF08_BC across China. Emerg Microbes Infect. 2021;10(1):497\u2013506.","journal-title":"Emerg Microbes Infect"},{"issue":"12","key":"5323_CR24","first-page":"1041","volume":"17","author":"M Chen","year":"2013","unstructured":"Chen M, Jia MH, Su YZ, Yang CJ, Chen HC, Chen L, et al. Investigation on HIV-1 genotypes and drug resistance threshold in Wenshan Prefecture of Yunnan Province in 2012. Chin J Dis Control Prev. 2013;17(12):1041\u20135.","journal-title":"Chin J Dis Control Prev"},{"issue":"3","key":"5323_CR25","first-page":"307","volume":"38","author":"JF Liu","year":"2017","unstructured":"Liu JF, Li JJ, Yang BH, Zhan M, Xie Q, Yang CX, et al. Study on drug-resistant gene mutation of HIV-1 virulent strains in Wenshan Prefecture of Yunnan Province during 2014\u20132015. Int J Lab Med. 2017;38(3):307\u201310.","journal-title":"Int J Lab Med"},{"issue":"Suppl 2","key":"5323_CR26","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1177\/135965350801302S04","volume":"13","author":"DE Bennett","year":"2008","unstructured":"Bennett DE, Myatt M, Bertagnolio S, Sutherland D, Gilks CF. Recommendations for surveillance of transmitted HIV drug resistance in countries scaling up antiretroviral treatment. Antivir Ther. 2008;13(Suppl 2):25\u201336.","journal-title":"Antivir Ther"},{"issue":"1","key":"5323_CR27","doi-asserted-by":"publisher","first-page":"2147023","DOI":"10.1080\/22221751.2022.2147023","volume":"12","author":"F Zhang","year":"2023","unstructured":"Zhang F, Yang Y, Liang N, Liang H, Chen Y, Lin Z, et al. Transmission network and phylogenetic analysis reveal older male-centered transmission of CRF01_AE and CRF07_BC in Guangxi, China. Emerg Microbes Infect. 2023;12(1):2147023.","journal-title":"Emerg Microbes Infect"},{"issue":"8","key":"5323_CR28","doi-asserted-by":"publisher","first-page":"2604","DOI":"10.1007\/s10461-018-2092-7","volume":"22","author":"PF Rebeiro","year":"2018","unstructured":"Rebeiro PF, McPherson TD, Goggins KM, Turner M, Bebawy SS, Rogers WB, et al. Health Literacy and Demographic Disparities in HIV Care Continuum Outcomes. AIDS Behav. 2018;22(8):2604\u201314.","journal-title":"AIDS Behav"},{"issue":"1","key":"5323_CR29","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1038\/s41564-023-01530-8","volume":"9","author":"M Monod","year":"2024","unstructured":"Monod M, Brizzi A, Galiwango RM, Ssekubugu R, Chen Y, Xi X, et al. Longitudinal population-level HIV epidemiologic and genomic surveillance highlights growing gender disparity of HIV transmission in Uganda. Nat Microbiol. 2024;9(1):35\u201354.","journal-title":"Nat Microbiol"},{"issue":"Suppl 2","key":"5323_CR30","doi-asserted-by":"publisher","first-page":"B39","DOI":"10.1016\/j.vaccine.2009.07.101","volume":"28","author":"Y Takebe","year":"2010","unstructured":"Takebe Y, Liao H, Hase S, Uenishi R, Li Y, Li XJ, et al. Reconstructing the epidemic history of HIV-1 circulating recombinant forms CRF07_BC and CRF08_BC in East Asia: the relevance of genetic diversity and phylodynamics for vaccine strategies. Vaccine. 2010;28(Suppl 2):B39\u201344.","journal-title":"Vaccine"},{"issue":"1","key":"5323_CR31","doi-asserted-by":"publisher","first-page":"e2169196","DOI":"10.1080\/22221751.2023.2169196","volume":"12","author":"Y Yu","year":"2023","unstructured":"Yu Y, Feng Y, Zhou Z, Li K, Hu X, Liao L, et al. Substitution of gp120 C4 region compensates for V3 loss-of-fitness mutations in HIV-1 CRF01_AE co-receptor switching. Emerg Microbes Infect. 2023;12(1):e2169196.","journal-title":"Emerg Microbes Infect"},{"issue":"7","key":"5323_CR32","doi-asserted-by":"publisher","first-page":"e29799","DOI":"10.1002\/jmv.29799","volume":"96","author":"H Yan","year":"2024","unstructured":"Yan H, Wu H, Li S, Wang J, Luo Y, Luo R, et al. The origin and spread of HIV-1 CRF59_01B epidemic in China: A molecular network and phylogeographic analysis. J Med Virol. 2024;96(7):e29799.","journal-title":"J Med Virol"},{"key":"5323_CR33","doi-asserted-by":"publisher","first-page":"1391215","DOI":"10.3389\/fcimb.2024.1391215","volume":"14","author":"T Luo","year":"2024","unstructured":"Luo T, Zhang F, Liang H, Yu D, Cen P, Zhong S, et al. Men with a history of commercial heterosexual contact play essential roles in the transmission of HIV-1 CRF55_01B from men who have sex with men to the general population in Guangxi, China. Front Cell Infect Microbiol. 2024;14:1391215.","journal-title":"Front Cell Infect Microbiol"}],"container-title":["BMC Microbiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12866-026-05323-x","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12866-026-05323-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12866-026-05323-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T01:48:27Z","timestamp":1788400107000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12866-026-05323-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,23]]},"references-count":33,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["5323"],"URL":"https:\/\/doi.org\/10.1186\/s12866-026-05323-x","relation":{},"ISSN":["1471-2180"],"issn-type":[{"value":"1471-2180","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,23]]},"assertion":[{"value":"3 February 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 June 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 June 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This study was conducted in accordance with the principles outlined in the 1974 Declaration of Helsinki on Human Research. The study was reviewed and approved by the Ethics Committee of Yunnan Provincial Infectious Disease Hospital (Approval number: KE-201920). Written informed consent was obtained from all participants, who were fully informed about the purpose, significance, voluntary nature, and confidentiality of the research before their participation. This study adheres to CONSORT guidelines (see the CONSORT checklist).","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"774"}}