{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T00:02:47Z","timestamp":1778284967956,"version":"3.51.4"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,3,19]],"date-time":"2021-03-19T00:00:00Z","timestamp":1616112000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,3,19]],"date-time":"2021-03-19T00:00:00Z","timestamp":1616112000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["51672009"],"award-info":[{"award-number":["51672009"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["51972005"],"award-info":[{"award-number":["51972005"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004826","name":"Natural Science Foundation of Beijing Municipality","doi-asserted-by":"publisher","award":["7192227"],"award-info":[{"award-number":["7192227"]}],"id":[{"id":"10.13039\/501100004826","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009504","name":"School of Stomatology, Peking University","doi-asserted-by":"publisher","award":["PKUSSNCT-19A05"],"award-info":[{"award-number":["PKUSSNCT-19A05"]}],"id":[{"id":"10.13039\/501100009504","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Head Face Med"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>3D facial scanning has changed the way facial aesthetic is evaluated and has numerous advantages for facial analysis. The specific relationship between lip vermilion morphological changes after orthodontic extraction treatment has not been fully explained. The objective of this study was to evaluate 3D morphological changes after orthodontic extraction treatment in lip vermilion of adult females with dentoalveolar protrusion using a structured light-based scanner.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Forty-two female subjects (25.2\u2009\u00b1\u20091.9\u00a0years) were recruited as the treatment group; these patients had undergone extraction treatment and achieved better sagittal profiles. Twenty female subjects (25.5\u2009\u00b1\u20092.1\u00a0years) were enrolled in the non-treatment group; these patients did not require any orthodontic treatment. The follow up time for the treatment group was more than 24\u00a0months and for the non-treatment group was more than 12\u00a0months. 3D facial scans were captured using 3D CaMega. Six landmarks (Ls, Li, R.Chp, L.Chp, R.Ch, and L.Ch), three linear measurements (mouth height, philtrum width, and mouth width), and three area measurements (upper, lower, and total vermilion area) were measured. The spatial deviations of three volumetric measurements (upper, lower, and total vermilion) were constructed for quantitative analysis. Color-coded displacement map were constructed for visualization of the soft-tissue displacement as qualitative evaluation.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Mouth height and philtrum width decreased (-0.93\u00a0mm and \u2212\u20091.08\u00a0mm, respectively) significantly (<jats:italic>p<\/jats:italic>\u2009=\u20090.008 and <jats:italic>p<\/jats:italic>\u2009=\u20090.027, respectively), and no significant (<jats:italic>p<\/jats:italic>\u2009=\u20090.488) change in mouth width was observed in the treatment group. The lower and total vermilion surface areas decreased (-51.00mm<jats:sup>2<\/jats:sup> and \u2212\u200969.82mm<jats:sup>2<\/jats:sup>, respectively) significantly (<jats:italic>p<\/jats:italic>\u2009=\u20090.003 and <jats:italic>p<\/jats:italic>\u2009=\u20090.031, respectively) in the treatment group, but no statistically significant (<jats:italic>p<\/jats:italic>\u2009=\u20090.752) change was detected in the upper vermilion. In the treatment group, significant retractions were observed in the color-coded displacement map, and three volumetric measurements of vermilion changed significantly (<jats:italic>p<\/jats:italic>\u2009=\u20090.012, <jats:italic>p<\/jats:italic>\u2009=\u20090.001 and <jats:italic>p<\/jats:italic>\u2009=\u20090.004, respectively). Significant differences were found between the treatment group and the non-treatment group in the linear, area and volumetric measurements.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>This study established a method for qualitative and quantitative evaluation of the lip vermilion. Significant 3D retraction of the lip vermilion after the extraction treatment was found, with morphological variation between upper and lower vermilion.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13005-021-00263-5","type":"journal-article","created":{"date-parts":[[2021,3,19]],"date-time":"2021-03-19T10:18:12Z","timestamp":1616149092000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Measurement of three\u2010dimensional changes in lip vermilion in adult female patients after orthodontic extraction: a retrospective longitudinal study"],"prefix":"10.1186","volume":"17","author":[{"given":"Lin-hui","family":"Shen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tian-yi","family":"Xie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruo-ping","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi-ran","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gui","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tian-min","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bing","family":"Han","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,3,19]]},"reference":[{"issue":"2","key":"263_CR1","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1590\/2176-9451.19.2.066-075.oar","volume":"19","author":"HNDR Fortes","year":"2014","unstructured":"Fortes HNDR, Guimar\u00e3es TC, Belo IML, Matta, E. N. R. D. Photometric analysis of esthetically pleasant and unpleasant facial profile. Dental Press J Orthod. 2014;19(2):66\u201375.","journal-title":"Dental Press J Orthod"},{"issue":"3","key":"263_CR2","first-page":"208","volume":"70","author":"EC Zierhut","year":"2000","unstructured":"Zierhut EC, Joondeph DR, Artun J, Little RM. Long-term profile changes associated with successfully treated extraction and nonextraction Class II Division 1 malocclusions. Angle Orthod. 2000;70(3):208\u201319.","journal-title":"Angle Orthod"},{"issue":"2","key":"263_CR3","first-page":"90","volume":"71","author":"HB Ong","year":"2001","unstructured":"Ong HB, Woods MG. An occlusal and cephalometric analysis of maxillary first and second premolar extraction effects. Angle Orthod. 2001;71(2):90\u2013102.","journal-title":"Angle Orthod"},{"issue":"1","key":"263_CR4","first-page":"51","volume":"74","author":"KP Moseling","year":"2004","unstructured":"Moseling KP, Woods MG. Lip curve changes in females with premolar extraction or nonextraction treatment. Angle Orthod. 2004;74(1):51\u201362.","journal-title":"Angle Orthod"},{"issue":"1","key":"263_CR5","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/j.adaj.2016.09.004","volume":"148","author":"W Iared","year":"2017","unstructured":"Iared W, da Silva EMK, Iared W, Macedo CR. Esthetic perception of changes in facial profile resulting from orthodontic treatment with extraction of premolars: a systematic review. J Am Dent Assoc. 2017;148(1):9\u201316.","journal-title":"J Am Dent Assoc"},{"issue":"2","key":"263_CR6","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1002\/rcs.141","volume":"3","author":"CH Kau","year":"2007","unstructured":"Kau CH, Richmond S, Incrapera A, English J, Xia JJ. Three-dimensional surface acquisition systems for the study of facial morphology and their application to maxillofacial surgery. Int J Med Robot. 2007;3(2):97\u2013110.","journal-title":"Int J Med Robot"},{"issue":"5","key":"263_CR7","doi-asserted-by":"publisher","first-page":"849","DOI":"10.2319\/103008-552.1","volume":"79","author":"C Tanikawa","year":"2009","unstructured":"Tanikawa C, Nakamura K, Yagi M, Takada K. Lip vermilion profile patterns and corresponding dentoskeletal forms in female adults. Angle Orthod. 2009;79(5):849\u201358.","journal-title":"Angle Orthod"},{"issue":"5","key":"263_CR8","doi-asserted-by":"publisher","first-page":"253","DOI":"10.4041\/kjod.2015.45.5.253","volume":"45","author":"SY Kim","year":"2015","unstructured":"Kim SY, Bayome M, Park JH, Kook YA, Kang JH, Kim KH, Moon HB. Evaluation of the facial dimensions of young adult women with a preferred facial appearance. Korean J Orthod. 2015;45(5):253\u201360.","journal-title":"Korean J Orthod"},{"issue":"5","key":"263_CR9","doi-asserted-by":"publisher","first-page":"795","DOI":"10.2319\/112913-877.1","volume":"84","author":"HW Ahn","year":"2014","unstructured":"Ahn HW, Chang YJ, Kim KA, Joo SH, Park YG, Park KH. Measurement of three-dimensional perioral soft tissue changes in dentoalveolar protrusion patients after orthodontic treatment using a structured Light scanner. Angle Orthod. 2014;84(5):795\u2013802.","journal-title":"Angle Orthod"},{"issue":"4","key":"263_CR10","doi-asserted-by":"publisher","first-page":"222","DOI":"10.4041\/kjod.2019.49.4.222","volume":"49","author":"ZY Liu","year":"2019","unstructured":"Liu ZY, Yu J, Dai FF, Jiang RP, Xu TM. Three-dimensional changes in Lip vermilion morphology of adult female patients after extraction and non-extraction orthodontic treatment. Korean J Orthod. 2019;49(4):222\u201334.","journal-title":"Korean J Orthod"},{"issue":"2","key":"263_CR11","doi-asserted-by":"publisher","first-page":"218","DOI":"10.1016\/j.ajodo.2013.03.018","volume":"144","author":"RC Solem","year":"2013","unstructured":"Solem RC, Marasco R, Guiterrez-Pulido L, et al. Three-dimensional soft-tissue and hard-tissue changes in the treatment of bimaxillary protrusion[J]. Am J Orthod Dentofac Orthop. 2013;144(2):218\u201328.","journal-title":"Am J Orthod Dentofac Orthop"},{"issue":"1","key":"263_CR12","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s13005-018-0179-z","volume":"14","author":"J Jung","year":"2018","unstructured":"Jung J, Lee CH, Lee JW, et al. Three dimensional evaluation of soft tissue after orthognathic surgery[J]. Head face medicine. 2018;14(1):1\u20138.","journal-title":"Head face medicine"},{"issue":"1","key":"263_CR13","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1016\/j.ajodo.2018.03.014","volume":"155","author":"H Li","year":"2019","unstructured":"Li H, Cao T, Zhou H, et al. Lip position analysis of young women with different skeletal patterns during posed smiling using 3-dimensional stereophotogrammetry[J]. Am J Orthod Dentofac Orthop. 2019;155(1):64\u201370.","journal-title":"Am J Orthod Dentofac Orthop"},{"issue":"5","key":"263_CR14","doi-asserted-by":"publisher","first-page":"757","DOI":"10.1016\/j.ajodo.2015.10.029","volume":"149","author":"F Dindaro\u011flu","year":"2016","unstructured":"Dindaro\u011flu F, Duran GS, G\u00f6rg\u00fcl\u00fc S. Reproducibility of the Lip position at rest: A 3-dimensional perspective[J]. Am J Orthod Dentofac Orthop. 2016;149(5):757\u201365.","journal-title":"Am J Orthod Dentofac Orthop"},{"issue":"1","key":"263_CR15","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1093\/ejo\/cjt075","volume":"37","author":"M Alqattan","year":"2015","unstructured":"Alqattan M, Djordjevic J, Zhurov AI, Richmond S. Comparison between landmark and surface-based three-dimensional analyses of facial asymmetry in adults. Eur J Orthod. 2015;37(1):1\u201312.","journal-title":"Eur J Orthod"},{"key":"263_CR16","doi-asserted-by":"crossref","unstructured":"Gonz\u00e1lez-Mart\u00edn O, Veltri M, Moraguez O, Belser UC. Quantitative three-dimensional methodology to assess volumetric and profilometric outcome of subepithelial connective tissue grafting at pontic sites: a prospective pilot study. Int J Periodontics Restorative Dent. 2014;34(5).","DOI":"10.11607\/prd.1808"},{"key":"263_CR17","first-page":"159","volume-title":"Anthropometry of the head and face","author":"LG Farkas","year":"1994","unstructured":"Farkas LG. Anthropometry of the attractive North American Caucasian face. In: Farkas LG, editor. Anthropometry of the head and face. 2nd ed. New York: Raven Press; 1994. pp.\u00a0159\u201379.","edition":"2"},{"issue":"3","key":"263_CR18","doi-asserted-by":"publisher","first-page":"492","DOI":"10.1111\/cid.12786","volume":"21","author":"J Tian","year":"2019","unstructured":"Tian J, Wei D, Zhao Y, Di P, Jiang X, Lin Y. Labial soft tissue contour dynamics following immediate implants and immediate provisionalization of single maxillary incisors: A 1-year prospective study. Clin Implant Dent Relat Res. 2019;21(3):492\u2013502.","journal-title":"Clin Implant Dent Relat Res"},{"issue":"4","key":"263_CR19","doi-asserted-by":"publisher","first-page":"521","DOI":"10.1093\/ejo\/cjs035","volume":"35","author":"N Trisnawaty","year":"2013","unstructured":"Trisnawaty N, Ioi H, Kitahara T, Suzuki A, Takahashi I. Effects of extraction of four premolars on Mouth height and Lip area in patients with bimaxillary protrusion. Eur J Orthod. 2013;35(4):521\u20138.","journal-title":"Eur J Orthod"},{"issue":"2","key":"263_CR20","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1590\/S1678-77572004000200016","volume":"12","author":"L Maltagliati","year":"2004","unstructured":"Maltagliati L, Henriques JFC, Janson G, Almeida RRD, Freitas MR. D. Influence of orthopedic treatment on hard and soft facial structures of individuals presenting with Class II, Division 1 malocclusion: a comparative study. J Appl Oral Sci. 2004;12(2):164\u201370.","journal-title":"J Appl Oral Sci"},{"issue":"4","key":"263_CR21","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1016\/j.odw.2006.09.001","volume":"65","author":"H Yasutomi","year":"2006","unstructured":"Yasutomi H, Ioi H, Nakata S, Nakasima A, Counts AL. Effects of retraction of anterior teeth on horizontal and vertical lip positions in Japanese adults with the bimaxillary dentoalveolar protrusion. Orthod Waves. 2006;65(4):141\u20137.","journal-title":"Orthod Waves"},{"issue":"2","key":"263_CR22","doi-asserted-by":"publisher","first-page":"119","DOI":"10.14368\/jdras.2013.29.2.119","volume":"29","author":"SH Lee","year":"2013","unstructured":"Lee SH, Chung DH, Cha KS, Lee JW, Lee SM. The Esthetic Impact of Extraction and Nonextraction Treatments on Korean People. J Dent Rehabil Appl Sci. 2013;29(2):119\u201326.","journal-title":"J Dent Rehabil Appl Sci"},{"issue":"2","key":"263_CR23","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1016\/j.jobcr.2018.07.003","volume":"9","author":"BV Freitas","year":"2019","unstructured":"Freitas BV, Rodrigues VP, Rodrigues MF, de Melo HV, dos Santos PC. Soft tissue facial profile changes after orthodontic treatment with or without tooth extractions in Class I malocclusion patients: A comparative study. J Oral Biol Craniofac Res. 2019;9(2):172\u20136.","journal-title":"J Oral Biol Craniofac Res"},{"issue":"2","key":"263_CR24","first-page":"167","volume":"74","author":"F Ayhan Basciftci","year":"2004","unstructured":"Ayhan Basciftci F, Uysal T, Buyukerkmen A, Demir A. The influence of extraction treatment on Holdaway soft-tissue measurements. Angle Orthod. 2004;74(2):167\u201373.","journal-title":"Angle Orthod"},{"issue":"1","key":"263_CR25","doi-asserted-by":"publisher","first-page":"196","DOI":"10.1186\/s12903-019-0898-y","volume":"19","author":"MM L\u00f3pez-Mateos","year":"2019","unstructured":"L\u00f3pez-Mateos MM, Carre\u00f1o-Carre\u00f1o J, Palma JC, Alarc\u00f3n JA, L\u00f3pez-Mateos CM, Men\u00e9ndez-N\u00fa\u00f1ez M. Three-dimensional photographic analysis of the face in European adults from southern Spain with normal occlusion: reference anthropometric measurements. BMC Oral Health. 2019;19(1):196.","journal-title":"BMC Oral Health"},{"issue":"1","key":"263_CR26","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1067\/mod.2002.125235","volume":"122","author":"I KocadereLi","year":"2002","unstructured":"KocadereLi I. Changes in soft tissue profile after orthodontic treatment with and without extractions. Am J Orthod Dentofac Orthop. 2002;122(1):67\u201372.","journal-title":"Am J Orthod Dentofac Orthop"},{"issue":"2","key":"263_CR27","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1016\/j.pio.2010.04.002","volume":"11","author":"F Torsello","year":"2010","unstructured":"Torsello F, Graci M, Grande NM, Deli R. Relationships between facial features in the perception of profile attractiveness. Prog Orthod. 2010;11(2):92\u20137.","journal-title":"Prog Orthod"},{"issue":"3","key":"263_CR28","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1111\/eos.12409","volume":"126","author":"D Konstantonis","year":"2018","unstructured":"Konstantonis D, Vasileiou D, Papageorgiou SN, ELiades T. Soft tissue changes following extraction vs. nonextraction orthodontic fixed appLiance treatment: a systematic review and meta-analysis. Eur J Oral Sci. 2018;126(3):167\u201379.","journal-title":"Eur J Oral Sci"},{"issue":"6","key":"263_CR29","doi-asserted-by":"publisher","first-page":"281","DOI":"10.4041\/kjod.2014.44.6.281","volume":"44","author":"HH Kim","year":"2014","unstructured":"Kim HH, Lee JW, Cha KS, Chung DH, Lee SM. Three-dimensional assessment of upper Lip positional changes according to simulated maxillary anterior tooth movements by white light scanning. Korean J Orthod. 2014;44(6):281\u201393.","journal-title":"Korean J Orthod"},{"issue":"10","key":"263_CR30","doi-asserted-by":"publisher","first-page":"e0164180","DOI":"10.1371\/journal.pone.0164180","volume":"11","author":"SA Othman","year":"2016","unstructured":"Othman SA, Majawit LP, Wan Hassan WN, et al. Anthropometric study of three-dimensional facial morphology in Malay adults. PloS one. 2016;11(10):e0164180.","journal-title":"PloS one"},{"issue":"8","key":"263_CR31","doi-asserted-by":"publisher","first-page":"908","DOI":"10.1016\/j.bjoms.2013.09.002","volume":"51","author":"YS Jayaratne","year":"2013","unstructured":"Jayaratne YS, Deutsch CK, Zwahlen RA. A 3D anthropometric analysis of the orolabial region in Chinese young adults. Br J Oral Maxillofac Surg. 2013;51(8):908\u201312.","journal-title":"Br J Oral Maxillofac Surg"},{"issue":"12","key":"263_CR32","doi-asserted-by":"publisher","first-page":"2032","DOI":"10.1016\/j.bjps.2009.12.015","volume":"63","author":"WW Wong","year":"2010","unstructured":"Wong WW, Davis DG, Camp MC, Gupta SC. Contribution of Lip proportions to facial aesthetics in different ethnicities: a three-dimensional analysis. J Plast Reconstr Aesthet Surg. 2010;63(12):2032\u20139.","journal-title":"J Plast Reconstr Aesthet Surg"}],"container-title":["Head &amp; Face Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s13005-021-00263-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s13005-021-00263-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s13005-021-00263-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,3,19]],"date-time":"2021-03-19T10:37:43Z","timestamp":1616150263000},"score":1,"resource":{"primary":{"URL":"https:\/\/head-face-med.biomedcentral.com\/articles\/10.1186\/s13005-021-00263-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,19]]},"references-count":32,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["263"],"URL":"https:\/\/doi.org\/10.1186\/s13005-021-00263-5","relation":{},"ISSN":["1746-160X"],"issn-type":[{"value":"1746-160X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,19]]},"assertion":[{"value":"29 September 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 March 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 March 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 a retrospective study conducted in accordance with the declaration of Helsinki (1975, as revised in 2000). The study protocol was approved by the local ethics committee (Institutional Review Board of Peking University School and Hospital of Stomatology, approval number: PKUSSIRB-201,948,110). All patients provided informed consent after a comprehensive consultation.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent to publish individual person\u2019s data (images) were obtained.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"9"}}