Objective: The purpose of this study is to investigate the appropriate dose of quetiapine in clinical psychiatric diseases by examining the drug prescription dose in the elderly and insomnia group through an analysis of the tendency of quetiapine dose prescribed by psychiatric diagnosis.Methods: Among the patients who had been taking outpatient treatment to the mental health department for about 7 years and 8 months from May 1, 2010 to December 31, 2017, 2,794 patients who were continuously taking quetiapine immediate-release form drugs were retrospectively tested. In addition, all subjects were classified into a total of four groups according to their maintenance dose, four mental diseases that most commonly prescribe quetiapine were selected and grouped, and further analyzed whether there was a difference in prescription capacity by age and comorbidities for the insomnia group.Results: Prescription dose of quetiapine was found to be less than 50 mg in depressive disorders and insomnia, which is a relatively low dose prescribed compared to schizophrenia and bipolar disorder. In the case of insomnia, quetiapine prescribed in the elderly patient group was 30.03±9.14 mg, which was relatively high compared to the non-elderly group. And in the case of insomnia accompanied by depressive disorder, 50.28±11.41 mg was prescribed, more than 60% higher doses than that of primary insomnia.Conclusion: In the case of primary insomnia, quetiapine dose prescribed in the elderly patient group is higher than that in the non-elderly patient group.
{"title":"Prescription Dose Analysis of Quetiapine in the Elderly and Insomnia","authors":"K. Lee, S. Ryu, J. Ha, H. Jeon, Doo-Heum Park","doi":"10.33069/cim.2021.0031","DOIUrl":"https://doi.org/10.33069/cim.2021.0031","url":null,"abstract":"Objective: The purpose of this study is to investigate the appropriate dose of quetiapine in clinical psychiatric diseases by examining the drug prescription dose in the elderly and insomnia group through an analysis of the tendency of quetiapine dose prescribed by psychiatric diagnosis.Methods: Among the patients who had been taking outpatient treatment to the mental health department for about 7 years and 8 months from May 1, 2010 to December 31, 2017, 2,794 patients who were continuously taking quetiapine immediate-release form drugs were retrospectively tested. In addition, all subjects were classified into a total of four groups according to their maintenance dose, four mental diseases that most commonly prescribe quetiapine were selected and grouped, and further analyzed whether there was a difference in prescription capacity by age and comorbidities for the insomnia group.Results: Prescription dose of quetiapine was found to be less than 50 mg in depressive disorders and insomnia, which is a relatively low dose prescribed compared to schizophrenia and bipolar disorder. In the case of insomnia, quetiapine prescribed in the elderly patient group was 30.03±9.14 mg, which was relatively high compared to the non-elderly group. And in the case of insomnia accompanied by depressive disorder, 50.28±11.41 mg was prescribed, more than 60% higher doses than that of primary insomnia.Conclusion: In the case of primary insomnia, quetiapine dose prescribed in the elderly patient group is higher than that in the non-elderly patient group.","PeriodicalId":277997,"journal":{"name":"Chronobiology in Medicine","volume":"193 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114555981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Actigraphy-derived locomotor activity recordings are novel and critical tools for evaluating rest-activity pattern and circadian phase in humans. We conducted a narrative review assessing rest-activity pattern and circadian phase alterations within various stages of Alzheimer’s disease, in consideration of the reciprocal associations between neurodegeneration and circadian rhythm disruption in patients with Alzheimer’s disease. The goal of this review was to characterize possible associations between circadian rhythm disruption and neurodegeneration in Alzheimer’s disease. To the best of our knowledge, only two studies have assessed rest-activity pattern and circadian phase alterations in the preclinical Alzheimer’s disease stage and the results of the studies were inconsistent. Several studies have evaluated rest-activity pattern and circadian phase alterations in patients with Alzheimer’s dementia. The most replicated findings were delayed phase and increased activity fragmentation, represented as increased intra-daily variability. Unfortunately, many studies performed in dementia patients have not examined neuroimaging biomarkers or structured neuropsychological tests, thus limiting the specification of dementia clinical diagnoses. Future studies should consider a more comprehensive evaluation of various clinical and biomarker characteristics in patients with dementia or Alzheimer’s disease.
{"title":"Rest-Activity Pattern and Circadian Phase Alterations Across the Alzheimer’s Disease Clinical Spectrum","authors":"H. W. Roh, S. Son","doi":"10.33069/cim.2021.0029","DOIUrl":"https://doi.org/10.33069/cim.2021.0029","url":null,"abstract":"Actigraphy-derived locomotor activity recordings are novel and critical tools for evaluating rest-activity pattern and circadian phase in humans. We conducted a narrative review assessing rest-activity pattern and circadian phase alterations within various stages of Alzheimer’s disease, in consideration of the reciprocal associations between neurodegeneration and circadian rhythm disruption in patients with Alzheimer’s disease. The goal of this review was to characterize possible associations between circadian rhythm disruption and neurodegeneration in Alzheimer’s disease. To the best of our knowledge, only two studies have assessed rest-activity pattern and circadian phase alterations in the preclinical Alzheimer’s disease stage and the results of the studies were inconsistent. Several studies have evaluated rest-activity pattern and circadian phase alterations in patients with Alzheimer’s dementia. The most replicated findings were delayed phase and increased activity fragmentation, represented as increased intra-daily variability. Unfortunately, many studies performed in dementia patients have not examined neuroimaging biomarkers or structured neuropsychological tests, thus limiting the specification of dementia clinical diagnoses. Future studies should consider a more comprehensive evaluation of various clinical and biomarker characteristics in patients with dementia or Alzheimer’s disease.","PeriodicalId":277997,"journal":{"name":"Chronobiology in Medicine","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115834006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Delayed sunrise time in winter makes it difficult to wake up and start the day at the usual wake-up time. Is it really normal to get up early and start the day long before sunrise during winter? All living things on Earth, except mankind, live according to sunrise and sunset. Diurnal animals usually initiate their activities at sunrise, and nocturnal animals generally start after sunset. Would not this pattern of humans, as a diurnal animal, that goes against the sunrise time, have an adverse effect on human life and health? Before humans developed electricity and artificial lighting, they generally began their daily routine when the sun rose. However, the availability of artificial lighting has created an environment wherein activities are possible even without sunlight. As a result, humans now live their daily lives according to the set time indicated by the clock, and not sunlight. In other words, even though there are variations in sunrise time between seasons, people live according to the standard time displaced by the clock. For example, humans still wake up at 6:00 AM when it is dark in the winter and get ready to go to school or work. Though this generally reflects the sunrise time, it does not take into account the seasonal changes associated with sunrise. For instance, the sunrise time in Seoul, South Korea, in 2021 is 5:11 AM and 7:43 AM in the summer and winter solstice, respectively, which is a difference of 2 h and 32 min. Since the sun rises earlier in summer and later in winter, people consider it natural that the sunlight shines in the bedroom much Can’t Humans Live According to the Sun, Not the Clock, Like Other Creatures on Earth?
{"title":"Can’t Humans Live According to the Sun, Not the Clock, Like Other Creatures on Earth?","authors":"Heon-Jeong Lee","doi":"10.33069/cim.2021.0027","DOIUrl":"https://doi.org/10.33069/cim.2021.0027","url":null,"abstract":"Delayed sunrise time in winter makes it difficult to wake up and start the day at the usual wake-up time. Is it really normal to get up early and start the day long before sunrise during winter? All living things on Earth, except mankind, live according to sunrise and sunset. Diurnal animals usually initiate their activities at sunrise, and nocturnal animals generally start after sunset. Would not this pattern of humans, as a diurnal animal, that goes against the sunrise time, have an adverse effect on human life and health? Before humans developed electricity and artificial lighting, they generally began their daily routine when the sun rose. However, the availability of artificial lighting has created an environment wherein activities are possible even without sunlight. As a result, humans now live their daily lives according to the set time indicated by the clock, and not sunlight. In other words, even though there are variations in sunrise time between seasons, people live according to the standard time displaced by the clock. For example, humans still wake up at 6:00 AM when it is dark in the winter and get ready to go to school or work. Though this generally reflects the sunrise time, it does not take into account the seasonal changes associated with sunrise. For instance, the sunrise time in Seoul, South Korea, in 2021 is 5:11 AM and 7:43 AM in the summer and winter solstice, respectively, which is a difference of 2 h and 32 min. Since the sun rises earlier in summer and later in winter, people consider it natural that the sunlight shines in the bedroom much Can’t Humans Live According to the Sun, Not the Clock, Like Other Creatures on Earth?","PeriodicalId":277997,"journal":{"name":"Chronobiology in Medicine","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129881681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
H. Kang, Jin Hyoung Kim, B. Kang, Taehoon Lee, S. Ra, K. Seo, Y. Jegal, J. Ahn
A recently published study on coronavirus disease 2019 (COVID-19) and obstructive sleep apnea (OSA) suggested that there might be an association between certain risk factors and comorbidities associated with OSA, which are also associated with poor COVID-19 outcomes. However, it is unclear whether undiagnosed OSA correlates with COVID-19 severity in a South Korean population. We identified 7 patients who presented with nocturnal hypoxemia during hospitalization due to COVID-19. All patients underwent polysomnography 5–9 weeks after the infection. We retrospectively collected the patients’ baseline characteristics, hospital admission data, and polysomnography findings. Of the 7 patients, all were diagnosed with OSA after COVID-19 infection. Their mean (±SD) age was 45.4±16.3 years, 57.1% were men, and their mean (±SD) body mass index was 33.4±6.0 kg/m2. Six patients presented with COVID-19-related pneumonia on chest X-rays, 3 of whom were admitted to the intensive care unit during the acute phase. The overnight polysomnography showed a mean AHI of 59.0±38.5/h and an oxygen desaturation index of 57.6±39.7/h. Undiagnosed OSA is a prevalent condition associated with moderate to severe COVID-19 infection. The study patients with sleep apnea and COVID-19 had obesity and severe oxygen desaturation but did not complain of daytime sleepiness.
{"title":"Undiagnosed Obstructive Sleep Apnea and Acute COVID-19 Infection—A Case Series","authors":"H. Kang, Jin Hyoung Kim, B. Kang, Taehoon Lee, S. Ra, K. Seo, Y. Jegal, J. Ahn","doi":"10.33069/cim.2021.0033","DOIUrl":"https://doi.org/10.33069/cim.2021.0033","url":null,"abstract":"A recently published study on coronavirus disease 2019 (COVID-19) and obstructive sleep apnea (OSA) suggested that there might be an association between certain risk factors and comorbidities associated with OSA, which are also associated with poor COVID-19 outcomes. However, it is unclear whether undiagnosed OSA correlates with COVID-19 severity in a South Korean population. We identified 7 patients who presented with nocturnal hypoxemia during hospitalization due to COVID-19. All patients underwent polysomnography 5–9 weeks after the infection. We retrospectively collected the patients’ baseline characteristics, hospital admission data, and polysomnography findings. Of the 7 patients, all were diagnosed with OSA after COVID-19 infection. Their mean (±SD) age was 45.4±16.3 years, 57.1% were men, and their mean (±SD) body mass index was 33.4±6.0 kg/m2. Six patients presented with COVID-19-related pneumonia on chest X-rays, 3 of whom were admitted to the intensive care unit during the acute phase. The overnight polysomnography showed a mean AHI of 59.0±38.5/h and an oxygen desaturation index of 57.6±39.7/h. Undiagnosed OSA is a prevalent condition associated with moderate to severe COVID-19 infection. The study patients with sleep apnea and COVID-19 had obesity and severe oxygen desaturation but did not complain of daytime sleepiness.","PeriodicalId":277997,"journal":{"name":"Chronobiology in Medicine","volume":"232 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132156785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Digital therapeutics (DTx) are products that provide evidence-based interventions driven by high-quality software programs to prevent, manage, or treat a medical disease. DTx are receiving increasing attention as a new therapeutic approach. Several DTx for insomnia are on the market, some of which have received approval by national regulatory agencies. DTx for insomnia are usually based on cognitive behavioral therapy for insomnia. No DTx for other sleep disorders, such as narcolepsy or sleep-related breathing disorders, have received regulatory authority approval as a medical device. DTx have the substantial benefits of being accessible and relatively low-cost. However, several issues related to DTx have not yet been fully resolved, and discussions regarding DTx are still in the early stages. To use DTx for sleep disorders as an effective treatment option in the future, considering the current status of DTx is necessary. This review discusses definitions and background of DTx; specific DTx for insomnia that have been developed; use of DTx for sleep and related psychiatric comorbid symptoms; global regulatory processes for DTx, including prescribing and medical billing issues; and remaining challenges regarding the use of DTx.
{"title":"Can Digital Therapeutics Open a New Era of Sleep Medicine?","authors":"K. Park, Suonaa Lee, Eun Lee","doi":"10.33069/cim.2021.0028","DOIUrl":"https://doi.org/10.33069/cim.2021.0028","url":null,"abstract":"Digital therapeutics (DTx) are products that provide evidence-based interventions driven by high-quality software programs to prevent, manage, or treat a medical disease. DTx are receiving increasing attention as a new therapeutic approach. Several DTx for insomnia are on the market, some of which have received approval by national regulatory agencies. DTx for insomnia are usually based on cognitive behavioral therapy for insomnia. No DTx for other sleep disorders, such as narcolepsy or sleep-related breathing disorders, have received regulatory authority approval as a medical device. DTx have the substantial benefits of being accessible and relatively low-cost. However, several issues related to DTx have not yet been fully resolved, and discussions regarding DTx are still in the early stages. To use DTx for sleep disorders as an effective treatment option in the future, considering the current status of DTx is necessary. This review discusses definitions and background of DTx; specific DTx for insomnia that have been developed; use of DTx for sleep and related psychiatric comorbid symptoms; global regulatory processes for DTx, including prescribing and medical billing issues; and remaining challenges regarding the use of DTx.","PeriodicalId":277997,"journal":{"name":"Chronobiology in Medicine","volume":"361 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132587362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: Previous studies have compared depressive episodes between bipolar disorder (BD) and major depressive disorder (MDD) using quantitative electroencephalogram (QEEG); however, there are no distinct discriminating feature between them. Here, we used QEEG to directly compare the alpha asymmetry and absolute power of each band between patients with BD and MDD.Methods: Fifty in-patients with major depressive episodes between 2019 and 2021 were retrospectively enrolled. Self-reported questionnaires including the Beck Depression Inventory (BDI), Korean version of the Childhood Trauma Questionnaire, and Adult Attention-Deficit/Hyperactivity Disorder Self Report Scale (ASRS) were used to evaluate the symptoms. The absolute power of QEEG delta, theta, alpha, beta, high beta waves, and the Z-scores of frontal alpha asymmetry were collected. A t-test and Pearson’s correlation test were conducted using these data and based on these results, an analysis of covariance was conducted.Results: There were no significant differences between MDD and BD in QEEG power or alpha asymmetry. Patients with severe depression (BDI ≥29) had higher alpha power at FP1 (p=0.037), FP2 (p=0.028), F3 (p=0.047), F4 (p=0.016), and higher right frontal alpha asymmetry at F3–F4 (p=0.039). Adult patients with features consistent with ADHD (ASRS ≥4) had higher right frontal alpha asymmetry at F3–F4 (p=0.046). Patients with insomnia had higher left frontal alpha asymmetry at F3–F4 (p=0.003).Conclusion: QEEG limited the differential diagnosis of MDD and BD. However, frontal alpha asymmetry did exist in depression and affected cognitive impairment, insomnia, and depression severity in particular. Future studies with improved methodologies are needed for a better comparison.
{"title":"Association Between Frontal Alpha Asymmetry With Cognitive Symptoms, Depression Severity, and Insomnia","authors":"Dae Yun Hwang, Yang Rae Kim, Young-Min Park","doi":"10.33069/cim.2021.0026","DOIUrl":"https://doi.org/10.33069/cim.2021.0026","url":null,"abstract":"Objective: Previous studies have compared depressive episodes between bipolar disorder (BD) and major depressive disorder (MDD) using quantitative electroencephalogram (QEEG); however, there are no distinct discriminating feature between them. Here, we used QEEG to directly compare the alpha asymmetry and absolute power of each band between patients with BD and MDD.Methods: Fifty in-patients with major depressive episodes between 2019 and 2021 were retrospectively enrolled. Self-reported questionnaires including the Beck Depression Inventory (BDI), Korean version of the Childhood Trauma Questionnaire, and Adult Attention-Deficit/Hyperactivity Disorder Self Report Scale (ASRS) were used to evaluate the symptoms. The absolute power of QEEG delta, theta, alpha, beta, high beta waves, and the Z-scores of frontal alpha asymmetry were collected. A t-test and Pearson’s correlation test were conducted using these data and based on these results, an analysis of covariance was conducted.Results: There were no significant differences between MDD and BD in QEEG power or alpha asymmetry. Patients with severe depression (BDI ≥29) had higher alpha power at FP1 (p=0.037), FP2 (p=0.028), F3 (p=0.047), F4 (p=0.016), and higher right frontal alpha asymmetry at F3–F4 (p=0.039). Adult patients with features consistent with ADHD (ASRS ≥4) had higher right frontal alpha asymmetry at F3–F4 (p=0.046). Patients with insomnia had higher left frontal alpha asymmetry at F3–F4 (p=0.003).Conclusion: QEEG limited the differential diagnosis of MDD and BD. However, frontal alpha asymmetry did exist in depression and affected cognitive impairment, insomnia, and depression severity in particular. Future studies with improved methodologies are needed for a better comparison.","PeriodicalId":277997,"journal":{"name":"Chronobiology in Medicine","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127693345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Circadian Medicine in Digital Era: New Technologies for New Normal?","authors":"Seog-Ju Kim","doi":"10.33069/cim.2021.0023","DOIUrl":"https://doi.org/10.33069/cim.2021.0023","url":null,"abstract":"","PeriodicalId":277997,"journal":{"name":"Chronobiology in Medicine","volume":"214 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114667876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Saehyeon Kim, Jihye Yeom, Seunghwa Jeong, J. Seo, Sehyun Jeon, Heon-Jeong Lee
Objective: Recent studies have extended the study of diurnal preferences to the genetic level. Most studies have focused on clock genes, but some studies have searched for the possibilities of other genes associated with the circadian rhythm. Considering that the circadian rhythm is associated with the serotonergic system, investigating the association between major genes of the serotonin system and the diurnal preference phenotype is essential. In this study, we evaluated whether the 5-HTTLPR polymorphism is associated with diurnal preference in a Korean population.Methods: In total, 509 healthy subjects were genotyped for the 5-HTTLPR polymorphism. The Korean version of the Composite Scale of Morningness (CSM) was used to measure the phenotype patterns of diurnal preference. In addition, scores of three subscales—morningness, activity planning, and morning alertness—were extracted from the CSM.Results: No significant associations were observed between CSM scores and the 5-HTTLPR genotype or allele carrier status.Conclusion: The results of this study suggests that 5-HTTLPR has no effect on diurnal preference in a healthy Korean population. Further studies with a large number of subjects from multiple ethnicities are necessary to fully evaluate the association between 5-HTTLPR and diurnal preference.
{"title":"No Association Between the 5-HTTLPR Polymorphism and Diurnal Preference in Koreans","authors":"Saehyeon Kim, Jihye Yeom, Seunghwa Jeong, J. Seo, Sehyun Jeon, Heon-Jeong Lee","doi":"10.33069/cim.2021.0020","DOIUrl":"https://doi.org/10.33069/cim.2021.0020","url":null,"abstract":"Objective: Recent studies have extended the study of diurnal preferences to the genetic level. Most studies have focused on clock genes, but some studies have searched for the possibilities of other genes associated with the circadian rhythm. Considering that the circadian rhythm is associated with the serotonergic system, investigating the association between major genes of the serotonin system and the diurnal preference phenotype is essential. In this study, we evaluated whether the 5-HTTLPR polymorphism is associated with diurnal preference in a Korean population.Methods: In total, 509 healthy subjects were genotyped for the 5-HTTLPR polymorphism. The Korean version of the Composite Scale of Morningness (CSM) was used to measure the phenotype patterns of diurnal preference. In addition, scores of three subscales—morningness, activity planning, and morning alertness—were extracted from the CSM.Results: No significant associations were observed between CSM scores and the 5-HTTLPR genotype or allele carrier status.Conclusion: The results of this study suggests that 5-HTTLPR has no effect on diurnal preference in a healthy Korean population. Further studies with a large number of subjects from multiple ethnicities are necessary to fully evaluate the association between 5-HTTLPR and diurnal preference.","PeriodicalId":277997,"journal":{"name":"Chronobiology in Medicine","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129610835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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