{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T15:33:45Z","timestamp":1788449625303,"version":"build-2803163510"},"reference-count":58,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2021,11,30]],"date-time":"2021-11-30T00:00:00Z","timestamp":1638230400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>(1) Background: Type 1 diabetes mellitus (T1DM) people\u2019s health-related quality of life (HRQoL) is affected by glycemic control. Regular exercise is strongly recommended to these patients due to its cardiovascular and metabolic benefits. However, a large percentage of patients with T1DM people present a sedentary behavior because of the fear of a post-exercise hypoglycemia event, lack of time, lack of motivation and the complicated management of exercise, glycemic and insulin dose interaction. High-intensity interval training (HIIT) is an efficient and safe methodology since it prevents hypoglycemia and does not require much time, which are the main barriers for this population to doing exercise and increasing physical conditioning. (2) Methods: Nineteen sedentary adults (37 \u00b1 6.5 years) with T1DM, were randomly assigned to 6 weeks of either HIIT (12-16-20 \u00d7 30-s intervals interspersed with 1-min rest periods) performed thrice weekly, or to the control group, which did not train. HRQoL, sleep quality, exercise motivation and enjoyment were measured as psychological variables. (4) Results: HRQoL improved in physical and social domains, PF (1.9%); PR (80.3%); GH (16.6); SF (34.1%). Sleep quality improved in the HIIT group by 21.4%. Enjoyment improved by 7% and intrinsic motivation was increased by 13%. (5) Conclusions: We suggest that the 6-week HIIT program used in the present study is safe, since no severe hypoglycemia were reported, and an effective strategy in improving HRQoL, sleep quality, exercise motivation and enjoyment which are important psychological well-being factors in T1DM people.<\/jats:p>","DOI":"10.3390\/ijerph182312612","type":"journal-article","created":{"date-parts":[[2021,11,30]],"date-time":"2021-11-30T23:22:28Z","timestamp":1638314548000},"page":"12612","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":54,"title":["Effect of High-Intensity Interval Training on Quality of Life, Sleep Quality, Exercise Motivation and Enjoyment in Sedentary People with Type 1 Diabetes Mellitus"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0903-1295","authenticated-orcid":false,"given":"Jes\u00fas","family":"Alarc\u00f3n-G\u00f3mez","sequence":"first","affiliation":[{"name":"Department of Physical Education and Sports, University of Valencia, 46010 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6612-1759","authenticated-orcid":false,"given":"Iv\u00e1n","family":"Chulvi-Medrano","sequence":"additional","affiliation":[{"name":"UIRFIDE Sport Performance and Physical Fitness Research Group, University of Valencia, 46010 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Martin-Rivera","sequence":"additional","affiliation":[{"name":"Research Group in Prevention and Health in Exercise and Sport, University of Valencia, 46010 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8670-8346","authenticated-orcid":false,"given":"Joaqu\u00edn","family":"Calatayud","sequence":"additional","affiliation":[{"name":"Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,11,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1309","DOI":"10.1002\/cphy.c110040","article-title":"Exercise and type 1 diabetes (T1DM)","volume":"3","author":"Galassetti","year":"2013","journal-title":"Compr. Physiol."},{"key":"ref_2","unstructured":"OMS (2016). Informe Mundial Sobre la Diabetes, OMS."},{"key":"ref_3","unstructured":"International Diabetes Federation (2019). Atlas de la Diabetes de la Fid, International Diabetes Federation. [9th ed.]."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"17016","DOI":"10.1038\/nrdp.2017.16","article-title":"Type 1 diabetes mellitus","volume":"3","author":"Katsarou","year":"2017","journal-title":"Nat. Rev. Dis. Prim."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.diabres.2016.08.021","article-title":"Type 1 diabetes, quality of life, occupational status and education level-A comparative population-based study","volume":"121","author":"Nielsen","year":"2016","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1111\/dom.13065","article-title":"The effect of exercise on sleep in adults with type 1 diabetes","volume":"20","author":"Reddy","year":"2018","journal-title":"Diabetes Obes. Metab."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1007\/s11892-018-0974-8","article-title":"Sleep in Type 1 Diabetes: Implications for Glycemic Control and Diabetes Management","volume":"18","author":"Perez","year":"2018","journal-title":"Curr. Diabetes Rep."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1177\/0269215510386254","article-title":"Influence of combined aerobic and resistance training on metabolic control, cardiovascular fitness and quality of life in adolescents with type 1 diabetes: A randomized controlled trial","volume":"25","author":"Hellinckx","year":"2011","journal-title":"Clin. Rehabil."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"107810","DOI":"10.1016\/j.diabres.2019.107810","article-title":"Benefits of physical activity in children and adolescents with type 1 diabetes: A systematic review","volume":"156","author":"Absil","year":"2019","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.jcjd.2013.08.268","article-title":"Lifestyle and cardiometabolic risk in adults with type 1 diabetes: A review","volume":"38","author":"Leroux","year":"2014","journal-title":"Can. J. Diabetes"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1016\/j.diabres.2014.09.038","article-title":"A systematic review and meta-analysis of exercise interventions in adults with type 1 diabetes","volume":"106","author":"Yardley","year":"2014","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/j.mehy.2017.05.033","article-title":"Exercise for type 1 diabetes mellitus management: General considerations and new directions","volume":"104","author":"Farinha","year":"2017","journal-title":"Med. Hypotheses"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1007\/s40279-013-0066-5","article-title":"High-intensity interval training, solutions to the programming puzzle. Part II: Anaerobic energy, neuromuscular load and practical applications","volume":"43","author":"Buchheit","year":"2013","journal-title":"Sports Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1111\/obr.12532","article-title":"The effects of high-intensity interval training vs. moderate-intensity continuous training on body composition in overweight and obese adults: A systematic review and meta-analysis","volume":"18","author":"Wewege","year":"2017","journal-title":"Obes. Rev."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1097\/CRD.0000000000000124","article-title":"High-intensity interval training versus moderate-intensity continuous training in the prevention\/management of cardiovascular disease","volume":"24","author":"Hussain","year":"2016","journal-title":"Cardiol. Rev."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/j.diabres.2017.12.017","article-title":"High-intensity interval training versus continuous training on physiological and metabolic variables in prediabetes and type 2 diabetes: A meta-analysis","volume":"137","author":"Tolves","year":"2018","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Oliveira, B.R.R., Santos, T.M., Kilpatrick, M., Pires, F.O., and Deslandes, A.C. (2018). Affective and enjoyment responses in high intensity interval training and continuous training: A systematic review and meta-analysis. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0197124"},{"key":"ref_18","first-page":"783","article-title":"High-intensity interval neuromuscular training promotes exercise behavioral regulation, adherence and weight loss in inactive obese women","volume":"39","author":"Batrakoulis","year":"2019","journal-title":"Eur. J. Sport Sci."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1124","DOI":"10.1016\/j.jdiacomp.2018.09.008","article-title":"Glycemic, inflammatory and oxidative stress responses to different high-intensity training protocols in type 1 diabetes: A randomized clinical trial","volume":"32","author":"Farinha","year":"2018","journal-title":"J. Diabetes Complicat."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Boff, W., Da Silva, A.M., Farinha, J.B., Rodrigues-Krause, J., Reischak-Oliveira, A., Tschiedel, B., Pu\u00f1ales, M., and Bertoluci, M.C. (2019). Superior effects of high-intensity interval vs. moderate-intensity continuous training on endothelial function and cardiorespiratory fitness in patients with type 1 diabetes: A randomized controlled trial. Front. Physiol., 10.","DOI":"10.3389\/fphys.2019.00450"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1210\/jc.2018-01309","article-title":"High-Intensity Interval Training Improves Aerobic Capacity Without a Detrimental Decline in Blood Glucose in People with Type 1 Diabetes","volume":"104","author":"Scott","year":"2018","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_22","first-page":"2050312116671725","article-title":"SF-36 total score as a single measure of health-related quality of life: Scoping review","volume":"4","author":"Liliane","year":"2016","journal-title":"SAGE Open Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"87","DOI":"10.4239\/wjd.v10.i2.87","article-title":"Quantities of comorbidities affects physical, but not mental health related quality of life in type 1 diabetes with confirmed polyneuropathy","volume":"10","author":"Wegeberg","year":"2019","journal-title":"World J. Diabetes"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1111\/sms.12896","article-title":"Cardiorespiratory fitness and health-related quality of life in women at risk for gestational diabetes","volume":"28","author":"Engberg","year":"2018","journal-title":"Scand. J. Med. Sci. Sports"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Galilea-Zabalza, I., Buil-Cosiales, P., Salas-Salvad\u00f3, J., Toledo, E., Ortega-Azor\u00edn, C., D\u00edez-Espino, J., V\u00e1zquez-Ruiz, Z., Zome\u00f1o, M.D., Vioque, J., and Mart\u00ednez, J.A. (2018). Mediterranean diet and quality of life: Baseline cross-sectional analysis of the PREDIMED-PLUS trial. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0198974"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1016\/S0895-4356(98)00081-X","article-title":"Overview of the SF-36 Health Survey and the International Quality of Life Assessment (IQOLA) Project","volume":"51","author":"Ware","year":"1998","journal-title":"J. Clin. Epidemiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"766","DOI":"10.3945\/ajcn.115.124669","article-title":"Higher-protein diets improve indexes of sleep in energy-restricted overweight and obese adults: Results from 2 randomized controlled trials","volume":"103","author":"Zhou","year":"2016","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/0165-1781(89)90047-4","article-title":"The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research","volume":"28","author":"Buysse","year":"1989","journal-title":"Psychiatry Res."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Castro, A.I., Gomez-Arbelaez, D., Crujeiras, A.B., Granero, R., Aguera, Z., Jimenez-Murcia, S., Sajoux, I., Lopez-Jaramillo, P., Fernandez-Aranda, F., and Casanueva, F.F. (2018). Effect of a very low-calorie ketogenic diet on food and alcohol cravings, physical and sexual activity, sleep disturbances, and quality of life in obese patients. Nutrients, 10.","DOI":"10.3390\/nu10101348"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1016\/j.jsams.2017.08.024","article-title":"Quality of life and sleep quality are similarly improved after aquatic or dry-land aerobic training in patients with type 2 diabetes: A randomized clinical trial","volume":"21","author":"Delevatti","year":"2018","journal-title":"J. Sci. Med. Sport"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Jurado-Fasoli, L., De-la-O, A., Molina-Hidalgo, C., Migueles, J.H., Castillo, M.J., and Amaro-Gahete, F.J. (2020). Exercise training improves sleep quality: A randomized controlled trial. Eur. J. Clin. Investig., 50.","DOI":"10.1111\/eci.13202"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1123\/jsep.26.2.191","article-title":"A modification to the behavioural regulation in exercise questionnaire to include an assessment of amotivation","volume":"26","author":"Markland","year":"2004","journal-title":"J. Sport Exerc. Psychol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"884","DOI":"10.1080\/09593985.2018.1457112","article-title":"Physical activity levels and self-determined motivation among future healthcare professionals: Utility of the Behavioral Regulation in Exercise Questionnaire (BREQ-2)","volume":"35","author":"Mahony","year":"2019","journal-title":"Physiother. Theory Pract."},{"key":"ref_34","first-page":"366","article-title":"Measuring self-determination motivation in a physical fitness setting: Validation of the Behavioral Regulation in Exercise Questionnaire-2 (BREQ-2) in a Spanish sample","volume":"47","author":"Murcia","year":"2007","journal-title":"J. Sports Med. Phys. Fit."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1016\/j.psychsport.2012.03.009","article-title":"On the nature and function of scoring protocols used in exercise motivation research: An empirical study of the behavioral regulation in exercise questionnaire","volume":"13","author":"Wilson","year":"2012","journal-title":"Psychol. Sport Exerc."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1174\/021093908784485093","article-title":"Propiedades psicom\u00e9tricas de la Physical Activity Enjoyment Scale (PACES) en el contexto Espa\u00f1ol","volume":"29","author":"Moreno","year":"2008","journal-title":"Estud. Psicol."},{"key":"ref_37","first-page":"595","article-title":"Validez y fiabilidad del cuestionario de disfrute por el ejercicio f\u00edsico (PACES) en adolescentes con sobrepeso y obesidad","volume":"33","year":"2016","journal-title":"Nutr. Hosp."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"24","DOI":"10.3389\/fspor.2019.00024","article-title":"Validity and Reliability of the New Portable Metabolic Analyzer PNOE","volume":"1","author":"Tsekouras","year":"2019","journal-title":"Front. Sports Act. Living"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Scott, S.N., Shepherd, S.O., Strauss, J.A., Wagenmakers, A.J.M., and Cocks, M. (2019). Home-based high-intensity interval training reduces barriers to exercise in people with type 1 diabetes. Exp. Physiol.","DOI":"10.1113\/EP088097"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1002","DOI":"10.2337\/dc16-1990","article-title":"Factors associated with diabetes-specific health-related quality of life in youth with type 1 diabetes: The global teens study","volume":"40","author":"Anderson","year":"2017","journal-title":"Diabetes Care"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Nazari, M., Shabani, R., and Dalili, S. (2020). The effect of concurrent resistance-aerobic training on serum cortisol level, anxiety, and quality of life in pediatric type 1 diabetes. J. Pediatr. Endocrinol. Metab.","DOI":"10.1515\/jpem-2019-0526"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/j.diabres.2016.09.010","article-title":"Physical activity does not inevitably improve quality of life in young adults with type 1 diabetes","volume":"121","author":"Tarkka","year":"2016","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1110","DOI":"10.1161\/CIR.0000000000000034","article-title":"Type 1 diabetes mellitus and cardiovascular disease a scientific statement from the american heart association andamerican diabetes association","volume":"130","author":"Fonseca","year":"2014","journal-title":"Circulation"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1696","DOI":"10.1177\/2047487317728370","article-title":"High-intensity interval training versus moderate-intensity continuous training on exercise capacity and quality of life in patients with coronary artery disease: A systematic review and meta-analysis","volume":"24","author":"Neves","year":"2017","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/j.ijcard.2018.02.076","article-title":"High intensity interval training versus moderate intensity continuous training on exercise capacity and quality of life in patients with heart failure with reduced ejection fraction: A systematic review and meta-analysis","volume":"261","author":"Saquetto","year":"2018","journal-title":"Int. J. Cardiol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1055\/s-0043-125074","article-title":"High-intensity Interval Training Frequency: Cardiometabolic Effects and Quality of Life","volume":"39","author":"Stavrinou","year":"2018","journal-title":"Int. J. Sports Med."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"dc200342","DOI":"10.2337\/dc20-0342","article-title":"Effect of High-Intensity Interval Training on Glycemic Control in Adults With Type 1 Diabetes and Overweight or Obesity: A Randomized Controlled Trial With Partial Crossover","volume":"43","author":"Lee","year":"2020","journal-title":"Diabetes Care"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Bujang, M.A., Adnan, T.H., Hatta, N.K.B.M., Ismail, M., and Lim, C.J. (2018). A Revised Version of Diabetes Quality of Life Instrument Maintaining Domains for Satisfaction, Impact, and Worry. J. Diabetes Res., 2018.","DOI":"10.1155\/2018\/5804687"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/j.smrv.2015.01.009","article-title":"The Pittsburgh sleep quality index as a screening tool for sleep dysfunction in clinical and non-clinical samples: A systematic review and meta-analysis","volume":"25","author":"Mollayeva","year":"2016","journal-title":"Sleep Med. Rev."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Jacobs, P.G., and Reddy, R. (2020). Exercise, Sleep, and Type 1 Diabetes. Neurological Modulation of Sleep, Elsevier.","DOI":"10.1016\/B978-0-12-816658-1.00015-6"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1818","DOI":"10.1249\/MSS.0000000000001642","article-title":"High-Intensity Interval Training in the Real World: Outcomes from a 12-Month Intervention in Overweight Adults","volume":"50","author":"Roy","year":"2018","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Thum, J.S., Parsons, G., Whittle, T., and Astorino, T.A. (2017). High-intensity interval training elicits higher enjoyment than moderate intensity continuous exercise. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0166299"},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Lascar, N., Kennedy, A., Hancock, B., Jenkins, D., Andrews, R.C., Greenfield, S., and Narendran, P. (2014). Attitudes and barriers to exercise in adults with type 1 diabetes (T1DM) and how best to address them: A qualitative study. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0108019"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1491","DOI":"10.1080\/02640414.2015.1119301","article-title":"Effects of autonomous motivational priming on motivation and affective responses towards High-Intensity interval training","volume":"34","author":"Brown","year":"2016","journal-title":"J. Sports Sci."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1037\/0003-066X.55.1.68","article-title":"Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being","volume":"55","author":"Ryan","year":"2000","journal-title":"Am. Psychol."},{"key":"ref_56","first-page":"213","article-title":"Complementando la teor\u00eda de la autodeterminaci\u00f3n con las metas sociales: Un estudio sobre la diversi\u00f3n en educaci\u00f3n f\u00edsica","volume":"26","year":"2009","journal-title":"Rev. Mex. Psicol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1203","DOI":"10.1080\/17461391.2017.1359679","article-title":"High-intensity interval and moderate-intensity continuous training elicit similar enjoyment and adherence levels in overweight and obese adults","volume":"17","author":"Vella","year":"2017","journal-title":"Eur. J. Sport Sci."},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Heinrich, K.M., Patel, P.M., O\u2019Neal, J.L., and Heinrich, B.S. (2014). High-intensity compared to moderate-intensity training for exercise initiation, enjoyment, adherence, and intentions: An intervention study. BMC Public Health, 14.","DOI":"10.1186\/1471-2458-14-789"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/23\/12612\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:37:44Z","timestamp":1760168264000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/23\/12612"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,30]]},"references-count":58,"journal-issue":{"issue":"23","published-online":{"date-parts":[[2021,12]]}},"alternative-id":["ijerph182312612"],"URL":"https:\/\/doi.org\/10.3390\/ijerph182312612","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,30]]}}}