{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T06:03:30Z","timestamp":1792476210340,"version":"4.5.0"},"reference-count":50,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2022,2,24]],"date-time":"2022-02-24T00:00:00Z","timestamp":1645660800000},"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: Parkinson\u2019s Disease (PD) is one of the most common causes of disability among older individuals. The advanced stages of PD are usually characterized by postural instability and, as a consequence, falls. Those are among the main factors that determine the quality of life, as well as the morbidity and mortality of a person with PD. In the field of PD rehabilitation, robotics is also rapidly gaining ground. As a primary aim, we evaluate the acceptability of the technology integrated intervention, using the Psychosocial Impact of Assistive Devices Scale (PIADS), in order to analyze the attitude of the participants towards the Tymo\u00ae system. As a secondary outcome, we assess the result of the rehabilitation treatment integrated with the Tymo\u00ae system on several patient\u2019s features. (2) Methods: We studied a population of 16 patients with Parkinson\u2019s Disease. Each recruited subject completed 10 treatment sessions, organized as two training sessions per week, for 5 weeks. The intervention included 30 min of traditional therapy and 20 min of technological treatment with a robotic system. PIADS is composed of three subscales (Competence subscale, Adaptability subscale, Self-esteem subscale) ranging from \u22123 to +3, reflecting, respectively, a negative or positive feeling towards the device. (3) Results: The Competence subscale, measuring feelings of competence and usefulness, obtained a score of 1.24 (SD = 0.78). The score of Adaptability subscale, indicating a willingness to try out new things and to take risks, was 1.83 (SD = 0.65). Finally, the Self-esteem subscale, indicating feelings of emotional health and happiness, reached a score of 1.31 (SD = 0.72). Moreover, statistical analysis reveals a significant effect on balance performance after intervention. (4) Conclusions: This feasibility study represents a starting point in the use of technology in the rehabilitation pathway of patients affected by Parkinson\u2019s Disease. In fact, our results suggest that a standard therapy combined with an innovative treatment using Tymo\u00ae may be accepted by PD patients, which may benefit especially from preserving balance.<\/jats:p>","DOI":"10.3390\/ijerph19052655","type":"journal-article","created":{"date-parts":[[2022,2,24]],"date-time":"2022-02-24T21:11:07Z","timestamp":1645737067000},"page":"2655","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Acceptability and Preliminary Results of Technology-Assisted Balance Training in Parkinson\u2019s Disease"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2414-3773","authenticated-orcid":false,"given":"Elvira","family":"Maranesi","sequence":"first","affiliation":[{"name":"Scientific Direction, IRCCS INRCA, 60124 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8466-1994","authenticated-orcid":false,"given":"Valentina","family":"Di Donna","sequence":"additional","affiliation":[{"name":"Clinical Unit of Physical Rehabilitation, IRCCS INRCA, 63900 Fermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0377-9713","authenticated-orcid":false,"given":"Giuseppe","family":"Pelliccioni","sequence":"additional","affiliation":[{"name":"Neurology Unit, IRCCS INRCA, 60127 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Cameriere","sequence":"additional","affiliation":[{"name":"Neurology Unit, IRCCS INRCA, 60127 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6356-0273","authenticated-orcid":false,"given":"Elisa","family":"Casoni","sequence":"additional","affiliation":[{"name":"Clinical Unit of Physical Rehabilitation, IRCCS INRCA, 60127 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renato","family":"Baldoni","sequence":"additional","affiliation":[{"name":"Clinical Unit of Physical Rehabilitation, IRCCS INRCA, 60127 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Benadduci","sequence":"additional","affiliation":[{"name":"Scientific Direction, IRCCS INRCA, 60124 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadia","family":"Rinaldi","sequence":"additional","affiliation":[{"name":"Clinical Unit of Physical Rehabilitation, IRCCS INRCA, 63900 Fermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7379-7714","authenticated-orcid":false,"given":"Lorenzo","family":"Fantechi","sequence":"additional","affiliation":[{"name":"Clinical Unit of Nuclear Medicine, IRCCS INRCA, 60127 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cinzia","family":"Giammarchi","sequence":"additional","affiliation":[{"name":"Scientific Direction, IRCCS INRCA, 60124 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Luzi","sequence":"additional","affiliation":[{"name":"Medical Direction, IRCCS INRCA, 60127 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6024-0183","authenticated-orcid":false,"given":"Paolo","family":"Pelliccioni","sequence":"additional","affiliation":[{"name":"Eye Clinic, Polytechnic University of Marche, 60127 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1862-4159","authenticated-orcid":false,"given":"Mirko","family":"Di Rosa","sequence":"additional","affiliation":[{"name":"Unit of Geriatric Pharmacoepidemiology, IRCCS INRCA, 60124 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Scendoni","sequence":"additional","affiliation":[{"name":"Clinical Unit of Physical Rehabilitation, IRCCS INRCA, 63900 Fermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni Renato","family":"Riccardi","sequence":"additional","affiliation":[{"name":"Clinical Unit of Physical Rehabilitation, IRCCS INRCA, 60127 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Bevilacqua","sequence":"additional","affiliation":[{"name":"Scientific Direction, IRCCS INRCA, 60124 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,2,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2143","DOI":"10.1212\/WNL.45.12.2143","article-title":"Prevalence of Parkinson\u2019s disease in the elderly: The Rotterdam Study","volume":"45","author":"Breteler","year":"1995","journal-title":"Neurology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"434683","DOI":"10.1155\/2015\/434683","article-title":"Balance dysfunction in Parkinson\u2019s disease","volume":"2015","author":"Rinalduzzi","year":"2015","journal-title":"Biomed. Res. Int."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"323","DOI":"10.3233\/JPD-181312","article-title":"Cardinal Motor Features of Parkinson\u2019s Disease Coexist with Peak-Dose Choreic-Type Drug-Induced Dyskinesia","volume":"8","author":"Goubault","year":"2018","journal-title":"J. Parkinsons. Dis."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1464","DOI":"10.1001\/archneur.57.10.1464","article-title":"Computerized posturography analysis of pro-gressive supranuclear palsy: A case-control comparison with Parkinson\u2019s disease and healthy controls","volume":"57","author":"Ondo","year":"2000","journal-title":"Arch. Neurol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"109","DOI":"10.14802\/jmd.15018","article-title":"What Is Wrong with Balance in Parkinson\u2019s Disease?","volume":"8","author":"Park","year":"2015","journal-title":"J. Mov. Disord."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"893","DOI":"10.3389\/fnins.2020.00893","article-title":"Microglial Activation and Inflammation as a Factor in the Pathogenesis of Progressive Supranuclear Palsy (PSP)","volume":"14","author":"Alster","year":"2020","journal-title":"Front. Neurosci."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1093\/brain\/awp261","article-title":"Unilateral pedunculopontine stimulation improves falls in Parkinson\u2019s disease","volume":"33","author":"Moro","year":"2010","journal-title":"Brain"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1016\/j.parkreldis.2008.01.006","article-title":"Loss of cholinergic neurons in the pedunculopontine nucleus in Parkinson\u2019s disease is related to disability of the patients","volume":"14","author":"Rinne","year":"2008","journal-title":"Parkinsonism. Relat. Disord."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1199","DOI":"10.1002\/mds.28051","article-title":"Pedunculopontine Nucleus Microstructure Predicts Postural and Gait Symptoms in Parkinson\u2019s Disease","volume":"35","author":"Craig","year":"2020","journal-title":"Mov. Disord."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1605","DOI":"10.1002\/mds.23790","article-title":"Balance and falls in Parkinson\u2019s disease: A meta-analysis of the effect of exercise and motor training","volume":"26","author":"Allen","year":"2011","journal-title":"Mov. Disord."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1002\/mds.21244","article-title":"Practice Recommendations Development Group. Evidence-based analysis of physical therapy in Parkinson\u2019s disease with recommendations for practice and research","volume":"22","author":"Keus","year":"2007","journal-title":"Mov. Disord."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"700","DOI":"10.2522\/ptj.20140090","article-title":"Does perturbation-based balance training prevent falls? Systematic review and meta-analysis of preliminary randomized controlled trials","volume":"95","author":"Mansfield","year":"2015","journal-title":"Phys Ther."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2330","DOI":"10.1007\/s00415-014-7496-3","article-title":"Dopaminergic medication does not improve stepping responses following backward and forward balance perturbations in patients with Parkinson\u2019s disease","volume":"261","author":"Nonnekes","year":"2014","journal-title":"J. Neurol."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Dhall, R., Krishnamurthi, N., Lieberman, A., Dhanani, S., and Pan, D. (2013). Why Levodopa May Increase Falls in Parkinson\u2019s Disease (P06.091). Neurology, 80, Available online: https:\/\/n.neurology.org\/content\/80\/7_Supplement\/P06.091.","DOI":"10.1212\/WNL.80.7_supplement.P06.091"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1016\/j.apmr.2004.08.008","article-title":"Efficacy of a physical therapy program in patients with Parkinson\u2019s disease:a randomized clinical trial","volume":"4","author":"Ellis","year":"2005","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_16","first-page":"1","article-title":"KNGF Guidelines for physical therapy in patients with Parkinson\u2019s disease","volume":"114","author":"Keus","year":"2004","journal-title":"Suppl. Dutch Physioth."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1159\/000481454","article-title":"Effects of Wearable Sensor-Based Balance and Gait Training on Balance, Gait, and Functional Performance in Healthy and Patient Populations: A Systematic Review and Meta-Analysis of Randomized Controlled Trials","volume":"64","author":"Gordt","year":"2018","journal-title":"Gerontology"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1038\/427311a","article-title":"Neuroplasticity: Changes in grey matter induced by training","volume":"427","author":"Draganski","year":"2004","journal-title":"Nature"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1016\/j.neurobiolaging.2013.06.021","article-title":"Structural brain plasticity in Parkinson\u2019s disease induced by balance training","volume":"35","author":"Sehm","year":"2014","journal-title":"Neurobiol. Aging"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1016\/j.parkreldis.2015.09.005","article-title":"Rehabilitation for Parkinson\u2019s disease: Current outlook and future challenges","volume":"22","author":"Abbruzzese","year":"2016","journal-title":"Parkinsonism Relat. Disord."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1177\/0269215507077269","article-title":"The effects of incremental speed-dependent treadmill training on postural instability and fear of falling in Parkinson\u2019s disease","volume":"21","author":"Cakit","year":"2007","journal-title":"Clin. Rehabil."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1186\/1743-0003-11-28","article-title":"Robot-assisted arm training in patients with Parkinson\u2019s disease: A pilot study","volume":"5","author":"Picelli","year":"2014","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_23","first-page":"5531331","article-title":"Assessment of Risk Factors for Falls among Patients with Parkinson\u2019s Disease","volume":"2021","author":"Margiel","year":"2021","journal-title":"Biomed. Res. Int."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Johansson, H., Hagstr\u00f6mer, M., Grooten, W.J.A., and Franz\u00e9n, E. (2020). Exercise-Induced Neuroplasticity in Parkinson\u2019s Disease: A Meta-synthesis of the Literature. Neural. Plast., 8961493.","DOI":"10.1155\/2020\/8961493"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"826","DOI":"10.1177\/1545968310376057","article-title":"Effect of balance training on postural instability in patients with idiopathic Parkinson\u2019s disease","volume":"24","author":"Smania","year":"2010","journal-title":"Neurorehabil. Neural. Repair."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1016\/j.mcna.2019.10.012","article-title":"Geriatric Rehabilitation: Gait in the Elderly, Fall Prevention and Parkinson Disease","volume":"104","author":"Swanson","year":"2020","journal-title":"Med. Clin. N. Am."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1186\/1743-0003-11-33","article-title":"The role of exergaming in Parkinson\u2019s disease rehabilitation: A systematic review of the evidence","volume":"11","author":"Barry","year":"2014","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1597","DOI":"10.1002\/mds.25670","article-title":"Virtual reality and motor imagery: Promising tools for assessment and therapy in Parkinson\u2019s disease","volume":"28","author":"Mirelman","year":"2013","journal-title":"Mov. Disord."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Bevilacqua, R., Maranesi, E., Di Rosa, M., Luzi, R., Casoni, E., Rinaldi, N., Baldoni, R., Lattanzio, F., Di Donna, V., and Pelliccioni, G. (2020). Rehabilitation of older people with Parkinson\u2019s disease: An innovative protocol for RCT study to evaluate the potential of robotic-based technologies. BMC Neurol., 20.","DOI":"10.1186\/s12883-020-01759-4"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1212\/WNL.17.5.427","article-title":"Parkinsonism: Onset, progression and mortality","volume":"17","author":"Hoehn","year":"1967","journal-title":"Neurology"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1530","DOI":"10.1093\/ptj\/66.10.1530","article-title":"Gait assesment for neurologically imparired. Standards for outcome assessment","volume":"66","author":"Holden","year":"1986","journal-title":"Phys. Ther."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1161\/01.STR.19.5.604","article-title":"Interobserver agreement for the assessment of handicap in stroke patients","volume":"19","author":"Koudstaal","year":"1988","journal-title":"Stroke"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1034\/j.1600-0579.2003.00216.x","article-title":"Validation of the five-item geriatric depression scale in elderly subjects in three different settings","volume":"51","author":"Rinaldi","year":"2003","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/0022-3956(75)90026-6","article-title":"Mini-mental state. A pratical method for grading the cognitive state of patients for the clinician","volume":"12","author":"Folstein","year":"1975","journal-title":"J. Psychiatr. Res."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1017\/S1041610297004870","article-title":"Clinical Dementia Rating: A Reliable and Valid Diagnostic and Staging Measure for Dementia of the Alzheimer Type","volume":"9","author":"Morris","year":"1997","journal-title":"Int. Psychogeriatr."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"107","DOI":"10.3233\/TAD-2002-14305","article-title":"Psychosocial Impact of Assistive devices Scale (PIADS)","volume":"14","author":"Jutai","year":"2002","journal-title":"Technol. Disabil."},{"key":"ref_37","first-page":"61","article-title":"Functional Evaluation: The Barthel Index","volume":"14","author":"Mahoney","year":"1965","journal-title":"Md. State Med. J."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1111\/j.1532-5415.1986.tb05480.x","article-title":"Performance-oriented assessment of mobility problems in elderly patients","volume":"34","author":"Tinetti","year":"1986","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_39","unstructured":"Ware, J.E., Kosinski, M., and Keller, S.D. (1998). SF-12: How to Score the SF-12 Physical and Mental Health Summary Scales, QualityMetric Incorporated. [3rd ed.]."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/j.archger.2009.09.031","article-title":"Validation of the Italian version of the falls efficacy scale international (FES-I) and the SHORT FES-I in community dwelling older persons","volume":"49","author":"Ruggiero","year":"2009","journal-title":"Arch. Gerontol. Geriatr."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"932","DOI":"10.1111\/j.1532-5415.2011.03395.x","article-title":"Wii-Fit as an adjunct for mild cognitive impairment: Clinical perspectives","volume":"59","author":"Padala","year":"2011","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/j.parkreldis.2019.08.001","article-title":"Quantifying physical activity in early Parkinson disease using a commercial activity monitor","volume":"66","author":"Pradhan","year":"2019","journal-title":"Parkinsonism Relat. Disord."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1007\/s40520-020-01612-1","article-title":"Guidelines on exercise testing and prescription for patients at different stages of Parkinson\u2019s disease","volume":"33","author":"Martignon","year":"2021","journal-title":"Aging Clin. Exp. Res."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Bevilacqua, R., Casaccia, S., Cortellessa, G., Astell, A., Lattanzio, F., Corsonello, A., D\u2019Ascoli, P., Paolini, S., Di Rosa, M., and Rossi, L. (2020). Coaching Through Technology: A Systematic Review into Efficacy and Effectiveness for the Ageing Population. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17165930"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1177\/1742395316653453","article-title":"Acceptance of technology-based tools in a sample of Parkinson\u2019s patients","volume":"13","author":"Duroseau","year":"2017","journal-title":"Chronic. Illn."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1186\/1743-0003-1-10","article-title":"Motor rehabilitation using virtual reality","volume":"1","author":"Sveistrup","year":"2004","journal-title":"J. Neuro Eng. Rehabil."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1089\/109493103322011524","article-title":"Experimental studies of virtual reality-delivered compared to conventional exercise programs for rehabilitation","volume":"6","author":"Sveistrup","year":"2003","journal-title":"Cyberpsychol. Behav."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1186\/s12984-019-0492-1","article-title":"Recent advances in rehabilitation for Parkinson\u2019s Disease with Exergames: A Systematic Review","volume":"16","author":"Folkerts","year":"2019","journal-title":"J. Neuro Eng. Rehabil."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.parkreldis.2017.05.011","article-title":"An interactive videogame for arm and hand exercise in people with Parkinson\u2019s disease: A randomized controlled trial","volume":"41","author":"Allen","year":"2017","journal-title":"Parkinsonism Relat. Disord."},{"key":"ref_50","first-page":"684758","article-title":"Executive function and postural instability in people with Parkinson\u2019s disease","volume":"2014","author":"Xu","year":"2014","journal-title":"Parkinsons Dis."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/5\/2655\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:27:02Z","timestamp":1760135222000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/5\/2655"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,24]]},"references-count":50,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2022,3]]}},"alternative-id":["ijerph19052655"],"URL":"https:\/\/doi.org\/10.3390\/ijerph19052655","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2,24]]}}}