Effects of Setting on Psychedelic Experiences, Therapies, and Outcomes: A Rapid Scoping Review of the Literature

Golden, Tasha L.; Magsamen, Susan; Sandu, Clara C.; Lin, Shuyang; Roebuck, Grace Marie; Shi, Kathy M.; Barrett, Frederick S.

doi:10.1007/7854_2021_298

Effects of Setting on Psychedelic Experiences, Therapies, and Outcomes: A Rapid Scoping Review of the Literature

Tasha L. Golden¹,
Susan Magsamen¹,
Clara C. Sandu¹,
Shuyang Lin¹,
Grace Marie Roebuck¹,
Kathy M. Shi² &
Frederick S. Barrett²

Chapter
First Online: 10 February 2022

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Part of the Current Topics in Behavioral Neurosciences book series

Abstract

The health and well-being impacts of art and aesthetic experiences have been rigorously studied by a range of disciplines, including cognitive neuroscience, psychiatry, public health, and translational clinical research. These experiences, encompassed in the concepts of set and setting, have long been claimed to be pivotal in determining the acute and enduring effects of psychedelic experiences. Responding to the field’s longstanding emphasis on the role and value of setting, a rapid scoping review was undertaken to identify the extent to which effects of setting and aesthetics on psychedelic experiences and therapies have been explicitly studied. It offers an analysis of the strengths and limitations of the extant literature and discusses evidentiary gaps as well as evidentiary opportunities for the field. The 43 included studies indicate apparent consensus regarding the importance of setting in psychedelic therapies, as well as consistent interest in theorizing about these effects. However, this consensus has yet to generate consistent, prospective, rigorous tests of setting and its complexities. As a result, the field continues to lack understanding or agreement regarding the effects of various specific elements of setting, the mechanisms by which they affect outcomes, for whom these effects occur, under what circumstances, given what conditions, and other critical factors. Further studies of setting and aesthetics in the context of psychedelic therapies are likely to not only improve these therapies and their delivery, but also inform considerations of setting and aesthetics for non-psychedelic interventions.

Keywords

Aesthetics
Arts
Arts and health
Ceremonial setting
Classic psychedelics
Enriched environment
Music
Naturalistic setting
Neuroaesthetics
Plant based medicine
Psychedelic therapy
Psychedelics
Ritual setting
Scoping review
Setting
Sociocultural setting

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References

Amir-Behghadami M, Janati A (2020) Population, intervention, comparison, outcomes and study (picos) design as a framework to formulate eligibility criteria in systematic reviews. Emerg Med J 37(6):387–387. https://doi.org/10.1136/emermed-2020-2095
CrossRef Google Scholar
Arksey H, O’Malley L (2005) Scoping studies: towards a methodological framework. Int J Soc Res Methodol 8(1):19–32. https://doi-org.echo.louisville.edu. https://doi.org/10.1080/1364557032000119616
CrossRef Google Scholar
Axon R, Whaley S, Marupuru S (2021) Extra-pharmacological factors predictive of clinical and humanistic outcomes associated with classical psychedelic assisted experiences: a systematic review. CRD42021234760. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021234760
Barbosa PC, Giglio JS, Dalgalarrondo P (2005) Altered states of consciousness and short-term psychological after-effects induced by the first time ritual use of ayahuasca in an urban context in Brazil. J Psychoactive Drugs 37(2):193–201. https://doi.org/10.1080/02791072.2005.10399801
CrossRef Google Scholar
Barrett FS, Robbins H, Smooke D, Brown JL, Griffiths RR (2017) Qualitative and quantitative features of music reported to support peak mystical experiences during psychedelic therapy sessions. Front Psychol 8:1238
Google Scholar
Belser AB, Agin-Liebes G, Swift TC, Terrana S, Devenot N, Friedman HL, Guss J, Bossis A, Ross S (2017) Patient experiences of psilocybin-assisted psychotherapy: an interpretative phenomenological analysis. Journal of Humanistic Psychology 57(4):354–388. https://doi.org/10.1177/0022167817706884
CrossRef Google Scholar
Beyer SV (2010) Singing to the plants: a guide to Mestizo Shamanism in the Upper Amazon, Reprint edn. University of New Mexico Press, Albuquerque
Google Scholar
Bøhling F (2017) Psychedelic pleasures: an affective understanding of the joys of tripping. Int J Drug Policy 49:133–143. https://doi.org/10.1016/j.drugpo.2017.07.017
CrossRef Google Scholar
Boyce M, Bungay H, Munn-Giddings C, Wilson C (2018) The impact of the arts in healthcare on patients and service users: a critical review. Health Soc Care Community 26(4):458–473. https://doi.org/10.1111/hsc.12502
CrossRef Google Scholar
Boyd B (2018) The evolution of stories: from mimesis to language, from fact to fiction. WIREs Cogn Sci 9(1444). https://doi.org/10.1002/wcs.1444
Brofenbrenner U (1979) The ecology of human development. Harvard University Press, pp 1–352
Google Scholar
Carbonaro TM, Bradstreet MP, Barrett FS, MacLean KA, Jesse R, Johnson MW, Griffiths RR (2016) Survey study of challenging experiences after ingesting psilocybin mushrooms: acute and enduring positive and negative consequences. J Psychopharmacol 30(12):1268–1278. https://doi.org/10.1177/0269881116662634
CrossRef Google Scholar
Chandler AL, Hartman MA (1960) Lysergic acid diethylamide (LSD-25) as a facilitating agent in psychotherapy. AMA Arch Gen Psychiatry 2:286–299. https://doi.org/10.1001/archpsyc.1960.03590090042008
CrossRef Google Scholar
Chung IM (1983 Sep) Bad trips. Aust Fam Physician 12(9):689–690. PMID: 6651634
Google Scholar
Coughlin SS (1990) Recall bias in epidemiologic studies. J Clin Epidemiol 43(1):87–91. https://doi.org/10.1016/0895-4356(90)90060-3
CrossRef Google Scholar
Dobkin De Rios M (1975) Man, culture and hallucinogens: an overview. In: Rubin V (ed) Cannabis and culture. Mouton Publishers, The Hague, pp 401–416
Google Scholar
Eagle CT (1972) Music and LSD: an empirical study. J Music Ther 9(1):23–36. https://doi.org/10.1093/jmt/9.1.23
CrossRef Google Scholar
Ebner-Priemer UW, Kuo J, Welch SS, Thielgen T, Witte S, Bohus M, Linehan MM (2006) A valence-dependent group-specific recall bias of retrospective self-reports: a study of borderline personality disorder in everyday life. J Nerv Ment Dis 194(10):774–779. https://doi.org/10.1097/01.nmd.0000239900.46595.72
CrossRef Google Scholar
Eisner B (1997) Set, setting, and matrix. J Psychoactive Drugs 29(2):213–216. https://doi.org/10.1080/02791072.1997.10400190
CrossRef Google Scholar
Eisner BG, Cohen S (1958) Psychotherapy with lysergic acid diethylamide. J Nerv Ment Dis 127(6):528–539. https://doi.org/10.1097/00005053-195812000-00006
CrossRef Google Scholar
Elimimian EB, Elson L, Stone E et al (2020) A pilot study of improved psychological distress with art therapy in patients with cancer undergoing chemotherapy. BMC Cancer 20(899). https://doi.org/10.1186/s12885-020-07380-5
Equator (2018) Centre for statistics in medicine (CSM), NDORMS, University of Oxford
Google Scholar
Faillace LA, Szara S (1968) Hallucinogenic drugs: influence of mental set and setting. Dis Nerv Syst 29(2):124–126
Google Scholar
Fancourt D (2017) Arts in health: designing and researching interventions, vol 1. Oxford University Press, pp 3–8
Google Scholar
Fancourt D, Finn S (2019) What is the evidence on the role of the arts in improving health and well-being? WHO Regional Office for Europe, Copenhagen, p 67. https://www.ncbi.nlm.nih.gov/books/NBK553773/
Google Scholar
Franklin N (2018) Biophilic design the key to improving mental health, productivity and stress levels. Workplace Insights
Google Scholar
Garcia-Romeu A, Richards WA (2018) Current perspectives on psychedelic therapy: use of serotonergic hallucinogens in clinical interventions. Int Rev Psychiatry 30:291–316. https://doi.org/10.1080/09540261.2018.1486289
CrossRef Google Scholar
Gaston ET, Eagle CT Jr (1970) The function of music in LSD therapy for alcoholic patients. J Music Ther 7(1):3–19
Google Scholar
Glasziou P, Meats E, Heneghan C, Shepperd S (2008) What is missing from descriptions of treatment in trials and reviews? BMJ 336:1472–1474. https://doi.org/10.1136/bmj.39590.732037.47
CrossRef Google Scholar
Golden T (2020) Innovation and equity in public health research: testing arts-based methods for trauma-informed, culturally-responsive inquiry. [Doctoral Dissertation, University of Louisville.] Think IR Electronic Theses and Dissertations. https://doi.org/10.18297/etd/3233
Golden SD, Earp JA (2012) Social ecological approaches to individuals and their contexts: twenty years of health education & behavior health promotion interventions. Health Educ Behav 39(3):364–372. https://doi.org/10.1177/1090198111418634
CrossRef Google Scholar
Golden TL, Wendel ML (2020) Public health’s next step in advancing equity: re-evaluating epistemological assumptions to move social determinants from theory to practice. Front Public Health 8:131. https://doi.org/10.3389/fpubh.2020.00131
CrossRef Google Scholar
Golden TL, Springs S, Kimmel HJ, Gupta S, Tiedemann A, Sandu CC, Magsamen S (2021) The use of music in the treatment and management of serious mental illness: a global scoping review of the literature. Front Psychol 12:649840. https://doi.org/10.3389/fpsyg.2021.649840
CrossRef Google Scholar
Grinspoon L (1981) LSD reconsidered. Sciences 21:20–23. https://doi.org/10.1002/j.2326-1951.1981.tb01901.x
CrossRef Google Scholar
Haijen E, Kaelen M, Roseman L, Timmermann C, Kettner H, Russ S, Nutt D, Daws RE, Hampshire A, Lorenz R, Carhart-Harris RL (2018) Predicting responses to psychedelics: a prospective study. Front Pharmacol 9:897. https://doi.org/10.3389/fphar.2018.00897
CrossRef Google Scholar
Hartogsohn I (2017) Constructing drug effects: a history of set and setting. Drug Sci Policy Law. https://doi.org/10.1177/2050324516683325
Iyendo TO (2016) Exploring the effect of sound and music on health in hospital settings: a narrative review. Int J Nurs Stud 63:82–100. https://doi.org/10.1016/j.ijnurstu.2016.08.008
CrossRef Google Scholar
Jin Y, Sanger N, Shams I, Luo C, Shahid H, Li G et al (2018) Does the medical literature remain inadequately described despite having reporting guidelines for 21 years? – A systematic review of reviews: an update. J Multidiscip Healthc 11:495–510. https://doi.org/10.2147/JMDH.S155103
CrossRef Google Scholar
Johnson M, Richards W, Griffiths R (2008) Human hallucinogen research: guidelines for safety. Journal of psychopharmacology (Oxford, England) 22(6):603–620. https://doi.org/10.1177/0269881108093587
CrossRef Google Scholar
Kaelen M, Giribaldi B, Raine J, Evans L, Timmerman C, Rodriguez N, Roseman L, Feilding A, Nutt D, Carhart-Harris R (2018) The hidden therapist: evidence for a central role of music in psychedelic therapy. Psychopharmacology (Berl) 235(2):505–519. https://doi.org/10.1007/s00213-017-4820-5
CrossRef Google Scholar
Kaelen M, Roseman L, Kahan J, Santos-Ribeiro A, Orban C, Lorenz R, Barrett FS, Bolstridge M, Williams T, Williams L, Wall MB, Feilding A, Muthukumaraswamy S, Nutt DJ, Carhart-Harris R (2016) LSD modulates music-induced imagery via changes in parahippocampal connectivity. Eur Neuropsychopharmacol 26(7):1099–1109. https://doi.org/10.1016/j.euroneuro.2016.03.018
CrossRef Google Scholar
Kaimal G, Ray K, Muniz J (2016) Reduction of cortisol levels and participants’ responses following art making. J Am Art Ther Assoc 33(2):74–80. https://doi.org/10.1080/07421656.2016.1166832
CrossRef Google Scholar
Kettner H, Rosas FE, Timmermann C, Kärtner L, Carhart-Harris RL, Roseman L (2021) Psychedelic communitas: intersubjective experience during psychedelic group sessions predicts enduring changes in psychological wellbeing and social connectedness. Front Pharmacol 12:623985. https://doi.org/10.3389/fphar.2021.623985
CrossRef Google Scholar
Kilic S, Karadag G, Oyucu S, Kale O, Zengin S, Ozdemir E, Korhan EA (2015) Effect of music on pain, anxiety, and patient satisfaction in patients who present to the emergency department in Turkey. Jpn J Nurs Sci 12(1):44–53. https://doi.org/10.1111/jjns.12047
CrossRef Google Scholar
Kondo MC, Fluehr JM, McKeon T, Branas CC (2018) Urban green space and its impact on human health. Int J Environ Res Public Health 15(3):445. https://doi.org/10.3390/ijerph15030445
CrossRef Google Scholar
Kuiper K (2018 Venus of Willendorf. Encyclopedia Britannica. https://www.britannica.com/topic/Venus-of-Willendorf
Google Scholar
Lambert P, Betts D, Rollins J, Sonke J, Swanson K (2017) Arts, health, and well-being in America. National Organization for Arts in Health, pp 1–52
Google Scholar
Lankston L, Cusack P, Fremantle C, Isles C (2010) Visual art in hospitals: case studies and review of the evidence. J R Soc Med 103(12):490–499. https://doi.org/10.1258/jrsm.2010.100256
CrossRef Google Scholar
Leary T (1961) Drugs, set & suggestibility. Paper presented at the annual meeting of the American Psychological Association, 6 Sept 1961
Google Scholar
Leary T, Litwin GH, Metzner R (1963) Reactions to psilocybin administered in a supportive environment. J Nerv Ment Dis 137:561–573. https://doi.org/10.1097/00005053-196312000-00007
CrossRef Google Scholar
Liang Z, Ren D, Choi J, Happ MB, Hravnak M, Hoffman LA (2016) Music intervention during daily weaning trials-A 6 day prospective randomized crossover trial. Complement Ther Med 29:72–77. https://doi.org/10.1016/j.ctim.2016.09.003
CrossRef Google Scholar
Lyttle T, Montagne M (1992) Drugs, music, and ideology: a social pharmacological interpretation of the acid house movement. Int J Addict 27(10):1159–1177. https://doi.org/10.3109/10826089209047341
CrossRef Google Scholar
Mason AS (2016) Ancient aesthetics, vol 1. Routledge, London, p 8. https://doi.org/10.4324/9781315697444
CrossRef Google Scholar
Mays N, Roberts EPopay J (2001) Synthesising research evidence. In: Fulop N, Allen P, Clarke A, Black N (eds) Methods for studying the delivery and organisation of health services, Routledge
Google Scholar
McLeroy KR, Bibeau D, Steckler A, Glanz K (1988) An ecological perspective on health promotion programs. Health Educ Q 15(4):351–377. https://doi.org/10.1177/109019818801500401
CrossRef Google Scholar
Metzner R, Leary T (1967) On programming psychedelic experiences. Psychedelic Rev 9:5–19
Google Scholar
Neitzke-Spruill L (2019) Race as a component of set and setting: how experiences of race can influence psychedelic experiences. J Psychedelic Stud 4:1–10. https://doi.org/10.1556/2054.2019.022
CrossRef Google Scholar
Olson JA, Suissa-Rocheleau L, Lifshitz M, Raz A, Veissière S (2020) Tripping on nothing: placebo psychedelics and contextual factors. Psychopharmacology (Berl) 237(5):1371–1382. https://doi.org/10.1007/s00213-020-05464-5
CrossRef Google Scholar
Pallavicini C, Cavanna F, Zamberlan F, de la Fuente LA, Ilksoy Y, Perl YS, Arias M, Romero C, Carhart-Harris R, Timmermann C, Tagliazucchi E (2021) Neural and subjective effects of inhaled N,N-dimethyltryptamine in natural settings. J Psychopharmacol 35(4):406–420. https://doi.org/10.1177/0269881120981384
CrossRef Google Scholar
Perkins D, Schubert V, Simonová H, Tófoli LF, Bouso JC, Horák M, Galvão-Coelho NL, Sarris J (2021) Influence of context and setting on the mental health and wellbeing outcomes of Ayahuasca drinkers: results of a large international survey. Front Pharmacol 12:623979. https://doi.org/10.3389/fphar.2021.623979
CrossRef Google Scholar
Peters MDJ, Godfrey C, McInerney P, Munn Z, Tricco AC, Khalil H (2020) Chapter 11: scoping reviews. In: Aromataris E, Munn Z (eds) JBI manual for evidence synthesis. https://synthesismanual.jbi.global. https://doi.org/10.46658/JBIMES-20-12
CrossRef Google Scholar
Phelps J (2017) Developing guidelines and competencies for the training of psychedelic therapists. J Humanist Psychol 57(5):450–487. https://doi.org/10.1177/0022167817711304
CrossRef Google Scholar
Pinch TJ, Bijker WE (1984) The social construction of facts and artefacts: or how the sociology of science and the sociology of technology might benefit each other. Soc Stud Sci 14(3):399–441
Google Scholar
Powell J (2019) Cave paintings that recorded the night sky. In: From cave art to Hubble, Astronomers’ Universe. Springer, Cham. https://doi.org/10.1007/978-3-030-31688-4_2
CrossRef Google Scholar
Preller KH, Herdener M, Pokorny T, Planzer A, Kraehenmann R, Stämpfli P, Liechti ME, Seifritz E, Vollenweider FX (2017) The fabric of meaning and subjective effects in LSD-induced states depend on serotonin 2A receptor activation. Curr Biol 27(3):451–457. https://doi.org/10.1016/j.cub.2016.12.030
CrossRef Google Scholar
Raphael K (1987) Recall bias: a proposal for assessment and control. Int J Epidemiol 16(2):167–170. https://doi.org/10.1093/ije/16.2.167
CrossRef Google Scholar
Roseman L, Ron Y, Saca A, Ginsberg N, Luan L, Karkabi N, Doblin R, Carhart-Harris R (2021) Relational processes in Ayahuasca Groups of Palestinians and Israelis. Front Pharmacol 12:607529. https://doi.org/10.3389/fphar.2021.607529
CrossRef Google Scholar
Sandison, R. A. (1959). The role of psychotropic drugs in group therapy. Bull World Health Organ, 21(4-5), 505–515.
Google Scholar
Sato H, Kawahara JI (2011) Selective bias in retrospective self-reports of negative mood states. Anxiety Stress Coping 24(4):359–367. https://doi.org/10.1080/10615806.2010.543132
CrossRef Google Scholar
Schlicht J, Mitcheson M, Henry M (1972) Medical aspects of large outdoor festivals. Lancet 1(7757):948–952. https://doi.org/10.1016/s0140-6736(72)91508-5
CrossRef Google Scholar
Scott S (2020) Learning spaces: biophilic design in schools. Teacher Mag
Google Scholar
Sepeda ND, Clifton JM, Doyle LY, Lancelotta R, Griffiths RR, Davis AK (2020) Inhaled 5-methoxy-N,N-dimethyltryptamine: supportive context associated with positive acute and enduring effects. J Psychedelic Stud 4(2):114–122. Retrieved 11 Sept 2021, from https://akjournals.com/view/journals/2054/4/2/article-p114.xml
Smigielski L, Kometer M, Scheidegger M, Krähenmann R, Huber T, Vollenweider FX (2019) Characterization and prediction of acute and sustained response to psychedelic psilocybin in a mindfulness group retreat. Sci Rep 9(1):14914. https://doi.org/10.1038/s41598-019-50612-3
CrossRef Google Scholar
Staricoff R (2004) Arts in health: a review of the medical literature. Arts Council England, London
Google Scholar
Stineman MG, Streim JE (2010) The biopsycho-ecological paradigm: a foundational theory for medicine. PM R 2(11):1035–1045. https://doi.org/10.1016/j.pmrj.2010.06.013
CrossRef Google Scholar
Strickland JC, Garcia-Romeu A, Johnson MW (2020) Set and setting: a randomized study of different musical genres in supporting psychedelic therapy. ACS Pharmacol Transl Sci 4(2):472–478. https://doi.org/10.1021/acsptsci.0c00187
CrossRef Google Scholar
Stuckey HL, Nobel J (2010) The connection between art, healing, and public health: a review of current literature. Am J Public Health 100(2):254–263. https://doi.org/10.2105/AJPH.2008.156497
CrossRef Google Scholar
Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, Moher D, Peters MDJ, Horsley T, Weeks L, Hempel S, Akl EA, Chang C, McGowan J, Stewart L, Hartling L, Aldcroft A, Wilson MG, Garritty C, Lewin S, Godfrey CM, Macdonald MT, Langlois EV, Soares-Weiser K, Moriarty J, Clifford T, Tunçalp Ö, Straus SE (2018 Oct 2) PRISMA extension for scoping reviews (PRISMAScR): checklist and explanation. Ann Intern Med. American College of Physicians. https://doi.org/10.7326/M18-0850
Uthaug MV, Mason NL, Toennes SW, Reckweg JT, de Sousa Fernandes Perna EB, Kuypers K, van Oorsouw K, Riba J, Ramaekers JG (2021) A placebo-controlled study of the effects of ayahuasca, set and setting on mental health of participants in ayahuasca group retreats. Psychopharmacology (Berl) 238(7):1899–1910. https://doi.org/10.1007/s00213-021-05817-8
CrossRef Google Scholar
Vitos B (2017) “Go Out on the Weekends to the Forest, Get Trashed and Dance”: residual behaviors and reconfigured environments at psychedelic trance festivals. Leis Sci 39:1–18. https://doi.org/10.1080/01490400.2016.1256796
CrossRef Google Scholar
WHO Regional Office for Europe (2021) Green and blue spaces and mental health: new evidence and perspectives for action (2021) Copenhagen. Licence: CC BY-NC-SA 3.0 IGO
Google Scholar
Yin J, Yuan J, Arfaei N, Catalano PJ, Allen JG, Spengler JD (2020) Effects of biophilic indoor environment on stress and anxiety recovery: a between-subjects experiment in virtual reality. Environ Int 136:105427. https://doi.org/10.1016/j.envint.2019.105427
CrossRef Google Scholar
Zinberg NE, Jacobson RC, Harding WM (1975) Social sanctions and rituals as a basis for drug abuse prevention. Am J Drug Alcohol Abuse 2(2):165–182. https://doi.org/10.3109/00952997509002732
CrossRef Google Scholar

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Authors and Affiliations

International Arts + Mind Lab, Center for Applied Neuroaesthetics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
Tasha L. Golden, Susan Magsamen, Clara C. Sandu, Shuyang Lin & Grace Marie Roebuck
Department of Psychiatry and Behavioral Sciences, Center for Psychedelic and Consciousness Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA
Kathy M. Shi & Frederick S. Barrett

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Tasha L. Golden
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Susan Magsamen
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Clara C. Sandu
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Shuyang Lin
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Grace Marie Roebuck
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Kathy M. Shi
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Golden, T.L. et al. (2022). Effects of Setting on Psychedelic Experiences, Therapies, and Outcomes: A Rapid Scoping Review of the Literature. In: Current Topics in Behavioral Neurosciences. Springer, Berlin, Heidelberg. https://doi.org/10.1007/7854_2021_298

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DOI: https://doi.org/10.1007/7854_2021_298
Published: 10 February 2022
Publisher Name: Springer, Berlin, Heidelberg