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Huang C, Ren X, Xu B, Liu P, Li T, Zhu Q, Huang J, Chen X, Wu D, Yang X, Zhu F, Liu J. Urinary nicotine metabolites are associated with cognitive impairment among the elderly in southern China. Tob Induc Dis 2023; 21:123. [PMID: 37799805 PMCID: PMC10548790 DOI: 10.18332/tid/170423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 08/03/2023] [Accepted: 08/05/2023] [Indexed: 10/07/2023] Open
Abstract
INTRODUCTION This study comprehensively assessed the association between eight metabolites of urinary nicotine and cognitive impairment. METHODS This cross-sectional study was based on the data of Shenzhen Aging Related Disorder Cohort (SADC), including 51 elderly community data variables such as demographic characteristics, neuropsychological assessment and environmental factors, from July 2017 to November 2018. Participant's cognitive function was assessed by Mini-Mental State Examination (MMSE) scale and urinary nicotine metabolite [including cotinine N-β-D-glucuronide (CotGluc), rac 4-hydroxy-4-(3-pyridyl) butanoic acid dicyclohexylamine salt (HyPyBut), trans-3'-hydroxy cotinine O-β-D-glucuronide (OHCotGluc), and cotinine (Cot), etc.] concentrations were measured by high-performance liquid chromatography-tandem mass spectrometry (LC-MS/MS). Generalized linear models and restricted cubic spline models were used to explore the relationships between the urinary levels of nicotine metabolite and cognitive function. RESULTS A total of 296 individuals aged >60 years were included. Individuals in the third quartile of CotGluc had a 0.786 point (95% CI: -1.244 - -0.329) decrease or in the highest quartile of OHCotGluc had a 0.804 point (95% CI: -1.330 - -0.278) decreased in attention and calculation compared to those in the lowest quartile (all p for trend <0.05). Compared with those in the lowest quartile, individuals in the highest quartile of CotGluc, HyPyBut, OHCotGluc and Cot, respectively, corresponded to a 1.043 point (95% CI: -2.269-0.182), 1.101 points (95% CI: -2.391-0.188), 2.318 points (95% CI: -3.615 - -1.020), and 1.460 points (95% CI: -2.726 - -0.194) decreased in MMSE total score (all p for trend <0.05). A non-linear dose-response relationship between urinary levels of CotGluc, HyPyBut, OHCotGluc or Cot and cognitive function (all overall p<0.05, non-linear p<0.05). Subgroup analysis showed that urinary levels of CotGluc, OHCotGluc or Cot were significantly negatively associated with cognitive function (all p for trend <0.05) among females and non-smokers. CONCLUSIONS The findings highlight the public health implications of environmental tobacco smoke exposure, and effective interventions need to be performed for vulnerable populations.
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Affiliation(s)
- Chao Huang
- Shenzhen Key Laboratory of Modern Toxicology, Shenzhen Medical Key Discipline of Health Toxicology (2020-2024), Shenzhen Center for Disease Control and Prevention, Shenzhen, People’s Republic of China
| | - Xiaohu Ren
- Shenzhen Key Laboratory of Modern Toxicology, Shenzhen Medical Key Discipline of Health Toxicology (2020-2024), Shenzhen Center for Disease Control and Prevention, Shenzhen, People’s Republic of China
| | - Benhong Xu
- Shenzhen Key Laboratory of Modern Toxicology, Shenzhen Medical Key Discipline of Health Toxicology (2020-2024), Shenzhen Center for Disease Control and Prevention, Shenzhen, People’s Republic of China
| | - Peiyi Liu
- Shenzhen Key Laboratory of Modern Toxicology, Shenzhen Medical Key Discipline of Health Toxicology (2020-2024), Shenzhen Center for Disease Control and Prevention, Shenzhen, People’s Republic of China
| | - Tian Li
- Shenzhen Key Laboratory of Modern Toxicology, Shenzhen Medical Key Discipline of Health Toxicology (2020-2024), Shenzhen Center for Disease Control and Prevention, Shenzhen, People’s Republic of China
| | - Qinqin Zhu
- Shenzhen Key Laboratory of Modern Toxicology, Shenzhen Medical Key Discipline of Health Toxicology (2020-2024), Shenzhen Center for Disease Control and Prevention, Shenzhen, People’s Republic of China
| | - Jia Huang
- Shenzhen Key Laboratory of Modern Toxicology, Shenzhen Medical Key Discipline of Health Toxicology (2020-2024), Shenzhen Center for Disease Control and Prevention, Shenzhen, People’s Republic of China
| | - Xiao Chen
- Shenzhen Key Laboratory of Modern Toxicology, Shenzhen Medical Key Discipline of Health Toxicology (2020-2024), Shenzhen Center for Disease Control and Prevention, Shenzhen, People’s Republic of China
| | - Desheng Wu
- Shenzhen Key Laboratory of Modern Toxicology, Shenzhen Medical Key Discipline of Health Toxicology (2020-2024), Shenzhen Center for Disease Control and Prevention, Shenzhen, People’s Republic of China
| | - Xifei Yang
- Shenzhen Key Laboratory of Modern Toxicology, Shenzhen Medical Key Discipline of Health Toxicology (2020-2024), Shenzhen Center for Disease Control and Prevention, Shenzhen, People’s Republic of China
| | - Feiqi Zhu
- Cognitive Impairment Ward of Neurology Department, The Third Affiliated Hospital of Shenzhen University Medical College, Shenzhen, People’s Republic of China
| | - Jianjun Liu
- Shenzhen Key Laboratory of Modern Toxicology, Shenzhen Medical Key Discipline of Health Toxicology (2020-2024), Shenzhen Center for Disease Control and Prevention, Shenzhen, People’s Republic of China
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Murff HJ, Greevy RA, Sternlieb S, Gilliam K, King S, Sanghani R, Tindle HA. The Fish Oil to Reduce Tobacco Use iN Expectant mothers (FORTUNE) feasibility trial. Am J Obstet Gynecol MFM 2022; 4:100707. [PMID: 35948268 DOI: 10.1016/j.ajogmf.2022.100707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 08/03/2022] [Accepted: 08/04/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Three small clinical trials have suggested that supplementation with n-3 long-chain polyunsaturated fatty acids (eicosapentaenoic acid and docosahexaenoic acid) found in fish oils may reduce nicotine cravings and at higher doses reduce cigarette consumption. Pregnant women who smoke have fewer pharmacologic options to aid them with smoking cessation. Although n-3 long-chain polyunsaturated fatty acid supplementation has been studied in pregnancy, few studies have evaluated doses of ≥4 g per day, and no previous studies have selectively enrolled pregnant women who smoke. High-dose n-3 long-chain polyunsaturated fatty acids may aid cessation but could be poorly tolerated in pregnant women who smoke because of gastrointestinal side effects. OBJECTIVE We conducted a feasibility trial to determine the tolerability of high-dose n-3 long-chain polyunsaturated fatty acid supplementation in pregnant women who smoked. We hypothesized that n-3 long-chain polyunsaturated fatty acid doses of 4.2 g a day would be well-tolerated relative to an olive oil placebo. We assessed red blood cell phospholipid membrane concentrations at baseline and end of therapy (4 weeks) and piloted outcomes for a future efficacy trial of n-3 long-chain polyunsaturated fatty acid supplementation for smoking cessation in pregnancy. STUDY DESIGN We recruited 28 pregnant women between the gestational ages of 6 and 36 weeks who reported daily cigarette smoking and were motivated to quit to participate in a double-blind placebo-controlled randomized feasibility trial of 4.2 g per day of n-3 long-chain polyunsaturated fatty acid supplementation. Participants reported cigarettes per day, completed the Fagerström Test for Cigarette Dependence, and provided blood, urine, and exhaled CO samples. We used repeated-measures analysis of variance to pilot analyses of changes in cigarettes per day and Fagerström Test for Cigarette Dependence scores. RESULTS At baseline, red blood cell membrane eicosapentaenoic acid concentrations were negatively correlated with cigarettes per day (r=-0.44; P=.04). By 4 weeks, circulating n-3 long-chain polyunsaturated fatty acid levels increased by 18% in the n-3 long-chain polyunsaturated fatty acid supplementation arm vs a decrease of 3% in the placebo arm. Occurrence of gastrointestinal side effects such as burping, heartburn, diarrhea, abdominal pain, or nausea did not differ statistically between study arms. At 4 weeks, participants allocated to the n-3 long-chain polyunsaturated fatty acids arm reported a median of 3 cigarettes per day (interquartile range, 1-8) vs 7 cigarettes per day (interquartile range, 1-14) in the placebo arm, which was not statistically significant (P=.99). Participants allocated to the n-3 long-chain polyunsaturated fatty acids arm had a decrease of 1 (interquartile range, 0-1) on the Fagerström Test for Cigarette Dependence score vs 0 (interquartile range, 0-0) for placebo (P=.46). CONCLUSION High-dose n-3 long-chain polyunsaturated fatty acids may be tolerated in pregnant women who smoke; however, there was a high level of participant dropout, with more participants allocated to the fish oil arm becoming lost to follow-up. These results will inform the design of a future large-scale randomized controlled trial to test the impact of fish oil supplements on smoking cessation in pregnancy.
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Affiliation(s)
- Harvey J Murff
- Division of General Internal Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN (Drs Murff and Sternlieb, Ms Gilliam, Mr King, and Dr Tindle); Geriatric Research, Education, and Clinical Centers, United States Department of Veterans Affairs, VA Tennessee Valley Healthcare System, Nashville, TN (Drs Murff and Tindle); Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN (Drs Murff and Tindle).
| | - Robert A Greevy
- Departments of Biostatistics (Dr Greevy), Vanderbilt University Medical Center, Nashville, TN
| | - Sarah Sternlieb
- Division of General Internal Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN (Drs Murff and Sternlieb, Ms Gilliam, Mr King, and Dr Tindle)
| | - Karen Gilliam
- Division of General Internal Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN (Drs Murff and Sternlieb, Ms Gilliam, Mr King, and Dr Tindle)
| | - Stephen King
- Division of General Internal Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN (Drs Murff and Sternlieb, Ms Gilliam, Mr King, and Dr Tindle)
| | - Reesha Sanghani
- Departments of Obstetrics and Gynecology (Dr Sanghani), Vanderbilt University Medical Center, Nashville, TN
| | - Hilary A Tindle
- Division of General Internal Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN (Drs Murff and Sternlieb, Ms Gilliam, Mr King, and Dr Tindle); Geriatric Research, Education, and Clinical Centers, United States Department of Veterans Affairs, VA Tennessee Valley Healthcare System, Nashville, TN (Drs Murff and Tindle); Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN (Drs Murff and Tindle)
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Mazumder S, Shia W, Bendik PB, Achilihu H, Sosnoff CS, Alexander JR, Luo Z, Zhu W, Pine BN, Feng J, Blount BC, Wang L. Nicotine Exposure in the U.S. Population: Total Urinary Nicotine Biomarkers in NHANES 2015-2016. Int J Environ Res Public Health 2022; 19:ijerph19063660. [PMID: 35329347 PMCID: PMC8955498 DOI: 10.3390/ijerph19063660] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/15/2022] [Accepted: 03/17/2022] [Indexed: 02/01/2023]
Abstract
We characterize nicotine exposure in the U.S. population by measuring urinary nicotine and its major (cotinine, trans-3′-hydroxycotinine) and minor (nicotine 1′-oxide, cotinine N-oxide, and 1-(3-pyridyl)-1-butanol-4-carboxylic acid, nornicotine) metabolites in participants from the 2015−2016 National Health and Nutrition Examination Survey. This is one of the first U.S. population-based urinary nicotine biomarker reports using the derived total nicotine equivalents (i.e., TNEs) to characterize exposure. Serum cotinine data is used to stratify tobacco non-users with no detectable serum cotinine (−sCOT), non-users with detectable serum cotinine (+sCOT), and individuals who use tobacco (users). The molar concentration sum of cotinine and trans-3′-hydroxycotinine was calculated to derive the TNE2 for non-users. Additionally, for users, the molar concentration sum of nicotine and TNE2 was calculated to derive the TNE3, and the molar concentration sum of the minor metabolites and TNE3 was calculated to derive the TNE7. Sample-weighted summary statistics are reported. We also generated multiple linear regression models to analyze the association between biomarker concentrations and tobacco use status, after adjusting for select demographic factors. We found TNE7 is positively correlated with TNE3 and TNE2 (r = 0.99 and 0.98, respectively), and TNE3 is positively correlated with TNE2 (r = 0.98). The mean TNE2 concentration was elevated for the +sCOT compared with the −sCOT group (0.0143 [0.0120, 0.0172] µmol/g creatinine and 0.00188 [0.00172, 0.00205] µmol/g creatinine, respectively), and highest among users (33.5 [29.6, 37.9] µmol/g creatinine). Non-daily tobacco use was associated with 50% lower TNE7 concentrations (p < 0.0001) compared with daily use. In this report, we show tobacco use frequency and passive exposure to nicotine are important sources of nicotine exposure. Furthermore, this report provides more information on non-users than a serum biomarker report, which underscores the value of urinary nicotine biomarkers in extending the range of trace-level exposures that can be characterized.
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Affiliation(s)
- Shrila Mazumder
- Tobacco and Volatiles Branch, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (W.S.); (P.B.B.); (H.A.); (C.S.S.); or (J.R.A.); (Z.L.); (W.Z.); (B.N.P.); (J.F.); (B.C.B.); (L.W.)
- Correspondence:
| | - Winnie Shia
- Tobacco and Volatiles Branch, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (W.S.); (P.B.B.); (H.A.); (C.S.S.); or (J.R.A.); (Z.L.); (W.Z.); (B.N.P.); (J.F.); (B.C.B.); (L.W.)
- Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, TN 37830, USA
| | - Patrick B. Bendik
- Tobacco and Volatiles Branch, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (W.S.); (P.B.B.); (H.A.); (C.S.S.); or (J.R.A.); (Z.L.); (W.Z.); (B.N.P.); (J.F.); (B.C.B.); (L.W.)
- Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, TN 37830, USA
| | - Honest Achilihu
- Tobacco and Volatiles Branch, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (W.S.); (P.B.B.); (H.A.); (C.S.S.); or (J.R.A.); (Z.L.); (W.Z.); (B.N.P.); (J.F.); (B.C.B.); (L.W.)
| | - Connie S. Sosnoff
- Tobacco and Volatiles Branch, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (W.S.); (P.B.B.); (H.A.); (C.S.S.); or (J.R.A.); (Z.L.); (W.Z.); (B.N.P.); (J.F.); (B.C.B.); (L.W.)
| | - Joseph R. Alexander
- Tobacco and Volatiles Branch, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (W.S.); (P.B.B.); (H.A.); (C.S.S.); or (J.R.A.); (Z.L.); (W.Z.); (B.N.P.); (J.F.); (B.C.B.); (L.W.)
| | - Zuzheng Luo
- Tobacco and Volatiles Branch, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (W.S.); (P.B.B.); (H.A.); (C.S.S.); or (J.R.A.); (Z.L.); (W.Z.); (B.N.P.); (J.F.); (B.C.B.); (L.W.)
| | - Wanzhe Zhu
- Tobacco and Volatiles Branch, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (W.S.); (P.B.B.); (H.A.); (C.S.S.); or (J.R.A.); (Z.L.); (W.Z.); (B.N.P.); (J.F.); (B.C.B.); (L.W.)
| | - Brittany N. Pine
- Tobacco and Volatiles Branch, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (W.S.); (P.B.B.); (H.A.); (C.S.S.); or (J.R.A.); (Z.L.); (W.Z.); (B.N.P.); (J.F.); (B.C.B.); (L.W.)
- Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, TN 37830, USA
| | - June Feng
- Tobacco and Volatiles Branch, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (W.S.); (P.B.B.); (H.A.); (C.S.S.); or (J.R.A.); (Z.L.); (W.Z.); (B.N.P.); (J.F.); (B.C.B.); (L.W.)
| | - Benjamin C. Blount
- Tobacco and Volatiles Branch, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (W.S.); (P.B.B.); (H.A.); (C.S.S.); or (J.R.A.); (Z.L.); (W.Z.); (B.N.P.); (J.F.); (B.C.B.); (L.W.)
| | - Lanqing Wang
- Tobacco and Volatiles Branch, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (W.S.); (P.B.B.); (H.A.); (C.S.S.); or (J.R.A.); (Z.L.); (W.Z.); (B.N.P.); (J.F.); (B.C.B.); (L.W.)
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Kim J, Cho HD, Suh JH, Lee JY, Lee E, Jin CH, Wang Y, Cha S, Im H, Han SB. Analysis of Nicotine Metabolites in Hair and Nails Using QuEChERS Method Followed by Liquid Chromatography-Tandem Mass Spectrometry. Molecules 2020; 25:molecules25081763. [PMID: 32290380 PMCID: PMC7221804 DOI: 10.3390/molecules25081763] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 04/05/2020] [Accepted: 04/09/2020] [Indexed: 12/18/2022] Open
Abstract
Many studies have analyzed nicotine metabolites in blood and urine to determine the toxicity caused by smoking, and assess exposure to cigarettes. Recently, hair and nails have been used as alternative samples for the evaluation of smoking, as not only do they reflect long-term exposure but they are also stable and easy to collect. Liquid-liquid or solid-phase extraction has mainly been used to detect nicotine metabolites in biological samples; however, these have disadvantages, such as the use of toxic organic solvents and complex pretreatments. In this study, a modified QuEChERS method was proposed for the first time to prepare samples for the detection of nicotine metabolite cotinine (COT) and trans-3′-hydroxycotinine (3-HCOT) in hair and nails. High-performance liquid chromatography–tandem mass spectrometry (LC–MS/MS) was used to analyze traces of nicotine metabolites. The established method was validated for selectivity, linearity, lower limit of quantitation, accuracy, precision and recovery. In comparison with conventional liquid-liquid extraction (LLE), the proposed method was more robust, and resulted in higher recoveries with favorable analytical sensitivity. Using this method, clinical samples from 26 Korean infants were successfully analyzed. This method is expected to be applicable in the routine analysis of nicotine metabolites for environmental and biological exposure monitoring.
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Affiliation(s)
- Junhee Kim
- Department of Pharmaceutical Analysis, College of Pharmacy, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul 06974, Korea; (J.K.); (H.-D.C.); (J.-Y.L.); (E.L.); (C.H.J.)
| | - Hyun-Deok Cho
- Department of Pharmaceutical Analysis, College of Pharmacy, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul 06974, Korea; (J.K.); (H.-D.C.); (J.-Y.L.); (E.L.); (C.H.J.)
| | - Joon Hyuk Suh
- Department of Food Science and Human Nutrition, Citrus Research and Education Center, University of Florida, 700 Experiment Station Rd, Lake Alfred, FL 33850, USA; (J.H.S.); (Y.W.)
| | - Ji-Youn Lee
- Department of Pharmaceutical Analysis, College of Pharmacy, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul 06974, Korea; (J.K.); (H.-D.C.); (J.-Y.L.); (E.L.); (C.H.J.)
| | - Eunyoung Lee
- Department of Pharmaceutical Analysis, College of Pharmacy, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul 06974, Korea; (J.K.); (H.-D.C.); (J.-Y.L.); (E.L.); (C.H.J.)
| | - Chang Hwa Jin
- Department of Pharmaceutical Analysis, College of Pharmacy, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul 06974, Korea; (J.K.); (H.-D.C.); (J.-Y.L.); (E.L.); (C.H.J.)
| | - Yu Wang
- Department of Food Science and Human Nutrition, Citrus Research and Education Center, University of Florida, 700 Experiment Station Rd, Lake Alfred, FL 33850, USA; (J.H.S.); (Y.W.)
| | - Sangwon Cha
- Department of Chemistry, Dongguk University, 30 Pildong-ro 1-gil, Jung-gu, Seoul 04620, Korea;
| | - Hosub Im
- Institute for Life & Environmental Technology, Smartive Corporation, Dobong-ro 110 na-gil, Dobong-gu, Seoul 01454, Korea;
| | - Sang Beom Han
- Department of Pharmaceutical Analysis, College of Pharmacy, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul 06974, Korea; (J.K.); (H.-D.C.); (J.-Y.L.); (E.L.); (C.H.J.)
- Correspondence: ; Tel.: +82-2-820-5596
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