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Hermansson, LiselotteORCID iD iconorcid.org/0000-0003-4247-2236
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Publications (10 of 109) Show all publications
Jarl, G. & Hermansson, L. (2019). A modified walk-in clinic for shoe insoles: Follow-up of non-attendants. Prosthetics and orthotics international, 43(6), 597-600
Open this publication in new window or tab >>A modified walk-in clinic for shoe insoles: Follow-up of non-attendants
2019 (English)In: Prosthetics and orthotics international, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 43, no 6, p. 597-600Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: = 1286), we found that a modified walk-in system reduced waiting times for prescription of shoe insoles by 40 days compared to scheduled appointments but resulted in a non-attendance rate of 17% compared to 6% for scheduled appointments.

OBJECTIVES: To investigate the reasons for non-attendance at the modified walk-in clinic.

STUDY DESIGN: This is a cross-sectional survey.

METHODS: Unlike traditional walk-in clinics, a limited number of patients were invited each week from the waiting list to attend the modified walk-in clinic on pre-specified days during the following 5 weeks. A questionnaire was sent to 137 patients who did not attend the modified walk-in clinic, of whom 50 (36%) responded.

RESULTS: The most frequently reported reasons for not attending were the following: could not attend on the suggested days and times (30%), had already received help (18%) and illness or other medical interventions (16%). The majority of these issues could have been overcome by rescheduling to a scheduled appointment.

CONCLUSION: The main reason for not attending a modified walk-in clinic was that suggested days and times did not suit the patients. The option to reschedule the appointment needs to be clearly emphasized in the information provided to the patient.

CLINICAL RELEVANCE: With clear information about rescheduling options, a modified walk-in clinic could be used to reduce waiting times for certain groups of patients.

Place, publisher, year, edition, pages
Sage Publications, 2019
Keywords
Rehabilitation, lower limb orthotics, orthotics
National Category
Orthopaedics
Identifiers
urn:nbn:se:oru:diva-77462 (URN)10.1177/0309364619879285 (DOI)000491458700001 ()31621506 (PubMedID)
Note

Funding Agency:

Region Örebro County, Sweden

Available from: 2019-10-21 Created: 2019-10-21 Last updated: 2019-12-12Bibliographically approved
Widehammar, C., Lidström-Holmqvist, K., Pettersson, I. & Hermansson, L. (2019). Attitudes is the most important environmental factor for use of powered mobility devices - users' perspectives. Scandinavian Journal of Occupational Therapy
Open this publication in new window or tab >>Attitudes is the most important environmental factor for use of powered mobility devices - users' perspectives
2019 (English)In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014Article in journal (Refereed) Epub ahead of print
Abstract [en]

Introduction: Different factors in the environment influence the use of powered wheelchairs or powered scooters, i.e. powered mobility devices (PMDs), but there is limited knowledge about how these factors interact and if any factor has a greater impact. According to the ICF the environment consists of five areas.

Aim: To describe users' experiences of how environmental factors from all ICF areas influence the use of PMDs.

Methods: Descriptive qualitative design including 14 interviews with PMD users, analyzed using inductive qualitative content analysis.

Findings: Use of PMDs means a conditional freedom depending on the interaction of several environmental factors. Regardless of environmental factor the societal attitudes were always present, directly or indirectly, and influenced the participants' feeling of being included and involved in society. The environmental factors and how they influence PMD use are described in four categories, comprising the following subjects: societal attitudes, the service delivery process, accessibility to the physical environment and financial resources.

Conclusion: The findings show that societal attitudes influence all other factors, directly by others people's attitudes, or indirectly by how legislation and guidelines are formulated, interpreted and applied. Therefore, a change of societal attitudes seems necessary to increase accessibility and participation for PMD users.

Place, publisher, year, edition, pages
Taylor & Francis, 2019
Keywords
Powered mobility devices, environment, qualitative research, assistive technology, powered scooters, powered wheelchairs
National Category
Occupational Therapy Other Health Sciences
Identifiers
urn:nbn:se:oru:diva-71766 (URN)10.1080/11038128.2019.1573918 (DOI)000472909700001 ()30856033 (PubMedID)
Note

Funding Agencies:

Uppsala-Örebro Regional Research Council  

Research Committee of Örebro County Council, Sweden 

Available from: 2019-01-23 Created: 2019-01-23 Last updated: 2020-02-24Bibliographically approved
Lindner, H. Y., Hill, W., Hermansson, L. & Lilienthal, A. J. (2019). Cognitive load and compensatory movement in learning to use a multi-function hand. In: ISPO 17th World Congress: Basics to Bionics: Abstract Book. Paper presented at ISPO 17th WORLD CONGRESS, Kobe, Japan October 5-8, 2019 (pp. 52-52). ISPO
Open this publication in new window or tab >>Cognitive load and compensatory movement in learning to use a multi-function hand
2019 (English)In: ISPO 17th World Congress: Basics to Bionics: Abstract Book, ISPO , 2019, p. 52-52Conference paper, Poster (with or without abstract) (Refereed)
Abstract [en]

BACKGROUND: Recent technology provides increased dexterity in multi-function hands with the potential to reduce compensatory body movements. However, it is challenging to learn how to operate a hand that has up to 36 grips. While the cognitive load required to use these hands is unknown, it is clear that if the cognitive load is too high, the user may stop using the multi-functional hand or may not take full advantage of its advanced features.

AIM: The aim of this project was to compare cognitive load and compensatory movement in using a multi-function hand versus a conventional myo hand.

METHOD: An experienced prosthesis user was assessed using his conventional myo hand and an unfamiliar iLimb Ultra hand, with two-site control and the same wrist for both prostheses. He was trained to use power grip, lateral grip and pinch grip and then completed the SHAP test while wearing the Tobii Pro 2 eye-tracking glasses. Pupil diameter (normal range: 2-4mm during normal light) was used to indicate the amount of cognitive load.[1] The number of eye fixations on the prosthesis indicate the need of visual feedback during operation. Dartfish motion capture was used to track the maximum angles for shoulder abduction and elbow flexion.

RESULTS: Larger pupils were found in the use of Ilimb ultra (2.6-5.6mm) than in the use of conventional myo hand (2.4-3.5mm) during the SHAP abstract light tests. The pupils dilated most often during changing grips, e.g. switching to pinch grip for the tripod task (from 2.7 to 5.6mm). After training of using power grip and pinch grip repeatedly, the maximum pupil diameter decreased from 5.6 to 3.3mm. The number of eye fixations on the I-limb ultra (295 fixations) were also higher than on the conventional myo-hand (139 fixations). Smaller shoulder abduction and elbow flexion were observed in the use of I-limb ultra (16.6°, 36.1°) than in the use of conventional myo hand (57°, 52.7°).

DISCUSSION AND CONCLUSION: Although it is cognitively demanding to learn to use a multi-function hand, it is possible to decrease this demand with adequate prosthetic training. Our results suggest that using a multi-function hand enables reduction of body compensatory movement, however at the cost of a higher cognitive load. Further research with more prosthesis users and other multi-function hands is needed to confirm the study findings.

REFERENCES [1] van der Wel P, van Steenbergen H. Psychon Bull Rev 2018; 25(6):2005-15.

ACKNOWLEDGEMENTS: This project was supported financially by Norrbacka-Eugenia Foundation, Promobilia Foundation and Örebro University.

Place, publisher, year, edition, pages
ISPO, 2019
Keywords
Eye tracking, upper limb prosthetics, cognitive load, compensatory movement
National Category
Occupational Therapy Medical Ergonomics
Research subject
Rehabilitation Medicine; Occupational therapy
Identifiers
urn:nbn:se:oru:diva-78855 (URN)
Conference
ISPO 17th WORLD CONGRESS, Kobe, Japan October 5-8, 2019
Available from: 2020-01-02 Created: 2020-01-02 Last updated: 2020-02-14Bibliographically approved
Lindner, H. Y., Buer, N. & Hermansson, L. (2019). Compensatory Movement in Upper Limb Prosthesis Users during Activity Performance. In: ISPO 17th World Congress:  Basics to Bionics: Abstract Book. Paper presented at ISPO 17th WORLD CONGRESS Kobe Convention Center Kobe, Hyogo, Japan 5 – 8 Oct, 2019. ISPO
Open this publication in new window or tab >>Compensatory Movement in Upper Limb Prosthesis Users during Activity Performance
2019 (English)In: ISPO 17th World Congress:  Basics to Bionics: Abstract Book, ISPO , 2019, p. -512Conference paper, Poster (with or without abstract) (Refereed)
Abstract [en]

BACKGROUND: Low dexterity of conventional two-function (open, close) myoelectric hand prostheses with limited wrist movement often leads to compensatory shoulder and elbow movements, e.g. excess shoulder abduction and elbow flexion. Compensatory movements may lead to musculoskeletal pain [1] and it is thus important to identify prosthesis users with compensatory movements and to develop preventive treatments for musculoskeletal pain.

AIM: The study aim was to measure and compare compensatory movements during activity performance among upper limb prosthesis users with different levels of myoelectric control.

METHOD: Twenty-seven users of conventional myoelectric hand prosthesis performed the Assessment of Capacity for Myoelectric Control (ACMC) at the Örebro Limb Deficiency and Arm Prosthesis Centre. The performances were recorded and analyzed with Dartfish motion capture video analysis software. The software was used to track and measure the maximum angles for shoulder abduction and elbow flexion at the non-prosthetic and prosthetic sides during the activity performance. Two independent raters used Dartfish to analyze 10 videos and Intra-class Correlation Coefficient (ICC) was used to calculate inter-rater reliability. The ability to control a myoelectric prosthetic hand was assessed by the ACMC.

RESULTS: The within-individual differences for shoulder abduction ranged from 2° to 52° and for elbow flexion from 1° to 66°. When compared between prosthetic and non-prosthetic side, larger differences in shoulder abduction and elbow flexion were found among the users with ACMC ≤ 0 than users with ACMC > 0 (Fig.1a). When comparing the within-individual side differences between prosthesis users with ACMC ≤0 and users with ACMC >0, a significant angle difference was found in the elbows (p=0.03) but not in the shoulders (p=0.34) (Fig.1b). Inter-rater reliability between the two independent raters was excellent (ICC 0.91).

DISCUSSION AND CONCLUSION: Compensatory elbow movements during activity performance are higher in upper limb prosthesis users with low level of myoelectric control. Prevention for musculoskeletal pain should consist of both training for improved prosthetic control and improved prosthetic use in activity performance. Measurement of compensatory movements can help to identify amputees with frequent compensatory movements. Future studies are needed to investigate the effect of ability to control myoelectric prosthesis on musculoskeletal pain.

REFERENCES [1] Jones LE, Davidson JH. Prosthet Orthot Int 1999; 23(1):55-8.

ACKNOWLEDGEMENTS This study was supported financially by the Norrbacka-Eugenia Foundation.

Place, publisher, year, edition, pages
ISPO, 2019
National Category
Medical Ergonomics Physiotherapy Occupational Therapy
Research subject
Rehabilitation Medicine
Identifiers
urn:nbn:se:oru:diva-78856 (URN)
Conference
ISPO 17th WORLD CONGRESS Kobe Convention Center Kobe, Hyogo, Japan 5 – 8 Oct, 2019
Available from: 2020-01-02 Created: 2020-01-02 Last updated: 2020-02-17Bibliographically approved
Tavemark, S., Hermansson, L. & Blomberg, K. (2019). Enabling activity in palliative care: focus groups among occupational therapists. BMC Palliative Care, 18(1), Article ID 17.
Open this publication in new window or tab >>Enabling activity in palliative care: focus groups among occupational therapists
2019 (English)In: BMC Palliative Care, ISSN 1472-684X, E-ISSN 1472-684X, Vol. 18, no 1, article id 17Article in journal (Refereed) Published
Abstract [en]

Background: Activity participation may support clients in palliative care to maintain dignity and quality of life. Literature and policy documents state that occupational therapists should be part of the team in palliative care, but give limited guidance on how interventions should be employed. Thus, the aim was to describe occupational therapists’ experiences of enabling activity for seriously ill and dying clients.

Methods: In a descriptive, qualitative study, three focus groups with occupational therapists (n = 14) were conducted. The data were analysed using qualitative content analysis.

Results: The findings showed that occupational therapists were enabling activity in clients in palliative care whilst considering the client’s individual preferences. Motivation was seen to facilitate activity, while environmental restrictions act as barriers. The occupational therapists wanted to bring activities physically closer to the clients and felt a need for more client contact to enable activity.

Conclusions: Occupational therapists’ interventions in palliative care includes prioritizing and planning activities according to clients’ preferences and capacities. The individual nature of these activities makes it impossible to create standardised protocol for interventions, but the study results can be used to describe occupational therapists’ strategies and to guide their work, especially unexperienced occupational therapists in palliative care.

Place, publisher, year, edition, pages
BioMed Central, 2019
Keywords
Activities of daily living, leisure activities, client participation, quality of life, qualitative research
National Category
Occupational Therapy
Research subject
Occupational therapy
Identifiers
urn:nbn:se:oru:diva-71694 (URN)10.1186/s12904-019-0394-9 (DOI)000458150200001 ()30732615 (PubMedID)2-s2.0-85061266778 (Scopus ID)
Note

Funding Agency:

University Health Care Research Center, Region Örebro County, Örebro, Sweden

Available from: 2019-01-23 Created: 2019-01-23 Last updated: 2019-06-18Bibliographically approved
Widehammar, C., Lidström, H. & Hermansson, L. (2019). Environmental barriers to participation and facilitators for use of three types of assistive technology devices. Assistive technology, 31(2), 68-76
Open this publication in new window or tab >>Environmental barriers to participation and facilitators for use of three types of assistive technology devices
2019 (English)In: Assistive technology, ISSN 1040-0435, E-ISSN 1949-3614, Vol. 31, no 2, p. 68-76Article in journal (Refereed) Published
Abstract [en]

The aim was to compare the presence of environmental barriers to participation and facilitators for assistive technology (AT) use and study the relation between barriers and AT use in three different AT devices. A cross-sectional survey was conducted. Inclusion criteria were ?one year of experience as a user of myoelectric prosthesis (MEP), powered mobility device (PMD), or assistive technology for cognition (ATC) and age 20-90 years. Overall, 156 participants answered the Swedish version of the Craig Hospital Inventory of Environmental Factors and a study-specific questionnaire on facilitating factors. Non-parametric tests were used for comparisons. Barriers to participation were lowest in MEP users (md = 0.12; p < 0.001), and highest in ATC users (md = 1.56; p < 0.001) with the least support for AT use (p < 0.001 - p = 0.048). A positive correlation between fewer barriers and higher use of MEP was seen (r = 0.30, p = 0.038). The greatest barriers to participation were Natural environment, Surroundings and Information, and the most support came from Relatives and Professionals. Support, training and education are vital in the use of AT. These factors may lead to a more sustained and prolonged use of AT and may enable increased participation. Future research should focus on interventions that meet the needs of people with cognitive disabilities.

Place, publisher, year, edition, pages
Taylor & Francis, 2019
Keywords
Electronic aids to daily living, information technology and telecommunications, prosthetics, service delivery, wheelchair transportation, wheeled mobility aids
National Category
Nursing Other Health Sciences
Identifiers
urn:nbn:se:oru:diva-61735 (URN)10.1080/10400435.2017.1363828 (DOI)000458565800002 ()28783455 (PubMedID)2-s2.0-85029455687 (Scopus ID)
Note

Funding Agency:

Research Committee of Örebro County Council, Sweden  OLL-590701  OLL-615061  OLL-642141  OLL-685701

Available from: 2017-11-06 Created: 2017-11-06 Last updated: 2019-06-19Bibliographically approved
Spang, L., Holmefur, M., Hermansson, L. & Lidström-Holmqvist, K. (2019). Factors in daily life leading to the need for moving to a nursing home: Experiences from nursing home applicants. In: : . Paper presented at International Association of Gerontology and Geriatrics European Region Congress (IAGG-ER), Gothenburg, Sweden, May 23-25, 2019.
Open this publication in new window or tab >>Factors in daily life leading to the need for moving to a nursing home: Experiences from nursing home applicants
2019 (English)Conference paper, Poster (with or without abstract) (Other academic)
Abstract [en]

Background/Aim In Sweden, most people age in ordinary housing, called aging in place. To support aging in place, older people can apply for home-based care such as Meals on Wheels or response alarm .Despite this support, the municipalities receive applications to nursing homes on a daily basis, which indicates that aging in place does not fill everyone’s needs. The aim of this study was to describe what experiences in daily life that make older people aging in place apply for a nursing home.

Method This study has a descriptive design. Face to face interviews were conducted with older people with declining physical health who had a granted application for a place in a nursing home and were waiting for a placement. Some waited in their homes with or without home-based care and some waited in a short-term facility run by the municipality. Interviews were analyzed by qualitative content analysis according to Elo and Kyngäs.

Preliminary findings One main category emerged - “To move to a nursing home- a way to regain control over my life”. It was characterized by a feeling of decreasing level of independence which led to experiences of lack of social context or being in a state of dependence where someone else controlled decisions of their lives.  The participants had reached a point where they strongly felt that something has to be done to change their situation. This was usually associated with a critical event such as a hospitalization or after been informed of a cancer diagnosis. These experiences are described by three generic categories with seven subcategories.  The generic categories are “The opportunity to belong to a context”, “A state of dependence” and “Reaching a turning point”.

Conclusions The findings show that a feeling of lost control due to perceived dependence, falling health or critical everyday life events may lead to a nursing home application. Therefore, in order to enhance aging in place it is important to enable older people to be socially involved, get support to stay as independent as possible in their daily activities and to handle critical events such as hospitalization.

National Category
Gerontology, specialising in Medical and Health Sciences
Identifiers
urn:nbn:se:oru:diva-73633 (URN)
Conference
International Association of Gerontology and Geriatrics European Region Congress (IAGG-ER), Gothenburg, Sweden, May 23-25, 2019
Available from: 2019-04-10 Created: 2019-04-10 Last updated: 2019-06-07Bibliographically approved
Hermansson, L. (2019). Structured Training for Adult users of Hand Prosthesis: introduction to SIRS-Adult for patients with any type of prosthetic hand. In: : . Paper presented at ISPO 17th World Congress 2019, Kobe, Japan, 5-8 October, 2019.
Open this publication in new window or tab >>Structured Training for Adult users of Hand Prosthesis: introduction to SIRS-Adult for patients with any type of prosthetic hand
2019 (English)Conference paper, Oral presentation with published abstract (Refereed)
Abstract [en]

New prosthetic hands with advanced technology making it possible to perform many different grasps and positions are now available on the market. This new advanced technology is also difficult for users to control, and studies have shown that the new hand functions are not used to the extent expected. Most training programs have their main focus on control training. The activity performance and regular occupational therapy training is less described. In this instructional course we will present a new structured method for training adult patients with prosthetic hands of any type – from passive hands to new multifunctional hands. The method originates from the Skills Index Ranking Scale (SIRS), a method that was developed for children and has been in use for more than 30 years. Besides basic training the new version, SIRS-Adult, covers the new skills that patients need to master in order to use multifunctional hands to their full potential. The SIRS-Adult comprises integration of the artificial limb, structured control training, and activity performance in self chosen activities. By practicing use of the hand through performance of everyday activities, the patient achieves a natural use of the hand. The method can be applied upon prescription of any multifunctional prosthetic hand, and also for standard hands, body powered and passive prosthesis. The instructional course will use practical demonstrations through videos and case examples. Active discussions will support the learning process. The attendees will have electronic access to written documentation that describes the SIRS-Adult in more detail. Learning objectives: After completing this course the attendees should have learned hands on skills to perform SIRS–Adult to patients with any kind of hand prosthesis and gained deepened knowledge in how to learn patients use prosthesis.

National Category
Medical and Health Sciences Orthopaedics
Identifiers
urn:nbn:se:oru:diva-77682 (URN)
Conference
ISPO 17th World Congress 2019, Kobe, Japan, 5-8 October, 2019
Available from: 2019-10-30 Created: 2019-10-30 Last updated: 2019-10-31Bibliographically approved
Hermansson, L. & Hill, W. (2019). Treatment for upper limb malformation in different areas of the world. In: : . Paper presented at Trent International Prosthetic Symposium (TIPS 2019), The Lowry, Salford, UK, March 20-22, 2019.
Open this publication in new window or tab >>Treatment for upper limb malformation in different areas of the world
2019 (English)Conference paper, Oral presentation with published abstract (Refereed)
Abstract [en]

Children with upper limb malformation may present with deficiencies in many ways and the treatment that they are offered may vary greatly around the world. Handsmart is a volunteer organization with the mission to support and empower people world-wide who are engaged in this field of rehabilitation through www.handsmart.org. A web-based survey was used to gather data about treatment for children with upper limb malformation in different areas of the world. Sixty-eight respondents from 18 countries representing Oceania, Asia, Europe, and North America with 35 occupational therapists, 6 physiotherapists, 23 prosthetists, and four other health care professionals participated. Only five countries do not have governmental funding for the provision of care for people with upper limb loss. Intervention is guided by the presentation of the limb. Most surgical procedures are made for functional benefits. Not all respondents report that they fit body-powered prostheses for children. The majority of respondents stated that training is offered for use of the prosthesis in their country. In some clinics (12 of 68 respondents), no treatment other than functional prostheses is provided for these children. Overuse or repetitive strain injuries are common with this population, especially as children age into adolescence and adulthood. Many people stated they would like to see clear guidelines used by multi-disciplinary teams to fit children. Recommendations should include treatment guidelines and follow-up practices.

Keywords
Upper limb, prostheses, child
National Category
Occupational Therapy
Research subject
Occupational therapy
Identifiers
urn:nbn:se:oru:diva-71691 (URN)
Conference
Trent International Prosthetic Symposium (TIPS 2019), The Lowry, Salford, UK, March 20-22, 2019
Available from: 2019-01-23 Created: 2019-01-23 Last updated: 2019-04-24Bibliographically approved
Jarl, G. & Hermansson, L. (2018). A modified walk-in system versus scheduled appointments in a secondary-care prosthetic and orthotic clinic. Prosthetics and orthotics international, 42(5), 483-489
Open this publication in new window or tab >>A modified walk-in system versus scheduled appointments in a secondary-care prosthetic and orthotic clinic
2018 (English)In: Prosthetics and orthotics international, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 42, no 5, p. 483-489Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Waiting is common in health care, delays intervention, and has negative effects on satisfaction with services.

OBJECTIVES: To evaluate effects of a modified walk-in system, where patients were invited consecutively from the waiting list to attend the clinic on a walk-in basis, on waiting times, services, and work environment.

STUDY DESIGN: Parallel-group trial.

METHODS: In all, 1286 consecutive patients in need of shoe insoles were randomized to waiting lists for modified walk-in ( n = 655) or a scheduled appointment ( n = 631). Seven staff members also participated.

RESULTS: The median indirect waiting time to first appointment was 40 days shorter for modified walk-in (135 days) than for scheduled appointment (175 days; p < 0.001); 17% of those randomized to modified walk-in did not attend the clinic compared to 6% for scheduled appointment ( p < 0.001). Mean direct waiting time in the waiting room was 9.9 min longer for modified walk-in than for scheduled appointment ( p < 0.001). Patients attending modified walk-in or a scheduled appointment reported similar levels of satisfaction with services. Staff reported more support from co-workers with modified walk-in than with scheduled appointment ( p = 0.041).

CONCLUSION: The modified walk-in can reduce indirect waiting times without any substantial worsening of direct waiting times, service quality, or work environment. Studies are needed to investigate why many patients drop out from modified walk-in. Clinical relevance A modified walk-in system can cut the queues and create more timely interventions by reducing indirect waiting times. This system can therefore be recommended in secondary-care prosthetic and orthotic clinics to reduce patients' suffering from their health condition.

Place, publisher, year, edition, pages
Sage Publications, 2018
Keywords
Rehabilitation, lower limb orthotics, orthotics
National Category
Orthopaedics
Identifiers
urn:nbn:se:oru:diva-69230 (URN)10.1177/0309364617728120 (DOI)000444981600003 ()28905683 (PubMedID)2-s2.0-85041927809 (Scopus ID)
Note

Funding Agency:

Region Örebro County, Sweden

Available from: 2018-10-04 Created: 2018-10-04 Last updated: 2018-10-04Bibliographically approved
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ORCID iD: ORCID iD iconorcid.org/0000-0003-4247-2236

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