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1. Introduction
The coronavirus disease caused by the SARS-CoV-2 virus (COVID-19) pandemic induced overload in acute healthcare and significantly increased the burden of chronic diseases. One of the new manifestations of chronic diseases is the post-COVID-19 disorder, for which a common definition has not yet been established, but which creates the preconditions for expanding the prevalence of related diseases. The results of an online survey of 3762 participants with confirmed (diagnostic/antibody positive; 1020) or suspected (diagnostic/antibody negative or untested; 2742) COVID-19, performed in 56 countries, from September 6, 2020 to November 25, 2020, demonstrated that 1700 respondents (45.2%) required a reduced work schedule compared to pre-illness, and an additional 839 (22.3%) were not working at the time of survey due to illness. After 6 months of the post-COVID conditions, the most frequent symptoms were fatigue, post-exertional malaise, and cognitive dysfunction. Cognitive dysfunction or memory issues were common across all age groups (~88%) [1]. Already in July 2020, Dr. Anthony Fauci, the Director of the National Institute for Allergy and Infectious Diseases (US Department of Health and Human Services), assumed that patients post-COVID-19 can develop “a post-viral syndrome that’s very strikingly similar to myalgic encephalomyelitis/chronic fatigue syndrome” [2].
The authors, in one of the previous studies on the COVID-19 pandemic consistencies in healthcare [3], revealed that since October 2020, several articles have reported myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) as a potentially post-COVID-19-associated disease [4, 5, 6, 7, 8, 9, 10, 11]. The literature reviews on the potential causal interaction between post-COVID-19 and ME/CFS also appeared in the following period [12, 13, 14, 15, 16, 17, 18, 19]. The reviews’ results highlighted problems associated with the definitions and diagnostic criteria for ME/CFS and post-COVID-19 disorder. There were various manifestations of the interaction between post-COVID-19 and ME/CFS, from the similarity of the symptoms to the assumption that it is the same disease [3]. Over time, the COVID-19 long-haulers reported an overall reduction of most symptoms including unrefreshing sleep and post-exertional malaise, but an intensification of neurocognitive symptoms. When compared to ME/CFS, the COVID-19 sample was initially more symptomatic for the immune and orthostatic domains but over time, the long-haulers evidenced significantly less severe symptoms than those with ME/CFS, except in the orthostatic domain [20]. However, almost all publications indicated the need for further research into the similarities and differences between post-COVID-19 and ME/CFS to determine the nature of these conditions and define risk factors, prevalence, and possible interventions [3].
Concerning the definitions, ME/CFS commonly is defined as a poorly understood, serious, complex, multisystem disorder, characterized by symptoms lasting at least 6 months, with severe incapacitating fatigue not alleviated by rest, and other symptoms—many autonomic or cognitive in nature—including profound fatigue, cognitive dysfunction, sleep disturbances, muscle pain, and post-exertional malaise, which lead to substantial reductions in the functional activity and quality of life [21]. The common definition of post-COVID-19 disorder has not yet been established, but the results of some studies suggest, for instance, that it is composed of heterogeneous sequelae that often affect multiple organ systems, with significant impacts on morbidity, mortality, and quality of life [1]. Regarding the defining post-COVID-19 symptoms, based on the relapsing/remitting nature of post-COVID-19 symptoms, the following integrative classification was proposed by researchers: potentially infection-related symptoms (up to 4–5 weeks), acute post-COVID-19 symptoms (from week 5 to week 12), long post-COVID-19 symptoms (from week 12 to week 24), and persistent post-COVID-19 symptoms (lasting more than 24 weeks) [22]. Therefore, in the context of the time reference, ME/CFS is most closely associated with persistent post-COVID symptoms.
Persistent post-COVID symptoms were considered in light of a new “syndrome,” as the British Medical Association defines a syndrome “as a set of medical signs and symptoms which are correlated with each other and associated with a particular disease” [22]. Accordingly, the term “Persistent Post-COVID-19 Syndrome (PPCS)” was introduced in practice, as a pathologic entity, which involves persistent physical, medical, and cognitive sequelae following COVID-19, including persistent immunosuppression as well as pulmonary, cardiac, and vascular fibrosis [23]. Consequently, some authors note that the preliminary findings raise concern regarding a possible future ME/CFS-like pandemic in SARS-CoV-2 survivors [24].
The prevalence of ME/CFS in population varies from 0.19% to 7,6% [21]. Based on the earlier studies on other infections, researchers suggested that 10% of COVID-19 survivors could develop ME/CFS [2]. Accordingly, it is estimated that the US ME/CFS prevalence of 1.5 million prior to the COVID-19 pandemic (and an annual economic impact of $36–51 billion) could rise to between five and nine million people. This would incur an annual US economic impact of $149 to $362 billion in medical expenses and lost income, exclusive of other costs, such as disability benefits, social services, and lost wages of caretakers [25].
Considering the health-related quality of life (HRQoL) ME/CFS demonstrates a significant negative impact on general health, physical functioning, emotional health, vitality, cognitive health, and well-being, in different populations [12, 26, 27, 28, 29, 30, 31, 32]. Various tools are used to elaborate the HRQoL, such as EuroQoL-5 Dimensions (EQ-5D-3L) [26, 31] and (EQ-5D-5L) [12], 36-Item Health Survey (SF-36) [29, 31], Pediatric Quality of Life Inventory (PedsQL) [28], overall health status reported on a Visual Analogue Scale (VAS) [12, 27, 30], Abbreviated World Health Organization Quality of Life questionnaire (WHOQOL-BREF) [32], completed by people with ME/CFS, and Family Reported Outcome Measure (FROM-16) questionnaire [30, 32], completed by family members. Simultaneously, HRQol widely affected by all post-COVID-19 domains [24] mostly is assessed by EuroQoL-5 Dimension EQ-5D-5L and VAS [33, 34, 35].
The predominant score of ME/CFS and PPCS patients’ healthcare is related to primary healthcare, given that patients of these syndromes are mostly treated on an outpatient basis [36, 37, 38, 39]. The unifying issues for these diseases are also complex and multisystem nature, which requires coordinated integrative multidisciplinary teamwork to achieve treatment goals [34, 39]. Previous research demonstrated significant results of the interdisciplinary approach, such as the “Recovering from COVID” course, which took a whole system, biopsychosocial approach to understanding COVID-19 and post-viral fatigue and was led by an interdisciplinary team consisting of a clinical psychologist, physiotherapist, occupational therapist, dietitian, speech and language therapist, and a personal support navigator [34].
Moreover, COVID-19 is associated with high rates of psychiatric symptoms, including anxiety, depression, fatigue, sleep disruption, and posttraumatic stress, and consistent risk factors for psychiatric symptoms include the history of a psychiatric disorder and female gender [40]. Researchers notified that while the exact etiology remains unknown, and future research is needed, it is now recognized that overlapping symptomology between post-COVID-19 syndrome and ME/CFS provides a promising avenue for the development of post-COVID-19 rehabilitation [34].
Prior to the COVID-19 pandemic, it was assumed that primary care transformation will usher in a new era of advanced team-based care with extensive roles beyond the physician to build authentic healing relationships with patients [41]. The pandemic hampered the development of primary healthcare, with an emphasis on the hospital sector, but some achievements remain topical. In the context of integrity, the integrative and patient-centric view argues strongly that populations with physical, developmental, or cognitive disabilities—often with related chronic conditions or complex illnesses—endow the concept of healthcare integration with unique logic and meaning. Vulnerable individuals have complicated and ongoing needs (which frequently are part-medical, part-physical, part-psychological, and part-social), experience difficulties in everyday living, require a mix of services delivered sequentially or simultaneously by multiple providers, and receive both cure and care in the home, community, and institutional settings [42]. These statements mostly are applicable also for ME/CFS and post-COVID-19 conditions.
In order to organize person-centered health services for a growing number of people with multiple complex health and social care needs, a shift from fragmented to integrated health services delivery has to take place. For the organization of governance in integrated health services, it is important to better understand the underlying factors that drive collaboration, decision-making, and behavior between individuals and organizations [43]. There are multiple levels of integrated care, and four levels of health services delivery are investigated more often: the personal, the professional, the management, and the system level [43, 44]. In addition to the different levels, researchers present two crucial dimensions of integration: systemic integration, which includes the coherence of rules and policies in the health system, and normative integration, which comprises the role of shared values in coordination and collaboration [43, 44, 45].
In the scope of this research, the authors focus on two central levels of the integrative model—the personal level, assuming the relation with the person-centered approach, and the professional level of collaboration (Figure 1).
Figure 1.
The research focused on the personal and the professional level of integrated health services for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and post-COVID-19 patients.
The following section provides an example of professional collaboration and patient outcomes in the integrative approach for ME/CFS and post-COVID-19 care.
2. Coaching as a supportive tool in integrative primary healthcare of post-COVID-19 and ME/CFS patients
Assuming that an integrative approach positively affects the treatment of chronic multimorbid conditions, this research aimed to identify opportunities to improve the health status of post-COVID-19 and ME/CFS patients by involving a professional coach in healthcare teamwork.
The theoretical foundation of coaching is based on psychological concepts [46]. Several types of models and theories form the basis of behavioral change in coaching. Those most frequently referred to in the literature include the Transtheoretical Model of Change (TTM), the Theory of Planned Behavior (TPB), Social Cognitive Theory (SCT), the Information-Motivation-Behavioral-Skills Model (IMB), Self-Determination Theory (SDT), Health Action Process Approach (HAPA), and Social Learning Theory (SLT) [47]. Each theory is distinct; however, coaching recognizes that individuals intrinsically learn in different ways, and thus the process could involve one or a combination of models or theories which may complement one another [46]. Practical coaching intends to facilitate, support, challenge, and guide a change to achieve a goal [48].
Regarding the coaching experience in healthcare during the COVID-19 pandemic, literature resources identified that COVID-19-specific tele-coaching effectively supported the risk-reduction behavior of patients with heart failure [49] and improved diabetes patients’ health behavior [50], as well as coaching promoted medical staff well-being during COVID-19 [51] and demonstrated a positive effect on medical students’ well-being [52]. On the whole, there are insufficient studies on the use of coaching in ME/CFS and post-COVID-19 patients.
To evaluate the complementary opportunities provided by couching in post-COVID-19 in ME/CFS patients’ healthcare, the longitude case study was performed in a primary care institution, in Latvia. The professional team consisted of a general practitioner, infectiologist, and coach. The coaching sessions were led by a certified coach of the Erickson Coaching International. Patient-centeredness, patient-determined goals, use of a self-discovery process, accountability, and consistent coaching relationship represent the key elements of coaching. Erickson coaching expands the coaching over and above these elements by strict focus at the solution (i.e. client’s determined goal) not only throughout the individual coaching conversation but also throughout the entire coaching relationship (solution-focused Erickson coaching) [53].
Four patients, two ME/CFS and two post-COVID-19 patients with symptoms persistent for more than 6 months prior to diagnosis “Long-COVID-19,” were invited to participate in this study. “Portraits” of the patients prepared by the supervising physicians are available in Figure 2. Virtual coaching sessions were held for each patient once a week for 4 weeks, in March and April 2022 (two additional sessions were conducted for Patient 2, by her request).
Figure 2.
“Portraits” of Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and post-COVID-19 patients in the study.
The work steps were devoted to the assessment of patients’ HRQoL before and after the coaching course. In order to obtain comparable data for evaluation of the potential impact of the coaching process, HRQoL was assessed using the EuroQol-5D-5L measure (certified translation: EQ-5D-5L Latvian) as the patient-reported outcomes (PROs). The EuroQol EQ-5D-5L assesses HRQoL across five dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression [54], and it was mentioned in previous research [12, 33, 34, 35]. Prior to the coaching course, patients were asked to assess their health across five dimensions, before the illness and at the present time. Accordingly, after the last coaching session, the patients had reassessed their health status.The results of the PROs are shown in Figure 3 (each dimension of health was scored from 1 (extreme problems) to 5 (no problems)). Descriptive and analytical statistical methods were utilized for the analysis of the obtained data.
Figure 3.
Patient-reported health-related quality of life, as measured by the EuroQol-5D-5L framework (1—extreme problems, 2—severe problems, 3—moderate problems, 4—slight problems, and 5—no problems), in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and post-COVID-19 patients: prior illness, prior coaching course, and after 4 weeks coaching course (Patient 2—after 6 weeks).
The results (Figure 3) show that Patient 1 (ME/CFS) and Patient 3 (post-COVID-19) demonstrated full-health HRQoL prior to illness, but Patient 2 (ME/CFS) and Patient 4 (post-COVID-19) had the pain and discomfort also before making the diagnosis. Self-care ability was less affected by the illness—by two points in sum for all patients; usual activities were more affected—by five points in sum for all patients; mobility was affected harder—by six points in sum for all patients; anxiety/depression was activated—by six points in sum for all patients; and pain/discomfort was most accelerated—by seven points in sum for all patients. After the coaching course, PROs demonstrate a stronger impact on pain/discomfort reduction—by eight points in sum for all patients, and on anxiety/depression—by four points in sum for all patients; while mobility was improved—by five points in sum for all patient, usual activities—by three points in sum for all patient, and self-care ability—by two points in sum for all patient (self-care ability was less affected by illness).
Additionally, the overall health self-assessment was performed by the VAS. Prior to the coaching, patients were asked to rate their health on a scale from 0 to 100 (where 0 means the worst health patient can imagine, and 100 means the best health patient can imagine), before the illness and at the present time. Accordingly, after the last coaching session, the patients had reassessed their health status. The results of the PROs by the VAS are shown in Figure 4.
Figure 4.
Patient-reported health-related quality of life, as measured by the Visual Analogue Scale (0—the worst health patient can imagine, and 100—the best health patient can imagine), in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and post-COVID-19 patients: prior illness, prior to the coaching course, and after 4 weeks coaching course (Patient 2—after 6 weeks).
PROs by the VAS (Figure 4) show that all patients reported a significant reduction in overall health status due to illness: Patient 1 (ME/CFS)—by 40%, Patient 2 (ME/CFS) and Patient 3 (post-COVID-19)—by 20%, and Patient 4 (post-COVID-19)—by 15%. After the coaching period, all patients demonstrated an improvement in overall health status by more than half: Patient 1 and Patient 2—by 30%, Patient 3—by 20%, and Patient 4—by 10%. Remarkably that ME/CFS patients reported greater improvement in overall health, and Patient 2 reported a higher score of overall health after the coaching course than it was before the diagnosis of illness.
In order to obtain more information on the health status of patients during the study, the physicians supervising these patients were also asked to assess patients’ health state, prior to the coaching course and after the course. The assessment was performed by the VAS with a rating on a scale from 0 to 100 (where 0 means the worst health state of the patient, and 100 means the best health state of the patient). Three dimensions of health were defined for evaluation: overall health, emotional health, and cognitive health. The results of the assessment of the patients’ health provided by the physicians are shown in Figure 5. Significant improvement was indicated in all dimensions of health in each patient. Remarkable that the physicians indicated a lower initial rate of the health states for ME/CFS patients in comparison with the health status of post-COVID-19 patients. Notably that the improvement also is greater in ME/CFS patients. Overall health state assessment after the coaching period is correlated with the results of PROs performed by VAS (Figure 4) (except for Patient 2 data in which patient’s self-assessment is higher—probably by the fact that Patient 2 performed the last self-assessment after two additional weeks of coaching). The stabilization between all dimensions of health was a common tendency for all patients (Figure 5).
Figure 5.
Evaluation of the patient’s overall health status, emotional health, and cognitive health, measured by the Visual Analogue Scale (0—the worst health state of the patient, and 100—the best possible health state of the patient), in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and post-COVID-19 patients: prior to the coaching course, and after 4 weeks coaching course.
Overall results of the study demonstrate significant improvement in the health state of ME/CFS and post-COVID-19 patients, particularly, in overall health, emotional stability, and cognitive functionality. However, this case study has limitations, such as the following: data are not statistically significant for extrapolation to the whole population of patients; there are no sufficient data for comparison with data in other countries on couching approach in healthcare of post-COVID-19 and ME/CFS patients; during the couching period, patients continued to receive the standard treatment; therefore, coaching could be considered as a complementary tool in an integrative approach, but not as a monomethod. The strength of this research is focused on the great additional opportunity to resolve the problems arising in chronic diseases management, by affective collaboration and integrative approach, particularly, in primary healthcare.
This study can encourage the further investigation of coaching potential in healthcare, to receive more evidence on the effectiveness of this approach. Additionally, more sensitive evaluation instruments could be considered and would facilitate patients’ self-assessment of such symptoms as anxiety, depression, fatigue, sleep disruption, and posttraumatic stress. At the same time, patients should be supported by teaching to work with the PROs tools in the process of health self-assessment. Eventually, in the scope of managerial and system level of integrative healthcare, it should be considered that the financing of the integrative approach can face the challenges in countries with strictly limited budget allocation for healthcare and social issues.
3. Conclusion
This chapter provided insight into the integrative approach to healthcare, with a particular focus on post-COVID-19 and ME/CFS disorders. Integrated healthcare consists of four main levels of health services delivery: the personal, the professional, the management, and the system level. In the framework of the practical research, the example of integration of coaching in the personal and professional level of primary healthcare of post-COVID-19 and ME/CFS patients demonstrated the potential for improvement in healthcare outcomes.
Acknowledgments
The study was supported by the Latvian Science Council’s Fundamental and Applied Research project No. lzp-2019/1-0380 “Selection of biomarkers in ME/CFS for patient stratification and treatment surveillance/optimization,” with the approval of the Research Ethics Committee of the Riga Stradins University (Decision No. 6-1/05/33–30 April 2020, Riga).
Conflict of interest
The authors declare no conflict of interest.
\n',keywords:"persistent post-COVID-19 syndrome (PPCS), myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), integrative approach, coaching, patient-reported outcomes (PROs)",chapterPDFUrl:"https://cdn.intechopen.com/pdfs/82708.pdf",chapterXML:"https://mts.intechopen.com/source/xml/82708.xml",downloadPdfUrl:"/chapter/pdf-download/82708",previewPdfUrl:"/chapter/pdf-preview/82708",totalDownloads:0,totalViews:0,totalCrossrefCites:0,dateSubmitted:"May 17th 2022",dateReviewed:"June 21st 2022",datePrePublished:"August 18th 2022",datePublished:null,dateFinished:"July 16th 2022",readingETA:"0",abstract:"The coronavirus disease caused by the SARS-CoV-2 virus (COVID-19) pandemic has changed not only global epidemiological and economic developments but also the lives of every individual, with particular severity for patients. The number of acute illness cases grew rapidly, significantly increasing the workload of hospitals, and simultaneously, new chronic diseases emerged, such as persistent post-COVID-19 syndrome (PPCS), with unclear etiology, symptoms, and complexity—similar to myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Accordingly, the burden of chronic diseases poses new long-term challenges for primary healthcare and requires new approaches to patient care. This chapter provides insight into the integrative approach to healthcare and focuses on potentially new solutions by implementing an integrative attitude to the treatment of post-COVID-19 and ME/CFS patients in primary healthcare. Integrative health coaching contributes the holistic approach to patients’ overall health and resilience through cognitive practice and patient active engagement. The findings of this chapter can enrich the person-centered approach and healthcare system strengthening through holistic measures and systems thinking.",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/82708",risUrl:"/chapter/ris/82708",signatures:"Diana Araja, Angelika Krumina, Uldis Berkis, Zaiga Nora-Krukle and Modra Murovska",book:{id:"11592",type:"book",title:"COVID-19 Pandemic, Mental Health and Neuroscience - New Scenarios for Understanding and Treatment",subtitle:null,fullTitle:"COVID-19 Pandemic, Mental Health and Neuroscience - New Scenarios for Understanding and Treatment",slug:null,publishedDate:null,bookSignature:"Ph.D. Sara Palermo and Prof. Berend Olivier",coverURL:"https://cdn.intechopen.com/books/images_new/11592.jpg",licenceType:"CC BY 3.0",editedByType:null,isbn:"978-1-80355-091-6",printIsbn:"978-1-80355-090-9",pdfIsbn:"978-1-80355-092-3",isAvailableForWebshopOrdering:!0,editors:[{id:"233998",title:"Ph.D.",name:"Sara",middleName:null,surname:"Palermo",slug:"sara-palermo",fullName:"Sara Palermo"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}},authors:null,sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_2",title:"2. Coaching as a supportive tool in integrative primary healthcare of post-COVID-19 and ME/CFS patients",level:"1"},{id:"sec_3",title:"3. Conclusion",level:"1"},{id:"sec_4",title:"Acknowledgments",level:"1"},{id:"sec_7",title:"Conflict of interest",level:"1"}],chapterReferences:[{id:"B1",body:'Davis HE, Assaf GS, McCorkell L, et al. Characterizing long COVID in an international cohort: 7 months of symptoms and their impact. The Lancet. 2021;38:101019'},{id:"B2",body:'Komaroff AL, Bateman L. Will COVID-19 lead to myalgic encephalomyelitis / chronic fatigue syndrome? Frontiers in Medicine. 2021;7:606824'},{id:"B3",body:'Araja D, Berkis U, Murovska M. COVID-19 pandemic-revealed consistencies and inconsistencies in healthcare: A medical and organizational view. Health. 2022;10:1018. DOI: 10.3390/healthcare10061018'},{id:"B4",body:'Strayer DR, Youn D, Mitchell WM. 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Medical Hypotheses. 2018;120:43-47. DOI: 10.1016/j.mehy.2018.08.012'},{id:"B54",body:'Stolk E, Ludwig K, Rand K, van Hout B, Ramos-Goñi JM. Overview, update, and lessons learned from the international EQ-5D-5L valuation work: Version 2 of the EQ-5D-5L valuation protocol. Value Health. 2019;22(1):23-30'}],footnotes:[],contributors:[{corresp:"yes",contributorFullName:"Diana Araja",address:"araja.diana@gmail.com",affiliation:'
Institute of Microbiology and Virology, Riga Stradins University, Riga, Latvia
Institute of Microbiology and Virology, Riga Stradins University, Riga, Latvia
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Corresponding authors will receive a 25% discount on their Open Access Publication Fees (OAPF) for Open Access book chapters. A 20% discount for publishing a long-form monographs, 25% for compacts and 23% for short-form monographs.
\\n\\n
CSIC affiliated authors can also take advantage of a central Open Access fund (amounting to 10,000 EUR) to cover up to 50% of the rest of the OAPF until it expires. Effective for chapters accepted from January 1, 2020.
Corresponding authors will receive a 25% discount on their Open Access Publication Fees (OAPF) for Open Access book chapters. A 20% discount for publishing a long-form monographs, 25% for compacts and 23% for short-form monographs.
Corresponding authors will receive a 25% discount on their Open Access Publication Fees (OAPF) for Open Access book chapters. A 20% discount for publishing a long-form monographs, 25% for compacts and 23% for short-form monographs.
Corresponding authors will receive a 25% discount on their Open Access Publication Fees (OAPF) for Open Access book chapters. A 20% discount for publishing a long-form monographs, 25% for compacts and 23% for short-form monographs.
The Claremont Colleges are pledging funds via the Knowledge Unlatched program to ensure academics can publish Open Access content more easily.
\\n\\n
Corresponding authors will receive a 15% discount on their Open Access Publication Fees (OAPF) for Open Access book chapters or monograph publications. To use the discount you will need to verify your institutional email address. These discounts are valid from 2020 to 2022.
The University of Massachusetts, Amherst is pledging funds via the Knowledge Unlatched program to ensure academics can publish Open Access content more easily.
\\n\\n
Corresponding authors will receive a 10% discount on their Open Access Publication Fees (OAPF) for Open Access book chapters or monograph publications. To use the discount you will need to verify your institutional email address. These discounts are valid from 2020 to 2022.
The University of Surrey is pledging funds via the Knowledge Unlatched program to ensure academics can publish Open Access content more easily.
\\n\\n
Corresponding authors will receive a 10% discount on their Open Access Publication Fees (OAPF) for Open Access book chapters or monograph publications. To use the discount you will need to verify your institutional email address. These discounts are valid from 2020 to 2022.
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\\n\\t
Virginia Polytechnic Institute and State University
Corresponding authors will receive a 25% discount on their Open Access Publication Fees (OAPF) for Open Access book chapters. A 20% discount for publishing a long-form monographs, 25% for compacts and 23% for short-form monographs.
\n\n
CSIC affiliated authors can also take advantage of a central Open Access fund (amounting to 10,000 EUR) to cover up to 50% of the rest of the OAPF until it expires. Effective for chapters accepted from January 1, 2020.
Corresponding authors will receive a 25% discount on their Open Access Publication Fees (OAPF) for Open Access book chapters. A 20% discount for publishing a long-form monographs, 25% for compacts and 23% for short-form monographs.
Corresponding authors will receive a 25% discount on their Open Access Publication Fees (OAPF) for Open Access book chapters. A 20% discount for publishing a long-form monographs, 25% for compacts and 23% for short-form monographs.
Corresponding authors will receive a 25% discount on their Open Access Publication Fees (OAPF) for Open Access book chapters. A 20% discount for publishing a long-form monographs, 25% for compacts and 23% for short-form monographs.
The Claremont Colleges are pledging funds via the Knowledge Unlatched program to ensure academics can publish Open Access content more easily.
\n\n
Corresponding authors will receive a 15% discount on their Open Access Publication Fees (OAPF) for Open Access book chapters or monograph publications. To use the discount you will need to verify your institutional email address. These discounts are valid from 2020 to 2022.
The University of Massachusetts, Amherst is pledging funds via the Knowledge Unlatched program to ensure academics can publish Open Access content more easily.
\n\n
Corresponding authors will receive a 10% discount on their Open Access Publication Fees (OAPF) for Open Access book chapters or monograph publications. To use the discount you will need to verify your institutional email address. These discounts are valid from 2020 to 2022.
The University of Surrey is pledging funds via the Knowledge Unlatched program to ensure academics can publish Open Access content more easily.
\n\n
Corresponding authors will receive a 10% discount on their Open Access Publication Fees (OAPF) for Open Access book chapters or monograph publications. To use the discount you will need to verify your institutional email address. These discounts are valid from 2020 to 2022.
\n\n
\n\t
Virginia Polytechnic Institute and State University
Important: You must be a member or grantee of the above listed institutions in order to apply for their Open Access publication funds.
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He was elected a Yangtze River Scholars Distinguished Professor in 2013, a member of the International Statistical Institute (ISI) in 2016, a member of the board of the International Chinese Statistical Association (ICSA) in 2018, and a fellow of the Institute of Mathematical Statistics (IMS) in 2021. He received the ICSA Outstanding Service Award in 2018 and the National Science Foundation for Distinguished Young Scholars of China in 2012. He serves as a member of the editorial board of Statistics and Its Interface and Journal of Systems Science and Complexity. He is also a field editor for Communications in Mathematics and Statistics. His research interests include biostatistics, empirical likelihood, missing data analysis, variable selection, high-dimensional data analysis, Bayesian statistics, and data science. He has published more than 190 research papers and authored five books.",institutionString:"Yunnan University",institution:{name:"Yunnan University",country:{name:"China"}}},{id:"1177",title:"Prof.",name:"António",middleName:"J. R.",surname:"José Ribeiro Neves",slug:"antonio-jose-ribeiro-neves",fullName:"António José Ribeiro Neves",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/1177/images/system/1177.jpg",biography:"Prof. António J. R. Neves received a Ph.D. in Electrical Engineering from the University of Aveiro, Portugal, in 2007. Since 2002, he has been a researcher at the Institute of Electronics and Informatics Engineering of Aveiro. Since 2007, he has been an assistant professor in the Department of Electronics, Telecommunications, and Informatics, University of Aveiro. He is the director of the undergraduate course on Electrical and Computers Engineering and the vice-director of the master’s degree in Electronics and Telecommunications Engineering. He is an IEEE Senior Member and a member of several other research organizations worldwide. His main research interests are computer vision, intelligent systems, robotics, and image and video processing. He has participated in or coordinated several research projects and received more than thirty-five awards. He has 161 publications to his credit, including books, book chapters, journal articles, and conference papers. He has vast experience as a reviewer of several journals and conferences. As a professor, Dr. Neves has supervised several Ph.D. and master’s students and was involved in more than twenty-five different courses.",institutionString:null,institution:{name:"University of Aveiro",country:{name:"Portugal"}}},{id:"11317",title:"Dr.",name:"Francisco",middleName:null,surname:"Javier Gallegos-Funes",slug:"francisco-javier-gallegos-funes",fullName:"Francisco Javier Gallegos-Funes",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/11317/images/system/11317.png",biography:"Francisco J. Gallegos-Funes received his Ph.D. in Communications and Electronics from the Instituto Politécnico Nacional de México (National Polytechnic Institute of Mexico) in 2003. He is currently an associate professor in the Escuela Superior de Ingeniería Mecánica y Eléctrica (Mechanical and Electrical Engineering Higher School) at the same institute. His areas of scientific interest are signal and image processing, filtering, steganography, segmentation, pattern recognition, biomedical signal processing, sensors, and real-time applications.",institutionString:"Instituto Politécnico Nacional",institution:{name:"Instituto Politécnico Nacional",country:{name:"Mexico"}}},{id:"428449",title:"Dr.",name:"Ronaldo",middleName:null,surname:"Ferreira",slug:"ronaldo-ferreira",fullName:"Ronaldo Ferreira",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/428449/images/21449_n.png",biography:null,institutionString:null,institution:{name:"University of Aveiro",country:{name:"Portugal"}}},{id:"165328",title:"Dr.",name:"Vahid",middleName:null,surname:"Asadpour",slug:"vahid-asadpour",fullName:"Vahid Asadpour",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/165328/images/system/165328.jpg",biography:"Vahid Asadpour, MS, Ph.D., is currently with the Department of Research and Evaluation, Kaiser Permanente Southern California. He has both an MS and Ph.D. in Biomedical Engineering. He was previously a research scientist at the University of California Los Angeles (UCLA) and visiting professor and researcher at the University of North Dakota. He is currently working in artificial intelligence and its applications in medical signal processing. In addition, he is using digital signal processing in medical imaging and speech processing. Dr. Asadpour has developed brain-computer interfacing algorithms and has published books, book chapters, and several journal and conference papers in this field and other areas of intelligent signal processing. He has also designed medical devices, including a laser Doppler monitoring system.",institutionString:"Kaiser Permanente Southern California",institution:null},{id:"169608",title:"Prof.",name:"Marian",middleName:null,surname:"Găiceanu",slug:"marian-gaiceanu",fullName:"Marian Găiceanu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/169608/images/system/169608.png",biography:"Prof. Dr. Marian Gaiceanu graduated from the Naval and Electrical Engineering Faculty, Dunarea de Jos University of Galati, Romania, in 1997. He received a Ph.D. (Magna Cum Laude) in Electrical Engineering in 2002. Since 2017, Dr. Gaiceanu has been a Ph.D. supervisor for students in Electrical Engineering. He has been employed at Dunarea de Jos University of Galati since 1996, where he is currently a professor. Dr. Gaiceanu is a member of the National Council for Attesting Titles, Diplomas and Certificates, an expert of the Executive Agency for Higher Education, Research Funding, and a member of the Senate of the Dunarea de Jos University of Galati. He has been the head of the Integrated Energy Conversion Systems and Advanced Control of Complex Processes Research Center, Romania, since 2016. He has conducted several projects in power converter systems for electrical drives, power quality, PEM and SOFC fuel cell power converters for utilities, electric vehicles, and marine applications with the Department of Regulation and Control, SIEI S.pA. (2002–2004) and the Polytechnic University of Turin, Italy (2002–2004, 2006–2007). He is a member of the Institute of Electrical and Electronics Engineers (IEEE) and cofounder-member of the IEEE Power Electronics Romanian Chapter. He is a guest editor at Energies and an academic book editor for IntechOpen. He is also a member of the editorial boards of the Journal of Electrical Engineering, Electronics, Control and Computer Science and Sustainability. Dr. Gaiceanu has been General Chairman of the IEEE International Symposium on Electrical and Electronics Engineering in the last six editions.",institutionString:'"Dunarea de Jos" University of Galati',institution:{name:'"Dunarea de Jos" University of Galati',country:{name:"Romania"}}},{id:"4519",title:"Prof.",name:"Jaydip",middleName:null,surname:"Sen",slug:"jaydip-sen",fullName:"Jaydip Sen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/4519/images/system/4519.jpeg",biography:"Jaydip Sen is associated with Praxis Business School, Kolkata, India, as a professor in the Department of Data Science. His research areas include security and privacy issues in computing and communication, intrusion detection systems, machine learning, deep learning, and artificial intelligence in the financial domain. He has more than 200 publications in reputed international journals, refereed conference proceedings, and 20 book chapters in books published by internationally renowned publishing houses, such as Springer, CRC press, IGI Global, etc. Currently, he is serving on the editorial board of the prestigious journal Frontiers in Communications and Networks and in the technical program committees of a number of high-ranked international conferences organized by the IEEE, USA, and the ACM, USA. He has been listed among the top 2% of scientists in the world for the last three consecutive years, 2019 to 2021 as per studies conducted by the Stanford University, USA.",institutionString:"Praxis Business School",institution:null},{id:"320071",title:"Dr.",name:"Sidra",middleName:null,surname:"Mehtab",slug:"sidra-mehtab",fullName:"Sidra Mehtab",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00002v6KHoQAM/Profile_Picture_1584512086360",biography:"Sidra Mehtab has completed her BS with honors in Physics from Calcutta University, India in 2018. She has done MS in Data Science and Analytics from Maulana Abul Kalam Azad University of Technology (MAKAUT), Kolkata, India in 2020. Her research areas include Econometrics, Time Series Analysis, Machine Learning, Deep Learning, Artificial Intelligence, and Computer and Network Security with a particular focus on Cyber Security Analytics. Ms. Mehtab has published seven papers in international conferences and one of her papers has been accepted for publication in a reputable international journal. She has won the best paper awards in two prestigious international conferences – BAICONF 2019, and ICADCML 2021, organized in the Indian Institute of Management, Bangalore, India in December 2019, and SOA University, Bhubaneswar, India in January 2021. Besides, Ms. Mehtab has also published two book chapters in two books. Seven of her book chapters will be published in a volume shortly in 2021 by Cambridge Scholars’ Press, UK. Currently, she is working as the joint editor of two edited volumes on Time Series Analysis and Forecasting to be published in the first half of 2021 by an international house. Currently, she is working as a Data Scientist with an MNC in Delhi, India.",institutionString:"NSHM College of Management and Technology",institution:{name:"Association for Computing Machinery",country:{name:"United States of America"}}},{id:"226240",title:"Dr.",name:"Andri Irfan",middleName:null,surname:"Rifai",slug:"andri-irfan-rifai",fullName:"Andri Irfan Rifai",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/226240/images/7412_n.jpg",biography:"Andri IRFAN is a Senior Lecturer of Civil Engineering and Planning. He completed the PhD at the Universitas Indonesia & Universidade do Minho with Sandwich Program Scholarship from the Directorate General of Higher Education and LPDP scholarship. He has been teaching for more than 19 years and much active to applied his knowledge in the project construction in Indonesia. His research interest ranges from pavement management system to advanced data mining techniques for transportation engineering. He has published more than 50 papers in journals and 2 books.",institutionString:null,institution:{name:"Universitas Internasional Batam",country:{name:"Indonesia"}}},{id:"314576",title:"Dr.",name:"Ibai",middleName:null,surname:"Laña",slug:"ibai-lana",fullName:"Ibai Laña",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/314576/images/system/314576.jpg",biography:"Dr. Ibai Laña works at TECNALIA as a data analyst. He received his Ph.D. in Artificial Intelligence from the University of the Basque Country (UPV/EHU), Spain, in 2018. He is currently a senior researcher at TECNALIA. His research interests fall within the intersection of intelligent transportation systems, machine learning, traffic data analysis, and data science. He has dealt with urban traffic forecasting problems, applying machine learning models and evolutionary algorithms. He has experience in origin-destination matrix estimation or point of interest and trajectory detection. Working with large volumes of data has given him a good command of big data processing tools and NoSQL databases. He has also been a visiting scholar at the Knowledge Engineering and Discovery Research Institute, Auckland University of Technology.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"314575",title:"Dr.",name:"Jesus",middleName:null,surname:"L. Lobo",slug:"jesus-l.-lobo",fullName:"Jesus L. Lobo",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/314575/images/system/314575.png",biography:"Dr. Jesús López is currently based in Bilbao (Spain) working at TECNALIA as Artificial Intelligence Research Scientist. In most cases, a project idea or a new research line needs to be investigated to see if it is good enough to take into production or to focus on it. That is exactly what he does, diving into Machine Learning algorithms and technologies to help TECNALIA to decide whether something is great in theory or will actually impact on the product or processes of its projects. So, he is expert at framing experiments, developing hypotheses, and proving whether they’re true or not, in order to investigate fundamental problems with a longer time horizon. He is also able to design and develop PoCs and system prototypes in simulation. He has participated in several national and internacional R&D projects.\n\nAs another relevant part of his everyday research work, he usually publishes his findings in reputed scientific refereed journals and international conferences, occasionally acting as reviewer and Programme Commitee member. Concretely, since 2018 he has published 9 JCR (8 Q1) journal papers, 9 conference papers (e.g. ECML PKDD 2021), and he has co-edited a book. He is also active in popular science writing data science stories for reputed blogs (KDNuggets, TowardsDataScience, Naukas). Besides, he has recently embarked on mentoring programmes as mentor, and has also worked as data science trainer.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"103779",title:"Prof.",name:"Yalcin",middleName:null,surname:"Isler",slug:"yalcin-isler",fullName:"Yalcin Isler",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRyQ8QAK/Profile_Picture_1628834958734",biography:"Yalcin Isler (1971 - Burdur / Turkey) received the B.Sc. degree in the Department of Electrical and Electronics Engineering from Anadolu University, Eskisehir, Turkey, in 1993, the M.Sc. degree from the Department of Electronics and Communication Engineering, Suleyman Demirel University, Isparta, Turkey, in 1996, the Ph.D. degree from the Department of Electrical and Electronics Engineering, Dokuz Eylul University, Izmir, Turkey, in 2009, and the Competence of Associate Professorship from the Turkish Interuniversity Council in 2019.\n\nHe was Lecturer at Burdur Vocational School in Suleyman Demirel University (1993-2000, Burdur / Turkey), Software Engineer (2000-2002, Izmir / Turkey), Research Assistant in Bulent Ecevit University (2002-2003, Zonguldak / Turkey), Research Assistant in Dokuz Eylul University (2003-2010, Izmir / Turkey), Assistant Professor at the Department of Electrical and Electronics Engineering in Bulent Ecevit University (2010-2012, Zonguldak / Turkey), Assistant Professor at the Department of Biomedical Engineering in Izmir Katip Celebi University (2012-2019, Izmir / Turkey). He is an Associate Professor at the Department of Biomedical Engineering at Izmir Katip Celebi University, Izmir / Turkey, since 2019. In addition to academics, he has also founded Islerya Medical and Information Technologies Company, Izmir / Turkey, since 2017.\n\nHis main research interests cover biomedical signal processing, pattern recognition, medical device design, programming, and embedded systems. He has many scientific papers and participated in several projects in these study fields. He was an IEEE Student Member (2009-2011) and IEEE Member (2011-2014) and has been IEEE Senior Member since 2014.",institutionString:null,institution:{name:"Izmir Kâtip Çelebi University",country:{name:"Turkey"}}},{id:"339677",title:"Dr.",name:"Mrinmoy",middleName:null,surname:"Roy",slug:"mrinmoy-roy",fullName:"Mrinmoy Roy",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/339677/images/16768_n.jpg",biography:"An accomplished Sales & Marketing professional with 12 years of cross-functional experience in well-known organisations such as CIPLA, LUPIN, GLENMARK, ASTRAZENECA across different segment of Sales & Marketing, International Business, Institutional Business, Product Management, Strategic Marketing of HIV, Oncology, Derma, Respiratory, Anti-Diabetic, Nutraceutical & Stomatological Product Portfolio and Generic as well as Chronic Critical Care Portfolio. A First Class MBA in International Business & Strategic Marketing, B.Pharm, D.Pharm, Google Certified Digital Marketing Professional. Qualified PhD Candidate in Operations and Management with special focus on Artificial Intelligence and Machine Learning adoption, analysis and use in Healthcare, Hospital & Pharma Domain. Seasoned with diverse therapy area of Pharmaceutical Sales & Marketing ranging from generating revenue through generating prescriptions, launching new products, and making them big brands with continuous strategy execution at the Physician and Patients level. Moved from Sales to Marketing and Business Development for 3.5 years in South East Asian Market operating from Manila, Philippines. Came back to India and handled and developed Brands such as Gluconorm, Lupisulin, Supracal, Absolut Woman, Hemozink, Fabiflu (For COVID 19), and many more. In my previous assignment I used to develop and execute strategies on Sales & Marketing, Commercialization & Business Development for Institution and Corporate Hospital Business portfolio of Oncology Therapy Area for AstraZeneca Pharma India Ltd. Being a Research Scholar and Student of ‘Operations Research & Management: Artificial Intelligence’ I published several pioneer research papers and book chapters on the same in Internationally reputed journals and Books indexed in Scopus, Springer and Ei Compendex, Google Scholar etc. Currently, I am launching PGDM Pharmaceutical Management Program in IIHMR Bangalore and spearheading the course curriculum and structure of the same. I am interested in Collaboration for Healthcare Innovation, Pharma AI Innovation, Future trend in Marketing and Management with incubation on Healthcare, Healthcare IT startups, AI-ML Modelling and Healthcare Algorithm based training module development. I am also an affiliated member of the Institute of Management Consultant of India, looking forward to Healthcare, Healthcare IT and Innovation, Pharma and Hospital Management Consulting works.",institutionString:null,institution:{name:"Lovely Professional University",country:{name:"India"}}},{id:"1063",title:"Prof.",name:"Constantin",middleName:null,surname:"Volosencu",slug:"constantin-volosencu",fullName:"Constantin Volosencu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/1063/images/system/1063.png",biography:"Prof. Dr. Constantin Voloşencu graduated as an engineer from\nPolitehnica University of Timișoara, Romania, where he also\nobtained a doctorate degree. He is currently a full professor in\nthe Department of Automation and Applied Informatics at the\nsame university. Dr. Voloşencu is the author of ten books, seven\nbook chapters, and more than 160 papers published in journals\nand conference proceedings. He has also edited twelve books and\nhas twenty-seven patents to his name. He is a manager of research grants, editor in\nchief and member of international journal editorial boards, a former plenary speaker, a member of scientific committees, and chair at international conferences. His\nresearch is in the fields of control systems, control of electric drives, fuzzy control\nsystems, neural network applications, fault detection and diagnosis, sensor network\napplications, monitoring of distributed parameter systems, and power ultrasound\napplications. He has developed automation equipment for machine tools, spooling\nmachines, high-power ultrasound processes, and more.",institutionString:'"Politechnica" University Timişoara',institution:null},{id:"221364",title:"Dr.",name:"Eneko",middleName:null,surname:"Osaba",slug:"eneko-osaba",fullName:"Eneko Osaba",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/221364/images/system/221364.jpg",biography:"Dr. Eneko Osaba works at TECNALIA as a senior researcher. He obtained his Ph.D. in Artificial Intelligence in 2015. He has participated in more than twenty-five local and European research projects, and in the publication of more than 130 papers. He has performed several stays at universities in the United Kingdom, Italy, and Malta. Dr. Osaba has served as a program committee member in more than forty international conferences and participated in organizing activities in more than ten international conferences. He is a member of the editorial board of the International Journal of Artificial Intelligence, Data in Brief, and Journal of Advanced Transportation. He is also a guest editor for the Journal of Computational Science, Neurocomputing, Swarm, and Evolutionary Computation and IEEE ITS Magazine.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"275829",title:"Dr.",name:"Esther",middleName:null,surname:"Villar-Rodriguez",slug:"esther-villar-rodriguez",fullName:"Esther Villar-Rodriguez",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/275829/images/system/275829.jpg",biography:"Dr. Esther Villar obtained a Ph.D. in Information and Communication Technologies from the University of Alcalá, Spain, in 2015. She obtained a degree in Computer Science from the University of Deusto, Spain, in 2010, and an MSc in Computer Languages and Systems from the National University of Distance Education, Spain, in 2012. Her areas of interest and knowledge include natural language processing (NLP), detection of impersonation in social networks, semantic web, and machine learning. Dr. Esther Villar made several contributions at conferences and publishing in various journals in those fields. Currently, she is working within the OPTIMA (Optimization Modeling & Analytics) business of TECNALIA’s ICT Division as a data scientist in projects related to the prediction and optimization of management and industrial processes (resource planning, energy efficiency, etc).",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"49813",title:"Dr.",name:"Javier",middleName:null,surname:"Del Ser",slug:"javier-del-ser",fullName:"Javier Del Ser",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/49813/images/system/49813.png",biography:"Prof. Dr. Javier Del Ser received his first PhD in Telecommunication Engineering (Cum Laude) from the University of Navarra, Spain, in 2006, and a second PhD in Computational Intelligence (Summa Cum Laude) from the University of Alcala, Spain, in 2013. He is currently a principal researcher in data analytics and optimisation at TECNALIA (Spain), a visiting fellow at the Basque Center for Applied Mathematics (BCAM) and a part-time lecturer at the University of the Basque Country (UPV/EHU). His research interests gravitate on the use of descriptive, prescriptive and predictive algorithms for data mining and optimization in a diverse range of application fields such as Energy, Transport, Telecommunications, Health and Industry, among others. In these fields he has published more than 240 articles, co-supervised 8 Ph.D. theses, edited 6 books, coauthored 7 patents and participated/led more than 40 research projects. He is a Senior Member of the IEEE, and a recipient of the Biscay Talent prize for his academic career.",institutionString:"Tecnalia Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"278948",title:"Dr.",name:"Carlos Pedro",middleName:null,surname:"Gonçalves",slug:"carlos-pedro-goncalves",fullName:"Carlos Pedro Gonçalves",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRcmyQAC/Profile_Picture_1564224512145",biography:'Carlos Pedro Gonçalves (PhD) is an Associate Professor at Lusophone University of Humanities and Technologies and a researcher on Complexity Sciences, Quantum Technologies, Artificial Intelligence, Strategic Studies, Studies in Intelligence and Security, FinTech and Financial Risk Modeling. 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