In the development of J58’s standing wheelchair, the end user is central: ‘You can fill a cemetery with innovations that ignore end user wishes’

Fellow Stephanie Jansen-Kosterink and Gabriel Costa (CEO of J58) were interviewed by Aafke Eppinga of Innovation Origins about the importance of patient-centered innovations, the ecosystem in Twente and making an impact. Below is a repost of this interview (https://innovationorigins.com/nl/bij-j58-staat-eindgebruiker-centraal-je-kunt-begraafplaats-vullen-met-innovaties-die-voorbijgaan-aan-wensen-van-eindgebruiker/).

 

The story of J58 has its origins in Brazil. When professional volleyball player Augusto Hosanna ends up in a wheelchair after a severe car accident, he has only one dream: to be able to play volleyball again. So Rivelino Montenegro, one of Hosanna’s best friends, came up with the idea of designing a wheelchair where his friend could stand – and thus play volleyball. J58’s founding team was complete when they met compatriot Gabriel Costa at a conference in 2017. All three bring their expertise: Hosanna knows from personal experience what it is like to be in a wheelchair, Montenegro has entrepreneurial experience, a medical background, and a PhD in material science, and Costa takes care of the technical side of things.

j58

Costa: “We are not the first to develop a standing wheelchair; there are already electric versions. But those are very heavy, and you can’t put them independently in a car, for example. Moreover, they are costly, and you are dependent on a battery. We wanted to design something with the advantages of such an electric sterol chair, but not the disadvantages.”

The result is The Next Wheelchair. A mechanical wheelchair made on the basis of gas springs enables precise movement, requires no motor or battery, is much lighter, and is many times cheaper than the electric version.

Whoever is not in a wheelchair takes a lot for granted

More importantly, the wheelchair allows users to experience the world on a par with the rest of the people. “Those not in wheelchairs take a lot for granted,” Costa now knows. “We can just look everyone in the eye. Wheelchair users can’t. Going to the supermarket independently is already a challenge; you must always ask for help to grab something from a higher shelf.”

This is also the experience of Jansen, a senior researcher at RRD who sees many patients. “If you are different, you would prefer to be as normal as possible, even if you’ve fully accepted being a wheelchair user. On top of that, it’s unhealthy to sit a lot.”

Many body processes depend on gravity, which occurs when we stand. For example, when you sit, less blood flows through your legs. Also, legs absorb less glucose while sitting, which can disrupt or reduce blood flow to the brain. Costa: “Because users can stand with our wheelchair, it improves circulation and strengthens muscle mass.”

A graveyard full of healthcare innovations

Instead of a tech push, what applies to innovations in healthcare is that users must be included in the development process. “You can fill a cemetery with innovations, AI algorithms, and apps for care that ignore the wishes of the patient or care workers and therefore did not make it through,” Jansen said. That’s why the end user is at the heart of RRD.

They share that philosophy at J58: the main starting point in designing the wheelchair has always been usability. Costa: “One of the biggest requirements is that users can move with our wheelchair to the toilet, bed, or another wheelchair. If you can’t do that yourself, our innovation doesn’t advance.”

Beyond the familiar

But how do you make sure you hook the end user in the right way? Jansen knows that it becomes problematic if you are not trained to talk to patients and look at a product from a tech lens. “So, we ask not only if the wheelchair is comfortable, but also when, how, and where patients would use it and what barriers they see to use it. We don’t ask those questions directly; the trick is to ask the question as openly as possible.”

Costa: “The famous saying of car manufacturer Henry Ford – ‘If I had asked what people want, they would have said faster horses’ – also applies in our case. We have to look beyond the known. Through our collaboration with RRD, we are succeeding. For example, in a pilot, we found it convenient to have someone sit in a wheelchair through the side.”

The most entrepreneurial university in the Netherlands

When the idea for a mechanical standing wheelchair arose in 2020, Costa was almost finished with his master’s degree in design engineering at the University of Twente. It is the most entrepreneurial university in the Netherlands, which is a perfect match. The budding entrepreneurs connect with Novel-T and gain access to coaching calls, an extensive network, and many funding opportunities. The startup also rents office space for a relatively low price at Incubase, an initiative of Novel-T, the University of Twente, and the Student Union. So Costa, born in Brazil and raised in Limburg, has settled in Twente.

‘The whole is more than the sum of its parts’

Right now, J58 is putting the finishing touches on the first production model. Once certification is in, the first pilot series can go into production this year. Talks are ongoing with manufacturers in South Africa and South Korea, but the goal is to grow the company from Twente.

What makes the Twente MedTech ecosystem so unique? Costa thinks it has to do with everyone being very approachable. “Even big companies, like Demcon, make time to run a pilot with us. Everyone wants to help each other.”

Jansen: “Are you familiar with Gestalt psychology? This movement believes that the whole is more than the sum of its parts: 1+1=3. That plays a big part here. We are not concerned with how we can improve ourselves but how we can get better together.”

Giving people back their freedom

In five years, Costa hopes The Next Wheelchair will be the global standard for wheelchair users. “The practical benefits of our innovation are nice, but our main goal is to give people back their freedom and independence. Our first test user has been in a wheelchair for 18 years after a diving accident. He took his wife to the test, and the first thing he did was kiss her. I will never forget that moment; our company is more than an engineering project.”

 

Do you want to easily send questionnaires to your target group? Check out our new questionnaire system!

Written by: Dennis Hofs

 

The SenSeeAct platform contains a questionnaire system that allows you, as a researcher or health care professional, to push any questionnaire to your end users at a certain schedule. This versatile system can be used for almost any scenario that involves questionnaires, such as the Experience Sampling Method.

 

How to use the questionnaire editor?

We have just launched a new web interface where you can design your own questionnaires and schedules. This works along with our smartphone app where your end users can answer the questions, and get a push notification when a new questionnaire is ready for them. The answers are securely stored in the backend and you can download the data any time from ‘My SenSeeAct’.

You can already use our questionnaire system with your own installation of our open-source backend in combination with our free smartphone app. This option gives you complete ownership of the data. If you don’t have the skills or resources of maintaining your own backend, we also provide hosting at our servers.

There are also more advanced capabilities. The questionnaire system can be seamlessly integrated into custom-built apps and web portals from our platform. Here are a few options:

  • Combine questionnaires along with other modules such as measurements from sensors and wearables, or video exercises.
  • Schedule the questionnaires according to event-based algorithms.
  • Show questionnaire data in custom views with aggregation or integration of other data.
  • Integrate the questionnaires in conversations with a virtual agent.
  • Provide coaching or interventions based on the given answers.

Want to learn more about this? Check our tutorial video or contact us!

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FOTO ERIC BRINKHORST

Dennis Hofs

Email: d.hofs@rrd.nl

Tel: 088 087 5763

Pharaon Final Conference & ForItAAL in Florence

20240705_Pharaon Final Conference

Written by: Christiane Grünloh

 

In the last week of June, Kira Oberschmidt and Christiane Grünloh attended the Final Conference of Pharaon in Florence. Pharaon is a large scale pilot project funded by European Union’s Horizon 2020 research and innovation programme under the grant agreement No 857188. The project started in December 2019 and with a one year extension ends in November 2024. We were excited to have the final conference of Pharaon in combination with ForItAAL, the Forum of Italian Ambient Assisted Living and the program was packed.

 

The Final Conference provided the opportunity to:

  • learn more about the Pharaon pilot results and lessons learnt, the impact of the project, experiences from other large-scale pilots,
  • connect with the different stakeholders
  • start discussion and exploitation of the project’s services.

 

We presented the results of the 6 pilots in 5 countries (Spain (Murcia and Andalusia), Italy, The Netherlands, Slovenia, Portugal) in the session Innovation in Action: Pharaon pilot results. Given that Christiane is the general pilot coordinator in this project, she was the session chair and guided the audience through the presentations and Q&A at the end. Christiane was also invited to join the panel of experts on Innovation Europe: achievements from large scale pilots. Here she presented lessons learned and policy recommendations from conducting action research in the Pharaon pilots (see PDF (available in English only)).

 

Finally, we had 4 accepted papers accepted to ForItAAL which were presented by Kira and Christiane:

  • Stakeholder Skill Training in Participatory Health Research: Themes and Topics for Future Research., by Kira Oberschmidt, Christiane Grünloh, Kevin Doherty, Ria Wolkorte, Sheree, May Saßmannshausen, Lara Siering, Åsa Cajander, Michal Dolezel, Svante Lifvergren, Karin van den Driesche
  • "I thought: everybody wants to participate, right?" - Exploring patient motivation for taking part in long-term qualitative research, by Kira Oberschmidt, Christiane Grünloh, Marijke Broekhuis, Michael Bui, Monique Tabak
  • They are the champions - identifying and supporting champions in eHealth Action Research projects, by Kira Oberschmidt, Christiane Grünloh, Mateja Erce, Francisco José Melero Muñoz, Elisabete Raquel Simão Pitarma, Monique Tabak
  • Novice action researchers' theoretical understanding and practical implementation of action research in eHealth, by Kira Oberschmidt, Christiane Grünloh, Lex van Velsen

 

The last paper was even nominated as "ForItAAL Best Student Paper Award"!

We had very interesting discussions during the Pharaon final conference and ForItAAL. Do you want more information about this project or about these papers? Contact Christiane Grünloh!

Christiane Grünloh

Christiane Grünloh                                      

Email: c.grunloh@rrd.nl

Tel: 088 087 5723

Registration to Masterclass societal impact is open!

In healthcare and in the social domain, it is becoming increasingly important to know exactly what the societal impact of an innovation is. This impact can be determined by using the SROI (Social Return on Investment) methodology. During the Masterclass Societal Impact, you will learn to use this method and to determine the societal impact of your innovation. Even at an early stage of the development of this innovation, the SROI method can be used.

This Masterclass is hosted by Pim Ketelaar, Maarten Ploeg and Stephanie Jansen and is a collaboration between VitaValley and Roessingh Research and Development.

All necessary information can be found in the flyer below or on our website Master class on SROI. Any questions? Please contact Stephanie Jansen!

FOTO ERIC BRINKHORST

Stephanie Jansen-Kosterink

Email: s.jansen@rrd.nl

Tel: 088 087 5717

Pharaon: Some preliminary conclusions from AdSysCo and Christiane Grünloh

Last year Christiane Grünloh was interviewed by Dirk Winkel, Manager of Marketing, Communication & Sales at AdSysCo to talk about the Pharaon project. Below is a repost of this interview (https://adsysco.nl/pharaon-enkele-voorlopige-conclusies/).

 

In early 2020, at the initiative of the European Commission, the Pharaon project started. Pharaon aimed to explore the extent to which digital technologies can support the lives of older people. In Pharaon, AdSysCo participates with the RegiCare customer portal. A higher quality of life with digital discoveries, that's what it's all about.

The Pharaon study will be completed at the end of 2024. So it's too early for final conclusions, but there are already some preliminary. This is evident from a conversation we had with Dr. Christiane Grünloh, senior researcher at RRD and responsible for the smooth running of the six Pharaon pilots. Christiane has long been researching the adoption of technology solutions in healthcare. 

In these six pilots in five countries, all sorts of different technologies are being tried ranging from sensors that monitor people's safety to various forms of video calling via TV. In some care organizations, robots are being tested. In the Netherlands, the emphasis is on social contact around the outings of the PlusBussen of the National Fund for the Elderly. The RegiCare customer portal supports these social activities with digital contact. 

Just after Pharaon started, the COVID-19 pandemic erupted. "This risk was not foreseen in any project plan," said Christiane, "Due to the new measures, our target group (older adults who may be vulnerable) was almost immediately inaccessible to researchers in all countries, at least physically, while the research requires a lot of interaction with the target group." Delay was not an option for the EU, after all, everyone had committed to the program. Besides, Pharaon is all about information and communication technology, so researchers and designers are also creative to explore other ways to interact with people.

The kick-off meeting was still held in-person in Pisa, but after that Pharaon played out behind (boring) computer screens for two years. Due to the pandemic, the recruitment of older adults for the study got off to a slow start. All in all, the Pharaon study has to make do with a limited number of participants, and this applies to all pilots. For quantitative research, this presents a challenge, so more effort has also been put into qualitative research such as interviews. "Of course it is not great to have fewer participants than promised in the research proposal. But there is also an opportunity to go more into depth. Why do people participate or not? What challenges do they run into in their daily lives when they have to start using technology. These insights are super important," Christiane says.

 

Development for and with users

People in healthcare and welfare also had a high workload during the pandemic and hardly any additional capacities available. In addition to the pandemic, doubts against the use of technologies also played a role in many places. "I don't know it", "it doesn't work", "I don't get it" and "what's in it for me?". In Pharaon, we came across all kinds of arguments to not use a solution, and they were all justified. 

Technology can improve care and also make it more efficient and cheaper, Christiane knows, but it has to be developed for and with the users to take their needs into account, and that's often the crux of the matter. "I don't know it", "it doesn't work", "I don't get it" and "what's in it for me?" is well known. Close end-user involvement in the design and step-by-step building and testing of a digital solution for care and well-being is necessary to reduce these problems. "If we develop technology together with the target group and thereby ensure that it really connects with users' needs and values, we can increase acceptance, stimulate use and ultimately have effect and impact," Christiane has learned from her many research projects.

 

Development of RegiCare

AdSysCo recognizes this well. New developments in the RegiCare suite, such as the mobile applications and the customer portal, are developed for and with users. This also applies to the implementation: active involvement and ownership of users is a key success factor. Simply making a nice solution with lots of functionality available without actively involving the end-user in the how, the what and the why misses the mark. "Not the technical solution but the user experience determines success" says Christiane. "It does take more time, but do you want a cheap solution that doesn't work or a slightly more expensive solution that does?" she says smiling.

Once the research is complete, there will be a follow-up conversation between AdSysCo and Christiane.

SenSeeAct is now open-source: allowing digital health developers to benefit from and build on top of our software platform

Written by: Dennis Hofs

 

We have just released the first open-source version of SenSeeAct, our software platform that has driven many of our research projects and applications for more than ten years. During that time the platform has gone through several iterations, growing into a mature, flexible and secure backend with web portals and mobile apps.

The name SenSeeAct reflects the functionalities that the platform focuses on.

 

Sense: Collecting data through questionnaires, diaries, wearables, and smart home devices.

See: Presenting the data in user-friendly ways to both end users and health care professionals.

Act: Coaching users toward healthier behaviour with virtual agents, video exercises and gamification.

 

We now published the SenSeeAct backend as open-source software to help stimulate health technology innovation and collaboration. It facilitates the development of new applications by third parties, and enables organizations to take full control of their data ownership and access.

senseeact_app_portal

We are continuously improving the platform. Some of the new features that we anticipate in the near future are:

  • Enhanced support to author your own questionnaires and use them in our mobile app with your own backend.
  • Improved security with two-factor authentication.
  • A web interface to download your data or the data of your research participants.
  • A major update of our iOS app bringing it to the same level as the Android app.
  • Extending our earlier announced collaboration with DialogueBranch toolkit by Fruit Tree Labs.
  • More documentation and guides to help you get started with the open-source backend.

Read more about it at https://www.senseeact.com/?lng=nl

 

FOTO ERIC BRINKHORST

Dennis Hofs

Email: d.hofs@rrd.nl

Tel: 088 087 5763

 

Major research starts to tackle osteoarthritis on a tailor-made basis

By 2040, osteoarthritis is likely to be the most common chronic disease in the Netherlands. Currently, almost 1.5 million people in our country have osteoarthritis. The nature and extent of the symptoms may vary, but they always have an impact on people’s daily life. Osteoarthritis progresses differently for everyone, which requires tailor-made treatment. In order to be able to offer this as good as possible, insight is needed into the characteristics of the person and the disease process. Until now, that insight has been lacking. But this is about to change thanks to the funded research efforts of a unique partnership.

In November, researchers from the Interdisciplinary Consortium for Clinical Movement Sciences & Technology (ICMS) will start with the TopTreat project. They will follow 500 people with osteoarthritis over the next five years and will comprehensively map their characteristics. The aim is to gain insight into who qualifies for which treatment. The reason for this is because universal treatment is not effective for everyone due to the fact that the diversity among people with osteoarthritis is quite large.

 

Measuring and knowing precisely with a unique technology platform

This is the first time that the various manifestations of osteoarthritis are being measured with advanced technology and collected in a platform. The aim is to map extremely accurately how people with osteoarthritis feel, how they move, how their disease develops and which medicine is most effective for whom. Because physical, psychological and social factors all play a role in health, researchers are looking at the whole spectrum, from cell to well-being, and are conducting the study in consultation with the patients themselves. The insights from the study make it possible to optimally tailor treatment to the person with osteoarthritis. 

The promise of improvement

The research includes existing technologies such as 'joint-on-a-chip', accurate measurements of substances in the body that are indicative of the disease (biomarkers), analysis of movement with sensors, and making computer models of joint movement and load on cartilage. In doing so, the researchers aim to understand and capture specific characteristics of people with osteoarthritis. Based on these insights, practitioners can determine the most promising treatment for their patient.

Broad inclusion

Besides people with advanced osteoarthritis, two groups with an increased risk of osteoarthritis formation will also participate in the study. These are people with a broken or removed meniscus or with a leg amputation.

Moving forward together

TopTreat has a significant relevance for the progress of care of people with osteoarthritis. Moreover, the project is expected to develop a technology platform that is patent-worthy, and can be quickly translated into more healthcare applications. With this ambitious project, ICMS aims to maximise clinical and societal progress.

About ICMS

The Interdisciplinary Consortium for Clinical Movement Sciences & Technology (ICMS) is a unique partnership between RadboudUMC, Sint Maartenskliniek, Roessingh Research and Development and the TechMed Centre of the University of Twente. In TopTreat, these partners work together with ReumaNederland, the companies ATRO Medical and Moveshelf, the Rheumatism Foundation Sint Maartenskliniek, the Twente Graduate School and the Dutch Ministry of Defence. Together with funding from the Top Consortium for Knowledge and Innovation High-tech Systems & Materials, the project involves about EUR 4.8 million.

Roessingh Research and Development and Fruit Tree Labs announce formal collaboration

Summary:

  • Roessingh Research and Development, Impact Lab for Personalised Health Technology in the Netherlands and Fruit Tree Labs, a Portuguese start-up focused on open-source dialogue technology sign a partnership agreement.
  • The agreement formalizes years of existing friendly relations between the two parties.
  • Collaboration paves the way for a deeper integration of two important software platforms: SenSeeAct, the general-purpose eHealth platform by RRD and DialogueBranch, the dialogue-scripting platform by FTL.

 

The fourth quarter of 2023 begins with the happy news of an official collaboration between Roessingh Research and Development and Fruit Tree Labs.

Roessingh Research and Development (RRD) is an Impact Lab for Personalized Health Technology, based in the eastern part of the Netherlands, with close connections to the University of Twente and Roessingh Center for Rehabilitation. RRD provides scientific research on innovative healthcare technology with a focus on the end user. For RRD, co-creation with end users and stakeholders is essential to ensure the innovation meets user needs and fits into the healthcare context.

Fruit Tree Labs (FTL) is a start-up, founded early in 2023 in the Lisbon Metropolitan Area, focused on dialogue-driven interaction. The core product of FTL is a free and open-source dialogue platform that gives complete freedom and creative control to author-scripted conversations between users and virtual agents in serious web- or mobile application contexts.

CEO and Co-Founder of Fruit Tree Labs, Harm op den Akker has started his career working for RRD, obtaining his PhD degree through the University of Twente, and moving into a Senior Researcher position, strengthening the HCI-focused research at RRD between 2013 and 2021. Since then, relations have always remained warm, and collaborations continued through the co-development of open-source software. With the official collaboration agreement that is now in place, these friendly relations are now formalized in a long-lasting partnership.

For both parties, the partnership agreement comes at an exciting and fun time, as both RRD and FTL embark on new adventures in the open-source software community. RRD is in the process of publicly releasing its eHealth platform "SenSeeAct", allowing digital health developers to benefit from and build on top of a highly professional and stable software platform. At the same time, FTL recently launched the DialogueBranch platform made public (fully open-source and MIT licensed) and is looking for new partners and collaboration and funding opportunities.

With the new agreement in place, both parties commit to integrating these two open software platforms, strengthening the offering from both sides and opening new opportunities for potential users of either platform. Are you looking for a stable, highly customizable Digital Health platform, with integrated virtual agent capabilities? The combination of SenSeeAct and DialogueBranch might just be the thing for you!

 

 

Festive farewell to prof. dr. Jaap Buurke

Last week on September 7, we said goodbye to prof. dr. Jaap Buurke, together with family, friends and (former) colleagues from the field.

After working at RRD for more than 30 years, we ushered the retirement of Jaap Buurke. Jaap started his career on September 19th, 1983 as a conscientious objector within Roessingh, centre for Rehabilitation. After completing his conscientious objector period, Jaap started working as a physiotherapist at the rehabilitation centre on May 1st, 1985. Two years later, Jaap started working in the Research & Innovation Department for 18 hours a week. For a long time, he combined his career as a physiotherapist with work as a researcher at RRD.

In 2005, Jaap obtained his PhD on research into the recovery of walking after a stroke. This research formed an important basis for the introduction of neurorehabilitation principles in the Netherlands and the start of successful courses in gait image analysis that are still provided by RRD and Roessingh, Centre for Rehabilitation. On 1 May 2008, Jaap made the full transition to RRD and became a senior researcher there and had a bridging function with the rehabilitation centre. A year later, he became cluster manager and has been a manager within RRD for many years.

In many (inter)national research projects, Jaap focused on further developing rehabilitation technology and gait analysis. He combined these tasks with a position as professor at the University of Twente (UT) in the field of movement analysis and technology. From this position, he supervised many researchers in their PhD trajectories. In addition to his work at RRD and UT, Jaap's positions included adjunct professor at North Western University in Chicago, medical scientific director of IMDI SPRINT, board member of SMALLL and president of the Dutch association for Neurorehabilitation "Keypoint".

Jaap has marked his retirement from RRD, but he will continue to be involved in various courses in gait image analysis in the coming year.

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Scale-Up4Rehab: Important step forward in digitalisation rehabilitation sector

To ensure equal access to rehabilitation care and promote the resilience of health systems across Northwest Europe, a new 5-year project is being launched.

Scale-Up4Rehab will take a major step forward in the digitisation of the rehabilitation sector by being the first to build an open virtual rehabilitation "clinic," which will scale up existing virtual rehabilitation therapies. In five regional pilots (NL/DE/IR/BE/LU), acting as showcases, rehabilitation professionals in different care settings will integrate virtual rehabilitation into their daily practice.

Why is digitalisation in rehabilitation needed?

Remco Hoogendijk, Manager Projects & Innovation Sint Maartenskliniek (The Netherlands): "Access to rehabilitation is unequal, both between and within countries. Technology offers the opportunity to provide efficient care and access to dedicated rehabilitation care, regardless of patient location. Various forms of rehabilitation therapy using virtual technologies are already taking place. However, these digital applications are used only in local settings and economies of scale are not being exploited. Transnational collaboration is needed to achieve these economies of scale and take the digital transformation of the rehabilitation sector to the next level."

Rehabilitation plays an important role in improving the health and well-being of the population and the overall efficiency and sustainability of health systems. With an aging population, the number of people in need of rehabilitation will increase while there is a shortage of health care personnel.

Partners in this new project

Partners in achieving equal access to rehabilitation care and promoting the resilience of health systems throughout Northwest Europe are:

  • Rehabilitation clinics and university medical centers: St. Maartens Clinic, St. Mauritius Therapieklinik, Centre National de Rééducation Fonctionnelle et de Réadaptation, Roessingh Research and Development, University College Dublin, School of Public Health, Physiotherapy and Sports Science, University College Cork, Discipline of Physiotherapy, School of Clinical Therapies, Radboudumc Department of Rehabilitation, UniKlinik RWTH Aachen.
  • Universities, specializing in engineering and computer science research and development: University of Lille, University of Tilburg.
  • Innovation Networks: In4care, Health Valley Netherlands, Eurasanté.

Additionally, we will set-up a group of associated organisations, interested to follow the project, including:

  • Teeside University
  • XR4Rehab collaborative network
  • EIT Health Belgium-Netherlands
  • Shift Medical
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For additional information about our role in Scale-Up4Rehab, you can contact Stephanie Jansen-Kosterink:
FOTO ERIC BRINKHORST

Stephanie Jansen-Kosterink

Email: s.jansen@rrd.nl

Tel: 088 087 5717

Scale-Up4Rehab obtained a grant of € 6.5 million from Interreg North West Europe
scale up 4rehab europa
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