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Latini, Francesco, Ph.D.ORCID iD iconorcid.org/0000-0002-4702-526X
Publications (10 of 33) Show all publications
Hossain, I., Younsi, A., Leon, A. M., Lippa, L., Toth, P., Terpolilli, N., . . . Rostami, E. (2023). Huge variability in restrictions of mobilization for patients with aneurysmal subarachnoid hemorrhage - A European survey of practice. BRAIN AND SPINE, 3, Article ID 101731.
Open this publication in new window or tab >>Huge variability in restrictions of mobilization for patients with aneurysmal subarachnoid hemorrhage - A European survey of practice
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2023 (English)In: BRAIN AND SPINE, ISSN 2772-5294, Vol. 3, article id 101731Article in journal (Refereed) Published
Abstract [en]

Introduction: One of the major goals of neurointensive care is to prevent secondary injuries following aSAH. Bed rest and patient immobilization are practiced in order to decrease the risk of DCI.

Research question: To explore the current practices in place concerning the management of patients with aSAH, specifically, protocols and habits regarding restrictions of mobilization and HOB positioning.

Material and methods: A survey was designed, modified, and approved by the panel of the Trauma & Critical Care section of the EANS to cover the practice of restrictions of patient mobilization and HOB positioning in patients with aSAH.

Results: Twenty-nine physicians from 17 countries completed the questionnaire. The majority (79.3%) stated that non-secured aneurysm and the presence of an EVD were the factors related to the establishment of restriction of mobilization. The average duration of the restriction varied widely ranging between 1 and 21 days. The presence of an EVD (13.8%) was found to be the main reason to recommend restriction of HOB elevation. The average duration of restriction of HOB positioning ranged between 3 and 14 days. Rebleeding or complications related to CSF over-drainage were found to be related to these restrictions.

Discussion and conclusion: Restriction of patient mobilization regimens vary widely in Europe. Current limited evidence does not support an increased risk of DCI rather the early mobilization might be beneficial. Large prospective studies and/or the initiative of a RCT are needed to understand the significance of early mobilization on the outcome of patients with aSAH.

Place, publisher, year, edition, pages
Elsevier, 2023
Keywords
Subarachnoid hemorrhage, Early mobilization, Head-of-bed elevation, Cerebral vasospasm
National Category
Neurology
Identifiers
urn:nbn:se:uu:diva-513334 (URN)10.1016/j.bas.2023.101731 (DOI)001053346000001 ()37383447 (PubMedID)
Available from: 2023-10-09 Created: 2023-10-09 Last updated: 2023-10-09Bibliographically approved
Latini, F., Fahlström, M., Fällmar, D., Marklund, N., Cunningham, J. & Feresiadou, A. (2022). Can diffusion tensor imaging (DTI) outperform standard magnetic resonance imaging (MRI) investigations in post-COVID-19 autoimmune encephalitis?. Upsala Journal of Medical Sciences, 127(1), Article ID e8562.
Open this publication in new window or tab >>Can diffusion tensor imaging (DTI) outperform standard magnetic resonance imaging (MRI) investigations in post-COVID-19 autoimmune encephalitis?
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2022 (English)In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 127, no 1, article id e8562Article in journal (Refereed) Published
Abstract [en]

Background: Neurological and psychiatric manifestations related to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection are widely recognised. Standard magnetic resonance imaging (MRI) investigations are normal in 40-80% of symptomatic patients, eventually delaying appropriate treatment when MRI is unrevealing any structural changes. The aim of this study is to investigate white matter abnormalities during an early stage of post-COVID-19 (coronavirus disease 2019) encephalitis while conventional MRI was normal. Methods: A patient with post-COVID-19 autoimmune encephalitis was investigated by serial MRIs and diffusion tensor imaging (DTI). Ten healthy control individuals (HC) were utilised as a control group for the DTI analysis. Major projection, commissural and association white matter pathways were reconstructed, and multiple diffusion parameters were analysed and then compared to the HC average using a z-test for serial examinations. Results: Eleven days after the onset of neurological symptoms, DTI revealed early white matter changes, compared with HC, when standard MRI was normal. On day 68, DTI showed multiple white matter lesions compared with HC, visible at this time also by the MRI images, indicating inflammatory changes in different association and projection white matter pathways. Conclusion: We confirm a limitation in the sensitivity of conventional MRI at the acute setting of postCOVID-19 autoimmune encephalitis. A complementary DTI investigation could be a valuable diagnostic tool in early therapeutic decisions concerning COVID-19-related neurological symptoms.

Place, publisher, year, edition, pages
Uppsala Medical Society, 2022
Keywords
COVID-19, white matter, encephalitis, DTI, MRI
National Category
Neurology Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:uu:diva-479883 (URN)10.48101/ujms.v127.8562 (DOI)000811349300001 ()35722186 (PubMedID)
Funder
Swedish Research CouncilSwedish Research CouncilSwedish Research Council
Available from: 2022-07-05 Created: 2022-07-05 Last updated: 2022-07-05Bibliographically approved
Borota, L., Libard, S., Fahlström, M., Latini, F. & Lundström, E. (2022). Complete functional recovery in a child after endovascular treatment of basilar artery occlusion caused by spontaneous dissection: a case report. Child's Nervous System, 38(8), 1605-1612
Open this publication in new window or tab >>Complete functional recovery in a child after endovascular treatment of basilar artery occlusion caused by spontaneous dissection: a case report
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2022 (English)In: Child's Nervous System, ISSN 0256-7040, E-ISSN 1433-0350, Vol. 38, no 8, p. 1605-1612Article in journal (Refereed) Published
Abstract [en]

Stroke caused by dissection of arteries of the vertebrobasilar system in children is still poorly investigated in terms of etiology, means of treatment, course of disease, and prognosis. The aim of this report was to describe the unusual course of a spontaneous dissection of the basilar artery (BA) in a child treated with endovascular techniques and to point out that the plasticity of the brain stem can fully compensate for structural damage caused by stroke. We report the case of a 15-year-old boy who suffered a wake-up stroke with BA occlusion caused by spontaneous dissection. A blood clot was aspirated from the false lumen and the true lumen re-opened, but the patient deteriorated a few hours later, and repeated angiography revealed that the intimal flap was detached, occluding the BA again. The lumen of BA was then reconstructed by a stent. Despite a large pons infarction, the patient was completely recovered 11 months after the onset. The case was analyzed with angiograms and magnetic resonance imaging, macroscopic and microscopic pathological analysis, computed tomographic angiography, magnetic resonance-based angiography, and diffusion tensor imaging. This case illustrates that applied endovascular techniques and intensive care measures can alter the course of potentially fatal brain stem infarction. Our multimodal analysis gives new insight into the anatomical basis for the plasticity mechanism of the brain stem.

Place, publisher, year, edition, pages
Springer Nature, 2022
Keywords
Pons, Infarction, Diffusion tensor imaging
National Category
Neurology
Identifiers
urn:nbn:se:uu:diva-464332 (URN)10.1007/s00381-021-05428-w (DOI)000729010300001 ()
Note

A Correction to this article was published on 11 January 2022. In this article the author name “Sylwia Libard” was incorrectly written as “Sylvia Libard”.The original article has been corrected.

Available from: 2022-01-13 Created: 2022-01-13 Last updated: 2023-07-04Bibliographically approved
Axelson, H., Latini, F., Jemstedt, M., Ryttlefors, M. & Zetterling, M. (2022). Continuous subcortical language mapping in awake glioma surgery. Frontiers in Oncology, 12, Article ID 947119.
Open this publication in new window or tab >>Continuous subcortical language mapping in awake glioma surgery
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2022 (English)In: Frontiers in Oncology, E-ISSN 2234-943X, Vol. 12, article id 947119Article in journal (Refereed) Published
Abstract [en]

Repetitive monopolar short-train stimulation (STS) delivered from a suction probe enables continuous mapping and distance assessment of corticospinal tracts during asleep glioma resection. In this study, we explored this stimulation technique in awake glioma surgery. Fourteen patients with glioma involving language-related tracts were prospectively included. Continuous (3-Hz) cathodal monopolar STS (five pulses, 250 Hz) was delivered via the tip of a suction probe throughout tumor resection while testing language performance. At 70 subcortical locations, surgery was paused to deliver STS in a steady suction probe position. Monopolar STS influence on language performance at different subcortical locations was separated into three groups. Group 1 represented locations where STS did not produce language disturbance. Groups 2 and 3 represented subcortical locations where STS produced language interference at different threshold intensities (>= 7.5 and <= 5 mA, respectively). For validation, bipolar Penfield stimulation (PS; 60 Hz for 3 s) was used as a "gold standard" comparison method to detect close proximity to language-related tracts and classified as positive or negative regarding language interference. There was no language interference from STS in 28 locations (Group 1), and PS was negative for all sites. In Group 2 (STS threshold >= 7.5 mA; median, 10 mA), there was language interference at 18 locations, and PS (median, 4 mA) was positive in only one location. In Group 3 (STS threshold <= 5 mA; median, 5 mA), there was language interference at 24 locations, and positive PS (median 4 mA) was significantly (p < 0.01) more common (15 out of 24 locations) compared with Groups 1 and 2. Despite the continuous stimulation throughout tumor resection, there were no seizures in any of the patients. In five patients, temporary current spread to the facial nerve was observed. We conclude that continuous subcortical STS is feasibly also in awake glioma surgery and that no language interference from STS or interference at >= 7.5 mA seems to indicate safe distance to language tracts as judged by PS comparisons. STS language interference at STS <= 5 mA was not consistently confirmed by PS, which needs to be addressed.

Place, publisher, year, edition, pages
Frontiers Media S.A., 2022
Keywords
awake craniotomy, subcortical electrical stimulation, short-train stimulation, monopolar stimulation, intraoperative language testing, tractography
National Category
Neurology
Identifiers
urn:nbn:se:uu:diva-486382 (URN)10.3389/fonc.2022.947119 (DOI)000861048900001 ()36033478 (PubMedID)
Available from: 2022-10-10 Created: 2022-10-10 Last updated: 2024-01-17Bibliographically approved
Svedung-Wettervik, T., Munkhammar, Å. A., Jemstedt, M., Ersson, M., Latini, F., Ryttlefors, M. & Zetterling, M. (2022). Dynamics in cognition and health-related quality of life in grade 2 and 3 gliomas after surgery. Acta Neurochirurgica, 164(12), 3275-3284
Open this publication in new window or tab >>Dynamics in cognition and health-related quality of life in grade 2 and 3 gliomas after surgery
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2022 (English)In: Acta Neurochirurgica, ISSN 0001-6268, E-ISSN 0942-0940, Vol. 164, no 12, p. 3275-3284Article in journal (Refereed) Published
Abstract [en]

Background

The focus of clinical management and research in gliomas has been on survival, but the interest in the treatment effects on cognition and health-related quality of life (HRQoL) is emerging. The primary aim of this study was to investigate the dynamics in cognition after brain tumor surgery for astrocytomas and oligodendrogliomas grade 2 and 3. The secondary aim was to investigate the association of postoperative changes in cognition with changes HRQoL.

Methods

In this observational study, 48 patients operated for an astrocytoma or oligodendrogliomas, grade 2 or 3, at the Department of Neurosurgery, Uppsala, Sweden, 2016–2021, were included. Cognitive and language skills were assessed with a selected test battery and HRQoL was patient-reported as assessed with RAND-36 pre- and approximately 3 months postoperatively.

Results

There was a significant postoperative decrease in attention span and verbal learning, but the patients improved in the test for visual memory. There was no change in visual attention, executive function, verbal memory, visual organization and construction, verbal fluency, and confrontation naming. The RAND-36 variables physical function, role physical, general health, vitality, and social functioning decreased significantly after surgery. Patients operated for tumor recurrence exhibited greater deterioration in attention and a greater extent of resection correlated with a less pronounced decrease in verbal memory, but there were otherwise weak associations between the dynamics in cognition and patient-, tumor-, and treatment-variables. A decline in cognitive variables was not associated with worse HRQoL.

Conclusions

Although both several cognitive and HRQoL domains deteriorated postoperatively, these changes did not correlate with each other. This highlights the complexity of cognitive and HRQoL dynamics in the early postoperative phase.

Place, publisher, year, edition, pages
Springer Nature, 2022
Keywords
Astrocytoma, Brain tumor, Cognition, Health-related quality of life, Low-grade glioma, Oligodendroglioma
National Category
Neurology
Research subject
Neurosurgery
Identifiers
urn:nbn:se:uu:diva-491006 (URN)10.1007/s00701-022-05408-2 (DOI)000878977700001 ()36331612 (PubMedID)
Funder
Uppsala University
Available from: 2022-12-16 Created: 2022-12-16 Last updated: 2023-03-03Bibliographically approved
Latini, F., Jakola, A. & Ruda, R. (2022). Investigating the gliomas/white matter interplay and its implications for multidisciplinary treatment: State of art and future perspectives. Frontiers in Neuroscience, 16, Article ID 1100972.
Open this publication in new window or tab >>Investigating the gliomas/white matter interplay and its implications for multidisciplinary treatment: State of art and future perspectives
2022 (English)In: Frontiers in Neuroscience, ISSN 1662-4548, E-ISSN 1662-453X, Vol. 16, article id 1100972Article in journal, Editorial material (Other academic) Published
Place, publisher, year, edition, pages
Frontiers Media S.A., 2022
Keywords
brain connectome networks, diffuse gliomas, white matter, brain mapping, neuroplasticity, advanced neuroimaging, individualized oncological treatment
National Category
Neurosciences Neurology
Identifiers
urn:nbn:se:uu:diva-494793 (URN)10.3389/fnins.2022.1100972 (DOI)000902159500001 ()36570851 (PubMedID)
Available from: 2023-01-23 Created: 2023-01-23 Last updated: 2023-01-23Bibliographically approved
Svedung-Wettervik, T., Ersson, M., Latini, F., Ryttlefors, M. & Zetterling, M. (2022). Patient-reported quality of life in grade 2 and 3 gliomas after surgery, can we do more?. Clinical neurology and neurosurgery, 214, Article ID 107175.
Open this publication in new window or tab >>Patient-reported quality of life in grade 2 and 3 gliomas after surgery, can we do more?
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2022 (English)In: Clinical neurology and neurosurgery, ISSN 0303-8467, E-ISSN 1872-6968, Vol. 214, article id 107175Article in journal (Refereed) Published
Abstract [en]

Objective: To study the effects of surgery and the explanatory variables for patient-reported health-related quality of life (HRQoL) after brain tumor surgery for astrocytomas and oligodendrogliomas grade 2 and 3.

Methods: Patients operated for an astrocytoma or an oligodendrogliomas, grade 2 or 3, at the Department of Neurosurgery, Uppsala, Sweden, 2016-2021, were included. HRQoL was assessed with RAND-36 preoperatively and 4 months postoperatively. Demographic, tumor, and treatment data were prospectively collected.

Results: Sixty-two patients were included, 34 with an astrocytoma and 28 with an oligodendroglioma. Physical function, role physical, general health, vitality, and social functioning decreased significantly (p-values < 0.01) 4 months after surgery, whereas bodily pain, role emotional, and mental health remained unchanged. In Spearman analyses, younger patients deteriorated more in role physical, females worsened less often in general health but more often in social functioning than males, a higher level of education correlated with a more pronounced drop in social functioning, and a greater extent of resection corresponded to a worsening in physical function postoperatively (p-values < 0.05).

Conclusions: Several HRQoL domains deteriorated after glioma surgery in specific groups of patients, particularly general health, vitality, physical, and social functions. This was only weakly explained by surgical variables. Specific groups of patients may need closer follow-ups and tailored support/rehabilitation to detect and address these HRQoL deteriorations.

Place, publisher, year, edition, pages
ElsevierElsevier BV, 2022
Keywords
<p>Astrocytoma</p>, Brain tumor, Health-related quality of life, Low-grade glioma, Oligodendroglioma
National Category
Neurology
Identifiers
urn:nbn:se:uu:diva-474323 (URN)10.1016/j.clineuro.2022.107175 (DOI)000788161300003 ()35176634 (PubMedID)
Available from: 2022-05-18 Created: 2022-05-18 Last updated: 2024-01-15Bibliographically approved
Latini, F., Fahlström, M., Vedung, F., Stensson, S., Larsson, E.-M., Lubberink, M., . . . Marklund, N. (2022). Refined Analysis of Chronic White Matter Changes after Traumatic Brain Injury and Repeated Sports-Related Concussions: Of Use in Targeted Rehabilitative Approaches?. Journal of Clinical Medicine, 11(2), Article ID 358.
Open this publication in new window or tab >>Refined Analysis of Chronic White Matter Changes after Traumatic Brain Injury and Repeated Sports-Related Concussions: Of Use in Targeted Rehabilitative Approaches?
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2022 (English)In: Journal of Clinical Medicine, E-ISSN 2077-0383, Vol. 11, no 2, article id 358Article in journal (Refereed) Published
Abstract [en]

Traumatic brain injury (TBI) or repeated sport-related concussions (rSRC) may lead to long-term memory impairment. Diffusion tensor imaging (DTI) is helpful to reveal global white matter damage but may underestimate focal abnormalities. We investigated the distribution of post-injury regional white matter changes after TBI and rSRC. Six patients with moderate/severe TBI, and 12 athletes with rSRC were included ≥6 months post-injury, and 10 (age-matched) healthy controls (HC) were analyzed. The Repeatable Battery for the Assessment of Neuropsychological Status was performed at the time of DTI. Major white matter pathways were tracked using q-space diffeomorphic reconstruction and analyzed for global and regional changes with a controlled false discovery rate. TBI patients displayed multiple classic white matter injuries compared with HC (p < 0.01). At the regional white matter analysis, the left frontal aslant tract, anterior thalamic radiation, and the genu of the corpus callosum displayed focal changes in both groups compared with HC but with different trends. Both TBI and rSRC displayed worse memory performance compared with HC (p < 0.05). While global analysis of DTI-based parameters did not reveal common abnormalities in TBI and rSRC, abnormalities to the fronto-thalamic network were observed in both groups using regional analysis of the white matter pathways. These results may be valuable to tailor individualized rehabilitative approaches for post-injury cognitive impairment in both TBI and rSRC patients.

Place, publisher, year, edition, pages
MDPI AG, 2022
Keywords
traumatic brain injury, sport related concussion, memory impairment, diffusion tensor imaging, white matter lesions, rehabilitative approaches
National Category
Neurosciences
Identifiers
urn:nbn:se:uu:diva-464334 (URN)10.3390/jcm11020358 (DOI)000747543900001 ()35054052 (PubMedID)
Funder
Swedish Research Council, 2018-02500_VRThe Swedish Brain Foundation, FO2020-0147The Swedish Brain Foundation, FO2019-0190The Swedish Brain Foundation, FO2018-0166Swedish National Centre for Research in Sports, P2019-0133Swedish National Centre for Research in Sports, P2020-0116Swedish National Centre for Research in Sports, P2021-0105Insamlingsfonden Bissen Brainwalk
Note

De två första författarna delar förstaförfattarskapet

Available from: 2022-01-13 Created: 2022-01-13 Last updated: 2022-02-21Bibliographically approved
Roodakker, K. R., Ezra, B., Gauffin, H., Latini, F., Zetterling, M., Berntsson, S. G. & Landtblom, A.-M. (2021). Ecstatic and gelastic seizures related to the hypothalamus. Epilepsy & Behavior Reports, 16, Article ID 100400.
Open this publication in new window or tab >>Ecstatic and gelastic seizures related to the hypothalamus
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2021 (English)In: Epilepsy & Behavior Reports, E-ISSN 2589-9864, Vol. 16, article id 100400Article in journal (Refereed) Published
Abstract [en]

Ecstatic seizures constitute a rare form of epilepsy, and the semiology is diverse. Previously, brain areas including the temporal lobe and the insula have been identified to be involved in clinical expression. The aim of this report is to review changes in ecstatic seizures in a patient before and after operation for a hypothalamic hamartoma, and to scrutinize the relation to gelastic seizures. In this case, the ecstatic seizures disappeared after surgery of the hamartoma but reappeared eleven years later. Clinical information was retrospectively obtained from medical records, interviews, and a questionnaire covering seizure semiology that pertained to ecstatic and gelastic seizures. Our findings imply a possible connection between gelastic and ecstatic seizures, originating from a hypothalamic hamartoma. To our knowledge, this location has not previously been described in ecstatic seizures. Gelastic seizures may in this case be associated with ecstatic seizures. We speculate that patients with ecstatic seizures may have an ictal activation of neuronal networks that involve the insula. Our case may add information to the knowledge concerning ecstatic seizures. (C) 2020 The Authors. Published by Elsevier Inc.

Place, publisher, year, edition, pages
ElsevierELSEVIER SCIENCE INC, 2021
Keywords
Ecstatic seizures, Gelastic seizures, Epilepsy, Hamartoma, Hypothalamus
National Category
Neurology
Identifiers
urn:nbn:se:uu:diva-466635 (URN)10.1016/j.ebr.2020.100400 (DOI)000742618500001 ()35028554 (PubMedID)
Available from: 2022-01-31 Created: 2022-01-31 Last updated: 2024-01-15Bibliographically approved
Latini, F., Trevisi, G., Fahlström, M., Jemstedt, M., Alberius Munkhammar, Å., Zetterling, M., . . . Ryttlefors, M. (2021). New Insights Into the Anatomy, Connectivity and Clinical Implications of the Middle Longitudinal Fasciculus. Frontiers in Neuroanatomy, 14, Article ID 610324.
Open this publication in new window or tab >>New Insights Into the Anatomy, Connectivity and Clinical Implications of the Middle Longitudinal Fasciculus
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2021 (English)In: Frontiers in Neuroanatomy, E-ISSN 1662-5129, Vol. 14, article id 610324Article in journal (Refereed) Published
Abstract [en]

The middle longitudinal fascicle (MdLF) is a long, associative white matter tract connecting the superior temporal gyrus (STG) with the parietal and occipital lobe. Previous studies show different cortical terminations, and a possible segmentation pattern of the tract. In this study, we performed a post-mortem white matter dissection of 12 human hemispheres and an in vivo deterministic fiber tracking of 24 subjects acquired from the Human Connectome Project to establish whether a constant organization of fibers exists among the MdLF subcomponents and to acquire anatomical information on each subcomponent. Moreover, two clinical cases of brain tumors impinged on MdLF territories are reported to further discuss the anatomical results in light of previously published data on the functional involvement of this bundle. The main finding is that the MdLF is consistently organized into two layers: an antero-ventral segment (aMdLF) connecting the anterior STG (including temporal pole and planum polare) and the extrastriate lateral occipital cortex, and a posterior-dorsal segment (pMdLF) connecting the posterior STG, anterior transverse temporal gyrus and planum temporale with the superior parietal lobule and lateral occipital cortex. The anatomical connectivity pattern and quantitative differences between the MdLF subcomponents along with the clinical cases reported in this paper support the role of MdLF in high-order functions related to acoustic information. We suggest that pMdLF may contribute to the learning process associated with verbal-auditory stimuli, especially on left side, while aMdLF may play a role in processing/retrieving auditory information already consolidated within the temporal lobe.

Place, publisher, year, edition, pages
Frontiers Media S.A., 2021
Keywords
diffusion tensor tractography, verbal memory, visual-auditory integration, Human Connectome Project, verbal learning, auditory hallucinations, white matter, MdLF
National Category
Neurosciences Neurology
Identifiers
urn:nbn:se:uu:diva-437229 (URN)10.3389/fnana.2020.610324 (DOI)000617157500001 ()33584207 (PubMedID)
Available from: 2021-03-12 Created: 2021-03-12 Last updated: 2024-01-15Bibliographically approved
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ORCID iD: ORCID iD iconorcid.org/0000-0002-4702-526X

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