Loading…

Smart homes, private homes? An empirical study of technology researchers' perceptions of ethical issues in developing smart-home health technologies

Smart-home technologies, comprising environmental sensors, wearables and video are attracting interest in home healthcare delivery. Development of such technology is usually justified on the basis of the technology's potential to increase the autonomy of people living with long-term conditions....

Full description

Saved in:
Bibliographic Details
Published in:BMC medical ethics 2017-04, Vol.18 (1), p.23-23, Article 23
Main Authors: Birchley, Giles, Huxtable, Richard, Murtagh, Madeleine, Ter Meulen, Ruud, Flach, Peter, Gooberman-Hill, Rachael
Format: Article
Language:English
Subjects:
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
cited_by cdi_FETCH-LOGICAL-c493t-fec1ab0ac010550a825b0af33cb625e6278b3af3f78373c03e6108e2c8ac6afd3
cites cdi_FETCH-LOGICAL-c493t-fec1ab0ac010550a825b0af33cb625e6278b3af3f78373c03e6108e2c8ac6afd3
container_end_page 23
container_issue 1
container_start_page 23
container_title BMC medical ethics
container_volume 18
creator Birchley, Giles
Huxtable, Richard
Murtagh, Madeleine
Ter Meulen, Ruud
Flach, Peter
Gooberman-Hill, Rachael
description Smart-home technologies, comprising environmental sensors, wearables and video are attracting interest in home healthcare delivery. Development of such technology is usually justified on the basis of the technology's potential to increase the autonomy of people living with long-term conditions. Studies of the ethics of smart-homes raise concerns about privacy, consent, social isolation and equity of access. Few studies have investigated the ethical perspectives of smart-home engineers themselves. By exploring the views of engineering researchers in a large smart-home project, we sought to contribute to dialogue between ethics and the engineering community. Either face-to-face or using Skype, we conducted in-depth qualitative interviews with 20 early- and mid-career smart-home researchers from a multi-centre smart-home project, who were asked to describe their own experience and to reflect more broadly about ethical considerations that relate to smart-home design. With participants' consent, interviews were audio-recorded, transcribed and analysed using a thematic approach. Two overarching themes emerged: in 'Privacy', researchers indicated that they paid close attention to negative consequences of potential unauthorised information sharing in their current work. However, when discussing broader issues in smart-home design beyond the confines of their immediate project, researchers considered physical privacy to a lesser extent, even though physical privacy may manifest in emotive concerns about being watched or monitored. In 'Choice', researchers indicated they often saw provision of choice to end-users as a solution to ethical dilemmas. While researchers indicated that choices of end-users may need to be restricted for technological reasons, ethical standpoints that restrict choice were usually assumed and embedded in design. The tractability of informational privacy may explain the greater attention that is paid to it. However, concerns about physical privacy may reduce acceptability of smart-home technologies to future end-users. While attention to choice suggests links with privacy, this may misidentify the sources of privacy and risk unjustly burdening end-users with problems that they cannot resolve. Separating considerations of choice and privacy may result in more satisfactory treatment of both. Finally, through our engagement with researchers as participants this study demonstrates the relevance of (bio)ethics as a critical partner to smart-home e
doi_str_mv 10.1186/s12910-017-0183-z
format article
fullrecord <record><control><sourceid>proquest_doaj_</sourceid><recordid>TN_cdi_doaj_primary_oai_doaj_org_article_bec215dbfcb24052b15c11c6457be026</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><doaj_id>oai_doaj_org_article_bec215dbfcb24052b15c11c6457be026</doaj_id><sourcerecordid>1894173926</sourcerecordid><originalsourceid>FETCH-LOGICAL-c493t-fec1ab0ac010550a825b0af33cb625e6278b3af3f78373c03e6108e2c8ac6afd3</originalsourceid><addsrcrecordid>eNpdUk1v1DAQjRCItgs_gAuyxIEeCHjsxHEuRVXFR6VKHICz5TiTjVdJHOxkpe3v4AfjbEppOVj22G_evBm_JHkF9D2AFB8CsBJoSqGIS_L09klyClnBUlHy8umD80lyFsKORqDk7HlywiQvhAQ4TX5_77WfSOt6DO_I6O1eT7iGH8nlQLAfrbdGdyRMc30griETmnZwndseiMeA2psWfXhLRvQGx8m6ISwwnNpjng1hxkDsQGrcY-dGO2xJWKqmSxnSou6m9h-rxfAiedboLuDLu32T_Pz86cfV1_Tm25frq8ub1GQln9IGDeiKakOB5jnVkuUxajg3lWA5ClbIise4iV0X3FCOAqhEZqQ2Qjc13yTXK2_t9E7F5qOqg3LaquOF81sVZVrToarQMMjrqjEVy2jOKsgNgBFZXlRImYhcFyvXOFc91gaHyevuEenjl8G2auv2KudFWYgiEpzfEXj3K05sUr0NBrtOD-jmoEDKLBMZxP_cJG_-g-7c7Ic4qogqMyh4eVQEK8p4F4LH5l4MULX4R63-UdEWavGPuo05rx92cZ_x1zD8D9texUc</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1894173926</pqid></control><display><type>article</type><title>Smart homes, private homes? An empirical study of technology researchers' perceptions of ethical issues in developing smart-home health technologies</title><source>Publicly Available Content Database</source><source>PubMed Central</source><creator>Birchley, Giles ; Huxtable, Richard ; Murtagh, Madeleine ; Ter Meulen, Ruud ; Flach, Peter ; Gooberman-Hill, Rachael</creator><creatorcontrib>Birchley, Giles ; Huxtable, Richard ; Murtagh, Madeleine ; Ter Meulen, Ruud ; Flach, Peter ; Gooberman-Hill, Rachael</creatorcontrib><description>Smart-home technologies, comprising environmental sensors, wearables and video are attracting interest in home healthcare delivery. Development of such technology is usually justified on the basis of the technology's potential to increase the autonomy of people living with long-term conditions. Studies of the ethics of smart-homes raise concerns about privacy, consent, social isolation and equity of access. Few studies have investigated the ethical perspectives of smart-home engineers themselves. By exploring the views of engineering researchers in a large smart-home project, we sought to contribute to dialogue between ethics and the engineering community. Either face-to-face or using Skype, we conducted in-depth qualitative interviews with 20 early- and mid-career smart-home researchers from a multi-centre smart-home project, who were asked to describe their own experience and to reflect more broadly about ethical considerations that relate to smart-home design. With participants' consent, interviews were audio-recorded, transcribed and analysed using a thematic approach. Two overarching themes emerged: in 'Privacy', researchers indicated that they paid close attention to negative consequences of potential unauthorised information sharing in their current work. However, when discussing broader issues in smart-home design beyond the confines of their immediate project, researchers considered physical privacy to a lesser extent, even though physical privacy may manifest in emotive concerns about being watched or monitored. In 'Choice', researchers indicated they often saw provision of choice to end-users as a solution to ethical dilemmas. While researchers indicated that choices of end-users may need to be restricted for technological reasons, ethical standpoints that restrict choice were usually assumed and embedded in design. The tractability of informational privacy may explain the greater attention that is paid to it. However, concerns about physical privacy may reduce acceptability of smart-home technologies to future end-users. While attention to choice suggests links with privacy, this may misidentify the sources of privacy and risk unjustly burdening end-users with problems that they cannot resolve. Separating considerations of choice and privacy may result in more satisfactory treatment of both. Finally, through our engagement with researchers as participants this study demonstrates the relevance of (bio)ethics as a critical partner to smart-home engineering.</description><identifier>ISSN: 1472-6939</identifier><identifier>EISSN: 1472-6939</identifier><identifier>DOI: 10.1186/s12910-017-0183-z</identifier><identifier>PMID: 28376811</identifier><language>eng</language><publisher>England: BioMed Central</publisher><subject>Attitude ; Bioethical Issues ; Bioethics ; Choice ; Choice Behavior ; Confidentiality ; Delivery of Health Care - methods ; Empirical ethics ; Engineering - ethics ; Ethics ; Female ; Health technology ; Home Care Services - ethics ; Home health care ; Humans ; Male ; Medical technology ; Privacy ; Qualitative research ; Research ethics ; Research Personnel - ethics ; Sensors ; Smart houses ; Technology</subject><ispartof>BMC medical ethics, 2017-04, Vol.18 (1), p.23-23, Article 23</ispartof><rights>Copyright BioMed Central 2017</rights><rights>The Author(s). 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c493t-fec1ab0ac010550a825b0af33cb625e6278b3af3f78373c03e6108e2c8ac6afd3</citedby><cites>FETCH-LOGICAL-c493t-fec1ab0ac010550a825b0af33cb625e6278b3af3f78373c03e6108e2c8ac6afd3</cites><orcidid>0000-0002-2973-2163</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5379767/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/1894173926?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,25732,27903,27904,36991,36992,44569,53770,53772</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28376811$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Birchley, Giles</creatorcontrib><creatorcontrib>Huxtable, Richard</creatorcontrib><creatorcontrib>Murtagh, Madeleine</creatorcontrib><creatorcontrib>Ter Meulen, Ruud</creatorcontrib><creatorcontrib>Flach, Peter</creatorcontrib><creatorcontrib>Gooberman-Hill, Rachael</creatorcontrib><title>Smart homes, private homes? An empirical study of technology researchers' perceptions of ethical issues in developing smart-home health technologies</title><title>BMC medical ethics</title><addtitle>BMC Med Ethics</addtitle><description>Smart-home technologies, comprising environmental sensors, wearables and video are attracting interest in home healthcare delivery. Development of such technology is usually justified on the basis of the technology's potential to increase the autonomy of people living with long-term conditions. Studies of the ethics of smart-homes raise concerns about privacy, consent, social isolation and equity of access. Few studies have investigated the ethical perspectives of smart-home engineers themselves. By exploring the views of engineering researchers in a large smart-home project, we sought to contribute to dialogue between ethics and the engineering community. Either face-to-face or using Skype, we conducted in-depth qualitative interviews with 20 early- and mid-career smart-home researchers from a multi-centre smart-home project, who were asked to describe their own experience and to reflect more broadly about ethical considerations that relate to smart-home design. With participants' consent, interviews were audio-recorded, transcribed and analysed using a thematic approach. Two overarching themes emerged: in 'Privacy', researchers indicated that they paid close attention to negative consequences of potential unauthorised information sharing in their current work. However, when discussing broader issues in smart-home design beyond the confines of their immediate project, researchers considered physical privacy to a lesser extent, even though physical privacy may manifest in emotive concerns about being watched or monitored. In 'Choice', researchers indicated they often saw provision of choice to end-users as a solution to ethical dilemmas. While researchers indicated that choices of end-users may need to be restricted for technological reasons, ethical standpoints that restrict choice were usually assumed and embedded in design. The tractability of informational privacy may explain the greater attention that is paid to it. However, concerns about physical privacy may reduce acceptability of smart-home technologies to future end-users. While attention to choice suggests links with privacy, this may misidentify the sources of privacy and risk unjustly burdening end-users with problems that they cannot resolve. Separating considerations of choice and privacy may result in more satisfactory treatment of both. Finally, through our engagement with researchers as participants this study demonstrates the relevance of (bio)ethics as a critical partner to smart-home engineering.</description><subject>Attitude</subject><subject>Bioethical Issues</subject><subject>Bioethics</subject><subject>Choice</subject><subject>Choice Behavior</subject><subject>Confidentiality</subject><subject>Delivery of Health Care - methods</subject><subject>Empirical ethics</subject><subject>Engineering - ethics</subject><subject>Ethics</subject><subject>Female</subject><subject>Health technology</subject><subject>Home Care Services - ethics</subject><subject>Home health care</subject><subject>Humans</subject><subject>Male</subject><subject>Medical technology</subject><subject>Privacy</subject><subject>Qualitative research</subject><subject>Research ethics</subject><subject>Research Personnel - ethics</subject><subject>Sensors</subject><subject>Smart houses</subject><subject>Technology</subject><issn>1472-6939</issn><issn>1472-6939</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNpdUk1v1DAQjRCItgs_gAuyxIEeCHjsxHEuRVXFR6VKHICz5TiTjVdJHOxkpe3v4AfjbEppOVj22G_evBm_JHkF9D2AFB8CsBJoSqGIS_L09klyClnBUlHy8umD80lyFsKORqDk7HlywiQvhAQ4TX5_77WfSOt6DO_I6O1eT7iGH8nlQLAfrbdGdyRMc30griETmnZwndseiMeA2psWfXhLRvQGx8m6ISwwnNpjng1hxkDsQGrcY-dGO2xJWKqmSxnSou6m9h-rxfAiedboLuDLu32T_Pz86cfV1_Tm25frq8ub1GQln9IGDeiKakOB5jnVkuUxajg3lWA5ClbIise4iV0X3FCOAqhEZqQ2Qjc13yTXK2_t9E7F5qOqg3LaquOF81sVZVrToarQMMjrqjEVy2jOKsgNgBFZXlRImYhcFyvXOFc91gaHyevuEenjl8G2auv2KudFWYgiEpzfEXj3K05sUr0NBrtOD-jmoEDKLBMZxP_cJG_-g-7c7Ic4qogqMyh4eVQEK8p4F4LH5l4MULX4R63-UdEWavGPuo05rx92cZ_x1zD8D9texUc</recordid><startdate>20170404</startdate><enddate>20170404</enddate><creator>Birchley, Giles</creator><creator>Huxtable, Richard</creator><creator>Murtagh, Madeleine</creator><creator>Ter Meulen, Ruud</creator><creator>Flach, Peter</creator><creator>Gooberman-Hill, Rachael</creator><general>BioMed Central</general><general>BMC</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>AABKS</scope><scope>ABSDQ</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-2973-2163</orcidid></search><sort><creationdate>20170404</creationdate><title>Smart homes, private homes? An empirical study of technology researchers' perceptions of ethical issues in developing smart-home health technologies</title><author>Birchley, Giles ; Huxtable, Richard ; Murtagh, Madeleine ; Ter Meulen, Ruud ; Flach, Peter ; Gooberman-Hill, Rachael</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c493t-fec1ab0ac010550a825b0af33cb625e6278b3af3f78373c03e6108e2c8ac6afd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Attitude</topic><topic>Bioethical Issues</topic><topic>Bioethics</topic><topic>Choice</topic><topic>Choice Behavior</topic><topic>Confidentiality</topic><topic>Delivery of Health Care - methods</topic><topic>Empirical ethics</topic><topic>Engineering - ethics</topic><topic>Ethics</topic><topic>Female</topic><topic>Health technology</topic><topic>Home Care Services - ethics</topic><topic>Home health care</topic><topic>Humans</topic><topic>Male</topic><topic>Medical technology</topic><topic>Privacy</topic><topic>Qualitative research</topic><topic>Research ethics</topic><topic>Research Personnel - ethics</topic><topic>Sensors</topic><topic>Smart houses</topic><topic>Technology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Birchley, Giles</creatorcontrib><creatorcontrib>Huxtable, Richard</creatorcontrib><creatorcontrib>Murtagh, Madeleine</creatorcontrib><creatorcontrib>Ter Meulen, Ruud</creatorcontrib><creatorcontrib>Flach, Peter</creatorcontrib><creatorcontrib>Gooberman-Hill, Rachael</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health &amp; Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Philosophy Collection</collection><collection>Philosophy Database</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>BMC medical ethics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Birchley, Giles</au><au>Huxtable, Richard</au><au>Murtagh, Madeleine</au><au>Ter Meulen, Ruud</au><au>Flach, Peter</au><au>Gooberman-Hill, Rachael</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Smart homes, private homes? An empirical study of technology researchers' perceptions of ethical issues in developing smart-home health technologies</atitle><jtitle>BMC medical ethics</jtitle><addtitle>BMC Med Ethics</addtitle><date>2017-04-04</date><risdate>2017</risdate><volume>18</volume><issue>1</issue><spage>23</spage><epage>23</epage><pages>23-23</pages><artnum>23</artnum><issn>1472-6939</issn><eissn>1472-6939</eissn><abstract>Smart-home technologies, comprising environmental sensors, wearables and video are attracting interest in home healthcare delivery. Development of such technology is usually justified on the basis of the technology's potential to increase the autonomy of people living with long-term conditions. Studies of the ethics of smart-homes raise concerns about privacy, consent, social isolation and equity of access. Few studies have investigated the ethical perspectives of smart-home engineers themselves. By exploring the views of engineering researchers in a large smart-home project, we sought to contribute to dialogue between ethics and the engineering community. Either face-to-face or using Skype, we conducted in-depth qualitative interviews with 20 early- and mid-career smart-home researchers from a multi-centre smart-home project, who were asked to describe their own experience and to reflect more broadly about ethical considerations that relate to smart-home design. With participants' consent, interviews were audio-recorded, transcribed and analysed using a thematic approach. Two overarching themes emerged: in 'Privacy', researchers indicated that they paid close attention to negative consequences of potential unauthorised information sharing in their current work. However, when discussing broader issues in smart-home design beyond the confines of their immediate project, researchers considered physical privacy to a lesser extent, even though physical privacy may manifest in emotive concerns about being watched or monitored. In 'Choice', researchers indicated they often saw provision of choice to end-users as a solution to ethical dilemmas. While researchers indicated that choices of end-users may need to be restricted for technological reasons, ethical standpoints that restrict choice were usually assumed and embedded in design. The tractability of informational privacy may explain the greater attention that is paid to it. However, concerns about physical privacy may reduce acceptability of smart-home technologies to future end-users. While attention to choice suggests links with privacy, this may misidentify the sources of privacy and risk unjustly burdening end-users with problems that they cannot resolve. Separating considerations of choice and privacy may result in more satisfactory treatment of both. Finally, through our engagement with researchers as participants this study demonstrates the relevance of (bio)ethics as a critical partner to smart-home engineering.</abstract><cop>England</cop><pub>BioMed Central</pub><pmid>28376811</pmid><doi>10.1186/s12910-017-0183-z</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0002-2973-2163</orcidid><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 1472-6939
ispartof BMC medical ethics, 2017-04, Vol.18 (1), p.23-23, Article 23
issn 1472-6939
1472-6939
language eng
recordid cdi_doaj_primary_oai_doaj_org_article_bec215dbfcb24052b15c11c6457be026
source Publicly Available Content Database; PubMed Central
subjects Attitude
Bioethical Issues
Bioethics
Choice
Choice Behavior
Confidentiality
Delivery of Health Care - methods
Empirical ethics
Engineering - ethics
Ethics
Female
Health technology
Home Care Services - ethics
Home health care
Humans
Male
Medical technology
Privacy
Qualitative research
Research ethics
Research Personnel - ethics
Sensors
Smart houses
Technology
title Smart homes, private homes? An empirical study of technology researchers' perceptions of ethical issues in developing smart-home health technologies
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-22T12%3A13%3A21IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_doaj_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Smart%20homes,%20private%20homes?%20An%20empirical%20study%20of%20technology%20researchers'%20perceptions%20of%20ethical%20issues%20in%20developing%20smart-home%20health%20technologies&rft.jtitle=BMC%20medical%20ethics&rft.au=Birchley,%20Giles&rft.date=2017-04-04&rft.volume=18&rft.issue=1&rft.spage=23&rft.epage=23&rft.pages=23-23&rft.artnum=23&rft.issn=1472-6939&rft.eissn=1472-6939&rft_id=info:doi/10.1186/s12910-017-0183-z&rft_dat=%3Cproquest_doaj_%3E1894173926%3C/proquest_doaj_%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c493t-fec1ab0ac010550a825b0af33cb625e6278b3af3f78373c03e6108e2c8ac6afd3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=1894173926&rft_id=info:pmid/28376811&rfr_iscdi=true