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Early trajectories of pulmonary hemodynamics in ARDS patients undergoing V-V ECMO: key determinants and prognostic impact - Critical Care
Humbert M, Kovacs G, Hoeper MM, Badagliacca R, Berger RMF, Brida M, et al. 2022 ESC/ERS guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Respir J. 2023;61:2200879. https://doi.org/10.1183/13993003.00879-2022. Google Scholar Zapol WM, Kobayashi K, Snider MT, Greene R, Laver MB. Vascular obstruction causes pulmonary hypertension in severe acute respiratory failure. Chest. 1977;71:306–7. https://doi.org/10.1378/chest.71.2_supplement.306.
Effect of Physiotherapy on Clinical Outcomes in Patients with Brain Injury: A Post-hoc Analysis of the ENIO Study
Keywords physiotherapy critical care brain injury mortality Get full text access Log in, subscribe or purchase for full access. References 1. Taran, S. ∙ Stevens, R.D. ∙ Perrot, B. ... Incidence and Outcomes of Acute Respiratory Distress Syndrome in Brain-Injured Patients Receiving Invasive Ventilation: A Secondary Analysis of the ENIO Study J Intensive Care Med. 2024; 39:136-145 2. Battaglini, D. ∙ Parodi, L. ∙ Cinotti, R. ...
Nomogram for Predicting Osteoradionecrosis After Fibula Free Flap for Mandibular Reconstruction
1 Introduction Osteoradionecrosis (ORN) is a severe and debilitating late complication of radiotherapy (RT), characterized by multistep radiation-induced tissue injuries that lead to hypoxia, hypovascularization, secondary chronic infection, necrosis, and bone loss in the absence of tumor recurrence [1-3]. Mandibular ORN is a known complication of high-dose RT, particularly in the treatment of oropharyngeal and oral cavity cancers, either in the definitive or adjuvant setting [4].
HARNESSING RED GRAPE POMACE EXTRACT FOR SUSTAINABLE BROAD-SPECTRUM PHOTOPROTECTION IN A RECONSTRUCTED HUMAN EPIDERMIS MODEL
ORIGINAL RESEARCH article Front. Pharmacol. Sec.
Immune-related osteitis mimicking femoral head osteonecrosis during dual checkpoint blockade: a case report
Introduction The introduction of immune checkpoint inhibitors (ICIs) has revolutionized the treatment landscape of advanced melanoma (1). Recent 10-year results from the KEYNOTE-006 and CheckMate 067 trials have confirmed that approximately 50% of patients with advanced melanoma achieved long-term overall survival (OS) benefit with single agent PD-1 blockade or combined CTLA-4 and PD-1 blockade, respectively, marking an unprecedented shift in the natural history of this disease (2, 3).
Beyond the ventilator: rethinking daily evaluation of respiratory drive and effort
Get full text access Log in, subscribe or purchase for full access. References 1. Tonelli, R ∙ Protti, A ∙ Spinelli, E ∙ et al. Assessing inspiratory drive and effort in critically ill patients at the bedside Crit Care. 2025; 29:339 2. Goligher, EC ∙ Dres, M ∙ Fan, E ∙ et al. Mechanical ventilation-induced diaphragm atrophy strongly impacts clinical outcomes Am J Respir Crit Care Med. 2018; 197:204-213 3. Bertoni, M ∙ Telias, I ∙ Urner, M ∙ et al.
Management of Posterior Crossbite with Maxillary Expansion: A Narrative Review of Contemporary Evidence
Keywords Crossbite children corrective mixed dentition, evidence-based Background The prevalence of posterior crossbite in children in the mixed dentition is around 11% in Europe and 29% in America.1 A functional posterior crossbite occurs as the result of interference between two or more teeth when an individual closes their jaw. The strain on the jaw muscles and joints due to unusual movement and positioning of the lower jaw may lead to skeletal facial asymmetries.
Identification of prognostic liquid biopsy biomarkers in patients with cutaneous squamous cell carcinoma treated with cemiplimab - Journal of Translational Medicine
Cemiplimab was administered to patients considered unsuitable for curative surgery or radiotherapy, as determined by a multidisciplinary team discussion. Cemiplimab was administered intravenously (IV) at a dose of 350 mg flat dose every 3 weeks. The clinical response was assessed radiologically according to the RECIST 1.1 criteria [23] or clinically according to the WHO criteria [24].
Persistent candidemia caused by different Candida species: data from a multicenter contemporary cohort
Keywords Candida candidemia C. auris C. parapsilosis persistent candidemia INTRODUCTION Persistent candidemia represents a clinically relevant yet underexplored condition.
Marginal Bone Level Changes in Full‐Arch Rehabilitation: Digital Versus Analog Protocols-A 5‐Year Retrospective Study
1 Introduction The spread of full-arch immediate loading rehabilitations has revolutionized the field of dentistry, offering patients the possibility to achieve fixed restorations and fully restore masticatory function in a quick and lasting manner. Studies have shown that even a reduced number of implants can be sufficient, provided that they are adequately long and that loads, particularly for non-axial implants, are correctly distributed [1, 2].
Extracellular vesicles as a biomarkers in traumatic brain injury: a systematic review of animal and clinical studies - Critical Care
References Menon DK, Schwab K, Wright DW, Maas AI. Position statement: definition of traumatic brain injury. Arch Phys Med Rehabil. 2010;91(11):1637–40. PubMed Google Scholar James SL, Theadom A, Ellenbogen RG, Bannick MS, Montjoy-Venning W, Lucchesi LR, et al. Global, regional, and National burden of traumatic brain injury and spinal cord injury, 1990–2016: a systematic analysis for the global burden of disease study 2016. Lancet Neurol. 2019;18(1):56–87.
Imaging and pulmonary function techniques in ARDS diagnosis and management: current insights and challenges - Critical Care
Effective management of ARDS requires integrating multiple diagnostic tools and therapies. Imaging modalities such as CT, LUS, and EIT provide complementary perspectives on lung structure and function. While each technique has unique strengths, none is sufficient in isolation. Chest CT provides high-resolution visualization of lung structures in ARDS [3].
First Case of Lateral Oropharyngectomy Performed Using the Vitom Eagle: A Novel Exoscopic System for Transoral Surgery
1 Introduction The management of oropharyngeal squamous cell carcinoma (OPSCC) has evolved significantly, driven by the increasing prevalence of HPV-related OPSCC, which has a better prognosis than HPV-negative cases [1]. This has spurred interest in treatment de-intensification and minimally invasive surgical strategies, with single-modality approaches favored for early-stage disease [2].
Neurological outcomes and mortality following hyperoxemia in adult patients with acute brain injury: an updated meta-analysis and meta-regression - Critical Care
The protocol for this review was registered with PROSPERO (CRD42023433502) and published in an open-access peer-reviewed journal [29] according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines (Table S1 in Supplement) [30].
A narrative review on the future of ARDS: evolving definitions, pathophysiology, and tailored management - Critical Care
For many years, management of ARDS has been mainly supportive, focusing on providing adequate oxygenation while minimizing the incidence of ventilator-induced lung injury (VILI) [26,27,28,29]. Effective ventilation in ARDS requires individualized strategies that account for the underlying pathophysiology. Although standard thresholds and targets are commonly used, the heterogeneity of ARDS demands a more tailored approach [15].
Assessment of recruitment from CT to the bedside: challenges and future directions - Critical Care
References Crotti S, Mascheroni D, Caironi P, Pelosi P, Ronzoni G, Mondino M, et al. Recruitment and derecruitment during acute respiratory failure a clinical study. Am J Respir Crit Care Med. 2001;164:131–40. Article CAS PubMed Google Scholar Borges JB, Okamoto VN, Matos GFJ, Caramez MPR, Arantes PR, Barros F, et al. Reversibility of lung collapse and hypoxemia in early acute respiratory distress syndrome. Am J Respir Crit Care Med. 2006;174:268–78. Article PubMed Google Scholar Ghadiali SN, Gaver DP.
Comparative Targeted Genome Profiling between Solid and Liquid Biopsies in Gastroenteropancreatic Neuroendocrine Neoplasms: A Proof-of-Concept Pilot Study
Keywords: Gastroenteropancreatic neuroendocrine tumor, Genome profiling, Circulating tumor DNA, Liquid biopsy Keywords: Gastroenteropancreatic neuroendocrine tumor, Genome profiling, Circulating tumor DNA, Liquid biopsy Keywords: Gastroenteropancreatic neuroendocrine tumor, Genome profiling, Circulating tumor DNA, Liquid biopsy Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) originate from the diffuse neuroendocrine system of the gastrointestinal tract and pancreas.
Hypothermia versus normothermia in patients with cardiac arrest and shockable rhythm: a secondary analysis of the TTM-2 study - Critical Care
References Dankiewicz J, Cronberg T, Lilja G, Jakobsen JC, Levin H, Ullen S, et al. Hypothermia versus normothermia after out-of-hospital cardiac arrest. N Engl J Med. 2021;384(24):2283–94. Article PubMed Google Scholar Sandroni C, Nolan JP, Andersen LW, Böttiger BW, Cariou A, Cronberg T, et al. ERC-ESICM guidelines on temperature control after cardiac arrest in adults. Intensive Care Med. 2022;48(3):261–9.
Quantitative CT-analysis of over aerated lung tissue and correlation with fibrosis extent in patients with idiopathic pulmonary fibrosis - Respiratory Research
This study reports a significant proportion of over aerated lung as assessed by quantitative CT analysis in spontaneously breathing IPF patients when passing from RV to TLC. Further, a significant relationship between over aeration and the extent of lung fibrosis was reported, independent on the different lung lobes.
Medullary carcinomas of the nonampullary small intestine: association with coeliac disease, mismatch repair deficiency, PD‐L1 expression, and favourable prognosis
CK cytokeratin CoeD coeliac disease CPS combined positive score dMMR mismatch repair deficiency EBER EBV-encoded small RNAs EBV Epstein-Barr virus MC medullary carcinoma MMR mismatch repair MSI microsatellite instability NM-SBA nonmedullary small bowel adenocarcinoma PD-L1 programmed death-ligand 1 pMMR mismatch repair proficient SBA small bowel adenocarcinoma SBA-NOS small bowel adenocarcinoma SB-MC small bowel medullary carcinoma SWI/SNF switch/sucrose nonfermentable TIL tumor-infiltrating...
Evaluation of palate morphology in patients treated with leaf expander and hyrax expander: A geometric morphometric analysis
1 INTRODUCTION Transverse discrepancy between maxillary and mandibular arches often produces posterior crossbite, representing one of the most frequent malocclusions in mixed dentition with a prevalence of 7%–23%.1, 2 When it occurs unilaterally, posterior crossbite shows a functional shift of the mandible towards the crossbite side, due to a maxillary constriction which leads to teeth interferences in maximum intercuspation: in this situation, molar relationship will be asymmetric, with a...
Surgical outcomes of profunda artery perforator flap in head and neck reconstruction: A systematic review and meta‐analysis
1 INTRODUCTION In recent years, free flaps have emerged as the preferred method for head and neck reconstruction. Among these, the anterolateral thigh flap (ALT), the radial forearm flap (RFFF), and the latissimus dorsi (LD) flap have become workhorse flaps for soft-tissue reconstruction.1, 2 These flaps may present specific reconstructive requirements, other than various limitations.
Transpulmonary pressure monitoring in critically ill patients: pros and cons - Critical Care
Once ensured the correct positioning and inflation of the esophageal balloon, further reasoning and computations are necessary to use it as a tool to titrate mechanical ventilation settings. The simplest application of esophageal pressure monitoring in passive mechanically ventilated patients is the partitioning of the respiratory system elastance (Ers) in its two components: lung elastance (EL) and chest wall elastance (Ecw) [1, 3, 20].
Cortical Myoclonus and Complex Paroxysmal Dyskinesias in a Patient with NAA15 Variant
NAA15 gene encodes for a protein involved in amino-terminal acetylation of cytosolic proteins. Patients with NAA15 variants show variable levels of intellectual disability, dysmorphic features, cardiac and visual anomalies, and movement disorders, including pediatric-onset dystonia and dystonia parkinsonism.1-3 We report the clinical and neurophysiological characteristics observed in a young girl harboring a novel pathogenic NAA15 variant.
Contemporary management of aneurysmal subarachnoid haemorrhage. An update for the intensivist - Intensive Care Medicine
Abstract Aneurysmal subarachnoid haemorrhage (aSAH) is a rare yet profoundly debilitating condition associated with high global case fatality and morbidity rates. The key determinants of functional outcome include early brain injury, rebleeding of the ruptured aneurysm and delayed cerebral ischaemia. The only effective way to reduce the risk of rebleeding is to secure the ruptured aneurysm quickly.
A plea for long term follow-up studies
Our group at University of Genoa School of Medicine has extensive experience with hypoabsorptive bariatric surgery, and our paper highlights the results of biliopancreatic diversion (BPD) at very long term. Two main findings emerged from the study: first, hypoabsorptive bariatric surgery is very effective at maintaining a stable weight loss and excellent control of the metabolic comorbidities decades after the initial operation, but second, this comes at high, and ever increasing, clinical cost.
Biliopancreatic diversion for severe obesity: long-term weight maintenance and occurrence of nutritional complications are two facets of the same coin
Despite the widespread clinical use of hypoabsorptive metabolic bariatric surgery, very long-term outcomes are still lacking. The aim of the study was to assess the long-term safety and efficacy of biliopancreatic diversion at 30 years in patients with class 3 obesity (BMI over 40 kg/m2). This retrospective single-centre study used data from a prospectively collected database on a sample of consecutive patients submitted to biliopancreatic diversion with a minimum follow-up of 30 years.
Depth of Invasion Assessment in Laryngeal Glottic Carcinoma: A Preoperative Imaging Approach for Prognostication
INTRODUCTION Depth of invasion (DOI), defined as the distance from the deep extent of tumor growth to the basal membrane, is an important prognostic factor in the head and neck area, especially in cutaneous melanoma and oral cavity squamous cell carcinoma1, 2 for which it has been incorporated as a staging parameter in the 8th edition of American Joint Committee on Cancer's (AJCC).3 According to the National Comprehensive Cancer Network (NCCN) guidelines, DOI in oral cavity cancer is also a...
Primary endobronchial melanoma: a case report and clinical management indications - BMC Pulmonary Medicine
A 71-year-old Caucasian male, a former smoker, presented with worsening dyspnoea and cough accompanied by occasional haemoptysis over a two-month period. He had no significant medical history. Radiographic assessment revealed complete atelectasis of the left upper lobe and partial atelectasis of the left lower lobe. A comprehensive diagnostic workup, including total body computed tomography (CT) and total body positron emission tomography (PET), showed a suspicious left lung nodule.
BRAFV600E immunohistochemistry can reliably substitute BRAF molecular testing in the Lynch syndrome screening algorithm in colorectal cancer
CI confidence intervals CRC colorectal cancer dMMR MMR deficiency FFPE formalin-fixed and paraffin-embedded ICC intraclass correlation coefficient IHC immunohistochemistry LS Lynch syndrome MMR MisMatch repair MSI microsatellite instability MSS microsatellite stability NPV negative predictive value PCR polymerase chain reaction PPV positive predictive value Introduction Lynch syndrome (LS) is one of the most frequent hereditary cancer syndromes,1 predisposing to an increased risk of...
Long-term neurological symptoms after acute COVID-19 illness requiring hospitalization in adult patients: insights from the ISARIC-COVID-19 follow-up study | Journal of Neurology
References Levine RL (2022) Addressing the long-term effects of COVID-19. JAMA 328:823 Article CAS PubMed Google Scholar World Heart Organization (WHO). Post COVID-19 condition (Long COVID) [Internet]. December 7. 2022. https://www.who.int/europe/news-room/fact-sheets/item/post-covid-19-condition. Accessed 13 Jun 2023 Lopez-Leon S, Wegman-Ostrosky T, Perelman C, Sepulveda R, Rebolledo PA, Cuapio A et al (2021) More than 50 long-term effects of COVID-19: a systematic review and meta-analysis.
Institution of an interdisciplinary IBD centre is associated with improved healthcare utilisation
1 INTRODUCTION Inflammatory Bowel Diseases (IBD) are chronic, disabling diseases that impact various aspects of patients' life, and that can determine complex interactions involving both medical and psychosocial well-being.1 The coordinated collaboration, possibly within the same centre, of physicians involved in the management of the gastroenterological, surgical, nutritional, and psychological issues that may arise in patients with IBD, and the close collaboration with physicians involved...
Primary antibiotic resistance of Helicobacter pylori in the Asia-Pacific region between 1990 and 2022: an updated systematic review and meta-analysis
Summary We previously showed rising primary antibiotic resistance of Helicobacter pylori during 1990–2015 in the Asia-Pacific region. However, whether primary antibiotic resistance continues to rise is unknown. Therefore, we aimed to assess the latest prevalence of H pylori antibiotic resistance in this region.
Predicting the need for prophylactic gastrostomy in major head and neck cancer surgery: The PEG score
To elaborate a preoperative score to predict the necessity of enteral nutrition at 28 days postoperatively in patients undergoing head and neck surgery. A total of 424 patients with oral cavity, oropharyngeal, laryngeal, and hypopharyngeal carcinoma were retrospectively enrolled and analyzed to identify preoperative predictors of prolonged postsurgical enteral feeding which were used to create a prediction model with an easy-to-use nomogram.
Kidney dysfunction after Acute Brain Injury
Accepted manuscripts are PDF versions of the author’s final manuscript, as accepted for publication by the journal but prior to copyediting or typesetting. They can be cited using the author(s), article title, journal title, year of online publication, and DOI. They will be replaced by the final typeset articles, which may therefore contain changes. The DOI will remain the same throughout.
Kidney dysfunction after acute brain injury
Traumatic brain injury (TBI), one of the most fatal and debilitating conditions worldwide, can be associated with increased renal clearance. This may involve subtherapeutic dosing strategies and can be exacerbated by progressive impairment of renal function [1]. This editorial aims to describe the relationship between the brain and kidney in TBI, and the potential impact on renal function through increased sympathetic tone, catecholamine release and a hypertensive state after TBI.
Case report: SLC6A1 mutations presenting with isolated absence seizures: description of 2 novel cases
Introduction The Solute Carrier Family 6 Member 1 (SLC6A1) gene encodes GAT-1, a voltage-dependent gamma-aminobutyric acid (GABA) transporter that is responsible for the re-uptake of GABA from the synapse. GABA is the principal inhibitory neurotransmitter that counterbalances neuronal excitation in the brain. Disruption of this inhibitory balance can result in seizures and other neurodevelopmental disorders (Mermer et al., 2021).
Ventilator-associated pneumonia in neurocritically ill patients: insights from the ENIO international prospective observational study - Respiratory Research
The main findings of this study, in a cohort of 1285 brain injured patients, are: (1) VAP prevalence and rate is high in ABI patients, especially in TBI.
The fading guardian: clinical relevance of TP53 null mutation in high-grade serous ovarian cancers
1 Introduction Epithelial ovarian cancer (EOC) is the fifth most common cause of female cancer death in the developed world. It affects every year 21,750 women in the USA of whom 13,940 will die of the disease (1). Despite aggressive surgeries and combined chemotherapies, the prognosis remains worrisome. The reason for this high mortality rate is the late presentation, meaning that more than 70% of EOC are diagnosed at stage III or IV with a 5-year Overall Survival of approximately 15-30%.
Molecular testing-guided therapy versus susceptibility testing-guided therapy in first-line and third-line Helicobacter pylori eradication: two multicentre, open-label, randomised controlled, non-inferiority trials
Background Helicobacter pylori infection is an important causal factor of gastric cancer and peptic ulcer disease and is associated with immune thrombocytopenic purpura and functional dyspepsia. In H pylori strains, point mutations in the 23S rRNA and gyrA genes are associated with clarithromycin resistance and levofloxacin resistance, respectively.
Endovascular aortic repair impact on myocardial contractility: A prospective study
4 DISCUSSION The main finding of the present study is that the altered transmission of the sphygmic wave induced by EVAR is associated with an early contractile impairment. Since this alteration is obviously transmitted throughout the entire arterial tree, this impairment might affect the pressure in the proximity of the AV and thus the afterload to LV contraction.
Utilization of mechanical power and associations with clinical outcomes in brain injured patients: a secondary analysis of the extubation strategies in neuro-intensive care unit patients and associations with outcome (ENIO) trial | Critical Care | Full Te
In this preplanned, secondary analysis of the ENIO study assessing use and effect of mechanical power in ABI, our main findings are: (1) MP varied widely by region, tended to be higher based on presence and severity of ARDS, and differed by trajectory of P/F ratio, (2) MP at all time points was associated with hospital mortality, need for reintubation, tracheostomy placement and development of moderate-severe ARDS, and (3) associations between MP and hospital mortality, reintubation, and ARDS...
The stroke care puzzle: Does tracheostomy timing fit? - Critical Care
Author notes Sung-Min Cho and Denise Battaglini contributed equally as senior authors.
Distribution of transpulmonary pressure during one-lung ventilation in pigs at different body positions
1 Introduction One-lung ventilation (OLV) for thoracic surgery leads to pronounced changes in respiratory system mechanics. When the thorax is opened and lung isolation achieved, not only absolute values, but also the distribution of intrathoracic pressure may change importantly. Furthermore, lateral decubitus position, which is commonly used during thoracic surgery, can promote atelectasis formation, and reduce the total lung volume.
Clinical risk factors for increased respiratory drive in intubated hypoxemic patients - Critical Care
Authors and Affiliations Department of Anesthesia, Critical Care and Emergency, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy Elena Spinelli, Antonio Pesenti, Douglas Slobod, Giacomo Grasselli & Tommaso Mauri Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy Antonio Pesenti, Giacomo Grasselli & Tommaso Mauri Department of Critical Care Medicine, McGill University, Montreal, QC, Canada Douglas Slobod Research Centre On Public Health,...
Inhaled amikacin for pneumonia treatment and dissemination prevention: an experimental model of severe monolateral Pseudomonas aeruginosa pneumonia - Critical Care
This study describes the development of a porcine model of monolateral severe P. aeruginosa pneumonia resistant to AMK and susceptible to MEM, which we used to explore the inhaled amikacin therapy. Our findings demonstrate that MEM treatment drove a reduction in lung tissue concentration of P. aeruginosa, and that adding inhaled AMK as adjunctive therapy only reduced the bacterial burden of tracheal secretions.
“CORE” a new assay for rapid identification of Klebsiella pneumoniae COlistin REsistant strains by MALDI-TOF MS in positive-ion mode
Gianluca Foglietta1, Elena De Carolis2*, Giordana Mattana1, Manuela Onori1, Marilena Agosta1, Claudia Niccolai3, Vincenzo Di Pilato4, Gian M. Rossolini3, 5, Maurizio Sanguinetti2, Carlo F. Perno1 and Paola Bernaschi1 1Microbiology Unit and Diagnostic Immunology, Bambino Gesù Pediatric Hospital, IRCCS, Italy 2Microbiology Unit, Department of Laboratory Sciences and Infectious Diseases, Fondazione Policlinico Universitario A.
Neurologic, Neuropsychologic, and Neuroradiologic Features of EBF3-Related Syndrome
Results The 6 children globally presented the same phenotype but with significative differences in severity expression of the disease. No sex-related discrepancies were detectable. Genetic results, clinical and neuropsychologic data, and MRI/EEG findings are summarized in Table 1.
Severe Epilepsy and Movement Disorder May Be Early Symptoms of TMEM106B-Related Hypomyelinating Leukodystrophy
Abstract Objective To report the clinical presentation of the first Italian child affected by hypomyelinating leukodystrophy (HLD) associated with the recurrent variant p.Asp252Asn in the TMEM106B gene. Methods The methods included clinical case description, neurophysiologic assessment, brain MRI, and whole-exome sequencing (WES). Results The child presented soon after birth with nystagmus and hyperkinetic movement disorder.
Point-of-care ultrasound training for residents in anaesthesia and critical care: results of a national survey comparing residents and training program directors’ perspectives | BMC Medical Education | Full Text
In this survey on the current state of ultrasound training in Italian critical care, anaesthesia, and pain therapy residency schools we found that 1. ultrasound teaching in Italian residency school is mainly based on bedside teaching and classroom lessons, is mentored by consultant physicians, and is perceived as adequate for vascular access only; 2. there are significant discrepancies in residents’ and directors’ perception of many aspects of the training; 3.
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