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AMA Must Work Harder to End Racism in Medicine, Delegates Say

The American Medical Association (AMA) needs to work harder to help rid the medical profession of racism, several AMA members said at a special meeting of the AMA’s House of Delegates.

“Numerous publications have demonstrated how racism affects housing, education, healthcare, criminal justice, and more,” said Anna Heffron, a medical student from Wisconsin, speaking on behalf of the Medical Student Section at a meeting of the AMA’s Reference Committee on Amendments to Constitution and Bylaws. “The Board of Trustees has noted that it’s vital that medicine play a critical role in eliminating racism, but the AMA only has two policies using the word ‘racism.'”

Heffron was speaking in support of a resolution authored by the Medical Student Section that calls for the AMA to “recognize racism, in its systemic, cultural, interpersonal, and other forms, as a serious threat to public health” and to “identify a set of current best practices for healthcare institutions, physician practices, and academic medical centers to recognize, address, and mitigate the effects of racism on patients, providers, and populations.”

Support for the Resolution

“I support this wholeheartedly,” said Alan Klitzke, MD, of Buffalo, New York, a delegate for the American College of Nuclear Medicine who was speaking for himself and the Section Council on Radiology. “I hear people say that the time for racism should be past, but racism and bias exist … It is the duty of us as professionals and leaders in medicine to recognize this and create structural mechanisms to eliminate divisive and demoralizing practices. Racism is a public health threat that we must recognize and combat.”

Stephen Taylor, MD, a delegate from the American Society of Addiction Medicine who was speaking for himself, also praised the resolution “as someone who has to think twice when a police officer stops me when I’m driving my car, and recognizes that I’m at a real risk any time I go anywhere because of the way I look,” said Taylor, who is African American. “People in the community I serve suffer similar aggressions … I strongly support this action.”

While the vast majority of speakers at the reference committee were in favor of the resolution, there were a few critics. The Louisiana delegation recommended removal of the first two parts of the resolution — which acknowledge that racist healthcare practices have harmed marginalized communities and that racism is a serious threat to public health — “in order to focus the resolution on the action items” that would be left, said Jeff White, MD, of Shreveport, Louisiana, representing the delegation.

The remaining parts of the resolution recommending specific actions “can be approved and actualized without the debate that may be engendered by the first two resolves.” The delegation also objected to the resolution’s call for the AMA to “support the development of policy to combat racism and its effects,” calling it “very expansive” and recommending its removal.

The Florida delegation initially objected to part of the resolution referring to “historic and racist medical practices.” “I’ve been in

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dentist

Dentist Natalia Nairn is jailed for skipping coronavirus quarantine to work

Dentist JAILED for treating 41 patients when she was meant to be in coronavirus quarantine isolation in Perth

  • Ukrainian dentist Nataliia Nairn flew from Canberra to Perth via Sydney
  • Instead of 14 days of isolation, she treated 41 patients over eight days 
  • Jailed for two months with a further five months’ suspended sentence  

A Ukrainian dentist who treated patients while she was supposed to be in mandatory coronavirus quarantine has been jailed for two months.

Natalia Nairn, 31, flew into Western Australia from Canberra via Sydney and was meant to go straight into 14 days of self-isolation due to border restrictions.

Instead the dentist and keen powerlifter treated 41 patients over eight days at a Joondalup dental practice in  where she worked part-time. 

Natalia Nairn (right) outside Joondalup Magistrates Court on Monday

Natalia Nairn (right) outside Joondalup Magistrates Court on Monday

The weightlifting dentist from Tapping, Perth, previously pleaded guilty to eight charges of failing to comply with a direction under the Emergency Management Act in Joondalup Magistrates Court.

Defence lawyer Katherine Dowling told the court that Nairn was remorseful for her actions, and was under financial stress at the time, trying to pay off her debts. 

Nairn, who has no previous convictions, had told the court she was a health professional who had taken the necessary safety precautions such as wearing protective equipment when she travelled. 

Nataliia Nairn (pictured) was sentenced to seven months' jail with only two months to serve

Nataliia Nairn (pictured) was sentenced to seven months’ jail with only two months to serve

Nairn, who is a powerlifter, was supposed to be in self-isolation when she treated patients

Nairn, who is a powerlifter, was supposed to be in self-isolation when she treated patients 

Magistrate Matthew Walton described her excuse as ‘untenable’ and ‘staggeringly naive’ on Monday before sentencing her to a seven months’ jail.

She will only have to serve two months behind bars with the remainder of the sentence suspended for eight months.

Nairn walked into the courthouse on Monday but didn’t come out again as she was taken directly to prison. 

Her career as a dentist has now been threatened by her criminal conviction, with the  Australian Health Practitioner Regulation Agency to decide if she can work again after she serves out her sentence, 7News reported.

When police officers visited Nairn’s home in the Perth suburb of Tapping to check on her quarantine between June 17 and 18, they found she was not there. 

The dentist broke quarantine on several occasions between June 17 and 18, and again between June 21 and June 29. 

Although she tested negative for coronavirus, the close personal nature of her work would have put her patients at serious risk if she had been carrying the virus.  

The offences carry a maximum penalty of $50,000 or 12 months in prison. 

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Some types of ‘hard work’ actually increase dementia risk, study says

Physical activity is known to help prevent dementia and disease, but it’s possible that the kind you do makes a difference.

A new study found that hard physical work not only doesn’t lower the risk of dementia, it increases the risk of developing the disease.

Researchers found that people who do hard physical work have a 55 percent higher risk of developing dementia than those doing sedentary work.

“The WHO [World Health Organization] guide to preventing dementia and disease on the whole mentions physical activity as an important factor. But our study suggests that it must be a ‘good’ form of physical activity, which hard physical work is not,” said researcher Kirsten Nabe-Nielsen.

“Guides from the health authorities should therefore differentiate between physical activity in your spare time and physical activity at work, as there is reason to believe that the two forms of physical activity have opposite effects,” said Nabe-Nielson, an associate professor from the Department of Public Health at the University of Copenhagen.

Another study from the University of Copenhagen recently showed that a healthy lifestyle can halve the risk of developing dementia.

Researchers from the University of Copenhagen and the National Research Centre for the Working Environment used data from the Copenhagen Male Study, in which 4,721 Danish men reported in the 1970s about the type of work they did for 14 Copenhagen-based companies.

Over the years, researchers compiled health data on the respondents.

Now, researchers are collecting more data with the intent to identify healthier ways of doing hard physical work in a way that it has an “exercise effect.”

“A lot of workplaces have already taken steps to improve the health of their staff. The problem is that it is the most well-educated and resourceful part of the population that uses these initiatives,” said study co-author Andreas Holtermann.

“Those with a shorter education often struggle with overweight, pain and poor physical fitness, even though they take more steps during the day and to a larger extent use their body as a tool,” said Holtermann, of the National Research Centre for the Working Environment.

“For workmen, it is not enough, for example, to avoid heavy lifts if they wish to remain in the profession until age 70. People with a shorter education doing manual labour also need to take preventive steps by strengthening the body’s capacity via, for example, exercise and strength training,” Holtermann said in a university news release.

The research was published recently in the Scandinavian Journal of Medicine and Science in Sports.



More information

Visit the Mayo Clinic for more on physical activity.

Copyright 2020 HealthDay. All rights reserved.

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Employers are rethinking sick leave, work from home policies to protect COVID-19 ‘long haulers’

As the COVID-19 pandemic continues to devastate the United States, many employers are reevaluating their sick leave, work from home and disability policies to accommodate their employees, especially those now known as COVID-19 “long haulers.”

Working from home has become the de facto policy of many white-collar job employers, but employees in blue-collar or essential jobs may still be required to show up in person. This has brought up complex and thorny questions about how employers should best protect their workers while on the job.

The novel coronavirus has also brought up concerns about companies’ traditional sick leave policies. At this time, if employees do get sick with the virus, they could turn out to be asymptomatic, they could get sick and then quickly recover or they could experience aggressive symptoms and need further care. Some may need more time to recuperate than the standard two weeks of paid sick leave allows.

Some people could experience symptoms for weeks or months, and could end up needing long-term disability coverage; these people are the ones now being referred to as COVID-19 long haulers.

MORE: Twitter says it will allow employees to work from home ‘forever’

“The first concern of all employers should be for the health and safety of their employees,” said Dr. Sachin Jain, an internal medicine physician, the CEO of SCAN Health Plan and the former CEO of CareMore. “Employees who return to work too soon put both their own health and the health of their co-workers at risk.”

Different companies are choosing to manage these COVID-19 complications in different ways, and many are reconsidering their in-person work setups.

“Companies should encourage employees to track their symptoms, share that information with their physicians and take [medical] leave as appropriate,” said Dr. Asha S. Collins, the U.S. country head for country clinical operations at Genentech. “We still have a lot to learn about this virus.”

PHOTO: A doctor consults a patient in this stock photo. (STOCK PHOTO/Getty Images)
PHOTO: A doctor consults a patient in this stock photo. (STOCK PHOTO/Getty Images)

When an employee becomes a COVID-19 long hauler, employers should encourage him or her to stay home in isolation, so as to protect his or her colleagues and family members.

“If an employee has symptoms of COVID-19, their employer should work with them to ensure that they have the time and space they need to recover from their illness before they return to the office,” said Jain.

According to some experts, COVID-19 could be considered a chronic illness if a person has persistent symptoms.

“[They] fall into the same category as any chronic illness with lingering requirements to have persistent care,” said Dr. Ken Abrams, the managing director and chief medical officer at Deloitte.

Employers should be prepared for this, and — if they don’t already — make sure they have policies in place to ensure that those with chronic illness are not discriminated against, Abrams said.

“It is important for us to promote the importance of recognizing the difference between infectious versus recovered, and should not be discriminating against

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health

Third of staff ‘fear catching Covid at work’

workers
workers

More than a third of workers are concerned about catching coronavirus on the job, according to a study by the Resolution Foundation think tank.

The poorest paid are particularly worried, the research found, but also the least likely to speak up about it.

Younger workers are also less likely to raise a complaint, the Resolution Foundation said.

The widespread concerns come despite government advice on making workplaces Covid-secure, researchers said.

Lindsay Judge, research director at the Resolution Foundation, said: “More than one-in-three workers are worried about catching coronavirus on the job, despite the extensive steps employers have taken to make workplaces Covid-secure.

“Given many workers’ limited ability to get employers to address Covid concerns, the UK needs a strong enforcement regime to ensure that workplaces are as safe as can be.

“But instead health and safety resources have been cut, inspections have been slow, and Covid-related enforcement notices are few and far between.”

Funding question

The researchers said they were also concerned about the reduction in funding at the Health and Safety Executive.

The HSE’s funding for each site it has the right to inspect has shrunk from £224 a decade ago to £100 for the current financial year, according to the report.

“The Foundation says policy makers should overturn the current view that health and safety is a ‘brake on business’ and take a more proactive approach to enforcement in the face of the pandemic,” it said.

A government spokesman said £14m of funding was given to the HSE to combat coronavirus earlier this year.

An HSE spokesperson said: “We thank the Resolution Foundation for its report, and with our partners across government we will examine its findings. We welcome the acknowledgement of our increased activity and share the commitment to ensure all employees have a voice.

“Making sure Great Britain’s workplaces are Covid-Secure is our priority; this effort will not be affected by recent additional restrictions announced across England, Scotland and Wales. We will work with stakeholders to deliver workplace health and safety during this coronavirus pandemic.

“Inspection and putting duty holders on the spot is just one part of a wide ranging regulatory approach. We use a number of different ways to gather intelligence and reach out to businesses with a combination of site visits, phone calls and through collection of supporting visual evidence such as photos and video footage.”

While a new lockdown in England is planned from Thursday, up to half of workers could still be going to work in jobs such as essential retail, education and health, Resolution said.

The research used an online YouGov survey of 6,061 adults across the UK.

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fitness

Work out with these active exercise titles



a woman sitting at a beach: The best fitness games for 2020 Work out with these active exercise titles image 1


© Provided by Pocket-lint
The best fitness games for 2020 Work out with these active exercise titles image 1

(Pocket-lint) – Videogames have long since moved past worries about inactivity and sedentary behaviour – while it’s true that many games will suck players into playing for hours at a time without much benefit to their physical wellbeing, the relaxation and enjoyment they offer is almost peerless.

  • Best dieting apps: 8 apps to help you lose weight at home

That said, there is still a range of games on the market that could scratch both itches, giving you fun gameplay and systems to interact with, while also getting your pulse pounding and helping you to keep active. Right now, given how many of us are spending large amounts of time at home, that could be the perfect combination.

So, to that end, we’ve gathered together some of the very best active videogames for you, so that you can get a burst of exercise without leaving your home, all with the help of your games console. 

Our pick of the best exercise games to buy or try today

Ring Fit Adventure

Nintendo’s latest fitness game, after the success of Wii Fit so many years ago, is an absolute sensation. It’s flown off the shelves, making it really difficult to find at the moment, but if you can spot it in stock anywhere it’s the perfect fitness title for the stay-at-home age. 

With the aid of flexible Ring-con controller and a leg strap, you’ll squat, stretch and flex your way through workouts masquerading as a quasi-RPG, and have a great time doing it. It’s beautifully designed and will help you get a bit fitter while monitoring your progress and encouraging you along the way.

Just Dance 2021

Another staple on the active gaming scene is the Just Dance series, which is available on the Switch, Xbox One and PS4. It’s a full-body rhythm action game, challenging you to dance along to a soundtrack full of popping tracks, matching your movements to the directions on-screen.

It’s a colourful, glorious bit of fun, and while it doesn’t have to be massively exerting if you play it concertedly and make sure to keep up the regularity of your sessions, it can be a great way of staying active without necessarily feeling like you’re flogging yourself with workouts. 

Fitness Boxing

Another great game for the Switch, Fitness Boxing takes maximum advantage of the Joy-Con controllers to let you take virtual boxing lessons and punch your way to getting fit.

It’s more explicitly about fitness than some of the others on this list, which brings with it a different tone and a bit more potential intensity to make sure that even if you get properly in shape it’ll still offer up solid workouts. It might not have the lustre of more mainstream efforts, but it’s still a great option. 

Beat Saber

Moving into the world of VR, Beat Saber is a really fun VR game that’s pretty taxing

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health

COVID Exposure Risk Outside of Work Increasing for Clinicians

Editor’s note: Find the latest COVID-19 news and guidance in Medscape’s Coronavirus Resource Center.

One third of COVID-19 exposures among health care providers (HCPs) in Minnesota are due to family or community exposure, not patient care, according to a study conducted by the Minnesota Department of Health (MDH) and published online October 30 in Morbidity and Mortality Weekly Report. And nonwork exposures were more likely to lead to COVID-19 infections.

Between March 6 and July 11, 2020, researchers with the MDH evaluated 21,406 incidences of HCP exposure to confirmed COVID-19 cases. Of those, 5374 (25%) were classified as higher-risk exposures, meaning the provider had close contact for 15 minutes or more, or during an aerosol-generating procedure.

Two thirds (66%) of the higher-risk exposures occurred during direct patient care and 34% were related to nonpatient care interactions (eg, coworkers, social and household contacts). Overall, 6.9% (373) of the HCPs with a higher-risk exposure received a positive SARS-CoV-2 test result within 14 days of the exposure. Notably, HCPs with household or social exposure had the highest positivity rate across all exposure types at 13%.

“Since the time period covered in this report, we’ve seen a significant increase in the proportion of HCPs who have had higher-risk exposures outside of work due to household or social contacts,” said lead author Ashley Fell, MPH, from the Minnesota Department of Health.

“HCPs with household or social exposures are also more likely to test positive than HCPs with higher risk exposures within the healthcare setting, which is an important message for both HCPs and the community at large that more COVID-19 spreading in our communities poses a greater risk to our HCPs and health care system,” Fell told Medscape Medical News.

When evaluating personal protective equipment (PPE) use among exposed HCPs, researchers found that 90% of providers in acute or ambulatory care were wearing a respirator or medical-grade face mask at time of exposure, compared with just 68% of HCPs working in congregate living or long-term care facilities.

Further, investigators found that an HCP with a positive SARS-CoV-2 test working in a congregate living or long-term care facility resulted in exposure of a median of three additional HCPs (interquartile range [IQR], 1-6) compared with a median of one additional HCP exposure in acute or ambulatory care (IQR, 1-3).

The researchers also found that, compared with HCPs in acute or ambulatory settings, HCPs working in long-term care or congregate living settings were more likely to return to work following a high-risk exposure (57% vs 37%) and work while symptomatic (4.8% vs 1.3%).

When asked whether these findings apply to HCPs in other states, Andrew T. Chan, MD, from Massachusetts General Hospital, Boston, noted: “These data are not surprising and confirm what many of us have been seeing in our own areas.

“Clearly, the risk of contracting COVID-19 is particularly high for front-line health care workers in long-term care facilities and nursing homes,” Chan said.

“Furthermore, the infection control practices in these care settings are often

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health

Does Hard Work Help Preserve the Brain? | Health News

By Cara Murez, HealthDay Reporter

(HealthDay)

MONDAY, NOV 2, 2020 (HealthDay News) — Physical activity is known to help prevent dementia and disease, but it’s possible that the kind you do makes a difference.

A new study found that hard physical work not only doesn’t lower the risk of dementia, it increases the risk of developing the disease.

Researchers found that people who do hard physical work have a 55 percent higher risk of developing dementia than those doing sedentary work.

“The WHO [World Health Organization] guide to preventing dementia and disease on the whole mentions physical activity as an important factor. But our study suggests that it must be a ‘good’ form of physical activity, which hard physical work is not,” said researcher Kirsten Nabe-Nielsen, an associate professor from the Department of Public Health at the University of Copenhagen. “Guides from the health authorities should therefore differentiate between physical activity in your spare time and physical activity at work, as there is reason to believe that the two forms of physical activity have opposite effects.”

Another study from the University of Copenhagen recently showed that a healthy lifestyle can halve the risk of developing dementia.

Researchers from the University of Copenhagen and the National Research Centre for the Working Environment used data from the Copenhagen Male Study, in which 4,721 Danish men reported in the 1970s about the type of work they did for 14 Copenhagen-based companies. Over the years, researchers compiled health data on the respondents.

Now, researchers are collecting more data with the intent to identify healthier ways of doing hard physical work in a way that it has an “exercise effect.”

“A lot of workplaces have already taken steps to improve the health of their staff. The problem is that it is the most well-educated and resourceful part of the population that uses these initiatives. Those with a shorter education often struggle with overweight, pain and poor physical fitness, even though they take more steps during the day and to a larger extent use their body as a tool,” said study co-author Andreas Holtermann, from the National Research Centre for the Working Environment.

“For workmen, it is not enough, for example, to avoid heavy lifts if they wish to remain in the profession until age 70. People with a shorter education doing manual labour also need to take preventive steps by strengthening the body’s capacity via, for example, exercise and strength training,” Holtermann said in a university news release.

The research was published recently in the Scandinavian Journal of Medicine and Science in Sports.

SOURCE: University of Copenhagen, Faculty of Health and Medical Sciences, news release, Oct. 26, 2020

Copyright © 2020 HealthDay. All rights reserved.

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Paralympic athlete, others work through Ability360 gym closure due to COVID-19

For people with disabilities, Ability360’s fitness center is not just a gym. It’s a gift, a lifeline, a privilege, a necessity.

The 45,000-square-foot fitness center, part of a 62,000-square-foot campus tucked in a business area east of Phoenix Sky Harbor International Airport and along the light rail route, is the first of its kind in the western United States and one of only a few in the nation.

Its equipment is designed with accessibility in mind. For example, the lap pool has a lowered bench for transferring directly from a wheelchair to the water. The fitness room features strength, cardio and free weight equipment like any gym, but they’re designed to accommodate people with disabilities.

The campus is also home to a slew of nonprofits that help people with various disabilities and is typically bustling with activity. Ability360’s fitness center started the year with 2,800 members.

For those with recent injuries, the gym is a place to see and meet others who have coped with and grown stronger from their injuries, a place for encouragement.

For others, it’s the only place they ever get to use accessible equipment. It might be the only reason they leave the house.

For a select few, like those who had been training to play in the 2020 Summer Paralympics in Tokyo, it’s one of the best and most adaptive training facilities in the state.

“This is a place like nowhere else,” said Ability360 vice president and general manager Gus LaZear. “It’s warm, it’s welcoming, people are friendly but also keep you accountable for working out.”

Like many gyms, Ability360 shut down March 17. But when other gyms raced to reopen, Ability360 leaders were more cautious. They serve a more vulnerable population.

The Arizona Republic followed three Ability360 members over several months, documenting as they coped with the rollercoaster of closures and re-openings at the facility they described as being like a second home, a place where their disability didn’t define them.

CLOSE

When Ability360, a Phoenix gym for people with disabilities closed because of the COVID-19 pandemic, they adapted.

Arizona Republic

For a Paralympic athlete, Ability360 is essential

Joe Jackson, 30, has been paralyzed from the waist down since being injured during a Hamilton High School football game in 2005.

Breaking his C6 vertebrae in his lower neck left him without the ability to sweat, meaning he can quickly overheat — a common result of spinal cord injuries.

He didn’t used to have to think about it because of the air conditioned rooms at Ability360. He’d been going there three to five days a week for sessions spanning several hours since the gym’s opening in 2011.

Ability360’s focus on accessibility has been a “game-changer” for Jackson, he said.

Jackson in 2007 started playing quad rugby and joined Ability360’s team, which practiced three times per week for three hours at a time at the facility on top of regular games and tournaments.

In 2017, Jackson became a member of the U.S. Paralympic wheelchair rugby team,

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health

Intermittent Fasting Does Work for Weight Loss, Doctor Clarifies

There’s been a lot of talk about the effectiveness of popular weight-loss plan intermittent fasting. With many studies being done on this time-restricted eating plan, there’s also always new information being presented, but the end result is largely the same: intermittent fasting works for weight loss.

Recently, a study was published in JAMA that looked at time-restricted eating and its weight loss effects in both men and women. As the results were shared, some of the information seemed to get misconstrued, according to a doctor who now wants to clarify.

Monique Tello, M.D., MPH, a practicing physician at Massachusetts General Hospital, director of research and academic affairs for the MGH DGM Healthy Lifestyle Program, and clinical instructor at Harvard Medical School, was not involved in the study. But, she recently published a blog post on Harvard Health’s blog saying she had seen headlines about this study claiming that intermittent fasting doesn’t work and has a significant negative impact on muscle mass. She believes, though, that these research results have largely been misinterpreted. (Related: 5 Science-Backed Benefits of Intermittent Fasting.)

The original study tested 141 overweight patients over a period of 12 weeks. Some were put on a time-restricted eating plan while others followed a traditional eating plan. Dr. Tello points out that there was no true control group in the study because each patient was put on a schedule of some sort. A true control group would have been given no instructions or guidelines.

In the end, both groups lost weight, but the study showed that the intermittent fasting group lost more, including muscle mass that wasn’t identified in those on a traditional eating plan. But as Dr. Tello explains in her post, the study makes no mention about the quality of food both groups were eating.

“By the way, all of these folks may have been eating fried or fast foods, and sugary sodas and candy—we don’t know,” writes Dr. Tello in Harvard Health. “The study doesn’t mention quality of diet or physical activity. This isn’t how IF is supposed to be done! And yet the IF folks still lost between half a pound and 4 pounds.”

Plus, Dr. Tello notes that both groups were given a structured eating plan. Dr. Tello believes having a true control group, in which participants continued to eat as they normally would, could’ve made these research findings more conclusive.

She reiterated that the study did, in fact, show that intermittent fasting works for weight loss, it’s just that some of the results weren’t necessarily presented properly, and the study was, perhaps, a bit flawed in its setup.

“While this one negative study adds to the body of literature on IF, it doesn’t reverse it,” Dr. Tello writes in her post. “We simply need more high-quality studies in order to have a better understanding of how to most effectively incorporate IF into a healthy lifestyle.”

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