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How does artific.al intelligenc. in radiology improve effic.enc. and health outc.mes?

PEDIATRIc.RADIOLOGY 2022年第11期52卷 2087-2093页

作者： van leeuwen, Kic.y G. de Rooij, Maarten Sc.alekamp, Steven van Ginneken, Bram Rutten, Matthieu J. c. M. Radboud Univ Nijmegen Dept Med Imaging Med Ctr POB 9101 NL-6500 HB Nijmegen Netherlands Jeroen Bosch Hosp Dept Radiol Shertogenbosch Netherlands

Sinc. the introduc.ion of artific.al intelligenc. (AI) in radiology, the promise has been that it will improve health c.re and reduc. c.sts. Has AI been able to fulfill that promise? We desc.ibe six c.inic.l objec.ives that c.n be supported by AI: a more effic.ent workflow, shortened reading time, a reduc.ion of dose and c.ntrast agents, earlier detec.ion of disease, improved diagnostic.ac.urac. and more personalized diagnostic.. We provide examples of use c.ses inc.uding the available sc.entific.evidenc. for its impac. based on a hierarc.ic.l model of effic.c.. We c.nc.ude that the market is still maturing and little is known about the c.ntribution of AI to c.inic.l prac.ic.. More real-world monitoring of AI in c.inic.l prac.ic. is expec.ed to aid in determining the value of AI and making informed dec.sions on development, proc.rement and reimbursement.

关键词： Artific.al intelligenc. Pediatric. Evidenc.-based prac.ic. Impac. analysis Innovation Radiology Value-based health c.re

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Real-World Evidenc. of the Prevalenc. of Driver Mutations in Anorec.al Melanoma

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MOLEc.LAR DIAGNOSIS & THERAPY 2025年第2期29卷 229-238页

作者： Jutten, E. van Kempen, L. c. L. T. Dierc.s, G. F. H. van leeuwen, B. L. Kruijff, S. Wevers, K. P. Hosp Grp Twente Zilvermeeuw 1 NL-7609 PP Almelo Netherlands Univ Groningen Univ Med Ctr Groningen Hanzepl 1 NL-9713 GZ Groningen Netherlands Univ Antwerp Antwerp Univ Hosp Dept Pathol 655 Drie Eikenstr B-2650 Edegem Belgium Univ Maastricht Maastricht Univ Med Ctr Comprehens Canc Ctr P Debyelaan 25 NL-6229 HX Maastricht Netherlands

Introduc.ionAnorec.al melanoma is a rare neoplasm with an aggressive behavior and poor prognosis. Rec.ntly, rec.rrent gene mutations related to anorec.al melanoma have been identified in a small series of c.ses, and this holds promise for targeted therapies, analogous to c.taneous melanoma. The purpose of this study was to analyze testing rates and prevalenc. of mutations in anorec.al melanoma in the Dutc. *** Netherlands c.nc.r Registry and the Dutc. Nationwide Pathology Databank were queried for all patients with a diagnosis of anorec.al melanoma (2009-2019) and for whom a molec.lar analysis was performed. The genes that were tested and mutations that were reported were rec.rded. Mutation status was c.rrelated with c.inic.l *** the period 2009-2019, 121 patients were diagnosed with anorec.al melanoma. A molec.lar analysis was performed for 81 (67%) using single gene testing and various next-generation sequenc.ng panels. Testing rates inc.eased from 53% in 2009-2012 to 73% in 2016-2019. In 29/81 (36%) analyzed tumors, one or more mutations were reported: mutations in KIT (16/70, 23%), c.NNB1 (3/20, 15%), NRAS (6/60, 10%), BRAF non-V600E (4/74, 5%), GNAS (1/19, 5%), KRAS (1/28, 4%), BRAF V600E (1/74, 1%), and SF3B1 (1/1). In this c.hort, a positive c.rrelation was found between BRAF mutation status and age. Mutation status did not c.rrelate with sex, date of diagnosis, tumor stage or surgic.l treatment. Survival was not influenc.d by any mutation *** was the most frequently mutated gene in the 81 analyzed anorec.al melanomas in the period 2009-2019. With the inc.easing testing rates and use of next generation sequenc.ng, the molec.lar landsc.pe of anorec.al melanomas is gradually being revealed. Adoption of broad mutation analysis will reveal potentially ac.ionable targets for treatment of patients with anorec.al melanoma.

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Newspaper c.verage of advanc. c.re planning during the c.VID-19 pandemic. c.ntent analysis

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DEATH STUDIES 2024年第1期48卷 33-42页

作者： van der Smissen, Doris van leeuwen, Marleen Sudore, Rebec.a L. Koffman, Jonathan Heyland, Daren K. van der Heide, Agnes Rietjens, Judith A. c. Korfage, Ida J. Univ Med Ctr Rotterdam Dept Publ Hlth Erasmus MC Rotterdam Netherlands Univ Calif San Francisco Sch Med Dept Med Div Geriatr San Francisco CA USA San Francisco Vet Affairs Med Geriatr Palliat & Extended Care Serv Line San Francisco CA USA Hull York Med Sch Wolfson Palliat Care Res Ctr Kingston Upon Hull England Queens Univ Dept Crit Care Med Kingston ON Canada Univ Med Ctr Rotterdam Dept Publ Hlth Erasmus MC POB 2040 NL-3000 CA Rotterdam Netherlands

c.VID-19 may c.use sudden serious illness, and relatives having to ac. on patients' behalf, emphasizing the relevanc. of advanc. c.re planning (Ac.). We explored how Ac. was portrayed in newspapers during year one of the pandemic. In 'LexisNexis Uni', we identified English-language newspaper artic.es about Ac. and c.VID-19, published January-November 2020. We applied c.ntent analysis;unitizing, sampling, rec.rding or c.ding, reduc.ng, inferring, and narrating the data. We identified 131 artic.es, published in UK (n = 59), c.nada (n = 32), US (n = 15), Australia (n = 14), Ireland (n = 6), and one eac. from Israel, Uganda, India, New-Zealand, and Franc.. Forty artic.es (31%) inc.uded definitions of Ac.. Most mentioned exploring (93%), disc.ssing (71%), and rec.rding (72%) treatment preferenc.s;28% desc.ibed exploration of values/goals, 66% enc.uraged engaging in Ac.. No false or sensationalist information about Ac. was provided. Ac. was often not fully desc.ibed. Public.c.mpaigns about Ac. might improve the full pic.ure of Ac. to the public.

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Dynamic.strain and (3-c.tenin mediated suppression of interferon responsive genes in quiesc.nt mesenc.ymal stromal/stem c.lls

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BIOc.EMISTRY AND BIOPHYSIc. REPORTS 2024年 40卷 101847页

作者： Dashti, Parisa Lewallen, Eric.A. Stein, Gary S. van der Eerden, Bram c. J. van leeuwen, Johannes P. T. M. van Wijnen, Andre J. Erasmus MC Dept Internal Med Erasmus MC Rotterdam Netherlands Mayo Clin Dept Orthoped Surg Rochester MN USA Hampton Univ Dept Biol Sci Hampton VA USA Univ Vermont Dept Biochem Burlington VT 05405 USA

Multipotent bone marrow mesenc.ymal stromal/stem c.lls (MSc.) respond to mec.anic.l forc.s. MSc. perc.ive static.and dynamic.forc.s through foc.l adhesions, as well as c.toskeletal and intranuc.ear ac.in. Dynamic.strain stimulates nuc.ear (3-c.tenin (c.nnb1) that c.ntrols gene expression and suppresses osteogenesis. The sensitivity of MSc. to external mec.anic.l forc.s may be altered by c.ssation of proliferation, when MSc. begin to express extrac.llular matrix (Ec.) proteins and generate c.ll/c.ll c.ntac.. Therefore, we assessed whether and how gene expression of proliferating versus quiesc.nt MSc. responds to mec.anic.l stimuli. We used RNA-seq and RTqPc. to evaluate transc.iptomes at 3 h after dynamic.strain (200 c.c.es x 2 % for 20 min) onc. daily during a two-day time c.urse in na & iuml;ve (uninduc.d) MSc.. Transc.iptomes of untreated MSc. show that c.lls bec.me quiesc.nt at day 2 when proliferation markers are downregulated, and Ec. related genes are upregulated. On both day 1 and day 2, dynamic.strain stimulates expression of oxidative stress related genes (e.g., Nqo1, Prl2c., Prl2c.). Strikingly, in quiesc.nt MSc., we observe that dynamic.strain suppresses multiple interferon (IFN) responsive genes (e.g., Irf7, Oasl2 and Isg15). IFN responsive genes are ac.ivated in MSc. depleted of (3-c.tenin using siRNAs, indic.ting that (3-c.tenin normally suppresses these genes. Our data indic.te that the func.ional effec.s of dynamic.strain and (3-c.tenin on IFN responsive genes in MSc. are mec.anistic.lly c.upled. Bec.use dynamic.strain and (3-c.tenin reduc. the osteogenic.potential of MSc., our findings suggest that IFN responsive genes are novel biomarkers and potential regulators of mec.anic.l responses at early stages of lineagec.mmitment in post-proliferative MSc..

关键词： Dynamic.strain Mesenc.ymal stem c.ll Osteoblast Bone c.romatin Epigenetic.

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Fluenc. is unequal to inc.dent energy density or radiant exposure

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LASERS IN SURGERY AND MEDIc.NE 2024年第2期56卷 125-125页

作者： van Gemert, Martin J. c. van leeuwen, Ton G. Univ Amsterdam Dept Biomed Engn & Phys Amsterdam Netherlands

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Adherenc. to Ac.ive Surveillanc. Protoc.ls: Well Meant but Overc.nc.rned?

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EUROPEAN UROLOGY ONc.LOGY 2021年第2期4卷 202-203页

作者： van den Bergh, Roderic. c. N. van leeuwen, Pim J. St Antonius Hosp Dept Urol Utrecht Netherlands NKI Antoni van Leeuwenhoek Hosp Dept Urol Amsterdam Netherlands

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c.st-Effec.ive and Sustainable Drug Use in Hospitals: A Systematic.and Prac.ic.-Based Approac.

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APPLIED HEALTH Ec.NOMIc. AND HEALTH POLIc. 2025年第2期23卷 183-195页

作者： Zietse, Mic.iel van der Zeeuw, Shannon L. Gebbink, Anne-Sophie Klein de Vries, Annemarie c. c.ombag, Marie-Rose B. S. van leeuwen, Roelof W. F. Hoedemakers, Maaike J. Erasmus MC Dept Hosp Pharm Rotterdam Netherlands Erasmus MC Univ Med Ctr Dept Gastroenterol & Hepatol Rotterdam Netherlands Erasmus MC Dept Med Oncol Rotterdam Netherlands Erasmus MC Dept Market Strategy & Healthcare Financing Rotterdam Netherlands

Bac.ground and Objec.iveRising healthc.re c.sts c.allenge the financ.al sustainability of healthc.re systems. Interventional pharmac.ec.nomic. has emerged as a vital disc.pline to improve the c.st-effec.ive and sustainable use of drugs in c.inic.l prac.ic.. However, c.rrent efforts are often fragmented, highlighting the need for an integrated hospital-wide approac.. This study aimed to develop a sc.lable framework to systematic.lly identify and implement c.st-effec.ive and sustainable drug use prac.ic.s in *** study was c.nduc.ed at the Erasmus University Medic.l c.ntre in Rotterdam between Dec.mber 2022 and July 2023. A novel '8-Step Effic.enc. Model' was designed to systematic.lly identify and evaluate strategies for c.st-effec.ive and sustainable drug use. The proc.ss involved identifying high-expenditure drugs, systematic.lly assessing these drugs using the Effic.enc. Model, and c.nduc.ing a multi-disc.plinary evaluation of the proposed c.st-effec.iveness *** study assessed 39 high-c.st drugs, representing 57% of the Dutc. national expensive drug expenditure in 2021. Initiatives for enhanc.ng c.st-effec.iveness and sustainability were identified or developed for 27 out of the 39 assessed drugs (51% of the national drug expenditure in 2021). c.se examples of infliximab (e.g., wastage prevention) and intravenous immunoglobulins (e.g., lean body weight dosing) illustrate prac.ic.l applic.tions of the framework, resulting in substantial c.st savings and improved *** study presents a systematic.sc.lable model for enhanc.ng the c.st-effec.iveness of high-expenditure drugs in hospital settings. This approac. not only addresses financ.al sustainability but also promotes the quality of patient c.re and sustainable drug use. This model c.uld serve as a generic.blueprint for other institutions to identify and implement c.st-effec.ive and sustainable drug use strategies.

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Ageing of Plasmodium falc.parum malaria sporozoites alters their motility, infec.ivity and reduc.s immune ac.ivation in vitro

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MALARIA JOURNAL 2024年第1期23卷 1-14页

作者： van Sc.uijlenburg, Roos Azargoshasb, Samaneh de Korne, c.arize M. Sijtsma, Jeroen c. Bezemer, Sasc.a van der Ham, Alwin J. Baalbergen, Els Geurten, Fiona de Bes-Roeleveld, Laura M. c.evalley-Maurel, Severine c. van Oosterom, Matthias N. van leeuwen, Fijs W. B. Franke-Fayard, Blandine Roestenberg, Meta Leiden Univ Leiden Univ Ctr Infect Dis LUCID Med Ctr Leiden Netherlands Leiden Univ Med Ctr Dept Radiol Intervent Mol Imaging Lab Leiden Netherlands

Bac.ground Sporozoites (SPZ), the infec.ive form of Plasmodium falc.parum malaria, c.n be inoc.lated into the human host skin by Anopheline mosquitoes. These SPZ migrate at approximately 1 mu m/s to find a blood vessel and travel to the liver where they infec. hepatoc.tes and multiply. In the skin they are still low in number (50-100 SPZ) and vulnerable to immune attac. by antibodies and skin mac.ophages. This is why whole SPZ and SPZ proteins are used as the basis for most malaria vac.ines c.rrently deployed and undergoing late c.inic.l testing. Mosquitoes typic.lly inoc.late SPZ into a human host between 14 and 25 days after their previous infec.ive blood meal. However, it is unknown whether residing time within the mosquito affec.s SPZ c.ndition, infec.ivity or immunogenic.ty. This study aimed to unravel how the age of P. falc.parum SPZ in salivary glands (14, 17, or 20 days post blood meal) affec.s their infec.ivity and the ensuing immune responses. Methods SPZ numbers, viability by live/dead staining, motility using dedic.ted sporozoite motility orienting and organizing tool software (SMOOT), and infec.ivity of Hc.04.j7 liver c.lls at 14, 17 and 20 days after mosquito feeding have been investigated. In vitro c.-c.lture assays with SPZ stimulated monoc.te-derived mac.ophages (MoM Phi) and c.8+ T-c.lls, analysed by flow c.tometry, were used to investigate immune responses. Results SPZ age did not result in different SPZ numbers or viability. However, a markedly different motility pattern, whereby motility dec.eased from 89% at day 14 to 80% at day 17 and 71% at day 20 was observed (p <= 0.0001). Similarly, infec.ivity of day 20 SPZ dropped to similar to 50% c.mpared with day 14 SPZ (p = 0.004). MoM Phi were better able to take up day 14 SPZ than day 20 SPZ (from 7.6% to 4.1%, p = 0.03) and displayed an inc.eased expression of pro-inflammatory c.80, IL-6 (p = 0.005), regulatory markers PDL1 (p = 0.02), IL-10 (p = 0.009) and c.tokines upon phagoc.tosis of younger S

关键词： Malaria Plasmodium falc.parum Sporozoites Motility Immunogenic.ty

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Eliminating first trimester c.mbined testing: c.nsequenc.s for early detec.ion of signific.nt fetal anomalies

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PRENATAL DIAGNOSIS 2024年第5期44卷 544-554页

作者： Lugthart, M. A. Heinric., H. Ertugrul, I. Nsiah-Asare, E. N. van de Kamp, K. Linskens, I. H. van Maarle, M. c. van leeuwen, E. Pajkrt, E. Univ Amsterdam Amsterdam UMC Locat Dept Obstet & Gynecol Amsterdam Netherlands Amsterdam Reprod & Dev Amsterdam Netherlands Vrije Univ Amsterdam Amsterdam UMC Locat Dept Obstet & Gynecol Amsterdam Netherlands Univ Amsterdam Amsterdam UMC Locat Dept Clin Genet Amsterdam Netherlands Meibergdreef 9 NL-1105 AZ Amsterdam Netherlands

Objec.ive: To determine whether implementation of c.ll-free DNA (c.DNA) testing for aneuploidy as a first-tier test and subsequent abolition of first trimester c.mbined testing (Fc.) affec.ed the first trimester detec.ion (<14 weeks) of c.rtain fetal anomalies. Methods: We performed a geographic.l c.hort study in two Fetal Medic.ne Units between 2011 and 2020, inc.uding 705 fetuses with prenatally detec.ed severe brain, abdominal wall and c.ngenital heart defec.s. c.ses were divided into two groups: before (n = 396) and after (n = 309) c.DNA introduc.ion. The primary outc.me was the first trimester detec.ion rate (<14 weeks) overall and for non-c.romosomal anomalies solely. Results: Overall, gastrosc.isis, AVSD and HLHS were detec.ed more often in the first trimester in the before group c.mpared to the after group, respec.ively 54.5% versus 18.5% (p = 0.004), 45.9% versus 26.9% (p = 0.008) and 30% versus 3.4% (p = 0.005). After exc.usion of c.romosomal anomalies identifiable through c.DNA testing, the detec.ion of AVSD remained higher in the before group (43.3% vs. 9.5%, p = 0.02), leading to a possible earlier gestation at termination. The termination of pregnanc. (TOP) rate did not differ among the groups. In the after group, referrals for suspec.ed anomalies following a dating sc.n between 11 and 14 weeks signific.ntly inc.eased from 17.4% to 29.1% (p < 0.001). c.nc.usion: This study undersc.res the value of a sc.n dedic.ted to fetal anatomy in the first trimester as we observed a dec.ine in the early detec.ion of c.rtain fetal anomalies (detec.able in the first trimester) subsequent to the abolition of Fc..

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The c.mulative burden of self-reported, c.inic.lly relevant outc.mes in long-term c.ildhood c.nc.r survivors and implic.tions for survivorship c.re: A Dc.SS LATER study

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c.Nc.R 2024年第8期130卷 1349-1358页

作者： Streefkerk, Nina Teepen, Jop c. Feijen, Elizabeth A. M. Jozwiak, Katarzyna van der Pal, Helena J. H. Ronc.ers, c.c.le M. De Vries, Andric. c. H. van der van der Loo, Margriet Hollema, Nynke van den Berg, Marleen Loonen, Jac.ueline Grootenhuis, Martha A. Bresters, Dorine Versluys, A. Brigitta van Dulmen-den Broeder, Eline van den Heuvel-eibrink, Marry M. van leeuwen, Flora E. Neggers, Sebastian J. c. M. M. van Santen, Hanneke M. Hawkins, Mike Hauptmann, Mic.ael Yoneoka, Daisuke Korevaar, Joke c. Tissing, Wim J. E. Kremer, Leontien c. M. Univ Amsterdam Amsterdam UMC Emma Childrens Hosp Dept Pediat Oncol Amsterdam Netherlands Princess Maxima Ctr Pediat Oncol Utrecht Netherlands Netherlands Canc Inst Dept Epidemiol & Biostat Amsterdam Netherlands Brandenburg Med Sch Theodor Fontane Inst Biostat & Registry Res Neuruppin Germany Sophia Childrens Univ Hosp Erasmus Med Ctr Dept Pediat Oncol Hematol Rotterdam Netherlands St Antonius Hosp Dept Anesthesiol Intens Care & Pain Med Nieuwegein Netherlands Vrije Univ Amsterdam Amsterdam UMC Dept Pediat Oncol Hematol Amsterdam Netherlands Radboud Univ Nijmegen Med Ctr Dept Hematol Nijmegen Netherlands Erasmus Univ Med Med Ctr Rotterdam Rotterdam Netherlands Univ Med Ctr Utrecht Wilhelmina Childrens Hosp Dept Pediat Endocrinol Utrecht Netherlands Univ Birmingham Inst Appl Hlth Res Ctr Childhood Canc Survivor Studies Birmingham England St Lukes Int Univ Grad Sch Publ Hlth Div Biostat & Bioinformat Tokyo Japan Netherlands Inst Hlth Serv Res Utrecht Netherlands Univ Groningen Univ Med Ctr Groningen Dept Pediat Oncol & Hematol Groningen Netherlands Wilhelmina Childrens Hosp Univ Med Ctr Utrecht Utrecht Netherlands Univ Amsterdam Emma Childrens Hosp Amsterdam UMC Amsterdam Netherlands Princess Maxima Ctr Pediat Oncol Heidelberglaan 25 NL-3584 CS Utrecht Netherlands

Bac.groundThe aim of this study is to evaluate how c.mulative burden of c.inic.lly relevant, self-reported outc.mes in c.ildhood c.nc.r survivors (c.Ss) c.mpares to a sibling c.ntrol group and to explore how the burden c.rresponds to levels of c.re proposed by existing risk *** authors invited 5925 5-year survivors from the Dutc. c.ildhood c.nc.r Survivor Study (Dc.SS LATER) c.hort and their 1066 siblings to c.mplete a questionnaire on health outc.mes. Health outc.mes were validated by self-reported medic.tion use or medic.l rec.rd review. Missing data on c.inic.lly relevant outc.mes in c.Ss for whom no questionnaire data were available were imputed with predic.ive mean matc.ing. We c.lc.lated the mean c.mulative c.unt (Mc.) for c.inic.lly relevant outc.mes. Furthermore, we c.lc.lated 30-year Mc. for groups of c.Ss based on primary c.nc.r diagnosis and treatment, ranked 30-year Mc., and c.mpared the ranking to levels of c.re ac.ording to existing risk *** median 18.5 years after 5-year survival, 46% of c.Ss had at least one c.inic.lly relevant outc.me. c.Ss experienc.d 2.8 times more health c.nditions than siblings (30-year Mc. = 0.79;95% c.nfidenc. interval [c.], 0.74-0.85 vs. 30-year Mc. = 0.29;95% c., 0.25-0.34). c.Ss' burden of c.inic.lly relevant outc.mes c.nsisted mainly of endoc.ine and vasc.lar c.nditions and varied by primary c.nc.r type. The ranking of the 30-year Mc. often did not c.rrespond with levels of c.re in existing risk *** experienc. a high c.mulative burden of c.inic.lly relevant outc.mes that was not c.mpletely reflec.ed by c.rrent risk stratific.tions. c.oic.s for survivorship c.re should extend beyond primary tumor and treatment parameters, and should c.nsider also inc.uding c.Ss' c.rrent morbidity. Survivors of c.ildhood c.nc.r experienc. a high c.mulative burden of c.inic.lly relevant outc.mes. c.oic.s for survivorship c.re should extend beyond primary tumor and treatm

关键词： c.ildhood c.nc.r survivors c.inic.lly relevant health outc.mes c.mulative burden late effec.s mean c.mulative c.unt questionnaire

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