Newswise — Millions of Americans with tobacco-related lung disease have symptoms that do not fit any existing tobacco-related disease criteria – including the most common of those, chronic obstructive pulmonary disease (COPD) – according to a new study led by researchers at UC San Francisco.
In a study publishing Aug. 1, 2023, in the Journal of the American Medical Association (JAMA), the research team found that half of the participants with extensive tobacco exposure had a persistently high level of respiratory symptoms, including shortness of breath, daily cough and phlegm, and decreased ability to exercise, but performed well in the breathing tests used to diagnose COPD.
COPD assessment was an essential part of the “SubPopulations and InteRmediate Outcome Measures In COPD Study” (SPIROMICS) – a multicenter study of 1379 people 40 to 80 years old who had more than 20 pack-years of tobacco exposure (smoking one pack of cigarettes per day for 20 or more years). The study also included control participants who had never smoked cigarettes and did not have airflow obstruction.
COPD is the sixth leading cause of death in the United States and is frequently associated with long-term tobacco exposure. In 2020, an estimated 12.5 million Americans reported having been diagnosed with COPD, according to the Centers for Disease Control and Prevention. Yet previous studies indicated that more than 18 million had evidence of impaired lung function, a sign that millions more might be suffering without a clear diagnosis.
COPD is assessed with spirometry, a lung function test that measures how quickly and effectively a person can fill and then empty their lungs at maximum effort. It is diagnosed when the test shows airflow obstruction, indicating a problem with getting enough air out in the normal amount of time. Evidence of airflow obstruction is medically defined as an abnormally low ratio of the forced expiratory volume in the first second (FEV1) of an exhalation to total forced vital capacity (FVC).
“We found that many people who have a lot of primary tobacco exposure have the same symptoms as people who have COPD, but can’t be diagnosed with COPD, because their FEV1/FVC ratio is considered normal on spirometry,” said William McKleroy, MD, a former UCSF Pulmonology Fellow and first author of the study. “This demonstrates a major gap in effective and compassionate care for tobacco-exposed persons and highlights the need for further study to find ways to help them.”
Participants were enrolled in SPIROMICS I from November 2010 to July 2015 and followed through July 2021 in an extension study, SPIROMICS II. They underwent spirometry, 6-minute walk distance testing, assessment of respiratory symptoms, and CT scans of their lungs, at yearly visits for 3 to 4 years. Many of these participants then completed another round of testing 5 to 10 years after their original visit.
Some of the study participants were found to have COPD after undergoing spirometry, while others had “preserved spirometry,” meaning they did not have COPD. The researchers found that the vast majority of the participants with tobacco exposure and preserved spirometry (TEPS) and pulmonary symptoms at the beginning of the study continued to have symptoms through more than five years of follow-up. They also had high rates of respiratory exacerbations and shortness of breath that limited their ability to be active over the course of the study.
Additionally, participants with symptomatic TEPS did not have increased incidence of COPD compared those with asymptomatic TEPS (33.0% among participants with symptomatic TEPS vs. 31.6% among those with asymptomatic TEPS), or a faster rate of lung function decline, as measured by the decline in FEV1 over time, compared to asymptomatic TEPS participants. By contrast, participants with COPD did have a more rapid rate of FEV1 decline compared to symptomatic TEPS participants.
“These findings suggest that a large proportion of tobacco smoke-exposed persons without airflow obstruction have a persistent, symptomatic non-obstructive chronic airway disease that is distinct from COPD,” said Prescott Woodruff, MD, MPH, UCSF division chief of Pulmonology and principal investigator for SPIROMICS. “Although tobacco-exposed persons with preserved spirometry are currently categorized as having pre-COPD by the COPD guidelines, the data from the current study emphasize that the definition of smoking-related lung disease needs to be broadened so new treatments can be developed.”
The study found that many individuals with a history of smoking have respiratory symptoms and increased risk of exacerbations that persist over several years, added James Kiley, Ph.D., director of the Division of Lung Diseases at the National Heart, Lung, and Blood Institute, part of the National Institutes of Health.
“Even in persons with no respiratory symptoms and normal breathing tests, smoking continues to harm their lungs,” Kiley said. “The study results highlight the importance of smoking cessation, underscore the need for regular follow-up of smokers with and without symptoms, and call for more research to treat respiratory symptoms due to smoking.”
In addition to the findings related to symptomatic TEPS, the study also found a higher proportion of black individuals in the study had symptomatic TEPS compared with white participants. They also found an increased risk of progression to COPD in black participants as compared with white participants in this study. The authors suggest an evaluation of the contribution of occupational and environmental exposures, socioeconomic status and structural racism to the development of these symptoms.
Authors: In addition to Woodruff, additional UCSF authors include Mehrdad Arjomandi, MD, and Stephen Lazarus, MD. For other authors, please see the study.
Funding: The study was supported by the National Heart, Lung, and Blood Institute (grants U01 HL137880, U24 H141762, F32HL158222, 5K24LH137013). See the study for additional funders.
About UCSF Health: UCSF Health is recognized worldwide for its innovative patient care, reflecting the latest medical knowledge, advanced technologies and pioneering research. It includes the flagship UCSF Medical Center, which is a top-ranked specialty hospital, as well as UCSF Benioff Children’s Hospitals, with campuses in San Francisco and Oakland; Langley Porter Psychiatric Hospital and Clinics; UCSF Benioff Children’s Physicians; and the UCSF Faculty Practice. These hospitals serve as the academic medical center of the University of California, San Francisco, which is world-renowned for its graduate-level health sciences education and biomedical research. UCSF Health has affiliations with hospitals and health organizations throughout the Bay Area. Visit https://ucsfhealth.org. Follow UCSF Health on Facebook or on Twitter.
CVS Health study shows continuing suicide crisis in the U.S.
Awareness of the crisis is widespread, but most Americans lack strong knowledge of the warning signs
Despite national trends, Aetna, a CVS Health company, members have seen reductions in suicide-related events over the past year, compared to 2019 baselines
WOONSOCKET, R.I. /PRNewswire/ — A recent CVS Health® (NYSE: CVS)/Harris Poll survey of Americans 18 years and older found that nearly one in five (18%) U.S. adults say they were plagued with suicidal thoughts in the past year.
Other key findings from the survey include:
- More than a third of younger adults aged 18-34 (36%) say they had moments in the past year where they contemplated suicide.
- An overwhelming nine in ten (89%) U.S. adults deem suicide prevention efforts a major priority in our society.
- However, less than a third (32%) strongly agree they can recognize the warning signs of someone potentially at risk, and only four in ten (43%) are strongly aware of resources that offer support and information on suicide prevention.
- Nearly eight in ten (77%) U.S. adults believe health care providers have a crucial role in suicide prevention, and there is an opportunity for providers to have more discussions about suicide with patients.
“Our nation continues to face a mental health and suicide crisis, especially among youth and older adults,” said Cara McNulty, President of Behavioral Health and Mental Well-being at CVS Health. “However, with timely, evidence-based interventions, and public awareness efforts, we know suicide is preventable. We’ve developed an approach based on early detection, data-backed support methods, programs for those that have lost someone to suicide and community education to help those in need and empower their support systems. Every life saved is worth the effort.”
Growing reduction in Aetna members’ suicide attempts
As part of its ongoing commitment to mental health and well-being, CVS Health continues to focus on reducing suicide attempts among Aetna members.
- Despite the increasing national trends, Aetna has seen a 16% reduction in suicide attempts among Aetna adult Commercial members when compared with a 2019 baseline.
- Aetna member youth (13–17-year-olds) attempts remain above the 2019 baseline. However, since Aetna launched dedicated youth programming in 2021, attempts are trending downward with a 13% reduction when comparing 2022 with 2021.
- Aetna has seen a 13.7% reduction in suicide attempts among its Medicare Advantage members compared to 2019.
“Every suicide that is prevented is a life that is saved,” said Taft Parsons III, M.D., Vice President and Chief Psychiatric Officer at CVS Health. “We are working closely with our partners to implement targeted interventions for youth and develop similar programming for older adults. Together we can help raise awareness of the ongoing crisis and connect those in need to evidence-based resources that can help saves lives.”
CVS Health resources to prevent suicide
CVS Health has implemented several programs and partnerships to help address the suicide crisis focused on both individuals and health care providers.
Partnerships and programs to support Aetna members in need
- CVS Health launched a proactive outreach program for high-risk youth members. Clinical staff outreach those families to connect them with specialized services and resources.
- Aetna members have access to specialized outpatient programs, such as a suicide prevention program that combines digital solutions with telehealth sessions and specially trained, licensed clinicians.
- Through the Caring Contacts program, at-risk Aetna members receive simple messages of hope after being discharged from an intensive level of care related to suicide. More than 20,000 caring contacts or care bags are delivered annually.
- CVS Health continues to scale universal screenings and safety planning for all Aetna members, whether or not there is a clear suicide risk, in order to better take action if and when needed.
Partnerships and programs to support health care providers
- Aetna launched a free suicide prevention training, support and continuing education qualification program for contracted behavioral health and EAP providers. All therapists who provide counseling and other mental health services in MinuteClinics® in select CVS Pharmacy locations are certified in this program.
- Aetna works with SafeSide, an organization dedicated to mental health education, to train primary care physicians, medical practices and their staff in identification and early intervention for patients at risk of suicide.
- Aetna facilitates a program in which pediatricians are able to participate in the ECHO suicide prevention training opportunity from the American Foundation for Suicide Prevention and American Academy of Pediatrics.
CVS Health also offers a number of mental health guides, podcasts and trainings centered around different populations – from the LGBTQ+ community to young adults to parents and caregivers to teachers – and their unique mental health needs.
This survey was conducted online within the United States by The Harris Poll on behalf of CVS Health from August 3-7, 2023, among 2,016 U.S. adults age 18+ who agreed to answer questions about sensitive and personal information related to mental health, including topics surrounding suicide. The sampling precision of Harris online polls is measured by using a Bayesian credible interval. For this study, the sample data is accurate to within ±2.7 percentage points using a 95% confidence level. For complete research methods, including weighting variables, please contact [Doug Feingold ([email protected])].
About CVS Health
CVS Health® is the leading health solutions company, delivering care like no one else can. We reach more people and improve the health of communities across America through our local presence, digital channels and over 300,000 dedicated colleagues – including more than 40,000 physicians, pharmacists, nurses and nurse practitioners. Wherever and whenever people need us, we help them with their health – whether that’s managing chronic diseases, staying compliant with their medications or accessing affordable health and wellness services in the most convenient ways. We help people navigate the health care system – and their personal health care – by improving access, lowering costs and being a trusted partner for every meaningful moment of health. And we do it all with heart, each and every day. Follow @CVSHealth on social media.
Aetna, a CVS Health business, serves an estimated 34 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental and behavioral health plans, and medical management capabilities, Medicaid health care management services, workers’ compensation administrative services and health information technology products and services. Aetna’s customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups and expatriates. For more information, visit www.aetna.com and explore how Aetna is helping to build a healthier world.
SOURCE CVS Health
More than 100 Experiences at the 2023 Kroger Wellness Festival, September 22 & 23 in Downtown Cincinnati
Two-day health and wellness festival to feature panel discussions, food demonstrations, fitness classes and musical performances
CINCINNATI /PRNewswire/ — The Kroger Wellness Festival, presented by PepsiCo featuring Gatorade, celebrates physical, mental and emotional health for the whole family. This year’s festival will be held on September 22 and 23, from 11 a.m. to 7 p.m. at The Banks, in Downtown Cincinnati. The event will feature more than 100 experiences and food offerings focused on six core pillars of transformation: Balance, move, breathe, care, uplift and play.
The Kroger Wellness Festival will feature panel discussions, food demonstrations, fitness classes and musical performances, which will take place across six stages: Kenvue Stage, BODYARMOR Stage, Gatorade Stage, Campbell’s Food as Medicine Stage, American Greetings Stage and Saratoga Stage over two days.
More than 7,000 parking spots are available in and around The Banks. Learn more here.
Plan Ahead with the New Event App
Download the new Kroger Wellness Festival app to receive festival alerts, browse programing and explore a map. The free app is available in the iTunes store and Google Play.
The event runs along Second Street and Freedom Way from Joe Nuxhall Way to Elm Street at the Banks. Click here for the official event map.
Celebrity and Professional Athlete Appearances
Celebrities who will appear at the 2023 Kroger Wellness Festival include: WWE Champion and actor John Cena, actress Cameron Diaz, Food Network chef Amanda Freitag, Cincinnati Bengals legend Chad Johnson, TV host of “The Talk” Amanda Kloots, Super Bowl champions Eli and Peyton Manning, Peloton instructor Alex Toussaint and professional tennis player Venus Williams.
Two Free Concerts: Barenaked Ladies on Friday and Flo Rida on Saturday
On Friday from 5 p.m. to 6:30 p.m., the Barenaked Ladies, presented by General Mills, will perform on the BODYARMOR Stage. The Toronto band sold 15 million records worldwide and built up an arsenal of hits such as “If I Had $1000000,” “One Week,” “Pinch Me” and “The Big Bang Theory Theme.” The band is currently releasing new material from its forthcoming 18th studio album due out in September. On Saturday from 5 p.m. to 6:30 p.m., Flo Rida, presented by smartwater, will perform on the Kenvue Stage. Poised at the confluence of feel-good rap, pop and electronic, Flo Rida established himself as the party king of the late 2000s with global smash hits like the T-Pain-assisted “Low” and the massive club banger “Right Round” featuring Kesha. Known for his dynamic rapped/sung attack and larger-than-life personality, Flo Rida has been able to move freely between the rap and pop worlds with 100 million records sold world-wide.
Race to Vaccinate Racecar
On Friday and Saturday between 9 and 5 pm, Kroger’s Race to Vaccinate racecar will be on-site and our medical providers will be available to administer flu vaccines to people. People will need to provide their government issued identification and insurance cards to receive a vaccine.
2023 Kroger Wellness Festival Programming Highlights
Friday, September 22
11-11:30 a.m., Campbell’s Food as Medicine Stage
- Reds Hall of Fame Broadcaster Marty Brennaman and his wife, Amanda, will share comfort meal recipes from the original Campbell’s Cookbook and Laura’s Lean.
11:15-12 pm., American Greetings Stage
- Explore the shifting employer landscape and future of workforce with former bachelor-turned-entrepreneur Dylan Barbour.
12:15-12:45pm, Campbell’s Food as Medicine Stage
- Chef Christian Gill will lead two chefs in making Cincinnati recipes with a healthy, surprise twist during the Culinary Creator Challenge.
12:30-1:15 p.m., Gatorade Stage
- Venus Williams, seven-time Grand Slam Winner, entrepreneur and wellness leader, will lead a fireside chat on leadership and resilience, presented by PepsiCo.
1:15-2 p.m., Saratoga Stage
- Unplug and recharge with a digital detox with mindfulness expert Meriden McGraw.
1:30-2 p.m., BODYARMOR Stage
- Learn basketball fundamentals, mindset and competitive spirit from the Cincinnati Bearcats, led by former player Alex Meacham.
4:15-5 p.m., Kenvue Stage
- Amanda Kloots, “The Talk” television host, dancer, actress and fitness instructor, will lead an empowering HIIT workout.
Saturday, September 23:
11a.m.-12 p.m., BODYARMOR Stage
- Bengals legend Chad Johnson and FC Cincinnati player Michael Millay and team will lead a workout session, presented by BODYARMOR.
12:15 -1 p.m., Saratoga Stage
- Internationally recognized barber Vernon Jackson and little-person super-athlete Allison Warrell and others share powerful stories of peak performers who defy the odds.
12:15-1 p.m., Campbell’s Food as Medicine Stage
- Actor, author and entrepreneur Cameron Diaz will share her favorite organic recipes that support longevity and healthy aging.
12:45-1:15 p.m., BODYARMOR Stage
- Cincinnati and Northern Kentucky’s favorite mascots, including the Krojis, will join a Tik Tok dance routine led by Jess Evans from Dance Factory Fitness and KISS 107’s Jon Jon.
1:15-2 p.m., Gatorade Stage
- 16-time World Champion, New York Times best-selling author and record-setting Make-A-Wish granter John Cena will host a fierce workout led by Cornerstone Fitness.
1:45-2:15 p.m., Campbell’s Food as Medicine Stage
- Food Network Chef Amanda Freitag will explore plant-based meals during this cooking demonstration, presented by Blue Diamond Almond Flour.
2:30-3:30 p.m., Kenvue Stage
- Bartender Molly Wellmann will lead a demonstration and tasting of a spectrum of tequila spirits with (21+- ID required.)
2:45-3:30 p.m., BODYARMOR Stage
- Drew and Lea Lachey will present label•less, their musical that focuses on the issues that affect our society with inspiring musical performances.
3-3:45 p.m., Campbell’s Food as Medicine Stage
- Former NFL great Chad Johnson and Chris Marschall of Sans Bar will discuss the health benefits associated with alcohol abstinence and the importance of living a fully present life.
4-4:45 p.m., Gatorade Stage
- NFL Super Bowl champions Eli and Peyton Manning will be joined on-stage by special guests, unveiling their secrets to achieving peak performance on and off the field, presented by Gatorade.
4:15-5 p.m., American Greetings Stage
- Matt Summers, Bengals director of Sports Medicine, and NFL Hall of Famer Anthony Muñoz will discuss how to fuel your sports performance.
For more information, visit the Kroger Wellness Festival website.
About Kroger Health:
Kroger Health, the healthcare division of The Kroger Co., is one of America’s leading retail healthcare organizations, with over 2,200 pharmacies and 220 clinics in 35 states serving more than 17 million customers. Our team of 24,000 healthcare practitioners – from pharmacists and nurse practitioners to dietitians and technicians – are committed to helping people live healthier lives. We believe in practicing at the top of our licenses and enabling “Food as Medicine” to help prevent or manage certain diseases. We are dedicated to providing testing and wellness services to help Americans combat the COVID-19 crisis. For more information, visit https://www.krogerhealth.com.
About The Kroger Co.:
At The Kroger Co. (NYSE: KR), we are Fresh for Everyone™ and dedicated to our Purpose: To Feed the Human Spirit®. We are, across our family of companies, nearly half a million associates who serve over 11 million customers daily through a seamless shopping experience under a variety of banner names. We are committed to creating #ZeroHungerZeroWaste communities by 2025.
PepsiCo products are enjoyed by consumers more than one billion times a day in more than 200 countries and territories around the world. PepsiCo generated more than $79 billion in net revenue in 2021, driven by a complementary beverage and convenient foods portfolio that includes Lay’s, Doritos, Cheetos, Gatorade, Pepsi-Cola, Mountain Dew, Quaker, and SodaStream. PepsiCo’s product portfolio includes a wide range of enjoyable foods and beverages, including many iconic brands that generate more than $1 billion each in estimated annual retail sales.
Guiding PepsiCo is our vision to Be the Global Leader in Beverages and Convenient Foods by Winning with PepsiCo Positive (pep+). pep+ is our strategic end-to-end transformation that puts sustainability and human capital at the center of how we will create value and growth by operating within planetary boundaries and inspiring positive change for planet and people. For more information, visit www.pepsico.com.
SOURCE The Kroger Co.
3 pasos hacia un corazón más sano
(Family Features) Cuidar el corazón es fundamental para la salud en general, aunque todos los aspectos de la salud son importantes. Las enfermedades cardíacas son la principal causa de muerte entre los estadounidenses, pero no tiene por qué serlo: las elecciones de estilo de vida desempeñan un papel importante para la salud del corazón y nunca es demasiado pronto para adoptar hábitos saludables.
Considere estos sencillos pasos: desde hacer ejercicio y dormir lo suficiente hasta comer saludable, incluyendo refrigerios buenos para el corazón como las uvas.
Adoptar una dieta equilibrada y nutritiva, rica en frutas, verduras, cereales integrales, proteínas magras y grasas saludables puede tener un impacto en la salud del corazón. Una forma de reducir el riesgo de sufrir enfermedades cardíacas es consumir alimentos bajos en grasas saturadas y colesterol, como las uvas.
Como alimento fácil, conveniente y saludable para el corazón, las uvas son el ingrediente perfecto para un plan de alimentación saludable que incluye recetas como ensalada de uvas, brócoli y aguacate con cobertura de avena tostada. La sabrosa ensalada de brócoli se combina perfectamente con la dulce frescura de las jugosas uvas de California, mientras que la cobertura de avena tostada aporta un toque crujiente.
Las uvas son bajas en sodio y una buena fuente de vitamina K, que promueve la salud del corazón, y contienen el 7% de la ingesta diaria recomendada de potasio, un nutriente fundamental para la salud del corazón. Las uvas son una fuente natural de antioxidantes beneficiosos y otros polifenoles y ayudan a mantener una circulación saludable al promover la relajación de los vasos sanguíneos.
De hecho, según un estudio publicado en el “Journal of Nutrition”, (Diario de la nutrición) los hombres con síndrome metabólico que consumían 1 1/2 tazas de uvas al día mostraron una presión arterial más baja, una mejor función de los vasos sanguíneos y una disminución en un marcador clave de inflamación.
Las mujeres que consumieron 1 1/4 tazas de uvas todos los días como parte de un estudio separado publicado en el “Journal of Nutrition” se beneficiaron y mostraron una reducción en los niveles de triglicéridos en la sangre, los niveles de colesterol LDL, las proteínas inflamatorias y otros marcadores de enfermedades cardíacas.
El sueño también es fundamental para tener un corazón sano. La mayoría de los expertos recomiendan que los adultos duerman entre 7 a 9 horas por noche. Para ayudar a lograr ese objetivo, crea una rutina a la hora de acostarse despertándose y durmiendo a las mismas horas. También asegúrese de tener un espacio cómodo para dormir apagando los dispositivos electrónicos y ajustando el termostato a una temperatura agradable.
Mantener una rutina de ejercicio de forma regular es bueno para la salud en general. Puede ser especialmente beneficioso para la salud del corazón al reducir la presión arterial, reducir la inflamación y ayudar a mantener un peso saludable. La Asociación Americana del Corazón recomienda al menos 150 minutos por semana de actividad aeróbica de intensidad moderada o 75 minutos de actividad aeróbica vigorosa. Impulse su entrenamiento y recuperación con alimentos hidratantes y saludables para el corazón, como las uvas.
Encuentre más recetas saludables para el corazón en GrapesFromCalifornia.com.
Ensalada de uvas, brócoli y aguacate con cobertura de avena tostada
Tiempo de preparación: 30 minutos
Tiempo de cocción: 5 minutos
Cobertura de avena tostada:
- 1/2 cucharada de mantequilla
- 1/3 taza de almendras fileteadas, picadas en trozos grandes
- 3 cucharadas de avena de grano entero cortada
- 1/8 cucharadita de sal sazonada
- 1/4 cucharadita de condimento de hierbas italiano
- 6 cucharadas de aceite de oliva extra virgen
- 1/3 taza de uvas rojas o verdes de California en cuartos
- 1/4 taza de vinagre de vino
- 1 cucharada de miel de abeja
- 1/4 cucharadita de sal marina
- pimienta recién molida, al gusto
- 1 bolsa (12 onzas) de ensalada de brócoli finamente picado
- 2 tazas de col rizada desmenuzada, ligeramente compactada
- 1 1/2 tazas de uvas de California partidas a la mitad
- 1/2 taza de cebolla morada finamente picada
- 1/3 taza de higos secos picados
- pimienta recién molida, al gusto
- 1 aguacate grande, firme pero maduro, cortado en cubos
- Para hacer cobertura de avena tostada: En una sartén mediana a fuego medio-bajo, cocine la mantequilla, las almendras, la avena, la sal y el condimento de hierbas italianas por unos 5 minutos, o hasta que estén ligeramente tostados y fragantes, revolviendo con frecuencia.
- Para hacer el aderezo: En una licuadora pequeña, haga puré el aceite de oliva, las uvas, el vinagre de vino, la miel, la sal marina y la pimienta al gusto, hasta que quede de consistencia suave.
- Para hacer la ensalada: En un tazón grande, mezcle la ensalada de brócoli, la col rizada, las uvas, la cebolla morada y los higos; sazone con pimienta al gusto y rocíe con el aderezo; revuelva bien para cubrir. Agregue el aguacate y revuelva ligeramente. Transfiera a seis platos o tazones para servir y espolvoree con cobertura de avena tostada.
Información nutricional por porción: 320 calorías; 5 g de proteína; 29 g de carbohidratos; 22 g de grasa (62% de calorías de grasa); 3.5 g de grasa saturada (10% de calorías de grasa saturada); 5 mg de colesterol; 160 mg de sodio; 7 g de fibra.
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