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[PMID]:28694829
[Au] Autor:Duzkoylu Y; Basceken SI; Kesilmez EC
[Ad] Endereço:General Surgery Department, Islahiye State Hospital, Gaziantep, Turkey.
[Ti] Título:Physical Trauma among Refugees: Comparison between Refugees and Local Population Who Were Admitted to Emergency Department-Experience of a State Hospital in Syrian Border District.
[So] Source:J Environ Public Health;2017:8626275, 2017.
[Is] ISSN:1687-9813
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Hundreds of thousands of people have fled to Turkey since the civil war started in Syria in 2011. Refugees and local residents have been facing various challenges such as sociocultural and economic ones and access to health services. Trauma exposure is one of the most important and underestimated health problems of refugees settling in camps. AIMS: We aimed to evaluate refugee admissions to emergency department because of trauma in means of demographics of patients and mechanism of trauma and compare the results with the local population. METHODS: Retrospective evaluation of results and comparison with the results of local population. RESULTS: We determined that the ratio of emergency admission of refugee patients because of trauma was significantly higher than the local population for most types of trauma. CONCLUSION: Further studies with more refugee participants are needed to fully understand the underlying reasons for this high ratio to protect refugees as well as for planning to take caution to attenuate the burden on healthcare systems.
[Mh] Termos MeSH primário: Serviço Hospitalar de Emergência/estatística & dados numéricos
Refugiados/estatística & dados numéricos
Ferimentos e Lesões/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Serviço Hospitalar de Emergência/utilização
Feminino
Hospitais Estaduais/estatística & dados numéricos
Hospitais Estaduais/utilização
Seres Humanos
Masculino
Prevalência
Estudos Retrospectivos
Síria/epidemiologia
Turquia/epidemiologia
Ferimentos e Lesões/etiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171108
[Lr] Data última revisão:
171108
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170712
[St] Status:MEDLINE
[do] DOI:10.1155/2017/8626275


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[PMID]:28008094
[Au] Autor:Man S; Cox M; Patel P; Smith EE; Reeves MJ; Saver JL; Bhatt DL; Xian Y; Schwamm LH; Fonarow GC
[Ad] Endereço:From Department of Neurology, Miami Valley Hospital, Wright State University Boonshoft School of Medicine, Dayton, OH (S.M.); the Duke Clinical Research Center, Durham, NC (M.C., Y.X.); Department of Advocacy and Quality, American Heart Association, Dallas, TX (P.P.); Department of Clinical Neurosci
[Ti] Título:Differences in Acute Ischemic Stroke Quality of Care and Outcomes by Primary Stroke Center Certification Organization.
[So] Source:Stroke;48(2):412-419, 2017 Feb.
[Is] ISSN:1524-4628
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND PURPOSE: Primary stroke center (PSC) certification was established to identify hospitals providing evidence-based care for stroke patients. The numbers of PSCs certified by Joint Commission (JC), Healthcare Facilities Accreditation Program, Det Norske Veritas, and State-based agencies have significantly increased in the past decade. This study aimed to evaluate whether PSCs certified by different organizations have similar quality of care and in-hospital outcomes. METHODS: The study population consisted of acute ischemic stroke patients who were admitted to PSCs participating in Get With The Guidelines-Stroke between January 1, 2010, and December 31, 2012. Measures of care quality and outcomes were compared among the 4 different PSC certifications. RESULTS: A total of 477 297 acute ischemic stroke admissions were identified from 977 certified PSCs (73.8% JC, 3.7% Det Norske Veritas, 1.2% Healthcare Facilities Accreditation Program, and 21.3% State-based). Composite care quality was generally similar among the 4 groups of hospitals, although State-based PSCs underperformed JC PSCs in a few key measures, including intravenous tissue-type plasminogen activator use. The rates of tissue-type plasminogen activator use were higher in JC and Det Norske Veritas (9.0% and 9.8%) and lower in State and Healthcare Facilities Accreditation Program certified hospitals (7.1% and 5.9%) (P<0.0001). Door-to-needle times were significantly longer in Healthcare Facilities Accreditation Program hospitals. State PSCs had higher in-hospital risk-adjusted mortality (odds ratio 1.23, 95% confidence intervals 1.07-1.41) compared with JC PSCs. CONCLUSIONS: Among Get With The Guidelines-Stroke hospitals with PSC certification, acute ischemic stroke quality of care and outcomes may differ according to which organization provided certification. These findings may have important implications for further improving systems of care.
[Mh] Termos MeSH primário: Isquemia Encefálica/terapia
Certificação/normas
Hospitais Estaduais/normas
Qualidade da Assistência à Saúde/normas
Acidente Vascular Cerebral/terapia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Isquemia Encefálica/diagnóstico
Isquemia Encefálica/epidemiologia
Feminino
Seres Humanos
Masculino
Meia-Idade
Estudos Prospectivos
Estudos Retrospectivos
Acidente Vascular Cerebral/diagnóstico
Acidente Vascular Cerebral/epidemiologia
Ativador de Plasminogênio Tecidual/administração & dosagem
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
EC 3.4.21.68 (Tissue Plasminogen Activator)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170512
[Lr] Data última revisão:
170512
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161224
[St] Status:MEDLINE
[do] DOI:10.1161/STROKEAHA.116.014426


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[PMID]:27634450
[Au] Autor:O'Neil ML
[Ad] Endereço:Gender and Women's Studies Research Center, Kadir Has University, Kadir Has Caddesi, Cibali, 34083 Istanbul, Turkey. Electronic address: mloneil@khas.edu.tr.
[Ti] Título:The availability of abortion at state hospitals in Turkey: A national study.
[So] Source:Contraception;95(2):148-153, 2017 Feb.
[Is] ISSN:1879-0518
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Abortion in Turkey has been legal since 1983 and remains so today. Despite this, in 2012 the Prime Minister declared that, in his opinion, abortion was murder. Since then, there has been growing evidence that abortion access particularly in state hospitals is being restricted, although no new legislation has been offered. OBJECTIVES: The study aimed to determine the number of state hospitals in Turkey that provide abortions. STUDY DESIGN: The study employed a telephone survey in 2015-2016 where 431 state hospitals were contacted and asked a set of questions by a mystery patient. If possible, information was obtained directly from the obstetrics/gynecology department. I removed specialist hospitals from the data set and the remaining data were analyzed for frequency and cross-tabulations were performed. RESULTS: Only 7.8% of state hospitals provide abortion services without regard to reason which is provided for by the current law, while 78% provide abortions when there is a medical necessity. Of the 58 teaching and research hospitals in Turkey, 9 (15.5%) provide abortion care without restriction to reason, 38 (65.5%) will do the procedure if there is a medical necessity and 11 (11.4%) of these hospitals refuse to provide abortion services under any circumstances. There are two regions, encompassing 1.5 million women of childbearing age, where no state hospital provides for abortion without restriction as to reason. CONCLUSION: The vast majority of state hospitals only provide abortions in the narrow context of a medical necessity, and thus are not implementing the law to its full extent. It is clear that although no new legislation restricting abortion has been enacted, state hospitals are reducing the provision of abortion services without restriction as to reason. IMPLICATIONS: This is the only nationwide study to focus on abortion provision at state hospitals.
[Mh] Termos MeSH primário: Aborto Induzido/legislação & jurisprudência
Aborto Induzido/estatística & dados numéricos
Aborto Legal/legislação & jurisprudência
Aborto Legal/estatística & dados numéricos
[Mh] Termos MeSH secundário: Feminino
Pesquisas sobre Serviços de Saúde
Acesso aos Serviços de Saúde/estatística & dados numéricos
Hospitais/estatística & dados numéricos
Hospitais Estaduais/estatística & dados numéricos
Hospitais de Ensino/estatística & dados numéricos
Seres Humanos
Gravidez
Telefone
Turquia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170928
[Lr] Data última revisão:
170928
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160917
[St] Status:MEDLINE


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[PMID]:27732825
[Au] Autor:Montross C
[Ad] Endereço:From the Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI.
[Ti] Título:Hard Time or Hospital Treatment? Mental Illness and the Criminal Justice System.
[So] Source:N Engl J Med;375(15):1407-1409, 2016 Oct 13.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Hospitais Psiquiátricos
Hospitais Estaduais
Transtornos Mentais/terapia
Serviços de Saúde Mental
Prisões
[Mh] Termos MeSH secundário: Direito Penal
Seres Humanos
Masculino
Serviços de Saúde Mental/provisão & distribuição
Transtornos Paranoides
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1701
[Cu] Atualização por classe:170127
[Lr] Data última revisão:
170127
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:161013
[St] Status:MEDLINE


  5 / 1703 MEDLINE  
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[PMID]:27427840
[Au] Autor:Ortiz G; Hollen V; Schacht L
[Ad] Endereço:ORTIZ, HOLLEN, and SCHACHT: National Association of State Mental Health Program Directors Research Institute Inc. (NRI), Falls Church, VA.
[Ti] Título:Antipsychotic Medication Prescribing Practices Among Adult Patients Discharged From State Psychiatric Inpatient Hospitals.
[So] Source:J Psychiatr Pract;22(4):283-97, 2016 Jul.
[Is] ISSN:1538-1145
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: The goal of this study was to explore antipsychotic medication prescribing practices in a sample of 86,034 patients discharged from state psychiatric inpatient hospitals and to find the prevalence of patients discharged with no antipsychotic medications, on antipsychotic monotherapy, and on antipsychotic polypharmacy. For patients discharged on antipsychotic polypharmacy, the study explored the adjusted rates of antipsychotic polypharmacy, the reasons patients were discharged on antipsychotic polypharmacy, the proportion of antipsychotic polypharmacy by mental health disorder, and the characteristics associated with being discharged on antipsychotic polypharmacy. METHODS: This cross-sectional study analyzed all discharges for adult patients (18 to 64 y of age) from state psychiatric inpatient hospitals between January 1 and December 31, 2011. The relationship among variables was explored using χ, t test, and analysis of variance. Logistic regression was used to determine predictors of antipsychotic polypharmacy. RESULTS: The prevalence of antipsychotic polypharmacy was 12%. Of the discharged patients receiving at least 1 antipsychotic medication (adjusted rate), 18% were on antipsychotic polypharmacy. The strongest predictors of antipsychotic polypharmacy being prescribed were having a diagnosis of schizophrenia and a length of stay of 90 days or more. Patients were prescribed antipsychotic polypharmacy primarily to reduce their symptoms. CONCLUSIONS: Antipsychotic polypharmacy continues at a high enough rate to affect nearly 10,000 patients with a diagnosis of schizophrenia each year in state psychiatric inpatient hospitals. Further analysis of the clinical presentation of these patients may highlight particular aspects of the illness and its previous treatment that are contributing to practices outside the best-practice guideline. An increased understanding of trend data, patient characteristics, and national benchmarks provides an opportunity for decision-making that is sensitive to the patient's needs and cognizant of the hospital's accomplishments in adopting best practices.
[Mh] Termos MeSH primário: Antipsicóticos/uso terapêutico
Prescrições de Medicamentos/estatística & dados numéricos
Hospitais Psiquiátricos/estatística & dados numéricos
Hospitais Estaduais/estatística & dados numéricos
Transtornos Mentais/tratamento farmacológico
Alta do Paciente/estatística & dados numéricos
Polimedicação
[Mh] Termos MeSH secundário: Adulto
Estudos Transversais
Feminino
Seres Humanos
Masculino
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antipsychotic Agents)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170922
[Lr] Data última revisão:
170922
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160719
[St] Status:MEDLINE
[do] DOI:10.1097/PRA.0000000000000163


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[PMID]:27333648
[Au] Autor:Darzi A
[Ti] Título:ON PEER REVIEW. Powerful lessons from the nuclear industry.
[So] Source:Health Serv J;126(6481):16-7, 2016 Apr 06.
[Is] ISSN:0952-2271
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Revisão por Pares
Gestão da Segurança
Transferência de Tecnologia
[Mh] Termos MeSH secundário: Hospitais Estaduais
Centrais Nucleares
Medicina Estatal
Reino Unido
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1607
[Cu] Atualização por classe:161126
[Lr] Data última revisão:
161126
[Sb] Subgrupo de revista:H
[Da] Data de entrada para processamento:160624
[St] Status:MEDLINE


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[PMID]:27255912
[Au] Autor:Sevinç S; Ajghif M; Uzun Ö; Gülbil U
[Ad] Endereço:Nursing Department, School of Health, Kilis 7 Aralik University, Kilis, Turkey.
[Ti] Título:Expectations of relatives of Syrian patients in intensive care units in a state hospital in Turkey.
[So] Source:J Clin Nurs;25(15-16):2232-41, 2016 Aug.
[Is] ISSN:1365-2702
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIMS AND OBJECTIVES: The purpose of the study was to describe the personal experiences of relatives of Syrian patients in the intensive care unit in one hospital in Turkey. BACKGROUND: The concept of the intensive care unit can be particularly frightening for family members. Current recommendations for training Intensive care unit nurses should support a holistic approach to patient (and family) care, including explanations at a level that families can easily understand and allowing family members to see the patient at regular intervals. DESIGN: This qualitative study was conducted between June and August 2014 and included a study sample of 30 Syrian family members related to patients receiving treatment at a state hospital intensive care unit in Turkey. METHODS: Data were collected by semi-structured interviews. We used percentages to represent descriptive data and conducted qualitative content analysis. RESULTS: Following data analysis, six themes arose: (1) communication-related difficulties, (2) difficulties receiving information regarding the patient's condition, (3) difficulties meeting personal needs, (4) difficulties communicating with other family members, (5) difficulties receiving support from other family members, and (6) unmet expectations from nurses and hospital administration. CONCLUSIONS: Syrian patient's relatives receiving treatment in an intensive care unit in Turkey experienced communication difficulties in terms of receiving information from health care personnel, informing other family members, receiving social support from other family members, and having various unmet expectations from nurses and hospital administration. RELEVANCE TO CLINICAL PRACTICE: The results of this study can be used to develop guidelines and predictions for scenarios that are likely to arise for patients' relatives from foreign countries who arrive to support patients who receive healthcare services in our increasingly global world.
[Mh] Termos MeSH primário: Família/psicologia
Hospitais Estaduais
Unidades de Terapia Intensiva
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Criança
Comunicação
Feminino
Seres Humanos
Masculino
Meia-Idade
Relações Profissional-Família
Pesquisa Qualitativa
Apoio Social
Síria
Turquia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170221
[Lr] Data última revisão:
170221
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:160604
[St] Status:MEDLINE
[do] DOI:10.1111/jocn.13254


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[PMID]:27193986
[Au] Autor:Özen Ö; Kiyan S
[Ad] Endereço:Department of Emergency Medicine, Ege University Faculty of Medicine Hospital, Izmir-Turkey.
[Ti] Título:Views of emergency physicians working in university and state hospitals in Turkey regarding the use of analgesics in patients with acute abdominal pain.
[So] Source:Ulus Travma Acil Cerrahi Derg;22(2):175-83, 2016 Mar.
[Is] ISSN:1306-696X
[Cp] País de publicação:Turkey
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Use of narcotic analgesics in patients with acute abdominal pain does not cause delayed misdiagnosis, increases patient comfort and does not suppresses physical examination. The purpose of this study was to determine attitudes anddaily practices of emergency medicine (EM) specialists, residents and faculty members in Turkey on the use of analgesics in patients with acute abdominal pain and factors affecting their decisions on the use of analgesics. METHODS: A cross-sectional study was performed between November 15, 2013 and January 25, 2014 by conducting a questionnaire to EM physicians working in University Hospitals, Education and Research Hospitals of the Ministry of Health, State Hospitals, and Private Hospitals in Turkey. RESULTS: A total of 803 questionnaires (participation rate: 47%) were completed. 59.3% (n=470) of the participants were research assistants. 49.5% of the participants reported that analgesic drugs "suppressed'' physical examination findings. They stated that 90% of the patients "always'' and "often'' requested analgesics and that 34.6% of surgery consultant physicians "rarely" recommended the use of analgesics, while 28.7% "never" recommended, and that there was no common policy established together with surgical departments (79.1%). According to the comparison between the EM specialists and residents, residents in the group stating that they would "never'' use analgesics were higher than specialists in number (p=0.002); residents reported that they administered analgesics "upon surgical intervention decision", while specialists reported that they administered analgesics "after patient's examination and treatment plan" (p=0.021); residents reported that analgesics "suppressed'' physical examination findings, while specialists reported that analgesics "clarified'' physical examination findings (p<0.0001); residents reported that they did not administer analgesics "before examination by surgeon'', while specialists reported otherwise (p=0.0001). Senior residents (>24 months) reported that they administered analgesics "often'' compared to junior residents (p=0.034) and that junior residents believed that the use of analgesics would "suppress physical examination findings'' at a higher percentage (p=0.002). CONCLUSION: The rates of use of analgesics in patients with acute abdominal pain by EM physicians are very low. The rates of use of analgesics by EM residents are much lower compared to EM specialists, and they highly believe that analgesic drugs suppress physical examination findings. Residents tend to administer analgesic drugs at a later stage. As seniority of residents increases, the rate of analgesics use and the opinion that analgesic drugs have no effect on physical examination findings increases.
[Mh] Termos MeSH primário: Dor Abdominal/tratamento farmacológico
Analgésicos/provisão & distribuição
Atitude do Pessoal de Saúde
Padrões de Prática Médica
[Mh] Termos MeSH secundário: Adulto
Estudos Transversais
Medicina de Emergência
Feminino
Hospitais Estaduais
Hospitais Universitários
Seres Humanos
Masculino
Inquéritos e Questionários
Turquia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics)
[Em] Mês de entrada:1612
[Cu] Atualização por classe:161230
[Lr] Data última revisão:
161230
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160520
[St] Status:MEDLINE
[do] DOI:10.5505/tjtes.2015.06706


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[PMID]:27044408
[Au] Autor:Allen N; Knowles A; Patterson D; Ross S; Samuels A; Battaglia J; Weiss A; Abrams M
[Ad] Endereço:Albert Einstein College of Medicine, Bronx, NY, USA. nicolecallen@gmail.com.
[Ti] Título:Transforming Frustration into Possibility: A Model for Understanding and Navigating Complex Systems in a Changing Landscape.
[So] Source:Acad Psychiatry;40(6):887-892, 2016 Dec.
[Is] ISSN:1545-7230
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Currículo/normas
Psiquiatria/educação
Análise de Sistemas
[Mh] Termos MeSH secundário: Ética Médica
Relações Familiares
Psiquiatria Legal
Frustração
Recursos em Saúde
Hospitais Psiquiátricos
Hospitais Estaduais
Seres Humanos
Transferência de Pacientes
Papel do Médico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1701
[Cu] Atualização por classe:170123
[Lr] Data última revisão:
170123
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160406
[St] Status:MEDLINE


  10 / 1703 MEDLINE  
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[PMID]:26695498
[Au] Autor:Chien J; Novosad D; Mobbs KE
[Ad] Endereço:Dr. Chien is with the Department of Psychiatry, Oregon State Hospital, Salem (e-mail: jocn16@gmail.com ). Dr. Novosad is with the Department of Psychiatry, Atlanta Veterans Affairs Medical Center, Atlanta, Georgia. Dr. Mobbs is with the Department of Psychiatry, Oregon Health and Science University, Portland. Lisa B. Dixon, M.D., M.P.H., and Brian Hepburn, M.D., are editors of this column.
[Ti] Título:The Oregon Health and Science University-Oregon State Hospital Collaboration: Reflections on an Evolving Public-Academic Partnership.
[So] Source:Psychiatr Serv;67(3):262-4, 2016 Mar.
[Is] ISSN:1557-9700
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:This column describes the conceptualization and implementation of an innovative collaboration between Oregon State Hospital and Oregon Health and Science University that was created to address understaffing and improve the quality of care. The hospital created a forensic evaluation rotation to address the growing population of forensic patients, which created a valuable recruiting tool for the hospital. One of the authors, a recent recruit, provides a first-person account of his experience working within the collaboration. The model could be emulated by other public-sector facilities facing similar challenges with psychiatrist recruitment and retention.
[Mh] Termos MeSH primário: Comportamento Cooperativo
Hospitais Estaduais/organização & administração
Psiquiatria/educação
Universidades/organização & administração
[Mh] Termos MeSH secundário: Hospitais Estaduais/recursos humanos
Seres Humanos
Modelos Organizacionais
Oregon
Seleção de Pessoal
Psiquiatria/recursos humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1612
[Cu] Atualização por classe:161230
[Lr] Data última revisão:
161230
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:151224
[St] Status:MEDLINE
[do] DOI:10.1176/appi.ps.201500467



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