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  1 / 1515 MEDLINE  
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[PMID]:27771524
[Au] Autor:Panda S; Kumar MS
[Ad] Endereço:National Institute of Cholera & Enteric Diseases (Indian Council of Medical Research), P-33 CIT Road, Scheme-XM, Beliaghata, Kolkata 700010, West Bengal, India.
[Ti] Título:Injecting drug use in India and the need for policy and program change.
[So] Source:Int J Drug Policy;37:115-116, 2016 11.
[Is] ISSN:1873-4758
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Mh] Termos MeSH primário: Legislação de Medicamentos/tendências
Abuso de Substâncias por Via Intravenosa/epidemiologia
[Mh] Termos MeSH secundário: Adulto
Idade de Início
Analgésicos Opioides
Usuários de Drogas
Feminino
Infecções por HIV/epidemiologia
Infecções por HIV/etiologia
Infecções por HIV/prevenção & controle
Redução do Dano
Hepatite C/epidemiologia
Hepatite C/etiologia
Hepatite C/prevenção & controle
Seres Humanos
Índia/epidemiologia
Masculino
Uso Comum de Agulhas e Seringas
Programas de Troca de Agulhas
Abuso de Substâncias por Via Intravenosa/complicações
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics, Opioid)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE


  2 / 1515 MEDLINE  
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[PMID]:29253386
[Au] Autor:Uyei J; Fiellin DA; Buchelli M; Rodriguez-Santana R; Braithwaite RS
[Ad] Endereço:Department of Population Health, New York University School of Medicine, New York, NY, USA. Electronic address: jennifer.uyei@nyumc.org.
[Ti] Título:Effects of naloxone distribution alone or in combination with addiction treatment with or without pre-exposure prophylaxis for HIV prevention in people who inject drugs: a cost-effectiveness modelling study.
[So] Source:Lancet Public Health;2(3):e133-e140, 2017 Mar.
[Is] ISSN:2468-2667
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: In the USA, an epidemic of opioid overdose deaths is occurring, many of which are from heroin. Combining naloxone distribution with linkage to addiction treatment or pre-exposure prophylaxis (PrEP) for HIV prevention through syringe service programmes has the potential to save lives and be cost-effective. We estimated the outcomes and cost-effectiveness of five alternative strategies: no additional intervention, naloxone distribution, naloxone distribution plus linkage to addiction treatment, naloxone distribution plus PrEP, and naloxone distribution plus linkage to addiction treatment and PrEP. METHODS: We developed a decision analytical Markov model to simulate opioid overdose, HIV incidence, overdose-related deaths, and HIV-related deaths in people who inject drugs in Connecticut, USA. Model input parameters were derived from published sources. We compared each strategy with no intervention, as well as simultaneously considering all strategies. Sensitivity analysis was done for all variables. Linkage to addiction treatment was referral to an opioid treatment programme for methadone. Endpoints were survival, life expectancy, quality-adjusted life-years (QALYs), number and percentage of overdose deaths averted, number of HIV-related deaths averted, total costs (in 2015 US$) associated with each strategy, and incremental cost per QALY gained. FINDINGS: In the base-case analysis, compared with no additional intervention, the naloxone distribution strategy yielded an incremental cost-effectiveness ratio (ICER) of $323 per QALY, and naloxone distribution plus linkage to addiction treatment was cost saving compared with no additional intervention (greater effectiveness and less expensive). The most efficient strategies (ie, those conferring the greatest health benefit for a particular budget) were naloxone distribution combined with linkage to addiction treatment (cost saving), and naloxone distribution combined with PrEP and linkage to addiction treatment (ICER $95 337 per QALY) at a willingness-to-pay threshold of $100 000. In probabilistic sensitivity analysis, the combination of naloxone distribution, PrEP, and linkage to addiction treatment was the optimal strategy in 37% of iterations and the combination of naloxone distribution and linkage to addiction treatment was the optimal strategy in 34% of iterations. INTERPRETATION: Naloxone distribution through syringe service programmes is cost-effective compared with syringe distribution alone, but when combined with linkage to addiction treatment is cost saving compared with no additional services. A strategy that combines naloxone distribution, PrEP, and linkage to addiction treatment results in greater health benefits in people who inject drugs and is also cost-effective. FUNDING: State of Connecticut Department of Public Health and the National Institute of Mental Health.
[Mh] Termos MeSH primário: Infecções por HIV/prevenção & controle
Naloxona/provisão & distribuição
Profilaxia Pré-Exposição/utilização
Abuso de Substâncias por Via Intravenosa/terapia
[Mh] Termos MeSH secundário: Connecticut
Análise Custo-Benefício
Seres Humanos
Modelos Teóricos
Naloxona/economia
Programas de Troca de Agulhas/economia
Profilaxia Pré-Exposição/economia
Avaliação de Programas e Projetos de Saúde
Abuso de Substâncias por Via Intravenosa/economia
Resultado do Tratamento
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Nm] Nome de substância:
36B82AMQ7N (Naloxone)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180214
[Lr] Data última revisão:
180214
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171219
[St] Status:MEDLINE


  3 / 1515 MEDLINE  
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[PMID]:28456473
[Au] Autor:Deren S; Naegle M; Hagan H; Ompad DC
[Ti] Título:Continuing Links Between Substance Use and HIV Highlight the Importance of Nursing Roles.
[So] Source:J Assoc Nurses AIDS Care;28(4):622-632, 2017 Jul - Aug.
[Is] ISSN:1552-6917
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Links between HIV and substance use were identified early in the U.S. HIV epidemic. People who use drugs are at risk of HIV infection through shared injection equipment and risky sexual behaviors. In addition, substance use has negative health consequences for people living with HIV. The prescription opioid misuse epidemic, linked to injection drug use, hepatitis C infection, and HIV, poses a new threat to declining HIV rates. We reviewed evidence-based interventions that decrease HIV risk in people who use drugs (needle/syringe programs, medication-assisted treatment, engagement in HIV care, and preexposure prophylaxis/postexposure prophylaxis). The critical roles of nurses in HIV prevention/care for this population are described, including applying the principles of harm reduction, screening for substance use, and undertaking implementation and research efforts. As the nation's largest health care profession, nurses are positioned to contribute to the quality of HIV-related prevention/care for people who use drugs and to lead practice initiatives.
[Mh] Termos MeSH primário: Medicina Baseada em Evidências
Infecções por HIV/prevenção & controle
Uso Comum de Agulhas e Seringas/efeitos adversos
Papel do Profissional de Enfermagem
Transtornos Relacionados ao Uso de Opioides/psicologia
Abuso de Substâncias por Via Intravenosa/psicologia
[Mh] Termos MeSH secundário: Adulto
Redução do Dano
Seres Humanos
Programas de Troca de Agulhas
Uso Indevido de Medicamentos sob Prescrição
Assunção de Riscos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171214
[Lr] Data última revisão:
171214
[Sb] Subgrupo de revista:IM; N; X
[Da] Data de entrada para processamento:170501
[St] Status:MEDLINE


  4 / 1515 MEDLINE  
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[PMID]:28644276
[Au] Autor:Potera C
[Ad] Endereço:Carol Potera.
[Ti] Título:An Innovative Syringe Exchange Program.
[So] Source:Am J Nurs;117(7):17, 2017 Jul.
[Is] ISSN:1538-7488
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Nevada's pilot vending machine program encourages users to enter treatment programs.
[Mh] Termos MeSH primário: Automação/instrumentação
Infecções por HIV/prevenção & controle
Programas de Troca de Agulhas/organização & administração
Abuso de Substâncias por Via Intravenosa/tratamento farmacológico
Seringas/provisão & distribuição
[Mh] Termos MeSH secundário: Seres Humanos
Nevada
Projetos Piloto
Avaliação de Programas e Projetos de Saúde
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170713
[Lr] Data última revisão:
170713
[Sb] Subgrupo de revista:AIM; IM; N
[Da] Data de entrada para processamento:170624
[St] Status:MEDLINE
[do] DOI:10.1097/01.NAJ.0000520934.96160.36


  5 / 1515 MEDLINE  
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[PMID]:28604437
[Au] Autor:Burt RD; Tinsley J; Glick SN
[Ad] Endereço:*HIV/STD Program, Public Health-Seattle & King County, Seattle, WA; and †Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA.
[Ti] Título:A Decline in HIV Testing Among Persons Who Inject Drugs in the Seattle Area, 2004-2015.
[So] Source:J Acquir Immune Defic Syndr;75 Suppl 3:S346-S351, 2017 Jul 01.
[Is] ISSN:1944-7884
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Promoting HIV testing is a key component of the public health response to HIV. Assessing HIV testing frequency among persons who inject drugs (PWID) monitors the status of these efforts and can identify unmet needs and opportunities to more effectively promote testing. METHODS: Data were combined from 4 Seattle-area surveys of PWID from the National HIV Behavioral Surveillance (NHBS) program (2005-2015) and 6 surveys of Needle Exchange clients (2004-2015). RESULTS: The proportion of PWID reporting an HIV test in the previous 12 months declined from 64% in 2005% to 47% in 2015 in the NHBS surveys and from 72% to 58% in the Needle Exchange surveys. These declines persisted in multivariate analyses controlling for differences in the study populations in age, race, sex, area of residence, education, current homelessness, drug most frequently injected, daily injection frequency, and combined male-to-male sex and amphetamine injection status. The proportion of NHBS participants reporting not knowing the HIV status of their last injection partner increased from 38% to 45%. The proportion not knowing the HIV status of their last sex partner increased from 27% to 38%. CONCLUSIONS: A decrease in HIV testing was found in 2 independent Seattle-area study populations. This was complemented by increases in the proportions not knowing the HIV status of their last sex and last injection partners. Research is needed to ascertain if such declines are observed elsewhere, the reasons for the decline, and appropriate means to effectively attain optimal HIV testing frequency among PWID.
[Mh] Termos MeSH primário: Infecções por HIV/diagnóstico
Programas de Troca de Agulhas
Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos
Abuso de Substâncias por Via Intravenosa/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Sistema de Vigilância de Fator de Risco Comportamental
District of Columbia/epidemiologia
Feminino
Infecções por HIV/prevenção & controle
Infecções por HIV/transmissão
Conhecimentos, Atitudes e Prática em Saúde
Seres Humanos
Masculino
Programas de Rastreamento
Meia-Idade
Parceiros Sexuais
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171004
[Lr] Data última revisão:
171004
[Sb] Subgrupo de revista:IM; X
[Da] Data de entrada para processamento:170613
[St] Status:MEDLINE
[do] DOI:10.1097/QAI.0000000000001409


  6 / 1515 MEDLINE  
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[PMID]:28604433
[Au] Autor:Mackesy-Amiti ME; Boodram B; Spiller MW; Paz-Bailey G; Prachand N; Broz D; NHBS Study Group
[Ad] Endereço:*Division of Epidemiology and Biostatistics, University of Illinois at Chicago, School of Public Health, Chicago, IL; †Centers for Disease Control and Prevention, Atlanta, GA; and ‡Chicago Department of Public Health, Chicago, IL.
[Ti] Título:Injection-Related Risk Behavior and Engagement in Outreach, Intervention and Prevention Services Across 20 US Cities.
[So] Source:J Acquir Immune Defic Syndr;75 Suppl 3:S316-S324, 2017 Jul 01.
[Is] ISSN:1944-7884
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Monitoring the effects of HIV prevention efforts on risk behaviors among persons who inject drugs is a key to inform prevention programs and policy. METHODS: Using data from the 2012 National HIV Behavioral Surveillance interviews with persons who inject drugs across 20 US cities (n = 10,171), we conducted latent class analysis to identify injection risk classes and assess the relationship between engagement in prevention services and injection-related risk behavior. We conducted stratified analyses to examine the consistency of these associations across different geographical regions. RESULTS: The latent class analysis identified 6 distinct classes of injection-related risk behavior. The class structure was consistent across regions of the United States, but the distribution of risk classes varied significantly across regions. With covariate adjustment, the South had the most high-risk behavior (21%) and the Midwest had the least (6%). Participation in syringe access services and other prevention services was the lowest in the South. Syringe access was associated with a significantly lower likelihood of membership in the highest risk class in all regions except the Midwest. Participation in individual or group intervention with a practical skills component was associated with less risky injection behavior in all regions except the Northeast. Interventions that featured only safer injection information and discussion had no relationship with risk class. CONCLUSIONS: Our findings support evidence of the effectiveness of syringe service programs and safer injection skills training in reducing high-risk injection behavior and underscore the need to improve access to these prevention interventions in the South of the United States.
[Mh] Termos MeSH primário: Cidades
Infecções por HIV/prevenção & controle
Política de Saúde
Programas de Troca de Agulhas
Serviços Preventivos de Saúde
Abuso de Substâncias por Via Intravenosa/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Sistema de Vigilância de Fator de Risco Comportamental
Feminino
Infecções por HIV/transmissão
Conhecimentos, Atitudes e Prática em Saúde
Seres Humanos
Masculino
Meia-Idade
Avaliação de Programas e Projetos de Saúde
Assunção de Riscos
Estados Unidos/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171004
[Lr] Data última revisão:
171004
[Sb] Subgrupo de revista:IM; X
[Da] Data de entrada para processamento:170613
[St] Status:MEDLINE
[do] DOI:10.1097/QAI.0000000000001406


  7 / 1515 MEDLINE  
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[PMID]:28399843
[Au] Autor:Fernandes RM; Cary M; Duarte G; Jesus G; Alarcão J; Torre C; Costa S; Costa J; Carneiro AV
[Ad] Endereço:Center for Evidence-Based Medicine, Faculty of Medicine, University of Lisbonl, Av. Prof. Egas Moniz, 1649-028, Lisbon, Portugal.
[Ti] Título:Effectiveness of needle and syringe Programmes in people who inject drugs - An overview of systematic reviews.
[So] Source:BMC Public Health;17(1):309, 2017 Apr 11.
[Is] ISSN:1471-2458
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Needle and syringe programmes (NSP) are a critical component of harm reduction interventions among people who inject drugs (PWID). Our primary objective was to summarize the evidence on the effectiveness of NSP for PWID in reducing blood-borne infection transmission and injecting risk behaviours (IRB). METHODS: We conducted an overview of systematic reviews that included PWID (excluding prisons and consumption rooms), addressed community-based NSP, and provided estimates of the effect regarding incidence/prevalence of Human Immunodeficiency Virus (HIV), Hepatitis C virus (HCV), Hepatitis B virus (HBV) and bacteremia/sepsis, and/or measures of IRB. Systematic literature searches were undertaken on relevant databases, including EMBASE, MEDLINE, and PsychINFO (up to May 2015). For each review we identified relevant studies and extracted data on methods, and findings, including risk of bias and quality of evidence assessed by review authors. We evaluated the risk of bias of each systematic review using the ROBIS tool. We categorized reviews by reported outcomes and use of meta-analysis; no additional statistical analysis was performed. RESULTS: We included thirteen systematic reviews with 133 relevant unique studies published between 1989 and 2012. Reported outcomes related to HIV (n = 9), HCV (n = 8) and IRB (n = 6). Methods used varied at all levels of design and conduct, with four reviews performing meta-analysis. Only two reviews were considered to have low risk of bias using the ROBIS tool, and most included studies were evaluated as having low methodological quality by review authors. We found that NSP was effective in reducing HIV transmission and IRB among PWID, while there were mixed results regarding a reduction of HCV infection. Full harm reduction interventions provided at structural level and in multi-component programmes, as well as high level of coverage, were more beneficial. CONCLUSIONS: The heterogeneity and the overall low quality of evidence highlights the need for future community-level studies of adequate design to support these results. TRIAL REGISTRATION: The protocol of this systematic review was registered in Prospective Register of Systematic Reviews (PROSPERO 2015: CRD42015026145 ).
[Mh] Termos MeSH primário: Infecções por HIV/epidemiologia
Hepatite B/epidemiologia
Hepatite C/epidemiologia
Programas de Troca de Agulhas/estatística & dados numéricos
Abuso de Substâncias por Via Intravenosa/epidemiologia
[Mh] Termos MeSH secundário: Adulto
Infecções por HIV/transmissão
Redução do Dano
Hepatite B/transmissão
Hepatite C/transmissão
Seres Humanos
Estudos Prospectivos
Assunção de Riscos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170816
[Lr] Data última revisão:
170816
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170413
[St] Status:MEDLINE
[do] DOI:10.1186/s12889-017-4210-2


  8 / 1515 MEDLINE  
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[PMID]:28302153
[Au] Autor:Barbour K; McQuade M; Brown B
[Ad] Endereço:UC Irvine School of Medicine, Irvine; Orange County Needle Exchange Program (OCNEP), Santa Ana, USA. kyle.barbour@uci.edu.
[Ti] Título:Students as effective harm reductionists and needle exchange organizers.
[So] Source:Subst Abuse Treat Prev Policy;12(1):15, 2017 Mar 17.
[Is] ISSN:1747-597X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Needle exchange programs are safe, highly effective programs for promoting health among people who inject drugs. However, they remain poorly funded, and often illegal, in many places worldwide due to fear and stigma surrounding drug use. Continued advocacy, education, and implementation of new needle exchanges are thus essential to improve public health and reduce structural inequality. COMMENTARY: We argue that students, and especially professional and graduate students, have the potential to play an important role in advancing harm reduction. Students benefit from the respect given to the professions they are training to enter, which gives them leverage to navigate the political hurdles often faced by needle exchange organizers, especially in areas that presently lack services. In addition, due to their relative simplicity, needle exchanges do not require much of the licensing, clinical knowledge, and infrastructure associated with more traditional student programs, such as student-run free medical clinics. Students are capable of learning harm reduction cultural approaches and techniques if they remain humble, open-minded, and seek the help of the harm reduction community. Consequently, students can generate tremendous benefits to their community without performing beyond their appropriate clinical limitations. Students benefit from organizing needle exchanges by gaining applied experience in advocacy, organization-building, and political finesse. Working in a needle exchange significantly helps erode stigma against multiple marginalized populations. Students in health-related professions additionally learn clinically-relevant knowledge that is often lacking from their formal training, such as an understanding of structural violence and inequality, root causes of substance use, client-centered approaches to health services, and interacting with clients as peers, rather than through the standard hierarchical medical interaction. CONCLUSION: We therefore encourage students to learn about and consider organizing needle exchanges during their training. Our experience is that students can be successful in developing sustainable programs which benefit their clients, the broader harm reduction movement, and themselves alike.
[Mh] Termos MeSH primário: Redução do Dano
Programas de Troca de Agulhas/métodos
Estudantes
[Mh] Termos MeSH secundário: Seres Humanos
Avaliação de Programas e Projetos de Saúde
[Pt] Tipo de publicação:EDITORIAL
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171023
[Lr] Data última revisão:
171023
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170318
[St] Status:MEDLINE
[do] DOI:10.1186/s13011-017-0099-0


  9 / 1515 MEDLINE  
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[PMID]:28296603
[Au] Autor:Wakeman SE
[Ad] Endereço:From Massachusetts General Hospital and Harvard Medical School - both in Boston.
[Ti] Título:Another Senseless Death - The Case for Supervised Injection Facilities.
[So] Source:N Engl J Med;376(11):1011-1013, 2017 Mar 16.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Overdose de Drogas/prevenção & controle
Dependência de Heroína/reabilitação
Programas de Troca de Agulhas
Tratamento de Substituição de Opiáceos/métodos
Abuso de Substâncias por Via Intravenosa/reabilitação
[Mh] Termos MeSH secundário: Buprenorfina/administração & dosagem
Dependência de Heroína/tratamento farmacológico
Seres Humanos
Metadona/administração & dosagem
Abuso de Substâncias por Via Intravenosa/tratamento farmacológico
Abuso de Substâncias por Via Intravenosa/psicologia
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
40D3SCR4GZ (Buprenorphine); UC6VBE7V1Z (Methadone)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170424
[Lr] Data última revisão:
170424
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170316
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMp1613651


  10 / 1515 MEDLINE  
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[PMID]:28183925
[Au] Autor:Malakoff D
[Ti] Título:Politics vs. data on needle swaps.
[So] Source:Science;355(6325):565, 2017 Feb 10.
[Is] ISSN:1095-9203
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Infecções por HIV/prevenção & controle
Programas de Troca de Agulhas/economia
[Mh] Termos MeSH secundário: Seres Humanos
Hungria
Política
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170919
[Lr] Data última revisão:
170919
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170211
[St] Status:MEDLINE
[do] DOI:10.1126/science.355.6325.565



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