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Vonoprazan 10 mg or 20 mg vs. lansoprazole 15 mg as maintenance therapy in Asian patients with healed erosive esophagitis: A randomized controlled trial

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中华医学杂志(英文版) 2024年第8期137卷 962-971页

作者： Xiao Yinglian Qian Jiaming Zhang Shutian Dai Ning Chun hoon jai Chiu Chengtang Chong Chui Fung Funao Nobuo Sakurai Yuuichi Eisner Jessica D. Xie Li Chen Minhu Beijing 100006 Beijing Friendship Hospital Capital Medical University Beijing 100050 Sir Run Run Shaw Hospital School of Medicine Zhejiang University Hangzhou Zhejiang 310020 Department of Internal Medicine Korea University Anam Hospital Department of Gastroenterology Korea University College of Medicine 73 Goryeodae-ro Seongbuk-gu Seoul 02841 Republic of Korea Department of Gastroenterology & Hepatology Linkou Medical Center Chang Gung Memorial Hospital Taoyuan The First Affiliated Hospital Taiwan 33353 Takeda Development Center Asia Singapore 018981 Singapore Takeda Pharmaceutical Company Chuo-ku Osaka 540-8645 Japan Takeda Pharmaceuticals International Company Cambridge Sun Yat-sen University MA 02142 USA China Medical Team Takeda China Beijing 100027 Guangzhou Guangdong 510062 China Peking Union Medical College Hospital Peking Union Medical College Chinese Academy of Medical Sciences

Background: Erosive esophagitis (EE) is a gastroesophageal reflux disease characterized by mucosal breaks in the esophagus. Proton pump inhibitors are widely used as maintenance therapy for EE, but many patients still relapse. In this trial, we evaluated the noninferiority of vonoprazanvs. lansoprazole as maintenance therapy in patients with healed EE.Methods: We performed a double-blind, double-dummy, multicenter, phase 3 clinical trial among non-Japanese Asian adults with endoscopically confirmed healed EE from April 2015 to February 2019. Patients from China, South Korea, and Malaysia were randomized to vonoprazan 10 mg or 20 mg once daily or lansoprazole 15 mg once daily for 24 weeks. The primary endpoint was endoscopically confirmed EE recurrence rate over 24 weeks with a noninferiority margin of 10% using a two-sided 95% confidence interval (CI). Treatment-emergent adverse events (TEAEs) were recorded.Results: Among 703 patients, EE recurrence was observed in 24/181 (13.3%) and 21/171 (12.3%) patients receiving vonoprazan 10 mg or 20 mg, respectively, and 47/184 (25.5%) patients receiving lansoprazole (differences: -12.3% [95% CI, -20.3% to-4.3%] and -13.3% [95% CI, -21.3% to -5.3%], respectively), meeting the primary endpoint of noninferiority to lansoprazole in preventing EE recurrence at 24 weeks. Evidence of superiority (upper bound of 95% CI <0%) was also observed. At 12 weeks, endoscopically confirmed EE recurrence was observed in 5/18, 2/20, and 7/20 of patients receiving vonoprazan 10 mg, vonoprazan 20 mg, and lansoprazole, respectively. TEAEs were experienced by 66.8% (157/235), 69.0% (156/226), and 65.3% (158/242) of patients receiving vonoprazan 10 mg, vonoprazan 20 mg, and lansoprazole, respectively. The most common TEAE was upper respiratory tract infection in 12.8% (30/235) and 12.8% (29/226) patients in vonoprazan 10 mg and 20 mg groups, respectively and 8.7% (21/242) patients in lansoprazole group.Conclusion: Vonoprazan maintenance therapy was well-tolerated and noninferior to lansoprazole f

关键词： Erosive esophagitis Lansoprazole Maintenance therapy Potassium-competitive acid blockers Vonoprazan

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Immunotherapy for pancreatic cancer

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World Journal of Clinical Cases 2021年第13期9卷 2969-2982页

作者： jai hoon yoon Ye-Ji Jung Sung-hoon Moon Department of Internal Medicine Hanyang University College of MedicineSeoul 04763South Korea Department of Internal Medicine Hallym UniversityAnyang 14068South Korea Department of Internal Medicine University of Hallym College of MedicineHallym University Sacred Heart HospitalAnyang 14068South Korea

Pancreatic cancer, a highly lethal cancer, has the lowest 5-year survival rate forseveral reasons, including its tendency for the late diagnosis, a lack of serologicmarkers for screening, aggressive local invasion, its early metastaticdissemination, and its resistance to chemotherapy/radiotherapy. Pancreaticcancer evades immunologic elimination by a variety of mechanisms, includinginduction of an immunosuppressive microenvironment. Cancer-associatedfibroblasts interact with inhibitory immune cells, such as tumor-associatedmacrophages and regulatory T cells, to form an inflammatory shell-like desmoplasticstroma around tumor cells. Immunotherapy has the potential to mobilizethe immune system to eliminate cancer cells. Nevertheless, althoughimmunotherapy has shown brilliant results across a wide range of malignancies,only anti-programmed cell death 1 antibodies have been approved for use inpatients with pancreatic cancer who test positive for microsatellite instability ormismatch repair deficiency. Some patients treated with immunotherapy whoshow progression based on conventional response criteria may prove to have adurable response later. Continuation of immune-based treatment beyond diseaseprogression can be chosen if the patient is clinically stable. Immunotherapeuticapproaches for pancreatic cancer treatment deserve further exploration, given theplethora of combination trials with other immunotherapeutic agents, targetedtherapy, stroma-modulating agents, chemotherapy, and multi-way combinationtherapies.

关键词： Pancreatic adenocarcinoma Pancreatic cancer Immunotherapy Immune checkpoint inhibitor

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Clinical outcomes of endoscopic papillectomy of ampullary adenoma: A multi-center study

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World Journal of Gastroenterology 2022年第17期28卷 1845-1859页

作者： Seong Ji Choi Hong Sik Lee Jiyeong Kim Jung Wan Choe Jae Min Lee Jong Jin Hyun jai hoon yoon Hyo Jung Kim Jae Seon Kim Ho Soon Choi Department of Internal Medicine Hanyang University College of MedicineSeoul 04763South Korea Division of Gastroenterology and Hepatology Department of Internal MedicineKorea University College of MedicineSeoul 02841South Korea Lab of Biostatistical Consulting and Research Medical Research Collaborating CenterIndustry-University Cooperation FoundationHanyang UniversitySeoul 04763South Korea

BACKGROUND Ampullary adenoma is a rare premalignant lesion,but its incidence is increasing.Endoscopic papillectomy has become the first treatment of choice for ampullary adenomas due to its safety and effectiveness,thereby replacing surgical resection.However,recurrence rates and adverse events after endoscopic papillectomy were reported in up to 30%of cases.AIM To review the long-term outcomes of endoscopic papillectomy and investigate the factors that affect these outcomes.METHODS We retrospectively analyzed the data of patients who underwent endoscopic papillectomy for ampullary adenoma at five tertiary hospitals between 2013 and 2020.We evaluated clinical outcomes and their risk factors.The definitions of outcomes were as follow:(1)curative resection:complete endoscopic resection without recurrence;(2)endoscopic success:treatment of ampullary adenoma with endoscopy without surgical intervention;(3)early recurrence:reconfirmed adenoma at the first endoscopic surveillance;and(4)late recurrence:reconfirmed adenoma after the first endoscopic surveillance.RESULTS A total of 106 patients were included for analysis.Of the included patients,81(76.4%)underwent curative resection,99(93.4%)had endoscopic success,showing that most patients with noncurative resection were successfully managed with endoscopy.Sixteen patients(15.1%)had piecemeal resection,22 patients(20.8%)had shown positive/uncertain resection margin,11 patients(16.1%)had an early recurrence,13 patients(10.4%)had a late recurrence,and 6 patients(5.7%)had a re-recurrence.In multivariate analysis,a positive/uncertain margin[Odds ratio(OR)=4.023,P=0.048]and piecemeal resection(OR=6.610,P=0.005)were significant risk factors for early and late recurrence,respectively.Piecemeal resection was also a significant risk factor for non-curative resection(OR=5.424,P=0.007).Twenty-six patients experienced adverse events(24.5%).CONCLUSION Endoscopic papillectomy is a safe and effective treatment for ampullary adenomas.Careful selection and follow-up of patients is mandat

关键词： Endoscopic papillectomy Ampullary adenoma Clinical outcome Recurrence Adverse event

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Vomiting-induced pharyngeal perforation during bowel preparation for colonoscopy:A case report

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World Journal of Clinical Cases 2024年第18期12卷 3615-3621页

作者： Geonhee Kim Won Hyuk Lee Seokin Kang Jung Rock Moon yoon Suk Lee Jun Hyuk Son Nam-hoon Kim Jong Wook Kim Department of Internal Medicine Ilsan Paik HospitalInje University College of MedicineGoyang 10380South Korea

BACKGROUND Effective bowel cleansing is essential for a successful colonoscopy.Laxatives,such as polyethylene glycol,are commonly used for bowel preparation.Vomiting is a frequent complication during bowel preparation,and forceful vomiting can potentially lead to esophageal perforation,as reported in several previous cases.However,pharyngeal perforation during bowel preparation has not been previously documented.Here,we present a case of pharyngeal perforation induced by forceful vomiting during bowel preparation.CASE SUMMARY A 38-year-old man with a history of hypertension,dyslipidemia,diabetes mellitus,and end-stage renal disease on hemodialysis was admitted for evaluation of recurrent abdominal pain.The patient complained of sudden pain in the neck,throat,and anterior chest following forceful vomiting during bowel preparation.Physical examination revealed crepitus under the skin of the neck and anterior chest on palpation,and upper gastrointestinal endoscopy revealed pharyngeal perforation.The perforation site was located above the upper esophageal sphincter,which distinguished it from Boerhaave’s syndrome.Conservative medical management was chosen after consultation with a thoracic surgeon and an otolaryngologist,considering the patient's mild symptoms,stable vital signs,and the small size of the lesion;the perforation resolved without endoscopic or surgical intervention.The patient was discharged from hospital two weeks after the perforation.CONCLUSION Despite its rarity,pharyngeal perforation should be considered a potential complication of bowel preparation for colonoscopy.

关键词： Colonoscopy Pharynx Polyethylene glycols Spontaneous perforation Case report

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Trends in the eradication rates of Helicobacter pylori infection for eleven years

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World Journal of Gastroenterology 2012年第45期18卷 6628-6634页

作者： jai hoon yoon Gwang Ho Baik Kyoung Min Sohn Dae Yong Kim Yeon Soo Kim Ki Tae Suk Jin Bong Kim Dong Joon Kim Jin Bae Kim Woon Geon Shin Hak Yang Kim Il Hyun Baik Hyun Joo Jang Department of Internal Medicine Hallym University College of MedicineChuncheon Sacred Heart Hospital153Gyo-dongChuncheonGangwon-do 200-704South Korea Department of Internal Medicine Hallym University College of MedicineKangnam Sacred Heart HospitalSeoul 150-950South Korea Department of Internal Medicine Hallym University College of MedicineKangdong Sacred Heart HospitalSeoul 134-814South Korea Department of Internal Medicine Hallym University College of MedicineHallym University Sacred Heart HospitalAnyang 431-070South Korea Department of Internal Medicine Hallym University College of MedicineHangang Sacred Heart HospitalSeoul 150-719South Korea

AIM:To evaluate the trends in the eradication rate of Helicobacter pylori(H.pylori) over the past 11 years in a single center.METHODS:This retrospective study covered the period from January 2000 to December 2010.We evaluated 5746 patients diagnosed with gastric ulcers(GU),duodenal ulcers(DU),GU + DU,or nonpeptic ulcers associated with an H.pylori infection.We treated them annually with the 2 wk standard first-line triple regimen,proton pump inhibitor(PPI) + amoxicilin + clarithromycin(PAC;PPI,clarithromycin 500 mg,and amoxicillin 1 g,all twice a day).The follow-up test was performed at least 4 wk after the completion of the 2 wk standard H.pylori eradication using the PAC regimen.We also assessed the eradication rates of 1 wk second-line therapy with a quadruple standard regimen(PPI b.i.d.,tripotassium dicitrate bismuthate 300 mg q.i.d.,metronidazole 500 mg t.i.d.,and tetracycline 500 mg q.i.d.) after the failure of the first-line therapy.Statistical analysis was performed with 95%CI for the differences in the annual eradication rates.RESULTS:A total of 5746 patients [2333 males(58.8%),1636 females(41.2%);mean age of males vs females 51.31 ± 13.1 years vs 52.76 ± 13.6 years,P < 0.05,total mean age 51.9 ± 13.3 years(mean ± SD)] were investigated.Among these patients,1674 patients were excluded:35 patients refused treatment;18 patients ceased H.pylori eradication due to side effects;1211 patients had inappropriate indications for H.pylori eradication,having undergone stomach cancer operation or chemotherapy;and 410 patients did not undergo the follow-up.We also excluded 103 patients who wanted to stop eradication treatment after only 1 wk due to poor compliance or the side effects mentioned above.Finally,we evaluated the annual eradication success rates in a total of 3969 patients who received 2 wk first-line PAC therapy.The endoscopic and clinical findings in patients who received the 2 wk PAC were as follows:gastric ulcer in 855(21.5%);duodenal ulcer in 878(22.1%);gastric and duodenal ulcer in 124(3.1%),erosive,

关键词：根除幽门螺杆菌发展趋势感染幽门螺旋杆菌治疗方案十二指肠质子泵抑制剂

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FBX015 plays a critical suppressive functional role in regulation of breast cancer progression

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Signal Transduction and Targeted Therapy 2021年第7期6卷 1972-1975页

作者： Yi Zhao Nayeon Shim Yan-Hong Cui Jae-Hyeok Kang Ki-Chun Yoo Seungmo Kim Joo Mi Yi Min-Jung Kim jai hoon yoon Su-Jae Lee Department of Life Science Research Institute for Natural SciencesHanyang UniversitySeoulSouth Korea Department of Medicine Section of DermatologyUniversity of ChicagoChicagoILUSA Department of Microbiology and Immunology College of MedicineInje UniversityBusanSouth Korea Laboratory of Radiation Exposure and Therapeutics National Radiation Emergency Medical CenterKorea Institute of Radiological and Medical SciencesSeoulSouth Korea Department of Internal Medicine College of MedicineHanyang UniversitySeoulSouth Korea

Dear Editor,Breast cancer is a leading type of cancer in women,the treatment of basal type,including triple negative breast cancer(TNBC),remains challenging due to its aggressive behaviors and lack of targeted therapeutic options1.F-box proteins(FBPs)can serve as either oncogenes or tumor suppressors depending on their substrates,and various studies have been conducted on their involvement in different types of cancer and play significant roles in cancer development and progression2.However,the related mechanisms and targets of F-box protein 15(FBX015)are still remain unclear in human breast cancers.

关键词： breast involvement Breast

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Osteoporosis and bone fractures in alcoholic liver disease:A meta-analysis

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World Journal of Gastroenterology 2015年第13期21卷 4038-4047页

作者： Chang Seok Bang In Soo Shin Sung Wha Lee Jin Bong Kim Gwang Ho Baik Ki Tae Suk jai hoon yoon Yeon Soo Kim Dong Joon Kim Department of Internal Medicine Hallym University College of MedicineChuncheon 200-704South Korea College of Education Jeonju UniversityJeonju 560-759South Korea

AIM: To evaluate the association between alcoholic liver disease(ALD) and bone fractures or osteoporosis. METHODS: Non-randomized studies were identified from databases(Pub Med, EMBASE, and the Cochrane Library). The search was conducted using Boolean operators and keywords, which included "alcoholic liver diseases", "osteoporosis", or "bone fractures". The prevalence of any fractures or osteoporosis, and bone mineral density(BMD) were extracted and analyzed using risk ratios and standardized mean difference(SMD). A random effects model was applied. RESULTS: In total, 15 studies were identified and analyzed. Overall, ALD demonstrated a RR of 1.944(95%CI: 1.354-2.791) for the development of bone fractures. However, ALD showed a RR of 0.849(95%CI: 0.523-1.380) for the development of osteoporosis. BMD was not significantly different between the ALD and control groups, although there was a trend toward lower BMD in patients with ALD(SMD in femur-BMD:-0.172, 95%CI:-0.453-0.110; SMD in spine-BMD:-0.169, 95%CI:-0.476-0.138). Sensitivity analyses showed consistent results. CONCLUSION: Current publications indicate significant associations between bone fractures and ALD, independent of BMD or the presence of osteoporosis.

关键词： Alcoholic liver diseases Bone fractures Osteoporos

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Transarterial chemoembolization in Barcelona Clinic Liver Cancer Stage 0/A hepatocellular carcinoma

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World Journal of Gastroenterology 2014年第3期20卷 745-754页

作者： Heung Cheol Kim Ki Tae Suk Dong Joon Kim jai hoon yoon Yeon Soo Kim Gwang Ho Baik Jin Bong Kim Chang hoon Kim Hotaik Sung Jong Young Choi Kwang Hyub Han Seung Ha Park Department of Radiology Hallym University College of Medicine Department of Internal Medicine Hallym University College of Medicine College of Medicine Upstate Medical UniversityState University of New York Department of Biology Stanford University Department of Internal Medicine Catholic University College of Medicine Liver Cirrhosis Clinical Research Center Yonsei University College of Medicine Department of Internal Medicine Inje University College of Medicine

AIM:To evaluate the clinical characteristics of patients with Barcelona Clinic Liver Cancer(BCLC)stage 0 and A hepatocellular carcinoma(HCC)after transarterial chemoembolization(TACE).METHODS:Between January 2001 and September2011,129 patients with BCLC stage 0 and stage A HCC who underwent TACE were retrospectively enrolled.Patient characteristics,routine computed tomography and TACE findings,survival time and 1-,5-,and 10-year survival rates,risk factors for mortality,and survival rates according to the number of risk factors were assessed.RESULTS:The mean size of HCC tumors was 2.4±1.1 cm,and the mean number of TACE procedures performed was 2.5±2.1.The mean overall survival time and 1-,5-,and 10-year survival rates were 80.6±4.9 mo and 91%,63%and 49%,respectively.In the Cox regression analysis,a Child-Pugh score>5(P=0.005,OR=3.86),presence of arterio-venous shunt(P=0.032,OR=4.41),amount of lipiodol used(>7 mL;P=0.013,OR=3.51),and female gender(P=0.008,OR=3.47)were risk factors for mortality.The 1-,5-,and 10-year survival rates according to the number of risk factors present were 96%,87%and 87%(no risk factors),89%,65%,and 35%(1 risk factor),96%,48%and unavailable(2 risk factors),and 63%,17%,and 0%(3 risk factors),respectively(P<0.001).CONCLUSION:TACE may be used as curative-intent therapy in patients with BCLC stage 0 and stage A HCC.The Child-Pugh score,arterio-venous shunt,amount of lipiodol used,and gender were related to mortality after TACE.

关键词： Carcinoma Hepatocellular Chemoembolization Therape

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Highly Flexible Fabrics/Epoxy Composites with Hybrid Carbon Nanofillers for Absorption-Dominated Electromagnetic Interference Shielding

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Nano-Micro Letters 2022年第11期14卷 307-323页

作者： Jong-hoon Lee yoon-Sub Kim Hea-Jin Ru Seul-Yi Lee Soo-Jin Park Department of Chemistry Inha University100 InharoIncheon 22212Korea Korea Architecture Safety Testing and Research Institute(KASTI) 88 Gasan Digital 1-roSeoul 08590Korea

Epoxy-based nano-composites can be ideal electromagnetic interference(EMI)-shielding materials owing to their lightness,chemical inertness,and mechanical durability.However,poor conductivity and brittleness of the epoxy resin are challenges for fast-growing portable and flexible EMI-shielding applications,such as smart wristband,medical cloth,aerospace,and military equipment.In this study,we explored hybrid nanofillers of single-walled carbon nanotubes(SWCNT)/reduced graphene oxide(rGO)as conductive inks and polyester fabrics(PFs)as a substrate for flexible EMI-shielding composites.The highest electrical conductivity and fracture toughness of the SWCNT/rGO/PF/epoxy composites were 30.2 S m^(−1)and 38.5 MPa m^(1/2),which are~270 and 65%enhancement over those of the composites without SWCNTs,respectively.Excellent mechanical durability was demonstrated by stable electrical conductivity retention during 1000 cycles of bending test.An EMI-shielding effectiveness of~41 dB in the X-band frequency of 8.2-12.4 GHz with a thickness of 0.6 mm was obtained with an EM absorption-dominant behavior over a 0.7 absorption coefficient.These results are attributed to the hierarchical architecture of the macroscale PF skeleton and nanoscale SWCNT/rGO networks,leading to superior EMI-shielding performance.We believe that this approach provides highly flexible and robust EMI-shielding composites for next-generation wearable electronic devices.

关键词： Conductive polymer composites Fracture toughness Flexible composites Absorption-dominated electromagnetic interference shielding

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Real-time porosity reduction during metal directed energy deposition using a pulse laser

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Journal of Materials Science & Technology 2022年第21期116卷 214-223页

作者： hoon Sohn Peipei Liu Hansol yoon Kiyoon Yi Liu Yang Sangjun Kim Department of Civil and Environmental Engineering Korea Advanced Institute of Science and Technology(KAIST)Daejeon 34141Republic of Korea Center for 3D Printing Nondestructive Testing Korea Advanced Institute of Science and Technology(KAIST)Daejeon 34141Republic of Korea Global R&D Center SQ EngineeringSeoul 05818Republic of Korea Department of Civil and Environmental Engineering The Hong Kong University of Science and TechnologyClear Water BayKowloonHong KongChina

Porosity is a challenging issue in additive manufacturing and is detrimental to the quality of the additively manufactured products.In this study,a real-time porosity reduction technique was developed by incorporating a pulse laser into a laser metal powder directed energy deposition(DED)system.The incorporated pulse laser can accelerate fluid flow within the melt pool and facilitate the escape of pores before complete solidification.It achieves this real-time porosity reduction by inducing accelerated and turbulent Marangoni flow,ultrasonic waves,and shock waves into the melt pool.The uniqueness and advantages of the proposed technique include the following:(1)For a laser metal powder DED process,this study proposed a noncontact,nondestructive,and real-time porosity reduction technique at the melt pool level.(2)It was experimentally and numerically validated that the developed technique did not alter the geometry and the grain structure of the manufactured Ti-6Al-4V samples.(3)Because the porosity reduction is accomplished at the melt pool level,its application is not limited by the size,shape,or complexity of the printing target.(4)The developed technique can be readily incorporated into the existing DED systems without any modification of the original tool-path design.The experimental results showed that the pore volume fraction decreased from 0.132%to 0.005%,no pores larger than 6×10^(4)μm^(3) were observed,and a 91%reduction in the total pore number was achieved when the pulse laser energy reached 11.5 mJ.

关键词： Real-time porosity reduction Pulse laser Melt pool Directed energy deposition Ti-6Al-4V

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