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Together mens health week cheap eulexin 250 mg with mastercard, they make up about 40% of all primary brain tumours and around 70% of all primary malignant brain tumours. Glial cells provide structure in the brain and spinal cord, and probably have other functions such as nourishing nerve cells and playing a role in learning and memory. A higher grade means that the tumour is less like normal brain cells and grows faster. The incidence of astrocytomas seems to be falling each year, but this may be because the criteria for determining whether a brain tumour is an astrocytoma or an oligodendroglioma have changed. Oligodendrogliomas Oligodendrogliomas probably grow from oligodendrocytes, which are cells that insulate nerve fibres in the brain. People with oligodendrogliomas may have had seizures for a long period of time before the tumour is diagnosed. Adult gliomas (astrocytomas and oligodendrogliomas): a guide for patients, their families and carers 10 108 Adult gliomas (astrocytomas and oligodendrogliomas): a guide for patients, their families and carers the incidence of oligodendroglioma (the number diagnosed each year) has risen recently, but this is probably because the criteria for determining whether a brain tumour is an astrocytoma or an oligodendroglioma have changed. For the vast majority of people with a brain tumour, no outside cause can be clearly identified. Most astrocytomas and oligodendrogliomas occur when there is damage (a mutation) in genes that control how a cell grows and multiplies. The cells with the gene mutation develop into the tumour, but the abnormality cannot be inherited by the persons children. Radiation Exposure to ionising radiation (such as X rays and gamma rays) can cause brain tumours, but cases where this is the known cause are very rare. Non-ionising electromagnetic radiation (such as radio waves, microwaves, ultraviolet rays or infrared rays) has been suspected as a cause of malignant brain tumours for many years, but there is not strong evidence that this is an important cause. Studies in people exposed to high levels of non-ionising electromagnetic radiation, such as electrical workers and heavy users of mobile phones, have mainly shown no effect. For earlier-generation analogue-type mobile phones, prolonged use has been associated with a slight increase in the incidence of benign brain tumours. Studies conducted more recently do not provide clear evidence for whether or not non- ionising radiation increases the risk of brain tumours. Genetically inherited tendency People with certain rare genetic conditions have a higher risk of developing a brain tumour than the general population. People from families that seem to have more brain tumours than average should be referred to a cancer genetics service, which is a special clinic for people with familial (inherited) cancers. Adult gliomas (astrocytomas and oligodendrogliomas): a guide for patients, their families and carers 11 Adult gliomas (astrocytomas and oligodendrogliomas): a guide for patients, their families and carers 119 Why we dont know the causes of brain tumours Brain tumours are rare, so it is extremely difficult to collect information about a large enough group of cases to enable statisticians to make reliable conclusions. However, information is being collected around the world, and researchers plan to analyse data from a large number of patients with gliomas. Research is underway into whether certain genes are important risk factors for brain tumours.

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Locally advanced dis- including Japan prostate cancer genetic testing cheap eulexin 250 mg with visa, with only Israel having an ease is frequently managed by a combina- intermediate rate. Such endocrine Definition fourth decades of life and declining after treatment may comprise luteinizing hor- the most common malignant tumours of age 50; the median age at diagnosis for mone-releasing hormone agonists, anti- the testis (>90%) are germ cell tumours, testicular nonseminoma is 24 years and a androgens or orchidectomy. The initial choice of treatment is best done after counselling the patient and with access to a multidisciplinary team. Endocrine treat- ment almost invariably achieves a remis- sion of the disease for a period, followed by a relapse and the development of endocrine unresponsive cancer. This type of disease needs aggressive but compas- sionate management, depending upon the general health status of the patient. More research is, however, essential to establish specific optimal treatment for the individual patient. Stage and grade determine the outcome of the disease in both localized and advanced disease. The limiting factor to cure is the presence of extraprostatic extension of the < 0. Incidence has increased significantly while mortality has decreased, due to effective chemotherapy. Germ cell tumours can also arise of testicular cancer have not been estab- tion, ultrasonography and biopsy. There is an increased incidence of patients with nonseminoma, serum Ovarian germ cell tumours of young the disease in individuals with a history of tumour markers alpha-fetoprotein and/or women share clinical features and treat- an undescended testicle, testicular femi- human chorionic gonadotrophin are elevat- ment approaches with male germ cell nization and those with a family history of ed in 80% of patients with disseminated tumours. In utero exposure to disease and in 50% of patients with early monly associated with the presence of exogenous estrogens may increase the stage disease. Patients with testicular isochromosome 12p (an abnormal chro- risk of testicular cancer as a result of seminoma may have modestly elevated mosome 12 with two identical short increased incidence of cryptorchidism and levels of human chorionic gonadotrophin arms), a region which contains the gene dysgenesis. The initiation of a to diethylstilbestrol has been associated There are no reliable screening tests for germ cell tumour is associated with var- with an increased relative risk of up to 5. Testicular cancer is more common in a high cure rate, advocacy of testicular mental pathway of the germ cell (Fig. About 90% of testicular malignancies tumours should yield average cure rates in arise from germ cells and these tumours excess of 95%, and even 80% of patients Detection are classified as seminoma (40%) (Fig. The division of a precursor cell, the spermatocyte (4n), produces 4 sperm cells each with one set of chromosomes (1n. The fusion of egg and sperm to form the zygote doubles the number of chromosomes to the normal complement (2n. Aberrant deve- lopment may produce a cell which has twice the normal chromosomal complement (4n. Approximately 30% Stage I disease, confined to the testis, is Nonseminoma of patients under surveillance will relapse managed by post-operative radiotherapy Patients with local nonseminoma confined and are reliably cured with chemotherapy. Good toneal lymph node dissection and are Cancers of the male reproductive tract 213 found to have positive nodes can consider Patients with nonseminoma who have nor- two cycles of adjuvant chemotherapy malized serum tumour markers and resid- (100% cure rate. Note the high incidence rates in Central and South America, Southern Africa and India.

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The sist him during the operations androgen hormone kinetics proven 250 mg eulexin, I had the feeling most important concern for me before going to that these operations cannot be done better. Helsinki was long, dark and cold winter, since After a couple of weeks I realized my mistake, unusual weather conditions in winter had been because these operations were being done bet- 300 Ozgur Celik | Visiting Helsinki Neurosurgery | 8 ter everytime by him. Despite his incredible sur- I think Professor Hernesniemi is a teacher of gical skills and established main surgical prin- not only neurosurgery but also life. How should one present think it is a kind of challenge and a way to en- himself to patients, to collegues and to friends My other ini- Briey, how should one be a good human being tial wrong observation was about his surgical and a good neurosurgeon In the beginning of my fellowship, my are the things that cannot be learnt elsewhere. He starts to operate on a case immediately after he is consulted for neurosurgical pathology. He sits down in front of the radiological workstation to study the im- ages and starts to operate in his mind. He pre- pares himself for surgery and avoids everything that interrupts his concentration or inuences his surgery negatively. Finally, I want to come to the most important point I learnt from Hernesniemi School. However, the most important things I learnt from him are beyond advanced surgical knowledge (although they are unique. We were welcomed here with the simple prevention rather than treatment will characteristic open arms from the chairman of be the main focus. In a non-private govern- Mika Niemela, vascular fellow Martin Lehecka, ment funded health system Simple, fast and the wonderful team of anesthesiologists, nurs- safe excellent microneurosurgery Many for the next Live Course and went to see for were stunned regarding the alleged quality and myself. There were many audible sighs of disbelief, amaze- There was another major inuencing factor and ment, approval and disapproval, with mixed that was the character of Juha. His kind man- feelings all too often found in neurosurgery nerism and humility was so clear and evident gatherings. We were ees from a variety of nationalities and back- asked to see for ourselves this safe, fast, and grounds with wide ranging levels of experience simple surgery.

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Cross Reference Horners syndrome Heterophoria Heterophoria is a generic term for a latent tendency to imbalance of the ocular axes (latent strabismus; cf prostate cancer under 50 buy eulexin 250mg. Phorias may be in the horizontal (esophoria, exophoria) or vertical plane (hyperphoria, hypophoria. Cross References Cover tests; Esophoria; Exophoria; Heterotropia; Hyperphoria; Hypophoria Heterotropia Heterotropia is a generic term for manifest deviation of the eyes (manifest stra- bismus; cf. This may be obvious; an amblyopic eye, with poor visual acuity and xation, may become deviated. Sometimes it may be more subtle, coming to attention only with the patients complaint of diplopia. Using the alternate cover (cross-cover) test, in which binocular xation is not permitted, an imbalance in the visual axes may be demonstrated, but this will not distinguish between heterotropia and heterophoria. To make this distinction the cover test is required: if the uncovered eye moves to adopt xation then het- erotropia is conrmed. Tropias may be in the horizontal (esotropia, exotropia) or vertical plane (hypertropia, hypotropia. Cross References Amblyopia; Cover tests; Esotropia; Exotropia; Heterophoria; Hypertropia; Hypotropia -177 - H Hiccups Hiccups A hiccup (hiccough) is a brief burst of inspiratory activity involving the diaphragm and the inspiratory intercostal muscles with reciprocal inhibition of expiratory intercostal muscles. The sound (hic) and discomfort result from glot- tic closure immediately after the onset of diaphragmatic contraction, i. Most episodes of hiccups are self-limited, but prolonged or intractable hic- cuping (hocquet diabolique) should prompt a search for a structural or functional cause, either gastroenterological or neurological. Hiccuping is seldom the only abnormality if the cause is neurological since it usually reects pathology within the medulla or affecting the afferent and efferent nerves of the respiratory muscles. If none is identied, physical measures to stop the hiccups such as rebreathing may then be tried. Of the many various pharmacotherapies tried, the best are probably baclofen and chlorpromazine. It may perhaps be envisaged as the equivalent to Gowers sign but with hip adductor, rather than gluteal, weakness. It may reect an imbalance between afferent pupillary sympathetic and parasympathetic autonomic activity. Hitselberg Sign Hypoaesthesia of the posterior wall of the external auditory canal may be seen in facial paresis since the facial nerve sends a sensory branch to innervate this territory. Although sometimes a normal nding, for example, in the presence of generalized hyperreexia (anxiety, hyperthyroidism), it may be indicative of a corticospinal tract lesion above C5 or C6, particularly if present unilaterally. Reaction to accommodation is preserved (partial iri- doplegia), hence this is one of the causes of light-near pupillary dissociation.

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Prophylactic antenatal exposure to magnesium sulfate on postnatal thyroid hormones for prevention of neuroprotection and mortality in preterm morbidity and mortality in preterm infants prostate cancer gleason score eulexin 250 mg on line. Vitamin K prior to preterm birth with medically and surgically treated for preventing neonatal periventricular necrotizing enterocolitis. Intrapartum electronic fetal heart rate Efficacy of intensive versus nonintensive monitoring and the prevention of perinatal physiotherapy in children with cerebral brain injury. The adverse neuro- the use of botulinum toxin type A in the developmental effects of postnatal steroids management of children with cerebral palsy: in the preterm infant: a systematic review of a systematic review. Effectiveness of in preterm infants: systematic review of repeated treatment with botulinum toxin effects on mortality and motor function. Effectiveness of botulinum toxin A for upper and lower limb spasticity in children with cerebral palsy: a summary of evidence. European consensus table 2006 on Botulinum toxin type A in the management botulinum toxin for children with cerebral of equinus in children with cerebral palsy: palsy. Outcomes after selective dorsal toxin A as an adjunct to treatment in the rhizotomy for spastic cerebral palsy. Systematic Treatment Outcomes Committee Review review of progressive strength training in Panel. Report of a antispastic drugs in nonprogressive meeting held at Wolfson College, Oxford. Efficacy of review of the effectiveness of treadmill electrical stimulation to increase muscle training and body weight support in strength in people with neurological pediatric rehabilitation. Effect of weight supported treadmill training on cardiorespiratory training on aerobic fitness children with cerebral palsy. Does horseback riding therapy or children with cerebral palsy: a systematic therapist-directed hippotherapy rehabilitate review. Effectiveness Occupational therapy for children with of adaptive seating on sitting posture and cerebral palsy: a systematic review. A analysis in the rehabilitation of children with systematic review of upper extremity casting walking difficulties. Quality of reporting of randomized, Effects of gastrostomy feeding in children controlled trials in cerebral palsy. Gastrostomy therapy for cerebral palsy: the state of the feeding in cerebral palsy: a systematic evidence. Is injection of botulinum Effectiveness of physiotherapy and toxin type A effective in the treatment of conductive education interventions in drooling in children with cerebral palsy Effects of surgical botulinum toxin for the treatment of adductor releases for hip subluxation in sialorrhea. A systematic bone mineral density in children with review of the evidence for hip surveillance cerebral palsy. Pain in children with cerebral palsy: Impact on the surgical management of implications for pediatric physical therapy.


  • Are often pink or pale red
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  • Has heightened or low senses of sight, hearing, touch, smell, or taste
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However mens health 60 day transformation review purchase eulexin with amex, this is not a form of impaired muscle relaxation akin to myotonia and paramyotonia. For instance, when lifting the legs by placing the hands under the knees, the legs may be held extended at the knees despite encouragement on the part of the examiner for the patient to ex the knees. Generally, tendon reexes are normal, plantar responses downgoing, and there is no clonus. Gegenhalten is a sign of bilateral frontal lobe dysfunction, especially mesial cortex and superior convexity (premotor cortex, area 6. It is not uncommon in otherwise healthy elderly individuals with diffuse frontal lobe cerebrovascular disease. Cross References Frontal release signs; Myotonia; Paramyotonia; Rigidity; Spasticity Geophagia, Geophagy Geophagia or geophagy describes earth or clay eating, reports of which dating back to Hippocrates have been found. This may also fall under the rubric of pica, or pagophagia, a morbid craving for unusual or unsuitable food. Besides the obvious risk of infection from ingesting potentially contaminated material, geophagia may be associated with neurological complications. Cases of accid quadriparesis and of proximal myopathy associated with profound hypokalaemia in the context of geophagia have been reported, which may lead to walking difculty. Gerstmann syndrome occurs with lesions of the angular gyrus and supra- marginal gyrus in the posterior parietotemporal region of the dominant (usually left) hemisphere, for example, infarction in the territory of the middle cerebral artery. Hence this may be an example of a - 158 - Girdle Sensation G disconnection syndrome. Nonetheless the Gerstmann syndrome remains useful for the purposes of clinical localization. The enigma of Gerstmanns syndrome: a telling tale of the vicissitudes of neuropsychology. Geste antagoniste consists of a tactile or proprioceptive stimulus, which is learned by the patient, which reduces or eliminates the dystonic posture. For example, touching the chin, face, or neck may overcome cervical dystonia (torti- collis), and singing may inhibit blepharospasm.

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External factors relate to technical issues such as booking process and comfort of waiting area and internal factors 89 90 91 relate to patient-therapist interaction prostate 5lx amazon buy 250 mg eulexin mastercard. Our survey yielded high satisfaction rates with services 90 91 95 and is comparable to other satisfaction surveys which tend to produce high satisfaction rates. This can possibly be explained by the fact that therapy sessions were held consistently every tonight, whereas with the hospital based group, the bookings were more random. Some authors postulate that bookings should be made in line with the 90 91 schedules of clients to maximise satisfaction and compliance. Therefore, the consistency in bookings might be seen as an enhancer to the satisfaction for caregivers in the community based treatment group as it also gave them more control over planning their routines. This is very noteworthy considering that most of the caregivers were unemployed and reported financial strain. Therefore, a consistent booking schedule grants caregivers the autonomy to plan their schedules in advance which may be critical in juggling between sourcing for survival and attending therapy sessions. This could also explain why the fortnight gap is more acceptable to caregivers in the community based treatment group as depicted by higher compliance and satisfaction rates. Therefore, in the context of the local setting, it is the authors opinion that availability of seats would greatly affect satisfaction as most caregivers have to stand while awaiting services. Evidence supports that the greater the amount spent with the therapist, the 93 45 greater the satisfaction. Secondly, a lower ratio would also imply less time pressure on the part of therapists. This could have accounted for the dissatisfaction with the amount of explanations and the advice given by therapists in recipients of hospital based services. This is essential as the amount of knowledge of the impairment(s)/health condition and of 8 90 99 the treatment process is associated with greater satisfaction. More so, these workshops give caregivers ample time to ask questions as opposed to the usual treatment scenario were the pressure is to serve as many clients in a short space of time. Furthermore, workshops are also an excellent platform for practical demonstrations of various treatment regimes. Therefore, it seems reasonable to expect caregivers who would have gone through workshops to be more satisfied with prescribed home exercise programs as they will have background knowledge of therapy. It is likely that due to time pressure and shortage of professional counsellors, caregivers in the hospital based group were are more likely to leave with unanswered questions which cannot be addressed in normal treatment sessions as opposed to workshops scenario. Organizational issues have a bearing on the inter-personal relationship between therapists and 90 91 95 97 caregivers thus ultimately affecting satisfaction. The discrepancy in satisfaction can be accounted for by organizational differences between the two modes of care, for instance, 105 differences in continuity of care. Continuity of treatment, whereby the therapists are allocated a specific workload i. Moreover, continuity of care has the potential to provide a platform for more dialogue and understanding between caregiver and therapist as opposed to being treated by a different therapist all the time.

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Fine motor activities in elementary school: preliminary findings and provisional implications for children with fine motor problems prostate defense generic 250 mg eulexin visa. Stepping over obstacles: anticipatory modifications in children with and without Down syndrome. Unlike the muscles of the limbs, the muscles involved in lumbopelvic stability also perform a variety of essential homeostatic functions, such as breathing and continence, in addition to movement and control of the trunk (Hodges & Gandevia, 2000; McGill et al. Thus, it is also possible that faulty posture and anatomical changes cause the physiological function changes in the body that is starting as a adoptive breathing strategies, such adoptive strategies would relax the abdominal musculature more than the neccessory on inspiration. The adoptive breathing pattern may result in the more upper chest breathing and less efficient diaphragm activity. The purpose of this study is that as there are various factors which comes in play in the patient of the chronic low back pain like the postural disturbances, pain, weakness of the abdominal muscles, the weakness of the thoracic muscles, weakness of the chest wall muscles and also the important respiratory muscles of respiration that is the diaphragm, there are several other factors also like the duration of the low back pain or the intensity and the functional status of the patient. Method: Sample size- 120 subjects (41 male and 19 female in patient group, and 39 male and 21 female in normal person group),Study design- A Non experimental correlation design. The normal healthy subjects are selected from the students population or also the normal subjects who are visited the hospital along with the other patients. After selecting the patient as well normal healthy individuals informed written consent was also obtained from each subjects including patient as well as healthy normal subjects. After explaining the purpose of study, subject are go through a thorough assessment, and a general clinical examination, was also carried out to rule out any gross pulmonary or the heart diseases and nervous system disorders. Additional questions were asked to reveal the type of the occupation to exclude those patients who worked in any industries or in the polluted area or also to see that whether the subject is a sport person. The subject is sitted erect in a slient room and takes a rest for some time and get relax before the procedure. Each subject was shown a demonstration of the test before actual test was carried out on him/her. First give them their mouthpiece and ask him/her to try with, by blowing through it as fast as hard for as long as possible. The minimum of three readings were recorded of each test performed by every subject and the best of the three are selected having reproducibility and validity of recorded parameters. The actual values of all these parameters of patient group as well as the healthy subjects group were taken. Data analysis- All the data are collected by examine the patient as per the assessment format and function test was performed by using the spirometery. Andreoni, 1999) as well as nonpulmonary factors (motivation, sensorium, muscles force and endurance.

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Venous thromboembolism causes death in fewer than one in 100 cases prostate oncology wikipedia buy eulexin visa, but it can cause serious complications. Prevention Blood clots can be prevented by special compression stockings and anti-clotting medicines such as heparin. Preventive treatment with heparin (usually given by injection under the skin) is recommended for most people with a glioma, especially those most at risk because they are elderly, unable to walk much, or have a high-grade tumour. These medicines can increase the risk of bleeding, so they should be stopped if the person needs surgery. Treatment should be started again after surgery and continued until the person is active and walking again. Treatment for blood clots Treatment with heparin is recommended to treat blood clots in people with gliomas. If a blood clot occurs immediately after brain surgery, heparin and warfarin are not normally used and the clot is treated other ways. The risk is higher for people with risk factors, including old age and brain tumours. Brain tumours could have a higher risk of bleeding into the brain, because they have a more blood vessels than normal brain tissue. Swelling in the brain (oedema) Oedema is common in people with brain tumours and leads to symptoms of headache, nausea and vomiting. It is not normally given if the oedema is seen on a scan but the person has no symptoms. Dexamethasone is also used to help prevent oedema in people who have radiotherapy to a large part of the brain. The usual starting dose of dexamethasone is 16 mg each day, usually given in two or four doses. After starting dexamethasone, the dose should be gradually reduced until the person is taking the lowest amount that will still control their symptoms. If possible, dexamethasone treatment should be gradually stopped after the person has finished radiotherapy. There is information about side effects of corticosteroids in the next section (Other side effects of cancer treatments. Adult gliomas (astrocytomas and oligodendrogliomas): a guide for patients, their families and carers 80 8078 Adult gliomas (astrocytomas and oligodendrogliomas): a guide for patients, their families and carers Other side effects of cancer treatments Radiotherapy Although radiotherapy is aimed at the tumour, it damages surrounding healthy tissue as well. Effects on brain function the side effects of radiotherapy depend on a persons age, the doses of radiation given at each time, the total dose of radiation they received, and the timing of chemotherapy (if given.

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Nevertheless androgen hormone pregnancy purchase cheapest eulexin and eulexin, the benefits of -adrenergic blockers in patients with either coronary artery disease or heart failure ensure that these drugs will continue to be widely used. On the other hand, the peripheral resistance usually rises acutely but falls toward (if not to) normal with time. Renin level falls promptly due to reduction in the processing of prorenin and active renin [18]. Various preparations have equal antihypertensive efficacy but some, particularly the lipophilic preparation, may not provide a full 24-hour lowering of blood pressure which can be particularly critical in protecting against early morning cardiovascular catastrophes. Most preparations have a flat dose response curve, but the combination with even a low dose of diuretic will enhance their efficacy [103]. Treatment of hypertension 59 Combined - and -adrenergic receptor blockers Modification of the conventional -blocker structure has provided agents with combined - and - blocking properties. The antihypertensive effect of these agents is mainly mediated by a fall in peripheral vascular resistance. Carvidolol has been shown to reduce the risk of death and hospitalization by cardiovascular causes in various degrees of heart failure. Labetalol has been used both orally and intravenously to treat hypertensive emergencies, acute aortic dissection, phaeochromocytoma, clonidine withdrawal and cocaine-related hypertensive crises. The most common side-effect of these agents is orthostatic hypotension and the most serious is hepatotoxicity, which can progress slowly with minimal symptomatology [104]. Direct vasodilators these agents enter the vascular smooth muscle cells to produce direct vasodilation unmediated by other mechanisms, such as inhibiting hormonal vasoconstriction, calcium entry or blocking -adrenergic receptors. Coincidental to peripheral vasodilatation, the heart rate, stroke volume and cardiac output increase as a result of baroreceptors-mediated reflex increase in sympathetic discharge. They are chosen as third agents in multidrug treatment of severe hypertension, usually in combination with -blockers and diuretics. Minoxidil is more potent than hydralazine and has become a mainstay in the therapy of severe hypertension associated with renal insufficiency. They interact with the L-type voltage-gated plasma membrane channel to produce vasodilation [107]. They also restore nitric oxide availability, most probably by an antioxidant effect on endothelial cells. Additionally they relatively inhibit aldosterone production resulting in natriuresis.


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  • https://www.ncjrs.gov/pdffiles1/bja/205621.pdf
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