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Guerrero-López CM, Serván-Mori E, Jan S, Downey L, Heredia-Pi I, Orozco-Núñez E, Muradás-Troitiño MDLC, Norton R. Gender disparities in lost productivity resulting from non-communicable diseases in Mexico, 2005-2021. J Glob Health 2024; 14:04121. [PMID: 38818618 PMCID: PMC11140423 DOI: 10.7189/jogh.14.04121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2024] Open
Abstract
Background Non-communicable diseases (NCDs) cause long-term impacts on health and can substantially affect people's ability to work. Little is known about how such impacts vary by gender, particularly in low- and middle-income countries (LMICs), where productivity losses may affect economic development. This study assessed the long-term productivity loss caused by major NCDs among adult women and men (20-76 years) in Mexico because of premature death and hospitalisations, between 2005 and 2021. Methods We conducted an economic valuation based on the Human Capital Approach. We obtained population-based data from the National Employment Survey from 2005 to 2021 to estimate the expected productivity according to age and gender using a two-part model. We utilised expected productivity based on wage rates to calculate the productivity loss, employing Mexican official mortality registries and hospital discharge microdata for the same period. To assess the variability in our estimations, we performed sensitivity analyses under two different scenarios. Results Premature mortality by cancers, diabetes, chronic cardiovascular diseases (CVD), chronic respiratory diseases (CRD) and chronic kidney disease (CKD) caused a productivity loss of 102.6 billion international US dollars (Intl. USD) from 2.8 million premature deaths. Seventy-three percent of this productivity loss was observed among men. Cancers caused 38.3% of the productivity loss (mainly among women), diabetes 38.1, CVD 15.1, CRD 3.2, and CKD 5.3%. Regarding hospitalisations, the estimated productivity loss was 729.7 million Intl. USD from 54.2 million days of hospitalisation. Men faced 65.4 and women 34.6% of these costs. Cancers caused 41.3% of the productivity loss mainly by women, followed by diabetes (22.1%), CKD (20.4%), CVD (13.6%) and CRD (2.6%). Conclusions Major NCDs impose substantial costs from lost productivity in Mexico and these tend to be higher amongst men, while for some diseases the economic burden is higher for women. This should be considered to inform policymakers to design effective gender-sensitive health and social protection interventions to tackle the burden of NCDs.
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Affiliation(s)
- Carlos M Guerrero-López
- Center for Health Systems Research, The National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Edson Serván-Mori
- Center for Health Systems Research, The National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Stephen Jan
- The George Institute for Global Health, UNSW, Sydney, New South Wales, Australia
- The George Institute for Global Health, School of Public Health, Imperial College London, London, Scotland, UK
- Centre for Health Economics and Policy Innovation, Business School, Imperial College London, London
| | - Laura Downey
- The George Institute for Global Health, UNSW, Sydney, New South Wales, Australia
- The George Institute for Global Health, School of Public Health, Imperial College London, London, Scotland, UK
| | - Ileana Heredia-Pi
- Center for Health Systems Research, The National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Emanuel Orozco-Núñez
- Center for Health Systems Research, The National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | | | - Robyn Norton
- The George Institute for Global Health, UNSW, Sydney, New South Wales, Australia
- The George Institute for Global Health, School of Public Health, Imperial College London, London, Scotland, UK
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Ida FS, Ferreira HP, Vasconcelos AKM, Furtado IAB, Fontenele CJPM, Pereira AC. Post-COVID-19 syndrome: persistent symptoms, functional impact, quality of life, return to work, and indirect costs - a prospective case study 12 months after COVID-19 infection. CAD SAUDE PUBLICA 2024; 40:e00022623. [PMID: 38381867 PMCID: PMC10877695 DOI: 10.1590/0102-311xpt026623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 09/13/2023] [Accepted: 10/05/2023] [Indexed: 02/23/2024] Open
Abstract
The persistent symptoms of post-COVID-19 syndrome negatively impact health, quality of life, and productivity. This study aimed to describe the persistent symptoms of post-COVID-19 syndrome (especially neurological ones) and their 12-month post-infection cognitive, emotional, motor, quality of life, and indirect cost repercussions. Patients showing the first symptoms of COVID-19 from January to June 2021 who developed post-COVID-19 syndrome and sought care at the Fortaleza Unit (Ceará, Brazil) of the SARAH Network of Rehabilitation Hospitals were included in this study. Information was obtained at the baseline follow-up and by telephone interview 12 months post-infection. In total, 58 people participated in this study with an average age of 52.8±10.5 years, of which 60% required an ICU. The most frequent symptoms on admission included fatigue (64%), arthralgia (51%), and dyspnea (47%), whereas, after 12 months, fatigue (46%) and memory impairment (39%). The following scales/functional tests showed alterations: PCFS, MoCA, HAD, FSS, SF-36, TLS5x, timed up and go, 6-minute walk, and handgrip. Indirect costs totaled USD 227,821.00, with 11,653 days of absenteeism. Moreover, 32% of patients were unable to return to work. Better TLS5x and higher SF-36 scores in the functional capacity, physical functioning, vitality, and pain dimensions were associated with return to work (p ≤ 0.05). The most frequent persistent symptoms referred to fatigue, arthralgia, dyspnea, anxiety, and depression, which negatively affected cognitive, emotional, and motor function and quality of life. These symptoms lasted for over a year, especially fatigue and memory alteration, the latter of which being the most reported after COVID-19 infections. Results also show a significant difficulty returning to work and indirect costs of USD 4,847.25 per person/year.
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Affiliation(s)
- Fernando Shizuo Ida
- Centro de Neurorreabilitação SARAH Fortaleza, Rede SARAH de Hospitais de Reabilitação, Fortaleza, Brasil
| | - Hebert Pereira Ferreira
- Centro de Neurorreabilitação SARAH Fortaleza, Rede SARAH de Hospitais de Reabilitação, Fortaleza, Brasil
| | | | - Iris Aline Brito Furtado
- Centro de Neurorreabilitação SARAH Fortaleza, Rede SARAH de Hospitais de Reabilitação, Fortaleza, Brasil
| | | | - Antonio Carlos Pereira
- Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas, Piracicaba, Brasil
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Di Fabio S, La Torre G. Analysis of the Economic Burden of COVID-19 on the Workers of a Teaching Hospital in the Centre of Italy: Changes in Productivity Loss and Healthcare Costs Pre and Post Vaccination Campaign. Vaccines (Basel) 2023; 11:1791. [PMID: 38140197 PMCID: PMC10747819 DOI: 10.3390/vaccines11121791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 11/10/2023] [Accepted: 11/28/2023] [Indexed: 12/24/2023] Open
Abstract
Introduction: Following the concerning levels of spread and severity of the infection, on 11 March 2020, the World Health Organisation declared the COVID-19 outbreak a pandemic. In response to the pandemic, governments adopted several mitigation strategies. The pandemic posed a great threat to the Italian healthcare workforce (HW), with Italy being one of the hardest-hit countries. The aim of this study is to estimate the economic burden of COVID-19 on the workforce of a teaching hospital in Central Italy. Two periods are compared: 1 March 2020-9 February 2021 vs. 10 February 2021-31 March 2022. Methods: This study is conducted from a societal perspective. The database (n = 3298) of COVID-19-confirmed cases among the HW was obtained from the occupational health office of the hospital. The first entry on the database refers to 1 March 2020. Cost data were used to assess the economic burden of COVID-19 on the hospital workforce. They include two main groups: hourly salaries and medical expenses. The cost of productivity loss, hospital admission, at-home treatments, and contact tracing and screening tests were computed for the first and second periods of the analysis. Results: The total economic burden during the first period is estimated to be around EUR 3.8 million and in the second period EUR 4 million. However, the average cost per person is smaller in the second period (EUR 1561.78) compared to the first one (EUR 5906). In both periods, the cost of productivity loss is the largest component of the economic burden (55% and 57%). The cost of hospital admission decreased by more than 60% in the second period. Conclusion: Outcomes of the analysis suggest that the economic burden of COVID-19 on the HW is higher in the first period of analysis compared to the second period. The main reason could be identified in the shift from more severe and critical confirmed cases to more asymptomatic, mild, and moderate cases. The causes of this shift are not easily detectable. Vaccination, variants of the virus, and an individual's determinants of health could all be causes of the decrease in the economic burden of COVID-19 on the HW. COVID-19 can generate a high economic burden on healthcare workers and, more generally, on HWs. However, a comprehensive estimate of the economic burden of the pandemic needs to integrate the mental health repercussions and the long-term COVID-19 that will become evident in the coming years.
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Affiliation(s)
| | - Giuseppe La Torre
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
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Ortega-Ortega M, Hanly P, Pearce A, Soerjomataram I, Sharp L. Projected Impact on Labour Productivity Costs of Cancer-Related Premature Mortality in Europe 2018-2040. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2023; 21:877-889. [PMID: 37552416 PMCID: PMC10627946 DOI: 10.1007/s40258-023-00824-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/04/2023] [Indexed: 08/09/2023]
Abstract
AIM To estimate the potential cost of lost labour productivity due to cancer-related premature mortality in Europe (EU-27 plus Norway, Switzerland, Iceland and United Kingdom) from 2018 to 2040. METHODS Deaths and years of potential productive life lost due to 23 types of cancer were estimated for 2018-2040, for 31 European countries. The data were analysed by age groups, by sex and by year. Projected productivity costs were estimated by calculating gross earnings by country, gender and age group using the Human Capital Approach, adjusting for projected labour force participation and unemployment rates. Various data sources were used. Sensitivity analyses were conducted. RESULTS Between 2018 and 2040, cancer is expected to cause around eight million premature deaths (58% male). The cumulative projected productivity costs in this respect are €1.3 trillion, representing an annual average of €58.7 billion, or 0.43% of the EU-27 gross domestic product. Labour productivity costs are projected to decrease by 6% from 2018 to 2040. The highest cost region is Western Europe, where Germany and France will experience the highest cumulative losses (€288 and €192 billion, respectively). The most costly cancers, in terms of total costs related to productivity losses, are of the lung and colorectum (€264.4 and €116.3 billion, respectively). In terms of average productivity cost per death, the most costly forms of cancer are Hodgkin lymphoma (€301,157) and melanoma (€260,522). CONCLUSION The novel information presented could help national policymakers anticipate possible areas for cost savings. Action should be taken on disease prevention, on reducing mortality and on delaying the age of death due to Hodgkin lymphoma, brain cancer, leukaemia and melanoma. Furthermore, the study findings enhance our understanding of macroeconomic variables and could be useful in determining a re-allocation of health expenditures.
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Affiliation(s)
- Marta Ortega-Ortega
- Department of Applied and Public Economics, and Political Economy, Complutense University of Madrid, Campus de Somosaguas, Pozuelo de Alarcón, 28223, Madrid, Spain.
| | - Paul Hanly
- School of Business, National College of Ireland, Mayor Street, Dublin 1, Ireland
| | - Alison Pearce
- Daffodil Centre, University of Sydney, A Joint Venture with Cancer Council NSW, The University of Sydney, Sydney, NSW, 2006, Australia
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Isabelle Soerjomataram
- Cancer Surveillance Branch, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372, Lyon CEDEX 08, France
| | - Linda Sharp
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Sir James Spence Institute, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne, NE1 4LP, UK
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Wang H, Zeng W, Kabubei KM, Rasanathan JJK, Kazungu J, Ginindza S, Mtshali S, Salinas LE, McClelland A, Buissonniere M, Lee CT, Chuma J, Veillard J, Matsebula T, Chopra M. Modelling the economic burden of SARS-CoV-2 infection in health care workers in four countries. Nat Commun 2023; 14:2791. [PMID: 37188709 DOI: 10.1038/s41467-023-38477-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 05/03/2023] [Indexed: 05/17/2023] Open
Abstract
Health care workers (HCWs) experienced greater risk of SARS-CoV-2 infection during the COVID-19 pandemic. This study applies a cost-of-illness (COI) approach to model the economic burden associated with SARS-CoV-2 infections among HCWs in five low- and middle-income sites (Kenya, Eswatini, Colombia, KwaZulu-Natal province, and Western Cape province of South Africa) during the first year of the pandemic. We find that not only did HCWs have a higher incidence of COVID-19 than the general population, but in all sites except Colombia, viral transmission from infected HCWs to close contacts resulted in substantial secondary SARS-CoV-2 infection and death. Disruption in health services as a result of HCW illness affected maternal and child deaths dramatically. Total economic losses attributable to SARS-CoV-2 infection among HCWs as a share of total health expenditure ranged from 1.51% in Colombia to 8.38% in Western Cape province, South Africa. This economic burden to society highlights the importance of adequate infection prevention and control measures to minimize the risk of SARS-CoV-2 infection in HCWs.
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Affiliation(s)
| | - Wu Zeng
- Department of Global Health, Georgetown University, Washington, DC, USA.
| | | | | | - Jacob Kazungu
- Health Economics Research Unit, KEMRI Welcome Trust Research Program, Nairobi, Kenya
| | | | - Sifiso Mtshali
- Public Health Medicine Department, University of KwaZulu-Natal, Durban, South Africa
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Benoni R, Campagna I, Moretti F, Tardivo S. Comparing swab- and different symptoms-based strategies to ascertain COVID-19 recovery in healthcare workers: a cost-effectiveness analysis. Cost Eff Resour Alloc 2022; 20:50. [PMID: 36096794 PMCID: PMC9465662 DOI: 10.1186/s12962-022-00385-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 08/13/2022] [Indexed: 11/15/2022] Open
Abstract
Objective Given the human and economic cost of the COVID-19 pandemic, protecting healthcare workers (HCW) and ensuring continuity of care is critical. The aim of this study is to evaluate the cost-effectiveness of different strategies to ascertain COVID-19 recovery in HCWs. Methods Data were collected from the hospital health surveillance program on HCWs at the University Hospital of Verona between 29/02/2020 and 14/04/2021. The diagnosis of SARS-CoV-2 infection and the assessment of the recovery were made through RT-PCR on oro-nasopharyngeal swab-sample. Recovery time and probability were estimated through Kaplan–Meier estimate. For each recovery assessment strategy costs (laboratory diagnostics and human resources), expressed in local currency (euro—€), and working days saved (WDS—effectiveness) were estimated. A decision-tree was created where each knot was a time point scheduled by the different recovery assessment strategies. A Monte Carlo simulation method was used, and probabilistic sensitivity analysis assessed the effect of input uncertainty. Results In the study period 916 (9.9%) HCWs tested positive. Recovery time through symptom-based strategy (21 days 0.95 CI 16–24) was significantly lower compared to swab-based one (25 days 0.95 CI 23–28, p < 0.001). The swab-based strategy was dominated by all symptoms-based ones. Symptoms-based with a swab on days 14 and 17 had an ICER of 2 €/WDS and 27 €/WDS compared to the one scheduled on days 10 and 17 and with only one swab on the 17th day. Conclusions Scheduling swabs on days 14 and 17 in a symptom-based strategy was the most cost-effective, saving 7.5 more working days than the standard one with swabs on days 10 and 17. Supplementary Information The online version contains supplementary material available at 10.1186/s12962-022-00385-w.
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Benavides FG, Vives A, Zimmerman M, Silva-Peñaherrera M. [Excess mortality in 2020 in the working-age population of nine Latin American countriesExcesso de mortalidade na população em idade ativa em nove países da América Latina no ano de 2020]. Rev Panam Salud Publica 2022; 46:e75. [PMID: 35747472 PMCID: PMC9211029 DOI: 10.26633/rpsp.2022.75] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 04/05/2022] [Indexed: 11/24/2022] Open
Abstract
Objetivo. Estimar el impacto de la pandemia de la COVID-19 durante el año 2020, a través del exceso de mortalidad por todas las causas y los años potenciales de vida laboral perdidos en la población en edad de trabajar, de una selección de países latinoamericanos y el Caribe. Métodos. Estudio basado en datos de defunciones por todas las causas entre 15 y 69 años, procedentes principalmente de los Institutos Nacionales de Estadísticas. Se estimaron defunciones esperadas a partir de las registradas entre 2015 y 2019. El exceso de mortalidad fue estimado a través del indicador P, la razón de mortalidad estandarizada (RME) y los años potenciales de vida laboral perdidos (AVLP) hasta los 70 años. Resultados. El exceso de defunciones en Brasil, Bolivia, Chile, Colombia, Costa Rica, Cuba, México, Perú y República Dominicana sumó 426 978 (279 591 en hombres y 147 438 en mujeres), lo que representó una pérdida de 5 710 048 (3 738 775 en hombres y 1 971 273 en mujeres) de APVLP. La mortalidad observada fue significativamente superior a la esperada en todos los países, menos República Dominicana. Conclusiones. El impacto de la COVID-19 en la población en edad de trabajar tendrá un impacto profundo en la situación socioeconómica. El recuento oportuno del exceso de muertes resulta útil y puede ser usado como un sistema de alerta temprana para monitorizar la magnitud de los brotes de COVID-19. La monitorización del exceso de mortalidad en personas en edad de trabajar, realizada por el Observatorio Iberoamericano de Seguridad y Salud en el Trabajo permite evaluar con mayor exactitud la carga social y económica de la COVID-19.
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Affiliation(s)
- Fernando G Benavides
- Observatorio Iberoamericano de Seguridad y Salud en el Trabajo Centro de Investigación en Salud Laboral Universitat Pompeu Fabra IMIM (Instituto Hospital del Mar de Investigaciones Médicas) CIBER Epidemiología y Salud Pública (CIBERESP) Barcelona España Observatorio Iberoamericano de Seguridad y Salud en el Trabajo, Centro de Investigación en Salud Laboral, Universitat Pompeu Fabra, IMIM (Instituto Hospital del Mar de Investigaciones Médicas) CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, España
| | - Alejandra Vives
- Departamento de Salud Pública, Pontificia Universidad Católica de Chile CEDEUS Santiago Chile Departamento de Salud Pública, Pontificia Universidad Católica de Chile. CEDEUS. Santiago, Chile
| | - Marta Zimmerman
- Instituto Nacional de Seguridad y Salud en el Trabajo Ministerio de Trabajo y Economía Social España Instituto Nacional de Seguridad y Salud en el Trabajo, Ministerio de Trabajo y Economía Social, España
| | - Michael Silva-Peñaherrera
- Observatorio Iberoamericano de Seguridad y Salud en el Trabajo Centro de Investigación en Salud Laboral Universitat Pompeu Fabra IMIM (Instituto Hospital del Mar de Investigaciones Médicas) CIBER Epidemiología y Salud Pública (CIBERESP) Barcelona España Observatorio Iberoamericano de Seguridad y Salud en el Trabajo, Centro de Investigación en Salud Laboral, Universitat Pompeu Fabra, IMIM (Instituto Hospital del Mar de Investigaciones Médicas) CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, España
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The Impact of COVID-19 Vaccination on the Italian Healthcare System: A Scenario Analysis. Clin Drug Investig 2022; 42:237-242. [PMID: 35218000 PMCID: PMC8881093 DOI: 10.1007/s40261-022-01127-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2022] [Indexed: 12/02/2022]
Abstract
Background and Objective During 2020, the only instruments for fighting against the pandemic peaks were lockdowns, physical distancing, closure of schools and non-essential businesses, and travel restrictions. The new vaccination strategy adopted in Italy in 2021 represented a new perspective for policymakers. Objective The aim of this study was to estimate the effects of the national immunisation strategy for coronavirus disease 2019 (COVID-19) in Italy on the national healthcare system. Methods An epidemiological scenario analysis was developed in order to simulate the impact of the COVID-19 pandemic on the Italian national healthcare system in 2021. Hospitalisations, intensive care unit (ICU) admissions and death rates were modelled based on 2020 data. Costs were estimated using hospital admissions from the Policlinico of Tor Vergata Hospital in Rome. Two scenarios were tested, one with vaccination and the second without. Results The roll-out of vaccinations to protect against COVID-19 was estimated to prevent 52,115 deaths in 2021, 45.2% less than what was expected in the absence of immunisation. Based on the assumptions underlying the two epidemiological scenarios, our model predicted an overall reduction of 2.4 million hospital admissions and 259,000 ICU admissions (74.9% and 71.3% less, respectively, than the world without vaccinations between June and December 2021). Overall, in Italy, the model estimated over €3.0 billion costs of hospitalisations due to COVID-19 in 2020. In 2021, vaccines prevented around 36% of the overall costs. Conclusions This is the first study highlighting the effect of vaccines on the Italian healthcare system in terms of avoided cases, hospitalisations and costs. Our results have the potential to inform policymakers and the general population on the benefits of vaccinations. Supplementary Information The online version contains supplementary material available at 10.1007/s40261-022-01127-9.
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