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Kim MS, Kim KH, Choe G, Park YH. Comparative Effectiveness of Personal Sound Amplification Products Versus Hearing Aids for Unilateral Hearing Loss: A Prospective Randomized Crossover Trial. J Korean Med Sci 2024; 39:e179. [PMID: 38887200 PMCID: PMC11182698 DOI: 10.3346/jkms.2024.39.e179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Accepted: 05/14/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND This study compared hearing outcomes with use of personal sound amplification products (PSAPs) and hearing aids (HAs) in patients with moderate to moderately severe unilateral hearing loss. METHODS Thirty-nine participants were prospectively enrolled, and randomly assigned to use either one HA (basic or premium type) or one PSAP (basic or high-end type) for the first 8 weeks and then the other device for the following 8 weeks. Participants underwent a battery of examinations at three visits, including sound-field audiometry, word recognition score (WRS), speech perception in quiet and in noise, real-ear measurement, and self-report questionnaires. RESULTS Functional gain was significantly higher with HAs across all frequencies (P < 0.001). While both PSAPs and HAs improved WRS from the unaided condition, HAs were superior to PSAPs. The speech recognition threshold in quiet conditions and signal-to-noise ratio in noisy conditions were significantly lower in the HA-aided condition than in the PSAP-aided condition, and in the PSAP-aided condition than in the unaided condition. Subjective satisfaction also favored HAs than PSAPs in questionnaires, Abbreviated Profile of Hearing Aid Benefit, International Outcome Inventory for Hearing Aids, and Host Institutional Questionnaire. CONCLUSION While PSAPs provide some benefit for moderate to moderately severe unilateral hearing loss, HAs are more effective. This underscores the potential role of PSAPs as an accessible, affordable first-line intervention in hearing rehabilitation, particularly for individuals facing challenges in accessing conventional HAs.
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Affiliation(s)
- Min Su Kim
- Department of Otolaryngology-Head and Neck Surgery, Chungnam National University College of Medicine, Daejeon, Korea
| | - Kwan Ho Kim
- Department of Otolaryngology-Head and Neck Surgery, Chungnam National University College of Medicine, Daejeon, Korea
| | - Goun Choe
- Department of Otolaryngology-Head and Neck Surgery, Chungnam National University Sejong Hospital, Chungnam National University College of Medicine, Sejong, Korea.
| | - Yong-Ho Park
- Department of Otolaryngology-Head and Neck Surgery, Chungnam National University College of Medicine, Daejeon, Korea
- Brain Research Institute, College of Medicine, Chungnam National University, Daejeon, Korea.
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Sheffield SW, Jacobs M, Ellis C, Gerasimchik A. Comparing Direct-to-Consumer Devices to Hearing Aids: Amplification Accuracy for Three Types of Hearing Loss. Am J Audiol 2023:1-12. [PMID: 38052055 DOI: 10.1044/2023_aja-22-00170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023] Open
Abstract
PURPOSE The U.S. Food and Drug Administration finalized regulations for over-the-counter hearing aids (OTC-HAs) on August 17, 2022. Little is known about the comparative performance of OTC-HAs and prescription HAs. This study compared amplification accuracy of prescription HAs and direct-to-consumer devices (DTCDs, including personal sound amplification products [PSAPs] and OTC-HAs). METHOD Eleven devices were programmed to meet prescriptive targets in an acoustic manikin for three degrees of hearing loss. Devices consisted of high- and low-end HAs, PSAPS, and OTC-HAs. Each was tested, and deviations from target measured with an HA analyzer at every combination of 10 frequencies and low-, average-, and high-level inputs. Accuracy was compared using a multilevel Poisson model with device-specific intercepts controlling for input level, frequency, and device type. RESULTS For mild-moderate hearing loss, deviations from targets were not statistically different between high- and low-end HAs, but PSAPs (5.50 dB, SE = 0.92 dB) and OTC-HAs (8.83 dB, SE = 1.10 dB) had larger differentials. For flat moderate hearing loss, compared to high-end HAs, average differentials were larger for all device types at all input levels and frequencies (Low HA: 3.82 dB, SE = 1.10 dB; PSAP: 9.24 dB, SE = 1.22 dB; OTC-HA: 8.61 dB, SE = 1.19 dB). For mild sloping to severe hearing loss, compared to high-end HAs, OTC-HAs (9.72 dB, SE = 1.20 dB) and PSAPs (7.34 dB, SE = 1.07 dB) had larger differentials and significant variability at the highest and lowest frequencies. Half (three) of the PSAPs and OTC-HAs met most targets within ±5 dB. CONCLUSIONS DTCDs were unable to meet prescriptive targets for severe types of hearing loss but could meet them for mild hearing loss. This study provides an examination of current hearing devices. More research is needed to determine whether meeting prescriptive targets provides any benefit in the outcomes and performance with DTCD devices.
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Affiliation(s)
- Sterling W Sheffield
- Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville
| | - Molly Jacobs
- Department of Health Services Research, Management and Policy, University of Florida, Gainesville
| | - Charles Ellis
- Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville
| | - Amber Gerasimchik
- Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville
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Venkitakrishnan S, Urbanski D, Wu YH. Efficacy and Effectiveness of Evidence-Based Non-Self-Fitting Presets Compared to Prescription Hearing Aid Fittings and a Personal Sound Amplification Product. Am J Audiol 2023; 33:1-24. [PMID: 37956699 PMCID: PMC11001427 DOI: 10.1044/2023_aja-23-00121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 09/07/2023] [Accepted: 09/14/2023] [Indexed: 11/15/2023] Open
Abstract
PURPOSE In this study, we compare the efficacy and effectiveness of gain-frequency responses of evidence-based presets developed by our lab for over-the-counter hearing aids to conventional National Acoustic Laboratories' nonlinear fitting procedure, version 2 (NAL-NL2) gain-frequency response and to gain-frequency response of a personal sound amplification product (PSAP). We hypothesized that the hearing aids with our presets would perform better than a PSAP with poor frequency response and comparably to the hearing aid with NAL-NL2 frequency response. METHOD We used a single-blinded, randomized cross-over design to compare audibility, speech recognition, sound quality, listening effort, and subjective preferences in 37 participants in laboratory settings and following field trials. RESULTS The presets developed in our lab showed comparable outcomes to the hearing aids with NAL-NL2 gain-frequency response in most measured domains. Performance with the presets was better than the PSAP gain-frequency response in the domains of listening effort and sound quality in laboratory testing and speech recognition in our real-world measures. We also found that most participants (54.05%) preferred our presets over the PSAPs and were willing to pay significantly more to purchase the hearing aids with our presets. CONCLUSION Our evidence-based presets have better outcomes than a PSAP with a single, poorly suited frequency response while performing comparably to the clinical best-practice National Acoustic Laboratories condition.
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Affiliation(s)
- Soumya Venkitakrishnan
- Department of Communication Sciences and Disorders, California State University, Sacramento
| | - Dana Urbanski
- Department of Communication Sciences and Disorders, University of Minnesota Duluth
| | - Yu-Hsiang Wu
- Department of Communication Sciences and Disorders, The University of Iowa, Iowa City
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Kim GY, Moon IJ. Changes in the Hearing Aid Market Due to Over-the-Counter Hearing Aids. Clin Exp Otorhinolaryngol 2023; 16:199-200. [PMID: 37591485 PMCID: PMC10471901 DOI: 10.21053/ceo.2023.00948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 07/06/2023] [Accepted: 07/13/2023] [Indexed: 08/19/2023] Open
Affiliation(s)
- Ga-Young Kim
- Hearing Research Laboratory, Samsung Medical Center, Seoul, Korea
- Medical Research Institute, Sungkyunkwan University School of Medicine, Suwon, Korea
- Department of Digital Health, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Suwon, Korea
| | - Il Joon Moon
- Hearing Research Laboratory, Samsung Medical Center, Seoul, Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Suwon, Korea
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Chen CH, Huang CY, Cheng HL, Lin HYH, Chu YC, Chang CY, Lai YH, Wang MC, Cheng YF. Comparison of personal sound amplification products and conventional hearing aids for patients with hearing loss: A systematic review with meta-analysis. EClinicalMedicine 2022; 46:101378. [PMID: 35434580 PMCID: PMC9006672 DOI: 10.1016/j.eclinm.2022.101378] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 03/10/2022] [Accepted: 03/21/2022] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Hearing loss is a common morbidity that requires a hearing device to improve quality of life and prevent sequelae, such as dementia, depression falls, and cardiovascular disease. However, conventional hearing aids have some limitations, including poor accessibility and unaffordability. Consequently, personal sound amplification products (PSAPs) are considered a potential first-line alternative remedy for patients with hearing loss. The main objective of this study was to compare the efficacy of PSAPs and conventional hearing aids regarding hearing benefits in patients with hearing loss. METHODS This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Five databases and reference lists were searched from inception to January 12, 2022. Studies including randomised, controlled trials; nonrandomised, controlled trials; or observational studies comparing PSAPs and hearing aids with regard to hearing gain performance (e.g., speech intelligence) were considered eligible. The review was registered prospectively on PROSPERO (CRD42021267187). FINDINGS Of 599 records identified in the preliminary search, five studies were included in the review and meta-analysis. A total of 124 patients were divided into the PSAP group and the conventional hearing aid group. Five studies including seven groups compared differences for speech intelligence in the signal-noise ratio (SNR) on the hearing in noise test (HINT) between PSAPs and conventional hearing aids. The pooled results showed nonsignificant differences in speech intelligence (SMD, 0.14; 95% CI, -0.19 to 0.47; P = .41; I 2=65%), sound quality (SMD, -0.37; 95% CI, -0.87 to 0.13; P = .15; I 2=77%) and listening effort (SMD 0.02; 95% CI, -0.24 to 0.29; P = .86; I 2=32%). Nonsignificant results were also observed in subsequent analyses after excluding patients with moderately severe hearing loss. Complete sensitivity analyses with all of the possible combinations suggested nonsignificant results in most of the comparisons between PSAPs and conventional hearing aids. INTERPRETATION PSAPs are potentially beneficial as conventional hearing aids are in patients with hearing loss. The different features among PSAPs should be considered for patients indicated for hearing devices. FUNDING This work was supported by grants from Ministry of Science and Technology (MOST-10-2622-8-075-001) and Veterans General Hospitals and University System of Taiwan Joint Research Program (VGHUST111-G6-11-2 and VGHUST111c-140).
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Affiliation(s)
- Chih-Hao Chen
- Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei 112, Taiwan
| | - Chii-Yuan Huang
- Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei 112, Taiwan
- Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
| | - Hsiu-Lien Cheng
- Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei 112, Taiwan
- Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
| | - Heng-Yu Haley Lin
- Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei 112, Taiwan
| | - Yuan-Chia Chu
- Department of Information Management, Taipei Veterans General Hospital, Taipei 112, Taiwan
- Medical AI Development Center, Taipei Veterans General Hospital, Taipei 112, Taiwan
- Department of Information Management, National Taipei University of Nursing and Health Sciences, Taipei 112, Taiwan
| | - Chun-Yu Chang
- Department of Anesthesiology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 231, Taiwan
| | - Ying-Hui Lai
- Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
- Medical Device Innovation & Translation Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Mao-Che Wang
- Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei 112, Taiwan
- Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
- Institute of Hospital and Health Care Administration, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
| | - Yen-Fu Cheng
- Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei 112, Taiwan
- Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
- Institute of Hospital and Health Care Administration, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
- Department of Medical Research, Taipei Veterans General Hospital, 201, Sec. 2, Shi-Pai Road, Taipei 112, Taiwan
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
- Corresponding author at: Department of Medical Research, Taipei Veterans General Hospital, Faculty of Medicine, National Yang Ming Chiao Tung University, 201, Sec. 2, Shi-Pai Road, Taipei 112, Taiwan.
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Kim GY, Kim S, Jo M, Seol HY, Cho YS, Lim J, Moon IJ. Hearing and Speech Perception for People With Hearing Loss Using Personal Sound Amplification Products. J Korean Med Sci 2022; 37:e94. [PMID: 35347902 PMCID: PMC8960939 DOI: 10.3346/jkms.2022.37.e94] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 02/25/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Hearing loss (HL) is the most common chronic disease and has been linked to negative health outcomes. Hearing aids (HAs) are regarded as the gold standard for HL management, however, the adoption rate of HAs is relatively low for various reasons. With this background, hearing devices, such as personal sound amplification products (PSAPs) received significant attention as an alternative to conventional HAs. This study aimed to evaluate the clinical efficacy of PSAPs in patients with mild to moderately severe HL. METHODS Nineteen patients with mild hearing loss (MHL), 23 with moderate hearing loss (MDHL), and 15 with moderately severe hearing loss (MSHL) participated in the study. Electroacoustic analysis, simulated real-ear measurements (REMs), and three clinical evaluations were implemented. RESULTS All devices satisfied the electroacoustic tolerances. All devices provided sufficient gain for MHL and MDHL audiograms. However, in MSHL audiogram, the gains of PSAPs were insufficient, especially for high frequencies. In terms of clinical evaluations, sound-field audiometry showed significant improvements between aided and unaided thresholds in all groups for all devices (P < 0.001). Significant improvements of word recognition scores were only shown for HAs between aided and unaided conditions. The Korean version of the Hearing In Noise Test did not show any consistent findings for all devices and groups. CONCLUSION Certain PSAPs are beneficial for improving hearing and speech perception in patients with HL. Well-chosen PSAPs could be an alternative hearing rehabilitation option for these patients.
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Affiliation(s)
- Ga-Young Kim
- Hearing Research Laboratory, Samsung Medical Center, Seoul, Korea
| | - Sunyoung Kim
- Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Mini Jo
- Hearing Research Laboratory, Samsung Medical Center, Seoul, Korea
| | - Hye Yoon Seol
- Hearing Research Laboratory, Samsung Medical Center, Seoul, Korea
- Medical Research Institute, Sungkyunkwan University School of Medicine, Suwon, Korea
| | - Young Sang Cho
- Hearing Research Laboratory, Samsung Medical Center, Seoul, Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Jihyun Lim
- Center for Clinical Epidemiology, Samsung Medical Center, Seoul, Korea
| | - Il Joon Moon
- Hearing Research Laboratory, Samsung Medical Center, Seoul, Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea.
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Seol HY, Moon IJ. Hearables as a gateway to hearing health care: A review. Clin Exp Otorhinolaryngol 2022; 15:127-134. [PMID: 35249320 PMCID: PMC9149229 DOI: 10.21053/ceo.2021.01662] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 10/19/2021] [Indexed: 11/26/2022] Open
Abstract
The market for hearing technology is evolving—with the emergence of hearables, it now extends beyond hearing aids and includes any ear-level devices with wireless connectivity (i.e., wireless earbuds). However, will this evolving marketplace bring forth opportunities or challenges to individuals’ hearing health care and the profession of audiology and otolaryngology? The debate has been ongoing. This study explores the wide spectrum of hearables available in the market and discusses the necessity of high-quality clinical evidence prior to the implementation of over-the-counter devices into clinical practice.
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Choe G, Park MK. The Effectiveness of Personal Sound Amplification Products in Adults With Mild to Moderate Hearing Loss: Is Their Use Inevitable? Clin Exp Otorhinolaryngol 2022; 15:1-2. [PMID: 35124943 PMCID: PMC8901941 DOI: 10.21053/ceo.2021.01081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 06/10/2021] [Indexed: 11/22/2022] Open
Affiliation(s)
- Goun Choe
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Moo Kyun Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea
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Cho YS, Kim GY, Choi JH, Baek SS, Seol HY, Lim J, Park JG, Moon IJ. Factors Influencing Hearing Aid Adoption in Patients With Hearing Loss in Korea. J Korean Med Sci 2022; 37:e11. [PMID: 35014225 PMCID: PMC8748670 DOI: 10.3346/jkms.2022.37.e11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 11/19/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The purpose of this study was two-fold: 1) to identify differences in the characteristics of adopters and non-adopters of hearing aids (HAs); and 2) to investigate factors influencing the purchase of HA. METHODS This study was conducted among 1,464 subjects (818 male and 646 female) with hearing loss. A national face-to-face survey was performed from August 2019 to October 2020 by otologists or HA experts. The questionnaire consisted of three domains: demographic, audiological, and HA-related domains. Multivariate logistic regression analysis was performed after adjusting for degree of hearing loss. RESULTS The mean age of the participants was 70.4 ± 12.2 years. Of the 1,464 respondents, 1,190 (81.3%) had already purchased HA. We identified educational level, household income, hearing loss period, place of HA purchase, and government HA assistance program status as factors influencing HA adoption. Among these factors, third party reimbursement was the most important factor affecting HA purchase intent. The main reasons for not adopting HA were feeling that their hearing was adequate, inability to afford HA, and perceptions that HA are uncomfortable. CONCLUSION Various factors are involved in the purchase of HA, but disabled registration status and third party reimbursement were identified as the most critical factors. In the future, the government should take a more active role in increasing the distribution of HA to patients with hearing loss.
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Affiliation(s)
- Young Sang Cho
- Hearing Research Laboratory, Samsung Medical Center, Seoul, Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ga-Young Kim
- Hearing Research Laboratory, Samsung Medical Center, Seoul, Korea
| | - Jae Hyuk Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | | | - Hye Yoon Seol
- Hearing Research Laboratory, Samsung Medical Center, Seoul, Korea
- Medical Research Institute, Sungkyunkwan University School of Medicine, Suwon, Korea
| | - Jihyun Lim
- Center for Clinical Epidemiology, Samsung Medical Center, Seoul, Korea
| | | | - Il Joon Moon
- Hearing Research Laboratory, Samsung Medical Center, Seoul, Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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