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Katayama Y, Tanaka K, Domi H, Masui J, Nakao S, Tachino J, Hirose T, Kitamura T, Oda J, Matsuoka T. Outcome of emergency patients transported by ambulance during the COVID-19 pandemic in Osaka Prefecture, Japan: a population-based descriptive study. Front Public Health 2024; 11:1322236. [PMID: 38274542 PMCID: PMC10808805 DOI: 10.3389/fpubh.2023.1322236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 12/18/2023] [Indexed: 01/27/2024] Open
Abstract
Background The novel corona virus (COVID-19) pandemic occurred worldwide. Although an excessive burden was placed on emergency medical institutions treating urgent and severe patients, its impact on patient outcome remains unknown. This study aimed to assess the impact of the COVID-19 pandemic in 2021 on the emergency medical services (EMS) system and patient outcomes in Osaka Prefecture, Japan. Methods This was a retrospective descriptive study with a study period from January 1, 2019 to December 31, 2021. We included patients who were transported by ambulance and had cleaned data that was recorded in the ORION system. The study endpoints were the number of patients transported by ambulance and the number of deaths among these patients in each month. To assess the impact of the COVID-19 pandemic on the EMS system, the incidence rate ratio (IRR) and 95% confidence interval (CI) were calculated using 2019 as the reference year. Mortalities were evaluated based on deaths in the emergency department and deaths at 21 days after hospitalization. Results The numbers of patients transported by ambulance were 500,194 in 2019, 443,321 in 2020 (IRR: 0.88, 95% CI: 0.87-0.88), and 448,054 in 2021 (IRR: 0.90, 95% CI: 0.89-0.90). In 2019, the number of patients transported by ambulance and who died in the emergency departments was 4,980, compared to 5,485 in 2020 (IRR: 1.10, 95% CI; 1.06-1.44) and 5,925 in 2021 (IRR: 1.19, 95% CI: 1.15-1.24). In 2019, the number of patients who died within 21 days after hospitalization was 11,931, compared to 11,913 in 2020 (IRR; 1.00, 95% CI; 0.98-1.03) and 13,376 in 2021 (IRR; 1.12, 95% CI; 1.09-1.15). Conclusion The COVID-19 pandemic decreased the number of ambulance requests and worsened mortality of patients transported by ambulance in Osaka Prefecture during 2021.
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Affiliation(s)
- Yusuke Katayama
- The Working Group to Analyze the Emergency Medical Care System in Osaka Prefecture, Osaka, Japan
- Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Kenta Tanaka
- Department of Social and Environmental Medicine, Division of Environmental Medicine and Population Sciences, Osaka University Graduate School of Medicine, Suita, Japan
| | - Hisaya Domi
- The Working Group to Analyze the Emergency Medical Care System in Osaka Prefecture, Osaka, Japan
- Osaka Prefectural Government, Osaka, Japan
| | - Jun Masui
- The Working Group to Analyze the Emergency Medical Care System in Osaka Prefecture, Osaka, Japan
- Department of Emergency Medicine, Tane General Hospital, Osaka, Japan
| | - Shunichiro Nakao
- Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Jotaro Tachino
- Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Tomoya Hirose
- Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Tetsuhisa Kitamura
- The Working Group to Analyze the Emergency Medical Care System in Osaka Prefecture, Osaka, Japan
- Department of Social and Environmental Medicine, Division of Environmental Medicine and Population Sciences, Osaka University Graduate School of Medicine, Suita, Japan
| | - Jun Oda
- Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Tetsuya Matsuoka
- The Working Group to Analyze the Emergency Medical Care System in Osaka Prefecture, Osaka, Japan
- Rinku General Medical Center, Izumisano, Japan
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Ojima M, Ishida K, Katayama Y, Hirose T, Nakao S, Tachino J, Noda T, Umemura Y, Kiguchi T, Kiyohara K, Matsuyama T, Kitamura T, Oda J, Ohnishi M. Impact of the COVID-19 pandemic on epidemiology, treatment, and outcome of major trauma in Japan in 2020: a retrospective observational nationwide registry-based study. Acute Med Surg 2023; 10:e817. [PMID: 36698916 PMCID: PMC9849826 DOI: 10.1002/ams2.817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 01/01/2023] [Indexed: 01/21/2023] Open
Abstract
Aim The nationwide impact of the coronavirus disease (COVID-19) pandemic on major trauma in Japan is unknown. The nationwide registry-based data of the Japanese Trauma Data Bank were analyzed to elucidate the impact of COVID-19 on the epidemiology, treatment, and outcomes of major trauma patients. Methods Among patients transported directly from the injury site by ambulance with an Injury Severity Score of ≥16, we compared patients managed from April to December in 2019 to those managed from April to December in 2020. Results In total, 9792 patients were included in this study (2019, n = 5194; 2020, n = 4598). There were no significant differences in age or sex, but there were significant differences between 2019 and 2020 in the rates of "self-injury (suicide)", "motor vehicle accident", "fall from height", "fall down", and "fall to the ground", which are factors associated with patient age. Injury severity in 2019 and 2020 did not differ to a statistically significant extent, but the rate of major spinal injury increased. The time of prehospital care significantly increased in 2020 compared to 2019. There was no noticeable change in hospital treatment or in-hospital mortality between 2019 and 2020. Conclusion This study suggests that the COVID-19 pandemic might have altered the injuries of major trauma; however, medical services for major trauma were well supplied in Japan in 2020.
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Affiliation(s)
- Masahiro Ojima
- Department of Acute Medicine and Critical Care Medical CenterNational Hospital Organization Osaka National HospitalOsakaJapan
| | - Kenichiro Ishida
- Department of Acute Medicine and Critical Care Medical CenterNational Hospital Organization Osaka National HospitalOsakaJapan
| | - Yusuke Katayama
- Department of Traumatology and Acute Critical MedicineOsaka University Graduate School of MedicineSuitaJapan
| | - Tomoya Hirose
- Department of Traumatology and Acute Critical MedicineOsaka University Graduate School of MedicineSuitaJapan
| | - Shunichiro Nakao
- Department of Traumatology and Acute Critical MedicineOsaka University Graduate School of MedicineSuitaJapan
| | - Jotaro Tachino
- Department of Traumatology and Acute Critical MedicineOsaka University Graduate School of MedicineSuitaJapan
| | - Tomohiro Noda
- Department of Traumatology and Critical Care MedicineOsaka Metropolitan University School of MedicineOsakaJapan
| | - Yutaka Umemura
- Department of Emergency and Critical CareOsaka General Medical CenterOsakaJapan
| | - Takeyuki Kiguchi
- Department of Emergency and Critical CareOsaka General Medical CenterOsakaJapan
| | - Kosuke Kiyohara
- Department of Food Science, Faculty of Home EconomicsOtsuma Women's UniversityTokyoJapan
| | - Tasuku Matsuyama
- Department of Emergency MedicineKyoto Prefectural University of MedicineKyotoJapan
| | - Tetsuhisa Kitamura
- Division of Environmental Medicine and Population Sciences, Department of Social and Environmental MedicineOsaka University Graduate School of MedicineSuitaJapan
| | - Jun Oda
- Department of Traumatology and Acute Critical MedicineOsaka University Graduate School of MedicineSuitaJapan
| | - Mitsuo Ohnishi
- Department of Acute Medicine and Critical Care Medical CenterNational Hospital Organization Osaka National HospitalOsakaJapan
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Katayama Y, Tanaka K, Kitamura T, Dohmi H, Masui J, Hirose T, Nakao S, Tachino J, Oda J, Matsuoka T. Incidence and outcome of patients with difficulty in hospital acceptance during COVID-19 pandemic in Osaka Prefecture, Japan: A population-based descriptive study. Acute Med Surg 2023; 10:e880. [PMID: 37564634 PMCID: PMC10410119 DOI: 10.1002/ams2.880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/24/2023] [Accepted: 07/14/2023] [Indexed: 08/12/2023] Open
Abstract
Aim The impact of the coronavirus disease (COVID-19) pandemic on the emergency medical service system in Japan has not been fully revealed. The purpose of this study was to determine the impact of the COVID-19 pandemic in 2021 on the difficulty in hospital acceptance of patients and patient outcome in Osaka Prefecture. Methods This study was a descriptive epidemiological study with a 3-year study period from January 2019 to December 2021. We included patients who were transported by ambulance and had registered in the Osaka Emergency Information Research Intelligent Operation Network (ORION) system. The primary end-point of this study was the difficulty in hospital acceptance by month, and the secondary outcome was the mortality of patients who experience difficulty in hospital acceptance in each year. Results We included 1,302,646 cases in this study. The proportion of cases with difficulty in hospital acceptance was 2.74% (12,829/468,709) in 2019, 3.74% (15,527/414,987) in 2020, and 5.09% (21,311/418,950) in 2021. The crude odds ratio for 2020 was 1.38 (95% confidence interval, 1.35-1.41) and for 2021 was 1.90 (95% confidence interval, 1.86-1.95). In 2019, 218 patients with difficulty in hospital acceptance had died by 21 days after hospitalization, whereas the number increased to 405 in 2020 and 750 in 2021. Conclusion The number of patients experiencing difficulty in hospital acceptance during the COVID-19 pandemic in Osaka Prefecture increased, and patient outcomes were worse than before the pandemic.
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Affiliation(s)
- Yusuke Katayama
- The Working Group to Analyse the Emergency Medical Care System in Osaka PrefectureOsakaJapan
- Department of Traumatology and Acute Critical MedicineOsaka University Graduate School of MedicineSuitaJapan
| | - Kenta Tanaka
- Division of Environmental Medicine and Population Sciences, Department of Social and Environmental MedicineOsaka University Graduate School of MedicineSuitaJapan
| | - Tetsuhisa Kitamura
- The Working Group to Analyse the Emergency Medical Care System in Osaka PrefectureOsakaJapan
- Division of Environmental Medicine and Population Sciences, Department of Social and Environmental MedicineOsaka University Graduate School of MedicineSuitaJapan
| | - Hisaya Dohmi
- The Working Group to Analyse the Emergency Medical Care System in Osaka PrefectureOsakaJapan
- Osaka Prefectural GovernmentOsakaJapan
| | - Jun Masui
- The Working Group to Analyse the Emergency Medical Care System in Osaka PrefectureOsakaJapan
- Osaka Prefectural GovernmentOsakaJapan
- Department of Emergency MedicineTane General HospitalOsakaJapan
| | - Tomoya Hirose
- Department of Traumatology and Acute Critical MedicineOsaka University Graduate School of MedicineSuitaJapan
| | - Shunichiro Nakao
- Department of Traumatology and Acute Critical MedicineOsaka University Graduate School of MedicineSuitaJapan
| | - Jotaro Tachino
- Department of Traumatology and Acute Critical MedicineOsaka University Graduate School of MedicineSuitaJapan
| | - Jun Oda
- Department of Traumatology and Acute Critical MedicineOsaka University Graduate School of MedicineSuitaJapan
| | - Tetsuya Matsuoka
- The Working Group to Analyse the Emergency Medical Care System in Osaka PrefectureOsakaJapan
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Araujo MLV, Miranda JGV, Vasconcelos RN, Cambui ECB, Rosário RS, Macedo MCF, Bandeira AC, Souza MSPL, Silva ACFN, Filho ASN, Murari TB, Jorge EMF, Saba H. A Critical Analysis of the COVID-19 Hospitalization Network in Countries with Limited Resources. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073872. [PMID: 35409558 PMCID: PMC8997845 DOI: 10.3390/ijerph19073872] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/11/2022] [Accepted: 03/21/2022] [Indexed: 12/10/2022]
Abstract
To effectively combat the COVID-19 pandemic, countries with limited resources could only allocate intensive and non-intensive care units to a low number of regions. In this work, we evaluated the actual displacement of infected patients in search of care, aiming to understand how the networks of planned and actual hospitalizations take place. To assess the flow of hospitalizations outside the place of residence, we used the concepts of complex networks. Our findings indicate that the current distribution of health facilities in Bahia, Brazil, is not sufficient to effectively reduce the distances traveled by patients with COVID-19 who require hospitalization. We believe that unnecessary trips to distant hospitals can put both the sick and the healthy involved in the transport process at risk, further delaying the stabilization of the COVID-19 pandemic in each region of the state of Bahia. From the results found, we concluded that, to mitigate this situation, the implementation of health units in countries with limited resources should be based on scientific methods, and international collaborations should be established.
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Affiliation(s)
- Marcio L. V. Araujo
- Modelagem Computacional e Tecnologia Industrial (PPG MCTI), Centro Universitário SENAI CIMATEC, Av. Orlando Gomes, 1845—Piatã, Salvador 41650-010, Brazil;
- Department of Computer Science, Federal Institute of Bahia, Rua São Cristóvão, s/n—Novo Horizonte, Lauro de Freitas 42700-000, Brazil
- Núcleo de Pesquisa Aplicada e Inovação (NPAI), Universidade do Estado da Bahia—UNEB/Centro Universitário SENAI CIMATEC, Salvador 41650-010, Brazil; (A.S.N.F.); (T.B.M.); (E.M.F.J.)
- Correspondence: ; Tel.: +55-719-8889-6527
| | - José G. V. Miranda
- Department of Physics, Federal University of Bahia, Campus Universitário de Ondina—Ondina, Salvador 40210-340, Brazil; (J.G.V.M.); (R.S.R.); (M.C.F.M.)
| | - Rodrigo N. Vasconcelos
- Department of Earth and Environmental Sciences, State University of Feira de Santana, Av. Transnordestina, s/n—Feira de Santana, Novo Horizonte 44036-900, Brazil;
| | - Elaine C. B. Cambui
- Department of Ecology, Federal University of Bahia, Campus Universitário de Ondina—Ondina, Salvador 40210-340, Brazil;
| | - Raphael S. Rosário
- Department of Physics, Federal University of Bahia, Campus Universitário de Ondina—Ondina, Salvador 40210-340, Brazil; (J.G.V.M.); (R.S.R.); (M.C.F.M.)
| | - Márcio C. F. Macedo
- Department of Physics, Federal University of Bahia, Campus Universitário de Ondina—Ondina, Salvador 40210-340, Brazil; (J.G.V.M.); (R.S.R.); (M.C.F.M.)
| | - Antonio C. Bandeira
- Health Secretary of the State of Bahia, 4ª Avenida Centro Administrativo da Bahia, 400—Centro Administrativo da Bahia, Salvador 40301-110, Brazil; (A.C.B.); (M.S.P.L.S.); (A.C.F.N.S.)
| | - Márcia S. P. L. Souza
- Health Secretary of the State of Bahia, 4ª Avenida Centro Administrativo da Bahia, 400—Centro Administrativo da Bahia, Salvador 40301-110, Brazil; (A.C.B.); (M.S.P.L.S.); (A.C.F.N.S.)
| | - Ana C. F. N. Silva
- Health Secretary of the State of Bahia, 4ª Avenida Centro Administrativo da Bahia, 400—Centro Administrativo da Bahia, Salvador 40301-110, Brazil; (A.C.B.); (M.S.P.L.S.); (A.C.F.N.S.)
| | - Aloisio S. Nascimento Filho
- Núcleo de Pesquisa Aplicada e Inovação (NPAI), Universidade do Estado da Bahia—UNEB/Centro Universitário SENAI CIMATEC, Salvador 41650-010, Brazil; (A.S.N.F.); (T.B.M.); (E.M.F.J.)
- Gestão e Tecnologia Industrial (PPG GETEC), Centro Universitário SENAI CIMATEC, Av. Orlando Gomes, 1845—Piatã, Salvador 41650-010, Brazil
| | - Thiago B. Murari
- Núcleo de Pesquisa Aplicada e Inovação (NPAI), Universidade do Estado da Bahia—UNEB/Centro Universitário SENAI CIMATEC, Salvador 41650-010, Brazil; (A.S.N.F.); (T.B.M.); (E.M.F.J.)
- Gestão e Tecnologia Industrial (PPG GETEC), Centro Universitário SENAI CIMATEC, Av. Orlando Gomes, 1845—Piatã, Salvador 41650-010, Brazil
| | - Eduardo M. F. Jorge
- Núcleo de Pesquisa Aplicada e Inovação (NPAI), Universidade do Estado da Bahia—UNEB/Centro Universitário SENAI CIMATEC, Salvador 41650-010, Brazil; (A.S.N.F.); (T.B.M.); (E.M.F.J.)
- Department of Exact and Earth Sciences, University of the State of Bahia, R. Silveira Martins, 2555—Cabula, Salvador 41180-045, Brazil
| | - Hugo Saba
- Modelagem Computacional e Tecnologia Industrial (PPG MCTI), Centro Universitário SENAI CIMATEC, Av. Orlando Gomes, 1845—Piatã, Salvador 41650-010, Brazil;
- Núcleo de Pesquisa Aplicada e Inovação (NPAI), Universidade do Estado da Bahia—UNEB/Centro Universitário SENAI CIMATEC, Salvador 41650-010, Brazil; (A.S.N.F.); (T.B.M.); (E.M.F.J.)
- Department of Exact and Earth Sciences, University of the State of Bahia, R. Silveira Martins, 2555—Cabula, Salvador 41180-045, Brazil
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Impact of COVID-19 on Hospital Admissions and Healthcare Quality Indicators in Non-COVID Patients: A Retrospective Study of the First COVID-19 Year in a University Hospital in Spain. J Clin Med 2022; 11:jcm11071752. [PMID: 35407360 PMCID: PMC8999691 DOI: 10.3390/jcm11071752] [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] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/15/2022] [Accepted: 03/18/2022] [Indexed: 01/18/2023] Open
Abstract
Few studies have assessed the impact of the COVID-19 pandemic on non-COVID diseases and healthcare quality. We aimed to evaluate changes in rates of hospitalisations, complications, in-hospital mortality, and readmissions among patients with non-COVID diseases during a one-year period after the pandemic onset. From March 2018 to February 2021 a retrospective observational study of hospital admissions in a university hospital in Spain was conducted. Non-COVID hospitalisations admitted through the emergency department were compared between the pre-COVID period (n = 28,622) and the COVID period (n = 11,904). We assessed rate ratios (RaR), comparing the weekly number of admissions and risk ratios (RR) to examine rates of complications, in-hospital mortality, readmissions, and severity. Statistical significance was set at p < 0.05. The weekly admission rate dropped by 20.8% during the complete lockdown. We observed significant reductions in admissions related to diseases of the respiratory system and circulatory system. Admissions for endocrine and metabolic diseases increased. The complication rates increased (RR = 1.21, 95% CI: 1.05;1.4), while in-hospital mortality rates held steady during the COVID period (RR = 1.09, 95% CI: 0.98;1.2). Hospital efforts to maintain quality and safety standards despite disruptions translated into a moderate increase in complications but not in in-hospital mortality. Reduced hospitalisations for conditions requiring timely treatment may have significant public health consequences.
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Lopez-Villegas A, Bautista-Mesa RJ, Baena-Lopez MA, Garzon-Miralles A, Castellano-Ortega MA, Leal-Costa C, Peiro S. Impact of the COVID-19 Pandemic on Healthcare Activity in the Regional Hospitals of Andalusia (Spain). J Clin Med 2022; 11:jcm11020363. [PMID: 35054055 PMCID: PMC8781610 DOI: 10.3390/jcm11020363] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 01/04/2022] [Accepted: 01/07/2022] [Indexed: 01/03/2023] Open
Abstract
(1) Background: The large global outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has overloaded the public health systems and reduced the regular healthcare activity, leading to a major health crisis. The main objective of this study was to carry out a comparative evaluation of the healthcare activities in the hospitals of Eastern Andalusia, Spain. (2) Methods: In this study, an observational, multicentered, and retrospective approach was adopted to compare the healthcare activities of the Poniente Hospital (PH) and the Alto Guadalquivir Health Agency (AGHA). Data was collected over a period of 24 months, i.e., from 1 January 2019 to 31 December 2020, and the variables evaluated were: patients seen in the hospital emergency service (HES), X-ray tests performed, patients cited in outpatient consultations, surgical interventions performed, and patients included in the waiting list. (3) Results: The analysis of the above-mentioned variables revealed a significant reduction in the number of patients registered in 2020 at HES as compared to that in 2019 for both PH (p = 0.002) and AGHA (p < 0.001). Moreover, the number of surgical interventions in 2020 was significantly reduced from that in 2019 for both PH (p = 0.001) and AGHA (p = 0.009). Moreover, for PH (p < 0.001), a significant reduction was observed in the waiting list admissions in 2020 compared to that in 2019; however, no significant difference in the waiting list admissions between the years 2020 and 2019 was observed for AGHA (p = 0.446). In 2020, the number of teleconsultations was significantly increased from that in 2019 for both PH (p < 0.001) and AGHA (p = 0.006). (4) Conclusion: The analysis carried out indicates that in 2020, compared to 2019, healthcare activity was significantly reduced in most of the parameters included in this study.
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Affiliation(s)
- Antonio Lopez-Villegas
- Social Involvement of Critical and Emergency Medicine, CTS-609 Research Group, Poniente Hospital, 04700 El Ejido, Spain;
| | | | | | | | | | - Cesar Leal-Costa
- Nursing Department, University of Murcia, 30120 El Palmar, Spain
- Correspondence: ; Tel.: +34-868-889-771
| | - Salvador Peiro
- Health Services Research Unit, Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), 46020 Valencia, Spain;
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