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The recognition and classification of human diseases are fundamental for the practice of medicine cheap eurax 20gm mastercard skin care after 30, with accurate diagnoses essential for successful treatment buy eurax 20 gm amex acne 9 days before period. Although diagnostics have begun to embrace the identification and measurement of molecular disease mechanisms eurax 20gm acne disease, the classification of disease is still largely based on phenotypic factors cheap eurax 20 gm on-line skin care 1006, or symptoms and signs. Remarkable advances in molecular biology have brought biomedical research to an inflection point, putting the life sciences at the cusp of delivering dramatic improvements in understanding disease to reap the health benefits that formed the rationale for the Human Genome Project. Some in the life sciences community are calling for the launch of a wide-ranging new program to use molecular and systems approaches to build a new taxonomy of human diseases. Embarking on such a program would require that existing data linking molecular, environmental, and experiential factors to disease states be surveyed and compiled, and that gaps in these data be identified and priorities set and acted upon to fill these gaps. Criteria must also be established for providing or denying access to and interpretation of data. And the many ethical considerations surrounding such a program would need to be addressed. Toward Precision Medicine: Building a Knowledge Network for Biomedical Research and a New Taxonomy of Disease Each of these areas is technically complex. Undertaking such a program would clearly require the participation and collaboration of many government and private entities over a considerable period of time. To ensure that progress is being made, goals and milestones against which program success can be measured would need to be developed. The Committee would leverage the expertise of additional scientists, clinicians, and others by holding a large (approximately 100 participants) workshop to obtain ideas from the broader scientific and medical communities. Desmond-Hellmann previously served as president of product development at Genentech, a position she held from March 2004 through April 30, 2009. In this role, she was responsible for Genentech s pre-clinical and clinical development, process research and development, business development and product portfolio management. She also served as a member of Genentech s executive Committee, beginning in 1996. She joined Genentech in 1995 as a clinical scientist, and she was named chief medical officer in 1996. In 1999, she was named executive vice president of development and product operations. She holds a bachelor of science degree in pre-medicine and a medical degree from the University of Nevada, Reno, and a master s degree in public health from the University of California, Berkeley. Prior to joining Genentech, Desmond-Hellmann was associate director of clinical cancer research at Bristol-Myers Squibb Pharmaceutical Research Institute. While at Bristol-Myers Squibb, she was the project team leader for the cancer-fighting drug Taxol. She also spent two years in private practice as a medical oncologist before returning to clinical research. In January 2009, Desmond-Hellmann joined the Federal Reserve Bank of San Francisco s Economic Advisory Council for a three-year term. In July 2008, she was appointed to the California Academy of Sciences board of trustees. Desmond-Hellmann was named to the Biotech Hall of Fame in 2007 and as the Healthcare Businesswomen s Association Woman of the Year for 2006. She was listed among Fortune magazine s top 50 most powerful women in business in 2001 and from 2003 to 2008. In 2005 and 2006, the Wall Street Journal listed Desmond-Hellmann as one of its women to watch. Toward Precision Medicine: Building a Knowledge Network for Biomedical Research and a New Taxonomy of Disease 84 served a three-year term as a member of the American Association for Cancer Research board of directors, and from 2001 to 2009, she served on the executive Committee of the board of directors of the Biotechnology Industry Organization. Sawyers laboratory is currently focused on characterizing signal transduction pathway abnormalities in prostate cancer, with an eye toward translational implications. Sawyers work in prostate cancer has defined critical signaling pathways for disease initiation and progression through studies in mouse models and humane tissues. Sawyers is past President of the American Society of Clinical Investigation and served on the National Cancer Institute s Board of Scientific Councilors. He has won numerous honors and awards, including: the Richard and Hinda Rosenthal Foundation Award; the Dorothy Landon Prize from the American Association of Cancer Research and the David A. Karnofsky Award from the American Society of Clinical Oncology; and the 2009 Lasker DeBakey Clinical Medical Research Award. He is a member of the Institute of Medicine and in 2010 was elected to the National Academy of Sciences. David is a co-founder of Perlegen, and was most recently Chief Scientific Officer of the company since its formation in 2000. David was Professor of Genetics and Pediatrics at the Stanford University School of Medicine as well as the co-director of the Stanford Genome Center. He completed a Pediatric Residency at the Yale-New Haven Hospital in New Haven, Connecticut and was a Fellow in both genetics and pediatrics at the University of California, San Francisco. David is certified by the American Board of Pediatrics and the American Board of Medical Genetics. Toward Precision Medicine: Building a Knowledge Network for Biomedical Research and a New Taxonomy of Disease of the Human Genome Project while carrying out research involving the molecular basis of human genetic disease. He has authored over 100 peer- reviewed scientific publications and has served on numerous editorial boards. Cox s honors include election to the Institute of Medicine of the National Academy of Sciences. Fraser-Liggett is Director of the Institute for Genome Sciences and a Professor of Medicine at the University Of Maryland School Of Medicine in Baltimore, Maryland. Previously she was the President and Director of The Institute for Genomic Research in Rockville, Maryland. She led the teams that sequenced the genomes of several microbial organisms, including important human and animal pathogens, and as a consequence helped to initiate the era of comparative genomics. She has served on a number of National Research Council Committees on counter-bioterrorism, domestic animal genomics, polar biology, and metagenomics. Fraser-Liggett has more than 220 scientific publications, and has served on Committees of the National Science Foundation, Department of Energy and National Institutes of Health. She received her PhD in pharmacology from State University of New York at Buffalo. He is also Co-Director of the Stanford Center for Genomics and Personalized Medicine. Galli s research focuses on the development and function of mast cells and basophils (key players in anaphylaxis, allergies, asthma and many other biological responses), and on developing new animal models to study the diverse roles of these cells in health and disease. Galli serves on the editorial boards of several medical journals and is a co-editor of The Annual Review of Pathology: Mechanisms of Disease. Toward Precision Medicine: Building a Knowledge Network for Biomedical Research and a New Taxonomy of Disease 86 of a three year elected term, Dr. Galli was the Chair of the Advisory Board to the President and Provost of Stanford University. Goldstein is currently Professor of Molecular Genetics & Microbiology and Director of the Center for Human Genome Variation at Duke University.

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Tropical medicine and travel medicine: medical advice for aviation medical examiners concerning flight operations in tropical areas cheap 20gm eurax skin care network barnet ltd. Oral zinc supplementation in pregnant women and its effect on birth weight: a randomised controlled trial order eurax 20 gm with mastercard acne questions. Integration and reimbursement of complementary and alternative medicine by managed care and insurance providers: 2000 update and cohort analysis 20gm eurax visa acne scar removal cream. Journal article with indication that additional text follows it discussion Hoffmann J buy cheap eurax 20gm online acne at 40, Lenhard A. Economic evaluation of nurse led intermediate care versus standard care for post-acute medical patients: cost minimisation analysis of data from a randomised controlled trial. Journal article with an indication it may be found in PubMed Amalberti R, Auroy Y, Berwick D, Barach P. Community-based interventions for improving perinatal and neonatal health outcomes in developing countries: a review of the evidence. Supported by a Public Health Service grant from the National Institute of Mental Health. Sample Citation and Introduction to Citing Parts of Journal Articles The general format for a reference to a part of a journal article, including punctuation: Examples of Citations to Parts of Journal Articles Rather than citing an entire journal article, a part of an article such as a table may be cited. In general, most modern articles have standardized to three types of parts: figures, tables, and appendixes. Because a reference should start with the individual or organization responsible for the journal article start with the article information, then follow it with the information about the part. Journal articles frequently contain charts, figures, and other illustrative material that has been reproduced with permission from other sources. Continue to Citation Rules with Examples for Parts of Journal Articles Continue to Examples of Citations to Parts of Journal Articles Citation Rules with Examples for Parts of Journal Articles Components/elements are listed in the order they should appear in a reference. In this case, give whatever name has been used for the illustration and follow it with a comma and the title. Experiences of older women with cancer receiving hospice care: significance for physical therapy. Parts of journal articles not in English with original or romanized language included 17. Evolucion de la mortalidad infantil de La Rioja (1980-1998) [Evolution of the infant mortality rate in la Rioja in Spain Journals 65 (1980-1998)]. Appendix, [Excerpts from "Prescription Pain Medications: Frequently Asked Questions and Answers for Health Care Professionals"]; p. Parts of journals in two equal languages Location (Pagination) of Part for Parts of Journal Articles (required) General Rules for Location (Pagination) Begin location with "p. S10-8 End page information with a period Specific Rules for Location (Pagination) Roman numerals used as page numbers No page numbers appear on the pages of the part Box 69 Roman numerals used as page numbers Unlike the practice with volume and issue numbers, keep roman numerals when they are used as page numbers Give them in upper or lower case, whichever appears in the publication Appendix 2, Common aquatic invertebrates; p. Parts of journals in two equal languages Examples of Citations to Parts of Journal Articles 1. Cyclooxygenase inhibitors suppress aromatase expression and activity in breast cancer cells. Long-term radiographic and functional outcome of extracorporeal shock wave lithotripsy induced perirenal hematomas. Evaluation and management of patients with uncontrolled systolic hypertension: is another new paradigm really needed? Unnumbered/unlettered and untitled figure in a journal article Roth S, Semjonow A, Waldner M, Hertle L. Risk of bowel dysfunction with diarrhea after continent urinary diversion with ileal and ileocecal segments. Predictive value of a cross-cultural asthma case-detection tool in an elementary school population. Appendix A, International study of asthma and allergy in childhood questionnaire; p. Longitudinal change in height of men and women: implications for interpretation of the body mass index: the Baltimore Longitudinal Study of Aging. Appendix, Equations, obtained from cross-sectional analysis, relating height to age; p. Synthesis of (-)-longithorone A: using organic synthesis to probe a proposed biosynthesis. Expression of caveolin-1 and caveolin-2 in urothelial carcinoma of the urinary bladder correlates with tumor grade and squamous differentiation. Image 4, Immunohistochemical staining of a urothelial carcinoma with squamous differentiation with anti- caveolin-1; p. Evolucion de la mortalidad infantil de La Rioja (1980-1998) [Evolution of the infant mortality rate in la Rioja in Spain (1980-1998)]. Raccomandazioni per il trasporto inter ed intra ospedaliero del paziente critico = Recommendations on the transport of critically ill patients. Sample Citation and Introduction to Citing Entire Journal Titles The general format for a reference to an entire journal title, including punctuation: - for a title continuing to be published: - for a title that ceased publication: Journals 71 Examples of Citations to Entire Journal Titles If a journal is still being published, as shown in the first example, follow volume and date information with a hyphen and three spaces. If a journal has ceased publication, as in example two, separate beginning and ending volume and date information with a hyphen surrounded by a space. When citing a journal, always provide information on the latest title and publisher unless you are citing an earlier version. If you wish to cite all volumes for a journal that has changed title, provide a separate citation for each title. Many journal titles with both print and Internet versions do not carry the same exact content. If you viewed a journal title on the Internet, do not cite it as if it were a print one. Note that the rules for creating references to journal titles are not the same as the rules for cataloging them. Continue to Citation Rules with Examples for Entire Journal Titles Continue to Examples of Citations to Entire Journal Titles Citation Rules with Examples for Entire Journal Titles Components/elements are listed in the order they should appear in a reference. Box 73 Journals appearing in different editions If a journal is published in more than one edition: Capitalize all significant words in edition information 74 Citing Medicine Separate the edition from the title itself by a space and place it in parentheses End all title information with a period Examples: American Homeopathy (Consumer Edition). Ausgabe Klientiere Heimtiere becomes Tierarztliche Praxis (Ausgabe Klientiere Heimtiere). Romanization, a form of transliteration, means using the roman (Latin) alphabet to represent the letters or characters of another alphabet. Journal title with unknown place of publication and publisher Publisher for Entire Journal Titles (required) General Rules for Publisher Record the name of the publisher as it appears in the journal, using whatever capitalization and punctuation are found there Abbreviate well-known publisher names if desired but with caution to avoid confusion. 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You don t realize it order 20 gm eurax overnight delivery skin care with hyaluronic acid, but your own (c) The G protein passes the hormone s message to the cell by switching on body sent this substance a hormone called a cell enzyme (purple) that triggers epinephrine to protect you buy eurax 20 gm cheap skin care ingredients to avoid, telling you to a response eurax 20gm line acne light mask. Your body reacts generic eurax 20 gm without prescription acne xojane, whipping up the familiar, spine-tingling, ght-or-ight response that gears you to respond quickly to potentially threatening situations such as this one. Getting into a cell is a challenge, a strictly guarded process kept in control by a protective gate called the plasma membrane. Figuring out how molecular triggers like epinephrine communicate important messages to the inner parts of cells earned two scientists the Nobel Prize in physiology or medicine in 1994. Getting a cellular message across the membrane is called signal transduction, and it the world have focused on these signaling occurs in three steps. Research on G proteins and on all epinephrine) encounters the outside of a cell aspects of cell signaling has prospered, and as Got It? In the fall of 2000, Gilman embarked on transducer, or switch molecule, passes the a groundbreaking effort to begin to untangle What is a liposome? The group has a big dream: to understand One of the Nobel Prize winners, pharma everything there is to know about signaling cologist Alfred G. According to Gilman, Alliance Describe how Texas Southwestern Medical Center at Dallas, researchers focus lots of attention on G G proteins work. As with any switch, G proteins must be revolution in biomedical turned on only when needed, then shut off. Some illnesses, including fatal diseases like cholera, occur when a G protein is errantly left on. In the case of cholera, the poisonous weaponry of the cholera bacterium freezes in place one particular type of G protein that controls water balance. In the few decades since Gilman and the other Nobel Prize winner, the late National Institutes of Health scientist Martin Rodbell, made their fundamental discovery about G protein switches, pharmacologists all over 48 National Institute of General Medical Sciences Medicines for the Future he advances in drug development and T delivery described in this booklet reect scientists growing knowledge about human biology. This knowledge has allowed them to develop medicines targeted to specic molecules or cells. In the future, doctors may be able to treat or prevent diseases with drugs that actually repair cells or protect them from attack. No one knows which of the techniques now being developed will yield valuable future medicines, but it is clear that thanks to pharmacology research, tomorrow s doctors will have an unprecedented array of weapons to ght disease. Medicines By Design I Medicines for the Future 49 Careers in Pharmacology Wanna be a pharmacologist? These cology as a career, here are some of the places you scientists often work with patients and spend a might nd yourself working: lot of time trying to understand issues relating College or University. Most basic biomedical to drug dosage, including side effects and research across the country is done by scientists drug interactions. Pharmacologists and cologists perform research to determine how toxicologists play key roles in formulating drug medicines interact with living systems. Agonist | A molecule that triggers a cellular Bioinformatics | A eld of research that relies response by interacting with a receptor. Analgesic | A medicine s ability to relieve pain, or a drug that alleviates pain; the term comes from Biotechnology | The industrial use of living the Greek word algos, which means pain. Antagonist | A molecule that prevents the action of other molecules, often by competing Biotransformation | The conversion of a for a cellular receptor; opposite of agonist. Antibiotic | A substance that can kill or inhibit the growth of certain microorganisms. Blood-brain barrier | A blockade consisting of cells and small blood vessels that limits the Antibody | A protein of the immune system, movement of substances from the bloodstream produced in response to an antigen (a foreign, into the brain. Carcinogen | Any substance that, when exposed Anti-inammatory | A drug s ability to to living tissue, may cause cancer. Cell | The basic subunit of any living organism; the simplest unit that can exist as an independent Antipyretic | Fever-reducing; the term comes living system. Central nervous system | The brain and Arachidonic acid | A molecule that synthesizes spinal cord. Bacterium | One-celled organism without Chemical genetics | A research approach a nucleus that reproduces by cell division; can resembling genetics in which scientists custom- infect humans, plants, or animals. Medicines By Design I Glossary 51 Cholesterol | A lipid unique to animal cells that Dose-response curve | A graph drawn to is used in the construction of cell membranes and show the relationship between the dose of a drug as a building block for some hormones. Chromosome | A structure in the cell nucleus Enzyme | A molecule (usually a protein) that that contains hereditary material (genes); humans speeds up, or catalyzes, a chemical reaction with have 23 pairs of chromosomes in each body cell, out being permanently altered or consumed. G protein | One of a group of switch proteins Combinatorial genetics | A research process involved in a signaling system that passes incoming in which scientists remove the genetic instructions messages across cell membranes and within cells. Genomics | The study of all of an organism s Cytochrome P450 | A family of enzymes genetic material. Neurotransmitter | A chemical messenger that allows neurons (nerve cells) to communicate with Lipid | A fatty, waxy, or oily molecule that each other and with other cells. Nucleus | The membrane-bound structure within a cell that contains most of the cell s Liposome | Oily, microscopic capsules designed genetic material. Organelle | A specialized, membrane-bound structure that has a dened cellular function; Membrane | A thin covering surrounding a cell for example, the nucleus. Pharmacodynamics | The study of how drugs Metabolism | All enzyme-catalyzed reactions act at target sites of action in the body. Pharmacokinetics | The study of how the Metabolite | A chemical intermediate in body absorbs, distributes, breaks down, and metabolic reactions; a product of metabolism. Sepsis | A clinical condition in which infectious Prostaglandins | Any of a class of hormone- agents (bacteria, fungi) or products of infection like, fat-soluble, regulatory molecules made from (bacterial toxins) enter the blood and profoundly fatty acids such as arachidonic acid; prostaglandins affect body systems. Steroid | A type of molecule that has a multiple ring structure, with the rings sharing molecules Receptor | A specialized molecule that receives of carbon. Toxicology | The study of how poisonous substances interact with living organisms. X-ray crystallography | A technique used to determine the detailed, three-dimensional structure of molecules based on the scattering of X rays through a crystal of the molecule. It aims to advance access to medicine in low- and middle-income countries by stimulating and guiding the pharmaceutical industry to play a greater role in improving access to medicine. For ten years, the Foundation has been building consensus on the role for the pharmaceutical industry in improving access to medicine and vaccines. It published its frst benchmark of industry activity in this area in 2008, in the frst Access to Medicine Index, now in its ffth iteration. In 2017, the Foundation will publish the frst Access to Vaccines Index, funded by the Dutch National Postcode Lottery. The Foundation is1 grateful for their time and expertise, and would like to thank them for providing valuable insights throughout the development of the 2016 Index. Iyer Warren Kaplan Danny Edwards Jillian Kohler Anna Massey Niranjan Konduri Emma Ross Prashant Yadav 1 This acknowledgement does not infer that the individuals and institutions mentioned above endorse the Access to Medicine Index analyses or results. Decisions regarding the inclusion of feedback were made by the Access to Medicine Foundation. We continue to make progress toward pany is best, overall, at mobilising to reach the major public health goals: polio is close to being poor.

Tree Pollen Antigens There seems to be a higher degree of specificity to skin testing with individual tree pollen extracts compared with grass pollens because pollens of individual tree species may contain unique allergens 20gm eurax fast delivery skin care manufacturers. Despite this observation purchase 20gm eurax overnight delivery acne 9gag, several amino acid homologies and antigenic cross-reactivities have been noted order eurax 20 gm free shipping acne under jaw. A major birch-pollen allergen effective eurax 20 gm acne active, Bet v 1, has been isolated by a combination chromatographic technique. Monoclonal antibodies directed against this allergen have simplified the purification process ( 88). There is considerable (80%) amino acid homology between Bet v 1 and other group I tree allergens ( 2). Bet v 1 is the birch tree allergen that cross-reacts with a low-molecular-weight apple allergen, a discovery that helps to explain the association between birch sensitivity and oral apple sensitivity ( 90). Further investigations by the same workers extend this cross-reactivity to include pear, celery, carrot, and potato allergens. Most of the 20 patients tested had birch-specific serum IgE (anti Bet v 1 and anti Bet v 2) that cross-reacted to these fruits and vegetables. Bet v 2 has been cloned and identified as profilin, a compound responsible for actin polymerization in eukaryotes. There is approximately 33% amino acid homology between the human and birch profilin molecules ( 77). Bet v 3 and Bet v 4 have both been cloned and further described as calcium binding molecules ( 91,92). Recombinant Bet v 5 appears to have sequence homology with isoflavone reductase, but the biochemical function remains unknown ( 93). It reacts with IgE from 20% of birch allergic patients and has been identified as a cyclophilin ( 94). A major allergen has been isolated from the Japanese cedar, which contributes the most important group of pollens causing allergy in Japan. This allergen, designated Cry j 1, was initially separated by a combination of chromatographic techniques. Four subfractions were found to be antigenically and allergenically identical (95). There is some amino acid homology between Cry j 1 and Amb a 1 and 2, but the significance of this is unclear. Allergens from mountain cedar (Juniperus ashei) are important in the United States. The major allergen, Jun a 1, has a 96% homology with Cry j 1 and with Japanese cypress (Chamaecyparis obtusa) (97). In 1726, Sir John Floyer noted asthma in patients who had just visited a wine cellar; in 1873, Blackley suggested that Chaetomium and Penicillium were associated with asthma attacks; and in 1924, van Leeuwen noted the relationship of climate to asthma and found a correlation between the appearance of fungal spores in the atmosphere and attacks of asthma ( 99). Over the next 10 years, case reports appeared attributing the source of fungal allergies to the home or to occupational settings. In the 1930s, Prince and associates ( 100) and Feinberg (101) reported that outdoor air was a significant source of fungal spores and demonstrated that many of their patients had positive skin test reactivity to fungal extracts. More alarming is the association noted between elevated Alternaria airborne spore concentrations and risk of respiratory arrests in Alternaria-sensitive individuals ( 102). Initially, fungal sensitivity was equated to skin test reactivity, but more direct evidence for the role of fungal sensitivity in asthma has been presented by inhalation challenge studies by Licorish and co-workers ( 103). In addition to IgE-mediated reactions, sensitization to certain fungi, especially Aspergillus, can lead to hypersensitivity pneumonitis ( 104). Although fungal spores are thought to be the causative agents in atopic disorders, other particles that become airborne (including mycelial fragments) also may harbor allergenic activity. Alternaria is an important allergenic fungus and has been associated with significant episodes of respiratory distress. Among the Alternaria species, A alternata has been the subject of the most research. The Alt a 1 allergen is rich in carbohydrates, and glycosylation of proteins may be necessary for allergenic activity (107). Alt a 1 can induce positive intradermal test results at extremely low concentrations (6 pg/mL) in Alternaria-sensitive subjects. Interestingly, the fungus Stemphyllium shares at least 10 antigens with Alternaria and an allergen immunochemically identical to Alt a 1 (110). Commercial Alternaria extracts contain widely varying amounts of Alt a 1, underscoring the need for improved methods of standardization (111). There is also evidence of further cross-reactivity with Saccharomyces and Candida (114). Cladosporium species are among the most abundant airborne spores in the world ( 17). Two species, Cladosporium cladosporoides and Cladosporium herbarum, have been the focus of intense investigation. Two major, 10 intermediate, and at least 25 minor allergens have been identified ( 115). Allergen content of 10 isolates of Cladosporium varied from 0% to 100% relative to a reference extract. Two major allergens have been isolated from Cladosporium herbarum: Cla h 1 and Cla h 2 (116). Cla h 1 (Ag-32) was isolated by chromatographic and isoelectric focusing techniques. Cla h 2 (Ag-54) is a glycoprotein that is reactive in a smaller percentage of patients than Cla h 1. Neither allergen is cross-reactive, as determined by passive transfer skin testing. In contrast to Cladosporium and Alternaria extracts, which are traditionally prepared by extracting mycelia and spores, Aspergillus fumigatus extracts generally are prepared from culture filtrate material. This disorder is characterized by the presence of both IgE and IgG antibodies to the offending fungal antigens. When the strains used in the extract were investigated individually, they varied in their quantities of the four most important allergens. Other studies demonstrated that disrupted spore antigens did not cross-react with either mycelial or culture filtrate allergens ( 121). Common allergens occur within the fumigatus and niger groups, which are allergenically distinct from the versicolor, nidulans, and glaucus groups (99). Asp f 1 has been cloned and identified as a cytotoxin, mitogillin, which is excreted from the fungus only during growth ( 122,123). A combination of Asp f 1, Asp f 3, and Asp f 5 has a sensitivity of 97% for diagnosing Aspergillus sensitivity (125). Pen c 1 is a 33-kDa alkaline serine protease with 93% IgE reactivity among patients sensitive to Penicillium species (128,129). Pen c 3 has 83% sequence homology with Asp f 3 peroxisomal membrane protein allergen (131). Sensitivity to spores of the Basidiomycetes is a significant precipitant of allergic disease.

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