H1N1 pandemic news started 06/11/2009

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Re: H1N1 pandemic news started 06/11/2009

Post by 19kilo » Sat Sep 26, 2009 8:25 pm

String wrote:I was curious why you thought this H1N1 wouldn't be too bad this year? Looking at the CDC site it looks like we are heading into a big flu season. I see an exceptional increase in almost all stats. Maybe the most telling is the "Outpatient Illness Surveillance", it looks like it is about 4 times higher than a regular flu season.

I'm also interested to hear what you think your hospitals ability to maintain ventilator service would be like with a 20%-40% absentee (illness/no show) rate might be. Thanks for your insight, it's always nice to hear from someone on the inside.

http://www.cdc.gov/flu/weekly/" onclick="window.open(this.href);return false;

String
The second wave of the flu is usually the more deadly. The first takes on the young and elderly while the second is the one that affects the more healthy.

This is just my opinion, I am just seeing pt. after pt come in thinking that the world is endin because they have the swine flu and are sent home with albuterol,ibuprofen and told to drink lots of fluid.

Maybe it will hit, I am just not seeing it.
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Re: H1N1 pandemic news started 06/11/2009

Post by 19kilo » Sat Sep 26, 2009 8:45 pm

Ellie With An Axe wrote:19k, when you say your hospital has 300 disposable vents, do you mean something like Surevent?

I've been seeing that a couple of children's hospitals, one in Austin and one in Memphis, have set up tents to deal with the overload of people coming in to get their kids looked at.

Video of the one in Austin - http://www.cbsnews.com/video/watch/?id= ... photovideo" onclick="window.open(this.href);return false; (article link under the video)
Article of the Memphis tent - http://www.myeyewitnessnews.com/news/lo ... ime1Q.cspx" onclick="window.open(this.href);return false; (video with the article)

The doctor interviewed in the Austin video said that they predicted a peak of activity about 4 weeks out. Their computer models are also what spurred them to set up the tents, as they predicted the higher flow of patients.

I think it's a pretty good idea. Austere... and some kids frighten easily around hospitals... but still good. I'd like to see other hospitals in the US or elsewhere in the northern hemisphere doing something similar right now.

Ours is call Var-plus.

http://www.vortran.com/products/var-vor ... tator.html" onclick="window.open(this.href);return false;

The tent, triage stations are a good idea. We have them for flu out break and NBC style events. We just had a drill not too long ago where we uset up tents and had our normally operated triage set up in them and treated pts for a few hours. But I was not here for it.

I honestly have no idea how we will operate with 20-40% less staff and 150-300 extra ventilators. That isn't something I look forward to. Since our night shift has three therapists on right now and four most times.

Here is our state map 21 confirmed in my county this year.

http://www.health.state.pa.us/H1N1Map/" onclick="window.open(this.href);return false;
Last edited by 19kilo on Sun Sep 27, 2009 12:42 am, edited 1 time in total.
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Re: H1N1 pandemic news started 06/11/2009

Post by Kathy in FL » Sat Sep 26, 2009 10:55 pm

You may not be seeing it yet. There is rarely a day that goes by that Florida doesn't have at least one death due to H1N1-09. The hospitalization due to H1N1 is skyrocketing all over. The Google flu trends chart can be view as a whole for the country or by state.

http://www.google.org/flutrends/intl/en_us/" onclick="window.open(this.href);return false;

The trends by state are pretty significant in comparison to previous years.

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Re: H1N1 pandemic news started 06/11/2009

Post by callista » Sat Sep 26, 2009 11:11 pm

Does anybody know whether it's possible to have a case of H1N1 that's as mild as the common cold?

The reason I'm asking is that I've actually got a cold right now (pretty sure it's just a cold though) and it got me thinking--if there's a large variability in the severity of the illness, then people with a mild case could spread it around and infect a lot more than if everybody universally got the chills/fever/exhaustion variety that puts you in bed pretty much right away.

I've heard people talking about how they had it and it wasn't even as bad as the regular flu; and then I'm hearing reports of deaths.

So... large variability in severity? Significantly more than the seasonal flu? Anybody know?
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Re: H1N1 pandemic news started 06/11/2009

Post by 19kilo » Sun Sep 27, 2009 12:49 am

Kathy in FL wrote:You may not be seeing it yet. There is rarely a day that goes by that Florida doesn't have at least one death due to H1N1-09. The hospitalization due to H1N1 is skyrocketing all over. The Google flu trends chart can be view as a whole for the country or by state.

http://www.google.org/flutrends/intl/en_us/" onclick="window.open(this.href);return false;

The trends by state are pretty significant in comparison to previous years.
I might be reading the info wrong, but it looks like only 89 deaths confirmed to be H1N1.
While that seems like a lot, There are more than 30,000 seasonal flu deaths a year nationwide. I think we will be dealing with a rough flu season in general.
http://www.doh.state.fl.us/Disease_ctrl ... s.htm#map1" onclick="window.open(this.href);return false;

Ireally hope I am right. To think about what a real pandemic flu woud do to our city is disturbing. especially when my wife also works in a hospital (pt). Just the increase in seasonal flu is pretty demanding in the last two weeks.
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Re: H1N1 pandemic news started 06/11/2009

Post by sheddi » Sun Sep 27, 2009 1:49 am

19kilo wrote:I might be reading the info wrong, but it looks like only 89 deaths confirmed to be H1N1.
I'm not sure where you got that figure, but the CDC total quoted at http://www.flucount.org/" onclick="window.open(this.href);return false; is 695.
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Re: H1N1 pandemic news started 06/11/2009

Post by 19kilo » Sun Sep 27, 2009 2:33 am

sheddi wrote:
19kilo wrote:I might be reading the info wrong, but it looks like only 89 deaths confirmed to be H1N1.
I'm not sure where you got that figure, but the CDC total quoted at http://www.flucount.org/" onclick="window.open(this.href);return false; is 695.

That figure was deaths in Florida. Should have pointed that out. Your site said 87 in FL though. 10 here in PA.
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Re: H1N1 pandemic news started 06/11/2009

Post by Kathy in FL » Sun Sep 27, 2009 7:41 am

19kilo wrote:
sheddi wrote:
19kilo wrote:I might be reading the info wrong, but it looks like only 89 deaths confirmed to be H1N1.
I'm not sure where you got that figure, but the CDC total quoted at http://www.flucount.org/" onclick="window.open(this.href);return false; is 695.

That figure was deaths in Florida. Should have pointed that out. Your site said 87 in FL though. 10 here in PA.
It's the hospitalizations that are causing the most problems. They can send a lot of people home and just tell them to deal with it and they'll recover ... even 98% of cases recovered during the big 1918 pandemic ... but with the higher number of hospitalizations we've seen hospitals changing their visitor rules (no children, period, not even in the waiting/family area in some locations) and most elective surgeries are being postponed or delayed due to staffing shortage or bed shortage. So far the impact has been absorbable ... but we are no where near peak yet. A sustained hospitalization rate of what we are seeing right now or greater and we'll start running into more staffing shortages and supply shortages. There is already a shortage of children's liquid Tamiflu.

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Re: H1N1 pandemic news started 06/11/2009

Post by JojoZS » Sun Sep 27, 2009 10:17 am

I just watched a Doc on my local TV, explain that the H1N1 test can give a false negative. Many people that were told they just have a cold actually have the virus.
There is a local 13yr old boy here in critical condition, he was sent home after testing neg for H1N1, since being back at the hospital he tested pos.

I don't see how they can ever get real #'s on this virus with a lack of testing and those that are tested having false negatives, the #'s should be much higher.

I'm pretty sure my husband just got over it, all his symptoms were the same as someone we know that tested positive for it, he was hit pretty hard, stayed home a week from work. Everyday we hear from someone else that has it here.

I don't know if it's a good thing or a bad thing that I didn't get it, I usually get everything else he brings home. :|
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Re: H1N1 pandemic news started 06/11/2009

Post by awe4fire » Sun Sep 27, 2009 11:16 am

well out here in northwest ohio the panic has not set in. I'm a home health nurse and so far only school age kids have come down with it they think. By the time they decide it's swine flu( yes i'm old school and remeber the 1975-76 outbreak). so far the flu is lesser than even the yearly outbreaks so far. my clients for the most part are home bound and haven't been affected. they only ones showing signs of sickness have recieved there flu shot.

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Re: H1N1 pandemic news started 06/11/2009

Post by Ellie With An Axe » Sun Sep 27, 2009 11:22 am

I believe it was revealed pretty early on that the standard rapid flu test was giving correct results only 50% of the time. Many places just decided to stop testing for that and other reasons. I was not tested. I believe there have also been deaths from people being given negative results, and thus not given Tamiflu. Kathy could probably tell you, she's been keeping up with cases like that I think.

If your husband's signs and symptoms matched the CDC's list, he probably had it. I mean, you could say you'll never know because he didn't get tested, but you'd probably assume correctly anyway. At the clinic I went to, they were only testing high-risk patients, but they were still up to their eyeballs in tests, so any tests that didn't need to be done, the better. Everybody else was getting the standard: a quick assessment, scrips, and instructions for bed rest, fluids, and isolation.

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Re: H1N1 pandemic news started 06/11/2009

Post by Kathy in FL » Sun Sep 27, 2009 12:22 pm

Swine Flu Surge Closes Schools, Tests Hospitals

By Rob Stein
Washington Post Staff Writer
Sunday, September 27, 2009



In Austin, so many parents are rushing their children to the Dell Children's Medical Center of Central Texas with swine flu symptoms that the hospital had to set up tents in the parking lot to cope with the onslaught.

In Memphis, the Le Bonheur Children's Medical Center emergency room got so crowded with feverish, miserable youngsters that it had to do the same thing.

And in Manning, S.C., a private school where an 11-year-old girl died shut down after the number of students who were out sick with similar symptoms reached nearly a third of the student body.

"It just kind of snowballed," said Kim Jordan, a teacher at the Laurence Manning Academy, which closed Wednesday after Ashlie Pipkin died, and the number of ill students hit 287. "We had several teachers out also. That was the reason to close the school -- so everyone could just be away from one another for a few days."

After months of warnings and frantic preparations, the second wave of the swine flu pandemic is starting to be felt around the country, as doctors, health clinics, hospitals and schools are reporting rapidly increasing numbers of patients experiencing flu symptoms.

"H1N1 is spreading widely throughout the U.S.," said Thomas R. Frieden, director of the federal Centers for Disease Control and Prevention in Atlanta during a briefing on Friday. At least 26 states, including Maryland and Virginia, are now reporting widespread flu activity, up from 21 a week earlier, the CDC reported. "H1N1 activity is now widespread," Frieden said.

While so far most cases are mild, and the health-care system is handling the load, officials say the number of people seeking treatment for the flu is unprecedented for this time of year. Even though some parts of the Southeast that started seeing a surge of cases first now seem to be showing a decline in cases, that could be a temporary reprieve, Frieden said. And other parts of the country are likely just starting to feel the second wave.

Maryland health authorities on Friday said a Baltimore-area youth with an underlying health problem had died of swine flu, the state's first such fatality involving a youth.

Despite new federal guidelines aimed at keeping schools open, the pandemic has already prompted scattered school closings around the country in recent weeks, including 42 schools that closed in eight states on Friday, affecting more than 16,000 students.

Many colleges and universities have been hit particularly hard, forcing some to open separate dorms for sick students. Ninety-one percent of the 267 colleges and universities being surveyed by the American College Health Association are now reporting cases.

At the Le Bonheur Children's Medical Center, the number of patients coming in each day shot up from about 180 to a peak of more than 400, prompting officials to erect a 2,500-square foot tent in the parking lot to handle the surge. More than 300 patients are still coming in every day.

"What we initially did was try to bring in extra folks, but you soon run out of extra people and extra spaces to put people," said Barry Gilmore, the hospital's medical director for emergency services.

Doctors, nurses, paramedics or other workers screen patients in the tent and decide who can safely go home. Anyone with other health problems that put them at risk, such as asthma, heart disease or kidney disease, is sent immediately to the emergency room. All patients who are sent home are contacted within 24 to 48 hours to make sure they are recovering.

"We are mostly dealing with the worried well or kids who are mildly ill but not severely ill," he said.

At least 14 patients, however, were admitted to the hospital and perhaps six required intensive care, he said. One teenager died.

Swine flu, also known as H1N1, tends to strike more younger people than the usual seasonal flu. At least 49 children have died from complications caused by the virus so far in the United States.

At the Dell Children's Medical Center, the number of patients coming in each day shot up from about 180 to more than 340, prompting the hospital to require staff to work extra shifts and erect two tents outside the emergency room to handle the overflow and keep possibly infected patients separate from others.

"We are able to take care of them really rapidly without a long wait, and they don't have to be mixed in with other patients who do not have the flu," said Pat Crocker, chief of emergency medicine. "It's been highly efficient."

But Crocker, noting that the hospital is already busier than it was in the wake of hurricanes Katrina and Rita, said the hospital has a third tent ready to be set up.

Individual doctors' offices are also reporting a surge of patients in many parts of the country.

"We're completely swamped," said Ari Brown, an Austin pediatrician whose office had to call in extra nurses to handle the volume of patients. "It's been extraordinarily busy. We have a small parking lot to begin with. People now are circulating the neighborhood to try to find a place to park and the waiting room is completely packed."

Unless patients are seriously ill or have other conditions that put them at risk, Brown and other doctors say they tell parents to take their children home, give them Motrin or Tylenol for their fevers, headaches and body aches, and lots of fluids, and wait it out. Some doctors report that children tend to recover within about four days, a day or two shorter than with the typical flu.

Nevertheless, "people are so worried about this," Brown said. "There's clearly a certain level of hysteria."

Although no hospitals in the Washington region have yet had to activate their emergency plans, many are reporting an increase in patients, as are individual doctors.

"Some of that is because of the swine flu and some of it is because of phobia about the flu," said Steven Mumbauer, a Waynesboro, Va., pediatrician. "But we definitely are seeing sicker kids and have treated more kids with pneumonia than we typically would this time of the year. There have been some days where we've been absolutely swamped."

At the University of Maryland Medical Center in Baltimore, some children have gotten so sick that they have required intensive care, and that includes some children with no other health problems.

"We have some very sick children," said Ina Stephens, a pediatric infectious disease specialist at the hospital. "I'm concerned it's just the tip of the iceberg -- that we're just seeing the beginning of it."

http://www.washingtonpost.com/wp-dyn/co ... 54_pf.html" onclick="window.open(this.href);return false;

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Re: H1N1 pandemic news started 06/11/2009

Post by liberty45 » Sun Sep 27, 2009 3:53 pm

My cousin's daughter is in the hospital with regular flu. Has pneumonia and had a fever of 105.3.

They had a horrible time finding a vein for the IV due to her veins collapsing. Most likely caused by dehydration.

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Re: H1N1 pandemic news started 06/11/2009

Post by Ovationman » Sun Sep 27, 2009 5:49 pm

liberty45 wrote:My cousin's daughter is in the hospital with regular flu. Has pneumonia and had a fever of 105.3.

They had a horrible time finding a vein for the IV due to her veins collapsing. Most likely caused by dehydration.
Did they test her for H1N1?

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Re: H1N1 pandemic news started 06/11/2009

Post by JakkSchitt » Sun Sep 27, 2009 9:26 pm

U.S. reports 572 flu-related deaths, 5,486 hospitalizations in past week

2009-09-26

http://news.xinhuanet.com/english/2009- ... 112897.htm" onclick="window.open(this.href);return false;

HOUSTON, Sept. 25 (Xinhua) -- The federal Centers for Disease Control and Prevention (CDC) on Friday reported that 572 people had died of influenza and pneumonia-associated complications in the past week, bringing the death toll to 936 since the beginning of September.

Meanwhile, according to the latest statistics released by the CDC, 5,486 people across the country have been admitted last week to hospitals resulting from all types or subtypes of influenza, not just those from the A/H1N1 influenza virus, bringing the total number to 10,082.

In an effort to add additional structure to the aggregate reporting, the Council of State and Territorial Epidemiologists (CSTE) and the CDC have developed new case definitions for influenza-associated hospitalizations and deaths to be applied for the 2009-2010 influenza season, formally beginning from Oct. 4.

This new system was implemented on Aug. 30, 2009 and replaces the weekly report of laboratory confirmed A/H1N1-related hospitalizations and deaths since July.

States can now report to the CDC either laboratory confirmed or pneumonia and influenza syndromic hospitalizations and deaths resulting from all types or subtypes of influenza. To allow states to implement the new case definition, counts were reset to zero by the CDC on Aug. 30, 2009.

The CDC said the latest data, based on reports by U.S. States and territories on Sept. 22, shows that 26 states had geographically widespread influenza activity in the past week, comparing to 21 states in the previous week.

The five more states that had widespread influenza activity include the most populous states of California and Texas. Meanwhile, four more states had regional influenza activity in the past week, bringing the total to 11.

All these indicate the second wave of the pandemic is imminent.

The seasonal influenza A (H1) and A (H3) viruses co-circulated at low levels with the A/H1N1 virus, the CDC said in a conclusion, adding that 99 percent of all subtyped influenza A viruses being reported to the CDC last week were the new A/H1N1 virus.

However, the CDC said that, during the first three weeks in September, all deaths reported through the 122-Cities Mortality Reporting System due to pneumonia and influenza (P&I) was 6.1 percent, a little over 6.0 percent in the previous week, but still below the epidemic threshold of 6.3 percent, the CDC explained on its website.

Nationwide, 4.6 percent of patient visits -- comparing to 4.4 percent in the previous week -- were due to influenza-like illness(ILI), according to the CDC experts, who point out to the fact that this percentage more than doubles the national baseline of 2.4 percent.

The A/H1N1 virus infection was first identified in the United States in late April. By August, 555 people had died of the new virus with hospitalizations of 8,842. More than 40,000 confirmed and probable cases had been reported and more than 1 million infections were estimated to have occurred in the United States.

The CDC and state officials are preparing for massive A/H1N1 flu immunizations, starting with school children in the first week of October.
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Re: H1N1 pandemic news started 06/11/2009

Post by JakkSchitt » Sun Sep 27, 2009 9:28 pm

Liberty, if she is in the hospital with the flu is it more than likely NOT regular seasonal flu.
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Re: H1N1 pandemic news started 06/11/2009

Post by callista » Mon Sep 28, 2009 8:44 am

No, it's still quite possible; there's seasonal flu going around and people do get hospitalized when they get it. (Aside: Yes, it's worth it getting the regular flu shot this year.)
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Re: H1N1 pandemic news started 06/11/2009

Post by liberty45 » Mon Sep 28, 2009 12:32 pm

I believe they tested for H1N1 but it came back negative. This is what I heard down the grapevine. I have not seen her parents since Friday.

The doctors said she should of had the regular flu shot but told them not to give the "new shot" for H1N1, as it has not been properly tested. And this is coming from the area's largest hospital in Allentown, Pennsylvania.

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Re: H1N1 pandemic news started 06/11/2009

Post by FordGuy2001 » Mon Sep 28, 2009 1:43 pm

Now its hittin close to home.

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Re: H1N1 pandemic news started 06/11/2009

Post by JakkSchitt » Mon Sep 28, 2009 2:56 pm

Something like 99% of the samples sent to the CDC test positive for H1N1. The rapid test is less than 50% accurate. There have been people who tested negative 3 times before death and after death when the samples were sent to the CDC it came back positive. If someone is in the hospital with the flu type A, than it is more than likely H1N1.
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Re: H1N1 pandemic news started 06/11/2009

Post by Kathy in FL » Mon Sep 28, 2009 4:41 pm

JakkSchitt wrote:Something like 99% of the samples sent to the CDC test positive for H1N1. The rapid test is less than 50% accurate. There have been people who tested negative 3 times before death and after death when the samples were sent to the CDC it came back positive. If someone is in the hospital with the flu type A, than it is more than likely H1N1.
+1

And this is what is driving some doctors and labs crazy. They are hitting a positive for Inf type A but they aren't able to subtype it.

Put your tinfoil hats on here ... there are some that think that H1N1-09 has already had so many micro mutations that by and large the shorter tests are useless and that it is only the full subtyping test that determines whether it is H1N1-09 or not.

I'm not sure if that is the answer or if it is the fact that the quick tests were rushed into production so quickly that their accuracy is debatable whether it is a postive or negative or not. But, given the complete samples of hopsitalized and fatal cases that are being sent to the CDC testing 99% H1N1 I would have to say it would be rare for a hospitalized case could be anything but H1N1-09. It isn't even seasonal flu season yet in most locations so that makes it further less likely to be anything but H1N1-09.

Doesn't mean the girl can't be in that 1% ... but it is 99% unlikely.

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Re: H1N1 pandemic news started 06/11/2009

Post by callista » Mon Sep 28, 2009 5:01 pm

Hmm... a fast mutation rate will be good for us in the long run, though; the less severe a flu is, in general the better it spreads, because its victims are up and walking around; and the better it spreads the more successful it is... in which case it'd tame down to the level of the common cold, eventually... But that does not make me very happy about the short run, while it's still figuring out, "Hey, if I don't kill people, I get to reproduce more."

What I don't like is the prospect of it being capable of killing some while leaving others healthy enough to become walking disease vectors. That frankly scares me, and I still haven't found anything to contradict that it's happening.
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Re: H1N1 pandemic news started 06/11/2009

Post by liberty45 » Mon Sep 28, 2009 6:49 pm

Everyone knew this was coming, it shouldn't be a surprise... but non the less not good.

http://www.newsday.com/long-island/mand ... print=true" onclick="window.open(this.href);return false;
Mandatory flu vaccination splits workers
Despite a planned rally in Albany Tuesday to protest a state regulation requiring health care workers be vaccinated against influenza — both seasonal and swine flu — New York’s top public health official predicts dissenters will ultimately extinguish their anger and roll up their sleeves.

The regulation, which was approved in August, comes with a stinging addendum: Get vaccinated or get fired.
http://www.wor710.com/2009/09/28/top-ne ... te/5316988" onclick="window.open(this.href);return false;
Rally in Albany Tuesday Over H1N1 Flu Shot Debate
(New York, NY) -- Hundreds of health care workers will rally in Albany Tuesday, angry that they are being made to receive H1N1 flu shots. The State Health Department has made it mandatory that all health care workers get immunized by November 30th. The protestors say their rights are being violated and that they can not be forced to get a H1N1 flu shot. Officials say there will be exceptions for those health care workers who have a personal health issue that would prevent them from getting the shot.

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Re: H1N1 pandemic news started 06/11/2009

Post by Broken1 » Mon Sep 28, 2009 10:02 pm

That is a pretty tough spot to be in, for both sides...
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