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Meister T, Foessleitner P, Breuer G, Winder FM, Favero M, Friemann M, Krischer B, Weiss M, Windsperger K. The impact of gender on the self-confidence of practical and surgical skills among OBGYN residents: a trinational survey. Arch Gynecol Obstet 2024; 309:2669-2679. [PMID: 37695372 PMCID: PMC11147860 DOI: 10.1007/s00404-023-07202-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 08/22/2023] [Indexed: 09/12/2023]
Abstract
INTRODUCTION Gender disparities exist in the OBGYN discipline. This study investigates, for the first time, whether gender impacts on the confidence of practical and surgical skills among OBGYN residents, and of being prepared to work as a specialist. METHODS The gynecological societies of Austria, Germany, and Switzerland established a web-based survey of 30 questions that was sent to all registered OBGYN members-in-training from August to September 2020. Data collection, controlling and analysis were performed by the Swiss Federal Institute of Technology in Zurich (ETH). RESULTS A total of 422 participants took part in the survey, of which 375 (88.9%) were female, 46 (10.9%) were male, and one (0.2%) was divers. The diverse participant was excluded from further analyses. The gender distribution was comparable in all three countries. Multiple regression analyses showed that gender is an independent variable significantly impacting on the confidence levels in performing standard gynaecological (p = 0.03) and obstetric (p < 0.001) procedures. Similarly, the feeling of confidence in being prepared for working as a specialist in a clinic showed to be gender-dependent (p < 0.001), however, not the feeling of being prepared for working as specialist in an outpatient setting (p = 0.37). The "female factor" significantly decreases the confidence rating for surgical and practical skills and for working in a hospital. Covariates including year of training, country, workload, receiving regular feedback, and implemented simulation training were included in all analyses. DISCUSSION Improvements of residency programs to promote female doctors to overcome factors reducing their confidence in their own OBGYN skills are highly warranted.
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Affiliation(s)
- Tara Meister
- Division of Obstetrics and Feto-Maternal Medicine, Department of Obstetrics and Gynecology, Medical University of Vienna, Währinger Guertel 18-20, 1090, Vienna, Austria
| | - Philipp Foessleitner
- Division of Obstetrics and Feto-Maternal Medicine, Department of Obstetrics and Gynecology, Medical University of Vienna, Währinger Guertel 18-20, 1090, Vienna, Austria
| | - Georg Breuer
- Department of Obstetrics and Gynecology, University Hospital Tulln, Tulln, Austria
| | | | | | - Margareta Friemann
- Department of Gynaecology and Obstetrics, Municipal Clinical Center Lüneburg, Lüneburg, Germany
| | | | - Martin Weiss
- Department of Women's Health, Eberhard Karls University, 72076, Tübingen, Germany
| | - Karin Windsperger
- Division of Obstetrics and Feto-Maternal Medicine, Department of Obstetrics and Gynecology, Medical University of Vienna, Währinger Guertel 18-20, 1090, Vienna, Austria.
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Bickel-Dabadghao M, Rau Y, Matrisch L. Female Attendings in University Clinics of Surgery in Germany: A Scoping Analysis of an Ongoing Disparity. Cureus 2024; 16:e60860. [PMID: 38910788 PMCID: PMC11192168 DOI: 10.7759/cureus.60860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2024] [Indexed: 06/25/2024] Open
Abstract
INTRODUCTION Gender-based discrimination, particularly in healthcare, affects women's roles and opportunities, including in surgery where they remain underrepresented in leadership positions. The extent to which such discrimination is prevalent in attending positions is unclear. METHODS The publicly available records of 48 universities and university-associated hospitals in Germany were extracted to quantify gender ratios among attending surgeons and head surgeons in the fields of visceral, vascular, cardiac, thoracic, pediatric, orofacial, neuro-, trauma, and plastic surgery. Statistical analysis, including Chi-Square tests and Student's t-test, was used to analyze the data. RESULTS Among the 367 department heads, 353 (96.2%) were male and 14 (3.8%) were female. Among the 2,366 attendings, 1,854 (78.4%) were men and 512 (21.6%) were women. These differences were significant (χ²=64.95, p<0.001, odds ratio=0.14, 95% confidence interval=0.08-0.25). Departments being led by a female department head were not more likely to employ female attendings (χ²=0.379, p=0.538, odds ratio=1.17, 95% confidence interval=0.70-1.96). CONCLUSION German surgical departments in University Hospitals have significant gender disparities, with women underrepresented at higher levels. This may negatively affect patient outcomes. To tackle the problem, further research is needed to fully understand the issue.
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Affiliation(s)
| | - Yannick Rau
- General Practice, General Practice Teetzmann, Mölln, DEU
| | - Ludwig Matrisch
- Internal Medicine, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, DEU
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Meyer B, Riedel F, Amann N, Graf A, Stuehrenberg A, Ritter V, Wallwiener M, Heublein S, Recker F, Weiss M, Riedel M. Exploring the current state of clinical and practical teaching in obstetrics and gynecology in the era of competency-based education: a nationwide survey among German teaching coordinators. BMC MEDICAL EDUCATION 2024; 24:165. [PMID: 38383443 PMCID: PMC10880315 DOI: 10.1186/s12909-024-05138-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 02/05/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND Obstetrics and gynecology (OB/GYN) is an essential medical field that focuses on women's health. Universities aim to provide high-quality healthcare services to women through comprehensive education of medical students. In Germany, medical education is undergoing a phase of restructuring towards the implementation of competency-based learning. The objective of the current survey was to gain insights into the teaching methods, resources, and challenges at German medical universities in the field OB/GYN. This aims to document the current state of medical education and derive potential suggestions for improvements in the era of competency-based learning. The survey was conducted with teaching coordinators from the majority of OB/GYN departments at German universities. METHODS A questionnaire was sent to the teaching coordinators in all 41 OB/GYN departments at German university hospitals. The survey was delivered via email with a link to an online survey platform. RESULTS The study received 30 responses from 41 universities. Differences were observed in the work environment of teaching coordinators concerning release from clinical duties for teaching purposes and specialized academic training. Overall, medical education and student motivation were perceived positively, with noticeable gaps, particularly in practical gynecological training. Deficiencies in supervision and feedback mechanisms were also evident. Subfields such as urogynecology and reproductive medicine appear to be underrepresented in the curriculum, correlating with poorer student performance. E-learning was widely utilized and considered advantageous. CONCLUSION The present study provides valuable insights into the current state of medical education in OB/GYN at German universities from the perspective of teaching experts. We highlight current deficits, discuss approaches to overcome present obstacles, and provide suggestions for improvement.
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Affiliation(s)
- Bastian Meyer
- Department of Gynecology and Obstetrics, Klinikum Rechts Der Isar, Technical University Munich, Munich, Germany
| | - Fabian Riedel
- Department of Gynecology and Obstetrics, Heidelberg University Hospital, Heidelberg, Germany
| | - Niklas Amann
- Department of Gynecology and Obstetrics, Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Erlangen, Germany
| | - Anna Graf
- Department of Gynecology and Obstetrics, Klinikum Rechts Der Isar, Technical University Munich, Munich, Germany
| | - Antonia Stuehrenberg
- Department of Gynecology and Obstetrics, Klinikum Rechts Der Isar, Technical University Munich, Munich, Germany
| | - Viktoria Ritter
- Department of Gynecology and Obstetrics, Klinikum Rechts Der Isar, Technical University Munich, Munich, Germany
| | - Markus Wallwiener
- Department of Gynecology and Obstetrics, Halle University, Halle, Germany
| | - Sabine Heublein
- Department of Gynecology and Obstetrics, Heidelberg University Hospital, Heidelberg, Germany
- Department of Gynecology and Obstetrics, Halle University, Halle, Germany
| | - Florian Recker
- Department of Gynecology and Obstetrics, Bonn University Hospital, Bonn, Germany
| | - Martin Weiss
- Department of Women's Health, University of Tübingen, Tübingen, Germany
- NMI Natural and Medical Sciences Institute, University of Tübingen, Reutlingen, Germany
| | - Maximilian Riedel
- Department of Gynecology and Obstetrics, Klinikum Rechts Der Isar, Technical University Munich, Munich, Germany.
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Ní hÉalaithe C, Howard A, Corcoran P, McCarthy CM, Horgan M, Bennett D, O'Donoghue K, O'Sullivan S. Factors influencing medical students' decision to pursue a career in obstetrics and gynaecology. PLoS One 2023; 18:e0288130. [PMID: 38051720 DOI: 10.1371/journal.pone.0288130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 06/20/2023] [Indexed: 12/07/2023] Open
Abstract
INTRODUCTION The career intentions of medical students can exert influence on service provision and medical staffing in the health services. It is vital for a specialty's development and sustainability that it has a constant stream of trainees into it annually. An appreciation of how a specialty is viewed by medical students can be used as an opportunity for early intervention in order to improve perception of the specialty and reduce future workforce problems, such as retention and attrition within obstetrics and gynaecology (O&G). We aimed to analyse positive and negative factors of the specialty of O&G as perceived by medical students in order to gain insight into changes that need to be made to improve recruitment and retention into the specialty. METHODS A 70-item structured questionnaire consisting of demographic information and 5-point Likert scale questions relating to O&G was administered to final year medical students in the Republic of Ireland. Data were analysed with descriptive statistics, logistic regression, and odds ratios as appropriate. RESULTS Of 195 medical students approached, 134 completed the questionnaire, a response rate of 68.7%. The majority were female (55.2%, n = 74) and 76.1% of respondents (n = 102) were Direct Entry Medicine students, with the remainder Graduate Entry Medicine students. 30.8% (n = 41) of students who responded scored 6 or more on a 10-point Likert scale when asked about their likelihood of considering a career in O&G. Students' clerkship experience factored heavily into their perception of the specialty and was more likely to be positive if they experienced direct consultant engagement and the opportunity for hands-on experience. Lifestyle factors, litigation and media were found to be deterrents to considering the specialty after graduation. CONCLUSIONS This study demonstrates the importance of good clerkship experience in fostering an interest amongst undergraduates in O&G. Educators and those working within the specialty should showcase the strengths of the specialty during undergraduate education, and work on ameliorating deterrents to ultimately provide a structured approach to improving recruitment into O&G.
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Affiliation(s)
- Caoimhe Ní hÉalaithe
- Department of Obstetrics and Gynaecology, University College Cork, Cork, Ireland
| | - Aoife Howard
- Department of Obstetrics and Gynaecology, University College Cork, Cork, Ireland
| | - Paul Corcoran
- National Perinatal Epidemiology Centre, University College Cork, Cork, Ireland
| | | | - Mary Horgan
- Royal College of Physicians of Ireland, Dublin, Ireland
| | - Deirdre Bennett
- Medical Education Unit, School of Medicine, University College Cork, Cork, Ireland
| | - Keelin O'Donoghue
- Department of Obstetrics and Gynaecology, University College Cork, Cork, Ireland
- Irish Centre for Maternal and Child Health Research (INFANT), University College Cork, Cork, Ireland
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Alaqeel SA, Alhammad BK, Basuhail SM, Alderaan KM, Alhawamdeh AT, Alquhayz MF, Alzunaidi AM, Alrashed FA. Investigating factors that influence residency program selection among medical students. BMC MEDICAL EDUCATION 2023; 23:615. [PMID: 37644551 PMCID: PMC10466777 DOI: 10.1186/s12909-023-04602-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/21/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUNDS Medical students and interns face several decisions during their career development. One of the most critical decisions they have to make is choosing a residency program that suits their career goals and aspirations. The selection process can be challenging, as several factors can influence the decision-making process. There was limited research on the role of GPA and opportunities in residency program selection. Therefore, this study examines the factors that influence interns' and 5th-year medical students' choices of residency programs. METHODS Observational and analytical cross-sectional studies were conducted at King Saud University (KSU) in Riyadh, Saudi Arabia. A sample of 5th-year medical students as well as medical interns was included in the study. This study only includes students who were interested in choosing a residency program in one of these eight domains: Medicine, Family Medicine, Orthopedics, Pediatrics, Radiology, Surgery, Obstetrics/Gynecology, and Ophthalmology. RESULTS The total number of students with 5th-year medical students was 205 (60.1%) and the number of students with medical interns was 135 (39.5%). The majority of students (51.0%) had a GPA above 4.5 out of 5, followed by 3.5 to 4.5 among 146 (42.8) students, and only 21 (6.2) had a GPA below 3.5. Those students with less than a 3.5 GPA out of 5 were found not to have any favorite residency program specialties when it came to academic achievement. Furthermore, in the case of those students whose GPA was 3.5 to 4.5, they had a certain mindset when it came to choosing a residency program. A 1.9 times greater likelihood of selecting obstetrics and gynecology (OR = 1.9, p = 0.19) was achieved by students with GPAs between 3.5 and 4.5, followed by a 1.5 times greater probability of selecting radiology (OR = 1.5; p = 0.55). High achievers, ophthalmology (OR = 1.7; p = 0.32) and surgery (OR = 1.4; p = 0.31) were the most popular residency programs. A student with a high GPA (mean score = 7.3) also chooses his or her career based on better opportunities than a student with a low GPA (mean score = 6.8). CONCLUSIONS The study highlights the correlation between academic achievement and preferred specialties for future careers among medical students. While the study's findings should be considered in the context of various other factors such as lifestyle, social life, and income can influence students' preferred specialties for residency programs.
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Affiliation(s)
| | | | | | | | | | | | | | - Fahad Abdulaziz Alrashed
- Department of Cardiac Sciences, College of Medicine, King Saud University (KSU), P.O. Box 7805, Riyadh, 11472, Saudi Arabia.
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Win Kyaw M, Cheng HC, Obermair H, Woods C, Perry C, de Costa C. Australian medical students' and junior doctors' perceptions of gender discrepancies in obstetrics and gynaecology. Aust N Z J Obstet Gynaecol 2023; 63:247-253. [PMID: 36334057 DOI: 10.1111/ajo.13617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 08/18/2022] [Indexed: 02/17/2024]
Abstract
BACKGROUND There is currently a gender imbalance 85:15 female/male in the intake into specialist training for the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG). AIMS To determine the views and perceptions of Australian medical students, and junior doctors in the first five years of practice, toward obstetrics and gynaecology (O&G) as a career, including whether there are any perceived barriers to the pursuit of such a career. MATERIALS AND METHODS A semi-structured questionnaire was developed with members of the RANZCOG Gender Equity and Diversity Working Group There were two separate studies: the first involved telephone interviews of medical students across three campuses of a medical school in North Queensland. The second study surveyed junior doctors in Queensland who are members of the Australian Medical Association. Responses were analysed and compared using quantitative and qualitative methods. RESULTS Both studies found that experiences with O&G as a medical student influenced the decision to pursue O&G as a career. Exclusion from clinical scenarios and difficulty establishing good relationship with midwives within busy birthing suites were some reasons deterring male students from O&G. In addition, students felt poorly informed about the specialty in their preclinical years, affecting their early decisions in choice of specialty. Post-rotation, more female than male students reported positive experiences and were considering O&G as a career. CONCLUSIONS Both groups see medical student experience as critical in attitudes toward the specialty as a possible career. This experience plays a significant role in encouraging female students toward a career in O&G and discouraging male students. More exposure to the specialty in the preclinical years, and attention to improving clinical rotations for all students, is required.
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Affiliation(s)
- Monyi Win Kyaw
- Cairns Hospital, James Cook University, Cairns, Queensland, Australia
| | - Hon C Cheng
- James Cook University, Cairns, Queensland, Australia
| | - Helena Obermair
- Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Cindy Woods
- Melbourne University & James Cook University, Townsville, Queensland, Australia
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Darici D, Schneider AYD, Missler M, Pfleiderer B. Are stereotypes in decline? The portrayal of female anatomy in e-learning. ANATOMICAL SCIENCES EDUCATION 2022. [PMID: 35844161 DOI: 10.1002/ase.2211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 07/06/2022] [Accepted: 07/10/2022] [Indexed: 06/15/2023]
Abstract
Sex and gender bias in anatomy learning materials are considered a "hidden obstacle" to gender equity in medical curricula. The purpose of this study was to investigate whether quantitative sex and gender biases do exist in popular anatomy e-learning platforms and compare the results with those found in contemporary textbooks and atlases. A systematic content-analysis was performed on N = 3767 images published from 2008 to 2021 in which sex/gender could be identified by considering technical aspects of illustration and various intersectional categories. E-learning platforms took into account an appropriate representation of the female body and presented even more females (n = 932/1412; 66%), more frequently from a ventral/anterior (χ2 = 26, P < 0.001) and whole-body perspective (χ2 = 27, P < 0.001). This was in contrast to German anatomy books, where the results pointed to a significant sex and gender bias. For example, all books assessed underrepresented females (n = 707/2355; 30%) and placed them in stereotypical sex-specific context (χ2 = 348, P < 0.001), showing them more often from a caudal/inferior (χ2 = 99, P < 0.001) and internal (χ2 = 132, P < 0.001) perspective. Altogether, the visual representation of sex and gender in anatomical curricula is still biased and the stereotypical perceptions of human anatomy seem to be a global issue. However, the increasing use of electronic learning platforms, which gradually replace traditional books is changing the way the male and female body is depicted, which might offer new opportunities for reducing stereotypes in anatomy education.
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Affiliation(s)
- Dogus Darici
- Institute of Anatomy and Molecular Neurobiology, Westfälische Wilhelms-University, Münster, Germany
| | | | - Markus Missler
- Institute of Anatomy and Molecular Neurobiology, Westfälische Wilhelms-University, Münster, Germany
| | - Bettina Pfleiderer
- Radiology Clinic, Medical Faculty, Westfälische Wilhelms-University, Münster, Germany
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Riedel M, Eisenkolb G, Amann N, Karge A, Meyer B, Tensil M, Recker F, Dobberkau AM, Riedel F, Kuschel B, Klein E. Experiences with alternative online lectures in medical education in obstetrics and gynecology during the COVID-19 pandemic—possible efficient and student-orientated models for the future? Arch Gynecol Obstet 2021; 305:1041-1053. [PMID: 34961899 PMCID: PMC8712207 DOI: 10.1007/s00404-021-06356-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 12/05/2021] [Indexed: 11/25/2022]
Abstract
Purpose The onset of the COVID-19 pandemic posed an eminent challenge for medical teachers worldwide. Face-to-face lectures and seminars were no longer possible, and alternatives had to be found. E-learning concepts quickly emerged as the only practicable solutions and also offered the opportunity to evaluate whether traditional face-to-face lectures could be translated into an online format, independent of the COVID-19 pandemic. Methods We offered an e-learning program consisting of lecture notes, screencasts with audio narration, and online webinars that covered topics normally taught in traditional lectures and seminars. To evaluate the learning behavior and quality of our e-learning program, we drafted a questionnaire that students completed at the end of the 2020 summer semester that had been designed to enable a comparative analysis of the different e-learning modules. Results Voluntary participation in the online courses was high. Survey analysis revealed high satisfaction with and a distinctive preference for the format, even under regular, COVID-19-independent conditions. In general, a positive appraisal of e-learning—especially as a substitute for regular lectures—was found. Students also reported higher studying efficiency. Exam results were equal to those of previous semesters. Conclusion Both acceptance of and satisfaction with our e-learning modules were high, and students displayed increased demand for this kind of e-learning format. We, therefore, conclude that e-learning offerings could serve as reasonable, efficient, student-orientated substitutes for certain medical courses, especially lectures. These curricular adaptations would correlate with the high digitalization seen in students’ everyday lives. This correlation may also hold true independent of the ongoing COVID-19 pandemic.
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Affiliation(s)
- Maximilian Riedel
- Department of Gynecology and Obstetrics, Klinikum rechts der Isar, Technical University, Munich, Germany
| | - Gabriel Eisenkolb
- Department of Gynecology and Obstetrics, Klinikum rechts der Isar, Technical University, Munich, Germany
| | - Niklas Amann
- Department of Gynecology and Obstetrics, Ludwig Maximilians University (LMU), Munich, Germany
| | - Anne Karge
- Department of Gynecology and Obstetrics, Klinikum rechts der Isar, Technical University, Munich, Germany
| | - Bastian Meyer
- Department of Gynecology and Obstetrics, Klinikum rechts der Isar, Technical University, Munich, Germany
| | | | - Florian Recker
- Department of Gynecology and Obstetrics, Bonn University Hospital, Bonn, Germany
| | - Anna Maria Dobberkau
- Department of Gynecology and Obstetrics, Heidelberg University Hospital, Heidelberg, Germany
| | - Fabian Riedel
- Department of Gynecology and Obstetrics, Heidelberg University Hospital, Heidelberg, Germany
| | - Bettina Kuschel
- Department of Gynecology and Obstetrics, Klinikum rechts der Isar, Technical University, Munich, Germany
| | - Evelyn Klein
- Department of Gynecology and Obstetrics, Klinikum rechts der Isar, Technical University, Munich, Germany
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