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de Castilhos Busato MA, Bondan AP, Bastiani MF, Lizot LF, Hahn RZ, Antunes MV, Linden R. Determination of meropenem in capillary plasma microsamples using LC-MS/MS. Bioanalysis 2024; 16:443-452. [PMID: 38497756 PMCID: PMC11216516 DOI: 10.4155/bio-2023-0268] [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: 12/22/2023] [Accepted: 02/29/2024] [Indexed: 03/19/2024] Open
Abstract
Background: The measurement of meropenem plasma concentrations is employed for dosing regimen individualization. The aim of this study was to develop and validate a LC-MS/MS assay for quantification of meropenem in capillary plasma microsamples. Methods: Samples were prepared by protein precipitation with acetonitrile, followed by clean-up with dichloromethane. The method was validated and applied to 12 paired samples of venous and capillary plasma. Results: The method was linear in the range of 0.5-50 μg/ml. Matrix effects were minimal. Inter- and intra-assay were 3.8-7.9% and 2.7-5.5%, respectively, while accuracy was 91.7-100.6%. Concentrations in capillary and venous plasma were highly correlated. Conclusion: An assay for the quantification of meropenem in capillary plasma microsamples was fully validated, showing potential for clinical application.
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Affiliation(s)
- Maria Amélia de Castilhos Busato
- Laboratório de Toxicologia Analítica, Universidade Feevale, Rua Rubem Berta 200, Novo Hamburgo, Rio Grande do Sul, Brazil
- Programa de Pós-graduação em Toxicologia e Toxicologia Analítica, Universidade Feevale, Rodovia RS 239 2755, Novo Hamburgo, Rio Grande do Sul, Brazil
| | - Amanda Pacheco Bondan
- Laboratório de Toxicologia Analítica, Universidade Feevale, Rua Rubem Berta 200, Novo Hamburgo, Rio Grande do Sul, Brazil
| | - Marcos Frank Bastiani
- Laboratório de Toxicologia Analítica, Universidade Feevale, Rua Rubem Berta 200, Novo Hamburgo, Rio Grande do Sul, Brazil
- Programa de Pós-graduação em Toxicologia e Toxicologia Analítica, Universidade Feevale, Rodovia RS 239 2755, Novo Hamburgo, Rio Grande do Sul, Brazil
| | - Lilian Feltraco Lizot
- Laboratório de Toxicologia Analítica, Universidade Feevale, Rua Rubem Berta 200, Novo Hamburgo, Rio Grande do Sul, Brazil
- Programa de Pós-graduação em Toxicologia e Toxicologia Analítica, Universidade Feevale, Rodovia RS 239 2755, Novo Hamburgo, Rio Grande do Sul, Brazil
| | - Roberta Zilles Hahn
- Laboratório de Toxicologia Analítica, Universidade Feevale, Rua Rubem Berta 200, Novo Hamburgo, Rio Grande do Sul, Brazil
| | - Marina Venzon Antunes
- Laboratório de Toxicologia Analítica, Universidade Feevale, Rua Rubem Berta 200, Novo Hamburgo, Rio Grande do Sul, Brazil
- Programa de Pós-graduação em Toxicologia e Toxicologia Analítica, Universidade Feevale, Rodovia RS 239 2755, Novo Hamburgo, Rio Grande do Sul, Brazil
| | - Rafael Linden
- Laboratório de Toxicologia Analítica, Universidade Feevale, Rua Rubem Berta 200, Novo Hamburgo, Rio Grande do Sul, Brazil
- Programa de Pós-graduação em Toxicologia e Toxicologia Analítica, Universidade Feevale, Rodovia RS 239 2755, Novo Hamburgo, Rio Grande do Sul, Brazil
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Yang X, Williams K, Elliott R, Hokom M, Allen J, Fischer SK. Validation of low-volume sampling devices for pharmacokinetic analysis: technical and logistical challenges and solutions. Bioanalysis 2023; 15:1407-1419. [PMID: 37855111 DOI: 10.4155/bio-2023-0156] [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] [Indexed: 10/20/2023] Open
Abstract
While low-volume sampling technologies offer numerous advantages over venipuncture, implementation in clinical trials poses technical and logistical challenges. Bioanalytical methods were validated for measuring the concentration of crenezumab and etrolizumab in dried blood samples collected using Mitra and Tasso-M20. The data generated demonstrate that the concentrations of crenezumab and etrolizumab in dried blood collected by either device could be determined using calibrators prepared in serum. Drug concentrations from dried blood were converted to serum concentrations using patient hematocrit levels. Contract Research Organization experience in sample handling and analysis allowed us to compare differences between various low-volume sampling technologies. This study evaluated challenges and presented potential solutions for use of different low-volume sampling technologies for pharmacokinetic analysis.
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Affiliation(s)
- Xiaoyun Yang
- BioAnalytical Sciences, Genentech, Inc., 1 DNA Way, South San Francisco, CA 94080, USA
| | - Kathi Williams
- BioAnalytical Sciences, Genentech, Inc., 1 DNA Way, South San Francisco, CA 94080, USA
| | - Rebecca Elliott
- BioAnalytical Sciences, Genentech, Inc., 1 DNA Way, South San Francisco, CA 94080, USA
| | - Martha Hokom
- BioAnalytical Sciences, Genentech, Inc., 1 DNA Way, South San Francisco, CA 94080, USA
| | - Janis Allen
- BioAnalytical Sciences, Genentech, Inc., 1 DNA Way, South San Francisco, CA 94080, USA
| | - Saloumeh K Fischer
- BioAnalytical Sciences, Genentech, Inc., 1 DNA Way, South San Francisco, CA 94080, USA
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Bachhav SS, Taylor M, Martin A, Green JA, Duparc S, Rolfe K, Sharma H, Tan LK, Goyal N. A pharmacometrics approach to assess the feasibility of capillary microsampling to replace venous sampling in clinical studies: Tafenoquine case study. Br J Clin Pharmacol 2023; 89:1187-1197. [PMID: 36199201 DOI: 10.1111/bcp.15554] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 08/26/2022] [Accepted: 09/22/2022] [Indexed: 11/28/2022] Open
Abstract
AIM Microsampling has the advantage of smaller blood sampling volume and suitability in vulnerable populations compared to venous sampling in clinical pharmacokinetics studies. Current regulatory guidance requires correlative studies to enable microsampling as a technique. A post hoc population pharmacokinetic (POPPK) approach was utilized to investigate blood capillary microsampling as an alternative to venous sampling. METHODS Pharmacokinetic data from microsampling and venous sampling techniques during a paediatric study evaluating tafenoquine, a single-dose antimalarial for P. vivax, were used. Separate POPPK models were developed and validated based on goodness of fit and visual predictive checks, with pharmacokinetic data obtained via each sampling technique. RESULTS Each POPPK model adequately described tafenoquine pharmacokinetics using a two-compartment model with body weight based on allometric scaling of clearance and volume of distribution. Tafenoquine pharmacokinetic parameter estimates including clearance (3.4 vs 3.7 L/h) were comparable across models with slightly higher interindividual variability (38.3% vs 27%) in capillary microsampling-based data. A bioavailability/bioequivalence comparison demonstrated that the point estimate (90% CI) of capillary microsample versus venous sample model-based individual post hoc estimates for area under the concentration-time curve from time zero to infinity (AUC0-inf ) (100.7%, 98.0-103.5%) and Cmax (79.7%, 76.9-82.5%) met the 80-125% and 70-143% criteria, respectively. Overall, both POPPK models led to the same dose regimen recommendations across weight bins based on achieving target AUC. CONCLUSIONS This analysis demonstrated that a POPPK approach can be employed to assess the performance of alternative pharmacokinetic sampling techniques. This approach provides a robust solution in scenarios where variability in pharmacokinetic data collected via venous sampling and microsampling may not result in a strong linear relationship. The findings also established that microsampling techniques may replace conventional venous sampling methods.
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Affiliation(s)
- Sagar S Bachhav
- Clinical Pharmacology Modeling and Simulation, GSK, Collegeville, PA, USA
| | - Maxine Taylor
- Drug Metabolism and Pharmacokinetics, In Vitro/In Vivo Translation, R&D GSK, Ware, Herts, UK
| | | | | | | | | | | | | | - Navin Goyal
- Clinical Pharmacology Modeling and Simulation, GSK, Collegeville, PA, USA
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Guerra Valero YC, Dorofaeff T, Coulthard MG, Sparkes L, Lipman J, Wallis SC, Roberts JA, Parker SL. Optimal dosing of cefotaxime and desacetylcefotaxime for critically ill paediatric patients. Can we use microsampling? J Antimicrob Chemother 2022; 77:2227-2237. [PMID: 35678266 PMCID: PMC9333413 DOI: 10.1093/jac/dkac168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 04/25/2022] [Indexed: 11/30/2022] Open
Abstract
Objectives To describe the population pharmacokinetics of cefotaxime and desacetylcefotaxime in critically ill paediatric patients and provide dosing recommendations. We also sought to evaluate the use of capillary microsampling to facilitate data-rich blood sampling. Methods Patients were recruited into a pharmacokinetic study, with cefotaxime and desacetylcefotaxime concentrations from plasma samples collected at 0, 0.5, 2, 4 and 6 h used to develop a population pharmacokinetic model using Pmetrics. Monte Carlo dosing simulations were tested using a range of estimated glomerular filtration rates (60, 100, 170 and 200 mL/min/1.73 m2) and body weights (4, 10, 15, 20 and 40 kg) to achieve pharmacokinetic/pharmacodynamic (PK/PD) targets, including 100% ƒT>MIC with an MIC breakpoint of 1 mg/L. Results Thirty-six patients (0.2–12 years) provided 160 conventional samples for inclusion in the model. The pharmacokinetics of cefotaxime and desacetylcefotaxime were best described using one-compartmental model with first-order elimination. The clearance and volume of distribution for cefotaxime were 12.8 L/h and 39.4 L, respectively. The clearance for desacetylcefotaxime was 10.5 L/h. Standard dosing of 50 mg/kg q6h was only able to achieve the PK/PD target of 100% ƒT>MIC in patients >10 kg and with impaired renal function or patients of 40 kg with normal renal function. Conclusions Dosing recommendations support the use of extended or continuous infusion to achieve cefotaxime exposure suitable for bacterial killing in critically ill paediatric patients, including those with severe or deep-seated infection. An external validation of capillary microsampling demonstrated skin-prick sampling can facilitate data-rich pharmacokinetic studies.
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Affiliation(s)
| | - Tavey Dorofaeff
- UQ Centre for Clinical Research, The University of Queensland, Brisbane, Australia.,Paediatric Intensive Care, Queensland Children's Hospital, Brisbane, Australia
| | - Mark G Coulthard
- Paediatric Intensive Care, Queensland Children's Hospital, Brisbane, Australia.,Mayne Academy of Paediatrics, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Louise Sparkes
- Paediatric Intensive Care, Queensland Children's Hospital, Brisbane, Australia
| | - Jeffrey Lipman
- UQ Centre for Clinical Research, The University of Queensland, Brisbane, Australia.,Department of Intensive Care Medicine, Royal Brisbane & Women's Hospital, Brisbane, Australia.,Jamieson Trauma Institute, Royal Brisbane & Women's Hospital, Herston, QLD 4029, Australia
| | - Steven C Wallis
- UQ Centre for Clinical Research, The University of Queensland, Brisbane, Australia
| | - Jason A Roberts
- UQ Centre for Clinical Research, The University of Queensland, Brisbane, Australia.,Department of Intensive Care Medicine, Royal Brisbane & Women's Hospital, Brisbane, Australia.,Department of Pharmacy, Royal Brisbane & Women's Hospital, Brisbane, Australia
| | - Suzanne L Parker
- UQ Centre for Clinical Research, The University of Queensland, Brisbane, Australia
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Guerra Valero Y, Dorofaeff T, Parker L, Coulthard MG, Sparkes L, Lipman J, Wallis SC, Roberts JA, Parker SL. Microsampling to support pharmacokinetic clinical studies in pediatrics. Pediatr Res 2022; 91:1557-1561. [PMID: 34023854 DOI: 10.1038/s41390-021-01586-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 04/26/2021] [Accepted: 04/29/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND Conventional sampling for pharmacokinetic clinical studies requires removal of large blood volumes from patients. This can result in a physiological/emotional burden for children. Microsampling to support pharmacokinetic clinical studies in pediatrics may reduce this burden. METHODS Parents/guardians and bedside nurses completed a questionnaire describing their perception of the use of microsampling compared to conventional sampling to collect blood samples, based on their child's participation or their own role within a paired-sample pharmacokinetic clinical study. Responses were based on a seven-point Likert scale and were analyzed using frequency distributions. RESULTS Fifty-one parents/guardians and seven bedside nurses completed a questionnaire. Parents/guardians (96%) and bedside nurses (100%) indicated that microsampling was highly acceptable and recommended as a method for collecting blood samples for pediatric patients. Responding to a question about the child indicating pain during the blood sampling procedure, 61% of parent/guardians reported no pain in their children, 14% remained neutral, and 26% reported that their child indicated pain; 71% of the bedside nurses slightly agreed that the children indicated pain. CONCLUSIONS This study strongly suggests that parents/guardians and bedside nurses prefer microsampling to conventional sampling to conduct pediatric pharmacokinetic clinical studies. Employing microsampling may support increased participation by children in these studies. IMPACT Pharmacokinetic clinical studies require the withdrawal of blood samples at multiple times during a dosing interval. This can result in a physiological or emotional burden, particularly for neonates or pediatric patients. Microsampling offers an important opportunity for pharmacokinetic clinical studies in vulnerable patient populations, where smaller sample volumes can be collected. However, microsampling is not commonly used in clinical studies. Understanding the perceptions of parents/guardians and bedside nurses about microsampling may ascertain if this technique offers an improvement to conventional blood sample collection to perform pharmacokinetic clinical studies for pediatric patients.
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Affiliation(s)
- Yarmarly Guerra Valero
- UQ Centre for Clinical Research, The University of Queensland, Brisbane, QLD, Australia.
| | - Tavey Dorofaeff
- UQ Centre for Clinical Research, The University of Queensland, Brisbane, QLD, Australia.,Pediatric Intensive Care Unit, Queensland Children's Hospital, Brisbane, QLD, Australia
| | - Lisa Parker
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Mark G Coulthard
- Pediatric Intensive Care Unit, Queensland Children's Hospital, Brisbane, QLD, Australia.,Mayne Academy of Paediatrics, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Louise Sparkes
- Pediatric Intensive Care Unit, Queensland Children's Hospital, Brisbane, QLD, Australia
| | - Jeffrey Lipman
- UQ Centre for Clinical Research, The University of Queensland, Brisbane, QLD, Australia.,Jameson Trauma Institute, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia.,Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Steven C Wallis
- UQ Centre for Clinical Research, The University of Queensland, Brisbane, QLD, Australia
| | - Jason A Roberts
- UQ Centre for Clinical Research, The University of Queensland, Brisbane, QLD, Australia.,Jameson Trauma Institute, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia.,Department of Pharmacy, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - Suzanne L Parker
- UQ Centre for Clinical Research, The University of Queensland, Brisbane, QLD, Australia
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Evaluation of low-volume plasma sampling for the analysis of meropenem in clinical samples. Anal Bioanal Chem 2022; 414:2155-2162. [DOI: 10.1007/s00216-021-03851-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 11/22/2021] [Accepted: 12/14/2021] [Indexed: 11/01/2022]
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Xiaoyong X, Jinglin W, Guangfei W, Huimin Z, Hong X, Zhiping L. Applicability of vancomycin, meropenem, and linezolid in capillary microsamples vs. dried blood spots: A pilot study for microsampling in critically ill children. Front Pediatr 2022; 10:1055200. [PMID: 36704149 PMCID: PMC9872121 DOI: 10.3389/fped.2022.1055200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 12/12/2022] [Indexed: 01/11/2023] Open
Abstract
INTRODUCTION Therapeutic drug monitoring (TDM) has been shown to be clinically beneficial for critically ill patients. However, this is a burden for neonates or children with small circulating blood volumes. Here, we aimed to develop and validate a microsampling TDM platform (including dried blood spots (DBS) and capillary microsamples (CMS)) for the simultaneous quantification of vancomycin, meropenem, and linezolid. METHODS Paired DBS and CMS samples were obtained from an intensive care unit (ICU) to evaluate its clinical application. Estimated plasma concentrations (EPC) were calculated from DBS concentrations. Agreement between methods was evaluated using Deming regression and Bland-Altman difference plots. RESULTS The microsampling methods validation showed excellent reliability and compatibility with the analysis of the sample matrix and hematocrit range of the studied population. The DBS and CMS accuracy and precision results were within accepted ranges and samples were stable at room temperature for at least 2 days and 8 h, respectively. Hematocrit had no impact on CMS, but sightly impacted DBS measurements. The CMS and DBS antibiotic concentrations correlated well (r > 0.98). The drug concentration ratio in DBS samples to that in CMS was 1.39 for vancomycin, 1.34 for meropenem, and 0.94 for linezolid. The EPC calculated from the DBS using individual hematocrit ranges presented comparable absolute values for vancomycin (slope: 1.06) and meropenem (slope: 1.04), with a mean of 98% and 99% of the measured CMS concentrations, respectively. DISCUSSION This study provides a microsampling TDM platform validated for clinical use for a rapid quantification of three antibiotics and is suitable for real-time TDM-guided personalization of antimicrobial treatment in critically ill children.
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Affiliation(s)
- Xu Xiaoyong
- Department of Clinical Pharmacy, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Wang Jinglin
- Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wang Guangfei
- Department of Clinical Pharmacy, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Zhang Huimin
- Department of Pharmaceutics, China Pharmaceutical University, Nanjing, China
| | - Xu Hong
- Department of Nephrology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Li Zhiping
- Department of Clinical Pharmacy, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
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A whole blood microsampling assay for vancomycin: development, validation and application for pediatric clinical study. Bioanalysis 2020; 12:1295-1310. [PMID: 32945688 DOI: 10.4155/bio-2020-0112] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Background: Vancomycin is a commonly used antibiotic, which requires therapeutic drug monitoring to ensure optimal treatment. Microsampling assays are attractive tools for pediatric clinical research and therapeutic drug monitoring. Results: A LC-MS/MS method for the quantification of vancomycin in human whole blood employing volumetric absorptive microsampling (VAMS®) devices (20 μl) was developed and validated. Vancomycin was stable in human whole blood VAMS under assay conditions. Stability for vancomycin was established for at least 160 days as dried microsamples at -78°C. Conclusion: This method is currently being utilized for the quantitation of vancomycin in whole blood VAMS for an ongoing pediatric clinical study and representative clinical data are reported.
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Swiner DJ, Jackson S, Burris BJ, Badu-Tawiah AK. Applications of Mass Spectrometry for Clinical Diagnostics: The Influence of Turnaround Time. Anal Chem 2020; 92:183-202. [PMID: 31671262 PMCID: PMC7896279 DOI: 10.1021/acs.analchem.9b04901] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
This critical review discusses how the need for reduced clinical turnaround times has influenced chemical instrumentation. We focus on the development of modern mass spectrometry (MS) and its application in clinical diagnosis. With increased functionality that takes advantage of novel front-end modifications and computational capabilities, MS can now be used for non-traditional clinical analyses, including applications in clinical microbiology for bacteria differentiation and in surgical operation rooms. We summarize here recent developments in the field that have enabled such capabilities, which include miniaturization for point-of-care testing, direct complex mixture analysis via ambient ionization, chemical imaging and profiling, and systems integration.
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Affiliation(s)
- Devin J. Swiner
- Department of Chemistry and Biochemistry, The Ohio State University, Columbus, Ohio 43210
| | - Sierra Jackson
- Department of Chemistry and Biochemistry, The Ohio State University, Columbus, Ohio 43210
| | - Benjamin J. Burris
- Department of Chemistry and Biochemistry, The Ohio State University, Columbus, Ohio 43210
| | - Abraham K. Badu-Tawiah
- Department of Chemistry and Biochemistry, The Ohio State University, Columbus, Ohio 43210
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