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Injury Surveillance and Training Load Methods Used by Health Professionals in Tennis: An Online Multinational Survey. J Sport Rehabil 2023; 32:235-241. [PMID: 36191905 DOI: 10.1123/jsr.2022-0044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 08/02/2022] [Accepted: 08/22/2022] [Indexed: 11/07/2022]
Abstract
CONTEXT Injury surveillance and training load monitoring are both essential for the development of preventative strategies for gradual-onset musculoskeletal injuries in elite sport. Our aim was to survey health professionals working with elite tennis players on whether and how they monitor injuries and training load. DESIGN A cross-sectional multinational online open-survey. METHODS The survey was developed and advertised in English, Spanish, and Portuguese languages on social media channels, a tennis academic journal, professional tennis associations, and clinical networks of the research team, from December 2020 to April 2021. RESULTS 72 health professionals from 27 different countries working with elite tennis players responded to the survey. Injury surveillance is performed by 94% (68/72) of the survey respondents, with only 10% (7/68) using the consensus-recommended Oslo Sports Trauma Research Center questionnaire. Most common barriers identified by health professionals to injury surveillance are time constraints (66%), lack of knowledge (43%), and technology (31%). Training load monitoring is performed by 50% (36/72) of the health professionals working with elite tennis players. Main metrics monitored are weekly differences in training load (72%) and acute:chronic workload ratio (58%). Most common reasons for training load monitoring are injury prevention (94%), training planning (81%), and player feedback (53%). CONCLUSIONS Despite a high percentage of health professionals implementing injury surveillance metrics, most of them do not use any validated method. Only half of health professionals working with elite tennis players monitor training load. Lack of knowledge and technology were the main barriers reported for adequately monitoring injuries.
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Nordstrøm A, Bahr R, Bache-Mathiesen LK, Clarsen B, Talsnes O. Association of Training and Game Loads to Injury Risk in Junior Male Elite Ice Hockey Players: A Prospective Cohort Study. Orthop J Sports Med 2022; 10:23259671221129646. [PMID: 36338353 PMCID: PMC9629576 DOI: 10.1177/23259671221129646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 07/24/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Training and game loads are potential risk factors of injury in junior elite ice hockey, but the association of training and game loads to injuries is unknown. PURPOSE To investigate the association of chronic training and game loads to injury risk in junior male elite ice hockey players. STUDY DESIGN Cohort study; Level of evidence, 2. METHODS In this prospective cohort study, we monitored all health problems among 159 male junior ice hockey players (mean age, 16 years; range, 15-19 years) at sports-specific high schools during the 2018-2019 school year. Players reported their health problems every week using the Oslo Sports Trauma Research Center Overuse Questionnaire on Health Problems (OSTRC-H2). The number of training sessions and games was reported for 33 weeks. We calculated the previous 2-week difference in training/game loads as well as the cumulative training/game loads of the previous 2, 3, 4, and 6 weeks and explored potential associations between training/game loads and injury risk using mixed-effects logistic regression. RESULTS The players reported 133 acute injuries, 75 overuse injuries, and 162 illnesses in total, and an average of 8.8 (SD ±3.9) training sessions and 0.9 (SD ± 1.1) games per week. We found no association between the difference of the two previous weeks or the previous 2- 3- and 4-week cumulative, training or game load and acute injuries, nor the difference of the two previous weeks, or the previous 4- and 6-week cumulative, training or game load and overuse injuries (OR, ∼1.0; P > .05 in all models). CONCLUSION In the current study of junior elite ice hockey players, there was no evidence of an association between cumulative exposure to training/game loads and injury risk.
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Affiliation(s)
- Anine Nordstrøm
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway.,Sykehuset Innlandet HF, Innlandet Hospital Trust, Elverum, Norway.,Anine Nordstrøm, MD, Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sports Sciences, PB 4014 Ullevål Stadion 0806 Oslo, Norway ()
| | - Roald Bahr
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | - Lena K. Bache-Mathiesen
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | - Ben Clarsen
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway.,Center for Disease Burden Norwegian Institute of Public Health, Bergen, Norway
| | - Ove Talsnes
- Sykehuset Innlandet HF, Innlandet Hospital Trust, Elverum, Norway.,Investigation performed at Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
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Temm DA, Standing RJ, Best R. Training, Wellbeing and Recovery Load Monitoring in Female Youth Athletes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11463. [PMID: 36141735 PMCID: PMC9517577 DOI: 10.3390/ijerph191811463] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/02/2022] [Accepted: 09/09/2022] [Indexed: 06/16/2023]
Abstract
Participation in youth sports is ever-increasing, along with training and competition demands placed upon youth athletes. Young athletes may experience high training loads due to playing several sports, as well as participating in school physical education. Therefore, monitoring youth athlete load is an emerging area of research that may help limit non-functional overreaching, injury, or illness and assist with long-term athlete development. This narrative review highlights that multiple measures have been explored to monitor both internal and external load. However, the validity, reliability and practicality of these measures are often not fully understood in female youth populations. The most commonly used external monitoring methods are GPS tracking and TRIMP whereas common internal monitoring tools are questionnaires, perceived exertion rating and heart rate measures. The reporting of injuries and menstrual cycles is also crucial for providing completeness when monitoring an athlete. It has been suggested that the combination of training load, recovery and wellbeing monitoring variables is the optimal way to monitor an athlete's fatigue levels. Whichever monitoring method is applied, in a youth population it is important that the protocol can be individualised, is inexpensive and can be easily implemented and reported so that the monitoring is sustainable.
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Bache-Mathiesen LK, Andersen TE, Dalen-Lorentsen T, Clarsen B, Fagerland MW. Assessing the cumulative effect of long-term training load on the risk of injury in team sports. BMJ Open Sport Exerc Med 2022; 8:e001342. [PMID: 35722043 PMCID: PMC9152939 DOI: 10.1136/bmjsem-2022-001342] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2022] [Indexed: 11/30/2022] Open
Abstract
Objectives Determine how to assess the cumulative effect of training load on the risk of injury or health problems in team sports. Methods First, we performed a simulation based on a Norwegian Premier League male football dataset (n players=36). Training load was sampled from daily session rating of perceived exertion (sRPE). Different scenarios of the effect of sRPE on injury risk and the effect of relative sRPE on injury risk were simulated. These scenarios assumed that the probability of injury was the result of training load exposures over the previous 4 weeks. We compared seven different methods of modelling training load in their ability to model the simulated relationship. We then used the most accurate method, the distributed lag non-linear model (DLNM), to analyse data from Norwegian youth elite handball players (no. of players=205, no. of health problems=471) to illustrate how assessing the cumulative effect of training load can be done in practice. Results DLNM was the only method that accurately modelled the simulated relationships between training load and injury risk. In the handball example, DLNM could show the cumulative effect of training load and how much training load affected health problem risk depending on the distance in time since the training load exposure. Conclusion DLNM can be used to assess the cumulative effect of training load on injury risk.
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Affiliation(s)
| | - Thor Einar Andersen
- Department of Sports Medicine, Oslo Sports Trauma Research Centre, Norwegian School of Sports Sciences, Oslo, Norway
| | - Torstein Dalen-Lorentsen
- Department of Sports Medicine, Oslo Sports Trauma Research Centre, Norwegian School of Sports Sciences, Oslo, Norway.,Department of Smart Sensors and Microsystems, SINTEF Digital, Oslo, Norway
| | - Benjamin Clarsen
- Department of Sports Medicine, Oslo Sports Trauma Research Centre, Norwegian School of Sports Sciences, Oslo, Norway.,Centre for Disease Burden, Norwegian Institute of Public Health, Bergen, Norway
| | - Morten Wang Fagerland
- Department of Sports Medicine, Oslo Sports Trauma Research Centre, Norwegian School of Sports Sciences, Oslo, Norway.,Research Support Services, Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
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Nordstrøm A, Bahr R, Clarsen B, Talsnes O. Association Between Preseason Fitness Level and Risk of Injury or Illness in Male Elite Ice Hockey Players: A Prospective Cohort Study. Orthop J Sports Med 2022; 10:23259671221076849. [PMID: 35224120 PMCID: PMC8873563 DOI: 10.1177/23259671221076849] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 11/12/2021] [Indexed: 12/03/2022] Open
Abstract
Background: Little is known about the association between physical fitness and the risk of injury or illness in ice hockey. The least-fit players may be more prone to injury and illness. Purpose: To examine the association between preseason fitness level and injury or illness risk among elite ice hockey players during the regular season. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 133 male ice hockey players in the GET League (the premier professional league in Norway) completed 8 different exercises (40-m sprint, countermovement jump, 3000-m run, squat, bench press, chin-ups, brutal bench, and box jump) at the annual 1-day preseason testing combine. During the 2017-2018 competitive season, the players reported all health problems (acute injuries, overuse injuries, and illnesses) weekly (31 weeks) using the Oslo Sports Trauma Research Center Questionnaire on Health Problems. Results: Overall, the players reported 191 acute injuries, 82 overuse injuries, and 132 illnesses. The least-fit tercile of players did not report more health problems (mean, 3.0; 95% CI, 2.2-3.8) compared with the most-fit (mean, 3.4; 95% CI, 2.6-4.2) or the medium-fit (mean, 2.7; 95% CI, 1.9-3.5) players. The most-fit players reported more substantial health problems (mean, 2.0; 95% CI, 1.6-2.5) compared with the medium-fit (mean, 1.3; 95% CI, 0.8 -1.8) and least-fit (mean, 1.8; 95% CI, 1.3-2.3) (P = .02) players. There was no association between low physical fitness and number of health problems when comparing the least-fit tercile of the players with the rest of the cohort (P > .05); however, there was an association between low physical fitness and greater severity of all health problems when comparing the least-fit tercile of players to the rest of the cohort after adjusting for time on ice per game, playing position, and age (P = .02). Conclusion: Low physical fitness was not associated with increased rate of injury or illness but was associated with greater severity of all health problems after adjusting for time on ice per game, playing position, and age.
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Affiliation(s)
- Anine Nordstrøm
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
- Sykehuset Innlandet HF, Innlandet Hospital Trust, Elverum, Norway
| | - Roald Bahr
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | - Ben Clarsen
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
- Center for Disease Burden Norwegian Institute of Public Health, Bergen, Norway
| | - Ove Talsnes
- Sykehuset Innlandet HF, Innlandet Hospital Trust, Elverum, Norway
- University of Oslo, Oslo University Hospital, Oslo, Norway
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Bache-Mathiesen LK, Andersen TE, Clarsen B, Fagerland MW. Handling and reporting missing data in training load and injury risk research. SCI MED FOOTBALL 2021; 6:452-464. [DOI: 10.1080/24733938.2021.1998587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- L. K. Bache-Mathiesen
- Oslo Sports Trauma Research Centre, Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | - Thor Einar Andersen
- Oslo Sports Trauma Research Centre, Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | - Benjamin Clarsen
- Oslo Sports Trauma Research Centre, Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
- Centre for Disease Burden, Norwegian Institute of Public Health, Bergen, Norway
| | - Morten Wang Fagerland
- Oslo Sports Trauma Research Centre, Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
- Oslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway
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Damji F, MacDonald K, Hunt MA, Taunton J, Scott A. Assessing acute:chronic workload ratio methodologies for the prediction of knee pain in men's elite volleyball. TRANSLATIONAL SPORTS MEDICINE 2021. [DOI: 10.1002/tsm2.250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Faraz Damji
- Centre for Hip Health and Mobility Vancouver Coastal Health Research Institute Vancouver BC Canada
- Department of Physical Therapy Faculty of Medicine University of British Columbia Vancouver BC Canada
| | - Kerry MacDonald
- Department of Athletics and Recreation University of British Columbia Vancouver BC Canada
- School of Kinesiology Faculty of Education University of British Columbia Vancouver BC Canada
| | - Michael A. Hunt
- Department of Physical Therapy Faculty of Medicine University of British Columbia Vancouver BC Canada
| | - Jack Taunton
- Department of Family Medicine Faculty of Medicine University of British Columbia Vancouver BC Canada
| | - Alex Scott
- Centre for Hip Health and Mobility Vancouver Coastal Health Research Institute Vancouver BC Canada
- Department of Physical Therapy Faculty of Medicine University of British Columbia Vancouver BC Canada
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Myers NL, Farnsworth II JL, Knudson DV. Different external training workload models show no association with injury in competitive junior tennis players. GERMAN JOURNAL OF EXERCISE AND SPORT RESEARCH 2021. [DOI: 10.1007/s12662-021-00751-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Bache-Mathiesen LK, Andersen TE, Dalen-Lorentsen T, Clarsen B, Fagerland MW. Not straightforward: modelling non-linearity in training load and injury research. BMJ Open Sport Exerc Med 2021; 7:e001119. [PMID: 34422292 PMCID: PMC8351477 DOI: 10.1136/bmjsem-2021-001119] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2021] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES To determine whether the relationship between training load and injury risk is non-linear and investigate ways of handling non-linearity. METHODS We analysed daily training load and injury data from three cohorts: Norwegian elite U-19 football (n=81, 55% male, mean age 17 years (SD 1)), Norwegian Premier League football (n=36, 100% male, mean age 26 years (SD 4)) and elite youth handball (n=205, 36% male, mean age 17 years (SD 1)). The relationship between session rating of perceived exertion (sRPE) and probability of injury was estimated with restricted cubic splines in mixed-effects logistic regression models. Simulations were carried out to compare the ability of seven methods to model non-linear relationships, using visualisations, root-mean-squared error and coverage of prediction intervals as performance metrics. RESULTS No relationships were identified in the football cohorts; however, a J-shaped relationship was found between sRPE and the probability of injury on the same day for elite youth handball players (p<0.001). In the simulations, the only methods capable of non-linear modelling relationships were the quadratic model, fractional polynomials and restricted cubic splines. CONCLUSION The relationship between training load and injury risk should be assumed to be non-linear. Future research should apply appropriate methods to account for non-linearity, such as fractional polynomials or restricted cubic splines. We propose a guide for which method(s) to use in a range of different situations.
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Affiliation(s)
- Lena Kristin Bache-Mathiesen
- Department of Sports Medicine, Oslo Sports Trauma Research Centre, Norwegian School of Sports Sciences, Oslo, Norway
| | - Thor Einar Andersen
- Department of Sports Medicine, Oslo Sports Trauma Research Centre, Norwegian School of Sports Sciences, Oslo, Norway
| | - Torstein Dalen-Lorentsen
- Department of Sports Medicine, Oslo Sports Trauma Research Centre, Norwegian School of Sports Sciences, Oslo, Norway
| | - Benjamin Clarsen
- Department of Sports Medicine, Oslo Sports Trauma Research Centre, Norwegian School of Sports Sciences, Oslo, Norway
- Centre for Disease Burden, Norwegian Institute of Public Health, Bergen, Norway
| | - Morten Wang Fagerland
- Department of Sports Medicine, Oslo Sports Trauma Research Centre, Norwegian School of Sports Sciences, Oslo, Norway
- Research Support Services, Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
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Benson LC, Owoeye OBA, Räisänen AM, Stilling C, Edwards WB, Emery CA. Magnitude, Frequency, and Accumulation: Workload Among Injured and Uninjured Youth Basketball Players. Front Sports Act Living 2021; 3:607205. [PMID: 33889842 PMCID: PMC8056300 DOI: 10.3389/fspor.2021.607205] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 02/11/2021] [Indexed: 01/26/2023] Open
Abstract
Overuse injuries are common in basketball. Wearable technology enables the workload to be monitored in sport settings. However, workload-injury models lack a biological basis both in the metrics recorded and how workload is accumulated. We introduce a new metric for monitoring workload: weighted jump height, where each jump height is weighted to represent the expected effect of the jump magnitude on damage to the tendon. The objectives of this study were to use principal components analysis to identify distinct modes of variation in all workload metrics accumulated over 1, 2, 3, and 4 weeks and to examine differences among the modes of variation in workload metrics between participants before the injury and uninjured participants. Forty-nine youth basketball players participated in their typical basketball practices and games, and lower extremity injuries were classified as patellar or Achilles tendinopathy, other overuse, or acute. An inertial measurement unit recorded the number and height of all jumps, and session rating of perceived exertion was recorded. The previous 1-, 2-, 3-, and 4-week workloads of jump count, jump height, weighted jump height, and session rating of perceived exertion were summed for each participant-week. Principal components analysis explained the variance in the accumulated workload variables. Using the retained principal components, the difference between the workload of injured participants in the week before the injury and the mean workload of uninjured participants was described for patellar or Achilles tendinopathy, overuse lower extremity injury, and any lower extremity injury. Participants with patellar or Achilles tendinopathy and overuse lower extremity injuries had a low workload magnitude for all variables in the 1, 2, 3, and 4 weeks before injury compared with the weeks before no injury. Participants with overuse lower extremity injuries and any lower extremity injury had a high previous 1-week workload for all variables along with a low previous 3- and 4-week jump count, jump height, and weighted jump height before injury compared with the weeks before no injury. Weighted jump height represents the cumulative damage experienced by tissues due to repetitive loads. Injured youth basketball athletes had a low previous 3- and 4-week workloads coupled with a high previous 1-week workload.
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Affiliation(s)
- Lauren C. Benson
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
- United States Olympic and Paralympic Committee, Colorado Springs, CO, United States
| | - Oluwatoyosi B. A. Owoeye
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
- Department of Physical Therapy and Athletic Training, Doisy College of Health Sciences, Saint Louis University, Saint Louis, MO, United States
| | - Anu M. Räisänen
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
- Department of Physical Therapy Education, College of Health Sciences, Western University of Health Sciences, Lebanon, OR, United States
| | - Carlyn Stilling
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - W. Brent Edwards
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB, Canada
| | - Carolyn A. Emery
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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