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Dami A, Chicoine D, Payen E, Bouchard M, Belzile EL, Corbeil P, Moisan G. Lower limbs biomechanical deficits associated with stage 1 and 2 posterior tibialis tendon dysfunction during walking. Gait Posture 2024; 110:10-16. [PMID: 38460464 DOI: 10.1016/j.gaitpost.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 03/01/2024] [Accepted: 03/06/2024] [Indexed: 03/11/2024]
Abstract
BACKGROUND Posterior tibialis tendon dysfunction (PTTD) is a chronic degenerative musculoskeletal disorder causing a progressive ankle complex and arch collapse altering lower limb biomechanics. However, biomechanical changes associated with stage 1 and 2 PTTD need to be better characterized during walking to guide clinical recommendations and improve non-operative treatments. RESEARCH QUESTION What are the lower limb kinematic and kinetic differences between individuals with stage 1 (PTTD1), individuals with stage 2 PTTD (PTTD2) and healthy counterparts during gait? METHODS Sixteen PTTD1, 11 PTTD2 and 20 healthy controls were included in this multicentric case-control study to compare their lower limb gait biomechanics. Kinematic and kinetic data were recorded using a three-dimensional motion capture system and a force plate. One-dimensional statistical parametric mapping was used to compare lower limb joint motion and moments between groups during the stance phase. RESULTS PTTD1 had minimal biomechanical differences compared with the control group. In contrast, PTTD2 presented significant differences compared with controls and PTTD1. At the ankle, PTTD2 exhibited greater plantarflexion and eversion angles and midfoot dorsiflexion and inversion angles throughout stance compared with controls and PTTD1. PTTD2 presented lower midfoot abduction moments compared with controls. These changes led PTTD2 to exhibit knee and hip adaptative biomechanical mechanisms in the frontal and transverse planes in late stance. PTTD2 had greater knee internal rotation angles and smaller knee external rotation moments compared to controls. PTTD2 had smaller hip internal rotation angles compared with PTTD1 and smaller hip adduction moments compared with controls. SIGNIFICANCE PTTD1 showed minimal biomechanical differences compared to controls and important differences compared to PTTD2. The lower limb biomechanical deficits accentuate as the pathology advances from stage 1 to stage 2. PTTD is a progressive condition needing early clinical management at stage 1 to avoid successive biomechanical changes associated with stage 2.
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Affiliation(s)
- Ahmed Dami
- Department of Human Kinetics, University du Québec à Trois-Rivières, 3351, Boul. des Forges, Trois-Rivières, QC G8Z 4M3, Canada; Groupe de Recherche sur les Affections Neuromusculosquelettiques (GRAN), 3351, Boul. des Forges, Trois-Rivières, QC G8Z 4M3, Canada.
| | - Dominic Chicoine
- Department of Human Kinetics, University du Québec à Trois-Rivières, 3351, Boul. des Forges, Trois-Rivières, QC G8Z 4M3, Canada
| | - Eléna Payen
- Department of Human Kinetics, University du Québec à Trois-Rivières, 3351, Boul. des Forges, Trois-Rivières, QC G8Z 4M3, Canada; Groupe de Recherche sur les Affections Neuromusculosquelettiques (GRAN), 3351, Boul. des Forges, Trois-Rivières, QC G8Z 4M3, Canada
| | - Marc Bouchard
- CHU de Québec-Université Laval, 11, côte du Palais, Québec, QC G1R 2J6, Canada
| | - Etienne L Belzile
- CHU de Québec-Université Laval, 11, côte du Palais, Québec, QC G1R 2J6, Canada
| | - Phillipe Corbeil
- Department of Kinesiology, University Laval, 2325, rue de l'Université, Québec, QC G1V 0A6, Canada; Centre for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), 525, Boul. Wilfrid-Hamel, Québec, QC G1M 2S8, Canada
| | - Gabriel Moisan
- Department of Human Kinetics, University du Québec à Trois-Rivières, 3351, Boul. des Forges, Trois-Rivières, QC G8Z 4M3, Canada; Groupe de Recherche sur les Affections Neuromusculosquelettiques (GRAN), 3351, Boul. des Forges, Trois-Rivières, QC G8Z 4M3, Canada; Department of Kinesiology, University Laval, 2325, rue de l'Université, Québec, QC G1V 0A6, Canada; Centre for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), 525, Boul. Wilfrid-Hamel, Québec, QC G1M 2S8, Canada
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Kołodziej Ł, Ciechanowicz D, Wójtowicz M, Król M, Szabałowska M, Kwiatkowski S, Szymczak M, Czajka R. Prospective, Long-Term Functional Outcomes of Extra-Osseous Talotarsal Stabilization (EOTTS) Using HyProCure in Adult Patients with Talotarsal Joint Instability: Assessment of Physical Activity and Patient Satisfaction. J Clin Med 2023; 12:4872. [PMID: 37510987 PMCID: PMC10381448 DOI: 10.3390/jcm12144872] [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: 06/18/2023] [Revised: 07/17/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND The partial dislocation of the talus from the calcaneus and navicular bones is a primary factor leading to a prolonged overpronation during weightbearing. This study aimed to assess the possibility of returning to physical activity and long-term patient satisfaction after an extra-osseous talotarsal stabilization (EOTTS) procedure with a HyProCure sinus tarsi implant for partial talotarsal joint dislocation (TTJ). METHODS A total of 41 adult patients (61 feet), with an average age of 46.41, were included and treated surgically with EOTTS as a stand-alone surgery. Physical activity and functional scores were assessed pre- and post-operatively using questionnaires-the UCLA Activity Score, Symptom-Related Ankle Activity Scale (SAAS), Sports Frequency Score (SFS), Lower Extremity Functional Scale (LEFS), and VAS scale. Satisfaction was assessed on a ten-point scale. The follow-up period was on average 8.61 years (from 7.33 to 10.31). RESULTS EOTTS had a positive impact on physical activity, and a high rate of patient satisfaction (8.95 ± 1.9) was noted. The treatment led to a reduction in foot pain, as well as an increase in SAAS and LEFS scores (15,6% and 19,3%, respectively, p <0.01). The VAS pain score decreased by 18,6% (p <0.001). SFS and UCLA scores showed a small increase, but it was not statistically significant. A positive correlation was noted between patient satisfaction and time of physical activity per week (R = 0.33, p =0.04), and also between patient satisfaction and SAAS scores (R = 0.43, p =0.005). Pain from other joints (knee, hip) was eliminated or reduced in 40% of patients after surgery. CONCLUSIONS EOTTS with a HyProCure implant is an effective long-term treatment option for partial talotarsal joint dislocation, leading to a reduction in foot pain and increased patient satisfaction, and allowing for a return to physical activity.
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Affiliation(s)
- Łukasz Kołodziej
- Department of Orthopaedics, Traumatology and Musculoskeletal Oncology, Pomeranian Medical University, 71-281 Szczecin, Poland
| | - Dawid Ciechanowicz
- Department of Orthopaedics, Traumatology and Musculoskeletal Oncology, Pomeranian Medical University, 71-281 Szczecin, Poland
| | - Maria Wójtowicz
- Department of Orthopaedics, Traumatology and Musculoskeletal Oncology, Pomeranian Medical University, 71-281 Szczecin, Poland
| | - Marta Król
- Department of Orthopaedics, Traumatology and Musculoskeletal Oncology, Pomeranian Medical University, 71-281 Szczecin, Poland
| | - Małgorzata Szabałowska
- Department of Orthopaedics, Traumatology and Musculoskeletal Oncology, Pomeranian Medical University, 71-281 Szczecin, Poland
| | | | | | - Radomir Czajka
- Department of Orthopaedics, Traumatology and Musculoskeletal Oncology, Pomeranian Medical University, 71-281 Szczecin, Poland
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Andreo-García MV, Navarro-Flores E, Losa-Iglesias ME, Becerro-de-Bengoa-Vallejo R, Gómez Salgado J, López-López D. Effect of foot health-related quality of life in rural population: A case-control study. J Tissue Viability 2023:S0965-206X(23)00045-1. [PMID: 37127484 DOI: 10.1016/j.jtv.2023.04.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 02/23/2023] [Accepted: 04/20/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND Foot health problems can affect quality of life and general health producing a source of discomfort and pain. Low levels of foot health-related quality of life (HRQoL) are present in patients with foot disabilities, such as hallux valgus, plantar fasciitis, or minor toe deformities. OBJECTIVE The objective was to analyze the foot health status in patients with and without foot problems in a rural population and its relationship with quality of life. MATERIAL AND METHODS A prospective case-control study was developed with a sample of 152 patients, 76 subjects with podiatric pathologies and 76 without, in a rural population. HRQoL was measured through the SF-36 Health Questionnaire in the Spanish version. RESULTS The case group had a mean age of 49.18 ± 14.96 and the control group 44.16 ± 11.79. Regarding the score of the lowest levels of quality of life related to foot problems, the case group compared to the controls showed: for physical function (79.86 ± 26.38 vs. 92.63 ± 11 0.17, p < 0.001); for the physical role (73.68 ± 41.00 vs. 88.48 ± 27.51, p < 0.0022); for body pain (45.81 ± 27.18 vs. 73.68 ± 41.00, p < 0.035); and for general health (60.36 ± 30.58 vs. 68.71 ± 18.52, p < 0.047). The differences between groups were analyzed using the Mann-Whitney U test, which showed statistical significance (P < 0.05). CONCLUSIONS In the rural population, people with foot pathologies present a worse quality of life compared to those who do not present foot pathology, especially for the health domains: physical function, physical role, body pain and health general.
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Affiliation(s)
- María Victoria Andreo-García
- Research, Health and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry, Industrial Campus of Ferrol, Universidade da Coruña, 15403, Ferrol, Spain.
| | - Emmanuel Navarro-Flores
- Department of Nursing, Faculty of Nursing and Podiatry, Frailty Research Organized Group, University of Valencia, Valencia, Spain.
| | | | | | - Juan Gómez Salgado
- Department of Sociology, Social Work and Public Health, Universidad de Huelva, Huelva, Spain; Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil, 092301, Ecuador.
| | - Daniel López-López
- Research, Health and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry, Industrial Campus of Ferrol, Universidade da Coruña, 15403, Ferrol, Spain.
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Khan F, Chevidikunnan MF, Alsobhi MG, Ahmed IAI, Al-Lehidan NS, Rehan M, Alalawi HA, Abduljabbar AH. Diagnostic Accuracy of Various Radiological Measurements in the Evaluation and Differentiation of Flatfoot: A Cross-Sectional Study. Diagnostics (Basel) 2022; 12:diagnostics12102288. [PMID: 36291977 PMCID: PMC9600622 DOI: 10.3390/diagnostics12102288] [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: 09/01/2022] [Revised: 09/12/2022] [Accepted: 09/16/2022] [Indexed: 11/16/2022] Open
Abstract
Arch angle is used to indicate flatfoot, but in some cases, it is not easily defined. The presence of flatfoot deformity remains difficult to diagnose due to a lack of reliable radiographic assessment tools. Although various assessment methods for flatfoot have been proposed, there is insufficient evidence to prove the diagnostic accuracy of the various tools. The main purpose of the study was to determine the best radiographic measures for flatfoot concerning the arch angle. Fifty-two feet radiographs from thirty-two healthy young females were obtained. Five angles and one index were measured using weight-bearing lateral radiographs; including arch angle, calcaneal pitch (CP), talar-first metatarsal angle (TFM), lateral talar angle (LTA), talar inclination angle (TIA) and navicular index (NI). Receiver-operating characteristics were generated to evaluate the flatfoot diagnostic accuracy for all radiographic indicators and Matthews correlation coefficient was calculated to determine the cutoff value for each measure. The strongest correlation was between arch angle and CP angle [r = −0.91, p ≤ 0.0001, 95% confidence interval (CI) (from −0.94 to −0.84)]. Also, significant correlations were found between arch angle and NI [r = 0.62, p ≤ 0.0001, 95% CI (0.42 to 0.76)], and TFM [r = 0.50, p ≤ 0.0001, 95% CI (from 0.266 to 0.68)]. Furthermore, CP (cutoff, 12.40) had the highest accuracy level with value of 100% sensitivity and specificity followed by NI, having 82% sensitivity and 89% specificity for the cutoff value of 9.90. In conclusion, CP angle is inversely correlated with arch angle and considered a significant indicator of flatfoot. Also, the NI is easy to define radiographically and could be used to differentiate flat from normal arched foot among young adults.
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Affiliation(s)
- Fayaz Khan
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah 22252, Saudi Arabia
- Correspondence:
| | - Mohamed Faisal Chevidikunnan
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah 22252, Saudi Arabia
| | - Mashael Ghazi Alsobhi
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah 22252, Saudi Arabia
| | - Israa Anees Ibrahim Ahmed
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah 22252, Saudi Arabia
| | - Nada Saleh Al-Lehidan
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah 22252, Saudi Arabia
| | - Mohd Rehan
- King Fahd Medical Research Center, King Abdulaziz University, Jeddah 22252, Saudi Arabia
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah 22252, Saudi Arabia
| | - Hashim Abdullah Alalawi
- Department of Radiology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah 22252, Saudi Arabia
| | - Ahmed H. Abduljabbar
- Department of Radiology, Faculty of Medicine, King Abdulaziz University Hospital, Jeddah 22252, Saudi Arabia
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Fuller RM, Eble SK, Day J, Cororaton AD, Rajan L, Deland JT, Kumar P, Ellis SJ. Return to Physical Activity Following Flatfoot Reconstruction. Foot Ankle Int 2022; 43:772-782. [PMID: 35259974 DOI: 10.1177/10711007221077098] [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] [Indexed: 02/01/2023]
Abstract
BACKGROUND Progressive collapsing foot deformity (PCFD) is a debilitating condition encompassing several interrelated, progressive deformities requiring a combination of reconstructive procedures. Few studies investigate returns to activity following flatfoot reconstruction, and existing studies only examine 1 or 2 of the numerous procedures employed. This study aims to provide the first generalizable assessment of returns to sports and physical activity following reconstruction surgery in patients with flexible flatfoot deformity. METHODS Patients aged 18-60 years who underwent reconstructive surgery between February 16 and May 19 for symptomatic flexible-stage flatfoot deformity were identified by registry review. Eighty-two of 113 eligible patients (73%) were reached at a mean 2.9 years (range, 2.0-5.4) of follow-up with mean age at surgery of 48.9 years (range, 18-59). Returns to physical activity were evaluated with a sports-specific survey. Clinical outcomes were evaluated with Patient-Reported Outcomes Measurement Information System (PROMIS) scores. RESULTS Patients reported participation in 21 specific sports and activities. One-fourth (25.6%) of patients (21/82) reported increased difficulty with physical activities postoperatively, 15.9% reported equal difficulty, and 58.5% (48/82) reported decreased difficulty. Median return times were 9-12 months for participation and 12-18 months to reach maximum preoperative participation levels. Improvements in Physical Function (P= .001), Pain Interference (P < .001), Pain Intensity (P <.001), and Global Physical Health (P = .004) were associated with increased satisfaction with respect to sports and physical activities. DISCUSSION This study investigated participation in specific sports and physical activities following flatfoot reconstruction. Our findings suggest mixed outcomes, where many patients reported life-changing improvements but many also experienced prolonged pain and difficulty after surgery. Some patients reported increased difficulty or inability to return to their preoperative maximum level of participation, indicating that flatfoot reconstructions can lead to athletic limitations. CONCLUSION Although flatfoot reconstruction can be a powerful tool to increase patients' capacity to engage in physical activity, in our cohort many patients had reduced physical activity outcomes. LEVEL OF EVIDENCE Level IV, retrospective case series.
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Affiliation(s)
| | | | - Jonathan Day
- Department of Orthopaedics, Georgetown University Medical Center, Washington, DC, USA
| | | | - Lavan Rajan
- Hospital for Special Surgery, New York, NY, USA
| | | | - Prashanth Kumar
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
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Navarro-Sánchez A, Luri-Prieto P, Compañ-Rosique A, Navarro-Ortiz R, Berenguer-Soler M, Gil-Guillén VF, Cortés-Castell E, Navarro-Cremades F, Gómez-Pérez L, Pérez-Tomás C, Palazón-Bru A, Montejo AL, Pérez-Jover V. Sexuality, Quality of Life, Anxiety, Depression, and Anger in Patients with Anal Fissure. A Case-Control Study. J Clin Med 2021; 10:jcm10194401. [PMID: 34640419 PMCID: PMC8509279 DOI: 10.3390/jcm10194401] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 08/05/2021] [Accepted: 09/01/2021] [Indexed: 12/17/2022] Open
Abstract
Anal fissures (AFs) are lesions located in the lower anal canal. They can be primary (chronic or acute) or secondary to a basic disease. There is high comorbidity of depression and anxiety in patients with chronic AF, with poorer quality of life (QoL) and sexual function. This is a case–control study carried out in the San Juan Hospital (Alicante, Spain). Sixty-seven participants were included in the study, including 35 cases and 32 controls: 36 males and 31 females. This study aims to investigate the association of presenting AFs with sexuality, quality of life, anxiety, depression, and anger. The instruments used were the Spanish validated versions of the validated original selected questionnaires. These instruments were used to assess health-related quality of life, anxiety, anger, depression, and sexual function. Results show higher values in cases than in controls with statistical significance in anxiety state and trait; anxiety and depression; bodily pain, general health, and vitality; and 10 of the 12 anger factors. Higher values in controls than in cases with statistical significance in sexuality and many of the QoL factors were found. Addressing these issues in AF surgical patients would be beneficial for their clinical assessment and intervention.
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Affiliation(s)
- Antonio Navarro-Sánchez
- Faculty of Psychology, Miguel Hernández University, 03202 Elche, Spain; (A.N.-S.); (M.B.-S.); (V.P.-J.)
| | - Paloma Luri-Prieto
- Department of Surgery, San Juan University Hospital, 03550 San Juan, Spain; (P.L.-P.); (A.C.-R.); (L.G.-P.); (C.P.-T.)
| | - Antonio Compañ-Rosique
- Department of Surgery, San Juan University Hospital, 03550 San Juan, Spain; (P.L.-P.); (A.C.-R.); (L.G.-P.); (C.P.-T.)
- Department of Pathology and Surgery, School of Medicine, Miguel Hernández University, 03550 San Juan, Spain; (V.F.G.-G.); (E.C.-C.); (F.N.-C.); (A.P.-B.)
| | - Ramón Navarro-Ortiz
- Orthopedic Surgery and Traumatology Service, Torrevieja University Hospital, 03186 Torrevieja, Spain;
| | - María Berenguer-Soler
- Faculty of Psychology, Miguel Hernández University, 03202 Elche, Spain; (A.N.-S.); (M.B.-S.); (V.P.-J.)
| | - Vicente F. Gil-Guillén
- Department of Pathology and Surgery, School of Medicine, Miguel Hernández University, 03550 San Juan, Spain; (V.F.G.-G.); (E.C.-C.); (F.N.-C.); (A.P.-B.)
| | - Ernesto Cortés-Castell
- Department of Pathology and Surgery, School of Medicine, Miguel Hernández University, 03550 San Juan, Spain; (V.F.G.-G.); (E.C.-C.); (F.N.-C.); (A.P.-B.)
| | - Felipe Navarro-Cremades
- Department of Pathology and Surgery, School of Medicine, Miguel Hernández University, 03550 San Juan, Spain; (V.F.G.-G.); (E.C.-C.); (F.N.-C.); (A.P.-B.)
| | - Luis Gómez-Pérez
- Department of Surgery, San Juan University Hospital, 03550 San Juan, Spain; (P.L.-P.); (A.C.-R.); (L.G.-P.); (C.P.-T.)
- Department of Pathology and Surgery, School of Medicine, Miguel Hernández University, 03550 San Juan, Spain; (V.F.G.-G.); (E.C.-C.); (F.N.-C.); (A.P.-B.)
| | - Carla Pérez-Tomás
- Department of Surgery, San Juan University Hospital, 03550 San Juan, Spain; (P.L.-P.); (A.C.-R.); (L.G.-P.); (C.P.-T.)
| | - Antonio Palazón-Bru
- Department of Pathology and Surgery, School of Medicine, Miguel Hernández University, 03550 San Juan, Spain; (V.F.G.-G.); (E.C.-C.); (F.N.-C.); (A.P.-B.)
| | - Angel L. Montejo
- Psychiatry Service, Clinical Hospital of the University of Salamanca, 37007 Salamanca, Spain
- Institute of Biomedical Research of Salamanca (IBSAL), Paseo San Vicente SN, 37007 Salamanca, Spain
- Department of Psychiatry, Nursing School, University of Salamanca, Av. Donantes de Sangre SN, 37007 Salamanca, Spain
- Correspondence: ; Tel.: +34-63-9754-620
| | - Virtudes Pérez-Jover
- Faculty of Psychology, Miguel Hernández University, 03202 Elche, Spain; (A.N.-S.); (M.B.-S.); (V.P.-J.)
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