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1681篇 您的检索式:作者名="ROBERT M C"
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1最新AD研究用诊断标准:IWG-2标准显示文摘在过去的8年中,国际工作组织(IWG)和美国国立老化研究院-阿尔茨海默协会(NIA-AA)建立了阿尔茨海默病(AD)诊断标准,它能更好地定义AD的临床表型,整合了生物标记物于诊断流程中,并覆盖了疾病的全程。本意见书充分地权衡了IWG标准的优缺点,建议改进诊断框架。依据这些改进,AD的诊断变得简单,只要有恰当的AD临床表型(典型或不典型)和与AD的病理相一致的病理生理学生物标志物出现。我们认为疾病的下游的定位性生物标志,如容积性磁共振成像(MRI)和氟脱氧葡萄糖-正电子发射型计算机断层成像(FDG-PET)等,适合更好地测量和监测疾病过程。本文还详述了非典型性AD、混合性AD和AD临床前期的特异诊断标准。陈刚 曹雯炜 俞羚 糜建华 Dubois B Feldman HH Jacova C Hampel H Molinuevo JL Blennow K DeK osky ST Gauthier S Selkoe D Bateman R Cappa S Crutch S Engelborghs S Frisoni GB Fox NC Galasko D Habert MO Jicha GA Nordberg A Pasquier F Rabinovici G Robert P Rowe C Salloway S Sarazin M Epelbaum S de Souza LC Vellas B Visser PJ Schneider L Stern Y Scheltens P Cummings JL 2014神经病学与神经康复学杂志2014,11,3:31
2Validation of the Rockall scoring system for outcomes from non-variceal upper gastrointestinal bleeding in a Canadian setting显示文摘AIM: To validate the Rockall scoring system for predicting outcomes of rebleeding, and the need for a surgical procedure and death. METHODS: We used data extracted from the Registry of Upper Gastrointestinal Bleeding and Endoscopy including information of 1869 patients with non-variceal upper gastrointestinal bleeding treated in Canadian hospitals. Risk scores were calculated and used to classify patients based on outcomes. For each outcome, we used χ2 goodness-of-fit tests to assess the degree of calibration, and built receiver operating characteristic curves and calculated the area under the curve (AUC) to evaluate the discriminative ability of the scoring system. RESULTS: For rebleeding, the χ2 goodness-of-fit test indicated an acceptable fit for the model [χ2 (8) = 12.83, P = 0.12]. For surgical procedures [χ2 (8) = 5.3, P = 0.73] and death [χ2 (8) = 3.78, P = 0.88], the tests showed solid correspondence between observed proportions and predicted probabilities. The AUC was 0.59 (95% CI: 0.55-0.62) for the outcome of rebleeding and 0.60 (95% CI: 0.54-0.67) for surgical procedures, representing apoor discriminative ability of the scoring system. For the outcome of death, the AUC was 0.73 (95% CI: 0.69-0.78), indicating an acceptable discriminative ability. CONCLUSION: The Rockall scoring system provides an acceptable tool to predict death, but performs poorly for endpoints of rebleeding and surgical procedures.Robert A Enns Yves M Gagnon Alan N Barkun David Armstrong Jamie C Gregor Richard N Fedorak RUGBE Investigators Group 2006World Journal of Gastroenterology2006,12,48:14
3Cyclooxygenase-2 and epithelial growth factor receptor up-regulation during progression of Barrett's esophagus to adenocarcinoma显示文摘瞄准:在整个 Barretts 食管的前进调查 cyclooxygenase-2 (COX-2 ) 和上皮的生长因素受体(EGFR ) 的表示() 。方法:COX-2 和 EGFR 蛋白质表情被使用免疫检测组织化学的方法。详细 cytomorphological 改变的 A 是坚定的。COX-2 和 EGFR 表示的区域被使用计算机成像系统确定。结果:COX-2 和 EGFR 的表情与前进一起增加了从到食管腺癌(EAC ) 。积极关联在 COX-2 表示和 EGFR 表示之间被发现。结论:COX-2 和 EGFR 可能在逐步的前进从是合作的到 EAC,从而导致致癌作用。Yan Li John M Wo Mukunda B Ray Whitney Jones Ruifeng R Su Susan Ellis Robert C G Martin 2006World Journal of Gastroenterology2006,12,6:14
4Diffusion-weighted magnetic resonance imaging to predict response of hepatocellular carcinoma to chemoembolization显示文摘AIM: To investigate whether intra-procedural diffusion- weighted magnetic resonance imaging can predict response of hepatocellular carcinoma (HCC) during trans- catheter arterial chemoembolization (TACE). METHODS: Sixteen patients (15 male), aged 59 ±11 years (range: 42-81 years) underwent a total of 21 separate treatments for unresectable HCC in a hybrid magnetic resonance/interventional radiology suite. Ana- tomical imaging and diffusion-weighted imaging (b = 0, 500 s/mm2) were performed on a 1.5-T unit. Tumor enhancement and apparent diffusion coefficient (ADC, mm2/s) values were assessed immediately before and at 1 and 3 mo after TACE. We calculated the percent change (PC) in ADC values at all time points. We compared follow-up ADC values to baseline values using a paired t test (α = 0.05). RESULTS: The intra-procedural sensitivity, specificity, and positive and negative predictive values (%) for detecting a complete or partial 1-mo tumor response using ADC PC thresholds of ±5%, ±10%, and ±15% were 77, 67, 91, and 40; 54, 67, 88, and 25; and 46, 100, 100, and 30, respectively. There was no clear predictive value for the 3-mo follow-up. Compared to baseline, the immediate post-procedure and 1-mo mean ADC values both increased; the latter obtaining statistical significance (1.48 ± 0.29 mm2/s vs 1.65 ± 0.35 × 10-3 mm2/s, P < 0.014). CONCLUSION: Intra-procedural ADC changes of > 15% predicted 1-mo anatomical HCC response with the greatest accuracy, and can provide valuable feedback at the time of TACE.Johnathan C Chung Neel K Naik Robert J Lewandowski Mary F Mulcahy Laura M Kulik Kent T Sato Robert K Ryu Riad Salem Andrew C Larson Reed A Omary 2010World Journal of Gastroenterology2010,16,25:13
5Modern imaging techniques for preoperative detection of distant metastases in gastric cancer显示文摘A substantial portion of patients with newly diagnosed gastric cancer has distant metastases(M1 disease).These patients have a very poor prognosis and it is generally accepted that they should be treated with noncurative intent. Because it dramatically changes prognosis and treatment plans, it is very important to diagnose distant metastases. In this article, the definition, pathways, incidence and sites of distant metastases in gastric cancer are described.Subsequently, the current performance of imaging in detecting distant metastases in newly diagnosed gastric cancer is outlined and future prospects are discussed.Robert M Kwee Thomas C Kwee 2015World Journal of Gastroenterology2015,21,37:12
6Gastroenteropancreatic neuroendocrine tumours显示文摘Irvin M Modlin Kjell Oberg Daniel C Chung Robert T Jensen Wouter W de Herder Rajesh V Thakker Martyn Caplin Gianfranco Delle Fave Greg A Kaltsas Eric P Krenning Steven F Moss Ola Nilsson Guido Rindi Ramon Salazar Philippe Ruszniewski Anders Sundin 2008Lancet Oncology2008,,1:8
7Efficacy and safety of tenofovir in chronic hepatitis B: Australian real world experience显示文摘AIM To evaluate the long-term treatment outcomes of tenofovir therapy in patients in a real world Australian tertiary care setting.METHODS We performed a retrospective analysis of treatment outcomes among treatment-na?ve and treatment-experienced patients receiving a minimum 3 mo tenofovir therapy through St Vincent's Hospital Melbourne, Australia. We included patients receiving tenofovir [tenofovir disoproxil fumarate(TDF)] monotherapy, as well as patients treated with TDF in combination with a second antiviral agent. Patients were excluded if they demonstrated human immune-deficiency virus/hepatitis C virus/hepatitis delta virus coinfection or were less than 18 years of age. We considered virological and biochemicalresponse, as well as safety outcomes. Virological response was determined by measurement of hepatitis B virus(HBV) DNA using sensitive assays; biochemical response was determined via serum liver function tests; histological response was determined from liver biopsy and fibroscan; safety analysis focused on glomerular renal function and bone mineral density. The primary efficacy endpoint was complete virological suppression over time, defined by HBV DNA < 20 IU/m L. Secondary efficacy endpoints included rates of biochemical response, and HB e antigen(HBe Ag)/HB surface antigen loss and seroconversion over time.RESULTS Ninety-two patients were identified who fulfilled the enrolment criteria. Median follow-up was 26 mo(range 3-114). Mean age was 46(24-78) years, 64(70%) were male and 77(84%) were of Asian origin. 55(60%) patients were treatment-na?ve and 62 patients(67%) were HBe Ag-negative. Complete virological suppression was achieved by 45/65(71%) patients at 12 mo, 37/46(80%) at 24 mo and 25/28(89%) at 36 mo. Partial virological response(HBV DNA 20-2000 IU/m L) was achieved by 89/92(96.7%) of patients. Multivariate analysis showed a significant relationship between virological suppression at end of follow-up and baseline HBV DNA level(OR = 0.897, 95%CI: 0.833-0.967, P = 0.0046) and HBe Ag positive status(OR = 0.373, 95%CI: 0.183-0.762, P = 0.0069). There was no difference in response comparing treatment-na?ve and treatment-experienced patients. Three episodes of virological breakthrough occurred in the setting of noncompliance. Tenofovir therapy was well tolerated.CONCLUSION Tenofovir is an efficacious, safe and well-tolerated treatment in an Australian real-world tertiary care setting. Our data are similar to the reported experience from registration trials.Grace C Lovett Tin Nguyen David M Iser Jacinta A Holmes Robert Chen Barbara Demediuk Gideon Shaw Sally J Bell Paul V Desmond Alexander J Thompson 2017World Journal of Hepatology2017,9,1:7
8Clinical outcomes following salvage Gamma Knife radiosurgery for recurrent glioblastoma显示文摘Glioblastoma multiforme(GBM) is the most common malignant primary brain tumor with a survival prognosis of 14-16 mo for the highest functioning patients. Despite aggressive, multimodal upfront therapies, the majority of GBMs will recur in approximately six months. Salvage therapy options for recurrent GBM(r GBM) are an area of intense research. This study compares recent survival and quality of life outcomes following Gamma Knife radiosurgery(GKRS) salvage therapy. Following a Pub Med search for studies usingGKRS as salvage therapy for malignant gliomas, nine articles from 2005 to July 2013 were identified which evaluated rG BM treatment. In this review, we compare overall survival following diagnosis, overall survival following salvage treatment, progression-free survival, time to recurrence, local tumor control, and adverse radiation effects. This report discusses results for rG BM patient populations alone, not for mixed populations with other tumor histology grades. All nine studies reported median overall survival rates(from diagnosis, range:16.7-33.2 mo; from salvage, range:9-17.9 mo). Three studies identified median progression-free survival(range:4.6-14.9 mo). Two showed median time to recurrence of GBM. Two discussed local tumor control. Six studies reported adverse radiation effects(range:0%-46% of patients). The greatest survival advantages were seen in patients who received GKRS salvage along with other treatments, like resection or bevacizumab, suggesting that appropriately tailored multimodal therapy should be considered with each rG BM patient. However, there needs to be a randomized clinical trial to test GKRS for rG BM before the possibility of selection bias can be dismissed.Erik W Larson Halloran E Peterson Wayne T Lamoreaux Alexander R MacKay Robert K Fairbanks Jason A Call Jonathan D Carlson Benjamin C Ling John J Demakas Barton S Cooke Christopher M Lee 2014World Journal of Clinical Oncology2014,5,2:5
9Controversies in fluid therapy: Type, dose and toxicity显示文摘Fluid therapy is perhaps the most common intervention received by acutely ill hospitalized patients; however, a number of critical questions on the efficacy and safety of the type and dose remain. In this review, recent insights derived from randomized trials in terms of fluid type, dose and toxicity are discussed. We contend that the prescription of fluid therapy is context-specific and that any fluid can be harmful if administered inappropriately. When contrasting ‘‘crystalloid vs colloid'', differences in efficacy are modest but differences in safety are significant. Differences in chloride load and strong ion difference across solutions appear to be clinically important. Phases of fluid therapy in acutely ill patients are recognized, including acute resuscitation, maintaining homeostasis, and recovery phases. Quantitative toxicity(fluid overload) is associated with adverse outcomes and can be mitigated when fluid therapy basedon functional hemodynamic parameters that predict volume responsiveness and minimization of non-essential fluid. Qualitative toxicity(fluid type), in particular for iatrogenic acute kidney injury and metabolic acidosis, remain a concern for synthetic colloids and isotonic saline, respectively. Physiologically balanced crystalloids may be the ‘‘default'' fluid for acutely ill patients and the role for colloids, in particular hydroxyethyl starch, is increasingly unclear. We contend the prescription of fluid therapy is analogous to the prescription of any drug used in critically ill patients.Robert C McDermid Karthik Raghunathan Adam Romanovsky Andrew D Shaw Sean M Bagshaw 2014World Journal of Critical Care Medicine2014,3,1:5
10睾酮缺乏症的诊断和治疗显示文摘近些年来,随着睾酮缺乏症(TD)发病率的上升、新药的不断开发、以及商业推广的深入,睾酮替代疗法(TST)的临床应用显著增多。然而,关于睾酮缺乏症的诊断标准以及TST的应用和监测,仍然不是很明确。此种现象主要源于睾酮的多重作用靶点。在人体内,睾酮参与了很多生理过程的调节,同时睾酮的表达水平也受很多疾病及药物的影响。因此,睾酮缺乏症的临床症状和体征具有多样性和非特异性,也就增加了睾酮缺乏症的诊断难度,尤其在老年人群中。临床上,关于血清睾酮水平的检测也存在争议,不同实验室之间存在一定的差异,因此也很难界定睾酮水平的诊断标准。很多医学专业组织试图制定睾酮缺乏症的诊断指南,但彼此间很难达成统一。另外,临床使用的睾酮制剂也层出不穷,相应的TST治疗方案也像TD的诊断标准一样不断更新和变化。临床上,随着TST的不断推进,专科医师必须不断更新对于TD和HTST的了解和治疗及应用。本文旨在阐述TD的最新概念及其诊断和治疗的新进展。James A McBride Culley C Carson Robert M Coward 2015Asian Journal of Andrology2015,17,2:5
11Model combining pre-transplant tumor biomarkers and tumor size shows more utility in predicting hepatocellular carcinoma recurrence and survival than the BALAD models显示文摘AIM To assess the performance of BALAD, BALAD-2 and their component biomarkers in predicting outcome of hepatocellular carcinoma(HCC) patients after liver transplant.METHODS BALAD score and BALAD-2 class are derived from bilirubin, albumin, alpha-fetoprotein(AFP), Lens culinaris agglutinin-reactive AFP(AFP-L3), and des-gammacarboxyprothrombin(DCP). Pre-transplant AFP, AFP-L3 and DCP were measured in 113 patients transplanted for HCC from 2000 to 2008. Hazard ratios(HR) for recurrence and death were calculated. Univariate and multivariate regression analyses were conducted. C-statistics were used to compare biomarker-based to predictive models. RESULTS During a median follow-up of 12.2 years, 38 patients recurred and 87 died. The HRs for recurrence in patients with elevated AFP, AFP-L3, and DCP defined by BALAD cut-off values were 2.42(1.18-5.00), 1.86(0.98-3.52), and 2.83(1.42-5.61), respectively. For BALAD, the HRs for recurrence and death per unit increased score were 1.48(1.15-1.91) and 1.59(1.28-1.97). For BALAD-2, the HRs for recurrence and death per unit increased class were 1.45(1.06-1.98) and 1.38(1.09-1.76). For recurrence prediction, the combination of three biomarkers had the highest c-statistic of 0.66 vs. 0.64, 0.61, 0.53, and 0.53 for BALAD, BALAD-2, Milan, and UCSF, respectively. Similarly, for death prediction, the combination of three biomarkers had the highest c-statistic of 0.66 vs 0.65,0.61, 0.52, and 0.50 for BALAD, BALAD-2, Milan, and UCSF. A new model combining biomarkers with tumor size at the time of transplant(S-LAD) demonstrated the highest predictive capability with c-statistics of 0.71 and 0.69 for recurrence and death. CONCLUSION BALAD and BALAD-2 are valid in transplant HCC patients, but less predictive than the three biomarkers in combination or the three biomarkers in combination with maximal tumor diameter(S-LAD).Nicha Wongjarupong Gabriela M Negron-Ocasio Roongruedee Chaiteerakij Benyam D Addissie Essa A Mohamed Kristin C Mara William S Harmsen J Paul Theobald Brian E Peters Joseph G Balsanek Melissa M Ward Nasra H Giama Sudhakar K Venkatesh Denise M Harnois Michael R Charlton Hiroyuki Yamada Alicia Algeciras-Schimnich Melissa R Snyder Terry M Therneau Lewis R Roberts 2018World Journal of Gastroenterology2018,24,12:5
12Recurrent ectopic pancreatitis of the jejunum and mesentery over a 30-year period显示文摘BACKGROUND:Ectopic pancreas is defined as pancreatic tissue found outside its usual anatomical position,with no ductal or vascular communication with the native pancreas. We describe a case of ectopic pancreas of the small bowel and mesentery causing recurrent episodes of pancreatitis, initially suspected on computed tomography(CT)and magnetic resonance cholangiopancreatography(MRCP),and confirmed on histological review of the resection. METHODS:A 67-year-old woman presented with clinical symptoms and biochemical evidence of pancreatitis.She had similar episodes over the past 30 years with unrevealing investigations,and was concluded to have idiopathic pancreatitis. She underwent CT and MRCP,with findings suggestive of ectopic pancreas,a diagnosis confirmed on histology of the resection. RESULTS:MRCP identified a mass in the proximal small bowel mesentery isointense to the native pancreas,with a small duct draining into a proximal jejunal loop.The resected specimen consisted of normal parenchyma with lobulated acinar tissue with scattered islets of Langerhans,an occasional ductular structure,and admixed areas of adipose tissue.The patient remained asymptomatic with normal biochemistry six months post-operatively. CONCLUSION:In an individual with abdominal pain,elevated serum amylase/lipase,but imaging findings of a normal native pancreas,ectopic pancreatitis should be considered,and can be evaluated by CT and MRCP.John CT Wong Charlotte Robinson Edward C Jones Alison Harris Charles Zwirewich Robert Wakefield Richard K Simons Eric M Yoshida 2011Hepatobiliary & Pancreatic Diseases International2011,10,2:4
13Influence of irritable bowel syndrome on treatment outcome in gastroesophageal reflux disease显示文摘AIM: To investigate the influence of irritable bowel syndrome (IBS)-like symptoms on treatment outcomes with pantoprazole in gastroesophageal reflux disease (GERD) in a real life setting. METHODS: For this prospective, open-label, multinational, multicentre study, 1888 patients assessed by the investigators as suffering from GERD were recruited. The patients were additionally classified as with or without IBS-like symptoms at baseline. They were treated with pantoprazole 40 mg once daily and completed the Reflux Questionnaire (ReQuest) short version daily. Response rates and symptom scores were compared after 4 and 8 wk of treatment for subgroups defined by the subclasses of GERD [erosive(ERD) and non-erosive reflux disease (NERD)] and the presence of IBS-like symptoms. RESULTS: IBS-like symptoms were more prevalent in NERD than in ERD (18.3% vs 12.7%, P = 0.0015). Response rates after 4 and/or 8 wk of treatment were lower in patients with IBS-like symptoms than in patients without IBS-like symptoms in both ERD (Week 4: P < 0.0001, Week 8: P < 0.0339) and NERD (Week 8: P = 0.0088). At baseline, ReQuest 'lower abdominal com- plaints' symptom scores were highest in NERD patients with IBS-like symptoms. Additionally, these patients had the strongest symptom improvement after treatment compared with all other subgroups. CONCLUSION: IBS-like symptoms influence treatment outcome and symptom burden in GERD and should be considered in management. Proton pump inhibitors can improve IBS-like symptoms, particularly in NERD.Hubert Mnnikes Robert C Heading Holger Schmitt Hubert Doerfler 2011World Journal of Gastroenterology2011,17,27:4
14Testing for HCV Infection: An Update of Guidance for Clinicians and Laboratorians显示文摘Getchell Jane P Wroblewski Kelly E DeMaria Alfred Bean Christine L Parker Monica M Pandori Mark Dufour D Robert Busch Michael P Brecher Mark E Meyer William A Pesano Rick L Teo Chong-Gee Beckett Geoffrey A Araujo Aufra C Branson Bernard M D 2013MMWR. Morbidity and Mortality Weekly Report2013,,18:3
15Sofosbuvir with pegylated interferon alfa-2a and ribavirin for treatment-naive patients with hepatitis C genotype-1 infection (ATOMIC): an open-label, randomised, multicentre phase 2 trial显示文摘Kris V Kowdley Eric Lawitz Israel Crespo Tarek Hassanein Mitchell N Davis Michael DeMicco David E Bernstein Nezam Afdhal John M Vierling Stuart C Gordon Jane K Anderson Robert H Hyland Hadas Dvory-Sobol Di An Robert G Hindes Efsevia Albanis William T Symo 2013The Lancet2013,,9883:3
16Subepicardial endothelial cells invade the embryonic ventricle wall to form coronary arteries显示文摘冠的动脉把血流动带到心肌肉。理解冠的动脉的发展程序提供卓见进冠的动脉疾病的治疗。多重来源被描述了为包括 proepicardium,湾穴 venosus (SV ) ,和心内膜贡献冠的动脉。然而,冠的容器的发展起源仍然在强烈学习下面。我们为学习冠的开发生产了一个新基因工具,一只 AplnCreER 老鼠在开发冠的容器明确地衬里 recombinase,它表示可诱导的 Cre。冠的开发和 AplnCreER 命运跟踪的预定正式就职的定量分析证明 subepicardial endothelial 房间(EC ) 的子孙两个都入侵紧缩的心肌层形成冠的动脉并且在表面上留下生产静脉。我们发现这些 subepicardial EC 是 intramyocardial 的主要来源在发展中的心的冠的容器。在 vitro 将生物的活组织移植于培养基中培养,试金显示这些 subepicardial EC 的多数从 SV 和中庭的心内膜,然而并非从室的心内膜产生。Apln 积极的房间的同种细胞的分析显示单个 subepicardial EC 同等地作出贡献到冠的动脉和静脉。一起,这些数据建议 subepicardial EC 是 intramyocardial 的主要来源在室的冠的动脉墙,和那冠的动脉和静脉在发展中的心有普通起源。Xueying Tian Tianyuan Hu Hui Zhang Lingjuan He Xiuzhen Huang Qiaozhen Liu Wei Yu Liang He Zhongzhou Yang Zhen Zhang Tao P Zhong Xiao Yang Zhen Yang Yan Yan Antonio Baldini Yunfu Sun Jie Lu Robert J Schwartz Sylvia M Evans Adriana C Gittenberger-de Groot Kristy Red-Horse Bin Zhou 2013Cell Research2013,23,9:3
1714-day triple, 5-day concomitant, and 10-day sequential therapies for Helicobacter pylori infection in seven Latin American sites: a randomised trial显示文摘E Robert Greenberg Garnet L Anderson Douglas R Morgan Javier Torres William D Chey Luis Eduardo Bravo Ricardo L Dominguez Catterina Ferreccio Rolando Herrero Eduardo C Lazcano-Ponce María Mercedes Meza-Montenegro Rodolfo Pe?a Edgar M Pe?a Eduardo Salazar- 2011The Lancet2011,,9790:2
18Degradation Mechanisms of Vertical Cavity Surface Emitting Lasers, Quantum Electronics显示文摘Michael C Y Robert W H Pierre M P 1996IEEE Journal1996,32,:2
19Axitinib treatment in patients with cytokine-refractory metastatic renal-cell cancer: a phase II study显示文摘Olivier Rixe Ronald M Bukowski M Dror Michaelson George Wilding Gary R Hudes Oliver Bolte Robert J Motzer Paul Bycott Katherine F Liau James Freddo Peter C Trask Sinil Kim Brian I Rini 2007Lancet Oncology2007,,:2
20Therapeutic efficiency of everolimus and lapatinib in xenograft model of human colorectal carcinoma with KRAS mutation显示文摘Céline Chu Marie‐Sophie No?l‐Hudson Valérie Boige Diane Goéré Sylvie Marion Mélanie Polrot Ludovic Bigot Patrick Gonin Robert Farinotti Laurence Bonhomme‐Faivre 2013Fundamental & Clinical Pharmacology2013,,4:2
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