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  • 1. Aifa, Sami
    et al.
    Johansen, Knut
    Nilsson, Ulrica K
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Pharmacology.
    Liedberg, Bo
    Linköping University, Department of Physics, Chemistry and Biology, Sensor Science and Molecular Physics . Linköping University, The Institute of Technology.
    Lundström, Ingemar
    Svensson, Samuel
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Pharmacology.
    Interactions between the juxtamembrane domain of the EGFR and calmodulin measured by surface plasmon resonance2002In: Cellular Signalling, ISSN 0898-6568, E-ISSN 1873-3913, Vol. 14, no 12, p. 1005-1013Article in journal (Refereed)
    Abstract [en]

    One early response to epidermal growth factor receptor (EGFR) activation is an increase in intracellular calcium. We have used surface plasmon resonance (SPR) to study real-time interactions between the intracellular juxtamembrane (JM) region of EGFR and calmodulin. The EGFR-JM (Met644-Phe688) was expressed as a GST fusion protein and immobilised on a sensor chip surface. Calmodulin specifically interacts with EGFR-JM in a calcium-dependent manner with a high on and high off rate. Chemical modification of EGFR-JM by using arginine-selective phenylglyoxal or deletion of the basic segment Arg645-Arg657 inhibits the interaction. Phosphorylation of EGFR-JM by protein kinase C (PKC) or glutamate substitution of Thr654 inhibits the interaction, suggesting that PKC phosphorylation electrostatically interferes with calmodulin binding to basic arginine residues. Calmodulin binding was also inhibited by suramin. Our results suggest that EGFR-JM is essential for epidermal growth factor (EGF)-mediated calcium-calmodulin signalling and for signal integration between other signalling pathways.

  • 2.
    Berg, Katarina
    et al.
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Idvall, Ewa
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Nilsson, Ulrica
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Unosson, Mitra
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Postoperativerecovery after different orthopaedic day surgical proceduresManuscript (preprint) (Other academic)
    Abstract [en]

    Orthopaedic day surgery is common. Postoperative recovery may differ according to surgical procedures and personal factors. We studied postoperative recovery up to two weeks after different orthopaedic day surgical procedures, and tried to identify possible predictors associated with recovery. Three-hundred and fifty-eight patients who had undergone knee arthroscopy or surgery on the hand/arm, foot/leg or shoulder were included. Data were collected preoperatively and on postoperative days 1, 7 and 14 using the Swedish Post-discharge Surgery Recovery scale, the emotional state, physical comfort and physical independence dimensions in the Quality of Recovery-23, and a general health question. A multiple linear regression was used to explore predictors of recovery. The shoulder patients experienced significantly lower postoperative recovery and general health one and two weeks after surgery compared to the other patient groups (p<0.001). Significant predictors of recovery were age, perceived health and emotional status on the first postoperative day, and type of surgery. Postoperative recovery after common orthopaedic day surgical procedures differs, and factors influencing it need to be further explored. The impact of a patient’s emotional state on recovery after day surgery can be of particular interest in this work. Post-discharge planning needs to be tailored to the surgical procedure.

  • 3.
    Nilsson, Ulrica
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    The effect of music and music in combination with therapeutic suggestions on postoperative recovery2003Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The aim of this thesis was to test the effect of music with or without therapeutic suggestions performed intra- or postoperatively on patients' postoperative recovery. A total of 422 patients were included in four studies with a mean age of 53 years. Of these patients 75 were included in two studies. The surgical procedures were hysterectomy, hernia repair surgery and varicectomy. The anaesthesia and postoperative analgesia were standardized.

    All patients were allocated random into one of three groups; two intervention groups and one control group. The intervention groups were exposed to; music or music and therapeutic suggestions intraoperatively in one study and postoperatively in another study. In the third and fourth study the role of music intraoperatively versus music postoperatively was evaluated.

    To evaluate the effect on postoperative recovery of these interventions pain, nausea, anxiety, fatigue, sleep, well-being, urinary problems, headache, mobilization, bowel function, hospital stay, blood pressure, oxygen saturation, heart rate, serum-cortisol and blood-glucose and plasma immunoglobulin A were assessed.

    The results showed that patients that were exposed to intraoperative music rated less postoperative pain after 1 and 2 hours at the postoperative care unit (PACU) and the first day after surgery, required less morphine for the first hour at the PACU, were less fatigued at discharge and had an earlier mobilization compared to the control group. Patients exposed to intraoperative music in combination with therapeutic suggestions rated less mean pain intensity for the first 2 hours at the PACU, required less ketobemidone the day of surgery and were less fatigued at discharge compared to the control group. Patients listening to postoperative music rated less postoperative pain after 1 and 2 hours and less mean pain intensity for the first 2 hours after surgery, required less morphine for the first hour at the PACU, rated less postoperative anxiety after 1 hour, had less marked increase in glucose levels and greater reduction in cortisol levels after 2 hours and had an increased oxygen saturation after 1 hour at the PACU compared to the control patients. The patients listening to postoperative music in combination with therapeutic suggestions rated less mean pain for the first 2 hours at the PACU compared to the control group. However, in general the analgesic effects of the interventions were modest and of relatively short duration.

    Music or music in combination with therapeutic suggestions during surgery and postoperative recovery can be used as an adjunct in multimodal regimes to improve patient recovery process. These interventions are simple, inexpensive and non invasive tools that can be applied in intra- and postoperative care.

    List of papers
    1. Improved recovery after music and therapeutic suggestions during general anaesthesia: a double-blind randomised controlled trial
    Open this publication in new window or tab >>Improved recovery after music and therapeutic suggestions during general anaesthesia: a double-blind randomised controlled trial
    Show others...
    2001 (English)In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 45, no 7, p. 812-817Article in journal (Refereed) Published
    Abstract [en]

    Purpose: This study was designed to determine whether music or music in combination with therapeutic suggestions in the intra-operative period under general anaesthesia could improve the recovery of hysterectomy patients.

    Methods: In a double-blind randomised clinical investigation, 90 patients who underwent hysterectomy under general anaesthesia were intra-operatively exposed to music, music in combination with therapeutic suggestion or operation room sounds. The anaesthesia was standardised. Postoperative analgesia was provided by a patient-controlled analgesia (PCA). The pain scores were recorded by means of a visual analogue scale. Nausea, emesis, bowel function, fatigue, well-being and duration of hospital stay were studied as outcome variables.

    Results: On the day of surgery, patients exposed to music in combination with therapeutic suggestions required less rescue analgesic compared with the controls. Patients in the music group experienced more effective analgesia the first day after surgery and could be mobilised earlier after the operation. At discharge from the hospital patients in the music and music combined with therapeutic suggestion group were less fatigued compared to the controls. No differences were noted in nausea, emesis, bowel function, well-being or length of hospital stay between the groups.

    Conclusion: This double-blind study has demonstrated that intra-operative music and music in combination with therapeutic suggestions may have some beneficial effects on postoperative recovery after hysterectomy. Further controlled studies are necessary to confirm our results.

    Keywords
    Fatigue, General anesthesia, Hysterectomy, Intra-operative, Mobilisation, Music, Pain, Therapeutic suggestions, Well-being
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-27053 (URN)10.1034/j.1399-6576.2001.045007812.x (DOI)11699 (Local ID)11699 (Archive number)11699 (OAI)
    Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13
    2. Analgesia following music and therapeutic suggestions in the PACU in ambulatory surgery: a randomized controlled trial
    Open this publication in new window or tab >>Analgesia following music and therapeutic suggestions in the PACU in ambulatory surgery: a randomized controlled trial
    2003 (English)In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 47, no 3, p. 278-283Article in journal (Refereed) Published
    Abstract [en]

    Background: This study was designed to determine whether music (M), or music in combination with therapeutic suggestions (M/TS) could improve the postoperative recovery in the immediate postoperative in daycare surgery.

    Methods: One-hundred and eighty-two unpremedicated patients who underwent varicose vein or open inguinal hernia repair surgery under general anaesthesia were randomly assigned to (a) listening to music (b) music in combination with therapeutic suggestions or (c) blank tape in the immediate postoperative period. The surgical technique, anaesthesia and postoperative analgesia were standardized. Analgesia, the total requirement of morphine, nausea, fatigue, well-being, anxiety, headache, urinary problems, heart rate and oxygen saturation were studied as outcome variables.

    Results: Pain intensity (VAS) was significantly lower (P = 0.002) in the M (2.1), and the M/TS (1.9) group compared with the control group (2.9) and a higher oxygen saturation in M (99.2%) and M/TS (99.2%) group compared with the control (98.0%), P < 0.001, were found. No differences were noted in the other outcome variables.

    Conclusion: This controlled study has demonstrated that music with or without therapeutic suggestions in the early postoperative period has a beneficial effect on patients' experience of analgesia. Although statistically significant, the improvement in analgesia is modest in this group of patients with low overall pain levels.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-27054 (URN)10.1034/j.1399-6576.2003.00064.x (DOI)11700 (Local ID)11700 (Archive number)11700 (OAI)
    Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13
    3. Stress and immune response in patients exposed to intra- or postoperative music: a randomised controlled trial
    Open this publication in new window or tab >>Stress and immune response in patients exposed to intra- or postoperative music: a randomised controlled trial
    (English)Manuscript (preprint) (Other academic)
    Abstract [en]

    This randomised controlled trial was designed to evaluate whether intra- or postoperative music could influence stress and immune response during and after general anaesthesia and also if there was a different response between patients exposed to music intraoperatively or postoperatively. Seventy-five patients undergoing open hernia repair as day care surgery were randomly allocated to three groups: intraoperative music (IM), postoperative music (PM) and silence i.e. control group. The anaesthesia and postoperative analgesia were standardised and the same surgeon performed all the operations. Stress response was assessed during and after surgery by determining the plasma cortisol and blood glucose levels. Immune function was evaluated by studying immuuoglobulin A (IgA) levels. Patients' postoperative pain, anxiety, blood pressure, heart rate and oxygen saturation were also studied as stress markers. The results showed that there were significant differences between the PM group and the control group with regard to more marked decreased levels of cortisol and less marked increased glucose levels after 2 hours in the postanaesthesia care unit (PACU). The PM group also rated less anxiety and the IM and PM group rated less pain after 1 hour in the PACU compared with the control group. There was no difference in IgA, blood pressure, heart rate and oxygen saturation between the groups. This study indicating that postoperative music decreases patients' stress response with regard to s-cortisol, b-glucose and anxiety. Music therapy also has an influence intra- or postoperatively on postoperative pain intensity, but not on immune function as assessed by IgA.

    Keywords
    Music, general anaesthesia, intraoperative, postoperative, cortisol, glucose, IgA, anxiety, pain
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-85128 (URN)
    Available from: 2012-11-06 Created: 2012-11-06 Last updated: 2012-11-06
    4. A comparison of intra-operative or postoperative exposure to music: a controlled trial of the effects on postoperative pain
    Open this publication in new window or tab >>A comparison of intra-operative or postoperative exposure to music: a controlled trial of the effects on postoperative pain
    2003 (English)In: Anaesthesia, ISSN 0003-2409, E-ISSN 1365-2044, Vol. 58, no 7, p. 699-703Article in journal (Refereed) Published
    Abstract [en]

    The effect of intra-operative compared to postoperative music on postoperative pain was evaluated in a controlled trial. In all, 151 patients undergoing day case surgery for inguinal hernia repair or varicose vein surgery under general anaesthesia were randomly allocated to three groups: group 1 listened to music intra-operatively, group 2 listened to music postoperatively and group 3, the control group, listened to ‘white noise’. The anaesthetic and postoperative analgesic techniques were standardised. Pain was assessed using a numeric rating scale (0–10) and patients requirements for postoperative morphine, paracetamol and ibuprofen was recorded. The effect of music on nausea, fatigue and anxiety was also investigated. The results showed that patients exposed to music intra-operatively or postoperatively reported significantly lower pain intensity at 1 and 2 h postoperatively and patients in the postoperative music group required less morphine at 1 h compared to the control group. No differences were noted in the other variables. This study demonstrates that there is a short-term pain-reducing effect of music therapy however, the beneficial effects do not differ if the patient is exposed to music intra-operatively or postoperatively.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-27055 (URN)10.1046/j.1365-2044.2003.03189_4.x (DOI)11701 (Local ID)11701 (Archive number)11701 (OAI)
    Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13
  • 4.
    Nilsson, Ulrica K
    Linköping University, Department of Medicine and Care.
    Improved recovery after therapeutic suggestions and music during general anaesthesia2000In: 6th world congress for nurse anesthetics, Chicago, US,2000, 2000Conference paper (Other academic)
  • 5.
    Nilsson, Ulrica K
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    Music and therapeutic suggestions in anaesthesia2002In: 7th World Congress for Nurse Anasthetists, Helsingfors, Finland,2002, 2002Conference paper (Refereed)
  • 6.
    Nilsson, Ulrica K
    et al.
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Rawal, Narinder
    Department of Clinical Medicine, Division of Anaesthesiology, Örebro University Hospital, Örebro.
    Engqvist, B
    Department of Oro-Maxillary Surgery, Eastman Institute, Stockholm, Sweden.
    Unossoon, Mitra
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Analgesia following music and therapeutic suggestions in the PACU in ambulatory surgery: a randomized controlled trial2003In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 47, no 3, p. 278-283Article in journal (Refereed)
    Abstract [en]

    Background: This study was designed to determine whether music (M), or music in combination with therapeutic suggestions (M/TS) could improve the postoperative recovery in the immediate postoperative in daycare surgery.

    Methods: One-hundred and eighty-two unpremedicated patients who underwent varicose vein or open inguinal hernia repair surgery under general anaesthesia were randomly assigned to (a) listening to music (b) music in combination with therapeutic suggestions or (c) blank tape in the immediate postoperative period. The surgical technique, anaesthesia and postoperative analgesia were standardized. Analgesia, the total requirement of morphine, nausea, fatigue, well-being, anxiety, headache, urinary problems, heart rate and oxygen saturation were studied as outcome variables.

    Results: Pain intensity (VAS) was significantly lower (P = 0.002) in the M (2.1), and the M/TS (1.9) group compared with the control group (2.9) and a higher oxygen saturation in M (99.2%) and M/TS (99.2%) group compared with the control (98.0%), P < 0.001, were found. No differences were noted in the other outcome variables.

    Conclusion: This controlled study has demonstrated that music with or without therapeutic suggestions in the early postoperative period has a beneficial effect on patients' experience of analgesia. Although statistically significant, the improvement in analgesia is modest in this group of patients with low overall pain levels.

  • 7.
    Nilsson, Ulrica K
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    Rawal, Narinder
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Anaesthesiology.
    Enqvist, Björn
    Stockholm.
    Unosson, Mitra
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    Analgesic effect of soothing music wiht or without therapeutic suggestions...2002In: 10th World Congress on Pain, San Diego, USA,2002, 2002Conference paper (Refereed)
  • 8.
    Nilsson, Ulrica K
    et al.
    Department of Anaesthesiology and Intensive Care and Department of Clinical Medicine, Division of Anaesthesiology, Örebro University Hospital, Sweden.
    Rawal, Narinder
    Department of Clinical Medicine, Division of Anaesthesiology, Örebro University Hospital, Sweden.
    Unosson, Mitra
    Department of Anaesthesiology and Intensive Care, Örebro University Hospital, Sweden.
    A comparison of intra-operative or postoperative exposure to music: a controlled trial of the effects on postoperative pain2003In: Anaesthesia, ISSN 0003-2409, E-ISSN 1365-2044, Vol. 58, no 7, p. 699-703Article in journal (Refereed)
    Abstract [en]

    The effect of intra-operative compared to postoperative music on postoperative pain was evaluated in a controlled trial. In all, 151 patients undergoing day case surgery for inguinal hernia repair or varicose vein surgery under general anaesthesia were randomly allocated to three groups: group 1 listened to music intra-operatively, group 2 listened to music postoperatively and group 3, the control group, listened to ‘white noise’. The anaesthetic and postoperative analgesic techniques were standardised. Pain was assessed using a numeric rating scale (0–10) and patients requirements for postoperative morphine, paracetamol and ibuprofen was recorded. The effect of music on nausea, fatigue and anxiety was also investigated. The results showed that patients exposed to music intra-operatively or postoperatively reported significantly lower pain intensity at 1 and 2 h postoperatively and patients in the postoperative music group required less morphine at 1 h compared to the control group. No differences were noted in the other variables. This study demonstrates that there is a short-term pain-reducing effect of music therapy however, the beneficial effects do not differ if the patient is exposed to music intra-operatively or postoperatively.

  • 9.
    Nilsson, Ulrica K
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    Rawal, Narinder
    Örebro.
    Unosson, Mitra
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    Musik och positiva suggestioner peroperativt; en omvårdnadshandling för narkossköterskan.2001In: Nordisk konferens i intesiv- och anestesisjukvård, NOKIAS, Reykjavik, Island,2001, 2001, p. 20-21Conference paper (Refereed)
  • 10.
    Nilsson, Ulrica K
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    Unosson, Mitra
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    Rawal, Narinder
    Örebro.
    Kihlgren, Mona
    Örebro.
    Kvinnors upplevelser av den postoperativa återhämtningen efter hysterektomi: en jämförelse mellan intervention med positiva suggestioner och musik peroperativt.2001In: Hälso och sjukvårdsstämman, Stockholm,2001, 2001Conference paper (Refereed)
  • 11.
    Nilsson, Ulrica K
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    Unosson, Mitra
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    Rawal, Narinder
    Örebro.
    Kihlgren, Mona
    Örebro.
    Women's experience of the postoperative period during hysterectomy: a comparision of intervention with music, therapeutic suggestions, and no intervention under general anaesthesia.2001In: International council of nurses, ICN 22nd quadrennial congress, Köpenhamn,2001, 2001, p. 597-597Conference paper (Refereed)
  • 12.
    Nilsson, Ulrica
    et al.
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Rawal, N
    Department of Anaesthesiology and Intensive Care, Örebro Medical Centre Hospital, Örebro.
    Uneståhl, L
    Scandinavian International University, Örebro.
    Zetterberg, C
    Department of Obstetrics & Gynaecology, Örebro Medical Centre Hospital, Örebro, Sweden.
    Unosson, Mitra
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Improved recovery after music and therapeutic suggestions during general anaesthesia: a double-blind randomised controlled trial2001In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 45, no 7, p. 812-817Article in journal (Refereed)
    Abstract [en]

    Purpose: This study was designed to determine whether music or music in combination with therapeutic suggestions in the intra-operative period under general anaesthesia could improve the recovery of hysterectomy patients.

    Methods: In a double-blind randomised clinical investigation, 90 patients who underwent hysterectomy under general anaesthesia were intra-operatively exposed to music, music in combination with therapeutic suggestion or operation room sounds. The anaesthesia was standardised. Postoperative analgesia was provided by a patient-controlled analgesia (PCA). The pain scores were recorded by means of a visual analogue scale. Nausea, emesis, bowel function, fatigue, well-being and duration of hospital stay were studied as outcome variables.

    Results: On the day of surgery, patients exposed to music in combination with therapeutic suggestions required less rescue analgesic compared with the controls. Patients in the music group experienced more effective analgesia the first day after surgery and could be mobilised earlier after the operation. At discharge from the hospital patients in the music and music combined with therapeutic suggestion group were less fatigued compared to the controls. No differences were noted in nausea, emesis, bowel function, well-being or length of hospital stay between the groups.

    Conclusion: This double-blind study has demonstrated that intra-operative music and music in combination with therapeutic suggestions may have some beneficial effects on postoperative recovery after hysterectomy. Further controlled studies are necessary to confirm our results.

  • 13.
    Nilsson, Ulrica
    et al.
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Unosson, Mitra
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Rawal, Narinder
    Department of Clinical Medicine, Division of Anaesthesiology, Örebro University Hospital, Sweden.
    Stress and immune response in patients exposed to intra- or postoperative music: a randomised controlled trialManuscript (preprint) (Other academic)
    Abstract [en]

    This randomised controlled trial was designed to evaluate whether intra- or postoperative music could influence stress and immune response during and after general anaesthesia and also if there was a different response between patients exposed to music intraoperatively or postoperatively. Seventy-five patients undergoing open hernia repair as day care surgery were randomly allocated to three groups: intraoperative music (IM), postoperative music (PM) and silence i.e. control group. The anaesthesia and postoperative analgesia were standardised and the same surgeon performed all the operations. Stress response was assessed during and after surgery by determining the plasma cortisol and blood glucose levels. Immune function was evaluated by studying immuuoglobulin A (IgA) levels. Patients' postoperative pain, anxiety, blood pressure, heart rate and oxygen saturation were also studied as stress markers. The results showed that there were significant differences between the PM group and the control group with regard to more marked decreased levels of cortisol and less marked increased glucose levels after 2 hours in the postanaesthesia care unit (PACU). The PM group also rated less anxiety and the IM and PM group rated less pain after 1 hour in the PACU compared with the control group. There was no difference in IgA, blood pressure, heart rate and oxygen saturation between the groups. This study indicating that postoperative music decreases patients' stress response with regard to s-cortisol, b-glucose and anxiety. Music therapy also has an influence intra- or postoperatively on postoperative pain intensity, but not on immune function as assessed by IgA.

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