Last data update: May 13, 2024. (Total: 46773 publications since 2009)
Records 1-18 (of 18 Records) |
Query Trace: Schoendorf K[original query] |
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Mapping geographic variation in infant mortality and related black-white disparities in the U.S
Rossen LM , Khan D , Schoendorf KC . Epidemiology 2016 27 (5) 690-6 BACKGROUND: In the U.S., black infants remain more than twice as likely as white infants to die in the first year of life. Prior studies of geographic variation in infant mortality disparities have been limited to large metropolitan areas where stable estimates of infant mortality rates by race can be determined, leaving much of the U.S. unexplored. METHODS: The objective of this analysis was to describe geographic variation in county-level racial disparities in infant mortality rates across the 48 contiguous U.S. states and District of Columbia using national linked birth and infant death period files (2004-2011). We implemented Bayesian shared component models in OpenBUGS, borrowing strength across both spatial units and racial groups. We mapped posterior estimates of mortality rates for black and white infants as well as relative and absolute disparities. RESULTS: Black infants had higher infant mortality rates than white infants in all counties, but there was geographic variation in the magnitude of both relative and absolute disparities. The mean difference between black and white rates was 5.9 per 1,000 (median: 5.8, interquartile range 5.2 to 6.6 per 1,000), while those for black infants were 2.2 times higher than for white infants (median: 2.1, interquartile range 1.9 to 2.3). One quarter of the county-level variation in rates for black infants was shared with white infants. CONCLUSIONS: Examining county-level variation in infant mortality rates among black and white infants and related racial disparities may inform efforts to redress inequities and reduce the burden of infant mortality in the U.S. |
Trends in allergy prevalence among children aged 0-17 years by asthma status, United States, 2001-2013
Akinbami LJ , Simon AE , Schoendorf KC . J Asthma 2015 53 (4) 1-21 OBJECTIVES: Children with asthma and allergies-particularly food and/or multiple allergies--are at risk for adverse asthma outcomes. This analysis describes allergy prevalence trends among US children by asthma status. METHODS: We analyzed 2001-2013 National Health Interview Survey data for children aged 0-17 years. We estimated trends for reported respiratory, food, and skin allergy and the percentage of children with one, two, or all three allergy types by asthma status. We estimated unadjusted trends, and among children with asthma, adjusted associations between demographic characteristics and allergy. RESULTS: Prevalence of any allergy increased by 0.3 percentage points annually among children without asthma but not among children with asthma. However, underlying patterns changed among children with asthma: food and skin allergy prevalence increased as did the percentage with all three allergy types. Among children with asthma, risk was higher among younger and non-Hispanic black children for reported skin allergy, among non-Hispanic white children for reported respiratory allergy, and among nonpoor children for food and respiratory allergies. Prevalence of having one allergy type decreased by 0.50 percentage points annually, while the percent with all three types increased 0.2 percentage points annually. Non-poor and non-Hispanic white children with asthma were more likely to have multiple allergy types. CONCLUSIONS: While overall allergy prevalence among children with asthma remained stable, patterns in reported allergy type and number suggested a greater proportion may be at risk of adverse asthma outcomes associated with allergy: food allergy increased as did the percentage with all three allergy types. |
Location of usual source of care among children and adolescents in the United States, 1997-2013
Simon AE , Rossen LM , Schoendorf KC , Larson K , Olson LM . J Pediatr 2015 167 (6) 1409-14 OBJECTIVES: To examine national trends in the percentage of children whose usual source of care is at a clinic, health center, or hospital outpatient department (hereafter "clinics") and whether trends differ by sociodemographic subpopulations. STUDY DESIGN: Analysis of serial, cross-sectional, nationally representative in-person household surveys, the 1997-2013 National Health Interview Surveys, was conducted to identify children with a usual source of care (n = 190 571), and the percentage receiving that care in a clinic. We used joinpoint regression to identify changes in linear trends, and logistic regression with predictive margins to obtain per-year changes in percentages, both unadjusted and adjusted for sociodemographic factors. Interaction terms in logistic regressions were used to assess whether trends varied by sociodemographic subgroups. RESULTS: Of all children with a usual source of care, the percentage receiving that care in a clinic declined 0.44 percentage points per year (P < .001) from 22.97% in 1997 to 19.31% in 2002. Thereafter, it increased approximately 0.57 percentage points per year (P < .001), reaching 26.1% in 2013. Trends for some sociodemographic subgroups varied from these overall trends. No changes were observed between 2003 and 2013 for non-Hispanic black and Medicaid/State Children's Health Insurance Program insured children. CONCLUSIONS: This study shows that, although the percentage of children with a usual source of care in a clinic declined between 1997 and 2002, it has steadily increased since that time. |
Trends in racial and ethnic disparities in infant mortality rates in the United States, 1989-2006
Rossen LM , Schoendorf KC . Am J Public Health 2014 104 (8) 1549-56 OBJECTIVES: We sought to measure overall disparities in pregnancy outcome, incorporating data from the many race and ethnic groups that compose the US population, to improve understanding of how disparities may have changed over time. METHODS: We used Birth Cohort Linked Birth-Infant Death Data Files from US Vital Statistics from 1989-1990 and 2005-2006 to examine multigroup indices of racial and ethnic disparities in the overall infant mortality rate (IMR), preterm birth rate, and gestational age-specific IMRs. We calculated selected absolute and relative multigroup disparity metrics weighting subgroups equally and by population size. RESULTS: Overall IMR decreased on the absolute scale, but increased on the population-weighted relative scale. Disparities in the preterm birth rate decreased on both the absolute and relative scales, and across equally weighted and population-weighted indices. Disparities in preterm IMR increased on both the absolute and relative scales. CONCLUSIONS: Infant mortality is a common bellwether of general and maternal and child health. Despite significant decreases in disparities in the preterm birth rate, relative disparities in overall and preterm IMRs increased significantly over the past 20 years. |
Trends in racial disparities for asthma outcomes among children 0 to 17 years, 2001-2010
Akinbami LJ , Moorman JE , Simon AE , Schoendorf KC . J Allergy Clin Immunol 2014 134 (3) 547-553 e5 BACKGROUND: Racial disparities in childhood asthma have been a long-standing target for intervention, especially disparities in hospitalization and mortality. OBJECTIVES: Describe trends in racial disparities in asthma outcomes using both traditional population-based rates and at-risk rates (based on the estimated number of children with asthma) to account for prevalence differences between race groups. METHODS: Estimates of asthma prevalence and outcomes (emergency department [ED] visits, hospitalizations, and deaths) were calculated from national data for 2001 to 2010 for black and white children. Trends were calculated using weighted loglinear regression, and changes in racial disparities over time were assessed using Joinpoint. RESULTS: Disparities in asthma prevalence between black and white children increased from 2001 to 2010; at the end of this period, black children were twice as likely as white children to have asthma. Population-based rates showed that disparities in asthma outcomes remained stable (ED visits and hospitalizations) or increased (asthma attack prevalence, deaths). In contrast, analysis with at-risk rates, which account for differences in asthma prevalence, showed that disparities in asthma outcomes remained stable (deaths), decreased (ED visits, hospitalizations), or did not exist (asthma attack prevalence). CONCLUSIONS: Using at-risk rates to assess racial disparities in asthma outcomes accounts for prevalence differences between black and white children, and adds another perspective to the population-based examination of asthma disparities. An at-risk rate analysis shows that among children with asthma, there is no disparity for asthma attack prevalence and that progress has been made in decreasing disparities in asthma ED visit and hospitalization rates. |
Medicaid enrollment gap length and number of Medicaid enrollment periods among US children
Simon AE , Schoendorf KC . Am J Public Health 2014 104 (9) e1-e7 OBJECTIVES: We examined gap length, characteristics associated with gap length, and number of enrollment periods among Medicaid-enrolled children in the United States. METHODS: We linked the 2004 National Health Interview Survey to Medicaid Analytic eXtract files for 1999 through 2008. We examined linkage-eligible children aged 5 to 13 years in the 2004 National Health Interview Survey who disenrolled from Medicaid. We generated Kaplan-Meier curves of time to reenrollment. We used Cox proportional hazards models to assess the effect of sociodemographic variables on time to reenrollment. We compared the percentage of children enrolled 4 or more times across sociodemographic groups. RESULTS: Of children who disenrolled from Medicaid, 35.8%, 47.1%, 63.5%, 70.8%, and 79.1% of children had reenrolled in Medicaid by 6 months, 1, 3, 5, and 10 years, respectively. Children who were younger, poorer, or of minority race/ethnicity or had lower educated parents had shorter gaps in Medicaid and were more likely to have had 4 or more Medicaid enrollment periods. CONCLUSIONS: Nearly half of US children who disenrolled from Medicaid reenrolled within 1 year. Children with traditionally high-risk demographic characteristics had shorter gaps in Medicaid enrollment and were more likely to have more periods of Medicaid enrollment. |
Emergency department visits for mental health conditions among US children, 2001-2011
Simon AE , Schoendorf KC . Clin Pediatr (Phila) 2014 53 (14) 1359-66 We examined mental health-related visits to emergency departments (EDs) among children from 2001 to 2011. We used the National Hospital Ambulatory Medical Care Survey-Emergency Department, 2001-2011 to identify visits of children 6 to 20 years old with a reason-for-visit code or ICD-9-CM diagnosis code reflecting mental health issues. National percentages of total visits, visit counts, and population rates were calculated, overall and by race, age, and sex. Emergency department visits for mental health issues increased from 4.4% of all visits in 2001 to 7.2% in 2011. Counts increased 55 000 visits per year and rates increased from 13.6 visits/1000 population in 2001 to 25.3 visits/1000 in 2011 (P < .01 for all trends). Black children (all ages) had higher visit rates than white children and 13- to 20-year-olds had higher visit rates than children 6 to 12 years old (P < .01 for all comparisons). Differences between groups did not decline over time. |
Individual-level influences on population data
Schoendorf KC . Paediatr Perinat Epidemiol 2014 28 (3) 179-80 Despite advances in the care of extremely preterm infants, the accurate and consistent ascertainment of population-level outcomes, such as mortality, among those infants remains difficult.1 The article by Charafeddine et al. in this issue of Paediatric and Perinatal Epidemiology sheds some light on this phenomenon from a different perspective than usually considered by the journal's audience.2 The authors undertook a survey of Lebanese paediatricians who care for extremely preterm infants, painting a somewhat subjective picture of the physicians' attitudes towards initiating resuscitation of those infants. The physicians' own opinions regarding limits of viability, predicted actions in two possible case settings, and, interestingly, an assessment of the physicians' opinions of parental preferences were ascertained. | The Charafeddine article is not the usual fare for Paediatric and Perinatal Epidemiology. It is a somewhat subjective exploration of hypothetical behaviours, rather than a descriptive analysis, an investigation of exposure-outcome relationships, or an evaluation of methodological techniques, and the findings likely are not generalisable to other populations; given the survey's response rate, they may not even be generalisable to Lebanon. However, despite – and partially because of – those factors, the paper is useful on several levels. |
Trends in caffeine intake among US children and adolescents
Branum AM , Rossen LM , Schoendorf KC . Pediatrics 2014 133 (3) 386-93 BACKGROUND AND OBJECTIVE: Physicians and policy makers are increasingly interested in caffeine intake among children and adolescents in the advent of increasing energy drink sales. However, there have been no recent descriptions of caffeine or energy drink intake in the United States. We aimed to describe trends in caffeine intake over the past decade among US children and adolescents. METHODS: We assessed trends and demographic differences in mean caffeine intake among children and adolescents by using the 24-hour dietary recall data from the 1999-2010 NHANES. In addition, we described the proportion of caffeine consumption attributable to different beverages, including soda, energy drinks, and tea. RESULTS: Approximately 73% of children consumed caffeine on a given day. From 1999 to 2010, there were no significant trends in mean caffeine intake overall; however, caffeine intake decreased among 2- to 11-year-olds (P < .01) and Mexican-American children (P = .003). Soda accounted for the majority of caffeine intake, but this contribution declined from 62% to 38% (P < .001). Coffee accounted for 10% of caffeine intake in 1999-2000 but increased to nearly 24% of intake in 2009-2010 (P < .001). Energy drinks did not exist in 1999-2000 but increased to nearly 6% of caffeine intake in 2009-2010. CONCLUSIONS: Mean caffeine intake has not increased among children and adolescents in recent years. However, coffee and energy drinks represent a greater proportion of caffeine intake as soda intake has declined. These findings provide a baseline for caffeine intake among US children and young adults during a period of increasing energy drink use. |
Preventive asthma medication discontinuation among children enrolled in fee-for-service Medicaid
Capo-Ramos DE , Duran C , Simon AE , Akinbami LJ , Schoendorf KC . J Asthma 2014 51 (6) 618-26 OBJECTIVE: Local-area studies demonstrate that preventive asthma medication discontinuation among Medicaid and Children's-Health-Insurance-Program (CHIP) enrolled children leads to adverse outcomes. We assessed time-to-discontinuation for preventive asthma medication and its risk factors among fee-for-service Medicaid/CHIP child beneficiaries. METHODS: National-Health-Interview-Survey participants (1997-2005) with ≥1 Medicaid- or CHIP-paid claims when 2-17 years-old (n=4262) were linked to Medicaid-Analytic-eXtract claims (1999-2008). Multivariate Cox proportional-hazards models to assess time-to-discontinuation (i.e., failing to refill prescriptions <30 days after previous supplies ran out) included demographic factors and medication regimen (inhaled corticosteroids [ICS], long-acting beta2-agonists, leukotriene modifiers, mast cell stabilizers, and monoclonal antibodies). RESULTS: Sixty-three percent discontinued preventive asthma medications by 90 days after the first prescription. Adolescents and toddlers had slightly higher hazards of discontinuation (adjusted hazard ratios [aHR], 1.13; 95% CI, 1.05-1.23; and 1.12; 1.03-1.21, respectively) versus 5-11 year-olds, as did Hispanics (aHR, 1.24; 1.13-1.35) and non-Hispanic blacks (aHR, 1.17; 1.07-1.28) versus non-Hispanic whites, children in households with one adult and ≥3 children (aHR, 1.17; 1.05-1.30) versus multiple adults and ≤2 children, and children with caregivers' educational-attainment ≤12th grade (aHR, 1.11; 1.02-1.20) versus caregivers with some college. Compared to regimens including both ICS and leukotriene modifiers, discontinuation was greater for those on ICS without leukotriene modifiers or on other preventive asthma medications (aHR, 1.67; 1.56-1.80; and 2.23; 1.78-2.80, respectively). CONCLUSION: More than 60% of children enrolled in fee-for-service Medicaid/CHIP discontinued preventive asthma medications by 90 days. Risk was increased for minorities and children from disadvantaged households. Understanding these factors may inform future pediatric asthma guidelines. |
Diabetes and colorectal cancer screening among men and women in the USA: National Health Interview Survey: 2008, 2010
Miller EA , Tarasenko YN , Parker JD , Schoendorf KC . Cancer Causes Control 2014 25 (5) 553-60 PURPOSE: Adults with diabetes are at increased risk of being diagnosed with and dying from colorectal cancer, but it is unclear whether colorectal cancer screening (CRCS) use is lower in this population. Using the 2008 and 2010 National Health Interview Survey data, we examined whether guideline-concordant CRCS is lower among men and women with self-reported diabetes. METHODS: We calculated the weighted percentage of guideline-concordant CRCS and unadjusted and adjusted prevalence ratios (PR) comparing adults aged 51-75 years with diabetes (n = 6,514) to those without (n = 8,371). We also examined effect modification by age (51-64 and 65-75), race/ethnicity, and number of medical office visits (0-3, ≥4). RESULTS: The unadjusted prevalence of CRCS among men with diabetes was significantly higher than men without (63.3 vs. 58.0 %; PR = 1.09 95 % CI 1.03-1.16). In adjusted models, this relationship was evident among older [adjusted PR (aPR) = 1.13 95 % CI 1.06-1.21] but not younger men (aPR = 0.99 95 % CI 0.91-1.08; p for interaction term ≤0.01). There was no significant association between diabetes and CRCS among women overall (56.6 vs. 57.9 %; PR = 0.98 95 % CI 0.92-1.04) or by age group. Race/ethnicity and the number of medical visits did not significantly modify the association between diabetes and CRCS for men or women. CONCLUSIONS: Men and women with self-reported diabetes were not less likely to be up to date with CRCS than those without diabetes. Older men with diabetes were more likely to be up to date with CRCS than those without diabetes. |
Excess screen time in US children: association with family rules and alternative activities
Gingold JA , Simon AE , Schoendorf KC . Clin Pediatr (Phila) 2014 53 (1) 41-50 We describe the association of screen time in excess of American Academy of Pediatrics recommendations (≤2 h/d) with family television-use policies and regular nonscreen activities among US school-aged children. Data from the 2007 National Survey of Children's Health were used. The sum of minutes spent on television, videos, video games, and recreational computer use was calculated for children 6 to 17 years old. Bivariate and multivariate logistic regression models were used to calculate relative odds of exceeding American Academy of Pediatrics guidelines and of heavy screen use (>4 h/d) for varying family media-use policies and frequency of alternative activities (physical activity and family meals). In all, 49% of school-aged children had screen time >2 h/d and 16% had screen time >4 h/d. Lower frequency of family meals, presence of TV in the bedroom, absence of rules about TV viewing, and less physical activity were associated with both >2 and >4 hours per day of screen time. |
A longitudinal view of child enrollment in medicaid
Simon AE , Driscoll A , Gorina Y , Parker JD , Schoendorf KC . Pediatrics 2013 132 (4) 656-62 BACKGROUND: Although national cross-sectional estimates of the percentage of children enrolled in Medicaid are available, the percentage of children enrolled in Medicaid over longer periods of time is unknown. Also, the percentage and characteristics of children who rely on Medicaid throughout childhood, rather than transiently, are unknown. METHODS: We performed a longitudinal examination of Medicaid coverage among children across a 5-year period. Children 0 to 13 years of age in the 2004 National Health Interview Survey file were linked to Medicaid Analytic eXtract files from 2004 to 2008. The percentage of children enrolled in Medicaid at any time during the 5-year observation period and the number of years during which children were enrolled in Medicaid were calculated. Duration of Medicaid enrollment was compared across sociodemographic characteristics by using chi(2) tests. RESULTS: Forty-one percent of all US children were enrolled in Medicaid at least some time during the 5-year period, compared with a single-year estimate of 32.8% in 2004 alone. Of enrolled children, 51.5% were enrolled during all 5 years. Children with lower parental education, with lower household income, of minority race or ethnicity, and in suboptimal health were more likely to be enrolled in Medicaid during all 5 years. CONCLUSIONS: Longitudinal data reveal higher percentages of children with Medicaid insurance than shown by cross-sectional data. Half of children enrolled in Medicaid are enrolled during at least 5 consecutive years, and these children have higher risk sociodemographic profiles. |
Allostatic load may not be associated with chronic stress in pregnant women, NHANES 1999-2006
Morrison S , Shenassa ED , Mendola P , Wu T , Schoendorf K . Ann Epidemiol 2013 23 (5) 294-7 PURPOSE: Pregnant women are generally excluded from studies that measure allostatic load (AL) because there is concern that the changing levels of AL-related biomarkers during pregnancy do not reflect a woman's true AL. The goal of this study was to determine whether AL can be measured in a meaningful way during pregnancy. METHODS: The National Health and Nutrition Examination Survey (NHANES) is a nationally representative, cross-sectional survey of the U.S. civilian population. AL was based on the distributions of 10 biomarkers in pregnant (n=1138) and nonpregnant (n=4993) women aged 15 to 44 from NHANES (1999-2006). RESULTS: The distribution of each AL-related biomarker differed significantly between pregnant and nonpregnant women (P<.01). Among nonpregnant women, high AL findings were consistent with previous studies (e.g., higher AL in women who are black, are older, and who have lower incomes). However, these associations were not seen in pregnant women. CONCLUSIONS: Our results suggest that the various biomarkers that comprise AL may reflect proximal factors in pregnancy more strongly than they represent exposure to chronic stress over a woman's lifetime. Therefore, our approach to measuring AL may not provide meaningful information about chronic stress in pregnant women without further consideration of pregnancy-related factors. |
Current vision and future directions
Schoendorf KC . Paediatr Perinat Epidemiol 2013 27 (3) 228 I am excited and honoured to join Paediatric and Perinatal Epidemiology's Editorial Board. I will serve as an associate editor focusing on paediatric and child-related research, a counterpoint to Dr. Jennifer Zeitlin's concentration on reproductive and perinatal topics. As introduction to the Paediatric and Perinatal Epidemiology (PPE) readership, our editor-in-chief, Dr. Cande Ananth, requested that I provide a ‘vision statement’ elucidating my thoughts about the journal and its direction. | Unfortunately, I do not see things as clearly and precisely as I once did. At this stage of life, my vision depends upon various combinations of corrective eyewear, with significant interaction by object size, distance and lighting. Depending on the combination of those variables, I can identify small details but miss the full picture, or can recognise the outlines of large objects without perceiving the particulars. (I'm also exceptionally bad at identifying items in the refrigerator, but that seems a common Y-chromosome trait). However, this inconsistent perception is not a liability. Differing perspectives enhance appreciation of Monet's water lilies and Picasso's Ladies of Avignon; they also generally enrich insight and understanding of the full picture regardless of medium. |
Measuring health disparities: trends in racial-ethnic and socioeconomic disparities in obesity among 2- to 18-year old youth in the United States, 2001-2010
Rossen LM , Schoendorf KC . Ann Epidemiol 2012 22 (10) 698-704 PURPOSE: Although eliminating health disparities by race, ethnicity, and socioeconomic status (SES) is a top public health priority internationally and in the United States, weight-related racial/ethnic and SES disparities persist among adults and children in the United States. Few studies have examined how these disparities have changed over time; these studies are limited by the reliance on rate differences or ratios to measure disparities. We sought to advance existing research by using a set of disparity metrics on both the absolute and relative scales to examine trends in childhood obesity disparities over time. METHODS: Data from 7066 children, ages 2 to 18 years, in the National Health and Nutrition Examination Surveys were used to explore trends in racial/ethnic and SES disparities in pediatric obesity from 2001 to 2010 using a set of different disparity metrics. RESULTS: Racial/ethnic and SES-related disparities in pediatric obesity did not change significantly from 2001 to 2010 and remain significant. CONCLUSIONS: Disparities in obesity have not improved during the past decade. The use of different disparity metrics may lead to different conclusions with respect to how disparities have changed over time, highlighting the need to evaluate disparities using a variety of metrics. |
Electronic fetal heart rate monitoring and its relationship to neonatal and infant mortality in the United States
Klebanoff MA , Branum AM , Schoendorf KC , Lynch CD . Am J Obstet Gynecol 2012 206 (1) e18-9 The Journal recently published an article suggesting a causal association between electronic fetal monitoring (EFM) and decreased infant mortality.1 We have strong reservations regarding the ability of that paper to offer guidance regarding the effectiveness of EFM because it is inappropriate to use vital statistics data to make the leap from statistical association to causation. | Several years ago, two of us contributed to a set of American Journal of Obstetrics and Gynecology commentaries discussing the reasonable use of secondary vital statistics data.2, 3 Those commentaries raised important issues and limitations that should be considered, acknowledged, and addressed. |
Trends in US sex ratio by plurality, gestational age and race/ethnicity
Branum AM , Parker JD , Schoendorf KC . Hum Reprod 2009 24 (11) 2936-44 BACKGROUND: The sex ratio in the USA has declined over recent decades, resulting in fewer male births. Concurrent changes in the childbearing population may have influenced the sex ratio, including increases in multiple births, improvements in perinatal survival and increased Hispanic births. METHODS: Data from the US natality files (1981-2006) were analyzed to determine the impact of changes in birth characteristics on male birth proportion. Male birth proportion was calculated as the number of male births divided by the total number. In separate analyses, trends in male birth proportion from 1981 to 2006 were adjusted for plurality (singleton, multiple), gestational age (<28, 28-32, 33-36, ≥37 weeks) and, from 1989, maternal Hispanic ethnicity. Separate analyses were conducted for white and black births. Log binomial regression was performed to estimate crude and adjusted trends with year as independent variable. RESULTS: Trends in male birth proportion differed significantly according to plurality among white (P < 0.01), but not black births. Adjustment for gestational age tempered the trends among white singletons (P < 0.0001) and multiples (P < 0.05) but had no effect on trends in black male birth proportion. Adjustment for Hispanic ethnicity had no impact on trends in black male birth proportion and any effect on white births was negated by changes in gestational age trends. CONCLUSIONS: Lack of consistent influences on, or patterns of change in, the proportion of male births between different subpopulations of births suggests that a single mechanism is unlikely to explain the oft-referenced decrease in the overall US sex ratio. |
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