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Your Baby

Fish Oil During Pregnancy May Reduce Baby’s Asthma Risk

2:00

A Danish study’s results suggests pregnant women that take a fish oil supplement during the final 3 months of pregnancy may reduce their baby’s risk of developing asthma or persistent wheezing.

The study involved 736 pregnant women, in their third trimester. Half the women took a placebo containing olive oil and the other group was given 2.4 grams of fish oil. The women took the supplements until one week after birth.

Among children whose mothers took fish-oil capsules, 16.9 percent had asthma by age 3, compared with 23.7 percent whose mothers were given placebos. The difference, nearly 7 percentage points, translates to a risk reduction of about 31 percent.

In the study, the researchers noted that they are not ready to recommend that pregnant women routinely take fish oil. Although the results of the study were positive, several experts have noted that more research needs to be done before higher doses of fish oil supplements are recommended over eating more fish.

Researchers found no adverse effects in the mothers or babies, the doses were high, 2.4 grams per day is 15 to 20 times what most Americans consume from foods.

One in five young children are affected by asthma and wheezing disorders. In recent decades, the rate has more than doubled in Western countries. Previous research has shown that those conditions are more prevalent among babies whose mothers have low levels of fish oil in their bodies. The new large-scale test, reported in The New England Journal of Medicine, is the first to see if supplements can actually lower the risk.

Before doctors can make any recommendations, the study should be replicated, and fish oil should be tested earlier in pregnancy and at different doses, Dr. Hans Bisgaard, the leading author of the study, said in an email to the New York Times. He is a professor of pediatrics at the University of Copenhagen and the head of research at the Copenhagen Prospective Studies on Asthma in Childhood, an independent research unit.

Dr. Bisgaard said it was not possible to tell from the study whether pregnant women could benefit from simply eating more fish. Pregnant women are generally advised to limit their consumption of certain types of fish like swordfish and tuna because they contain mercury. But many other types are considered safe, especially smaller fish like sardines that are not at the top of the food chain and therefore not likely to accumulate mercury and other contaminants from eating other fish.

“It is possible that a lower dose would have sufficed," the Bisgaard team said.

The supplements didn't seem to affect the odds of a baby or toddler developing the skin condition eczema, or an allergy such as a reaction to milk or egg products, or a severe asthma attack.

An editorial in the same journal by an expert who was not part of the study praised the research, saying it was well designed and carefully performed. The author of that editorial, Dr. Christopher E. Ramsden, from the National Institutes of Health, said the findings would help doctors develop a “precision medicine” approach in which fish-oil treatment could be tailored to women who are most likely to benefit.

If the findings are confirmed in other populations, doctors could test to see who would mostly likely benefit from fish oil supplements. "The health care system is currently not geared for such," Bisgaard said. "But clearly this would be the future."

If you are considering taking fish oil supplements during pregnancy, be sure and check with your OB/GYN for a recommended dose.

All fish oils are not the same. Some brands of fish oil are of higher quality than others. A reputable fish oil manufacturer should be able to provide documentation of third-party lab results that show the purity levels of their fish oil, down to the particles per trillion level. Also, if the supplements smell or taste fishy, they shouldn’t. High quality fish oil supplements don’t. Avoid fish oils that have really strong or artificial flavors added to them because they are most likely trying to hide the fishy flavor of rancid oil.

Story sources: Denise Grady, http://www.nytimes.com/2016/12/28/health/fish-oil-asthma-pregnancy.html?WT.mc_id=SmartBriefs-Newsletter&WT.mc_ev=click&ad-keywords=smartbriefsnl

Gene Emery, http://www.reuters.com/article/us-health-asthma-fish-oil-idUSKBN14H1T3

http://americanpregnancy.org/pregnancy-health/omega-3-fish-oil/

 

Daily Dose

No Screen Time for a Week!

Kids are spending over 7 hours a day in front a screen: TV, watching video, playing games event texting. How much is too much?So, how much screen time does your child have?  You know what I mean, TV time, computer time, playing video games, using a cell phone (including texting). The list goes on and on!

The average American child spends 7 hours a day involved with some type of media, which is more than any other activity besides SLEEP! With that being said, this is National Turn Off Week!  My colleagues at the American Academy of Pediatrics are supporting an effort to encourage parents to implement a “screen free week” in their home. If the average child spends over 1000 hours a year involved in some type of media but only 900 hours a year in school it seems obvious that we are doing something wrong. The solution is to start limiting screen time beginning at the earliest ages. With so many parents believing that Baby Einstein videos will make their infant smarter (there is no proof), and parents who are teaching their children to use a computer or I-phone or I-pad by the age of two, early guidelines regarding time spend “on screen” are exceedingly important. The AAP endorses a “no TV for children under the age of two” rule and limiting TV/media time to 2 hours per day for children and teens.  Unfortunately, many parents may know that their children are home, but are not clear about what they are doing while at home, which often involves screen time in the “privacy” of their own rooms. I ask every patient and or parent about media time and if there is a TV or computer in the child’s room. I am continually amazed at how often the answer is yes, even for the elementary school set. Parents often view putting a TV in their child’s room as a “right of passage” despite the fact that there are really good studies to show that having a TV in a child’s room contributes to poor sleep habits which may impact children in many negative ways. I must say, there isn’t a teenager that I take care of that is “happy” that we are discussing media time, but just like other subjects that need to be addressed during a pediatric visit, this one may be more important than previously thought. For all of this interactive screen time may actually be becoming new “peer group” for a child, rather than having face to face time with their peers. So by turning off the “screens” and spending some time enjoying one another, a new normal could be started.  Families cooking together after the homework is finished, or going outside for a family walk or quick game, or reading together, or even playing board games, the list seems endless.  What a treat to get back 2, 3 or even 4 hours a day with your child.  Think about the  benefits that come from decreasing screen time, which include better academics, better sleep, less depression and anxiety and even an impact on obesity. I know it is challenging for all of us, but this is a “do-able” task for a week. While all of the screen are in the “OFF” mode, talk about new guidelines for when the screens go back on.  In this case the adage “less is more” seems appropriate. That's your daily dsoe for today.  We'll chat again tomorrow. Send your question or comment to  Dr. Sue!

Your Child

Young Girls Less Likely to See Women as “Really, Really Smart”

2:00

One of the surprise box office hits this year is “Hidden Figures.” It’s based on the true story of a team of female African-American mathematicians at NASA in the late 50s and early 60s that helped launch the first U.S. astronaut into space. The women were brilliant but faced enormous challenges for acceptance because of their race and gender.

According to a new study, you might could say that there are millions of "hidden figures" in who young girls and boys’ perceive as someone who is “really, really smart.”

Researchers wanted to try and figure out why women are underrepresented in the science, technology, engineering and mathematics, or STEM, fields. While most women make the decision to pursue these courses in high school or college, the scientists found that children develop a stereotype of which gender is naturally smarter early in life.

The study involved 400 children, aged 5 to 7 and included a story told by Lin Bian, a co-author and psychologist at the University of Illinois.

“There are lots of people at the place where I work, but there is one person who is really special. This person is really, really smart,” said Bian. “This person figures out how to do things quickly and comes up with answers much faster and better than anyone else. This person is really, really smart.”

She then showed them pictures of four adults—two men and two women—and asked them to guess which was the protagonist of the story. She also gave them two further tests: one in which they had to guess which adult in a pair was “really, really smart”, and another where they had to match attributes like “smart” or “nice” to pictures of unfamiliar men and women.

The results were revealing.  The 5 year-old boys and girls associated the “smart” person with their own gender. But among those aged 6 or 7, only the boys still held to that view. At an age when girls tend to outperform boys at school, and when children in general show large positive biases towards their own in-groups, the girls became less likely than boys to attribute brilliance to their own gender.

As the boys continued to believe in their own intelligence, the girls – on average – tended to see everyone on more equal terms.

Bian also found that the older girls were less interested in games that were meant for “really, really smart” children.

The stereotype that brilliance and genius are male traits is common among adults. In various surveys, men rate their intelligence more favorably than women, and in a recent study of biology undergraduates, men overrated the abilities of male students above equally talented and outspoken women.

Bian’s study suggests that the seeds of this bias are planted at a very early age. Even by the age of 6, boys and girls are already diverging in who they think is smart.

The findings could help illuminate the challenge schools face in combating gender stereotypes, even though girls often outperform boys in school. Girls drop out of high school at a lower rate than boys. Women are more likely than men to enroll in college, and they earn more college degrees each year than men.

Other games were played and social tests were given during the study with similar results. The 5 year-olds were equally interested in participating, but the 6 and 7 year-old girls were less interested in the ones that relied on “being smart.” Both genders were attracted to the games requiring persistence and hard work.

In today’s business and scientific world, more educators, policymakers and corporations are making an effort to include women in leadership roles, but breaking through the stereotypes developed at such a young age can hinder girls and women in those and other disciplines.

Children model what they see. If they are raised in an environment that diminishes young girls’ achievements but rewards young boys for the same achievements, it often sets up a life-long struggle for them to feel and accept their own self-value. 

Teachers also play an important role in encouraging all children to reach their highest achievement level.

Young girls, as well as young boys, should be recognized for their intelligence and encouraged to pursue science, technology, engineering and math studies – the rest of the world will benefit.

The research can't explain how these messages are getting to kids or how they could be changed, says Andrei Cimpian, a professor of psychology at New York University and an author of the study, He is planning a long-term study of young children that would measure environmental factors, including media exposure and parental beliefs. That would give a better idea of what factors predict the emergence of stereotypes, and what levers are available to change attitudes.

The study was published in the journal Science.

Story sources:  Ed Yong, https://www.theatlantic.com/science/archive/2017/01/six-year-old-girls-already-have-gendered-beliefs-about-intelligence/514340/

Katherine Hobson, http://www.npr.org/sections/health-shots/2017/01/26/511801423/young-girls-are-less-apt-to-think-women-are-really-really-smart

Nick Anderson, https://www.washingtonpost.com/news/grade-point/wp/2017/01/26/research-shows-young-girls-are-less-likely-to-think-of-women-as-really-really-smart/?utm_term=.fc30e9030500&wpisrc=nl_sb_smartbrief

 

Your Teen

Young Male Athletes, Parental Pressure and Doping

1:45

When 129 young male athletes, whose average age was 17, were asked what would make them consider “doping” as a way to boost their athletic ability – the majority said parental pressure.

A new study from the University of Kent in England asked the young male athletes about their attitudes on "doping" -- the use of prohibited drugs, such as steroids, hormones or stimulants, to increase athletic competence.

These substances, sometimes called performance-enhancing drugs, can potentially alter the human body and biological functions. However, they can be extremely harmful to a person's health, experts warn.

The study group was also asked about four different aspects of perfectionism. The areas were: parental pressure; self-striving for perfection; concerns about making mistakes; and pressure from coaches.

Only parental pressure was linked to positive feelings about doping among the athletes, the study authors found. Although the study was small, it did point out how important demanding expectations from parents can be to kids. 

Lead author of the study, Daniel Madigan, a Ph.D. student in the university's School of Sport and Exercise Sciences, said the findings suggest that parents need to recognize the consequences of putting too much pressure on young athletes in the family.

"The problem of pressure from parents watching their children play sports is widely known, with referees and sporting bodies highlighting the difficulties and taking steps to prevent it," Madigan said in a university news release.

"With the rise of so-called 'tiger' parenting-- where strict and demanding parents push their children to high levels of achievement -- this study reveals the price young athletes may choose to pay to meet their parents' expectations and dreams," Madigan added.

The researchers only focused on young men for this study but plan to investigate if the same result will occur with young female athletes, and if there are differences between athletes in team versus individual sports.

The study findings are scheduled for publication in the April print issue of the Journal of Sports Sciences.

Story source: Robert Preidt, http://teens.webmd.com/news/20160229/young-athletes-pressured-by-parents-may-resort-to-doping

 

Your Baby

Study: Preemies Do Well in School

1:45

Parents of premature babies often worry how their child will do academically later in life. A new study may ease their minds.

Researchers followed more than 1.3 million premature babies born in Florida and found that two-thirds of those born at only 23 or 24 weeks were ready for kindergarten on time, and almost 2 percent of those infants later achieved gifted status in school.

Though extremely premature babies often scored low on standardized tests, preterm infants born 25 weeks or later performed only slightly lower than full-term infants. For babies born after 28 weeks, the differences in test scores were negligible.

"We know a lot about the medical and clinical outcomes [of premature babies] and we know some about short-term educational outcomes, but what we didn't know is how the babies do once they get further out into elementary school and middle school," the study's first author Dr. Craig Garfield, associate professor of pediatrics and of medical social sciences at Northwestern University Feinberg School of Medicine, told CBS News.

The babies were born in Florida from 1992 to 2002 with gestational ages of 23 to 41 weeks who later entered Florida public schools between 1995 and 2012. The scope of the study included a diverse group of children with varied backgrounds and economic status.

The study did not include additional research possibly connected to the children’s development such as medical issues related to premature birth, or information about factors that may have helped these children perform well in school, such as their biological makeup or if they got extra support from family or school programs.

"This is a really large group of children," Garfield said. "A lot of studies are done in a select group, but the population in this study is really all the babies that were born and lived up to one year in Florida and we were able to follow them through the education system to eighth grade."

Senior author David Figlio, director of the Institute for Policy Research at Northwestern University, acknowledges concerns that very premature infants (those born between 22 and 24 weeks of pregnancy) tend to score well below their full-term peers on standardized tests. However, he said he believes "the glass is more than half-full."

"Most infants born at 23 to 24 weeks still demonstrate a high degree of cognitive functioning at the start of kindergarten and throughout school," he said in a statement.

The study is good news for parents already consumed with uncertainty about the future of their premature infant – something they need during a very difficult time.

Story source: Ashley Welch, http://www.cbsnews.com/news/premature-babies-preemies-catch-up-in-school-study/

Your Teen

Teens: Fatal Car Crashes Down

2:00

It seems like there are far too many studies reporting bad outcomes where teens are involved; too much drinking, eating, smoking and risky behaviors.

However, a recent study concludes that fatal car crashes involving teens have dropped by over half in the last decade. Researchers believe one reason may be that more teenagers are receiving driving licenses attached with restrictions.

"Many factors are probably at play, but there is wide agreement the graduated licensing programs are an important contributor to the decline in fatal crashes," lead study author Ruth Shults, an injury prevention researcher at the U.S. Centers for Disease Control and Prevention in Atlanta, said in an to email to Reuters Health.

Graduated licenses may limit teens from diving at night as well as restrict how many teenage passengers can ride in a car with a teen driver.

Shults says that may be partly responsible for reducing the overall crash rate by 20 to 40 percent.

According to the Centers for Disease Control and Prevention (CDC), the number of drivers aged 16 to 19 involved in fatal crashes fell by 55 percent to 2,568 in 2013, down from 5,724 in 2004, supported by an increase in graduated licenses programs.

The numbers may also be down because some teenagers are waiting till they are 18 to get their driving license, said Eric Teoh, a senior statistician at the Insurance Institute for Highway Safety in Arlington, Virginia.

"An 18-year-old novice is probably more prepared maturity-wise than a 16-year-old novice," said Teoh, who wasn't involved in the study.

Many parents have changed what they look for in a car for their teenager. Newer models have better safety features - such as electronic stability to help keep the car in line if the driver loses control. That one feature alone may also be a contributing factor in fewer crashes.

Across 42 states included in the survey, the proportion of high school students who drive ranged from about 53 percent to about 90 percent, with the highest rates in the mid-western and mountain states, where population density is low. West coast states including California, Washington and Oregon were among eight excluded from the study.

In cities, fewer students drove, which may be related to family income, shorter travel distances and wider use of public transportation or alternatives such as walking or bicycling.

Nationwide in 2013, about three in four high school students 16 and older reported driving in the past month; the proportion was lower among black and Hispanic teens compared to white youth.

The economy may have also played a role in the reduction of teen drivers. Less dispensable money may have forced teens to look for alternative means such as public transportation, bicycles or walking.

"The economic downturn resulted in changes in the way people drive, with people taking fewer elective trips," said Raymond Bingham, a professor at the University of Michigan's Transportation Research Institute in Ann Arbor, who wasn't involved in the study.

Leisure trips, as opposed to driving to work or school, are associated with more crashes, Bingham said.

Whatever the reasons, it’s good to know that more of our teenage drivers are living to grow into adulthood and making it pass the turbulent adolescent years.

Source: Lisa Rapaport, http://www.reuters.com/article/2015/04/08/us-health-teens-drivers-crashes-idUSKBN0MZ21020150408

Your Child

Childhood Mental Health Problems Linked to Adult Troubles

2:00

 

Children who suffer from poor mental health may also have a lower chance of success later in life, according to a new study from researchers at Duke University.

The scientists found that children with mental health problems such as depression, anxiety and/or behavioral problems were six times more likely than those with no psychiatric problems to have difficulties in adulthood.

Those later struggles included addiction, early pregnancy, criminal charges, and difficulty getting and keeping jobs, education failures and housing instability, the study authors said.

Researchers analyzed data from more than 1,400 participants in 11 North Carolina counties who were followed from childhood through adulthood. Most of the study participants are now in their 30s.

While still in childhood, about 26 percent of the participants met the criteria for depression, anxiety or a behavioral disorder, 31 percent had milder forms below the full threshold of a diagnosis, and nearly 43 percent had no mental health problems.

Researchers followed up with the participants as adults.

Among those diagnosed with a psychiatric disorder in childhood, more than 59 percent had a serious challenge in adulthood and about 34 percent had numerous problems. The rates among those with milder forms of mental illness were about 42 percent and 23 percent, respectively.

"When it comes to key psychiatric problems -- depression, anxiety, behavior disorders -- there are successful interventions and prevention programs," study author William Copeland, an assistant clinical professor of psychiatry and behavioral sciences, said in a Duke news release.

"So, we do have the tools to address these, but they aren't implemented widely. The burden is then later seen in adulthood, when these problems become costly public health and social issues," he added.

The findings show the need to treat mental health problems early. But, only about 40 percent of children with diagnosed psychiatric disorders receive treatment, and the rate is even lower for those with milder mental health problems, according to Copeland.

"A big problem with mental health in the United States is that most children don't get treatment and those who do don't get what we would consider optimal care," he said. "So the problems go on much longer than they need to and cost much more than they should in both money and damaged lives."

Parents and family members are typically the first to notice if a child seems to have problems with emotions or behavior, but may not know when they should seek professional help for a child.  The following signs may indicate the need for professional help:

•       Decline in school performance

•       Poor grades despite strong efforts

•       Constant worry or anxiety

•       Repeated refusal to go to school or to take part in normal activities

•       Hyperactivity or fidgeting

•       Persistent nightmares

•       Persistent disobedience or aggression

•       Frequent temper tantrums

•       Depression, sadness or irritability

Getting children help when they are young can change the course of their lives. If you suspect your child may need a mental health evaluation, talk with your pediatrician or family doctor about available resources.

While the study found an association between poor mental health in childhood and problems later in life, it did not prove a cause-and-effect link. However, even children with mild or passing episodes of psychiatric problems were found to be at an increase risk for struggles later in life.

The study was published in the July 15th issue of the journal JAMA Psychiatry.

Sources: Robert Preidt, http://consumer.healthday.com/kids-health-information-23/kids-ailments-health-news-434/mental-health-problems-in-childhood-linked-to-greater-chances-of-trouble-in-adulthood-701298.html

http://www.mentalhealthamerica.net/recognizing-mental-health-problems-children

Your Child

Trying to Guilt Kids into Exercising Doesn’t Work

1:45

 

Experts often discuss how kids aren't getting the proper amount of exercise they need to be healthy. But, trying to guilt children into exercising often results in the opposite desired effect according to a new study.

Researchers from the University of Georgia found that middle school students were less likely to be physically active if they didn't feel in control of their exercise choices or if they felt pressured by adults to get more exercise.

Kids who felt that whether they exercised or not was their own choice were much more likely to choose to exercise, the researchers said.

"Can we put these children in situations where they come to value and enjoy the act of being physically active?" lead author Rod Dishman, a professor of kinesiology, said in a university news release.

Dishman and his colleagues said they are looking for ways to help more children identify themselves as someone who likes to exercise.

"Just like there are kids who are drawn to music and art, there are kids who are drawn to physical activity. But what you want is to draw those kids who otherwise might not be drawn to an activity," Dishman said.

So how do you get your child to exercise? Make it about fun, not exercise says Dishman..

“The best thing is to do it because it's fun. It's the kids who say they are intrinsically motivated who are more active than the kids who aren't," Dishman concluded.

Children's activity levels typically fall 50 percent between fifth and sixth grades, the authors noted in the September issue of the journal Medicine & Science in Sports & Exercise.

Using guilt as a motivator seldom achieves the desired result, no matter whether it’s exercising or any other choice. Playing the guilt card with kids only makes them resent what you are trying to get them to do and more often than not, they will do the opposite.

Building a lifetime of healthy choices never began with a guilt trip. Being creative and adding an element of fun and challenge will achieve more than coercion through guilt. 

Children need to identify themselves as someone who wants to exercise instead of someone forced to exercise. The best results have been achieved when families make exercise a part of their daily routine and treat it like anything else they enjoy doing together.

Source: Robert Preidt, http://www.webmd.com/children/news/20150923/want-your-kids-to-exercise-skip-the-guilt

 

Your Baby

Eating Fish During Pregnancy Benefits Baby’s Brain Development

2:00

Can eating more fish during pregnancy help babies’ brains function better as they grow older? Yes, according to a new study from Spain. The researchers say that mothers who eat three substantial servings of fish – each week- during pregnancy may be giving their children an advantage as they mature.

Researchers followed nearly 2,000 mother-child pairs from the first trimester of pregnancy through the child’s fifth birthday and found improved brain function in the kids whose mothers ate the most fish while pregnant, compared to children of mothers who ate the least.

Even when women averaged 600 grams, or 21 ounces, of fish weekly during pregnancy, there was no sign that mercury or other pollutants associated with fish were having a negative effect that offset the apparent benefits.

“Seafood is known to be an important source of essential nutrients for brain development, but at the same time accumulates mercury from the environment, which is known to be neurotoxic,” lead author Jordi Julvez, of the Center for Research in Environmental Epidemiology in Barcelona, said in an email to Reuters Health.

This important health concern prompted the U.S. Food and Drug Administration (FDA) to come up with a guideline for pregnant women in 2014. It encourages women to eat more fish during pregnancy, but limit the intake to no more than 12 ounces per week.

For this study, researchers analyzed data from the Spanish Childhood and Environment Project, a large population study that recruited women in their first trimester of pregnancy, in four provinces of Spain, between 2004 and 2008.

Julvez and colleagues focused on records of the women’s consumption of large fatty fish such as swordfish and albacore tuna, smaller fatty fish such as mackerel, sardines, anchovies or salmon, and lean fish such as hake or sole, as well as shellfish and other seafood.

Women were tested for blood levels of vitamin D and iodine, and cord blood was tested after delivery to measure fetal exposure to mercury and PCB pollutants. At ages 14 months and five years, the children underwent tests of their cognitive abilities and Asperger Syndrome traits to assess their neuropsychological development.

On average, the women had consumed about 500 g, or three servings, of seafood per week while pregnant. But with every additional 10 g per week above that amount, children’s test scores improved, up to about 600 g. The link between higher maternal consumption and better brain development in children was especially apparent when kids were five.

The researchers also saw a consistent reduction in autism-spectrum traits with increased maternal fish consumption.

Mothers’ consumption of lean fish and large fatty fish appeared most strongly tied to children’s scores, and fish intake during the first trimester, compared to later in pregnancy, also had the strongest associations.

“I think that in general people should follow the current recommendations,” Julvez said. “Nevertheless this study pointed out that maybe some of them, particularly the American ones, should be less stringent.”

Julvez noted that there didn’t appear to be any additional benefit when women ate more than 21 ounces (about 595 g) of fish per week.

“I think it's really interesting, and it shed a lot more light on the benefits of eating fish during pregnancy,” said Dr. Ashley Roman, director of Maternal Fetal Medicine at NYU Langone Medical Center in New York.

“I think what's interesting about this study compared to some data previously is that they better quantify the relationship between how much fish is consumed in a diet and then the benefits for the fetus and ultimately the child,” said Roman, who was not involved in the study.

Roman also noted that pregnant women should avoid certain fish such as tilefish, shark, swordfish and giant mackerel. These are larger fish with longer life spans that may accumulate more mercury in their tissue.

While fish may be a great source of protein and benefit brain development in utero, most experts agree that women should consult their obstetrician about what fish are safer to eat and how much they should eat during pregnancy.

The study was published online in the January edition of the American Journal of Epidemiology

Source: Shereen Lehman, http://www.reuters.com/article/us-health-pregnancy-fish-idUSKCN0UW1S4

 

 

 

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