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News Reports for August 10

by: gardner

Sat Aug 09, 2008 at 23:14:43 PM EDT

Open this diary to read today's news and to see a summary of yesterday's news.
New Stories for Today:
  • Contact With Birds Not Required to Contract Bird Flu Infection
  • Three questions for presidential science debate
  • USA - CO - Health official says new flu virus likely
  • Indonesia - Jakarta - 13 Indonesians test negative for bird flu
  • USA - PA - Pittsburg TV - Flu Bird Horror (sci-fi)
  • UAE - Veratect launches disease early warning system for emerging biological threats
  • Japanese-aided animal disease control project underway in Myanmar
  • USA - FL - Turning a good deal bad
gardner :: News Reports for August 10
Summary of News for August 9, 2008
•   'Sovereignty' That Risks Global Health (on virus samples) (Link)
•   AskMen mag - Avian Influenza 101 (Link)
•   Crofsblogs on the Indonesia outbreak (Link)
•   Indonesia slaughters birds, awaits flu tests (Link)
•   Indonesia clears from bird flu cluster in village (Link)
•   Indonesian villagers test negative for bird flu: health ministry (Link)
•   Department of Health-WHO involved four officials (translated article on investigation in Indonesia) (Link)
•   Indonesia: The patient suspect bird flu began to improve (Link)
•   Summary of AIR BATU situation (Link and Link)
•   Rwanda: Over 60 Health Experts to Discuss Avian Flu (Link)
•   Venezuela: Mystery killer disease may be spread by vampire bats (Link)

Usual disclaimer that I may not have captured everything. Feel free to add news where omissions have occurred. Please note that I copy the links directly from the prior day's news thread so if they don't work you may need to re-visit the thread:
News Reports for August 9

WHO-confirmed total human cases as of June 19, 2008: 385 cases with 243 deaths
2008 WHO-confirmed cases: 34 cases with 26 deaths

Link to most recent WHO report

Thanks to all of the newshounds! Special thanks to the newshound volunteers who translate international stories - thanks for keeping us all informed!
Other useful links:
CDC Weekly Influenza Summary
CDC Morbidity & Mortality Weekly Report
CIDPC (Canada) Weekly FluWatch
European CDC Influenza News
Charts and Graphs on H5N1 from WHO
Wiki Main Page
Tags: , , (All Tags)
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Contact With Birds Not Required to Contract Bird Flu Infection

NaturalNews) The World Health Organization (WHO) has warned that it may be possible to contract the avian flu without coming into direct contact with infected poultry.

In a report published in the New England Journal of Medicine, WHO researchers examined all 350 known cases of infection with the H5N1 strain of influenza, known popularly as "bird flu." Approximately three-quarters of these cases could be attributed to close contact with infected birds, often by poultry workers. A very few cases of human-to-human transmission are suspected, always between family members who came into close contact with each other. But the rest of the cases were more ambiguous.

"In one quarter or more of patients with influenza A (H5N1) virus infection, the source of exposure is unclear, and environment-to-human transmission remains possible," the researchers wrote. Some of the unclear cases occurred in people whose only contact with birds was walking through live poultry markets.

The authors speculated that the virus may remain active in fertilizer made from bird feces, or in certain fluids that stick to surfaces eventually touched by humans. The question has also been raised as to whether the virus needs to enter the nose or can infect humans by merely being eaten.

"It is unknown whether influenza A (H5N1) virus infection can begin in the human gastrointestinal tract," the researchers wrote. "In several patients, diarrheal disease preceded respiratory symptoms, and virus has been detected in feces."

The report confirmed government reassurances that well-cooked food is not a source of the disease, but cautioned that non-potable water might be: "Drinking potable water and eating properly cooked foods are not considered to be risk factors, but ingestion of virus-contaminated products or swimming or bathing in virus-contaminated water might pose a risk."


Comment Very interesting and what we suspected.

 "Natural News" people are not too timely.  They are writing a story now about a NEJM article that appeared more than six months ago, back in January:

Update on Avian Influenza A (H5N1) Virus Infection in Humans

Volume 358:261-273  January 17, 2008  Number 3


[ Parent ]
Oopse missed that. I was a bit busy back in January n/t

[ Parent ]
Three questions for presidential science debate
Sunday, August 10, 2008

Here are three of the 14 science-oriented questions the organizers of Science Debate 2008 want Barack Obama and John McCain to address. For the complete list, see www. sciencedebate2008.com/ www/index.php?id=35


2. Some estimates suggest that if H5N1 avian flu becomes a pandemic, it could kill more than 300 million people. In an era of constant and rapid international travel, what steps should the United States take to protect our population from global pandemics or deliberate biological attacks?


At a "science summit" last summer in Aspen, Colo., Krauss and other attendees talked of ways to heighten the public's awareness of the need for sound science in government policy-making. A small working group brainstormed how to raise the profile of science in the upcoming campaign.

Krauss publicly broached the idea for a science and technology debate in a Wall Street Journal op-ed piece last December. The idea quickly gained traction among bloggers and on Web forums such as Facebook and YouTube.

National support mushroomed and today includes dozens of Nobel laureates; current and former members of Congress; the National Academy of Sciences; university presidents including those at CWRU, Oberlin and Kenyon; organizations such as the Cleveland Clinic and Great Lakes Science Center; and thousands of citizens.

That enthusiasm, however, didn't extend to the presidential candidates. During the primary season, they stuck to subjects intended to appeal to voters in key battleground states - jobs in the rust belt, immigration in the Southwest.

"The sense from the candidates was that [science] wasn't an issue that would move voters," said Krauss, 54, who is leaving CWRU after 15 years to be a professor at Arizona State University.

With time growing short and McCain and Obama already committed to three fall general-topic debates organized by the Commission on Presidential Debates, the science debate's backers have switched to Plan B. They've asked the McCain and Obama camps to prepare written answers to 14 science-oriented questions culled from those solicited from the public.

Spokesmen for both candidates told The Plain Dealer on Friday that McCain and Obama will respond to the questions. McCain didn't rule out participating in an actual debate, while the Obama spokesman said the senator believes it is "vital that we restore the role of objective science in policymaking."

Even if a presidential science debate doesn't happen this year, Krauss said, the idea isn't going away.

"This election was just the first chance," he said. "We want to slowly but surely make this a part of the political process."

there's an index of bloggers
who support the science debates and who were among the first listed. Organized by Chris Mooney, we are listed.

[ Parent ]
USA - CO - Health official says new flu virus likely
In preparing for the upcoming winter flu season, be aware that a worldwide outbreak of a completely new strain of avian flu would require planning for the long haul, said Joe Fowler, the epidemiologist at the San Juan Basin Health Department.

The current scourge, the avian flu known as H5N1, meets only the first two criteria.

"But it's not a matter of if but a matter of when a pandemic will occur," Fowler said. "By keeping informed about pandemic influenza and being aware of likely actions on the part of policymakers, businesses can plan how best to respond."


More from Joe Fowler:
But a pandemic outbreak would be of epic proportions, Fowler said. There would be 25 percent to 35 percent absenteeism in crucial areas such as law enforcement, government and medical services, demand would increase for such services, but there would be no outside help for a crisis that would last at least a year.

"The concern about a pandemic has dropped out of government funding and out of the media," Fowler said. "But it hasn't dropped off the planet. It isn't going away."


[ Parent ]
Indonesia - Jakarta - 13 Indonesians test negative for bird flu

A senior health official says 13 villagers hospitalized with bird flu-like symptoms in western Indonesia have tested negative for the disease.
Nyoman Kandun said the test results came back negative on Saturday and the patients' conditions are improving.
He says dozens of chickens started dying last week from the H5N1 bird flu virus in Air Batu, a village on Sumatra Island, sending panicked residents rushing to a nearby hospital.


Colorado: Health official says new flu virus likely
In preparing for the upcoming winter flu season, be aware that a worldwide outbreak of a completely new strain of avian flu would require planning for the long haul, said Joe Fowler, the epidemiologist at the San Juan Basin Health Department....

..."But it's not a matter of if but a matter of when a pandemic will occur," Fowler said. "By keeping informed about pandemic influenza and being aware of likely actions on the part of policymakers, businesses can plan how best to respond."

Common varieties of flu kill 36,000 people a year in the United States, Fowler said. But a pandemic outbreak would be of epic proportions, Fowler said. There would be 25 percent to 35 percent absenteeism in crucial areas such as law enforcement, government and medical services, demand would increase for such services, but there would be no outside help for a crisis that would last at least a year....


Others estimate up to 40% absenteeism:

"The truth does not change according to our ability to stomach it."  Flannery O'Connor

Great minds think alike ;-) n/t

[ Parent ]
Great minds think for themselves : P
You've got mail!

Pray for all people and rulers
1Timothy 2:1-4

(Extending the culture of life.)


[ Parent ]
Think for youself,
Standing firm,

 Hi. Very good and your are right.

  Now you have mail ;-)


[ Parent ]
just being a little saucy
got it - thanks!

but yeah it really is true.

It is so easy to be carried along in the stream.

Take Care Kobie

Pray for all people and rulers
1Timothy 2:1-4

(Extending the culture of life.)


[ Parent ]
USA - PA - Pittsburg TV - Flu Bird Horror
 Sci fi channel story with nothing to do with H5N1

Flu Bird Horror '08. Townspeople fight for survival when giant birds spread a deadly virus. (R) (2:00) SCI-FI: Sat. 9 P.M., 1 A.M.



UAE - Veratect launches disease early warning system for emerging biological threats
The spread of infectious disease and the threat of terrorism have become acute challenges to a globally connected business world; but recent improvements in early warning and tracking will now enable corporations to not only better defend themselves, but to also find strategic opportunities to grow and become more profitable amidst the disruption, according to the curiously named Scot Land, chief executive of the Veratect Corporation.

A person with a human case of Avian Influenza (H5N1) in Asia, for example, can be in London, Dubai, Moscow, New York or dozens of other major cities in less than 24 hours; the economic impact to global businesses, their insurers or reinsurers and stakeholders can be extraordinarily debilitating," said Land.

Any significant disruption to existing social and business patterns inevitably present both challenges and opportunities. Companies with deep and timely situational awareness about their business are far more likely to not only survive the inevitable disruptions in their industry, but can emerge stronger for it.


Japanese-aided animal disease control project underway in Myanmar
A Japanese-aided animal disease control project targeting two townships in Myanmar's northern Mandalay division is underway, the Livestock Breeding and Veterinary Department (LBVD) said on Sunday.

   With the aid worth of 102 million Japanese yens (about 829,000 U.S. dollars) provided by the Japan International Cooperation Agency (JICA), the three-year project (2008-2010), which covers the townships of Pin Oo Lwin and Amarapura, is aimed at fighting five animal diseases, including* avian influenza*, by setting up laboratories, exchanging information and conducting refresher courses for the diseases control.


USA - FL - Turning a good deal bad
Story - the underbelly of money and EMS that could be any city - not just Ocala in Florida - IMHO

When the Marion County Commission and the Ocala City Council joined forces five years ago and, with the community's two big hospitals, formed the Emergency Medical Services Alliance, it was rare and refreshing to see the two long-feuding governments working together for good of the whole, city and county alike.

So it is disappointing now that EMSA is about to end its five-year run and be folded into the county Fire-Rescue that the City Council is trying to strongarm the county for $1 million cash for what it claims is its share of the ambulance service's assets. Nothing has been sold and nothing has been bought. Yet the city says it is owed $1 million.

That's nonsense. All that has happened is one public entity, the county, has taken over management of the ambulance service from another public entity --- fulfilling a state-mandated responsibility in the process.


things may be a bit more political there, than elsewhere...  the state fire school is in Ocala.

[ Parent ]
WHO Investigation In Sumatra Raises Concerns
Recombinomics Commentary August 10, 2008
The United States consulate general (the USA) in Medan also asked about the situation and the last condition for the Damuli Hut community, the IV Village, the Air Batu Village of 39,Kecamatan Air Batu, this Regency

Experts from the World Health Organisation (WHO) had arrived in the affected village in North Sumatra to help investigate the possible outbreak and the sudden death of three residents last week, a provincial health official said.

The above comments on the outbreak in Medan reflect the level of concern of non-Indonesian agencies with the situation in Medan. As noted, three patients died with bird flu symptoms, and additional patients were hospitalized.  Although these patients are said to have tested negative, poultry in the region is H5N1 positive.

The presence of a WHO team, in the absence of confirmed H5N1 cases, is unusual, and raises concerns that there has been unreported lab evidence of H5N1 in patients in the region.
This region has had a history of confirmed or suspect clusters. The largest confirmed cluster was in Karo over two years ago,  The cluster was linked to clear human to human to human transmission (Snip)

That cluster was followed by a cluster of similar size, but those patients tested negative.  However, negative testing in Indonesia remains highly suspect.  False negatives can be generated by widespread and aggressive Tamiflu use and the suspect sensitivity of the testing in Indonesia.  (Snip) Indonesia also has the highest case fatality rate, over 80%, raising concerns that milder cases are either not tested or test negative.

Indonesia's failure to test H5N1 infected patients in clusters is also cause for concern. Recent confirmed cases have been associated with relatives who die with bird flu symptoms, but these fatalities are said to be lung inflammation, typhus, or dengue fever.

These clusters, representing limited human to human transmissions have been followed by a new policy of delaying reports of cases.  International Health Regulations require notification of WHO 24-48 hours after confirmed cases. (Snip)
The WHO team on the ground, coupled with reporting failures by Indonesia and WHO, continue to raise concerns about the true situation in the Medan region of North Sumatra.

Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown


Daily Kos post on Indonesia
and the WaPo Holbrooke/Garret article, designed to reach a larger audience.


ProMed will no longer post on Indonesian AI
unless it is confirmed by the Indonesian government.

"Until further notice, ProMED-mail will not report suspected human cases of avian influenza in Indonesia until they have been confirmed by the Indonesian Ministry of Health."

Hmmm. What's up with this?

That's a big help . . .
Not.  :(

[ Parent ]
Well, what do ya'll think of that?
Promed mail won't post anymore suspect bird flu cases?!
Just another red flag to add to the others. "It's not what they say, it's what they do." I believe we the public deserve a reason, an explaination. But we'll never get it.

Sometimes folks, the politics gets a little to much for one to stomach!!

And why is it everytime WHO gets involved with suspect bird flu patients, every single one test negative? Sorry but my flustration level has past my anxiety level. ;-)

United we stand: Divided we fall

[ Parent ]
Niman on Pro-med
ProMED Halts Reports Of Suspect H5N1 Cases in Indonesia
Recombinomics Commentary 02:54
August 11, 2008

Until further notice, ProMED-mail will not report suspected human cases of avian influenza in Indonesia until they have been confirmed by the Indonesian Ministry of Health.

The above statement by ProMED is unfortunate.  It is in response to Indonesia's failure to confirm H5N1 in the 13 hospitalized patients in North Sumatra.  Indonesia's track record on confirming H5N1 patients has been poor. In addition to having the largest number of confirmed H5N1 cases and confirmed H5N1 deaths, it also has the highest case fatality rate, raising questions about its ability to detect non-fatal cases of H5N1.
Although Indonesia has failed to recently confirm H5N1 in patients in North Sumatra, H5N1 has been confirmed in poultry and three patients recently died with H5N1 symptoms.  However, these patients were not tested for H5N1, which is still not uncommon in Indonesia.

The number of hospitalized patients continues to rise, and some are being diagnosed with dengue fever.  However, Indonesia's record on diagnosing H5N1 patients as dengue fever cases has also raised concerns, especially when the dengue fever diagnosis is confirmed by the Minister of Health even when the sister of the dengue fever patient tested positive for H5N1.

The presence of a WHO team investigating the three fatal cases is unusual, especially since no H5N1 cases in humans has been reported.

ProMED's reliance on confirmation by the Indonesian Ministry of Health is unfortunate.  The Ministry of Health has yet to issue a report the lab confirmed cases from July, and they have stated that they will report cases on a delayed basis.

ProMED's aiding and abetting of this diminished transparency in Indonesia, the country with the highest number of confirmed H5N1 cases in the world, should not stand.

Dengue? Not so fast.
Dengue Fever Diagnosis In Sumatra Raises Concerns
Recombinomics Commentary 02:11
August 11, 2008
The concerned atmosphere was mixed with panic covered casualties's family from the Asahan Regency, they expected his two children terjangkit bird flu because by chance their area was found by casualties suspect bird flu. "Melihat our child's fever did not descend-descended we concerned was mixed with panic, we suspected our child of being affected by bird flu because in our area was found by bird flu casualties but after being brought by us to this hospital and results were stated positive DBD not flu burung" clear Zuhaina the mother Fitra and Aiman to the reporter.

the Team of the doctor suspected the patient of being suspected of by bird flu having the initials F (7) was attacked by dengue fever dengue fever or DBD. the Content trombosit in the F body was below normal.

We were not sure the dengue fever attack happened from here (Medan), said public relations of RSUP Adam Malik Medan Sinar Ginting, on Sunday (10/8).

The volunteer furthermore was assigned to monitor 5 to 10 families that suffered the sign of bird flu.

The above translation describes the hospitalization of more patients with bird flu symptoms.  These comments suggest multiple members from the same family are being hospitalized, and some reports have piu the number of patients seeking treatment above 70.  The above translation indicates some patients being hospitalized in Medan are being diagnosed with dengue fever.

Fatal dengue fever cases are being reported in other cities in the area, which raises additional concerns.  In the past, H5N1 patients have been misdiagnosed as dengue fever because symptoms are similar, especially for the more serious dengue hemorrhagic fever.  However, the dengue fever diagnosis for a family member of a confirmed H5N1 case raised serious questions about an increased reliance of a dengue fever diagnosis to reduce the number of confirmed H5N1 cases.  This diagnosis was of particular concern because it was repeated by the Director General at the Ministry of Health, Nyoman Kandun, who has also indicated the the dramatic increase in hospitalized patients is due to villager concern over the H5N1 poultry.  However, H5N1 positive poultry is common in Indonesia, where it has been declared endemic.

Recently, WHO has dispatched a team to North Sumatra in the absence of any confirmed H5N1 cases, raising concerns that the public denials of cases is inconsistent with the situation on the ground.  Similarly, Japan agreed to supply an additional 500,000 courses of Tamiflu to southeast Asian countries, raising additional concerns regarding the situation in Indonesia.  The earlier shipment of 500,000 courses of Tamiflu was stored in Singapore, which is adjacent to North Sumatra.

More information on the patients with bird flu symptoms and those being diagnosed with dengue fever would be useful.

This may be it...ya think? I'm feeling pretty nervous about it. n/t

Always have a plan B.

[ Parent ]
It's a pretty terrible feeling

[ Parent ]
MIH, my opinion
is that the only thing that is different about this cluster in Air Batu is that we learned about it.  

My hunch (labeled as such) is that there are any number of cases and clusters which resemble this one that have occurred in Indo since, say, Jan. of '07.  I don't think that this kind of an incident is really out of the norm for their experience now.  

That means two things:

One, that the situation in Indonesia is bad, and is likely much worse than we realize.

Two, that the situation has been very bad for some time, and in several places around Indonesia, and has not yet gone pandemic (Tangerang, Pekanabru, Medan, etc.) - so we can't take this Air Batu as an indication that pandemic liftoff is around the corner.    

It would be nice if the answer were clearer, but it's not.  

This Air Batu cluster came to our attention only because of the leak of a nurse.  It was never meant to come to our attention at all, and probably on an ordinary day would not have.  Our knowing about it doesn't affect the virus or the meaning of the situation itself in the least. Because the world was alerted, suddenly lots and lots of Indonesian officials punched the time clock and showed up.  WHO arrived because word leaked about the cluster and likely the report reaching WHO was that more than one person had tested positive or they wouldn't have put boots on the ground.  

But still, without this cluster having come to the attention of the world media, there would have been three unexplained deaths at Air Batu, chickens would have died and later tested H5N1 positive (a fairly regular event since H5N1 is endemic in the poultry everywhere in Indo), a command post would have (quietly) been set up to distribute Tamiflu, we would have never heard a word from the local hospital about the 11 symptomatic patients (we almost never hear from those small, remote, hospitals), and the two suspect critical cases would have been (quietly) moved to Adam Malik - all without a word to the media. We would have never known.

If you look at the actions of someone like Nyomen Kandun, he's almost phoning it all in at this point (in fact, he text messaged it all in, news reports said).  No alarm, no elaboration in his statements. Why get all ruffled?  

Btw, have you noticed that our gal Supari is MIA and has not said a word?  (a vacation at the Beijing Olympics perhaps?) It's very unlike her not to grab the microphone and the spotlight when there's a chance.  She must be away.

Another tip-off that this Air Batu scenario might be more familiar to them than we have realized is that the officials descended on the village sans bunny suits.  With three deaths, 13 hospitalized, and "dozens" of villagers symptomatic (and 5 to 10 families being treated and "monitored") one would think that the outsiders would have resorted to serious PPE. Yet, there's no indication of that from the photos, and even the caretakers of those hospitalized are wearing only surgical masks with no other protection. That all, to me, bespeaks a level of "ordinariness" that I would not necessarily expect to see in this kind of an event.  But if they see these cases and clusters frequently, and they contain them, why would they act in anything but a pretty casual manner?  

Yes, the attention of the world media got everybody who's an official within a hundred miles of the incident to put their two cents in, but otherwise it seems very much like business as usual.  

As long as the Tamiflu continues to work, these scenarios may pop up and be handled in the same way - whether we (or WHO) know about them or not. The only thing which may differ in next week's or next month's cluster is that the lockdown on the leakers/media may be more intense.  Otherwise, until the Tamiflu wall breaks it will pretty much be business as usual, as I believe it's been since the clusters in Jan. of '07.  So that's bad, and that's good, that's good, and that's bad.  No telling when things will change.  

All this is, once again, imo (for those who like such labels).

[ Parent ]
Thanks !
As a reader who is trying to figure stuff out, it's definitely helpful to learn the thinking of someone who has been following this matter as closely as you have.

[ Parent ]
H to H
Do you have much of a feel for the fraction of the cases that are probably H to H?

[ Parent ]
Shires Told To Develop Pandemic Plans - Victorian Government, Australia
Council seeks help with flu strategy

Posted 2 hours 15 minutes ago

The Towong Shire Council is calling for Victorian Government assistance to develop a plan to cope with an influenza pandemic.

The Department of Human Services has told all Victorian councils to come up with a strategy to manage the impact of an outbreak in their shire.

The Towong council chief executive officer, David Laugher, says the cost of developing the plan will be too great for the relatively small council.

"The amount of work that is required to bring that up to speed is not that far different from a larger council and so it has a retrospective, corresponding ... impact on what it would cost us compared to someone else," he said.

"We have fairly finite resources."


Dengue Fever Facts

There is no specific treatment for dengue.

What are the signs and symptoms of dengue fever and dengue hemorrhagic fever?

Dengue fever usually starts suddenly with a high fever, rash, severe headache, pain behind the eyes, and muscle and joint pain. The severity of the joint pain has given dengue the name "breakbone fever." Nausea, vomiting, and loss of appetite are common. A rash usually appears 3 to 4 days after the start of the fever. The illness can last up to 10 days, but complete recovery can take as long as a month. Older children and adults are usually sicker than young children.

Most dengue infections result in relatively mild illness, but some can progress to dengue hemorrhagic fever. With dengue hemorrhagic fever, the blood vessels start to leak and cause bleeding from the nose, mouth, and gums. Bruising can be a sign of bleeding inside the body. Without prompt treatment, the blood vessels can collapse, causing shock (dengue shock syndrome). Dengue hemorrhagic fever is fatal in about 5 percent of cases, mostly among children and young adults.

How soon after exposure do symptoms appear?

The time between the bite of a mosquito carrying dengue virus and the start of symptoms averages 4 to 6 days, with a range of 3 to 14 days. An infected person cannot spread the infection to other persons but can be a source of dengue virus for mosquitoes for about 6 days.

How is dengue diagnosed?
Dengue is diagnosed by a blood test

United we stand: Divided we fall

Then if all these cases are Dengue, why are they giving them Tamiflu?

and even more importantly, why is Tamiflu making them better? If it was Dengue tamiflu would be ineffective would it not?

Always have a plan B.

[ Parent ]
Because they don't
really think it's dengue?  

Because one child in the cluster maybe has a co-infection of dengue and H5N1?  (Not infeasible).

I do know that when they start handing out Tamiflu to symptomatic people at a hastily set-up medical command center that they're not suspecting dengue.  

I also surmise that if 5-10 families have been given Tamiflu and are being "monitored" by experienced people from Karo that they're not being "monitored" for dengue.  

[ Parent ]

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