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  1. Article ; Online: Posterolateral Complex Reconstruction With Distal Femoral Varus Opening-Wedge Osteotomy for Unstable Neglected Multiligamentous Knee Injury With Valgus Malalignment.

    Liao, Hung-Kai / Yang, Cheng-Pang / Chao-Yu Chen, Alvin / Chan, Yi-Sheng

    Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews

    2021  Volume 5, Issue 8

    Abstract: We presented a case of a 25-year-old woman with early posttraumatic degenerative change to the articular cartilage accompanied with valgus malalignment despite receiving anterior cruciate ligament reconstruction after a multiligamentous injury sustained ... ...

    Abstract We presented a case of a 25-year-old woman with early posttraumatic degenerative change to the articular cartilage accompanied with valgus malalignment despite receiving anterior cruciate ligament reconstruction after a multiligamentous injury sustained 2 years earlier. Rapid deteriorating valgus malalignment may result from chronic instability and intra-articular bone loss. Simultaneous distal femoral varus osteotomy and posterolateral complex reconstruction were performed during a single surgery. Six months after the surgery, the patient could walk briskly and climb stairs without any discomfort. Salvage procedures and biological reconstruction could be the primary choice for young patients to recover their knee function while avoiding joint replacement.
    MeSH term(s) Adult ; Anterior Cruciate Ligament Reconstruction ; Female ; Humans ; Joint Instability/complications ; Joint Instability/surgery ; Knee Injuries/complications ; Knee Injuries/diagnostic imaging ; Knee Injuries/surgery ; Knee Joint/surgery ; Osteotomy/methods
    Language English
    Publishing date 2021-08-10
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 2898328-2
    ISSN 2474-7661 ; 1067-151X
    ISSN (online) 2474-7661
    ISSN 1067-151X
    DOI 10.5435/JAAOSGlobal-D-21-00102
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Arthroscopic Superior Capsule Reconstruction With Fascia Lata Autograft And In-Situ Biceps Tendon Augmentation: Feasible Outcomes After Minimum Two-Year Follow-Up.

    Cheng, You-Hung / Wu, Chun-Te / Chiu, Chih-Hao / Hsu, Kuo-Yao / Chan, Yi-Sheng / Chao-Yu Chen, Alvin

    Arthroscopy, sports medicine, and rehabilitation

    2022  Volume 4, Issue 5, Page(s) e1675–e1682

    Abstract: Purpose: To investigate the preliminary functional and radiographic outcomes after arthroscopic superior capsule reconstruction (SCR) with long head of biceps tendon (LHBT) augmentation for irreparable rotator cuff tears (RCTs).: Methods: ... ...

    Abstract Purpose: To investigate the preliminary functional and radiographic outcomes after arthroscopic superior capsule reconstruction (SCR) with long head of biceps tendon (LHBT) augmentation for irreparable rotator cuff tears (RCTs).
    Methods: Retrospective review of medical records was conducted in patients receiving unilateral SCR with fascia lata autograft and LHBT augmentation for irreparable RCTs between January 2016 and March 2019. LHBT was adopted when the integrity was intact or partial tear was less than 50% in width. We used all-suture anchors for folded graft patch fixation with 2 in supraglenoid fossa and another 2 plus two knotless anchors via compression suture-bridging technique in greater tuberosity. Reinforced fixation with side-to-side suture was added between infraspinatus tendon and graft patch, and between proximal LHBT and graft to improve force coupling. Clinical and radiographic outcomes including magnetic resonance imaging analysis at 2-year follow-up were investigated and compared with preoperative status.
    Results: Consecutive 18 patients (mean age, 66.1 years) were included. Mean active forward elevation significantly improved from 75.6⁰ to 157.2⁰ (P < .0001), and external rotation from 33.3⁰ to 53.3⁰ (P < .01). Mean acromiohumeral distance increased from 6.1 ± 2.5 mm to 8.5 ± 2.1 mm (P < .001). The American Shoulder and Elbow Surgeons score improved from 33.8 ± 5.6 to 93.4 ± 5.92 points (P < .00001). Comparable outcomes were found in patients with intact LHBT and those with partial tear. Nine patients had partial tear of graft patch (5, tuberosity side; 4 posterior glenoid); 2 patients had complete tear (tuberosity side) showing inferior outcomes.
    Conclusions: The index surgery restored superior glenohumeral stability and function of the shoulder with irreparable RCTs. Despite high incidence of partial graft tear, favorable outcomes suggest SCR with biceps tendon augmentation is a feasible treatment for irreparable RCTs.
    Level of evidence: Level IV, therapeutic case series.
    Language English
    Publishing date 2022-08-14
    Publishing country United States
    Document type Journal Article
    ISSN 2666-061X
    ISSN (online) 2666-061X
    DOI 10.1016/j.asmr.2022.06.014
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Arthroscopic diagnosis of long head of biceps tendon instability in refractory anterior shoulder pain

    Jo-Ting Kao / Chih-Hao Chiu / Kuo-Yau Hsu / Shih-Sheng Chang / Yi-Sheng Chan / Alvin Chao-Yu Chen

    Biomedical Journal, Vol 46, Iss 1, Pp 163-

    A comparison study between pulley tear and non-tear lesions

    2023  Volume 169

    Abstract: Background: Long head of the biceps tendon (LHBT) instability and biceps reflection pulley (BRP) lesions are common cause of refractory anterior shoulder pain. We described a technique using dynamic arthroscopy to determine associated intraarticular ... ...

    Abstract Background: Long head of the biceps tendon (LHBT) instability and biceps reflection pulley (BRP) lesions are common cause of refractory anterior shoulder pain. We described a technique using dynamic arthroscopy to determine associated intraarticular pathologies. Methods: Patients with refractory anterior shoulder pain and arthroscopically-diagnosed LHBT instability were enrolled. LHBT instability and the integrity of BRP and concomitant intra-articular lesions were investigated by ramp test. Demographics and arthroscopic findings were compared between patients with and without BRP tear. Results: Forty patients were enrolled. BRP tear was noted in 25 patients (group A) and superior glenohumeral ligament (SGHL) insufficiency through ramp test in 15 patients (group B). Concomitant intraarticular pathologies were noted in 27 patients, including 19 in group A (76%) and eight in group B (53%), without significant group-wise difference (p = 0.138). The incidence of articular-side subscapularis tear was significantly higher in group A (p = 0.021), and those of the other intraarticular pathologies were similar between groups A and B. Fraying at the articular side of the subscapularis and supraspinatus tendons was frequent in group B, without difference of incidence as compared to group A (p = 0.5 and p = 0.084, respectively). Conclusions: LHBT instability was a common disorder in patients with refractory shoulder pain. In those patients, dynamic assessment of BRP lesions and SGHL insufficiency and meticulous survey of associated intra-articular pathologies, including subscapularis tear are necessary for making accurate diagnosis and treatment decision.
    Keywords Arthroscopy ; Biceps tendon ; Pulley lesion ; Ramp test ; Anterior shoulder pain ; Medicine (General) ; R5-920 ; Biology (General) ; QH301-705.5
    Subject code 616
    Language English
    Publishing date 2023-02-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: Impact of infection-related admission in patients with heart failure

    Chao-Yu Chen / Cheng-Han Lee / Hui-Wen Lin / Sheng-Hsiang Lin / Yi-Heng Li

    Scientific Reports, Vol 13, Iss 1, Pp 1-

    a 10 years national cohort study

    2023  Volume 10

    Abstract: Abstract Infection is a common cause of hospitalization in patients with heart failure (HF). The impact of infection on long term cardiovascular outcome in HF is not well studied. The aim of this study was to compare the long term risk of major adverse ... ...

    Abstract Abstract Infection is a common cause of hospitalization in patients with heart failure (HF). The impact of infection on long term cardiovascular outcome in HF is not well studied. The aim of this study was to compare the long term risk of major adverse cardiovascular events (MACE) in HF patients with or without prior hospitalization for infection. From 2009 to 2015, 310,485 patients with their first HF admissions were enrolled from the Taiwan National Health Insurance Research Database. Among the patients, those with readmission due to infection within one year after HF discharge were defined as infection group and those without any infection admission were controls. The propensity score matching method was used to balance covariates between the two groups. Patients were followed until the occurrence of any component of the MACE or the end date of the study, December 31, 2019. In a mean follow-up time of 4.29 ± 2.92 years, 86.19% of patients in the infection group and 63.63% of patients in the control group had MACE. Multivariate Cox proportional hazards analysis showed the infection group had a higher risk of MACE (HR 1.760, 95% CI 1.714–1.807), including all-cause mortality (HR 1.587, 95% CI 1.540–1.636), myocardial infarction (HR 1.332, 95% CI 1.224–1.450), stroke (HR 1.769, 95% CI 1.664–1.882) and hospitalization for HF (HR 1.993, 95% CI 1.922–2.066). In conclusion, many HF patients discharged from the hospital experienced acute infection that required readmission. The patients had worse cardiovascular outcome after readmission for infectious disease compared to those without any infection.
    Keywords Medicine ; R ; Science ; Q
    Subject code 616
    Language English
    Publishing date 2023-04-01T00:00:00Z
    Publisher Nature Portfolio
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article: Anatomical Dermal Allograft and Autologous Biceps Long Head Superior Capsule Reconstruction for Irreparable Posterosuperior Rotator Cuff Tears.

    Chiu, Chih-Hao / Weng, Chun-Jui / Tang, Hao-Che / Yang, Cheng-Pang / Chang, Shih-Sheng / Hsu, Kuo-Yao / Chao-Yu Chen, Alvin

    Arthroscopy techniques

    2021  Volume 10, Issue 10, Page(s) e2237–e2243

    Abstract: Superior capsule reconstruction (SCR) can be performed using fascia lata, dermal allograft, and long head of the biceps tendon (LHBT). We present a Technical Note combining dermal allograft and autologous LHBT, reconstructing the superior capsule's ... ...

    Abstract Superior capsule reconstruction (SCR) can be performed using fascia lata, dermal allograft, and long head of the biceps tendon (LHBT). We present a Technical Note combining dermal allograft and autologous LHBT, reconstructing the superior capsule's actual anatomical thickness and augmenting with single-stranded LHBT. The glenoid side consists of intact LHBT insertion and is covered with dermal allograft. The lateral side comprises posteriorly transpositioned LHBT, dermal allograft, and repairable remnant cuff. First, 1 suture-based anchor is used to fix the biceps 5 to 8 mm posterior to the bicipital groove, and tenotomy is done distal to it, while the glenoid side of the biceps is preserved. Second, 2 suture-based anchors are used to fix the dermal allograft at the glenoid side by 1 double-pulley and 2 mattress sutures. Third, 2 SwiveLock anchors are used to fix allograft's lateral side by 2 reverse mattress sutures. The tension and coverage of the graft can be determined by the position of the SwiveLock anchors. In this way, fewer anchors are needed than the conventional dermal allograft SCR and larger footprint coverage can be achieved than LHBT SCR. A better spacer effect may be achieved by combining both biological grafts' thickness, mimicking the intact shoulder's true anatomy.
    Language English
    Publishing date 2021-09-08
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 2653101-X
    ISSN 2212-6287
    ISSN 2212-6287
    DOI 10.1016/j.eats.2021.05.028
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Arthroscopic Superior Capsule Reconstruction Using Autologous Fascia Lata and Biceps Tendon Augmentation.

    Hsu, Chen-Heng / Chiu, Chih-Hao / Weng, Chun-Jui / Hsu, Kuo-Yau / Chan, Yi-Sheng / Chao-Yu Chen, Alvin

    Arthroscopy techniques

    2021  Volume 10, Issue 6, Page(s) e1411–e1415

    Abstract: Whereas arthroscopic superior capsule reconstruction has recently been introduced to treat irreparable rotator cuff tears with encouraging outcomes, graft options and fixation remain debated. The purpose of this article is to introduce a modified ... ...

    Abstract Whereas arthroscopic superior capsule reconstruction has recently been introduced to treat irreparable rotator cuff tears with encouraging outcomes, graft options and fixation remain debated. The purpose of this article is to introduce a modified arthroscopic technique using the long head of the biceps tendon as augmentation for superior capsule reconstruction with fascia lata autograft.
    Language English
    Publishing date 2021-05-03
    Publishing country Netherlands
    Document type Journal Article
    ISSN 2212-6287
    ISSN 2212-6287
    DOI 10.1016/j.eats.2021.02.004
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Anatomic Double-Bundle ACL Reconstruction With Extra-articular Anterolateral Ligament Reconstruction and Internal Brace.

    Chiu, Chih-Hao / Chi, Jia-En / Huang, Po-Hua / Chang, Shih-Sheng / Hsu, Kuo-Yao / Chao-Yu Chen, Alvin / Chan, Yi-Sheng

    Arthroscopy techniques

    2021  Volume 10, Issue 3, Page(s) e789–e796

    Abstract: Anterior cruciate ligament reconstruction (ACLR) with additional procedures could be necessary for patients with increased preoperative pivot shift. Double-bundle (DB) ACLR provides more footprint coverage and recreates the 2 functional anteromedial (AM) ...

    Abstract Anterior cruciate ligament reconstruction (ACLR) with additional procedures could be necessary for patients with increased preoperative pivot shift. Double-bundle (DB) ACLR provides more footprint coverage and recreates the 2 functional anteromedial (AM) and posterolateral (PL) bundles, which are believed to give better joint function and stability than single-bundle (SB) ACLR. Internal brace augmentation with suture tape is proposed along with tendon graft in ACLR to protect the newly reconstructed ligament during rehabilitation. Additional reconstruction with anterolateral ligament (ALL) during ACLR has shown significant reduction in the level of persistent pivot shift. In Technical Note we present a modified surgical technique of combined anatomic DB ACLR and ALLR with hamstring autograft and internal brace, using button suspensory fixation device and aperture screws. The objective of this technique is to decrease residual anterior and rotational instability after ACLR and ALLR.
    Language English
    Publishing date 2021-03-10
    Publishing country Netherlands
    Document type Journal Article
    ISSN 2212-6287
    ISSN 2212-6287
    DOI 10.1016/j.eats.2020.10.069
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Comparison of hook plate alone, hook plate augmented with suture anchor, and arthroscopically-assisted tightrope fixation in the treatment of patients with acute type v acromioclavicular joint dislocations.

    Sheu, Huan / Weng, Chun-Jui / Tang, Hao-Che / Yang, Cheng-Pang / Hsu, Kuo-Yao / Chan, Yi-Sheng / Chao-Yu Chen, Alvin / Chih-Hao Chiu, Joe

    Orthopaedics & traumatology, surgery & research : OTSR

    2022  Volume 109, Issue 4, Page(s) 103494

    Abstract: Introduction: The best treatment for Rockwood type V acromioclavicular (AC) joint dislocation is unknown.: Hypothesis: Hook plate augmented with suture anchor (HA) may have different clinical and radiological results than hook plate alone (H), and ... ...

    Abstract Introduction: The best treatment for Rockwood type V acromioclavicular (AC) joint dislocation is unknown.
    Hypothesis: Hook plate augmented with suture anchor (HA) may have different clinical and radiological results than hook plate alone (H), and arthroscopically assisted TightRope (TR) techniques in treating acute type V AC joint dislocations.
    Material and methods: This retrospective study included 71 patients with acute type V AC joint dislocations between December 2010 and August 2018. Patients were categorized into three groups: H group (n=22), HA group (n=23) and TR group (n=26). We measured the coracoclavicular distance (CCD) differences and CCD ratio compared to uninjured side pre-operatively, immediately post-operatively, at 3-month and 2-year after operation. Clinical outcomes were assessed as well at the same time points. Loss of correction was determined by the CCD difference and ratio between surgical and uninjured sides.
    Results: The mean age and follow-up period were 41.8±24.7 years and 30.2±4.3 months, respectively. No significant differences were found in the demographic data between the three groups. The HA group presented a trend of less overcorrection but without significance compared with the H group at immediately post-operation, 3-month, and 2-year follow-up. (CCD difference: -2.4mm vs. -3.7mm, -1.6mm vs. -1.8, and 0.2mm vs -1.9mm, CCD ratio: 67.7% vs. 40.9%, 79.3% vs. 70.1%, and 100.6% vs. 86.5%, respectively). The HA group also had significantly less loss of correction compared with the TR group at 3-month and 2-year after the operation (CCD difference: -1.6mm vs. 1.6mm, 0.2mm vs. 2.4mm; CCD ratio: 79.3% vs. 122.2%, 100.6% vs. 136.1%, all p<0.05). All three methods achieved significant improvement in function and pain without inter-group differences. No coracoid-related or tunnel complications occurred.
    Discussion: The hook plate alone, and hook plate with suture anchor augmentation techniques provided less residual vertical instability compared to TightRope fixation at 2-year follow-up. The patient-reported functional outcomes were promising and comparable among the three groups.
    Level of evidence: III, Retrospective comparative therapeutic trial.
    MeSH term(s) Humans ; Acromioclavicular Joint/diagnostic imaging ; Acromioclavicular Joint/surgery ; Bone Plates ; Joint Dislocations/diagnostic imaging ; Joint Dislocations/surgery ; Retrospective Studies ; Shoulder Dislocation ; Suture Anchors ; Treatment Outcome
    Language English
    Publishing date 2022-11-28
    Publishing country France
    Document type Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 1877-0568
    ISSN (online) 1877-0568
    DOI 10.1016/j.otsr.2022.103494
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Adhesion of the Long Head of the Biceps Tendon: A Case Series.

    Chiu, Chih-Hao / Lin, Yu-Ching / Chen, Poyu / Chao-Yu Chen, Alvin / Chan, Yi-Sheng / Hsu, Kuo-Yao / Lädermann, Alexandre

    Arthroscopy, sports medicine, and rehabilitation

    2020  Volume 3, Issue 1, Page(s) e79–e87

    Abstract: Purpose: To present the clinical and imaging findings and results of treatment in patients with intra-articular long head of the biceps tendon (LHBT) adhesion to the undersurface of the rotator cuff found incidentally during shoulder arthroscopy.: ... ...

    Abstract Purpose: To present the clinical and imaging findings and results of treatment in patients with intra-articular long head of the biceps tendon (LHBT) adhesion to the undersurface of the rotator cuff found incidentally during shoulder arthroscopy.
    Methods: Patients with intra-articular LHBT adhesion to the undersurface of the rotator cuff found incidentally during arthroscopy were included with a minimal 2-year follow-up. Demographic data, images, and physical examinations were recorded. LHBT release, tenotomy, or tenodesis were performed according to the patient's age and surgeon's preference.
    Results: Twelve patients were included in the study. All of them presented with chronic anterior shoulder pain and positive Speed and O'Brien tests. The average age was 46.8 ± 17 years (range 20-79 years) and the pain sustained from 6 to 96 (average 25.5 ± 28.6) months. Before the operation, 6 patients had a positive Jobe's test, 1 had a positive lift-off test, and all had positive O'Brien and Speed tests and tenderness over the LHBT. Three release, 4 tenotomy, and 5 LHBT tenodesis were done in addition to other procedures if needed. All range of motion except external rotation, pain visual analog score, and functional outcome scores showed significant improvement at 6 months after surgery. There were no significant differences in range of motion and functional scores between 6 months and 12 months postoperatively. No difference was found in LHBT scores at 6 and 12 months after the operation. Magnetic resonance imaging revealed thickened coracohumeral ligament overlying the LHBT.
    Conclusions: Patients who had intra-articular LHBT adhesion to the undersurface of the rotator cuff and underwent release of the adhesion around LHBT, tenotomy, or tenodesis all had good clinical outcomes. The lesion was observed in 2.2% of all shoulder arthroscopies. Although difficult to diagnose before surgery, surgeons should be aware of this unusual condition in patients with chronic and insidious anterior shoulder pain.
    Level of evidence: Level IV, Therapeutic case series.
    Language English
    Publishing date 2020-12-24
    Publishing country United States
    Document type Journal Article
    ISSN 2666-061X
    ISSN (online) 2666-061X
    DOI 10.1016/j.asmr.2020.09.001
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Arthroscopy-Assisted Corrective Osteotomy, Reduction, Internal Fixation and Strut Allograft Augmentation for Tibial Plateau Malunion or Nonunion

    Jr-Yi Wang / Chun-Ying Cheng / Alvin Chao-Yu Chen / Yi-Sheng Chan

    Journal of Clinical Medicine, Vol 9, Iss 973, p

    2020  Volume 973

    Abstract: Purpose: The purpose of this study was to present the results of arthroscopy-assisted corrective osteotomy (AACO), reduction, internal fixation, and strut allograft augmentation for tibial plateau malunion or nonunion. Methods: Fifty-eight patients, mean ...

    Abstract Purpose: The purpose of this study was to present the results of arthroscopy-assisted corrective osteotomy (AACO), reduction, internal fixation, and strut allograft augmentation for tibial plateau malunion or nonunion. Methods: Fifty-eight patients, mean age 49 ± 11.9 years old, with tibial plateau malunion ( n = 44) or nonunion ( n = 14), were included in this study. There were 19 Schatzker type II fractures (32.7%), 2 type III fractures (3.4%), 7 type IV fractures (12%), 20 type V fractures (34.5%), and 10 type VI fractures (17.2%). The mean follow-up period was 46.2 ± 17.6 months. Clinical and radiologic outcomes were scored by the Rasmussen system. Articular depression was measured from computed tomography. Secondary osteoarthritis was diagnosed when radiographs showed a narrowed joint space in the injured knee at follow-up. Results: Mean clinical score improved from 15.4 ± 3.9 (pre-revision) to 23.2 ± 4.5 (post-revision). Mean radiologic score improved from 7.7 ± 2.5 (pre-revision) to 12.0 ± 3.9 (post-revision). Fifty-six fractures achieved successful union. The average union time was 19.6 ± 7.5 weeks. Post-revision, 81% had good or excellent clinical results and 62% had good or excellent radiological results. Secondary osteoarthritis (OA) was noted in 91% of all injured knees, where 25.8% were mild OA, 25.8 % were moderate OA, and 38% were severe OA. There were 6 cases of deep infection (10.3%) and 1 case of wound edge necrosis (1.7%). Five cases were converted to total knee replacement after the index surgery with an average period of 13.5 months (range 8–24 months). Conclusions: Arthroscopy-assisted corrective osteotomy, reduction, internal fixation, and strut allograft augmentation can restore tibial plateau malunion/nonunion with well-documented radiographic healing and good clinical outcomes.
    Keywords Arthroscopy-assisted corrective osteotomy ; tibial plateau malunion ; tibial plateau nonunion ; Medicine ; R
    Language English
    Publishing date 2020-04-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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