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  1. Article ; Online: Development and outcomes of surgical and urological kidney transplantation programs in Germany: a total population analysis from 2006 to 2021.

    Reimold, Philipp / Aksoy, Cem / Beckmann, Jonas / Zacharis, Aristeidis / Groeben, Christer / Karschuck, Philipp / Eisenmenger, Nicole / Geks, Josef / Huber, Johannes / Flegar, Luka

    World journal of urology

    2024  Volume 42, Issue 1, Page(s) 65

    Abstract: Purpose: Kidney transplantation (KT) is the most frequently performed organ transplantation. In Germany, KT is performed in urology and surgery departments with unknown consequences of this parallel structure. The aim of the study was to compare the ... ...

    Abstract Purpose: Kidney transplantation (KT) is the most frequently performed organ transplantation. In Germany, KT is performed in urology and surgery departments with unknown consequences of this parallel structure. The aim of the study was to compare the development and outcome of KT in urology and surgery departments.
    Methods: On an institutional level, we analyzed the annual caseload from 2006 to 2021 with the reimbursement. INFO tool based on hospitals' quality reports (Reimbursement Institute, Hürth, Germany). For outcome comparison we extracted raw data from the transplantation centers' quality reports (Deutsche Stiftung Organtransplantation, DSO).
    Results: A total of 23,599 cases (17,781 deceased donor and 5,818 living donor KTs) were included. The total number of KTs decreased from 1851 in 2006 to 1701 in 2021 (- 8%; p = 0.12). The total number of urological KTs decreased from 592 cases in 2006 to 395 cases in 2021 (- 33.3%; p = 0.01). Further analysis revealed no significant differences between intra- and postoperative complications and graft quality at one year for deceased donor KTs (DDKT) although differences in immediate renal function and graft quality at discharge could be observed. There were no significant differences in immediate renal function and graft quality at discharge for living donor KTs (LDKT) between the specialties.
    Conclusion: KTs performed in urology departments declined between 2006 and 2021. Nevertheless, intra- and postoperative complications as well as long-term function did not differ between surgical and urological KT programs. Hence, an interdisciplinary approach, especially considering the upcoming challenges in KT as, e.g., robot-assisted surgery seems reasonable.
    MeSH term(s) Humans ; Kidney Transplantation ; Postoperative Complications/epidemiology ; Robotic Surgical Procedures ; Germany/epidemiology ; Living Donors
    Language English
    Publishing date 2024-02-01
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 380333-8
    ISSN 1433-8726 ; 0724-4983
    ISSN (online) 1433-8726
    ISSN 0724-4983
    DOI 10.1007/s00345-023-04740-1
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  2. Article ; Online: Trends in Selective Internal Radiation Therapy (SIRT) for Treating Hepatocellular Carcinoma, Cholangiocarcinoma, and Liver Metastasis: A Total Population Analysis from 2006 to 2021 in Germany.

    Thoduka, Smita George / Flegar, Luka / Groeben, Christer / Huber, Johannes / Eisenmenger, Nicole / Paulus, Tobias / Vogt, Katharina / Luster, Markus / Abolmaali, Nasreddin

    Current oncology (Toronto, Ont.)

    2023  Volume 30, Issue 12, Page(s) 10325–10335

    Abstract: The aim of this study was to investigate trends in selective internal radiation therapy (SIRT) for hepatocellular carcinoma (HCC), cholangiocarcinoma (CCC), and liver metastasis in Germany. We analyzed the nationwide German hospital billing database from ...

    Abstract The aim of this study was to investigate trends in selective internal radiation therapy (SIRT) for hepatocellular carcinoma (HCC), cholangiocarcinoma (CCC), and liver metastasis in Germany. We analyzed the nationwide German hospital billing database from 2006 to 2019 for the diagnosis of HCC, CCC or liver metastasis in combination with SIRT. For analyses of SIRT on the hospital level, we used the reimbursement.INFO tool based on German hospitals' quality reports from 2008 to 2021. Linear regression analysis was performed to detect changes over time. We included a total of 14,165 SIRT procedures. The annual numbers increased from 99 in 2006 to 1605 in 2015 (
    MeSH term(s) Humans ; Carcinoma, Hepatocellular/radiotherapy ; Liver Neoplasms/radiotherapy ; Cholangiocarcinoma/radiotherapy ; Germany/epidemiology
    Language English
    Publishing date 2023-12-05
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 1236972-x
    ISSN 1718-7729 ; 1198-0052
    ISSN (online) 1718-7729
    ISSN 1198-0052
    DOI 10.3390/curroncol30120752
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  3. Article ; Online: Insufficient utilization of care in male incontinence surgery: health care reality in Germany from 2006 to 2020 and a systematic review of the international literature.

    Baunacke, Martin / Abbate, Elena / Eisenmenger, Nicole / Witzsch, Ulrich / Borkowetz, Angelika / Huber, Johannes / Thomas, Christian / Putz, Juliane

    World journal of urology

    2023  Volume 41, Issue 7, Page(s) 1813–1819

    Abstract: Purpose: Data suggest that the utilization of care in male incontinence surgery (MIS) is insufficient. The aim of this study was to analyse the utilization of care in MIS from 2006 to 2020 in Germany, relate this use to the number of radical ... ...

    Abstract Purpose: Data suggest that the utilization of care in male incontinence surgery (MIS) is insufficient. The aim of this study was to analyse the utilization of care in MIS from 2006 to 2020 in Germany, relate this use to the number of radical prostatectomies (RP) and provide a systematic review of the international literature.
    Methods: We analysed OPS codes using nationwide German billing data and hospitals' quality reports from 2006 to 2020. A systematic review was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA).
    Results: MIS increased by + 68% from 2006 to 2011 (1843-3125; p = 0.009) but decreased by - 42% from 2011 to 2019 (3104-1799; p < 0.001). In 2020, only 1435 MISs were performed. In contrast, RP increased from 2014 to 2019 by 33% (20,760-27,509; p < 0.001). From 2012 to 2019, the number of artificial urinary sphincters (AUSs) changed minimally (- 12%; 1291-1136; p = 0.02). Sling/sling systems showed a decrease from 2011 to 2019 (- 68% 1632-523; p < 0.001). In 2019, 63% of patients received an AUS, 29% sling/sling systems, 6% paraurethral injections, and 2% other interventions. In 2019, few high-volume clinics [n = 27 (13%)] performed 55% of all AUS implantations, and few high-volume clinics [n = 10 (8%)] implanted 49% of retropubic slings.
    Conclusion: MIS have exhibited a relevant decrease since 2011 despite the increase in RP numbers in Germany, indicating the insufficient utilization of care in MIS. The systematic review shows also an international deficit in the utilization of care in MIS.
    MeSH term(s) Humans ; Male ; Suburethral Slings ; Urinary Incontinence/epidemiology ; Urinary Incontinence/surgery ; Urinary Sphincter, Artificial ; Prostatectomy ; Germany ; Urinary Incontinence, Stress/surgery
    Language English
    Publishing date 2023-06-01
    Publishing country Germany
    Document type Systematic Review ; Journal Article
    ZDB-ID 380333-8
    ISSN 1433-8726 ; 0724-4983
    ISSN (online) 1433-8726
    ISSN 0724-4983
    DOI 10.1007/s00345-023-04433-9
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  4. Article ; Online: Trends in kidney transplantation and living donor nephrectomy in Germany: a total population analysis from 2006 to 2021.

    Zacharis, Aristeidis / Reimold, Philipp / Aksoy, Cem / Jung, Jonas / Martin, Thomas / Eisenmenger, Nicole / Thoduka, Smita George / Groeben, Christer / Huber, Johannes / Flegar, Luka

    World journal of urology

    2024  Volume 42, Issue 1, Page(s) 24

    Abstract: Purpose: To analyze recent trends of surgical access routes, length of hospital stay (LOS), and mortality in kidney transplantation (KT) and living donor nephrectomy (LDN) in Germany.: Materials and methods: We studied the nationwide German hospital ... ...

    Abstract Purpose: To analyze recent trends of surgical access routes, length of hospital stay (LOS), and mortality in kidney transplantation (KT) and living donor nephrectomy (LDN) in Germany.
    Materials and methods: We studied the nationwide German hospital billing database and the German hospital quality reports from 2006 to 2021.
    Results: There were a total of 35.898 KTs. In total, 9044 (25%) were living donor transplantations, while 26.854 (75%) were transplantations after donation after brain death (DBD). The share of open LDN decreased from 82% in 2006 to 22% in 2020 (- 4%/year; p < 0.001). The share of laparoscopic LDN increased from 18% in 2006 to 70% in 2020 (+ 3%/year; p < 0.001). The share of robotic LDN increased from 0% in 2006 to 8% in 2020 (+ 0.6%/year; p < 0.001). Robotic-assisted KT increased from 5 cases in 2016 to 13 procedures in 2019 (p = 0.2). LOS was shorter after living donor KT, i.e., 18 ± 12.1 days versus 21 ± 19.6 days for DBD renal transplantation (p < 0.001). Moreover, LOS differed for open versus laparoscopic versus robotic LDN (9 ± 3.1 vs. 8 ± 2.9 vs. 6 ± 2.6; p = 0.031). The overall in-hospital mortality was 0.16% (n = 5) after LDN, 0.47% (n = 42) after living donor KT and 1.8% (n = 475) after DBD KT.
    Conclusions: There is an increasing trend toward minimal-invasive LDN in recent years. Overall, in-hospital mortality was low after KT. However, 5 deceased healthy donors after LKD caution that the risks of this procedure should also be taken very seriously.
    MeSH term(s) Humans ; Kidney Transplantation ; Living Donors ; Tissue and Organ Harvesting ; Germany ; Nephrectomy
    Language English
    Publishing date 2024-01-10
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 380333-8
    ISSN 1433-8726 ; 0724-4983
    ISSN (online) 1433-8726
    ISSN 0724-4983
    DOI 10.1007/s00345-023-04737-w
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  5. Article ; Online: Trends in the use of testicular prostheses in Germany: a total population analysis from 2006-2021.

    Aksoy, Cem / Reimold, Philipp / Karschuck, Philipp / Groeben, Christer / Koch, Rainer / Eisenmenger, Nicole / Thoduka, Smita / Zacharis, Aristeidis / Schmelz, Hans / Huber, Johannes / Flegar, Luka

    Andrology

    2024  

    Abstract: Introduction: Testicular tumors are the most common malignancies in young adults and their incidence is growing. The implantation of a testicular prosthesis, for example, during orchiectomy is a standard procedure but its frequency in Germany is unknown. ...

    Abstract Introduction: Testicular tumors are the most common malignancies in young adults and their incidence is growing. The implantation of a testicular prosthesis, for example, during orchiectomy is a standard procedure but its frequency in Germany is unknown. This study aims to analyze trends of testicular prosthesis implantation in recent years in Germany.
    Material and methods: The nationwide German hospital billing database and the German hospital quality reports from 2006 to 2021 were studied.
    Results: A total of 12,753 surgical procedures with implantation of testicular prosthesis and 1,244 procedures with testicular prosthesis explantation were included. Testicular prosthesis implantation increased in total from 699 cases in 2006 to 870 cases in 2020 (+11.4 cases/year; p < 0.001). The share of implantation of testicular prosthesis due to testicular tumor decreased from 72.6% in 2006 to 67.5% in 2020 (p < 0.001). The share of implantation due to gender affirming surgery increased from 6.8% in 2006 to 23.3% in 2020 (p < 0.001). The share of implantation due to testicular atrophy decreased from 11.4% in 2006 to 3.4% in 2020 (p < 0.001). Simultaneous implantation of testicular prosthesis during orchiectomy for testicular cancer increased from 7.8% in 2006 to 11.4% in 2020 (p < 0.001). In 2006, 146 hospitals (85%) performed < 5 testicular prosthesis implantation, while 20 hospitals (12%) performed 5-15 implantation procedures and 6 hospitals (3%) performed > 15 testicular implantation surgeries. In 2021, 115 hospitals (72%) performed < 5 testicular prosthesis implantation, while 39 hospitals (25%) performed 5-15 implantation procedures and 5 hospitals (3%) performed > 15 testicular implantation surgeries.
    Conclusion: This study shows that implantation of testicular prostheses is steadily increasing. Explantation rates are low. Besides testicular cancer transgender surgeries were the main driver for increasing case numbers in recent years.
    Language English
    Publishing date 2024-01-16
    Publishing country England
    Document type Journal Article
    ZDB-ID 2696108-8
    ISSN 2047-2927 ; 2047-2919
    ISSN (online) 2047-2927
    ISSN 2047-2919
    DOI 10.1111/andr.13598
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  6. Article ; Online: Alternative- and focal therapy trends for prostate cancer: a total population analysis of in-patient treatments in Germany from 2006 to 2019.

    Flegar, Luka / Zacharis, Aristeidis / Aksoy, Cem / Heers, Hendrik / Derigs, Marcus / Eisenmenger, Nicole / Borkowetz, Angelika / Groeben, Christer / Huber, Johannes

    World journal of urology

    2022  Volume 40, Issue 7, Page(s) 1645–1652

    Abstract: Purpose: Focal therapy (FT) offers an alternative approach for prostate cancer (PCa) treatment in selected patients. However, little is known on its actual establishment in health care reality.: Patients and methods: We defined FT as high-intensity ... ...

    Abstract Purpose: Focal therapy (FT) offers an alternative approach for prostate cancer (PCa) treatment in selected patients. However, little is known on its actual establishment in health care reality.
    Patients and methods: We defined FT as high-intensity focused ultrasound (HIFU), hyperthermia ablation, cryotherapy, transurethral ultrasound ablation (TULSA) or vascular-targeted photodynamic therapy (VTP) TOOKAD
    Results: We identified 23,677 cases of FT from 2006 to 2019. Considering all PCa cases with surgery, radiotherapy or FT, the share of FT was stable at 4%. The annual caseload of FT increased to a maximum of 2653 cases in 2008 (p < 0.001) and then decreased to 1182 cases in 2014 (p < 0.001). Since 2015, the cases of FT remained on a plateau around 1400 cases per year. The share of HIFU was stable at 92-96% from 2006 to 2017 and decreased thereafter to 75% in 2019 (p = 0.015). In 2019, VTP-TOOKAD
    Conclusion: The FT development in Germany followed the Gartner hype cycle. While HIFU treatment is the most commonly performed FT, the share of newer FT modalities such as VTP-TOOKAD
    MeSH term(s) Germany/epidemiology ; High-Intensity Focused Ultrasound Ablation/methods ; Humans ; Male ; Photochemotherapy/methods ; Prostatic Neoplasms/surgery ; Quality of Life ; Treatment Outcome
    Language English
    Publishing date 2022-05-13
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 380333-8
    ISSN 1433-8726 ; 0724-4983
    ISSN (online) 1433-8726
    ISSN 0724-4983
    DOI 10.1007/s00345-022-04024-0
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  7. Conference proceedings: Stellenwert der Urodynamik in der urologischen Versorgungsrealität

    Baunacke, Martin / Kontschak, Livia / Grabbert, Markus / Borkowetz, Angelika / Mehralivand, Sherif / Eisenmenger, Nicole / Huber, Johannes / Schultz-Lampel, Daniela

    2023  , Page(s) 27

    Event/congress 34. Kongress der Deutschen Kontinenz Gesellschaft; Leipzig; Deutsche Kontinenz Gesellschaft e.V.; 2023
    Keywords Medizin, Gesundheit
    Publishing date 2023-10-31
    Publisher German Medical Science GMS Publishing House; Düsseldorf
    Document type Conference proceedings
    DOI 10.3205/23dkg27
    Database German Medical Science

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  8. Article ; Online: Outpatient care concept and potential inpatient cost savings associated with the administration of dalbavancin - A real-world data and retrospective cost analysis.

    Baltin, Christoph T / Wulf, Carolin / Rongisch, Robert / Lehmann, Clara / Wingen-Heimann, Sebastian / Eisenmenger, Nicole / Bonn, Jennifer / Fabri, Mario / von Stebut, Esther / Cornely, Oliver A / Kron, Florian

    Journal of infection and public health

    2023  Volume 16, Issue 6, Page(s) 955–963

    Abstract: Background: The treatment of acute bacterial skin and skin structure infections (ABSSSI) usually involves intravenous (i.v.) antibiotics requiring hospitalisation and increasing hospital costs. Since 2014, dalbavancin is approved for ABSSSIs treatment. ... ...

    Abstract Background: The treatment of acute bacterial skin and skin structure infections (ABSSSI) usually involves intravenous (i.v.) antibiotics requiring hospitalisation and increasing hospital costs. Since 2014, dalbavancin is approved for ABSSSIs treatment. However, evidence of its health economic impact on the German healthcare system is still limited.
    Methods: Diagnosis-related groups (DRG) based cost analysis was used to evaluate real-world data (RWD) from a German tertiary care center. All patients treated with i.v. antibiotics in the Department of Dermatology and Venereology at the University Hospital of Cologne were included to detect potential cost savings from a payer perspective. Thus, for the inpatient care German diagnosis-related groups (G-DRG) tariffs, length of stay (LOS), main- and secondary DRG-diagnoses and for the outpatient setting 'Einheitlicher Bewertungsmaßstab' (EBM) codes were evaluated.
    Results: This retrospective study identified 480 inpatient cases treated for ABSSSI between January 2016 until December 2020. Complete cost data were available for 433 cases and the detection of long-hospital-stay patients based on surcharges for exceeding the upper limit LOS led to 125 cases (29%) including 67 females (54%) and 58 males (46%) with an overall mean age of 63.6 years; all treated for International Classification of Diseases (ICD -10th revision) code A46 'erysipelas'. A sub-analysis focussed on DRG J64B with a total of 92 cases exceeding the upper limit LOS by a median of 3 days resulted in a median surcharge of €636 (mean value €749; SD €589; IQR €459-€785) per case. In comparison, we calculated outpatient treatment costs of approximately €55 per case. Thus, further treatment of these patients in an outpatient setting before exceeding the upper limit LOS might result in a cost-saving potential of approximately €581 per case.
    Conclusion: Dalbavancin appears a cost-efficient option to reduce inpatient treatment costs by transitioning to an outpatient setting of patients with ABSSSI potentially exceeding the upper limit LOS.
    MeSH term(s) Male ; Female ; Humans ; Middle Aged ; Retrospective Studies ; Inpatients ; Cost Savings ; Skin Diseases, Bacterial/drug therapy ; Anti-Bacterial Agents ; Ambulatory Care
    Chemical Substances dalbavancin (808UI9MS5K) ; Anti-Bacterial Agents
    Language English
    Publishing date 2023-04-20
    Publishing country England
    Document type Journal Article
    ZDB-ID 2467587-8
    ISSN 1876-035X ; 1876-0341
    ISSN (online) 1876-035X
    ISSN 1876-0341
    DOI 10.1016/j.jiph.2023.04.015
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  9. Article ; Online: Focal Therapy for Renal Cancer: Comparative Trends in the USA and Germany from 2006 to 2020 and Analysis of the German Health Care Landscape.

    Flegar, Luka / Thoduka, Smita George / Mahnken, Andreas H / Figiel, Jens / Heers, Hendrik / Aksoy, Cem / Eisenmenger, Nicole / Groeben, Christer / Huber, Johannes / Zacharis, Aristeidis

    Urologia internationalis

    2023  Volume 107, Issue 4, Page(s) 396–405

    Abstract: Introduction: The aim of the study was to investigate trends of FT for in-patient treatment of renal RCC in the USA and Germany.: Methods: We analyzed the SEER database for the USA and the nationwide German hospital billing database each from 2006 to ...

    Abstract Introduction: The aim of the study was to investigate trends of FT for in-patient treatment of renal RCC in the USA and Germany.
    Methods: We analyzed the SEER database for the USA and the nationwide German hospital billing database each from 2006 to 2019 for a RCC diagnosis in combination with FT, radical nephrectomy, and partial nephrectomy. FT was defined as radiofrequency ablation (RFA) or cryotherapy. Linear regression analysis was performed to detect changes over time.
    Results: For the USA, we included 7,318 FT cases. The share of FT increased from 2.4% in 2006 to 6.4% in 2019 (p < 0.001). For Germany, we identified 2,920 FT cases. The share of FT increased from 0.7% in 2006 to 2.0% in 2019 (p < 0.001). The number of RFAs in the USA steadily increased by 227% from a total of 93 in 2006 to 304 in 2019 while the number of cryotherapies in the USA steadily increased by 289% from a total of 127 in 2006 to 494 in 2019 (p < 0.001). The number of RFAs in Germany increased by 344% from a total of 59 in 2006 to 262 in 2019 (p < 0.001) while the number of cryotherapies steadily increased by 43% from a total of 54 in 2006 to 77 in 2019 (p < 0.001). In Germany, RFA is significantly more performed than cryotherapy while in the USA cryotherapy is more frequently applied.
    Conclusion: We observed a constant increase of FT in the USA and Germany for RCC in-patient treatment with a higher share in the USA.
    MeSH term(s) Humans ; United States ; Male ; Carcinoma, Renal Cell/surgery ; Kidney Neoplasms/epidemiology ; Kidney Neoplasms/surgery ; Kidney ; Nephrectomy ; Delivery of Health Care ; Prostatic Neoplasms/surgery ; Treatment Outcome
    Language English
    Publishing date 2023-01-26
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 204045-1
    ISSN 1423-0399 ; 0042-1138
    ISSN (online) 1423-0399
    ISSN 0042-1138
    DOI 10.1159/000528559
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  10. Article ; Online: Adoption of Lutetium-

    Flegar, Luka / Thoduka, Smita George / Librizzi, Damiano / Luster, Markus / Zacharis, Aristeidis / Heers, Hendrik / Eisenmenger, Nicole / Ahmadzadehfar, Hojjat / Eiber, Matthias / Weber, Wolfgang / Groeben, Christer / Huber, Johannes

    European journal of nuclear medicine and molecular imaging

    2023  Volume 50, Issue 7, Page(s) 2188–2195

    Abstract: Purpose: This study is to investigate the adoption and current trends of Lutetium-: Methods: We analyzed data from the reimbursement.INFO tool based on German hospitals' quality reports for Lutetium-: Results: General therapy with open ... ...

    Abstract Purpose: This study is to investigate the adoption and current trends of Lutetium-
    Methods: We analyzed data from the reimbursement.INFO tool based on German hospitals' quality reports for Lutetium-
    Results: General therapy with open radionuclides increased from 2006 to 2020. We identified a total of 12,553
    Conclusion: Treatment of mCRPC with
    MeSH term(s) Male ; Humans ; Prostatic Neoplasms, Castration-Resistant/radiotherapy ; Prostatic Neoplasms, Castration-Resistant/pathology ; Prostate-Specific Antigen ; Lutetium/therapeutic use ; Radioisotopes/therapeutic use ; Germany/epidemiology ; Heterocyclic Compounds, 1-Ring/therapeutic use ; Dipeptides ; Treatment Outcome ; Retrospective Studies
    Chemical Substances Prostate-Specific Antigen (EC 3.4.21.77) ; Lutetium (5H0DOZ21UJ) ; Radioisotopes ; Heterocyclic Compounds, 1-Ring ; Dipeptides
    Language English
    Publishing date 2023-02-24
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 8236-3
    ISSN 1619-7089 ; 0340-6997 ; 1619-7070
    ISSN (online) 1619-7089
    ISSN 0340-6997 ; 1619-7070
    DOI 10.1007/s00259-023-06139-x
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