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Article: Listening to music prior to bronchoscopy reduces anxiety - a randomised controlled trial.

Jeppesen, Elisabeth / Pedersen, Carsten M / Larsen, Klaus R / Walsted, Emil S / Rehl, Anne / Ehrenreich, Julie / Schnoor, Sascha / Backer, Vibeke

European clinical respiratory journal

2019 Volume 6, Issue 1, Page(s) 1583517

Abstract: ... ...

Abstract	Background
Language	English
Publishing date	2019-03-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	2834928-3
ISSN	2001-8525
ISSN	2001-8525
DOI	10.1080/20018525.2019.1583517
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: The prevalence of ALK rearrangement in pulmonary adenocarcinomas in an unselected Caucasian population from a defined catchment area: impact of smoking.

Skov, Birgit G / Clementsen, Paul / Larsen, Klaus R / Sørensen, Jens B / Mellemgaard, Anders

Histopathology

2017 Volume 70, Issue 6, Page(s) 889–895

Abstract: Aims: To assess the prevalence of EML4-ALK rearrangement gene measured by immunohistochemistry in an unselected population-based consecutive cohort of patients with adenocarcinoma of the lung (ACL), and the correlation with smoking history, thyroid ... ...

Abstract	Aims: To assess the prevalence of EML4-ALK rearrangement gene measured by immunohistochemistry in an unselected population-based consecutive cohort of patients with adenocarcinoma of the lung (ACL), and the correlation with smoking history, thyroid transcription factor 1 (TTF1), gender and age. Methods and results: All patients diagnosed in the population of the greater Copenhagen area were included, irrespective of gender, age, smoking habits, stage or type of available diagnostic material. Tumours were stained with immunohistochemistry (clone 5A4). Immunohistochemistry-positive tumours were tested by fluorescence in-situ hybridization (FISH). During a 16-month period, 760 patients in the population were diagnosed with ACL. In 2.6% there was insufficient material for ALK testing (20 of 760). Eleven per cent of the remaining 740 ACL patients were never smokers, 43% were ex-smokers smokers and 46% were current smokers. Fourteen patients [1.9%, 95% confidence interval (CI) = 1.1-3.2] were ALK-positive by immunohistochemistry. Nine of 82 never-smokers (11%, 95% CI = 5.9-19.6) and five of 652 ex- or current smokers (0.8%, 95% CI = 0.4-2.1) were ALK-positive. Only two ALK-positive patients were found among 586 heavy smokers (> 15 pack-years) (0.3%, 95% CI = 0.09-1.2). Thirteen of the 14 immunohistochemistry-positive patients were FISH-positive. All ALK-positive tumours were TTF1-positive. The number needed to test (NNT) to identify one ALK positive patient was 9, 22 and 293 among never smokers, light and heavy smokers, respectively. Conclusions: Immunohistochemical analysis of ALK rearrangement was possible in 97.4% of patients. ALK rearrangement was found primarily in never smokers. NNT to identify one ALK-positive patient was 9, 22 and 293 among never smokers, light and heavy smokers, respectively.
MeSH term(s)	Adenocarcinoma/genetics ; Adenocarcinoma/metabolism ; Adenocarcinoma of Lung ; Adult ; Aged ; DNA-Binding Proteins/biosynthesis ; European Continental Ancestry Group ; Female ; Gene Rearrangement ; Humans ; Immunohistochemistry ; In Situ Hybridization, Fluorescence ; Lung Neoplasms/genetics ; Lung Neoplasms/metabolism ; Male ; Middle Aged ; Oncogene Proteins, Fusion/genetics ; Smoking/adverse effects ; Transcription Factors
Chemical Substances	DNA-Binding Proteins ; EML4-ALK fusion protein, human ; Oncogene Proteins, Fusion ; TTF1 protein, human ; Transcription Factors
Language	English
Publishing date	2017-02-09
Publishing country	England
Document type	Journal Article
ZDB-ID	131914-0
ISSN	1365-2559 ; 0309-0167
ISSN (online)	1365-2559
ISSN	0309-0167
DOI	10.1111/his.13148
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Article: Bronchoscopy as a supplement to computed tomography in patients with haemoptysis may be unnecessary.

Nielsen, Klaus / Gottlieb, Magnus / Colella, Sara / Saghir, Zaigham / Larsen, Klaus R / Clementsen, Paul F

European clinical respiratory journal

2016 Volume 3, Page(s) 31802

Abstract: Background: Haemoptysis is a common symptom and can be an early sign of lung cancer. Careful investigation of patients with haemoptysis may lead to early diagnosis. The strategy for investigation of these patients, however, is still being debated.: ... ...

Abstract	Background: Haemoptysis is a common symptom and can be an early sign of lung cancer. Careful investigation of patients with haemoptysis may lead to early diagnosis. The strategy for investigation of these patients, however, is still being debated. Objectives: We studied whether the combination of computed tomography (CT) and bronchoscopy had a higher sensitivity for malignant and non-malignant causes of haemoptysis than CT alone. Methods: The study was a retrospective, non-randomised, two-centre study and included patients who were referred from primary care for the investigation of haemoptysis. Results: A total of 326 patients were included in the study (mean age 60.5 [SD 15.3] years, 63.3% male). The most common aetiologies of haemoptysis were cryptogenic (52.5%), pneumonia (16.3%), emphysema (8.0%), bronchiectasis (5.8%) and lung cancer (4.0%). In patients diagnosed with lung cancer, bronchoscopy, CT and the combination of bronchoscopy and CT had a sensitivity of 0.61, 0.92 (p<0.05) and 0.97 (p=0.58), respectively. In patients with non-malignant causes of haemoptysis, most aetiologies were diagnosed by CT and comprised mainly pneumonia, emphysema and bronchiectasis. Bronchoscopy did not reveal these conditions and the sensitivity to these conditions was not increased by combining CT and bronchoscopy. Conclusions: CT can stand alone as a diagnostic workup for patients with haemoptysis referred to an outpatient clinic. Bronchoscopy does not identify any malignant aetiologies not already diagnosed by CT. Combining the two test modalities does not result in a significant increase in sensitivity for malignant or non-malignant causes of haemoptysis.
Language	English
Publishing date	2016-06-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	2834928-3
ISSN	2001-8525
ISSN	2001-8525
DOI	10.3402/ecrj.v3.31802
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Article ; Online: Bronchoscopic mucosal cryobiopsies as a method for studying airway disease.

Hvidtfeldt, Morten / Pulga, Alexis / Hostrup, Morten / Sanden, Caroline / Mori, Michiko / Bornesund, Daisy / Larsen, Klaus R / Erjefält, Jonas S / Porsbjerg, Celeste

Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology

2018 Volume 49, Issue 1, Page(s) 27–34

Abstract: Background: Investigating disease mechanisms and treatment responses in obstructive airway diseases with invasive sampling are hampered by the small size and mechanical artefacts that conventional forceps biopsies suffer from. Endoscopic cryobiopsies ... ...

Abstract	Background: Investigating disease mechanisms and treatment responses in obstructive airway diseases with invasive sampling are hampered by the small size and mechanical artefacts that conventional forceps biopsies suffer from. Endoscopic cryobiopsies are larger and more intact and are being increasingly used. However, the technique has not yet been explored for obtaining mucosa biopsies. Objective: To investigate differences in size and quality of endobronchial mucosal biopsies obtained with cryotechnique and forceps. Further, to check for eligibility of cryobiopsies to be evaluated with immunohistochemistry and in situ hybridization and to investigate tolerability and safety of the technique. Methods: Endobronchial mucosal biopsies were obtained with cryotechnique and forceps from patients with haemoptysis undergoing bronchoscopy and evaluated by quantitative morphometry, automated immunohistochemistry and in situ hybridization. Results: A total of 40 biopsies were obtained from 10 patients. Cross-sectional areas were threefold larger in cryobiopsies (median: 3.08 mm Conclusion and clinical relevance: By yielding significantly larger and more intact biopsies, the cryotechnique represents a valuable new research tool to explore the bronchi in airway disease. Ultimately with the potential to create better understanding of underlying disease mechanisms and improvement of treatments.
MeSH term(s)	Adult ; Aged ; Asthma/diagnosis ; Asthma/metabolism ; Asthma/pathology ; Biopsy ; Bronchoscopy ; Cross-Sectional Studies ; Female ; Humans ; Immunohistochemistry ; In Situ Hybridization ; Male ; Middle Aged ; Pilot Projects ; Pulmonary Disease, Chronic Obstructive/diagnosis ; Pulmonary Disease, Chronic Obstructive/metabolism ; Pulmonary Disease, Chronic Obstructive/pathology ; Respiratory Mucosa/metabolism ; Respiratory Mucosa/pathology
Language	English
Publishing date	2018-10-12
Publishing country	England
Document type	Clinical Trial ; Journal Article
ZDB-ID	645204-8
ISSN	1365-2222 ; 0954-7894 ; 0960-2178
ISSN (online)	1365-2222
ISSN	0954-7894 ; 0960-2178
DOI	10.1111/cea.13281
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Zs.A 767: Show issues

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Article ; Online: Effect of postsurgical rehabilitation programmes in patients operated for lung cancer: A systematic review and meta-analysis.

Sommer, Maja S / Staerkind, Maja E B / Christensen, Jan / Vibe-Petersen, Jette / Larsen, Klaus R / Holst Pedersen, Jesper / Langberg, Henning

Journal of rehabilitation medicine

2018 Volume 50, Issue 3, Page(s) 236–245

Abstract: Objective: To review the evidence concerning the effects of postoperative exercise interventions on exercise capacity and health-related quality of life following resection for non-small cell lung cancer, and to review whether different initiation times ...

Abstract	Objective: To review the evidence concerning the effects of postoperative exercise interventions on exercise capacity and health-related quality of life following resection for non-small cell lung cancer, and to review whether different initiation times of exercise produce different effects on exercise capacity. Data sources: Comprehensive literature search of MEDLINE, Embase, CENTRAL, CINAHL and PEDro. Study selection: Randomized controlled trials examining the effects of exercise interventions were eligible for inclusion. Data extraction: Postoperative outcome measurements were extracted and the quality of evidence was graded using Grading of Recommendations Assessment, Development and Evaluation (GRADE) Working Group. Data synthesis: Four randomized controlled trials were identified involving 262 participants. Short-term follow-up (12-20 weeks) showed significantly higher exercise capacity and physical component of health-related quality of life in the intervention group (standardized mean difference (SMD) 0.48; 95% confidence interval (CI) 0.04-0.93) compared with the control group (SMD 0.50; 95% CI 0.19-0.82). There was no difference between the effect of late- and early-initiated exercise intervention. Conclusion: Exercise has a small-to-moderate effect at short-term follow-up on exercise capacity and the physical component of health-related quality of life in patients operated for lung cancer. The long-term effects of exercise capacity are unknown. Early-initiated exercise programmes (2 weeks post-operation) did not show an effect on exercise capacity. These findings should be interpreted with caution.
MeSH term(s)	Aged ; Carcinoma, Non-Small-Cell Lung/pathology ; Carcinoma, Non-Small-Cell Lung/rehabilitation ; Carcinoma, Non-Small-Cell Lung/surgery ; Exercise Therapy/methods ; Female ; Humans ; Lung Neoplasms/pathology ; Lung Neoplasms/rehabilitation ; Lung Neoplasms/surgery ; Middle Aged ; Postoperative Period ; Quality of Life/psychology ; Randomized Controlled Trials as Topic
Language	English
Publishing date	2018-02-28
Publishing country	Sweden
Document type	Journal Article ; Meta-Analysis ; Review
ZDB-ID	2039427-5
ISSN	1651-2081 ; 1651-2235 ; 0891-060X ; 1650-1977
ISSN (online)	1651-2081 ; 1651-2235
ISSN	0891-060X ; 1650-1977
DOI	10.2340/16501977-2292
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Article: Music does not alter anxiety in patients with suspected lung cancer undergoing bronchoscopy: a randomised controlled trial.

Jeppesen, Elisabeth / Pedersen, Carsten M / Larsen, Klaus R / Rehl, Anne / Bartholdy, Karen / Walsted, Emil S / Backer, Vibeke

European clinical respiratory journal

2016 Volume 3, Page(s) 33472

Abstract: Background: The use of music to relieve anxiety has been examined in various studies, but the results are inconclusive.: Methods: From April to October 2015, 160 patients undergoing examination of pulmonary nodules were randomly assigned to MusiCure ... ...

Abstract	Background: The use of music to relieve anxiety has been examined in various studies, but the results are inconclusive. Methods: From April to October 2015, 160 patients undergoing examination of pulmonary nodules were randomly assigned to MusiCure or no music. MusiCure was administered through earplugs to ensure blinding of the staff and was played from admission to the operating theatre to the end of the bronchoscopy. Spielberger's State-Trait Anxiety Inventory (STAI) was administered on admission, immediately before bronchoscopy, and on discharge. Secondary outcomes were Results: The STAI scores were similar on admission, but after a 10-min wait in the operating theatre, scores varied significantly between patients with and without music, with lower scores in the music group [median (interquartile range, IQR) 35 (18) vs. 43 (25); Conclusions: Ten minutes with MusiCure does not alter anxiety when adjusting for baseline anxiety and sex. The current study indicates that this field of research has many confounders.
Language	English
Publishing date	2016-11-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	2834928-3
ISSN	2001-8525
ISSN	2001-8525
DOI	10.3402/ecrj.v3.33472
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Article ; Online: Development and validation of a theoretical test in endosonography for pulmonary diseases.

Savran, Mona M / Clementsen, Paul Frost / Annema, Jouke T / Minddal, Valentina / Larsen, Klaus R / Park, Yoon Soo / Konge, Lars

Respiration; international review of thoracic diseases

2014 Volume 88, Issue 1, Page(s) 67–73

Abstract: Background: Theoretical testing provides the necessary foundation to perform technical skills. Additionally, testing improves the retention of knowledge.: Objectives: The aims of this study were to develop a multiple-choice test in endosonography for ...

Abstract	Background: Theoretical testing provides the necessary foundation to perform technical skills. Additionally, testing improves the retention of knowledge. Objectives: The aims of this study were to develop a multiple-choice test in endosonography for pulmonary diseases and to gather validity evidence for this test. Methods: Initially, 78 questions were constructed after informal conversational interviews with 4 international experts in endosonography. The clarity and content validity of the questions were tested using a Delphi-like approach. Construct validity was explored by administering the test to 3 groups with different levels of endosonography experience: 27 medical students, 18 respiratory physicians with limited endosonography experience, and 14 experts in endosonography. Results: Two Delphi iterations reduced the test to 52 questions. After item analysis, the final test consisted of 46 questions with a mean item discrimination of 0.47 and a mean item difficulty of 0.63. The internal consistency reliability was calculated at 0.91. The 3 groups performed significantly differently (ANOVA: p < 0.001), and post hoc tests were significant. The experts performed significantly more consistently than the novices (p = 0.037) and the intermediates (p < 0.001). Conclusions: This study provides a theoretical test in endosonography consisting of multiple-choice questions. Validity evidence was gathered, and the test demonstrated content and construct validity.
MeSH term(s)	Clinical Competence/standards ; Diagnostic Techniques, Respiratory System/standards ; Educational Measurement ; Endosonography/standards ; Humans ; Lung Diseases/diagnostic imaging ; Reproducibility of Results
Language	English
Publishing date	2014
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Validation Studies
ZDB-ID	206674-9
ISSN	1423-0356 ; 0025-7931
ISSN (online)	1423-0356
ISSN	0025-7931
DOI	10.1159/000362884
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Article ; Online: Perioperative Rehabilitation in Operable Lung Cancer Patients (PROLUCA): A Feasibility Study.

Sommer, Maja S / Trier, Karen / Vibe-Petersen, Jette / Missel, Malene / Christensen, Merete / Larsen, Klaus R / Langer, Seppo W / Hendriksen, Carsten / Clementsen, Paul Frost / Pedersen, Jesper H / Langberg, Henning

Integrative cancer therapies

2016 Volume 15, Issue 4, Page(s) 455–466

Abstract: Introduction Surgical resection in patients with non-small cell lung cancer (NSCLC) may be associated with significant morbidity, functional limitations, and decreased quality of life. Objectives The safety and feasibility of a preoperative and early ... ...

Abstract	Introduction Surgical resection in patients with non-small cell lung cancer (NSCLC) may be associated with significant morbidity, functional limitations, and decreased quality of life. Objectives The safety and feasibility of a preoperative and early postoperative rehabilitation program in patients operated for NSCLC was determined in a nonhospital setting, with focus on high-intensity interval exercise. Methods Forty patients with biopsy-proven NSCLC stages I to IIIa referred for surgical resection at the Department of Cardiothoracic Surgery RT, Rigshospitalet, University of Copenhagen, were randomly assigned to 1 of 4 groups (3 intervention groups and 1 control group). The preoperative intervention consisted of a home-based exercise program, while the postoperative exercise program comprised a supervised group exercise program involving resistance and high-intensity interval cardiorespiratory exercise 2 hours weekly for 12 weeks combined with individual counseling. The study endpoints were inclusion rate, adherence, and number of adverse events. Results Forty patients (of 124 screened; 32%) were included and randomized into the 4 groups. The postoperative exercise was completed by 73% of the patients randomized to this intervention. No adverse events were observed, indicating that the early postoperative exercise program is safe. The preoperative home-based exercise program was not feasible due to interfering diagnostic procedures and fast-track surgery that left only 1 to 2 weeks between diagnosis and surgery. Conclusion The early postoperative exercise program for patients with NSCLC was safe and feasible, but in a fast-track set up, a preoperative home-based exercise program was not feasible for this population.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Carcinoma, Non-Small-Cell Lung/rehabilitation ; Carcinoma, Non-Small-Cell Lung/surgery ; Exercise/physiology ; Exercise Therapy/methods ; Feasibility Studies ; Female ; Humans ; Lung Neoplasms/rehabilitation ; Lung Neoplasms/surgery ; Male ; Middle Aged ; Perioperative Period/rehabilitation ; Quality of Life
Language	English
Publishing date	2016
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2182320-0
ISSN	1552-695X ; 1534-7354
ISSN (online)	1552-695X
ISSN	1534-7354
DOI	10.1177/1534735416635741
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Article ; Online: Changes in Health-Related Quality of Life During Rehabilitation in Patients With Operable Lung Cancer: A Feasibility Study (PROLUCA).

Sommer, Maja S / Trier, Karen / Vibe-Petersen, Jette / Christensen, Karl B / Missel, Malene / Christensen, Merete / Larsen, Klaus R / Langer, Seppo W / Hendriksen, Carsten / Clementsen, Paul F / Pedersen, Jesper H / Langberg, Henning

Integrative cancer therapies

2016 Volume 17, Issue 2, Page(s) 388–400

Abstract: Introduction: Surgical resection in patients with non-small cell lung cancer (NSCLC) may be associated with significant morbidity, functional limitations, and decreased quality of life.: Objectives: The objective is to present health-related quality ... ...

Abstract	Introduction: Surgical resection in patients with non-small cell lung cancer (NSCLC) may be associated with significant morbidity, functional limitations, and decreased quality of life. Objectives: The objective is to present health-related quality of life (HRQoL) changes over time before and 1 year after surgery in patients with NSCLC participating in a rehabilitation program. Methods: Forty patients with NSCLC in disease stage I to IIIa, referred for surgical resection at the Department of Cardiothoracic Surgery RT, Rigshospitalet, were included in the study. The rehabilitation program comprised supervised group exercise program, 2 hours weekly for 12 weeks, combined with individual counseling. The study endpoints were self-reported HRQoL (Functional Assessment of Cancer Therapy-Lung, European Organization for Research and Treatment in Cancer-Quality of Life Questionnaire-QLQ-C30, Short-Form-36) and self-reported distress, anxiety, depression, and social support (National Comprehensive Cancer Network Distress Thermometer, Hospital Anxiety and Depression Scale, Multidimensional Scale of Perceived Social Support), measured presurgery, postintervention, 6 months, and 1 year after surgery. Results: Forty patients were included, 73% of whom completed rehabilitation. Results on emotional well-being ( P < .0001), global quality of life ( P = .0032), and mental health component score ( P = .0004) showed an overall statistically significant improvement during the study. Conclusion: This feasibility study demonstrated that global quality of life, mental health, and emotional well-being improved significantly during the study, from time of diagnosis until 1 year after resection, in patients with NSCLC participating in rehabilitation.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Anxiety/psychology ; Carcinoma, Non-Small-Cell Lung/psychology ; Carcinoma, Non-Small-Cell Lung/rehabilitation ; Depression/psychology ; Emotions/physiology ; Exercise/psychology ; Exercise Therapy/methods ; Feasibility Studies ; Female ; Humans ; Lung Neoplasms/psychology ; Lung Neoplasms/rehabilitation ; Male ; Middle Aged ; Neoplasm Staging/methods ; Quality of Life/psychology ; Social Support ; Surveys and Questionnaires
Language	English
Publishing date	2016-10-03
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2182320-0
ISSN	1552-695X ; 1534-7354
ISSN (online)	1552-695X
ISSN	1534-7354
DOI	10.1177/1534735416668258
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Article ; Online: Airway responses to eucapnic hyperpnea, exercise, and methacholine in elite swimmers.

Pedersen, Lars / Winther, Simon / Backer, Vibeke / Anderson, Sandra D / Larsen, Klaus R

Medicine and science in sports and exercise

2008 Volume 40, Issue 9, Page(s) 1567–1572

Abstract: Purpose: The International Olympic Committee Medical Commission (IOC-MC) requires athletes to provide the result of an objective test to support a diagnosis of asthma or exercise-induced bronchoconstriction (EIB) if they want to inhale a beta-2-agonist. ...

Abstract	Purpose: The International Olympic Committee Medical Commission (IOC-MC) requires athletes to provide the result of an objective test to support a diagnosis of asthma or exercise-induced bronchoconstriction (EIB) if they want to inhale a beta-2-agonist. The purpose of the study was to evaluate the airway response to a methacholine challenge and to hyperpnea induced by exercise in the field and in the laboratory or that induced voluntarily by eucapnic hyperpnea in a group of female elite swimmers. Methods: Sixteen female nonasthmatic elite swimmers performed a eucapnic voluntary hyperpnea (EVH) test, a field-based exercise test (FBT), a laboratory-based exercise test (LBT), and a methacholine challenge. The criteria suggested by the IOC-MC were used to define a positive response to the challenges (EVH, field test, and laboratory test: minimum 10% decrease in FEV1; methacholine: PD20 < or = 2 micromol). Results: Eight swimmers (50%) had at least one positive test to hyperpnea. Five were identified with the EVH test, four with FBT, and four with LBT. None were identified using methacholine. Three swimmers with airway hyperresponsiveness to exercise would have been identified using a higher cutoff for methacholine (PD20 < or = 8 micromol). Conclusions: The EVH test is the test that diagnoses most swimmers with an abnormal response to hyperpnea, but not all cases of EIB are identified with the EVH test. Performing a methacholine test using IOC-MC's cutoff value does not improve the chances of diagnosing EIB. We recommend performing the EVH test when diagnosing and evaluating EIB in elite swimmers and if EVH test negative then proceeding to a strenuous LBT.
MeSH term(s)	Adolescent ; Airway Resistance/drug effects ; Asthma/diagnosis ; Bronchi/physiopathology ; Bronchoconstrictor Agents/administration & dosage ; Bronchoconstrictor Agents/pharmacology ; Bronchoconstrictor Agents/therapeutic use ; Exercise ; Female ; Humans ; Hyperventilation/physiopathology ; Methacholine Chloride/administration & dosage ; Methacholine Chloride/pharmacology ; Methacholine Chloride/therapeutic use ; Swimming ; Young Adult
Chemical Substances	Bronchoconstrictor Agents ; Methacholine Chloride (0W5ETF9M2K)
Language	English
Publishing date	2008-09
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	603994-7
ISSN	1530-0315 ; 0195-9131 ; 0025-7990
ISSN (online)	1530-0315
ISSN	0195-9131 ; 0025-7990
DOI	10.1249/MSS.0b013e31875719a
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