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Health

Ex-CEO Claims She Was Fired For Being ‘Disabled’ After Being Diagnosed With Breast Cancer

Kathleen Mason, ex-CEO of Tuesday Morning (Credit: Lubbock Avalanche-Journal)

Shortly after informing the board of directors of her breast cancer, former CEO of Tuesday Morning was ousted as the head of the furniture retail company last June. Kathleen Mason, who served as CEO for 12 years, has filed a lawsuit against the company, claiming she was discriminated against.

The Wall Street Journal reports this may be an unprecedented lawsuit among cases over alleged discrimination:

While employee suits over alleged discrimination are common, it is rare for one to come from a former CEO. Ms. Mason’s lawsuit, filed on Thursday in county court in Dallas, claims the board wrongfully dismissed her because “it regarded her as being disabled” after she informed some fellow directors about her diagnosis.

Mason, 64 years old, said that she informed board members of her cancer in March and she was asked to resign in mid-May. The board eventually released a letter criticizing Mason hours before she was fired that read, “[she] led an extraordinary destruction of shareholder value.” The company denies her allegations, noting the company’s stock fell nearly 60 percent before she was fired.

Though the law is very clear that gender and health discrimination is illegal, women in the workplace still regularly face repercussions over getting pregnant, taking birth control, or contracting diseases that affect predominantly women. And based on the strong reactions to Angelina Jolie’s recent news that she had a preventative double mastectomy to reduce her risk of breast cancer, it’s clear that the stigma over health issues that affect a woman’s anatomy still exists.

It is unclear whether Mason experienced her own discrimination, but the issue is hardly a women-only issue. Examples abound where employees have lost their jobs over perceived weakness after they developed cancer or recovered from surgery.

Health

Americans Who Battle Cancer Are Twice As Likely To Go Bankrupt, Even If They Have Health Insurance

Cancer patients are much more likely to go bankrupt than Americans who aren’t faced with a cancer diagnosis, a new study finds. Even the Americans who have access to health insurance aren’t necessarily safe from bankruptcy, since the high cost of treating cancer can still put an untenable strain their finances.

A team of researchers in Washington state collected data from nearly 400,000 adults, evenly split between those who had been treated for cancer and those who were cancer-free. After checking to see which of those adults had filed for bankruptcy between 1995 and 2009, the researchers found that cancer patients were 2.5 times as likely to go bankrupt in that period.

Although the study didn’t specifically look at insurance coverage, previous research has demonstrated that the Americans who cite major health issues as the reason they filed for bankruptcy are actually often insured. One 2006 study found that more than 60 percent of bankruptcies in the United States are due to high medical bills, and in those cases, three-quarters of those Americans had insurance when they got sick. NBC News interviewed one cancer patient who found herself in this situation, even though she was employed and insured when she first got her diagnosis:

That rings true for Janet Literski, 57, who had purchased health insurance as an independent contractor working in sales. When she was diagnosed with non-Hodgkin’s lymphoma in 2008 Literski discovered her insurance covered only part of her surgical costs and none of her diagnostic tests. Then there were co-payments and deductibles. By the time she was diagnosed with pancreatic cancer two years later, she was about $150,000 in medical debt.

In 2011, no longer able to work, Literski and her disabled husband filed for bankruptcy. “It was a gut wrenching decision because you feel like a personal failure, and that makes me angry because I had tried to do everything right,” Literski says. “I had health insurance, I was working.”

Literski is now covered by Medicaid and receives disability payments and though she hasn’t been told she’s in remission, she says she is “healthy enough.”

[The study's lead author, Dr. Scott Ramsey,] says cancer centers need to do a better job of assessing each patient’s financial status, offering credit counseling, and managing patient care.

Even bigger disparities emerged when the researchers broke down the cancer patients in their study by different demographics. The younger groups were up to 10 times more likely to go broke than the older patients, and non-white women were the most likely to run out of money.The cancer that is associated with the highest risk of bankruptcy is thyroid cancer — likely because that disease mostly affects younger women. On the other hand, older men with prostate cancer are the least likely to reach financial rock bottom.

Ramsey and his researchers first presented their research in 2011, and their final findings were published in the Health Affairs journal this week. The timing of the study’s release coincides with some recent pressure to help lower the cost of cancer drugs. Last month, a group of over 100 doctors criticized Big Pharma companies for making “life-saving” cancer drugs too expensive for Americans to afford. The doctors asserted that the “unsustainable drug prices” were “causing harm to patients,” and urged reforms in this area to ensure that cancer patients don’t have to go without the treatment they need.

Cancer patients have also been recently caught up in the budget battles resulting from sequestration. At the end of April, cancer clinics blasted Congress for taking legislative action to restore the sequester cuts that were causing airport delays rather than working to address the cuts that are undermining Americans’ chemotherapy treatment. As a result of the automatic budget cuts, some Americans are being forced to delay their chemotherapy, and some cancer clinics may even be forced to close their doors.

Alyssa

Why I Hope Angelina Jolie Considers Continuing To Do Nude Scenes Post Her Double Mastectomy

Given that there’s much more pressure on women to take their clothes off for roles in film, theater, and television than men, I wouldn’t normally go on the record rooting for a female actor to do nude scenes. But following Angelina Jolie’s announcement today that, in response to learning that she has a BRCA1 gene mutation that increases her likelihood of developing breast and ovarian cancer, she had a preventative double mastectomy and breast reconstruction surgery, I’m hoping that Jolie won’t feel like she can’t do nude scenes in the future, if she feels drawn to roles that include nude or sex scenes.

Jolie is a strong dramatic actress, and is justly recognized for her international humanitarian and human rights work. But she also is also a strikingly good-looking woman whose film career has included a number of emotionally and physically naked sex scenes. And it’s because of that, as Amanda Hess wrote in Slate, that some observers are reacting to the news of her decision to take preventative health measures as if her career is over, or as if it’s a sign of some sort of desperation:

Commenters snarked that Jolie had received a “boob job.” Some suggested that her medical emergency was just a tabloid ruse to cover up elective breast implants. Others morbidly asked after the whereabouts of the breast tissue removed from her body. “RIP Angelina’s boobs” was a typical ignorant comment. Said one commenter on a Jezebel post about the op-ed, “How many guys stopped reading as soon as they realized Angelina Jolie has no breasts—she’s dead to me!”…perversely, some fans feel as if a part of Jolie has been stolen from them. One well-meaning but misguided commenter told me on Twitter yesterday: “Happy to hear she’s giving herself much better odds. As a guy, I will miss her lovely curves though.” (The reconstructive surgery she described presumably restored her curves.)

But as Hess pointed out, and Jolie herself clarified in her New York Times Op-Ed, her children “can see my small scars and that’s it. Everything else is just Mommy, the same as she always was.”

And I wonder if there might be some social value to mass audiences seeing those scars, too, and seeing that a woman who has them can still be sexual and sexy. It’s not as if pop culture never takes on the issues of women, breast cancer, and sexuality, but they often do so in a way that presents sex as a sign of recovery, or an act of tenderness before death. In Sex and the City, Samantha’s (Kim Cattrall) chemotherapy treatments diminished her famous libido, and when her boyfriend Smith returned from a movie shoot to visit her, they had rather comparatively tender sex to celebrate her recovery and their decision to commit to their relationship. Parenthood followed Kristina Braverman (Monica Potter) through her breast cancer treatments this season, and let her dress up in a hot pink wig for a date with her husband in a sign that her illness may have taken its toll, but it hadn’t robbed her of her of her femininity or her sexuality. And the 2005 romantic comedy The Family Stone included a sex scene between Diane Keaton, playing Sybil Stone, and Craig T. Nelson (who also stars in Parenthood) as her husband Kelly that was one of the few mainstream depictions I can think of a woman with a double mastectomy—but without the kind of reconstructive surgery Jolie experienced—who was treated as sexual and desirable.

Now, if Jolie has decided that she’s done with nude scenes or with sex scenes, that’s entirely her decision, and all of us should respect that. But if she does accept such roles in the future, I hope that she, and the writers and directors she works with, see her scars as a feature of her body, rather that some sort of grotesquerie to be hidden by shot angles or erased in post-production. Mastectomy scars should be treated like a physical characteristic that could inflect characters Jolie plays in the future without requiring major plot alterations or commentary. And it would be good for audiences, particularly of the kind that snarked on Jolie today for her brave revelation, to see that they don’t make her any less stunningly gorgeous.

Health

On Women’s Health Week, Angelina Jolie Goes Public About Her Double Mastectomy

Oscar-winning actress Angelina Jolie shared the story of her preventative double mastectomy, a decision she made after discovering she carries a gene that gives her an extremely high risk of developing breast cancer, in a New York Times op-ed published on Tuesday. Her public announcement coincided with National Women’s Health Week, a government initiative to encourage U.S. women to better safeguard their health and seek out preventative care. In Jolie’s editorial, she explains that she hopes other women might benefit from learning about her experience.

Jolie is one of the few woman who carries a rare gene mutation, BRCA1, that predisposes her to breast and ovarian cancers. While the average woman has about a 12 percent risk of developing breast cancer at some point in her life, those with a BRCA1 mutation have an average 65 percent risk. After Jolie underwent the blood testing that revealed her own genetic mutation, her doctors estimated that she had an 87 percent risk of breast cancer and a 50 percent risk of ovarian cancer.

The actress — whose own mother passed away from cancer — wrote that she decided to take preventative measures with her own six children in mind. “Once I knew that this was my reality, I decided to be proactive and to minimize the risk as much I could,” Jolie writes. She shares step-by-step details about the mastectomy procedure and recovery process in her op-ed.

“I choose not to keep my story private because there are many women who do not know that they might be living under the shadow of cancer,” Jolie explains. She notes that although the word “cancer” still tends to strike fear into people’s hearts, and often produces “a deep sense of powerlessness,” she wants other women to know that they have options. And she also hopes to communicate that the health issues that impact women’s anatomy — even breasts, which have become somewhat of a cultural signifier for femininity — don’t serve to diminish womanhood. “I do not feel any less of a woman. I feel empowered that I made a strong choice that in no way diminishes my femininity,” Jolie notes.

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Health

Drug Makers Will Help Expand Access To The HPV Vaccine By Dropping Prices In Poor Countries

(Credit: Partners In Health)

Two pharmaceutical giants — Merck and GlaxoSmithKline — have announced that they will drop their prices for HPV vaccines that help protect against cervical cancer to about $4.50 per dose for the world’s poorest countries. The move may help tens of millions of girls in dozens of developing nations gain access to life-saving medications that they would previously have been unable to afford.

Although some critics noted that the companies could drop their prices even further, spokespeople for Merck and Glaxo emphasized that they expected the vaccines’ costs to plummett further in the future. That’s particularly significant given that 275,000 women in poor countries die from cervical cancer every year, mainly due to the high costs of preventative medical services:

The low price will initially apply to a few million doses for demonstration projects in Kenya, Ghana, Laos, Madagascar and elsewhere, but Dr. Seth Berkley, the alliance’s chief executive officer, said he hoped that by 2020, 30 million girls in 40 countries would get the vaccine at that price or less.

The vaccines cost about $130 a dose in the United States, and each girl needs three doses. The lowest price that any other agency or government has negotiated, Dr. Berkley said, is the $13 paid by the Pan American Health Organization, which negotiates a bulk price for Latin American countries. [...]

Dr. Berkley described the new prices as a ceiling, and said he expected them to go down as millions more doses were ordered and as rival vaccine makers from lower-cost countries like India and China entered the field. Other companies, including the Serum Institute of India, the world’s largest vaccine manufacturer, are developing papillomavirus vaccines, but at the moment only the Glaxo and Merck vaccines have approval from the World Health Organization.

Combined with robust public outreach efforts to administer the vaccinations, the lower prices could swell the ranks of immunized women in developing nations beyond the U.S.’s current rates, which the Centers for Disease Control (CDC) has deemed “unacceptably low.”

In fact, the financial and medical benefits of the price cut for poor women could be even greater if the shots are given to younger girls aged nine to 13. A recent study published in the Journal of the American Medical Association (JAMA) found that just two doses of the vaccine were enough to immunize girls in that age range, as opposed to the usual three — meaning that women in developing nations could be protected for a lifetime for just $9 or even less.

Drug accessibility in developing nations has always been a major problem in the public health community, since brand name pharmaceutical companies tend to charge much more for their products than residents of such countries can afford. These drug makers also extend the life of their product patents through gimmicks such as adding “inactive ingredients” to the original medications. The Indian Supreme Court recently ruled against pharmaceutical giant Novartis for precisely this, instead siding with a generic drug manufacturer that distributes a much cheaper — but equally effective — version of the brand name company’s cancer drug. Merck and Glaxo’s proactive decision to cut their HPV vaccine prices means that there are even bigger savings in the future as generic drug makers step up their efforts to compete in the pharmaceutical marketplace.

Health

The Surprising Link Between Religious Belief And Health Care Spending

(Credit: The Telegraph)

A new study published in the Journal of the American Medical Association (JAMA) Internal Medicine raises a provocative question: can patients’ religious faith — and the spiritual support given to them by their caregivers — influence their decisions on end-of-life medical services and health care spending? The short answer, according to researchers’ findings, is yes — with some caveats.

Dr. Tracy Balboni of Dana-Farber Cancer Institute in Boston led the new study, which tracked 343 Americans with advanced cancers from its launch in 2002 up through their deaths. The results were striking. Compared to those who reported a lower level of spiritual support, the 43 percent of study participants who reported “high spiritual support” from religious communities were about a third as likely to receive end-of-life (EoL) hospice care, over two and half times more likely to to receive some form of aggressive — and expensive — EoL service (like being put on a ventilator or pursuing additional chemotherapy), and five times more likely to die in a hospital ICU in their last week of life.

Furthermore, patients who self-reported the highest levels of “religious coping” during their final days were 11 times as likely to receive aggressive EoL treatments and 22 times more likely to die in the ICU compared to those with lower levels of religious coping. Those numbers were also elevated for minority populations, particularly African Americans, who are among America’s most religious ethnic groups.

So what’s at the root of these notable trends — and what lessons do they hold for doctors who want to provide their patients with the best care while also reducing the number of unnecessary procedures they must undergo in their last days? Researchers speculate that the numbers may have something to do with religious Americans’ belief in a higher power and the prospect of God working through medical professionals. “One possibility is that religious people consider medicine to be a primary means of divine intervention,” wrote Balboni and her colleagues. They also mused that strong religious community support could foster the desire to “persevere” through “hope found within suffering” — in essence, the mettle to refuse to call it quits.

But as the study’s findings on these religious community-supported patients’ ICU death rates shows, channeling that faith-based will to live into aggressive medical care isn’t necessarily effective — and, to be blunt, it contributes to wasteful health care spending by Americans and public entitlement programs such as Medicare. EoL hospice care isn’t a huge proportion of total health care spending — but aggressive medical interventions for chronically ill elderly Americans on the cusp of death is, with the top five percent of such patients accounting for over $600 billion in health spending every year.

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Health

FDA Pushes For Cancer Warning Labels On Tanning Beds In Effort To Fight Melanoma

(Credit: University of California, San Francisco)

The U.S. Food and Drug Administration (FDA) on Monday took steps to ensure that consumers are aware of the cancer-related risks of using commercial tanning booths. In its proposed rule, the FDA wants the booths “to carry language warning people under the age of 18 about the risks of indoor tanning” and “require manufacturers to meet certain safety and performance requirements before marketing their devices.”

If given final approval, tanning booths would also reclassify the machines themselves to “moderate-risk” products, and give the FDA more power to change their design to make them safer for public use:

Medical groups like the American Academy of Dermatology have been urging the U.S. government to take action on tanning beds for years, citing increases in the number of cases of skin cancer among women in their teens and twenties. Dermatologists say indoor tanning advertisements directly appeal to teenagers’ desire to be attractive.

Currently the machines are classified as low-risk devices, in the same group as bandages and tongue depressors. By increasing their classification to moderate-risk, or class II, devices the FDA proposal could limit the levels of radiation the devices emit and make other changes to their design.

The move comes in the wake of lobbying by public health and medical advocacy groups concerned with the ballooning rates of lethal skin cancers like melanoma. The incidence of such cancers has been steadily rising over the last three decades, and the Centers for Disease Control (CDC) expects over 75,000 Americans to be diagnosed with melanoma this year alone. Clearer warnings on the risks of commercial tanning by American youth is particularly important given that “people who begin tanning younger than age 35 have a 75 percent higher risk of melanoma” and the reality that less than 11 percent of tanning facilities followed FDA’s safety schedule limiting young people’s use of the beds to three times a week at most — in fact, the vast majority of such facilities “would allow teens to use their facilities all seven days for the first week.”

Several states — including Vermont, California, and New Jersey — actually have outright bans on under-18 tanning due to the associated public health risks. Maine Gov. Paul LePage (R) recently vetoed a bill that would enact the same restrictions in his state, parroting tanning bed producers’ and tanning salon owners’ argument that it could actually be riskier for kids to get their tan on in regular sunshine, which also exposes them to UV rays. Those claims were debunked in a 2010 American Association for Cancer Research study, which concluded that the more concentrated rays use in tanning beds are actually more dangerous than normal sunlight.

Health

STUDY: The HPV Vaccine Is 33 Percent More Effective When Given To Younger Girls

According to a new study published in the Journal of the American Medical Association (JAMA), young girls may get the same benefits from less doses of the HPV vaccine compared to older women. Study authors hope that the findings will result in higher rates of girls’ HPV immunization in the U.S., which the Centers for Disease Control (CDC) have deemed “unacceptably low.”

The study finds that giving girls aged nine to 13 two doses of the HPV vaccine — commonly called Gardasil — is enough to immunize them. “Nine to 13-year-old girls make a much better anti-body, a better protective response to the vaccine than 16 to 26 year olds,” said Dr. Simon Dobson, lead study author and University of British Columbia pediatrician. That could potentially convince more American parents to get their children vaccinated by making the process less cumbersome, since the HPV vaccine is usually administered over the course of three doses to older girls and women.

This latest study gives credence to federal officials’ recommendations that girls — and boys — receive the vaccination beginning at age 11 as a preventative measure. Many American parents have ignored those suggestions, pointing to the statistic that most people who are infected with HPV do not develop cancer. However, that’s a risky bet given that there is no way to know who is at risk of contracting cervical cancer from an HPV infection, and who isn’t.

A mere 30 percent of U.S. women between the ages of 19 and 26 have received one or more doses of the HPV vaccine — a percentage that some surveys indicate may fall even further. That may partly be because many parents are swayed by conspiracy theories endorsed by fear-mongering politicians that Gardasil is unsafe — a claim that has been thoroughly and repeatedly debunked by the scientific community.

Health

Cancer Clinics: Congress Should Have Restored Our Sequester Cuts Before Addressing Airport Delays

This past week, Congress approved a measure to restore funding to the Federal Aviation Administration (FAA) after sequester cuts to the national transportation agency disrupted airline travel across the country — but they haven’t taken similar steps to provide relief for other programs that are struggling as a result of sequestration. Now, employees at cancer clinics are sharply criticizing that move, pointing out that lawmakers should have prioritized their funding before working to alleviate airport delays.

After automatic budget cuts slashed their funding, cancer clinics have been forced to delay chemotherapy treatment for their patients. Some clinics may actually have to close their doors altogether if the sequester cuts are not reversed. As several cancer doctors told the Hill, they suspect they may not have been at the top at Congress’ list because reduced access to chemotherapy doesn’t personally inconvenience lawmakers in the same way that airport delays do:

I would invite anyone in Washington to come look my patients in the eye and tell them that waiting for a flight is a bigger problem than traveling farther and waiting longer for chemotherapy,” said William Nibley, a doctor at Utah Cancer Specialists in Salt Lake City. [...]

Unfortunately, this doesn’t (hit) home directly to members, as traveling does,” said Ted Okon, executive director of the Community Oncology Alliance, which is aggressively lobbying Congress to soften the cuts to cancer clinics.

Okon said he has sympathy for the FAA employees who were furloughed — the FAA is one of a slew of federal agencies that docked employees’ hours and pay as a result of the sequester. He does not begrudge furloughed FAA workers their fix, but he said Congress needs to move quickly on cancer care, too.

Earlier this month, Rep. Renee Ellmers (R-NC) proposed restoring some funding for cancer clinics after realizing the “unintended consequences” of sequestration. Unlike the measure to address airport delays, Ellmers’ legislation has not yet seen any movement in Congress. She told the Hill that she hopes it will soon be “expedited in the same way that the FAA bill was this week.”

Ellmers isn’t the only Republican who is beginning to acknowledge the potentially disastrous effects of sequestration, and the other funding priorities that should likely take precedent over air travel. On Meet the Press this morning, Sen. John McCain (R-AZ) suggested that Congress has “our priorities a little bit skewed here.”

“With all due respect to my friends, it’s a little bit hypocritical that, on the same day when all of the focus was on the delays we have in getting through airports, the chief of staff of the U.S. army was saying that if we don’t reverse this we will be unable to defend the nation and it will take us 10 to 15 years to recover,” McCain said. “Look, I’m for giving the FAA flexibility, but I also want to give the military flexibility and I don’t want the sequestration cuts to be as deep as they are in our national defense.”

In his most recent weekly address, President Obama also suggested that the swift action on the FAA’s funding was largely due to the fact that lawmakers were directly impacted by airport delays, even though there are more pressing budget priorities at hand following the automatic sequester cuts. “I hope Members of Congress will find the same sense of urgency and bipartisan cooperation to help the families still in the crosshairs of these cuts,” Obama said. “They may not feel the pain felt by kids kicked off Head Start, or the 750,000 Americans projected to lose their jobs because of these cuts, or the long-term unemployed who will be further hurt by them. But that pain is real.”

Health

Over 100 Doctors Slam Big Pharma Over The Sky-High Cost Of Cancer Drugs

A group of over 100 doctors who specialize in chronic myeloid leukemia (CML) published a detailed editorial in the medical journal Blood on Friday that slams pharmaceutical companies for jacking up cancer medication prices to unaffordable degrees. The open letter also calls for immediate reform to help patients access drugs that mean the difference between life and death for millions of Americans.

The doctors argue that, despite the creativity and innovation involved in creating cancer drugs, pharmaceutical companies still charge far more than they are objectively worth, knowing that patients have no other choice than to pay the prices they dictate. The writers then urge an all-in approach to reforming the U.S. medical culture that facilitates price-gouging at the expense of Americans’ physical and financial health:

If drug price reflects value, then it should be proportional to the benefit to patients in objective measures, such as survival prolongation, degree of tumor shrinkage, or improved quality of life. For many tumors, drug prices do not reflect these endpoints, since most anti-cancer drugs provide minor survival benefits, if at all. For example, in pancreatic cancer, where the median survival is 6 months, a new drug that may prolong survival by 2 months, and is priced at $100,000 per year, will cost $67,000 over 8 months survived, or $33,500 per additional month lived, equivalent to $400,000 per additional year lived. [...]

As physicians, we follow the Hippocratic Oath of “Primum non nocere”, first (or above all) do no harm. We believe the unsustainable drug prices in CML and cancer may be causing harm to patients. Advocating for lower drug prices is a necessity to save the lives of patients who cannot afford them. Pricing of cancer and other drugs involves complex societal and political issues which demand immediate attention, and which will need to consider many factors and involve many constituencies…We propose to begin the dialogue by organizing regular meetings, involving all parties concerned, to address the reasons behind high cancer drug prices and offer solutions to reduce them. For CML, and for other cancers, we believe drug prices should reflect objective measures of benefit, but should also not exceed values that harm our patients and societies.

The doctors’ assertions are borne out by the facts. The high costs of treating chronic conditions causes one in four American seniors to go bankrupt. With regard to cancer specifically, the trend is even more pronounced. One study conducted over 14 years in Washington state found a clear relationship between cancer registry data and bankruptcy court records. “Patients diagnosed with cancer may face significant financial stress due to income loss and out-of-pocket costs associated with their treatment,” said health care economist and study author Dr. Scott Ramsey. “On average, bankruptcy rates increased fourfold within five years of diagnosis.”

Pharmaceutical companies often argue that the bloated costs are necessary to cover the substantial research investments and trials-and-error of creating a successful drug. But that logic is undermined by these same companies’ profit-maximizing gimmicks, such as adding inactive ingredients to pills so as to extend expensive brand name drugs’ patents, and paying kickbacks to pharmacies and generic drug manufacturers in exchange for higher market share.

Some developing nations have actually gone beyond the doctors’ suggestions and ruled against brand name cancer drug makers in favor of less costly generic drugs in an effort to help their poor populations access the critical medicines.

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