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1.
Rev. argent. salud publica ; 10(41): 28-36, 29/12/2019.
Artigo em Espanhol | LILACS, BINACIS, ARGMSAL | ID: biblio-1048235

RESUMO

La mortalidad guarda relación con las temperaturas diarias y los eventos extremos. Este estudio buscó analizar los efectos de las bajas temperaturas sobre la mortalidad en las principales ciudades de Argentina en el período 2005-2015. MÉTODOS: Se realizó un estudio de series temporales con modelos aditivos generalizados, modelando la relación entre bajas temperaturas y mortalidad para 21 ciudades de Argentina entre 2005 y 2015. Se analizó la mortalidad general y por grupos de sexo, edad y causa de muerte, en días fríos y días de olas de frío, así como los rezagos de 7 y 14 días posteriores a dichos eventos. RESULTADOS: En los 7 días posteriores a un día frío, el riesgo de muerte aumenta en la mitad de las ciudades entre un 1,04 [IC95%: 1,00-1,08] y un 1,14 [IC95%: 1,06-1,23] según la ciudad. El grupo de 65 años y más es el que muestra mayor impacto, con un incremento de hasta el 1,20 [IC95%: 1,05-1,39]. Las olas de frío se asocian con un aumento más pronunciado en el riesgo de morir en los siguientes 7 días en 8 ciudades (1,05 [IC95%: 1,03-1,08] a 1,30 [IC95%: 1,03-1,65]), y en 10 ciudades en los siguientes 14 días, aunque con valores algo más bajos. CONCLUSIONES: Con diferencias en magnitud y robustez estadística según las ciudades, la población de las áreas urbanas presenta un riesgo aumentado de muerte durante los 7 y 14 días posteriores a un evento de frío extremo


Assuntos
Mudança Climática , Mortalidade , Temperatura Baixa , Frio Extremo
2.
Arch Argent Pediatr ; 117(6): 368-374, 2019 Dec 01.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31758878

RESUMO

INTRODUCTION: Pollution and climate have an impact on pediatric respiratory diseases; few studies have assessed this in the Autonomous City of Buenos Aires. OBJECTIVE: To assess the impact of the interaction between air pollutants and climate on the Emergency Department visits for acute lower respiratory tract infection (ALRTI) in a children's hospital. METHODS: Ecological, time-series study with generalized additive models that included total visits and visits for ALRTI to the Emergency Department between 2012 and 2016. A series with 7-day moving averages for ALRTI visits was founded as a bias control measure. Predictors were daily levels of air pollutants (carbon monoxide, nitrous dioxide, particulate matter < 10 µ) and meteorological variables (temperature, humidity). Pollutants were measured at three monitoring stations. Temporal variables (day of the week, warm/cold semester) were controlled. RESULTS: There were 455 256 total visits; 17 298 accounted for visits for ALRTI. A correlation was established only between total visits and day of the week (Mondays and Saturdays, more visits; Thursdays, less visits). Less visits for ALRTI were recorded in the warm semester compared to the cold semester (relative risk = 0.23; 95 % confidence interval: 0.29-0.18; p < 0.001). One monitoring station did not show any correlation; the other two stations showed a weak correlation between carbon monoxide and particulate matter < 10 µ and visits for ALRTI. CONCLUSION: The season accurately accounts for the increased number of total visits and visits for ALRTI. Although there was a correlation between the level of certain pollutants and the number of visits, its impact was irrelevant.

4.
Cad Saude Publica ; 35(9): e00165218, 2019 Sep 09.
Artigo em Espanhol | MEDLINE | ID: mdl-31508697

RESUMO

This study aimed to analyze mortality during heat waves in the city of Buenos Aires, Argentina, in 2005-2015. We used a time series design with generalized additive models, linking mortality to days of heat waves throughout the period, and to days of the heat wave in 2013, the longest wave since 1906, controlling for time variables, mean temperature, and humidity. Risk of death from natural causes increased by 14% (RR = 1.140; 95%CI: 1.108-1.173) during heat waves when compared to the other days in the hot season. The increase occurred in both sexes and in all age groups, and individuals under 15 years of age were more affected (RR = 1.167; 95%CI: 1.019-1.335) as were those over 84 years (RR = 1.201; 95%CI: 1.098-1.313). The heat wave in December 2013 showed an increase of 43% (RR = 1.428; 95%CI: 1.399-1.457) in total daily deaths, increasing to 51% in individuals over 84 years (RR = 1.515; 95%CI: 1.372-1.674) and 65% (RR = 1.647; 95%CI: 1.367-1.986) for renal causes. We conclude that heat waves pose a significant risk of death, differing according to sex and age in the population of Buenos Aires.

5.
Environ Health Perspect ; 127(9): 97007, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31553655

RESUMO

BACKGROUND: There is strong experimental evidence that physiologic stress from high temperatures is greater if humidity is higher. However, heat indices developed to allow for this have not consistently predicted mortality better than dry-bulb temperature. OBJECTIVES: We aimed to clarify the potential contribution of humidity an addition to temperature in predicting daily mortality in summer by using a large multicountry dataset. METHODS: In 445 cities in 24 countries, we fit a time-series regression model for summer mortality with a distributed lag nonlinear model (DLNM) for temperature (up to lag 3) and supplemented this with a range of terms for relative humidity (RH) and its interaction with temperature. City-specific associations were summarized using meta-analytic techniques. RESULTS: Adding a linear term for RH to the temperature term improved fit slightly, with an increase of 23% in RH (the 99th percentile anomaly) associated with a 1.1% [95% confidence interval (CI): 0.8, 1.3] decrease in mortality. Allowing curvature in the RH term or adding terms for interaction of RH with temperature did not improve the model fit. The humidity-related decreased risk was made up of a positive coefficient at lag 0 outweighed by negative coefficients at lags of 1-3 d. Key results were broadly robust to small model changes and replacing RH with absolute measures of humidity. Replacing temperature with apparent temperature, a metric combining humidity and temperature, reduced goodness of fit slightly. DISCUSSION: The absence of a positive association of humidity with mortality in summer in this large multinational study is counter to expectations from physiologic studies, though consistent with previous epidemiologic studies finding little evidence for improved prediction by heat indices. The result that there was a small negative average association of humidity with mortality should be interpreted cautiously; the lag structure has unclear interpretation and suggests the need for future work to clarify. https://doi.org/10.1289/EHP5430.

6.
Environ Int ; 131: 105027, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31351381

RESUMO

An increase in the global health burden of temperature was projected for 459 locations in 28 countries worldwide under four representative concentration pathway scenarios until 2099. We determined that the amount of temperature increase for each 100 ppm increase in global CO2 concentrations is nearly constant, regardless of climate scenarios. The overall average temperature increase during 2010-2099 is largest in Canada (1.16 °C/100 ppm) and Finland (1.14 °C/100 ppm), while it is smallest in Ireland (0.62 °C/100 ppm) and Argentina (0.63 °C/100 ppm). In addition, for each 1 °C temperature increase, the amount of excess mortality is increased largely in tropical countries such as Vietnam (10.34%p/°C) and the Philippines (8.18%p/°C), while it is decreased in Ireland (-0.92%p/°C) and Australia (-0.32%p/°C). To understand the regional variability in temperature increase and mortality, we performed a regression-based modeling. We observed that the projected temperature increase is highly correlated with daily temperature range at the location and vulnerability to temperature increase is affected by health expenditure, and proportions of obese and elderly population.

7.
Cad. Saúde Pública (Online) ; 35(9): e00165218, 2019. tab, graf
Artigo em Espanhol | LILACS-Express | ID: biblio-1019635

RESUMO

Resumen: El objetivo de este trabajo es analizar la mortalidad durante las olas de calor en la ciudad de Buenos Aires, Argentina, para el período 2005-2015. Utilizamos un diseño de series temporales con modelos aditivos generalizados, vinculando mortalidad con días de ola de calor en todo el período, y con días de la ola de calor de 2013, la más prolongada desde el año 1906, controlando por variables temporales, temperatura media y humedad. Encontramos que el riesgo de muerte por causas naturales se incrementa en un 14% (RR = 1,140; IC95%: 1,108-1,173) durante las olas de calor, respecto al resto de los días del semestre cálido. El incremento se da en ambos sexos y en todos los grupos de edad, siendo más afectados los menores de 15 (RR = 1,167; IC95%: 1,019-1,335) y los mayores de 84 años (RR = 1,201; IC95%: 1,098-1,313). En la ola de calor de diciembre de 2013 aumentaron 43% (RR = 1,428; IC95%: 1,399-1,457) las muertes diarias totales, valor que sube al 51% para el grupo de mayores de 84 años (RR = 1,515; IC95%: 1,372-1,674) y al 65% (RR = 1,647; IC95%: 1,367-1,986) para las causas renales. Concluimos que las olas de calor constituyen un factor significativo de riesgo de muerte, diferente según sexo y edad, para la población de la ciudad de Buenos Aires.


Abstract: This study aimed to analyze mortality during heat waves in the city of Buenos Aires, Argentina, in 2005-2015. We used a time series design with generalized additive models, linking mortality to days of heat waves throughout the period, and to days of the heat wave in 2013, the longest wave since 1906, controlling for time variables, mean temperature, and humidity. Risk of death from natural causes increased by 14% (RR = 1.140; 95%CI: 1.108-1.173) during heat waves when compared to the other days in the hot season. The increase occurred in both sexes and in all age groups, and individuals under 15 years of age were more affected (RR = 1.167; 95%CI: 1.019-1.335) as were those over 84 years (RR = 1.201; 95%CI: 1.098-1.313). The heat wave in December 2013 showed an increase of 43% (RR = 1.428; 95%CI: 1.399-1.457) in total daily deaths, increasing to 51% in individuals over 84 years (RR = 1.515; 95%CI: 1.372-1.674) and 65% (RR = 1.647; 95%CI: 1.367-1.986) for renal causes. We conclude that heat waves pose a significant risk of death, differing according to sex and age in the population of Buenos Aires.


Resumo: O objetivo deste trabalho é analisar a mortalidade durante as ondas de calor na cidade de Buenos Aires, Argentina, no período de 2005-2015. Foi usado um desenho de séries temporais com modelos aditivos generalizados, vinculando a mortalidade com dias de onda de calor em todo o período, e com dias da onda de calor em 2013, a mais prolongada desde o ano de 1906, controlando através de variáveis temporais, temperatura media e umidade. Encontramos que o risco de morte por causas naturais teve um incremento de 14% (RR = 1,140; IC95%: 1,108-1,173) durante as ondas de calor, ao respeito do resto dos dias do semestre cálido. O incremento se produz em ambos os sexos e em todos os grupos de idade, sendo mais afetados os menores de 15 (RR = 1,167; IC95%: 1,019-1,335) e os maiores de 84 anos (RR = 1,201; IC95%: 1,098-1,313). Na onda de calor que ocorreu em dezembro de 2013 aumentaram um 43% (RR = 1,428; IC95%: 1,399-1,457) as mortes diárias totais, valor que sobe a 51% para o grupo de pessoas maiores de 84 anos (RR = 1,515; IC95%: 1,372-1,674) e a 65% (RR = 1,647; IC95%: 1,367-1,986) para as causas renais, Concluímos que as ondas de calor constituem um fator significativo de risco de morte, diferente segundo o sexo e idade, para a população da cidade de Buenos Aires.

8.
Rev Fac Cien Med Univ Nac Cordoba ; 74(4): 365-371, 2017 12 14.
Artigo em Espanhol | MEDLINE | ID: mdl-29902145

RESUMO

Objective: to evaluate the impact of air pollution and weather changes on the number of visits to a pediatric emergency department in Buenos Aires, Argentina. Materials and methods: we designed an ecological time-series study using generalized additive models (GAM) for the period 2012-2014. The outcome variable was the number of daily visits to a pediatric emergency department taking into account daily consultations. The potential predictors were the average daily air pollution levels (carbon monoxide -CO-, nitrogen dioxide -NO2-, particulate matter 10 microns or less in diameter -PM10-) and weather variables (temperature, humidity, wind speed and direction, and rainfall) and we controlled by weekday and long-time trend. Results: the number of visits during the winter months (286 daily) was significantly higher than those in the other seasons (p <0.0001). The change in air pollution levels did not show a significant and consistent correlation with the visits. Temperature, relative humidity, rainfall, and wind speed and direction were not significant variables for any of the examined lags. Conclusions: Considering the population and variables of our study, air pollution does not affect the health outcomes, as does seasonal epidemics. Studies that examine other health variables are necessary to establish the impact of air pollution on children's health in Buenos Aires.


Assuntos
Poluição do Ar/efeitos adversos , Mudança Climática/estatística & dados numéricos , Clima , Serviço Hospitalar de Emergência/estatística & dados numéricos , Hospitais Pediátricos/estatística & dados numéricos , Adolescente , Poluição do Ar/estatística & dados numéricos , Argentina , Criança , Pré-Escolar , Humanos , Lactente , Risco , Estatísticas não Paramétricas
9.
Arch Argent Pediatr ; 114(1): 52-5, 2016 Feb.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-26914075

RESUMO

INTRODUCTION: Global climate change circulation pattern respiratory syncytial virus (RSV). We assessed whether RSV season has changed over the past 20 years and its correlation with mean annual temperature. METHODS: Cross-sectional study that included records of RSV and temperatures from Buenos Aires (1995-2014). RSV season onset, offset and duration, and its correlation with mean annual temperature were described for each year. RESULTS: A total of 8109 RSV infections were identified. The duration of RSV season reduced significantly (1995: 29 weeks vs. 2014: 17 weeks; R: 0.6; p < 0.001) due to an early ending (1995: week 45 vs. 2014: week 33; R: 0.6; p < 0.001). No correlation was observed between mean annual temperature and RSV season start, end and duration. CONCLUSIONS: Over the past 20 years, RSV season shortened significantly, but no correlation with temperature was observed.


Assuntos
Mudança Climática , Infecções por Vírus Respiratório Sincicial/epidemiologia , Estações do Ano , Argentina/epidemiologia , Estudos Transversais , Humanos , Vírus Sincicial Respiratório Humano/isolamento & purificação
10.
Cien Saude Colet ; 19(9): 3763-73, 2014 Sep.
Artigo em Espanhol | MEDLINE | ID: mdl-25184582

RESUMO

Based on the theoretical framework of environmental risk, this article discusses the management of air quality in the Autonomous City of Buenos Aires in relation to current and potential impacts of toxic gases and global climate change on the health of the population. Information on historical and current management of the air was linked to the results of the South American Emissions, Megacities and Climate research project to assess danger, exposure, vulnerability and uncertainty as the dimensions of risk. By contextualizing public policies developed in recent decades on this subject, it was possible to identify emerging configurations of risk and uncertainties as accelerators of social vulnerability. On the one hand, the fact that there is a positive correlation between mortality, changes in temperature and air pollution was confirmed. On the other hand, it became clear that there is a disconnect between air quality management and health care management, while limitations were found in the proposed mitigation measures relating to emissions of greenhouse gases produced by fuel, revealing uncertainties regarding their efficacy.


Assuntos
Poluição do Ar , Mudança Climática , Saúde Pública , Saúde da População Urbana , Poluição do Ar/efeitos adversos , Argentina , Cidades , Previsões , Humanos , Risco , Populações Vulneráveis
11.
Ciênc. saúde coletiva ; 19(9): 3763-3773, 09/2014.
Artigo em Espanhol | LILACS | ID: lil-720563

RESUMO

Desde el marco teórico del riesgo ambiental, el presente artículo aborda la gestión de la calidad del aire en la Ciudad Autónoma de Buenos Aires en relación con los impactos actuales y potenciales de los gases tóxicos y del cambio climático global sobre la salud de la población. Se vinculó información sobre gestión histórica y actual del aire con los resultados del proyecto de investigación South American Emissions, Megacities and Climate para evaluar peligrosidad, exposición, vulnerabilidad e incertidumbre como dimensiones del riesgo. Al contextualizar las políticas públicas desarrolladas en las últimas décadas sobre este tema, fue posible identificar configuraciones de riesgo y de incertidumbres emergentes, amplificadoras de la vulnerabilidad social. Por una parte se confirmó que existe una correlación positiva entre la mortalidad, los cambios en la temperatura y en la contaminación del aire. Por otra se constató la desvinculación entre la gestión de la calidad del aire y la gestión de salud, a la vez que se encontraron limitaciones en las medidas de mitigación propuestas en relación a las emisiones de gases efecto invernadero producidas por los combustibles, señalando las incertidumbres respecto a su eficacia.


Based on the theoretical framework of environmental risk, this article discusses the management of air quality in the Autonomous City of Buenos Aires in relation to current and potential impacts of toxic gases and global climate change on the health of the population. Information on historical and current management of the air was linked to the results of the South American Emissions, Megacities and Climate research project to assess danger, exposure, vulnerability and uncertainty as the dimensions of risk. By contextualizing public policies developed in recent decades on this subject, it was possible to identify emerging configurations of risk and uncertainties as accelerators of social vulnerability. On the one hand, the fact that there is a positive correlation between mortality, changes in temperature and air pollution was confirmed. On the other hand, it became clear that there is a disconnect between air quality management and health care management, while limitations were found in the proposed mitigation measures relating to emissions of greenhouse gases produced by fuel, revealing uncertainties regarding their efficacy.


Assuntos
Humanos , Poluição do Ar , Mudança Climática , Saúde Pública , Saúde da População Urbana , Argentina , Poluição do Ar/efeitos adversos , Cidades , Previsões , Risco , Populações Vulneráveis
12.
Interface comun. saúde educ ; 15(37): 505-518, abr.-jun. 2011.
Artigo em Espanhol | LILACS | ID: lil-592642

RESUMO

Indagamos las experiencias y perspectivas de los usuarios de un servicio hospitalario público de acupuntura del noroeste argentino. Basamos el análisis en 18 entrevistas semi-estructuradas realizadas en el año 2005. Los entrevistados recurren a la acupuntura por dolencias crónicas, especialmente como paliativo del dolor, aunque varios extienden su uso para otros problemas de salud, frente a la ineficacia y/o efectos adversos de los tratamientos biomédicos, o para evitar cirugías menores. Incorporan la acupuntura a estrategias pluralistas de cuidado que junto con la biomedicina incluyen típicamente otras medicinas no convencionales. El contexto hospitalario facilita que prueben una medicina foránea. Varios usuarios encuentran el servicio de asesoramiento para "negociar" los tratamientos con sus médicos convencionales. Destacan la eficiencia organizativa del servicio y el compromiso de los médicos. Ante la demanda creciente de atención en un contexto de escasez de recursos advierten que ésta puede afectar la disponibilidad de turnos y la interacción médico-paciente.


We investigate the experiences and perspectives of users of a public hospital-based service of acupuncture located in the Northwest region of Argentina. In 2005 we interviewed 18 patients. They use acupuncture for chronic conditions, mostly to alleviate pain-- although several extended its use over time to treat other health problems-because of the limited efficacy experienced with biomedicine and the adverse effects of medications, or to avoid surgical interventions. They incorporate acupuncture into pluralistic health care strategies, which in addition to biomedicine typically include other unconventional medicines. The hospital context facilitates the use of an alternative medicine, and some patients find in the service guidance to "negotiate" treatments with conventional physicians. The organizational efficiency and the doctors' commitment to their work were highly valued. Due to the increasing demand for treatments in a context of scarce resources, patients worry that the availability of appointments and doctor-patient interactions may be affected.


Investigamos experiências e perspectivas dos usuários de um serviço hospitalar público de acupuntura do noroeste argentino. Baseamos a análise em 18 entrevistas semi-estruturadas realizadas no ano 2005. Os entrevistados recorrem à acupuntura por doenças crônicas, especialmente como paliativo da dor, embora vários estendam seu uso para outros problemas de saúde, diante da ineficácia e/ou efeitos adversos dos tratamentos biomédicos, ou para evitar cirurgias menores. Incorporam a acupuntura a estratégias pluralistas de cuidado, que junto com a biomedicina incluem tipicamente outras medicinas não convencionais. O contexto hospitalar facilita o fato de experimentar uma medicina alternativa. Vários usuários buscam o serviço de apoio para "negociar" os tratamentos com seus médicos convencionais. Destacam a eficiência organizacional do serviço e o compromisso dos médicos. Diante da demanda crescente de atenção em um contexto de escassez de recursos os usuários advertem que ela pode afetar a disponibilidade para marcar consultas médicas e a interação médico-paciente.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Acupuntura , Terapias Complementares , Serviços de Saúde , Relações Médico-Paciente
13.
Buenos Aires; Universidad de Buenos Aires. Facultad de Ciencias Sociales. Instituto de Investigaciones Gino Germani; marzo de 2010. 100 p.
Monografia em Espanhol | BINACIS | ID: bin-132055

RESUMO

La utilización de medicinas alternativas y complementarias (MACs) es un fenómeno global, y de gran importancia en nuestro país. Si bien existen varios estudios sobre el tema, fundamentalmente en el campo de la antropología, el caso de la acupuntura ha sido menos explorado, a pesar de su gran popularidad en nuestro medio. El presente estudio se centra en los usuarios de acupuntura en la ciudad de Buenos Aires. El objetivo es conocer sus razones para utilizar esta medicina, las modalidades de uso y las experiencias con los tratamientos, y enmarcar la utilización de la acupuntura en sus estrategias más generales de cuidado de la salud. Entendiendo que el cuidado dela salud es una práctica socio-cultural que se constituye en la interacción social, indagamos más específicamente: 1) el rol que juegan las redes sociales en la orientación del consumo de acupuntura, en la selección de sus proveedores y en la circulación de credibilidad en una terapia culturalmente ôexóticaö en nuestro medio; y 2) el proceso de construcción de confianza en los especialistas a partir del encuentro de la acupuntura en distintos contextos de provisión separados por barreras profesionales y étnicas. A través del abordaje de estos temas buscamos aportar conocimiento empírico y comprensión teórica sobre las experiencias de los usuarios que transitan los mundos terapéuticos de la acupuntura en la ciudad de Buenos Aires donde la oferta de tratamientos es muy diversificada. El trabajo de campo, con entrevistas en profundidad, se llevó a cabo en los años 2005, 2006 y 2009. (AU).


The use of alternative and complementary medicine (CAM) is a global phenomenon, and it has been very salient in Argentina. There is an important body of empirical research on the topic, mostly in the field of anthropology, but the case of acupuncture has been under-researched despite its local popularity. The present study focuses on users of acupuncture in Buenos Aires city. Our aim is to know their reasons to resort to this CAM, their modalities of use of acupuncture and experiences with treatments, and to frame the use of CAM into their broader strategies of health care. Under the premise that health care is a socio-cultural practice that takes place in social interaction, we inquiry more specifically: 1. the role that social networks play to guide the consumption of acupuncture treatments, in how users choose the specialist, and in the circulation of credibility of a culturally exotic medicine; and 2. how users buildtrust in the specialist as they encounter acupuncture treatments in different clinical contexts, divided by professional and ethnic barriers. By addressing these issues, we expect to contribute to the empirical knowledge and the theoretical debate on users that navigate the various acupuncture worlds in Buenos Aires city. Data comes from in-depth interviews conducted during 2005, 2006 and 2009. (AU)


Assuntos
Humanos , Terapias Complementares , Acupuntura , Antropologia , Características Culturais , Condições Sociais
14.
Buenos Aires; Universidad de Buenos Aires. Facultad de Ciencias Sociales. Instituto de Investigaciones Gino Germani; diciembre de 2008. 36 p.
Monografia em Espanhol | BINACIS | ID: bin-132056

RESUMO

Este trabajo analiza dos aspectos de la Política Nacional de Medicamentos en la Argentina: la Ley sobre Prescripción de Medicamentos por su nombre Genérico y la implementación del Plan Remediar. La investigación apunta a evaluar el impacto económico de esta política sobre el gasto de las familias en salud, centrando el análisis en las patologías más frecuentes, especialmente en la franja más pobre de la población. (AU)


This research aims to analyze two components of the National Drug Policy in Argentina: The Generics Medicine Prescribing Law and The Remediar Programme. The study focuses on the evaluation of the economic impact of these policies on family health expenditures, emphasizing the effects on the most economically deprivedpopulation. (AU)


Assuntos
Humanos , Política Nacional de Medicamentos , Prescrições de Medicamentos , Política de Medicamentos Genéricos , Valor da Vida/economia , Pobreza , Renda , Família
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