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1.
FASEB J ; 36 Suppl 12022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35553373

RESUMO

Adverse childhood experiences (ACEs) represent psychosocial stressors that occur during critical developmental periods and are associated in a dose-dependent manner with adverse cardiovascular outcomes in emerging adults, including greater age-related increases in blood pressure (BP) and increased circulating endothelin-1 (ET-1), a psychosocial stress-responsive, endothelium-derived peptide and potent vasoconstrictor. ACEs have also been linked to lower resilience and hope, which is a motivational state based on goal-directed energy (agency) and goal planning (pathways). Importantly, resilience and hope are each stable psychological traits that may protect against adversity. We examined the effects of a structured, progressive exercise training program on hope agency, hope pathways, resilience, BP, and circulating ET-1 in young adult women with a history of moderate-to-severe (e.g., 4 or more) adverse childhood experiences (ACEs). We hypothesized that exercise training would increase resilience and hope, but lower systolic BP (SBP), diastolic BP (DBP), and circulating ET-1. We further hypothesized that changes in hope and resilience would be associated with changes in BP and ET-1 across the intervention period in the young women with ACEs. Forty-two otherwise healthy young adult women with either four or more (ACE+) or with no ACEs (ACE-) were recruited and completed this study. Participants with ACEs (ACE+) were randomly assigned to either an exercise (n=14) or non-exercise (n=14) control group, whereas women without a history of ACEs (ACE-) were assigned to a non-exercise control (e.g., negative control group; n=14). Statistical analyses included two-way mixed (group x time) effects and bivariate correlational analyses. Changes are reported as means ± SE. Agency did not change in any group (p = 0.14), but pathways improved only in the ACE+ exercise group (+1.6 ± 0.74 au; p = 0.03). ET-1 decreased in the ACE+ exercise group only (-0.31 ± 0.29 pg/ml, p= 0.04). While the interactions for resilience and SBP did not reach significance (p = 0.06 and 0.05, respectively), forced post-hoc analyses indicated that resilience improved (+4.9 ± 1.9 au, p = 0.01) and SBP tended to improve (-4.0 ± 2.0 mmHg; p = 0.05) in the ACE+ exercise group only. DBP did not change in any group (p = 0.43). There were significant inverse associations between changes in pathways and SBP (ρ = -0.43, p= 0.02) and pathways and ET-1 (ρ = -0.56, p= 0.003), and a significant direct association between changes in SBP and ET-1 (ρ = 0.49; p = 0.01) in the ACE+ young women. Associations among resilience and BP and ET-1 were weaker and non-significant (ρ = -0.17-0.29, p≥ 0.13). Our results suggest that structured, progressive exercise training promotes improvements in positive psychological factors, SBP, and circulating ET-1 levels in young adults with a history of ACEs. Further, changes in pathways were related to changes in SBP and ET-1 across the intervention period, suggesting a potential psychophysiological relationship between positive psychological traits and cardiovascular risk factors in young women with ACEs.

2.
Metabolites ; 12(1)2022 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-35050203

RESUMO

Post-meal triglycerides are an independent cardiovascular disease (CVD) risk factor, but the ideal high-fat meal formulation has yet to be standardized and is one challenge prohibiting widespread clinical adoption of postprandial triglyceride assessment. Two general approaches often used are giving individuals a high-fat meal scaled to body weight or a standardized high-fat meal containing a set fat bolus. A recent expert panel statement has endorsed the latter, specifying 75 g of fat as an appropriate fat dosage. Despite this recommendation, no study to date has tested whether there is a difference in postprandial triglycerides or if risk classification is affected based on these different approaches. We recruited 16 generally healthy individuals with roughly equal distribution among body mass index (BMI)class (n = 5-6/per BMI category) and sex (n = 2-3 M/F) within each BMI class. Each participant underwent two abbreviated fat tolerance tests separated by ~1 week: one with a scaled to body weight high-fat meal (9 kcal/kg; 70% fat) and a standardized meal containing 75 g of fat (70% fat). Fasting, 4 h, and absolute change in triglycerides across the entire sample and within each BMI category were similar regardless of high-fat meal. Only one participant with obesity had discordant postprandial responses between the fat tolerance tests (i.e., different CVD risk classification). These findings suggest that, within a certain range of fat intake, generally healthy individuals will have a similar postprandial triglyceride response. Considering the greater convenience of utilizing standardized high-fat meals, our data suggest that a standardized high-fat meal may be acceptable for large-scale studies and clinical implementation.

4.
Clin Nutr ; 40(7): 4762-4771, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34242916

RESUMO

BACKGROUND & AIMS: Individuals with fasting triglycerides (TG) <150 mg/dL can experience a deleterious postprandial TG response ≥220 mg/dL to a high-fat meal (HFM). The purpose of this study was to identify individuals based on fasting TG that would benefit most from additional postprandial screening. METHODS: We conducted a secondary analysis of 7 studies from our laboratories featuring 156 disease-free participants (64 M, 92 F; age 18-70 years; BMI 18.5-30 kg/m2). Participants observed a 10-12 h overnight fast, after which they consumed an HFM (10-13 kcal/kg body mass; 61-64% kcal from fat). Two methods were used to identify lower and upper fasting TG cut points. Method 1 identified the lower limit as the TG concentration at which ≥90% of individuals presented peak postprandial TG (PPTG) <220 mg/dL and the upper limit as the concentration which ≥90% of individuals presented PPTG ≥220 mg/dL. Method 2 utilized receiver operating characteristic (ROC) curves and identified the lower limit as the fasting TG concentration where sensitivity was ≈95% and the upper limit as the concentration at which specificity was ≈95%. RESULTS: In Method 1, 90% of individuals with fasting TG >130 mg/dL (>1.50 mmol/L) exhibited PPTG ≥220 mg/dL (≥2.50 mmol/L), while 100% of individuals with fasting TG <66 mg/dL (0.75 mmol/L) had PPTG that did not exceed 220 mg/dL (2.50 mmol/L). In Method 2, when sensitivity was ≈95%, the corresponding fasting TG concentration was 70 mg/dL (0.79 mmol/L). When specificity was ≈95%, the corresponding fasting TG concentration was 114 mg/dL (1.29 mmol/L). Based on methods 1 and 2, there was a moderate positive association (r = 0.37, p < 0.004) between fasting and PPTG for individuals with fasting TG between 70 and 130 mg/dL (0.79-1.50 mmol/L), in which 24% exhibited PPTG ≥220 mg/dL (≥2.50 mmol/L) while 76% did not. CONCLUSIONS: Postprandial TG testing is likely most useful for individuals with fasting TG concentrations between 70 and 130 mg/dL (0.79-1.50 mmol/L). Outside of this range, postprandial TG responses are largely predictable. Establishing a specific patient group for which postprandial TG testing is most useful may lead to earlier risk detection in these individuals.


Assuntos
Hipertrigliceridemia/diagnóstico , Período Pós-Prandial , Medição de Risco/métodos , Triglicerídeos/sangue , Adolescente , Adulto , Idoso , Jejum/sangue , Feminino , Voluntários Saudáveis , Fatores de Risco de Doenças Cardíacas , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Sensibilidade e Especificidade , Adulto Jovem
5.
Am J Physiol Heart Circ Physiol ; 321(3): H532-H541, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34328346

RESUMO

Adverse childhood experiences (ACEs) are psychosocial stressors that occur during sensitive developmental windows and are associated with increased lifetime cardiovascular disease (CVD) risk in a dose-dependent manner. Vascular endothelial dysfunction is a pathophysiological mechanism that promotes hypertension and CVD and may be a mechanism by which ACEs contribute to lifetime CVD risk. We examined whether exposure to ACEs is associated with reduced vascular endothelial function (VEF) in otherwise healthy, young adult women (20.7 ± 3 yr) with (ACE+) versus without (ACE-) ACEs, explored whether differences in circulating sirtuin 1 (SIRT1) or systemic oxidative stress could explain ACEs-related differences in VEF, and examined the ability of a pilot, 8-wk exercise intervention to augment VEF and SIRT1 or reduce oxidized LDL cholesterol (oxLDL) in ACE+ young adult women. Forty-two otherwise healthy young adults completed this study. Prior to the intervention, VEF (P = 0.002) and SIRT1 (P = 0.004) were lower in the ACE+ than ACE- group, but oxLDL concentrations were not different (P = 0.77). There were also significant relationships (P ≤ 0.04) among flow-mediated dilation (FMD), SIRT1, and oxLDL in the ACE+, but not ACE- group. Adjusting for circulating SIRT1 and oxLDL reduced the differences in FMD observed between groups (P = 0.10), but only SIRT1 was a significant adjuster of the means (P < 0.05). Finally, the exercise intervention employed was unable to enhance VEF or SIRT1 in the ACE+ exercise group. Our data suggest that ACEs likely increase susceptibility to hypertension and CVD by causing endothelial dysfunction, perhaps through a SIRT1 pathway-related mechanism.NEW & NOTEWORTHY Our study provides novel evidence that young adult women with moderate-to-severe adverse childhood experience (ACE) exposure present impaired endothelial function and lower circulating sirtuin 1 (SIRT1) concentrations than age-matched controls. However, an 8-wk exercise intervention was unable to augment endothelial function or SIRT1 concentrations in a subset of those with ACEs. Our data suggest that ACEs-related impairments in endothelial function may be secondary to decreased NO bioavailability via SIRT1 and/or oxidative stress-related mechanisms.


Assuntos
Experiências Adversas da Infância , Endotélio Vascular/metabolismo , Estresse Oxidativo , Sirtuína 1/genética , Estresse Psicológico/metabolismo , Adolescente , Adulto , Idoso , Endotélio Vascular/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sirtuína 1/metabolismo , Estresse Psicológico/etiologia , Estresse Psicológico/fisiopatologia
6.
Clin Nutr ESPEN ; 43: 428-435, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34024551

RESUMO

BACKGROUND & AIMS: Postprandial lipemia (PPL) is predictive of cardiovascular disease risk, but the current method for assessing PPL is a burdensome process. Recently, the validity of an abbreviated fat tolerance test (AFTT) has been demonstrated. As a continuation of this research, the purpose of this study was to determine the reliability of the AFTT and compare it to the reliability of the oral glucose tolerance test (OGTT). METHODS: In this randomized crossover trial, 20 healthy adults (10 male and 10 female) completed 2 AFTTs and 2 OGTTs, each separated by a 1-week washout. For the AFTT, triglycerides (TG) were measured at baseline and 4 h post-consumption of a high-fat meal, during which time participants were able to leave the lab. For the OGTT, we measured blood glucose at baseline and 2 h post-consumption of a 75-g pure glucose solution, and participants remained in the lab. To determine reliability, we calculated within-subject coefficient of variation (WCV) and intraclass correlation coefficient (ICC). RESULTS: The mean 4-h TG WCV for the AFTT was 12.6%, while the mean 2-h glucose WCV for the OGTT was 10.5%. ICC values for 4-h TG and TG change were 0.79 and 0.71, respectively, while ICC values for 2-h glucose and glucose change were 0.66 and 0.56, respectively. CONCLUSIONS: Based on WCV and ICC, the TG response to an AFTT was similarly reliable to the glucose response to an OGTT in our sample of healthy adults, supporting the AFTT's potential as a standard clinical test for determining PPL. However, reliability of the AFTT needs to be further tested in individuals at greater risk for cardiometabolic disease.


Assuntos
Glicemia , Período Pós-Prandial , Adulto , Feminino , Teste de Tolerância a Glucose , Humanos , Masculino , Reprodutibilidade dos Testes , Triglicerídeos
7.
Clin Nutr ESPEN ; 41: 439-442, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33487304

RESUMO

BACKGROUND & AIMS: Coffee is typically prohibited prior to metabolic assessment in clinical and research settings. However, whether coffee meaningfully alters fasted metabolic testing or the results of a fat tolerance test is unclear. We investigated whether allowing black coffee intake within a fast prior to blood work affected fasting triglycerides (TG) and glucose, as well as the postprandial lipemic and glycemic response following an abbreviated fat tolerance test (AFTT). METHODS: Participants completed two randomized AFTTs separated by at least 1 week. For each AFTT, participants arrived into the laboratory following a 10 h overnight fast and consumed either 8 oz of water or black coffee. Thirty minutes later, a baseline blood draw was collected. Immediately following, participants consumed a standardized high-fat shake (70% fat; 9 kcal/kg body mass), vacated the laboratory, and returned 4 h later for a follow-up blood draw. RESULTS: Ten healthy individuals (5M, 5F; age: 22.9 ± 3.8 years; BMI: 24.3 ± 2.6 kg/m2) completed the study. There was no difference between trials with regard to baseline TG (MD = 1.7 mg/dL; p = 0.74), 4 h TG (MD = 2.7 mg/dL; p = 0.75), Δ TG (MD = 4.4 mg/dL; p = 0.52), or % change TG (MD = 7.7%; p = 0.99). Similarly, following coffee consumption, baseline glucose was unchanged relative to water (MD = 0.4 mg/dL; p = 0.84) and there were no differences in postprandial glucose measures, including 4 h (MD = 0.9 mg/dL; p = 0.58), Δ (MD = 1.3 mg/dL; p = 0.31), and % change in glucose (MD = 1.6%; p = 0.29). CONCLUSION: In our small study sample, coffee intake prior to an AFTT did not affect baseline or postprandial TG and glucose. Therefore, coffee intake prior to an AFTT may not affect its validity.


Assuntos
Café , Jejum , Adulto , Glicemia , Humanos , Período Pós-Prandial , Triglicerídeos , Adulto Jovem
8.
Liver Int ; 41(5): 894-904, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33506572

RESUMO

Non-alcoholic fatty liver disease (NAFLD) is a spectrum of liver disease that is becoming more prevalent in concert with obesity and poor lifestyle habits. Although NAFLD is treatable via lifestyle modification in early stages, more advanced liver pathologies (eg non-alcoholic steatohepatitis [NASH]) are harder to reverse. There is no Food and Drug Administration approved pharmacological treatment for NAFLD, and little research has been done to identify compounds that target key NAFLD mechanisms. Bile acids and bile acid receptors have been implicated in NAFLD pathogenesis and modulating bile acids and bile acid receptors has recently been targeted as a therapeutic treatment option for NAFLD. Fibroblast growth factor 19 (FGF19), a nutritionally regulated post-prandial hormone, is a chief regulator of bile acid metabolism and an important player in lipid and carbohydrate metabolism, including key mechanisms of NAFLD pathogenesis. In this review, we discuss recent findings related to FGF19-regulated processes involved in the pathogenesis of NAFLD. We summarize known and conjectural frameworks and limitations for the clinical application of FGF19-targeted therapies as they relate to NAFLD.


Assuntos
Fatores de Crescimento de Fibroblastos , Hepatopatia Gordurosa não Alcoólica , Ácidos e Sais Biliares/metabolismo , Fatores de Crescimento de Fibroblastos/metabolismo , Humanos , Metabolismo dos Lipídeos , Fígado/metabolismo , Hepatopatia Gordurosa não Alcoólica/tratamento farmacológico , Hepatopatia Gordurosa não Alcoólica/metabolismo
9.
Nutr Res ; 83: 73-85, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33032071

RESUMO

This study examined whether an acute bout of resistance exercise (RE) attenuated postprandial responses to a high fat meal (HFM) similarly in younger versus older adult men, and probed relationships among skeletal muscle mass (SMM), age, the metabolic load index (MLI) response, and the improvement in the MLI elicited by RE versus CON. Eleven younger (24 ±â€¯4y) and 9 older (61 ±â€¯5y) men completed RE or control (CON) the night prior to a HFM. Before and 1, 3, and 5 hours after the HFM, blood triglycerides (TG), glucose (GLU), MLI, and cholesterol concentrations were quantified. Following a 7 ±â€¯1-day washout period, participants returned and completed the opposite condition. Independent of age, TGs were 32.1 ±â€¯27.1 mg/dL and 52.7 ±â€¯26.8 mg/dL lower in RE than CON at 3 and 5 hours, respectively. MLI was also 24.3 to 56.9 mg/dL lower in RE than CON from 1 to 5 hours post-meal independent of age. The TG and MLI area under the curves (AUCs) were 15% to 31% lower in RE than CON. The GLU response was greater in the older than younger men at 1 to 5 hours post-meal. Moreover, the average GLU response was 5.6 ±â€¯2.5 mg/dL lower in RE versus CON and was inversely related to SMM across the sample (r = -0.615). However, age, volume, or SMM were not related to the MLIAUC, nor to the improvement elicited by RE. Therefore, although the older men displayed a greater postprandial glucose response than the younger men, RE attenuated the postprandial metabolic response to a HFM similarly in younger and older men.


Assuntos
Dieta Hiperlipídica , Gorduras na Dieta/metabolismo , Período Pós-Prandial , Treinamento de Força , Adulto , Idoso , Envelhecimento , Área Sob a Curva , Glicemia/metabolismo , Colesterol/sangue , Estudos Cross-Over , Humanos , Masculino , Refeições , Pessoa de Meia-Idade , Músculo Esquelético/anatomia & histologia , Triglicerídeos/sangue , Adulto Jovem
10.
Int J Sport Nutr Exerc Metab ; : 1-8, 2020 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-32908019

RESUMO

The consumption of a high-fat meal can induce postprandial lipemia and endothelial dysfunction. The authors assessed the impact of age and physical activity on metabolic and vascular outcomes following meal consumption in healthy adults. The authors recruited four groups: younger active (age 22.1 ± 1.4 years; n = 9), younger inactive (age 22.6 ± 3.7 years; n = 8), older active (age 68.4 ± 7.7 years; n = 8), and older inactive (age 67.7 ± 7.2 years; n = 7). The metabolic outcomes were measured at the baseline and hourly for 6 hr post high-fat meal consumption (12 kcal/kg; 63% fat). Flow-mediated dilation was measured at the baseline, 2 hr, and 4 hr postmeal. The total area under the curve for triglycerides was significantly lower in the more active groups, but did not differ based on age (younger active = 6.5 ± 1.4 mmol/L × 6 hr, younger inactive = 11.7 ± 4.8, older active = 6.8 ± 2.7, older inactive = 12.1 ± 1.7; p = .0004). After adjusting for artery diameter, flow-mediated dilation differed between groups at the baseline (younger active = 4.8 ± 1.6%, younger inactive = 2.5 ± 0.5, older active = 3.4 ± 0.9, older inactive = 2.2 ± 0.4; p < .001) and decreased significantly across groups 4 hr postmeal (mean difference = 0.82; 95% CI [0.02, 1.6]; p = .04). These findings highlight the beneficial effect of regular physical activity on postprandial lipemia, independent of age.

11.
Am J Physiol Gastrointest Liver Physiol ; 319(4): G512-G518, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-32845171

RESUMO

Regular aerobic exercise has numerous benefits on human physiology, arguably by serving as a hormetic stressor resulting in positive adaptations over time. It has long been known that aerobic exercise at a variety of intensities and durations induces intestinal permeability, which is a feature of many pathologies of the gastrointestinal tract and metabolic diseases. Given the health benefits of exercise, it seems unlikely that intestinal permeability induced by exercise outweighs the positive adaptations. In fact, a growing body of evidence suggests adoption of exercise regimens lasting weeks to months improves indicators of intestinal permeability. In this brief review, we summarize factors contributing to acute exercise-induced intestinal permeability and what is known about chronic exercise and the gut barrier. Additionally, we outline known and theoretical adaptations of the gut to chronic exercise that may explain emerging reports that exercise improves markers of gut integrity.


Assuntos
Exercício Físico/fisiologia , Hormese/fisiologia , Intestinos/fisiologia , Sistema Cardiovascular , Absorção Gastrointestinal/fisiologia , Microbioma Gastrointestinal/fisiologia , Humanos , Imunidade/fisiologia , Mucosa Intestinal/fisiologia , Permeabilidade , Circulação Esplâncnica/fisiologia , Termotolerância/fisiologia
12.
Nutrients ; 11(5)2019 May 16.
Artigo em Inglês | MEDLINE | ID: mdl-31100881

RESUMO

BACKGROUND: Postprandial lipemia (PPL) is a cardiovascular disease risk factor. However, the effects of different fat sources on PPL remain unclear. We aimed to determine the postprandial response in triglycerides (TG) to four dietary fat sources in adults. METHODS: Participants completed four randomized meal trials. For each meal trial, participants (n = 10; 5M/5F) consumed a high-fat meal (HFM) (13 kcal/kg; 61% of total kcal from fat) with the fat source derived from butter, coconut oil, olive oil, or canola oil. Blood was drawn hourly for 6 h post-meal to quantify PPL. RESULTS: Two-way ANOVA of TG revealed a time effect (p < 0.0001), but no time-meal interaction (p = 0.56), or meal effect (p = 0.35). Meal trials did not differ with regard to TG total (p = 0.33) or incremental (p = 0.14) area-under-the-curve. When stratified by sex and the TG response was averaged across meals, two-way ANOVA revealed a time effect (p < 0.0001), time-group interaction (p = 0.0001), and group effect (p = 0.048), with men exhibiting a greater response than women, although this difference could be attributed to the pronounced difference in BMI between men and women within the sample. CONCLUSION: In our sample of young adults, postprandial TG responses to a single HFM comprised of different fat sources did not differ.


Assuntos
Gorduras na Dieta/metabolismo , Ácidos Graxos Monoinsaturados/administração & dosagem , Ácidos Graxos/administração & dosagem , Lipídeos/sangue , Período Pós-Prandial , Adolescente , Adulto , Peso Corporal , Exercício Físico , Feminino , Análise de Alimentos , Humanos , Masculino , Adulto Jovem
13.
Nutrients ; 11(1)2019 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-30654471

RESUMO

BACKGROUND: A large post-meal triglyceride (TG) response is an independent risk factor for cardiovascular disease, but postprandial lipemia assessments are not clinically practical in their current form. Therefore, we assessed the validity of an abbreviated, clinically feasible protocol in measuring postprandial lipemia. METHOD: Eighteen healthy adults (8 male and 10 female) completed 3 high-fat meal trials in random order: (1) a Standard in Lab (SL) protocol wherein blood draws (to determine TG) were made from a catheter at baseline and hourly for 6 h; (2) an Abbreviated in Lab (AL) protocol in which participants remained in the laboratory but blood draws were only made at baseline and 4 h post-meal; and (3) an Abbreviated with Freedom (AF) protocol in which participants vacated the laboratory between the meal and the 4-h blood draw. RESULTS: TG increase from baseline was very similar (p = 0.93) across the 3 trials (SL: 68.5 ± 62.7 mg/dL; AL: 71.1 ± 58.0 mg/dL; AF: 66.7 ± 46.4 mg/dL), as were 4-h TG levels (SL: 144.6 ± 84.2 mg/dL; AL: 171.4 ± 88.2 mg/dL; AF: 157.7 ± 76.7 mg/dL; p = 0.49). Similarly, total and incremental area under the curve (AUC) were not significantly different across the trials (p = 0.12 and 0.91, respectively). CONCLUSION: The TG results of the clinically feasible, abbreviated protocol were similar to those of the more exhaustive standard protocol. The AF protocol could be a valid and feasible clinical tool for measurement of postprandial lipemia and assessment of cardiovascular risk, although studies in larger and more diverse cohorts are needed.


Assuntos
HDL-Colesterol/sangue , LDL-Colesterol/sangue , Hiperlipidemias/sangue , Hiperlipidemias/diagnóstico , Período Pós-Prandial , Triglicerídeos/sangue , Adolescente , Glicemia/metabolismo , Índice de Massa Corporal , Estudos Cross-Over , Dieta Hiperlipídica , Gorduras na Dieta/administração & dosagem , Estudos de Viabilidade , Feminino , Seguimentos , Humanos , Masculino , Refeições , Reprodutibilidade dos Testes , Fatores de Risco , Adulto Jovem
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