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1.
MMWR Morb Mortal Wkly Rep ; 69(3): 67-71, 2020 Jan 24.
Artigo em Inglês | MEDLINE | ID: mdl-31971935

RESUMO

Zika virus infection during pregnancy can cause congenital brain and eye abnormalities and is associated with neurodevelopmental abnormalities (1-3). In areas of the United States that experienced local Zika virus transmission, the prevalence of birth defects potentially related to Zika virus infection during pregnancy increased in the second half of 2016 compared with the first half (4). To update the previous report, CDC analyzed population-based surveillance data from 22 states and territories to estimate the prevalence of birth defects potentially related to Zika virus infection, regardless of laboratory evidence of or exposure to Zika virus, among pregnancies completed during January 1, 2016-June 30, 2017. Jurisdictions were categorized as those 1) with widespread local transmission of Zika virus; 2) with limited local transmission of Zika virus; and 3) without local transmission of Zika virus. Among 2,004,630 live births, 3,359 infants and fetuses with birth defects potentially related to Zika virus infection during pregnancy were identified (1.7 per 1,000 live births, 95% confidence interval [CI] = 1.6-1.7). In areas with widespread local Zika virus transmission, the prevalence of birth defects potentially related to Zika virus infection during pregnancy was significantly higher during the quarters comprising July 2016-March 2017 (July-September 2016 = 3.0; October-December 2016 = 4.0; and January-March 2017 = 5.6 per 1,000 live births) compared with the reference period (January-March 2016) (1.3 per 1,000). These findings suggest a fourfold increase (prevalence ratio [PR] = 4.1, 95% CI = 2.1-8.4) in birth defects potentially related to Zika virus in widespread local transmission areas during January-March 2017 compared with that during January-March 2016, with the highest prevalence (7.0 per 1,000 live births) in February 2017. Population-based birth defects surveillance is critical for identifying infants and fetuses with birth defects potentially related to Zika virus regardless of whether Zika virus testing was conducted, especially given the high prevalence of asymptomatic disease. These data can be used to inform follow-up care and services as well as strengthen surveillance.


Assuntos
Anormalidades Congênitas/epidemiologia , Anormalidades Congênitas/virologia , Vigilância da População , Complicações Infecciosas na Gravidez/virologia , Infecção por Zika virus/complicações , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Gravidez , Prevalência , Porto Rico/epidemiologia , Estados Unidos/epidemiologia , Ilhas Virgens Americanas/epidemiologia
4.
N C Med J ; 81(1): 14-22, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31908326

RESUMO

BACKGROUND The Zika virus (ZIKV) epidemic that began in 2015 presented a risk for ZIKV infection among persons who traveled to ZIKV-affected countries. Latinas in North Carolina and their sexual partners may be exposed to ZIKV when traveling to these regions.METHODS We administered a cross-sectional survey, measuring ZIKV risk and knowledge, to a convenience sample of 262 reproductive-age Latinas attending a Federally Qualified Health Center in rural North Carolina. We described ZIKV risk and knowledge in the sample, and compared responses between those who were pregnant or recently pregnant, and those who were not pregnant. We further identified factors associated with 1) awareness of ZIKV and 2) high knowledge of ZIKV sequelae and prevention among those who were aware of ZIKV, using log-binomial regression.RESULTS Two-thirds of participants had ever heard of ZIKV, which was positively associated with educational attainment. Most participants aware of ZIKV had moderate/high knowledge of ZIKV transmission (92.5%) and symptoms (73.2%), but knowledge of preventing sexual and congenital transmission was limited. Travel was infrequent among pregnant or recently pregnant participants (5.4%) and their partners (7.1%). Despite low risk for ZIKV infection, participants were willing to practice ZIKV prevention.LIMITATIONS Our study is limited by a lack of generalizability to Latinas in other regions of the country, self-reporting bias, and lack of survey validation as an indicator of English language proficiency.CONCLUSIONS Providers should identify patients likely to become pregnant and travel to high-risk areas, inquire about partner travel history, and offer culturally appropriate ZIKV risk counseling.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde/etnologia , Hispano-Americanos/psicologia , Doença Relacionada a Viagens , Infecção por Zika virus/etnologia , Estudos Transversais , Feminino , Hispano-Americanos/estatística & dados numéricos , Humanos , North Carolina , Gravidez , Fatores de Risco , Serviços de Saúde Rural
5.
Spec Care Dentist ; 40(1): 3-9, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31794083

RESUMO

INTRODUCTION: Deciduous teeth eruption is connected to children's growth and development. In Brazil, with the increase in the occurrence of children born with microcephaly associated to exposure to Zika virus, studies about orofacial alterations were necessary. OBJECTIVE: Describe the chronology and sequence of deciduous teeth in children with microcephaly due to the fetal exposure to Zika virus. METHODOLOGY: A cross-sectional study involving 74 children of a neuropediatric reference unit in Salvador, Bahia, in 2017 was conducted. Through use of secondary data, interviews with mothers and children's exam, the population was characterized, the chronology and sequence of deciduous teeth eruption was registered, and the analysis of the variables was proceeded. RESULTS: The first eruption happened between 4 and 17 months of age and 52.70% had a delay in the eruption of incisors. The average eruption time for the maxilla varies from 17.92 (16.56-19.28; 95% CI) to 20.43 (19.35-21.51; 95% CI) months, and the jaw from 11.57 (6.85-18.99; 95% CI) to 20.20 (19.09-21.31; 95% CI) months. In 77.94% of population, the eruption of the first teeth was in the lower arch and in 33.82%, molars and/or canines erupted before the incisors. CONCLUSIONS: There were alteration in the chronology and sequence of deciduous teeth eruption.


Assuntos
Microcefalia , Infecção por Zika virus , Zika virus , Brasil , Criança , Estudos Transversais , Humanos , Erupção Dentária , Dente Decíduo
6.
Mayo Clin Proc ; 94(12): 2572-2586, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31806107

RESUMO

Zika virus outbreaks have been explosive and unpredictable and have led to significant adverse health effects-as well as considerable public anxiety. Significant scientific work has resulted in multiple candidate vaccines that are now undergoing further clinical development, with several vaccines now in phase 2 clinical trials. In this review, we survey current vaccine efforts, preclinical and clinical results, and ethical and other concerns that directly bear on vaccine development. It is clear that the world needs safe and effective vaccines to protect against Zika virus infection. Whether such vaccines can be developed through to licensure and public availability absent significant financial investment by countries, and other barriers discussed within this article, remains uncertain.


Assuntos
Surtos de Doenças/prevenção & controle , Desenvolvimento de Medicamentos , Vacinas Virais , Infecção por Zika virus/prevenção & controle , Humanos , Infecção por Zika virus/diagnóstico , Infecção por Zika virus/epidemiologia
7.
Rev Fac Cien Med Univ Nac Cordoba ; 76(4): 217-221, 2019 12 03.
Artigo em Inglês | MEDLINE | ID: mdl-31833744

RESUMO

Introduction: We present temporal and spatial variation of deaths from microcephaly in children under 1 year of age is analyzed at regional, state, and municipal level in the pre-Zika period in Brazil. Materials and Methods: Data on births and deaths of infants with microcephaly was obtained from DATASUS from 1996 to 2013. Infant mortality rate from microcephaly (IMR-M) was estimated at Region, Federative Unit (UF), and Municipality level. Secular trend (ST) and risk of death variation were estimated using a Poisson regression model. Satscan software was used to obtain a statistic spatial scan for the Poisson model. Results: IMR-M shows a non-significant negative ST in the Southeast, South and Central West Regions of Brazil. A greater IMR-M risk of death variation is found in the North and Northeast Regions. Most UFs in the Southeast, South and Central West Regions showed a negative ST, in contrast to what occurs in the UFs of the North and Northeast Regions showed a positive ST. Six high risk significant clusters were found: 3 in the North-Northeast and 3 in the South-SouthWest-Center-West. Conclusions: The North and Northeast Regions showed positive ST for IRM-M and higher death risk, which was not observed in the other regions. Cluster distribution for higher IMR-M and risk resembles the distribution of the microcephaly and Zika cases in the outbreak period.


Assuntos
Mortalidade Infantil , Microcefalia/mortalidade , Microcefalia/virologia , Infecção por Zika virus/epidemiologia , Infecção por Zika virus/mortalidade , Brasil/epidemiologia , Surtos de Doenças , Humanos , Lactente , Recém-Nascido , Análise Espaço-Temporal
8.
BMC Infect Dis ; 19(1): 986, 2019 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-31752731

RESUMO

BACKGROUND: Zika virus (ZIKV) infection gained public health concern after the 2015 outbreak in Brazil, when microcephaly rates increased in babies born from infected mothers. It was demonstrated that ZIKV causes a congenital Zika virus syndrome, including various alterations in the development of the central nervous system. Although the infection of cells from the nervous system has been well documented, less is known in respect of ZIKV ability to infect immune cells. Herein, we investigated if peripheral blood mononuclear cells (PBMCs), freshly-isolated from healthy donors, could be infected by ZIKV. METHODS: PBMCs from healthy donors were isolated and cultured in medium with ZIKV strain Rio-U1 (MOI = 0.1). Infection was analyzed by RT-qPCR and flow cytometry. RESULTS: We detected the ZIKV RNA in PBMCs from all donors by RT-qPCR analysis. The detection of viral antigens by flow cytometry revealed that PBMC from more than 50% the donors were infected by ZIKV, with CD3+CD4+ T cells, CD3-CD19+ B cells and CD3+CD8+ T cells being, respectively, the most frequently infected subpopulations, followed by CD14+ monocytes. Additionally, we observed high variability in PBMC infection rates among different donors, either by numbers or type infected cells. CONCLUSIONS: These findings raise the hypothesis that PBMCs can act as a reservoir of the virus, which may facilitate viral dissemination to different organs, including immune-privileged sites.


Assuntos
Leucócitos Mononucleares/virologia , Infecção por Zika virus/virologia , Zika virus/isolamento & purificação , Antígenos CD19/genética , Antígenos CD19/imunologia , Linfócitos B/imunologia , Brasil , Linfócitos T CD8-Positivos/imunologia , Linfócitos T CD8-Positivos/virologia , Células Cultivadas , Humanos , Leucócitos Mononucleares/imunologia , Monócitos/imunologia , Monócitos/virologia , Reação em Cadeia da Polimerase em Tempo Real , Zika virus/genética , Zika virus/fisiologia , Infecção por Zika virus/diagnóstico , Infecção por Zika virus/genética , Infecção por Zika virus/imunologia
10.
BMC Infect Dis ; 19(1): 963, 2019 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-31718580

RESUMO

BACKGROUND: Colombia was the second most affected country during the American Zika virus (ZIKV) epidemic, with over 109,000 reported cases. Despite the scale of the outbreak, limited genomic sequence data were available from Colombia. We sought to sequence additional samples and use genomic epidemiology to describe ZIKV dynamics in Colombia. METHODS: We sequenced ZIKV genomes directly from clinical diagnostic specimens and infected Aedes aegypti samples selected to cover the temporal and geographic breadth of the Colombian outbreak. We performed phylogeographic analysis of these genomes, along with other publicly-available ZIKV genomes from the Americas, to estimate the frequency and timing of ZIKV introductions to Colombia. RESULTS: We attempted PCR amplification on 184 samples; 19 samples amplified sufficiently to perform sequencing. Of these, 8 samples yielded sequences with at least 50% coverage. Our phylogeographic reconstruction indicates two separate introductions of ZIKV to Colombia, one of which was previously unrecognized. We find that ZIKV was first introduced to Colombia in February 2015 (95%CI: Jan 2015 - Apr 2015), corresponding to 5 to 8 months of cryptic ZIKV transmission prior to confirmation in September 2015. Despite the presence of multiple introductions, we find that the majority of Colombian ZIKV diversity descends from a single introduction. We find evidence for movement of ZIKV from Colombia into bordering countries, including Peru, Ecuador, Panama, and Venezuela. CONCLUSIONS: Similarly to genomic epidemiological studies of ZIKV dynamics in other countries, we find that ZIKV circulated cryptically in Colombia. More accurately dating when ZIKV was circulating refines our definition of the population at risk. Additionally, our finding that the majority of ZIKV transmission within Colombia was attributable to transmission between individuals, rather than repeated travel-related importations, indicates that improved detection and control might have succeeded in limiting the scale of the outbreak within Colombia.


Assuntos
Genoma Viral , Infecção por Zika virus/virologia , Zika virus/genética , Aedes/virologia , Animais , Colômbia/epidemiologia , Surtos de Doenças , Evolução Molecular , Variação Genética , Humanos , Filogenia , Filogeografia , Zika virus/classificação , Zika virus/isolamento & purificação , Infecção por Zika virus/epidemiologia , Infecção por Zika virus/transmissão
11.
Braz J Med Biol Res ; 52(11): e8339, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31721902

RESUMO

A progressive increase in the circulation of arboviruses in tropical countries has been observed, accounting for 700,000 yearly deaths in the world. The main objective of this article was to identify the presence of Zika (ZIKV), dengue (DENV), and Chikungunya (CHIKV) viruses in immature stages of Aedes aegypti and Ae. albopictus. Household collections of immature phases of the vectors were carried out in the years 2015 and 2016. A total of 2902 dwellings were visited and the rate of infestation with larvae and pupae of Aedes mosquitoes was 283/1462 (19.4%) in March 2015 and 55/1440 (3.8%) in June 2015. In March 2015, 907 larvae/pupae were collected (583 or 64.3% of Ae. aegypti and 324 or 35.7% of Ae. albopictus) while in June 2015 there was a reduction in the number of immature forms found: 197 larvae/pupae (121 or 61.4% of Ae. aegypti and 76 or 38.6% of Ae. albopictus). This reduction was accompanied by a decrease in suspected human ZIKV cases from March to June 2015. The RT-qPCR performed in 18 pools identified that three (two of Ae. aegypti and one of Ae. albopictus) were positive for ZIKV, and none were positive for DENV or CHIKV. Our findings demonstrated that ZIKV was present in immature stages of insect vectors in the study region at least five months prior to the peak of ZIKV associated cases. Xenomonitoring of immature phases of the vectors may prove useful for predicting outbreaks.


Assuntos
Aedes/virologia , Vírus Chikungunya/isolamento & purificação , Vírus da Dengue/isolamento & purificação , Mosquitos Vetores/virologia , Zika virus/isolamento & purificação , Aedes/classificação , Animais , Humanos , Mosquitos Vetores/classificação , RNA Viral/análise , Reação em Cadeia da Polimerase em Tempo Real , Estações do Ano , Infecção por Zika virus/transmissão
12.
Rev Assoc Med Bras (1992) ; 65(10): 1249-1253, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31721956

RESUMO

OBJECTIVE: In this study, we intend to identify the prevalence of clinical variables in children with microcephaly. METHODS: This is a cross-sectional and observational study with data collected from medical records of patients admitted to the microcephaly outpatient clinic of a referral center in Teresina-PI. Demographic (gender and age) and clinical data (presence of epilepsy, dysphagia, irritability, and associated comorbidities) were collected. The frequency of Zika virus as a probable etiology was determined from computed tomography patterns and the exclusion of other etiologies by serological tests. RESULTS: A total of 67 patient records were evaluated, of which 31 were male and 36 were female, with a mean age of 1 year and 10 months. The most prevalent clinical variables were epilepsy, present in 47 children (70.2%), and irritability in 37 (55.2%). Also with a high frequency, 22 had dysphagia (32.8%), and 13 had musculoskeletal comorbidities (19.4%). Only three patients in the sample had cardiac abnormalities (4.5%), and no endocrine comorbidity was found. A total of 38 children in the sample (56.7%) presented ZIKV as a probable etiology and, in these cases, there was a higher frequency of epilepsy and dysphagia compared to other etiologies, although not statistically significant. CONCLUSION: Epilepsy, irritability, dysphagia, and musculoskeletal comorbidities were the most frequent clinical variables in children with microcephaly. There was a high prevalence of congenital ZIKV microcephaly syndrome in this sample.


Assuntos
Epilepsia/epidemiologia , Microcefalia/virologia , Anormalidades Musculoesqueléticas/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Infecção por Zika virus/epidemiologia , Brasil/epidemiologia , Pré-Escolar , Comorbidade , Anormalidades Congênitas/epidemiologia , Anormalidades Congênitas/etiologia , Estudos Transversais , Feminino , Humanos , Lactente , Masculino , Registros Médicos , Microcefalia/reabilitação , Gravidez , Complicações Infecciosas na Gravidez/etiologia , Prevalência , Centros de Reabilitação , Estudos Retrospectivos , Infecção por Zika virus/congênito , Infecção por Zika virus/reabilitação
13.
Emerg Microbes Infect ; 8(1): 1668-1678, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31735122

RESUMO

Since its emergence in Yap Island in 2007, Zika virus (ZIKV) has affected all continents except Europe. Despite the hundreds of cases imported to European countries from ZIKV-infested regions, no local cases have been reported in localities where the ZIKV-competent mosquito Aedes albopictus is well established. Here we analysed the vector competence of European Aedes (aegypti and albopictus) mosquitoes to different genotypes of ZIKV. We demonstrate that Ae. albopictus from France was less susceptible to the Asian ZIKV than to the African ZIKV. Critically we show that effective crossing of anatomical barriers (midgut and salivary glands) after an infectious blood meal depends on a viral load threshold to trigger: (i) viral dissemination from the midgut to infect mosquito internal organs and (ii) viral transmission from the saliva to infect a vertebrate host. A viral load in body ≥4800 viral copies triggered dissemination and ≥12,000 viral copies set out transmission. Only 27.3% and 18.2% of Ae. albopictus Montpellier mosquitoes meet respectively these two criteria. Collectively, these compelling results stress the poor ability of Ae. albopictus to sustain a local transmission of ZIKV in Europe and provide a promising tool to evaluate the risk of ZIKV transmission in future outbreaks.


Assuntos
Aedes/fisiologia , Mosquitos Vetores/fisiologia , Infecção por Zika virus/transmissão , Zika virus/fisiologia , Aedes/genética , Aedes/virologia , Animais , Europa (Continente) , Feminino , Humanos , Mosquitos Vetores/genética , Mosquitos Vetores/virologia , Carga Viral , Zika virus/genética , Infecção por Zika virus/virologia
14.
15.
Clinics (Sao Paulo) ; 74: e798, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31644665

RESUMO

OBJECTIVE: To describe the nutritional profile of newborns with microcephaly and factors associated with worse outcomes during the first 14 days of life. METHODS: This investigation is a longitudinal, descriptive study carried out in 21 full-term neonates exposed vertically to the Zika virus and hospitalized in a neonatal intensive care unit from February to September 2016. Patients receiving parenteral nutrition were excluded. Data analysis was performed using a generalized estimating equation model and Student's t-test to evaluate the association between worsening weight-for-age z-scores and independent clinical, sociodemographic and nutritional variables during hospitalization, with p<0.05 indicating significance. RESULTS: During hospitalization, there was a decrease in the mean values of the weight-for-age z-scores. The factors associated with worse nutritional outcomes were symptomatic exposure to the Zika virus, low maternal schooling, absence of maternal income and consumption of infant formula (p<0.05). Calcification and severe microcephaly were also associated with poor nutritional outcomes. Energy and macronutrient consumption remained below the recommendations and had an upward trend during hospitalization. CONCLUSION: The presence of cerebral calcification, the severity of microcephaly and symptomatic maternal exposure to Zika virus affected the nutritional status of newborns. In terms of nutritional factors, human milk intake had a positive impact, reducing weight loss in the first days of life. Other known factors, such as income and maternal schooling, were still associated with a poor nutritional status.


Assuntos
Microcefalia/fisiopatologia , Estado Nutricional/fisiologia , Infecção por Zika virus/complicações , Adolescente , Adulto , Feminino , Humanos , Recém-Nascido , Estudos Longitudinais , Masculino , Microcefalia/virologia , Fatores de Risco , Índice de Gravidade de Doença , Fatores Socioeconômicos , Adulto Jovem
18.
BMC Infect Dis ; 19(1): 888, 2019 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-31651247

RESUMO

BACKGROUND: Several Zika virus (ZIKV) outbreaks have occurred since October 2015. Because there is no effective treatment for ZIKV infection, developing an effective surveillance and warning system is currently a high priority to prevent ZIKV infection. Despite Aedes mosquitos having been known to spread ZIKV, the calculation approach is diverse, and only applied to local areas. This study used meteorological measurements to monitor ZIKV infection due to the high correlation between climate change and Aedes mosquitos and the convenience to obtain meteorological data from weather monitoring stations. METHODS: This study applied the Bayesian structured additive regression modeling approach to include spatial interactive terms with meteorological factors and a geospatial function in a zero-inflated Poisson model. The study area contained 32 administrative departments in Colombia from October 2015 to December 2017. Weekly ZIKV infection cases and daily meteorological measurements were collected. Mapping techniques were adopted to visualize spatial findings. A series of model selections determined the best combinations of meteorological factors in the same model. RESULTS: When multiple meteorological factors are considered in the same model, both total rainfall and average temperature can best assess the geographic disparities of ZIKV infection. Meanwhile, a 1-in. increase in rainfall is associated with an increase in the logarithm of relative risk (logRR) of ZIKV infection of at most 1.66 (95% credible interval [CI] = 1.09, 2.15) as well as a 1 °F increase in average temperature is significantly associated with at most 0.79 (95% CI = 0.12, 1.22) increase in the logRR of ZIKV. Moreover, after controlling rainfall and average temperature, an independent geospatial function in the model results in two departments with an excessive ZIKV risk which may be explained by unobserved factors other than total rainfall and average temperature. CONCLUSION: Our study found that meteorological factors are significantly associated with ZIKV infection across departments. The study determined both total rainfall and average temperature as the best meteorological factors to identify high risk departments of ZIKV infection. These findings can help governmental agencies monitor at risk areas according to meteorological measurements, and develop preventions in those at risk areas in priority.


Assuntos
Infecção por Zika virus/epidemiologia , Aedes/virologia , Animais , Teorema de Bayes , Colômbia/epidemiologia , Surtos de Doenças , Humanos , Masculino , Conceitos Meteorológicos , Mosquitos Vetores/virologia , Chuva , Risco , Temperatura Ambiente
20.
Arch Virol ; 164(12): 3027-3034, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31598845

RESUMO

The rate of evolution of viral genomes is a fundamental parameter for understanding the origin and spread of epidemics. For instance, molecular dating is one of the many practical outcomes of evolutionary rate estimation. In this sense, the rate of evolution of ZIKV merits attention, because it has been shown to be higher than the average rate reported for other flaviviruses. It has been hypothesized that the higher rate of ZIKV evolution is due to a bias related to the analysis of sequences collected within a short time range, which would increase the chance of sampling slightly deleterious nucleotide polymorphisms. To investigate this hypothesis, we assembled datasets with different ranges of sampling times and also decomposed the ZIKV evolutionary rate into synonymous and non-synonymous rates. Our results demonstrated that the rate of ZIKV evolution is time dependent and that the observed increase in short-term rates is largely accounted for by a higher non-synonymous rate, suggesting the presence of slightly deleterious variants not yet eliminated by purifying selection. On the other hand, we show that synonymous rates were less impacted by the range of sampling times, generating timescales with reduced uncertainty. We conclude that, for inferring the ZIKV timescale and reconstructing the history of epidemics, synonymous changes are the most appropriate substitution type to be examined. We were able to obtain ZIKV divergence times that were time independent and exhibited greater precision than previous estimates. This observation should also hold for other serially sampled fast-evolving pathogens with evidence of time dependence of evolutionary rates.


Assuntos
Evolução Molecular , Infecção por Zika virus/virologia , Zika virus/genética , Genoma Viral , Humanos , Cinética , Filogenia , Zika virus/química , Zika virus/classificação , Zika virus/isolamento & purificação
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