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Wireless Networking Hardware Science

Taking Care of Mobile Patients 105

Posted by Zonk from the wardriving-your-pulse dept.
Roland Piquepaille writes "After a patient has been hospitalized for a surgical intervention, he usually wants to return to his normal life. But doctors would like to monitor him to be sure that the operation was successful. How can they manage this without being too intrusive? In "Health Care Monitoring of Mobile Patients," Italian researchers offer a three-layer networking solution. First, a body area sensor network would continuously record your cardiac activity or your body temperature. A second level would involve a home sensor network, including for example a PC wirelessly receiving this information. Finally, this home network would be able to alert an hospital network if needed. Right now, this whole idea is at the proof-of-concept level, but it really looks promising."
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Taking Care of Mobile Patients More

Taking Care of Mobile Patients

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  • Exactly What We Don't Need (Score:4, Interesting)

    by Anonymous Coward on Saturday February 26, 2005 @08:21PM (#11790978)
    Exactly what we don't need, more high tech flim-flammery for diseases that should have been prevented. More money for antismoking, better diet, better exercise, better public health, not this kind of nonsense
    • But the problem is that we'll probably be using this sort of stuff on the baby boomers that have already done plenty of damage to their bodies by now. We are going to need this sort of technology because when all the boomers start getting sick, we're not going to have enough room in the hospitals to keep 'em all.
      • But are baby boomers going to be the best patients for this type of treatment? It seems as if they are going to need more urgent care than most. Granted, this will be a case by case basis, but I'm speaking on average.
    • "more high tech flim-flammery for diseases that should have been prevented"

      Where did they mention "diseases that should have been prevented"? They could be talking about surgery for broken bones, gall stones, appendectomies, or whatever ... you leapt to the conclusion that it would be a "lifestyle" disease.

    • There is a BIG initiative to improve people's health before they have to see a doctor. Most insurance companies are exploring ways of informing their members to get regular checkups and keep healthy.

      However, they're having a hard time keeping the overweight family of 4 who you run into at Wal-Mart from eating all those Ho-Ho's and Ding-Dongs between feedings.
    • More money for antismoking, better diet, better exercise, better public health, not this kind of nonsense

      What exactly would we do with more money in these programs? We already have ad campaigns and school programs that deal with these issues, other than hiring personal trainers for everyone, what would the money be used for? You can't just throw money at problems and hope they disappear.
    • you got a time machine?

      (besides. even if you had a healthy life you would get diseases, just maybe a bit later, or with bad luck earlier. it's not like you live forever with good diet and exercise - you'll still eventually get some disease that gets the best of you. unless of course you die by some other means)

      so mr. anon cow. please retain from any hightech medical nonsense so we can save some money when you die a bit earlier.

  • First Post! (Score:1, Funny)

    by G4CubeNu ( 721811 )
    If I have surgery, I don't want a bunch of docs hovering around me. Good idea.

  • Just wait (Score:3, Funny)

    by daeg ( 828071 ) on Saturday February 26, 2005 @08:22PM (#11790989)
    Just wait until his ISP kicks him off due to threats by the .*AA and he flatlines on them.
    • OK, you're just joking.

      But what about all possible privacy and security issues? I mean, we're dealing with personal medical data here, and the sentence "A second level would involve a home sensor network, including for example a PC wirelessly receiving this information." was already enough to get me somewhat alarmed, thinking about all the possible viruses, troijans and such that would most likely have infected this said (most likely Windows) PC. Second, the sentence "Finally, this home network would be ab
      • If the computers were transmitting data that could lead to someone commiting identity theft, or using your billing/insurance info for something devious then there would be a problem.

        If it's just your medical records....well then what exactly would you lose other than privacy as far as to what has ailed you in the past? Why should a hospital have to have your explicit consent to send your medical history to another hospital, or to a network of hospitals - assuming of course that they are only exchanging you
        • Actually, in this case these sensors would just be sending some kind of case number and whether you're dead yet to the hospital.

          While it's not actually sending your medical history, the fact that it's sending anything at all gives away certain information about you, like "I might die soon so my employer might want to look at a replacement, or at least an excuse to fire me and keep the insurance premiums from going up more"
      • I doubt the system would send records anywhere. The hospital monitoring you would store your records, all the computer system monitoring you would need to do is send specific signals. Sending a single, encrypted chain of values for things like pulse rate is completely different from your home PC broadcasting your medical history.

        Also, if the system knows what is 'normal' it could send a single code telling the hospital everything is perfectly alright.

        Still not sure about the trojans tho...

  • Oh Cool!!! (Score:3)

    by AltGrendel ( 175092 ) <`su.0tixe' `ta' `todhsals-ga'> on Saturday February 26, 2005 @08:22PM (#11790992) Homepage
    Gives a whole new meaning to war driving.
    • Note that hacking a WiFi network does not directly mean that you can interfere with this protocol. You can always digitally sign/encrypt data units on application level. This would mean that you might have access to the network, or even internet connection, but that you would still have to hack the devices/software or operating system themselves. Of course, the advent of WiFi networks with their insecurities (insecure in practice, well thought out security *does* exist for WiFi) does not help.

  • -1 Roland (Score:5, Funny)

    by Anonymous Coward on Saturday February 26, 2005 @08:25PM (#11791017)
    +1 No link to his bogus website.

  • They better have rock-solid network security (Score:2, Funny)

    by Anonymous Coward
    Or the War Catheterizers will wreak havoc.

  • TOO MUCH SLASHDOT (Score:4, Funny)

    by bobdotorg ( 598873 ) on Saturday February 26, 2005 @08:36PM (#11791098)
    I somehow read the title as, "Taking care of mobile patents," and immediately got bent about some organization having the gaul to patent how to take care of patients.

    Ack - slashdot has turned me from a skeptic into a cynic.

    I must sign off now, but of course I'll hit reload one last time just in case another interesting article has been posted. So yeah - I'll probably still be here in a our or so...
  • For a minute I was wondering what mobile patents were and why they needed to be taken care of.
  • There's no cure for an unhealthy lifestyle. A heart monitor aint gonna cure that.

    Go on.. Eat that cheeseburger, fries and jumbo coke and sit on your butt all day.

    • how original. copy the first post.

      don't you realise that no matter how healthy you live you will get some (semi)'lifestyle' disease sooner or later that kills you. because you won't live forever - you WILL have problems with your heart, lungs, brains, muscles or something else, regardless of how healthy you have lived(it might take some healthy years later than if you had eaten unhealthy.. but you wont live forever).

  • Expecting a patient that wants to "return to normal life" is never going to leave the house is unrealistic. Why create a home network layer for this kind of application when you can use something like Bluetooth and a GSM/GPRS cell phone to relay the information instead. This way the patient can go anywhere as long as they keep their cell phone with them and the hospital can still receive updates on the patients health. They may have to shield some of the sensetive equipment from the cell transmitter however, but that's something that they should already have looked into. The Bluetooth/GPRS combo is incredibly underrated. I bought a $30 usb bluetooth dongle for my laptop and now I have wireless internet access everywhere. Albeit not that fast but sufficient for an ssh session, or in this case, sending vital signs every couple minutes.
    - Cary
    --Fairfax Underground [fairfaxunderground.com]: Where Fairfax County comes out to play
    • Three big reasons I could see:
      1) Signal availabilty: If you live in areas with poor or no reception you're out of luck. Also in larger-scale emergency situations cells have been known to be overloaded.

      2) Reliability: Something like this needs to run 24/7 without a problem. Home networks can be hardened with good hardware and backup power sources. Accidentally breaking the phone goes from being a temporary nuisance to a possibly fatal mistake.

      3) Cost: Even if it only takes 10 seconds to transmit the dat
    • Well said, and with the advance of UMTS you would get an always on experience as well. Currently GPRS means that you need to setup a new connection all the time (which is cumbersome and very costly). At this time UMTS is pretty expensive, and not that available, but this will change rapidly. And then we will have continuous access to cyberspace from anywhere at all. Same for WiFi in some places. And there are Gbit connections just around the corner. Overlooking this kind of technology is the biggest mistake
  • And how do patients expect to get their IV pain medications from home? Do they expect a PICC line and unfettered access to enough Dilaudid to stop their respirations?
    • Not to mention how are hospitals going to respond to critical changes in a patient's vital signs? Once cardiovascular or pulmonary stats start going downhill, you don't have a great deal of time.

      Although this is a far shot better than being sent home with no follow-up, it could also lead to a false sense of security - you just don't have stand-by nurses and operating theatres in your average home.
  • hope they don't use WAPI http://politics.slashdot.org/article.pl?sid=05/02/ 25/1321259&tid=193&tid=219&tid=218 [slashdot.org]

    seriously though, how would they keep this data secure, especially with all of the HIPAA requirements these days

  • Yeah I can see the doctor's inbox: (Score:5, Funny)

    by Rosco P. Coltrane ( 209368 ) on Saturday February 26, 2005 @08:44PM (#11791153)

    From: superpenis@hotmail.com
    Subject: MAKE YOUR PENIS HUGE!!!

    From: viagra4cheap@someispinchina.cn
    Subject: V14gra 4 cH4Ap

    From: yourfriendjoe@spamhole.com
    Subject: Jesus loves you you know!

    From: cathy234@yahoo.com
    Subject: Holy crap, check this out! [virus deleted]

    From: hotsex12sdfsdf@bullcraponline.com
    Subject: Te quiero much mi amor [virus deleted]

    From: automated@healthmonitor.org
    Subject: Pulse 0, patient dead

    From: boss@hospital.org
    Subject: WHY THE FUCK DIDN'T YOU DO SOMETHING?! YOU'RE SO FIRED!!!
    • As someone who works for a highly electronic clinical group, I know that our doctors have seperate internal and external email addresses. This helps to ensure hippa requirements as well as keeps important work related email seperate from the rest of the crap.

      However, I know that the organization I work for is not the current norm. This could potentially be a serious problem at other places which implement this.
    • From: superpenis@hotmail.com
      Subject: MAKE YOUR PENIS HUGE!!!

      Didn't you know that all doctors have access to secret penis-enlargement surgeries and drugs that are unavailable to mere mortals? (don't believe me? Watch late-night TV... if there's a conspiracy to keep effective weight-loss and cancer treatments from the general public, you just KNOW we're doing the same for our penis-enlargement treatments).

      From: viagra4cheap@someispinchina.cn
      Subject: V14gra 4 cH4Ap

      Heh... One word: Samples.

  • Sorry to say this (Score:5, Interesting)

    by The Tyro ( 247333 ) * on Saturday February 26, 2005 @08:46PM (#11791173)
    But beware the cult of data, particularly as it relates to medicine.

    There is a human tendency to focus on the numbers; the objective things that we can quantify and measure. Unfortunately, numbers in medicine are fuzzy... they MUST be interpreted within the context of individual patient normals, and existing illness.

    Here's a great example from my own experience (Disclaimer: I am a physician who works in Emergency Services). Home blood-pressure monitoring devices are widespread now, such that many patients maintain these devices in their own homes. I sometimes see a half-dozen patients a day who present because they got a "high" number on their blood pressure machine. These people are asymptomatic, have no signs of end-organ damage, but are concerned enough about the number to come to the ER. I usually explain the phenomenon of cerebral BP autoregulation to them, and tell them that they're actually in greater danger if I aggressively lower their high blood pressure than if we gradually lower it with some medication changes. They often leave, still anxious despite the reassurance... they're worried about that number... that concrete, objective, hard piece of data to which we're all taught to lend so much weight.

    This is the problem with absolute numbers... they have to be interpreted by a clinician in the context of the individual patient. Gathering the numbers is easy... it's interpreting them that's the difficult and rate-limiting step. Every student is taugh early in training to "treat the patient, not the number." It's a cliche, but it contains a kernel of hard truth; one must recognize the importance of individualized treatment and interpretation.

    This system seems like it gathers lots of data... I just wonder what they're going to do to interpret it.
    • I sometimes see a half-dozen patients a day who present because they got a "high" number on their blood pressure machine. These people are asymptomatic, have no signs of end-organ damage, but are concerned enough about the number to come to the ER.

      Those patients you mention *are* sick, they suffer from hypochondry. Yes, they do tend to clog up ERs, but on the other end, after one or two thorough physical examinations, they can be properly diagnosed and directed to a psychologist for treatment earlier than
    • The other thing to remember is that people vary.

      For example - I always have a bitch of a time donating blood, because I usually run a little hot - 99.2 F. That's my normal temperature - and too many health professionals forget that the original studies that determined body temp were done in Celcius, and were accurate to a degree ( have you ever wondered why 98.6 F = 37.0 C? Because the measurement was done in Celcius first, then converted).

      You have to have the background data - what is normal for the pati
      • Every doctor should have tattoed to their arm (under the medic alert stuff) Always Treat Who not What!! The numbers will vary due to who (marathon runner, dancer, cumputer tech, gardener) even when you limit to a given age range

    • Here's a great example from my own experience (Disclaimer: I am a physician who works in Emergency Services). Home blood-pressure monitoring devices are widespread now, such that many patients maintain these devices in their own homes. I sometimes see a half-dozen patients a day who present because they got a "high" number on their blood pressure machine.

      I know exactly what you mean about these patients. The way I've started dealing with them is to take a piece of paper and draw a quick graph that shows

    • But beware the cult of data, particularly as it relates to medicine.

      There is a human tendency to focus on the numbers;
      ...
      I sometimes see a half-dozen patients a day who present because they got a "high" number on their blood pressure machine.

      Hmm, lives *have* been saved due to people being alerted by such home-based diagnosis units - these machines have a place. The correct way to combat the misinterpretation you mentioned of some limited data is to obtain better data and have better understanding all a

      • A Holter only records the data, it does not interpret it. Holter monitors most certainly DO have a place... but again, they only record the ECG data (not BP) and some give you statistics; a human cardiologist still has to interpret it in the context of that patient's individual situation, history, and pre-existing conditions.

        Most ECG machines give you a "machine read" when they record a tracing... but it's very often incomplete/wrong. I don't know a single clinician who bases their treatment soley off th
        • > A Holter only records the data, it does not interpret it.

          Yes, I know that. I have a Holter scheduled early next month. :)

          > Holter monitors most certainly DO have a place... but again,
          > they only record the ECG data (not BP) and some give you statistics;

          I was surprised to learn it, but the GP who referred me to the cardiac specialists said these Holters record blood pressure too. I asked if this was based on some sort of automated inflation, deflation of some cuff at regular intervals, but my G
    • I am NOT a physician, but I do design test equipment - so metrology (the science of measurement) is something near and dear to me.

      I have a thermometer at home (old-school, alcohol filled glass tube). I also have a sphygmomamometer (one of the old-school types - cuff, dial, stethoscope).

      Now, if my thermometer shows me running a bit hot, or if my sphygmomamometer shows me running a bit high, am I going to get terribly excited?

      No, because I have NO IDEA what the calibration states of those instruments are -
  • Before you know it, the big brother will be monitoring your heartbeat to determine your political inclination :)
    • If the hospitals can monitor at-risk patients, why not just monitor everyone such that immediate response can be enacted for emergencies? And if hospitals may monitor for health emergencies, why not just let the government get in on it to monitor for crime emergencies? In fact, why not just implant trackers into citizens for easier monitoring? Wow, this would be a great way to make the world a safer place for authoirty!

  • Piquepaille (Score:1, Troll)

    by stud9920 ( 236753 )
    more like Pissepaille am i rite...
  • Wouldn't this kind of equipment interfere with an artificial heart stimulator? On the other hand, if the patient is flat-lining and the equipment starts transmitting, it just might bring him back! :)

  • Wait until your ISP hears about it (Score:5, Interesting)

    by bluGill ( 862 ) on Saturday February 26, 2005 @08:56PM (#11791245)

    ISPs are gonna love this. Suddenly your net connection is as critical as a phone connection. People will die when the net connection goes down. Suddenly telco 99.999% uptime looks small.

    Even when the ISP doesn't care about you, their lawyers care because your heirs will have an easy suit if they can prove the network was down for even 30 seconds at about the time you died.

    Geeks everywhere will rejoice if this happens after "fast enough" netconnections are rolled out. Suddenly the bandwidth we want will be legally 24x7, and an effective static ip address because 30 seconds is less than how long it can take to reconnect after a dhcp lease changes.

    • Even when the ISP doesn't care about you, their lawyers care because your heirs will have an easy suit if they can prove the network was down for even 30 seconds at about the time you died

      Well, no.

      You know that combinations of words you have to agree to (by voice or signature) when you sign up for a net connection? It often states that there is no guarantee that the connection will be available at all times.

      There goes the suit. And it should. If you want 100% uptime (hefty compensation when offline) you

      • Doesn't matter, the law trumps anything in a contract. The law will take very dimly to any contract that allows someone to die. In fact once this becomes common you can sue your ISP for downtime, despite that part of the contract.

        Any judge who hears these words: "Your honor, they cannot know when my great aunt will come for a visit after surgery. Therefore they need to assume I always have someone visiting who needs a net connection." The judge is likely to find that the ISP must keep the net connec

        • Perhaps you are right, but then again I pity anyone living in the United States (or with your system of law to be precise).

          In Sweden (where I live), this would probably not be possible. For example, it would be impossible for me to sue the seller of a microwave oven for not explicitly stating that it cannot be used to dry my cat. Heck, even if he tells me it can, I still would not be able to sue him.

          People have to think for themselves sometimes.

          • Our system of laws makes it possible for the little guy to get his day in court. It is easily abused, but despite all the stories about abuse it isn't that bad in reality.

            Personally I pity you, living in a country where a faceless company can kill someone though negligence and there is nothing you can do about it, just because your contract doesn't prohibit it. Though from what I know of Swedish law (very little) my guess is that your courts are more likely to take my side of the argument than our cour

  • Just wait until someone comes up with a good reciever for these signals...

    Man goes on subway to get lunch/groceries/whatever...
    another man passes him in close proximity, takes reading, privacy invaded.
    • Man goes on subway to get lunch/groceries/whatever...
      another man passes him in close proximity, takes reading, privacy invaded.

      The smart sick person goes get lunch/groceries/whatever..., saves the tinfoil wrapping, puts it on head immediately, another man passes him in close proximity, takes no reading, privacy maintained!

  • Obligatory (Score:3, Funny)

    by Rosco P. Coltrane ( 209368 ) on Saturday February 26, 2005 @09:03PM (#11791306)
    Okay, I've been waiting a while to see the Microsoft jokes come up, but none yet. Someone's gotta do it I guess:

    It gives a whole new meaning to "blue screen of death"

    Sorry...

  • Get them OUT of the hospital ASAP! (Score:4, Interesting)

    by Tsu Dho Nimh ( 663417 ) <abacaxi&hotmail,com> on Saturday February 26, 2005 @09:14PM (#11791385)
    ""After a patient has been hospitalized for a surgical intervention, he usually wants to return to his normal life. But doctors would like to monitor him to be sure that the operation was successful. How can they manage this without being too intrusive?"

    Even if they only go to a convalescent care center, the faster they get out of the hospital and into a place that is more like a home envoronment, the better for all concerned. Hospitals are no place to try to rest and recover from anything (and I speak as an ex-Med Tech).

    Being able to monitor blood pressure, temp and pulse, perhaps with a "store and send" technology, would be a big step, because the firsat sign of a complicating infection is usually shown when one or more of the three goes off the patient's usual pattern.

  • Brave new world. (Score:5, Interesting)

    by ramblin billy ( 856838 ) <defaultaddy@yahoo.com> on Saturday February 26, 2005 @09:31PM (#11791483)
    I can just imagine it now...

    Sensor modules are located in the appropriate places - cardiac, temperature, blood oxygen level - all connected by bluetooth to the hub of your Body Sensor Suite - your cell phone. The phone stores 2 hours worth of telemetry at the maximum collection rate. It runs the input data through gates, constantly checking for pre-loaded alert triggers. If it detects a problem it can react with a variety of responses, from warning you in a kindly caretaker voice (maybe recorded messages from your 3 daughters) to take it easy, activating a medpak release, automatically connecting with your doctors office, up to sending a mayday on the 911 channel with automatic integration to the nearest EMT unit. The EMTs and your doctor receive real time sensor feeds as well as a GPS upload from your phone. Your doctor can remote activate medpaks, adjust your pacemaker, or use your phones camera to check pupil dilation. The EMTs have your complete medical history as well as treatment instructions from your doctor before they reach the scene. Your phone handshakes with the infotags embedded in the EMT's drug deliver system - verifying doses and checking for allergies.

    If you don't have any problems every two hours your phone links with your PC at home. Data is downloaded. Your complete records are available to your doctor (or his Virtual Physicians Assistant) via internet. He can monitor trends and modify the alert trips and actions. These new settings are uploaded to your phone during regular updates. Lifestyle information linking time, place, and physical condition are available for diagnostic evaluation. Your phone calls you and says "you are entering the first phase of an allergic reaction, what are you touching?" Sensors are available for environmental contaminants, radiation, air quality, even electromagnetic and sonic energy. Your phone won't let you drive drunk or fall asleep at the wheel. There's a hack available that masks cannabis detection. There's a lot of hacks available - recreational, performance enhancing, popular supplements. To refill your medpaks you just insert them into the AutoScript at your favorite store - yes - hacks are available. Of course if your phone indicates you have been deviating from your doctor prescribed regimen your co-pays go up. And there is that nasty rumor about the NSA...

    And of course.....it runs linex.

  • And The 4th Part (Score:3, Funny)

    by nate nice ( 672391 ) on Saturday February 26, 2005 @09:52PM (#11791622) Journal
    The doctors are able to electrocute you to death when you fail to make payments.

  • Dick Cheney (Score:2, Funny)

    by krikat ( 861906 )
    I wonder if Dick Cheney has one of these with like a "Hit Counter" so he knows how many heart attacks he has.

  • It's been done. Devices are on patients now. (Score:3, Informative)

    by LordByronStyrofoam ( 587954 ) on Saturday February 26, 2005 @11:44PM (#11792195)
    Cardionet [cardionet.com] makes an ambulatory cardiac patient monitor with a chest-worn sensor that transmits heartbeat waveform data to a belt-worn unit over ISM band (range is actually up to 30 feet - useful for when the belt-worn unit is in it's recharger on the nightstand and the patient gets up to use the restroom down the hall).
    The belt-worn unit, running VxWorks, continuously analyzes the waveform, comparing results with physician-defined thresholds. When a threshold is exceeded the unit communicates with the monitoring center using it's built-in cell phone. It the patient is outside, the built-in GPS tells the ambulance where to find him/her. The monitoring center can contact the physician. The system is in active use today in Philadelphia.
  • "How can they manage this without being too intrusive?"

    Step 1: No rectal thermometers at work.

  • Now I'll have to line my organs with tin-foil before surgery to prevent those medical government-controlled hacks from trying to control me!
  • This French company [tamtelesante.com] manufactures intelligent health monitoring clothing that can be setup to connect remotely...

  • I though the idea was (Score:3, Insightful)

    by Jozer99 ( 693146 ) on Sunday February 27, 2005 @11:21AM (#11794229)
    I thought that the whole idea was that the patient was there in case their heart suddenly stopped after surgery. While a home sensor system like this would TELL the doctors it happened, there would not be much they could do about it for the 5 minutes that it takes an amublance to get there. If the patient is in the hospital, someone with a defibulator would be there in seconds.
    Can't people take a day or two off for a triple bypass anymore? IT isn't like you are isolated from the world. Many hosipitals now have computer terminals that you can use, and free WiFi if you want to use your own. Not to mention telephones.

  • Bad idea from experience (Score:3, Informative)

    by kbielefe ( 606566 ) <karl@bielefeldt.gmail@com> on Sunday February 27, 2005 @01:55PM (#11795329)
    My daughter was born last June 3 months premature, spent 3 months in the hospital, and then 4 months on a home heart/apnea monitor because complications with her hydrocephalus cause bradycardia (low heart rate).

    I think wireless transmission to the hospital would be a bad idea for the following reasons:

    • If you are bad enough off to need a monitor you need someone at your home trained in CPR and the interpretation of the monitor alarms anyway in order to respond fast enough.
    • Those things go crazy with false alarms. Our daughter had about 300 alarms a month, only a couple of which were actually cause for concern, and none of which required medical intervention. Every time our daughter breathed a little shallow when she was eating, wiggled a little too much, or got a little upset when her diaper was changed, the alarm went off. A human must look at the person to verify if the alarm is valid, even in the hospital. It was pretty fun to have the battery get low after a 4 hour plane flight and set off the ear-piercing alarm in the terminal.
    Now a real innovation would be making these the size of a cell phone instead of that VCR we were hauling around.

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