What vessels follow the paraduodenal hernia into the fossa of Landzert?

STM (short-term memory) and WM (working memory) are related concepts but they are not interchangeable.

STM refers to the temporary storage of information in the brain for a brief period of time, typically several seconds to a minute. STM has a limited capacity and relies heavily on rehearsal to keep information active.

Working memory, on the other hand, is a more complex process that involves not only the temporary storage of information but also the manipulation and processing of that information in order to accomplish a specific task. WM includes both storage and active processing of information and has been shown to be related to a wide range of cognitive abilities, such as reasoning, problem-solving, and decision-making.

In summary, while STM is a component of WM, WM involves more complex processes than just simple storage and requires the manipulation and processing of information to accomplish a specific task. Therefore, they are not interchangeable concepts.

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Idiopathic retroperitoneal fibrosis is also known as Ormond's disease. It is a rare condition where fibrous tissue forms in the retroperitoneal space, which is the area behind the abdominal cavity where important structures such as the kidneys and major blood vessels are located.

The cause of this condition is not well understood, hence the term "idiopathic," which means unknown origin. The fibrous tissue can put pressure on these structures, leading to complications such as kidney failure, hypertension, and deep vein thrombosis. Symptoms of retroperitoneal fibrosis may include back pain, abdominal pain, leg swelling, and urinary problems.

Diagnosis is typically made through imaging studies such as CT scans or MRI. Treatment may involve medication to reduce inflammation and surgery to remove the fibrous tissue if necessary. Regular follow-up with a healthcare provider is important for management of this condition.

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The crown-of-thorns sea star, acanthaster planci, feeds on the living tissue of coral polyps, specifically the soft tissues of the coral's polyps, which provide the necessary nutrients for the sea star's survival.

When the sea star attacks the coral, it uses its tube feet to grip and pull apart the coral, exposing the soft tissue within. The sea star then extrudes its stomach over the coral, secreting digestive enzymes to break down the coral's tissues and absorb the nutrients. Therefore, the soft tissue of the coral polyps is what provides nutrition to the crown-of-thorns sea star.

the crown-of-thorns sea star (Acanthaster planci) and which part of the coral provides nutrition to it when it preys on live coral. The part of the coral that provides nutrition to the crown-of-thorns sea star is the coral's soft tissues and polyps. The sea star uses its specialized tube feet to extrude its stomach, which releases digestive enzymes that break down the coral tissues and polyps.

The sea star then absorbs the nutrients from the digested tissues, leaving the coral skeleton behind.

In summary, the crown-of-thorns sea star gains nutrition from the coral by consuming its soft tissues and polyps.

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Elastase is a protease enzyme produced by a variety of cells in the body, including neutrophils, macrophages, and mast cells.

In a healthy individual's bronchoalveolar lavage, the presence of elastase would suggest an increased level of inflammation in the lungs. Neutrophils are the primary cells responsible for releasing elastase in response to inflammation. They are the first cells to arrive at the site of infection or injury and play a crucial role in fighting off pathogens. Macrophages are also capable of releasing elastase, but they do so at a much lower level than neutrophils.

Mast cells are another potential source of elastase, but they are primarily associated with allergic reactions and are not typically found in high numbers in the lungs. In summary, if elastase is present in a healthy individual's bronchoalveolar lavage, it likely came from neutrophils or, to a lesser extent, macrophages. Further testing and evaluation would be necessary to determine the underlying cause of the inflammation.

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The appropriate codes for this screening colonoscopy would be 45378, 45385-51, and 45385-59.

Code 45378 is used to report a diagnostic colonoscopy, which includes examination of the entire colon and rectum. In this case, the colonoscope was inserted and passed through all flexures to the cecum, indicating that a complete examination was performed.

Code 45385 is used to report the removal of a sessile polyp in the colon. In this case, a small sessile polyp was removed by snare in the distal sigmoid.

The -51 modifier is used to indicate that multiple procedures were performed during the same session, and the -59 modifier is used to indicate that the second procedure (polypectomy) was a distinct and separate procedure from the first (colonoscopy).

So, the appropriate codes for this screening colonoscopy with polypectomy would be 45378 for the colonoscopy, and 45385-51 and 45385-59 for the removal of the polyp.

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The viscerosomatic reflex is a type of reflex where a visceral organ, such as the liver or stomach, causes a response in the musculoskeletal system. Responsible for this reflex in the lower abdomen and pelvis region.

These segments receive sensory input from the organs in this area and send signals to the muscles and tissues surrounding them. This can lead to muscle tension or spasms, as well as pain or discomfort in the area. Viscerosomatic reflexes can be helpful in diagnosing and treating certain conditions, as they can indicate dysfunction or inflammation in the affected organs. It is important to address these reflexes as they can contribute to chronic pain and discomfort in patients.

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Answer:

The most common neural tube defect linked to valproic acid use is spina bifida (opening in the spine). The chance of a neural tube defect when taking valproic acid is approximately 1 in 50 to 1 in 100 (1-2%)

Explanation:

The most common congenital abnormality associated with the use of Sodium Valproate during Pregnancy is Fetal Valproate Syndrome(FVS) in the baby.

Sodium Valproate is a drug that is approved in the UK and is mainly used in the treatment of bipolar disorder and treating migraine and severe headaches sometimes.

But, it is not recommended for the pregnant woman. The primary reason for this is that it may cause Fetal Valproate Syndrome(FVS) in the baby. Babies who are born with this syndrome may face long-term difficulties in learning and memorizing.

In very rare cases, women that used Sodium Valproate during pregnancy deliver babies that do not develop FVS syndrome.

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Answer:

A. Radon.

Explanation:

Radon is a leading cause of lung cancer in the United States.

During the absolute refractory period, which lasts about 1 ms, no action potential can be generated no matter what the stimulus strength is because the sodium (Na+) channels that opened during depolarization are inactivated or closed, and the potassium (K+) channels that opened during repolarization are still open.

As a result, the membrane potential is hyperpolarized and the threshold for activation of Na+ channels is not reached. This ensures that each action potential is discrete and propagates in one direction only. The absolute refractory period is followed by the relative refractory period during which a stronger-than-normal stimulus can generate an action potential.

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An indication of stress testing is D. evaluation of chest pain in a patient with normal baseline EKG.

The correct answer is Option D.

Stress testing is a diagnostic tool used by medical professionals to assess the cardiovascular system's response to physical stress. It helps identify potential abnormalities, such as blocked arteries or irregular heart rhythms, that may not be apparent during rest.
In the context of the given options:
A. Angina at rest is not an indication for stress testing, as it represents a condition where the patient experiences chest pain due to insufficient blood flow to the heart, even when not physically active.
B. Acute myocardial infarction, commonly known as a heart attack, is a medical emergency and not an indication for stress testing. Immediate medical intervention is required to treat this condition.
C. Severe hypertension, or high blood pressure, is not an indication for stress testing. Instead, it requires proper management through lifestyle modifications and medications.
D. Evaluation of chest pain in a patient with a normal baseline EKG is an indication for stress testing. In this case, the test can help determine the cause of the chest pain, such as underlying coronary artery disease or other heart-related issues. The stress test can also help guide appropriate treatments and preventive measures for the patient.
To summarize, stress testing is indicated for evaluating chest pain in a patient with a normal baseline EKG, as it can provide valuable information about the patient's cardiovascular health and guide appropriate treatment strategies.

The correct answer is Option D.

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answer: "I will call my health provider if I develop a fever"

Explanation: With neutropenia, the client has an increased risk of acquiring infections. Therefore, the client should notify the health care provider immediately if an increased temperature or chills occur.

The client statement that indicates an understanding of the instructions is "I will call my health provider if I develop a fever". This is because neutropenia is a condition where the client has a low white blood cell count, making them more susceptible to infections.

A fever can be a sign of an infection, so it is important for the client to report any fevers to their health provider promptly. Using a soft toothbrush and wearing a mask can also help reduce the risk of infection, but the statement about calling the health provider is the most specific to the client's condition. The statement about the grandchildren getting an infection from the client is also true, but it does not necessarily indicate an understanding of the instructions given by the nurse.

The other statements also show good understanding of how to manage neutropenia, but they do not address the most critical concern of identifying and treating infections in a timely manner. Using a soft toothbrush can help prevent mouth sores that can lead to infection, wearing a mask can help protect the client from exposure to infectious agents, and being aware of the risk of infection for others is important for infection control, but these actions do not directly address the need to monitor for signs of infection and seek prompt treatment.

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The treatment for Actinomyces infection involves long-term high-dose antibiotics, typically penicillin or amoxicillin, for several months to a year or more. In some cases, surgery may also be required to drain abscesses or remove infected tissue.

Nocardia infection is typically treated with a combination of antibiotics, including sulfonamides (such as sulfamethoxazole-trimethoprim), imipenem, amikacin, and/or ceftriaxone, depending on the severity of the infection and the patient's underlying health status. Treatment may continue for several months or longer, and may require hospitalization in severe cases. It is important to note that Actinomyces and Nocardia infections are rare and may be difficult to diagnose, as they can mimic other types of infections. Therefore, it is important to obtain cultures and susceptibility testing to guide appropriate treatment. In addition, close monitoring and follow-up are essential to ensure that the infection is effectively treated and to watch for potential side effects or complications associated with the use of antibiotics.

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The probable reason that approximately a dozen runner broke the 4-minute barrier within one year after Roger Bannister originally did was their expectations that it could be done, option (d) is correct.

While factors such as enhanced training procedures, improved equipment, and superior coaching may have played a role in improving athletes' performances, the primary reason that many runner were able to break the 4-minute barrier after Bannister was that they believed it was possible.

Before Bannister's historic run in 1954, many experts believed that running a mile in under 4 minutes was a physical impossibility. However, once Bannister achieved this feat, it demonstrated to other athletes that it was indeed possible, and this belief gave them the confidence to push themselves to new heights, option (d) is correct.

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The complete question is:

The probable reason that approximately a dozen runners broke the 4-minute barrier within one year after Roger Bannister originally did was their

a. enhanced training procedures

b. improved equipment

c. faster tracks

d. expectations that it could be done

e. superior coaching

Answer: Mortality from certain illnesses, certain diseases, disabilities

Epigenetics refer to the study of heritable changes in gene expression that do not involve alterations to the DNA sequence itself. Two major mechanisms involved in epigenetic regulation are histone modification and DNA methylation.

Acetylating histones involves the addition of acetyl groups to lysine residues on histone proteins, which are the proteins around which DNA is wrapped. This modification tends to loosen the histone-DNA interactions, making the DNA more accessible to transcription factors and other regulatory proteins, leading to increased gene expression.

On the other hand, methylating cytosine and adenine involves the addition of a methyl group to the DNA nucleotide bases. DNA methylation generally leads to the repression of gene expression, as it can inhibit the binding of transcription factors and other regulatory proteins to the DNA.

Overall, both histone acetylation and DNA methylation are important mechanisms for regulating gene expression and maintaining cellular identity, but they work through different mechanisms and can have opposing effects on gene expression.

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Swan neck deformity is a common manifestation of rheumatoid arthritis (RA) that occurs due to several anatomic causes from distal to proximal. It is characterized by hyperextension of the proximal interphalangeal joint (PIP) and flexion of the distal interphalangeal joint (DIP), leading to a characteristic S-shaped curve of the finger.

The first anatomic cause is synovial inflammation of the PIP joint, which leads to the destruction of the volar plate and other supporting structures. This causes the extensor tendon to become slack, leading to hyperextension of the PIP joint.

The second anatomic cause is the imbalance between the intrinsic and extrinsic muscles of the hand, which occurs due to the destruction of the joint. The intrinsic muscles, responsible for the flexion of the fingers, become weak, leading to the extension of the PIP joint.

The third anatomic cause is the development of fibrous adhesions between the extensor tendon and the proximal phalanx. These adhesions pull the extensor tendon towards the wrist, leading to hyperextension of the PIP joint.

The fourth anatomic cause is the formation of a boutonniere deformity, which occurs due to the imbalance between the intrinsic and extrinsic muscles of the hand. The intrinsic muscles, responsible for the flexion of the fingers, become stronger, leading to the flexion of the DIP joint.

In summary, the anatomic causes of RA swan neck deformity include synovial inflammation of the PIP joint, imbalance between the intrinsic and extrinsic muscles of the hand, fibrous adhesions between the extensor tendon and the proximal phalanx, and the development of a boutonniere deformity.

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Answer:

Calories that are based on sugar or fat are often referred to as empty calories.

Explanation:

Empty calories are calories that come from foods or drinks that contain little or no nutritional value. Foods and drinks that are high in added sugars or fats, such as candy, soda, and fried foods, are examples of items that are often high in empty calories. These foods and drinks can contribute to weight gain and other health problems if consumed in excess, as they do not provide the body with the vitamins, minerals, and other nutrients it needs to function properly.

Mindfulness-based cognitive therapy (MBCT) was created by three psychologists named Zindel Segal, Mark Williams, and John Teasdale. They combined the principles of cognitive therapy with mindfulness meditation practices to create a new approach for treating depression.

The development of MBCT began in the 1990s when Segal, Williams, and Teasdale recognized the potential of mindfulness meditation to help patients with depression. They saw that mindfulness could help individuals become more aware of their thoughts and emotions and learn to manage them in a more constructive way. The three psychologists collaborated to create an eight-week program that combined mindfulness meditation with cognitive therapy techniques. The program was designed to help individuals with depression learn to recognize negative thought patterns and develop more positive ways of thinking. The effectiveness of MBCT was first tested in a study conducted in 2000. The results of the study showed that individuals who participated in the program experienced a significant reduction in depressive symptoms compared to those who received traditional treatments. Since then, MBCT has become a widely accepted treatment for depression, anxiety, and other mental health conditions. It has also been adapted for use in a variety of settings, including schools, workplaces, and prisons.

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A convoluted immunological pathway, including numerous cytokines and chemokines, is used to attract and activate eosinophils.

In response to an allergen or infection, the innate immune system releases IL-5, which stimulates the production and release of eosinophils from the bone marrow. Once in circulation, eosinophils are attracted to the site of inflammation by chemokines, such as eotaxin, which are produced by epithelial cells, mast cells, and T lymphocytes.

At the site of inflammation, eosinophils are activated by a range of stimuli, including complement proteins, cytokines (e.g. IL-4 and IL-13), and cell-cell interactions with other immune cells (such as mast cells). Activated eosinophils release a range of cytokines, enzymes, and other mediators that contribute to the allergic response and tissue damage.

In summary, eosinophils are recruited and activated by a complex interplay of immune signals that ultimately lead to their migration to sites of inflammation and the release of pro-inflammatory mediators.

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"The physical impossibility of death in the mind of someone living" is a phrase coined by British artist Damien Hirst in reference to his famous artwork, a preserved shark in a glass tank filled with formaldehyde.

Hirst's work explores the concept of mortality and the human struggle to come to terms with death. The artwork symbolizes the impossibility of escaping the inevitability of death, while also representing the human tendency to try to control and preserve life. Ultimately, the piece is a haunting reminder of our own mortality and the fragility of life.

It serves as a powerful statement about the human condition, inviting viewers to contemplate the meaning of life and the inevitability of death in a world that is often characterized by uncertainty and impermanence."

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The primacy effect and the recency effect are two well-known phenomena that influence our memory recall.

The primacy effect refers to our tendency to better remember items at the beginning of a list, while the recency effect describes our ability to better remember items at the end of a list. When it comes to the impact of delay or distraction on these effects, it turns out that the two effects are affected differently. While delay or distraction can decrease the recency effect, it does not have the same effect on the primacy effect. One explanation for this difference is that the primacy effect is thought to be related to the way in which information is initially encoded and stored in memory. According to this view, items that are encountered early in a list receive more attention and are more deeply processed, leading to stronger memory traces. This means that even if a delay or distraction occurs after the list is presented, the initial encoding and storage process for the items at the beginning of the list has already occurred, leading to a persistent primacy effect.

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In a diabetic patient with poor glycemic control, when they exercise, the body will activate the adenosine monophosphate-activated protein kinase (AMPK) pathway early.

AMPK is a key enzyme that plays a critical role in regulating glucose and lipid metabolism in response to changes in energy availability. In skeletal muscle, AMPK activation promotes glucose uptake and utilization, which can help to lower blood glucose levels in diabetic patients. Therefore, regular exercise can be a useful tool to improve glycemic control in diabetic patients by promoting the activation of the AMPK pathway.

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The t(11;33) translocation is associated with acute myeloid leukemia (AML) with the KMT2A-MLLT3 (also known as MLL-AF3) gene fusion.

This translocation results in the fusion of the KMT2A gene on chromosome 11 and the MLLT3 gene on chromosome 9, leading to the formation of an abnormal protein that promotes the development of leukemia cells. AML with KMT2A-MLLT3 is a rare subtype of AML that is associated with a poor prognosis and requires aggressive treatment.

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The major hemodynamic adaptation that maintains cardiac output in a patient with acute aortic regurgitation is left ventricular dilation.

Aortic regurgitation is a condition in which blood flows back from the aorta into the left ventricle during diastole, causing volume overload and increased pressure in the left ventricle. In response, the left ventricle compensates by dilating to accommodate the increased volume of blood, which allows for greater stroke volume and maintains cardiac output.

This adaptation occurs in the early stages of the disease and is crucial in maintaining cardiac function. However, over time, the compensatory mechanism becomes less effective, leading to progressive left ventricular dysfunction and heart failure.

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Anemia is a condition in which the body does not have enough red blood cells or hemoglobin to carry adequate oxygen to the tissues. Chronic anemia, which is defined as anemia lasting for several months or longer, can have several effects on the cardiovascular system, including cardiac output.

Cardiac output is the amount of blood that the heart pumps per minute and is determined by the heart rate and stroke volume (the amount of blood ejected by the heart with each beat). In chronic anemia, the decreased oxygen-carrying capacity of the blood can lead to a compensatory increase in cardiac output to maintain adequate tissue perfusion.

Initially, the increase in cardiac output is achieved through an increase in heart rate and stroke volume. However, in severe or prolonged cases of anemia, the heart's ability to increase cardiac output may be limited, and the compensatory mechanisms may become inadequate to meet the body's oxygen demand. This can lead to a decrease in cardiac output, which can result in symptoms such as fatigue, shortness of breath, and decreased exercise tolerance.

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Hemi-resection interpositional arthroplasty of the distal radioulnar joint is a surgical procedure that involves removal of a portion of the distal ulna bone and insertion of an interpositional material between the ulna and the radius. This procedure is indicated in certain conditions of the wrist joint.

1) Rheumatoid arthritis - This is an autoimmune disorder that causes inflammation and joint damage. In severe cases, the distal radioulnar joint may be affected, and hemi-resection interpositional arthroplasty may be required to alleviate pain and restore function.

2) Osteoarthritis - This is a degenerative joint disease that causes cartilage loss and bone damage. When the distal radioulnar joint is affected, hemi-resection interpositional arthroplasty may be recommended to reduce pain and improve mobility.

3) Instability - Trauma or chronic ligamentous laxity can cause instability of the distal radioulnar joint. Hemi-resection interpositional arthroplasty may be performed to stabilize the joint and prevent further damage.

4) Fractures - Severe fractures of the distal radius or ulna can cause joint incongruity and impair joint function. Hemi-resection interpositional arthroplasty may be considered as a salvage procedure in such cases to restore joint stability and preserve joint function.

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Three transbronchial biopsies of the lower right and two of the left lobe are reported individually using specific codes for each biopsy site. The codes are determined based on the location of the biopsy and the number of biopsies performed at each site.

For example, in the case provided, the three biopsies of the lower right lobe would be reported using the code 31628 x 3, which indicates that three biopsies were taken at that site. Similarly, the two biopsies of the left lobe would be reported using the code 31632 x 2.

It is important to report each biopsy separately to provide a detailed and accurate description of the procedure performed. This information is necessary for proper documentation, billing, and follow-up care. The codes used to report the biopsies are part of the Current Procedural Terminology (CPT) coding system, which is used by healthcare providers to describe medical procedures and services.

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By understanding the goals of each type of psychotherapy, you can match them with the appropriate therapeutic approach for specific issues and concerns. 1. Cognitive-Behavioral Therapy (CBT) - Goal is to identify and change negative or unhelpful thought patterns and behaviors that contribute to mental health issues.

2. Psychodynamic Therapy - Goal is to explore unconscious thoughts and past experiences to gain insight into current emotional and behavioral patterns.

3. Humanistic Therapy - Goal is to help individuals achieve self-actualization and personal growth by fostering a supportive, non-judgmental therapeutic relationship.

4. Dialectical Behavior Therapy (DBT) - Goal is to help individuals regulate their emotions, improve relationships, and reduce impulsive or self-destructive behaviors.

5. Family Therapy - Goal is to improve communication and relationships within a family system to address and resolve conflicts and promote positive interactions.

6. Interpersonal Therapy - Goal is to address and improve communication and relationship patterns with others to reduce symptoms of mental health issues.

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Daneman and Carpenter's (1980) study on working memory span found that individuals with higher working memory spans performed better on complex cognitive tasks that required processing and storing information simultaneously.

The study involved a reading span task where participants were presented with a series of sentences to read and recall the last word of each sentence. Participants with higher working memory spans were able to recall more words, indicating a greater capacity for holding and processing information. The study supported the concept of working memory as a limited capacity system that plays a crucial role in higher-order cognitive processes. The findings have been widely replicated and have implications for understanding cognitive abilities and developing interventions for individuals with working memory deficits.

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Defense mechanism: Identification

Example behavior: A child who admires a superhero and imitates their actions and mannerisms, hoping to feel as powerful and capable as the hero.

Identification is a defense mechanism proposed by Anna Freud in which an individual takes on the qualities or characteristics of someone else in order to cope with feelings of inadequacy or anxiety. The individual may admire or idealize the other person, and may try to emulate their behaviors, attitudes, or appearance.

In the example behavior given, a child who admires a superhero is demonstrating identification as a defense mechanism. The child may feel vulnerable or powerless in certain situations, and may turn to the superhero as a source of strength and security. By imitating the superhero's actions and mannerisms, the child may feel more capable and in control, and may be better able to cope with their feelings of anxiety or insecurity.

Identification can be a helpful coping mechanism in some situations, but it can also lead to problems if the individual becomes overly dependent on the other person or loses their sense of self. As with all defense mechanisms, it's important to recognize when they are being used and to seek help if they are interfering with one's ability to function effectively in daily life.

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