PD

Characterization of Parkinson Disease With Restlessness

Highlights

  • A study was conducted of restless leg syndrome, leg motor restlessness, and their variants in Parkinson disease and related disorders.
  • A total of 49.2% of PD patients had any restlessness, including RLS and LMR.
  • LMR variants and RLS variants are rare in PD and related disorders.
  • PD with restlessness was related to autonomic, sleep and depressive symptoms.

Objective
The objective of this study was to investigate the prevalence of restless leg syndrome (RLS), leg motor restlessness (LMR) and RLS/LMR variants and their relationship with clinical factors in patients with Parkinson’s disease (PD) and related disorders.

Methods
Sixty-three PD patients, 17 multiple system atrophy (MSA) patients and 11 progressive supranuclear palsy (PSP) patients were included in this study. Through face-to-face interviews, the patients were diagnosed with RLS/LMR, or with RLS/LMR variants in which the symptoms occur predominantly in body parts other than the legs.

Results
The frequency of RLS, LMR, RLS variants and LMR variants was as follows: PD (12.7%, 11.1%, 0% and 1.6%); MSA (5.9%, 11.8%, 0% and 0%); and PSP (0%, 9.1%, 0% and 0%). Restlessness without the urge to move was observed in 25.4% of the PD patients, 11.8% of the MSA patients and 0% of the PSP patients. The PD patients with restlessness exhibited higher Hoehn and Yahr stages and higher scores on the Scales for Outcomes in PD-Autonomic, PD sleep scale-2 and Beck Depression Inventory-II. The olfactory functioning, 123I-MIBG myocardial scintigraphy uptake and dopamine transporter single photon emission computed tomography findings did not differ between the PD patients with restlessness and those without. The severity of RLS was correlated with the autonomic symptoms among the PD patients with restlessness.

Conclusion
PD with restlessness was characterized by increased autonomic, sleep and depressive symptoms. Further studies including a large sample are warranted to characterize restlessness in PD and related disorders.

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How to Date when you have Parkinson’s

In my wildest imagination, I never would have predicted that I’d be in my 50s, single, living with Parkinson’s and living on long-term disability. Nevertheless, here I am. I was diagnosed in 2008 and became single again in 2015. That same year, I relocated my newly single self to a new state. I had family nearby, but otherwise, I knew no one.

Determined that my life would not be defined by Parkinson’s, I set out to live the best life I could. My priorities were to establish a community of friends and a new team of healthcare providers, to get my finances in order and to create a full and happy single life.

I socialized and made friends, but I specifically avoided group or one-on-one settings that hinted of dating. I wasn’t yet comfortable enough with my new single life.

While all of these priorities require ongoing attention, after about a year I felt sufficiently comfortable in this new life to consider the possibility of dating. I was feeling happy, and that set the foundation for me to enjoy romantic companionship as a nice addition to my life.

While online dating was unfamiliar territory, it seemed like the most straightforward way to meet someone. When I set out to compose my dating profile, I considered starting with “Unemployed, single woman with an incurable, progressive neurodegenerative disease seeks…..”

I decided that wasn’t the way to go, even though I got a good chuckle out of it.

When I met the first compatible guy, I had some genuine discomfort with not knowing exactly how or when to share my diagnosis. I felt vulnerable laying out my cards like that, but I also knew that avoiding vulnerability wasn’t an option if I wanted to live my life to its fullest potential.

So having Parkinson’s became just one of many things I’d share. One more “are we compatible” question to be answered in time. Mr. Compatibility never blinked when our plan to walk around the park became a walk to the nearest bench. And he was understanding if I canceled our plans because I was hit with a bout of fatigue. When we stopped dating after a few months, it was not because of Parkinson’s.

Since my re-entry into dating, I’ve had a dozen or so coffee or happy hour first dates and a couple of months-long relationships. I learn more about myself with every coffee, chat or relationship. People are endlessly fascinating, and each guy I meet teaches me something.

Because I believe that a relationship could enhance my life, I’ll keep at it. My father taught me that there are four relationships states in reverse priority order: Unhappily coupled, unhappily single, happily single and happily coupled.

I’ll admit that I still occasionally wonder why anyone would choose to be with someone who has Parkinson’s. Fortunately, the times I’ve asked that aloud have been to my therapist, family or friends. In other words, people who know my inherent worth. I believe that all human beings are worthy of being loved even though I, too, need a periodic reminder. Fortunately, I also know that everyone, without exception, suffers from their insecurities and that those come front and center when dating.

Over time, I’ve learned the value of packing up my insecurities and choosing to play the game rather than taking my ball and going home. After all, dating is just that. Dating. I don’t go on a first date thinking this is my next husband. I agree to go on a date because I think I might enjoy this person’s company.

My plan, for now, is to continue dating as opportunities present themselves, and I’ll remain open to the possibility of being happily coupled while continuing to live the life I love and enjoying my “happily single status.”

Article from Davis Phinney Foundation.

Other resources on dating with Parkinson’s:
Forming New Relationships
5 Tips for Singles with Parkinson’s
Advice on Dating after a PD Diagnosis

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Intimacy Issues & Parkinson’s

Warning: This article contains adult-themed issues and terms.

This article summarizes a presentation on sexual disfunction by Gila Bronner, MPH, MSW, CST, Director of Sex Therapy at the SHEBA Medical Center in Israel.

Jessica made an appointment with Gila Bronner, MPH, MSW, CST, a sex therapist, to discuss a specific issue: how could she address her husband’s drooling interfering with their sex life. Even though her husband was the one living with Parkinson’s disease (PD), some symptoms affected the both of them.

Intimacy issues and sexual dysfunction is a “couple problem.” It affects both partners. One person’s sexual dysfunction often results in the same effect in their partner. For example, when a man experiences a sexual dysfunction, his partner is more likely to experience sexual dysfunction and dissatisfaction as well.

There is a high prevalence of sexual dysfunction in PD, with problems ranging from erectile dysfunction, reduced desire and frequency, vaginal dryness, orgasm difficulties and more. According to one study, people with PD rate sexual dysfunction in their top 12 most bothersome symptoms (Politis, et al., 2010). Another study cites that 41.9 percent of men and 28.2 percent of women cease sexual activity after being diagnosed with PD (Bronner, et al. 2004).

Sexual dysfunction in PD can be compounded by depression, anxiety, pain and movement-related symptoms, which can affect desire, erectile dysfunction and sexual satisfaction. Sexual dissatisfaction has been associated with movement symptoms in men, anxiety in women and depression in both genders.

As a sex therapist, Gila reminds her patients that it is important to remember that sexuality is not only about sex and orgasms; its emotional, non-sexual physical and intimate aspects play important parts. Intimate touch and sexual activity contribute to a better quality of life and health overall. They are associated with emotional and physical relaxation, better self-esteem, increased vitality and well-being, and closeness between partners.

The increase in oxytocin that comes from massage and touch can even reduce pain. Older people who continue to engage in sexual activity have better overall cognitive functioning (Hartmans, et al. 2014). Therapeutic touch has even been shown to decrease behavioral symptoms of dementia (Woods, et al. 2005).

There are many alternative intimate and sexual activities to treat sexual dysfunction, such as outercourse (other sexual activities besides sex), self-stimulation, non-demanding touch (relaxing and pleasant touch), open sexual communication, compensatory strategies and sexual aids, and erotic thoughts and fantasies.

Intimacy Tips from People with PD and Their Partners

  1. Plan sex for when movement symptoms are at a minimum.
  2. Apply oily lubricants to lessen the effects of tremor on skin.
  3. Use sexual aids.
  4. Plan positions in advance with minimized movements between positions.
  5. Use lubricants for penetration during intercourse, and be sure to read the lubricant’s instructions before you begin.
  6. Use satin sheets to ease movement.
  7. Perform intimacy training and erotic tasks.
  8. Reduce stress and burden on your partner.

“Remember that the right to share love, touch and intimate moments accompanies us along our life,” said Gila.

Information provided by PDF.

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Contact sports increase Parkinson disease risk

Injuries from playing contact sports, such as rugby, boxing, and martial arts, have been linked to a heightened risk of dementia. A new study now says that contact sports may actually lead to other neurodegenerative diseases, and it explains why.

At Medical News Today, we have covered studies linking brain injury — usually as a result of playing contact sports — with a higher risk of developing various conditions later in life.

One such study argued that brain injuries could accelerate the processes that bring about Alzheimer’s disease, which is the most common type of dementia. It is characterized most prominently by memory loss, a sense of disorientation, and an impaired ability to carry on a daily routine.

Numerous studies during the past few years have suggested that repeated head injuries obtained from participation in contact sports are linked to chronic traumatic encephalopathy (CTE), which is a degenerative brain disease that can lead to dementia.

Now, a study led by researchers from the Boston University School of Medicine in Massachusetts has found that people engaging in contact sports may also be more likely to develop Lewy body disease.

In that condition, a protein called alpha-synuclein forms abnormal deposits known as Lewy bodies in the brain. Lewy body disease is associated with dementia symptoms, as well as with Parkinson’s disease.

Traditionally, scientists have believed that the motor symptoms — such as tremors, slowness of movement, and difficulty walking — experienced by some athletes are attributable to CTE.

However, the researchers argue instead that those symptoms are actually a byproduct of Lewy body disease, independently of CTE.

“We found the number of years an individual was exposed to contact sports, including football, ice hockey, and boxing, was associated with the development of neocortical [Lewy body disease], and Lewy body disease, in turn, was associated with Parkinsonism and dementia,” says study author Dr. Thor Stein.

The researchers’ findings are now published in the Journal of Neuropathology and Experimental Neurology.

Risk increased in long-term sports players

Dr. Stein and team drew their conclusions after studying 694 donated brains from three sources: the Veteran’s Affairs-Boston University-Concussion Legacy FoundationBrain Bank, Boston University Alzheimer’s Disease Center, and the Framingham Heart Study.

They found that the total number of years that a person had spent playing contact sports was associated with an increased risk of developing Lewy bodies in the cerebral cortex.

People who participated in contact sports for over 8 years had the greatest risk of developing Lewy body disease — six times higher, in fact, than the increase in risk seen in people who had played contact sports for 8 years or under. Moreover, people who had both CTE and Lewy body disease had a higher risk of dementia and Parkinson’s than those who only had CTE.
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Artificial intelligence to monitor Parkinson’s symptoms

Researchers at Massachusetts Institute of Technology, US have developed an artificial intelligence system that can monitor Parkinson’s symptoms from the other side of a solid wall.

The x-ray technology – named RF-Pose – will use radio signals to sense individuals’ posture and movement. This will help medical professionals track the development of Parkinson’s and provide more effective care.

Dina Katabi, professor of electrical engineering and computer science at Massachusetts Institute of Technology, said: “We’ve seen that monitoring patients’ walking speed and ability to do basic activities on their own gives healthcare providers a window into their lives that they didn’t have before.

“A key advantage of our approach is that patients do not have to wear sensors or remember to charge their devices.”

 

Article from EPDA.

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Video: Not all disabilities are visible

In this video from Parkinson’s UK, people all over the world talk about their Parkinson’s.

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How to Travel (with greater ease) with Parkinson’s

For the average person, traveling is a minor frustration. Security lines, delays, crowded airports and cramped and long lines at snack shops and restaurants are par for the course. However, if you’re living with Parkinson’s, those things aren’t just frustrations, they can be so troublesome and aggravating to deal with that you choose to stay at home.

That’s why we decided to reach out to our Davis Phinney Foundation Ambassadors, many of whom are avid travelers, to get their best tips for traveling with Parkinson’s. Armed with this information, when you get out and about this summer, we hope you’ll do so with greater ease.

Medication Management

Managing medications topped nearly everyone’s list. Here are a few suggestions our expert travelers offered.

Bring more than you need. (And always know how to get more in a pinch.) When you’re headed out for a long trip, it’s easy to miscalculate; so, bring extra.

Put your medications in more than one location. This way if something happens with your luggage or you forget a backpack somewhere, you’re covered. Ideally, keep them in your carry-on bags or on you if possible.

Set timers or alarms on your phone so you’re always prompted to take them, even if you’re caught up in another activity.

If you’re going to be in multiple time zones, plan a consistent schedule for taking your medication. Your body doesn’t care that you started in Boston and ended up in LA – it wants Sinemet every three hours.

Sometimes travel days will stretch on and on, far beyond a typical day at home. If your awake time demands it, take an extra dose of something and make sure you account for those extra doses when packing your meds.

If you’re traveling with a companion or care partner, have them carry an extra dose of your medications.

Always carry a complete list of medications with you. And be ready to show them if asked.

Make sure at least one set of your prescriptions are in Rx bottles with labels. If someone in authority questions the contents of your pill bags or bottles and you can’t prove what the medication is, they can take them if they must.

If you have any liquid medications (e.g., the gel form of carbidopa/levodopa for the Duopa pump that’s approved in the US), you’ll need a letter from your doctor. Although you’re allowed to travel with medications greater than the three-ounce limit specified by the Transportation Safety Administration, those medications will be subject to additional scrutiny, and you’ll need the documentation from your doctor as part of that process. Be sure to keep these medications with you in your carry on. Do not put them in your checked luggage.

Planning

Consider traveling by train rather than getting trapped in those tiny airplane seats. Trains have plenty of legroom, there’s no TSA and you get an amazing view.

When buying plane, train or bus tickets, be sure to allow enough time between legs if you have to have a layover so you have the time you need—and more—to get to your next gate.

Travel when you’re at your best. For example, if you feel best in the morning because that’s when your medications offer you the best relief from symptoms, consider flying or traveling at that time.

Make a list of everything you could possibly need for your trip and save it. You might have different lists for bike rides, road trips, weekend getaways, international trips, work trips and long-term travel. Update your lists on your computer each time you travel so they’re ready to print out when you prepare for your next adventure.

Check the weather! If you need to pack a few days before you leave, and you pack for the current weather report, you could get stuck with the wrong clothes. Be sure to check again the day before you leave since weather reports change quickly, and you may need to adjust what you pack. Many people living with Parkinson’s don’t do that well in the heat or in the cold. Not having the correct clothing can be a real problem.

Put all of your paperwork in an easy to access location. This might be in the top pocket or your backpack or maybe the pocket of your pants or jacket.

Consider including in your paperwork an emergency contact list with information about your neurologist, primary care physician and other healthcare providers as well as the names and contact information of family members or other people who should be contacted in case of emergency.

If you tend to run late, avoid stress by getting to the airport extra early. Everything takes longer than you expect, so think through the steps you’ll need to take for airport security, airline boarding, baggage handling, lines at the bathroom, snack shopping, etc.

If you’re going to be out of town for a while, take a quick picture of where you parked or make a note in your phone in case you forget exactly where you left your car when you return.

Read up on flying with a disability so you know what’s available to you.

Getting Around

Carry a cane or a walking stick, even if you think you don’t need it. Stress often makes Parkinson’s symptoms worse, and travel is stressful. Even if you don’t need it, it’s a warning sign to others to not crowd you or run over you in the terminal or on the street.

Arrange for a wheelchair to get through the airport. This can help a lot in crowds or in unfamiliar places.

If you need to use a handicap bathroom, use them when you see them.

Take advantage of TSA Pre✓® and Clear.

If you need help, ask for it. If help is offered, take it. This includes having someone carry your bags, taking advantage of extra time allowed for boarding, having someone get food and bringing it to you, etc.

Take a disposable plastic grocery bag with you so you can open it up and sit on it on the plane. When you want to get out of your chair, the plastic reduces friction which makes it much easier to get out of your chair.

Practice getting in and out of your airplane seat (or any seat) before you go. One of our Ambassadors Amy Carlson made this great video to show you how to do it with greater ease.

Food & Drink

Have your food items at the ready since you need to separate them when going through security.

Fill your water bottle after security and between flights.

Bring more snacks than you think you’ll need on the plane in case you get stuck, delayed and re-routed and suddenly your two-hour flight turns into a six hour one.

Communication

Remember that communication is on the person with Parkinson’s. As Kathleen Kiddo says, “Nobody can read our cue cards so it’s our job to let them know what’s up.”

Consider wearing or traveling with a card that says something like, “I’ve got Parkinson’s and I need a bit more time and space. Thank you.

Some people with Parkinson’s carry this card.

I'm not intoxicated, I have Parkinson's

Or this card from the Parkinson’s Foundation.

Sleep and Rest

Slow down and don’t overschedule your days. Choose the activities that are most important to you rather than trying to rush through to hit every possible spot. You will have the most enjoyable time if you learn how to conserve energy so that you have it when it matters most.

Try to time your travel so that you have plenty of time to rest once you arrive at your destination. For example, if you’re traveling to Europe, consider going a day early so you have time to get your body clock adjusted.

If you travel somewhere that has a significant time change, take a one to two-hour nap when you arrive. Go out for dinner and then go to bed at what would be a normal time for the part of the world you’re in. Immediately try to assimilate into the routine of your new environment.

Bring a sleep mask and earplugs. Many people with Parkinson’s have difficulty sleeping. Keeping a sleep mask and a pair of soft foam earplugs nearby can help you get some rest when you’re traveling. You might also consider bringing an inflatable neck pillow for additional comfort.

Clothes

Pack light and feel secure knowing that, unless you’re traveling to a remote area, you’ll be able to pick up anything you need once you reach your destination.

Travel in comfortable clothing that’s easy to get on and off in bathrooms. Slip-on shoes or sandals, shoes that don’t require you to lean over to take them off, are great for airports. And keep an extra pair of socks in your carry on for cold planes.

Wear knee-high compression socks for road trips and air travel. They keep the blood flowing and reduce swelling.

Bring a change of clothes in your carry on bag just in case.

Exercise

Consider bringing a jump rope. It travels well and it offers a great workout. It’s an aerobic and motor challenge, a great exercise for travel.

Whether in a car or on a plane or train, take time to get up and stretch every 30-45 minutes.

As much as possible, try to continue to exercise and do the things that are part of your daily routine for living well while you’re on the road. It can be a challenge when you’re in a different place and don’t have access to the same routine or equipment, but veering too far off schedule can create problems both when you’re traveling and when you arrive home. Adjust as needed, but continue to do the activities that make you feel well.

Miscellaneous

Use a label maker to put your name and cell number on loose objects, like canes.

If you don’t have a handicap placard, get one.

While you’re exploring new areas, consider checking out the local Parkinson’s offerings.  Does the place you’re visiting offer something in the way of support for people living with Parkinson’s that you don’t have where you live? If not, do they need your skills? Could you bring something to share with the community you’re visiting?

Don’t be afraid of letting your travel companion(s) know that you’re too tired to do certain activities and you just need time to rest.

If you have DBS, bring the Medtronic device wallet card (or whatever company made yours). You may be asked for it. It’s best to not try and explain DBS to security people.  Just say you have a “medical device” or even just say you have a pacemaker as that’s something they hear all the time. Remember, you can’t go through the old style security check machines or let them use wands to check you. Be prepared for a pat down.

Pay for luxuries and conveniences while traveling if you can. They’re designed to make your life easier and if you ever need that, it’s when you’re traveling.

If at all possible, travel with others who get you so well that they know when you need help and when to back off. They know when you need to rest and when you’re ready to go. And they, more than anything, can gracefully manage the unpredictability of Parkinson’s and not let it get in the way of a fabulous trip.

Maintain a sense of humor. Travel is difficult even under the easiest of circumstances. When something goes wrong, and it almost always does, the way you handle it will have a big impact on your physical and emotional well-being. Eventually, you’ll get where you need to go; so, in the meantime, have a good laugh about it.

Finally, while there’s a lot that happens when you travel that you can’t control, you can control your experience. Don’t let Parkinson’s stop you from traveling. As Jill Ater says, “Most people in the word are incredibly understanding and patient. If you like to travel, then it’s part of your living fully with Parkinson’s.”

 

Article from Davis Phinney Foundation.

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WPA on The Morning Blend

Jeremy Otte, our director of outreach & education, and board member Ron Mohorek were on the The Morning Blend on TMJ4 this morning talking about Parkinson’s and our upcoming Symposium!

Thanks to Amada Senior Care for including us!

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Former LPGA Golfer Cherie Zaun to Participate in Parkinson’s Fundraiser

In the 1970s, Golfer Cherie Zaun was on her way toward a promising career, and put her career on hold to raise two children. In the 1990s, with her children grown, Cherie decided to follow her dream: to compete at the highest level in golf. With a lot of hard work and dedication Cherie earned her way to the LPGA tour. She competed in over 30 tournaments and practiced week after week to improve her play. Struggling with her game, she began to realize that something was not quite right with her body. She tried to remain strong and work through it, only to have her symptoms get worse.

In 2003, determined to figure out what was going on with her body, Cherie left the tour, and was diagnosed with Parkinson disease. Symptoms of Parkinson disease can include tremor, slowness of movement, rigidity, problems with balance, and more. While Parkinson’s can be managed with exercise and medication, it is chronic and progressive and has no cure.

Cherie chose to get involved with many organizations and events that promote living well with Parkinson disease. The LPGA tour lost a very talented player, but the Parkinson world gained a great spokesperson. Cherie wants to be a part of the journey to find a cure for Parkinson’s in her lifetime. She now travels around the country speaking and appearing at charity golf outings — including the Movers & Shakers Classic on Saturday, June 2 at Evergreen Golf Course in Elkhorn, Wisconsin.

Coordinated by Joe & Patti Schlicher, the Movers & Shakers Golf Classic includes a golf outing, live and silent auctions, raffle, and a dinner for golfers, family members, and the community. Cherie will be a part of the day, and will be sharing her story at dinner. All proceeds from the event benefit Wisconsin Parkinson Association, which provides hope, community, support and resources for people with Parkinson’s and their loved ones.

“We are so honored the Movers & Shakers Classic has again chosen to support WPA,” said Gary Garland, executive director of Wisconsin Parkinson Association. “This annual event has raised over $35,000 that assists support and exercise groups and educational programs around the state. Cherie’s presence will be a great addition this year!”

Cost to participate in the golf outing (including dinner) is $96/golfer. The dinner only option is available for $24 (for a hamburger or brat) or $32 (for steak or chicken). To participate or to donate money or an item for the auction, contact Joe Schlicher at 262-949-8011.

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Exercise Improves Cognition in Parkinson’s Disease

It’s well known that exercise invigorates both body and mind. Exercise studies in Parkinson’s disease (PD) have shown improved mobility and quality of life, and possibly slower rate of disease progression. But what can exercise do for memory and thinking (cognition), which can be affected to different degrees at different points in the course of Parkinson’s?

Recently, a group of researchers answered that question by reviewing exercise and cognition studies conducted in people with Parkinson’s over the past 10 years. They confirmed the benefit of exercise on cognitive function in people living with PD.

For this study, researchers analyzed nine randomized controlled trials from several countries. The participants of these trials were, on average, 60 to 74 years old, diagnosed with Parkinson’s six years prior and living with mild to moderate disease. Exercise programs varied in length, number and duration of sessions, and included studies with a treadmill, stationary bicycle, stretching and strengthening (with and without a Wii Fit exercise program), tai chi and tango. Volunteers’ cognitive function was tested throughout each study to see if the exercise had an effect.

Of the specific exercise programs reviewed, tango, stretching and strengthening with a cognitive component (a Wii Fit exercise program), and treadmill training had benefits on cognition. The latter — walking at a person’s preferred speed or slightly slower for about an hour three times a week for 24 weeks — boosted cognitive function more than the other two exercise programs.

More support for exercise, and treadmill exercise in particular. But this doesn’t mean that treadmill walking is the best exercise for Parkinson’s. Many questions remain about the optimal type, amount and intensity of exercise to keep cognitive (and other) symptoms at bay. Larger, well-designed studies can help provide answers and clarify effects.

Multiple forms of exercise for many symptoms are currently being investigated. Register for Fox Trial Finder to match with recruiting trials. As researchers work to define the ideal exercise for your Parkinson’s, continue regular exercise that you enjoy.

Speak with your physician and physical therapist to design a program that meets your needs and visit our website to learn more.

 

Article from Michael J. Fox Foundation for Parkinson’s Research.

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