iron deficiency

缺铁
  • 文章类型: Journal Article
    Objective.评估儿童和青少年缺铁性贫血(IDA)与龋齿之间关系的证据。方法。从记录开始到2023年10月,在4个国际数据库中进行了搜索。包括评估6个月至18岁个体中IDA与龋齿之间关联的研究。使用纽卡斯尔渥太华量表评估偏倚风险。使用逆方差或Mantel-Haenzel方法进行定量合成,取决于分析结果的类型。关联的度量包括赔率比和均值差异,采用具有95%置信区间的随机效应模型。结果。总共确定了1161项研究,其中12项进行定性回顾,9项进行荟萃分析.发现IDA与龋齿之间存在显着关联(比值比为3.54;95%CI:2.54-4.94),并且在存在IDA的情况下龋齿的发生率更高(平均差异为1.96;95%CI:1.07-2.85)。根据等级的证据确定性被评为非常低。Conclusions.尽管确定性有限,研究结果表明IDA与龋齿之间存在显著关联.谨慎地解释这些结果是谨慎的,考虑到研究的方法学局限性。然而,鉴于该协会对公共卫生的潜在相关性,推荐口腔健康策略,包括预防性和矫正性牙科干预措施,对于贫血控制计划强调了更严格的未来研究的重要性,以加强证据的确定性并指导这些策略的实施。
    Objective. To evaluate the evidence regarding the association between iron deficiency anemia (IDA) and dental caries in children and adolescents. Methods. Searches were conducted in 4 international databases from the beginning of records until October 2023. Studies evaluating the association between IDA and dental caries in individuals aged 6 months to 18 years were included. Risk of bias was assessed using the Newcastle Ottawa Scale. Quantitative synthesis was performed using the inverse variance or Mantel-Haenzel method, depending on the type of outcome analyzed. Measures of association included odds ratios and mean differences, employing a random-effects model with a 95% confidence interval. Results. A total of 1161 studies were identified, of which 12 were selected for qualitative review and 9 for meta-analysis. A significant association was found between IDA and dental caries (odds ratio of 3.54; 95% CI: 2.54-4.94) and a higher rate of dental caries in the presence of IDA (mean difference of 1.96; 95% CI: 1.07-2.85). The certainty of evidence according to GRADE was rated as very low. Conclusions. Despite the limited certainty, the findings indicate a significant association between IDA and dental caries. It is prudent to interpret these results with caution, considering the methodological limitations of the studies. However, given the potential relevance of this association for public health, recommending oral health strategies, including preventive and corrective dental interventions, for anemia control programs underlines the importance of more rigorous future research to strengthen the certainty of the evidence and guide the implementation of these strategies.
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  • 文章类型: Journal Article
    <b>简介:</b>术前贫血的患病率在结直肠癌(CRC)患者组中最高,可能达到75%以上。手术后,CRC患者的贫血患病率进一步增加。大约75-80%的贫血CRC患者存在绝对或功能性缺铁(ID)。术前贫血是异体输血(ABT)的独立危险因素。术后并发症,住院时间延长,和死亡率增加。ABT本身与发病率和死亡率增加有关。&lt;b&gt;目的:&lt;/b&gt;这篇综述文章的目的是介绍CRC患者术前缺铁性贫血(IDA)的病理生理学和当前诊断和治疗方法。<b>材料和方法:</b>对医学文献数据库进行了广泛的搜索(Pubmed,Embase)。使用的关键词如下:CRC,结直肠手术,ID,IDA,静脉注射铁,患者血液管理(PBM)。<b>结果:</b>有几个实验室参数可用于IDA诊断,然而,最简单和最具成本效益的是网织红细胞血红蛋白当量(RET-He)。CRC患者IDA的病理生理学特征倾向于静脉内治疗,与口头相反,铁配方。应用PBM策略最大限度地减少了对ABT的暴露。结论:</b>术前IDA在CRC患者中非常普遍。术前贫血是ABT的独立危险因素,发病率和死亡率增加,以及延长住院时间。同样的负面后果与ABT有关。因此,CRC患者的术前IDA需要进行筛查,诊断,并在手术前治疗。CRC患者术前IDA的有效治疗是静脉内铁制剂。由于存在负面临床后果的风险,ABT应该是最后的治疗手段,包括癌症复发率的增加。
    <b>Introduction:</b> The prevalence of preoperative anemia is the highest in the group of colorectal cancer (CRC) patients and may reach over 75%. The prevalence of anemia in CRC patients increases even further following surgery. Approximately 75-80% of anemic CRC patients present with absolute or functional iron deficiency (ID). Preoperative anemia constitutes an independent risk factor for allogeneic blood transfusion (ABT), postoperative complications, prolonged length of hospital stay, and increased mortality. ABT is itself associated with increased morbidity and mortality.<b>Aim:</b> The aim of this review article was to present the pathophysiology and the current approach to the diagnostics and treatment of preoperative iron deficiency anemia (IDA) in CRC patients.<b>Material and methods:</b> Extensive search of medical literature databases was performed (Pubmed, Embase). The key words that were used were as follows: CRC, colorectal surgery, ID, IDA, intravenous iron, Patient Blood Management (PBM).<b>Results:</b> There are several laboratory parameters that can be used for IDA diagnosis, however, the simplest and most cost- -effective is reticulocyte hemoglobin equivalent (RET-He). Pathophysiologic features of IDA in CRC patients favor treatment with intravenous, as opposed to oral, iron formulations. Applying PBM strategies minimizes the exposure to ABT.<b>Conclusions:</b> Preoperative IDA is highly prevalent among CRC patients. Preoperative anemia is an independent risk factor for ABT, increased morbidity and mortality, as well as prolonged hospital length of stay. The same negative consequences are associated with ABT. Therefore, preoperative IDA in CRC patients needs to be screened for, diagnosed, and treated before surgery. Effective treatment of preoperative IDA in CRC patients is with intravenous iron formulations. ABT should be the treatment of last resort due to the risk of negative clinical consequences, including an increased rate of cancer recurrence.
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  • 文章类型: Journal Article
    目前的证据表明,缺铁(ID)在表现为不安的疾病的发病机理中起着关键作用,例如注意力缺陷多动障碍(ADHD)和不宁腿综合征(RLS)。在临床实践中,在这种情况下,诊断检查和/或作为治疗选择不常规考虑ID和铁补充剂。因此,我们对ID指南进行了范围研究文献综述.在包括的58条准则中,只有9个包括RLS,3包括ADHD。铁蛋白是最常被引用的生物标志物,虽然截止值在指南和年龄等其他因素之间有所不同,性别,和合并症。围绕可测量的铁生物标志物和截止值的建议在指南之间有所不同;此外,尽管抓住了炎症作为一个概念的作用,大多数指南通常不包括如何评估这一点的建议.铁和炎症生物标志物的解释缺乏协调,这引发了人们对当前指南在临床实践中的适用性的质疑。Further,本综述中的大多数ID指南不包括ID相关疾病,ADHD和RLS由于ID可以与改变的运动模式相关联,在不同临床表型的背景下,研究和解释铁的状态需要一个新的共识.
    Current evidence suggests that iron deficiency (ID) plays a key role in the pathogenesis of conditions presenting with restlessness such as attention deficit hyperactivity disorder (ADHD) and restless legs syndrome (RLS). In clinical practice, ID and iron supplementation are not routinely considered in the diagnostic work-up and/or as a treatment option in such conditions. Therefore, we conducted a scoping literature review of ID guidelines. Of the 58 guidelines included, only 9 included RLS, and 3 included ADHD. Ferritin was the most frequently cited biomarker, though cutoff values varied between guidelines and depending on additional factors such as age, sex, and comorbidities. Recommendations surrounding measurable iron biomarkers and cutoff values varied between guidelines; moreover, despite capturing the role of inflammation as a concept, most guidelines often did not include recommendations for how to assess this. This lack of harmonization on the interpretation of iron and inflammation biomarkers raises questions about the applicability of current guidelines in clinical practice. Further, the majority of ID guidelines in this review did not include the ID-associated disorders, ADHD and RLS. As ID can be associated with altered movement patterns, a novel consensus is needed for investigating and interpreting iron status in the context of different clinical phenotypes.
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  • 文章类型: Journal Article
    贫血的发生是由于红细胞产生和损失之间的不平衡。这种失衡可能是由于无效的红细胞生成,失血或溶血。虽然贫血的原因有很多,缺铁性贫血(IDA)仍然是世界范围内的主要原因。
    在过去的几年中,关于IDA的管理有许多更新的准则。由于IDA的原因很多,评估需要彻底的分析和有针对性的调查。作为一种早期无症状的疾病,IDA可能导致其管理中的许多错误。本审查强调了在评估和管理IDA方面的潜在错误以及避免这些错误的建议。
    IDA的有效管理需要全面和多学科的方法。通过认识和解决本叙述性审查中强调的常见错误,医疗保健专业人员可以改善患者的治疗效果,尽量减少并发症,提高整体护理质量。
    UNASSIGNED: Anaemia occurs due to an imbalance between erythrocyte production and loss. This imbalance can be due to ineffective erythropoiesis, blood loss or haemolysis. Whilst there are many causes for anaemia, iron deficiency anaemia (IDA) remains the predominant cause worldwide.
    UNASSIGNED: There have been many updated guidelines on the management of IDA in the past few years. As the reasons for IDA are many, evaluation requires thorough analysis and focused investigations. As an asymptomatic disease in the early stages, IDA can lead to many mistakes in its management. This review highlights potential mistakes in assessing and managing IDA and recommendations to avoid them.
    UNASSIGNED: The effective management of IDA necessitates a comprehensive and multidisciplinary approach. By recognising and addressing the common mistakes highlighted in this narrative review, healthcare professionals can improve patient outcomes, minimise complications, and enhance the overall quality of care.
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  • 文章类型: Journal Article
    目的:在相当比例的患者中,缺铁(ID)与心力衰竭(HF)有关。为了提高生活质量,降低住院频率,和较低的慢性HF患者的死亡率(HF),本荟萃分析将探讨使用羧基麦芽糖铁(FCM)补充铁的作用.方法和结果:从开始到2023年10月1日,我们对同行评审出版物的电子数据库进行了全面的文献检索。纳入约5229例HF患者,其中2691人接受FCM,2538人接受安慰剂。结论:FCM可降低HF相关住院率,但不能改善HF和ID患者的总体死亡率或心血管死亡率。总体结果支持FCM在治疗心力衰竭缺铁中的作用。
    心力衰竭(HF)患者经常患有缺铁(ID),恶化他们的症状和生活质量。静脉铁剂治疗,如羧基麦芽糖铁(FCM),已对其在HF中的益处进行了研究。这项荟萃分析观察了现有的研究,发现FCM治疗降低了HF的住院率,但对总死亡率没有显著影响。尽管FCM改善了患者的生活,需要更多的研究来充分了解其长期影响。这项研究强调了在HF管理中解决ID的重要性,并支持FCM治疗作为HF患者的有益选择。
    Aim: Iron deficiency (ID) is associated with heart failure (HF) in a considerable proportion of patients. To improve the quality of life, lower the frequency of hospitalizations, and lower mortality rates of chronic HF patients (HF), this meta-analysis will look into the role of iron supplementation using ferric carboxymaltose (FCM). Methods & results: From inception until 1 October 2023, we conducted a thorough literature search of electronic databases for peer-reviewed publications. Around 5229 HF patients were included, of which 2691 received FCM while 2538 received placebo. Conclusion: FCM reduces HF-related hospitalizations but doesn\'t improve overall or cardiovascular mortality in those with HF and ID. The overall results support FCM\'s role in managing iron deficiency in heart failure.
    Heart failure (HF) patients often suffer from iron deficiency (ID), worsening their symptoms and quality of life. Intravenous iron therapy, like ferric carboxymaltose (FCM), has been studied for its benefits in HF. This meta-analysis looked at existing research and found that FCM treatment reduced hospitalizations for HF but didn\'t significantly impact overall mortality. Although FCM improves patients\' lives, more research is needed to understand its long-term effects fully. This study highlights the importance of addressing ID in HF management and supports FCM therapy as a beneficial option for HF patients.
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  • 文章类型: Journal Article
    进行系统评价和荟萃分析以确定贫血的患病率。缺铁(ID),中国孕妇缺铁性贫血(IDA)。共收集了2010年1月至2020年12月期间发表的722篇关于妊娠期贫血的文章。对包括1,376,204名孕妇在内的57项符合条件的研究进行了系统评价和荟萃分析,以确定贫血的患病率和不同亚组的患病率.结果表明,贫血的患病率,ID,中国孕妇中的IDA为30.7%(95%CI:26.6%,34.7%),45.6%(95%CI:37.0%,54.2%),和17.3%(95%CI:13.9%,20.7%),分别。所有患病率随着妊娠的进展而增加。贫血的患病率有相当大的地区差异,ID,和IDA。一般来说,在该国经济较发达的东部地区,患病率较低,东部地区的ID患病率高于西部地区。农村地区贫血和IDA患病率高于城市地区,但城市地区的ID患病率较高。总之,贫血患病率的地区差异和城乡差异表明,需要更多针对具体环境的干预措施来预防和治疗贫血.研究发现,饮食因素是贫血的主要原因之一,含铁补充剂和营养咨询可以成为降低贫血患病率的有效干预措施,ID,和IDA在中国孕妇中。
    The systematic review and meta-analysis were conducted to ascertain the prevalence of anemia, iron deficiency (ID), and iron deficiency anemia (IDA) among Chinese pregnant women. A total of 722 articles on maternal anemia during pregnancy published between January 2010 and December 2020 were compiled, and a systematic review and meta-analysis were conducted on 57 eligible studies including 1,376,204 pregnant women to ascertain the prevalence of anemia and the prevalence in different subgroups. The results showed that the prevalence of anemia, ID, and IDA among pregnant women in China were 30.7% (95% CI: 26.6%, 34.7%), 45.6% (95% CI: 37.0%, 54.2%), and 17.3% (95% CI: 13.9%, 20.7%), respectively. All prevalence increased with the progression of the pregnancy. There were sizable regional variations in the prevalence of anemia, ID, and IDA. Generally, lower prevalence was observed in the economically more advanced eastern region of the country, while the prevalence of ID was higher in the eastern region than that in the western region. The prevalence of anemia and IDA in rural areas was higher than that in urban areas, but ID prevalence was higher in urban areas. In conclusion, the regional differences and urban-rural disparities in the prevalence of anemia indicate the need for more context-specific interventions to prevent and treat anemia. It was found that dietary factors were one of the major causes of anemia, and iron-containing supplements and nutrition counseling could be effective interventions to reduce the prevalence of anemia, ID, and IDA among Chinese pregnant women.
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  • 文章类型: Journal Article
    口腔疾病干预措施主要侧重于行为改变,如改善饮食和确保更好的口腔卫生。然而,认识到生物因素的影响,包括遗传学和早期营养,至关重要。缺铁(ID)及其高级形式,缺铁性贫血(IDA),影响全球近20亿人,尤其是儿童和孕妇。我们通过EndNote和WebofScience使用Medline进行了全面搜索,使用与缺铁性贫血(IDA)相关的关键词,我们确定了36项被认为与纳入本文献综述相关的研究.孕妇和幼儿的IDA患病率尤其高。IDA和幼儿龋齿(ECC)对贫困人口的影响不成比例,强调这个问题的社会经济层面。IDA表现出各种口腔粘膜变化,并与念珠菌病密切相关。此外,IDA可以阻碍牙齿发育并削弱免疫反应。多项人口调查显示,ECC和IDA之间存在显着关联。虽然一些研究探索了IDA与牙周病的联系,目前的证据在其稳健性上相对有限。总之,更全面的纵向研究对于加深我们对IDA-口腔疾病联系的理解至关重要.研究潜在的生物学机制对于开发有效的干预措施至关重要,特别是受国际开发协会影响的弱势群体。
    Oral disease interventions primarily focus on behavioral changes like dietary improvements and ensuring better oral hygiene. However, recognizing the influence of biological factors, including genetics and early-life nutrition, is crucial. Iron deficiency (ID) and its advanced form, iron deficiency anemia (IDA), affect nearly two billion people globally, especially children and pregnant women. We conducted a comprehensive search using Medline via EndNote and Web of Science, employing keywords related to iron deficiency anemia (IDA), and we identified 36 studies deemed relevant for inclusion in this literature review. IDA prevalence is notably high among pregnant women and young children. Both IDA and early-childhood caries (ECC) disproportionately affect impoverished populations, highlighting the socioeconomic dimension of this issue. IDA presents with various oral mucosal changes and is closely linked to candidiasis. Additionally, IDA can hinder tooth development and weaken the immune response. Multiple population surveys have revealed a significant association between ECC and IDA. While some studies have explored the IDA-periodontal disease link, the current evidence is relatively limited in its robustness. In conclusion, more comprehensive longitudinal studies are essential to deepen our understanding of the IDA-oral disease connection. Investigating the underlying biological mechanisms is critical to developing effective interventions, particularly for vulnerable populations affected by IDA.
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  • 文章类型: Journal Article
    缺铁和心力衰竭经常同时发生,在过去的20年里,引发了对铁补充在这种情况下的作用的临床研究。尽管早期的非随机研究和随后的中等规模的随机对照试验显示,使用静脉注射铁剂可改善症状和功能指标,最近3项用于检测硬心血管结局差异的大型试验未能达到其主要终点。此外,有潜在的担忧与静脉注射铁的副作用有关,无论是短期还是长期。这篇综述讨论了铁生物学和调控的基础知识,缺铁的诊断标准和静脉铁在心力衰竭中的临床证据,安全问题,和替代疗法。我们还为铁缺乏和心力衰竭患者的管理提出了切实可行的建议,并概述了未来需要研究的关键领域。
    Iron deficiency and heart failure frequently co-occur, sparking clinical research into the role of iron repletion in this condition over the last 20 years. Although early nonrandomized studies and subsequent moderate-sized randomized controlled trials showed an improvement in symptoms and functional metrics with the use of intravenous iron, 3 recent larger trials powered to detect a difference in hard cardiovascular outcomes failed to meet their primary endpoints. Additionally, there are potential concerns related to side effects from intravenous iron, both in the short and long term. This review discusses the basics of iron biology and regulation, the diagnostic criteria for iron deficiency and the clinical evidence for intravenous iron in heart failure, safety concerns, and alternative therapies. We also make practical suggestions for the management of patients with iron deficiency and heart failure and outline key areas in need of future research.
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  • 文章类型: Journal Article
    调查数字健康干预措施对提高孕妇口服铁补充剂依从性的影响。
    从成立到2023年10月,搜索了五个数据库,没有日期限制。
    评估数字健康干预措施对口服补铁依从性影响的随机对照试验(RCT)(例如,片剂和胶囊)与针对孕妇的非数字健康干预措施相比是合格的。
    我们使用逆方差法对连续变量计算了具有95%置信区间(CI)的标准化平均差(SMD)和平均差(MD)。我们使用Mantel-Haenszel模型用95CI计算分类变量的比值比(OR)。使用建议分级评估来评估证据的确定性,发展,和评估(等级)方法。使用Cochrane偏倚风险工具2.0评估纳入的随机对照试验的偏倚风险。
    纳入10项试验,1,633名参与者。根据7项试验,与非数字健康干预相比,数字健康干预可以提高客观依从性(1,289名参与者,OR=4.07[2.19,7.57],p<0.001,I2=69%)在孕妇中。与非数字健康干预相比,数字健康干预可以改善主观依从性行为(3项试验,434名参与者,SMD=0.82[0.62,1.01],p<0.001,I2=0%)在孕妇中。基于3次试验,与非数字健康干预相比,数字健康干预可以改善平板电脑的消费(333名参与者,SMD=1.00[0.57,1.42],p<0.001,I2=66%)在孕妇中。与非数字健康干预相比,数字健康干预可以提高血红蛋白水平(7项试验,1,216名与会者,MD=0.59[0.31,0.88],p<0.001,I2=93%)在孕妇中。
    数字健康干预措施可有效改善孕妇对口服铁补充剂的依从性和血红蛋白水平。
    UNASSIGNED: To investigate the effects of digital health interventions for improving adherence to oral iron supplementation in pregnant women.
    UNASSIGNED: Five databases were searched from their inception to October 2023 with no date restrictions.
    UNASSIGNED: Randomized controlled trials (RCTs) that assessed the effects of digital health interventions on adherence to oral iron supplementation (e.g., tablets and capsules) compared to non-digital health interventions for pregnant women were eligible.
    UNASSIGNED: We calculated standardized mean differences (SMDs) and mean differences (MDs) with 95% confidence intervals (CIs) for continuous variables using the inverse variance method. We calculated odds ratios (OR) with 95%CI for categorical variables using the Mantel-Haenszel model. The certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. The risk of bias of the included RCTs was assessed using the Cochrane risk of bias tool 2.0.
    UNASSIGNED: Ten trials with 1,633 participants were included. Based on 7 trials, digital health interventions can improve objective adherence rate comparing with non-digital health interventions (1,289 participants, OR = 4.07 [2.19, 7.57], p < 0.001, I2 = 69%) in pregnant women. Digital health interventions can improve subjective adherence behavior comparing with non-digital health interventions (3 trials, 434 participants, SMD = 0.82 [0.62, 1.01], p < 0.001, I2 = 0%) in pregnant women. Based on 3 trials, digital health interventions can improve tablets consumption comparing with non-digital health interventions (333 participants, SMD = 1.00 [0.57, 1.42], p < 0.001, I2 = 66%) in pregnant women. Digital health interventions can improve hemoglobin level comparing with non-digital health interventions (7 trials, 1,216 participants, MD = 0.59 [0.31, 0.88], p < 0.001, I2 = 93%) in pregnant women.
    UNASSIGNED: Digital health interventions were effective at improving adherence to oral iron supplementation and hemoglobin levels in pregnant women.
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  • 文章类型: Journal Article
    母乳喂养妇女的贫血是一个被忽视的全球健康问题,对母婴健康具有重大影响。尽管它的广泛发生和不利影响,这个问题在全球卫生议程上仍然是未知和被忽视的。尽管努力改善健康覆盖率并提供铁和叶酸补充剂,贫血持续存在。这突出表明需要采取全面的方法来解决这一问题。必须采取紧急行动,优先开展教育和提高认识运动,确保获得有营养的食物,加强医疗服务。教育计划应侧重于促进富含铁的饮食,消除文化神话,并提供实际指导。改善医疗保健服务需要增加可用性,确保铁补充剂的持续供应,并为医疗保健提供者提供足够的培训。成功的实施依赖于政府之间的强有力的合作,医疗保健提供者,和社区。至关重要的是,我们承认,仅靠高覆盖率不足以解决问题,强调有针对性的干预措施和战略实施的重要性。通过采取全面的方法并解决贫血的根本原因,印度尼西亚可以在降低其患病率和改善其人口的整体健康方面取得重大进展,尤其是母乳喂养的妇女。
    Anemia in breastfeeding women is a neglected global health issue with significant implications for maternal and child health. Despite its widespread occurrence and adverse effects, this problem remains largely unknown and overlooked on the global health agenda. Despite efforts to improve health access coverage and provide iron and folic acid supplementation, anemia persists. This underscores the need for a comprehensive approach to address the problem. Urgent action must be taken to prioritize education and awareness campaigns, ensure access to nutritious food, and enhance healthcare services. Education programs should focus on promoting iron-rich diets, dispelling cultural myths, and providing practical guidance. Improving healthcare services requires increasing availability, ensuring a consistent supply of iron supplements, and providing adequate training for healthcare providers. A successful implementation relies on a strong collaboration between the government, healthcare providers, and community. It is crucial that we acknowledge that high coverage alone is insufficient for solving the issue, emphasizing the importance of targeted interventions and a strategic implementation. By adopting a comprehensive approach and addressing the underlying causes of anemia, Indonesia can make significant progress in reducing its prevalence and improving the overall health of its population, particularly among breastfeeding women.
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