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Hardin Memorial Health | Oncology Services 2017 Annual Report | Page: 1
Annual Report 2017
Hardin Memorial Health Oncology Services
Hardin Memorial Health | Oncology Services 2017 Annual Report | Page: 2
TABLE OF CONTENTS:
Mission, Vision, Uniqueness . . . . . . . . . . . . . . . 3
Comments from Cancer Committee Chair . . . . . 4
Comments from Cancer Liaison Physician. . . . . . 5
Meet Our Cancer Care Providers . . . . . . . . . . . . 6
2016 Data . . . . . . . . . . . . . . . . . . . . . . . . . . 7 - 8
Multidisciplinary Breast Cancer Care . . . . . . . . . 9 - 10
Multidisciplinary Lung Cancer Care . . . . . . . . . . 11 - 12
Clinical Trials. . . . . . . . . . . . . . . . . . . . . . . . . 13 - 14
Community Outreach . . . . . . . . . . . . . . . . . . 15 - 21
Survivorship . . . . . . . . . . . . . . . . . . . . . . . . . 22
Hardin Memorial Health Cancer Care Services
Hardin Memorial Health | Oncology Services 2017 Annual Report | Page: 3
HMH Cancer ProgramHardin Memorial Health is pleased to present its 2017 Cancer Program Annual Report. This report outlines the activities of the Cancer Program and newly diagnosed analytic cancer cases for 2016. Analytic cases are those that were either diagnosed and/or treated at our facility.
MissionTo exceed the physical, emotional and spiritual needs of our patients and their families by providing comprehensive, state-of-the art cancer treatments and therapies.
VisionTo provide hope and healing as the premier community cancer center in Kentucky.
Our UniquenessOur medical, surgical and radiation oncology specialists incorporate multidisciplinary treatments to provide advanced, cutting edge cancer expertise close to home.
As an affi liate of the University of Kentucky’s Markey Cancer Center, the only National Cancer Institute (NCI) designated cancer program in Kentucky, we off er patients, when appropriate, access to clinical trials and NCI medical center expertise.
We are Commission on Cancer (CoC) accredited which recognizes our integrated continuum of care. Our comprehensive resources include prevention and screening, genetic counseling, nurse navigation, social work, fi nancial counseling, an onsite dedicated pharmacy, survivorship and palliative care.
We value our caring relationships with our patients and families.
Hardin Memorial Health | Oncology Services 2017 Annual Report | Page: 4
Comments from Karen Johnson, M.D. Cancer Committee Chair
At Hardin Memorial Health, cancer care is a top priority. We utilize advanced
technology and have access to the most current treatment regimens available.
Hardin Memorial Health’s cancer program is a Commission on Cancer accredited
program which is a special designation for centers meeting strict quality criteria
for cancer care. In addition, we are accredited by the American College of
Radiology as a Breast Imaging Center of Excellence.
Hardin Memorial Health’s cancer program has a long history of excellence with
tumor conferences allowing physicians from multiple specialties an opportunity
to discuss complex cancer patients with one another and coordinate care. We
also are a part of the University of Kentucky’s Markey Cancer Center’s clinical trial
program which allows us to off er clinical trials to our cancer patients and keeps
patients close to home while receiving comprehensive care.
Karen Johnson, M.D.
Hardin Memorial Health | Oncology Services 2017 Annual Report | Page: 5
Hardin Memorial Health is dedicated to providing
state-of-the-art cancer care in a community setting,
allowing our patients to stay close to home for their
care. Our physicians are committed in the fi ght against
cancer including utilization of cutting edge diagnostic
technology and treatment. We are proud to be an active
affi liate of the University of Kentucky Markey Cancer
Center, which is the only NCI designated cancer center
in the Commonwealth of Kentucky.
Adam Lye, M.D. Cancer Liaison Physician
Adam Lye, M.D.
Hardin Memorial Health | Oncology Services 2017 Annual Report | Page: 6
Adam Lye, M.D.Specialty: Medical OncologyBoard Certifi ed in Internal Medicine/Medical OncologyMedical School: University of KentuckyPracticing since 2013
Meet Our Cancer Care Providers
Chandler Park, M.D.Specialty: Medical OncologyBoard Certifi ed in Internal Medicine/Medical Oncology/Hematology Medical School: University of LouisvillePracticing since 2016
Richard Seither, M.D.Specialty: Radiation Oncology Board Certifi ed in Radiation Oncology Medical School: Louisiana State University Practicing since 1992
Cora Veza, M.D.Specialty: Medical OncologyMedical School: University of Santo Tomas, Manila, Philippines Practicing since 1985
Kathryn Francescon, APRNSpecialty: Medical OncologyGraduate School: Spalding University, MSN
Kelly White, APRNSpecialty: Medical OncologyGraduate School: Spalding University, MSN
Hardin Memorial Health | Oncology Services 2017 Annual Report | Page: 7
2016 Top 5 Diagnoses
160
140
120
100
80
60
40
20
0
Lung Breast Prostate Bladder Colon 147 126 118 45 45
2012-2016 Top 5 Cases Top 5 Cancer Diagnoses by Year
180
160
140
120
100
80
60
40
20
0
2016 Data
Prostate
2012 2013 2014 2015 2016
Breast, female & male Trachea, bronchus, lung
Colon Bladder
Hardin Memorial Health | Oncology Services 2017 Annual Report | Page: 8
2016 Stage Breakdown: All Diagnoses
200
175
150
125
100
75
50
25
0
Stage 0 Stage 1 Stage 2 Stage 3 Stage 4 Stage Unk. 56 208 172 122 164 91
K E N T U C K Y
Hardin
Breckenridge
Grayson
Hart
Larue
MeadeBullitt
Nelson
Taylor
Green
AdairMedcalfeBarren
EdmonsonButler
Warren
Muhlenburg
OhioMcClean
Daviess
Hancock
Jeff erson
Spencer
Shelby
Anderson
Washington
Marion
Casey
Pulaski
Lincoln
Boyle
Mercer
Woodford
Franklin
HarrisonPerry
SpencerWarrick
I N D I A N A
43
54
453
66
716
8
63
64
20
Primary Secondary Tertiary
2016 Cases by Service Area
Hardin Memorial Health | Oncology Services 2017 Annual Report | Page: 9
1122
33
44
55
66
7788
99
1010
Annual Screening
HMH Women’s Care Center, Elizabethtown
Diagnostic Imaging, Bardstown
Diagnostic Center
Biopsy
HMH Women’s Care Center
Coordinationof Care
HMH Nurse Navigator
Breast Clinic& Case Review
HMH Radiologist, Surgeon, Pathology, Radiation Oncologist, Medical
Oncologist, & Plastic & Reconstructive Surgeon
Cancer Treatment HMH Surgeon, Medical
Oncologist & RadiationOncologist
BreastReconstruction
HMH Plastic & Reconstructive
Surgeon
MULTIDISCIPLINARYBREAST PROGRAM
BreastConcern
Clinical or Self Exam
Pathology Results/
Diagnosis
SupportServices
Cancer Care Center
Audrey Cleaver, BSN, RNNurse Navigator – Multidisciplinary Breast Program
Hardin Memorial HealthO�ce: (270) 706-6904 | Mobile: (270) 734-3194
111111
SurvivorsClinic
Cancer Care Center
DiagnosticMammogram,
MRI or Ultrasound
HMH Women’s Care Center & Elizabethtown
Diagnostic Imaging
Multidisciplinary Breast Cancer CareHMH pioneers new tool for cancer patients
Hardin Memorial Health recently began utilizing
a new device to help cancer patients prevent hair
loss while undergoing chemotherapy treatments.
Funding from the HMH Foundation allowed HMH
to be the fi rst in Kentucky to off er the Paxman®
Scalp Cooling System.
The system uses a “cold cap” to reduce the scalp
temperature immediately before, during and after
a chemotherapy treatment. The cooling reduces
the blood fl ow to hair follicles which helps to
prevent or minimize the loss of hair.
HMH Cancer Care Medical Director Adam Lye, M.D.
touted the technology as an additional benefi t
HMH can off er patients who are facing an
emotional cancer journey.
“Patients often ask me if they are
going to lose their hair,” Lye said.
“With the Paxman® Scalp Cooling
System, we can try to alleviate
that stressor and allow the
patients to focus on their
treatment.” Lye said taking care
of the whole patient is critically
important. “We know when
we also take care of patients’
emotional and spiritual needs, it
helps to optimize healing.”
Jamie OwenFirst patient to use Paxman Cooling Caps
Hardin Memorial Health | Oncology Services 2017 Annual Report | Page: 10
Multidisciplinary Breast Cancer Care Team
Audrey Cleaver, BSN, RN Nurse Navigator
Sarah Callahan, M.D.Radiology
Gwen Godfrey, D.O.Pathology
Karen Johnson, M.D. General Surgery
Ashley Kerekes, M.D.Plastic & ReconstructiveSurgery
Adam Lye, M.D.Hematology/Oncology
Chandler Park, M.D. Hematology/Oncology
Richard Seither, M.D.Radiation Therapy
Sidney Verble, M.D.Pathology
Hardin Memorial Health | Oncology Services 2017 Annual Report | Page: 11
Multidisciplinary Lung Cancer Care
A multidisciplinary lung clinic began in November 2016
to support the large number of new annual lung cancer
cases in the Lincoln Trail District to improve the timeliness
of care for newly diagnosed patients with cancer. The
clinic minimizes the number of visits the patient requires
while providing comprehensive multidisciplinary cancer
care close to home.
Patients with lung nodules, worrisome diagnostic fi ndings,
or a new diagnosed lung cancer are seen on Tuesday
afternoons following a lung tumor board. The clinic is
led by Hardin Memorial physicians Dr. William Cundiff ,
Dr. Aaron Mulhall, and Dr. Navin Kaini (pulmonology), Dr.
Jordan Miller (University of Kentucky thoracic surgery), Dr.
Richard Seither (radiation therapy), and Dr. Adam Lye and
Dr. Chandler Park (medical oncology). The comprehensive
team also includes radiologists, pathologists, a nurse
navigator, oncology social worker, and others.
Since its inception, volumes have increased from two
new cancer cases monthly to greater than 10 new lung
cancers monthly. The clinic will expand from a half day
clinic to a full day clinic beginning in January 2018 to be
able to accommodate the increase in case volume. Dr.
Lye noted that all participating physicians and patients
appreciate the one stop service and obtaining cutting
edge comprehensive care closer to home. Dr. Park added
the multidisciplinary clinic is instrumental for patients
who wish to remain in the 10 county service area of HMH.
Hardin Memorial Health | Oncology Services 2017 Annual Report | Page: 12
Adam Lye, M.D.Hematology/Oncology
Multidisciplinary Lung Cancer Care Team
William Cundiff , D.O. Pulmonary/Critical Care
Navin Kaini, M.D.Pulmonary/Critical Care
Kelli Mathew, D.O.Pulmonary/Critical Care
Aaron Mulhall, M.D. Pulmonary/Critical Care
Chandler Park, M.D. Hematology/Oncology
Jordan Miller, D.O.Cardiothoracic SurgeryUK HealthCare
Richard Seither, M.D.Radiation Therapy
Connie Barnes, MSN, RNNurse Navigator
Gwen Godfrey, D.O.Pathology
Sidney Verble, M.D.Pathology
Ronald Wurth, M.D. Radiology
Jessie Bryant, M.D. Radiology
Hardin Memorial Health | Oncology Services 2017 Annual Report | Page: 13
Clinical Trials
The National Comprehensive Cancer Network (NCCN)
“Believes the best management for any cancer
patients is in a clinical trial.” Clinical trials play a major
role in advancing the science of fi ghting cancer at
all levels. HMH oncologists follow NCCN guidelines
in the treatment of their cancer patients and HMH’s
Cancer Center is accredited by the American College of
Surgeon’s Commission on Cancer.
The mission of the clinical research program is to reduce
the impact of cancer by increasing awareness of new
evidence, trends and practice standards. It is our goal to
increase the involvement of those in the community to
participate in cancer research activities creating more
opportunities for community based research services.
When patients receive care at HMH Cancer Center,
they also have access to information on clinical trials
– upcoming new treatments that seek to improve
responses in cancer treatment, prolong live and improve
quality of life. Expert care close to home.
Each clinical trial asks specifi c questions, such as: Is
this more durable; is it less toxic with same outcome;
or better outcome? Cancer clinical trials are strictly
governed by protocols that outline each step. Every
detail of the trial is reviewed to determine need,
usefulness, and importance of the data collected. Each
individual trial is evaluated to ensure patient safety by
an Institutional Review Board (IRB), consisting of medical
experts, scientists, and other impartial members.
Cancer treatment clinical trials are studies involving research to fi nd more durable and successful ways to treat cancer.
Hardin Memorial Health | Oncology Services 2017 Annual Report | Page: 14
As an affi liate of the University of Kentucky Markey
Cancer Center, the state’s only NCI-designated Cancer
Center, we off er patients access to national clinical trials
and NCI medical expertise. HMH participates in the NCI
and National Clinical Trial Support Unit (CTSU) through
the University of Kentucky.
We are also affi liated with the Kentucky Clinical
Trial Network (KCTN), sponsor for one of our current
trials, “Optimization of Smoking Cessation Strategies
Concurrent with Treatment of Tobacco Related
Malignancies (MOST).” This trial focuses on patients
currently undergoing treatment for tobacco related
cancers wanting to stop smoking. HMH has consistently
remained the top enroller for this trial among nine other
sites in the state for three years.
A recent trial opened is the Kentucky Lung Education
Awareness Detection and Survivorship (LEADS) Trial in
collaboration with the University of Kentucky, University
of Louisville, Kentucky Cancer Consortium, and Lung
Cancer Alliance, and is funded by a grant from Bristol-
Myers Squibb Foundation. This trial focuses on provider
education and importance of low dose CT in early
detection and survivorship care in regards to lung cancer.
In searching for a cure for cancer, knowledge increases
leading to new therapies and constantly evolving
treatments; that is why clinical trials research is important
to the patient diagnosed with cancer. Clinical trials
potentially off er access to therapies that could be years
away from public use before they become available as
standard of care. The clinical trials of yesterday are the
standard of care today. New and better therapies are
unattainable without the generosity and caring of those
cancer patients who want to give a little more.
Talk to your doctor about clinical trials, and for more
information or to learn about eligibility requirement for
the trials we off er, call the Clinical Trial Offi ce at
(270) 706-5470, and ask for the Research Coordinator.
“We look forward to increasing our clinical trial portfolio with the exciting future and promise of clinical trials, and in the improved survival and quality of life of our patients.”
Chandler Park, M.D.
Hardin Memorial Health | Oncology Services 2017 Annual Report | Page: 15
Community Outreach
Public Reporting Outcomes
Community Health Initiatives: Cancer Prevention and Screening Awareness
WOW Wellness on WheelsSM mobile health unit provides regional monthly preventive
health and wellness screenings in Hardin, Meade, LaRue, Nelson and Grayson counties.
From January – September, 338 community clients visited the WOW, and 152 clients
voluntarily shared they are up to date regarding preventive cancer screening for breast,
colon, skin and lung. Noting, 45% of the clients are following the American Cancer Society
recommended guidelines for cancer preventive screenings for breast, colon, skin and lung.
Cancer Health Initiatives on WOW
150
125
100
75
50
25
0 Breast Colon Skin Lung Counseled regarding
preventive screeningInformationdistributed
Follow up to encourage appointment
Hardin Memorial Health | Oncology Services 2017 Annual Report | Page: 16
Tobacco/Smoking CessationAdult Focus
Hardin Memorial Health off ers a variety of assistance to help individuals become tobacco
free: Cooper/Clayton Method of Stop Smoking, and Live Smoke Free! smoking cessation
support group. However, no courses were implemented due to lack of registration.
Tobacco cessation resource packets were mailed in conjunction with telephonic
counseling for 12 community participants who inquired about assistance along with
referrals to the Quit Line.
Wellness coaching through a Well@Work worksite wellness provided assistance to a local
employer working with employees to earn health insurance incentives for becoming
tobacco free. Ninety clients indicated they were tobacco users. Clients were referred to
the 1-800-QUIT NOW Kentucky tobacco cessation assistance phone line. Ten employees
completed the Quit Line earning a certifi cate for telephonic tobacco cessation. Of the
10 employees, one employee became tobacco free and two other clients indicated a
signifi cant decrease in tobacco usage continuing on the path to becoming tobacco free.
CANCER PREVENTION % SCREENED COUNSELED INFORMATION FOLLOW UP INITIATIVES
BREAST HEALTH 91% 90 25 15
COLON HEALTH 91% 139 48 16
SKIN HEALTH 38% 57 55 3
LUNG HEALTH 39% 60 10 4
Demographics: Male: 53 • Female: 99 • African American: 11 • Hispanic: 0 • Caucasian/Other Nationality: 141
Regarding Preventive Screenings
Hardin Memorial Health | Oncology Services 2017 Annual Report | Page: 17
Youth Focus
Recognizing smoking is the leading cause of lung cancer linked to 80-90% of lung cancers, in
January 2017 Hardin Memorial Health implemented Botvin Life-Skills Training evidence-based
tobacco prevention program for middle school students; reaching an average of 180 6th
grade students at LaRue County Middle School. The initial pilot focused on the comprehensive
approach of health information, life skills and drug resistance skills specifi cally addressing the
dangers of tobacco abuse and promoting healthy alternatives to risky behaviors teaching
activities to resist social (peer) pressures to smoke.
Botvin LifeSkills prevention program cuts tobacco use by up to 80% with eff ect lasting up to
6 years. Therefore, for the 2017-2018 school year, 194 incoming 6th grade students started the
program with the returning students from 2016 now in 7th grade continuing the program
this winter.
Pre-Post Test Results from 2016-17 school year 6th grade students:
Pre-Tests with the following results to the question: How likely would you be to say “No” when
someone off ered you a cigarette were administered to Group 1 and Group 2.
Group 1: 91 pre-tests administered, however post-test was unavailable due to teacher not
returning post-tests.
Group 2: 93 students participated in pre & post-testing.
PRETEST RESULTS GROUP 1 | GROUP 2 POSTTEST RESULTS GROUP 1 | GROUP 2
Defi nitely Would Say “No”: 77.0% 87.1%. Defi nitely Would Say “No: 0.0% 89.0%
Probably Would Say “No”: 2.0% 3.2% Probably Would Say “No”: 0.0% 5.0%
Not Sure If I Would Say “No”: 2.0% 0.0% Not Sure If I Would Say “No”: 0.0% 1.2%
Probably Would Not Say “No”: 0.0% 1.0% Probably Would Not Say “No”: 0.0% 0.0%
Defi nitely Would Not Say “No”: 8.0% 7.5%. Defi nitely Would Not Say “No”: 0.0% 2.4%
No Answer To The Question: 2.2% 1.2% No Answer To The Question: 0.0% 2.4%
The 7th grade students (previously) 6th grade students, will be pre-tested and not post-tested
until after the completion of the entire program. Additionally, we plan to ask if they would
choose to smoke; if they have tried; or if they are currently using any tobacco products. Upon
conclusion of the entire pilot, a post-test will be administered to 8th grade students which
includes the questions regarding life skills content.
Hardin Memorial Health | Oncology Services 2017 Annual Report | Page: 18
• 26 kits distributed
• Kits returned testing negative: 12 female, 5 male
• Kits returned testing positive: 1 female (had colonoscopy follow up-all clear)
• Kits never returned: (patient was contacted by Kentucky CancerLink three times and last attempt letter was mailed with no response)
• 5 females
• 2 males
• 1 male did not complete the kit, however he completed a colonoscopy (results: client had 2 polyps removed).
Other Prevention AndScreening Initiatives
Dress in Blue DayMarch 3, 2017
In recognition of Colorectal Cancer Awareness Month, HMH collaborated with Kentucky
CancerLink to provide OC-Light® FIT fecal immunochemical test screening method
for hemoglobin in stool as an early screening method to detect colorectal cancer. The
community outreach awareness event encouraged individuals to learn risk factors for
colorectal cancer and discover recommended prevention screening guidelines for
colorectal cancer. Starting in March, 26 FIT kits were distributed with 19 kits returned to
KY CancerLink for follow up regarding test and discussion of fi ndings.
Results from 3/3/17 - 10/25/17
Hardin Memorial Health | Oncology Services 2017 Annual Report | Page: 19
Purses, Pumps and Prevention: A Cancer Awareness Social April 20, 2017
Recognizing April is National Cancer Control Month, Hardin Memorial Health held its
second annual community cancer prevention awareness program featuring a fashion
show, dinner and educational program for participants to learn about breast, colorectal,
cervical, skin and lung cancer prevention to the 190 attendees. Cancer prevention
educational handouts were provided in addition to local support and resources. A pre
and-post cancer survey was administered to participants to encourage adult individuals
to recognize cancer prevention screening recommended guidelines and seek appropriate
medical assistance.
Hardin Memorial Health | Oncology Services 2017 Annual Report | Page: 20
Purses, Pumps and Prevention: A Cancer Awareness Social Statistics
Average Age: 50
Ethnic Origin: Caucasian: 68 • Hispanic: 2 • Asian: 1 • Mixed: 2 • Native American: 1
Pre-Event Questionnaire
Background Yes No N/A
Do you have a family history of cervical cancer? 6 87 0
Do you have a family history of colon cancer? 24 71 1
Do you have a family history of skin cancer? 24 66 0
Do you have a family history of breast cancer? 25 65 1
Do you have a family history of lung cancer? 18 74 0
Do you use tobacco products? 3 89 0
I am a cancer survivor 10 60 18
*1 is a current cancer patient
Within the past year, I have completed:
Annual physical by my primary care provider (PCP) 83 9 0
Pap Smear 69 17 2
Colonoscopy 26 61 4
Routine skin self-exam 72 18 0
Mammogram 62 28 2
Monthly breast self-exam 67 22 2
Post-Event Questionnaire
Yes No AlreadyScheduled
Annual physical by my primary care provider (PCP) 33 8 20
Pap Smear 29 12 15
Colonoscopy 11 39 5
Routine skin self-exam 41 8 8
Mammogram 26 18 14
Monthly breast self-exam 46 7 0
*About 50% of participants turned in a questionnaire. Of these 50%, numerous questions were left unanswered.
Hardin Memorial Health | Oncology Services 2017 Annual Report | Page: 21
Screening Programs
Screening Program: Skin Cancer Screening June 9, 2017
In recognition of National Skin Cancer Detection and Prevention Month, a free skin
cancer screening was provided: 64 community members screened following the
American Academy of Dermatology (AAD) screening guidelines with the assistance
of 3 local dermatologists. Educational materials from the American Academy of
Dermatology and National Cancer Institute were distributed to promote skin cancer
prevention. Demographics below:
Average Age: 50
General Cancer Awareness/Prevention Activities
Numerous regional festivals and organizational health fairs off ered the opportunity
to provide 10 educational cancer prevention encounters reaching over 3,000
community members.
Topics of focus from colorectal, skin, breast and lung aligned with the National Cancer
Awareness Health Observance months. Healthcare professionals also shared prevention
tips from dietary, exercise and behavior modifi cation to encouraging early detection
through screening.
Submitted by: Karen G. Blaiklock, MS, RN Communications and Community Relations Director, HMHCommunity Outreach Coordinator, Cancer Committee
22 42
30 referred for follow-up
(15 males and 13 females)
10 biopsies recommended
Hardin Memorial Health | Oncology Services 2017 Annual Report | Page: 22
Survivorship At Hardin Memorial Health (HMH), patients completing curative treatment receive
a survivorship care plan and treatment summary. The cancer committee develops,
monitors and evaluates the dissemination process of these care plan and treatment
summaries, annually.
The Institute of Medicine report “From Cancer Patient to Cancer Survivor” outlines the
importance of providing cancer survivors with a comprehensive summary of treatment
received, post treatment needs and follow-up care to improve health and quality of life.
The American Society of Clinical Oncology (ASCO) defi nes the minimum data elements
to be included in the treatment summary. The HMH Cancer Center uses Journey
Forward disease specifi c templates.
A survivorship nurse navigator identifi es appropriate patients who have completed
curative therapy. Curative therapy includes surgery, chemotherapy, immunotherapy,
and or radiation. The survivorship nurse navigator meets with the patient to review the
survivorship care plan within the requirements for timely delivery. A copy of the care
plan is shared with the Primary Care Physician.
The Commission on Cancer introduced this standard in 2012 with a gradual roll out
beginning in 2015. For 2017, 50% of the patients completing curative treatment must
receive a survivorship care plan.
DeAnna Werle, RN, BSN, OCNSurvivorship Nurse Navigator
Hardin Memorial Health | Oncology Services 2017 Annual Report | Page: 23
521 Robinbrooke BlvdElizabethtown, Kentucky 42701
www.hmh.net
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