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Male Female Age Fractures since the age of 50 (excluding major trauma, e.g. Enter height in feet and inches. Fracture Risk Assessment Tool (FRAX) - APTA Has your mother or father had a hip fracture? Data Sources: We reviewed all cited references from the original 2009 review article, then performed a PubMed search using the following key words: osteoporosis, osteopenia, screening, diagnosis, treatment, prevention, secondary, and vitamin D. The search included meta-analyses, randomized controlled trials, clinical trials, and reviews. Combination Therapy. Author disclosure: No relevant financial affiliations. Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. How Does Resistance Training Prevent Osteoporosis. Additional searches included Essential Evidence Plus, the U.S. Preventive Services Task Force, the Institute for Clinical Systems Improvement, the National Guideline Clearinghouse, the Cochrane Database of Systematic Reviews, and the National Osteoporosis Foundation website. QRISK3 Your score is then plotted on a graph that suggests whether you should get treatment or make lifestyle changes to manage your risk. American Bone Health4208 Six Forks RoadSuite 1000Raleigh, NC 27609. RA is a risk factor for fracture. Several simplified paper versions, based on the number of risk factors are also available, and can be downloaded for . CALCIUM - Calcium Calculator | International Osteoporosis Foundation After initiation of treatment, the need for follow-up bone density testing is uncertain. Enter yes if the patient has a disorder strongly associated with osteoporosis. Raloxifene, a selective estrogen receptor modulator, is approved for treating postmenopausal osteoporosis, and is effective at reducing vertebral fractures only.16,26 Raloxifene is commonly associated with increased vasomotor symptoms. 1. Consuming more than 2.5 units of caffeine daily (1 unit = one cup of coffee or two cups of tea) may increase fracture risk.24 Diets with adequate protein intake are necessary for optimal bone health, but the proper amount or source (plant vs. animal) remains controversial. We avoid using tertiary references. The filter allows the FRAX score into the DXA report only when the patient does not meet the first two of the NOF treatment criteria (prior hip or vertebral fracture or T-score below 2.5) but could possibly meet the third NOF treatment criterion based on FRAX risk calculation: an untreated postmenopausal woman or man age 50 years or older . After your bone density test, your doctor can use the FRAX tool to calculate your FRAX scores and give you an estimate of your 10-year fracture risk. . the QRISK3-2018 calculator. In their most sophisticated form, the FRAX tool is computer-driven and is available on this site. Copyright 2023 American Academy of Family Physicians. Check all that apply.Check all that apply. Medical Calculators, Dosage Calculations, Clinical - GlobalRPH Weight (kg) 4. Calcitonin nasal spray is an antiresorptive agent approved for the treatment of postmenopausal osteoporosis. Cadarette (2004) Osteoporos Int 15(5):361-366 [PubMed] Frax score calculator mdcalc - QQMCUO Resistance training is one of the best things you can do to manage osteoporosis. Frax | A Better Way to Learn Fractions The loss of bone mass makes them weaker and more likely to break if you fall or are otherwise injured. Osteoporosis: fragility fracture risk - National Institute for Health Several simplified paper versions, based on the number of risk factors are also available, and can be downloaded for office use. About 60% of your bone density is a result of genetics. The Women's Health Initiative study confirmed that estrogen, with or without progesterone, slightly reduced the risk of hip and vertebral fractures; however, this benefit did not outweigh the increased risk of stroke, venous thromboembolism, coronary heart disease, and breast cancer, even for women at high risk of fracture.46 Lower doses of conjugated equine estrogens and estradiol have been shown to improve BMD, but a reduced risk of fracture has not been demonstrated and the safety is unknown.47. Patient does not provide medical advice, diagnosis or treatment. The National Osteoporosis Foundation also recommends screening all men 70 years and older, based on the assumption that this group has a similar osteoporotic fracture risk and treatment effectiveness as 65-year-old white women.1, Primary osteoporosis is related to aging and loss of gonadal function. Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. Bisphosphonates should be used as first-line pharmacologic treatment for osteoporosis. If you do not know your Femoral Neck T-score, leave this field blank and click next. This means making your home safer by: You may also be advised to work on balance exercises. In patients with newly diagnosed osteoporosis, suggested laboratory tests to identify secondary causes include serum 25-hydroxyvitamin D, calcium, creatinine, and thyroid-stimulating hormone. The purpose of FRAX is to characterise fracture risk so that decisions can be facilitated on the need for treatment and, in some instances, the type of treatment [6, 13].This demands the consideration of intervention thresholds which, in the case of FRAX, is the 10-year probability of fracture above which pharmacological intervention should be considered. For these groups, the International Society for Clinical Densitometry recommends use of the z score (age and sex norms). Follow this link for information on the tool:http://www.garvan.org.au/bone-fracture-risk/, Osteoporosis, New Zealand, While the original paper describes the size of the lesion as a percentage of the cortex, in practice it is classified as a percentage of the width (diameter) of the bone at that level. Have you broken bones with little impact, such as a trip or fall from level ground, since age 45? Learn how osteoporosis can affect your spine, and the treatments and exercises that can help you manage symptoms. Welcome to the QFracture -2016 Web Calculator. note: This review updates a previous article on this topic by Sweet, Sweet, Jeremiah, and Galazka.29. Raloxifene. hip, wrist, shoulder or spine) fracture or hip fracture alone by answering some simple questions. FRAX is administered by a health care provider and can be used for those who meet certain conditions: For the FRAX score calculator, youll have to answer several questions about habits such as alcohol intake and other disorders you may have that are linked to osteoporosis, such as type 1 diabetes. The University of Sheffield launched the FRAX tool in 2008. The Fracture Risk Assessment Tool (FRAX) (1) is a fracture risk calculator that estimates an individual's 10-year probability of incurring a hip or other major osteoporotic fracture, your FRAX score will be calculated, A risk score of >20 points indicates a very high risk of diabetes (50% chance of diabetes M81.0 - Postmenopausal osteoporosis. if you break any bone (except fingers and toes) from a trip or fall on level ground after age 45, you are twice as likely to break another bone! Click here to display the FRAXcalculation tool. Are you taking a prescription medicine for osteoporosis? The FRAX score (with BMD) identified 46.8% of patients who had DXA suitable for treatment, in contrast to 19.1% by the T-score alone. Have you ever had a bone density test on a table machine? Professional Reference tools are designed for health professionals to use. Patients Perspectives as a Catalyst for Action to Improving Osteoporosis Care, https://www.bonehealthandosteoporosis.org/medical-disclaimer/. MDCalc is a 13-year-old medical reference started by two practicing emergency medicine physicians, Dr. Joe Habboushe and Dr. Graham Walker. Genetics is one of the most important factors that determine your risk of fractures. Gaucher disease is an inherited disorder that causes a buildup of GCase in your body. The output is a 10-year probability of hip fracture and the 10-year probability of a major osteoporotic fracture (clinical spine, forearm, hip or shoulder fracture). All rights reserved. Enter yes or no. This is a corrected version of the article that appeared in print. Weight must be between 70 and 300 pounds. A fracture detected as a radiographic observation alone (a morphometric vertebral fracture) counts as a previous fracture. The U.S. Preventive Services Task Force (USPSTF) recommends screening all women 65 years and older.5 DEXA of the hip and lumbar spine is the preferred assessment method. A unit of alcohol varies slightly in different countries from 8-10g of alcohol. The American Bone Health Fracture Risk Calculator Version 3.0 estimates fracture risk for women and men over age 45. The FRAX tool has been developed to evaluate fracture risk of patients. These are real scientific discoveries about the nature of the human body, which can be invaluable to physicians taking care of patients. It is based on individual patient models that integrate the risks associated with clinical risk factors as well as bone mineral density (BMD) at the femoral neck. Shown to have greater variability in agreement when scored by medical and radiation oncologists, to whom these patients are most likely to present. Enter your Femoral Neck T-score as a decimal number. They are considered first-line pharmacologic therapy. Have you been told that you have a spine fracture? FRAX is a sophisticated risk assessment instrument, developed by the University of Sheffield. More aggressive treatment usually includes a type of medication called bisphosphonates, such as alendronate (Fosamax) and ibandronate (Boniva). Although research continues, there is currently a limited role for combination therapy beyond clinical trials. Methods: Fracture risk was calculated using the different screening tools (FRAX, OST, ORAI, OSIRIS and SCORE) for each woman. Getting more exercise, including weight-bearing activities, is helpful too. 1.How do you rate your confidence that you could get and keep an erection? However, your doctor may suggest one earlier if you have a personal history of fractures or a family history of bone problems. This osteoporosis risk score calculator stratifies osteoporosis risk, especially useful in women with low bone density. The need for follow-up bone mineral density testing in patients receiving treatment for osteoporosis is uncertain. Read our editorial policy. Enter age in whole years, rounding to the nearest year. Do you have a question about how theFracture Risk Calculatorworks for you?Find answers on theCalculator Frequently Asked Questions (FAQs) page. Privacy Policy. Fracture risk calculators | Osteoporosis Receive updates and information about Bone Health, Our Events, and Specialty Programs each month. Osteoporosis is a disease that weakens or thins your bones. The American Bone Health Fracture Risk Calculator (ABH FRC) Version 3.0, published 03/04/2021, estimates 10-year fracture risk for postmenopausal women and men age 45 and older who are not receiving treatment for osteoporosis. 24/7 Live Expert. The optimal length of oral bisphosphonate therapy is unknown. NetScaler AAA MICHAEL P. JEREMIAH, MD, BRIAN K. UNWIN, MD, MARK H. GREENAWALD, MD, AND VINCENT E. CASIANO, MD. In general, a bone density test is recommended for women starting at age 65 and men at age 70. GlobalRPH has a medcalc for every major clinical specialty including: Cardiology, Critical Care, Dermatology, Endocrinology, Gastroenterology and Hepatology, Geriatrics, Hematology, Infectious Disease, Neurology, Nephrology, Nutrition (TPN, BMR calculators, Fiber), Oncology, Pain Management, Pharmacokinetics, Psychiatry, Rheumatology, Statistics, You can learn more about how we ensure our content is accurate and current by reading our. Some tests measure the BMD of the entire skeleton. It is based on individual patient models that integrate the risks associated with clinical risk factors as well as bone mineral density (BMD) at the femoral neck. Bone Fracture Risk Calculator - Garvan Institute of Medical Research The loss of bone minerals quicker than you can replace them is called bone demineralization, which can lead to other conditions like osteoporosis. The WHO criteria should not be applied to men younger than 50 years, children, or premenopausal women. Alternatively, enter the T-score based on the NHANES III female reference data. A hip or vertebral (clinical or morphometric) fracture, T-score -2.5 at the femoral neck or spine after appropriate evaluation to exclude secondary causes, Low bone mass (T-score between -1.0 and -2.5 at the femoral neck or spine) and a 10-year probability of a hip fracture 3% or a 10-year probability of a major osteoporosis-related fracture 20% based on the US-adapted WHO algorithm, Clinicians judgment and/or patient preferences may indicate treatment for people with 10-year fracture probabilities above or below these levels. FRAX score: What is it, and what do the results mean? - Medical News Today Healthline Media does not provide medical advice, diagnosis, or treatment. Do not routinely repeat dual energy x-ray absorptiometry (DEXA) scans more often than once every two years. In a dosage of 20 mcg per day given subcutaneously for up to two years, teriparatide decreases vertebral and nonvertebral fractures.16,26 Teriparatide is approved for the treatment of postmenopausal women with severe bone loss, men with osteoporosis who have high risk of fracture, and individuals whose condition has not improved with bisphosphonate therapy. They are written by UK doctors and based on research evidence, UK and European Guidelines, so you may find the language more technical than the condition leaflets. First-line treatment to prevent fractures consists of fall prevention, smoking cessation, moderation of alcohol intake, and bisphosphonate therapy. Assessment of absolute fracture risk, using either the Garvan Fracture Risk Calculator or the Fracture Risk Assessment Tool (www.shef.ac.uk/FRAX) may be useful in assessing the need for treatment in individuals who do not clearly fit established criteria. The World Health Organization (WHO) 8 has quantified this as forces equivalent to a fall from a standing height or less. If you have a spine fracture, you are four times as likely to have another spine fracture. Mirels' Criteria for Prophylactic Fixation - MDCalc A recent survey by EB Medicine has shown that MDCalc's . Calcitonin. 1.4 Use either FRAX [ 8] (without a bone mineral density [BMD] value if a dual-energy X-ray absorptiometry [DXA] scan has not previously been undertaken) or QFracture [ 9 . Diagnosis and Management of Osteoporosis | AAFP For the FRAX score calculator, you'll have to answer several questions about habits such as alcohol intake and other disorders you may have that are linked to osteoporosis, such as type 1. Your FRAX score is your risk of having an osteoporosis-related fracture in the next 10 years. Sex Male Female 3. FRAX - North American Menopause Society (NAMS) Is It Ever Too Late for Osteoporosis Treatment? (2017). Learn more about how these and other nutrients can help you prevent osteoporosis, Bone density screenings are used to determine your risk of osteoporosis or of fracturing a bone and may also be used to check whether treatment is, Typically, you don't stop treatment. CHADS-VASc Score for Atrial Fibrillation Stroke Risk Calculates stroke risk for patients with atrial fibrillation, possibly better than the CHADS Score. About the bone fracture risk calculator. The impact of fractures includes loss of function, significant costs, and increased mortality. The QRISK 3 algorithm calculates a person's risk of developing a heart attack or stroke over the next 10 years. Low insulin levels in childhood or adolescence may lead to weaker bones and an increased risk of fractures in adulthood. The osteoporosis self-assessment tool (OST) 1 in women is a simple formula that predicts risk of osteoporosis for the patient based solely on current weight and age. Too much alcohol interferes with calcium and vitamin D absorption, affects the liver, and decreases estrogen. Comparison of FRAX score to bone mineral density for estimating Please answer the questions below to calculate the ten year probability of fracture with BMD. The FRAX calculator for the United States is unique in that there exist distinct databases for ethnic minorities. If lifestyle changes are appropriate, your doctor may recommend: You will also be advised to reduce your fall risk in several ways. Copyright Medicalalgorithms.com Limited. And if youve been taking glucocorticoids for a long time, talk with your doctor about whether you can cut back or stop taking those medications altogether. The formula for measuring your risk uses factors such as: Osteoporosis means porous bone. Bones become more brittle, usually due to hormonal changes or reduced levels of calcium or vitamin D in the body. These may be lifestyle and dietary measures, or medication. Bone health is primarily determined by dual energy x-ray absorptiometry (DXA) scanning after women have been screened for possible disease. MDCalc loves calculator creators - researchers who, through intelligent and often complex methods, discover tools that describe scientific facts that can then be applied in practice. All rights reserved. Fractions knowledge in grade 5 uniquely predicts student success in Algebra and . Comparing Bone Demineralization and Osteoporosis, What to Know About Osteoporosis and Your Spine, What You Need to Know About Gaucher Disease and Osteoporosis, A Complete Guide to Infusions for Osteoporosis, 4 Types of Exercises and Activities to Avoid When You Have Osteoporosis. All information should be verified by a qualified health professional, and all use is subject to Medicalalgorithms.com Terms and Conditions. Enter "Yes" if you drink 3 or more alcoholic beverages a day. Why fractions matter. Other perimenopausal or postmenopausal women with risk factors for osteoporosis if willing to consider pharmacologic interventions: Excessive consumption of alcohol (> 2 drinks per day for women), Low body weight (< 58 kg [128 lb] or body mass index < 20 kg per m, Any history of long-term systemic glucocorticoid therapy ( 3 months), American College of Obstetricians and Gynecologists, Bone density screening no more than once every two years beginning at 65 years of age, unless new health risks develop, Selective screening in women younger than 65 years if they are postmenopausal and have other osteoporosis risk factors or fracture, In the absence of new risk factors, DEXA monitoring of therapy should not be repeated after BMD is determined to be stable or improved, In women 65 years and older and in men 70 years and older, In postmenopausal women and men 50 to 69 years of age; recommended based on risk factor profile, With vertebral imaging in those who have had a fracture to determine degree of disease severity, At DEXA facilities using accepted quality assurance measures, In women 65 years and older and in men 70 years and older to diagnose vertebral fractures if T-score is 1.5, In women 70 years and older and in men 80 years and older to diagnose vertebral fractures, regardless of T-score, In postmenopausal women and men 50 years and older with a low-trauma fracture, In postmenopausal women and men 50 to 69 years of age to diagnose vertebral fractures if there is height loss 4 cm (1.5 in), or recent or ongoing long-term glucocorticoid therapy, To check for causes of secondary osteoporosis, BMD testing one to two years after initiating therapy to reduce fracture risk and every two years thereafter, More frequent testing in certain clinical situations, Longer interval between repeat BMD tests for patients without major risk factors and who have an initial T-score in the normal or upper lowbone mass range, Risk factors: glucocorticoid use (> 3 months cumulative therapy in past year), high-risk medication use, hypogonadism or premature menopause (age < 45 years), malabsorption syndrome, hyperparathyroidism, other associated disorders, Low body weight (< 60 kg [132 lb]) or weight loss (> 10% of weight at 25 years of age), Vertebral fracture or osteopenia on radiography, Repeat BMD testing in one to three years and reassess risk in moderate- and high-risk groups, United Kingdom National Osteoporosis Guideline Group, Case finding for BMD assessment is based on risk factor assessment and comparison of risk to age- and sex-specific fracture probabilities, Screen for osteoporosis in women 65 years and older, and in younger women whose fracture risk is equal to or greater than that of a 65-year-old white woman who has no additional risk factors, Current evidence is insufficient to assess the balance of benefits and harms of screening for osteoporosis in men, Central nervous system disorders (e.g., epilepsy, multiple sclerosis, Parkinson disease, spinal cord injury, stroke), Endocrine/metabolic disorders (adrenal insufficiency, athletic amenorrhea, Cushing syndrome, hemochromatosis, homocystinuria, primary hyperparathyroidism, hyperprolactinemia, hyperthyroidism, primary or secondary hypogonadism, premature menopause, thyrotoxicosis, type 1 diabetes mellitus), Gastrointestinal disorders (celiac disease, gastric bypass, inflammatory bowel disease, malabsorption, pancreatic insufficiency, primary biliary cirrhosis), Hematologic disorders (hemophilia, leukemia and lymphomas, monoclonal gammopathies, multiple myeloma, sickle cell disease, thalassemia), Human immunodeficiency virus infection or AIDS, Nutrition disorders (alcoholism, anorexia nervosa/bulimia, malnutrition, vitamin A excess, vitamin D deficiency), Anticonvulsants (e.g., phenobarbital, phenytoin [Dilantin]), Gonadotropin-releasing hormone agonists and antagonists, Thiazolidinediones (e.g., pioglitazone [Actos]), 4 drinks per day for men or 2 drinks per day for women, 2.5 cups of coffee or 5 cups of tea per day, Multicomponent exercise with strength and balance training, Consider drug discontinuation after 5 years in low-risk patients, Small risk of atypical femoral shaft fractures; osteonecrosis of the jaw, Alendronate/cholecalciferol (Fosamax Plus D), Muscular and joint pains; small risk of osteonecrosis of the jaw (especially older women with poor dental hygiene or cancer) Contraindications: hypocalcemia; pregnancy. Your QRISK score will tell you whether you are at low, moderate or high risk of developing CVD in the next 10 years. ", Postgraduate Medicine: Primary care use of FRAX: absolute fracture risk assessment in postmenopausal women and older men., University of Sheffield: Calculation Tool, Welcome to FRAX.. Egton Medical Information Systems Limited. Other Calculators - ISCD If ages below or above are entered, the programme will compute probabilities at 40 and 90 year, respectively. CALCIUM - Calcium Calculator | International Osteoporosis Foundation of 2 Are you getting ENOUGH CALCIUM ? English | Arabic | Bengali | Chinese Simplified | Chinese Traditional | Croatian | Czech | Danish | Dutch | Estonian | Farsi | Finnish | French | Georgian | German | Greek | Icelandic | Italian | Indonesian | Japanese | Korean | Lithuanian | Norwegian | Polish | Portuguese (Portugal) | Portuguese | Romanian | Russian | Serbia | Slovak | Spanish | Swedish | Thai | Turkish | Ukrainian, Individuals with fracture risk assessed since 1st June 2011, Centre for Metabolic Bone Diseases, University of Sheffield, UK, Professor Emeritus, University of Sheffield, Click here to view the applications available. Clinicians should consider discontinuing bisphosphonate therapy after five years in women without a personal history of vertebral fractures. FRAX Osteoporosis Calculator | Assessment Tool | Medical Algorithm It has been shown to decrease the occurrence of vertebral compression fractures only.16,26 Although calcitonin has modest analgesic properties in the setting of acute and chronic vertebral compression fracture, it is not considered first-line treatment for osteoporosis because more effective medications are available.16,41 There have also been reports of increased cancer rates associated with use of calcitonin.42, Teriparatide. Can only be used to predict fracture risk in long bones (i.e., not in vertebral mets). Secondary osteoporosis No Yes 11. Frax Tool Bone Source Any clinician can use this calculator [3] to predict the probability . Personal details (such as height and weight, medication history, smoking history and family history) are entered to predict whether someone is at risk of developing osteoporosis in the next 10 years. Calculation Tool - University of Sheffield Now there is a Fracture Risk Assessment Tool (FRAX ) for evaluating fracture risk. Knowing your 10-year risk for fractures will allow you and your doctor to make decisions about treatment. This is not taken into account and the computations assume average exposure. Upgrade to Patient Pro Medical Professional? See Osteoporosis Risk Factors; Where other Osteoporosis risks exist, use FRAX Score or Osteoporosis SCORE Estimation; VI. Age (between 40 and 90 years) or Date of Birth Age: Date of Birth: Y: M: D: 2. Or very high doses of inhaled steroids for extended periods of time? Try our Symptom Checker Got any other symptoms? People with a high. The site and reference technology is DXA at the femoral neck. Garvan Institute Assessment Tool To help determine your risk for such an injury, doctors developed the Fracture Risk Assessment Tool (FRAX). Last medically reviewed on December 8, 2017. Physical activity is important when you have osteoporosis, but some exercises can cause more harm than good. English | Arabic | Bengali | Chinese Simplified | Chinese Traditional | Croatian | Czech | Danish | Dutch | Estonian | Farsi | Finnish | French | Georgian | German | Greek | Icelandic | Italian | Indonesian | Japanese | Korean | Lithuanian | Norwegian | Polish | Portuguese (Portugal) | Portuguese | Romanian | Russian | Serbia | Slovak | Spanish | Swedish | Thai | Turkish | Ukrainian, Individuals with fracture risk assessed since 1st June 2011, Age (between 40 and 90 years) or Date of Birth, Centre for Metabolic Bone Diseases, University of Sheffield, UK. OR Densitometer by DXA GE Lunar by DXA Hologic Primary care use of FRAX: absolute fracture risk assessment in - PubMed FRAX: A tool for estimating your fracture risk. MDCalc - Medical calculators, equations, scores, and guidelines Creatinine Clearance (Cockcroft-Gault Equation) Calculates CrCl according to the Cockcroft-Gault equation. How has Covid-19 affected the treatment of osteoporosis? This is equivalent to a standard glass of beer (285ml), a single measure of spirits (30ml), a medium-sized glass of wine (120ml), or 1 measure of an aperitif (60ml) (see also notes on risk factors). Enter yes where the patient has a confirmed diagnosis of rheumatoid arthritis. Standardized osteoporosis risk factor calculator - The z-score is the number of standard deviations away from the average value they calculate the risk of. Fracture Risk Assessment (FRAX) Tool - Physiopedia Reduced bone density 9 is a major risk factor for fragility fractures. The risk is expressed as a percentage: for example, 10% means 10 people out of a 100, with this level of risk, will develop osteoporosis in the next 10 years. Enter "No" if you have never smoked or have quit. A prior clinical vertebral fracture or a hip fracture is an especially strong risk factor. Women who smoke go through menopause at a younger age than women who dont smoke. A diagnosis of osteoporosis isnt a guarantee that youll have a fracture. the higher the exposure, the greater the risk. Caution:A qualified health practitioner should verify all results.Keep patient data confidential and comply with all legal requirements. See permissionsforcopyrightquestions and/or permission requests. Be sure to use the minus sign if the T-score is negative. A doctor told you or it was reported on an x-ray? SCORE = Race + Rheumatoid Arthritis + Fracture history + Estrogen + (3 x Age / 10) - (Weight in lbs / 10) The SCORE was developed after the study conducted by Lydick and colleagues as a stratification tool for post-menopausal women at risk of osteoporosis (consistent with BMD T scores <-2).

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