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Trial registered on ANZCTR
Registration number
ACTRN12617000109303p
Ethics application status
Submitted, not yet approved
Date submitted
12/01/2017
Date registered
20/01/2017
Date last updated
20/01/2017
Type of registration
Prospectively registered
Titles & IDs
Public title
Does using an automated bladder diary improve compliance and data accuracy in patient completing a bladder diary?
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Scientific title
Does a fully automated bladder diary improve patient compliance and data accuracy in patients performing a bladder diary for investigation of their lower urinary tract symptoms?
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Secondary ID [1]
290902
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None
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Universal Trial Number (UTN)
U1111-1191-5286
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Overactive Bladder
301621
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Lower Urinary Tract Symptoms
301622
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Nocturia
301623
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Condition category
Condition code
Renal and Urogenital
301329
301329
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0
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Other renal and urogenital disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Automated Bladder Diary
- Participants will be asked to use a portable automated device to measure their urine over a 3 day period in addition to the usual practice of manual measuring of urine to help assess volumes passed by the patient
- The device is called "iUFlow" and is manufactured by Kesem Health Pty Ltd.
- The aim is to assess whether the use of this device provides superior results compared to patient manual measurement and paper documentation of urine volumes
- The iUFlow device is placed over the toilet bowl and collects urine as the patient voids. This is linked to a smartphone application that each patient downloads free of charge
- The application tallies the total volumes of the urine and the patient is asked to provide a rating for each void of their urgency (how pressured they felt to urinate) and incontinence (any involuntary leakage of urine that occurred)
- The intervention is the use of this device
- All patients will be using the device
- The patient will be using this device i.e. performing their own intervention
- Instructions on device use are brief and mainly relate to activation of the device. A brief instructional video is available on youtube: https://youtu.be/WHT7fRK67_A
- assessment of patients will take place by a consultant urologist
- no medical decisions will be made based on the outcome of the patients collected data from the device
- intervention will be delivered individually
- intervention will take place in the patients home as an ambulant study as this device is designed to replace a process that takes place in the patients home
- The intervention will take place over 3 days (standard length of time for bladder diary) and will only occur once. Patients will be asked to use the device continuously for 72 hours. Dose and intensity not applicable to this study
- Participants will be assigned to 2 groups through the use of random allocation of white unmarked envelopes to decide which diary type they will perform first
- Group 1 will perform the automated diary first followed by the paper diary, group 2 will perform the paper diary first followed by the automated diary.
- The 2 diaries will preferably be performed over 6 consecutive days
- No changes have been made to the design
- Adherence and fidelity to the intervention are measured outcomes of the intervention itself, so no measures were made to improved compliance as this is an outcome measure testing the effect of the device
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Intervention code [1]
296848
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Diagnosis / Prognosis
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Comparator / control treatment
- All patient will complete a "traditional" paper voiding diary. This involves patients collecting their urine with each void in a measuring jug and recording the amounts of urine they pass. This amount is recorded in a "diary" and with each voiding event, the patient also writes down if they had any incontinence or if they felt a very strong urge to urinate. The volumes tallied are added up at the end of the day to assess the pattern of voiding.
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Control group
Active
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Outcomes
Primary outcome [1]
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- Compliance with data entry will be assesed by patient survey
- Patients will be asked how many times they went to the toilet and failed to record their urine volumes for each of the diary types. This will be a measure of "compliance" with diary procedures
- Data provided by the automated bladder diary of patients will not be used to make decisions for health care
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Assessment method [1]
300731
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Timepoint [1]
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72hours
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Secondary outcome [1]
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- Preference of Automated Diary Compared to Traditional paper diary
- This will be assesed by survey and direct input by patients who will have a chance to explain their preference for paper vs. device use
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Assessment method [1]
330735
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Timepoint [1]
330735
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end of study (7 days)
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Secondary outcome [2]
330821
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Ease of use of the device
- assessed through survey assessing patient rating of ease of use
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Assessment method [2]
330821
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Timepoint [2]
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7 days (end of trial)
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Secondary outcome [3]
330823
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Time taken to perform diary
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Assessment method [3]
330823
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Timepoint [3]
330823
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Assessed by patient report at survey point at days 3 and 6
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Eligibility
Key inclusion criteria
- >18 years old
- non-pregnant
- patients being investigated for lower urinary tract symptoms
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Non-english speaking background
Pregnant females
Healthy participants
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Study design
Purpose of the study
Diagnosis
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Allocation not concealed
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation using procedures like coin-tossing and dice-rolling
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Crossover
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Other design features
- In this study participants will perform both diary types
- This study will involve half of the recruited patients completing the traditional paper diary first followed by the automated diary, with the other half of the cohort beginning with the automated diary and completing the paper diary second.
- This will be done to combat any bias in results from learned experience (getting used to doing a diary so becoming better at it) and from "diary fatigue" (becoming less compliant with completing a diary due to the length of time of effort)
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Previous research in a healthy volunteer population has shown the mean reduction of missedurinary data input events to be 2.5 for the traditional diary group and 1.1 for the device group with a standard deviation of 2 in each group. This is expected to increase based on an inflation factor of 50% in a patient population due to increased pathology. Power calculations were performed using Stata v.12.0SE (College Station, TX, USA) and showed analysis was conducted based upon an independent samples t-test, assuming statistical power of 0.80 and an alpha value of 0.05. Calculations lead to approximately 11 patients in each arm of the group. To allow for 4 patients from each arm of the study not completing or withdrawing from the study we aim to recruit 15 patients for each arm, 30 patients in total.
It is feasible that approximately 4 patients would be able to be recruited each week so an
expected recruitment period of 7-8 weeks is the aim.
Data will be entered in an Excel 2016 spread sheet (Microsoft, Redmond, CA, USA). Analysis will be performed using Stata v.12.0SE (College Station, TX, USA). Data will be defined as categorical or continuous. Distribution of continuous data will be assessed and deemed parametric or nonparametric. Categorical data will be analysed using Fishers' exact or Chi Square as appropriate. Parametric continuous data will be analysed using an independent t test or one-way ANOVA. Non-parametric continuous data will be assessed using Mann-Whitney U test or Kruskal Wallis.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/02/2017
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Actual
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Date of last participant enrolment
Anticipated
15/08/2017
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Actual
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Date of last data collection
Anticipated
30/08/2017
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Actual
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Sample size
Target
30
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
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Epworth Cliveden - Melbourne East
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Recruitment hospital [2]
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Epworth Eastern Hospital - Box Hill
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Recruitment hospital [3]
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Epworth Freemasons - Melbourne
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Recruitment postcode(s) [1]
15044
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3002 - Melbourne East
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Recruitment postcode(s) [2]
15045
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3128 - Box Hill
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Recruitment postcode(s) [3]
15046
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3002 - Melbourne
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Funding & Sponsors
Funding source category [1]
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Commercial sector/Industry
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Name [1]
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Kesem Health PTY PTD
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Address [1]
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Kesem Health PTY PTD
33 Cameron Ave.
Oakleigh South
3123, Victoria
AUSTRALIA
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Country [1]
295326
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Australia
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Primary sponsor type
Individual
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Name
Nathan Lawrentschuk
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Address
Austin Health
145 Studley Rd.
Heidelberg, VIC 3084
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Country
Australia
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Secondary sponsor category [1]
294150
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None
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Name [1]
294150
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Address [1]
294150
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Country [1]
294150
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Ethics approval
Ethics application status
Submitted, not yet approved
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Ethics committee name [1]
296663
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Epworth Healthcare HREC
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Ethics committee address [1]
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89 Bridge Road, Richmond VIC 3121
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Ethics committee country [1]
296663
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Australia
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Date submitted for ethics approval [1]
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18/01/2017
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Approval date [1]
296663
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Ethics approval number [1]
296663
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Summary
Brief summary
Voiding diaries are essential in the effective evaluation of males and females with lower urinary tract symptoms (LUTS). Since their initial use more than 50 years ago, voiding diaries have helped to contribute to the diagnosis and appropriate management of many patients suffering from functional urological issues. The evolution of the bladder diary over time has led to multiple formats and alterations tailored to suit differing clinical need. Although there is no accepted scoring system for urgency, incontinence and patient validation, the bladder diary is still currently the recommended and most accurate method of collecting voiding data. Despite this, these dairies are frequently tedious and time-consuming and are fraught with erroneous results due to a lack of patient compliance and accuracy of data collected. With the recent utilization of e-health devices and technology in both society and clinical practice, electronic voiding diaries have been introduced. These electronic diaries offer advantages over traditional paper diaries that result in improved data quality and increased patient compliance. However, current electronic diaries still depend on patient handling and measurement of urine and manual input of voiding data into devices. This remains burdensome and is a potential additive factor to inaccurately recorded volumes, incomplete data collection and potential misdiagnosis. The use of a fully automated voiding diary has definite potential advantages. By eliminating urine handling and automating measurement, it reduces the burden to patients, adds to accuracy of measured volumes and facilitates immediate and precise data entry. This may benefit clinicians by providing more detailed, easy to interpret results and ultimately improve clinical outcomes for the patient. The iUFlow (Kesem Health, Melbourne, Australia) device is one such example of an automated voiding diary.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
71678
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Prof Nathan Lawrentschuk
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Address
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Austin Health
145 Studley Rd.
Heidelberg 3084, VIC
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Country
71678
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Australia
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Phone
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+61 3 94965000
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Fax
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Email
71678
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[email protected]
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Contact person for public queries
Name
71679
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Daniel Christidis
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Address
71679
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Austin Health
145 Studley Rd.
Heidelberg 3084, VIC
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Country
71679
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Australia
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Phone
71679
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+61 3 94965853
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Fax
71679
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Email
71679
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[email protected]
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Contact person for scientific queries
Name
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Daniel Christidis
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Address
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Austin Health
145 Studley Rd.
Heidelberg 3084, VIC
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Country
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Australia
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Phone
71680
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+61 3 94965853
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Fax
71680
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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