Clinical scientists: Free workshop on PCORI’s pragmatic clinical studies initiative, Sept. 20

pcori logo

The Patient-Centered Outcomes Research Institute (PCORI) is hosting a free one-day workshop on understanding their pragmatic clinical studies initiative. This workshop is specifically designed for experienced clinical investigators and will address:

  • PCORI’s funding opportunities, letters of intent and application requirements.
  • PCORI’s priority clinical areas and targeted research topics.
  • Problems and questions that may arise in the early stages of conducting a large pragmatic clinical study.
  • Challenges in conducting clinical trials.
  • Insights into ways to overcome the common pitfalls associated with clinical trials.
  • Approaches to mapping out the recruitment process.
  • PCORI’s model of stakeholder engagement and team science.
  • Case studies that highlight effective models for developing clinical studies.

Sunday, Sept. 20, 2015
6 to 8 p.m.

Embassy Suites Portland – Airport
7900 NE 82nd Avenue
Portland, Oregon 97220

Register here.

For questions, email

Research Courtyard: Construction testing on Vollum and RJH, Sept. 4-6

vollum_instituteUPDATE 9/2/15 at 11 a.m.: The testing scheduled for Sept. 4-6, has been canceled. The work is expected to occur Sept. 11-13. More details to come.

OHSU has embarked on large renovation project on the Vollum Institute—and part of this renovation includes replacing the façade, which is damaged in places and thus represents a potential hazard. With construction to remove the façade of the building expected to begin next May, crews will be performing a series of tests this weekend to determine sound and vibration impacts of the project. Beginning at 10 a.m. Friday, Sept. 4, and continuing through Sunday, Sept. 6, crews will remove tile and a window from the lower left front of the building, removing brick on the east side of the first and third floors, and doing some minor test drilling on other parts of the façade. This exploratory work is necessary to determine what will be involved in the complete removal of the building’s aging terra cotta tile exterior. Note: Occupants in the Vollum and adjacent buildings should expect to experience a fair amount of noise. There is unlikely to be any vibration that would disrupt imaging or electrophysiology work.

At the same time, a new high-voltage conduit for the Old Library service will be installed. Crews will be running electrical conduits under CROET through the tunnel into the electrical vault beneath Richard Jones Hall. This work will be done Friday and Saturday morning from 5 a.m. to 10 a.m. and will involve rotohammering anchors into the underside of the concrete building structure. The noise will transmit throughout both RJH and CROET. It will be most intense on the lower floors, but noticeable on all.

The Vollum and surrounding buildings are no strangers to construction noise and related disruptions. The research courtyard has been the site of several large-scale projects in the past year, including completing the North Campus Utility Plant behind RJH and Vollum. Currently, the courtyard is Ground Zero for the construction of the Center for Radiochemistry Research, which will be located between the Medical Research Building and Mackenzie Hall.

Building occupants are asked to provide feedback to the team conducting this test. How were you impacted? What was the level of disruption, if any? What specific areas were affected? What are your biggest concerns? Feedback and questions should be directed to Lee Weidman at Individual outreach is also planned to collect further data on the potential impacts.

Who’s new at OHSU? Mitchell Sally, M.D.

Mitchell Sally, M.D. is an assistant professor of surgery, Division of Trauma, Critical Care, and Acute Care Surgery at OHSU. He is also assigned to the section of surgical critical care, and is the GME site director, Surgical ICU with the VA Portland Health Care System. His research focus is identifying factors that contribute to organ donation success.

Where were you before coming to OHSU and what brought you here?

I grew up in Chapel Hill, N.C., and attended the University of Pennsylvania for undergraduate studies, majoring in English. I’d always had an interest in medicine; I minored in biology and chemistry at Penn. After graduating, I decided to switch gears by taking more classes and spending a year in a lab doing gene therapy research. I went to medical school at the University of North Carolina and then came to OHSU for my residency, working with Markus Grompe, M.D., for a couple of years during training. After completing residency, I wosallyrked as a general surgeon at Kaiser in Portland but decided that wasn’t what I wanted to do, ultimately. There was little time for research, and I missed the academic environment. I returned to OHSU for a trauma and critical care fellowship. Now my job is just fantastic because I get to do a little bit of everything. I feel very lucky.

What areas of research are you involved in?

I’ve always been drawn to the field of transplant surgery and associated immunology. When I first started training, I was interested in becoming a transplant surgeon. But along the way, I discovered critical care and really enjoyed being able to care for patients in that setting. Fortunately, one of the surgeons at the Portland VA, Darren Malinoski, M.D., had a tremendous background in research on potential organ donors, looking at the critical care of these patients and the immunologic process behind the determination of “death by neurologic criteria,” commonly referred to as “brain death.” I was able to stay connected to the field by getting involved with his research. I first worked with Darren during my fellowship, and was able to expand on some of the work that he had initiated, using a robust database looking at critical care values as they relate to organ outcomes. Darren and his collaborators had developed a system of donor management goals – critical care endpoints to potentially maximize the number and quality of organs from each donor. Early studies showed that if you targeted these basic normal physiologic variables in the donor, outcomes were much better in terms of the number of organs donated, as well as the success of the organs after they’re transplanted.

To illustrate, a study that I completed was to determine the optimal threshold for glucose control in organ donors after neurologic determination of death. Before the study, a standard baseline of 150 mg/dL was considered optimal, but was inconsistent with critical care guidelines. So we looked at what would happen if we raised levels. It turns out we have better outcomes when donors have slightly higher glucose levels, which was consistent with current standards of care in the ICU. These types of projects bring together my interests and experience as both a critical care physician and someone who is interested in organ donation research.

The evolution of the overall project began by looking at how meeting critical care endpoints results in more organs transplanted per donor. A database of roughly 70 to 80 values at different time points in a donor’s course was established, examining many critical care parameters and interventions. We were able to analyze the number of organs procured and the transplantation success. This database is constantly evolving, and to-date, has focused mainly on organ usage. What we’ve done in the last year or so is taken those data and combined them with data from the Scientific Registry of Transplant Recipients (SRTR), which provides information on organ recipient outcomes. This gives us a more complete picture. We can now look at certain donor characteristics, how those impact the number of organs transplanted, and, of those transplanted, how many showed long-term success in recipients. We can then make associations and create different models as to what really does affect organ utilization and organ outcomes. It’s an evolving process that started maybe six or seven years ago, and we’ve made a lot of progress. But there’s still much to do.

So the main project is ongoing and started by piecing together the big picture, and we’re now focusing on individual organs and trying to figure out what will predict successful grafts with each. One of these focused studies I’m working on right now is examining the factors that predict pancreatic graft success, which may be completely different than what makes for a successful cardiac or liver graft, based on management in the donor.

What avenues of research do you plan to explore next?

All of my research has been very clinically based so far, but my interest lies in going to the bench and examining more closely what happens during the process of “death by neurologic criteria.” We know a tremendous inflammatory reaction occurs, but we don’t fully understand what’s happening on a molecular or cellular level. So the first step is to learn more about the process, and then look at whether there’s some way to manipulate it to improve outcomes. For instance, living donor kidneys do much better than deceased donor kidneys when transplanted, so there are clearly processes at work that we have yet to fully appreciate. I’m interested in looking at epigenetic and genomic regulation around the time of “death by neurologic criteria” – what happens during and after, and is that a modifiable process?

I’m also involved in a smaller study examining coagulation in donor patients. Most appear to be hypercoaguable, and there is evidence of graft failure due to thrombosis (clotting), possibly as a result of this hypercoaguable state. My question centers on there being a way to anti-coagulate donors, which we currently don’t do, to improve success.

On a practical level, my goal is to help people waiting for organs, and make the possibility of transplantation more likely to be successful. There is a huge organ shortage in the United States with the number of people needing organs climbing, but the number of organs being donated staying the same. I want to help bridge that ever-widening gap and potentially, help narrow it.

What do you do when you’re not at work?

Spend time with my wife and daughters, four and six years old, doing normal, Northwest parent things. What could be better?

Who’s new at OHSU? Dmitry Dukhovny, M.D., M.P.H.

Dmitry Dukhovny, M.D., M.P.H., is an assistant professor of pediatrics and neonatologist at OHSU. His research focus is on cost-effective analysis and decision science to help optimize health care resources with a special emphasis on neonatal intensive care. He joined OHSU in October 2014.

Where are you from originally?

I was born in Kiev, Ukraine, though it was still the Soviet Union at the time my family emigrated. We moved to Santa Monica when I was 11 years old. I did my undergrad work at UC Berkeley and then went to medical school at Boston University School of Medicine and ended up staying in Boston for 14 years. I completed my residency in pediatrics in the Boston Combined Residency in Pediatrics at Boston Children’s Hospital and Boston Medical Center. Then I was a fellow in the Harvard neonatology program, a joint program between four major teaching hospitals of Harvard Medical School. I also did a pediatric health services research fellowship at Boston’s Children Hospital. I earned my MPH at that time and was an attending at Beth Israel Deaconess Medical Center and Boston Children’s Hospital for four years before coming here.Dukhovny Family Picture copy2

What brought you to OHSU?

A number of things. My wife [Stephanie Dukhovny, M.D.] is also a physician here. She’s originally from the West Coast as well, so we wanted to move closer to family. In addition, there were great opportunities here for both of us both clinically and academically. There’s a great group of neonatologists here to work with. Being in a large academic center gives me the opportunity to see the more acute and challenging cases and provide a high level of care. This is what I had in Boston, and I wanted to work in that same environment, so that was a big draw. From an academic standpoint, I’m particularly interested in health economics and resource utilization and how to improve value in care. The chair of OHSU’s Department of Ob/Gyn, Aaron Caughey, is also a health economist, and there’s also the Center for Health Systems Effectiveness, as well as pediatric health services researchers based here, so I saw many opportunities for mentorship and collaboration.

How do you conduct health economic research?

My mentor, John Zupancic, in Boston, who I still work with closely, conducted economic evaluations alongside randomized trials in neonatology, looking at cost effectiveness of different interventions. Because of my association with him, I was able to be involved in trial-based evaluations both in neonatology and post-partum depression based on his collaborations with national and international investigators. In a sense, we piggyback on clinical studies that are looking at a clinical outcome and try to assess the resource utilization and economic outcome at the same time.

What are some of the projects you’ve been involved with?

One of my first projects that I had a chance to do was the economic evaluation alongside the Caffeine for Apnea of Prematurity Trial study on which I was first author. This was a large international trial, and we did a retrospective evaluation looking at the cost effectiveness of caffeine as a treatment for apnea in premature infants. It turns out caffeine is cost saving because of its efficacy and ability to reduce bronchopulmonary dysplasia, a common lung condition in the NICU.

What are you working on now?

I’m involved in several projects right now. Some are in the finishing stages of analysis, and others are just starting to collect data for economic evaluations. One is looking at how to prevent postpartum depression in high-risk moms. High risk in this study is defined as being low socioeconomic status and on Medicaid, as well has having had a high-risk birth of a pre-term baby between 26 and 34 weeks. We’re looking at the costs that accumulate throughout that process over the first year of the baby’s life as well as at the mother’s quality of life. The study involves a problem-solving intervention where peers help moms effectively deal with the hardships they encounter. A trained counselor has six sessions with the mother on life-building skills and problem solving – three sessions are done while the baby is still in the NICU, and the other three are after the baby goes home. Part of the cost is the intervention itself, so that’s factored in. When doing economic evaluations, the results you get will change based on the perspective you undertake. So, most broadly, you can look at societal costs and benefits, or you can look at direct medical costs of the mother and child, as well as the cost of the intervention. It may be that from a societal perspective, this intervention is cost saving but from strictly a medical cost perspective, results may be different. The perspective is a critical component of economic evaluations as it avoids cost-shifting from the hospital to the patient (or in the case of the neonate, the family).

I’m also working on two other projects that involve genomic sequencing; one in adults and one in babies. With babies, we’re randomizing and carrying out whole genome sequencing compared to routine care for both sick babies and well babies and looking at the cost effectiveness of that intervention. It’s an interesting issue because obviously genome sequencing is extraordinarily expensive, in addition to multiple ethical and psychosocial implications that need to be assessed. We have to consider the psychological effects it may have on the family and questions arise: Do you talk to the family only about findings that will affect the baby in the immediate term? Do you inform them of something that may arise in childhood? Or do you let them know everything the screen shows, even though there may be no implications until well into late adulthood? From an economic perspective, one can hypothesize that learning more information early on can help personalize the care throughout the life span that then reduces healthcare costs.

How are results from this research incorporated into policies or practices?

There’s a big movement in medicine to increase cost awareness. There’s the Choosing Wisely initiative that calls upon medical professional associations to identify commonly used tests and procedures that they consider unnecessary or may cause harm and provide no benefit. These lists are a starting point of discussion between the patient and provider. Our group just published the list for neonatology in the journal Pediatrics. I was part of the team that put that together. So, that’s one way of translating the results into potentially better practices.

I think it’s intuitive that if we improve quality of care for the individual and the population, we are naturally going to reduce cost because you’re eliminating unnecessary care. There’s too much money being spent on unnecessary treatments in this country. Depending on what you read, between $800 billion and $900 billion is considered spent on wasted care. I do hope that my work going forward will be able to help decision makers (clinicians, hospital administrators, and policy makers) determine whether it’s “worth” it to introduce a new technology, drug or health intervention, or at the least assess the value (or “bang for the buck”) of that intervention. Particularly for trial-based work, so many trials come out with a neutral result, meaning there isn’t a benefit to an intervention, but it’s not really worse than another treatment. It’s interesting to then ask the question “Is there a cost difference?” If the clinical benefit is the same, then shouldn’t the cost be driving our decision making?

What do you do for fun?

Well, I have a two year old and a five year old, so that keeps me busy. Also, I’m still very much a New England sports fan, so I’m looking forward to fall (and the 2016 baseball season, it’s too late for this year)!

Reminder: Q & A session on new funding for start-up ventures, Aug. 25

Do you have an idea for an invention or startup company? Do you need help getting started? Then come and learn about a new resource that recently became available to the OHSU community.

VentureWell is a non-profit higher education network, cultivating science and technology innovation and entrepreneurship on university and college campuses,and moving them forward to commercialization. There are two available grant programs aimed at graduate students and faculty.Andrew Watson, PhD

Student grant program: VentureWell’s E-Team student grant program provides veteran coaching, experiential workshops, and early-stage grant funding of up to $75,000. (Deadline: Oct. 7, 2015)

Faculty grant program: The faculty program works to support student inventors by working to fund new, or modify existing, courses and programs in technology entrepreneurship, providing funding of up to $50,000. (Deadline: Nov. 4, 2015)

Andrew Watson, Ph.D., director of technology transfer, will be holding an informational Q&A session about the program to assist student and faculty entrepreneurs in moving new tech ideas out of the lab or classroom and into the marketplace.

Tuesday, Aug. 25, 2015
4 to 5 p.m.
Mackenzie Hall 2201

Questions? Please contact Andrew Watson at

Save the date: MedTech Alliance fall meeting, Nov. 4

The MedTech Alliance is a platform for investor, industry, and community partners to stay up to date on early-stage collaboration and investment opportunities at OHSU. Mark your calendars for the MedTech Alliance fall 2015 meeting.

From left to right: Trina Voss, Dorota Shortell, Andrew Chitty, Akana Ma

From left to right: Trina Voss, Dorota Shortell, Andrew Chitty, Akana Ma

Wednesday, Nov. 4, 2015
5 to 7:30 p.m.
Collaborative Life Sciences Building 3A001
Register now.

This event will be an evening of networking and learning to mark the one-year anniversary of the launch of OHSU’s MedTech Alliance program. The meeting will include highlighted inventor speakers and a networking session.

For questions or inquiries, please contact Trish Pruis at

Who’s new at OHSU? Hagai Tavori, Ph.D.


Hagai Tavori and family

Hagai Tavori, Ph.D., an assistant professor at OHSU’s Knight Cardiovascular Institute, joined the OHSU faculty in January 2014. Tavori’s research focuses primarily on lipoprotein metabolism and atherosclerosis.

Where are you from originally?
I completed my undergraduate and graduate studies in Israel where I was born and raised.  I earned my Ph.D. in clinical biochemistry at the faculty of medicine of Technion (Israel Institute of Technology), which is located in the beautiful coastal city of Haifa in Northern Israel.

What brought you to OHSU?
I came to the U.S. about four years ago for a postdoctoral fellowship at Vanderbilt University in Nashville, Tenn. I worked with Dr. [Sergio] Fazio in his atherosclerosis research unit. After two-and-a-half years at Vanderbilt, I began looking for new career and research growth opportunities. When Dr. Fazio relocated to OHSU as the director of the Center for Preventive Cardiology, I took the opportunity to join his enterprise. In addition, my wife liked the idea of moving to Portland, so that helped in making our decision.

What specific areas of research are you exploring?
In the Center for Preventive Cardiology, I’m involved in clinical, translational, and basic research related to lipoprotein metabolism. My main goal is to better understand the pathophysiology of dyslipidemia – abnormal amount of lipids in the blood – and to explore new therapeutic avenues to reduce cardiovascular risk.

One very interesting clinical research area we are pursuing involves working with patients undergoing lipoprotein apheresis. This is a procedure much like dialysis performed in patients with kidney failure, but rather than removing toxins from the blood, the process removes “bad” cholesterol. It’s a treatment that’s used as a last resort for those patients who don’t respond to other types of treatment and who are extremely high risk for cardiovascular disease. Our study is designed to estimate the ratios between plasma lipids and PCSK9, a protein that regulates plasma cholesterol levels, as an index to determine the optimal treatment interval for each individual patient. The current strategy of twice-a-month treatment for all patients derives from early studies, but personal experience shows us that some patients have a different return to baseline of their cholesterol levels. Our goal is to demonstrate that patients can benefit from a personalized frequency of apheresis, providing better outcomes and cost savings.

I’m also working with Michael Shapiro and Bart Duell on a translational study involving patients who have high Lipoprotein(a). This type of cholesterol carrier has deleterious effects, however; doctors don’t regularly test for it when ordering a lipid panel. High levels of Lp(a) are associated with heredity, and, until recently, there were no therapies to reduce levels other than apheresis. New PCSK9 inhibitor drugs recently approved by the FDA reduce Lp(a) levels, but the mechanism leading to this effect is unknown. So, we’re examining the interaction between PCSK9 and Lp(a) in patients with elevated Lp(a) levels to better understand the relationship between the two.

On the basic research side, I’m interested in understanding the role of HDL, or “good cholesterol,” in health and disease. Though the correlation between HDL levels and cardiovascular health in the general population has been known for decades, fairly recent studies have shown that raising HDL cholesterol does not provide a clinical benefit in terms of cardiovascular disease risk. The reasons for this are unknown, and there are various avenues of study being conducted to find answers. Investigators are looking at the possibility that the protein composition or particle size of HDL, rather than levels, is what’s significant. Others are examining HDL’s function of cholesterol extraction. A theory we’re exploring is that under pathological conditions, HDL is not getting into areas it needs to in order to be protective; it isn’t able to penetrate to the artery wall where plaque is starting to accumulate. Normally, HDL is produced by the liver and the small intestine and secreted to the circulation; however, in order to act in other organs, it needs to penetrate the target tissue. Our approach is to force cells in the artery wall to produce the HDL protein known as apoAI, thereby increasing the efficiency of cholesterol extraction from plaques.

What future directions of study do you want to undertake?
I’m expanding my “good cholesterol” studies into a gene therapy approach that may be applicable to humans by inserting the gene expressing the HDL protein into a plaque and then studying whether this intervention induces plaque regression. I collaborate with Jonathan Lindner and his team to test their micro-bubble approach to delivering genes to specific areas of the body.

Are you looking for collaborators in your research?
We are always open for collaborations, especially in areas of research where proteins involved in lipoprotein metabolism appear in different types of pathological conditions. We want to know more about the connection between the presence of these proteins and underlying metabolic processes. Are there links? Or does the presence of these proteins rule certain things out?

What do you like to do for fun?
Spend time with my family. I have a five year old and a two and a half year old, so we are members of just about every museum in town. We also like the outdoors, and living in Portland makes life easy. I am an amateur bike rider and will try some local racing this year.


Three-session inventor workshop, Sept. 9, 16, 23

Do you have an invention, but don’t know where to start?

Jackson-Jeff_11-copySenior Patent Associate, Jeff Jackson, M.S., J.D., will lead this three-session, interactive workshop that will teach you how to identify, define, and set apart your intellectual property.

Session 1: Wednesday, Sept. 9, 4 to 5 p.m., Center for Health & Healing, 6052
The first session of this workshop will help inventors in writing an initial description of their own invention. Participants will learn how to describe their invention and the problems it solves. The presenter and other participants will be available throughout the session to provide feedback.

Session 2: Wednesday, Sept. 16, 4 to 5 p.m., Center for Health & Healing, 6052
In the second session, the presenter and participants will discuss the list of features and benefits of their invention. The presenter and participants will discuss the list together and will provide feedback.

Session 3: Wednesday, Sept. 23, 4 to 5 p.m., Center for Health & Healing, 6052
In the third session, the participants will identify other attempts to solve the problem in the patent literature, scientific literature, and in the market, and explain how to differentiate their invention from those other attempts. By the end of the workshop series, the goal is for every participant to prepare an invention disclosure for submission to the technology transfer and business development office.

As this workshop is intended to be interactive (and confidential), participants MUST commit to attending all three sessions and preparing work product in preparation for each session. Seating will be limited to four participants, so please reserve your spot as soon as possible. For questions regarding this workshop or to reserve a seat, please contact Karen Boren at

OHSU Startup Spotlight: Nzumbe, Inc.

Nzumbe logoLaunched in 2013, Nzumbe, Inc., is an OHSU startup company providing research services to accelerate the development of breakthrough therapies in challenging diseases, such as cancer. Nzumbe focuses on a root cause of cancer known as gene silencing. When critical genes, known as tumor suppressor genes, are silenced, a cancer cell can arise and grow to form a tumor that may spread throughout the body. Mitch Turker, Ph.D., J.D., whose lab resides in the Oregon Institute of Occupational Health Sciences at OHSU, created a platform to screen for drugs and compounds that can reactivate and stabilize these silenced genes. This discovery served as the platform from which the company was initially founded.

Nzumbe’s goal with this technology is to identify early steps in the gene silencing process, hitting the root cause of disease before and after the disease has occurred. The company was named Nzumbe, zombie in Angolan dialect, because of the company’s mission to give permanent life back to the zombie-type genes that would otherwise remain half-alive  (i.e. reactivated tumor suppressor genes) through the cell-based screening platform.

Michael Rountree, an expert in the field of epigenetics, was then appointed to serve as the company’s scientific director. Rountree’s expertise with both mammalian systems and the fungus, Neurospora crassa, adds distinctive value to Nzumbe’s drug screening capabilities. Neurospora possesses the same epigenetic marks as humans, but with a far more simplistic genome. Nzumbe is exploiting this genetically tractable fungal system to design more rapid, less expensive epigenetic drug screening platforms.

Nzumbe, Inc., has received several sources of funding, including support from the Oregon Translational Research and Development Institute (OTRADI) and an OHSU/Portland Development Commission commercialization grant. In 2014, Nzumbe was awarded its first Small Business Technology Transfer (STTR) grant. The team hopes that monies from its STTR grant will be a real driver for company success to help demonstrate commercialization progress and move on to the next stage of development.

Nzumbe, Inc., is now working to identify business partners or opportunities for larger investment. Obtaining buy-in and identifying potential partners to screen epigenetic compound libraries will be crucial in ultimately selling its screening product and research services. The company hopes that working with new partners will help validate its platform and expand the application of its technology to other fields, such as toxicology, childhood developmental diseases, neurological and geriatric disorders. In the future, the company aspires to have a larger economic impact that includes providing jobs and opportunities in the local Northwest biotech community.



Community Conversation series resumes Aug. 25

Join the Northwest Association for Biomedical Research for the next installment in the 2015 Community Conversations series:

You are what you eat: antibiotic resistance from chickens to your table.”

The event will explore the connection between chickens and human health with a discussion on how the use of antibiotics in large scale chicken farming impacts the economy and our health. The discussion will be co-facilitated by Kathy Hessler, J.D., LL.M, Lewis & Clark Law School and Emma Newton, M.S., Canisius College.

Tuesday, Aug. 25, 2015
5:45 to 7:45 p.m.
The Lucky Labrador Pub (all ages)
1700 N. Killingsworth St. in Portland

$5 general admission includes discussion and first glass of wine/beer (over age 21). Register now.

Community Conversations are informal discussions that explore a topic in biomedical science and its relationship with ethics, medicine, research and society, and connecting people to the biomedical research community. Contact Jen Wroblewski for more information.

Welcome to the Research News Blog

Welcome to the Research News Blog

OHSU Research News is your portal to information about all things research at Oregon Health & Science University. Visit often for updates on events, discoveries, and important funding information.

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