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Dr. Mary Newport November 2009 www.coconutketones.com COCONUT OIL & ALZHEIMER’S DISEASE Ketones as Fuel for Neurons.

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Presentation on theme: "Dr. Mary Newport November 2009 www.coconutketones.com COCONUT OIL & ALZHEIMER’S DISEASE Ketones as Fuel for Neurons."— Presentation transcript:

1 Dr. Mary Newport November 2009 www.coconutketones.com COCONUT OIL & ALZHEIMER’S DISEASE Ketones as Fuel for Neurons

2 Steve Newport 2009

3 Steve Newport  BSBA in Accounting from Xavier University, Cincinnati, Ohio  Worked for 9 years as accountant/office manager for mental health centers until 1980  1980’s to 2003 - Worked from home for medical practice – accounting, management, billing, while caring for our children  Computer wiz  Loves landscaping, cooking, reading novels, kayaking  Can fix anything, invents tools

4 Onset Of Alzheimer’s Disease Early clues (retrospective):  Grade School: Couldn’t remember rules of football Couldn’t remember rules of football “Fired” as altar boy – couldn’t remember flow of the service “Fired” as altar boy – couldn’t remember flow of the service  Early adult: Couldn’t catch on to card games Couldn’t catch on to card games Did not feel he was functioning as well in accounting/ office manager position by late 20’s Did not feel he was functioning as well in accounting/ office manager position by late 20’s  30’s and 40’s Hoarding – amasses garage full of “stuff” Hoarding – amasses garage full of “stuff”

5  Age 50-51: Frequently forgets appointments even with 30 minute reminders Frequently forgets appointments even with 30 minute reminders Often loses wallet and keys Often loses wallet and keys  Age 51-52: Payroll errors Payroll errors Procrastinates with tax reports Procrastinates with tax reports Misses deadlines Misses deadlines Can’t remember going to bank and post office Can’t remember going to bank and post office Misplaces important mail Misplaces important mail Psychiatrist believes it is depression rather than dementia - starts anti-depressants and counseling Psychiatrist believes it is depression rather than dementia - starts anti-depressants and counseling Onset Of Alzheimer’s Disease

6  Age 56: Can no longer follow map – gets lost in New Port Richey Can no longer follow map – gets lost in New Port Richey Misses turn and ends up in Jacksonville Misses turn and ends up in Jacksonville Can’t remember how to turn on windshield wiper Can’t remember how to turn on windshield wiper Confusion at tollbooth Confusion at tollbooth Gives up driving Gives up driving Stops reading – can’t explain why Stops reading – can’t explain why Often walks around house and yard with one shoe Often walks around house and yard with one shoe No matching pairs of shoes in the house!No matching pairs of shoes in the house! Mild to Moderate Alzheimer’s Disease

7  Age 57: Doesn’t recognize some relatives at family reunion – lost and confused Doesn’t recognize some relatives at family reunion – lost and confused Loses 10 pounds in 3 weeks – no longer preparing meals for himself Loses 10 pounds in 3 weeks – no longer preparing meals for himself Develops intention tremor and problem with keeping food on fork Develops intention tremor and problem with keeping food on fork Develops jaw tremor when talking Develops jaw tremor when talking Gait becomes slow, can no longer run Gait becomes slow, can no longer run Forgets that he “sired” older daughter Forgets that he “sired” older daughter Personality and sense of humor fading Personality and sense of humor fading Takes lawn tractor and vacuum cleaner apart Takes lawn tractor and vacuum cleaner apart difficulty spelling simple written words, such as “out” and “put,” and trouble recalling many common words when speaking difficulty spelling simple written words, such as “out” and “put,” and trouble recalling many common words when speaking Moderate Alzheimer’s Disease

8 Clinical Trials  Age 58 (May 2008): Participates in ADRC annual evaluation and screens for vaccine trial at Johnnie Byrd Participates in ADRC annual evaluation and screens for vaccine trial at Johnnie Byrd MRI: “Diffuse involutional change of frontal and parietal lobes and moderate left-sided and severe right-sided amygdala and hippocampal atrophy with no ischemic change, which would support a clinical diagnosis of Alzheimer’s disease.”MRI: “Diffuse involutional change of frontal and parietal lobes and moderate left-sided and severe right-sided amygdala and hippocampal atrophy with no ischemic change, which would support a clinical diagnosis of Alzheimer’s disease.” Scores only 12 of 30 on MMSEScores only 12 of 30 on MMSE Doesn’t qualify for study – told to try again in a couple of weeks Doesn’t qualify for study – told to try again in a couple of weeks

9  Scheduled for screenings for 2 different clinical trials May 20 and 21, 2008  Late night internet research “risks and benefits”  Learn about Accera product, Ketasyn, now called Axona – read patent application Active ingredient is medium chain triglyceride oil – derived from coconut oil Active ingredient is medium chain triglyceride oil – derived from coconut oil 47% in pilot study had significant improvement in memory (ADAS-COG,) the rest declined minimally 47% in pilot study had significant improvement in memory (ADAS-COG,) the rest declined minimally Clinical Trials

10 Glucose as Energy  Glucose is the usual source of energy for neurons (brain cells).

11 Glucose as Energy  In certain diseases, neurons and/or other brain and nerve cells have a problem with transporting glucose into the cell and essentially starve and die.

12 “Diabetes of the Brain”

13 PET SCANS FOR GLUCOSE UPTAKE NORMAL BRAINALZHEIMER’S BRAIN

14 ALZHEIMER’S VS. NORMAL BRAIN

15 Medium chain triglycerides converted in liver to Ketones

16 Ketone Bodies

17 Ketones: Metabolism’s Ugly Duckling Theodore B. VanItallie, M.D., and Thomas H. Nufert, B.A. Nutrition Reviews, Vol. 61, No. 10

18 KETONES AS FUEL Ketones can be taken up by neurons that cannot use glucose

19 KETONES CONVERT TO ENERGY IN NEURON + =

20 Neuron Can Function And Stay Alive

21 Diagram from: Parkinson disease: primacy of age as a risk factor for mitochondrial dysfunction Theodore B. VanItallie, Metabolism Clinical and Experimental 57 (Suppl 2) (2008) S50–S55

22 Normal neurons can use glucose or ketones but usually use glucose if available

23 For neurons that cannot use glucose, Ketones can serve as an “alternate fuel.”

24 DAY BEFORE COCONUT OIL INTERVENTION  Steve screens for clinical trial in St. Pete Scores only 14 of 30 on MMSE, needs 16 to qualify Scores only 14 of 30 on MMSE, needs 16 to qualify Doctor asks him to draw a clock – consistent with moderately severe Alzheimer’s Doctor asks him to draw a clock – consistent with moderately severe Alzheimer’s We pick up coconut oil on the way home We pick up coconut oil on the way home More internet research, learn about medium chain triglycerides, ketones More internet research, learn about medium chain triglycerides, ketones

25 HOW MUCH? Coconut Oil is 60% MCT oil 4 teaspoons MCT Oil or 7 teaspoons Coconut oil provide same amount of medium chain triglycerides 4 teaspoons MCT Oil or 7 teaspoons Coconut oil provide same amount of medium chain triglycerides

26 1 st DAY OF COCONUT OIL INTERVENTION  Receives at least 35 grams coconut oil with breakfast  Screens at Johnnie Byrd Center for vaccine clinical trial Scores 18 of 30 on MMSE Scores 18 of 30 on MMSE Qualifies for study Qualifies for study

27 First Days after Coconut Oil Intervention  Begins daily consumption of coconut oil Measured dose at breakfast, cooking and other coconut containing foods for dinner Measured dose at breakfast, cooking and other coconut containing foods for dinner  More alert - Personality and sense of humor resurface  Steve says the “light switch came back on” and the “fog lifted”  Facial tremor disappears  Intention tremor infrequent

28 14 Days After Starting Coconut Oil

29 37 Days After Starting Coconut Oil

30 Steve’s Clocks DAY BEFORE COCONUT OIL 14 DAYS ON COCONUT OIL 37 DAYS ON COCONUT OIL

31 More Research  Ketones, medium chain triglycerides, fatty acids, coconut oil  Dr. Richard Veech/NIH – Ketone expert Ketone ester (beta-hydroxybutyrate) Ketone ester (beta-hydroxybutyrate) Suggested ketone levels Suggested ketone levels

32 Ketone Ester Dr. Richard Veech – NIH-Rockville, MD  Became interested in studying ketones in early 1990’s  Developed an ester of ketone body beta- hydroxybutyrate – oral or IV  Can achieve levels comparable to starvation – 10 x coconut oil or MCT oil levels  No adverse effects in recent human toxicity testing  Needs funding to mass produce for testing in AD and other diseases

33 35 grams (7 teaspoons) coconut oil with breakfast and with dinner 35 grams (7 teaspoons) coconut oil with breakfast and with dinner

34 20 grams (4 teaspoons) medium chain triglyceride oil (C:8)

35 Expanded Coconut Oil Intake  As a result of levels with coconut oil also used measured amounts at lunch and dinner  Mixing coconut oil and MCT oil  Substituting foods with MCTs for others: Goat’s milk and cheese for cow’s milk and cheese Goat’s milk and cheese for cow’s milk and cheese Coconut milk for other liquids in cooking Coconut milk for other liquids in cooking

36 Between 2 - 4 months after Intervention  Visual disturbance resolves  Normalization of gait – able to run again  Completes household and gardening tasks with minimal to no supervision and without distraction  Wears both shoes and keeps pairs together  His ability to initiate and continue a course of conversation improves  Recognizes family members that he couldn’t recall one year earlier  Family says he no longer looks lost, conversation makes sense

37 Between 4 -10 Months After Intervention  Conversational skills continue to improve  Reading comprehension improves  Short term and recent memory improves  Stops having episodes of near syncope  No longer depressed – Says, “I have my life back.”  Wants to do more with his life - volunteers in hospital warehouse  Vacuums, cuts grass and weeds gardens again (instead of taking equipment apart!)

38 Getting the Message Out  Family confirms Steve has improved  Article: “What If There Was a Cure for Alzheimer’s Disease and No One Knew?” July 2008 Sent letters to high profile persons to investigate MCT oil studies and make public aware Sent letters to high profile persons to investigate MCT oil studies and make public aware Chicago ICAD conference Chicago ICAD conference Grass roots method/internet Grass roots method/internet St Petersburg Times article October 2008 St Petersburg Times article October 2008 Website: www.coconutketones.com Website: www.coconutketones.com Legislators March 2009 Legislators March 2009

39 Diseases With Decreased Glucose Uptake into Brain/Nerve Cells Alzheimer’s disease Alzheimer’s disease Parkinson’s disease Parkinson’s disease Multiple sclerosis Multiple sclerosis Huntington’s chorea Huntington’s chorea ALS/Lou Gehrig’s disease ALS/Lou Gehrig’s disease Duchenne muscular dystrophy Duchenne muscular dystrophy Some forms of autism Down’s syndrome – develop Alzheimer’s disease by ages 30-40 Acute brain injury, accompanied by lack of oxygen Type I and Type II diabetes

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41 Other Reported Improvements  Parkinson’s disease  Multiple sclerosis  Improved blood sugars in type II diabetes  Down’s syndrome  Bipolar disorder  Glaucoma  Macular degeneration  Cognition in elderly dog

42 Foods with Short and Medium Chain Fatty Acids  Fats/Oils: Coconut oil 59% Coconut oil 59% Palm Kernel Oil 54% Palm Kernel Oil 54% Babassu Oil55% (Amazon palm) Babassu Oil55% (Amazon palm) Ucuhuba butter13% (Amazon tree seed) Ucuhuba butter13% (Amazon tree seed) Butter 11.5% Butter 11.5% Nutmeg Butter 3.1% Nutmeg Butter 3.1% Sheanut Oil 1.7% Sheanut Oil 1.7%

43 Foods with Short and Medium Chain Fatty Acids  Per 8 ounces: Goat Milk 1.7 grams Goat Milk 1.7 grams Whole Cow Milk 0.9 grams Whole Cow Milk 0.9 grams Human breast milk 0.78 grams Human breast milk 0.78 grams Infant formula 1.0 grams Infant formula 1.0 grams Cottage Cheese0.64 grams Cottage Cheese0.64 grams

44 Foods with Short and Medium Chain Fatty Acids  Per ounce: Goat cheese2.0 grams Goat cheese2.0 grams Feta cheese1.4 grams Feta cheese1.4 grams Cream cheese0.96 grams Cream cheese0.96 grams American cheese 0.85 grams American cheese 0.85 grams Mozarella0.78 grams Mozarella0.78 grams

45 Newborns and Ketones  Newborn develops “ketosis” at onset of breastfeeding  Ketones provide 25% of energy requirements during first weeks of life  Even with equivalent amount MCTs in formula, same degree of “ketosis” doesn’t occur – missing factor?

46 Newborn MCFAs Equivalent in Adult  10 pound breastfeeding baby gets about 3.12 grams MCFAs per quart breast milk =  47 grams MCFAs for 150 pound adult =  5.5 tablespoons of coconut oil

47 Coconut Oil Equivalents  Coconut oil - 1 tablespoon = Coconut Milk (undiluted) – 4 ½ tablespoons Coconut Milk (undiluted) – 4 ½ tablespoons Coconut meat – 2” x 2” x ½” piece Coconut meat – 2” x 2” x ½” piece Coconut grated – 1/3 cup Coconut grated – 1/3 cup Coconut oil capsules (1 gm) – 14 capsules Coconut oil capsules (1 gm) – 14 capsules

48 Use only NON-HYDROGENATED Coconut Oil

49 START SLOW  Common effect – Diarrhea Begin with 1 teaspoon and increase slowly Begin with 1 teaspoon and increase slowly Start on a day when you don’t have to go somewhere immediately! Start on a day when you don’t have to go somewhere immediately! Take with other food Take with other food Can take it slowly during meal over 20-30 minutes Can take it slowly during meal over 20-30 minutes Some foods may help retain oil – cottage cheese Some foods may help retain oil – cottage cheese Try grated coconut or coconut milk as alternative for part of “dose” Try grated coconut or coconut milk as alternative for part of “dose”

50 Food Ideas  Use coconut oil instead of butter on toast, English muffins, bagels, grits, corn on the cob, potatoes or sweet potatoes.  Add coconut oil or coconut milk to your favorite smoothie recipe.  Mix coconut oil into: Oatmeal or other hot cereal. Oatmeal or other hot cereal. R ice, vegetables, noodles, pasta. R ice, vegetables, noodles, pasta. Half and half with salad dressings. Half and half with salad dressings. Soup, chili or spaghetti sauce. Soup, chili or spaghetti sauce.

51 Food Ideas  Use a measured amount of coconut oil to stir fry or sauté any of your favorite dishes.  Purchase or make coconut macaroons made from all natural products.  Make Coconut oil “fudge”  Eat a 2” x 2” square of raw coconut for a snack to provide 15 grams of oil.  Add flaked or grated coconut to hot or cold cereal, yogurt, fruit or vegetable salads

52 Mixing MCT and Coconut Oil  Reason: to achieve higher and continuous levels of ketones  One combination: MCT Oil 16 ounces + Coconut oil 12 ounces MCT Oil 16 ounces + Coconut oil 12 ounces Can emulsify with soy lethicin (about ½ teaspoon) Can emulsify with soy lethicin (about ½ teaspoon) Start low and increase as tolerated Start low and increase as tolerated Take with each meal Take with each meal

53 Mixing MCT and Coconut Oil  Advantages: Stays liquid when mixed Stays liquid when mixed Mixes more easily into many foods Mixes more easily into many foods Takes advantage of properties of each oil Takes advantage of properties of each oil More portable for eating away from home More portable for eating away from home

54 Do Eat Foods with Omega-3 Fatty Acids

55 Eat Whole Foods

56 Don’t Eat Foods with Transfats and Hydrogenated or Partially Hydrogenated Oils

57 Why not use just MCT oil?  Many other fatty acids of all chain lengths in coconut oil that may serve special purpose: Supports thyroid Supports thyroid Anti-microbial properties – kills certain viruses and bacteria that some research implicates in Alzheimer’s and Parkinson’s Anti-microbial properties – kills certain viruses and bacteria that some research implicates in Alzheimer’s and Parkinson’s Herpes virusesHerpes viruses Helicobacter pyloriHelicobacter pylori May be other factors in the “whole” oil that benefit Alzheimer’s and other diseases May be other factors in the “whole” oil that benefit Alzheimer’s and other diseases

58 Why not use just Coconut Oil?  Ketone levels higher with MCT oil  Recent evidence that medium chains cross blood brain barrier and appear to also be used by neurons as fuel

59 Cholesterol Issue  Proponents of each side of issue can find studies to support their beliefs  Large scale study with men and women of all ages needs be done to lay the issue to rest  Consider risks vs. benefits in making decision to try this intervention in Alzheimer’s and other diseases

60 Expectations  Most people will not have immediate or dramatic response and some “stabilize” Keep a journal Keep a journal  Must be consistent and persistent  Cannot miss a day If no fuel in the tank the car won’t run If no fuel in the tank the car won’t run  Strongly suggest at least three month trial Monitor closely if stopping this intervention Monitor closely if stopping this intervention Some don’t realize how much it was helping until they stop it Some don’t realize how much it was helping until they stop it

61 Is there a relationship between lack of MCFAs AND AUTISM?  A Mother’s Observation: Child developed neurologic symptoms of autism after discontinuing infant formula at 18 months Lack of MCFAs the culprit? Lack of MCFAs the culprit? Do MCFAs delay onset of neuro symptoms? Do MCFAs delay onset of neuro symptoms? Onset of autism often during second year Onset of autism often during second year  Parental Survey: Most autistic children not breastfed Most autistic children not breastfed

62  Website for information only Copies of article, “What If…? Copies of article, “What If…? Diet guidelines and FAQs Diet guidelines and FAQs Complete articles - scientific references related to ketones that can be printed out Complete articles - scientific references related to ketones that can be printed out Interviews Interviews Can email me with questions Can email me with questions Updates Updates Blog Blog www.coconutketones.com

63 Drs. George Cahill, Mary Newport & Richard Veech in Capitol Building – March 2009

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66 KETOGENIC DIET  History Fasting used as treatment for seizures and epilepsy in biblical times and middle ages Fasting used as treatment for seizures and epilepsy in biblical times and middle ages Early 1900’s - NY Pediatrician Rawle Geyelin successfully fasted children to control seizures (15 day fast) – 18% were helped Early 1900’s - NY Pediatrician Rawle Geyelin successfully fasted children to control seizures (15 day fast) – 18% were helped 1921 – Wilder proposed that benefits of fasting (increase in ketone bodies) could be produced by diet rich in fats and low in carbohydrates - - “ketogenic diet” 1921 – Wilder proposed that benefits of fasting (increase in ketone bodies) could be produced by diet rich in fats and low in carbohydrates - - “ketogenic diet”

67 KETOGENIC DIET  History (continued): 1924 – Peterman reports effectiveness of diet from Mayo Clinic – 51% seizure free after 2 ½ years on diet 1924 – Peterman reports effectiveness of diet from Mayo Clinic – 51% seizure free after 2 ½ years on diet 1 gram protein per kg body weight1 gram protein per kg body weight 10-15 grams/day carbohydrate10-15 grams/day carbohydrate Remainder of calories as fatRemainder of calories as fat Total calories Basal Metabolic Rate + 50%Total calories Basal Metabolic Rate + 50% Identical to ketogenic diet used today – some variations exist – including MCT oil version – half of calories are MCT oil Identical to ketogenic diet used today – some variations exist – including MCT oil version – half of calories are MCT oil

68 KETOGENIC DIET  Reported positive effects of ketogenic diet: Epilepsy Epilepsy Alzheimer’s disease Alzheimer’s disease Parkinson’s disease Parkinson’s disease Lou Gehrig’s disease (ALS) Lou Gehrig’s disease (ALS) Traumatic brain injury and stroke Traumatic brain injury and stroke Oxygen toxicity Oxygen toxicity Glioblastoma and other cancerous tumors Glioblastoma and other cancerous tumors Weight loss Weight loss

69 Brain Metabolism during Fasting 0. E. OWEN, A. P. MORGAN, H. G. KEMP, J. M. SULLIVAN, M. G. HERRERA, AND G. F. CAHILL, JR. The Journal of Clinical Investigation Vol. 46, No. 10, 1967 First report of ability of brain to use ketones as fuel

70 Diagram from: Ketone Bodies as a Fuel for the Brain during Starvation - Oliver E. Owen‡ BIOCHEMISTRY AND MOLECULAR BIOLOGY EDUCATION Vol. 33, No. 4, pp. 246–251, 2005 Overnight in normal people: glucose 100% of fuel Starvation: Ketones about 2/3 of fuel

71 Diagram from: Ketone Bodies as a Fuel for the Brain during Starvation Oliver E. Owen‡ BIOCHEMISTRY AND MOLECULAR BIOLOGY EDUCATION Printed in U.S.A. Vol. 33, No. 4, pp. 246–251, 2005 FIG. 3. Concentrations of ketone bodies and free fatty acids during starvation in humans. Values are shown as the means S.E. Ketone bodies undergo the greatest changes of all fuels during total starvation.

72  Presence of ketone in circulation, even at low levels increases cerebral blood flow by as much as 40%  Ketones used within mitochondria to drive the chain reaction that produces ATP  Reduces generation of free radicals and at same time increases the scavengers of free radicals linked to the NADP system, such as glutathione.  Activates anti-inflammatory mechanisms Ketone Effects

73 Presence of ketone in circulation, even at low levels increases cerebral blood flow by as much as 40% Presence of ketone in circulation, even at low levels increases cerebral blood flow by as much as 40% Rectify cerebral energy metabolism (provide alternative fuel) Rectify cerebral energy metabolism (provide alternative fuel) Protect cerebral function Protect cerebral function Suppress cerebral edema and reduce extent of cerebral infarction in brain injury Suppress cerebral edema and reduce extent of cerebral infarction in brain injury Treat diseases involving free radical damage such as occurs in coronary reperfusion, diabetic angiopathy, inflammatory bowel disease, pancreatitis Treat diseases involving free radical damage such as occurs in coronary reperfusion, diabetic angiopathy, inflammatory bowel disease, pancreatitis Ketone Effects

74  “Utilizing the nerve growth/ stimulatory effects of the ketone bodies…cells that are still viable can be caused to improve beyond the state to which they have degenerated and accordingly some improvement of function will be seen in patients.” Veech has shown in mice receiving 30% ketone ester diet, significant increase in brain peptides BDNF and NGF, compared to high CHO or high fat diet. Veech has shown in mice receiving 30% ketone ester diet, significant increase in brain peptides BDNF and NGF, compared to high CHO or high fat diet. Ketone Effects

75 Would allow diabetics to maintain better control of blood sugars without fear of hypoglycemic consequences and thereby prevent the vascular changes in eye and kidney Would allow diabetics to maintain better control of blood sugars without fear of hypoglycemic consequences and thereby prevent the vascular changes in eye and kidney May treat refractory epilepsy and other seizure related disorders currently treatable with ketogenic diet May treat refractory epilepsy and other seizure related disorders currently treatable with ketogenic diet Potential Effects of Ketones

76 D,L-3-hydroxybutyrate treatment of multiple acyl-CoA dehydrogenase deficiency (MADD,) Johan L K Van Hove, et.al., Lancet 2003; 361: 1433–35 After a 150 mg/kg dose of D,L-3- hydroxybutyrate, plasma physiological ketone body concentrations peaked between 0·19 mmol/L and 0·36 mmol/L after 30 min to 1 h, and remained above pre- treatment concentrations for 4 h. Brain MRI scans were obtained before (A and D), after 2 months (B and E), and after 9 months of treatment (C and F). There is diffuse involvement of the supratentorial white matter both centrally and peripherally and in the corpus callosum (A, D). On the posttreatment scans there is a progressive change in the central white matter with a decrease in signal intensity. Cavitation can occasionally be seen (F)

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78 CELL BASICS – SIMPLE DIAGRAM

79 CELL

80 CELL MEMBRANE  Electron micrograph of cell membrane

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82 CELL MEMBRANE

83 FATTY ACIDS

84 Hydrogenation produces abnormally shaped molecules called transfats

85 FUEL ANALOGY Different vehicles use different fuels

86 NEURONS

87 NEUROTRANSMITTERS

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