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Trial registered on ANZCTR
Registration number
ACTRN12618000329268
Ethics application status
Approved
Date submitted
21/02/2018
Date registered
6/03/2018
Date last updated
8/02/2019
Date data sharing statement initially provided
8/02/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
Metabolic effects of kiwifruit in people with prediabetes
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Scientific title
Effects of longterm kiwifruit consumption on metabolic outcomes in people with prediabetes
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Secondary ID [1]
294112
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Nil known
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Universal Trial Number (UTN)
U111112068414
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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:
Diabetes
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prediabetes
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Condition category
Condition code
Metabolic and Endocrine
305805
305805
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0
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Diabetes
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Intervention:
Participants will be assigned randomly to two groups of 20 subjects each. Both the groups will be asked to continue with their customary diet for fifteen weeks (3 weeks lead in, 12 weeks trial period), but not to consume vitamin supplements. During the lead in period of 3 weeks, all the participants will be asked not to consume any kiwifruit to ensure that the 12 weeks kiwifruit intervention period is a discrete kiwifruit consumption period. The control group will then continue to not consume any kiwifruit for twelve weeks but will be asked to drink 250 mL of provided water 30minutes before their breakfast every day.
The kiwifruit intervention group will be asked to consume two kiwifruit per day for 12 weeks, PREFERABLY 30 MINUTES BEFORE BREAKFAST.
All participants will be asked to attend the Plant & Food Research clinic in the mornings twice, (1) at the beginning of the trial, (2) at the end of the twelve weeks.. The participants will be asked to fast overnight (10-12 hours) and allow 30 mL of venous blood to be withdrawn from their arm by a trained phlebotomist. Finger prick blood will also be taken for fasting blood glucose measurement. Anthropometric measurement including height, weight, blood pressure (automatic sphygmomanometer), waist and hip circumference will be taken during each visit and questions regarding their general wellbeing will be asked. The participants will therefore be expected to attend the clinic two times during the trial and once for screening before the start of the trial.
Participants will also be asked to fill out a seven day food diary two times, covering the seven days leading up to each visit to the clinic.
Blood sampling and analytes:
On the two visits to the clinic during the intervention period, the participants will be asked to provide fasting venous blood samples which will be taken by a trained phlebotomist. Subjects will be seated and once relaxed and comfortable venous blood will be withdrawn from the anterior cubital fossa into Vacutainer™ tubes. Total blood volume collected at each clinic visit will be 30m.
The blood samples will be used to measure the following:
1. HbA1c, insulin, uric acid, creatinine
2. Serum lipids
3. Biomarkers of oxidative stress and inflammation
4. Plasma vitamin C
Capillary finger prick blood sample will be taken for fasting blood glucose measurement.
SunGold kiwifruit will be supplied by the study team.
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Intervention code [1]
300393
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Lifestyle
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Intervention code [2]
300446
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Prevention
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Comparator / control treatment
12 weeks of consuming customary diet with no kiwifruit but drinking 250 mL sparkling water 30 minutes before breakfast.
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Control group
Active
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Outcomes
Primary outcome [1]
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Change in HbA1c level
Change in HbA1c level in the blood sample. HbA1c between 41-49 mmol/mol is considered as prediabetic range. Therefore, change in HbA1c value would be monitered
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Assessment method [1]
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Timepoint [1]
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Blood samples will be taken at the start of the trial and at the end of twelve weeks
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Secondary outcome [1]
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Plasma lipid profile: HDL cholesterol, LDL cholesterol and total lipids.
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Assessment method [1]
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Timepoint [1]
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Blood samples will be taken at the start of the trial and at the end of twelve weeks.
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Secondary outcome [2]
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Insulin
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Assessment method [2]
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Timepoint [2]
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Blood samples will be taken at the start of the trial and at the end of twelve weeks.
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Secondary outcome [3]
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Uric acid
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Assessment method [3]
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Timepoint [3]
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Blood samples will be taken at the start of the trial and at the end of twelve weeks.
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Secondary outcome [4]
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creatinine
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Assessment method [4]
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Timepoint [4]
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Blood samples will be taken at the start of the trial and at the end of twelve weeks.
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Secondary outcome [5]
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biomarkers of inflammation eg, c-reactive proteins
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Assessment method [5]
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Timepoint [5]
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Blood samples will be taken at the start of the trial and at the end of twelve weeks.
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Eligibility
Key inclusion criteria
All participants have pre-diabetes and may or may not be taking medication
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Minimum age
18
Years
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Maximum age
70
Years
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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
Intolerance of kiwifruit.
Allergic to kiwifruit
Planned change in diet or medication within the trial period
Any illness or gastrointestinal disorder within the 3 weeks prior to the trial.
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Study design
Purpose of the study
Prevention
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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)
Subjects coded by independent person so that identity of subjects unknown to allocator at the time of allocation
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation using a computer generated randomisation table.
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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
Parallel
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Other design features
Intervention-free lead-in
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Although this is a pilot study, we will power on a relatively large change in HbA1c of 0.5%. With 80% power and alpha set to 0.05, a sample size of 20 per group is required to detect a difference between groups in HbA1c of 0.5%, given a SD estimate of 0.7% (Incani, M., et al. (2015). "Glycated hemoglobin for the diagnosis of diabetes and prediabetes: Diagnostic impact on obese and lean subjects, and phenotypic characterization." Journal of Diabetes Investigation 6(1): 44-50) and a within-person correlation of 0.6 (from our own data). If we use a within-person correlation of 0.7 we get n=16 per group, which allows for some drop-outs if we have 20 in each group.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
8/03/2018
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Actual
8/03/2018
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Date of last participant enrolment
Anticipated
29/06/2018
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Actual
29/06/2018
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Date of last data collection
Anticipated
14/12/2018
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Actual
14/12/2018
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Sample size
Target
40
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Accrual to date
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Final
34
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Recruitment outside Australia
Country [1]
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New Zealand
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State/province [1]
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Manawatu
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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High Value Nutrition Science Challenge, New Zealand Government
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Address [1]
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University of Auckland
Private Bag 92019
Auckland 1142
New Zealand.
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Country [1]
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New Zealand
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Primary sponsor type
Government body
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Name
New Zealand Institute for Plant and Food Research Limited
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Address
New Zealand Institute for Plant and Food Research Limited,
Private Bag 11600,
Palmerston North,
New Zealand
4442
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Country
New Zealand
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
297924
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Country [1]
297924
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
299686
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Health and Disability Ethics Committees
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Ethics committee address [1]
299686
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Ministry of Health 133 Molesworth Street PO Box 5013 Wellington 6011
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Ethics committee country [1]
299686
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New Zealand
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Date submitted for ethics approval [1]
299686
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05/01/2018
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Approval date [1]
299686
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16/02/2018
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Ethics approval number [1]
299686
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18/CEN/2
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Summary
Brief summary
Fruit, including kiwifruit, are a valuable component of the human diet because of the wide range of vitamins, minerals and other bioactives that they supply. They are also generally rich in sugars, in particular fruit sugar (fructose) and glucose. Now that glucose intolerance and diabetes are becoming global megatrends there is a growing challenge of how to include fruit in the diets of glucose-intolerant consumers, especially in Asian markets for kiwifruit, in which the incidence of diabetes is expected to reach >400 million by 2030. Glucose may increase exposure to glycaemia and risk of long-term medical complications typical of diabetes. On the other hand, fructose, although less glycaemic, may raise blood triglycerides. Therefore, a concern is that reduced exposure to glycaemia as a result of ingesting fruit in place of more glycaemic foods may be counteracted by unfavourable changes in blood lipids. The challenge is, therefore, multifaceted: • How to increase fruit intake without adversely increasing exposure to glucose-induced postprandial glycaemia (HbA1c). • How to do so without unfavourably altering plasma lipids due to an increase in fructose intake, • How to use whole kiwifruit to gain the protective benefits of fruit bioactives against processes leading to diabetic complications. The associated research questions are: 1. Can kiwifruit be included in the diet without exacerbating exposure to postprandial glycaemia? 2. Can the fructose-rich sugars in kiwifruit be regularly consumed without plasma lipid changes associated with increased disease risk? 3. Can it be shown that regular consumption of kiwifruit in fact counteracts the systemic biochemical processes through which glycaemia leads to medical complications typical of long-term diabetes, which are believed to be mediated by glycation, inflammation and oxidative stress, and counteracted by fruit bioactives such as phenolics and vitamin C?
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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
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Dr John Monro
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Address
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The New Zealand Institute for Plant and Food Research,
Private Bag 11600,
Palmerston North
4442
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Country
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New Zealand
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Phone
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+6463556137
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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John Monro
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Address
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The New Zealand Institute for Plant and Food Research,
Private Bag 11600,
Palmerston North
4442
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Country
81295
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New Zealand
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Phone
81295
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+6463556137
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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John Monro
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Address
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The New Zealand Institute for Plant and Food Research,
Private Bag 11600,
Palmerston North
4442
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Country
81296
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New Zealand
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Phone
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+6463556137
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Fax
81296
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Email
81296
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
Only average values from all participants will be used in the publication
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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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