Friday, November 24, 2017

AG FERGUSON, JOINED BY THE STATE PATROL AND PROSECUTORS, RELEASES OPIOID REPORT RECOMMENDING STRATEGIES TO COMBAT OPIOID EPIDEMIC

Press release issued 11/ 21/ 17
http://www.atg.wa.gov/news/news-releases/ag-ferguson-joined-state-patrol-and-prosecutors-releases-opioid-report

OLYMPIA — Attorney General Ferguson today released a report recommending specific policies to reduce the supply of opioids in Washington state. The report recommends a comprehensive approach to the problem, addressing prevention, treatment and enforcement. Ferguson is also unveiling three opioid-related bills he will take to the Legislature in January.

The Attorney General’s Office, Washington State Patrol and the Washington Association of Prosecuting Attorneys developed the report based on information shared at the Summit on Reducing the Supply of Opioids in Washington State in June 2017.

“The opioid epidemic is devastating Washington families,” Ferguson said. “This report makes it clear we have a crisis, and provides concrete, evidence-based solutions. I am proposing some of these common-sense changes as legislation in the upcoming session, including limiting new opioid prescriptions and using the existing Prescription Monitoring Program to empower providers with a more complete picture of their patients’ history before writing new prescriptions. It is time for the Legislature to take action.”

On average, two people die each day from opioid overdoses in Washington state. In 2011, at the peak of overall sales in Washington, more than 112 million daily doses of all prescription opioids were dispensed in the state — enough for a 16-day supply for every woman, man and child in Washington.

At the opioid summit in June, Ferguson pledged he would put forward legislation consistent with the report’s recommendations. Today Ferguson announced he is introducing three agency request bills this session consistent with policy recommendations in the report.

One bill requires health care providers to check the state’s prescription-monitoring database before prescribing opioids. Another limits the number of opioids a provider can initially prescribe. A third bill gives the Attorney General’s Office Medicaid Fraud Control Unit more authority to investigate and prosecute opioid-related Medicaid fraud cases.

Prescription-monitoring program

Washington currently has a prescription-monitoring program in place to collect records when patients receive controlled substances such as opioids. This program, funded by public dollars, can flag misuse or dangerous prescribing patterns. Although pharmacies are entering all controlled substance prescription information into the database, only 30 percent of providers have registered to use it.

Ferguson’s legislation, sponsored by Senator Kevin Van De Wege, D-Sequim, requires health care providers to check the prescription-monitoring database for a patient’s prescription history before prescribing opioids.

The report notes that some patients visit multiple providers to feed their addiction or to sell opioids for profit, a tactic known as “doctor shopping.” Requiring providers to check the prescription-monitoring program allows doctors to spot this behavior and refer these patients to treatment.

Currently, 30 states require providers to check their prescription-monitoring program before issuing prescriptions of opioids. After New York instituted a prescription-monitoring mandate, doctor shopping decreased by 90 percent. Research found no indication that those with legitimate medical needs had difficulty accessing medication.

Prescription limits

Ferguson is also proposing legislation, sponsored by Senator Annette Cleveland, D-Vancouver, and Representative Eileen Cody, D-Seattle, limiting initial opioid prescriptions to prevent overprescribing.

Prescribing more than a week’s supply of opioids approximately doubles the chance that the person will still be using the drugs one year later. Overprescribing leads to unused pills. If not disposed of properly, these opioids are available for misuse by teens and young adults. Prescribing only the lowest effective dose can prevent misuse, addiction and overdose, according to the report.
Based on the report’s recommendations, the proposed law limits initial opioid prescriptions to a three-day supply for those under 21 and a seven-day supply for those 21 and older. The bill makes Washington’s laws consistent with state Medicaid policy and CDC guidelines. According to the Centers for Disease Control and Prevention, for most conditions, a three-day supply of opioids will often be sufficient; more than seven days is rarely needed.
The bill exempts cancer patients, as well as palliative, hospice and other end-of-life care. Providers will have discretion to issue greater quantities of opioids if a patient’s medical condition requires it.

Medicaid Fraud Control Unit
Ferguson is introducing a third bill, sponsored by Representative Roger Goodman, D-Kirkland, and Senator-Elect Manka Dhingra, D-Kirkland, that gives the Attorney General’s Office Medicaid Fraud Control Unit authority to issue search warrants and make arrests in Medicaid fraud cases, including those involving opioid misuse.
For example, one Medicaid fraud case involved a pharmacy technician who used his access to the pharmacy’s patient records to obtain opioids with high street value. These illegally diverted drugs were billed to the government.
Currently, since Washington’s Medicaid Fraud Control Unit is one of the few Medicaid fraud control units in the country lacking these critical law enforcement powers, it must rely heavily on the assistance of local law enforcement to carry out investigations. Providing these critical law enforcement powers will assist the unit’s investigations of dangerous ‘pill mill’ operations.

Other report recommendations
In addition to the Attorney General’s request legislation, the report outlines a range of recommendations for Washington state policymakers that address law enforcement, addiction treatment and prevention. These strategies include:
Encouraging pain relief alternatives. For most conditions, non-opioid pain treatments such as ibuprofen and acetaminophen are equally or more effective with significantly less risk than opioids.
Expanding drug take-back initiatives. One study of medicine take-back events found more than 60 percent of opioids originally dispensed go unused. Secure drop boxes, particularly those conveniently located at pharmacies, help keep unused drugs out of the hands of youth or criminals.
Drug courts. Drug courts can reduce prison sentences for those who receive drug treatment, making them less likely to reoffend.
Law enforcement assisted diversion programs. A King County law enforcement program diverts those arrested for nonviolent offenses, such as drug possession, into treatment and support services. Program participants are 87 percent less likely to go to prison than those within the traditional criminal justice system.
Enhanced penalties for trafficking strong synthetic opioids such as fentanyl. Fentanyl, a synthetic opioid, can be deadly even in small doses—a few salt-sized grains—and is more than 100 times more potent than heroin.
Increased funding for drug-gang task forces. In 2014, Washington’s drug task forces disrupted or dismantled more than 150 drug trafficking organizations. However, since 2015, they have received no state funding.


(PAGE 2) OUR PARKS AND FOREST

FROM THE US DEPT. of INTERIOR

San Juan National Historic Site in Puerto Rico Reopening Areas to Visitors
Press release issued 11/ 21/ 17
https://www.doi.gov/pressreleases/san-juan-national-historic-site-puerto-rico-reopening-areas-visitors

WASHINGTON - U.S. Secretary of the Interior Ryan Zinke and the National Park Service (NPS) today announced that the NPS has resumed normal operations and public tours at the visitor center and Castillo San Cristóbal area of San Juan National Historic Site. Castillo San Felipe del Morro is expected to reopen as early as next week. The National Park Service is an important tourism factor in Puerto Rico, generating more than $100 million in economic activity every year for the island. In 2016, more than 1.4 million people visited NPS sites in Puerto Rico, spurring more than $85 million in visitor spending. The 1,065 jobs the park visitors supported created more than a $100 million in economic output and $40 million in income.

On September 20, Category 5 Hurricane Maria hit Puerto Rico causing damage to the historic fortifications at San Juan National Historic Site and forcing closures at the site. Since that time the NPS has been working to repair and restore the site and to ensure that facilities are safe for visitors and employees.

“For over 400 years, Castillo San Felipe del Morro has stood as guardian and symbol of Puerto Rico’s heritage, and it's also a major tourism attraction for visitors from all over the world” said Secretary Zinke. “I’m incredibly proud of the National Park Service and entire Interior family who have been working nonstop to reopen this important cultural and tourism attraction. Part of rebuilding communities means rebuilding revenue streams so folks can get back to work, earn a living, and care for their families. The National Park Service will continue to work closely with the people of Puerto Rico to restore life into this vibrant community.”
The governor of Puerto Rico, Ricardo Rosselló, said, "with the announcement of the reopening of these spaces we show that we are en route to the recovery of our Island. The San Cristóbal Castle and San Felipe del Morro Castle are part of the historical and cultural heritage of Puerto Rico, essential spaces to continue promoting tourism as part of our economy. We invite all Puerto Ricans and visitors to continue enjoying the national historic sites of our Island."
San Juan National Historic Site is comprised of Castillo San Felipe del Morro, Castillo San Cristóbal, Fort San Juan de La Cruz (El Cañuelo), La Puerta de San Juan and most of the city wall. The park is open every day from 9:00 a.m to 6:00 p.m, except on Thanksgiving, Christmas, and New Year’s Day.
It is anticipated that Castillo San Felipe del Morro will open on Monday, November 27, 2017. On Saturday, December 2, 2017, the park is planning to host a community reopening event for the public.

 National Parks to reopen in U.S. Virgin Islands following hurricanes
Press release issued 11/ 20/ 17
https://www.doi.gov/pressreleases/national-parks-reopen-us-virgin-islands-following-hurricanes

WASHINGTON – Today, U.S. Secretary of the Interior Ryan Zinke and U.S. Virgin Islands Governor Kenneth Mapp announced the reopening of Christiansted National Historic Site and Buck Island Reef National Monument on the island of St. Croix and Trunk Bay Beach at Virgin Islands National Park on the island of St. John. The National Park Service is an important economic engine in the USVI, attracting more than a half a million visitors in 2016 and supporting 900 jobs in the community. Visitors spent $70 million and helped support $34 million in labor and more than $90 million in economic output.

“I couldn’t be more proud of the hard work of National Park Service staff, volunteers, and their partners in the Virgin Islands. Their commitment to the park and to the community is inspiring. I’ve heard many stories of staff tending to the needs of the park and their neighbors before even taking care of themselves,” said Secretary Zinke. “We have a long way to go, but every day we make progress toward getting these parks fully functional to visitors and back to providing important economic support to these communities as they return to normal.”

"The reopening of Buck Island Reef National Monument, Trunk Bay Beach, and Christiansted National Historic Site represents another significant milestone in the recovery of the U.S. Virgin Islands," Governor Kenneth E. Mapp said. "These are, of course, premiere destinations for visitors, but are also significant recreation areas for Virgin Islanders - many of whom traditionally celebrate Thanksgiving at our beaches. Thanks to the Department of Interior, the National Park and all the Virgin Islanders that continue to work on facilitating our efforts to rebuild."

“National parks such as Christiansted National Historic Site, Buck Island Reef National Monument on St. Croix and Trunk Bay Beach at Virgin Islands National Park on St. John protect some of the best of our natural heritage. Together with other protected areas, they attract millions of visitors annually and help to protect the U.S. Virgin Islands' unique wildlife by acting as a refuge for threatened species​," said Delegate Stacey Plaskett. "Although their primary purpose is the protection of biodiversity, National Parks also deliver other invaluable economic, social, cultural, and health benefits to our territory's residents. Future generations deserved the right to see these natural values intact and protected as we do today.”

The National Park Service protects and preserves significant historic sites, important ecosystems, and popular beaches that are vital to the tourism economy in the Virgin Islands. For example, visitors to national parks in the Virgin Islands spent $70 million in 2016.
Christiansted National Historic Site demonstrates the architectural, economic, and political influence of 18th century Europe like no other place in the Caribbean. The 19,015-acre Buck Island Reef National Monument includes the 176-acre island consisting of tropical dry forest and 18,839 acres of submerged lands and coral reefs.
With the opening of Trunk Bay Beach, Virgin Islands National Park now has three popular tourist destinations ready to receive visitors. Honeymoon and Hawksnest beaches reopened on November 13. Water sports equipment rental is currently available at Honeymoon Beach and equipment rental will resume at Trunk Bay Beach today. Taxi service, essential to getting visitors to park beaches, has also resumed.
To reopen Trunk Bay Beach, the National Park Service stabilized numerous structures and removed fallen trees and more than 480 cubic yards of debris. Dive teams removed underwater debris from swimming areas, however visitors are encouraged to use caution when swimming in all areas of Virgin Islands National Park.
While these sites are open to visitors, many services and features at NPS sites across the islands remain closed or inaccessible while cleanup continues.

AT THE STATE LEVEL

WDFW Budget and Policy Advisory Group sets first meeting Dec. 6 on long-term finance plan
Press release issued 11/ 17/ 17
http://wdfw.wa.gov/news/nov1717b/

OLYMPIA – The Washington Department of Fish and Wildlife (WDFW) has appointed a 20-member advisory committee to help the department with strategic planning, development of legislative proposals, and future budget requests.
The group's kick-off meeting is scheduled for 9 a.m. to 4 p.m. Wednesday, Dec. 6, in Room 186 of the South Puget Sound Community College campus in Lacey, 4220 6th Ave. Its first task will be to help WDFW develop a long-term revenue plan in response to legislative direction.
When they enacted the 2017-19 biennial state operating budget, lawmakers directed WDFW to complete three tasks to improve the department's long-term financial stability and operational efficiency:
Develop a long-term plan to balance projected expenses and revenues by providing prioritized options for spending reductions and revenue increases.
Identify and implement management improvements and operating efficiencies.
Conduct a "zero-based budget review" to accompany the department's proposed 2019-21 operating budget.
The Legislature also directed WDFW to obtain public input on revenue options and to report its activities quarterly to the Fish and Wildlife Commission, the Governor's budget office, and the Legislature.
Nate Pamplin, WDFW policy director, said this process represents the department's first comprehensive management, operations, and financial review in more than 10 years.
"Rapid population growth and recent state and federal budget trends pose major challenges for fish and wildlife management," Pamplin said. "The advisory committee will provide valuable perspectives and recommendations about the role the department plays in conservation and the outdoor economy."

WDFW delays commercial crab fishery on Washington coast due to low meat content
Press released 11/ 20/ 17
http://wdfw.wa.gov/news/nov2017b/

OLYMPIA – State shellfish managers have delayed the opening of the commercial Dungeness crab fishery on Washington's coast due to inadequate meat in crab shells.
The commercial fishery on Washington's coast typically opens Dec. 1. Recent testing indicates crabs along the coast do not have sufficient meat in their shells to meet industry standards for harvest. The fishery will be delayed until at least Dec. 16 to allow more time for crabs to fill with more meat.
Another round of testing will take place after the Thanksgiving holiday to determine whether the fishery can open Dec. 16 or will need to be further delayed, said Dan Ayres, coastal shellfish manager for the Washington Department of Fish and Wildlife (WDFW).
"It's not unusual for crabs to need more time to fatten up," Ayres said. "We'll re-evaluate in another week or two."
Contrary to an erroneous news report, WDFW did not delay the commercial crab fishery due to a harmful algae bloom, Ayres said. Algae blooms can cause elevated levels of domoic acid, which can be harmful or fatal if consumed in sufficient quantities. Recent test results indicate crabs along the Washington coast are currently safe to eat.
Recreational crabbing remains open in Washington's coastal waters as well as in several areas of Puget Sound. More information about recreational crab fishing in Washington can be found on WDFW's website at http://wdfw.wa.gov/fishing/shellfish/crab/

(PAGE 3) OUR ENVIRONMENTAL HEALTH

Reports from the EPA

Terminix Companies Sentenced for Applying Restricted-Use Pesticide to Residences in the U.S. Virgin Islands
Press release 11/ 20/ 17
https://www.epa.gov/newsreleases/terminix-companies-sentenced-applying-restricted-use-pesticide-residences-us-virgin

WASHINGTON (November 20, 2017) - Terminix International Company LP (TERMINIX LP) and U.S. Virgin Islands operation Terminix International USVI LLC (TERMINIX, USVI) were sentenced today for violations of the Federal Insecticide, Fungicide, and Rodenticide Act in the U.S. Virgin Islands, announced the Department of Justice and the Environmental Protection Agency.

The Virgin Islands pest control company illegally applied fumigants containing methyl bromide in multiple residential locations in the U.S. Virgin Islands, including the condominium resort complex in St. John where a family of four fell seriously ill in March 2015 after the unit below them was fumigated. According to the plea recommendation, TERMINIX LP and TERMINIX, USVI are to pay a total of $10 million in criminal fines, community service, and restitution payments. Under the agreed recommendation, TERMINIX, USVI will pay $4 million in fines and $1 million in restitution to the EPA for response and clean-up costs at the St. John resort. TERMINIX LP will pay a fine of $4 million and will perform community service related to training commercial pesticide applicators in fumigation practices and a separate health services training program.

“The sentences in this case reflect the serious nature of the defendants’ illegal actions and the unacceptable consequences of those actions,” said EPA Administrator Scott Pruitt. “This case should serve as a stark reminder that pesticides must be applied as intended and that those who ignore laws that protect public health will be held accountable by EPA and our law enforcement partners.”
“The tragic incident at issue in this case shows the extreme danger posed by the improper use of toxic pesticides,” said Acting Assistant Attorney General Jeffrey H. Wood of the Justice Department’s Environment and Natural Resources Division. “Businesses using these products must take appropriate cautions to safeguard the public, or else the consequences can be devastating. We trust that the result in this case shows how imperative it is that users of these products take the time to review, understand, and employ appropriate techniques and uses.”
“This case demonstrates how critical it is to comply with environmental laws and regulations,” said Acting United States Attorney Joycelyn Hewlett for the District of the Virgin Islands. “An entire family suffered horrendous and life-altering injuries. We will continue to aggressively enforce environmental laws to help prevent something like this from ever happening again.”
In 1984, the EPA banned the indoor use of methyl bromide products. The few remaining uses are severely restricted and largely limited to commodity applications for quarantine and pre-shipment purposes. Pesticides containing methyl bromide in the U.S. are restricted-use due to their acute toxicity, meaning that they may only be applied by a certified applicator. Health effects of acute exposure to methyl bromide are serious and include central nervous system and respiratory system damage. Pesticides can be very toxic and it is critically important that they be used only as approved by EPA.
According to the information filed in federal court in the U.S. District Court of the Virgin Islands, the defendants knowingly applied restricted-use fumigants at the Sirenusa resort in St. John for the purpose of exterminating household pests on or about October 20, 2014, and on or about March 18, 2015. The companies were also charged with applying the restricted-use pesticide in 12 residential units in St. Croix and one additional unit in St. Thomas between September 2012 and February 2015.
According to the factual basis of the plea agreement, TERMINIX, USVI provided pest control services in the Virgin Islands including fumigation treatments for Powder Post Beetles, a common problem in the islands. These fumigation treatments were referred to as “tape and seal” jobs, meaning that the affected area was to be sealed off from the rest of the structure with plastic sheeting and tape prior to the introduction of the fumigant. Customers were generally told that after a treatment, persons could not enter the building for a two- to three-day period.
On or about March 18, 2015, two employees of TERMINIX, USVI, performed a fumigation pesticide treatment at the lower rental unit of Building J at Sirenusa in St. John. The upper unit in Building J was occupied by a Delaware family of four. Via various means, methyl bromide from the lower unit migrated to the upper unit of Building J, causing serious injury to and hospitalization of the entire family. 
EPA regional staff responded immediately to the incident in St. John, securing the scene, performing testing, and addressing the contamination. Within days, the EPA sent out a pesticide use warning to pesticides applicators in Puerto Rico and the U.S. Virgin Islands, followed by a broader pesticide notice to regulators in all states, the British Virgin Islands, and to other Caribbean and Latin American countries.
After the government began its investigation, TERMINIX LP voluntarily ceased its use of methyl bromide in the U.S. and in U.S. territories. The government has notified the district court that the defendants have made full restitution to the Esmond family. The family is satisfied with the criminal resolution and has asked that their privacy be respected.
The case was investigated by EPA Criminal Investigation Division working cooperatively with the Virgins Islands government and, the Agency for Toxic Substances and Disease Registry.
 Senior Litigation Counsel Howard P. Stewart of the Department of Justice, Environmental Crimes Section, and Assistant U.S. Attorney Kim L. Chisholm of the District of the Virgin Islands are prosecuting the case with assistance of Patricia Hick, EPA Region II Regional Criminal Enforcement Counsel.

EPA backs North Dakota’s plan to improve water quality with $14.7 million in water infrastructure funding
Press release issued 11/ 21/ 17
https://www.epa.gov/newsreleases/epa-backs-north-dakotas-plan-improve-water-quality-147-million-water-infrastructure

DENVER (Nov. 21, 2017) - The U.S. Environmental Protection Agency has awarded $14,715,000 in Clean Water and Drinking Water state revolving loan (SRF) funding to the North Dakota Department of Health to support key water infrastructure projects, including new and upgraded wastewater and drinking water plants to ensure clean drinking and surface water, better serve residents, increase efficiency and reduce pollution.
“Investing in our nation’s water infrastructure is one of EPA’s most fundamental priorities,” said EPA Regional Administrator Doug Benevento. “These funds will ensure that the state and its communities are providing clean and safe water to all North Dakotans.”
In addition to the $14.7 million just funded, North Dakota’s water infrastructure projects are also funded with state match, repayments from prior SRF loans, and interest earnings. Several projects targeted for wastewater treatment as well as drinking water SRF loans include:
$66 m for Grand Forks to replace an aging water treatment plant with a new plant outside of the floodplain that will help treat source water of varying quality.
$9.4 m for Larimore to replace 6.2 miles of sewer lines and construct storm water control projects to reduce flooding and infiltration into the sanitary sewer system.
$2.4 m for Jamestown to improve the wastewater treatment plant and for water main rehabilitation for drinking water.

$1 m for the City of Oakes to refinance a project to replace deteriorated sanitary sewer mains, as well as $365k for the relocation of the main lift station to avoid flooding.

$1 m to Wahpeton for the reconstruction of storm sewer and sanitary sewer mains to ensure sufficient capacity in both systems.
$906k to Cavalier to extend sewer services to the Pines Subdivision.
$785k to Ross for rehabilitating water mains for safe drinking water.
$580k to Horace to replace a drinking water main.
$100k to Lidgerwood for emergency sewer main repairs to prevent sewage backups.
The Clean Water State Revolving Fund (CWSRF) program is a federal-state partnership that provides communities a permanent, independent source of low-cost financing for a wide range of water quality infrastructure projects. The CWSRF program provides low interest loans for the construction of wastewater treatment facilities and other projects vital to protecting and improving water quality in rivers, lakes and streams for drinking water, recreation and natural habitat.  The loans help communities keep water and sewer rates more affordable while addressing local water quality problems. https://www.epa.gov/cwsrf
The Drinking Water State Revolving Fund (DWSRF) program is a federal-state partnership to help ensure safe drinking water. Created by the 1996 Amendments to the Safe Drinking Water Act (SDWA) the program provides financial support to water systems and to state safe water programs.

AT THE STATE LEVEL

EPA settlement with Emerald Services, Inc. in Tacoma helps protect community from hazardous waste
Press release issued 11/ 20/ 17
https://www.epa.gov/newsreleases/epa-settlement-emerald-services-inc-tacoma-helps-protect-community-hazardous-waste

Seattle – The U.S. Environmental Protection Agency, Region 10, has reached a settlement with Emerald Services, Inc., a hazardous waste storage and treatment facility in Tacoma, Washington, over violations of the Resource Conservation and Recovery Act (RCRA) and violations of the facility’s RCRA permit. This enforcement action was coordinated with the Washington Department of Ecology. The facility is located within the boundaries of the Puyallup Tribe’s reservation.
Emerald Services manages large volumes of hazardous waste, solvents, and antifreeze and re-refines used oil at the Tacoma facility. Emerald was purchased by Safety-Kleen Systems, Inc. on July 8, 2016, and both Emerald and Safety-Kleen are owned by parent holding company, Clean Harbors, Inc. Ensuring that funds will be available if the company’s operations harm people or damage property is an essential element of the “cradle to grave” RCRA hazardous waste management program. 
This settlement resolves several RCRA violations at the Tacoma-area facility. Specifically, the company failed to maintain adequate third-party liability insurance coverage of the facility for the past six years.  As part of the settlement, Emerald Services agreed to pay a $125,800 penalty and amended its current insurance policy to comply with its RCRA permit.
“Having adequate insurance coverage for your business, especially one that stores and handles hazardous waste, isn’t an option, it’s the law,” said Ed Kowalski, Director of EPA’s Region 10 Compliance and Enforcement Division in Seattle. “Liability insurance is a key requirement of the hazardous waste permitting system, ensuring that commercial hazardous waste handlers operate in a safe manner to protect people’s health and the environment.”
There is a history of spills and incidents at Emerald’s Tacoma facility. In 2013, a 1,900-gallon spill of a highly dangerous fuel oil/asphalt mixture injured a worker. Emerald’s pattern of spills and releases suggests the facility may have a higher probability of future accidents, underscoring the need to have liability coverage for possible bodily injury, property damage and environmental restoration.
Violating environmental laws puts public health and the environment at risk. EPA protects communities by ensuring compliance with federal environmental laws. By fairly enforcing environmental laws, we level the playing field by deterring violators and denying companies an unfair business advantage over facilities and businesses that follow the rules.


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Colossians 2:6-7 NKJV

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