It’s going to be pants this Christmas

It's going to be PANTS this Christmas

Helping the homeless & vulnerable in Oxford this winter – It’s going to be PANTS this Christmas is the campaign for 2020. Building on the SOX APPEAL campaign from 2019, we are supporting The Gatehouse again this year, in even harder circumstances.

Started Christmas shopping? Buy an extra gift this year!

This year we would love PANTS as well as SOCKS. We would also welcome POTS of noodles, pasta or similar. Due to COVID clients are unable to access all centers and food and drink needs to be in takeaway containers.

It’s going to be PANTS this Christmas

The Gatehouse Oxford

Why help homeless at Christmas?

Homeless clients experience great discomfort from wet and damp shoes/socks. Their feet are often painful and are vulnerable to fungal infections, bacteria infections, trench foot and amputation. At Zest Podiatry where we are all podiatrists, we are very aware of the problems experienced and are keen to offer our help. It’s going to be PANTS this Christmas.

How Zest Podiatry help through the year

Throughout the year we provide free (organised through Forgotten Feet) podiatry care at The Gatehouse in St Giles Church. Ideally this would happen every 6 weeks where we see around 20 clients. After each podiatry treatment they are very appreciative of new socks that they can pop onto their newly treated feet. Covid has limited our help this year.

We need your help with It’s going to be PANTS this Christmas campaign

Please download the “It’s going to be pants this Christmas” marketing for your school or organisation and use the tag #pantsthischristmas.

Donations can we sent to us by post or dropped to our clinic, they need to be received by Friday 18th December. Please call us so we can arrange reception to let you in.

Legs Get Loud

legs get loud

Legs get loud is the national campaign for legs matter week that we are supporting. This year we’re turning the volume up! Are you ready to make some noise about legs and feet.

 12-16th October 2020. #legsgetloud #legsmatter

The Legs Matter coalition works together to increase awareness, understanding and action on lower leg and foot conditions among the public and healthcare professionals. They operate under the governance of the Tissue Viability Society, a registered charity.

Every day, thousands of people’s quality of life is devastated by the lack of support and advice on the prevention of lower leg and foot conditions and the failure to correctly diagnose and treat them. We’re determined to change this.

What is on this week at the Legs Matter Lounge

Throughout the week there is an exciting online program of FREE events on everything from footwear to meditation, hosted by experts from the worlds of healthcare, wellbeing and yoga.

Monday Tuesday Wednesday Thursday Friday

Three point leg check – Legs Get Loud

What are your legs and feet trying to tell you? Don’t ignore even the smallest change to the skin, shape or feel of your legs and feet. Get to know what’s normal and what’s not.

We know that your legs and feet probably haven’t been top of your list recently, but it’s time to give them some attention. Even the smallest change to the way they look or feel can be a sign of something more serious.

That’s why we’re asking everyone to check their legs and feet and to speak up if things aren’t looking or feeling right.

  • Skin – Check the skin on your legs and feet for any change in colour or texture, including dry, scaly or red skin, or skin that’s hot to touch. A cut, blister or insect bite that hasn’t healed after two weeks is not normal and needs to be seen by a nurse or podiatrist. Make an appointment at your GP surgery.
  • Shape – Swollen legs or feet are your body’s way of saying that something isn’t right. This might be because of an injury or it could be a sign that your veins or lymphatic system aren’t working as well as they should. If your legs or feet are uncomfortably swollen, they need to be seen by a nurse or podiatrist. Make an appointment at your GP surgery.
  • Feel – It’s normal to feel an occasional cramp in your legs when walking but if it happens a lot, it could be a sign that your body’s circulatory system isn’t working as well as it should. Tired, throbbing and painful legs can also be a sign that something’s not  right – ask your pharmacist for advice  or make an appointment at your GP surgery.

Why legs matter – The little things to look out for

Our legs and feet do a lot for us but often they don’t get the attention they deserve. It’s really important that we keep an eye on our lower legs and feet. Even the smallest change to the way they look or feel can be a sign of something more serious.

Get to know what’s normal for you when it comes to your legs and feet. Here are some things to look out for:

  • Swelling
  • Sores, ulcers or wounds that are not healing
  • Tired, throbbing and painful legs
  • Varicose veins
  • Dry, itchy and scaly skin
  • Reddish brown staining above the ankle
  • Cramp or pain after walking
  • Hot, inflamed and tender skin

If you notice any of these, make sure you get your legs and feet checked out at your GP practice.

Legs Get Loud Downloadable help guides

Our legs and feet do a lot for us but often they don’t get the attention they deserve. It’s really important that we keep an eye on our lower legs and feet. Even the smallest change to the way they look or feel can be a sign of something more serious. We’ve put together this short guide to help you get to know your lower legs and feet – and know when to go and get them checked out at your local health services. 

Get to know you legs and feet – short guide

What are your legs trying to tell you 

CONTACT US

Have you thought about a career in podiatry?

career in podiatry

What is podiatry?

Podiatry is the study of the lower limb. For a career in podiatry you need to study an undergraduate degree, and attain a Bachelor of Science (BSc). In the UK we are part of the Allied Health Professionals. https://www.england.nhs.uk/ahp/role/

You will work with people’s feet and legs. You’ll diagnose and treat abnormalities and offer professional advice on care of feet and legs to prevent foot problems.

Career in podiatry – what areas can I work in?

Podiatrists work in a number of areas from the NHS, private practice to surgical teams and sporting facilities. We have podiatrists that were part of the Olympic Support Team in 2012, and podiatrists that run international private clinics. 

Podiatry is recognised internationally and many countries are keen to employ UK taught podiatrists.

Who does a podiatrist treat?

A podiatrist diagnose and treat a range of conditions:

  • In multidisciplinary teams focusing on diabetes, rheumatology and wound care. 
  • Musculoskeletal areas look at injuries, rehabilitation and gait, and the use of orthotics for activities. Sport Podiatry.
  • Children’s development. 
  • Dermatology focuses on skin lesions and treatments available.
  • Ingrown nails with nail surgery and the use of local anaesthetic.
  • Podiatric surgery which requires further study.

Do I need to do a podiatry degree?

Podiatry is taught at an undergraduate degree level, it is a science based degree (Bachelor of Science BSc). There are 12 universities that offer Podiatry, you apply through ucas.

For a career in podiatry there are a few routes into studying, from A-levels, Access courses and launched in 2020 the apprenticeship scheme.

Information on the UCAS site for podiatry career can be found at : https://www.ucas.com/ucas/after-gcses/find-career-ideas/explore-jobs/job-profile/podiatrist

Can I do a podiatry apprenticeship?

Degree apprenticeships combine on-the-job experience with a full degree-level qualification. This style of university-level study means you gain a full honors degree, earn a wage, and gain valuable work-experience at the same time. 

This is an ideal route if you are a school leaver looking for an alternative to a full-time university course, or if you’re an existing employee seeking to benefit from this higher-level training, but not able to enroll in traditional study. There are many routes for your career in podiatry.

Plymouth university offer this now: https://www.plymouth.ac.uk/study/apprenticeships/students

What do I need to study podiatry? career in podiatry

In order to be accepted onto the podiatry course you will need to meet the academic requirements and also have experience and knowledge of the profession. We would advise you to gain this by:

  • Shadowing and work experience in podiatry
  • Contact NHS podiatry departments and private practice clinic
  • Visit the Zest Podiatry career page

Develop your career in podiatry further

What is podiatric surgery?

Podiatric Surgery is a specialist field of practice within the Podiatry. Podiatric Surgeons are Podiatrists who have had extensive postgraduate training in the surgical management of foot and ankle problems.

Zest Podiatry & Physio clinic re-opens

shielding

Zest Podiatry & Physio clinic re-opened on Monday 1st June. Initially we shall open Mondays to Wednesdays in June, extending to Thursdays with MSK treatments available in July.

Following the Government announcement on the 12 October 2020 of the three-tier COVID-19 restrictions, the College can confirm that podiatrists can continue to practice. 

13th October 2020

Can you treat me?

YES – we are now able to treat everyone.

We have been adhering to the strict government guidelines about who is eligible and are pleased we can now appointments to the less vulnerable. If you would like to book in, contact us or go online.

APPOINTMENTS

I am high risk, can I come in ?

Yes you can come to Zest Podiatry if you are high risk. If you are shielding then you are one of the clinically extremely vulnerable. We have worked hard to ensure our clinic meets the government guidance so you feel reassured to visit us if your health needs require podiatry treatment.

The government recommendation is to ensure you continue to receive the care you need during this time and access medical assistance where necessary.

Maintaining a safe clinic

We have followed government and the college of podiatry guidelines about social distancing, PPE and clinic hygiene. 48 hours before your appointment you must confirm your current health. This will be on email or by a telephone call (if no email facility) and MUST be completed.

If you have signs of covid-19 you will be asked to self-isolate and contact us in 14 days.

What to expect when the clinic re-opens

  • Entry to the clinic if you have an appointment only.
  • You MUST wear a mask or face covering.
  • You will be asked to clean your hands with gel.
  • Your temperature will be taken and recorded on your notes.
  • The NHS covid-19 app is available for you to check in.
  • All clinicians will be wearing appropriate PPE.
  • If you arrive in the car please stay in the car & your clinician will come and meet you.
  • Should you arrive on foot, bike or public transport please use the bell to inform us of your arrival and we will place you in reception, away from others.
  • We shall try and limit who you come into contact with.
  • Only one person can enter the clinic, unless accompanying a child or a carer.
  • All the treatment rooms will have the Dyson pure hot+cold purifying system.
  • We ask that you only use the toilet if a must (just ask – it is not a problem).
  • Your clinician will make any future appointments within the clinic, or ask for reception to contact you.
  • You can pay before or at the time using the contact less system on the car reader, no cash payments please.

If your temperature is higher than 37.5 or you are awaiting a covid test result, you will be asked to leave the clinic immediately.

What if I feel unwell on the appointment day?

If you feel unwell on the day, please call us, we can discuss your symptoms and how best to progress with the appointment, do NOT come in if you feel unwell, we will be sympathetic to late cancellations during this time. We all need to remain safe.

A foot virus

verrucae

A foot virus is commonly known as verrucae or warts. Verrucae or warts are known by health professionals as the human papilloma virus (HPV).  There are over 100 HPV subtypes which can look slightly different on the skin.

What is a virus?

A virus is a tiny agent which can infect living organisms (host). The virus can copy itself inside our cells, it takes over the cell machinery and reproduces itself. The cell then bursts open, spreading the virus. There is a barrier around them making it hard for our body’s defence mechanism to locate them. Viruses infect a variety of living organisms, including bacteria, plants, and animals. 

The HPV (human papilloma virus)  

The HPV infects the skin cells in the outer layer of skin (epidermis) where it can stay undetected. They are harmless in that they don’t invade the body any deeper than the top layer of skin. They can however spread to other parts of the foot or onto the hands.

The virus causes an excess amount of keratin to develop in the top skin layer (epidermis). The extra keratin produces the unsightly and rough texture of the verrucae and wart. 

Are you sure it is a verrucae?

It is common for people to misdiagnosis a verruca, with a corn or a foreign body. If you are unsure do contact a podiatrist for confirmation as these conditions would require very different treatments.

How does it spread?

A foot virus / HPV is picked up by barefoot contact on floors and surfaces. This is most common in wet changing room floors and shower areas. The HPV can survive for up to 3 weeks without a host. The virus can lie dormant in the skin cell for up to 8 months after exposure.

The virus is passed from one person to another by infected skin cells falling off. When someone walks over the skin cells if their skin is vulnerable they may contract the virus.

Vulnerable skin can be:

  • very dry skin
  • very wet/damp skin
  • skin that has by microscopically abraded ie scuff in skin

Who gets verrucae and warts?

The HPV is so common that it is thought most people will have them at some point in their life. They are commonly seen in children, teenagers and young adults. Patients whose immune system is suppressed by drugs or a medical condition as well. 

There is an estimate that it occurs in between 5 – 30% of children and young adults. 

How does our body fight this virus?

Our immune system is designed to do this job (own immune response). It will monitor, recognise, and even remember the virus. Recognition of the virus is through the viral proteins within the skin cell around the virus. The immune system will take action to eliminate it when the virus invades healthy cells. 

The immune system does this by releasing chemicals that trigger virus-fighting cells. These cells are then sent to wipe out the enemy. Most resolve naturally in adults on average within 8 years and in children within 2 years.

However the viral proteins can inhibit the body’s reaction to the virus and as such the body remains ‘ignorant’.This means no action is taken and the virus remains.

Treatments for HPV (a foot virus)

The aim of all treatments for HPV is to destroy the virus infected skin cells and provoke the body’s own immune response. As described above our immune response should take action and eliminate, thus kill the virus from within.

There are a number of treatment options. All have success variations. 

  • No treatment – rely on body’s own immune response
  • Salicylic acids – destroy skin and burn out viral infected skin tissue, provoke an immune response
  • Cryotherapy – destroy skin cells and provokes an immune response
  • Microwave therapy – destroy tissue and provokes an immune response
  • Removal – aims to remove all viral skin cells

If you would like to come and see us for a verrucae treatment, please contact us direct or book online.

Ingrown sore nails

ingrown sore nails

Case Study

Ingrown sore nails: Phoebe aged 17 years. Fit and healthy. No previous nail conditions.

In April 2019 Phoebe spent 4 days walking in the Peak District for her gold DofE. She walked 10-15 km per day over a range of terrains.

  • Day 1 she experienced some pain, blisters started to form and the toes started to hurt. Phoebe added dressings to prevent some of the rubbing.
  • Day 2 the nails ached at night and were sore (bruised).
  • Day 3 she found that the toenails became very painful and sore whilst walking, and they started to show signs of bleeding. Some of the blisters had popped. 
  • Day 4 the toes bled and were so painful that she had to use paracetamol to help with the ingrown sore nails.

After the expedition

Phoebe came to see us not long after she got back. The big toenails were bruised. She had cut her nails, and the wounds from the blisters were healing. We advised salt water bathing daily and to avoid any tight footwear or impact sports for the next week. We advised that she may lose the toenails, and to monitor them.

Tips for healthy toe nails on expeditions

  • Check that your boots fit and comfortable before your trip
  • Wear appropriate socks for the weather and terrain
  • Cut your toenails before leaving home
  • Take dressings and blister plasters with you

6 months later

In September Phoebe came back to see us as both big toes were giving her some pain, down the sides of the nails and if any pressure was applied to them. It made sports and activities hard work. They were ingrown sore nails.

She had not lost the nails; however they were both now growing into the skin and were causing pain. After cutting them back and monitoring for a further month, Phoebe decided to have nail surgery.

Nail Surgery for ingrown sore nails

Podiatrists are able to perform nail surgery. They are trained during their podiatry degree, for more information on nail surgery please check out the information on the college of podiatry website.

Nail surgery involves either part or all of the nail being removed. We always try and do part if possible (sides), and in most cases we do. Sometimes only one side is necessary. We do this whilst your toe is numb from local anaesthetic, much like the dentist with fillings in your mouth.

We cut the ingrown sore nails away, then a chemical is applied called phenol which destroys the nail bed and stops it growing back. The result is a slimmer nail, that doesn’t grow in and or cause pain. The nail takes around 3-4 weeks to heal, however the pain is normally reduced the following day. 

Phoebe update

One month after surgery, the nails were checked and Phoebe confirms she is still in no pain from her toenails.

Nail surgery with phenol works in 96% of cases

To find out more about ingrown sore nails and nail surgery at Zest Podiatry, click here.

Keep Exercising

keep exercising

As we get further into the start of 2020 we are often still thinking about turning over a new leaf or are just struggling to keep exercising. Should you wish to get healthier, shed a few pounds, need motivation or just want to improve your running we can certainly help you.

Our experienced msk team can advise you where you may potentially have weaknesses or asymmetries in your walking/running that could lead to potential injury. We are also able to use our Run3d gait analysis providing fantastic reports and guidance. Linking with our local sports shops (below), physiotherapists, and other health professionals we will put together a package for you. This package will get you to be where you want to be, whether limping or running your first sub- 20 minute 5K or just be able to get around the supermarket without in pain we can help you.

Running Events

We now starting the countdown towards some pretty major sporting and running events. One of the most participated in but also the most challenging of events is the London Marathon. Those running will be starting to increase their mileage over the next few months to be ready for the event on 26 April. As the mileage increases so does the impact upon your body so we will often advise runners who are starting to get some small levels of discomfort to get it checked out sooner rather than later. A small change to running style or footwear can make a big difference between something becoming mildly uncomfortable to becoming a full-blown injury that can put your place in your big race at doubt. A great local marathon is the Abingdon Marathon, which takes place in October.

Training Concerns

Should you be starting to get any little aches and pains beyond what you would normally expect them would certainly advise that you check out a few things. At Zest Podiatry we want to help you, to keep exercising.

Trainers

First of all check out your running shoes. Make sure they are giving you enough cushioning and support and are not looking worn out. If they are starting look a little bit worse for wear it may be a good time to start breaking in a new set. You’re unsure what sort of footwear you should be going for then we have a simple set of answers for you.

  • Comfort is key. You have to cover a lot of miles on your feet in trainers so something that is feeling a bit uncomfortable at mile two may be unbearably uncomfortable at mile 18 to make sure that you are happy with the shoes that you are running in.
  • Once you have got the shoe that you like and you are comfortable in would certainly recommend getting hold of 2 to 3 pairs if you are looking to wear them for your big event. The mileage that you are doing is to increase to over the next couple of months is certainly going to place incredible strain not only in your body, but also in your shoes. Last thing want to be doing in 2 to 3 weeks before your main event is having to look around for a new set of shoes because your other ones have become so worn they are not giving you the cushioning you need. We know how important it is to keep exercising when you are mid training.
  • The right shoe for the right job.With most events like the London Marathon being a road race we would certainly say look towards a set of good quality road running trainers for this. However should you be looking to complete your event on uneven surfaces you should certainly wear a slightly more structured supportive shoe like a trail shoe for this. This may mean that you have a set of trail shoes for your off-road runs as a road shoes that you’re looking to run in day-to-day but also for the main event.

Socks

  • If you buy shoes, buy socks. Good running socks at the singularly most undervalued bit of sporting equipment. We certainly recommend spending as much as you can on these.

Running Shops

Any good running shop can help you. We are fortunate to have great links and can recommend our friends in Oxford Up & Running, Fit to Run near Abingdon and Abingdon Sports in Abingdon town centre, all will be able to help you. They will be able to give you some good advice regarding footwear and socks to be used with the shoes.

If you have any doubts talk to the professionals like us at Zest Podiatry, we will help you keep exercising!

Start Exercising Today

walking

The festive period has long finished, the chocolates and shortbread biscuits are all eaten (well done!) and the plan of New Year resolutions is a distance past, fear not. Start exercising today, but not too much or too quickly as injuries can occur.

Start exercising slowly

When you are not used to exercising the challenges of a sudden increase in the level of activity can lead to injury which ultimately can dampen our aspirations, put them on hold but often knocks them dead in their tracks.

Tips to help you exercise

Activity

  • Should you start exercising and get a niggle or an injury as you increase your distance then it would be a good idea to get this checked out. We suggest that you speak to the professionals relating to the area of the body where you are having a problem. It is in your lower limb particularly your foot ankle or shin that it would be advantageous to come and see the team at Zest Podiatry for an MSK assessment. A quick check over can put your mind at ease or give you the information you need to manage or cure your discomfort. 
  • Start out slow. If you’re looking to start running easiest thing to do is to try a few brisk walks for 30 minutes or so each day for gradually increasing into a jog. Ramblers have a great website if you want to walk with others. If this is the first time you have taken up running would certainly advise you to do a little work on your core strength and stability which is very important when you are starting activity. Something like yoga, Pilates, or tai chi, can be a good start.

Footwear & hosiery

  • Pick the right shoes for the right job. You are looking to start running decide which surfaces you’re going to run on. The majority of training shoes are designed for road running however should you live in the countryside be wanting to go across uneven surfaces something like a trail shoe may be more advantageous in giving you more grip and support. You can also use trail shoes on the road so there is any doubt and always choose for the most rugged surface you plan to run on.
  • Ignore all the hype surrounding footwear. Shoes are important, don’t get me wrong, but sometimes we can get over focused upon brands, styles, and how much support the foot is likely to need. Don’t be taken into all of the gimmicks that are surrounding structures, motion control, anti-pronation, barefoot running style shoes. The bottom line is go to someone who knows what they’re doing and can give you impartial advice based on evidence. A good quality running shoe does not have to cost the earth and if you’re going to pick on one thing make it comfort, pick the shoe that feels the best.
  • Never underestimate the power of a good pair of socks. Socks that we choose to run in are almost as important as the shoes. Poor quality socks can cause rubs and blisters and prevent you getting out and about. Would certainly recommend that you buy 3 to 4 pairs of decent running socks although this will be potentially quite expensive as they can been nearly £10 a pair they will be the best £10 you’ve ever spent if you progress further in your running.

If you find that you are just not progressing as you would like to perhaps it would be a good idea to get some professional advice and some high quality gait analysis (run3D) and see how you can improve.. It is our job to keep you on your feet. So why wait till it hurts.

Microwave away your verrucae & warts!

swift microwave

SWIFT microwave treatment for verrucae and warts

Swift microwave therapy was developed as a result of its use for cancer treatment. Microwave technology has been used in medicine for over 30 years globally as a treatment for cancer. Microwaves are a form of non-ionising radiation which means that they cannot cause damage to the DNA of living things.

SWIFT microwave prompts the local immune system of our bodies. The aim is to cause a response by the body to recognise the human papilloma virus (HPV) and therefore heal itself.

SWIFT microwave was launched as a dermatology and podiatry treatment in 2015, (research available). The SWIFT system delivers enough energy to agitate water molecules and causes friction (as opposed to damaging DNA).

How does it work?

The SWIFT microwave system has been designed to ensure that the microwaves travel in straight lines with no lateral spread. This is in contrast to commonly seen in cryotherapy. The thermal energy travels to a depth of approximately 3.5 – 4mm in the skin.

The further beauty of the SWIFT microwave system is that it is pre-set to deliver precise controlled energy dose. Therefore it does not cause damage to the skin, unlike other modalities such as cryotherapy and laser ablation. 

The current success rates of SWIFT Emblation is approximately 80%. This is in contrast to lower success rates of cryotherapy, needling or the use of salicylic acids.

Treatment

The treatment is quick , delivered in a small sequence of short burst applications typically 2 seconds duration. As a result there is no need for a local anaesthetic or post procedure dressings. The treatment causes no scarring and most patients report low post procedural pain.

After the recommended package of 3 treatments, there are certainly changes to the verruca or wart. Pain levels have shown to reduce, and it consequently it starts to regress both in diameter and depth towards a final resolution.

SWIFT microwave is delivered by HCPC registered podiatrists only and here at Zest Podiatry we are very pleased to be able to offer this treatment as part of our Verruca and wart treatments.

We are insured to deal with verruca on the feet and warts on the hands.

Trench foot – is this still a thing?

trench foot

Trench foot is a condition documented widely during the First and Second World Wars when soldiers had to endure months of exposure to wet and cold conditions in the trenches, affecting tens of thousands of troops.

Despite its history, this condition is still affecting many people today where they are exposed to wet, damp and cold conditions. Feet can become red initially but as the blood vessels constrict the skin becomes pale and wrinkled. This then causes the feet to swell and they can also become numb with feelings of heaviness, prickly or pain.

If left untreated, damage can occur to the tissues and nerves inside the foot with resultant blistering and ulceration of the skin. Worse still ulcers can turn into gangrene.

Who’s at risk?

Those people who are vulnerable and homeless. They are subjected to prolonged periods of time in cold, wet and damp conditions. They are very at risk of Trench Foot but it is not just isolated to the homeless or during winter months.

Sports competitors (runners,rowers, sailors, windsurfers) are susceptible to trench foot. Festival goers who spend wet weekend events knee high in mud are also pron to trench foot.

Management of trench foot

Managing trench foot is similar to dealing with frostbite. Where re-warming the feet gently and slowly is key- rapid rewarming can make the symptoms worse. Dressings blisters as part of wound care is important to prevent ulcers. It is worth noting that nerve damage and other symptoms may persist for many months afterwards. Podiatrists are trained in the management of trench foot.

How do you prevent it?

Prevention is always better than cure for trench foot.

Wearing clean, dry socks is key and having spares to change into is also a must . Putting sock liners into footwear can help draw moisture away from skin. 

Footwear should be removed frequently during the day and it is important that footwear is neither too tight or too loose. Like socks, footwear needs to be dry before wearing.

The feet should be clean and allowed to dry, with any excess sweating controlled by aluminium chloride products.

Massaging the feet can help promote circulation , and smoking is to be avoided as this restricts blood flow into the feet. 

Trench foot is not just a soldiers problem. Click here to read more about our winter homeless campaign with the gatehouse in Oxford assisting the collection of new socks.

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