Dr Madeleine Hinwood

Dr Madeleine Hinwood

Research Academic

School of Medicine and Public Health

Applied epidemiology to improve cognitive outcomes associated with chronic diseases

Dr Madeleine Hinwood’s research uses causal inference methodology and evidence synthesis to translate preclinical research findings into human populations.

She adopts statistical and epidemiological methods to answer comparative effectiveness questions using observational data and randomised trials when available. Madeleine applies these methods primarily to a variety of neurological disorders associated with an increased risk of cognitive decline, dementia, and psychiatric disorders, such as stroke and multiple sclerosis. She is also an academic evaluator in the Newcastle Evaluation Group, providing external evaluations of industry submissions to the Pharmaceutical Benefits Advisory Committee.

Madeleine is committed to improving the way the cognitive sequelae of neurological disorders are treated and prevented in Australia. From preclinical research to informing health policy, the impact of Madeleine’s work is two-fold: contributing to a better understanding of neurological disorders, and ensuring safe, effective medications are accessible to the public.

Delivering affordable treatments

In her role as an external academic evaluator for the Pharmaceutical Benefits Scheme, Madeleine provides expert clinical and economic advice to the federal government to inform decisions about which new medicines should be subsidised for the Australian public, to make them more accessible.

Since 2015, Madeleine’s work has helped deliver subsidised pharmaceuticals for thousands of patients annually.

“We evaluate the effectiveness, safety, and cost-effectiveness of new pharmaceutical listings. This is applied research that directly informs health policy and clinical practice, and impacts upon public access to medicines.”

Innovative epidemiological research

After completing a Master of Clinical Epidemiology in 2018, Madeleine is now combining her background in neurobiology, obtained during her PhD, with novel epidemiological research techniques, to better understand the cognitive and psychological outcomes associated with neurological disorders.

“I’m particularly interested in stroke and multiple sclerosis — both neurological disorders where the cognitive and psychological impacts have tended to be a bit neglected in clinical practice.”

“My research focuses on how factors such as stress and prescribed drugs can modify cognitive outcomes such as learning problems and dementia, using causal inference techniques applied to observational data, and evidence synthesis of randomised trials.”

Madeleine’s current projects all have a central focus on the role of the neuro-immune system to alter neurological conditions. Recently, she was part of a team awarded a grant by the National Health and Medical Research Council (NHMRC) looking at the effect of prescribed drugs taken after stroke on the risk of developing dementia or cognitive impairment.

“In the first of many projects, we’re looking at drugs that might shut off the brain’s innate repair cells (called microglia) after stroke, and thereby increase the risk of cognitive decline. The long-term neurocognitive effects of drugs are hard to elucidate — we can’t see them in short-term clinical trials. I’m hoping to use causal inference methods to analyse observational datasets and investigate the potential long-term effects of these drugs.”

“The hypothesis for this study arose from a series of animal studies. We’re taking a novel approach to analysing epidemiological data, using the Swedish national health registers, to translate the work relatively rapidly from animal to human studies.”

Another focus for Madeleine’s research surrounds the comparative effectiveness of disease-modifying therapies (DMTs) in connection with multiple sclerosis. Although this has been studied previously, she is hoping to investigate a different set of outcomes — lesions as seen on MRI and cognition.

“DMTs have mainly been evaluated for their effects on relapses and disability progression. These drugs act on the immune system — and multiple sclerosis is one of the only neurological diseases to have so many treatment options. We’re interested to see whether we can use this information to generate hypotheses in reverse about cognition in neurological disorders, based on the mechanisms of these drugs.”

Looking to the future

Madeleine’s work is attracting well-deserved attention. She has secured $7.4 million in research funding, received a University of Newcastle Faculty of Health and Medicine award for best new project in 2021 and, in 2018, was selected to participate in the faculty-facilitated ThinkWell Early and Mid-Career Women’s Development Program. This program provides support for emerging researchers, helping them progress in their field.

For Madeleine, the idea of ‘making a mark’ means building on preclinical research to help in the translation of novel prevention strategies and treatments for mental and neurological disorders and delivering them into the hands of the public.

“We are still early in our understanding of the brain and disorders of the central nervous system. I’d love to see what we know about how the brain works in another 100 years!”

Applied epidemiology to improve cognitive outcomes associated with chronic diseases

Dr Madeleine Hinwood’s research uses causal inference methodology and evidence synthesis to translate preclinical research findings into human populations.

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Career Summary

Biography

Dr Madeleine Hinwood is a research academic in the School of Medicine and Public Health with the University of Newcastle. In this role, Madeleine provides external evaluation of submissions to the Pharmaceutical Benefits Advisory Committee, examining the effectiveness, safety, and cost-effectiveness of new pharmaceuticals for the Pharmaceutical Benefits Scheme. Her work directly informs health policy and clinical practice, helping to ensure drugs are safe, effective and accessible for the public. A promising early-career researcher, Madeleine is also involved in multiple traditional research projects that build on her early work as a preclinical neuroscientist, helping translate preclinical and early-phase neurological research into clinical approaches using epidemiological techniques.

Madeleine’s curiosity for how the brain works began during her undergraduate years studying psychology, where she focused on neurobiology. In 2013, Madeleine completed her PhD in neuroscience at the University of Newcastle, supported by an Australian Postgraduate Award. Her PhD research focused on the relationship between central immune system activation, stress and mood disorder. Madeleine investigated neuroadaptations in response to chronic stress, examining how neurons and immune cells (microglia) in the brain change when exposed to chronic stress, and then targeted these adaptations with translational compounds, including medicines commonly used to treat infections or mood disorder.

Chronic stress is a known precursor to many disorders, such as depression, anxiety, and cardiovascular disease. By examining how chronic stress changes the brain, Madeleine’s PhD work highlighted how stress-related neurological changes may be associated with depression. The project also measured how antidepressants and other compounds affected these processes.

Before stepping into her current role with the University, Madeleine spent three years working in public health and health planning for a federal government program, running projects in health planning, epidemiology, and mental health. Her love for applied research, especially clinical studies, brought her back to the University in 2015 as a research academic, where she also completed a Master of Clinical Epidemiology in 2017.

Madeleine’s research interests include stress-related disorders (depression, anxiety, PTSD, and cardiovascular disorders); stress associated with chronic disease; health technology assessment; clinical epidemiology; systematic reviews; network meta-analysis; pharmaceutical evaluation; methodological research and cohort studies. Madeleine has published eight articles in peer-reviewed journals and 10 health technology assessment reports. Collectively she is cited over 700 times.


Qualifications

  • Doctor of Philosophy, University of Newcastle
  • Bachelor of Psychology (Honours), University of Newcastle
  • Master of Clinical Epidemiology, University of Newcastle

Keywords

  • Epidemiology
  • Health economics
  • Mental Health
  • Neurological disorders
  • Pharmacoeconomics
  • Pharmacoepidemiology
  • Public health
  • Statistics
  • Stress

Languages

  • English (Mother)

Fields of Research

Code Description Percentage
380108 Health economics 30
420317 Patient safety 20
321403 Clinical pharmacy and pharmacy practice 50

Professional Experience

UON Appointment

Title Organisation / Department
Research Academic University of Newcastle
School of Medicine and Public Health
Australia
Research Academic University of Newcastle
School of Medicine and Public Health
Australia

Teaching

Code Course Role Duration
PUBH6250 Health Economics
School of Medicine & Public Health, Faculty of Health & Medicine, University of Newcastle | Australia
Lecturer 25/2/2019 - 30/6/2019
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Publications

For publications that are currently unpublished or in-press, details are shown in italics.


Journal article (14 outputs)

Year Citation Altmetrics Link
2020 Gyawali P, Hinwood M, Chow WZ, Kluge M, Ong LK, Nilsson M, Walker FR, 'Exploring the relationship between fatigue and circulating levels of the pro-inflammatory biomarkers interleukin-6 and C-reactive protein in the chronic stage of stroke recovery: A cross-sectional study', Brain, Behavior, & Immunity - Health, 9 (2020)
DOI 10.1016/j.bbih.2020.100157
Co-authors Michael Nilsson, Rohan Walker, Linkooi Ong, Murielle Kluge
2020 Higginson S, Milovanovic K, Gillespie J, Matthews A, Williams C, Wall L, et al., 'COVID-19: The need for an Australian economic pandemic response plan', Health Policy and Technology, 9 488-502 (2020) [C1]

Objectives: Pandemics pressure national governments to respond swiftly. Mitigation efforts created an imbalance between population health, capacity of the healthcare system and ec... [more]

Objectives: Pandemics pressure national governments to respond swiftly. Mitigation efforts created an imbalance between population health, capacity of the healthcare system and economic prosperity. Each pandemic arising from a new virus is unknown territory for policy makers, and there is considerable uncertainty of the appropriateness of responses and outcomes. Methods: A qualitative approach was used to review mixed sources of data including Australian reports, official government publications, and COVID-19 data to discern robust future responses. Publicly available epidemiological and economic data were utilised to provide insight into the impact of the pandemic on Australia's healthcare system and economy. Results: Policies implemented by the Australian Government to mitigate the spread of COVID-19 impacted the healthcare sector and economy. This paper incorporates lessons learned to inform optimal economic preparedness. The rationale for an economic response plan concomitant with the health pandemic plan is explored to guide Australian Government policy makers in ensuring holistic and robust solutions for future pandemics. Conclusions: In future, an Australian Economic Pandemic Response Plan will aid in health and economic system preparedness, whilst a strong Australian economy and strategic planning will ensure resilience to future pandemics.

DOI 10.1016/j.hlpt.2020.08.017
Co-authors Laura Wall, Christopher M Williams, Francesco Paolucci, Adrian Melia
2020 Hinwood M, Ilicic M, Gyawali P, Kluge MG, Coupland K, Smith A, et al., 'Exploration of stress management interventions to address psychological stress in stroke survivors: a protocol for a scoping review', BMJ OPEN, 10 (2020)
DOI 10.1136/bmjopen-2019-035592
Citations Web of Science - 1
Co-authors Murielle Kluge, Kirsten Coupland, Rohan Walker, Michael Nilsson, Marina Ilicic
2020 Wall L, Hinwood M, Lang D, Smith A, Bunzli S, Clarke P, et al., 'Attitudes of patients and surgeons towards sham surgery trials: a protocol for a scoping review of attributes to inform a discrete choice experiment', BMJ OPEN, 10 (2020)
DOI 10.1136/bmjopen-2019-035870
Co-authors Francesco Paolucci, Danielle Lang, Laura Wall
2020 Gyawali P, Chow WZ, Hinwood M, Kluge M, English C, Ong LK, et al., 'Opposing Associations of Stress and Resilience With Functional Outcomes in Stroke Survivors in the Chronic Phase of Stroke: A Cross-Sectional Study', FRONTIERS IN NEUROLOGY, 11 (2020) [C1]
DOI 10.3389/fneur.2020.00230
Citations Scopus - 3Web of Science - 3
Co-authors Rohan Walker, Coralie English, Murielle Kluge, Michael Nilsson, Linkooi Ong
2019 Hinwood M, Kluge MG, Ilicic M, Walker FR, 'Understanding microglial involvement in stress-induced mood disturbance: a modulator of vulnerability?', Current Opinion in Behavioral Sciences, 28 98-104 (2019) [C1]

Evidence demonstrating that microglial mediated neuroimmune disturbances play a central role in the aetiology of mood pathology have transformed the landscape within psychiatric n... [more]

Evidence demonstrating that microglial mediated neuroimmune disturbances play a central role in the aetiology of mood pathology have transformed the landscape within psychiatric neuroscience. This article will place in context these recent developments and will place a particular focus on considering how microglia may contribute to shaping the operating environment of the CNS to foster susceptibility and resilience to psychopathology. Specifically, we will consider contributions from microglial priming, microglial modulation of synaptic plasticity, glial modulation of glutamatergic tone, and finally the role of neuroinflammatory disturbances in cerebrovascular integrity. Although much has been revealed about neuroimmune contributions to mood state and psychological health, our understanding of core mechanisms is still very much in a state of flux and it is likely that new insights will continue to shape our understanding well into the future.

DOI 10.1016/j.cobeha.2019.01.001
Citations Scopus - 1Web of Science - 1
Co-authors Marina Ilicic, Murielle Kluge, Rohan Walker
2013 Tynan RJ, Beynon SB, Hinwood M, Johnson SJ, Nilsson M, Woods JJ, Walker FR, 'Chronic stress-induced disruption of the astrocyte network is driven by structural atrophy and not loss of astrocytes', Acta Neuropathologica, 126 75-91 (2013) [C1]
DOI 10.1007/s00401-013-1102-0
Citations Scopus - 94Web of Science - 89
Co-authors Michael Nilsson, Rohan Walker, Sarah Johnson
2013 Hinwood M, Tynan RJ, Charnley JL, Beynon SB, Day TA, Walker FR, 'Chronic Stress Induced Remodeling of the Prefrontal Cortex: Structural Re-Organization of Microglia and the Inhibitory Effect of Minocycline', CEREBRAL CORTEX, 23 1784-1797 (2013) [C1]
DOI 10.1093/cercor/bhs151
Citations Scopus - 171Web of Science - 155
Co-authors Rohan Walker
2012 Tynan R, Weidenhofer JC, Hinwood M, Cairns MJ, Day TA, Walker FR, 'A comparative examination of the anti-inflammatory effects of SSRI and SNRI antidepressants on LPS stimulated microglia', Brain Behavior and Immunity, 26 469-479 (2012) [C1]
Citations Scopus - 209Web of Science - 203
Co-authors Rohan Walker, Murray Cairns, Judith Weidenhofer
2012 Hinwood M, Morandini J, Day TA, Walker FR, 'Evidence that microglia mediate the neurobiological effects of chronic psychological stress on the medial prefrontal cortex', Cerebral Cortex, 22 1442-1454 (2012) [C1]
Citations Scopus - 248Web of Science - 231
Co-authors Rohan Walker
2011 Hinwood M, Tynan R, Day TA, Walker FR, 'Repeated social defeat selectively increases DeltaFosB expression and histone H3 acetylation in the infralimbic medial prefrontal cortex', Cerebral Cortex, 21 262-271 (2011) [C1]
DOI 10.1093/cercor/bhq080
Citations Scopus - 46Web of Science - 39
Co-authors Rohan Walker
2010 Tynan R, Naicker S, Hinwood M, Nalivaiko E, Buller KM, Pow DV, et al., 'Chronic stress alters the density and morphology of microglia in a subset of stress-responsive brain regions', Brain Behavior and Immunity, 24 1058-1068 (2010) [C1]
DOI 10.1016/j.bbi.2010.02.001
Citations Scopus - 307Web of Science - 287
Co-authors Eugene Nalivaiko, Rohan Walker
2009 Walker FR, Naicker S, Hinwood M, Dunn N, Day TA, 'Strain differences in coping behaviour, novelty seeking behaviour, and susceptibility to socially conditioned fear: A comparison between Wistar and Sprague Dawley rats', Stress: The International Journal on the Biology of Stress, 12 507-516 (2009) [C1]
DOI 10.3109/10253890802673134
Citations Scopus - 15Web of Science - 14
Co-authors Rohan Walker
2008 Walker FR, Hinwood M, Masters LM, Dielenberg R, Day TA, 'Individual differences predict susceptibility to conditioned fear arising from psychosocial trauma', Journal of Psychiatric Research, 42 371-383 (2008) [C1]
DOI 10.1016/j.jpsychires.2007.01.007
Citations Scopus - 22Web of Science - 20
Co-authors Rohan Walker
Show 11 more journal articles

Conference (7 outputs)

Year Citation Altmetrics Link
2012 Walker FR, Tynan R, Hinwood M, Woodworth SB, 'The role of microglia in cognitive disturbance: A new frontier in the neurobiology of stress', Brain, Behavior, and Immunity, San Diego, CA (2012) [E3]
Co-authors Rohan Walker
2011 Walker FR, Tynan R, Day TA, Ng A, Hinwood M, 'What have microglia got to do with it? New directions in the neurobiology of depression', Brain, Behavior, and Immunity, Chicago, Illinois (2011) [E3]
Co-authors Rohan Walker
2008 Hinwood M, Walker R, Day TA, 'Characterisation and cellular specificity of the [triangle symbol] FOSB response to chronic social stress in rat infralimbic cortex', Australian and New Zealand Journal of Psychiatry, Newcastle, NSW (2008) [E3]
2007 Hinwood M, Walker FR, Day TA, 'Characterisation of fosB response in rat forebrain following exposure to chronic social stress (Poster)', 7th IBRO 2007 World Congress of Neuroscience Program, Melbourne (2007) [E3]
Co-authors Rohan Walker
2007 Walker FR, Hinwood M, Masters LM, Dielenberg R, Day TA, 'Individual differences predict susceptibility to conditioned fear arising from psychosocial trauma (Poster)', 7th IBRO 2007 World Congress of Neuroscience Program, Melbourne (2007) [E3]
Co-authors Rohan Walker
2006 Paton BK, Hinwood M, Budd TW, 'The effects of MR scanner noise on auditory thresholds: a psychoacoustic study using SAM white noise, pure tones and complex tones', Clinical EEG and Neuroscience V37, April 2006, Proceedings of the 15th Annual Conference of the Australasian Society for Psychophysiology, University of Wollongong, Sydney, Australia (2006) [E3]
Co-authors Bryan Paton, Bill Budd
2006 Hinwood M, Paton BK, Budd TW, 'Acoustic masking by EPI gradient sounds on detection thresholds for amplitude modulation as a function of a modulation rate', Clinical EEG and Neuroscience V37, April 2006, Proceedings of the 15th Annual Conference of the Australasian Society for Psychophysiology, University of Wollongong, Sydney, Australia (2006) [E3]
Co-authors Bryan Paton, Bill Budd
Show 4 more conferences

Other (3 outputs)

Year Citation Altmetrics Link
2020 Paolucci F, Lee D, Wall L, Hinwood M, Antonini M, 'A $200 fine for not wearing a mask is fair, as long as free masks go to those in need', (2020) [O1]
Co-authors Francesco Paolucci, Laura Wall, Doowon Lee
2020 Milovanovic K, Higginson S, Gillespie J, Wall L, Moy N, Hinwood M, et al., 'COVID-19: The Need for an Australian Economic Pandemic Response Plan', : SSRN (2020)
DOI 10.2139/ssrn.3663929
Co-authors Christopher M Williams, Laura Wall, Francesco Paolucci
2017 Bell R, Prior F, Bell J, Hinwood M, O'Hara K, Goon L, 'Exercise and Weight Loss Supplements: Understanding the risk', (2017) [O1]
Co-authors Robin Bell
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Grants and Funding

Summary

Number of grants 6
Total funding $8,887,427

Click on a grant title below to expand the full details for that specific grant.


20213 grants / $475,592

Using a national level multi-registry analysis to determine whether prescribed anti-platelet therapies post-stroke can modify the risk of cognitive decline or dementia$452,550

Funding body: NHMRC (National Health & Medical Research Council)

Funding body NHMRC (National Health & Medical Research Council)
Project Team Professor Michael Nilsson, Professor Rohan Walker, Frederick Walker, Georg Kuhn, Georg Kuhn, Professor John Attia, Sara Gustavsson, Dr Sara Gustavsson, Georg Kuhn, Doctor Madeleine Hinwood, Jenny Nyberg, Dr Jenny Nyberg, Jenny Nyberg, Doctor Christopher Oldmeadow, Doctor Marina Ilicic, Sara Gustavsson, Professor Neil Spratt, Professor Chris Levi, Dr Leeanne Carey
Scheme Ideas Grants
Role Investigator
Funding Start 2021
Funding Finish 2023
GNo G2000554
Type Of Funding C1100 - Aust Competitive - NHMRC
Category 1100
UON Y

Determine whether prescribed anti-platelet therapies such as Clopidogrel can modify the risk of cognitive decline or dementia post-stroke$18,182

Funding body: Hunter New England Local Health District

Funding body Hunter New England Local Health District
Project Team Conjoint Associate Professor Michael Pollack, Doctor Marina Ilicic, Doctor Madeleine Hinwood, Professor Michael Nilsson, Professor Rohan Walker
Scheme John Hunter Hospital Charitable Trust Grant
Role Investigator
Funding Start 2021
Funding Finish 2021
GNo G2100339
Type Of Funding C2400 – Aust StateTerritoryLocal – Other
Category 2400
UON Y

Statistical support for data linkage and cleaning associated with establishing a large linked stroke dataset$4,860

Funding body: Hunter Medical Research Institute

Funding body Hunter Medical Research Institute
Project Team Doctor Madeleine Hinwood
Scheme Research Grant
Role Lead
Funding Start 2021
Funding Finish 2021
GNo G2100140
Type Of Funding C3300 – Aust Philanthropy
Category 3300
UON Y

20202 grants / $206,936

Health Technology Assessment, Research Support and Other Services Panel$178,382

Funding body: Department of Health

Funding body Department of Health
Project Team Ms Danielle Lang, Mr Rob Bell, Mr Marc Bevan, Doctor Emily Walkom, Mr Jarrod Bell, Ms Lynn Goon, Doctor Madeleine Hinwood
Scheme Project Grant
Role Investigator
Funding Start 2020
Funding Finish 2020
GNo G2000297
Type Of Funding C2100 - Aust Commonwealth – Own Purpose
Category 2100
UON Y

Research Funding for Treatment of alcohol dependence with an mTOR inhibitor (TAMI) Study$28,554

Funding body: Hunter New England Local Health District

Funding body Hunter New England Local Health District
Project Team Conjoint Professor Adrian Dunlop, Doctor Amanda Brown, Professor Chris Dayas, Doctor Madeleine Hinwood, Professor Jennifer Martin
Scheme Research Funding
Role Investigator
Funding Start 2020
Funding Finish 2023
GNo G2000584
Type Of Funding C2400 – Aust StateTerritoryLocal – Other
Category 2400
UON Y

20161 grants / $8,204,899

Provision of external evaluation of Pharmaceutical Benefits Advisory Committee (PBAC) and health technology related submissions$8,204,899

Funding body: Department of Health

Funding body Department of Health
Project Team Ms Danielle Lang, Mr Jarrod Bell, Mr Rob Bell, Mr Marc Bevan, Ms Lynn Goon, Doctor Madeleine Hinwood, Doctor Emily Walkom, Miss Chiara Berardi
Scheme Consultancy/Tender
Role Investigator
Funding Start 2016
Funding Finish 2021
GNo G1601071
Type Of Funding C2100 - Aust Commonwealth – Own Purpose
Category 2100
UON Y
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Research Supervision

Number of supervisions

Completed0
Current2

Current Supervision

Commenced Level of Study Research Title Program Supervisor Type
2020 PhD To What Extent are Hybrid Healthcare Systems Converging? Economic Analysis of the Implications of Hybridity on Health, Well-being and Performance PhD (Economics), College of Human and Social Futures, The University of Newcastle Co-Supervisor
2020 PhD The Economics of Pandemics: an Evaluation of the Micro and Macro Effect of the COVID-19 Pandemic and its Effects on the Healthcare System PhD (Health Economics), College of Health, Medicine and Wellbeing, The University of Newcastle Co-Supervisor
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Research Projects

Patient and Surgeon preferences for sham surgery trials 2019 -

Publications

Wall L, Hinwood M, Lang D, Smith A, Bunzli S, Clarke P, et al., 'Attitudes of patients and surgeons towards sham surgery trials: a protocol for a scoping review of attributes to inform a discrete choice experiment', BMJ OPEN, 10 (2020)

Bunzli S, Choong E, Shadbolt C, Wall L, Nelson E, Schilling C, et al., 'Placebo Surgery Controlled Trials: Do They Achieve What They Set Out To Do? A Systematic Review.', Ann Surg, 273 1102-1107 (2021)

Collaborators

Name Organisation
Professor Francesco Paolucci University of Newcastle
Doctor Madeleine Hinwood University of Newcastle
Ms Danielle Leigh Lang University of Newcastle

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Dr Madeleine Hinwood

Position

Research Academic
Newcastle Evaluation Group
School of Medicine and Public Health
College of Health, Medicine and Wellbeing

Contact Details

Email madeleine.hinwood@newcastle.edu.au
Phone (02) 4014 3013

Office

Building Level 5, Clinical Sciences Building.
Location Mater Hospital, Edith Street Waratah

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