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All Posts in Category: PLDC Over the Years

The Prescription Opioid Epidemic: How Our Office Has Reacted

While watching television the other night, my husband tuned to a documentary about the opioid epidemic our nation is facing. I half listened to the program while I was finishing up some work on the computer. The program got me thinking about how prescription medications have changed drastically for the dental community and, more specifically, Pike Lake Dental Center over the last number of years.

20+ years ago, when I worked in the front office at Pike Lake Dental Center, it was easy to simply call in a prescription for Lortab. Dr. Matt would prescribe the drug for our patients to control pain associated with toothaches and extractions or large procedures that might cause some discomfort after the anesthetic wore off. The opioid drugs, Lortab in particular, seemed to be miracle drugs. The medication was easy and inexpensive to obtain. It worked really, really well to manage pain. It seemed wonderful… at first. Little did we know as providers, consumers and as an entire society just how dangerous and addicting these drugs would be!

About 10-15 years ago, a shift slowly started to take place. We started to hear more about drug-seekers, people who would call dentists after hours or on the weekends claiming they were in severe pain and hope the dentist on call would choose to prescribe medication over the phone versus going into the office on the weekend. That same drug-seeking individual might call multiple dental offices and also visit the emergency room, attempting to acquire the same prescription drugs in large quantities. Sometimes we heard about these people through our friends in the dental community. Sometimes a pharmacy would tip us off that it was this person’s second or third prescription for the same drug in a short amount of time.

Thankfully, it has been our office policy for as long as I can remember that we DO NOT come into the office in the evenings or on the weekends to see a person who isn’t a patient of record. This policy was put in place to protect our staff from the possible dangers meeting a stranger at night in an empty office might bring. It is also against our office policy to prescribe medications to individuals who are not patients of record at our office, thus relieving us of the decision to call in a prescription for a desperate “potential” patient seeking prescription medications late at night or on the weekends. Instead, we refer them to the local emergency room, which is always open and staffed with extremely capable physicians to help manage pain.

I remember being particularly alarmed and immediately suspicious when a patient would claim, “Only the 10 mg. Lortab tablets work for me. Could I get 30 of them, please?” It seemed awfully convenient that they knew what drug and just how much of it they desired on a Saturday night. Looking back, I wonder how often these drugs were blindly prescribed across America for patients, all parties involved having no idea how harmful and addictive the drugs could and would be.

Slowly, very slowly, we began opening our eyes as a society to the dangers of the prescription narcotics. We, as dental professionals, were also learning more about the addictions patients faced while consuming the drugs. The movement took years and sadly cost many people addicted to opioids their families, their homes, their jobs and, for some, their lives.

Recently, the FDA has clamped down on prescription opioids. The dependencies people have developed to the drugs have reached epidemic levels throughout the United States. Drastic and immediate measures needed to take place to control the opioids and I believe we are starting to see a positive change. Education on the drugs and their potential hazards are more widely shared with the public. We are now aware of the frighteningly fast rate of dependency some people suffer from with opioids.

Today at Pike Lake Dental Center, we almost never prescribe narcotics for our patients. Instead, we give our patients detailed instructions for managing their pain without strong and potentially addictive prescription medications. It is amazing how discomfort can be controlled by means other than potentially addicting prescription medications.

The way prescription opioids are ordered by practitioners through pharmacies has also dramatically changed over the years. No longer can an office simply call a pharmacy and order up 10 tablets of Lortab for a patient. A computer generated, watermarked prescription must be printed and signed by the ordering dentist or physician and be hand delivered to the pharmacy by the patient. We don’t even have the old-school prescription pads at our office anymore. Instead of large quantities of the medications, we now prescribe 2 or 3 pills at a time, not 10, and certainly no refills without carefully monitored patient progress.

As I cleaned out our family medicine cabinet recently, I found some opioids my daughter’s surgeon had prescribed for her a few years ago following a broken arm and emergency surgery. Knowing the risks of these drugs, we had successfully managed her pain with over the counter medications. The entire prescription remained forgotten in our medicine cabinet for years. What was the best way to dispose of the pills? I didn’t want them falling into the wrong hands or harming the environment. I did some research and found some valuable information for safe and local disposal of medications.

If you are looking to safely dispose of any medications you may have at home, please refer to these local websites:

St. Louis County Sheriff’s Office website

St. Louis County website (for our friends on the Iron Range)

WLSSD website

Listed on each of these linked websites are instructions and locations on how and where to safely dispose of any unwanted household over the counter or prescription medications, even unused pet medications. If you don’t live near Duluth or on the Iron Range of Minnesota, please search your local county or city websites for more information on how and where to safely dispose of medications. Safely disposing of these drugs is important for people, pets, wild animals and our environment.

As an entire society and as an independent dental practice, I feel we have made great progress to limit the amounts of opioids prescribed to patients. I am thankful that it’s much harder to prescribe and to acquire the drugs than it was just 10 years ago. I’m also thankful we are all finally aware of the dangers of opioids. Knowledge is key, especially when it comes to prescription medications.

Written and submitted by Stephanie Jugovich, staff member at Pike Lake Dental Center

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Time Flies When You’re Cleaning Teeth

Many of you read Stephanie’s recent post about the history of Pike Lake Dental. As she mentioned, she began her employment there in 1998, and Dr. Matt purchased the practice in 1999. BUT … long before that … 1984, to be exact … a young, fresh out of school, wide eyed hygienist burst onto the Pike Lake Dental scene ready to save the world one mouth at a time!

I remember the first day I walked into the office. At that time, it was located in the geodesic dome. (How many of you know that Pike Lake Dental started its life on the same side of the road that it is currently located?) As I entered the atrium-like lobby, I was greeted by a mustachioed man with wire rimmed glasses enjoying his newspaper. I recall being impressed with the bright sun streaming in through the large triangular windows overhead, and the whole concept of the dome building, in general. I had never been in a dome before! The man with the newspaper was Dr. Carter Johnson. Over the years, the dome would come to represent, for me, the fact that Carter was clearly a man who thought outside the proverbial box! He was a delight!

Dr. Carter with Deb’s son at his first dental appointment.

So speeding through this part:

-I get the job!!!
-I work for Carter for 16ish years
-Sadly, Carter falls to cancer
-Matt buys the practice (lucky guy gets this really awesome hygienist in the deal!)
-We grow to the point that we burst the seams of the dome
-We build and move across the highway
-And here we are today, still growing! Part of the reason for that is that Dr. Matt doesn’t let any grass grow under his feet! Pike Lake Dental is “state of the art”!

A lot has happened since 1984. In the time that I have practiced hygiene, we have gone from “wet finger” gloveless dentistry, wearing street clothes at the office, and wearing no protective eyewear or masks, to being fully enrobed in barrier protection and wearing scrubs that get washed in-house at the end of the day. Protection for us, protection for the patient.

Another change our office made some time ago, was the switch to digital x-ray. Prior to that, we used films that left us blind as to our success until that film took a five minute ride through the automatic processor. Now we see our results instantly! And speaking of the automatic processor -the old AT-2000- it was a machine that was filled with chemicals that needed changing on a regular basis, and the chemicals required special testing and disposal. It was also filled with a series of rollers and gears to carry the films through the chemicals. With all those moving parts, as you can imagine, it broke down on a regular basis. Needless to say, we don’t miss it, and are loving our updated equipment. In addition to digital bitewing x-rays, we also have a digital panorex, or full mouth machine. This machine can also take 3-D images to help Dr. Matt and Dr. Meaghan in some procedures they perform, such as dental implants.

That brings up another amazing advance in our in-office technology. When I first started at PLD, crowns were sent out to a lab to be produced. A patient would come in to have the tooth prepared, the doctor would place a temporary crown, and the patient would return two weeks later to place the lab crown. Actually, one of the dentists that we worked with made his own crowns in the office. It involved waxing up a model, putting it in plaster, heating it to melt the wax, and then melting a gold alloy, and casting it by putting it into a hand-spun centrifuge to force the gold into the mold! Super cool and crafty, but a ton of work … not to mention that it was time away from patients! Now, although there are occasional reasons to send out for a lab crown or bridge, most are done in-office and are typically completed within 1 1/2 hours! AND, beyond that, our office is trained and equipped to offer dental implants!

When I began at PLD, the thought of doing a dental implant as a routine in-office procedure was just a futuristic glimmer in a general dentist’s eye! In the past, when a patient lost a tooth, it would likely have been replaced with a partial denture or a bridge. Then implants came onto the scene! I remember our first implant cases. They had to be very committed patients, as they would have to travel to the Twin Cities to have much of their work done!! When this procedure made its way north, it still required the patient dancing between the oral surgeon and the dentist. Now, technology and training have brought implant placement right into Pike Lake Dental! I was talking to Dr. Matt a few days ago about a conversation I’d had with Dr. Johnson many years ago. When we started seeing so many patients coming in either having had, or aiming toward hip/knee/shoulder replacement, Carter told me that within short order, having a joint replaced would be as common as having a crown or a root canal done … and he was right! Now, that same story come true with dental implants Dr. Matt feels the procedure is going to become even quicker and easier in a very short time! Our CAD/CAM technology is an amazing thing, and our highly trained staff allows PLD to offer our patients cutting edge treatment! I see and work with these advances every day, and I am still astounded by them!

Now, moving forward … literally … even our front office staff members are riding the technology wave! I remember when scheduling was done in a binder with paper pages (and a fair amount of eraser leavings)! Our receptionist would flip through the pages with her pencil in hand, looking for appointment times for our patients. As you might expect, after six plus months of flipping through them, adding and erasing names, the pages became quite tattered! I also remember when it was time to move the scheduling to the computer. It would be so much more tidy and efficient to schedule this way! Our receptionist, however, was not convinced! The thought of all those patients helplessly floating in a computer instead of being safe in a book in front of her was daunting! I swear to you, it was like a child giving up a pacifier! The switch was made, and it did, indeed, prove to be just as tidy and efficient as promised … most days!

Gone are the days of hand writing insurance claims and trying to read patients’ accounts off a tiny microfiche that might be a month behind in it’s information. Our computer system keeps staff quite up to date to answer patient questions. Gone, also, are the days of calling every patient (which, currently, could easily be up to 50 individuals, or more) to remind them of their upcoming visit. Patients are phoned automatically, as well as having the option of an email or text message.We have also gone “paperless” with patient files. It definitely does not mean less work … I can vouch for this … but, again, it is a much more efficient and secure way to manage our patients’ information!

There are so many more things I could write about, but I think the point has been made. In 33+ years, Pike Lake Dental has seen me change from a single work force neophyte, to a wife, a mom, a seasoned vet, and, hopefully in a few years, a retiree! I, in turn, have watched Pike Lake Dental grow into a formidable, yet comfortable practice. It has been fun to see the evolution and innovation! And what’s even better, is that there’s more on the horizon! I can’t wait to see what’s next!

Written by Deb Trethewey, RDH at Pike Lake Dental Center

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Are Dentists Typically Pack Rats?

In a word: YES!!!

I pulled open a drawer in our office lab a couple months ago and found this note on a cardboard box containing a hand mirror. This is Monty’s handwriting. I couldn’t help but smile when I saw this – partly because I still miss Monty (who retired a year or so ago from our office) and partly because this puts into words what we experience so often in the dental field. This is 100% real. I couldn’t make this stuff up. Seriously.

Our storage closet, just of Dr. Matt’s office.

We have a closet, located in Dr. Matt’s office, that houses supplies and other important necessities – like this straw hat. It’s an organized mess. I was digging around in there with Nancy one day in an attempt to clean some things out and gain some additional storage space. Among many other things, we found the box for our E-Z Press, a press that Matt used to replace the bearings in our dental handpieces. The E-Z Press was a great tool to have and saved us a ton of money by replacing the worn-out components in our handpieces ourselves and not having to send them out for repair. We don’t own any of those handpieces anymore. So why do we keep the E-Z Press around? You got it: Just in case.

The E-Z Press.

We have changed the artwork throughout the building a few times in the years we’ve been in the new office. Behind the door of Dr. Matt’s office is a perfect place to store old artwork. Why do we hang into it? Just in case.

Some of the artwork we’ve had up in the office over the years.

You’d like to see a dental journal from the year 2013? Which month? We have them all!

Dental journals from 2013 to present.

Now, our office is not unique. Dr. Johnson, the dentist Dr. Matt purchased Pike Lake Dental Center from, saved a ton of stuff too. When we moved from the geodesic dome across the highway to our new building, we were able to get rid of a lot of old things that were obsolete. I’m pretty sure we also transferred a few things to our new building during the move.

I finally passed along our old assisting chairs that belonged to Dr. Johnson this past summer to our nephews for their hunting shack. Out of our pole barn and into their hands. That was a small success.

Dr. Matt also has saved this very special boombox from his college years. This little gem is housed in a closet at the office. If tapes ever make a comeback, we will be ready!

Dr. Matt’s boombox from the 1980s.

An old door to the office? Don’t you worry – we have it in the shed! You never know when an extra door will come in handy.

Dr. Matt’s ADA membership card from 2005? We’ve been saving it for just this moment!

ADA membership card from 2005.

We also used to save old hand instruments “just in case”. Nancy and I recently went through a big bin of instruments I had cleaned out of Dr. Matt’s desk drawer. He used to save them for patients who then used them for wood carving or in their garages. We had about 5 pounds of dental instruments we were able to recycle. It was a small win, but recycling all those instruments was a win!

Sterile, but old, instruments ready to be recycled.

Rest assured, we keep a clean and efficient office in the clinical and front desk spaces. Behind the scenes, in a closet or desk drawers or the shed out back, we also keep a lot of things we really don’t need. I think dentists in general are pretty cost-savvy and practical. Also, they never know when they might need something. In Matt’s defense, he is able to fix a lot of things within the office himself and having spare parts on hand is very useful in those circumstances.

After so many years together, I figure the best way to look at the “just in case” things we have accumulated over the years is simply with a smile.

Written and submitted by Stephanie Jugovich

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The Short Story of Pike Lake Dental Center

When I started at Pike Lake Dental Center in 1998, I worked for Dr. Carter Johnson in the geodesic dome across the street from our current office location. Carter was ill with cancer the entire time we worked together. I remember him as being bald with a big smile, that he dry-brushed his teeth in the car on his commute to and from work, and that he highly valued continuing education. He was quick with compliments and he had many adoring, loyal patients. Carter was a very special guy. He knew his cancer was terminal and wanted his dental practice to continue on in good hands. I remember him coming into my office, plunking down in the second chair, and telling me, “You should get that boyfriend of yours to buy my practice.” It took some months and negotiating, but we finally convinced my boyfriend to make the move.

Late 1998, just after Matt and I started dating.

Matthew Jugovich, DDS purchased Pike Lake Dental Center in 1999. He left his job with Dr. Kim Chart on 4th Street in the Central Hillside neighborhood of Duluth and began practicing solo at Pike Lake Dental Center with a lot of dreams and a little debt. Together, we sent out a letter to Matt’s “4th Street patients”, as we affectionately still call them today, telling them of his departure from one practice and ownership of another.

The geodesic dome, the original home of Pike Lake Dental Center.

I asked Matt how many patients he thought would follow him up over the hill and he replied with, “My family for sure.” That was about a total of 8 people. No worries. We could handle that number along with Dr. Johnson’s patients.

Not only did Matt’s family members follow him, but an outstanding number of loyal, amazing patients followed him too. You guys know who you are and we are privileged to still call you our friends today, all these years later. Most of the “Carter patients”, as we affectionately call them, also chose to stay and see the new guy.

Our sign (and our old car and motorcycle) at the geodesic dome.

We started out small with 3 dental chairs (two doctor chairs and one hygiene chair) and Carter’s 5 employees, plus Dr. Matt. Two of us gals worked up front. We ran the phones, handled the schedule and all the billing aspects of the office. The office also employed two assistants, one of whom was Monty (recently retired in 2016), and one hygienist, Deb, who is still with our office today. It was a perfect staff for an office that size. We worked well together and were excited to keep Pike Lake Dental Center continuing on with new leadership.

The geodesic dome.

The geodesic dome had its unique challenges, space being our primary struggle. Under Dr. Matt’s lead, we were busier than we had been with Dr. Johnson while he was ill. Pike Lake Dental Center was growing quickly! Essentially, we had combined two dental practices, Dr. Matt’s and Dr. Johnson’s, into one. Within a few years, it was painfully obvious: we were outgrowing the building and there was no room for expansion at our current location.

Our former home and the future location of Pike Lake Dental Center.

A residential home went up for sale across the street from the geodesic dome and Dr. Matt jumped at the chance to purchase it. He put his little house in Woodland up for sale and moved into the house on Miller Trunk Highway. In the meantime, Matt and I got engaged. We were married in 2002, had our first baby and started building a house in Hermantown in 2003. We moved into our house, had another baby in 2004 and immediately began plans to move the house off the property in Pike Lake and build a new dental office in its place. We moved into the new office in December of 2004. Because we are a little bit crazy, we had our third – and last – child in 2005. It was truly a whirlwind of three or four years. We were young, in love and ready to tackle the world.

Inside the current Pike Lake Dental Center.

At the time of the move to the new office, we thought 6 dental chairs (three doctor chairs and 3 hygiene chairs) was more room than we could ever need. The office was clean, spacious and every piece of new equipment worked. It truly was a dream come true to work in the new office. We slowly added staff as we continued to steadily grow over the years in the new building. Sue, Nancy and Lisa would have joined us around this time.

During these early years, Matt assumed an astronomical amount of debt. In the span of just a handful of years, we had purchased Carter’s dental practice, bought a house, built a new house, built the new office and purchased all the equipment needed for the new office. When I heard the final total of our debt for the entirety of Pike Lake Dental Center, I will admit I was nauseous for a long time. How in the world could we pay back all that money? Why in the world had we been allowed to borrow so much? Matt was fiercely driven and rose to the challenge. There were many sleepless nights and countless hours spent worrying, but I am very proud to say we never missed a payment on anything. Ever. In fact, we managed to pay most of the loans off early. Just last month, we made our last payment to Wells Fargo for the building. We officially own the entire dental office free and clear now. Whew! That is a huge accomplishment!

Pike Lake Dental Center building mortgage PAID IN FULL!!!

Today, we are again bursting at the seams with 15 employees and Dr. Matt. Of the original Dr. Johnson staff, only Debbie and I remain. Our lunchroom is standing room only. We always try to creatively maximize each day’s schedule to the best of our ability. Matt has continued to add new technology and procedures to the office, always maintaining his high standards of patient care. We have experienced overwhelming growth and loyalty from our patients. Is it time to add onto the office again? Only time will tell.

We are packed in like sardines but we still manage to have fun!

As I reflect on the changes Pike Lake Dental Center has undergone in the years since I started working here, I am truly amazed. Matt’s determination and drive has continually taken Pike Lake Dental Center to new and challenging heights. I also find myself beaming with pride for all he’s accomplished. I hope Dr. Johnson would be proud of Pike Lake Dental Center today, a dental practice he literally started from the ground up. I am eternally thankful for the wonderful patients and staff we have had the privilege of serving and working with these nearly 20 years. Without you, Pike Lake Dental Center wouldn’t and couldn’t exist. So, from the bottom of our hearts, THANK YOU!

Dr. Matt and Stephanie, young and in love in 2001.

Written and submitted by Stephanie Jugovich

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Happy Holidays from the Jugovich Family!

Happy Holidays! What a year 2017 has been for our family! We hope this joyous season finds you and yours happy and healthy. I’ll give you a quick rundown on each of us…

Campbell and Ollie relaxing on the pontoon.

Campbell is a Freshman already. She is finishing up drivers ed and is ready for her permit as soon as she turns 15 in January. She plays golf and volleyball, and is also involved in a few clubs at school. Campbell is co-managing the JV and Varsity boys basketball team this season and is loving the role. Upper School has been especially awesome for her so far. She has developed many new friendships this school year and is constantly Snapping, texting or Instagramming friends. As the oldest, she’s our overachiever and perfectionist. She’s also one of the coolest people I know.

Jack with a nice bass off our dock.

Jack is 13 and in 8th grade. He is our basketball and soccer player. Jack has blossomed in the past year and a half from a kid who wanted to be invisible at school into a kid who has tons of friends and brims with self confidence. He is a textbook middle child and is a much more relaxed kid than his sisters, which is both a blessing and a curse. Jack is also crazy funny. Sometimes I laugh until I cry over his stories and jokes. He is constantly jumping, throwing a ball and “breaking our ankles” (faking like he’s going one way, then cuts the opposite way and makes us alter our course). He spent many, many hours fishing off the dock this summer, catching and releasing sunnies and bass. Jack’s two greatest loves remain his phone and candy. We are so excited to see how Jack will continue to develop in both personality and height in the coming years. He’s shot up many inches already this past year.

Katie is a fantastic captain!

Katie is about to turn 12 and is rocking 6th grade. She’s still a little spit-fire and keeps us on our toes with her passionate personality. That said, she’s also the kid who will fiercely defend her friends and is so compassionate she’s brought me to tears on more than one occasion. She’s a fantastic reader and always has a handful of books she’s reading at once. She completed her ATV safety class and can’t wait to drive the 4 wheeler a lot this coming summer. Kate played Junior Olympic volleyball last winter and is excited for the season to start up again soon. She just told me today she plans to play volleyball, basketball, golf, tennis and maybe run cross country for school next year. If anyone is going to conquer it all, it’ll be Katie The Legend (yes, she has created that catchy name for her future 6’2” self).

Matt and a beautiful Lake of the Woods walleye.

Matt seems to always have something up his sleeve. If there isn’t a project or idea already in the works, he’s cooking a new one up. There’s no rest for the weary and he oftentimes reminds me of the Energizer Bunny. He captains our boat and fishes like a pro. He works hard and plays hard. In October, he and a buddy headed to New Mexico for an elk hunt. He came back without an elk this time, which is just fine – we have a lot of other meat in the freezer. Matt remains busy at the office. He’s constantly looking to make the practice better, more productive and more efficient. Thankfully, he has a great team and everyone works well together. I am so proud of everything he’s created there!

My annual birthday selfie – 29 again!

I went back to work part-time in February. I really enjoy what I do and love to be back at the office again. I’m still trying to find that elusive, perfect balance of home and work. If you’ve got any pointers, I’m all ears. I keep busy running the kids to and from school, and to their never-ending activities. It’s common for me to put 400+ miles on the family vehicle in a week and not travel farther than a 20 mile radius from home. I’m happy to play the role of #1 fan at all the kids’ sports. I still read as much as I can – over 150 books in 2017 already. I will always love camping and boating; the fishing we do is just an added bonus. I treasure family time and warm weather – I can never get enough of either one!

Alvin.

Ollie.

The dogs, Alvin and Ollie, are happy and healthy and finally get along. Ollie was trained in Northfield for a couple months this year and has the skills to be a fantastic hunter. He also went to South Dakota with Matt for a short pheasant hunt in October and did a great job. He loves the water! Alvin enjoys riding in the car and fearlessly protecting our yard from squirrels, chipmunks, rabbits, deer and birds. Ollie is Alvin’s faithful sidekick, but is not nearly as diligent in his patrol.

Soaking up the sun and practicing our Spanish in Mexico.

We have many highlights from the past 12 months. Aruba has turned into our go-to place for a winter escape in February the past few years. All five of us enjoy a week of warm weather, relaxation, sun and sand. I took the kids to Mexico in March. It was an amazing trip! The Baudette  area on Lake of the Woods continues to be our favorite camping and fishing spot. We spent many weekends up there last summer and are already looking forward to more memories there in 2018. We took a quick trip to Nebraska to see the solar eclipse in August. The total eclipse was one of the coolest things we’ve ever experienced. Matt and I also celebrated our 15th wedding anniversary in August.

A little slice of heaven on Bass Lake.

We are very excited about our cabin lot on Bass Lake, just outside Biwabik. We spent many hours playing and working there this past spring and summer. The campfires and pontoon rides around the lake are some of our favorite memories. We hope to build a cabin of our own on the property next summer. There is still an overwhelming amount of work to do, but we have a vision. If you’re ever in the area, please stop by!

We wish you peace, health and happiness in 2018. Enjoy every moment you spend with the ones you love. Soak up the memories. Share your love and talents with others. Count your blessings. There are so many things to be thankful for!

With warmest thoughts this Holiday Season and always,

~Stephanie, Matt, Campbell, Jack and Katie Jugovich

Just after viewing the total solar eclipse in Nebraska.

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