transport - objective safety
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EMS Fleet Telematics and
Nadine Levick, MD MPHResearch Director, EMS Safety FoundationCEO, Objective Safety, New York, USAChair, TRB, EMS Subcommittee, National Academies
Telematics and Safety Technology
Tools
97% are routineONLY 3% are life threatening critical
EMS Transport Surprising FACTS
g25% there is NO Patient TRANSPORTED
Vehicle/Fleet SafetyOccupant protectionDriver performance monitoring and feedback
Key elements to fleet transport safety policies
feedbackHours of serviceDriver/provider wellness and fitnessDriver/provider impairmentPublic safety
Transport Medicine
Impact BiomechanicsTransport ErgonomicsTransport ErgonomicsFleet Safety
A “Fleet” to many in Emergency Medical care means….
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CrashworthinessVehicle designO t t ti
Impact biomechanics
Occupant protection
Operational tasksHuman factors analysisRange of reach
Transport Ergonomics
Range of reachPatient loading and unloading
Operational policies – dispatch, safetyFleet mixVehicle selection – safety, ESC, loading heightDriver performance and monitoring
Fleet safety
Driver performance and monitoringScene safetyVisibility and conspicuitySafety measurement and management
Evidence in clinical studiesvs
evidence in engineering
Parachutes reduce the risk of injury after gravitational challenge, but their effectiveness has not been proved with
randomised controlled trials
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When it comes to engineering, the laws of physics prevail…
The Laws of Physics Prevail..
Philosophiæ Naturalis Principia Mathematica, July 1687
Change and Innovation
• Improved data systems for injury• Enhanced data on denominator• New technologies• New policies/standards• Interdisciplinary collaboration
R & D“Ripoff and Duplicate”
Avoid reinventing the wheel at all costs
Where are the best practices that we need to transfer knowledge from
TRB MISSION
To provide leadership in transportation innovation and progress through research and information exchange, conducted within a setting that is objective, interdisciplinary, and multimodal.
Special role for EMS at TRB
One of the Key 4 E’s–Engineering–Education–Enforcement–Emergency Medical Services
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Transportation Research Board is an excellent resource… we should be
using it!!ANB10 (5) TRB EMS
Subcommittee Mission'Bridging the gap between what we do and what is known
E h i b l t t- Enhancing ambulance transport safety through shared knowledge of technical data'.
Fragmentation Panacea
ANB10(5) is an independent platform for:Bringing fragmented information togetherUniting diverse disciplinesUniting diverse disciplinesFocus on technically robust information
One Day event, 30 presentationsHeld in Washington DC, Keck CenterSimulcast Live to EMS Today
2012 EMS Safety Systems, Strategies and Solutions Summit
Simulcast Live to EMS TodayLive Webinar Access - globallyOver 100 participants live across 3 continentsGreater that 10,000 downloads of handouts within the first week!!
Opening Address: A.J. HeightmanSafety Developments Update – N. Levick Research needs assessment forms explained – E. Frazer1: Data and Recent Initiatives
2: Transport, Human Factors - Bridging Diverse Disciplines
3: Testing and Standards
The 2012 TRB EMS Safety Summitprint this page & your smart phone will play the 8 sessions from the eTags! (even in B&W)
4: New systems safety technology solutions & telematics
5: Fleet management strategies
6: Innovative Vehicle Design
7: Operationalizing Safety
8: Panel: How to optimize the safety of your existing fleet Wrap up – from Prof. Art Cooper
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The 2012 TRB Safety Systems, Strategies and Solutions Summit
a GRATIS resource for anyone, anywhere in world,
and also via your smartphone
4:New systems safety technology solutions & telematics
http://www.emssafetyfoundation.org/2012TRBSummitAgendawithLinks.pdf
TRB 2012 Summit – addressed the key and interdisciplinary applied solutions issues, in one day – please seek that information out. www.objectivesafety.net/TRBSummit2012.htmThere have been two prior TRB Summits held,
Its out there NOW
There have been two prior TRB Summits held, 2008, 2009 and both with vehicle engineering and transportation systems technical expertise See www.trb.org, and for the Summit archives: www.objectivesafety.net/TRBSummit2008.htmwww.objectivesafety.net/TRBSummit2009.htm
Safe Practices for Motor Vehicle Operations
ASSE/ANSI Z15.1 2012https://www.asse.org/cartpage.php?link=Z15_1_2012&utm_source=ASSE
+Members&utm_campaign=b4472c203c-Z15_5_12_125_11_2012&utm_medium=email
ANSI/ASSE Z15.1-2012 Revised Standard is now available. “ Safe Practices for Motor Vehicle Operations“
Newly Revised ANSI/ASSE Z15.1-2012 Standard is now
available.
pThese practices are designed for use by those having the responsibility for the administration and operation of motor vehicles as a part of organizational operations.
Z15.1 Technical Briefhttp://asse.us2.list-
manage.com/track/click?u=c607f19210bc178f7ceb6d716&id=a311862ffc&e=8007d740a6
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What Z15 encompassesSafety ProgramSafety PolicyResponsibilities and AccountabilitiesDriver Recruitment, Selection and AssessmentOrganizational Safety RulesOrientation and TrainingReporting Rates and Major Incidents to ExecutivesOversight
Telematics
Communication Technology trends Smartphone navigation devices
A lot is now possible and for less!
Driver behaviorVehicle behaviorR d id ITSRoadside ITSFuel consumption/EconomicsResource modeling
How?
Deployment technology toolsInvehicle telematicsSmartphone telematicsSmartphone telematics
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Since 2009New perspectivesNew technologiesNew generations focusNew vehiclesNew vehiclesNew platformsNew policies/standardsNew international models
Rules/Policies Addressing Known Hazards
Federal Motor Carrier Safety Ad i i t ti (FMCSA)Administration (FMCSA)–Cell phone use – November 2011–Hours of Service – December 2011
Federal Motor Carrier Safety Administration - FMCSA
http://www.fmcsa.dot.gov/
Nov 2011, Hand Held Cell Phone Banhttp://www.fmcsa.dot.gov/about/news/news-releases/2011/Secretary-LaHood-Announces-Step-towards-Safer-Highways.aspx
Dec 2011, New FMCSA Hours of Servicehttp://www.fmcsa.dot.gov/rules-regulations/topics/hos/index.htm
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DOT HOS Rules Limits established for on-duty hoursEstablishes minimum levels of off-duty time-8 hours if on duty less than 12 hours FRA or if over 12 hours then 10 hour off-duty timeCommercial airline pilot can fly up to 100 hrs/monthAdopts 60/70 hour weekly maximum for truck drivers, 10 hour off-duty time
What are your policies???– If your patient is pink, warm and talking?– Are you required to notify the driver if you
When is it safe to do what… ?
Are you required to notify the driver if you are out of your seat belt?
– Are ‘routine procedures’ putting you at risk?
Policies to protect you too!Policy makes a difference…
DOH NYS, 2012 Advisory on patient care in a moving ambulance
www.EMSSafetyFoundation.org/2012-04_NYSAdvisory_on_Patient_Care_in_a _Moving_Ambulance.pdf
EMS VEHICLE OPERATIONS/SAFETY EMMCO WEST REGIONAL PROTOCOL
Pennsylvania Department of Health Operations 123– BLS– Adult/PedsEffective 07/01/11 Protocol 123
Criteria: A. All EMS operations, including incident responses and patient transports.
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Balance of concerns and risk during transport
Response and transport time
Clinical care provision
Occupant safety/protection
Public Safety
Communicating risk
LivesTime
Safety is a tool to save
Money
must be evidenced based
What is your transport safety record in your service?How can you improve if you don’t have a meaningful measure of safety
Data…
a meaningful measure of safety performance?Transport safety is not guesswork, it is a science
What we need to consider, where is the ‘bang for buck’ in ambulance transport safetyyWhere is the low hanging fruit?
Whats out there?
Integrated systems with mapping, safety and economyDeployment systemsDeployment systemsDriver management systemsIntelligent transport system
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Fleet Management technologiesACETech/FernoFleetEyes – IntermedixZoll rescuenet and roadsafety fleet management systemsg yMarvlisTelematicusOptimaNorthrop Grummen
ACETech/Ferno
ACETECHTM Web
Mapping, reports, alerts, hotspots, vehicle data
Fleet eyes
ZOLL systems Telematicus
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Fleet Management capability
Vehicle database• Individual vehicle/ data• Fleet mileage collection/Checklists• Link to other systems (SAP, Fleet)
Maintenance & Service Plans
Telematicus
Maintenance & Service Plans• Repair history & Scheduling • Action planning
Reporting• Export to Excel for manipulation• Scorecards views, Crystal Reports reporting•Direct Feedback
Optima: Demand/Resource analysis and modeling and base location planning
Northrop Grumman Marvlis
•• The dashboard The dashboard calculates:calculates:•• current percent of current percent of
demand coveragedemand coverage•• three closest vehiclethree closest vehicle
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•• three closest vehiclethree closest vehiclerecommendations recommendations for recent incidentsfor recent incidents
•• realistic travel timerealistic travel timeestimates for eachestimates for eachpossible responderpossible responder
Marvlis
•• The web The web interface:interface:•• individual choice of individual choice of
reference mapsreference maps•• integration of AVL/ARL integration of AVL/ARL
and other live feedsand other live feeds
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and other live feedsand other live feeds•• native Android clientnative Android client•• creation/update of creation/update of
spatial data direct to spatial data direct to ArcGIS ServerArcGIS Server
•• customization options customization options to extend functionalityto extend functionality
Priority Dispatch
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SAABOverview of these fleet
management approaches
Driver Training
Cost Savings Real-time Feedback
How How
ZOLL systems
Reward and Coach
Data Upload and Reporting
Immediate Improvements
Benchmark Drivers
Event Analysis
Road Road Safety Safety WorksWorks
Data Collection & Driver Feedback System
Onboard computer installed in each vehicle to assess driving performance
A dibl f db k t d i i
ZOLL systems
Audible feedback puts drivers in control of performance
Audio Speaker
Onboard Computer
Data Upload and ReportingData collected onboard is transferred via wireless data
hub to ZOLL online for reporting and analytics.
ZOLL systems5% of Drivers Cause 95% of Problems
Identify safe,
efficient drivers and
provide additional incentives
and
ZOLL systems
and rewards.
Identify and manage
the exceptions.
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ABC’s of Safe Driving
Driver grading system– Average miles
ZOLL systems
– Between– Counts (violations)
Other events and behaviors monitored
Braking, acceleration and side/sway forcesEmergency lights and sirensEngine RPM
ZOLL systems
Engine RPMEngine idle time (indicates wasted fuel)Distance drivenTurn signalsNumerous others—what’s important to you?
The “Feedback box”Driver behavior monitoring and feedback device
Extensive Indirect cost savingsFewer out of service vehiclesImproved transport timesDecreased administrative lost in
ZOLL systems
Decreased administrative lost in managing unsafe behaviorsDecreased legal burdenAutomatic system wide dataInsurance benefits
Demonstrated EffectivenessMEMS MONTHLY OVER SPEED VIOLATION TREND 2003/2004
216,922
550,353
2,074 1,609285 547
4,046
207 407 710 7803,069
1,004 1657 2709
179,721
0
100,000
200,000
300,000
400,000
500,000
600,000
Series1
March April MayJu
neJuly
August
September
October
Novembe r
December
January
February
MarchApril May
June
MONTHI II III
I – blind data, no growls
II – growls & tones ON unidentified data capture
III – identified data 0.04
4
0.01
7
0.01
8
3.88
6 5.24
415
.843
12.0
599.
9414
.823
13.4
299.
319
7.24
9.41
6.9 8.39
9.61
2.27
7.57
4.28
99.
2717
.43
15.2
5 16.6
117
.49
15.7
619
.32
13.1
1
0
5
10
15
20
25
Mar
chA
pril
May
June July
Aug
ust
Sep
tem
ber
Oct
ober
Nov
embe
rD
ecem
ber
Janu
ary
Febr
uary
Mar
chA
pril
May
June July
Aug
ust
Sep
tem
ber
Oct
ober
Nov
embe
rD
ecem
ber
*Jan
uary
200
5Fe
brua
ryM
arch
Apr
ilM
ay
MEMS ABC Miles Per Month
Unit 302 Accident
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Monitoring and feedback devices
Implementation well received by the providers. 20% cost saving in vehicle maintenance within 6 months.
ZOLL systems
No increase in response times Fewer crashes and less severe crashes Sustained improvement in safety proxies, with no inservice or retraining after the initial introduction period.
safety environmentefficiency
Telematicus
Global Green Drivers“Low Cost Safe Driving Platform”
The smartphone is capable of detecting:– Vehicle motion and speed via both the
accelerometer and changes in GPS and GPRS l ti
Smart phone Data terminal featuresTelematicus
location– Has the capacity to identify harsh braking – Software configuration can also disable the use
of texting and non-emergency calls whilst the vehicle is in motion.
Telematicus
GPS and GPRS status
GGD viewsA smart phone App that is a safety tool
Telematicus
Driver and vehicle ids
“Convergence?”
DriverTechnology
Handheld device collects and communicates key data‐ Speed‐ Braking & Acceleration‐ Time & Location‐ Pictures & Video
More information via Bluetooth OBDII, Black Boxes• More refined braking• Specific data e.g. Seat Belts• Tracking of vehicle.
Telematicus
AftermarketTechnology
OEMTechnology
Connected vehicle becomes an IP point, data access
Installation to vehicle
Slide 84
AMD1 A core part of the OEM technology is Infotainment where there are opportunities for advertising and payfor media (music, video) services.
Given a lead in this area and openness (points of integration) for other categories of application including social media, travel, insurance/safety/risk management the Smart Phone becomes a useful platform for user interaction removing the costs of display in lower value marques. It will be resisted or dismissed by the more expensive marques e.g. Mercedes.DoreA, 11/9/2011
AMD2 For safety simply adding OBDII with minimal cost of install provides "high resolution" acceleration analysis.DoreA, 11/9/2011
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Fleet Management capability
Vehicle database• Individual vehicle/ data• Fleet mileage collection/Checklists• Link to other systems (SAP, Fleet)
Maintenance & Service Plans
Telematicus
Maintenance & Service Plans• Repair history & Scheduling • Action planning
Reporting• Export to Excel for manipulation• Scorecards views, Crystal Reports reporting•Direct Feedback
Safety Capability
Driver Alarm• Instant SMS & Email location
Driver Risks• Scorecards and Graphs• Automated Messages
Telematicus
•Training
Trip playback•Speed, Braking, Acceleration
Incident Recording•Accident/Breakdown •Photographs
0.002.004.006.008.00
10.0012.0014.00
Incident Reporting
GGD Data Capture• Real time• Key details• Photographs• Details on application
Business System
Telematicus
y• Individual records linked to drivers and vehicles• Action planning and assignment• Attachments e.g. photos
Reports• Launch accident reporting process• Export to Excel for manipulation• Scorecard or crystal reporting
• Capability
• Computing Power
So WhatTelematicus
• Convergence
• Costs
“Capabilities”
Duty of Incl Driver
On Line
Mobile/ Driver
Telematicus
LicenceCheck
On line Passive
Risk Assess
Duty of Care Low
Resolution Accel/
Braking GPSAlarm
Incl.Data
AnalysisAction
FeedbackReports
Driver Safety
MessageAccidentReport
TrainingGPS
OBDIIFault
Codes* With
handheld device
Black BoxHigh
ResolutionAccel/
BrakingGPS
CANbusFleet MgtSpeed,IdlingSeat Belts
per driver/vehicle per month from low to high cost
Driver Focus
Fixed/ Vehicle Install
Integrated business system
Organisation Hierarchy
Telematicus
Outlook view on home pagewith GGD modules included
List of Drivers within the system with key details, easy access to sorting information.
Slide 89
AMD3 ODBII is not really a fixed install. It's a bit of a hybrid but does give "high resolution" acceleration data.
I think the duty of care picture needs to show Smart Phone as well as handheld.. This leads to £5 + £2 (OBD11) giving £7 as good competitor for £13 black box. Otherwise the £13 black box seems to offer good value for money. Plus the accelormeter in the Smart Phone offers the potential for accident detection just like the black box. An area yet to be explored.DoreA, 11/9/2011
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Emergency Vehicle Intelligence with
The ACETECH System provides system wide, on‐board intelligence that improves the efficiency and safety of your emergency vehicles
and staff, while reducing your operating costs.
Four Modular Functions
1. Vehicle operations center– Driver & vehicle operations
2. Patient Compartment– Mobile trauma bay environment; passive supportMobile trauma bay environment; passive support– Communication, temperature, lighting,
securement & access, storage, & overall interiorly & exterior safety
3. Medic platform – work environment & safety– Seating, operating areas, reach & access
4. Patient platform – care & safety focused– Cot & restraint system, patient care accessories
1. Integrated/Modular Solution2. ROI 3. Vehicle Performance4 U P
ACETECH Core Benefit
4. User Power5. Service– Affordability– Excellent warranty– Reliable– Modular design– Forward thinking– Product/OEM Support
ACETECHTM ECO-RunThis graph indicates battery drain when engine is off and on- scene lighting was
active. Auxiliary battery dropped to 11.5 volts (pre-programmed ECO-RUN start) in approximately 2.7 hours.
Voltage vs Time
13
14
ge
10
11
12
Enginerunning/
idling
Enginestopped
1h 2h 3h 4h 5h 6h 7h 8h
Time
Volta
g
Main Battery
Comms Battery
Aux Battery
Eco Run
ACETECHTM WebMapping, reports, alerts, hotspots, vehicle data
ACETECHTM Safety System Benefits ROIThe following is a partial list of benefits that may be realized through a properly managed vehicle safety program.• Fewer collisions• Fewer collision/near collision related injuries• Reduced insurance premiums• Fewer lawsuits• Reduced repair costs• Fewer towing bills• Reduced light duty• Increased vehicle life• Less time spent investigating incidents- more time for beneficial activities• Improved image• Improved financial performance
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ACETECHTM Geo FencingSet boundaries for vehicle travel and to receive automaticnotification when a vehicle leaves this boundaryImportant in theft control. Maintain vehicles at expected locations thereby p yreducing response times, speeding events and fuel expense.
ACETECHTM in the FutureAdvanced camera systems. Use of cameras to improve safety and security is not new. Camera systems include:
Rear viewSide ViewFront view
Cameras may also be used to provide real time consult with on-line medical control.
Niagara Region Demographics
Population: 430,000 (12 Municipalities)
Niagara region: 1850 square km
Ambulance call volume: 75,000 (annually)
Mileage: 2,000,000 km driven annually
26 Peak Vehicles
Acetech Integrated Vehicle Intelligence System
Fully integrated, vehicle performance monitoring and control system with on-board intelligence.
Safety Systems Eco Run Module BenefitsEco-Run Module BenefitsAsset Protection Benefits
Safety System (Integrated into AVI)Speeding infractions, Unbelted, Unsecured occupants Lights and siren complianceC t D i S f t R t idCreate Driver Safety Reports- provide feedback to employees Set pre-defined speed limiters
Niagara EMS Decrease in Speeding Infractions
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Optimize your fuel efficiency and reduce your carbon footprint
Reduce idle times by as much as 40% to lower your fuel consumption and costs
Reduce carbon emissions and contribute to a greener environment
Prevent flat batteries
Reduce engine wear and reduce maintenance costs while extending vehicle & engine life
Monitor driver behaviour to reduce excessive rpm for additional reduction of fuel consumption
Report Generated for One Week of Excessive Idling and Potential Savings on 5 vehicles
Niagara SummaryAutomatic Vehicle Informatics (AVI) Benefits
Protect assets with theft protection and geo-fencingReduce engine wear and reduce maintenance costs while extending vehicle & engine lifeModify driving behaviors with real time dashboard and full featured reports andModify driving behaviors with real time dashboard and full featured reports, and automatic updates on driving violationsImprove fleet efficiency and operations with remote vehicle diagnostics & real time Fleet Management Track information through web based interface or integration with established dispatch software
Safety TechnologySunstar: A System Perspective
Presented by Charlene CobbSunstar Paramedics
Pinellas County, Florida
Marvlis SystemOverview
Front End Technology
Marvlis at SunstarPrior to Marvlis: We used history and geography
Since Marvlis: WeSince Marvlis: We have data based on Year, week, day minute (17 years)
We now weather the “storms” with more efficiency
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Utilization of Marvlis
Improved response timesHelps determine post plansForecasts Routes
Dynamic Service AreaBlue overlay shows us what parts of the county arecounty are coveredTakes into account dead ends, traffic, geography water ways
Fleet EyesOverview
Back End TechnologyFleet Eyes Functionality
WeatherTrafficRoutingSpeedTrackingArea Resources
Fleet Eyes/Geo-FencingRoute Review
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Real Time Tracking Call Details
Road SafetyOverview
Retrospect Technology
Road Safety Provides Data for Incident Investigation
• Text to address outline• Ideally less than 24 words per slide
Monthly Driver Reports
•Identifies high risk behaviors
P id l ti•Provides real time feedback to driver
•Provides reports for employee evaluation
Measuring Our Success at Sunstar Paramedics
5 Year Road Safety Report - Unsafe Reverses
100001200014000
rses
02000400060008000
10000
Jan-06 Jan-11
Years
Uns
afe
Reve
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Sunstar Summary
Through these technologies:
Realized dramatic change in our drivers attitude toward safety
Have evidence based data to use for individual driver training and refresher courses
Are able to identify drivers that fail to align themselves with our mission of safety
Ambulance Safety InnovationDesign Module 1.0
www.INDEMO.infothe future you can have right
now!!!now!!!Better, safer and cheaper
INDEMO @ MedStartr -http://www.medstartr.com/ small changes can make a
BIG DIFFERENCE
PREPARE – TEACH – REACH – RESPOND– Look at your own safety record– Teach safety and hazard awareness– Reach out with safety information to all your EMS
providers– Respond with the best safety practices
PREDICTABLEPREVENTABLE
andNO ACCIDENT
ConclusionEMS transport has serious hazards and safety issuesMajor advances in EMS safety research, technology infrastructure and practice over the past 5 yearsDevelopment of substantive EMS safety standards is a necessity and a realityMultidisciplinary safety issues that EMS cannot solve internallyinternallyNew tech tools can increase fleet safety managementFailure to transfer knowledge from transportation, automotive safety and new technology is unacceptable and dangerous EMS is still way behind the state of the art in vehicle, transportation, new technologies and occupational safety
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Your electronic handout/resource link
Or if you are > 30 years
www.objectivesafety.net/PDFHO.htm
Thank you! Any Questions??
Electronic handout and resources available onlinehttp://www.objectivesafety.net
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