The 12th Invest in ME Research Conference June, 2017, Part 2
MEMum presents the second article in a series of three about the recent 12th Invest In ME International Conference (IIMEC12) in London.
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High impact exercise reverses damage to mitochondia?

Discussion in 'General Treatment' started by invisible ME, May 22, 2011.

  1. invisible ME

    invisible ME

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    I was recently informed that there is new research suggesting that high impact exercise supports repair to mitochondria. This was from a doctor who, though not a CFS specialist, definitely thinks PWCs are sick, and is especially interested in mitochondrial damage as an underlying factor. This is not my area of expertise at all. I tried to have a look around here and online, but was very overwhelmed, and in well over my head.

    Does anyone know what studies he might have been referring to, and whether they have anything to do with ME/CFS or are about mitochondrial function more generally?

    His advice to me: start high impact exercise (a little at a time). Specifically, run as hard as possible until you can't continue and/or weight bearing exercise (not at the same time :D), giving yourself plenty of time to recover.

    So, needless to say, I am more than a bit hesitant to just jump in with both feet, especially given the extreme caution towards this type of exercise displayed by every knowledgable ME/CFS doc I know of. [Note: I have been mostly bed/housebound for the last year or so.]

    Interestingly, this MD noted he thought the light/slow graded exercise approach was all wrong.

    Thanks in advance!

    Saw this on Dr. Myhill's website, and thought it might be related?
     
  2. mon me

    mon me

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    There are studies/information that you can search online that explains how high impact aerobic exercise can not only permanently damage the mitochondrial DNA, progress the illness, cause severe relapses in ME/CFS patients but can also potentially kill them!

    Why is someone who is completely ignorant about an illness advising you? seriously an idiot. I would avoid this person like the plague.
     
  3. Wonko

    Wonko Senior Member

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    The other side.
    The approach on that link is questionable for anyone but definately bad for anyone with ME. TBH it's self-contradictary in places.

    I base this statement on personal experiences and research, and nearly 2 years of (mostly) successful lifting free weights with ME.

    Although I havent personally tried 90sec hits of max effort aerobic exercise I would suggest it would be inadviseable for pwME.

    The whole concept of more mitochondria being helpful is dubious for pwME IMO, unless existing numbers are too low (such as in clinical deconditioning), more mitochondria means faster energy generation, meaning more toxins faster, faster useage of available fuel/resources etc., decreasing the time you can work for before experienceing issues, not increasing it - this is a real effect, personally experienced, not a hypothesis.

    However as I said above I do use weights, I even use some of the same lifts recommended in that link, but I've spent nearly 2 years learning how to do it without aggrivating PEM unacceptably (I'm still learning) - and based on personal experience the way they say to do it is almost 100% wrong, from every perspective.

    Weights are useful for 3 things at least in my case.

    1. Lifting around 75-80% (of my max) helps the nervous system be more efficient, and allows you to utilise what muscle you have got more effectively.
    2. The same level of exercise promotes growth hormone release which helps your body repair more than just the muslce you've used.
    3. Being a bit stronger helps when crashed, it makes the difference between a crash leaving you bedbound or housebound.

    Lifting wieghts doesnt 'fix' anything re ME, it 'might' make life easier re some symptoms if it's done right and if your body co-operates, it might also cause major issues for you even if apparently done correctly, there is no way of knowing.

    And it will take energy, increasing amounts, if you dont have any spare then dont consider it as an option.
     
  4. Boule de feu

    Boule de feu Senior Member

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    PLEASE read this before doing anything

    I would be very worried about undiagnosed cardiomyopathy in CFS.

    Dr Cheney has written a lot about it.

    There is a whole section on mitochondria and another on exercise.


    http://www.medicalinsider.com/cardiac1.html

    "What other symptoms are there of cardiomyopathy in CFS patients besides lower cardiac output and a decreased propensity for heavy exercise? Other symptoms can include elevated pulse rate (during rest, standing up from a reclining posture - known as Postural Orthostatic Tachycardia Syndrome (POTS) - see links below, or indeed during light exercise), a heavy heart beat, palpitations and even chest pains (if not enough oxygen or ATP is available for the cardiac muscle) when fatigued or when lieing down on the left side."

    And

    "I believe that my observed pattern in myself and others suggests that the deficiencies behind CFS, typically mitochondrial function and also hormonal function are stimulated by regular light exercise to some extent, if mitochondrial capacity allows it, and that such factors are really the root cause behind some patients conditions. As each case is different, one cannot really assume anything, but must try to determine the exact picture with each patient on a case by case basis.

    Dr Cheney's theory does not appear to explain why moderate exercise actually helps some CFS patients, both in the short term and also long term, BUT MAKES OTHERS EXTREMELY ILL, EVEN IN SMALL AMOUNTS. Perhaps this 'training' of the heart muscle is why these patients get better, but what about the other patients? Do CFS patients really have weak heart muscles, i.e. less muscle mass, or is it merely just an inability for the same muscle mass to function as it normally should, on account of mitochondrial and endocrine system insufficiency, which over time, and a lack of heavy exercise and training, leads to a gradual deterioration of the heart muscle? Those patients that use gentle exercise and show a sign of improvement (rather than deterioration) often do not completely recover; I myself at various points was able to build up my cardiovascular fitness over time, and hike up to 5 hours of vigorous walking, three times a week, week in, week out, but still the other actual aspects of my condition, i.e. mental energy and ability to concentrate hardly showed any improvement at all. This was odd as in some respects I was probably fitter than the average member of the public, but had very little mental energy and of course disrupted sleep patterns and impaired digestion etc."
     
  5. Boule de feu

    Boule de feu Senior Member

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    If you don't agree with your doctor's treatment, you could print this list and ask him to look at the titles. Some of them are pretty scary! :-(

    He might tell you to wait before starting your program?


    New Research on Cardiac Insufficiency

    VanNess JM, Snell CR, Stevens SR, "Diminished Cardiopulmonary Capacity During Post-Exertional Malaise," Journal of Chronic Fatigue Syndrome, Vol. 14, No. 2, 2007, pp. 77-85 [PDF]

    Wyller VB, Due R, Saul JP, Amlie JP, Thaulow E., "Usefulness of an abnormal cardiovascular response during low-grade head-up tilt-test for discriminating adolescents with chronic fatigue from healthy controls," Am J Cardiol. 2007 Apr 1;99(7):997-1001. [PDF]

    Information on the study "Left Ventricular Function in Chronic Fatigue Syndrome (CFS): Data From Nuclear Ventriculography Studies of Response to Exercise and Postural Stress," by Arnold Peckerman, Benjamin Natelson et al. [This study found that the heart failed to pump enough blood following exertion and upright posture in the CFS patients that were studied.]

    Peckerman A, LaManca JJ, Dahl KA, Chemitiganti R, Qureishi B, Natelson BH. "Abnormal impedance cardiography predicts symptom severity in chronic fatigue syndrome." Am J Med Sci. 2003 Aug;326(2):55-60.

    Arnold Peckerman, PhD, John J. LaManca, PhD, Bushra Qureishi, MD, Kristina A. Dahl, MD, Roseli Golfetti, PhD, Yoshiharu Yamamoto, PhD and Benjamin H. Natelson, "Baroreceptor Reflex and Integrative Stress Responses in Chronic Fatigue Syndrome." Psychosomatic Medicine 65:889-895 (2003)

    Myhill S, Booth NE, McLaren-Howard, J., "Chronic fatigue syndrome and mitochondrial dysfunction,". Int J Clin Exp Med (2009) 2, 1-16 [PDF Format]

    Dr. Sarah Myhill, "CFS is Heart Failure Secondary to Mitochondrial Malfunction." Pamphlet. [PDF Format]

    Carol Sieverling, "The Heart of the Matter: CFS & Cardiac Issues." Dr. Paul Cheney's theoretical insights on ME/CFS and heart failure. Pamphlet. [PDF Format]

    Dr. Paul Cheney, "CFS and Diastolic Cardiomyopathy" [A three-hour talk in streaming video for viewing on the Web with a broadband connection only, not a dial-up connection.]

    Mihai Gheorghiade; William T. Abraham; Nancy M. Albert; Barry H. Greenberg; Christopher M. OConnor; Lilin She; Wendy Gattis Stough; Clyde W. Yancy; James B. Young; Gregg C. Fonarow; for the OPTIMIZE-HF Investigators and Coordinators, "Systolic Blood Pressure at Admission, Clinical Characteristics, and Outcomes in Patients Hospitalized With Acute Heart Failure," JAMA. 2006;296:2217-2226. [PDF Format]

    Francesca Bursi; Susan A. Weston; Margaret M. Redfield; Steven J. Jacobsen; Serguei Pakhomov; Vuyisile T. Nkomo; Ryan A. Meverden; Vronique L. Roger, "Systolic and Diastolic Heart Failure in the Community," JAMA. 2006;296:2209-2216. [PDF Format]

    Gerard P. Aurigemma, M.D., "Diastolic Heart Failure A Common and Lethal Condition by Any Name," NEJM, Volume 355:308-310. [PDF Format]

    Theophilus E. Owan, M.D.,et al., "Trends in Prevalence and Outcome of Heart Failure with Preserved Ejection Fraction," NEJM, Volume 355:251-259. [PDF Format]

    R. Sacha Bhatia, M.D., M.B.A., et al., "Outcome of Heart Failure with Preserved Ejection Fraction in a Population-Based Study," NEJM, Volume 355:260-269. [PDF Format]
     
  6. Boule de feu

    Boule de feu Senior Member

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    Another reason to avoid heavy exercising: hypoglycemia

    Heavy exercising lowers blood sugar.

    http://www.chronicfatigue-help.com/five.htm

    "I don't intend to get into a detailed medical explanation of hypoglycemia because it is complicated and somewhat controversial. However, in simple terms it is caused by overactivity of the pancreas which produces too much insulin when sugar or sweet foods are eaten.

    In a healthy person, the pancreas produces just enough insulin to neutralise any sugar eaten, to bring the blood sugar back to normal. But in those with hypoglycemia, the pancreas overreacts and produces too much insulin in response to the sugar eaten. This over-abundance of insulin metabolises not only the sugar which has been eaten but also some of the glucose which was already present in the bloodstream.

    The result is a state of low blood sugar which can cause an alarming number of distressing symptoms -fatigue being only one of them. Other symptoms include headaches, dizziness and feeling faint, irritability, depression, difficulty in remembering, blurred vision and in most cases an overwhelming craving for something sweet or a stimulant such as tea or coffee.

    If any of those symptoms sound familiar, particularly if they are accompanied by a craving for sweet food, then it is very likely you are suffering from hypoglycemia. Strenuous exercise also lowers the blood sugar, which is why those with chronic fatigue syndrome should be careful not to over-do any physical activity. After heavy physical work, a healthy person feels tired, his energy has been drained. However, if he rests, his strength will return reasonably quickly.

    What has happened? The exercise has burned up part of the glucose in the blood. Stored glycogen in the liver is then used to bring the blood sugar level back to normal - even if the person doesn't eat anything immediately. The adrenal glands help raise the blood sugar level by releasing catecholamines which convert glycogen into blood sugar.

    Thus, the healthy body has a system of checks and balances, involving mainly the liver, pancreas and adrenal glands, to ensure the blood sugar level stays stable. But in a person suffering from hypoglycemia (and chronic fatigue syndrome) the system doesn't work properly. After strenuous exercise, the person's blood glucose is depleted and the adrenal glands react by releasing catecholamines to convert stored glycogen into glucose. But unlike the process in a healthy person, in the hypoglycemic the new glucose stimulates the pancreas to produce more insulin - which once again lowers the blood sugar level.

    The pancreas of a hypoglycemic person is extremely sensitive to extra glucose, whatever the source. It over-reacts to glucose with a secretion of insulin too large to maintain an equilibrium in the body - and the person suffers the symptoms of hypoglycemia.

    The cure for hypoglycemia is to prevent large swings in the blood sugar level, by eating little or no sugar and by avoiding excessive physical exercise. But it is much more difficult than it sounds. Sugar is found in so many foods these days, particularly packaged foods, which almost always have sugar added. Some people are also sensitive to "natural" sugars such-as those in fruit and even milk.
     
  7. Boule de feu

    Boule de feu Senior Member

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    Two ideas

    If you don't feel comfortable doing what your doctor has suggested, there are two things you can do:

    1. Tell him/her that you would be interested to start this program if he can give you some reading material on the subject. He must prove that heavy exercising is good for the mitochondria.

    2. You will start this if he signs a paper saying that he will be held responsible if you get worse.
     
  8. Boule de feu

    Boule de feu Senior Member

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    How severe is your ME?

    Which daily activities are you able to do, right now?
     
  9. kurt

    kurt Senior Member

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    Holy Cow, high impact exercise for CFS? As everyone is saying on this thread, that sounds ill-informed. Maybe your doctor should learn about all the different types of mitochondria damage. IF the mitochondria in CFS are being poisoned by excess nitric oxide metabolites as Drs Pall and Bell suggest, or by lack of glutathione as Rich VanK and others suggest, then the cause of the mito damage is a metabolic defect that expresses itself under conditions of oxidative stress. Therefore the damage is not from a one-time insult that can be corrected by simply stimulating regrowth (from high-impact exercise perhaps), but rather ongoing. In this case, whenever the metabolism is stressed due to oxidative stress, there will be even more mito damage. Thus high impact exercise would just poison the mitochondria more, and possibly push a CFS patient deep into ATP/ADP depletion.

    How to educate this doctor? I would buy him a copy of Dr Bell's book about Neuro-Immune Fatigue. It is a short book and a quick read for a well-educated MD, and it certainly paints a more accurate clinical picture of CFS, based on research, than most non-CFS doctors have in their own heads. Here is a link, and I literally would give this to your doctor, worth every penny if he/she would actually read the book:

    Cellular Hypoxia and Neuro Immune Fatigue, by David Bell, MD

    So tired of hearing doctors treat CFS as an ordinary illness they can work with, when they have no idea what they are talking about much less what they are doing clinically when treating CFS patients. Based on recent research CFS is biologically similar to MS, Parkinson's Disease and Alzheimers. Dr Bell believes that CFS may in fact be a self-limiting variety of MS, without plaque damage. Would those non-CFS doctors tell patients with MS, Park or Alzheimer to just try some high-impact exercises? Ack.
     
  10. valia

    valia Senior Member

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    You are taking the P*ss
     
  11. caledonia

    caledonia

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    I was doing those sorts of exercises before and while I was becoming sick. If they would make you better, by that logic, I wouldn't have gotten sick in the first place.

    This is like telling polio patients to exercise and learn how to walk again and be normal. What actually happened was they killed all their good motor neurons and later developed post-polio. Doctors now advise them to conserve energy and not push, so they don't get even worse.
     
  12. justy

    justy Donate Advocate Demonstrate

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    Hi, i just wanted to point out that the linko to Dr Myhills website does not have anything to do with the first half of the original post. Dr Myhill does not advocate high impact exercise to any off her patients. The linkt hat you have posted is in the section of her website entitled "your very good health" which is a section aimed at every living person in order to keep themselves in optimum physical and mentl health. She does not advocate any form of exercise for her PWME until they are substantially recovered and then she recommends a gradual return to exercise with an emphasis on stretching and strengthening through weights, which she feels supports the repair of the mitochondria. It is Dr Myhill with John Maclaren Howard who has done excellent research into mitochondrial dysfunction in M.E/CFS and uses the mitochondrial function screening test which many of us in the U.K have found very useful.

    It seems to me that the first doctor you spoke to was advocating high impact aerobic exercise which would be very damaging to any CFS patient
    For the sake of clarification i am presently too ill to do any exercise beyond 5 mins of yoga and a very short gentle stroll on most but not every day, so i have no personal experience of the exercises suggested by Dr Myhill.
     
  13. dannybex

    dannybex Senior Member

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    That needs to be read very carefully, as it's very clear she's in no way talking about "High Impact Exercise".

    Just two of her points:

    "Each exercise is done for 45-90 seconds, which is how he arrives at 12 minutes a week!

    Each exercise is done very slowly you may only do 4 or 6 repeats of each movement."

    ETA: Yup, what Justy said...(didn't see the post until after I posted.)
     
  14. Snow Leopard

    Snow Leopard Hibernating

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    I think perhaps there was some miss communication between 'invisible ME' and the physician in question.

    Damage to mitochondria implies mitochrondrial disease and this won't be 'reversed' merely by exercising. Deconditioning will result in lower mitochondrial numbers and this can be reversed with exercise. However while those who were fit/active before contracting CFS certainly have experienced deconditioning. But according to the scientific literature, this is still insufficient to explain the dramatic differences in recovery times from exercise between sedentary patients and CFS patients that have been matched in terms of exercise levels.

    "High impact" exercise is typically aerobic exercise which involves both legs leaving the ground at the same time eg, jumping, running etc. This is supposed to promote bone strength.

    It is not (moderate) strength training, stretching etc which is along the lines of what Myhill recommends on her website. If you wish to increase your level of exercise, slowly easing into this is suggested, rather than graded walking for example.
     
  15. invisible ME

    invisible ME

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    Hi all,

    Firstly, thanks for you thoughtful responses. Second, my apologies for what I now realize is a lack of clarity in my first post. In an effort to avoid being long and rambling, I think I might have unnecessarily raised some alarms. But I do very much appreciate the helpful and entirely accurate info provided here.

    To clarify:

    The doctor who made these suggestions was a specialist of sorts, and not my GP. I took his suggestions about exercise and mitochondria with a huge grain (barrel?) of salt. He was however, extremely helpful in other ways. I originally posted my query because I was wondering if anyone here on PR knew what new studies on mitochondria he might be referring to. I assumed that they were not studies on PWCs, but rather on mitochondrial function in healthy people, or possible people with idiopathic fatigue? But I have very little background with that literature, so I wasn't sure. I posted a link to Dr. Myhill's website, because what I read there sounded like it might have been based on the same theory the MD I saw was referencing, but I wasn't sure. If anyone with some knowledge about mitochondria has an idea what those studies might be, I would be interested. Even if they are not related to ME/CFS... which I assume is the case.

    As someone who is largely bed/housebound I would NEVER EVER attempt any kind of high impact anything in my condition. Once bitten, twice shy, or words to that effect. But I know that not everyone knows this, and many people with ME/CFS (especially those "new" to the disease) might be vulnerable to such a suggestion coming from an MD, so thanks again for responding with words of caution.

    As a side note, I do think this doctor's advice is an example of the extreme confusion caused by a lack of definitional clarity (intentional or otherwise) in research on fatigue, chronic fatigue, chronic fatigue syndrome, ME/CFS. Everything becomes so muddled that even a well-meaning and semi-literate (in CFS, I mean) doctor can give such potentially harmful advice. Not good!!
     
  16. PoetInSF

    PoetInSF Senior Member

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    I've been doing 4 * (100m run + 5min rest), and it doesn't seem to make much difference. I still crash if I walk 2km at more than 5km/hr speed even though I can walk 4km without stopping or walk about for hours running errands and doing shopping as long as I keep my walking speed at 4km/hr.

    My conclusion: my cfs will improve on its own schedule no matter what I do and I can only play a supporting role. But improving it has and I now function almost normal as long as I stay away from sustained high impact activities.
     
  17. pine108kell

    pine108kell Senior Member

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    I am going to write this somewhat in ignorance because I did not read the posts, just the title of the thread and the words "high impact exercise". Maybe I do not know what high impact exercise is, but I would venture a guess that is the absolute WORST advice someone could give to a person with CFS. High impact anything (excercise, thinking, socializing, etc) is bad for CFS, at least the disease I unfortunately am familiar with.
     
  18. coolron33

    coolron33

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    High Impact Exercisse

    High impact exercise is difficult for people with the x virus. I run on a treadmill and if I go overboard I pay for in with severe sleep intruptions and extreme fatigue over the next couple of days.



     
  19. CAcfs

    CAcfs Senior Member

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    I am going to go out on a limb and say, "you never know."

    First of all, if you are used to doing no exercise, very high impact could be dangerous. So you would have to maybe get to the point where you could at least walk a mile, or walk up a hill without intense struggle. I spent about 6 months working to get myself there (and trust me, it didn't feel like the right thing to do, either during or after, or the days after). It's still not easy, but I felt I had no other choices left, treatment wise.

    Now, once I've built up a sort-of moderate baseline, I sometimes will do things that I feel are outside of what I technically should be doing (like I will full-out RUN a block or two hard-ish, then walk a few blocks). It is sort of amazing, that it does feel good in a way. It feels like that feeling after a good cry. Where your soul almost hurts from being cleansed, but it feels good and refreshing. I still feel like crap all the time, but it feels good to push myself, and tear up a little bit of pavement under my feet. I still have what I would call disabling CFS (as in, it is severe enough to prevent me from working because I sleep a lot and am very disorganized because of fatigue, can't keep up with household chores, and I can never predict how I'll feel, never have a great day, etc). But, every once in awhile I challenge myself physically, and it does seem to have benefits that are hard to put my finger on. Since taking Tyrosine daily, this is even more attainable for me (see my post in treatment section).

    Sometimes, lately, I notice that either afterwards, or the day after doing something higher impact, my face looks a little less sick (dark circles around eyes not as bad, face looks less puffy/inflamed, skin doesn't look pale in color and drained of life).

    I was actually in amazing shape when I had my crash. So I agree that lack of exercise isn't what caused the problem. And when I first crashed, I was shocked at how I tried to run and almost collapsed, despite being in amazing physical shape (a runner/sprinter/athlete). So I agree with caledonia that the logic of it doesn't add up. BUT, I disagree that that means we shouldn't try this. I think it is counterintuitive, and yes, goes against certain sound theories/science........but I think it still could work. This is solely an opinion, so I am sure others will disagree.
     
  20. taniaaust1

    taniaaust1

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    I couldnt run about a block but went on a get fit craze last year with doing high impact for as long as I could and then walking till I'd recovered from the short run then running again (for me that high impact each time was 35-50 seconds only and then I'd start to get my muscles like freezing up if I continued at that level, where it became very hard to keep them moving..sudden feel like legs had been extremely weighted which makes it impossible for me to continue at that pace). I was able to do this run walk till recovered then run thing for 2 hrs per day (having POTS it was near impossible for me to do standing but this exercise I could do as long as high impact was very very short spurts below 50 seconds).

    I did this daily for 6-12 weeks (exercising in middle of the night and when it was very cold and wearing wet clothes.. to try to keep the POTS at bay, I faint if I get warm with exercise) and at the end of that time.. I found my fitness level had hardly improved at all (only some seconds) :( , it was highly disappointing.
    I wasnt capable of doing hardly no more then I had been when i started doing it. Stamina to maintain high impact didnt shift. It was clear there is something very abnormal about my body.

    Looking back I think that I never did get my body into an aerobic exercise state as I was stopping the high impact probably as that was starting to kick in.. and my experience makes me think that getting fit dont improve our illness at all.
     

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