I did the following WOW at UE after working a busy day shift in the ER.  It was a great workout.

MedX Overhead Press, Rear Deltoid Fly (jrep halves), EZ Bar Biceps Curl, Nautilus Triceps Extension, EZ Bar Reverse Curl, Formulator Flexion, Calf Press on MedX Leg Press.


The image above has been hanging in UE for months now.  One of my clients owns an integrative medicine practice that includes thermal imaging (used as an adjunct or replacement for mammography).  These images are of one of our female clients.  The images on the left are done the day before a workout, and the images on the right are done the day after a workout.  The colors from hottest to coldest are: red, orange, yellow, green then blue.  The hot areas represent increased thermogenesis through brown fat upregulation.  Recently there has been a lot of attention focused on cold thermogenesis as a means of increasing brown fat activity.  Tim Ferriss included it in the Four Hour Body, Jack Kruse, MD includes it as a major component of his interventions and most recently Dr. Ellington Darden has used it as part of the protocol in his new book Body Fat Breakthrough. Although I have not read Dr. Darden’s book yet, I believe he has taken this concept to the next level by exploiting the relationship between high intensity exercise and cold thermogenesis.  Check out the link to the article below.  If you can manage to slog through the technicalities what you will find is that the activation of uncoupling protein (the molecule that uncouples oxidative phosphorylation so that heat is expended in lew or energy production and storage) is improved by the presence of Interleukin-6 (IL-6).  If you will recall, IL-6 is a myokine released by skeletal muscle during intense exercise.  This study used IL-6 knockout mice (animals that are genetically modified to be unable to generate IL-6) to further delineate the action of this myokine as it relates to brown fat thermogenesis.  What the study found was that IL-6 not only amplifies the effects of cold thermogenesis, but that cold thermogenesis is heavily dependent on the presence of IL-6.  With this understanding in mind, the thermal imaging photos taken above take on a whole new meaning.  This subject did not partake of any cold therapy, only her workouts at UE. I can only imagine the synergistic effects if the two were combined.  Perhaps we can repeat this with the inclusion of cold thermogenesis and report back.


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Last week’s WOW was put in the comment thread of the previous post.  I worked out yesterday at UE with Wendy while the kids carried out their paid janitorial gig.

Wendy’s WOW:  MedX Compound Row (with SS cam), MedX Chest Press, SS Systems Pulldown, MedX Overhead Press, MedX Leg Press, Calf Press on MedX Leg Press, TSC Neck Flex/Ext

My WOW:  SS Systems Pulldown, MedX Chest Press, SS Systems Neck Flexion, Nautilus Pullover with SS retrofits, MedX Compound Row, SS Systems Neck Extension, MedX Leg Press.  Workout T-Shirt is the Ideal Exercise Vision Test taken from the Ren and Stimpy cartoon where they joined the army.  Pictures are available on Instagram ultimate_exercise_.

Sticking to my theme of being hooked on myokines, I am attaching the following full text article on the relationship of myokines and exercise to decreasing cancer risk and for treating the cachexia of cancer.  We have had several cancer patients at UE who have had great results training through their diagnosis, much of their chemo and after their chemo is complete.  In the future I believe high intensity strength exercise will be a very big part of both oncology care and cancer prevention.


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Wendy and I did out WOW’s (14 days for Wendy) at UE on Sunday.  There are some photos and videos up on our Instagram and Twitter accounts.  The links can be found now at the bottom of drmcguff.com.

My WOW:  Lumbar Extension on SS Pulldown, MedX Leg Press, Nautilus Pullover with SS retrofits, MedX Chest Press, SS Systems Neck Flexion, MedX Compound Row with SS cam, SS Systems Neck Extension (coupling the chest press with neck flexion and row with neck extension really amplifies the effect on the neck).

Wendy’s WOW: MedX Chest Press, SS Systems Pulldown, MedX Overhead Press, MedX Leg Press, TSC hip adduction/abduction, Freehand squat, TSC neck flexion/extension.

This week’s workout T-shirt was from Doug Holland’s Intelligent Exercise in Shreveport, LA.  Each week will feature a new T-shirt, watch for it on Instagram.  Nothing new to post on the scientific front for now.  Just trying to have some fun with BBS/UE and life in general.

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I have gone back to some workouts emphasizing the full body.  While there is still some split emphasis, the whole body was covered in these workouts.  Both were done at UE.

5/05/14:  Calf on MedX Leg Press, Lumbar Extension on SS Systems Pulldown, MedX Leg Press, MedX Chest Press, Weighted Plank

5/12/14:  Supervised (and video’d) by Instructor Joe Byers:  Nautilus Plate Load Biceps, SS Systems Pulldown, Nautilus Plate Load Triceps, MedX Chest Press, MedX Row with SS cam, MedX Leg Press (reclined “squat” position.

The first workout produced some mild ROBAT on day 2 post-workout that was handled by simply taking a nap.  Today’s workout….we’ll see.  The RenEx pre-exhaust arm routine is a Dura Mater (tough mother-in honor of mother’s day).  For the first couple of hours I felt great and very pumped.  Now the fatigue is setting in.  I will report back tomorrow.  This is definitely one of the most demanding routines I have come across.

In this posting I wanted to make everyone aware that I am opening an additional website: www.drmcguff.com.  I will still be posting my WOW’s and commentary here, and the blog posts will also be available at my new website under the heading “Learn”.  The focus of the new website will be to showcase the products and services that I offer.   Consultations can be scheduled through an online calendar.  Speaking engagements, weekend seminars, and consultations for corporate fitness center, hospital wellness programs can also be accessed there.  The Body by Science Youtube channel can be accessed under the “Watch” heading and I plan on adding content on a much more regular basis.  Finally, my web gurus have insisted that I engage in social media as a means of drawing in more traffic.  I should be participating on Facebook, twitter and Instagram.  Please be patient as I have ZERO experience with social media.  I have gotten my pinky toe a little wet by posting some images and video to Instagram from my workout today.  My Instagram account is listed under ultimate_exercise_.  Go give a look and do what you can to get me started.  Any pointers from those more experienced is appreciated.

My intent is to get much more video and instructional content out there for folks to watch.  I know it can get boring just posting and discussing.  Hopefully this will result in more and better content for everyone to follow.

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I woke up late Saturday after getting home around 2am from working a very busy evening shift.  I did the following workout for shoulders and arms.

MedX Overhead Press

Infimetric Rear Deltoid Fly

Infimetric Lateral Raise

Thick Bar Biceps Curl

Nautilus Plate Load Triceps (with SS retrofits)

Reverse EZ Bar Curl

Thick Bar Wrist Flexion

This was a very effective workout.  The infimetric shoulder work was incredible.  I am always amazed at how quickly and deeply I can inroad with infimetrics.  The same goes for timed static contraction.  With both of these methods I can achieve such a deep level of inroad that I cannot even move my infimetric device or keep in contact with my yoga blocks.  Infimetrics and TSC both seem to illustrate how much we might be able to “hide” during standard, dynamic load-based training.  With infimetrics and TSC I can only last about 45-60 seconds with a graded intent of 50%, 75% and then 100% effort.  With TSC this means each period at a given effort level lasts only 15-20 seconds.

With standard dynamic repetitions I have been using the graded rep intent method (25% on the 1st rep, 50% on 2nd, 75% on 3rd and 100% on all subsequent reps).  I have found that if I am vigilant against any sandbagging that I rarely make it beyond the fourth repetition. This results in a TUL of around 1:20-1:30, which is a fairly short TUL but still not 45-60 seconds.  I am not certain if this is a result of the opportunity to “hide” or sandbag, or if it is simply a difference in modality.  One thing is for certain, using my infimetric device that I constructed out of plumbing pipe from Lowe’s for about $7.00 has resulted in an almost infinite return on investment.  I will attach some photos below of my first 3 exercises in this week’s WOW.


That little device can be used for lateral raise, rear delt fly, chest fly, biceps and triceps and can inroad the targeted musculature to china in about a minute.

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My most recent workout was done on a mini-vacation to Myrtle Beach.  I was due for Chest/Back so I did the Following:

Dumbbell Row, Dumbbell Flat Bech Press, Pulldown (technogym with motion similar to old Nautilus Rotary Latissimus machine), Dumbbell Incline Press, Dumbbell Deadlift.  This was a great workout.  Left me quite sore, but not systemically drained.

Today Wendy did her workout at UE:  MedX Chest Press, SS Systems Pulldown, MedX Overhead Press, MedX Leg Press, TSC hip adduction/abduction, TSC neck flexion/extension.

BBS follower Ricardo sent the following NY Times article on myokines and how they keep your skin looking young.  While not specific to strength training, the article is specific to IL-15 which has been shown to be released with strength exercise.  The link to the article is below for your perusal.


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I did the following workouts over the past week.  I did legs/abs at Fike Gym and Back/Chest/Neck at UE.

3/31 at Fike:  Calf Press, Leg Extension (full extension from 3rd rep on), Leg Curl, Hammer Leg Press, Hammer Clam Shell Abdominal

4/06 at UE:  SS Systems Pulldown, MedX Chest Press (horizontal handles), SS Systems Neck Flexion, Nautilus Pullover with SS retrofits, MedX Chest Press (vertical handles), MedX Row with SS cam, SS Systems Neck Extension.

Both workouts were great.  I recovered well despite a very hectic week in the ER.

There has been much debate in the past about whether resistance training significantly affects hormonal profiles as it pertains to muscle growth.  There is little evidence to show that increases in sex steroids or growth hormone are contributing factors to the growth mechanism.  However, recent research does indicate that resistance training does improve overall hormonal profiles as the relate to general health and sexual function.  This recent study shows that resistance training can restore the activity of enzymes involved in sex steroid synthesis, and ultimately testosterone levels in older male subjects.  Activity levels were restored to youthful levels in this study.

The problem with T supplementation or drugs for erectile dysfunction is that the thought process is like pushing with a rope.  Rather than trying to create the right conditions for the end product, you just supply the end product.  The problem is that the end product is part of a feedback loop; when you supply it exogenously, you further inhibit production.  With resistance exercise you are create the proper stimulus to require the desired end-product, thus keeping both sides of the feedback loop stimulated and balanced.  You get the end product as a result of stimulated production rather than as a supplied entity that shuts down production.

FASEB J. 2014 Apr;28(4):1891-7. doi: 10.1096/fj.13-245480. Epub 2014 Jan 17.

Resistance training restores muscle sex steroid hormone steroidogenesis in older men.


Skeletal muscle can synthesize testosterone and 5α-dihydrotestosterone (DHT) from dehydroepiandrosterone (DHEA) via steroidogenic enzymes in vitro, but hormone levels and steroidogenic enzyme expression decline with aging. Resistance exercise has been shown to increase in plasma sex steroid hormone levels. However, it remains unclear whether resistance training can restore impaired steroidogenic enzyme expressions in older individuals. Six young and 13 older men were recruited, and muscle biopsies were taken from the vastus lateralis at basal state. The same group of older subjects underwent resistance training involving knee extension and flexion exercises for 12 wk, and post-training biopsies were performed 4-5 d after the last exercise session. Muscular sex steroid hormone levels and sex steroidgenesis-related enzyme expressions were significantly lower in older subjects than younger ones at baseline, but 12 wk of resistance training significantly restored hormone levels (DHEA: 432±26 at baseline, 682±31 pg/μg protein, DHT: 6.2±0.9 at baseline, 9.8±1.4 pg/μg protein). Furthermore, the steroidogenesis-related enzymes such as 3β-hydroxysteroid dehydrogenase (HSD), 17β-HSD, and 5α-reductase expressions were significantly restored by resistance training. We conclude progressive resistance training restores age-related declines in sex steroidogenic enzyme and muscle sex steroid hormone levels in older men.-Sato, K., Iemitsu, M., Matsutani, K., Kurihara, T., Hamaoka, T., Fujita, S. Resistance training restores muscle sex steroid hormone steroidogenesis in older men.

Ask your doctor if diet and exercise are right for you!

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The goal is to drive the nail all the way in, flush with the board.  This is the desired level of inroad, fatigue, weight exposure and metabolic work…the “pop-up timer”.

Nail Gun:  This can drive the nail to the desired location with a single action.  As a result, you can accomplish a lot in a shorter span of time.  This is analogous to proper use of RenEx equipment, SuperSlow Systems equipment (in good condition), Retrofitted MedX and Nautilus (in good condition) and certain select pieces from other manufactures such as Cybex or Nautilus.  Properly done, one set gives you all that you need or can stand.  You can stimulate the entire body in short order.  There is little wasted work energy dissipated in the process.  BTW, timed static contraction probably falls in the category, many times requiring no equipment.

Hammer:  This is an elegant and effective tool for getting the job done.  You can drive the nail in with one strike (remember the Karate Kid?), but you also run a risk of bending the nail and subverting the end goal.  Unless you are very practiced, it is likely a better approach to take a more modulated run-up to the end goal, using more controlled and focused strikes until the head of the nail is quite close to the board and then you can finish it off with some hard strikes.  Most barbell movements fit the hammer analogy.  You could squat single set to failure and get a great HIT/BBS effect, but you also will dissipate some energy (ding the board) and are much more likely to bend the nail (lose form and tweak your back, for instance).  Instead I find these movements can still achieve the goal efficiently but through use of cluster sets or jreps.  In cluster reps instead of reaching failure in 12 continuous reps, you might set a goal of performing 5 very solid reps and then resting an interval (anything between 10 and 30 seconds) then repeat 5 reps focusing on perfect form and hard contractions, then rest and keep repeating 5 reps until you get to a cluster where you fail before completing 5 reps.  This basically gives you a running start at any complicating sticking points so that you accumulate adequate contraction and fatigue rather than premature failure due to not being able to overcome the sticking point.  Jreps would involve dividing the movement above and below the sticking point(s), using a weight where you can show perfect form and then working in the hardest zone, then the easier zone(s).  If there are safety issues, the hard zone can be worked close to failure and only the easy zones taken to failure.  John’s Max Pyramid is another variation of making multiple strikes with the hammer to reach the end goal.  With MP you select a very light weight to hold statically at the point of minimum leverage (mid range for most compound movements) for 20 seconds.  Then you jump the weight and repeat.  Do the increases until you cannot make the 20 second mark.  Then go back down the pyramid in the same fashion.  Your set is done when you reach a weight where you can hold for the full 20 seconds or you arrive at your ridiculously light starting weight.  The “hammer” approach applies to most barbell movements and machines that have strength curve issues, but still have acceptable levels of friction.

Rock: This is a really poor tool for the job.  You will have to be very cautious and measured to get the job done.  Even so, you will likely damage the hand holding the nail, have chunks of the tool fly off and when you finally get down to the board, you will likely ding the board as well.  If you are in a survival situation you may elect to use this tool, but most times you will just wait.  Examples include certain barbell movements done incongruently (see the writings and videos of Bill De Simone-enter Moment Arm Exercise at Youtube or your search engine) for examples of what to do and what not to do.  The most common examples however are poorly designed machines.  Unfortunately, this includes most modern manufactured equipment.  Poor biomechanics married with high friction and poor strength curves results in a “rock” that is not worth using.  These really require workarounds and many times will still leave you frustrated.  Think of almost every hotel gym you have been at.  Think of Curves.  Think of the health clubs or university gyms that replaced an entire line of MedX with the latest line of popular equipment.

My latest WOW’s

3/23: Lumbar Extension on SS Systems Pulldown, MedX Chest Press (horizontal handles), Nautilus Pullover with SS retrofits, MedX Chest Press (vertical handles with hand adduction throughout-squeeze handles together), MedX Compound Row with SS cam, SS Systems neck flexion/extension.  All done at UE-Nail Gun style

3/28:  Barbell Overhead Press (cluster 5′s), Dumbbell rear delt (jrep halves), Dumbbell lateral raise (jrep halves), EZ barbell curl (MAE), EZ lying triceps extension (MAE), EZ reverse curl (SSTF), Dumbbell Shrug, MAE forearms using same dumbbells from shrug.  This workout was representative of the “Hammer” approach.

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Here is an update of my last 2 WOW’s.  Chest and Back was done at Fike Gym, and Shoulders/Arms was done at UE.  I kind of wore myself out on the myokine post, and I simply cannot find any studies or topics to post with my most recent WOW’s.  We will therefore leave the responses open to general discussion.

Chest/Back at Fike:  Hands supinated Chins, Dumbbell Bench Press, Dumbbell Rows, Dumbbell Incline Press, Hammer Pulldown, Chest Fly

Shoulders/Arms at UE:  MedX Overhead Press, Bent Fly (rear delt)-Jrep halves, Thick Bar Curls, Nautilus Plate Load Triceps, Thick Bar Wrist Flexion/Extension

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I did my Legs/Abs rotation at Fike this past Tuesday.  It was a good workout overall, except for the “goblet squats” that I had to resort to when all the squat racks and leg presses were occupied.  Through co-contraction and lingering in the lower turnaround, I got the desired effect, but the whole process felt like a monument to outroading.

Calf Exercise

Leg Extesnion

Leg Curl

Goblet Squat

Hammer Clam Shell Abdominal

I know you all are probably tired of hearing me go on about myokines, but I really do believe that they will offer us insight into a lot of what we argue and speculate about.  More importantly, they will uncover objective health and disease-prevention benefits that may change the practice of medicine.  Perhaps one day we will see commercials that say…”ask your doctor if diet and exercise are right for you”.  One of the ways that I know that this may represent a big breakthrough for exercise, is the fact that the literature is not coming out of the exercise physiology community, but is instead coming from departments of cell biology, biochemistry and physiology.  With that in mind I offer the following review article from the Journal of Applied Physiology entitled: Edward F. Adolph Distinguished Lecture: Muscle as an Endocrine Organ: IL-6 and other myokines. I am providing a link to the full text article here:  http://www.jappl.org/content/107/4/1006.full.  I highly suggest taking some time to review the entire article, as it will begin to tie together for you how muscle has effects on other tissues that seem out of proportion to their simple contribution to energy balance.  I will give you a brief rundown of the effects of the major myokines below.

IL-6- This myokine is liberated from contracting skeletal muscle and is currently the most well-understood myokine.  Its concentration increases 100-fold shortly after a bout of contraction.  This abrupt increase entrains an increase in IL-6 receptor (IL-6R) sensitivity.  The increased IL-6R sensitivity results in a lower basal level of IL-6 when exercise is not occurring.  This seems to be a mechanism whereby exercise tolerance and recovery are mediated.  The rapid rise of IL-6 during exercise seems to occur as a result of an amplification cascade and it precedes the release of inflammatory cytokines that are released during exercise.   IL-6 also seems to be an energy sensor, as it tends to amplify more during low-glycogen states and its release can be inhibited by glucose ingestion during an exercise bout.  Release of Nitric Oxide (NO) in contracting skeletal muscle seems to be a pre-translational signaling event that is required for the enhanced release of IL-6, so a pump does seem to feel good for a reason.  IL-6 also underpins the amazing metabolic adaptability of skeletal muscle.  IL-6 helps to augment to adaptions both in glucose and fatty acid oxidation in response to substrate availability.  Fatty acid oxidation is increased and glucose uptake and utilization are optimized.  IL-6 can also function as a Leptin surrogate to activate insulin signaling, which in turn improves insulin sensitivity, explaining why IL-6 knockout mice develop obesity and diabetes.  IL-6 receptor sensitivity correlates directly with exercise tolerance and is in fact trainable, suggesting that recovery ability may be more trainable than we previously thought.  I seriously wonder if fibromyalgia and chronic fatigue will be found to be linked to problems with IL-6 production or receptor sensitivity.   IL-6 is also a powerful anti-inflammatory agent, but it is a pro-inflammatory agent.  In other words, as IL-6R sensitivity decreases and IL-6 levels rise, more inflammation will occur.  This lack of IL-6R sensitivity is thought to be the underlying reason for the systemic inflammation and loss of insulin receptor sensitivity in the metabolic syndrome.

IL-15- This myokine got some coverage in Chapter 8 of BBS for its role in determining one’s potential muscle mass.  Its major role however, is in muscle-fat cross-talk.  IL-15 mRNA levels (genetic signal to be like Doritos and make more) is upregulated in human skeletal muscle after a single bout of strength training suggesting that IL-15 may accumulate in muscle as a consequence of regular training.  One of the major effects of IL-15 is the reduction in fat mass, particularly trunkal/abdominal fat (which is the fat that produces the most inflammatory cytokines known as adipokines). IL-15 may be involved in signaling that signals “uncoupling protein” which converts energy-storing white fat into heat-liberating brown fat.   IL-15 has also been shown to increase bone mineral content.  The changes in fat mass are irrespective of the energy balance contribution of the activity, and the effects of bone mineral content are irrespective of mechanical loading issues as these effects are seen with simple infusion of IL-15 in lab animals.  The exact signaling pathways for these effects are not yet known, but are a fertile ground for ongoing scholarly activity.

IL-8- IL-8 was previously known as a chemokine that attracted neutrophils (white blood cells) during infection or tissue damage and was also known to be involved with angiogenesis, tumorogenesis and metastasis of cancer cells.  However, these were its systemic effect. Recent findings have shown that IL-8 has a local effect within skeletal muscle that are triggered by exhaustive exercise.  The major effect is to signal angiogenesis (the development of new blood vessels) to serve the working muscle and provide the supply network to service new muscle growth.  IL-8 has some systemic effects that are worrisome, but fortunately, IL-8 produced in skeletal muscles exerts only local effects and is not released into the systemic circulation.

BDNF- BDNF is a member of the neurotrophic family of cytokines that promotes the survival, growth and maintenance of neurons.  BDNF thus plays a major role in learning and memory.  Like many things in life, BDNF’s value is most when we lose it.  BDNF has been shown to be decreased in Alzheimer’s disease, major depression, memory impairment unrelated to dementia, obesity, type II diabetes and is an independent marker for mortality in the elderly.  BDNF also increases fat oxidation.  BDNF has been shown to be increased in skeletal muscle as a result of exercise, but has not been shown to be released into the circulation.  However, BDNF work in both an autocrine and paracrine fashion and its effects may be related to total body stores and not circulating levels.

Myomouse and other Cytokins- Kenneth Walsh in Boston has created a very muscular mouse called “myomouse” by manipulating a gene for “myogenic Akt” signaling.  The resultant animal demonstrates increased muscle mass, decreased fat mass and optimized whole body metabolism.  Walsh has devised a protocol to discover new myokines that confer the phenotypic changes brought on by myogenic Akt induction.  As a result he has recently discovered FGF21 (previously known to be induced by fasting) which causes increased fatty acid utilization as well as increased gluconeogenesis (making glucose from end products of glucose metabolism or proteins) with out increasing glycogenolysis (glycogen breakdown)…in other words you can make new glucose without having to tap your glucose stores (not eating your metabolic seed corn).  This animal model promises to uncover many new myokines in the future.

Just some of the descriptors of these myokines triggers some questions in my head.  For instance, can IL-6R sensitivity be optimized on a certain continuum of intensity/volume/frequency?  Could this be why some experience ROBAT more aggressively when they go to infrequent consolidated routines.  Is there some defect in IL-6R sensitivity that underlies fibromyalgia that could be corrected with proper exercise dosing?  Does IL-6R sensitivity correlate with my notion of “the active genotype” and the rise in NEAT (non-exercise activity therom0genesis) in my clients?  If IL-8 is released during exhaustive exercise, could super high intensity techniques result in levels that allow leakage into the general circulation causing unintended systemic inflammation, and could this be the biomarker for “outroading” or ROBAT? (run over by a truck, for those unfamiliar with the lingo).  Could subfailure sessions have some value by the action on keepin IL-6R sensitivity high between higher intensity sessions?  Could the myomouse demonstrate the optimal balance of myokines that correlates with this particular phenotype?   If so, could we collect data on how protocol affects these ratios and finally come up with a way to replicate the myokine profile of the myomouse as a means of optimizing our own body composition and metabolism?  All I can offer at this point is to quote Glenn Reynolds at Instapundit and say….”FASTER PLEASE”.

Post your WOW’s and your thoughts.

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