CPR COACH - Cpr Optimization and ACHievement

Less than half of children who suffer an in-hospital cardiac arrest (IHCA) will survive to hospital discharge. Effective chest compression depth, rate and minimal interruptions are essential to improve outcomes following IHCA. Devices placed on the chest that provide visual feedback during cardiopulmonary resuscitation (CPR) can improve chest compression quality, but there is substantial room for improvement. Strategies are needed to help teams translate visual CPR feedback into optimized CPR delivery.

Hunt et al are developing the CPR Coach “at the Bench”, i.e. in the simulation lab after recognizing Resuscitation Leaders cannot simultaneously manage high quality basic life support (BLS), pediatric advanced life support (PALS), diagnose and treat reversible causes and do all well. A CPR Coach will provide real time feedback to compressors to optimize compliance with American Heart Association (AHA) CPR guidelines and cognitively unload the Resuscitation Leader, enabling them to focus on the PALS algorithm and reversible causes. Hunt's previous research reports a significant increase in “excellent epochs” of CPR (22% to 45%; p<0.001) after integrating the CPR Coach into resuscitation teams using CPR feedback defibrillators as part of a resuscitation quality bundle at a single site. Cheng et al recently leveraged the INSPIRE network to conduct a multicenter, randomized controlled trial of simulated cardiac arrests, with significant improvement in excellent CPR for teams with a CPR Coach versus those without. The next step in translation from Bench to Bedside is assessment of scalability and generalizability, i.e. to roll out the simulation-based CPR Coach role curriculum at a clinical unit level across the PediRES-Q international resuscitation network, enrolling 14 sites with existing Data Use Agreements.   

Goals and Aims

Our specific aims are to:

1. Develop a simulation-based “CPR Coach Roll-out” curriculum for clinical units that employs the Rapid Cycle Deliberate Practice (RCDP) approach and on-line endurable educational materials.
    
2. Perform a stepped wedge, cluster randomized trial across the PediRES-Q Network to assess whether implementation of the CPR Coach Roll-out is associated with increased compliance with AHA CPR guidelines for pediatric IHCA at the unit level
    
3. Perform exploratory analyses to enable design of future studies regarding the relationship between the CPR Coach Roll-out and the a) Resuscitation Leader’s perceived workload and b) survival to discharge.

The long-term objective of this project is to increase neurologically intact survival from IHCA for children. If successful, introducing the CPR Coach Roll-out curriculum will be associated with increased compliance with AHA CPR guidelines on a multi-center level and enable design of larger studies to evaluate the impact on survival. This project directly aligns with the INSPIRE mission to improve delivery of medical care (high quality CPR) to acute ill children (in cardiac arrest) and ultimately improve survival (our exploratory aim) in the pediatric population.

Sites and Enrollment

We are currently no longer accepting sites for enrollment Our current sites include:

• Akron Children's Hospital
• Boston Children's Hospital
• Children's Healthcare of Atlanta
• Cincinnati Children's Hospital Medical Center
• Children's Hospital of Orange County
• Children's Hospital of Philadelphia
• Cohen Children's Medical Center 
• Johns Hopkins All Children's Hospital 
• Nationwide Children's Hospital
• Riley Hospital of Children
• Seattle Children's Hospital
• Sick Kids of Toronto 
• Stanford Children's Health
• UT-Southwestern

Please contact [email protected] with any questions.

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Cheng, A., Duff, J. P., Kessler, D., Tofil, N. M., Davidson, J., Lin, Y., … Hunt, E. A. (2018). Optimizing CPR performance with CPR coaching for pediatric cardiac arrest: A randomized simulation-based clinical trial. Resuscitation, 132, 33–40. https://doi.org/10.1016/j.resuscitation.2018.08.021

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Cheng, A., Nadkarni, V. M., Mancini, M. B., Hunt, E. A., Sinz, E. H., Merchant, R. M., … Bhanji, F. (2018). Resuscitation Education Science: Educational Strategies to Improve Outcomes From  Cardiac Arrest: A Scientific Statement From the American Heart Association. Circulation. https://doi.org/10.1161/CIR.0000000000000583

Brown, K. M., Mudd, S. S., Hunt, E. A., Perretta, J. S., Shilkofski, N. A., Diddle, J. W., … Nelson McMillan, K. (2018). A Multi-Institutional Simulation Boot Camp for Pediatric Cardiac Critical Care Nurse Practitioners. Pediatric Critical Care Medicine : A Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 19(6), 564–571. https://doi.org/10.1097/PCC.0000000000001532

Cheng, A., Auerbach, M., Calhoun, A., Mackinnon, R., Chang, T. P., Nadkarni, V., … Kessler, D. (2018). Building a Community of Practice for Researchers: The International Network for Simulation-Based Pediatric Innovation, Research and Education. Simulation in Healthcare : Journal of the Society for Simulation in Healthcare, 13(3S Suppl 1), S28–S34. https://doi.org/10.1097/SIH.0000000000000269

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Lautz, A. J., Martin, K. C., Nishisaki, A., Bonafide, C. P., Hales, R. L., Hunt, E. A., … Boyer, D. L. (2018). Focused Training for the Handover of Critical Patient Information During Simulated Pediatric Emergencies. Hospital Pediatrics, 8(4), 227–231. https://doi.org/10.1542/hpeds.2017-0173

Romig, M., Duval-Arnould, J., Winters, B. D., Newton, H., & Sapirstein, A. (2018). Intensivist Presence at Code Events Is Associated with High Survival and Increased Documentation Rates. Critical Care Clinics, 34(2), 259–266. https://doi.org/10.1016/j.ccc.2017.12.009

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Shilkofski, N. A., Perretta, J. S., & Hunt, E. A. (2018). In Reply to Maloney et al. Academic Medicine : Journal of the Association of American Medical Colleges, 93(3), 343. https://doi.org/10.1097/ACM.0000000000002090

Nelson McMillan, K., Rosen, M. A., Shilkofski, N. A., Bradshaw, J. H., Saliski, M., & Hunt, E. A. (2018). Cognitive Aids Do Not Prompt Initiation of Cardiopulmonary Resuscitation in Simulated Pediatric Cardiopulmonary Arrests. Simulation in Healthcare : Journal of the Society for Simulation in Healthcare, 13(1), 41–46. https://doi.org/10.1097/SIH.0000000000000297

Atkins, D. L., de Caen, A. R., Berger, S., Samson, R. A., Schexnayder, S. M., Joyner, B. L. J., … Meaney, P. A. (2018). 2017 American Heart Association Focused Update on Pediatric Basic Life Support and Cardiopulmonary Resuscitation Quality: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation, 137(1), e1–e6. https://doi.org/10.1161/CIR.0000000000000540

Cheng, A., Lin, Y., Nadkarni, V., Wan, B., Duff, J., Brown, L., … Hunt, E. A. (2018). The effect of step stool use and provider height on CPR quality during pediatric  cardiac arrest: A simulation-based multicentre study. CJEM, 20(1), 80–88. https://doi.org/10.1017/cem.2017.12

Jung, J., Franzen, D., Lawson, L., Manthey, D., Tews, M., Dubosh, N., … Hiller, K. (2018). The National Clinical Assessment Tool for Medical Students in the Emergency Department (NCAT-EM). The Western Journal of Emergency Medicine, 19(1), 66–74. https://doi.org/10.5811/westjem.2017.10.34834

Shilkofski, N., Crichlow, A., Rice, J., Cope, L., Kyaw, Y. M., Mon, T., … Jung, J. (2018). A Standardized Needs Assessment Tool to Inform the Curriculum Development Process for Pediatric Resuscitation Simulation-Based Education in Resource-Limited Settings. Frontiers in Pediatrics, 6, 37. https://doi.org/10.3389/fped.2018.00037

Duval-Arnould, J. M., Newton, H. M., McNamara, L., Engorn, B. M., Jones, K., Bernier, M., … Hunt, E. A. (2018). Design and Deployment of a Pediatric Cardiac Arrest Surveillance System. Critical Care Research and Practice, 2018, 9187962. https://doi.org/10.1155/2018/9187962

Hamrick, J. T., Hamrick, J. L., Bhalala, U., Armstrong, J. S., Lee, J.-H., Kulikowicz, E., … Shaffner, D. H. (2017). End-Tidal CO2-Guided Chest Compression Delivery Improves Survival in a Neonatal Asphyxial Cardiac Arrest Model. Pediatric Critical Care Medicine : A Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 18(11), e575–e584. https://doi.org/10.1097/PCC.0000000000001299

Chime, N. O., & Hunt, E. A. (2017). The authors reply. Pediatric Critical Care Medicine : A Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 18(11), 1089–1090. https://doi.org/10.1097/PCC.0000000000001315

Noje, C., Fishe, J. N., Costabile, P. M., Klein, B. L., Hunt, E. A., & Pronovost, P. J. (2017). Interhospital Transport of Children Undergoing Cardiopulmonary Resuscitation: A Practical and Ethical Dilemma. Pediatric Critical Care Medicine : A Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 18(10), e477–e481. https://doi.org/10.1097/PCC.0000000000001271

Hunt, E. N., Martens, M. P., Wang, K. T., & Yan, G. C. (2017). Acculturative stress as a moderator for international student drinking behaviors  and alcohol use consequences. Journal of Ethnicity in Substance Abuse, 16(3), 263–275. https://doi.org/10.1080/15332640.2016.1185656

Bhatti, N. I., Abid, M. A., Stewart, C. M., Fleishman, C., Jefferson, N., & Ishman, S. L. (2017). Development and Pilot Testing of an Objective Structured Clinical Examination for Obstructive Sleep Apnea. Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery, 157(3), 524–529. https://doi.org/10.1177/0194599817695544

Chime, N. O., Riese, V. G., Scherzer, D. J., Perretta, J. S., McNamara, L., Rosen, M. A., & Hunt, E. A. (2017). Epinephrine Auto-Injector Versus Drawn Up Epinephrine for Anaphylaxis Management: A Scoping Review. Pediatric Critical Care Medicine : A Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 18(8), 764–769. https://doi.org/10.1097/PCC.0000000000001197

Yang, C. P., Hunt, E. A., Shilkofski, N., Dudas, R., Egbuta, C., & Schwartz, J. M. (2017). Can Telemedicine Improve Adherence to Resuscitation Guidelines for Critically Ill Children at Community Hospitals? A Randomized Controlled Trial Using High-Fidelity Simulation. Pediatric Emergency Care, 33(7), 474–479. https://doi.org/10.1097/PEC.0000000000000653

Heiser Rosenberg, C. E., Terhaar, M. F., Ascenzi, J. A., Walbert, A., Kokoszka, K. M., Perretta, J. S., & Miller, M. R. (2017). Becoming Parent and Nurse: High-Fidelity Simulation in Teaching Ambulatory Central Line Infection Prevention to Parents of Children with Cancer. Joint Commission Journal on Quality and Patient Safety, 43(5), 251–258. https://doi.org/10.1016/j.jcjq.2017.02.007

Hunt, Elizabeth A., Duval-Arnould, J. M., Chime, N. O., Jones, K., Rosen, M., Hollingsworth, M., … Perretta, J. S. (2017). Integration of in-hospital cardiac arrest contextual curriculum into a basic life support course: a randomized, controlled simulation study. Resuscitation, 114, 127–132. https://doi.org/10.1016/j.resuscitation.2017.03.014

Coombs, C. M., Shields, R. Y., Hunt, E. A., Lum, Y. W., Sosnay, P. R., Perretta, J. S., … Shilkofski, N. A. (2017). Design, Implementation, and Evaluation of a Simulation-Based Clinical Correlation Curriculum as an Adjunctive Pedagogy in an Anatomy Course. Academic Medicine : Journal of the Association of American Medical Colleges, 92(4), 494–500. https://doi.org/10.1097/ACM.0000000000001387

Scherzer, D. J., Chime, N. O., Tofil, N. M., Hamilton, M. F., Singh, K., Stanley, R. M., … Hunt, E. A. (2017). Survey of pediatric trainee knowledge: dose, concentration, and route of epinephrine. Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology, 118(4), 516–518. https://doi.org/10.1016/j.anai.2017.01.024

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Portnoy, D. S., Willis, S. C., Hunt, E., Swift, D. G., Gold, J. R., & Conway, K. W. (2017). Molecular phylogenetics of New World searobins (Triglidae; Prionotinae). Molecular Phylogenetics and Evolution, 107, 382–387. https://doi.org/10.1016/j.ympev.2016.11.017

Bhanji, F., Topjian, A. A., Nadkarni, V. M., Praestgaard, A. H., Hunt, E. A., Cheng, A., … Berg, R. A. (2017). Survival Rates Following Pediatric In-Hospital Cardiac Arrests During Nights and  Weekends. JAMA Pediatrics, 171(1), 39–45. https://doi.org/10.1001/jamapediatrics.2016.2535

Hiller, K. M., Franzen, D., Lawson, L., Manthey, D., Fisher, J., Haughey, M., … Jung, J. (2017). Clinical Assessment of Medical Students in the Emergency Department, a National Consensus Conference. The Western Journal of Emergency Medicine, 18(1), 82–83. https://doi.org/10.5811/westjem.2016.11.32686

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Jung, J. (2016). Optimizing Survival Outcomes For Adult Patients With Nontraumatic Cardiac Arrest. Emergency Medicine Practice, 18(10), 1–24.

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Raymond, T. T., Bonafide, C. P., Praestgaard, A., Nadkarni, V. M., Berg, R. A., Parshuram, C. S., & Hunt, E. A. (2016). Pediatric Medical Emergency Team Events and Outcomes: A Report of 3647 Events From the American Heart Association’s Get With the Guidelines-Resuscitation Registry. Hospital Pediatrics, 6(2), 57–64. https://doi.org/10.1542/hpeds.2015-0132

Cheng, A., Kessler, D., Mackinnon, R., Chang, T. P., Nadkarni, V. M., Hunt, E. A., … Auerbach, M. (2016b). Reporting guidelines for health care simulation research: extensions to the CONSORT and STROBE statements. Advances in Simulation (London, England), 1, 25. https://doi.org/10.1186/s41077-016-0025-y

Shilkofski, N., & Hunt, E. A. (2015). Identification of Barriers to Pediatric Care in Limited-Resource Settings: A Simulation Study. Pediatrics, 136(6), e1569-1575. https://doi.org/10.1542/peds.2015-2677

Cheng, A., Hunt, E. A., Grant, D., Lin, Y., Grant, V., Duff, J. P., … Chime, N. (2015). Variability in quality of chest compressions provided during simulated cardiac arrest across nine pediatric institutions. Resuscitation, 97, 13–19. https://doi.org/10.1016/j.resuscitation.2015.08.024

Atkins, D. L., Berger, S., Duff, J. P., Gonzales, J. C., Hunt, E. A., Joyner, B. L., … Schexnayder, S. M. (2015a). Part 11: Pediatric Basic Life Support and Cardiopulmonary Resuscitation Quality:  2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation, 132(18 Suppl 2), S519-525. https://doi.org/10.1161/CIR.0000000000000265

Bord, S., Retezar, R., McCann, P., & Jung, J. (2015). Development of an Objective Structured Clinical Examination for Assessment of Clinical Skills in an Emergency Medicine Clerkship. The Western Journal of Emergency Medicine, 16(6), 866–870. https://doi.org/10.5811/westjem.2015.9.27307

Atkins, D. L., Berger, S., Duff, J. P., Gonzales, J. C., Hunt, E. A., Joyner, B. L., … Schexnayder, S. M. (2015b). Part 11: Pediatric Basic Life Support and Cardiopulmonary Resuscitation Quality:  2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care (Reprint). Pediatrics, 136 Suppl 2, S167-175. https://doi.org/10.1542/peds.2015-3373E

Eppich, W. J., Hunt, E. A., Duval-Arnould, J. M., Siddall, V. J., & Cheng, A. (2015). Structuring feedback and debriefing to achieve mastery learning goals. Academic Medicine : Journal of the Association of American Medical Colleges, 90(11), 1501–1508. https://doi.org/10.1097/ACM.0000000000000934

Mangold, K. A., Jeffers, J. M., Burns, R. A., Trainor, J. L., Unti, S. M., Eppich, W., & Adler, M. D. (2015). An Objective Structured Clinical Examination to Improve Formative Assessment for  Senior Pediatrics Residents. Journal of Graduate Medical Education, 7(3), 470–474. https://doi.org/10.4300/JGME-D-14-00777.1

Arnholt, A. M., Duval-Arnould, J. M., McNamara, L. M., Rosen, M. A., Singh, K., & Hunt, E. A. (2015). Comparatively Evaluating Medication Preparation Sequences for Treatment of Hyperkalemia in Pediatric Cardiac Arrest: A Prospective, Randomized, Simulation-Based Study. Pediatric Critical Care Medicine : A Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 16(7), e224-230. https://doi.org/10.1097/PCC.0000000000000497

Cheng, A., Lockey, A., Bhanji, F., Lin, Y., Hunt, E. A., & Lang, E. (2015). The use of high-fidelity manikins for advanced life support training--A systematic review and meta-analysis. Resuscitation, 93, 142–149. https://doi.org/10.1016/j.resuscitation.2015.04.004

Welsh, W. N., Lin, H.-J., Peters, R. H., Stahler, G. J., Lehman, W. E. K., Stein, L. A. R., … Frisman, L. K. (2015). Effects of a strategy to improve offender assessment practices: Staff perceptions of implementation outcomes. Drug and Alcohol Dependence, 152, 230–238. https://doi.org/10.1016/j.drugalcdep.2015.03.033

Bouchghoul, H., Hornez, E., Duval-Arnould, X., Philippe, H.-J., & Nizard, J. (2015). Humanitarian obstetric care for refugees of the Syrian war. The first 6 months of experience of Gynecologie Sans Frontieres in Zaatari Refugee Camp (Jordan). Acta Obstetricia et Gynecologica Scandinavica, 94(7), 755–759. https://doi.org/10.1111/aogs.12638

Gedlu, E., Tadesse, A., Cayea, D., Doherty, M., Bekele, A., Mekasha, A., … Jung, J. (2015). INTRODUCTION OF SIMULATION BASED MEDICAL EDUCATION AT ADDIS ABABA UNIVERSITY COLLEGE OF HEALTH SCIENCES: EXPERIENCE AND CHALLENGE. Ethiopian Medical Journal, Suppl 2, 1–8.

Tackett, S., Shochet, R., Shilkofski, N. A., Colbert-Getz, J., Rampal, K., Abu Bakar, H., & Wright, S. (2015). Learning environment assessments of a single curriculum being taught at two medical schools 10,000 miles apart. BMC Medical Education, 15, 105. https://doi.org/10.1186/s12909-015-0388-0

Parshuram, C. S., Dryden-Palmer, K., Farrell, C., Gottesman, R., Gray, M., Hutchison, J. S., … Willan, A. R. (2015). Evaluating processes of care and outcomes of children in hospital (EPOCH): study  protocol for a randomized controlled trial. Trials, 16, 245. https://doi.org/10.1186/s13063-015-0712-3

Chime, N. O., Luo, X., McNamara, L., Nishisaki, A., & Hunt, E. A. (2015). A survey demonstrating lack of consensus on the sequence of medications for treatment of hyperkalemia among pediatric critical care providers. Pediatric Critical Care Medicine : A Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 16(5), 404–409. https://doi.org/10.1097/PCC.0000000000000384

McCrory, Michael C., Aboumatar, H. A., & Hunt, E. A. (2015). Communication at pediatric rapid response events: a survey of health care providers. Hospital Pediatrics, 5(6), 301–308. https://doi.org/10.1542/hpeds.2014-0120

Tews, M. C., Ditz Wyte, C. M., Coltman, M., Hiller, K., Jung, J., Oyama, L. C., … Ander, D. S. (2015). Implementing a third-year emergency medicine medical student curriculum. The Journal of Emergency Medicine, 48(6), 732-743.e8. https://doi.org/10.1016/j.jemermed.2014.12.063

Hunt, E., Bornovalova, M. A., Kimonis, E. R., Lilienfeld, S. O., & Poythress, N. G. (2015). Psychopathy factor interactions and co-occurring psychopathology: Does measurement approach matter? Psychological Assessment, 27(2), 583–595. https://doi.org/10.1037/pas0000055

Hunt, E., Peters, R. H., & Kremling, J. (2015). Behavioral health treatment history among persons in the justice system: Findings from the Arrestee Drug Abuse Monitoring II Program. Psychiatric Rehabilitation Journal, 38(1), 7–15. https://doi.org/10.1037/prj0000132

Hunt, Elizabeth A., Heine, M., Shilkofski, N. S., Bradshaw, J. H., Nelson-McMillan, K., Duval-Arnould, J., & Elfenbein, R. (2015). Exploration of the impact of a voice activated decision support system (VADSS) with video on resuscitation performance by lay rescuers during simulated cardiopulmonary arrest. Emergency Medicine Journal : EMJ, 32(3), 189–194. https://doi.org/10.1136/emermed-2013-202867

Cheng, A., Brown, L. L., Duff, J. P., Davidson, J., Overly, F., Tofil, N. M., … Nadkarni, V. M. (2015). Improving cardiopulmonary resuscitation with a CPR feedback device and refresher  simulations (CPR CARES Study): a randomized clinical trial. JAMA Pediatrics, 169(2), 137–144. https://doi.org/10.1001/jamapediatrics.2014.2616

Schmidt, T. A., Hunt, E. O., Zive, D., Fromme, E., & Tolle, S. (2015). In response to letter to the editor. The Journal of Emergency Medicine, 48(2), 217–218. https://doi.org/10.1016/j.jemermed.2014.07.057

Cheng, A., Overly, F., Kessler, D., Nadkarni, V. M., Lin, Y., Doan, Q., … Brown, L. L. (2015). Perception of CPR quality: Influence of CPR feedback, Just-in-Time CPR training and provider role. Resuscitation, 87, 44–50. https://doi.org/10.1016/j.resuscitation.2014.11.015

Hunt, Elizabeth A., Cruz-Eng, H., Bradshaw, J. H., Hodge, M., Bortner, T., Mulvey, C. L., … Sinz, E. H. (2015). A novel approach to life support training using “action-linked phrases”. Resuscitation, 86, 1–5. https://doi.org/10.1016/j.resuscitation.2014.10.007

Sullivan, N. J., Duval-Arnould, J., Twilley, M., Smith, S. P., Aksamit, D., Boone-Guercio, P., … Hunt, E. A. (2015). Simulation exercise to improve retention of cardiopulmonary resuscitation priorities for in-hospital cardiac arrests: A randomized controlled trial. Resuscitation, 86, 6–13. https://doi.org/10.1016/j.resuscitation.2014.10.021

Berg, K., Blatt, B., Lopreiato, J., Jung, J., Schaeffer, A., Heil, D., … Hojat, M. (2015). Standardized patient assessment of medical student empathy: ethnicity and gender  effects in a multi-institutional study. Academic Medicine : Journal of the Association of American Medical Colleges, 90(1), 105–111. https://doi.org/10.1097/ACM.0000000000000529

Tackett, S., Bakar, H. A., Shilkofski, N. A., Coady, N., Rampal, K., & Wright, S. (2015). Profiling medical school learning environments in Malaysia: a validation study of the Johns Hopkins Learning Environment Scale. Journal of Educational Evaluation for Health Professions, 12, 39. https://doi.org/10.3352/jeehp.2015.12.39

Lee, J. K., Brady, K. M., Chung, S.-E., Jennings, J. M., Whitaker, E. E., Aganga, D., … Shaffner, D. H. (2014). A pilot study of cerebrovascular reactivity autoregulation after pediatric cardiac arrest. Resuscitation, 85(10), 1387–1393. https://doi.org/10.1016/j.resuscitation.2014.07.006

Hunt, Elizabeth A., Duval-Arnould, J. M., Nelson-McMillan, K. L., Bradshaw, J. H., Diener-West, M., Perretta, J. S., & Shilkofski, N. A. (2014). Pediatric resident resuscitation skills improve after “rapid cycle deliberate practice” training. Resuscitation, 85(7), 945–951. https://doi.org/10.1016/j.resuscitation.2014.02.025

Cheng, A., Auerbach, M., Hunt, E. A., Chang, T. P., Pusic, M., Nadkarni, V., & Kessler, D. (2014). Designing and conducting simulation-based research. Pediatrics, 133(6), 1091–1101. https://doi.org/10.1542/peds.2013-3267

Edelson, D. P., Yuen, T. C., Mancini, M. E., Davis, D. P., Hunt, E. A., Miller, J. A., & Abella, B. S. (2014). Hospital cardiac arrest resuscitation practice in the United States: a nationally representative survey. Journal of Hospital Medicine, 9(6), 353–357. https://doi.org/10.1002/jhm.2174

Bruch, J., Rehn, B., Duval-Arnould, G., Efskind, J., Roderer, G., & Sebastian, P. (2014). Toxicological investigations on the respirable fraction of silicon carbide grain  products by the in vitro vector model. Inhalation Toxicology, 26(5), 278–288. https://doi.org/10.3109/08958378.2014.885099

Murphy, D., Hunt, E., Luzon, O., & Greenberg, N. (2014). Exploring positive pathways to care for members of the UK Armed Forces receiving  treatment for PTSD: a qualitative study. European Journal of Psychotraumatology, 5. https://doi.org/10.3402/ejpt.v5.21759

Hunt, E. J. F., Wessely, S., Jones, N., Rona, R. J., & Greenberg, N. (2014). The mental health of the UK Armed Forces: where facts meet fiction. European Journal of Psychotraumatology, 5. https://doi.org/10.3402/ejpt.v5.23617

Aufderheide, T. P., Nolan, J. P., Jacobs, I. G., van Belle, G., Bobrow, B. J., Marshall, J., … Eng Hock Ong, M. (2013). Global health and emergency care: a resuscitation research agenda--part 1. Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine, 20(12), 1289–1296. https://doi.org/10.1111/acem.12270

Lou, J.-S., Dimitrova, D. M., Hammerschlag, R., Nutt, J., Hunt, E. A., Eaton, R. W., … Oken, B. S. (2013). Effect of expectancy and personality on cortical excitability in Parkinson’s disease. Movement Disorders : Official Journal of the Movement Disorder Society, 28(9), 1257–1262. https://doi.org/10.1002/mds.25471

Cummings, J. R., Bornovalova, M. A., Ojanen, T., Hunt, E., MacPherson, L., & Lejuez, C. (2013). Time doesn’t change everything: the longitudinal course of distress tolerance and its relationship with externalizing and internalizing symptoms during early adolescence. Journal of Abnormal Child Psychology, 41(5), 735–748. https://doi.org/10.1007/s10802-012-9704-x

Cheng, A., Hunt, E. A., Donoghue, A., Nelson-McMillan, K., Nishisaki, A., Leflore, J., … Nadkarni, V. M. (2013). Examining pediatric resuscitation education using simulation and scripted debriefing: a multicenter randomized trial. JAMA Pediatrics, 167(6), 528–536. https://doi.org/10.1001/jamapediatrics.2013.1389

Hunt, E. (2013). Promoting fluid intake. Nursing Standard (Royal College of Nursing (Great Britain) : 1987), 27(34), 57.

Hunt, E. A. K., Jain, N. G., & Somers, M. J. G. (2013). Apheresis therapy in children: an overview of key technical aspects and a review  of experience in pediatric renal disease. Journal of Clinical Apheresis, 28(1), 36–47. https://doi.org/10.1002/jca.21260

Colbert-Getz, J. M., Fleishman, C., Jung, J., & Shilkofski, N. (2013). How do gender and anxiety affect students’ self-assessment and actual performance on a high-stakes clinical skills examination? Academic Medicine : Journal of the Association of American Medical Colleges, 88(1), 44–48. https://doi.org/10.1097/ACM.0b013e318276bcc4

Deiorio, N. M., Fitch, M. T., Jung, J., Promes, S. B., Thibodeau, L. G., Woolley, W. L., … Gruppen, L. D. (2012). Evaluating educational interventions in emergency medicine. Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine, 19(12), 1442–1453. https://doi.org/10.1111/acem.12022

Meaney, P. A., Sutton, R. M., Tsima, B., Steenhoff, A. P., Shilkofski, N., Boulet, J. R., … Nadkarni, V. M. (2012). Training hospital providers in basic CPR skills in Botswana: acquisition, retention and impact of novel training techniques. Resuscitation, 83(12), 1484–1490. https://doi.org/10.1016/j.resuscitation.2012.04.014

Cunningham, N. J., Weiland, T. J., van Dijk, J., Paddle, P., Shilkofski, N., & Cunningham, N. Y. (2012). Telephone referrals by junior doctors: a randomised controlled trial assessing the impact of SBAR in a simulated setting. Postgraduate Medical Journal, 88(1045), 619–626. https://doi.org/10.1136/postgradmedj-2011-130719

Soong, T. R., Jung, J. J., Kelen, G. D., Rothman, R. E., Burah, A., Shahan, J. B., & Hsieh, Y.-H. (2012). Is inadequate human immunodeficiency virus care associated with increased ED and  hospital utilization? A prospective study in human immunodeficiency virus-positive ED patients. The American Journal of Emergency Medicine, 30(8), 1466–1473. https://doi.org/10.1016/j.ajem.2011.11.020

Hunt, E., Gee, S., & Ranjith, G. (2012). Vitamin prescription for the prevention and treatment of Wernicke’s encephalopathy. QJM : Monthly Journal of the Association of Physicians, 105(10), 1033. https://doi.org/10.1093/qjmed/hcs160

Hunt, E. (2012). Atrial fibrillation. Nursing Standard (Royal College of Nursing (Great Britain) : 1987), 27(1), 59–60. https://doi.org/10.7748/ns2012.09.27.1.59.c9272

Bembea, M. M., Rapan Parbuoni, K. A., Zimmer, K. P., Veltri, M. A., Shilkofski, N. A., McMillan-Nelson, K., … Hunt, E. A. (2012). Characteristics of medication use during pediatric medical emergency team events  and the role of a pharmacist-provided medication supply. The Journal of Pediatric Pharmacology and Therapeutics : JPPT : The Official Journal of PPAG, 17(3), 236–245. https://doi.org/10.5863/1551-6776-17.3.236

McCrory, Michael Conor, Aboumatar, H., Custer, J. W., Yang, C. P., & Hunt, E. A. (2012). “ABC-SBAR” training improves simulated critical patient hand-off by pediatric interns. Pediatric Emergency Care, 28(6), 538–543. https://doi.org/10.1097/PEC.0b013e3182587f6e

Bornovalova, M. A., Gratz, K. L., Daughters, S. B., Hunt, E. D., & Lejuez, C. W. (2012). Initial RCT of a distress tolerance treatment for individuals with substance use  disorders. Drug and Alcohol Dependence, 122(1–2), 70–76. https://doi.org/10.1016/j.drugalcdep.2011.09.012

Lucio, R., Hunt, E., & Bornovalova, M. (2012). Identifying the necessary and sufficient number of risk factors for predicting academic failure. Developmental Psychology, 48(2), 422–428. https://doi.org/10.1037/a0025939

Schuster, R., Bornovalova, M., & Hunt, E. (2012). The influence of depression on the progression of HIV: direct and indirect effects. Behavior Modification, 36(2), 123–145. https://doi.org/10.1177/0145445511425231

Duval-Arnould, J., Mathews, S. C., Weeks, K., Colantuoni, E., Mukherjee, A., Nundy, S., … Berenholtz, S. M. (2012). Using the Opportunity Estimator tool to improve engagement in a quality and safety intervention. Joint Commission Journal on Quality and Patient Safety, 38(1), 41–47, 1.

Rosen, M. A., Hunt, E. A., Pronovost, P. J., Federowicz, M. A., & Weaver, S. J. (2012). In situ simulation in continuing education for the health care professions: a systematic review. The Journal of Continuing Education in the Health Professions, 32(4), 243–254. https://doi.org/10.1002/chp.21152

Jung, J. (2012). Trends in medical education: simulation. Maryland Medicine : MM : A Publication of MEDCHI, the Maryland State Medical Society, 13(1), 21–22.

Clever, S. L., Dudas, R. A., Solomon, B. S., Yeh, H. C., Levine, D., Bertram, A., … Cofrancesco, J. J. (2011). Medical student and faculty perceptions of volunteer outpatients versus simulated patients in communication skills training. Academic Medicine : Journal of the Association of American Medical Colleges, 86(11), 1437–1442. https://doi.org/10.1097/ACM.0b013e3182305bc0

Watson, C. M., Duval-Arnould, J. M., McCrory, M. C., Froz, S., Connors, C., Perl, T. M., & Hunt, E. A. (2011). Simulated pediatric resuscitation use for personal protective equipment adherence measurement and training during the 2009 influenza (H1N1) pandemic. Joint Commission Journal on Quality and Patient Safety, 37(11), 515–523.

Cheng, A., Nadkarni, V., Hunt, E. A., & Qayumi, K. (2011). A multifunctional online research portal for facilitation of simulation-based research: a report from the EXPRESS pediatric simulation research collaborative. Simulation in Healthcare : Journal of the Society for Simulation in Healthcare, 6(4), 239–243. https://doi.org/10.1097/SIH.0b013e31821d5331

Hsieh, Y.-H., Jung, J. J., Shahan, J. B., Pollack, H. A., Hairston, H. S., Moring-Parris, D., … Rothman, R. E. (2011). Outcomes and cost analysis of 3 operational models for rapid HIV testing services in an academic inner-city emergency department. Annals of Emergency Medicine, 58(1 Suppl 1), S133-139. https://doi.org/10.1016/j.annemergmed.2011.03.037

Kecojevic, A., Lindsell, C. J., Lyons, M. S., Holtgrave, D., Torres, G., Heffelfinger, J., … Rothman, R. E. (2011). Public health and clinical impact of increasing emergency department-based HIV testing: perspectives from the 2007 conference of the National Emergency Department HIV Testing Consortium. Annals of Emergency Medicine, 58(1 Suppl 1), S151-159.e1. https://doi.org/10.1016/j.annemergmed.2011.03.040

Ramathal, C., Wang, W., Hunt, E., Bagchi, I. C., & Bagchi, M. K. (2011). Transcription factor CCAAT enhancer-binding protein beta (C/EBPbeta) regulates the formation of a unique extracellular matrix that controls uterine stromal differentiation and embryo implantation. The Journal of Biological Chemistry, 286(22), 19860–19871. https://doi.org/10.1074/jbc.M110.191759

Duval-Arnould, X., Lopes, P., & Philippe, H.-J. (2011). [Residentship in obstetrics and gynaecology in Nantes]. Gynecologie, obstetrique & fertilite, 39(6), 402. https://doi.org/10.1016/j.gyobfe.2011.04.016

Cheng, A., Hunt, E. A., Donoghue, A., Nelson, K., Leflore, J., Anderson, J., … Nadkarni, V. (2011). EXPRESS--Examining Pediatric Resuscitation Education Using Simulation and Scripting. The birth of an international pediatric simulation research collaborative--from concept to reality. Simulation in Healthcare : Journal of the Society for Simulation in Healthcare, 6(1), 34–41. https://doi.org/10.1097/SIH.0b013e3181f6a887

Frazier, A., Hunt, E. A., & Holmes, K. (2011). Pediatric cardiac emergencies: Children are not small adults. Journal of Emergencies, Trauma, and Shock, 4(1), 89–96. https://doi.org/10.4103/0974-2700.76842

Yang, C. P., Leung, J., Hunt, E. A., Serwint, J., Norvell, M., Keene, E. A., & Romer, L. H. (2011). Pediatric residents do not feel prepared for the most unsettling situations they  face in the pediatric intensive care unit. Journal of Palliative Medicine, 14(1), 25–30. https://doi.org/10.1089/jpm.2010.0314

Bhanji, F., Mancini, M. E., Sinz, E., Rodgers, D. L., McNeil, M. A., Hoadley, T. A., … Hazinski, M. F. (2010). Part 16: education, implementation, and teams: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation, 122(18 Suppl 3), S920-933. https://doi.org/10.1161/CIRCULATIONAHA.110.971135

Goeschel, C. A., Holzmueller, C. G., Berenholtz, S. M., Marsteller, J. A., Murphy, D. J., Sawyer, M., … Pronovost, P. J. (2010). Executive/Senior Leader Checklist to improve culture and reduce central line-associated bloodstream infections. Joint Commission Journal on Quality and Patient Safety, 36(11), 519–524.

Bembea, M. M., Nadkarni, V. M., Diener-West, M., Venugopal, V., Carey, S. M., Berg, R. A., & Hunt, E. A. (2010). Temperature patterns in the early postresuscitation period after pediatric inhospital cardiac arrest. Pediatric Critical Care Medicine : A Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 11(6), 723–730. https://doi.org/10.1097/PCC.0b013e3181dde659

Chen, T.-H., Kutty, P., Lowe, L. E., Hunt, E. A., Blostein, J., Espinoza, R., … Ostroff, S. M. (2010). Measles outbreak associated with an international youth sporting event in the United States, 2007. The Pediatric Infectious Disease Journal, 29(9), 794–800. https://doi.org/10.1097/INF.0b013e3181dbaacf

Eppich, W. J., Zonfrillo, M. R., Nelson, K. L., & Hunt, E. A. (2010). Residents’ mental model of bag-mask ventilation. Pediatric Emergency Care, 26(9), 646–652. https://doi.org/10.1097/PEC.0b013e3181ef045a

Liao, S. C., Hunt, E. A., & Chen, W. (2010). Comparison between inter-rater reliability and inter-rater agreement in performance assessment. Annals of the Academy of Medicine, Singapore, 39(8), 613–618.

Sawyer, M., Weeks, K., Goeschel, C. A., Thompson, D. A., Berenholtz, S. M., Marsteller, J. A., … Pronovost, P. J. (2010). Using evidence, rigorous measurement, and collaboration to eliminate central catheter-associated bloodstream infections. Critical Care Medicine, 38(8 Suppl), S292-298. https://doi.org/10.1097/CCM.0b013e3181e6a165

DeVita, M. A., Smith, G. B., Adam, S. K., Adams-Pizarro, I., Buist, M., Bellomo, R., … Winters, B. (2010). “Identifying the hospitalised patient in crisis”--a consensus conference on the afferent limb of rapid response systems. Resuscitation, 81(4), 375–382. https://doi.org/10.1016/j.resuscitation.2009.12.008

Frazier, J. L., Bova, G. S., Jockovic, K., Hunt, E. A., Lee, B., & Ahn, E. S. (2010). Disseminated intravascular coagulation associated with ventriculoperitoneal shunt surgery. Journal of Neurosurgery. Pediatrics, 5(3), 306–309. https://doi.org/10.3171/2009.10.PEDS0974

Hsieh, Y.-H., Jung, J. J., Shahan, J. B., Moring-Parris, D., Kelen, G. D., & Rothman, R. E. (2009). Emergency medicine resident attitudes and perceptions of HIV testing before and after a focused training program and testing implementation. Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine, 16(11), 1165–1173. https://doi.org/10.1111/j.1553-2712.2009.00507.x

Hunt, Elizabeth A., Vera, K., Diener-West, M., Haggerty, J. A., Nelson, K. L., Shaffner, D. H., & Pronovost, P. J. (2009). Delays and errors in cardiopulmonary resuscitation and defibrillation by pediatric residents during simulated cardiopulmonary arrests. Resuscitation, 80(7), 819–825. https://doi.org/10.1016/j.resuscitation.2009.03.020

Hunt, E. A., Brunetti, M., Nelson, K. L., Shilkofski, N. A., & Peddy, S. B. (2009). Recognition and initial management of cardiac emergencies in children. Minerva Pediatrica, 61(2), 141–162.

Nishisaki, A., Hales, R., Biagas, K., Cheifetz, I., Corriveau, C., Garber, N., … Nadkarni, V. (2009). A multi-institutional high-fidelity simulation “boot camp” orientation and training program for first year pediatric critical care fellows. Pediatric Critical Care Medicine : A Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 10(2), 157–162. https://doi.org/10.1097/PCC.0b013e3181956d29

Hunt, Elizabeth A., Patel, S., Vera, K., Shaffner, D. H., & Pronovost, P. J. (2009). Survey of pediatric resident experiences with resuscitation training and attendance at actual cardiopulmonary arrests. Pediatric Critical Care Medicine : A Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 10(1), 96–105. https://doi.org/10.1097/PCC.0b013e3181937170

Hunt, Elizabeth A., Mancini, M. E., Smyth, M., & Truitt, T. L. (2009). Using the American Heart Association’s National Registry of Cardiopulmonary Resuscitation for performance improvement. Joint Commission Journal on Quality and Patient Safety, 35(1), 13–20.

Heitmiller, E. S., Nelson, K. L., Hunt, E. A., Schwartz, J. M., Yaster, M., & Shaffner, D. H. (2008). A survey of anesthesiologists’ knowledge of American Heart Association Pediatric  Advanced Life Support Resuscitation Guidelines. Resuscitation, 79(3), 499–505. https://doi.org/10.1016/j.resuscitation.2008.07.018

Schwartz, J. M., Nelson, K. L., Saliski, M., Hunt, E. A., & Pronovost, P. J. (2008). The daily goals communication sheet: a simple and novel tool for improved communication and care. Joint Commission Journal on Quality and Patient Safety, 34(10), 608–613, 561.

Hunt, Elizabeth A., Fiedor-Hamilton, M., & Eppich, W. J. (2008). Resuscitation education: narrowing the gap between evidence-based resuscitation guidelines and performance using best educational practices. Pediatric Clinics of North America, 55(4), 1025–1050, xii. https://doi.org/10.1016/j.pcl.2008.04.007

Eppich, W. J., Brannen, M., & Hunt, E. A. (2008). Team training: implications for emergency and critical care pediatrics. Current Opinion in Pediatrics, 20(3), 255–260. https://doi.org/10.1097/MOP.0b013e3282ffb3f3

McCabe, M. E., Hunt, E. A., & Serwint, J. R. (2008). Pediatric residents’ clinical and educational experiences with end-of-life care. Pediatrics, 121(4), e731-737. https://doi.org/10.1542/peds.2007-1657

Hunt, Elizabeth A., Zimmer, K. P., Rinke, M. L., Shilkofski, N. A., Matlin, C., Garger, C., … Miller, M. R. (2008). Transition from a traditional code team to a medical emergency team and categorization of cardiopulmonary arrests in a children’s center. Archives of Pediatrics & Adolescent Medicine, 162(2), 117–122. https://doi.org/10.1001/archpediatrics.2007.33

Hunt, Elizabeth A., Walker, A. R., Shaffner, D. H., Miller, M. R., & Pronovost, P. J. (2008). Simulation of in-hospital pediatric medical emergencies and cardiopulmonary arrests: highlighting the importance of the first 5 minutes. Pediatrics, 121(1), e34-43. https://doi.org/10.1542/peds.2007-0029

Shilkofski, N. A., Nelson, K. L., & Hunt, E. A. (2008). Recognition and treatment of unstable supraventricular tachycardia by pediatric residents in a simulation scenario. Simulation in Healthcare : Journal of the Society for Simulation in Healthcare, 3(1), 4–9. https://doi.org/10.1097/SIH.0b013e31815bfa4e

Nelson, K. L., Shilkofski, N. A., Haggerty, J. A., Saliski, M., & Hunt, E. A. (2008). The use of cognitive AIDS during simulated pediatric cardiopulmonary arrests. Simulation in Healthcare : Journal of the Society for Simulation in Healthcare, 3(3), 138–145. https://doi.org/10.1097/SIH.0b013e31816b1b60

Maher, E. N., Hansen, S. F., Heine, M., Meers, H., Yaster, M., & Hunt, E. A. (2007). Knowledge of procedural sedation and analgesia of emergency medicine physicians. Pediatric Emergency Care, 23(12), 869–876. https://doi.org/10.1097/pec.0b013e31815c9dbe

Hunt, Elizabeth A., Heine, M., Hohenhaus, S. M., Luo, X., & Frush, K. S. (2007). Simulated pediatric trauma team management: assessment of an educational intervention. Pediatric Emergency Care, 23(11), 796–804. https://doi.org/10.1097/PEC.0b013e31815a0653

Ding, R., Jung, J. J., Kirsch, T. D., Levy, F., & McCarthy, M. L. (2007). Uncompleted emergency department care: patients who leave against medical advice. Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine, 14(10), 870–876. https://doi.org/10.1197/j.aem.2007.06.027

Nelson, K. L., Mills, W. J., Umbel, S., Crosson, J. E., Shaffner, D. H., & Hunt, E. A. (2007). Lightning, sudden cardiac death, simulation and an automated external defibrillator: the perfect storm. Resuscitation, 74(3), 567–571. https://doi.org/10.1016/j.resuscitation.2007.02.005

Hunt, Elizabeth A., Shilkofski, N. A., Stavroudis, T. A., & Nelson, K. L. (2007). Simulation: translation to improved team performance. Anesthesiology Clinics, 25(2), 301–319. https://doi.org/10.1016/j.anclin.2007.03.004

Winters, B. D., Pham, J. C., Hunt, E. A., Guallar, E., Berenholtz, S., & Pronovost, P. J. (2007). Rapid response systems: a systematic review. Critical Care Medicine, 35(5), 1238–1243. https://doi.org/10.1097/01.CCM.0000262388.85669.68

Shilkofski, N. A., & Hunt, E. A. (2007). A pediatric medical emergency team manages a complex child with hypoxia and worried parent. Joint Commission Journal on Quality and Patient Safety, 33(4), 236–241, 185.

Ding, R., McCarthy, M. L., Li, G., Kirsch, T. D., Jung, J. J., & Kelen, G. D. (2006). Patients who leave without being seen: their characteristics and history of emergency department use. Annals of Emergency Medicine, 48(6), 686–693. https://doi.org/10.1016/j.annemergmed.2006.05.022

Hunt, Elizabeth A., Nelson, K. L., & Shilkofski, N. A. (2006). Simulation in medicine: addressing patient safety and improving the interface between healthcare providers and medical technology. Biomedical Instrumentation & Technology, 40(5), 399–404.

Pronovost, P. J., Berenholtz, S. M., Goeschel, C. A., Needham, D. M., Sexton, J. B., Thompson, D. A., … Hunt, E. (2006). Creating high reliability in health care organizations. Health Services Research, 41(4 Pt 2), 1599–1617. https://doi.org/10.1111/j.1475-6773.2006.00567.x

Yuan, C., Guo, Y., Ravi, R., Przyklenk, K., Shilkofski, N., Diez, R., … Murphy, A. M. (2006). Myosin binding protein C is differentially phosphorylated upon myocardial stunning in canine and rat hearts-- evidence for novel phosphorylation sites. Proteomics, 6(14), 4176–4186. https://doi.org/10.1002/pmic.200500894

Hunt, Elizabeth A., Hohenhaus, S. M., Luo, X., & Frush, K. S. (2006). Simulation of pediatric trauma stabilization in 35 North Carolina emergency departments: identification of targets for performance improvement. Pediatrics, 117(3), 641–648. https://doi.org/10.1542/peds.2004-2702

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