The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2024

Authors: Nobuaki Shime, Taka-aki Nakada, Tomoaki Yatabe, Kazuma Yamakawa, Yoshitaka Aoki, Shigeaki Inoue, Toshiaki Iba, Hiroshi Ogura, Yusuke Kawai, Atsushi Kawaguchi, Tatsuya Kawasaki, Yutaka Kondo, Masaaki Sakuraya, Shunsuke Taito, Kent Doi, Hideki Hashimoto, Yoshitaka Hara, Tatsuma Fukuda, Asako Matsushima, Moritoki Egi, Shigeki Kushimoto, Takehiko Oami, Kazuya Kikutani, Yuki Kotani, Gen Aikawa, Makoto Aoki, Masayuki Akatsuka, Hideki Asai, Toshikazu Abe, Yu Amemiya, Ryo Ishizawa, Tadashi Ishihara, Tadayoshi Ishimaru, Yusuke Itosu, Hiroyasu Inoue, Hisashi Imahase, Haruki Imura, Naoya Iwasaki, Noritaka Ushio, Masatoshi Uchida, Michiko Uchi, Takeshi Umegaki, Yutaka Umemura, Akira Endo, Marina Oi, Akira Ouchi, Itsuki Osawa, Yoshiyasu Oshima, Kohei Ota, Takanori Ohno, Yohei Okada, Hiromu Okano, Yoshihito Ogawa, Masahiro Kashiura, Daisuke Kasugai, Ken-ichi Kano, Ryo Kamidani, Akira Kawauchi, Sadatoshi Kawakami, Daisuke Kawakami, Yusuke Kawamura, Kenji Kandori, Yuki Kishihara, Sho Kimura, Kenji Kubo, Tomoki Kuribara, Hiroyuki Koami, Shigeru Koba, Takehito Sato, Ren Sato, Yusuke Sawada, Haruka Shida, Tadanaga Shimada, Motohiro Shimizu, Kazushige Shimizu, Takuto Shiraishi, Toru Shinkai, Akihito Tampo, Gaku Sugiura, Kensuke Sugimoto, Hiroshi Sugimoto, Tomohiro Suhara, Motohiro Sekino, Kenji Sonota, Mahoko Taito, Nozomi Takahashi, Jun Takeshita, Chikashi Takeda, Junko Tatsuno, Aiko Tanaka, Masanori Tani, Atsushi Tanikawa, Hao Chen, Takumi Tsuchida, Yusuke Tsutsumi, Takefumi Tsunemitsu, Ryo Deguchi, Kenichi Tetsuhara, Takero Terayama, Yuki Togami, Takaaki Totoki, Yoshinori Tomoda, Shunichiro Nakao, Hiroki Nagasawa, Yasuhisa Nakatani, Nobuto Nakanishi, Norihiro Nishioka, Mitsuaki Nishikimi, Satoko Noguchi, Suguru Nonami, Osamu Nomura, Katsuhiko Hashimoto, Junji Hatakeyama, Yasutaka Hamai, Mayu Hikone, Ryo Hisamune, Tomoya Hirose, Ryota Fuke, Ryo Fujii, Naoki Fujie, Jun Fujinaga, Yoshihisa Fujinami, Sho Fujiwara, Hiraku Funakoshi, Koichiro Homma, Yuto Makino, Hiroshi Matsuura, Ayaka Matsuoka, Tadashi Matsuoka, Yosuke Matsumura, Akito Mizuno, Sohma Miyamoto, Yukari Miyoshi, Satoshi Murata, Teppei Murata, Hiromasa Yakushiji, Shunsuke Yasuo, Kohei Yamada, Hiroyuki Yamada, Ryo Yamamoto, Ryohei Yamamoto, Tetsuya Yumoto, Yuji Yoshida, Shodai Yoshihiro, Satoshi Yoshimura, Jumpei Yoshimura, Hiroshi Yonekura, Yuki Wakabayashi, Takeshi Wada, Shinichi Watanabe, Atsuhiro Ijiri, Kei Ugata, Shuji Uda, Ryuta Onodera, Masaki Takahashi, Satoshi Nakajima, Junta Honda, Tsuguhiro Matsumoto

Source: Journal of Intensive Care, Vol 13, Iss 1, Pp 1-61 (2025)

Subject Terms: Evidence-based medicine, GRADE, Infection, Intensive care, Organ failure, Systematic review, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9

File Description: electronic resource

Relation: https://doaj.org/toc/2052-0492

Access URL: https://doaj.org/article/377a9a4b9d234ff3894e98d0b52671e8

Association between sub-phenotypes identified using latent class analysis and neurological outcomes in patients with out-of-hospital cardiac arrest in Japan

Authors: Hiroyuki Tamura, Hideto Yasuda, Takatoshi Oishi, Yutaro Shinzato, Shunsuke Amagasa, Masahiro Kashiura, Takashi Moriya

Source: BMC Cardiovascular Disorders, Vol 24, Iss 1, Pp 1-11 (2024)

Subject Terms: Cardiac arrest, Latent class analysis, Sub-phenotype, Glasgow coma scale, Partial pressure of arterial oxygen, Diseases of the circulatory (Cardiovascular) system, RC666-701

File Description: electronic resource

Relation: https://doaj.org/toc/1471-2261

Access URL: https://doaj.org/article/46bd95dcbfbc46b38d860d9cf0820314

Effectiveness of a hybrid emergency room system in the management of acute ischemic stroke: a single-center experience

Authors: Masahiro Kashiura, Chisato Nakajima, Yuki Kishihara, Keiichiro Tominaga, Hiroyuki Tamura, Hideto Yasuda, Masashi Ikota, Kenji Yamada, Yoshikazu Yoshino, Takashi Moriya

Source: Frontiers in Medicine, Vol 11 (2024)

Subject Terms: cerebral infarction, endovascular procedures, intracranial embolism and thrombosis, radiographic image enhancement, thrombectomy, Medicine (General), R5-920

File Description: electronic resource

Relation: https://www.frontiersin.org/articles/10.3389/fmed.2024.1420951/full; https://doaj.org/toc/2296-858X

Access URL: https://doaj.org/article/add0a45b8de3473e949fe3e948a3f468

Thyrohyoidotomy: A complication of cricothyroidotomy

Authors: Haruka Taira, Masahiro Kashiura, Takashi Moriya

Source: Acute Medicine & Surgery, Vol 11, Iss 1, Pp n/a-n/a (2024)

Subject Terms: Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9

File Description: electronic resource

Relation: https://doaj.org/toc/2052-8817

Access URL: https://doaj.org/article/0231bfbe7dc5468a882903a62bde6154

Extracorporeal membrane oxygenation‐facilitated palliative radiotherapy for severe airway obstruction due to lung cancer: A case report

Authors: Hitoshi Mori, Masahiro Kashiura, Yuya Yoshimura, Yuki Yamahata, Tomohisa Tokura, Tatsuya Nodagashira, Akihide Konn, Takashi Moriya

Source: Acute Medicine & Surgery, Vol 11, Iss 1, Pp n/a-n/a (2024)

Subject Terms: lung cancer, malignant central airway obstruction, radiotherapy, severe respiratory distress, venovenous extracorporeal membrane oxygenation, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9

File Description: electronic resource

Relation: https://doaj.org/toc/2052-8817

Access URL: https://doaj.org/article/7efcabac4bec44e1b0e21b581acd519a

Relationship between institutional intensive care volume prior to the COVID-19 pandemic and in-hospital death in ventilated patients with severe COVID-19

Authors: Shunsuke Amagasa, Masahiro Kashiura, Hideto Yasuda, Mineji Hayakawa, Kazuma Yamakawa, Akira Endo, Takayuki Ogura, Atsushi Hirayama, Hideo Yasunaga, Takashi Tagami

Source: Scientific Reports, Vol 12, Iss 1, Pp 1-7 (2022)

Subject Terms: Medicine, Science

File Description: electronic resource

Relation: https://doaj.org/toc/2045-2322

Access URL: https://doaj.org/article/a72af86b897e4b3fb8855b9bb51b87ae

Comparison of the effects of lidocaine and amiodarone for out-of-hospital cardiac arrest patients with shockable rhythms: a retrospective observational study from a multicenter registry

Authors: Yuki Kishihara, Masahiro Kashiura, Shunsuke Amagasa, Fumihito Fukushima, Hideto Yasuda, Takashi Moriya

Source: BMC Cardiovascular Disorders, Vol 22, Iss 1, Pp 1-9 (2022)

Subject Terms: Amiodarone, Lidocaine, Out-of-hospital cardiac arrest, Shockable rhythm, Diseases of the circulatory (Cardiovascular) system, RC666-701

File Description: electronic resource

Relation: https://doaj.org/toc/1471-2261

Access URL: https://doaj.org/article/0ad0065c83c54b1aabf9879802703d17

Association between short-term neurological outcomes and extreme hyperoxia in patients with out-of-hospital cardiac arrest who underwent extracorporeal cardiopulmonary resuscitation: a retrospective observational study from a multicenter registry

Authors: Masahiro Kashiura, Hideto Yasuda, Yuki Kishihara, Keiichiro Tominaga, Masaaki Nishihara, Ken-ichi Hiasa, Hiroyuki Tsutsui, Takashi Moriya

Source: BMC Cardiovascular Disorders, Vol 22, Iss 1, Pp 1-9 (2022)

Subject Terms: Blood gas analysis, Cardiopulmonary resuscitation, Extracorporeal membrane oxygenation, Heart arrest, Hyperoxia, Post-cardiac arrest syndrome, Diseases of the circulatory (Cardiovascular) system, RC666-701

File Description: electronic resource

Relation: https://doaj.org/toc/1471-2261

Access URL: https://doaj.org/article/e16cffdcc19c4d05a276c15fb90602b2

Evaluation of the Jichi Medical University diverticular hemorrhage score in the clinical management of acute diverticular bleeding with emergency or elective endoscopy: A pilot study

Authors: Takeshi Uehara, Satohiro Matsumoto, Hiroyuki Tamura, Masahiro Kashiura, Takashi Moriya, Kenichi Yamanaka, Hakuei Shinhata, Masanari Sekine, Hiroyuki Miyatani, Hirosato Mashima

Source: PLoS ONE, Vol 18, Iss 8 (2023)

Subject Terms: Medicine, Science

File Description: electronic resource

Relation: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10446219/?tool=EBI; https://doaj.org/toc/1932-6203

Access URL: https://doaj.org/article/6bfc87afa2b542428902ce8ecd66ca8a

Clinical parameter‐guided initial resuscitation in adult patients with septic shock: A systematic review and network meta‐analysis

Authors: Tetsuya Yumoto, Tomoki Kuribara, Kohei Yamada, Takehito Sato, Shigeru Koba, Kenichi Tetsuhara, Masahiro Kashiura, Masaaki Sakuraya

Source: Acute Medicine & Surgery, Vol 10, Iss 1, Pp n/a-n/a (2023)

Subject Terms: capillary refill timecarbon dioxide gapcentral venous oxygen saturationlactatenetwork meta‐analysissepsisseptic shock, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9

File Description: electronic resource

Relation: https://doaj.org/toc/2052-8817

Access URL: https://doaj.org/article/7a719bd58c7243d59b72e7513027693d

Impact of the failure of initial insertion of a peripheral intravascular catheter on the development of adverse events in patients admitted to the intensive care unit from the emergency room: A post hoc analysis of the AMOR‐VENUS study

Authors: Yuki Kishihara, Hideto Yasuda, Masahiro Kashiura, Takashi Moriya, Yutaro Shinzato, Yuki Kotani, Natsuki Kondo, Kosuke Sekine, Nobuaki Shime, Keita Morikane, the AMOR‐VENUS study group

Source: Acute Medicine & Surgery, Vol 10, Iss 1, Pp n/a-n/a (2023)

Subject Terms: catheters, critical illness, equipment failure, intensive care units, risk factors, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9

File Description: electronic resource

Relation: https://doaj.org/toc/2052-8817

Access URL: https://doaj.org/article/236ae80ab30e4c3fb2c71e47ac0e5796

Relationship between institutional ventilated COVID-19 case volume and in-hospital death: A multicenter cohort study.

Authors: Shunsuke Amagasa, Satoko Uematsu, Mitsuru Kubota, Masahiro Kashiura, Hideto Yasuda, Mineji Hayakawa, Kazuma Yamakawa, Akira Endo, Takayuki Ogura, Atsushi Hirayama, Hideo Yasunaga, Takashi Tagami

Source: PLoS ONE, Vol 18, Iss 6, p e0287310 (2023)

Subject Terms: Medicine, Science

File Description: electronic resource

Relation: https://doaj.org/toc/1932-6203

Access URL: https://doaj.org/article/10cf70f20bc040b8b4838d4f1e6a43ec

A study of the risk factors for phlebitis in patients stratified using the acute physiology and chronic health evaluation II score and admitted to the intensive care unit: A post hoc analysis of the AMOR-VENUS study

Authors: Yuki Kishihara, Hideto Yasuda, Takashi Moriya, Masahiro Kashiura, Midori Koike, Yuki Kotani, Natsuki Kondo, Kosuke Sekine, Nobuaki Shime, Keita Morikane, Takayuki Abe

Source: Frontiers in Medicine, Vol 9 (2022)

Subject Terms: APACH II score, catheter, critically ill patient, risk factors, intensive care unit (ICU), peripheral, Medicine (General), R5-920

File Description: electronic resource

Relation: https://www.frontiersin.org/articles/10.3389/fmed.2022.965706/full; https://doaj.org/toc/2296-858X

Access URL: https://doaj.org/article/b54027f629fd4d67aa237d642dc1fe6f

Risk factors for peripheral venous catheter-related phlebitis stratified by body mass index in critically ill patients: A post-hoc analysis of the AMOR-VENUS study

Authors: Masahiro Kashiura, Hideto Yasuda, Takatoshi Oishi, Yuki Kishihara, Takashi Moriya, Yuki Kotani, Natsuki Kondo, Kosuke Sekine, Nobuaki Shime, Keita Morikane

Source: Frontiers in Medicine, Vol 9 (2022)

Subject Terms: body mass index, catheter-related infections, catheters, intensive care units, phlebitis, Medicine (General), R5-920

File Description: electronic resource

Relation: https://www.frontiersin.org/articles/10.3389/fmed.2022.1037274/full; https://doaj.org/toc/2296-858X

Access URL: https://doaj.org/article/e5417738d083419181139b7de09d0b1e

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J-SSCG 2020)

Authors: Moritoki Egi, Hiroshi Ogura, Tomoaki Yatabe, Kazuaki Atagi, Shigeaki Inoue, Toshiaki Iba, Yasuyuki Kakihana, Tatsuya Kawasaki, Shigeki Kushimoto, Yasuhiro Kuroda, Joji Kotani, Nobuaki Shime, Takumi Taniguchi, Ryosuke Tsuruta, Kent Doi, Matsuyuki Doi, Taka-aki Nakada, Masaki Nakane, Seitaro Fujishima, Naoto Hosokawa, Yoshiki Masuda, Asako Matsushima, Naoyuki Matsuda, Kazuma Yamakawa, Yoshitaka Hara, Masaaki Sakuraya, Shinichiro Ohshimo, Yoshitaka Aoki, Mai Inada, Yutaka Umemura, Yusuke Kawai, Yutaka Kondo, Hiroki Saito, Shunsuke Taito, Chikashi Takeda, Takero Terayama, Hideo Tohira, Hideki Hashimoto, Kei Hayashida, Toru Hifumi, Tomoya Hirose, Tatsuma Fukuda, Tomoko Fujii, Shinya Miura, Hideto Yasuda, Toshikazu Abe, Kohkichi Andoh, Yuki Iida, Tadashi Ishihara, Kentaro Ide, Kenta Ito, Yusuke Ito, Yu Inata, Akemi Utsunomiya, Takeshi Unoki, Koji Endo, Akira Ouchi, Masayuki Ozaki, Satoshi Ono, Morihiro Katsura, Atsushi Kawaguchi, Yusuke Kawamura, Daisuke Kudo, Kenji Kubo, Kiyoyasu Kurahashi, Hideaki Sakuramoto, Akira Shimoyama, Takeshi Suzuki, Shusuke Sekine, Motohiro Sekino, Nozomi Takahashi, Sei Takahashi, Hiroshi Takahashi, Takashi Tagami, Goro Tajima, Hiroomi Tatsumi, Masanori Tani, Asuka Tsuchiya, Yusuke Tsutsumi, Takaki Naito, Masaharu Nagae, Ichiro Nagasawa, Kensuke Nakamura, Tetsuro Nishimura, Shin Nunomiya, Yasuhiro Norisue, Satoru Hashimoto, Daisuke Hasegawa, Junji Hatakeyama, Naoki Hara, Naoki Higashibeppu, Nana Furushima, Hirotaka Furusono, Yujiro Matsuishi, Tasuku Matsuyama, Yusuke Minematsu, Ryoichi Miyashita, Yuji Miyatake, Megumi Moriyasu, Toru Yamada, Hiroyuki Yamada, Ryo Yamamoto, Takeshi Yoshida, Yuhei Yoshida, Jumpei Yoshimura, Ryuichi Yotsumoto, Hiroshi Yonekura, Takeshi Wada, Eizo Watanabe, Makoto Aoki, Hideki Asai, Takakuni Abe, Yutaka Igarashi, Naoya Iguchi, Masami Ishikawa, Go Ishimaru, Shutaro Isokawa, Ryuta Itakura, Hisashi Imahase, Haruki Imura, Takashi Irinoda, Kenji Uehara, Noritaka Ushio, Takeshi Umegaki, Yuko Egawa, Yuki Enomoto, Kohei Ota, Yoshifumi Ohchi, Takanori Ohno, Hiroyuki Ohbe, Kazuyuki Oka, Nobunaga Okada, Yohei Okada, Hiromu Okano, Jun Okamoto, Hiroshi Okuda, Takayuki Ogura, Yu Onodera, Yuhta Oyama, Motoshi Kainuma, Eisuke Kako, Masahiro Kashiura, Hiromi Kato, Akihiro Kanaya, Tadashi Kaneko, Keita Kanehata, Ken-ichi Kano, Hiroyuki Kawano, Kazuya Kikutani, Hitoshi Kikuchi, Takahiro Kido, Sho Kimura, Hiroyuki Koami, Daisuke Kobashi, Iwao Saiki, Masahito Sakai, Ayaka Sakamoto, Tetsuya Sato, Yasuhiro Shiga, Manabu Shimoto, Shinya Shimoyama, Tomohisa Shoko, Yoh Sugawara, Atsunori Sugita, Satoshi Suzuki, Yuji Suzuki, Tomohiro Suhara, Kenji Sonota, Shuhei Takauji, Kohei Takashima, Sho Takahashi, Yoko Takahashi, Jun Takeshita, Yuuki Tanaka, Akihito Tampo, Taichiro Tsunoyama, Kenichi Tetsuhara, Kentaro Tokunaga, Yoshihiro Tomioka, Kentaro Tomita, Naoki Tominaga, Mitsunobu Toyosaki, Yukitoshi Toyoda, Hiromichi Naito, Isao Nagata, Tadashi Nagato, Yoshimi Nakamura, Yuki Nakamori, Isao Nahara, Hiromu Naraba, Chihiro Narita, Norihiro Nishioka, Tomoya Nishimura, Kei Nishiyama, Tomohisa Nomura, Taiki Haga, Yoshihiro Hagiwara, Katsuhiko Hashimoto, Takeshi Hatachi, Toshiaki Hamasaki, Takuya Hayashi, Minoru Hayashi, Atsuki Hayamizu, Go Haraguchi, Yohei Hirano, Ryo Fujii, Motoki Fujita, Naoyuki Fujimura, Hiraku Funakoshi, Masahito Horiguchi, Jun Maki, Naohisa Masunaga, Yosuke Matsumura, Takuya Mayumi, Keisuke Minami, Yuya Miyazaki, Kazuyuki Miyamoto, Teppei Murata, Machi Yanai, Takao Yano, Kohei Yamada, Naoki Yamada, Tomonori Yamamoto, Shodai Yoshihiro, Hiroshi Tanaka, Osamu Nishida

Source: Journal of Intensive Care, Vol 9, Iss 1, Pp 1-144 (2021)

Subject Terms: Evidence-based medicine, GRADE, Guidelines, Sepsis, Septic shock, Systematic review, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9

File Description: electronic resource

Relation: https://doaj.org/toc/2052-0492

Access URL: https://doaj.org/article/bd8bcd9a31804363a495429e441d995f

Hyperoxia Is Not Associated With 30-day Survival in Out-of-Hospital Cardiac Arrest Patients Who Undergo Extracorporeal Cardiopulmonary Resuscitation

Authors: Mioko Kobayashi, Masahiro Kashiura, Hideto Yasuda, Kazuhiro Sugiyama, Yuichi Hamabe, Takashi Moriya

Source: Frontiers in Medicine, Vol 9 (2022)

Subject Terms: blood gas analysis, cardiopulmonary resuscitation, extracorporeal membrane oxygenation, hyperoxia, post-cardiac arrest syndrome, cardiac arrest, Medicine (General), R5-920

File Description: electronic resource

Relation: https://www.frontiersin.org/articles/10.3389/fmed.2022.867602/full; https://doaj.org/toc/2296-858X

Access URL: https://doaj.org/article/affc83259aff42068c25afee53dfdf58

Can Cerebral Regional Oxygen Saturation (rSO2) Be Used as an Indicator of the Quality of Chest Compressions in Patients With Cardiopulmonary Arrest? A Study Evaluating the Association Between rSO2 and Mean Arterial Pressure: The PRESS Study

Authors: Yuki Kishihara, Hideto Yasuda, Masahiro Kashiura, Naoshige Harada, Takashi Moriya

Source: Frontiers in Medicine, Vol 9 (2022)

Subject Terms: arterial pressure, cardiopulmonary resuscitation, cerebral regional oxygen saturation, cerebrovascular circulation, prognosis, Medicine (General), R5-920

File Description: electronic resource

Relation: https://www.frontiersin.org/articles/10.3389/fmed.2022.810449/full; https://doaj.org/toc/2296-858X

Access URL: https://doaj.org/article/96c8d50e004c487e8f01b6d2f0618e6f

Emphysematous liver abscess with Edwardsiella tarda infection

Authors: Ryutaro Tominaga, Masahiro Kashiura, Hirosato Hatano, Takashi Moriya

Source: IDCases, Vol 29, Iss , Pp e01543- (2022)

Subject Terms: Anaerobic bacterium, Computed tomography, Diabetes mellitus, Edwardsiella tarda, Immunocompromised host, Liver abscess, Infectious and parasitic diseases, RC109-216

File Description: electronic resource

Relation: http://www.sciencedirect.com/science/article/pii/S2214250922001718; https://doaj.org/toc/2214-2509

Access URL: https://doaj.org/article/cadb06a21d6c43f997063c0c14f62d16

Clinical application of skin antisepsis using aqueous olanexidine: a scoping review

Authors: Yutaro Shinzato, Eiryu Sakihara, Yuki Kishihara, Masahiro Kashiura, Hideto Yasuda, Takashi Moriya

Source: Acute Medicine & Surgery, Vol 9, Iss 1, Pp n/a-n/a (2022)

Subject Terms: Catheter‐related bloodstream infection, olanexidine, scoping review, skin antiseptic solution, surgical site infection, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9

File Description: electronic resource

Relation: https://doaj.org/toc/2052-8817

Access URL: https://doaj.org/article/5f658d2cf08442a8ab8de44fd52f57b1

Efficacy and safety of 1.5% aqueous olanexidine gluconate antiseptic solution compared to 1% alcoholic chlorhexidine for the prevention of intravenous catheter-related infections (Apollo study): a protocol for a randomised controlled trial

Authors: Takayuki Abe, Nobuaki Shime, Masahiro Kashiura, Takashi Moriya, Toru Hifumi, Hideto Yasuda, Junichi Sasaki, Yuki Kishihara, Keita Morikane

Source: BMJ Open, Vol 11, Iss 12 (2021)

Subject Terms: Medicine

File Description: electronic resource

Relation: https://bmjopen.bmj.com/content/11/12/e053925.full; https://doaj.org/toc/2044-6055

Access URL: https://doaj.org/article/7a9bed6adf0644f991fa93becaaf100c