The influx of Gen-Xers and Yers into today’s workforce is pushing the industry’s conservative management leaders to play more games. Cutting-edge, fast-paced, highly competitive computer-based simulations and games designed to educate as they engage are gaining traction in the industry. The influx of Gen-Xers and Yers — digital natives, as they are called — into today’s work force is pushing the industry’s conservative management leaders to play more games. Cutting-edge, fast-paced, highly competitive computer-based simulations and games designed to educate as they engage are gaining traction in the industry. Make no mistake: these games are not the Blinky, Pinky, Inky, and of course, Sue of Ms. Pac-Man fame, but rather they are meaningful, exciting exercises created to enhance professional development. By Robin Robinson January 2008 he growing gaming trend includes the use of computer-based simulation training as well as game show platforms. According to Marc Prensky, founder and CEO of Corporate Gameware LLC, games for training in the healthcare sector overall are gaining momentum. “The pharma industry began using games to educate physicians, patients, and consumers, as well as to train production staff, compliance officers, and other employees, as early as the 1990s,” says Mr. Prensky, who is also an author, educator, and game designer. “The whole games arena for the healthcare field has been expanding in many directions, and pharma is included in that mix. In fact, there are pharma companies that have been using games far longer than companies in some other industries.” For example, Mr. Prensky has worked with Pfizer to develop a simulation game that explains the drug-development process. “Pfizer has been doing simulations for the drug-development process for some time, but the company didn’t have a good way to explain to its public relations people why it takes 10 years and X billions of dollars to develop a drug,” he says. Mr. Prensky developed a custom drug-development simulation game for just that purpose and once the PR staff played through it — phase after phase — everyone clearly understood the process. Mr. Prensky also explains how Johnson & Johnson is using simple games to convey basic legal concepts to employees. “When the managers at the corporate legal department wanted to create learning around the concept of effective communications, they developed a Website with a number of simple games for learners to play that helped them understand the elements needed for clear and effective communications,” he says. “These games included crossword puzzles, hangman, word search, and cryptograms.” Missy Covington, director of communications at LearningWare and co-author of the book, “I’ll Take Learning for 500: Using Game Shows to Engage, Motivate and Train,” says one of her company’s biggest clients by industry is pharma, and the use of games for training is spread over many areas. “One of the reasons why pharma is such a large component of the gaming sector is that there is so much training that has to happen — compliance, sales, product, and process education,” Ms. Covington says. “Creative trainers will find a way to use gaming. More people understand the concept that training isn’t telling — a trainer can’t just tell people information and expect them to pick up on it; training has to be interactive.” In the past five years, pharma has shown more interest in using games to train sales reps. “While simple games have been in use for a number of years, more sophisticated games are advancing,” says Steve Woodruff, founder and president of Impactiviti LLC. “This trend is being driven somewhat by the younger members of the salesforces — the generations that grew up playing intense competitive games online, on their cell phones, PDAs, and iPods. Unlike baby boomers, whose concept of gaming may be outdated, the younger generations are very comfortable with gaming and are demanding interactivity and competitiveness in their training. One of the best ways to move information into the minds and hearts of these people is through gaming platforms.” A Generation Gap Baby boomers in particular seem to be resistant to training techniques that are “too fun.” When leaving a gaming presentation at a recent conference, one of our experts reports overhearing a conversation between two participants: “Gaming won’t take hold in this industry until the baby boomers retire.” A colleague replied, “No, probably not until they die.” Ken Begasse Jr., founding partner of Concentric, says the major objections from clients who have previewed simulation games is that the programs look like too much fun. “We didn’t expect this to be one of the objections,” Mr. Begasse says. “Immediately, upper management was having concerns that reps might be jumping on games during the day to play and therefore would lose their focus on their sales objectives.” Glen Low, Ed.D., director, e-learning strategies, at Total Learning Concepts, says clients have to get over the fear that training can’t be fun. “Training can be fun, entertaining, instructionally sound, and effective,” Dr. Low says. Mr. Prensky calls this attitude “the fear of the G-word,” which may wane slowly as younger people get into higher procurement positions. “The reason this a factor is that when older people grew up, games were trivial and something people did on a Saturday afternoon,” he says. “Older adults don’t realize how much games have changed.” This doesn’t mean, however, that the games are less effective for baby boomers, Ms. Covington says. “We’ve been using gaming training for almost 11 years, and we have found these programs are widely accepted by all ages; audiences of all ages need to be engaged to learn,” she says. According to Dr. Low, no one at any age likes to sit through a PowerPoint presentation for training. “While gaming training addresses the way Gen-Xers and Gen-Yers want to learn, baby boomers are tired of static learning modules, too, so it is not just a generational need in the way all people want to learn,” he says. Gaming improves retention because a player becomes engaged and emotional during the training session. “When people are playing a game they are in an emotional state, and we know emotion increases retention,” Ms. Covington says. Joe Leah, learning solutions and change management principal, Americas, IMS, says the more interaction in a training session, the higher the impact on learning. If a scale was to be drawn on the effectiveness of different training methods, reading would be at the low end and actual experience would be at the high end. “Simulation fits somewhere between case studies and real experience,” he says. “The benefit is that the simulations have no negative impact if the player makes the wrong decision.” But trainers may still have a long way to go before convincing senior managers that people learn faster and gain higher retention when they learn in an engaging and emotional setting. At a recent Society of Pharmaceutical and Biotech Trainers conference, Bloomsburg University Professor Karl Kapp gave a presentation about gaming training and one of the written comments submitted after his session was: “We are not training 6 year olds, so why are you telling me this?” Professor Kapp says this response is very telling of where some people in the industry are in their thinking about training with a gaming component. Practice Makes Perfect Like laparoscopic surgeons and poker players, pharmaceutical sales representatives have much to gain from gaming training. According to a study published in the February 2007 edition of the Archives of Surgery, video game skills may give younger surgeons a leg up on more experienced practitioners for laparoscopic procedures. Surgeons who played video games at least three hours a week in their past were 27% faster, with 37% fewer errors than nonplayers in simulations of laparoscopic surgery than nonplayers, the Beth Israel Medical Center study concluded. According to Professor Kapp, a similar concept is at play regarding younger, less-experienced poker players who can beat the long-time playing masters. “The younger poker afficionados, who play poker online at a rate of up to eight hands at a time, are gaining experience that increases their proficiency to equal or better than the older professionals,” Professor Kapp says. “I couldn’t understand how these young players could beat the masters, then I figured it out; it was practice.” The same theory can be applied to inexperienced sales representatives, he says. Although the younger sales representatives may be more computer and game savvy, they also bring less sales and pharmaceutical experience to the table, and gaming can improve their performance. “Using situational-based game simulations, sales reps can gain experience without actually being on a sales call,” Professor Kapp says. Mr. Leah says he tries to create a realistic environment or learning laboratory that simulates the learning objective where trainees can practice the new learned behavior. “At the end of the day, any time people can practice in a place where they can improve their decision-making skills and where the stakes of failure are low, the learning process is accelerated,” Mr. Leah says. “If a rep loses the sale of a product in a simulation exercise, he learns that he didn’t identify the right factors without actually losing the sale. The result may be bad, but no money has been lost for the company, and across the board that is an advantage.” Uptake for sales training has been slower than in other departments because of the rapid turnover of sales trainers, Impactiviti’s Mr. Woodruff says. “Sales training is often viewed as a developmental position with staff moving on after a year or so,” he says. “It will take a visionary who stays long enough to fight the battle to bring gaming training to the table and then long enough to roll it out and get high-level management to agree to make the investment.” While the trend for gaming training is growing, many people in top management will have to make a paradigm shift in their thinking before the use of gaming in sales training can be effective. And pharmaceutical companies may want to make that shift pretty soon. “Now is the time for the industry to pay attention to the effectiveness of gaming training,” Mr. Begasse says. “With salesforces being reduced and the amount of time a physician will give to sales reps diminishing to as little as 30 seconds, sales reps need to be able to think on their feet and react quickly to situations, keeping in mind the physician’s needs and what the product can deliver.” No matter how tough the pressures on sales become, there will always be a need for face-to-face sales contact in pharma, and therefore the industry needs to find a more effective way to train these individuals. “One way is through games,” Mr. Begasse says. “For example, Concerta has developed a sales training platform called RepRace.” Kim Metcalf, senior manager, sales training, at Celgene Corp., says when training sales representatives it is important that these learners apply and practice their new or improved selling skills. “Formal role-playing — where behavior change is often validated — is not always the best starting point for the practice of selling skills,” she says. “Gaming training, if created properly, can provide a bridge between the selling skills and the formal role play.” Effective games simulate the real world and create a situation where learners can practice individual components of the sales call before putting all the parts together in a single call. Plus, using games in this way can help reduce learner anxiety and provide an interactive forum where sales professionals can learn from their peers. “Effective training should stimulate and engage learners,” Ms. Metcalf says. “This can be achieved via a variety of methods, which is why many trainers opt for a blended-learning approach. Instead of looking for the magic bullet of training methods, it makes more sense to begin with setting the appropriate learning objectives. Then one can determine the most appropriate training method to meet those particular objectives.” Fun can inspire serious results Getting approval from upper management can be one of the the biggest hurdles for trainers, and without top to bottom buy-in, the program will not be successful, experts say. However, a powerful argument for using gaming lies in the ability to collect live data on participants and their performance, such as when participants are logging on, for how long, and how well they performed. These numbers can be directly and immediately compared with who is performing well in the field, reinforcing that gaming can yield a healthy return on investment. According to Mr. Begasse, Bayer used gaming training for the sales reps of its MS treatment, Betaseron. After the training, the market share for the older drug moved up one full point for the first time since 1995. “We were trying to stop the natural decline of the older treatment; combined with new science and better trained sales reps, we not only stopped the decline but impacted positive market share,” Mr. Begasse says. Beth Bour, associate manager, training and development, at Reliant Pharmaceuticals, agrees. She says her company used gaming training during its national launch meeting, and there was a lot of energy in the room. “Our people were so excited I think they forgot they were learning,” Ms. Bour says. “The session was a sight to behold — 300 reps in one room very jazzed up. When a question would pop up on their screens, the noise level went from a roar to deafening silence. When they got closer to formulating the answer, the volume gradually increased and when the answer came up on the screen, there was an eruption.” Ms. Bour says training in this way is new, different, and exciting; it’s also a little bit scary to abandon the tried-and-true approaches. “We combined gaming with traditional training to help solidify key learnings, and we found this approach to be very successful,” she says. According to Dr. Low at Total Learning Concepts, studies have proven that gaming training produces four times the learning or knowledge transfer rate than traditional training, and recall rates measured six weeks after the training are 10 times that of traditional training. Gaming is so effective because its instructional strategy sets up a situation that is forcing the learner to be challenged while playing, imprinting the information on the brain when the learner takes an active role in learning. Plus, the ROI of gaming is “completely astronomical” compared with more traditional ways of learning, Dr. Low says. IMS reports it recently conducted a large event for a pharma sales management unit and the objective was to use simulation to improve the tactical business planning process and also to demonstrate the value of the information that was available to the company internally. The usage rates of the information were fairly low, because the field force wasn’t using the data as much as it should be, Mr. Leah says. IMS designed a simulation that not only explained the planning process but also included some of the actual sales analysis information. “Ultimately, in the course of the event, we explained the value of good analysis and how this information could help sales make better decisions,” he says. “More than 80 teams competed against each other. By the end of the exercise it was abundantly clear to the participants that the information was valuable and using the data could increase their sales call effectiveness. In a matter of weeks, the client reported a dramatic spike in the use of the internal sales analysis tool. Within one day of simulation training, the company saw direct results.” Signs of the Times Gaming training in the pharma industry may not be at the mainstream level, but it is moving closer to bridging the adoption chasm. Early adopters are definitely leading the way and when conservative movers witness that it works in enough places, the use of gaming will increase. According to Mr. Prensky, the industry needs to move with the times and take a new look at gaming. “Both professional training and patient care games are starting to come into their own and a lot of this has to do with the generational change and the changes in gaming design,” he says. “Games can effectively train people in reaching goals, changing behaviors, improving decision making skills — and they give the industry a more palatable way to achieve these goals.” Sooner rather than later, pharma, as well as all other industries, will be forced to train using computer-based games, Mr. Woodruff predicts. Advergaming The concept behind an advergame — interactive video gaming technologies — is to deliver embedded marketing messages to consumers and to get consumers to talk about a product without really talking about the product. “In other words, consumers enjoy playing the game and pass it along to their friends,” Professor Kapp says. “We want people engaged in the content without caring that they are studying a product. The game keeps the brand name in front of the client while marketers get the viral marketing impact of friends passing the game on to friends.” Professor Kapp cites the Levitra Orange Night game as an example. According to Meg Columbia-Walsh, managing partner and president of consumer and e-business at CommonHealth, now is the time for pharma to take a more vested interest in advergaming, particularly when 40% of the gaming population online is women and the average age of those women is 28. “From a marketing standpoint it was assumed this segment was made up of kids but it is not,” Ms. Columbia-Walsh says. “Pharma is not paying enough attention to advergaming. Brand teams should be studying this gaming audience and identifying how the games on the Web could be an effective means of reaching them.” The fastest-growing trend among women is gaming, and other industries are using this fact to their advantage. “Other industries have adopted the use of games to reach consumers,” Ms. Columbia-Walsh says. “If compliance is the pharma industry’s No. 1 issue and 40% of the gamers are women, how do we use gaming to reach them?” One of the drawbacks to advergaming is that changes in sales results cannot be linked directly to the game. The company knows how many people have viewed the game, but it can’t determine how many of those people went out and bought the product. Nevertheless, Ms. Columbia-Walsh says it is time for pharma to tap into the gaming audience. “When we consider electronic arts and iPod use and the way people are playing and transporting online network games, pharma needs a strategy for showing up in this environment,” she says. “We need to take a hard look, because people are spending a tremendous amount of time with these games.” In addition, Ms. Columbia-Walsh views advergaming as an excellent opportunity for companies to improve patient compliance and adherence. “The pharma industry needs to partner with the gaming industry to engage consumers in a way that helps them understand either a medical condition or a branded product,” she says. PharmaVOICE welcomes comments about this article. E-mail us at [email protected]. Professor Karl Kapp Bloomsburg University The new tools that are being developed are going to make it easier to create games; this ease of use, mixed with the backlash against boring e-learning methods and younger people coming into the field, will propel the gaming training trend forward. Kim Metcalf Celgene Corp. Gaming training, if created properly, can provide a bridge between the selling skills and the formal role play. COMPUTER-BASED training Sound Bites from the Field PharmaVOICE asked experts to provide their opinion on the effectiveness of gaming training for sales and advergaming for reaching consumers. Lisa Flaiz is VP, Group Director and National Pharma Practice Lead with the Philadelphia office of Avenue A | Razorfish, which is an interactive services firm that helps companies use the online channel as a marketing and business tool. For more information, visit avenuea-razorfish.com. “Pharma is more than ready to use games in its efforts to reach consumers online. And the audience is there. Women are a huge group of casual gamers, with 70 million playing regularly online. Online gaming is different from console gaming, and there are different attitudes toward advertising. With online gaming, advergaming is perfectly acceptable. There are many opportunities for pharma, both in terms of sponsoring or advertising around existing games or developing custom games that feature integrated brand messages. We’ve seen some great pharma examples of custom games built right into rich media ad units. In recent brand-impact studies, associating a brand with the fun of a game has been shown to lift metrics, such as brand awareness, message association, and purchase intent.” Rich Kelly is Communications Director for Machine Dreams, Minneapolis, which specializes in interactive learning using wireless response devices and dynamic media. For more information, visit machine-dreams.com. “The health industry is focusing on capturing more metrics, learning more from its participants, and steering away from PowerPoint. The trend is moving toward delivering content through interactive simulations and case studies, movies, 3D navigable algorithms, and team-oriented learning games and challenges. We know that the best medical education and training programs challenge participants in realistic situations; extract knowledge, ideas, and best practices from everyone; deliver rich media that stimulate the senses; and portray complexity in intricate and elegant visual maps. The best education and training practices today include high-quality immersive case studies linked to dynamic simulations, team challenges, and individual feedback loops.” Diana Long is a Principal at DML Consulting, Philadelphia, a network of senior-level specialists in brand building and customer relationship management that has developed a game experience to help clients learn from their customers. For more information, e-mail [email protected]. “When a game is used to elicit perspectives from a group with diverse customer segments, several things happen more productively. First, game teammates find creative ways to align on a unified point of view as a way to win. Second, gamers are more likely to put forward more interesting or daring points of view than if they were arguing a point to a judgmental management. The clearest boon of using a game to engage brand teams has to do with changing the tenor of the consulting engagement itself. By playing a game with new partners, intradepartment distinctions become less important. Moving the business forward and providing an exceptional customer experience seem to take the driver’s seat.” Peter Marchesini is Chief Learning Officer at inVentiv Health Inc., Somerset, N.J., which is a provider of commercialization and complementary services to the global pharmaceutical and life-sciences industries. For more information, visit inventivhealth.com. “Gaming training and traditional training methods are not in conflict with each other, but should be used to complement each other. Individual learners have preferences in how they like to receive information, and likewise, trainers have certain preferences in how they like to deliver information. By understanding that both trainers and audiences are diverse, curriculums can be designed to meet their distinct needs. The ultimate goal of any gaming training is to increase the level of engagement with the activity and the energy of the delivery. With the increased use of technology to deliver a self-paced curriculum, gaming can support learning, competition, and a gap analysis for missed questions, topics, etc. There are some great templates that allow PowerPoint presentations to be put into a gaming format to engage the audience and drive home the key learnings that may be lost in a didactic presentation. The important thing to remember is that the goal is to impart learning to a student. A training program must keep that goal in mind and measure results to figure out what is the appropriate mix.” Peter H. Nalen is President and CEO of Compass Healthcare Communications, Princeton, N.J., which is an independent, full-service online marketing agency that supports brands in the healthcare industry. For more information, visit compasshc.com. “Gaming can, and does, work for the pharma industry. It is most effective when the game leverages the entertainment and interactive aspect of gaming in the form of ‘edutainment,’ similar to many successful online learning programs. Of course it is necessary to be contextually appropriate and sensitive; there are therapeutic categories that may be too serious for gaming, for example, oncology.” Donna Wray is a Management Advisor at TGaS Advisors LLC, which provides peer-set benchmark solutions for improving the strategy and effectiveness of pharmaceutical and biopharmaceutical operations. For more information, visit tgas.com. “Games, when done well, are inherently rewarding to Website visitors. There is certainly a saturation of games online; a simplistic effort on a pharmaceutical product site can’t stand up to the average gaming site. That said, a quiz game format can be a great way to generate more interest in dry content, while keeping the content completely product appropriate and credible. What’s more, the development costs and med/legal review effort are relatively low compared with a more complex game. This works well for both consumer promotion and salesforce training applications.” Steve Woodruff Impactiviti Typically trainers understand the value of using games in training; the hard sell is with sales management who may view this approach as a distraction without understanding the value. Marc Prensky Corporate Gameware People don’t want to use the G-word, but that attitude is going away as younger people move into jobs with more responsibility and become decision makers who have budgets. Ken Begasse Jr. Concentric Healthcare Advertising With salesforces being reduced and the amount of time a physician will give to sales reps diminishing to as little as 30 seconds, now is the time for the industry to pay attention to the effectiveness of gaming training. Sales reps need to be able to think on their feet and react quickly to situations, keeping the physician’s needs, and what the product can deliver, in mind. Meg Columbia-Walsh CommonHealth Pharma is not paying enough attention to advergaming. Brand teams should be studying these gamers and identifying how the Web could be an effective means of reaching them. Dr. Glen Low Total Learning Concepts While gaming training addresses the way Gen-Xers and Gen-Yers want to learn, baby boomers are tired of static learning modules, too, so it is not just a generational need in the way all people want to learn. The Toy Box In 2001, Bayer was one of the first pharmaceutical companies to launch an advergame, which was part of the Tylenol Ouch! campaign. The campaign, developed by Faith Popcorn BrainReserve, contained many components designed to appeal to the 18- to 28-year-old crowd. Bayer also developed a game for promoting Levitra with the help of agency MagiClick. the three-level platform “Orange Night” game was built around a middle-aged, white-collar male character, representing the primary target audience of Levitra. GlaxoSmithKline also has created games with MagiClick for physicians prescribing Avandia (Dr. Avandia) and to help interns (Tusonline) to prepare for exams. Learning objectives generally are categorized into learning facts, learning behaviors, or learning systems and processes. There are as many different types of training games as there are types of learning behaviors and the quest is to find the right game for the training. Below is a brief overview of some of the more popular options. Digital Games Simple games such as crossword puzzles, hangman, and word searches, as well as game shows such as Jeopardy and Wheel of Fortune, are good ways for participants to learn facts and gain basic declarative knowledge. These digital games reinforce facts and knowledge by requiring quick and correct responses to questions to advance through the game. Sometimes these games involve multiple players who compete against each other. The e-learning games combine content with both video games and computer games. To view an example of a game show training program, visit learningware.com. Simulation Games Simulation games are best used for learning behaviors and processes. Simulations put the participants into situations or scenarios similar to real life in which they make choices that lead them to another consequence until they have solved the problem. The choices can be set up to be straight right or wrong answers or on a good, better, best scale where a poor choice will not knock a player out of the game but rather make the player deal with the consequences. Simulation games require a mixture of skill, chance, and strategy to replicate an aspect of reality. Some are intended to reflect the real world; others are intended to simulate a fictional world; still others are designed to be both. To view an example of a simulation game, visit reprace.com. Serious gaming All gaming training can be considered serious gaming, but in this context it is a combination of traditional content presented digitally with visuals that reinforce that content. This type of training can help break down complicated material, such as mechanisms of action, into simpler segments that are enhanced by games, rich media, video, and graphics that help explain each concept. In the case of Total Learning Concepts’ new partnership with Qube book training, the content is presented in a digital book form, and the game includes note-taking ability, games to reinforce learning, and a motivational section for comparing scores against other players. To view an example, visit tlconline.com. Beth Bour Reliant Pharmaceuticals We combined gaming with traditional training to help solidify key learnings, and we found this approach to be very successful. Missy Covington LearningWare Sales people are accustomed to moving around and interacting with people; they are not used to sitting at a table and being lectured to. A game show program allows them to learn in an environment they are most used to, and that includes interacting and competing. Joe Leah IMS One of the biggest challenges clients face is how to train people and implement the new learnings quickly. Creating a simulation that mirrors the business case is a speedy solution. Experts on this Topic Ken Begasse Jr. Director of Client Services, Founding Partner, Concentric Healthcare Advertising, New York; Concentric is an independent agency. For more information, visit reprace.com. Beth Bour. Associate Manager, Training and Development, Reliant Pharmaceuticals Inc., Liberty Corner, N.J.; Reliant, a privately held specialty pharmaceutical company, is focused on cardiovascular therapies. For more information, visit reliantrx.com. (Editor’s note: In November 2007, GlaxoSmithKline and Reliant Pharmaceuticals announced that the two had reached an agreement under which Reliant would be acquired by GSK for $1.65 billion [£800 million] in cash.) Meg Columbia-Walsh. Managing Partner and President of Consumer and e-Business, CommonHealth, Parsippany, N.J.; CommonHealth is a network of highly specialized healthcare marketing companies, all aligned to build brands. For more information, visit commonhealth.com. Missy Covington. Director of Communications, LearningWare, Minneapolis; LearningWare is a software provider in the training and educational markets. For more information, visit learningware.com. Karl M. Kapp, Ed.D., CFPIM, CIRM. Professor of Instructional Technology, Bloomsburg University, Bloomsburg, Pa.; Mr. Kapp is a consultant and scholar on learning, technology, and business operations; he also is the author of “Gadgets, Games and Gizmos for Learning.” For more information, visit karlkapp.com. Joe Leah. Learning Solutions and Change Management Principal, Americas, IMS, Plymouth Meeting, Pa.; IMS Health is a provider of market intelligence to the pharmaceutical and healthcare industries. For more information, visit imshealth.com. Glen Low, ED.d. Director of E-Learning Strategies, Total Learning Concepts, Boston; Total Learning Concepts is a provider of pharmaceutical and biotech sales training. For more information, visit tlconline.com. Kim Metcalf, MBA, CMR. Senior Manager, Sales Training, Celgene Corp., Summit, N.J.; Celgene is a multinational integrated biopharmaceutical company. For more information, visit celgene.com. Marc Prensky. Founder and CEO, Corporate Gameware LLC, New York; Corporate Gameware combines computer games and educational content into a new “Nintendo Generation” approach to business learning. For more information, visit corporategameware.com or games2train.com. Steve Woodruff. Founder and CEO, Impactiviti LLC, Boonton, N.J.; Impactiviti is a branding and sales training consulting agency focusing on healthcare and pharmaceuticals. For more information, visit impactiviti.com.

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