Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. wasted no time in launching into an agenda that was widely reported on even before his confirmation hearings, including restoring HHS to evidence-based science and medicine. Those working in the public health strongly opposed his nomination, however, fearing his lack of knowledge and experience and his past reliance on conspiracy theories would bring devastating outcomes for the patients, families and communities we serve.Kennedy has been working at unprecedented speed to decapitate and gut the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC), recognized as the premier agencies for biomedical research and the promotion and protection of public health, respectively. Hundreds of the country's brightest and most-renowned scientists and researchers have been fired or put on leave, disrupting clinical trials that Americans count on to promote health. At the Food and Drug Administration (FDA), Thomas Corry, who handled the agency's communications, and Peter Marks, the top official who oversaw regulation of vaccines, resigned under pressure when they both refused to advance vaccine misinformation. Kennedy was confirmed at the onset of the worst measles outbreak in the U.S. in decades, and he has stumbled immediately. His failure to use the platform to promote a national vaccination campaign for the measles, mumps, rubella (MMR) vaccine, that has been established to be among the safest vaccines available, is nothing short of irrational. Currently, there are more than 600 cases reported in this multi-state measles outbreak now occurring in 22 jurisdictions. Sadly, two children and one adult have died.People demonstrate outside the main campus of the Centers for Disease Control and Prevention (CDC) on April 1, in Atlanta, Georgia.
We commend Kennedy's participation in the weekend funeral in Texas for one of the deceased children, surely a comfort to the family, and his belated endorsement of MMR vaccination as the most effective way to prevent the spread of measles. However, on X he took the opportunity to refer to two unorthodox therapies for measles that are unproven treatments for the disease, budesonide and clarithromycin. In addition, just as President Donald Trump encouraged hydroxychloroquine and ivermectin to treat COVID-19, both unproven therapies, Kennedy claims that vitamin A supplementation using cod liver oil will prevent and treat measles despite no scientific basis for this intervention. Some parents are unfortunately heeding his guidance. Pharmacists in Lubbock County, Texas, the epicenter of the epidemic, report that cod liver oil has been "flying off the shelves." Apparently, the secretary is unaware that vitamin A is fat soluble and not easily excreted, with any excess stored in the liver. The New YorkTimes reported that several children have been hospitalized with liver failure.Equally disconcerting is that we are hearing from epidemiologists and immunologists like Dr.Michael Mina, whose essay appeared in The New York Times on April 2, theorizing that the U.S.is barreling towards a measles epidemic. Mina supported his warning with data from a 2018 European epidemic. As in our country, in Europe measles was on the road to elimination, but low vaccination rates contributed to more than 80,000 cases, tens of thousands of hospitalizations and more than 70 preventable deaths. Vaccine hesitancy has spiked in our country making this same scenario highly plausible. Optimistically, due to media attention and the increase in cases, some parents in Texas are choosing to vaccinate their children after an initial reluctance to do so.Secretary Kennedy has long held the belief that vaccines cause autism, even though his own children are fully vaccinated. He refuses to acknowledge that more than 200 studies in 2004 and more than 1,000 studies in 2011 were re-evaluated to thoroughly examine the data on this question. The reviews were conducted by the National Academy of Medicine, an impartial group of the world's leading experts, and they concluded that there is no evidence for a link between autism and vaccines. In an attempt to revisit this settled issue, Kennedy has assigned a vaccine skeptic, David Geier, to lead a government study of immunizations and autism. Geier has also propagated this long-debunked theory on autism and vaccines, thus we expect that he will enter this endeavor with a pre-determined conclusion. Geier's research background is limited, but it is notable that he was disciplined for practicing medicine without a license.Making good on his promise to "give infectious disease a break for about eight years," Kennedy began his tenure by firing more than 1,000 workers at the National Institute of Health (NIH).More than 1,000 clinical trials have come to a halt across the country and world, ranging from cardiovascular disease treatment to HIV prevention, to childhood and adult cancer treatment.Also on the chopping block were 40 grants focused on vaccine hesitancy and ways to increase vaccine acceptance. According to their memo, the NIH said these no longer align with agency priorities.Prevention is a big part of Kennedy's platform, and we would not argue that it is crucial when tackling chronic disease. Chronic diseases are the leading causes of death and disability, costing $4.5 trillion in annual health care expenditures. The United States lags behind other high-income countries in average life expectancy, with heart disease, stroke, lung diseases, and cancer shortening millions of lives per year. However, the presumption that HHS has neglected evidence-based policies and failed to address the "epidemic" of chronic disease is flawed.Additionally, decreasing the workforce of the HHS by another 10,000 full-time specialized workers will not "Make America Healthy Again."
If we want real change in America's health, we must invest in the people who make it possible. A healthier future depends on a public health workforce that is prepared, trained, and empowered—not just to respond to crises, but to lead lasting change. It's time to build the systems, not cut them and the support that let public health professionals do what they do best: create the conditions where everyone, everywhere, has a real chance to be healthy.
Dr. Timothy Holtz is a professor at the Milken Institute School of Public Health at George Washington University. Teri Mills, MSN, RN Emeritus, Adult Nurse Practitioner (retired) is the former President of theNational Nursing Network Organization.The views expressed in this article are the writer's own.
A seismic shift unleashed by Health and Human Services Secretary
Robert F. Kennedy Jr. has cast a chilling shadow over science, health care
and the patients they serve. Like so many Americans who rely on
scientific developments to keep us safe and healthy, residents of the
Pacific Northwest are now watching their lives upended, and in some
cases, shattered by these sweeping changes.
Our research institutions are reeling from President Trump’s directive to
cap NIH payments by 15%. Oregon Health & Sciences University faces a
loss of $73.6 million. These dollars help pay for overhead costs related to
research grants. The scientific community was dealt another blow when
Kennedy announced plans to slash 10,000 jobs at HHS, including 1,200
positions at the National Institutes of Health, many held by scientists and
researchers.
OHSU is Portland’s largest employer and an economic driver for the state.
In fiscal year 2024, Oregon received $388 million in NIH awards,
supporting 4,435 jobs. In addition to OHSU, this financial boost assisted
many other institutions such as Legacy Health System, Northwest
Portland Area Indian Health Board, and Providence Health and Services.
Much like other universities and research centers in the Pacific
Northwest, OHSU takes pride in incorporating research into treatment
modalities that have vastly improved patient outcomes. It’s common for
Oregonians to participate in research programs based in other states
while continuing to receive care at OHSU, so nationwide funding cuts are
likely to have ripple effects that directly impact patients here at home.
Americans strongly disapprove of these cuts based on polling led by
Research America that took place prior to the Presidential election. In
fact, 84% of those polled said they believe the United States should set a
higher spending goal on research and development. They want the
country to be a leader in research. Americans said they were even willing
to be taxed a dollar more a week to support these efforts. This is not
surprising, because most of us benefit from NIH research.
Today we have standard treatments for common causes of blindness
such as diabetic retinopathy, cochlear implants that give children the
ability to hear, a vaccine that prevents cervical cancer, and targeted
therapies to ease the side effects of chemotherapy. The NIH deserves
credit for discoveries that have saved lives or mitigated serious health
conditions. In an interview with MSNBC journalist Alex Witt,
Congresswoman Debbie Wasserman Schultz praised the NIH, saying she
likely would not have survived breast cancer without it.
Now instead of being able to count on clinical trials that might improve
health and extend longevity, patients are receiving notifications that their
studies are either being terminated or put on hold. Both have dire
consequences. As frontline nurses, we’re hearing from patients of all
ages whose lives have already been affected.
Ron Patterson, 80, has an aggressive form of Stage IV prostate cancer. He
is currently participating in a clinical trial at the Fred Hutchinson Cancer
Center in Seattle. The testosterone antagonist he’s receiving has had a
remarkable effect — before the trial, his body was riddled with cancer;
now he is cancer-free.
After hearing about the administration’s decision to cut NIH research
funding, Patterson became fearful that his trial might be terminated — an
outcome that could cost him his life. He immediately called his doctor
and was relieved to learn that his particular trial is not NIH-funded. Still,
much of the center depends heavily on NIH support and may not be
shielded from the consequences of these sweeping cuts.
Parents of children with hard-to-treat brain tumors have been clinging to
hope for a breakthrough, one that might save their child. But instead of
progress, biomedical engineers and professors like Rachael Sirianni of
UMass Chan Medical School have shut down their labs. Sirianni’s
research specifically focused on treating pediatric brain cancer. The
reason her lab closed? Cuts and delays in federal research funding.
As the nation waits on Congress and the courts to determine the future of
NIH funding, fear and uncertainty rise, for health care professionals,
scientists and the patients whose lives depend on their work.
Contact your U.S. representative and Sens. Ron Wyden and Jeff Merkley.
Urge them to stop the firing of our premier NIH scientists and
researchers, and restore grant funding immediately. Clinical trials must
continue. Lives are not theoretical. Real people are waiting, and they’re
counting on us to act.
Donna A. Gaffney and Teri Mills, Nurses for America.
Raising children in America has never been more difficult, thanks to the Trump administration and a GOP-led Congress that continues to put politics over the well-being of our youngest citizens. Instead of protecting the health, safety, and future of our children, Republicans are making decisions that put them at risk.
Four examples alert us to what is at stake for our children.
One in six children in America attend school with a disability and many of them depend on services that support physical and learning needs to be able to attend school. A main role of the Department of Education (DOE) is to support these services. But President Donald Trump has made it a mission to shutter the DOE. A promise to help our children with disabilities after cutting off this support has been made. However, imagine telling the parent of a child needing this help that their child can no longer go to school, but one day that might happen.
By the year 2000, America had eliminated measles; not one case happened that year. And it would have stayed that way if we kept immunizing our children with the MMR vaccine. But now forces are on the rise talking parents out of giving their children the MMR. This has reached an intense level since the GOP Senate majority under the leadership of Sen. Bill Cassidy, a doctor, voted to confirm Robert F. Kennedy Jr., a known vaccine skeptic as head of the U.S. Department of Health and Human Services. Instead of using his platform to protect public health, Kennedy continues to cast doubt on lifesaving immunizations, saying “It would be better if everybody got the measles,” thereby supporting the spread of a disease that kills children and carries the risk of serious complications in 30% of reported cases. The world imagined by RFK Jr. is now upon us in Texas, New Mexico, and now Ohio. One child has died directly as a result of the decision not to give her the MMR vaccine. The risk that more children will die from measles will only increase as cases continue to spread.
The growing crisis of the basics moving out of reach for millions of Americans is on clear view when it comes to food. Right now, a full quarter of all children in America will go hungry without help from the Supplemental Nutri:on Assistance Program (SNAP) to put food on their table. The current budget, passed by the GOP House, ends SNAP. Let all know, this action will force American children into hunger.
These children are also among the 40 million kids who depend on Medicaid for their health care, the program that insures half of America’s children. In addition to providing preventative screenings and care for complex health conditions, children receiving Medicaid have shown improved health, lower rates of mortality and higher educational and economic outcomes as compared to children without insurance. Despite these benefits, Republicans propose slashing Medicaid funding by $880 billion over the next 10 years to pay for $4.5 trillion tax cuts for the wealthy.
Make no mistake. Our children’s lives are at risk, as is the future of our nation. A country that neglects its children is a country that is dooming itself. If we want the next generation to grow up in a safe, stable, and supportive America, we cannot stand by in silence. The time for action is now. Our children’s futures depend on it.
Dr. Arthur Lavin recently retired as a Cleveland-area pediatrician. Teri Mills, of Oregon, has a leadership role in Nurses for America.
Consumer confidence isn’t just slipping — it’s plummeting. But the economic downturn isn’t the only crisis we’re facing. Confidence in vaccines has hit an all-time low, with more parents rejecting the CDC-approved immunization schedule and leaving their children vulnerable.
The consequences are devastating in Maine and throughout the country. Influenza is surging in Maine, with 42 flu-related deaths and 109 flu outbreaks during the 2024-2025 flu season reported as of Feb. 26. Measles is spreading like wildfire, with over 200 cases in 12 jurisdictions and two reported deaths.
Robert F. Kennedy Jr., a longtime vaccine cynic, currently leads the Department of Health and Human Services (HHS) — the agency responsible for setting vaccine policies that protect public health. Kennedy lacks education, background or experience in health care and his refusal to accept settled science on vaccines threatens decades of progress and endangers children’s lives.
When pressed during his first Cabinet meeting about the Texas measles outbreak and the nation’s first measles-related death since 2005, Kennedy shrugged it off, dismissing the crisis by claiming, “Measles outbreaks are not unusual.”
Given the public and professional outrage, Kennedy now says the measles epidemic is his top priority, calling for action in an op-ed published on Fox News. He claims vaccines are safe but carefully chooses statistics to minimize just how serious measles is to children. He failed to mention that complications occur in 30% of reported cases, instead referring to them as “rare.”
He recommends using vitamin A and cod liver oil to prevent measles mortality, however he does not stress that this treatment should not be used as a replacement for vaccination and that it can be toxic with overuse. Kennedy also claimed that under his leadership, HHS will always remain committed to radical transparency to regain the public’s trust in its health agencies. Yet, he recently issued a statement disallowing public participation from the majority of business that HHS conducts.
As frontline nurses who grew up in the 1960s, long before modern vaccines eliminated childhood diseases like measles, mumps and rubella, we remember the misery firsthand. Today nurses are caring for too many sick children in the pediatric intensive care unit afflicted with influenza and measles.
Additionally, we are fighting an epidemic of hesitancy and reluctance. As public trust in vaccines continues to erode, nurses are stepping up to fill the void with science, truth and patient advocacy. We won’t stand by as decades of medical progress are undone.
We, along with countless medical providers, consider vaccines to be miraculous. They prevent diseases often difficult to treat once contracted.
Vaccines are tested and then retested and verified by multiple agencies, more so than any other drug sold to the public. Vaccines are effective and they are life-saving. A 2024 study published in The Lancet estimated that vaccines have saved 154 million lives globally since 1974, comparable to a rate of six lives every minute.
In our practice, we occasionally hear that parents prefer to “slow walk” the vaccination schedule, making their own determinations as to what vaccine should be given and at what age of the child. Delaying the childhood vaccination schedule not only puts your child at more risk for disease, it also puts every child in their surrounding at risk. For instance, measles is so contagious that the unvaccinated or those with no immunity have a 90% chance of catching the disease if exposed to this virus.
With spring break right around the corner, we asks parents to please heed of the important role vaccines play in keeping your kids healthy. Do not risk their health based on hearsay and quackery. Trust your nurses and physicians who have the expertise and best interest of your child at heart. There is no room for regrets. Get your kids vaccinated.
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ABOUT THE AUTHORS
Donna A. Gaffney is a psychotherapist and author of “Courageous Well-Being for Nurses: Strategies for Renewal.” Teri Mills is a retired adult nurse practitioner and former president of the National Nursing Network Organization.
We both attended the U.S. Senate Committee on Health, Education, Labor and Pensions hearing for Robert F. Kennedy Jr. on Jan. 30. When reflecting on the many commitments Kennedy made to U.S. Sen. Bill Cassidy, a Louisiana Republican, that day in order to gain his critical vote to become the next Health and Human Services (HHS) secretary, the words of Dionne Warwick’s song sadly ring true. “You made me promises, promises. Knowing I’d believe promises, promises. You knew I’d never keep.”
Senator Cassidy, a gastroenterologist with over 30 years of experience, proudly claims that he has dedicated his life to saving lives and we do not disagree. Throughout Kennedy’s confirmation hearings, Cassidy reiterated his support for vaccines, having personally witnessed their rigorous safety monitoring and effectiveness throughout his career. He also brought up his grave reservations about Kennedy’s past conspiracy theories and vaccine cynicism.
In order to vote yes to confirm Kennedy, Cassidy obtained several promises. He made it clear during his floor speech that preceded the full Senate vote he would be watching for any efforts made by Kennedy that would wrongfully sow public doubt about vaccines. Yet, just days after being sworn in and despite his pledge that he would not change the nation’s current vaccination schedule, in his very first address to HHS employees, Kennedy vowed to investigate the childhood vaccine schedule that prevents measles, polio and other dangerous diseases (“Kennedy says panel will examine childhood vaccine schedule after promising not to change it,” Feb. 18).
The fledgling HHS secretary’s timing could not be worse. Currently, there is a serious outbreak of measles in Texas with 58 reported cases, most of these in children. Measles is dangerous, potentially deadly, highly contagious and is spreading rapidly to other states.
Kennedy also has a history of drawing false conclusions about vaccines, often linking them to unrelated, unproven end results. His most widely known and repeated lie is that vaccines cause autism. They do not. Now, in his mission to “make America healthy again” by decreasing chronic health conditions, he announced he wants an investigation linking the cause of these diseases to vaccinations. Several meta-analysis studies have tested this hypothesis and found that no link exists between vaccines and chronic disease.
Doctors for America and Nurses for America opposed Kennedy’s nomination, never fooled by RFK Jr’s insincerity. This may have been his first promises broken, but they will not be the last. Senator Cassidy, it’s your move now.
— Timothy Holtz, M.D. and Teri Mills, R.N., Chevy Chase
The writers are, respectively, a professor at the George Washington University Milken Institute School of Public Health and the former president of the National Nursing Network Organization.
The Republican-led House Budget Committee has announced details of its 2025 Budget Reconciliation bill. Surprisingly, their proposal doesn’t focus on the waste and fraud you might expect. It calls for slashing Medicaid funding by $880 billion in the next 10 years.
The Republican party sent their leadership to Mar-A-Lago last month to outline budget priorities with two objectives: to reduce the federal deficit and fulfill Trump’s campaign promise to extend the 2017 tax cuts that went to those with incomes above roughly $400,000. Extending those tax cuts would provide an average annual tax reduction of $62,000 for households in this top 1% of earners.
Pennsylvanians, along with all Americans, have reason to be alarmed.
Alarming for Pennsylvania
In 2024, 3.1 million of the state’s population were covered by Medicaid and the Children’s Health Insurance Program (CHIP). Medicaid operates as a shared financial responsibility, with costs covered by both federal and state governments.
In fiscal year 2022, total Medicaid spending in Pennsylvania was $44 billion. The federal government paid 63.5% of these Medicaid costs and the state budget picked up the rest. Without help from the federal government, the Pennsylvania legislature would struggle to fund the steep cost without making deep cuts to education and public safety.
If the cuts are made, how will they affect patients and their families? Medicaid, established in 1965 as part of the Social Security Amendments, was intended to provide healthcare coverage to America’s poorest people.
Today, with specific criteria, most states cover children, adults with disabilities, aging adults and non-disabled adults. Medicaid also makes payments to hospitals and long term care facilities that serve a large number of Medicaid and low-income uninsured patients to offset uncompensated care costs.
As nurses, we have cared for countless Medicaid patients and seen the life-changing impact of this coverage. Now, these same patients live in fear of losing the care they rely on.
Devastating cuts
One professional told us, “I am a nurse working in an assisted living, long-term care facility. I would estimate 80% of the patients I care for are on Medicaid. These proposed cuts will devastate my community.”
Her patients wouldn’t be the only victims. “Like many who work in hospitals and settings that rely on Medicaid government reimbursement, I would likely lose my job. This is a double whammy for my family, as I work part-time, so am not eligible to receive benefits through my employer. I too rely on Medicaid and the same goes for my three children.”
Another Medicaid recipient said, “I'm a single mom with disabilities, including temporal lobe epilepsy, fibromyalgia, and two types of lupus erythematosus. I have a special needs child who depends on anti-rejection meds due to a liver transplant. Without Medicaid, we could not afford our medications and this would be a death sentence for us.”
A concerned grandmother reports, “My 12-year-old granddaughter was just diagnosed with significant scoliosis at 45° and 47°. She will almost certainly need corrective surgery. If Medicaid is cut, her parents will not be able to afford over $100,000 for this surgery, and the curvatures in her spine will continue to get worse.”
There are 3.1 million stories just like these, and that’s just in Pennsylvania alone. The Kaiser Family Foundation reported that 82 million Americans were enrolled in Medicaid as of August 2024.
When pressed on improvements he would make to Medicaid during his confirmation hearing in the Finance Committee, Robert F. Kennedy Jr. provided no specific examples.
He simply declared that “Medicaid is not working for Americans and most Americans prefer private insurance.” Actually, those who have Medicaid are satisfied with their plans, with 80% of enrollees viewing their insurance positively.
He also refused twice to commit to protecting Medicaid funding, saying both times that he would work with President Donald Trump to make Medicaid “better,” but he failed to say he would rule out cuts or to provide any further specifics. He’s now the head of the Department of Health and Human Services.
On the chopping block
Is this a doomsday scenario for Medicaid and the people who depend upon for their health, and even their lives? Not yet — but we’re dangerously close. Republicans only need a simple majority in the Senate to pass this measure — no filibuster, no 60 votes required. That means Medicaid is on the chopping block, and millions of lives are on the line.
The House of Representatives is our last line of defense. With the GOP holding a razor-thin 218-215 majority, very single vote matters — and so does your voice.
Donna Gaffney and Teri Mills are leaders in Nurses for America. Their previous article was “Mr. Fetterman and Mr. McCormick, say no to RFK Jr.”.
First Published: February 21, 2025, 2:30 a.m.
Less than a month into the Trump presidency, critical protections and incentives to improve health and safeguard public safety in the U.S. have been rescinded and a vaccine cynic, Robert F. Kennedy Jr., who struggled to answer basic questions about Medicare and Medicaid during his hearing, has been confirmed as Health and Human Services (HHS) Secretary.
There is now uncertainty about the future of Medicaid with the House GOP-led Budget Committee recommending steep cuts in funding to the tune of $880 billion over the next ten years. Also, included in their reconciliation bill is roughly $150 billion in reductions to the Supplemental Nutrition Assistance Plan (SNAP) that helps to provide free breakfasts and lunches to children.
One of President Trump’s first actions was withdrawing the United States from the World Health Organization (WHO). To put this exit into perspective, the world’s population is around 8 billion. The only other country within the United Nations that does not belong to WHO is Liechtenstein, population 40,000. Trump’s decision impacts far more than just those within our borders. Until January 20th, the US was the world’s top global donor, financing programs ranging from HIV to public health emergencies. As Americans work to regain a sense of normalcy post-pandemic, there are already new threats like Avian flu (H5N1) emerging globally. Withdrawing from WHO comes at an especially critical time as it prevents the U.S. from accessing vital scientific information that drives the development of vaccines and treatments.
Additionally, President Trump wasted no time in exiting the Paris climate agreement, joining Iran, Yemen and Libya as non-participating countries. Although there has been ample gasoline in the U.S. currently selling for an average of $3.25 a gallon as compared to 6 to 8 dollars per gallon in Europe, Trump’s focus on expanding oil drilling -“drill, drill, drill”-will result in increased pollutants entering the atmosphere. Despite global consensus that greenhouse gas emissions drive climate change, Trump refuses to acknowledge that we are facing a climate crisis. Trump signed an order to revoke Biden’s target goal of 50% electric vehicle adoption by 2030, ignoring what we’ve witnessed this past year. Record temperatures have fueled unprecedented weather extremes, underscoring the urgent need for action. We saw catastrophic events including flooding in North Carolina, a snowstorm in New Orleans, and the recent destructive and deadly fires in Southern California, leaving tens of thousands homeless. Trump justified these policy changes by arguing if China is able to pollute our air, the U.S. should not unilaterally limit its own industries. His actions directly impact all of us, but especially the 35 million Americans living with chronic lung disease who depend on clean air to breathe.
During his campaign, Trump promised to reduce the cost of living for hard working Americans. He also bragged during his inaugural address he will make America healthy again. Yet, he swiftly signed an executive order revoking the Biden administration’s ability to negotiate drug prices which was a key part of the Inflation Reduction Act.
Three in ten Americans struggle to pay for their medications. As nurses, working on the frontlines of healthcare, we see all too often patients who cut pills in half or skip them entirely in order to purchase groceries or pay their heating bill. The ability to afford medications has not only improved patients' health outcomes but also led to a $6 billion reduction in spending as reported by the Centers for Medicare and Medicaid Services (CMS). It’s not surprising a Kaiser Family Foundation poll conducted in October 2024 found strong bipartisan support with 85% of those surveyed supporting the federal government’s negotiation of the price of prescription medications.
Actions speak louder than words, and President Trump’s pledge, to “make America healthy again” rings hollow. It’s either an empty cliché or a meaningless campaign slogan because his actions so far have directly undermined public health. Every measure he has taken seems designed to erode, not protect, the health and well-being of Americans. Is this what we signed up for?
Donna Gaffney, Pacific Palisades, CA and Teri Mills, Tualatin, OR (both are leaders in Nurses for America)
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