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tv   Biosecurity Experts and Medical Professionals Discuss Biological Terrorism  CSPAN  August 28, 2017 6:05pm-8:02pm EDT

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ladies and gentlemen, landseer of the potomac institute and it is my privilege to welcome you here today with the seminar on combating biological terrorism. i am proud to report for now almost exactly 20 years the potomac institute has been involved in the study of this issue of bio terrorism
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has only grown worse over time and is more threatening and more imminent and certainly those tools for dealing with this is inadequate today is 20 years ago the most political people are distracted from the threats which ships running over each other the pacific that the threats are more as long wolf driving cars to open spaces in your opinion united states and they forget the potential of a lone wolf with the
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biological realm is still quite possible in some would say likely in the future. the newsletter for eating less and terrorizing as the we are here to take a moment to see if we cannot refocus on the issue of biological terrorism. the works that summarized a lot of activities over the last 20 years of a focus run by professor alexander and how countries around the world focusing on terrorism
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that uses technology of the modern age as weapons and spend a key focus so as a mark of 20 years studying this issue to highlight the fact the solutions are not getting easier as much focus now is we have never had on the issue of potential of biological tools to kill vast amounts of our population and it makes me very proud the institute has
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had such of its people to and vice us to revise the politicians and policy makers never a great program ahead of you here today into your thoughts and input with question answer i highly encouraged that the engagement of the people in this room in the communities around the country and around the world and dealing with threats like i.r.a. terrorism is a professor alexander in all of you know before the record publishing over 100 bucks of aspects on terrorism for the academic study of all aspects of terrorism and to give a
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framework for what we're talking about today. [applause] >> that was very generous social credit does not belong to me but over many decades to evolve that threat of terrorism the different dimensions and what are those responses to address of threats of the
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future? submitting to work on everyone here and i would like to do this first working with these other participants to assist us in developing with more clarity so the first speaker really needs no introduction and university of maryland with johns hopkins university in
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the way they distributed them because if we have to deal with the contributions not just two hours but we day fall semester so let's move on to the full speakers from georgetown university and i recall some of years ago that we met in jerusalem
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at the of the big at the of medical school from the medical school in nebraska from the potomac institute. and last but not least currently a consultant and director of the intelligence community center of biological weapons program and last but not least of former commandants of the
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u.s. marine corps from the potomac institute. so the information of the speaker is of course, related to vocable so the members of the u.s. government who are participating today as well as some members from congress and also a representative of 11 countries with whom are concerned about the threats of terrorism. if i may, i just one footnote and basically we made sure that we have the threat within the proper perspective of the terrorist
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threat m particularly i think such as the lone wolf the disruptive threat with those weapons of mass destruction and 21 years ago from 1996 to issue the first declaration in to encourage
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others and members of the international community as they know they tried also the 1998 with a al qaeda operative than many of you would recall the united states embassies and a few days later and said the
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united states cruise missiles with those terrorist locations with the retaliation attacks on the embassy's. so with this anniversary and with that threat of terrorism. and with this disruption in the united states with the first effect on the world trade center in 1993. sedan for and indeed now and orlando and of course, the most recent attacks in the
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u.s. and the day before yesterday actually had to close the university and the campus if they have to close the university is and to remember very vividly also london, etc. and barcelona. one important element and specifically in is a target of of of choice with those medical facilities
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throughout the world the and of course, particularly children so if we let the record and withal this incident 17 years ago than medical aid workers roper by the television and so the question is are we going to remember to express bus sympathy and condolences to the victims and their families but also a comprehensive strategy to deal with terrorism in general so we aim to
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recognize those governments living with of problem. but i think we are approaching the 100 readier anniversary of the 1918 in plants that epidemic that killed an estimated 50 through 100 million people as you know so therefore it is important i feet for all of us to assess the potential dangers of mother nature of biological terrorism nationally and globally. so to develop a
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comprehensive via security strategy and to address these issues and hopefully these participants with these accommodations to reduce the risk. >> with this very important introduction. can we put that back to the beginning? and with these
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developments of understanding the threats but the wingback at 11 this is the anthrax incident. i was chair of the interagency committee as we attempted to root track down the of a perpetrator in from the anthrax that was sent out in the letters a round of washington area starting off with the reporter since then we were able to attract
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down the perpetrators source and since then i have spent all this time in the period of time focused on how we can rapidly identify bacteria and viruses and parasites in a way that is actionable and accurate so let me describe first of all, focusing on those microorganisms all of us in this room that we are 90% bacteria in viruses. those in our debt produce vitamins and they protect us
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against invading microorganisms. and with those active commanders and they looked into slow going. in bed with saliva it with those protective microorganisms. but those are associated with disease it is amazing with causation everything
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from simple lack any an unsold -- and so forth. the with the first computer program in the united states but also of their rorer competition and capability. with us at techniques to the present it with infectious
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diseases and post the 11 the techniques were tedious. and with the serum in the health. in this year after growth of microorganisms but today we have a terrible threat to globally. running out of antibiotics to be active against the common infectious agent in becoming increasingly resistant to the most powerful of the antibiotics. and this use has led us is a
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condition a multiply heavy duty resistant microorganisms introduced into a population could create many death especially for children and the elderly . in fact, antibiotic resistance is say causative agent which where i have worked all of my career is only 100,000 deaths so you can see the of magnitude that this provides. what i get after finishing my term was to establish a
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company and i did that was much easier than to get a grant from the nih even if i did publish a lot of papers so focused intensely on how we could identify bacteria and viruses so the approach taken by that anthrax organism that was right after 9/11 even to edit it six years to accumulate so to determine the source and
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the perpetrator. so to commit suicide the day the fbi went to arrest him so we will never know if he worked alone. we don't have six years. and infectious agents and food animals and water needs to be treated in a way from being introduced. it can take different profiles and if you isolate
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the organize and -- organize some -- organism but that technique with of described to extract the dna that is a long time period but once we have the sequence that we can identify within 10 minutes down to species and strain for the fund is in the repair sites this is extremely important development there are people working as well to those that demonstrated so dramatically that would
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offer a vacation with his parents he was in and out of hospitals and check the blood sample and found out that it was unusual the visually discharged in the mouse urine and with penicillin was treated because of the inability to identify the organism so fortunately we hideous some examples in calcutta with
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the infectious disease hospital but we did was a very intense study with a standard technique with 50 or 60 patients looking for bacteria that has the patience came in for the stool sample in the analyzed that bias sequencing technique. in those controls and those members of the community so
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they could haddad pathogen and then in comparison on the western side from nih the micro biome work that is being done. they had about 20 samples i will explain what that means. we could identify all of the bacteria yes we picked up caller of but that there was not a single package gene so this technique that even severe infections were with
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a single pathogen to survey the entire earth dna we find that those are critical bedmate not be as a single agent. and we are able to identify that is mostly a mixture of equal live -- ecoli that is already in our debt but those that carry a the pathogens to carry these
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pathogens this is the good bacteria like if you drink buttermilk so this is consistent ended say mechanism to determine whether an individual that claims to have lived here for it decade that is very different bedded say forensic tool with the technique than the dna analysis and i will have
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more to say about that at the end of my talk. to identify all of these pathogens you can see clearly these are all kinds of pathogens that are present in the room identified the species and the strain with this elegant technique of sequencing. in the metabolic jeans. i don't have time to go into all of that that we can determine that has a whole lot more carbohydrates but then you now with every meal of rice is served.
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and to characterize human beings. but mostly of lots of ecoli. so also the antibiotic resistant. every donate prescription but those that had they known infection they are resistant to tetracycline
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and a the kind row harder trade. it to spend a lasted years to develop and then to supply and. fell in the water and ended up whether the fasciitis. streptococcus is unusual but the race to that time and with those strains of the clyde bader bacteria.
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three of those trains are genetically is identical. so to find out why this organism and then to be systematic. but then having arms amputated to the elbow eventually succumbed because it had on systemic. so with the mice to inject all for into the muscle of negative. looking at the liver and the spleen and individually none
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of them went but it was such an unusual experiment that if we're going to get this published to engineer that one strain and to make a long story short and then to produce a toxin. because they broke down the tissue said the importance
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hear it is it just the species now all i will move on quickly. steadying endocarditis. working with the cleveland clinic and working with heart tissue that cannot be identified by standard techniques but to confirm those samples but what they
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could not we were still able those that our fastidious this is a very powerful approach to a though standard techniques this is very, very important coming back to the bio forensics approach we have taken all the data that has been published and combined them around the world data from 10 countries and 600 samples to say this might be the
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global average but when you work at each of the different countries but this is quite fascinating what you are from two antonia based on diet, and a culture your genetics, and with that population and these are just of parasites that is
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say medical tool end to have a forensic tool those have not wasted the last 10 years to identify rapidly and accurately. the sequence of time is getting shorter and shorter. right now the size of a thumb drive we tied it to that device so i will close by the caveat with this
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capacity at the ready but we also need to understand that this bio threats it took six years spent the next one might be a whole lot more complicated we need to be vigilant and have that program that is to the moment to wonder states and at the ready to protect our population. [applause]
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>> professor alexander correctly pointed of the target of bio terrorism to raise certain extent to protect us the georgetown medical community center these are a group did that apparently the slides that i brought to day to get the slides i will we get from my notes in the title that i would take is what can the global brandt -- blood transfusion experience contribute to this subject? or a subtitle might be, why is blood transfusion on the agenda today? i think there are three reasons that i cannot justify. one. there is an international network of bio vigilance
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that is monitoring complications of blood transfusion so that is one topic that professor alexander and his colleagues and the other is every day in the united states, there was about 35,000 tubes of blood so that is quite a network and goes to the cdc on a daily basis so we have then had quite a national network of infectious disease the third reason is more relevant but their 300 medical centers so a few
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transplant bone marrow you are required to immunosuppressed to the point where any of those lymphocytes, over that technically you can get the disease that the immune system of that donor gets into the person and goes after that person. the only way you can do that is to radiate the lymphocytes' coming over with the gamma radiator. so those of the topics that could be pertinent with regard to the international network of collaboration with the health and human services with the international society of blood transfusion that
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monitors for infectious agents. so what are those infectious agents we are interested in? and in contrast to what a terrorist would look for r&d agents that we are looking at. syphilis or hepatitis b or hepatitis c was not a real virus, these are all infectious agents of very low community ability. get that 500 ml of blood or have sex with the infected person or a bit by a mosquito that is the something that will spread the wage terrorist wants to.
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bettis is suitable for bio terrorism it is highly communicable. they all wait for a blood transfusion so it is well developed in the western industrialized country and is now down in latin america and the heart of africa and other places where new agents that have historically been in the animal kingdom said with the human species like ben gay or ebola. our network with the newly emerging agent and those low
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comedic ability and with those categories of agents we get about 300 of these and united states between 2,006,000 kerry saw a the long -- the wrong person got a hold of around downtown george washington we could close the town for the rest of our lives because that would not be suitable but unfortunately and i would not be discussing it of the corrective action was not already well in place, we
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are converting to non-nuclear radiators. we need about 25 of gamma radiation to do to the lymphocytes what we need to be done. it would take about 20 minutes for the standard linear accelerator if we took the bag down it would take about 20 minutes that is unsuitable for the turnaround time for a blood transfusion. so with the department of energy in the regulatory commission industry has done what it can do to miniaturize those accelerators to get the equivalent of 25 grey in
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about five minutes which is acceptable turn around time and that is happening. the department of energy so that the court can be disposed of safely if they were thrown out in the waste it is highly supervised cannot dispose of it without the federal agency oversight to put that into a suitable disposal. i didn't bring this topic in without realizing it is closing down.
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with that issue aside issue for the future. thank you. [applause] >> afternoon. thank you professor and everybody else for having me here today. i have enjoyed it tremendously to be a part of this organization so thank you so much all three of you. to dave the topic i would be discussing is not as sophisticated as professor
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as both of them have done a remarkable work i think what you are doing will revolutionize is specifically in the united states is a remarkable effort over the last 10 years and we should acknowledge at and a professor sanders moving from that current technology is safe and better for the nation's security. my talk is specifically with the infectious disease epidemiologist for what is doing to be proactively seeking answers to problems
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and to doing things very quickly as possible to address that unpredictable future and it has been rather unpredictable with a different challenge is and we have to be ready to make a deal with them. this talks about how the global population has changed from 20/20 so bear with me a little bit so what you can see in 2015 the population was 2.5 billion but in 2020 it is 8.5 million so there is the huge increase in the number of people that is a very
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critical question and one of the problems associated with the increase? some talk about those emerging threats and triumphs -- trends in those states of governance become a prime breeding ground for terrorism that clearly is demonstrated by research that in some states those domestic groups have transition to those networks to embed themselves. and with those transitional networks and it will continue has caused a lot of
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these problems and will continue to do this. they will decrease as a result of regime change that it has been counterproductive to creating a defacto new state of terrorist organizations. . .
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>> we have to pay particular attention to the stations. terrorism between 2,002,013, and the numbers of people who have died from terrorism activity
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have increased and as you can see, there are multiple lines over here, the first red run the ac is a global total, and you can see that it has gone up. you can see the countries where the majority of the activities have happened and you can see iraq, afgha afghanistan, nigerid syria. then he can see the rest of the world at the bottom has gone up, but not as much. but you can see is isis with law enforcement and some of these activities have increased now some of that is going away and then a couple years i'm hoping this trend with all activities were doing is going to go down. the next chart shows tourism groups and ideology. what is terrorism about? what is the ideology behind it?
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is it a separatist, political, or separat religious? the biggest problem we see when it comes to terrorism is religious based terrorism. i'm not going to go through this in any detail, know what the definition of bioterrorism is. the most important thing for bioterrorist is to cause havoc, whether it's one case or 1000 casualties, it really doesn't matter. if you have even one case or ten cases, the entire population is affected. we can see that after the attacks how much funding was allocated, how many resources were put into effect, what kind of security procedures we have to go through. it's costing a tremendous amount of money. unfortunately, they are
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successful. there on successful in taking life but there on successful because were still paying the price for it. just recent historical events in 1925, and 43 the bio program and united states was launched in response to the soviet union and a defensive program was established. with all due respect and all the things that nixon did, one of the great things i think he accomplished was he dismantled an entire bio offensive program of the united states of america and started a bio defensive program. so we start building and we completely destroyed all them. seventy-two biological conventions cyber hundred three
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countries, there still sums that haven't signed that and then the geneva convention was ratified. this is the historical perspective that i listed on the website. in all honesty, intentional use of bio threat can cause disease and death. but biological attacks well orchestrated can cause mass casualties or just heard a limited number of people. the cost the nation's to pay and the world is tremendous. again, these are the recent things that have been documented. the big one we talked about, anthrax in 2001 the casualties and all the different things involved in it. and all of you are familiar with it. we haven't had a major crisis in terms of the kind of attack of what were same between 70 and
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2001. we have seen attempts that have been stopped through intelligence work et cetera. i'm sure the speaker actor ms. going to talk a little bit about that. i will do that to him. there have been other instances and have been stopped. moving on from the human element that creates a problem to what nature does. and these are the emerging and reemerging infectious diseases we see in the world. the one in the red are the newly emerging and black is a deliberate emerging. and that is the anthrax. there are many diseases i mentioned, including last year, zika. and how it came and rooted itself in the united states.
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it's a the threat is substantial still. and in 2001 or 2015 about 5000 cases were travel associated, locally transmitted within the united states. and then a record which was not documented earlier, sexually transmitted. [inaudible] [inaudible] 37000 cases have happened and
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most of them were local transmissions. so, zika doesn't cost a tremendous amount of harm for people her age but some people are young and females it causes a serious problem. it results in potential birth defects. the defects it causes are horrendous. the cost to deal with that is astronomical. those are the kind of things where facing constantly and we will continue to face them until their more people like rita will be doing research that are doing to make sure we can identify appropriately by strain and treat them effectively and stop the influx of antibiotic resistance were facing. just for your pleasure, small example of what happened, there's a hotel in hong kong. one person goes there from a
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province in china, one person that is a, the disease spreads all across the world from that one patient. not a lot of cases, but what an interesting way of taking a look at things and how did diseases transmit and cause havoc and cause a huge problem in the united states and canada. they went to europe and various other countries. so diseases will spread. the impact of the influenza epidemic, as stated there 214 countries affected, 19000 people died, why is the numbers about 284,000 people and that's a huge number. is 15 times more than what was predicted initially. they all causes tremendous amount of problem. when we look at 30 years of life
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lost, look at that. it's huge. so infectious diseases do cause problems and will continue to cause problems. i showed you that circle for yemen earlier. what i called this was in the footsteps of war, colorado meningitis crisis in yemen. as the civil war escalates there at the verge of total collapse. more and infectious diseases combined together is incredible. 18 million people are need of humanitarian aid. three my people are totally displaced and tens of thousands have died or been injured. food is scarce and prices are high drastically. as in previous emergencies there particularly subject to cholera.
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since april to august 2017, 443,000 suspected cases have been reported in approximately 2000 deaths have occurred because of color in yemen. on top of that it's a problem that's causing huge issues. and because it is meningitis it area, meningitis has emerged. it's causing a tremendous amount of death sense july 2017, over 2000 suspected cases of meningitis have been reported. for the entire last year, about over two months over 2000 cases being reported, the entire last year was 2500 cases. so yes we can create bio threat weapons and dispense them and
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disperse them causing tremendous amount of death or small amount of death, we can also inflict diseases by destroying the infrastructure of a nation. that's what's happening in yemen. the saudi airstrikes have destroyed all infrastructure could in hospitals and public water systems. civilian areas and put people in crowded and unsanitary conditions. it's caused problems in terms of getting food and medical supplies. food and other humanitarian access to that area. if it continues, we'll have a lot more cases of cholera. more cases of meningitis also in that region. coming to the point that not only can we be create these weapons, we can create situations that diseases that are endemic rising cause these
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problems in havoc. in conclusion, the world is making this up as we go and we have to be more comfortable with uncertainty. country with poor governments, we call systems a few basic health of the structures in place cannot withstand send shock weather comes from a change in climate, a virus, bioterrorism, or terrorism itself. preparedness including readiness to go in tandem with good surveillance and lab supported places critical for all nations around the world. most controlled intervention all by itself is sufficient or more powerful than anything else. to work together seamlessly so that we can control problems. one weakness will cause entire system to fail.
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community engagement is one factor that underlies six success of all other control measures so we have to work with governments and people trying to make sure they are also understanding and appreciating what's going on. communication is a huge issue. when a behavioral change for diet and antibiotic use. complex changes related to the use of untested interventions because we have not tested a lot of them. it will be a problem. ace upon the country and the indigenous way of thinking or behavior that people are used to. i will end with that. thank you very much. [applause] [inaudible]
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>> good afternoon. thank you very much for the invitation to participate. i had an amazing set of slides prepared for this. the best that i ever did, but in sympathy with doctor -- i'm not going to show them. i'm just kidding. i didn't prepare slides. i'm just going to give some remarks. most of the u.s. government resources that have been devoted to countering bioterrorism or bio -- in general have been focused on on response after the fact. that's for the preponderance of resources generally go and that's been the case for as long as i'm aware.
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what i'm going to talk today is, the left side of the equation, the prevention side. how one might prevent an instance of bioterrorism. since were talking terrorism i'm going to narrow it down and limit my remarks not to state-sponsored activities, but to it's called phone actor, lone wolf, small group. going to read a quote from nobel laureate josh -- 1998. there is no technical solution to the problem of biological warfare. he needs an ethical, human, and moral solution if it's going to happen at all. then he goes on to continue, but
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what an ethical or moral solution appeal to a sociopath? when i would submit that the answer is probably no. i would submit that the answers probably know when it comes to bioterrorism. if someone is going to do this, that person will not be swayed by ethical and moral persuasion. so, how does one have a shot at preventing this? to me, the answer is what i like to call deputizing the good guy. going to use a phrase from my talk, bystanders. i'm going to defined bystanders as a person or individuals who have become aware that someone might be bent on perpetrating a bioterrorism event. i will give you an example or
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two of the potential efficacy bystanders. november 2012, probably butcher the name -- a polish professor, chemist by training at kraków's agriculture university, novembed authorities at his home found detonators, handgun, ammunition, and body armor. what his plan was was to get a truck loaded with 4 tons of ammonium nitrate. he has and obtain the full tons but that was his plan to loaded up and drive it into the polish parliament and take out the polish parliament. that never happened. he was arrested. he had been put under surveillance polish authorities.
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why did they put him under surveillance? his wife turned timid. it gets more interesting. his wife turned him in because of the following, she is a biologist by training. he had been questioning her about what could one do with pathogens? what kind of harm could one cause with infectious agents and pathogens. and she became concerned, she alerted authorities, she turned them in. she thought he was bent on vw. turns out he wasn't. that's an example of a trained individual who is a bystander and made a decision to blow the whistle, in this case it happened to be her husband.
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he had previously boasted a plan to others to kill lots of people to use a german agent. he wanted to make a big splash bigger than someone who killed some to seven people. so that's an example of a bystander. i give one more example. this is more recent, october 2014, canadian brother by the name of martin runs down with his car and kills one person, injures another. they're both canadian armed forces personnel. he was specifically targeting canadian armed forces. one person died one injured. eighteen months before that event he converted to islam. personality change, grew a beard, stopped wearing jeans, started wearing robes, started going to a mosque frequently. decided he wanted to travel to
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syria and aid the isis cause. in june 2013 a few months after his conversion his father becomes concerned and notifies authority that his son might pose a threat. the sun is bent on traveling to turkey. authorities confiscated his passport and he cannot go. then the system tries to intervene, beside his family intervening with this individual, the e mom at his mosque intervened and canadian authorities intervened and counseled the person had done a number of sessions with him trying to get him off the path that he was on. a couple of days before october 2014 when he took his car and ran down the two oh forces individuals he had a meeting with mounted police and
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was able to convince him he was no longer a threat. so the bystanders if they didn't intervene, family, the authorities, they all intervened and in this case it wasn't successful. but it points to the power bystanders to prevent something. i worked on this issue long time. for over one dozen years in my previous capacity. when it comes to loan actors, i haven't found anything other than bystanders that gives you have a decent shot at the prevention side of the problem. what kind of recommendations i have? for loan actors countering nonactors? there needs to be the development of ethics based programs for biologist students and practitioners, like the molecular bio, like the
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hippocratic oath. there needs to be done worldwide. i'm talking about worldwide activities. that has to include the ethical responsibility to report someone who is conducting themselves in this suspicious manner. that can be defined in many different ways. his anomalous behavior. something ain't right with charlie. my not even behavior in the lab but something's not right and it's making me nervous. the bystander system itself needs to be something that it has to be safe to report, it's a system i'm talking about. there's a bunch of steps this has been written about this not just me pointing the finger at you and everything happens and it's great, there's a number of
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steps so from questioning george or george is a collie, do i want to report a collie? what's the potential for abuse? wherever promotions of he nails me and i'll get promoted, good for george. so whatever system has to be put in place has to be thought of in a very methodical manner. there many steps beat before the first reporting, who is the individual report to? is it safe so i don't feel if i report that i'm going to be fired? are adverse repercussions taken. needs to be accessible, safe, and effective. again you need to think of this as a system all the way through to the end state which is stopping someone for doing something. there's many parts of this and
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there have been publications. one thing i haven't seen as a cultural aspect of this. in this country you have institutions that are personal liability systems in place. and that includes responsibility to flake someone like a bruce ivins responsibility to flake someone who might be going off the reservation. but if i transplant that system to south america, southeast asia, to africa, does it play out the same way or not? what are the cultural aspects of a bystander situation so it's effective here is effective someplace else and you can't make the assumption that it can be just transplanted. there needs to be researched because there's little research on the cultural aspect of
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bystander systems. my final recommendation is developing and supporting these bystander systems worldwide. there's not a lot of money of all. this is relatively cheap in terms of billions of dollars this government has put into the response side of the equation. many billions have gone into response. were talking pennies on the dollar here. what an ounce of prevention, right. i'll conclude my remarks at that and hopefully it will stimulate some discussion on the prevention side. thank you. [applause] >> think you very much for all the panelist for your contributions and insight. i would say that we need we need
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years to deal with those issues. let me begin to have a question firstly of the panel on the roundtable you had a very interesting and practical i think recommendation, the bottom line is it, is at the role of government, the role of educational institutions? the role of religious institutions? the media, or the fake media? >> at the risk of being flattened the answers all of the above. there's a role for government to play, government has its own labs in this country and around the world. academic institutions have a role to play, the private sector
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and there's interesting bio research conducted in the biocentric especially basic research and i don't know that in this country if they will direct that. but private company several in fostering an attitude of personal or personal responsibility. and to me it's a cultural activity that starts at the top. where the individuals in charge, of a molecular bio department at a university or director of research at pick your pharmaceutical company, make it a point of developing, instituting, and preaching this
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ethical responsibility. then the school systems himself. you can start at the college level, but there's research being done at high school level that a couple of decades ago may have gotten you in line for nobel prize. the lower you can start the better off you are. there's a responsibility at the lower than college academic level as well. clearly, it has to be all of the above. that's in this country. other country the systems may differ. again, it gets to the cultural aspect and what will sell here will not necessarily sell in the same form overseas. you mentioned the role of the wife or the family, obviously we are seeing increasing numbers so that some connections whether a brother, wife and so forth, so how can you deal with this
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aspect of the families to begin the dialogue on the cultural level of the moral and ethical level. so there's two sides of the claim. anyway, to someone else on the panel want to talk? since you spoke about the unpredictable future. one can argue what about technology? as technology moves very rapidly and we know nothing is new under the sun except technology. the question arises in regards to the bio emergent that some people are looking at the artificial intelligence and all that, should we be worried about
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that? >> technology cannot stop. that's the first thing and things will continue to evolve, whether it's on my kid not to use the iphone, he will still use it. he uses my iphone better than i can and thus this will not stop. technology will grow whether it's biotechnology or other means. one has to appreciate the fact that we have to develop measures, we are all educated, we are all asking the same questions, so i don't we put safeguards so these technologies do not come back and harm us? that still needs to be looked at and scientist are talking about. we talk about artificial intelligence, is listening to a 12-year-old boy being interviewed by bbc was a
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protége, an incredibly brilliant guy, his right like for books already. he was talking about artificial intelligence. he said why are you so afraid of artificial intelligence? it is not supposed to replace the human mind, but help us. use it as a tool. if technology is used as a tool that we can essentially be safe. but if it is used to replace the mind completely, then i believe we have a problem. as far as infectious diseases are concerned, we worked on a particular program where we look dead how -- mutate on a computer and how they mutate in the human genome. we found tremendous similarities in terms of how mutations appe
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appear. it was to take influence and take the computer model to see how it would propagate. and hiv sensually see how it would change itself. the same week thing we can do with influenza. a lot of i research needs to be done. again, this technology needs to be used as a tool to enhance health in my opinion. safeguards have to be placed so those technologies do not become harmful to human beings. >> okay. one more question the way open for discussion with the audience. if anyone else, what is your assessment the professional assessment in terms of the responsive strategies of u.s.
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government, other governments, international organization, the united nations, nato and american are the african space or whatever, do you think this works if you're talking about time to do both mother nature threats? >> i think the heads are in the sand. i find it frustrating because every time i've been on committees panels, talked with officials there is turned to the nuclear threat. yes, it's a very serious one, but the bio thread is always there, it's an undercurrent.
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i don't think there's been a globalization. some communities do have an effective program, san diego i think has had some trials of what to do in a major emergency of a given epidemic, but given the most part. [inaudible] >> will respond by going back to doctors can't, the most effective way is right down at the grassroot, the from way up there here not going to be able to spot and deal with that way down there. in your point is the one that i would use to answer professor alexander's question, i don't think the most effective way is going to be national agencies, i think was suggested which is, we have to work way down with the operative is, is probably going
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to be more effective and i support his viewpoint. >> you describe the many wonderful technologies that microbiologists are using an interesting i read a description by you of recent sequencing of the anthrax genome from 2001. immediately you went right to -- was a great achievement of yours. so the other day read an article that may be of seen about anthrax screening in ivory coast it doesn't affect human beings immediately come to mind, what is the role of the genome editing technology that
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terrorist groups might take on themselves? to take that genome, modify it so that they could use it and release it upon the world, something like that, with all the technology advertise so easy to use and very attractive to terrorist groups, so i can we expect in what kind the concerns are being expressed about that? what kind of actions are being taken. >> that's a good question, the first part is that you mention the string of anthrax and that's quite different. there was precisely my point, it's not good enough to use the simple techniques to give you
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general information, you really have to get down to the strain. and we're to the point now where we can pick up variations within the gene coming mutations in base differences, that's critical. you ask how could some of the newer techniques be used? >> if you had to modify the stray. >> yes, you anticipated my next point, which is this approach is much more elegant and precise, and is simpler to use, is simply the investigator, jennifer and her colleague were able to discover they figured out how viruses infecting bacteria and how they can protect themselves. from that evolved this capability of making these precise changes.
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i don't think it's a novel in the sense of something entirely new, just say you can do it better, more precisely more easily, that puts it in the hands of a terrorist, but i think your question to me is that we have got to be able to identify, immediately what the agent is, and whether or not it has been engineered and whether or not it will be rapidly infectious to humans. were getting to that point i think that's what we have to do. >> hello. doctor, having worked this program that you're talking about on the defense department side and having worked with you, your rate that we focused at the
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time on the effect after the attack, the action, good treatment, decontamination, et cetera. what is your suggestion first date sponsored terrorism in terms of prevention? what can we do about intentional state-sponsored biological terrorism? >> it's an interesting question, it is a legitimate concern to look at the state enabling terrorist group, so i will take it away from just state as a state on state warfare which i think is beyond the purview of this discussion and look at the possibility of a state enabling a nonstate actor to further that
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states onan. my personal opinion is that, i think it is unlikely for that to happen for the following recent. number one, why would a state trusted terrorist group? there's always the potential for that group now that it has the capability to use it against the state that provided that capability and secondly, give me a second here. attribution, so to say the terrorist group either gets cut before hand or gets caught in the act are after-the-fact and fingers the state that provided the capability to that group, so now, you have a very angry recipient of that even who's
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going to look not to the terrorist group but the state that enabled it. first state to deliberately enable a terrorist group is quite unlikely. a different side of the equation is for an individual who is part of the state program to buy himself or herself aided terrorist without the states knowledge for example when he had the fall of the soviet union, the united states government put money into trying to gainfully employed former soviet union scientists precisely to prevent them from offering their knowledge whether nuclear, cam, or bio to other countries and potentially nonstate actors. to me that is a much more likely when an individual trained by state program decides by himself or herself to surreptitiously without consent or knowledge of the state aided terrorist group.
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then you have a big problem. the heavy you have a highly skilled individual who is aiding and abetting a nonstate actor. that's not good news. >> thank you. have a question on rapid detection. twelve or 13 years ago i was in a state department meeting and the associate director was talking about the problem of training er doctors to detect the symptoms. the pathogens in the symptoms the first amassing appear to be flu. my impression is that too many med students do rotations and
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tropical medicine. my son was doing his rotation so what you do if you get something suspicious and he said you call the cdc. to know if we progress much since then and to what extent there's better training for er doctors and others to quickly identify the symptoms? the above the situation showed there were lakes identifying the disease. >> yes. your question is right to the point. there is a capacity using next-generation sequencing resequencing devices, they are available all over the world, not just in the u.s., but there is a lake face into adoption. those like myself who are working on handheld devices will position bedside could be able to do sequencing right away. it is happening, and the -- trip
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does have a devices size. so, it's a matter of the company manufacturing the devices, having invested in today's technology, not tomorrow's technology in today's happens to be pcr and techniques which give identification of an individual pathogen, but i'm talking about being able to identify everything that is there and they will make the diagnosis. that's a little bit more expensive. is being used in extreme cases of chronic infections that can be diagnosed by simple techniques. if the matter of adoption by the hospitals were beginning to use it, they now have sequencers in their laboratories that they can do this on site, or their
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contracted to things like lab core and quest. so it's getting there, but it's amazing to me to see this time like when it's such an important capability that can be used right now. but it's sort of running out the current stockpile if you will of what i call the almost obsolete techniques to get the new technique into the hospital. i would expect that within three or four years will be using this technique, if not the one my team has developed, it'll be the team, san francisco or wherever. but we together i think are changing microbiology. we are modernizing it. >> ten or 20 years ago if i had
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students in emergency room or some other place i would ask the group a question and then the student who was down like this i knew had it prepared her wasn't up-to-date in the information, today when the student goes down like that, i know they're picking up their cell phone and answering with information that i never even thought of. last night it occurred to me that the story that is going on would be something of interest. i went to the supervisor of our transfusion service and i said how much do we have here i don't know, they wouldn't let me know, this stuff is kinda hush-hush. so i went to the radiation safety officer, said david, al doesn't know how much cesium do a half, he says well i don't think you talk about that.
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so i went to google, i put in the krishna google. i asked the question, how much cesium is there in a blood radiator. there's a legal document, the first one that comes up if you look at, their 300 centers in the united states that have it, there's -- 137 and each one depending on how fast they want to do it. and, these are the agencies that provide funding for doing it. so to answer your question, none of my generation are smart enough to have all that kind of information online appear. here is how our medical students are going to be accessing that information, if it happened ten minutes ago, it's already going to be here. so i think this is the tool that is going to replace what used to keep me up at night preparing
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for a lecture or my med students. this is better. >> i would like to raise the question about the economic dimension of terrorism. because terrorism has generated vast and rapidly growing domestic security industry. for example, the homeland security department, thousands of guards everywhere, what implications for employment, for civil liberties? thank you. >> so, this is a loaded question and the loaded answer probably. so one of the things we have
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seen and i talked about it since 9/11 and even before when it was in 1999 i was given a specific path to challenge by darpa to develop an early detection for bioterrorism at john hopkins. investment was being made at that point in my career essentially being clinician moved away from being a clinician to working in this field. because i saw an opportunity and i enjoy doing what i was doing so i did that. industry to grow a tremendous amount of money has been poured into this effort and it continues to be poured into it. at times it's too much money that goes into certain areas which i believe shouldn't go into it but should go into issues like infectious disease and microbiology's and how to
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develop point-of-care diagnostics, but nobody listens. if you think about it for a second, how does a legislator answer the constituency when they say, are we protected against a certain biological threat? they say we will do our best. there's a program in our state and it's a national integrated surveillance system which has been there and a lot of money has been spent in the program. it has not been very effective, but every administration says we have to stop the program and it continues because people are going to save you stop this program it will cause problems. buy a watch program has yielded
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not name in the industry that's working on that programs, they spend billions of dollars on that effort without a serious yield. we have not produced a timeline in terms of getting results as quickly as we anticipate. if there is something in the air predicting there is a biological agent near 24 - 48 hours after is in the and sometimes it's not really useful. those are the things that will continue. the same can be said at airport security. would you allow yourself to say, i do not want the airport security screening people for bones or chemicals, cycling to happen. it will continue. this money will be spent unfortunately that will continue
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to be spent, meaning some industries are going to make a very large money. i hope that somehow answered your question. >> my question is the dressing doctor rita caldwells, dazzling information. i wasn't familiar with this and i know what i'm going to be going to about tonight and learning about. they have this question, the goal of course is to get a therapy, something that will treat the organism. the classical method would be to culture organism, he put some penicillin here, some cephalosporin there and you see how response. you have the organism, with this
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fantastic new technology you have a piece of paper and a picture any of it genome. how do you go from that in real time to what you're going to use to kill a bug? >> you get more than identification. from this technique you get a listing of the genes of antibiotic resistance and the pathogenic properties. what it allows you to do and if you'll forgive me for saying this, it allows you not to create a secondary infection. normally you would say hot, well treated with -- so than the secondary organism that's resistant gross up and now you have to treat the secondary organism. now you can look at the genes of a person treated at the same time.
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sears that being present chill pathogen stayed away. >> thank you. very informative. >> i think this has been a timely and superb presentation on the part of our panelists. i think one thing we have noticed over time, about 17 - 20 years ago we had a number of very important conferences on this overall topic. we got into a big time and we for some reasons why today, but as a nation in terms of leaders and thoughtful people, we really were addressing this challenge should a bioterror and all of that means.
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in concert with chemical terrorism as well as other weapons of mass destruction. one look sometimes that the combination of these effects, and have to understand that if you had a cyber brownout for example in new england in a chemical weapon used in york and a biological weapon used in this area, not only would have tremendous technical challenges on your hand, you'd also have a psychological challenge. the likes of which we don't spend much time thinking about. as i said in 2001, about 16 or 17 years ago at the university of virginia on the same topic, we need to come up with a
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campaign plan as a nation, and as part of a player in the free world. we need to talk about how we want the world to look like ten or 15 years from now, and what steps should we take over time. obviously there is good news here from what rita and her friends have talked about today, you can see were much more knowledgeable today than we were 15 or 20 years ago. not just on the medical, technical and detection side, but across the board. i think what doctor con has told us about the by standard approach, this is really worth thinking about in our campaign plan. bystanders, friends, other people who enjoy freedom, if there alert and on the ball, if they are thinking, and if they become streetwise as i say in this whole topic, then they
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could be an important weapon and asset as you need to defend against these kind of threats. if we have this camp campaign plan and if we really get serious about educating the american people and educating the free world as we know it today on what were dealing with, we can make enormous stride toward having a better future and global situation. so, education is a big part of that. the academic side of the house has to be deeply involved as well. the moral, ethical, all that which has been covered, it's crucial to any approach. of course on the eternal optimist, science in spite of all this i see bright spots ahead and we have to keep charging. as for his institute is
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concerned, we will take the initiative now to reawaken everybody on this whole threat, people have already been asked to look into this, to think about an agenda, to think about people we could bring it and have some seminars and think tank type operations that will infuse if you will but we have heard about today and increase everybody's knowledge and the like. above all, we need to think the what if game a little bit. that's where we're headed at the institute and any and all of you will be pleased if you think about it and perhaps participate. thank you all very much. [applause]
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>> this might be the only government class ever take. you'll be a voter forever. a jury forever. i need to give you tools that will help you for the rest of your life and those pursuits. >> tuesday night on eight eastern, hig high school teaches discuss how current events affect their lessons on history, politics, and government . .
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tomorrow booktv in primetime looks at authors on the reading list for members of congress. when you think about a one-day festival, the national book festival, and you have over
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100 authors, from children's authors, illustrators, graphic novelist is, al of these different authors there all day, over 100,000 people come in and celebrate books and reading. you can't have a better time, i think, and i'm a little prejudiced because i'm a librarian but any read her, a book festival is the place. the communicators recently visit micft

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