OPENPediatrics

This podcast focuses on essential information for neonatal and pediatric critical care, and fetal care providers to serve as Spiritual Care Agents in their clinical settings. LEARNING OBJECTIVES - Define spirituality and spiritual care - Discuss how to identify spiritual care needs in critical care and fetal care settings - Anticipate how to address spiritual needs of pediatric patients and families - Review spiritual care screening tools - Describe how to integrate spiritual care into interprofessional practice AUTHORS Melissa Vela, DMin, BCC Chaplain, Spiritual Care Boston Children's Hospital Ibrahim Sayar, MA, BCC Chaplain, Spiritual Care Boston Children's Hospital Ann Haywood-Baxter, MDiv, BCC Chaplain, Spiritual Care Boston Children's Hospital Susan Harris, MHL, BCC Director, Spiritual Care Boston Children's Hospital Michele DeGrazia, PhD, RN, NNP-BC, FAAN Director of Research, NICU Nurse Scientist Maternal Child Health Faculty, Sandra L. Fenwick Institute Boston Children's Hospital DATES Initial Publication: November 2, 2026. Please visit: www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children's Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open-access, thus at no expense to the user. For further information on how to enroll, please email: [email protected] CITATION Vela M, Sayar I, Haywood-Baxter A, Harris S, Marcley S, DeGrazia M. Spiritual Care Agents in Pediatric and Fetal Care Settings. 11/2026. OPENPediatrics. Online Podcast. https://on.soundcloud.com/E2YbsDsBXq9tC6jX3v.

In this World Shared Practice Forum podcast, Dr. David Inwald discusses the findings of the recently published PRESSURE randomized clinical trial. The trial evaluated permissive blood pressure targets for critically ill children receiving mechanical ventilation and vasoactive support compared to usual care. Dr. Inwald reviews the rationale that prompted the study, summarizes the primary and secondary outcomes, and discusses clinical implications of the findings. The host and speaker also explore how these results may influence hemodynamic management and evidence-based decision-making across diverse healthcare settings. LEARNING OBJECTIVES - Describe the rationale for investigating permissive blood pressure targets in pediatric critical care that led to the PRESSURE trial - Analyze the study design, inclusion criteria, intervention strategy, and primary outcomes of the PRESSURE randomized clinical trial - Interpret the trial's findings regarding clinical outcomes, safety measures, and adverse events associated with permissive MAP targeting - Evaluate the implications of the PRESSURE trial findings for pediatric critical care practice across diverse healthcare settings AUTHORS David Inwald, MB, BChir, FRCPCH, PhD Service Director, PICU consultant The Portland Hospital, London Jeffrey Burns, MD, MPH Emeritus Chief Division of Critical Care Medicine Department of Anesthesiology, Critical Care and Pain Medicine Boston Children's Hospital Professor of Anesthesia Harvard Medical School DATE Initial publication date: October 27, 2026. REFERENCES Inwald DP, Laing E, Broomhall JM, et al. Permissive Blood Pressure Targets in Pediatric Critical Care: The PRESSURE Randomized Clinical Trial. JAMA. Published online September 28, 2026. doi:10.1001/jama.2026.19747 Bulgakov, M. (1975). A Country Doctor's Notebook (M. Glenny, Trans.). Oxford University Press. (Original work published 1925–1926) TRANSCRIPT https://cdn.bfldr.com/D6LGWP8S/as/44tqhjqtkt7cfwhjcxfnnt6/20261021_WSP_Inwald_Transcript Please visit: http://www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children’s Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open-access thus at no expense to the user. For further information on how to enroll, please email: [email protected] CITATION Inwald D, O’Hara J, Burns JP. Insights from the PRESSURE Trial. 10/2026. OPENPediatrics. Online Podcast. https://soundcloud.com/openpediatrics/insights-from-the-pressure-trial-d-inwald-openpediatrics.

In this special Complex Care Journal Club podcast episode, host Dr. Kilby Mann interviews presenters of posters and educational sessions relevant to the care of children with medical complexity at the American Academy for Cerebral Palsy and Developmental Medicine (AACPDM) 80th Annual Meeting, September 27-30, 2026, in Philadelphia, Pennsylvania. Speakers describe their key lessons learned and the value of partnering with people with lived experience in training and program design.‌ SPEAKERS Dynai Eilig, MD, MBA Orthopedic Surgeon Clinical Associate, Pediatric Orthopedic Department British Columbia Children’s Hospital Clinical Assistant Professor University of British Columbia Lauren Fetsko, DO Assistant Professor of Pediatrics University of Wisconsin Catherine Jones, BSc Dietitian British Columbia Children’s Hospital Esther Lee, MD Clinical Assistant Professor University of British Columbia Sara Liegel, MD Assistant Professor of Pediatrics University of Wisconsin Jordan Sheriko, MD Assistant Professor Medical Director of Pediatric Rehabilitation Dalhousie University Melissa Villegas, MD Assistant Professor of Pediatrics University of Wisconsin HOST Kilby Mann, MD Associate Professor Director of Pediatric Rehabilitation University of North Carolina School of Medicine DATE Initial publication date: October 20, 2026. RESOURCES REFERENCED - American Academy for Cerebral Palsy and Developmental Medicine. 2026 AACPDM final program. Accessed October 5, 2026. https://www.aacpdm.org/UserFiles/file/am26-PhiladelphiaFP-v8-web.pdf - Brooks J, Day S, Shavelle R, Strauss D. Low weight, morbidity, and mortality in children with cerebral palsy: new clinical growth charts. Pediatrics. 2011;128(2):e299-e307. doi:10.1542/peds.2010-280." - MacLellan A, Farid Marihan, Ford Z. Am I Ableist?: Disability Awareness in Healthcare. Accessed October 5, 2026. https://sites.google.com/view/amiableist/home - Perioperative Clinical Action Network, Specialist Services Committee. Pediatric Surgical Prehabilitation Toolkit. Published August 2026. Accessed October 12, 2026. https://sscbc.ca/sites/default/files/surgical-prehabilitation/BC%20Pediatric%20Toolkit.pdf - Specialist Services Committee. Surgical prehabilitation toolkit for healthcare providers. Published 2025. Accessed October 12, 2026. https://sscbc.ca/surgical-prehab-toolkit TRANSCRIPT https://cdn.bfldr.com/D6LGWP8S/as/c5ws3wcg4zfgfx98t7cgx/AACPDM_Transcript_10-13-26_kh%E2%80%8C Clinicians across healthcare professions, advocates, researchers, and patients/families are all encouraged to engage and provide feedback! You can recommend an article for discussion using this form: https://forms.gle/Bdxb86Sw5qq1uFhW6. Please visit: http://www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children’s Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open-access thus at no expense to the user. For further information on how to enroll, please email: [email protected] CITATION Eilig D, Fetsko L, Jones C, Lee E, Liegel S, Sheriko J, Villegas M, Mann K. Practice-Changing Research in Complex Care at the AACPDM Annual Meeting 2026. 10/2026. OPENPediatrics. Online Podcast. https://soundcloud.com/openpediatrics/practice-changing-research-in-complex-care-at-the-aacpdm-annual-meeting-2026.

This Nursing World Shared Practice Forum explores end-of-life care simulation and skills education, designed to strengthen acute care nurses’ clinical skills, communication abilities, and resilience. The panel discusses the inspiration and evolution of the program, its target audience, course structure, high-fidelity simulation experiences, and methods used to evaluate outcomes. Speakers highlight how simulation provides a psychologically safe environment for nurses to practice difficult conversations. They also share lessons learned from implementing the program and offer practical guidance for organizations and nurse leaders considering similar initiatives. LEARNING OBJECTIVES - Describe the rationale and inspiration for developing a pediatric end-of-life care simulation program - Identify key components of an effective end-of-life simulation program, including psychological safety, communication skills practice, high-fidelity simulation, and structured debriefing - Explain how simulation can help nurses develop confidence and skills for difficult end-of-life conversations and emotionally complex clinical situations - Identify key considerations for developing, evaluating, and sustaining an end-of-life simulation program within a healthcare organization AUTHORS Patricia Hickey, PhD, MBA, RN, NEA-BC, FAAN Senior Vice President, Associate Chief Nursing Officer (ACNO) Cardiovascular, Critical Care, Perioperative Nursing/PCO Boston Children’s Hospital Assistant Professor of Pediatrics Harvard Medical School Michele DeGrazia, PhD, RN, NNP-BC, FAAN Director of Research Neonatal Intensive Care Unit (NICU) Maternal Child Health Faculty, Sandra L. Fenwick Institute Nurse Scientist Boston Children's Hospital Dorothy Beke, MS, RN, CPNP-PC/AC, WCC, FAAN Cardiac Intensive Care Unit Nurse Practice Specialist CICU Mechanical Circulatory Support Nursing Resource Cardiology Clinic Nurse Practitioner Heart Center Bereavement Coordinator Boston Children's Hospital Annette Imprescia, BSN, RN, CCRN Clinical Educator Staff Nurse III Associate Clinical Director of Nursing Immersive Design Systems, Cardiac Intensive Care Unit Boston Children's Hospital JoEllen Edson, MSN, RN, CPHON Professional Development Practitioner Stem Cell Transplant Unit Boston Children's Hospital DATE Initial publication date: October 13, 2026. TRANSCRIPT https://cdn.bfldr.com/D6LGWP8S/as/n9bg8gsrx94phc5338j6v6g/NWSP_Building_Nurse_Resilience_Through_End-of-Life_Care_Training__Hickey_101226 Please visit: http://www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children’s Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open-access thus at no expense to the user. For further information on how to enroll, please email: [email protected] CITATION Hickey PA, DeGrazia M, Beke DM, Imprescia A, Marcley S, Edson JE. Building Nurse Resilience Through End-of-Life Care Training. 10/2026. OPENPediatrics. Online Podcast. https://soundcloud.com/openpediatrics/building-nurse-resilience-through-end-of-life-care-training-by-p-hickey-et-al-openpediatrics.

In this World Shared Practice Forum Podcast, co-authors Dr. Barry Markovitz and Ms. Ann Schrooten discuss their book, Shared Struggles: Stories from Parents and Pediatricians Caring for Children with Serious Illness. They share personal experiences and narratives from families and clinicians to explore the unique partnership between families and healthcare providers caring for children with serious illness and medical complexity. Lastly, they highlight the importance of communication, empathy, trust, and humility in building meaningful relationships that support children and their families throughout their care journey. LEARNING OBJECTIVES - Describe the role of parent-physician partnerships in caring for children with serious illness and medical complexity - Recognize strategies for effective communication with children who are nonverbal and the importance of incorporating parents' expertise in clinical decision-making - Discuss how empathy, compassion, and active listening contribute to trust and help build therapeutic relationships between healthcare providers and families - Examine the value of shared decision-making in delivering family-centered pediatric and palliative care AUTHORS Barry Markovitz, MD, MPH Professor of Pediatrics University of Utah Spencer Fox Eccles School of Medicine Intermountain Primary Children's Hospital Ann F. Schrooten, JD Attorney Fitzgibbons Law Offices, P.L.C Jeffrey Burns, MD, MPH Emeritus Chief Division of Critical Care Medicine Department of Anesthesiology, Critical Care and Pain Medicine Boston Children's Hospital Professor of Anesthesia Harvard Medical School DATE Initial publication date: September 22, 2026. REFERENCES - Schrooten A, Markovitz BP. Just Because I Can't Talk Doesn't Mean I Have Nothing to Say. Pediatr Crit Care Med. 2025;26(6):e860-e861. - Schrooten AF, Markovitz BP, eds. Shared Struggles: Stories from Parents and Pediatricians Caring for Children with Serious Illnesses. Copernicus Books; 2021. TRANSCRIPT https://cdn.bfldr.com/D6LGWP8S/as/8w9gnk94ctgww7bq3b3qszs7/20260917_WSP_Markovitz_and_Schrooten_transcript Please visit: www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children’s Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open-access thus at no expense to the user. For further information on how to enroll, please email: [email protected] CITATION Markovitz BP, Schrooten A, O’Hara J, Burns JP. Pediatric Medical Complexity: Shared Insights. 09/2026. OPENPediatrics. Online Podcast. https://soundcloud.com/openpediatrics/pediatric-medical-complexity-shared-insights-by-b-markovitz-and-a-schrooten-openpediatrics

This podcast provides viewers with an overview of pediatric cough including how to conduct a thorough patient history, identify significant physical exam findings, and generate a differential diagnosis emphasizing the difference between acute and chronic cough causes. LEARNING OBJECTIVES - Conduct a thorough history for pediatric patients presenting with a cough. - Explain the significance of key physical exam findings in evaluating pediatric cough. - Discuss a broad differential diagnosis for cough in pediatric patients. AUTHORS Christina Callas, MD Pediatrician University of California, Davis Children's Hospital Eli C. Freiman, MD Pediatric Emergency Medicine Physician Mass General Brigham/Newton Wellesley Hospital DATES Initial Publication: September 17, 2026. Please visit: www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children's Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open-access, thus at no expense to the user. For further information on how to enroll, please email: [email protected] Please note: OPENPediatrics does not support or control any related videos in the sidebar; these are placed by YouTube. We apologize for any inconvenience this may cause. CITATION Callas C, Freiman E, Fantasia K, McFee AM, Wolbrink TA, Wills K. Approach to Cough. 09/2026. OPENPediatrics. Online Podcast. https://soundcloud.com/openpediatrics/approach-to-cough-by-c-callas.

In this Complex Care Journal Club podcast episode, Dr. Jason Zamkoff discusses a quality-improvement cohort study of a surgical hospitalist co-management program (Surgical Hospitalist Assisted Recovery/SHARe Team, or “Pink Team”) for children with medical complexity at Children’s Hospital Colorado. They describe how patients are selected using an internal complexity score and the institutional trust-building needed to launch the program, resulting in fewer post-operative emergency transfers to intensive care. Next steps include developing an externally validated complexity scoring tool and extending hospitalist involvement into the pre-operative period.‌ SPEAKER Jason Zamkoff, MD Professor of Pediatrics University of Colorado School of Medicine Pediatric Hospitalist Children's Hospital Colorado HOST Kilby Mann, MD Associate Professor, Director of Pediatric Rehabilitation University of North Carolina School of Medicine DATE Initial publication date: September 8, 2026. JOURNAL CLUB ARTICLE Zamkoff J, Acker SN, Martin A, Anderson L, Bennett H, Thysens J, Thomas JJ, Conant M, Kurtz M, Gupta R, Scarberry J, Burke M, Koehler R, Rolison E, Whitney G, Ziniel SI, Carney KP, Wilcox D, Lockwood JM. Surgical Hospitalist Assisted REcovery (SHARe): Preventing Post-Operative Emergency Transfers. Hosp Pediatr. 2026 Jul 21:e2025008778. doi: 10.1542/hpeds.2025-008778. Epub ahead of print. PMID: 42476571. OTHER ARTICLES REFERENCED Martin A, Acker S, Hankinson TC, Zamkoff J. Perspectives on Interdisciplinary Perioperative Care for Children with Medical Complexity. Pediatr Clin North Am. 2026 Apr;73(2):513-524. doi: 10.1016/j.pcl.2025.12.003. Epub 2026 Feb 26. PMID: 42020046.‌ TRANSCRIPT https://cdn.bfldr.com/D6LGWP8S/as/9c5mmqqq86knpmsgss5xrm8/Zamkoff_transcript_9-1-26‌ Clinicians across healthcare professions, advocates, researchers, and patients/families are all encouraged to engage and provide feedback! You can recommend an article for discussion using this form: https://forms.gle/Bdxb86Sw5qq1uFhW6. Please visit: http://www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children’s Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open-access thus at no expense to the user. For further information on how to enroll, please email: [email protected] CITATION Zamkoff J, Mann K. The Pink Team Effect: Reducing Postoperative Emergency Transfers in Complex Care. 08/2026. OPENPediatrics. Online Podcast. https://soundcloud.com/openpediatrics/the-pink-team-effect-reducing-postoperative-emergency-transfers-in-complex-care

This video provides an overview of pediatric septic shock, including definitions, pathophysiology, management, and the use of the sepsis bundle to guide timely management.‌ LEARNING OBJECTIVES • Describe patients who present with signs and symptoms of septic shock, including exam features that support early recognition and assessment. ‌‌• Review the arterial oxygen content formula and strategies to optimize oxygen delivery to the tissues. • Apply current sepsis definitions to clinical care to identify, evaluate, and guide the management of patients with suspected sepsis or septic shock.‌ • ‌‌Explain the role of the sepsis bundle in optimizing timely management, improving adherence to evidence-based interventions, and supporting better patient outcomes.‌ AUTHORS Jill O'Hara, MD, MPH Assistant in Critical Care Medicine, Department of Anesthesiology, Critical Care and Pain Medicine‌ Boston Children's Hospital Kate Madden, MD, MMSc‌ Assistant in Critical Care Medicine, Department of Anesthesiology, Critical Care and Pain Medicine‌ Boston Children's Hospital DATES Initial Publication: September 4, 2026. Please visit: www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children's Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open-access, thus at no expense to the user. For further information on how to enroll, please email: [email protected] Please note: OPENPediatrics does not support or control any related videos in the sidebar; these are placed by YouTube. We apologize for any inconvenience this may cause. CITATION O'Hara JE, Brodie K, Madden K. Pediatric Septic Shock. 09/2026. OPENPediatrics. Online Video. https://on.soundcloud.com/xB071iR4TUcWNxUBIj.

In this World Shared Practice Forum Podcast, Drs. Danielle DeCourcey and Sabrina Derrington provide their insight on the methodology and development of the 2026 Guidelines on the Care and Management of Pediatric and Neonatal Intensive Care Patients at the End-of-Life, sharing actionable guidance for clinicians at the bedside. The authors review GRADE methodology and provide context behind the conditional recommendations. The speakers reflect on next steps including implementation, research, and addressing disparities in end-of-life care. LEARNING OBJECTIVES - Understand the design and methodology for the 2026 pediatric and neonatal end-of-life guidelines - Describe GRADE methodology and its impact on the guideline’s recommendations - Discuss practical applications of the guidelines for clinicians AUTHORS Danielle D'Emilia DeCourcey, MD, MPH Associate Chief, Division of Medical Critical Care Boston Children's Hospital Associate Professor of Pediatrics Harvard Medical School Sabrina Derrington, MD, MA, HEC-C, FAAP Director of the Center for Bioethics Children's Hospital Los Angeles Associate Professor of Clinical Pediatrics Keck School of Medicine, University of Southern California (USC) Jeffrey Burns, MD, MPH Emeritus Chief Division of Critical Care Medicine Department of Anesthesiology, Critical Care and Pain Medicine Boston Children's Hospital Professor of Anesthesia Harvard Medical School DATE Initial publication date: August 25, 2026. ARTICLES REFERENCED & ADDITIONAL REFERENCES - Derrington S, Broden Arciprete EG, Lin MC, et al. Executive Summary of Society of Critical Care Medicine 2026 Guidelines on the Care and Management of Pediatric and Neonatal Intensive Care Patients at the End of Life. Pediatr Crit Care Med. 2026;27(4):487-493. - The Correspondent by Virginia Evans - Pilgrim at Tinker Creek by Annie Dillard TRANSCRIPT https://cdn.bfldr.com/D6LGWP8S/as/v66vz9xj5t6qtmjwjkcrmr7/202608_WSP_Derrington_and_DeCourcey_Transcript Please visit: http://www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children’s Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open-access thus at no expense to the user. For further information on how to enroll, please email: [email protected] CITATION DeCourcey DD, Derrington S, O’Hara JE, Burns JP. Pediatric End-of-Life Guidelines & Insights. 08/2026. OPENPediatrics. Online Podcast. https://soundcloud.com/openpediatrics/pediatric-end-of-life-guidelines-and-insights-by-d-decourcey-and-s-derrington-openpediatrics.

This video discusses the preoperative, operative, and postoperative considerations for patients undergoing tracheostomy including: anatomy and pathophysiology, anesthetic and operative approach, and postoperative care. LEARNING OBJECTIVES - Explain the anatomy and pathophysiology - Describe the anesthetic management plan, including intraoperative management - Review common operative approaches - Describe postoperative considerations AUTHORS Roger Nuss, MD Associate, Department of Otolaryngology and Communication Enhancement Assistant Professor of Otolaryngology, Harvard Medical School Jennifer Perez, MD Fellow, Division of Critical Care Medicine Boston Children's Hospital Jessica Laird-Gion, MD Department of Pediatrics, Division of Cardiology Stanford Medicine DATE Initial publication date: August 12, 2026. Please visit: www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children’s Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open-access thus at no expense to the user. For further information on how to enroll, please email: [email protected] CITATION Laird-Gion J, Perez J, Nuss R, McFee AM, Marcley S, Wolbrink TA. Tracheostomy. 08/2026. Online Podcast. OPENPediatrics. https://soundcloud.com/openpediatrics/tracheostomy-by-r-nuss-j-perez/s-hIyYqiXKAId?si=25e19540480b43cbb133b57d067213f9&utm_source=clipboard&utm_medium=text&utm_campaign=social_sharing.