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Metabolic disease and the liver: A review

World Journal of Hepatology 2024年第1期16卷 33-40页

作者： Márcia Vargas Sheila de Castro Cardoso Toniasso Patricia G Riedel Camila Pereira Baldin Francielle Lopes dos Reis Robson Martins Pereira Maria Carlota Borba Brum Dvora Joveleviths mario Reis Alvares-da-Silva Program of Graduate Science in Gastroenterology and Hepatology Federal University of Rio Grande do SulPorto Alegre 90040-060Rio Grande do SulBrazil School of Medicine Federal University of Rio Grande do SulPorto Alegre 90040-060Brazil Program of Graduate Science in Gastroenterology and Hepatology Clinicas Hospital of Porto AlegrePorto Alegre 90410000Brazil Medicine Faculty Federal University of Rio Grande do Sul Federal University of Rio Grande do SulPorto Alegre 90040-060Brazil Division of Gastroenterology and Hepatology Clinicas Hospital of Porto AlegrePorto Alegre 90035007Brazil

Metabolic dysfunction-associated steatotic liver disease(MASLD)is the most common liver disease worldwide,with an estimated prevalence of 31%in Latin *** presence of metabolic comorbidities coexisting with liver disease varies substantially among *** is acknowledged that obesity is boosting the type 2 diabetes mellitus“epidemic,”and both conditions are significant contributors to the increasing number of patients with *** steatohepatitis represents a condition of chronic liver inflammation and is considered the most severe form of *** diagnosis is based on the presence of steatosis,noninvasive scores and altered liver *** scores of liver fibrosis,such as serum biomarkers,which should be used in primary care to rule out advanced fibrosis,are simple,inexpensive,and widely ***,guidelines from international hepatology societies recommend using noninvasive strategies to simplify case finding and management of high-risk patients with MASLD in clinical ***,there is no definite pharmacological treatment for the *** public health policies to treat patients with risk factors for MASLD prevention is essential.

关键词： Nonalcoholic fatty liver disease Primary care Metabolic risk Liver Metabolism

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Storylines of family medicine Ⅹ:standing up for diversity,equity and inclusion

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Family Medicine and Community Health 2024年第S3期12卷 89-98页

作者： William B Ventres Leslie A Stone Wayne W Bryant Jr mario F Pacheco Edgar Figueroa Francis N Chu Shailendra Prasad David N Blane Na'amah Razon Ranit Mishori Robert L Ferrer Garrett S Kneese Family and Preventive Medicine University of Arkansas for Medical Sciences College of MedicineLittle RockArkansasUSA Family and Community Medicine University of New Mexico School of MedicineAlbuquerqueNew MexicoUSA Medicine Weill Cornell Medical CollegeNew YorkNew YorkUSA San Jose Family Medicine Residency Kaiser PermanenteSan JoseCaliforniaUSA Family Medicine and Community Health University of Minnesota Medical School—Twin Cities CampusMinneapolisMinnesotaUSA School of Health and Wellbeing University of GlasgowGlasgowUK Family and Community Medicine University of CaliforniaDavisSacramentoCaliforniaUSA Family Medicine Georgetown University School of MedicineWashingtonDistrict of ColumbiaUSA Family and Community Medicine UT Health San Antonio Long School of MedicineSan AntonioTexasUSA UC San Diego Family Medicine Residency Program San DiegoCaliforniaUSA

Storylines of Family Medicine is a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine as interpreted by individual family physicians and medical educators in the USA and elsewhere around the ***‘Ⅹ:standing up for diversity,equity and inclusion’,authors address the following themes:‘The power of diversity—why inclusivity is essential to equity in healthcare’,‘Medical education for whom?’,‘Growing a diverse and inclusive workforce’,‘Therapeutic judo—an inclusive approach to patient care’,‘Global family medicine—seeing the world“upside down”’,‘The inverse care law‘,‘Social determinants of health as a lens for care’,‘Why family physicians should care about human rights’and‘Toward health equity—the opportunome’.May the essays that follow inspire readers to promote change.

关键词： illustration education family

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Exploring conservative management for cervical intraepithelial neoplasia grade 2 in organised cervical cancer screening programmes:a multicentre study in Italy

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Family Medicine and Community Health 2024年第S2期12卷 1-7页

作者： Silvia Gori Helena Frayle Alessio Pagan Marika Soldà Cesare Romagnolo Egle Insacco Licia Laurino mario Matteucci Giuseppe Sordi Enrico Busato Manuel Zorzi Tiziano Maggino Annarosa Del Mistro CIN2 study Working Group Veneto Institute of Oncology IOV-IRCCS PadovaItaly Local Health Unit Marca Trevigiana TrevisoItaly Local Health Unit Serenissima VeneziaItaly Obstetrics and Gynecology Azienda Ospedale UniversitàPadovaItaly Local Health Unit Scaligera VeronaItaly Veneto Tumour Registry Azienda ZeroPadovaItaly 不详

Cervical intraepithelial neoplasia grade 2(CIN2)lesions may regress spontaneously,offering an alternative to immediate treatment,especially for women of childbearing age(15–45 years).We conducted a prospective multicentre study on conservative CIN2 management,with semiannual follow-up visits over 24 months,biomarkers’investigation and treatment for progression to CIN3+or CIN2 persistence for more than 12 ***,we assess women’s willingness to participate and adherence to the study *** study was set in population-based organised cervical cancer *** April 2019 to October 2021,640 CIN2 cases were diagnosed in women aged 25–64 participating in the screening *** to our predefined inclusion and exclusion criteria,228(35.6%)women were not eligible;93(22.6%)of the 412 eligible refused,and 319(77.4%)were *** for personal reasons(ie,desire to become pregnant,anxiety,difficulty in complying with the study protocol)and external barriers(ie,residence elsewhere and language problems)accounted for 71%and 17%,*** 9%expressed a preference for *** primary ineligibility factor was the upper age limit of 45 *** enrolment,12(4%)women without evidence of progression requested treatment,125(39%)were lost to follow-up(mostly after 6–12 months)and 182(57%)remained ***,40%of enrolees did not fully adhere to the protocol,whereas only 5%(20/412)of the eligible women desired *** study demonstrates a good acceptance of conservative management for CIN2 lesions by the women,supporting its implementation within cervical screening programmes.

关键词： cervical conservative centre

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Sound waves and solutions:Point-of-care ultrasonography for acute kidney injury in cirrhosis

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World Journal of Critical Care Medicine 2024年第2期13卷 83-92页

作者： David Aguirre-Villarreal mario Andrés de Jesús Leal-Villarreal Ignacio García-Juárez Eduardo R Argaiz Abhilash Koratala Departamento de Gastroenterología Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMexico City 14080Mexico Cardiología Instituto Nacional de Cardiología Ignacio ChávezMexico City 14080Mexico Unidad de Hepatología y Trasplante Departamento de GastroenterologíaInstituto Nacional de Ciencias Medicas y Nutricion Salvador ZubiranMexico City 14080Mexico Departamento de Nefrología y Metabolismo Mineral Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMexico City 14080Mexico Tecnológico de Monterrey Escuela de Medicina y Ciencias de la SaludMexico City 64710Mexico Department of Nephrology Medical College of WisconsinMilwaukeeWI 53226United States

This article delves into the intricate challenges of acute kidney injury(AKI)in cirrhosis,a condition fraught with high morbidity and *** complexities arise from distinguishing between various causes of AKI,particularly hemodynamic AKI,in cirrhotic patients,who experience hemodynamic changes due to portal *** term"hepatocardiorenal syndrome"is introduced to encapsulate the intricate interplay among the liver,heart,and *** narrative emphasizes the often-overlooked aspect of cardiac function in AKI assessments in cirrhosis,unveiling the prevalence of cirrhotic cardiomyopathy marked by impaired diastolic *** conventional empiric approach involving volume expansion and vasopressors for hepatorenal syndrome is critically analyzed,highlighting potential risks and variable patient *** advocate for a nuanced algorithm for AKI evaluation in cirrhosis,prominently featuring point-of-care ultrasonography(POCUS).POCUS applications encompass assessing fluid tolerance,detecting venous congestion,and evaluating cardiac function.

关键词： Point-of-care ultrasonography Bedside ultrasound Cirrhosis Congestion Acute kidney injury Congestive nephropathy

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A Systematic Review of Cannabidiol Effects in Coronary Syndromes: Challenges to Clinical Translation

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Journal of Biosciences and Medicines 2024年第4期12卷 246-263页

作者： mario E. Zuñiga-Ayala Alejandra Meaney-Martínez Alejandro Alcocer-Chauvet Vidal Gonzalez-Coronado Nestor Rubio-Infante Gerardo Garcia-Rivas Department of Cardiology Instituto de Seguridad Social and Trabajadores del Estado (ISSSTE) Hospital Regional Primero de Octubre Mexico City Mexico Department of Interventional Cardiology Instituto de Seguridad Social y Trabajadores del Estado (ISSSTE) Hospital Regional Primero de Octubre Mexico City Mexico Instituto Tecnó logico de Monerrey Escuela de Medicina and Ciencias de la Salud C&#225tedra de Cardiolog&#237a and Medicina Vascular Monterrey Mexico

Background: Myocardial ischemia in addition to other several cardiac syndromes represent a pathological proinflammatory state alongside a complex cellular microenvironment that can be modified by using cannabinoids. Cannabidiol (CBD), a non-psychoactive compound of cannabis has been recently proposed as an immudomodulatory and cardioprotective drug. Objectives: In this systematic review we sought to clarify and summarize the clinical and preclinical evidence of potential benefit of the use of CBD in coronary syndromes. Methods: We conducted a systematic search and review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Review of Animal Data from Experimental Studies (CAMARADES) guidelines, in the electronic database from PubMed, Web of Science and Scopus up to April 2022 using predefined search terms. Pre-specified exclusion and inclusion criteria were considered, finally 11 articles were chosen to be included for this peer review. Results: Currently there are no good-quality clinical trials with the use of CBD in acute or chronic coronary syndromes. A total of 11 preclinical studies where prescreened and 5 demonstrated reproducible positive cardiovascular outcomes on in-vivo models treated with CBD. Mechanisms of CBD cardioprotection observed: 1) reduction in oxidative stress and inflammation, 2) activation of adenosine receptors and 3) increased expression of angiotensin type 2-receptor. Experimental models included ischemia/reperfusion injury, myocardial infarction, arrhythmias, and metabolic syndrome-like conditions. Conclusion: No clinical recommendation can be issued with the current evidence, on the use of CBD in acute and chronic coronary syndromes. Based on preclinical evidence, we considered there is enough evidence to propose the development of well-designed clinical trials that include CBD in the management of coronary syndromes.

关键词： Cannabis Cannabidiol Acute Coronary Syndromes Myocardial Infarction Myocardial Ischemia and Oxidative Stress

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以设计构建可持续未来雅加达Aruma分层花园

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室内设计与装修 2024年第8期 20-25页

作者： [印度尼西亚]RAD+ar mario Wibowo(摄影) 西竹(编译) RAD+ar

面对不断上涨的土地价值,Aru ma分层花园应运而生。它旨在研究分层设计的发展,即如何在多个租户组成的复合体中创造独特的区域,同时在相对紧凑的空间内,将自然融入建筑环境中。该项目将屋顶、立面、墙体、对角悬挑结构和家具等设计要素... 详细信息

面对不断上涨的土地价值,Aru ma分层花园应运而生。它旨在研究分层设计的发展,即如何在多个租户组成的复合体中创造独特的区域,同时在相对紧凑的空间内,将自然融入建筑环境中。该项目将屋顶、立面、墙体、对角悬挑结构和家具等设计要素相融合,将现代设计与商业区域的热带环境相融合,并在建筑和空间中结合自然光线、绿植、自然景观、天然材料和其他感官体验,形成一个和谐的整体。

关键词：自然光线热带环境天然材料感官体验分层设计设计要素悬挑结构自然景观

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Transarterial embolization is an acceptable bridging therapy to hepatocellular carcinoma prior to liver transplantation

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World Journal of Transplantation 2024年第2期14卷 126-134页

作者： Gabriel Lazzarotto-da-Silva Leandro A Scaffaro Mauricio Farenzena Lucas Prediger Rafaela K Silva Flávia Heinz Feier Tomaz J M Grezzana-Filho Pablo D Rodrigues Alexandre de Araujo mario Reis Alvares-da-Silva Roberta C Marchiori Cleber Rosito Pinto Kruel Marcio Fernandes Chedid Department of Liver Transplant and Hepatobiliary Surgery Unit Hospital de Clínicas de Porto AlegrePorto Alegre 90035-007Brazil Department of Interventional Radiology Unit Hospital de Clínicas de Porto AlegrePorto Alegre 90035-007Brazil Department of Gastroenterology and Hepatology Hospital de Clínicas de Porto AlegrePorto Alegre 90035-007Brazil

BACKGROUND Hepatocellular carcinoma(HCC)is an aggressive malignant neoplasm that requires liver transplantation(LT).Despite patients with HCC being prioritized by most organ allocation systems worldwide,they still have to wait for long *** therapies(LRTs)are employed as bridging therapies in patients with HCC awaiting *** largely used in the past,transarterial embolization(TAE)has been replaced by transarterial chemoembolization(TACE).However,the superiority of TACE over TAE has not been consistently shown in the *** To compare the outcomes of TACE and TAE in patients with HCC awaiting *** All consecutive patients with HCC awaiting LT between 2011 and 2020 at a single center were *** patients underwent LRT with either TACE or *** patients also underwent percutaneous ethanol injection(PEI),concom-itantly or in different treatment *** choice of LRT for each HCC nodule was determined by a multidisciplinary *** primary outcome was waitlist dropout due to tumor progression,and the secondary outcome was the occurrence of adverse *** the subset of patients who underwent LT,complete pathological response and post-transplant recurrence-free survival were also *** Twelve(18.5%)patients in the TACE group(only TACE and TACE+PEI;n=65)and 3(7.9%)patients in the TAE group(only TAE and TAE+PEI;n=38)dropped out of the waitlist due to tumor progression(P log-rank test=0.29).Adverse events occurred in 8(12.3%)and 2(5.3%)patients in the TACE and TAE groups,respectively(P=0.316).Forty-eight(73.8%)of the 65 patients in the TACE group and 29(76.3%)of the 38 patients in the TAE group underwent LT(P=0.818).Among these patients,complete pathological response was detected in 7(14.6%)and 9(31%)patients in the TACE and TAE groups,respectively(P=0.145).Post-LT,HCC recurred in 9(18.8%)and 4(13.8%)patients in the TACE and TAE groups,respectively(P=0.756).Posttransplant recurrence-free survival was simila

关键词： Hepatocellular carcinoma Transarterial embolization Transarterial chemoembolization Liver transplantation Locoregional therapy Bridging

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Incidence of urinary incontinence following endoscopic laser enucleation of the prostate by en-bloc and non-en-bloc techniques:a multicenter,real-world experience of 5068 patients

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Asian Journal of Andrology 2024年第3期26卷 233-238页

作者： Daniele Castellani Vineet Gauhar Khi Yung Fong mario Sofer Moisés Rodríguez Socarrás Azimdjon N Tursunkulov Lie Kwok Ying Sarvajit Biligere Ho Yee Tiong Dean Elterman Abhay Mahajan Mark Taratkin Sorokin Nikolai Ivanovich Tanuj Pal Bhatia Dmitry Enikeev Nariman Gadzhiev Mohammed Taif Bendigeri Jeremy Yuen-Chun Teoh Marco Dellabella Fernando Gómez Sancha Bhaskar Kumar Somani Thomas Reinhard William Herrmann Urology Unit IRCCS INRCAAncona 60127Italy Urology Unit Marche University HospitalLe Marche Polytechnic UniversityAncona 60126Italy Department of Urology Ng Teng Fong General HospitalSingapore 609606Singapore Yong Loo Lin School of Medicine National University of SingaporeSingapore 117597Singapore Department of Urology Tel Aviv Sourasky Medical CenterAffiliated to the Sackler School of MedicineTel Aviv UniversityTel Aviv 6423906Israel Department of Urology and Robotic Surgery ICUA-Clínica CEMTROMadrid 28701Spain Urology Division Akfa Medline HospitalTashkent 100211Uzbekistan Advanced Urology Gleneagles HospitalSingapore 258499Singapore Department of Urology National University HospitalSingapore 119228Singapore Divisionof Urology Department of SurgeryUniversity of TorontoOntarioToronto M5G 2C4Canada Department of Urology Mahatma Gandhi Mission’s Medical College and HospitalAurangabad 431003India Institute for Urology and Reproductive Health Sechenov UniversityMoscow119435Russian Federation Department of Urologyand Andrology Lomonosov Moscow State UniversityMoscow 119992Russian Federation Department of Urology Sarvodaya Hospital and Research CentreFaridabadHaryana 121006India Department of Urology Medical University of ViennaVienna 1090Austria Department of Urology Saint-Petersburg State University HospitalSaint-Petersburg 199034Russian Federation Department of Urology Asian Institute of Nephrology and UrologyHyderabad 500082India S.H.Ho UrologyCentre Department of SurgeryFaculty of MedicineThe Chinese University of Hong KongHong Kong 96H2+Q9China Department of Urology University Hospitals Southampton NHS TrustSouthampton SO166YDUnited Kingdom Department of Urology Cantonal Hospital Thurgau AGFraunfeld 8500Switzerland

We aim to evaluate the incidence of incontinence following laser endoscopic enucleation of the prostate(EEP)comparing en-bloc(Group 1)versus 2-lobe/3-lobe techniques(Group 2).We performed a retrospective review of patients undergoing EEP for benign prostaticenlargement in 12 centers between January 2020 and January *** were presented as median and interquartile range(IQR).Univariable and multivariable logistic regression analysis was performed to evaluate factors associated with stress urinary incontinence(SUI)and mixed urinary incontinence(MUI).There were 1711 patients in Group 1 and 3357 patients in Group *** in Group 2were significantly younger(68[62–73]years vs 69[63–74]years,P=0.002).Median(interquartile range)prostate volume(PV)wassimilar between the groups(70[52–92]ml in Group 1 vs 70[54–90]ml in Group 2,P=0.774).There was no difference in preoperativeInternational Prostate Symptom Score,quality of life,or maximum flow ***,morcellation,and total surgical time weresignificantly shorter in Group *** 1 month,overall incontinence rate was 6.3%in Group 1 versus 5.3%in Group 2(P=0.12),and urge incontinence was significantly higher in Group 1(55.1%vs 37.3%in Group 2,P<0.001).After 3 months,the overall rate ofincontinence was 1.7%in Group 1 versus 2.3%in Group 2(P=0.06),and SUI was significantly higher in Group 2(55.6%vs 24.1%in Group 1,P=0.002).At multivariable analysis,PV and IPSS were factors significantly associated with higher odds of transient SUI/***,surgical time,and no early apical release technique were factors associated with higher odds of persistent SUI/MUI.

关键词： benign prostatic hyperplasia en-bloc enucleation endoscopic enucleation of the prostate laser therapy stress urinaryincontinence urge urinary incontinence

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A digital earth platform for sustainability

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International Journal of Digital Earth 2017年第4期10卷 342-355页

作者： mario Hernandez Engagement Committee Future EarthMexico CityMexico International Society for Digital Earth Mexico CityMexico

Based on the experience of the International Society for Digital Earth(ISDE),this paper describes some challenges foreseen in order to develop a Digital Earth platform that can support the implementation of the Sustainable Development *** use of ready-to-use derived geospatial information is *** Earth’s methodology of‘co-design’aims to bring together natural,social scientists and decision makers to plan and carry out research for *** implies transdisciplinary research,but in order for scientists of different disciplines to work together,they will need to be able to share,access and use common *** is by far not simple!While the good will to share data might exist,the associated technological,ethical and privacy issues are difficult to *** adequate e-infrastructure will be *** could consider to use the SDGs is the basis to develop the desired Digital Earth *** paper,by no means,covers everything for a Digital Earth platform,it aims to trigger research discussions and to have a good view about a starting point.

关键词： Digital earth platform sustainable development Sustainable Development Goals future earth

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Extravasated contrast volumetric assessment on computed tomography angiography in gastrointestinal bleeding:A useful predictor of positive angiographic findings

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World Journal of Radiology 2024年第5期16卷 115-127页

作者： Laura Maria Cacioppa Chiara Floridi Alessandra Bruno NicolòRossini Tommaso Valeri Alessandra Borgheresi Riccardo Inchingolo Francesco Cortese Giacomo Novelli Alessandro Felicioli mario Torresi Pietro Boscarato Letizia Ottaviani Andrea Giovagnoni Division of Interventional Radiology Department of Radiological SciencesUniversity Politecnica Delle MarcheAncona 60126Italy Department of Clinical Special and Dental SciencesUniversity Politecnica Delle MarcheAncona 60126Italy Division of Radiology Department of Radiological SciencesUniversity Hospital"Azienda Ospedaliero Universitaria Delle Marche"Ancona 60126Italy Interventional Radiology Unit "F Miulli"Regional General HospitalAcquaviva delle Fonti 70021Italy Department of Radiology IRCCS INRCAAncona 60126Italy

BACKGROUND Gastrointestinal bleeding(GIB)is a severe and potentially life-threatening condition,especially in cases of delayed *** tomography angiography(CTA)plays a pivotal role in the early identification of upper and lower GIB and in the prompt treatment of the *** To determine whether a volumetric estimation of the extravasated contrast at CTA in GIB may be a predictor of subsequent positive angiographic *** In this retrospective single-centre study,35 patients(22 men;median age 69 years;range 16-92 years)admitted to our institution for active GIB detected at CTA and further submitted to catheter angiography between January 2018 and February 2022 were ***-three(65.7%)patients underwent endoscopy before *** volumetry was evaluated in both arterial and venous phases via a semi-automated dedicated *** rate was obtained from volume change between the two phases and standardised for unit *** were divided into two groups,according to the angiographic signs and their concordance with *** Upper bleeding accounted for 42.9%and lower GIB for 57.1%.Mean haemoglobin value at the admission was 7.7 g/dL.A concordance between positive CTA and direct angiographic bleeding signs was found in 19(54.3%)*** no significant differences in terms of bleeding volume in the arterial phase(0.55 mL vs 0.33 mL,P=0.35),a statistically significant volume increase in the venous phase was identified in the group of patients with positive angiography(2.06 mL vs 0.9 mL,P=0.02).In the latter patient group,a significant increase in bleeding rate was also detected(2.18 mL/min vs 0.19 mL/min,P=0.02).CONCLUSION In GIB of any origin,extravasated contrast volumetric analysis at CTA could be a predictor of positive angiography and may help in avoiding further unnecessary procedures.

关键词： Gastrointestinal haemorrhage Computed tomography angiography Volumetric analysis Computer-assisted image interpretation Therapeutic embolization Transcatheter arterial embolization

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