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Roe C, Safic S, Mwaipopo L, Dotchin C, Klaptocz J, Gray K, Joseph M, Walker R. 426 PREVALENCE OF, AND RISK FACTORS FOR, DEMENTIA IN ADULT OUTPATIENT REFERRALS TO A REGIONAL REFERRAL HOSPITAL IN ARUSHA, TANZANIA. Age Ageing 2021. [DOI: 10.1093/ageing/afab118.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
The global burden of dementia is increasing, with the greatest increase predicted to occur in sub-Saharan Africa (SSA). Despite this there are limited previous data on the prevalence of, and risk factors for, dementia in SSA. This study aimed to estimate the prevalence of dementia, and investigate its associations, in those aged 60 years and older attending the outpatient department of Mount Meru Hospital in northern Tanzania. This is the first hospital-based outpatient dementia prevalence and risk factors study to be conducted in an east African population.
Methods
This was a one-phase cross-sectional study. Adults aged 60 years and over attending medical outpatients were screened for dementia using The Identification and Intervention for Dementia in Elderly Africans cognitive screening tool. Those who scored ≤9 were clinically assessed using the DSM-IV criteria. Demographic, medical comorbidity and lifestyle information were collected during a clinical assessment.
Results
Prevalence of dementia was 5.0% (95% confidence interval: 3.7–6.3). Binary logistic regression found female sex (odds ratio (OR) = 2.778), having no formal education (OR = 6.088), quantity of alcohol consumption (units/week) (OR = 1.080), uncorrected visual impairment (OR = 4.260), body mass index <18.5 kg/m2 (OR = 6.588) and stroke (OR = 15.790 with wide 95% confidence interval (3.48–74.475)) to be significantly, independently associated with dementia.
Conclusions
The prevalence of dementia in this population is lower than previously reported community-based rates in Tanzania, and similar to those in high-income countries. This is the first time the association between uncorrected visual impairment and dementia has been reported in SSA. Other associations identified are in keeping with previous literature. Further research on the management of dementia and its risk factors, and the support and education of carers and patients in east African populations is required.
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Wolske G, Joseph M, Rosenauer H, Widhalm K. Hypertension among obese children and youth age 8-12:Project EDDY-Kids 2019. CHILD AND ADOLESCENT OBESITY 2021. [DOI: 10.1080/2574254x.2021.1894869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Joseph M, Gaszynski R, Bender K, Daly D, Merrett N, Apostolou C. How to perform transcystic stenting in the COVID-19 pandemic: an approach to biliary stenting without specialized endobiliary stenting equipment. ANZ J Surg 2021; 91:1290-1291. [PMID: 33720509 PMCID: PMC8250197 DOI: 10.1111/ans.16727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 02/15/2021] [Indexed: 12/01/2022]
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Modan S, Joseph M, Parvar S, Sinhal A, Perry R, Kashkavij S. Percutaneous Left Atrial Appendage Closure: A Single-Centre Experience Using 2D and 3D Transoesophageal Echocardiography. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Wu X, Perry R, Hecker T, Gunton J, Joseph M. Left Atrial Reservoir Strain: An Emerging Non-Invasive Differentiator of Pre- and Post-Capillary Pulmonary Hypertension? Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Pham K, Upadhyaya S, Hecker T, Ullah S, Joseph M, Gunton J. Utility of Transthoracic Echocardiogram in Detecting Pulmonary Hypertension in Patients Awaiting Liver Transplant. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Wernery U, Kinne J, Jose S, Gupta AD, Taha A, Ismail AA, Joseph M, Nagy P, Juhasz J. ‘Alpaca Fever’ in Dromedary Camel Calves–A Case Report. J CAMEL PRACT RES 2021. [DOI: 10.5958/2277-8934.2021.00045.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Mathew RP, Jose M, Jayaram V, Joy P, George D, Joseph M, Sleeba T, Toms A. Current status quo on COVID-19 including chest imaging. World J Radiol 2020; 12:272-288. [PMID: 33510852 PMCID: PMC7802080 DOI: 10.4329/wjr.v12.i12.272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 12/07/2020] [Accepted: 12/16/2020] [Indexed: 02/06/2023] Open
Abstract
With each day the number coronavirus disease 2019 (COVID-19) cases continue to rise rapidly and our imaging knowledge of this disease is expeditiously evolving. The role of chest computed tomography (CT) in the screening or diagnosis of COVID-19 remains the subject of much debate. Despite several months having passed since identifying the disease, and numerous studies related to it, controversy and concern still exists regarding the widespread use of chest CT in the evaluation and management of COVID-19 suspect patients. Several institutes and organizations around the world have released guidelines, recommendations and statements against the use of CT for diagnosing or screening COVID-19 infection and advocating its use only for those cases with a strong clinical suspicion of complication or an alternate diagnosis. However, these guidelines and recommendations are in disagreement with majority of the widely available literature, which strongly favour CT as a pivotal tool in the early diagnosis, management and even follow-up of COVID-19 infection. This article besides comprehensively reviewing the current status quo on COVID-19 disease in general, also writes upon the current consensus statements/recommendations on the use of diagnostic imaging in COVID-19 as well as highlighting the precautions and various disinfection procedures being employed world-wide at the workplace to prevent the spread of infection.
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Mathew RP, Kunhimohammed SP, Joseph M. A Case of Topical Metronidazole–Induced Encephalopathy. JAMA Neurol 2020; 77:1318-1319. [DOI: 10.1001/jamaneurol.2020.2596] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Gangireddy M, Chan Gomez J, Kanderi T, Joseph M, Kundoor V. Recurrence of Endometrial Stromal Sarcoma, Two Decades Post-Treatment. Cureus 2020; 12:e9249. [PMID: 32821595 PMCID: PMC7430693 DOI: 10.7759/cureus.9249] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Endometrial stromal cell sarcomas (ESS) are a unique subtype of uterine malignancy. Recurrent low grade endometrial stromal sarcomas (LESS) is identified in half of the patients. Here, we discuss a case of a 76-year-old Asian female with a past medical history of adenomyosis and hypertension who presented to the outpatient clinic with a chief complaint of painless hematuria for one day. Computed tomography scan of abdomen and pelvis with contrast showed a new right-sided mixed cystic and solid pelvic mass measuring up to 6 cm, obstructing and invading the distal right ureter, which was concerning for malignancy. Positron emission tomography (PET scan) demonstrated a right pelvic mass with increased radiotracer activity consistent with malignancy. She underwent laparotomy with excision of the right-sided pelvic mass with an abdominal washout and at the same time, also underwent cystoscopy with right ureteral stent placement. Tissue pathology was consistent with spindle cell neoplasm with staining and histologic features consistent with a recurrent stromal cell sarcoma. Uterine sarcomas tend to have an aggressive nature but there are key features about ESS that distinguish it from other uterine sarcomas. ESS has a more indolent clinical course and can reoccur years after initial diagnosis. They usually relapse locally, although relapses in extra-uterine sites have also been reported. Treatment of ESS depends on the grade and stage at the time of diagnosis. The main line of treatment for ESS consists of a total abdominal hysterectomy (TAH) and salpingo-oophorectomy (BSO). The significance of this case demonstrates that, although remission can be obtained after the initial diagnosis, recurrence can happen. Even when patients seem to be disease-free, clinicians should follow them closely; early diagnosis is important as treatment for this type of entity has a high survival rate.
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Chan Gomez J, Saleem T, Snyder S, Joseph M, Kanderi T. Drug-Induced Immune Hemolytic Anemia due to Amoxicillin-Clavulanate: A Case Report and Review. Cureus 2020; 12:e8666. [PMID: 32699666 PMCID: PMC7370667 DOI: 10.7759/cureus.8666] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Mishra S, P VA, Sridhar M, Pandey N, Sankaran K, Joseph M. Characterization of gamma irradiated PUREX solvent – A systematic study. SEP SCI TECHNOL 2020. [DOI: 10.1080/01496395.2019.1594895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Abstract
Mortality in thyroid storm, without appropriate treatment, can rise as high as 100%. Thyroid storm coexisting with ischemic stroke is a rare presentation that further increases the risk of mortality. Early recognition and appropriate management are critical to the prevention of mortality and morbidity. Here, we review the case of a 63-year-old male presenting with new neurological deficits who was found to have thyroid storm; appropriate management of the co-existing conditions are also reviewed.
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Tiver K, Horsfall M, De Pasquale C, Horsfall E, Joseph M, Russell A, Bridgman J, McGavigan A, Vaile J, Chew D, De Pasquale C. 334 Effect of Cardiologist Echocardiography Experience on Interpretation of Highly Limited Echocardiographic Screening Images for Diagnosis of Heart Disease. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Jones D, Chew D, Horsfall M, Sinhal A, Chuang A, Baker R, Bennetts J, Selvanayagam J, Joseph M, Lehman S. 607 Frailty Improves After Aortic Valve Intervention for Severe Aortic Stenosis. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Hecker T, Kashkavij S, Mcleod A, Wu K, Perry R, Gunton J, Ganesan A, Joseph M. 292 Assessment of Novel Left Atrial Strain Software in Healthy Volunteers to Obtain Normal Ranges and Assess for Feasibility and Reproducibility. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Jones D, Chew D, Horsfall M, Sinhal A, Chuang A, Baker R, Bennetts J, Selvanayagam J, Joseph M, Lehman S. 597 Augmentation Index Predicts Poor Symptomatic Recovery After Aortic Valve Intervention. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Murray L, Mugwagwa A, Horsfall M, Tam P, Teh J, Gordon D, Bennetts J, Joseph M. 504 Infective Endocarditis at a Tertiary Hospital in Adelaide, Australia. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Swinson D, Hall P, Lord S, Marshall H, Ruddock S, Allmark C, Cairns D, Waters J, Wadsley J, Falk S, Roy R, Joseph M, Nicoll J, Kamposioras K, Tillett T, Cummins S, Grumett S, Stokes Z, Waddell T, Chatterjee A, Garcia A, Khan M, Petty R, Seymour M. OPTIMIZING CHEMOTHERAPY FOR FRAIL AND/OR ELDERLY PATIENTS WITH ADVANCED GASTROESOPHAGEAL CANCER (AGOAC): THE GO2 PHASE III TRIAL. J Geriatr Oncol 2019. [DOI: 10.1016/s1879-4068(19)31133-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Joseph M, Szafron V, Yang B, Srivaths L, Anvari S, Castells M, Noroski L. M030 FERRIC CARBOXYMALTOSE DESENSITIZATION IN REFRACTORY IDIOPATHIC IRON-DEFICIENCY ANEMIA, IRON-INFUSION ANAPHYLAXIS, SEVERE ATOPY AND HYPERTRYPTASEMIA. Ann Allergy Asthma Immunol 2019. [DOI: 10.1016/j.anai.2019.08.099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Marrouche N, Joseph M, Godfrey J, Phillips P, Piazza D, Macnamara F, Harari D. P2866Automated ultrasound ablation parameters predict lesion depth in a perfused thigh model. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.1175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The accuracy and safety of lesions created during catheter ablation of cardiac tissue rely on the user's ability to predict the size of lesions that form under variable conditions during treatment. A user-directed robotic system was developed that uses Low-Intensity Collimated Ultrasound (LICU) for cardiac imaging and to produce linear lesions without tissue contact. Molecular absorption of mechanical energy induced in the tissue by LICU causes a temperature rise resulting in thermal tissue necrosis.
Purpose
By varying the speed of the LICU beam as it traces the desired lesion path, while considering the beam intensity, distance from catheter tip to tissue, and relative motion of the target tissue, we demonstrate the capability to deposit lesions of known depth according to a predictive model.
Methods
The LICU catheter was mounted in a servo-controlled, 3 axis stage suspended above a perfused porcine thigh that simulates the thermodynamic properties of the myocardium such as acoustic attenuation, thermal conduction, and specific heat capacity. Therapy was delivered along a linear path while varying the distance to tissue, speed of the beam, and motion of the catheter relative to the tissue in 3 dimensions. Programmed relative motion was representative of typical and extreme motion in humans. Pathological analysis after necropsy was used to quantify lesion depth which was then compared to lesion depth as predicted by a mathematical model from approx. 4–12 mm.
Results
Data from 66 samples were categorized according to typical and extreme motion at 4 different distances (3, 8, 9 and 13 mm). Measured vs predicted lesion depth was well correlated (R = 0.898) with 98.5% of the samples within ±2 mm.
Assessment of LICU lesion depth
Conclusion
Lesion depth using LICU is well controlled in an animal model for the range of distances and relative motion typically encountered in a human subject. The range of acoustic beam speeds and acoustic power density with LICU predictably produces lesions up to 12 mm deep. The LICU thermal model may be useful to create lesions of known depth thus ensuring transmurality of lesions while potentially avoiding unintended extra-cardiac injury.
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Becker A, Aggarwal P, Ebrahim M, Joseph M, Kondamudi N. 300 Identification of Social Determinants of Health in a Pediatric Emergency Department. Ann Emerg Med 2019. [DOI: 10.1016/j.annemergmed.2019.08.258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Kumar S, King EC, Christison AL, Kelly AS, Ariza AJ, Borzutzky C, Cuda S, Kirk S, Ali L, Armstrong S, Binns H, Brubaker J, Cristison A, Fox C, Gordon C, Hendrix S, Hes D, Jenkins L, Joseph M, Heyrman M, Liu L, McClure A, Hofley M, Negrete S, Novick M, O'Hara V, Rodrue J, Santos M, Stoll J, Stratbucker W, Sweeney B, Tester J, Walka S, deHeer H, Wallace S, Walsh S, Wittcopp C, Weedn A, Yee J, Grace B. Health Outcomes of Youth in Clinical Pediatric Weight Management Programs in POWER. J Pediatr 2019; 208:57-65.e4. [PMID: 30853195 DOI: 10.1016/j.jpeds.2018.12.049] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 12/13/2018] [Accepted: 12/19/2018] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To describe treatment outcomes of children and adolescents enrolled in the Pediatric Obesity Weight Evaluation Registry, a consortium of multicomponent pediatric weight management programs in the US. STUDY DESIGN This multicenter prospective observational cohort study, established in 2013, includes youth (2-18 years of age) with obesity enrolled from 31 Pediatric Obesity Weight Evaluation Registry (POWER) sites over a 2-year period and followed up to 12 months. Weight status was evaluated by the percentage of the 95th percentile for body mass index (%BMIp95). Associations of weight status outcomes with patient characteristics and program exposure were analyzed with multivariable mixed effects modeling. RESULTS We included 6454 children and adolescents (median age, 11 years; IQR, 9-14 years; 53% white, 32% Hispanic; 73% with severe obesity) who were enrolled in POWER. Median changes in %BMIp95 for this cohort were -1.88 (IQR, -5.8 to 1.4), -2.50 (IQR, -7.4 to 1.8), -2.86 (IQR, -8.7 to 1.9), at 4-6, 7-9, and 10-12 of months follow-up, respectively (all P < .05). Older age (≥12 years), greater severity of obesity, and Hispanic race/ethnicity were associated with better improvement in %BMIp95. A 5-percentage point decrease in %BMIp95 was associated with improvement in cardiometabolic risk factors. CONCLUSIONS Overall, treatment in pediatric weight management programs is associated with a modest median decrease in BMI as measured by change in %BMIp95. Further studies are needed to confirm these findings, as well as to identify additional strategies to enhance the effectiveness of these multicomponent interventions for youth with severe obesity. TRIAL REGISTRATION ClinicalTrials.gov: NCT02121132.
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Ashok Kumar GVS, Venkata Subramani CR, Kumar R, Sivakumar S, Murugan S, Varadharajan S, Sureshkumar KV, Ananthasivan K, Joseph M, Srinivasan G. Design, installation and preliminary flux measurements at the Fast Flux Experimental Facility (FFEF) of the Fast Breeder Test Reactor (FBTR). J Radioanal Nucl Chem 2019. [DOI: 10.1007/s10967-019-06463-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Hassan F, Wernery U, Joseph M, Anouassi A, Mariena K, Rangsun P. Molecular identification of 20 Escherichia coli isolates from dead neonatal camel calves (Camelus dromedarius) in the United Arab Emirates. J CAMEL PRACT RES 2019. [DOI: 10.5958/2277-8934.2019.00041.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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