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Balk SJ, Bochner RE, Ramdhanie MA, Reilly BK. Preventing Excessive Noise Exposure in Infants, Children, and Adolescents. Pediatrics 2023; 152:e2023063753. [PMID: 37864408 DOI: 10.1542/peds.2023-063753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/27/2023] [Indexed: 10/22/2023] Open
Abstract
Noise exposure is a major cause of hearing loss in adults. Yet, noise affects people of all ages, and noise-induced hearing loss is also a problem for young people. Sensorineural hearing loss caused by noise and other toxic exposures is usually irreversible. Environmental noise, such as traffic noise, can affect learning, physiologic parameters, and quality of life. Children and adolescents have unique vulnerabilities to noise. Children may be exposed beginning in NICUs and well-baby nurseries, at home, at school, in their neighborhoods, and in recreational settings. Personal listening devices are increasingly used, even by small children. Infants and young children cannot remove themselves from noisy situations and must rely on adults to do so, children may not recognize hazardous noise exposures, and teenagers generally do not understand the consequences of high exposure to music from personal listening devices or attending concerts and dances. Environmental noise exposure has disproportionate effects on underserved communities. In this report and the accompanying policy statement, common sources of noise and effects on hearing at different life stages are reviewed. Noise-abatement interventions in various settings are discussed. Because noise exposure often starts in infancy and its effects result mainly from cumulative exposure to loud noise over long periods of time, more attention is needed to its presence in everyday activities starting early in life. Listening to music and attending dances, concerts, and celebratory and other events are sources of joy, pleasure, and relaxation for many people. These situations, however, often result in potentially harmful noise exposures. Pediatricians can potentially lessen exposures, including promotion of safer listening, by raising awareness in parents, children, and teenagers. Noise exposure is underrecognized as a serious public health issue in the United States, with exposure limits enforceable only in workplaces and not for the general public, including children and adolescents. Greater awareness of noise hazards is needed at a societal level.
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Affiliation(s)
- Sophie J Balk
- Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York
| | - Risa E Bochner
- Department of Pediatrics, New York City Health and Hospitals Harlem, Columbia University Vagelos College of Physicians and Surgeons, New York, New York
| | | | - Brian K Reilly
- Otolaryngology and Pediatrics, George Washington University Medical School, Children's National Hospital, Washington, District of Columbia
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Kraus D, Horowitz‐Kraus T. Functional MRI research involving healthy children: Ethics, safety and recommended procedures. Acta Paediatr 2022; 111:741-749. [PMID: 34986521 DOI: 10.1111/apa.16247] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 11/26/2021] [Accepted: 01/04/2022] [Indexed: 12/11/2022]
Abstract
AIM This specific review aims to expose clinicians, researchers and administrators in hospitals to the importance, procedures and safety of fMRI studies to promote the increased utilisation of such studies in different geographical places worldwide. The child's brain is developing rapidly, both structurally and functionally. These functional changes can only be detected using functional scans generated from an MRI machine and referred to as a functional MRI (fMRI). This method may be used clinically in complex medical and surgical conditions (e.g., epilepsy surgery), but these days are often used for research purposes. However, due to ethical and logistical considerations, fMRI in the paediatric population is not widely and equally used in different geographical places. CONCLUSIONS The benefits of using this method to define the functional changes occurring in the developing brain are discussed in this review, along with desensitisation methods recommended when working with this vulnerable population in research and even in a clinical setting.
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Affiliation(s)
- Dror Kraus
- Pediatric Neurology Institute Schneider Children's Medical Center of Israel Tel Aviv University Petach‐Tiqua Israel
| | - Tzipi Horowitz‐Kraus
- Educational Neuroimaging Group Faculty of Education in Science and Technology Faculty of Biomedical Engineering Haifa Israel
- Kennedy Krieger Institute Baltimore Maryland USA
- Department of Psychiatry and Behavioral Sciences Johns Hopkins University School of Medicine Baltimore Maryland USA
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Carr CM, Lane JI, Eckel LJ, Diehn FE, Kallmes DF, Carlson ML, Shu Y, Bernstein MA, Gunderson TM, Poling GL. Evaluation of hearing loss in young adults after exposure to 3.0T MRI with standard hearing protection. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2022; 151:1913. [PMID: 35364910 DOI: 10.1121/10.0009824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 03/02/2022] [Indexed: 06/14/2023]
Abstract
Standard clinical protocols require hearing protection during magnetic resonance imaging (MRI) for patient safety. This investigation prospectively evaluated the auditory function impact of acoustic noise exposure during a 3.0T MRI in healthy adults. Twenty-nine participants with normal hearing underwent a comprehensive audiologic assessment before and immediately following a clinically indicated head MRI. Appropriate hearing protection with earplugs (and pads) was used per standard of practice. To characterize noise hazards, current sound monitoring tools were used to measure levels of pulse sequences measured. A third audiologic test was performed if a significant threshold shift (STS) was identified at the second test, within 30 days post MRI. Some sequences produced high levels (up to 114.5 dBA; 129 dB peak SPL) that required hearing protection but did not exceed 100% daily noise dose. One participant exhibited an STS in the frequency region most highly associated with noise-induced hearing loss. No participants experienced OSHA-defined STS in either ear. Overall, OAE measures did not show evidence of changes in cochlear function after MRI. In conclusion, hearing threshold shifts associated with hearing loss or OAE level shifts reflecting underlying cochlear damage were not detected in any of the 3.0T MRI study participants who used the current recommended hearing protection.
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Affiliation(s)
- Carrie M Carr
- Division of Neuroradiology, Department of Radiology, Mayo Clinic, 200 First Street Southwest, Rochester, Minnesota 55905, USA
| | - John I Lane
- Division of Neuroradiology, Department of Radiology, Mayo Clinic, 200 First Street Southwest, Rochester, Minnesota 55905, USA
| | - Larry J Eckel
- Division of Neuroradiology, Department of Radiology, Mayo Clinic, 200 First Street Southwest, Rochester, Minnesota 55905, USA
| | - Felix E Diehn
- Division of Neuroradiology, Department of Radiology, Mayo Clinic, 200 First Street Southwest, Rochester, Minnesota 55905, USA
| | - Dave F Kallmes
- Division of Neuroradiology, Department of Radiology, Mayo Clinic, 200 First Street Southwest, Rochester, Minnesota 55905, USA
| | - Matthew L Carlson
- Division of Audiology, Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, 200 First Street Southwest, Rochester, Minnesota 55905, USA
| | - Yunhong Shu
- Division of Medical Physics, Department of Radiology, Mayo Clinic, 200 First Street Southwest, Rochester, Minnesota 55905, USA
| | - Matt A Bernstein
- Division of Medical Physics, Department of Radiology, Mayo Clinic, 200 First Street Southwest, Rochester, Minnesota 55905, USA
| | - Tina M Gunderson
- Department of Biomedical Statistics and Informatics, Mayo Clinic, 200 First Street Southwest, Rochester, Minnesota 55905, USA
| | - Gayla L Poling
- Division of Audiology, Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, 200 First Street Southwest, Rochester, Minnesota 55905, USA
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Ljungberg E, Damestani NL, Wood TC, Lythgoe DJ, Zelaya F, Williams SCR, Solana AB, Barker GJ, Wiesinger F. Silent zero TE MR neuroimaging: Current state-of-the-art and future directions. PROGRESS IN NUCLEAR MAGNETIC RESONANCE SPECTROSCOPY 2021; 123:73-93. [PMID: 34078538 PMCID: PMC7616227 DOI: 10.1016/j.pnmrs.2021.03.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 03/08/2021] [Accepted: 03/09/2021] [Indexed: 06/12/2023]
Abstract
Magnetic Resonance Imaging (MRI) scanners produce loud acoustic noise originating from vibrational Lorentz forces induced by rapidly changing currents in the magnetic field gradient coils. Using zero echo time (ZTE) MRI pulse sequences, gradient switching can be reduced to a minimum, which enables near silent operation.Besides silent MRI, ZTE offers further interesting characteristics, including a nominal echo time of TE = 0 (thus capturing short-lived signals from MR tissues which are otherwise MR-invisible), 3D radial sampling (providing motion robustness), and ultra-short repetition times (providing fast and efficient scanning).In this work we describe the main concepts behind ZTE imaging with a focus on conceptual understanding of the imaging sequences, relevant acquisition parameters, commonly observed image artefacts, and image contrasts. We will further describe a range of methods for anatomical and functional neuroimaging, together with recommendations for successful implementation.
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Affiliation(s)
- Emil Ljungberg
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.
| | - Nikou L Damestani
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Tobias C Wood
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - David J Lythgoe
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Fernando Zelaya
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Steven C R Williams
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | | | - Gareth J Barker
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Florian Wiesinger
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom; ASL Europe, GE Healthcare, Munich, Germany
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Turay CB, Ozer F, Yildirim T, Erbek S. Evaluation of the possible effect of magnetic resonance imaging noise on peripheral hearing organ with the otoacoustic emission. Am J Otolaryngol 2020; 41:102586. [PMID: 32629148 DOI: 10.1016/j.amjoto.2020.102586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 05/20/2020] [Accepted: 05/26/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE The aim of this study is to evaluate the effect of noise produced by magnetic resonance imaging (MRI) device on hearing by using objective and subjective audiological assessments. METHODS A total of 38 patients between the ages of 18 and 50 without hearing loss, and had performed MRI for brain, head, neck or cervical imaging were included in this prospective clinical study. Pure tone audiometry, speech audiometry, high frequency audiometry, transient evoked otoacoustic emissions (TEOAE) and distortion product otoacoustic emission (DPOAE) were performed before and after MRI. RESULTS There was no statistically significant difference in TEOAE, pure tone audiogram, high frequency audiogram and speech audiogram thresholds. In DPOAE, the median value before and after MRI at the frequency of the left ear at 4.0 kHz was 13.6 (8.5-19.9) and 15.7 (8.9-20.7) SNR respectively (p > .05). The median value before MRI at the right ear 4.0 kHz frequency was 14.1 (9.1-20.5) SNR, whereas the median value after MRI was 13.2 (8.8-19.8 SNR (p = 0,03). There was no statistically significant difference in other frequencies in DPOAE. CONCLUSIONS This is the first objective study that examines the MRI noise on speech audiometry and otoacoustic emission together. However, the effect of MRI noise on hearing pathway is still doubt. Based on the difference at 4 kHz frequency on DPOAE; on-earphones may not sufficiently protect the patients from the MRI noise and this issue should deserve further research.
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Wang FH, Zhang J, Xiao M, Wu F, Liu L, Zhou XH. [Sedative effect of intranasal midazolam in neonates undergoing magnetic resonance imaging: a prospective single-blind randomized controlled study]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2020; 22:441-445. [PMID: 32434638 PMCID: PMC7389410 DOI: 10.7499/j.issn.1008-8830.1911147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 04/15/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To compare intranasal midazolam and intramuscular phenobarbital sodium for their sedative effect in neonates undergoing magnetic resonance imaging (MRI). METHODS A total of 70 neonates who underwent cranial MRI from September 2017 to March 2019 were randomized into an observation group and a control group, with 35 cases in each group. The observation group received intranasal drops of midazolam (0.3 mg/kg), and the control group received intramuscular injection of phenobarbital sodium (10 mg/kg). The sedation status of the neonates was evaluated using the Ramsay Sedation Scale. Meanwhile, the two groups were compared for the success rate of MRI procedure and incidence of adverse reactions. RESULTS In the observation group, the sedation score was the highest at 20 minutes post administration, then was gradually decreasing, and decreased to the lowest level at 70 minutes post administration. In the control group, the sedation score was the lowest at 10 minutes post administration, then was gradually increasing, and increased to the highest level at 40 minutes and 50 minutes post administration, followed by a gradual decrease. Comparison of the sedation score at each time period suggested that the sedation score was significantly higher in the observation group than in the control group within 40 minutes post administration (P<0.05), while there were no significant differences between the two groups in the sedation score after 40 minutes post administration (P>0.05). The success rate of MRI procedure was significantly higher in the observation group than in the control group (89% vs 69%, P<0.05). There was no significant difference between the two groups in the incidence of adverse reactions (P>0.05). CONCLUSIONS Intranasal midazolam is superior to intramuscular phenobarbital sodium in the sedative effect in neonates undergoing MRI, with the benefits of being fast, convenient, safe, and effective.
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Affiliation(s)
- Fang-Hui Wang
- Department of Neonatology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China.
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Hearing Thresholds Changes after MRI 1.5T of Head and Neck. Radiol Res Pract 2019; 2019:8756579. [PMID: 31316833 PMCID: PMC6601493 DOI: 10.1155/2019/8756579] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 04/24/2019] [Accepted: 05/26/2019] [Indexed: 12/20/2022] Open
Abstract
Introduction Exposure to high intensity noise produced by MRI is a cause for concern. This study was conducted to determine the temporary and permanent effects of exposure to noise created by performing MRI on the hearing threshold of the subjects using conventional and extended high frequency audiometry. Methods This semiexperimental study was performed on 35 patients referred to Shahid Rahnemoun Hospital for head and neck MRI due to different clinical conditions. The hearing threshold of patients was measured before, immediately after, and 24 hours after performing 1.5 Tesla MRI using conventional and extended high frequency audiometry. SPSS version 18 was used to compare the mean hearing thresholds before and after MRI using paired T test and repeated measures analysis. Results Comparison of auditory thresholds in conventional and extended high frequencies before and immediately after MRI showed a significant shift at 4 KHz (P = 0.008 and P = 0.08 for right and left ears), 6 KHz (P = 0.03 and P = 0.01 for right and left ears), and 14 KHz (P =0.03 and P = 0.31 for right and left ears). However, there was no significant difference between audiometric thresholds before and 24 hours after MRI. Conclusion Noise due to 1.5 Tesla MRI can only cause transient threshold shift.
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Jin C, Li H, Li X, Wang M, Liu C, Guo J, Yang J. Temporary Hearing Threshold Shift in Healthy Volunteers with Hearing Protection Caused by Acoustic Noise Exposure during 3-T Multisequence MR Neuroimaging. Radiology 2018; 286:602-608. [PMID: 28813235 DOI: 10.1148/radiol.2017161622] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Chao Jin
- From the Department of Diagnostic Radiology, the First Affiliated Hospital of Xi’an Jiaotong University, 277 West Yanta Road, Xi’an 710061, PR China (C.J., H.L., X.L., M.W., C.L., J.G., J.Y.); and Department of Biomedical Engineering, School of Life Science and Technology, Xi’an Jiaotong University, Xi’an, PR China (X.L., J.Y.)
| | - Huan Li
- From the Department of Diagnostic Radiology, the First Affiliated Hospital of Xi’an Jiaotong University, 277 West Yanta Road, Xi’an 710061, PR China (C.J., H.L., X.L., M.W., C.L., J.G., J.Y.); and Department of Biomedical Engineering, School of Life Science and Technology, Xi’an Jiaotong University, Xi’an, PR China (X.L., J.Y.)
| | - Xianjun Li
- From the Department of Diagnostic Radiology, the First Affiliated Hospital of Xi’an Jiaotong University, 277 West Yanta Road, Xi’an 710061, PR China (C.J., H.L., X.L., M.W., C.L., J.G., J.Y.); and Department of Biomedical Engineering, School of Life Science and Technology, Xi’an Jiaotong University, Xi’an, PR China (X.L., J.Y.)
| | - Miaomiao Wang
- From the Department of Diagnostic Radiology, the First Affiliated Hospital of Xi’an Jiaotong University, 277 West Yanta Road, Xi’an 710061, PR China (C.J., H.L., X.L., M.W., C.L., J.G., J.Y.); and Department of Biomedical Engineering, School of Life Science and Technology, Xi’an Jiaotong University, Xi’an, PR China (X.L., J.Y.)
| | - Congcong Liu
- From the Department of Diagnostic Radiology, the First Affiliated Hospital of Xi’an Jiaotong University, 277 West Yanta Road, Xi’an 710061, PR China (C.J., H.L., X.L., M.W., C.L., J.G., J.Y.); and Department of Biomedical Engineering, School of Life Science and Technology, Xi’an Jiaotong University, Xi’an, PR China (X.L., J.Y.)
| | - Jianxin Guo
- From the Department of Diagnostic Radiology, the First Affiliated Hospital of Xi’an Jiaotong University, 277 West Yanta Road, Xi’an 710061, PR China (C.J., H.L., X.L., M.W., C.L., J.G., J.Y.); and Department of Biomedical Engineering, School of Life Science and Technology, Xi’an Jiaotong University, Xi’an, PR China (X.L., J.Y.)
| | - Jian Yang
- From the Department of Diagnostic Radiology, the First Affiliated Hospital of Xi’an Jiaotong University, 277 West Yanta Road, Xi’an 710061, PR China (C.J., H.L., X.L., M.W., C.L., J.G., J.Y.); and Department of Biomedical Engineering, School of Life Science and Technology, Xi’an Jiaotong University, Xi’an, PR China (X.L., J.Y.)
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Wolak T, Cieśla K, Rusiniak M, Piłka A, Lewandowska M, Pluta A, Skarżyński H, Skarżyński PH. Influence of Acoustic Overstimulation on the Central Auditory System: An Functional Magnetic Resonance Imaging (fMRI) Study. Med Sci Monit 2016; 22:4623-4635. [PMID: 27893698 PMCID: PMC5132427 DOI: 10.12659/msm.897929] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background The goal of the fMRI experiment was to explore the involvement of central auditory structures in pathomechanisms of a behaviorally manifested auditory temporary threshold shift in humans. Material/Methods The material included 18 healthy volunteers with normal hearing. Subjects in the exposure group were presented with 15 min of binaural acoustic overstimulation of narrowband noise (3 kHz central frequency) at 95 dB(A). The control group was not exposed to noise but instead relaxed in silence. Auditory fMRI was performed in 1 session before and 3 sessions after acoustic overstimulation and involved 3.5–4.5 kHz sweeps. Results The outcomes of the study indicate a possible effect of acoustic overstimulation on central processing, with decreased brain responses to auditory stimulation up to 20 min after exposure to noise. The effect can be seen already in the primary auditory cortex. Decreased BOLD signal change can be due to increased excitation thresholds and/or increased spontaneous activity of auditory neurons throughout the auditory system. Conclusions The trial shows that fMRI can be a valuable tool in acoustic overstimulation studies but has to be used with caution and considered complimentary to audiological measures. Further methodological improvements are needed to distinguish the effects of TTS and neuronal habituation to repetitive stimulation.
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Affiliation(s)
- Tomasz Wolak
- Institute of Physiology and Pathology of Hearing, World Hearing Center, Warsaw/Kajetany, Poland
| | - Katarzyna Cieśla
- Institute of Physiology and Pathology of Hearing, World Hearing Center, Warsaw/Kajetany, Poland
| | - Mateusz Rusiniak
- Institute of Physiology and Pathology of Hearing, World Hearing Center, Warsaw/Kajetany, Poland
| | - Adam Piłka
- Institute of Physiology and Pathology of Hearing, World Hearing Center, Warsaw/Kajetany, Poland
| | - Monika Lewandowska
- Institute of Physiology and Pathology of Hearing, World Hearing Center, Warsaw/Kajetany, Poland
| | - Agnieszka Pluta
- Institute of Physiology and Pathology of Hearing, World Hearing Center, Warsaw/Kajetany, Poland
| | - Henryk Skarżyński
- Institute of Physiology and Pathology of Hearing, World Hearing Center, Warsaw/Kajetany, Poland
| | - Piotr H Skarżyński
- Institute of Physiology and Pathology of Hearing, World Hearing Center, Warsaw/Kajetany, Poland.,Department of Heart Failure and Cardiac Rehabilitation, Medical University of Warsaw, Warsaw, Poland
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