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Martín-González C, Fernández-Alonso P, Pérez-Hernández O, Abreu-González P, Espelosín-Ortega E, Fernández-Rodríguez CM, Martín-Ponce E, González-Reimers E. Sarcopenic Obesity in People with Alcoholic Use Disorder: Relation with Inflammation, Vascular Risk Factors and Serum Vitamin D Levels. Int J Mol Sci 2023; 24:9976. [PMID: 37373124 DOI: 10.3390/ijms24129976] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 05/30/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
In recent years, the terms sarcopenia, sarcopenic obesity, and osteosarcopenic obesity (OSO) were coined to define a situation in elderly people strongly associated with frailty and increased mortality. Possibly, a complex interplay of several hormones and cytokines are involved in its development. Ongoing research detected that OSO may occur at any age and in several conditions. The prevalence of OSO in alcoholism was poorly analyzed. The aim of this study was to analyze the prevalence of OSO in alcoholism and its relationship with proinflammatory cytokines and/or common complications of alcoholism, such as cirrhosis, cancer, or vascular disease. We included 115 patients with alcoholic use disorder. Body composition analysis was performed by double X-ray absorptiometry. Handgrip strength was recorded using a dynamometer. We assessed liver function according to Child's classification, and determined serum levels of proinflammatory cytokines (TNF-α, IL-6, IL-8), routine laboratory variables, and vitamin D. People with alcoholic use disorder showed a high prevalence of OSO, especially regarding OSO obesity (60%), OSO osteopenia (55.65%), and OSO lean mass (60.17%). OSO handgrip was closely, independently, related to the presence of vascular calcification (χ2 = 17.00; p < 0.001). OSO handgrip was related to several proinflammatory cytokines and vitamin D. Vitamin D deficiency kept a close correlation with OSO handgrip (rho = -0.54, p < 0.001). Therefore, among people with alcohol use disorder, OSO prevalence was high. OSO handgrip is related to serum proinflammatory cytokine levels supporting the possible pathogenetic role of these cytokines on OSO development. Vitamin D deficiency is related to OSO handgrip suggesting its pathogenetic involvement in sarcopenia in patients with alcohol use disorder. The close association between OSO handgrip and vascular calcification is clinically relevant and suggests that OSO handgrip may constitute a prognostic tool in these patients.
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Affiliation(s)
- Candelaria Martín-González
- Departamento de Medicina Interna, Universidad de La Laguna, Servicio de Medicina Interna, Hospital Universitario de Canarias, Tenerife, Canary Islands, 38320 La Laguna, Spain
| | - Paula Fernández-Alonso
- Departamento de Medicina Interna, Universidad de La Laguna, Servicio de Medicina Interna, Hospital Universitario de Canarias, Tenerife, Canary Islands, 38320 La Laguna, Spain
| | - Onán Pérez-Hernández
- Departamento de Medicina Interna, Universidad de La Laguna, Servicio de Medicina Interna, Hospital Universitario de Canarias, Tenerife, Canary Islands, 38320 La Laguna, Spain
| | - Pedro Abreu-González
- Departamento de Ciencias Médicas Básicas, Unidad de Fisiología, Universidad de la Laguna, Tenerife, Canary Islands, 38320 La Laguna, Spain
| | - Elisa Espelosín-Ortega
- Servicio de Laboratorio, Hospital Universitario de Canarias, Tenerife, Canary Islands, 38320 La Laguna, Spain
| | - Camino María Fernández-Rodríguez
- Departamento de Medicina Interna, Universidad de La Laguna, Servicio de Medicina Interna, Hospital Universitario de Canarias, Tenerife, Canary Islands, 38320 La Laguna, Spain
| | - Esther Martín-Ponce
- Departamento de Medicina Interna, Universidad de La Laguna, Servicio de Medicina Interna, Hospital Universitario de Canarias, Tenerife, Canary Islands, 38320 La Laguna, Spain
| | - Emilio González-Reimers
- Departamento de Medicina Interna, Universidad de La Laguna, Servicio de Medicina Interna, Hospital Universitario de Canarias, Tenerife, Canary Islands, 38320 La Laguna, Spain
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Lappas NT, Lappas CM. Ethanol. Forensic Toxicol 2022. [DOI: 10.1016/b978-0-12-819286-3.00021-x] [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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3
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Haber PS, Kortt NC. Alcohol use disorder and the gut. Addiction 2021; 116:658-667. [PMID: 32511812 DOI: 10.1111/add.15147] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 04/14/2020] [Accepted: 06/02/2020] [Indexed: 02/07/2023]
Abstract
Acute and chronic gastrointestinal problems are common in the setting of excessive alcohol use, and excessive alcohol use is associated with injury to all parts of the gastrointestinal tract. There is mounting evidence of gastrointestinal injury and increased cancer risk even from moderate alcohol consumption. The major causes of alcohol-related morbidity and mortality within the gastrointestinal system are liver disease, pancreatitis and gastrointestinal cancer. Other alcohol-related intestinal dysfunction is common but not life-threatening, leading to diarrhoea, malabsorption and nutritional deficiencies. This review describes non-neoplastic and neoplastic alcohol-related disorders of the gastrointestinal tract, omitting the liver, which has been reviewed elsewhere.
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Affiliation(s)
- Paul S Haber
- Royal Prince Alfred Hospital, Camperdown, NSW, 2050, Australia.,University of Sydney, Sydney, NSW, 2050, Australia
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Berger B, Brooks S, Zuiker R, Richard M, Muehlan C, Dingemanse J. Pharmacological Interactions between the Dual Orexin Receptor Antagonist Daridorexant and Ethanol in a Double-Blind, Randomized, Placebo-Controlled, Double-Dummy, Four-Way Crossover Phase I Study in Healthy Subjects. CNS Drugs 2020; 34:1253-1266. [PMID: 33205362 DOI: 10.1007/s40263-020-00768-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/23/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Daridorexant (ACT-541468) is a potent dual orexin receptor antagonist under development for the treatment of sleep disorders. Concomitant intake of ethanol and hypnotics has been shown to result in additive/supra-additive depression of the central nervous system, resulting in pronounced sedation. OBJECTIVE The aim of this study was to evaluate the pharmacokinetic (PK) and pharmacodynamic (PD) interactions between ethanol and daridorexant. METHOD This was a single-center, double-blind, placebo-controlled, randomized, four-way crossover study conducted in 19 healthy male/female subjects. Subjects received the following four treatments: ethanol with daridorexant, daridorexant alone, ethanol alone, and placebo. Daridorexant 50 mg and the matching placebo were administered as single oral tablets. Ethanol was infused intravenously and clamped at a level of 0.6 g/L for 5 h. The PK of ethanol and daridorexant were assessed and a battery of PD tests performed. RESULTS Concomitant administration of ethanol prolonged the time to reach maximum plasma concentrations (tmax) of daridorexant (median difference 1.25 h). No other relevant PK interactions were observed. Coadministration with ethanol produced a numerically greater impairment on saccadic peak velocity, body sway, visual analog scale (VAS) alertness, VAS alcohol intoxication, smooth pursuit, and adaptive tracking compared with daridorexant alone. All treatments were generally well tolerated without serious adverse events (AEs). The most commonly reported treatment-emergent AEs following coadministration of daridorexant and ethanol included somnolence, headache, fatigue, sudden onset of sleep, and dizziness. CONCLUSIONS Apart from a shift in tmax, no relevant changes in PK parameters were observed following coadministration of daridorexant and ethanol. The coadministration led to reinforced drug actions that were, at most, indicative of infra-additive effects on certain PD markers. Patients will be advised not to consume ethanol with daridorexant. CLINICAL TRIALS REGISTRATION NUMBER NCT03609775 (ClinicalTrials.gov Identifier).
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Affiliation(s)
- Benjamin Berger
- Department of Clinical Pharmacology, Idorsia Pharmaceuticals Ltd, Hegenheimermattweg 91, 4123, Allschwil, Switzerland.
| | - Sander Brooks
- Centre for Human Drug Research (CHDR), Leiden, The Netherlands.,Leiden University Medical Center, Leiden, The Netherlands
| | - Rob Zuiker
- Centre for Human Drug Research (CHDR), Leiden, The Netherlands
| | - Muriel Richard
- Department of Clinical Pharmacology, Idorsia Pharmaceuticals Ltd, Hegenheimermattweg 91, 4123, Allschwil, Switzerland
| | - Clemens Muehlan
- Department of Clinical Pharmacology, Idorsia Pharmaceuticals Ltd, Hegenheimermattweg 91, 4123, Allschwil, Switzerland
| | - Jasper Dingemanse
- Department of Clinical Pharmacology, Idorsia Pharmaceuticals Ltd, Hegenheimermattweg 91, 4123, Allschwil, Switzerland
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Gonzalez Z, Herlihy D, Phan C, Diaz J, Dominguez K, McCallum R. Alcohol and gastric motility: pathophysiological and therapeutic implications. J Investig Med 2020; 68:965-971. [PMID: 32447287 DOI: 10.1136/jim-2020-001327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2020] [Indexed: 01/16/2023]
Abstract
Alcohol has been associated with alterations in gastric motility. The literature identifies that various factors play a role in alcohol's effect on gastric emptying including differences in alcohol concentration, osmolarity, caloric content, amino acids as well as different processing techniques (fermentation vs distillation). Additionally, chronic alcohol consumption has been shown to alter the myenteric nitrergic system resulting in impaired gastrointestinal motor function, and it also has an inhibitory effect on the release of several neurotransmitters that play a key role in gastrointestinal motility, including acetylcholine. Whether social or limited intake of alcohol could have a therapeutic role has not been apparent. Serendipitously, we have identified a therapeutic role for alcohol with a meal in the entity of dumping syndrome (DS) where there is postprandial rapid emptying of voluminous and hyperosmolar gastric contents into the small bowel. In the clinical setting of DS attributed to impaired vagal nerve function, there was normalization of gastric emptying and resolution of accompanying symptoms when drinking a glass of wine before and during meals. We propose that alcohol's anticholinergic effect was augmented in the setting of vagal nerve denervation resulting in slowing of gastric emptying and in alleviation of symptoms of early DS. This review article provides an in-depth analysis of the published literature on alcohol and gastric motility focusing on the accumulated knowledge that may have clinical application and relevance.
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Affiliation(s)
- Zorisadday Gonzalez
- Gastroenterology, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, USA
| | - Daniel Herlihy
- Gastroenterology, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, USA
| | - Cong Phan
- Paul L Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, Texas, USA
| | - Jesus Diaz
- Nuclear Medicine, University Medical Center of El Paso, El Paso, Texas, USA
| | - Kenneth Dominguez
- Nuclear Medicine, University Medical Center of El Paso, El Paso, Texas, USA
| | - Richard McCallum
- Gastroenterology, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, USA
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Shabanzadeh DM, Novovic S. Alcohol, smoking and benign hepato-biliary disease. Best Pract Res Clin Gastroenterol 2017; 31:519-527. [PMID: 29195671 DOI: 10.1016/j.bpg.2017.09.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 08/29/2017] [Accepted: 09/03/2017] [Indexed: 01/31/2023]
Abstract
Gallstone disease and pancreatitis are the most frequent benign hepato-biliary causes of hospital admissions. Gallstone disease is prevalent, but symptomatic disease develops only in about one out of five carriers. Alcohol intake seems to protect gallstone formation in cohort studies possibly through effects on bile cholesterol metabolism, the enterohepatic circulation, and gallbladder function. The impact of smoking on gallstone formation seems minor. Both alcohol intake and smoking do not alter the clinical course of gallstone disease carriers. Cholecystectomy is the preferred treatment for symptomatic gallstone disease. Studies about the impact of alcohol and smoking on the post-cholecystectomy state are few and future studies should be performed. Pancreatitis is associated with both excessive alcohol intake and smoking in observational studies. Interpretation of associations with pancreatitis is hampered by an incomplete understanding of underlying mechanisms and by the co-existence of excessive alcohol intake and smoking. Smoking cessation and alcohol abstinence is recommended in the treatment of pancreatitis, but higher-level evidence is needed.
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Affiliation(s)
- Daniel Mønsted Shabanzadeh
- Digestive Disease Center, Bispebjerg University Hospital, Copenhagen, Denmark; Research Centre for Prevention and Health, Denmark.
| | - Srdan Novovic
- Department of Gastroenterology and Gastrointestinal Surgery, Copenhagen University Hospital Hvidovre, Denmark.
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Abraham KA, Kearney ML, Reynolds LJ, Thyfault JP. Red wine enhances glucose-dependent insulinotropic peptide (GIP) and insulin responses in type 2 diabetes during an oral glucose tolerance test. Diabetol Int 2016; 7:173-180. [PMID: 30603261 PMCID: PMC6224998 DOI: 10.1007/s13340-015-0234-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Accepted: 08/07/2015] [Indexed: 12/25/2022]
Abstract
BACKGROUND Ingestion of ethanol before a glucose challenge enhances the insulin response by an unknown mechanism. In addition, epidemiological studies consistently indicate that moderate alcohol consumption reduces the risk of developing type 2 diabetes (T2D). The purposes of this study were to evaluate the potential involvement of glucose-dependent insulinotropic peptide (GIP) and glucagon-like peptide 1 (GLP-1) in alcohol-induced augmentation of the insulin response and to determine if red wine acutely improves glucose tolerance during an oral glucose tolerance test (OGTT). METHODS Nine subjects (eight T2D and one pre-diabetes) completed two OGTT 30 min after consumption of 263 ml water or red wine (28 g ethanol). Blood samples were obtained for 3 h and analyzed for glucose, insulin, C-peptide, GIP, and GLP-1. RESULTS Compared with water, consumption of red wine increased the incremental area under the curve (iAUC) for insulin by 50 % (14,837 ± 4759 vs. 9885 ± 2686 µU/ml × min; p < 0.05) and for GIP by 25 % (7729 ± 1548 vs. 6191 ± 1049 pmol/l × min; p < 0.05). Glucose and GLP-1 responses were not affected by red wine. CONCLUSION Wine consumption before an OGTT augments the insulin response, which may be partially driven by a greater GIP response. Because glucose levels were not reduced, acute wine consumption may not be effective treatment for enhancing glycemic control or may need to be combined with therapy that improves insulin sensitivity.
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Affiliation(s)
- Kirk A. Abraham
- Exercise Science Program, Transylvania University, 300 N. Broadway, Lexington, KY 40508 USA
| | - Monica L. Kearney
- Department of Nutrition and Exercise Physiology, McKee Gymnasium, University of Missouri, Columbia, MO 65211 USA
| | - Leryn J. Reynolds
- Department of Nutrition and Exercise Physiology, McKee Gymnasium, University of Missouri, Columbia, MO 65211 USA
| | - John P. Thyfault
- Department of Nutrition and Exercise Physiology and Medicine, McKee Gymnasium, University of Missouri, Columbia, MO 65211 USA
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SHIBATA T, YAMASHITA H, KAWAMURA T, JODAI Y, OMORI T, SUMI K, ICHIKAWA Y, OKUBO M, ISHIZUKA T, TAHARA T, NAGASAKA M, NAKAGAWA Y, HIRATA I, OHMIYA N, NAKAO M. <b>The effect of consuming small volumes of beer on gastric motility and the involvement of gene </b><b>polymorphisms </b>. Biomed Res 2016; 37:305-310. [DOI: 10.2220/biomedres.37.305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/02/2024]
Affiliation(s)
| | | | | | - Yasutaka JODAI
- Department of Gastroenterology, Fujita Health University
| | - Takafumi OMORI
- Department of Gastroenterology, Fujita Health University
| | - Kazuya SUMI
- Department of Gastroenterology, Fujita Health University
| | | | - Masaaki OKUBO
- Department of Gastroenterology, Fujita Health University
| | | | | | | | | | - Ichiro HIRATA
- Department of Gastroenterology, Fujita Health University
| | - Naoki OHMIYA
- Department of Gastroenterology, Fujita Health University
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Pohanka M. Toxicology and the biological role of methanol and ethanol: Current view. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2015; 160:54-63. [PMID: 26006090 DOI: 10.5507/bp.2015.023] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 04/24/2015] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Alcohol variants such as ethanol and methanol are simple organic compounds widely used in foods, pharmaceuticals, chemical synthesis, etc. Both are becoming an emerging health problem; abuse of ethanol containing beverages can lead to disparate health problems and methanol is highly toxic and unfit for consumption. METHODS AND RESULTS This review summarizes the basic knowledge about ethanol and methanol toxicity, the effect mechanism on the body, the current care of poisoned individuals and the implication of alcohols in the development of diseases. Alcohol related dementia, stroke, metabolic syndrome and hepatitis are discussed as well. Besides ethanol, methanol toxicity and its biodegradation pathways are addressed. CONCLUSIONS The impact of ethanol and methanol on the body is shown as case reports, along with a discussion on the possible implication of alcohol in Alzheimer's disease and antidotal therapy for methanol poisoning. The role of ethanol in cancer and degenerative disorders seems to be underestimated given the current knowledge. Treatment in case of poisoning is another issue that remains unresolved even though effective protocols and drugs exist.
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Affiliation(s)
- Miroslav Pohanka
- Faculty of Military Health Sciences, University of Defense, Trebesska 1575, Hradec Kralove, Czech Republic
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Bitters: Time for a New Paradigm. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:670504. [PMID: 26074998 PMCID: PMC4446506 DOI: 10.1155/2015/670504] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 04/29/2015] [Indexed: 12/20/2022]
Abstract
In plant-based medical systems, bitter tasting plants play a key role in managing dyspepsia. Yet when it comes to defining their mechanism of activity, herbalists and pharmacologists are split between two theories: one involves cephalic elicited vagal responses while the other comprises purely local responses. Recent studies indicate that bitters elicit a range of cephalic responses which alter postprandial gastric phase haemodynamics. Caffeine and regular coffee (Coffea arabica semen, L.) increase heart rate whereas gentian (Gentiana lutea radix, L.) and wormwood (Artemisia absinthium herba L.) increase tonus in the vascular resistance vessels. Following meals increased cardiac activity acts to support postprandial hyperaemia and maintain systemic blood pressure. The increased vascular tonus acts in parallel with the increased cardiac activity and in normal adults this additional pressor effect results in a reduced cardiac workload. The vascular response is a sympathetic reflex, evident after 5 minutes and dose dependent. Thus gentian and wormwood elicit cephalic responses which facilitate rather than stimulate digestive activity when postprandial hyperaemia is inadequate. Encapsulated caffeine elicits cardiovascular responses indicating that gastrointestinal bitter receptors are functionally active in humans. However, neither encapsulated gentian nor wormwood elicited cardiovascular responses during the gastric phase. These findings provide the platform for a new evidence-based paradigm.
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The effect of drugs and stimulants on gastric myoelectrical activity. GASTROENTEROLOGY REVIEW 2014; 9:130-5. [PMID: 25097708 PMCID: PMC4110358 DOI: 10.5114/pg.2014.43573] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Revised: 09/22/2012] [Accepted: 10/16/2012] [Indexed: 11/17/2022]
Abstract
Electrogastrography (EGG) is a non-invasive diagnostic method useful for the registration and analysis of gastric myoelectrical activity. Abnormalities within an electrogastrogram were found to correlate with a number of disorders and symptoms, like functional dyspepsia, diabetic gastroparesis and terminal hepatic or renal failure. The EGG is also a valuable diagnostic method enabling the evaluation of the effect of drugs on gastric myoelectrical activity, which can be intentional, as in the case of prokinetics, or can have an adverse character. Our review focuses on drugs with a proven impact on gastric myoelectrical activity and hence on the electrogastrogram. The paper assembles and discusses the results of investigations dealing with changes in the electrogastrograms evoked by various drugs. Moreover, the mechanisms of the influence on the gastric myoelectrical activity of drugs, curative substances and stimulants are presented.
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