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Karimian A, Behjati M, Karimian M. Molecular mechanisms involved in anosmia induced by SARS-CoV-2, with a focus on the transmembrane serine protease TMPRSS2. Arch Virol 2022; 167:1931-1946. [PMID: 35939103 PMCID: PMC9358639 DOI: 10.1007/s00705-022-05545-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 05/31/2022] [Indexed: 11/26/2022]
Abstract
Since 2020, SARS-CoV-2 has caused a pandemic virus that has posed many challenges worldwide. Infection with this virus can result in a number of symptoms, one of which is anosmia. Olfactory dysfunction can be a temporary or long-term viral complication caused by a disorder of the olfactory neuroepithelium. Processes such as inflammation, apoptosis, and neuronal damage are involved in the development of SARS-CoV-2-induced anosmia. One of the receptors that play a key role in the entry of SARS-CoV-2 into the host cell is the transmembrane serine protease TMPRSS2, which facilitates this process by cleaving the viral S protein. The gene encoding TMPRSS2 is located on chromosome 21. It contains 15 exons and has many genetic variations, some of which increase the risk of disease. Delta strains have been shown to be more dependent on TMPRSS2 for cell entry than Omicron strains. Blockade of this receptor by serine protease inhibitors such as camostat and nafamostat can be helpful for treating SARS-CoV-2 symptoms, including anosmia. Proper understanding of the different functional aspects of this serine protease can help to overcome the therapeutic challenges of SARS-CoV-2 symptoms, including anosmia. In this review, we describe the cellular and molecular events involved in anosmia induced by SARS-CoV-2 with a focus on the function of the TMPRSS2 receptor.
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Affiliation(s)
- Ali Karimian
- Department of Otorhinolaryngology, School of Medicine, Kashan University of Medical Science, Kashan, Iran
| | - Mohaddeseh Behjati
- Cellular, Molecular and Genetics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Karimian
- Department of Molecular and Cell Biology, Faculty of Basic Sciences, University of Mazandaran, Babolsar, 47416-95447, Iran.
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da Silva Júnior RT, Santos Apolonio J, Cuzzuol BR, da Costa BT, Silva CS, Araújo GRL, Silva Luz M, Marques HS, Santos LKDS, Pinheiro SLR, Lima de Souza Gonçalves V, Calmon MS, Freire de Melo F. COVID-19 neuropsychiatric repercussions: Current evidence on the subject. World J Methodol 2022; 12:365-380. [PMID: 36186752 PMCID: PMC9516547 DOI: 10.5662/wjm.v12.i5.365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 06/30/2022] [Accepted: 07/25/2022] [Indexed: 02/07/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has affected the entire world, causing the coronavirus disease 2019 (COVID-19) pandemic since it was first discovered in Wuhan, China in December 2019. Among the clinical presentation of the disease, in addition to fever, fatigue, cough, dyspnea, diarrhea, nausea, vomiting, and abdominal pain, infected patients may also experience neurological and psychiatric repercussions during the course of the disease and as a post-COVID-19 sequelae. Thus, headache, dizziness, olfactory and gustatory dysfunction, cerebrovascular disorders, neuromuscular abnormalities, anxiety, depression, and post-traumatic stress disorder can occur both from the infection itself and from social distancing and quarantine. According to current evidence about this infection, the virus has the ability to infect the central nervous system (CNS) via angiotensin-converting enzyme 2 (ACE2) receptors on host cells. Several studies have shown the presence of ACE2 in nerve cells and nasal mucosa, as well as transmembrane serine protease 2, key points for interaction with the viral Spike glycoprotein and entry into the CNS, being olfactory tract and blood-brain barrier, through hematogenous dissemination, potential pathways. Thus, the presence of SARS-CoV-2 in the CNS supports the development of neuropsychiatric symptoms. The management of these manifestations seems more complex, given that the dense parenchyma and impermeability of brain tissue, despite protecting the brain from the infectious process, may hinder virus elimination. Still, some alternatives used in non-COVID-19 situations may lead to worse prognosis of acute respiratory syndrome, requiring caution. Therefore, the aim of this review is to bring more current points related to this infection in the CNS, as well as the repercussions of the isolation involved by the pandemic and to present perspectives on interventions in this scenario.
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Affiliation(s)
| | - Jonathan Santos Apolonio
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029094, Brazil
| | - Beatriz Rocha Cuzzuol
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029094, Brazil
| | - Bruna Teixeira da Costa
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029094, Brazil
| | - Camilo Santana Silva
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029094, Brazil
| | - Glauber Rocha Lima Araújo
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029094, Brazil
| | - Marcel Silva Luz
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029094, Brazil
| | - Hanna Santos Marques
- Universidade Estadual do Sudoeste da Bahia, Universidade Estadual do Sudoeste da Bahia, Vitória da Conquista 45083900, Brazil
| | - Luana Kauany de Sá Santos
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029094, Brazil
| | - Samuel Luca Rocha Pinheiro
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029094, Brazil
| | | | - Mariana Santos Calmon
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029094, Brazil
| | - Fabrício Freire de Melo
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029094, Brazil
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The residual effect of coronovirus disease 2019 on olfactory acuity and mucociliary clearance time: a cross-sectional, controlled study. The Journal of Laryngology & Otology 2022; 136:742-746. [PMID: 35382920 PMCID: PMC9203362 DOI: 10.1017/s0022215122000925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Objective This study evaluated the olfactory, sinonasal and mucociliary functions of patients with post-coronavirus disease 2019 long-term persistent olfactory dysfunction. Method Three groups of 30 patients each were formed: patients with a history of coronavirus disease 2019 infection with self-reported, persistent, sudden-onset olfactory dysfunction (group 1), patients with a history of coronavirus disease 2019 infection without any self-reported olfactory dysfunction (group 2) and healthy controls with no history of coronavirus disease 2019 infection (group 3). Saccharin time, Sniffin’ Sticks, Turkish Nasal Obstruction Symptom Evaluation and Sino-Nasal Outcome Test 22 scores were compared. Results Turkish Nasal Obstruction Symptom Evaluation scores were similar between groups (p = 0.252). Sino-Nasal Outcome Test-22 scores were higher in group 1 than groups 2 and 3 (p < 0.01 and p < 0.001, respectively). Saccharin time was significantly longer in group 1 than groups 2 and 3 (p < 0.05 and p < 0.01, respectively). Group 1 had lower olfactory scores than groups 2 and 3 (p < 0.001 and p < 0.001, respectively). Conclusion Mucociliary clearance time was significantly prolonged in patients with post-coronavirus disease 2019 persistent olfactory dysfunction. Coronavirus disease 2019 infection was likely to cause asymptomatic olfactory dysfunction.
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Zarachi A, Pezoulas V, Komnos I, Lianou A, Milionis O, Klouras E, Katsikatsos K, Fotiadis D, Kastanioudakis I, Milionis C, Liontos A. Clinical Symptoms in Hospitalized and Self-Quarantined Patients with SARS-CoV-2 Infection in Northwestern Greece - Association with Olfactory and Gustatory Dysfunction. MAEDICA 2022; 17:277-284. [PMID: 36032619 PMCID: PMC9375888 DOI: 10.26574/maedica.2022.17.2.277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Backround: We aimed to assess the relation of chemosensory dysfunction with the reported symptoms in two subgroups of patients in Northwestern Greece: the first one included patients with moderate to severe symptomatology who needed hospitalization and the second one, patients with mild symptoms who recovered at home. Methods:We used a questionnaire to select information about patient demographics, medical history and reported symptoms during infection. Three hundred COVID-19 positive patients who were identified via RT-PCR test in the University Hospital of Ioannina, Greece, were included in the present study, of which 150 recovered at home and the remaining 150 needed hospitalization. Statistical analysis was based on IBM-SPSS Statistics 26.0. Results:The majority of patients had fever during infection, while o minor percentage of those who needed hospitalization (12.67%) suffered from sore throat. There was a statistically significant difference between the loss of smell and clinical symptoms including fatigue, nose congestion, body aches and headache, and loss of taste and reported symptoms including fatigue, body aches, runny nose, headache and sore throat. Conclusion: Fever was the symptom with the highest percentage rate, while sore throat was the symptom with the lowest percentage rate. There are reported clinical symptoms related with olfactory and gustatory dysfunction during COVID-19 infection.
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Affiliation(s)
- Athina Zarachi
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Vasileios Pezoulas
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, Ioannina, Greece
| | - Ioannis Komnos
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Aikaterini Lianou
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Orestis Milionis
- Faculty of Medicine, Department of Internal Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Eleutherios Klouras
- Faculty of Medicine, Department of Internal Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Konstantinos Katsikatsos
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, Ioannina, Greece
| | - Dimitrios Fotiadis
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, Ioannina, Greece
| | - Ioannis Kastanioudakis
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Charalampos Milionis
- Faculty of Medicine, Department of Internal Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Angelos Liontos
- Faculty of Medicine, Department of Internal Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
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Zarachi A, Pezoulas V, Milionis O, Lianou AN, Klouras E, Komnos I, Fotiadis D, Kastanioudakis I, Milionis C, Liontos A. The Impact of Age and Gender and Their Association with Chemosensory Dysfunction, in Hospitalized and Self-Quarantine Patients with Covid-19 Infection, in Epirus, Greece. MAEDICA 2022; 17:28-36. [PMID: 35733759 PMCID: PMC9168572 DOI: 10.26574/maedica.2022.17.1.28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective:Olfactory and gustatory dysfunction that relates with the infection from severe acute respiratory syndrome-related coronavirus (SARS-CoV-2) has already improved. The relation between chemosensory dysfunction and age and gender in covid-19 positive patients is the main objective of the present study. Methods:We used a questionnaire to select information about medical history, patient demographics and reported symptoms during infection. Three hundred covid-19 positive patients, who underwent a RT-PCR test in the University Hospital of Ioannina, Grecce, were included in this study; 150 of them recovered at home and the remaining 150 were admitted to hospital. Statistical analysis based on ÉBM-SPSS Statistics 26.0 was done. Results:The total sample included 300 patients, of which 106 females and 194 males. There was a statistically significant difference between the subgroup of patients aged 21-25, 61-65 and 71-75 with loss of smell, that of hospitalized patients aged 41-45 with loss of smell and the subgroup of those aged 31-35 and 71-75 with loss of taste. Conclusion:There is a significant association between chemosensory dysfunction and younger age groups. Olfactory and gustatory dysfunction appears more frequently in women than men. Male gender relates with disease severity.
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Affiliation(s)
- Athina Zarachi
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Vasileios Pezoulas
- Unit of Medical Technology and Intelligent Information Systems, Departement of Materials Science and Engineering, University of Ioannina, Ioannina, Greece
| | - Orestis Milionis
- Faculty of Medicine, Department of Internal Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Aikaterini N Lianou
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Eleutherios Klouras
- Faculty of Medicine, Department of Internal Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Ioannis Komnos
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Dimitrios Fotiadis
- Unit of Medical Technology and Intelligent Information Systems, Departement of Materials Science and Engineering, University of Ioannina, Ioannina, Greece
| | - Ioannis Kastanioudakis
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Charalampos Milionis
- Faculty of Medicine, Department of Internal Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Angelos Liontos
- Faculty of Medicine, Department of Internal Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
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Schambeck SE, Crowell CS, Wagner KI, D’Ippolito E, Burrell T, Mijočević H, Protzer U, Busch DH, Gerhard M, Poppert H, Beyer H. Phantosmia, Parosmia, and Dysgeusia Are Prolonged and Late-Onset Symptoms of COVID-19. J Clin Med 2021; 10:jcm10225266. [PMID: 34830550 PMCID: PMC8618742 DOI: 10.3390/jcm10225266] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/09/2021] [Accepted: 11/09/2021] [Indexed: 12/28/2022] Open
Abstract
Deficiencies in smell and taste are common symptoms of COVID-19. Quantitative losses are well surveyed. This study focuses on qualitative changes such as phantosmia (hallucination of smell), parosmia (alteration of smell), and dysgeusia (alteration of taste) and possible connections with the adaptive immune system. Subjective experience of deficiency in taste and smell was assessed by two different questionnaires after a median of 100 and 244 days after first positive RT-PCR test. SARS-CoV-2-specific antibody levels were measured with the iFlash-SARS-CoV-2 assay. After 100 days a psychophysical screening test for olfactory and gustatory dysfunction was administered. 30 of 44 (68.2%) participants reported a chemosensory dysfunction (14 quantitative, 6 qualitative, 10 quantitative, and qualitative) during COVID-19, eleven (25.0%) participants (1 quantitative, 7 qualitative, 3 quantitative, and quantity) after 100 days, and 14 (31.8%) participants (1 quantitative, 10 qualitative, 3 quantitative and qualitative) after 244 days. Four (9.1%) participants, who were symptom-free after 100 days reported now recently arisen qualitative changes. Serological and T-cell analysis showed no correlation with impairment of taste and smell. In conclusion, qualitative changes can persist for several months and occur as late-onset symptoms months after full recovery from COVID-19-induced quantitative losses in taste and smell.
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Affiliation(s)
- Sophia E. Schambeck
- Helios Klinikum München West, Steinerweg 5, 81241 München, Germany; (H.P.); (H.B.)
- Institute for Medical Microbiology, Immunology and Hygiene, Technical University of Munich, Trogerstr. 30, 81675 München, Germany; (C.S.C.); (K.I.W.); (E.D.); (T.B.); (D.H.B.); (M.G.)
- Correspondence:
| | - Claudia S. Crowell
- Institute for Medical Microbiology, Immunology and Hygiene, Technical University of Munich, Trogerstr. 30, 81675 München, Germany; (C.S.C.); (K.I.W.); (E.D.); (T.B.); (D.H.B.); (M.G.)
- German Center for Infection Research (DZIF), Partner Site Munich, 81675 Munich, Germany;
| | - Karolin I. Wagner
- Institute for Medical Microbiology, Immunology and Hygiene, Technical University of Munich, Trogerstr. 30, 81675 München, Germany; (C.S.C.); (K.I.W.); (E.D.); (T.B.); (D.H.B.); (M.G.)
| | - Elvira D’Ippolito
- Institute for Medical Microbiology, Immunology and Hygiene, Technical University of Munich, Trogerstr. 30, 81675 München, Germany; (C.S.C.); (K.I.W.); (E.D.); (T.B.); (D.H.B.); (M.G.)
| | - Teresa Burrell
- Institute for Medical Microbiology, Immunology and Hygiene, Technical University of Munich, Trogerstr. 30, 81675 München, Germany; (C.S.C.); (K.I.W.); (E.D.); (T.B.); (D.H.B.); (M.G.)
| | - Hrvoje Mijočević
- Institute of Virology, School of Medicine, Technical University of Munich, Trogerstr. 30, 81675 München, Germany;
| | - Ulrike Protzer
- German Center for Infection Research (DZIF), Partner Site Munich, 81675 Munich, Germany;
- Institute of Virology, School of Medicine, Technical University of Munich, Trogerstr. 30, 81675 München, Germany;
| | - Dirk H. Busch
- Institute for Medical Microbiology, Immunology and Hygiene, Technical University of Munich, Trogerstr. 30, 81675 München, Germany; (C.S.C.); (K.I.W.); (E.D.); (T.B.); (D.H.B.); (M.G.)
- German Center for Infection Research (DZIF), Partner Site Munich, 81675 Munich, Germany;
| | - Markus Gerhard
- Institute for Medical Microbiology, Immunology and Hygiene, Technical University of Munich, Trogerstr. 30, 81675 München, Germany; (C.S.C.); (K.I.W.); (E.D.); (T.B.); (D.H.B.); (M.G.)
- German Center for Infection Research (DZIF), Partner Site Munich, 81675 Munich, Germany;
| | - Holger Poppert
- Helios Klinikum München West, Steinerweg 5, 81241 München, Germany; (H.P.); (H.B.)
- Klinik und Poliklinik für Neurologie im Neuro-Kopf-Zentrum, Klinikum Rechts der Isar, Ismaninger Str. 22, 81675 München, Germany
| | - Henriette Beyer
- Helios Klinikum München West, Steinerweg 5, 81241 München, Germany; (H.P.); (H.B.)
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Soares LES, Guirado MMG, Berlingieri G, Ramires MCCH, Lyra LADOP, Teixeira IS, Oliveira PC, Tateno RY, Palma LF, Campos L. Intranasal photobiomodulation therapy for COVID-19-related olfactory dysfunction: A Brazilian multicenter case series. Photodiagnosis Photodyn Ther 2021; 36:102574. [PMID: 34628071 PMCID: PMC8496972 DOI: 10.1016/j.pdpdt.2021.102574] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 09/29/2021] [Accepted: 10/04/2021] [Indexed: 12/28/2022]
Abstract
Olfactory dysfunction is commonly seen in COVID-19 patients; however, little is known about the pathophysiology and management. The present study aimed to report a series of cases in which three protocols of intranasal photobiomodulation therapy (PBMT) were used for COVID-19-related olfactory dysfunction. Irrespective of the PBMT protocol, olfaction recovery was noted in all cases but with varying degrees of improvement. Although intranasal PBMT seems to be a promising therapeutic modality, more research is needed to better define effectiveness.
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Affiliation(s)
- Luís Eduardo Silva Soares
- Graduate Program in Biomedical Engineering, University of Vale do Paraíba (UNIVAP), Research and Development Institute (IP&D). São José dos Campos, SP, Brazil; Study Group of Laser and Health Institute, São Paulo, SP, Brazil
| | - Milena Miranda Goulart Guirado
- Study Group of Laser and Health Institute, São Paulo, SP, Brazil; Doutor José de Carvalho Florence Hospital, São José dos Campos, SP, Brazil
| | | | | | | | - Inessa Solek Teixeira
- Study Group of Laser and Health Institute, São Paulo, SP, Brazil; Imperial Charity Hospital, Florianópolis, SC, Brazil
| | - Patrícia Costa Oliveira
- Study Group of Laser and Health Institute, São Paulo, SP, Brazil; Instituto Federal do Paraná, Campus Londrina, PR, Brazil
| | - Ricardo Yudi Tateno
- Graduate Program in Implantology, University of Santo Amaro, School of Dentistry. São Paulo, SP, Brazil
| | - Luiz Felipe Palma
- Graduate Dentistry Program, Ibirapuera University. São Paulo, SP, Brazil
| | - Luana Campos
- Study Group of Laser and Health Institute, São Paulo, SP, Brazil; Graduate Program in Implantology, University of Santo Amaro, School of Dentistry. São Paulo, SP, Brazil.
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