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Kawase F, Masaki Y, Ozawa H, Imanaka M, Sugiyama A, Wada H, Kobayashi S, Tsukahara T. Association of resting energy expenditure with phase angle in hospitalized older patients: a cross-sectional analysis. Eur J Clin Nutr 2024; 78:187-192. [PMID: 37990127 DOI: 10.1038/s41430-023-01370-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 11/01/2023] [Accepted: 11/09/2023] [Indexed: 11/23/2023]
Abstract
BACKGROUND/OBJECTIVES Resting energy expenditure (REE) constitutes the largest component of total energy expenditure and undergoes an age-related decline that is unexplained by decreased fat-free mass. Phase angle (PhA) is a cellular health indicator that is possibly associated with REE. We investigated the association of REE and PhA in hospitalized older adults. SUBJECTS/METHODS This single-center, cross-sectional analysis utilized the baseline data from a prospective longitudinal study and included 131 eligible patients aged ≥70 years. The REE was measured using indirect calorimetry, and PhA and body composition were assessed using bioelectrical impedance. The association between REE, PhA, and body composition was examined, and REE was compared using previously reported PhA cutoff values. RESULTS In this cohort with a mean (±standard deviation) age of 87.4 (±7.0) years, 34.4% of the participants were men. REE and PhA correlated strongly (r: 0.562, p < 0.001) and significantly after adjusting for age and sex (r: 0.433, p < 0.001). Multivariate analysis showed a significant independent association between REE and PhA and skeletal muscle mass (standardized β [95% CI]; 28.072 [2.188-53.956], p = 0.035) without any significant interaction between PhA and age on REE. The low PhA group had a significantly lower REE (kcal/day; 890 [856-925] vs. 1077 [1033-1122], p < 0.001), and this remained significant after adjusting for age, sex, and skeletal muscle mass index. CONCLUSIONS PhA is associated with REE in older adults. Adjusting REE calculation algorithms based on PhA values and correcting predicted REE according to PhA may aid in determining more accurate energy requirements.
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Affiliation(s)
- Fumiya Kawase
- Department of Nutrition, Asuke Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Toyota, Aichi, Japan.
- Graduate School of Nutritional Science, Nagoya University of Arts and Sciences, Nisshin, Aichi, Japan.
| | - Yoshiyuki Masaki
- Department of Internal Medicine, Asuke Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Toyota, Aichi, Japan
- Department of Community-Based Medical Education, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Hiroko Ozawa
- Department of Nursing, Asuke Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Toyota, Aichi, Japan
| | - Manami Imanaka
- Department of Nursing, Asuke Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Toyota, Aichi, Japan
| | - Aoi Sugiyama
- Department of Nursing, Asuke Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Toyota, Aichi, Japan
| | - Hironari Wada
- Department of Rehabilitation Therapy, Asuke Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Toyota, Aichi, Japan
| | - Shinya Kobayashi
- Department of Internal Medicine, Asuke Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Toyota, Aichi, Japan
| | - Takayoshi Tsukahara
- Graduate School of Nutritional Science, Nagoya University of Arts and Sciences, Nisshin, Aichi, Japan
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de Lima Macena M, Tenório da Costa Paula D, da Silva Júnior AE, Rodrigues Silva Praxedes D, Bueno NB. Longitudinal estimates of resting energy expenditure using predictive equations in individuals with excess weight after weight loss: A systematic review with meta-analysis. Clin Nutr ESPEN 2023; 58:263-269. [PMID: 38057015 DOI: 10.1016/j.clnesp.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/11/2023] [Accepted: 10/06/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND & AIMS To determine which resting energy expenditure (REE) predictive equation has the lowest bias in the aggregate level in individuals with excess weight during weight loss interventions. METHODS Searches were performed in MEDLINE, Web of Science, Scopus, CENTRAL and gray literature databases. Longitudinal studies on weight loss interventions which evaluated REE by predictive equations compared to that measured by indirect calorimetry in adults with excess weight at different follow-up times were included. Meta-analyses were performed with the differences between biases of predictive equations of the REE at the different follow-up times of weight loss. RESULTS Of the total of 2178 occurrences found in the databases, only eight studies were included. The Harris-Benedict (1919) equation showed the smallest differences between bias up to the third month (MD = 103.33 kcal; 95%CI = -39.01; 245.67), in the sixth month (MD = 59.16 kcal; 95%CI = 8.74; 109.57) and at the 12th month (MD = -71.41 kcal; 95%CI = -150.38; 7.55) of weight loss follow-up. Weight loss does not seem to have an effect on bias at different follow-up times. CONCLUSION Harris-Benedict (1919) equation seems to be the most adequate to assess the REE of individuals with excess weight during weight loss. However, the finding of large estimated predictive intervals may indicate that predictive equations may not be handy tools for individuals losing and regaining weight due to changes other than body weight.
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Affiliation(s)
- Mateus de Lima Macena
- Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil; Laboratório de Nutrição e Metabolismo, Faculdade de Nutrição, Universidade Federal de Alagoas, Maceió, Alagoas, Brazil
| | | | - André Eduardo da Silva Júnior
- Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil; Laboratório de Nutrição e Metabolismo, Faculdade de Nutrição, Universidade Federal de Alagoas, Maceió, Alagoas, Brazil
| | - Dafiny Rodrigues Silva Praxedes
- Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil; Laboratório de Nutrição e Metabolismo, Faculdade de Nutrição, Universidade Federal de Alagoas, Maceió, Alagoas, Brazil
| | - Nassib Bezerra Bueno
- Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil; Laboratório de Nutrição e Metabolismo, Faculdade de Nutrição, Universidade Federal de Alagoas, Maceió, Alagoas, Brazil.
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Danielewicz AL, Lazzer S, Marra A, Abbruzzese L, D’Alleva M, Martino MD, Isola M, Avelar NCP, Mendonça VA, Lacerda ACR, Sartorio A. Prediction of resting energy expenditure in Italian older adults with severe obesity. Front Endocrinol (Lausanne) 2023; 14:1283155. [PMID: 38027183 PMCID: PMC10663312 DOI: 10.3389/fendo.2023.1283155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Abstract
Background In the last decade a large number of studies proposed and/or validated equations to estimate the Resting Energy Expenditure (REE) in adults and/or older adults, however, no equation currently available showed good accuracy for older adults with severe obesity. Thus, this study aimed to develop and validate new predictive equations for REE, based on data from the indirect calorimetry, in Italian older adults with severe obesity. Methods A retrospective study was as conducted with 764 Caucasian older adults with severe obesity (age range: 60-74 years and BMI ≥ 35 kg/m/²). Four models were used to test the accuracy of anthropometry and body composition variables in multivariable prediction of REE. All models were derived by stepwise multiple regression analysis using a calibration group of 382 subjects [295 females and 87 males] and the equations were cross-validated in the remaining 382 subjects [295 females and 87 males] as validation group. The new prediction equations and the other published equations were tested using the Bland-Altman method. Prediction accuracy was defined as the percentage of subjects whose REE was predicted within ± 10% of measured REE. Results All the equations analyzed predicted higher energy requirements for males than females, and most of them underestimated the energy requirement values of our sample. The highest accuracy values were observed in the new equations, with 62% in the anthropometric model and 63% in the body composition model. Conclusion Although the accuracy of our equations was slightly higher in comparison with the other taken into consideration, they cannot be considered completely satisfactory for predicting REE in Italians older adults with severe obesity. When predicting equations cannot guarantee precise or acceptable values of REE, the use of indirect calorimetry (if available) should be always recommended, especially in clinical practice.
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Affiliation(s)
- Ana Lúcia Danielewicz
- Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Experimental Laboratory for Auxo-endocrinological Research, Piancavallo-Verbania, Italy
- Department of Health Sciences, Graduate Program in Rehabilitation Sciences, Federal University of Santa Catarina, Araranguá, Santa Catarina, Brazil
| | - Stefano Lazzer
- Department of Medicine, University of Udine, Udine, Italy
- School of Sport Science, University of Udine, Udine, Italy
| | - Alice Marra
- Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Experimental Laboratory for Auxo-endocrinological Research, Piancavallo-Verbania, Italy
| | - Laura Abbruzzese
- Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Division of Eating and Nutrition Disorders, Piancavallo-Verbania, Italy
| | - Mattia D’Alleva
- Department of Medicine, University of Udine, Udine, Italy
- School of Sport Science, University of Udine, Udine, Italy
| | | | - Miriam Isola
- Department of Medicine, University of Udine, Udine, Italy
| | - Núbia Carelli Pereira Avelar
- Department of Health Sciences, Graduate Program in Rehabilitation Sciences, Federal University of Santa Catarina, Araranguá, Santa Catarina, Brazil
| | - Vanessa Amaral Mendonça
- Department of Physiotherapy, Federal University of the Jequitinhonha and Mucuri Valleys, Diamantina, Minas Gerais, Brazil
| | - Ana Cristina Rodrigues Lacerda
- Department of Physiotherapy, Federal University of the Jequitinhonha and Mucuri Valleys, Diamantina, Minas Gerais, Brazil
| | - Alessandro Sartorio
- Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Experimental Laboratory for Auxo-endocrinological Research, Piancavallo-Verbania, Italy
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Detopoulou P, Tsiouda T, Pilikidou M, Palyvou F, Mantzorou M, Perzirkianidou P, Kyrka K, Methenitis S, Kondyli FS, Voulgaridou G, Zarogoulidis P, Matthaios D, Oikonomidou R, Romanidou M, Giannakidis D, Papadopoulou SK. Dietary Habits Are Related to Phase Angle in Male Patients with Non-Small-Cell Lung Cancer. Curr Oncol 2022; 29:8074-8083. [PMID: 36354697 PMCID: PMC9689548 DOI: 10.3390/curroncol29110637] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 10/18/2022] [Accepted: 10/22/2022] [Indexed: 11/05/2022] Open
Abstract
Introduction: Lung cancer constitutes the most common cause of cancer death. Phase angle (PhA) has been related to lung cancer prognosis, which implies that the identification of dietary or other factors that could predict or modify PhA may have beneficial effects. Νutritional interventions have been linked with positive changes in PhA in certain types of cancer. Aim: The present study aimed to investigate the relationships between dietary habits/nutrition and PhA in NSCLC patients. Methods: The sample consisted of 82 male patients with non-small-cell lung cancer (NSCLC; stage IV) from the 'Theageneio' Cancer Hospital (Thessaloniki, Greece). Several parameters were assessed, such as body mass index (BMI), lean mass, PhA, Mediterranean diet score (MedDietScore), dietary patterns, smoking, resting metabolic rate, resting oxygen consumption (VO2), ventilation rate, and physical activity. Results: According to our results, a dietary pattern rich in potatoes and animal proteins (meat and poultry) was a significant determinant of PhA (B ± SE, p: 0.165 ± 0.08, p = 0.05) in multiple linear regression models after adjusting for age, smoking, lean tissue, and MedDietScore. Conclusion: In conclusion, dietary patterns may affect PhA, suggesting the crucial role of protein in cancer management and the prevention of sarcopenia.
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Affiliation(s)
- Paraskevi Detopoulou
- Department of Clinical Nutrition, General Hospital Korgialenio Benakio, 11526 Athens, Greece
- Department of Nutritional Sciences and Dietetics, University of the Peloponnese, 24100 Kalamata, Greece
| | - Theodora Tsiouda
- Pulmonary-Oncology Department, ‘Theageneio’ Cancer Hospital, 54007 Thessaloniki, Greece
| | - Maria Pilikidou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece
| | - Foteini Palyvou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece
| | - Maria Mantzorou
- Department of Food Science and Nutrition, University of Aegean, 81400 Lemnos, Greece
| | | | - Krystallia Kyrka
- Pulmonary-Oncology Department, ‘Theageneio’ Cancer Hospital, 54007 Thessaloniki, Greece
| | - Spyridon Methenitis
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece
- Sports Performance Laboratory, School of Physical Education and Sports Science, National and Kapodistrian University of Athens, 15772 Athens, Greece
- Theseus, Physical Medicine and Rehabilitation Center, 17671 Athens, Greece
| | - Foivi S. Kondyli
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece
| | - Gavriela Voulgaridou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece
| | - Paul Zarogoulidis
- Pulmonary Department, General Clinic Euromedica Private Hospital, 54645 Thessaloniki, Greece
- 3rd Surgery Department, AHEPA University Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
- Correspondence:
| | | | | | - Maria Romanidou
- Dietitian, Adult Eating Disorders Service, Essex Partnership University NHS Foundation Trust, Wickford SS11 7XX, UK
| | - Dimitrios Giannakidis
- 1st Department of Surgery, Attica General Hospital “Sismanogleio—Amalia Fleming”, 15126 Athens, Greece
| | - Sousana K. Papadopoulou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece
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Iaccarino Idelson P, Speranza E, Marra M, Pasanisi F, Sammarco R, Galletti F, Strazzullo P, Barbato A. Evaluation of the Nutritional Status of Gaucher Disease Type I Patients under Enzyme Replacement Treatment. Nutrients 2022; 14:nu14153180. [PMID: 35956356 PMCID: PMC9370155 DOI: 10.3390/nu14153180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 07/28/2022] [Accepted: 07/31/2022] [Indexed: 12/04/2022] Open
Abstract
(1) Background: Gaucher disease (GD) is a rare lysosomal storage disease. The few studies analyzing Resting Energy Expenditure (REE) in GD involved mainly untreated patients and supported a hypermetabolic condition possibly due to the associated inflammatory state. Definitive conclusions could not be drawn also because of the heterogeneity and the small size of the samples investigated. In order to expand current knowledge concerning, in particular the condition of patients under Enzyme Replacement Therapy (ERT), we evaluated the nutritional status of a relatively large sample of GD patients followed at Federico II University Hospital in Naples, Italy. (2) Methods: The study, having a cross-sectional design and involving 26 patients on ERT, included routine biochemical analyses, bioelectrical impedance analysis, indirect calorimetry, and administration of food frequency and physical activity questionnaires. The results in GD patients were compared with those from an appropriate control group. (3) Results: GD patients had normal biochemical parameters in 80% of cases, except for HDL-cholesterol, consumed a hyper-lipidic diet, and had a 60% prevalence of overweight/obesity. Body composition did not differ between patients and controls; however, measured REE was significantly lower than predicted and was reduced in comparison with the healthy controls. (4) Conclusions: This study provided novel elements to the present knowledge about REE and the nutritional status of GD patients under ERT. Its results warrant confirmation in even larger GD population samples and a more in-depth investigation of the long-term effects of treatment superimposed on the basic pathophysiological disease condition.
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Fernández-Verdejo R, Galgani JE. Predictive equations for energy expenditure in adult humans: From resting to free-living conditions. Obesity (Silver Spring) 2022; 30:1537-1548. [PMID: 35854398 DOI: 10.1002/oby.23469] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 03/01/2022] [Accepted: 03/02/2022] [Indexed: 11/06/2022]
Abstract
Humans acquire energy from the environment for survival. A central question for nutritional sciences is how much energy is required to sustain cellular work while maintaining an adequate body mass. Because human energy balance is not exempt from thermodynamic principles, the energy requirement can be approached from the energy expenditure. Conceptual and technological advances have allowed understanding of the physiological determinants of energy expenditure. Body mass, sex, and age are the main factors determining energy expenditure. These factors constitute the basis for predictive equations for resting (REE) and total (TEE) energy expenditure in healthy adults. These equations yield predictions that differ up to ~400 kcal/d for REE and ~550 kcal/d for TEE. Identifying additional factors accounting for such variability and the most valid equations appears relevant. This review used novel approaches based on mathematical modeling of REE and analyses of the data from which REE predictive equations were generated. As for TEE, R2 and SE were considered because only a few predictive equations are available. From these analyses, Oxford's and Plucker's equations appear valid for predicting REE and TEE in adults, respectively.
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Affiliation(s)
- Rodrigo Fernández-Verdejo
- Carrera de Nutrición y Dietética, Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Laboratorio de Fisiología del Ejercicio y Metabolismo (LABFEM), Escuela de Kinesiología, Facultad de Medicina, Universidad Finis Terrae, Santiago, Chile
| | - José E Galgani
- Carrera de Nutrición y Dietética, Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Departamento de Nutrición, Diabetes y Metabolismo, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
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Marra M, Di Vincenzo O, Cioffi I, Sammarco R, Morlino D, Scalfi L. Resting energy expenditure in elite athletes: development of new predictive equations based on anthropometric variables and bioelectrical impedance analysis derived phase angle. J Int Soc Sports Nutr 2021; 18:68. [PMID: 34702296 PMCID: PMC8549253 DOI: 10.1186/s12970-021-00465-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 10/04/2021] [Indexed: 12/16/2022] Open
Abstract
Background An accurate estimation of athletes’ energy needs is crucial in diet planning to improve sport performance and to maintain an appropriate body composition. This study aimed to develop and validate in elite athletes new equations for estimating resting energy expenditure (REE) based on anthropometric parameters as well as bioimpedance analysis (BIA)-derived raw variables and to validate the accuracy of selected predictive equations. Methods Adult elite athletes aged 18–40 yrs were studied. Anthropometry, indirect calorimetry and BIA were performed in all subjects. The new predictive equations were generated using different regression models. The accuracy of the new equations was assessed at the group level (bias) and at the individual level (precision accuracy), and then compared with the one of five equations used in the general population or three athletes-specific formulas. Results One-hundred and twenty-six male athletes (age 26.9 ± 9.1 yrs; weight 71.3 ± 10.9 kg; BMI 22.8 ± 2.7 kg/m2) from different sport specialties were randomly assigned to the calibration (n = 75) or validation group (n = 51). REE was directly correlated with individual characteristics, except for age, and raw BIA variables. Most of the equations from the literature were reasonably accurate at the population level (bias within ±5%). The new equations showed a mean bias −0.3% (Eq. A based on anthropometric parameters) and −0.6% (Eq. B based on BIA-derived raw variables). Precision accuracy (individual predicted-measured differences within ±5%) was ~75% in six out of eight of the selected equations and even higher for Eq. A (82.4%) and Eq. B (92.2%). Conclusion In elite athletes, BIA-derived phase angle is a significant predictor of REE. The new equations have a very good prediction accuracy at both group and individual levels. The use of phase angle as predictor of REE requires further research with respect to different sport specialties, training programs and training level.
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Affiliation(s)
- Maurizio Marra
- Department of Clinical Medicine and Surgery, Federico II University of Naples, Via S. Pansini 5, 80138, Naples, Italy.
| | - Olivia Di Vincenzo
- Department of Clinical Medicine and Surgery, Federico II University of Naples, Via S. Pansini 5, 80138, Naples, Italy
| | - Iolanda Cioffi
- Department of Clinical Medicine and Surgery, Federico II University of Naples, Via S. Pansini 5, 80138, Naples, Italy
| | - Rosa Sammarco
- Department of Clinical Medicine and Surgery, Federico II University of Naples, Via S. Pansini 5, 80138, Naples, Italy
| | - Delia Morlino
- Department of Clinical Medicine and Surgery, Federico II University of Naples, Via S. Pansini 5, 80138, Naples, Italy
| | - Luca Scalfi
- Department of Public Health, Federico II University of Naples, Via S. Pansini 5, 80138, Naples, Italy
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