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Ervin J, Fleitas Alfonzo L, Taouk Y, Maheen H, King T. Unpaid caregiving and mental health during the COVID-19 pandemic-A systematic review of the quantitative literature. PLoS One 2024; 19:e0297097. [PMID: 38635604 PMCID: PMC11025839 DOI: 10.1371/journal.pone.0297097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 12/19/2023] [Indexed: 04/20/2024] Open
Abstract
The COVID-19 pandemic imposed additional and specific challenges on the lives and wellbeing of informal unpaid carers. Addressing an important gap in the existing literature, this systematic review (prospectively registered with PROSPERO CRD42022376012) synthesises and evaluates the quantitative evidence examining the association between unpaid caregiving and mental health (compared to non-caring), during the pandemic. Five databases were searched (Medline, PsycInfo, EMBASE, Scopus, Web of Science) from Jan 1, 2020, to March 1, 2023. Population-based, peer-reviewed quantitative studies using any observational design were included, with screening, data extraction and quality assessment (amended NOS) independently conducted by two reviewers. Of the 3,073 records screened, 20 eligible studies (113,151 participants) were included. Overall quality of evidence was moderate. Narrative synthesis was complemented by Effect-direction and Albatross plots (given significant between-study heterogeneity precluded meta-analysis). Results indicate that the mental health of informal carers, already poorer pre-COVID compared to non-caregivers, was disproportionally impacted as a result of the pandemic and its associated public health containment measures. This review highlights the vulnerability of this group and should motivate political will and commensurate policies to ensure unpaid caregivers are better supported now, in the medium term, and crucially if, and when, another global public health emergency emerges.
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Affiliation(s)
- Jennifer Ervin
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Ludmila Fleitas Alfonzo
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Yamna Taouk
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Humaira Maheen
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Tania King
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
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Worrall S, Christiansen P, Khalil A, Silverio SA, Fallon V. Associations between prematurity, postpartum anxiety, neonatal intensive care unit admission, and stress. Front Psychiatry 2024; 15:1323773. [PMID: 38463430 PMCID: PMC10921229 DOI: 10.3389/fpsyt.2024.1323773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 02/02/2024] [Indexed: 03/12/2024] Open
Abstract
Introduction It is well established that a premature birth increases the likelihood of developing anxiety during the postpartum period, and that the environment of the neonatal intensive care unit (NICU) might be a contributing factor. Mothers of earlier premature infants may experience these anxieties to a higher degree compared to mothers of later premature infants. The aim of this study was to explore the association between prematurity and postpartum-specific anxiety, and the relationship between postpartum-specific anxiety and stress in the NICU. Materials and methods Mothers (N = 237) of infants aged between birth and 12 months completed an online survey containing the Postpartum Specific Anxiety Scale - Research Short Form (PSAS-RSF) and the Parental Stressor Scale: Neonatal Intensive Care Unit (PSS:NICU). Structural equation modeling was used to analyze the relationship between gestational age and postpartum-specific anxiety, with one-way ANOVAs used to analyze this relationship with respect to categories of gestational age. Hierarchical regression models analyzed the relationship between postpartum-specific anxiety and stress in the NICU. Results For the PSAS-RSF, Practical Infant Care Anxieties (p = 0.001), Maternal Competence and Attachment Anxieties (p = 0.033), and Infant Safety and Welfare Anxieties (p = 0.020) were significantly associated with week of gestation. Practical Infant Care and Infant Safety and Welfare Anxieties were significantly higher for mothers of late premature infants, compared to mothers of term infants (p < 0.001; p = 0.019). There were no significant between-group differences with respect to Maternal Competence and Attachment Anxieties. After controlling for potential confounders, Infant Safety and Welfare Anxieties were significantly associated with increased stress in the NICU (p < 0.001) as measured by the PSS:NICU. Conclusions Our findings highlight the need for interventions for mothers with premature infants, which specifically target anxieties reflected in the PSAS-RSF, such as routine care and increasing maternal self-efficacy.
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Affiliation(s)
- Semra Worrall
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
| | - Paul Christiansen
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
| | - Asma Khalil
- Fetal Medicine Unit, Liverpool Women’s NHS Foundation Trust, Liverpool, United Kingdom
- Fetal Medicine Unit, St George’s University Hospitals NHS Foundation Trust, London, United Kingdom
| | - Sergio A. Silverio
- Department of Women & Children’s Health, School of Life Course & Population Sciences, King’s College London, London, United Kingdom
- School of Psychology, Faculty of Health, Liverpool John Moores University, Liverpool, United Kingdom
| | - Victoria Fallon
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
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Zuo T. From Tolerance for Ambiguity to Stress and Anxiety: The Mediating Role of Need for Cognitive Closure Among Chinese University Students. Psychol Rep 2023:332941231212833. [PMID: 37936412 DOI: 10.1177/00332941231212833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
Based on the Entropy Model of Uncertainty, this study examined the relationship between tolerance for ambiguity and stress and anxiety, as well as the mediating roles of overall need for cognitive closure and its dimensions in this relationship. Four hundred and eighty-eight Chinese university students were recruited online and completed the survey voluntarily and anonymously. The results of structural equation modeling revealed that tolerance for ambiguity negatively predicted students' perceived stress and anxiety. Moreover, overall need for cognitive closure, as well as its dimensions of preference for order and decisiveness played full mediating roles in this relationship. Specifically, tolerance for ambiguity negatively predicted students' overall need for cognitive closure, preference for order, preference for predictability, decisiveness, and closed-mindedness. Further, preference for order negatively predicted students' perceived stress and anxiety, while overall need for cognitive closure and decisiveness positively predicted such. However, preference for predictability and closed-mindedness were not significant predictors of perceived stress and anxiety.
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Affiliation(s)
- Tingting Zuo
- School of Psychology, Nanjing Normal University, Nanjing, China
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Kim AJ. Differential Effects of Musical Expression of Emotions and Psychological Distress on Subjective Appraisals and Emotional Responses to Music. Behav Sci (Basel) 2023; 13:491. [PMID: 37366743 DOI: 10.3390/bs13060491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 06/07/2023] [Accepted: 06/09/2023] [Indexed: 06/28/2023] Open
Abstract
This study aims to investigate how musical expressions of emotion and individuals' psychological distress impact subjective ratings of emotional response and subjective appraisals, including familiarity, complexity, and preference. A sample of 123 healthy adults participated in an online survey experiment. After listening to four music excerpts with distinct musical expressions of emotional valence and arousal in a randomized sequence. Participants rated subjective emotions of energy, tension, and valence, as well as subjective appraisals, on a visual analogue scale ranging from 0 to 100. The results of repeated measures ANOVA demonstrated significant differences in emotional responses and appraisals across the ratings for different music excerpts (p > 0.01, respectively). The generalized linear mixed model results further revealed a significant main effect of musical valence on all emotional response dimensions of energy (β = -4.73 **), tension (β = 14.31 ***), valence level (β = -18.81 ***), and subjective appraisal in terms of familiarity (β = -23.06 ***), complexity (β = -6.67 ***), and preference (β = -19.54 ***). Musical arousal showed comparable results except for effects on emotional valence ratings. However, significant effects of psychological distress regarding depression, anxiety, and stress scores were only partially observed. Findings suggest that the expression of emotions through music primarily influences emotional responses and subjective appraisals, while the influence of an individual's psychological distress level may be relatively subtle.
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Affiliation(s)
- Aimee Jeehae Kim
- Department of Musicology and Culture, Music Therapy Major, Graduate School, Dong-A University, Busan 49315, Republic of Korea
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Burke LA, Chijioke S, Le TP. Gendered racial microaggressions and emerging adult Black women's social and general anxiety: Distress intolerance and stress as mediators. J Clin Psychol 2023; 79:1051-1069. [PMID: 36413584 DOI: 10.1002/jclp.23460] [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: 03/23/2022] [Revised: 10/21/2022] [Accepted: 11/04/2022] [Indexed: 11/23/2022]
Abstract
There is robust evidence that gendered racial microaggressions affect Black women's mental health. However, few studies have examined how this form of discrimination affects Black women's social anxiety in addition to their general anxiety, as well as the underlying mechanisms related to gendered racial microaggressions and anxiety. OBJECTIVE The purpose of this study was to examine the associations between gendered racial microaggressions stress (GRMS) and gendered racial microaggressions frequency (GRMF), and Black women's social anxiety and general anxiety symptoms. We also examined the mediating roles of distress intolerance and stress in these associations. METHOD One hundred and sixty-three Black women, between the ages of 18 and 25 years old, completed a cross-sectional survey. Regression analyses were used to examine the associations between gendered racial microaggressions and social anxiety and general anxiety, and mediation analyses examined the indirect effect of gendered racial microaggressions on the outcome variables through distress intolerance and stress. RESULTS GRMS was associated with greater social and general anxiety through the mechanisms of distress intolerance and stress. GRMF was associated with reduced social anxiety and was not associated with general anxiety. CONCLUSIONS Intervention efforts should be aimed to prevent the experience of gendered racial microaggressions to prevent subsequent stress and mental health outcomes for Black women.
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Affiliation(s)
- Lindsey A Burke
- Department of Psychology, The University of Maryland, College Park, Maryland, USA
| | - Sandra Chijioke
- Department of Psychology, The University of Maryland, College Park, Maryland, USA
| | - Thomas P Le
- Department of Psychology, The University of Maryland, College Park, Maryland, USA
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Posamentier J, Seibel K, DyTang N. Preventing Youth Suicide: A Review of School-Based Practices and How Social-Emotional Learning Fits Into Comprehensive Efforts. TRAUMA, VIOLENCE & ABUSE 2023; 24:746-759. [PMID: 35139714 DOI: 10.1177/15248380211039475] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Schools in the United States increasingly incorporate social-emotional learning (SEL) as a part of comprehensive youth suicide prevention programs in schools. We reviewed the literature to investigate the inclusion of SEL in youth suicide prevention efforts. We identified several known risk factors to youth suicide, namely, hopelessness, anxiety, substance use, and child sexual abuse, then cross-walked that review to SEL competencies shown to mitigate each of those known risk factors. We found all SEL competencies, to some extent, across all the evidence-based, school-based youth suicide prevention programs we identified. Further, we found that all five SEL competencies are shown directly to address and mitigate the major, known risk factors for youth suicide. These findings suggest that SEL can play a productive role in upstream youth suicide prevention. State-level policy makers and school administrators should consider the inclusion of evidence-based SEL in efforts to address youth suicide prevention.
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Lovegrove CJ, Marsden J, Smith M, Sturkenboom I, Bannigan K. Characteristics of Occupational Therapy Interventions for Community-Dwelling Adults With Anxiety: Protocol for a Scoping Review. JMIR Res Protoc 2023; 12:e41230. [PMID: 36857111 PMCID: PMC10018378 DOI: 10.2196/41230] [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: 07/19/2022] [Revised: 12/14/2022] [Accepted: 12/14/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Anxiety is linked to decreased life quality and well-being. Living with an anxiety disorder results in higher personal and societal financial expenditure. Occupational therapists work with people living with anxiety in a variety of settings. A preliminary database search was conducted, and no current or underway systematic or scoping reviews on the topic were identified. Developing an overview of studies of occupational therapy interventions for people with anxiety is a necessary first step to understanding the existing knowledge and to increase the impact of future interventions. This scoping review will build on the findings of a previously conducted systematic review. OBJECTIVE This scoping review will identify the following: (1) what occupational therapy interventions exist for adults with anxiety and (2) the intervention characteristics including outcomes used and impact observed. METHODS This protocol was reviewed by an occupational therapist as part of a patient and public involvement consultation. The review will consider all studies and publications of occupational therapy that include community-dwelling adults with a diagnosis of anxiety who are aged 18 years and older and diagnosed with an anxiety disorder (Diagnostic and Statistical Manual of Mental Disorders [DSM-5-TR] criteria). Databases to be searched are MEDLINE, CINAHL, Cochrane Library, Science Direct, PsycArticles, Psychology & Behavioural Sciences Collection, Embase, PubMed, TRIP, Proquest, Social Care Online, JBI EBP database, OpenGrey, and OALster. Titles and abstracts will be screened against the inclusion criteria using Rayyan Qatar Computing Research Institute. Potentially relevant studies will be retrieved in full and assessed against the inclusion criteria. Articles published in English will be included. No date limiters will be used. Study selection will be completed by 2 independent reviewers. Data will be extracted using a data extraction tool. RESULTS Data will be charted using the Template for Intervention Description and Replication (TIDieR) checklist in alignment with the review objectives. The scoping review will be reported in accordance with the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols statement. CONCLUSIONS This scoping review will produce valuable information about community-based interventions used to improve participation, life quality, and well-being for adults with anxiety to support the development of occupational therapy interventions. The findings will be disseminated through professional and National Health Service bodies, employer organizations, conferences, and research articles. The findings will be of value to health care professionals and researchers working to improve the lives of people living with anxiety. TRIAL REGISTRATION Open Science Framework DOI 10.17605/OSF.IO/JS549; https://osf.io/js549/. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/41230.
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Affiliation(s)
- Christopher J Lovegrove
- School of Health Professions, University of Plymouth, Plymouth, United Kingdom.,The University of Plymouth Centre for Innovations in Health and Social Care, a Joanna Briggs Institute Centre of Excellence, Plymouth, United Kingdom.,Royal Devon University Healthcare NHS Foundation Trust, Exeter, United Kingdom
| | - Jonathan Marsden
- School of Health Professions, University of Plymouth, Plymouth, United Kingdom.,The University of Plymouth Centre for Innovations in Health and Social Care, a Joanna Briggs Institute Centre of Excellence, Plymouth, United Kingdom
| | - Mary Smith
- Exeter Health Library, Exeter, United Kingdom
| | | | - Katrina Bannigan
- The University of Plymouth Centre for Innovations in Health and Social Care, a Joanna Briggs Institute Centre of Excellence, Plymouth, United Kingdom.,Department of Occupational Therapy, Human Nutrition, and Dietetics, Glasgow Caledonian University, Glasgow, United Kingdom
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8
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Jones MC, Byun JY, Billings R, Shorten A, Kempf MC, Vance DE, Puga F. Tools for Screening and Measuring Anxiety Among Women Living with HIV of Reproductive Age: A Scoping Review. AIDS Behav 2023:10.1007/s10461-023-03990-9. [PMID: 36757556 DOI: 10.1007/s10461-023-03990-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2023] [Indexed: 02/10/2023]
Abstract
Emerging evidence suggests that women living with HIV (WLWH) may experience higher rates of anxiety than men living with HIV and women living without HIV. To date, relatively little knowledge exists on valid anxiety screening and diagnostic tools and how they are used among WLWH, specifically WLWH of reproductive age. Thus, the purpose of this scoping review was to describe what is known in the published literature about anxiety among WLWH and the tools used to measure and screen for anxiety in clinical and research contexts. The Arksey and O'Malley methodological framework was used to guide a scoping review of published articles in PsycINFO, Scopus, Sociological Abstracts, and PubMed databases. Twenty-one measures of anxiety were used across the 52 articles identified in the search. Most measures used were self-report. Inconsistencies in standardized screening tools and cutoff scores were observed across studies. Further, measures to assess anxiety varied among studies focused on WLWH. Based on the results from this review, there is a need for consistent, valid measures of anxiety to advance research and clinical practice to support the well-being of WLWH.
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Affiliation(s)
- Meghan C Jones
- School of Nursing, University of Alabama at Birmingham, 1701 University Blvd, 35294-1210, Birmingham, AL, USA.
| | - Jun Y Byun
- School of Nursing, University of Alabama at Birmingham, 1701 University Blvd, 35294-1210, Birmingham, AL, USA
| | - Rebecca Billings
- UAB Libraries, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Allison Shorten
- School of Nursing, University of Alabama at Birmingham, 1701 University Blvd, 35294-1210, Birmingham, AL, USA
| | - Mirjam-Colette Kempf
- School of Nursing, University of Alabama at Birmingham, 1701 University Blvd, 35294-1210, Birmingham, AL, USA
| | - David E Vance
- School of Nursing, University of Alabama at Birmingham, 1701 University Blvd, 35294-1210, Birmingham, AL, USA
| | - Frank Puga
- School of Nursing, University of Alabama at Birmingham, 1701 University Blvd, 35294-1210, Birmingham, AL, USA
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9
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Duarte BA, Kelly MM, Shirk SD, Chamberlin ES, Reilly ED. A quantitative and qualitative examination of the impacts of the COVID-19 pandemic on U.S. veterans with self-reported anxiety and alcohol use disorder. Front Psychiatry 2022; 13:1083212. [PMID: 36762293 PMCID: PMC9904239 DOI: 10.3389/fpsyt.2022.1083212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 12/30/2022] [Indexed: 01/19/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic generated concerns about rising stress and alcohol use, especially in U.S. veterans who experience high rates of anxiety disorders (ADs), alcohol use disorder (AUD), and dual AD+AUD diagnoses. This study investigated differences among these diagnostic groups in a veteran population related to their concern about COVID-19, impacts of COVID-19 on quality of life, and self-reported changes to urge to drink and drinking frequency. METHODS A nationally administered online survey was given to a sample of U.S. veterans reporting substance use issues during the pandemic. Differences in the level of concern about COVID-19, impacts of COVID-19 on quality of life, and drinking behaviors were examined in those self-reporting AD (n = 98), AUD (n = 46), or AD+AUD (n = 67). Consensual qualitative research was used to analyze an open-ended question about COVID-19's impact on substance use, health, and quality of life. RESULTS Veterans with AD+AUD experienced significant increases in urge to drink and alcohol consumption compared to veterans with AD only. Greater urge and frequency of drinking were associated with greater negative impacts of COVID-19 on quality of life. There were no differences among groups in global negative impact on quality of life or level of COVID-19 concern. However, respondents described specific COVID-19 worries, with qualitative findings revealing that those with AD+AUD reported a disproportionate psychosocial burden due to the pandemic. DISCUSSION Special attention in screening and treatment should be given to those with a dual AD+AUD diagnosis who may be experiencing both an increase in alcohol use and psychosocial burden as stress increases due to the pandemic.
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Affiliation(s)
- Brooke A Duarte
- Department of Psychology, Suffolk University, Boston, MA, United States
| | - Megan M Kelly
- Mental Illness Research, Education, and Clinical Center (MIRECC), VA Bedford Healthcare System, Bedford, MA, United States.,Department of Psychiatry, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Steven D Shirk
- Mental Illness Research, Education, and Clinical Center (MIRECC), VA Bedford Healthcare System, Bedford, MA, United States.,Department of Psychiatry, University of Massachusetts Chan Medical School, Worcester, MA, United States.,Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
| | - Elizabeth S Chamberlin
- Mental Illness Research, Education, and Clinical Center (MIRECC), VA Bedford Healthcare System, Bedford, MA, United States
| | - Erin D Reilly
- Mental Illness Research, Education, and Clinical Center (MIRECC), VA Bedford Healthcare System, Bedford, MA, United States.,Department of Psychiatry, University of Massachusetts Chan Medical School, Worcester, MA, United States
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Kirouac GJ. The Paraventricular Nucleus of the Thalamus as an Integrating and Relay Node in the Brain Anxiety Network. Front Behav Neurosci 2021; 15:627633. [PMID: 33732118 PMCID: PMC7959748 DOI: 10.3389/fnbeh.2021.627633] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 01/28/2021] [Indexed: 12/25/2022] Open
Abstract
The brain anxiety network is composed of a number of interconnected cortical regions that detect threats and execute appropriate defensive responses via projections to the shell of the nucleus accumbens (NAcSh), dorsolateral region of the bed nucleus of the stria terminalis (BSTDL) and lateral region of the central nucleus of the amygdala (CeL). The paraventricular nucleus of the thalamus (PVT) is anatomically positioned to integrate threat- and arousal-related signals from cortex and hypothalamus and then relay these signals to neural circuits in the NAcSh, BSTDL, and CeL that mediate defensive responses. This review describes the anatomical connections of the PVT that support the view that the PVT may be a critical node in the brain anxiety network. Experimental findings are reviewed showing that the arousal peptides orexins (hypocretins) act at the PVT to promote avoidance of potential threats especially following exposure of rats to a single episode of footshocks. Recent anatomical and experimental findings are discussed which show that neurons in the PVT provide divergent projections to subcortical regions that mediate defensive behaviors and that the projection to the NAcSh is critical for the enhanced social avoidance displayed in rats exposed to footshocks. A theoretical model is proposed for how the PVT integrates cortical and hypothalamic signals to modulate the behavioral responses associated with anxiety and other challenging situations.
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Affiliation(s)
- Gilbert J. Kirouac
- Department of Oral Biology, Dr. Gerald Niznick College of Dentistry, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
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刘 晓, 杨 洋, 周 建, 刘 建, 谭 建. [Blood pressure and heart rate changes of 640 single dental implant surgeries]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2020; 53:390-395. [PMID: 33879916 PMCID: PMC8072418 DOI: 10.19723/j.issn.1671-167x.2021.02.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To investigate the blood pressure and heart rate changes and influencing factors during single dental implant surgery. METHODS A retrospective cohort study was conducted. Six hundred and forty cases underwent single dental implant placement in Department of Prosthodontics, Peking University School and Hospital of Stomatology from January 2016 to December 2016 were recruited in this study according to the inclusion and exclusion criteria. They were divided into different groups according to the exposure factors which were patient characteristics (gender, age) and surgical procedures (immediate placement, flap elevation, bone grafting). The correlation between blood pressure and heart rate variability during single dental implant surgery and the patient characteristics and surgical procedures were analyzed. RESULTS The average systolic blood pressure variability was 9.47%±6.45% (maximum 46.04%), the average diastolic blood pressure variability was 12.18%±9.39% (maximum 88.00%), and the average heart rate variability was 10.59%±7.68% (maximum 49.12%). The effects of age and bone grafting on blood pressure variability, and of gender and immediate placement on heart rate variability, were statistically significant (P < 0.05), respectively. The incidence of abnormal intraoperative blood pressure rise was 4.69%, of which there were 4 cases (0.63%) of systolic blood pressure ≥180 mmHg and/or diastolic blood pressure ≥110 mmHg. The incidence of abnormal intraoperative heart rate rise was 6.72%. Hierarchical analysis showed a higher risk of abnormal intraoperative blood pressure rise in the elderly (≥60 years) male patients [P < 0.05, RR=3.409 (95%CI: 1.155-10.062) ] and flap elevation with bone grafting cases [P < 0.05, RR=2.382 (95%CI: 1.126-5.040)], respectively. There was no statistically significant association between abnormal heart rate rise and patient characteristics or surgical procedures (P>0.05). CONCLUSION There was a certain risk of blood pressure and heart rate variability during dental implant surgery. Elderly male patients and flap elevation with bone grafting were risk factors of abnormal intraoperative blood pressure rise.
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Affiliation(s)
- 晓强 刘
- />北京大学口腔医学院·口腔医院,修复科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 洋 杨
- />北京大学口腔医学院·口腔医院,修复科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 建锋 周
- />北京大学口腔医学院·口腔医院,修复科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 建彰 刘
- />北京大学口腔医学院·口腔医院,修复科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 建国 谭
- />北京大学口腔医学院·口腔医院,修复科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
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12
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A projection from the paraventricular nucleus of the thalamus to the shell of the nucleus accumbens contributes to footshock stress-induced social avoidance. Neurobiol Stress 2020; 13:100266. [PMID: 33344719 PMCID: PMC7739169 DOI: 10.1016/j.ynstr.2020.100266] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 10/26/2020] [Accepted: 10/28/2020] [Indexed: 12/27/2022] Open
Abstract
The paraventricular nucleus of the thalamus (PVT) is an area of the dorsal midline thalamus that contributes to footshock induced anxiety. The PVT sends a dense projection to the shell of the nucleus accumbens (NAcSh) and the present study explored if this projection is involved in the behavioral changes produced by a single exposure of rats to inescapable footshocks. The inhibitory Designer Receptors Exclusively Activated by Designer Drugs (DREADDs) hM4Di was transduced in PVT neurons that project to the NAcSh. Rats were exposed to an episode of moderately intense footshock (1.5 mA × 2 s × 5) and assigned to either high-responder (HR) or low-responder groups (LR) according to their level of fear generalization 24 h later. The effect of chemogenetic inhibition of the PVT-NAcSh projection on anxiety- and fear-like behaviors was assessed at approximately 2 weeks post-footshock. HR showed a higher level of social avoidance compared to non-shocked animals and LR. The elevated level of social avoidance was attenuated in the HR treated with the hM4Di agonist clozapine (0.01 mg/kg, i.p.) or clozapine N-oxide (CNO) administrations in the NAcSh while avoidance of open spaces and contextual fear expression were not affected. Analysis of protein product of the early to immediate gene cfos indicated that these effects were mediated by dynorphin neurons in the NAcSh. This study provides evidence for a role of a projection from the PVT to the NAcSh in stress-induced social avoidance independent of anxiety to non-social stimuli and contextual fear mechanisms.
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Liu JJW, Ein N, Gervasio J, Vickers K. Subjective and physiological responses to the 35% carbon dioxide challenge in healthy and non-clinical control populations: a meta-analysis and systematic review. ANXIETY STRESS AND COPING 2020; 32:216-230. [PMID: 30696328 DOI: 10.1080/10615806.2019.1570803] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND/RATIONALE The carbon dioxide (CO2) challenge has been reliably used in laboratory settings as a panicogen in clinical populations. However, the magnitude of these effects on healthy and non-clinical control populations are not clear. The aim of this meta-analysis and systematic review is to provide quantitative estimates of those effects. Specifically, the current paper will evaluate the relative efficacy of the CO2 challenge in eliciting both subjective and physiological arousal in healthy and non-clinical control populations. METHOD A total of 16 articles with 35 independent samples were included in the meta-analysis, while 37 studies with 74 independent samples were included in the systematic review. RESULTS Both the meta-analysis and systematic review found the CO2 challenge to elicit an increase in subjective distress via self-reported anxiety and fear. Physiological responses via blood pressure and heart rate were heterogeneous in studies sampled, with no significant changes observed across studies. Moderator analyses revealed the variations in findings may be attributed to participant screening and invasive sampling. DISCUSSION Findings highlight the CO2 challenge as a useful tool in the provocation of subjective distress. Implications for both the use of the CO2 challenge and its anticipated effects in healthy and non-clinical control populations are discussed.
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Affiliation(s)
- Jenny J W Liu
- a Department of Psychology , Ryerson University , Toronto , Canada.,b Institute for Stress and Wellbeing Research , Ryerson University , Toronto , Ontario , Canada
| | - Natalie Ein
- a Department of Psychology , Ryerson University , Toronto , Canada.,b Institute for Stress and Wellbeing Research , Ryerson University , Toronto , Ontario , Canada
| | - Julia Gervasio
- a Department of Psychology , Ryerson University , Toronto , Canada.,b Institute for Stress and Wellbeing Research , Ryerson University , Toronto , Ontario , Canada
| | - Kristin Vickers
- a Department of Psychology , Ryerson University , Toronto , Canada.,b Institute for Stress and Wellbeing Research , Ryerson University , Toronto , Ontario , Canada
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Tonetti Ciaramicoli M, Kabadayan F, Bernardi MM, Barbosa Suffredini I, Coury Saraceni CH. Diazepam as attenuator of pain induced by dentin hypersensitivity in rats exposed to stress. Arch Oral Biol 2018; 97:165-169. [PMID: 30391792 DOI: 10.1016/j.archoralbio.2018.10.033] [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: 04/26/2018] [Revised: 10/22/2018] [Accepted: 10/26/2018] [Indexed: 11/25/2022]
Abstract
The pain in dentin hypersensitivity (DH) has distinct sensory and emotional origins, with variations that occur in different intensities for each individual. The aim of this study is to evaluate the effects of diazepam in the attenuation of the pain induced by DH. DESIGN Fifty male Wistar rats were divided into five groups: control group received water ad libitum (C); stress group received water ad libitum plus stress (S); DH induced by erosion challenge with isotonic solution ad libitum (G); DH and stress (GS); and DH, stress and diazepam (GSD) groups. Animals of the GS group were exposed to the New York Subway Stress Model. Animals treated with diazepam (GSD group) received 1 mg/kg every 3 days, from the 15th day of treatment until the end of the stress-inducing period. The body weights of rats were weekly registered. After 30 days, all groups were submitted to the DH test, which was assessed using cold water stimuli, and were graded 0, 0.5, 1, 2, or 3. Dental elements were evaluated using scanning electron microscopy (SEM). RESULTS 1) Groups G and GS presented the highest DH scores, which confirms that stress increased pain response; 2) GSD group had significantly reduced DH scores compared to G and GS groups; 3) SEM of dental elements showed exposed dentin tubules in G, GS, and GSD groups, as expected. CONCLUSIONS diazepam attenuated pain induced by dentin hypersensitivity in rats exposed to stress.
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Affiliation(s)
- Márcia Tonetti Ciaramicoli
- Graduate Program in Dentistry, Paulista University - UNIP, Av. Dr. Bacelar, 1212, Vila Clementino, 04026-002, São Paulo, SP, Brazil
| | - Fernanda Kabadayan
- Graduate Program in Dentistry, Paulista University - UNIP, Av. Dr. Bacelar, 1212, Vila Clementino, 04026-002, São Paulo, SP, Brazil
| | - Maria Martha Bernardi
- Graduate Program in Dentistry, Paulista University - UNIP, Av. Dr. Bacelar, 1212, Vila Clementino, 04026-002, São Paulo, SP, Brazil
| | - Ivana Barbosa Suffredini
- Graduate Program in Dentistry, Paulista University - UNIP, Av. Dr. Bacelar, 1212, Vila Clementino, 04026-002, São Paulo, SP, Brazil; Center for Research in Biodiversity, Paulista University - UNIP, Av. Paulista, 900, 1st floor, Bela Vista, 01310-100, São Paulo, Brazil
| | - Cintia Helena Coury Saraceni
- Graduate Program in Dentistry, Paulista University - UNIP, Av. Dr. Bacelar, 1212, Vila Clementino, 04026-002, São Paulo, SP, Brazil.
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Salma RG, Abu-Naim H, Ahmad O, Akelah D, Salem Y, Midoun E. Vital signs changes during different dental procedures: A prospective longitudinal cross-over clinical trial. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 127:30-39. [PMID: 30219249 DOI: 10.1016/j.oooo.2018.08.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Revised: 07/13/2018] [Accepted: 08/03/2018] [Indexed: 01/28/2023]
Abstract
OBJECTIVES The purpose of this study was to evaluate the magnitude of vital signs changes during 3 different dental treatments. STUDY DESIGN A prospective longitudinal multiarm cross-over clinical trial was conducted. Three dental procedures were performed on each participant: supragingival scaling, dental restoration under local anesthesia (LA), and exodontia under LA. The following parameters were recorded for in each dental procedure: body temperature (BT), respiratory rate (RR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), and peripheral oxygen saturation (SpO2). Three repeated measurements of each parameter were recorded at 3 phases of each procedure. RESULTS A total of 150 dental interventions were performed on 50 patients. Scaling caused a statistically significant rise in BT, RR, and SpO2, and a reduction in HR. Restorative treatment caused a statistically significant rise in SpO2 during LA. Exodontia caused a statistically significant rise in BT, RR, SBP (during the procedure), and SpO2 (during LA). CONCLUSIONS Scaling and restorative treatment did not significantly impact heart rate. The respiratory rate may temporarily rise during LA injection and some dental procedures, especially exodontia. Increase in systolic blood pressure and heart rate during exodontia was tolerated by healthy patients.
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Affiliation(s)
- Ra'ed Ghaleb Salma
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Riyadh Elm University, Riyadh, Saudi Arabia.
| | - Horiyah Abu-Naim
- Teaching Assistant, Arab American University, Jenin, State of Palestine
| | - Osama Ahmad
- General practice, New You Medical Center, Riyadh, Saudi Arabia
| | - Doa'a Akelah
- General practice, Riyadh Elm University, Riyadh, Saudi Arabia
| | - Yasmin Salem
- General practice, Riyadh Elm University, Riyadh, Saudi Arabia
| | - Essma Midoun
- General practice, Riyadh Elm University, Riyadh, Saudi Arabia
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Chlebowy DO, Batscha C, Kubiak N, Crawford T. Relationships of Depression, Anxiety, and Stress with Adherence to Self-Management Behaviors and Diabetes Measures in African American Adults with Type 2 Diabetes. J Racial Ethn Health Disparities 2018; 6:71-76. [DOI: 10.1007/s40615-018-0500-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 04/25/2018] [Accepted: 05/07/2018] [Indexed: 12/26/2022]
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Lovegrove CJ, Bannigan K, Cheeseman D, Latour JM. The involvement of people with Parkinson’s in designing a study of the lived experience of anxiety. Br J Occup Ther 2017. [DOI: 10.1177/0308022617700654] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction Anxiety is a common non-motor symptom of Parkinson’s and is an important consideration for occupational therapists working with this population. Little is known about how people with Parkinson’s experience anxiety. A pragmatic inquiry framework and inductive approach were used to perform a patient and public consultation round to inform future occupational therapy research exploring anxiety in people with Parkinson’s. Method Seven telephone and two Skype interviews were conducted with people with Parkinson’s, who were accessed and recruited through the charity Parkinson’s UK. They were selected on the basis of their previous experience and training to participate in a consultation exercise. Thematic analysis was used to develop codes using an inductive approach. Findings Three key themes emerged: experiences of anxiety in Parkinson’s; coping with anxiety in Parkinson’s; and considerations for future research. These include timing with regards to medication ‘wearing-off’ phenomena, easy access to medications, and providing a safe, sensitive research environment. Occupational therapists need to take these findings into account when designing intervention studies. Conclusion This patient and public involvement consultation round proved valuable and the participants’ contributions will directly improve the design of future occupational therapy research exploring the lived experience of anxiety for people with Parkinson’s.
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Affiliation(s)
- Christopher J Lovegrove
- Clinical Lead Occupational Therapist in Neurology, Stroke and Neuro-rehabilitation, Royal Devon & Exeter NHS Foundation Trust, Exeter, UK
- Postgraduate student, School of Health Professions, Faculty of Health & Human Sciences, Plymouth University, UK
| | - Katrina Bannigan
- Associate Professor (Reader) of Occupational Therapy, School of Health Professions, Faculty of Health & Human Sciences, Plymouth University, UK
| | - Debbie Cheeseman
- Consultant Nurse for Older People, Royal Devon & Exeter NHS Foundation Trust, Exeter, UK
- Postgraduate student, School of Health Professions, Faculty of Health & Human Sciences, Plymouth University, UK
| | - Jos M Latour
- Professor in Clinical Nursing, School of Nursing and Midwifery, Faculty of Health & Human Sciences, Plymouth University, UK
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Wilde E, Aubdool AA, Thakore P, Baldissera L, Alawi KM, Keeble J, Nandi M, Brain SD. Tail-Cuff Technique and Its Influence on Central Blood Pressure in the Mouse. J Am Heart Assoc 2017; 6:e005204. [PMID: 28655735 PMCID: PMC5669161 DOI: 10.1161/jaha.116.005204] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Accepted: 04/24/2017] [Indexed: 12/05/2022]
Abstract
BACKGROUND Reliable measurement of blood pressure in conscious mice is essential in cardiovascular research. Telemetry, the "gold-standard" technique, is invasive and expensive and therefore tail-cuff, a noninvasive alternative, is widely used. However, tail-cuff requires handling and restraint during measurement, which may cause stress affecting blood pressure and undermining reliability of the results. METHODS AND RESULTS C57Bl/6J mice were implanted with radio-telemetry probes to investigate the effects of the steps of the tail-cuff technique on central blood pressure, heart rate, and temperature. This included comparison of handling techniques, operator's sex, habituation, and influence of hypertension induced by angiotensin II. Direct comparison of measurements obtained by telemetry and tail-cuff were made in the same mouse. The results revealed significant increases in central blood pressure, heart rate, and core body temperature from baseline following handling interventions without significant difference among the different handling technique, habituation, or sex of the investigator. Restraint induced the largest and sustained increase in cardiovascular parameters and temperature. The tail-cuff readings significantly underestimated those from simultaneous telemetry recordings; however, "nonsimultaneous" telemetry, obtained in undisturbed mice, were similar to tail-cuff readings obtained in undisturbed mice on the same day. CONCLUSIONS This study reveals that the tail-cuff technique underestimates the core blood pressure changes that occur simultaneously during the restraint and measurement phases. However, the measurements between the 2 techniques are similar when tail-cuff readings are compared with telemetry readings in the nondisturbed mice. The differences between the simultaneous recordings by the 2 techniques should be recognized by researchers.
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Affiliation(s)
- Elena Wilde
- Vascular Biology and Inflammation Section, BHF Cardiovascular Centre of Research Excellence, Cardiovascular Division, King's College London, London, United Kingdom
| | - Aisah A Aubdool
- Vascular Biology and Inflammation Section, BHF Cardiovascular Centre of Research Excellence, Cardiovascular Division, King's College London, London, United Kingdom
| | - Pratish Thakore
- Pharmaceutical Sciences Division, King's College London, London, United Kingdom
| | - Lineu Baldissera
- Vascular Biology and Inflammation Section, BHF Cardiovascular Centre of Research Excellence, Cardiovascular Division, King's College London, London, United Kingdom
| | - Khadija M Alawi
- Vascular Biology and Inflammation Section, BHF Cardiovascular Centre of Research Excellence, Cardiovascular Division, King's College London, London, United Kingdom
| | - Julie Keeble
- Pharmaceutical Sciences Division, King's College London, London, United Kingdom
| | - Manasi Nandi
- Pharmaceutical Sciences Division, King's College London, London, United Kingdom
| | - Susan D Brain
- Vascular Biology and Inflammation Section, BHF Cardiovascular Centre of Research Excellence, Cardiovascular Division, King's College London, London, United Kingdom
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