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Park SJ, Yoo KH. One-Year Safety Evaluation of New Hyaluronic Acid Fillers (YYS Series): A Prospective, Multicenter, Observational Study. Dermatol Surg 2024; 50:731-738. [PMID: 38595129 PMCID: PMC11288390 DOI: 10.1097/dss.0000000000004190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
BACKGROUND With the continuous increasing availability of new filler products, each hyaluronic acid filler brand has distinctive pharmacokinetics, which may be associated with different complications. Therefore, the long-term safety of new generations of fillers should be evaluated. OBJECTIVE This prospective, multicenter, observational, postmarketing study ( ClinicalTrials.gov identifier: NCT04738019) aimed to investigate the incidence of delayed-onset nodules and adverse reactions after the injection of new hyaluronic acid fillers (YYS series) into the facial skin. METHODS Subjects scheduled to receive an injection YYS series filler were followed up for 52 weeks. The authors aimed to determine the incidence of a self-reported delayed-onset nodule-a visible or palpable nodule or mass at the injection site that was detected beyond the 14th day following the injection-during the 1-year follow-up period. RESULTS Among the 1,022 subjects who received an injection of the YYS series, the incidences of delayed-onset nodules were 0% for YYS 360, YYS 540, and YYS 720. A 0.21% incidence (1 delayed hypersensitivity reaction) of a delayed-onset adverse reaction was noted for YYS 720, although none were reported for YYS 360 and YYS 540. CONCLUSION In this study, a notably low frequency of adverse reactions associated with the YYS series was observed.
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Affiliation(s)
- Su Jung Park
- Department of Dermatology, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
| | - Kwang Ho Yoo
- Department of Dermatology, College of Medicine, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong-si, Republic of Korea
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2
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McKenzie S, Wang J, Mora Hurtado AC, Uppal P, Taylor SC, Elbuluk N. Cosmetic injectables in skin of color: A review of uses, safety, and effectiveness of neuromodulators and dermal fillers. J Cosmet Dermatol 2024; 23:2345-2360. [PMID: 38553836 DOI: 10.1111/jocd.16297] [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: 08/05/2023] [Revised: 01/20/2024] [Accepted: 03/12/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND Skin of color (SOC) individuals represent a growing market for cosmetic injectables and can have different aesthetic goals and responses to treatment. OBJECTIVE A review of the uses, safety, and effectiveness of injectable neuromodulators and dermal fillers in SOC individuals. METHODS AND MATERIALS A search of the PubMed/MEDLINE database was conducted from August 1960 to December 2020. Studies that were included either had a focus on SOC (>20% SOC study participants) or dedicated article content commenting on the safety and/or efficacy of injectables in SOC participants. RESULTS Of the 503 publications identified, a total of 88 articles were selected for this review. Differences in aging and cultural factors can influence aesthetic goals amongst SOC populations. Available data suggests that botulinum toxin (BTX) and dermal fillers are safe and effective in SOC populations, with the largest amount of data existing for Asian populations. There remains a paucity of research on Black and Latinx populations. CONCLUSION BTX and dermal fillers are generally effective and well tolerated in SOC populations, particularly Asian populations for which the greatest amount of data exists. More high quality, randomized controlled trials in Black and Latinx populations are warranted.
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Affiliation(s)
- Shanice McKenzie
- Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Jason Wang
- Department of Dermatology, University of California San Francisco, San Francisco, California, USA
| | | | - Pushpinder Uppal
- Department of Anesthesia, University of Maryland, Baltimore, Maryland, USA
| | - Susan C Taylor
- Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Nada Elbuluk
- Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
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3
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Han HS, Kim BR, Kim M, Na JI, Seo SB, Huh CH, Shin JW. Needleless laser injector versus needle injection for skin enhancement and rejuvenation effect of dermal filler. Lasers Surg Med 2023; 55:809-816. [PMID: 37632290 DOI: 10.1002/lsm.23719] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 07/11/2023] [Accepted: 08/13/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND AND OBJECTIVES A needleless laser-induced microjet injector is a novel transdermal drug delivery system that can rapidly inject a very small and precise drug dose into the skin with minimal pain and downtime. In this study, we aimed to compare the laser-induced microjet injection versus needle injection of polylactic acid/hyaluronic acid filler for skin enhancement and rejuvenation. PATIENTS AND METHODS A 24-week prospective, single-center, assessor-blinded, randomized, split-face study was conducted. The enrolled patients underwent one treatment session of dermal filler injection using a laser-induced microjet injector on one half of the face or a traditional needle injection on the other half of the face. Evaluation was conducted at baseline before treatment and at 4, 12, and 24 weeks after treatment. RESULTS A single treatment of filler injection with a laser-induced microjet injector resulted in similar improvements in skin hydration and elasticity as a single treatment of filler injection by using manual needle injection, with reduced pain, side effects, and decreased treatment time. CONCLUSIONS Laser-induced microjet injector enabled not only the application of a controlled dose and filler depth but also even distribution, improved clinical efficacy, reduced pain and side effects, and sufficient time for clinicians to perform treatment.
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Affiliation(s)
- Hye Sung Han
- Department of Dermatology, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, Gyeonggi-do, Korea
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
| | - Bo Ri Kim
- Department of Dermatology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Minjae Kim
- Department of Dermatology, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea
| | - Jung-Im Na
- Department of Dermatology, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea
| | | | - Chang-Hun Huh
- Department of Dermatology, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea
| | - Jung-Won Shin
- Department of Dermatology, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea
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Parikh AO, Conger JR, Sibug Saber ME, Samimi D, Burnstine MA. Multiple Cases of Facial Disfigurement From Filler Use and One Injector. Ophthalmic Plast Reconstr Surg 2023; 39:366-369. [PMID: 36735327 DOI: 10.1097/iop.0000000000002323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
PURPOSE To present a case of facial disfigurement from an injectable permanent filler and describe the consequences to patients exposed to the same injector (common source outbreak). METHODS Case report and discussion of a common source outbreak after a group of persons developed complications years after permanent filler given by one injector. RESULTS A 39-year-old transgender model underwent polymethylmethacrylate (Artefill) facial filler injections to the lips, cheeks, and chin in 2018. A year later, the patient presented to the emergency room with severe facial swelling and difficulty breathing. Treatments have included 4 surgeries to remove filler and scar tissue and chronic low-dose oral steroid therapy. Upon questioning the patient, 6 additional people suffered from similar facial swelling years after injection by the same injector. The injector cannot be located. CONCLUSIONS Care must be taken in giving all facial fillers, particularly permanent ones. When one source patient is identified, questioning the patient's knowledge of others affected is critical to help manage an epidemic problem and to report a rogue injector. Physicians have a duty to investigate and report such cases.
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Affiliation(s)
- Alomi O Parikh
- USC Roski Eye Institute, University of Southern California Keck School of Medicine, Los Angeles, California
| | - Jordan R Conger
- USC Roski Eye Institute, University of Southern California Keck School of Medicine, Los Angeles, California
- Eyesthetica, Los Angeles, California
| | - Maria E Sibug Saber
- USC Roski Eye Institute, University of Southern California Keck School of Medicine, Los Angeles, California
- Department of Pathology, University of Southern California Keck School of Medicine, Los Angeles, California, U.S.A
| | - David Samimi
- USC Roski Eye Institute, University of Southern California Keck School of Medicine, Los Angeles, California
- Eyesthetica, Los Angeles, California
| | - Michael A Burnstine
- USC Roski Eye Institute, University of Southern California Keck School of Medicine, Los Angeles, California
- Eyesthetica, Los Angeles, California
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Arici C, Tosuner Z. Infraorbital mass long after dermal filler injection: A report of two cases. J Cosmet Dermatol 2023; 22:1245-1248. [PMID: 36606376 DOI: 10.1111/jocd.15583] [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: 09/15/2022] [Revised: 11/21/2022] [Accepted: 12/11/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Hyaluronic acid fillers have been increasingly used throughout the world in the management of aging skin in the periocular region and other areas. OBJECTIVE To evaluate very late-term orbital mass formation secondary to Hyaluronic acid filler injection into the inferior eyelid. METHODS We report two cases that presented with a subcutaneous palpable mass localized at the right medial lower infraorbital area. Following clinical and radiological examination, surgical excision was required for the differential diagnosis of tumor. RESULTS After pathologic examination and the finding of a foreign-body granulomatous reaction, both patients recalled that hyaluronic acid filler had once been injected into their lower eyelids approximately 10 years prior. This is consistent with the fact that dermal-filler-related granuloma formation may occur even years later in the differential diagnosis of mass lesions. CONCLUSION It is suggested that patients be informed about the possible but rare mass effect in the infraorbital region. Clinicians should also attend to delayed hypersensitivity reactions, since patients may not recall details due to the length of time since injection.
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Affiliation(s)
- Ceyhun Arici
- Department of Ophthalmology, Cerrahpaşa Medical Faculty, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Zeynep Tosuner
- Department of Pathology, Acibadem Health Group, Istanbul, Turkey
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Dryden SC, Gabbard RD, Meador AG, Stoner AE, Klippenstein KA, Wesley RE. A Case of Orbital Granuloma Secondary to Dermal Filler Injection. Cureus 2021; 13:e20606. [PMID: 35103182 PMCID: PMC8781651 DOI: 10.7759/cureus.20606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2021] [Indexed: 11/22/2022] Open
Abstract
A foreign body granulomatous reaction is a rare complication of the subcutaneous injection of fillers. We describe a 57-year-old female that presented with a six-month history of a non-painful, right lower eyelid mass. She had a dermal filler in the zygomatic region several months before the onset of her symptoms. Anterior orbitotomy and pathology revealed multinuclear giant cells consistent with a hyaluronic acid-based filler. This case describes the clinical presentation, histopathologic features, and treatment of an orbital granuloma secondary to dermal filler injection. Our case was uncommon because the zygomatic filler migrated across the orbital septum. Additionally, transconjunctival orbitotomy was used instead of a hyaluronidase injection due to the inferior location of the granuloma.
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Affiliation(s)
| | - Ryan D Gabbard
- Ophthalmology, Prisma Health/University of South Carolina, Columbia, USA
| | | | - Alison E Stoner
- Pathology and Laboratory Medicine, PathGroup, Brentwood, USA
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Trinh LN, McGuigan KC, Gupta A. Delayed Complications following Dermal Filler for Tear Trough Augmentation: A Systematic Review. Facial Plast Surg 2021; 38:250-259. [PMID: 34666405 DOI: 10.1055/s-0041-1736390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Tear trough deformity is a popular target for the treatment with filler injections. The side effects are generally mild and transient. However, delayed complications may occur. We aim to perform a thorough systematic review of the published literature related to delayed complications after tear trough filler injections. A search of published literature was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in June 2021 and included PubMed, ScienceDirect, and Embase databases. The Medical Subject Headings (MeSH) terms used included the following terms: delayed complications, nodules, granulomas, swelling, discoloration, dermal filler, hyaluronic acid (HA), polyacrylamide, calcium hydroxyapatite (CaHA), poly-L-lactic acid (PLLA), eyelid, periorbital, periocular, and tear trough. Twenty-eight articles consisting of 52 individual cases were included in the final analysis. 98% (51/52) of patients were female and had an average age of 48.3 years. HA was the most reported product (71.2%, 37/52), followed by PLLA (4/52, 7.7%), and CaHA (4/52, 7.7%). The most common delayed complication with any dermal filler was swelling (42.3%, 22/52) followed by lumps or nodules (25.0%, 13/52). Xanthelasma-like reaction (17.3%, 9/52), migration (7.7%, 4/52), discoloration (3%, 3/52) also occurred. The average time of onset of any complication was 16.8 months with xanthelasma-like reaction appearing soonest (mean: 10 months) and discoloration appearing latest (mean: 52 months). Most swelling cases were caused by HA. Semi-permanent fillers such as PMMA and synthetic fillers such as PLLA were more likely to be associated with lumps and nodules than other complications. It is important that clinicians who perform tear trough augmentation with dermal fillers have a thorough understanding of the risks of the procedure to diagnose and manage them promptly as well as provide patients with accurate information regarding the potential adverse effects.
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Affiliation(s)
- Lily Nguyen Trinh
- School of Medicine, Tulane University School of Medicine, New Orleans, Louisiana.,Department of Otolaryngology-Head and Neck Surgery, Mass Eye and Ear, Boston, Massachusetts
| | - Kelly C McGuigan
- School of Medicine, Thomas Jefferson University Sidney Kimmel Medical College, Philadelphia, Pennsylvania
| | - Amar Gupta
- Department of Otolarynology, Private Practice-Head and Neck Surgery, Los Angeles, California
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Gorbea E, Kidwai S, Rosenberg J. Nonsurgical Tear Trough Volumization: A Systematic Review of Patient Satisfaction. Aesthet Surg J 2021; 41:NP1053-NP1060. [PMID: 33693530 DOI: 10.1093/asj/sjab116] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Nonsurgical rejuvenation of the tear trough area via the use of injectable filler material has become a popular procedure in facial rejuvenation. This procedure offers immediate, albeit temporary, results with minimal recovery time. OBJECTIVES The aim of this systematic review was to report on patient satisfaction and complication rates to further guide practitioners. METHODS PubMed, Cochrane, and Scopus libraries were queried for articles containing relevant terms. Articles with more than 5 patients who reported on satisfaction and/or complications from the procedure were included for review. In addition to these variables, we noted other aspects of injection, including filler material, technique, and needle or cannula delivery. Studies that did not otherwise fulfill inclusion criteria for statistical analysis but reported on intravascular injection-related complications were cited. RESULTS Initial query resulted in 1655 studies which were assessed for duplicates and inclusion/exclusion criteria. After screening, 28 articles were included for analysis. In total, 1956 patients were captured who had been injected with 1 of 4 materials: hyaluronic acid (1535), calcium hydroxyapatite (376), autologous fibroblast/keratin gel (35), and collagen-based filler (10). Short- and long-term satisfaction rates were 84.4% and 76.7%, respectively. Minor complications were common (44%). Secondarily, we found the use of cannula for filler injection of this region to be associated with a lower rate of ecchymosis (7% vs 17%, P < 0.05). CONCLUSIONS Filler injection volumization of tear trough deformity is an effective technique for facial rejuvenation associated with high patient satisfaction. Multiple filler materials offer acceptable satisfaction and complication profiles. LEVEL OF EVIDENCE: 4
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Affiliation(s)
- Enrique Gorbea
- Department of Otolaryngology, Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sarah Kidwai
- Department of Otolaryngology-Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, University of Washington School of Medicine, Seattle, WA, USA
| | - Joshua Rosenberg
- Department of Otolaryngology, Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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The use of periocular fillers in aesthetic medicine. J Plast Reconstr Aesthet Surg 2021; 74:1602-1609. [PMID: 33546985 DOI: 10.1016/j.bjps.2020.12.079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 12/08/2020] [Accepted: 12/20/2020] [Indexed: 11/22/2022]
Abstract
The periocular area is the first to display signs of ageing. Dermal fillers are an increasingly popular, minimally invasive method for facial rejuvenation. The eye is anatomically delicate and complex. Therefore, special consideration must be taken if dermal fillers are employed. This article examines the literature to assess the efficacy and safety of dermal fillers around the eye as well as the management of complications secondary to dermal filler use, such as oedema, granuloma formation, filler migration, xanthelasma, skin necrosis and visual loss. Hyaluronic acid (HA) is the most popular and commonly employed dermal filler for periocular use. It is effective, with good observer improvement and patient satisfaction (p<0.0001). Ninety percent of adverse events are mild in nature and self-resolve within 1 month. Malar oedema is a delayed complication unique to the periocular area, occurring in 11% of patients. This can be managed with use of hyaluronidase if a HA filler has been employed. Other complications, such as granuloma formation, filler migration and xanthelasma, have also been reported with variable management outcomes. Vascular adverse events include skin necrosis and visual loss. No Level 1 evidence exists for the management of visual loss. Two cases of visual restoration have been identified in the literature; however, this is rare.
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Thanasarnaksorn W, Puttacharoenlarp P, Boonchoo K, Suwanchinda A. Case Report: The role of intradermal micro-droplet hyaluronic acid injection in the correction of filler nodules complication. Dermatol Ther 2020; 33:e14315. [PMID: 32951305 DOI: 10.1111/dth.14315] [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: 08/10/2020] [Accepted: 09/07/2020] [Indexed: 11/30/2022]
Abstract
Filler injection has been widely used as a non-surgical intervention for skin rejuvenation and augmentation for the past decade. Hyaluronic acid (HA) is considered the most common treated material with high safety profile. Various mechanisms, including promoting collagen synthesis are postulated the efficacy of this powerful skin rejuvenation. The greater number of its used, the more complications were seen. Among the non-vascular complications from filler injection, the most frequent one is nodule formation. It could occur as early or late onset even with HA injection. One of the causes of these nodule formation is from poor injection technique leading to visible skin beads and lumps. The current treatments of these filler side effects mainly aim to remove or reduce excessive or displaced filler product. To the best of our knowledge, there has been no report of using the intradermal injection of the micro-droplet HA to correct filler nodule and simultaneously revitalize the skin quality. This novel treatment technique could be a safe alternative for nodule formation correction.
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Affiliation(s)
- Wilai Thanasarnaksorn
- Faculty of Medicine, Division of Dermatology, Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.,Doctor Younger Clinic, Bangkok, Thailand
| | - Puttida Puttacharoenlarp
- Faculty of Medicine, Division of Dermatology, Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Kanjana Boonchoo
- Faculty of Medicine, Division of Dermatology, Department of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Atchima Suwanchinda
- Faculty of Medicine, Division of Dermatology, Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.,Department of Dermatology, School of Anti-Aging and Regenerative Medicine, Mae Fah Luang University, Bangkok, Thailand
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Lee SJ, Lee WS, Chung CH. Safety and efficacy of polycaprolactone copolymer nanosphere hydrogel injected into the scalp dermal tissue of rats. ARCHIVES OF AESTHETIC PLASTIC SURGERY 2019. [DOI: 10.14730/aaps.2019.01739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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