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Covalent modification of nephrilin peptide with valproic acid increases its efficacy as a therapeutic in burn trauma. BURNS OPEN 2020; 4:85-89. [PMID: 35572093 PMCID: PMC9097890 DOI: 10.1016/j.burnso.2020.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Introduction: Nephrilin peptide, a designed inhibitor of Rictor complex, modulates systemic responses to trauma, alleviating clinically relevant variables in a rat scald model and sepsis mortality in a mouse model. This study explores the possibility that chemical conjugation of small molecules to the aminoterminus of nephrilin can modify its biological activity in the rat scald model. Methods: One of four molecules (valproic acid, decanoic acid, fenofibric acid and ibuprofen) was chemically attached to the amino terminus of nephrilin during synthesis. Animals were treated with each modified nephrilin by subcutaneous bolus injection on days 1–7 post-burn. Results: Compared to nephrilin, valproic acid-modified nephrilin showed significantly (all p < 0.05) improved systemic effects on kidney function (creatinine 0.17 ± 0.03 vs 0.31 ± 0.09 mg/dL), glycemic control (AUC 57.5 ± 40 vs 136.4 ± 69.2 mg.dL.hr), inflammation (IL-6 24 ± 9 vs 39 ± 8 pg/ml), pathological angiogenesis (1.46 ± 0.87 vs 6.53 ± 3.16 pct pixels) and weight gain (3.74 ± 0.31 vs 2.99 ± 0.53 slope), all variables previously shown to bear upon clinically relevant burn injury outcomes. Conclusion: Modification of nephrilin with valproic acid increases the efficacy of nephrilin peptide in burns.
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Mascarenhas DD, El Ayadi A, Ravikumar P, Kang GJ, Langer T, Moreno C, Amento EP. Positive effects of ferric iron on the systemic efficacy of nephrilin peptide in burn trauma. Scars Burn Heal 2020; 6:2059513120928494. [PMID: 32612853 PMCID: PMC7307390 DOI: 10.1177/2059513120928494] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Nephrilin peptide is a designed inhibitor of Rictor complex (also known as mTORC2), an evolutionarily conserved assembly believed to modulate responses to cellular stress. We previously demonstrated the ability of nephrilin peptide to suppress neuroinflammation, loss of body mass, glycaemic control and kidney function in a rat scald model, as well as sepsis mortality in a mouse model. The present study explores the effect of nephrilin plus iron formulations on clinically relevant outcomes in the rat scald model. METHODS Animals were treated with nephrilin by subcutaneous bolus injection on post-burn days 1-7. Equimolar ferric iron in the formulation improved the positive systemic effects of nephrilin on kidney function, glycaemic control, oxidative stress, early hyperinflammation, late inflammasome activation, hyperangiogenesis and body mass, all variables previously shown to bear upon clinically relevant burn injury outcomes. The sparing effects of nephrilin-iron were demonstrated in both sexes. DISCUSSION Surprisingly, optimum daily treatment doses were in the range of 2-4 mg/kg, while 8 mg/kg was less effective, suggesting the possibility of marginal pro-oxidant effects from the 'free' iron fraction. Thus, although ferric iron in the nephrilin formulation is clearly helpful, care must be exercised to select an optimum treatment dose. CONCLUSION Iron increases the efficacy of nephrilin peptide in burns.
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Affiliation(s)
- Desmond D Mascarenhas
- Mayflower Organization for Research
& Education, Sunnyvale, CA, USA
- Transporin, Inc., Sunnyvale, CA,
USA
| | - Amina El Ayadi
- Department of Surgery, The University of
Texas Medical Branch, Galveston, TX, USA
- Shriners Hospitals for Children -
Galveston, Galveston, TX, USA
| | - Puja Ravikumar
- Molecular Medicine Research Institute,
Sunnyvale, CA, USA
| | | | - Tammy Langer
- Molecular Medicine Research Institute,
Sunnyvale, CA, USA
| | - Carlos Moreno
- Molecular Medicine Research Institute,
Sunnyvale, CA, USA
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Guo Y, You Y, Lv D, Yan J, Shang FF, Wang X, Zhang C, Fan Q, Luo S. Inducible nitric oxide synthase contributes to insulin resistance and cardiac dysfunction after burn injury in mice. Life Sci 2019; 239:116912. [PMID: 31634465 DOI: 10.1016/j.lfs.2019.116912] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 09/12/2019] [Accepted: 09/24/2019] [Indexed: 11/18/2022]
Abstract
AIMS Cardiac dysfunction is a major cause of multi-organ dysfunction in critical care units following severe burns. The purpose of this study was to investigate the role of inducible nitric oxide synthase (iNOS) in cardiac dysfunction in burned mice. MATERIALS AND METHODS Wild-type and iNOS-knockout mice were subjected to 30% total body surface area burns. Next, the expression of iNOS was measured at 1, 3 and 7 days post-burn. Cardiac function, insulin sensitivity, inflammation, oxidative stress, and apoptosis in the hearts of the mice were assessed at 3 days post-burn. KEY FINDINGS Compared to control mice, iNOS expression was increased and reached a maximum in the heart of burned mice at 3 days post-burn. iNOS deficiency significantly alleviated the cardiac dysfunction and insulin resistance in burned mice. In addition, burn-induced inflammation, oxidative stress, and apoptosis in the heart were markedly reduced in iNOS-knockout burned mice when compared to corresponding values in wild-type burned mice. SIGNIFICANCE Our study demonstrates that iNOS contributes to insulin resistance in the hearts of mice following burn injury, and iNOS deficiency protects cardiac function against burn injury in mice, suggesting iNOS as a potential therapeutic target to treat burn injuries.
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Affiliation(s)
- Yongzheng Guo
- Division of cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China; Institute of Life Science, Chongqing Medical University, Chongqing, 400016, China
| | - Yuehua You
- Division of cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China; Institute of Life Science, Chongqing Medical University, Chongqing, 400016, China
| | - Dingyi Lv
- Division of cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China; Institute of Life Science, Chongqing Medical University, Chongqing, 400016, China
| | - Jianghong Yan
- Institute of Life Science, Chongqing Medical University, Chongqing, 400016, China
| | - Fei-Fei Shang
- Institute of Life Science, Chongqing Medical University, Chongqing, 400016, China
| | - Xiaowen Wang
- Department of Cardiothoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Cheng Zhang
- Department of Cardiothoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Qingdan Fan
- Division of cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Suxin Luo
- Division of cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
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Rose S, Carvalho E, Diaz EC, Cotter M, Bennuri SC, Azhar G, Frye RE, Adams SH, Børsheim E. A comparative study of mitochondrial respiration in circulating blood cells and skeletal muscle fibers in women. Am J Physiol Endocrinol Metab 2019; 317:E503-E512. [PMID: 31211617 DOI: 10.1152/ajpendo.00084.2019] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Skeletal muscle mitochondrial respiration is thought to be altered in obesity, insulin resistance, and type 2 diabetes; however, the invasive nature of tissue biopsies is an important limiting factor for studying mitochondrial function. Recent findings suggest that bioenergetics profiling of circulating cells may inform on mitochondrial function in other tissues in lieu of biopsies. Thus, we sought to determine whether mitochondrial respiration in circulating cells [peripheral blood mononuclear cells (PBMCs) and platelets] reflects that of skeletal muscle fibers derived from the same subjects. PBMCs, platelets, and skeletal muscle (vastus lateralis) samples were obtained from 32 young (25-35 yr) women of varying body mass indexes. With the use of extracellular flux analysis and high-resolution respirometry, mitochondrial respiration was measured in intact blood cells as well as in permeabilized cells and permeabilized muscle fibers. Respiratory parameters were not correlated between permeabilized muscle fibers and intact PBMCs or platelets. In a subset of samples (n = 12-13) with permeabilized blood cells available, raw measures of substrate (pyruvate, malate, glutamate, and succinate)-driven respiration did not correlate between permeabilized muscle (per mg tissue) and permeabilized PBMCs (per 106 cells); however, complex I leak and oxidative phosphorylation coupling efficiency correlated between permeabilized platelets and muscle (Spearman's ρ = 0.64, P = 0.030; Spearman's ρ = 0.72, P = 0.010, respectively). Our data indicate that bioenergetics phenotypes in circulating cells cannot recapitulate muscle mitochondrial function. Select circulating cell bioenergetics phenotypes may possibly inform on overall metabolic health, but this postulate awaits validation in cohorts spanning a larger range of insulin resistance and type 2 diabetes status.
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Affiliation(s)
- Shannon Rose
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
- Arkansas Children's Research Institute, Little Rock, Arkansas
| | - Eugenia Carvalho
- Arkansas Children's Research Institute, Little Rock, Arkansas
- Department of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
- Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal
| | - Eva C Diaz
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
- Arkansas Children's Research Institute, Little Rock, Arkansas
- Arkansas Children's Nutrition Center, Little Rock, Arkansas
| | - Matthew Cotter
- Arkansas Children's Research Institute, Little Rock, Arkansas
- Arkansas Children's Nutrition Center, Little Rock, Arkansas
| | - Sirish C Bennuri
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
- Arkansas Children's Research Institute, Little Rock, Arkansas
| | - Gohar Azhar
- Department of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Richard E Frye
- Department of Neurology, Barrow Neurological Research Institute at Phoenix Children's Hospital, Phoenix, Arizona
- Department of Child Health, University of Arizona College of Medicine-Phoenix, Phoenix, Arizona
| | - Sean H Adams
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
- Arkansas Children's Nutrition Center, Little Rock, Arkansas
| | - Elisabet Børsheim
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
- Arkansas Children's Research Institute, Little Rock, Arkansas
- Department of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
- Arkansas Children's Nutrition Center, Little Rock, Arkansas
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Nakazawa H, Ikeda K, Shinozaki S, Yasuhara S, Yu YM, Martyn JAJ, Tompkins RG, Yorozu T, Inoue S, Kaneki M. Coenzyme Q10 protects against burn-induced mitochondrial dysfunction and impaired insulin signaling in mouse skeletal muscle. FEBS Open Bio 2019; 9:348-363. [PMID: 30761259 PMCID: PMC6356165 DOI: 10.1002/2211-5463.12580] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 12/13/2018] [Accepted: 12/14/2018] [Indexed: 12/29/2022] Open
Abstract
Mitochondrial dysfunction is associated with metabolic alterations in various disease states, including major trauma (e.g., burn injury). Metabolic derangements, including muscle insulin resistance and hyperlactatemia, are a clinically significant complication of major trauma. Coenzyme Q10 (CoQ10) is an essential cofactor for mitochondrial electron transport, and its reduced form acts as a lipophilic antioxidant. Here, we report that burn injury induces impaired muscle insulin signaling, hyperlactatemia, mitochondrial dysfunction (as indicated by suppressed mitochondrial oxygen consumption rates), morphological alterations of the mitochondria (e. g., enlargement, and loss of cristae structure), mitochondrial oxidative stress, and disruption of mitochondrial integrity (as reflected by increased mitochondrial DNA levels in the cytosol and circulation). All of these alterations were significantly alleviated by CoQ10 treatment compared with vehicle alone. These findings indicate that CoQ10 treatment is efficacious in protecting against mitochondrial dysfunction and insulin resistance in skeletal muscle of burned mice. Our data highlight CoQ10 as a potential new strategy to prevent mitochondrial damage and metabolic dysfunction in burn patients.
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Affiliation(s)
- Harumasa Nakazawa
- Department of Anesthesia, Critical Care and Pain Medicine Massachusetts General Hospital Harvard Medical School Charlestown MA USA.,Shriners Hospitals for Children Boston MA USA.,Department of Anesthesiology Kyorin University School of Medicine Tokyo Japan
| | - Kazuhiro Ikeda
- Division of Gene Regulation and Signal Transduction Research Center for Genomic Medicine Saitama Medical University Japan
| | - Shohei Shinozaki
- Department of Anesthesia, Critical Care and Pain Medicine Massachusetts General Hospital Harvard Medical School Charlestown MA USA.,Shriners Hospitals for Children Boston MA USA.,Department of Life Sciences and Bioethics Tokyo Medical and Dental University Japan
| | - Shingo Yasuhara
- Department of Anesthesia, Critical Care and Pain Medicine Massachusetts General Hospital Harvard Medical School Charlestown MA USA.,Shriners Hospitals for Children Boston MA USA
| | - Yong-Ming Yu
- Shriners Hospitals for Children Boston MA USA.,Department of Surgery Massachusetts General Hospital Harvard Medical School Boston MA USA
| | - J A Jeevendra Martyn
- Department of Anesthesia, Critical Care and Pain Medicine Massachusetts General Hospital Harvard Medical School Charlestown MA USA.,Shriners Hospitals for Children Boston MA USA
| | - Ronald G Tompkins
- Shriners Hospitals for Children Boston MA USA.,Department of Surgery Massachusetts General Hospital Harvard Medical School Boston MA USA
| | - Tomoko Yorozu
- Department of Anesthesiology Kyorin University School of Medicine Tokyo Japan
| | - Satoshi Inoue
- Division of Gene Regulation and Signal Transduction Research Center for Genomic Medicine Saitama Medical University Japan.,Tokyo Metropolitan Institute of Gerontology Japan
| | - Masao Kaneki
- Department of Anesthesia, Critical Care and Pain Medicine Massachusetts General Hospital Harvard Medical School Charlestown MA USA.,Shriners Hospitals for Children Boston MA USA
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Abstract
PURPOSE OF REVIEW After major progress in the 1980s of burn resuscitation resulting, the last years' research has focused on modulation of metabolic response and optimization of substrate utilization. The persisting variability of clinical practice is confirmed and results in difficult comparisons between burn centers. RECENT FINDINGS Recent research explores intracellular mechanisms of the massive metabolic turmoil observed after burns: very early alterations at the mitochondrial level largely explain the hypermetabolic response, with a diminished coupling of oxygen consumption and ATP production. The metabolic alterations (elevated protein and glucose turnover) have been shown to be long lasting. Modulating this response by pharmacological tools (insulin, propranolol, and oxandrolone) results in significant clinical benefits. A moderate glucose control proves to be safe in adult burns; data in children remain uncertain as the risk of hypoglycemia seems to be higher. The enteral feeding route is confirmed as an optimal route: some difficulties are now clearly identified, such as the risk of not delivering sufficient energy by this route. SUMMARY Major burn patients differ from other critically ill patients by the magnitude and duration of their inflammatory and metabolic responses, their energy and substrate requirements. Pieces of the metabolic puzzle finally seem to fit together.
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Affiliation(s)
- Mette M Berger
- Service of Adult Intensive Care Medicine and Burns, CHUV University Hospital, Lausanne, Switzerland
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Čapek KD, Culnan DM, Desai MH, Herndon DN. Fifty Years of Burn Care at Shriners Hospitals for Children, Galveston. Ann Plast Surg 2018; 80:S90-S94. [PMID: 29461291 PMCID: PMC5825277 DOI: 10.1097/sap.0000000000001376] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
More than 50 years ago, Shriners Hospitals for Children expanded their philanthropy to include care for burned children. In so doing, the effects of their work weightily expanded from rehabilitation and quality of life outcomes to include survival proper. As the first facility dedicated to the care of burned children, originally designated the Shriners Burn Institute, the Galveston hospital remains the cornerstone of this endeavor. Shriners maintains charitable pediatric hospitals, provide care irrespective of the patient's or the family's ability to pay, and promote research. The sole criterion for admission at Shriners Hospitals for Children is the determination by a surgeon at a Shriners hospital that "the child's trouble may be corrected or improved." This philanthropic effort to provide medical care for children is one expression of the human commonality recognized by Shriners. In this article, we provide some background information on how this hospital came into existence as well as a global summary of its interventions toward greater survival and more complete rehabilitation of burned children. Based on the findings presented herein, we assert that there is less suffering and less loss of life due to childhood burns today than in previous years. We attribute much of this improvement to the simple voluntary collective decision by Shriners to provide alms for burned children.
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Mascarenhas DD, Ayadi AE, Wetzel M, Prasai A, Mifflin R, Jay J, Herndon DN, Finnerty CC. Effects of the nephrilin peptide on post-burn glycemic control, renal function, fat and lean body mass, and wound healing. INTERNATIONAL JOURNAL OF BURNS AND TRAUMA 2016; 6:44-50. [PMID: 28078180 PMCID: PMC5218868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 11/14/2016] [Indexed: 06/06/2023]
Abstract
The mechanisms underlying the effects of severe burn trauma are not well understood. We previously demonstrated the ability of nephrilin peptide (an iron-binding peptide believed to enter cells through iron-uptake pathways) to suppress aspects of the neuroinflammatory response in a rat scald model, as well as sepsis mortality in a mouse model. This study explores the effect of nephrilin on other clinically relevant outcomes in the rat scald model. In a rat scald model, animals were treated with nephrilin either in week 1 or week 2 post-burn. Measurements were made of serum glucose and creatinine as well as wound area by planimetry and body composition by DEXA. Given the potential role of iron, results were analyzed both for the entire cohort of animals and for the normoferremic (>100 ug/dL serum iron) subset of animals. Nephrilin improved body composition, wound healing, kidney function, and glycemic control. The first two effects were significant in normoferremic but not in hypoferremic animals suggesting an effect of iron status on burn injury outcomes. Nephrilin treatment modulates a number of relevant variables in the rat scald model.
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Affiliation(s)
- Desmond D Mascarenhas
- Mayflower Organization for Research & EducationSunnyvale, CA 94085, USA
- Transporin, Inc.Sunnyvale, CA 94085, USA
| | - Amina El Ayadi
- Department of Surgery, The University of Texas Medical BranchUSA
- Shriners Hospitals for Children - GalvestonGalveston, TX 77550, USA
| | - Michael Wetzel
- Shriners Hospitals for Children - GalvestonGalveston, TX 77550, USA
- Cell Biology Graduate Program, The University of Texas Medical BranchGalveston, TX 77555, USA
| | - Anesh Prasai
- Shriners Hospitals for Children - GalvestonGalveston, TX 77550, USA
- Cell Biology Graduate Program, The University of Texas Medical BranchGalveston, TX 77555, USA
| | - Randy Mifflin
- Department of Surgery, The University of Texas Medical BranchUSA
- Shriners Hospitals for Children - GalvestonGalveston, TX 77550, USA
| | - Jayson Jay
- Shriners Hospitals for Children - GalvestonGalveston, TX 77550, USA
- The Institute for Translational Sciences and The Sealy Center for Molecular Medicine, The University of Texas Medical BranchGalveston, TX 77550, USA
| | - David N Herndon
- Department of Surgery, The University of Texas Medical BranchUSA
- Shriners Hospitals for Children - GalvestonGalveston, TX 77550, USA
- The Institute for Translational Sciences and The Sealy Center for Molecular Medicine, The University of Texas Medical BranchGalveston, TX 77550, USA
| | - Celeste C Finnerty
- Department of Surgery, The University of Texas Medical BranchUSA
- Shriners Hospitals for Children - GalvestonGalveston, TX 77550, USA
- The Institute for Translational Sciences and The Sealy Center for Molecular Medicine, The University of Texas Medical BranchGalveston, TX 77550, USA
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Effects of insulin combined with ethyl pyruvate on inflammatory response and oxidative stress in multiple-organ dysfunction syndrome rats with severe burns. Am J Emerg Med 2016; 34:2154-2158. [DOI: 10.1016/j.ajem.2016.08.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 08/01/2016] [Accepted: 08/06/2016] [Indexed: 01/08/2023] Open
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Abstract
Management of burn injuries requires treatments and interventions from many disciplines. Worldwide, burn patients suffer from physical and psychological challenges that impact their lives socially and economically. In this review, we will highlight a handful of the numerous articles published in multiple areas of burn care. The areas of burn care addressed in the article are: epidemiology; burn resuscitation, critical care, and infection; nutrition and metabolism; pain and rehabilitation; prevention and firefighter safety; psychology; and reconstruction and wounds.
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