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Kim Y, Won SH, Bae KN, Lee J, Shin K, Kim H, Ko HC, Kim MB, Kim BS. Change in the Usage of Complementary and Alternative Medicine in the Era of Biologics Among Korean Patients With Psoriasis. J Korean Med Sci 2023; 38:e204. [PMID: 37401497 DOI: 10.3346/jkms.2023.38.e204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 03/13/2023] [Indexed: 07/05/2023] Open
Abstract
BACKGROUND Patients with long-standing psoriasis who are not treated with conventional medicine seek complementary and alternative medicine (CAM). The biological revolution in the field of psoriasis since the late 2000s has progressed, expecting clearance or almost clearance of the disease. The frequency and type of CAM usage may have changed after these advances. We aimed to investigate changes in CAM use in Korean patients with psoriasis before and after the prevalent use of biologics. METHODS Patients with psoriasis who visited Pusan National University Hospitals (Busan and Yangsan) between March 2020 and June 2022 were made to complete a face-to-face structured questionnaire. These results were compared with our previous study conducted approximately 10 years ago. RESULTS In total, 207 patients were included. Compared with the previous results, the frequency of CAM use (67.6%) increased (P < 0.001). Oriental medicine (67.1%) has most commonly been used, followed by health supplements and bath therapy. The biggest reason for using CAM was "to try all the potential treatments." Meanwhile, negative concerns about conventional medicine (13.5%) significantly decreased during the 10-year period (P < 0.001). CONCLUSION Although treatment efficacy has increased with biologics development, CAM usage remains prevalent among Korean patients with psoriasis. Therefore, dermatologists need more efforts to improve patients' understanding of conventional medicine, including biologics.
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Affiliation(s)
- Yeona Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
- Department of Dermatology, Pusan National University Yangsan Hospital, Yangsan, Korea
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Sang-Hyun Won
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
- Department of Dermatology, Pusan National University Hospital, Busan, Korea
| | - Kyung-Nam Bae
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
- Department of Dermatology, Pusan National University Hospital, Busan, Korea
| | - Jungsoo Lee
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
- Department of Dermatology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Kihyuk Shin
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
- Department of Dermatology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Hoonsoo Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
- Department of Dermatology, Pusan National University Hospital, Busan, Korea
| | - Hyun-Chang Ko
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
- Department of Dermatology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Moon-Bum Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
- Department of Dermatology, Pusan National University Hospital, Busan, Korea
| | - Byung Soo Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
- Department of Dermatology, Pusan National University Hospital, Busan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
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2
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Does the lifestyle of patients with psoriasis affect their illness? POSTEP HIG MED DOSW 2021. [DOI: 10.2478/ahem-2021-0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Psoriasis is one of the most common chronic, incurable inflammatory skin diseases, affecting 2–4% of the general population. Etiopathogenesis of this disease remains unclear. It is widely considered to be a multifactorial disorder caused by the interaction between inherited susceptibility alleles and environmental risk factors, such as lifestyle, diet, stimulants, foci of inflammation, and psychological factors. The widespread prevalence of psoriasis is a very significant health and socioeconomic problem. Treatment of psoriasis is based on relieving the acute symptoms of the disease. Despite the implementation of many therapeutic options, including biological treatment, effectiveness of these options is not always sufficient, or in some patients it is not satisfactory. In order to properly control the symptoms of the disease, the patient should be told that the therapeutic effect is achieved not only by pharmacotherapy but also by introducing appropriate healthy habits in everyday life. This article discusses the importance of patient-controlled factors that affect the severity of psoriasis. Theimportance of regular exercise, smoking avoidance, and reduced alcohol consumption is explained, as well as the importance for psoriasis treatment of psychotherapy and spa therapy. Understanding the essence of these factors in the treatment of psoriasis is important in achieving satisfactory therapeutic effects.
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3
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Wagner MFMG, Theodoro TR, Filho CDASM, Oyafuso LKM, Pinhal MAS. Extracellular matrix alterations in the skin of patients affected by psoriasis. BMC Mol Cell Biol 2021; 22:55. [PMID: 34715781 PMCID: PMC8555298 DOI: 10.1186/s12860-021-00395-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 10/15/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Psoriasis is a chronic inflammatory disease dependent upon a complex interaction between genetic predisposition and immunological factors. It is characterized by skin lesions throughout the body, causing great morbidity and affecting life quality. The present study aimed to evaluate the protein and mRNA expression of heparanase-1 (HPSE), heparanase-2 (HPSE2), syndecan-1 (SYND1), metalloproteinases (MMP2, MMP9), and tissue inhibitor metalloproteinases 2 (TIMP2) in skin samples. METHODS From each psoriasis patient, two samples were collected, one sample from a psoriasis plaque (n = 23) and the other sample from non-affected skin (n = 23), as well as tissue collected by blepharoplasty from control individuals (n = 18). Protein expression was investigated by immunohistochemistry, followed by digital quantification. Quantitative RT-PCR obtained mRNA expression. Statistical analyses were done, and p values < 0.05 were considered significant. RESULTS A significant increase in protein and mRNA expression was observed in both heparanases (HPSE and HPSE2), and higher protein levels of MMP9 and TIMP2 were observed in the psoriasis plaque compared to the non-affected skin. The data point to a probable activation of MMP2 by TIMP2. Moreover, there was a significant increase in HPSE2, SYND1, MMP9, and TIMP2 in non-affected skin samples from patients with psoriasis than in the control sample (tissue obtained by individuals who do not have psoriasis). CONCLUSIONS These results show a possible correlation between the characteristic inflammatory process and alterations in the expression of the extracellular matrix in psoriasis. The increased expression of HPSE2, SYND1, MMP9, and TIMP2, even in the absence of psoriatic plaque, indicates that these molecules may be involved with extracellular matrix changes in the initial alterations the psoriatic process and may be candidates for the development of target treatments.
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Affiliation(s)
| | - Thérèse Rachell Theodoro
- Biochemistry Department of Centro Universitário Saúde ABC (FMABC), Avenida Lauro Gomes 2000, Santo André, São Paulo, CEP 09060870, Brazil
| | | | | | - Maria Aparecida Silva Pinhal
- Biochemistry Department of Centro Universitário Saúde ABC (FMABC), Avenida Lauro Gomes 2000, Santo André, São Paulo, CEP 09060870, Brazil.
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4
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Morrone A, Dell'Anna ML, Cristaudo A, Wubayehu T, Godefay H, Barnabas GA, Dassoni F, Padovese V, Latini O, Lotti T, Saraceni P, Di Domenico EG, Lora V. Psoriasis in Tigray, Ethiopia: Focusing on available treatments. Dermatol Ther 2020; 35:e14718. [PMID: 33368850 DOI: 10.1111/dth.14718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 12/21/2020] [Indexed: 12/21/2022]
Abstract
Psoriasis has been reported to be rare in people with skin of color. However, the actual prevalence is probably underestimated by the lack of wide epidemiological studies. The aim of the study is to present our experience in Tigray, Ethiopia, focusing on the issues related to diagnosis, clinical features and therapies. A total of 1288 people affected by psoriasis were visited and 954 were included in a retrospective analysis through the review of medical records of patients attending at three Dermatologic Centers in Ethiopia from 2005 to 2016. The most common clinical form is plaque psoriasis (62.9%), followed by guttate (13.9%), pustular (9.5%), inverse (7.5%), and erythrodermic (6.1%) ones. The prevalence of psoriatic arthritis is 17%. It is often diagnosed late resulting in particularly deforming and debilitating disease. Patients with severe psoriasis often require hospitalization due to the reduced availability of effective treatments and appropriate skin care, resulting in a prolonged recurrence rate or decreased disease-free interval. In poorer rural areas, patients use some traditional African plants such as Kigelia africana which have been shown to have partial benefits in the treatment of psoriasis. Unfortunately, the only available conventional therapies are topical steroids, salicylic acid, methotrexate, and the sun. More studies concerning the appropriate management of people with psoriasis in low income countries, including standardization of indigenous therapies and a reduction of costs of conventional drugs, could help the care of people with psoriasis.
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Affiliation(s)
- Aldo Morrone
- San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | | | | | | | | | | | | | | | - Ottavio Latini
- San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Torello Lotti
- University G. Marconi of Rome, Dermatology and Venereology, Rome, Italy
| | | | | | - Viviana Lora
- San Gallicano Dermatological Institute IRCCS, Rome, Italy
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5
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Darlenski R, Bogdanov I, Kacheva M, Zheleva D, Demerdjieva Z, Hristakieva E, Fluhr JW, Tsankov N. Disease severity, patient-reported outcomes and skin hydration improve during balneotherapy with hydrocarbonate- and sulphur-rich water of psoriasis. J Eur Acad Dermatol Venereol 2020; 35:e196-e198. [PMID: 32869298 DOI: 10.1111/jdv.16908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- R Darlenski
- Department of Dermatology and Venereology, Acibadem City Clinic Tokuda Hospital - Sofia, Sofia, Bulgaria.,Department of Dermatology and Venereology, Medical Faculty, Trakia University- Stara Zagora, Stara Zagora, Bulgaria
| | - I Bogdanov
- Department of Dermatology and Venereology, Acibadem City Clinic Tokuda Hospital - Sofia, Sofia, Bulgaria
| | - M Kacheva
- Department of Dermatology and Venereology, Acibadem City Clinic Tokuda Hospital - Sofia, Sofia, Bulgaria
| | - D Zheleva
- Department of Dermatology and Venereology, Acibadem City Clinic Tokuda Hospital - Sofia, Sofia, Bulgaria
| | - Z Demerdjieva
- Department of Dermatology and Venereology, Acibadem City Clinic Tokuda Hospital - Sofia, Sofia, Bulgaria
| | - E Hristakieva
- Department of Dermatology and Venereology, Medical Faculty, Trakia University- Stara Zagora, Stara Zagora, Bulgaria
| | - J W Fluhr
- Department of Dermatology and Allergology, Charité Universitätsmedizin, Berlin, Germany
| | - N Tsankov
- Department of Dermatology and Venereology, Acibadem City Clinic Tokuda Hospital - Sofia, Sofia, Bulgaria
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6
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Kalashnikova NG, Lotti T, Urakova DS, Jafferany M. Treatment of psoriatic skin lesions with a new Er:Yag laser technology: A case series study. Dermatol Ther 2020; 33:e13264. [DOI: 10.1111/dth.13264] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 02/02/2020] [Accepted: 02/07/2020] [Indexed: 12/28/2022]
Affiliation(s)
| | - Torello Lotti
- Dermatology and Venereology Guglielmo Marconi University Rome Italy
| | - Diana S. Urakova
- Department of Dermatology Institute of Medical and Social Technologies Moscow Russia
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7
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Chiang CC, Cheng WJ, Korinek M, Lin CY, Hwang TL. Neutrophils in Psoriasis. Front Immunol 2019; 10:2376. [PMID: 31649677 PMCID: PMC6794444 DOI: 10.3389/fimmu.2019.02376] [Citation(s) in RCA: 140] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 09/23/2019] [Indexed: 12/22/2022] Open
Abstract
Neutrophils are the most abundant innate immune cells. The pathogenic roles of neutrophils are related to chronic inflammation and autoimmune diseases. Psoriasis is a chronic systemic inflammatory disease affecting ~2–3% of the world population. The abundant presence of neutrophils in the psoriatic skin lesions serves as a typical histopathologic hallmark of psoriasis. Recent reports indicated that oxidative stress, granular components, and neutrophil extracellular traps from psoriatic neutrophils are related to the initial and maintenance phases of psoriasis. This review provides an overview on the recent (up to 2019) advances in understanding the role of neutrophils in the pathophysiology of psoriasis, including the effects of respiratory burst, degranulation, and neutrophil extracellular trap formation on psoriatic immunity and the clinical relationships.
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Affiliation(s)
- Chih-Chao Chiang
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Supervisor Board, Taoyuan Chinese Medicine Association, Taoyuan, Taiwan.,Puxin Fengze Chinese Medicine Clinic, Taoyuan, Taiwan
| | - Wei-Jen Cheng
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,School of Traditional Chinese Medicine, Chang Gung University, Taoyuan, Taiwan.,Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Michal Korinek
- Graduate Institute of Natural Products, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Research Center for Chinese Herbal Medicine, Research Center for Food and Cosmetic Safety, and Graduate Institute of Health Industry Technology, Chang Gung University of Science and Technology, Taoyuan, Taiwan.,Department of Biotechnology, College of Life Science, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Cheng-Yu Lin
- Graduate Institute of Natural Products, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Tsong-Long Hwang
- School of Traditional Chinese Medicine, Chang Gung University, Taoyuan, Taiwan.,Graduate Institute of Natural Products, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Research Center for Chinese Herbal Medicine, Research Center for Food and Cosmetic Safety, and Graduate Institute of Health Industry Technology, Chang Gung University of Science and Technology, Taoyuan, Taiwan.,Chinese Herbal Medicine Research Team, Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan.,Department of Anesthesiology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Department of Chemical Engineering, Ming Chi University of Technology, New Taipei City, Taiwan
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8
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Trong HN, Tat TN, Anh TTN, Uyen NP, Van TN, Hau KT, Gandolfi M, Satolli F, Feliciani C, Tirant M, Vojvodic A, Lotti T. Efficacy of Adding Oral Simvastatin to Topical Therapy for Treatment of Psoriasis: The Vietnamese Experience. Open Access Maced J Med Sci 2019; 7:237-242. [PMID: 30745969 PMCID: PMC6364708 DOI: 10.3889/oamjms.2019.060] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 01/16/2019] [Accepted: 01/17/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Psoriasis, the prevalence of which ranges from 2% to 3% of the general population, has been recently recognised as not only a chronic inflammatory skin disorder but also an immunometabolic systemic disease. Dyslipidemia is one of the most important comorbidities of psoriasis. Statins, frequently used as anti-hyperlipidemic agents, may be beneficial in the treatment of several autoimmune diseases, including psoriasis, due to their anti-inflammatory and immunomodulatory characteristics. Hence, we hypothesised that using this medication was not only beneficial for reducing hyperlipidemia but also improving psoriatic conditions. AIM We conducted a study to determine the prevalence of dyslipidemia in psoriatic patients as well as whether the addition of statins (simvastatin prescribed forms) to standard topical antipsoriatic treatment can improve skin lesions in psoriatic patients. METHODS A group of 128 psoriatic patients and 128 healthy controls who were matched with the patients regarding ethnicity, age, and sex were enrolled, and their lipid concentrations were determined. Furthermore, sixty patients were randomly selected from the former group and divided into two treatment subgroups to evaluate the effect of statins on the severity of psoriasis using the PASI score. RESULTS We found that the rate of dyslipidemia in the patient group was significantly higher than in the healthy group (53.9% versus 21.9%, p < 0.001), particularly the triglyceride concentration (1.86 ± 1.17 versus 1.43 ± 0.79 mg/dL, p < 0.001). Also, the PASI score reduction in the simvastatin-treated subgroup was significantly different from that in the placebo-treated one after eight weeks of therapy (8.63 ± 4.78 versus 5.34 ± 3.59, p < 0.01). CONCLUSION This study showed that simvastatin might play a role in controlling hyperlipidemia and in turn decrease the PASI score in psoriatic patients.
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Affiliation(s)
- Hao Nguyen Trong
- Departments of Dermatology, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
- HCMC Hospital of Dermato-Venereology, Ho Chi Minh City, Vietnam
- Department of Dermatology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | - Thang Nguyen Tat
- Departments of Dermatology, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | | | - Nhi Pham Uyen
- HCMC Hospital of Dermato-Venereology, Ho Chi Minh City, Vietnam
| | - Thuong Nguyen Van
- National Hospital of Dermatology and Venereology, Ho Chi Minh City, Vietnam
| | - Khang Tran Hau
- National Hospital of Dermatology and Venereology, Ho Chi Minh City, Vietnam
| | | | | | | | - Michael Tirant
- University of Rome G. Marconi, Rome, Italy
- Psoriasis Eczema Clinic, Melbourne, Australia
| | - Aleksandra Vojvodic
- Department of Dermatology and Venereology, Military Medical Academy of Belgrade, Belgrade, Serbia
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9
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Xuan THT, Thi VB, Ngoc AT, Van ED, Dang QT, Van TN, Minh PPT, Thi LP, Huu ND, Gandolfi M, Satolli F, Feliciani C, Tirant M, Vojvodic A, Lotti T. Quality of Life in Psoriasis Vietnamese Patients Treated with Metformin in Combination with Methotrexate. Open Access Maced J Med Sci 2019; 7:302-303. [PMID: 30745987 PMCID: PMC6364721 DOI: 10.3889/oamjms.2019.066] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 01/16/2019] [Accepted: 01/17/2019] [Indexed: 12/03/2022] Open
Abstract
A cross-sectional study was performed on 48 psoriasis Vietnamese patients treated with metformin as an add-on for methotrexate and 48 psoriasis patients treated methotrexate alone. The mean PASI scores were 5.25 ± 5.72. Total QOL scores had a slight difference between patients treated metformin combined with methotrexate and methotrexate alone (62.32 ± 18.1 vs 60.91 ± 19.63). Combined therapy with metformin and methotrexate contributes to significantly improve the quality of life for patients with psoriasis.
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Affiliation(s)
| | - Van Bui Thi
- 108 Institute of Clinical Medical and Pharmaceutical Sciences, Hanoi, Vietnam
| | - Anh Tran Ngoc
- Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | - Em Dang Van
- 108 Institute of Clinical Medical and Pharmaceutical Sciences, Hanoi, Vietnam
| | | | | | | | - Lan Pham Thi
- National Hospital of Dermatology and Venereology, Hanoi, Vietnam
| | - Nghi Dinh Huu
- National Hospital of Dermatology and Venereology, Hanoi, Vietnam
| | | | | | | | - Michael Tirant
- University of Rome G. Marconi, Rome, Italy.,Psoriasis Eczema Clinic, Melbourne, Australia
| | - Aleksandra Vojvodic
- Department of Dermatology and Venereology, Military Medical Academy of Belgrade, Belgrade, Serbia
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