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Hu H, Hu C, Guo W, Zhu B, Wang S. Wearable ultrasound devices: An emerging era for biomedicine and clinical translation. ULTRASONICS 2024; 142:107401. [PMID: 39004039 DOI: 10.1016/j.ultras.2024.107401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 07/08/2024] [Accepted: 07/09/2024] [Indexed: 07/16/2024]
Abstract
In recent years, personalized diagnosis and treatment have gained significant recognition and rapid development in the biomedicine and healthcare. Due to the flexibility, portability and excellent compatibility, wearable ultrasound (WUS) devices have become emerging personalized medical devices with great potential for development. Currently, with the development of the ongoing advancements in materials and structural design of the ultrasound transducers, WUS devices have improved performance and are increasingly applied in the medical field. In this review, we provide an overview of the design and structure of WUS devices, focusing on their application for diagnosis and treatment of various diseases from a clinical application perspective, and then explore the issues that need to be addressed before clinical translation. Finally, we summarize the progress made in the development of WUS devices, and discuss the current challenges and the future direction of their development. In conclusion, WUS devices usher an emerging era for biomedicine with great clinical promise.
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Affiliation(s)
- Haoyuan Hu
- Department of Cardiology, Renmin Hospital of Wuhan University, China; Cardiac Autonomic Nervous System Research Center of Wuhan University, China; Cardiovascular Research Institute, Wuhan University, China; Hubei Key Laboratory of Cardiology, China
| | - Changhao Hu
- Department of Cardiology, Renmin Hospital of Wuhan University, China; Cardiac Autonomic Nervous System Research Center of Wuhan University, China; Cardiovascular Research Institute, Wuhan University, China; Hubei Key Laboratory of Cardiology, China
| | - Wei Guo
- Department of Cardiology, Renmin Hospital of Wuhan University, China; Cardiac Autonomic Nervous System Research Center of Wuhan University, China; Cardiovascular Research Institute, Wuhan University, China; Hubei Key Laboratory of Cardiology, China
| | - Benpeng Zhu
- School of Optical and Electronic Information, Huazhong University of Science and Technology, China.
| | - Songyun Wang
- Department of Cardiology, Renmin Hospital of Wuhan University, China; Cardiac Autonomic Nervous System Research Center of Wuhan University, China; Cardiovascular Research Institute, Wuhan University, China; Hubei Key Laboratory of Cardiology, China.
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Cai S, Lin Y, Chen H, Huang Z, Zhou Y, Zheng Y. Automated analysis of pectoralis major thickness in pec-fly exercises: evolving from manual measurement to deep learning techniques. Vis Comput Ind Biomed Art 2024; 7:8. [PMID: 38625580 PMCID: PMC11021386 DOI: 10.1186/s42492-024-00159-6] [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: 12/05/2023] [Accepted: 03/22/2024] [Indexed: 04/17/2024] Open
Abstract
This study addresses a limitation of prior research on pectoralis major (PMaj) thickness changes during the pectoralis fly exercise using a wearable ultrasound imaging setup. Although previous studies used manual measurement and subjective evaluation, it is important to acknowledge the subsequent limitations of automating widespread applications. We then employed a deep learning model for image segmentation and automated measurement to solve the problem and study the additional quantitative supplementary information that could be provided. Our results revealed increased PMaj thickness changes in the coronal plane within the probe detection region when real-time ultrasound imaging (RUSI) visual biofeedback was incorporated, regardless of load intensity (50% or 80% of one-repetition maximum). Additionally, participants showed uniform thickness changes in the PMaj in response to enhanced RUSI biofeedback. Notably, the differences in PMaj thickness changes between load intensities were reduced by RUSI biofeedback, suggesting altered muscle activation strategies. We identified the optimal measurement location for the maximal PMaj thickness close to the rib end and emphasized the lightweight applicability of our model for fitness training and muscle assessment. Further studies can refine load intensities, investigate diverse parameters, and employ different network models to enhance accuracy. This study contributes to our understanding of the effects of muscle physiology and exercise training.
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Affiliation(s)
- Shangyu Cai
- School of Biomedical Engineering, Medical School, Shenzhen University, Shenzhen, 518073, China
| | - Yongsheng Lin
- School of Biomedical Engineering, Medical School, Shenzhen University, Shenzhen, 518073, China
| | - Haoxin Chen
- School of Biomedical Engineering, Medical School, Shenzhen University, Shenzhen, 518073, China
| | - Zihao Huang
- Department of Biomedical Engineering, the Hong Kong Polytechnic University, Hong Kong, 999077, China
| | - Yongjin Zhou
- School of Biomedical Engineering, Medical School, Shenzhen University, Shenzhen, 518073, China.
| | - Yongping Zheng
- Department of Biomedical Engineering, the Hong Kong Polytechnic University, Hong Kong, 999077, China.
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Almufareh MF, Kausar S, Humayun M, Tehsin S. Leveraging Motor Imagery Rehabilitation for Individuals with Disabilities: A Review. Healthcare (Basel) 2023; 11:2653. [PMID: 37830690 PMCID: PMC10572951 DOI: 10.3390/healthcare11192653] [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: 08/12/2023] [Revised: 09/20/2023] [Accepted: 09/26/2023] [Indexed: 10/14/2023] Open
Abstract
Motor imagery, an intricate cognitive procedure encompassing the mental simulation of motor actions, has surfaced as a potent strategy within the neuro-rehabilitation domain. It presents a non-invasive, economically viable method for facilitating individuals with disabilities in enhancing their motor functionality and regaining self-sufficiency. This manuscript delivers an exhaustive analysis of the significance of motor imagery in augmenting functional rehabilitation for individuals afflicted with physical impairments. It investigates the fundamental mechanisms governing motor imagery, its applications across diverse disability conditions, and the prospective advantages it renders. Moreover, this document addresses the prevailing obstacles and prospective trajectories in this sector, accentuating the necessity for continued investigation and the invention of cutting-edge technologies that optimize the potentiality of motor imagery in aiding disabled persons.
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Affiliation(s)
- Maram Fahaad Almufareh
- Department of Information Systems, College of Computer and Information Sciences, Jouf University, Sakakah 72388, Saudi Arabia
| | - Sumaira Kausar
- Center of Excellence in Artificial Intelligence COE-AI, Department of CS, Bahria University, Islamabad 44000, Pakistan; (S.K.); (S.T.)
| | - Mamoona Humayun
- Department of Information Systems, College of Computer and Information Sciences, Jouf University, Sakakah 72388, Saudi Arabia
| | - Samabia Tehsin
- Center of Excellence in Artificial Intelligence COE-AI, Department of CS, Bahria University, Islamabad 44000, Pakistan; (S.K.); (S.T.)
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Tong CY, Zhu RTL, Ling YT, Scheeren EM, Lam FMH, Fu H, Ma CZH. Muscular and Kinematic Responses to Unexpected Translational Balance Perturbation: A Pilot Study in Healthy Young Adults. Bioengineering (Basel) 2023; 10:831. [PMID: 37508858 PMCID: PMC10376184 DOI: 10.3390/bioengineering10070831] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 06/24/2023] [Accepted: 07/03/2023] [Indexed: 07/30/2023] Open
Abstract
Falls and fall-related injuries are significant public health problems in older adults. While balance-controlling strategies have been extensively researched, there is still a lack of understanding regarding how fast the lower-limb muscles contract and coordinate in response to a sudden loss of standing balance. Therefore, this pilot study aims to investigate the speed and timing patterns of multiple joint/muscles' activities among the different challenges in standing balance. Twelve healthy young subjects were recruited, and they received unexpected translational balance perturbations with randomized intensities and directions. Electromyographical (EMG) and mechanomyographical (MMG) signals of eight dominant-leg's muscles, dominant-leg's three-dimensional (3D) hip/knee/ankle joint angles, and 3D postural sways were concurrently collected. Two-way ANOVAs were used to examine the difference in timing and speed of the collected signals among muscles/joint motions and among perturbation intensities. This study has found that (1) agonist muscles resisting the induced postural sway tended to activate more rapidly than the antagonist muscles, and ankle muscles contributed the most with the fastest rate of response; (2) voluntary corrective lower-limb joint motions and postural sways could occur as early as the perturbation-induced passive ones; (3) muscles reacted more rapidly under a larger perturbation intensity, while the joint motions or postural sways did not. These findings expand the current knowledge on standing-balance-controlling mechanisms and may potentially provide more insights for developing future fall-prevention strategies in daily life.
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Affiliation(s)
- Cheuk Ying Tong
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China
| | - Ringo Tang-Long Zhu
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China
- Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China
| | - Yan To Ling
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China
- Centre for Developmental Neurobiology, King's College London, London SE1 1UL, UK
| | - Eduardo Mendonça Scheeren
- Graduate Program in Health Technology, Pontifícia Universidade Católica do Paraná, Curitiba 80215-901, Brazil
| | - Freddy Man Hin Lam
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China
| | - Hong Fu
- Department of Mathematics and Information Technology, The Education University of Hong Kong, Hong Kong SAR 999077, China
| | - Christina Zong-Hao Ma
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China
- Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China
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Zheng Q, He C, Huang Y, Xu T, Jie Y, Ma CZH. Can Computer-Aided Design and Computer-Aided Manufacturing Integrating with/without Biomechanical Simulation Improve the Effectiveness of Spinal Braces on Adolescent Idiopathic Scoliosis? CHILDREN (BASEL, SWITZERLAND) 2023; 10:927. [PMID: 37371158 DOI: 10.3390/children10060927] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 05/20/2023] [Accepted: 05/22/2023] [Indexed: 06/29/2023]
Abstract
The CAD/CAM technology has been increasingly popular in manufacturing spinal braces for patients with adolescent idiopathic scoliosis (AIS) in clinics. However, whether the CAD/CAM-manufactured braces or the CAD/CAM-manufactured braces integrating with biomechanical simulation could improve the in-brace correction angle of spinal braces in AIS patients, compared to the manually manufactured braces, has remained unclear. The purpose of this systematic review and meta-analysis was to compare the in-brace correction angle of (1) computer-aided design and computer-aided manufacturing (CAD/CAM)-manufactured braces or (2) the CAD/CAM-manufactured braces integrating with biomechanical simulation with that of (3) manually manufactured braces. The Web of Science, OVID, EBSCO, PUBMED, and Cochrane Library databases were searched for relevant studies published up to March 2023. Five randomized controlled trials (RCTs) or randomized controlled crossover trials were included for qualitative synthesis, and four of them were included for meta-analysis. The meta-analysis effect sizes of the in-brace correction angle for CAD/CAM versus manual method, and CAD/CAM integrating with biomechanical simulation versus the manual method in the thoracic curve group and the thoracolumbar/lumbar curve group were 0.6° (mean difference [MD], 95% confidence intervals [CI]: -1.06° to 2.25°), 1.12° (MD, 95% CI: -8.43° to 10.67°), and 3.96° (MD, 95% CI: 1.16° to 6.76°), respectively. This review identified that the braces manufactured by CAD/CAM integrating with biomechanical simulation did not show sufficient advantages over the manually manufactured braces, and the CAD/CAM-manufactured braces may not be considered as more worthwhile than the manually manufactured braces, based on the in-brace correction angle. More high-quality clinical studies that strictly follow the Scoliosis Research Society (SRS) guidelines with long-term follow-ups are still needed to draw more solid conclusions and recommendations for clinical practice in the future.
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Affiliation(s)
- Qian Zheng
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue, Wuhan 430030, China
| | - Chen He
- Institute of Rehabilitation Engineering and Technology, University of Shanghai for Science and Technology, Shanghai 200093, China
| | - Yan Huang
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue, Wuhan 430030, China
| | - Tao Xu
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue, Wuhan 430030, China
| | - Yi Jie
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China
- Department of Rehabilitation Engineering, The Fifth Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China
| | - Christina Zong-Hao Ma
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China
- Research Institute for Smart Aging, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China
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Perotti L, Stamm O, Mesletzky L, Vorwerg S, Fournelle M, Müller-Werdan U. Needs and Attitudes of Older Chronic Back Pain Patients towards a Wearable for Ultrasound Biofeedback during Stabilization Exercises: A Qualitative Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4927. [PMID: 36981835 PMCID: PMC10049307 DOI: 10.3390/ijerph20064927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 03/03/2023] [Accepted: 03/05/2023] [Indexed: 06/18/2023]
Abstract
Chronic back pain has a high prevalence, especially in older adults, and seriously affects sufferers' quality of life. Segmental stabilization exercise (SSE) is often used during physiotherapy to enhance core stability. The execution of SSE requires the selective contraction of deep abdominal and back muscles. Motor learning can be supported using ultrasound imaging as visual biofeedback. ULTRAWEAR is a mobile ultrasound system that provides deep learning-based biofeedback on SSE execution, which is currently under development. We interviewed 15 older chronic back pain patients (CBPPs) to investigate their pain management behavior, experience with SSE, as well as their needs and requirements for ULTRAWEAR. We also gathered information about future-usage scenarios. CBPPs reported a high willingness to use the system as a feedback tool both in physiotherapeutic practices and at home. The automated detection and evaluation of muscle contraction states was highlighted as a major benefit of the system compared to the more subjective feedback provided by traditional methods such as palpation. The system to be developed was perceived as a helpful solution to support learning about SSE.
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Affiliation(s)
- Luis Perotti
- Department of Geriatrics and Medical Gerontology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 13347 Berlin, Germany
| | - Oskar Stamm
- Department of Geriatrics and Medical Gerontology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 13347 Berlin, Germany
| | - Lisa Mesletzky
- Department of Geriatrics and Medical Gerontology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 13347 Berlin, Germany
| | - Susan Vorwerg
- Department of Geriatrics and Medical Gerontology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 13347 Berlin, Germany
| | - Marc Fournelle
- Department of Ultrasound, Fraunhofer Institute for Biomedical Engineering, 66280 Sulzbach, Germany
| | - Ursula Müller-Werdan
- Department of Geriatrics and Medical Gerontology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 13347 Berlin, Germany
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How Does Lower Limb Respond to Unexpected Balance Perturbations? New Insights from Synchronized Human Kinetics, Kinematics, Muscle Electromyography (EMG) and Mechanomyography (MMG) Data. BIOSENSORS 2022; 12:bios12060430. [PMID: 35735577 PMCID: PMC9220852 DOI: 10.3390/bios12060430] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/10/2022] [Accepted: 06/16/2022] [Indexed: 11/16/2022]
Abstract
Making rapid and proper compensatory postural adjustments is vital to prevent falls and fall-related injuries. This study aimed to investigate how, especially how rapidly, the multiple lower-limb muscles and joints would respond to the unexpected standing balance perturbations. Unexpected waist-pull perturbations with small, medium and large magnitudes were delivered to twelve healthy young adults from the anterior, posterior, medial and lateral directions. Electromyographical (EMG) and mechanomyographical (MMG) responses of eight dominant-leg muscles (i.e., hip abductor/adductors, hip flexor/extensor, knee flexor/extensor, and ankle dorsiflexor/plantarflexors) together with the lower-limb joint angle, moment, and power data were recorded. The onset latencies, time to peak, peak values, and/or rate of change of these signals were analyzed. Statistical analysis revealed that: (1) agonist muscles resisting the delivered perturbation had faster activation than the antagonist muscles; (2) ankle muscles showed the largest rate of activation among eight muscles following both anteroposterior and mediolateral perturbations; (3) lower-limb joint moments that complied with the perturbation had faster increase; and (4) larger perturbation magnitude tended to evoke a faster response in muscle activities, but not necessarily in joint kinetics/kinematics. These findings provided insights regarding the underlying mechanism and lower-limb muscle activities to maintain reactive standing balance in healthy young adults.
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Lyu PZ, Zhu RTL, Ling YT, Wang LK, Zheng YP, Ma CZH. How Paretic and Non-Paretic Ankle Muscles Contract during Walking in Stroke Survivors: New Insight Using Novel Wearable Ultrasound Imaging and Sensing Technology. BIOSENSORS 2022; 12:bios12050349. [PMID: 35624650 PMCID: PMC9138866 DOI: 10.3390/bios12050349] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 05/11/2022] [Accepted: 05/13/2022] [Indexed: 05/11/2023]
Abstract
Abnormal muscle tone and muscle weakness are related to gait asymmetry in stroke survivors. However, the internal muscle morphological changes that occur during walking remain unclear. To address this issue, this study investigated the muscle activity of the tibialis anterior (TA) and medial gastrocnemius (MG) of both the paretic and non-paretic sides during walking in nine stroke survivors, by simultaneously capturing electromyography (EMG), mechanomyography (MMG), and ultrasound images, and using a validated novel wearable ultrasound imaging and sensing system. Statistical analysis was performed to examine the test−retest reliability of the collected data, and both the main and interaction effects of each “side” (paretic vs. non-paretic) and “gait” factors, in stroke survivors. This study observed significantly good test−retest reliability in the collected data (0.794 ≤ ICC ≤ 0.985), and significant differences existed in both the side and gait factors of the average TA muscle thickness from ultrasound images, and in the gait factors of TA and MG muscle’s MMG and EMG signals (p < 0.05). The muscle morphological characteristics also appeared to be different between the paretic and non-paretic sides on ultrasound images. This study uncovered significantly different internal muscle contraction patterns between paretic and non-paretic sides during walking for TA (7.2% ± 1.6%) and MG (5.3% ± 4.9%) muscles in stroke survivors.
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Affiliation(s)
- Pei-Zhao Lyu
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China; (P.-Z.L.); (R.T.-L.Z.); (Y.T.L.); (L.-K.W.); (Y.-P.Z.)
| | - Ringo Tang-Long Zhu
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China; (P.-Z.L.); (R.T.-L.Z.); (Y.T.L.); (L.-K.W.); (Y.-P.Z.)
- Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China
| | - Yan To Ling
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China; (P.-Z.L.); (R.T.-L.Z.); (Y.T.L.); (L.-K.W.); (Y.-P.Z.)
| | - Li-Ke Wang
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China; (P.-Z.L.); (R.T.-L.Z.); (Y.T.L.); (L.-K.W.); (Y.-P.Z.)
| | - Yong-Ping Zheng
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China; (P.-Z.L.); (R.T.-L.Z.); (Y.T.L.); (L.-K.W.); (Y.-P.Z.)
- Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China
| | - Christina Zong-Hao Ma
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China; (P.-Z.L.); (R.T.-L.Z.); (Y.T.L.); (L.-K.W.); (Y.-P.Z.)
- Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China
- Correspondence: ; Tel.: +852-2766-7671
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