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Zhang L, Dong YF, Chen Y, Li XG, Wang YH, Wang Y, Ge ZT, Wang X, Cai S, Yang X, Zhu QL, Li JC. Impact of Microbubble Degradation and Flow Velocity on Subharmonic-aided Pressure Estimation (SHAPE): An Experimental Investigation. ULTRASOUND IN MEDICINE & BIOLOGY 2024; 50:1020-1027. [PMID: 38594125 DOI: 10.1016/j.ultrasmedbio.2024.03.010] [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: 01/10/2024] [Revised: 03/12/2024] [Accepted: 03/21/2024] [Indexed: 04/11/2024]
Abstract
OBJECTIVE This study aimed to investigate the impact of microbubble degradation and flow velocity on Sub-Harmonic Aided Pressure Estimation (SHAPE), and to explore the correlation between subharmonic amplitude and pressure as a single factor. METHODS We develop an open-loop vascular phantom platform system and utilize a commercial ultrasound machine and microbubbles for subharmonic imaging. Subharmonic amplitude was measured continuously at constant pressure and flow velocity to assess the impact of microbubble degradation. Flow velocity was varied within a range of 4-14 cm/s at constant pressure to investigate its relationship to subharmonic amplitude. Furthermore, pressure was varied within a range of 10-110 mm Hg at constant flow velocity to assess its isolated effect on subharmonic amplitude. RESULTS Under constant pressure and flow velocity, subharmonic amplitude exhibited a continuous decrease at an average rate of 0.221 dB/min, signifying ongoing microbubble degradation during the experimental procedures. Subharmonic amplitude demonstrated a positive correlation with flow velocity, with a variation ratio of 0.423 dB/(cm/s). Under controlled conditions of microbubble degradation and flow velocity, a strong negative linear correlation was observed between pressure and subharmonic amplitude across different Mechanical Index (MI) settings (all R2 > 0.90). The sensitivity of SHAPE was determined to be 0.025 dB/mmHg at an MI of 0.04. CONCLUSION The assessment of SHAPE sensitivity is affected by microbubble degradation and flow velocity. Excluding the aforementioned influencing factors, a strong linear negative correlation between pressure and subharmonic amplitude was still evident, albeit with a sensitivity coefficient lower than previously reported values.
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Affiliation(s)
- Li Zhang
- Department of Diagnostic Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Yi-Fan Dong
- Department of Diagnostic Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Yao Chen
- Department of Ultrasound, GE Healthcare Medical System (China), Shanghai, China
| | - Xiao-Gang Li
- Biobank Facility, National Infrastructures for Translational Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Ya-Hong Wang
- Department of Diagnostic Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Ying Wang
- Department of Diagnostic Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Zhi-Tong Ge
- Department of Diagnostic Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Xin Wang
- Department of Diagnostic Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Sheng Cai
- Department of Health Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Xiao Yang
- Department of Diagnostic Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Qing-Li Zhu
- Department of Diagnostic Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Jian-Chu Li
- Department of Diagnostic Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
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AIUM Practice Parameter for the Performance of Contrast-Enhanced Ultrasound. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2024; 43:E8-E19. [PMID: 37873725 DOI: 10.1002/jum.16360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 09/29/2023] [Indexed: 10/25/2023]
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Zalloum IO, Jafari Sojahrood A, Paknahad AA, Kolios MC, Tsai SSH, Karshafian R. Controlled Tempering of Lipid Concentration and Microbubble Shrinkage as a Possible Mechanism for Fine-Tuning Microbubble Size and Shell Properties. LANGMUIR : THE ACS JOURNAL OF SURFACES AND COLLOIDS 2023; 39:17622-17631. [PMID: 38016673 DOI: 10.1021/acs.langmuir.3c01599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
The acoustic response of microbubbles (MBs) depends on their resonance frequency, which is dependent on the MB size and shell properties. Monodisperse MBs with tunable shell properties are thus desirable for optimizing and controlling the MB behavior in acoustics applications. By utilizing a novel microfluidic method that uses lipid concentration to control MB shrinkage, we generated monodisperse MBs of four different initial diameters at three lipid concentrations (5.6, 10.0, and 16.0 mg/mL) in the aqueous phase. Following shrinkage, we measured the MB resonance frequency and determined its shell stiffness and viscosity. The study demonstrates that we can generate monodisperse MBs of specific sizes and tunable shell properties by controlling the MB initial diameter and aqueous phase lipid concentration. Our results indicate that the resonance frequency increases by 180-210% with increasing lipid concentration (from 5.6 to 16.0 mg/mL), while the bubble diameter is kept constant. Additionally, we find that the resonance frequency decreases by 260-300% with an increasing MB final diameter (from 5 to 12 μm), while the lipid concentration is held constant. For example, our results depict that the resonance frequency increases by ∼195% with increasing lipid concentration from 5.6 to 16.0 mg/mL, for ∼11 μm final diameter MBs. Additionally, we find that the resonance frequency decreases by ∼275% with increasing MB final diameter from 5 to 12 μm when we use a lipid concentration of 5.6 mg/mL. We also determine that MB shell viscosity and stiffness increase with increasing lipid concentration and MB final diameter, and the level of change depends on the degree of shrinkage experienced by the MB. Specifically, we find that by increasing the concentration of lipids from 5.6 to 16.0 mg/mL, the shell stiffness and viscosity of ∼11 μm final diameter MBs increase by ∼400 and ∼200%, respectively. This study demonstrates the feasibility of fine-tuning the MB acoustic response to ultrasound by tailoring the MB initial diameter and lipid concentration.
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Affiliation(s)
- Intesar O Zalloum
- Department of Physics, Toronto Metropolitan University, Toronto M5B 2K3, Ontario, Canada
- Institute for Biomedical Engineering, Science and Technology (iBEST), A Partnership between Toronto Metropolitan University and St. Michael's Hospital, 209 Victoria Street, Toronto M5B 1T8, Ontario, Canada
- Keenan Research Centre for Biomedical Science, Unity Health Toronto, 209 Victoria Street, Toronto M5B 1W8, Ontario, Canada
| | - Amin Jafari Sojahrood
- Department of Physics, Toronto Metropolitan University, Toronto M5B 2K3, Ontario, Canada
- Institute for Biomedical Engineering, Science and Technology (iBEST), A Partnership between Toronto Metropolitan University and St. Michael's Hospital, 209 Victoria Street, Toronto M5B 1T8, Ontario, Canada
- Keenan Research Centre for Biomedical Science, Unity Health Toronto, 209 Victoria Street, Toronto M5B 1W8, Ontario, Canada
| | - Ali A Paknahad
- Department of Mechanical and Industrial Engineering, Toronto Metropolitan University, 350 Victoria Street, Toronto M5B 2K3, Ontario, Canada
- Institute for Biomedical Engineering, Science and Technology (iBEST), A Partnership between Toronto Metropolitan University and St. Michael's Hospital, 209 Victoria Street, Toronto M5B 1T8, Ontario, Canada
- Keenan Research Centre for Biomedical Science, Unity Health Toronto, 209 Victoria Street, Toronto M5B 1W8, Ontario, Canada
| | - Michael C Kolios
- Department of Physics, Toronto Metropolitan University, Toronto M5B 2K3, Ontario, Canada
- Institute for Biomedical Engineering, Science and Technology (iBEST), A Partnership between Toronto Metropolitan University and St. Michael's Hospital, 209 Victoria Street, Toronto M5B 1T8, Ontario, Canada
- Keenan Research Centre for Biomedical Science, Unity Health Toronto, 209 Victoria Street, Toronto M5B 1W8, Ontario, Canada
| | - Scott S H Tsai
- Department of Mechanical and Industrial Engineering, Toronto Metropolitan University, 350 Victoria Street, Toronto M5B 2K3, Ontario, Canada
- Institute for Biomedical Engineering, Science and Technology (iBEST), A Partnership between Toronto Metropolitan University and St. Michael's Hospital, 209 Victoria Street, Toronto M5B 1T8, Ontario, Canada
- Keenan Research Centre for Biomedical Science, Unity Health Toronto, 209 Victoria Street, Toronto M5B 1W8, Ontario, Canada
- Graduate Program in Biomedical Engineering, Toronto Metropolitan University, 350 Victoria Street, Toronto M5B 2K3, Ontario, Canada
| | - Raffi Karshafian
- Department of Physics, Toronto Metropolitan University, Toronto M5B 2K3, Ontario, Canada
- Institute for Biomedical Engineering, Science and Technology (iBEST), A Partnership between Toronto Metropolitan University and St. Michael's Hospital, 209 Victoria Street, Toronto M5B 1T8, Ontario, Canada
- Keenan Research Centre for Biomedical Science, Unity Health Toronto, 209 Victoria Street, Toronto M5B 1W8, Ontario, Canada
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Machado P, Gupta I, Fenkel JM, Gummadi S, Stanczak M, Wessner CE, Shaw CM, Schultz S, Soulen MC, Wallace K, Eisenbrey JR, Forsberg F. Ultrasound Pressure Estimation for Diagnosing Portal Hypertension in Patients Undergoing Dialysis for Chronic Kidney Disease. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2022; 41:2181-2189. [PMID: 34850412 PMCID: PMC9156659 DOI: 10.1002/jum.15897] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 10/08/2021] [Accepted: 10/27/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES Hepatic venous pressure gradient (HVPG) is considered the standard in quantifying portal hypertension, but can be unreliable in dialysis patients. A noninvasive ultrasound technique, subharmonic-aided pressure estimation (SHAPE), may be a valuable surrogate of these pressure estimates. This study compared SHAPE and HVPG with pathology findings for fibrosis in dialysis patients. METHODS This was a subgroup study from an IRB-approved trial that included 20 patients on dialysis undergoing SHAPE examinations of portal and hepatic veins using a modified Logiq 9 scanner (GE, Waukesha, WI), during infusion of Sonazoid (GE Healthcare, Oslo, Norway). SHAPE was compared to HVPG and pathology findings using the Ludwig-Batts scoring system for fibrosis. Logistic regression, ROC analysis, and t-tests were used to compare HVPG and SHAPE with pathological findings of fibrosis. RESULTS Of 20 cases, 5 had HVPG values corresponding to subclinical and clinical portal hypertension (≥6 and ≥10 mmHg, respectively) while 15 had normal HVPG values (≤5 mmHg). SHAPE and HVPG correlated moderately (r = 0.45; P = .047). SHAPE showed a trend toward correlating with fibrosis (r = 0.42; P = .068), while HVPG did not (r = 0.18; P = .45). SHAPE could differentiate between mild (stage 0-1) and moderate to severe (stage 2-4) fibrosis (-10.4 ± 4.9 dB versus -5.4 ± 3.2 dB; P = .035), HVPG could not (3.0 ± 0.6 mmHg versus 4.8 ± 0.7 mmHg; P = .30). ROC curves showed a diagnostic accuracy for SHAPE of 80%, while HVPG reached 76%. CONCLUSION Liver fibrosis staging in dialysis patients evaluated for portal hypertension appears to be more accurately predicted by SHAPE than by HVPG; albeit in a small sample size.
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Affiliation(s)
- Priscilla Machado
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Ipshita Gupta
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Jonathan M Fenkel
- Division of Gastroenterology and Hepatology, Department of Medicine, Thomas Jefferson University, Philadelphia, PA, USA
| | | | - Maria Stanczak
- Department of Medical Imaging and Radiation Sciences, Thomas Jefferson University, Philadelphia, PA, USA
| | - Corinne E Wessner
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Colette M Shaw
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Susan Schultz
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Michael C Soulen
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | | | - John R Eisenbrey
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Flemming Forsberg
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA
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Forsberg F, Piccoli CW, Sridharan A, Wilkes A, Sevrukov A, Ojeda-Fournier H, Mattrey RF, Machado P, Stanczak M, Merton DA, Wallace K, Eisenbrey JR. 3D Harmonic and Subharmonic Imaging for Characterizing Breast Lesions: A Multi-Center Clinical Trial. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2022; 41:1667-1675. [PMID: 34694019 PMCID: PMC9884499 DOI: 10.1002/jum.15848] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 09/20/2021] [Indexed: 05/12/2023]
Abstract
OBJECTIVE Breast cancer is the most frequent type of cancer among women. This multi-center study assessed the ability of 3D contrast-enhanced ultrasound to characterize suspicious breast lesions using clinical assessments and quantitative parameters. METHODS Women with suspicious breast lesions scheduled for biopsy were enrolled in this prospective, study. Following 2D grayscale ultrasound and power Doppler imaging (PDI), a contrast agent (Definity; Lantheus) was administrated. Contrast-enhanced 3D harmonic imaging (HI; transmitting/receiving at 5.0/10.0 MHz), as well as 3D subharmonic imaging (SHI; transmitting/receiving at 5.8/2.9 MHz), were performed using a modified Logiq 9 scanner (GE Healthcare). Five radiologists independently scored the imaging modes (including standard-of-care imaging) using a 7-point BIRADS scale as well as lesion vascularity and diagnostic confidence. Parametric volumes were constructed from time-intensity curves for vascular heterogeneity, perfusion, and area under the curve. Diagnostic accuracy was determined relative to pathology using receiver operating characteristic (ROC) and reverse, step-wise logistical regression analyses. The κ-statistic was calculated for inter-reader agreement. RESULTS Data were successfully acquired in 219 cases and biopsies indicated 164 (75%) benign and 55 (25%) malignant lesions. SHI depicted more anastomoses and vascularity than HI (P < .021), but there were no differences by pathology (P > .27). Ultrasound achieved accuracies of 82 to 85%, which was significantly better than standard-of-care imaging (72%; P < .03). SHI increased diagnostic confidence by 3 to 6% (P < .05), but inter-reader agreements were medium to low (κ < 0.52). The best regression model achieved 97% accuracy by combining clinical reads and parametric SHI. CONCLUSIONS Combining quantitative 3D SHI parameters and clinical assessments improves the characterization of suspicious breast lesions.
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Affiliation(s)
- Flemming Forsberg
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA
| | | | - Anush Sridharan
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA
- Department of Electrical and Computer Engineering, Drexel University, Philadelphia, PA, USA
| | - Annina Wilkes
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Alexander Sevrukov
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA
| | | | - Robert F Mattrey
- Department of Radiology, University of California San Diego, San Diego, CA, USA
| | - Priscilla Machado
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Maria Stanczak
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Daniel A Merton
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA
| | | | - John R Eisenbrey
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA
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van Hoeve W, de Vargas Serrano M, Te Winkel L, Forsberg F, Dave JK, Sarkar K, Wessner CE, Eisenbrey JR. Improved Sensitivity of Ultrasound-Based Subharmonic Aided Pressure Estimation Using Monodisperse Microbubbles. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2022; 41:1781-1789. [PMID: 34724241 DOI: 10.1002/jum.15861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 09/29/2021] [Accepted: 10/01/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES Subharmonic aided pressure estimation (SHAPE) has been shown effective for noninvasively measuring hydrostatic fluid pressures in a variety of clinical applications. The objective of this study was to explore potential improvements in SHAPE sensitivity using monodisperse microbubbles. METHODS Populations of monodisperse microbubbles were created using a commercially available microfluidics device (Solstice Pharmaceuticals). Size distributions were assessed using a Coulter Counter and stability of the distribution following fabrication was evaluated over 24 hours. Attenuation of the microbubble populations from 1 to 10 MHz was then quantified using single element transducers to identify each formulation's resonance frequency. Frequency spectra over increasing driving amplitudes were investigated to determine the nonlinear phases of subharmonic signal generation. SHAPE sensitivity was evaluated in a hydrostatic pressure-controlled water bath using a Logiq E10 scanner (GE Healthcare). RESULTS Monodisperse lipid microbubble suspensions ranging from 2.4 to 5.3 μm in diameter were successfully created and they showed no discernable change in size distribution over 24 hours following activation. Calculated resonance frequencies ranged from 2.1 to 6.3 MHz and showed excellent correlation with microbubble diameter (R2 > 0.99). When investigating microbubble frequency response, subharmonic signal occurrence was shown to begin at 150 kPa peak negative pressure, grow up to 225 kPa, and saturate at approximately 250 kPa. Using the Logiq E10, monodisperse bubbles demonstrated a SHAPE sensitivity of -0.17 dB/mmHg, which was nearly twice the sensitivity of the commercial polydisperse microbubble currently being used in clinical trials. CONCLUSIONS Monodisperse microbubbles have the potential to greatly improve the sensitivity of SHAPE for the noninvasive measurement of hydrostatic pressures.
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Affiliation(s)
| | | | | | - Flemming Forsberg
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Jaydev K Dave
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Kausik Sarkar
- Department of Mechanical and Aerospace Engineering, The George Washington University, Washington, DC, USA
| | - Corinne E Wessner
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA
| | - John R Eisenbrey
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA
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Ultrasound contrast agents: microbubbles made simple for the pediatric radiologist. Pediatr Radiol 2021; 51:2117-2127. [PMID: 34117892 PMCID: PMC9288183 DOI: 10.1007/s00247-021-05080-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 02/25/2021] [Accepted: 04/12/2021] [Indexed: 02/07/2023]
Abstract
The ability to provide prompt, real-time, easily accessible and radiation-free diagnostic assessments makes ultrasound (US) one of the most versatile imaging modalities. The introduction and development of stable microbubble-based ultrasound contrast agents (UCAs) in the early 1990s improved visualization of complex vascular structures, overcoming some of the limitations of B-mode and Doppler imaging. UCAs have been used extensively in the adult population to visualize vasculature and to evaluate perfusion and blood flow dynamics in organs and lesions. Since the first observations that air bubbles within a liquid can generate a strong echogenic effect, to the early makeshift approaches with agitated saline, and later to the development of industrially produced and federally approved UCAs, these agents have evolved to become both clinically and commercially viable. Perhaps the most exciting potential of UCAs is being uncovered by current research that explores the use of these agents for molecular imaging and therapeutic applications. As contrast-enhanced ultrasound (CEUS) becomes more widely available, it is important for pediatric radiologists to understand the physics of the interaction between the US signal and the microbubbles in order to properly utilize them for the highest level of diagnostic imaging and interventions. In this article we introduce the composition of UCAs and the physics of their behavior in US, and we offer a brief history of their development over the last decades.
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