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Li Z, Zeng CM, Dong YG, Cao Y, Yu LY, Liu HY, Tian X, Tian R, Zhong CY, Zhao TT, Liu JS, Chen Y, Li LF, Huang ZY, Wang YY, Hu Z, Zhang J, Liang JX, Zhou P, Lu YQ. A segmentation model to detect cevical lesions based on machine learning of colposcopic images. Heliyon 2023; 9:e21043. [PMID: 37928028 PMCID: PMC10623278 DOI: 10.1016/j.heliyon.2023.e21043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 10/12/2023] [Accepted: 10/13/2023] [Indexed: 11/07/2023] Open
Abstract
Background Semantic segmentation is crucial in medical image diagnosis. Traditional deep convolutional neural networks excel in image classification and object detection but fall short in segmentation tasks. Enhancing the accuracy and efficiency of detecting high-level cervical lesions and invasive cancer poses a primary challenge in segmentation model development. Methods Between 2018 and 2022, we retrospectively studied a total of 777 patients, comprising 339 patients with high-level cervical lesions and 313 patients with microinvasive or invasive cervical cancer. Overall, 1554 colposcopic images were put into the DeepLabv3+ model for learning. Accuracy, Precision, Specificity, and mIoU were employed to evaluate the performance of the model in the prediction of cervical high-level lesions and cancer. Results Experiments showed that our segmentation model had better diagnosis efficiency than colposcopic experts and other artificial intelligence models, and reached Accuracy of 93.29 %, Precision of 87.2 %, Specificity of 90.1 %, and mIoU of 80.27 %, respectively. Conclution The DeepLabv3+ model had good performance in the segmentation of cervical lesions in colposcopic post-acetic-acid images and can better assist colposcopists in improving the diagnosis.
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Affiliation(s)
- Zhen Li
- Department of Gynecological Oncology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China
| | - Chu-Mei Zeng
- Department of Obstetrics and gynecology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510062, China
| | - Yan-Gang Dong
- Institute for Brain Research and Rehabilitation, the South China Normal University, Guangzhou, Guangdong, 510631, China
| | - Ying Cao
- Department of Obstetrics and Gynecology, Academician expert workstation, The Central Hospital of Wuhan, Tongji Medical College Huazhong University of Science and Technology, Wuhan, Hubei, 430014, China
| | - Li-Yao Yu
- Department of Obstetrics and Gynecology, Academician expert workstation, The Central Hospital of Wuhan, Tongji Medical College Huazhong University of Science and Technology, Wuhan, Hubei, 430014, China
| | - Hui-Ying Liu
- Department of Obstetrics and gynecology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510062, China
| | - Xun Tian
- Department of Obstetrics and Gynecology, Academician expert workstation, The Central Hospital of Wuhan, Tongji Medical College Huazhong University of Science and Technology, Wuhan, Hubei, 430014, China
| | - Rui Tian
- the Generulor Company Bio-X Lab, Zhuhai, Guangdong, 519060, China
| | - Chao-Yue Zhong
- the Generulor Company Bio-X Lab, Zhuhai, Guangdong, 519060, China
| | - Ting-Ting Zhao
- the Generulor Company Bio-X Lab, Zhuhai, Guangdong, 519060, China
| | - Jia-Shuo Liu
- Department of Obstetrics and gynecology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510062, China
| | - Ye Chen
- Department of Obstetrics and gynecology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510062, China
| | - Li-Fang Li
- Department of Obstetrics and gynecology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510062, China
| | - Zhe-Ying Huang
- Department of Obstetrics and gynecology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510062, China
| | - Yu-Yan Wang
- Department of Obstetrics and gynecology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510062, China
| | - Zheng Hu
- Department of Gynecological Oncology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China
| | - Jingjing Zhang
- Department of Gynecological Oncology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China
| | - Jiu-Xing Liang
- Institute for Brain Research and Rehabilitation, the South China Normal University, Guangzhou, Guangdong, 510631, China
| | - Ping Zhou
- Department of Gynecology, Dongguan Maternal and Child Hospital, Dongguan, Guangdong, 523057, China
| | - Yi-Qin Lu
- Department of Gynecology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 101121, China
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Wei FF, Chen SL, Chen C, Yu ZP, Zhou YY, Xu TY, Wu YZ, Dong YG, Liu C. [Associations of all-cause mortality with admission blood pressure variability during multiple hospitalizations in acute decompensated heart failure]. Zhonghua Xin Xue Guan Bing Za Zhi 2023; 51:377-383. [PMID: 37057324 DOI: 10.3760/cma.j.cn112148-20230110-00023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 04/15/2023]
Abstract
Objective: To investigate whether admission blood pressure (BP) variability during multiple hospitalizations is associated with all-cause mortality independent of baseline BP in acute decompensated heart failure (ADHF). Methods: Patients with ADHF admitted to the Department of Cardiology, The First Affiliated Hospital of Sun Yat-Sen University from September 2013 to December 2017 were retrospectively enrolled. The risk of all-cause mortality associated with indices of BP variability, including mean admission BPs, standard deviation of BP and coefficient of variation of BP during multiple hospitalizations was assessed, using Cox regression model. Results: A total of 1 006 ADHF patients (mean aged (69.3±13.5) years; 411 (40.8%) female; 670 (66.6%) with preserved ejection fraction) were enrolled. During a median follow-up of 1.54 years, 47.0% of patients died. In all ADHF patients, after adjusting for confounding factors, for every 1-standard deviation (SD) increase in SD and coefficient of variation (CV) of systolic BP, the risk of all-cause mortality increased by 10% and 11%, respectively (SD: HR, 1.10, 95%CI, 1.01-1.21, P=0.029, CV: HR, 1.11, 95%CI, 1.02-1.21, P=0.017); for every 1-SD increase in the mean of diastolic BP, the risk of all cause mortality decreased by 25% (HR, 0.75; 95%CI, 0.65-0.87; P<0.001). In ADHF patients with preserved ejection fraction, after accounted for potential confounders, higher SD and CV of admitted systolic and diastolic BP were significantly associated with higher risk of all-cause mortality, regardless of whether confounding factors were adjusted (P≤0.049); After adjusting for confounding factors, the risk of all-cause mortality increased by 18% and 19% for every 1-SD increase in SD and CV of systolic BP, while the risk of all-cause mortality increased by 11% and 15% for every 1-SD increase in SD and CV of diastolic BP. In ADHF patients with reduced ejection fraction, after adjusting for confounding factors, the higher the mean admission systolic BP during multiple hospitalizations, the lower the risk of total mortality (HR, 0.68; 95%CI, 0.47-1.00; P=0.049). Conclusions: In patients with ADHF, independent of baseline BP, BP variability during multiple hospitalizations was strong predictor of all-cause mortality.
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Affiliation(s)
- F F Wei
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, National Health Commission Key Laboratory of Assisted Circulation (Sun Yat-Sen University), Guangzhou 510080, China
| | - S L Chen
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, National Health Commission Key Laboratory of Assisted Circulation (Sun Yat-Sen University), Guangzhou 510080, China
| | - C Chen
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, National Health Commission Key Laboratory of Assisted Circulation (Sun Yat-Sen University), Guangzhou 510080, China
| | - Z P Yu
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, National Health Commission Key Laboratory of Assisted Circulation (Sun Yat-Sen University), Guangzhou 510080, China
| | - Y Y Zhou
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, National Health Commission Key Laboratory of Assisted Circulation (Sun Yat-Sen University), Guangzhou 510080, China
| | - T Y Xu
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, National Health Commission Key Laboratory of Assisted Circulation (Sun Yat-Sen University), Guangzhou 510080, China
| | - Y Z Wu
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, National Health Commission Key Laboratory of Assisted Circulation (Sun Yat-Sen University), Guangzhou 510080, China
| | - Y G Dong
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, National Health Commission Key Laboratory of Assisted Circulation (Sun Yat-Sen University), Guangzhou 510080, China
| | - C Liu
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, National Health Commission Key Laboratory of Assisted Circulation (Sun Yat-Sen University), Guangzhou 510080, China
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Zhang B, Yue ZY, Yang ZM, Nan P, Xu B, Dong YG, Hu YY, Li WX, Sun XH, Sun XM. [The screening value of the numerical control standardized cell block preparation technique in high-grade squamous epithelial lesions of the cervix]. Zhonghua Bing Li Xue Za Zhi 2020; 49:842-844. [PMID: 32746555 DOI: 10.3760/cma.j.cn112151-20191220-00819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- B Zhang
- Department of Pathology, the Third Affiliated Hospital of Guangdong Medical University (Longjiang Hospital, Shunde District, Foshan City), Foshan 528000, China
| | - Z Y Yue
- Department of Pathology, the Central Hospital of Shengli Oilfield, Dongying 257000, China
| | - Z M Yang
- Department of Pathology, the Fourth People's Hospital, Nanhai District, Foshan City, Guangdong Province, Foshan 528200, China
| | - P Nan
- Department of Gynecology, the Central Hospital of Shengli Oilfield, Dongying 257000, China
| | - B Xu
- Department of Pathology, the Central Hospital of Shengli Oilfield, Dongying 257000, China
| | - Y G Dong
- Department of Pathology, the Central Hospital of Shengli Oilfield, Dongying 257000, China
| | - Y Y Hu
- Department of Pathology, the Central Hospital of Shengli Oilfield, Dongying 257000, China
| | - W X Li
- Department of Pathology, the Central Hospital of Shengli Oilfield, Dongying 257000, China
| | - X H Sun
- Department of Pathology, the Central Hospital of Shengli Oilfield, Dongying 257000, China
| | - X M Sun
- Department of Pathology, the Central Hospital of Shengli Oilfield, Dongying 257000, China
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Wang H, Li YY, Chai K, Zhang W, Li XL, Dong YG, Zhou JM, Huo Y, Yang JF. [Contemporary epidemiology and treatment of hospitalized heart failure patients in real clinical practice in China]. Zhonghua Xin Xue Guan Bing Za Zhi 2019; 47:865-874. [PMID: 31744275 DOI: 10.3760/cma.j.issn.0253-3758.2019.11.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To observe the etiology, comorbidities, clinical features and treatment patterns of hospitalized patients with heart failure (HF) in China. Methods: Data were collected prospectively on hospitalized patients with HF who were enrolled in China Heart Failure Center Registry Study from 169 participating hospitals from January 2017 to August 2018. In this cross-sectional study, patients were stratified by left ventricular ejection fraction (LVEF) category: heart failure with reduced ejection fraction (HFrEF, LVEF<40%); heart failure with mid-ranged ejection fraction (HFmrEF, 40%≤LVEF<50%) and heart failure with preserved ejection fraction (HFpEF, LVEF≥50%). The clinical data were collected, including demographic information, diagnosis, signs, electrocardiogram, echocardiography, laboratory tests, and treatment. Results: A total of 31 356 hospitalized patients with HF were included, 19 072 (60.8%) were males and the average age was (67.9±13.6) years old. The common causes of HF were hypertension (57.2%), coronary heart disease (54.6%), dilated cardiomyopathy (14.7%), valvular heart disease (9.2%). The common complications were atrial fibrillation/atrial flutter (34.1%), diabetes (29.2%), and anemia (26.7%). 32.8% of patients had a history of hospitalization for HF within the previous 12 months. There were 11 034 (35.2%) patients with HFrEF, 6 825 (21.8%) patients with HFmrEF and 13 497 (43.0%) patients with HFpEF. Compared with patients with HFpEF, patients with HFrEF had a lower systolic blood pressure ((124.7±21.1)mmHg(1 mmHg=0.133 kPa) vs. (134.9±22.9)mmHg), faster heart rate ((85±19) beats/minutes vs. (81±19)beats/minutes), and higher percentage of New York Heart Association (NYHA) class Ⅳ, smoking, alcohol, left bundle branch block, and QRS time≥130 ms, and higher levels of blood uric acid, BNP, and NT-proBNP (all P<0.05). Compared with patients with HFmrEF and HFrEF, patients with HFpEF were older, more women, and higher comorbidity burden including hypertension, atrial fibrillation/atrial flutter, anemia and chronic obstructive pulmonary disease (all P<0.05). HFmrEF took a mid-position between HFrEF and HFpEF in age, gender, heart rate, systolic blood pressure, hypertension, atrial fibrillation/atrial flutter, anemia, and chronic obstructive pulmonary disease (all P<0.05). Patients with HFmrEF had the highest proportion of coronary heart disease, myocardial infarction and percutaneous coronary intervention (all P<0.05). During hospitalization, loop diuretics were used in 90.2% of patients, and intravenous inotropics were used in 20.4% of patients. The use of ACEI/ARB/ARNI, β blockers and aldosterone receptor antagonists at discharge were 71.8%, 79.1% and 83.6% in HFrEF and 69.9%, 75.5% and 72.4% in HFmrEF, respectively. The use of digoxin at discharge was 25.3% (HFrEF 36.7%, HFmrEF 23.1%, HFpEF 17.0%). The rates of cardiac resynchronization therapy and implantable cardioverter defibrillator in HFrEF were 2.7% and 2.1%. Conclusions: Among the hospitalized patients with HF in China, coronary heart disease and hypertension are the mostly prevalent causes. HFpEF accounts for a large proportion of hospitalized patients with HF. HFrEF, HFmrEF and HFpEF have different etiology and clinical features. In real-world, there are still large gaps in the effective application of the guideline recommended therapies to HF patients, especially the non-pharmacological therapy option, which needs to be improved further in China.
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Affiliation(s)
- H Wang
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
| | - Y Y Li
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
| | - K Chai
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
| | - W Zhang
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai 200032, China
| | - X L Li
- Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Y G Dong
- First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - J M Zhou
- Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Y Huo
- Department of Cardiology, Peking University First Hospital, Beijing 100034, China
| | - J F Yang
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
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Mao JB, Wu SL, Chen YQ, Dong YG, Zheng B, Tao JW, Zhao SX, Fang D, Shen LJ. [The efficiency of 23 G vitrectomy combined with preoperative subtenon injection of triamcinolone acetonide for treatment of retinal detachment associated with choroidal detachment]. Zhonghua Yan Ke Za Zhi 2018; 54:252-257. [PMID: 29747353 DOI: 10.3760/cma.j.issn.0412-4081.2018.04.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To evaluate the efficiency of 23 G vitrectomy combined with preoperative subtenon injecfion of triamcinolone acetonide for treatment of rhegmatogenous retinal detachment associated with choroidal detachment. Methods: A retrospective analysis. Forty-eight (16 males and 32 females, aged 57.3±13.9) consecutive patients (48 eyes) who were diagnosed with rhegmatogenous retinal detachment associated with choroidal detachment and received 23 G vitrectomy at the Eye Hospital of Wenzhou Medical University during January 2012 and January 2015 were enrolled. Twenty-three eyes were treated with subtenon injection TA 5 d before the planned 23 G vitrectomy (TA group). Twenty-five eyes were treated with dexamethasone 3 to 5 d before the planned vitrectomy (Dex group). Type-B ultrasonic, intraocular pressure, best corrected visual acuity examinations were conducted for all eyes on admission day, preoperatively and at 1 month, 3 month postoperatively, and during the last visit. The rate of reattachment, change of height of choroidal detachment, intraocular pressure, best corrected visual acuity, and the complication of the eyes between the two groups were compared. All patients were followed up at least half a year after the repair surgery. Results: The intraocular pressure of the TA group was higher than the Dex group[(8.58±3.83)mmHg vs. (6.70±2.49)mmHg (1 mmHg=0.133 kPa), (t=2.032)], and the height of choroidal detachment was lower in TA group [0.90(0.00, 3.84)mm vs. 4.03(1.05, 5.38)mm, Z=-2.569, P<0.05]. There is no statistic difference between the reattachment rate of the two groups [95.7%(22/23) vs. 76.0%(19/25), χ(2)=2.304, P=0.129], but it seems it was better in TA group. The best corrected visual acuity results of the last visit was better in TA group than Dex group [(0.91±0.54) vs. (1.25±0.62), t=-2.034, P=0.048]. The rate of hypertention was higher in TA group than Dex group at 1 month, 3 month postoperatively(χ(2)=2.304, 5.648, P<0.05), while there was no statistic difference of hypertention rate during last visit between the two groups (χ(2)=0.006, P=0.941). Conclusions: The treatment of 23 G vitrectomy combined with subtenon injection of triamcinolone acetonide can improve the intraocular pressure, reduce the height of choroidal detachment, and improve the best corrected visual acuity after the surgery, but it may cause heyertenion. (Chin J Ophthalmol, 2018, 54: 252-257).
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Affiliation(s)
- J B Mao
- The affiliated Eye Hospital of Wenzhou Medical University, Wenzhou 325027, China
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Yue ZY, Guo XH, Pang MX, Dong YG, Wang H, Li WX. [Primary esophageal malignant peripheral nerve sheath tumor: report of a case]. Zhonghua Bing Li Xue Za Zhi 2017; 46:345-346. [PMID: 28468046 DOI: 10.3760/cma.j.issn.0529-5807.2017.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Yue ZY, Zhang LY, Song DX, Ding B, Wang H, Dong YG. [Gastric myoglandular hematoma: report of a case]. Zhonghua Bing Li Xue Za Zhi 2017; 46:57-58. [PMID: 28072981 DOI: 10.3760/cma.j.issn.0529-5807.2017.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Yue ZY, Song DX, Miao J, Wang H, Dong YG. [Primary ovarian mesenchymal chondrosarcoma: report of a case]. Zhonghua Bing Li Xue Za Zhi 2016; 45:805-806. [PMID: 27821242 DOI: 10.3760/cma.j.issn.0529-5807.2016.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Yue ZY, Tian ZJ, Song DX, Wang H, Dong YG, Li WX. [Plumonary adenofibroma: report of a case]. Zhonghua Bing Li Xue Za Zhi 2016; 45:650-651. [PMID: 27646899 DOI: 10.3760/cma.j.issn.0529-5807.2016.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Yue ZY, Ding B, Dong YG, Wang H, Li WX. [Primary gastric aggressive fibromatosis: report of a case]. Zhonghua Bing Li Xue Za Zhi 2016; 45:583-584. [PMID: 27510790 DOI: 10.3760/cma.j.issn.0529-5807.2016.08.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Yue ZY, Zhang LY, Wei JG, Song DX, Dong YG, Li WX. [Primary lymphoepithelioma-like carcinoma of ureter: report of a case]. Zhonghua Bing Li Xue Za Zhi 2016; 45:482-483. [PMID: 27430698 DOI: 10.3760/cma.j.issn.0529-5807.2016.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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