Publications by authors named "Fabio D"

31 Publications

Cervical injury related to mandibular fractures. A retrospective study of 315 cases.

Cranio 2019 May 8;37(3):188-195. Epub 2017 Nov 8.

b Department of Life, Health & Environmental Sciences , University of L'Aquila , L'Aquila , Italy.

Objective To define the association between mandibular fractures and alterations of the cranio-atlo-axial joint (CAAJ). Methods 315 cases of displaced mandibular fractures were retrospectively evaluated by CT scan and cervical X-ray for associated alterations of the CAAJ. Statistical analysis employed the chi-square and Cohen's kappa coefficient. Results Single fractures amounted to 69.84% and multiple fractures to 30.16% of total fractures. CT scans showed a rotation of the atlas on the same side of single fractures and subluxation of the CAAJ. Vertical derangement of the joint was observed in 79.65% of single fractures and in 20.35% of multiple fractures. Approximately16.19% of all displaced mandibular fractures showed cervical disorders at long-term follow-up. Discussion The outcomes of this study revealed an association between traumatic mandibular fractures and CAAJ, accompanied by clinical disorders. These conditions require clinical attention due to their effects on long-term craniocervical functionality and future forensic issues.
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http://dx.doi.org/10.1080/08869634.2017.1398921DOI Listing
May 2019

Adherence to physical activity guidelines in mid-pregnancy does not reduce sedentary time: an observational study.

Int J Behav Nutr Phys Act 2015 Feb 24;12:27. Epub 2015 Feb 24.

Department of Food Science and Human Nutrition, Iowa State University, 220 MacKay Hall, Ames, Iowa, 50011, USA.

Background: Physical activity (PA) interventions designed to prevent prenatal complications have focused on increasing moderate PA yielding conflicting results. Minimal attention has focused on the evaluation of sleep, sedentary behavior (SB), light activity or total daily PA during pregnancy. The purpose of this prospective, longitudinal study was to 1) objectively quantify and compare habitual PA and SB during the 2nd and 3rd trimester; and 2) evaluate differences in activity patterns for women meeting prenatal PA guidelines versus those that did not.

Methods: Forty-six participants wore 2 PA monitors (SenseWear Mini and activPAL) during week 18 and week 35 of pregnancy. We compared differences in sleep duration, postural allocation, daily steps, and PA between the 2nd and 3rd trimester and for women who met and did not meet PA guidelines.

Results: During the 2(nd) trimester, 30% of the women's day (24-hours) was total sleep; 52% SB; 13% light; 3% moderate; and 0% vigorous PA. Light (P = 0.05), vigorous (P = 0.02), and moderate-vigorous PA (MET-minutes; P = 0.02), decreased with a trend in increased SB (P = 0.07). Activity of other intensities and sleep duration did not significantly change. Only 39% and 37% of participants slept between 7-9 hours/night at week 18 and 35, respectively. Forty-six percent (n = 21) and 28% (n = 13) of participants met prenatal PA guidelines during the 2(nd) and 3(rd) trimester, respectively. At week 18, no differences in total sleep, SB, or light PA existed for women who met PA guidelines versus those who did not; total PA was significantly greater for women who met guidelines. At week 35, women that met PA guidelines had significantly less SB (P < 0.005) than women who did not.

Conclusions: This study demonstrates that pregnant women spend the majority of their day in SB. Significant reductions in total activity across pregnancy may be attributed, in part to shifts in light PA and increased SB. Based on the lifestyle of our sample, regardless of meeting PA guidelines in mid-pregnancy, no significant difference exists in time spent in SB, however meeting PA recommendations in late pregnancy may reduce SB. Future interventions should target reducing SB by increasing light and moderate PA beyond volitional exercise.
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http://dx.doi.org/10.1186/s12966-015-0191-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4345024PMC
February 2015

Pathological (late) fractures of the mandibular angle after lower third molar removal: a case series.

J Med Case Rep 2013 Apr 30;7:121. Epub 2013 Apr 30.

Department of Life, Health & Environmental Sciences, Maxillofacial Surgery Operative Unit, University of L'Aquila, via della Comunità Europea, 13, 67100, L'Aquila, Italy.

Introduction: Pathological (late) fracture of the mandibular angle after third molar surgery is very rare (0.005% of third molar removals). There are 94 cases reported in the literature; cases associated with osseous pathologies such as osteomyelitis or any local and systemic diseases that may compromise mandibular bone strength have not been included. We describe three new cases of pathological (late) fracture of the mandibular angle after third molar surgery.

Case Presentations: The first patient was a 27-year-old Caucasian man who had undergone surgical removal of a 3.8, mesioangular variety, class II-C third molar 20 days before admission to our clinic. The fracture of his left mandibular angle, complete and composed, occurred during chewing. The second patient was a 32-year-old Caucasian man. He had undergone surgical removal of a 3.8, mesioangular variety, class II-B third molar 22 days before his admission. The fracture, which occurred during mastication, was studied by computed tomography that showed reparative tissue in the fracture site. The third patient was a 36-year-old Caucasian man who had undergone surgical removal of a 3.8, vertical variety, class II-C third molar 25 days before the observation. In this case the fracture of his mandibular angle was oblique (unfavorable), complete and composed. The fracture had occurred during chewing. We studied the fracture by optical projection tomography and computed tomography.All of the surgical removals of the 3.8 third molars, performed by the patients' dentists who had more than 10 years of experience, were difficult. We treated the fractures with open surgical reduction, internal fixation by titanium miniplates and intermaxillary elastic fixation removed after 6 weeks.

Conclusions: The literature indicates that the risk of pathological (late) fracture of the mandibular angle after third molar surgery for total inclusions (class II-III, type C) is twice that of partial inclusions due to the necessity of ostectomies more generous than those for partial inclusions. Other important factors are the anatomy of the teeth and the features of the teeth roots. These fractures predominantly occur in patients who are older than 25 years. The highest incidence (67.8% of cases) is found in the second and third week postsurgery. We emphasize that before the third molar surgery it is extremely important to always provide adequate instructions to the patient in order to avoid early masticatory loads and prevent this rare event.
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http://dx.doi.org/10.1186/1752-1947-7-121DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3667143PMC
April 2013

High-grade chondroblastic and fibroblastic osteosarcoma of the upper jaw.

Ann Maxillofac Surg 2011 Jul;1(2):176-80

Health Sciences Department Maxillofacial Surgery, University of L'Aquila - Italy.

Osteosarcomas (OS) are extremely uncommon in maxillofacial region (6%-10% of all sarcomas). Jaw lesions are diagnosed on average two decades later than sarcomas of long bone, with a peak incidence between 20 and 40 years. Head and neck OS (HNOS) are associated with a lower metastatic rate than long bone OS, and they have a better 5-year survival rate, ranging between 27% and 84%. Approximately 80% of HNOS originate from soft tissues, while 20% arise from bone. The majority of OS were classified as osteoblastic HNOS (77.0%), followed by chondroblastic (15.8%) and fibroblastic (3.4%). Patients older than 60 years were more likely to be diagnosed with other histologic types compared with patients 60 years or younger. The authors describe a rare case of Stage II high-grade mixed chondroblastic and fibroblastic osteosarcoma of the upper jaw diagnosed in a subject older than 60 years. CT i.e., total body scintigraphy, radiograph of chest, and epathic ultrasonography have been executed to staging (T3N0M0). The size of the tumor >6 cm, histopathological findings, and patient older than 60 years, made necessary a multimodality therapy. Surgery (right subtotal maxillectomy with closure of surgical area by local sliding and advanced cheek flap) and adjuvant radiotherapy (for overall 6500 Gy) were the definitive treatment. Follow-up at 2 years shows no local recurrence and the patient is disease free.
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http://dx.doi.org/10.4103/2231-0746.92790DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3591009PMC
July 2011

Measurement of S-methylcysteine and S-methyl-mercapturic acid in human urine by alkyl-chloroformate extractive derivatization and isotope-dilution gas chromatography-mass spectrometry.

Biomed Chromatogr 2011 Mar;25(3):330-43

LaTMA Laboratory for Analytical Toxicology and Metabonomics, Department of Medicine, Surgery and Dental Sciences, Università degli Studi di Milano at Ospedale San Paolo, v. A di Rudinì 8, Milan, Italy.

S-methylcysteine (SMC) is a minor amino acid naturally excreted in human urine, a protective agent against oxidative stress and a biotransformation product of the fumigant biocide methyl bromide and of nicotine. A metabolic source of SMC is catabolism of the repair catalytic protein MGMT (EC 2.1.1.37), which specifically removes the methyl group from the modified DNA nucleotide O-6-methyl-guanine to revert the normal GC base pairing. To assess the value of SMC and of S-methylmercapturic acid (SMMA) as candidate biomarkers of proliferative phenomena, a sensitive analytical method by GC-MS was applied in a pilot study of healthy subjects to assess their urinary elimination and the intra- and inter-individual variability. Extractive alkylation with butylchloroformate-n-butanol-pyridine (Husek technique) was employed for sample derivatization and isotope dilution GC-MS with S-[CD(3) ]-SMC and -SMMA was applied for specific and sensitive detection. To resolve the target analytes from the main coeluting interferents in the derivatized urine extract a medium-polarity stationary phase was employed. SMMA was not detected in the morning urine of three healthy fertile-age women followed for one month above the minimum detectable level of approx. 500 µg/L while SMC concentrations were in the 0.02-0.7 µg/mL range (n = 61) with large inter-day and inter-individual variations. In a young healthy male urine samples taken throughout a few days yielded concentrations in the same 90-810 µg/L range (n = 11). These preliminary results points at SMC as a candidate biomarker for the study of methylation turnover in several biochemical processes.
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http://dx.doi.org/10.1002/bmc.1451DOI Listing
March 2011

Toward an "omic" physiopathology of reactive chemicals: thirty years of mass spectrometric study of the protein adducts with endogenous and xenobiotic compounds.

Mass Spectrom Rev 2009 Sep-Oct;28(5):725-84

Laboratory for Analytical Toxicology and Metabonomics, Department of Medicine, Surgery and Odontology, Università degli Studi di Milano at Ospedale San Paolo, v. Antonio di Rudinì 8, Milano I-20142, Italy.

Cancer and degenerative diseases are major causes of morbidity and death, derived from the permanent modification of key biopolymers such as DNA and regulatory proteins by usually smaller, reactive molecules, present in the environment or generated from endogenous and xenobiotic components by the body's own biochemical mechanisms (molecular adducts). In particular, protein adducts with organic electrophiles have been studied for more than 30 [see, e.g., Calleman et al., 1978] years essentially for three purposes: (a) as passive monitors of the mean level of individual exposure to specific chemicals, either endogenously present in the human body or to which the subject is exposed through food or environmental contamination; (b) as quantitative indicators of the mean extent of the individual metabolic processing which converts a non-reactive chemical substance into its toxic products able to damage DNA (en route to cancer induction through genotoxic mechanisms) or key proteins (as in the case of several drugs, pesticides or otherwise biologically active substances); (c) to relate the extent of protein modification to that of biological function impairment (such as enzyme inhibition) finally causing the specific health damage. This review describes the role that contemporary mass spectrometry-based approaches employed in the qualitative and quantitative study of protein-electrophile adducts play in the discovery of the (bio)chemical mechanisms of toxic substances and highlights the future directions of research in this field. A particular emphasis is given to the measurement of often high levels of the protein adducts of several industrial and environmental pollutants in unexposed human populations, a phenomenon which highlights the possibility that a number of small organic molecules are generated in the human organism through minor metabolic processes, the imbalance of which may be the cause of "spontaneous" cases of cancer and of other degenerative diseases of still uncharacterized etiology. With all this in mind, it is foreseen that a holistic description of cellular functions will take advantage of new analytical methods based on time-integrated metabolomic measurements of a new biological compartment, the "adductome," aimed at better understanding integrated organism response to environmental and endogenous stressors.
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http://dx.doi.org/10.1002/mas.20207DOI Listing
September 2009

Resolution of migraine by transcatheter patent foramen ovale closure with Premere Occlusion System in a preliminary series of patients with previous cerebral ischemia.

Catheter Cardiovasc Interv 2007 Sep;70(3):429-33

PFO-Related Syndromes Management Program, Cardiovascular Diagnosis and Interventions Service, Rovigo General Hospital, Italy.

Background: Transcatheter closure of PFO with nitinol devices may be problematic in young patients with migraine due the risk of late erosions. Alternative devices with less amount of metal as the last generation devices may be preferable in such cases. We present the results of transcatheter closure of PFO with the last generation Premere Occlusion System device in a preliminary series of young adults with migraine and previous cerebral ischemia.

Methods: During a 12-month period (January 31, 2006 to December 31, 2006) 26 patients (18 female and 8 male, mean age 40 +/- 3.7 years) with previous stroke and severe disabling migraine were referred to our center for transcatheter closure of PFO. Migraine disability assessment score (MIDAS) was used to assess MHA incidence and severity. Patients were selected for Premere occlusion system (absence of atrial septal aneurysm and length >15 mm) on the basis of presence/absence of right and left bulging atrial septal aneurysm and length of PFO channel (<15 mm or >15 mm) on transesophageal echocardiography. Transesophageal echocardiography and transcranial Doppler were performed at 1 month, transthoracic echocardiography and cerebral magnetic resonance imaging at 6 and 12 months. Cardiologic and neurological visit was scheduled at 1, 6, and 12 months with MIDAS questionnaire administration.

Results: Ten patients (2 males, mean age 32 +/- 7.6 years, mean MIDAS score 38.9 +/- 5.8) underwent transcatheter PFO closure with the Premere occlusion system. Mean fossa ovalis diameters by ICE measurement was 20.6 +/- 3.1 mm. Thus, two 20-mm and eight 25-mm Premere devices were implanted. The procedure was successful in all of the patients with no perioperative and in-hospital complications. After a mean follow-up of 10.9 +/- 5.8 months, all patients were free from migraine symptoms (mean MIDAS score 2.9 +/- 1.9) with PFO complete closure in all patients on transesophageal and transcranial Doppler ultrasound.

Conclusion: While waiting for larger studies evaluating the impact of new generation devices in curing PFO-related migraine, this preliminary anecdotal series suggests that the Premere occlusion system may be an effective and safe device for young patients with previous cerebral ischemia and migraine at least in the midterm period.
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http://dx.doi.org/10.1002/ccd.21173DOI Listing
September 2007

Is transesophageal echocardiography useful in planning surgery of mediastinal thymomas? Transesophageal investigation of a mediastinal thymoma.

Int J Cardiol 2007 Oct 22;121(3):312-4. Epub 2006 Dec 22.

Thymomas are the commonest tumors arising in the anterior mediastinum, sometimes representing an incidental finding at radiological examination. Surgery of these neoplasms must be planned after accurately assessing the invasive or non-invasive nature of the mass. In the present case this could be achieved also by submitting the patient to transesophageal echocardiography which could accurately exclude infiltration of heart walls. We therefore think that this technique can be considered a useful complement to radiological ones in defining the surgical strategy of mediastinal thymomas.
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http://dx.doi.org/10.1016/j.ijcard.2006.09.026DOI Listing
October 2007

Histopathological grading of response to induction chemotherapy in non-small cell lung cancer: a preliminary study.

Lung Cancer 1996 Sep;15(2):183-7

Department of Cardiothoracic Surgery, Spedali Civili, Brescia, Italy.

Management of locally advanced NSCLC is controversial. Induction chemotherapy followed by surgery has become an accepted approach for Stage III disease. However, the clinical assessment of the efficacy of preoperative treatment is inaccurate. We propose a four-grade histopathological evaluation of the response to chemotherapy based on the analysis of 20 evaluable cases and compared with clinical outcome. Follow-up ranged from 12 to 68 months. Correlation between different grading of necrosis and survival is statistically significant. Based on these preliminary results, we suggest that grading of response is a valid parameter to evaluate standard regimens and novel drug associations in larger trials.
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http://dx.doi.org/10.1016/0169-5002(95)00581-1DOI Listing
September 1996

[Pulsating tumor of the sternum: enlarged exeresis and reconstruction with marlex-methylmethacrylate prosthesis].

Minerva Chir 1996 May;51(5):359-63

Divisione Chirurgia Cardio, Toracica, Spedali Civili, Brescia.

The authors report on a rare case of pulsating tumor of the sternum. En bloc resection was carried out with removal of the sternal manubrium and body, tracts of the I-II-III rib with the intercostal muscles and part of the left pectoralis major. Reconstruction of the thoracic wall was performed with a marlex MMA sandwich prosthesis. From a histological viewpoint, the carcinoma was well differentiated and compatible with thyroid primitivity. Non complementary antiblastic therapies were provided as all the examinations carried out were negative and the intervention was radical. The patient had been followed-up with serial controls and three complete stagings at one, three and five years after intervention (CT, echography and function tests of the thyroid, bone scintigraphy). At follow-up of more than six years the patient is doing well and is event free. The authors believe, even with the help of reports from the literature that, in sternal metastases from thyroid carcinomas, especially when single and large, surgical therapy is required.
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May 1996

Castleman's disease presenting as an asymptomatic solitary pulmonary nodule.

Monaldi Arch Chest Dis 1995 Oct;50(5):363-5

Sant'Orsola Hospital, Dept of Medicine, Brescia, Italy.

We report the case of a 51 year old white woman with an asymptomatic solitary pulmonary nodule, fortuitously discovered on chest radiography. Her physical examination and biochemical tests were unremarkable for pathological findings. Thoracic computed tomography (CT) scan and nuclear magnetic resonance (NMR) spectroscopy confirmed the presence of a dishomogeneous thick lesion of lobular shape, localized between the middle and lower lobe of the right lung. Fibreoptic bronchoscopic examination failed to produce histological diagnosis of the lesion. Surgical removal of the lesion demonstrated intraparenchymal localization of Castelman's disease (giant lymph node hyperplasia). Three years after surgery, no sign of disease recurrence has been recorded.
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October 1995

[Surgical correction of pectus excavatum].

Minerva Chir 1995 Apr;50(4):343-8

Divisione di Chirurgia Cardio-Toracica, Spedali Civili, Brescia.

From 1979 to March 1993 a corrective surgical operation was performed on 14 patients with pectus excavatum. Patients' age ranged between 11 and 23, (mean value 16); 11 were males and 3 females with family history of deformities of the thoracic wall in 5 cases and scoliosis in 8. In 11 patients the defect was present at birth or during the first year of life. At present, the following examinations are carried out routinely: X-ray of the chest in the two standard positions and of the backbone, spirometry and ECG in standard conditions and under stress, Doppler echocardiogram, CT, psychomotor and intellectual behaviour test. Indication to surgery was for marked deformity and resulting cardiorespiratory physiopathologic repercussions present or expected in future. The surgical technique performed, a modification of the Ravitch procedure, was sternochondroplasty. A temporary stabilization support was added in 9 patients between the age of 16 and 23 (Rehbein plates in 3, sliding staplesplints in 6) so as to prevent secondary depressions. There were no deaths in this series. Cosmetic results were satisfactory with disappearance of a psychosomatic troubles.
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April 1995

[Surgical stabilization of post-traumatic flail chest. Our experience with 116 cases treated].

Minerva Chir 1995 Mar;50(3):227-33

Divisione di Chirurgia Cardio-Toracica, Spedali Civili, Brescia.

The therapeutic approach in a patient with traumatic flail chest is varied and controversial, both as regards the type of treatment and as regards the surgical techniques to be employed. The authors have examined 116 cases of flail chest treated surgically; these represented 17.7% of the 655 chest traumas operated in the period from July 1975 to March 1993. Increasing experience has reduced indications for surgery: at present it is not performed in cases of serious craniocerebral lesions, of severe pulmonary contusions, or, however, when mechanical ventilation is required. As for surgical techniques, external traction was applied in the first 15 cases treated but then discontinued because of the poor outcome. Osteosynthesis (77 cases), associated with thoracotomy, was carried out with Kirschner wires, Vecsei metal plates, Judet agraffe, alone or variously combined. Recently, a less aggressive personal technique has been employed prevalently: Kirschner wires placed vertically within the chest, bridging between one rib (generally the V or VI, well fixed with metal plates), and the clavicle and/or sternum. The overall mortality rate, prevalently due to associated lesions, was 20.6%. Excluding emergencies, these patients should be operated in deferred emergency within 24-48 hours of trauma. Osteosynthesis, when indicated is the procedure offering the greatest assurance of success. The authors believe that, in selected cases, surgical stabilization is necessary.
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March 1995

[Computerized tomography and magnetic resonance assessment of multiple bilateral neurinomas of the cervical plexus and the phrenic nerve].

Radiol Med 1991 May;81(5):735-7

Cattedra di Radiologia, Università degli Studi, Spedali Civili, Brescia.

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May 1991

[Recurrence of bronchial cancer after surgery. Radiologic data].

J Radiol 1990 Apr;71(4):265-9

Servizio Radiologia I, Spedali Civili di Brescia.

The post-surgical malignant recurrences of bronchogenic cancer may be classified as local, regional, locoregional. The present series is based on 115 patients observed in 1982-1987. In all of them a tumour recurrence was clinically and/or radiologically suspected: the histological findings or the follow-up confirmed such a diagnosis in 52 cases. A correct radiological assessment is based on a full knowledge of three items: 1) early and late complications of the surgical intervention; 2) available diagnostic tools for a differential diagnosis between usual post-operatory sequelae and neoplastic recurrences. 3) pathologic history of the patient and his tumour.
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April 1990

[Traumatic rupture of the pericardium].

Minerva Chir 1984 Feb;39(4):255-9

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February 1984

[Symphyseal therapy with tetracycline in neoplastic pleurisy and spontaneous pneumothorax].

Minerva Med 1984 Feb;75(8):381-4

The treatment of 15 patients with neoplastic pleurisy and 25 with spontaneous pneumothorax occurring for the second time is described. All were given endopleural tetracycline therapy for symphyseal purposes. In the neoplastic pleurisy cases, the treatment reduced the number of thoracenteses required. In only 1 case did spontaneous pneumothorax recur a short time after treatment.
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February 1984

[Isolated communication between the left atrium and the coronary sinus (author's transl)].

G Ital Cardiol 1980 ;10(9):1224-7

The communication between the coronary sinus and the left atrium is a very exceptional case. In this work the AA. report the difficulties of the pre and peroperating diagnosis, above all because the coronary sinus, in this case, is not enlarged, but usual. The identification of the malformation, that is also isolated, is difficult also at the surgery, if you don't make a left atriotomy. A personal operative method of correction is reported.
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April 1981

[Our experience in the surgical treatment of pulmonary stenosis].

Boll Soc Ital Cardiol 1974 ;19(4):343-4

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December 1975

[Correction of the atrial defect. Experience in 626 cases].

G Ital Cardiol 1972 ;2(5):734-40

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December 1972
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