4,322 results match your criteria Normal Pressure Hydrocephalus


Pathologically Verified Corticobasal Degeneration Mimicking Richardson's Syndrome Coexisting with Clinically and Radiologically Shunt-Responsive Normal Pressure Hydrocephalus.

Mov Disord Clin Pract 2022 May 12;9(4):508-515. Epub 2022 Apr 12.

Department of Neurology National Center Hospital, National Center of Neurology and Psychiatry Tokyo Japan.

Background: Normal pressure hydrocephalus (NPH) manifests as gait instability, cognitive impairment, and urinary incontinence. This clinical triad of NPH sometimes occurs with ventriculomegaly in patients with neurodegenerative disease. Patients with pathologically verified neurodegenerative diseases, such as progressive supranuclear palsy (PSP), have received antemortem diagnoses of NPH. Read More

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Management of patients with cervical myelopathy and normal pressure hydrocephalus: Epidemiology, medical and surgical complications.

Clin Neurol Neurosurg 2022 Apr 30;218:107269. Epub 2022 Apr 30.

Department of Orthopaedic Surgery, Alpert Medical School of Brown University, Providence, RI 02903, USA. Electronic address:

Objective: Normal pressure hydrocephalus (NPH) and degenerative cervical myelopathy (DCM) can each lead to gait dysfunction and urinary incontinence and may occur concurrently in some patients. In patients presenting with NPH and DCM, there is a paucity of literature describing the medical and surgical complications of treatment and the potential consequences of the sequence of surgical procedures. The aim of this study is to evaluate patients with DCM, NPH, and dual pathology to determine epidemiology and how the order of surgical intervention for both conditions may impact complications and patient outcomes. Read More

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Pathophysiological Mechanisms Underlying Idiopathic Normal Pressure Hydrocephalus: A Review of Recent Insights.

Front Aging Neurosci 2022 28;14:866313. Epub 2022 Apr 28.

Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States.

The pathophysiologic mechanisms underpinning idiopathic normal pressure hydrocephalus (iNPH), a clinically diagnosed dementia-causing disorder, continue to be explored. An increasing body of evidence implicates multiple systems in the pathogenesis of this condition, though a unifying causative etiology remains elusive. Increased knowledge of the aberrations involved has shed light on the iNPH phenotype and has helped to guide prognostication for treatment with cerebrospinal fluid diversion. Read More

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A new screening test for idiopathic normal pressure hydrocephalus using bimanual coordination: A preliminary study.

NeuroRehabilitation 2022 May 10. Epub 2022 May 10.

Department of Rehabilitation Medicine, The Jikei University School of Medicine, Nishishimbashi, Minato-ku, Tokyo, Japan.

Background: The clinical spectrum of idiopathic normal pressure hydrocephalus (iNPH) comprises the triad of gait disturbance, cognitive impairment, and urinary incontinence. However, motor abnormalities involving the upper extremities in iNPH patients have few quantitative studies.

Objective: The present study was designed to quantitatively assess bimanual tapping tasks in iNPH patients and to compare with the control groups. Read More

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A case of idiopathic normal pressure hydrocephalus with fragile X-associated tremor/ataxia syndrome.

Clin Neurol Neurosurg 2022 May 4;218:107278. Epub 2022 May 4.

Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E Medical Center Dr, UH B2, Ann Arbor, MI 48109, USA.

Clinical management of patients with fragile X-associated tremor/ataxia syndrome (FXTAS) is a challenge, and there has been not an established treatment for FXTAS, which is now treated symptomatically. Diagnosis of coexistent idiopathic normal pressure hydrocephalus (iNPH) with FXTAS is also hard because clinical and imaging features can overlap between the FXTAS patients coexistent with and without iNPH. We present a 79-year-old male genetically diagnosed with FXTAS who was successfully treated by a shunt surgery and consequently diagnosed with iNPH, and suggest the management of coexistent iNPH with FXTAS when it is clinically suspicious. Read More

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Cognitive Impairment in Idiopathic Normal Pressure Hydrocephalus.

Neurosci Bull 2022 May 15. Epub 2022 May 15.

Institute of Neuroscience, Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, 200031, China.

Idiopathic normal pressure hydrocephalus (iNPH) is a significant cause of the severe cognitive decline in the elderly population. There is no cure for iNPH, but cognitive symptoms can be partially alleviated through cerebrospinal fluid (CSF) diversion. In the early stages of iNPH, cognitive deficits occur primarily in the executive functions and working memory supported by frontostriatal circuits. Read More

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Comparison of shunt outcomes for non-bacterial infectious hydrocephalus with common hydrocephalus etiologies: a retrospective case-control study.

World Neurosurg 2022 May 9. Epub 2022 May 9.

Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA.

Background: Shunting is an established treatment for hydrocephalus, yet reports on shunt outcomes for non-bacterial infectious (NBI) hydrocephalus are limited. Furthermore, comparison of mechanisms and rates of failure for shunted NBI hydrocephalus versus more typical etiologies remains undetermined.

Methods: Patients who underwent shunting for hydrocephalus at two centers (1995-2020) were included. Read More

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Discordant horizontal-torsional nystagmus: a sign of posterior semicircular canal dysfunction.

J Neurol 2022 May 11. Epub 2022 May 11.

Department of Neurology, Seoul National University College of Medicine, Seoul, South Korea.

In central as well as peripheral vestibular lesions, right-beating horizontal nystagmus is almost always associated with clockwise (top poles of the eyes beating to the right ear) torsional nystagmus when observed and vice versa (concordant nystagmus). This study aimed to determine the etiologies and mechanisms of horizontal and torsional nystagmus beating in the opposite directions (discordant nystagmus). We reviewed the medical records of 16 consecutive patients with discordant horizontal-torsional nystagmus who had been evaluated at the dizziness clinics of Seoul National University Bundang Hospital (n = 11, from March 2003 to March 2021) and Korea University Medical Center (n = 5, from March 2019 to March 2021). Read More

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Bibliometric overview of the Top 100 most cited articles on hydrocephalus.

Surg Neurol Int 2022 29;13:176. Epub 2022 Apr 29.

Department of Adult Neurosurgery, National Neuroscience Institute, King Fahad Medical City, Altawwan District, Riyadh, Saudi Arabia.

Background: Hydrocephalus is one of the most common brain disorders and numerous articles were published to address the clinical aspect and its management. This study aims to highlight the most influential work on hydrocephalus on bibliometric basis.

Methods: A thorough search of Scopus database was performed using the word "hydrocephalus. Read More

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Value of MRI-based semi-quantitative structural neuroimaging in predicting the prognosis of patients with idiopathic normal pressure hydrocephalus after shunt surgery.

Eur Radiol 2022 Apr 30. Epub 2022 Apr 30.

Department of Radiology, The First Affiliated Hospital of Shenzhen University, Shenzhen University, Shenzhen Second People's Hospital, 3002 SunGang Road West, Shenzhen, 518035, Guangdong Province, China.

Objectives: To explore the value of structural neuroimaging in predicting the prognosis of shunt surgery for idiopathic normal-pressure hydrocephalus (iNPH) using two different standard semi-quantitative imaging scales.

Methods: A total of 47 patients with iNPH who underwent shunt surgery at our hospital between 2018 and 2020 were included in this study. The modified Rankin Scale (mRS) and iNPH grading scale (iNPHGS) were used to evaluate and quantify the clinical symptoms before and after shunt surgery. Read More

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Semi-quantitative analysis of periventricular gray-white matter ratio on CT in patients with idiopathic normal pressure hydrocephalus.

J Clin Neurosci 2022 Apr 29;101:16-20. Epub 2022 Apr 29.

Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea. Electronic address:

To investigate alterations in the periventricular gray-white matter ratio (GWR) on computed tomography (CT) in patients with idiopathic normal pressure hydrocephalus (INPH), a total of 140 patients with INPH and 52 age-and sex-matched controls were included by using Japanese guidelines published in 2021: possible, probable, and definite INPH for a retrospective case-control study. The non-enhanced brain CT was reviewed, and the Hounsfield unit (HU) was semi-quantitatively measured using the region of interest (ROI). The size (40 mm) and location of the ROI were standardized within the periventricular white matter (WM) and thalamus. Read More

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Brain ventricles, CSF and cognition: a narrative review.

Psychogeriatrics 2022 Apr 30. Epub 2022 Apr 30.

Medical School, Universidade Federal de Pernambuco, Recife, Brazil.

The brain ventricles are structures that have been related to cognition since antiquity. They are essential components in the development and maintenance of brain functions. The aging process runs with the enlargement of ventricles and is related to a less selective blood-cerebrospinal fluid barrier and then a more toxic cerebrospinal fluid environment. Read More

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Magnetic resonance elastography of the ageing brain in normal and demented populations: A systematic review.

Hum Brain Mapp 2022 Apr 30. Epub 2022 Apr 30.

Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.

The aim of this systematic review was to evaluate the ability of magnetic resonance elastography (MRE) to identify significant changes in brain mechanical properties during normal and pathological aging. PubMed, Web of Science and Scopus were searched for human studies using MRE to assess brain mechanical properties in cognitively healthy individuals, individuals at risk of dementia or patients diagnosed with dementia. Study characteristics, sample demographics, clinical characterization and main MRE outcomes were summarized in a table. Read More

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Correlation of palpation anterior fontanometry and cerebrospinal fluid opening pressure in early childhood hydrocephalus.

Niger Postgrad Med J 2022 Apr-Jun;29(2):151-154

Department of Surgery, University of Nigeria Teaching Hospital, Enugu, Nigeria.

Background: The anterior fontanelle (AF) tension has been a traditional clinical method of indirect assessment of intracranial pressure (ICP). How does this time-tested bedside assessment technique compare with an objective ventricular cerebrospinal fluid (CSF) opening pressure?

Objective: To determine the correlation of palpation anterior fontanometry and CSF opening pressure in early childhood hydrocephalus.

Materials And Methods: Children diagnosed with hydrocephalus who were planned for CSF diversion using ventriculo-peritoneal (V-P) shunt were prospectively studied over 18 months. Read More

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Reduced cerebral blood flow of lingual gyrus associated with both cognitive impairment and gait disturbance in patients with idiopathic normal pressure hydrocephalus.

J Neurol Sci 2022 Apr 20;437:120266. Epub 2022 Apr 20.

Division of Neurology and Clinical Neuroscience, Department of Internal Medicine III, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata 990-9585, Japan. Electronic address:

Background: Idiopathic normal pressure hydrocephalus (iNPH) is primarily characterized by cognitive impairment and gait disturbance. Our objective was to evaluate the clinical characteristics of iNPH and the association between cerebral blood flow (CBF), measured using single-photon emission computed tomography (SPECT), and both cognitive and gait disturbances in iNPH patients.

Methods: We compared cognitive and motor functions and neuroimaging findings between 29 iNPH patients and 35 age-matched Parkinson's disease (PD) patients. Read More

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Alzheimer resemblance atrophy index, BrainAGE, and normal pressure hydrocephalus score in the prediction of subtle cognitive decline: added value compared to existing MR imaging markers.

Eur Radiol 2022 Apr 29. Epub 2022 Apr 29.

CIMC - Centre d'Imagerie Médicale de Cornavin, Geneva, Switzerland.

Objectives: Established visual brain MRI markers for dementia include hippocampal atrophy (mesio-temporal atrophy MTA), white matter lesions (Fazekas score), and number of cerebral microbleeds (CMBs). We assessed whether novel quantitative, artificial intelligence (AI)-based volumetric scores provide additional value in predicting subsequent cognitive decline in elderly controls.

Methods: A prospective study including 80 individuals (46 females, mean age 73. Read More

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Impact of Early Intervention for Idiopathic Normal Pressure Hydrocephalus on Long-Term Prognosis in Prodromal Phase.

Front Neurol 2022 11;13:866352. Epub 2022 Apr 11.

Department of Neurosurgery, Osaka Medical and Pharmaceutical University, Takatsuki, Japan.

Objectives: Because the progression of idiopathic normal pressure hydrocephalus (iNPH) is partially irreversible, we hypothesized that early intervention would markedly improve its prognosis. To test this hypothesis, we retrospectively investigated the long-term prognosis of patients with early intervention in the prodromal phase of iNPH.

Methods: We defined the prodromal phase of iNPH as a 3m Timed Up and Go (TUG) of 13. Read More

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Open-aqueduct LOVA, LIAS, iNPH: a comparative clinical-radiological study exploring the "grey zone" between different forms of chronic adulthood hydrocephalus.

Acta Neurochir (Wien) 2022 Apr 27. Epub 2022 Apr 27.

Department of Neurosurgery, IRCCS Istituto Delle Scienze Neurologiche Di Bologna, Via Altura 3, 40139, Bologna, Italy.

Purpose: The definition of chronic adult hydrocephalus encompasses different pathological entities with overlapping characteristics, including long-standing overt ventriculomegaly in adults (LOVA), late-onset idiopathic aqueductal stenosis (LIAS) and idiopathic normal pressure hydrocephalus (iNPH). The aim of our study was to identify preoperative clinical and radiological features peculiar of these diseases providing some pathophysiology inferences on these forms of hydrocephalus.

Methods: Clinical and radiological preoperative records, type of surgical treatment and clinical outcome of patients with chronic adult hydrocephalus who were surgically treated between 2013 and 2019 were retrospectively reviewed. Read More

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Evaluation of Surgical Treatment Effect on Idiopathic Normal Pressure Hydrocephalus.

Front Surg 2022 7;9:856357. Epub 2022 Apr 7.

Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China.

Background: We aimed to observe the long-term effectiveness and safety of the ventriculoperitoneal (VP) shunt in treating idiopathic normal pressure hydrocephalus (iNPH).

Methods: A total of 65 patients with iNPH were retrospectively analyzed. All the patients were treated with VP shunt and the clinical efficacy was assessed using follow-up questionnaire, the Modified Rankin Scale (mRS), and iNPH grading scale (iNPHGS) after operation. Read More

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Intrathecal Contrast-Enhanced Magnetic Resonance Imaging of Cerebrospinal Fluid Dynamics and Glymphatic Enhancement in Idiopathic Normal Pressure Hydrocephalus.

Front Neurol 2022 6;13:857328. Epub 2022 Apr 6.

Department of Radiology, Oslo University Hospital-Rikshospitalet, Oslo, Norway.

Idiopathic normal pressure hydrocephalus (iNPH) is a neurodegenerative disease, characterized by cerebrospinal fluid (CSF) flow disturbance. Today, the only available treatment is CSF diversion surgery (shunt surgery). While traditional imaging biomarkers typically assess CSF space anatomy, recently introduced imaging biomarkers of CSF dynamics and glymphatic enhancement, provide imaging of CSF dynamics and thereby more specifically reveal elements of the underlying pathophysiology. Read More

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Cellular Distribution of Brain Aquaporins and Their Contribution to Cerebrospinal Fluid Homeostasis and Hydrocephalus.

Biomolecules 2022 03 31;12(4). Epub 2022 Mar 31.

Institute of Biomedicine of Seville (IBiS), Virgen del Rocío University Hospital, (HUVR)/Spanish National Research Council (CSIC)/University of Seville, 41013 Seville, Spain.

Brain aquaporins facilitate the movement of water between the four water compartments: blood, cerebrospinal fluid, interstitial fluid, and intracellular fluid. This work analyzes the expression of the four most abundant aquaporins (AQPs) (AQP1, AQP4, AQP9, and AQP11) in the brains of mice and discuss their contribution to hydrocephalus. We analyzed available data from single-cell RNA sequencing of the central nervous system of mice to describe the expression of aquaporins and compare their distribution with that based on qPCR, western blot, and immunohistochemistry assays. Read More

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A Comparison of Cerebrospinal Fluid Beta-Amyloid and Tau in Idiopathic Normal Pressure Hydrocephalus and Neurodegenerative Dementias.

Clin Interv Aging 2022 11;17:467-477. Epub 2022 Apr 11.

Unit for Brain Aging and Dementia, Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.

Purpose: Idiopathic normal pressure hydrocephalus (iNPH) is the leading reversible cause of cognitive impairment and gait disturbance that has similar clinical manifestations and accompanies to major neurodegenerative disorders in older adults. We aimed to investigate whether cerebrospinal fluid (CSF) biomarker for Alzheimer's disease (AD) may be useful in the differential diagnosis of iNPH.

Patients And Methods: Amyloid-beta (Aß) 42 and 40, total tau (t-tau), phosphorylated tau (p-tau) were measured via ELISA in 192 consecutive CSF samples of patients with iNPH (n=80), AD (n=48), frontotemporal dementia (FTD) (n=34), Lewy body diseases (LBDs) (n=30) consisting of Parkinson's disease dementia and dementia with Lewy bodies. Read More

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Evaluation of the Effectiveness of the Tap Test by Combining the Use of Functional Gait Assessment and Global Rating of Change.

Front Neurol 2022 28;13:846429. Epub 2022 Mar 28.

Department of Neurosurgery, Osaka Medical and Pharmaceutical University, Takatsuki, Japan.

Background: Although the tap test for patients with suspected idiopathic normal pressure hydrocephalus (iNPH) is still often performed as part of the preoperative evaluation, it is true that some studies have reported the limitations of the tap test, claiming that it does not provide the additional information for appropriate patient selection for surgery. We aimed to determine whether a better method of pre- and post-tap test assessment could lead to appropriate patient selection for shunting.

Methods: We performed the tap test as part of the preoperative evaluation in all 40 patients who underwent lumboperitoneal shunt surgery for iNPH from April 2021 to September 2021. Read More

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Physical Capacity and Activity in Patients With Idiopathic Normal Pressure Hydrocephalus.

Front Neurol 2022 28;13:845976. Epub 2022 Mar 28.

Department of Neurology and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.

Introduction: Most patients with idiopathic normal pressure hydrocephalus (iNPH) improve gait after surgery. However, knowledge on physical capacity and activity after shunt surgery is limited. One of the aims of this study was to evaluate the effect of shunt surgery in patients with iNPH on short-distance walking, functional exercise capacity, functional strength, and variables of activity and sleep, 3 and 6 months postoperatively. Read More

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[Characteristics and Treatment of Young Adult-Onset Hydrocephalus].

Authors:
Hisayuki Murai

No Shinkei Geka 2022 Mar;50(2):387-392

Department of Neurosurgery, Chibaken Saiseikai Narashino Hospital.

Certain congenital or developmental anomalies of adult-onset hydrocephalus often share clinical symptoms with idiopathic normal pressure hydrocephalus(iNPH). These anomalies include long-standing overt ventriculomegaly in adults(LOVA), persistent Break's pouch cyst(PBC)and panventriculomegaly(PaVM). Certain patients with adult-onset hydrocephalus might have congenital or secondary etiologies, such as late-onset idiopathic aqueductal stenosis(LIAS), and syndrome of hydrocephalus in young and middle-aged adults(SHYMA). Read More

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[Indication and Technique of Ventriculo:Atrial Shunt for Normal Pressure Hydrocephalus].

Authors:
Daisuke Suyama

No Shinkei Geka 2022 Mar;50(2):358-365

Department of Neurosurgery, Fuchu Keijinkai Hospital.

The type of shunt surgery with the best outcome and lowest complication rate has not been established. Ventriculo-atrial(V-A)shunts have almost been abandoned as the first choice of surgery. However, the V-A shunt has many advantages; the operative site is narrower than in other types of shunt surgery, and intra-atrial pressure is lower than intra-abdominal pressure, which may guarantee constant cerebrospinal fluid flow and less malfunction. Read More

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[Lumbo-Peritoneal Shunt for Patients with Idiopathic Normal Pressure Hydrocephalus:Surgical Technique].

No Shinkei Geka 2022 Mar;50(2):348-357

Department of Neurosurgery, NPH center, Tokyo Kyosai Hospital.

The SINPHONI-2 study(a group of Japanese prospective multicenter cohort studies on the treatment of idiopathic normal pressure hydrocephalus[iNPH])showed the safety and efficacy of lumboperitoneal(L-P)shunt surgery for iNPH. A total of 660 probable iNPH patients underwent L-P shunt surgery at our NPH center between April 2009 and March 2020(age: 77.3 ± 6. Read More

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[Idiopathic Normal Pressure Hydrocephalus and Neurodegenerative Diseases: a Short Review of Differential Diagnosis].

No Shinkei Geka 2022 Mar;50(2):319-330

Department of Neurology, Kyoto Prefectural University of Medicine.

There are a variety of neurodegenerative diseases that require differentiation from idiopathic normal pressure hydrocephalus(iNPH), including Alzheimer's disease, Parkinson's disease, dementia with Lewy bodies, frontotemporal dementia, progressive supranuclear palsy, and corticobasal degeneration. As the clinical features and structural imaging findings of these diseases may overlap with iNPH, biomarkers reflecting disease-specific pathology are necessary for differential diagnosis. In addition, these diseases often coexist with iNPH in elderly patients, and it is important to confirm the coexistence of their pathology even in cases clinically diagnosed as iNPH. Read More

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[Epidemiology of Idiopathic Normal Pressure Hydrocephalus and Hereditary Hydrocephalus].

Authors:
Chifumi Iseki

No Shinkei Geka 2022 Mar;50(2):309-317

Department of Neurology and Clinical Neuroscience, Faculty of Medicine, Yamagata University.

Several cohort studies in Japan have revealed that the prevalence of idiopathic normal pressure hydrocephalus(iNPH)is around 1.6% among the elderly population(≧ 50 years old). The incidence of iNPH from the Yamagata(Takahata)cohort was 1. Read More

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