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The level of urbanization influences acute ischemic stroke care: A nationwide ecological study from Germany.

J Neurol Sci 2021 Sep 13;430:119983. Epub 2021 Sep 13.

Department of Neurology, St. Josef-Hospital Bochum, Ruhr University Bochum, Germany; Medical Faculty, Ruhr University Bochum, Germany. Electronic address:

Background And Purpose: Regional differences in acute ischemic stroke (AIS) care are still reported for Germany but not fully understood. We aimed to analyze the impact of the level of urbanization on the application of proved treatment procedures and the incidence of hospitalized AIS cases in Germany.

Methods: The level of urbanization of the 401 districts and district-free cities in Germany was defined according to the Federal Institute for Building, Urban Affairs and Spatial Research classification. Read More

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September 2021

The largest isoform of Ankyrin-G is required for lattice structure of the axon initial segment.

Biochem Biophys Res Commun 2021 Sep 8;578:28-34. Epub 2021 Sep 8.

State Key Laboratory of Membrane Biology, College of Life Sciences, Peking University, Beijing, 100871, China; PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, 100871, China. Electronic address:

Alzheimer's disease (AD) is the most frequent neurodegenerative disease and a common dementia in elderly individuals. Previous studies found a strong correlation between axon initial segment (AIS) defects and AD, but it remains unclear whether AD itself changes the arrangement of AIS components, and the mechanisms by which adaptor proteins and ion channels in the AIS are disturbed in AD are not well understood. With super-resolution structured illumination microscopy (SIM) revealing axonal structures, here we imaged the lattice structure of completely assembled AIS in APP/PS1 neurons. Read More

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September 2021

Assessment of reliability and validity of the adapted Persian version of the Spinal Appearance Questionnaire in adolescents with idiopathic scoliosis.

Spine Deform 2021 Sep 17. Epub 2021 Sep 17.

Department of Rehabilitation, Faculty of Allied Medicine, Kerman University of Medical Sciences, Medical University Campus, Haft-Bagh Highway, Kerman, Iran.

Purpose: This study investigates the reliability and validity of the adapted Persian version of the Spinal Appearance Questionnaire (P-SAQ).

Methods: The stages of cross-cultural adaptation were conducted according to an internationally accepted guidelines. Reliability of the P-SAQ was measured by evaluating internal consistency and test-retest reproducibility using Cronbach's α and intraclass correlation coefficient (ICC). Read More

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September 2021

Association of age with the timing of acute spine surgery-effects on neurological outcome after traumatic spinal cord injury.

Eur Spine J 2021 Sep 17. Epub 2021 Sep 17.

Clinical and Experimental Spinal Cord Injury Research (Neuroparaplegiology), Department of Neurology and Experimental Neurology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany.

Purpose: To investigate the association of age with delay in spine surgery and the effects on neurological outcome after traumatic spinal cord injury (SCI).

Methods: Ambispective cohort study (2011-2017) in n = 213 patients consecutively enrolled in a Level I trauma center with SCI care in a metropolitan region in Germany. Age-related differences in the injury to surgery interval and conditions associated with its delay (> 12 h after SCI) were explored using age categories or continuous variables and natural cubic splines. Read More

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September 2021

Combined everolimus and endocrine therapy in advanced HR-positive, HER2-negative Chinese breast cancer patients: a retrospective study.

Ann Transl Med 2021 Aug;9(16):1334

Department of Breast Medical Oncology, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China.

Background: Everolimus (EVE) is an inhibitor of the mammalian target of rapamycin (mTOR) pathway, and it is approved for the treatment of advanced breast cancer (ABC). However, there is still little real-world data on using EVE in Chinese breast cancer patients. We retrospectively analyzed real-world data to determine the factors affecting EVE treatment efficacy and patient outcomes. Read More

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A randomized placebo-controlled study: Phellodendron Bawei tablets combined with standard management can improve storage symptoms, sleep quality, and medication compliance in patients with benign prostatic hyperplasia compared to placebo with standard management.

Transl Androl Urol 2021 Aug;10(8):3423-3431

Department of Urology, Xiangya Hospital, Central South University, Changsha, China.

Background: Benign prostatic hyperplasia (BPH) is a common micturition disorder in middle-aged and elderly males, and it is one of the most common urology-related diseases worldwide. However, standard therapeutic drugs (α1-receptor blockers + 5α reductase inhibitors) do not provide anti-inflammatory or anti-infective effects. The Phellodendron Bawei tablet is a proprietary Chinese medicine with anti-inflammatory and anti-infective effects. Read More

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Fibrinogen Level Combined With Platelet Count for Predicting Hemorrhagic Transformation in Acute Ischemic Stroke Patients Treated With Mechanical Thrombectomy.

Front Neurol 2021 31;12:716020. Epub 2021 Aug 31.

Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

A serious complication of acute ischemic stroke (AIS) after mechanical thrombectomy (MT) is hemorrhagic transformation (HT), which is potentially associated with clinical deterioration. This study examined predictors of HT following MT in AIS patients. Patients with AIS due to large artery occlusion in the anterior circulation, treated with MT and successfully recanalized (modified Thrombolysis in Cerebral Infarction score 2b/3), were studied retrospectively. Read More

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The type 2 diabetes factor methylglyoxal mediates axon initial segment shortening and alters neuronal function at the cellular and network levels.

eNeuro 2021 Sep 16. Epub 2021 Sep 16.

Department of Neuroscience, Cell Biology, and Physiology, Boonshoft School of Medicine, Wright State University, Dayton, OH, 45435 USA

Recent evidence suggests that alteration of axon initial segment (AIS) geometry (i.e., length or location along the axon) contributes to CNS dysfunction in neurological diseases. Read More

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September 2021

Association between low-density cholesterol change and outcomes in acute ischemic stroke patients who underwent reperfusion therapy.

BMC Neurol 2021 Sep 16;21(1):360. Epub 2021 Sep 16.

Center of Cerebrovascular Diseases, Department of Neurology, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, Sichuan, 610041, Chengdu, China.

Background: Low-density lipoprotein cholesterol (LDL-C) can increase cardiovascular risk. However, the association between LDL-C change and functional outcomes in acute ischemic stroke (AIS) patients who underwent reperfusion therapy remains unclear.

Methods: Patients who received reperfusion therapy were consecutively enrolled. Read More

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September 2021

Clinical significance of stroke nurse in patients with acute ischemic stroke receiving intravenous thrombolysis.

BMC Neurol 2021 Sep 16;21(1):359. Epub 2021 Sep 16.

Department of Neurology, Nanjing First Hospital, Nanjing Medical University, 210006, Nanjing, China.

Background: Reports have proven that shorter door-to-needle time (DTN time) indicates better outcomes in AIS patients received intravenous thrombolysis. Efforts have been made by hospitals and centers to minimize DTN time in many ways including introducing a stroke nurse. However, there are few studies to discuss the specific effect of stroke nurse on patients' prognosis. Read More

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September 2021

Association between emergency medical service transport time and survival in patients with traumatic cardiac arrest: a Nationwide retrospective observational study.

BMC Emerg Med 2021 Sep 16;21(1):104. Epub 2021 Sep 16.

Department of Emergency, Critical Care, and Disaster Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, 2-5-1 Shikatacho, Kitaku, Okayama, 700-8558, Japan.

Background: Patients with traumatic cardiac arrest (TCA) are known to have poor prognoses. In 2003, the joint committee of the National Association of EMS Physicians and the American College of Surgeons Committee on Trauma proposed stopping unsuccessful cardiopulmonary resuscitation (CPR) sustained for > 15 min after TCA. However, in 2013, a specific time-limit for terminating resuscitation was dropped, due to the lack of conclusive studies or data. Read More

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September 2021

Risk factors for the development of DJK in AIS patients undergoing posterior spinal instrumentation and fusion.

Spine Deform 2021 Sep 16. Epub 2021 Sep 16.

Department of Orthopaedic Surgery, Columbia Universityl, New York, NY, USA.

Purpose: Typically, selection of lowest instrumented vertebra (LIV) in Adolescent Idiopathic Scoliosis (AIS) is based on the coronal radiograph; however, increasing evidence suggests that fusions proximal to the stable sagittal vertebrae (SSV) on the lateral radiograph can result in distal junctional kyphosis (DJK). The purpose of this study is to compare rates of DJK in patients with AIS that have a discordance between the Lowest Touched Vertebra (LTV) and the SSV and to identify risk factors for developing DJK.

Methods: Patients with AIS Lenke type 1, 2 and 3 curves treated with a posterior spinal fusion were separated into two groups. Read More

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September 2021

Clinical Significance of Hyperdense Lesions on Non-enhanced Brain CT Obtained Immediately after Arterial Revascularization in Acute Ischemic Stroke Patients.

Comput Math Methods Med 2021 3;2021:1562502. Epub 2021 Sep 3.

Department of Neurology, Shandong Provincial Third Hospital, Cheeloo College of Medicine, Shandong University, No. 12, Wuyingshan Middle Road, Tianqiao District, Jinan 250031, China.

Purpose: To analyze the characteristics of hyperdense lesions on brain CT conducted immediately after arterial revascularization (AR) in patients with acute ischemic stroke (AIS), track the outcome of those lesions and investigate their clinical significance.

Materials And Methods: 97 AIS patients were enrolled in our study. Among them, 52 patients showed hyperdense lesions and were divided into three categories: type I, type II and type III according to the morphologic characteristics of hyperdense lesions. Read More

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September 2021

Endovascular Treatment With and Without Intravenous Thrombolysis in Large Vessel Occlusions Stroke: A Systematic Review and Meta-Analysis.

Front Neurol 2021 30;12:697478. Epub 2021 Aug 30.

Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China.

Previous studies have shown conflicting results about the benefits of pretreatment with intravenous thrombolysis before endovascular treatment (EVT) in patients with acute ischemic stroke (AIS) with large vessel occlusions (LVOs). This study aimed to investigate the clinical efficacy and safety of EVT alone vs. bridging therapy (BT) in patients with AIS with LVOs. Read More

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Dengzhanxixin Injection Ameliorates Cognitive Impairment Through a Neuroprotective Mechanism Based on Mitochondrial Preservation in Patients With Acute Ischemic Stroke.

Front Pharmacol 2021 30;12:712436. Epub 2021 Aug 30.

State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China.

Acute ischemic stroke (AIS) is a global health burden and cognitive impairment is one of its most serious complication. Adequate interventions for AIS may have the potential to improve cognitive outcomes. In the present study, we selected (Vaniot) Hand. Read More

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Functional independence in the Finnish spinal cord injury population.

Spinal Cord 2021 Sep 15. Epub 2021 Sep 15.

The Finnish Association of People with Physical Disabilities, Helsinki, Finland.

Study Design: A cross-sectional survey of the Finnish population with spinal cord injury (FinSCI database).

Objectives: To describe the functional independence of the population with spinal cord injury (SCI) in Finland and to identify how generic and lesion characteristics affect their functional independence.

Setting: The participants were recruited from the registers of three SCI outpatient clinics responsible for lifelong follow-up and care for people with SCI in Finland. Read More

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September 2021

Phenotypes of Chronic Covert Brain Infarction in Patients With First-Ever Ischemic Stroke: A Cohort Study.

Stroke 2021 Sep 16:STROKEAHA121034347. Epub 2021 Sep 16.

Department of Neurology, Inselspital, Bern University Hospital, and University of Bern, Switzerland. (J.V., M.B., D.J.S., S.J., M.R.H., U.P., M.G., M.A., U.F., T.R.M.).

Background And Purpose: The aim of this study was to assess the rate of chronic covert brain infarctions (CBIs) in patients with acute ischemic stroke (AIS) and to describe their phenotypes and diagnostic value.

Methods: This is a single-center cohort study including 1546 consecutive patients with first-ever AIS on magnetic resonance imaging imaging from January 2015 to December 2017. The main study outcomes were CBI phenotypes, their relative frequencies, location, and association with vascular risk factors. Read More

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September 2021

Rapid Risk Stratification of Acute Ischemic Stroke Patients in the Emergency Department: The Incremental Prognostic Role of Left Atrial Reservoir Strain.

J Stroke Cerebrovasc Dis 2021 Sep 12;30(11):106100. Epub 2021 Sep 12.

Department of Cardiology, MultiMedica IRCCS, San Giuseppe Hospital, Milan, Italy.

Objectives: To determine the prognostic value of positive global left atrial strain (LA-GSA+), measured by two-dimensional speckle tracking echocardiography (2D-STE) in a population of acute ischemic stroke (AIS) patients without atrial fibrillation (AF), in the setting of Emergency Department (ED).

Methods: All consecutive AIS patients with sinus rhythm on ECG and without AF history entered this prospective study. All patients underwent complete blood tests and transthoracic echocardiography implemented with 2D-STE analysis of LA strain parameters within 6-12 h after symptoms onset. Read More

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September 2021

Comparison of interventions and outcomes of enhanced recovery after surgery: a systematic review and meta-analysis of 2456 adolescent idiopathic scoliosis cases.

Eur Spine J 2021 Sep 15. Epub 2021 Sep 15.

Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.

Purpose: The objective of this meta-analysis and systematic review is to compare the methodology and evaluate the efficacy of Enhanced recovery after Spine Surgery (ERAS) for adolescent idiopathic scoliosis (AIS) and to compare the outcomes with traditional discharge (TD) pathways.

Methods: Using major databases, a systematic search was performed. Studies comparing the implementation of ERAS or ERAS-like and TD pathways in patients with AIS were identified. Read More

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September 2021

Adolescents' Experiences of Idiopathic Scoliosis in the Presurgical Period: A Qualitative Study.

J Pediatr Psychol 2021 Sep 15. Epub 2021 Sep 15.

School of Psychology, University College Dublin and.

Objective: Adolescent idiopathic scoliosis (AIS) is a sideways curvature of the spine that can progress severely during adolescent development and require surgical intervention. This qualitative study was conducted to explore the psychosocial experiences of adolescents with idiopathic scoliosis during the presurgical stage of treatment.

Methods: Fourteen adolescents with moderate-to-severe AIS aged 12-17 years participated in semistructured interviews and data were analyzed using inductive reflexive thematic analysis. Read More

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September 2021

An Adrenocortical Carcinoma Evolving After Nine Years of Latency From a Small Adrenal Incidentaloma.

Cureus 2021 Aug 3;13(8):e16851. Epub 2021 Aug 3.

Department of Critical Care Medicine, Mayo Clinic Health System, Mankato, USA.

Adrenal incidentalomas (AIs) are common incidental findings in medical practice with clinical significance. Although most AIs are nonsecretory and nonmalignant, they require a short course of follow-up over one to two years to rule out malignancy or hormonal secretion according to clinical practice guidelines. However, this can result in some adrenocortical carcinomas (ACCs) being missed if they transform at a later stage or evolve slowly. Read More

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Magnetic Resonance Imagery Findings in Androgen Insensitivity: A case series.

Sultan Qaboos Univ Med J 2021 Aug 29;21(3):472-476. Epub 2021 Aug 29.

Sapthagiri Institute of Medical Science and Research Centre, Bengaluru, Karnataka, India.

Androgen insensitivity syndrome (AIS) is a sex-development disorder resulting from mutations in the androgen receptor. In its complete form, patients are genetically male but phenotypically female, presenting with primary amenorrhea. We report three cases of AIS highlighting the multifaceted role of magnetic resonance imaging (MRI) for presurgical planning by evaluating location and type of gonads and detecting complications. Read More

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Elusive tuberculous meningitis with rare neurological complication of longitudinally extensive transverse myelitis: a case report.

Spinal Cord Ser Cases 2021 Sep 14;7(1):82. Epub 2021 Sep 14.

Department of Medicine, Shalamar Hospital, Lahore, Pakistan.

Introduction: Longitudinally extensive transverse myelitis (LETM) is inflammation of the spinal cord that spans three or more spinal segments. LETM is a rare occurrence on its own and has seldom been reported with tuberculous meningitis (TBM), the rarest and deadliest of tuberculous manifestations. TBM is usually seen in children, the immunocompromised, or those with a previous history of tuberculosis infection. Read More

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September 2021

Thrombectomy with or without thrombolysis in patients with acute ischemic stroke: a systematic review and meta-analysis.

J Neurol 2021 Sep 14. Epub 2021 Sep 14.

Department of Neurosurgery and Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, Jiangsu Province, China.

Background: Recently, several randomized controlled trials (RCTs) about direct mechanical thrombectomy (d-MT) vs. intravenous thrombolysis before MT (IVT + MT) for acute ischemic stroke (AIS) patients have been reported. This study aims to investigate the differences in efficacy and safety of MT with or without IVT for the treatment of patients with AIS. Read More

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September 2021

Perioperative major neurologic deficits as a complication of spine surgery.

Spinal Cord Ser Cases 2021 Sep 13;7(1):81. Epub 2021 Sep 13.

Department of Orthopaedic Surgery, Harbor-UCLA Medical Center, Torrance, CA, USA.

Study Design: Retrospective review of spine surgery patients with new major neurologic complication.

Objective: To define the causes and severity of new neurologic damage to the spinal cord or cauda equina caused by spinal surgery.

Materials And Methods: Consult records were reviewed for all postoperative spine surgery patients referred to a tertiary spinal cord injury rehabilitation center over a 12-year period. Read More

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September 2021

Prognostic significance of urinary protein and urinary ketone bodies in acute ischemic stroke.

Nutr Metab Cardiovasc Dis 2021 Jul 26. Epub 2021 Jul 26.

Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, China; Institutes of Neuroscience, Soochow University, Suzhou, 215123, China.

Background And Aims: Prior studies have shown an association between positive urinary protein and an elevated risk of long-term mortality in patients with acute ischemic stroke (AIS); however, data on the short-term prognostic significance of urinary protein and urinary ketone bodies in patients with AIS is sparse.

Methods And Results: A total of 2842 AIS patients enrolled from December 2013 to May 2014 across 22 hospitals in Suzhou city were included. Patients were divided into urinary protein positive and negative, urinary ketone bodies positive and negative by urine dipstick. Read More

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Does Navigation Make Spinal Fusion for Adolescent Idiopathic Scoliosis Safer? Insights From a National Database.

Spine (Phila Pa 1976) 2021 Oct;46(19):E1049-E1057

Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA.

Study Design: Retrospective Cohort.

Objective: To evaluate the effect of computer-assisted navigation (NAV) on rates of complications and reoperations after spinal fusion (SF) for adolescent idiopathic scoliosis (AIS) using a nationally representative claims database.

Summary Of Background Data: Significant controversy surrounds the reported benefits of NAV in SF for AIS. Read More

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October 2021

Minimally Invasive Versus Standard Surgery in Idiopathic Scoliosis Patients: A Comparative Study.

Spine (Phila Pa 1976) 2021 Oct;46(19):1326-1335

Division of Paediatric Orthopaedics, Geneva University Hospitals, Faculty of Medicine, Geneva, Switzerland.

Study Design: Retrospective review of prospective case-control study.

Objective: To compare minimally invasive scoliosis surgery (MIS) and posterior spinal fusion (PSF) in a large group of patients.

Summary Of Background Data: MIS, has been shown to have benefits over standard PSF in adolescent idiopathic scoliosis (AIS). Read More

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October 2021

Thrombectomy for distal medium vessel occlusion with a new generation of Stentretriever (Tigertriever 13).

Interv Neuroradiol 2021 Sep 13:15910199211039926. Epub 2021 Sep 13.

Department of Interventional Neuroradiology, 70496Erasme University Hospital, Brussels, Belgium.

Purpose: To evaluate the safety and efficacy of the Tigertriever 13 (Rapid Medical, Yoqneam, Israel) stent retriever in acute ischemic stroke (AIS) patients with primary or secondary distal, medium vessel occlusions (DMVO).

Methods: We performed a retrospective analysis of all consecutive AIS patients who underwent thrombectomy with the Tigertriever13 for DMVO. Patients' characteristics were reviewed, procedural complications, angiographic (modified thrombolysis in cerebral infarction score [mTICI]) and clinical (modified Rankin Scale [mRS]) outcomes were documented. Read More

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September 2021

Contemporary Trends in the Treatment of Mild Ischemic Stroke with Intravenous Thrombolysis: Paul Coverdell National Acute Stroke Program.

Cerebrovasc Dis 2021 Aug 17:1-7. Epub 2021 Aug 17.

Division of Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

Background: Presentation with mild symptoms is a common reason for intravenous thrombolysis (IVT) nonuse among acute ischemic stroke (AIS) patients. We examined the impact of IVT on the outcomes of mild AIS over time.

Methods: Using the Paul Coverdell National Stroke Program data, we examined trends in IVT utilization from 2010 to 2019 among AIS patients presenting with National Institutes of Health Stroke Scale (NIHSS) scores ≤5. Read More

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