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Effect of plasma glucose at admission on COVID-19 mortality: experience from a tertiary hospital.

Endocr Connect 2021 May 1. Epub 2021 May 1.

S Misra, Director and Chief Executive Officer, All India Institute of Medical Sciences Jodphur, Jodhpur, India.

Objective: Plasma glucose has been correlated with in-hospital mortality among many diseases including infections. We aimed to study plasma glucose at admission of hospitalized patients with COVID-19 at a tertiary care referral hospital at Jodhpur, India and its relation with mortality.

Design: A hospital-based clinical study of plasma glucose of COVID-19 patients conducted from May 15th to June 30th, 2020 after ethical approval. Read More

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The effect of COVID-19 epidemic on vital signs in hospitalized patients: a pre-post heat-map study from a large teaching hospital.

J Clin Monit Comput 2021 May 10. Epub 2021 May 10.

IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089, Milan, Italy.

The Lombardy SARS-CoV-2 outbreak in February 2020 represented the beginning of COVID-19 epidemic in Italy. Hospitals were flooded by thousands of patients with bilateral pneumonia and severe respiratory, and vital sign derangements compared to the standard hospital population. We propose a new visual analysis technique using heat maps to describe the impact of COVID-19 epidemic on vital sign anomalies in hospitalized patients. Read More

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Thrombotic Events in COVID-19 Are Associated With a Lower Use of Prophylactic Anticoagulation Before Hospitalization and Followed by Decreases in Platelet Reactivity.

Front Med (Lausanne) 2021 22;8:650129. Epub 2021 Apr 22.

Department of Central Diagnostic Laboratory Research, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.

Coronavirus disease of 2019 (COVID-19) is associated with a prothrombotic state and a high incidence of thrombotic event(s) (TE). To study platelet reactivity in hospitalized COVID-19 patients and determine a possible association with the clinical outcomes thrombosis and all-cause mortality. Seventy nine hospitalized COVID-19 patients were enrolled in this retrospective cohort study and provided blood samples in which platelet reactivity in response to stimulation with ADP and TRAP-6 was determined using flow cytometry. Read More

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High Output Cardiovascular Physiology and Outcomes in Fetal Diagnosis of Vein of Galen Malformation.

Pediatr Cardiol 2021 May 8. Epub 2021 May 8.

Pediatric Heart Center, Icahn School of Medicine At Mount Sinai, New York, NY, USA.

Vein of Galen aneurysmal malformation (VGAM) is a rare anomaly associated with poor outcomes from high output cardiac failure and neurologic complications. Studies addressing fetal cardiovascular status and outcomes in this population are limited. A single-center retrospective review was conducted on patients with a prenatal diagnosis of VGAM who underwent a fetal echocardiogram between January 2015 and July 2019. Read More

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High-dose CytoSorb hemoadsorption is associated with improved survival in patients with septic shock: A retrospective cohort study.

J Crit Care 2021 Apr 20;64:184-192. Epub 2021 Apr 20.

Department of Anesthesiology, Surgical Intensive Care, Emergency and Pain Medicine, Ruhr-University Bochum, Klinikum Herford, Herford, Germany.

Background And Purpose: Hemoadsorption with CytoSorb® offers a possible therapeutic approach in septic shock, but modes of application and dosing are still undetermined.

Materials And Methods: Data from surgical patients with septic shock, treated with hemoadsorption adjunctive to renal replacement therapy were analyzed retrospectively. The 28-day mortality was compared to predicted mortality. Read More

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Malignant pertussis in infants: factors associated with mortality in a multicenter cohort study.

Ann Intensive Care 2021 May 7;11(1):70. Epub 2021 May 7.

Service de Réanimation et Urgences Pédiatriques, Hospices Civils de Lyon, Hôpital Femme Mère Enfant, 59 Boulevard Pinel, 69677, Bron cedex, France.

Background: Malignant pertussis (MP) affects young infants and is characterized by respiratory distress, perpetual tachycardia and hyperleukocytosis up to 50 G/l, leading to multiple organ failure and death in 75% of cases. Leukodepletion may improve prognosis. A therapeutic strategy based on leukodepletion and extracorporeal life support (ECLS) according to different thresholds of leucocytes has been proposed by Rowlands and colleagues. Read More

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Clinical Features and Outcomes of ICU Patients with COVID-19 Infection in Tehran, Iran: a Single-Centered Retrospective Cohort Study.

Tanaffos 2020 Dec;19(4):300-311

Clinical Tuberculosis and Epidemiology Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: The clinical characteristics of the novel coronavirus disease (COVID-19) were diverse and unspecific. Here, we identified the associated factors with surviving of COVID-19 ICU patients based on the clinical characteristics of patients admitted to one of the Corona Centre Hospitals of Iran.

Materials And Methods: This cohort study was performed retrospectively from February to June 2020 on 133 COVID-19 patients admitted to 4 intensive care units of Masih Daneshvari Hospital in Tehran, Iran. Read More

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December 2020

Extracorporeal photopheresis to attenuate decline in lung function due to refractory obstructive allograft dysfunction.

Transfus Med 2021 May 5. Epub 2021 May 5.

Department of Pathology & Immunology, Division of Laboratory & Genomic Medicine, Department of Anesthesiology, Division of Cardiothoracic Anesthesiology, Washington University School of Medicine, St. Louis, Missouri, USA.

Background: This study was designed to prospectively evaluate the efficacy of extracorporeal photopheresis (ECP) to attenuate the rate of decline of FEV in lung transplant recipients with refractory bronchiolitis obliterans. Due to an observed higher than expected early mortality, a preliminary analysis was performed.

Study Design And Methods: Subjects from 10 lung transplant centres were assigned to ECP treatment or to observation based on spirometric criteria, with potential crossover for those under observation. Read More

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Temporal patterns of organ dysfunction after severe trauma.

Crit Care 2021 05 5;25(1):165. Epub 2021 May 5.

Perioperative Medicine and Intensive Care, Karolinska University Hospital, Solna, 171 76, Stockholm, Sweden.

Background: Understanding temporal patterns of organ dysfunction (OD) may aid early recognition of complications after trauma and assist timing and modality of treatment strategies. Our aim was to analyse and characterise temporal patterns of OD in intensive care unit-admitted trauma patients.

Methods: We used group-based trajectory modelling to identify temporal trajectories of OD after trauma. Read More

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Serum potassium levels and prognosis in HBV-associated decompensated cirrhosis.

J Clin Lab Anal 2021 May 5:e23775. Epub 2021 May 5.

Department of Clinical Laboratory, Shengzhou People's Hospital, Shengzhou Branch of the First Affiliated Hospital of Zhejiang University, Shengzhou, China.

Background: Serum potassium disorders are commonly seen in patients with advanced cirrhosis and have a detrimental effect on clinical outcome, but its role in HBV-related decompensated cirrhosis (DeCi) is remained to be illustrated. We aim to assess the effects of serum potassium on outcomes in HBV-DeCi patients.

Methods: Retrospective study included 155 subjects. Read More

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Renal impairment and its impact on clinical outcomes in patients who are critically ill with COVID-19: a multicentre observational study.

Anaesthesia 2021 03 16;76(3):320-326. Epub 2020 Oct 16.

Division of Anaesthetics, Pain Medicine and Intensive Care, Imperial College London, London, UK.

Renal impairment is common in patients who are critically ill with coronavirus disease-19 (COVID-19). We examined the association between acute and chronic kidney disease with clinical outcomes in 372 patients with coronavirus disease-19 admitted to four regional intensive care units between 10 March 2020 and 31 July 2020. A total of 216 (58%) patients presented with COVID-19 and renal impairment. Read More

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Characteristics, outcomes and risk factors for mortality of 522 167 patients hospitalised with COVID-19 in Brazil: a retrospective cohort study.

BMJ Open 2021 05 4;11(5):e049089. Epub 2021 May 4.

Secretariat of Health Surveillance, Brazilian Ministry of Health, Brasilia, Brazil.

Objective: To provide a comprehensive description of demographic, clinical and radiographic characteristics; treatment and case outcomes; and risk factors associated with in-hospital death of patients hospitalised with COVID-19 in Brazil.

Design: Retrospective cohort study of hospitalised patients diagnosed with COVID-19.

Setting: Data from all hospitals across Brazil. Read More

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Admission blood glucose level and outcome in patients requiring venoarterial extracorporeal membrane oxygenation.

Clin Res Cardiol 2021 May 4. Epub 2021 May 4.

Department of Cardiology and Angiology I (Heart Center Freiburg-Bad Krozingen), Faculty of Medicine, Medical Center-University of Freiburg, University of Freiburg, Hugstetterstrasse 55, 79106, Freiburg, Germany.

Background: Patients with cardiogenic shock or cardiac arrest undergoing venoarterial extracorporeal membrane oxygenation (V-A ECMO) frequently present with blood glucose levels out of normal range. The clinical relevance of such findings in the context of V-A ECMO is unknown. We therefore investigated the prognostic relevance of blood glucose at time of cannulation for V-A ECMO. Read More

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A severity-of-illness score in patients with tuberculosis requiring intensive care.

S Afr Med J 2021 Mar 2;111(3):245-249. Epub 2021 Mar 2.

Division of Pulmonology, Department of Medicine, Faculty of Health Sciences, Stellenbosch University and Tygerberg Academic Hospital, Cape Town, South Africa.

Background: We previously retrospectively validated a 6-point severity-of-illness score aimed at identifying patients at risk of dying of tuberculosis (TB) in the intensive care unit (ICU). Parameters included septic shock, HIV infection with a CD4 count <200 cells/µL, renal dysfunction, a ratio of partial pressure of arterial oxygen to fraction of inspired oxygen (P/F) <200 mmHg, a chest radiograph demonstrating diffuse parenchymal infiltrates, and no TB treatment on admission.

Objectives: To prospectively validate the severity-of-illness scoring system in patients with TB requiring intensive care, and to refine and simplify the score in order to expand its clinical utility. Read More

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Interleukin-9 promotes intestinal barrier injury of sepsis: a translational research.

J Intensive Care 2021 May 3;9(1):37. Epub 2021 May 3.

Department of Critical Care Medicine, Nanjing First Hospital, Nanjing Medical University, 68 Changle Road, Nanjing, 210006, Jiangsu Province, China.

Background: Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. Intestinal mucosal barrier injury is one of the important manifestations of sepsis. Interleukin-9 (IL-9) and IL-9-producing CD4(+) T cells were emerging pro-inflammatory mediators with development of intestinal injury. Read More

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Rescue extracorporeal cardiopulmonary resuscitation in pediatric patients: a nine-year single-center experience in Zagreb, Croatia.

Croat Med J 2021 Apr;62(2):146-153

Matija Bakoš, Department of Pediatrics, University Hospital Center Zagreb, Kišpatićeva 12, 10 000 Zagreb, Croatia,

Aim: To investigate the risk factors and the outcomes of extracorporeal membrane oxygenation (ECMO) in pediatric patients treated at the University Hospital Center Zagreb, the largest center in Croatia providing pediatric ECMO.

Methods: This retrospective study enrolled all the pediatric patients who required E-CPR from 2011 to 2019. Demographic data, cardiac anatomy, ECMO indications, ECMO complications, and neurodevelopmental status at hospital discharge were analyzed. Read More

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Immune Profile in Patients With COVID-19: Lymphocytes Exhaustion Markers in Relationship to Clinical Outcome.

Front Cell Infect Microbiol 2021 15;11:646688. Epub 2021 Apr 15.

Centre for Primary Immunodeficiencies, Clinic of Pneumology and Phthisiology, Jessenius Faculty of Medicine, Comenius University in Bratislava, Martin University Hospital, Martin, Slovakia.

The velocity of the COVID-19 pandemic spread and the variable severity of the disease course has forced scientists to search for potential predictors of the disease outcome. We examined various immune parameters including the markers of immune cells exhaustion and activation in 21 patients with COVID-19 disease hospitalised in our hospital during the first wave of the COVID-19 pandemic in Slovakia. The results showed significant progressive lymphopenia and depletion of lymphocyte subsets (CD3, CD4, CD8 and CD19) in correlation to the disease severity. Read More

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Dietary inflammatory index and mortality in hemodialysis patients by path analysis approach (NUGE-HD study).

Nutrition 2021 Mar 9;89:111239. Epub 2021 Mar 9.

Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil. Electronic address:

Objective: The aim of this study was to evaluate the interrelationships between dietary, nutritional, and inflammatory factors in predicting all-cause mortality among individuals in hemodialysis (HD) treatment.

Methods: Participating in this study were 137 patients undergoing HD (58.4% men, 61. Read More

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Epidemiology, outcomes, and utilization of intensive care unit resources for critically ill COVID-19 patients in Libya: A prospective multi-center cohort study.

PLoS One 2021 30;16(4):e0251085. Epub 2021 Apr 30.

Faculty of Medicine University of Tripoli, Tripoli, Libya.

Background: The coronavirus disease (COVID-19) pandemic has severely affected African countries, specifically the countries, such as Libya, that are in constant conflict. Clinical and laboratory information, including mortality and associated risk factors in relation to hospital settings and available resources, about critically ill patients with COVID-19 in Africa is not available. This study aimed to determine the mortality and morbidity of COVID-19 patients in intensive care units (ICU) following 60 days after ICU admission, and explore the factors that influence in-ICU mortality rate. Read More

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Employing machine learning and microscopy images of AIB1-stained biopsy material to assess the 5-year survival of patients with colorectal cancer.

Microsc Res Tech 2021 Apr 30. Epub 2021 Apr 30.

Department of Medical Physics, School of Health Sciences, Faculty of Medicine, University of Patras, Patras, Greece.

Our purpose was to employ microscopy images of amplified in breast cancer 1 (AIB1)-stained biopsy material of patients with colorectal cancer (CRC) to: (a) find statistically significant differences (SSDs) in the texture and color of the epithelial gland tissue, between 5-year survivors and non-survivors after the first diagnosis and (b) employ machine learning (ML) methods for predicting the CRC-patient 5-year survival. We collected biopsy material from 54 patients with diagnosed CRC from the archives of the University Hospital of Patras, Greece. Twenty-six of the patients had survived 5 years after the first diagnosis. Read More

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Blood Urea Nitrogen to Serum Albumin Ratio Independently Predicts Mortality in Critically Ill Patients With Acute Pulmonary Embolism.

Authors:
Jihong Fang Bin Xu

Clin Appl Thromb Hemost 2021 Jan-Dec;27:10760296211010241

Department of Vascular Surgery, Hwa Mei Hospital, University of Chinese Academy of Sciences (Ningbo No.2 Hospital), Ningbo, Zhejiang Province, China.

Acute pulmonary embolism (APE) is one of the prominent causes of death in patients with cardiovascular disease. Currently, reliable biomarkers to predict the prognosis of patients with APE are limited. The present study aimed to investigate the association of blood urea nitrogen to serum albumin (B/A) ratio and intensive care unit (ICU) mortality in critically ill patients with APE. Read More

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Prognostic Value of Bioactive Adrenomedullin in Critically Ill Patients with COVID-19 in Germany: An Observational Cohort Study.

J Clin Med 2021 Apr 13;10(8). Epub 2021 Apr 13.

Department of Intensive and Intermediate Care, University Hospital RWTH Aachen, 52074 Aachen, Germany.

The coronavirus disease 2019 (COVID-19) pandemic has placed a significant burden on hospitals worldwide. Objective biomarkers for early risk stratification and clinical management are still lacking. The aim of this work was to determine whether bioactive adrenomedullin can assist in the risk stratification and clinical management of critically ill COVID-19 patients. Read More

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Lipid and Lipoprotein Dysregulation in Sepsis: Clinical and Mechanistic Insights into Chronic Critical Illness.

J Clin Med 2021 Apr 14;10(8). Epub 2021 Apr 14.

Department of Emergency Medicine, College of Medicine-Jacksonville, University of Florida, 655 West 8th Street, Jacksonville, FL 32209, USA.

In addition to their well-characterized roles in metabolism, lipids and lipoproteins have pleiotropic effects on the innate immune system. These undergo clinically relevant alterations during sepsis and acute inflammatory responses. High-density lipoprotein (HDL) plays an important role in regulating the immune response by clearing bacterial toxins, supporting corticosteroid release, decreasing platelet aggregation, inhibiting endothelial cell apoptosis, reducing the monocyte inflammatory response, and inhibiting expression of endothelial cell adhesion molecules. Read More

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Ventilator Parameters in the Diagnosis and Prognosis of Acute Respiratory Distress Syndrome in Postoperative Patients: A Preliminary Study.

Diagnostics (Basel) 2021 Apr 3;11(4). Epub 2021 Apr 3.

Department of Medical Research, Taipei Veterans General Hospital, Taipei 112, Taiwan.

This study investigated the usefulness of ventilator parameters in the prediction of development and outcome of acute respiratory distress syndrome (ARDS) in postoperative patients with esophageal or lung cancer on admission to the surgical intensive care unit (SICU). A total of 32 post-operative patients with lung or esophageal cancer from SICU in a tertiary medical center were retrospectively analyzed. The study patients were divided into an ARDS group ( = 21) and a non-ARDS group ( = 11). Read More

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Visual lung damage CT score at hospital admission of COVID-19 patients and 30-day mortality.

Eur Radiol 2021 Apr 29. Epub 2021 Apr 29.

Université de Paris, F-75015, Paris, France.

Objectives: Chest CT has been widely used to screen and to evaluate the severity of COVID-19 disease in the early stages of infection without severe acute respiratory syndrome, but no prospective data are available to study the relationship between extent of lung damage and short-term mortality. The objective was to evaluate association between standardized simple visual lung damage CT score (vldCTs) at admission, which does not require any software, and 30-day mortality.

Methods: In a single-center prospective cohort of COVID-19 patients included during 4 weeks, the presence and extent of ground glass opacities(GGO), consolidation opacities, or both of them were visually assessed in each of the 5 lung lobes (score from 0 to 4 per lobe depending on the percentage and out of 20 per patient = vldCTs) after the first chest CT performed to detect COVID-19 pneumonia. Read More

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Compassionate Deactivation of Pediatric Ventricular Assist Devices: A Review of 14 Cases.

J Pain Symptom Manage 2021 Feb 2. Epub 2021 Feb 2.

Department of Anesthesia, Stanford University School of Medicine, Palo Alto, California, USA.

Context: Compassionate deactivation (CD) of ventricular assist device (VAD) support is a recognized option for children when the burden of therapy outweighs the benefits.

Objectives: To describe the prevalence, indications, and outcomes of CD of children supported by VADs at the end of life.

Methods: Review of cases of CD at our institution between 2011-2020. Read More

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February 2021

Rapid clinical evolution for COVID-19 translates into early hospital admission and unfavourable outcome: a preliminary report.

Multidiscip Respir Med 2021 Jan 2;16(1):744. Epub 2021 Apr 2.

Department of Anaesthesiology and Intensive Care Medicine, University hospital rechts der Isar, Technical University of Munich, School of Medicine, Munich.

Background: A wide range of mortality rates has been reported in COVID-19 patients on the intensive care unit. We wanted to describe the clinical course and determine the mortality rate in our institution's intensive care units.

Methods: To this end, we performed a retrospective cohort study of 50 COVID-19 patients admitted to the ICU at a large German tertiary university hospital. Read More

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January 2021

A Frailty Assessment Tool to Predict In-Hospital Mortality in Patients with Acute Exacerbations of Chronic Obstructive Pulmonary Disease.

Int J Chron Obstruct Pulmon Dis 2021 20;16:1093-1100. Epub 2021 Apr 20.

Department of Laboratory Medicine,The Affiliated People's Hospital of Jiangsu University, Zhejiang, 212002, People's Republic of China.

Background: The exacerbation of chronic obstructive pulmonary disease (AECOPD) is a chronic, frequent, and life-threatening lung disease. In 2014, a frailty index (FI) based on deficits in commonly used laboratory tests (FI-Lab) was suggested to identify older adults at increased risk of death.

Objective: We aim to study the prognostic value of the FI-Lab in older Chinese patients who were admitted because of AECOPD. Read More

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Prognostic Value of Angiopoietin-Like 4 in Patients with Acute Respiratory Distress Syndrome.

Shock 2021 Jan 20. Epub 2021 Jan 20.

*Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, and Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University. Guoxuexiang 37, Chengdu, Sichuan 610041, China †Department of Critical Care Medicine, Haikou Municipal Hospital, and Central South University, Xiangya School of Medicine Affiliated Haikou Hospital.

Background: Angiopoietin-like 4 (ANGPTL4) is a secreted glycoprotein that plays an important role in endothelial injury and the inflammatory response. Experimental models have implicated ANGPTL4 in acute respiratory distress syndrome (ARDS), but its impact on the progression of ARDS is unclear.

Methods: Paired bronchoalveolar lavage fluid (BALF) and serum samples were obtained from patients with ARDS (n = 56) within 24 h of diagnosis and from control subjects (n = 32). Read More

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January 2021

Survival outcomes of in-hospital cardiac arrest in pediatric patients in the USA.

Eur J Pediatr 2021 Apr 26. Epub 2021 Apr 26.

Department of Pediatrics Critical Care, Indiana University/Riley Hospital for Children, Indiana University Health Physicians, Indianapolis, IN, USA.

We report on in-hospital cardiac arrest outcomes in the USA. The data were obtained from the National (Nationwide) Inpatient Sample datasets for the years 2000-2017, which includes data from participating hospitals in 47 US states and the District of Columbia. We included pediatric patients (< 18 years of age) with cardiac arrest, and we excluded patients with no cardiopulmonary resuscitation during the hospitalization. Read More

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