Seminars in respiratory and critical care medicine最新文献

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What Is Next for COVID-19 Vaccination?
IF 2.3 3区 医学
Seminars in respiratory and critical care medicine Pub Date : 2025-03-31 DOI: 10.1055/a-2531-1211
Antoni Trilla, Guillem Trilla, Marta Aldea, Anna Vilella
{"title":"What Is Next for COVID-19 Vaccination?","authors":"Antoni Trilla, Guillem Trilla, Marta Aldea, Anna Vilella","doi":"10.1055/a-2531-1211","DOIUrl":"https://doi.org/10.1055/a-2531-1211","url":null,"abstract":"<p><p>Whenever a new COVID-19 vaccination season starts, we must face new challenges, including which vaccines to use, the update of the high-risk groups to be vaccinated, and especially the type and amount of information to be communicated to people in order to promote vaccination. COVID-19 vaccination recommendations should fit these specific conditions. The use of effective vaccines against the predominant SARS-CoV-2 virus variants and the extent of the immune response (waning immunity) are key aspects to try to protect better the high-risk populations. Updated vaccines are currently swiftly available. However, the number of people vaccinated with any additional booster dose is declining. Improved health information and training for health care professionals, together with the use of better tools to make simpler vaccination recommendations, can encourage higher vaccination rates. Addressing these challenges is essential to improve vaccination coverage and ensure adequate protection in the face of evolving COVID-19 threats. The SARS-CoV-2 virus has become a constant presence in our society. The virus changes but is neither endemic nor seasonal so far. The Omicron variant prevailed for nearly 2 years and now several of its subvariants like JN.1, KP.2, or XEC are or can be the dominant ones. In the face of this moving situation, the main message must be the same: COVID-19 vaccines are safe and effective. The role of current COVID-19 vaccination efforts is to mitigate the severity of the disease and reduce the risk of complications and death, instead of preventing most SARS-CoV-2 infections. New vaccines against COVID-19 are now at different stages of clinical research.</p>","PeriodicalId":21727,"journal":{"name":"Seminars in respiratory and critical care medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluation of Neuromuscular Disease in Adults Presenting with Dyspnea.
IF 2.3 3区 医学
Seminars in respiratory and critical care medicine Pub Date : 2025-03-31 DOI: 10.1055/a-2535-0859
Daniel Scullin, Joseph Barney
{"title":"Evaluation of Neuromuscular Disease in Adults Presenting with Dyspnea.","authors":"Daniel Scullin, Joseph Barney","doi":"10.1055/a-2535-0859","DOIUrl":"https://doi.org/10.1055/a-2535-0859","url":null,"abstract":"<p><p>Neuromuscular disorders in adults can present with a wide array of clinical features and vary from acute life-threatening complications such as respiratory failure to slow progressive weakness and comorbidity. Common to most of these disorders are symptoms of weakness and dyspnea. Many patients with occult neuromuscular disorders will be evaluated for underlying cardiac and pulmonary disease by primary care and subspecialty providers and can experience delays in diagnosis due to challenges in attaining early neurological testing and recognizing vague symptoms as potentially arising from the neuromuscular apparatus. Additionally, many adults who develop neuromuscular disorders have concomitant cardiac or pulmonary disease and the presence of dyspnea or limitations in mobility are often attributed to these without pursuing further workup. We outline a review of neuromuscular diseases in adults and an approach to evaluation.</p>","PeriodicalId":21727,"journal":{"name":"Seminars in respiratory and critical care medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Sleep and Circadian-Related Outcomes after Critical Illness.
IF 2.3 3区 医学
Seminars in respiratory and critical care medicine Pub Date : 2025-03-31 DOI: 10.1055/a-2531-1137
Margaret A Pisani
{"title":"Sleep and Circadian-Related Outcomes after Critical Illness.","authors":"Margaret A Pisani","doi":"10.1055/a-2531-1137","DOIUrl":"https://doi.org/10.1055/a-2531-1137","url":null,"abstract":"<p><p>Sleep and circadian disruptions are frequently reported in studies of critically ill patients. Less is known about sleep and circadian disruptions after an intensive care unit (ICU) admission. It is recognized now that survivors of critical illness may develop what is termed post-intensive care syndrome (PICS) which is a constellation of symptoms of which two of the most prominent features are fatigue and sleep complaints. Clinicians and researchers are now recognizing the importance of examining symptoms in survivors which impact their quality of life. Although current data are limited this review addresses what is now known about sleep and circadian disruptions post-ICU. Current ongoing research and future studies should continue to inform our understanding of how critical illness and the ICU environment both influence long-term outcomes in critically ill patients.</p>","PeriodicalId":21727,"journal":{"name":"Seminars in respiratory and critical care medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Interplay between Asthma, Obesity, and Obstructive Sleep Apnea.
IF 2.3 3区 医学
Seminars in respiratory and critical care medicine Pub Date : 2025-03-31 DOI: 10.1055/a-2531-1104
Lucia R Rodriguez, Sunita Sharma
{"title":"The Interplay between Asthma, Obesity, and Obstructive Sleep Apnea.","authors":"Lucia R Rodriguez, Sunita Sharma","doi":"10.1055/a-2531-1104","DOIUrl":"https://doi.org/10.1055/a-2531-1104","url":null,"abstract":"<p><p>The interrelationship between asthma, obesity, and obstructive sleep apnea (OSA) presents a critical area of investigation within sleep medicine, given the rising prevalence of these conditions globally. This article explores the multifactorial interactions among these three disorders that contribute to significant morbidity. Asthma, a chronic inflammatory condition of the airways, is one of the most common chronic respiratory conditions globally. Asthma in people with obesity is associated with poor asthma control, increased asthma severity, and an increased frequency of exacerbations. Obesity, characterized by excessive fat accumulation, is a well-established risk factor for the development of OSA. This sleep-related breathing disorder disrupts airflow during sleep due to pharyngeal collapse. Conversely, OSA may worsen asthma symptoms through intermittent hypoxia and sleep fragmentation, further complicating asthma management. This review analyzes existing literature to illustrate the bidirectional relationships among these conditions. It discusses the role of systemic inflammation, hormone dysregulation, and lifestyle factors, such as diet and physical inactivity, in the development and persistence of asthma and OSA in obese patients. Furthermore, it highlights the importance of comprehensive management strategies that address these overlapping disorders. Clinical implications are examined, with consideration given to the potential for targeted therapies and lifestyle interventions that could mitigate symptoms and improve the quality of life for affected individuals. Understanding these complex interactions is essential for healthcare practitioners in optimizing the management of patients with asthma, obesity, and OSA. By recognizing the interconnectedness of these conditions, clinicians can adopt a more holistic approach to treatment, leading to improved outcomes and a better understanding of the patient's overall health trajectory. Future research directions are suggested to investigate potential therapeutic interventions and the influence of socioeconomic factors on these chronic conditions.</p>","PeriodicalId":21727,"journal":{"name":"Seminars in respiratory and critical care medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Sleep and Respiratory Infections.
IF 2.3 3区 医学
Seminars in respiratory and critical care medicine Pub Date : 2025-03-31 DOI: 10.1055/a-2531-1018
Ignacio Boira, Eusebi Chiner
{"title":"Sleep and Respiratory Infections.","authors":"Ignacio Boira, Eusebi Chiner","doi":"10.1055/a-2531-1018","DOIUrl":"10.1055/a-2531-1018","url":null,"abstract":"<p><p>Sleep disorders that involve circadian rhythm disruption and sleep-disordered breathing (SDB) such as obstructive sleep apnea (OSA) are closely linked to respiratory infections. SDB leads to a proinflammatory state due to intermittent hypoxia, sleep fragmentation, increased oxidative stress, and elevation of inflammatory mediators such as tumor necrosis factor (TNF), interleukin-6 (IL-6), and C-reactive protein (CRP). Furthermore, inflammatory mediator levels correlate with SDB severity, especially in people with OSA. Nocturnal microaspiration, gastroesophageal reflux, and associated comorbidities (e.g., obesity) increase the risk of community-acquired pneumonia, viral infections such as SARS-CoV-2, respiratory complications, and death. OSA has been associated with post-COVID syndrome. It also increases the risk of postoperative complications in both adults and children. Circadian rhythm disorders such as insomnia predispose to immune disorders and increase the risk of infection. Chronic conditions such as bronchiectasis, with or without concomitant cystic fibrosis, can lead to structural sleep changes and increase the risk of OSA due to chronic cough, arousals, aspirations, hypoxia, upper airway edema, and overexpression of proinflammatory cytokines. The protective effect of treatment for sleep disorders against respiratory infection is currently unknown. However, in people presenting with respiratory infection, it is important to test for SDB to prevent complications.</p>","PeriodicalId":21727,"journal":{"name":"Seminars in respiratory and critical care medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Critical Role of Sleep in Enhancing Pulmonary Rehabilitation Outcomes.
IF 2.3 3区 医学
Seminars in respiratory and critical care medicine Pub Date : 2025-03-31 DOI: 10.1055/a-2557-8463
Mario Henríquez-Beltrán, Jessica González, Gonzalo Labarca, Adriano D S Targa
{"title":"The Critical Role of Sleep in Enhancing Pulmonary Rehabilitation Outcomes.","authors":"Mario Henríquez-Beltrán, Jessica González, Gonzalo Labarca, Adriano D S Targa","doi":"10.1055/a-2557-8463","DOIUrl":"https://doi.org/10.1055/a-2557-8463","url":null,"abstract":"<p><p>Pulmonary rehabilitation is a comprehensive, interdisciplinary intervention that aims to enhance the physical and psychological well-being of individuals with chronic respiratory diseases. This approach entails the implementation of tailored therapies, including exercise training, education, and behavioral modification. Sleep plays a crucial role in numerous physiological processes, including the regulation of inflammation and tissue repair, both of which are fundamental to the efficacy of rehabilitation. A paucity of optimal sleep health has been associated with deleterious effects on pivotal factors that are indispensable for favorable outcomes in pulmonary rehabilitation, including mental and physical health and immune function. This, in turn, may increase susceptibility to impaired pulmonary function. The integration of pulmonary rehabilitation protocols with healthy sleep practices is expected to yield significant improvements in lung function and overall health, which will, in turn, promote long-term adherence to rehabilitative behaviors. This study aims to examine the relationship between sleep health and pulmonary rehabilitation outcomes.</p>","PeriodicalId":21727,"journal":{"name":"Seminars in respiratory and critical care medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Early Experience on Universal Prophylaxis in Infants against Respiratory Syncytial Virus: Facts and Expectations. 婴儿 RSV 普遍预防的早期经验:事实与期望。
IF 2.3 3区 医学
Seminars in respiratory and critical care medicine Pub Date : 2025-03-18 DOI: 10.1055/a-2531-0968
Antoni Soriano-Arandes, Anna Creus-Costa, Aida Perramon-Malavez, Cristina Andrés, Jorgina Vila, Anna Gatell, Maria Piñana, Pepe Serrano, Alejandra González-Sánchez, Ramon Capdevila, Clara Prats, Pere Soler-Palacin, Andrés Antón
{"title":"Early Experience on Universal Prophylaxis in Infants against Respiratory Syncytial Virus: Facts and Expectations.","authors":"Antoni Soriano-Arandes, Anna Creus-Costa, Aida Perramon-Malavez, Cristina Andrés, Jorgina Vila, Anna Gatell, Maria Piñana, Pepe Serrano, Alejandra González-Sánchez, Ramon Capdevila, Clara Prats, Pere Soler-Palacin, Andrés Antón","doi":"10.1055/a-2531-0968","DOIUrl":"10.1055/a-2531-0968","url":null,"abstract":"<p><p>During the 2023/24 season, nirsevimab significantly reduced the risk of bronchiolitis and confirmed respiratory syncytial virus (RSV) infections in primary care, hospital, and pediatric intensive care unit admissions among infants aged 0 to 11 months, even in a season with a high community RSV burden, particularly for older infants. These findings are very useful for public health authorities to continue to implement immunization campaigns against RSV in the coming seasons. Moreover, universal immunization against RSV represents a transformative step toward reducing the burden of RSV in infants. With promising evidence from recently published studies, the expectations for a reduction of RSV-associated hospitalizations, alongside the improvement of public health outcomes and equitable access to these measures, are high. However, achieving these goals will require addressing challenges related to vaccine uptake, funding, and RSV surveillance to prompt detect resistances due to mutations of the virus. These interventions need to be integrated into public health strategies because they hold the potential to make a significant impact on infant's health worldwide.</p>","PeriodicalId":21727,"journal":{"name":"Seminars in respiratory and critical care medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pulmonary Embolism and Obstructive Sleep Apnea.
IF 2.3 3区 医学
Seminars in respiratory and critical care medicine Pub Date : 2025-02-18 DOI: 10.1055/a-2517-7880
Alberto García-Ortega, Ana Pedro-Tudela, Laura Taberner-Lino, Esther Barreiro, Miguel Ángel Martínez-García, Grace Oscullo
{"title":"Pulmonary Embolism and Obstructive Sleep Apnea.","authors":"Alberto García-Ortega, Ana Pedro-Tudela, Laura Taberner-Lino, Esther Barreiro, Miguel Ángel Martínez-García, Grace Oscullo","doi":"10.1055/a-2517-7880","DOIUrl":"10.1055/a-2517-7880","url":null,"abstract":"<p><p>Pulmonary embolism (PE) and obstructive sleep apnea (OSA) remain a major health issue worldwide with potential overlapping pathophysiological mechanisms. PE, the most severe form of venous thromboembolism, is associated with high morbidity and mortality, presenting challenges in management and prevention, especially in high-risk populations. OSA is a prevalent condition characterized by repeated episodes of upper airway closure resulting in intermittent hypoxia and sleep fragmentation. Although the understanding of epidemiological and pathogenic relationships between OSA and PE is still limited, current data suggest that interactions between these two conditions appear to be relevant. OSA is emerging as a novel risk factor for PE, potentially affecting all components of Virchow's triad: hypercoagulability, endothelial dysfunction, and venous stasis. Epidemiological studies indicate a high prevalence of undiagnosed OSA in acute PE patients. Moderate-to-severe OSA has been linked to worse clinical presentations and outcomes. Furthermore, OSA has been associated with increased risks of PE recurrence and mortality. Future research directions should include clarifying the bidirectional relationship between these conditions and evaluating the effectiveness and safety of continuous positive airway pressure therapy in improving outcomes in patients with concurrent acute PE and OSA.</p>","PeriodicalId":21727,"journal":{"name":"Seminars in respiratory and critical care medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
SLEEP, CIRCADIAN RHYTHMS, AND LUNG CANCER.
IF 2.3 3区 医学
Seminars in respiratory and critical care medicine Pub Date : 2025-02-03 DOI: 10.1055/a-2531-1059
Daniel Cooper, Isaac Lopez, Tetyana Kendzerska
{"title":"SLEEP, CIRCADIAN RHYTHMS, AND LUNG CANCER.","authors":"Daniel Cooper, Isaac Lopez, Tetyana Kendzerska","doi":"10.1055/a-2531-1059","DOIUrl":"https://doi.org/10.1055/a-2531-1059","url":null,"abstract":"<p><p>Lung cancer is the leading cause of cancer-related mortality worldwide, with the prevalence of the disease continually rising. Therefore, identifying disease-modifying risk factors is critical, with increasing recognition of the impact of sleep quality/sleep disorders. This narrative review summarizes the evidence on the role of five domains of sleep on lung cancer incidence and progression: (i) sleep quality/duration, (ii) sleep disordered breathing, (iii) circadian rhythm disturbances, (iv) sleep-related movement disorders and (v) personal, environmental and social factors that modulate each of these associations. Epidemiological evidence supports reduced sleep duration, increased sleep duration, poor sleep quality, insomnia, obstructive sleep apnea, evening chronotype, peripheral limb movements in sleep, and less robustly for night shift work and restless leg syndrome to be associated with increased risk of lung cancer development, with potential impacts on cancer survival outcomes. Proposed mechanisms underlying the biological plausibility of these epidemiological associations are also explored, with common theories relating to immune dysregulation, metabolic alterations, reductions in melatonin, sympathetic overactivation, increased reactive oxygen species, production of protumorigenic exosomes and inflammation. We also summarized potential treatments addressing impaired sleep quality/sleep disorders and their ability to attenuate the risk of lung cancer and cancer survival. While evidence on reversibility is inconsistent, there are trends toward positive outcomes. Future research should focus on clinical trials to confirm cause and effect relationships, large epidemiologic studies for incidence/prognosis, clarification on the relative efficacy of treatment modalities, and more in vivo animal models to establish the molecular mechanisms underlying these relationships.</p>","PeriodicalId":21727,"journal":{"name":"Seminars in respiratory and critical care medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Vaccination against Respiratory Infections in the Immunosenescent Older Adult Population: Challenges and Opportunities. 免疫衰老老年人预防呼吸道感染的疫苗接种:挑战与机遇。
IF 2.3 3区 医学
Seminars in respiratory and critical care medicine Pub Date : 2025-01-30 DOI: 10.1055/a-2500-2121
Fiona Ecarnot, Stefania Maggi
{"title":"Vaccination against Respiratory Infections in the Immunosenescent Older Adult Population: Challenges and Opportunities.","authors":"Fiona Ecarnot, Stefania Maggi","doi":"10.1055/a-2500-2121","DOIUrl":"10.1055/a-2500-2121","url":null,"abstract":"<p><p>Respiratory infections are associated with a huge burden of disease every year and disproportionately affect older adults, namely those aged 65 years and older. Older adults are at increased risk of infections compared with their younger counterparts, and once infected, have a higher risk of experiencing severe disease course, complications, and long-term sequelae. Therefore, vaccination is clearly a key strategy to prevent infection and its attendant negative consequences. We review here the burden of common respiratory diseases in older adults, namely influenza, pneumococcal disease, and respiratory syncytial virus. We then review some of the challenges facing immunization of older adults, namely immunosenescence, inflammaging, and low vaccine uptake. Next, potential opportunities for overcoming these challenges are reviewed, including the use of higher antigen doses and/or adjuvants in vaccine formulations for older adults, and the potential of multiomics analyses to improve development, performance, and implementation of vaccines.</p>","PeriodicalId":21727,"journal":{"name":"Seminars in respiratory and critical care medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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