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1.
Aerosol and Air Quality Research ; 20(7):1541-1551, 2020.
Article | WHO COVID | ID: covidwho-691830

ABSTRACT

The outbreak of 2019 novel coronavirus (COVID-19) has hugely impacted the world and becomes a global public threat To prevent the spread of COVID-19, human activities are largely restricted in China in early February, 2020 The influence of strict COVID-19 control policies on air quality and the potential influence of particulate matter concentration on COVID-19 infection in China are of great interest This study analyzes the concentrations of six major air pollutants in 366 urban areas across mainland China during January 1 to April 30 in 2017-2020 Results show that strict COVID-19 control policies have significantly improved the air quality in many provinces Compared to 2019, national mean concentrations of PM2 5, PM10, SO2, NO2 and CO in 2020 decrease by 14%, 15%, 12%, 16% and 12%, respectively, while the concentration of O-3 increases by 9% Generally, the diurnal variation of PM2 5 and PM10 concentrations remains unchanged during COVID-19 and their concentrations are high in the morning and evening while low in the afternoon Correlation analysis shows that daily COVID-19 infections are positively correlated with PM2 5 concentration in many provinces, indicating a potential risk of aerosol transmission in high PM2 5 environment Thus it is suggested to stay at home in highly polluted days and go out in the afternoon to reduce the risk of infection due to aerosol transmission

2.
EClinicalMedicine ; 2020.
Article | WHO COVID | ID: covidwho-689274

ABSTRACT

BackgroundThe ferocious global assault of COVID-19 continues Critically ill patients witnessed significantly higher mortality than severe and moderate ones Herein, we aim to comprehensively delineate clinical features of COVID-19 and explore risk factors of developing critical disease

3.
Acta Paediatr ; 2020 Jul 27.
Article in English | MEDLINE | ID: covidwho-676888

ABSTRACT

AIM: This review examined how applicable national and regional clinical practice guidelines and recommendations for managing neonates born to mothers with COVID-19 mothers were to the evolving pandemic. METHODS: A systematic search and review identified 20 guidelines and recommendations that had been published by 25 May 2020. We analysed documents from 17 countries: Australia, Brazil, Canada, China, France, India, Italy, Japan, Saudi Arabia, Singapore, South Africa, South Korea, Spain, Sweden, Switzerland, the UK and the USA. RESULTS: The documents were based on expert consensus with limited evidence and were of variable, low methodological rigour. Most did not provide recommendations for delivery methods or managing symptomatic infants. None provided recommendations for post-discharge assimilation of potentially-infected infants into the community. The majority encouraged keeping mothers and infants together, subject to infection control measures, but one-third recommended separation. Although breastfeeding or using breastmilk were widely encouraged, two countries specifically prohibited this. CONCLUSION: The guidelines and recommendations for managing infants affected by COVID-19 were of low, variable quality and may be unsustainable. It is important that transmission risks are not increased when new information is incorporated into clinical recommendations. Practice guidelines should emphasise the extent of uncertainty and clearly define gaps in the evidence.

4.
Open Access (OA) Online-First Publ. Res. Pap. COVID-19 ; 2020.
Article | WHO COVID | ID: covidwho-659708

ABSTRACT

A review Comparison of domestic and foreign standards for medical personal protective equipment for the prevention and control of new coronavirus pneumonia

7.
J Mol Cell Biol ; 2020 Jul 08.
Article in English | MEDLINE | ID: covidwho-637628

ABSTRACT

For patients with COVID-19 caused by SARS-CoV-2, the damages to multiple organs have been clinically observed. Since most of current investigations for virus-host interaction are based on cell level, there is an urgent demand to probe tissue-specific features associated with SARS-CoV-2 infection. Based on collected proteomic datasets from human lung, colon, kidney, liver and heart, we constructed a virus-receptor network, a virus-interaction network and a virus-perturbation network. In the tissue-specific networks associated with virus-host crosstalk, both common and different key hubs are revealed in diverse tissues. Ubiquitous hubs in multiple tissues such as BRD4 and RIPK1 would be promising drug targets to rescue multi-organ injury and deal with inflammation. Certain tissue-unique hubs such as REEP5 might mediate specific olfactory dysfunction. The present analysis implies that SARS-CoV-2 could affect multi-targets in diverse host tissues, and the treatment of COVID-19 would be a complex task.

8.
Cell ; 2020 Jun 28.
Article in English | MEDLINE | ID: covidwho-628738

ABSTRACT

Vaccines are urgently needed to control the ongoing pandemic COVID-19 and previously emerging MERS/SARS caused by coronavirus (CoV) infections. The CoV spike receptor-binding domain (RBD) is an attractive vaccine target but is undermined by limited immunogenicity. We describe a dimeric form of MERS-CoV RBD that overcomes this limitation. The RBD-dimer significantly increased neutralizing antibody (NAb) titers compared to conventional monomeric form and protected mice against MERS-CoV infection. Crystal structure showed RBD-dimer fully exposed dual receptor-binding motifs, the major target for NAbs. Structure-guided design further yielded a stable version of RBD-dimer as a tandem repeat single-chain (RBD-sc-dimer) which retained the vaccine potency. We generalized this strategy to design vaccines against COVID-19 and SARS, achieving 10- to 100-fold enhancement of NAb titers. RBD-sc-dimers in pilot scale production yielded high yields, supporting their scalability for further clinical development. The framework of immunogen design can be universally applied to other beta-CoV vaccines to counter emerging threats.

9.
Am J Kidney Dis ; 2020 Jul 03.
Article in English | MEDLINE | ID: covidwho-628057

ABSTRACT

RATIONALE & OBJECTIVE: Patients receiving maintenance hemodialysis (MHD) are highly vulnerable to infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The current study was designed to evaluate the prevalence of SARS-CoV-2 infection based on both nucleic acid testing (NAT) and antibody testing in Chinese patients receiving MHD. STUDY DESIGN: Cross-sectional study. SETTING & PARTICIPANTS: From Dec 1, 2019 to Mar 31, 2020, 1027 MHD patients in five large hemodialysis centers in Wuhan, China were enrolled. Patients were screened for SARS-CoV-2 infection by symptoms and initial chest computed tomography (CT). If patients developed symptoms after initial screening was negative, a repeat CT was obtained. Patients suspected of being infected with SARS-CoV-2 were tested with two consecutive throat swabs for viral RNA. In mid-March 2020 antibody testing for SARS-CoV-2 was obtained for all MHD patients. EXPOSURE: NAT and antibody test results for SARS-CoV-2. OUTCOMES: Morbidity, clinical features, laboratory and radiologic findings. ANALYTICAL APPROACH: Differences between groups were examined by Student's t-test or Mann-Whitney U test, comparing those not infected to those infected and comparing those with infection detected by NAT to those with infection detected by positive serology test results. RESULTS: Among 1027 patients receiving MHD, 99 were identified as having SARS-CoV-2 infection, for a prevalence of 9.6%. Among these 99 cases, 52 (53%) were initially diagnosed with SARS-CoV-2 infection by positive NAT; 47 (47%) were identified later by positive IgG or IgM antibodies against SARS-CoV-2. There was a spectrum of antibody profiles in these 47 patients: IgM antibodies in 5 (11%), IgG antibodies in 35 (74%), and both IgM and IgG antibodies in 7 (15%). Of the 99 cases, 51% were asymptomatic during the epidemic; 61% had ground-glass or patchy opacities on chest CT compared to 11.6% among uninfected patients (P<0.001). Patients with hypertensive kidney disease were more often found to have SARS-CoV-2 infection and they were more likely to be symptomatic than patients with another primary cause of kidney failure. LIMITATIONS: Possible false-positive and false-negative results for both NAT and antibody testing; possible lack of generalizability to other dialysis populations. CONCLUSIONS: Half of the SARS-CoV-2 infections in patients receiving MHD were subclinical and were not identified by universal chest CT and selective NAT. Serologic testing may help to evaluate the overall prevalence and understand the diversity of clinical courses among patients receiving MHD who are infected with SARS-CoV-2.

10.
J. Thorac. Dis. ; 5(12): 2827-2829, 20200501.
Article in English | ELSEVIER | ID: covidwho-594758
11.
Chin Med J (Engl) ; 133(11): 1261-1267, 2020 Jun 05.
Article in English | MEDLINE | ID: covidwho-547754

ABSTRACT

BACKGROUND: The 2019 novel coronavirus has caused the outbreak of the acute respiratory disease in Wuhan, Hubei Province of China since December 2019. This study was performed to analyze the clinical characteristics of patients who succumbed to and who recovered from 2019 novel coronavirus disease (COVID-19). METHODS: Clinical data were collected from two tertiary hospitals in Wuhan. A retrospective investigation was conducted to analyze the clinical characteristics of fatal cases of COVID-19 (death group) and we compare them with recovered patients (recovered group). Continuous variables were analyzed using the Mann-Whitney U test. Categorical variables were analyzed by χ test or Fisher exact test as appropriate. RESULTS: Our study enrolled 109 COVID-19 patients who died during hospitalization and 116 recovered patients. The median age of the death group was older than the recovered group (69 [62, 74] vs. 40 [33, 57] years, Z = 9.738, P < 0.001). More patients in the death group had underlying diseases (72.5% vs. 41.4%, χ = 22.105, P < 0.001). Patients in the death group had a significantly longer time of illness onset to hospitalization (10.0 [6.5, 12.0] vs. 7.0 [5.0, 10.0] days, Z = 3.216, P = 0.001). On admission, the proportions of patients with symptoms of dyspnea (70.6% vs. 19.0%, χ = 60.905, P < 0.001) and expectoration (32.1% vs. 12.1%, χ = 13.250, P < 0.001) were significantly higher in the death group. The blood oxygen saturation was significantly lower in the death group (85 [77, 91]% vs. 97 [95, 98]%, Z = 10.625, P < 0.001). The white blood cell (WBC) in death group was significantly higher on admission (7.23 [4.87, 11.17] vs. 4.52 [3.62, 5.88] ×10/L, Z = 7.618, P < 0.001). Patients in the death group exhibited significantly lower lymphocyte count (0.63 [0.40, 0.79] vs. 1.00 [0.72, 1.27] ×10/L, Z = 8.037, P < 0.001) and lymphocyte percentage (7.10 [4.45, 12.73]% vs. 23.50 [15.27, 31.25]%, Z = 10.315, P < 0.001) on admission, and the lymphocyte percentage continued to decrease during hospitalization (7.10 [4.45, 12.73]% vs. 2.91 [1.79, 6.13]%, Z = 5.242, P < 0.001). Alanine transaminase (22.00 [15.00, 34.00] vs. 18.70 [13.00, 30.38] U/L, Z = 2.592, P = 0.010), aspartate transaminase (34.00 [27.00, 47.00] vs. 22.00 [17.65, 31.75] U/L, Z = 7.308, P < 0.001), and creatinine levels (89.00 [72.00, 133.50] vs. 65.00 [54.60, 78.75] µmol/L, Z = 6.478, P < 0.001) were significantly higher in the death group than those in the recovered group. C-reactive protein (CRP) levels were also significantly higher in the death group on admission (109.25 [35.00, 170.28] vs. 3.22 [1.04, 21.80] mg/L, Z = 10.206, P < 0.001) and showed no significant improvement after treatment (109.25 [35.00, 170.28] vs. 81.60 [27.23, 179.08] mg/L, Z = 1.219, P = 0.233). The patients in the death group had more complications such as acute respiratory distress syndrome (ARDS) (89.9% vs. 8.6%, χ = 148.105, P < 0.001), acute cardiac injury (59.6% vs. 0.9%, χ = 93.222, P < 0.001), acute kidney injury (18.3% vs. 0%, χ = 23.257, P < 0.001), shock (11.9% vs. 0%, χ = 14.618, P < 0.001), and disseminated intravascular coagulation (DIC) (6.4% vs. 0%, χ = 7.655, P = 0.006). CONCLUSIONS: Compared to the recovered group, more patients in the death group exhibited characteristics of advanced age, pre-existing comorbidities, dyspnea, oxygen saturation decrease, increased WBC count, decreased lymphocytes, and elevated CRP levels. More patients in the death group had complications such as ARDS, acute cardiac injury, acute kidney injury, shock, and DIC.


Subject(s)
Betacoronavirus , Coronavirus Infections/complications , Pneumonia, Viral/complications , Adult , Aged , Aged, 80 and over , C-Reactive Protein/analysis , Coronavirus Infections/mortality , Female , Humans , Male , Middle Aged , Oxygen/blood , Pandemics , Pneumonia, Viral/mortality , Retrospective Studies
12.
Journal of Nepal Medical Association ; 58(225):360-362, 2020.
Article | WHO COVID | ID: covidwho-620850

ABSTRACT

Oral cavity cancer is one of the most common preventable cancers in the world The burden of the disease is high in South Asia Therefore, public health strategies such as creating awareness and disease screening should be advocated for its prevention and early detection Mouth self-examination serves both the purposes It is easy to perform, non-invasive, and low-cost methods It not only helps in the early detection of suspicious oral lesions but also helps people to quit their high-risk behaviors such as consumption of tobacco and alcohol BACKGROUND: At the end of 2019, a novel coronavirus outbreak causative organism has been subsequently designated the 2019 novel coronavirus (2019-nCoV) The effectiveness of adjunctive glucocorticoid therapy in the management of 2019-nCoV-infected patients with severe lower respiratory tract infections is not clear, and warrants further investigation METHODS: The present study will be conducted as an open-labeled, randomized, controlled trial We will enrol 48 subjects from Chongqing Public Health Medical Center Each eligible subject will be assigned to an intervention group (methylprednisolone via intravenous injection at a dose of 1-2 mg/kg/day for 3 days) or a control group (no glucocorticoid use) randomly, at a 1:1 ratio Subjects in both groups will be invited for 28 days of follow-up which will be scheduled at four consecutive visit points We will use the clinical improvement rate as our primary endpoint Secondary endpoints include the timing of clinical improvement after intervention, duration of mechanical ventilation, duration of hospitalization, overall incidence of adverse events, as well as rate of adverse events at each visit, and mortality at 2 and 4 weeks DISCUSSION: The present coronavirus outbreak is the third serious global coronavirus outbreak in the past two decades Oral and parenteral glucocorticoids have been used in the management of severe respiratory symptoms in coronavirus-infected patients in the past However, there remains no definitive evidence in the literature for or against the utilization of systemic glucocorticoids in seriously ill patients with coronavirus-related severe respiratory disease, or indeed in other types of severe respiratory disease In this study, we hope to discover evidence either supporting or opposing the systemic therapeutic administration of glucocorticoids in patients with severe coronavirus disease 2019 TRIAL REGISTRATION: ClinicalTrials gov, ChiCTR2000029386, http://www chictr org cn/showproj aspx?proj=48777

13.
Pharmacol Res ; 158: 104896, 2020 08.
Article in English | MEDLINE | ID: covidwho-351639

ABSTRACT

Corona virus disease (COVID-19) has now spread to all parts of the world and almost all countries are battling against it. This study aimed to assess the efficacy and safety of Integrated Traditional Chinese and Western Medicine (Hereinafter referred to as "Integrated Medicine") to COVID-19. We searched six major Chinese and English databases to identify randomized controlled trials (RCTs) and case-control studies (CCSs) of Integrated Medicine on COVID-19. Two reviewers independently screened, identified studies, and extracted data. Cochrane Risk of Bias tool and the Newcastle-Ottawa Scale were used to assess the quality of included RCTs and CCSs, respectively. Stata (version 13.0; StataCorp) was used to perform meta-analyses with the random-effects model. Risk ratio (RR) was used for dichotomous data while the weighted mean difference (WMD) was adopted for continuous variables as effect size, both of which were demonstrated in effect size and 95% confidence intervals (CI). A total of 11 studies were included. Four were RCTs and seven were CCSs. The sample size of including studies ranged from 42 to 200 (total 982). The traditional Chinese medicine included Chinese medicine compound drugs (QingFei TouXie FuZhengFang) and Chinese patent medicine (e.g. Shufeng Jiedu Capsule, Lianhua Qingwen granules). Compared with the control group, the overall response rate [RR = 1.230, 95%CI (1.113, 1.359), P = 0.000], cure rate [RR = 1.604, 95%CI (1.181, 2.177), P = 0.002], severity illness rate [RR = 0.350, 95%CI (0.154, 0.792), P = 0.012], and hospital stay [WMD = -1.991, 95%CI (-3.278, -0.703), P = 0.002] of the intervention group were better. In addition, Integrated Medicine can improve the disappearance rate of fever, cough, expectoration, fatigue, chest tightness and anorexia and reduce patients' fever, and fatigue time (P < 0.05). This review found that Integrated Medicine had better effects and did not increase adverse drug reactions for COVID-19. More high-quality RCTs are needed in the future.


Subject(s)
Betacoronavirus , Clinical Medicine/methods , Combined Modality Therapy/adverse effects , Combined Modality Therapy/methods , Coronavirus Infections/therapy , Medicine, Chinese Traditional/methods , Pneumonia, Viral/therapy , Humans , Pandemics
14.
J. Clin. Med. ; 5(9)20200501.
Article in English | ELSEVIER | ID: covidwho-343501

ABSTRACT

Cancer is a disease associated with aging. As the US population ages, the number of older adults with cancer is projected to dramatically increase. Despite this, older adults remain vastly underrepresented in research that sets the standards for cancer treatments and, consequently, clinicians struggle with how to interpret data from clinical trials and apply them to older adults in practice. A combination of system, clinician, and patient barriers bar opportunities for trial participation for many older patients, and strategies are needed to address these barriers at multiple fronts, five of which are offered here. This review highlights the need to (1) broaden eligibility criteria, (2) measure relevant end points, (3) expand standard trial designs, (4) increase resources (e.g., institutional support, interdisciplinary care, and telehealth), and (5) develop targeted interventions (e.g., behavioral interventions to promote patient enrollment). Implementing these solutions requires a substantial investment in engaging and collaborating with community-based practices, where the majority of older patients with cancer receive their care. Multifaceted strategies are needed to ensure that older patients with cancer, across diverse healthcare settings, receive the highest-quality, evidence-based care.

15.
Sci Total Environ ; 731: 139133, 2020 Aug 20.
Article in English | MEDLINE | ID: covidwho-186671

ABSTRACT

Measures taken to control the disease (Covid-19) caused by the novel coronavirus dramatically reduced the number of vehicles on the road and diminished factory production. For this study, changes in the air quality index (AQI) and the concentrations of six air pollutants (PM2.5, PM10, CO, SO2, NO2, and O3) were evaluated during the Covid-19 control period in northern China. Overall, the air quality improved, most likely due to reduced emissions from the transportation and secondary industrial sectors. Specifically, the transportation sector was linked to the NO2 emission reductions, while lower emissions from secondary industries were the major cause for the reductions of PM2.5 and CO. The reduction in SO2 concentrations was only linked to the industrial sector. However, the reductions in emissions did not fully eliminate air pollution, and O3 actually increased, possibly because lower fine particle loadings led to less scavenging of HO2 and as a result greater O3 production. These results also highlight need to control emissions from the residential sector.


Subject(s)
Air Pollution , Betacoronavirus , Coronavirus Infections , Pandemics , Pneumonia, Viral , Air Pollutants , China , Environmental Monitoring , Humans , Particulate Matter
16.
Chin Med J (Engl) ; 133(9): 1080-1086, 2020 May 05.
Article in English | MEDLINE | ID: covidwho-154455

ABSTRACT

BACKGROUND: At the end of 2019, a novel coronavirus outbreak causative organism has been subsequently designated the 2019 novel coronavirus (2019-nCoV). The effectiveness of adjunctive glucocorticoid therapy in the management of 2019-nCoV-infected patients with severe lower respiratory tract infections is not clear, and warrants further investigation. METHODS: The present study will be conducted as an open-labeled, randomized, controlled trial. We will enrol 48 subjects from Chongqing Public Health Medical Center. Each eligible subject will be assigned to an intervention group (methylprednisolone via intravenous injection at a dose of 1-2 mg/kg/day for 3 days) or a control group (no glucocorticoid use) randomly, at a 1:1 ratio. Subjects in both groups will be invited for 28 days of follow-up which will be scheduled at four consecutive visit points. We will use the clinical improvement rate as our primary endpoint. Secondary endpoints include the timing of clinical improvement after intervention, duration of mechanical ventilation, duration of hospitalization, overall incidence of adverse events, as well as rate of adverse events at each visit, and mortality at 2 and 4 weeks. DISCUSSION: The present coronavirus outbreak is the third serious global coronavirus outbreak in the past two decades. Oral and parenteral glucocorticoids have been used in the management of severe respiratory symptoms in coronavirus-infected patients in the past. However, there remains no definitive evidence in the literature for or against the utilization of systemic glucocorticoids in seriously ill patients with coronavirus-related severe respiratory disease, or indeed in other types of severe respiratory disease. In this study, we hope to discover evidence either supporting or opposing the systemic therapeutic administration of glucocorticoids in patients with severe coronavirus disease 2019. TRIAL REGISTRATION: ClinicalTrials.gov, ChiCTR2000029386, http://www.chictr.org.cn/showproj.aspx?proj=48777.


Subject(s)
Betacoronavirus/drug effects , Coronavirus Infections/drug therapy , Glucocorticoids/therapeutic use , Pneumonia, Viral/drug therapy , Randomized Controlled Trials as Topic , Glucocorticoids/adverse effects , Humans , Pandemics , Severity of Illness Index
17.
J Med Virol ; 92(7): 731-739, 2020 07.
Article in English | MEDLINE | ID: covidwho-97647

ABSTRACT

Coronavirus disease 2019 (COVID-19) is a novel type of highly contagious pneumonia caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Despite the strong efforts taken to control the epidemic, hundreds of thousands of people were infected worldwide by 11 March, and the situation was characterized as a pandemic by the World Health Organization. Pregnant women are more susceptible to viral infection due to immune and anatomic alteration, though hospital visits may increase the chance of infection, the lack of medical care during pregnancy may do more harm. Hence, a well-managed system that allows pregnant women to access maternal health care with minimum exposure risk is desired during the outbreak. Here, we present the managing processes of three pregnant women who had fever during hospitalization in the gynecology or obstetrics department, and then, we further summarize and demonstrate our maternal health care management strategies including antenatal care planning, patient triage based on the risk level, admission control, and measures counteracting emergencies and newly discovered high-risk cases at in-patient department. In the meantime, we will explain the alterations we have done throughout different stages of the epidemic and also review relative articles in both Chinese and English to compare our strategies with those of other areas. Although tens of COVID-19 cases were confirmed in our hospital, no nosocomial infection has occurred and none of the pregnant women registered in our hospital was reported to be infected.


Subject(s)
Betacoronavirus/pathogenicity , Clinical Laboratory Techniques/methods , Coronavirus Infections/diagnosis , Disease Outbreaks , Fever/diagnosis , Health Services Accessibility/organization & administration , Pneumonia, Viral/diagnosis , Pregnancy, Ectopic/diagnosis , Adult , Betacoronavirus/genetics , Biomarkers/blood , China/epidemiology , Coronavirus Infections/blood , Coronavirus Infections/epidemiology , Coronavirus Infections/virology , Diagnosis, Differential , Female , Fever/blood , Fever/epidemiology , Fever/virology , Hospitalization/statistics & numerical data , Humans , Maternal Health , Pandemics , Pneumonia, Viral/blood , Pneumonia, Viral/epidemiology , Pneumonia, Viral/virology , Pregnancy , Pregnancy, Ectopic/blood , Pregnancy, Ectopic/epidemiology , Pregnancy, Ectopic/virology , Tomography, X-Ray Computed , Triage/organization & administration
18.
Emerg Infect Dis ; 26(7): 1575-1579, 2020 07.
Article in English | MEDLINE | ID: covidwho-76568

ABSTRACT

During the early phase of the coronavirus disease epidemic in Hong Kong, 1,715 survey respondents reported high levels of perceived risk, mild anxiety, and adoption of personal-hygiene, travel-avoidance, and social-distancing measures. Widely adopted individual precautionary measures, coupled with early government actions, might slow transmission early in the outbreak.


Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Pneumonia, Viral/epidemiology , Adolescent , Adult , Aged , Aged, 80 and over , Coronavirus Infections/prevention & control , Female , Hong Kong/epidemiology , Humans , Male , Middle Aged , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Young Adult
19.
Nature ; 580(7803): E7, 2020 Apr.
Article in English | MEDLINE | ID: covidwho-73543

ABSTRACT

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

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