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Pahlen, S., Hamdi, N. R., Dahl Aslan, A. K., Horwitz, B. N., Panizzon, M. S., Petersen, I., . . . McGue, M. (2018). Age-moderation of genetic and environmental contributions to cognitive functioning in mid- and late-life for specific cognitive abilities. Intelligence, 68, 70-81
Open this publication in new window or tab >>Age-moderation of genetic and environmental contributions to cognitive functioning in mid- and late-life for specific cognitive abilities
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2018 (English)In: Intelligence, ISSN 0160-2896, E-ISSN 1873-7935, Vol. 68, p. 70-81Article in journal (Refereed) Published
Abstract [en]

Age moderation of genetic and environmental contributions to Digits Forward, Digits Backward, Block Design, Symbol Digit, Vocabulary, and Synonyms was investigated in a sample of 14,534 twins aged 26 to 98 years. The Interplay of Genes and Environment across Multiple Studies (IGEMS) consortium contributed the sample, which represents nine studies from three countries (USA, Denmark, and Sweden). Average test performance was lower in successively older age groups for all tests. Significant age moderation of additive genetic, shared environmental, and non-shared environmental variance components was observed, but the pattern varied by test. The genetic contribution to phenotypic variance across age was smaller for both Digit Span tests, greater for Synonyms, and stable for Block Design and Symbol Digit. The non-shared environmental contribution was greater with age for the Digit Span tests and Block Design, while the shared environmental component was small for all tests, often more so with age. Vocabulary showed similar age-moderation patterns as Synonyms, but these effects were nonsignificant. Findings are discussed in the context of theories of cognitive aging. 

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
Adult development, Aging, Behavior genetics, Cognitive ability
National Category
Gerontology, specialising in Medical and Health Sciences Psychology
Identifiers
urn:nbn:se:hj:diva-40996 (URN)10.1016/j.intell.2017.12.004 (DOI)000432796700009 ()2-s2.0-85044170805 (Scopus ID)HHJARNIS (Local ID)HHJARNIS (Archive number)HHJARNIS (OAI)
Available from: 2018-07-17 Created: 2018-07-17 Last updated: 2018-07-17Bibliographically approved
Piirtola, M., Jelenkovic, A., Latvala, A., Sund, R., Honda, C., Inui, F., . . . Silventoinen, K. (2018). Association of current and former smoking with body mass index: A study of smoking discordant twin pairs from 21 twin cohorts. PLoS ONE, 13(7), Article ID e0200140.
Open this publication in new window or tab >>Association of current and former smoking with body mass index: A study of smoking discordant twin pairs from 21 twin cohorts
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2018 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 13, no 7, article id e0200140Article in journal (Refereed) Published
Abstract [en]

Background Smokers tend to weigh less than never smokers, while successful quitting leads to an increase in body weight. Because smokers and non-smokers may differ in genetic and environmental family background, we analysed data from twin pairs in which the co-twins differed by their smoking behaviour to evaluate if the association between smoking and body mass index (BMI) remains after controlling for family background.

Methods and findings

The international CODATwins database includes information on smoking and BMI measured between 1960 and 2012 from 156,593 twin individuals 18–69 years of age. Individual-based data (230,378 measurements) and data of smoking discordant twin pairs (altogether 30,014 pairwise measurements, 36% from monozygotic [MZ] pairs) were analysed with linear fixed-effects regression models by 10-year periods. In MZ pairs, the smoking co-twin had, on average, 0.57 kg/m2 lower BMI in men (95% confidence interval (CI): 0.49, 0.70) and 0.65 kg/m2 lower BMI in women (95% CI: 0.52, 0.79) than the never smoking co-twin. Former smokers had 0.70 kg/m2 higher BMI among men (95% CI: 0.63, 0.78) and 0.62 kg/ m2 higher BMI among women (95% CI: 0.51, 0.73) than their currently smoking MZ co-twins. Little difference in BMI was observed when comparing former smoking co-twins with their never smoking MZ co-twins (0.13 kg/m2, 95% CI 0.04, 0.23 among men; -0.04 kg/m2, 95% CI -0.16, 0.09 among women). The associations were similar within dizygotic pairs and when analysing twins as individuals. The observed series of cross-sectional associations were independent of sex, age, and measurement decade.

Conclusions

Smoking is associated with lower BMI and smoking cessation with higher BMI. However, the net effect of smoking and subsequent cessation on weight development appears to be minimal, i.e. never more than an average of 0.7 kg/m2 

Place, publisher, year, edition, pages
Public Library of Science, 2018
Keywords
adult, aged, article, body mass, controlled study, female, human, major clinical study, male, remission, smoking cessation
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:hj:diva-41670 (URN)10.1371/journal.pone.0200140 (DOI)000438457400025 ()30001359 (PubMedID)2-s2.0-85049777857 (Scopus ID)HHJARNIS (Local ID)HHJARNIS (Archive number)HHJARNIS (OAI)
Available from: 2018-10-01 Created: 2018-10-01 Last updated: 2018-11-01Bibliographically approved
Hallgren, J., Fransson, E., Reynolds, C. A., Finkel, D., Pedersen, N. L. & Dahl Aslan, A. K. (2018). Cognitive trajectories in relation to hospitalization among older Swedish adults. Archives of gerontology and geriatrics (Print), 74, 9-14
Open this publication in new window or tab >>Cognitive trajectories in relation to hospitalization among older Swedish adults
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2018 (English)In: Archives of gerontology and geriatrics (Print), ISSN 0167-4943, E-ISSN 1872-6976, Vol. 74, p. 9-14Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION:

Research indicate that cognitive impairment might be related to hospitalization, but little is known about these effects over time.

OBJECTIVE:

To assess cognitive change before and after hospitalization among older adults in a population-based longitudinal study with up to 25 years of follow-up.

METHOD:

A longitudinal study on 828 community living men and women aged 50-86 from the Swedish Adoption/Twin Study of Ageing (SATSA) were linked to The Swedish National Inpatient Register. Up to 8 assessments of cognitive performance (general cognitive ability, verbal, spatial/fluid, memory, and processing speed) from 1986 to 2010 were available. Latent growth curve modelling was used to assess the association between cognitive performance and hospitalization including spline models to analyse cognitive trajectories pre- and post-hospitalization.

RESULTS:

A total of 735 persons (89%) had at least one hospital admission during the follow-up. Mean age at first hospitalization was 70.2 (±9.3)years. Persons who were hospitalized exhibited a lower mean level of cognitive performance in general ability, processing speed and spatial/fluid ability compared with those who were not hospitalized. The two-slope models revealed steeper cognitive decline before hospitalization than after among those with at least one hospitalization event, as compared to non-hospitalized persons who showed steeper cognitive decline after the centering age of 70 years.

CONCLUSIONS:

Persons being hospitalized in late life have lower cognitive performance across all assessed domains. The results indicate that the main decline occurs before the hospitalization, and not after. This might indicate that when you get treatment you also benefit cognitively.

Keywords
Cognition; Hospitalization; Latent growth curve modelling; Longitudinal study; Old age
National Category
Gerontology, specialising in Medical and Health Sciences
Identifiers
urn:nbn:se:hj:diva-29963 (URN)10.1016/j.archger.2017.09.002 (DOI)000415983300002 ()28923532 (PubMedID)2-s2.0-85029433562 (Scopus ID)HHJÅldrandeIS (Local ID)HHJÅldrandeIS (Archive number)HHJÅldrandeIS (OAI)
Available from: 2016-05-19 Created: 2016-05-19 Last updated: 2018-01-10Bibliographically approved
Marseglia, A., Dahl Aslan, A. K., Fratiglioni, L., Santoni, G., Pedersen, N. L. & Xu, W. (2018). Cognitive Trajectories of Older Adults With Prediabetes and Diabetes: A Population-Based Cohort Study. The journals of gerontology. Series A, Biological sciences and medical sciences, 73(3), 400-406
Open this publication in new window or tab >>Cognitive Trajectories of Older Adults With Prediabetes and Diabetes: A Population-Based Cohort Study
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2018 (English)In: The journals of gerontology. Series A, Biological sciences and medical sciences, ISSN 1079-5006, E-ISSN 1758-535X, Vol. 73, no 3, p. 400-406Article in journal (Refereed) Published
Abstract [en]

Background: Diabetes has been linked to dementia risk; however, the cognitive trajectories in older adults with diabetes remain unclear. We aimed to investigate the effect of prediabetes and diabetes on cognitive trajectories among cognitively intact older adults in a long-term follow-up study.

Methods: Within the Swedish Adoption/Twin Study of Aging, 793 cognitively intact older adults aged ≥50 were identified at baseline and followed for up to 23 years. Based on standardized scores from 11 cognitive tests, administered at baseline and up to seven follow-ups, four cognitive domains (verbal abilities, spatial/fluid, memory, perceptual speed) were identified by principal-component analysis. Prediabetes was defined according to blood glucose levels in diabetes-free participants. Diabetes was ascertained based on self-report, hypoglycemic medication use and blood glucose levels. Data were analyzed with linear mixed-effect models adjusting for potential confounders.

Results: At baseline, 68 participants (8.6%) had prediabetes and 45 (5.7%) had diabetes. Compared to diabetes-free individuals, people with diabetes had a steeper decline over time in perceptual speed and verbal abilities. The annual declines in these domains were greater than the annual decline in memory. Prediabetes was associated with lower performance in memory in middle-age, but also associated with a less steep memory decline over the follow-up.

Conclusions: Diabetes is associated with a faster decline in perceptual speed and verbal abilities, while prediabetes is associated with lower memory performance in middle-age. However, the detrimental effects of hyperglycemia seem to not affect memory over time.

Place, publisher, year, edition, pages
Oxford University Press, 2018
Keywords
Type 2 diabetes; Cognitive aging; Longitudinal study; Hyperglycemia
National Category
Endocrinology and Diabetes Geriatrics
Identifiers
urn:nbn:se:hj:diva-40988 (URN)10.1093/gerona/glx112 (DOI)000426829500022 ()28633303 (PubMedID)2-s2.0-85042926199 (Scopus ID)HHJARNIS (Local ID)HHJARNIS (Archive number)HHJARNIS (OAI)
Available from: 2018-07-13 Created: 2018-07-13 Last updated: 2018-10-03Bibliographically approved
Rizzuto, D., Feldman, A. L., Karlsson, I. K., Dahl Aslan, A. K., Gatz, M. & Pedersen, N. L. (2018). Detection of dementia cases in two Swedish health registers: A validation study. Journal of Alzheimer's Disease, 61(4), 1301-1310
Open this publication in new window or tab >>Detection of dementia cases in two Swedish health registers: A validation study
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2018 (English)In: Journal of Alzheimer's Disease, ISSN 1387-2877, E-ISSN 1875-8908, Vol. 61, no 4, p. 1301-1310Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Population-based health registers are potential assets in epidemiological research; however, the quality of case ascertainment is crucial.

OBJECTIVE: To compare the case ascertainment of dementia, from the National Patient Register (NPR) and the Cause of Death Register (CDR) with dementia diagnoses from six Swedish population based studies.

METHODS: Sensitivity, specificity, and positive predictive value (PPV) of dementia identification in NPR and CDR were estimated by individual record linkage with six Swedish population based studies (n = 19,035). Time to detection in NPR was estimated using data on dementia incidence from longitudinal studies with more than two decades of follow-up.

RESULTS: Barely half of the dementia cases were ever detected by NPR or CDR. Using data from longitudinal studies we estimated that a record with a dementia diagnosis appears in the NPR on average 5.5 years after first diagnosis. Although the ability of the registers to detect dementia cases was moderate, the ability to detect non-dementia cases was almost perfect (99%). When registers indicate that there is a dementia diagnosis, there are very few instances in which the clinicians determined the person was not demented. Indeed, PPVs were close to 90%. However, misclassification between dementia subtype diagnoses is quite common, especially in NPR.

CONCLUSIONS: Although the overall sensitivity is low, the specificity and the positive predictive value are very high. This suggests that hospital and death registers can be used to identify dementia cases in the community, but at the cost of missing a large proportion of the cases.

Place, publisher, year, edition, pages
IOS Press, 2018
Keywords
Alzheimer’s disease, dementia, population-based registers, validation study, vascular dementia
National Category
Neurology Geriatrics
Identifiers
urn:nbn:se:hj:diva-38884 (URN)10.3233/JAD-170572 (DOI)000423364400006 ()29376854 (PubMedID)2-s2.0-85048059412 (Scopus ID)HHJARNIS (Local ID)HHJARNIS (Archive number)HHJARNIS (OAI)
Available from: 2018-02-20 Created: 2018-02-20 Last updated: 2018-09-26Bibliographically approved
Bannon, B. L., Dahl Aslan, A. K., Pedersen, N. L. & Reynolds, C. A. (2018). Illness behaviors mediate the link between social support and functional decline in the Swedish Adoption Twin Study of Aging. Annals of Behavioral Medicine, 52(Suppl. 1), S314-S314
Open this publication in new window or tab >>Illness behaviors mediate the link between social support and functional decline in the Swedish Adoption Twin Study of Aging
2018 (English)In: Annals of Behavioral Medicine, ISSN 0883-6612, E-ISSN 1532-4796, Vol. 52, no Suppl. 1, p. S314-S314Article in journal, Meeting abstract (Refereed) Published
Place, publisher, year, edition, pages
Oxford University Press, 2018
National Category
Gerontology, specialising in Medical and Health Sciences Psychology
Identifiers
urn:nbn:se:hj:diva-40980 (URN)000431185200717 ()
Available from: 2018-07-11 Created: 2018-07-11 Last updated: 2018-07-11Bibliographically approved
Hallgren, J. (2018). Risk factors for hospital readmission among Swedish older adults. European Geriatric Medicine, 9(5), 603-611
Open this publication in new window or tab >>Risk factors for hospital readmission among Swedish older adults
2018 (English)In: European Geriatric Medicine, ISSN 1878-7649, E-ISSN 1878-7657, Vol. 9, no 5, p. 603-611Article in journal (Refereed) Published
Abstract [en]

Introduction 

Hospital readmissions of older persons are common and often associated with complex health problems. The objectives were to analyze risk factors for readmission within 30 days from hospital discharge.

Methods

A prospective study with a multifactorial approach based on the population-based longitudinal Swedish Adoption/ Twin Study of Aging (SATSA) was conducted. During 9 years of follow-up, information on hospitalizations, readmissions and associated diagnoses were obtained from national registers. Logistic regression models controlling for age and sex were conducted to analyze risk factors for readmissions.

Results

Of the 772 participants, [mean age 69.7 (±11.1), 84 (63%)] were hospitalized and among these 208 (43%) had one or several readmissions within 30 days during the follow-up period. Most of the readmissions (57%) occurred within the frst week; mean days from hospital discharge to readmission was 7.9 (±6.2). The most common causes of admission and readmission were cardiovascular diseases and tumors. Only 8% of the readmissions were regarded as avoidable admissions. In a multivariate logistic regression, falling within the last 12 months (OR 0.57, p=0.039) and being a male (OR 1.84, p=0.006) increased the risk of readmission.

Conclusions

Most older persons that are readmitted return to hospital within the frst week after discharge. Experiencing a fall was a particular risk factor of readmission. Preventive actions should preferably take place already at the hospital to reduce the numbers of readmission. Still, it should be remembered that most readmissions were considered to be necessary.

Place, publisher, year, edition, pages
Springer, 2018
Keywords
Readmission · Prospective design · Older persons · Falls · Logistic regression
National Category
Geriatrics
Identifiers
urn:nbn:se:hj:diva-41440 (URN)10.1007/s41999-018-0101-z (DOI)000445464700007 ()30294396 (PubMedID)2-s2.0-85054336960 (Scopus ID)
Available from: 2018-09-14 Created: 2018-09-14 Last updated: 2018-11-09Bibliographically approved
Bokenberger, K., Sjölander, A., Dahl Aslan, A. K., Karlsson, I. K., Åkerstedt, T. & Pedersen, N. L. (2018). Shift work and risk of incident dementia: a study of two population-based cohorts. European Journal of Epidemiology, 33(10), 977-987
Open this publication in new window or tab >>Shift work and risk of incident dementia: a study of two population-based cohorts
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2018 (English)In: European Journal of Epidemiology, ISSN 0393-2990, E-ISSN 1573-7284, Vol. 33, no 10, p. 977-987Article in journal (Refereed) Published
Abstract [en]

This study aimed to investigate the association between shift work and incident dementia in two population-based cohorts from the Swedish Twin Registry (STR). The STR-1973 sample included 13,283 participants born 1926–1943 who received a mailed questionnaire in 1973 that asked about status (ever/never) and duration (years) of shift work employment. The Screening Across the Lifespan Twin (SALT) sample included 41,199 participants born 1900–1958 who participated in a telephone interview in 1998–2002 that asked about night work status and duration. Dementia diagnoses came from Swedish patient registers. Cox proportional-hazards regression was used to estimate hazard ratios (HR) with 95% confidence intervals (CI). Potential confounders such as age, sex, education, diabetes, cardiovascular disease and stroke were included in adjusted models. In genotyped subsamples (n = 2977 in STR-1973; n = 10,366 in SALT), APOE ε4 status was considered in models. A total of 983 (7.4%) and 1979 (4.8%) dementia cases were identified after a median of 41.2 and 14.1 years follow-up in the STR-1973 and SALT sample, respectively. Ever shift work (HR 1.36, 95% CI 1.15–1.60) and night work (HR 1.12, 95% CI 1.01–1.23) were associated with higher dementia incidence. Modest dose-response associations were observed, where longer duration shift work and night work predicted increased dementia risk. Among APOE ε4 carriers, individuals exposed to ≥ 20 years of shift work and night work had increased dementia risk compared to day workers. Findings indicate that shift work, including night shift work, compared to non-shift jobs is associated with increased dementia incidence. Confirmation of findings is needed. 

Place, publisher, year, edition, pages
Springer, 2018
Keywords
Dementia incidence, Epidemiology, Night shift work, Prospective cohort, Shift work
National Category
Public Health, Global Health, Social Medicine and Epidemiology Neurology
Identifiers
urn:nbn:se:hj:diva-41504 (URN)10.1007/s10654-018-0430-8 (DOI)000445160700007 ()30076495 (PubMedID)2-s2.0-85051647561 (Scopus ID)HHJARNIS (Local ID)HHJARNIS (Archive number)HHJARNIS (OAI)
Available from: 2018-09-19 Created: 2018-09-19 Last updated: 2018-10-26Bibliographically approved
Bokenberger, K., Ström, P., Dahl Aslan, A. K., Johansson, A. L. V., Gatz, M., Pedersen, N. L. & Åkerstedt, T. (2017). Association between sleep characteristics and incident dementia accounting for baseline cognitive status: A prospective population-based study. The journals of gerontology. Series A, Biological sciences and medical sciences, 72(1), 134-139
Open this publication in new window or tab >>Association between sleep characteristics and incident dementia accounting for baseline cognitive status: A prospective population-based study
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2017 (English)In: The journals of gerontology. Series A, Biological sciences and medical sciences, ISSN 1079-5006, E-ISSN 1758-535X, Vol. 72, no 1, p. 134-139Article in journal (Refereed) Published
Abstract [en]

Background: While research has shown that sleep disorders are prevalent among people with dementia, the temporal relationship is unclear. We investigated whether atypical sleep characteristics were associated with incident dementia while accounting for baseline cognitive functioning.

Methods: Screening Across the Lifespan Twin Study (SALT) participants were 11,247 individuals from the Swedish Twin Registry who were at least 65 years at baseline (1998-2002). Sleep and baseline cognitive functioning were assessed via the SALT telephone screening interview. Data on dementia diagnoses came from national health registers. Cox regression was performed to estimate hazard ratios (HR) for dementia.

Results: After 17 years of follow-up, 1,850 dementia cases were identified. Short (≤ 6 hours) and extended (> 9 hours) time-in-bed (TIB) compared to the middle reference group (HR=1.40, 95% CI=1.06-1.85, HR=1.11, 95% CI=1.00-1.24, respectively) and rising at 8:00AM or later compared to earlier rising (HR=1.12, 95% CI=1.01-1.24) were associated with higher dementia incidence. Bedtime, sleep quality, restorative sleep, and heavy snoring were not significant predictors. Findings stratified by baseline cognitive status indicated that the association between short TIB and dementia remained in those cognitively intact at the start.

Conclusions: Short and extended TIB as well as delayed rising among older adults predicted increased dementia incidence in the following 17 years. The pattern of findings suggests that extended TIB and late rising represent prodromal features whereas short TIB appeared to be a risk factor for dementia.

Place, publisher, year, edition, pages
Oxford University Press, 2017
Keywords
Dementia, cognitive impairment, incidence, sleep characteristics, prodromal sign, risk factor
National Category
Gerontology, specialising in Medical and Health Sciences
Identifiers
urn:nbn:se:hj:diva-30922 (URN)10.1093/gerona/glw127 (DOI)000396948200019 ()27402049 (PubMedID)2-s2.0-85014730987 (Scopus ID)HHJARNIS (Local ID)HHJARNIS (Archive number)HHJARNIS (OAI)
Available from: 2016-06-28 Created: 2016-06-28 Last updated: 2018-01-10Bibliographically approved
Ericsson, M., Lundholm, C., Fors, S., Dahl Aslan, A. K., Zavala, C., Reynolds, C. A. & Pedersen, N. L. (2017). Childhood social class and cognitive aging in the Swedish Adoption/Twin Study of Aging. Proceedings of the National Academy of Sciences of the United States of America, 114(27), 7001-7006
Open this publication in new window or tab >>Childhood social class and cognitive aging in the Swedish Adoption/Twin Study of Aging
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2017 (English)In: Proceedings of the National Academy of Sciences of the United States of America, ISSN 0027-8424, E-ISSN 1091-6490, Vol. 114, no 27, p. 7001-7006Article in journal (Refereed) Published
Abstract [en]

In this report we analyzed genetically informative data to investigate within-person change and between-person differences in late-life cognitive abilities as a function of childhood social class. We used data from nine testing occasions spanning 28 y in the Swedish Adoption/Twin Study of Aging and parental social class based on the Swedish socioeconomic index. Cognitive ability included a general factor and the four domains of verbal, fluid, memory, and perceptual speed. Latent growth curve models of the longitudinal data tested whether level and change in cognitive performance differed as a function of childhood social class. Between-within twin-pair analyses were performed on twins reared apart to assess familial confounding. Childhood social class was significantly associated with mean-level cognitive performance at age 65 y, but not with rate of cognitive change. The association decreased in magnitude but remained significant after adjustments for level of education and the degree to which the rearing family was supportive toward education. A between-pair effect of childhood social class was significant in all cognitive domains, whereas within-pair estimates were attenuated, indicating genetic confounding. Thus, childhood social class is important for cognitive performance in adulthood on a population level, but the association is largely attributable to genetic influences.

Place, publisher, year, edition, pages
National Academy of Sciences, 2017
Keywords
childhood social class; cognitive aging; adoption; twins
National Category
Gerontology, specialising in Medical and Health Sciences
Identifiers
urn:nbn:se:hj:diva-37239 (URN)10.1073/pnas.1620603114 (DOI)000404576100053 ()28630290 (PubMedID)2-s2.0-85021747712 (Scopus ID)HHJÅldrandeIS (Local ID)HHJÅldrandeIS (Archive number)HHJÅldrandeIS (OAI)
Available from: 2017-09-08 Created: 2017-09-08 Last updated: 2018-01-13Bibliographically approved
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Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-6305-8993

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