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Rundqvist, L., Engvall, J., Blomstrand, P., Carlsson, E. & Faresjö, M. (2019). Resting level of insulin-like growth factor 1 is not at play in cardiac enlargement in endurance-trained adolescents. BioMed Research International, 1-7, Article ID 9647964.
Open this publication in new window or tab >>Resting level of insulin-like growth factor 1 is not at play in cardiac enlargement in endurance-trained adolescents
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2019 (English)In: BioMed Research International, ISSN 2314-6133, E-ISSN 2314-6141, p. 1-7, article id 9647964Article in journal (Refereed) Published
Abstract [en]

Purpose. The study aimed to investigate resting levels of several selected growth and metabolic hormones in a group of 24 endurance-trained adolescents (aged 13-19 years) compared with 24 untrained age- and sex-matched controls, and to investigate if increased cardiac dimensions were related to these hormones at rest with emphasis on insulin-like growth factor-1 (IGF-1).

Methods. The hormones (cortisol, IGF-1, IGF-2, follicle-stimulating hormone, growth hormone, luteinizing hormone, prolactin, and thyroid-stimulating hormone) were analysed with chemiluminescence microparticle immunoassay (CMIA) or multiplex fluorochrome (Luminex) technique. Cardiac dimensions were assessed by echocardiographic examination at rest. Peak oxygen uptake was obtained by a maximal cardiopulmonary exercise test on a treadmill.

Results. Circulating levels of analysed hormones at rest did not differ between the groups. A correlation was found between increased cardiac dimensions and IGF-1 in the controls, but not in the active group. This correlation declined also among the controls when the cardiac parameters were indexed for body surface area.

Conclusion. Increased cardiac dimensions in endurance-trained adolescents could not be related to resting levels of hormones associated with growth and metabolism, including IGF-1 and GH. In addition, the resting levels of these hormones seem not to be affected by intense regular endurance exercise in adolescents. These findings may contribute to the knowledge about cellular signaling that trigger growth as well as cardiac adaptation to endurance training in young athletes. 

Place, publisher, year, edition, pages
Hindawi Publishing Corporation, 2019
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:hj:diva-43514 (URN)10.1155/2019/9647964 (DOI)000491982600002 ()31663002 (PubMedID)2-s2.0-85073601637 (Scopus ID)GOA HHJ 2019 (Local ID)GOA HHJ 2019 (Archive number)GOA HHJ 2019 (OAI)
Available from: 2019-04-23 Created: 2019-04-23 Last updated: 2019-11-14Bibliographically approved
Rundqvist, L., Engvall, J., Faresjö, M. & Blomstrand, P. (2018). Left ventricular diastolic function is enhanced after peak exercise in endurance-trained adolescents as well as in their non-trained controls. Clinical Physiology and Functional Imaging, 38(6), 1054-1061
Open this publication in new window or tab >>Left ventricular diastolic function is enhanced after peak exercise in endurance-trained adolescents as well as in their non-trained controls
2018 (English)In: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 38, no 6, p. 1054-1061Article in journal (Refereed) Published
Abstract [en]

The aims of the study were to explore the temporal change of cardiac function after peak exercise in adolescents, and to investigate how these functional changes relate to maximal oxygen uptake (VO2max ). The cohort consisted of 27 endurance-trained adolescents aged 13-19 years, and 27 controls individually matched by age and gender. Standard echocardiography and colour tissue Doppler were performed at rest, and immediately after as well as 15 min after a maximal cardio pulmonary exercise test (CPET) on a treadmill. The changes in systolic and diastolic parameters after exercise compared to baseline were similar in both groups. The septal E/e'-ratio increased immediately after exercise in both the active and the control groups (from 9·2 to 11·0; P<0·001, and from 8·7 to 10·2; P = 0·008, respectively). In a comparison between the two groups after CPET, the septal E/e'-ratio was higher in the active group both immediately after exercise and 15 min later compared to the control group (P = 0·007 and P = 0·006, respectively). We demonstrated a positive correlation between VO2max and cardiac function including LVEF and E/e' immediately after CPET, but the strongest correlation was found between VO2max and LVEDV (r = 0·67, P<0·001) as well as septal E/e' (r = 0·34, P = 0·013). Enhanced diastolic function was found in both groups, but this was more pronounced in active adolescents. The cardiac functional response to exercise, in terms of LVEF and E/e', correlates with the increase in VO2 uptake. These findings in trained as well as un-trained teenagers have practical implications when assessing cardiac function.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018
Keywords
E/e′, diastolic function, echocardiography, heart, systolic function, training, youngster
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:hj:diva-41801 (URN)10.1111/cpf.12534 (DOI)000446073500019 ()29947056 (PubMedID)2-s2.0-85054186924 (Scopus ID)PP HHJ 2019 embargo 12 (Local ID)PP HHJ 2019 embargo 12 (Archive number)PP HHJ 2019 embargo 12 (OAI)
Available from: 2018-10-10 Created: 2018-10-10 Last updated: 2019-06-26Bibliographically approved
Tompa, A., Nilsson-Bowers, A. & Faresjö, M. (2018). Subsets of CD4+, CD8+, and CD25hi Lymphocytes Are in General Not Influenced by Isolation and Long-Term Cryopreservation. Journal of Immunology, 201(6), 1799-1809
Open this publication in new window or tab >>Subsets of CD4+, CD8+, and CD25hi Lymphocytes Are in General Not Influenced by Isolation and Long-Term Cryopreservation
2018 (English)In: Journal of Immunology, ISSN 0022-1767, E-ISSN 1550-6606, Vol. 201, no 6, p. 1799-1809Article in journal (Refereed) Published
Abstract [en]

Several key factors can affect the outcome of immunological studies; isolation/cryopreservation can possibly alter T, B, NK, and T-regulatory (Treg) cell marker expression patterns. Blood samples from 50 blood donors supplemented with Na-heparin or K2EDTA were handled within 4 and 24 h after blood sampling. PBMC were isolated with different density gradients. Flow cytometric analysis of intracellular and extracellular CD markers was performed on blood samples freshly isolated PBMC, and PBMC was thawed 6 and 12 mo post-cryopreservation for the purpose of identifying B, NK, Th, T-cytotoxic, and Treg cells. No differences were observed in the percentages for CD3+, CD3+CD4+, CD3+CD8+, CD19+, or CD56+CD16+ cells within 24 h of sampling regardless of which supplement or isolation techniques were used. Differentiated (diff) CD4+ cells were in general less affected by isolation and cryopreservation than diff CD8+ cells. Terminally diff effector CD4+ and CD8+ cells were not affected by either isolation of lymphocytes or cryopreservation. In contrast, naive and early-diff effector memory CD4+ and CD8+ cells were affected by isolation and cryopreservation. The percentages of Treg cells defined as CD4+CD25hi expressing CD101 or CD129, CD4+CD25hiCD127, and CD4+CD25hiCD127FOXP3+, respectively, remained stable after isolation and cryopreservation. Subsets expressing CD127, with or without FOXP3, were not affected by isolation/cryopreservation. Subsets expressing CD39, contrary to CD45RA, on CD4+CD25+CD127 cells with or without FOXP3 were not affected by either isolation or cryopreservation. In conclusion, subsets of CD4+, CD8+, and CD25hi lymphocytes are in general not influenced by isolation and long-term cryopreservation.

Place, publisher, year, edition, pages
American Association of Immunologists, 2018
National Category
Immunology
Identifiers
urn:nbn:se:hj:diva-41150 (URN)10.4049/jimmunol.1701409 (DOI)000443585800020 ()30082322 (PubMedID)2-s2.0-85053143384 (Scopus ID)
Funder
Futurum - Academy for Health and Care, Jönköping County Council, Sweden
Available from: 2018-08-15 Created: 2018-08-15 Last updated: 2018-09-25Bibliographically approved
Björkman, B., Gimbler Berglund, I., Faresjö, M., Enskär, K. & Huus, K. (2017). Are radiographers prepared to meet children with special needs, when seen for an examination?. Paper presented at 62nd Nordic Congress of Radiology & 23rd Nordic Congress of Radiography. Acta Radiologica, 58(1 Suppl.), 16-16
Open this publication in new window or tab >>Are radiographers prepared to meet children with special needs, when seen for an examination?
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2017 (English)In: Acta Radiologica, ISSN 0284-1851, E-ISSN 1600-0455, Vol. 58, no 1 Suppl., p. 16-16Article in journal, Meeting abstract (Refereed) Published
Abstract [en]

Introduction: Anxiety is often experienced by children undergoing health care procedures, and children with autism spectrum disorders (ADS) experience more anxiety than typically developed children. A prerequisite for obtaining an optimum procedure is firstly based on the health care provider’s knowledge about children with ASD, but may also depend on the use of guidelines. Two previous national surveys showed, that none radiology or paediatric departments and a minority of anaesthesiology departments throughout Sweden use specific guidelines when seeing children with ASD. Following, the purpose was to develop guidelines to use when caring for and preparing children with ASD in those settings.

Methods: A modified Delphi method was used, including19 experts identified from the two afore mentioned surveys. The questions considered in the process, proceeded from previous research and the results from the surveys. The experts’ responses regarding the importance of each item, were analysed and scrutinized between each round.

Results: The Delphi process resulted in guidelines consisting of 15 items and a checklist with 16 aspects. The items cover the areas: planning and involving parents, features in the environment, use of time, communication, thehealth care professionals. The checklist covers the child’spattern of communication, anxiety, sensory stimuli, special interests and likes/dislikes.

Conclusions: To obtain an optimum caring encounter when a child with ASD is seen in the preoperative and radiology setting, a meticulous planning is important and the environment should be adjusted for the needs of the child. To accomplish this, guidelines need to be in place and be followed.

Place, publisher, year, edition, pages
Sage Publications, 2017
National Category
Nursing Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:hj:diva-37303 (URN)000404621700013 ()
Conference
62nd Nordic Congress of Radiology & 23rd Nordic Congress of Radiography
Available from: 2017-09-13 Created: 2017-09-13 Last updated: 2018-04-23Bibliographically approved
Gimbler Berglund, I., Björkman, B., Enskär, K., Faresjö, M. & Huus, K. (2017). Management of children with Autism Spectrum Disorder in the anesthesia and radiographic context. Journal of Developmental and Behavioral Pediatrics, 38(3), 187-196
Open this publication in new window or tab >>Management of children with Autism Spectrum Disorder in the anesthesia and radiographic context
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2017 (English)In: Journal of Developmental and Behavioral Pediatrics, ISSN 0196-206X, E-ISSN 1536-7312, Vol. 38, no 3, p. 187-196Article in journal (Refereed) Published
Abstract [en]

Objective: As a primary objective, this study purports to develop guidelines to better care for children with autism spectrum disorder (ASD), particularly regarding these children's preparation for anesthesia and radiologic procedures.

Methods: Using a Delphi method with an online distribution of questionnaire, guidelines for caring for children with ASD were created. Twenty-one participants were included in the expert panel. These participants were working with children with ASD in several anesthesia and radiology departments in Sweden. A list of items was created from a previous survey and the literature. In the first round, the items with <60% agreement were discarded. Items were merged, and a new list was created. Two more similar rounds were performed. In the last 2 rounds, 21 participants responded, and 80% agreement was considered to be consensus.

Results: The final guidelines consisted of 14 items and a checklist of 16 factors. The 5 areas covered by the items and the checklist were as follows: planning involving parents/guardians, features in the environment, and use of time, communication, and the health care professionals. The organization was important in making it possible for the health care professional to care for the individual child according to the child's needs. It was important to involve the parents/guardians to obtain knowledge about the functioning of the child.

Conclusion: A caring encounter involving a child with ASD in the anesthesia and radiology contexts requires advance planning, catered specifically to the individual needs of each child. To accomplish this, general knowledge regarding ASD and ASD's particular manifestation in the child entrusted to their care, is required from the health care workers. The organization needs to have structures in place to facilitate this process.

Place, publisher, year, edition, pages
Wolters Kluwer, 2017
National Category
Nursing Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:hj:diva-35267 (URN)10.1097/DBP.0000000000000432 (DOI)000399585500004 ()28333847 (PubMedID)2-s2.0-85015965039 (Scopus ID)
Available from: 2017-03-28 Created: 2017-03-28 Last updated: 2018-11-19Bibliographically approved
Björkman, B., Gimbler Berglund, I., Enskär, K., Faresjö, M. & Huus, K. (2017). Peri-radiographic guidelines for children with autism spectrum disorder: a nationwide survey in Sweden. Child Care Health and Development, 43(1), 31-36
Open this publication in new window or tab >>Peri-radiographic guidelines for children with autism spectrum disorder: a nationwide survey in Sweden
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2017 (English)In: Child Care Health and Development, ISSN 0305-1862, E-ISSN 1365-2214, Vol. 43, no 1, p. 31-36Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: This study aimed to investigate the prevalence of guidelines and routines used nationwide when children with autism spectrum disorder (ASD) are taken care of and examined in a radiology department during a peri-radiographic process.

METHOD: A nationwide survey was compiled and distributed to 94 radiology departments throughout Sweden, i.e. those performing more than 100 000 radiographic examinations annually. The survey was designed as a web questionnaire with seven questions on possible guidelines and/or routines for the departments when preparing and taking care of children with ASD in conjunction with a radiographic procedure. The data were scrutinized, using descriptive statistics.

RESULTS: In total, 86 radiology departments responded to the survey (response rate 92%). Of those departments, 40 did not examine children with ASD. None of the departments included in the study had existing guidelines underpinning the routines when preparing and performing radiographic examinations for children diagnosed with ASD. A few departments (n = 8) would set aside more time for the procedure if it were known in advance that the child to be examined had been diagnosed with ASD. Also, some departments (n = 7) had radiographers who were more experienced in the care of children who would be appointed to perform examinations for children with ASD.

CONCLUSION: It is suggested that guidelines should be developed in order to increase interaction in a supportive way and decrease anxiety during the peri-radiographic process with children with ASD.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2017
Keywords
autism spectrum disorder (ASD); children; guidelines; preparation; radiographic procedure
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-32259 (URN)10.1111/cch.12427 (DOI)000396460600003 ()27807874 (PubMedID)2-s2.0-84997047807 (Scopus ID)
Available from: 2016-11-10 Created: 2016-11-10 Last updated: 2017-04-21Bibliographically approved
Rundqvist, L., Engvall, J., Faresjö, M., Carlsson, E. & Blomstrand, P. (2017). Regular endurance training in adolescents impacts atrial and ventricular size and function. European Heart Journal Cardiovascular Imaging, 18(6), 681-687
Open this publication in new window or tab >>Regular endurance training in adolescents impacts atrial and ventricular size and function
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2017 (English)In: European Heart Journal Cardiovascular Imaging, ISSN 2047-2404, E-ISSN 2047-2412, Vol. 18, no 6, p. 681-687Article in journal (Refereed) Published
Abstract [en]

Aims: The aims of the study were to explore the effects of long-term endurance exercise on atrial and ventricular size and function in adolescents and to examine whether these changes are related to maximal oxygen uptake (VO2max).

Methods and results: Twenty-seven long-term endurance-trained adolescents aged 13–19 years were individually matched by age and gender with 27 controls. All participants, 22 girls and 32 boys, underwent an echocardiographic examination at rest, including standard and colour tissue Doppler investigation. VO2max was assessed during treadmill exercise. All heart dimensions indexed for body size were larger in the physically active group compared with controls: left ventricular end-diastolic volume 60 vs. 50 mL/m2 (P <0.001), left atrial volume 27 vs. 19 mL/m2 (P <0.001), and right ventricular (RV) and right atrial area 15 vs. 13 and 9 vs. 7 cm2/m2, respectively (P <0.001 for both). There were strong associations between the size of the cardiac chambers and VO2max. Further, we found improved systolic function in the active group compared with controls: left ventricular ejection fraction 61 vs. 59% (P= 0.036), tricuspid annular plane systolic excursion 12 vs. 10 mm/m2 (P= 0.008), and RV early peak systolic velocity s′ 11 vs. 10 cm/s (P = 0.031).

Conclusion: Cardiac remodelling to long-term endurance exercise in adolescents is manifested by an increase in atrial as well as ventricular dimensions. The physically active group also demonstrated functional remodelling with an increase in TAPSE and systolic RV wall velocity. These findings have practical implications when assessing cardiac enlargement and function in physically active youngsters.

Place, publisher, year, edition, pages
Oxford University Press, 2017
Keywords
Echocardiography; Heart; Athlete; Atria; Adolescent; Exercise
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:hj:diva-34670 (URN)10.1093/ehjci/jew150 (DOI)000405182500014 ()27406576 (PubMedID)2-s2.0-85029069005 (Scopus ID)
Note

Editor's Choice

Available from: 2017-01-11 Created: 2017-01-11 Last updated: 2019-08-29Bibliographically approved
Faresjö, M. (2016). Children diagnosed with both type 1 diabetes and celiac disease - an Immunological challenge. Immunoendocrinology, 3, 1-12
Open this publication in new window or tab >>Children diagnosed with both type 1 diabetes and celiac disease - an Immunological challenge
2016 (English)In: Immunoendocrinology, ISSN 2378-3079, Vol. 3, p. 1-12Article in journal (Refereed) Published
Abstract [en]

Type 1 diabetes (T1D) and celiac disease are both characterized by an autoimmune feature. As T1D and celiac disease share several common risk factors such as environment, genetics and immune dysregulation, patients have risk of developing the other disease subsequently. Patients with manifest T1D may have had a latent celiac disease, which is activated parallel to the anti-islet immune reactivity during the development of T1D. Contrary, a low prevalence of β-cell autoimmunity is found in young patients with celiac disease.

The role of antigen-specific T cells and their relation to cytokines and chemokines is not well characterized in children with combination of T1D and celiac disease. Defective regulation and an impaired ability of responder T cells to be suppressed are suggested to contribute. We have previously shown that children suffering from these two immunological diseases in combination have a suppressed immune response to several antigens for example food antigens like gluten. Low percentages of both early and late effector memory CD8+ cells together with observations of immune aberrancies seen in the gut, in children who are prone to T1D, may suggests poor development of oral tolerance that may predispose for development of celiac disease.    

This review highlights the immunological complexity in these two common pediatric immunological disorders that indicates that the combination of type 1 diabetes and celiac disease is an immunological challenge. It is obvious that we are far from understanding the immunological impact of these two autoimmune diseases in combination. This immunological challenge therefore needs to be elucidated to be able to predict and prevent these autoimmune diseases. 

Keywords
type 1 diabetes; celiac disease; children, immune system; immune response
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:hj:diva-29253 (URN)10.14800/ie.1110 (DOI)
Available from: 2016-01-28 Created: 2016-01-28 Last updated: 2016-03-31Bibliographically approved
Carlsson, E., Ludvigsson, J., Huus, K. & Faresjö, M. (2016). High physical activity in young children suggests positive effects by altering autoantigen-induced immune activity. Scandinavian Journal of Medicine and Science in Sports, 26(4), 441-450
Open this publication in new window or tab >>High physical activity in young children suggests positive effects by altering autoantigen-induced immune activity
2016 (English)In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 26, no 4, p. 441-450Article in journal (Refereed) Published
Abstract [en]

Physical activity in children is associated with several positive health outcomes such as decreased cardiovascular risk factors, improved lung function, enhanced motor skill development, healthier body composition, and also improved defense against inflammatory diseases. We examined how high physical activity vs a sedentary lifestyle in young children influences the immune response with focus on autoimmunity. Peripheral blood mononuclear cells, collected from 55 5-year-old children with either high physical activity (n = 14), average physical activity (n = 27), or low physical activity (n  = 14), from the All Babies In Southeast Sweden (ABIS) cohort, were stimulated with antigens (tetanus toxoid and beta-lactoglobulin) and autoantigens (GAD65, insulin, HSP60, and IA-2). Immune markers (cytokines and chemokines), C-peptide and proinsulin were analyzed. Children with high physical activity showed decreased immune activity toward the autoantigens GAD65 (IL-5, P < 0.05), HSP60 and IA-2 (IL-10, P < 0.05) and also low spontaneous pro-inflammatory immune activity (IL-6, IL-13, IFN-γ, TNF-α, and CCL2 (P  < 0.05)) compared with children with an average or low physical activity. High physical activity in young children seems to have positive effects on the immune system by altering autoantigen-induced immune activity.

Keywords
Autoimmunity; Cytokines; Immune response; Physical activity; Young children
National Category
Sport and Fitness Sciences
Identifiers
urn:nbn:se:hj:diva-26374 (URN)10.1111/sms.12450 (DOI)000373356600009 ()25892449 (PubMedID)2-s2.0-84961198218 (Scopus ID)
External cooperation:
Available from: 2015-04-24 Created: 2015-04-24 Last updated: 2017-12-04Bibliographically approved
Gimbler Berglund, I., Huus, K., Enskär, K., Faresjö, M. & Björkman, B. (2016). Perioperative and anesthesia guidelines for children with autism: A nationwide survey from Sweden. Journal of Developmental and Behavioral Pediatrics, 37(6), 457-464
Open this publication in new window or tab >>Perioperative and anesthesia guidelines for children with autism: A nationwide survey from Sweden
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2016 (English)In: Journal of Developmental and Behavioral Pediatrics, ISSN 0196-206X, E-ISSN 1536-7312, Vol. 37, no 6, p. 457-464Article in journal (Refereed) Published
Abstract [en]

Objective: The overall aim of this study was to describe the current set of guidelines for the preparation and care for children with autism spectrum disorder (ASD) in the perioperative setting across Sweden and explore the content of these guidelines in detail.

Method: An online questionnaire was distributed to the chairpersons of all anesthesia departments (n = 68) and pediatric departments (n = 38) throughout Sweden. Follow-up phone calls were made to those departments that did not return the questionnaire. The presence of guidelines was analyzed through descriptive statistics. These guidelines and comments on routines used in these departments were analyzed inspired by conventional content analysis.

Results: Seven of the 68 anesthesia departments and none of the 38 pediatric departments across Sweden have guidelines for preparing and/or administering care to children with ASD within the perioperative setting. From the guidelines and routines used, 3 categories emerge: "lacking the necessary conditions," "no extra considerations needed," and "care with specific consideration for children with ASD." These 3 categories span a continuum in the care. In the first category, the anesthesia induction could result in the child with ASD being physically restrained. In the last category, the entire encounter with the health care service would be adapted to the specific needs of the child.

Conclusion: There is a lack of evidence-based guidelines specifically designed to meet the needs of children with ASD in the preoperative period in Sweden. Further research is needed to understand if children with ASD would benefit from evidence-based guidelines.

Place, publisher, year, edition, pages
Wolters Kluwer, 2016
Keywords
autism spectrum disorder, children with ASD, guidelines, preparation, anesthesia, perioperative settings
National Category
Pediatrics
Identifiers
urn:nbn:se:hj:diva-29779 (URN)10.1097/DBP.0000000000000289 (DOI)000379783300004 ()27011004 (PubMedID)2-s2.0-84961390460 (Scopus ID)
Available from: 2016-04-14 Created: 2016-04-14 Last updated: 2018-02-19Bibliographically approved
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Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-9819-0468

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