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Article ; Online: Paediatric new onset type 1 diabetes and diabetic ketoacidosis during the COVID-19 pandemic in Malaysia.

Lee, Yee Lin / Nasir, Fatin Farihah Wan Ahmad / Selveindran, Nalini M / Zaini, Azriyanti Anuar / Lim, Poi Giok / Jalaludin, Muhammad Yazid

Diabetes research and clinical practice

2023 Volume 205, Page(s) 110981

Abstract: ... to determine the frequency, demographics, and clinical characteristics of new onset type 1 DM (T1DM) during ... diabetic ketoacidosis (DKA) worldwide following the COVID-19 pandemic, studies in Asia are lacking. We aimed ... Aims: Despite emerging evidence of increased paediatric diabetes mellitus (DM) and ...

Abstract	Aims: Despite emerging evidence of increased paediatric diabetes mellitus (DM) and diabetic ketoacidosis (DKA) worldwide following the COVID-19 pandemic, studies in Asia are lacking. We aimed to determine the frequency, demographics, and clinical characteristics of new onset type 1 DM (T1DM) during the pandemic in Malaysia. Methods: This is a retrospective multicenter study involving new onset T1DM paediatric patients in Klang Valley, Malaysia during two time periods ie 18th September 2017-17th March 2020 (pre-pandemic) and 18th March 2020-17th September 2022 (pandemic). Results: There was a total of 180 patients with new onset T1DM during the 5-year study period (71 pre-pandemic, 109 pandemic). An increase in frequency of T1DM was observed during the pandemic (52 in 2021, 38 in 2020, 27 in 2019 and 30 in 2018). A significantly greater proportion of patients presented with DKA (79.8 % vs 64.8 %), especially severe DKA (46.8 % vs 28.2 %) during the pandemic. Serum glucose was significantly higher (28.2 mmol vs 25.9 mmol/L) with lower venous pH (7.10 vs 7.16), but HbA1c was unchanged. Conclusions: New onset T1DM increased during the pandemic, with a greater proportion having severe DKA. Further studies are required to evaluate the mechanism leading to this rise to guide intervention measures.
MeSH term(s)	Child ; Humans ; Diabetes Mellitus, Type 1/complications ; Diabetes Mellitus, Type 1/epidemiology ; Diabetic Ketoacidosis/epidemiology ; Pandemics ; Malaysia/epidemiology ; COVID-19/epidemiology ; Retrospective Studies
Language	English
Publishing date	2023-10-25
Publishing country	Ireland
Document type	Multicenter Study ; Journal Article
ZDB-ID	632523-3
ISSN	1872-8227 ; 0168-8227
ISSN (online)	1872-8227
ISSN	0168-8227
DOI	10.1016/j.diabres.2023.110981
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Article ; Online: New onset diabetes, type 1 diabetes and COVID-19.

Boddu, Sirisha Kusuma / Aurangabadkar, Geeta / Kuchay, Mohammad Shafi

Diabetes & metabolic syndrome

2020 Volume 14, Issue 6, Page(s) 2211–2217

Abstract: ... 1 diabetes; COVID-19 induced DKA; new-onset diabetes after SARS-CoV-2 infection) to extract relevant ... electronic databases till October 2020, using relevant keywords (COVID-19 induced diabetes; COVID-19 and type ... 19), and its severity and complications in patients with type 2 diabetes mellitus (T2DM ...

Abstract	Background and aims: New data has emerged regarding higher risk of coronavirus disease 2019 (COVID-19), and its severity and complications in patients with type 2 diabetes mellitus (T2DM). However, there is a dearth of evidence regarding type 1 diabetes mellitus (T1DM). This article explores the possibility of COVID 19 induced diabetes and highlights a potential bidirectional link between COVID 19 and T1DM. Methods: A literature search was performed with Medline (PubMed), Scopus, and Google Scholar electronic databases till October 2020, using relevant keywords (COVID-19 induced diabetes; COVID-19 and type 1 diabetes; COVID-19 induced DKA; new-onset diabetes after SARS-CoV-2 infection) to extract relevant studies describing relationship between COVID-19 and T1DM. Results: Past lessons and new data teach us that severe acute respiratory syndrome coronaviruses (SARS-CoV and SARS-CoV-2) can enter islet cells via angiotensin converting enzyme-2 (ACE-2) receptors and cause reversible β-cell damage and transient hyperglycemia. There have been postulations regarding the potential new-onset T1DM triggered by COVID-19. This article reviews the available evidence regarding the impact and interlink between COVID-19 and Τ1DM. We also explore the mechanisms behind the viral etiology of Τ1DM. Conclusions: SARS-CoV-2 can trigger severe diabetic ketoacidosis at presentation in individuals with new-onset diabetes. However, at present, there is no hard evidence that SARS-CoV-2 induces T1DM on it's own accord. Long term follow-up of children and adults presenting with new-onset diabetes during this pandemic is required to fully understand the type of diabetes induced by COVID-19.
MeSH term(s)	Angiotensin-Converting Enzyme 2/antagonists & inhibitors ; Angiotensin-Converting Enzyme Inhibitors/pharmacology ; Angiotensin-Converting Enzyme Inhibitors/therapeutic use ; COVID-19/diagnosis ; COVID-19/mortality ; Diabetes Mellitus, Type 1/diagnosis ; Diabetes Mellitus, Type 1/drug therapy ; Diabetes Mellitus, Type 1/mortality ; Humans ; COVID-19 Drug Treatment
Chemical Substances	Angiotensin-Converting Enzyme Inhibitors ; ACE2 protein, human (EC 3.4.17.23) ; Angiotensin-Converting Enzyme 2 (EC 3.4.17.23)
Language	English
Publishing date	2020-11-17
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	2273766-2
ISSN	1878-0334 ; 1871-4021
ISSN (online)	1878-0334
ISSN	1871-4021
DOI	10.1016/j.dsx.2020.11.012
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Article ; Online: New-Onset Type 1 Diabetes in Children and COVID-19.

Alexandre, Maria Inês / Henriques, Ana Raquel / Cavaco, Daniela / Rodrigues, Luís / Costa, Sara / Robalo, Brígida / Pereira, Carla / Sampaio, Maria de Lurdes

Acta medica portuguesa

2021 Volume 34, Issue 9, Page(s) 642–643

MeSH term(s)	COVID-19 ; Child ; Diabetes Mellitus, Type 1/epidemiology ; Humans ; Risk Factors ; SARS-CoV-2
Language	English
Publishing date	2021-07-26
Publishing country	Portugal
Document type	Letter
ZDB-ID	603078-6
ISSN	1646-0758 ; 0870-399X
ISSN (online)	1646-0758
ISSN	0870-399X
DOI	10.20344/amp.16412
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Article ; Online: DKA and new-onset type 1 diabetes in Brazilian children and adolescents during the COVID-19 pandemic.

Luciano, Thais Milioni / Halah, Mariana Peduti / Sarti, Mariana Teresa Alves / Floriano, Vitor Gonçalves / da Fonseca, Benedito Antônio Lopes / Del Roio Liberatore, Raphael / Antonini, Sonir Rauber

Archives of endocrinology and metabolism

2022 Volume 66, Issue 1, Page(s) 88–91

Abstract: We assess the severity and frequency of diabetic ketoacidosis (DKA) in new-onset type 1 ... 2017, 2018, 2019, and 2020. During the COVID-19 pandemic, the number of new-onset T1D was over twice ... with COVID-19-related symptoms (any respiratory symptom, fever, nausea, vomiting, and diarrhea), but only one ...

Abstract	We assess the severity and frequency of diabetic ketoacidosis (DKA) in new-onset type 1 diabetes mellitus (T1D) patients and in patients with previous diagnosis of T1D in a referral Brazilian university hospital in the first five months of the COVID-19 pandemic. We also compare the data with data from pre-pandemic periods. Forty-three new-onset T1D patients were diagnosed between April and August of the years 2017, 2018, 2019, and 2020. During the COVID-19 pandemic, the number of new-onset T1D was over twice the number of new-onset T1D in the same period in the three previous years. All the 43 patients survived and are now on outpatient follow-up. We also compared the characteristics of the T1D patients hospitalized between April and August of the years 2017, 2018, and 2019 (32 hospitalizations) to the characteristics of the T1D patients hospitalized between April and August/2020 (35 hospitalizations; 1 patient was hospitalized twice in this period). Fourteen of the 34 patients admitted during the pandemic presented with COVID-19-related symptoms (any respiratory symptom, fever, nausea, vomiting, and diarrhea), but only one had positive SARS-CoV-2 RT-PCR test. Samples from 32 out of these 34 patients were assayed for SARS-CoV-2 antibodies, and four patients were positive for total antibodies (IgM and IgG). In agreement with recent reports from European countries, we observed increased frequency of DKA and severe DKA in new-onset and previously diagnosed T1D children and adolescents in a large referral public hospital in Brazil in the first five months of the COVID-19 pandemic. The reasons for this outcome might have been fear of SARS-CoV-2 infection in emergency settings, the more limited availability of primary healthcare, and the lack of school personnel's attention toward children's general well-being.
MeSH term(s)	Adolescent ; Brazil/epidemiology ; COVID-19/epidemiology ; Child ; Diabetes Mellitus, Type 1/epidemiology ; Diabetic Ketoacidosis/epidemiology ; Humans ; Pandemics ; SARS-CoV-2
Language	English
Publishing date	2022-01-13
Publishing country	Brazil
Document type	Journal Article
ISSN	2359-4292
ISSN (online)	2359-4292
DOI	10.20945/2359-3997000000433
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Article: Increased Severe Cases and New-Onset Type 1 Diabetes Among Children Presenting With Diabetic Ketoacidosis During First Year of COVID-19 Pandemic in Turkey.

Kiral, Eylem / Kirel, Birgul / Havan, Merve / Keskin, Mehmet / Karaoglan, Murat / Yildirim, Ahmet / Kangin, Murat / Talay, Mehmet Nur / Urun, Tuba / Altug, Umit / Kesici, Selman / Tufan, Erennur / Kacmaz, Ebru / Bozan, Gurkan / Azapagasi, Ebru / Uysal Yazici, Mutlu / Ozturk, Zeynelabidin / Yesilbas, Osman / Karaguzel, Gulay /

Kaya, Gulay / Barlas, Ulkem / Duyu, Muhterem / Boyraz, Merve / Sevketoglu, Esra / Akcay, Nihal / Hancili, Suna / Guven, Ayla / Dursun, Oǧuz / Ulgen Tekerek, Nazan / Ozcifci, Gokçen / Yazici, Pinar / Turanli, Eda / Kendirli, Tanil / Kahveci, Fevzi / Yetimakman, Ayse Filiz / Citak, Agop / Şik, Guntulu / Bingol, Ibrahim / Aygun, Fatih / Durak, Cansu / Yilmaz, Resul / Bugrul, Fuat / Sari, Yusuf / Tekguç, Hakan / Albayrak, Hatice / Yener, Nazik / Agin, Hasan / Soydan, Ekin / Yildizdas, Dincer / Dilek, Semine Ozdemir / Yalindag, Nilufer / Incekoy-Girgin, Feyza / Alacakir, Nuri / Tutunculer, Filiz / Arslanaoglu, Mehmet Ozgur / Aydin, Can / Bilgin, Muzaffer / Simsek, Enver / Dinleyici, Ener Cagri

Frontiers in pediatrics

2022 Volume 10, Page(s) 926013

Abstract: ... the COVID-19 pandemic (: Discussion: The frequency of new onset of Type 1 diabetes and severe cases ... pandemic on the severity of diabetic ketoacidosis (DKA) and new onset Type 1 diabetes presenting with DKA ... Results: The percentage of children with new-onset Type 1 diabetes presenting with DKA was higher during ...

Abstract	Introduction: There have been some significant changes regarding healthcare utilization during the COVID-19 pandemic. Majority of the reports about the impact of the COVID-19 pandemic on diabetes care are from the first wave of the pandemic. We aim to evaluate the potential effects of the COVID-19 pandemic on the severity of diabetic ketoacidosis (DKA) and new onset Type 1 diabetes presenting with DKA, and also evaluate children with DKA and acute COVID-19 infection. Methods: This is a retrospective multi-center study among 997 children and adolescents with type 1 diabetes who were admitted with DKA to 27 pediatric intensive care units in Turkey between the first year of pandemic and pre-pandemic year. Results: The percentage of children with new-onset Type 1 diabetes presenting with DKA was higher during the COVID-19 pandemic ( Discussion: The frequency of new onset of Type 1 diabetes and severe cases among children with DKA during the first year of the COVID-19 pandemic. Furthermore, the cause of the increased severe presentation might be related to restrictions related to the pandemic; however, need to evaluate the potential effects of SARS-CoV-2 on the increased percentage of new onset Type 1 diabetes.
Language	English
Publishing date	2022-06-29
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2711999-3
ISSN	2296-2360
ISSN	2296-2360
DOI	10.3389/fped.2022.926013
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Article ; Online: Incidence of COVID-19 and Risk of Diabetic Ketoacidosis in New-Onset Type 1 Diabetes.

Kamrath, Clemens / Rosenbauer, Joachim / Eckert, Alexander J / Pappa, Angeliki / Reschke, Felix / Rohrer, Tilman R / Mönkemöller, Kirsten / Wurm, Michael / Hake, Kathrin / Raile, Klemens / Holl, Reinhard W

Pediatrics

2021 Volume 148, Issue 3

Abstract: ... for ketoacidosis in 2020 was estimated from observed and expected rates in 3238 children with new-onset type 1 ... of diabetic ketoacidosis at diagnosis of type 1 diabetes during the year 2020 and to assess whether it was associated ... with the regional incidence of coronavirus disease 2019 (COVID-19) cases and deaths.: Methods: Multicenter ...

Abstract	Objectives: With this study, our aim was to quantify the relative risk (RR) of diabetic ketoacidosis at diagnosis of type 1 diabetes during the year 2020 and to assess whether it was associated with the regional incidence of coronavirus disease 2019 (COVID-19) cases and deaths. Methods: Multicenter cohort study based on data from the German Diabetes Prospective Follow-up Registry. The monthly RR for ketoacidosis in 2020 was estimated from observed and expected rates in 3238 children with new-onset type 1 diabetes. Expected rates were derived from data from 2000 to 2019 by using a multivariable logistic trend regression model. The association between the regional incidence of COVID-19 and the rate of ketoacidosis was investigated by applying a log-binomial mixed-effects model to weekly data with Germany divided into 5 regions. Results: The observed versus expected frequency of diabetic ketoacidosis was significantly higher from April to September and in December (mean adjusted RRs, 1.48-1.96). During the first half of 2020, each increase in the regional weekly incidence of COVID-19 by 50 cases or 1 death per 100 000 population was associated with an increase in the RR of diabetic ketoacidosis of 1.40 (95% confidence interval, 1.10-1.77; Conclusions: These findings suggest that the local severity of the pandemic rather than health policy measures appear to be the main reason for the increase in diabetic ketoacidosis and thus the delayed use of health care during the pandemic.
MeSH term(s)	COVID-19/epidemiology ; COVID-19/mortality ; Child ; Cohort Studies ; Confidence Intervals ; Diabetes Mellitus, Type 1/diagnosis ; Diabetes Mellitus, Type 1/epidemiology ; Diabetic Ketoacidosis/epidemiology ; Female ; Germany/epidemiology ; Humans ; Incidence ; Logistic Models ; Male ; Models, Statistical ; Registries ; Risk ; Time Factors
Language	English
Publishing date	2021-05-19
Publishing country	United States
Document type	Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
ZDB-ID	207677-9
ISSN	1098-4275 ; 0031-4005
ISSN (online)	1098-4275
ISSN	0031-4005
DOI	10.1542/peds.2021-050856
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Article ; Online: New onset diabetes, type 1 diabetes and COVID-19

Boddu, Sirisha Kusuma / Aurangabadkar, Geeta / Kuchay, Mohammad Shafi

Diabetes & Metabolic Syndrome: Clinical Research & Reviews ; ISSN 1871-4021

2020

Keywords	Internal Medicine ; Endocrinology, Diabetes and Metabolism ; General Medicine ; covid19
Language	English
Publisher	Elsevier BV
Publishing country	us
Document type	Article ; Online
DOI	10.1016/j.dsx.2020.11.012
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Article: The Examination of the Relationship Between COVID-19 and New-Onset Type 1 Diabetes Mellitus in Children.

Donbaloğlu, Zeynep / Tuhan, Hale / Tural Kara, Tuğçe / Bedel, Aynur / Barsal Çetiner, Ebru / Singin, Berna / Parlak, Mesut

Turkish archives of pediatrics

2022 Volume 57, Issue 2, Page(s) 222–227

Abstract: ... with new-onset type 1 diabetes mellitus between April 1, 2020, and April 1, 2021, were included ... Objective: This study aimed to evaluate presentations of new-onset type 1 diabetes ... years in terms of number of new-onset type 1 diabetes mellitus patients, rate of presentation ...

Abstract	Objective: This study aimed to evaluate presentations of new-onset type 1 diabetes mellitus in a pediatric cohort during the coronavirus disease 2019 pandemic. Materials and methods: This study was designed as a single-center, descriptive, cross-sectional retrospective study. The patients diagnosed with new-onset type 1 diabetes mellitus between April 1, 2020, and April 1, 2021, were included in the study. The rate of severe acute respiratory syndrome coronavirus 2 polymerase chain reactivity-positivity was investigated. The pandemic period was compared with the same period of the pre-pandemic 2 years in terms of number of new-onset type 1 diabetes mellitus patients, rate of presentation with diabetic ketoacidosis, and degree of diabetic ketoacidosis severity. Results: In total, 56 patients were diagnosed with type 1 diabetes mellitus during the pandemic and 2 (3.57%) of them tested positive for severe acute respiratory syndrome coronavirus 2 polymerase chain reaction. The number of new-onset type 1 diabetes mellitus patients was 39 in 2019 and 39 in 2018. The rate of presentation with diabetic ketoacidosis was similar in the pandemic period compared to the pre-pandemic periods (53.5% in 2020 vs. 56.4% in 2019 and 53.8% in 2018; P = .94). The proportion of severe diabetic ketoacidosis was also similar in all years, respectively (43.3% in 2020 vs. 45.4% in 2019 and 47.6% in 2018; P = .95). Conclusion: We reported only 2 cases that tested positive for severe acute respiratory syndrome coronavirus 2among the new-onset type 1 diabetes mellitus patients during the pandemic. Although we found an increase in the number of new-onset type 1 diabetes mellitus cases by comparing with prepandemic period, rates of diabetic ketoacidosis and severe diabetic ketoacidosis were similar. There was no finding to suggest that severe acute respiratory syndrome coronavirus 2taking a part in type 1 diabetes mellitus pathogenesis. Since the development of type 1 diabetes mellitus is a long process, prospective studies are needed to investigate the long-term effects of severe acute respiratory syndrome coronavirus 2.
Language	English
Publishing date	2022-04-02
Publishing country	Turkey
Document type	Journal Article
ISSN	2757-6256
ISSN	2757-6256
DOI	10.5152/TurkArchPediatr.2022.21284
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Article: New onset diabetes, type 1 diabetes and COVID-19

Boddu, Sirisha Kusuma Aurangabadkar Geeta Kuchay Mohammad Shafi

Diabetes & Metabolic Syndrome: Clinical Research & Reviews

Abstract: ... 1 diabetes;COVID-19 induced DKA;new-onset diabetes after SARS-CoV-2 infection) to extract relevant ... electronic databases till October 2020, using relevant keywords (COVID-19 induced diabetes;COVID-19 and type ... 19), and its severity and complications in patients with type 2 diabetes mellitus (T2DM ...

Abstract	Background and aims New data has emerged regarding higher risk of coronavirus disease 2019 (COVID-19), and its severity and complications in patients with type 2 diabetes mellitus (T2DM) However, there is a dearth of evidence regarding type 1 diabetes mellitus (T1DM) This article explores the possibility of COVID 19 induced diabetes and highlights a potential bidirectional link between COVID 19 and T1DM Methods A literature search was performed with Medline (PubMed), Scopus, and Google Scholar electronic databases till October 2020, using relevant keywords (COVID-19 induced diabetes;COVID-19 and type 1 diabetes;COVID-19 induced DKA;new-onset diabetes after SARS-CoV-2 infection) to extract relevant studies describing relationship between COVID-19 and T1DM Results Past lessons and new data teach us that severe acute respiratory syndrome coronaviruses (SARS CoV-1, -2) can enter islet cells via angiotensin converting enzyme-2 (ACE-2) receptors and cause reversible β-cell damage and transient hyperglycemia There have been postulations regarding the potential new-onset T1DM triggered by COVID-19 This article reviewed all the available evidence regarding the impact and interlink between COVID-19 and Τ1DM We also intended to explore the mechanisms behind the viral etiology of Τ1DM Conclusions SARS CoV-2 induces new-onset diabetes with diabetic ketoacidosis at presentation in several individuals However, at present, there is no hard evidence that SARS CoV-2 induces T1DM Long term follow-up of children and adults presenting with new-onset diabetes during this pandemic is required to fully understand the type of diabetes induced by COVID-19
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #926259
Database	COVID19

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Article ; Online: Incidence and presentation of new-onset type 1 diabetes in children and adolescents from Germany during the COVID-19 pandemic 2020 and 2021: Current data from the DPV Registry.

Baechle, C / Eckert, A / Kamrath, C / Neu, A / Manuwald, U / Thiele-Schmitz, S / Weidler, O / Knauer-Fischer, S / Rosenbauer, J / Holl, R W

Diabetes research and clinical practice

2023 Volume 197, Page(s) 110559

Abstract: ... diabetes, and diabetic ketoacidosis (DKA) at diabetes onset in 2020 and 2021 changed when compared to long ... Aims: To determine whether the incidence of type 1 diabetes mellitus (T1D), autoantibody-negative ... negative diabetes was observed during both pandemic years. Further monitoring and efforts for DKA ...

Abstract	Aims: To determine whether the incidence of type 1 diabetes mellitus (T1D), autoantibody-negative diabetes, and diabetic ketoacidosis (DKA) at diabetes onset in 2020 and 2021 changed when compared to long-standing trends. Methods: Our study is based on diabetes manifestation data of the 0.5-<18-year-old children/adolescents from the German multicenter Diabetes Prospective Follow-up Registry. Based on long-term pre-pandemic trends from 2011 to 2019, we estimated adjusted incidence rate ratios (IRR) for T1D and DKA, and prevalence rate ratios (PRR) regarding autoantibody status with 95 % confidence intervals (CI) for the years 2020 and 2021 (observed versus predicted rates), using multivariable negative binomial or beta-binomial regression, respectively. Results: We analyzed data of 30,840 children and adolescents with new-onset T1D. The observed incidences were significantly higher than the predicted incidences (IRR Conclusions: An increase in the incidences of T1D and DKA, but not of autoantibody-negative diabetes was observed during both pandemic years. Further monitoring and efforts for DKA prevention at onset are necessary.
MeSH term(s)	Child ; Humans ; Adolescent ; Diabetes Mellitus, Type 1/epidemiology ; Diabetes Mellitus, Type 1/complications ; Incidence ; Pandemics ; Prospective Studies ; COVID-19/epidemiology ; COVID-19/complications ; Diabetic Ketoacidosis/etiology ; Registries ; Germany/epidemiology
Language	English
Publishing date	2023-02-08
Publishing country	Ireland
Document type	Multicenter Study ; Journal Article
ZDB-ID	632523-3
ISSN	1872-8227 ; 0168-8227
ISSN (online)	1872-8227
ISSN	0168-8227
DOI	10.1016/j.diabres.2023.110559
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