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  1. Article ; Online: Endoscopic drainage of pancreatic fluid collections: Does hospital volume impact outcomes?

    Ketwaroo, Gyanprakash A / Protiva, Petr

    Gastrointestinal endoscopy

    2023  Volume 98, Issue 4, Page(s) 607–608

    Language English
    Publishing date 2023-09-07
    Publishing country United States
    Document type Editorial
    ZDB-ID 391583-9
    ISSN 1097-6779 ; 0016-5107
    ISSN (online) 1097-6779
    ISSN 0016-5107
    DOI 10.1016/j.gie.2023.06.057
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Clinical and socioeconomic determinants of survival in biliary tract adenocarcinomas.

    Sahyoun, Laura / Chen, Kay / Tsay, Cynthia / Chen, George / Protiva, Petr

    World journal of gastrointestinal oncology

    2024  Volume 16, Issue 4, Page(s) 1374–1383

    Abstract: Background: Despite advances in detection and treatments, biliary tract cancers continue to have poor survival outcomes. Currently, there is limited data investigating the significance of socioeconomic status, race/ethnicity, and environmental factors ... ...

    Abstract Background: Despite advances in detection and treatments, biliary tract cancers continue to have poor survival outcomes. Currently, there is limited data investigating the significance of socioeconomic status, race/ethnicity, and environmental factors in biliary tract cancer survival.
    Aim: To investigate how socioeconomic status and race/ethnicity are associated with survival.
    Methods: Data from the Surveillance, Epidemiology, and End Results database for biliary and gallbladder adenocarcinomas were extracted from 1975 to 2016. Socioeconomic data included smoking, poverty level, education, adjusted household income, and percentage of foreign-born persons and urban population. Survival was calculated with Cox proportional hazards models for death in the 5-year period following diagnosis.
    Results: Our study included 15883 gallbladder, 11466 intrahepatic biliary, 12869 extrahepatic biliary and 7268 ampulla of Vater adenocarcinoma cases. When analyzing county-specific demographics, patients from counties with higher incomes were associated with higher survival rates [hazard ratio (HR) = 0.97,
    Conclusion: Worse survival outcomes were observed in lower income counties while higher income and education level were associated with higher 5-year overall survival among gallbladder and biliary malignancies.
    Language English
    Publishing date 2024-04-05
    Publishing country China
    Document type Journal Article
    ZDB-ID 2573696-6
    ISSN 1948-5204
    ISSN 1948-5204
    DOI 10.4251/wjgo.v16.i4.1374
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Appendiceal adenocarcinoma is associated with better prognosis than cecal adenocarcinoma: a population-based comparative survival study.

    Chen, George / Chen, Kay / Sahyoun, Laura / Zaman, Saif / Protiva, Petr

    BMJ open gastroenterology

    2023  Volume 10, Issue 1

    Abstract: Objective: Although appendiceal cancer remains a rare gastrointestinal malignancy compared with colorectal cancer, incidence rates of appendiceal cancer have increased in the last two decades. Appendiceal and cecal adenocarcinomas have distinct genomic ... ...

    Abstract Objective: Although appendiceal cancer remains a rare gastrointestinal malignancy compared with colorectal cancer, incidence rates of appendiceal cancer have increased in the last two decades. Appendiceal and cecal adenocarcinomas have distinct genomic profiles, but chemotherapy protocols for these malignancies are the same and survival outcomes between them have not been compared extensively. To this end, we conducted a comparative survival analysis of appendiceal and cecal adenocarcinomas.
    Design: Using the Surveillance, Epidemiology and End Results (SEER) database, we identified individuals ≥30 years of age with appendiceal or cecal adenocarcinoma from 1975 to 2016. Demographic, clinical and county-level socioeconomic data were extracted using SEER*Stat software. Survival was compared by Mantel-Haenszel log-rank test, and survival curves were generated using the Kaplan-Meier method. Relative HRs for death in the 5-year period following diagnosis were calculated using multivariable Cox regression analysis, adjusted for all other covariates. The significance level was set at p<0.05 for two-tailed tests. Data were analysed using SAS V.9.4 and R software.
    Results: We identified 6491 patients with appendiceal adenocarcinoma and 99 387 patients with cecal adenocarcinoma. Multivariable Cox regression analysis demonstrated significantly higher cancer-specific and overall survival in appendiceal adenocarcinoma compared with cecal adenocarcinoma. Male sex, older age, earlier year of diagnosis, black race, single marital status, non-Hispanic ethnicity, and non-mucinous histology were associated with increased mortality rates. In addition, counties with lower percentage of individuals below the poverty line and higher colorectal cancer screening rates had better survival.
    Conclusion: This is the first study to show greater survival in appendiceal adenocarcinoma compared with cecal adenocarcinoma. We also highlighted novel associations of county-level socioeconomic factors with increased mortality in appendiceal adenocarcinoma. Future efforts to develop targeted molecular therapies and reduce socioeconomic barriers to diagnosis and treatment are warranted to improve survival.
    MeSH term(s) Humans ; Male ; Appendiceal Neoplasms/epidemiology ; Appendiceal Neoplasms/pathology ; Neoplasm Staging ; Adenocarcinoma/epidemiology ; Adenocarcinoma/pathology ; Prognosis ; Colorectal Neoplasms/pathology ; Colonic Neoplasms/pathology
    Language English
    Publishing date 2023-02-21
    Publishing country England
    Document type Journal Article
    ISSN 2054-4774
    ISSN 2054-4774
    DOI 10.1136/bmjgast-2022-001045
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Chronic Mesenteric Ischemia With Peristaltic Blanching.

    Tsay, Cynthia J / Protiva, Petr

    The American journal of gastroenterology

    2020  Volume 116, Issue 5, Page(s) 870

    MeSH term(s) Aged ; Chronic Disease ; Diagnosis, Differential ; Gastric Mucosa/blood supply ; Gastroscopy ; Humans ; Male ; Mesenteric Artery, Superior ; Mesenteric Ischemia/diagnostic imaging ; Mesenteric Ischemia/surgery ; Peristalsis ; Stomach Ulcer/diagnosis ; Tomography, X-Ray Computed
    Language English
    Publishing date 2020-07-29
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 390122-1
    ISSN 1572-0241 ; 0002-9270
    ISSN (online) 1572-0241
    ISSN 0002-9270
    DOI 10.14309/ajg.0000000000000796
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Impact of COVID-19 Treatment on Real-World Outcomes in Inflammatory Bowel Disease.

    Sahyoun, Laura C / Fetene, Jonathan / McMillan, Chandler / Protiva, Petr / Al Bawardy, Badr / Gaidos, Jill K J / Proctor, Deborah

    Digestive diseases and sciences

    2024  

    Abstract: Background: While there are multiple safe and effective agents for COVID-19 treatment, their impact in inflammatory bowel disease (IBD) remains uncertain.: Aims: Our objective was to assess the effects of these therapies on both IBD and COVID ... ...

    Abstract Background: While there are multiple safe and effective agents for COVID-19 treatment, their impact in inflammatory bowel disease (IBD) remains uncertain.
    Aims: Our objective was to assess the effects of these therapies on both IBD and COVID outcomes.
    Methods: A single-center retrospective study of adult patients with IBD who contracted COVID-19 between 12/2020 and 11/2022 was performed. Patients were stratified by COVID-19 treatment (antivirals and/or intravenous antibodies) vs no therapy. The primary outcome was the development of severe COVID-19 infection, defined by need for supplemental oxygen, corticosteroids and/or antibiotics, or hospitalization. Secondary outcomes included rates of withholding advanced IBD therapy (defined as biologic agents or small molecules) and of post-COVID-19 IBD flare.
    Results: Of 127 patients with COVID-19 infection, 70% were on advanced therapies, 35% received COVID-19 treatment, and 15% developed severe COVID-19. Those treated for COVID-19 were more likely to be on corticosteroids [odds ratio (OR) 4.61, 95% confidence interval (CI) 1.72-12.39, p = 0.002] or advanced IBD therapies (OR 2.78, 95% CI 1.04-7.43, p = 0.041). After adjusting for age, race, sex, corticosteroid use, obesity, COVID-19 vaccination status, and severe COVID-19 infection, those treated for COVID-19 were more likely to have IBD therapy held (OR 6.95, 95% CI 1.72-28.15, p = 0.007). There was no significant difference in rates of post-COVID-19 IBD flares or severe COVID-19 infection. There were no COVID-related deaths.
    Conclusions: Patients with IBD on advanced therapies were frequently treated for acute COVID-19. Although COVID-19 treatment was associated with temporary withholding of IBD therapy, it did not result in increased IBD flares.
    Language English
    Publishing date 2024-03-11
    Publishing country United States
    Document type Journal Article
    ZDB-ID 304250-9
    ISSN 1573-2568 ; 0163-2116
    ISSN (online) 1573-2568
    ISSN 0163-2116
    DOI 10.1007/s10620-024-08355-3
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Anal adenocarcinoma: case report, literature review and comparative survival analysis.

    Tsay, Cynthia J / Pointer, Thomas / Chandler, Jocelyn B / Nagar, Anil B / Protiva, Petr

    BMJ open gastroenterology

    2021  Volume 8, Issue 1

    Abstract: Introduction: Anal adenocarcinoma is a rare malignancy with a poor prognosis.: Methods: We present a case of rare anal adenocarcinoma in a patient with normal screening colonoscopy. Using the Surveillance, Epidemiology and End Result database between ...

    Abstract Introduction: Anal adenocarcinoma is a rare malignancy with a poor prognosis.
    Methods: We present a case of rare anal adenocarcinoma in a patient with normal screening colonoscopy. Using the Surveillance, Epidemiology and End Result database between 2000 and 2016, we performed survival analysis among individuals>20 years old comparing anal and rectal cancers.
    Results: Survival analysis showed that anal adenocarcinoma is associated with worse outcomes compared with rectal adenocarcinoma and anal squamous cell carcinoma.
    Discussion: This case and survival data illustrate the importance of prompt investigation of symptoms irrespective of colorectal cancer screening status with careful attention to examination of the anal area.
    MeSH term(s) Adenocarcinoma/diagnosis ; Adult ; Anus Neoplasms/diagnosis ; Humans ; Neoplasm Staging ; Rectal Neoplasms/diagnosis ; Survival Analysis ; Young Adult
    Language English
    Publishing date 2021-07-06
    Publishing country England
    Document type Case Reports ; Journal Article
    ISSN 2054-4774
    ISSN 2054-4774
    DOI 10.1136/bmjgast-2021-000661
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Calcium and 1,25-dihydroxyvitamin D3 modulate genes of immune and inflammatory pathways in the human colon: a human crossover trial

    Protiva, Petr / Pendyala, Swaroop / Nelson, Celeste / Augenlicht, Leonard H / Lipkin, Martin / Holt, Peter R

    American journal of clinical nutrition. 2016 May 01, v. 103, no. 5

    2016  

    Abstract: Background: A high dietary calcium intake with adequate vitamin D status has been linked to lower colorectal cancer risk, but the mechanisms of these effects are poorly understood. Objective: The objective of this study was to elucidate the effects of a ... ...

    Abstract Background: A high dietary calcium intake with adequate vitamin D status has been linked to lower colorectal cancer risk, but the mechanisms of these effects are poorly understood. Objective: The objective of this study was to elucidate the effects of a Western-style diet (WD) and supplemental calcium and/or 1,25-dihydroxyvitamin D3 [1,25(OH)2D3] on the colorectal mucosa. Design: We conducted 2 crossover trials to define molecular pathways in the human colorectum altered by 1) a 4-wk WD supplemented with and without 2 g calcium carbonate/d and 2) a 4-wk WD supplemented with 1,25(OH)2D3 (0.5 μg/d) with or without 2 g calcium carbonate/d. The primary study endpoint was genome-wide gene expression in biopsy specimens of the rectosigmoid colonic mucosa. Serum and urinary calcium concentrations were also measured. Results: Changes in urinary calcium accurately reflected calcium consumption. The WD induced modest upregulation of genes involved in inflammatory pathways, including interferon signaling, and calcium supplementation reversed these toward baseline. In contrast, supplementation of the WD with 1,25(OH)2D3 induced striking upregulation of genes involved in inflammation, immune response, extracellular matrix, and cell adhesion. Calcium supplementation largely abrogated these changes. Conclusions: Supplementing 1,25(OH)2D3 to a WD markedly upregulated genes in immune response and inflammation pathways, which were largely reversed by calcium supplementation. This study provides clinical trial evidence of global gene expression changes occurring in the human colorectum in response to calcium and 1,25(OH)2D3 intervention. One action of 1,25(OH)2D3 is to upregulate adaptive immunity. Calcium appears to modulate this effect, pointing to its biological interaction in the mucosa. This trial was registered at clinicaltrials.gov as NCT00298545. Trial protocol is available at http://clinicalstudies.rucares.org (protocol numbers PHO475 and PHO554).
    Keywords Western diets ; adaptive immunity ; biopsy ; blood serum ; calcium ; calcium carbonate ; cell adhesion ; clinical trials ; colon ; colorectal neoplasms ; cross-over studies ; extracellular matrix ; gene expression ; gene expression regulation ; genes ; humans ; immune response ; inflammation ; interferons ; mucosa ; protocols ; vitamin status
    Language English
    Dates of publication 2016-0501
    Size p. 1224-1231.
    Publishing place Oxford University Press
    Document type Article
    ZDB-ID 280048-2
    ISSN 1938-3207 ; 0002-9165
    ISSN (online) 1938-3207
    ISSN 0002-9165
    DOI 10.3945/ajcn.114.105304
    Database NAL-Catalogue (AGRICOLA)

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  8. Article ; Online: Calcium and 1,25-dihydroxyvitamin D3 modulate genes of immune and inflammatory pathways in the human colon: a human crossover trial.

    Protiva, Petr / Pendyala, Swaroop / Nelson, Celeste / Augenlicht, Leonard H / Lipkin, Martin / Holt, Peter R

    The American journal of clinical nutrition

    2016  Volume 103, Issue 5, Page(s) 1224–1231

    Abstract: Background: A high dietary calcium intake with adequate vitamin D status has been linked to lower colorectal cancer risk, but the mechanisms of these effects are poorly understood.: Objective: The objective of this study was to elucidate the effects ... ...

    Abstract Background: A high dietary calcium intake with adequate vitamin D status has been linked to lower colorectal cancer risk, but the mechanisms of these effects are poorly understood.
    Objective: The objective of this study was to elucidate the effects of a Western-style diet (WD) and supplemental calcium and/or 1,25-dihydroxyvitamin D3 [1,25(OH)2D3] on the colorectal mucosa.
    Design: We conducted 2 crossover trials to define molecular pathways in the human colorectum altered by 1) a 4-wk WD supplemented with and without 2 g calcium carbonate/d and 2) a 4-wk WD supplemented with 1,25(OH)2D3 (0.5 μg/d) with or without 2 g calcium carbonate/d. The primary study endpoint was genome-wide gene expression in biopsy specimens of the rectosigmoid colonic mucosa. Serum and urinary calcium concentrations were also measured.
    Results: Changes in urinary calcium accurately reflected calcium consumption. The WD induced modest upregulation of genes involved in inflammatory pathways, including interferon signaling, and calcium supplementation reversed these toward baseline. In contrast, supplementation of the WD with 1,25(OH)2D3 induced striking upregulation of genes involved in inflammation, immune response, extracellular matrix, and cell adhesion. Calcium supplementation largely abrogated these changes.
    Conclusions: Supplementing 1,25(OH)2D3 to a WD markedly upregulated genes in immune response and inflammation pathways, which were largely reversed by calcium supplementation. This study provides clinical trial evidence of global gene expression changes occurring in the human colorectum in response to calcium and 1,25(OH)2D3 intervention. One action of 1,25(OH)2D3 is to upregulate adaptive immunity. Calcium appears to modulate this effect, pointing to its biological interaction in the mucosa. This trial was registered at clinicaltrials.gov as NCT00298545 Trial protocol is available at http://clinicalstudies.rucares.org (protocol numbers PHO475 and PHO554).
    MeSH term(s) Aged ; Calcitriol/administration & dosage ; Calcium/blood ; Calcium/urine ; Calcium, Dietary/administration & dosage ; Colon/drug effects ; Colon/immunology ; Cross-Over Studies ; Diet, Western ; Endpoint Determination ; Female ; Humans ; Inflammation/drug therapy ; Inflammation/genetics ; Intestinal Mucosa/drug effects ; Intestinal Mucosa/immunology ; Male ; Microarray Analysis ; Middle Aged ; Phosphorus/blood ; Up-Regulation
    Chemical Substances Calcium, Dietary ; Phosphorus (27YLU75U4W) ; Calcitriol (FXC9231JVH) ; Calcium (SY7Q814VUP)
    Language English
    Publishing date 2016-03-23
    Publishing country United States
    Document type Journal Article ; Randomized Controlled Trial
    ZDB-ID 280048-2
    ISSN 1938-3207 ; 0002-9165
    ISSN (online) 1938-3207
    ISSN 0002-9165
    DOI 10.3945/ajcn.114.105304
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Quantification of Adequate Bowel Preparation for Screening or Surveillance Colonoscopy in Men.

    Clark, Brian T / Protiva, Petr / Nagar, Anil / Imaeda, Avlin / Ciarleglio, Maria M / Deng, Yanhong / Laine, Loren

    Gastroenterology

    2016  Volume 150, Issue 2, Page(s) 396–405; quiz e14–5

    Abstract: Background & aims: Bowel preparation is defined as adequate if it is sufficient for identification of polyps greater than 5 mm. However, adequate preparation has not been quantified. We performed a prospective observational study to provide an objective ...

    Abstract Background & aims: Bowel preparation is defined as adequate if it is sufficient for identification of polyps greater than 5 mm. However, adequate preparation has not been quantified. We performed a prospective observational study to provide an objective definition of adequate preparation, based on the Boston Bowel Prep Scale (BBPS, which consists of 0-3 points for each of 3 colon segments).
    Methods: We collected data from 438 men who underwent screening or surveillance colonoscopies and then repeat colonoscopy examinations within 60 days by a different blinded endoscopist (1161 colon segments total) at the West Haven Veterans Affairs Medical Center from January 2014 to February 2015. Missed polyps were defined as those detected on the second examination of patients with the best possible bowel preparation (colon segment BBPS score of 3) on the second examination. The primary outcome was the proportion of colon segments with adenomas larger than 5 mm that were missed in the first examination. We postulated that the miss rate was noninferior for segments with BBPS scores of 2 vs those with BBPS scores of 3 (noninferiority margin, <5%). Our secondary hypotheses were that miss rates were higher in segments with BBPS scores of 1 vs those with scores of 3 or of 2.
    Results: The adjusted proportion with missed adenomas greater than 5 mm was noninferior for segments with BBPS scores of 2 (5.2%) vs those with BBPS scores of 3 (5.6%) (a difference of -0.4%; 95% confidence interval [CI], -2.9% to 2.2%). Of study subjects, 347 (79.2%) had BBPS scores of 2 or greater in all segments on the initial examination. A higher proportion of segments with BBPS scores of 1 had missed adenomas larger than 5 mm (15.9%) than segments with BBPS scores of 3 (5.6%) (a difference of 10.3%; 95% CI, 2.7%-17.9%) or 2 (5.2%) (a difference of 10.7%; 95% CI, 3.2%-18.1%). Screening and surveillance intervals based solely on the findings at the first examination would have been incorrect for 16.3% of patients with BBPS scores of 3 in all segments, for 15.3% with BBPS scores of 2 or 3 in all segments, and for 43.5% of patients with a BBPS score of 1 in 1 or more segments.
    Conclusions: Patients with BBPS scores of 2 or 3 for all colon segments have adequate bowel preparation for the detection of adenomas larger than 5 mm and should return for screening or surveillance colonoscopy at standard guideline-recommended intervals. Colon segments with a BBPS score of 1 have a significantly higher rate of missed adenomas larger than 5 mm than segments with scores of 2 or 3. This finding supports a recommendation for early repeat colonoscopic evaluation in patients with a BBPS score of 0 or 1 in any colon segment.
    MeSH term(s) Adenomatous Polyps/pathology ; Aged ; Colon/pathology ; Colonic Neoplasms/pathology ; Colonic Polyps/pathology ; Colonoscopy ; Connecticut ; Diagnostic Errors ; Humans ; Male ; Middle Aged ; Observer Variation ; Predictive Value of Tests ; Prospective Studies ; Reproducibility of Results ; Therapeutic Irrigation/methods ; Time Factors ; Tumor Burden
    Language English
    Publishing date 2016-02
    Publishing country United States
    Document type Journal Article ; Observational Study ; Research Support, N.I.H., Extramural ; Video-Audio Media
    ZDB-ID 80112-4
    ISSN 1528-0012 ; 0016-5085
    ISSN (online) 1528-0012
    ISSN 0016-5085
    DOI 10.1053/j.gastro.2015.09.041
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article: Brief alcohol exposure alters transcription in astrocytes via the heat shock pathway.

    Pignataro, Leonardo / Varodayan, Florence P / Tannenholz, Lindsay E / Protiva, Petr / Harrison, Neil L

    Brain and behavior

    2013  Volume 3, Issue 2, Page(s) 114–133

    Abstract: Astrocytes are critical for maintaining homeostasis in the central nervous system (CNS), and also participate in the genomic response of the brain to drugs of abuse, including alcohol. In this study, we investigated ethanol regulation of gene expression ... ...

    Abstract Astrocytes are critical for maintaining homeostasis in the central nervous system (CNS), and also participate in the genomic response of the brain to drugs of abuse, including alcohol. In this study, we investigated ethanol regulation of gene expression in astrocytes. A microarray screen revealed that a brief exposure of cortical astrocytes to ethanol increased the expression of a large number of genes. Among the alcohol-responsive genes (ARGs) are glial-specific immune response genes, as well as genes involved in the regulation of transcription, cell proliferation, and differentiation, and genes of the cytoskeleton and extracellular matrix. Genes involved in metabolism were also upregulated by alcohol exposure, including genes associated with oxidoreductase activity, insulin-like growth factor signaling, acetyl-CoA, and lipid metabolism. Previous microarray studies performed on ethanol-treated hepatocyte cultures and mouse liver tissue revealed the induction of almost identical classes of genes to those identified in our microarray experiments, suggesting that alcohol induces similar signaling mechanisms in the brain and liver. We found that acute ethanol exposure activated heat shock factor 1 (HSF1) in astrocytes, as demonstrated by the translocation of this transcription factor to the nucleus and the induction of a family of known HSF1-dependent genes, the heat shock proteins (Hsps). Transfection of a constitutively transcriptionally active Hsf1 construct into astrocytes induced many of the ARGs identified in our microarray study supporting the hypothesis that HSF1 transcriptional activity, as part of the heat shock cascade, may mediate the ethanol induction of these genes. These data indicate that acute ethanol exposure alters gene expression in astrocytes, in part via the activation of HSF1 and the heat shock cascade.
    Language English
    Publishing date 2013-02-06
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2623587-0
    ISSN 2162-3279
    ISSN 2162-3279
    DOI 10.1002/brb3.125
    Database MEDical Literature Analysis and Retrieval System OnLINE

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