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  1. Article ; Online: Temporary Atrioventricular Sequential Conduction System Pacing in Patients With Acute Conduction Abnormalities and Cardiogenic Shock.

    Ngan, Ho-Ting / Chan, Kwong-Yue / Wong, Chun-Ka / Un, Ka-Chun / Sze, Shu-Yue / Shea, Puigi / Lam, Cheung-Chi / Lam, Yui-Ming / Tam, Chor-Cheung / Lau, Chu-Pak / Tse, Hung-Fat

    JACC. Clinical electrophysiology

    2023  Volume 9, Issue 9, Page(s) 1998–2000

    MeSH term(s) Humans ; Shock, Cardiogenic/therapy ; Heart Conduction System ; Cardiac Conduction System Disease
    Language English
    Publishing date 2023-07-26
    Publishing country United States
    Document type Letter
    ZDB-ID 2846739-5
    ISSN 2405-5018 ; 2405-500X ; 2405-500X
    ISSN (online) 2405-5018 ; 2405-500X
    ISSN 2405-500X
    DOI 10.1016/j.jacep.2023.06.006
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Case report: Recurrent severe mitral regurgitation due to ruptured artificial chords after transapical Neochord mitral valve repair.

    Zhou, Mi / Un, Ka-Chun / Wong, Chun Ka / Wong, On Yat / Siu, David Chung Wah / Yin, Lixue / Chan, Daniel Tai-Leung / Lam, Simon Cheung Chi

    Frontiers in cardiovascular medicine

    2022  Volume 9, Page(s) 985644

    Abstract: Transapical Neochord mitral valve repair has been proven to be a technically safe procedure to correct primary mitral regurgitation (MR). Recurrent MR due to ruptured artificial chords is rare. Here, we present 2 cases of recurrent severe MR due to the ... ...

    Abstract Transapical Neochord mitral valve repair has been proven to be a technically safe procedure to correct primary mitral regurgitation (MR). Recurrent MR due to ruptured artificial chords is rare. Here, we present 2 cases of recurrent severe MR due to the detached or partially ruptured artificial chords after the Neochord procedure.
    Language English
    Publishing date 2022-11-09
    Publishing country Switzerland
    Document type Case Reports
    ZDB-ID 2781496-8
    ISSN 2297-055X
    ISSN 2297-055X
    DOI 10.3389/fcvm.2022.985644
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: First-in-Human Undermining Iatrogenic Coronary Obstruction With Radiofrequency Needle (UNICORN) Procedure During Valve-in-Valve Transcatheter Aortic Valve Replacement.

    Chan, Kwong-Yue Eric / Tai-Leung Chan, Daniel / Lam, Cheung-Chi Simon / Shu-Yue Sze, Michael / Un, Ka-Chun / Tam, Chor-Cheung Frankie / Lam, Yui-Ming / Wong, Chun-Ka

    Circulation. Cardiovascular interventions

    2022  Volume 15, Issue 11, Page(s) 928–931

    MeSH term(s) Humans ; Transcatheter Aortic Valve Replacement/adverse effects ; Transcatheter Aortic Valve Replacement/methods ; Treatment Outcome ; Heart Valve Prosthesis ; Aortic Valve Stenosis/diagnostic imaging ; Aortic Valve Stenosis/surgery ; Coronary Occlusion/diagnostic imaging ; Coronary Occlusion/etiology ; Coronary Occlusion/therapy ; Iatrogenic Disease ; Aortic Valve/diagnostic imaging ; Aortic Valve/surgery ; Prosthesis Design
    Language English
    Publishing date 2022-10-21
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2450797-0
    ISSN 1941-7632 ; 1941-7640
    ISSN (online) 1941-7632
    ISSN 1941-7640
    DOI 10.1161/CIRCINTERVENTIONS.122.012399
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Advances in technology and techniques for transcatheter aortic valve replacement with concomitant peripheral arterial disease.

    Wong, Chun-Ka / Chiu, Alston Conrad Ho-On / Chan, Kwong-Yue Eric / Sze, Shu-Yue / Tam, Frankie Chor-Cheung / Un, Ka-Chun / Lam, Simon Cheung-Chi / Tse, Hung-Fat

    Frontiers in medical technology

    2022  Volume 4, Page(s) 959249

    Abstract: Aortic stenosis (AS) is a prevalent disease affecting 3.7% of the adult population aged 65 or above. In the past, surgical aortic valve replacement (SAVR) was the only definitive therapy available for the treatment of severe AS. Owing to the invasive ... ...

    Abstract Aortic stenosis (AS) is a prevalent disease affecting 3.7% of the adult population aged 65 or above. In the past, surgical aortic valve replacement (SAVR) was the only definitive therapy available for the treatment of severe AS. Owing to the invasive nature of open-heart surgery, patients with advanced age and frailty could not benefit from SAVR. The advent of transcatheter aortic valve replacement (TAVR) in the past decade has offered an alternative treatment option for patients with severe AS, particularly those who are deemed to have high surgical risks. Nevertheless, a large proportion of patients also have concomitant peripheral arterial disease (PAD), which increases the risk of peri-procedural vascular complication, and precludes the possibility of transfemoral TAVR owing to inadequate luminal size for delivery system deployment. In this review, the prevalence and outcome of TAVR patients with PAD will be discussed. Furthermore, novel technologies and techniques that enable TAVR to be safely performed using transfemoral or alternative access in patients with severe PAD will be reviewed.
    Language English
    Publishing date 2022-08-18
    Publishing country Switzerland
    Document type Journal Article ; Review
    ISSN 2673-3129
    ISSN (online) 2673-3129
    DOI 10.3389/fmedt.2022.959249
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Advance care planning for patients with advanced neurology diseases.

    Cheung, Ka-Chi / Lau, Vikki Wai-Kee / Un, Ka-Chun / Wong, Man-Sheung / Chan, Kwok-Ying

    Annals of palliative medicine

    2017  Volume 7, Issue 3, Page(s) 349–354

    Abstract: Background: Advanced neurology diseases including motor neuron disease (MND) are usually progressive life-limiting illness and could be devastating for patients, families and caregivers. Although medical technologies, such as enteral feeding and non- ... ...

    Abstract Background: Advanced neurology diseases including motor neuron disease (MND) are usually progressive life-limiting illness and could be devastating for patients, families and caregivers. Although medical technologies, such as enteral feeding and non-invasive ventilation, may prolong life expectancy of the patients, their utilization prompts important ethical questions in regard to their quality of life (QoL). Little attention had been paid on how ACP practice would practically help with patients suffering from different neurology diseases. We are unaware of any published studies on ACP practice among patients with different neurology diseases. In our study, we assessed end-of-life (EOL) care preferences, documentation, and communication in patients with various types of advanced neurology diseases.
    Methods: This was a retrospective chart review of all patients referred to the neuro-palliative care team (NPCT) in a local acute hospital in Hong Kong. The study was approved by the institutional review board of the University of Hong Kong. NPCT consultation was hand abstracted from the electronic health record if there was a subspecialty palliative care (PC) consultation note during the study period. Hand abstraction of data also included any content related to advance care planning (ACP) [advance directive (AD), resuscitation order, ventilator support, artificial feeding, patient wishes, legacy].
    Results: For patient who signed AD, items including cardiopulmonary resuscitation (100%), mechanical ventilation (100%), artificial nutrition and hydration (80%) were mentioned more frequently than other EOL interventions. For patients who had ACP but without AD, the most common diagnosis is bad stroke (60%). Place of death, artificial nutrition and hydration were most mentioned EOL interventions.
    Conclusions: EOL decision making in patients with advanced neurology disease is often delayed. This study showed that MND patients are readier to discuss their EOL issues and signed their AD. The NPCT can play a valuable role in EOL discussions in patients with advanced neurology diseases under collaboration between the PC and the neurology teams.
    MeSH term(s) Adult ; Advance Care Planning ; Advance Directives ; Aged ; Aged, 80 and over ; Decision Making ; Female ; Hong Kong ; Humans ; Male ; Middle Aged ; Motor Neuron Disease/therapy ; Nervous System Diseases/therapy ; Palliative Care ; Patient Care Team ; Retrospective Studies ; Terminal Care ; Young Adult
    Language English
    Publishing date 2017-10-13
    Publishing country China
    Document type Journal Article
    ZDB-ID 2828544-X
    ISSN 2224-5839 ; 2224-5820
    ISSN (online) 2224-5839
    ISSN 2224-5820
    DOI 10.21037/apm.2017.09.10
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Safety and feasibility of a midseptal implantation technique of a leadless pacemaker.

    Hai, Jo-Jo / Fang, Jonathan / Tam, Chor-Cheung / Wong, Chun-Ka / Un, Ka-Chun / Siu, Chung-Wah / Lau, Chu-Pak / Tse, Hung-Fat

    Heart rhythm

    2018  Volume 16, Issue 6, Page(s) 896–902

    Abstract: Background: The major risk of implanting a leadless pacemaker at the right ventricular (RV) apex is cardiac perforation.: Objective: The purpose of this study was to describe and prospectively evaluate the safety and feasibility of a technique for ... ...

    Abstract Background: The major risk of implanting a leadless pacemaker at the right ventricular (RV) apex is cardiac perforation.
    Objective: The purpose of this study was to describe and prospectively evaluate the safety and feasibility of a technique for midseptal implantation of the Micra leadless pacemaker.
    Methods: We positioned the device at the center of the cardiac silhouette in the right anterior oblique (RAO) view, toward the left in the left anterior oblique (LAO) view, and away from the sternum in the left lateral view.
    Results: Among the 51 patients (mean age 81.3 ± 9.3 years; 47% men) included in the study, 29 (57%) were >80 years old, 7 (14%) had body mass index <20 kg/m
    Conclusion: In this high-risk patient cohort, midseptal implantation of a leadless pacemaker as guided by RAO, LAO, and left lateral views was achieved in 90% of patients, with a low risk of complications.
    MeSH term(s) Aged, 80 and over ; Bradycardia/diagnosis ; Bradycardia/surgery ; Cardiac Pacing, Artificial/methods ; Electrocardiography/methods ; Feasibility Studies ; Female ; Fluoroscopy/methods ; Heart Injuries/etiology ; Heart Injuries/prevention & control ; Heart Ventricles/injuries ; Hong Kong ; Humans ; Intraoperative Complications/prevention & control ; Male ; Outcome and Process Assessment, Health Care ; Pacemaker, Artificial ; Prosthesis Implantation/adverse effects ; Prosthesis Implantation/methods ; Risk Adjustment/methods
    Language English
    Publishing date 2018-12-11
    Publishing country United States
    Document type Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 2229357-7
    ISSN 1556-3871 ; 1547-5271
    ISSN (online) 1556-3871
    ISSN 1547-5271
    DOI 10.1016/j.hrthm.2018.12.007
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Systemic progesterone for modulating electrocautery-induced secondary brain injury.

    Un, Ka Chun / Wang, Yue Chun / Wu, Wutian / Leung, Gilberto Ka Kit

    Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia

    2013  Volume 20, Issue 9, Page(s) 1329–1330

    Abstract: Bipolar electrocautery is an effective and commonly used haemostatic technique but it may also cause iatrogenic brain trauma due to thermal injury and secondary inflammatory reactions. Progesterone has anti-inflammatory and neuroprotective actions in ... ...

    Abstract Bipolar electrocautery is an effective and commonly used haemostatic technique but it may also cause iatrogenic brain trauma due to thermal injury and secondary inflammatory reactions. Progesterone has anti-inflammatory and neuroprotective actions in traumatic brain injury. However, its potential use in preventing iatrogenic brain trauma has not been explored. We conducted a pilot animal study to investigate the effect of systemic progesterone on brain cellular responses to electrocautery-induced injury. Adult male Sprague-Dawley rats received standardized bipolar electrocautery (40 W for 2 seconds) over the right cerebral cortex. The treatment group received progesterone intraperitoneally 2 hours prior to surgery; the control group received the drug vehicle only. Immunohistochemical studies showed that progesterone could significantly reduce astrocytic hypertrophy on postoperative day 1, 3 and 7, as well as macrophage infiltration on day 3. The number of astrocytes, however, was unaffected. Our findings suggest that progesterone should be further explored as a neuroprotective agent against electrocautery-induced or other forms of iatrogenic trauma during routine neurosurgical procedures. Future studies may focus on different dosing regimens, neuronal survival, functional outcome, and to compare progesterone with other agents such as dexamethasone.
    MeSH term(s) Animals ; Astrocytes/drug effects ; Astrocytes/pathology ; Brain Injuries/drug therapy ; Brain Injuries/etiology ; Electrocoagulation/adverse effects ; Male ; Progesterone/therapeutic use ; Rats ; Rats, Sprague-Dawley
    Chemical Substances Progesterone (4G7DS2Q64Y)
    Language English
    Publishing date 2013-09
    Publishing country Scotland
    Document type Journal Article
    ZDB-ID 1193674-5
    ISSN 1532-2653 ; 0967-5868
    ISSN (online) 1532-2653
    ISSN 0967-5868
    DOI 10.1016/j.jocn.2012.10.032
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Daily ambulatory remote monitoring system for drug escalation in chronic heart failure with reduced ejection fraction: pilot phase of DAVID-HF study.

    Wong, Chun Ka / Un, Ka Chun / Zhou, Mi / Cheng, Yangyang / Lau, Yuk Ming / Shea, Puigi Catherine / Lui, Hin Wai / Zuo, Ming Liang / Yin, Li Xue / Chan, Esther W / Wong, Ian C K / Sin, Simon Wai Ching / Yeung, Pauline Pui Ning / Chen, Hao / Wibowo, Sandi / Wei, Tong Li Nikki / Lee, Sze Ming / Chow, Augustine / Tong, Raymond Cheuk Fung /
    Hai, Jojo / Tam, Frankie Chor Cheung / Siu, Chung Wah

    European heart journal. Digital health

    2022  Volume 3, Issue 2, Page(s) 284–295

    Abstract: Aims: Underutilization of guideline-directed heart failure with reduced ejection fraction (HFrEF) medications contributes to poor outcomes.: Methods and results: A pilot study to evaluate the safety and efficacy of a home-based remote monitoring ... ...

    Abstract Aims: Underutilization of guideline-directed heart failure with reduced ejection fraction (HFrEF) medications contributes to poor outcomes.
    Methods and results: A pilot study to evaluate the safety and efficacy of a home-based remote monitoring system for HFrEF management was performed. The system included wearable armband monitors paired with the smartphone application. An HFrEF medication titration algorithm was used to adjust medication daily. The primary endpoint was HFrEF medication utilization at 120 days. Twenty patients (60.5 ± 8.2 years, men: 85%) with HFrEF were recruited. All received angiotensin-converting enzyme inhibitor (ACEI)/angiotensin receptor blocker (ARB)/angiotensin receptor-neprilysin inhibitor (ARNI) at recruitment; 45% received ≥50% maximal targeted dose (MTD) with % MTD of 44.4 ± 31.7%. At baseline, 90 and 70% received beta-adrenergic blocker and mineralocorticoid receptor antagonist (MRA), 35% received ≥50% MTD beta-adrenergic blocker with % MTD of 34.1 ± 29.6%, and 25% received ≥50% MTD MRA with % MTD of 25.0 ± 19.9%. At 120 days, 70% received ≥50% MTD ACEI/ARB/ARNI (
    Conclusion: Heart failure with reduced ejection fraction medication escalation with remote monitoring appeared feasible.
    Language English
    Publishing date 2022-05-07
    Publishing country England
    Document type Journal Article
    ISSN 2634-3916
    ISSN (online) 2634-3916
    DOI 10.1093/ehjdh/ztac024
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  9. Article ; Online: Prognostic implications of statin intolerance in stable coronary artery disease patients with different levels of high-sensitive troponin.

    Hai, Jo-Jo / Wong, Yuen-Kwun / Wong, Chun-Ka / Un, Ka-Chun / Chan, Pak-Hei / Siu, Chung-Wah / Yiu, Kai-Hang / Lau, Chu-Pak / Tse, Hung-Fat

    BMC cardiovascular disorders

    2019  Volume 19, Issue 1, Page(s) 168

    Abstract: Background: The prognostic implication of statin in tolerance (SI) in those with stable CAD remains unclear. We hypothesized that SI is of higher prognostic significance in stable CAD patients with elevated high-sensitive cardiac troponin I (hs-cTnI).!## ...

    Abstract Background: The prognostic implication of statin in tolerance (SI) in those with stable CAD remains unclear. We hypothesized that SI is of higher prognostic significance in stable CAD patients with elevated high-sensitive cardiac troponin I (hs-cTnI).
    Methods: A total of 952 stable CAD patients from the prospective Hong Kong CAD study who had complete clinical data, biomarker measurements and who were prescribed statin therapy were studied.
    Results: We identified 13 (1.4%) and 125 (13.1%) patients with complete and partial SI, respectively. At baseline, patients with SI were more likely to have diabetes mellitus and a higher hs-cTnI level, but no difference in LDL-C level compared with those without SI. After 51 months of follow-up, patients with SI had a higher mean LDL-C level than those without SI. A total of 148 (15.5%) patients developed major adverse cardiovascular events (MACEs). Both SI (HR 1.52, 95% CI 1.06-2.19, P = 0.02) and elevated hs-cTnI (HR 3.18, 95% CI 2.07-4.89, P < 0.01) were independent predictors of a MACE in patients with stable CAD. When stratified by hs-cTnI level, SI independently predicted MACE-free survival only in those with elevated hs-cTnI (HR 1.51, 95% CI 1.01-2.24, P = 0.04).
    Conclusions: SI independently predicted MACE in patients with stable CAD and high hs-cTnI, but not in those with low hs-cTnI. Hs-cTnI may be used to stratify stable CAD patients who have SI for intensive lipid-lowering therapy using non-statin agents.
    MeSH term(s) Aged ; Biomarkers/blood ; Cardiovascular Diseases/blood ; Cardiovascular Diseases/diagnosis ; Cardiovascular Diseases/mortality ; Cardiovascular Diseases/prevention & control ; Cholesterol, LDL/blood ; Coronary Artery Disease/blood ; Coronary Artery Disease/diagnosis ; Coronary Artery Disease/drug therapy ; Coronary Artery Disease/mortality ; Disease Progression ; Dyslipidemias/blood ; Dyslipidemias/diagnosis ; Dyslipidemias/drug therapy ; Dyslipidemias/mortality ; Female ; Hong Kong ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects ; Male ; Middle Aged ; Predictive Value of Tests ; Progression-Free Survival ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Time Factors ; Troponin I/blood
    Chemical Substances Biomarkers ; Cholesterol, LDL ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Troponin I
    Language English
    Publishing date 2019-07-15
    Publishing country England
    Document type Comparative Study ; Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 2059859-2
    ISSN 1471-2261 ; 1471-2261
    ISSN (online) 1471-2261
    ISSN 1471-2261
    DOI 10.1186/s12872-019-1152-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Cardiovascular sequalae in uncomplicated COVID-19 survivors.

    Zhou, Mi / Wong, Chun-Ka / Un, Ka-Chun / Lau, Yuk-Ming / Lee, Jeffrey Chun-Yin / Tam, Frankie Chor-Cheung / Lau, Yee-Man / Lai, Wing-Hon / Tam, Anthony Raymond / Lam, Yat-Yin / Pang, Polly / Tong, Teresa / Tang, Milky / Tse, Hung-Fat / Ho, Deborah / Ng, Ming-Yen / Chan, Esther W / Wong, Ian C K / Lau, Chu-Pak /
    Hung, Ivan Fan-Ngai / Siu, Chung-Wah

    PloS one

    2021  Volume 16, Issue 2, Page(s) e0246732

    Abstract: Background: A high proportion of COVID-19 patients were reported to have cardiac involvements. Data pertaining to cardiac sequalae is of urgent importance to define subsequent cardiac surveillance.: Methods: We performed a systematic cardiac ... ...

    Abstract Background: A high proportion of COVID-19 patients were reported to have cardiac involvements. Data pertaining to cardiac sequalae is of urgent importance to define subsequent cardiac surveillance.
    Methods: We performed a systematic cardiac screening for 97 consecutive COVID-19 survivors including electrocardiogram (ECG), echocardiography, serum troponin and NT-proBNP assay 1-4 weeks after hospital discharge. Treadmill exercise test and cardiac magnetic resonance imaging (CMR) were performed according to initial screening results.
    Results: The mean age was 46.5 ± 18.6 years; 53.6% were men. All were classified with non-severe disease without overt cardiac manifestations and did not require intensive care. Median hospitalization stay was 17 days and median duration from discharge to screening was 11 days. Cardiac abnormalities were detected in 42.3% including sinus bradycardia (29.9%), newly detected T-wave abnormality (8.2%), elevated troponin level (6.2%), newly detected atrial fibrillation (1.0%), and newly detected left ventricular systolic dysfunction with elevated NT-proBNP level (1.0%). Significant sinus bradycardia with heart rate below 50 bpm was detected in 7.2% COVID-19 survivors, which appeared to be self-limiting and recovered over time. For COVID-19 survivors with persistent elevation of troponin level after discharge or newly detected T wave abnormality, echocardiography and CMR did not reveal any evidence of infarct, myocarditis, or left ventricular systolic dysfunction.
    Conclusion: Cardiac abnormality is common amongst COVID-survivors with mild disease, which is mostly self-limiting. Nonetheless, cardiac surveillance in form of ECG and/or serum biomarkers may be advisable to detect more severe cardiac involvement including atrial fibrillation and left ventricular dysfunction.
    MeSH term(s) Adult ; Aged ; Arrhythmias, Cardiac/blood ; Arrhythmias, Cardiac/epidemiology ; Arrhythmias, Cardiac/physiopathology ; Biomarkers/blood ; COVID-19/blood ; COVID-19/complications ; COVID-19/physiopathology ; Electrocardiography ; Female ; Heart Diseases/blood ; Heart Diseases/epidemiology ; Heart Diseases/physiopathology ; Humans ; Male ; Middle Aged ; Natriuretic Peptide, Brain/blood ; Peptide Fragments/blood ; Prospective Studies ; SARS-CoV-2/isolation & purification ; Survival Analysis ; Survivors ; Ventricular Dysfunction, Left/blood ; Ventricular Dysfunction, Left/epidemiology ; Ventricular Dysfunction, Left/physiopathology
    Chemical Substances Biomarkers ; Peptide Fragments ; pro-brain natriuretic peptide (1-76) ; Natriuretic Peptide, Brain (114471-18-0)
    Language English
    Publishing date 2021-02-11
    Publishing country United States
    Document type Journal Article
    ISSN 1932-6203
    ISSN (online) 1932-6203
    DOI 10.1371/journal.pone.0246732
    Database MEDical Literature Analysis and Retrieval System OnLINE

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