scholarly journals Dietary Soy Intake Is Inversely Associated with Risk of Type 2 Diabetes in Japanese Women but Not in Men

2019 ◽  
Vol 149 (7) ◽  
pp. 1208-1214 ◽  
Author(s):  
Kie Konishi ◽  
Keiko Wada ◽  
Michiyo Yamakawa ◽  
Yuko Goto ◽  
Fumi Mizuta ◽  
...  
Keyword(s):  
Soy Protein ◽  
Smoking Status ◽  
Menopausal Status ◽  
Glycemic Load ◽  
Japanese Women ◽  
Cox Proportional Hazards ◽  
Dietary Factors ◽  
Soy Isoflavones ◽  
Soy Foods

ABSTRACT Background Whole soy foods, as well as their components, including protein and isoflavones, have garnered attention because they may have beneficial effects against diabetes. Objectives We examined associations between the intake of soy foods, soy protein, and soy isoflavones and the risk of diabetes in the Japanese population. Methods This prospective cohort study included 13,521 residents (5883 men and 7638 women; 35–69 y old) of Takayama City, Japan. The subjects responded to a self-administered baseline questionnaire in 1992 and to a follow-up questionnaire seeking information about diabetes in 2002. Their mean ± SD body mass index was 22.6 ± 2.6 kg/m2 (men) and 22.1 ± 2.7 (women). The intakes of total soy foods, fried soy foods, nonfried soy foods, soy protein, and soy isoflavones were estimated through the use of a validated food-frequency questionnaire administered in 1992. Associations between soy intake and the risk of diabetes were evaluated through the use of Cox proportional hazards models incorporating age, education level, physical activity, smoking status, alcohol consumption, history of hypertension, use of vitamin supplements, menopausal status, and dietary factors including glycemic load, total energy, total fat, meat, fruit, vegetables, and coffee. Results During a 10-y follow-up, 438 participants reported physician-diagnosed diabetes. Women in the highest tertile of intakes of total soy foods, fried soy foods, nonfried soy foods, soy protein, and soy isoflavone had significantly lower HRs, after controlling for covariates, than those with the lowest intakes. For example, HRs were 0.45 (95% CI: 0.30, 0.68; P-trend <0.001) for total soy food intake. In men, there were no significant associations between soy intake and the risk of diabetes. Conclusions These results suggest that a high soy intake may be associated with a lower risk of diabetes in Japanese women.

Consumption of flavonoid-rich fruits, flavonoids from fruits, and stroke risk: a prospective cohort study

2021 ◽  
pp. 1-26
Author(s):  
Qi Gao ◽  
Jia-Yi Dong ◽  
Renzhe Cui ◽  
Isao Muraki ◽  
Kazumasa Yamagishi ◽  
...  
Keyword(s):  
Lower Risk ◽  
Stroke Risk ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Dietary Factors ◽  
Citrus Fruits ◽  
Proportional Hazards Regression ◽  
Hazard Ratios ◽  
Index Study

Abstract We sought to examine the prospective associations of specific fruit consumption, in particular flavonoid-rich fruit (FRF) consumption, with the risk of stroke and subtypes of stroke in a Japanese population. A study followed a total of 39,843 men and 47,334 women aged 44-76 years, and free of cardiovascular disease, diabetes, and cancer at baseline since 1995 and 1998 to the end of 2009 and 2012, respectively. Data on total and specific FRF consumption for each participant were obtained using a self-administrated food frequency questionnaire. The hazard ratios (HRs) of stroke in relation to total and specific FRF consumption were estimated through Cox proportional hazards regression models. During a median follow-up of 13.1 years, 4092 incident stroke cases (2557 cerebral infarctions and 1516 hemorrhagic strokes) were documented. After adjustment for age, body mass index, study area, lifestyles, dietary factors, and other risk factors, it was found that total FRF consumption was associated with a significantly lower risk of stroke in women (HR= 0.70; 95% CI, 0.58-0.84), while the association in men was not significant (HR= 0.93; 95% CI, 0.79-1.09). As for specific FRFs, consumptions of citrus fruits, strawberries, and grapes were found associated with a lower stroke risk in women. Higher consumptions of FRFs, in particular citrus fruits, strawberries, and grapes, were associated with a lower risk of developing stroke in Japanese women.

scholarly journals Hemoglobin A1c in Patients with Diabetes Predict Long-Term Mortality Following Coronary Artery Surgery

2021 ◽  
Vol 10 (12) ◽  
pp. 2739
Author(s):  
Muhammad Abu Tailakh ◽  
Shlomo-yaron Ishay ◽  
Jenan Awesat ◽  
Liat Poupko ◽  
Gidon Sahar ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Hemoglobin A1c ◽  
Smoking Status ◽  
Artery Bypass ◽  
Cox Proportional Hazards ◽  
Chronic Obstructive ◽  
Hba1c Levels

Objective: to estimate the association between preoperative hemoglobin A1c (HbA1c) levels below and above 7%, and the rate of all-cause mortality (ACM) in diabetes mellitus (DM) patients after coronary artery bypass grafting (CABG) within a ten-year follow-up period. Methods: we collected data on patient HbA1c levels that were measured up to 3 months prior to isolated CABG in consecutive patients with DM, and analyzed the rates of ACM over a median of a 5.9-year post-operative period. Results: preoperative HbA1c levels were collected in 579 DM patients. The mean HbA1c was 8.0 ± 1.7%, where 206 (35.6%) patients had an HbA1c ≤ 7% and 373 (64.4%) had an HbA1c > 7%. During the follow-up period, mortality rates were 20.4% and 28.7% in the HbA1c ≤ 7% and HbA1c > 7% groups, respectively (Kaplan-Meier estimates, log-rank p = 0.01). Multivariable Cox proportional hazards regression, adjusted for age, gender, smoking status, chronic obstructive pulmonary disease, hypertension, chronic renal failure, old myocardial infarction, number of coronary artery bypass surgeries, and post-operative glycemic control, showed a hazard ratio of 2.67 for long-term ACM (p = 0.001) in patients with HbA1c > 7%. Conclusions: DM patients with high HbA1c levels prior to CABG are at higher risk for long-term complications, especially late ACM.

scholarly journals Association between Soy Food and Dietary Soy Isoflavone Intake and the Risk of Cardiovascular Disease in Women: A Prospective Cohort Study in Korea

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1407
Author(s):  
Jihyun Im ◽  
Kyong Park
Keyword(s):  
Cardiovascular Disease ◽  
Postmenopausal Women ◽  
Premenopausal Women ◽  
Soy Isoflavones ◽  
Korean Women ◽  
Cvd Risk ◽  
Soy Isoflavone ◽  
Soy Foods ◽  
Cardiovascular Disease In Women

The association between soy food and soy isoflavone intake and cardiovascular disease (CVD) risk is uncertain, especially in women. We aimed to investigate this association in Korean women. We analyzed data from the Korean Genome and Epidemiology Study, including 4713 Korean women aged 40–69 years with no CVD or cancer at baseline. Dietary information was obtained using a validated semi-quantitative food frequency questionnaire, and the incidence of CVD was assessed using biennial self-reported questionnaires on medical history. The mean follow-up time was 7.4 years, during which 82 premenopausal and 200 postmenopausal women reported CVD incidence. The highest tofu, total soy foods, and dietary soy isoflavone intake groups were significantly associated with a decreased CVD risk in premenopausal women (tofu: hazard ratio (HR) 0.39; 95% confidence interval (CI), 0.19–0.80; total soy food: HR 0.36; 95% CI, 0.18–0.70; dietary soy isoflavones: HR 0.44; 95% CI, 0.22–0.89), whereas no association was observed in postmenopausal women. Other soy foods showed no association with CVD incidence. Dietary soy isoflavones and total soy foods are associated with a decreased CVD risk in premenopausal women. Among soy foods, only tofu showed significant health benefits.

Abstract P196: Bidirectional Association Between Hypertension and Gout: The Singapore Chinese Health Study

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
An Pan ◽  
Gim Gee Teng ◽  
Jian-Min Yuan ◽  
Woon-Puay Koh
Keyword(s):  
Smoking Status ◽  
Final Analysis ◽  
Normal Weight ◽  
Cox Proportional Hazards ◽  
Health Study ◽  
Increased Risk ◽  
Bidirectional Association ◽  
Singapore Chinese ◽  
Incident Cases

Introduction: Although it has been hypothesized that the hypertension-gout relation is bidirectional, few studies have addressed this hypothesis in a prospective setting, particularly in the Asian populations. Methods: We analyzed data from the Singapore Chinese Health Study (SCHS), a cohort of 63,257 Chinese aged 45-74 years at recruitment from 1993-98. The information about self reports of physician-diagnosed hypertension and gout was enquired at follow-ups I (1999-2004) and II (2006-2010). We included participants with complete data for both follow-ups and who were free of heart disease, stroke and cancer at follow-up I. For the analysis of hypertension and risk of incident gout, participants with prevalent gout were further excluded and the final analysis included 31,694 participants. For the analysis of gout and risk of incident hypertension, participants with prevalent hypertension were further excluded and the final analysis included 20,490 participants. Cox proportional hazards models were used to estimate multivariable-adjusted relative risks (RRs) and 95% confidence intervals (CIs) with adjustment for age, sex, years of interview, dialect group, education, smoking status, alcohol intake, physical activity, body mass index (BMI) and history of diabetes. Results: The mean age of the participants at baseline was 60.1 (SD 7.3) years, and the average follow-up year was 6.8 (SD 1.4) years. In the analysis of hypertension and risk of gout, 836 incident cases were identified. Compared to normotensive participants, hypertensive patients had a 93% increased risk of developing gout (RR 1.93; 95% CI 1.66-2.24). The association was slightly stronger in women (RR 2.09; 95% CI 1.69-2.58) compared to men (RR 1.72; 95% CI 1.39-2.14; P for interaction=0.056). The association was also stronger in normal weight adults (BMI <24 kg/m2; RR 2.25; 95% CI 1.82-2.77) compared to overweight/obese individuals (BMI ≥24 kg/m2; RR 1.66; 95% CI 1.34-2.04; P for interaction=0.03). In the parallel analysis of gout and risk of hypertension, 5491 participants reported to have newly diagnosed hypertension during the follow-up. Compared to participants without gout, those with gout had a 17% increased risk of developing hypertension (RR 1.17; 95% CI 1.01-1.35). The association was evident in men (RR 1.29; 95% CI 1.07-1.55) but not in women (RR 0.94; 95% CI 0.73-1.20; P for interaction=0.03). The association was present in normal weight adults (RR 1.34; 95% CI 1.09-1.64) but not among overweight/obese individuals (RR 0.99; 95% CI 0.80-1.23; P for interaction=0.03). Conclusions: Our results provide compelling evidence that the hypertension-gout association is bidirectional in Chinese population. The potential interactions of the bidirectional association with sex and obesity deserve further investigations.

Abstract 43: Association of Plasminogen Activator Inhibitor-1 with Prevalent and Incident Obesity is Independent of Inflammatory Markers: The Multi-Ethnic Study of Atherosclerosis (MESA)

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Sadiya S Khan ◽  
Donald M Lloyd-Jones ◽  
Cheelin Chan ◽  
Kiang Liu ◽  
Mary Cushman ◽  
...  
Keyword(s):  
Plasminogen Activator ◽  
Inflammatory Markers ◽  
Smoking Status ◽  
Plasminogen Activator Inhibitor ◽  
Cox Proportional Hazards ◽  
Plasminogen Activator Inhibitor 1 ◽  
Ethnic Study ◽  
Activator Inhibitor ◽  
Pai 1

Background: In experimental animal models, deficiency of plasminogen activator inhibitor-1 (PAI-1) protects against development of obesity. In addition, elevated circulating levels of PAI-1 are associated in cross-sectional studies with prevalent obesity in humans. However, no studies have investigated the prospective association between PAI-1 and incident obesity. Methods: Plasma PAI-1 levels were measured in a random sample of men and women at baseline (2000-2002) in the Multi-Ethnic Study of Atherosclerosis. Obesity was defined as body mass index (BMI) > 30kg/m2. Incident obesity was identified at four follow-up exams (2002-2011) among those who were not obese at baseline. Logistic regression was used to examine the odds ratios (OR) and 95% confidence intervals (CI) of prevalent obesity at baseline. Cox proportional hazards regression was used to estimate hazard ratios (HR) for time to incident obesity. The covariates used for adjustment included baseline demographics (age, race, sex, center), lifestyle risk factors (physical activity, dietary energy intake, smoking status, alcohol consumption, education), and inflammatory markers (CRP and IL-6). Results: In 839 participants mean age was 59 years old; 59% and 47% of the cohort were female and white, respectively. At baseline, each standard deviation (SD) increase in log(PAI-1) level was associated with an odds ratio (OR) for adjusted prevalent obesity of 2.70 (95% CI: 2.21 - 3.30, p<0.001. This association remained significant after further adjustment for IL-6 and CRP with OR 2.39 (95% CI: 1.94-2.94, p<0.001). Over a median follow-up of 8.5 years, 16% of participants developed obesity. The multivariable adjusted hazard ratio for incident obesity was 1.36 (95% CI 1.09-1.69, p<0.001) per 1 SD increase in log(PAI-1). (Table). Conclusions: Elevated PAI-1 levels are associated with prevalent and incident obesity. These findings are consistent with results from murine studies and provide evidence suggesting a potential role of PAI-1 in the pathogenesis of obesity.

No difference in reoperation rates for nonunions (operative nonunions) in posterior cervical fusions stopping at C7 versus T1/2: a cohort of 875 patients

2021 ◽  
pp. 1-7
Keyword(s):  
Proportional Hazards ◽  
Smoking Status ◽  
Incidence Rates ◽  
Cox Proportional Hazards ◽  
Adjacent Segment ◽  
Spine Registry ◽  
Age At Surgery ◽  
Significant Difference ◽  
Reoperation Rates

OBJECTIVE The challenges of posterior cervical fusions (PCFs) at the cervicothoracic junction (CTJ) are widely known, including the development of adjacent-segment disease by stopping fusions at C7. One solution has been to cross the CTJ (T1/T2) rather than stopping at C7. This approach may have undue consequences, including increased reoperations for symptomatic nonunion (operative nonunion). The authors sought to investigate if there is a difference in operative nonunion in PCFs that stop at C7 versus T1/T2. METHODS A retrospective analysis identified patients from the authors’ spine registry (Kaiser Permanente) who underwent PCFs with caudal fusion levels at C7 and T1/T2. Demographics, diagnoses, operative times, lengths of stay, and reoperations were extracted from the registry. Operative nonunion was adjudicated via chart review. Patients were followed until validated operative nonunion, membership termination, death, or end of study (March 31, 2020). Descriptive statistics and 2-year crude incidence rates and 95% confidence intervals for operative nonunion for PCFs stopping at C7 or T1/T2 were reported. Time-dependent crude and adjusted multivariable Cox proportional hazards models were used to evaluate operative nonunion rates. RESULTS The authors identified 875 patients with PCFs (beginning at C3, C4, C5, or C6) stopping at either C7 (n = 470) or T1/T2 (n = 405) with a mean follow-up time of 4.6 ± 3.3 years and a mean time to operative nonunion of 0.9 ± 0.6 years. There were 17 operative nonunions, and, after adjustment for age at surgery and smoking status, the cumulative incidence rates were similar between constructs stopping at C7 and those that extended to T1/T2 (C7: 1.91% [95% CI 0.88%–3.60%]; T1/T2: 1.98% [95% CI 0.86%–3.85%]). In the crude model and model adjusted for age at surgery and smoking status, no difference in risk for constructs extended to T1/T2 compared to those stopping at C7 was found (adjusted HR 1.09 [95% CI 0.42–2.84], p = 0.86). CONCLUSIONS In one of the largest cohort of patients with PCFs stopping at C7 or T1/T2 with an average follow-up of > 4 years, the authors found no statistically significant difference in reoperation rates for symptomatic nonunion (operative nonunion). This finding shows that there is no added risk of operative nonunion by extending PCFs to T1/T2 or stopping at C7.

Does race affect outcomes in triple negative breast cancer (TNBC)?

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e17543-e17543
Author(s):  
S. Ahmed ◽  
M. M. Mirza ◽  
A. Farooq ◽  
L. Kronish ◽  
M. Jahanzeb ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Racial Differences ◽  
Statistical Significance ◽  
Menopausal Status ◽  
Cox Proportional Hazards ◽  
Rank Test ◽  
Stage At Diagnosis ◽  
Cancer Specific Survival ◽  
The Impact

e17543 Background: TNBC is associated with a worse prognosis than luminal subtypes. There is discordance among studies assessing the impact of race on outcomes of TNBC. Our objective was to assess whether African American (AA) vs. Caucasian (CA) race predicted survival outcomes for women with TNBC treated at a single institution in Memphis, TN. Secondary objectives were to examine the association of race with patient and tumor characteristics. Methods: Patients with stage I-III TNBC were identified from our breast cancer database and confirmed by review of pathology reports. Event free survival (EFS) was measured from the date of surgery to the date of first recurrence (locoregional, distant, or contralateral), death from breast cancer or last follow-up. Breast cancer specific survival (BCSS) was measured from the date of surgery to the date of death from breast cancer or last follow-up. Fisher's exact test was used for association between variables, Kaplan Meier method for survival estimates, and log rank test for survival comparison between groups (p < 0.05: significant). Cox proportional hazards models with patient, tumor and treatment variables were fitted for EFS and BCSS. Results: Of the 105 patients with TNBC, 71% were AA. There was no significant association between race and stage at diagnosis (p = 0.68). 71% of AA women were < 55 years old and 43% were pre-menopausal vs. 50% and 23% of CA women respectively. There was a trend towards association of race with age and menopausal status (p = 0.08). Ninety three percent of the patients received neo/adjuvant chemotherapy. With a median follow up of 26 months, 26% of AA vs. 20% of CA women had an event (p = 0.62). Overall 3 year EFS and BCSS estimates were 69% and 82% respectively. Racial differences in EFS and BCSS for AA vs. CA (65% vs. 80% and 78% vs. 89%, respectively) did not achieve statistical significance (log rank p = 0.22 for EFS and 0.26 for BCSS). Race was not a significant predictor of EFS or BCSS on uni-variable or multi-variable analysis. Stage at diagnosis retained significance for EFS and BCSS on uni-variable and multi-variable testing. Conclusions: Race did not affect outcomes in our cohort of TNBC patients treated similarly. The high event rate underscores the poor prognosis of TNBC and the need for more effective therapies. No significant financial relationships to disclose.

scholarly journals Determinants of Bone Strength Estimated by Calcaneal Ultrasonography in Inuit Women from Nuuk (Greenland)

2014 ◽  
Vol 2014 ◽  
pp. 1-11
Author(s):  
Alexandra-Cristina Paunescu ◽  
Pierre Ayotte ◽  
Sylvie Dodin ◽  
Éric Dewailly ◽  
Gert Mulvad ◽  
...  
Keyword(s):  
Bone Strength ◽  
Hormone Replacement ◽  
Menopausal Status ◽  
Broadband Ultrasound Attenuation ◽  
Dietary Factors ◽  
Stiffness Index ◽  
Omega 3 ◽  
Content Ratio ◽  
Selection Of Variables

This study was conducted to identify determinants of bone strength estimated by quantitative ultrasonography (QUS) at the calcaneus of Greenlandic Inuit women. A total of 153 Inuit women from Nuuk, aged from 49 to 64 years, participated in the first QUS measurement (year 2000) with an Achilles Lunar instrument (speed of sound (SOS); broadband ultrasound attenuation (BUA); stiffness index (SI)). A second measurement was performed two years later (year 2002) in 121 participants. Several factors known to be associated with bone strength were recorded at baseline for 118 of them. Determinants of QUS parameters were identified using an automatic (stepwise) selection of variables in linear regression. Significant determinants of baseline QUS measurements were age and body weight for all QUS parameters, height for BUA and SI, and hormone replacement therapy (HRT) use for SI. Significant predictors of follow-up QUS measurements were baseline QUS values, the smoking status and HRT use for all QUS parameters, omega-3/omega-6 PUFA content ratio of erythrocytes membrane phospholipids (BUA and SI), and menopausal status (BUA). Several modifiable dietary factors, such as a diet rich in omega-3 PUFAs and lifestyle factors (i.e., smoking, taking HRT), were shown to determine QUS parameters after a follow-up of two years.

Independent effects of waist circumference and physical activity on all-cause mortality in Canadian women

2006 ◽  
Vol 31 (3) ◽  
pp. 271-276 ◽  
Author(s):  
Peter T Katzmarzyk ◽  
Cora L Craig
Keyword(s):  
Physical Activity ◽  
Cohort Study ◽  
Waist Circumference ◽  
Physical Inactivity ◽  
Proportional Hazards ◽  
Leisure Time Physical Activity ◽  
Smoking Status ◽  
Cox Proportional Hazards ◽  
Independent Effects

The purpose of this study was to determine the independent effects of waist circumference (WC) and physical inactivity on the risk of mortality in women. This prospective cohort study included 5421 female participants 20-69 years of age in the 1981 Canada Fitness Survey. WC was measured with an anthropometric tape and leisure-time physical activity levels over the previous 12 months were assessed with a questionnaire. Mortality surveillance was conducted by data linkage with the Canadian Mortality Database through 31 December, 1993. The hazard ratios (HR) of mortality were estimated using Cox proportional hazards regression with age, smoking status, and alcohol con sumption included as covariates in all models. A total of 225 deaths occurred over an average of 12.4 years of follow up (67 500 person-years of follow up). Physical activity (HR = 0.78; 95% C.I.: 0.64-0.95) and WC (HR = 1.17; 95% C.I.: 1.05-1.31) were associated with mortality when included in separate regression models. When included in the same model, both physical activity (HR = 0.79; 95% CI: 0.65-0.96) and WC (HR = 1.16; 95% C.I.: 1.04-1.30) remained independent significant predictors of mortality. In conclusion, physical inactivity and high WC have significant independent risks of premature mortality among women.Key words: death, obesity, cohort study, Canada Fitness Survey.

scholarly journals Association of the state hope and decisional conflict with the outcomes of an educational intervention to decrease cardiovascular risk in women: mixed methods study in primary health care

2020 ◽  
Author(s):  
Slavica Juric Petricevic ◽  
Ivancica Pavlicevic ◽  
Natasa Mrduljas-Dujic ◽  
Liza Curcic ◽  
Sanja Dosen Jankovic ◽  
...  
Keyword(s):  
Risk Reduction ◽  
Educational Intervention ◽  
Smoking Status ◽  
Menopausal Status ◽  
Decisional Conflict ◽  
Lifestyle Changes ◽  
Mixed Methods Study ◽  
Positive Effect ◽  
Nutrition Habits

Abstract BackgroundPatient education in lifestyle changes has a positive effect on health in individuals with cardiovascular (CV) risk. We analyzed the effect of an educational intervention on women with different menopausal status in relation to their decisional conflict (DC) about treatment for CV risk and hope that their health will improve according to desired expectations.MethodsThis prospective interventional follow-up study exposed women to the intervention consisted of a 60-minute lecture on the change of lifestyle and nutrition habits to reduce CV risk. We measured the 10-year risk of fatal cardiovascular disease (CVD) and parameters that increase CV risk, the participants filled in 3 questionnaires and six months after the intervention we collected the participants’ feedback on the intervention.ResultsOut of 104 participants, 102 (98%) completed the study. The intervention significantly decreased the 10-year risk of fatal CVD at three months from median 3.3 (95% CI = 2.6–4.3) to 2.9 (95% CI = 2.2–3.6) (P < 0.001) regardless of their menopausal status. The intervention decreased decisional conflict for all respondents after the intervention, and it remained significantly lower at 3 months, but the overall state hope did not change. Two predictive factors of reduced CV risk were identified: high 10-year risk of fatal CVD at the beginning of the study (OR = 1.58, 95% CI 1.15–2.13) and smoking status before the intervention (OR = 4.05, 95% CI 1.07–15.51).ConclusionsA brief educational intervention may be effective in reducing CV risk. Hope and decisional conflict seem not to contribute to CV risk reduction, as only poor health and smoking habits were predictive of risk reduction success.Trial registrationTrial was retrospectively registrated in CT.gov in February 28th 2019.Number of protocol: IP-2014-09-7672. Number of registration: NCT03863210.

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