Antenatal Care Predicts Neonatal Mortality in Eastern Africa: A Systematic Review and Meta-analysis of Observational Studies

Background Sub-Saharan African countries, especially the Eastern region, present the dismal picture of neonatal mortality (NM) in the globe. The majority of these deaths could be avoided if effective health measures are provided throughout pregnancy and childbirth. Although antenatal care (ANC) is assumed as one of the viable interventions that contribute to neonatal survival, the effect of ANC on NM was not systematically analyzed in Eastern Africa. Thus, the study aimed to determine the pooled effect of ANC on NM in Eastern Africa. Methods PubMed, EMBASE, CINAHL, and HINARI databases were searched using appropriate keywords from January 1, 1990 to February 12, 2021. Independent authors selected eligible articles and extracted data. The risk of a bias assessment tool for nonrandomized studies was used to assess the quality of the study. Comprehensive meta-analysis version 2 was used for meta-analysis. The random-effect model was employed, and the outcome is expressed as a risk ratio with 95% confidence interval (CI). Results In total, 1149 studies were identified through database search, and only 27 studies were included in the meta-analysis. Having at least 1 ANC visit during pregnancy reduced the risk of neonatal death by 42% compared to their counterparts (RR = 0.58, 95% CI [0.47, 0.71]). The pooled prevalence of NM was 8.5% (95% CI [7.3, 9.6]), with NM rate of 46.3/1000 live births. Conclusion The study indicated that NM might be decreased even with a single ANC visit when compared to no visits. Scaling up ANC services through ANC promotion and tackling service-related barriers could potentially reduce NM in Eastern Africa.

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Prevalence of Schistosoma mansoni and S. haematobium in Snail Intermediate Hosts in Africa: A Systematic Review and Meta-analysis

Journal of Tropical Medicine ◽

10.1155/2020/8850840 ◽

2020 ◽

Vol 2020 ◽

pp. 1-18

Author(s):

Tamirat Hailegebriel ◽

Endalkachew Nibret ◽

Abaineh Munshea

Keyword(s):

Schistosoma Mansoni ◽

Control Strategies ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Freshwater Snails ◽

Intermediate Hosts ◽

African Countries ◽

Biomphalaria Pfeifferi ◽

Pooled Prevalence

Background. Schistosomiasis is caused by Schistosoma mansoni and S. haematobium in Africa. These schistosome parasites use freshwater snail intermediate hosts to complete their lifecycle. Varied prevalence rates of these parasites in the snail intermediate hosts were reported from several African countries, but there were no summarized data for policymakers. Therefore, this study was aimed to systematically summarize the prevalence and geographical distribution of S. mansoni and S. haematobium among freshwater snails in Africa. Methods. Literature search was carried out from PubMed, Science Direct, and Scopus which reported the prevalence of S. mansoni and S. haematobium among freshwater snails in Africa. The pooled prevalence was determined using a random-effect model, while heterogeneities between studies were evaluated by I2 test. The meta-analyses were conducted using Stata software, metan command. Results. A total of 273,643 snails were examined for the presence of S. mansoni and S. haematobium cercaria in the eligible studies. The pooled prevalence of schistosome cercaria among freshwater snails was 5.5% (95% CI: 4.9–6.1%). The pooled prevalence of S. mansoni and S. haematobium cercaria was 5.6% (95% CI: 4.9–6.3%) and 5.2% (95% CI: 4.6–5.7%), respectively. The highest pooled prevalence was observed from Nigeria (19.0%; 95% CI: 12.7–25.3%), while the lowest prevalence was reported from Chad (0.05%; 95% CI: 0.03–0.13). Higher prevalence of schistosome cercaria was observed from Bulinus globosus (12.3%; 95% CI: 6.2–18.3%) followed by Biomphalaria sudanica (6.7%; 95% CI: 4.5–9.0%) and Biomphalaria pfeifferi (5.1%; 95% CI: 4.1–6.2%). The pooled prevalence of schistosome cercaria obtained using PCR was 26.7% in contrast to 4.5% obtained by shedding cercariae. Conclusion. This study revealed that nearly 6% of freshwater snails in Africa were infected by either S. haematobium or S. mansoni. The high prevalence of schistosomes among freshwater snails highlights the importance of appropriate snail control strategies in Africa.

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Effect of Educational Status on Underweight among Lactating Women in Ethiopia A Systemic Review and Meta-Analysis

10.47363/jpr/2021(3)126 ◽

2021 ◽

pp. 1-6

Author(s):

Wosenyeleh Semeon Bagajjo ◽

◽

Kaleab Tesfaye Tegegne ◽

Berhanu Bifato ◽

Abiyu Ayalew Assefa ◽

...

Keyword(s):

Informal Education ◽

Formal Education ◽

Assessment Tool ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Educational Status ◽

Systemic Review ◽

Health Extension Workers ◽

Lactating Women

Objective: The objective of this systemic review and meta-analysis was to examine the relationship between educational status and underweight among lactating women in Ethiopia The studies conducted before indicate in consistence association between educational status and underweight among lactating women in Ethiopia. We include 7 studies in different regions of Ethiopia. Materials and Methods: The databases, including PubMed, Google scholar were systematically searched from 2015 to 2020. Data were extracted and tabulated by two reviewers using a table containing the following variables: author, title, date of publication, city(s)/ Region / study design, sample size, percentage women with informal education and percentage women with formal education and underweight. The Newcastle-Ottawa Scale for cross-sectional studies quality assessment tool was adapted and used to assess the quality of each study. The combined adjusted Odds ratios (OR)) and 95% confidence intervals were calculated using random effect model. Results: In the current meta-analysis seven observational studies involving 3113 lactating women’s were used to estimate the pooled effect size of underweight. The result of 7 included studies indicated that the pooled odd ratio of underweight among women with informal education compared with women with formal education in Ethiopia was 2.47 (95% CI: 1.69, 3.83). Publication bias for estimating the odd ratio of underweight for women with informal education compared to women with formal education (p = 0.881) and (p = 0.649 ) respectively Heterogeneity was statistically significant (I2=76% Q=25.06; P<0•001). From 54.35% (1692) women who have informal education 16.35% (509) women have underweight. The overall proportion of underweight was 16.35% and 6.58% for those having informal education and formal education respectively. Conclusions: There was evidence that lactating mothers with informal education are more likely to experience underweight. Based on our findings, we strongly recommended that the health education activities about nutrition should be targeted among lactating women with informal education through health extension workers

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Prevalence of Malaria among Adults in Ethiopia: A Systematic Review and Meta-Analysis

Journal of Tropical Medicine ◽

10.1155/2021/8863002 ◽

2021 ◽

Vol 2021 ◽

pp. 1-9

Author(s):

Fasil Adugna Kendie ◽

Tamirat Hailegebriel W/kiros ◽

Endalkachew Nibret Semegn ◽

Melaku Wale Ferede

Keyword(s):

Systematic Review ◽

Subgroup Analysis ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Control Measures ◽

African Countries ◽

Mortality And Morbidity ◽

Regional State ◽

Pooled Prevalence

Background. Malaria is one of the leading causes of mortality and morbidity in tropical and subtropical regions. The bulk of the global malaria burden is in sub-Saharan African countries, including Ethiopia. Malaria adversely affects the health of the peoples as well as the economic development of many developing countries including Ethiopia. Methods. This review article was reported according to PRISMA guidelines. Related published articles were searched from online public databases, such as PubMed, Google Scholar, and ScienceDirect. The search approach used to retrieve related articles were “prevalence,” “malaria,” “adults,” and “Ethiopia.” The quality of articles was assessed using Joana Brigg’s Institute (JBI) critical appraisal checklist. The meta-analysis was computed using STATA version 14. The pooled prevalence estimates with 95% confidence interval were analyzed using a random-effect model, and the possible source of heterogeneity across studies was indicated through subgroup analysis, inverse of variance (I2), and time series analysis. The presence of publication bias was evaluated using funnel plots and Egger’s regression test. Results. Out of 144 studies collected, only eight full-text articles were screened and included in the final quantitative meta-analysis. The pooled prevalence of malaria among adults in Ethiopia was 13.61%. Subgroup analysis based on types of malaria cases showed that the prevalence of malaria among symptomatic and asymptomatic adults was 15.34% and 11.99%, respectively. Similarly, regional subgroup analysis showed that the highest malaria prevalence was recorded in Southern Nations, Nationalities, and Peoples’ Region (SNNPR) (16.17%) followed by Oromia Regional State (13.11%) and Amhara Regional State (12.41%). Discussion and Conclusion. The current systematic review and meta-analysis showed that the pooled prevalence of malaria among adults was found to be greater than the general population and nearly equal to pregnant women. Therefore, the current prevention and control measures, which are related to both vectors and parasites, should be strengthened.

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Postnatal Outcome and Associated Anomalies of Prenatally Diagnosed Right Aortic Arch with Concomitant Right Ductal Arch: A Systematic Review and Meta-Analysis

Diagnostics ◽

10.3390/diagnostics10100831 ◽

2020 ◽

Vol 10 (10) ◽

pp. 831

Author(s):

Paolo Ivo Cavoretto ◽

Alexandros Sotiriadis ◽

Serena Girardelli ◽

Silvia Spinillo ◽

Massimo Candiani ◽

...

Keyword(s):

Systematic Review ◽

Quality Assessment ◽

Aortic Arch ◽

Assessment Tool ◽

Chromosomal Abnormalities ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Case Series ◽

Right Aortic Arch

Right aortic arch presents a reported incidence of 0.1% of the general population; the aim of our study was to evaluate the risk of associated intracardiac (ICA), extracardiac (ECA), or chromosomal abnormalities in fetuses with right aortic arch (RAA) and concomitant right ductal arch (RDA). A systematic review of the literature selected 18 studies including 60 cases of RAA/RDA. A meta-analysis with a random effect model calculated for each outcome the pooled crude proportion of associated abnormal outcomes in cases of RAA/RDA and the pooled proportions and odds ratios in RAA with LDA or RDA. Quality assessment of the included studies was achieved using the NIH quality assessment tool for case series studies. RAA/RDA presents risk of associated conotruncal CHDs of about 30% and risk of 22q11 microdeletion in the region of 1%. Two-thirds of 22q11 microdeletions had concomitant thymic hypoplasia and no other chromosomal defects were described. Risks for ICA, ECA, 22q11 microdeletion, and aberrant left subclavian artery are not substantially different in RAA with right or left arterial duct. RAA increases the risk of associated cardiac defects regardless of laterality of the ductal arch. In isolated RDA/RAA cases, absolute risks of extracardiac associated problems or surgery are rather low, we would therefore recommend reassurance, particularly when the thymus and karyotype are normal.

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Systematic Review and Meta-analysis on COVID-19 Vaccine Hesitancy

10.1101/2021.05.15.21257261 ◽

2021 ◽

Author(s):

Shaimaa Abdulaziz Abdulmoneim ◽

Iman Ahmed Fathalla Aboelsaad ◽

Dina Mohamed Hanaa Hafez ◽

Abdallah Almaghraby ◽

samar ossama el-ganainy ◽

...

Keyword(s):

Quality Assessment ◽

Assessment Tool ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Case Fatality ◽

Vaccine Hesitancy ◽

Cross Sectional ◽

Vaccine Acceptance ◽

Factors Affecting

Background: The presented meta-analysis was developed in response to the publication of several studies addressing COVID-19 vaccines hesitancy. We aimed to identify the proportion of vaccine acceptance and rejection, and factors affecting vaccine hesitancy worldwide especially with the fast emergency approval of vaccines. Methods: Online database search was performed, and relevant studies were included with no language restriction. A meta-analysis was conducted using R software to obtain the random effect model of the pooled prevalence of vaccine acceptance and rejection. Egger regression test was performed to assess publication bias. Quality assessment was assessed using Newcastle-Ottawa Scale quality assessment tool. Results: Thirty-nine out of 12246 articles met the predefined inclusion criteria. All studies were cross-sectional designs. The pooled proportion of COVID-19 vaccine hesitancy was 17% (95% CI: 14-20) while the pooled proportion of COVID-19 vaccine acceptance was 75% (95% CI: 71-79). The vaccine hesitancy and the vaccine acceptance showed high heterogeneity (I 2 =100%). Case fatality ratio and the number of reported cases had significant effect on the vaccine acceptance as the pooled proportion of vaccine acceptance increased by 39.95% (95% CI: 20.1-59.8) for each 1% increase in case fatality (P<0.0001) and decreased by 0.1% (95% CI: -0.2-0.01) for each 1000 reported case of COVID-19, P= 0.0183). Conclusion: Transparency in reporting the number of newly diagnosed COVID-19 cases and deaths is mandatory as these factors are the main determinants of COVID-19 vaccine acceptance.

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Prevalence and risk factors for antibiotic utilization in Chinese children

BMC Pediatrics ◽

10.1186/s12887-021-02706-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Shasha Guo ◽

Qiang Sun ◽

Xinyang Zhao ◽

Liyan Shen ◽

Xuemei Zhen

Keyword(s):

Risk Factors ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Healthcare Research ◽

Chinese Children ◽

Rural Setting ◽

Antibiotic Prescribing ◽

Antibiotic Utilization ◽

At Home

Abstract Background Antibiotic resistance poses a significant threat to public health globally. Irrational utilization of antibiotics being one of the main reasons of antibiotic resistant. Children as a special group, there's more chance of getting infected. Although most of the infection is viral in etiology, antibiotics still are the most frequently prescribed medications for children. Therefore, high use of antibiotics among children raises concern about the appropriateness of antibiotic prescribing. This systematic review aims to measuring prevalence and risk factors for antibiotic utilization in children in China. Methods English and Chinese databases were searched to identify relevant studies evaluating the prevalence and risk factors for antibiotic utilization in Chinese children (0-18 years), which were published between 2010 and July 2020. A Meta-analysis of prevalence was performed using random effect model. The Agency for Healthcare Research and Quality (AHRQ) and modified Jadad score was used to assess risk of bias of studies. In addition, we explored the risk factors of antibiotic utilization in Chinese children using qualitative analysis. Results Of 10,075 studies identified, 98 eligible studies were included after excluded duplicated studies. A total of 79 studies reported prevalence and 42 studies reported risk factors for antibiotic utilization in children. The overall prevalence of antibiotic utilization among outpatients and inpatients were 63.8% (35 studies, 95% confidence interval (CI): 55.1-72.4%), and 81.3% (41 studies, 95% CI: 77.3-85.2%), respectively. In addition, the overall prevalence of caregiver’s self-medicating of antibiotics for children at home was 37.8% (4 studies, 95% CI: 7.9-67.6%). The high prevalence of antibiotics was associated with multiple factors, while lacking of skills and knowledge in both physicians and caregivers was the most recognized risk factor, caregivers put pressure on physicians to get antibiotics and self-medicating with antibiotics at home for children also were the main factors attributed to this issue. Conclusion The prevalence of antibiotic utilization in Chinese children is heavy both in hospitals and home. It is important for government to develop more effective strategies to improve the irrational use of antibiotic, especially in rural setting.

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A meta-analysis comparing short-term weight and cardiometabolic changes between olanzapine/samidorphan and olanzapine

Scientific Reports ◽

10.1038/s41598-021-87285-w ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Manit Srisurapanont ◽

Sirijit Suttajit ◽

Surinporn Likhitsathian ◽

Benchalak Maneeton ◽

Narong Maneeton

Keyword(s):

Weight Gain ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Dropout Rates ◽

Lower Percentage ◽

Current Evidence ◽

Weight Changes ◽

Short Term ◽

Short Term Treatment

AbstractThis study compared weight and cardiometabolic changes after short-term treatment of olanzapine/samidorphan and olanzapine. Eligible criteria for an included trial were ≤ 24 weeks, randomized controlled trials (RCTs) that compared olanzapine/samidorphan and olanzapine treatments in patients/healthy volunteers and reported weight or cardiometabolic outcomes. Three databases were searched on October 31, 2020. Primary outcomes included weight changes and all-cause dropout rates. Standardized mean differences (SMDs) and risk ratios (RRs) were computed and pooled using a random-effect model. This meta-analysis included four RCTs (n = 1195). The heterogeneous data revealed that weight changes were not significantly different between olanzapine/samidorphan and olanzapine groups (4 RCTs, SDM = − 0.19, 95% CI − 0.45 to 0.07, I2 = 75%). The whole-sample, pooled RR of all-cause dropout rates (4 RCTs, RR = 1.02, 95% CI 0.84 to 1.23, I2 = 0%) was not significant different between olanzapine/samidorphan and olanzapine groups. A lower percentage of males and a lower initial body mass index were associated with the greater effect of samidorphan in preventing olanzapine-induced weight gain. Current evidence is insufficient to support the use of samidorphan to prevent olanzapine-induced weight gain and olanzapine-induced cardiometabolic abnormalities. Samidorphan is well accepted by olanzapine-treated patients.

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Low versus high level of physical resemblance in simulation for the acquisition of basic surgical skill: a meta-analysis

BMJ Simulation and Technology Enhanced Learning ◽

10.1136/bmjstel-2020-000797 ◽

2021 ◽

pp. bmjstel-2020-000797

Author(s):

Fabrizio Consorti ◽

Gianmarco Panzera

Keyword(s):

Undergraduate Students ◽

Scoring System ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Surgical Skill ◽

Undergraduate Medical Students ◽

Study Selection ◽

High Level ◽

Physical Resemblance

BackgroundMany studies explored the use of simulation in basic surgical education, with a variety of devices, contexts and outcomes, with sometimes contradictory results.ObjectivesThe objectives of this meta-analysis were to focus the effect that the level of physical resemblance in a simulation has on the development of basic surgical skill in undergraduate medical students and to provide a foundation for the design and implementation of a simulation, with respect to its effectiveness and alignment with the learning outcomes.Study selectionWe searched PubMed and Scopus database for comparative randomised studies between simulations with a different level of resemblance. The result was synthesised as the standardised mean difference, under a random effect model.FindingsWe selected 12 out of 2091 retrieved studies, reporting on 373 undergraduate students (mean of subjects 15.54±6.89). The outcomes were the performance of simple skills and the time to complete a task. Two studies reported a scoring system; seven studies reported time for a task; and three studies reported both. The total number of measures included in the meta-analysis was 456 for score and 504 for time. The pooled effect size did not show any significant advantage in a simulation of a high level of physical resemblance over a lower level, both for the scoring system (−0.19, 95% CI −0.44 to 0.06) and for time (−0.14, 95% CI −0.54 to 0.27).ConclusionSimulations with a low level of physical resemblance showed the same effect as the simulation using a higher level of resemblance on the development of basic surgical skills in undergraduate students.

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Alteration of Postural Balance in Patients with Fibromyalgia Syndrome—A Systematic Review and Meta-Analysis

Diagnostics ◽

10.3390/diagnostics11010127 ◽

2021 ◽

Vol 11 (1) ◽

pp. 127

Author(s):

David Núñez-Fuentes ◽

Esteban Obrero-Gaitán ◽

Noelia Zagalaz-Anula ◽

Alfonso Javier Ibáñez-Vera ◽

Alexander Achalandabaso-Ochoa ◽

...

Keyword(s):

Systematic Review ◽

Postural Balance ◽

Fibromyalgia Syndrome ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Healthy Controls ◽

Functional Balance ◽

Sensory Organization ◽

Effect Model

Balance problems are one of the most frequent symptoms in patients with Fibromyalgia Syndrome (FMS). However, the extent and nature of this balance disorder are not known. The objective of this work was to determine the best evidence for the alteration of postural balance in patients with FMS and analyze differences with healthy controls. To meet this objective, a systematic review with meta-analysis was performed. A bibliographical search was carried out in PubMed Medline, Scopus, Web of Science, CINAHL and SciELO. Observational studies that assessed postural balance in patients with FMS compared to healthy subjects in baseline conditions, were selected. In a random-effect model, the pooled effect was calculated with the Standardized Mean Difference (SMD) and its 95% confidence interval (CI). Nineteen studies reporting data of 2347 participants (95% female) were included. FMS patients showed poor balance with a large effect on static (SMD = 1.578; 95% CI = 1.164, 1.992), dynamic (SMD = 0.946; 95% CI = 0.598, 1.294), functional balance (SMD = 1.138; 95% CI = 0.689, 1.588) and on balance confidence (SMD = 1.194; 95% CI = 0.914, 1.473). Analysis of the Sensory Organization Test showed large alteration of vestibular (SMD = 1.631; 95% CI = 0.467, 2.795) and visual scores (SMD = 1.317; 95% CI = 0.153, 2.481) compared to healthy controls. Patients with FMS showed worse scores for different measures of postural balance compared to healthy controls. Concretely, FMS patients appear to have poor vestibular and visual scores with a possible somatosensory dependence.

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The Prevalence of Mild Cognitive Impairment among Chinese People: A Meta-Analysis

Neuroepidemiology ◽

10.1159/000512597 ◽

2021 ◽

Vol 55 (2) ◽

pp. 79-91

Author(s):

Yan Deng ◽

Siqi Zhao ◽

Guangwen Cheng ◽

Jiajia Yang ◽

Benchao Li ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Diagnostic Criteria ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Internal Validity ◽

Screening Tools ◽

Chinese Elderly ◽

Pooled Prevalence

Background: Mild cognitive impairment (MCI) induced the majority number of dementia patients. The prevalence of MCI in China varied across studies with different screening tools and diagnostic criteria. Objective: A systematic review and meta-analysis was conducted to estimate the pooled MCI prevalence among the population aged 55 years and older in China. Methods: PubMed, EMBASE, CNKI, Wanfang, CQVIP, and CBMdisc were searched for studies on prevalence of MCI among Chinese elderly between January 1, 1980, and February 10, 2020. The quality assessment was conducted via external validity, internal validity, and informativity, the pooled prevalence was calculated through the random-effect model, and the homogeneity was evaluated by Cochran’s Q test and I2. Results: Fifty-three studies with 123,766 subjects were included. The pooled prevalence of MCI among Chinese elderly was 15.4% (95% CI: 13.5–17.4%). Subgroup analyses indicated that the prevalence calculated with different screening tools was 20.2% (95% CI: 15.1–25.9%) for Montreal Cognitive Assessment (MoCA) and 13.0% (95% CI: 10.7–15.5%) for Mini-Mental State Examination (MMSE). According to different diagnostic criteria, the prevalence was 14.8% (95% CI: 12.2–17.6%) for Petersen criteria, 15.0% (95% CI: 12.7–17.5%) for DSM-IV, and 21.2% (95% CI: 17.5–25.2%) for Chinese Expert Consensus on Cognitive Impairment (CECCI). Besides, women, older adults, illiterate people, rural residents, and those who lived with unhealthy lifestyles and morbidity showed higher prevalence. Conclusions: The prevalence of MCI in China was 15.4%, which varied by demographics, lifestyles, morbidity, screening tools, and diagnostic criteria. In further studies, screening tools and diagnosis criteria should be considered when estimating MCI prevalence.

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