Clinical and immunological features and prognosis of different phenotypes of occupational asthma

2021 ◽  
Vol 61 (7) ◽  
pp. 436-441
Author(s):  
Sergey A. Babanov ◽  
Leonid A. Strizhakov ◽  
Antonina G. Baikova ◽  
Darya S. Budash ◽  
Anna S. Agarkova ◽  
...  
Keyword(s):  
Acute Phase ◽  
Forced Vital Capacity ◽  
Occupational Asthma ◽  
Vital Capacity ◽  
Pulmonary Function Tests ◽  
Control Group ◽  
Fibrinogen Concentration ◽  
Immunological Parameters ◽  
Expiratory Flow

Introduction. Occupational asthma is a complex and heterogeneous disease. Development of personalized treatment and prevention tactics becomes feasible due to phenotyping, which means identifying of markers to combine cases of occupational asthma with similar manifestations (clinical, instrumental, laboratory) and prognosis to phenotypes. The study aims to determination and comparative analysis of spirographic and immunological parameters for different phenotypes of occupational asthma. Materials and methods. In this study, we included 170 patients with different phenotypes of occupational asthma and 50 participants in control group. The spirographic examination was performed using computer spirograph with determination of the following parameters: forced vital capacity (FVC), forced expiratory volume during the first second (FEV1), Tiffeneau-Pinelli index (FEV1/FVC), peak expiratory flow (PEF), maximal expiratory flow at 75%, 50%, 25% of the forced vital capacity (MEF75%VC, MEF50%VC, MEF25%VC). Quantification of the immunoglobulins IgA, IgM, and IgG in human serum was conducted by Mancini method; levels of IgE, C-reactive protein and fibronectin were determined using a solid-phase enzyme immunoassay. Fibrinogen concentration in plasma was measured by an automatic coagulometer. Haptoglobin concentration in serum was determined by spectrophotometry. Results. According to spirometry and laboratory results obtained, there is a strong evidence, that the phenotype "occupational asthma - occupational chronic obstructive pulmonary disease" has the lowest values in pulmonary function tests and the most significant changes in immunoglobulins, fibronectin and acute phase proteins levels among other studied phenotypes of occupational asthma. Conclusions. Dynamic determination of spirometric, immunological parameters, fibronectin and proteins of the acute phase of inflammation in workers at risk for the formation of occupational bronchial asthma may be recommended to be carried out once every 6 months, followed by the isolation of disease phenotypes. This will optimize diagnostics, therapeutic and preventive tactics, as well as predict the course of this pathology.

Features of the immunological profile in various phenotypes of occupational bronchial asthma

2021 ◽  
pp. 19-26
Author(s):  
S.A. Babanov ◽  
A. G. Baykova
Keyword(s):  
Forced Vital Capacity ◽  
Occupational Asthma ◽  
Vital Capacity ◽  
Acute Phase Proteins ◽  
Solid Phase ◽  
Pulmonary Function Tests ◽  
Control Group ◽  
Chronic Obstructive ◽  
Fibrinogen Concentration ◽  
Expiratory Flow

Introduction. Occupational asthma is a complex and heterogeneous disease. Development of personalized treatment and prevention tactics becomes feasible due to phenotyping, which means identifying of markers to combine cases of occupational asthma with similar manifestations (clinical, instrumental, laboratory) and prognosis to phenotypes. The study aims to determination and comparative analysis of spirographic and immunological parameters for different phenotypes of occupational asthma. Materials and methods. In this study, we included 170 patients with different phenotypes of occupational asthma and 50 participants in control group. The spirographic examination was performed using computer spirograph with determination of the following parameters: forced vital capacity (FVC), forced expiratory volume during the first second (FEV1), Tiffeneau-Pinelli index (FEV1/FVC), peak expiratory flow (PEF), maximal expiratory flow at 75 %, 50 %, 25 % of the forced vital capacity (MEF75 %VC, MEF50 %VC, MEF25 %VC). Quantification of the immunoglobulins IgA, IgM, and IgG in human serum was conducted by Mancini method; levels of IgE, C-reactive protein and fibronectin were determined using a solid-phase enzyme immunoassay. Fibrinogen concentration in plasma was measured by an automatic coagulometer. Haptoglobin concentration in serum was determined by spectrophotometry. Results. According to spirometry and laboratory results obtained, there is a strong evidence, that the phenotype «occupational asthma — occupational chronic obstructive pulmonary disease» has the lowest values in pulmonary function tests and the most significant changes in immunoglobulins, fibronectin and acute phase proteins levels among other studied phenotypes of occupational asthma.

scholarly journals Pulmonary functions in car air conditioner users and non-air conditioner users in tertiary care centre, South Tamilnadu, India

2019 ◽  
Vol 7 (9) ◽  
pp. 3510
Author(s):  
Hoshea Jeba Ruth S. ◽  
Lisha Vincent
Keyword(s):  
Pulmonary Function ◽  
Forced Vital Capacity ◽  
Vital Capacity ◽  
Pulmonary Function Tests ◽  
Forced Expiratory Volume ◽  
Control Group ◽  
Air Conditioner ◽  
Air Conditioners ◽  
Function Tests ◽  
Expiratory Flow

Background: Air conditioners are used extensively these days of the modern lifestyle. Inhalation of cold dry air while using Air conditioners causes bronchoconstriction due to which alteration may occur in pulmonary function. This study was aimed to compare the Pulmonary Function tests of Car AC users and non AC users. Methods: The Study included 52 employees not exposed to car air conditioner as a control (group I) and 52 employees exposed to car air conditioner  with minimum exposure of 1 hour per day for 6 months as a subject (group II). Pulmonary function tests were performed using computerised spirometer. Statistical analysis was done by unpaired t test.Results: Age, Height and weight are not statistically significant between study group and control group. Forced vital capacity, forced expiratory volume in 1 second, Ratio of Forced vital capacity and Forced expiratory volume in 1 second, Inspiratory reserve volume, Expiratory reserve volume, Maximum voluntary ventilation are decreased in car air conditioner users compared to non-users, but was not significant. Forced expiratory flow (FEF), Peak expiratory flow rate (PEFR) values shows statistically significant decreased in car air conditioner users.Conclusions: The present study shows hyper-responsive airways on exposure to cold air which leads to bronchoconstriction. The significant decrease in PEFR, FEF suggest that upper airways as well as smaller airways are affected on exposure to car AC. So, Exposure to car Air Conditioner leads to risk of developing respiratory dysfunction.

scholarly journals Effects of PM2.5 on Cardio-Pulmonary Function Injury in Open Manganese Mine Workers

2019 ◽  
Vol 16 (11) ◽  
pp. 2017 ◽  
Author(s):  
Yuanni Huang ◽  
Mian Bao ◽  
Jiefeng Xiao ◽  
Zhaolong Qiu ◽  
Kusheng Wu
Keyword(s):  
Pulmonary Function ◽  
Forced Vital Capacity ◽  
Prevalence Rate ◽  
Vital Capacity ◽  
Open Pit ◽  
Control Group ◽  
Significant Difference ◽  
Forced Expiratory Flow ◽  
Pm2.5 Exposure ◽  
Expiratory Flow

Exposure to fine particulate matter 2.5 (PM2.5) is associated with adverse health effects, varying by its components. The health-related effects of PM2.5 exposure from ore mining may be different from those of environment pollution. The aim of this study was to investigate the effects of different concentrations of PM2.5 exposure on the cardio-pulmonary function of manganese mining workers. A total of 280 dust-exposed workers who were involved in different types of work in an open-pit manganese mine were randomly selected. According to the different concentrations of PM2.5 in the working environment, the workers were divided into an exposed group and a control group. The electrocardiogram, blood pressure, and multiple lung function parameters of the two groups were measured and analyzed. The PM2.5 exposed group had significantly lower values in the pulmonary function indexes of forced expiratory volume in one second (FEV1.0), maximum mid expiratory flow (MMEF), peak expiratory flow rate (PEFR), percentage of peak expiratory flow out of the overall expiratory flow volume (PEFR%), forced expiratory flow at 25% and 75% of forced vital capacity (FEF 25, FEF75), forced expiratory flow when 25%, 50%, and 75% of forced vital capacity has been exhaled (FEF25%,FEF50%, FEF75%), and FEV1.0/FVC% (the percentage of the predicted value of forced vital capacity) than the control group (all p < 0.05). Both groups had mild or moderate lung injury, most of which was restrictive ventilatory disorder, and there was significant difference in the prevalence rate of restrictive respiratory dysfunction between the two groups (41.4% vs. 23.6%, p = 0.016). Electrocardiogram (ECG) abnormalities, especially sinus bradycardia, were shown in both groups, but there was no statistical difference of the prevalence rate between the two groups (p > 0.05). Also, no significant difference of the prevalence rate of hypertension was observed between the PM2.5 exposure and control groups (p > 0.05). PM2.5 exposure was associated with pulmonary function damage of the workers in the open-pit manganese mine, and the major injury was restrictive ventilatory disorder. The early effect of PM2.5 exposure on the cardiovascular system was uncertain at current exposure levels and exposure time.

Pulmonary Function Testing Reference Values and Interpretations in Pediatric Training Programs

PEDIATRICS ◽  
1990 ◽  
Vol 85 (5) ◽  
pp. 768-773
Author(s):  
Edward N. Pattishall
Keyword(s):  
Pulmonary Function ◽  
Statistical Methods ◽  
Forced Vital Capacity ◽  
Vital Capacity ◽  
Training Programs ◽  
Pulmonary Function Tests ◽  
Forced Expiratory Volume ◽  
Reference Standards ◽  
Forced Expiratory Flow ◽  
Expiratory Flow

A questionnaire was sent to all pediatric training programs to evaluate the use of pulmonary function reference standards and the interpretation of pulmonary function test results. Responses were obtained from 107 of 130 institutions, and 94 of these had pulmonary function laboratories available. Of the 94, 60 used one of three reference standards. The primary reason the reference standards were chosen was either unknown or because they came with the spirometer (24), were recommended by another person or were those used in that person's training (34), or were thought to be the best standards available or most applicable to the population to be tested (31). To define abnormality, most used an 80% predicted cutoff for forced vital capacity, forced expiratory volume in 1 second, and forced expiratory flow at 25% to 75% vital capacity. For a change in an individual through time, most used a 10% change for forced vital capacity, forced expiratory volume in 1 second, and forced expiratory flow at 25% to 75% vital capacity. Thirteen used statistical methods to define abnormal individuals and none used statistical methods to define a significant change over time. Although there are a few guidelines for reference standards and interpretations of pulmonary function tests, it appears that most laboratories are not using those guidelines and that further guidelines and education are needed.

scholarly journals Evaluation of spirometry in asthmatic children

2017 ◽  
Vol 4 (3) ◽  
pp. 729
Author(s):  
Kriti Hegde ◽  
Amit S. Saxena ◽  
Rajesh Kumar Rai
Keyword(s):  
Peak Expiratory Flow ◽  
Forced Vital Capacity ◽  
Vital Capacity ◽  
Pulmonary Function Tests ◽  
Forced Expiratory Volume ◽  
Cold Weather ◽  
Asthmatic Children ◽  
Modifiable Factors ◽  
Forced Expiratory Flow ◽  
Expiratory Flow

Background:The use of spirometry in the assessment of children with asthma is taking on new importance with the realization that considerable airway obstruction may exist in the absence of clinically detectable abnormalities. Hence this study was planned to evaluate, forced expired volume in 1 second (FEV1), forced vital capacity (FVC), the forced expiratory flow between 25% and 75% of vital capacity (FEF25-75) and Peak Expiratory Flow rates (PEFR) in asthmatic children aged 6-12 years. The objective of the study was to determine prevalence of asthma according to clinical classification and identify common trigger factors and to determine which is more sensitive between FEV1, FVC, FEV1/FVC, FEF 25-75 and PEFR in different age groups.Methods: The present study was conducted among 60 patients of age group 6 to 12 years with asthma. Forced vital capacity (FVC), Forced expiratory volume in 1 second (FEV1), Ratio of forced expiratory volume in 1 second and forced vital capacity (FEV1/FVC), PEFR and Forced expiratory flow between 25-75% were recorded. Data was analyzed using chi-square test, Karl Pearson’s correlation coefficient. Level of significance was set at 5%. All p values less than 0.05 were treated as significant.Results:In Age and Sex wise correlation with classification of asthma, a male preponderance was seen in all the age groups i.e. between 6-8 years, 9-10 years and 11-12 years. Mosquito coils were the most common indoor agents to trigger an asthmatic accounting for nearly 80%. Amongst the outdoor triggers, exacerbation of symptoms during the cold weather accounted for 90 % followed by variation during festivals like Diwali, dust, pollution, exercise and insects. Comparison of Pre and Post bronchodilator FEF 25-75 values have shown a high statistical significance.Conclusions:Parents need to be educated regarding certain modifiable factors that can improve the prognosis. Pulmonary Function tests should be performed as a routine office procedure. Peak expiratory flow meter is a handy instrument. In all children above 6 years of age suspected to have asthma, this test should be performed before beginning therapy.

Chest wall muscle atrophy as a contributory factor for forced vital capacity decline in systemic sclerosis-associated interstitial lung disease

Rheumatology ◽  
2020 ◽  
Vol 60 (1) ◽  
pp. 250-255
Author(s):  
Takashi Nawata ◽  
Yuichiro Shirai ◽  
Mikito Suzuki ◽  
Masataka Kuwana
Keyword(s):  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Chest Wall ◽  
Muscle Atrophy ◽  
Forced Vital Capacity ◽  
Vital Capacity ◽  
Pulmonary Function Tests ◽  
Potential Contribution ◽  
Muscle Area ◽  
Chest Wall Muscle

Abstract Objective To investigate the potential contribution of accessory respiratory muscle atrophy to the decline of forced vital capacity (FVC) in patients with SSc-associated interstitial lung disease (ILD). Methods This single-centre, retrospective study enrolled 36 patients with SSc-ILD who underwent serial pulmonary function tests and chest high-resolution CT (HRCT) simultaneously at an interval of 1–3 years. The total extent of ILD and chest wall muscle area at the level of the ninth thoracic vertebra on CT images were evaluated by two independent evaluators blinded to the patient information. Changes in the FVC, ILD extent, and chest wall muscle area between the two measurements were assessed in terms of their correlations. Multiple regression analysis was conducted to identify the independent contributors to FVC decline. Results Interval changes in FVC and total ILD extent were variable among patients, whereas chest wall muscle area decreased significantly with time (P=0.0008). The FVC change was negatively correlated with the change in ILD extent (r=−0.48, P=0.003) and was positively correlated with the change in the chest wall muscle area (r = 0.53, P=0.001). Multivariate analysis revealed that changes in total ILD extent and chest wall muscle area were independent contributors to FVC decline. Conclusion In patients with SSc-ILD, FVC decline is attributable not only to the progression of ILD but also to the atrophy of accessory respiratory muscles. Our findings call attention to the interpretation of FVC changes in patients with SSc-ILD.

Pulmonary function in men after oxygen breathing at 3.0 ATA for 3.5 h

1991 ◽  
Vol 71 (3) ◽  
pp. 878-885 ◽  
Author(s):  
J. M. Clark ◽  
R. M. Jackson ◽  
C. J. Lambertsen ◽  
R. Gelfand ◽  
W. D. Hiller ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Forced Vital Capacity ◽  
Vital Capacity ◽  
Large Change ◽  
Forced Expiratory Volume ◽  
Diffusing Capacity ◽  
Mild Degree ◽  
Oxygen Breathing ◽  
Multiple Organs ◽  
Expiratory Flow

As a pulmonary component of Predictive Studies V, designed to determine O2 tolerance of multiple organs and systems in humans at 3.0–1.5 ATA, pulmonary function was evaluated at 1.0 ATA in 13 healthy men before and after O2 exposure at 3.0 ATA for 3.5 h. Measurements included flow-volume loops, spirometry, and airway resistance (Raw) (n = 12); CO diffusing capacity (n = 11); closing volumes (n = 6); and air vs. HeO2 forced vital capacity maneuvers (n = 5). Chest discomfort, cough, and dyspnea were experienced during exposure in mild degree by most subjects. Mean forced expiratory volume in 1 s (FEV1) and forced expiratory flow at 25–75% of vital capacity (FEF25–75) were significantly reduced postexposure by 5.9 and 11.8%, respectively, whereas forced vital capacity was not significantly changed. The average difference in maximum midexpiratory flow rates at 50% vital capacity on air and HeO2 was significantly reduced postexposure by 18%. Raw and CO diffusing capacity were not changed postexposure. The relatively large change in FEF25–75 compared with FEV1, the reduction in density dependence of flow, and the normal Raw postexposure are all consistent with flow limitation in peripheral airways as a major cause of the observed reduction in expiratory flow. Postexposure pulmonary function changes in one subject who convulsed at 3.0 h of exposure are compared with corresponding average changes in 12 subjects who did not convulse.

scholarly journals P151 Forced vital capacity in patients with systemic sclerosis associated pulmonary fibrosis: predictors of meaningful decline

Rheumatology ◽  
2020 ◽  
Vol 59 (Supplement_2) ◽  
Author(s):  
Svetlana I Nihtyanova ◽  
Emma C Derrett-Smith ◽  
Carmen Fonseca ◽  
Voon H Ong ◽  
Christopher P Denton
Keyword(s):  
Systemic Sclerosis ◽  
Pulmonary Fibrosis ◽  
Forced Vital Capacity ◽  
Vital Capacity ◽  
Cox Regression ◽  
Pulmonary Function Tests ◽  
Age At Onset ◽  
Time Factors ◽  
Standard Management ◽  
Over Time

Abstract Background Pulmonary fibrosis (PF) is common in systemic sclerosis (SSc) and serial pulmonary function tests (PFTs) are used for routine PF monitoring. Forced vital capacity (FVC) decline reflects progression in PF and FVC is frequently used as an endpoint in clinical trials. We explore the changes in FVC over time in patients with SSc-PF, receiving standard management, including immunosuppression. Methods Only SSc patients with CT-confirmed PF were included. FVC changes over the first 10 years from onset and their associations were assessed using linear mixed effects models. Predictors of time from first PFT to development of threshold FVC (FVC&lt;70% and FVC&lt;50%) were analysed using Cox regression. Results We identified 505 SSc-PF subjects, 21.6% were male, average age at onset was 47 years and 49.3% had diffuse cutaneous subset (dcSSc). The most common autoantibody was anti-Scl70 in 40.4%, followed by anti-RNA polymerase (ARA) in 11.7% and anti-centromere (ACA) in 7.1%. In 16.4% of the patients, ANA was positive, but no ENAs were identified (ANA+ENA-). Average FVC at 12 months from onset was 80.1% (SD 19.3) and this declined by 0.32% per year (p = 0.007) at a group level. There was no significant correlation between baseline FVC and subsequent change (correlation coefficient -0.13; 95%CI -0.26, 0.01). For every year older age at onset, average FVC increased by 0.32%, p &lt; 0.001. Males had 3.3% lower FVC at 1 year from onset (p &lt; 0.001) and 0.6% faster decline per year (p = 0.034) compared to females. DcSSc subjects had 5.6% lower FVC compared to limited disease (p = 0.003). Average FVC at 1 year from onset in ARA+ subjects were higher than any other antibody (15.1% v. ANA+ENA-, p &lt; 0.001; 14.6% v. ATA, p &lt; 0.001 and 12.5% v. ACA, p = 0.010). Nevertheless, ARA+ subjects had FVC decline rates similar to ATA+ and ANA+ENA- subjects, while ACA+ patients had a small but significant increase in FVC over time. Factors that increased the risk for FVC drop below the thresholds were male sex, ATA and low baseline FVC (Table 1). Conclusion This study provides insight into long-term patterns of FVC change and develops a model that may help predict those most at risk of significant decline. Disclosures S.I. Nihtyanova None. E.C. Derrett-Smith None. C. Fonseca None. V.H. Ong None. C.P. Denton None.

Association of Gastroesophageal Factors and Worsening of Forced Vital Capacity in Systemic Sclerosis

2013 ◽  
Vol 40 (6) ◽  
pp. 850-858 ◽  
Author(s):  
Xuli Jerry Zhang ◽  
Ashley Bonner ◽  
Marie Hudson ◽  
Murray Baron ◽  
Janet Pope ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Forced Vital Capacity ◽  
Topoisomerase I ◽  
Vital Capacity ◽  
Disease Duration ◽  
Pulmonary Function Tests ◽  
Esophageal Dysmotility ◽  
Increased Risk ◽  
Risk Of Progression ◽  
Waking Up

Objective.Interstitial lung disease (ILD) is a common complication of systemic sclerosis (SSc) and causes death. Once lung fibrosis occurs, disease course may become stable or decline. Little is known about risks for progression. We studied SSc–gastroesophageal (GE) involvement in relation to worsening forced vital capacity (FVC) on pulmonary function tests (PFT) to investigate whether it was related to progression. Our objective was to determine whether GE reflux and dysphagia are associated with progressive moderate/severe ILD as measured by PFT over 3 years.Methods.The Canadian Scleroderma Research Group is a multicenter SSc database that collects data annually. Using indicators of GE involvement and annual PFT, comparisons were made between no/mild ILD, stable moderate/severe ILD, and progressive moderate/severe ILD groups based on changes of FVC. Multivariate analyses determined associations between GE factors and ILD development and progression.Results.There were 1043 patients with SSc (mean age 55.7 yrs, mean disease duration 10.8 yrs); one-quarter had pulmonary fibrosis on chest radiograph that was related to FVC percentage predicted (Spearman’s rho −0.39; p < 0.01). Physician indicators such as esophageal dysmotility (p = 0.009) and postesophageal dilatation (p = 0.041), and patient indicators such as difficulty swallowing (p = 0.016) and waking up choking (p = 0.026) were associated with low FVC. In comparing progressive and stable moderate/severe FVC (< 70% predicted), early satiety (p = 0.018) and a combination term of postdilatation and choking (p = 0.042) increased risk of progression of ILD. Topoisomerase I was not associated with progression over followup.Conclusion.Symptoms of esophageal dysmotility were associated with worsening FVC in SSc, especially if both need for esophageal dilatation and choking were present.

scholarly journals Are preterm-born survivors at risk of long-term respiratory disease?

2017 ◽  
Vol 11 (7) ◽  
pp. 277-287 ◽  
Author(s):  
Katarzyna Kaczmarczyk ◽  
Ida Wiszomirska ◽  
Magdalena Szturmowicz ◽  
Andrzej Magiera ◽  
Michalina Błażkiewicz
Keyword(s):  
Preterm Birth ◽  
Forced Vital Capacity ◽  
Vital Capacity ◽  
Reference Group ◽  
Statistical Significance ◽  
Forced Expiratory Volume ◽  
Significant Difference ◽  
Expiratory Flow ◽  
Preterm Born

Background: To evaluate the long-term impact of preterm birth on respiratory function in female patients born preterm, we undertook spirometric examinations twice, as they reached the age of puberty, then follow-up examinations of part of the same cohort in adulthood. We sought evidence that preterm birth is correlated with poorer spirometric results into adulthood. Methods: A total of 70 girls (aged 12.2 ± 1.5 years in 1997) who had been born preterm (at 34.7 ± 1.86 weeks, none having experienced bronchopulmonary dysplasia) took part in spriometric examinations in 1997 and again in 1998. Of those, after a gap of 17 years, a group of 12 were successfully recontacted and participated in the 2015 examination as adults (then aged 27.6 ± 2.6 years, born at 34.5 ± 1.92 weeks). We compared spirometric results across the adolescent and adult examinations, and compared the adult results with an adult reference group. Results: The percentage values of FEV1 (forced expiratory volume in 1 s), FVC (forced vital capacity) and MVV (maximal voluntary ventilation) showed significant improvement between the two examinations in the early adolescent period. In adulthood, FEV1%pred (percentage predicted forced expiratory volume in 1 s) showed no statistically significant difference. The mean values of both FVC and FVC%pred (percentage predicted forced vital capacity) for the preterm-born group were lower than for the reference group, but this was not statistically significant. The preterm-born group showed lower values of such parameters as forced expiratory flow at 25–75% of FVC, MEF25 (maximal expiratory flow at 25% of forced vital capacity) and FEV1/FVC as compared with the reference group, but again without statistical significance. Conclusions: (1) A somewhat below-norm level of respiratory parameters among preterm-born girls entering pubescence may attest to continued negative impact on their respiratory system. (2) A significant improvement in their spirometric results 1 year later may indicate that pubescence helps compensate for the earlier negative effect of preterm birth. (3) No significant differences were seen in lung function in preterm-born adults as compared with a reference group of adults, although the preterm-born group did exhibit lower values of all parameters studied and more frequent obstructive disorders.

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