Publisher: American Society of Nephrology   (Total: 2 journals)   [Sort by number of followers]

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Clinical J. of the American Society of Nephrology     Full-text available via subscription   (Followers: 24, SJR: 3.099, CiteScore: 5)
J. of the American Society of Nephrology     Full-text available via subscription   (Followers: 38, SJR: 4.819, CiteScore: 7)
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Clinical Journal of the American Society of Nephrology
Journal Prestige (SJR): 3.099
Citation Impact (citeScore): 5
Number of Followers: 24  
 
  Full-text available via subscription Subscription journal
ISSN (Print) 1555-9041 - ISSN (Online) 1555-905X
Published by American Society of Nephrology Homepage  [2 journals]
  • Treatment Options for Venous Thromboembolism in Patients Receiving
           Dialysis

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      Authors: Mavrakanas; T. A.
      Pages: 623 - 625
      PubDate: 2022-05-06T10:00:31-07:00
      DOI: 10.2215/CJN.03410322
      Issue No: Vol. 17, No. 5 (2022)
       
  • Functional Assessment of High-Risk APOL1 Genetic Variants

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      Authors: Robinson-Cohen; C.
      Pages: 626 - 627
      PubDate: 2022-05-06T10:00:31-07:00
      DOI: 10.2215/CJN.03470322
      Issue No: Vol. 17, No. 5 (2022)
       
  • Learnings from Throwing Paint at the Wall for COVID-19 with an SGLT2
           Inhibitor

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      Authors: Tuttle; K. R.
      Pages: 628 - 630
      PubDate: 2022-05-06T10:00:31-07:00
      DOI: 10.2215/CJN.03250322
      Issue No: Vol. 17, No. 5 (2022)
       
  • CRRT Fluid Choices: A Solution for a Common Problem'

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      Authors: Vijayan; A.
      Pages: 631 - 633
      PubDate: 2022-05-06T10:00:31-07:00
      DOI: 10.2215/CJN.03390322
      Issue No: Vol. 17, No. 5 (2022)
       
  • Association of Phosphate-Containing versus Phosphate-Free Solutions on
           Ventilator Days in Patients Requiring Continuous Kidney Replacement
           Therapy

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      Authors: Thompson Bastin, M. L; Stromberg, A. J, Nerusu, S. N, Liu, L. J, Mayer, K. P, Liu, K. D, Bagshaw, S. M, Wald, R, Morris, P. E, Neyra, J. A.
      Pages: 634 - 642
      Abstract: Background and objectivesHypophosphatemia is commonly observed in patients receiving continuous KRT. Patients who develop hypophosphatemia may be at risk of respiratory and neuromuscular dysfunction and therefore subject to prolongation of ventilator support. We evaluated the association of phosphate-containing versus phosphate-free continuous KRT solutions with ventilator dependence in critically ill patients receiving continuous KRT.Design, setting, participants, & measurementsOur study was a single-center, retrospective, pre-post cohort study of adult patients receiving continuous KRT and mechanical ventilation during their intensive care unit stay. Zero-inflated negative binomial regression with and without propensity score matching was used to model our primary outcome: ventilator-free days at 28 days. Intensive care unit and hospital lengths of stay as well as hospital mortality were analyzed with a t test or a chi-squared test, as appropriate.ResultsWe identified 992 eligible patients, of whom 649 (65%) received phosphate-containing solutions and 343 (35%) received phosphate-free solutions. In multivariable models, patients receiving phosphate-containing continuous KRT solutions had 12% (95% confidence interval, 0.17 to 0.47) more ventilator-free days at 28 days. Patients exposed to phosphate-containing versus phosphate-free solutions had 17% (95% confidence interval, –0.08 to –0.30) fewer days in the intensive care unit and 20% (95% confidence interval, – 0.12 to –0.32) fewer days in the hospital. Concordant results were observed for ventilator-free days at 28 days in the propensity score matched analysis. There was no difference in hospital mortality between the groups.ConclusionsThe use of phosphate-containing versus phosphate-free continuous KRT solutions was independently associated with fewer ventilator days and shorter stay in the intensive care unit.
      PubDate: 2022-05-06T10:00:31-07:00
      DOI: 10.2215/CJN.12410921
      Issue No: Vol. 17, No. 5 (2022)
       
  • Dapagliflozin and Kidney Outcomes in Hospitalized Patients with COVID-19
           Infection: An Analysis of the DARE-19 Randomized Controlled Trial

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      Authors: Heerspink, H. J. L; Furtado, R. H. M, Berwanger, O, Koch, G. G, Martinez, F, Mukhtar, O, Verma, S, Gasparyan, S. B, Tang, F, Windsor, S. L, de Souza-Dantas, V. C, del Sueldo, M, Frankel, R, Javaheri, A, Maldonado, R. A, Morse, C, Mota-Gomes, M, Shemin, D, Silva, O. L, Tognon, A. P, Twahirwa, M, Buenconsejo, J, Esterline, R, Oscarsson, J, Ambery, P, Langkilde, A. M, Kosiborod, M. N.
      Pages: 643 - 654
      Abstract: Background and objectivesPatients who were hospitalized with coronavirus disease 2019 (COVID-19) infection are at high risk of AKI and KRT, especially in the presence of CKD. The Dapagliflozin in Respiratory Failure in Patients with COVID-19 (DARE-19) trial showed that in patients hospitalized with COVID-19, treatment with dapagliflozin versus placebo resulted in numerically fewer participants who experienced organ failure or death, although these differences were not statistically significant. We performed a secondary analysis of the DARE-19 trial to determine the efficacy and safety of dapagliflozin on kidney outcomes in the overall population and in prespecified subgroups of participants defined by baseline eGFR.Design, setting, participants, & measurementsThe DARE-19 trial randomized 1250 patients who were hospitalized (231 [18%] had eGFR
      PubDate: 2022-05-06T10:00:31-07:00
      DOI: 10.2215/CJN.14231021
      Issue No: Vol. 17, No. 5 (2022)
       
  • Provider Perspectives and Clinical Outcomes with Inpatient Telenephrology

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      Authors: Androga, L. A; Zoghby, Z, Ramar, P, Amundson, R. H, dUscio, M, Philpot, L. M, Thorsteinsdottir, B, Kattah, A. G, Albright, R. C.
      Pages: 655 - 662
      Abstract: Background and objectivesDespite the dramatic increase in the provision of virtual nephrology care, only anecdotal reports of outcomes without comparators to usual care exist in the literature. This study aimed to provide objective determination of clinical noninferiority of hybrid (telenephrology plus face-to-face) versus standard (face-to-face) inpatient nephrology care.Design, setting, participants, & measurementsThis retrospective study compares objective outcomes in patients who received inpatient hybrid care versus standard nephrology care at two Mayo Clinic Health System community hospitals. Outcomes were then additionally compared with those patients receiving care at another Mayo Clinic Health System site where only standard care is available. Hospitalized adults who had nephrology consults from March 1, 2020 to February 28, 2021 were considered. Regression was used to assess 30-day mortality, length of hospitalization, readmissions, odds of being prescribed dialysis, and hospital transfers. Sensitivity analysis was performed using patients who had ≥50% of their care encounters via telenephrology. Structured surveys were used to understand the perspectives of non-nephrology hospital providers and telenephrologists.ResultsIn total, 850 patients were included. Measured outcomes that included the number of hospital transfers (odds ratio, 1.19; 95% confidence interval, 0.37 to 3.82) and 30-day readmissions (odds ratio, 0.97; 95% confidence interval, 0.84 to 1.06), among others, did not differ significantly between controls and patients in the general cohort. Telenephrologists (n=11) preferred video consults (82%) to phone for communication. More than half (64%) of telenephrologists spent less time on telenephrology compared with standard care. Non-nephrology hospital providers (n=21) were very satisfied (48%) and satisfied (29%) with telenephrology response time and felt telenephrology was as safe as standard care (67%), while providing them enough information to make patient care decisions (76%).ConclusionsOutcomes for in-hospital nephrology consults were not significantly different comparing hybrid care versus standard care. Non-nephrology hospital providers and telenephrologists had favorable opinions of telenephrology and most perceived it is as safe and effective as standard care.PodcastThis article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2022_04_11_CJN13441021.mp3
      PubDate: 2022-05-06T10:00:31-07:00
      DOI: 10.2215/CJN.13441021
      Issue No: Vol. 17, No. 5 (2022)
       
  • SGLT2 Inhibition and Uric Acid Excretion in Patients with Type 2 Diabetes
           and Normal Kidney Function

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      Authors: Suijk, D. L. S; van Baar, M. J. B, van Bommel, E. J. M, Iqbal, Z, Krebber, M. M, Vallon, V, Touw, D, Hoorn, E. J, Nieuwdorp, M, Kramer, M. M. H, Joles, J. A, Bjornstad, P, van Raalte, D. H.
      Pages: 663 - 671
      Abstract: Background and objectivesSodium-glucose transporter 2 (SGLT2) inhibitor–induced uric acid lowering may contribute to kidney-protective effects of the drug class in people with type 2 diabetes. This study investigates mechanisms of plasma uric acid lowering by SGLT2 inhibitors in people with type 2 diabetes with a focus on urate transporter 1.Design, setting, participants, & measurementsWe conducted an analysis of two randomized clinical trials. First, in the Renoprotective Effects of Dapagliflozin in Type 2 Diabetes study, 44 people with type 2 diabetes were randomized to dapagliflozin or gliclazide for 12 weeks. Plasma uric acid, fractional uric acid excretion, and hemodynamic kidney function were measured in the fasted state and during clamped euglycemia or hyperglycemia. Second, in the Uric Acid Excretion study, ten people with type 2 diabetes received 1 week of empagliflozin, urate transporter 1 blocker benzbromarone, or their combination in a crossover design, and effects on plasma uric acid, fractional uric acid excretion, and 24-hour uric acid excretion were measured.ResultsIn the Renoprotective Effects of Dapagliflozin in Type 2 Diabetes study, compared with the fasted state (5.3±1.1 mg/dl), acute hyperinsulinemia and hyperglycemia significantly reduced plasma uric acid by 0.2±0.3 and 0.4±0.3 mg/dl (both P
      PubDate: 2022-05-06T10:00:31-07:00
      DOI: 10.2215/CJN.11480821
      Issue No: Vol. 17, No. 5 (2022)
       
  • GWAS of Hematuria

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      Authors: Gagliano Taliun, S. A; Sulem, P, Sveinbjornsson, G, Gudbjartsson, D. F, Stefansson, K, Paterson, A. D, Barua, M.
      Pages: 672 - 683
      Abstract: Background and objectivesGlomerular hematuria has varied causes but can have a genetic basis, including Alport syndrome and IgA nephropathy.Design, setting, participants, & measurementsWe used summary statistics to identify genetic variants associated with hematuria in White British UK Biobank participants. Individuals with glomerular hematuria were enriched by excluding participants with genitourinary conditions. A strongly associated locus on chromosome 2 (COL4A4-COL4A3) was identified. The region was reimputed using the Trans-Omics for Precision Medicine Program followed by sequential rounds of regional conditional analysis, conditioning on previous genetic signals. Similarly, we applied conditional analysis to identify independent variants in the MHC region on chromosome 6 using imputed HLA haplotypes.ResultsIn total, 16,866 hematuria cases and 391,420 controls were included. Cases had higher urinary albumin-creatinine compared with controls (women: 13.01 mg/g [8.05–21.33] versus 12.12 mg/g [7.61–19.29]; P
      PubDate: 2022-05-06T10:00:31-07:00
      DOI: 10.2215/CJN.13711021
      Issue No: Vol. 17, No. 5 (2022)
       
  • APOL1 Kidney Risk Variants and Proteomics

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      Authors: Chen, T. K; Surapaneni, A. L, Arking, D. E, Ballantyne, C. M, Boerwinkle, E, Chen, J, Coresh, J, Köttgen, A, Susztak, K, Tin, A, Yu, B, Grams, M. E.
      Pages: 684 - 692
      Abstract: Background and objectivesThe APOL1 risk variants (G1 and G2) are associated with kidney disease among Black adults, but the clinical presentation is heterogeneous. In mouse models and cell systems, increased gene expression of G1 and G2 confers cytotoxicity. How APOL1 risk variants relate to the circulating proteome warrants further investigation.Design, setting, participants, & measurementsAmong 461 African American Study of Kidney Disease and Hypertension (AASK) participants (mean age: 54 years; 41% women; mean GFR: 46 ml/min per 1.73 m2), we evaluated associations of APOL1 risk variants with 6790 serum proteins (measured via SOMAscan) using linear regression models. Covariates included age, sex, percentage of European ancestry, and protein principal components 1–5. Associated proteins were then evaluated as mediators of APOL1-associated risk for kidney failure. Findings were replicated among 875 Atherosclerosis Risk in Communities (ARIC) study Black participants (mean age: 75 years; 66% women; mean eGFR: 67 ml/min per 1.73 m2).ResultsIn the AASK study, having two (versus zero or one) APOL1 risk alleles was associated with lower serum levels of APOL1 (P=3.11E-13; P=3.12E-06 [two aptamers]), APOL2 (P=1.45E-10), CLSTN2 (P=2.66E-06), MMP-2 (P=2.96E-06), SPOCK2 (P=2.57E-05), and TIMP-2 (P=2.98E-05) proteins. In the ARIC study, APOL1 risk alleles were associated with APOL1 (P=1.28E-11); MMP-2 (P=0.004) and TIMP-2 (P=0.007) were associated only in an additive model, and APOL2 was not available. APOL1 high-risk status was associated with a 1.6-fold greater risk of kidney failure in the AASK study; none of the identified proteins mediated this association. APOL1 protein levels were not associated with kidney failure in either cohort.ConclusionsAPOL1 risk variants were strongly associated with lower circulating levels of APOL1 and other proteins, but none mediated the APOL1-associated risk for kidney failure. APOL1 protein level was also not associated with kidney failure.
      PubDate: 2022-05-06T10:00:31-07:00
      DOI: 10.2215/CJN.14701121
      Issue No: Vol. 17, No. 5 (2022)
       
  • Apixaban versus Warfarin for Treatment of Venous Thromboembolism in
           Patients Receiving Long-Term Dialysis

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      Authors: Wetmore, J. B; Herzog, C. A, Yan, H, Reyes, J. L, Weinhandl, E. D, Roetker, N. S.
      Pages: 693 - 702
      Abstract: Background and objectivesThe association of apixaban compared with warfarin for the treatment of venous thromboembolism in patients receiving maintenance dialysis is not well studied.Design, setting, participants, & measurementsWe conducted a retrospective cohort study of Medicare fee-for-service beneficiaries receiving dialysis using United States Renal Data System data from 2013 to 2018. The study included patients who received a new prescription for apixaban or warfarin following a venous thromboembolism diagnosis. The outcomes were recurrent venous thromboembolism, major bleeding, and death. Outcomes were analyzed using Cox proportional hazards regression for intention-to-treat and censored-at-drug-switch-or-discontinuation analyses. Models incorporated inverse probability of treatment and censoring weights to minimize confounding and informative censoring.ResultsIn 12,206 individuals, apixaban, compared with warfarin, was associated with lower risks of both recurrent venous thromboembolism (hazard ratio [HR], 0.58; 95% confidence interval [95% CI], 0.43 to 0.77) and major bleeding (HR, 0.78; 95% CI, 0.62 to 0.98) in the intention-to-treat analysis over 6 months of follow-up. However, there was no difference between apixaban and warfarin in terms of risk of all-cause death (HR, 1.04; 95% CI, 0.94 to 1.16). Corresponding hazard ratios for the 6-month censored-at-drug-switch-or-discontinuation analysis and for corresponding analyses limited to a shorter (3-month) follow-up were all highly similar to the primary analysis.ConclusionsIn a large group of US patients on dialysis with recent venous thromboembolism, we observed that apixaban was associated with lower risk of recurrent venous thromboembolism and of major bleeding than warfarin. There was no observed difference in mortality.
      PubDate: 2022-05-06T10:00:31-07:00
      DOI: 10.2215/CJN.14021021
      Issue No: Vol. 17, No. 5 (2022)
       
  • Implementation of a Staff-Assisted Peritoneal Dialysis Program in the
           United States: A Feasibility Study

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      Authors: Hussein, W. F; Bennett, P. N, Anwaar, A, Atwal, J, Legg, V, Abra, G, Zheng, S, Pravoverov, L, Schiller, B.
      Pages: 703 - 705
      PubDate: 2022-05-06T10:00:31-07:00
      DOI: 10.2215/CJN.00940122
      Issue No: Vol. 17, No. 5 (2022)
       
  • The Intensivist's Perspective of Shock, Volume Management, and Hemodynamic
           Monitoring

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      Authors: Kashani, K; Omer, T, Shaw, A. D.
      Pages: 706 - 716
      Abstract: One of the primary reasons for intensive care admission is shock. Identifying the underlying cause of shock (hypovolemic, distributive, cardiogenic, and obstructive) may lead to entirely different clinical pathways for management. Among patients with hypovolemic and distributive shock, fluid therapy is one of the leading management strategies. Although an appropriate amount of fluid administration might save a patient's life, inadequate (or excessive) fluid use could lead to more complications, including organ failure and mortality due to either hypovolemia or volume overload. Currently, intensivists have access to a wide variety of information sources and tools to monitor the underlying hemodynamic status, including medical history, physical examination, and specific hemodynamic monitoring devices. Although appropriate and timely assessment and interpretation of this information can promote adequate fluid resuscitation, misinterpretation of these data can also lead to additional mortality and morbidity. This article provides a narrative review of the most commonly used hemodynamic monitoring approaches to assessing fluid responsiveness and fluid tolerance. In addition, we describe the benefits and disadvantages of these tools.
      PubDate: 2022-05-06T10:00:31-07:00
      DOI: 10.2215/CJN.14191021
      Issue No: Vol. 17, No. 5 (2022)
       
  • Overview of Diagnostic Criteria and Epidemiology of Acute Kidney Injury
           and Acute Kidney Disease in the Critically Ill Patient

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      Authors: Birkelo, B. C; Pannu, N, Siew, E. D.
      Pages: 717 - 735
      Abstract: Since the description ischuria renalis by William Heberden (1), AKI has remained a prominent complication of critical illness. Beyond KRT, treatment has been limited by the capacity to phenotype this condition. Here, we chronicle the evolution of attempts to classify AKI, including the adoption of consensus definitions, the expansion of diagnosis and prognosis with novel biomarkers, and emerging tools such as artificial intelligence (AI).
      PubDate: 2022-05-06T10:00:31-07:00
      DOI: 10.2215/CJN.14181021
      Issue No: Vol. 17, No. 5 (2022)
       
  • The Transition of a Pediatric Kidney Transplant Recipient from Childhood
           to Adult Care

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      Authors: Bell; L. E.
      Pages: 736 - 738
      PubDate: 2022-05-06T10:00:31-07:00
      DOI: 10.2215/CJN.14991121
      Issue No: Vol. 17, No. 5 (2022)
       
  • Recurrent Podocytopathy after Kidney Transplantation

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      Authors: Garg, N; Djamali, A.
      Pages: 739 - 741
      PubDate: 2022-05-06T10:00:31-07:00
      DOI: 10.2215/CJN.15891221
      Issue No: Vol. 17, No. 5 (2022)
       
  • Changing the Trajectory of Heart Failure and Kidney Disease: A Call for
           Action

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      Authors: Rangaswami, J; Bhalla, V, Chertow, G. M, Harrington, R. A, Staruschenko, A, Tuttle, K, Braunwald, E.
      Pages: 742 - 745
      PubDate: 2022-05-06T10:00:31-07:00
      DOI: 10.2215/CJN.00470122
      Issue No: Vol. 17, No. 5 (2022)
       
  • SARS-CoV-2 Vaccine Mandates for Patients on the Kidney Transplant
           Waitlist: Are They Ethical'

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      Authors: Tallaa, F; Gunaratnam, L, Suri, R. S.
      Pages: 746 - 748
      PubDate: 2022-05-06T10:00:31-07:00
      DOI: 10.2215/CJN.15611121
      Issue No: Vol. 17, No. 5 (2022)
       
  • Mass Transport in High-Flux Hemodialysis: Application of Engineering
           Principles to Clinical Prescription

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      Authors: Mohajerani, F; Clark, W. R, Ronco, C, Narsimhan, V.
      Pages: 749 - 756
      Abstract: An understanding of the processes underlying mass transfer is paramount for the attainment of adequate solute removal in the dialytic treatment of patients with kidney failure. In this review, engineering principles are applied to characterize the physical mechanisms behind the two major modes of mass transfer during hemodialysis, namely diffusion and convection. The manner in which flow rate, dialyzer geometry, and membrane microstructure affect these processes is discussed, with concepts such as boundary layers, effective membrane diffusivity, and sieving coefficients highlighted as critical considerations. The objective is to improve clinicians’ understanding of these concepts as important factors influencing the prescription and delivery of hemodialysis therapy.
      PubDate: 2022-05-06T10:00:31-07:00
      DOI: 10.2215/CJN.09410721
      Issue No: Vol. 17, No. 5 (2022)
       
  • Detecting and Treating Lung Congestion with Kidney Failure

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      Authors: Zoccali, C; Mallamaci, F, Picano, E.
      Pages: 757 - 765
      Abstract: Fluid overload is a common complication in patients with CKD, particularly patients with kidney failure, a population with a very high risk for pulmonary edema. Lung ultrasound is now a well-validated technique that allows for reliable estimates of lung water in clinical practice. Several studies in patients with kidney failure documented a high prevalence of asymptomatic lung congestion of moderate to severe degree in this population, and this alteration was only weakly related with fluid excess as measured by bioimpedance spectroscopy. Furthermore, in these studies, lung congestion correlated in a dose-dependent fashion with death risk. In the Lung Water by Ultra-Sound Guided Treatment to Prevent Death and Cardiovascular Complications in High Risk Kidney Failure Patients with Cardiomyopathy (LUST) trial, a treatment strategy guided by lung ultrasound safely relieved lung congestion but failed to significantly reduce the risk for a combined end point including death, nonfatal myocardial infarction, and decompensated heart failure. However, in line with three trials in patients with heart failure, a post hoc analysis of the LUST trial showed that the use of lung ultrasound reduces the risk for repeated episodes of acute heart failure and repeated cardiovascular events. Given the high cardiovascular risk of pulmonary edema in patients with predialysis CKD, defining the epidemiology of lung congestion in this population is a public health priority. Specific trials in this population and additional trials in patients with kidney failure will establish whether targeting lung congestion at an asymptomatic phase may improve the severe cardiovascular prognosis of both patients predialysis and patients on dialysis.
      PubDate: 2022-05-06T10:00:31-07:00
      DOI: 10.2215/CJN.14591121
      Issue No: Vol. 17, No. 5 (2022)
       
 
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