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Effect of the human papillomavirus vaccine on the risk of genital warts: a nationwide cohort study of Korean adolescent girls
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Jaeyoung Cho, Eun Mi Kim, Jihye Kim, Ju-Young Shin, Eui Hyeok Kim, Jong Heon Park, Seunghyun Lewis Kwon, Geun-Yong Kwon, Soon-Ae Shin, Jaiyong Kim
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Epidemiol Health. 2024;46:e2024040. Published online March 18, 2024
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DOI: https://doi.org/10.4178/epih.e2024040
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Abstract
OBJECTIVES The purpose of this study was to assess the effectiveness of human papillomavirus (HPV) vaccination administered to adolescent girls through Korea’s National Immunization Program.
METHODS This retrospective cohort study included patients who were 12-13 years old, whether vaccinated or unvaccinated, between July 2016 and December 2017. The incidence of genital warts (GWs) was monitored through 2021. Time-stratified hazard ratios (HRs) were estimated, adjusting for birth year, socioeconomic status, and the level of urbanization of the region, and were presented with 95% confidence intervals (CIs). Data were sourced from the Immunization Registry Integration System, linked with the National Health Information Database.
RESULTS The study included 332,062 adolescent girls, with an average follow-up period of approximately 4.6 years. Except for the first year, the HRs for the vaccinated group were lower than those for the unvaccinated group. The HRs for specific cut-off years were as follows: year 2, 0.62 (95% CI, 0.31 to 1.13); year 3, 0.58 (95% CI, 0.35 to 0.96); and year 4 and beyond, 0.39 (95% CI, 0.28 to 0.52).
CONCLUSIONS Our findings indicate that HPV vaccination was associated with a reduction in the risk of GWs among adolescent girls. Notably, this reduction became significant as the incidence of GWs increased with age.
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Summary
Korean summary
이 연구는 후향적 코호트 연구로써, HPV 예방접종이 한국의 여자 청소년에서 생식기사마귀 질환의 위험을 감소시키는 것과 연관성이 있다는 것을 보여주었다. 따라서 단기적으로 한국의 국가예방접종 사업은 생식기사마귀 질환에 있어 효과가 있었다고 볼 수 있다. 향후에는 전암성 병변 또는 암 등과 같은 심각한 질환에 대한 백신의 영향을 확인할 필요가 있다.
Key Message
In this retrospective cohort study, our results demonstrated that HPV vaccination is associated with a reduction in the risk of GWs among adolescent girls. In the short term, the NIP of Korea can be considered effective in providing protection against GWs. Future studies need to analyze the impact of vaccines on more serious diseases such as precancerous lesions or cancer.
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Risk of cancer, cardiovascular disease, thromboembolism, and mortality in patients with rheumatoid arthritis receiving Janus kinase inhibitors: a real-world retrospective observational study using Korean health insurance data
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Hong Ki Min, Hyeongsu Kim, Ho Jin Jeong, Se Hee Kim, Hae-Rim Kim, Sang-Heon Lee, KunSei Lee, Soon-Ae Shin, Jong Heon Park
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Epidemiol Health. 2023;45:e2023045. Published online April 15, 2023
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DOI: https://doi.org/10.4178/epih.e2023045
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Abstract
OBJECTIVES This study investigated whether Janus kinase inhibitors (JAKis) raise the risk of cardiovascular disease (CVD), venous thromboembolism (VTE), and cancer in patients with rheumatoid arthritis (RA).
METHODS We conducted a real-world retrospective observational study using data obtained from the Korean National Health Insurance Service database. Two data sets were analyzed: tumor necrosis factor inhibitor (TNFi)/JAKi-naive RA patients (set 1) and all RA patients who used TNFis or JAKis (set 2). The incidence rate ratios (IRRs) and hazard ratios (HRs) for acute myocardial infarction (AMI), stroke, cardiovascular (CV)-related mortality, major adverse cardiovascular events (MACE), VTE, arterial thromboembolism (ATE), cancer, and all-cause mortality were compared between the JAKi and TNFi groups.
RESULTS Set 1 included 1,596 RA patients (JAKi group: 645; TNFi group: 951), and set 2 included 11,765 RA patients (JAKi group: 2,498; TNFi group: 9,267). No adverse events (AEs) showed significantly higher IRRs in the JAKi groups than in the TNFi groups of sets 1 and 2. The HRs for MACE in the JAKi groups of sets 1 and 2 were 0.59 (95% confidence [CI], 0.35 to 0.99) and 0.80 (95% CI, 0.67 to 0.97), respectively. The JAKi group of set 2 showed a significantly higher risk of all-cause mortality (HR, 1.71; 95% CI, 1.32 to 2.20), but the other AEs did not demonstrate increased risks in the JAKi groups.
CONCLUSIONS In this study, JAKis did not increase the risk of AMI, stroke, CV-related mortality, MACE, VTE, ATE, or cancer in Korean RA patients relative to TNFis.
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Summary
Korean summary
1. 한국인 류마티스관절염 환자를 대상으로 한 실제임상자료 결과, JAK 억제제가 종양괴사인자 억제제에 비해 심혈관질환, 혈전증, 암 등의 심각한 부작용을 증가시키지는 않았다.
2. 본 연구를 토대로 한국인 대상자에서 JAK 억제제가 심혈관질환 등의 심각한 부작용을 증가시키는지에 대한 재평가가 필요하다.
Key Message
1. The real word-data based results showed that risks of MACE, thromboembolism, and cancers were not increased in Korean RA patients with JAK inhibitor when compared to Korean RA patients with TNF inhibitors.
2. Therefore, the risk of serious adverse events of JAK inhibitors in Korean population should be reconsidered and reassessed before adding black box warning of JAK inhibitors.
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Citations
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- Multicenter evaluation of tofacitinib retention and safety in rheumatoid arthritis – why cardiovascular risk factors do not equate to overt risk
Anna Felis-Giemza, Mateusz Moskal, Krzysztof Proc, Zbigniew Guzera, Marcin Stajszczyk, Karolina Palej, Kornelia Chmurzyńska, Piotr Wiland, Krzysztof Batko, Bogdan Batko Rheumatology.2024; 61(6): 414. CrossRef - Biologics Versus JAK Inhibitors. Part I: Cancer Risk. A Narrative Review
Miguel Mansilla-Polo, Daniel Morgado-Carrasco Dermatology and Therapy.2024; 14(6): 1389. CrossRef - JAK inhibitor selectivity: new opportunities, better drugs?
Anniina Virtanen, Francesca Romana Spinelli, Jean Baptiste Telliez, John J. O’Shea, Olli Silvennoinen, Massimo Gadina Nature Reviews Rheumatology.2024; 20(10): 649. CrossRef - Safety and Effectiveness of Baricitinib in Chinese Patients with Moderate-to-Severe Rheumatoid Arthritis: 24-Week Results from a Post-Marketing Safety Study
Chan-yuan Wu, Qian Wang, Jian Shi, Xiu-ying Zhang, Rong Du, Jie-ruo Gu, Qi-huan Liu, Jiao Yu, Jia-wei Xu, Yan-jie Zhang, Hao Zhu, Meng-tao Li, Xiao-feng Zeng Rheumatology and Therapy.2023; 10(6): 1609. CrossRef - Comparative cardiovascular safety with janus kinase inhibitors and biological disease-modifying antirheumatic drugs as used in clinical practice: an observational cohort study from Sweden in patients with rheumatoid arthritis
Hannah Bower, Thomas Frisell, Daniela di Giuseppe, Benedicte Delcoigne, Johan Askling RMD Open.2023; 9(4): e003630. CrossRef - Are JAKis more effective among elderly patients with RA, smokers and those with higher cardiovascular risk? A comparative effectiveness study of b/tsDMARDs in Sweden
Hannah Bower, Thomas Frisell, Daniela di Giuseppe, Benedicte Delcoigne, Ulf Lindström, Carl Turesson, Katerina Chatzidionysiou, Elisabet Lindqvist, Ann Knight, Helena Forsblad-d'Elia, Johan Askling RMD Open.2023; 9(4): e003648. CrossRef
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The impact of COVID-19 on screening for colorectal, gastric, breast, and cervical cancer in Korea
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Hyeree Park, Seung Hee Seo, Jong Heon Park, Shin Hye Yoo, Bhumsuk Keam, Aesun Shin
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Epidemiol Health. 2022;44:e2022053. Published online June 21, 2022
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DOI: https://doi.org/10.4178/epih.e2022053
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Abstract
OBJECTIVES The coronavirus disease 2019 (COVID-19) pandemic has affected the utilization of healthcare services, including participation in cancer screening programs. We compared cancer screening participation rates for colorectal, gastric, breast, and cervical cancers among participants in the National Cancer Screening Program (NCSP) in 2019 and 2020 to address the potential distraction effect of COVID-19 on cancer screening.
METHODS Data from the NCSP for 4 cancer types (stomach, colorectal, breast, and cervical) in 2019 and 2020 were used to calculate cancer screening participation rates by calendar month, gender, age group, and geographical region. Monthly participation rates were analyzed per 1,000 eligible individuals.
RESULTS The screening participation rate decreased in 2020 compared to 2019 for all 4 cancers: colorectal (40.5 vs. 35.3%), gastric (61.9 vs. 54.6%), breast (63.8 vs. 55.8%), and cervical (57.8 vs. 52.2%) cancers. Following 2 major COVID-19 waves in March and December 2020, the participation rates in the 4 types of cancer screening dropped compared with those in 2019. The highest decline was observed in the elderly population aged 80 years and older (percentage change: -21% for colorectal cancer; -20% for gastric cancer; -26% for breast cancer; -20% for cervical cancer).
CONCLUSIONS After the 2 major COVID-19 waves, the screening participation rate for 4 types of cancer declined compared with 2019. Further studies are needed to identify the indirect effects of the COVID-19 pandemic on cancer patients, such as delayed diagnoses of cancer or excess cancer deaths.
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Summary
Korean summary
본 연구는 코로나 대유행 기간 전과 후 대장암, 위암, 유방암, 자궁경부암 검진 수검률 차이를 비교하고자 하였다. 첫 코로나 확진자가 발생한 2020년을 코로나 대유행 기간, 전년도 기간인 2019년을 코로나 대유행 전 기간으로 설정하며 국민건강보험공단에서 집계된 전수자료를 이용하여 암 검진 대상자 수와 수검자 수를 비교 분석하였다. 4개 암종 모두에서 2019년도와 비교하여 2020년도에 전국적으로 수검률이 감소하는 경향이 있었으며, 1차 대유행이 있었던 3월과 3차 대유행 시기인 12월에 2019년도 동기간과 비교하여 수검률이 크게 감소하였고, 80대 이상 노인 인구에서 감소폭이 다른 연령대와 비교하여 크게 나타났다.
Key Message
We found decline of the colorectal, gastric, breast and cervical cancer screening participation rates in 2020 following the two major COVID-19 waves, compared with those of 2019, and the highest decline was observed in the elderly population aged 80 years and older.
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Jinah Sim, Jihye Shin, Hyun Jeong Lee, Yeonseung Lee, Young Ae Kim, Chong-Chi Chiu PLOS ONE.2024; 19(2): e0296808. CrossRef - Access to colorectal cancer screening in populations in China, 2020: A coverage‐focused synthesis analysis
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Francisco Estupiñán-Romero, Santiago Royo-Sierra, Javier González-Galindo, Natalia Martínez-Lizaga, Petronille Bogaert, Nienke Schutte, Liesbet Van Eycken, Nancy Van Damme, Kris Henau, Ronan A Lyons, Sarah J Aldridge, Andrea Faragalli, Flavia Carle, Rosar European Journal of Public Health.2024; 34(Supplement): i50. CrossRef - Incidence trends of gastric cancer in the United States over 2000–2020: A population-based analysis
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Data resource profile: the allergic disease database of the Korean National Health Insurance Service
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Sunyong Yoo, Dong-Wook Kim, Young-Eun Kim, Jong Heon Park, Yeon-Yong Kim, Kyu-dong Cho, Mi-Ji Gwon, Jae-In Shin, Eun-Joo Lee
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Epidemiol Health. 2021;43:e2021010. Published online January 21, 2021
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DOI: https://doi.org/10.4178/epih.e2021010
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Abstract
Researchers have been interested in probing how the environmental factors associated with allergic diseases affect the use of medical services. Considering this demand, we have constructed a database, named the Allergic Disease Database, based on the National Health Insurance Database (NHID). The NHID contains information on demographic and medical service utilization for approximately 99% of the Korean population. This study targeted 3 major allergic diseases, including allergic rhinitis, atopic dermatitis, and asthma. For the target diseases, our database provides daily medical service information, including the number of daily visits from 2013 and 2017, categorized by patients’ characteristics such as address, sex, age, and duration of residence. We provide additional information, including yearly population, a number of patients, and averaged geocoding coordinates by <i>eup, myeon</i>, and <i>dong</i> district code (the smallest-scale administrative units in Korea). This information enables researchers to analyze how daily changes in the environmental factors of allergic diseases (e.g., particulate matter, sulfur dioxide, and ozone) in certain regions would influence patients’ behavioral patterns of medical service utilization. Moreover, researchers can analyze long-term trends in allergic diseases and the health effects caused by environmental factors such as daily climate and pollution data. The advantages of this database are easy access to data, additional levels of geographic detail, time-efficient data-refining and processing, and a de-identification process that minimizes the exposure of identifiable personal information. All datasets included in the Allergic Disease Database can be downloaded by accessing the National Health Insurance Service data sharing webpage (https://nhiss.nhis.or.kr).
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Summary
Korean summary
알레르기질환DB는 환경적 변화와 의료이용 연관성 연구를 지원하기 위해 만들어진 누구나 다운로드 가능한 공개용DB이다. 알레르기질환DB는 한국 전국민의 사회인구학적 특성 및 의료이용 정보가 구축되어 있는 국민건강보험공단의 국민건강정보DB를 활용하여 구축되었다. 알레르기질환DB는 2013년~2017년 알레르기성 비염, 아토피, 천식 상병코드로 청구된 의료이용 정보를 제공하고 있으며, 이를 활용하여 특정 지역에 다양한 환경적 변화와 의료이용과의 연관성 연구 등에 활발히 활용될 것으로 기대된다.
Key Message
The Allergic Disease Database based on the National Health Insurance Data is constructed for analyzing how environmental factors affect the use of medical services. The database provides most Korean medical service information of allergic diseases, such as allergic rhinitis, atopic dermatitis, and asthma from 2013 and 2017. This information enables researchers to study how daily changes of environmental factors in certain regions would influence patients’ behavioral patterns of medical service utilization. Moreover, researchers can analyze the long-term trend of allergic diseases, and health effects caused by environmental factors such as daily climate and pollution data.
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Sungho Bea, Dongwon Yoon, Han Eol Jeong, Juhong Jung, Seung-Mok Park, Juhee Jeon, Young-Min Ye, Jae-Hyun Lee, Ju-Young Shin Yonsei Medical Journal.2024; 65(2): 120. CrossRef - The relationship between exposure to environmental noise and risk of atopic dermatitis, asthma, and allergic rhinitis
Yongho Lee, Seunghyun Lee, Seula Park, Seong-Kyu Kang, June-Hee Lee, Dong-Wook Lee, Won-Jun Choi, Wanhyung Lee Ecotoxicology and Environmental Safety.2023; 268: 115677. CrossRef - Increased risk of cataract surgery in patients with allergic disease: a population based cohort study
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Family tree database of the National Health Information Database in Korea
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Yeon-Yong Kim, Hae-young Hong, Kyu-Dong Cho, Jong Heon Park
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Epidemiol Health. 2019;41:e2019040. Published online October 1, 2019
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DOI: https://doi.org/10.4178/epih.e2019040
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Abstract
We constructed the family tree database (DB) by using a new family code system that can logically express interpersonal family relationships and by comparing and complementing health insurance eligibility data and resident register data of the National Health Information Database (NHID). In the family tree DB, Parents and grandparents are matched for more than 95% of those who were born between 2010 and 2017. Codes for inverse relationships and extended relationships are generated using sequences of the three-digit basic family codes. The family tree DB contains variables such as sex, birth year, family relations, and degree of kinship (maximum of 4) between subjects and family members. Using the family tree DB, we find that prevalence rates of hypertension, diabetes, ischemic heart disease, cerebrovascular disease, and cancer are higher for those with family history. The family tree DB may omit some relationships due to incomplete past data, and some family relations cannot be uniquely determined because the source data only contain relationships between head and members of the household. The family tree DB is a part of the NHID, and researchers can submit requests for data on the website at http://nhiss.nhis.or.kr. Requested data will be provided after approval from the data service review board. However, the family tree DB can be limitedly provided for studies with high public value in order to maximize personal information protection.
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Summary
Korean summary
가족관계도(family tree) DB는 건강보험공단이 보유하는 건강보험 가입자정보와 행정전산망 정보를 바탕으로 가공·구축된 자료다. 4촌까지의 가족 관계를 파악할 수 있으며, 세대주 중심의 관계코드가 아닌 개인 단위의 논리적 기호로 구성된 관계코드를 통해 촌수, 계통, 성별을 구분하도록 하였다. 이를 바탕으로 의학적, 사회정책적으로 다양한 연구가 가능하다.
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Seon‐Mi Kim, Yujin Jeong, Yae Lim Kim, Minjung Kang, Eunjeong Kang, Hyunjin Ryu, Yunmi Kim, Seung Seok Han, Curie Ahn, Kook‐Hwan Oh Journal of the American Heart Association.2023;[Epub] CrossRef - Genograma y árbol genealógico
María Yanes-Rodríguez, María Concepción Cruz-Cánovas, Enrique José Gamero-de-Luna Medicina de Familia. SEMERGEN.2022; 48(3): 200. CrossRef - National General Health Screening Program in Korea: history, current status, and future direction
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Jin-Su Park, Chan Hee Lee Journal of Rheumatic Diseases.2021; 28(3): 119. CrossRef - Comparison between calcium channel blocker with angiotensin converting enzyme inhibitor or angiotensin II type 1 receptor blocker combination on the development of new-onset diabetes in hypertensive Korean patients
Yong Hoon Kim, Ae-Young Her, Seung-Woon Rha, Byoung Geol Choi, Se Yeon Choi, Jae Kyeong Byun, Dong Oh Kang, Won Young Jang, Woohyeun Kim, Ju Yeol Baek, Woong Gil Choi, Tae Soo Kang, Jihun Ahn, Sang-Ho Park, Sung Hun Park, Ji Yeon Hong, Ji Young Park, Min- Journal of Diabetes & Metabolic Disorders.2020; 19(1): 405. CrossRef
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Effects of living in the same region as one’s workplace on the total fertility rate of working women in Korea
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Yeon-Yong Kim, Hee-Jin Kang, Seongjun Ha, Jong Heon Park
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Epidemiol Health. 2019;41:e2019043. Published online October 9, 2019
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DOI: https://doi.org/10.4178/epih.e2019043
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Abstract
OBJECTIVES The lowest-low fertility status of Korea has continued for the past 17 years despite governmental efforts to encourage childbirth. As the number of working women has increased, their residence patterns have changed; however, the impact of this factor has yet to be explored. Therefore, this study was conducted to investigate the effects of residence patterns relative to the workplace on the total fertility rate of working women.
METHODS Information on eligibility and healthcare utilization was obtained from the National Health Information Database between 2011 and 2015. The study participants were working women aged 15-49 years. We classified their residence relative to their workplace into 3 patterns: same municipality, same province, and different province. The total fertility rate was calculated and logistic regression was performed of childbirth according to residence pattern, adjusting for age, insurance contribution quartile, size of the workplace, year of birth, and province of residence.
RESULTS The total fertility rates of working women from 2011 to 2015 were 1.091, 1.139, 1.048, 1.073, and 1.103, respectively. The total fertility rate by residence pattern was highest in women residing in the same municipality as their workplace. After adjustment, the odds of childbirth in women from the same municipality and the same province were 21.6% and 16.0% higher than those of women residing in a different province, respectively.
CONCLUSIONS The total fertility rate was higher among women living near their workplace. Therefore, effective policy measures should be taken to promote the proximity of working women’s workplace and residence.
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Summary
Korean summary
이 연구를 통하여 직장과 동일한 시군구에 거주하는 직장 여성의 출산율이 타 시군구 및 타 시도에 거주하는 경우보다 더 높게 나타나는 것을 확인하였다. 기존 인구사회학적 특성 위주의 출산 관련 연구에 비해 이 연구에서는 직장과 거주지의 차이의 영향을 확인하였다는 데 의의가 있다. 저출산 대책에 대한 다양한 정책적 접근이 요구되는 시점에 직장 여성의 출산율을 높이기 위하여 거주지 대책 등이 종합적으로 고려될 수 있음을 시사한다.
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Citations
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