Browse publications by year: 2008

Fulltext Words from the current editor of MJMS

Abdullah JM

Malays J Med Sci, 2008 Oct;15(4):1.
PMID: 22589627
Fulltext Why diagnosa was started

Majid MR

Malays J Med Sci, 2008 Oct;15(4):2.
PMID: 22589628
Fulltext Beginning of scientific publications in school of medical sciences, universiti sains malaysia

Chand P

Malays J Med Sci, 2008 Oct;15(4):3.
PMID: 22589629
Fulltext MJMS : the past and future

Embong M

Malays J Med Sci, 2008 Oct;15(4):5-7.
PMID: 22589631
MeSH terms: Periodicals as Topic
Fulltext MJMS and the challenges of a research university

Mohamed M

Malays J Med Sci, 2008 Oct;15(4):8.
PMID: 22589632
Life event, stress and illness

Salleh MR

Malays J Med Sci, 2008 Oct;15(4):9-18.
PMID: 22589633

The relationship between stress and illness is complex. The susceptibility to stress varies from person to person. Among the factors that influenced the susceptibility to stress are genetic vulnerability, coping style, type of personality and social support. Not all stress has negative effect. Studies have shown that short-term stress boosted the immune system, but chronic stress has a significant effect on the immune system that ultimately manifest an illness. It raises catecholamine and suppressor T cells levels, which suppress the immune system. This suppression, in turn raises the risk of viral infection. Stress also leads to the release of histamine, which can trigger severe broncho-constriction in asthmatics. Stress increases the risk for diabetes mellitus, especially in overweight individuals, since psychological stress alters insulin needs. Stress also alters the acid concentration in the stomach, which can lead to peptic ulcers, stress ulcers or ulcerative colitis. Chronic stress can also lead to plaque buildup in the arteries (atherosclerosis), especially if combined with a high-fat diet and sedentary living. The correlation between stressful life events and psychiatric illness is stronger than the correlation with medical or physical illness. The relationship of stress with psychiatric illness is strongest in neuroses, which is followed by depression and schizophrenia. There is no scientific evidence of a direct cause-and-effect relationship between the immune system changes and the development of cancer. However, recent studies found a link between stress, tumour development and suppression of natural killer (NK) cells, which is actively involved in preventing metastasis and destroying small metastases.
Fulltext Correlations between subdural empyema and paraclinical as well as clinical parameters amongst urban malay paediatric patients

Nayan SA, Abdullah MS, Naing NN, Haspani MS, Md Ralib AR

Malays J Med Sci, 2008 Oct;15(4):19-27.
PMID: 22589634 MyJurnal

Paediatric subdural empyema is frequently seen in developing Asean countries secondary to rinosinusogenic origins. A cross-sectional analysis on the surgical treatment of intracranial subdural empyema in Hospital Kuala Lumpur (HKL), a major referral center, was done in 2004. A total number of 44 children who fulfilled the inclusion criteria were included into this study. The methods of first surgery, volume of empyema on contrasted CT brain, improvement of neurological status, re-surgery, mortality and morbidity, as well as the demographic data such as age, gender, sex, duration of illness, clinical presentation, probable origin of empyema, cultures and follow-up were studied. Chi-square test was performed to determine the association between surgical methods and the survival of the patients, neurological improvement, clearance of empyema on CT brain, re-surgery and long morbidity among the survivors. If the 20% or more of the cells were having expected frequency less than five, then Fisher's Exact test was applied. The level of significance was set at 0.05. SPSS version 12.0 was used for data entry and data analysis. There were 44 patients who were less than 18 years. Their mean age was 5.90 ± 6.01 years. There were 30 males (68.2%) and 14 females (31.8%) involved in the study. Malays were majority with 28 (63.6%) followed by Indian 8 (18.2%), Chinese 5 (11.4%) and others 3 (6.8%). The variables which were under interest were gender, race, headache, vomiting, seizures, sign of meningism, cranial nerve palsy, thickness site of abscess, first surgical treatment, improvement in neurological deficit, clearance of CT and whether re-surgery was necessary. All variables were found not to be associated with Henk W Mauser Score for PISDE grading. Comparison between this urban study and a rural setting study by the same corresponding author in the same period on subdural empyema was done. Common parameters were compared and it was found out that seizures were more prevalent in urban study where the patients are more than one year old (p=0.005). Mortality was much higher in urban study than the rural one (p=0.040). The larger proportion of urban group had volume of abscess less than or equal to 50 ml (p=< 0.001).

MeSH terms: Abscess; Child; Child, Preschool; Cranial Nerve Diseases; Cross-Sectional Studies; Empyema; Female; Follow-Up Studies; Head; Headache; Humans; Infant; Malaysia; Male; Meningism; Seizures; Empyema, Subdural; Vomiting; Prevalence; Chi-Square Distribution
Fulltext Knowledge, attitude and practice of sawmill workers towards noise-induced hearing loss in kota bharu, kelantan

Rus RM, Daud A, Musa KI, Naing L

Malays J Med Sci, 2008 Oct;15(4):28-34.
PMID: 22589635

The purpose of this study was to determine the sawmill workers' knowledge, attitude and practice (KAP) in relation to noise-induced hearing loss (NIHL). A cross-sectional study was conducted involving 83 workers from 3 factories in Kota Bharu, Kelantan. Questionnaires were distributed to obtain the socio-demography, knowledge, attitude and practice level in relation to noise-induced hearing loss (NIHL). The weak areas identified in the knowledge section were treatment aspects (15.5%), signs and symptoms of NIHL (20.2%) and risk factors (31%). As for attitude; the prevention aspects were the lowest (25.3%), followed by risk taking attitude (26.2%), and causes of hearing loss (42.1%). Overall, the practice was not encouraging at all. It is important to have an education program to raise workers' awareness and to improve their attitude and practices towards noise-induced hearing loss.

MeSH terms: Cross-Sectional Studies; Deafness; Demography; Hearing Loss, Noise-Induced; Surveys and Questionnaires; Risk Factors; Risk-Taking
Evaluation of the management of sexually transmitted infections by private practitioners in pulau pinang, malaysia

Anwar M, Sulaiman SA

Malays J Med Sci, 2008 Oct;15(4):41-7.
PMID: 22589637 MyJurnal

To determine the current practices of private practitioners for the management of STIs in Pulau Pinang, Malaysia, evaluation of pharmacotherapy for STIs in private clinics and to ascertain the management of STIs compared to standard guidelines.
METHODS: Data was collected by self-administered questionnaire for private practitioners, which gathered information on their socio-demographic as well as practice characteristics. Descriptive statistical analysis was performed by using SPSS for Windows version 13.0.
RESULTS: Data was collected from 78 practitioners. Most of the treatment choices mentioned for the treatment of gonorrhea were inconsistent with the guidelines. About 51.2% of practitioners did not screen their patients for HIV/AIDS. Majority of private practitioners counseled their patients about HIV/AIDS on an irregular basis. A high percentage of 59% did not inform health authorities about STI cases and 32.1% mentioned that they did not use any guidelines.
CONCLUSIONS: Management of STIs by private practitioners with respect to selection of antibiotics, patient counseling and case notification leaves a lot to be desired. Current management practices can adversely impact on HIV/AIDS transmission in the country. Interventions are needed to improve the management practices of private practitioners.
Fulltext Functional outcome at 6 months in surgical treatment of spontaneous supratentorial intracerebral haemorrhage

Ghani AR, John JT, Idris Z, Ghazali MM, Murshid NL, Musa KI

Malays J Med Sci, 2008 Oct;15(4):48-55.
PMID: 22589638 MyJurnal

A prospective cohort study was done to evaluate the role of surgery in patients with spontaneous supratentorial intracerebral haemorrhage (SICH) and to identify predictors of outcome including the use of invasive regional cortical cerebral blood flow (rCoBF) and microdialysis. Surgery consisted of craniotomy or decompressive craniectomy. The ventriculostomy for intracranial pressure (ICP) monitoring and drainage and regional cortical cerebral blood flow (rCoBF) and microdialysis were performed in all subjects. Pre and post operative information on subjects were collected. The study end points was functional outcome at 6 months based on a dichotomised Glasgow Outcome Scale (GOS).The selected clinical, radiological, biochemical and treatment factors that may influence the functional outcome were analysed for their significance. A total of 36 patients were recruited with 27(75%) patients had Glasgow Coma Score (GCS) between 5 to 8 on admission and 9(25%) were admitted with GCS of 9. At 6 months, 86 % had a poor or unfavourable outcome (GOS I-III) and 14% had good or favourable outcome (GOS IV-V). The mortality rate at 6 months was 55%. Univariate analysis for the functional outcome identified 2 significant variables, the midline shift (p=0.013) and mean lactate:pyruvate ratio (p=0.038). Multivariate analysis identified midline shift as the single significant independent predictor of functional outcome (p=0.013).Despite aggressive regional cortical cerebral blood flow (rCoBF) and microdialysis study for detection of early ischemia, surgical treatment for spontaneous intracerebral haemorrhage only benefited a small number of patients in terms of favourable outcome (14%) and in the majority of patients (86%), the outcome was unfavourable. Patients with midline shift > 5mm has almost 21 times higher chances (adj) OR 20.8 of being associated with poor outcome (GOS I-III).

MeSH terms: Cerebral Hemorrhage; Cerebrovascular Circulation; Coma; Drainage; Humans; Intracranial Pressure; Lactates; Prospective Studies; Pyruvates; Regional Blood Flow; Ventriculostomy; Multivariate Analysis; Microdialysis; Glasgow Outcome Scale; Decompressive Craniectomy
Fulltext Delayed traumatic intracranial haemorrhage and progressive traumatic brain injury in a major referral centre based in a developing country

Jeng TC, Haspani MS, Adnan JS, Naing NN

Malays J Med Sci, 2008 Oct;15(4):56-67.
PMID: 22589639

A repeat Computer Tomographic (CT) brain after 24-48 hours from the 1(st) scanning is usually practiced in most hospitals in South East Asia where intracranial pressure monitoring (ICP) is routinely not done. This interval for repeat CT would be shortened if there was a deterioration in Glasgow Coma Scale (GCS). Most of the time the prognosis of any intervention may be too late especially in hospitals with high patient-to-doctor ratio causing high mortality and morbidity. The purpose of this study was to determine the important predictors for early detection of Delayed Traumatic Intracranial Haemorrhage (DTICH) and Progressive Traumatic Brain Injury (PTBI) before deterioration of GCS occurred, as well as the most ideal timing of repeated CT brain for patients admitted in Malaysian hospitals. A total of 81 patients were included in this study over a period of six months. The CT scan brain was studied by comparing the first and second CT brain to diagnose the presence of DTICH/PTBI. The predictors tested were categorised into patient factors, CT brain findings and laboratory investigations. The mean age was 33.1 ± 15.7 years with a male preponderance of 6.36:1. Among them, 81.5% were patients from road traffic accidents with Glasgow Coma Scale ranging from 4 - 15 (median of 12) upon admission. The mean time interval delay between trauma and first CT brain was 179.8 ± 121.3 minutes for the PTBI group. The DTICH group, 9.9% of the patients were found to have new intracranial clots. Significant predictors detected were different referral hospitals (p=0.02), total GCS status (p=0.026), motor component of GCS (p=0.043), haemoglobin level (p<0.001), platelet count (p=0.011) and time interval between trauma and first CT brain (p=0.022). In the PTBI group, 42.0% of the patients were found to have new changes (new clot occurrence, old clot expansion and oedema) in the repeat CT brain. Univariate statistical analysis revealed that age (p=0.03), race (p=0.035), types of admission (p=0.024), GCS status (p=0.02), pupillary changes (p=0.014), number of intracranial lesion (p=0.004), haemoglobin level (p=0.038), prothrombin time (p=0.016) as the best predictors of early detection of changes. Multiple logistics regression analysis indicated that age, severity, GCS status (motor component) and GCS during admission were significantly associated with second CT scan with changes. This study showed that 9.9% of the total patients seen in the period of study had DTICH and 42% had PTBI. In the early period after traumatic head injury, the initial CT brain did not reveal the full extent of haemorrhagic injury and associated cerebral oedema. Different referral hospitals of different trauma level, GCS status, motor component of the GCS, haemoglobin level, platelet count and time interval between trauma and the first CT brain were the significant predictors for DTICH. Whereas the key determinants of PTBI were age, race, types of admission, GCS status, pupillary changes, number of intracranial bleed, haemoglobin level, prothrombin time and of course time interval between trauma and first CT brain. Any patients who had traumatic head injury in hospitals with no protocol of repeat CT scan or intracranial pressure monitoring especially in developing countries are advised to have to repeat CT brain at the appropriate quickest time .

MeSH terms: Accidents, Traffic; Adolescent; Adult; Brain; Brain Edema; Brain Injuries; Developing Countries; Craniocerebral Trauma; Humans; Intracranial Pressure; Male; Middle Aged; Platelet Count; Prognosis; Prothrombin Time; Referral and Consultation; Tomography, X-Ray Computed; Glasgow Coma Scale; Intracranial Hemorrhage, Traumatic; Young Adult; Brain Injuries, Traumatic
Fulltext Stomach gastrointestinal stromal tumours (GIST) intussuscepted into duodenum : a case report

Siam FA, Siow SL

Malays J Med Sci, 2008 Oct;15(4):68-70.
PMID: 22589640

Gastrointestinal stromal tumours (GIST) are tumours of gastrointestinal tract and mesentery. The commonest site of its occurrence is the stomach. Patients with GIST are usually asymptomatic but they can present as abdominal pain, bleeding and rarely gastric outlet obstruction. In this particular case, the patient presents with symptoms of anaemia, partial gastric outlet obstruction and intermittent epigastric pain. Laparotomy was performed and a diagnosis of gastroduodenal intussusception secondary to gastrointestinal stromal tumour was made.

MeSH terms: Adult; Case Reports; Hospitals, General; Humans; Intussusception*; Malaysia; Male; Gastrointestinal Stromal Tumors*
Potential use of a monoclonal antibody for the detection of Candida antigens in an experimental systemic candidiasis model

Wong SF, Mak JW, Pook CK

Hybridoma (Larchmt), 2008 Oct;27(5):361-73.
PMID: 18823263 DOI: 10.1089/hyb.2008.0021

The Candida species are the most common fungal pathogens of systemic candidiasis. The diagnosis of invasive candidiasis remains a laboratory and clinical challenge. Thus, development of diagnostic assays to detect systemic candidiasis and to identify Candida virulence factors and associated pathogenesis through immunohistochemistry using specific monoclonals and polyclonals will be useful. Inbred Balb/c mice were immunized with C. albicans antigens, and blood was checked for the presence of reactive antibodies using ELISA. Fusion was performed using the harvested spleen cells and NS1 myeloma cells, and the clones were screened for the presence of antibody producing hybrid cells by dot-blot. Western blot analysis showed that the L2D10 monoclonal antibody was reactive against the antigens with molecular weight of 20 kDa. Experimental systemic candidiasis in mice was induced through intravenous injection of C. albicans and all the vital organs were collected for immunohistochemistry study. The monoclonal antibody reacted to surface epitopes on the yeast cells, germ tubes, and hyphae, and to immune complexes. It was used with the polyclonal antibody in a sandwich ELISA for the detection of circulating antigens in experimental candiadiasis in mice. Antibody levels were also determined using the ELISA method, and the antibody levels of C. albicans infected mice were increased compared with uninfected animals. The monoclonal antibody was used in immunoperoxidase and immunofluorescence techniques for the detection of fungal infection in tissue sections and was found to be more sensitive than conventional periodic acid Schiff or silver staining techniques. This monoclonal antibody may serve as potential primary capture antibodies for the development of a rapid diagnostic test for human systemic fungal infection.

MeSH terms: Animals; Antibodies, Monoclonal/immunology*; Antigens, Fungal/immunology*; Candida albicans/immunology; Candida albicans/isolation & purification; Candidiasis/blood*; Candidiasis/diagnosis; Candidiasis/microbiology; Humans; Mice, Inbred BALB C; Mice
Analysis of urinary andrographolides and antioxidant status after oral administration of Andrographis paniculata leaf extract in rats

Akowuah GA, Zhari I, Mariam A

Food Chem Toxicol, 2008 Dec;46(12):3616-20.
PMID: 18824206 DOI: 10.1016/j.fct.2008.09.008

A simple high-performance liquid chromatography (HPLC) method was developed to determine the content of andrographolide (AP) and 14-deoxy-11,12-dideoxyandrographolide (DIAP) in a pooled urine of rat obtained within 24h after an oral dose of Andrographis paniculata leaf extract at 1g/kg body weight. Cumulative urinary excretion of AP and DIAP in 24h after oral administration of the extract was 0.88% and 1.61% of oral dose administered, respectively. The extract showed significant reduction (p<0.05) of MDA levels and elevation of total antioxidant status in rat urine samples collected in 24 after oral administration.

MeSH terms: Administration, Oral; Animals; Antioxidants/metabolism*; Chromatography, High Pressure Liquid; Diterpenes/urine*; Plant Extracts/pharmacology; Reference Standards; Reproducibility of Results; Lipid Peroxidation/drug effects; Rats, Sprague-Dawley; Plant Leaves/chemistry; Andrographis/chemistry*; Rats
Effect of full and partial-bed configuration on carbon removal performance of biological aerated filters

Suja F, Donnelly T

Water Sci Technol, 2008;58(5):977-83.
PMID: 18824794 DOI: 10.2166/wst.2008.454

A comparative study to explore the characteristics of partially and fully packed biological aerated filters (BAFs) in the removal of carbon pollutant, reveals that the partial-bed reactor can perform comparably well with the full-bed reactor. The organic removal rate was 5.34 kg COD m(-3) d(-1) at Organic Loading Rates (OLR) 5.80+/-0.31 kg COD m(-3) d(-1) for the full-bed, and 5.22 kg COD m(-3) d(-1) at OLR 5.79+/-0.29 kg COD m(-3) d(-1) for the partial-bed. In the partial-bed system, where the masses of biomass were only 41-51% of those of the full-bed, the maximum carbon removal limit was still between 5 to 6 kg COD m(-3) d(-1). At organic loadings above 5.0 kg COD m(-3) d(-1), the carbon removal capacity in both systems was limited by the mass and activity of microorganisms. The SRT in the full and partial-bed reactors was primarily controlled by the biomass loss in the effluent and during backwash operation. The SRT was reduced from 20.08 days at OLR 4.18+/-0.20 kg COD m(-3) d(-1) to 7.62 days at OLR 5.80+/-0.31 kg COD m(-3) d(-1) in the full-bed, and from 7.17 days to 4.21 days in the partial-bed. After all, SRT values in the partial-bed were always lower than those in the full-bed.

MeSH terms: Carbon/isolation & purification*; Filtration/methods; Waste Disposal, Fluid/instrumentation*; Waste Disposal, Fluid/methods*; Water Microbiology; Reproducibility of Results; Biofilms; Bioreactors/microbiology
Isolation of dinucleotide microsatellite markers in commercially threatened Malaysian Mahseer, Tor tambroides

Bhassu S, Bakar Y, Rashid ZA

Genetika, 2008 Aug;44(8):1145-7.
PMID: 18825966

Seven single locus dinucleotide microsatellite markers were developed to characterize an economically important sport fish and food fish in Malaysia and in Southeast Asia. They were obtained by using a rapid method namely the 5' anchored PCR enrichment protocol. The specific primers were designed to flank the repeat sequences and these were subsequently used to characterize 120 unrelated fish from Malaysia and 30 fishes from Indonesia. The number of alleles per locus ranged from 2 (SYKVJ1-11) to 6 (SYKVJ1-4) while the levels of heterozygosity ranged from 0.0472 (SYKVJ1-11) to 0.7745 (SYKVJ1-2).

MeSH terms: Alleles*; Animals; Cypriniformes/genetics*; Heterozygote; Microsatellite Repeats/genetics*; Dinucleotide Repeats/genetics*; Quantitative Trait Loci/genetics*
Treatment with bindarit, an inhibitor of MCP-1 synthesis, protects mice against trinitrobenzene sulfonic acid-induced colitis

Bhatia M, Landolfi C, Basta F, Bovi G, Ramnath RD, de Joannon AC, et al.

Inflamm Res, 2008 Oct;57(10):464-71.
PMID: 18827968 DOI: 10.1007/s00011-008-7210-y

Chemokines play a fundamental role in trafficking and activation of leukocytes in colonic inflammation. We investigated the ability of bindarit, an inhibitor of monocyte chemoattractant protein-1 (MCP-1/CCL2) synthesis, to inhibit chemokine production by human intestinal epithelial cells (HT-29) and its effect in trinitro-benzene sulfonic acid (TNBS)-induced colitis in mice.

MeSH terms: Animals; Cells, Cultured; Colitis/chemically induced*; Colitis/drug therapy; Colitis/pathology; Colitis/prevention & control*; Epithelial Cells/cytology; Epithelial Cells/drug effects; Female; Humans; Interferon-gamma/immunology; Mice, Inbred BALB C; Trinitrobenzenesulfonic Acid/pharmacology*; Tumor Necrosis Factor-alpha/immunology; Disease Progression; Chemokine CCL2/antagonists & inhibitors*; Chemokine CCL2/genetics; Chemokine CCL2/metabolism; Mice
Polyphenols in cocoa and cocoa products: is there a link between antioxidant properties and health?

Jalil AM, Ismail A

Molecules, 2008 Sep 16;13(9):2190-219.
PMID: 18830150

Cocoa and cocoa products have received much attention due to their significant polyphenol contents. Cocoa and cocoa products, namely cocoa liquor, cocoa powder and chocolates (milk and dark chocolates) may present varied polyphenol contents and possess different levels of antioxidant potentials. For the past ten years, at least 28 human studies have been conducted utilizing one of these cocoa products. However, questions arise on which of these products would deliver the best polyphenol contents and antioxidant effects. Moreover, the presence of methylxanthines, peptides, and minerals could synergistically enhance or reduce antioxidant properties of cocoa and cocoa products. To a greater extent, cocoa beans from different countries of origins and the methods of preparation (primary and secondary) could also partially influence the antioxidant polyphenols of cocoa products. Hence, comprehensive studies on the aforementioned factors could provide the understanding of health-promoting activities of cocoa or cocoa products components.

MeSH terms: Animals; Antioxidants/pharmacology; Antioxidants/therapeutic use; Antioxidants/chemistry*; Blood Pressure/drug effects; Cacao/chemistry*; Flavonoids/pharmacology; Flavonoids/therapeutic use; Flavonoids/chemistry*; Humans; Phenols/pharmacology; Phenols/therapeutic use; Phenols/chemistry*; Xanthines/pharmacology; Xanthines/therapeutic use; Xanthines/chemistry; Lipid Peroxidation/drug effects; Molecular Structure; Polyphenols
Fulltext Cystogastrocolic fold and associated atrophy of the gallbladder

Pamidi N, Nayak S, Vollala VR

Singapore Med J, 2008 Sep;49(9):e250-1.
PMID: 18830532

Peritoneal anomalies are common in humans. We report the presence of a cystogastrocolic fold associated with an abnormally small gallbladder in a 50-year-old male cadaver. Presence of this fold is one of the clinically important anomalies, which can result in atrophy of the gallbladder or congenital obstruction of the duodenum.

MeSH terms: Atrophy; Duodenum/pathology; Gallbladder/abnormalities*; Gallbladder/anatomy & histology*; Gallbladder/pathology*; Humans; Intestinal Obstruction/diagnosis*; Intestinal Obstruction/pathology; Liver/pathology; Male; Middle Aged; Peritoneum/abnormalities; Peritoneum/pathology; Stomach/pathology
Fulltext Multiple accessory structures in the upper limb of a single cadaver

Vollala VR, Nagabhooshana S, Bhat SM, Potu BK, Rakesh V

Singapore Med J, 2008 Sep;49(9):e254-8.
PMID: 18830534

The arterial and muscular variations of the upper limbs are common but important with regard to surgical approaches. Even though anomalies of the coracobrachialis muscle are rare, anatomical variations of the biceps brachii, existence of the accessory muscles in the forearm and persistent median artery are known and well documented. During routine dissection, we observed some important anatomical variations in a 50-year-old male cadaver. The variations were unilateral. The anomalies were: third head for biceps brachii muscle, an accessory belly for coracobrachialis muscle crossing the median nerve and brachial vessels and continuing with the medial head of triceps brachii muscle to be inserted to the olecranon process (coracoulnaris), a persistent median artery and an additional muscle in the anterior compartment of forearm. Although there are individual reports about these variations, the combination of these variations in one cadaver has not previously been described in the literature. Awareness of these variations is necessary to avoid complications during radiodiagnostic procedures or surgeries in the upper limb.

MeSH terms: Arm/blood supply*; Arm/innervation*; Brachial Artery/pathology; Humans; Male; Middle Aged; Models, Anatomic; Muscle, Skeletal/abnormalities*; Muscle, Skeletal/pathology*

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