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The devil in the details—Unpacking functional recovery after ileal pouch-anal anastomosis 细节中的魔鬼——回肠袋-肛管吻合术后的开封功能恢复
IF 2.7 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-11-14 DOI: 10.1111/codi.70312
Xiaoyu Wang
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引用次数: 0
Robotic revision of ileoanal pouch–in situ pouch inlet reimplantation for chronic stricture: A video vignette 慢性狭窄的回肠袋-原位袋口再植术的机器人修正:视频短片。
IF 2.7 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-11-14 DOI: 10.1111/codi.70301
Stravodimos Georgios, Giannos Georgios, Lee Yu Jin, Celentano Valerio
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引用次数: 0
Concerns on the statistical methodology and incomplete reporting of patient information in the long-term outcomes of biologic therapy for prepouch ileitis 关注统计方法学和不完整的患者信息报告在生物治疗前回肠炎的长期结果
IF 2.7 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-11-14 DOI: 10.1111/codi.70309
Yuzhou Zhu, Ziqiang Wang
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引用次数: 0
Does the impact of a colostomy on quality of life change with time? – Prospective evaluation in rectal cancer patients 结肠造口术对生活质量的影响是否随时间而改变?-直肠癌患者的前瞻性评价
IF 2.7 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-11-14 DOI: 10.1111/codi.70305
Helle Ø Kristensen, Peter Christensen, Ismail Gögenur, Karen Irene Jacobsen, Therese Juul, Sissel Ravn, Marianne Krogsgaard

Aim

Improved outcomes after treatment for rectal cancer (RC) have resulted in more long-term survivors, some with a permanent colostomy. The challenges associated with a stoma may impact health-related quality of life (HRQoL) and change over time. We report changes in stoma-related sequelae and HRQoL from a prospective follow-up program.

Methods

Patients were included from a systematic late sequelae screening program using patient-reported outcome measures. Patients undergoing RC surgery with a permanent colostomy were included. Patients completed the colostomy impact (CI) score and EuroQol five-dimensional five-level (EQ-5D-5L) at 3, 12, 24 and 36 months after surgery. CI scores and mean EQ-5D-5L scores were compared, and multivariable regression analysis was performed to explore potential risk factors for major CI at 12 months.

Results

A total of 301 patients (34% female) were included, with a mean age of 71.2 years. Median CI scores, EQ-5D-5L index and EQ-5D-5L visual analogue scale scores remained unchanged. However, the distribution of the individual symptoms composing the CI score changed from 3 to 12 months, with more smell and leakage, more parastomal bulging and better self-care. Between 3 and 12 months, 27% of patients shifted CI category and around 20% of patients shifted category at 2 and 3 years post surgery. Logistic regression showed a significantly higher risk of major CI at 12 months in younger patients, patients with higher American Society of Anaesthesiologists scores, preoperative radiotherapy or postoperative complications.

Conclusion

Stoma-related sequelae change during the first years after surgery. However, this is not reflected in CI Score or generic HRQoL.

目的改善直肠癌(RC)治疗后的预后,导致更多的长期幸存者,其中一些人进行了永久性结肠造口。与造口相关的挑战可能会影响健康相关的生活质量(HRQoL),并随着时间的推移而改变。我们报告了前瞻性随访项目中气孔相关后遗症和HRQoL的变化。方法采用患者报告的结果测量方法,从系统性晚期后遗症筛查项目中纳入患者。接受RC手术和永久性结肠造口术的患者也包括在内。患者分别于术后3、12、24、36个月完成结肠造口影响(CI)评分和EuroQol五维五水平(EQ-5D-5L)。比较CI评分与EQ-5D-5L平均评分,并进行多变量回归分析,探讨12个月时主要CI的潜在危险因素。结果共纳入301例患者,其中女性34%,平均年龄71.2岁。CI评分中位数、EQ-5D-5L指数和EQ-5D-5L视觉模拟量表评分保持不变。然而,构成CI评分的个体症状分布在3 - 12个月内发生变化,气味和渗漏更多,造口旁鼓胀更多,自我保健更好。在术后3 - 12个月,27%的患者转移CI类别,约20%的患者在术后2 - 3年转移CI类别。Logistic回归显示,年龄较小的患者、美国麻醉学会评分较高的患者、术前放疗或术后并发症在12个月时发生严重CI的风险明显较高。结论术后1年内与造口相关的后遗症有所改变。然而,这并不反映在CI评分或一般HRQoL中。
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引用次数: 0
Risk of re-operation after incision and drainage for acute, abscess-forming pilonidal sinus disease: A Danish population-based cohort study 急性脓肿形成的毛突窦疾病切开引流后再手术的风险:一项丹麦人群队列研究
IF 2.7 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-11-14 DOI: 10.1111/codi.70307
Ida Kaad Faurschou, Rune Erichsen, Dietrich Doll, Susanne Haas

Background

Acute abscess-forming pilonidal sinus disease (PSD) is treated surgically, with lateral incision and drainage (I&D) considered the gold standard; however, the risk of re-operation is unknown.

Aim

To evaluate re-operation rates following abscess-forming PSD treatment with lateral I&D, and to identify factors influencing re-operation rates.

Methods

Using data from nationwide Danish databases covering 2010–2021, we identified patients diagnosed with abscess-forming PSD undergoing lateral I&D as the initial treatment for PSD. Patients were followed up until re-operation, death, emigration, or the end of the study period. Stratified by sex, the risk of re-operation was reported as a cumulative incidence function (CIF). To explore risks, we used Cox regression analysis to calculate crude and age-adjusted hazard ratios (aHR).

Results

Of 8251 (62% male) patients included, 2455 underwent re-operation for PSD. The overall five-year CIF was 32% for males and 33% for females. In males, the five-year CIF decreased from 47% among 0- to 16-year-olds to 14% among 50+ year-olds. In females, the corresponding numbers were 37% and 13%, respectively. A family history of PSD was found to increase re-operation risk, especially among female patients (aHR: 1.64 (95% confidence interval [95% CI]: 1.39–1.93)). The risk increases following the second and third consecutive I&D procedures to 52% and 69% in males, and to 57% and 64% in females, respectively.

Conclusion

As roughly two-thirds of patients do not require additional surgery, our findings do not support mandatory follow-up with definitive surgery for all PSD patients undergoing I&D. For certain high-risk subgroups, however, subsequent definitive surgery may be appropriate.

背景:急性脓肿形成的毛鞘窦疾病(PSD)是外科治疗,侧边切开和引流(I&;D)被认为是金标准;然而,再次手术的风险尚不清楚。目的评价外侧I&;D治疗形成脓肿的PSD后的再手术率,并探讨影响再手术率的因素。方法利用2010-2021年丹麦全国数据库的数据,我们确定了诊断为脓肿形成的PSD的患者,他们接受了外侧I&;D作为PSD的初始治疗。随访患者至再次手术、死亡、移民或研究期结束。按性别分层,再手术风险以累积发生率函数(CIF)报告。为了探索风险,我们使用Cox回归分析计算粗风险比和年龄调整风险比(aHR)。结果8251例患者(62%为男性)中,2455例因PSD再次手术。5年的总体CIF为男性32%,女性33%。在男性中,5年CIF从0- 16岁的47%下降到50岁以上的14%。在女性中,相应的数字分别为37%和13%。有PSD家族史会增加再手术风险,尤其是女性患者(aHR: 1.64(95%可信区间[95% CI]: 1.39-1.93))。在连续第二次和第三次I&;D手术后,男性的风险分别增加到52%和69%,女性分别增加到57%和64%。结论:由于大约三分之二的患者不需要额外的手术,我们的研究结果不支持对所有接受I&;D的PSD患者进行强制性随访和最终手术。然而,对于某些高危亚群,随后的最终手术可能是合适的。
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引用次数: 0
Laparoscopic right hemicolectomy with CME-CVL, with intracorporeal ileotransverse anastomosis using the ASPIRE technique – A video vignette 腹腔镜右半结肠切除术加CME-CVL,采用ASPIRE技术进行体内回肠横切吻合术-视频片段。
IF 2.7 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-11-11 DOI: 10.1111/codi.70304
Gaurav R. Kumar, Karthikeyan Parthasarathy, Pavan Sugoor
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引用次数: 0
Clinical efficacy of subsensory sacral neuromodulation in adults with faecal incontinence: The SUBSoNIC crossover randomised controlled trial and cohort follow-up study 亚感觉骶神经调节治疗成人大便失禁的临床疗效:亚音速交叉随机对照试验和队列随访研究。
IF 2.7 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-11-11 DOI: 10.1111/codi.70308
Paul F. Vollebregt, Yan Li Goh, Anil Bagul, Claire Chan, Tom Dudding, Paul Furlong, Shaheen Hamdy, Joanne Haviland, Richard Hooper, James Jones, Eleanor McAlees, Christine Norton, P. Ronan O'Connell, Michael Powar, S. Mark Scott, Natasha Stevens, Kerry Tubby, Sian Worthen, Yuk Lam Wong, Charles H. Knowles

Aim

Sacral neuromodulation (SNM) is considered the first-line surgical treatment in adults with refractory faecal incontinence (FI). However, its clinical efficacy has not been rigorously tested in a trial setting.

Method

Randomised, multicentre, double-blind crossover trial (two 16-week periods) of active stimulation versus sham, and open-label follow-up to 58 weeks. Participants: adults aged 18–80 with refractory FI. Interventions: Active: subsensory sacral nerve stimulation with an implanted pulse generator; Sham: identical implant but turned off. Primary outcome: FI episodes per week (paper bowel diary) during final 4 weeks of crossover periods (allowing 12 weeks' washout). Randomised allocation (1:1) to arm 1 (SNM/sham) or arm 2 (sham/SNM). Blinding: participants, surgeons, assessors; tamper-proof tape-masked stimulation settings. Sample size: 80 patients to detect a 30% reduction in episodes. Groups compared using a paired t-test, and treatment effects summarised by mean differences.

Results

Trial delivery was severely affected by COVID-19. Thirty-nine patients of 220 screened (arm 1: N = 17; arm 2: N = 22) were recruited at 10 sites (February 2018–July 2022), of whom only 16 (arm 1: N = 9; arm 2: N = 7) had complete primary outcome data. Of the 39, 19 completed follow-up to 58 weeks. SNM conferred a non-significant reduction in mean FI episodes per week compared to sham (−0.795 [95% CI: −1.5 to 0.0], p = 0.06). Improvements were observed in FI symptoms at 58 weeks compared to baseline (FI episodes per week: 3.2 [SD 3.3] vs. 6.2 [SD 5.9]).

Conclusions

The SUBSoNIC trial failed to find conclusive evidence of the experimental efficacy of SNM. Further demonstration of experimental efficacy remains important as SNM is a high-cost and invasive therapy.

目的:骶神经调节(SNM)被认为是成人难治性尿失禁(FI)的一线手术治疗方法。然而,其临床疗效尚未在试验环境中经过严格测试。方法:随机,多中心,双盲交叉试验(两个16周的周期),积极刺激与假刺激,开放标签随访至58周。参与者:18-80岁的难治性FI患者。干预:主动:植入脉冲发生器刺激骶下神经;假:相同的植入,但关闭。主要结局:最后4周交叉期每周FI发作(纸质肠道日记)(允许12周洗脱期)。随机分配(1:1)至组1 (SNM/sham)或组2 (sham/SNM)。盲法:参与者、外科医生、评估员;防篡改磁带屏蔽刺激设置。样本量:80例患者检测到发作减少30%。组间比较采用配对t检验,治疗效果由均数差异总结。结果:新冠肺炎疫情严重影响试验交付。在10个地点(2018年2月至2022年7月)招募了220名筛查患者中的39名(第1组:N = 17;第2组:N = 22),其中只有16名(第1组:N = 9;第2组:N = 7)具有完整的主要结局数据。39例中,19例完成了58周的随访。与假手术组相比,SNM组每周平均FI发作数无显著减少(-0.795 [95% CI: -1.5至0.0],p = 0.06)。与基线相比,58周时观察到FI症状的改善(每周FI发作:3.2次[SD 3.3]对6.2次[SD 5.9])。结论:亚音速试验未能找到确凿的证据证明SNM的实验效果。由于SNM是一种高成本和侵入性的治疗方法,因此进一步证明实验疗效仍然很重要。
{"title":"Clinical efficacy of subsensory sacral neuromodulation in adults with faecal incontinence: The SUBSoNIC crossover randomised controlled trial and cohort follow-up study","authors":"Paul F. Vollebregt,&nbsp;Yan Li Goh,&nbsp;Anil Bagul,&nbsp;Claire Chan,&nbsp;Tom Dudding,&nbsp;Paul Furlong,&nbsp;Shaheen Hamdy,&nbsp;Joanne Haviland,&nbsp;Richard Hooper,&nbsp;James Jones,&nbsp;Eleanor McAlees,&nbsp;Christine Norton,&nbsp;P. Ronan O'Connell,&nbsp;Michael Powar,&nbsp;S. Mark Scott,&nbsp;Natasha Stevens,&nbsp;Kerry Tubby,&nbsp;Sian Worthen,&nbsp;Yuk Lam Wong,&nbsp;Charles H. Knowles","doi":"10.1111/codi.70308","DOIUrl":"10.1111/codi.70308","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Sacral neuromodulation (SNM) is considered the first-line surgical treatment in adults with refractory faecal incontinence (FI). However, its clinical efficacy has not been rigorously tested in a trial setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Randomised, multicentre, double-blind crossover trial (two 16-week periods) of active stimulation versus sham, and open-label follow-up to 58 weeks. Participants: adults aged 18–80 with refractory FI. Interventions: <i>Active</i>: subsensory sacral nerve stimulation with an implanted pulse generator; <i>Sham</i>: identical implant but turned off. Primary outcome: FI episodes per week (paper bowel diary) during final 4 weeks of crossover periods (allowing 12 weeks' washout). Randomised allocation (1:1) to arm 1 (SNM/sham) or arm 2 (sham/SNM). Blinding: participants, surgeons, assessors; tamper-proof tape-masked stimulation settings. Sample size: 80 patients to detect a 30% reduction in episodes. Groups compared using a paired <i>t</i>-test, and treatment effects summarised by mean differences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Trial delivery was severely affected by COVID-19. Thirty-nine patients of 220 screened (arm 1: <i>N</i> = 17; arm 2: <i>N</i> = 22) were recruited at 10 sites (February 2018–July 2022), of whom only 16 (arm 1: <i>N</i> = 9; arm 2: <i>N</i> = 7) had complete primary outcome data. Of the 39, 19 completed follow-up to 58 weeks. SNM conferred a non-significant reduction in mean FI episodes per week compared to sham (−0.795 [95% CI: −1.5 to 0.0], <i>p</i> = 0.06). Improvements were observed in FI symptoms at 58 weeks compared to baseline (FI episodes per week: 3.2 [SD 3.3] vs. 6.2 [SD 5.9]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The SUBSoNIC trial failed to find conclusive evidence of the experimental efficacy of SNM. Further demonstration of experimental efficacy remains important as SNM is a high-cost and invasive therapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 11","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12605715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145494644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
D3 lymphadenectomy in nonagenarians: Clarifying confounding, endpoints and reporting 老年D3淋巴结切除术:澄清混淆,终点和报告。
IF 2.7 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-11-10 DOI: 10.1111/codi.70310
Lielong Yang, Ziqiang Wang, Song Bin, Yuzhou Zhu
{"title":"D3 lymphadenectomy in nonagenarians: Clarifying confounding, endpoints and reporting","authors":"Lielong Yang,&nbsp;Ziqiang Wang,&nbsp;Song Bin,&nbsp;Yuzhou Zhu","doi":"10.1111/codi.70310","DOIUrl":"10.1111/codi.70310","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 11","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145488092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comment on: Analysis of preoperative predictors for pouchitis after surgery for ulcerative colitis: A multicentre retrospective study of the clinical outcome of surgery for ulcerative colitis in Japan (COSUC study) 评论:溃疡性结肠炎术后袋炎的术前预测因素分析:日本溃疡性结肠炎手术临床结果的多中心回顾性研究(COSUC研究)。
IF 2.7 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-11-10 DOI: 10.1111/codi.70306
Yanqi Cheng, Dongmei Luo, Ying Sun
{"title":"Comment on: Analysis of preoperative predictors for pouchitis after surgery for ulcerative colitis: A multicentre retrospective study of the clinical outcome of surgery for ulcerative colitis in Japan (COSUC study)","authors":"Yanqi Cheng,&nbsp;Dongmei Luo,&nbsp;Ying Sun","doi":"10.1111/codi.70306","DOIUrl":"10.1111/codi.70306","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 11","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145488122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
World's first live AI-assisted augmented reality (AR) robotic colon surgery with instrument deocclusion: Navigating the future of surgery 世界上第一个现场人工智能辅助增强现实(AR)机器人结肠手术与器械去闭塞:导航手术的未来。
IF 2.7 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-11-10 DOI: 10.1111/codi.70296
Thalia Petropoulou, Jente Simoens, Andreas Polydorou, Pieter De Backer, Alex Mottrie

Artificial intelligence (AI) and augmented reality (AR) are transforming the landscape of minimally invasive surgery. We present the world's first live integration of an AI-assisted AR overlay with real-time instrument deocclusion in robotic colorectal surgery.

A real surgical case of robotic right colectomy was performed using a da Vinci Xi platform enhanced by an AI-driven AR system. The technology generated three-dimensional anatomical overlays while simultaneously applying instrument deocclusion algorithms to maintain continuous visualization of critical anatomy (Video 1).

The procedure was successfully completed without conversion, demonstrating the technical feasibility of combining AI-based overlays and deocclusion in a complex intraoperative environment. The system allowed stable AR guidance despite dynamic camera movements and instrument interference. From the operating surgeon's perspective, the AR overlay was useful, non-disruptive to workflow, and enhanced anatomical orientation. These impressions are preliminary and require validation in prospective studies.

This proof-of-concept highlights the feasibility of AI-assisted AR with instrument deocclusion in robotic colorectal surgery and represents an important step toward digital surgery of the future. While no formal outcomes or structured user assessments were collected in this initial demonstration, future studies will focus on systematic evaluation of usability, surgeon feedback, and clinical performance metrics.

Thalia Petropoulou: Conceptualization; investigation; writing – original draft; methodology; validation; visualization; writing – review and editing; formal analysis. Jente Simoens: Methodology; validation; software. Andreas Polydorou: Investigation; validation; supervision. Pieter De Backer: Conceptualization; methodology; validation; software; formal analysis; data curation. Alex Mottrie: Methodology; validation; software; supervision.

No funding was used.

No conflict of interest between the authors.

This study was conducted in accordance with the ethical standards of the 1964 Helsinki Declaration and its later amendments.

人工智能(AI)和增强现实(AR)正在改变微创手术的格局。我们在机器人结肠直肠手术中展示了世界上第一个人工智能辅助AR覆盖与实时仪器去闭塞的实时集成。使用由人工智能驱动的AR系统增强的达芬奇Xi平台进行了一个真实的机器人右结肠切除术病例。该技术生成三维解剖叠加,同时应用器械去闭塞算法来保持关键解剖的连续可视化(视频1)。该手术成功完成,无需转换,证明了在复杂的术中环境下将基于ai的覆盖与去咬合相结合的技术可行性。该系统允许稳定的AR制导,尽管动态相机运动和仪器干扰。从外科医生的角度来看,AR覆盖是有用的,不会干扰工作流程,并增强了解剖方向。这些印象是初步的,需要在前瞻性研究中验证。这一概念验证强调了人工智能辅助AR在机器人结肠直肠手术中的可行性,并代表了未来数字化手术的重要一步。虽然在最初的演示中没有收集到正式的结果或结构化的用户评估,但未来的研究将集中在可用性、外科医生反馈和临床表现指标的系统评估上。Thalia Petropoulou:概念化;调查;写作——原稿;方法;验证;可视化;写作——审阅和编辑;正式的分析。Jente Simoens:方法论;验证;软件。Andreas Polydorou:调查;验证;监督。Pieter De Backer:概念化;方法;验证;软件;正式的分析;数据管理。Alex motrie:方法论;验证;软件;监督。没有使用任何资金。作者之间无利益冲突。这项研究是按照1964年《赫尔辛基宣言》及其后来的修正案的道德标准进行的。
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引用次数: 0
期刊
Colorectal Disease
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