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Dravid A, Sung WS, Song J, Dubey A, Eftekhar B. Subarachnoid Haemorrhage Incidence Pattern Analysis with Circular Statistics. Emerg Med Int 2024; 2024:6631990. [PMID: 38655008 PMCID: PMC11039014 DOI: 10.1155/2024/6631990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 09/27/2023] [Accepted: 03/28/2024] [Indexed: 04/26/2024] Open
Abstract
Knowledge about biological rhythms of diseases may not only help in understanding the pathophysiology of diseases but can also help health service policy makers and emergency department directors to allocate resources efficiently. Aneurysmal subarachnoid haemorrhage (SAH) has high rates of morbidity and mortality. The incidence of SAH has been attributed to patient-related factors such as characteristics of aneurysms, smoking, and hypertension. There are studies showing that the incidence of aneurysmal SAH appears to behave in periodic fashions over long time periods. However, there are inconsistencies in the literature regarding the impact of chronobiological factors such as circadian, seasonal, and lunar cycle factors on the occurrence of SAH. In this study, we focused on the analysis of a temporal pattern of SAH (infradian rhythms) with a novel approach using circular statistical methods. We aimed to see whether there is a circular pattern for the occurrence of SAH at all and if so, whether it can be related to known temporal patterns based on available literature. Our study did not support the notion that aneurysmal subarachnoid haemorrhages occur on any specific day in a cycle with specific lengths up to 365 days including specific weekdays, full moon, equinoxes, and solstices. Hence, we found no relationship between SAH incidence and timing. Study in larger populations using similar circular statistical methods is suggested.
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Affiliation(s)
- Ashish Dravid
- Department of Neurosurgery, Nepean Hospital, The University of Sydney, Sydney, Australia
| | - Wen-Shan Sung
- Department of Neurosurgery, Royal Hobart Hospital, Hobart, Australia
| | - Jeeuk Song
- Department of Neurosurgery, Royal Hobart Hospital, Hobart, Australia
| | - Arvind Dubey
- Department of Neurosurgery, Royal Hobart Hospital, Hobart, Australia
| | - Behzad Eftekhar
- Department of Neurosurgery, Nepean Hospital, The University of Sydney, Sydney, Australia
- Department of Neurosurgery, Australian School of Advanced Medicine, Macquarie University, Sydney, Australia
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Uddin M, Nursetyo AA, Iqbal U, Nguyen PA, Jian WS, Li YC, Syed-Abdul S. Assessment of effects of moon phases on hospital outpatient visits: An observational national study. AIMS Public Health 2023; 10:324-332. [PMID: 37304591 PMCID: PMC10251051 DOI: 10.3934/publichealth.2023024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 03/08/2023] [Accepted: 03/12/2023] [Indexed: 06/13/2023] Open
Abstract
Objectives A vast amount of literature has been conducted for investigating the association of different lunar phases with human health; and it has mixed reviews for association and non-association of diseases with lunar phases. This study investigates the existence of any impact of moon phases on humans by exploring the difference in the rate of outpatient visits and type of diseases that prevail in either non-moon or moon phases. Methods We retrieved dates of non-moon and moon phases for eight years (1st January 2001-31st December 2008) from the timeanddate.com website for Taiwan. The study cohort consisted of 1 million people from Taiwan's National Health Insurance Research Database (NHIRD) followed over eight years (1st January 2001-31st December 2008). We used the two-tailed, paired-t-test to compare the significance of difference among outpatient visits for 1229 moon phase days and 1074 non-moon phase days by using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes from NHIRD records. Results We found 58 diseases that showed statistical differences in number of outpatient visits in the non-moon and moon phases. Conclusions The results of our study identified diseases that have significant variations during different lunar phases (non-moon and moon phases) for outpatient visits in the hospital. In order to fully understand the reality of the pervasive myth of lunar effects on human health, behaviors and diseases, more in-depth research investigations are required for providing comprehensive evidence covering all the factors, such as biological, psychological and environmental aspects.
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Affiliation(s)
- Mohy Uddin
- Research Quality Management Section, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard - Health Affairs, Riyadh, Kingdom of Saudi Arabia
| | | | - Usman Iqbal
- Health ICT, Department of Health, Tasmania, Australia
- Global Health and Health Security Department, College of Public Health, Taipei Medical University, Taipei, Taiwan
- International Center for Health Information Technology, Taipei Medical University, Taiwan
| | - Phung-Anh Nguyen
- Clinical Data Center, Office of Data Science, Taipei Medical University, Taipei, Taiwan
- Clinical Big Data Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- Research Center of Health Care Industry Data Science, College of Management, Taipei Medical University, Taipei, Taiwan
| | - Wen-Shan Jian
- School of Hospital Health care Administration, Taipei Medical University, Taiwan. No 250 Wu-Hsing Street, Taipei 110, Taiwan
| | - Yu-Chuan Li
- International Center for Health Information Technology, Taipei Medical University, Taiwan
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taiwan. No 250 Wu-Hsing Street, Taipei 110, Taiwan
- Research Center of Cancer Translational Medicine, Taipei Medical University, Taiwan
| | - Shabbir Syed-Abdul
- International Center for Health Information Technology, Taipei Medical University, Taiwan
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taiwan. No 250 Wu-Hsing Street, Taipei 110, Taiwan
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Asano S. Meteorological and demographic factors associated with the onset of acute appendicitis in rural islands of Japan. SURGERY IN PRACTICE AND SCIENCE 2022. [DOI: 10.1016/j.sipas.2022.100128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Bjursten H, Oudin Åström D, Nozohoor S, Ahmad K, Tang M, Bjurbom M, Hansson EC, Jeppsson A, Joost Holdflod Møller C, Jormalainen M, Juvonen T, Mennander A, Olsen PS, Olsson C, Ahlsson A, Oudin A, Pan E, Raivio P, Wickbom A, Sjögren J, Geirsson A, Gudbjartsson T, Zindovic I. Once after a full moon: acute type A aortic dissection and lunar phases. Interact Cardiovasc Thorac Surg 2022; 34:105-110. [PMID: 34999801 PMCID: PMC8743114 DOI: 10.1093/icvts/ivab220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 06/26/2021] [Accepted: 07/13/2021] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVES Acute type A aortic dissection (ATAAD) is a rare but severe condition, routinely treated with emergent cardiac surgery. Many surgeons have the notion that patients with ATAAD tend to come in clusters, but no studies have examined these observations. This investigation was undertaken to study the potential association between the lunar cycle and the incidence of ATAAD. METHODS We collected information on 2995 patients who underwent ATAAD surgery at centres from the Nordic Consortium for Acute Type A Aortic Dissection collaboration. We cross-referenced the time of surgery with lunar phase using a case-crossover design with 2 different definitions of full moon (>99% illumination and the 7-day full moon period). RESULTS The period when the moon was illuminated the most (99% definition) did not show any significant increase in incidence for ATAAD surgery. However, when the full moon period was compared with all other moon phases, it yielded a relative risk of 1.08 [95% confidence interval (CI) 1.00-1.17, P = 0.057] and, compared to waxing moon, only the relative risk was 1.11 (95% CI 1.01-1.23, P = 0.027). The peak incidence came 4-6 days after the moon was fully illuminated. CONCLUSIONS This study found an overrepresentation of surgery for ATAAD during the full moon phase. The explanation for this is not known, but we speculate that sleep deprivation during full moon leads to a temporary increase in blood pressure, which in turn could trigger rupture of the aortic wall. While this finding is interesting, it needs to be corroborated and the clinical implications are debateable.
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Affiliation(s)
- Henrik Bjursten
- Department of Cardiothoracic Surgery, Lund University, Skåne University Hospital, Lund, Sweden
| | - Daniel Oudin Åström
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
- Division of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Shahab Nozohoor
- Department of Cardiothoracic Surgery, Lund University, Skåne University Hospital, Lund, Sweden
| | - Khalil Ahmad
- Department of Thoracic and Cardiovascular Surgery, Aarhus University Hospital, Skejby, Denmark
| | - Mariann Tang
- Department of Thoracic and Cardiovascular Surgery, Aarhus University Hospital, Skejby, Denmark
| | - Markus Bjurbom
- Department of Thoracic and Cardiovascular Surgery, Karolinska University Hospital, Stockholm, Sweden
| | - Emma C Hansson
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Anders Jeppsson
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden
| | | | - Miko Jormalainen
- Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland
| | - Tatu Juvonen
- Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland
- Research Unit of Surgery, Anesthesia, and Critical Care, University of Oulu, Oulu, Finland
| | - Ari Mennander
- Heart Centre, Tampere University Hospital and University of Tampere, Tampere, Finland
| | - Peter S Olsen
- Department of Cardiothoracic Surgery, Centre for Cardiac, Vascular, Pulmonary and Infectious Diseases, Rigshospitalet, Copenhagen, Denmark
| | - Christian Olsson
- Department of Thoracic and Cardiovascular Surgery, Karolinska University Hospital, Stockholm, Sweden
| | - Anders Ahlsson
- Department of Thoracic and Cardiovascular Surgery, Karolinska University Hospital, Stockholm, Sweden
| | - Anna Oudin
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
- Division of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Emily Pan
- Department of Surgery, Central Finland Central Hospital, Jyväskylä, Finland
- Turku University Hospital, Turku, Finland
| | - Peter Raivio
- Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland
| | - Anders Wickbom
- Department of Cardiothoracic and Vascular Surgery, Orebro University Hospital and Faculty of Medicine and Health, Orebro University, Orebro, Sweden
| | - Johan Sjögren
- Department of Cardiothoracic Surgery, Lund University, Skåne University Hospital, Lund, Sweden
| | - Arnar Geirsson
- Section of Cardiac Surgery, Yale University School of Medicine, New Haven, CT, USA
- Department of Cardiothoracic Surgery, Landspitali University Hospital and Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Tomas Gudbjartsson
- Department of Cardiothoracic Surgery, Landspitali University Hospital and Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Igor Zindovic
- Department of Cardiothoracic Surgery, Lund University, Skåne University Hospital, Lund, Sweden
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Wang RR, Hao Y, Chen J, Wang MQ, Zheng RY, Shi LS, He J. Sex differences in the effects of the moon on ischemic stroke incidence: new findings from Beijing, China. Chronobiol Int 2020; 37:935-945. [PMID: 32654529 DOI: 10.1080/07420528.2019.1696811] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Stroke is a major cause of death and disability in China, and no therapies have proven effective to prevent it. Popular belief holds that the lunar cycle affects human physiology, behavior, and health. The aim of our study is to determine whether the lunar cycle impacts the incidence of stroke subtypes [intracerebral hemorrhage (ICH), transient ischemic attack (TIA) and ischemic stroke (IS)]. We retrospectively extracted the discharge registry data of all patients with first-ever acute stroke hospitalized in the affiliated hospital of Beijing University of Traditional Chinese Medicine during 2002-2015. The onset times of stroke were assigned to four primary lunar phases based on NASA definitions. Chi-square tests and multiple logistic regression analyses were used to estimate the association between the lunar cycle and stroke incidence with adjustment for age, sex and season. A total of 5,965 patients with stroke (4,909 admissions for ischemic stroke IS, 754 admissions for ICH, and 302 admissions for TIA) were evaluated in our study. Subgroup analysis indicated that the admission rates of different sexes for IS tended to have opposite variation during the four moon phases. More female patients were admitted during the new moon than in the first and third quarters, while fewer male patients were admitted during the new moon than in the first and third quarters (χ2 = 15.589, P = .001). Multiple logistic regression analyses revealed that men were more likely to be admitted for IS in the first quarter than during the new moon (odds ratio [OR] = 1.252, 95% confidence interval [CI] = 1.076-1.456) (P = .004), and a corresponding trend was also identified for the third quarter (OR = 1.235, 95% CI = 1.062-1.437) (P = .006). No significant gender differences were shown in ICH or TIA. No sex difference is obvious during the full moon. Moon phases seem to affect both genders, but in very different ways. It seems that the new moon is a protective factor for male ischemic stroke patients and a risk factor for female ones. Woman tends to be more vulnerable than ever at the new moon, so deserves more attention and care. The mechanisms underlying this observation are worth studying further.
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Affiliation(s)
- Ran-Ran Wang
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine , Beijing, China
| | - Yu Hao
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine , Beijing, China
| | - Jian Chen
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine , Beijing, China
| | - Meng-Qi Wang
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine , Beijing, China
| | - Ruo-Yun Zheng
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine , Beijing, China
| | - Ling-Sheng Shi
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine , Beijing, China
| | - Juan He
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine , Beijing, China
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Role of bioclimate conditions on cerebral aneurysm rupture in the Brittany region of France. Neurochirurgie 2019; 66:9-15. [PMID: 31836487 DOI: 10.1016/j.neuchi.2019.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 08/30/2019] [Accepted: 11/03/2019] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Subarachnoid hemorrhage (SAH) from intracranial aneurysm rupture is an unpredictable event responsible for significant morbidity and mortality. Despite inconsistencies, some studies suggest a potential role of climate conditions in SAH onset. The purpose of this study was to determine the impact of climatic and lunar factors on onset of SAH in an oceanic climate such as that of Brittany, France. METHODS All adults with SAH admitted to the neurosurgery department and intensive care unit of the University Hospital of Rennes (France) between January 1st, 2011 and December 31st, 2012 were included. Meteorological variables, their variations, lunar phases and tidal coefficients were compared between days with and without SAH. RESULTS We retrospectively included 295 patients with SAH. Mean minimum temperature was significantly lower during days with SAH (7.7±4.7°C versus 8.3±4.6°C; P=0.039); temperature variation between 2 successive days was significantly greater for days with SAH (8.6±4.1°C versus 7.9±3.8°C; P<0.01). Multivariate analysis showed that a 2-day temperature drop greater than or equal to 8°C was associated with 35% increased risk of SAH (odds ratio 1.35 [1.03-1.77]). There were no significant effects of other meteorological variables, lunar phase or tidal coefficient on SAH occurrence. CONCLUSION Low temperature and sudden temperature drop were associated with increased occurrence of SAH in Brittany, France.
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Affiliation(s)
- Hisato Takagi
- Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan.,Department of Cardiovascular Surgery, Kitasato University School of Medicine, Sagamihara, Japan
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Petridis AK, Kamp MA, Cornelius JF, Beez T, Beseoglu K, Turowski B, Steiger HJ. Aneurysmal Subarachnoid Hemorrhage. DEUTSCHES ARZTEBLATT INTERNATIONAL 2018; 114:226-236. [PMID: 28434443 DOI: 10.3238/arztebl.2017.0226] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 08/29/2016] [Accepted: 11/28/2016] [Indexed: 01/10/2023]
Abstract
BACKGROUND Aneurysmal subarachnoid hemorrhage (SAH) is associated with a mortality of more than 30%. Only about 30% of patients with SAB recover sufficiently to return to independent living. METHODS This article is based on a selective review of pertinent literature retrieved by a PubMed search. RESULTS Acute, severe headache, typically described as the worst headache of the patient's life, and meningismus are the characteristic manifestations of SAH. Computed tomog raphy (CT) reveals blood in the basal cisterns in the first 12 hours after SAH with approximately 95% sensitivity and specificity. If no blood is seen on CT, a lumbar puncture must be performed to confirm or rule out the diagnosis of SAH. All patients need intensive care so that rebleeding can be avoided and the sequelae of the initial bleed can be minimized. The immediate transfer of patients with acute SAH to a specialized center is crucially important for their outcome. In such centers, cerebral aneurysms can be excluded from the circulation either with an interventional endovascular procedure (coiling) or by microneurosurgery (clipping). CONCLUSION SAH is a life-threatening condition that requires immediate diagnosis, transfer to a neurovascular center, and treatment without delay.
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Affiliation(s)
- Athanasios K Petridis
- Department of Neurosurgery, Düsseldorf University Hospital; Department of Diagnostic and Interventional Radiology, Düsseldorf University Hospital; Department of Diagnostic and Interventional Radiology, Düsseldorf University Hospital
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Bunevicius A, Gendvilaite A, Deltuva VP, Tamasauskas A. The association between lunar phase and intracranial aneurysm rupture: Myth or reality? Own data and systematic review. BMC Neurol 2017; 17:99. [PMID: 28525979 PMCID: PMC5437543 DOI: 10.1186/s12883-017-0879-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Accepted: 05/09/2017] [Indexed: 11/24/2022] Open
Abstract
Background It is a common belief in medical community that lunar phases have an impact on human health. A growing body of evidence indicates that lunar phases can predict the risk to develop acute neurological and vascular disorders. The goal of present report was to present our institution data and to perform systematic review of studies examining the association of intracranial aneurysm rupture with moon phases. Methods We identified all patients admitted to our department for ruptured intracranial aneurysms in a period between November, 2011 and December, 2014. Patients with a known aneurysm rupture date were included. Lunar phases were determined by dividing lunar month (29.5 days) into eight equal parts, i.e., new moon, waxing crescent, first quarter, waxing gibbous, full moon, waning gibbous, last quarter and waning crescent. A systematic literature review was undertaken to identify studies that evaluated the association of lunar phases with the incident of intracranial aneurysm rupture. Result One hundred and eighty-six patients (62 men and 124 women, median age 56 years) were admitted to our department for treatment of ruptured intracranial aneurysms. The rate of intracranial aneurysm rupture was equally distributed across all phases of the lunar cycle (X2 [7; 185] = 12.280, p = 0.092). We identified three studies that evaluated the association between incident intracranial aneurysm rupture and lunar phases with a total of 1483 patients. One study from Lebanon found that the incidence rate of intracranial aneurysm rupture was statistically significantly greater during the new moon phase (25% cases), relative to the other seven lunar phases (p < 0.001). Two subsequent studies from Austria and Germany in larger patient samples (n = 717 and n = 655, respectively) did not find an association between lunar phases and intracranial aneurysm rupture (p-values of 0.84 and 0.97, respectively). When analyzing all four studies together, we did not find an association between lunar phases and incidence of intracranial aneurysm rupture (X2 [1668; 7] = 2.080, p = 0.955). Conclusions Moon phases are not associated with incidence of intracranial aneurysm rupture. Studies investigating the association of intracranial aneurysm rupture with lunar illumination defined using more sensitive approaches are encouraged.
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Affiliation(s)
- Adomas Bunevicius
- Institute of Neurosciences, Lithuanian University of Health Sciences, Eiveniu g. 2, LT-50009, Kaunas, Lithuania. .,Department of Neurosurgery, Hospital of Lithuanian University of Health Sciences Kaunas Clinics, Kaunas, Lithuania.
| | - Agne Gendvilaite
- Faculty of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Vytenis Pranas Deltuva
- Institute of Neurosciences, Lithuanian University of Health Sciences, Eiveniu g. 2, LT-50009, Kaunas, Lithuania.,Department of Neurosurgery, Hospital of Lithuanian University of Health Sciences Kaunas Clinics, Kaunas, Lithuania
| | - Arimantas Tamasauskas
- Institute of Neurosciences, Lithuanian University of Health Sciences, Eiveniu g. 2, LT-50009, Kaunas, Lithuania.,Department of Neurosurgery, Hospital of Lithuanian University of Health Sciences Kaunas Clinics, Kaunas, Lithuania
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Banfield JC, Abdolell M, Shankar JS. Secular pattern of aneurismal rupture with the lunar cycle and season. Interv Neuroradiol 2016; 23:60-63. [PMID: 27895241 DOI: 10.1177/1591019916675632] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background The lunar cycle and seasons may be associated with rates of rupture of intracranial aneurysms, but the literature is mixed. Studies of the association between the lunar cycle and rates of aneurysm rupture used the eight qualitative moon phases. The purpose of this study was to assess any association of aneurysm rupture with the lunar cycle and with the season. Materials and methods We retrospectively reviewed all cases of subarachnoid haemorrhage secondary to ruptured intracranial aneurysm treated with endovascular coiling in our institution over a 10-year period. We included only cases with a known rupture date. We used the degree of illumination of the moon to quantitatively code the lunar cycle. Results A total of 212 cases were included in our analyses. The odds of aneurysm rupture were significantly greater ( p < 0.001) when the moon was least (new moon) and most (full moon) illuminated, as compared to the middle of the lunar cycle. The odds of rupture tended to be higher ( p = 0.059) in the summer, compared to autumn. Conclusions The odds of aneurysm rupture were greater when the moon was least illuminated (new moon) and most illuminated (full moon), compared to the middle of the lunar cycle.
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Affiliation(s)
- Jillian C Banfield
- Department of Diagnostic Imaging, QE II Health Sciences Centre, Halifax, NS, Canada
| | - Mohamed Abdolell
- Department of Diagnostic Imaging, QE II Health Sciences Centre, Halifax, NS, Canada
| | - Jai S Shankar
- Department of Diagnostic Imaging, QE II Health Sciences Centre, Halifax, NS, Canada
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Bevington M. Lunar biological effects and the magnetosphere. PATHOPHYSIOLOGY 2015; 22:211-22. [DOI: 10.1016/j.pathophys.2015.08.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2012] [Revised: 08/12/2015] [Accepted: 08/28/2015] [Indexed: 12/24/2022] Open
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Piippo A, Niemelä M. Subarachnoid Hemorrhage: Brain Surgery or Rocket Science? World Neurosurg 2015; 84:634-5. [DOI: 10.1016/j.wneu.2015.04.035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 04/16/2015] [Indexed: 11/24/2022]
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Mao Y, Schnytzer Y, Busija L, Churilov L, Davis S, Yan B. “MOONSTROKE”: Lunar patterns of stroke occurrence combined with circadian and seasonal rhythmicity—A hospital based study. Chronobiol Int 2015; 32:881-8. [DOI: 10.3109/07420528.2015.1049614] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Stienen MN, Smoll NR, Battaglia M, Schatlo B, Woernle CM, Fung C, Roethlisberger M, Daniel RT, Fathi AR, Fandino J, Hildebrandt G, Schaller K, Bijlenga P. Intracranial Aneurysm Rupture Is Predicted by Measures of Solar Activity. World Neurosurg 2015; 83:588-95. [DOI: 10.1016/j.wneu.2014.12.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2014] [Accepted: 12/10/2014] [Indexed: 12/01/2022]
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Lai PMR, Dasenbrock H, Du R. The association between meteorological parameters and aneurysmal subarachnoid hemorrhage: a nationwide analysis. PLoS One 2014; 9:e112961. [PMID: 25393630 PMCID: PMC4231088 DOI: 10.1371/journal.pone.0112961] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2014] [Accepted: 10/16/2014] [Indexed: 02/05/2023] Open
Abstract
Prior research has suggested that regional weather patterns impact the risk of rupture of cerebral aneurysms, but the findings in the literature have been inconsistent. Furthermore, no nationwide analysis to date has examined the association between meteorological factors and the post-procedural outcomes of patients after the treatment for ruptured cerebral aneurysms. The purpose of this study was to use a nationwide sample to analyze the association between specific meteorological parameters—temperature, precipitation, sunlight, and humidity—and hospital admission rate for and outcome after aneurysmal subarachnoid hemorrhage. Patients were identified using the Nationwide Inpatient Sample (2001–2010): Those with an ICD-9 diagnosis code for subarachnoid hemorrhage and a procedural code for aneurysm repair were included. Climate data were obtained from the State of the Climate Report 2010 released by the National Climatic Data Center. Multivariate regression models were constructed to analyze the association between average state monthly temperature, precipitation, and percent possible sunlight, as well as relative morning humidity and both monthly hospital admission rate, adjusted for annual state population in millions, and in-hospital mortality. 16,970 admissions were included from 723 hospitals across 41 states. Decreased daily sunlight and lower relative humidity were associated with an increased rate of admission for ruptured cerebral aneurysms (p<0.001), but had no association with differential inpatient mortality. No significant changes in these observed associations were seen when multivariate analyses were constructed. This is the first nationwide study to suggest that decreased sunlight and lower relative humidity are associated with admission for ruptured cerebral aneurysms. While it has been postulated that external atmospheric factors may cause hormonal and homeostatic changes that impact the risk of rupture of cerebral aneurysms, additional research is needed to confirm and further understand these relationships.
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Affiliation(s)
- Pui Man Rosalind Lai
- Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
| | - Hormuzdiyar Dasenbrock
- Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
| | - Rose Du
- Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
- * E-mail:
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Rosenbaum BP, Weil RJ. Aneurysmal subarachnoid hemorrhage: relationship to solar activity in the United States, 1988-2010. ASTROBIOLOGY 2014; 14:568-576. [PMID: 24979701 DOI: 10.1089/ast.2014.1138] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Aneurysmal subarachnoid hemorrhage (SAH) is a common condition treated by neurosurgeons. The inherent variability in the incidence and presentation of ruptured cerebral aneurysms has been investigated in association with seasonality, circadian rhythm, lunar cycle, and climate factors. We aimed to identify an association between solar activity (solar flux and sunspots) and the incidence of aneurysmal SAH, all of which appear to behave in periodic fashions over long time periods. The Nationwide Inpatient Sample (NIS) provided longitudinal, retrospective data on patients hospitalized with SAH in the United States, from 1988 to 2010, who underwent aneurysmal clipping or coiling. Solar activity and SAH incidence data were modeled with the cosinor methodology and a 10-year periodic cycle length. The NIS database contained 32,281 matching hospitalizations from 1988 to 2010. The acrophase (time point in the cycle of highest amplitude) for solar flux and for sunspots were coincident. The acrophase for aneurysmal SAH incidence was out of phase with solar activity determined by non-overlapping 95% confidence intervals (CIs). Aneurysmal SAH incidence peaks appear to be delayed behind solar activity peaks by 64 months (95% CI; 56-73 months) when using a modeled 10-year periodic cycle. Solar activity (solar flux and sunspots) appears to be associated with the incidence of aneurysmal SAH. As solar activity reaches a relative maximum, the incidence of aneurysmal SAH reaches a relative minimum. These observations may help identify future trends in aneurysmal SAH on a population basis.
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Affiliation(s)
- Benjamin P Rosenbaum
- 1 Department of Neurosurgery, Neurological Institute, Cleveland Clinic , Cleveland, Ohio
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Shuhaiber JH, Fava JL, Shin T, Dobrilovic N, Ehsan A, Bert A, Sellke F. The influence of seasons and lunar cycle on hospital outcomes following ascending aortic dissection repair. Interact Cardiovasc Thorac Surg 2013; 17:818-22. [PMID: 23838340 PMCID: PMC3805194 DOI: 10.1093/icvts/ivt299] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2013] [Revised: 05/27/2013] [Accepted: 06/13/2013] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES The effect of the lunar cycle and seasonal variation on ascending aortic dissection surgery outcomes is unknown. We investigated these temporal effects on risk-adjusted hospital mortality and then on the length of stay (LOS) following surgery for survivors. METHODS We examined prospectively collected data from cardiac operations at two major centres within a single state between January 1996 and December 2011. We first examined the relationship between the lunar cycle and seasonal variation, along with demographic and risk profile covariates, with mortality using univariate analyses, followed by multiple logistic regression modelling that controlled for demographic and patient risk variables including age, gender, risk profile (diabetes, hypertension, dyslipidaemia and renal failure), and two surgical groups: Group A, consisting of patients having repair of ascending aorta dissection repair only, and Group B, with those having ascending aorta repair plus aortic valve surgery or coronary bypass surgery or both. We further examined the relationship with LOS using both univariate and multiple regression analyses. RESULTS There were 210 patients who had repair of dissection in the study period, with 109 patients in Group A and 101 in Group B. The average age of this sample was 59.5 (standard deviation = 16.0), 65.7% were male and 18.1% died prior to discharge following repair. The greatest percentage of deaths occurred in winter (31.6%, n = 12), while the least were in summer (21.1%, n = 8) and fall (21.1%, n = 8). An overall χ(2) test found there was no difference in mortality for season (P = 0.55). Univariate analyses also found the age of patients who died vs lived was significantly higher (65.9 vs 58.1 years; P = 0.001), and a significantly greater (P = 0.029) percentage of patients with diabetes vs without diabetes died (41.7 vs 16.7%). Univariate analyses found all other covariates were not significantly related to mortality. In the multiple logistic regression model, there was no significant effect for season, while the odds of dying increased with age (odds ratio [OR] = 1.04, 95% confidence interval [95% CI] = 1.01-1.07, P = 0.012), and the odds of dying in the full-moon cycle vs the new moon cycle was significantly reduced (OR = 0.21, 95% CI = 0.05-0.81, P = 0.024). No other covariate significantly increased or decreased the odds of death, including diabetes risk, which had been significantly related to death in the univariate analysis. Within a linear regression model that examined the relationship with LOS, Group B (P = 0.020), male sex (P = 0.036) and the full-moon lunar phase (P = 0.001) were significantly related to shorter LOS. CONCLUSIONS Season had no effect on mortality or LOS following aortic dissection repair, while patient age significantly increased the odds of death. The full-moon cycle appeared to reduce the odds of death, and the full-moon cycle, along with being male and requiring a concomitant cardiac procedure, was associated with shorter LOS.
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Affiliation(s)
- Jeffrey H. Shuhaiber
- Centers for Behavioral and Preventive Medicine, Rhode Island Hospital, Warren Alpert School of Medicine, Brown University, Providence, RI, USA
- Department of Critical Care and Anesthesia, Rhode Island Hospital, Warren Alpert School of Medicine, Brown University, Providence, RI, USA
- Department of Cardiothoracic Surgery, Rhode Island Hospital, Hasbro Children Hospital, Brown Medical School, Providence, RI, USA
| | - Joseph L. Fava
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
| | - Tai Shin
- Centers for Behavioral and Preventive Medicine, Rhode Island Hospital, Warren Alpert School of Medicine, Brown University, Providence, RI, USA
- Department of Critical Care and Anesthesia, Rhode Island Hospital, Warren Alpert School of Medicine, Brown University, Providence, RI, USA
| | - Nikola Dobrilovic
- Centers for Behavioral and Preventive Medicine, Rhode Island Hospital, Warren Alpert School of Medicine, Brown University, Providence, RI, USA
- Department of Critical Care and Anesthesia, Rhode Island Hospital, Warren Alpert School of Medicine, Brown University, Providence, RI, USA
| | - Afshin Ehsan
- Centers for Behavioral and Preventive Medicine, Rhode Island Hospital, Warren Alpert School of Medicine, Brown University, Providence, RI, USA
- Department of Critical Care and Anesthesia, Rhode Island Hospital, Warren Alpert School of Medicine, Brown University, Providence, RI, USA
| | - Arthur Bert
- Centers for Behavioral and Preventive Medicine, Rhode Island Hospital, Warren Alpert School of Medicine, Brown University, Providence, RI, USA
- Department of Critical Care and Anesthesia, Rhode Island Hospital, Warren Alpert School of Medicine, Brown University, Providence, RI, USA
| | - Frank Sellke
- Centers for Behavioral and Preventive Medicine, Rhode Island Hospital, Warren Alpert School of Medicine, Brown University, Providence, RI, USA
- Department of Critical Care and Anesthesia, Rhode Island Hospital, Warren Alpert School of Medicine, Brown University, Providence, RI, USA
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Jeong TS, Park CW, Yoo CJ, Kim EY, Kim YB, Kim WK. Association between the daily temperature range and occurrence of spontaneous intracerebral hemorrhage. J Cerebrovasc Endovasc Neurosurg 2013; 15:152-7. [PMID: 24167793 PMCID: PMC3804651 DOI: 10.7461/jcen.2013.15.3.152] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Revised: 07/01/2013] [Accepted: 08/07/2013] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE We have observed, anecdotally, that the incidence of primary spontaneous intracerebral hemorrhage (sICH), as well as spontaneous subarachnoid hemorrhage, varies in accordance with seasonality and meteorological conditions. This retrospective single-hospital-based study aimed to determine the seasonality of sICH and the associations, if any, between the occurrence of sICH and meteorological parameters in Incheon city, which is a northwestern area of South Korea. METHODS Electronic hospital data on 708 consecutive patients admitted with primary sICH from January 2008 to December 2010 was reviewed. Traumatic and various secondary forms of ICHs were excluded. Average monthly admission numbers of sICH were analyzed, in relation with the local temperature, atmospheric pressure, humidity, and daily temperature range data. The relationships between the daily values of each parameter and daily admission numbers of sICH were investigated using a combination of correlation and time-series analyses. RESULTS No seasonal trend was observed in sICH-related admissions during the study period. Furthermore, no statistically significant correlation was detected between the daily sICH admission numbers and the meteorological parameters of temperature, atmospheric pressure and humidity. The daily temperature range tended to correlate with the number of daily sICH-related admissions (p = 0.097). CONCLUSION This study represents a comprehensive investigation of the association between various meteorological parameters and occurrence of spontaneous ICH. The results suggest that the daily temperature range may influence the risk of sICH.
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Affiliation(s)
- Tae Seok Jeong
- Department of Neurosurgery, Gil Medical Center, Gachon University, Incheon, Korea
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Impact of the moon on cerebral aneurysm rupture. Acta Neurochir (Wien) 2013; 155:1525-30. [PMID: 23702791 DOI: 10.1007/s00701-013-1740-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2013] [Accepted: 04/22/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Several external and internal risk factors for cerebral aneurysm rupture have been identified to date. Recently, it has been reported that moon phases correlate with the incidence of aneurysmal subarachnoid hemorrhage (SAH), however, another author found no such association. Therefore, the present study investigates the influence of the lunar cycle on the incidence of aneurysmal rupture, the initial clinical presentation, and the amount of subarachnoid blood. METHODS Lunar phase and the particular day of the lunar cycle were correlated to the date of aneurysm rupture, aneurysm location, initial clinical presentation, and amount of subarachnoid blood assessed from CT scans of all patients treated for basal SAH in our department from 2003 to 2010. RESULTS We found no correlation between incidence of aneurysmal SAH, location of the aneurysm, initial clinical presentation, or amount of subarachnoid blood and the lunar cycle. CONCLUSIONS The moon influences neither the incidence of aneurysmal SAH nor the grade of initial neurological deterioration or amount of subarachnoid blood.
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Izumihara A. Epidemiology of subarachnoid hemorrhage in the Yaeyama Islands, an isolated subtropical region of Japan most frequently affected by typhoons: A population-based study. Clin Neurol Neurosurg 2012; 114:1226-31. [DOI: 10.1016/j.clineuro.2012.03.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2011] [Revised: 02/21/2012] [Accepted: 03/01/2012] [Indexed: 10/28/2022]
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Popular belief meets surgical reality: impact of lunar phases, Friday the 13th and zodiac signs on emergency operations and intraoperative blood loss. World J Surg 2011; 35:1945-9. [PMID: 21713579 DOI: 10.1007/s00268-011-1166-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND The influence of superstition, moon calendars, and popular belief on evidence-based medicine is stunning. More than 40% of medical staff is convinced that lunar phases can affect human behavior. The idea that Friday the 13th is associated with adverse events and bad luck is deep-rooted in the population of Western industrial countries. The aim of the present study was to test the hypothesis that these myths are transferable to real-life surgery. METHODS We analyzed the extent to which moon phases, zodiac signs, and Friday the 13th influence blood loss, emergency frequency, and intestinal perforations by evaluating the operation records of all 27,914 consecutive patients of our institution undergoing general, visceral, or vascular surgery between August 2001 and August 2010. Dates of surgery were allocated to lunar phases and to zodiac signs, as well as to Friday the 13th. RESULTS A total of 111 lunar cycles and 15 Fridays the 13th occurred within the 3,281-day observation period. Patients' characteristics did not differ in lunar phases, zodiac signs, or Fridays the 13th. Full moon phases, the presence of Friday the 13th, and zodiac signs influenced neither intraoperative blood loss nor emergency frequency. No statistical peaks regarding perforated aortic aneurysms and gastrointestinal perforations were found on full moon or Friday the 13th. CONCLUSIONS Scientific analysis of our data does not support the belief that moon phases, zodiac signs, or Friday 13th influence surgical blood loss and emergency frequency. Our data indicate that such beliefs are myths far beyond reality.
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Schmid M, Grimm C, Kuessel L, Wirth S, Worda C, Krampl-Bettelheim E. Lunar cycle and fetal nuchal translucency in the first trimester of pregnancy. BIOL RHYTHM RES 2010. [DOI: 10.1080/09291010903478053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Promberger R, Ott J, Mikola B, Freissmuth M, Hermann M. Lunar phase does not influence the incidence of postoperative haemorrhage after thyroid surgery: an analysis of 26,852 operations. Eur Surg 2010. [DOI: 10.1007/s10353-010-0523-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Lahner D, Marhold F, Gruber A, Schramm W. Impact of the lunar cycle on the incidence of aneurysmal subarachnoid haemorrhage: myth or reality? Clin Neurol Neurosurg 2008; 111:352-3. [PMID: 19101078 DOI: 10.1016/j.clineuro.2008.11.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2008] [Revised: 09/03/2008] [Accepted: 11/12/2008] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To investigate the impact of the lunar cycle on the incidence of aneurysmal subarachnoid haemorrhages. METHODS We retrospectively identified all patients admitted to the department of neurosurgery during 1992 and 2004 suffering from aneurysmal subarachnoid haemorrhage. The onset of bleeding was compared with the lunar phase. RESULTS We did not observe any significant impact of the lunar cycle on the incidence of aneurysmal subarachnoid haemorrhage in 717 consecutive patients (p=0.84). CONCLUSION The impact of the lunar cycle on aneurysmal subarachnoid haemorrhage is a myth rather than reality.
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Affiliation(s)
- Daniel Lahner
- Department of Anaesthesia, General Intensive Care Medicine and Pain Management, Medical University of Vienna, Waehringerguertel 18-20, 1090 Vienna, Austria.
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