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Esmaiel NN, Ashaat EA, Al-Ettribi GM, Fayez A, Alsaiedi SA, El Ruby MO. Association between MTHFR C677T variant and risk for congenital heart defects in Egyptian children: a case–control study including meta-analysis based on 147 cases and 143 controls. EGYPTIAN JOURNAL OF MEDICAL HUMAN GENETICS 2023. [DOI: 10.1186/s43042-023-00408-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
Abstract
Abstract
Background
Stratification analysis studies showed that ethnicity has a significant association regarding MTHFR C677T variant and congenital heart diseases (CHDs) risk, and many published studies have controversial conclusions toward this association.
Methods
In this study, the association between the MTHFR C677T variant and the risk for CHDs was evaluated in 91 children with CHD and 95 healthy controls, as new cases, by using restriction fragment length polymorphism (RFLP) technique. Besides that, 2 case–control studies in the Egyptian population published before 2021 were included in this meta-analysis. The association was assessed by the odds ratio (OR) with a 95% confidence interval (CI) based on 294 alleles in CHD cases and 286 alleles in controls.
Results
The overall meta-analysis showed a significant association between MTHFR C677T variant and CHDs risk in Egyptian children with heterogeneity (Heterogeneity = 0.001) in all the genetic models with the highly significant association in T versus C allele (pooled OR 1.89, 95% CI 1.31–2.74; p value < 0.0004). The consistency of the genotypes was detected by Hardy–Weinberg equilibrium (HWE).
Conclusions
Our results support the MTHFR -677T allele as a susceptibility factor for CHDs in the Egyptian pediatric patients.
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Raina JK, Panjaliya RK, Dogra V, Sharma S, Anupriya, Kumar P. "Association of MTHFR and MS/MTR gene polymorphisms with congenital heart defects in North Indian population (Jammu and Kashmir): a case-control study encompassing meta-analysis and trial sequential analysis". BMC Pediatr 2022; 22:223. [PMID: 35468734 PMCID: PMC9036697 DOI: 10.1186/s12887-022-03227-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 03/11/2022] [Indexed: 12/01/2022] Open
Abstract
Background The risk of Congenital Heart Defects (CHD) is greatly influenced by variants within the genes involved in folate-homocysteine metabolism. Polymorphism in MTHFR (C677T and G1793A) and MS/MTR (A2756G) genes increases the risk of developing CHD risk, but results are controversial. Therefore, we conducted a case–control association pilot study followed by an up-dated meta-analysis with trial sequential analysis (TSA) to obtain more precise estimate of the associations of these two gene variants with the CHD risk. Methods For case–control study, we enrolled 50 CHD patients and 100 unrelated healthy controls. Genotyping was done by PCR–RFLP method and meta-analysis was performed by MetaGenyo online Statistical Analysis System software. For meta-analysis total number of individuals was as follows: for MTHFR C677T 3450 CHD patients and 4447 controls whereas for MS A2756G 697 CHD patients and 777 controls. Results Results of the original pilot study suggested lack of association for MTHFR C677T and MS A2756G polymorphism with risk of CHD whereas MTHFR G1793A was significantly associated with the disease. On performing meta-analysis, a significant association was observed with MTHFR C677T polymorphism but not with MS A2756G. Trial sequential Analysis also confirmed the sufficient sample size requirement for findings of meta-analysis. Conclusions The results of the meta-analysis suggested a significant role of MTHFR in increased risk of CHD.
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Affiliation(s)
- Jyotdeep Kour Raina
- Institute of Human Genetics, University of Jammu Jammu and Kashmir, 180006, Jammu, India
| | | | - Vikas Dogra
- Department of Zoology Govt. Degree College, Samba, J&K, Jammu, India
| | - Sushil Sharma
- Department of Neonatology, University Hospital Southampton, Hampshire, UK
| | - Anupriya
- Institute of Human Genetics, University of Jammu Jammu and Kashmir, 180006, Jammu, India
| | - Parvinder Kumar
- Institute of Human Genetics, University of Jammu Jammu and Kashmir, 180006, Jammu, India. .,Department of Zoology, University of Jammu, Jammu and Kashmir, 180006, Jammu, India.
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Liu PF, Ding B, Zhang JY, Mei XF, Li F, Wu P, Mei CH, Zhou YF, Chen T. Association Between MTHFR C677T Polymorphism and Congenital Heart Disease. Int Heart J 2020; 61:553-561. [PMID: 32418960 DOI: 10.1536/ihj.19-389] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Many published studies have evaluated the association between the 5,10-methylenetetrahydrofolate reductase (MTHFR) C677T (rs1801133) polymorphism and the risk of congenital heart disease (CHD); however, the specific conclusion is still controversial.To get a more accurate conclusion, we used a meta-analysis to evaluate the association between the MTHFR gene C677T polymorphism and the risk of CHD.Based on the design-based search strategy, a comprehensive literature search was conducted on PubMed, OVID, Cochrane Library, Embase, Wanfang, CNKI, and Web of Science. We selected the Newcastle-Ottawa Scale (NOS) to assess the quality of the included studies. We performed a heterogeneity test on the results of the study and calculated the combined odds ratios (ORs) and its corresponding 95% confidence intervals (95% CIs) under a random- or fixed-effect model. Subgroup analyses were conducted by ethnicity, source of controls, sample size, and genotyping method. Sensitivity analysis was used to insure authenticity of this meta-analysis result. Egger's test and Begg's funnel plot were performed to detect publication bias.Eventually, our meta-analysis included 15 eligible studies. We observed a significant correlation between the MTHFR C677T polymorphism and the development of CHD in the recessive model (OR: 1.35, 95% CI: 1.06-1.71, P = 0.006) for the overall population. In subgroups stratified by ethnicity and source of controls, subgroup analyses indicated similar associations in Asians and hospital-based groups, but not for Caucasians and population-based groups. Egger's test and Begg's funnel plot demonstrated no significant publication bias in our study.Our analysis identified that MTHFR C677T allele is a risk genetic for CHD development, especially in Asians compared with Caucasians.
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Affiliation(s)
- Peng-Fei Liu
- Department of Cardiology, The First Affiliated Hospital of Soochow University
| | - Bing Ding
- Department of Cardiology, The First Affiliated Hospital of Soochow University
| | - Jun-Yi Zhang
- Department of Cardiology, The First Affiliated Hospital of Soochow University
| | - Xiao-Fei Mei
- Department of Cardiology, The First Affiliated Hospital of Soochow University
| | - Fei Li
- Department of Cardiology, The First Affiliated Hospital of Soochow University
| | - Peng Wu
- Department of Cardiology, The First Affiliated Hospital of Soochow University
| | - Chun-Hao Mei
- Department of Cardiology, The First Affiliated Hospital of Soochow University
| | - Ya-Feng Zhou
- Department of Cardiology, The First Affiliated Hospital of Soochow University
| | - Tan Chen
- Department of Cardiology, The First Affiliated Hospital of Soochow University
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A probe directed recombinase amplification assay for detection of MTHFR A1298C polymorphism associated with congenital heart disease. Biotechniques 2019; 64:211-217. [PMID: 29793361 DOI: 10.2144/btn-2018-2010] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Single nucleotide polymorphisms (SNPs) play an important role in susceptibility to complex diseases, treatment efficacy and adverse drug responses. Conventional methods to detect SNPs are usually based on PCR or DNA sequencing, which are typically time-consuming and require sophisticated equipment. In this proof-of-concept study, a probe-directed recombinase amplification (PDRA) assay was developed to detect the A1298C polymorphism of 5,10-methylenetetrahydrofolate reductase (MTHFR). The PDRA assay included two real-time reactions to detect the A and C nucleotides of A1298C polymorphism. Each reaction contained only one primer and one probe and was finished at 39°C within 35 min. The results of genotyping of 150 clinical samples using PDRA were completely consistent with those by direct sequencing. Additionally, when the 1000 Genomes Project HCB frequencies were used as the control group, MTHFR A1298C was found to be associated with congenital heart disease. In conclusion, the proposed novel PDRA assay is a valuable tool for the detection of SNPs and demonstrates significant potential to be widely applicable in both research and clinical settings.
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He X, Zhang X, Jing H, Zhang X, Gao M, Chen H, Geng J, Zheng Z, Fu Q, Zhu Z, Zheng J. Rare Copy Number Variations Might Not be Involved in the Molecular Pathogenesis of PA-IVS in an Unselected Chinese Cohort. Pediatr Cardiol 2019; 40:762-767. [PMID: 30868185 DOI: 10.1007/s00246-019-02062-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 01/29/2019] [Indexed: 11/30/2022]
Abstract
Congenital heart defect (CHD) is one of the most common birth defects in China, while pulmonary atresia with intact ventricular septum (PA-IVS) is the life-threatening form of CHD. Numerous previous studies revealed that rare copy number variants (CNVs) play important roles in CHD, but little is known about the prevalence and role of rare CNVs in PA-IVS. In this study, we conducted a genome-wide scanning of rare CNVs in an unselected cohort consisted of 54 Chinese patients with PA-IVS and 20 patients with pulmonary atresia with ventricular septal defect (PA-VSD). CNVs were identified in 6/20 PA-VSD patients (30%), and three of these CNVs (15%) were considered potentially pathogenic. Two pathogenic CNVs occurred at a known CHD locus (22q11.2) and one likely pathogenic deletion located at 13q12.12. However, no rare CNVs were detected in patients with PA-IVS. Potentially pathogenic CNVs were more enriched in PA-VSD patients than in PA-IVS patients (p = 0.018). No rare CNVs were detected in patients with PA-IVS in our study. PA/IVS might be different from PA/VSD in terms of genetics as well as anatomy.
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Affiliation(s)
- Xiaomin He
- Department of Pediatric Cardiothoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dongfang Road, Shanghai, 200127, China
| | - Xiaoqing Zhang
- The Department of Laboratory Medicine, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, 200127, China
| | - Hui Jing
- Department of Pediatric Cardiothoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dongfang Road, Shanghai, 200127, China
| | - Xiaoyang Zhang
- Department of Pediatric Cardiothoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dongfang Road, Shanghai, 200127, China
| | - Manchen Gao
- Department of Pediatric Cardiothoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dongfang Road, Shanghai, 200127, China
| | - Huiwen Chen
- Department of Pediatric Cardiothoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dongfang Road, Shanghai, 200127, China
| | - Juan Geng
- Hangzhou Joingenome Diagnostics, Hangzhou, 311188, China
| | - Zhaojing Zheng
- Hangzhou Joingenome Diagnostics, Hangzhou, 311188, China
| | - Qihua Fu
- The Department of Laboratory Medicine, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, 200127, China
| | - Zhongqun Zhu
- Department of Pediatric Cardiothoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dongfang Road, Shanghai, 200127, China.
| | - Jinghao Zheng
- Department of Pediatric Cardiothoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dongfang Road, Shanghai, 200127, China.
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Yu D, Zhuang Z, Wen Z, Zang X, Mo X. MTHFR A1298C polymorphisms reduce the risk of congenital heart defects: a meta-analysis from 16 case-control studies. Ital J Pediatr 2017; 43:108. [PMID: 29202788 PMCID: PMC5715640 DOI: 10.1186/s13052-017-0425-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 11/13/2017] [Indexed: 12/13/2022] Open
Abstract
Background Methylenetetrahydrofolate reductase (MTHFR) plays a crucial role in the hyperhomocysteinemia, which is a risk factor related to the occurrence of congenital heart defect (CHD). However, the association between MTHFR polymorphism and CHD has been inconclusive. Methods We conducted an updated meta-analysis to provide comprehensive evidence on the role of MTHFR A1298C polymorphism in CHD. Databases were searched and a total of 16 studies containing 2207 cases and 2364 controls were included. Results We detected that a significant association was found in the recessive model (CC vs. AA + AC: OR = 1.38, 95% CI: 1.10–1.73) for the overall population. Subgroup analysis showed that associations were found in patients without Down Syndrome in genetic models for CC vs. AA (OR = 1.47, 95% CI: 1.01–2.14), CC vs. AC (OR = 1.29, 95% CI: 1.00–1.66) and recessive model (OR = 1.44, 95% CI: 1.14–1.82). We conducted a meta-regression analysis, Galbraith plots and a sensitivity analysis to assess the sources of heterogeneity. Conclusions In summary, our present meta-analysis supports the MTHFR 1298C allele as a risk factor for CHD. However, further studies should be conducted to investigate the correlation of plasma homocysteine levels, enzyme activity, and periconceptional folic acid supplementation with the risk of CHD. Electronic supplementary material The online version of this article (10.1186/s13052-017-0425-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Di Yu
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China
| | - Zhulun Zhuang
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China
| | - Zhongyuan Wen
- Department of Cardiovascular Center, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, 210008, China
| | - Xiaodong Zang
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China
| | - Xuming Mo
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China.
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Chen XF, Jiang F, Li L, Chen Y, Chen X, Jiang YY, Xiang L, Ma XJ. Application of low-dose dual-source computed tomography angiography in children with complex congenital heart disease. Exp Ther Med 2017; 14:1177-1183. [PMID: 28810576 DOI: 10.3892/etm.2017.4591] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2015] [Accepted: 07/21/2016] [Indexed: 11/06/2022] Open
Abstract
The objective of the present study was to evaluate image quality and radiation dosage using a low-dose prospectively electrocardiogram (ECG)-gated computed tomography (CT) protocol for dual-source angiography in children with complex congenital heart disease. A total of 206 patients with complex congenital heart disease were equally assigned into two groups at random. The children in group A underwent low-dose retrospective ECG-gated CT scanning with an ECG-pulsing technique, and group B underwent prospective ECG-gated scanning with an ECG-pulsing technique. Radiation dose volume computed tomography dose index (CTDI vol), dose length product (DLP) and effective dose (ED) were recorded after scanning. Raw data were transferred to workstations for post-processing, diagnosis, grading, comparison with intra-operation findings or cardiac catheterisation, and the coincidence, false negative rate and misdiagnosis rates of groups A and B, respectively, were subsequently recorded. The results of the present study indicated that the height, age and weight of the children in the two groups exhibited no significant differences. The image quality of group A was graded as 3.94±0.08, whereas the grade for the image quality in group B was 4.05±0.08; no significant difference was detected. The coincidence rates of groups A and B were 89.37 and 88.48%, respectively; the false negative rates of groups A and B were 9.66 and 10.60%, respectively; the misdiagnosis rates of groups A and B were 0.97 and 0.92%. No significant differences between the two groups were detected. The CTDI value of group A was 3.24±1.62 mGy, the DLP value was 47.53±33.28 mGy·cm2, the ED value was 0.93±0.42 mSv. By contrast, the CTDI value of group B was 2.27±0.94 mGy, the DLP value was (27.03±17.64) mGy·cm2, and the ED value was 0.53±0.23 mSv. Significant differences were detected between the two groups (CTDI t=5.287, P<0.05; DLP t=5.523, P<0.05; ED t=8.497, P<0.05), and the radiation dose of group B was markedly decreased, compared with group A. In conclusion, the present study demonstrated that prospectively ECG-gated scanning of dual-source CT is an effective method of examination for dose reduction in children with congenital heart disease without impairment of image quality, which suggests that this protocol may be suitable for future application and dissemination.
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Affiliation(s)
- Xian-Feng Chen
- Department of Radiology, Wuhan Asia Heart Hospital, Wuhan, Hubei 430000, P.R. China
| | - Fan Jiang
- Department of Radiology, Wuhan Asia Heart Hospital, Wuhan, Hubei 430000, P.R. China
| | - Lin Li
- Department of Radiology, Wuhan Asia Heart Hospital, Wuhan, Hubei 430000, P.R. China
| | - Yan Chen
- Department of Radiology, Wuhan Asia Heart Hospital, Wuhan, Hubei 430000, P.R. China
| | - Xin Chen
- Department of Radiology, Wuhan Asia Heart Hospital, Wuhan, Hubei 430000, P.R. China
| | - Yan-Yan Jiang
- Department of Radiology, Wuhan Asia Heart Hospital, Wuhan, Hubei 430000, P.R. China
| | - Li Xiang
- Department of Radiology, Wuhan Asia Heart Hospital, Wuhan, Hubei 430000, P.R. China
| | - Xiao-Jing Ma
- Department of Radiology, Wuhan Asia Heart Hospital, Wuhan, Hubei 430000, P.R. China
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Abstract
Genetic and environmental factors may be similar in certain CHD. It has been widely accepted that it is the cumulative effect of these risk factors that results in disease. Pulmonary atresia is a rare type of complex cyanotic CHD with a poor prognosis. Understanding the molecular mechanism of pulmonary atresia is essential for future diagnosis, prevention, and therapeutic approaches. In this article, we reviewed several related copy number variants and related genetic mutations, which were identified in patients with pulmonary atresia, including pulmonary atresia with ventricular septal defect and pulmonary atresia with intact ventricular septum.
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Wang Y, Zhang H, Yue S, Zhang K, Wang H, Dong R, Yang X, Liu Y, Ma Y. Evaluation of High Resolution Melting for MTHFR C677T Genotyping in Congenital Heart Disease. PLoS One 2016; 11:e0151140. [PMID: 26990189 PMCID: PMC4798616 DOI: 10.1371/journal.pone.0151140] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2015] [Accepted: 02/23/2016] [Indexed: 01/30/2023] Open
Abstract
Background High resolution melting (HRM) is a simple, flexible and low-cost mutation screening technique. The methylenetetrahydrofolate reductase (MTHFR) gene encoding a critical enzyme, potentially affects susceptibility to some congenital defects like congenital heart disease (CHD). We evaluate the performance of HRM for genotyping of the MTHFR gene C677T locus in CHD cases and healthy controls of Chinese Han population. Methods A total of 315 blood samples from 147 CHD patients (male72, female 75) and 168 healthy controls (male 92, female 76) were enrolled in the study. HRM was utilized to genotype MTHFR C677T locus of all the samples. The results were compared to that of PCR-RFLP and Sanger sequencing. The association of the MTHFR C677T genotypes and the risk of CHD was analyzed using odds ratio with their 95% confidence interval (CIs) from unconditional logistic regression. Results All the samples were successfully genotyped by HRM within 1 hour and 30 minutes while at least 6 hours were needed for PCR-RFLP and sequencing. The genotypes of MTHFR C677T CC, CT, and TT were 9.52%, 49.66%, and 40.82% in CHD group but 29.17%, 50% and 20.83% in control group, which were identical using both methods of HRM and PCR-RFLP, demonstrating the sensitivity and specificity of HRM were all 100%. Conclusion MTHFR C677T is a potential risk factor for CHD in our local residents of Shandong province in China. HRM is a fast, sensitive, specific and reliable method for clinical application of genotyping.
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Affiliation(s)
- Ying Wang
- Research Institute of Pediatrics, Qilu Children’s Hospital of Shandong University, Ji’nan, 250022, China
| | - Haiyan Zhang
- Research Institute of Pediatrics, Qilu Children’s Hospital of Shandong University, Ji’nan, 250022, China
| | - Shuying Yue
- Department of Medicine, Shandong Medical College, Ji’nan, 250002, China
| | - Kun Zhang
- Cardiovascular Department, Qilu Children’s Hospital of Shandong University, Ji’nan, 250022, China
| | - Hui Wang
- Cardiovascular Department, Qilu Children’s Hospital of Shandong University, Ji’nan, 250022, China
| | - Rui Dong
- Research Institute of Pediatrics, Qilu Children’s Hospital of Shandong University, Ji’nan, 250022, China
| | - Xiaomeng Yang
- Research Institute of Pediatrics, Qilu Children’s Hospital of Shandong University, Ji’nan, 250022, China
| | - Yi Liu
- Research Institute of Pediatrics, Qilu Children’s Hospital of Shandong University, Ji’nan, 250022, China
- * E-mail: (YL); (YM)
| | - Yanhui Ma
- Research Institute of Pediatrics, Qilu Children’s Hospital of Shandong University, Ji’nan, 250022, China
- * E-mail: (YL); (YM)
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