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Hirayama T, Morioka H, Sugisawa T, Shibukawa M, Ebina J, Hanashiro S, Nagasawa J, Yanagihashi M, Okuni I, Nakajima T, Murakami Y, Yamanaka K, Ebihara S, Kano O. A preliminary study on the effects of long-term robot suit exercise training on gait function and quality of life in patients with spinal and bulbar muscular atrophy. J Clin Neurosci 2024; 128:110778. [PMID: 39168060 DOI: 10.1016/j.jocn.2024.110778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 07/05/2024] [Accepted: 08/07/2024] [Indexed: 08/23/2024]
Abstract
Spinal and bulbar muscular atrophy (SBMA) progressively impairs gait function, resulting in the need for patients to use a wheelchair approximately 20 years after onset. No reports have investigated the effects of long-term exercise training using the Hybrid Assisted Limb (HAL) in patients with multiple SBMA. This study investigated the effects of long-term exercise training using HAL in patients with SBMA and its effects on the quality of life (QoL). Six courses of HAL treatment were administered to three males with SBMA, and leuprorelin was administered to each patient. Each course had a 4-5 week duration, during which the treatment was performed nine times, with a rest period of at least 2 months between each course. A 2-minute walk test (2MWT) and a 10-m walk test (10MWT) were performed to measure gait ability, and a blood test to measure the serum creatine kinase (CK) and creatinine (CRE) levels was performed before and after each course of treatment. We evaluated QoL using the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36). The average 2MWT distance improved over 2 years (p = 0.038), and the 10MWT showed neither improvement nor decline. No increase or decrease in serum CK or CRE levels was observed. There were no significant changes in the SF-36 physical, mental, or social summary scores. In combination with leuprorelin therapy, robot-assisted training using HAL maintained gait ability and QoL in patients with SBMA for 2 years.
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Affiliation(s)
- Takehisa Hirayama
- Department of Neurology, Toho University Faculty of Medicine, Tokyo, Japan
| | - Harumi Morioka
- Department of Neurology, Toho University Faculty of Medicine, Tokyo, Japan
| | - Tatsuki Sugisawa
- Department of Rehabilitation Medicine, Toho University Faculty of Medicine, Tokyo, Japan
| | - Mari Shibukawa
- Department of Neurology, Toho University Faculty of Medicine, Tokyo, Japan
| | - Junya Ebina
- Department of Neurology, Toho University Faculty of Medicine, Tokyo, Japan
| | - Sayori Hanashiro
- Department of Neurology, Toho University Faculty of Medicine, Tokyo, Japan
| | - Junpei Nagasawa
- Department of Neurology, Toho University Faculty of Medicine, Tokyo, Japan
| | - Masaru Yanagihashi
- Department of Neurology, Toho University Faculty of Medicine, Tokyo, Japan
| | - Ikuko Okuni
- Department of Rehabilitation Medicine, Toho University Faculty of Medicine, Tokyo, Japan
| | - Takashi Nakajima
- Departments of Neurology and Rehabilitation Medicine, National Hospital Organization Niigata National Hospital, Niigata, Japan
| | - Yoshitaka Murakami
- Department of Medical Statistics, Toho University Faculty of Medicine, Tokyo, Japan
| | - Koji Yamanaka
- Department of Neuroscience and Pathobiology, Research Institute of Environmental Medicine, Nagoya University, Nagoya, Japan
| | - Satoru Ebihara
- Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Osamu Kano
- Department of Neurology, Toho University Faculty of Medicine, Tokyo, Japan.
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Truque-Díaz C, Meroño-Gallut J, Molina-García C, Cuesta-Barriuso R, Pérez-Llanes R. Stability, Balance, and Physical Variables in Patients with Bilateral Hemophilic Arthropathy of the Ankle versus Their Healthy Peers: A Case-Control Study. Life (Basel) 2024; 14:1051. [PMID: 39202791 PMCID: PMC11355264 DOI: 10.3390/life14081051] [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: 07/16/2024] [Revised: 08/18/2024] [Accepted: 08/20/2024] [Indexed: 09/03/2024] Open
Abstract
(1) Background: The recurrence of hemarthrosis in patients with hemophilia triggers a pathophysiological process of degenerative, progressive, and irreversible joint destruction. This hemophilic arthropathy is characterized by chronic pain, muscle atrophy, loss of mobility, and proprioceptive alterations. As the same joint undergoes repeated hemarthrosis, the function of the mechanical receptors deteriorates, causing a pathophysiological modulation and deterioration of the musculoskeletal system. The objective was to analyze the differences in stability and balance, as well as in ankle dorsal flexion, functionality, and muscle strength, between patients with bilateral hemophilic arthropathy and their healthy peers. (2) Methods: A cross-sectional descriptive case-control study was performed. Twenty-two participants were recruited: 10 adult patients with bilateral hemophilic arthropathy of the knee and ankle and 12 healthy subjects. The variables were balance (Rs Scan pressure platform), ankle dorsiflexion range of motion (Leg Motion), functionality (2-Minute Walk Test), and ankle dorsal strength (dynamometry). (3) Results: Statistically significant differences (p < 0.05) were found in the balance without visual support in the Max-Y variable (MD = 2.83; CI95%: 0.33;5.33; Effect size (d) = 0.67), ankle dorsiflexion (MD = 16.00; CI95%: 14.30; 20.0; d = 7.46), and strength of the ankle flexor muscles (MD = 128.50; CI95%: 92.50; 153.60; d = 2.76). (4) Conclusions: Ankle range of motion in dorsal flexion, functionality, and muscle strength in dorsal flexion is poorer in patients with bilateral lower limb hemophilic arthropathy than in their healthy peers. Patients with bilateral hemophilic ankle arthropathy have statistically poorer stability and balance without visual support than their healthy peers.
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Affiliation(s)
- Carlos Truque-Díaz
- Faculty of Physiotherapy, Podiatry and Occupational Therapy, Catholic University San Antonio-UCAM, 30107 Murcia, Spain; (C.T.-D.); (C.M.-G.)
| | - Javier Meroño-Gallut
- Tú. Bienestar 360°, Physiotherapy and Medical Center, 30730 San Javier, Spain;
- InHeFis Research Group, Instituto Asturiano de Investigación Sanitaria (ISPA), 33011 Oviedo, Spain;
| | - Cristina Molina-García
- Faculty of Physiotherapy, Podiatry and Occupational Therapy, Catholic University San Antonio-UCAM, 30107 Murcia, Spain; (C.T.-D.); (C.M.-G.)
| | - Rubén Cuesta-Barriuso
- InHeFis Research Group, Instituto Asturiano de Investigación Sanitaria (ISPA), 33011 Oviedo, Spain;
- Department of Surgery and Medical-Surgical Specialties, University of Oviedo, 33003 Oviedo, Spain
| | - Raúl Pérez-Llanes
- InHeFis Research Group, Instituto Asturiano de Investigación Sanitaria (ISPA), 33011 Oviedo, Spain;
- Department of Physiotherapy, University of Murcia, 30100 Murcia, Spain
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Nguyen DT, Penta M, Questienne C, Garbusinski J, Nguyen CV, Sauvage C. Normative values in healthy adults for the 6-minute and 2-minute walk tests in Belgium and Vietnam: implications for clinical practice. J Rehabil Med 2024; 56:jrm18628. [PMID: 38501732 PMCID: PMC10964022 DOI: 10.2340/jrm.v56.18628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 01/25/2024] [Indexed: 03/20/2024] Open
Abstract
OBJECTIVE To establish reference values for the 6-minute walk test (6MWT) and 2-minute walk test (2MWT) distances, to investigate the correlation between these 2 tests, and to establish prediction equations for these distances in healthy populations of Belgium and Vietnam. DESIGN Cross-sectional study. SUBJECTS AND METHODS The 6MWT and 2MWT were administered to a convenience sample of 239 Belgian and 303 Vietnamese participants between the ages of 18 and 80 years. RESULTS The mean (standard deviation; SD) 2MWT distances were 215 (32.8) m for Belgian participants and 156 (25.5) m for Vietnamese participants. The mean (SD) 6MWT distances were 625 (90.7) m for Belgian participants and 449 (70.4) m for Vietnamese participants. The Pearson correlation coefficient between the 2 tests was 0.901 (p < 0.001) for Belgian participants and 0.871 (p < 0.001) for Vietnamese participants. Age and sex were the 2 most important predictors of walking distance, followed by body mass index for Belgium and height for Vietnam. The adjusted R² ranged from 0.31 to 0.49 across 4 predictive equations. CONCLUSION These results can be used to determine the presence of walking performance deficits and to guide future studies. The 2MWT is suggested as a useful and convenient alternative to the 6MWT for assessing walking performance in clinical practice.
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Affiliation(s)
- Duy Thanh Nguyen
- Faculty of Nursing and Medical Technology, University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam; Faculty of Motricity Sciences, Université Libre de Bruxelles, Belgium.
| | - Massimo Penta
- Institute of NeuroScience, Université catholique de Louvain, Louvain-la-Neuve, Belgium; Arsalis, Glabais, Belgium
| | - Claire Questienne
- Department of Neurorehabilitation, Erasme Hospital, Université Libre de Bruxelles, Belgium
| | - Johanne Garbusinski
- Department of Neurorehabilitation, Erasme Hospital, Université Libre de Bruxelles, Belgium
| | - Chinh Van Nguyen
- Faculty of Nursing and Medical Technology, University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam
| | - Chloé Sauvage
- Faculty of Motricity Sciences, Université Libre de Bruxelles, Belgium; Department of Neurorehabilitation, Erasme Hospital, Université Libre de Bruxelles, Belgium
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Cuerda-Ballester M, Proaño B, Alarcón-Jimenez J, de Bernardo N, Villaron-Casales C, Lajara Romance JM, de la Rubia Ortí JE. Improvements in gait and balance in patients with multiple sclerosis after treatment with coconut oil and epigallocatechin gallate. A pilot study. Food Funct 2023; 14:1062-1071. [PMID: 36594273 DOI: 10.1039/d2fo02207a] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Multiple sclerosis (MS) is a neurodegenerative disease that progressively decreases the muscular and functional capacity. Thus, there is an alteration in the ability to walk that affects balance, speed and resistance. Since MS pathology involves neuroinflammation, cellular oxidation and mitochondrial alterations, the objective of the study was to assess the impact of a nutritional intervention with coconut oil and epigallocatechin gallate (EGCG) on gait and balance. In order to do this, 51 patients with MS were enrolled and randomly distributed into an intervention group and a control group, which received either a daily dose of 800 mg of EGCG and 60 ml of coconut oil, or a placebo, all during a period of 4 months and which followed a Mediterranean isocaloric diet. Initial and final assessments consisted of the evaluation of quantitative balance (Berg scale), perceived balance (ABC scale), gait speed (10MWT) and resistance (2MWT). Besides, muscle strength was measured using a dynamometer and levels of β-hydroxybutyrate (BHB) were measured in serum samples. In the intervention group, there was a significant improvement in the gait speed, quantitative balance and muscle strength of the right quadriceps; an improvement in gait resistance was observed in both groups. There were also significant and positive correlations between balance and gait scales. In conclusion, the administration of EGCG and coconut oil seems to improve gait speed and balance in MS patients, although the latter was not perceived by them. Furthermore, these variables appear to be related and contribute to functionality.
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Affiliation(s)
- María Cuerda-Ballester
- Doctoral Degree School, Catholic University of Valencia San Vicente Mártir, C/Quevedo, 2, 46001 Valencia, Spain.
| | - Belén Proaño
- Department of Nursing, Catholic University of Valencia San Vicente Mártir, C/Espartero, 7, 46007 Valencia, Spain.
| | - Jorge Alarcón-Jimenez
- Department of Physiotherapy, Catholic University of Valencia San Vicente Mártir, C/Quevedo, 2, 46001 Valencia, Spain.
| | - Nieves de Bernardo
- Department of Physiotherapy, Catholic University of Valencia San Vicente Mártir, C/Quevedo, 2, 46001 Valencia, Spain.
| | - Carlos Villaron-Casales
- Department of Physiotherapy, European University of Valencia, Avda/Alameda, 7, 46010, Valencia, Spain.
| | - José María Lajara Romance
- Department of Law, Economical and Social Sciences, Multimedia Area, Catholic University of Valencia San Vicente Mártir, C/Guillem de Castro, 94, 46001 Valencia, Spain.
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Cuerda-Ballester M, Martínez-Rubio D, García-Pardo MP, Proaño B, Cubero L, Calvo-Capilla A, Sancho-Cantus D, de la Rubia Ortí JE. Relationship of Motor Impairment with Cognitive and Emotional Alterations in Patients with Multiple Sclerosis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1387. [PMID: 36674140 PMCID: PMC9864158 DOI: 10.3390/ijerph20021387] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 01/09/2023] [Accepted: 01/10/2023] [Indexed: 06/17/2023]
Abstract
Introduction. Multiple sclerosis (MS) is a neurodegenerative disease that, despite mainly affecting women, is more severe in men and causes motor, cognitive and emotional alterations. The objective of this study was to determine the possible relationship between motor, cognitive and emotional alterations. Materials and Methods. This is a descriptive, observational and cross-sectional study, with 67 patients with MS (20 men and 47 women), who were given the following questionnaires: Expanded Disability Status Scale (EDSS), Two-Minute Walk Test (2MWT), Berg Balance Scale, Beck’s Depression Inventory (BDI-II), State-Trait Anxiety Inventory (STAI) and Prefrontal Symptoms Inventory (PSI) to analyze their cognitive level, body mass index (BMI) and percentage of muscle mass. In addition, regression analysis was conducted to study the relationship among variables. Results. No significant differences were found between men and women in any of the variables. Regarding the relationship between parameters, the regression analysis was statistically significant, showing an effect of age on the walking and balance performance (β ≅ −0.4, p < 0.05); in addition, there was a relationship between 2MWT and STAI A/S, indicating that both older age and a high anxiety state could impact walking performance. On the other hand, prefrontal symptoms showed moderate relationships with both anxiety and depression (β ≅ 0.6, p < 0.05); thus, high levels of anxiety and depression could increase prefrontal alterations. Conclusions. There is a relationship between motor and emotional variables. Specifically, state anxiety is related to walking resistance. No relationship was found between depression and cognitive alteration and balance or walking ability. Only age has an effect in these relationships.
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Affiliation(s)
- María Cuerda-Ballester
- Doctoral School, Catholic University of Valencia San Vicente Mártir, 46001 Valencia, Spain
| | - David Martínez-Rubio
- Psicoforma Integral Psychology Center, 46001 Valencia, Spain
- Department of Psychology, European University of Valencia, 46010 Valencia, Spain
| | - María Pilar García-Pardo
- Department of Psychology and Sociology, University of Zaragoza, Campus Teruel, 44003 Teruel, Spain
| | - Belén Proaño
- Department of Basic Medical Sciences, Catholic University of Valencia, 46001 Valencia, Spain
| | - Laura Cubero
- Department of Basic Medical Sciences, Catholic University of Valencia, 46001 Valencia, Spain
| | - Antonio Calvo-Capilla
- Department of Medicine and Animal Surgery, Catholic University of Valencia, 46001 Valencia, Spain
| | - David Sancho-Cantus
- Department of Basic Medical Sciences, Catholic University of Valencia, 46001 Valencia, Spain
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Rakbangboon T, Guerra G, Kla-arsa S, Padungjaroen U, Tangpornprasert P, Virulsri C, Sasaki K. High-Level Mobility of Trans-Tibial Prosthesis Users Wearing Commercial and sPace Energy-Storing Prosthetic Feet. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12606. [PMID: 36231917 PMCID: PMC9566704 DOI: 10.3390/ijerph191912606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 09/27/2022] [Accepted: 09/27/2022] [Indexed: 06/16/2023]
Abstract
UNLABELLED Outcomes of users provided with a commercial ESR Vari-Flex foot (Össur, Reykjavik, Iceland) and a locally designed sPace foot were investigated. Step activity with users' own prosthetic foot compared to the sPace foot was explored. METHODS Eleven individuals with unilateral trans-tibial amputation participated and were provided with an sPace and Vari-Flex foot. Ten- and twenty-meter walk tests (10/20MWT) at comfortable and fast walking speeds (CWS/FWS), the two-minute walk test (2-MWT) and Comprehensive High-Level Activity Mobility Predictor (CHAMP) were administered. A subgroup was provided a pedometer to record their steps over a 7-day period in their own foot and later the sPace. RESULTS The sPace foot performed well in a battery of high-level mobility outcome measures. On CHAMP, participants scored 16.94 ± 5.41 and 16.72 ± 6.09 with the sPace and Vari-Flex feet, respectively. Subgroup testing of step activity showed 4490 ± 3444 steps in users' own feet and 3115 ± 1967 in the sPace foot, p = 0.176. CONCLUSIONS Participants using the sPace foot were capable of performing walking, high-level mobility and activity outcome measures.
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Affiliation(s)
- Thanyaporn Rakbangboon
- Sirindhorn School of Prosthetics and Orthotics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Gary Guerra
- Department of Exercise and Sport Science, St. Mary’s University, San Antonio, TX 78228, USA
| | - Saloottra Kla-arsa
- Sirindhorn School of Prosthetics and Orthotics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Uthumporn Padungjaroen
- Sirindhorn School of Prosthetics and Orthotics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Pairat Tangpornprasert
- Department of Mechanical Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok 10330, Thailand
| | - Chanyaphan Virulsri
- Department of Mechanical Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok 10330, Thailand
| | - Kazuhiko Sasaki
- Sirindhorn School of Prosthetics and Orthotics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
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Zhang J, Zou Y, Wang Z, Chen X, Pan J, Yu H, Li E, Zou H. Two-minute walk distance reference equations for middle-aged and elderly Chinese individuals with obesity. PLoS One 2022; 17:e0273550. [PMID: 36001629 PMCID: PMC9401169 DOI: 10.1371/journal.pone.0273550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 08/11/2022] [Indexed: 11/19/2022] Open
Abstract
Background and objective While the six-minute walk test (6MWT) is often used to assess exercise capacity, the less well-known two-minute walk test (2MWT) is more feasible for some patients. In previous studies, we developed reference equations for the two-minute walk distance (2MWD) for healthy Chinese adults. However, our study did not recruit people with obesity, and the reference equations did not apply to participants with a body mass index (BMI) > 30 kg/m2. The main objective of this study was to establish reference equations for the 2MWD among middle-aged and elderly Chinese individuals with obesity. Methods A total of 295 individuals were recruited. The participants underwent two 2MWTs, with the longer of the two 2MWDs used for further analyses. The reference equations for the 2MWD were developed using stepwise multiple regression analysis. The newly established equations for the 2MWD were then compared with the existing equations. Results The mean 2MWD of the participants was 176±20 m. Age and BMI were identified as independent factors that influenced the 2MWD and explained 28% and 32% of the variance in walking distance for the male and female groups, respectively. The reference equations for the 2MWD were as follows: Conclusion This study resulted in the development of reference equations for predicting 2MWD among middle-aged and elderly Chinese people with obesity. These equations will be a clinically valuable tool for evaluating functional capacity, determining prognoses and monitoring treatment in middle-aged and elderly Chinese people with obesity.
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Affiliation(s)
- Jia Zhang
- Department of Medical Inspection, Wenzhou People’s Hospital, The Wenzhou Third Clinical Institute Affiliated with Wenzhou Medical University, Wenzhou, Zhejiang, China
- School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yingying Zou
- Digestive System Department, The Third Affiliated Hospital of Qiqihar Medical College, Qiqihar, Heilongjiang, China
| | - Zibin Wang
- Obstetrics Department, Wenzhou People’s Hospital, The Wenzhou Third Clinical Institute Affiliated with Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xiaoshu Chen
- Department of Cardiovascular Medicine, Wenzhou People’s Hospital, The Wenzhou Third Clinical Institute Affiliated with Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jingye Pan
- Department of General and Intensive Medical Care, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Haizhu Yu
- Department of General Practice, Zhejiang Hospital, Hangzhou, Zhejiang, China
| | - Enci Li
- Nursing Department, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - He Zou
- Department of Cardiovascular Medicine, Wenzhou People’s Hospital, The Wenzhou Third Clinical Institute Affiliated with Wenzhou Medical University, Wenzhou, Zhejiang, China
- * E-mail:
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