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Haemodynamische Auswirkungen einer intramyometranen Epinephrininjektionen zur Blutungsreduktion bei laparoskopischer Myomenukleation. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Einfluss der totalen versus subtotalen laparoskopischen Hysterektomie auf die weibliche Sexualität. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Einfluss einer Ulipristalacetatmedikation auf die weibliche Sexualität bei Frauen mit symptomatischem Uterus myomatosus. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Einfluss der totalen versus subtotalen laparoskopischen Hysterektomie auf die weibliche Sexualität – Was erwarten Patientinnen? Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1593301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Operative Optionen bei Uterus myomatosus. GYNAKOLOGISCHE ENDOKRINOLOGIE 2015. [DOI: 10.1007/s10304-015-0023-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Medikamentöse Myomtherapie. GYNAKOLOGISCHE ENDOKRINOLOGIE 2015. [DOI: 10.1007/s10304-015-0021-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Geburtsverlauf und kindliches Outcome bei prägravide untergewichtigen Frauen. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Bilaterale transgastrale Adnexektomie. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Die weibliche Sexualität nach der Geburt. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Effektivität einer topischen transdermalen Schmerzmittelapplikation nach gynäkologischen minimal invasiven Eingriffen – Ergebnisse einer prospektiv randomisierten verblindeten Studie. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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[Caesarean section in german hospitals: validity of hospital quality report data for monitoring C-section rates]. DAS GESUNDHEITSWESEN 2014; 77:278-83. [PMID: 25077731 DOI: 10.1055/s-0034-1381990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE It is not known if "hospital quality reports" (HQR) document Caesarean (C-) section rates at the hospital level accurately enough for use as a reliable data source when it comes to explaining regional variations of C-sections in Germany by factors at the hospital level. We aimed to answer this question using HQR from hospitals in Baden-Württemberg as data source. METHOD Diagnostic and procedure codes from HQR for the year 2008 (HQRdata), were used to calculate numbers of births, numbers of C-sections, and rates of births by C-section (CSR) for 94 of 97 hospitals in Baden-Württemberg. These numbers were compared to internal hospital (IH) data delivered upon request by 80 of 97 hospitals and stemming from vital statistics, birth registry forms, or external quality assurance datasets. RESULTS There was no difference in the number of births between HQR data and IH data, but the number of C-sections and the CSR differed significantly (p<0.05; Wilcoxon rank sum test). CSR calculated using HQR data was 4.9 ± 17.9% higher than CSR from IH data (absolute difference 1.5 ± 5.8%). The correlation between the 2 data sources was moderate (r=0.73). Only 55% of the variance in IH data-based CSR was explained by HQR data. The proportion between highest and lowest CSR in hospitals in Baden-Württemberg was 4.9 for HQR data and 3.6 for IH data. CONCLUSION There are significant and relevant differences between C-section rates based on ei-ther HQR or IH data. This questions routine data from HQR for 2008 as a reliable data source for research work.
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Bioelektrische Impedanzanalyse: Normwerte in der Schwangerschaft. Z Geburtshilfe Neonatol 2013. [DOI: 10.1055/s-0033-1361341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Gynaecological laparoscopic surgery for benign conditions: do women care about incisions? Eur J Obstet Gynecol Reprod Biol 2013; 169:84-7. [DOI: 10.1016/j.ejogrb.2013.02.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Revised: 11/04/2012] [Accepted: 02/05/2013] [Indexed: 10/27/2022]
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Prevalence, Trend and Determining Factors of Gestational Diabetes in Germany. Geburtshilfe Frauenheilkd 2012; 72:311-315. [PMID: 25284837 DOI: 10.1055/s-0031-1298390] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2011] [Revised: 02/02/2012] [Accepted: 02/29/2012] [Indexed: 10/28/2022] Open
Abstract
Purpose: The true prevalence of gestational diabetes in Germany is unknown. Thus, the study's purposes were to estimate the prevalence of gestational diabetes as well as to describe the temporal prevalence trend and to identify determinants. Material and Methods: We calculated prevalence estimates based on two datasets: the register-based German perinatal statistic (n = 650 232) and the maternal self-reports from the German children and youth health survey (KiGGS; n = 15 429). Differences between prevalence estimates were analysed using χ2 and trend tests, and determinants were identified using logistic regression. Results: According to the perinatal statistic, gestational diabetes was present in 3.7 % of pregnant women in Germany in 2010. The prevalence across the years 2001 to 2006 was estimated at 1.9 % which differed significantly from the prevalence estimate derived from the KiGGS dataset for the same period of time (5.3 %; 95 % confidence interval: 4.6-6.1 %). Both datasets show an increasing trend of gestational diabetes (p < 0.001). The risk for gestational diabetes was mainly associated with age, BMI and social class of pregnant women as well as with multiple pregnancies. Conclusion: The lack of significant screening studies among representative samples hampers a sound estimation of the true prevalence of gestational diabetes in Germany. The increasing trend in gestational diabetes might continue due to the projected increase of important risk factors (e.g., maternal age, obesity). Our analyses support the current consensus recommendations regarding standardised gestational diabetes screening.
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Laparoscopic nerve-sparing surgery of deep infiltrating endometriosis: description of the technique and patients' outcome. Arch Gynecol Obstet 2010; 284:131-5. [PMID: 20680309 DOI: 10.1007/s00404-010-1624-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2010] [Accepted: 07/12/2010] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The radical surgery of the deep infiltrating endometriosis of the rectovaginal septum and the uterosacral ligaments with or without bowel resection can cause a serious damage of the pelvic autonomic nerves with urinary retention and the need of self-catheterization. PATIENTS AND METHODS We introduce a case series report of 16 patients with laparoscopic nerve-sparing surgery of deep infiltrating endometriosis. We describe the technique step by step and compare the patients' outcome with patients who had undergone a non-nerve-sparing surgical technique. In 12 patients, a double-sided and in four patients, a single-sided identification of the inferior hypogastric nerve and plexus were performed. RESULTS In all patients at least single-sided resection of the uterosacral ligaments were performed. Postoperatively dysmenorrhoea, pelvic pain, and dyspareunia disappeared in all patients. The average operating time was 82 min (range 45-185). Postoperatively, the overall time to resume voiding function was 2 days. The residual urine volume was in all patients <50 ml at two ultrasound measurements. DISCUSSION Identification of the inferior hypogastric nerve and plexus was feasible. In comparison with non-nerve-sparing surgical technique, no cases of bladder self-catheterization for a long or even life time was observed, confirming the importance of the nerve-sparing surgical procedure.
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Lack of differences in nephrotoxicity of intravenous bisphosphonates in metastatic breast cancer. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.1122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Total laparoscopic hysterectomy without uterine manipulator: description of a new technique and its outcome. Arch Gynecol Obstet 2010; 283:1053-7. [DOI: 10.1007/s00404-010-1494-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2010] [Accepted: 04/21/2010] [Indexed: 12/01/2022]
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[Prevention of complications in twin gestations and pregnancies after assisted reproduction]. Z Geburtshilfe Neonatol 2010; 213:228-33. [PMID: 20099210 DOI: 10.1055/s-0029-1241846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Twin pregnancies and gestations after assisted reproductive therapy (ART) are of special obstetric significance with regard to their associated risks. However, little is known about preventive approaches specifically evaluated for these constellations. METHODS A selective literature search was conducted to examine possible preventive approaches for complications such as hypertensive disorders, anaemia, gestational diabetes, prematurity, and others, seen significantly more often in twin gestations and pregnancies after ART. RESULTS For both constellations, preventive approaches are not specifically evaluated for the majority of complications. For some preventive methods a possible detrimental effect cannot even be ruled out. CONCLUSIONS The knowledge about specific preventive approaches against complications in twin pregnancies and gestations after ART is scarce. More prospective trials are urgently needed to assess the risks and benefits of prophylactic approaches for these risk constellations.
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Einfluss der assistierten Reproduktion auf Geburtshilfe und Neonatologie. Z Geburtshilfe Neonatol 2010; 213:221-7. [DOI: 10.1055/s-0029-1238275] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Gibt es einen Unterschied der direkten Entbindungskosten bei spontan eingetretener Zwillingsgravidität und Gemini nach Kinderwunschbehandlung? Z Geburtshilfe Neonatol 2010; 213:267-71. [DOI: 10.1055/s-0029-1241883] [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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Successful laser therapy of a papular acantholytic dyskeratosis of the vulva: case report and review of literature. Arch Gynecol Obstet 2009; 281:723-5. [PMID: 20012979 DOI: 10.1007/s00404-009-1313-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2009] [Accepted: 11/24/2009] [Indexed: 11/24/2022]
Abstract
BACKGROUND The papular acantholytic dyskeratosis summarizes a collection of papular skin lesions which occur in intertriginous areas and in the genital area. They show a very characteristic histology without the connection to a syndrome such as the Hailey-Hailey disease or the Darier disease. METHODS We present the case of an affected 45-year-old woman and evaluate the laser therapy as therapeutic option. RESULTS A long lasting reduction of the symptoms was achieved by paying special attention to involving the deep tissue layers while performing the laser therapy. Despite causing a long and painful healing process, this was the only way to achieve a lasting reduction of the symptoms. CONCLUSIONS Laser therapy in afflicted areas can improve the symptoms of the papular acantholytic dyskeratosis. The deep tissue laser therapy showed more success than the superficial laser therapy.
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[Seasonality of omphalocele in northern Germany]. ULTRASCHALL IN DER MEDIZIN (STUTTGART, GERMANY : 1980) 2009; 30:591-595. [PMID: 19085743 DOI: 10.1055/s-2008-1027896] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
PURPOSE Omphalocele is a rare congenital abdominal wall defect that has been attributed to environmental factors such as increased levels of herbicides in surface water. We wanted to verify a seasonal variation of the incidence of Omphalocele and thus to identify possible environmental factors in an area in Northern Germany that is characterized by a predominantly agricultural setting. MATERIALS AND METHODS A retrospective analysis of all pregnancies (n = 28 935) screened by ultrasound at our University Hospital between January 1, 1993 and December 31, 2007 was carried out. After identification of fetuses with persisting Omphalocele, analysis for additional structural defects and for chromosomal anomalies, such as trisomy 18, was carried out. We further categorized all patients with regard to the date of conception during summer (April-September) and winter months (October-March). Categorical variables were compared by the Mann-Whitney-U test and were considered statistically significant when two tailed analyses yielded p = 0.05. RESULTS There was no significant difference in the seasonal distribution of conception neither for all fetuses (p = 0.70) nor for fetuses with Omphalocele (p = 0.94). The results were constant for fetuses with isolated Omphalocele and with additional malformation and for those with Omphalocele and associated chromosomal anomalies. The incidence of fetal Omphalocele has remained relatively stable within the last 15 years. No significant difference was found in the seasonal incidence of Omphalocele in patients from an urban or rural background. CONCLUSION Since we were unable to demonstrate a relationship between the time of conception and the incidence of fetal Omphalocele in our cohort of pregnant women from a predominantly agricultural background, other factors should be investigated for possible associations with the onset of Omphalocele.
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Hysteroskopische Befunde bei Frauen mit zwei und mit mehr Frühaborten. Geburtshilfe Frauenheilkd 2009. [DOI: 10.1055/s-0029-1238932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Geburtshilfe. Indikationen zur Antikoagulation in der Schwangerschaft. Geburtshilfe Frauenheilkd 2009. [DOI: 10.1055/s-0029-1186118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Allgemeine Gynäkologie. Thromboseprophylaxe auch bei ambulanten und minimal-invasiven gynäkologischen Eingriffen? Geburtshilfe Frauenheilkd 2008. [DOI: 10.1055/s-2008-1039288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Primäre Sectiones subventionieren Spontangeburten. Spielen finanzielle Interessen bei der steigenden Sectiorate eine Rolle? Geburtshilfe Frauenheilkd 2008. [DOI: 10.1055/s-2008-1039049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Gestagene- Allheilmittel zur Prophylaxe und Therapie von Schwangerschaftspathologien? Geburtshilfe Frauenheilkd 2008. [DOI: 10.1055/s-0028-1089184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Ökonomie der Geburtshilfe–Primäre Sektio versus Spontanpartus – Bilanz der aktuellen Vergütung im G-DRG System. Geburtshilfe Frauenheilkd 2008. [DOI: 10.1055/s-0028-1088648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Chronische entzündliche Darmerkrankungen und Schwangerschaft – Welchen Risiken und Komplikationen sind zu beachten? Geburtshilfe Frauenheilkd 2008. [DOI: 10.1055/s-0028-1088778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Chronisch entzündliche Darmerkrankungen und Reproduktion - Aktuelles zu Datenlage und Behandlungskonzepten. Geburtshilfe Frauenheilkd 2008. [DOI: 10.1055/s-2007-989410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Aktuelle Therapiekonzepte. Maternale Thrombozytopenie als Schwangerschaftskomplikation. Geburtshilfe Frauenheilkd 2008. [DOI: 10.1055/s-2008-1038340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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A new approach to label sentinel nodes in endometrial cancer. Gynecol Oncol 2007; 105:457-61. [PMID: 17313975 DOI: 10.1016/j.ygyno.2007.01.021] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2006] [Revised: 12/20/2006] [Accepted: 01/02/2007] [Indexed: 10/23/2022]
Abstract
PURPOSE The objective of the study was to determine the feasibility of a new method of labeling sentinel lymph nodes in patients with endometrial cancer using blue dye. PATIENTS AND METHODS 4 ml of blue dye was subserously administered in 25 patients with endometrial cancer at eight sites. After 8 min, sentinel lymph nodes were harvested. RESULTS Detection rate was 92.0%, sensitivity was 62.5%, and negative predictive value was 92.5%. In two patients there was no detection of sentinel nodes and in addition in two patients only sentinel nodes were harvested due to minimal disease. No side effects occurred. CONCLUSIONS This new and simple approach yielded a high pelvic detection rate. This new approach reveals a way to label sentinel nodes in endometrial cancer. Combining a different labeling agent with the proposed new method might overcome the lack of para-aortic sentinel detection.
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