Antivirals

抗病毒药物
  • 文章类型: Journal Article
    1型糖尿病(T1D),需要强化胰岛素治疗的严重疾病,会增加并发症的风险并缩短寿命。某些病毒与T1D的病因学有关,与\'活\',最近在诊断时在胰腺中发现的复制型肠道病毒(EV)。这一发现促使一项使用抗病毒药物减缓疾病进展的试验。在新发病的T1D患者中,联合pleconaril和利巴韦林的6个月治疗保留了1年后的残余胰岛素产量。不像安慰剂.结果支持病毒可能在遗传易感个体中引起T1D的理论。一个低级的,持续性病毒感染可能会引发一系列最初涉及先天免疫系统的致病机制,诱导β细胞应激和新抗原释放,导致自身免疫,最终破坏产生胰岛素的β细胞。
    Type 1 diabetes (T1D), a severe disease requiring intensive insulin treatment, carries an increased risk for complications and reduced lifespan. Certain viruses have been implicated in T1D\'s etiology, with \'live\', replicating enteroviruses (EVs) recently found in the pancreas at diagnosis. This discovery prompted a trial to slow down disease progression using antiviral drugs. A 6-month treatment combining pleconaril and ribavirin in new-onset T1D patients preserved residual insulin production after 1 year, unlike placebo. The results support the theory that viruses may cause T1D in genetically susceptible individuals. A low-grade, persistent viral infection may initiate a cascade of pathogenic mechanisms initially involving the innate immune system, inducing β-cell stress and neoantigen release, leading to autoimmunity, and eventually the destruction of insulin-producing β-cells.
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  • 文章类型: Journal Article
    背景:急性COVID期间的治疗是否能对长期COVID发病率产生保护作用尚不清楚。
    目的:评估抗病毒药物急性COVID治疗之间的关系,皮质类固醇,单克隆抗体(mAb)和长期COVID发病率,以及它们对不同人群和个体症状的影响。
    方法:直到2024年1月29日在PubMed进行了搜索,Medline,WebofScience,和Embase。
    方法:报道急性COVID后COVID长期发病率的文章,随访至少30天,无语言限制。
    方法:有COVID-19诊断史的患者。
    方法:接受抗病毒药物治疗的患者,皮质类固醇或单克隆抗体。
    质量评估基于纽卡斯尔-渥太华量表,ROBINS-I和Cochrane偏差工具的风险。
    记录每个研究的基本特征。随机森林模型和元回归用于评估治疗与长期COVID之间的相关性。
    结果:我们的搜索确定了2363条记录,其中32项纳入定性综合,25项纳入荟萃分析。来自14篇研究急性COVID抗病毒治疗的论文的效果大小得出结论,其对长期COVID的保护功效(OR0.61,95%CI:0.48-0.79,p=0.0002);然而,皮质类固醇(OR1.57,95%CI:0.80-3.09,p=0.1913)和mAb治疗(OR0.94,95%CI:0.56-1.56,p=0.8012)未产生这种效果.随后的亚组分析显示,抗病毒药物在老年人中提供了更强的保护,男性,未接种疫苗和非糖尿病人群。此外,抗病毒药物有效地减少了22例分析的长期COVID症状中的8例。
    结论:我们的荟萃分析确定,抗病毒药物降低了人群的长期covid发病率,因此应推荐用于急性COVID治疗。单克隆抗体治疗与长期COVID之间没有关系,但应进行研究以阐明急性COVID皮质类固醇对COVID急性期的潜在有害影响。
    BACKGROUND: Whether treatment during acute COVID results in protective efficacy against long COVID incidence remains unclear.
    OBJECTIVE: To assess the relationship between acute COVID treatments of antivirals, corticosteroids, and monoclonal antibodies (mAbs) and long COVID incidence, and their effects in different populations and individual symptoms.
    METHODS: Searches were conducted up to Jan 29, 2024 in PubMed, Medline, Web of Science, and Embase.
    METHODS: Articles that reported long COVID incidence post-acute COVID with a follow-up of at least 30 days with no language restrictions.
    METHODS: Patients with a COVID-19 diagnosis history.
    METHODS: Patients treated with antivirals, corticosteroids or mAbs.
    UNASSIGNED: Quality assessment was based on Newcastle-Ottawa scale, ROBINS-I and Cochrane risk of bias tool.
    UNASSIGNED: Basic characteristics were documented for each study. Random forest model and meta-regression was used to evaluate correlation between treatments and long COVID.
    RESULTS: Our search identified 2363 records, 32 of which were included in the qualitative synthesis and 25 included into the meta-analysis. Effect size from 14 papers investigating acute COVID antiviral treatment concluded its protective efficacy against long COVID (OR 0.61, 95% CI: 0.48-0.79, p = 0.0002); however, corticosteroid (OR 1.57, 95% CI: 0.80-3.09, p = 0.1913) and mAbs treatments (OR 0.94, 95% CI: 0.56-1.56, p = 0.8012) did not generate such effect. Subsequent subgroup analysis revealed that antivirals provided stronger protection in the aged, male, unvaccinated and non-diabetic populations. Furthermore, antivirals effectively reduced eight out of the twenty-two analyzed long COVID symptoms.
    CONCLUSIONS: Our meta-analysis determined that antivirals reduced long covid incidence across populations and should thus be recommended for acute COVID treatment. There was no relationship between mAbs treatment and long COVID, but studies should be conducted to clarify acute COVID corticosteroids\' potential harmful effects on the post-acute phase of COVID.
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  • 文章类型: Journal Article
    最近的研究表明,乙型肝炎病毒(HBV)DNA的基线水平与慢性乙型肝炎(CHB)患者肝细胞癌(HCC)的治疗风险之间存在负相关关系。然而,数据仅限于亚洲队列,目前尚不清楚类似的关联是否适用于非亚洲人CHB。我们的目的是评估基线HBVDNA与肝硬化和肝癌的长期风险之间的主要非亚洲队列CHB患者在美国的关联。
    使用来自国家退伍军人事务数据库的纵向数据,我们评估了肝硬化或肝癌的非肝硬化CHB成人谁是连续抗病毒治疗的风险,通过基线HBVDNA的中等水平(4.00-6.99log10IU/mL)与高水平的基线HBVDNA(7.00log10IU/mL或更高)。应用倾向得分加权,并利用竞争风险累积发生率函数和Cox比例风险模型。
    在1,129名非肝硬化CHB患者中(41%非西班牙裔白人,36%非洲裔美国人,平均年龄57.0岁,62.2%乙肝e抗原(HBeAg)阳性),585有中等水平的基线HBVDNA和544有高HBVDNA。在倾向得分加权后,在中度与中度之间观察到肝硬化的风险没有显着差异。高基线HBVDNA(4.55vs.5.22每100人年,风险比(HR):0.87,95%置信区间(CI):0.69-1.09,P=0.22),但肝癌的风险显著高于中度患者。高基线HBVDNA(0.84vs.每100人年0.69,HR:1.33,95%CI:1.09-1.62,P<0.01)。
    在国家队列中,主要是非亚洲美国退伍军人与非肝硬化CHB抗病毒治疗,与高HBVDNA相比,中等水平的基线HBVDNA与更高的HCC风险相关.
    UNASSIGNED: Recent studies suggest an inverse relationship between baseline levels of hepatitis B virus (HBV) DNA and on-treatment risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB). However, data are limited to Asian cohorts, and it is unclear if similar associations hold true for non-Asians with CHB. We aimed to evaluate association of baseline HBV DNA with long-term risks of cirrhosis and HCC among a predominantly non-Asian cohort of CHB patients in the USA.
    UNASSIGNED: Using longitudinal data from the national Veterans Affairs database, we evaluated the risk of cirrhosis or HCC among adults with non-cirrhotic CHB who are on continuous antiviral therapy, stratified by moderate levels of baseline HBV DNA (4.00 - 6.99 log10 IU/mL) vs. high levels of baseline HBV DNA (7.00 log10 IU/mL or higher). Propensity score weighting was applied, and competing risks cumulative incidence functions and Cox proportional hazards models were utilized.
    UNASSIGNED: Among 1,129 non-cirrhotic CHB patients (41% non-Hispanic White, 36% African American, mean age 57.0 years, 62.2% hepatitis B e antigen (HBeAg) positive), 585 had moderate levels of baseline HBV DNA and 544 had high HBV DNA. After propensity score weighting, no significant difference in risk of cirrhosis was observed between moderate vs. high baseline HBV DNA (4.55 vs. 5.22 per 100 person-years, hazard ratio (HR): 0.87, 95% confidence interval (CI): 0.69 - 1.09, P = 0.22), but risk of HCC was significantly higher in patients with moderate vs. high baseline HBV DNA (0.84 vs. 0.69 per 100 person-years, HR: 1.33, 95% CI: 1.09 - 1.62, P < 0.01).
    UNASSIGNED: Among a national cohort of predominantly non-Asian US veterans with non-cirrhotic CHB on antiviral therapy, moderate levels of baseline HBV DNA was associated with higher risk of HCC than high HBV DNA.
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  • 文章类型: Journal Article
    几种病毒劫持各种形式的内吞作用以感染宿主细胞。这里,我们报告发现了一种具有抗病毒特性的分子,我们将其命名为韦拉替尼,这限制了巨细胞胞吞作用的病毒进入。韦拉替尼的鉴定来自使用高通量显微镜的化学筛选,其中我们鉴定了能够防止表达SARS-CoV-2的刺突(S)蛋白的假型病毒感染的化学实体。随后的实验证实了韦拉替尼抑制SARS-CoV-2以及其他病毒感染的能力,如猴痘病毒和TBEV。机制分析显示该化合物抑制巨细胞增多症,限制病毒的此进入路径。重要的是,韦拉替尼对宿主细胞无明显毒性。总之,我们发现了一种抑制巨噬细胞增多的分子,从而限制了使用这种进入途径的病毒如SARS-CoV2的感染性。
    Several viruses hijack various forms of endocytosis in order to infect host cells. Here, we report the discovery of a molecule with antiviral properties that we named virapinib, which limits viral entry by macropinocytosis. The identification of virapinib derives from a chemical screen using high-throughput microscopy, where we identified chemical entities capable of preventing infection with a pseudotype virus expressing the spike (S) protein from SARS-CoV-2. Subsequent experiments confirmed the capacity of virapinib to inhibit infection by SARS-CoV-2, as well as by additional viruses, such as mpox virus and TBEV. Mechanistic analyses revealed that the compound inhibited macropinocytosis, limiting this entry route for the viruses. Importantly, virapinib has no significant toxicity to host cells. In summary, we present the discovery of a molecule that inhibits macropinocytosis, thereby limiting the infectivity of viruses that use this entry route such as SARS-CoV2.
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  • 文章类型: Case Reports
    在日本,在整个COVID-19大流行期间,流感活动一直很低,直到2022-23季节,自2020-21季节以来首次爆发流感。在COVID-19大流行期间的流感监测中,尚未发现SARS-CoV-2和流感病毒的共同感染;但是,2024年1月,我们发现3名儿科门诊患者同时感染了这些病毒:1名患有SARS-CoV-2OmicronEG.5亚谱系HK.3和甲型流感(H3N2),2名患有SARS-CoV-2OmicronBA.2.86亚谱系JN.1.5和甲型流感(H1N1)pdm09.我们评估了SARS-CoV-2对RNA依赖性RNA聚合酶抑制剂(remdesivir和molnupiravir)和3C样蛋白酶抑制剂(nirmatrelvir和ensitrelvir)的敏感性,以及针对神经氨酸酶抑制剂的流感病毒(奥司他韦,帕拉米韦,扎那米韦,和laninamivir)和帽依赖性核酸内切酶抑制剂baloxavir。所有测试的病毒对这些抗病毒药物敏感,并且不具有与降低的抗病毒易感性相关的氨基酸取代。患者接受抗流感药物治疗,尽管合并感染,但没有出现严重症状。由于SARS-CoV-2和流感病毒不断进化,持续监测其血液循环对于评估公共卫生措施和支持临床管理仍然至关重要.
    In Japan, influenza activity was low throughout the COVID-19 pandemic until the 2022-23 season, when the first influenza outbreak occurred since the 2020-21 season. In our influenza surveillance during the COVID-19 pandemic, co-infection with SARS-CoV-2 and influenza virus had not been detected; however, in January 2024, we identified three pediatric outpatients co-infected with these viruses: one with SARS-CoV-2 Omicron EG.5 sublineage HK.3 and influenza A(H3N2) and two with SARS-CoV-2 Omicron BA.2.86 sublineage JN.1.5 and influenza A(H1N1)pdm09. We evaluated the susceptibility of SARS-CoV-2 against RNA-dependent RNA polymerase inhibitors (remdesivir and molnupiravir) and 3C-like protease inhibitors (nirmatrelvir and ensitrelvir), and that of influenza viruses against neuraminidase inhibitors (oseltamivir, peramivir, zanamivir, and laninamivir) and the cap-dependent endonuclease inhibitor baloxavir. All viruses tested were susceptible to these antiviral drugs and did not possess amino acid substitutions associated with reduced antiviral susceptibility. The patients were treated with anti-influenza drugs and did not develop severe symptoms despite the co-infection. Since SARS-CoV-2 and influenza viruses continue to evolve, continuous monitoring of their circulation remains essential to assess public health measures and support clinical management.
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  • 文章类型: Journal Article
    暂无摘要。
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  • 文章类型: Journal Article
    一个小的抗病毒特性(≈1kDa),新型Ru(II)光动力化合物(PDC),称为TLD-1433(Ruvidar™),被呈现。TLD-1433先前已被证明具有强大的抗菌和抗癌特性。我们评估了TLD-1433灭活几种人类致病病毒的能力。未光活化的TLD-1433能够在117nM的浓度下有效灭活50%的流感H1N1病毒(ID50)。照片激活后,ID50降低至<10nM。降低H1N1感染性>99%(ID99)所需的光活化TLD-1433的剂量约为170nM。同样,对于其他测试的包膜病毒,光活化的TLD-1433的ID99被确定为约20至120nM;特别是,一种人类冠状病毒,单纯疱疹病毒,痘病毒痘苗病毒,和寨卡病毒。TLD-1433还灭活了两种测试的无包膜病毒;特别是,腺病毒5型和哺乳动物正病毒,但是浓度要高得多。对TLD-1433处理的膜的分析表明,脂质过氧化是包膜病毒灭活的主要原因。TLD-1433介导的病毒灭活是温度依赖性的,当病毒在37°C处理时,比在室温(~22°C)处理时,具有大约10倍的有效杀病毒活性。胎牛血清和病毒溶液浊度的存在降低了TLD-1433介导的杀病毒效率。TLD-1433处理的人冠状病毒的免疫印迹表明处理的刺突蛋白保持颗粒相关。
    The anti-viral properties of a small (≈1 kDa), novel Ru(II) photo dynamic compound (PDC), referred to as TLD-1433 (Ruvidar™), are presented. TLD-1433 had previously been demonstrated to exert strong anti-bacterial and anti-cancer properties. We evaluated the capacity of TLD-1433 to inactivate several human pathogenic viruses. TLD-1433 that was not photo-activated was capable of effectively inactivating 50 % of influenza H1N1 virus (ID50) at a concentration of 117 nM. After photo-activation, the ID50 was reduced to <10 nM. The dose of photo-activated TLD-1433 needed to reduce H1N1 infectivity >99 % (ID99) was approximately 170 nM. Similarly, the ID99 of photo-activated TLD-1433 was determined to range from about 20 to 120 nM for other tested enveloped viruses; specifically, a human coronavirus, herpes simplex virus, the poxvirus Vaccinia virus, and Zika virus. TLD-1433 also inactivated two tested non-enveloped viruses; specifically, adenovirus type 5 and mammalian orthoreovirus, but at considerably higher concentrations. Analyses of TLD-1433-treated membranes suggested that lipid peroxidation was a major contributor to enveloped virus inactivation. TLD-1433-mediated virus inactivation was temperature-dependent, with approximately 10-fold more efficient virucidal activity when viruses were treated at 37 °C than when treated at room temperature (∼22 °C). The presence of fetal bovine serum and virus solution turbidity reduced TLD-1433-mediated virucidal efficiency. Immunoblots of TLD-1433-treated human coronavirus indicated the treated spike protein remained particle-associated.
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  • 文章类型: Journal Article
    寨卡病毒(ZIKV)是一种重新出现的RNA病毒,已知会导致婴儿的眼部和神经系统异常。ZIKV利用感染细胞中的自噬过程来增强其复制和传播。因此,自噬抑制剂已成为对抗RNA病毒的有效治疗靶点,羟氯喹(HCQ)是最有希望的候选之一。在这项研究中,我们合成了几种新型的小分子喹啉衍生物,评估他们的抗病毒活性,并确定了潜在的分子机制。在九种合成的类似物中,两位主要候选人,标记为GL-287和GL-382,显著减弱ZIKV在人类眼细胞中的复制,主要通过抑制自噬。这两种化合物的抗病毒功效超过了HCQ和其他现有的自噬抑制剂,如ROC-325、DC661和GNS561。此外,与HCQ不同,这些新的类似物在眼细胞中没有表现出细胞毒性。在ZIKV感染的细胞中用化合物GL-287和GL-382处理增加了LC3斑点的丰度,表明自噬过程的中断。此外,化合物GL-287和GL-382可有效抑制ZIKV诱导的眼细胞先天炎症反应。总的来说,我们的研究证明了新型自噬抑制剂对ZIKV具有安全有效的抗病毒活性.
    Zika virus (ZIKV) is a re-emerging RNA virus that is known to cause ocular and neurological abnormalities in infants. ZIKV exploits autophagic processes in infected cells to enhance its replication and spread. Thus, autophagy inhibitors have emerged as a potent therapeutic target to combat RNA viruses, with Hydroxychloroquine (HCQ) being one of the most promising candidates. In this study, we synthesized several novel small-molecule quinoline derivatives, assessed their antiviral activity, and determined the underlying molecular mechanisms. Among the nine synthesized analogs, two lead candidates, labeled GL-287 and GL-382, significantly attenuated ZIKV replication in human ocular cells, primarily by inhibiting autophagy. These two compounds surpassed the antiviral efficacy of HCQ and other existing autophagy inhibitors, such as ROC-325, DC661, and GNS561. Moreover, unlike HCQ, these novel analogs did not exhibit cytotoxicity in the ocular cells. Treatment with compounds GL-287 and GL-382 in ZIKV-infected cells increased the abundance of LC3 puncta, indicating the disruption of the autophagic process. Furthermore, compounds GL-287 and GL-382 effectively inhibited the ZIKV-induced innate inflammatory response in ocular cells. Collectively, our study demonstrates the safe and potent antiviral activity of novel autophagy inhibitors against ZIKV.
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  • 文章类型: Journal Article
    由于收集频繁和定期的诊断测试结果的后勤,病毒SARS-CoV-2反弹(病毒RNA反弹)在大型队列中具有挑战性。以药学为基础的测试数据提供了一个在大量人群中研究这种现象的机会,还可以进行子组分析。当前的真实世界证据方法补充了专注于较小,前瞻性研究设计。
    我们通过标记化将来自国家基于药学的测试的实时逆转录定量聚合酶链反应测试数据与医疗保健声明数据相关联,以计算在Omicron时代(2021年12月至2022年11月)和Omicron时代(2020年10月至2021年11月)之前,在nirmatrelvir/ritonavir(NMV-r)治疗和未经治疗的个体中阳性测试结果
    在30646名患者中,在NMV-r治疗的感染中,病毒RNA反弹率为3.5%(95%CI,2.0%-5.7%),而在Omicron时代未治疗的感染中,病毒RNA反弹率为1.5%(95%CI,1.3%-1.7%),在Omicron时代之前为1.9%(95%CI,1.7%-2.1%).接种疫苗的患者的病毒RNA反弹(n=8151),高风险(n=4411),或以上(≥65岁,n=4411)的发生率与整体队列(范围,1.1%-4.8%)。在NMV-r处理的感染中,病毒反弹至高RNA水平发生在8%的病毒反弹中,与未处理的感染中的5%至11%相比。NMV-r治疗的病毒RNA反弹感染患者(0%)和未经治疗的病毒RNA反弹患者(0%-1.2%)之间的住院率相当。
    我们的研究结果表明,病毒RNA反弹是罕见的(<5%),其发生率与EPIC-HR试验(高风险患者对COVID-19蛋白酶抑制的评估)一致。大多数病毒RNA反弹事件与低病毒RNA水平有关,未观察到病毒RNA反弹进展为严重疾病。
    UNASSIGNED: Viral SARS-CoV-2 rebound (viral RNA rebound) is challenging to characterize in large cohorts due to the logistics of collecting frequent and regular diagnostic test results. Pharmacy-based testing data provide an opportunity to study the phenomenon in a large population, also enabling subgroup analyses. The current real-world evidence approach complements approaches focused on smaller, prospective study designs.
    UNASSIGNED: We linked real-time reverse transcription quantitative polymerase chain reaction test data from national pharmacy-based testing to health care claims data via tokenization to calculate the cumulative incidence of viral RNA rebound within 28 days following positive test results in nirmatrelvir/ritonavir (NMV-r)-treated and untreated individuals during the Omicron era (December 2021-November 2022) and prior to the Omicron era (October 2020-November 2021).
    UNASSIGNED: Among 30 646 patients, the rate of viral RNA rebound was 3.5% (95% CI, 2.0%-5.7%) in NMV-r-treated infections as compared with 1.5% (95% CI, 1.3%-1.7%) in untreated infections during the Omicron era and 1.9% (95% CI, 1.7%-2.1%) prior to the Omicron era. Viral RNA rebound in patients who were vaccinated (n = 8151), high risk (n = 4411), or older (≥65 years, n = 4411) occurred at comparable rates to the overall cohort (range, 1.1%-4.8%). Viral rebounds to high RNA levels in NMV-r-treated infections occurred in 8% of viral rebounds as compared with 5% to 11% in untreated infections. Rates of hospitalization were comparable between patients with NMV-r-treated infections with viral RNA rebound (0%) and untreated patients with viral RNA rebound (0%-1.2%).
    UNASSIGNED: Our findings suggest viral RNA rebound is rare (< 5%), with rates that were consistent with those from the EPIC-HR trial (Evaluation of Protease Inhibition for COVID-19 in High-Risk Patients). Most occurrences of viral RNA rebound were associated with low viral RNA levels, and viral RNA rebound progression to severe disease was not observed.
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  • 文章类型: Journal Article
    靶向蛋白质降解已被广泛采用作为消除已建立和先前顽固的治疗靶标的新方法。在这里,我们报告了登革热病毒包膜(E)蛋白的小分子降解物的开发。我们开发了两类二价E降解剂,连接两个先前报道的E结合小分子,GNF-2和CVM-2-12-2,用于基于戊二酰亚胺的CRL4CRBN连接酶招募者,以实现蛋白体介导的E蛋白降解。ZXH-2-107(基于GNF-2)是具有ABL抑制的E降解剂,而ZXH-8-004(基于CVM-2-12-2)是选择性和有效的E降解剂。这两种化合物提供了概念证明,即使用二价降解剂可以有效消除诸如病毒包膜蛋白之类的难药用靶标,并为未来开发新一类抗病毒药物提供了起点。
    Targeted protein degradation has been widely adopted as a new approach to eliminate both established and previously recalcitrant therapeutic targets. Here we report the development of small molecule degraders of the envelope (E) protein of dengue virus. We developed two classes of bivalent E-degraders, linking two previously reported E-binding small molecules, GNF-2 and CVM-2-12-2, to a glutarimide-based recruiter of the CRL4CRBN ligase to effect proteosome-mediated degradation of the E protein. ZXH-2-107 (based on GNF-2) is an E degrader with ABL inhibition while ZXH-8-004 (based on CVM-2-12-2) is a selective and potent E-degrader. These two compounds provide proof-of-concept that difficult-to-drug targets such as a viral envelope protein can be effectively eliminated using a bivalent degrader and provide starting points for the future development of a new class antiviral drugs.
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