Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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On Sep 2018




Prof. Somashekhar Nimbalkar

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Chairman, Research Group, Charutar Arogya Mandal, Karamsad
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On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



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Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
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Professor and Head
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Saraswati Dental College
Lucknow
On Sep 2018




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Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




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Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
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Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011
Anuradha

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.


Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020

Important Notice

Experimental Research
Year : 2010 | Month : February | Volume : 4 | Issue : 1 | Page : 2134 - 2138 Full Version

The Effect Of Acute And Chronic Administration Of The Aqueous Extract Of Triphala On Haloperidol Induced Catalepsy In Mice.


Published: February 1, 2010 | DOI: https://doi.org/10.7860/JCDR/2010/.625
GOPALA KRISHNA H N*, SUDHAKAR P, DORABABU P **, PAI MRS M ***, COLACO N **, VINEETHA V**

*Ph.D,Assoc.Professor**PG student,***M.D.Professor&Head Department of Pharmacology, Kasturba Medical College, MANGALORE-575 001.

Correspondence Address :
Sudhakar Pemminati (Ph.D), Lecturer,Department of Pharmacology, Kasturba Medical College,MANGALORE –575 001,Phone No. : ( O ) 0824 -2423452 Ext.- 5568,E-mail:pemmineti@yahoo.com

Abstract

Neuroleptics that are commonly used in the treatment of schizophrenia and other affective disorders are often associated with distressing extrapyramidal side effects (catalepsy). Catalepsy induced by neuroleptics in animals has been used as a model for the extrapyramidal side effects associated with antipsychotic agents in human beings. In the present study, we have attempted to evaluate the protective effect of Triphala on haloperidol induced catalepsy in mice. Inbred albino mice were divided into five groups, each containing six animals. Both, the test drug, the aqueous extract of Triphala and the standard drug scopolamine were dissolved in 1% gum acacia solution. Catalepsy was induced with haloperidol (1mg/kg). The first group received the vehicle (10ml/kg), the second group received scopolamine (1mg/kg) and the remaining three groups of animals received the test compound, Triphala (2.5, 6.25 and 12.5 mg/kg respectively) orally. In the acute study, a single dose of vehicle and the test drug were administered, while in the chronic study, they were given once a day for seven days, 30 minutes prior to haloperidol administration. Catalepsy was determined by the standard bar test after 30 minutes of haloperidol administration and was scored as described by Ahtee and Benumbe. In the acute study, the aqueous extract of Triphala at all the doses tested, significantly (P<0.01) reduced the cataleptic score after the latency of 60 minutes. However, in the chronic study, the reduction in the cataleptic score was seen throughout the period of observations. These effects were comparable to that produced by the standard drug scopolamine. Pretreatment of Triphala decreased haloperidol induced catalepsy in mice, which is comparable to that produced by the standard drug scopolamine. Triphala seems to be more effective when it is repeatedly administered than with a single administration. It can be used as an alternative drug or with a combination of currently available drugs in treating drug induced extrapyramidal side effects.

Keywords

Triphala, catalepsy, haloperidol

Introduction
Neuroleptics that are commonly used in the treatment of schizophrenia and other affective disorders (1), are often associated with distressing extrapyramidal side effects (2),(3). The phenomenon of cataleptic immobility induced in rodents by typical neuroleptics (eg.haloperidol), is a robust behavioural model to study nigrostriatal function and its modulation by cholinergic, 5-hydroxytryptamine (5-HT, serotonergic), nitrergic and other neurotransmitter systems (4),(5). Haloperidol induced catalepsy (HIC) occurs due to the blockade of dopamine (D2) receptors and reduced dopaminergic transmission (6). Enhanced stimulation of the intrinsic central cholinergic system has also been implicated in haloperidol induced catalepsy, as it has been reported to be enhanced and antagonised by a cholinergic agonist and the blocker, atropine respectively (7). Hence, scopolamine (a known anticholinergic agent) was used as standard drug in this study to compare the anticataleptic effect of the test compound, Triphala.
Triphala, a cornerstone of traditional Ayurvedic medicine, is composed of equal parts of three dried fruits, namely, Terminlia chebula, Terminalia belerica and Emblica officinalis. Triphala is used in head ache, dyspepsia, constipation, ascitis and leucorrhoea, and also as a blood purifier. It is also reported to have antiinflammatory, analgesic, antiarthritic, hypoglycaemic, antioxidant and anti-aging properties (8),(9),(10),(11),(12). Gallic acid has been found to be a major ingredient of Triphala(13). The standardization of the aqueous extract of Triphala and the estimation of the active principle was done by the Quality Control Laboratory, M/s. Natural Remedies, Bangalore, lab reference no.0505211, dt.31-05-2005.

Experimental evidence indicates that Triphala has very good antioxidant and nitric oxide scavenging activities (14),(15).

From our laboratory, we have reported the anticataleptic activity of Emblica officinalis and NR-ANX-C (a polyherbal product) on haloperidol induced catalepsy in mice (16),(17). Emblica officinalis is one of the components of Triphala and Triphala is one of the components of NR-ANX-C. As evidence indicates that the involvement of the reactive oxygen species involved in haloperidol induced catalepsy and Triphala has very good antioxidant activity, this study was undertaken to evaluate the anticataleptic activity of Triphala in mice.

Material and Methods

Animals
Adult male albino mice (weighing 25-30gm), which were bred in the central animal house of kasturba medical college, Mangalore, were used for the study. The animals were housed under standard 12h: 12h light/dark cycle and ad libitum food and water. They were allowed to acclimatize to laboratory conditions for at least seven days prior to any experimentation. Each animal was used once. The experimental procedures were performed between 10.00 and 16.00 hrs. The experimental protocol was approved by the Institutional Animal Ethics Committee and the study was conducted according to the Indian National Science Academy Guidelines for the use and care of experimental animals.

Drugs and Dosage
The Test Drug: Triphala (dry powder supplied by Natural Remedies Pvt. Ltd., Bangalore). It is a brown to very dark brown powder with characteristic odour and taste, stored in air tight containers and protected from light. The standard drug, scopolamine (German Remedies Ltd., Mumbai) and Triphala were suspended/ dissolved in 1% gum acacia solution(18), while haloperidol (RPG Life Sciences Ltd.,Mumbai) was dissolved in distilled water and the doses of Triphala (2.5, 6.25 and 12.5 mg / kg) were selected on the basis of earlier studies (25% of Triphala was present in NR-ANX-C). The treatments were received by each group (each group consisted of six animals, n=6) are shown in (Table/Fig 1),(Table/Fig 2). The control group was the receiving vehicle; 1% gum acacia (10ml/kg), Scopolamine (1.0mg/kg) and Triphala (2.5, 6.25 and 12.5 mg / kg) were given orally, whereas haloperidol was given intraperitoneally.

Experimental Design
Haloperidol Induced Catalepsy (HIC): Catalepsy induced with haloperidol (1.0mg/kg i.p.) and was assessed at 30 minutes intervals until 120 minutes and at the end of 240 minutes, by means of a standard bar test (19). Haloperidol 1mg/kg i.p. was chosen so that it could elicit and thus enable the detection of either attenuation or potentiation of the phenomenon (6). Catalepsy was assessed in terms of the time for which the mouse maintained an imposed position with both front limbs extended and resting on a four cms high wooden bar (1.0cm diameter). The end point of catalepsy was considered to occur when both front paws were removed from the bar or if the animal moved its head in an exploratory manner. A cut-off time of 1100 seconds was applied between determinations (18). The animals were returned to their individual home cages. All observations were made between 10.00 and 16.00 hrs in a quiet room at 23-25º C.

Scoring Method: If the animal maintained the imposed posture for at least 20 seconds, it was considered to be cataleptic and was given one point. For every additional 20 seconds that the cataleptic posture was maintained, one extra point was given. The animals were tested twice at 30 minute time intervals and only the greater duration of immobility was considered (20).

In acute study, Triphala and scopolamine were administered only once, 30 min prior to haloperidol administration. In chronic study, these drugs were administered once daily, 30 min prior to haloperidol administration for seven days. Catalepsy was determined 30 min after haloperidol administration on the first and on the seventh day of treatment.

Statistical Analysis
For each group, mean± SEM was calculated and the data was analyzed by one way ANOVA, followed by Dunnet’s multiple comparison test. P<0.05 was considered to be statistically significant.

Results

Acute study (Table/Fig 1)

In the acute phase of the study, after the administration of 2.5, 6.25 and 12.5 mg/kg of Triphala and Scopolamine,a significant (P<0.01) decrease in the cataleptic score was observed at all time intervals, except at the 30 min interval.

Chronic study (Table/Fig 2)

In the chronic phase of the study, after the administration of 2.5, 6.25 and 12.5 mg/kg of Triphala and Scopolamine,a significant (P<0.01) decrease in the cataleptic score was observed throughout the period of observation.

Discussion

Typical neuroleptic agents like chlorpromazine, haloperidol and reserpine induce a cataleptic state in rodents and it is being used as a model to test the extrapyramidal side effects. Neuroleptic induced catalepsy has been linked to a blockade of the postsynaptic striatal dopamine D1 and D2 receptors (20). Despite this evidence, several other neurotransmitters such as acetylcholine, serotonin, angiotensin, adenosine, or opioids have also been implicated (21). In addition to the implications of various neurotransmitters in catalepsy, many preclinical and clinical studies have proposed reactive oxygen species in haloperidol induced toxicity (22). Evidence indicates that drugs which potentiate or attenuate neuroleptic induced catalepsy in rodents might aggravate or reduce extrapyramidal signs, respectively in human beings (23).

In the present study, the aqueous extract of Triphala decreased the haloperidol induced catalepsy, which is comparable to that of the standard drug, scopolamine. The anticataleptic effect is more pronounced when Triphala was administered repeatedly (chronic administration), than with a single dose administration. The protective effect of Triphala against HIC was consistent with our earlier reports on the anticataleptic effect of a polyherbal product, NR-ANX-C (18), in which Triphala is one of the components. The reports on the individual components of Triphala; Terminalia chebula belongs to the family Combretaceae, commonly known as ‘haritaki’ in Ayurveda. The dried fruits are rich in tannins and also the presence of a variety of carbohydrates, glucose, sorbitol, saponins, anthrones and anthranols has also been documented (24). Terminalia bellerica belongs to the family Combretaceae, commonly known as ‘vibhitaki’ in Ayurveda. The dried fruit contains about 20% of both condensed and hydrolysable tannins, lipids, b-sitosterol, saponins, gallic and ellagic acid and their derivatives, glycosides and various carbohydrates. Fruits of Terminalia chebula and Terminalia bellerica were reported to be stronger antioxidants than alpha-tocopherol(25). Emblica officinalis (EO) belongs to the family Euphorbiaceae, commonly known as ‘amalaki’ in Ayurveda. It contains tannins and other phenolic compounds. These include hydrolysable tannins (10-12%) such as emblicanins A and B, punigluconin, pedunculagin and an ellagitannin, putranjivain A. Recent investigations have shown that the tannoid principles of Emblica officinalis have significant antioxidant effects in rat brain frontal cortex and striatum (26), and also, EO was found to be effectively reduce haloperidol induced catalepsy in mice (16). Triphala has been found to attenuate cold-stress induced elevation in lipid peroxidation (LPO) and corticosterone levels (27).

Based on the present study results and earlier antioxidant reports on Triphala, it is clear that further human studies are required to confirm the effectiveness of Triphala against the extrapyramidal side effects of antipsychotic drugs. At this juncture, it is difficult to point out which constituent of the preparation is /are responsible for the anticataleptic activity of this test compound.The anticataleptic effect of Triphala could be due to its antioxidant and free radicals scavenging action (14),(15). Further investigations on their mode of action are needed to unravel the molecular mechanisms involved in the observed effects.

Key Message

Antipsychotics are usually associated with extrapyramidal side effects. The mice were treated by standard drugs like scopolamine or by centrally acting anticholinergics; but these have many side effects like dryness of mouth, blurred vision etc. As Triphala is readily available in India and it can be used as an alternative to presently available drugs against drug induced extrapyramidal side effects.

Acknowledgement

M/s. Natural Remedies Pvt. Ltd., Bangalore provided the test drug, Triphala.

References

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. Klemm WR. Evidence for a cholinergic role in haloperidol-induced catalepsy. Psychopharmacol 1985;85(2):139-42.
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. Rege NN, Thatte UM , Dahanukar SA. Adaptogenic properties of six rasayana herbs used in Ayurvedic medicine. Phytother Res 1999;13:275-91.
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. Mehta BK, Shitut S, Wankhade H. in vitro antimicrobial efficacy of Triphala. Fitoterapia 1993;64:371-2.
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. Vani T, M Rajani, S. Sarkar and C. J. Shishoo. Antioxidant properties of the Ayurvedic formulation Triphala and its constituents. Pharmaceutical biology 1997;35(5):313- 7.
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