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Bjarnegård, Niclas
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Publications (10 of 24) Show all publications
Ha, H., Ziegler, M., Welander, M., Bjarnegård, N., Carlhäll, C., Lindenberger, M., . . . Dyverfeldt, P. (2018). Age-Related Vascular Changes Affect Turbulence in Aortic Blood Flow. Frontiers in Physiology, 9, Article ID 36.
Open this publication in new window or tab >>Age-Related Vascular Changes Affect Turbulence in Aortic Blood Flow
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2018 (English)In: Frontiers in Physiology, ISSN 1664-042X, E-ISSN 1664-042X, Vol. 9, article id 36Article in journal (Refereed) Published
Abstract [en]

Turbulent blood flow is implicated in the pathogenesis of several aortic diseases but the extent and degree of turbulent blood flow in the normal aorta is unknown. We aimed to quantify the extent and degree of turbulece in the normal aorta and to assess whether age impacts the degree of turbulence. 22 young normal males (23.7 +/- 3.0 y.o.) and 20 old normal males (70.9 +/- 3.5 y.o.) were examined using four dimensional flow magnetic resonance imaging (4D Flow MRI) to quantify the turbulent kinetic energy (TKE), a measure of the intensity of turbulence, in the aorta. All healthy subjects developed turbulent flow in the aorta, with total TKE of 3-19 mJ. The overall degree of turbulence in the entire aorta was similar between the groups, although the old subjects had about 73% more total TKE in the ascending aorta compared to the young subjects (young = 3.7 +/- 1.8 mJ, old = 6.4 +/- 2.4 mJ, p amp;lt; 0.001). This increase in ascending aorta TKE in old subjects was associated with age-related dilation of the ascending aorta which increases the volume available for turbulence development. Conversely, age-related dilation of the descending and abdominal aorta decreased the average flow velocity and suppressed the development of turbulence. In conclusion, turbulent blood flow develops in the aorta of normal subjects and is impacted by age-related geometric changes. Non-invasive assessment enables the determination of normal levels of turbulent flow in the aorta which is a prerequisite for understanding the role of turbulence in the pathophysiology of cardiovascular disease.

Place, publisher, year, edition, pages
FRONTIERS MEDIA SA, 2018
Keywords
turbulent kinetic energy (TKE); turbulent blood flow; aortic blood flow; aortic dilation; normal values; 4D flow MRI; phase contrast MRI
National Category
Physiology
Identifiers
urn:nbn:se:liu:diva-145129 (URN)10.3389/fphys.2018.00036 (DOI)000423400000001 ()29422871 (PubMedID)
Note

Funding Agencies|Swedish Research Council [2013-6077, 2014-6191]; Swedish Heart and Lung foundation [20140398]; Kangwon National University [D1001179-01-01]; Basic Science Research Program through the National Research Foundation of Korea (NRF) - Ministry of Education [2016R1A6A3A03006337]

Available from: 2018-02-19 Created: 2018-02-19 Last updated: 2019-04-17
Cinthio, M., Albinsson, J., Erlov, T., Bjarnegård, N., Länne, T. & Ryden Ahlgren, A. (2018). LONGITUDINAL MOVEMENT OF THE COMMON CAROTID ARTERY WALL: NEW INFORMATION ON CARDIOVASCULAR AGING. Ultrasound in Medicine and Biology, 44(11), 2283-2295
Open this publication in new window or tab >>LONGITUDINAL MOVEMENT OF THE COMMON CAROTID ARTERY WALL: NEW INFORMATION ON CARDIOVASCULAR AGING
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2018 (English)In: Ultrasound in Medicine and Biology, ISSN 0301-5629, E-ISSN 1879-291X, Vol. 44, no 11, p. 2283-2295Article in journal (Refereed) Published
Abstract [en]

Putative changes in the multiphasic pattern of longitudinal movement of the common carotid artery wall in the normal aging process are unknown. The aim of this study was to explore the phases, and resulting patterns, of the longitudinal movement of the intima-media complex of the human common carotid artery with respect to age and gender. One hundred thirty-five healthy non-smoking patients of different ages were investigated using in-house-developed ultrasound methods. The patterns of longitudinal movement seen in middle-aged and older patients were markedly different from those commonly seen in young patients, including the appearance of two additional phases of motion and, thus, new complex patterns. The displacement and maximum velocity of one of the phases, occurring at the time of aortic valve closure, increased quadratically with age in both men and women. (C) 2018 World Federation for Ultrasound in Medicine amp; Biology. All rights reserved.

Place, publisher, year, edition, pages
ELSEVIER SCIENCE INC, 2018
Keywords
Aging; Ultrasound; Biomarkers; Physiology; Hemodynamics; Clinical studies; Atherosclerosis; Vascular disease
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:liu:diva-152050 (URN)10.1016/j.ultrasmedbio.2018.06.001 (DOI)000445511600013 ()30077411 (PubMedID)
Note

Funding Agencies|Swedish Research Council; Medical Faculty, Lund University; Skane County Councils Research and Development Foundation; Swedish Heart-Lung Foundation; Technical Faculty, Lund University

Available from: 2018-10-29 Created: 2018-10-29 Last updated: 2019-04-09
Bjarnegård, N., Länne, T., Cinthio, M., Ekstrand, J., Hedman, K., Nylander, E. & Henriksson, J. (2018). Vascular characteristics in young women: Effect of extensive endurance training or a sedentary lifestyle. Acta Physiologica, 223(2), Article ID UNSP e13041.
Open this publication in new window or tab >>Vascular characteristics in young women: Effect of extensive endurance training or a sedentary lifestyle
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2018 (English)In: Acta Physiologica, ISSN 1748-1708, E-ISSN 1748-1716, Vol. 223, no 2, article id UNSP e13041Article in journal (Refereed) Published
Abstract [en]

AimTo explore whether high-level endurance training in early age has an influence on the arterial wall properties in young women. MethodsForty-seven athletes (ATH) and 52 controls (CTR), all 17-25 years of age, were further divided into runners (RUN), whole-body endurance athletes (WBA), sedentary controls (SC) and normally active controls (AC). Two-dimensional ultrasound scanning of the carotid arteries was conducted to determine local common carotid artery (CCA) geometry and wall distensibility. Pulse waves were recorded with a tonometer to determine regional pulse wave velocity (PWV) and pulse pressure waveform. ResultsCarotid-radial PWV was lower in WBA than in RUN (P amp;lt; .05), indicating higher arterial distensibility along the arm. Mean arterial pressure was lower in ATH than in CTR and in RUN than in WBA (P amp;lt; .05). Synthesized aortic augmentation index (AI@75) was lower among ATH than among CTR (-12.8 1.6 vs -2.6 +/- 1.2%, P amp;lt; .001) and in WBA than in RUN (-16.4 +/- 2.5 vs -10.7 +/- 2.0%, P amp;lt; .05), suggesting a diminished return of reflection waves to the aorta during systole. Carotid-femoral PWV and intima-media thickness (IMT), lumen diameter and radial distensibility of the CCA were similar in ATH and CTR. ConclusionElastic artery distensibility and carotid artery IMT are not different in young women with extensive endurance training over several years and in those with sedentary lifestyle. On the other hand, our data suggest that long-term endurance training is associated with potentially favourable peripheral artery adaptation, especially in sports where upper body work is added. This adaptation, if persisting later in life, could contribute to lower cardiovascular risk.

Place, publisher, year, edition, pages
WILEY, 2018
Keywords
aortic augmentation index; artery; athletes; blood pressure; physical activity; pulse wave velocity
National Category
Sport and Fitness Sciences
Identifiers
urn:nbn:se:liu:diva-148088 (URN)10.1111/apha.13041 (DOI)000431957600002 ()29359513 (PubMedID)
Note

Funding Agencies|Lansforsakringsbolagen Research Foundation, Sweden; Academy for Health and Care, Region Jonkoping County, Sweden; FORSS-the Research Council of South-East Sweden; Swedish Research Council [12161]; Swedish Heart-Lung Foundation

Available from: 2018-05-30 Created: 2018-05-30 Last updated: 2019-08-28
Hedman, K., Bjarnegård, N. & Länne, T. (2017). Left Ventricular Adaptation to 12 Weeks of Indoor Cycling at the Gym in Untrained Females.. International Journal of Sports Medicine, 38(9), 653-658
Open this publication in new window or tab >>Left Ventricular Adaptation to 12 Weeks of Indoor Cycling at the Gym in Untrained Females.
2017 (English)In: International Journal of Sports Medicine, ISSN 0172-4622, E-ISSN 1439-3964, Vol. 38, no 9, p. 653-658Article in journal (Refereed) Published
Abstract [en]

Cross-sectional studies provide evidence of larger cardiac dimensions and mass in endurance trained than in untrained females. Much less is known regarding adaptations in cardiac function following training in untrained subjects. We aimed to study left ventricular (LV) adaptation to indoor cycling in previously untrained females, in regard of LV dimensions, mass and function. 42 sedentary females were divided into 2 equally sized groups, either training indoor cycling at regular classes at a local gym for 12 weeks, in average 2.6 times per week, or maintaining their sedentary lifestyle. Echocardiography at rest and a maximal exercise test were performed before and after the intervention. Exercise capacity increased in average 16% in the exercise group (p<0.001), together with decreased heart rate at rest (p<0.05) and at 120 watts steady-state (p<0.001). There were no difference in systolic or diastolic function following the intervention and minimal increases in LV internal diameter in diastole (+1 mm, p<0.01). LV mass was unchanged with training (137±25 vs. 137±28 g, p=0.911). Our findings indicate that attending indoor cycling classes at a gym 2-to-3 times per week for 12 weeks is enough to improve exercise capacity, while a higher volume of training is required to elicit cardiac adaptations.

National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:liu:diva-140006 (URN)10.1055/s-0043-112341 (DOI)000407018300001 ()28704880 (PubMedID)
Available from: 2017-08-25 Created: 2017-08-25 Last updated: 2019-08-28Bibliographically approved
Hedman, K., Tamás, É., Bjarnegård, N., Brudin, L. & Nylander, E. (2015). Cardiac systolic regional function and synchrony in endurance trained and untrained females. BMJ Open Sport & Exercise Medicine, 25(1), Article ID :e000015.
Open this publication in new window or tab >>Cardiac systolic regional function and synchrony in endurance trained and untrained females
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2015 (English)In: BMJ Open Sport & Exercise Medicine, ISSN 2055-7647, Vol. 25, no 1, article id :e000015Article in journal (Refereed) Published
Abstract [en]

Background Most studies on cardiac function in athletes describe overall heart function in predominately male participants. We aimed to compare segmental, regional and overall myocardial function and synchrony in female endurance athletes (ATH) and in age-matched sedentary females (CON).

Methods In 46 ATH and 48 CON, echocardiography was used to measure peak longitudinal systolic strain and myocardial velocities in 12 left ventricular (LV) and 2 right ventricular (RV) segments. Regional and overall systolic function were calculated together with four indices of dyssynchrony.

Results There were no differences in regional or overall LV systolic function between groups, or in any of the four dyssynchrony indices. Peak systolic velocity (s′) was higher in the RV of ATH than in CON (9.7±1.5 vs 8.7±1.5 cm/s, p=0.004), but not after indexing by cardiac length (p=0.331). Strain was similar in ATH and CON in 8 of 12 LV myocardial segments. In septum and anteroseptum, basal and mid-ventricular s′ was 6–7% and 17–19% higher in ATH than in CON (p<0.05), respectively, while s′ was 12% higher in CON in the basal LV lateral wall (p=0.013). After indexing by cardiac length, s′ was only higher in ATH in the mid-ventricular septum (p=0.041).

Conclusions We found differences between trained and untrained females in segmental systolic myocardial function, but not in global measures of systolic function, including cardiac synchrony. These findings give new insights into cardiac adaptation to endurance training and could also be of use for sports cardiologists evaluating female athletes.

National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:liu:diva-122839 (URN)10.1136/bmjsem-2015-000015 (DOI)
Available from: 2015-11-26 Created: 2015-11-26 Last updated: 2019-08-28Bibliographically approved
Hedman, K., Tamás, E., Henriksson, J., Bjarnegård, N., Brudin, L. & Nylander, E. (2015). Female athlete's heart: Systolic and diastolic function related to circulatory dimensions. Scandinavian Journal of Medicine and Science in Sports, 25(3), 372-381
Open this publication in new window or tab >>Female athlete's heart: Systolic and diastolic function related to circulatory dimensions
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2015 (English)In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 25, no 3, p. 372-381Article in journal (Refereed) Published
Abstract [en]

There are relatively few studies on female athletes examining cardiac size and function and how these measures relate to maximal oxygen uptake (VO2max ). When determining sports eligibility, it is important to know what physiological adaptations and characteristics may be expected in female athletes, taking body and cardiac size into account. The purposes of this study were (a) to compare right and left heart dimensions and function in female endurance athletes (ATH) and in non-athletic female controls of similar age (CON); and (b) to explore how these measures related to VO2max . Forty-six ATH and 48 CON underwent a maximal bicycle exercise test and an echocardiographic examination at rest, including standard and color tissue Doppler investigation. All heart dimensions indexed for body size were larger in ATH (all P < 0.01). The diastolic mitral E/A ratio was 27% higher in ATH (P < 0.001) while systolic left and right atrio-ventricular longitudinal displacement was 7% (P = 0.002) and 15% (P < 0.001) larger in ATH, respectively. Half (50.3%) of the variability in VO2max could be explained by left ventricular end-diastolic volume. Our results could be useful in evaluating female endurance athletes with suspected cardiac disease and contribute to understanding differences between female athletes and non-athletes.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2015
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-113770 (URN)10.1111/sms.12246 (DOI)000354568800021 ()24840312 (PubMedID)
Available from: 2015-01-30 Created: 2015-01-30 Last updated: 2019-08-28
Hedman, K., Nylander, E., Henriksson, J., Bjarnegård, N., Brudin, L. & Tamás, É. (2015). The size and shape of the inferior vena cava in trained and untrained females in relation to maximal oxygen uptake.
Open this publication in new window or tab >>The size and shape of the inferior vena cava in trained and untrained females in relation to maximal oxygen uptake
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2015 (English)Manuscript (preprint) (Other academic)
Abstract [en]

Background. The increase in cardiac dimensions following endurance training is well acknowledged. A few studies report a larger inferior vena cava (IVC) in trained, predominatly male subjects while athlete-control studies upon females are lacking. Previous studies were constrained to long-axis measurements, and there are no reports in the literature on IVC short-axis dimensions and shape in athletes.

Methods and Results. Forty-eight sedentary and 46 endurance trained females (mean age 21±2 years, VO2max 39±5 vs. 52±5 mL×kg-1×min-1, p<0.001) underwent echocardiographic examination including IVC diameter and cross-sectional area measured in the subcostal view. IVC shape was calculated as the ratio of short-axis major-to-minor diameter.

Five out of eight IVC dimensions were larger in trained females, including maximal long-axis diameter (mean 24±3 vs. 20±3 mm, p<0.001) and maximal short-axis area (mean 5.5±1.5 vs. 4.7±1.4 cm2, p=0.022). Both groups presented with a slightly oval IVC with no differences between the groups in IVC shape or inspiratory decrease in any IVC dimension. The IVC long-axis diameter reflected the minor-axis diameter obtained in the short-axis view, during both expiration and inspiration. Positive correlations were seen between maximal IVC long-axis diameter and maximal oxygen uptake (r=0.52, p<0.01), left ventricular end-diastolic volume (r=0.46, p<0.01) and right atrial area (r=0.49, p<0.01).

Conclusion. The IVC was larger in endurance trained than in untrained females but showed similar shape and inspiratory decrease in dimensions. The long-axis IVC diameter was related to maximal oxygen uptake.

Keywords
Inferior Vena Cava, Athlete’s heart, Exercise Training, Sports Cardiology, Maximal Oxygen Uptake
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:liu:diva-123315 (URN)
Available from: 2015-12-10 Created: 2015-12-10 Last updated: 2019-08-28Bibliographically approved
Bjarnegård, N., Morsing, E., Cinthio, M., Länne, T. & Brodszki, J. (2013). Cardiovascular function in adulthood following intrauterine growth restriction with abnormal fetal blood flow. Ultrasound in Obstetrics and Gynecology, 41(2), 177-184
Open this publication in new window or tab >>Cardiovascular function in adulthood following intrauterine growth restriction with abnormal fetal blood flow
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2013 (English)In: Ultrasound in Obstetrics and Gynecology, ISSN 0960-7692, E-ISSN 1469-0705, Vol. 41, no 2, p. 177-184Article in journal (Refereed) Published
Abstract [en]

Objectives To examine whether intrauterine growth restriction (IUGR) is associated with increased cardiovascular risk later in life. Methods We examined 19 young adults (aged 2225 years) who were born at term after IUGR, along with 18 controls. All had been examined previously with fetal Doppler, and in the present follow-up with echocardiography, carotid echo-tracking ultrasound, applanation tonometry, blood pressure and laser Doppler, in order to characterize their cardiac and vascular geometry and/or function. Results The diameter of the ascending aorta and the left ventricular diameter were smaller in the IUGR group, but only ascending aortic diameter remained significantly smaller after adjustment for body surface area (Pandlt;0.05). The aortic pressure augmentation index was higher in the IUGR group (Pandlt;0.05). The common carotid artery diameter, intimamedia thickness and distensibility as well as left ventricular mass and function were similar in the two groups. IUGR status was found to be an independent predictor of ascending aortic diameter. Conclusions IUGR due to placental dysfunction seems to contribute to the higher systolic blood pressure augmentation and the smaller aortic dimensions that are observed in adults more than 20 years later, with possible negative consequences for future left ventricular performance due to increased aortic impedance.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2013
Keywords
aorta, echocardiography, intrauterine growth restriction, pulse wave analysis, young adulthood
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-89805 (URN)10.1002/uog.12314 (DOI)000314473600011 ()
Available from: 2013-03-07 Created: 2013-03-07 Last updated: 2017-12-06
Dahlén, E. M., Bjarnegård, N., Länne, T., Nyström, F. H. & Östgren, C. J. (2013). Sagittal abdominal diameter is a more independent measure compared with waist circumference to predict arterial stiffness in subjects with type 2 diabetes - a prospective observational cohort study. Cardiovascular Diabetology, 12
Open this publication in new window or tab >>Sagittal abdominal diameter is a more independent measure compared with waist circumference to predict arterial stiffness in subjects with type 2 diabetes - a prospective observational cohort study
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2013 (English)In: Cardiovascular Diabetology, ISSN 1475-2840, E-ISSN 1475-2840, Vol. 12Article in journal (Refereed) Published
Abstract [en]

Background

Anthropometric measurements are useful in clinical practice since they are non-invasive and cheap. Previous studies suggest that sagittal abdominal diameter (SAD) may be a better measure of visceral fat depots. The aim of this study was to prospectively explore and compare how laboratory and anthropometric risk markers predicted subclinical organ damage in 255 patients, with type 2 diabetes, after four years.

Methods

Baseline investigations were performed in 2006 and were repeated at follow-up in 2010. Carotid intima-media thickness (IMT) was evaluated by ultrasonography and aortic pulse wave velocity (PWV) was measured with applanation tonometry over the carotid and femoral arteries at baseline and at follow-up in a cohort of subjects with type 2 diabetes aged 55–65 years old.

Results

There were significant correlations between apolipoprotein B (apoB) (r = 0.144, p = 0.03), C - reactive protein (CRP) (r = 0.172, p = 0.009) at baseline and IMT measured at follow-up. After adjustment for sex, age, treatment with statins and Hba1c, the associations remained statistically significant. HbA1c, total cholesterol or LDL-cholesterol did not correlate to IMT at follow-up. Baseline body mass index (BMI) (r = 0.130, p = 0.049), waist circumference (WC) (r = 0.147, p = 0.027) and sagittal Abdominal Diameter (SAD) (r = 0.184, p = 0.007) correlated to PWV at follow-up. Challenged with sex, SBP and HbA1c, the association between SAD, not WC nor BMI, and PWV remained statistically significant (p = 0.036). In a stepwise linear regression, entering both SAD and WC, the association between SAD and PWV was stronger than the association between WC and PWV.

Conclusions

We conclude that apoB and CRP, but not LDL-cholesterol predicted subclinical atherosclerosis. Furthermore, SAD was more independent in predicting arterial stiffness over time, compared with WC, in middle-aged men and women with type 2 diabetes.

Place, publisher, year, edition, pages
BioMed Central, 2013
Keywords
Abdominal obesity, Type 2 diabetes, Atherosclerosis, Intima-media thickness, Pulse wave velocity
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-93864 (URN)10.1186/1475-2840-12-55 (DOI)000318415400001 ()
Note

Funding Agencies|Medical Research Council of Southeast Sweden||Center for Medical Image Science and Visualization (CMIV)||Linkoping University||Futurum||King Gustaf V and Queen Victoria Freemason Foundation||GE Healthcare||Swedish Heart-Lung Foundation||Swedish Research Council Grant|12661|

Available from: 2013-06-11 Created: 2013-06-11 Last updated: 2017-12-06
Bjarnegård, N. & Länne, T. (2010). Arterial properties along the upper arm in humans: age-related effects and the consequence of anatomical location. JOURNAL OF APPLIED PHYSIOLOGY, 108(1), 34-38
Open this publication in new window or tab >>Arterial properties along the upper arm in humans: age-related effects and the consequence of anatomical location
2010 (English)In: JOURNAL OF APPLIED PHYSIOLOGY, ISSN 8750-7587, Vol. 108, no 1, p. 34-38Article in journal (Refereed) Published
Abstract [en]

The normal aging process of the brachial artery (BA) wall is of specific interest since it is often selected as a model artery in studies of vascular function. With echo-tracking ultrasound, diameter, absolute diameter change, and intima-media thickness (IMT) were registered in 60 healthy subjects, 21-86 yr (30 men), at a proximal, upper third, and distal arterial site along the upper arm. Blood pressure was recorded noninvasively, and the distensibility coefficient (DC) was calculated. The diameter at the proximal site increased with age from 5.5 +/- 0.2 mm in the young subjects to 6.9 +/- 0.3 mm (P andlt; 0.01) in the elderly subjects, concomitantly as IMT increased from 0.40 +/- 0.01 to 0.65 +/- 0.03 mm (P andlt; 0.001). The diameter at the other sites was similar in the young and elderly subjects, whereas IMT increased slightly with age. At the proximal site, DC decreased dramatically from 40.7 +/- 2.2 to 10.1 +/- 0.8 10(-3)/kPa (P andlt; 0.001) with age, whereas hardly no change was seen in the distal upper arm. The principal transit zone between elastic to predominantly muscular artery behavior seems to be located within the proximal part of the brachial artery, emphasizing the importance of carefully defining the arterial examination site.

Keywords
distensibility, echo-tracking, intima-media thickness, upper arm
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-54067 (URN)10.1152/japplphysiol.00479.2009 (DOI)000274158200008 ()
Available from: 2010-02-22 Created: 2010-02-22 Last updated: 2017-03-27Bibliographically approved
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