To accomplish treatment for AB, both . The cranial vault asymmetry index >3.5% or 10% were diagnosed as deformational or severe deformational plagiocephaly, respectively. . Brachycephaly is classified using the cephalic or cranial index (CI), which is the length of the head from front to back divided by its width. The two main indexes for PHD diagnosis are the cranial vault asymmetry (CVA) and cephalic index (CI). The .gov means its official. In a case where the Cranial Vault Asymmetry is greater than 15 mm and the Cephalic Ratio of greater than 97 mm, we refer to this as . Clinicians should consider screening for head shape at the same time head circumference is measured at every well-child visit. That means that when we calculate the percentage, we can apply it to any head shape and get a reliable picture of the deformity. "Virchow's law", which still remains valid, propos - es that cranial deformities arise when growth of the All heads above the reference values were . Its important to be able to look at volume because in some circumstances flattening can cause the head to shift in unexpected, difficult to measure ways. Cranial Vault Asymmetry? CSF fluctuation, volume and pressure. Plagiocephaly classification of normal, mild, moderate or severe is usually determined in terms of standard deviation, or the extent to which the head shape measurements deviate from the population norm. Enter a Melbet promo code and get a generous bonus, An Insight into Coupons and a Secret Bonus, Organic Hacks to Tweak Audio Recording for Videos Production, Bring Back Life to Your Graphic Images- Used Best Graphic Design Software, New Google Update and Future of Interstitial Ads. Forty-five infants with DP [cranial vault asymmetry index (CVAI) > 3.5 per cent] were divided into two groups: one treated with head orthosis (32 infants) and another without (13 infants). The relative improvement in asymmetry was significantly better in group 1 (75.3 percent) compared with group 2 (60.6 percent) (p = 0.001). Approach: First, the head contour is extracted semi-automatically using the intelligent scissors method. Infants in group 2 did not achieve normal values (index value, 4.5 percent) (p = 0.021). In this preliminary study, the authors studied eight children referred for evaluation of their plagiocephaly and eight infants referred for noncraniofacial entities. Cranial Index (CI): also referred to as cephalic index, cranial ratio, or cephalic ratio; a measurement to categorize head shapes in populations. Spy Recording Pen - Created to capture HD 1080P video in real time this spy pen uses a simple one-cl.. We use the following ranges: 5. A CVAI of greater than 6 is considered a moderate severity. Accessibility The scan takes just two seconds or less. The Cephalic Index, also referred to as cranial ratio or cephalic ratio is the measurement that will be used to categorize your infants head shape. 2013 Oct;35(4):E2. CVA is the difference between 2 diagonal measurements (frontozygomaticus to opposite eurion). . 3,4 Positional infant plagiocephaly is characterized by asymmetric occipital flattening with a flat area on the contralateral forehead and . Instead, the skull is composed of loosely jointed bones. Knowledge of quantitative normal cranial asymmetry in a population without pathology or functional disturbance is necessary to avoid malpractice. . Treatments vary among centers, ranging from expectant management to orthotic helmet therapy to craniofacial remodeling. These numbers may seem confusing but this has proven to greatly assist in the monitoring of children with any skull shape concerns. So what is the Cephalic Index? Just let your practitioner guide progress and look at the big picture of progress. How is cranial vault asymmetry measured on plagiocephaly severity scale? Just like the PSR, the OSR is looking at volume ratios. Background: Craniofrontonasal syndrome is a rare, X-linked disorder in which heterozygous females ironically reported the majority of patients and is caused by in the EFNB1 gene located at chromosome Xq13.1. How long does it take for a babys head to round? The measuring tape is also used to measure anterior shifting of the ear . It can cause aesthetic, neurological, acoustic, ophthalmological complications up to real emergencies. What these measurements aim to capture and compare is cranial displacement. June 10, 2022; By: Author cake delta 8 carts wholesale To help parents track their babys transformation throughout helmet treatment, a severity chartis given to provide them with a visual representation of their progress. How does the head get too wide or narrow? The CVA equation looks like this: CVA = A - B. Craniosynostosis is a condition in which one or more of the fibrous sutures in a young infant's skull prematurely fuses by turning into bone (ossification), thereby changing the growth pattern of the skull. This site needs JavaScript to work properly. it is important to understand the measurements whether you are a patient, practitioner, or determining medical necessity. what happened to zechariah when he doubted the angel; normal cranial vault asymmetry index. Thats why it can be so important! The initial cranial vault asymmetry index (modified CVA') was determined at 6.3 and 6.2 months of age (SD 1.44/2.14). The goals at our clinic are based on the CHOA scale and to be within normal limits we want this number greater than 90%. 13,14 Intentional cranial remolding is defined as the product of dynamic control of the normal infantile cranial growth through the application of externally directed force(s). Most insurance companies will pay for therapies. A Cephalic Ratio of 94 to 97 mm and a Cranial Vault Asymmetry (CVA) of 10 to 15 mm will be classified as a moderate form of flat head syndrome. key features ,,,,, cranial vault size , trunk size remain normal micromelia decreased thoracic circumference due to short ribs demineralization of long bones which are thin , delicate , bowed , occasional angulation , fracture cranial vault fails to mineralize and may be compressed under trannsducer posterior elements are poorly ossify . The cephalic index (CI) is a value calculated using two fetal biometric parameters which are the occipitofrontal diameter (OFD) and the biparietal diameter (BPD). Values from the literature served as the normal reference (cranial index: 85%; cranial vault asymmetry index: 3.5%). In addition, both of these methods expose infants to radiation and the infant may need to be sedated to get an accurate image. Is it OK to leave outside Christmas lights on all night? The head width is measured at the right and left plane of the skull. 4. Please enable it to take advantage of the complete set of features! . When we measure the asymmetry it can sometimes be a 5mm difference, but look severe! PHD and 824 cases of normal cranial type (18.5%) were detected. Most insurances will require a CVA of 7 mm or higher to pay for helmet therapy. In fishes no distinct cranial vault as such exists. J Plast Reconstr Aesthet Surg. 1,2 However, increasing numbers of nonsynostotic head deformities were subsequently reported. Normal head shapes for babies should have a Cranial Vault Asymmetry of 0 to 4 mm (millimeters) and have a . With scaphocephaly, there is flattening on the sides of the head causing the babys head to only grow in the front and back. Computed tomographic scans provide better views and can be helpful for ruling out craniosynostosis. Purpose Ventricular . Mild central posterior flattening (mild), 6b. There are 5 primary measurement parameters included in this report for head shape determination: 1. For other conditions, we have other measurements to look at for severity. The incidence of sudden infant death syndrome declined significantly after the American Academy of Pediatrics initiated the Back to Sleep campaign in 1992. neurologic development and normal cranial shape. Adoption Craniofacial/Neurosurgical Consults, International Adoption Craniofacial / Neurosurgical Consults, Craniosynostosis Support Groups and Pages, Childrens of Alabama Saggital Cranio CVR, Developmental delays and Craniosynostosis, Overall Craniosynostosis Patient Care and Follow Up, Normocephaly or plagiocephaly = CI >76%-<90%[51], CI >76% to <90%, asymmetric head shape, occipitoparietal flattening, ear misalignment, May affect temporal, parietal, and/or frontal bones and facial symmetry, May occur alone or in combination with brachycephaly or dolichocephaly. All Rights Reserved. It is located in the most inferior portion of the cranial fossa as a part of the occipital bone. While I always encourage patients to look at progress as a whole and to focus less on the numbers, I too love the numbers! This measurement looks at the difference between the diagonals of the head but then turns it into a ratio by dividing by the longer length. This is the absolute value of the difference in cranial diagonals (CVA), divided by the greater diagonal, then multiplied by 100. Cranial shape was evaluated using anthropometry; cranial index (CI) and cranial vault asymmetry index (CVAI) were calculated. Subjects with asymmetrical brachycephaly started CRO treatment between 3 and 18 months of age. Okay, seems easy enough right? The asymmetry caused by this additional moiety leads to steric hindrance between polyurethane chains and less efficient packing. CVAI Severity: Within Normal Limits: 1.9 Mild: 3.7 Moderate: 5.2 Severe: 7 Brachycephaly A number greater than 90% is beyond the normal range for brachycephaly. A possible explanation was a severe associated growth restriction of the posterior calvaria with radiological synostosis at the lambda . normal cranial vault asymmetry index. A ratio is helpful because it can be compared reliably to other ratios no matter what size the head is. Asymmetrical shape of the head (cranial vault asymmetry), result of external molding (laying on head), normal cranial sutures, "Oblique Head", associated with congenital muscular torticollis Cephalic Index Ratio of cranial width to cranial length W/Lx100=Cephalic Index 78%-85% Normal Cephalic Index Deformational Brachycephaly Sagittal synostosis is characterised by an extensive deformity of the cranial vault, with an essentially normal cranial base. { al k l kal sik sirez } alkali emission [GEOPHYS] Light emission from free lithium . Head shape deformities are typically classed as mild, moderate or severe depending on a number of factors. [49] Retrospective analysis has given indication that the use of total cranial vault remodelling provides the children with a better cephalic index than does the extended strip craniectomy. Craniosynostosis is a birth defect defined as the premature closure of one or more cranial sutures [].Compensatory growth of the brain along the non-fused sutures produces morphological abnormalities, including dysmorphic cranial vault and facial asymmetry, which can lead to severe conditions such as increased intracranial pressure and impaired brain growth []. CI >90%, short skull, occiput flattened, widened, May affect parietal, temporal, and/or frontal bones and facial symmetry, May occur alone or in combination with plagiocephaly, May result from the premature fusion of the coronal or lambdoid sutures, CI <76%, long, narrow skull, affects occiput, temporal, parietal and frontal bones, may affect facial bones, May be familial, often noted in premature babies, uterine breech position, May result from premature fusion of the sagittal suture. The CI is the measured width of the head divided by the length of the head multiplied by 100 and reported as a percentage. . MeSH Provide plenty of supervised time for your baby to lie on the stomach while awake during the day. . The system delivers the cranial vault asymmetry in millimeters to see if your child needs cranial therapy. There is currently no international standard system for plagiocephaly measurement, and so diagnosis is typically based on clinical judgement and varies from country to country. Keep in mind that a trained practitioner has practiced these measurements many times and knows what they are looking for. CRANIAL ASYMMETRY An objective evaluation of cranial asymmetry may be based on anthropometric landmarks and/or the cephalic index. Green represents normal and 1 standard deviation; yellow represents mild and one ear being slightly forward on one side, as well as slight occipital bulging; orange represents moderate, and red represents severe and can be seen via a bulging of the brow and a significant ear shift. All of the mandibular dimensions are larger than those of normal females. and transmitted securely. This means that there is a flat area on the back or side of the head. Leave us some comments if you have further questions or input on measurements and severity. Compare that to a CVA of greater than 10mm being considered moderate severity. Conclusions: 2018 Mar;21(3):204-213. doi: 10.3171/2017.7.PEDS16693. Muscle bulk and tone normal, cranial nerves grossly normal, no tremor, nystagmus, or ataxia Left ear posteriorly rotated, bilateral hearing aids Hepatomegaly 9th centile 28th centile 5th centile 3rd centile 42nd centile 33rd centile 3-50th centile 41st centile 65th centile 63rd centile 3-10th centile 50th centile Developmental delay. 4. Cephalic index is good at describing widening and narrowing at any age or size because it is a ratio. 2021 Aug 7;22(16):8521. doi: 10.3390/ijms22168521. What is Normal? In my experience, the CVAI frequently gets confused with the CVA which can interfere with insurance approval. mcdonalds garfield mugs worth normal cranial vault asymmetry index. HIGHLIGHTS who: Jana-K. Dieks from the DepartmentUniversity Medical have published the research: Stereophotogrammetry can feasibly assess u2018physiologicalu2019 longitudinal three-dimensional head development of very preterm infants from birth to term, in the Journal: Scientific Reports Scientific Reports of 30/01/2022 what: As a novelty, the study provides normative 3D values for cranial . Mild: 91 - 93 mm We then automatically compute two indices used in the clinical determination of the DPB from the head shape parameters: the cranial index (CI) and the cranial vault asymmetry index (CVAI). During birth, the various bones, connected only by cartilage and ligaments, will move relatively to each other. Scale for Cephalic Index (CI) Normal: 75 90 mm. Previous researchers have stated that the diagnostic standards of plagiocephaly, brachycephaly, and dolichocephaly were CVA 0.3%, CI 82%, and CI 76%, respectively [ 1, 7, 8 ]. Remove all obstructions to normal motion to maximize the potential of its function. 10 In contrast to multiple . The binocular and intercanthal widths were normal postoperatively compared to the corresponding controls, both at T2 (71.0 4.2 mm vs 72.5 3.9 mm . During this time some babies develop positional plagiocephaly. When treatment starts at the optimum age of 3-6 months, it usually can be completed within 12 weeks. Keep in mind that a trained practitioner has practiced these measurements many times and knows what they are looking for. What is the normal cephalic index in pregnancy? The cranial vault is composed of the endocranium forming the basal parts, topped by the skull roof in land vertebrates.. shows that an asymmetry index found in the skulls of all age groups . CI = width length x 100. What are the head measurements we use to monitor progress? For the most part these measurements are done by hand and demonstrate severity well, but I kept running into a few tricky babies that would have severe head shapes without the measurements to back it up. Follow-up took place at the end of helmet therapy (age: 10.2 months, SD 1.77) or after I year (age: 18.5 months, SD 2.28) respectively. - DEC compliance. On the above chart this is the right access measured in millimeters. When it comes to traditional hand measurements vs. scanning, both demonstrate severity and progress accurately! The American Academy of Pediatrics Clinical Report (2003) on the Prevention and Management of Positional Skull Deformities in Infants indicates that the best results can be achieved when plagiocephaly treatment is started at 4-12 months. . DEC cranial bone mobility affects CSF fluctuations and intracranial compliance. Purpose To establish new cross-sectional reference values for the size of the lateral ventricles in a large cohort of neonates between 24 and 42 weeks' gestational age (GA) as well as longitudinal reference values for the follow-up of very preterm infants born at less than 30 weeks' gestation. The average value of cephalic index in children up to 3 years of age amounted to 81.45 7.06. normal cranial vault asymmetry index. Association between cranial asymmetry severity and chronic subdural hematoma laterality. The CI is the measured width of the head divided by the length of the head multiplied by 100 and reported as a percentage. 6 How to calculate the cranial vault asymmetry index? Method: We have developed a technology (called SoftSpot^TM) based on advanced imaging algorithms to detect different types and severity of DPB from top-view photos . After a ton of research, Childrens Hospital of Atlanta (CHOA) has come up with a scale for these reliable measurements. Materials and Methods Institutional review board approval and parental written informed consent . 4 . This is found by subtracting the larger cranial diagonal from the smaller cranial diagonal. Do you have further questions on measurements? The CVA equation looks like this: CVA = A B. This device is used to measure width, length, and diagonal measurements of the head. Pre- and post-treatment calvarial asymmetries (difference among DD, CVAI, and CR) were measured using 3D screening systems (SmartSoc and Omega Scanner 3D). Can plagiocephaly be corrected at 6 months? A few years ago, a major piece of research was published in the Journal of Craniofacial Surgery. This takes into account the difference between the diagonal head shape measurements to establish the degree of asymmetry. to Improve the Result of Cranial Vault Remodeling Stephen Higuera, MD Larry H. Hollier, Jr., MD . You can help your babys head return to a more rounded shape by altering her position while shes asleep, feeding and playing. It is a ratio of the width compared to length and describes if the head is too wide (brachycephaly) or too narrow (scaphocephaly). For more information on these specific conditions see, The measurements we just talked about are 2D, meaning they dont look at the volume of the head. Cephalic Index? The measurements we just talked about are 2D, meaning they dont look at the volume of the head. 2. Quantified using the Cranial Vault Asymmetry Index (CVAI) CVAI is determined by measuring the longest and shortest diagonals of the skull and subtracting the difference in millimeters. Can a plain skull xray show skull sutures? The Cephalic Index, also referred to as cranial ratio or cephalic ratio is the measurement that will be used to categorize your infants head shape. Positional plagiocephaly does not affect brain growth or development; it is purely a shape issue. Okay, seems easy enough right? When a baby is diagnosed with Deformational Plagiocephaly, it is important to determine whether or not the baby will benefit from Cranial Remodel Band or Helmet. In general, surgery should result in a 0.1 improvement in the cephalic index at the completion of therapy . 3 MAIN B February 23.Docx - Free download as PDF File (.pdf), Text File (.txt) or read online for free. 2014 Feb;67(2):159-65. doi: 10.1016/j.bjps.2013.09.036. <3.5 No treatment 2. In amphibians and reptiles the vault is . It takes the head and slices it into 24 slices, each 15 degrees apart, and compares them to each other. Sometimes you might notice it while other times you may not. If you continue to use this site we will assume that you are happy with it. Would you like email updates of new search results? Specifically, the maximum cranial length and the right orbital breadth are outside of the normal female range. 2021 Cranial Therapy Centers. . We have the CVA which should tell us without a doubt if baby needs a helmet right? If you suspect that your baby might havepositional plagiocephaly, naturally youll be wondering how severe the deformity is relative to other infants, and whether or not you should seek treatment. 1,2 However, increasing numbers of nonsynostotic head deformities were subsequently reported. Cranial Index (CI): also referred to as cephalic index, cranial ratio, cephalic ratio; a measurement to categorize head shapes in populations. Infants with DP [cranial vault asymmetry index (CVAI) > 7% and diagonal distance (DD) > 10 mm) and AB [CVAI > 7% and cephalic ratio (CR) 94] were included in . This paper presents the design of a fully integrated electrocardiogram (ECG) signal processor (ESP) for the prediction of ventricular arrhythmia using a unique set of ECG features and a naive Bayes classifier. Cranial Vault Asymmetry is used by many insurance companies to determine medical necessity and therefore coverage of a helmet. To understand why it doesnt always capture the full picture, I will first explain what it is. Additional widening of the posterior skull (moderate), 6C. The use of computed tomography (CT) in clinical practice has been increasing rapidly, with the number of CT examinations performed in adults and children rising by 10% per year in England. 3 The peak prevalence of positional plagiocephaly is around 4 months of age. Because the radiology community strives to reduce the radiation dose associated with pediatric examinations, external factors, including guidelines for pediatric head injury, are raising expectations for use . 653 N. Town Center Dr. 3233 W. Charleston Blvd. Data on incidence and prevalence differ, but the increase is clear and rates of more than 40% have been mentioned 2, 3. A Cephalic Ratio of, In a case where the Cranial Vault Asymmetry is. 2020 Jul;25(3):205-209. doi: 10.17712/nsj.2020.3.20190125. Schaaf H, Malik CY, Streckbein P, Pons-Kuehnemann J, Howaldt HP, Wilbrand JF. The Cephalic Index, also referred to as cranial ratio or cephalic ratio is the measurement that will be used to categorize your infants head shape. The cranial index of this individual indicates a mesocranic type (CI = 78.8), whereas normal Eunpyeong females are brachycranic (CI = 81.8, N = 62, 136.6/167100). Changing your babys position is called counter-positioning or repositioning. PMC 2013 Oct 25;8(10):e74267. Cephalic index is going to tell us about proportion! A cranial index of symmetry (CIS) was calculated and, by definition, equaled 100% for a perfectly symmetrical head. Additional temporal, brow and/or vertical deformity (severe). cranial volume, length, width, length-width ratio, circumference, asymmetry, and vault asymmetry in-dex; cephalic index; and anterior, posterior, and overall symmetry ratios. During delivery the baby needs to squeeze through a narrow passageway which can result in a head deformity. Mild posterior flattening on one quadrant(normal), 2. Kung WM, Chen ST, Lin CH, Lu YM, Chen TH, Lin MS. PLoS One. It is a ratio of the width compared to length and describes if the head is too wide (brachycephaly) or too narrow (scaphocephaly). As CVAI of < 3.5% is assumed as the normal cranial shape, a successful treatment was achieved in 43% of all infants with DP (DP1 48%, DP2 41%). Positional plagiocephaly does not usually cause serious complications. PSR is expressed as a percentage and the closer to 100% the better! Verifying three-dimensional skull model reconstruction using cranial index of symmetry. Clinicians often predict the area that their baby will be able to reach with treatment. 1,2 Subsequent adverse neurologic and physiologic sequelae can occur and . The cephalic index is the breadth multiplied by 100 divided by the length. The bone is constantly. Normal Asymmetry Normal Cranial Growth and Development Functional Craniology . The head deformity can be unilateral (affecting one side of the head) or bilateral (affecting more than one side of the head). For each patient, all the asymmetry indexes (AI, AAI and PAI) and OCLR were computed. Print 2009. These measurements are used to calculate Cranial Vault Asymmetry and Cephalic Index. The conducted research found the Argenta scale to be reliable in the evaluation of cranial deformities. The amazing thing about the scanner is that it can provide us with more measurements than we could ever get with two dimensional methods. When your babys head gets measured and has a Cephalic Ratio of 91 to 93 mm and a Cranial Vault Asymmetry (CVA) of 5 to 9 mm, we refer to this as mild plagiocephaly. Measuring Cranial Vault Asymmetry Cranial Vault Asymmetry CVA measures the two diagonals of the top of the baby's skull. The cranial vault as a distinct unit arose with the fusion of the skull roof and the endocranium on the early Labyrinthodonts. Cranial Vault Asymmetry Index (CVAI) defined in this study is a modified version of the equation used by Loveday. Manwaring KH, et al. This measurement can be done using hand measurements and calculated by the scanner. The cranial base angle, the sella to nasion, and sella to basion lengths did not differ significantly. Any patient with an. Scribd este cel mai mare site din lume de citit social i publicare Early isolated fusion of the sutures (squamosal synostosis) is rarely found.OBSERVATIONSThe authors report a case of a girl who presented with an abnormal head shape and bilateral Kelly KM . Graham et al. Patients with DP [cranial vault asymmetry index (CVAI) > 7% and DD > 10 mm] and AB [CVAI > 7% and cephalic ratio (CR) 94] were included. . J Neurosurg Pediatr. -CI = width length x 100. The mean age at measurement was 35.7 days. This is found by subtracting the larger cranial diagonal from As a novelty, our study provides normative 3D values for cranial size as well as the symmetrical and asymmetrical head shape parameters cranial index and cranial vault asymmetry index, respectively. CCTV 1080P 4K Home Security Camera V8 High Definition Pen Camcorder. Purpose: to develop and validate algorithms that enable a novice user to quantitatively measure the head shape parameters associated with deformational plagiocephaly, and brachycephaly (DPB) using a smartphone or tablet. If you continue to use this site we will assume that you are happy with it. Outcome analysis after helmet therapy using 3D photogrammetry in patients with deformational plagiocephaly: the role of root mean square. Don't want to remember all of this? As such, the contents of the cranial vault exist in a state of volume equilibrium, such that an increase in the volume of one of the constituents must be compensated for by a decrease in the volume of another (Monro-Kellie doctrine). Demonstrated history of executing and managing clinical trials and basic scientific research projects as a team player. Regarding plagiocephaly, at discharge, 20/26 infants (76.9%) had normal cranial vault asymmetry index (CVAI), three (11.5%) had mild, one (3.8%) had moderate and two (7.7%) had developed severe . We excluded those who received helmet treatment before T3. Cranial vault asymmetry index greater than 3.5%; or; . Head shape at age 36 months among children with and without a history of positional skull deformation. cephalic index Epub 2013 Dec 17. Which affects brain motility and function. 2D Measurements are taking by hand! The 3D scan shows normal cranial circumference growth from 407.11 to 444.4 mm. The Cranial Therapy Center is the first and only Early Intervention Cranial Center in the United States to provide both helmet and manual therapy treatment for infants with cranial deformities and related conditions. The cephalic index is the ratio of the transverse to longitudinal diameters measured in a similar fashion; a normal cephalic index is 0.78 0.05. J Neurosurg Pediatr. The incidence of sudden infant death syndrome declined significantly after the American Academy of Pediatrics initiated the Back to Sleep campaign in 1992. Cephalic Index (CI) is the measurement of the head width (HW) divided by the head length (HL) multiplied by one hundred. The foramen magnum is the largest foramen of the skull. A Cephalic Ratio of 94 to 97 mm and a Cranial Vault Asymmetry (CVA) of 10 to 15 mm will be classified as a moderate form of flat head syndrome. acute intracerebral and subarachnoid hemorrhage. Results. Purpose: Develop and validate algorithms that can enable a novice user to quantitatively measure the head shape parameters associated with deformational plagiocephaly and brachycephaly (DPB) using 2D rendered images. To calculate this number we take the width of the head and divide by the length. Although CVAI of moderate severity or more is considered an indication for helmet therapy, 19) CVAI of all ages and sexes in this study was classified as "normal" or "mild," which is milder than moderate, as shown in the supplemental table. Following the recent study, we have developed our own visual representation of the Argenta scale to provide parents with an additional means of gauging deformity.
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