Displaying publications 1 - 20 of 77 in total

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  1. Fulltext Solitary Skull Metastasis as Initial Manifestation of Hepatocellular Carcinoma - A Case Report
    Ellyda, M.N., Mohd Shafie, A.
    International Medical Journal Malaysia, 2009;8(2):47-52.
    MyJurnal
    Metastatic spread of tumors to the skull is quite unusual and often represents diagnostic and therapeutic issues. Skull involvement can be observed in various neoplasms of epithelial origin and are most often due to lung, breast, thyroid, kidney and prostate cancers. However, skull metastases from hepatocellular carcinoma (HCC) have been rarely reported. The prognosis for patients with hepatocellular carcinoma is so poor that treatment of such distant metastatic lesion cannot be achieved before death occurs due to the primary malignancy. Therefore, the clinical manifestations of cranial metastasis prior to that of primary hepatocellular carcinoma have rarely been reported. This case illustrates a rare case of skull metastasis as an initial manifestation of hepatocellular carcinoma. Although a solitary skull metastasis prior to the diagnosis of HCC demonstrates rare metastatic behavior for HCC, especially in Asia, skull metastases from HCC should be included in the differential diagnosis of skull tumors, even if the patient is asymptomatic of liver cirrhosis.
  2. Fulltext Bilateral congenital renal arteriovenous malformation: A rare entity with uncommon presentation.
    Radhiana, H., Mohd Shafie, A., Mohd Ariff, M.A.
    International Medical Journal Malaysia, 2009;8(1):53-55.
    MyJurnal
    Renal arteriovenous malformation (AVM) is a rare congenital anomaly of the urinary system. We present a patient with bilateral renal AVMs who presented with back pain and microscopic hematuria. This case highlights the importance of careful diagnostic work-up in the evaluation of upper tract hematuria. Renal AVM was found to be the cause of mild back pain and persistent microscopic hematuria in a 45-year-old lady. This case highlights the importance of complete diagnostic work-up in the evaluation of microscopic hematuria in arriving at the correct diagnosis of an uncommon clinical entity.
  3. Fulltext The measurement of utilities in asthma patients: a preliminary study. [Abstract]
    Yong YV, Shafie AA
    Value Health, 2014 Nov;17(7):A568.
    PMID: 27201892 DOI: 10.1016/j.jval.2014.08.1892
    Objectives: To assess the feasibility of a computer-based Standard Gamble (SG) visual prop whilst measuring utilities of different asthma health states at the same time.
    Methods: Twenty adult asthma patients literate in either Malay or English language were conveniently sampled from a public hospital in Penang, Malaysia. They were interviewed by two trained interviewers using a bilingual script. Each patient was requested to value the given health states using Visual Analogue Scale (VAS) prior to SG exercise. There were three chronic health states (C1-C3) for 10 years, three temporary states (T1-T3) for 3 months, and two anchor states (healthy and dead). During the SG exercise, the visual prop was fully operated by the interviewers. The probability of being in a worse state was changed in a ‘ping-pong’ fashion until the indifference point was reached.
    Results: All patients understood the SG exercise and rated SG easier than VAS. Around 85% (n=17) completed SG within 30 minutes. There was 90% (n=18) who ranked T3 as the worst temporary health state during VAS. Two patients provided logical inconsistency data in SG. The preferences by SG were higher than VAS. Preferences were also higher in temporary states measured by chained SG than other states by conventional SG. The mean utilities for C1=0.56 (SD 0.38), C2=0.47 (SD 0.33), C3=0.53 (SD 0.38), T1=0.65 (SD 0.31), T2=0.53 (SD 0.35), and T3=0.38 (SD 0.38).
    Conclusions: The SG methods including the props are feasible for utilities measurement in asthma, based on the agreements achieved with other studies on the pattern of utilities measured in this preliminary study.
  4. Fulltext Willingness to pay for voluntary community-based health insurance: findings from an exploratory study in the state of Penang, Malaysia
    Shafie AA, Hassali MA
    Soc Sci Med, 2013 Nov;96:272-6.
    PMID: 23528670 DOI: 10.1016/j.socscimed.2013.02.045
    Health care in Malaysia is funded primarily through taxation and is no longer sustainable. One funding option is voluntary community-based health insurance (VCHI), which provides insurance coverage for those who are unable to benefit immediately from either a social or private health insurance plan. This study is performed to assess the willingness of Malaysians to participate in a VCHI plan. A cross-sectional study was performed in the state of Penang between August and mid-September 2009 with 472 randomly selected respondents. The respondents were first asked to select their preferred health financing plan from three plans (out-of-pocket payment, compulsory social health insurance and VCHI). The extent of the household's willingness to pay for the described VCHI plan was later assessed using the contingent valuation method in an ex-ante bidding game approach until the maximum amount they would be willing to pay to obtain such a service was agreed upon. Fifty-four per cent of the participants were female, with a mean age of 34 years (SD = 11.9), the majority of whom had a monthly income of Int$1157-2312. The results indicated that more than 63.1% of the respondents were willing to join and contribute an average of Int$114.38 per month per household towards VCHI. This amount was influenced by ethnicity, educational level, household monthly income, the presence of chronic disease and the presence of private insurance coverage (p 
  5. Economic evaluation of respiratory medication therapy adherence clinic (RMTAC) on asthma patients in Malaysia. [Abstract]
    Yong YV, Shafie AA
    Value Health, 2015 Nov;18(7):A501.
    PMID: 26532812 DOI: 10.1016/j.jval.2015.09.1419
    Objectives: To evaluate the long-term cost-effectiveness of RMTAC (an adjunct
    pharmaceutical asthma management) vs. usual physician care clinic by using decision analytic modelling method. Methods: A dynamic adherence asthma Markov
    cohort model was developed. The economic evaluation was based on a lifetime
    horizon and cycle length of one month, from the healthcare provider‘s (Ministry
    of Health) perspective, with the outcomes assessed in cost per QALY gained and
    cost per hospitalization averted. Probabilities of asthma control-adherence states
    from RMTAC database, costs from national sources, utilities using standard gamble method on Malaysia’s asthma patients, and other inputs from secondary data
    sources were used to inform the probabilistic model, according to gender and age
    subgroups. A scenario analysis was conducted to test the structural assumption on
    follow-up visits after the final treatment visit. Results: In female subgroup, RMTAC
    management dominates the usual care by having 0.91 (95% CI 0.24 – 1.69) QALY
    gained and 0.58 (95% CI -2.30 – 6.23) hospitalization averted, at a lower cost. For male
    subgroup, the ICERs were RM10 (95% CI -RM14431 – RM8323) per QALY gained and
    RM18 (95% CI -RM35790 – RM30266) per hospitalization averted. At the willingnessto-pay threshold of RM29000 per an additional QALY gained, the RMTAC intervention
    is likely to be cost-effective 99% and 57% of the time (for QALY and hospitalization
    outcome, respectively). The analysis was robust to assumptions of follow-up visits
    frequency and patients’ gender. Conclusions: Implementing RMTAC in Malaysia
    has high probability of being more cost-effective than the usual care management
    for both male and female subgroups across all age groups. Further investigation is
    necessary to ensure that implementing this decision does not exceed the overall
    national healthcare expenditure

    Study site : Universiti Sains Malaysia, Penang, Malaysia
  6. Assessment of knowledge, attitude and practice of food allergies among food handlers in the state of Penang, Malaysia
    Shafie AA, Azman AW
    Public Health, 2015 Sep;129(9):1278-84.
    PMID: 25931434 DOI: 10.1016/j.puhe.2015.03.016
    Food handler's knowledge, attitude and practice regarding food allergies are important to prevent debilitating and sometimes fatal reactions. This study aimed to assess their food allergy knowledge, attitude and practice, which could help to maintain the safety and hygiene of food consumed by the public.
  7. Fulltext Resource Utilization Pattern And Cost Of Tuberculosis Treatment In Penang, Malaysia
    Atif M, Sulaiman SA, Shafie AA, Asif M
    Value Health, 2014 Nov;17(7):A725-6.
    PMID: 27202579 DOI: 10.1016/j.jval.2014.08.051
  8. Fulltext Assessing the cost effectiveness of an anticoagulation clinic in comparison with the usual medical clinic In Kuala Lumpur Hospital [Abstract]
    Thanimalai S, Shafie AA, Ahmad HM, Sinnadurai J
    Value Health, 2014 Nov;17(7):A487.
    PMID: 27201439 DOI: 10.1016/j.jval.2014.08.1428
    Objectives: Systematic anticoagulation management clinic is now recommended to manage warfarinized atrial fibrillation (AF) patient. In Malaysia, the service is recently introduced as pharmacist managed Warfarin Medication Therapy Adherence Clinic (WMTAC). The objective of the present study was to assess the cost effectiveness of anticoagulation clinic in comparison with usual medical in Kuala Lumpur Hospital.
    Methods: A Markov model built using the provider perspective and 20 year time horizon was used to assess the cost effectiveness. The base case analysis assumed a cohort of patients with AF 57 years of age with comorbid illnesses. Data sources include a 6 month retrospective cohort analysis of the effectiveness of the clinics, the cost of drugs, cost of personnel and space of the clinics, cost of monitoring and cost of adverse events were obtained from the local source and publications. The transition probabilities of these clinics outcomes were obtained from a literature search. Future costs were discounted by 3% to convert to present values. All costs were in Ringgit Malaysia (RM) based on year 2012.
    Results: The results of a 20-year period model showed that UMC was dominated by the WMTAC in the same time period. The mean cost of the WMTAC was RM 5864 whereas the UMC cost was RM 6550. The sensitivity analysis showed that clinic treatment costs and effectiveness influenced the cost-effectiveness. If the cost of WMTAC was increased by 50% of the current cost, the WMTAC would not be a dominant intervention. WMTAC was also cost effective for a willingness to pay of RM32000.
    Conclusions: The anticoagulation management service appears to cost less and provide greater effectiveness than usual care. In conclusion, the Markov model suggests that from the provider perspective the anticoagulation clinic is a more cost effective option than the usual medical clinic in Kuala Lumpur Hospital.
    Study site: Medication Therapy Adherence Clinic, Hospital Kuala Lumpur, Malaysia
  9. Fulltext Knowledge and perceptions of prescribers regarding adherence to standard treatment guidelines for malaria: a comparative cross-sectional study from Pakistan
    Malik M, Hassali MA, Shafie AA, Hussain A
    East Mediterr Health J, 2014 Apr;20(4):221-8.
    PMID: 24952118
    Despite the availability of standard treatment guidelines for malaria in Pakistan adherence to protocols by prescribers is poor. This descriptive, cross-sectional study aimed to explore the perceptions and knowledge of prescribers in Islamabad and Rawalpindi cities towards adherence to standard treatment guidelines for malaria. A questionnaire was distributed to a random sample of 360 prescribers; 64.7% were satisfied with the available antimalarial drugs and 41.3% agreed that antimalarial drugs should only be prescribed after diagnostic testing. Only half the prescribers had the guidelines available in their health facility. Almost all the prescribers (97.7%) agreed that there was a need for more educational programmes about the guidelines. Most prescribers were unaware of the correct standard treatment regimen for Plasmodium falciparum and P. vivax malaria. There were no differences in knowledge between males and females, but prescribers having more experience, practising as general practitioners and working in private health-care facilities possessed significantly better knowledge than their counterparts.
  10. Cost-Effectiveness of Clinical Pharmacy Education on Infection Management among Patients with Chronic Kidney Disease in an Indonesian Hospital
    Nasution A, Syed Sulaiman SA, Shafie AA
    Value Health Reg Issues, 2013 May;2(1):43-47.
    PMID: 29702851 DOI: 10.1016/j.vhri.2013.02.009
    OBJECTIVES: This study evaluated the clinical and economic impacts of clinical pharmacy education (CPE) on infection management among patients with chronic kidney disease (CKD) stages 4 and 5 in Haji Adam Malik Hospital, Indonesia.

    METHODS: A quasi-experimental economic evaluation comparing CPE impact on 6-month CKD mortality was conducted on the basis of payer perspective. The experimental group (n = 63) received care by health care providers who were given CPE on drug-related problems and dose adjustment. The control group (n = 80) was based on the historical cohort of patients who received care before the CPE. Measure of clinical outcome applied in this study was number of lives saved/100 patients treated. Cost-effectiveness ratios for CKD stages 4 and 5 patients without CPE and with CPE and incremental cost-effectiveness ratios (ICERs) for CKD stages 4 and 5 patients were analyzed.

    RESULTS: Lives saved (%) in the treatment of CKD without CPE: CKD stage 4, 78.57; CKD stage 5, 57.58. Lives saved (%) in the treatment of CKD with CPE: CKD stage 4, 88.89; CKD stage 5, 65.45. Cost-effectiveness ratios for stage 4 with and without CPEs were Rp3,348,733.27 and Rp3,519,931.009, respectively. Cost-effectiveness ratios for stage 5 with and without CPEs were Rp7,137,874.93 and Rp7,871,822.27, respectively. ICERs were Rp2,045,341.22 for CKD stage 4 and Rp1,767,585.60 for CKD stage 5.

    CONCLUSIONS: Treatment of CKD stages 4 and 5 with CPE was more effective and cost-effective compared with treatment of CKD stages 4 and 5 without CPE. The ICERs indicated that extra costs were required to increase life saved in both stages.

  11. Optimized fuzzy inference system to enhance prediction accuracy for influent characteristics of a sewage treatment plant
    Ansari M, Othman F, El-Shafie A
    Sci Total Environ, 2020 Jun 20;722:137878.
    PMID: 32199382 DOI: 10.1016/j.scitotenv.2020.137878
    Sewage treatment plants (STPs) keep sewage contamination within safe levels and minimize the risk of environmental disasters. To achieve optimum operation of an STP, it is necessary for influent parameters to be measured or estimated precisely. In this research, six well-known influent chemical and biological characteristics, i.e., biochemical oxygen demand (BOD), chemical oxygen demand (COD), Ammoniacal Nitrogen (NH3-N), pH, oil and grease (OG) and suspended solids (SS), were modeled and predicted using the Sugeno fuzzy logic model. The membership function range of the fuzzy model was optimized by ANFIS, the integrated Genetic algorithms (GA), and the integrated particle swarm optimization (PSO) algorithms. The results were evaluated by different indices to find the accuracy of each algorithm. To ensure prediction accuracy, outliers in the predicted data were found and replaced with reasonable values. The results showed that both integrated GA-FIS and PSO-FIS algorithms performed at almost the same level and both had fewer errors than ANFIS. As the GA-FIS algorithm predicts BOD with fewer errors than PSO-FIS and the aim of this study is to provide an accurate prediction of missing data, GA-FIS was only used to predict the BOD parameter; the other parameters were predicted by PSO-FIS algorithm. As a result, the model successfully could provide outstanding performance for predicting the BOD, COD, NH3-N, OG, pH and SS with MAE equal to 3.79, 5.14, 0.4, 0.27, 0.02, and 3.16, respectively.
  12. Fulltext Drug attitude and adherence: a qualitative insight of patients with hypertension
    Saleem F, Hassali M, Shafie A, Atif M
    J Young Pharm, 2012 Apr;4(2):101-7.
    PMID: 22754262 DOI: 10.4103/0975-1483.96624
    The study is aimed to explore the perceptions and experiences of hypertensive patients toward medication use and adherence. The study was qualitative in nature conducted at Sandamen Provisional Hospital of Quetta city, Pakistan; a public hospital catering to the health needs of about 40% of the population. A qualitative approach was used to gain an in-depth knowledge of the issues. Sixteen patients were interviewed, and the saturation point was achieved after the 14(th) interview. All interviews were audio-taped, transcribed verbatim, and were then analyzed for thematic contents by the standard content analysis framework. Thematic content analysis yielded five major themes. (1) Perceived benefits and risks of medications, (2) physician's interaction with patients, (3) perception toward traditional remedies, (4) layman concept toward medications, and (5) beliefs toward hypertension and its control. The majority of the patients carried specific unrealistic beliefs regarding the long-term use of medication; yet these beliefs were heavily accepted and practiced by the society. The study indicated a number of key themes that can be used in changing the beliefs and experiences of hypertensive patients. Physician's attitude, patient's past experiences, and knowledge related to hypertension were noted as major contributing factors thus resulting in nonadherence to therapy prescribed.
  13. Fulltext General Public Expectation from the Communication Process with their Healthcare Providers
    Hassali M, Shafie A, Khan T
    J Young Pharm, 2012 Jul;4(3):193-8.
    PMID: 23112539 DOI: 10.4103/0975-1483.100028
    The current study aimed to explore the public views and expectation about a successful communication process between the healthcare providers/physicians and patients in Penang Island, Malaysia. A cross-sectional study was conducted in Penang Island using a 14-item questionnaire. Statistical Package for Social Sciences (SPSS) software version 15.0(®) were used to analyze the collected data. A nonparametric statistics was applied; the Chi-square test was applied to measure the association among the variables. P-values less than 0.05 were considered statistically significant. A total of N (500) respondents have shown willingness to participate in the study with a response rate of 83.3%. The majority 319 (63.9%) have disclosed to communicate with their healthcare providers in the Malay language and about 401 (80.4%) of the respondents were found satisfied with the information provided by the physician. It was a common expectation by the most of the sample to focus more on the patient history before prescribing any medicine. Moreover, about 60.0% of the respondents expected that the healthcare providers must show patience to the patient's queries. The level of satisfaction with the information shared by the healthcare providers was higher among the respondents with a higher education level. Furthermore, patients with higher level of education expect that physician shouldwell understand their views and medical history to prescribe a better therapeutic regimen.
  14. Enhancing the performance of data-driven models for monthly reservoir evaporation prediction
    Allawi MF, Aidan IA, El-Shafie A
    Environ Sci Pollut Res Int, 2021 Feb;28(7):8281-8295.
    PMID: 33052565 DOI: 10.1007/s11356-020-11062-x
    The accuracy level for reservoir evaporation prediction is an important issue for decision making in the water resources field. The traditional methods for evaporation prediction could encounter numerous obstacles owing to the effect of several parameters on the shape of the evaporation pattern. The current research presented modern model called the Coactive Neuro-Fuzzy Inference System (CANFIS). Modification for such model has been achieved for enhancing the evaporation prediction accuracy. Genetic algorithm was utilized to select the effective input combination. The efficiency of the proposed model has been compared with popular artificial intelligence models according to several statistical indicators. Two different case studies Aswan High Dam (AHD) and Timah Tasoh Dam (TTD) have been considered to explore the performance of the proposed models. It is concluded that the modified GA-CANFIS model is better than GA-ANFIS, GA-SVR, and GA-RBFNN for evaporation prediction for both case studies. GA-CANFIS attained minimum RMSE (15.22 mm month-1 for AHD, 8.78 mm month-1 for TTD), minimum MAE (12.48 mm month-1 for AHD, 5.11 mm month-1 for TTD), and maximum determination coefficient (0.98 for AHD, 0.95 for TTD).
  15. Performance of ANFIS versus MLP-NN dissolved oxygen prediction models in water quality monitoring
    Najah A, El-Shafie A, Karim OA, El-Shafie AH
    Environ Sci Pollut Res Int, 2014 Feb;21(3):1658-1670.
    PMID: 23949111 DOI: 10.1007/s11356-013-2048-4
    We discuss the accuracy and performance of the adaptive neuro-fuzzy inference system (ANFIS) in training and prediction of dissolved oxygen (DO) concentrations. The model was used to analyze historical data generated through continuous monitoring of water quality parameters at several stations on the Johor River to predict DO concentrations. Four water quality parameters were selected for ANFIS modeling, including temperature, pH, nitrate (NO3) concentration, and ammoniacal nitrogen concentration (NH3-NL). Sensitivity analysis was performed to evaluate the effects of the input parameters. The inputs with the greatest effect were those related to oxygen content (NO3) or oxygen demand (NH3-NL). Temperature was the parameter with the least effect, whereas pH provided the lowest contribution to the proposed model. To evaluate the performance of the model, three statistical indices were used: the coefficient of determination (R (2)), the mean absolute prediction error, and the correlation coefficient. The performance of the ANFIS model was compared with an artificial neural network model. The ANFIS model was capable of providing greater accuracy, particularly in the case of extreme events.
  16. Fulltext Assessing the role of urban green spaces for human well-being: a systematic review
    Jabbar M, Yusoff MM, Shafie A
    GeoJournal, 2021 Jul 20.
    PMID: 34305268 DOI: 10.1007/s10708-021-10474-7
    Human has been evolving in a natural environment over a long time; thus, he is habitual to adapt it. Green spaces are obligatory landscapes in an urban structure that provide a natural environment and accelerate other life events. In contrast, unplanned urbanization, and conversion from green to grey structures have damaged natural environmental resources. Studies through different angles have highlighted the importance of urban green spaces for human well-being but now need to identify their role according to the potential. The demands of urban green spaces may differ with the change of population size, types of grey structure, urban expansion, the altitude of the place, and geographical location. Therefore, this systematic review aims to analyse the significance of urban green spaces for human well-being. The study opted for a systematic process during the selection and organization of studies for this review. After analysing, 46 studies were finalized with the consensus of three review authors. Accordingly, literature was analysed under the central theme of "Urban Green Spaces for Human Well-being." Human Well-being was assessed under six sub-themes; physical, psychological, mental, social, subjective, and environmental well-being. The review concluded that urban green spaces are the primary pillar for a sustainable urban place and human well-being due to highly positive and positive correlations. Moreover, the study did not find any demarcation line between green spaces and grey structures according to any specific need. Therefore, the study suggested that the role of urban green spaces for human well-being should be analysed according to their potential and required optimal ratio under different communities' urban specific environments and social behaviour.
  17. Fulltext The prevalence of tobacco smoking in patients with diabetes in Hospital Pulau Pinang, Malaysia [Abstract]
    Albaroodi KA, Syed Sulaiman SA, Shafie AA, Awaisu A, Lajis R
    Value Health, 2014 Nov;17(7):A590.
    PMID: 27202012 DOI: 10.1016/j.jval.2014.08.2023
    Widespread evidence has demonstrated the negative effects of tobacco smoking in patients with diabetes. Although many studies have explored the prevalence of tobacco smoking in the general population, data are lacking regarding its prevalence in a specific population with a chronic disease such as diabetes.
    Objectives: This study aims to determine the prevalence of tobacco smoking among patients with diabetes in Hospital Pulau Pinang, Malaysia.
    Methods: A cross-sectional survey was conducted to study diabetic patients who attended the endocrine clinic at Hospital Pulau Pinang in Malaysia from March to August 2012. All the diabetic patients who attended the endocrine clinic during that period were asked about their smoking status, and their medical records were reviewed. A total of 1,118 patients with diabetes were reviewed to determine the prevalence of tobacco smoking in diabetic patients at the endocrine clinic of Hospital Pulau Pinang.
    Results: The majority of the study population was male, with Malay and Chinese patients in almost equal proportions and a smaller proportion of Indian patients. Most of these patients had started smoking before they were diagnosed with diabetes. Among the 1,118 diabetic patients, only 108 patients smoked; therefore, the prevalence of tobacco smoking in our patients with diabetes was 9.66%.
    Conclusions: A low prevalence of tobacco smoking was estimated in this study. This prevalence is close to the corresponding value in the general population in Malaysia.
    Study site: Endocrine clinic, Hospital Pulau Pinang, Malaysia
  18. Fulltext Effect of Health Education Program on Knowledge, Attitude, Practice and Health Related Quality of Life in Hepatitis-B Patients
    Haq N, Hassali MA, Shafie AA, Saleem F, Farooqui M, Iqbal Q
    Value Health, 2014 Nov;17(7):A807.
    PMID: 27203043 DOI: 10.1016/j.jval.2014.08.529
  19. Fulltext Determination of Cost-Effectiveness Threshold For Malaysia
    Lim YW, Shafie AA, Chua GN, Hassali MA
    Value Health, 2014 Nov;17(7):A438.
    PMID: 27201168 DOI: 10.1016/j.jval.2014.08.1137
  20. Wavelet neural networks applied to pulping of oil palm fronds
    Zainuddin Z, Wan Daud WR, Pauline O, Shafie A
    Bioresour Technol, 2011 Dec;102(23):10978-86.
    PMID: 21996481 DOI: 10.1016/j.biortech.2011.09.080
    In the organosolv pulping of the oil palm fronds, the influence of the operational variables of the pulping reactor (viz. cooking temperature and time, ethanol and NaOH concentration) on the properties of the resulting pulp (yield and kappa number) and paper sheets (tensile index and tear index) was investigated using a wavelet neural network model. The experimental results with error less than 0.0965 (in terms of MSE) were produced, and were then compared with those obtained from the response surface methodology. Performance assessment indicated that the neural network model possessed superior predictive ability than the polynomial model, since a very close agreement between the experimental and the predicted values was obtained.
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