Txo cov phom sij los ntawm cov txiv neej hluas uas muaj kev tiv thaiv hauv Internet (2013)

Behav hlwb Funct. 2013; 9: 11.

Luam tawm hauv internet 2013 March 12. doi:  10.1186/1744-9081-9-11
 
PMCID: PMC3608995
Tsis ntev-Beom Hong,1,2,3 Jae Won Kim,3 Eun-Jung Choi,4 Ho-Hyun Kim,5 Jeong-Eun Sau,6 Tsuag-Dai Kim,7 Paul Klauser,1 Sarah Whittle,1 Murat Yűcel,1 Christos Pantelis,1 thiab Tsis ntev-Hyung Yisau tus kws sau ntawv4
Sau cov lus qhia ► Tshooj ntawv ► Cov Ntaub Ntawv Tawm Xov Tooj thiab Ntawv Tso Cai ►
Mus rau:

Abstract

Tom qab

Lub orbitofrontal cortex (OFC) tau cuam tshuam tas li nyob rau hauv pathology ntawm ob qho tib si tshuaj thiab kev coj tus cwj pwm. Txawm li cas los xij, tsis muaj kev kawm txog hnub tau tshawb xyuas OFC tuab hauv kev quav yeeb quav tshuaj hauv internet. Hauv qhov kev kawm tam sim no, peb tau tshawb xyuas qhov muaj nyob ntawm qhov sib txawv ntawm cortical tuab ntawm OFC rau cov hluas nrog kev quav yeeb quav tshuaj hauv internet. Raws li kev nyuam qhuav hais txog kev theoretical cov qauv ntawm kev quav, peb tau kwv yees txo qhov tuab ntawm daim OFC ntawm internet quav rau tib neeg.

Kev tshawb pom

Cov neeg tuaj koom yog 15 cov txiv neej hluas raug kuaj pom tias muaj kev quav yeeb quav tshuaj hauv internet thiab 15 txiv neej noj qab haus huv sib piv. Lub hlwb sib nqus resonance cov duab tau los ntawm 3T MRI thiab pab pawg sib txawv hauv cortical tuab tau txheeb xyuas siv FreeSurfer. Peb cov txiaj ntsig tau lees paub tias cov txiv neej hluas nrog kev quav yeeb quav tshuaj hauv internet tau txo qis cov tawv ncauj ntawm txoj cai tom qab OFC (p

xaus

Qhov kev tshawb pom no txhawb qhov pom tias daim OFC hloov pauv rau cov neeg hluas nrog kev quav yeeb quav tshuaj hauv internet cuam tshuam nrog cov cim neurobiological ntawm kev quav tshuaj muaj feem cuam tshuam nrog kev tsis sib haum xeeb.

 
keywords: Kev quav yeeb yaj kiab hauv Is Taws Nem, Magnetic resonance imaging, Cortical thickness, Orbitofrontal cortex
Mus rau:

Introduction

Kev quav yeeb quav tshuaj hauv Internet tau raug lees paub tias yog kev puas hlwb. Cov kev kwv yees tsis ntev los no txog nws qhov kev nthuav dav siab hauv cov tub ntxhais hluas, ua ke nrog cov pov thawj tias kev siv internet muaj teeb meem yog kev coj cwj pwm tsis zoo nrog kev ua haujlwm thiab kev mob hlwb, txhawb nqa qhov tseeb ntawm kev kuaj mob [1]. Txawm li cas los xij, muaj kev tsis sib haum xeeb ntau hauv txoj kev npaj rau DSM-V txog kev yuav ua li cas lub tswv yim txog tus mob no, lossis nws cov psychopathology tseem ceeb [2]. Muab cov keeb kwm yav dhau los no, txheeb xyuas qhov tshwm sim ntawm ib qho cim roj ntsha yuav pab txhim kho kev kuaj mob siv tau [3].

Lub hauv paus neural ntawm kev quav yeeb tshuaj tau kawm ntau ntxiv thiab tau tsim zoo dua piv rau lwm cov 'yees' (xws li, kev coj tus cwj pwm). Txog tam sim no, ntau cov kev tshawb fawb hauv cov ntawv nyeem tau cuam tshuam lub luag haujlwm ntawm lub orbitofrontal cortex (OFC) hauv kev quav [4-6]. Volkow thiab cov npoj yaig (2000, 2002) qhia tias daim OFC yog ib qho ntawm feem cuam tshuam hauv cheeb tsam ua ntej hauv yeeb tshuaj [4,7]. Tsis ntev los no, cov kws tshawb nrhiav hauv peb pab pawg tau tshaj tawm cov lus qhia txog kev tshawb nrhiav qhov ntev uas qhia hais tias kev teeb tsa kev ua haujlwm tsis zoo hauv OFC yuav tuaj yeem kwv yees thiab ua rau muaj kev pheej hmoo rau kev siv cannabis tom qab hauv cov hluas [8]. Zoo sib xws, txawm hais tias ob peb txoj kev tshawb fawb tau ua, qhov kev tshaj tawm ua haujlwm thiab cov qauv hloov tau pom nyob rau hauv kev quav yeeb quav tshuaj hauv internet tau zoo sib xws hauv kev ua kom pom qhov kev hloov pauv ntawm OFC muaj nuj nqi (tshwj xeeb yog hauv txoj cai hemisphere) thiab kev teeb tsa [9-14].

Peb xav tias cov hluas nrog kev quav yeeb quav tshuaj hauv internet yuav qhia pom qhov tsis zoo ntawm OFC, nyiam nyob rau txoj kev hemisphere. Tshwj xeeb, peb tau coj los sib hais – tswj kev sib piv ntawm cov cortical tuab rau cov neeg hluas nrog thiab tsis muaj kev quav yeeb quav tshuaj hauv internet, tshwj xeeb yog tsom mus rau kev ua si hauv online ntau dhau, uas yog ntawm cov kev cuam tshuam tseem ceeb ntawm qhov kev cuam tshuam no [15].

Mus rau:

Cov ntaub ntawv thiab cov hau kev

kawm

Kaum tsib txoj cai txiv neej hluas nrog kev quav yeeb quav tshuaj hauv internet tau raug tshaj tawm los ntawm kev tshaj tawm hauv Seoul National University Hospital. Kev nrhiav neeg ua tiav thaum lub Ob Hlis thiab Lub Rau Hli 2011. Kuvn txhawm rau tsim kev kuaj mob los ntawm kev quav yeeb quav tshuaj hauv internet uas peb siv Cov Khoom Siv Hluav Taws Xob Hluav Taws Xob Hluav Taws Xob (YIAS) [16]. Tsis tas li ntawd, cov neeg tuaj koom tau lees paub rau cov kev qhia tias tau muaj kev sib raug zoo nrog rau lawv txoj kev ua si hauv online suav nrog: kam rau siab, thim tawm, kev txhawj xeeb nrog kev ua si nws, rov ua tsis tiav qhov kev sim txo lossis txiav nws, cuam tshuam los ntawm lub siab thaum sim txo nws, thiab tsis saib xyuas kev sib raug zoo lossis kev ua ub ua no vim tias nws [17,18].

Txhawm rau tshem tawm ib qho kev tsis txaus siab ntawm cov kev puas siab puas ntsws, peb siv Kiddie-Teem Sij Hawm Rau Kev Tiv Thaiv Tsis Zoo thiab Schizophrenia-Tam Sim No thiab Ib Sim Neej (K-SADS-PL) [19]. Cov txiv neej noj qab haus huv tau raug xaiv los ntawm kev tshaj tawm hauv cov tsev kawm hauv nroog thiab raug tshuaj xyuas siv cov kev ntsuas tib yam uas tau piav qhia saum toj no. Kev tsis suav rau ob pawg yog ib txoj kab kev tsis sib haum I suav nrog kev quav yeeb tshuaj, mob vwm lossis lwm cov leeg hlwb, thiab keeb kwm yav dhau los ntawm mob taub hau heev. Qhov ntau ntawm kev quav dej quav cawv hauv internet tau kwv yees ntau dua hauv cov pojniam dua hauv poj niam [1]. Muab hais tias cov txiv neej yog dhau mus sawv cev hauv kev siv internet ntxiv, thiab muab sijhawm thiab nyiaj txiag, peb tau txiav txim siab los saib rau cov tub hluas ntxhais hluas. Txoj kev kawm no tau pom zoo los ntawm cov thawj coj saib xyuas cov tib neeg rau ntawm Seoul National University. Txhua tus hluas thiab lawv niam thiab txiv tau sau ntawv pom zoo ua ntej tuaj kawm.

Cov ntaub ntawv tshaaj tau

Tag nrho lub paj hlwb T1-hnyav MR cov duab tau los ntawm 3T Siemens scanner (Siemens Magnetom Trio Tim Syngo MR B17, Lub Tebchaws Yelemees) nrog cov ntsuas hauv qab no: TR 1900 ms; TE 2.36 ms; inversion lub sijhawm 700 ms; ntxeev lub kaum 9 °; voxel loj 1.0 hli3; hlais 224. Cov lus tsa suab lub taub hau yog qhov tsawg kawg nkaus los ntawm kev sau qhov chaw khoob ncig lub taub hau nrog rau cov khoom siv txhuam thiab txhawm rau kho lub puab tsaig qis nrog daim kab xev.

Image ua

Cortical thickness tau kwv yees siv FreeSurfer 5.1.0 (Massachusetts General Tsev Kho Mob, Boston, MA, Asmeskas), cov txheej txheem ntawm software cov cuab yeej uas muab cov txheej txheem ib nrab ua haujlwm los tshawb xyuas lub hlwb morphometry. Cov kwj deg saum npoo av cuam tshuam nrog (i) kev ua kom lub hlwb lub teeb liab siv, (ii) pob txha taub hau-tshem tawm, (iii) cais cov teeb meem grey thiab dawb, (iv) txiav tawm ntawm qhov grey-dawb interface (sab hauv sab hauv), thiab (v) ) tracing ntawm pial (sab nraud) saum npoo. Qhov kev ncua deb ntawm cov piv txwv nyob rau hauv ob qhov chaw nruab nrab yog cortical thickness. Tag nrho cov Cortex ntawm txhua qhov kev kawm tau raug kuaj pom thiab kho cov kev ua haujlwm kom raug rau qhov yuam kev tsis pom tseeb rau pawg neeg ntawm cov koom. Peb tau siv peb cov qauv los tsim qhov nruab nrab ntawm cov hom phiaj nruab nrab thiab cov ntaub ntawv rau txhua tus neeg tuaj koom tau ua ntej-smoothed nrog qhov puv qhov nruab nrab ib nrab-qhov siab tshaj plaws ntawm Gaussian ntsiav ntawm 10 hli ua ntej kev txheeb xyuas cov ntsuas.

Cov ntaub ntawv ntsuam xyuas

Thaj av-ntawm-paj (ROI) -based tshuaj ntsuam tau ua qhov sib piv cortical tuab ntawm daim OFC tsim los ntawm FreeSurfer raws li Desikan-Killiany atlas20]. Tshwj xeeb tshaj yog, Desikan-Killiany atlas txhais qhov kev txiav txim siab tom ntej thiab kev sib faib ntawm OFC. Cov rostral / caudal thiab medial / lateral ib thaj tsam ntawm ob cov qauv no yog qhov ua tau zoo tshaj plaws ntawm thaj tsam ntawm sab nraub qaum orbital gyrus (thiab / ntu nruab nrab ntawm cov voos tom qab lossis tom qab gyrus thiab qhov nruab nrab ntawm olfactory sulcus / lub tsev txhab nyiaj ntawm cov nqaj qaum lossis tom qab (thiab / lossis lub voj voos kheej kheej (insular sulcus) rau tom qab OFC; thiab lub rostral raws cov medial orbital gyrus / lub caudal feem ntawm medial orbital gyrus (los yog gyrus rectus) thiab cingulate cortex / lub tsev txhab nyiaj nruab nrab ntawm cov sab hauv pem hauv ntej gyrus rau medial OFC, ntsig txog [20]. Kev soj ntsuam ntawm covariance (ANCOVA) siv cov qauv dav dav (GLM) tau ua nrog SPSS 19.0 (SPSS Inc., Chicago, IL, USA), thiab cov txiaj ntsig tseem ceeb ntawm pab pawg (kev quav yeeb tshuaj hauv internet thiab tswj kev noj qab haus huv) tau tshawb xyuas kev tswj hwm rau lub hnub nyoog , txawj ntse quotient (IQ), thiab ntim hauv intracranial (ICV). Cov txiaj ntsig ntawm qhov kev tshuaj ntsuam no tau qhia nrog qhov pib zoo ntawm p<0.05 (ob-tw).

Mus rau:

tau

Tus cwj pwm koom nrog

Cov pawg ntawm cov tub ntxhais hluas nrog thiab tsis muaj kev tiv thaiv kev tiv thaiv hauv internet sib txawv hauv lub hnub nyoog (13.33 ± 2.84 rau kev quav yeeb tshuaj hauv internet; 15.40 ± 1.24 rau kev tswj hwm; p= 0.018). IQ tau sib piv thoob plaws ob pawg (103.80 ± 15.84 rau kev quav yeeb tshuaj hauv internet; 109.06 ± 9.84 rau kev tswj hwm; p= 0.283), thiab qhov sib txawv tseem ceeb hauv ICV tau pom (1434.42 ± 158.33 cm3 rau kev quav yeeb quav tshuaj hauv internet; 1577.21 ± 183.12 cm3 rau kev tswj hwm; p= 0.030). YIAS cov qhab nia tau nce siab nyob hauv pawg neeg quav yeeb yaj kiab (57.26 ± 16.11 rau kev quav yeeb yaj kiab hauv internet; 37.60 ± 9.72 rau kev tswj hwm; p= 0.000).

Kev tshuaj ntsuam ROI-based

Qhov tsom xam tau qhia txog plaub qhov ROI nrog qhov sib txawv sib txawv hauv cortical tuab (p<0.05), uas yog qhov tom qab ua haujlwm ntawm OFC, isthmus ntawm lub cingulate cortex, thiab pars orbitalis hauv txoj cai hemisphere thiab tom qab occipital cortex nyob rau sab laug hemisphere, txhua qhov ua kom pom cov cortical thinning hauv cov hluas nrog kev tiv thaiv hauv internet piv rau cov kev tswj kom zoo1).

rooj 1 

Tshem tawm cheeb tsam-ntawm-kev txaus siab sib piv ntawm cortical tuab ntawm cov neeg hluas nrog kev quav yeeb quav tshuaj hauv internet thiab cov kev tswj xyuas kev noj qab haus huv

Kev ntsuam xyuas theem nrab

Txhawm rau muab kev pom zoo ntxiv ntawm peb qhov kev tshawb nrhiav, ib qho kev soj ntsuam ntawm lub hlwb tag nrho uas siv FreeSurfer's Qdec (version 1.4) tau ua los ntawm kev haum ntawm qhov nruab nrab ntawm ntu GLM ntawm txhua qhov saum npoo av los piv rau cov cortical tuab ntawm cov pab pawg (tsis paub meej, p<0.001). Xws li qhia hauv daim duab1, qhov txo qis ntawm OFC tuab dua tau rov ua dua los ntawm qhov kev tshuaj ntsuam no.

Daim duab 1 

Vertex-paub zoo tag nrho lub hlwb sib piv ntawm cortical tuab ntawm cov neeg hluas nrog kev quav yeeb quav tshuaj hauv internet thiab cov kev tswj xyuas kev noj qab haus huv. Liab xim qhia cortical thickness ntau dua nyob rau hauv cov hluas nrog kev quav yeeb tshuaj hauv internet, thiab xim xiav qhia cortical thickness ...
Mus rau:

kev sib tham

Qhov no yog thawj zaug kev teeb tsa lub hlwb kev kawm ntawm cortical tuab rau cov hluas nrog kev quav yeeb quav tshuaj hauv internet. Raws li peb qhov kev xav, cov txiaj ntsig tau qhia tias txo qhov tuab ntawm OFC nyob rau hauv kev siv tshuaj ntxiv hauv internet sib piv nrog cov tswj kev noj qab haus huv. Qhov kev tshawb pom no yog ua raws li cov txiaj ntsig ntawm cov kev tshawb nrhiav neuroimaging dhau los ntawm kev quav yeeb quav tshuaj hauv internet [9-14], thiab txhawb cov qauv theoretical ntawm kev quav dej quav cawv, uas hais txog kev koom tes ntawm OFC.

Qhov pom tam sim no ntawm kev quav yeeb quav tshuaj hauv internet txhawb cov txiaj ntsig ntawm kev tshawb fawb yav dhau los ntawm kev quav yeeb tshuaj, suav nrog peb tus kheej8], uas tau sib cav tias txoj cai OFC ua lub luag haujlwm tseem ceeb hauv kev siv roj ntsha ua rau kev quav yeeb quav tshuaj muaj ntau dua. Qhov txiaj ntsig ntawm qhov kev kawm no tsis yog tsuas yog ua tiav nrog ntau yam kev tshawb pom hauv cov ntawv nyeem cuam tshuam lub luag haujlwm ntawm OFC nyob rau hauv kev quav [4-6], tab sis kuj tseem nrog cov uas qhia tias cheeb tsam no lub hlwb hauv txoj cai hemisphere yog qhov tseem ceeb tshwj xeeb [21].

Hauv txoj kev tshawb fawb no, tsuas yog tom qab thiab tsis yog medial OFC tau pom tias muaj qhov sib txawv ntawm cov hluas nrog kev quav yeeb quav tshuaj hauv internet. Cov laj thawj rau qhov kev tshawb pom no tsis meej, tab sis muaj ntau qhov kev tshawb fawb qhia txog cov haujlwm sib txawv ntawm txoj haujlwm sab thiab tom qab OFC, tshwj xeeb tshaj yog nyob rau kev txiav txim siab muaj txiaj ntsig [22]. Piv txwv li, qhov nruab nrab ntawm OFC tau pom tias yog cov khoom siv zoo dua rau hauv cov kev xaiv cuam tshuam nrog cov khoom plig tam sim, hos cov OFC tom qab tau muaj kev cuam tshuam hauv cov kev xaiv hais txog cov khoom plig qeeb lossis kev txwv ntawm cov lus teb ua ntej [23,24]. Nws yog qhov tseem ceeb tias pars orbitalis, uas yog nyob ib sab ntawm ib sab OFC, kuj pom qhov tseem ceeb cortical thinning hauv cov hluas nrog kev quav yeeb quav tshuaj hauv internet. Qhov kev tshawb pom no txhawb nqa qhov cortical thinning yog tshwj xeeb tshaj yog nyob rau sab tom ntej ntawm OFC, yam uas tsis muaj los yog tsawg dua koom nrog kev ua daim OFC. Ntxiv ua haujlwm yog raug lees paub rau qhov sib txawv uas muaj peev xwm tom qab thiab medial OFC ua haujlwm.

LateC OFC kuj tseem raug cuam tshuam rau hauv qhov ua kom lub zeem muag hloov pauv tsis yooj yim thiab hauv txoj kev paub ntawm keeb kwm ntawm lub neej pathological [25]. Hauv qhov no, Chamberlain thiab cov npoj yaig (2008) qhia tias tom qab OFC tuaj yeem yog qhov nruab nrab ntawm cov qauv neurobiological ntawm cov kev xav tsis zoo-tsis sib haum (OCD) [26]. Kev coj tus cwj pwm feem ntau suav tias yuav qhia cov yam ntxwv zoo sib xws nrog lwm cov kev paub tsis meej nrog rau OCD [2], koom nrog cov teeb meem tshwj xeeb hauv kev rov zwm tseg los ntawm qee tus cwj pwm uas ua rau muaj kev txhaum loj rau nws tus kheej. Kev sib hloov thiab cov npoj yaig (2008, 2010), raws li lawv qhov kev ntsuas meta yav dhau los [27,28], tshawb xyuas overlapping lub hlwb thaj tsam ntawm cov ntaub ntawv ntawm lub cev thiab ua haujlwm ntawm lub hlwb daim phiaj xwm uas pom tias muaj teeb meem loj grey hloov pauv thiab kev ua haujlwm thaum qhov tsos mob cuam tshuam, feem, hauv cov neeg mob OCD: cov sau phau ntawv pom tias tsuas yog thaj tsam ntawm lub paj hlwb yog qhov kev txiav txim siab tom qab OFC. Tsis ntev los no, Zhou thiab cov npoj yaig (2012) tau pom tias muaj kev puas hlwb yooj yim nrog rau cov lus teb tsis zoo rau cov neeg hluas uas muaj internet sib ntxiv [29]. Qhov cuam tshuam ntawm kev txo cortical tuab nyob rau sab hauv OFC, hais txog nws lub luag haujlwm hauv kev quav yeeb quav tshuaj hauv internet thiab lwm yam mob uas zoo li neurobehavioral zoo sib xws, yuav muaj kev kawm tom ntej.

Qhov kev kawm tam sim no muaj qee qhov kev txwv tseem ceeb. Qhov tseem ceeb tshaj, kev faib tawm lub hnub nyoog sib txawv ntawm cov pab pawg yog qhov kev txwv tseem ceeb ntawm txoj kev tshawb no. Txawm li cas los xij, cov ntawv tshaj tawm dhau los ntawm kev loj hlob ntawm lub hlwb tau pom tias cortical thickness peaks ntawm kwv yees li 8 – 9 xyoo thiab tom qab ntawd thoob ntiaj teb cortical thinning pib tom qab [30]. Ntawm kev ceeb toom yog tias txhua tus neeg tuaj koom hauv peb qhov kev kawm no muaj hnub nyoog laus dua. Yog li, hauv cov neeg hluas, cov neeg hluas yuav muaj cov tawv ntoo ntau dua; peb txoj kev nrhiav pom ntawm txoj cai qub OFC hauv pawg hluas sib ntxiv hauv internet yog li qhia tau tias cov hnub nyoog sib txawv hauv cov pab pawg tsis zoo li yuav cuam tshuam qhov tshwm sim. Thib ob, peb tsis ntsuas qhov kev ncua ntev ntawm kev tiv thaiv kev tiv thaiv internet. Thib peb, cov kawm koom nrog pawg pab cuam hauv internet yog cov neeg twv txiaj hauv online ntau dhau, thiab vim li ntawd, qhov kev tshawb pom tam sim no tuaj yeem txwv tsis pub muaj lwm qhov kev quav yeeb quav tshuaj nyob hauv internet [15].

Hauv cov ntsiab lus, cov txiaj ntsig ntawm qhov kev tshawb fawb tam sim no qhia cov kev tshawb pom ua ntej ntawm kev txo txoj cai tuab ntawm txoj cai OFC hauv cov hluas nrog kev quav yeeb quav tshuaj hauv internet. Cov kev tshawb pom tau hais qhia ntxiv ntawm kev sib koom neurobiological mechanism ntawm kev quav yeeb quav tshuaj hauv internet thiab lwm yam kev cuam tshuam ntxiv.

Mus rau:

Kev nyiam kev sib tw

Txhua tus neeg sau ntawv tshaj tawm tias lawv tsis muaj kev nyiam sib tw.

Mus rau:

Tus sau phau ntawv sau npe

SBH tau tshawb xyuas cov ntaub ntawv txheeb xyuas thiab sau thawj tsab ntawv tshaj xo. JWK, CDK, thiab SHY yog lub luag haujlwm rau lub tswv yim kawm thiab qauv tsim. SBH, EJC, HHK, thiab JES yog lub luag haujlwm rau kev nrhiav cov ntaub ntawv soj ntsuam thiab kev kos duab. PK thiab SW tau pab nrog ntsuam xyuas cov ntaub ntawv. PK, SW, MY, thiab CP pab txhawb nqa tsab ntawv tshaj tawm zaum kawg. JWK, CDK, MY, CP, thiab SHY tau pab rau kev txhais cov ntaub ntawv thiab muab cov ntsiab lus kev txawj ntse tseem ceeb. Txhua tus neeg sau tau tshawb xyuas cov ntsiab lus thiab qhov kev pom zoo zaum kawg xa mus rau kev tshaj tawm.

Mus rau:

Acknowledgements

Qhov haujlwm no tau pab los ntawm Seoul National University Lub Hlwb Fusion Program Tshawb Fawb Cov Nyiaj. SBH tau txais kev txhawb nqa los ntawm Lub Teb Chaws Tshawb Nrhiav Kev Ruaj Ntseg Hauv Tebchaws Kauslim (NRF) (Cov Nyiaj Pab Rau Cov Haujlwm Hauv Ntiaj Teb) tau nyiaj los ntawm tsoomfwv Kauslim (MEST). KUV tau txais kev txhawb nqa los ntawm NHMRC Kev Sib Koom Tes (#1021973). Cov peev nyiaj tsis muaj lub luag haujlwm hauv kev tshawb fawb tsim, sau, tsom xam lossis txhais cov ntaub ntawv, sau cov ntawv sau, lossis kev txiav txim siab xa daim ntawv rau kev tshaj tawm.

Mus rau:

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