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Volume 40(4); August 2016
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Reviews
Obesity and Metabolic Syndrome
The Effect of Regular Exercise on Insulin Sensitivity in Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis
Kimberley L. Way, Daniel A. Hackett, Michael K. Baker, Nathan A. Johnson
Diabetes Metab J. 2016;40(4):253-271.   Published online August 2, 2016
DOI: https://doi.org/10.4093/dmj.2016.40.4.253
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AbstractAbstract PDFSupplementary MaterialPubReader   

The purpose of this study was to examine the effect of regular exercise training on insulin sensitivity in adults with type 2 diabetes mellitus (T2DM) using the pooled data available from randomised controlled trials. In addition, we sought to determine whether short-term periods of physical inactivity diminish the exercise-induced improvement in insulin sensitivity. Eligible trials included exercise interventions that involved ≥3 exercise sessions, and reported a dynamic measurement of insulin sensitivity. There was a significant pooled effect size (ES) for the effect of exercise on insulin sensitivity (ES, –0.588; 95% confidence interval [CI], –0.816 to –0.359; P<0.001). Of the 14 studies included for meta-analyses, nine studies reported the time of data collection from the last exercise bout. There was a significant improvement in insulin sensitivity in favour of exercise versus control between 48 and 72 hours after exercise (ES, –0.702; 95% CI, –1.392 to –0.012; P=0.046); and this persisted when insulin sensitivity was measured more than 72 hours after the last exercise session (ES, –0.890; 95% CI, –1.675 to –0.105; P=0.026). Regular exercise has a significant benefit on insulin sensitivity in adults with T2DM and this may persist beyond 72 hours after the last exercise session.

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Roles of Reactive Oxygen Species on Insulin Resistance in Adipose Tissue
Chang Yeop Han
Diabetes Metab J. 2016;40(4):272-279.   Published online June 28, 2016
DOI: https://doi.org/10.4093/dmj.2016.40.4.272
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AbstractAbstract PDFPubReader   

Obesity resulting from the delivery of an excess amount of energy to adipose tissue from glucose or free fatty acids is associated with insulin resistance and adipose tissue inflammation. Reactive oxygen species (ROS) have been implicated as contributors to both the onset and the progression of insulin resistance. ROS can be generated by overloading the mitochondrial oxidative phosphorylation system, and also by nicotinamide adenine dinucleotide phosphate oxidases (NOX) produced by either adipocytes, which only produce NOX4, or by macrophages, which produce mainly NOX2. The source of the ROS might differ in the early, intermediate and late stages of obesity, switching from NOX4-dependence in the early phases to NOX2-dependence, in the intermediate phase, and transiting to mitochondria-dependence later in the time course of obesity. Thus, depending on the stage of obesity, ROS can be generated by three distinct mechanisms: i.e., NOX4, NOX2, and mitochondria. In this review, we will discuss whether NOX4-, NOX2-, and/or mitochondria-derived ROS is/are causal in the onset of adipocyte insulin resistance as obesity progresses. Moreover, we will review the pathophysiological roles of NOX4, NOX2, and mitochondria-derived ROS on adipose tissue inflammation.

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Editorial
Epidemiology
Dietary Sodium Intake in Patients with Type 2 Diabetes Mellitus
Mi-Kyung Kim
Diabetes Metab J. 2016;40(4):280-282.   Published online August 18, 2016
DOI: https://doi.org/10.4093/dmj.2016.40.4.280
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PDFPubReader   

Citations

Citations to this article as recorded by  
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Original Articles
Clinical Care/Education
Glycemic Effects of Rebaudioside A and Erythritol in People with Glucose Intolerance
Dong Hee Shin, Ji Hye Lee, Myung Shin Kang, Tae Hoon Kim, Su Jin Jeong, Chong Hwa Kim, Sang Soo Kim, In Joo Kim
Diabetes Metab J. 2016;40(4):283-289.   Published online June 15, 2016
DOI: https://doi.org/10.4093/dmj.2016.40.4.283
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AbstractAbstract PDFPubReader   
Background

Rebaudioside A and erythritol are nonnutritive sweeteners. There have been several studies of their glycemic effects, but the outcomes remain controversial. The purpose of this study was to evaluate the glycemic effects of rebaudioside A and erythritol as a sweetener in people with glucose intolerance.

Methods

This trial evaluated the glycemic effect after 2 weeks of consumption of rebaudioside A and erythritol as sweeteners in a pre-diabetic population. The patients were evaluated for fructosamine, fasting plasma glucose, C-peptide, insulin, and 2-hour plasma glucose before and after consumption of sweetener. The primary outcome was a change in fructosamine levels from the baseline to the end of treatment. Secondary outcomes were the changes in levels of fasting plasma glucose and 2-hour plasma glucose.

Results

From the baseline to the end of experiment, the changes in fructosamine levels after consumption of rebaudioside A and erythritol, did not differ significantly (244.00±19.57 vs. 241.68±23.39 µmol/L, P=0.366). The change in levels from the baseline to end of the study for rebaudioside A and erythritol were fasting plasma glucose (102.56±10.72 vs. 101.32±9.20 mg/dL), 2-hour plasma glucose (154.92±54.53 vs. 141.92±42.22 mg/dL), insulin (7.56±4.29 vs. 7.20±5.12 IU/mL), and C-peptide (2.92±1.61 vs. 2.73±1.31 ng/mL), respectively, and also did not differ significantly (P>0.05 for all).

Conclusion

Our study suggests that consumption of rebaudioside A and erythritol does not alter the glucose homeostasis in people with glucose intolerance.

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    Szimonetta Lohner, Ingrid Toews, Joerg J. Meerpohl
    Nutrition Journal.2017;[Epub]     CrossRef
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    Katie C. Hootman, Jean-Pierre Trezzi, Lisa Kraemer, Lindsay S. Burwell, Xiangyi Dong, Kristin A. Guertin, Christian Jaeger, Patrick J. Stover, Karsten Hiller, Patricia A. Cassano
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Epidemiology
Dietary Sodium Intake in People with Diabetes in Korea: The Korean National Health and Nutrition Examination Survey for 2008 to 2010
Myung Shin Kang, Chong Hwa Kim, Su Jin Jeong, Tae Sun Park
Diabetes Metab J. 2016;40(4):290-296.   Published online June 23, 2016
DOI: https://doi.org/10.4093/dmj.2016.40.4.290
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AbstractAbstract PDFPubReader   
Background

Diabetics are likely to receive advice from their physicians concerning lifestyle changes. To understand how much sodium is consumed by diabetics in Korea, we compared the average daily sodium intake between diabetics and non-diabetics after controlling for confounding factors.

Methods

We obtained the sodium intake data for 13,957 individuals who participated in the Korean National Health and Nutrition Examination Survey (KNHANES), 2008 to 2010, which consisted of a health interview and behavioral and nutritional surveys. The KNHANES uses a stratified, multistage, probability-sampling design, and weighting adjustments were conducted to represent the entire population.

Results

Our analysis revealed that, overall, diabetics tended to have lower sodium intake (4,910.2 mg) than healthy individuals (5,188.2 mg). However, both diabetic and healthy individuals reported higher sodium intake than is recommended by the World Health Organization (WHO). Stratified subgroup analyses revealed that the sodium intake (4,314.2 mg) among newly diagnosed diabetics was higher among women when compared to patients with known diabetes (3,812.5 mg, P=0.035). Female diabetics with cardiovascular disease had lower average sodium intake compared to those without cardiovascular disease after adjusting for sex, age, body mass index, and total energy intake (P=0.058). Sodium intake among male diabetics with hypercholesterolemia (P=0.011) and female diabetics with hypertriglyceridemia (P=0.067) tended to be higher than that among those who without dyslipidemia.

Conclusion

The average sodium intake of diabetics in Korea was higher than the WHO recommends. Sodium intake in newly diagnosed diabetics was significantly higher than that in non-diabetics and previously diagnosed diabetics among females. Prospective studies are needed to identify the exact sodium intake.

Citations

Citations to this article as recorded by  
  • Salt Intake in Adults with Diabetes and Hypertension: The Longitudinal Study of Adult Health-Brasil Study
    Natália Gonçalves Ribeiro, Deborah F. Lelis, Rosane H. Griep, Sandhi M. Barreto, Maria del Carmen B Molina, Maria I. Schmidt, Bruce B. Duncan, Isabela Bensenor, Paulo A. Lotufo, José G. Mill, Marcelo Perim Baldo
    Metabolic Syndrome and Related Disorders.2024;[Epub]     CrossRef
  • Effects of different diets on glycemic control among patients with type 2 diabetes: A literature review
    Maryam E Al-Adwi, Zinab M Al-Haswsa, Karmen M Alhmmadi, Yasmin A Eissa, Aya Hamdan, Hiba Bawadi, Reema F Tayyem
    Nutrition and Health.2023; 29(2): 215.     CrossRef
  • Dietary salt intake predicts future development of metabolic syndrome in the general population
    Hiroyuki Takase, Kazusa Hayashi, Fumihiko Kin, Suguru Nakano, Masashi Machii, Shin Takayama, Tomonori Sugiura, Yasuaki Dohi
    Hypertension Research.2023; 46(1): 236.     CrossRef
  • High Sodium Intake, as Assessed by Urinary Sodium Excretion, Is Associated with Nonalcoholic Fatty Liver Disease or Sarcopenia
    Eugene Han, Mi Kyung Kim, Seung-Soon Im, Hye Soon Kim, Taeg Kyu Kwon, Byoung Kuk Jang
    Gut and Liver.2023; 17(3): 456.     CrossRef
  • Trends of Dietary Intakes and Metabolic Diseases in Japanese Adults: Assessment of National Health Promotion Policy and National Health and Nutrition Survey 1995–2019
    Muhammad Fauzi, Indri Kartiko-Sari, Hemant Poudyal
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  • Determinants of Type 2 Diabetes Mellitus Among Adults in Dill-Chora Referral Hospital, Dire Dawa, East Ethiopia
    Tewodros Getnet Amera, Yibekal Manaye Tefera, Tameru Menberu, Aminu Mohammed Yassin
    Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy.2022; Volume 15: 3565.     CrossRef
  • Dietary sodium and cardiovascular morbidity/mortality: a brief commentary on the ‘J-shape hypothesis’
    Christiana Tsirimiagkou, Kalliopi Karatzi, Antonios Argyris, Eirini D. Basdeki, Panagiota Kaloudi, Mary Yannakoulia, Athanase D. Protogerou
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    Hajime Haimoto, Takashi Murase, Shiho Watanabe, Keiko Maeda, Kenji Wakai
    Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy.2021; Volume 14: 4569.     CrossRef
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    Jeong-Hyeon Bae, Min-Young Shin, Eun Ha Kang, Yun Jong Lee, You-Jung Ha
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    Sang Young Kim, Jeanne H Freeland-Graves, Hyun Ja Kim
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Complications
Prevalence and Risk Factors of Gastroesophageal Reflux Disease in Patients with Type 2 Diabetes Mellitus
Jun Ouk Ha, Tae Hee Lee, Chang Won Lee, Ja Young Park, Seong Ho Choi, Hee Seung Park, Jae Seung Lee, Seung Heon Lee, Eun Hee Seo, Young Hwan Kim, Young Woo Kang
Diabetes Metab J. 2016;40(4):297-307.   Published online June 8, 2016
DOI: https://doi.org/10.4093/dmj.2016.40.4.297
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AbstractAbstract PDFSupplementary MaterialPubReader   
Background

Gastrointestinal symptoms are common in patients with type 2 diabetes mellitus (T2DM). The prevalence of gastroesophageal reflux disease (GERD) in Korea appears to be increasing. Some studies have shown that T2DM is a risk factor for symptomatic GERD. However, this possibility is still debated, and the pathogenesis of GERD in T2DM is not yet fully understood. The aim of this study was to analyze the prevalence and risk factors (including autonomic neuropathy) of GERD in patients with T2DM.

Methods

This cross-sectional case-control study enrolled T2DM patients (n=258) and healthy controls (n=184). All participants underwent physical examinations and laboratory tests. We evaluated medical records and long-term diabetes complications, including peripheral and autonomic neuropathy in patients with T2DM. Esophagogastroduodenoscopy was performed in all patients. The Los Angeles (LA) classification was used to grade GERD. GERD was defined as LA grade A (or higher) or minimal change with GERD symptoms. GERD symptoms were examined using a frequency scale. Data were expressed as mean±standard error. Independent t-tests or chi-square tests were used to make comparisons between groups.

Results

The prevalence of GERD (32.6% vs. 35.9%, P=0.266) and GERD symptoms (58.8% vs. 59.2%, P=0.503) was not significantly different between T2DM patients and controls. We found no significant differences between T2DM patients with GERD and T2DM patients without GERD with respect to diabetic complications, including autonomic neuropathy, peripheral neuropathy, duration of DM, and glucose control.

Conclusion

The prevalence of GERD in patients with T2DM showed no difference from that of controls. GERD was also not associated with peripheral and cardiovascular autonomic neuropathy, age, or duration of DM in patients with T2DM.

Citations

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  • Ураження органів травлення при цукровому діабеті
    M.O. Borovets , О.М. Radchenko , Kh.A. Moskva , O.Yo. Komarytsya , A.M. Urbanovych
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    Dongwon Yi
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  • Response: Prevalence and Risk Factors of Gastroesophageal Reflux Disease in Patients with Type 2 Diabetes Mellitus (Diabetes Metab J2016;40:297-307)
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Others
Application of the Oral Minimal Model to Korean Subjects with Normal Glucose Tolerance and Type 2 Diabetes Mellitus
Min Hyuk Lim, Tae Jung Oh, Karam Choi, Jung Chan Lee, Young Min Cho, Sungwan Kim
Diabetes Metab J. 2016;40(4):308-317.   Published online June 2, 2016
DOI: https://doi.org/10.4093/dmj.2016.40.4.308
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AbstractAbstract PDFPubReader   
Background

The oral minimal model is a simple, useful tool for the assessment of β-cell function and insulin sensitivity across the spectrum of glucose tolerance, including normal glucose tolerance (NGT), prediabetes, and type 2 diabetes mellitus (T2DM) in humans.

Methods

Plasma glucose, insulin, and C-peptide levels were measured during a 180-minute, 75-g oral glucose tolerance test in 24 Korean subjects with NGT (n=10) and T2DM (n=14). The parameters in the computational model were estimated, and the indexes for insulin sensitivity and β-cell function were compared between the NGT and T2DM groups.

Results

The insulin sensitivity index was lower in the T2DM group than the NGT group. The basal index of β-cell responsivity, basal hepatic insulin extraction ratio, and post-glucose challenge hepatic insulin extraction ratio were not different between the NGT and T2DM groups. The dynamic, static, and total β-cell responsivity indexes were significantly lower in the T2DM group than the NGT group. The dynamic, static, and total disposition indexes were also significantly lower in the T2DM group than the NGT group.

Conclusion

The oral minimal model can be reproducibly applied to evaluate β-cell function and insulin sensitivity in Koreans.

Citations

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  • Fimasartan increases glucose‐stimulated insulin secretion in patients with type 2 diabetes and hypertension compared with amlodipine
    Ye Seul Yang, Min Hyuk Lim, Seong Ok Lee, Eun Roh, Chang Ho Ahn, Soo Heon Kwak, Young Min Cho, Sungwan Kim, Andrea Mari, Kyong Soo Park, Hye Seung Jung
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Others
Comparison of the Usefulness of the Updated Homeostasis Model Assessment (HOMA2) with the Original HOMA1 in the Prediction of Type 2 Diabetes Mellitus in Koreans
Young Seok Song, You-Cheol Hwang, Hong-Yup Ahn, Cheol-Young Park
Diabetes Metab J. 2016;40(4):318-325.   Published online May 27, 2016
DOI: https://doi.org/10.4093/dmj.2016.40.4.318
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AbstractAbstract PDFPubReader   
Background

The original homeostasis model assessment (HOMA1) and the updated HOMA model (HOMA2) have been used to evaluate insulin resistance (IR) and β-cell function, but little is known about the usefulness of HOMA2 for the prediction of diabetes in Koreans. The aim of this study was to demonstrate the usefulness of HOMA2 as a predictor of type 2 diabetes mellitus in Koreans without diabetes.

Methods

The study population consisted of 104,694 Koreans enrolled at a health checkup program and followed up from 2001 to 2012. Participants were divided into a normal glucose tolerance (NGT) group and a pre-diabetes group according to fasting glucose and glycosylated hemoglobin levels. Anthropometric and laboratory data were measured at the baseline checkup, and HOMA values were calculated at the baseline and follow-up checkups. The hazard ratios (HRs) of the HOMA1 and HOMA2 values and the prevalence of diabetes at follow-up were evaluated using a multivariable Cox proportional hazards model and Kaplan-Meier analysis.

Results

After adjusting for several diabetes risk factors, all of the HOMA values except 1/HOMA1-β and 1/HOMA2-β in the NGT group were significant predictors of the progression to diabetes. In the NGT group, there was no significant difference in HOMA1-IR (HR, 1.09; 95% confidence interval [CI], 1.04 to 1.14) and HOMA2-IR (HR, 1.11; 95% CI, 1.04 to 1.19). However, in the pre-diabetes group, 1/HOMA2-β was a more powerful marker (HR, 1.29; 95% CI, 1.26 to 1.31) than HOMA1-IR (HR, 1.23; 95% CI, 1.19 to 1.28) or 1/HOMA1-β (HR, 1.14; 95% CI, 1.12 to 1.16). In the non-diabetic group (NGT+pre-diabetes), 1/HOMA2-β was also a stronger predictor of diabetes (HR, 1.27; 95% CI, 1.25 to 1.29) than HOMA1-IR (HR, 1.14; 95% CI, 1.12 to 1.15) or 1/HOMA1-β (HR, 1.13; 95% CI, 1.11 to 1.14).

Conclusion

HOMA2 is more predictive than HOMA1 for the progression to diabetes in pre-diabetes or non-diabetic Koreans.

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Others
Evaluation of a Novel Glucose Area Under the Curve (AUC) Monitoring System: Comparison with the AUC by Continuous Glucose Monitoring
Satoshi Ugi, Hiroshi Maegawa, Katsutaro Morino, Yoshihiko Nishio, Toshiyuki Sato, Seiki Okada, Yasuo Kikkawa, Toshihiro Watanabe, Hiromu Nakajima, Atsunori Kashiwagi
Diabetes Metab J. 2016;40(4):326-333.   Published online July 26, 2016
DOI: https://doi.org/10.4093/dmj.2016.40.4.326
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AbstractAbstract PDFPubReader   
Background

Management of postprandial hyperglycemia is a key aspect in diabetes treatment. We developed a novel system to measure glucose area under the curve (AUC) using minimally invasive interstitial fluid extraction technology (MIET) for simple monitoring of postprandial glucose excursions. In this study, we evaluated the relationship between our system and continuous glucose monitoring (CGM) by comparing glucose AUC obtained using MIET with that obtained using CGM for a long duration.

Methods

Twenty diabetic inpatients wearing a CGM system were enrolled. For MIET measurement, a plastic microneedle array was applied to the skin as pretreatment, and hydrogels were placed on the pretreated area to collect interstitial fluid. Hydrogels were replaced every 2 or 4 hours and AUC was predicted on the basis of glucose and sodium ion levels.

Results

AUC predicted by MIET correlated well with that measured by CGM (r=0.93). Good performances of both consecutive 2- and 4-hour measurements were observed (measurement error: 11.7%±10.2% for 2 hours and 11.1%±7.9% for 4 hours), indicating the possibility of repetitive measurements up to 8 hours. The influence of neither glucose fluctuation nor average glucose level over the measurement accuracy was observed through 8 hours.

Conclusion

Our system showed good relationship with AUC values from CGM up to 8 hours, indicating that single pretreatment can cover a large portion of glucose excursion in a day. These results indicated possibility of our system to contribute to convenient monitoring of glucose excursions for a long duration.

Citations

Citations to this article as recorded by  
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    Yi-Hsuan Lin, Chia-Hung Lin, Yu-Yao Huang, Hsin-Yun Chen, An-Shun Tai, Shih-Chen Fu, Sheng-Hwu Hsieh, Jui-Hung Sun, Szu-Tah Chen, Sheng-Hsuan Lin
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    JMIR Medical Informatics.2020;[Epub]     CrossRef
  • Comparison of Glucose Area Under the Curve Measured Using Minimally Invasive Interstitial Fluid Extraction Technology with Continuous Glucose Monitoring System in Diabetic Patients
    Mei Uemura, Yutaka Yano, Toshinari Suzuki, Taro Yasuma, Toshiyuki Sato, Aya Morimoto, Samiko Hosoya, Chihiro Suminaka, Hiromu Nakajima, Esteban C. Gabazza, Yoshiyuki Takei
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Letter
Letter: Effects of Rebamipide on Gastrointestinal Symptoms in Patients with Type 2 Diabetes Mellitus (Diabetes Metab J 2016;40:240-7)
Jin Hwa Kim
Diabetes Metab J. 2016;40(4):334-335.   Published online August 18, 2016
DOI: https://doi.org/10.4093/dmj.2016.40.4.334
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Response
Response: Effects of Rebamipide on Gastrointestinal Symptoms in Patients with Type 2 Diabetes Mellitus (Diabetes Metab J 2016;40:240-7)
Sejeong Park, So Young Park, Sang Youl Rhee
Diabetes Metab J. 2016;40(4):336-337.   Published online August 18, 2016
DOI: https://doi.org/10.4093/dmj.2016.40.4.336
  • 2,765 View
  • 39 Download
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