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161. Endovascular Treatment of Stroke Due to Medium-Vessel Occlusion.
作者: Mayank Goyal.;Johanna M Ospel.;Aravind Ganesh.;Dar Dowlatshahi.;David Volders.;Markus A Möhlenbruch.;Mouhammad A Jumaa.;Shahid M Nimjee.;Thomas C Booth.;Brian H Buck.;James Kennedy.;Jai J Shankar.;Franziska Dorn.;Liqun Zhang.;Christian Hametner.;Sandor Nardai.;Atif Zafar.;William Diprose.;Shabnam Vatanpour.;Alexander Stebner.;Salome Bosshart.;Nishita Singh.;Ivy Sebastian.;Kazutaka Uchida.;Karla J Ryckborst.;Robert Fahed.;Sherry X Hu.;Dominik F Vollherbst.;Syed F Zaidi.;Vivien H Lee.;Jeremy Lynch.;Jeremy L Rempel.;Rachel Teal.;Anurag Trivedi.;Felix J Bode.;Ayokunle Ogungbemi.;Mirko Pham.;Peter Orosz.;Mohamad Abdalkader.;Christian Taschner.;Jason Tarpley.;Sven Poli.;Ravinder-Jeet Singh.;Reade De Leacy.;George Lopez.;Demetrios Sahlas.;Michael Chen.;Paul Burns.;Joanna D Schaafsma.;Richard Marigold.;Arno Reich.;Adewumi Amole.;Thalia S Field.;Richard H Swartz.;Fabio Settecase.;Gábor Lenzsér.;Santiago Ortega-Gutierrez.;Negar Asdaghi.;Kyriakos Lobotesis.;Adnan H Siddiqui.;Joerg Berrouschot.;Maxim Mokin.;Koji Ebersole.;Hauke Schneider.;Albert J Yoo.;Jennifer Mandzia.;Jesse Klostranec.;Changez Jadun.;Tufail Patankar.;Eric Sauvageau.;Robert Lenthall.;Lissa Peeling.;Thien Huynh.;Ronald Budzik.;Seon-Kyu Lee.;Levansri Makalanda.;Michael R Levitt.;Richard J Perry.;Thant Hlaing.;Babak S Jahromi.;Paul Singh.;Andrew M Demchuk.;Michael D Hill.; .
来源: N Engl J Med. 2025年392卷14期1385-1395页
Whether the large effect size of endovascular thrombectomy (EVT) for stroke due to large-vessel occlusion applies to stroke due to medium-vessel occlusion is unclear.
162. Oral Regimens for Rifampin-Resistant, Fluoroquinolone-Susceptible Tuberculosis.
作者: Lorenzo Guglielmetti.;Uzma Khan.;Gustavo E Velásquez.;Maelenn Gouillou.;Amanzhan Abubakirov.;Elisabeth Baudin.;Elmira Berikova.;Catherine Berry.;Maryline Bonnet.;Matteo Cellamare.;Vijay Chavan.;Vivian Cox.;Zhanna Dakenova.;Bouke Catherine de Jong.;Gabriella Ferlazzo.;Aydarkhan Karabayev.;Ohanna Kirakosyan.;Nana Kiria.;Mikanda Kunda.;Nathalie Lachenal.;Leonid Lecca.;Helen McIlleron.;Ilaria Motta.;Sergio Mucching Toscano.;Hebah Mushtaque.;Payam Nahid.;Lawrence Oyewusi.;Samiran Panda.;Sandip Patil.;Patrick P J Phillips.;Jimena Ruiz.;Naseem Salahuddin.;Epifanio Sanchez Garavito.;Kwonjune J Seung.;Eduardo Ticona.;Lorenzo Trippa.;Dante E Vargas Vasquez.;Sean Wasserman.;Michael L Rich.;Francis Varaine.;Carole D Mitnick.; .
来源: N Engl J Med. 2025年392卷5期468-482页
For decades, poor treatment options and low-quality evidence plagued care for patients with rifampin-resistant tuberculosis. The advent of new drugs to treat tuberculosis and enhanced funding now permit randomized, controlled trials of shortened-duration, all-oral treatments for rifampin-resistant tuberculosis.
163. Abelacimab versus Rivaroxaban in Patients with Atrial Fibrillation.
作者: Christian T Ruff.;Siddharth M Patel.;Robert P Giugliano.;David A Morrow.;Bruce Hug.;Julia F Kuder.;Erica L Goodrich.;Shih-Ann Chen.;Shaun G Goodman.;Boyoung Joung.;Robert G Kiss.;Jindrich Spinar.;Wojciech Wojakowski.;Jeffrey I Weitz.;Sabina A Murphy.;Stephen D Wiviott.;Sanobar Parkar.;Daniel Bloomfield.;Marc S Sabatine.; .
来源: N Engl J Med. 2025年392卷4期361-371页
Abelacimab is a fully human monoclonal antibody that binds to the inactive form of factor XI and blocks its activation. The safety of abelacimab as compared with a direct oral anticoagulant in patients with atrial fibrillation is unknown.
164. Perioperative Chemotherapy or Preoperative Chemoradiotherapy in Esophageal Cancer.
作者: Jens Hoeppner.;Thomas Brunner.;Claudia Schmoor.;Peter Bronsert.;Birte Kulemann.;Rainer Claus.;Stefan Utzolino.;Jakob Robert Izbicki.;Ines Gockel.;Berthold Gerdes.;Michael Ghadimi.;Benedikt Reichert.;Johan F Lock.;Christiane Bruns.;Ernst Reitsamer.;Maximillian Schmeding.;Frank Benedix.;Tobias Keck.;Gunnar Folprecht.;Peter Thuss-Patience.;Ulf Peter Neumann.;Andreas Pascher.;Detlef Imhof.;Severin Daum.;Tanja Strieder.;Christian Krautz.;Simone Zimmermann.;Jens Werner.;Rolf Mahlberg.;Gerald Illerhaus.;Peter Grimminger.;Florian Lordick.
来源: N Engl J Med. 2025年392卷4期323-335页
The best multimodal approach for resectable locally advanced esophageal adenocarcinoma is unclear. An important question is whether perioperative chemotherapy is preferable to preoperative chemoradiotherapy.
165. Survival with Trastuzumab Emtansine in Residual HER2-Positive Breast Cancer.
作者: Charles E Geyer.;Michael Untch.;Chiun-Sheng Huang.;Max S Mano.;Eleftherios P Mamounas.;Norman Wolmark.;Priya Rastogi.;Andreas Schneeweiss.;Andres Redondo.;Hans H Fischer.;Véronique D'Hondt.;Alison K Conlin.;Valentina Guarneri.;Irene L Wapnir.;Christian Jackisch.;Claudia Arce-Salinas.;Peter A Fasching.;Michael P DiGiovanna.;John P Crown.;Pia Wuelfing.;Zhimin Shao.;Elena Rota Caremoli.;Hervé R Bonnefoi.;Bryan T Hennessy.;Ljiljana Stamatovic.;Hugo Castro-Salguero.;Adam M Brufsky.;Adam Knott.;Asna Siddiqui.;Chiara Lambertini.;Thomas Boulet.;Beatrice Nyawira.;Eleonora Restuccia.;Sibylle Loibl.; .
来源: N Engl J Med. 2025年392卷3期249-257页
Patients with human epidermal growth factor receptor 2 (HER2)-positive early breast cancer with residual invasive disease after neoadjuvant systemic therapy have a high risk of recurrence and death. The primary analysis of KATHERINE, a phase 3, open-label trial, showed that the risk of invasive breast cancer or death was 50% lower with adjuvant trastuzumab emtansine (T-DM1) than with trastuzumab alone.
166. Fracture Prevention with Infrequent Zoledronate in Women 50 to 60 Years of Age.
作者: Mark J Bolland.;Zaynah Nisa.;Anna Mellar.;Chiara Gasteiger.;Veronica Pinel.;Borislav Mihov.;Sonja Bastin.;Andrew Grey.;Ian R Reid.;Greg Gamble.;Anne Horne.
来源: N Engl J Med. 2025年392卷3期239-248页
Zoledronate prevents fractures in older women when administered every 12 to 18 months, but its effects on bone density and bone turnover persist beyond 5 years. Whether infrequent zoledronate administration would prevent vertebral fractures in early postmenopausal women is unknown.
167. A Comparison of Peripherally Inserted Central Catheter Materials.
作者: Amanda J Ullman.;Deanne August.;Tricia M Kleidon.;Rachel M Walker.;Nicole Marsh.;Andrew C Bulmer.;Ben Pearch.;Naomi Runnegar.;Joanne Leema.;Paul Lee-Archer.;Cathy Biles.;Victoria Gibson.;Ruth Royle.;Katrina Southam.;Joshua Byrnes.;Vineet Chopra.;Alan Coulthard.;Peter Mollee.;Claire M Rickard.;Patrick N A Harris.;Robert S Ware.
来源: N Engl J Med. 2025年392卷2期161-172页
New catheter materials for peripherally inserted central catheters (PICCs) may reduce the risk of device failure due to infectious, thrombotic, and catheter occlusion events. However, data from randomized trials comparing these catheters are lacking.
168. Xalnesiran with or without an Immunomodulator in Chronic Hepatitis B.
作者: Jinlin Hou.;Wenhong Zhang.;Qing Xie.;Rui Hua.;Hong Tang.;Luis Enrique Morano Amado.;Sheng-Shun Yang.;Cheng-Yuan Peng.;Wei-Wen Su.;Wan-Long Chuang.;Dong Joon Kim.;Anchalee Avihingsanon.;Jia-Horng Kao.;Apinya Leerapun.;Man-Fung Yuen.;Tarik Asselah.;Xieer Liang.;Qingyan Bo.;Filippo Canducci.;Maria Teresa Catanese.;Ethan Chen.;Cong Cheng.;Farouk Chughlay.;Sudip Das.;Katerina Glavini.;Nelson Guerreiro.;Yan Huang.;Priyanka Kakrana.;Rémi Kazma.;Avinash Patil.;Vedran Pavlovic.;Bernadette Surujbally.;Miriam Triyatni.;Ruchi Upmanyu.;Cynthia Wat.;Edward Gane.; .
来源: N Engl J Med. 2024年391卷22期2098-2109页
Xalnesiran, a small interfering RNA molecule that targets a conserved region of the hepatitis B virus (HBV) genome and silences multiple HBV transcripts, may have efficacy, with or without an immunomodulator, in patients with chronic HBV infection.
169. Levofloxacin Preventive Treatment in Children Exposed to MDR Tuberculosis.
作者: Anneke C Hesseling.;Susan E Purchase.;Neil A Martinson.;Lee Fairlie.;H Simon Schaaf.;Joanna Brigden.;Suzanne Staples.;Diana M Gibb.;Anthony Garcia-Prats.;Francesca Conradie.;Charlotte McGowan.;Charlotte Layton.;Elize Batist.;Anne-Marie Demers.;Samukelisiwe Nyamathe.;Lisa Frigati.;Rebecca Turner.;Trinh Duong.;James A Seddon.
来源: N Engl J Med. 2024年391卷24期2315-2326页
Worldwide, approximately 2 million children younger than 15 years of age are infected with multidrug-resistant (MDR) Mycobacterium tuberculosis, with MDR tuberculosis developing in approximately 30,000 annually. Evidence from randomized, controlled trials on tuberculosis preventive treatment in persons exposed to MDR tuberculosis is lacking.
170. Levofloxacin for the Prevention of Multidrug-Resistant Tuberculosis in Vietnam.
作者: Greg J Fox.;Nguyen Viet Nhung.;Nguyen Cam Binh.;Nguyen Binh Hoa.;Frances L Garden.;Andrea Benedetti.;Pham Ngoc Yen.;Nguyen Kim Cuong.;Emily L MacLean.;H Manisha Yapa.;David W Dowdy.;Nguyen Huu Lan.;Elyse Guevara-Rattray.;Pham Duc Cuong.;Ori Solomon.;Marcel A Behr.;Ben J Marais.;Steven M Graham.;Dick Menzies.;Nguyen Thu Anh.;Guy B Marks.
来源: N Engl J Med. 2024年391卷24期2304-2314页
Prevention of drug-resistant tuberculosis is a global health priority. However, trials evaluating the effectiveness of treating Mycobacterium tuberculosis infection among contacts of persons with drug-resistant tuberculosis are lacking.
171. Axillary Surgery in Breast Cancer - Primary Results of the INSEMA Trial.
作者: Toralf Reimer.;Angrit Stachs.;Kristina Veselinovic.;Thorsten Kühn.;Jörg Heil.;Silke Polata.;Frederik Marmé.;Thomas Müller.;Guido Hildebrandt.;David Krug.;Beyhan Ataseven.;Roland Reitsamer.;Sylvia Ruth.;Carsten Denkert.;Inga Bekes.;Dirk-Michael Zahm.;Marc Thill.;Michael Golatta.;Johannes Holtschmidt.;Michael Knauer.;Valentina Nekljudova.;Sibylle Loibl.;Bernd Gerber.
来源: N Engl J Med. 2025年392卷11期1051-1064页
Whether surgical axillary staging as part of breast-conserving therapy can be omitted without compromising survival has remained unclear.
172. Imlunestrant with or without Abemaciclib in Advanced Breast Cancer.
作者: Komal L Jhaveri.;Patrick Neven.;Monica Lis Casalnuovo.;Sung-Bae Kim.;Eriko Tokunaga.;Philippe Aftimos.;Cristina Saura.;Joyce O'Shaughnessy.;Nadia Harbeck.;Lisa A Carey.;Giuseppe Curigliano.;Antonio Llombart-Cussac.;Elgene Lim.;María de la Luz García Tinoco.;Joohyuk Sohn.;André Mattar.;Qingyuan Zhang.;Chiun-Sheng Huang.;Chih-Chiang Hung.;Jorge Luis Martinez Rodriguez.;Manuel Ruíz Borrego.;Rikiya Nakamura.;Kamnesh R Pradhan.;Christoph Cramer von Laue.;Emily Barrett.;Shanshan Cao.;Xuejing Aimee Wang.;Lillian M Smyth.;François-Clément Bidard.; .
来源: N Engl J Med. 2025年392卷12期1189-1202页
Imlunestrant is a next-generation, brain-penetrant, oral selective estrogen-receptor (ER) degrader that delivers continuous ER inhibition, even in cancers with mutations in the gene encoding ERα (ESR1).
173. Daratumumab or Active Monitoring for High-Risk Smoldering Multiple Myeloma.
作者: Meletios A Dimopoulos.;Peter M Voorhees.;Fredrik Schjesvold.;Yael C Cohen.;Vania Hungria.;Irwindeep Sandhu.;Jindriska Lindsay.;Ross I Baker.;Kenshi Suzuki.;Hiroshi Kosugi.;Mark-David Levin.;Meral Beksac.;Keith Stockerl-Goldstein.;Albert Oriol.;Gabor Mikala.;Gonzalo Garate.;Koen Theunissen.;Ivan Spicka.;Anne K Mylin.;Sara Bringhen.;Katarina Uttervall.;Bartosz Pula.;Eva Medvedova.;Andrew J Cowan.;Philippe Moreau.;Maria-Victoria Mateos.;Hartmut Goldschmidt.;Tahamtan Ahmadi.;Linlin Sha.;Annelore Cortoos.;Eva G Katz.;Els Rousseau.;Liang Li.;Robyn M Dennis.;Robin Carson.;S Vincent Rajkumar.; .
来源: N Engl J Med. 2025年392卷18期1777-1788页
Daratumumab, an anti-CD38 monoclonal antibody, has been approved for the treatment of multiple myeloma. Data are needed regarding the use of daratumumab for high-risk smoldering multiple myeloma, a precursor disease of active multiple myeloma for which no treatments have been approved.
174. Blinatumomab in Standard-Risk B-Cell Acute Lymphoblastic Leukemia in Children.
作者: Sumit Gupta.;Rachel E Rau.;John A Kairalla.;Karen R Rabin.;Cindy Wang.;Anne L Angiolillo.;Sarah Alexander.;Andrew J Carroll.;Susan Conway.;Lia Gore.;Ilan Kirsch.;Holly R Kubaney.;Amanda M Li.;Jennifer L McNeer.;Olga Militano.;Tamara P Miller.;Yvonne Moyer.;Maureen M O'Brien.;Maki Okada.;Shalini C Reshmi.;Mary Shago.;Elizabeth Wagner.;Naomi Winick.;Brent L Wood.;Tara Haworth-Wright.;Faraz Zaman.;Gerhard Zugmaier.;Sue Zupanec.;Meenakshi Devidas.;Stephen P Hunger.;David T Teachey.;Elizabeth A Raetz.;Mignon L Loh.
来源: N Engl J Med. 2025年392卷9期875-891页
B-cell acute lymphoblastic leukemia (B-cell ALL) is the most common childhood cancer. Despite a high overall cure rate, relapsed B-cell ALL remains a leading cause of cancer-related death among children. The addition of the bispecific T-cell engager molecule blinatumomab (an anti-CD19 and anti-CD3 single-chain molecule) to therapy for newly diagnosed standard-risk (as defined by the National Cancer Institute) B-cell ALL in children may improve outcomes.
175. Nivolumab plus Ipilimumab in Microsatellite-Instability-High Metastatic Colorectal Cancer.
作者: Thierry Andre.;Elena Elez.;Eric Van Cutsem.;Lars Henrik Jensen.;Jaafar Bennouna.;Guillermo Mendez.;Michael Schenker.;Christelle de la Fouchardiere.;Maria Luisa Limon.;Takayuki Yoshino.;Jin Li.;Heinz-Josef Lenz.;Jose Luis Manzano Mozo.;Giampaolo Tortora.;Rocio Garcia-Carbonero.;Laetitia Dahan.;Myriam Chalabi.;Rohit Joshi.;Eray Goekkurt.;Maria Ignez Braghiroli.;Timucin Cil.;Elvis Cela.;Tian Chen.;Ming Lei.;Matthew Dixon.;Sandzhar Abdullaev.;Sara Lonardi.; .
来源: N Engl J Med. 2024年391卷21期2014-2026页
Patients with microsatellite-instability-high (MSI-H) or mismatch-repair-deficient (dMMR) metastatic colorectal cancer have poor outcomes with standard chemotherapy with or without targeted therapies. Nivolumab plus ipilimumab has shown clinical benefit in nonrandomized studies of MSI-H or dMMR metastatic colorectal cancer.
176. Effect of a Reduced PCV10 Dose Schedule on Pneumococcal Carriage in Vietnam.
作者: Lay-Myint Yoshida.;Michiko Toizumi.;Hien Anh Thi Nguyen.;Billy J Quilty.;Le Thuy Lien.;Le Huy Hoang.;Chihiro Iwasaki.;Mizuki Takegata.;Noriko Kitamura.;Monica L Nation.;Jason Hinds.;Kevin van Zandvoort.;Belinda D Ortika.;Eileen M Dunne.;Catherine Satzke.;Hung Thai Do.;Kim Mulholland.;Stefan Flasche.;Duc-Anh Dang.
来源: N Engl J Med. 2024年391卷21期1992-2002页
After pneumococcal disease and colonization have been controlled through vaccination campaigns, a reduced pneumococcal conjugate vaccine (PCV) schedule may be sufficient to sustain that control at reduced costs.
177. Twice-Yearly Lenacapavir for HIV Prevention in Men and Gender-Diverse Persons.
作者: Colleen F Kelley.;Maribel Acevedo-Quiñones.;Allison L Agwu.;Anchalee Avihingsanon.;Paul Benson.;Jill Blumenthal.;Cynthia Brinson.;Carlos Brites.;Pedro Cahn.;Valeria D Cantos.;Jesse Clark.;Meredith Clement.;Cathy Creticos.;Gordon Crofoot.;Ricardo S Diaz.;Susanne Doblecki-Lewis.;Jorge A Gallardo-Cartagena.;Aditya Gaur.;Beatriz Grinsztejn.;Shawn Hassler.;Juan Carlos Hinojosa.;Theo Hodge.;Richard Kaplan.;Marcus Lacerda.;Anthony LaMarca.;Marcelo H Losso.;José Valdez Madruga.;Kenneth H Mayer.;Anthony Mills.;Karam Mounzer.;Nkosiphile Ndlovu.;Richard M Novak.;Alma Perez Rios.;Nittaya Phanuphak.;Moti Ramgopal.;Peter J Ruane.;Jorge Sánchez.;Breno Santos.;Patric Schine.;Tanya Schreibman.;LaShonda Y Spencer.;Olivia T Van Gerwen.;Ricardo Vasconcelos.;Jose Gabriel Vasquez.;Zwelethu Zwane.;Stephanie Cox.;Chris Deaton.;Ramin Ebrahimi.;Pamela Wong.;Renu Singh.;Lillian B Brown.;Christoph C Carter.;Moupali Das.;Jared M Baeten.;Onyema Ogbuagu.; .
来源: N Engl J Med. 2025年392卷13期1261-1276页
Twice-yearly subcutaneous lenacapavir has been shown to be efficacious for prevention of human immunodeficiency virus (HIV) infection in cisgender women. The efficacy of lenacapavir for preexposure prophylaxis (PrEP) in cisgender men, transgender women, transgender men, and gender-nonbinary persons is unclear.
178. Standard or Extended Lymphadenectomy for Muscle-Invasive Bladder Cancer.
作者: Seth P Lerner.;Catherine Tangen.;Robert S Svatek.;Siamak Daneshmand.;Kamal S Pohar.;Eila Skinner.;Anne Schuckman.;Arthur I Sagalowsky.;Norm D Smith.;Ashish M Kamat.;Wassim Kassouf.;Melissa Plets.;Rick Bangs.;Theresa M Koppie.;Ajjai Alva.;Francisco G La Rosa.;Sumanta K Pal.;Adam S Kibel.;Daniel J Canter.;Ian M Thompson.; .
来源: N Engl J Med. 2024年391卷13期1206-1216页
Whether extended lymphadenectomy is associated with improved disease-free and overall survival, as compared with standard lymphadenectomy, among patients with localized muscle-invasive bladder cancer undergoing radical cystectomy is unclear.
179. Safety and Efficacy of Immunization with a Late-Liver-Stage Attenuated Malaria Parasite.
作者: Olivia A C Lamers.;Blandine M D Franke-Fayard.;Jan Pieter R Koopman.;Geert V T Roozen.;Jacqueline J Janse.;Severine C Chevalley-Maurel.;Fiona J A Geurten.;Helena M de Bes-Roeleveld.;Eva Iliopoulou.;Emil Colstrup.;Els Wessels.;Geert-Jan van Gemert.;Marga van de Vegte-Bolmer.;Wouter Graumans.;Thabitha R Stoter.;Benjamin G Mordmüller.;Emma L Houlder.;Teun Bousema.;Rajagopal Murugan.;Matthew B B McCall.;Chris J Janse.;Meta Roestenberg.
来源: N Engl J Med. 2024年391卷20期1913-1923页
Currently licensed and approved malaria subunit vaccines provide modest, short-lived protection against malaria. Immunization with live-attenuated Plasmodium falciparum malaria parasites is an alternative vaccination strategy that has potential to improve protection.
180. Middle Meningeal Artery Embolization for Nonacute Subdural Hematoma.
作者: Jianmin Liu.;Wei Ni.;Qiao Zuo.;Heng Yang.;Ya Peng.;Zhiqing Lin.;Zhenbao Li.;Jiyue Wang.;Yong Zhen.;Jing Luo.;Yuanxiang Lin.;Jian Chen.;Xuming Hua.;Hua Lu.;Ming Zhong.;Mingfa Liu.;Jianmin Zhang.;Yang Wang.;Jieqing Wan.;Yi Li.;Tianxiao Li.;Guohua Mao.;Wenyuan Zhao.;Liang Gao.;Conghui Li.;E Chen.;Xin Cheng.;Ping Zhang.;Zigao Wang.;Lei Chen.;Yongxin Zhang.;Bing Tian.;Fang Shen.;Yu Lei.;Yina Wu.;Yanjiang Li.;Guoli Duan.;Liquan Xu.;Nan Lv.;Jian Yu.;Xiaolong Xu.;Zhuoying Du.;Hongjian Zhang.;Jin Hu.;Zifu Li.;Qiang Yuan.;Yu Zhou.;Gang Wu.;Lei Zhang.;Chao Gao.;Dongwei Dai.;Xuehai Wu.;Yongwei Zhang.;Hanqiang Jiang.;Rui Zhao.;Jiabin Su.;Yi Xu.;Johanna Maria Ospel.;Charles B L M Majoie.;Mayank Goyal.;Qiang Li.;Pengfei Yang.;Yuxiang Gu.;Ying Mao.; .
来源: N Engl J Med. 2024年391卷20期1901-1912页
The effect of embolization of the middle meningeal artery in patients with subacute or chronic subdural hematoma is uncertain.
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