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   Table of Contents - Current issue
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November-December 2021
Volume 13 | Issue 6
Page Nos. 519-636

Online since Tuesday, November 30, 2021

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REVIEW ARTICLES  

Effects of coconut oil on oral health status of patients with poor oral hygiene: Systematic review and meta-analysis p. 519
Upasana Reddy, Shahnawaz Khijmatgar, Mithra N Hegde, Massimo Del Fabbro
DOI:10.4103/JIOH.JIOH_58_21  
Aim: The present systematic review and meta-analysis aim to evaluate randomized control trials (RCTs) to answer the question “Can oil pulling with coconut oil help patients with poor oral health?”Materials and Methods: A literature search was conducted for RCTs till January 2021. A total of 47 articles were retrieved through five electronic databases, i.e., Web of Science, PubMed, Cochrane Review, SCOPUS, and Embase using key words related to the topic. The selection of articles was based on the PICOS criteria and the PRISMA protocol for systematic reviews. The studies which discussed coconut oil and its effect on the plaque, gingival index, and Streptococcus mutans count were included in the study. Results: The final selection included 13 articles from which data were extracted for further evaluation. The articles included show coconut oil’s efficiency as an antimicrobial agent to reduce bacterial colonization with significant improvement in oral hygiene by practicing oil pulling. However, the quality of evidence is low and more well-designed clinical trials with a wide range of oral health outcomes are required. Conclusion: Based on the results of the systematic review, there is a significant statistical difference in plaque and gingival index between individuals with and without using coconut oil. Hence, further research is mandatory to clearly explain the role of microbiota and their transformations in the oral cavity. We conclude that continued surveillance of patients in a long-term study design with holistic alternatives and early management of complications are important in lifelong care and well-being of patients with a compromised oral cavity.
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Intermaxillary tooth-size ratios in Saudis: A systematic review p. 533
Sarah M Abuhassan, Moshabab A Asiry
DOI:10.4103/JIOH.JIOH_40_21  
Aim: The purposes of this study were to review all the studies that calculated the intermaxillary tooth-size ratios in Saudis, to review how gender and malocclusion groups influence tooth-size ratios, and to review the measurement methods for mesiodistal tooth width. Materials and Methods: MEDLINE, PubMed, Google Scholar, Saudi Dental Journal, and King Saud University Journal of Dental Sciences were searched for published studies reporting the intermaxillary tooth-size ratios of Saudis. No period of time for published studies was determined. The inclusion criteria were well-defined Saudi sample, reliable measurement method, and malocclusion classification determined for the study sample. Results: The searching process ended with five studies that met the final inclusion criteria. Gender and malocclusion groups are unlikely to have a significant influence on tooth-size ratios. Class III malocclusions cases have larger ratios. The anterior ratio and the overall ratio of Saudis seem not to be significantly different when compared with the Bolton results. Conclusion: All the studies that investigated tooth-size ratios in Saudis were conducted in major cities only. Until conducting more studies representing the overall population of Saudi Arabia, Bolton’s results can be used with caution for Saudi patients.
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Perspective on metal leachables from orthodontic appliances: A scoping review Highly accessed article p. 539
Riyam Haleem, Noor A Ahmad Shafiai, Siti N F Mohd Noor
DOI:10.4103/JIOH.JIOH_52_21  
Aim: Metal ion leaching from orthodontic fixed appliances can be retrieved through in vitro, in vivo, and clinical studies and this study aims at reporting the methodology employed in previous studies for assessing metal leachables from orthodontic appliances. Materials and Methods: Available reports from Google Scholar were compiled using PRISMA guidelines from 2009 to 2020, with certain keywords in identifying studies reporting on metal leaching from orthodontic appliances. A total of 1390 studies were identified and after the exclusion of articles, 69 final articles were reviewed. Data such as the types of materials, incubation medium, duration, type of cells, assay, and factors for corrosion were summarized. Results: Metal leachable from orthodontic appliances mostly occurred through a corrosion process caused by internal structural factors (such as metal composition and particle distribution), as well as external factors (such as media composition, pH, and biofilm). The studies involved various methodologies of research in metal ion release and cytotoxicity determination. Conclusion: Nickel was the most common ion investigated, followed by chromium in this study of cytotoxicity of orthodontic appliances during the past 10 years. The trends and needs in wearing orthodontic appliances should receive a different perspective with regards to metal leaching, which may give rise to adverse effects in long-term application.
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Restorative complications of the single implant-retained crown: A review p. 549
James Dudley, Arwa Bamajboor, Mansoor Walipoor, Jane Pellew
DOI:10.4103/JIOH.JIOH_91_21  
Aim: To discuss the literature pertinent to implant and prosthesis success, restorative complications, limitations of reporting on complications, and management strategies for complications of the single implant-retained crown. Materials and Methods: Literature was reviewed from PubMed, Scopus, and Google Scholar databases and included selected systematic reviews. Articles in the English language and published in peer-reviewed journals were included. Results: The accuracy of the literature reporting on implant and prosthesis success was reliant on the methodology and accuracy of measurement within individual studies. The accuracy of the literature reporting on complications suffered from variable definitions and methodologies. Conclusion: There was a comprehensive body of literature that provided a sound evidence base on implant and prosthesis success; however, the inconsistent definition of an implant complication and lack of a universally accepted system for classifying implant complications restricted the clinical application of the literature and hindered inter-study comparisons. Guidelines for managing complications, particularly restorative complications that also allow for individual patient variations, should be developed.
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ORIGINAL RESEARCH Top

Clinical effect of simvastatin gel with bone graft in grade II furcation defects: A randomized controlled clinical trial p. 555
Darshanaa Arunachalam, Sheeja S Varghese, Arvina Rajasekar
DOI:10.4103/JIOH.JIOH_132_21  
Aim: To evaluate the effectiveness of 1.2 mg/mL simvastatin (SMV) gel with hydroxyapatite (HA) bone graft in the surgical treatment of mandibular Grade II furcation defects compared with HA bone graft, SMV, and placebo after open-flap debridement (OFD). Materials and Methods: The present study was a single-center, triple-blind randomized controlled clinical trial wherein 23 mandibular grade II furcation defects from 15 chronic periodontitis patients were randomly assigned for treatment with either placebo gel (group 1; n = 5), HA (group 2; n = 6), SMV (group 3; n = 6), and SMV + HA (group 4; n = 6). Clinical parameters at the furcation defect site, such as horizontal and vertical probing depth (HPD and VPD), vertical clinical attachment level (VCAL), radiologic parameters, such as vertical defect depth in intraoral periapical radiograph (IOPA), vertical and horizontal defect depth, and volume of defect in cone-beam computed tomography (CBCT) were recorded at baseline, 3, and 6 months postoperatively and analyzed using SPSS software. For intragroup comparison, paired t test and Wilcoxon test were used, and for intergroup comparison, ANOVA and Kruskal-Wallis test were used. Results: SMV + HA group had improvement in all the clinical parameters when compared to baseline but were not significantly different when compared to other groups. However, statistically significant improvement in HPD was evident in SMV + HA group at 3 months (1.8 ± 1.3; P = 0.019; P < 0.05) when compared to HA group. In CBCT, SMV + HA group had significant improvement in VDD, HDD, and volume of the defect whereas in IOPA, there was no significant findings. Conclusion: Simvastatin with HA is more effective in reducing the horizontal component of grade II furcation defects.
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Short-term comparative evaluation of BioHPP and cast cobalt–chromium as framework for implant supported prostheses: A split mouth clinical randomized trial p. 564
Marwa M Amer, Mohamed M Elsheikh, Maha M Haleem, Sahar F Ghoraba, Amal A Salem
DOI:10.4103/JIOH.JIOH_181_21  
Aim: The purpose of this parallel randomized clinical trial was to evaluate the effects of BioHPP versus cobalt–chromium (Co–Cr) frameworks in screw-retained implant-supported fixed dental prostheses (FDPs) on peri-implant soft and hard tissues clinically and radiographically. Materials and Methods: Fifteen patients with bilateral partial edentulism in the posterior mandible received two implants at the positions of the second premolar and second molar on both sides: one side was restored with BioHpp-based screw-retained FDP (test group) and the other side was restored with Co–Cr-based screw-retained FDP (control group). All patients were clinically examined at the time of prosthesis insertion, and 6 and 12 months later for fracture of implant or framework, fracture, or looseness of the screw, veneer chipping, and fractures, modified bleeding index, modified plaque index, peri-implant probing depth, as well as radiographically for marginal bone loss. Results: At 12 months, both groups showed no statistically significant differences in the modified bleeding index (P = 1.00), modified plaque index (P = 0.383), probing depth (P = 0.925), and marginal bone loss (P = 0.222). No technical complications occurred during the evaluation period in either group. Conclusion: BioHPP framework represents a viable nonmetallic alternative to cast Co–Cr framework, shown by good soft and hard tissue responses.
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10% propolis as a subgingival irrigation agent after gingival curettage: A comparative study p. 571
Ayuda Nur Sukmawati, Puspaneka Wijayanti, Vincensia Maria Karina, Sri Pramestri Lastianny
DOI:10.4103/JIOH.JIOH_65_21  
Aim: Gingival curettage is a surgical periodontal therapy that aims at eliminating periodontal pockets. To enhance the output of this treatment, subgingival irrigation after curettage could be used as adjuvant therapy. Propolis, as a natural remedy, has antibacterial, anti-inflammatory, and antioxidant properties, which makes it a promising candidate as a subgingival irrigation agent. The purpose of the study was to compare the effect of 10% propolis and 1% tetracycline as subgingival irrigation agents after curettage on plaque index (PI), probing pocket depth (PPD), bleeding on probing (BOP), and concentration of interleukin-1β (IL-1β)Materials and Methods: This comparative analytical study was performed on a total of six participants, with each participant presenting with two sites of periodontal pockets. The periodontal pockets were assigned to two treatment groups: patients receiving 10% propolis after curettage (Group A) and patients receiving 1% tetracycline after curettage (Group B). PI, PPD, BOP, and concentration of IL-1β were recorded at baseline on day 0 before curettage and on day 21 after curettage. The measured parameters were analyzed with chi-square analysis, Mann-Whitney, and independent T-test at different intervals. Results: Statistical analysis showed that group A (curettage + subgingival irrigation with 10% propolis) had better improvement on PI and greater reduction of PPD, BOP, and concentration of IL-1β on day 21, compared with group B (curettage + subgingival irrigation with 1% tetracycline) with P value of 0.014, 0.003, 0.007, and 0.000, respectively (P < 0.05). Conclusion: 10% propolis as a subgingival irrigation agent was more effective compared with 1% tetracycline in improving clinical parameters of periodontal tissue and concentration of IL-1β on patients with chronic periodontitis.
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Factors associated with knowledge and perceptions regarding the COVID-19 pandemic among future health science professionals: A logistic model analysis p. 579
Casimira Chuquimez, Jasmín De la Cruz, Daniel Alvitez-Temoche, Abigail Temoche, Arnaldo Munive-Degregori, Frank Mayta-Tovalino
DOI:10.4103/JIOH.JIOH_121_21  
Aim: This study aimed to determine the factors associated with knowledge and perceptions regarding the coronavirus disease-2019 (COVID-19) pandemic among undergraduate students in different health science fields. Materials and Methods: An analytical, cross-sectional, prospective study was conducted. Data were collected between January and March 2021, from health science undergraduate students attending Federico Villarreal National University in Peru. To calculate the sample size, a formula to estimate a proportion was applied using Stata 15 software (n = 527). The examined factors were faculty, year of study, gender, region, residence, living with parents, and having family members infected with COVID-19, which were analyzed using a logit model to identify the impact of the intervening variables with a significance of P < 0.05. Results: None of the variables studied were found to affect knowledge and perceptions regarding COVID-19 preventive measures among Peruvian health science students, with the following odds ratios (OR) obtained: faculty (OR = 0.96; 95% confidence interval [CI]: 0.83–1.12), year of study (OR = 0.98; CI: 0.77–1.25), gender (OR = 1.12; CI: 0.54–2.28), region (OR = 1.32; CI: 0.35–4.78), residence (OR = 0.97; CI: 0.48–1.95), living with parents (OR = 1.5; CI: 0.52–4.39), and having infected family members (OR = 1.5; CI: 0.64–3.49). Conclusion: The results of this study show that students at a Peruvian public university have adequate knowledge and perceptions regarding preventive strategies to avoid contracting and spreading COVID-19. In addition, none of the examined factors were significant in this relationship.
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Pharmacophore-based screening of autoinducer-2 inhibitor in bacteria for prevention of oral biofilm formation: An exploratory study p. 586
Shantha Sundari, R Rajagopal, Rajagopalan Vijayaragavan
DOI:10.4103/JIOH.JIOH_168_21  
Aim: The aim of this study was to predict the 3D structure of luxS of Fusobacterium nucleatum and identification of key residues by in silico homology modeling and molecular docking for inhibiting autoinducer-2 (AI-2), responsible for biofilm formation. Materials and Methods: The current study was to explore 3D structure of luxS protein along with its major residues that are directly responsible for the activity by homology modeling employing Discovery Studio V4.0. Further, a ligand-based pharmacophore was generated, employing the known ligands to control AI-2 producing enzymes and to ultimately regulate biofilm formation in the oral environment subjecting to key bioinformatics tools. Results: The multiple sequence alignment study showed 26 and 56% similarity in target and template sequences of luxS protein, respectively. Homology modeling indicated high structural similarity between the two luxS proteins (homocysteine and 4, 5-dihydroxy-2, 3 pentanedione) with a low root mean square value of 0.6 Å, in addition to leading to major mutations that are responsible for the production of AI-2. A pharmacophore model was generated as a template for virtual screening to explore potent luxS inhibitor. ZINC15 database was used for similarity search algorithms and screening against a generated pharmacophore model. During molecular docking, a molecule was structurally identified with a high libdock score and significant binding energy, in addition to establishing a regulatory mechanism with the receptor protein. Conclusions: This investigation paves way for the high throughput virtual screening to characterize luxS and associated proteins resulting in considerable minimization of time and funds before taking up biological confirmatory tests in the wet laboratories during exploration of possible inhibitors.
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Prevalence of dental caries and their relation to oral health impact profile (OHIP-14) among national contact sports athletes: a cross-sectional study p. 593
Izzati Mohd Shaharuddin, Aiemeeza Rajali, Nik Rahayyu Nik Zulkifeli, Kamarul Hashimy Hussein, Nik Haziman Wan Hamat, Mohamed Ibrahim Abu Hassan
DOI:10.4103/JIOH.JIOH_162_21  
Aim: The prevalence of caries is a valuable index used for determining and monitoring the oral health status among the population and in general believed to be impactful towards the quality of life. The study aimed to determine decayed (D), missing (M), and filled (F) teeth index and its relation to the quality of life among national contact sports athletes. Materials and Methods: A total of 84 national athletes of age 18–36 years old were recruited by cluster sample method from rugby, silat, and hockey teams of the National Sports Institute of Malaysia. The intraoral examination was done for Decayed–Missing–Filled (DMFT) index using World Health Organization’s criteria and the Oral Health Impact Profile (OHIP-14) tool was distributed for oral health-related quality of life (OHRQoL). The collected data were analyzed using t-test, analysis of variance, and Pearson statistics. Results: From this study, 77.62% of athletes reported a prevalence of dental caries with a moderate mean DMFT index of 2.79 ± 2.87. On the basis of OHIP-14, most athletes (85.71%) reported a low impact level with mean 9.036 ± 7.635. The Pearson correlation showed that missing (M) (r = 0.324, P = 0.003) and total DMFT (r = 0.261, P = 0.017) had a significant positive relationship with the total OHIP-14. It affected the OHIP-14 domains of social disability, handicap, psychological discomfort, and psychological disability (P < 0.05). Conclusion: The prevalence of caries among contact sports athletes is ongoing toward remarkable improvement. However, missing (M) and total DMFT were found to be a significant impact on the OHRQoL of athletes. Hence, it is important to impart preventive measures for dental caries that will attribute to the quality of life.
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Measurements of mandibular radiomorphometric indices in Egyptian population at different ages using cone beam computed tomography: A cross-sectional study p. 601
Hanaa S Mansy, Reham M Hamdy, Sahar H El Dessouky, Yara R Helaly
DOI:10.4103/JIOH.JIOH_214_21  
Aim: This research was conducted to correlate the mandibular radiomophometric indices with age in a sample of Egyptian population using cone beam computed tomography (CBCT). Materials and Methods: A total number of 318 CBCT scans of the Egyptian population were assigned to six age groups (53 per group) in a cross-sectional study using the simple random sampling method. Mandibular radiomophometric indices were assessed for each side and for each age group. Four quantitative indices were measured. The quantitative indices were mental index (MI), panoramic mandibular index superior (PMIS), panoramic mandibular index inferior (PMII), and panoramic mandibular index average (PMIA), which were measured on the CBCT cross-sectional cuts. Post hoc pairwise comparisons between the groups and both sides were done. Association and correlation between the indices and age were done. Results: There was a positive weak correlation between the indices and age. There was a statistically significant difference between panoramic mandibular indices. Conclusions: Age affects the mandibular radiomophometric indices. The mental index and panoramic mandibular indices increase with age.
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Effect of video-recorded manikin simulation on radiographic technique performance of dental and dental hygiene students: A cross sectional study p. 610
Barbara Brent, Rohan Jagtap, Jason Griggs, Elizabeth Carr
DOI:10.4103/JIOH.JIOH_202_21  
Aim: The purpose of this study was to assess the beliefs, confidence, and perceptions of dental and dental hygiene students before and after watching a video demonstrating the photo-stimulable phosphor (PSP) plate technique. Material and Methods: Overall, 40 second-year dental students and 20 first-year dental hygiene students currently enrolled in a radiology didactic course were invited via an institutional email to complete an anonymous, 18-question survey using *survey software* software, view PSP plates training video via *online platform*, and complete a post-video survey assessing the same questions as the pre-video survey. The 10-min video outlined the process for exposing a full-mouth series using PSP plates, including assembly, placement, troubleshooting, and technique. The surveys assessed the students’ beliefs, confidence, and perceptions of PSP plates using either a 5-point Likert scale or 10-point rating scale questions. Results: Of the 60 potential participants, 68% (n = 41) completed both surveys. Of the 18 questions, 4 Likert-type questions and one rating question showed statistically significant differences between pre-video and post-video survey responses. Four of the five questions revealed statistically significant differences with P-values of < 0.001. The four statistically significant results were regarding student confidence. The fifth question that showed a statistically significant difference between pre-video and post-video survey responses dealt with student preparation. Conclusion: The study revealed several items of note, including a statistically significant increase in student confidence with the radiographic technique when exposed to a procedure video. The results also showed statistically significant increases in students’ perceptions of the steps required to expose radiographs with the PSP plates after watching the technique video.
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Impact of oral health problems on the quality of life among low income group in an urban area in Malaysia: A preliminary study p. 617
Elavarasi Kuppusamy, Nurul A Yahya, Norain Mansor, Siti H Awal, Ratnah T Subramanam, Farinawati Yazid
DOI:10.4103/JIOH.JIOH_154_21  
Aim: The aim of this article is to investigate the association between quality of life (QoL) and oral health problems among residents from low income groups in an urban area. Materials and Methods: Forty-five participants aged between 18 and 70 years residing in a residential area allocated for Malaysian citizens from the bottom 40% household income range (B40) in Kuala Lumpur were included in this study. A self-administered questionnaire adapted from the short version of Malaysian Oral Health Impact Profile [S-OHIP(M)] was used as an instrument to measure QoL of the participants. The respondents were separated into two groups, those aged below 40 years (<40) and those aged above 40 years (≥40). Results: In general, the residents within the B40 community participating in this study occasionally experienced the impact of their oral conditions as the percentages of “frequent” and “moderate” responses were higher in most of the items asked. The most frequent impact of oral disorders experienced by both age groups was physiological discomfort (89%). A significant association between the two age groups and the impact caused by bad breath was found. The perceived needs within this community were high (88.64%), and there was a low prevalence of edentulism. Conclusion: The majority of residents from a lower socioeconomic status in an urban area experienced the impact of oral health problems either frequently or moderately. Satisfaction with their oral health status and the perceived dental treatment need is deemed to be high.
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Perceived stress and subjective well-being of COVID-19 confinement in Latin American pediatric dentists and dental students: A cross sectional study p. 623
Ortega-López Miriam Fernanda, Armas-Vega Ana, Parise-Vasco Juan Marcos, Agudelo-Suárez Andrés, Arroyo-Bonilla David, Viteri-García Andrés
DOI:10.4103/JIOH.JIOH_148_21  
Aim: The COVID-19 pandemic, the first registered in the last 100 years, triggered fear and uncertainty, with manifestations related to stress, anxiety, and depression, mainly in health professionals. The study aimed to evaluate the psychological impact of the community quarantine, implemented due to the COVID-19 pandemic, in pediatric dentists and pediatric dentistry graduate students in Latin America. Materials and Methods: Convenience sample made up of 139 pediatric dentists and postgraduate pediatric dentistry students from different Latin American countries, who were asked to fill out a questionnaire, submitted electronically, with prior authorization of participation through an informed consent. The anonymity of the participants was protected using identification codes, and only their email address was requested for subsequent follow-up. Results: The multivariate model shows an association between the value of the PSS-14 v25 questionnaire and the different study variables; thus, the variables—quality of sleep (P ≤ 0.001), number of biosafety measures (P≤0.02), age (P = 0.04), and perception of their state of health (P = 0.03)—were statistically significant in the perceived stress and subjective well-being, caused by COVID-19 lockdown. In the same way, in the most representative demographic variables related to the affective and social support perceived by the participant, it was observed that, with increasing age, there is a decrease in perceived affective support and, consequently, in participants with mandatory quarantine and time restriction; there is a perception of not having emotional support. Conclusion: The disease caused by COVID-19 has modified the habits and quality of life of all professionals in the health field. The psychological impact that the community quarantine implemented due to the COVID-19 pandemic has produced is evident, as older and female individuals more frequently present signs of stress and anxiety, manifested by fear and uncertainty.
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Cariogenic snack consumption among Southern Thai preschool children and its international comparison during pandemic of COVID-19: A cross-sectional study p. 631
Achara Watanapa, Chantana Ungchusak, Sukanya Tianviwat
DOI:10.4103/JIOH.JIOH_109_21  
Aim: The aim of this study was to describe and analyze factors related to dietary habits among young children. This study is part of the practice guideline development to promote good oral health under the pandemic situation. Materials and Methods: A cross-sectional study was conducted among parents or relatives of 3–5 years old children who attended child care centers in one province of Southern Thailand using an online questionnaire submitted via teachers of each cluster. The number of participants required was 265 and cluster sampling method was performed. Logistic regression was used to identify the factors related to dietary habit. The questionnaire included general information, snack consumption, and factors related to snack consumption during the stay-at-home period. Results: Fifty-seven percent of the children did not increase their cariogenic snack consumption and most families increased their good food habits. Reservation of cariogenic snacks at home and high previous frequency of cariogenic snacks consumption were related to the increasing of cariogenic snack consumption when controlling for parents’ dietary control and good food behavior. Conclusion: Most of the children did not increase their snack consumption during the stay-at-home period and the factors related to increase of snake consumption behavior were reservation of snack and high baseline frequency of consumption.
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