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1.
目的探讨深圳市儿童乙型病毒性肝炎(简称乙肝)流行现状及乙肝疫苗应用效果。方法采用多阶段整群系统随机抽样方法抽取调查户,对深圳市1~14岁常住人口进行问卷调查并采血检测HBsAg、抗-HBs及抗-HBc。采用Epidata 3.2软件建立调查数据库,利用SPSS 16.0软件进行数据处理分析,两组之间率比较采用χ2检验,P<0.05为差异有统计学意义。结果调查1~14岁儿童1 653人,HBsAg阳性率2.06%,抗-HBs阳性率74.53%,抗-HBc阳性率5.32%,HBV感染率9.62%。有乙肝疫苗免疫史儿童1 349人,HBsAg阳性率1.85%、抗-HBs阳性率75.02%、抗-HBc阳性率4.60%及HBV感染率5.41%;无乙肝疫苗免疫史儿童92人,HBsAg阳性率4.35%、抗-HBs阳性率68.48%、抗-HBc阳性率10.87%及HBV感染率73.91%;有无乙肝疫苗免疫史儿童HBsAg阳性率、抗-HBs阳性率差异无统计学意义,抗-HBc阳性率、HBV感染率差异有统计学意义,(χ2=7.14、457.83,P均<0.01)。乙肝疫苗免疫3年以内儿童601人,其中HBsAg阳性率为0、抗-HBs阳性率73.71%、抗-HBc阳性率2.0%、HBV感染率2.0%;免疫7~9年183人,其中HBsAg阳性率5.46%、抗-HBs阳性率79.23%、抗-HBc阳性率8.74%、HBV感染率11.48%。乙肝疫苗不同免疫年限儿童抗-HBs阳性率差异无统计学意义,HBsAg阳性率、抗-HBc阳性率、HBV感染率差异有统计学意义(χ2=29.53、36.88、43.75,P均<0.01)。结论持续保持较高的乙肝疫苗接种率,可以有效降低乙肝流行率。研究和推行乙肝疫苗加强免疫策略也是乙肝防治工作重点之一。  相似文献   

2.
To estimate the efficacy in The Gambia (West Africa) of infant hepatitis B vaccination against infection and carriage with the virus at the age of 9 years. The HBV status of 9-year old children vaccinated in infancy was compared to that of unvaccinated children of the same age. Eight percent of the vaccinated children had been infected by HBV compared to 50% of the unvaccinated control group; HBV carrier status was 0.6 and 10% respectively, resulting in a vaccine efficacy of 83% against infection and of 95% against chronic carriage. The results show that infant vaccination provides a high level of protection at the age of nine years against both HBV infection and chronic carrier status and no booster dose of vaccine is required in the first decade. These findings support the WHO recommendation for the introduction of HBV vaccination into the Expanded Programme on Immunization in Africa.  相似文献   

3.
Hepatitis B virus (HBV) infection is a major cause of cirrhosis and liver cancer in the United States. The Advisory Committee on Immunization Practices (ACIP) has recommended a comprehensive strategy to eliminate HBV transmission, including prevention of perinatal HBV transmission; universal vaccination of infants; catch-up vaccination of unvaccinated children and adolescents; and vaccination of unvaccinated adults at increased risk for infection. The incidence of acute hepatitis B has declined 75%, from 8.5 per 100,000 population in 1990 to 2.1 per 100,000 population in 2004, with the greatest declines (94%) among children and adolescents. Incidence remains highest among adults, who accounted for approximately 95% of the estimated 60,000 new infections in 2004. To measure hepatitis B vaccination coverage among adults, data were analyzed from the 2004 National Health Interview Survey (NHIS). This report summarizes the results of that analysis, which indicated that, during 2004, 34.6% of adults aged 18-49 years reported receiving hepatitis B vaccine, including 45.4% of adults at high risk for HBV infection. To accelerate elimination of HBV transmission in the United States, public health programs and clinical care providers should implement strategies to ensure that adults at high risk are offered hepatitis B vaccine.  相似文献   

4.
To assess associations between the timing of hepatitis B virus (HBV) immunization relative to human immunodeficiency virus (HIV) diagnosis and vaccine effectiveness, US Military HIV Natural History Study cohort participants without HBV infection at the time of HIV diagnosis were grouped by vaccination status, retrospectively followed from HIV diagnosis for incident HBV infection, and compared using Cox proportional hazards models. A positive vaccine response was defined as hepatitis B surface antibody level ≥ 10 IU/L. Of 1,877 participants enrolled between 1989 and 2008, 441 (23%) were vaccinated prior to HIV diagnosis. Eighty percent of those who received vaccine doses only before HIV diagnosis had a positive vaccine response, compared with 66% of those who received doses both before and after HIV and 41% of those who received doses only after HIV (P < 0.01 for both compared with persons vaccinated before HIV only). Compared with the unvaccinated, persons vaccinated only before HIV had reduced risk of HBV infection after HIV diagnosis (hazard ratio = 0.38, 95% confidence interval: 0.20, 0.75). No reduction in HBV infection risk was observed for other vaccination groups. These data suggest that completion of the vaccine series prior to HIV infection may be the optimal strategy for preventing this significant comorbid infection in HIV-infected persons.  相似文献   

5.
《Vaccine》2018,36(17):2307-2313
BackgroundHepatitis B virus (HBV) can cause chronic HBV infection, which may lead to advanced cirrhosis and liver cancer. Healthcare workers (HCWs) are at risk HBV infection as an occupational hazard. Hepatitis B vaccination of HCWs is recommended by WHO, but the status of hepatitis B vaccination among HCWs in China is seldom reported.MethodologyWe conducted a cross-sectional study in 22 hospitals of 3 developed cities in China. We interviewed managers in infectious diseases and occupational health departments, and at least 40 HCWs per hospital.ResultsWe interviewed 929 HCWs; 80.8% were vaccinated against hepatitis B and 96.7% were willing to be vaccinated; 38.2% of HCWs reported having at least one needle stick or sharps injury. Three hospitals provide free hepatitis B vaccination for HCWs; hospitals with a hepatitis B vaccination policy, more HCWs reported being vaccinated (91.7% vs 79.0%, P < 0.001). HCWs in high risk departments (P = 0.011), with more knowledge of hepatitis B vaccine (P < 0.001), and with fewer working years (P = 0.002) were more likely to be vaccinated against HBV. Infectious diseases and occupational health managers had positive attitudes towards hepatitis B vaccination.ConclusionsHepatitis B vaccination was well accepted among HCWs. Hospital provision of free vaccine, greater HCW knowledge of HBV, and working in higher-risk settings were associated with being vaccinated. A national policy of offering hepatitis B vaccine to HCWs should be considered in China. Provision of free hepatitis B vaccine for HBsAb negative HCWs may be acceptable. Education about HBV and hepatitis B vaccine may help promote policy implementation.  相似文献   

6.
Hepatitis B is a viral disease of global importance. In Catalonia in the 1980s, the seroepidemiological pattern of HBV infection was low-intermediate. In 1990, the Expert Committee on Vaccinations of the Department of Health of the Generalitat of Catalonia evaluated the systematic introduction of hepatitis B vaccination in preadolescents, maintaining the vaccination of risk groups. The objective of this study was to estimate the effectiveness and impact of the systematic hepatitis B vaccination programme in preadolescents in Catalonia 21 years after its introduction. A retrospective cohort study was conducted, comparing the disease incidence in vaccinated and unvaccinated cohorts. Cases of hepatitis B were defined as those reported by the General Subdirectorate of Surveillance and Response to Public Health Emergencies between 2000 and 2014. The incidence rate was 2.5 per 100,000 persons in 1991 and 1.2 per 100,000 persons in 2014, a reduction of 52%. During the study period, 388 cases of hepatitis B infection were notified, of which three were classified as vaccine failures. Vaccine effectiveness was 99.30% (95% CI: 97.83–99.78) and the population prevented fraction in the cohorts of preadolescents studied was 64.56% (95% CI: 60.45–68.66). The effectiveness and impact of the hepatitis B vaccination program in preadolescents in Catalonia is high, with the consequent benefits for the population.  相似文献   

7.
BACKGROUND: The impact of the universal infant hepatitis B (HB) immunization program initiated in 1991 in Mongolia is still unclear. METHODS: A nationwide school-based cross-sectional serosurvey was conducted in 2004, with stratified, multistage, random cluster sampling from all public elementary schools (n=593) in Mongolia. All children were tested for serological markers of hepatitis B virus (HBV). RESULTS: Serology results were available for 1,145 children (592 boys and 553 girls) aged 7-12 years (survey response rate: 93%). Immunization card was available for 702 (61.3%) children. The coverage of complete HB vaccination was 60.1% and it was increased by birth cohort from 44% to 76%. Significantly higher proportion of children in Metropolitan cities (75.2%) was completely vaccinated with HB compared to those in Province centers (55.7%) and rural areas (59.1%). HBV infection occurred in 5.9%, 13.2%, and 20.8% of complete vaccinees living in Metropolitan, Province centers, and rural areas, respectively; of whom 1.2%, 2.9%, and 8.6% were HB surface antigen (HBsAg) carriers, respectively. Only 17.0% of the children had protective anti-HBs which decreased from 31.1% to 16.3% among 7 to 12-year-olds indicating its decay with time. CONCLUSIONS: Prevalence of HBV infection and carriage among young generation meaningfully declined compared with those of previous studies in Mongolia. The coverage of birth dose and complete HB vaccination was significantly low in Province centers and rural areas which should be taken into consideration.  相似文献   

8.
BackgroundBefore hepatitis B vaccine (HepB) introduction, level of endemicity of hepatitis B virus (HBV) in Ukraine was estimated as intermediate but the prevalence of HBV infection markers has not been measured in population-based serosurveys. Coverage with 3 doses of HepB, introduced in 2002, was 92%-98% during 2004–2007 but declined to 21%-48% during 2010–2016. To obtain data on HBV prevalence among children born after HepB introduction, we tested specimens from a serosurvey conducted in Ukraine in 2017, following circulating vaccine-derived poliovirus outbreak in 2015, among birth cohorts eligible for polio immunization response.MethodsThe serosurvey was conducted in Zakarpattya, Sumy, and Odessa provinces, and Kyiv City, targeting 2006–2015 birth cohorts. One-stage cluster sampling in the provinces and stratified simple random sampling in Kyiv were used for participant selection. All participants were tested for antibodies against HBV core antigen (anti-HBc). Anti-HBc-positive children were tested for HBV surface antigen (HBsAg). We also obtained information on HepB vaccination status for all children.ResultsOf 4,596 children tested, 81 (1.8%) were anti-HBc-positive and eight (0.2%) were HBsAg-positive. HBsAg prevalence was 0.7% (95% confidence interval, 0.3%-1.4%) in Zakarpattya, 0.1% (0.0%-0.4%) in Sumy, 0% (0.0%-03%) in Odessa, and 0.1% (0.0%-0.8%) in Kyiv. Across survey sites, the proportion of recipients of ≥ 3 HepB doses was 53%-80% in the 2006–2009 cohort and 28%-59% in the 2010–2015 cohort.ConclusionHBV prevalence among children in surveyed regions of Ukraine in 2017 was low, including in Zakarpattya—the only site above the 0.5% European Regional target for HBsAg seroprevalence. However, HepB vaccination was suboptimal, particularly among children born after 2009, resulting in large numbers of unvaccinated or incompletely vaccinated children at risk of future HBV infection. HepB coverage should be increased to further reduce HBV transmission among children in Ukraine and achieve regional and global hepatitis B control/elimination targets.  相似文献   

9.
目的了解宁波市实施乙型肝炎疫苗(乙肝疫苗)计划免疫7年后,儿童乙型肝炎病毒(HBV)感染及免疫状况.方法采用整群分层抽样法调查1982~1995年出生儿童血清HBsAg和抗-HBs阳性率(RIA法).结果①1992~1995年出生的免疫人群HBsAg阳性率为2.66%,比未免疫人群(10.95%)下降了75.71%(χ2=22.91,P<0.0001);②免疫人群抗-HBs阳性率达65.95%,显著高于未免疫人群的41.03%(χ2=113.67,P<0.0001);③在计划免疫后的第5~7年起显现了免疫人群HBsAg阳性率升高和抗-HBs阳性率下降的迹象.结论宁波市实施乙肝疫苗计划免疫7年后,儿童对HBV已呈现出高免疫、低感染的特征;但需进一步研究计划免疫4~5年后,免疫人群HBsAg阳性率升高、抗-HBs阳性率下降的现象和乙肝疫苗加强免疫的适时问题.  相似文献   

10.
In 1992, the World Health Organization (WHO) set a goal for all countries to integrate hepatitis B vaccination into their universal childhood vaccination programs by 1997. This report summarizes the global progress achieved toward vaccination of children against hepatitis B virus (HBV) infection. Although many countries have introduced hepatitis B vaccination into their national vaccination programs, efforts are needed to increase coverage with the 3-dose hepatitis B vaccination series and expand vaccination programs into countries where the vaccine has not yet been introduced.  相似文献   

11.
目的探讨江苏省农村地区儿童接种乙型肝炎(乙肝)疫苗后免疫效果及其影响因素。方法采用多阶段分层随机整群抽样方法,抽取江苏省农村地区在实施乙肝疫苗计划免疫后出生的农村儿童为研究对象,检测HBsAg、抗-HBs标志,对抗-HBs阴转儿童进行不同种类疫苗的加强免疫,并分析HBsAg阳性儿童乙肝病毒(HBV)感染的危险因素。结果2522名1~7岁儿童中HBsAg阳性率在0.28%~1.28%之间,抗-HBs随年龄增加而逐渐下降,由1岁时的76.7%降至7岁时的45.5%;出生时未及时接种乙肝疫苗的儿童的HBV感染率显著高于及时接种儿童(1.4%:0.5%, P=0.031);应用不同剂量疫苗加强免疫后,抗-HBs阳转率均为90%以上。结论江苏省农村地区计划免疫适龄儿童人群的HBsAg阳性率为0.28%~1.28%,平均为0.8%,儿童中HBV感染主要为母婴传播,并与未及时接种乙肝疫苗有关。  相似文献   

12.
ABSTRACT: * Background The Hepatitis B virus (HBV) infection is a major cause of liver disease and liver cancer worldwide according to the World Health Organization. Following acute HBV infection, 1-5% of infected healthy adults and up to 90% of infected infants become chronic carriers and have an increased risk of cirrhosis and primary hepatocellular carcinoma. The aim of this study was to estimate the reduction in hepatitis B incidence due to universal vaccination programmes in Catalonia (Spain), taking population changes into account, and to construct a model to forecast the future incidence of cases that allows the best preventive strategy to be adopted. * Methods Reported acute hepatitis B incidence in Catalonia according to age, gender, vaccination coverage, percentage of immigrants and the year of report of cases was analysed. A statistical analysis was made using three models: generalized linear models (GLM) with Poisson or negative binomial distribution and a generalized additive model (GAM). * Results The higher the vaccination coverage, the lower the reported incidence of hepatitis B (p <0.01). In groups with a vaccination coverage > 70%, the reduction in incidence was 2-fold higher than in vaccinated groups with a coverage <70% (p <0.01). The increase in incidence was significantly higher in groups with a high percentage of immigrants and more than 15% (p <0.01) in immigrant males of working age (19-49 years * Conclusions The results of the adjusted models in this study confirm that the global incidence of hepatitis B has declined in Catalonia after the introduction of the universal preadolescent vaccination programme, but the incidence increased in male immigrants of working age. Given the potential severity of hepatitis B for the health of individuals and for the community, universal vaccination programmes should continue and programmes in risk groups, especially immigrants, should be strengthened.  相似文献   

13.
OBJECTIVES: To measure hepatitis B virus (HBV) infection rates among injection drug users in Rio de Janeiro, Brazil, and to report their knowledge of and attitudes toward hepatitis and HBV vaccination. METHODS: 609 injection drug users recruited in Rio de Janeiro between 1999 and 2001 answered a questionnaire and were tested for hepatitis B and other blood-borne infections. Questions covered sociodemographic information, alcohol and illicit drug consumption, drug injection and sexual practices, medical history, and knowledge about HIV, AIDS and viral hepatitis. RESULTS: The prevalence of HBV infection was 27.1%, with 3.4% of the sample positive for HbsAg (active infection) and 0.8% positive for anti-HBs (indicating previous HBV vaccination). Most interviewees (81.3%) were aware of at least one form of viral hepatitis and received information from many different sources. In agreement with laboratory findings, 96.7% of the interviewees stated they had never been vaccinated against hepatitis B, but almost all unvaccinated interviewees (97.8%) said they would volunteer to be vaccinated if HBV vaccination were available. CONCLUSIONS: Few of the injection drug users surveyed had ever been vaccinated against HBV. Although most were aware of the risks posed by viral hepatitis, this awareness seldom translated into consistent behavioral change. The participants' willingness to be vaccinated against HBV suggests that the implementation of vaccination for this population may help decrease rates of hepatitis B infection.  相似文献   

14.
Asian and Pacific Islander (API) children in the United States have high rates of hepatitis B virus (HBV) infection (1-3). To prevent these infections, hepatitis B vaccination has been recommended for these children since the vaccine was first licensed by the Food and Drug Administration in 1981 (4). Recommendations have included universal hepatitis B vaccination of API infants beginning in 1990 and catch-up vaccination for API children aged <7 years (5). These recommendations were reinforced in 1991 when hepatitis B vaccination was recommended for all infants, particularly in populations such as API children with high rates of early childhood HBV infection (6). In 1995, vaccination was recommended for unvaccinated API children aged <11 years and catch-up vaccination for children aged 11-12 years who had not received hepatitis B vaccine (HepB) (7). Series completion among API children aged 19-35 months increased from 39% in 1994 to 88% in 1997 (8). However, among older API children, hepatitis B vaccination coverage was 10% in 1995 (7). In 1998, to examine trends in hepatitis B vaccination catch-up coverage among API children born before 1994, surveys were conducted in six U.S. cities. This report summarizes the results of the surveys, which indicate varying coverage among API children and suggest a need for continued focused vaccination programs for this population.  相似文献   

15.
This cross-sectional study aimed at assessing the prevalence of, and factors relating to, the acceptance of hepatitis B virus (HBV) vaccination by nursing students in a tertiary hospital in Pakistan. In total, 210 nursing students of Year 2 to Year 4 were invited to participate in the study; of them, 196 (93.3%) returned completed questionnaires. Overall, the prevalence of acceptance of HBV vaccination among them was 75.0%. Of these, 37.2% (73/196) were completely vaccinated, and 25.0% (49/196) had not been vaccinated at all. More than half (27/49, 55.1%) of the unvaccinated nursing students stated that they would accept vaccination if offered. Multiple logistic regression analysis indicated three variables significantly related to acceptance of HBV vaccination: history of accidental exposure to blood or blood products, acceptable knowledge about HBV infection, and adequate budget for HBV vaccination. Health institutions should allocate adequate budgets to vaccinate their nursing students. Effective intervention programmes designed to increase knowledge about HBV infection and adhering to universally-accepted precautions are needed.  相似文献   

16.
乙型肝炎疫苗长期免疫效果的研究   总被引:3,自引:1,他引:2  
目的:观察乙肝疫苗普种预防儿童期乙型肝炎病毒(HBV)感染、降低乙肝发病率的免疫效果。方法:建立肝病报告制度,对乙肝发病情况进行监测;以出生队列定群随访和横断面调查方法,观察新生儿接种乙肝疫苗后13年的免疫持久性、HBV感染标志变动和乙肝发病率;用放射免疫法测定HBV感染标志。结果:乙肝疫苗纳入计划免疫轨道,母亲不筛检,新生儿接种常规剂量乙肝疫苗,乙肝疫苗平均接种率达到85%以上。免疫后13年的长期连续定群观察结果和免疫10年后的横断面调查结果显示,免疫人群的HBsAg阳性率已从既往的16.0%下降为2.3%,HBV感染率从既往的51.5%降至3.5%,疫苗预防HBsAg的保护有效率达到89.7%,预防HBV感染的保护率达到96.2%,1-13岁年龄组人群的急性乙型肝炎发病率已由18.38/10万降至1.6/10万,下降了91.3%,保护效果稳定。结论:在肝癌高发区隆安县开展新生儿乙肝疫苗普种,可获得有效控制HBV感染和HBsAg慢性携带的长期免疫效果。  相似文献   

17.
目的:评价乙肝疫苗扩免策略实施效果。方法:分析烟台市新生儿乙肝疫苗接种及影响因素,整群随机检测1 543名7~12月龄儿童乙肝表面抗体(Anti-HBs)水平;描述分析15岁以下儿童乙肝发病状况。结果:烟台市新生儿乙肝疫苗接种率、及时率保持在97%以上,阳性母亲的新生儿77.35%采用乙肝免疫球蛋白(HBIG)联合阻断;5μg啤酒酵母扩免乙肝疫苗具有较高的免疫原性,80.75%儿童能够产生保护性应答,接种医院级别及父母乙肝感染状况是影响免疫应答的因素;扩免策略实施后儿童乙肝发病率大幅下降,5年降低了78.99%。结论:烟台市新生儿乙肝疫苗免疫策略效果显著,强化产科培训,正确把握接种禁忌,普及孕妇HBV检测,完善低/无应答者免疫将进一步降低乙肝发病率。  相似文献   

18.

Background

Vietnam has high endemic hepatitis B virus infection with >8% of adults estimated to have chronic infection. Hepatitis B vaccine was first introduced in the national childhood immunization program in 1997 in high-risk areas, expanded nationwide in 2002, and included birth dose vaccination in 2003. This survey aimed to assess the impact of Vietnam's vaccination programme by estimating the prevalence of hepatitis B surface antigen (HBsAg) among children born during 2000–2008.

Methods

This nationally representative cross-sectional survey sampled children based on a stratified three-stage cluster design. Demographic and vaccination data were collected along with a whole blood specimen that was collected and interpreted in the field with a point-of-care HBsAg test.

Results

A total of 6,949 children were included in the survey analyses. The overall HBsAg prevalence among surveyed children was 2.70% (95% confidence interval (CI): 2.20–3.30). However, HBsAg prevalence was significantly higher among children born in 2000–2003 (3.64%) compared to children born 2007–2008 (1.64%) (prevalence ratio (PR: 2.22, CI 1.55–3.18)). Among all children included in the survey, unadjusted HBsAg prevalence among children with ≥3 doses of hepatitis B vaccine including a birth dose (1.75%) was significantly lower than among children with ≥3 doses of hepatitis B vaccine but lacked a birth dose (2.98%) (PR: 1.71, CI: 1.00–2.91) and significantly lower than among unvaccinated children (3.47%) (PR: 1.99, CI: 1.15–3.45). Infants receiving hepatitis B vaccine >7 days after birth had significantly higher HBsAg prevalence (3.20%) than those vaccinated 0-1 day after birth (1.52%) (PR: 2.09, CI: 1.27–3.46).

Conclusion

Childhood chronic HBV infection prevalence has been markedly reduced in Vietnam due to vaccination. Further strengthening of timely birth dose vaccination will be important for reducing chronic HBV infection prevalence of under 5 children to <1%, a national and Western Pacific regional hepatitis B control goal.  相似文献   

19.
Background: Hepatitis B (HB) vaccine represents one of the major achievements in the 20th century. The most important epidemiologic factor affecting the chronic carrier rate is age of infection. The earlier in life an infection occurs, the higher the probability that this infection will result in chronic carriage. Methods: A seroepidemiologic study was conducted to examine the impact of HB vaccination on the carrier state among a vaccinated group of children (1000) compared to a non-vaccinated group (500) aged 6 years in Alexandria, Egypt. Results: The rate of HbsAg positivity among the vaccinated group was found to be 0.8% compared to 2.2% among the non-vaccinated group. The study showed that the efficacy of HB vaccine in preventing the carriage of HbsAg, 5 years after full course vaccination, was estimated to be around 67%. However, long-term monitoring should continue to confirm the efficacy of the vaccine in preventing chronic carrier state. On the other hand, studying the exposure to some risk factors associated with hepatitis B virus (HBV) infection revealed more or less a similar pattern of exposure among both vaccinated and unvaccinated children. Conclusion: It can be concluded that the significantly lower rate of HbsAg positivity among the vaccinated compared to the rate among the non-vaccinated is attributed to the preventive effect of the vaccine.  相似文献   

20.
We demonstrate that after implementation of recommendations for universal infant hepatitis B vaccination, HBV infection prevalence among children of foreign-born Asian parents in Georgia declined dramatically; horizontal transmission of infection within households has occurred infrequently; and the vast majority of infants and children have received the recommended hepatitis B vaccinations. These results provide evidence of the success of the hepatitis B infant vaccination program and highlight its potential impact on reducing chronic HBV infection morbidity and mortality among U.S. populations at high risk.  相似文献   

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