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Häggman-Henrikson, Birgitta
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Publications (10 of 36) Show all publications
Storm Mienna, C., Glas, L., Magnusson, M., Ilgunas, A., Häggman-Henrikson, B. & Wänman, A. (2019). Patients' experiences of supervised jaw-neck exercise among patients with localized TMD pain or TMD pain associated with generalized pain. Acta Odontologica Scandinavica
Open this publication in new window or tab >>Patients' experiences of supervised jaw-neck exercise among patients with localized TMD pain or TMD pain associated with generalized pain
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2019 (English)In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850Article in journal (Refereed) Epub ahead of print
Abstract [en]

Objective: To evaluate temporomandibular disorder (TMD) patients’ experiences of a supervised jaw-neck exercise programme.

Materials and methods: The study used a mixed method design. All patients were diagnosed with myalgia according to the Research Diagnostic Criteria for TMD and divided into local myalgia (n = 50; 38 women, mean age 43 yrs, SD 14), and myalgia with generalized pain (n = 28; 27 women, mean age 43 yrs, SD 13). Patients participated in a ten-session supervised exercise programme that included relaxation, coordination and resistance training of the jaw, neck and shoulders. After the 10 sessions an evaluation form was filled out including both open- and closed-ended questions. The quantitative analysis was based on closed-ended questions concerned experience, adaptation and side-effects from the exercise programme. The qualitative analysis was employing inductive content analysis of open-ended questions.

Results: Patients reported similar positive overall experiences of exercise regardless of diagnosis, although more individuals in the general pain group experienced pain during training (57%) compared to the local pain group (26%; p = .015). Patients in both groups shared similar experiences and acknowledged the possibility to participate in an individualized and demanding exercise programme. They expressed feelings of being noticed, taken seriously and respectful care management to be key factors for successful treatment outcome. The exercise programme was acknowledged as a valuable part of treatment.

Conclusion: The hypothesis generated was that individualized and gradually demanding exercise in the rehabilitation process of TMD stimulates self-efficacy and confidence in chronic TMD patients regardless of whether the pain was localized or combined with wide-spread pain.

Place, publisher, year, edition, pages
Abingdon: Taylor & Francis, 2019
Keywords
Exercise therapy, orofacial pain, pain, qualitative, temporomandibular disorders
National Category
Dentistry
Research subject
Odontology
Identifiers
urn:nbn:se:umu:diva-157932 (URN)10.1080/00016357.2019.1598573 (DOI)000465814900001 ()30957601 (PubMedID)
Available from: 2019-04-08 Created: 2019-04-08 Last updated: 2019-05-28
Lampa, E., Wänman, A., List, T. & Häggman-Henrikson, B. (2019). Relationship Between Psychosocial Factors and Pain in the Jaw and Neck Regions Shortly After Whiplash Trauma. Journal of Oral & Facial Pain and Headache, 33(2), 213-219
Open this publication in new window or tab >>Relationship Between Psychosocial Factors and Pain in the Jaw and Neck Regions Shortly After Whiplash Trauma
2019 (English)In: Journal of Oral & Facial Pain and Headache, ISSN 2333-0384, Vol. 33, no 2, p. 213-219Article in journal (Refereed) Published
Abstract [en]

Aims: To assess jaw pain shortly after whiplash trauma in relation to neck pain, physical symptoms, depression, and jaw pain-related disability.

Methods: A total of 181 cases (106 women and 75 men, mean ages 33.7 and 36.8 years, respectively) were examined within 1 month after a whiplash trauma and compared to 117 controls (68 women and 49 men, 34.2 and 30.9 years, respectively). Participants rated current jaw and neck pain intensity on a numeric rating scale and rated nonspecific physical symptoms and depression symptoms on subscales of the Symptom Checklist-90-Revised. The nonspecific physical symptoms were further analyzed with and without pain items. Disability related to jaw pain and neck pain was also assessed. Differences between groups were calculated using Mann-Whitney U test, and correlations were measured using Spearman correlation.

Results: Compared to controls, cases reported higher current jaw and neck pain intensity (P < .0001), together with higher scores for physical nonpain and pain symptoms, depression, and jaw pain-related disability (P < .0001 for all). For cases, there were moderate correlations between nonspecific physical symptoms and jaw pain and neck pain, as well as between jaw pain-related disability and jaw pain and neck pain (r = 0.43 to 0.77, P < .0001 for all). Low correlations were observed between depression and jaw pain and neck pain (r = 0.34 to 0.39, both P < .0001).

Conclusion: Shortly after a whiplash trauma, pain in the jaw and neck regions is associated with the severity of psychosocial factors. Thus, psychosocial factors may play a role in the development of pain in the jaw region after whiplash trauma.

Place, publisher, year, edition, pages
Quintessence Publishing Co., Inc., 2019
Keywords
jaw, pain, psychosocial factors, temporomandibular disorders, whiplash injury
National Category
Dentistry
Identifiers
urn:nbn:se:umu:diva-153178 (URN)10.11607/ofph.2226 (DOI)000468359000010 ()30371684 (PubMedID)2-s2.0-85065219390 (Scopus ID)
Funder
The Kempe FoundationsVästerbotten County Council
Available from: 2018-11-08 Created: 2018-11-08 Last updated: 2019-06-10Bibliographically approved
Lampa, E., Wänman, A., Nordh, E., Stålnacke, B.-M. & Häggman-Henrikson, B. (2019). The Course of Orofacial Pain and Jaw Disability after Whiplash Trauma: A 2-year Prospective Study.. Spine
Open this publication in new window or tab >>The Course of Orofacial Pain and Jaw Disability after Whiplash Trauma: A 2-year Prospective Study.
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2019 (English)In: Spine, ISSN 0362-2436, E-ISSN 1528-1159Article in journal (Refereed) Epub ahead of print
Abstract [en]

STUDY DESIGN: Prospective cohort study OBJECTIVE.: To evaluate the course of orofacial pain and jaw disability in relation to neck pain, neck disability and psychosocial factors at the acute stage and the chronic stage after whiplash trauma.Summary of Background Data Many individuals report chronic pain in the orofacial region after whiplash trauma. The possible association between whiplash trauma and orofacial pain is debated. Prospective studies are therefore needed to evaluate the development of orofacial pain after whiplash trauma.

METHODS: Within one month following a whiplash trauma, 176 cases were examined and compared to 116 controls with questionnaires concerning neck and jaw pain and related disability, non-specific physical symptoms and depression. At the 2-year follow-up, 119 cases (68%) and 104 controls (90%) were re-examined.

RESULTS: Compared to controls, cases reported more jaw and neck pain, both at baseline and follow-up. A majority (68%) of cases with pain in the jaw region in the acute stage also reported jaw pain at the follow-up. The intensity of jaw and neck pain was correlated both at baseline and follow-up. Both neck pain and jaw pain was correlated to non-specific physical symptoms and to depression.

CONCLUSION: Orofacial pain and jaw disability related to neck pain is often present already at the acute stage after whiplash trauma and persist into the chronic stage for most individuals. Assessment following whiplash trauma should therefore include both the neck and the orofacial regions. More studies are needed to further evaluate risk factors for development of orofacial pain after whiplash trauma.

LEVEL OF EVIDENCE: 3.

Keywords
Jaw pain, Neck Pain, Neck disability, Orofacial pain, Psychosocial factors, Temporomandibular disorders, TMD, Temporomandibular joint, TMJ, Whiplash injury
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:umu:diva-163963 (URN)10.1097/BRS.0000000000003212 (DOI)31513116 (PubMedID)
Available from: 2019-10-10 Created: 2019-10-10 Last updated: 2019-10-11
Bajramaj, E., Häggman-Henrikson, B., Dawson, A., Gerdle, B. & Ghafouri, B. (2019). The Effect of Microdialysis Catheter Insertion on Glutamate and Serotonin Levels in Masseter Muscle in Patients with Myofascial Temporomandibular Disorders and Healthy Controls. Diagnostics (Basel), 9(1), Article ID 14.
Open this publication in new window or tab >>The Effect of Microdialysis Catheter Insertion on Glutamate and Serotonin Levels in Masseter Muscle in Patients with Myofascial Temporomandibular Disorders and Healthy Controls
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2019 (English)In: Diagnostics (Basel), ISSN 2075-4418, Vol. 9, no 1, article id 14Article in journal (Refereed) Published
Abstract [en]

Myofascial temporomandibular disorders (TMD) are the most common cause of chronic pain in the orofacial region. Microdialysis has been used to study metabolic changes in the human masseter muscle. The insertion of the microdialysis probe causes acute tissue trauma that could affect the metabolic milieu and thereby influence the results when comparing healthy subjects to those with TMD. This study aimed to investigate the levels of serotonin and glutamate during the acute tissue trauma period in healthy subjects and in patients with TMD. Microdialysis was carried out in 15 patients with TMD and 15 controls, and samples were collected every 20 min during a period of 140 min. No significant alterations of serotonin or glutamate were observed over the 2 h period for the healthy subjects. For the TMD group, a significant decrease in serotonin was observed over time (p < 0.001), followed by a significant increase between 120 and 140 min (p < 0.001). For glutamate, a significant reduction was observed at 40 min compared to baseline. The results showed that there was a spontaneous increase of serotonin 2 h after the insertion of the catheter in patients with TMD. In conclusion, the results showed that there are differences in the masseter muscle levels of serotonin and glutamate during acute nociception in patients with myofascial TMD compared to healthy subjects.

Keywords
microdialysis, myofascial temporomandibular disorders, serotonin, glutamate, chronic pain
National Category
Dentistry
Identifiers
urn:nbn:se:umu:diva-158386 (URN)10.3390/diagnostics9010014 (DOI)000464204000001 ()30678220 (PubMedID)
Available from: 2019-04-29 Created: 2019-04-29 Last updated: 2019-04-29Bibliographically approved
Lövgren, A., Visscher, C. M., Alstergren, P., Lobbezoo, F., Häggman-Henrikson, B. & Wänman, A. (2019). The outcome of a temporomandibular joint compression test for the diagnosis of arthralgia is confounded by concurrent myalgia. Clinical Oral Investigations
Open this publication in new window or tab >>The outcome of a temporomandibular joint compression test for the diagnosis of arthralgia is confounded by concurrent myalgia
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2019 (English)In: Clinical Oral Investigations, ISSN 1432-6981, E-ISSN 1436-3771Article in journal (Refereed) Epub ahead of print
Abstract [en]

Objective: Pain in the orofacial region may originate from different structures, and one challenge for the clinician is to determine the primary origin of pain reported by the patient. In clinical practice, it is important to discriminate between a temporomandibular joint (TMJ) pain disorder and jaw muscle pain; therefore, tests that are proposed for such purposes warrant evaluation. The aim of the present study was to evaluate the outcome of a TMJ compression test in relation to a Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) arthralgia diagnosis.

Methods: A study population (n = 300), randomly selected from the adult population in Västerbotten, Sweden, was examined according to the DC/TMD criteria and with a TMJ compression test. This test is comprised of forceful unilateral biting for 20 s on a wooden spatula in the first molar region. Familiar pain on the contralateral side to the clenching side was considered a positive test outcome.

Results: Positive contralateral outcome of the TMJ compression test was associated with an arthralgia diagnosis (B = 1.737; OR 5.7, 95% CI 3.3–9.9). This association was confounded by concurrent myalgia (B = 1.737 → B = 0.996, 42.7%).

Conclusion: In a general population, a negative TMJ compression test was strongly associated with the absence of a contralateral TMJ arthralgia diagnosis according to DC/TMD. The association between a positive TMJ compression test and a DC/TMD arthralgia diagnosis was confounded by the presence of myalgia.

Clinical relevance: Concurrent myalgia renders the usefulness of the TMJ compression test for predicting an arthralgia diagnosis questionable.

Place, publisher, year, edition, pages
Springer, 2019
Keywords
Temporomandibular disorder, Temporomandibular joint, DC/TMD, Diagnostic tests, Diagnostic accuracy
National Category
Dentistry
Identifiers
urn:nbn:se:umu:diva-158398 (URN)10.1007/s00784-019-02891-3 (DOI)
Funder
Västerbotten County Council
Available from: 2019-04-26 Created: 2019-04-26 Last updated: 2019-04-29
Skog, C., Fjellner, J., Ekberg, E. & Häggman-Henrikson, B. (2019). Tinnitus as a comorbidity to temporomandibular disorders - A systematic review. Journal of Oral Rehabilitation, 46(1), 87-99
Open this publication in new window or tab >>Tinnitus as a comorbidity to temporomandibular disorders - A systematic review
2019 (English)In: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842, Vol. 46, no 1, p. 87-99Article, review/survey (Refereed) Published
Abstract [en]

The aim of this systematic review was to evaluate the prevalence of tinnitus in patients with temporomandibular disorders (TMD) and the possible effects of TMD treatment on tinnitus symptoms. A search of the PubMed, Web of Science and Cochrane databases from inception of each database up to January 2017 found 222 articles. After independent screening of abstracts by two of the authors, we assessed 46 articles in full text. The inclusion and exclusion criteria reduced these to 25 articles of which 22 studies reported prevalence based on 13 358 patients and 33 876 controls, and eight studies reported effect of TMD treatment on tinnitus based on 536 patients and 18 controls. The prevalence of tinnitus in patients with TMD varied from 3.7% to 70% (median 42.3%) whereas the prevalence in control groups without TMD varied between 1.7% and 26% (median 12%). The eight treatment studies indicated that treatment of TMD symptoms may have a beneficial effect on severity of tinnitus. However, only one treatment study included a control group, meaning that the overall level of evidence is low. The finding that tinnitus is more common in patients with TMD means that it can be regarded as a comorbidity to TMD. However, in view of the lack of evidence currently available, further well-designed and randomised studies with control groups are needed to investigate whether possible mechanisms common to tinnitus and TMD do exist and whether TMD treatment can be justified to try to alleviate tinnitus in patients with TMD and comorbidity of tinnitus.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
comorbidity, prevalence, temporomandibular disorders/oro-facial pain, temporomandibular joint dysfunction, tinnitus
National Category
Dentistry
Identifiers
urn:nbn:se:umu:diva-155090 (URN)10.1111/joor.12710 (DOI)000453587800011 ()30126027 (PubMedID)
Available from: 2019-01-10 Created: 2019-01-10 Last updated: 2019-01-10Bibliographically approved
Lövgren, A., Karlsson Wirebring, L., Häggman-Henrikson, B. & Wänman, A. (2018). Decision-making in dentistry related to temporomandibular disorders: a 5-yr follow-up study. European Journal of Oral Sciences, 126(6), 493-499
Open this publication in new window or tab >>Decision-making in dentistry related to temporomandibular disorders: a 5-yr follow-up study
2018 (English)In: European Journal of Oral Sciences, ISSN 0909-8836, E-ISSN 1600-0722, Vol. 126, no 6, p. 493-499Article in journal (Refereed) Published
Abstract [en]

Temporomandibular disorders (TMDs) are common, but many patients with such disorders go undetected and under-treated. Our aim was to evaluate the outcome of using a screening tool (5 yr after it was first implemented), on the clinical decision-making for patients with TMDs. Adults who attended for a dental check-up at the Public Dental Health Services in Västerbotten, Sweden, answered three screening questions (3Q/TMD) on frequent jaw pain, pain on jaw function, and catching/locking of the jaw. The dental records of a random sample of 200 individuals with at least one positive response to 3Q/TMD (3Q screen-positive patients) and 200 individuals with all negative responses (3Q screen-negative patients) were reviewed for TMD-related treatment decisions. A clinical decision related to TMD was absent in 45.5% of 3Q screen-positive patients. Treatment of TMDs was associated with a positive response to the screening question on jaw pain (OR = 6.7, 95% CI: 3.2-14.0) and was more frequent among 3Q screen-positive patients (24%) than among 3Q screen-negative patients (2%; OR = 15.5, 95% CI: 5.5-43.9), just as a female examiner was associated with more frequent treatment of TMDs (OR = 3.1, 95% CI: 1.2-8.4). The results indicate under-treatment of TMD within general dental practice and that male clinicians are less likely to initiate TMD treatment.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018
Keywords
clinical decision-making, facial pain, prospective study, temporomandibular joint disorders, therapy
National Category
Dentistry
Identifiers
urn:nbn:se:umu:diva-152625 (URN)10.1111/eos.12572 (DOI)000449881600007 ()30298596 (PubMedID)
Available from: 2018-10-16 Created: 2018-10-16 Last updated: 2018-12-18Bibliographically approved
Lövgren, A., Parvaneh, H., Lobbezoo, F., Häggman-Henrikson, B., Wänman, A. & Visscher, C. M. (2018). Diagnostic accuracy of three screening questions (3Q/TMD) in relation to the DC/TMD in a specialized orofacial pain clinic. Acta Odontologica Scandinavica, 76(6), 380-386
Open this publication in new window or tab >>Diagnostic accuracy of three screening questions (3Q/TMD) in relation to the DC/TMD in a specialized orofacial pain clinic
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2018 (English)In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 76, no 6, p. 380-386Article in journal (Refereed) Published
Abstract [en]

Objective: To determine the diagnostic accuracy of three screening questions (3Q/TMD) in relation to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), in a specialized clinic.

Material and methods: Consecutive patients, >18 years, referred with a possible TMD complaint to the Orofacial Pain and Dysfunction clinic, Academic Centre for Dentistry Amsterdam, the Netherlands, were included in the study. All patients (n = 449; mean age 44 years; 72% females), answered the 3Q/TMD and the DC/TMD questionnaire before a DC/TMD examination. The 3Q/TMD constitutes of two questions on weekly pain from the jaw, face and temple region (Q1), and on function (Q2), and one function-related question on weekly catching and/or locking of the jaw (Q3). Q1 and Q2 were evaluated in relation to a DC/TMD pain diagnosis and Q3 in relation to a subgroup of DC/TMD intra-articular diagnosis, referred to as the reference standard.

Results: In total, 44% of patients received a pain-related DC/TMD diagnosis and 33% an intra-articular reference DC/TMD diagnosis. Sensitivity for the two pain screening questions was high (0.83–0.94), whereas specificity was low (0.41–0.55). For the function-related question, sensitivity was low (0.48), whereas specificity was high (0.96).

Conclusions: In a specialized pain clinic, the two pain questions (Q1, Q2) are positive in most patients with pain-related TMD. Therefore, in case of a positive response, further diagnostic procedures for TMD pain are warranted. For the functional screening question (Q3), a positive response is indicative for an intra-articular DC/TMD diagnosis, while in case of a negative outcome, an intra-articular TMD might still be present.

Place, publisher, year, edition, pages
Taylor & Francis, 2018
Keywords
Temporomandibular disorders, DC/TMD, diagnostic accuracy, screening instrument
National Category
Dentistry
Identifiers
urn:nbn:se:umu:diva-145691 (URN)10.1080/00016357.2018.1439528 (DOI)000439703200001 ()29448865 (PubMedID)
Available from: 2018-03-14 Created: 2018-03-14 Last updated: 2018-08-31Bibliographically approved
Häggman-Henrikson, B., Wiesinger, B. & Wänman, A. (2018). The effect of supervised exercise on localized TMD pain and TMD pain associated with generalized pain. Acta Odontologica Scandinavica, 76(1), 6-12
Open this publication in new window or tab >>The effect of supervised exercise on localized TMD pain and TMD pain associated with generalized pain
2018 (English)In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 76, no 1, p. 6-12Article in journal (Refereed) Published
Abstract [en]

Objectives: To evaluate the effect of a supervised exercise program in patients with localized/regional temporomandibular disorder (TMD) pain and with TMD associated with generalized pain.

Material and methods: Consecutively referred patients with localized/regional TMD pain (n = 56; 46 women and 10 men, mean age 44 years) and TMD associated with generalized pain (n = 21; 21 women, mean age 41 years) participated. Patients underwent a 10-session structured supervised exercise program over 10-20 weeks that included relaxation, and coordination and resistance training of the jaw and neck/shoulders. The outcomes were jaw pain intensity on the Numerical Rating Scale, endurance time for jaw opening and protrusion against resistance and chewing, and effect of pain on daily activities.

Results: After the exercise program, a reduction in jaw pain was reported by the local (p = .001) and general (p = .011) pain groups. There were no significant differences in jaw pain intensity between the groups, before (p = .062) or after treatment (p =.121). Endurance time increased for both groups for jaw opening/protrusion (both p <. 001) and chewing (both p = .002). The effect of jaw pain on daily activities decreased after exercise compared to baseline for both the local (p < .001) and general (p = .008) pain groups.

Conclusions: Supervised exercise can reduce TMD pain and increase capacity in patients with TMD. The results suggest that activation of the jaw motor system with exercise has a positive effect in patients with localized/regional TMD pain and TMD associated with generalized pain.

Place, publisher, year, edition, pages
Taylor & Francis, 2018
Keywords
exercise therapy, orofacial pain, resistance training, temporomandibular disorders
National Category
Dentistry
Identifiers
urn:nbn:se:umu:diva-146242 (URN)10.1080/00016357.2017.1373304 (DOI)000426893500001 ()
Available from: 2018-04-06 Created: 2018-04-06 Last updated: 2018-06-09Bibliographically approved
Lampa, E., Wänman, A., Nordh, E. & Häggman-Henrikson, B. (2017). Effects on jaw function shortly after whiplash trauma. Journal of Oral Rehabilitation, 44(12), 941-947
Open this publication in new window or tab >>Effects on jaw function shortly after whiplash trauma
2017 (English)In: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842, Vol. 44, no 12, p. 941-947Article in journal (Refereed) Published
Abstract [en]

Normal jaw function involves muscles and joints of both jaw and neck. A whiplash trauma may disturb the integrated jaw-neck sensory-motor function and thereby impair chewing ability; however, it is not known if such impairment is present shortly after a neck trauma or develops over time. The aim was to evaluate jaw function after a recent whiplash trauma. Eighty cases (47 women) were examined within 1 month after a whiplash trauma and compared to 80 controls (47 women) without neck trauma. Participants completed the Jaw disability checklist (JDC) and Neck Disability Index (NDI) questionnaires and performed a 5-minute chewing test. Elicited fatigue and pain during chewing were noted, and group differences were evaluated with Fisher's exact test and Mann-Whitney U-test. Compared to controls, cases had higher JDC (P<.0001) and NDI scores (15% vs 2%, P<.0001), and reported more fatigue (53% vs 31%, P=.006) and pain (30% vs 10%, P=.003) during the chewing test. Cases also had a shorter onset time for fatigue and pain (both P=.001) Furthermore, cases reporting symptoms during chewing had higher JDC and NDI scores compared to cases not reporting symptoms (both P=.01). Symptoms mainly occurred in the trigeminal area for both groups, but also in spinal areas more often for cases than for controls. Taken together, the results indicate that jaw-neck sensory-motor function is impaired already within 1month after a whiplash trauma. The association between neck disability and jaw impairment underlines the close functional relationship between the regions, and stresses the importance of multidisciplinary assessment.

Place, publisher, year, edition, pages
WILEY, 2017
Keywords
accidents, facial pain, mastication, neck pain, temporomandibular joint dysfunction syndrome, traffic, iplash injuries
National Category
Dentistry
Identifiers
urn:nbn:se:umu:diva-142232 (URN)10.1111/joor.12571 (DOI)000414577300003 ()28891205 (PubMedID)
Available from: 2017-12-11 Created: 2017-12-11 Last updated: 2018-11-08Bibliographically approved
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