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Psychosocial Stress and Sudden Cardiac Death: Brain Mechanisms

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Stress and Heart Disease

Part of the book series: Developments in Cardiovascular Medicine ((DICM,volume 45))

Abstract

Psychosocial stress is known to be a risk factor for sudden cardiac death. In animals, we have shown that operationally defined stressor-events must be present for coronary artery occlusion to result in ventricular fibrillation. Each type of stressor-event has been found to evoke the same pattern of electrochemical responses in the frontal granular cortex. These event-related responses include, negative-polarity slow potentials, extracellular potassium-reduction, and norepinephrine-release. The magnitudes of each of the cerebral responses is related to the animal’s level of acquisition and/or adaptation to the stressor-stimuli. The effect of stress on cardiac vulnerability is prevented by either the blockade of frontocortical projections to the brainstem cardiovascular nuclei or the intracerebral injection of 1-propranolol (0.01 mg/kg). We conclude that psychosocial stressors increase cardiac vulnerability through a learning-dependent noradrenergic process in frontocortical neurons.

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References

  1. Cobb LA, Baum RS, Alvarez H, and Schaffer WA: Resuscitation from out-of-hospital ventricular fibrillation: 4 year follow up. Circulation Suppl III 1975: 52: 223–235.

    Google Scholar 

  2. Friedman H, Manwaring JH, Rosenman RH, Donlon G, Ortega F, and Grube SM. Instantaneous and sudden deaths. JAMA 1973: 225: 1319–1328.

    Article  PubMed  CAS  Google Scholar 

  3. Mortiz AR and Zamcheck N. Sudden and unexpected death of young soldiers. Arch Pathol 1946: 42: 459–494.

    Google Scholar 

  4. Kuller L and Lillenfield A. Epidemiological study of sudden and unexpected death due to arteriosclerotic heart disease. Circulation 1966: 34: 1056.

    PubMed  CAS  Google Scholar 

  5. Spiekerman RE, Brandenburg JT, Achor RWP, and Edward JE. Spectrum of coronary heart disease in a community of 30,000 clinicopathologic study. Circulation 1962: 25: 57.

    PubMed  CAS  Google Scholar 

  6. Schwartz CJ and Gerrity RG. Anatomical pathology of unexpected cardiac death. Circulation 1975: 52: 18–26.

    Google Scholar 

  7. Leriche R, Herman L, and Fontaine R. Ligature de La coronaire gauche et fonction de colur apres enervation sympathique. C R Soc Biol (Paris) 1931: 107: 547–548.

    Google Scholar 

  8. Ebert PA, Vanderveek RB, Allgood RJ, and Sabiston DC, Jr. Effect of chronic cardiac denervation of arrhythmias after coronary artery ligation. Cardiovasc Rev 1970: 4: 141–147.

    Article  CAS  Google Scholar 

  9. Skinner JE, Lie JT, and Entman ML. Modifiction of ventricular fibrillation latency following coronary artery occlusion in the conscious pig: the effects of psychological stress and beta-adrenergic blockade. Circulation 1975: 51: 656–667.

    PubMed  CAS  Google Scholar 

  10. Skinner JE and Reed JC. Blockade of a frontocortical-brainstem pathway prevents ventricular fibrillation of the ischemic heart in pigs. Am J Physiol 1981: 240: H156–H163.

    PubMed  CAS  Google Scholar 

  11. Lown B and Verrier RL. Neural activity and ventricular fibrillation. N Engl J Med 1976: 294: 1165–1170.

    Article  PubMed  CAS  Google Scholar 

  12. Verrier RL and Lown B. Autonomic nervous system and malignant cardiac arrhythmias. In: Weiner H, Hofer MA, and Stunkard AJ, eds. Brain, Behavior, and Bodily Disease. New York: Raven Press 1981: Association for Research in Nervous and Mental Disease, Research Publications 59: 273–291.

    Google Scholar 

  13. Corr PB and Gillis RA. Autonomic neural influences on the dsysrhythmias resulting from myocardial infarction. Circ Res 1978: 43: 1–9.

    PubMed  CAS  Google Scholar 

  14. Malliani A, Schwartz PJ, and Zanchetti A. Neural mechanisms in life-threatening arrhythmias. Am Heart J 1980: 100: 705–715.

    Article  PubMed  CAS  Google Scholar 

  15. Delgado JMR. Circulatory effects of cortical stimulation. Physiol Rev 1960: 40: Suppl 4 146–171.

    Google Scholar 

  16. Weinberg SJ and Fuster JM. Electrocardiographic changes produced by localized hypothalamic stimulations. Ann Intern Med 1960: 53: 332–341.

    PubMed  CAS  Google Scholar 

  17. Manning JW and Cotten MDeV. Mechanism of cardiac arrhythmias induced by diencephalic stimulation. Am J Physiol 1962: 203: 1120–1124.

    Google Scholar 

  18. Melville KI, Blum B, Shister HE, and Sliver MD. Cardiac ischemic changes in arrhythmias induced by hypothalamic stimulation. Am J Cardiol 1963: 12: 781–791.

    Article  PubMed  CAS  Google Scholar 

  19. Mauck HO, Hockman CH, and Hoff EC. ECG changes after cerebral stimulation of the mesencephalic reticular formation. Am Heart J 1964: 68: 98–101.

    Article  PubMed  Google Scholar 

  20. Hockman CH, Mauck HP, and Hoff EC. ECG changes resulting from cerebral stimultion. II A spectrum of venticular arrhythmias of sympathetic origin. Am Heart J 1966: 71: 695–701.

    Article  PubMed  CAS  Google Scholar 

  21. Garvey JL and Melville KI. Cardiovascular effects of lateral hypothalamic stimulation in normal and coronary-ligated dogs. J Cardiovasc. Surg 1969: 10: 377–385.

    CAS  Google Scholar 

  22. Hall RE, Livingston RR, and Bloor MD. Orbital cortical influences on cardiovascular dynamics and myocardial structure in conscious monkeys. J Neurosurg 1977: 46: 638–647.

    Article  Google Scholar 

  23. Hall RE, Sybers HD, Greenhoot JH, and Bloor CM. Myocrdial alterations after hypothalamic stimulation in the intact conscious dog. Am Heart J 1974: 88:770–776.

    Article  PubMed  CAS  Google Scholar 

  24. Ulyanisky LS, Stepanyan EP, and Krymsky IP. Cardiac arrhythmias o hypothalamic origin in sudden death. In: Proceedings USA-USRR Join Symposium on Sudden Death. DHEW No, (NIH) 78–1472, Washington, D. C.: US Government Printing Office, 1977: 417–429.

    Google Scholar 

  25. Johansson G, Johnsson L, Lannek N, Blomgren L, Lindberg P, and Pouph C Severe stress-cardiopathy in pigs. Am Heart J 1974: 87: 451–457.

    Article  PubMed  CAS  Google Scholar 

  26. Corley KC, Shiel FOM, Mauck HP, and Greenhoot J. Electrocardiographic an cardiac morphologic changes associated with environmental stress in squirrel monkeys. Psychosom Med 1973: 35: 361–36.

    PubMed  CAS  Google Scholar 

  27. Cebelin MS and Hirsch CS. Human stress cardiomyopathy: myocardial lesion in victims of homicidal assaults without internal injuries. Human Patho 1980 11: 123–132.

    Article  CAS  Google Scholar 

  28. Skinner JE and Yingling CD. Regulation of slow potential shifts in nucleus reticularis thalami by the mesencephalic reticular formation and the frontal cortex. Electroencephalogr Clin Neurophysiol 1976: 40: 288–296.

    Article  PubMed  CAS  Google Scholar 

  29. Skinner JE and Yingling CD. Central gating mechanisms that regulate event related potentials and behavior: a neural model for attention. In Desmedt, JE, ed. Progress in clinical neurophysiology Vol 1. Brussels Karger-Basel, 1977, pp. 70–96.

    Google Scholar 

  30. Skinner JE, Welch KMA, Reed JC, and Nell JH. Psychological stress reduce cyclic 3′,5′-adenosine monophosphate level in the parietal cortex of th conscious rat. J Neurochem 1978: 30: 691–698.

    Article  PubMed  CAS  Google Scholar 

  31. Skinner JE, Reed JC, Welch KMA, and Nell JH. Cutaneous shock produce correlated shifts in slow potential amplitude and cyclic 3′,5′-adenosir monophosphate level in the parietal cortex of the conscious rat. Neurochem 1978: 30: 699–704.

    Article  CAS  Google Scholar 

  32. Parkes CM. Bereavement. Br Med J 1967: 4: 13.

    Google Scholar 

  33. Rees WD and Lutkins SG. Mortality of bereavement. Br Med J 1976: 4: 13.

    Article  Google Scholar 

  34. Wolf S. Psychosocial forces in myocardial infarction and sudden death. Circulation (Suppl. IV) 1969: 39–40: 74–81.

    Google Scholar 

  35. Rahe RH, Bennett L, Romo M, Seltanen P, and Arthur RS. Subject’s recent life changes and coronary heart disease in Finland. Am J Psychiat 1973 130: 1222–1226.

    PubMed  CAS  Google Scholar 

  36. Jenkins CD. Recent evidence supporting psychosocial risk factors for coronary disease. N Engl J Med 1976: 294: 987 and 1033.

    Article  PubMed  CAS  Google Scholar 

  37. Vikhert AM, Velisheva LA, and Matova EE. Geographic distribution an pathology of sudden death in the Soviet Union. In: USA-USSR First Symposium on sudden Death. DHEW No (NIH) 78–1470. Washington, D. C.: U Government Printing Office 1977: pp. 19–40.

    Google Scholar 

  38. Rissanen V, Romo M, and Seltanen P. Premonitory symptoms and stess factor preceding sudden death from ischemic heart disease. Acta Med Scand 1978 204: 389.

    Article  PubMed  CAS  Google Scholar 

  39. Reich P, DeSilva RA, Lown B, and Murawski J. Acute psychologica disturbances prededing life-threatening ventricular arrhythmias. JAM 1981: 246: 233–235.

    Article  CAS  Google Scholar 

  40. Cannon WB. “Voodoo” death. Am Anthropol 1942: 44: 169–181.

    Article  Google Scholar 

  41. Burrell RJW. The possible bearing of curse death and other factors in Bant culture on the etiology of myocardial infarction. In: James TN and Key JW, eds. The etiology of myocardial infarction. Henry Ford Hospita International Symposium. Boston: Little Brown and Co, 1963.

    Google Scholar 

  42. Wolf S. Neural mechanisms in sudden cardiac death. The Jeremiah Metzge Lecture. Trans Am Clin Climatol Assoc 1967: 79: 158–176.

    Google Scholar 

  43. Cannon WB, Again the James-Lange and the thalamic theories of emotion. Psychol Rev 1931: 38: 281–295.

    Article  Google Scholar 

  44. Rockstroh B, Elbert T, Birbaumer N, and Lutzenberger W. Slow brai potentials and behavior. Baltimore: Urban and Schwarzenberg, 1982: pp. 12 and 169.

    Google Scholar 

  45. Nauta WJH. Some afferent connections of the prefrontal cortex in th monkey. In: Warren JW and Akert K, eds. The frontal granular cortex an behavior. New York: McGraw-Hill, 1964: 372–396.

    Google Scholar 

  46. DeVito J, Smith O, Stein J, and Walsh K. Autoradiographic analysis or hypothalamic area controlling cardiovascular response to emotion. Abstr Soc Neurosci 1979: 5: 230.

    Google Scholar 

  47. Smith OA, Astley CA, DeVito JL, Stein JM, and Walsh KE. Functiional analysis of hypothalamic control of the cardiovascular responses accompanying emotional behavior. Fed Proc 1980: 39: 2487–2494.

    PubMed  CAS  Google Scholar 

  48. Galosy RA, Clarke LK, Vasko MR, and Crawford IL. Neurophysiology and neuropharmacology of cardiovascular regulation and stress. Neurosci and Biobehav Revs 1981: 5: 137–175.

    Article  CAS  Google Scholar 

  49. Maclean, PD, The triune brain, emotion and scientific bias. In: Schmitt FO, ed. The Neurosciences, Second Study Program. New York: Rockefeller University Press, 1970: 336–348.

    Google Scholar 

  50. Timms RJ. Cortical inhibition and facilitation of the defense reaction. J Physiol 1977: 266: 98–99.

    Google Scholar 

  51. Skinner JE, Montaron M-F, and Pratt CM, Bilateral cryogenic blockade of the amygdaloid central nuclei will prevent ventricular fibrillation in the ischemic heart of the psychologically stressed pig. Soc Neurosci Abstr 1983: 9: 1057.

    Google Scholar 

  52. Skinner JE, Beder SD, and Entman ML. Psychological stress activates Phosphorylase in the heart of the conscious pig without increasing heart rate and blood pressure. Proc Natl Acad Sci USA 1983: 80: 4513–4517.

    Article  PubMed  CAS  Google Scholar 

  53. Baust W and Bohnert B. The regulation of heart rate during sleep. Exp Brain Res 1969: 7: 169–180.

    Article  PubMed  CAS  Google Scholar 

  54. Skinner JE, Mohr DN and Kellaway P. Sleep-stage regulation of ventricular arrhythmias in the unanesthetized pig. Circ Res 1975: 37: 342–349.

    PubMed  CAS  Google Scholar 

  55. Matta RJ, Lawler JE, and Lown B. Ventricular electrical instability in the conscious dog. Effects of psychologic stress and beta adrenergic blockade. Am J Cardiol 1976: 38: 594–598.

    Article  PubMed  CAS  Google Scholar 

  56. Pratt CM, Skinner JE, Montaron M-F and Entman ML, Evidence of a central nervous system site of action of antiarrhythmic drugs (in preparation) 1984. See also Skinner JE, Montaron M-F and Pratt CM. The efficacy of antiarrhythmic drugs in cardiac patients is proportional to their ability to reduce the amplitude of the cerebral event-related slow potential. Soc Neurosci Abstr 1982: 8: 428.

    Google Scholar 

  57. Knight RT, Hillyard SA, Woods DL and Neville HJ. The effects of frontal and temporal-parietal lesions on the auditory evoked potential in man. Electroenceph Clin Neurophysiol 1980: 50: 112–124.

    Article  PubMed  CAS  Google Scholar 

  58. Pratt CM, Skinner JE and Evans MB. Covariation of ventricular arrhythmia rates and cerebral event-related slow potentials during 24-hour ambulatory monitoring in cardiac patients with high ectopy. (In preparation) 1984.

    Google Scholar 

  59. Rossi GF and Zanchetti A. The brainstem reticular formation: anatomy and physiology. Arch Ital Biol 1957: 95: 199–435.

    Google Scholar 

  60. Skinner JE and Lindsley DB. The nonspecific medio-thalamic frontocortical system: its influence on electrocortical activity and behavior. In: Pribram KH and Luria AR, eds. Psychophysiology of the frontal lobes. New York: Academic Press, 1973: pp. 185–234.

    Google Scholar 

  61. Skinner JE and King GL. Electrogenesis of event-related slow potentials in the cerebral cortex of conscious animals. In: Pfurtscheller G, et al., eds. Rhythmic EEG activities and cortical activities. Amsterdam: Holland Beomedical Press, 1980: pp. 21–32.

    Google Scholar 

  62. Skinner JE, and King GL. Contribution of neuron dendrites to extracellular sustained potential shift. In: Kornhuber HH and Deeke L, eds. Motivation, motor and sensory processes of the brain: electrical potentials, behavior and clinical use. Prog Brain Res. Elsevier/North Holland Biomedical Press, 1980: pp. 89–102.

    Google Scholar 

  63. Libet B. Slow postsynaptic responses of sympathetic ganglion cells as models for slow potential changes in the brain. In: Otto DA, ed. Multi-disciplinary perspectives in event-related brain potential research. Washington, D. C.: US Environmental Protection Agency, 1978: pp. 12–18.

    Google Scholar 

  64. Ashton H, Millman JE, Telford R, and Thompson JW. The effect of caffiene, nitrazepam, and cigarette smoking on the contingent negative variation in man. Electroencephalogr Clin Neurophysiol 1974: 37: 59–71.

    Article  PubMed  CAS  Google Scholar 

  65. Teece JJ and Cole JO. Amphetamine effects in man: Paradoxical drowsiness and lowered electrical brain activity (CNV). Science 1974: 185: 451–453.

    Article  Google Scholar 

  66. Thompson JW, Newton P, Pocock PV, Cooper R, Crow H, McCallum WC, and Papakostopoulos D. Preliminary study of pharmacology of contingent negative variation in man. In: Otto, DA, ed. Multi-disciplinary perspectives in event-Related brain potential reseach. Washington, D. C.: US Environmental Protection Agency, 1978: pp. 51–55.

    Google Scholar 

  67. Marczynski TJ. In: Otto DA, ed, Multidisciplinary perspectives in event-related brain potential research. Washington, D. C.: US Environmental Protection Agency, 1978: pp. 25–35.

    Google Scholar 

  68. Hashiguchi T, Kobayashi H, Tosaka T, and Libet B. Two muscarinic depolarizing mechanisms in mammalian sympathetic neurons. Brain Res 1982: 242: 378–382.

    Article  PubMed  CAS  Google Scholar 

  69. Brown DA and Adams PD. Muscarinic suppression of a novel voltage-sensitive K+ current in a vertebrate neuron. Nature 1980: 283: 673–676.

    Article  PubMed  CAS  Google Scholar 

  70. Cole AE and Nicoll RA. Acetylcholine mediates a slow synaptic potential in hippocampal pyramidal cells. Science 1983: 221: 1299–1301.

    Article  PubMed  CAS  Google Scholar 

  71. Halliwell JV and Adams PR. Voltage-clamp analysis of muscarinic excitation in hippocampal neurons. Brain Res 1982: 250: 71–79.

    Article  PubMed  CAS  Google Scholar 

  72. Madison DV and Nicoll RA. Noradrenaline blocks accomodation of pyramidal cell discharge in the hippocampus. Nature 1982: 299: 636–638.

    Article  PubMed  CAS  Google Scholar 

  73. Haas H and Konnerth A. Histamine and noradrenaline decrease calcium activated conductance in hippocampal pyramidal cells. Nature 1983: 302:432–435.

    Article  PubMed  CAS  Google Scholar 

  74. Krnjevic K, Pumain R, and Renaud L. Effects of Ba2+ and tetra-ethylammonium on cortical ceurones. J Physiol 1971: 215: 223–245.

    PubMed  CAS  Google Scholar 

  75. Heinemann U and Lux HD. Undershoots following stimulus-induced rises of extracellular potassium concentration in cerebral cortex of cat. Brain Res 93: 63–76.

    Google Scholar 

  76. Skinner JE and Molnar M. Event-related extracellular potassiumion activity changes in the frontal cortex of the conscious cat. J Neurophysiol 1983: 49: 204–215.

    PubMed  CAS  Google Scholar 

  77. Skinner JE, Welch KMA, and Helpern JA. Neurochemical basis of the cortical event-related slow potential. J Neurochem (in preparation) 1984.

    Google Scholar 

  78. Skinner JE. Central gating mechanisms that regulate event-related potentials and behavior. In: Elbert T, Rockstroh B et al, eds. Self-regulation of the Brain and Behavior. New York: Springer 1984: 42–58.

    Google Scholar 

  79. Pettigrew JD and Kasamatsu T. Local perfusion of noradrenaline maintains visual cortical plasticity. Nature 1978: 271: 761–763.

    Article  PubMed  CAS  Google Scholar 

  80. Kasamatsu T. and Pettigrew JD. Depletion of brain catecholamines: Failure of ocular dominance shift after monocular occlusion in kittens. Science 1976: 194: 206–208.

    Article  PubMed  CAS  Google Scholar 

  81. Kasamatsu T and Pettigrew JD. Preservation of binocularity after monocular deprivation in the striate cortex of kittens treated with 6-OHDA. J Comp Neurol 185: 163–182. This same effect was reported in Houston (1984) to be produced by cortical infusion of propranolol; personal communication from T. Kasamatsu.

    Google Scholar 

  82. Daw NW, Rader RK, Robertson TW, and Ariel M. Effects of 6-hydroxydopamine on visual deprivation in the kitten striate cortex. J Neurosci 1983: 3: 907–914.

    PubMed  CAS  Google Scholar 

  83. Bliss TVP, Goddard GV, and Rives M. Reduction of long-term potentiation in the dentate gyrus of the rat following selective depletion of monoamines. J Physiol London 1983: 334: 475–491.

    PubMed  CAS  Google Scholar 

  84. Cotman CW, and McGaugh JL. Behavioral Neuroscience. New York: Academic Press, 1980.

    Google Scholar 

  85. Thompson RF. In: McFadden D, ed. Neural mechanisms in behavior. New York: Springer Verlag, 1980: p. 172.

    Google Scholar 

  86. Goddard GV. In: Wada JA, ed. Kindling 2. New York: Raven Press, 1981: pp. 1–14.

    Google Scholar 

  87. Hopkins WJ and Johnston D. Noradrenergic modulation of long-term potentiation in the hippocampus. Soc Neurosci Abstr 1982: 8: also Science (in press), 1984.

    Google Scholar 

  88. Teuber HL. Some effects of frontal lobotomy in man. In: Warren JM and Akert K, eds. The Frontal Granular Cortex and Behavior. San Francisco: McGraw Hill, 1964: 332–333

    Google Scholar 

  89. Rockstroh B, Elbert T, Birbaumer N and Lutzenberger W. Slow Brain Potentials and Behavior. Baltimore: Urban and Schwarzenberg, 1982: 128 and 169.

    Google Scholar 

  90. Heilman KM, Schwartz HD and Watson RT. Hypoarousal in patients with the neglect syndrome and emotional indifference. Neurology 1978: 28: 229–232.

    PubMed  CAS  Google Scholar 

  91. Bard P. Anatomical organization of the central nervous system in relation to control of the heart and blood vessels. Physiol Rev 1960: 40 (Suppl 4): 3–26.

    Google Scholar 

  92. Hilton SM. Inhibition of the baroreceptor reflex by the brainstem defense centre. In: Sleight, P, ed. Arterial Baroreceptors and Hypertension. Oxford: Oxford university Press, 1980: 318–323.

    Google Scholar 

  93. Biliman GE, Schwartz PJ and Stone HL. Baroreceptor reflex control of heart rate: a predictor of sudden cardiac death. Circulation 1982: 66: 874–880.

    Article  Google Scholar 

  94. Schwartz PJ, Billman GE and Stone HL. Autonomic mechanisms in ventricular fibrillation induced by myocardial ischemia during exercise in dogs with healed myocardial infarction. Circulation (in press) 1984.

    Google Scholar 

  95. Billman GE, Schwartz PJ and Stone HL. Effects of daily exercise on susceptibility to sudden cardiac death. Circulation (in press) 1984.

    Google Scholar 

  96. Watanabe A. Cholinergic agonists and antagonists. In: Rosen MR and Hoffman BF, eds. Cardiac Therapy. Boston: Martinas Nijhoff 1983: 95–144.

    Google Scholar 

  97. Beta-blocker Heart Attack Trials Research Group. A randomized trial of propranolol in patients with acute myocardial infarctions. JAMA 1982: 247: 1707–1714.

    Article  Google Scholar 

  98. Goodman LS and Gillman A. The Pharmacological Basis of Therapeutics. New York: MacMillan, 1970: 569.

    Google Scholar 

  99. Solomon S. Long Island Jewish-Hillside Medical Center. In Graedon, J (reporter) Does drug cause loss of memory? The Houston Post, September, 1983.

    Google Scholar 

  100. Axelrod J and Reisine TD. Stress hormones: their interaction and regulation. Science 1984: 224: 452–459.

    Article  PubMed  CAS  Google Scholar 

  101. Bloom F. Preliminary data reported in Houston, Univer. of Texas, 1983.

    Google Scholar 

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  1. James E. Skinner
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  1. University of Manitoba, Canada

    Robert E. Beamish , Pawan K. Singal  & Naranjan S. Dhalla ,  & 

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Skinner, J.E. (1985). Psychosocial Stress and Sudden Cardiac Death: Brain Mechanisms. In: Beamish, R.E., Singal, P.K., Dhalla, N.S. (eds) Stress and Heart Disease. Developments in Cardiovascular Medicine, vol 45. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-2587-1_3

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