Siriraj – Center of interventional neuroradiology

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What is Interventional Neuroradiology

Interventional Neuroradiology is a minimally invasive procedure using image-guiding techniques to insert a small tube or microcatheter, along with agents and devices, through a percutaneous route, usually at the groin area, in order to accomplish a wide variety of neurovascular conditions of the central nervous system, the head and neck region, the spine including vascular anomaly of whole body. Hence, this treatment technique diminishes the need for open surgery, leading to short hospital stays, fast recovery time, and decrease procedural risks.

The most common treatments in the practice of our dedicated experts 

  • Acute ischemic stroke by navigating clot retriever devices directly to the site of occlusion in the intracranial vessels, the so-called ”mechanical thrombectomy” procedure, which is also benefit in patients who have beyond golden period for intravenous thrombolytic treatment.
  • Chronic stroke and/or TIA (transient ischemic attack) from carotid artery stenosis by deployment of the stent at the stenotic site.
  • Intracranial aneurysms, both presenting with rupture and non-rupture, by endovascular deploying platinum coils through microcatheters into those aneurysmal sacs.
  • Intracranial /intrathecal hemorrhage or other neurological symptoms resulting from arteriovenous malformations (AVMs) or dural arteriovenous fistular (DAVF), by delivering embolic materials to occlude those abnormal vessels.
  • Traumatic vascular injury by direct intravascular closure precisely at the torn vessels by using proper embolic materials.
  • Venous malformations of whole body by direct intralesional injection of sclerosing agents.

Siriraj The Quality – Assured Organization

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Since the founding of Siriraj Hospital 134 years ago, a number of fields have advanced to ensure that Thai patients receive the best medical care possible. To ensure that Siriraj is of high quality, we have requested an evaluation of its quality from a number of institutions. The received accomplishments may be classified to the group by Siriraj’s primary missions, which include the following:

1. Medical Services

  • As the first institution in Thailand, the Healthcare Accreditation Institute endorsed the Hospital Accreditation (HA) standard in 2002 and the Advanced Hospital Accreditation (AHA) standard in 2014 and was approved for reaccreditation in 2017. The AHA standard has been evaluated for the hospital’s quality system, indicating that the institution is a learning, reliable, and high-achievement organization.
  • Three sub-organizations of SIRIRAJ, including Knee Joint Transplantation, Liver Transplantation (in 2016), and the Diabetes Center (in 2021), acquired Disease-Specific Certification (DSC).
  • Siriraj Piyamaharajkarun Hospital passed the Joint Commission International (JCI) assessed in 2014 as the first institute in Thailand.
  • All laboratories of Siriraj pass the ISO standards, classified as 40 of ISO 15189, 40 of ISO 15190, and 3 of ISO 17025.
  • The Thailand Productivity Institute certifies the quality of various organizations with the Thailand Quality Award. Siriraj acquired Thailand Quality Class (TQC) in 2016, TQC + (Operation) in 2020, and TQC + (Innovation) in 2021, the first of the educational institute and medical school category.

2. Medical Education

Undergraduate Education 

  • World Federation of Medical Education (WFME) certified medical program since 2015. SIRIRAJ is 1 of 3 medical schools in Thailand to acquire this standard.
  • Bachelor’s Degree Program in Applied Traditional Thai Medicine is Certified by the AUN-QA.
  • Bachelor’s Degree Program in Educational Technology in Medicine is Certified by AUN-QA.

Postgraduate Education        

  • All Resident training programs have been certified by WFME since 2018 (31 curriculums).
  • Master program in Immunology and in Anatomy certified by AUN-QA.

3. Research of SIRIRAJ

  • SIRIRAJ was the only Thai institution accredited by the Association for the Accreditation of Human Research Protection Program (AAHRPP) in 2014. AAHRPP accreditation is the global gold standard for research centers involving volunteers and is committed to conducting safe and ethical research that meets rigorous standards for quality and protection. The accreditation assures research participants, researchers, sponsors, government regulators, and the general public that an Organization’s human research protection program (HRPP) is focused on excellence.

4. Others

  • In 2019, the Knowledge Management Society (KMS) of Singapore presented Siriraj with the Knowledge Ready Organization (KRO) award, making Siriraj the first organization in Thailand to receive it and the 23rd organization in six countries to do so. This award signifies achievement in the learning and development process for quality management.
  • Bangkok GREEN & CLEAN Hospital Plus Award (BKKGC+), Diamond Level, in 2019-2020
  • Green Government Building Awards on Wastewater Management
  • Low Emission Support Scheme Award

Despite the fact that rewards can help to ensure high level of quality or achievement, Siriraj believes that trust, loyalty, and dependability are more crucial. As a result, Siriraj never stops at the rewards. We prioritize development to provide a fervent service that will win hearts and forge a lasting bond between the hospital and the patients.

The first world allergy organization center of excellence in ASEAN

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Siriraj Center of Research Excellence in Allergy & Immunology (SiCORE Allergy & Immunology) was established in 2017 with the aim to promote excellence in clinical care and higher education through quality research and innovation. The team members include multidisciplinary healthcare professionals from otorhinolaryngology, pediatrics, and internal medicine subspecialties. The other mission is to help local and international doctors advance their studies, so we offer an MS and PhD program in Biodesign in Medicine, as well as Fellowship Training in Rhinology and Allergy, and Allergy and Immunology in relevant departments.

SiCORE Allergy & Immunology’s significant research and innovation.

  • The intranasal cockroach allergy immunotherapy was developed to find the non-injection alternative for allergen-specific immunotherapy. After receiving GMP certification and patent, the product is currently under the process of a first-in-human (FIH) clinical trial.
  • The Diagnostic test kit for aero allergy, which consists of the 8 common allergens, has been endorsed by the Thai Food and Drug Administration (FDA) and released on the market.
  • House dust mite allergen vaccine for subcutaneous injection was also endorsed by the Thai FDA. It is the only option for allergic treatment with the ability to ‘cure’ the allergic diseases, especially allergic rhinitis, allergic asthma, and atopic dermatitis.
  • The development of component-resolved diagnostics (CRD) which allows clinicians to identify real allergen sensitization and helps to differentiate between cross-reactivity and co-sensitization. The component identification is also beneficial for the future development of recombinant allergen immunotherapy, which is a new trend in allergic treatment.
  • The Siriraj Dust Mite Center, Asia’s only dust mite center, is well known for producing the highest quality pure mite bodies in the world. The center offers services on dust mite production for research, dust analysis, anti-dust mite product test and research design on dust mite study.

The first allergy organization center of ASEAN

Until recently, 4 Patents and 7 Petty Patents related to cockroach and dust mite allergy and allergen extract have been issued to SiCORE Allergy & Immunology, along with 2 FDA-approved products (Therapeutic house dust mite vaccine and Allergen extract for diagnostic purposes). Additionally, in February this year, The World Allergy Organization (WAO), an international umbrella organization whose members consist of 103 regional and national allergology and clinical immunology societies, endorsed SiCORE Allergy & Immunology as a Center of Excellence (COE) for the term 2022-2024. To become the first COE in ASEAN and the 4th in Asia (after China, Japan, and South Korea), we can collaborate with other COE to provide scientific support and educational resources on a global scale. Furthermore, we could form international partnerships for research and education activities.

Although it appears that we are on the right track, we will continue to improve and learn from our mistakes as we progress toward great success. We always keep in mind that our ultimate goal is to transform health care services, not just to finish our research projects!

Siriraj – the first hub of robotic assisted joint replacement

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First center of hip and knee joint replacement surgery

Faculty of Medicine Siriraj Hospital was one of the first center in Thailand that provided the hip and knee joint replacement surgery, about 50 – 60 years ago. As time passes, modern technologies improve, and the functions of new hip and knee joints, as well as their longevity, have significantly increased. During the past decade, robots have become more important in many fields including medicine. Robotic-assisted surgery aids joints replacement surgery, and the relevant software has been developed to its best for not just total hip, total knee replacement, but even many small joints such as a patellofemoral joint replacement can be performed now. 

Robotic assisted joint replacement

Many advantages can be achieved from this advancement such as:

  • “The virtual simulation before actual surgery”. A software renders 3D images of the patient’s joint structures, allowing doctors to plan the most precise operation possible for each patient. The virtual simulation could even improve the safety of the surgery.
  • “The precision and accuracy”. Especially in complex cases whose bone or soft tissue have been severely damaged or deformed. For example, the arm of the machine will work according to the pre-operative plan and will stop once the procedure is made out of line more than 1 millimeter. This greatly helps in perfect alignment of the prosthesis which is crucial in joint replacement surgery. It also overcomes the surgeon’s experience dependent situation in the past.
  • “Fast recovery”. The delicacy of the robot could save the major surrounding tissues, such as arteries, veins or nerves, resulting in smaller wound size, less pain and rapid recovery after surgery. The patient can walk within 12-24 hours after surgery.

Siriraj The first hub of Thailand

Right now, in Thailand, Faculty of Medicine Siriraj Hospital is the first one to use this technology. SI Elite Hip and Knee Replacement Excellence Center has been established to serve the patients of the three hospitals: Siriraj Hospital, Siriraj Piyamaharajkarun Hospital, and the Golden Jubilee Medical Center. At the beginning, the robot took longer time than conventional technique, but right now after about 6 months training, the surgical time is not over than 5 minutes when compared to the conventional technique. Since we began utilizing the robot last year, we have completed 120 cases of robotic-assisted joint replacement, the majority of which were knee joint replacements, with excellent results.

We hope to become a referral center and a learning center in the near future, employing this robot to improve the quality of life for patients and to allow doctors from other hospitals across the country to learn the new techniques. We also plan to use telemedicine for patients’ follow up during their recoveries at home. 

Be Our Partners! Thailand Best Medical Institution

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We are Faculty of Medicine Siriraj Hospital

We – the Faculty of Medicine Siriraj Hospital – never stop forging ahead to become ‘a world changer’! We have been harvesting so many experiences and knowledge; therefore, we wish to share these insights with the world.

We’re certain that we have a lot to offer especially to those who are looking for a potential partner in medicine in Thailand. 

Siriraj Hospital, best medical stitutions

Let’s have a look at some evidence below!

  • Holding the top rank of leading medical institutions of Thailand from the beginning – SIRIRAJ has the highest numbers of patient treatments, with the health professional covering all the sub-specialties.
  • Our 16 Excellence Centers (and still counting) – engage and dedicate to finding novel insights, for we could raise the bar to respond to the global healthcare trends and healthcare standards.
  • Convenient access via public transport – we are located on the commuter-friendly complex where you can reach us by roads, river, and rails (by MRT and Skytrain in the near future).
  • We have a great capacity for medical research opportunities both in the basic sciences field and clinical trials – we are fully equipped with cutting-edge research instruments, a highly experienced research team, funding sources, and an international network.
  • The foundation of our hospitality comes from SIRIRAJ’s spirit and belief in ‘public beneficence,’ ‘courtesy,’ ‘mastery,’ and ‘virtue’. Competency in English communication skills of the people on campus eases the language barrier.
  • East meets West Practice – Here we combine the science of modern medicine and the time-honored Thai traditional medicine for the great benefit of our patients.

The Benefit for our partners

The following are some of the valuable benefits for our partners.

  • Increasing your institute’s brand recognition in the ASEAN region, which is one of the major players in the world with over 600 million people. Thailand has great potential as an ASEAN gateway because of its location and numerous robust networks.
  • Initiating a range of collaboration to expand the scope of new learning opportunities through a variety of activities such as student and staff exchange, jointed academic conference, jointed research, dual degree program, and so on.
  • Gaining knowledge in fields of tropical medicine and Thai Traditional Medicine
  • Joining hands to create the innovations in future healthcare and medical education – that promote both the circular resource use and the sustainable partnership
  • We would like to cordially invite medical schools, institutions, or research centers – from all over the world – to get acquainted, share, and exchange what you have with us for a better tomorrow of the next generation. We do believe in the power of partnership that benefits not only on both sides but to the world. With your partnership and collaboration, we know we can.

Thai & Japan Medical School Joint Doctoral Degree Program in Medical Sciences

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Thai & Japan Medical School Collaboration

Since August 2019, in order to support the national educational policy, the Faculty of Medicine Siriraj Hospital in collaboration with Tokyo Medical and Dental University (TMDU), Japan, has opened an international doctoral program in Medical Sciences. The main goals of this program are to develop global leaders who will conduct ongoing research and innovation in order to improve healthcare services. 

Joint Doctoral Degree Program in Medical Sciences

The following are some of the exclusive features of this program.

  1. The leading medical institutes of Thailand (Siriraj) and Japan (TMDU) have joined hands and spent hours after hours brainstorming, arguing and debating, and finally came up with an international program that is one of the most exquisite doctoral programs in medical sciences.
  2. The contents of this Ph.D program are up to date, focusing on a wide range of surgical specialties and disorders, particularly cancers of various organ systems. The program also offers learnings in Clinical Statistics & Informatics, Epidemiology, and Public Health, and Disease Prevention through various learning activities such as classroom, online & video learning, research meeting & consultation, laboratory techniques coaching, and surgical skills development in the operating room, all of which are supervised by many renowned lecturers.
  3. Both basic science research conducting skills and surgical skills are greatly consolidated throughout the program in order to enable the learners to be as competent as possible for their future careers. The program also sharpens creativity and systematic thinking and analytic skills, all of which are crucial for innovation development after completing the education.
  4. The learning activities are conducted in both Thailand and Japan, and the period of stay on either campus can be customized by the students. This provides an opportunity to learn about the diversity in medicine, research, culture, and social aspects that will even broaden the students’ perspectives.
  5. The opportunity of medical capacity enhancement is now available to those who want to achieve great success in medicine, especially surgery. The curriculum intensity and the exquisite expertise of the mentors will push the students to their maximal limits. The number of students is limited to 3 persons per year for the highest quality control. Graduates earn a Ph.D. degree endorsed by two universities which are highly regarded as a credential to success. 

The Application

The applicants must have graduated Doctor of Medicine (MD) or received a Bachelor of Medicine and Bachelor of Surgery (MBBS) with a cumulative grade point average of at least 3.50. The recruitment process will begin in December and end in February, in order to coincide with the start of the first semester in April.

Thailand’s First 4 Abdominal Organs Transplantation

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Case Study About bowels abnormal

Three years ago, Siriraj hospital admitted a female patient who had suffered from entire small bowels and proximal large bowels necrosis resulting from mesenteric vein thrombosis after a duodenal surgery. After repeated surgery, she was unable to eat or swallow anything and required total parenteral nutrition to survive. Her liver and pancreas were also damaged from ischemia and long-term intravenous nutrition.

“It was a terrible tragedy that I couldn’t do such basic daily activities as eating, chewing, swallowing, or even feeling full” the patient once moaned while waiting for the bowels transplantation which was the only option to put her back to normal life.

Bowels Transplantation Operation 

In Thailand, bowel transplantation operations have never been done before. Not only is it a complicated surgery, but the donated bowels must come from a blood-group-compatible and healthy donor close to Bangkok, as the small intestine is a delicate organ that cannot endure long periods of ischemia. It took more than 2 years before we finally received a perfect donation. In April 2021, 4 surgeons from the Siriraj transplantation surgery team traveled an hour away to a hospital to retrieve donated abdominal organs, which were liver, pancreas, stomach, and small bowels, which took nearly 3 hours. On the way back to Siriraj Hospital, another 4 surgeons, 3 anesthesiologists, and 15 surgical nurses had started a surgery to prepare the patient’s intra abdominal conditions for the impending unprecedented transplantation. 

The First 4 Abdominal Organs Transplantation

After 7 hours of intense strain and tiredness, the first-in-Thailand surgery was satisfactorily finished because of the surgeons’ expertise and excellent teamwork, and the patient uneventfully recovered a few days afterward. Parenteral nutrition was completely stopped 1 month later and the patient was discharged home to resume her normal life again.

“My first bite in years was quite a weird feeling, but I was overjoyed. I could not put into words how much I’m grateful to the whole team.” The patient stated when she came for a follow-up and was still doing well.

After the first successful kidney transplantation in 1973, Siriraj continues to provide help for the patients who require organ transplantation. Today, the transplantation team performs approximately 80 organ transplants/year including kidney, liver, heart, lung, and, most recently, intestines. Not only holding many country’s records,  but Siriraj hospital is also one of the hospitals that perform the highest number of organ transplants in Thailand with the best possible standard! 

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The best-in-class of Thailand’s ‘Precision Radiotherapy

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What is MRI-LINAC?

MRI-LINAC is a ground-breaking linear accelerator system equipped with a fully integrated diagnostic 1.5 Tesla MRI scanner. The cutting-edge technology of the fully integrated MRI with real-time on-board imaging is superior to CBCT for its precise localization of the tumor whereabouts, correction for internal target and organ motion, and adaptation for daily anatomical changes, such as respiratory motion, bowel gas movement, or bladder filling, enabling the most optimal radiation that destroys the tumor cells without damaging the surrounding normal tissue. 

For moving tumor targets, the system combined with a computerized multi-leaf collimator, allows tracking of tumor targets for exceptionally accurate radiation delivery. Moreover, many common long-term complications from radiation could be avoided with this easy-to-use device, resulting in substantially higher quality of life for the patients after completion of treatment. To date, the MRI-LINAC is the best-in-class of the truly personalized real-time adaptive precision radiotherapy system in the world.

Siriraj Hospital – The First Hospital in Thailand to install MRI-LINAC

Faculty of Medicine Siriraj Hospital, Mahidol University, is the first in Southeast Asia and the only hospital in Thailand to install the UNITY® 1.5T MRI 7MV-Linear accelerator for clinical use in radiation therapy and research program in December 2019. More than 140 cases have been treated over a two-year period, the majority of which is prostate cancer. The survival rate is satisfactorily high, at 100 percent, with 98 percent biochemical control. The occurrence of acute and late radiation-induced genitourinary toxicity has been significantly decreased from approximately 10% to 3% and even lower for gastrointestinal toxicity, resulting in better quality of life of the patients.

The Efficiency of MRI-LINAC

Siriraj’s radiation oncology team expects that the MRI-LINAC will enhance and maximize tumor control to benefit cancer patients, for example, prostate cancer, bladder cancer, gynecologic malignancy, and head and neck cancer. Many studies employing this approach are currently underway to explore better possible solutions for many conditions, and we are certain that we will be able to offer a new chapter in cancer treatment, which is precision cancer radiotherapy, to serve Thai patients as well as those in the ASEAN region.

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Mahidol University – The front runner of Thailand medicine

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“It’s not about being the best, it’s about being better than you were yesterday.”

Every year, many organizations distribute the results of international university ranking to provide deep insights about the quality of higher education and academic excellence to people pursuing education or looking for jobs. Those organizations, for example, include Quacquarelli Symonds (QS), Time Higher Education (THE) magazine, US News, Academic Ranking of World Universities (ARWU), and others. 

The indicators used to calculate scores could be varied in several ways, but many of them are shared, such as

  • Teaching reputation
  • Research outputs & Citations
  • Facilities
  • Employability
  • International outlook

Top Ranking of Mahidol University 

It’s been a great pride of Mahidol University to keep its leading position for many years. Here are the examples of evidence.

  • Mahidol University has been holding on to the best place of Thailand University ranking provided by Time Higher Education World University Ranking for 7 consecutive years since 2016.
  • Mahidol University has maintained at the top of Thailand University ranked by Academic Ranking of World Universities for 4 years in a row since 2018.
  • Mahidol University tops the ranking list of Thailand University provided by US News in 2022.
  • Mahidol University is ranked 130th (by THE), and 43th (by QS), among the Best Asian University in 2021.

About Faculty of Medicine Ranking

Mahidol University continues to be Thailand’s top university when ranked by subject medicine.

  • THE World University Ranking has recognized Mahidol University as the best in Thailand’s Medicine since 2018.
  • QS World University Ranking has placed Mahidol University at the top of Thailand’s Medicine since 2015.
  • Mahidol University has remained the best in Thailand’s clinical medicine on the ranking provided by ARWU since 2017.
  • Mahidol University again tops on Thailand’s clinical medicine on the list of US News in 2022.

Faculty of Medicine Siriraj Hospital joins forces with Faculty of Medicine Ramathibodi Hospital and Faculty of Tropical Medicine to make a greater contribution from Mahidol University to the local and global communities. We always realize that getting to the top is difficult, and staying there is even more challenging, which is the reason we work harder every day. To make our forefront position deserving, we commit ourselves to work tirelessly to inspire a new generation of thinkers and learners, as well as to help shape our world into a better place to live for all. We do believe that’s the best way to merit the trust we’ve received.

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Thailand’s Leader in Fetal Therapy – SIRIRAJ HOSPITAL

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“Love before first sight does exist.”

It’s been said that babies are like little suns that, in a magical way, bring warmth, happiness, and light to the families.

However, not every baby is born intact, since 1-2% of them may have some kind of physical anomalies, some of which are severe enough to cause death shortly after birth.

Thanks to the advancement in medicine that now we can provide intrauterine treatments to the unborn babies resulting in improved survival rate and fewer collateral consequences.

What is Siriraj fetal therapy center?

Siriraj fetal therapy center began employing a fetoscope in 2006 and was the first in Thailand to be successful in treating Twins to Twins Transfusion Syndrome (TTTS) by coagulating the connecting vessels in the placenta with a laser beam to reduce imbalanced perfusion. Since then, the center has continued to apply more techniques including radiofrequency ablation (RFA), and bipolar coagulation and have successfully treated more than 400 pairs of twin pregnancies until now.

The center also provides various other intrauterine procedures, for example 45 cases of intrauterine blood transfusion, 20 cases of shunt placement for treatment of pleural effusion or severe ascites, 5 cases of laser ablation of posterior urethral valve, and 4 cases of fetoscopic endoluminal tracheal occlusion (FETO) for severe congenital diaphragmatic hernia.

What is Congenital diaphragmatic hernia (CDH)?

Congenital diaphragmatic hernia (CDH) is an uncommon congenital anomaly found in 1-5 of approximately 10,000 live births. The herniated abdominal organs compress fetal lungs and cause pulmonary hypoplasia which is fatal in many cases. Surgical treatment after birth remains the treatment of choice but the outcomes are not very satisfactory especially when pulmonary hypoplasia is severe. 

FETO The New Treatment of (CDH)

The new treatment is FETO which shows significant benefit in severe cases of CDH. During 27-29 weeks of pregnancy, with the use of a fetoscope, a small balloon is firmly placed in the fetal trachea to store fluid within the fetal lungs in the hopes of expanding the compressed lungs so that the baby can survive after birth. The balloon will be taken out or decompressed at 34-35 weeks of gestation. 

Multidisciplinary team approach after birth is crucial for survival of the babies with CDH. Postnatal management in the NICU includes intubation and gentle ventilation, correction of pulmonary hypertension, ventricular dysfunction, and acid-base imbalance, as well as the preservation of hemodynamics. Previous studies showed that when compared to expectant management, the survival rate after FETO increased from 0-15 % to 40%. Siriraj hospital as Thailand’s leading referral center has received 33 cases of CHD during the last 5 years. FETO was performed in 4 severe cases and 1 baby survived.

In addition to treatment, Siriaj hospital provides procedural training for both local and foreign doctors. During the process of training, a model developed by Siriraj hospital team will be used for a simulation training to enhance their skills before any actual procedure. Many Thai hospitals are now capable of performing fetoscopic intrauterine procedures, and people no longer have to travel to Bangkok for treatment.

In the future, the center aims to incorporate innovative technologies into the utmost experiences and expertise to improve the core performances while also doing research to bring new insights to this field. The faculty’s philosophy of ‘..to the benefit of mankind’ will always be implemented in this center in order to make the mothers and their babies as safe as possible.

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