JP2006288627A - Blood pressure measuring apparatus, blood pressure measuring method and control program - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To constitute a blood pressure measuring apparatus using the concha and its circumference to enable a user to easily execute the switching of two or more pressurization control modes or the change of the pressurization value. <P>SOLUTION: A blood pressure measuring apparatus includes a cuff to press the concha and the proper place around it, a pressurization means to control the pressure value applied to the cuff, a setting means to set the pressurization control mode used for the control of the pressurization means, and a changing means which senses an operation in a prescribed period after the start of a measuring action and changes the pressurization control mode by the contents of the operation. <P>COPYRIGHT: (C)2007,JPO&INPIT

Description

  The present invention relates to a blood pressure measurement device, a blood pressure measurement method, and a control program, and more particularly to pressurization control of cuff internal pressure.

  Conventionally, two methods are known as automatic pressurization control of cuff pressure of a blood pressure measurement device that measures blood pressure based on a pulse wave signal. The first is a method of measuring the blood pressure by pressurizing the cuff after determining a fixed target pressurization value (fixed pressurization control). The second is without determining the fixed target pressurization value. A method (pulse wave detection pressurization control) in which the cuff is pressurized and control is performed by monitoring the pulse wave during pressurization (for example, pressurization is stopped by disappearance of the pulse wave as a trigger) is employed.

There is a problem in that the blood pressure value needs to be increased again when the pressure is insufficient in the fixed pressure control, which increases the burden on the subject. It can also be a burden on the subject. Therefore, as disclosed in Patent Document 1, a method has been proposed in which the pressurization target value can be dynamically changed during pressurization.
Japanese Examined Patent Publication No. 6-116

  However, when blood pressure is measured using the outer ear and its surroundings, pressurization control is difficult because the cuff volume is small, and it is difficult to pressurize without destroying the pulse wave signal waveform during pressurization. In particular, depending on the subject, the pulse wave signal may be weak, and there is a problem in that it is difficult to perform pressurization control based on the pulse wave signal.

  Therefore, a method of using fixed pressure control alone or in combination is conceivable. However, if a function of switching a plurality of pressure control modes or changing a pressure value is provided, device operation tends to be complicated. There was also a problem that the usability deteriorated for users.

  A cuff that compresses the outer ear and the surrounding area, a pressurizing control unit that controls a pressure value applied to the cuff, a setting unit that sets a target pressure value to be pressed by the pressurizing control unit, and a measurement And changing means for detecting an operation within a predetermined period after the operation is started and changing the pressure target value according to the operation content.

  According to the present invention, it is possible to simplify the switching operation of a plurality of cuff pressure pressurization control modes or the operation of changing the pressurization value when measuring blood pressure. It is also possible to provide a blood pressure measurement device that can reduce the mental and physical burden on the user during the measurement operation.

(First embodiment)
As a first embodiment of the electronic sphygmomanometer according to the present invention, a fixed pressurization mode in which a cuff is pressurized and measured to a predetermined pressure value is used as an initial pressurization control mode, and pressurization is performed based on a pulse wave by a predetermined operation. A photoelectric volume pulse wave sphygmomanometer that can be changed to a pulse wave detection pressurization mode that dynamically determines a value will be described below as an example.

<Device configuration>
FIG. 1 shows the configuration of the photoelectric volume pulse wave sphygmomanometer of the first embodiment. Reference numeral 101 denotes a cuff, which is fixed to a blood pressure measurement site. Reference numeral 102 denotes an air tube that forms a flow path of air into the cuff 101. Reference numeral 103 denotes a pressure pump that feeds pressurized air into the cuff 101. Reference numeral 104 denotes a rapid discharge valve that rapidly reduces the pressure in the cuff 101. 105 is a fine exhaust valve that reduces the pressure in the cuff 101 at a constant speed (for example, 2 to 3 mmHg / sec). A pressure sensor 106 changes an electrical parameter according to the pressure in the cuff 101. A pressure detection amplifier (AMP) 107 detects an electrical parameter of the pressure sensor 106, converts it into an electrical signal, amplifies it, and outputs an analog cuff pressure signal P (not shown).

  Reference numeral 108 denotes a pulse wave sensor installed in the cuff 101, which includes an LED 108a that irradiates light to a pulsating vascular blood flow, and a phototransistor 108b that detects reflected light from the vascular blood flow. Reference numeral 109 denotes a pulse wave detection amplifier (AMP) that amplifies the output signal of the phototransistor 108b and outputs an analog pulse wave signal M (not shown). Here, a light amount control unit 118 that automatically changes the light amount is connected to the LED 108a, while a pulse wave detection amplifier 109 is connected to a gain control unit 119a that automatically changes the gain and time constant control that changes the time constant. Part 119b is connected. Reference numeral 110 denotes an A / D converter (A / D), which converts analog signals M and P (not shown) into digital data.

  Reference numeral 111 denotes a control unit (CPU) which performs main control of the present photoelectric volume pulse wave sphygmomanometer. Details of this control will be described later according to the flowcharts of FIGS. 7 and 8 (or FIGS. 4 and 5). Reference numeral 112 denotes a ROM that stores various control programs executed by the CPU 111 and various parameters (such as an initial value of a pressurization value and a parameter for deriving a pressure value from an output signal of a pressure sensor). As examples of various control programs, there are programs that are executed by the CPU 111 and perform the control shown in FIGS. 7 and 8 (or FIGS. 4 and 5), for example. Reference numeral 113 denotes a RAM which includes a data memory for temporarily storing data, an image memory for image display, and the like. A liquid crystal display (LCD) 114 displays the contents of the image memory. Reference numeral 116 denotes a keyboard, which can perform a measurement start command, an adjustment pressure value setting, and the like by a user operation. Reference numeral 115 denotes a buzzer, which informs the user that the device has sensed that a key in the keyboard 116 has been depressed, the end of measurement, and the like. In the present embodiment, the CPU 111 is provided with the register 111 a for storing the pressurization value, but may be provided in the RAM 113.

  FIG. 2 shows an external perspective view of the photoelectric volume pulse wave sphygmomanometer of the first embodiment. Reference numeral 200 denotes a sphygmomanometer body, which includes a configuration excluding the cuff 101 and the pulse wave sensor 108 of FIG. Here, the air tube 102 includes a signal line (not shown) and is connected to a cuff 101 and a pulse wave sensor 108 (not shown). The LCD 114 uses a dot matrix type display panel, and therefore can display a variety of information (for example, characters, figures, signal waveforms, etc.). Reference numeral 201 denotes a power switch, and the keyboard 116 has a measurement start switch (ST) and a numeric keypad for inputting various setting values. Here, a sphygmomanometer having a numeric keypad is shown to allow manual numeric input, but the numeric keypad may be omitted if numeric input is not necessary.

<How to attach to measurement site>
FIG. 3 shows a diagram of an example of attaching a cuff to the outer ear peripheral portion which is a measurement site. In order to use the outer ear part, particularly the tragus and its periphery as a measurement site, the measurement part including the cuff is configured to press, for example, the tragus from both sides as shown in FIG.

<Blood pressure measurement operation of the device>
FIG. 5 shows a flowchart of a blood pressure measurement processing procedure in the photoelectric volume pulse wave sphygmomanometer of the first embodiment. However, only the flow when the pulse wave detection pressurization control mode is selected in the pressurization mode setting described later is shown. When the fixed pressurization control mode is selected, the operation is almost the same as the flowchart of FIG. 8 in a third embodiment described later.

  When the apparatus is turned on by the power switch 201, the CPU 111 first reads a self-diagnosis program and initial parameters stored in the ROM 112, performs self-diagnosis processing, initializes the apparatus, and enters a standby state. Thereafter, the blood pressure measurement process is started by pressing the measurement start switch ST.

  In step S501, the cuff pressure value P, which is a residual pressure value, is read from the pressure sensor.

  In step S502, it is determined whether or not P derived in step S501 is within a specified range (within an error range). If it is within the error range, the process proceeds to step S503, and if it is out of the range, step S503 is performed. The process proceeds to S518 and a residual pressure error is displayed.

  In step S503, the cuff pressure control mode is selected and changed. The selection / change operation of this pressurization control method will be described in detail later.

  In step S504, the pulse wave signal gain (light quantity and gain) is set.

  In steps S505 and S506, the quick exhaust valve 104 and the fine exhaust valve 105 are closed after the gain setting and the pressurization value setting are completed. In step S507, the driving of the pressure pump 103 is started, and in step S508, the cuff pressure is increased until a feature point corresponding to a feature point (b) in FIG. That is, pressurization is performed until the pulse wave disappears. Actually, it is desirable to pressurize to a pressure value (for example, +30 mmHg) higher than the cuff pressure at which the pulse wave signal disappears.

  In step S509, the pressure pump 103 is stopped, and in step S510, the fine exhaust valve 105 is opened, and the cuff pressure is started to decrease at a constant speed (for example, 2 to 3 mmHg / sec).

  In step S511, data processing by each functional block is performed during the period when the cuff pressure is decreasing, and measurement of the maximum blood pressure and the minimum blood pressure is performed. The operation for deriving the blood pressure value will be described in detail later.

  In step S512, it is determined whether or not a minimum blood pressure value is detected during decompression (for example, whether or not a feature point (d) in FIG. 4 to be described later is detected). Proceed to S515.

  In step S513, it is determined whether or not the cuff pressure is lower than a predetermined value L (for example, 40 mmHg). If P <L, it is still in the normal measurement range, and the flow returns to step S511. On the other hand, when P <L, the cuff pressure is already lower than the normal measurement range, so “measurement error” is displayed on the LCD 114 in step S514. If necessary, detailed information such as “abnormal signal during decompression” may be additionally displayed.

  In step S515, when the measurement is completed in the determination in step S512, the measurement process is completed in the normal measurement range. The remaining air in the cuff 101 is rapidly exhausted, and the maximum blood pressure value and the minimum blood pressure measured on the LCD 114 in step S516. The value is displayed, and a tone signal is sent to the buzzer 115 in step S517. Preferably, different tone signals are sent after normal termination and abnormal termination, the measurement is terminated, and the next measurement start is awaited.

<Pressure control method (mode) selection / change detailed operation>
The blood pressure measurement device has a “fixed pressurization control mode” that pressurizes to a given pressurization value in the internal ROM 112 and a “pulse wave detection pressurization control mode” that dynamically determines the pressurization value based on the pulse wave. Has a control program. In the following, for simplicity of explanation, as a blood pressure measurement device that operates in the fixed pressurization control mode in the normal state and operates in the pulse wave detection pressurization control mode when a predetermined change operation is performed by the user. explain.

  When the fixed pressurization control mode is selected (that is, when the changing operation is not performed), the same operation as the flowchart corresponding to FIG. 9 described in the third embodiment to be described later may be performed. Good.

  FIG. 6 shows a detailed flowchart of the pressurization mode setting (corresponding to step S503).

  In step S601, the CPU reads the fixed pressurization control mode program code stored in the ROM 112 and the initial value of the pressurization value (for example, 170 mmHg), stores them in the RAM 113 and the register 111a, respectively, and proceeds to step S602. .

  In step S602, waiting for a button pressing operation by the user is started. At this time, the measurement of the standby elapsed time is started using the timer function in the control software, and the process proceeds to step S603. Note that the button may include a dedicated button, but here, it is one of the switches in the keyboard 116 and also serves as a measurement start switch (ST) used as a trigger for starting measurement. .

  In step S603, it is confirmed whether the standby elapsed time is within a predetermined time (for example, 5 seconds). If the predetermined time has not elapsed, the process proceeds to step S604.

  In step S604, it is confirmed whether or not the user has pressed the button. If it has been pressed, the process proceeds to step S605. If it has not been pressed, the process returns to step S603.

  In step S605, the CPU reads the program code of the pulse wave detection pressurization control mode stored in the ROM 112 and stores it in the RAM 113. At this time, the fact that the mode has been changed is displayed on the display unit (not displayed). (Shown). Further, the buzzer may be sounded so that the user can easily confirm that the button has been pressed. Thereafter, the process proceeds to step S504 in FIG.

  In step S603, when the standby elapsed time has passed the predetermined time, the mode is not changed, the flow ends, and the process proceeds to step S504 in FIG.

<Detailed operation of blood pressure measurement>
FIG. 4 is a schematic diagram showing a time series change of the cuff pressure and the pulse wave during the blood pressure measurement operation.

  After pressing the measurement start switch (ST), the pressurization is started after setting the above-described pressurization control mode, and the characteristic points (a) to (d) of the pulse wave signal corresponding to the change of the cuff pressure appear.

  (A) and (d) correspond to the systolic blood pressure, and (b) and (c) correspond to the systolic blood pressure. That is, blood pressure measurement is completed by detecting the feature points (c) and (d) in the measurement at the time of cuff pressure reduction, which is often used. Measurement at the time of cuff pressure increase is also possible, and is achieved by detecting (a) and (b).

  In FIG. 4, the pressurization is started after the mode setting period. However, as shown in FIG. 7, the pressurization may be started during the mode setting period. Moreover, you may comprise so that a blood-pressure measurement may be performed at the time of cuff pressurization.

  At that time, by applying pressure slowly during the mode setting and increasing the pressurization speed after the mode setting is completed, it is possible to cope with a small-capacity cuff that is worn around the outer ear periphery.

  As described above, the photoelectric volume pulse wave sphygmomanometer according to the present embodiment can provide a blood pressure measurement device that can easily select the pressure control method in the cuff when measuring blood pressure.

  Since the intensity of the pulse wave largely depends on individual differences for each user, if it is known in advance that sufficient pulse wave can be obtained, change to pulse wave detection pressurization mode and measure It is possible to perform pressurization control according to the blood pressure value at that time.

(Second Embodiment)
In the second embodiment, the operation when the start button is pressed again shifts from a fixed pressurization mode in which pressurization is performed to a given pressurization value to a manual pressurization mode in which pressurization control is performed manually by the user. This is different from the first embodiment. Therefore, only the part related to the operation of the apparatus will be described in detail. The detailed operation of selecting and changing the pressurization control method (mode) itself is substantially the same as the description using FIG.

<Blood pressure measurement operation of the device>
When the manual pressurization mode is set, for example, the pressure value in the cuff obtained by the pressure sensor 106 is displayed on the LCD 114 in real time, and the pressurization operation is performed when a button (ST) that is one of the switches of the keyboard 116 is pressed. It is configured to stop when not pressed, and the user can freely set the pressurization value. It can be used when more precise blood pressure measurement is required.

(Third embodiment)
In the third embodiment, the apparatus configuration is substantially the same as in the first embodiment, except that the operation when the start button is pressed again is a change in the pressurization value in the fixed pressurization mode. Therefore, only the part related to the operation of the apparatus will be described in detail.

<Blood pressure measurement operation of the device>
FIG. 8 shows a flowchart of a blood pressure measurement processing procedure in the photoelectric volume pulse wave sphygmomanometer of the third embodiment.

  When the apparatus is turned on by the power switch 201, the CPU 111 first reads a self-diagnosis program and initial parameters stored in the ROM 112, performs self-diagnosis processing, initializes the apparatus, and enters a standby state. Thereafter, the blood pressure measurement process is started by pressing the measurement start switch ST.

  In step S801, the cuff pressure value P, which is a residual pressure value, is read from the pressure sensor.

  In step S802, it is determined whether or not P derived in step S801 is within a specified range (within an error range). If it is within the error range, the process proceeds to step S803, and if it is out of the range, step S803 is performed. The process proceeds to S818 and a residual pressure error is displayed.

  In step S803, a cuff pressurization value U (for example, a value larger than the maximum blood pressure value such as 120 to 280 mmHg) is set. The operation of setting the pressure value will be described in detail later.

  In step S804, the gain (light quantity and gain) of the pulse wave signal is set.

  In steps S805 and S806, after the gain setting and the pressurization value setting are completed, the rapid exhaust valve 104 and the fine exhaust valve 105 are closed. In step S807, the driving of the pressure pump 103 is started, and in step S808, the cuff pressure is increased until P> U.

  In step S809, when P> U, the pressure pump 103 is stopped, and in step S810, the fine exhaust valve 105 is opened, and the cuff pressure is started to decrease at a constant speed (for example, 2 to 3 mmHg / sec).

  In step S811, data processing by each functional block is performed during the period in which the cuff pressure is decreasing, and the systolic blood pressure and the diastolic blood pressure are measured. The operation for deriving the blood pressure value will be described in detail later.

  In step S812, it is determined whether or not a diastolic blood pressure value is detected during decompression. If it is detected, it is determined that the measurement has been completed, and the process proceeds to step S815.

  In step S813, it is determined whether or not the cuff pressure is lower than a predetermined value L (for example, 40 mmHg). If P <L, it is still in the normal measurement range, and the flow returns to step S811. On the other hand, when P <L, the cuff pressure is already lower than the normal measurement range, so “measurement error” is displayed on the LCD 114 in step S814. If necessary, detailed information such as “abnormal signal during decompression” may be additionally displayed.

  In step S815, when the measurement ends in the determination in step S812, the measurement process ends in the normal measurement range. The remaining air in the cuff 101 is rapidly exhausted, and the maximum blood pressure value and the minimum blood pressure measured on the LCD 114 in step S816. The value is displayed, and a tone signal is sent to the buzzer 115 in step S817. Preferably, different tone signals are sent after normal termination and abnormal termination, the measurement is terminated, and the next measurement start is awaited.

<Detailed operation of pressurization value setting>
FIG. 9 shows a detailed flowchart of the pressurization value setting (corresponding to step S803). Here, an example is shown in which the pressurization target value (pressurization value) is changed by further operating the measurement start switch after the measurement start switch (ST) is pressed (that is, the period after step S801).

  In step S901, the initial value (for example, 170 mmHg) of the pressurization value stored in the ROM 112 is read and stored in the register 111a, and the process proceeds to step S902.

  In step S902, waiting for a button pressing operation by the user is started. At this time, the measurement of the standby elapsed time is started using the timer function in the control software, and the process proceeds to step S903. Note that the button may include a dedicated button, but here, it is one of the switches in the keyboard 116 and also serves as a measurement start switch (ST) used as a trigger for starting measurement. .

  In step S903, it is confirmed whether the standby elapsed time is within a predetermined time (for example, 5 seconds). If the predetermined time has not elapsed, the process proceeds to step S904.

  In step S904, it is confirmed whether or not the user has pressed the button. If the button has been pressed, the process proceeds to step S905. If the button has not been pressed, the process returns to step S903.

  In step S905, a predetermined value is added to the value stored in the register 111a (for example, +10 mmHg), and the derived value is overwritten and stored in the register 111a. At this time, the derived value may be displayed (not shown) on the display unit. Further, the buzzer may be sounded so that the user can easily confirm that the button has been pressed. Thereafter, the process returns to step S903.

  In step S903, when the standby elapsed time has passed the predetermined time, the pressurization value setting operation ends, and the process proceeds to step S804 in FIG. Note that the value stored in the register 111a at the time when the elapsed time is used as the pressurization value of the cuff pressure. For example, when the button is pressed three times during the standby elapsed time, 200 mmHg (= 170 + 10 + 10 + 10) is used as the pressurization value.

  In addition, although it was set as the structure which complete | finishes a flow after predetermined time elapses here, for example, you may comprise so that a flow may be complete | finished on condition that there is no input for a fixed time.

  As described above, the blood pressure measurement device that allows simple pressure value change in the fixed pressure control for controlling the pressure in the cuff when measuring the blood pressure by the photoelectric volume pulse wave sphygmomanometer of the present embodiment. Can be provided.

  In this embodiment, the switch (button) for changing the pressurization value is a measurement start switch (ST) that is one of the switches in the keyboard 116. By adopting such a configuration, since it can be realized only by changing the control software, there is an advantage that it can be realized without increasing the apparatus cost.

  In the present embodiment, an example in which reflected light from blood in a blood vessel is detected has been described. Alternatively, transmitted light may be detected instead. In that case, 108a and 108b will be arrange | positioned on both sides so that a measurement part may be pinched | interposed. Moreover, you may use the pressure pulse wave by the change of the pressure value in a cuff, and you may comprise so that it may measure by using a Korotkoff sound using a microphone (not shown).

(Other embodiments)
Although the embodiments of the present invention have been described in detail above, the present invention may be applied to a system constituted by a plurality of devices or may be applied to an apparatus constituted by one device.

  The present invention can also be achieved by supplying a program that realizes the functions of the above-described embodiments directly or remotely to a system or apparatus, and the system or apparatus reads and executes the supplied program code. The Accordingly, the program code itself installed in the computer in order to realize the functional processing of the present invention by the computer is also included in the technical scope of the present invention. In this case, the program may be in any form as long as it has a program function, such as an object code, a program executed by an interpreter, or script data supplied to the OS.

  As a recording medium for supplying the program, for example, floppy (registered trademark) disk, hard disk, optical disk, magneto-optical disk, MO, CD-ROM, CD-R, CD-RW, magnetic tape, nonvolatile memory card ROM, DVD (DVD-ROM, DVD-R) and the like.

  As another program supply method, a client computer browser is used to connect to an Internet homepage, and the computer program itself of the present invention or a compressed file including an automatic installation function is downloaded from the homepage to a recording medium such as a hard disk. Can also be supplied. It can also be realized by dividing the program code constituting the program of the present invention into a plurality of files and downloading each file from a different homepage. That is, a WWW server that allows a plurality of users to download a program file for realizing the functional processing of the present invention on a computer is also included in the claims of the present invention.

  In addition, the program of the present invention is encrypted, stored in a storage medium such as a CD-ROM, distributed to users, and key information for decryption is downloaded from a homepage via the Internet to users who have cleared predetermined conditions. It is also possible to execute the encrypted program by using the key information and install the program on a computer.

  In addition to the functions of the above-described embodiments being realized by the computer executing the read program, the OS running on the computer based on the instruction of the program is a part of the actual processing. Alternatively, the functions of the above-described embodiment can be realized by performing all of them and performing the processing.

  Furthermore, after the program read from the recording medium is written in a memory provided in a function expansion board inserted into the computer or a function expansion unit connected to the computer, the function expansion board or The CPU or the like provided in the function expansion unit performs part or all of the actual processing, and the functions of the above-described embodiments are realized by the processing.

It is a block diagram of the photoelectric volume pulse wave blood pressure meter which concerns on 1st Embodiment. It is an external appearance perspective view of the photoelectric volume pulse wave sphygmomanometer according to the first embodiment. It is a figure which shows the example of mounting | wearing with the cuff to an outer ear periphery part. It is the model showing the time series change of the cuff pressure and pulse wave of the photoelectric volume pulse wave sphygmomanometer according to the first embodiment. It is a flowchart of the blood pressure measurement processing procedure of the photoelectric volume pulse wave sphygmomanometer according to the first embodiment. It is a flowchart of the pressurization mode setting of the photoelectric volume pulse wave blood pressure meter which concerns on 1st Embodiment. It is the schematic diagram showing the time-sequential change of the cuff pressure and pulse wave of the other photoelectric volume pulse wave sphygmomanometer according to the first embodiment. It is a flowchart of the blood pressure measurement processing procedure of the photoelectric volume pulse wave sphygmomanometer according to the third embodiment. It is a flowchart of the pressurization value setting of the photoelectric volume pulse wave blood pressure meter which concerns on 3rd Embodiment.

Claims (6)

A cuff that compresses the outer ear and the surrounding area,
Pressurizing means for controlling a pressure value applied to the cuff;
Setting means for setting a pressure control mode used for controlling the pressure means;
Change means for detecting an operation within a predetermined period after the start of the measurement operation and changing the pressure control mode according to the operation content;
A blood pressure measurement device comprising: The blood pressure measurement device further includes pulse wave detection means for detecting a pulse wave,
The blood pressure measurement device according to claim 1, wherein one of the pressurization control modes includes a mode in which pressurization control is performed by monitoring at least a change in the pulse wave.   The blood pressure measurement device according to claim 1, wherein one of the pressurization control modes includes at least a mode in which the pressurizing unit is manually controlled.   The blood pressure measuring device according to claim 1, wherein the changing unit is also used as a switch used for starting measurement. A compression process of cuffing the outer ear and the surrounding area with a cuff;
A pressurizing step for controlling a pressure value applied to the cuff;
A setting step for setting a pressurization control mode used for controlling the pressurization step;
A change step of detecting an operation within a predetermined period after the start of the measurement operation and changing the pressure control mode according to the operation content;
A blood pressure measurement method characterized by comprising: A control program for controlling the pressure in the cuff,
Program code for executing a compression process of cuffing the outer ear and the surrounding area with a cuff;
Program code for executing a pressurizing step for controlling a pressure value applied to the cuff;
A program code for executing a setting step for setting a pressurization control mode used for controlling the pressurization step;
A program code for detecting an operation within a predetermined period after the start of the measurement operation and executing a changing step of changing the pressurization control mode according to the operation content;
A control program comprising:

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