RU2743614C1 - Mobile transportable module for computer tomography - Google Patents

Abstract

FIELD: medical technology.

SUBSTANCE: invention relates to medical technology and can be used as a mobile medical diagnostic system for computer tomography and as a medical diagnostic system installed on a pre-prepared base. The module is in the form of a thermally insulated three-dimensional body with door openings and comprises three blocks which are arranged consecutively one after the other, wherein the first unit is designed so as to be capable of performing the functions of a sanitary lock, the second unit is designed in such a way as to accommodate a diagnostic CT scanner, and the third unit comprises a laboratory monitor, a radiologist’s workplace and equipment for the modular systems. The module comprises a fire alarm system, a system for preventing entry and calling of the patient, which comprises tape-controlled switching elements, visual displays, disinfection systems and ventilation systems.

EFFECT: technical result is increase in the comfort of carrying out mass diagnostic measures, increase in safety of radiological examinations of infected patients, and increase in throughput capacity.

10 cl, 1 dwg

Description

The invention relates to mobile medical equipment and can be used as a mobile medical diagnostic mobile complex for computed tomography, as well as a medical diagnostic complex, installed on a previously prepared base.

Modern radiation diagnostics is one of the most dynamically developing areas of clinical medicine. This is largely due to the ongoing progress in physics and computer technology. The vanguard of the development of radiation diagnostics are the methods of tomography, computed tomography (CT) and magnetic resonance imaging (MRI), which allow non-invasive assessment of the nature of the pathological process in the human body. CT is based on a quantitative analysis of the degree of absorption of X-ray radiation by various tissues. The X-ray tube rotates in the axial plane around the patient's body and emits a thin beam of radiation, which, passing through the layer under study, is attenuated to a different degree for each point and is recorded by a detector unit. Registration of the radiation transmitted through the body is carried out at different positions of the "tube-detectors" system, which makes it possible to create a planar image of the investigated section.

It is known from the prior art (RF patent for useful model No. 96747, publ. 08/20/2010) a medical diagnostic mobile complex, including a magnetic resonance imager, a compact X-ray apparatus, an installation for ultrasound diagnostics, a thermal imaging unit, equipment for cardiac monitoring and monitoring of the respiratory system, laboratory installation for blood tests, equipment for radio and video communication in real time and equipment for processing, reconciling and storing the obtained data, with which the said devices and apparatuses are connected by communication lines, while the said apparatus complex is placed on a specialized vehicle.

Also known is a mobile medical diagnostic and treatment complex based on a vehicle (Eurasian patent EA No. 019830, publ. 06/30/2014), containing a salon with workplaces, a unit for processing and analyzing information, devices for storing equipment, communication means, a power source, moreover, the salon is divided into compartments, each of which houses a medical department or an office with medical and diagnostic equipment and devices, bactericidal lamps and lighting devices are installed in the compartments, the salon is divided into compartments by means of removable partitions to adjust the size of the sections depending on the expected number of patients. The complex includes many departments, including those for performing X-ray and ultrasound examinations, ventilation, air conditioning and disinfection systems, and burglar alarms, as well as facilities for processing and analyzing information.

As an advantage of the above known technical solutions, their multifunctionality and the possibility of conducting complex surveys are indicated. However, for solving narrow diagnostic problems, these diagnostic complexes are expensive, structurally complex and have insufficient efficiency.

A portable medical diagnostic complex is known from the prior art (US patent for invention US No. 5727353, publ. 03.16.1998), which contains a body in the form of a shipping container, made with the possibility of moving by means of various means of transportation, and the specified body defines the outer surface and the inner zone of several sections, and includes at least one door to provide access to the inner area. The complex contains at least one medical diagnostic device located in one of the sections, as well as one operator station located in the other of the specified sections and designed to control the specified one or more medical diagnostic devices. In addition, said at least one medical diagnostic device emits one of many different forms of radiation. In addition, said section where at least one medical diagnostic device is located is shielded to prevent radiation outside said section. The complex also includes a climate control system for controlled climate control of the inner zone. The body of the specified diagnostic complex has a connecting element for connecting it to a loading / unloading device for installation on one of the mentioned vehicles for transportation.

Known autonomous room for X-ray examination (RF patent for utility model No. 20444, publ. 10.11.2001), mounted on the chassis of a car and representing a van-type body and containing in the internal volume the laboratory assistant's workplace and the X-ray department, separated from the rest of the volume by an X-ray protective partition with a sliding door, which houses an X-ray system including an X-ray source and an X-ray sensor, the space between which is intended for the patient; The X-ray system is made with a digital scanning system, and the internal volume of the claimed office is additionally divided by a partition with a door into two functional zones: a laboratory department with at least one laboratory assistant's workplace and an admission department equipped with a household unit and at least one vestibule formed by external and internal doors.

Known technical solution for the application of the PRC CN 106427736 (publ. 2.02.2017), which presents a mobile cabin with equipment for computed tomography. The cabin is made with a frame that is attached to the car, the cabin contains a scanning device, a table (bed) for a patient for scanning, an image processing system, a medical display, and the scanning device, an image processing system and a medical display are electrically connected, the cabin has an internal and outer skins, between which a circulating air duct is located, which is equipped with a circulating air pump, a disinfection device, a suction pump, a high-efficiency filter and an air supply device. The mount of the cab with the vehicle is equipped with damping springs and a rubber plate, the scanning device is mounted on an electric shock-absorbing device.

Known mobile medical vehicle (RF patent No. 2135142, publ. 27.08.1999), which contains a mobile X-ray diagnostic complex, including the hardware machine of the fluorographic department, located in a van body mounted on the chassis of the car, medical equipment of the X-ray department, located in the pneumatic medical connected to the body-van by a special transition made of rubberized fabric, the power plant of the power department, located in the body-box, mounted on the chassis of a car trailer, while the hardware machine is divided by an X-ray protective partition into a control compartment and a fluorographic cabin, and the fluorographic installation of the hardware machine contains a fluorographic camera , docking unit, developing machine. The vehicle for the automated diagnostic process contains a digital medical X-ray television system, electrically combined with a fluorographic installation and including interconnected multi-frame memory for X-ray television images, a portable portable personal computer, an infrared port and a transceiver, a control panel for elements of a digital medical X-ray television system.

Known mobile module with a computer tomograph at the request of the PRC CN 102988142 (publ. 03/27/2013). The module is divided into a diagnostic room with a scanning device, a patient table mounted on a base to reduce the vibrations of the CT scanner, and a room with an imaging workstation, medical display, work chair and printer for diagnostic reports. The module can be transported by self-loading and unloading trucks, including to the hospital grounds.

Closest to the claimed is the technical solution from the description of the invention to the Japanese patent JP No. 6494450 (publ. 03.04.2019). The medical transportable container contains medical equipment, namely a CT scanner. The container has a block structure and includes three blocks: the first block with a computed tomograph placed in it, the second block with a generator to provide independent power supply, and the third block to accommodate the radiologist's workplace. The first unit is equipped with a protective lead wall capable of shielding X-rays emitted during the operation of the X-ray apparatus. The third block for placement of the radiologist's workplace has a doorway for entry and exit outside and is located between the first and second blocks. The protective wall between the first and third blocks has a lead door and a lead-framed glass window. In addition, the first and second units have external service doors.

In these sources, conditions are not fully provided for carrying out diagnostic measures on a computed tomography scanner with infected patients with high throughput.

The problem solved by the proposed technical solution is to expand the arsenal of medical mobile transportable modules by creating a mobile transportable module for placing a diagnostic computed tomograph. Another challenge is to provide additional conditions to reduce the risk of spread of infection when conducting research on infected patients.

When solving the problem, a comprehensive technical result is achieved, which consists in increasing the comfort of carrying out mass diagnostic measures, in increasing the safety during X-ray examinations of infected patients, in increasing the throughput.

The technical result is achieved in that the mobile transportable module for computed tomography is a thermally insulated volumetric body with door openings, which is formed by a rigid frame, essentially in the form of a parallelepiped, the module is made with the possibility of transportation by ground transport and subsequent installation on a previously prepared vibration-resistant base and includes three blocks, which are placed sequentially one after another, while the first block is configured to perform the functions of a sanitary gateway, the second block is configured to accommodate a diagnostic computed tomograph; the module contains fire alarm systems, a system for prohibiting entry and patient call, which includes magnetically controlled switching elements and visual acoustic panels and ensures that the tomograph is turned off when any door to the second block is opened, power supply and lighting systems, a system for disinfection, a supply and exhaust ventilation and air conditioning system , water supply and sewerage systems; cable channels made of non-combustible material are laid on the floor and walls of the module; a vibration-damping base is installed in the second block, on which the gantry of the computed tomograph and the patient's table are installed, and the distance from the edge of the gantry of the computed tomograph to the block wall is about 1700 mm, and the sides of the patient's table are oriented parallel to the long side of the module; the second unit contains protection against X-ray radiation, including protective panels that are protected between the wall decoration and the outer wall, sheet lead panels in the base and roof of the unit, X-ray protective doors, while the places of cable passages, ventilation inlets are protected by leaded boxes, excluding the penetration of radiation through them ; the third block is divided into at least three rooms: a technical room for the placement of devices for ensuring the autonomous operation of the module systems and a computer tomograph, a room designed as a laboratory assistant with a tomograph control panel and a room with an automated workstation for a radiologist containing systems for receiving and analysis of information received from a computer tomograph; technical room contains water supply and sewerage inputs, power supply and computer network inputs; the power supply of the module devices is provided from a three-phase AC network through an uninterruptible power supply installed in the technical room; metal parts of electrical equipment installed in the module, normally not energized, are electrically connected to the ground bus; the first and third blocks, which are located at opposite ends of the module, are provided with door openings for entry and exit to the outside, each, as well as door openings for entering the second block; the first block is divided into two adjacent rooms, and at least one transfer box is installed in the adjacent wall, one of the named two adjacent rooms is designed to enter the module and undress, while performing the function of a sanitary lock, and has a doorway to the second block , which is designed to enter mobile patients into the second unit and move to the second unit and back to the entrance area of immobile and disabled patients; another room of the named two adjacent rooms of the first block is made as an exit area for dressing patients, having a doorway to the second block and is intended for the exit of mobile patients from the second block, and then outside the module; disinfection equipment is made on the basis of photocatalysis and / or aerosol disinfection devices, moreover, the operation of disinfection equipment and supply and exhaust ventilation and air conditioning systems are synchronized in automatic mode, the transfer box contains at its opposite ends closable openings to the first and second named adjacent rooms; the entrance doorway to the first block and the doorway to enter from the first to the second block have dimensions that meet the requirements for receiving patients with limited mobility, and the doors in the openings are equipped with locks; doorways for entering the module are equipped with ramps and / or external stairs; in the control room of the laboratory assistant and at the workplace of the radiologist, split systems are installed to maintain the microclimate.

The module frame can be made in the form of a spatial welded structure, while the thermal insulation of the ceiling and floor is made of a building material with a three-layer structure, consisting of two sheets of rigid material and a layer of insulation between them with a thickness of at least 100 mm, the thermal insulation of the walls is made of a layer of insulation with a thickness not less than 80 mm.

The module can contain auxiliary rooms, which are allocated in the first and third blocks, at least one room in each.

In one embodiment of the module, the transfer box is made in the form of a closable window.

In one embodiment of the module, the transfer box is made in the form of a chamber and contains, at its opposite ends, closed openings to the first and second named adjacent rooms.

The system for processing and analyzing information can be connected by channels of receiving and transmitting information with the coordination and control center.

The module may contain a system for communicating with the patient during scanning, which consists, for example, of a speaker and a microphone for the patient, mounted in the scanner aperture, as well as a speaker and microphone, which are installed on the scanning control panel.

To move the module can be used oversized transport on the wheelbase of a 40-foot trailer.

The base for installing the module can be made in the form of a pile foundation.

The essence of the claimed invention is illustrated by a drawing (Fig.). FIG. an example of the implementation of a mobile transportable module for placing a diagnostic computed tomograph is shown. The first block of the module contains rooms 1, 6. In this implementation example, an auxiliary room 7 is also allocated in the first block. The second block is room 2, in which the Gantry 26 and the patient's table 8 of the diagnostic computed tomograph are located. The main components of a computed tomograph: Gantry, patient table, power supply and systems for receiving, processing and transmitting images. Gantry (from the English gantry) is a movable, usually annular, part of a computer tomograph containing scanning equipment used to hold and aim medical equipment at a fixed patient. A computed tomography scanner usually contains an x-ray tube and a detector array that receives the radiation emitted from the x-ray tube. The X-ray tube and detector array are mounted on a rotating frame that rotates around the study area around the longitudinal axis. The rotating frame is connected to a fixed frame, which is attached to the base in room 2. Table 8 is configured to position the patient in a horizontal position on it in the examination area. The longitudinal arrangement of the table corresponds to the longitudinal arrangement of the module. The second block contains X-ray protective doors 17, 18, 27. The third block of the module contains room 3, in which the control panel 24 of the laboratory assistant is located and doors 15 are installed for going outside, doors 16 - into room 4. The third block of the module also contains rooms 4 and 5 Room 4 with an automated workstation for a radiologist 25 contains systems for obtaining and analyzing information received from a computer tomograph. In the technical room 5 there are devices for ensuring the autonomous operation of the module systems and the computer tomograph, a door 28 is installed, leading to the outside. The adjacent wall of rooms 1 and 6 is equipped with at least one box for the transfer of clothes. The figure shows two boxes 9 and 10. The entrance door to room 1 is equipped with a "Do not enter" board on the entrance side, and inside the room - an "Exit" board, in accordance with fire regulations. The door latch is opened with a handle on both sides. The entrance door to room 2 is equipped with a "Do not enter" board on the entrance side. The door latch is opened with a handle on both sides. The entrance door to room 6 is equipped with a "Do not enter" board and an "Exit" board on the entrance side, which is always on. The door latch is opened with a handle on both sides. The door to the exit from room 6 is equipped with an Exit board inside the room. The door latch opens with a handle only to the outside. From the outside, the door can only be opened with a key. In room 1 there is one video camera, in the field of view of which the patient in the room enters, and the entrance and exit doors (including the display above them is visible). In room 2, at least two video cameras are located, on both sides of the hall, so that the patient in the room, the entrance and exit doors, as well as the display above them, fall into their field of vision. In room 6, there is at least one video camera, in the field of view of which the patient, who is in the room, and the entrance and exit doors (including the display above them, are visible). Doors leading from the premises of the module to the outside are equipped with stairs and / or ramps 19, 20, 21, 22, 23. At the ends of the module there are external units of air conditioners (split systems) 11 and 12.

Before receiving patients, a cycle of disinfection and subsequent ventilation of rooms 1, 2, 6 is performed. The operation of the equipment for disinfection and the supply and exhaust ventilation and air conditioning systems are synchronized in automatic mode. In the disinfected room, the "Do not enter" board is turned on. Disinfectant is sprayed, and the spraying time is calculated based on the volume of the room. After spraying the disinfectant, a temporary exposure is carried out, then the supply and exhaust ventilation of the room is automatically switched on and works for a specified time. After processing the room, the "Do not enter" board is turned off. The module is prepared for receiving patients as follows. Power is supplied to the block-module, then to all systems of the module. The systems are reset. Above the entrances to the premises, the "Do not enter" board is on. A laboratory technician for CCTV cameras monitors the absence of patients and personnel in rooms 1, 2, 6 and conducts primary processing of rooms 1, 2, 6. The sequence of processing the rooms does not matter. After processing the premises, the laboratory assistant switches the ventilation to the "Work" mode. Ventilation in all rooms is automatic. Upon completion of the ventilation of the premises, the "Do not enter" display above the entrances to the prepared premises turns off. After ventilation of the premises, the module is ready to receive patients.

The reception of mobile patients is as follows. The patient enters room 1 through door 14 and prepares for the study, leaving things in one of the boxes 9, 10. After closing the entrance door 14 in room 1 above the entrance to it, the "Do not enter" board is turned on. The laboratory assistant from the control room asks to put an identity document on a hand-held scanner located in room 1 to identify the person and enter it into the database. A laboratory technician invites a patient over a speakerphone for examination. The patient, guided by the state of the "Do not enter" board (the board is off) at the entrance to room 2 (door 17), enters this room, closing door 17 behind him. At the same time, locks are triggered and the "Do not enter" board is turned on above the entrance to room 2 ... Room 1 is ready for the disinfection and ventilation cycle. Above his entrance the Do Not Enter sign is on. The laboratory assistant checks the absence of the patient in room 1 using the video surveillance camera in room 1 and issues a command from the control panel to start disinfection. A cycle of disinfection and subsequent ventilation of room 1 is in progress. At the end of the cycle, the “Do not enter” display above its entrance goes out. The Do Not Enter sign above room 2 remains on until the end of the disinfection and ventilation cycle in it. Room 1 is ready for the next patient. During the cycle of disinfection and ventilation of room 1, the laboratory assistant examines the patient in room 2, observing his actions through the appropriate cameras and giving instructions on hands-free communication with this room. Upon completion of the study, the patient, at the command of the laboratory assistant, exits through door 18 from room 2 to room 6, guided by the state of the "Do not enter" board above the entrance to room 6. After the patient exits into room 6 and closes the door, the "Do not enter" board above his entrance turn on and off only after completion of the cycle of disinfection and ventilation of the room. Room 2 is ready for the disinfection and ventilation cycle. The laboratory assistant checks the absence of the patient in room 2 by the video surveillance camera in room 2 and issues a command from the control panel to start the disinfection and ventilation cycle. Upon completion of the disinfection and ventilation cycle of room 2, the "Do not enter" board above its entrance is turned off. The Do Not Enter sign above room 6 remains on until the end of the disinfection and ventilation cycle in it. Room 2 is ready to receive the next patient. At this time, the patient in room 6 takes things from box 9 or 10, puts on his clothes and leaves room 6 through door 29. The laboratory assistant checks the absence of the patient in room 6 through the CCTV camera and issues a command from the control panel to start the disinfection and ventilation cycle ... After the completion of the disinfection and ventilation cycle, the "Do not enter" display above the entrance to it from the side of room 2 turns off. Room 6 is ready to receive the next patient. The received time cycle operation room 2: Disinfection - 2 minutes (air in the room is not supplied and is taken), forced ventilation - 2 min (1335 m ³ / h), the study of the patient - 5 minutes (air in the room is not supplied and not taken) ... In accordance with the described cycle of work, up to 6 studies can be carried out per hour (the cycle of one study is 9 minutes). Ventilation will supply and simultaneously remove air from the room 6 times (12 minutes in total). In a specific example of implementation, the parameters of the supply and exhaust ventilation system are selected in such a way that, with a room volume of 44 m ^{3, the} average rate of air exchange in the room will be 6 per intake and 6 per exhaust.

The module operates in the study mode of a sedentary patient as follows. Reception of a sedentary patient is carried out through a swing two-leaf door 13 from the end of the module with the help of a medical worker assisting the patient. The patient is prepared for the procedure and at the command of the laboratory assistant, guided by the state of the "Do not enter" board at the entrance to room 2, he is moved to room 2. All further actions are performed at the command of the laboratory assistant. After completing the examination of the patient and unloading him from the module through the swing door 13, the laboratory assistant issues a command from the control panel to start the disinfection and ventilation cycle of rooms 1 and 2. Upon completion of the cycle of disinfection and ventilation of rooms 1 and 2, the Do Not Enter board above their entrances is turned off. The module is ready to receive the next patients.

An automated workstation (AWS) for a radiologist in a computed tomography room is a hardware and software complex that includes a specialized workstation and a set of software tools designed to work with data obtained from a computed tomography scanner.

An uninterruptible power supply (UPS) provides power supply to the module's devices for a specified time, necessary to maintain the module's devices in working condition, in the absence of power supply from the external network.

In the control room of the laboratory assistant and at the workplace of the radiologist, the microclimate is maintained through the operation of two split systems, one for each room. To maintain the temperature regime in the premises (during the absence of patients or during non-working hours) and save energy, a mode is provided for switching ventilation systems to maintain the specified climatic parameters.

The developed module for placing a diagnostic computed tomograph in assembled and working condition is mobile and transportable, autonomous and suitable for operation without preliminary adjustment immediately after transportation.

With the help of the proposed solution “Mobile transportable module for placing a diagnostic computed tomograph”, it is possible to perform computer diagnostics tasks promptly, immediately after transportation and installation on a prepared base. In contrast to the known means, additional conditions are provided to reduce the risk of spreading infection from infected patients and a high throughput for receiving mobile and disabled patients. The module can be used, for example, in a village or on the territory of a manufacturing enterprise, with the possibility of rapid deployment on site to provide diagnostics.

Claims (10)

1. Mobile transportable module for computed tomography, characterized in that it is a thermally insulated volumetric body with door openings, which is formed by a rigid frame, essentially in the form of a parallelepiped, the module is made with the possibility of transportation on ground transport and subsequent installation on a previously prepared vibration-resistant base and includes three blocks, which are placed sequentially one after another, while the first block is configured to perform the functions of a sanitary gateway, the second block is configured to accommodate a diagnostic computed tomograph, and the third is configured to accommodate control systems, receive information, equipment for operating systems module; the module contains fire alarm systems, a patient call and entry barring system, which includes magnetically controlled switching elements and visual displays and ensures that the tomograph is turned off when any door to the second block is opened; power supply and lighting systems, disinfection system, supply and exhaust ventilation and air conditioning systems, water supply and drainage systems; cable channels made of non-combustible material are laid on the floor and walls of the module; the second block has a vibration-damping base, on which the Gantry CT scanner and the patient table are installed, and the distance from the edge of the CT Gantry to the block wall is about 1700 mm, and the sides of the patient table are oriented along the long side of the module, while the second block contains protection against ionizing radiation, including protective panels that are sewn between the wall decoration and the outer wall, sheet lead panels in the base and roof of the unit, X-ray protective doors, while the places of cable passages, ventilation inlets are protected by leaded boxes, excluding the penetration of X-rays through them; the third block is divided into at least three rooms - a technical room, which houses devices for ensuring the autonomous operation of the module's systems and a computer tomograph, a room designed as a laboratory assistant with a tomograph control panel and a room with an automated workstation for a radiologist containing systems obtaining and analyzing information received from a computer tomograph; technical room contains water supply and sewerage inputs, power supply and computer network inputs; the power supply of the module devices is provided from a three-phase AC network through an uninterruptible power supply installed in the technical room; metal parts of electrical equipment installed in the module, normally not energized, are electrically connected to the ground bus; the first and third blocks, which are located at opposite ends of the module, are provided with door openings for entry and exit to the outside, each, as well as door openings for entering the second block; the first block is divided into two adjacent rooms, and at least one transfer box is installed in the adjacent wall, one of the named two adjacent rooms is intended for entering the module and undressing, while performing the function of a sanitary lock, and has a doorway to the second block , which is designed to enter mobile patients into the second unit and move to the second unit and back to the entrance area of immobile and disabled patients; another room of the named two adjacent rooms of the first block is made as an exit area for dressing patients, having a doorway to the second block and is intended for the exit of mobile patients from the second block; disinfection equipment is made on the basis of photocatalysis and / or aerosol disinfection devices, and the operation of the disinfection equipment and the supply and exhaust ventilation and air conditioning systems are synchronized in automatic mode, the transfer box contains closable openings at its opposite ends to the first and second named adjacent rooms; the entrance doorway to the first block and the doorway to enter from the first to the second block have dimensions that meet the requirements for receiving patients with limited mobility, and the doors in the openings are equipped with locks; doorways for entering the module are equipped with ramps and / or external stairs; in the control room of the laboratory assistant and at the workplace of the radiologist, split systems are installed to maintain the microclimate. 2. The module according to claim 1, characterized in that the frame is made in the form of a spatial welded structure, while the thermal insulation of the ceiling and floor is made of a building material having a three-layer structure consisting of two sheets of rigid material and a layer of insulation between them with a thickness of at least 100 mm, wall insulation is made of a layer of insulation with a thickness of at least 80 mm. 3. The module according to claim 1, characterized in that in the first and third blocks, at least one auxiliary room is allocated in each. 4. The module according to claim 1, characterized in that the transfer box is made in the form of a closable window. 5. The module according to claim 1, characterized in that the transfer box is made in the form of a chamber and contains at its opposite ends closable openings into the first and second named adjacent rooms. 6. The module according to claim 1, characterized in that the system for processing and analyzing information is connected by information transmission and reception channels with the coordination and control center. 7. The module of claim. 1, characterized in that it contains a system that allows communication with the patient during scanning. 8. The module according to claim 7, characterized in that the system for communicating with the patient during scanning consists of a speaker and a microphone for the patient mounted in the scanner aperture, as well as a speaker and microphone that are installed on the scanning control panel. 9. The module according to claim 1, characterized in that for its movement, an oversized vehicle on the wheelbase of a 40-foot trailer is used. 10. The module according to claim 1, characterized in that the base is made in the form of a pile foundation.

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