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Search on : Heroin and Dependence [Words]
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[PMID]: 29402680
[Au] Autor:Brinkley-Rubinstein L; McKenzie M; Macmadu A; Larney S; Zaller N; Dauria E; Rich J
[Ad] Address:Department of Social Medicine, University of North Carolina, Chapel Hill, NC, United States. Electronic address: Lauren_Brinkley@med.unc.edu.
[Ti] Title:A randomized, open label trial of methadone continuation versus forced withdrawal in a combined US prison and jail: Findings at 12 months post-release.
[So] Source:Drug Alcohol Depend;184:57-63, 2018 Mar 01.
[Is] ISSN:1879-0046
[Cp] Country of publication:Ireland
[La] Language:eng
[Ab] Abstract:Recently, incarcerated individuals are at increased risk of opioid overdose. Methadone maintenance treatment (MMT) is an effective way to address opioid use disorder and prevent overdose; however, few jails and prisons in the United States initiate or continue people who are incarcerated on MMT. In the current study, the 12 month outcomes of a randomized control trial in which individuals were provided MMT while incarcerated at the Rhode Island Department of Corrections (RIDOC) are assessed. An as-treated analysis included a total of 179 participants-128 who were, and 51 who were not, dosed with methadone the day before they were released from the RIDOC. The results of this study demonstrate that 12 months post-release individuals who received continued access to MMT while incarcerated were less likely to report using heroin and engaging in injection drug use in the past 30 days. In addition, they reported fewer non-fatal overdoses and were more likely to be continuously engaged in treatment in the 12-month follow-up period compared to individuals who were not receiving methadone immediately prior to release. These findings indicate that providing incarcerated individuals continued access to MMT has a sustained, long-term impact on many opioid-related outcomes post-release.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:In-Data-Review

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[PMID]: 29502536
[Au] Autor:Ning T; Leng C; Chen L; Ma B; Gong X
[Ad] Address:College of Life Science, Jianghan University, Sanjiaohu Road, Wuhan, 430056, China. ttning@whu.edu.cn.
[Ti] Title:Metabolomics analysis of serum in a rat heroin self-administration model undergoing reinforcement based on H-nuclear magnetic resonance spectra.
[So] Source:BMC Neurosci;19(1):4, 2018 Mar 05.
[Is] ISSN:1471-2202
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Understanding the process of relapse to abused drugs and ultimately developing treatments that can reduce the incidence of relapse remains the primary goal for the study of substance dependence. Therefore, exploring the metabolite characteristics during the relapse stage is valuable. METHODS: A heroin self-administered rat model was employed, and analysis of the H-nuclear magnetic resonance-based metabolomics was performed to investigate the characteristic metabolite profile upon reintroduction to the drug after abstinence. RESULTS: Sixteen metabolites in the serum of rats, including phospholipids, intermediates in TCA (Tricarboxylic Acid Cycle) cycle, keto bodies, and precursors for neurotransmitters, underwent a significant change in the reinstatement stage compared with those in the control group. In particular, energy production was greatly disturbed as evidenced by different aspects such as an increase in glucose and decrease in intermediates of glycolysis and the TCA cycle. The finding that the level of 3-hydroxybutyrate and acetoacetate increased significantly suggested that energy production was activated from fatty acids. The concentration of phenylalanine, glutamine, and choline, the precursors of major neurotransmitters, increased during the reinstatement stage which indicated that an alteration in neurotransmitters in the brain might occur along with the disturbance in substrate supply in the circulatory system. CONCLUSIONS: Heroin reinforcement resulted in impaired energy production via different pathways, including glycolysis, the TCA cycle, keto body metabolism, etc. A disturbance in the substrate supply in the circulatory system may partly explain heroin toxicity in the central nervous system. These findings provide new insight into the mechanism underlying the relapse to heroin use.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:In-Data-Review
[do] DOI:10.1186/s12868-018-0404-5

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[PMID]: 29482055
[Au] Autor:Horyniak D; Strathdee SA; West BS; Meacham M; Rangel G; Gaines TL
[Ad] Address:Division of Global Public Health, University of California San Diego, La Jolla, CA, 92093, United States; Behaviours and Health Risks Program, Burnet Institute, Melbourne, VIC, 3004, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia.
[Ti] Title:Predictors of injecting cessation among a cohort of people who inject drugs in Tijuana, Mexico.
[So] Source:Drug Alcohol Depend;185:298-304, 2018 Feb 21.
[Is] ISSN:1879-0046
[Cp] Country of publication:Ireland
[La] Language:eng
[Ab] Abstract:INTRODUCTION: Little is known about the cessation of injecting drug use (IDU) among people who inject drugs (PWID) in low and middle-income settings, where access to effective interventions for reducing drug use (e.g., opioid substitution treatment; OST), may be limited. We measured the incidence and identified predictors of IDU cessation among a cohort of PWID in Tijuana, Mexico. METHODS: Data were drawn from 621 participants in Proyecto El Cuete IV, a prospective cohort of PWID recruited in 2011 and interviewed biannually to 2016. A multivariable Extended Cox model was constructed to identify socio-demographic, drug use, risk environment and health-related predictors of IDU cessation (no IDU for ≥six months). RESULTS: 141 participants (23%) reported at least one IDU cessation event during follow-up. The crude IDU cessation rate was 7.3 per 100 person-years (95% Confidence Interval [CI]: 6.2-8.7). IDU cessation was negatively associated with injecting at least daily on average and heroin/methamphetamine co-injection in the past six months, and positively associated with testing HIV positive at baseline, being on methadone maintenance therapy in the past six months, and recent arrest. Concern for personal safety was also independently associated with IDU cessation. CONCLUSIONS: The rate of IDU cessation among PWID in Tijuana was low. These findings underscore the importance of expansion of services including OST to help reduce drug use and facilitate IDU cessation for those who wish to do so. In this setting, interventions addressing individual-level economic barriers as well as broader social and structural barriers to harm reduction services are integral.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher

  4 / 13339 MEDLINE  
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[PMID]: 29432973
[Au] Autor:Des Jarlais D; Khue PM; Feelemyer J; Arasteh K; Thi Huong D; Thi Hai Oanh K; Thi Giang H; Thi Tuyet Thanh N; Vinh VH; Heckathorn DD; Moles JP; Vallo R; Quillet C; Rapoud D; Michel L; Laureillard D; Hammett T; Nagot N
[Ad] Address:Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, USA. Electronic address: ddesjarlais@chpnet.org.
[Ti] Title:Using dual capture/recapture studies to estimate the population size of persons who inject drugs (PWID) in the city of Hai Phong, Vietnam.
[So] Source:Drug Alcohol Depend;185:106-111, 2018 Feb 02.
[Is] ISSN:1879-0046
[Cp] Country of publication:Ireland
[La] Language:eng
[Ab] Abstract:BACKGROUND: Good estimates of key population sizes are critical for appropriating resources to prevent HIV infection. We conducted two capture/recapture studies to estimate the number of PWID currently in Hai Phong, Vietnam. METHODS: A 2014 respondent-driven sampling (RDS) survey served as one capture, and distribution of cigarette lighters at drug use "hotspots" in 2016 served as another "capture." A 2016 survey using RDS, conducted 1 week after lighter distribution, served as "recapture" for both captures. Recaptured participants in the two surveys were identified with a computerized fingerprint reader. Recaptured participants from the lighter distribution were asked to show their lighters. RESULTS: 1385 participants were included in the "recapture" survey. They were 94% male and had a median age of 39. All (100%) injected heroin, and HIV prevalence was 30%. 144 of the 603 participants in the 2014 survey and 152 of the 600 PWID who had received lighters were "recaptured" in the 2016 survey. After adjusting for police suppression of drug use hotspots and conducting sensitivity analyses, our best estimate of the population size from the lighter recapture was 4617 (95% CI: 4090-5143), and our best estimate from the 2014 survey recapture was 5220 (95% CI: 4568-5872). A combined best estimate of the PWID population in Hai Phong is 5000, range 4000-6000. CONCLUSIONS: The capture/recapture studies produced consistent estimates. Adding a lighter/token distribution to planned RDS surveys may provide an inexpensive method for estimating PWID population size. Analyses of the estimates should include contextual information about the local drug scene.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher

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[PMID]: 29188669
[Au] Autor:Huang WQ; Li LH; Li Z; Hong SJ
[Ad] Address:School of Forensic Medicine, Kunming Medical University, Kunming 650500, China.
[Ti] Title:[Forensic Analysis of 20 Dead Cases Related to Heroin Abuse].
[So] Source:Fa Yi Xue Za Zhi;32(4):266-268, 2016 Aug.
[Is] ISSN:1004-5619
[Cp] Country of publication:China
[La] Language:chi
[Ab] Abstract:OBJECTIVES: To perform retrospective analysis on 20 dead cases related to heroin abuse, and to provide references for the forensic assessment of correlative cases. METHODS: Among 20 dead cases related to heroin abuse, general situation, using method of drug, cause of death and result of forensic examination were analyzed by statistical analysis for summarizing the cause of death and pathologic changes. RESULTS: The dead were mostly young adults, with more male than female. The results of histopathological examinations showed non-specific pathological changes. There were four leading causes of death, including acute poisoning of heroin abuse or leakage (13 cases, 65%), concurrent diseases caused by heroin abuse (3 cases, 15%), inspiratory asphyxia caused by taking heroin (2 cases, 10%), and heroin withdrawal syndrome (2 cases, 10%). CONCLUSIONS: The forensic identification on dead related to heroin abuse must base on the comprehensive autopsy, and combine with the qualitative and quantitative analysis of heroin and its metabolites in death and the case information, as well as the scene investigation.
[Mh] MeSH terms primary: Drug Overdose/diagnosis
Heroin/poisoning
[Mh] MeSH terms secundary: Adult
Autopsy
Cause of Death
Female
Forensic Pathology
Forensic Toxicology
Humans
Male
Retrospective Studies
Young Adult
[Pt] Publication type:JOURNAL ARTICLE
[Nm] Name of substance:70D95007SX (Heroin)
[Em] Entry month:1802
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[Js] Journal subset:IM
[Da] Date of entry for processing:171201
[St] Status:MEDLINE
[do] DOI:10.3969/j.issn.1004-5619.2016.04.008

  6 / 13339 MEDLINE  
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[PMID]: 29510398
[Au] Autor:Groh A; Rhein M; Buchholz V; Burkert A; Huber CG; Lang UE; Borgwardt SJ; Heberlein A; Muschler MAN; Hillemacher T; Bleich S; Frieling H; Walter M
[Ad] Address:Laboratory of Molecular Neuroscience, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany.
[Ti] Title:Epigenetic Effects of Intravenous Diacetylmorphine on the Methylation of POMC and NR3C1.
[So] Source:Neuropsychobiology;, 2018 Mar 06.
[Is] ISSN:1423-0224
[Cp] Country of publication:Switzerland
[La] Language:eng
[Ab] Abstract:The administration of diacetylmorphine (DAM) reduces the activation of the hypothalamic-pituitary-adrenal (HPA) axis in opioid-maintained patients. However, the epigenetic effects of DAM on addiction-related genes have not been investigated yet. In a randomized controlled study, we examined the immediate effects of intravenous DAM versus placebo on the promoter methylation of the POMC (pro- opiomelanocortin) and NR3C1 (glucocorticoid receptor 1) genes. Twenty-eight heroin-dependent patients on DAM-assisted treatment received either DAM or saline in a randomized crossover design and 17 healthy participants received saline only. EDTA blood samples were taken 25 min before and 10 min after the injection of DAM or saline. We found reciprocal regulation effects for DAM versus saline application regarding the methylation of POMC; while DAM injection significantly increased methylation, saline injection led to a significant decrease in methylation for patients as well as controls. NR3C1 data did not show significant changes in methylation. Injection of DAM blunted stress hormone levels and the POMC promoter methylation of heroin-dependent patients. These findings provide first preliminary insights into the epigenetic mechanisms underlying the emotional regulation effects of DAM-assisted treatment in severe heroin-dependent patients.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180306
[Lr] Last revision date:180306
[St] Status:Publisher
[do] DOI:10.1159/000486973

  7 / 13339 MEDLINE  
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[PMID]: 29471930
[Au] Autor:Vuong T; Ritter A; Shanahan M; Ali R; Nguyen N; Pham K; Vuong TTA; Le GM
[Ad] Address:The Drug Policy Modelling Program, The National Drug and Alcohol Research Centre, UNSW Sydney, Australia. Electronic address: thu.vuong@unsw.edu.au.
[Ti] Title:Outcomes of compulsory detention compared to community-based voluntary methadone maintenance treatment in Vietnam.
[So] Source:J Subst Abuse Treat;87:9-15, 2018 Apr.
[Is] ISSN:1873-6483
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:INTRODUCTION: In Vietnam, like many countries in East and Southeast Asia, the government has invested heavily in center-based compulsory treatment (CCT) as the mainstay demand reduction strategy for illicit drug use. This approach has been criticised on human rights grounds. Meanwhile, community-based voluntary methadone maintenance treatment (MMT) has been implemented for nearly a decade with promising results. To date, there have been no comparative Vietnamese studies of these approaches. MATERIAL AND METHODS: The study, involving 208 CCT participants and 384 MMT participants with heroin dependence, was a combined retrospective and prospective observational study conducted over three years between 2012 and 2014 (with data at five time-points). The primary outcome was: self-report heroin use (confirmed by urinalysis). The four secondary outcomes were: illegal behaviours, overdose, blood-borne virus (BBV) risk behaviours, and monthly drug expenditure. Mixed effects regression analyses, which took into account baseline differences between the groups, were used to analyse the data. This study is registered with ClinicalTrials.gov, number NCT03071315. RESULTS: The study found MMT was more strongly associated with four outcome measures compared to CCT (reduction in heroin use ( = 3.39, SE = 0.31, p < .0001) (equivalent to an odds ratio of 29.67 (95% CI 21.76-40.45)), reduction in illegal behaviours ( = 0.94, SE = 0.39, p < .0001), (equivalent to an odds ratio of 2.56 (95% CI 1.79-3.78)), reduction in BBV risk behaviours ( = 1.08, SE = 0.17, p < .0001), (equivalent to an odds ratio of 2.94 (95% CI 2.48-3.49)), and reduction in monthly drug spending ( = -VND1,515,200 (equivalent to US$72.00), SE = VND452,900, p < .0001)). The analyses did not support the hypothesis that MMT was associated with better outcomes pertaining to overdose ( = -0.27, SE = 0.30, p = .62), probably due to the infrequency of these self-reported events. CONCLUSIONS: Our observational study suggests that MMT is associated with greater reductions in heroin use, BBV risk behaviours, drug-related illegal behaviours, and monthly drug spending compared with CCT. In the context that the CCT approach has been criticized for human rights violations, this study provides evidence to support the scale up of MMT and the transition of CCT to voluntary community based treatment.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180301
[Lr] Last revision date:180301
[Cl] Clinical Trial:ClinicalTrial
[St] Status:In-Data-Review

  8 / 13339 MEDLINE  
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[PMID]: 27776382
[Au] Autor:Parmar MK; Strang J; Choo L; Meade AM; Bird SM
[Ad] Address:MRC Clinical Trials Unit at University College London, London, UK.
[Ti] Title:Randomized controlled pilot trial of naloxone-on-release to prevent post-prison opioid overdose deaths.
[So] Source:Addiction;112(3):502-515, 2017 Mar.
[Is] ISSN:1360-0443
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND AND AIMS: Naloxone is an opioid antagonist used for emergency resuscitation following opioid overdose. Prisoners with a history of heroin injection have a high risk of drug-related death soon after release from prison. The NALoxone InVEstigation (N-ALIVE) pilot trial (ISRCTN34044390) tested feasibility measures for randomized provision of naloxone-on-release (NOR) to eligible prisoners in England. DESIGN: Parallel-group randomized controlled pilot trial. SETTING: English prisons. PARTICIPANTS: A total of 1685 adult heroin injectors, incarcerated for at least 7days pre-randomization, release due within 3months and more than 6months since previous N-ALIVE release. INTERVENTION: Using 1:1 minimization, prisoners were randomized to receive on release a pack containing either a single 'rescue' injection of naloxone or a control pack with no syringe. MEASUREMENTS: Key feasibility outcomes were tested against prior expectations: on participation (14 English prisons; 2800 prisoners), consent (75% for randomization), returned prisoner self-questionnaires (RPSQs: 207), NOR-carriage (75% in first 4 weeks) and overdose presence (80%). FINDINGS: Prisons (16) and prisoners (1685) were willing to participate [consent rate, 95% confidence interval (CI)=70-74%]; 218 RPSQs were received; NOR-carriage (95% CI=63-79%) and overdose presence (95% CI=75-84%) were as expected. We randomized 842 to NOR and 843 to control during 30months but stopped early, because only one-third of NOR administrations were to the ex-prisoner. Nine deaths within 12weeks of release were registered for 1557 randomized participants released before 9 December 2014. CONCLUSIONS: Large randomized trials are feasible with prison populations. Provision of take-home emergency naloxone prior to prison release may be a life-saving interim measure to prevent heroin overdose deaths among ex-prisoners and the wider population.
[Mh] MeSH terms primary: Drug Overdose/prevention & control
Heroin Dependence/mortality
Naloxone/therapeutic use
Narcotic Antagonists/therapeutic use
Prisoners/statistics & numerical data
[Mh] MeSH terms secundary: Adolescent
Adult
Drug Overdose/mortality
England/epidemiology
Female
Humans
Male
Middle Aged
Pilot Projects
Young Adult
[Pt] Publication type:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Name of substance:0 (Narcotic Antagonists); 36B82AMQ7N (Naloxone)
[Em] Entry month:1802
[Cu] Class update date: 180228
[Lr] Last revision date:180228
[Js] Journal subset:IM
[Da] Date of entry for processing:161025
[St] Status:MEDLINE
[do] DOI:10.1111/add.13668

  9 / 13339 MEDLINE  
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[PMID]: 29486421
[Au] Autor:Baldwin N; Gray R; Goel A; Wood E; Buxton JA; Rieb LM
[Ad] Address:Department of Family Practice, University of British Columbia, St. Paul's Hospital, 1081 Burrard St., Vancouver, B.C., Canada. Electronic address: nicholas.jc.baldwin@gmail.com.
[Ti] Title:Fentanyl and heroin contained in seized illicit drugs and overdose-related deaths in British Columbia, Canada: An observational analysis.
[So] Source:Drug Alcohol Depend;185:322-327, 2018 Feb 20.
[Is] ISSN:1879-0046
[Cp] Country of publication:Ireland
[La] Language:eng
[Ab] Abstract:BACKGROUND: Due to the alarming rise in opioid-related overdose deaths, a public health emergency was declared in British Columbia (BC). In this study, we examined the relationship between illicit fentanyl and heroin found in seized drugs and illicit overdose deaths in BC. METHODS: An observational cross-sectional survey was conducted using BC data from Health Canada's Drug Analysis Service, which analyzes drug samples seized by law enforcement agencies, and non-intentional illicit overdoses from the BC Coroner's Service, from 2000 to 2016. Initial scatter plots and subsequent multivariate regression analysis were performed to describe the potential relationship between seized illicit fentanyl samples and overdose deaths and to determine if this differed from seized heroin and overdose deaths. Fentanyl samples were analyzed for other drug content. RESULTS: Fentanyl is increasingly being found combined with other opioid and non-opioid illicit drugs. Strong positive relationships were found between the number of seized fentanyl samples and total overdose deaths (R2 = 0.97) as well as between seized fentanyl and fentanyl-detected overdose deaths (R2 = 0.99). A positive association was found between the number of seized heroin samples and total overdose deaths (R2 = 0.78). CONCLUSION: This research contributes to the expanding body of evidence implicating illicit fentanyl use (often combined with heroin or other substances) in overdose deaths in BC. Policy makers and healthcare providers are urged to implement drug treatment and harm reduction strategies for people at risk of overdose associated with current trends in illicit opioid use.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180227
[Lr] Last revision date:180227
[St] Status:Publisher

  10 / 13339 MEDLINE  
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[PMID]: 29477084
[Au] Autor:Bluthenthal RN; Chu D; Wenger LD; Bourgois P; Valente T; Kral AH
[Ad] Address:Department of Preventive Medicine, Institute for Prevention Research, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA, United States. Electronic address: rbluthen@usc.edu.
[Ti] Title:Differences in time to injection onset by drug in California: Implications for the emerging heroin epidemic.
[So] Source:Drug Alcohol Depend;185:253-259, 2018 Feb 15.
[Is] ISSN:1879-0046
[Cp] Country of publication:Ireland
[La] Language:eng
[Ab] Abstract:BACKGROUND: Heroin use is increasing in the US. Heroin use may predispose users towards injection routes of drug administration as compared to other illicit substances. OBJECTIVE: To explore the relationship between heroin use and drug injection, we compared time from first use to first injection (referred to as time to injection onset by drug [TTIOD]) of heroin, methamphetamine/speed, cocaine, and crack cocaine among people who inject drugs (PWID). METHODS: Age of first use and first injection by drug was collected from 776 PWID. Survival analyses were used to determine TTIOD and to examine demographic factors associated with TTIOD. Cox regression analysis was used to determine demographic factors associated with drug-specific injection onset. RESULTS: The eventual injection onset rate by the drug was 99% for participants who used heroin, 85% for participants who used methamphetamine/speed, 80% for participants who used powder cocaine, and 38% for participants who used crack cocaine. Hazard ratios for injection use within one year of first use by drug were: 1.37 (median survival time [MST] = 0.61 years) for heroin, 0.66 (MST = 1.10 years) for methamphetamine/speed, 0.50 (MST = 2.93 years) for powder cocaine, and 0.12 (MST = 39.59 years) for crack cocaine. Demographic differences in TTIOD were found for each drug. Demographic differences were found for eventual injection by drug for all substances except heroin. CONCLUSION: Among PWID, heroin use was associated with a more rapid transition to injection and a higher rate of eventual heroin injection regardless of demographics. More robust, innovative efforts to reduce heroin use and prevent injection initiation are urgently needed.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180228
[Lr] Last revision date:180228
[St] Status:Publisher


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