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BioHorizons conical dental prosthetic components connected to the endosseous dental implants are intended for use as an aid in prosthetic rehabilitations of the maxillary or mandibular arch to provide support for prosthetic restorations.

All digitally designed abutments for use with Conical Ti Base abutments are to be sent to a BioHorizons validated milling center for manufacture or to be designed and manufactured according to digital dentistry workflow. The workflow system integrates multiple components of the digital dentistry workflow: scan files from Intra-Oral Scanners, CAD software, CAM software, milling machine and associated tooling and accessories.

The BioHorizons Conical Ti Base abutments are prosthetic components and are intended for the restoration of BioHorizons dental implants within the specific indications of each implant system. All Conical Ti Base abutments are two-piece titanium-base type abutments with a pre-manufactured titanium base component cemented to a zirconia superstructure to create the final finished dental abutment. All the titanium bases are manufactured from Ti-6Al-4V titanium alloy per ASTM F136, Standard Specification for Wrought Titanium-6Aluminum-4Vanadium ELI (Extra Low Interstitial) Alloy (UNS R56401) for Surgical Implant Applications and are for single patient use. The prosthetics are provided non-sterile as indicated on the label. The subject devices are permanent or long-term, tissue/bone implant devices intended for more than 30 days of patient contact. BioHorizons dental prosthetics are invasive and / or surgically invasive devices placed in healed or compromised oral sites in direct contact with bone and soft tissue.

The Conical Ti-Base abutments are provided in engaging and non-engaging designs and are designed for single-unit or multi-unit restoration with a CAD/CAM zirconia superstructure attached to the abutment. The titanium base components are available for narrow and regular platforms and with gingival heights of 0.8 mm and 2.0 mm. The titanium base component post has been manufactured with matte finish creating a roughened surface to accommodate cementing. All patient-specific custom abutment fabrication for Conical Ti Base abutments are by prescription on the order of the clinician. All zirconia superstructures for use with the subject device Conical Ti Base abutments are made at a BioHorizons validated milling center under FDA quality system regulations, as cleared in K240187, or according to a digital dentistry workflow (subject of this submission described in the section below). As cleared in K240187, zirconia material, sagemax NexxZr® zirconia (K130991) is used to fabricate the patient-specific zirconia superstructure or direct crown. The cement for bonding of superstructures or crowns is a dual cure cement, 3M™ RelyX™ Unicem 2 Automix (K022476). These cleared materials are identical to the proposed digital dentistry workflow. The pre-manufactured titanium base component are not to be modified and are only intended to permit a customized zirconia restoration.

The design and fabrication of the zirconia superstructure will be conducted using a digital dentistry workflow requiring the use of the following equipment:

• Scanner: 3Shape Trios 5 intra-oral scanner.
• Design Software: 3Shape Abutment Designer Software, K151455.
• Zirconia Material: sagemax® NexxZr zirconia, K130991.
• CAM software: hyperDENT® Classic
• Milling machine: imes-icore® CORiTEC 150i Pro milling machine
• Cement: 3M™ RelyX™ Unicem 2 Automix Self-Adhesive Resin Cement, K022476.

The designed superstructure is attached to the titanium base component by the use of an FDA-cleared cement, 3M™ RelyX™Unicem 2 Automix Self-Adhesive Resin Cement, K022476. The resulting final prosthetic restoration is screwed to the dental implant. All subject abutments are single-use and provided non-sterile. Final restoration (which includes the corresponding screw) is intended to be sterilized at the dental clinic before it is placed in the patient. The final abutment is equivalent to the final abutment cleared in K240187.

The provided document is an FDA 510(k) clearance letter for the Conical Ti Base abutments.

*Crucially, this document does not contain information about acceptance criteria or a study proving that the device meets those criteria, nor does it provide details about any clinical studies, sample sizes, expert ground truth establishment, or AI effectiveness studies.

The letter focuses on establishing substantial equivalence to previously cleared predicate devices based on:

• Identical intended use: Both the subject device and the primary predicate (K240187) are "intended for use as an aid in prosthetic rehabilitations of the maxillary or mandibular arch to provide support for prosthetic restorations." The subject device adds the "digital dentistry workflow" aspect, which is equivalent to the secondary predicate (K231307).
• Similar or identical design and technological characteristics: This includes material composition (Ti-6Al-4V alloy for the titanium base, sagemax NexxZr zirconia for the superstructure), manufacturing methods, digital design software and hardware (for the zirconia superstructure), design limitations, usage, sterility, and biocompatibility.

The "Performance Data" section discusses:

• Reliance on predicate submission data for non-clinical aspects like mechanical testing, biological safety, steam sterilization, and magnetic resonance testing, as there were no changes since the previous clearance (K240187).
• New testing was conducted to support the CAD/CAM design and use within a digital dentistry workflow, demonstrating controls of this workflow and that the final abutment is equivalent to those produced by the validated milling center cleared in K240187. This involved assessing abutment angulation, diameter, height, wall thickness, tolerances, and part quality.
• Surface characterization (SEM and EDX) was done on the titanium base component to ensure no residual blast media.
• No clinical data were included in this submission.

Therefore, I cannot provide the requested information regarding acceptance criteria, specific study details, sample sizes, expert involvement, or AI effectiveness. The clearance is based on non-clinical data and substantial equivalence to existing devices.

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Noris Medical Ltd. Conical Platform Dental Implants System is intended to replace missing tooth/teeth in either jaw for supporting prosthetic devices that may aid in restoring the patient's chewing function.

Noris Medical Ltd. Conical platform Dental Implants diameter 3.25 are intended to replace lateral incisor in Maxilla and/or a central or lateral incisor in the mandible for supporting prosthetic devices that may aid in restoring the patient's chewing function.

The procedure can be accomplished in a one-stage surgical operation. All impants are appropriate for immediate loading when good primary stability is achieved and with appropriate occlusal loading.

The subject dental implant devices are single use devices, provided sterile by Gamma Radiation, made of Titanium alloy Ti- 6Al-4V ELI (ASTM F136). The UniCon and Tuff Unicon Implants are designed with conical connection comprises of cone and internal hex connection, diameters of 3.25, 3.5, 3.75 and 4.2 mm and lengths of 8, 10, 11.5, 13, 16 and 18 mm. Both Implants are designed with three thread zones, the Tuff UniCon with lower V-shape thread zone and UniCon with sharp buttress threads enables self-tapping. The middle zone square type thread of Tuff UniCon and wide edge buttress of UniCon is used for compressing cancellous bone. The micro threads on the upper zone enables less pressure on the crestal bone. The subject devices undergo RBM (Resorbable Blasting Media) surface treatment and color anodization within its connection for the purpose of color coding. It is indicated to replace missing tooth/teeth in either jaw for supporting prosthetic devices that may aid in restoring the patient's chewing function. The Implants Diameter Ø3.25 are intended to replace lateral incisor in maxilla and/or a central or lateral incisor in the mandible for supporting prosthetic devices that may aid in restoring the patient's chewing function.

Healing Caps are Titanium devices mounted onto the dental implant before the soft tissue is sutured around the implant and are intended to protect the implant bore. The Subject Healing Cap with the conical connection fits the UniCon and Tuff Unicon Implants. It is single use device, non-sterile and made of Titanium alloy Ti- 6Al-4V ELI (ASTM F136). The Healing Cap provided with 4.3mm, 4.8mm and 5.2mm Diameter and 4.5mm, 5.5mm, 6.5m, 7.5mm, 8.5mm External Body Height. The subject device undergoes color anodization.

The Subject Abutments (temporary, straight, angular and screw retained) with the conical connection fits the UniCon and Tuff UniCon Implants. It is single use device, non-sterile and made of Titanium alloy Ti- 6Al-4V ELI (ASTM F136). The subject device undergoes color anodization. The abutments are provided in different types and dimensions.

Multi-Unit Straight/Angular Screw Retained abutment are intended to function in the mandible or maxilla to support multiple-unit temporary or permanent restorations on Noris dental implants. The Subject Abutments with the conical connection fits the UniCon and Tuff UniCon Implants. It is single use device, non-sterile and made of Titanium alloy Ti- 6Al-4V ELI (ASTM F136). The subject device undergoes color anodization.

The abutment screw is intended to fasten the abutment to a dental implant. The Subject Abutments screw with the conical connection fits the UniCon and Tuff Unicon Implants. It is single use device, non-sterile and made of Titanium alloy Ti- 6Al-4V ELI (ASTM F136). The Abutments screw provided with 2mm Diameter and 7.3 mm Length. The subject device undergoes color anodization.

Cover screw- Healing Caps and Cover Screws are Titanium devices mounted onto the dental implant before the soft tissue is sutured in place around the implant and which are intended to protect the implant bore. The Subject Cover screw with the conical connection fits the UniCon and Tuff Unicon Implants. It is single use device, non-sterile and made of Titanium alloy Ti- 6Al-4V ELI (ASTM F136). The cover screws are provided with 3.2mm, 3.5mm Diameters and 4.9 mm Length. The subject device undergoes color anodization.

Based on the provided FDA 510(k) summary for the "Conical Platform Dental Implants System," here's a breakdown of the acceptance criteria and the study that proves the device meets them:

Important Note: This document is a 510(k) summary, which focuses on demonstrating substantial equivalence to a legally marketed predicate device. This is different from a PMA (Premarket Approval) application, which requires clinical efficacy and safety studies. Therefore, the "study that proves the device meets the acceptance criteria" in this context refers to non-clinical performance testing and comparisons to predicate devices, rather than a full-scale clinical trial with human subjects. The document primarily focuses on physical and material characteristics and demonstrates equivalence through engineering analyses rather than clinical outcomes with an AI component.

The request asks for information that is more typical of a software as a medical device (SaMD) or AI/ML device approval, such as "number of experts," "adjudication method," "MRMC study," and "training set ground truth." However, this document describes a dental implant system, which is a physical device, and does not mention any AI/ML components. Therefore, many of the requested points related to AI/ML device evaluation are not applicable or cannot be found in this submission. I will address the points that are applicable to this type of device and note where information is not present in the provided text.

1. Table of Acceptance Criteria and Reported Device Performance

The acceptance criteria for this physical device are primarily based on demonstrating substantial equivalence to predicate devices in terms of design, materials, indications for use, and performance testing (specifically fatigue).

2. Sample Size Used for the Test Set and Data Provenance

Since this is a physical device and the primary evidence provided is non-clinical performance data (fatigue testing, material characterization, etc.) rather than a clinical study with a "test set" of patients, the concept of a sample size for a test set and data provenance (country, retrospective/prospective) as it applies to AI/ML or clinical trial data isn't directly applicable here in the same way.

• Sample Size for Testing: The document states that "Fatigue tests per ISO 14801 were performed to determine the fatigue strength for UniCon implants." ISO 14801 specifies the number of samples for fatigue testing (typically 6-12 samples per group, depending on the desired confidence and methodology), but the exact number used is not explicitly stated in this summary. Other tests (biocompatibility, reprocessing, pyrogen, MRI review) were leveraged or based on scientific rationale, meaning new physical samples were likely not tested for these aspects as equivalence to previously cleared devices was the basis.
• Data Provenance: Not applicable in the context of a clinical test set for a physical device where the primary evaluation is non-clinical. The company is Noris Medical Ltd., located in Nesher, Israel.

3. Number of Experts Used to Establish Ground Truth for the Test Set and Qualifications

This question is highly relevant for AI/ML devices where "ground truth" often involves expert annotation or consensus. For this physical dental implant device, ground truth is established through:

• International Standards: e.g., ISO 14801 for fatigue testing, ASTM F136 for material specifications. These standards define the "ground truth" for material properties and mechanical performance.
• Regulatory Guidance: e.g., FDA Guidance for MRI safety, USP <85> for pyrogen limits. These guidances define the acceptable methodology and results.
• Predicate Device Characteristics: The comparison of technological characteristics to predicate devices (K140440, K142260, K130462) establishes the "ground truth" for substantial equivalence.

There is no mention of human experts defining "ground truth" in the way it's done for diagnostic image interpretation by multiple radiologists. The expertise lies within the material science, mechanical engineering, and regulatory compliance teams that designed the device and conducted/evaluated the non-clinical tests.

4. Adjudication Method for the Test Set

Not applicable. There is no human interpretation or subjective assessment of a test set that would require an adjudication method like 2+1 or 3+1. Performance is measured against objective engineering standards and direct comparison of physical/material characteristics.

5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study was Done

No. An MRMC study is specific to diagnostic imaging devices, particularly those involving human interpretation of medical images, often assisted by AI. This document pertains to a physical dental implant system and therefore, this type of study was not conducted or required. No AI assistance or human reader improvement is mentioned.

6. If a Standalone (Algorithm Only Without Human-in-the-Loop Performance) was Done

Not applicable. This device is a physical dental implant system and does not involve an algorithm or AI component.

7. The Type of Ground Truth Used

The "ground truth" for this device application is primarily based on:

• Engineering Standards: Specific material properties, mechanical performance (e.g., fatigue strength as per ISO 14801), and dimensional tolerances.
• Predicate Device Characteristics: The established safety and effectiveness of the chosen predicate devices serve as the benchmark for demonstrating substantial equivalence for the new device's indications for use, materials, and design.
• Leveraged Data: For biocompatibility, reprocessing sterilization, and pyrogen limits, the "ground truth" is that the material, manufacturing, and surface treatments are identical to previously cleared devices (K151909 and K140440), therefore their established safety and performance data (ground truth) is directly applicable.

No pathology reports or patient outcomes data as "ground truth" are mentioned in this 510(k) summary, as it relies on non-clinical data for substantial equivalence.

8. The Sample Size for the Training Set

Not applicable. There is no AI/ML component described, so there isn't a "training set" in the context of machine learning.

9. How the Ground Truth for the Training Set Was Established

Not applicable, as there is no AI/ML component or training set described.

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The Conical Plus Implant System is indicated for use in partially or fully edentulous mandibles and maxillae, In support of single or multiple-unit retained, screw-retained, screw-retained, or overdenture restorations, and terminal or intermediate abutment support for fixed bridgework. This system is dedicated for one and two stage surgical procedures. The systems is intended for delayed loading.

Not Found

I'm sorry, but this document does not contain the information requested. This document is a 510(k) clearance letter from the FDA for a dental implant system. It outlines the regulatory classification, general controls, and other requirements for the device. However, it does not describe any acceptance criteria, performance studies, or details about artificial intelligence (AI) or machine learning (ML) components.

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CONi provides for the archiving and viewing of medical images from the following DICOM modalities: Computed Tomography (CT), Magnetic Resonance (MR), X-ray (CR), Ultrasound (US), and Visible Light (External Camera (XC) and Other (OT)). Images and information can be viewed and stored via a secure Internet connection.

CONi is not intended for use in mammography.

CONi is not intended for diagnostic use on mobile devices

CONi (Capture Over Network Interface) is a secure cloud-based application for viewing and archiving medical images. The CONi software system is comprised of a Picture Archiving and Communication System (CONiPACS) and an image viewer (CONiView). CONi supports imaging studies from the following DICOM modalities: Computed Tomography (CT), Magnetic Resonance (MR), X-ray (CR), Ultrasound (US), and Visible Light (External Camera (XC) and Other (OT)). Images and information can be viewed and stored via a secure Internet connection.

The provided submission K130624 for GlobalMedia Group, LLC. CONi™ does not contain information about explicit acceptance criteria for device performance or a detailed study proving the device meets said criteria in the way a clinical performance study would.

Instead, this 510(k) summary focuses on demonstrating substantial equivalence to a predicate device (ALZ Web PACS, Version 1.0, K081304) for its intended use, technological characteristics, and safety/effectiveness, without presenting specific performance metrics.

The non-clinical tests listed are related to software development and validation, rather than a performance study with specific acceptance criteria:

• Establishment of Requirements
• Risk Analysis (software and system)
• DICOM Standard Conformance Statement
• HIPAA Compliance Statement
• Software Unit Testing
• Software Integration Testing
• Software System Testing
• Software Hazard Testing

Therefore, it is not possible to fill out the requested table and answer many of the study-specific questions.

Here's an attempt to address the questions based on the available information, noting where information is explicitly absent:

1. Table of acceptance criteria and the reported device performance

A table of acceptance criteria and reported device performance cannot be provided as this information is not present in the 510(k) summary. The submission focuses on demonstrating substantial equivalence, not on specific performance metrics or clinical study results with predefined acceptance criteria. Testing focused on software validation, DICOM conformance, and HIPAA compliance.

2. Sample size used for the test set and the data provenance (e.g., country of origin of the data, retrospective or prospective)

This information is not provided in the 510(k) summary. The document does not describe a clinical performance test set or data derived from real patient cases. The testing mentioned (Unit, Integration, System, Hazard) implies internal software quality assurance.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts (e.g., radiologist with 10 years of experience)

This information is not provided. No ground truth establishment for a test set of medical cases is described.

4. Adjudication method (e.g., 2+1, 3+1, none) for the test set

This information is not provided. No adjudication method is mentioned as there is no described test set requiring expert adjudication.

5. If a multi-reader multi-case (MRMC) comparative effectiveness study was done, if so, what was the effect size of how much human readers improve with AI vs without AI assistance

An MRMC comparative effectiveness study was not done and is not applicable to this device. CONi™ is a Picture Archiving Communication System (PACS) and image viewer, not an AI-assisted diagnostic tool designed to improve human reader performance. It does not provide AI assistance for diagnostic interpretation.

6. If a standalone (i.e., algorithm only without human-in-the-loop performance) was done

A standalone performance study was not done and is not applicable. CONi™ is a PACS and image viewer, which inherently involves human interaction for viewing and archiving images. It does not perform any diagnostic algorithms in a standalone capacity that would require such a study.

7. The type of ground truth used (expert consensus, pathology, outcomes data, etc.)

This information is not provided. No ground truth is mentioned as there are no diagnostic claims or performance analyses on medical images in the context of clinical accuracy.

8. The sample size for the training set

This information is not provided. As CONi™ is a PACS and image viewer (not an AI/CAD algorithm), it does not typically involve a "training set" in the machine learning sense. The software development process likely involved internal testing with various types of DICOM images to ensure proper functionality and rendering.

9. How the ground truth for the training set was established

This information is not provided and is not applicable as there is no "training set" in the context of machine learning described for diagnostic purposes.

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MIS Conical Connection Implants are intended to be surgically placed in the bone of the upper or lower jaw arches to provide support for prosthetic devices, such as artificial teeth, in order to restore a patient's chewing function.

When a one stage surgical procedure is applied, the implant may be immediately loaded when good primary stability is achieved and the occlusal load is appropriate.

The conical connection dental implants are self tapping, root-form, two piece screw type dental implants, indicated for use in surgical and restorative applications for placement in the upper or lower jaw to provide support for prosthetic devices such as artificial teeth, in order to restore the patient chewing function. The conical connection dental implants are provided in 3.75, 4.2 and 5.0 mm diameters and with the following lengths:

0 3.75mm diameter: 8mm, 10mm, 11.5mm, 13mm and 16mm

0 4.2mm diameter: 8mm, 10mm, 11.5mm, 13mm and 16mm

o 5.0mm diameter: 8mm, 10mm, 11.5mm, 13mm and 16mm

The implants surface is sand blasted and acid etched.

The conical connection dental implants are two piece devices whereas the implant is to be used in combination with cover screws, healing caps, abutments and superstructures.

The conical connection dental implants are made of Ti6AL4V ELI complying with standard ASTM F 136-08- Standard Specification for Wrought Titanium-6Aluminum-4Vanadium ELI (Extra Low Interstitial) Alloy for Surgical Implant. The conical connection dental implants were modified to integrate a new type of connection, internal conical connection of 6 degrees with an anti-rotation index of six positions, ensuring a more definite seal and a more stable connection.

This looks like information from a 510(k) premarket notification for a medical device, specifically dental implants. This type of submission is for demonstrating "substantial equivalence" to a predicate device, rather than proving safety and efficacy through clinical trials that would typically involve acceptance criteria and detailed performance studies like those common for PMAs or de novo submissions.

Therefore, many of the requested categories (like "acceptance criteria," "sample size for test set," "number of experts," "adjudication method," "MRMC study," "standalone performance," "type of ground truth," and "sample size for training set") are not applicable in the context of this 510(k) submission.

The document focuses on comparing the new device to a legally marketed predicate device based on technological characteristics and non-clinical performance (like fatigue testing), with a brief mention of a preliminary clinical evaluation for stability.

Here's a breakdown of the available information:

1. Table of acceptance criteria and the reported device performance

Not applicable in the typical sense for a 510(k) submission. The "acceptance criteria" here is "substantial equivalence" to the predicate device. The performance is demonstrated through a comparison of technological characteristics and non-clinical testing.

2. Sample size used for the test set and the data provenance (e.g. country of origin of the data, retrospective or prospective)

• Sample Size for Test Set:
  • Non-clinical (Fatigue Test): Not explicitly stated. Typically, fatigue tests follow ISO or ASTM standards, which specify sample sizes (e.g., 5-10 samples per group).
  • Clinical Evaluation: "case studies" - the specific number of cases is not stated, but "case studies" typically implies a small number.
• Data Provenance: Not specified for the non-clinical or preliminary clinical evaluation. Israel, where the company is located, is the likely origin for the internal testing.
• Retrospective or Prospective:
  • Non-clinical: Likely prospective (tests conducted specifically for this submission).
  • Clinical Evaluation: "preliminary clinical evaluation, based on case studies with six months follow up" suggests prospective observation of a small number of patients post-implantation.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts (e.g. radiologist with 10 years of experience)

Not applicable. For a device like this, the "ground truth" for the non-clinical fatigue test is measured physical parameters, not expert consensus on images. The preliminary clinical evaluation likely involved clinical observations made by the treating clinicians, not multiple independent experts establishing a "ground truth" for a test set in the same way as, for example, a diagnostic AI device.

4. Adjudication method (e.g. 2+1, 3+1, none) for the test set

Not applicable. No expert adjudication method is described for either the non-clinical or preliminary clinical evaluation.

5. If a multi reader multi case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance

Not applicable. This device is not an AI diagnostic device.

6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done

Not applicable. This device is not an AI diagnostic device/algorithm.

7. The type of ground truth used (expert consensus, pathology, outcomes data, etc)

• Non-clinical Fatigue Test: The ground truth is the physical measurement of fatigue properties (e.g., cycles to failure, maximum load) according to established engineering standards.
• Preliminary Clinical Evaluation: The "good stability" observation would be based on clinical outcomes and examinations by the treating clinician over the six-month follow-up period.

8. The sample size for the training set

Not applicable. This is not an AI device that requires a training set.

9. How the ground truth for the training set was established

Not applicable. This is not an AI device that requires a training set.

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3i's Conical Angled Abutments are indicated for use in single and multiple unit cases and as custom copings where tissue depth, as measured from the crest of the tissue to the shelf of the implant; angulation of the implant in relation to other implants or adjacent dentition; and, interarch distance measured form the shelf of the implant to the opposing dentition, provide for improved emergence profiles and contours for esthetic restorations.

The Conical Angled Abutments are designed to interface with 3i's internal and external connected implants. They will be available in 17° and 25° angles. The seating surface will be 4.1mm and 5.0mm diameters and the transmucosal tissue heights will be 2.0mm and 4.0mm. They will be manufactured out of Titanium Alloy.

I am sorry, but based on the provided text, there is no information about acceptance criteria or a study that proves a device meets such criteria. The document is a 510(k) summary for a dental device (Conical Angled Abutments), and it primarily focuses on describing the device, its classification, predicate devices, and an FDA letter confirming substantial equivalence.

It explicitly states: "Performance standards have not been established by the FDA under Section 514 of the Federal Food, Drug, and Cosmetic Act." This indicates that the approval for this device was based on substantial equivalence to a legally marketed predicate device, rather than meeting specific performance criteria demonstrated through a clinical study.

Therefore, I cannot provide the requested table or details about studies, sample sizes, experts, adjudication methods, MRMC studies, standalone performance, or ground truth establishment based on the given text.

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