ClinicalTrials.gg
RecruitingNCT05907538Updated Jun 18, 2023

Interoception in Patients With Medically Unexplained Symptoms

An observational study in Fibromyalgia and Burnout, Psychological, sponsored by Hasselt University. Recruiting at 2 sites in Belgium. Open to participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2023-06-18.

Sponsored by Hasselt University · Observational

From the registry’s dates

  • Primary completion was expected by Jun 2024, 2 years 4 months ago, but the record still lists the study as recruiting.
  • Started Jul 2022; still recruiting 4 years 3 months later.

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Study type
Observational
Model
Case-control
Time perspective
Cross-sectional
Enrollment
84
Ages
18 Years to 65 Years
Sex
All
01

Where this study stands

Counted across the records on this site · 2026-11-13

Among 23 studies in Fibromyalgia with a site in Belgium — 7 open to participants now, 7 under way, none of them phase 3. Fibromyalgia · Belgium.

Started
2022
with 2 others
Observational
9 of 23
5 open now
Registered
17th of 23
by date
Lead sponsor
2 of 23
Hasselt University

Among the 23 studies in Fibromyalgia with a site in Belgium, this one is one of 3 that started in 2022, is one of 9 observational ones, and was the 17th registered.

Fibromyalgia

1,243 studies on the registry are indexed under Fibromyalgia; 255 are open to participants now.

Browse Fibromyalgia studies →

Open to participants now

7 of the 23 studies in Fibromyalgia with a site in Belgium are open now. Recruiting first, the newest first:

1 more — sign in →

All 7 open studies →

A study can be open while its sites in Belgium have not opened yet or have stopped. Only those recruiting at a site in Belgium →

Who these studies take

Of the 160 Fibromyalgia studies recruiting now, 50 (31%) set no upper age limit and 96 (60%) stop at 75 or younger; 14 take children under 18; 35 take healthy volunteers.

This study: 18 Years to 65 Years · all sexes.

The full table on the hub →

This tab as a report to print or save as PDF → With an account.

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Watch this landscapeDownload CSVNarrow it in search →With an account: a weekly mail of what changed among 23 studies in Fibromyalgia with a site in Belgium, or all of them as a file.
02

Study summary

The goal of this observational study is to learn about interoception in patients with stress related syndromes (overstrain, burnout; SRS) and functional disorder (fibromyalgia/ chronic fatigue syndrome; FD). The main questions it aims to answer are:

  • Is there a significant difference in interoception between patients with SRS and healthy controls?
  • Is there a significant difference in interoception between patients with FD and healthy controls?
  • Is there a significant difference in interoception between patients with SRS and FD?

The participants will perform the respiratory occlusion discrimination task and have to fill out some questionnaires.

Researchers will compare healthy controls to see if there is a significant difference.

Read the detailed description

About 40-49% of primary care patients report somatic symptoms that cannot be explained by any well-known organic disease. Typical examples are headache, dizziness, shortness of breath, fatigue, muscle aches, nausea, and gastrointestinal symptoms. These bodily symptoms can occur in the context of SRS such as overstrain and burnout, but also as clusters in a more chronic form, often referred to as FD, such as fibromyalgia or chronic fatigue syndrome.

Fibromyalgia is a chronic widespread pain condition characterized by point tenderness, fatigue, sleep disturbance, cognitive complaints, and increasing somatic complaints. In addition, chronic fatigue syndrome is a chronic condition characterized by severe fatigue, impairments in concentration and short-term memory, sleep disturbance, and musculoskeletal pain. Both are multi-faceted and challenging chronic conditions with considerable overlap in symptoms, causes and treatments. According to multidisciplinary guidelines, overstrain is characterized by the following symptoms: disturbed or restless sleep, irritability, not being able to stand commotion/ noise, emotional lability, feeling stressed or rushed, not being able to relax, difficulty concentrating and/or forgetfulness with a duration of 3 months. Burnout occurs when symptoms of overstrain persist for more than 6 months, and feelings of fatigue and exhaustion become prominent. The patient experiences significant limitations in professional and/or social functioning.

Interoception has been described in the literature as "the overall process of how the nervous system senses, integrates, stores and displays information about the state of the internal body". Theory suggests that interoception should be divided into three measurable constructs: interoceptive accuracy (objective accuracy in detecting internal bodily sensations), interoceptive sensitivity (the self-perceived tendency to be internally self-focused), and interoceptive awareness (metacognition about his/her own interoceptive accuracy).

The measurement will take place in the TRACE labs of Ziekenhuis Oost Limburg (ZOL). The informed consent will be signed before any data collection takes place. The experiment will take approximately 30 minutes. Participants will start with the interoceptive accuracy task using the Respiratory Occlusion Discrimination Task (ROD task). The ROD task measures how good subjects are at distinguishing the lengths of short (max 620 ms) inspiratory occlusions (or respiratory interruptions). Occlusions of these lengths are not aversive or unpleasant. One trial consists of two occlusions within one inspiration (inter-occlusion interval = 300 milliseconds), one occlusion being the reference occlusion (always 440 milliseconds) and one occlusion being the test occlusion (longer or shorter than 440 milliseconds), administered in random order. The participant is asked to indicate which of the two occlusions was longest. An adaptive staircase paradigm is used to determine the just noticeable difference in lengths of inspiratory occlusions. The length of the task depends on the performance of the subject, but is on average 56 trials (= 15 minutes). After the experiment, another short side experiment of 16 trials will be conducted in which the participant should indicate how confident they were in their response on a Visual Analogue scale (VAS), in order to estimate interoceptive awareness. In the meantime, participants will be also asked to complete a questionnaire bundle at home (online), which takes approximately 45 minutes to complete.

The power calculations resulted in a total of 28 persons per group. Therefore the investigators plan to recruit a total of 84 people.

Primary outcomes are interoceptive accuracy, interoceptive sensibility, and interoceptive awareness. Secondary outcome measures are psychological variables measured using questionnaires.

Descriptive statistics will be used to display baseline group characteristics. To evaluate between-group differences (i.e. the difference between patients with FD,SRS and healthy controls regarding interoception and psychological variables) one-way ANOVA's will be used.

03

Conditions studied

  • Fibromyalgia
  • Burnout, Psychological

Keywords

  • Fibromyalgia
  • Burnout
  • Interoception
04

Who can participate

Ages eligible
18 Years to 65 Years
Sexes eligible
All
Sampling method
Probability sample

Study population

All patients with fibromyalgia diagnosed according to the ACR criteria (Wolfe et al., 2010; 2016) are eligible to participate, all patients with chronic fatigue syndrome diagnosed according to the CDC criteria (Fukuda et al., 1994), and all patients with overstrain or burnout diagnosed according to the multidisciplinary guidelines for overstrain and burnout for first-line professionals from the Dutch Society of Occupational Medicine (NVAB, 2011) are eligible to participate

Eligibility criteria

Eligibility Criteria patients with FD (fibromyalgia and/or chronic fatigue syndrome)

Inclusion Criteria:

  • patients with fibromyalgia should be diagnosed by using the ACR criteria (American College of Rheumatology, Wolfe et al., 2010; Wolfe et al., 2016). patients with chronic fatigue syndrome should be diagnosed by using the CDC criteria (Centers for Disease Control and Prevention; Fukuda et al., 1994).

Exclusion Criteria:

  • Younger than 18 or older than 65
  • Pregnancy
  • Primary depressive episode, anxiety disorder, eating disorder, substance abuse, neurocognitive, or psychotic episode diagnosed with (Diagnostic and Statistical Manual of Mental Disorders; MINI-s; Overbeek et al., 1999).
  • Presence of a chronic organic disorder (One speaks of a chronic organic disorder if it is present for a period of at least 3 months. Examples include: Epilepsy, Heart Disease, Rheumatism, Asthma, Diabetes, etc.) or acute organic condition (fever, flu, etc.)
  • > 30

Eligibility Criteria patients with SRS (overstrain or burnout)

Inclusion Criteria:

  • patients with overstrain or burnout should be diagnosed according to the multidisciplinary guidelines for overstrain and burnout for professionals from the Dutch Society of Occupational Medicine (NVAB, 2011)

Exclusion Criteria:

  • Younger than 18 or older than 65
  • Pregnancy
  • Primary depressive episode, anxiety disorder, eating disorder, substance abuse, neurocognitive, or psychotic episode diagnosed with DSM-V (MINI-s; Overbeek et al., 1999).
  • Presence of a chronic organic disorder (One speaks of a chronic organic disorder if it is present for a period of at least 3 months. Examples include: Epilepsy, Heart Disease, Rheumatism, Asthma, Diabetes, etc.) or acute organic condition (fever, flu, etc.)
  • BMI > 30

Eligibility Criteria healthy controls

Inclusion Criteria:

Healthy controls will be selected so that there is an equal ratio between patients and healthy controls for

  • Age group (per 5 years)
  • Gender (including X)
  • Educational attainment
  • BMI

all participants need a score \< 75 on the CSD (Walentynowicz, et al., 2018)

Exclusion Criteria:

  • Younger than 18 or older than 65
  • Pregnancy
  • Presence of a depressive episode, anxiety disorder, eating disorder, substance abuse, neurocognitive, or psychotic disorder diagnosed with DSM-V (MINI-s; Overbeek et al., 1999).
  • Presence of a chronic organic disorder (One speaks of a chronic organic disorder if it is present for a period of at least 3 months. Examples are: epilepsy, heart disease, rheumatism, asthma, diabetes, etc.) or acute organic disorder (fever, flu, etc.)
  • BMI > 30
  • Persistent physical symptoms (e.g., hyperventilation symptoms, prolonged COVID, chronic pain or fatigue, chronic tinnitus, etc.)
Terms in these criteria, in plain language(3)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

DSM diagnostic criteria

The American Psychiatric Association’s manual of mental health diagnoses. DSM-5 (2013, revised as DSM-5-TR in 2022) replaced DSM-IV, and some studies still name the older edition. “Meets DSM criteria for …” means diagnosed by that edition’s diagnostic criteria, usually by a clinician in an interview.

BMI (body mass index)

Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.

What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.

Line of therapy

A line of therapy is one course of treatment, which may combine several drugs. First-line is the first course given; second-line follows when that stops working or is not tolerated.

“Two prior lines” means two courses that count separately under the study’s rules — not simply two drugs. Ask the study team if you are unsure how yours are counted.

05

Study design

Observational model
Case-control
Time perspective
Cross-sectional
Enrollment
84 participants (estimated)
Patient registry
No

Groups and cohorts

  • Patients with functional disorder (FD)

    Patients with fibromyalgia diagnosed using the ACR criteria (American College of Rheumatology, Wolfe et al., 2010; 2016) Patients with chronic fatigue syndrome diagnosed using the CDC criteria (Centers for Disease Control and Prevention; Fukuda et al., 1994)

    Other: Interoceptive accuracy measurement · Other: Interoceptive sensibility measurement · Other: Interoceptive awareness measurement

  • Patients with stress related syndromes (SRS)

    Patients with overstrain and burnout according to the multidisciplinary guidelines for overstrain and burnout in primary care from the Dutch Society of Occupational Medicine (NVAB, 2011)

    Other: Interoceptive accuracy measurement · Other: Interoceptive sensibility measurement · Other: Interoceptive awareness measurement

  • Healthy controls

    Healthy controls will consist of people who experience few physical complaints in daily life. The healthy controls will thus be screened for inclusion using the CSD (Checklist for Symptoms in Daily life; Walentynowicz, et al., 2018). Only volunteers with a score of 75 or lower on this questionnaire will be included

    Other: Interoceptive accuracy measurement · Other: Interoceptive sensibility measurement · Other: Interoceptive awareness measurement

Interventions

  • OtherInteroceptive accuracy measurement

    Interoceptive accuracy will be measured using the Respiratory Occlusion Discrimination Task (ROD task; Van Den Houte et al., 2021). The ROD task measures how good subjects are at distinguishing the lengths of short (max 620 milliseconds) inspiratory occlusions (or respiratory interruptions).

  • OtherInteroceptive sensibility measurement

    Interoceptive sensibility will be measured using two self-report questionnaires, the The Interoceptive Sensitivity and Attention Questionnaire (ISAQ; Bogaerts et al., 2022) and the the Three-domain Interoceptive Sensations Questionnaire (THISQ; Vlemincx et al., 2021)

  • OtherInteroceptive awareness measurement

    Interoceptive awareness will be measures using a visual analogue scale (VAS)

06

What researchers measure

Primary outcomes

  1. Interoceptive accuracy

    Respiratory occlusion discrimination task (ROD task; Van Den Houte et al., 2021)

    Time frame: 20 minutes

  2. Interoceptive sensibility

    Interoceptive Sensitivity and Attention Questionnaire (ISAQ; Bogaerts et al., 2022)

    Time frame: 5 minutes

  3. Interoceptive sensibility

    THree-domain Interoceptive Sensations Questionnaire (THISQ; Vlemincx et al., 2021)

    Time frame: 5 minutes

  4. Interoceptive awareness

    Visual analogue scale (0-100). A score of 0 indicates that participants are not certain at all of their answer, a score of 100 indicates that participants are entirely certain of their answer

    Time frame: 5 minutes

Secondary outcomes

  1. Psychological variables

    Checklist for Symptoms in Daily Life (CSD; Walentynowicz et al., 2018)

    Time frame: 5 minutes

  2. Psychological variables

    Positive and Negative Affect Scale (PANAS; Watson et al., 1988)

    Time frame: 5 minutes

  3. Psychological variables

    Tellegen Absorption Scale (TAS; Tellegen \& Atkinson, 1974)

    Time frame: 5 minutes

  4. Psychological variables

    Traumatic Experiences Checklist (TEC; Nijenhuis et al., 2002)

    Time frame: 10 minutes

  5. Psychological variables

    Toronto Alexithymia Scale (TAS-20; Bagby et al., 1994)

    Time frame: 5 minutes

  6. Psychological variables

    Need for Controllability and Predictability Questionnaire (NCP-q; Ramakers et al., manuscript in preparation)

    Time frame: 5 minutes

  7. Psychological variables

    Frost Multidimensional Perfectionism Scale (FMPS; Frost et al., 1990)

    Time frame: 5 minutes

  8. Psychological variables

    Acceptance and Action Questionnaire-II (AAQ-II; Bond et al., 2011)

    Time frame: 5 minutes

07

Study locations

2 of 2 sites recruiting
08

References and documents

Publications

  • Haller H, Cramer H, Lauche R, Dobos G. Somatoform disorders and medically unexplained symptoms in primary care. Dtsch Arztebl Int. 2015 Apr 17;112(16):279-87. doi: 10.3238/arztebl.2015.0279. PubMed 25939319 ↗
  • Barsky AJ, Borus JF. Functional somatic syndromes. Ann Intern Med. 1999 Jun 1;130(11):910-21. doi: 10.7326/0003-4819-130-11-199906010-00016. PubMed 10375340 ↗
  • Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Katz RS, Mease P, Russell AS, Russell IJ, Winfield JB, Yunus MB. The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care Res (Hoboken). 2010 May;62(5):600-10. doi: 10.1002/acr.20140. PubMed 20461783 ↗
  • Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Hauser W, Katz RL, Mease PJ, Russell AS, Russell IJ, Walitt B. 2016 Revisions to the 2010/2011 fibromyalgia diagnostic criteria. Semin Arthritis Rheum. 2016 Dec;46(3):319-329. doi: 10.1016/j.semarthrit.2016.08.012. Epub 2016 Aug 30. PubMed 27916278 ↗
  • Walentynowicz, M., Witthöft, M., Raes, F., Van Diest, I., & Van den Bergh, O. (2018). Sensory and affective components of symptom perception: a psychometric approach. Journal of Experimental Psychopathology, 9(2), 1-13. Doi: 10.5127/jep.059716
  • Courtois I, Cools F, Calsius J. Effectiveness of body awareness interventions in fibromyalgia and chronic fatigue syndrome: a systematic review and meta-analysis. J Bodyw Mov Ther. 2015 Jan;19(1):35-56. doi: 10.1016/j.jbmt.2014.04.003. Epub 2014 Apr 18. PubMed 25603742 ↗
  • NVAB. (2011). Eén lijn in de eerste lijn bij overspanning en burnout: Multidisciplinaire richtlijn overspanning en burnout voor eerstelijns professionals. Geraadpleegd van https://nvab-online.nl/sites/default/files/bestanden-webpaginas/MDRL_Overspanning-Burnout.pdf
  • Terluin, B., Van der Klink, J., Schaufeli, W. (2005). Stressgerelateerde klachten: spanningsklachten, overspanning en burnout. In J. Van der Klink, B. Terluin B (Reds), Psychische problemen en werk. Handboek voor een activerende begeleiding door huisarts en bedrijfsarts (p. 259-290). Houten: Bohn Stafleu Van Loghum.
  • van der Klink JJ, van Dijk FJ. Dutch practice guidelines for managing adjustment disorders in occupational and primary health care. Scand J Work Environ Health. 2003 Dec;29(6):478-87. doi: 10.5271/sjweh.756. PubMed 14712856 ↗
  • Khalsa SS, Adolphs R, Cameron OG, Critchley HD, Davenport PW, Feinstein JS, Feusner JD, Garfinkel SN, Lane RD, Mehling WE, Meuret AE, Nemeroff CB, Oppenheimer S, Petzschner FH, Pollatos O, Rhudy JL, Schramm LP, Simmons WK, Stein MB, Stephan KE, Van den Bergh O, Van Diest I, von Leupoldt A, Paulus MP; Interoception Summit 2016 participants. Interoception and Mental Health: A Roadmap. Biol Psychiatry Cogn Neurosci Neuroimaging. 2018 Jun;3(6):501-513. doi: 10.1016/j.bpsc.2017.12.004. Epub 2017 Dec 28. PubMed 29884281 ↗
  • Garfinkel SN, Seth AK, Barrett AB, Suzuki K, Critchley HD. Knowing your own heart: distinguishing interoceptive accuracy from interoceptive awareness. Biol Psychol. 2015 Jan;104:65-74. doi: 10.1016/j.biopsycho.2014.11.004. Epub 2014 Nov 20. PubMed 25451381 ↗
  • Van Den Houte M, Vlemincx E, Franssen M, Van Diest I, Van Oudenhove L, Luminet O. The respiratory occlusion discrimination task: A new paradigm to measure respiratory interoceptive accuracy. Psychophysiology. 2021 Apr;58(4):e13760. doi: 10.1111/psyp.13760. Epub 2021 Jan 12. PubMed 33438245 ↗
  • Fukuda K, Straus SE, Hickie I, Sharpe MC, Dobbins JG, Komaroff A. The chronic fatigue syndrome: a comprehensive approach to its definition and study. International Chronic Fatigue Syndrome Study Group. Ann Intern Med. 1994 Dec 15;121(12):953-9. doi: 10.7326/0003-4819-121-12-199412150-00009. PubMed 7978722 ↗
  • Bogaerts K, Walentynowicz M, Van Den Houte M, Constantinou E, Van den Bergh O. The Interoceptive Sensitivity and Attention Questionnaire: Evaluating Aspects of Self-Reported Interoception in Patients With Persistent Somatic Symptoms, Stress-Related Syndromes, and Healthy Controls. Psychosom Med. 2022 Feb-Mar 01;84(2):251-260. doi: 10.1097/PSY.0000000000001038. PubMed 34840287 ↗
  • Vlemincx E, Walentynowicz M, Zamariola G, Van Oudenhove L, Luminet O. A novel self-report scale of interoception: the three-domain interoceptive sensations questionnaire (THISQ). Psychol Health. 2023 Sep-Oct;38(9):1234-1253. doi: 10.1080/08870446.2021.2009479. Epub 2021 Dec 7. PubMed 34875958 ↗
  • Watson D, Clark LA, Tellegen A. Development and validation of brief measures of positive and negative affect: the PANAS scales. J Pers Soc Psychol. 1988 Jun;54(6):1063-70. doi: 10.1037//0022-3514.54.6.1063. PubMed 3397865 ↗
  • Nijenhuis, E. R. S., van der Hart, O., & Kruger, K. (2002). The psychometric characteristics of the Traumatic Experiernce Checklist (TEC): First findings among psychiatric outpatients. Clinical Psychology & Psychotherapy, 9(3). 200-210. DOI: 10.1002/cpp.332
  • Bagby RM, Parker JD, Taylor GJ. The twenty-item Toronto Alexithymia Scale--I. Item selection and cross-validation of the factor structure. J Psychosom Res. 1994 Jan;38(1):23-32. doi: 10.1016/0022-3999(94)90005-1. PubMed 8126686 ↗
  • Bond FW, Hayes SC, Baer RA, Carpenter KM, Guenole N, Orcutt HK, Waltz T, Zettle RD. Preliminary psychometric properties of the Acceptance and Action Questionnaire-II: a revised measure of psychological inflexibility and experiential avoidance. Behav Ther. 2011 Dec;42(4):676-88. doi: 10.1016/j.beth.2011.03.007. Epub 2011 May 25. PubMed 22035996 ↗
  • Frost, R. O., Marten, P., Lahart, C., & Rosenblate, R. (1990). The dimensions of perfectionism. Cognitive Therapy and Research, 14(5), 449-468. https://doi.org/10.1007/BF01172967
  • Tellegen A, Atkinson G. Openness to absorbing and self-altering experiences ("absorption"), a trait related to hypnotic susceptibility. J Abnorm Psychol. 1974 Jun;83(3):268-77. doi: 10.1037/h0036681. No abstract available. PubMed 4844914 ↗
  • Overbeek, T., Schrueurs, K., & Griez, E. (1999). MINI-the international neuropsychiatric interview. Dutch version 5.0.0 DSM-IV. Maastricht (Netherlands): University of Maastricht.
  • Ramakers, I., Fonteyne, R., Walentynowicz, M., Van Oudenhove, L., Van Den Houte, M., & Bogaerts, K. (2023). The need for controllability and predictability questionnaire (NCP-q): Psychometric properties and first findings in a clinical sample. (Manuscript in preparation).
09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Started Jul 2022 (actual). Primary completion is estimated for Jun 2024, 23 months after the start.

How these figures are worked out, and which studies are left out of them.

Registered
May 24, 2023
First posted
Jun 18, 2023
StartActual
Jul 25, 2022
Primary completionEst.
Jun 30, 2024
CompletionEst.
Jun 30, 2024
Last update
Jun 18, 2023
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Jun 18, 2023, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT05907538
Lead sponsor
Hasselt University
Collaborators
TRACE labs Ziekenhuis Oost-Limburg (ZOL)
Responsible party
Indra Ramakers (PhD researcher, Hasselt University) — Principal investigator
First posted
Jun 18, 2023
Start date
Jul 25, 2022
Primary completion
Jun 30, 2024 (estimated)
Completion
Jun 30, 2024 (estimated)
Last update
Jun 18, 2023

Study contacts

Indra Ramakers, Dra
Contact
indra.ramakers@uhasselt.be
+32483082723
Marleen Missotten
Contact
CME@uhasselt.be
+32(0)11268502
Katleen Bogaerts, PhD
principal investigator · Hasselt University

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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