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Endocrinology

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Stress-impaired transcription factor expression and insulin secretion in transplanted human islets
Chunhua Dai, … , Roland Stein, Alvin C. Powers
Chunhua Dai, … , Roland Stein, Alvin C. Powers
Published April 11, 2016
Citation Information: J Clin Invest. 2016. https://doi.org/10.1172/JCI83657.
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Stress-impaired transcription factor expression and insulin secretion in transplanted human islets

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Abstract

Type 2 diabetes is characterized by insulin resistance, hyperglycemia, and progressive β cell dysfunction. Excess glucose and lipid impair β cell function in islet cell lines, cultured rodent and human islets, and in vivo rodent models. Here, we examined the mechanistic consequences of glucotoxic and lipotoxic conditions on human islets in vivo and developed and/or used 3 complementary models that allowed comparison of the effects of hyperglycemic and/or insulin-resistant metabolic stress conditions on human and mouse islets, which responded quite differently to these challenges. Hyperglycemia and/or insulin resistance impaired insulin secretion only from human islets in vivo. In human grafts, chronic insulin resistance decreased antioxidant enzyme expression and increased superoxide and amyloid formation. In human islet grafts, expression of transcription factors NKX6.1 and MAFB was decreased by chronic insulin resistance, but only MAFB decreased under chronic hyperglycemia. Knockdown of NKX6.1 or MAFB expression in a human β cell line recapitulated the insulin secretion defect seen in vivo. Contrary to rodent islet studies, neither insulin resistance nor hyperglycemia led to human β cell proliferation or apoptosis. These results demonstrate profound differences in how excess glucose or lipid influence mouse and human insulin secretion and β cell activity and show that reduced expression of key islet-enriched transcription factors is an important mediator of glucotoxicity and lipotoxicity.

Authors

Chunhua Dai, Nora S. Kayton, Alena Shostak, Greg Poffenberger, Holly A. Cyphert, Radhika Aramandla, Courtney Thompson, Ioannis G. Papagiannis, Christopher Emfinger, Masakazu Shiota, John M. Stafford, Dale L. Greiner, Pedro L. Herrera, Leonard D. Shultz, Roland Stein, Alvin C. Powers

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Activation of mTORC1 is essential for β-adrenergic stimulation of adipose browning
Dianxin Liu, … , Michael P. Czech, Sheila Collins
Dianxin Liu, … , Michael P. Czech, Sheila Collins
Published March 28, 2016
Citation Information: J Clin Invest. 2016. https://doi.org/10.1172/JCI83532.
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Activation of mTORC1 is essential for β-adrenergic stimulation of adipose browning

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Abstract

A classic metabolic concept posits that insulin promotes energy storage and adipose expansion, while catecholamines stimulate release of adipose energy stores by hydrolysis of triglycerides through β-adrenergic receptor (βARs) and protein kinase A (PKA) signaling. Here, we have shown that a key hub in the insulin signaling pathway, activation of p70 ribosomal S6 kinase (S6K1) through mTORC1, is also triggered by PKA activation in both mouse and human adipocytes. Mice with mTORC1 impairment, either through adipocyte-specific deletion of Raptor or pharmacologic rapamycin treatment, were refractory to the well-known βAR-dependent increase of uncoupling protein UCP1 expression and expansion of beige/brite adipocytes (so-called browning) in white adipose tissue (WAT). Mechanistically, PKA directly phosphorylated mTOR and RAPTOR on unique serine residues, an effect that was independent of insulin/AKT signaling. Abrogation of the PKA site within RAPTOR disrupted βAR/mTORC1 activation of S6K1 without affecting mTORC1 activation by insulin. Conversely, a phosphomimetic RAPTOR augmented S6K1 activity. Together, these studies reveal a signaling pathway from βARs and PKA through mTORC1 that is required for adipose browning by catecholamines and provides potential therapeutic strategies to enhance energy expenditure and combat metabolic disease.

Authors

Dianxin Liu, Marica Bordicchia, Chaoying Zhang, Huafeng Fang, Wan Wei, Jian-Liang Li, Adilson Guilherme, Kalyani Guntur, Michael P. Czech, Sheila Collins

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Estrogen-mediated downregulation of AIRE influences sexual dimorphism in autoimmune diseases
Nadine Dragin, … , Rozen Le Panse, Sonia Berrih-Aknin
Nadine Dragin, … , Rozen Le Panse, Sonia Berrih-Aknin
Published March 21, 2016
Citation Information: J Clin Invest. 2016. https://doi.org/10.1172/JCI81894.
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Estrogen-mediated downregulation of AIRE influences sexual dimorphism in autoimmune diseases

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Abstract

Autoimmune diseases affect 5% to 8% of the population, and females are more susceptible to these diseases than males. Here, we analyzed human thymic transcriptome and revealed sex-associated differences in the expression of tissue-specific antigens that are controlled by the autoimmune regulator (AIRE), a key factor in central tolerance. We hypothesized that the level of AIRE is linked to sexual dimorphism susceptibility to autoimmune diseases. In human and mouse thymus, females expressed less AIRE (mRNA and protein) than males after puberty. These results were confirmed in purified murine thymic epithelial cells (TECs). We also demonstrated that AIRE expression is related to sexual hormones, as male castration decreased AIRE thymic expression and estrogen receptor α–deficient mice did not show a sex disparity for AIRE expression. Moreover, estrogen treatment resulted in downregulation of AIRE expression in cultured human TECs, human thymic tissue grafted to immunodeficient mice, and murine fetal thymus organ cultures. AIRE levels in human thymus grafted in immunodeficient mice depended upon the sex of the recipient. Estrogen also upregulated the number of methylated CpG sites in the AIRE promoter. Together, our results indicate that in females, estrogen induces epigenetic changes in the AIRE gene, leading to reduced AIRE expression under a threshold that increases female susceptibility to autoimmune diseases.

Authors

Nadine Dragin, Jacky Bismuth, Géraldine Cizeron-Clairac, Maria Grazia Biferi, Claire Berthault, Alain Serraf, Rémi Nottin, David Klatzmann, Ana Cumano, Martine Barkats, Rozen Le Panse, Sonia Berrih-Aknin

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Gonadal steroid–dependent effects on bone turnover and bone mineral density in men
Joel S. Finkelstein, … , Jonathan M. Youngner, Elaine W. Yu
Joel S. Finkelstein, … , Jonathan M. Youngner, Elaine W. Yu
Published February 22, 2016
Citation Information: J Clin Invest. 2016. https://doi.org/10.1172/JCI84137.
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Gonadal steroid–dependent effects on bone turnover and bone mineral density in men

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Abstract

BACKGROUND. Severe gonadal steroid deficiency induces bone loss in adult men; however, the specific roles of androgen and estrogen deficiency in hypogonadal bone loss are unclear. Additionally, the threshold levels of testosterone and estradiol that initiate bone loss are uncertain.

METHODS. One hundred ninety-eight healthy men, ages 20–50, received goserelin acetate, which suppresses endogenous gonadal steroid production, and were randomized to treatment with 0, 1.25, 2.5, 5, or 10 grams of testosterone gel daily for 16 weeks. An additional cohort of 202 men was randomized to receive these treatments plus anastrozole, which suppresses conversion of androgens to estrogens. Thirty-seven men served as controls and received placebos for goserelin and testosterone. Changes in bone turnover markers, bone mineral density (BMD) by dual-energy x-ray absorptiometry (DXA), and BMD by quantitative computed tomography (QCT) were assessed in all men. Bone microarchitecture was assessed in 100 men.

RESULTS. As testosterone dosage decreased, the percent change in C-telopeptide increased. These increases were considerably greater when aromatization of testosterone to estradiol was also suppressed, suggesting effects of both testosterone and estradiol deficiency. Decreases in DXA BMD were observed when aromatization was suppressed but were modest in most groups. QCT spine BMD fell substantially in all testosterone-dose groups in which aromatization was also suppressed, and this decline was independent of testosterone dose. Estradiol deficiency disrupted cortical microarchitecture at peripheral sites. Estradiol levels above 10 pg/ml and testosterone levels above 200 ng/dl were generally sufficient to prevent increases in bone resorption and decreases in BMD in men.

CONCLUSIONS. Estrogens primarily regulate bone homeostasis in adult men, and testosterone and estradiol levels must decline substantially to impact the skeleton.

TRIAL REGISTRATION. ClinicalTrials.gov, NCT00114114.

FUNDING. AbbVie Inc., AstraZeneca Pharmaceuticals LP, NIH.

Authors

Joel S. Finkelstein, Hang Lee, Benjamin Z. Leder, Sherri-Ann M. Burnett-Bowie, David W. Goldstein, Christopher W. Hahn, Sarah C. Hirsch, Alex Linker, Nicholas Perros, Andrew B. Servais, Alexander P. Taylor, Matthew L. Webb, Jonathan M. Youngner, Elaine W. Yu

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PKCδ inhibition normalizes the wound-healing capacity of diabetic human fibroblasts
Mogher Khamaisi, … , Amy Wagers, George L. King
Mogher Khamaisi, … , Amy Wagers, George L. King
Published January 25, 2016
Citation Information: J Clin Invest. 2016. https://doi.org/10.1172/JCI82788.
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PKCδ inhibition normalizes the wound-healing capacity of diabetic human fibroblasts

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Abstract

Abnormal fibroblast function underlies poor wound healing in patients with diabetes; however, the mechanisms that impair wound healing are poorly defined. Here, we evaluated fibroblasts from individuals who had type 1 diabetes (T1D) for 50 years or more (Medalists, n = 26) and from age-matched controls (n = 7). Compared with those from controls, Medalist fibroblasts demonstrated a reduced migration response to insulin, lower VEGF expression, and less phosphorylated AKT (p-AKT), but not p-ERK, activation. Medalist fibroblasts were also functionally less effective at wound closure in nude mice. Activation of the δ isoform of protein kinase C (PKCδ) was increased in postmortem fibroblasts from Medalists, fibroblasts from living T1D subjects, biopsies of active wounds of living T1D subjects, and granulation tissues from mice with streptozotocin-induced diabetes. Diabetes-induced PKCD mRNA expression was related to a 2-fold increase in the mRNA half-life. Pharmacologic inhibition and siRNA-mediated knockdown of PKCδ or expression of a dominant-negative isoform restored insulin signaling of p-AKT and VEGF expression in vitro and improved wound healing in vivo. Additionally, increasing PKCδ expression in control fibroblasts produced the same abnormalities as those seen in Medalist fibroblasts. Our results indicate that persistent PKCδ elevation in fibroblasts from diabetic patients inhibits insulin signaling and function to impair wound healing and suggest PKCδ inhibition as a potential therapy to improve wound healing in diabetic patients.

Authors

Mogher Khamaisi, Sayaka Katagiri, Hillary Keenan, Kyoungmin Park, Yasutaka Maeda, Qian Li, Weier Qi, Thomas Thomou, Danielle Eschuk, Ana Tellechea, Aris Veves, Chenyu Huang, Dennis Paul Orgill, Amy Wagers, George L. King

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CYP24 inhibition as a therapeutic target in FGF23-mediated renal phosphate wasting disorders
Xiuying Bai, … , David Goltzman, Andrew C. Karaplis
Xiuying Bai, … , David Goltzman, Andrew C. Karaplis
Published January 19, 2016
Citation Information: J Clin Invest. 2016. https://doi.org/10.1172/JCI81928.
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CYP24 inhibition as a therapeutic target in FGF23-mediated renal phosphate wasting disorders

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Abstract

CYP24A1 (hereafter referred to as CYP24) enzymatic activity is pivotal in the inactivation of vitamin D metabolites. Basal renal and extrarenal CYP24 is usually low but is highly induced by its substrate 1,25-dihydroxyvitamin D. Unbalanced high and/or long-lasting CYP24 expression has been proposed to underlie diseases like chronic kidney disease, cancers, and psoriasis that otherwise should favorably respond to supplemental vitamin D. Using genetically modified mice, we have shown that renal phosphate wasting hypophosphatemic states arising from high levels of fibroblast growth factor 23 (FGF23) are also associated with increased renal Cyp24 expression, suggesting that elevated CYP24 activity is pivotal to the pathophysiology of these disorders. We therefore crossed 2 mouse strains, each with distinct etiology for high levels of circulating FGF23, onto a Cyp24-null background. Specifically, we evaluated Cyp24 deficiency in Hyp mice, the murine homolog of X-linked dominant hypophosphatemic rickets, and transgenic mice that overexpress a mutant FGF23 (FGF23R176Q) that is associated with the autosomal dominant form of hypophosphatemic rickets. Loss of Cyp24 in these murine models of human disease resulted in near-complete recovery of rachitic/osteomalacic bony abnormalities in the absence of any improvement in the serum biochemical profile. Moreover, treatment of Hyp and FGF23R1760-transgenic mice with the CYP24 inhibitor CTA102 also ameliorated their rachitic bones. Our results link CYP24 activity to the pathophysiology of FGF23-dependent renal phosphate wasting states and implicate pharmacologic CYP24 inhibition as a therapeutic adjunct for their treatment.

Authors

Xiuying Bai, Dengshun Miao, Sophia Xiao, Dinghong Qiu, René St-Arnaud, Martin Petkovich, Ajay Gupta, David Goltzman, Andrew C. Karaplis

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FGF21 and the late adaptive response to starvation in humans
Pouneh K. Fazeli, … , Parth Patwari, Matthew L. Steinhauser
Pouneh K. Fazeli, … , Parth Patwari, Matthew L. Steinhauser
Published November 3, 2015
Citation Information: J Clin Invest. 2015. https://doi.org/10.1172/JCI83349.
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FGF21 and the late adaptive response to starvation in humans

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Abstract

In mice, FGF21 is rapidly induced by fasting, mediates critical aspects of the adaptive starvation response, and displays a number of positive metabolic properties when administered pharmacologically. In humans, however, fasting does not consistently increase FGF21, suggesting a possible evolutionary divergence in FGF21 function. Moreover, many key aspects of FGF21 function in mice have been identified in the context of transgenic overexpression or administration of supraphysiologic doses, rather than in a physiologic setting. Here, we explored the dynamics and function of FGF21 in human volunteers during a 10-day fast. Unlike mice, which show an increase in circulating FGF21 after only 6 hours, human subjects did not have a notable surge in FGF21 until 7 to 10 days of fasting. Moreover, we determined that FGF21 induction was associated with decreased thermogenesis and adiponectin, an observation that directly contrasts with previous reports based on supraphysiologic dosing. Additionally, FGF21 levels increased after ketone induction, demonstrating that endogenous FGF21 does not drive starvation-mediated ketogenesis in humans. Instead, a longitudinal analysis of biologically relevant variables identified serum transaminases — markers of tissue breakdown — as predictors of FGF21. These data establish FGF21 as a fasting-induced hormone in humans and indicate that FGF21 contributes to the late stages of adaptive starvation, when it may regulate the utilization of fuel derived from tissue breakdown.

Authors

Pouneh K. Fazeli, Mingyue Lun, Soo M. Kim, Miriam A. Bredella, Spenser Wright, Yang Zhang, Hang Lee, Ciprian Catana, Anne Klibanski, Parth Patwari, Matthew L. Steinhauser

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A mutation in the nucleoporin-107 gene causes XX gonadal dysgenesis
Ariella Weinberg-Shukron, … , Offer Gerlitz, David Zangen
Ariella Weinberg-Shukron, … , Offer Gerlitz, David Zangen
Published October 20, 2015
Citation Information: J Clin Invest. 2015. https://doi.org/10.1172/JCI83553.
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A mutation in the nucleoporin-107 gene causes XX gonadal dysgenesis

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Abstract

Ovarian development and maintenance are poorly understood; however, diseases that affect these processes can offer insights into the underlying mechanisms. XX female gonadal dysgenesis (XX-GD) is a rare, genetically heterogeneous disorder that is characterized by underdeveloped, dysfunctional ovaries, with subsequent lack of spontaneous pubertal development, primary amenorrhea, uterine hypoplasia, and hypergonadotropic hypogonadism. Here, we report an extended consanguineous family of Palestinian origin, in which 4 females exhibited XX-GD. Using homozygosity mapping and whole-exome sequencing, we identified a recessive missense mutation in nucleoporin-107 (NUP107, c.1339G>A, p.D447N). This mutation segregated with the XX-GD phenotype and was not present in available databases or in 150 healthy ethnically matched controls. NUP107 is a component of the nuclear pore complex, and the NUP107-associated protein SEH1 is required for oogenesis in Drosophila. In Drosophila, Nup107 knockdown in somatic gonadal cells resulted in female sterility, whereas males were fully fertile. Transgenic rescue of Drosophila females bearing the Nup107D364N mutation, which corresponds to the human NUP107 (p.D447N), resulted in almost complete sterility, with a marked reduction in progeny, morphologically aberrant eggshells, and disintegrating egg chambers, indicating defective oogenesis. These results indicate a pivotal role for NUP107 in ovarian development and suggest that nucleoporin defects may play a role in milder and more common conditions such as premature ovarian failure.

Authors

Ariella Weinberg-Shukron, Paul Renbaum, Rachel Kalifa, Sharon Zeligson, Ziva Ben-Neriah, Amatzia Dreifuss, Amal Abu-Rayyan, Noa Maatuk, Nilly Fardian, Dina Rekler, Moien Kanaan, Abraham O. Samson, Ephrat Levy-Lahad, Offer Gerlitz, David Zangen

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Dynamin 2 regulates biphasic insulin secretion and plasma glucose homeostasis
Fan Fan, … , Louis H. Philipson, Xuelin Lou
Fan Fan, … , Louis H. Philipson, Xuelin Lou
Published September 28, 2015
Citation Information: J Clin Invest. 2015. https://doi.org/10.1172/JCI80652.
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Dynamin 2 regulates biphasic insulin secretion and plasma glucose homeostasis

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Abstract

Alterations in insulin granule exocytosis and endocytosis are paramount to pancreatic β cell dysfunction in diabetes mellitus. Here, using temporally controlled gene ablation specifically in β cells in mice, we identified an essential role of dynamin 2 GTPase in preserving normal biphasic insulin secretion and blood glucose homeostasis. Dynamin 2 deletion in β cells caused glucose intolerance and substantial reduction of the second phase of glucose-stimulated insulin secretion (GSIS); however, mutant β cells still maintained abundant insulin granules, with no signs of cell surface expansion. Compared with control β cells, real-time capacitance measurements demonstrated that exocytosis-endocytosis coupling was less efficient but not abolished; clathrin-mediated endocytosis (CME) was severely impaired at the step of membrane fission, which resulted in accumulation of clathrin-coated endocytic intermediates on the plasma membrane. Moreover, dynamin 2 ablation in β cells led to striking reorganization and enhancement of actin filaments, and insulin granule recruitment and mobilization were impaired at the later stage of GSIS. Together, our results demonstrate that dynamin 2 regulates insulin secretory capacity and dynamics in vivo through a mechanism depending on CME and F-actin remodeling. Moreover, this study indicates a potential pathophysiological link between endocytosis and diabetes mellitus.

Authors

Fan Fan, Chen Ji, Yumei Wu, Shawn M. Ferguson, Natalia Tamarina, Louis H. Philipson, Xuelin Lou

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Insulin demand regulates β cell number via the unfolded protein response
Rohit B. Sharma, … , Peter Arvan, Laura C. Alonso
Rohit B. Sharma, … , Peter Arvan, Laura C. Alonso
Published September 21, 2015
Citation Information: J Clin Invest. 2015. https://doi.org/10.1172/JCI79264.
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Insulin demand regulates β cell number via the unfolded protein response

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Abstract

Although stem cell populations mediate regeneration of rapid turnover tissues, such as skin, blood, and gut, a stem cell reservoir has not been identified for some slower turnover tissues, such as the pancreatic islet. Despite lacking identifiable stem cells, murine pancreatic β cell number expands in response to an increase in insulin demand. Lineage tracing shows that new β cells are generated from proliferation of mature, differentiated β cells; however, the mechanism by which these mature cells sense systemic insulin demand and initiate a proliferative response remains unknown. Here, we identified the β cell unfolded protein response (UPR), which senses insulin production, as a regulator of β cell proliferation. Using genetic and physiologic models, we determined that among the population of β cells, those with an active UPR are more likely to proliferate. Moreover, subthreshold endoplasmic reticulum stress (ER stress) drove insulin demand–induced β cell proliferation, through activation of ATF6. We also confirmed that the UPR regulates proliferation of human β cells, suggesting that therapeutic UPR modulation has potential to expand β cell mass in people at risk for diabetes. Together, this work defines a stem cell–independent model of tissue homeostasis, in which differentiated secretory cells use the UPR sensor to adapt organ size to meet demand.

Authors

Rohit B. Sharma, Amy C. O’Donnell, Rachel E. Stamateris, Binh Ha, Karen M. McCloskey, Paul R. Reynolds, Peter Arvan, Laura C. Alonso

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Dynamin 2 prevents insulin granule traffic jams
Fan Fan and colleagues demonstrate that dynamin 2 is important for maintaining insulin secretion dynamics in β cells…
Published September 28, 2015
Scientific Show StopperEndocrinology

UPR stress gets β cells going
Rohit Sharma and colleagues reveal that insulin demand-induced β cell proliferation is regulated by the unfolded protein response…
Published September 21, 2015
Scientific Show StopperEndocrinology

Restricting β cell growth
Sung Hee Um and colleagues reveal that S6K1-dependent alterations of β cell size and function are independent of intrauterine growth restriction…
Published June 15, 2015
Scientific Show StopperEndocrinology

Insight into Kallmann syndrome
Anna Cariboni and colleagues demonstrate that dysfunctional SEMA3E results in gonadotropin-releasing hormone neuron deficiency…
Published May 18, 2015
Scientific Show StopperEndocrinology

L cells to the rescue
Natalia Peterson and colleagues demonstrate that increasing L cell populations in the gut improves insulin responses and glucose tolerance in a murine type 2 diabetes model…
Published December 15, 2014
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