Abstract
Introduction: The National Cancer Institute (NCI) Center to Reduce Cancer Health Disparities (CRCHD) supports two national networks within its Integrated Network Program (INP): the ...Geographic Management of Cancer Health Disparities Program (GMaP) and the National Outreach Network (NON). CRCHD strategically engages in facilitation efforts to integrate and disseminate efforts focused on reducing cancer health disparities among the scientific community and to the underserved communities they serve. The GMaP Region 1 North (R1N) hub is one of 7 regional GMaP hubs, led by Regional Coordinating Directors (RCDs) and inclusive of 8 NON CHES across 6 cancer center sites. The R1N hub is based at the Markey Cancer Center in Lexington, Kentucky. R1N has partnered with Johns Hopkins University's Sidney Kimmel Comprehensive Cancer Center, the University of South Carolina, and the University of Virginia Cancer Center to serve Delaware, Kentucky, West Virginia, Maryland, Maine, New Hampshire, Vermont, Virginia, and Washington, DC. RCDs and NON CHEs collaborate to enhance the capacity of regional cancer centers, academic and research partners and community partners to reduce regional cancer health disparities. Identification of preventative screening programs, or “linkages to care,” currently in place across our region and dissemination of this information to key partners was a strategy employed by R1N.
Methods: RCDs conducted a web search of all R1N member institutions and organizations and of NON CHEs cancer outreach, education activities and cancer screening initiatives. Using key search terms such as “cancer screenings,” “cancer education,” “cancer awareness,” “clinical trials” for each cancer type (breast, colon, lung, prostate, cervical and ovarian), they searched within each state and DC as well as queried social media channels (Facebook, Google+, Twitter and YouTube) of each R1N member to reveal “linkages to care” data available for each.
Results: While search engines provided results in response to our query methods described above, we noted that cancer-specific awareness months offer frequencies for NON CHE interactions through member institutions and for community members occur at least once a quarter in correlation with cancer-specific awareness months campaigns. Based on methods used, RCDs successfully developed, implemented, and disseminated the plan to identify Linkages to Care within R1N.
Conclusions: RCDs recommend that R1N member institutions and organizations dedicate web pages to Linkages to Care and adopt social media accounts for their respective public health divisions and/or organizations sponsoring cancer education, outreach, screening initiatives and clinical trials recruitment. The goal is to increase visibility of collaborative efforts among regional cancer centers, academic partners, and minority serving institutions to coordinate Linkages to Care within an NCI CRCHD INP.
Citation Format: Julia F. Houston, Heenali Fozdar, Marcela Blinka, Mark Cromo. Reducing cancer disparities through identification of linkages to care partners within GMaP Region 1 North abstract. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr B110.
Abstract
Introduction: The National Cancer Institute (NCI) Center to Reduce Center Health Disparities (CRCHD) Geographic Management of Cancer Health Disparities Program (GMaP) initiated in 2009 ...brings together investigators, trainees, students, and community health educators to network and share information, scientific resources, and tools to promote cancer and cancer health disparities research, as well as community education outreach within and across regions. To reach their goals, CRCHD initiated 7 GMaP regional “hubs” across the United States to enhance their capacity in areas of disparities research, contribute to the next generation of researchers, and achieve measurable reductions in cancer health disparities. Each hub is led by Regional Coordinating Directors (RCDs) who facilitate connections, provide funding and training resources and “leverage the strengths of its people, programs, and resources to provide greater access to cancer information.”
Methods: The GMaP Region 1 North (R1N) hub is based at the Markey Cancer Center in Lexington, Kentucky. R1N partners with Johns Hopkins University's Sidney Kimmel Comprehensive Cancer Center, the University of South Carolina, and the University of Virginia Cancer Center to serve Delaware, Kentucky, Maryland, Maine, New Hampshire, Vermont, Virginia, West Virginia, Washington, DC, and West Virginia. The overall goal of GMaP R1N is to enhance the capacity of regional cancer centers, associated academic partners, community partners, and early-stage investigators to contribute to the reduction of cancer health disparities in the region. As part of the Continuing Umbrella of Research Experiences (CURE) Program, GMaP R1N promotes the F31, K series, and Diversity Supplement funding opportunities to potential applicants. R1N implemented pilot awards and travel scholarships for CURE-eligible candidates; developed a listserv to communicate with researchers, trainees, and potential applicants; and maintains regular contact with trainees to answer questions and encourage applications for NCI CURE Program and other grant opportunities.
Results: R1N awarded 11 pilot projects, 22 travel scholarships, helped identify mentors and 146 potential applicants for NCI CURE Program grants, and collaborated with points of contact (POC) at colleges and universities, including Historically Black Colleges and Universities to identify potential applicants for NCI CURE and other funding.
Conclusions: Methods have been successful in increasing interest in NCI Cancer health disparities training opportunities. RCDs are critical in establishing and maintaining linkages to support mentor-mentee relationships supported by available funding mechanisms; to engage institutional support for pre- and post-award activities, especially for new investigators; and for shrinking delays in the IRB review and approval process. RCDs have identified process barriers and work with regional POCs to eliminate these barriers and increase efficiencies to further the GMaP mission.
Citation Format: Marcela Blinka, Mark Cromo, Julia F. Houston, Mark Dignan, Nathan Vanderford, B. Mark Evers, Janice Bowie, Adrian Dobs, James Hebert, Tisha Felder, Roger Anderson. Results to date: Efforts to increase cancer health disparities training in Geographic Management of Cancer Health Disparities Program Region 1 North abstract. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A068.
Abstract
Introduction: The Geographic Management of Cancer Health Disparities Program (GMaP) is a national NCI program with the goal of increasing cancer health disparities (CHD) research. GMaP ...Region 1 North (R1N) is one of seven GMaP Regional “hubs” based at NCI-designated cancer centers (CCs) across the country, covering the states of DE, KY, ME, MD, NH, VA, VT, WV, and the District of Columbia. The National Outreach Network (NON) is a national NCI program with the goal of conducting cancer education and outreach in underserved communities to reduce CHD. NON Community Health Educators (CHEs) are based at 38 NCI-designated CCs across the country. Six NCI-designated CCs with NON CHEs fall within the GMaP R1N coverage area.
Methods: GMaP R1N staff and NON CHEs within the R1N coverage area met bimonthly to collaborate on the Screen to Save (S2S): NCI Colorectal Cancer (CRC) Outreach and Screening Initiative. The goal of S2S was to educate underserved communities on CRC and CRC screening. NON CHEs conducted the projects in diverse urban and rural communities within their CC catchment areas. Participants attended a CRC education event that provided an inflatable colon or a PowerPoint presentation and completed demographic and pre-/post-event surveys to gauge their knowledge of CRC screening. Surveys were submitted to NCI Center to Reduce Cancer Health Disparities program staff for review and data entry. Raw data files were returned to NON CHEs and shared with GMaP R1N staff for analysis. R1N staff provided research expertise to compare results between urban and rural S2S participants.
Results: There were a total of 328 participants in S2S (n=200 urban; n=128 rural) in the GMaP R1N/NON coverage area. The median age of urban participants was 59.5 vs. 49.0 for rural participants. 95% of urban participants and 96.1% of rural participants reported having health insurance (public or private). 92.9% of urban and 88.1% of rural participants attained at least a high school diploma or GED. 76.5% of urban and 41.4% of rural participants reported ever being screened for CRC by any method. The percent increase between pre- and post-test scores for the educational intervention was 15% for urban vs. 13.3% for rural participants, with an overall percent increase in knowledge of 14.2%.
Conclusions: The urban and rural participants were similar in educational and health insurance attainment levels. Urban residents reported much higher rates of previous CRC screening than rural residents, but this is likely due to the fact that more rural participants were younger than the recommended CRC initial screening age at the time (age 50). The S2S educational intervention was effective in increasing knowledge of CRC screening among both rural and urban participants, with similar increase between the two groups. Overall, this project demonstrated that two different yet complementary programs, GMaP and NON, can work together by utilizing program strengths to successfully implement an educational intervention conducted across a wide and diverse geographic area.
Citation Format: Mark Cromo, Rhonda Boozer-Yeary, Melinda L. Rogers, Katelyn Schifano, Jenna Schiffelbein, Katherine L. Jones, Marcela Blinka, Julia F. Houston, Betsy Grossman, Lindsay Hauser, James Zabora, Mark B. Dignan, Tracy Onega. Integrating research and outreach to increase CRC screening knowledge in underserved communities: The Geographic Management of Cancer Health Disparities Program and National Outreach Network Screen to Save partnership abstract. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A015.
Abstract
Purpose: The purpose of the Geographical Management of Cancer Health Disparities Program (GMaP) regional networks is to establish a multi-institutional framework to support and expand ...research and training of cancer health disparities researchers and trainees to reduce cancer-related health disparities. This study examined the efficacy of communication strategies within GMaP Regions 1 and 2 (R1R2) to improve uptake of communication and dissemination of jobs, training, fellowship, and collaboration opportunities over a two year period.
Background: An unequal burden of cancer among population groups exists in the United States. The National Cancer Institute (NCI) defines cancer health disparities as “adverse differences in cancer incidence, prevalence, morbidity, mortality, survivorship, and burden of cancer or related health conditions that exist among specific population groups in the United States.” Collaborative efforts across institutions within geographic regions have been limited despite previous efforts. Therefore, NCI's Center to Reduce Cancer Health Disparities (CRCHD) created GMaP, which consists of five hubs throughout the U.S. to increase collaborative efforts to reduce cancer health disparities intra- and inter-regionally. GMaP R1R2 includes 11 Eastern states and the District of Columbia. Members of GMaP R1R2 identified the need for an improved infrastructure to streamline program communications and facilitate collaborative efforts across a large membership group within R1R2.
Methods: A communications strategy was developed to improve efficiency and measure uptake. GMaP R1R2 launched an online platform including a Google® website that integrated social media, Google® applications, infographics and additional media channels for broader dissemination efforts. Google+ Circle®, Twitter®, and Facebook® accounts were created for R1R2. MailChimp® was selected for newsletter distribution replacing ineffective email communications to investigators of all career levels.
Results: Built-in analytics for each platform reflected uptake, which informed Program and Regional coordinator efforts. The GMaP R1R2 Google+ Circle® recruited 129 members and its Google® website averaged 1807 page views. MailChimp® includes an average of 920 subscribers. These members are grouped into 3 different listservs including GMaP R1/R2 Overall Group Email, Trainee's E-Blast, and Minority Serving Institutions (MSI) E-Blast. GMaP R1/R2 Group has an average open rate of 24.16%. The Trainee's E-blast group has an average open rate of 36.49%. The majority of these recipients viewed job and training opportunities, CRCHD Funding for Research and Training, and Funding Opportunities posted on the GMaP R1R2 website. The MSI list was created to recruit CURE trainees from minority serving institutes and had an average open rate of 20.87%. The MSI E-Blast revealed that information about CURE, Job/Training opportunities, CRCHD Funding for Research and Training, and Funding opportunities links were the most viewed (“clicks”) of the MailChimp® newsletter.
Conclusion: Improved communication and dissemination efforts were realized through the use of electronic media tools to address cancer-related health disparities by GMaP R1R2. Regional Coordinators cite that analytics reports provide valuable information for future communications and online development efforts. Additional research is needed to poll GMaP R1R2 listserv members to learn about the usefulness of this communications platform, the preferred method of social media communication among GMaP R1R2 network members and how to increase their contribution to the current platform for broader dissemination.
Citation Format: Julia F. Houston, Neha Jaggi, James R. Hebert, Ashleigh D. Gallagher, Mark Cromo, Athena Kheibari. Impact of targeted communications within a National Cancer Institute Center to Reduce Cancer Health Disparities Geographical Management of Cancer Health Disparities Program Regional Network. abstract. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr A16.
Abstract
Introduction:
Region 1 North of the National Cancer Institute's Geographic Management of Cancer Health Disparities Program (GMaP) is based at the University of Kentucky Markey Cancer Center ...(UK MCC). GMaP was funded for a three-year period as a supplement to the UK MCC Cancer Center Support Grant with an overall goal to reduce cancer health disparities. Efforts to achieve this goal include enhancing the capacity of regional cancer centers, associated academic partners, community partners, and early-stage investigators to increase research on disparities by fostering collaborative research applications and facilitating the career development of the next generation of underrepresented cancer and cancer health disparities investigators.
Methods:
UK MCC GMaP investigators are partnering with researchers at Johns Hopkins University Sidney Kimmel Comprehensive Cancer Center, the University of Virginia Cancer Center, the University of South Carolina Cancer Prevention and Control Program, and other regional cancer center and academic partners to implement multi-faceted programming to increase and strengthen collaborative research and training efforts across the Region 1 North coverage area, which includes DC, DE, KY, ME, MD, NH, VA, VT, and WV. GMaP Region 1 North has implemented an online survey of investigators and partners throughout the region to assess their career level, research focus and interests, and readiness to submit grant applications within the next 12 months.
Results:
A total of 161 responses to the survey have been received. The respondents include undergraduate and graduate students, faculty members, research and administrative staff and community members. Over 70% of respondents described themselves as researchers (32% cancer center researchers) and almost 50% as mentors. The most common response categories for types of research conducted include basic science (52%), translational (44%), cancer health disparities (39%) and behavioral/population focused research (36%). Of those currently funded by extramural sources, 26% reported R01 funding and nearly all of the remaining respondents reported funding by a wide variety of other NIH mechanisms. Most (88%) respondents indicated that they are planning R01 and/or R21 applications within the next 12 months.
Conclusion:
The survey has provided Region 1 North investigators with a working foundation for matching mentors with underrepresented early-stage investigators for K- and R-series grant applications. Additionally, the survey results provide a tool to promote collaborative applications across regional institutions through targeted communication and media efforts.
Citation Format: Mark B. Dignan, Nathan L. Vanderford, B Mark Evers, Mark Cromo, Janice Bowie, Adrian Dobs, Ashleigh Gallagher, Olive Mbah, Julia F. Houston, Neha Jaggi, Roger Anderson, James R. Hebert. Utilizing the Geographic Management of Cancer Health Disparities Program (GMaP) Region 1 North partnership survey as a tool to promote mentoring and collaborative grant applications. abstract. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr A81.
The Melanocortin-4 Receptor (MC4R) plays a pivotal role in energy homeostasis. We used human MC4R mutations associated with an increased or decreased risk of obesity to dissect mechanisms that ...regulate MC4R function. Most obesity-associated mutations impair trafficking to the plasma membrane (PM), whereas obesity-protecting mutations either accelerate recycling to the PM or decrease internalization, resulting in enhanced signaling. MC4R mutations that do not affect canonical Gαs protein-mediated signaling, previously considered to be non-pathogenic, nonetheless disrupt agonist-induced internalization, β-arrestin recruitment, and/or coupling to Gαs, establishing their causal role in severe obesity. Structural mapping reveals ligand-accessible sites by which MC4R couples to effectors and residues involved in the homodimerization of MC4R, which is disrupted by multiple obesity-associated mutations. Human genetic studies reveal that endocytosis, intracellular trafficking, and homodimerization regulate MC4R function to a level that is physiologically relevant, supporting the development of chaperones, agonists, and allosteric modulators of MC4R for weight loss therapy.
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•Obesity-associated MC4R mutations that do not reduce cAMP disrupt other processes•MC4R mutations impact receptor homodimerization, endocytosis, and trafficking•Obesity-protecting mutations increase plasma membrane MC4Rs and enhance signaling•Multiple mechanisms regulate melanocortin tone to a physiologically relevant level
Using mutations in the human Melanocortin-4 Receptor (MC4R), Brouwers et al. identify receptor trafficking and endocytosis, coupling to Gαs/β-arrestins, and homodimerization as mechanisms involved in the regulation of body weight that may be targeted for weight loss therapy.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Abstract We present a traumatic fatality of a 19-year-old man who had ingested blotter paper containing 25I-NBOMe 2-(4-iodo-2,5-dimethoxyphenyl)-N-(2-methoxyphenyl)methylethanamine. Postmortem ...specimens were analyzed by high performance liquid chromatography with tandem mass spectrometry (HPLC/MS/MS). Toxicology findings for fluids based upon blood or urine calibrators were as follows: peripheral blood, 405 pg/mL; heart blood, 410 pg/mL; urine, 2.86 ng/mL; and vitreous humor, 99 pg/mL. While findings based upon the method of standard additions were: gastric contents, 7.1 μg total; bile, 10.9 ng/g; brain, 2.54 ng/g and liver, 7.2 ng/g. To our knowledge the presented case is the first postmortem case of 25I-NBOMe intoxication documented by toxicological analysis of tissues and body fluids.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, VSZLJ
Summary Background Vitamin D is crucial for maintenance of musculoskeletal health, and might also have a role in extraskeletal tissues. Determinants of circulating 25-hydroxyvitamin D concentrations ...include sun exposure and diet, but high heritability suggests that genetic factors could also play a part. We aimed to identify common genetic variants affecting vitamin D concentrations and risk of insufficiency. Methods We undertook a genome-wide association study of 25-hydroxyvitamin D concentrations in 33 996 individuals of European descent from 15 cohorts. Five epidemiological cohorts were designated as discovery cohorts (n=16 125), five as in-silico replication cohorts (n=9367), and five as de-novo replication cohorts (n=8504). 25-hydroxyvitamin D concentrations were measured by radioimmunoassay, chemiluminescent assay, ELISA, or mass spectrometry. Vitamin D insufficiency was defined as concentrations lower than 75 nmol/L or 50 nmol/L. We combined results of genome-wide analyses across cohorts using Z -score-weighted meta-analysis. Genotype scores were constructed for confirmed variants. Findings Variants at three loci reached genome-wide significance in discovery cohorts for association with 25-hydroxyvitamin D concentrations, and were confirmed in replication cohorts: 4p12 (overall p=1·9×10−109 for rs2282679, in GC ); 11q12 (p=2·1×10−27 for rs12785878, near DHCR7 ); and 11p15 (p=3·3×10−20 for rs10741657, near CYP2R1 ). Variants at an additional locus (20q13, CYP24A1 ) were genome-wide significant in the pooled sample (p=6·0×10−10 for rs6013897). Participants with a genotype score (combining the three confirmed variants) in the highest quartile were at increased risk of having 25-hydroxyvitamin D concentrations lower than 75 nmol/L (OR 2·47, 95% CI 2·20–2·78, p=2·3×10−48 ) or lower than 50 nmol/L (1·92, 1·70–2·16, p=1·0×10−26 ) compared with those in the lowest quartile. Interpretation Variants near genes involved in cholesterol synthesis, hydroxylation, and vitamin D transport affect vitamin D status. Genetic variation at these loci identifies individuals who have substantially raised risk of vitamin D insufficiency. Funding Full funding sources listed at end of paper (see Acknowledgments).
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
•Heaviness of Smoking Index outperforms DSM in predicting smoking during pregnancy.•Sociodemographics and nicotine dependence predict SDP risk in nonlinear interaction.•Nicotine dependence is weak ...SDP predictor at high sociodemographic risk levels.•Research and administrative data can be combined to predict long-term outcome.
Understanding differences in nicotine dependence assessments’ ability to predict smoking cessation is complicated by variation in quit attempt contexts. Pregnancy reduces this variation, as each pregnant smoker receives the same strong cessation incentive. Cigarette smoking during pregnancy (SDP) provides a powerful paradigm for analyzing the interplay between nicotine dependence measures and sociodemographics in predicting cessation failure.
Data from a female twin cohort (median birth year 1980), assessed in teens and early twenties, were merged with birth records to identify those with smoking history who experienced childbirth (N = 1657 births, N = 763 mothers). Logistic regression predicting SDP, as a function of birth record sociodemographic variables, generated a sociodemographic risk-score. Further analysis incorporated the risk-score with data from research interviews on DSM-IV-Nicotine Dependence symptom count, Heaviness of Smoking Index.
Low maternal educational level, younger age at childbirth, and being unmarried all contributed risk for SDP. In addition to sociodemographic risk-score, the best predictors of SDP included HSI-score (OR:1.51), their two-way interaction (OR:0.39; reduced impact of dependence at intermediate-high sociodemographic risk), history of ≥ two failed quit attempts (OR:1.38), and a dummy variable for prior pregnancy at time of assessment (OR:1.82). DSM-IV-Nicotine Dependence symptoms underperformed the Heaviness of Smoking Index and did not improve prediction when added to the best model.
The 2-item Heaviness of Smoking Index measure and report of ≥ two failed quit attempts performed best for predicting SDP. The contribution of either nicotine dependence measure to SDP risk was diminished at increased levels of sociodemographic risk.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Fifty‐eight solid organ transplant recipients with zygomycosis were studied to assess the presentation, radiographic characteristics, risks for extra‐pulmonary dissemination and mortality of ...pulmonary zygomycosis. Pulmonary zygomycosis was documented in 31 patients (53%) and developed a median of 5.5 months (interquartile range, 2–11 months) posttransplantation. In all, 74.2% (23/31) of the patients had zygomycosis limited to the lungs and 25.8% (8/31) had lung disease as part of disseminated zygomycosis; cutaneous/soft tissue (50%, 4/8) was the most common site of dissemination. Pulmonary disease presented most frequently as consolidation/mass lesions (29.0%), nodules (25.8%) and cavities (22.6%). Patients with disseminated disease were more likely to have Mycocladus corymbifer as the causative pathogen. The mortality rate at 90 days after the treatment was 45.2%. In summary, pulmonary zygomycosis is the most common manifestation in solid organ transplant recipients with zygomycosis, and disseminated disease often involves the cutaneous/soft tissue sites but not the brain.
Pulmonary zygomycosis is now the most common presentation of zygomycosis in solid organ transplant recipients and disseminates preferentially to the cutaneous or soft tissue sites.
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BFBNIB, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
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