323:
435:
white formations that occur in the pockets. Researchers found aerobic bacteria present on the surface of tonsilloliths and anaerobic bacteria at the core of tonsilloliths. They have the potential to cause oral halitosis as they contain volatile sulfur compounds and sulfur derived gases, foul smelling compounds produced during bacterial metabolism. Tonsilloliths are formed when this trapped debris accumulates and are expressed from the tonsil. They are generally soft, sometimes rubbery. This tends to occur most often in people who suffer from chronic inflammation in their tonsils or repeated bouts of tonsillitis. They are often associated with
448:
335:
53:
311:
296:, and tonsil swelling. A medical study conducted in 2007 found an association between tonsilloliths and bad breath in patients with a certain type of recurrent tonsillitis. Among those with bad breath, 75% of the subjects had tonsilloliths, while only 6% of subjects with normal halitometry values (normal breath) had tonsilloliths. A foreign body sensation may also exist in the back of the throat. The condition may also be an
351:
186:, foreign body sensation, sore throat, pain or discomfort with swallowing, and cough. Generally there is no pain, though there may be the feeling of something present. The presence of tonsil stones may be otherwise undetectable; however, some people have reported seeing white material in the rear of their throat.
400:
236:
They are usually benign, so if tonsil stones do not bother the patient, no treatment is needed. However in rare cases, tonsilloliths have presented patients with further complications necessitating surgical extraction. Tonsilloliths that exceed the average size are typically seen in older individuals
257:
have become a more common mechanism to extract tonsilloliths and alleviate the discomfort and complications they exacerbate. Tonsil stones can become dislodged on their own while eating, drinking, gargling, and coughing. Additionally, an exhalation technique that vigorously shakes the tonsils may be
553:
threaded attachment or otherwise are suitable for tonsil stone removal and everyday washing of the tonsils because they can jet water at low-pressure levels that the user can adjust by simply manipulating the sink tap, allowing for a continuous range of pressures to suit each user's requirements.
552:
are also effective. Most electric oral irrigators are unsuitable for tonsil stone removal because they are too powerful and are likely to cause discomfort and rupture the tonsils, which could result in further complications such as infection. Irrigators that connect directly to the sink tap via a
434:
that form in the crypts of the palatal tonsils. They are also known to form in the throat and on the roof of the mouth. Tonsils are filled with crevices where bacteria and other materials, including dead cells and mucus, can become trapped. When this occurs, the debris can become concentrated in
382:
and tonsilloliths was shown. Central to the biofilm concept is the assumption that bacteria form a three dimensional structure, dormant bacteria being in the center to serve as a constant nidus of infection. This impermeable structure renders the biofilm immune to antibiotic treatment. By use of
459:, and tumors of the tonsil. On average, tonsil stones should appear within a similar range of the image on the right; however, individuals with extenuating cases have been reported. In these instances, extensive care such as extraction by a licensed medical professional may be needed.
253:. Up to 10% of people have tonsil stones. Biological sex does not influence the chance of having tonsil stones, but older people are more commonly affected. Many people opt to extract their own tonsil stones manually or with developments in dental hygiene products.
619:
Tonsilloliths or tonsillar concretions occur in up to 10% of the population, frequently due to episodes of tonsillitis. While small concretions in the tonsils are common, true stones are less so. They commonly occur in young adults and are rare in children.
370:
The mechanism by which these calculi form is subject to debate, though they appear to result from the accumulation of material retained within the crypts, along with the growth of bacteria and fungi—sometimes in association with persistent chronic purulent
559:
More simply still, gargling with warm, salty water may help alleviate the discomfort of tonsillitis, which often accompanies tonsil stones. Vigorous gargling each morning can also keep the tonsil crypts clear of all but the most persistent tonsilloliths.
274:. In fact, many dental professionals argue that tonsil stones are the leading cause of bad breath in their patients. The smell may be that of rotting eggs. Tonsil stones tend to happen most often in people with longterm inflammation in their tonsils.
1485:
1470:
556:
There are also manually pressurized tonsil stone removers. A manual pump-type tonsil stone remover can adjust the water pressure depending on the number of pumps, effectively removing tonsil stones.
600:
selectively vaporizes and smooths the surface of the tonsils. This technique flattens the edges of the crypts and crevices that collect the debris, preventing trapped material from forming stones.
354:
Low-power microscope magnification of a cross-section through one of the tonsillar crypts (running diagonally) as it opens onto the surface of the throat (at the top). Stratified
387:
and microelectrodes, biofilms similar to dental biofilms were shown to be present in the tonsillolith, with oxygen respiration at the outer layer of tonsillolith,
1354:
475:
may reveal nonspecific calcified images in the tonsillar zone. The differential diagnosis must be established with acute and chronic tonsillitis, tonsillar
1168:
Stoodley P, Debeer D, Longwell M, Nistico L, Hall-Stoodley L, Wenig B, Krespi YP (September 2009). "Tonsillolith: not just a stone but a living biofilm".
514:
1293:
Padmanabhan TK, Chandra Dutt GS, Vasudevan DM, Vijayakumar (May–June 1984). "Giant tonsillolith simulating tumour of the tonsil – a case report".
322:
455:
Much rarer than the typical tonsil stones are giant tonsilloliths. Giant tonsilloliths may often be mistaken for other oral maladies, including
1133:
Giudice M, Cristofaro MG, Fava MG, Giudice A (July 2005). "An unusual tonsillolithiasis in a patient with chronic obstructive sialoadenitis".
588:
Another option is to decrease the surface area (crypts, crevices, etc.) of the tonsils via laser resurfacing. The procedure is called a laser
589:
225:
g, and they are typically small in size. However, there are occasional reports of large tonsilloliths. They are often discovered during
572:(scooping) or otherwise, although thorough irrigation will still be required afterward to effectively wash out smaller pieces. Larger
764:
Ram S, Siar CH, Ismail SM, Prepageran N (July 2004). "Pseudo bilateral tonsilloliths: a case report and review of the literature".
277:
Occasionally there may be pain when swallowing. Even when they are large, some tonsil stones are only discovered incidentally on
1003:
727:
1081:
1013:
737:
580:, although these treatments may not completely help the bad breath issues that are often associated with this condition.
362:
tissue. Many lymph cells (dark-colored region) pass from the nodules toward the surface and will eventually mix with the
1108:
1071:
358:(e) covers the throat's surface and continues as a lining of the crypt. Beneath the surface are numerous nodules (f) of
1440:
1358:
201:, and calcium salts, either alone or in combination with other mineral salts. While they most commonly occur in the
285:. Other symptoms include a metallic taste, throat closing or tightening, coughing fits, itchy throat, and choking.
1211:
310:
1031:"Tonsillotomy versus tonsillectomy in adults suffering from tonsil-related afflictions: a systematic review"
1526:
334:
17:
1321:
229:
for other reasons and more recently, due to the impact and influence of social media platforms such as
288:
Larger tonsil stones may cause recurrent bad breath, which frequently accompanies a tonsil infection,
233:, medical professionals have experienced an increase in patient concern and tonsillolith evaluations.
1516:
1422:
282:
259:
1423:
S. G. Nour, Mafee, Mahmood F., Valvassori, Galdino E., Galdino E. Valbasson, Minerva Becker (2005).
676:
Ferguson M, Aydin M, Mickel J (October 2014). "Halitosis and the tonsils: a review of management".
538:
510:
246:
147:
422:
bacteria, viral infections, adenoviruses, influenza virus, enteroviruses and parainfluenza virus.
418:
studies. The cause of tonsil stones can include a multitude of sources from bacterial infections,
498:
297:
106:
1432:
1521:
456:
112:
1424:
597:
471:
mass that may be mistaken for foreign bodies, displaced teeth or calcified blood vessels.
8:
1489:
488:
384:
70:
611:
may be indicated if bad breath due to tonsillar stones persists despite other measures.
414:
in the absence of clear manifestations, and often constitute casual findings of routine
1405:
1380:
Darrow DH, Siemens C (August 2002). "Indications for tonsillectomy and adenoidectomy".
1319:
1270:
1193:
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77:
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1302:
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733:
693:
476:
447:
411:
190:
99:
65:
1425:
1409:
705:
1389:
1265:
1249:
1177:
1142:
1042:
967:
927:
886:
773:
685:
593:
1047:
1030:
777:
1237:
1181:
932:
436:
388:
226:
210:
202:
1253:
916:"Incidental Soft Tissue Calcifications in Cone-Beam Computed Tomography Images"
838:
Silvestre-Donat FJ, Pla-Mocholi A, Estelles-Ferriol E, Martinez-Mihi V (2005).
549:
518:
492:
254:
1479:
1320:
Silvestre-Donat F, Pla-Mocholi A, Estelles-Ferriol E, Martinez-Mihi V (2005).
1212:"Should You Worry About Tonsil Stones?: Dr. Raminder Singh: General Dentistry"
972:
955:
891:
878:
292:, white debris, a bad taste in the back of the throat, difficulty swallowing,
46:
Tonsillolith, tonsillolithiasis, tonsillar stones, chronic caseous tonsillitis
1510:
1261:
981:
855:
816:
689:
608:
542:
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431:
419:
250:
242:
143:
131:
1393:
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839:
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1401:
1340:
1292:
1279:
1189:
1154:
1056:
989:
900:
863:
824:
785:
697:
529:
If tonsil stones do not bother a person, no treatment is needed. Otherwise
468:
415:
214:
1306:
410:
Diagnosis is usually made upon inspection. Tonsilloliths are difficult to
262:
sound, at various pitches to shake both the palatine and lingual tonsils.
484:
372:
289:
93:
1462:
52:
801:"A Case Report of Tonsillolith Treated With Individualized Homoeopathy"
506:
480:
355:
271:
183:
138:
86:
82:
913:
541:
may also be tried. Surgical treatment may include partial or complete
399:
249:
may also be tried. Surgical treatment may include partial or complete
569:
502:
301:
270:
Tonsil stones may produce no symptoms or they may be associated with
237:
as the likelihood of developing tonsil stones is linear. Otherwise,
530:
379:
359:
238:
198:
120:
548:
Some people are able to remove tonsil stones using a cotton swab.
577:
472:
403:
293:
206:
194:
116:
914:
Bayramov N, Usdat Ozturk A, Ercalik
Yalcinkaya S (27 May 2022).
1474:
573:
363:
230:
171:
1073:
1167:
879:"Adenoid stones, an unknown culprit in pediatric throat pain"
278:
258:
performed to dislodge them. This involves loudly producing a
1132:
391:
toward the middle layer, and acidification toward the core.
350:
174:. When not mineralized, the presence of debris is known as
170:, are mineralizations of debris within the crevices of the
1028:
300:, with detection upon palpating a hard intratonsillar or
1069:
1235:
763:
513:
or rarely, isolated bone which is usually derived from
729:
Oral
Radiology - E-Book: Principles and Interpretation
27:
Mineralized debris within the crevices of the tonsils
1452:
217:. Tonsil stones have been recorded weighing from 0.3
1070:DeVault KR, Wallace MB, Aqel BA, Lindor KD (2016).
675:
501:of tonsilloliths includes foreign body, calcified
451:General size of a tonsilolith compared to a finger
1029:Wong Chung J, van Benthem P, Blom HM (May 2018).
953:
798:
1508:
766:Oral Surg Oral Med Oral Pathol Oral Radiol Endod
487:, granulomatous lesions or calcification of the
1379:
1329:Medicina Oral, PatologĂa Oral y CirugĂa Bucal
954:Sulibhavi A, Isaacson G (26 September 2021).
920:Turkiye Klinikleri Journal of Dental Sciences
876:
844:Medicina Oral, Patologia Oral y Cirugia Bucal
467:Imaging diagnostic techniques can identify a
805:Alternative Therapies in Health and Medicine
725:
568:Larger tonsil stones may require removal by
241:salt water and manual removal may be tried.
60:A tonsillolith lodged in the tonsillar crypt
1236:Yellamma Bai K, Vinod Kumar B (July 2015).
533:saltwater and manual removal may be tried.
479:, peritonsillar abscesses, foreign bodies,
799:Bhasme A, Lamba P, Sajjan U (April 2023).
671:
669:
667:
665:
663:
661:
659:
657:
655:
653:
51:
1269:
1046:
971:
931:
890:
877:Leonard JA, Reilly BK (2 February 2022).
732:. Elsevier Health Sciences. p. 527.
721:
719:
717:
715:
651:
649:
647:
645:
643:
641:
639:
637:
635:
633:
462:
442:
328:Large tonsillolith half exposed on tonsil
1103:
1101:
1099:
1097:
1095:
1093:
446:
398:
349:
316:A tonsillolith protrudes from the tonsil
1238:"Tonsillolith: A polymicrobial biofilm"
759:
757:
755:
753:
751:
749:
14:
1509:
1322:"Giant tonsillolith: report of a case"
840:"Giant tonsillolith: report of a case"
712:
630:
394:
1090:
1076:. John Wiley & Sons. p. 59.
1008:. Elsevier India. 2009. p. 607.
265:
1170:Otolaryngology–Head and Neck Surgery
746:
678:Otolaryngology–Head and Neck Surgery
430:Tonsilloliths or tonsil stones are
189:Risk factors may include recurrent
24:
1242:Medical Journal Armed Forces India
345:
197:composed of a number of different
25:
1538:
425:
378:In 2009, an association between
333:
321:
309:
1416:
1373:
1347:
1313:
1286:
1229:
1204:
1161:
1126:
1109:"Tonsil Stones (Tonsilloliths)"
1063:
1022:
960:Ear, Nose, & Throat Journal
614:
996:
947:
907:
883:Ear, Nose & Throat Journal
870:
831:
792:
592:. It can be performed using a
13:
1:
1431:. Stuttgart: Thieme. p.
1216:www.elitedentalanddenture.com
1048:10.1080/00016489.2017.1412500
778:10.1016/j.tripleo.2003.11.015
726:White SC, Pharoah MJ (2014).
623:
495:(elongated styloid process).
483:, ectopic bone or cartilage,
205:, they may also occur in the
1427:Imaging of the head and neck
1182:10.1016/j.otohns.2009.05.019
933:10.5336/dentalsci.2021-84346
563:
524:
7:
1254:10.1016/j.mjafi.2011.12.009
366:as salivary corpuscles (s).
176:chronic caseous tonsillitis
10:
1543:
1388:(8 Pt 2 Suppl 100): 6–10.
1005:Textbook of Oral Radiology
603:
193:. Tonsil stones contain a
130:Gargling with salt water,
1456:
973:10.1177/01455613211038340
892:10.1177/01455613221074139
340:Closeup of a tonsillolith
260:voiceless velar fricative
153:
137:
126:
105:
92:
76:
64:
59:
50:
42:
37:
690:10.1177/0194599814544881
583:
539:cetylpyridinium chloride
511:temporal styloid process
247:cetylpyridinium chloride
182:). Symptoms may include
148:cetylpyridinium chloride
1394:10.1002/lary.5541121404
1135:Dentomaxillofac Radiol
1035:Acta Oto-Laryngologica
499:Differential diagnosis
463:Differential diagnosis
452:
443:Enlarged tonsil stones
407:
367:
298:asymptomatic condition
107:Differential diagnosis
1147:10.1259/dmfr/19689789
517:originating from the
457:peritonsillar abscess
450:
402:
353:
113:granulomatous disease
1248:(Suppl 1): S95–S98.
598:carbon dioxide laser
1527:Otorhinolaryngology
489:stylohyoid ligament
395:Cause and diagnosis
385:confocal microscopy
71:Otorhinolaryngology
1361:on 3 December 2012
966:(3): NP183–NP184.
576:may require local
491:in the context of
453:
408:
368:
266:Signs and symptoms
1504:
1503:
1083:978-1-118-82907-3
1015:978-81-312-1148-9
739:978-0-323-09634-8
191:throat infections
161:
160:
100:throat infections
32:Medical condition
16:(Redirected from
1534:
1517:Tonsil disorders
1454:
1453:
1447:
1446:
1430:
1420:
1414:
1413:
1377:
1371:
1370:
1368:
1366:
1357:. Archived from
1351:
1345:
1344:
1326:
1317:
1311:
1310:
1290:
1284:
1283:
1273:
1233:
1227:
1226:
1224:
1222:
1208:
1202:
1201:
1165:
1159:
1158:
1130:
1124:
1123:
1121:
1119:
1105:
1088:
1087:
1067:
1061:
1060:
1050:
1026:
1020:
1019:
1000:
994:
993:
975:
956:"TikTok Tonsils"
951:
945:
944:
942:
940:
935:
911:
905:
904:
894:
874:
868:
867:
835:
829:
828:
796:
790:
789:
761:
744:
743:
723:
710:
709:
673:
594:local anesthetic
519:branchial arches
406:of tonsilloliths
337:
325:
313:
224:
220:
203:palatine tonsils
166:, also known as
55:
35:
34:
21:
1542:
1541:
1537:
1536:
1535:
1533:
1532:
1531:
1507:
1506:
1505:
1500:
1499:
1465:
1451:
1450:
1443:
1421:
1417:
1378:
1374:
1364:
1362:
1353:
1352:
1348:
1324:
1318:
1314:
1295:Indian J Cancer
1291:
1287:
1234:
1230:
1220:
1218:
1210:
1209:
1205:
1166:
1162:
1131:
1127:
1117:
1115:
1107:
1106:
1091:
1084:
1068:
1064:
1027:
1023:
1016:
1002:
1001:
997:
952:
948:
938:
936:
912:
908:
875:
871:
836:
832:
797:
793:
762:
747:
740:
724:
713:
674:
631:
626:
617:
606:
586:
566:
550:Oral irrigators
527:
515:embryonic rests
465:
445:
437:post-nasal drip
428:
397:
389:denitrification
348:
346:Pathophysiology
341:
338:
329:
326:
317:
314:
268:
227:medical imaging
222:
218:
211:lingual tonsils
33:
28:
23:
22:
15:
12:
11:
5:
1540:
1530:
1529:
1524:
1519:
1502:
1501:
1498:
1497:
1482:
1466:
1461:
1460:
1458:
1457:Classification
1449:
1448:
1441:
1415:
1372:
1346:
1312:
1285:
1228:
1203:
1160:
1125:
1089:
1082:
1062:
1041:(5): 492–501.
1021:
1014:
995:
946:
926:(2): 291–298.
906:
869:
850:(3): 239–242.
830:
791:
745:
738:
711:
628:
627:
625:
622:
616:
613:
605:
602:
585:
582:
565:
562:
543:tonsil removal
526:
523:
509:, an enlarged
493:Eagle syndrome
464:
461:
444:
441:
432:calcifications
427:
426:Classification
424:
396:
393:
347:
344:
343:
342:
339:
332:
330:
327:
320:
318:
315:
308:
267:
264:
255:Water flossers
251:tonsil removal
159:
158:
155:
151:
150:
141:
135:
134:
128:
124:
123:
109:
103:
102:
96:
90:
89:
80:
74:
73:
68:
62:
61:
57:
56:
48:
47:
44:
40:
39:
31:
26:
9:
6:
4:
3:
2:
1539:
1528:
1525:
1523:
1520:
1518:
1515:
1514:
1512:
1496:
1492:
1491:
1487:
1483:
1481:
1477:
1476:
1472:
1468:
1467:
1464:
1459:
1455:
1444:
1442:1-58890-009-6
1438:
1434:
1429:
1428:
1419:
1411:
1407:
1403:
1399:
1395:
1391:
1387:
1383:
1376:
1360:
1356:
1350:
1342:
1338:
1335:(3): 239–42.
1334:
1330:
1323:
1316:
1308:
1304:
1300:
1296:
1289:
1281:
1277:
1272:
1267:
1263:
1259:
1255:
1251:
1247:
1243:
1239:
1232:
1217:
1213:
1207:
1199:
1195:
1191:
1187:
1183:
1179:
1176:(3): 316–21.
1175:
1171:
1164:
1156:
1152:
1148:
1144:
1141:(4): 247–50.
1140:
1136:
1129:
1114:
1110:
1104:
1102:
1100:
1098:
1096:
1094:
1085:
1079:
1075:
1074:
1066:
1058:
1054:
1049:
1044:
1040:
1036:
1032:
1025:
1017:
1011:
1007:
1006:
999:
991:
987:
983:
979:
974:
969:
965:
961:
957:
950:
934:
929:
925:
921:
917:
910:
902:
898:
893:
888:
884:
880:
873:
865:
861:
857:
853:
849:
845:
841:
834:
826:
822:
818:
814:
810:
806:
802:
795:
787:
783:
779:
775:
771:
767:
760:
758:
756:
754:
752:
750:
741:
735:
731:
730:
722:
720:
718:
716:
707:
703:
699:
695:
691:
687:
684:(4): 567–74.
683:
679:
672:
670:
668:
666:
664:
662:
660:
658:
656:
654:
652:
650:
648:
646:
644:
642:
640:
638:
636:
634:
629:
621:
612:
610:
609:Tonsillectomy
601:
599:
595:
591:
581:
579:
575:
571:
561:
557:
554:
551:
546:
544:
540:
536:
535:Chlorhexidine
532:
522:
520:
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508:
504:
500:
496:
494:
490:
486:
482:
478:
474:
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460:
458:
449:
440:
438:
433:
423:
421:
420:streptococcus
417:
413:
405:
401:
392:
390:
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1522:Oral hygiene
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1382:Laryngoscope
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94:Risk factors
29:
1365:28 November
1301:(2): 90–1.
590:cryptolysis
485:lymph nodes
481:phlebolites
477:hypertrophy
373:tonsillitis
290:sore throat
43:Other names
18:Tonsilolith
1511:Categories
939:17 January
624:References
507:malignancy
469:radiopaque
356:epithelium
302:submucosal
272:bad breath
184:bad breath
139:Medication
111:Calcified
98:Recurrent
87:bad breath
83:Discomfort
1262:0377-1237
1198:209346548
1113:WebMD.com
982:1942-7522
856:1698-6946
817:1078-6791
570:curettage
564:Curettage
525:Treatment
503:granuloma
283:CAT scans
157:Up to 10%
154:Frequency
127:Treatment
66:Specialty
1410:24862952
1402:12172229
1355:"Images"
1341:15876967
1280:26265885
1190:19716006
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698:25096359
578:excision
531:gargling
412:diagnose
380:biofilms
360:lymphoid
294:ear ache
239:gargling
207:adenoids
199:bacteria
121:syphilis
78:Symptoms
1307:6530236
1271:4529540
1118:6 March
604:Surgery
574:lesions
473:CT scan
404:CT scan
221:g to 42
195:biofilm
172:tonsils
117:mycosis
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364:saliva
304:mass.
279:X-rays
231:TikTok
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1495:474.8
1480:J35.8
1406:S2CID
1325:(PDF)
1221:4 May
1194:S2CID
702:S2CID
584:Laser
1490:9-CM
1437:ISBN
1398:PMID
1367:2007
1337:PMID
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1258:ISSN
1223:2023
1186:PMID
1151:PMID
1120:2016
1078:ISBN
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978:ISSN
941:2023
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860:PMID
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213:and
1486:ICD
1471:ICD
1433:716
1390:doi
1386:112
1266:PMC
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1178:doi
1174:141
1143:doi
1043:doi
1039:138
968:doi
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