Ex vivo propofol permeation across nasal mucosa: A proof-of-concept study for outpatient light sedation via nasal route

<!DOCTYPE html> <html lang="en-US" xml:lang="en-US"> <head> <meta charset="utf-8"> <meta name="viewport" content="width=device-width, initial-scale=1.0"> <title> Ex vivo propofol permeation across nasal mucosa: A proof-of-concept study for outpatient light sedation via nasal route | ADMET and DMPK </title> <link rel="icon" href="https://pub.iapchem.org/ojs/public/journals/4/favicon_en_US.jpg"> <meta name="generator" content="Open Journal Systems 3.3.0.13"> <link rel="schema.DC" href="http://purl.org/dc/elements/1.1/" /> <meta name="DC.Creator.PersonalName" content="Michele Domenico Spampinato"/> <meta name="DC.Creator.PersonalName" content="Anna Costanzini"/> <meta name="DC.Creator.PersonalName" content="Roberto De Giorgio"/> <meta name="DC.Creator.PersonalName" content="Angelina Passaro"/> <meta name="DC.Creator.PersonalName" content="Nicola Realdon"/> <meta name="DC.Creator.PersonalName" content="Fabrizio Bortolotti"/> <meta name="DC.Creator.PersonalName" content="Sabrina Banella"/> <meta name="DC.Creator.PersonalName" content="Gaia Colombo"/> <meta name="DC.Date.created" scheme="ISO8601" content="2024-08-16"/> <meta name="DC.Date.dateSubmitted" scheme="ISO8601" content="2024-06-26"/> <meta name="DC.Date.issued" scheme="ISO8601" content="2024-10-31"/> <meta name="DC.Date.modified" scheme="ISO8601" content="2024-11-08"/> <meta name="DC.Description" xml:lang="en" content="Background and Purpose: Aiming to achieve light sedation via intranasal administration, this study showed that propofol (PPF) did not permeate across the rabbit nasal mucosa ex vivo from its marketed emulsion for injection. Experimental approach: Dilution of the emulsion with methyl-b-cyclodextrin in saline solution increased propofol solubility in water and diffusion across the nasal epithelium. Key results and conclusion: Despite these positive effects of the cyclodextrin, the amount of PPF permeated was minimal in 3 h, exceeding the formulation residence time in the nose. These results highlight the key role of formulation and the need for innovation in solubility and transmucosal transport enhancement techniques to optimize drug delivery and therapeutic efficacy."/> <meta name="DC.Format" scheme="IMT" content="application/pdf"/> <meta name="DC.Format" scheme="IMT" content="text/xml"/> <meta name="DC.Identifier" content="2403"/> <meta name="DC.Identifier.pageNumber" content="759-768"/> <meta name="DC.Identifier.DOI" content="10.5599/admet.2403"/> <meta name="DC.Identifier.URI" content="https://pub.iapchem.org/ojs/index.php/admet/article/view/2403"/> <meta name="DC.Language" scheme="ISO639-1" content="en"/> <meta name="DC.Rights" content="Copyright (c) 2024 ADMET and DMPK"/> <meta name="DC.Rights" content=""/> <meta name="DC.Source" content="ADMET and DMPK"/> <meta name="DC.Source.ISSN" content="1848-7718"/> <meta name="DC.Source.Issue" content="5"/> <meta name="DC.Source.Volume" content="12"/> <meta name="DC.Source.URI" content="https://pub.iapchem.org/ojs/index.php/admet"/> <meta name="DC.Subject" xml:lang="en" content="Sedative drug"/> <meta name="DC.Subject" xml:lang="en" content="nasal administration"/> <meta name="DC.Subject" xml:lang="en" content="aqueous solubility"/> <meta name="DC.Subject" xml:lang="en" content="betha-cyclodextrin"/> <meta name="DC.Subject" xml:lang="en" content="transmucosal permeation"/> <meta name="DC.Title" content="Ex vivo propofol permeation across nasal mucosa: A proof-of-concept study for outpatient light sedation via nasal route"/> <meta name="DC.Type" content="Text.Serial.Journal"/> <meta name="DC.Type.articleType" content="Original Scientific Articles"/> <meta name="gs_meta_revision" content="1.1"/> <meta name="citation_journal_title" content="ADMET and DMPK"/> <meta name="citation_journal_abbrev" content="ADMET DMPK"/> <meta name="citation_issn" content="1848-7718"/> <meta name="citation_author" content="Michele Domenico Spampinato"/> <meta name="citation_author_institution" content="Department of Translational Medicine, St. Anna University Hospital of Ferrara, University of Ferrara, 44124 Ferrara, Italy"/> <meta name="citation_author" content="Anna Costanzini"/> <meta name="citation_author_institution" content="Department of Translational Medicine, St. Anna University Hospital of Ferrara, University of Ferrara, 44124 Ferrara, Italy"/> <meta name="citation_author" content="Roberto De Giorgio"/> <meta name="citation_author_institution" content="Department of Translational Medicine, St. Anna University Hospital of Ferrara, University of Ferrara, 44124 Ferrara, Italy"/> <meta name="citation_author" content="Angelina Passaro"/> <meta name="citation_author_institution" content="Department of Translational Medicine, St. Anna University Hospital of Ferrara, University of Ferrara, 44124 Ferrara, Italy"/> <meta name="citation_author" content="Nicola Realdon"/> <meta name="citation_author_institution" content="Department of Pharmaceutical and Pharmacological Sciences, University of Padova, 35131 Padova, Italy"/> <meta name="citation_author" content="Fabrizio Bortolotti"/> <meta name="citation_author_institution" content="Department of Life Sciences and Biotechnology, University of Ferrara, Via Fossato di Mortara 19, 44121 Ferrara, Italy"/> <meta name="citation_author" content="Sabrina Banella"/> <meta name="citation_author_institution" content="Department of Life Sciences and Biotechnology, University of Ferrara, Via Fossato di Mortara 19, 44121 Ferrara, Italy"/> <meta name="citation_author" content="Gaia Colombo"/> <meta name="citation_author_institution" content="Department of Life Sciences and Biotechnology, University of Ferrara, Via Fossato di Mortara 19, 44121 Ferrara, Italy"/> <meta name="citation_title" content="Ex vivo propofol permeation across nasal mucosa: A proof-of-concept study for outpatient light sedation via nasal route"/> <meta name="citation_language" content="en"/> <meta name="citation_date" content="2024/08/16"/> <meta name="citation_volume" content="12"/> <meta name="citation_issue" content="5"/> <meta name="citation_firstpage" content="759"/> <meta name="citation_lastpage" content="768"/> <meta name="citation_doi" content="10.5599/admet.2403"/> <meta name="citation_abstract_html_url" content="https://pub.iapchem.org/ojs/index.php/admet/article/view/2403"/> <meta name="citation_keywords" xml:lang="en" content="Sedative drug"/> <meta name="citation_keywords" xml:lang="en" content="nasal administration"/> <meta name="citation_keywords" xml:lang="en" content="aqueous solubility"/> <meta name="citation_keywords" xml:lang="en" content="betha-cyclodextrin"/> <meta name="citation_keywords" xml:lang="en" content="transmucosal permeation"/> <meta name="citation_pdf_url" content="https://pub.iapchem.org/ojs/index.php/admet/article/download/2403/2247"/> <meta name="citation_reference" content="A.Y. 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</a> </div> </div> </div> <div class="pkp_navigation_user_wrapper" id="navigationUserWrapper"> <ul id="navigationUser" class="pkp_navigation_user pkp_nav_list"> <li class="profile"> <a href="https://pub.iapchem.org/ojs/index.php/admet/user/register"> Register </a> </li> <li class="profile"> <a href="https://pub.iapchem.org/ojs/index.php/admet/login"> Login </a> </li> </ul> </div> </nav> </div> </header> <div class="pkp_structure_content has_sidebar"> <div class="pkp_structure_main" role="main"> <a id="pkp_content_main"></a> <div class="page page_article"> <nav class="cmp_breadcrumbs" role="navigation" aria-label="You are here:"> <ol> <li> <a href="https://pub.iapchem.org/ojs/index.php/admet/index"> Home </a> <span class="separator">/</span> </li> <li> <a href="https://pub.iapchem.org/ojs/index.php/admet/issue/archive"> Archives </a> <span class="separator">/</span> </li> <li> <a href="https://pub.iapchem.org/ojs/index.php/admet/issue/view/123"> Vol. 12 No. 5 (2024) </a> <span class="separator">/</span> </li> <li class="current" aria-current="page"> <span aria-current="page"> Original Scientific Articles </span> </li> </ol> </nav> <article class="obj_article_details"> <h1 class="page_title"> Ex vivo propofol permeation across nasal mucosa: A proof-of-concept study for outpatient light sedation via nasal route </h1> <div class="row"> <div class="main_entry"> <section class="item authors"> <h2 class="pkp_screen_reader">Authors</h2> <ul class="authors"> <li> <span class="name"> Michele Domenico Spampinato </span> <span class="affiliation"> Department of Translational Medicine, St. Anna University Hospital of Ferrara, University of Ferrara, 44124 Ferrara, Italy </span> <span class="orcid"> <svg class="orcid_icon" viewBox="0 0 256 256" aria-hidden="true"> <style type="text/css"> .st0{fill:#A6CE39;} .st1{fill:#FFFFFF;} </style> <path class="st0" d="M256,128c0,70.7-57.3,128-128,128C57.3,256,0,198.7,0,128C0,57.3,57.3,0,128,0C198.7,0,256,57.3,256,128z"/> <g> <path class="st1" d="M86.3,186.2H70.9V79.1h15.4v48.4V186.2z"/> <path class="st1" d="M108.9,79.1h41.6c39.6,0,57,28.3,57,53.6c0,27.5-21.5,53.6-56.8,53.6h-41.8V79.1z M124.3,172.4h24.5 c34.9,0,42.9-26.5,42.9-39.7c0-21.5-13.7-39.7-43.7-39.7h-23.7V172.4z"/> <path class="st1" d="M88.7,56.8c0,5.5-4.5,10.1-10.1,10.1c-5.6,0-10.1-4.6-10.1-10.1c0-5.6,4.5-10.1,10.1-10.1 C84.2,46.7,88.7,51.3,88.7,56.8z"/> </g> </svg> <a href="https://orcid.org/0000-0002-2285-327X" target="_blank"> https://orcid.org/0000-0002-2285-327X </a> </span> </li> <li> <span class="name"> Anna Costanzini </span> <span class="affiliation"> Department of Translational Medicine, St. Anna University Hospital of Ferrara, University of Ferrara, 44124 Ferrara, Italy </span> <span class="orcid"> <svg class="orcid_icon" viewBox="0 0 256 256" aria-hidden="true"> <style type="text/css"> .st0{fill:#A6CE39;} .st1{fill:#FFFFFF;} </style> <path class="st0" d="M256,128c0,70.7-57.3,128-128,128C57.3,256,0,198.7,0,128C0,57.3,57.3,0,128,0C198.7,0,256,57.3,256,128z"/> <g> <path class="st1" d="M86.3,186.2H70.9V79.1h15.4v48.4V186.2z"/> <path class="st1" d="M108.9,79.1h41.6c39.6,0,57,28.3,57,53.6c0,27.5-21.5,53.6-56.8,53.6h-41.8V79.1z M124.3,172.4h24.5 c34.9,0,42.9-26.5,42.9-39.7c0-21.5-13.7-39.7-43.7-39.7h-23.7V172.4z"/> <path class="st1" d="M88.7,56.8c0,5.5-4.5,10.1-10.1,10.1c-5.6,0-10.1-4.6-10.1-10.1c0-5.6,4.5-10.1,10.1-10.1 C84.2,46.7,88.7,51.3,88.7,56.8z"/> </g> </svg> <a href="https://orcid.org/0000-0002-8644-1135" target="_blank"> https://orcid.org/0000-0002-8644-1135 </a> </span> </li> <li> <span class="name"> Roberto De Giorgio </span> <span class="affiliation"> Department of Translational Medicine, St. Anna University Hospital of Ferrara, University of Ferrara, 44124 Ferrara, Italy </span> <span class="orcid"> <svg class="orcid_icon" viewBox="0 0 256 256" aria-hidden="true"> <style type="text/css"> .st0{fill:#A6CE39;} .st1{fill:#FFFFFF;} </style> <path class="st0" d="M256,128c0,70.7-57.3,128-128,128C57.3,256,0,198.7,0,128C0,57.3,57.3,0,128,0C198.7,0,256,57.3,256,128z"/> <g> <path class="st1" d="M86.3,186.2H70.9V79.1h15.4v48.4V186.2z"/> <path class="st1" d="M108.9,79.1h41.6c39.6,0,57,28.3,57,53.6c0,27.5-21.5,53.6-56.8,53.6h-41.8V79.1z M124.3,172.4h24.5 c34.9,0,42.9-26.5,42.9-39.7c0-21.5-13.7-39.7-43.7-39.7h-23.7V172.4z"/> <path class="st1" d="M88.7,56.8c0,5.5-4.5,10.1-10.1,10.1c-5.6,0-10.1-4.6-10.1-10.1c0-5.6,4.5-10.1,10.1-10.1 C84.2,46.7,88.7,51.3,88.7,56.8z"/> </g> </svg> <a href="https://orcid.org/0000-0003-0867-5873" target="_blank"> https://orcid.org/0000-0003-0867-5873 </a> </span> </li> <li> <span class="name"> Angelina Passaro </span> <span class="affiliation"> Department of Translational Medicine, St. Anna University Hospital of Ferrara, University of Ferrara, 44124 Ferrara, Italy </span> <span class="orcid"> <svg class="orcid_icon" viewBox="0 0 256 256" aria-hidden="true"> <style type="text/css"> .st0{fill:#A6CE39;} .st1{fill:#FFFFFF;} </style> <path class="st0" d="M256,128c0,70.7-57.3,128-128,128C57.3,256,0,198.7,0,128C0,57.3,57.3,0,128,0C198.7,0,256,57.3,256,128z"/> <g> <path class="st1" d="M86.3,186.2H70.9V79.1h15.4v48.4V186.2z"/> <path class="st1" d="M108.9,79.1h41.6c39.6,0,57,28.3,57,53.6c0,27.5-21.5,53.6-56.8,53.6h-41.8V79.1z M124.3,172.4h24.5 c34.9,0,42.9-26.5,42.9-39.7c0-21.5-13.7-39.7-43.7-39.7h-23.7V172.4z"/> <path class="st1" d="M88.7,56.8c0,5.5-4.5,10.1-10.1,10.1c-5.6,0-10.1-4.6-10.1-10.1c0-5.6,4.5-10.1,10.1-10.1 C84.2,46.7,88.7,51.3,88.7,56.8z"/> </g> </svg> <a href="https://orcid.org/0000-0001-8462-7000" target="_blank"> https://orcid.org/0000-0001-8462-7000 </a> </span> </li> <li> <span class="name"> Nicola Realdon </span> <span class="affiliation"> Department of Pharmaceutical and Pharmacological Sciences, University of Padova, 35131 Padova, Italy </span> <span class="orcid"> <svg class="orcid_icon" viewBox="0 0 256 256" aria-hidden="true"> <style type="text/css"> .st0{fill:#A6CE39;} .st1{fill:#FFFFFF;} </style> <path class="st0" d="M256,128c0,70.7-57.3,128-128,128C57.3,256,0,198.7,0,128C0,57.3,57.3,0,128,0C198.7,0,256,57.3,256,128z"/> <g> <path class="st1" d="M86.3,186.2H70.9V79.1h15.4v48.4V186.2z"/> <path class="st1" d="M108.9,79.1h41.6c39.6,0,57,28.3,57,53.6c0,27.5-21.5,53.6-56.8,53.6h-41.8V79.1z M124.3,172.4h24.5 c34.9,0,42.9-26.5,42.9-39.7c0-21.5-13.7-39.7-43.7-39.7h-23.7V172.4z"/> <path class="st1" d="M88.7,56.8c0,5.5-4.5,10.1-10.1,10.1c-5.6,0-10.1-4.6-10.1-10.1c0-5.6,4.5-10.1,10.1-10.1 C84.2,46.7,88.7,51.3,88.7,56.8z"/> </g> </svg> <a href="https://orcid.org/0000-0001-5624-6876" target="_blank"> https://orcid.org/0000-0001-5624-6876 </a> </span> </li> <li> <span class="name"> Fabrizio Bortolotti </span> <span class="affiliation"> Department of Life Sciences and Biotechnology, University of Ferrara, Via Fossato di Mortara 19, 44121 Ferrara, Italy </span> <span class="orcid"> <svg class="orcid_icon" viewBox="0 0 256 256" aria-hidden="true"> <style type="text/css"> .st0{fill:#A6CE39;} .st1{fill:#FFFFFF;} </style> <path class="st0" d="M256,128c0,70.7-57.3,128-128,128C57.3,256,0,198.7,0,128C0,57.3,57.3,0,128,0C198.7,0,256,57.3,256,128z"/> <g> <path class="st1" d="M86.3,186.2H70.9V79.1h15.4v48.4V186.2z"/> <path class="st1" d="M108.9,79.1h41.6c39.6,0,57,28.3,57,53.6c0,27.5-21.5,53.6-56.8,53.6h-41.8V79.1z M124.3,172.4h24.5 c34.9,0,42.9-26.5,42.9-39.7c0-21.5-13.7-39.7-43.7-39.7h-23.7V172.4z"/> <path class="st1" d="M88.7,56.8c0,5.5-4.5,10.1-10.1,10.1c-5.6,0-10.1-4.6-10.1-10.1c0-5.6,4.5-10.1,10.1-10.1 C84.2,46.7,88.7,51.3,88.7,56.8z"/> </g> </svg> <a href="https://orcid.org/0009-0007-5053-2127" target="_blank"> https://orcid.org/0009-0007-5053-2127 </a> </span> </li> <li> <span class="name"> Sabrina Banella </span> <span class="affiliation"> Department of Life Sciences and Biotechnology, University of Ferrara, Via Fossato di Mortara 19, 44121 Ferrara, Italy </span> <span class="orcid"> <svg class="orcid_icon" viewBox="0 0 256 256" aria-hidden="true"> <style type="text/css"> .st0{fill:#A6CE39;} .st1{fill:#FFFFFF;} </style> <path class="st0" d="M256,128c0,70.7-57.3,128-128,128C57.3,256,0,198.7,0,128C0,57.3,57.3,0,128,0C198.7,0,256,57.3,256,128z"/> <g> <path class="st1" d="M86.3,186.2H70.9V79.1h15.4v48.4V186.2z"/> <path class="st1" d="M108.9,79.1h41.6c39.6,0,57,28.3,57,53.6c0,27.5-21.5,53.6-56.8,53.6h-41.8V79.1z M124.3,172.4h24.5 c34.9,0,42.9-26.5,42.9-39.7c0-21.5-13.7-39.7-43.7-39.7h-23.7V172.4z"/> <path class="st1" d="M88.7,56.8c0,5.5-4.5,10.1-10.1,10.1c-5.6,0-10.1-4.6-10.1-10.1c0-5.6,4.5-10.1,10.1-10.1 C84.2,46.7,88.7,51.3,88.7,56.8z"/> </g> </svg> <a href="https://orcid.org/0000-0003-2676-1951" target="_blank"> https://orcid.org/0000-0003-2676-1951 </a> </span> </li> <li> <span class="name"> Gaia Colombo </span> <span class="affiliation"> Department of Life Sciences and Biotechnology, University of Ferrara, Via Fossato di Mortara 19, 44121 Ferrara, Italy </span> <span class="orcid"> <svg class="orcid_icon" viewBox="0 0 256 256" aria-hidden="true"> <style type="text/css"> .st0{fill:#A6CE39;} .st1{fill:#FFFFFF;} </style> <path class="st0" d="M256,128c0,70.7-57.3,128-128,128C57.3,256,0,198.7,0,128C0,57.3,57.3,0,128,0C198.7,0,256,57.3,256,128z"/> <g> <path class="st1" d="M86.3,186.2H70.9V79.1h15.4v48.4V186.2z"/> <path class="st1" d="M108.9,79.1h41.6c39.6,0,57,28.3,57,53.6c0,27.5-21.5,53.6-56.8,53.6h-41.8V79.1z M124.3,172.4h24.5 c34.9,0,42.9-26.5,42.9-39.7c0-21.5-13.7-39.7-43.7-39.7h-23.7V172.4z"/> <path class="st1" d="M88.7,56.8c0,5.5-4.5,10.1-10.1,10.1c-5.6,0-10.1-4.6-10.1-10.1c0-5.6,4.5-10.1,10.1-10.1 C84.2,46.7,88.7,51.3,88.7,56.8z"/> </g> </svg> <a href="https://orcid.org/0000-0001-9033-2305" target="_blank"> https://orcid.org/0000-0001-9033-2305 </a> </span> </li> </ul> </section> <section class="item doi"> <h2 class="label"> DOI: </h2> <span class="value"> <a href="https://doi.org/10.5599/admet.2403"> https://doi.org/10.5599/admet.2403 </a> </span> </section> <section class="item keywords"> <h2 class="label"> Keywords: </h2> <span class="value"> Sedative drug, nasal administration, aqueous solubility, betha-cyclodextrin, transmucosal permeation </span> </section> <div class="item cover_image"> <div class="sub_item"> <img src="https://pub.iapchem.org/ojs/public/journals/4/submission_2403_2098_coverImage_en_US.png" alt="Graphical Abstract" > </div> </div> <section class="item abstract"> <h2 class="label">Abstract</h2> <p><strong>Background and Purpose:</strong> Aiming to achieve light sedation via intranasal administration, this study showed that propofol (PPF) did not permeate across the rabbit nasal mucosa ex vivo from its marketed emulsion for injection. <strong>Experimental approach:</strong> Dilution of the emulsion with methyl-b-cyclodextrin in saline solution increased propofol solubility in water and diffusion across the nasal epithelium. <strong>Key results and conclusion:</strong> Despite these positive effects of the cyclodextrin, the amount of PPF permeated was minimal in 3 h, exceeding the formulation residence time in the nose. These results highlight the key role of formulation and the need for innovation in solubility and transmucosal transport enhancement techniques to optimize drug delivery and therapeutic efficacy.</p> </section> <div class="item downloads_chart"> <h3 class="label"> Downloads </h3> <div class="value"> <canvas class="usageStatsGraph" data-object-type="Submission" data-object-id="2403"></canvas> <div class="usageStatsUnavailable" data-object-type="Submission" data-object-id="2403"> Download data is not yet available. </div> </div> </div> <section class="item references"> <h2 class="label"> References </h2> <div class="value"> <p>A.Y. Feng, A.D. Kaye, R.J. Kaye, K. Belani, R.D. Urman. Novel propofol derivatives and implications for anesthesia practice. Journal of Anaesthesiology Clinical Pharmacology 33 (2017) 9-15. <a href="http://dx.doi.org/10.4103/0970-9185.202205">http://dx.doi.org/10.4103/0970-9185.202205</a> </p> <p>B. Wilhelms, J. Broscheit, S. Shityakov. Chemical Analysis and Molecular Modelling of Cyclodextrin-Formulated Propofol and Its Sodium Salt to Improve Drug Solubility, Stability and Pharmacokinetics (Cytogenotoxicity). Pharmaceuticals (Basel) 16 (2023) 667. <a href="https://doi.org/10.3390/ph16050667">https://doi.org/10.3390/ph16050667</a> </p> <p>I. Cappellini, G. Bavestrello Piccini, L. Campagnola, C. Bochicchio, R. Carente, F. Lai, S. Magazzini, G. Consales. Procedural Sedation in Emergency Department: A Narrative Review. Emergency Care and Medicine 1 (2024) 103-136. <a href="https://doi.org/10.3390/ecm1020014">https://doi.org/10.3390/ecm1020014</a> </p> <p>W.H. Cordell, K.K. Keene, B.K. Giles, J.B. Jones, J.H. Jones, E.J. Brizendine. The high prevalence of pain in emergency medical care. The American Journal of Emergency Medicine 20 (2002) 165-169. <a href="https://doi.org/10.1053/ajem.2002.32643">https://doi.org/10.1053/ajem.2002.32643</a> </p> <p>EUSEM - European Curriculum of Emergency Medicine, <a href="https://eusem.org/education/curriculum/european-curriculum-of-emergency-medicine">https://eusem.org/education/curriculum/european-curriculum-of-emergency-medicine</a> (last accessed July 30th, 2024) </p> <p>S. Serra, M.D. Spampinato, A. Riccardi, M. Guarino, A. Fabbri, L. Orsi, F. De Iaco. Pain Management at the End of Life in the Emergency Department: A Narrative Review of the Literature and a Practical Clinical Approach. Journal Of Clinical Medicine 12 (2023) 4357. <a href="https://doi.org/10.3390/jcm12134357">https://doi.org/10.3390/jcm12134357</a> </p> <p>Y. Kanno, T. Ohira, Y. Harada, S. Koshita, T. Ogawa, H. Kusunose, Y. Koike, T. Yamagata, T. Sakai, K. Masu, K. Yonamine, K. Miyamoto, M. Tanaka, T. Shimada, F. Kozakai, K. Endo, H. Okano, D. Komabayashi, T. 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