scholarly journals Seroconversion rate and socioeconomic and ethnic risk factors for SARS-CoV-2 infection in children in a population-based cohort

2021 ◽  
Author(s):  
Folke Brinkmann ◽  
Hans H Diebner ◽  
Chantal Matenar ◽  
Anne Schlegtendal ◽  
Lynn Eitner ◽  
...  
Keyword(s):  
Risk Factors ◽  
Infection Control ◽  
Parental Education ◽  
Seroconversion Rate ◽  
Middle Eastern ◽  
Age Groups ◽  
Population Based ◽  
Metropolitan Region ◽  
Lower Socioeconomic ◽  
Preventive Examination

Introduction: Socioeconomic and ethnic background have been discussed as possible risk factors for SARS-CoV-2 infections in children. Improved knowledge could lead way to tailored prevention strategies and help to improve infection control. Methods: Observational population-based cohort study in children (6mo. - 18 ys.) scheduled for legally required preventive examination and their parents in a metropolitan region in Germany. Primary endpoint was the SARS-CoV-2 seroconversion rate during study period. Risk factors assessed included age, pre-existing medical conditions, socioeconomic factors, and ethnicity. Results: 2124 children and their parents were included. Seroconversion rates among children in all age groups increased by 3-4-fold from 06/2020 to 02/2021. Only 41% of seropositive children were symptomatic. In 51% of infected children at least one parent was also SARS-CoV-2 positive. Low level of parental education (OR 3.13 (0.72-13.69)) significantly increased the risk of infection. Of the total cohort, 38.5% had a migration background. Specifically, 9% were of Turkish and 5% of Middle Eastern origin. These children had the highest risk for SARS-CoV-2 infections (OR 6.24 (1.38-28.12) and 6.44 (1.14-36.45) after adjustment for other risk factors. Discussion: Seroprevalence of SARS-CoV-2 infections in children increased by 3-4-fold within the study period. Frequently, more than one family member was infected. Children from families with lower socioeconomic status were at higher risk. The highest risk for SARS- CoV-2 infection was identified in families with Turkish or Middle Eastern background. Culture sensitive approaches are essential to improve infection control and serve as a blueprint for vaccination strategies in this population.

scholarly journals A population-based exposure assessment of risk factors associated with gastrointestinal pathogens: a Campylobacter study

2012 ◽  
Vol 141 (5) ◽  
pp. 976-986 ◽  
Author(s):  
L. A. MacRITCHIE ◽  
C. J. HUNTER ◽  
N. J. C. STRACHAN
Keyword(s):  
Risk Factors ◽  
Population Density ◽  
Exposure Assessment ◽  
Disease Incidence ◽  
Univariate Analysis ◽  
Age Groups ◽  
Multivariate Logistic Regression Analysis ◽  
Environmental Water ◽  
Population Based ◽  
Elevated Exposure

SUMMARYA questionnaire survey was undertaken to determine the exposure of a study population to campylobacteriosis source risk factors (environmental, water, food) and results were stratified by age, population density and deprivation. Data were gathered using an exposure assessment carried out by telephone in the Grampian region of Scotland. Univariate analysis showed that children aged 5–14 years, living in low population density (0–44·4 persons/km2) and affluent areas had elevated exposure to environmental and water risk factors. Multivariate logistic regression analysis revealed that younger age groups and lower population density were significant indicators for most environmental risk factors. The results compared to reported disease incidence in Grampian showed that greater exposure to risk factors does not necessarily coincide with greater disease incidence for age groups, particularly for the 0–4 years age group. Further research is required to explain the relationship between exposure and disease incidence.

scholarly journals Age-Related Risk Factors and Complications of Patients With COVID-19: A Population-Based Retrospective Study

2022 ◽  
Vol 8 ◽  
Author(s):  
Han Zhang ◽  
Yingying Wu ◽  
Yuqing He ◽  
Xingyuan Liu ◽  
Mingqian Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Age Groups ◽  
Clinical Manifestations ◽  
Population Based ◽  
Male Gender ◽  
Poor Correlation ◽  
Age Related ◽  
Related Risk ◽  
Independent Risk Factors

Objective: To study the differences in clinical characteristics, risk factors, and complications across age-groups among the inpatients with the coronavirus disease 2019 (COVID-19).Methods: In this population-based retrospective study, we included all the positive hospitalized patients with COVID-19 at Wuhan City from December 29, 2019 to April 15, 2020, during the first pandemic wave. Multivariate logistic regression analyses were used to explore the risk factors for death from COVID-19. Canonical correlation analysis (CCA) was performed to study the associations between comorbidities and complications.Results: There are 36,358 patients in the final cohort, of whom 2,492 (6.85%) died. Greater age (odds ration [OR] = 1.061 [95% CI 1.057–1.065], p < 0.001), male gender (OR = 1.726 [95% CI 1.582–1.885], p < 0.001), alcohol consumption (OR = 1.558 [95% CI 1.355–1.786], p < 0.001), smoking (OR = 1.326 [95% CI 1.055–1.652], p = 0.014), hypertension (OR = 1.175 [95% CI 1.067–1.293], p = 0.001), diabetes (OR = 1.258 [95% CI 1.118–1.413], p < 0.001), cancer (OR = 1.86 [95% CI 1.507–2.279], p < 0.001), chronic kidney disease (CKD) (OR = 1.745 [95% CI 1.427–2.12], p < 0.001), and intracerebral hemorrhage (ICH) (OR = 1.96 [95% CI 1.323–2.846], p = 0.001) were independent risk factors for death from COVID-19. Patients aged 40–80 years make up the majority of the whole patients, and them had similar risk factors with the whole patients. For patients aged <40 years, only cancer (OR = 17.112 [95% CI 6.264–39.73], p < 0.001) and ICH (OR = 31.538 [95% CI 5.213–158.787], p < 0.001) were significantly associated with higher odds of death. For patients aged >80 years, only age (OR = 1.033 [95% CI 1.008–1.059], p = 0.01) and male gender (OR = 1.585 [95% CI 1.301–1.933], p < 0.001) were associated with higher odds of death. The incidence of most complications increases with age, but arrhythmias, gastrointestinal bleeding, and sepsis were more common in younger deceased patients with COVID-19, with only arrhythmia reaching statistical difference (p = 0.039). We found a relatively poor correlation between preexisting risk factors and complications.Conclusions: Coronavirus disease 2019 are disproportionally affected by age for its clinical manifestations, risk factors, complications, and outcomes. Prior complications have little effect on the incidence of extrapulmonary complications.

scholarly journals Association Between Subconjunctival Hemorrhage and Acute Coronary Syndrome: A 14-Year Nationwide Population-Based Cohort Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Ping-Hao Chiang ◽  
Jung-Nien Lai ◽  
Yun-Chi Chiang ◽  
Kai-Chieh Hu ◽  
Min-Yen Hsu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Cohort Study ◽  
Age Groups ◽  
Population Based ◽  
Research Database ◽  
Coronary Syndrome ◽  
Subconjunctival Hemorrhage ◽  
Related Risk ◽  
Patients With Diabetes

Purpose: Subconjunctival hemorrhage (SCH) is usually a benign ocular disorder that causes painless, redness under the conjunctiva. However, since SCH and acute coronary syndrome (ACS) share many vascular risk factors, studies have suggested that these two disorders may be significantly associated with each other, and evaluate the concomitance of ACS in patients with SCH.Methods: This population-based cohort study, enrolled 35,260 Taiwanese patients, and used the Taiwan National Health Insurance Research Database to identify patients with ACS and SCH. Outcomes were compared between the with and without SCH groups. The study population was followed until the date of ACS onset, the date of withdrawal, death, or December 31st 2013, whichever came first.Results: Of the 85,925 patients identified with SCH between 1996 and 2013, 68,295 were excluded based on the study's exclusion criteria, and a total of 17,630 patients with SCH who were diagnosed by ophthalmologists between 2000 and 2012 were eligible for analysis. After 1:1 propensity score matching for 5-year age groups, gender, and the index year, the results showed that SCH was more common in the 40–59 age group (53.82%) and females (58.66%). As for the ACS-related risk factors, patients with diabetes mellitus (aHR = 1.58, 95% CI = [1.38, 1.81]), hypertension (aHR = 1.71, 95% CI = [1.49, 1.96]) and patients taking aspirin (aHR = 1.67, 95% CI = [1.47, 1.90]) had a notably higher risk of ACS. However, it was found that there were no significant differences in the occurrence of ACS between the non-SCH and SCH patients.Conclusion: This results of this study regarding the risk factors and epidemiology of SCH and ACS were in keeping with previously reported findings. However, the results revealed no significant association between SCH and ACS.

scholarly journals Evaluation of community coalition training effects on youth hospital-admitted injury incidence in Victoria, Australia: 2001–2017

2019 ◽  
Vol 26 (5) ◽  
pp. 463-470 ◽  
Author(s):  
Janneke Berecki-Gisolf ◽  
Bosco Rowland ◽  
Nicola Reavley ◽  
Barbara Minuzzo ◽  
John Toumbourou
Keyword(s):  
Risk Factors ◽  
Injury Risk ◽  
Negative Binomial ◽  
Hospital Admissions ◽  
Intervention Strategy ◽  
Age Groups ◽  
Negative Binomial Regression ◽  
Population Based ◽  
Injury Incidence ◽  
The Impact

BackgroundInjuries are one of the three leading causes of morbidity and mortality for young people internationally. Although community risk factors are modifiable causes of youth injury, there has been limited evaluation of community interventions. Communities That Care (CTC) offers a coalition training process to increase evidence-based practices that reduce youth injury risk factors.MethodUsing a non-experimental design, this study made use of population-based hospital admissions data to evaluate the impact on injuries for 15 communities that implemented CTC between 2001 and 2017 in Victoria, Australia. Negative binomial regression models evaluated trends in injury admissions (all, unintentional and transport), comparing CTC and non-CTC communities across different age groups.ResultsStatistically significant relative reductions in all hospital injury admissions in 0–4 year olds were associated with communities completing the CTC process and in 0–19 year olds when communities began their second cycle of CTC. When analysed by subgroup, a similar pattern was observed with unintentional injuries but not with transport injuries.ConclusionThe findings support CTC coalition training as an intervention strategy for preventing youth hospital injury admissions. However, future studies should consider stronger research designs, confirm findings in different community contexts, use other data sources and evaluate intervention mechanisms.

scholarly journals Association of pre-existing comorbidities with mortality and disease severity among 167,500 individuals with COVID-19 in Canada: A population-based cohort study

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0258154
Author(s):  
Erjia Ge ◽  
Yanhong Li ◽  
Shishi Wu ◽  
Elisa Candido ◽  
Xiaolin Wei
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Cohort Study ◽  
Regression Models ◽  
Age Groups ◽  
Organ Transplant ◽  
Population Based ◽  
Solid Organ Transplant ◽  
Solid Organ ◽  
Risk Of Mortality

Background The novel coronavirus disease 2019 (COVID-19) has infected 1.9% of the world population by May 2, 2021. Since most previous studies that examined risk factors for mortality and severity were based on hospitalized individuals, population-based cohort studies are called for to provide evidence that can be extrapolated to the general population. Therefore, we aimed to examine the associations of comorbidities with mortality and disease severity in individuals with COVID-19 diagnosed in 2020 in Ontario, Canada. Methods and findings We conducted a retrospective cohort study of all individuals with COVID-19 in Ontario, Canada diagnosed between January 15 and December 31, 2020. Cases were linked to health administrative databases maintained in the ICES which covers all residents in Ontario. The primary outcome is all-cause 30-day mortality after the first COVID-19 diagnosis, and the secondary outcome is a composite severity index containing death and hospitalization. To examine the risk factors for the outcomes, we employed Cox proportional hazards regression models and logistic regression models to adjust for demographic, socio-economic variables and comorbidities. Results were also stratified by age groups. A total of 167,500 individuals were diagnosed of COVID-19 in 2020 and included in the study. About half (43.8%, n = 73,378) had at least one comorbidity. The median follow-up period were 30 days. The most common comorbidities were hypertension (24%, n = 40,154), asthma (16%, n = 26,814), and diabetes (14.7%, n = 24,662). Individuals with comorbidity had higher risk of mortality compared to those without (HR = 2.80, 95%CI 2.35–3.34; p<0.001), and the risk substantially was elevated from 2.14 (95%CI 1.76–2.60) to 4.81 (95%CI 3.95–5.85) times as the number of comorbidities increased from one to five or more. Significant predictors for mortality included comorbidities such as solid organ transplant (HR = 3.06, 95%CI 2.03–4.63; p<0.001), dementia (HR = 1.46, 95%CI 1.35–1.58; p<0.001), chronic kidney disease (HR = 1.45, 95%CI 1.34–1.57; p<0.001), severe mental illness (HR = 1.42, 95%CI%, 1.12–1.80; p<0.001), cardiovascular disease (CVD) (HR = 1.22, 95%CI, 1.15–1.30), diabetes (HR = 1.19, 95%, 1.12–1.26; p<0.001), chronic obstructive pulmonary disease (COPD) (HR = 1.19, 95%CI 1.12–1.26; p<0.001), cancer (HR = 1.17, 95%CI, 1.09–1.27; p<0.001), hypertension (HR = 1.16, 95%CI, 1.07–1.26; p<0.001). Compared to their effect in older age groups, comorbidities were associated with higher risk of mortality and severity in individuals under 50 years old. Individuals with five or more comorbidities in the below 50 years age group had 395.44 (95%CI, 57.93–2699.44, p<0.001) times higher risk of mortality compared to those without. Limitations include that data were collected during 2020 when the new variants of concern were not predominant, and that the ICES databases do not contain detailed individual-level socioeconomic and racial variables. Conclusion We found that solid organ transplant, dementia, chronic kidney disease, severe mental illness, CVD, hypertension, COPD, cancer, diabetes, rheumatoid arthritis, HIV, and asthma were associated with mortality or severity. Our study highlights that the number of comorbidities was a strong risk factor for deaths and severe outcomes among younger individuals with COVID-19. Our findings suggest that in addition of prioritizing by age, vaccination priority groups should also include younger population with multiple comorbidities.

scholarly journals Number of parity/live birth(s) and cardiovascular disease among Iranian women and men: Results of over 15 years of follow-up.

2020 ◽  
Author(s):  
Seyyed Saeed Moazzeni ◽  
Hossein Toreyhi ◽  
Samaneh Asgari ◽  
Fereidoun Azizi ◽  
Fahimeh Ramezani Tehrani ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Live Birth ◽  
Middle Eastern ◽  
Population Based ◽  
P Value ◽  
Cvd Risk ◽  
Live Births ◽  
Potential Risk Factors

Abstract Background: Most previous studies, conducted in non-Middle Eastern populations, have suggested that increase in the number of parity/live birth(s) leads to cardiovascular disease (CVD) development, although their findings were inconclusive on this issue for both sexes. Biologic and socioeconomic pathways were suggested to explain this association. We studied this issue among urban Iranian men and women. Methods: In this population-based cohort study, included 3929 women and 2571 men aged ≥ 30 years, Data for number of parity/live birth(s) were obtained by standard questionnaire. Participants were then annually followed for CVD events. Multivariate Cox proportional hazard models were used to estimate hazard ratios (HRs), and 95% confidence intervals (CIs) for the number of parity/live birth(s) and other traditional CVD risk factors. Results: During more than 15 years of follow-up, 456 and 524 CVD events have occurred among women and men, respectively. Among women, a J-shaped association was found between the number of live births and incident CVD with the lowest risk for women with 2 live births. Among women in multivariate analyses, each unit increase in parity had a HR of 1.05 (CI: 1.01-1.10) and having ≥4 parity was associated with a HR of 1.86 (0.97-3.56, p-value=0.061). Among men, in comparison with participants who had 1 child, multivariate HRs of having 2, 3 and ≥4 children were 1.97 (1.24-3.12), 2.08 (1.31-3.31) and 2.08 (1.30-3.34), respectively. Conclusion: To the best of our knowledge, the current study is the first report of this issue in the Middle East and North Africa region, a region with high burden of CVD. It can now be suggested that the number of parity/live birth(s) is linked to CVD among the Iranian population, with this issue being more prominent among men. Further research is needed to support our results and clarify the pathways between the number of parity/live birth(s) and CVD development among Iranian populations by considering potential risk factors, especially psycho-socio-economic risk factors.

scholarly journals Population Based Survey Study Associated With Prevalence Of Cardiovascular Risk Factors In India

2020 ◽  
Vol 3 (1) ◽  
pp. 144-148
Author(s):  
Mandheer Kaur ◽  
Sahil Sharma ◽  
Chaitanayajit Singh ◽  
Ankit Magotra ◽  
Preeti Devi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Age Groups ◽  
Heart Rhythm ◽  
Population Based ◽  
Blood Cholesterol ◽  
Survey Study ◽  
Level Of Knowledge ◽  
Group 3

The present study was conducted on 204 individuals of different regions of Chandigarh, Mohali, Panchkula, Himachal Pradesh and Haryana, India, to assess the level of knowledge and awareness of risk factors associated with cardiovascular disease (CVD) in targeted population. Population survey based study was carried out in people grouped in three age groups (Group 1: <18 years, Group 2: Between 18-40 years, Group 3: Above 40). Cardiovascular risk assessment questionnaire was used to assess the level of knowledge and awareness of risk factors via goggle forms and manually filling the same forms. Among risk factors 8.8 percent persons from our targeted population encountered with heart attack, angina, abnormal Heart Rhythm with significant hike in CVD cases was observed in group 3 individuals. Incidence of high blood pressure was observed in 32.4%, 4.9% are normal and 62.7% are unaware of their blood pressure status. Similarly, majority of the population 42.6% are not aware of their blood cholesterol level. The participants were not aware about regular physical activity and exercise, food intake to lower risk factors for the heart disease. There is an urgent need to increase awareness among the population utilizing community based education programs.

scholarly journals Number of parity/live birth(s) and cardiovascular disease among Iranian women and men: Results of over 15 years of follow-up.

2020 ◽  
Author(s):  
Seyyed Saeed Moazzeni ◽  
Hossein Toreyhi ◽  
Samaneh Asgari ◽  
Fereidoun Azizi ◽  
Fahimeh Ramezani Tehrani ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Live Birth ◽  
Middle Eastern ◽  
Population Based ◽  
P Value ◽  
Cvd Risk ◽  
Live Births ◽  
Potential Risk Factors

Abstract Background: Most previous studies conducted in non-Middle Eastern populations have suggested that an increase in the number of parity/live birth(s) leads to cardiovascular disease (CVD) development, although their findings were inconclusive on this issue for both sexes. Biologic and socioeconomic pathways were suggested to explain this association. We studied this issue among urban Iranian men and women.Methods: In this population-based cohort study, which included 3929 women and 2571 men aged ≥ 30 years, data for the number of parity/live birth(s) were obtained by a standard questionnaire. Participants were then annually followed for CVD events. Multivariate Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the number of parity/live birth(s) and other traditional CVD risk factors.Results: During more than 15 years of follow-up, 456 and 524 CVD events have occurred among women and men, respectively. Among women, a J-shaped association was found between the number of live births and incident CVD with the lowest risk for women with two live births. Among women in multivariate analyses, each unit increase in parity had a HR of 1.05 (CI: 1.01-1.10), and having ≥4 parity was associated with a HR of 1.86 (0.97-3.56, p-value=0.061). Among men, in comparison with participants who had 1 child, multivariate HRs of having 2, 3, and ≥4 children were 1.97 (1.24-3.12), 2.08 (1.31-3.31), and 2.08 (1.30-3.34), respectively.Conclusion: To the best of our knowledge, the current study is the first report on this issue in the Middle East and North Africa region, a region with a high burden of CVD. It can now be suggested that the number of parity/live birth(s) is linked to CVD among the Iranian population, with this issue being more prominent among men. Further research is needed to support our results and clarify the pathways between the number of parity/live birth(s) and CVD development among Iranian populations by considering potential risk factors, especially psycho-socio-economic risk factors.

scholarly journals Dynamics of Borrelia burgdorferi-Specific Antibodies: Seroconversion and Seroreversion between Two Population-Based, Cross-Sectional Surveys among Adults in Germany

2020 ◽  
Vol 8 (12) ◽  
pp. 1859
Author(s):  
Tom Woudenberg ◽  
Stefanie Böhm ◽  
Merle Böhmer ◽  
Katharina Katz ◽  
Niklas Willrich ◽  
...  
Keyword(s):  
Borrelia Burgdorferi ◽  
Seroconversion Rate ◽  
Age Groups ◽  
Population Based ◽  
German Population ◽  
Strong Response ◽  
Screening Assay ◽  
Serological Screening ◽  
Cross Sectional ◽  
The Impact

Lyme borreliosis (LB) caused by Borrelia burgdorferi spp. is the most common human tick-borne disease in Europe. Although seroprevalence studies are conducted in several countries, rates of seroconversion and seroreversion are lacking, and they are essential to determine the risk of infection. Seropositivity was determined using a two-step approach—first, a serological screening assay, and in the event of a positive or equivocal result, a confirmatory immunoblot assay. Seroconversion and seroreversion rates were assessed from blood samples taken from participants included in two nation-wide population-based surveys. Moreover, the impact of antigen reactivity on seroreversion rates was assessed. The seroprevalence of antibodies reacting against B. burgdorferi spp. in the German population was 8.5% (95% CI 7.5–9.6) in 1997–99 and 9.3% (95% CI 8.3–10.4) in 2008–2011. Seroprevalence increased with age, up to 20% among 70–79 year-olds. The age-standardized seroprevalence remained the same. The yearly seroconversion rate was 0.45% (95% CI: 0.37–0.54), and the yearly seroreversion rate was 1.47% (95% CI: 1.24–2.17). Lower levels of antibodies were associated with seroreversion. Participants with a strong response against antigen p83 had the lowest odds on seroreversion. Given the yearly seroreversion rate of 1.47% and a seroprevalence up to 20% in the oldest age groups, at least 20% of the German population becomes infected with B. burgdorferi in their lifetime. The slight increase in seroprevalence between the two serosurveys was caused by an aging population.

Non-genetic risk factors for atrial fibrillation are equally important in both young and old age: A nationwide population-based study

2020 ◽  
pp. 204748732091566
Author(s):  
Yun Gi Kim ◽  
Kyung-Do Han ◽  
Jong-Il Choi ◽  
Yun Young Choi ◽  
Ha Young Choi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Alcohol Consumption ◽  
Genetic Risk ◽  
Age Groups ◽  
Genetic Risk Factors ◽  
Population Based ◽  
The Impact ◽  
Onset Atrial Fibrillation ◽  
New Onset

Aims There are several non-genetic risk factors for new-onset atrial fibrillation, including age, sex, obesity, hypertension, diabetes, and alcohol consumption. However, whether these non-genetic risk factors have equal significance among different age groups is not known. We performed a nationwide population-based analysis to compare the clinical significance of non-genetic risk factors for new-onset atrial fibrillation in various age groups. Methods and results A total of 9,797,409 people without a prior diagnosis of atrial fibrillation who underwent a national health check-up in 2009 were included. During 80,130,090 person-years of follow-up, a total of 196,136 people were diagnosed with new-onset atrial fibrillation. The impact of non-genetic risk factors on new-onset atrial fibrillation was examined in different age groups. Obesity, male sex, heavy alcohol consumption, smoking, hypertension, diabetes and chronic kidney disease were associated with an increased risk of new-onset atrial fibrillation. With minor variations, these risk factors were consistently associated with the risk of new-onset atrial fibrillation among various age groups. Using these risk factors, we created a scoring system to predict future risk of new-onset atrial fibrillation in different age groups. In receiver operating characteristic curve analysis, the predictive value of these risk factors ranged between 0.556 and 0.603, and no significant trends were observed. Conclusions Non-genetic risk factors for new-onset atrial fibrillation may have a similar impact on different age groups. Except for sex, these non-genetic risk factors can be modifiable. Therefore, efforts to control non-genetic risk factors might have relevance for both the young and old.

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