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Age-and sex-specific seasonal variation of venous thromboembolism in patients with and without family history: a nationwide family study in Sweden.

https://arctichealth.org/en/permalink/ahliterature107143
Source
Thromb Haemost. 2013 Dec;110(6):1164-71
Publication Type
Article
Date
Dec-2013
Author
Bengt Zöller
Xinjun Li
Henrik Ohlsson
Jan Sundquist
Kristina Sundquist
Author Affiliation
Dr. Bengt Zöller, Center for Primary Health Care Research, CRC, Building 28, Floor 11, Jan Waldenströms gata 35, Skåne University Hospital, S-205 02 Malmö, Sweden, Tel.: +46 70 6691476, Fax: +46 40 391370, E-mail: bengt.zoller@med.lu.se 
Source
Thromb Haemost. 2013 Dec;110(6):1164-71
Date
Dec-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Age Factors
Aged
Aged, 80 and over
Child
Child, Preschool
Disease Progression
Family
Female
Genetic Predisposition to Disease
Humans
Incidence
Infant
Male
Middle Aged
Pedigree
Risk
Seasons
Sex Factors
Sweden
Venous Thromboembolism - epidemiology - genetics
Young Adult
Abstract
Seasonal variation in venous thromboembolism (VTE) risk in individuals with familial predisposition to VTE has not been explored. This nationwide study aimed to determine whether there are age- and sex-specific seasonal differences in risk of hospitalisation of VTE among individuals with and without a family history of VTE. The Swedish Multi-Generation Register was linked to Hospital Discharge Register data for the period 1964-2010. Seasonal variation in first VTE events in 1987-2010 for individuals with and without a family history of VTE (siblings or parents) was determined by several independent methods. Stratified analyses were performed according to age, sex, and VTE subtype (pulmonary embolism [PE] or deep venous thrombosis [DVT]). Seasonal variation in VTE incidence, mostly with a peak during the winter, was observed in both sexes in individuals with and without family history with overall peak-to-low ratios (PLRs) of 1.15 and 1.21, respectively. The peak day was December 25 and February 1 for those with and without a family history of VTE, respectively. Seasonal variation was strongest among individuals aged >50 years. Among individuals aged 0-25 years with a family history, the peak for VTE was in July (PLR = 1.20). Significant seasonal variation was observed for PE and DVT with the exception of DVT among those with a family history (PLR = 1.01). In conclusion, our data support the presence of a modest seasonal variation of VTE among individuals with and without a family history of VTE. However, young age and family history may modify and attenuate the effect of season on VTE.
PubMed ID
24048360 View in PubMed
Less detail

Age- and time-dependent changes in cancer incidence among immigrants to Sweden: colorectal, lung, breast and prostate cancers.

https://arctichealth.org/en/permalink/ahliterature129906
Source
Int J Cancer. 2012 Jul 15;131(2):E122-8
Publication Type
Article
Date
Jul-15-2012
Author
Seyed Mohsen Mousavi
Mahdi Fallah
Kristina Sundquist
Kari Hemminki
Author Affiliation
Division of Molecular Genetic Epidemiology, German Cancer Research Center, DKFZ, Heidelberg, Germany. m.mousavi@dkfz.de
Source
Int J Cancer. 2012 Jul 15;131(2):E122-8
Date
Jul-15-2012
Language
English
Publication Type
Article
Keywords
Age Factors
Breast Neoplasms - epidemiology
Colorectal Neoplasms - epidemiology
Emigration and Immigration
Female
Humans
Lung Neoplasms - epidemiology
Male
Prostatic Neoplasms - epidemiology
Sex Factors
Sweden - epidemiology
Abstract
To examine the role of gender, age at immigration and length of stay on incidence trends of common cancers, we studied risk of colorectal, lung, breast and prostate cancers in immigrants to Sweden from 1958 to 2008. The nationwide Swedish Family-Cancer Database was used to calculate standardized incidence ratios for common cancers among immigrants compared to Swedes. Immigrants were classified into "high-risk" countries when their risk was increased, into "low-risk" when their risk was decreased and into "other" when their risk was nonsignificant. Among those who immigrated at younger age (
PubMed ID
22052616 View in PubMed
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Age-Dependent Metastatic Spread and Survival: Cancer of Unknown Primary as a Model.

https://arctichealth.org/en/permalink/ahliterature279776
Source
Sci Rep. 2016 Mar 24;6:23725
Publication Type
Article
Date
Mar-24-2016
Author
Kari Hemminki
Nicholas Pavlidis
Konstantinos K Tsilidis
Kristina Sundquist
Jianguang Ji
Source
Sci Rep. 2016 Mar 24;6:23725
Date
Mar-24-2016
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Female
Humans
Incidence
Male
Middle Aged
Neoplasm Metastasis
Neoplasms, Unknown Primary - epidemiology - mortality - pathology
Prognosis
Proportional Hazards Models
Registries
Survival Analysis
Sweden - epidemiology
Abstract
In order to describe a novel approach for the clinical study of metastases, we provide here age-specific incidence and survival data for cancer of unknown primary (CUP). Metastases in various organs are found at CUP diagnosis, which have implications for prognosis, and we hypothesize similar prognostic implications for metastases found at diagnosis of primary cancers. We identified 33,224 CUP patients from the Swedish Cancer Registry and calculated incidence rates (IRs) for CUP development. Cox proportional hazards regression models were performed to estimate hazard ratios (HRs) for relative survival in CUP patients compared to the general population. In age-group specific analyses, a maximal IR was reached at age 85-89 years, followed by a marked decline to age 90+ (7-fold in men and 3-fold in women). The overall HR for relative survival declined systematically by age. CUP may be applied as an epidemiological age-incidence model for cancer metastases providing evidence in line with autopsy data that the metastatic potential, as shown by the incidence of CUP, appears to weaken markedly at age 85 years, depending on metastatic locations. The relative death rates were highest among young patients, which was probably entirely due to the low death rates in young background population.
Notes
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PubMed ID
27009354 View in PubMed
Less detail

Age, period and cohort trends in drug abuse hospitalizations within the total Swedish population (1975-2010).

https://arctichealth.org/en/permalink/ahliterature105832
Source
Drug Alcohol Depend. 2014 Jan 1;134:355-61
Publication Type
Article
Date
Jan-1-2014
Author
Giuseppe N Giordano
Henrik Ohlsson
Kenneth S Kendler
Marilyn A Winkleby
Kristina Sundquist
Jan Sundquist
Author Affiliation
Center for Primary Health Care Research, Lund University, Jan Waldenströmsgata 35, CRC, building 28, floor 11, entrance 72, Malmö University Hospital, Malmö, S-205 02, Sweden. Electronic address: giuseppe_nicola.giordano@med.lu.se.
Source
Drug Alcohol Depend. 2014 Jan 1;134:355-61
Date
Jan-1-2014
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Cohort Studies
Female
Hospitalization - trends
Humans
Male
Middle Aged
Population Surveillance - methods
Substance-Related Disorders - diagnosis - epidemiology - therapy
Sweden - epidemiology
Time Factors
Young Adult
Abstract
The societal consequences of drug abuse (DA) are severe and well documented, the World Health Organization recommending tracking of population trends for effective policy responses in treatment of DA and delivery of health care services. However, to correctly identify possible sources of DA change, one must first disentangle three different time-related influences on the need for treatment due to DA: age effects, period effects and cohort effects.
We constructed our main Swedish national DA database (spanning four decades) by linking healthcare data from the Swedish Hospital Discharge Register to individuals, which included hospitalisations in Sweden for 1975-2010. All hospitalized DA cases were identified by ICD codes. Our Swedish national sample consisted of 3078,129 men and 2921,816 women. We employed a cross-classified multilevel logistic regression model to disentangle any net age, period and cohort effects on DA hospitalization rates.
We found distinct net age, period and cohort effects, each influencing the predicted probability of hospitalisation for DA in men and women. Peak age for DA in both sexes was 33-35 years; net period effects showed an increase in hospitalisation for DA from 1996 to 2001; and in birth cohorts 1968-1974, we saw a considerable reduction (around 75%) in predicted probability of hospitalisation for DA.
The use of hospital admissions could be regarded as a proxy of the population's health service use for DA. Our results may thus constitute a basis for effective prevention planning, treatment and other appropriate policy responses.
PubMed ID
24300899 View in PubMed
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Alcohol Use Disorder and Mortality Across the Lifespan: A Longitudinal Cohort and Co-relative Analysis.

https://arctichealth.org/en/permalink/ahliterature282515
Source
JAMA Psychiatry. 2016 Jun 01;73(6):575-81
Publication Type
Article
Date
Jun-01-2016
Author
Kenneth S Kendler
Henrik Ohlsson
Jan Sundquist
Kristina Sundquist
Source
JAMA Psychiatry. 2016 Jun 01;73(6):575-81
Date
Jun-01-2016
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Age of Onset
Aged
Alcoholism - genetics - mortality
Cause of Death
Cohort Studies
Diseases in Twins - genetics - mortality
Female
Genetic Predisposition to Disease - genetics
Humans
Longitudinal Studies
Male
Middle Aged
Proportional Hazards Models
Registries
Risk factors
Statistics as Topic
Sweden
Young Adult
Abstract
Excess alcohol consumption and alcohol use disorders (AUDs) are associated with substantially increased mortality. Efforts to reduce this toll require an understanding of their causes.
To clarify the degree to which the excess mortality associated with AUDs arises (1) from the predispositions of the person who develops AUD (and which would likely be shared by close relatives) and (2) as a direct result of AUD itself.
A prospective cohort and co-relative design study involving all individuals born in Sweden from 1940 to 1965 who had neither died nor migrated prior to 1973 or age 15 years (N?=?2?821?036). They were followed up from January 1, 1973, until December 31, 2010. Alcohol use disorder was assessed from medical, criminal, and pharmacy registries. Half-siblings, full-siblings, and monozygotic twin pairs discordant for AUD were obtained from the Multi-Generation and Twin Register.
Death obtained from the Swedish Death registry.
Our cohort (1?447?887 males and 1?373?149 females) included 131?895 males and 42?163 females registered with AUD. The mean (SD) age at first AUD registration was 39 (13.4) years. We ascertained 127?347 and 76?325 deaths in the male and female subsamples, respectively. Controlling for sex, educational status, and year of birth, the mortality hazard ratio associated with AUD was 5.83 (95% CI, 5.76-5.90) and varied-with an inverted U-shaped function-by age. Examining the AUD-mortality association in the general population and in relative pairs discordant for AUD exposure demonstrated substantial familial confounding in early to mid-adulthood: the AUD-associated mortality hazard ratio was much lower in discordant close relatives than in the general population. In middle to late adulthood, evidence for familial confounding decreased with increasing evidence for a direct effect of AUD on elevated mortality. In the oldest age group (65-70 years), the mortality hazard ratios were similar across the population and all relative pairs, suggesting that the excess mortality was largely a result of having AUD. Adding years since onset of AUD to the model showed that both increasing age and increasing years of duration of AUD contributed to the reduction of familial confounding in the association between AUD and elevated mortality.
Excess mortality associated with AUD arises both from the predispositions of the person who develops AUD and the direct result of having AUD. The effect of predisposition is more prominent early in the life course and in the early years of AUD. The direct effect of AUD becomes progressively more important later in life and with longer duration of AUD. These results have implications for interventions seeking to reduce the elevated AUD-associated mortality.
Notes
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PubMed ID
27097014 View in PubMed
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Association of Short-Term Mortality of Venous Thromboembolism with Family History of Venous Thromboembolism and Charlson Comorbidity Index.

https://arctichealth.org/en/permalink/ahliterature299286
Source
Thromb Haemost. 2019 Jan; 119(1):48-55
Publication Type
Journal Article
Date
Jan-2019
Author
Bengt Zöller
MirNabi Pirouzifard
Jan Sundquist
Kristina Sundquist
Author Affiliation
Center for Primary Health Care Research, Lund University, Region Skåne, Malmö, Sweden.
Source
Thromb Haemost. 2019 Jan; 119(1):48-55
Date
Jan-2019
Language
English
Publication Type
Journal Article
Keywords
Adult
Age Factors
Aged
Anticoagulants
Comorbidity
Family Health
Female
Humans
Male
Middle Aged
Prognosis
Proportional Hazards Models
Pulmonary Embolism - complications - epidemiology - mortality
ROC Curve
Registries
Risk assessment
Sweden
Venous Thromboembolism - complications - epidemiology - mortality
Venous Thrombosis - complications - epidemiology - mortality
Abstract
Studies on short-term prognosis of venous thromboembolism (VTE) that take family history of VTE and Charlson Comorbidity Index (CCI) into account are sparse. The aim was to investigate the importance of family history of VTE and CCI for short-term mortality after a first episode of VTE. Using Swedish medical databases, we conducted a 90-day nationwide cohort study of 41,700 Swedish born patients with a first-time VTE (July 2005-August 2012). Patients diagnosed with VTE and prescribed anticoagulant treatment were included. Mortality hazard ratios (HRs) with 95% confidence intervals (CIs) were determined with Cox regression. Patients with first-degree (sibling/parent) family history of VTE (n?=?11,405, 27.4%) had significantly lower CCI than those without family history. Independent risk factors for 90-day mortality in the adjusted model were: female sex (HR?=?1.19, 95% CI: 1.09-1.29), increasing age (HR?=?1.02, 95% CI: 1.01-1.02 per year), pulmonary embolism (HR?=?1.21, 95% CI: 1.11-1.32) or combined pulmonary embolism and deep venous thrombosis (HR?=?1.60, 95% CI: 1.27-2.01) compared with deep venous thrombosis, CCI?=?1 (HR?=?2.93, 95% CI: 2.32-3.72), CCI?=?2 (HR?=?8.65, 95% CI: 7.16-10.46) or CCI?=?3 (HR?=?22.25, 95% CI: 18.73-26.44) compared with CCI?=?0. Having one or two or more affected first-degree relatives with VTE was associated with lower mortality, HR?=?0.83 (95% CI: 0.74-0.92) and HR?=?0.65 (95% CI: 0.51-0.85), respectively. The mortality rate was 0.70% in patients with a CCI of zero. In receiver operating characteristic (ROC) analysis, the area under the ROC curve for CCI was 0.84 (0.83-0.95). Family history of VTE is associated with lower mortality while CCI is a strong predictor for short-term mortality in VTE. Co-morbidities are important for risk assessment of VTE.
PubMed ID
30597499 View in PubMed
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Depression and anxiety in Swedish primary health care: prevalence, incidence, and risk factors.

https://arctichealth.org/en/permalink/ahliterature258046
Source
Eur Arch Psychiatry Clin Neurosci. 2014 Apr;264(3):235-45
Publication Type
Article
Date
Apr-2014
Author
Nadja Lejtzén
Jan Sundquist
Kristina Sundquist
Xinjun Li
Author Affiliation
Center for Primary Health Care Research, Clinical Research Centre (CRC), Building 28, Entrance 72, Jan Waldenströms gata 35, Skåne University Hospital, Lund University, 205 02, Malmö, Sweden.
Source
Eur Arch Psychiatry Clin Neurosci. 2014 Apr;264(3):235-45
Date
Apr-2014
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Anxiety - epidemiology
Demography - statistics & numerical data
Depression - epidemiology
Female
Humans
Incidence
Male
Middle Aged
Prevalence
Primary Health Care - methods - statistics & numerical data
Risk factors
Sex Factors
Sweden - epidemiology
Abstract
The aim of this study was to estimate the prevalence and incidence of mood disorders, anxiety disorders, and stress and adjustment disorders in primary health care in Sweden and to analyse the relationship between socioeconomic and demographic factors and incidence of these disorders. Prevalence and incidence data on the study population was retrieved from a Swedish primary health care database. A cohort study design was used to examine the incidence of, and risk factors for, mood disorders, anxiety disorders, and stress and adjustment disorders. Cox regression models were used in the statistical analyses. The overall 12-month prevalence of these clinically diagnosed disorders was 2.4 % (3.2 % in women and 1.5 % in men). The overall incidence was 18.4 per 1,000 person-years. The strongest sociodemographic risk factors for these disorders were female gender (HR = 2.04), low family income (HR = 1.52), living in a large city (HR = 1.37), and age 35-44 years (HR = 1.20). This large-scale study examined the prevalence and incidence of common psychiatric disorders diagnosed in primary health care, as well as the potential influence of sociodemographic factors on these disorders. The information obtained is useful for clinicians in primary health care and decision-makers.
PubMed ID
23828500 View in PubMed
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Determination of age-specific and sex-specific familial risks for the different manifestations of venous thromboembolism: a nationwide family study in Sweden.

https://arctichealth.org/en/permalink/ahliterature134176
Source
Thromb Haemost. 2011 Jul;106(1):102-12
Publication Type
Article
Date
Jul-2011
Author
Bengt Zöller
Xinjun Li
Jan Sundquist
Kristina Sundquist
Author Affiliation
Center for Primary Health Care Research, CRC, Malmö University Hospital, S-205 02 Malmö, Sweden. bengt.zoller@med.lu.se
Source
Thromb Haemost. 2011 Jul;106(1):102-12
Date
Jul-2011
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Child
Child of Impaired Parents - statistics & numerical data
Child, Preschool
Family
Female
Humans
Infant
Infant, Newborn
Male
Middle Aged
Risk
Sex Factors
Spouses
Sweden
Venous Thromboembolism - blood - epidemiology
Abstract
This nationwide study aimed to determine whether differences exist in age-specific and sex-specific familial risks for pulmonary embolism (PE), venous thrombosis of the lower limbs (VT) and other forms of venous thromboembolism (OVTE) among offspring, siblings and spouses of affected individuals. The Swedish Multi-Generation Register was linked to the Hospital Discharge Register data for the period 1987-2007. Standardised incidence ratios (SIRs) were calculated for individuals whose relatives were hospitalised for venous thromboembolism (VTE), as determined by the International Classification of Diseases (ICD), and those whose relatives were unaffected by VTE. The total number of hospitalised VTE patients was 45,362. All VTE patients were categorised as PE, VT or OVTE according to ICD at first hospitalisation. For example, the parental SIRs for PE, VT and OVTE in offspring at age 10-19 years were 2.89 (95% CI 1.48-5.06), 4.99 (95% CI 3.22-6.10) and 3.89 (95% CI 2.51-5.75), respectively. The low spousal risks of PE (1.08; 95% CI 1.02-1.13), VT (1.06; 95% CI 1.011.12) and OVTE (1.07; 95% CI 1.00-1.15) suggest the familial risks to be largely genetic. In both men and women, familial relative risks were increased for all the different manifestations of VTE with the exception of those older than 70 years. Familial history is a risk indicator in both sexes, and is potentially useful for clinical risk assessment for the different manifestations of VTE.
PubMed ID
21614406 View in PubMed
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Differences in declining mortality rates due to coronary heart disease by neighbourhood deprivation.

https://arctichealth.org/en/permalink/ahliterature302203
Source
J Epidemiol Community Health. 2018 04; 72(4):314-318
Publication Type
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Date
04-2018
Author
Daniel Oudin Åström
Jan Sundquist
Kristina Sundquist
Author Affiliation
Department of Clinical Sciences, Center for Primary Health Care Research, Lunds Universitet, Lund, Sweden.
Source
J Epidemiol Community Health. 2018 04; 72(4):314-318
Date
04-2018
Language
English
Publication Type
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Keywords
Adult
Age Distribution
Age Factors
Aged
Aged, 80 and over
Coronary Disease - mortality
Female
Health Status Disparities
Healthcare Disparities - statistics & numerical data
Humans
Male
Middle Aged
Mortality - trends
Population Surveillance
Poverty
Residence Characteristics
Socioeconomic Factors
Sweden - epidemiology
Abstract
Cardiovascular disease (CVD) is the main cause of death in most industrialised countries, including those in Europe. The mortality rates due to coronary heart disease (CHD), one of the most serious CVD conditions, have been decreasing in most European countries during the last decades. However, whether the trends over time in CHD mortality rates differ depending on neighbourhood deprivation has rarely been investigated.
For each year of the study period, 1988-2012, in Sweden, age-standardised mortality rates were calculated for three different types of neighbourhoods, characterised by a Neighbourhood Deprivation Index. Joinpoint regression was used to investigate potential changes in age-standardised mortality rates by neighbourhood deprivation and over time.
Over the study period, age-standardised mortality rates due to CHD were consistently the highest in the deprived neighbourhoods and the lowest in the affluent neighbourhoods. We observed a statistically significant overall decline, ranging from 67% to 59%, in the age-standardised CHD mortality rates for each level of neighbourhood deprivation. Furthermore, the decline for the affluent neighbourhoods was significantly higher compared with the decline in the deprived neighbourhoods.
Age-standardised CHD mortality rates decreased significantly in Sweden between 1988 and 2012. This decline was more pronounced in the affluent neighbourhoods, which indicates that the improvements in prevention and treatment of CHD have not benefited individuals residing in deprived neighbourhoods to an equal extent. Knowledge of time trends in CHD mortality by level of neighbourhood deprivation may help guide decision-makers in the development of appropriate healthcare policies for deprived neighbourhoods.
PubMed ID
29330167 View in PubMed
Less detail

End stage renal disease risk and neighbourhood deprivation: a nationwide cohort study in Sweden.

https://arctichealth.org/en/permalink/ahliterature265059
Source
Eur J Intern Med. 2014 Nov;25(9):853-9
Publication Type
Article
Date
Nov-2014
Author
Delshad Saleh Akrawi
Xinjun Li
Jan Sundquist
Kristina Sundquist
Bengt Zöller
Source
Eur J Intern Med. 2014 Nov;25(9):853-9
Date
Nov-2014
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Female
Humans
Kidney Failure, Chronic - epidemiology - etiology
Male
Middle Aged
Poverty - statistics & numerical data
Residence Characteristics - statistics & numerical data
Risk factors
Sex Factors
Socioeconomic Factors
Sweden - epidemiology
Young Adult
Abstract
Chronic kidney disease has been associated with socioeconomic disparities and neighbourhood deprivation. We aimed to determine whether there is an association between neighbourhood deprivation and end stage renal disease (ESRD), and whether this association is independent of individual-level sociodemographic factors and comorbidities.
National Swedish data registers were used. The entire Swedish population aged 20-69 years was followed from January 1, 2001 until December 31, 2010. Data were analysed by multilevel logistic regression, with individual-level sociodemographic factors (age, marital status, family income, education level, country of birth, urban/rural status, and mobility) and comorbidities at the first level and neighbourhood deprivation at the second level.
Neighbourhood deprivation was significantly associated with ESRD (age-adjusted odds ratio [OR] 1.45, 95% confidence interval [CI] 1.34-1.56 in men and OR 1.59, 95% CI 1.44-1.75 in women). The ORs for ESRD in men and women living in the most deprived neighbourhoods remained significantly increased when adjusted for age and individual-level sociodemographic factors (OR 1.25, 95% CI 1.15-1.35 in men and OR 1.30, 95% CI 1.17-1.44 in women). In the full model, which took account of sociodemographic factors and comorbidities, the ORs for ESRD remained significantly increased (OR 1.17, 95% CI 1.07-1.27 in men and OR 1.18, 95% CI 1.06-1.31 in women).
Neighbourhood deprivation is independently associated with ESRD in both men and women irrespective of individual-level sociodemographic factors and comorbidities.
Notes
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