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1.
目的 分析广州市艾滋病病毒感染者和艾滋病患者(HIV/AIDS)中艾滋病相关死亡的影响因素,为采取相应的措施提供依据。方法 利用国家艾滋病综合防治信息系统中1991-2013年广州市疫情资料,使用Cox风险比例模型分析艾滋病相关死亡的影响因素。结果 广州市HIV/AIDS病例中,报病时病程阶段为AIDS(HR=2.717,95%CI:2.039~3.621)、由医疗机构诊疗发现(HR=1.516,95%CI:1.159~1.981)、未接受过CD4+T淋巴细胞检测(HR=4.866,95%CI:3.674~6.444)、符合治疗标准未治疗(HR=12.213,95%CI:8.467~17.616)、报病时年龄40岁以上的病例发生艾滋病相关死亡的风险更高。另外,不符合治疗标准而未治疗的病例发生艾滋病相关死亡的风险也高于接受抗病毒治疗的病例(HR=1.936,95%CI:1.145~3.272)。结论 及早发现HIV/AIDS病例,接受CD4+T淋巴细胞检测和抗病毒治疗可降低HIV/AIDS的死亡风险,延长生存时间。  相似文献   

2.
目的 分析荆州市HIV/AIDS病死率及其影响因素。方法 资料来源于中国疾病预防控制信息系统的艾滋病综合防治信息系统,选取现住址为荆州市、确诊时年龄≥15岁、确诊时间为1996-2021年的HIV/AIDS作为研究对象。采用乘积极限法绘制死亡曲线,Cox比例风险回归模型识别死亡的影响因素。结果 HIV/AIDS共3 304例,随访16 091.5人年,死亡893例,病死率为5.5/100人年。HIV/AIDS确诊后1、5和10年的累积死亡概率分别为15.4%、25.0%和34.6%,参加抗病毒治疗者1、5和10年的累积死亡概率为6.9%、14.4%和23.7%,未参加抗病毒治疗者1、5和10年的累积死亡概率为68.0%、90.1%和98.7%。Cox比例风险回归模型分析结果显示,未参加抗病毒治疗者的死亡风险高于参加抗病毒治疗者(aHR=9.85,95%CI:8.19~11.85);参加抗病毒治疗者死亡的危险因素包括男性(aHR=1.64,95%CI:1.29~2.08)、确诊时年龄≥60岁(aHR=3.52,95%CI:2.38~5.20)、注射吸毒/其他途径感染(aHR=2.38,95%CI:1.30~4.34)、医疗机构发现(aHR=1.53,95%CI:1.11~2.11)和首次CD4+T淋巴细胞(CD4)计数<50个/μl(aHR=2.58,95%CI:1.87~3.58),死亡的保护因素是较高文化程度(高中/中专:aHR=0.64,95%CI:0.46~0.90;大专及以上:aHR=0.42,95%CI:0.24~0.73)。未参加抗病毒治疗者死亡的危险因素包括确诊时年龄较大(30~岁:aHR=2.32,95%CI:1.40~3.84;45~岁:aHR=2.61:95%CI:1.59~4.27;≥60岁:aHR=3.31,95%CI:2.01~5.47)、首次CD4计数较低(<50个/μl:aHR=10.47,95%CI:6.47~16.56;50~199个/μl:aHR=2.31,95%CI:1.08~4.94;200~349个/μl:aHR=2.35,95%CI:1.46~3.79)。结论 1996-2021年荆州市HIV/AIDS病死率较高,首次CD4计数、抗病毒治疗和确诊时年龄是影响HIV/AIDS死亡的主要因素,应进一步坚持扩大检测和“发现即治疗”政策,提升抗病毒治疗效果和HIV/AIDS生存率。  相似文献   

3.
目的 了解1997-2018年甘肃省HIV/AIDS生存时间与影响因素。方法 利用国家艾滋病防治基本信息系统1997-2018年甘肃省疫情资料,采用回顾性队列研究方法,用寿命表法计算生存率,用Kaplan-Meier法绘制生存曲线并计算平均生存时间,用Cox比例风险回归模型分析HIV/AIDS的艾滋病相关死亡的影响因素。结果 6 813例HIV/AIDS中,715例(10.5%)死于艾滋病相关疾病,平均生存时间为195.9(95%CI:189.7~202.2)个月,12、60、120和180个月的累积生存率分别为91.5%、86.1%、79.9%和73.8%。Cox比例风险回归模型分析结果显示,在艾滋病相关死亡风险方面,诊断时的年龄≥ 51岁组是≤ 25岁组的1.906倍(95%CI:1.353~2.685);其他传播途径病例是同性性传播病例的1.593倍(95%CI:1.226~2.069);通过入院就诊、受血/血制品及术前检测发现的病例是通过出入境、婚/孕前检测及新兵体检发现病例的5.113倍(95%CI:2.083~12.547);诊断时病程阶段为艾滋病的病例是HIV感染病例的4.012倍(95%CI:3.401~4.732);未检测CD4+T淋巴细胞(CD4)的病例是首次CD4值≥ 350个/μl病例的5.446倍(95%CI:3.835~7.732);未接受抗病毒治疗的病例是已接受抗病毒治疗病例的12.019倍(95%CI:9.861~14.648)。结论 1997-2018年甘肃省HIV/AIDS平均生存时间超过16年。诊断时年龄≥ 51岁、通过入院就诊、受血/血制品及术前检测发现、诊断时病程阶段为艾滋病、未检测CD4、未接受抗病毒治疗的HIV/AIDS死亡风险更高。应早发现、早诊断、早治疗,提高CD4检测率及治疗率,延长HIV/AIDS的生存时间。  相似文献   

4.
目的 了解1995-2018年贵州省HIV/AIDS生存时间及影响因素。方法 采用回顾性队列研究的方法,从"艾滋病防治基本信息系统"中下载1995-2018年贵州省报告的所有现住址为贵州省的HIV/AIDS报告卡。进行统计分析,运用寿命表法计算生存率、Kaplan-Meier法计算生存时间、Cox比例风险模型分析HIV/AIDS生存时间的影响因素。结果 纳入研究对象HIV/AIDS 53 232例,死亡率为8.53/100人年(14 210/166 679.18);生存时间中位数为10.20(95%CI:9.91~10.48)年,第1、5、10、20年的累积生存概率分别为0.85、0.68、0.51、0.36、0.19;多因素Cox比例风险模型分析结果显示,男性(与女性相比,aHR=0.757,95%CI:0.727~0.788)、未接受过抗病毒治疗(与接受过抗病毒治疗相比,aHR=0.173,95%CI:0.165~0.181)、首次CD4+T淋巴细胞(CD4)<200个/μl(与首次CD4 ≥ 200个/μl者相比,aHR=0.410,95%CI:0.387~0.435)、≥ 45岁 (与<45岁者相比,aHR=1.506,95%CI:1.193~1.901)、文盲(与高中及以上学历者相比,aHR=0.904,95%CI:0.832~0.982)、未婚(与离异或丧偶者相比, aHR=0.896,95%CI:0.848~0.946)、异性性传播(与同性性传播者相比,aHR=0.555,95%CI:0.487~0.632)、苗族等少数民族(与汉族相比,aHR=1.185,95%CI:1.114~1.262)、农民/民工(与家政/待业者相比, aHR=0.874,95%CI:0.834~0.916)均是影响病例生存时间的因素。结论 贵州省HIV/AIDS死亡率较高,近年来并未出现明显的下降趋势,男性、≥ 45岁、文化程度较低、少数民族、首次CD4检测<200个/μl等是影响HIV/AIDS生存时间的因素。应该针对具有这些特征的病例加强治疗和随访管理,以提高其生存质量。  相似文献   

5.
目的 分析全国2010年新报告HIV感染者/AIDS病例(HIV/AIDS)生存时间及影响因素。方法 使用艾滋病综合防治数据信息系统截至2015年12月31日的病例报告历史卡片和随访定时数据库,筛选出2010年新报告HIV/AIDS并整理出随访结局数据,以寿命表法计算其生存率,采用Kaplan-Meier法拟合不同状态下的生存曲线,Cox比例风险模型分析HIV/AIDS生存时间的影响因素。结果 40 335例HIV/AIDS中,11 975例因艾滋病及相关疾病死亡;截至观察终点时,中位生存时间为63.1(95%CI:63.0~63.2)个月,1年和5年生存率分别为81.2%和69.9%;多因素Cox比例风险模型分析结果显示,艾滋病死亡的风险随年龄增加而增加,25~34、35~44、45~54和≥55岁组因艾滋病死亡的风险分别是15~24岁组的1.41倍(95%CI:1.29~1.54)、1.90倍(95%CI:1.74~2.07)、2.24倍(95%CI:2.04~2.46)和2.81倍(95%CI:2.57~3.08);HIV/AIDS首次检测CD4T淋巴细胞(CD4)值≥500个/μl是CD4值<200个/μl 的0.12倍(95%CI:0.11~0.13);接受抗病毒治疗者是未接受治疗者的0.11倍(95%CI:0.10~0.12)。结论 确诊时年龄、确诊时CD4值水平、是否接受抗病毒治疗是HIV/AIDS生存时间的主要影响因素,应及早进行艾滋病检测、接受抗病毒治疗,以延长HIV/AIDS生存时间。  相似文献   

6.
目的 了解南京市接受抗病毒治疗(ART)的HIV感染者及艾滋病患者(HIV/AIDS)的ART依从性及其影响因素,为提高HIV/AIDS人群的ART依从性提供参考。方法 2014年5-6月在南京市第二医院接受免费高效抗反转录病毒治疗(HAART)的HIV/AIDS作为研究对象,收集一般人口学、ART情况及社会支持与歧视等信息,利用logistic回归分析HAART依从性的影响因素。结果 共调查HIV/AIDS 276例,以依从性支持评价中心的依从性指数为评价标准,调查发现总体依从性良好252例,占91.3%。经单因素及多因素分析显示,提醒服药(OR=0.13,95%CI:0.04~0.37)、年龄较大者(OR=0.52,95%CI:0.31~0.89)服药依从性较好;而存在ART副作用(OR=4.11,95%CI:1.35~12.56)、WHO分期较诊断时降低(OR=3.56,95%CI:1.37~9.21)和吸烟(OR=5.38,95%CI:2.00~14.45)是影响依从性的危险因素。结论 南京市HIV/AIDS人群ART依从性整体情况较好,为进一步巩固提高,对存在ART副作用、无提醒服药、吸烟、年龄较小、病情减轻的患者加强服药依从性教育。  相似文献   

7.
目的 分析2010-2019年凉山彝族自治州布拖县抗病毒治疗HIV/AIDS的死亡影响因素,为今后制定可持续的抗病毒治疗策略提供参考依据。方法 采用病例对照研究方法,收集2010-2019年布拖县接受抗病毒治疗HIV/AIDS与死亡者基本和随访信息,按病例数2倍抽样组成对照组,采用logistic回归模型分析其死亡的影响因素。结果 研究对象为抗病毒治疗的HIV/AIDS 3 355例,死亡组1 179例,对照组共2 176例。其中,30~49岁占81.34%,男性占69.09%,彝族占99.55%,已婚或同居占91.12%,初中及以下文化程度占95.77%,农民占88.41%。多因素logistic回归分析结果显示,研究对象的死亡风险因素中,年龄≥50岁是18~29岁的5.08倍(95%CI:3.05~8.48)、女性是男性的0.70倍(95%CI:0.52~0.94)、注射吸毒传播途径是异性性传播途径的1.43倍(95%CI:1.06~1.91)、治疗前CD4+T淋巴细胞计数(CD4)≥350个/μl是CD4<200个/μl的0.38倍(95%CI:0.30~0.48)、最近1次使用含洛匹那韦/利托那韦(LPV/r)抗病毒治疗方案是司他夫定(d4T)+拉米夫定(3TC)+奈韦拉平(NVP)/依非韦伦(EFV)方案的0.04倍(95%CI:0.01~0.18)、耐药是不耐药的3.40倍(95%CI:2.13~5.42),无病毒载量结果且未做耐药检测是不耐药的12.98倍(95%CI:10.28~16.40)。结论 年龄、性别、传播途径、治疗前CD4、最近1次抗病毒治疗方案、抗病毒治疗后耐药检测情况是布拖县接受抗病毒治疗HIV/AIDS的死亡影响因素。应扩大病毒载量和耐药检测覆盖面,科学更换抗病毒治疗方案,开展依从性教育和医务人员培训,降低抗病毒治疗HIV/AIDS死亡率。  相似文献   

8.
目的 了解云南省德宏州艾滋病病毒感染者/艾滋病患者(HIV/AIDS)阴性配偶HIV新发感染率及其危险因素。方法 2009年2月至2014年12月,在HIV/AIDS的阴性配偶中建立前瞻性队列,每年随访一次,进行问卷调查及HIV检测。结果 至2014年12月,共纳入研究对象2091例,其中1692例研究对象至少随访一次,34例研究对象新发感染HIV,累计观察时间为5494.52人年, HIV新发感染率为0.62/100人年。2009-2010、2011-2012、2013-2014年HIV新发感染率分别为0.79/100人年、0.62/100人年、0.47/100人年。Cox回归分析显示,HIV新发感染的危险因素为不坚持使用安全套(HR=4.64,95%CI:1.89~11.40,P=0.001);与阴性配偶入组时间相比,HIV/AIDS开始抗病毒治疗时间晚一年以上(HR=3.70,95%CI:1.44~9.49,P=0.007),HIV/AIDS未进行抗病毒治疗(HR=3.62,95%CI:1.14~11.51,P=0.029)。结论 德宏州HIV/AIDS阴性配偶中HIV新发感染率相对较低。仍需在阴性配偶人群中进一步宣传坚持使用安全套的重要性,并尽早对HIV/AIDS进行抗病毒治疗。  相似文献   

9.
目的了解河南省驻马店市HIV单阳家庭阴性配偶抗体阳转率及其影响因素。方法收集分析当地2006-2011年艾滋病综合防治信息系统和HIV单阳家庭随访管理信息系统中HIV单阳家庭随访信息,每6个月随访一次,包括HIV单阳家庭阴性配偶的人口学信息、原阳性配偶感染特征和抗病毒治疗情况,以及夫妻间性行为特征和社会支持情况,并检测阴性配偶的HIV血清阳转情况。采用Cox比例风险模型分析HIV单阳家庭阴性配偶抗体阳转的影响因素。结果4813户HIV单阳家庭中,127例阴性配偶发生HIV抗体阳转,2006-2011年总HIV抗体阳转率为0.63/100人年,各年抗体阳转率为0.29/100人年~1.28/100人年,维持在1%左右。HIV阴性配偶受教育程度为初中以下(RR=1.50,95%C1:1.02~2.21,P=0.04)、原阳性配偶为未接受抗病毒治疗(RR=3.16, 95%CI: 2.20~4.56,P<0.01)和最近一次CD4+淋巴细胞检测结果<200 cel即1(RR=2.11, 95%C1:1.40~3.19, P<0.01)、最近半年夫妻性生活中性行为频率≥4次/月(RR=4.27, 95%CI: 2.89-6.30, P<0.01)和从不使用安全套(RR=6.40, 95%CI: 3.67-11.17, P<0.01)以及最近半年家庭未获得过经济支持和关怀救助(RR=4.75, 95%CI: 2.34 - 9.64, P<0.01)均是阴性配偶HIV抗体阳转的影响因素。结论近年来驻马店市HIV单阳家庭阴性配偶抗体阳转率趋于稳定,并较之前水平有所下降。随访中需加强感染者抗病毒治疗和依从性管理及夫妻性行为干预,宣传正确的安全套使用知识及搭建社会支持平台。  相似文献   

10.
目的 了解初始抗病毒治疗(ART)儿童HIV感染者死亡和脱失情况及其影响因素。方法 采用回顾性队列研究方法,从我国艾滋病综合防治信息系统ART信息系统下载广西壮族自治区(广西)2004-2019年初始ART儿童HIV感染者数据库,采用Cox比例风险回归模型分析其死亡和脱失情况。结果 共计943例儿童HIV感染者进入队列,总体病死率和脱失率分别为1.00/100人年和0.77/100人年。初始治疗后第1年病死率和脱失率分别为3.90/100人年和1.67/100人年。初始ART后第1、2、5、10年的累计生存率分别为96.14%、95.80%、93.68%、91.54%。多因素Cox比例风险回归分析显示:女性(aHR=2.00,95%CI:1.17~3.40)、基线CD4+T淋巴细胞(CD4)计数<200个/μl(aHR=2.79,95%CI:1.54~5.06)、基线年龄别体重Z评分<-2(aHR=2.38,95%CI:1.32~4.26)、基线血红蛋白<80 g/L(aHR=2.47,95%CI:1.24~4.92)和初始ART方案含LPV/r(aHR=5.05,95%CI:1.15~22.12)是儿童HIV感染者死亡的关联性因素;女性(aHR=2.23,95%CI:1.22~4.07)和初始ART方案含LPV/r(aHR=2.02,95%CI:1.07~3.79)是儿童HIV感染者脱失的关联性因素。结论 广西儿童HIV感染者ART效果较好,但初始ART后第1年病死率和脱失率较高。需针对死亡和脱失的影响因素,加强医护人员培训和儿童HIV感染者及其父母的宣传教育以提高ART效果。  相似文献   

11.
Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.  相似文献   

12.
This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.  相似文献   

13.
Worker education in the primary prevention of occupational dermatoses   总被引:1,自引:0,他引:1  
This paper reports the evaluation of a skin care education programmeconducted on a fine chemicals manufacturing site where over1,000 employees are located. Approximately 60% are involvedin chemical manufacture. Over a 12 month period production staffreceived training in prevention of occupational dermatoses linkedto a site-wide poster initiative. The incidence of new casesof occupational dermatoses fell from 0.055 (70 cases in 1,277employees) to 0.021 (27 cases in 1,277 employees) before andafter the intervention respectively (p<0.0001). After otherfactors such as chemicals handled, observer bias and changesin reporting related to socioeconomic climate were taken intoaccount it is concluded that this study demonstrates the importanceof worker education as a tool for primary prevention of disease.Training materials such as video and poster presentations maybe effectively used in the chemical manufacturing industry asan adjunct to prevention and control of exposure to substanceshazardous to the skin. Such methods may also be used in otherindustries where there are significant risks of dermatoses.  相似文献   

14.
Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).  相似文献   

15.

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.  相似文献   

16.
To understand geographic variation in travel-related illness acquired in distinct African regions, we used the GeoSentinel Surveillance Network database to analyze records for 16,893 ill travelers returning from Africa over a 14-year period. Travelers to northern Africa most commonly reported gastrointestinal illnesses and dog bites. Febrile illnesses were more common in travelers returning from sub-Saharan countries. Eleven travelers died, 9 of malaria; these deaths occurred mainly among male business travelers to sub-Saharan Africa. The profile of illness varied substantially by region: malaria predominated in travelers returning from Central and Western Africa; schistosomiasis, strongyloidiasis, and dengue from Eastern and Western Africa; and loaisis from Central Africa. There were few reports of vaccine-preventable infections, HIV infection, and tuberculosis. Geographic profiling of illness acquired during travel to Africa guides targeted pretravel advice, expedites diagnosis in ill returning travelers, and may influence destination choices in tourism.  相似文献   

17.
18.
深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.  相似文献   

19.
Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO2) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO2. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO2 at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO2 gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO2 also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO2.  相似文献   

20.
Two hazard risk assessment matrices for the ranking of occupational health risks are described. The qualitative matrix uses qualitative measures of probability and consequence to determine risk assessment codes for hazard-disease combinations. A walk-through survey of an underground metalliferous mine and concentrator is used to demonstrate how the qualitative matrix can be applied to determine priorities for the control of occupational health hazards. The semi-quantitative matrix uses attributable risk as a quantitative measure of probability and uses qualitative measures of consequence. A practical application of this matrix is the determination of occupational health priorities using existing epidemiological studies. Calculated attributable risks from epidemiological studies of hazard-disease combinations in mining and minerals processing are used as examples. These historic response data do not reflect the risks associated with current exposures. A method using current exposure data, known exposure-response relationships and the semi-quantitative matrix is proposed for more accurate and current risk rankings.  相似文献   

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