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Adeyemo AA, Adedokun B, Adeolu J, Akinyemi JO, Omotade OO, Oluwatosin OM. Re-telling the story of aminoglycoside ototoxicity: tales from sub-Saharan Africa. Front Neurol 2024; 15:1412645. [PMID: 39006231 PMCID: PMC11239550 DOI: 10.3389/fneur.2024.1412645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Accepted: 06/12/2024] [Indexed: 07/16/2024] Open
Abstract
Background Aminoglycosides, such as Streptomycin, are cheap, potent antibiotics widely used Sub-Saharan Africa. However, aminoglycosides are the commonest cause of ototoxicity. The limited prospective epidemiological studies on aminoglycoside ototoxicity from Sub-Saharan Africa motivated this study to provide epidemiological information on Streptomycin-induced ototoxicity, identify risk factors and predictors of ototoxicity. Method A longitudinal study of 153 adults receiving Streptomycin-based anti-tuberculous drugs was done. All participants underwent extended frequency audiometry and had normal hearing thresholds at baseline. Hearing thresholds were assessed weekly for 2 months, then monthly for the subsequent 6 months. Ototoxicity was determined using the ASHA criteria. Descriptive statistics were used to analyze socio-demographic variables. Ototoxicity incidence rate was calculated, and Kaplan-Meier estimate used to determine cumulative probability of ototoxicity. Chi-square test was done to determine parameters associated with ototoxicity and Cox regression models were used to choose the predictors of ototoxicity. Results Age of participants was 41.43 ± 12.66 years, with a male-to-female ratio of 1:0.6. Ototoxicity was found in 34.6% of the participants, giving an incidence of 17.26 per 1,000-person-week. The mean onset time to ototoxicity was 28.0 ± 0.47 weeks. By 28th week, risk of developing ototoxicity for respondents below 40 years of age was 0.29, and for those above 40 years was 0.77. At the end of the follow-up period, the overall probability of developing ototoxicity in the study population was 0.74. A significant difference in onset of ototoxicity was found between the age groups: the longest onset was seen in <40 years, followed by 40-49 years, and shortest onset in ≥50 years. Hazard of ototoxicity was significantly higher in participants aged ≥50 years compared to participants aged ≤40 years (HR = 3.76, 95% CI = 1.84-7.65). The probability of ototoxicity at 40 g, 60 g and 80 g cumulative dose of Streptomycin was 0.08, 0.43 and 2.34, respectively. Age and cumulative dose were significant predictors of ototoxicity. Conclusion The mean onset time to Streptomycin-induced ototoxicity was 28 weeks after commencement of therapy. Age and cumulative dose can reliably predict the onset of Streptomycin-induced ototoxicity. Medium to long term monitoring of hearing is advised for patients on aminoglycoside therapy.
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Affiliation(s)
- Adebolajo A Adeyemo
- Institute of Child Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Otolaryngology, University College Hospital, Ibadan, Nigeria
| | - Babatunde Adedokun
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Josephine Adeolu
- Institute of Child Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Joshua O Akinyemi
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Olayemi O Omotade
- Institute of Child Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Odunayo M Oluwatosin
- Department of Surgery, College of Medicine, University of Ibadan, Ibadan, Nigeria
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Wang S, Wong LLN. Development of the Mandarin Digit-in-Noise Test and Examination of the Effect of the Number of Digits Used in the Test. Ear Hear 2024; 45:572-582. [PMID: 37990396 DOI: 10.1097/aud.0000000000001447] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2023]
Abstract
OBJECTIVES The study aimed to develop and validate the Mandarin digit-in-noise (DIN) test using four digit (i.e., two-, three-, four-, and five-digit) sequences. Test-retest reliability and criterion validity were evaluated. How the number of digits affected the results was examined. The research might lead to more informed choice of DIN tests for populations with specific cognitive needs such as memory impairment. DESIGN The International Collegium of Rehabilitative Audiology guideline for developing the DIN was adapted to create test materials. The test-retest reliability and psychometric function of each digit sequence were determined among young normal-hearing adults. The criterion validity of each digit sequence was determined by comparing the measured performance of older adult hearing aid users with that obtained from two other well-established sentence-in-noise tests: the Mandarin hearing-in-noise test and the Mandarin Chinese matrix test. The relation between the speech reception thresholds (SRTs) of each digit sequence of the DIN test and working memory capacity measured using the digit span test and the reading span test were explored among older adult hearing aid users. Together, the study sample consisted of 54 young normal-hearing adults and 56 older adult hearing aid users. RESULTS The slopes associated with the two-, three-, four-, and five-digit DIN test were 16.58, 18.79, 20.42, and 21.09 %/dB, respectively, and the mean SRTs were -11.11, -10.99, -10.56, and -10.02 dB SNR, respectively. Test-retest SRTs did not differ by more than 0.74 dB across all digit sequences, suggesting good test-retest reliability. Spearman rank-order correlation coefficients between SRTs obtained using the DIN across the four digit (i.e., two-, three-, four-, and five-digit) sequences and the two sentence-in-noise tests were uniformly high ( rs = 0.9) across all participants, when data from all participants were considered. Results from the digit span test and reading span test correlated significantly with the results of the five-digit sequences ( rs = -0.37 and -0.42, respectively) but not with the results of the two-, three-, and four-digit sequences among older hearing aid users. CONCLUSIONS While the three-digit sequence was found to be appropriate for clinical use for assessment of auditory perception, the two-digit sequence could be used for hearing screening. The five-digit sequence could be difficult for older hearing aid users, and with its SRT related to working memory capacity, its use in the evaluation of speech perception should be investigated further. The Mandarin DIN test was found to be reliable, and the findings are in line with SRTs obtained using standardized sentence tests, suggesting good criterion validity.
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Affiliation(s)
- Shangqiguo Wang
- Faculty of Education, The University of Hong Kong, Pokfulam, Hong Kong, China
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Schimmel C, Cormier K, Manchaiah V, Swanepoel DW, Sharma A. Digits-in-Noise Test as an Assessment Tool for Hearing Loss and Hearing Aids. Audiol Res 2024; 14:342-358. [PMID: 38666901 PMCID: PMC11047740 DOI: 10.3390/audiolres14020030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/28/2024] [Accepted: 04/04/2024] [Indexed: 04/29/2024] Open
Abstract
The aim of this study was to examine the relationship between an American English Digits in Noise (DIN) test and commonly used audiological measures to evaluate the DIN test's ability to detect hearing loss and validate hearing aid fitting. QuickSIN and DIN tests were completed by participants with untreated hearing loss (n = 46), prescription hearing aids (n = 15), and over-the-counter (OTC) hearing aids (n = 12). Performance on the QuickSIN showed moderate positive correlations with DIN for untreated hearing loss participants and prescription hearing aid users, but not for OTC hearing aid users. For untreated hearing loss participants, both QuickSIN and DIN tests showed positive moderate to strong correlations with high frequency puretone averages. In OTC users, DIN scores did not significantly change over a 6-month time period and were better when conducted remotely compared to in-person testing. Our results suggest that the DIN test may be a feasible monitoring option for individuals with hearing loss and those fitted with hearing aids. However, due to small sample size in this pilot study, future research is needed to examine DIN test's utility for fitting and validating OTC hearing aids.
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Affiliation(s)
- Carly Schimmel
- Department of Speech, Language, and Hearing Sciences, University of Colorado Boulder, Boulder, CO 80309, USA; (C.S.); (K.C.)
| | - Kayla Cormier
- Department of Speech, Language, and Hearing Sciences, University of Colorado Boulder, Boulder, CO 80309, USA; (C.S.); (K.C.)
| | - Vinaya Manchaiah
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, CO 80045, USA; (V.M.); (D.W.S.)
- UCHealth Hearing and Balance, University of Colorado Hospital, Aurora, CO 80045, USA
- Virtual Hearing Laboratory, Collaborative Initiative between University of Colorado School of Medicine and University of Pretoria, Aurora, CO 80045, USA
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria 0002, South Africa
- Department of Speech and Hearing, School of Allied Health Sciences, Manipal Academy of Higher Education, Manipal 576104, India
| | - De Wet Swanepoel
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, CO 80045, USA; (V.M.); (D.W.S.)
- Virtual Hearing Laboratory, Collaborative Initiative between University of Colorado School of Medicine and University of Pretoria, Aurora, CO 80045, USA
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria 0002, South Africa
| | - Anu Sharma
- Department of Speech, Language, and Hearing Sciences, University of Colorado Boulder, Boulder, CO 80309, USA; (C.S.); (K.C.)
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Ndegwa S, Pavlik M, Gallagher ER, King’e M, Bocha M, Mokoh LW, Macharia I, Stringer P, Njuguna I, Wamalwa D, Benki-Nugent S. Hearing Loss Detection and Early Intervention Strategies in Kenya. Ann Glob Health 2024; 90:10. [PMID: 38344005 PMCID: PMC10854416 DOI: 10.5334/aogh.4336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 01/03/2024] [Indexed: 02/15/2024] Open
Abstract
Background Thirty-four million children globally have disabling hearing loss, with the highest prevalence in low- and middle-income countries (LMICs). Early identification and management is crucial, yet barriers to screening and treatment of hearing loss are extensive in LMICs. Unaddressed hearing loss negatively impacts individuals and communities. The WHO's 2021 World Report on Hearing urges the development of Ear and Hearing Care (EHC) programs to improve access to all aspects of care, including screening, diagnostics, management, and developmental support. A joint Nairobi- and Seattle-based group convened in 2021 to discuss strategies for program development in Kenya, as presented in this paper. Findings Developing a national EHC program must include the necessary support services for a child with a diagnosed hearing loss, while simultaneously promoting engagement of family, community, and healthcare workers. Existing government and healthcare system policies and priorities can be leveraged for EHC programming. Strategies for success include strengthening connections between policymakers at national, county, and municipal levels and local champions for the EHC agenda, with a concurrent focus on policy, early detection and intervention, habilitation, and family-centered care. Updates to health policy and funding to support the accessibility of services and equipment should focus on leveraging national healthcare coverage for hearing technologies and services, strengthening referral pathways, training to bolster the workforce, and metrics for monitoring and evaluation. Additional strategies to support forward progress include strategic engagement of partners and leveraging local partners for phased scale-up. Conclusions and Recommendations Recommendations to strengthen EHC within the Kenyan health system include concurrent leverage of existing health policies and priorities, partner engagement, and strengthening referral pathways, monitoring and evaluation, and training. These strategies may be generalized to other countries too.
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Affiliation(s)
- Serah Ndegwa
- Department of Surgery, University of Nairobi, Nairobi, Kenya
- Kenyatta National Hospital, Nairobi, Kenya
| | - Michelle Pavlik
- Department of Health Systems and Population Health, University of Washington, Seattle, WA, USA
| | - Emily R. Gallagher
- Departments of Pediatrics and Global Health, University of Washington, Seattle, WA, USA
- Seattle Children’s Hospital, Seattle, WA, USA
| | - Maureen King’e
- Department of Paediatrics and Child Health, University of Nairobi, Nairobi, Kenya
| | - Manaseh Bocha
- Clinical Services, Ministry of Health, Nairobi, Kenya
| | | | - Isaac Macharia
- Department of Surgery, University of Nairobi, Nairobi, Kenya
| | - Paige Stringer
- Global Foundation For Children With Hearing Loss, Poulsbo, WA, USA
| | - Irene Njuguna
- Kenyatta National Hospital, Nairobi, Kenya
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Dalton Wamalwa
- Department of Paediatrics and Child Health, University of Nairobi, Nairobi, Kenya
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Humes LE, Dhar S, Manchaiah V, Sharma A, Chisolm TH, Arnold ML, Sanchez VA. A Perspective on Auditory Wellness: What It Is, Why It Is Important, and How It Can Be Managed. Trends Hear 2024; 28:23312165241273342. [PMID: 39150412 PMCID: PMC11329910 DOI: 10.1177/23312165241273342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 06/25/2024] [Accepted: 07/16/2024] [Indexed: 08/17/2024] Open
Abstract
During the last decade, there has been a move towards consumer-centric hearing healthcare. This is a direct result of technological advancements (e.g., merger of consumer grade hearing aids with consumer grade earphones creating a wide range of hearing devices) as well as policy changes (e.g., the U.S. Food and Drug Administration creating a new over-the-counter [OTC] hearing aid category). In addition to various direct-to-consumer (DTC) hearing devices available on the market, there are also several validated tools for the self-assessment of auditory function and the detection of ear disease, as well as tools for education about hearing loss, hearing devices, and communication strategies. Further, all can be made easily available to a wide range of people. This perspective provides a framework and identifies tools to improve and maintain optimal auditory wellness across the adult life course. A broadly available and accessible set of tools that can be made available on a digital platform to aid adults in the assessment and as needed, the improvement, of auditory wellness is discussed.
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Affiliation(s)
- Larry E. Humes
- Department of Speech, Language and Hearing Sciences, Indiana University, Bloomington, Indiana, USA
- Department of Communication Sciences and Disorders, Northwestern University, Evanston, Illinois, USA
| | - Sumitrajit Dhar
- Department of Communication Sciences and Disorders, Northwestern University, Evanston, Illinois, USA
| | - Vinaya Manchaiah
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, Colorado, USA
- UCHealth Hearing and Balance, University of Colorado Hospital, Aurora, Colorado, USA
- Virtual Hearing Lab, Collaborative initiative between University of Colorado School of Medicine and University of Pretoria, Aurora, Colorado, USA
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Anu Sharma
- Brain and Behavior Laboratory, Department of Speech Language and Hearing Sciences, Institute of Cognitive Science, Center for Neuroscience, University of Colorado Boulder, Boulder, Colorado, USA
| | - Theresa H. Chisolm
- Department of Communication Sciences & Disorders, University of South Florida, Tampa, Florida, USA
| | - Michelle L. Arnold
- Department of Communication Sciences & Disorders, University of South Florida, Tampa, Florida, USA
| | - Victoria A. Sanchez
- Department of Communication Sciences & Disorders, University of South Florida, Tampa, Florida, USA
- Department of Otolaryngology-Head & Neck Surgery, University of South Florida, Tampa, Florida, USA
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Rasidi WNA, Seluakumaran K, Jamaluddin SA. Simplified cochlear frequency selectivity measure for sensorineural hearing loss screening: comparison with digit triplet test (DTT) and shortened speech, spatial and qualities of hearing scale (SSQ) questionnaire. Eur Arch Otorhinolaryngol 2023; 280:4391-4400. [PMID: 36988687 DOI: 10.1007/s00405-023-07929-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 03/13/2023] [Indexed: 03/30/2023]
Abstract
PURPOSE Pure-tone audiometry (PTA) is the gold standard for screening and diagnosis of hearing loss but is not always accessible. This study evaluated a simplified cochlear frequency selectivity (FS) measure as an alternative option to screen for early frequency-specific sensorineural hearing loss (SNHL). METHODS FS measures at 1 and 4 kHz center frequencies were obtained using a custom-made software in normal-hearing (NH), slight SNHL and mild-to-moderate SNHL subjects. For comparison, subjects were also assessed with the Malay Digit Triplet Test (DTT) and the shortened Malay Speech, Spatial and Qualities of Hearing Scale (SSQ) questionnaire. RESULTS Compared to DTT and SSQ, the FS measure at 4 kHz was able to distinguish NH from slight and mild-to-moderate SNHL subjects, and was strongly correlated with their thresholds in quiet determined separately in 1-dB step sizes at the similar test frequency. Further analysis with receiver operating characteristic (ROC) curves indicated area under the curve (AUC) of 0.77 and 0.83 for the FS measure at 4 kHz when PTA thresholds of NH subjects were taken as ≤ 15 dB HL and ≤ 20 dB HL, respectively. At the optimal FS cut-off point for 4 kHz, the FS measure had 77.8% sensitivity and 86.7% specificity to detect 20 dB HL hearing loss. CONCLUSION FS measure was superior to DTT and SSQ questionnaire in detecting early frequency-specific threshold shifts in SNHL subjects, particularly at 4 kHz. This method could be used for screening subjects at risk of noise-induced hearing loss.
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Affiliation(s)
- Wan Nur Asyiqin Rasidi
- Auditory Lab, Department of Physiology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Kumar Seluakumaran
- Auditory Lab, Department of Physiology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Saiful Adli Jamaluddin
- Kulliyyah of Allied Health Sciences, International Islamic University of Malaysia, Kuantan, Pahang, Malaysia
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Oosthuizen I, Frisby C, Chadha S, Manchaiah V, Swanepoel DW. Combined hearing and vision screening programs: A scoping review. Front Public Health 2023; 11:1119851. [PMID: 36998276 PMCID: PMC10043331 DOI: 10.3389/fpubh.2023.1119851] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 02/20/2023] [Indexed: 03/17/2023] Open
Abstract
Background and aim The World Health Organization (WHO) estimates that 1.5 billion and 2.2 billion people have hearing and vision impairment, respectively. The burden of these non-communicable diseases is highest in low- and middle-income countries due to a lack of services and health professionals. The WHO has recommended universal health coverage and integrated service delivery to improve ear and eye care services. This scoping review describes the evidence for combined hearing and vision screening programs. Method A keyword search of three electronic databases, namely Scopus, MEDLINE (PubMed), and Web of Science, was conducted, resulting in 219 results. After removing duplicates and screening based on eligibility criteria, data were extracted from 19 included studies. The Joanna Briggs Institute Reviewer Manual and the Preferred Reporting Items for Systematic Reviews and Meta-analyzes (PRISMA) Extension for Scoping Reviews were followed. A narrative synthesis was conducted. Results Most studies (63.2%) were from high-income countries, with 31.6% from middle-income and 5.2% from low-income countries. The majority of studies (78.9%) involved children and the four studies reporting on adults all included adults above 50 years of age. Vision screening was most commonly performed with the "Tumbling E" and "Snellen Chart," while hearing was typically screened using pure tone audiometry. Studies reported referral rates as the most common outcome with sensitivity and specificity rates not reported in any included articles. Reported benefits of combined vision and hearing screenings included earlier detection of vision and hearing difficulties to support functioning and quality of life as well as resource sharing for reduced costs. Challenges to combined screening included ineffective follow-up systems, management of test equipment, and monitoring of screening personnel. Conclusions There is limited research evidence for combined hearing and vision screening programs. Although potential benefits are demonstrated, especially for mHealth-supported programs in communities, more feasibility and implementation research are required, particularly in low- and middle-income countries and across all age groups. Developing universal, standardized reporting guidelines for combined sensory screening programs is recommended to enhance the standardization and effectiveness of combined sensory screening programs.
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Affiliation(s)
- Ilze Oosthuizen
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Virtual Hearing Lab, Collaborative Initiative Between University of Colorado School of Medicine, Aurora, CO, United States
- University of Pretoria, Pretoria, South Africa
| | - Caitlin Frisby
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Virtual Hearing Lab, Collaborative Initiative Between University of Colorado School of Medicine, Aurora, CO, United States
- University of Pretoria, Pretoria, South Africa
| | - Shelly Chadha
- WHO Programme for Prevention of Deafness and Hearing Loss, World Health Organization, Geneva, Switzerland
| | - Vinaya Manchaiah
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Virtual Hearing Lab, Collaborative Initiative Between University of Colorado School of Medicine, Aurora, CO, United States
- University of Pretoria, Pretoria, South Africa
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, CO, United States
- UCHealth Hearing and Balance, University of Colorado Hospital, Aurora, CO, United States
- Department of Speech and Hearing, School of Allied Health Sciences, Manipal Academy of Higher Education, Manipal, India
| | - De Wet Swanepoel
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Virtual Hearing Lab, Collaborative Initiative Between University of Colorado School of Medicine, Aurora, CO, United States
- University of Pretoria, Pretoria, South Africa
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, CO, United States
- Ear Science Institute Australia, Subiaco, WA, Australia
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