The contribution of common mental disorders (CMD) co-occurring with chronic musculoskeletal disor... more The contribution of common mental disorders (CMD) co-occurring with chronic musculoskeletal disorders (MSD) to disability retirement is not known. A nationally representative sample (the Health 2000 survey) comprised 3943 occupationally active Finns aged 30-63. MSD and other chronic disorders were assessed by a physician in a standardized clinical examination, and CMD using the Composite International Diagnostic Interview. Disability pension data for 2000-2011 was retrieved from national pension records. Cox regression was used with censoring for death and pension other than that for disability. Covariate information was based on an interview. The baseline prevalence of CMD was 9.4% and of MSD 31.1%. CMD co-occurred with MSD in 3.3% of participants. The risks inflicted by CMD and MSD were additive. Thirty-eight per cent of the co-morbid subjects, 18% of those with CMD and 19% of those with MSD retired prematurely during the average follow-up of 8.6 years. Compared with those with neither type of disorder, the hazard ratio (HR) for disability pension was 2.4 (95% CI 1.7-2.7) for CMD only, 2.2 (1.8-2.7) for MSD only, and 4.1 (2.9-5.7) for the occurrence of both, allowing for age, gender, other chronic disorders, working conditions, and socio-economic and lifestyle factors. No synergistic or antagonistic interactive effects were observed. The determinants were measured only once and we had no information on incident disorders during the follow-up. It is important to identify subjects with both mental and musculoskeletal complaints in order to efficiently support their work ability.
Scandinavian Journal of Work, Environment & Health, 2012
Objectives The purpose of this study was to assess the effects of early part-time sick leave on r... more Objectives The purpose of this study was to assess the effects of early part-time sick leave on return to work (RTW) and sickness absence among patients with musculoskeletal disorders.
Scandinavian Journal of Work, Environment & Health, 2013
related effects of early parttime sick leave due to musculoskeletal disorders: a randomized contr... more related effects of early parttime sick leave due to musculoskeletal disorders: a randomized controlled trial. Scand J Work Environ Health.
Objective: To study the performance of a developed job exposure matrix (JEM) for the assessment o... more Objective: To study the performance of a developed job exposure matrix (JEM) for the assessment of psychosocial factors at work in terms of accuracy, possible misclassification bias and predictive ability to detect known associations with depression and low back pain (LBP).
The contribution of common mental disorders (CMD) co-occurring with chronic musculoskeletal disor... more The contribution of common mental disorders (CMD) co-occurring with chronic musculoskeletal disorders (MSD) to disability retirement is not known. A nationally representative sample (the Health 2000 survey) comprised 3943 occupationally active Finns aged 30-63. MSD and other chronic disorders were assessed by a physician in a standardized clinical examination, and CMD using the Composite International Diagnostic Interview. Disability pension data for 2000-2011 was retrieved from national pension records. Cox regression was used with censoring for death and pension other than that for disability. Covariate information was based on an interview. The baseline prevalence of CMD was 9.4% and of MSD 31.1%. CMD co-occurred with MSD in 3.3% of participants. The risks inflicted by CMD and MSD were additive. Thirty-eight per cent of the co-morbid subjects, 18% of those with CMD and 19% of those with MSD retired prematurely during the average follow-up of 8.6 years. Compared with those with neither type of disorder, the hazard ratio (HR) for disability pension was 2.4 (95% CI 1.7-2.7) for CMD only, 2.2 (1.8-2.7) for MSD only, and 4.1 (2.9-5.7) for the occurrence of both, allowing for age, gender, other chronic disorders, working conditions, and socio-economic and lifestyle factors. No synergistic or antagonistic interactive effects were observed. The determinants were measured only once and we had no information on incident disorders during the follow-up. It is important to identify subjects with both mental and musculoskeletal complaints in order to efficiently support their work ability.
Previous research suggests that work with a suitable workload may promote health and work retenti... more Previous research suggests that work with a suitable workload may promote health and work retention in people with disability. This study will examine whether temporary work modifications at the early stage of work disability are effective in enhancing return to work (RTW) or staying at work among workers with musculoskeletal or depressive symptoms. A single-centre controlled trial with modified stepped wedge design will be carried out in eight enterprises and their occupational health services (OHSs) in nine cities in Finland. Patients seeking medical advice due to musculoskeletal pain (≥4 on a scale from 0-10) or depressive symptoms (≥1 positive response to 2 screening questions) and fulfilling other inclusion criteria are eligible. The study involves an educational intervention among occupational physicians to enhance the initiation of work modifications. Primary outcomes are sustained RTW (≥4 weeks at work without a new sickness absence (SA)) and the total number of SA days duri...
To assess the associations of acceleration force indicators (aircraft type and flight hours) with... more To assess the associations of acceleration force indicators (aircraft type and flight hours) with cervical and lumbar pain and radiological degeneration among fighter pilots. The PubMed, Embase, Scopus and Web of Science databases were searched until October 2013. Twenty-seven studies were included in the review and 20 in the meta-analysis. There were no differences in the prevalence of neck pain (pooled OR=1.07, 95% CI 0.87 to 1.33), cervical disc degeneration (OR=1.26, CI 0.81 to 1.96), low back pain (OR=0.80, CI 0.47 to 1.38) or lumbar disc degeneration (OR=0.87, CI 0.67 to 1.13) between fighter pilots and helicopter or transport/cargo pilots. Moreover, the prevalence of cervical (OR=1.14, CI 0.61 to 2.16) or lumbar (OR=1.05, CI 0.49 to 2.26) disc degeneration did not differ between fighter pilots and non-flying personnel. Most studies did not control their estimates for age and other potential confounders. Among high-performance aircraft pilots, exposure to the highest G-forces ...
Asian Pacific journal of cancer prevention : APJCP
Information relating to cancer incidence trends in a community forms the scientific basis for the... more Information relating to cancer incidence trends in a community forms the scientific basis for the planning and organization of prevention, diagnosis and treatment of cancer. We here estimated the cumulative risk and trends in incidence of prostate cancer in Mumbai, India, using data collected by the Bombay Population-based Cancer Registry from the year 1986 to 2000. During the 15 year period, a total of 2864 prostate cancer cases (4.7% of all male cancers and 2.4% of all cancers) were registered by the Bombay Population-based Cancer Registry. For evaluation of the trend, we applied a linear regression model based on the logarithm of the observed incidence rates. The annual percentage changes were also computed for the evaluation. Cumulative incidence rates percentages were calculated by adding up the age specific incidence rates at single ages and then expressed as a percentage. Analysis of the trends in age-adjusted incidence rates of prostate cancer during the period 1986 to 2000 ...
Asian Pacific journal of cancer prevention : APJCP
We estimated the time trends in the incidence and the risk of developing an oral cancer in Mumbai... more We estimated the time trends in the incidence and the risk of developing an oral cancer in Mumbai, Indian population using the data collected by the Bombay Population Based Cancer Registry during the 15 year period from 1986 to 2000. A total of 9,670 oral cancers (8.2% of all neoplasms) were registered, of which 6577 were in males and 3093 in females (10.7% and 5.4% of the respective totals for the two genders). For evaluation of the trend, we applied a linear regression model based on the logarithm of the observed incidence rates. The annual percentage changes were also computed for the incidence rates to evaluate the time trend. In males, a statistically significant decreasing trend in the overall age-adjusted incidence rates were observed during the period 1986 to 2000, with an yearly decrease of 1.70%. This decrease was significant for men above the age of 40, but for young adult men below the age of 40, there was no significant decrease, the level being stable. In females, the ...
Asian Pacific journal of cancer prevention : APJCP
The time trend in incidence of stomach cancer in males and females in Mumbai, India during 1988 t... more The time trend in incidence of stomach cancer in males and females in Mumbai, India during 1988 to 1999 was estimated using data collected by the Bombay Population-based Cancer Registry. During the 12-year period, a total of 3657 stomach cancer cases (3.9% of all cancers) were registered by the Bombay Population-based Cancer Registry of which 2467 (5.1% of all male cancers) were in males and 1184 (2.6% of all female cancers) in females. For evaluation of the trend, we applied a linear regression model based on the logarithm of the observed incidence rates. The annual percentage changes were also computed for the incidence rates for evaluating the time trend. A statistically significant decreasing trend in the overall age-adjusted incidence rates of stomach cancer was observed during the period 1988 to 1999, with an yearly decrease of 4.44% in males and 2.56% in females. This decrease was most striking in males in the age groups 40-59 and 60+, and in females only in the age group 40-...
Objective To study the performance of a developed job exposure matrix (JEM) for the assessment of... more Objective To study the performance of a developed job exposure matrix (JEM) for the assessment of psychosocial factors at work in terms of accuracy, possible misclassification bias and predictive ability to detect known associations with depression and low back pain (LBP). Materials and Methods We utilized two large population surveys (the Health 2000 Study and the Finnish Work and Health Surveys), one to construct the JEM and another to test matrix performance. In the first study, information on job demands, job control, monotonous work and social support at work was collected via face-to-face interviews. Job strain was operationalized based on job demands and job control using quadrant approach. In the second study, the sensitivity and specificity were estimated applying a Bayesian approach. The magnitude of misclassification error was examined by calculating the biased odds ratios as a function of the sensitivity and specificity of the JEM and fixed true prevalence and odds ratio...
Objectives: The aim was to construct and validate a gender-specific job exposure matrix (JEM) for... more Objectives: The aim was to construct and validate a gender-specific job exposure matrix (JEM) for physical exposures to be used in epidemiological studies of low back pain (LBP).
Carpal tunnel syndrome (CTS) is the most common nerve entrapment syndrome. Studies on selected oc... more Carpal tunnel syndrome (CTS) is the most common nerve entrapment syndrome. Studies on selected occupational populations suggest an association of CTS with forceful repetitive work and vibration. Only few population-based studies have addressed the role of physical load factors in CTS. The aim of this study was to investigate the relations between exposures to a single or a combination of physical work load factors and CTS. The target population consisted of people aged 30 years or older residing in Finland during 2000-2001. Of the 7977 eligible subjects, 6254 (78.4%) were included in the study. Occupational physical load factors were assessed by interview and CTS by physical examination. The prevalence of possible or probable CTS was 2.1% in men and 5.3% in women. Work tasks with vibrating tools (adjusted odds ratio (OR) 1.9, 95% CI 1.2 to 2.9) and handgrip with high forces (OR 1.7, 95% CI 1.2 to 2.5) were related to an increased prevalence of CTS. There were joint effects between work tasks requiring handgrip with high forces and the use of vibrating tools (adjusted OR 3.3, 95% CI 2.0 to 5.4), between forceful activities (handgrip with high forces or handling of loads) and repetitive movements of the hands (OR 2.1, 95% CI 1.5 to 2.9), and between repetitive movements of the hands and the use of vibrating tools (OR 2.8, 95% CI 1.6 to 4.8). Only exposure in the most recent job was associated with CTS. Work tasks demanding handgrip with high forces or the use of vibrating tools are associated with CTS. The association is stronger if these work tasks are accompanied by repetitive movements of the hand or wrist.
We estimated the incidence and natural course of nocturia in an unselected Finnish male populatio... more We estimated the incidence and natural course of nocturia in an unselected Finnish male population. Materials and Methods: A mail interview of a cohort of 3,143 randomly selected men 50 to 70 year old at study entry was done in Finland in 1994, 1999 and 2004. The questionnaire included questions on sociodemographic status, overall health and disease, urinary symptoms, sexual functioning and symptom bother. The overall response rate was 70% on the 1994 survey, 75% on the 1999 survey and 76% on the 2004 survey. A response to nocturia questions was obtained from 1,633 men at the 1994 to 1999 followup and from 1,618 at the 1999 to 2004 followup. Results: The overall prevalence of 1 or more nocturnal voidings was 56% at baseline and 74% 10 years later. The crude incidence rate for nocturia was 75 new cases per 1,000 men annually (95% CI 66 to 85) during the first 5-year followup period and 126/1,000 (95% CI 113 to 140) during the second period. The incidence of moderate or severe nocturia was 9/1,000 (95% CI 7 to 11) and 14/1,000 men (95% CI 12 to 17), respectively. Incidence and prevalence increased clearly with age but also by calendar time, which was most prominent for the mild nocturia incidence. The incidence of moderate to severe symptoms increased, especially in the oldest cohort (incidence density ratio 5.6 to 5.7/5 years). Conclusions: Every year 10% more males older than 50 years start to void during the night. The incidence of mild nocturia increases, especially in men when they age from 50 to 60 years. In older men mild symptoms are more stable but the incidence of severe nocturia increases strongly after age 75 years.
The contribution of common mental disorders (CMD) co-occurring with chronic musculoskeletal disor... more The contribution of common mental disorders (CMD) co-occurring with chronic musculoskeletal disorders (MSD) to disability retirement is not known. A nationally representative sample (the Health 2000 survey) comprised 3943 occupationally active Finns aged 30-63. MSD and other chronic disorders were assessed by a physician in a standardized clinical examination, and CMD using the Composite International Diagnostic Interview. Disability pension data for 2000-2011 was retrieved from national pension records. Cox regression was used with censoring for death and pension other than that for disability. Covariate information was based on an interview. The baseline prevalence of CMD was 9.4% and of MSD 31.1%. CMD co-occurred with MSD in 3.3% of participants. The risks inflicted by CMD and MSD were additive. Thirty-eight per cent of the co-morbid subjects, 18% of those with CMD and 19% of those with MSD retired prematurely during the average follow-up of 8.6 years. Compared with those with neither type of disorder, the hazard ratio (HR) for disability pension was 2.4 (95% CI 1.7-2.7) for CMD only, 2.2 (1.8-2.7) for MSD only, and 4.1 (2.9-5.7) for the occurrence of both, allowing for age, gender, other chronic disorders, working conditions, and socio-economic and lifestyle factors. No synergistic or antagonistic interactive effects were observed. The determinants were measured only once and we had no information on incident disorders during the follow-up. It is important to identify subjects with both mental and musculoskeletal complaints in order to efficiently support their work ability.
Scandinavian Journal of Work, Environment & Health, 2012
Objectives The purpose of this study was to assess the effects of early part-time sick leave on r... more Objectives The purpose of this study was to assess the effects of early part-time sick leave on return to work (RTW) and sickness absence among patients with musculoskeletal disorders.
Scandinavian Journal of Work, Environment & Health, 2013
related effects of early parttime sick leave due to musculoskeletal disorders: a randomized contr... more related effects of early parttime sick leave due to musculoskeletal disorders: a randomized controlled trial. Scand J Work Environ Health.
Objective: To study the performance of a developed job exposure matrix (JEM) for the assessment o... more Objective: To study the performance of a developed job exposure matrix (JEM) for the assessment of psychosocial factors at work in terms of accuracy, possible misclassification bias and predictive ability to detect known associations with depression and low back pain (LBP).
The contribution of common mental disorders (CMD) co-occurring with chronic musculoskeletal disor... more The contribution of common mental disorders (CMD) co-occurring with chronic musculoskeletal disorders (MSD) to disability retirement is not known. A nationally representative sample (the Health 2000 survey) comprised 3943 occupationally active Finns aged 30-63. MSD and other chronic disorders were assessed by a physician in a standardized clinical examination, and CMD using the Composite International Diagnostic Interview. Disability pension data for 2000-2011 was retrieved from national pension records. Cox regression was used with censoring for death and pension other than that for disability. Covariate information was based on an interview. The baseline prevalence of CMD was 9.4% and of MSD 31.1%. CMD co-occurred with MSD in 3.3% of participants. The risks inflicted by CMD and MSD were additive. Thirty-eight per cent of the co-morbid subjects, 18% of those with CMD and 19% of those with MSD retired prematurely during the average follow-up of 8.6 years. Compared with those with neither type of disorder, the hazard ratio (HR) for disability pension was 2.4 (95% CI 1.7-2.7) for CMD only, 2.2 (1.8-2.7) for MSD only, and 4.1 (2.9-5.7) for the occurrence of both, allowing for age, gender, other chronic disorders, working conditions, and socio-economic and lifestyle factors. No synergistic or antagonistic interactive effects were observed. The determinants were measured only once and we had no information on incident disorders during the follow-up. It is important to identify subjects with both mental and musculoskeletal complaints in order to efficiently support their work ability.
Previous research suggests that work with a suitable workload may promote health and work retenti... more Previous research suggests that work with a suitable workload may promote health and work retention in people with disability. This study will examine whether temporary work modifications at the early stage of work disability are effective in enhancing return to work (RTW) or staying at work among workers with musculoskeletal or depressive symptoms. A single-centre controlled trial with modified stepped wedge design will be carried out in eight enterprises and their occupational health services (OHSs) in nine cities in Finland. Patients seeking medical advice due to musculoskeletal pain (≥4 on a scale from 0-10) or depressive symptoms (≥1 positive response to 2 screening questions) and fulfilling other inclusion criteria are eligible. The study involves an educational intervention among occupational physicians to enhance the initiation of work modifications. Primary outcomes are sustained RTW (≥4 weeks at work without a new sickness absence (SA)) and the total number of SA days duri...
To assess the associations of acceleration force indicators (aircraft type and flight hours) with... more To assess the associations of acceleration force indicators (aircraft type and flight hours) with cervical and lumbar pain and radiological degeneration among fighter pilots. The PubMed, Embase, Scopus and Web of Science databases were searched until October 2013. Twenty-seven studies were included in the review and 20 in the meta-analysis. There were no differences in the prevalence of neck pain (pooled OR=1.07, 95% CI 0.87 to 1.33), cervical disc degeneration (OR=1.26, CI 0.81 to 1.96), low back pain (OR=0.80, CI 0.47 to 1.38) or lumbar disc degeneration (OR=0.87, CI 0.67 to 1.13) between fighter pilots and helicopter or transport/cargo pilots. Moreover, the prevalence of cervical (OR=1.14, CI 0.61 to 2.16) or lumbar (OR=1.05, CI 0.49 to 2.26) disc degeneration did not differ between fighter pilots and non-flying personnel. Most studies did not control their estimates for age and other potential confounders. Among high-performance aircraft pilots, exposure to the highest G-forces ...
Asian Pacific journal of cancer prevention : APJCP
Information relating to cancer incidence trends in a community forms the scientific basis for the... more Information relating to cancer incidence trends in a community forms the scientific basis for the planning and organization of prevention, diagnosis and treatment of cancer. We here estimated the cumulative risk and trends in incidence of prostate cancer in Mumbai, India, using data collected by the Bombay Population-based Cancer Registry from the year 1986 to 2000. During the 15 year period, a total of 2864 prostate cancer cases (4.7% of all male cancers and 2.4% of all cancers) were registered by the Bombay Population-based Cancer Registry. For evaluation of the trend, we applied a linear regression model based on the logarithm of the observed incidence rates. The annual percentage changes were also computed for the evaluation. Cumulative incidence rates percentages were calculated by adding up the age specific incidence rates at single ages and then expressed as a percentage. Analysis of the trends in age-adjusted incidence rates of prostate cancer during the period 1986 to 2000 ...
Asian Pacific journal of cancer prevention : APJCP
We estimated the time trends in the incidence and the risk of developing an oral cancer in Mumbai... more We estimated the time trends in the incidence and the risk of developing an oral cancer in Mumbai, Indian population using the data collected by the Bombay Population Based Cancer Registry during the 15 year period from 1986 to 2000. A total of 9,670 oral cancers (8.2% of all neoplasms) were registered, of which 6577 were in males and 3093 in females (10.7% and 5.4% of the respective totals for the two genders). For evaluation of the trend, we applied a linear regression model based on the logarithm of the observed incidence rates. The annual percentage changes were also computed for the incidence rates to evaluate the time trend. In males, a statistically significant decreasing trend in the overall age-adjusted incidence rates were observed during the period 1986 to 2000, with an yearly decrease of 1.70%. This decrease was significant for men above the age of 40, but for young adult men below the age of 40, there was no significant decrease, the level being stable. In females, the ...
Asian Pacific journal of cancer prevention : APJCP
The time trend in incidence of stomach cancer in males and females in Mumbai, India during 1988 t... more The time trend in incidence of stomach cancer in males and females in Mumbai, India during 1988 to 1999 was estimated using data collected by the Bombay Population-based Cancer Registry. During the 12-year period, a total of 3657 stomach cancer cases (3.9% of all cancers) were registered by the Bombay Population-based Cancer Registry of which 2467 (5.1% of all male cancers) were in males and 1184 (2.6% of all female cancers) in females. For evaluation of the trend, we applied a linear regression model based on the logarithm of the observed incidence rates. The annual percentage changes were also computed for the incidence rates for evaluating the time trend. A statistically significant decreasing trend in the overall age-adjusted incidence rates of stomach cancer was observed during the period 1988 to 1999, with an yearly decrease of 4.44% in males and 2.56% in females. This decrease was most striking in males in the age groups 40-59 and 60+, and in females only in the age group 40-...
Objective To study the performance of a developed job exposure matrix (JEM) for the assessment of... more Objective To study the performance of a developed job exposure matrix (JEM) for the assessment of psychosocial factors at work in terms of accuracy, possible misclassification bias and predictive ability to detect known associations with depression and low back pain (LBP). Materials and Methods We utilized two large population surveys (the Health 2000 Study and the Finnish Work and Health Surveys), one to construct the JEM and another to test matrix performance. In the first study, information on job demands, job control, monotonous work and social support at work was collected via face-to-face interviews. Job strain was operationalized based on job demands and job control using quadrant approach. In the second study, the sensitivity and specificity were estimated applying a Bayesian approach. The magnitude of misclassification error was examined by calculating the biased odds ratios as a function of the sensitivity and specificity of the JEM and fixed true prevalence and odds ratio...
Objectives: The aim was to construct and validate a gender-specific job exposure matrix (JEM) for... more Objectives: The aim was to construct and validate a gender-specific job exposure matrix (JEM) for physical exposures to be used in epidemiological studies of low back pain (LBP).
Carpal tunnel syndrome (CTS) is the most common nerve entrapment syndrome. Studies on selected oc... more Carpal tunnel syndrome (CTS) is the most common nerve entrapment syndrome. Studies on selected occupational populations suggest an association of CTS with forceful repetitive work and vibration. Only few population-based studies have addressed the role of physical load factors in CTS. The aim of this study was to investigate the relations between exposures to a single or a combination of physical work load factors and CTS. The target population consisted of people aged 30 years or older residing in Finland during 2000-2001. Of the 7977 eligible subjects, 6254 (78.4%) were included in the study. Occupational physical load factors were assessed by interview and CTS by physical examination. The prevalence of possible or probable CTS was 2.1% in men and 5.3% in women. Work tasks with vibrating tools (adjusted odds ratio (OR) 1.9, 95% CI 1.2 to 2.9) and handgrip with high forces (OR 1.7, 95% CI 1.2 to 2.5) were related to an increased prevalence of CTS. There were joint effects between work tasks requiring handgrip with high forces and the use of vibrating tools (adjusted OR 3.3, 95% CI 2.0 to 5.4), between forceful activities (handgrip with high forces or handling of loads) and repetitive movements of the hands (OR 2.1, 95% CI 1.5 to 2.9), and between repetitive movements of the hands and the use of vibrating tools (OR 2.8, 95% CI 1.6 to 4.8). Only exposure in the most recent job was associated with CTS. Work tasks demanding handgrip with high forces or the use of vibrating tools are associated with CTS. The association is stronger if these work tasks are accompanied by repetitive movements of the hand or wrist.
We estimated the incidence and natural course of nocturia in an unselected Finnish male populatio... more We estimated the incidence and natural course of nocturia in an unselected Finnish male population. Materials and Methods: A mail interview of a cohort of 3,143 randomly selected men 50 to 70 year old at study entry was done in Finland in 1994, 1999 and 2004. The questionnaire included questions on sociodemographic status, overall health and disease, urinary symptoms, sexual functioning and symptom bother. The overall response rate was 70% on the 1994 survey, 75% on the 1999 survey and 76% on the 2004 survey. A response to nocturia questions was obtained from 1,633 men at the 1994 to 1999 followup and from 1,618 at the 1999 to 2004 followup. Results: The overall prevalence of 1 or more nocturnal voidings was 56% at baseline and 74% 10 years later. The crude incidence rate for nocturia was 75 new cases per 1,000 men annually (95% CI 66 to 85) during the first 5-year followup period and 126/1,000 (95% CI 113 to 140) during the second period. The incidence of moderate or severe nocturia was 9/1,000 (95% CI 7 to 11) and 14/1,000 men (95% CI 12 to 17), respectively. Incidence and prevalence increased clearly with age but also by calendar time, which was most prominent for the mild nocturia incidence. The incidence of moderate to severe symptoms increased, especially in the oldest cohort (incidence density ratio 5.6 to 5.7/5 years). Conclusions: Every year 10% more males older than 50 years start to void during the night. The incidence of mild nocturia increases, especially in men when they age from 50 to 60 years. In older men mild symptoms are more stable but the incidence of severe nocturia increases strongly after age 75 years.
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