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Andersson, Martin
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Publications (10 of 12) Show all publications
Andersson, M., Selin, F. & Järvholm, B. (2016). Asbestos exposure and the risk of sinonasal cancer. Occupational Medicine, 66(4), 326-331.
Open this publication in new window or tab >>Asbestos exposure and the risk of sinonasal cancer
2016 (English)In: Occupational Medicine, ISSN 0962-7480, E-ISSN 1471-8405, Vol. 66, no 4, 326-331 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: While the increased risk of lung cancer and mesothelioma is well established, the relationship between exposure to asbestos dust and sinonasal cancer is less clear.

AIMS: To study the risk of sinonasal cancer in relation to asbestos dust exposure.

METHODS: A retrospective cohort study of construction workers, linked to the Swedish Cancer Registry. Participants were classified into four exposure groups; heavy, medium, low or very low exposure to asbestos, according to the incidence of pleural mesothelioma in their occupational group. Standardized incidence ratios (SIRs) and relative risks (RRs) were analysed, adjusted for age and smoking habits. The risks of adenocarcinoma and squamous cell carcinoma were investigated separately.

RESULTS: Among the 280222 subjects, there was no increased risk of sinonasal cancer compared to the general population [SIR 0.85, 95% confidence interval (CI) 0.68-1.03], or any dose-response relationship with exposure to asbestos. The highest RR was found in the low exposure group (RR 1.25, 95% CI 0.69-2.28) and the lowest RR was found in the group with the highest exposure to asbestos (RR 0.71, 95% CI 0.33-1.53). No significantly increased risk or dose-response association could be found for adenocarcinoma or squamous cell carcinoma when analysed separately.

CONCLUSIONS: This study did not find an increased risk of developing sinonasal cancer after asbestos exposure.

Place, publisher, year, edition, pages
Oxford University Press, 2016
Keyword
Asbestos, construction workers, sinonasal cancer
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-118672 (URN)10.1093/occmed/kqw018 (DOI)000385021400014 ()26940471 (PubMedID)
Available from: 2016-03-29 Created: 2016-03-29 Last updated: 2018-01-10Bibliographically approved
Hedman, L., Andersson, M., Bjerg, A., Forsberg, B., Lundbäck, B. & Rönmark, E. (2015). Environmental risk factors related to the incidence of wheeze and asthma in adolescence. Clinical and Experimental Allergy, 45(1), 184-191.
Open this publication in new window or tab >>Environmental risk factors related to the incidence of wheeze and asthma in adolescence
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2015 (English)In: Clinical and Experimental Allergy, ISSN 0954-7894, E-ISSN 1365-2222, Vol. 45, no 1, 184-191 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Asthma is common among adolescents, but there are few population-based studies on the risk factors for incident asthma and wheeze at this age group OBJECTIVE: To study risk factors for incident asthma and wheeze in adolescence.

METHOD: Within the Obstructive Lung Disease In Northern Sweden (OLIN) studies, a cohort of 3430 school children (age 7-8y) was recruited in 1996. In the present study, this cohort was followed from age 12 to 19y. At baseline (age 12y), 3151 participated and skin prick tests (SPT) were performed. The cohort was resurveyed annually and risk factors for the cumulative incidence of asthma and wheeze from age 12 to19y were analysed using multivariate Cox regression.

RESULTS: Female sex (wheeze: HR1.4 95%CI 1.2-1.6; asthma: HR1.8 95%CI1.2-2.5) and a positive SPT to cat, dog or horse at baseline (wheeze: HR 1.6 95%CI 1.2-2.1; asthma: HR2.3 95%CI 1.4-4.0) were significantly associated with the cumulative incidence of wheeze and asthma. Increasing numbers of siblings were inversely related to the incidence of wheeze (HR0.9 95%CI 0.8-0.97) and asthma (HR0.8 95%CI 0.7-0.97). Parental asthma was related to the incidence of asthma (HR 1.8 95%CI 1.2-2.6) while ever smoking (HR 2.0 95%CI 1.6-2.4) and house dampness (HR 1.3 95%CI 1.1-1.6) were risk factors for the incidence of wheeze. Maternal ETS exposure increased the risk of incident asthma in non-sensitized subjects (HR 1.9 95%CI 1.0-3.7).

CONCLUSION AND CLINICAL RELEVANCE: Several environmental risk factors related to the incidence of asthma and wheeze in adolescence were identified and may be possible targets for intervention and prevention.

National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-91518 (URN)10.1111/cea.12335 (DOI)000346910800021 ()24773259 (PubMedID)
Available from: 2014-08-10 Created: 2014-08-10 Last updated: 2018-01-11Bibliographically approved
Hedman, L., Andersson, M., Stridsman, C. & Rönmark, E. (2015). Evaluation of a tobacco prevention programme among teenagers in Sweden. BMJ Open, 5(5), Article ID e007673.
Open this publication in new window or tab >>Evaluation of a tobacco prevention programme among teenagers in Sweden
2015 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 5, no 5, e007673Article in journal (Refereed) Published
Abstract [en]

Objective: To study the prevalence of tobacco use among teenagers, to evaluate a tobacco prevention programme and to study factors related to participation in the prevention programme. Design and setting: Population-based prospective cohort study. Method: Within the Obstructive Lung disease in Northern Sweden (OLIN) studies, a cohort study about asthma in schoolchildren started in 2006. All children aged 7-8 years in three municipalities were invited to a questionnaire survey and 2585 (96%) participated. The cohort was followed up at age 11-12 years (n=2612, 95% of invited) and 14-15 years (n=2345, 88% of invited). In 2010, some of the children in the OLIN cohort (n=447) were invited to a local tobacco prevention programme and 224 (50%) chose to participate. Results: At the age of 14-15 years, the prevalence of daily smoking was 3.5%. Factors related to smoking were female sex, having a smoking mother, participation in sports and lower parental socioeconomic status (SES). The prevalence of using snus was 3.3% and risk factors were male sex, having a smoking mother, having a snus-using father and non-participation in the prevention programme. In the prevention programme, the prevalence of tobacco use was significantly lower among the participants compared with the controls in the cohort. Factors related to non-participation were male sex, having a smoking mother, lower parental SES and participation in sports. Conclusions: The prevalence of tobacco use was lower among the participants in the tobacco prevention programme compared with the non-participants as well as with the controls in the cohort. However, the observed benefit of the intervention may be overestimated as participation was biased by selection.

Place, publisher, year, edition, pages
BMJ Publishing Group, 2015
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-105276 (URN)10.1136/bmjopen-2015-007673 (DOI)000354648100053 ()25976765 (PubMedID)
Available from: 2015-06-22 Created: 2015-06-22 Last updated: 2017-12-04Bibliographically approved
Bjerg, A., Rönmark, E. P., Hagstad, S., Eriksson, J., Andersson, M., Wennergren, G., . . . Ekerljung, L. (2015). Gas, dust, and fumes exposure is associated with mite sensitization and with asthma in mite-sensitized adults. Allergy. European Journal of Allergy and Clinical Immunology, 70(5), 604-607.
Open this publication in new window or tab >>Gas, dust, and fumes exposure is associated with mite sensitization and with asthma in mite-sensitized adults
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2015 (English)In: Allergy. European Journal of Allergy and Clinical Immunology, ISSN 0105-4538, E-ISSN 1398-9995, Vol. 70, no 5, 604-607 p.Article in journal (Refereed) Published
Abstract [en]

Occupational exposure to gas, dust, and fumes (GDF) increases the risk of asthma and eczema. We investigated the role of sensitization in the association between GDF and allergic conditions. A population-based sample of 788 adults from the West Sweden Asthma Study completed questionnaires and skin prick tests. After adjustment for confounders, GDF exposure was associated with a doubled risk of sensitization to mites, but not with other allergens. Mite sensitization also modified the effect of GDF on asthma. In mite-sensitized subjects, GDF was associated with physician-diagnosed asthma, adjusted OR 2.9 (1.2-7.2), and with wheeze, OR 2.4 (1.1-5.3). In non-mite-sensitized subjects, the corresponding ORs were 1.1 (0.5-2.6) and 0.6 (0.3-1.3). GDF was independently associated with eczema regardless of mite sensitization, but not with rhinitis. These novel findings suggest that components of GDF may act as adjuvants that facilitate sensitization to mites and that mite-sensitized individuals may be especially susceptible to inhalant occupational exposures.

Place, publisher, year, edition, pages
John Wiley & Sons, 2015
Keyword
asthma, atopic dermatitis, epidemiology, occupational exposure, rhinitis
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-103127 (URN)10.1111/all.12584 (DOI)000352538200017 ()25640536 (PubMedID)
Available from: 2015-05-26 Created: 2015-05-18 Last updated: 2018-01-11Bibliographically approved
Stjernbrandt, A., Björ, B., Andersson, M. & Liljelind, I. (2015). Kyla och hälsa i Norrland: deskriptiva data från enkätundersökning februari - maj 2015. Umeå: Umeå universitet.
Open this publication in new window or tab >>Kyla och hälsa i Norrland: deskriptiva data från enkätundersökning februari - maj 2015
2015 (Swedish)Report (Other academic)
Place, publisher, year, edition, pages
Umeå: Umeå universitet, 2015. 33 p.
Series
Yrkes- och miljömedicin i Umeå rapporterar, ISSN 1654-7314 ; 2/2015
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-111061 (URN)
Available from: 2015-11-03 Created: 2015-11-03 Last updated: 2018-01-10Bibliographically approved
Andersson, M., Hedman, L., Nordberg, G., Forsberg, B., Eriksson, K. & Rönmark, E. (2015). Swimming pool attendance is related to asthma among atopic school children: a population-based study. Environmental health, 14(14), Article ID 37.
Open this publication in new window or tab >>Swimming pool attendance is related to asthma among atopic school children: a population-based study
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2015 (English)In: Environmental health, ISSN 1476-069X, E-ISSN 1476-069X, Vol. 14, no 14, 37Article in journal (Refereed) Published
Abstract [en]

Background: By-products of water disinfectants have been suggested to cause asthma, especially in atopic children. However, studies on indoor swimming pool attendance and asthma in children have presented conflicting results. The present study examined the relationship between indoor swimming pool attendance and asthma among sensitized and non-sensitized children aged 11-12 years.

Methods: An extended ISAAC questionnaire was sent to the families of all children attending fifth or sixth grade, aged 11-12 years, in two municipalities in Northern Sweden in 2010. A total of 1866 participated (96% of those invited) in the questionnaire study and 1652 (89%) also participated in skin prick testing for 10 standard airborne allergens. Asthma was defined as physician-diagnosed asthma in combination with wheeze or use of asthma medication in the last 12 months. Current swimming pool attendance was reported as >= 1/week or <1/week. Logistic regression models were used for data analysis.

Results: The prevalence of current asthma was 8.9% (10.0% of boys; 7.9% of girls) and 14% had attended indoor pools >= 1/week. Children currently attending swimming pools >= 1/week had an increased risk of current asthma. Stratified analyses for allergic sensitization adjusted for sex, parental smoking, parental asthma, and damp housing, showed a statistically significant association for current asthma only among sensitized subjects (OR 95% CI 1.90 1.09-3.32). No association was found between current pool attendance and wheeze, sensitization, rhinitis or eczema.

Conclusions: The present study supports the proposed link between indoor swimming pool attendance and asthma in sensitized children.

Keyword
Asthma, Children, Swimming pools, Trichloramines, Sensitization
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-103215 (URN)10.1186/s12940-015-0023-x (DOI)000353534400001 ()
Available from: 2015-05-19 Created: 2015-05-18 Last updated: 2017-12-04Bibliographically approved
Andersson, M. (2013). Asthma in school age: prevalence, incidence and remission in relation to environmental determinants. The Obstructive Lung Disease in Northern Sweden (OLIN) Studies, Thesis XI. (Doctoral dissertation). Umeå: Umeå Universitet.
Open this publication in new window or tab >>Asthma in school age: prevalence, incidence and remission in relation to environmental determinants. The Obstructive Lung Disease in Northern Sweden (OLIN) Studies, Thesis XI
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background In the past half-century, the prevalence of asthma among children and adolescents has risen and asthma has become an important public health challenge in Sweden as well as in many other countries, necessitating further studies on this complex disease and its risk factor pattern. The studies included in this thesis aimed to investigate the clinical expression of childhood asthma over time, to describe the determinants of new-onset and remission of asthma, and to evaluate possible environmental risk factors in northern Sweden.

Methods As the result of a repeated questionnaire survey among primary school children aged 7-8 years in three municipalities in the north of Sweden, two pediatric cohorts were formed, one in 1996 (n=3430) and one in 2006 (n=2585). The cohort created in 1996 was followed annually until the age of 19 years. Skin prick testing was performed on children in both cohorts. Lung function and bronchial hyperreactivity testing were carried out in children with asthma in the first cohort. The study participation and retention rates were very high in both cohorts. Among children in the second cohort living in Luleå, the home addresses were assigned to coordinates in a geographical information system (GIS) to evaluate the impact on respiratory health of living near roads with much traffic, which was measured as the number of vehicles daily. We used a validated reported diagnosis of asthma and International Study of Asthma and Allergies in Childhood (ISAAC) questions were incorporated into the questionnaire. A cross-sectional study of children of the same age ten years apart, longitudinal studies on asthma incidence and remission as well as a cross-sectional study on vehicle traffic were performed.

Results While children aged 7-8 years in 2006 more often had a physician-diagnosed asthma compared to children of the same age in 1996 (7.4% vs 5.7%, p<0.001), they had less asthma symptoms, especially severe symptoms. In parallel, a more beneficial environment and a more intense treatment with inhaled corticosteroids (ICS) were observed. The explanation for this change in clinical expression probably includes also an increased awareness and diagnosing of asthma. From age 12 years to age 19 years, the cumulative incidence of physician-diagnosed asthma was 7.2% and of current wheeze 22.0%. The risk of new-onset asthma in adolescence was increased among girls, sensitized and those with heredity for asthma. Smoking and home dampness increased the risk for incident wheeze. The risk for both incident asthma and wheeze was inversely related to number of siblings. Among children with current asthma at age 7-8 years, 21% were in remission, 38% had periodic asthma and 41% had persistent asthma at a follow-up at age 19 years. Subjects in remission and with periodic asthma had significantly less airway obstruction and showed less bronchial hyperreactivity compared to subjects with persistent asthma. The probability of asthma remission from childhood to early adulthood was significantly increased by absence of allergic sensitization, male gender and a low asthma severity scoring at age 7-8 years. Sensitization to furred animals was more important as a determinant of both incidence and remission than sensitization to pollen. Living close to roads with high traffic flows, especially with heavy vehicles, was associated with an increased risk for current wheeze. Stratified analyses showed that the effect of traffic on asthma and wheeze was restricted to non-sensitized subjects.

Conclusion Asthma onset in adolescence was more common among girls and remission was more common among boys. Children sensitized to furred animals and children with a more severe asthma were risk groups for persistence of asthma. Environmental factors such as smoking and dampness were associated to onset of asthma symptoms during adolescence, and vehicle traffic was associated with asthma symptoms among children also in a small city with relatively low traffic flows. Preventive measures like smoking reduction programs, improvement of damp housing conditions and separation of areas where many children live from heavily trafficked roads could prove to be beneficial.

Place, publisher, year, edition, pages
Umeå: Umeå Universitet, 2013. 66 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1565
Keyword
asthma, wheeze, environment, prevalence, incidence, remission, vehicle traffic, sensitization
National Category
Other Clinical Medicine
Research subject
Occupational and Environmental Medicine
Identifiers
urn:nbn:se:umu:diva-69623 (URN)978-91-7459-595-6 (ISBN)
Public defence
2013-05-29, Sal 135, by 9A, Norrlands Universitetssjukhus, Umeå, 13:00 (Swedish)
Opponent
Supervisors
Projects
OLIN-studierna
Available from: 2013-05-07 Created: 2013-05-03 Last updated: 2013-05-07Bibliographically approved
Andersson, M., Hedman, L., Bjerg, A., Forsberg, B., Lundbäck, B. & Rönmark, E. (2013). Remission and Persistence of Asthma Followed From 7 to 19 Years of Age. Pediatrics, 132(2), E435-E442.
Open this publication in new window or tab >>Remission and Persistence of Asthma Followed From 7 to 19 Years of Age
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2013 (English)In: Pediatrics, ISSN 0031-4005, E-ISSN 1098-4275, Vol. 132, no 2, E435-E442 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND AND OBJECTIVE: To date, a limited number of population-based studies have prospectively evaluated the remission of childhood asthma. This work was intended to study the remission and persistence of childhood asthma and related factors. METHODS: In 1996, a questionnaire was distributed to the parents of all children aged 7 to 8 years in 3 municipalities in northern Sweden, and 3430 (97%) participated. After a validation study, 248 children were identified as having asthma; these children were reassessed annually until age 19 years when 205 (83%) remained. During the follow-up period lung function, bronchial challenge testing, and skin prick tests were performed. Remission was defined as no use of asthma medication and no wheeze during the past 12 months as reported at endpoint and in the 2 annual surveys preceding endpoint (ie, for >= 3 years). RESULTS: At age 19 years, 21% were in remission, 38% had periodic asthma, and 41% persistent asthma. Remission was more common among boys. Sensitization to furred animals and a more severe asthma (asthma score >= 2) at age 7 to 8 years were both inversely associated with remission, odds ratio 0.14 (95% confidence interval 0.04-0.55) and 0.19 (0.07-0.54), respectively. Among children with these 2 characteristics, 82% had persistent asthma during adolescence. Asthma heredity, damp housing, rural living, and smoking were not associated with remission. CONCLUSIONS: The probability of remission of childhood asthma from age 7- to 8-years to age 19 years was largely determined by sensitization status, particularly sensitization to animals, asthma severity, and female gender, factors all inversely related to remission.

Keyword
adolescence, asthma, longitudinal, remission, sensitization
National Category
Pediatrics
Identifiers
urn:nbn:se:umu:diva-81019 (URN)10.1542/peds.2013-0741 (DOI)000322957300016 ()
Available from: 2013-10-01 Created: 2013-09-30 Last updated: 2017-05-09Bibliographically approved
Andersson, M., Modig, L., Hedman, L., Forsberg, B. & Rönmark, E. (2011). Heavy vehicle traffic is related to wheeze among schoolchildren: a population-based study in an area with low traffic flows. Environmental health, 10(91).
Open this publication in new window or tab >>Heavy vehicle traffic is related to wheeze among schoolchildren: a population-based study in an area with low traffic flows
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2011 (English)In: Environmental health, ISSN 1476-069X, E-ISSN 1476-069X, Vol. 10, no 91Article in journal (Refereed) Published
Abstract [en]

Background: An association between traffic air pollution and respiratory symptoms among children has been reported. However, the effects of traffic air pollution on asthma and wheeze have been very sparsely studied in areas with low traffic intensity in cold climate with poor dispersion. We evaluated the impact of vehicle traffic on childhood asthma and wheeze by objective exposure assessment.

Methods: As a part of the Obstructive Lung Disease in Northern Sweden (OLIN) studies, a questionnaire was sent to the families of all children attending first or second grade in Luleå (72,000 inhabitants) in Northern Sweden in 2006. The age of the children was 7-8 years and the participation rate was 98% (n = 1357). Skin prick tests were performed in 1224 (89%) children. The home addresses were given geographical coordinates and traffic counts were obtained from the local traffic authorities. A proximity model of average daily traffic and average daily heavy vehicle traffic within 200 meters from each participant's home address was used. The associations between traffic exposure and asthma and wheeze, respectively, were analysed in an adjusted multiple logistic regression model.

Results: Exposure to high traffic flows was uncommon in the study area; only 15% of the children lived within 200 meters from a road with a traffic flow of ≥8000 vehicles per day. Living closer than 200 meters from a road with ≥500 heavy vehicles daily was associated with current wheeze, odds ratio 1.7 (confidence interval 1.0-2.7). A dose-response relation was indicated. An increased risk of asthma was also seen, however not significant, odds ratio 1.5 (confidence interval 0.8-2.9). Stratified analyses revealed that the effect of traffic exposure was restricted to the non-sensitized phenotype of asthma and wheeze. The agreement between self-reported traffic exposure and objective measurements of exposure was moderate.

Conclusions: This study showed that already at low levels of exposure, vehicle traffic is related to an increased risk of wheeze among children. Thus, the global burden of traffic air pollution may be underestimated.

Place, publisher, year, edition, pages
London: BioMed Central, 2011
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-49214 (URN)10.1186/1476-069X-10-91 (DOI)21995638 (PubMedID)
Available from: 2011-11-04 Created: 2011-11-04 Last updated: 2018-01-12Bibliographically approved
Andersson, M., Bjerg, A., Forsberg, B., Lundbäck, B. & Rönmark, E. (2010). The clinical expression of asthma in schoolchildren has changed between 1996 and 2006. Pediatric Allergy and Immunology, 21(5), 859-866.
Open this publication in new window or tab >>The clinical expression of asthma in schoolchildren has changed between 1996 and 2006
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2010 (English)In: Pediatric Allergy and Immunology, ISSN 0905-6157, E-ISSN 1399-3038, Vol. 21, no 5, 859-866 p.Article in journal (Refereed) Published
Abstract [en]

Several studies have reported diverging trends in the prevalence of asthma and wheeze. The aim of this study was to investigate the clinical expression of childhood asthma in 1996 and 2006 by studying asthma morbidity, treatment, and environmental exposures in school children with physician-diagnosed asthma and wheeze, respectively. All children enrolled in first or second grade (7-8 yr-old) in three municipalities in northern Sweden were invited to a questionnaire study in 1996 and 2006, respectively. In 1996, 3430 (97%) participated; and in 2006, 2585 (96%) participated. The same parental completed questionnaire, including the ISAAC questions, was used in both surveys. Physician-diagnosed asthma was reported at 5.7% in 1996 and 7.4% in 2006. A significantly greater proportion of children with asthma were using inhaled corticosteroids (ICS) in 2006, 67% vs. 55% in 1996. This increase was parallel to a major decrease in severe asthma symptoms such as disturbed sleep because of wheeze (49% vs. 38%) and troublesome asthma (21% vs. 11%). The prevalence of current wheeze among the asthmatics decreased significantly; however, this was seen only among children not using ICS. Parental smoking decreased significantly as did the proportion living in damp buildings. In conclusion, although asthma remains a major public health issue in school age children, children with asthma had less respiratory symptoms and a better asthma control in 2006 compared to 1996. This parallels with an increase in treatment with ICS, more beneficial environmental conditions, and an increased diagnostic intensity resulting in a larger proportion of children with mild symptoms being diagnosed as having asthma.

Keyword
asthma;children;epidemiology;medication;environment
National Category
Respiratory Medicine and Allergy Immunology in the medical area Pediatrics
Identifiers
urn:nbn:se:umu:diva-34782 (URN)10.1111/j.1399-3038.2010.01055.x (DOI)000280200000009 ()20408972 (PubMedID)
Available from: 2010-06-18 Created: 2010-06-18 Last updated: 2018-01-12Bibliographically approved
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