11 results on '"Christie M Bartels"'
Search Results
2. Development of an extension of the OMERACT Summary of Measurement Properties table to capture equity considerations: SOMP-Equity
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Peter Tugwell, Valerie Umaefulam, Jennifer Petkovic, Jennifer L. Barton, Regina Greer-Smith, Beverley Shea, Lara J Maxwell, Aimée Wattiaux, Cheryl Barnabe, Dorcas E. Beaton, Alex Young Soo Lee, Christie M. Bartels, Catherine Hofstetter, and Jennifer Humphreys
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education.field_of_study ,business.industry ,Applied psychology ,Population ,Equity (finance) ,Reproducibility of Results ,Construct validity ,Prom ,humanities ,Anesthesiology and Pain Medicine ,Social Class ,Rheumatology ,Categorization ,Humans ,Medicine ,Patient-reported outcome ,Social determinants of health ,education ,business ,Socioeconomic status - Abstract
Objective To develop an equity extension of the OMERACT Summary of Measurement Properties (SOMP) Table, SOMP Equity to describe whether a patient reported outcome measure (PROM) works well among patients of diverse languages and cultures, education levels, and other population characteristics. Methods We used the PROGRESS-Plus framework to categorize equity characteristics assessed in trials of PROM. PROGRESS refers to Place of residence, Race/ethnicity/culture/language, Occupation, Gender/sex, Religion, Education, Socioeconomic status, and Social Capital, while the ‘plus’ captures additional characteristics, such as age. We pilot tested our SOMP Equity Extension using the Health Assessment Questionnaire (HAQ) as a prototypical PROM. Results The SOMP Equity Extension retains the same columns as the original OMERACT SOMP (domain match, feasibility, construct validity, test-retest reliability, longitudinal construct validity, clinical trial discrimination, thresholds of meaning) but uses the PROGRESS-Plus characteristics as rows. We found several examples of studies of the HAQ which had assessed one or more PROGRESS-Plus characteristics. Conclusions The most commonly reported equity considerations were related to language. OMERACT Equity virtual meeting participants were polled and they indicated that the SOMP Equity Extension is useful for highlighting and tracking equity considerations for OMERACT Core Outcome Measurement Instruments.
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- 2021
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3. Thirty-Day Re-observation, Chronic Re-observation, and Neighborhood Disadvantage
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William R. Buckingham, Menggang Yu, W. Ryan Powell, Christie M. Bartels, Fangfang Shi, Ann M. Sheehy, Amy J.H. Kind, Andrea Gilmore Bykovskyi, Jen Birstler, and Farah Acher Kaiksow
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Male ,Social Determinants of Health ,Aftercare ,Medicare ,Rate ratio ,Patient Readmission ,Risk Assessment ,Clinical Observation Units ,Residence Characteristics ,Risk Factors ,Humans ,Medicine ,Socioeconomic status ,Disadvantage ,Aged ,Skilled Nursing Facilities ,business.industry ,Retrospective cohort study ,General Medicine ,Odds ratio ,Emergency department ,Length of Stay ,United States ,Disadvantaged ,Socioeconomic Factors ,Chronic Disease ,Female ,business ,Risk assessment ,Demography - Abstract
Objective To determine whether neighborhood socioeconomic disadvantage, as determined by the Area Deprivation Index, increases 30-day hospital re-observation risk. Participants and Methods This retrospective study of 20% Medicare fee-for-service beneficiary observation stays from January 1, 2014, to November 30, 2014, included 319,980 stays among 273,308 beneficiaries. We evaluated risk for a 30-day re-observation following an index observation stay for those living in the 15% most disadvantaged compared with the 85% least disadvantaged neighborhoods. Results Overall, 4.5% (270,600 of 6,080,664) of beneficiaries had index observation stays, which varied by disadvantage (4.3% [232,568 of 5,398,311] in the least disadvantaged 85% compared with 5.6% [38,032 of 682,353] in the most disadvantaged 15%). Patients in the most disadvantaged neighborhoods had a higher 30-day re-observation rate (2857 of 41,975; 6.8%) compared with least disadvantaged neighborhoods (13,543 of 278,005; 4.9%); a 43% increased risk (unadjusted odds ratio [OR], 1.43; 95% CI, 1.31 to 1.55). After adjustment, this risk remained (adjusted OR, 1.13; 95% CI, 1.04 to 1.22). Discharge to a skilled nursing facility reduced 30-day re-observation risk (OR, 0.63; 95% CI, 0.57 to 0.69), whereas index observation length of stay of 4 or more days (3 midnights) conferred increased risk (OR, 1.29; 95% CI, 1.09 to 1.52); those living in disadvantaged neighborhoods were less likely to discharge to skilled nursing facilities and more likely to have long index stays. Beneficiaries with more than one 30-day re-observation (chronic re-observation) had progressively greater disadvantage by number of stays (adjusted incident rate ratio, 1.08; 95% CI, 1.02 to 1.14). Observation prevalence varied nationally. Conclusion Thirty-day re-observation, especially chronic re-observation, is highly associated with socioeconomic neighborhood disadvantage, even after accounting for factors such as race, disability, and Medicaid eligibility. Beneficiaries least able to pay are potentially most vulnerable to costs from serial re-observations and challenges of Medicare observation policy, which may discourage patients from seeking necessary care.
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- 2020
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4. A systematic review and meta-analysis of cutaneous manifestations in late- versus early-onset systemic lupus erythematosus
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Karen E. Hansen, Jennifer L. Medlin, Sara R. Fitz, and Christie M. Bartels
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Male ,Vasculitis ,medicine.medical_specialty ,Skin Diseases ,Article ,Late Onset Disorders ,03 medical and health sciences ,0302 clinical medicine ,Rheumatology ,Odds Ratio ,medicine ,Humans ,Lupus Erythematosus, Systemic ,Photosensitivity Disorders ,030212 general & internal medicine ,Age of Onset ,skin and connective tissue diseases ,Livedo Reticularis ,Livedo reticularis ,030203 arthritis & rheumatology ,business.industry ,Alopecia ,Raynaud Disease ,Odds ratio ,Exanthema ,Middle Aged ,Dermatology ,Anesthesiology and Pain Medicine ,Meta-analysis ,Etiology ,Female ,medicine.symptom ,Age of onset ,Malar rash ,business ,Anti-SSA/Ro autoantibodies - Abstract
Although systemic lupus erythematosus (SLE) most commonly occurs in reproductive-age women, some are diagnosed after the age of 50. Recognizing that greater than one-third of SLE criteria are cutaneous, we undertook a systematic review and meta-analysis to evaluate differences in cutaneous manifestations in early- and late-onset SLE patients.We searched the literature using PubMed, CINAHL, Web of Science, and Cochrane Library. We excluded studies that did not include ACR SLE classification criteria, early-onset controls, that defined late-onset SLE as50 years of age, or were not written in English. Two authors rated study quality using the Newcastle Ottawa Quality Scale. We used Forest plots to compare odds ratios (95% CI) of cutaneous manifestations by age. Study heterogeneity was assessed using I(2).Overall, 35 studies, representing 11,189 early-onset and 1727 late-onset patients with SLE, met eligibility criteria. The female:male ratio was lower in the late-onset group (5:1 versus 8:1). Most cutaneous manifestations were less prevalent in the late-onset group. In particular, malar rash [OR = 0.43 (0.35, 0.52)], photosensitivity [OR = 0.72 (0.59, 0.88)], and livedo reticularis [OR = 0.33 (0.17, 0.64)] were less common in late-onset patients. In contrast, sicca symptoms were more common [OR = 2.45 (1.91, 3.14)]. The mean Newcastle Ottawa Quality Scale score was 6.3 ± 0.5 (scale: 0-9) with high inter-rater reliability for the score (0.96).Overall, cutaneous manifestations are less common in late-onset SLE patients, except sicca symptoms. Future studies should investigate etiologies for this phenomenon including roles of immune senescence, environment, gender, and immunogenetics.
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- 2016
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5. The impact of a patient’s concordant and discordant chronic conditions on diabetes care quality measures
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Mari Palta, Christie M. Bartels, E. Magnan, Heather M. Johnson, Jessica R. Schumacher, and Maureen A. Smith
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,Endocrinology, Diabetes and Metabolism ,media_common.quotation_subject ,Primary health care ,Comorbidity ,Article ,Midwestern United States ,Diabetes Complications ,Young Adult ,Endocrinology ,Terminology as Topic ,Diabetes mellitus ,Diabetes Mellitus ,Internal Medicine ,medicine ,Electronic Health Records ,Humans ,Quality (business) ,Young adult ,Intensive care medicine ,Aged ,Quality of Health Care ,media_common ,Glycated Hemoglobin ,Primary Health Care ,business.industry ,Middle Aged ,Patient Acceptance of Health Care ,medicine.disease ,Logistic Models ,Chronic disease ,Hyperglycemia ,Chronic Disease ,Female ,Multiple Chronic Conditions ,business - Abstract
Most patients with diabetes have comorbid chronic conditions that could support (concordant) or compete with (discordant) diabetes care. We sought to determine the impact of the number of concordant and discordant chronic conditions on diabetes care quality.Logistic regression analysis of electronic health record data from 7 health systems on 24,430 patients with diabetes aged 18-75 years. Diabetes testing and control quality care goals were the outcome variables. The number of diabetes-concordant and the number of diabetes-discordant conditions were the main explanatory variables. Analysis was adjusted for health care utilization, health system and patient demographics.A higher number of concordant conditions were associated with higher odds of achieving testing and control goals for all outcomes except blood pressure control. There was no to minimal positive association between the number of discordant conditions and outcomes, except for cholesterol testing which was less likely with 4+ discordant conditions.Having more concordant conditions makes diabetes care goal achievement more likely. The number of discordant conditions has a smaller, inconsistently significant impact on diabetes goal achievement. Interventions to improve diabetes care need to align with a patient's comorbidities, including the absence of comorbidities, especially concordant comorbidities.
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- 2015
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6. Superior outcomes for rural patients after abdominal aortic aneurysm repair supports a systematic regional approach to abdominal aortic aneurysm care
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Glen Leverson, Amy J.H. Kind, Matthew W. Mell, Maureen A. Smith, and Christie M. Bartels
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medicine.medical_specialty ,Multivariate analysis ,Referral ,business.industry ,medicine.medical_treatment ,Specialty ,Odds ratio ,medicine.disease ,Endovascular aneurysm repair ,Abdominal aortic aneurysm ,Confidence interval ,Surgery ,Emergency medicine ,medicine ,Rural area ,business ,Cardiology and Cardiovascular Medicine - Abstract
ObjectiveThe impact of geographic isolation on abdominal aortic aneurysm (AAA) care in the United States is unknown. It has been postulated but not proven that rural patients have less access to endovascular aneurysm repair (EVAR), vascular surgeons, and high-volume treatment centers than their urban counterparts, resulting in inferior AAA care. The purpose of this study was to compare the national experience for treatment of intact AAA for patients living in rural areas or towns with those living in urban areas.MethodsPatients who underwent intact AAA repair in 2005 to 2006 were identified from a standard 5% random sample of all Medicare beneficiaries. Data on patient demographics, comorbidities, type of repair, and specialty of operating surgeon were collected. Hospitals were stratified into quintiles by yearly AAA volume. Primary outcomes included 30-day mortality and rehospitalization.ResultsA total of 2616 patients had repair for intact AAA (40% open, 60% EVAR). Patients from rural and urban areas were equally likely to receive EVAR (rural 60% vs urban 61%; P = .99) and be treated by a vascular surgeon (rural 48% vs urban 50%; P = .82). Most rural patients (86%) received care in urban centers. Primary outcomes occurred in 11.6% of rural patients (1.3% 30-day mortality; 10.3% rehospitalization) vs 16.0% of urban patients (3% 30-day mortality, 13% rehospitalization; P = .04). In multivariate analyses, rural residence was independently associated with treatment at high-volume centers (odds ratio, 1.64; 95% confidence interval, 1.34-2.01; P < .0001) and decreased death or rehospitalization (odds ratio, 0.69; 95% confidence interval, 0.49-0.97; P = .03).ConclusionsDespite geographic isolation, patients in rural areas needing treatment for intact AAAs have equivalent access to EVAR and vascular surgeons, increased referral to high-volume hospitals, and improved outcomes after repair. This suggests that urban patients may be disadvantaged even with nearby access to high-quality centers. This study supports the need for criteria that define centers of excellence to extend the benefit of regionalization to all patients.
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- 2012
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7. Lipid Testing in Patients with Rheumatoid Arthritis and Key Cardiovascular-Related Comorbidities: A Medicare Analysis
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Christie M. Bartels, Carolyn T. Thorpe, Amy J.H. Kind, Patrick E. McBride, Rachel J Cook, Maureen A. Smith, and Christine M. Everett
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Male ,medicine.medical_specialty ,Hyperlipidemias ,Comorbidity ,Medicare ,Article ,law.invention ,Arthritis, Rheumatoid ,Rheumatology ,Randomized controlled trial ,law ,Internal medicine ,Diabetes mellitus ,Hyperlipidemia ,Diabetes Mellitus ,medicine ,Humans ,Mass Screening ,Mass screening ,Aged ,Retrospective Studies ,Preventive healthcare ,Aged, 80 and over ,Primary Health Care ,business.industry ,Retrospective cohort study ,medicine.disease ,Lipids ,United States ,Anesthesiology and Pain Medicine ,Cardiovascular Diseases ,Rheumatoid arthritis ,Physical therapy ,Female ,business - Abstract
Objective For patients with rheumatoid arthritis (RA) and comorbid cardiovascular disease (CVD), diabetes, or hyperlipidemia, annual lipid testing is recommended to reduce morbidity and mortality from comorbidities. Given trends encouraging complex patients to receive care in "medical homes," we examined associations between regularly seeing a primary care provider (PCP) and lipid testing in RA patients with cardiovascular-related comorbidities. Methods We performed a retrospective cohort study examining a 5% random USA Medicare sample (2004-06) of beneficiaries over 65 years old with RA and concomitant CVD, diabetes, or hyperlipidemia ( n = 16,893). We examined the relationship between receiving lipid testing in 2006 and having at least 1 PCP visit per year in 2004, 2005, and 2006 using multivariate regression. Results Ninety percent of patients had prevalent CVD; 46% had diabetes, and 64% had hyperlipidemia. However, annual lipid testing was only performed in 63% of these RA patients. Thirty percent of patients saw a PCP less than once per year, despite frequent visits (mean >9) with other providers. Patients without at least 1 annual PCP visit were 16% less likely to have lipid testing. Increased age, complexity scores, hospitalization, and large town residence predicted decreased lipid testing. Conclusions Despite comorbid CVD, diabetes, or hyperlipidemia, 30% of Medicare RA patients saw a PCP less than once per year, and 1 in 3 lacked annual lipid testing. Findings support advocating primary care visits at least once per year. Remaining gaps in lipid testing suggest the need for additional strategies to improve lipid testing in at-risk RA patients.
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- 2012
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8. Failure to rescue and mortality after reoperation for abdominal aortic aneurysm repair
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Christie M. Bartels, Maureen A. Smith, Amy J.H. Kind, and Matthew W. Mell
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Male ,Reoperation ,medicine.medical_specialty ,Time Factors ,Failure to rescue ,Patient demographics ,Medicare ,Risk Assessment ,Article ,Postoperative Complications ,Risk Factors ,Odds Ratio ,medicine ,Humans ,Treatment Failure ,Aged ,Aged, 80 and over ,Chi-Square Distribution ,business.industry ,Odds ratio ,Middle Aged ,medicine.disease ,United States ,Abdominal aortic aneurysm ,Surgery ,Logistic Models ,Female ,Clinical Competence ,Cardiology and Cardiovascular Medicine ,Complication ,Risk assessment ,business ,Vascular Surgical Procedures ,Lower mortality ,Chi-squared distribution ,Aortic Aneurysm, Abdominal - Abstract
ObjectivesComplications after abdominal aortic aneurysm (AAA) repair resulting in reintervention increase mortality risk, but have not been well studied. Mortality after reintervention is termed failure to rescue and may reflect differences related to quality management of the complication. This study describes the relationship between reoperation and mortality and examines the effect of physician speciality on reintervention rates and failure to rescue after AAA repair.MethodsData were extracted for 2616 patients who underwent intact AAA repair in 2005 to 2006 from a standard 5% random sample of all Medicare beneficiaries. Patient demographics, comorbidities, hospital characteristics, repair type, and speciality of operating surgeon were collected. Primary outcomes were 30-day reoperation and 30-day mortality. Logistic regression analysis identified characteristics predicting reoperation.ResultsA total of 156 reoperations were required in 142 (4.2%) patients. Early mortality was far more likely for patients requiring reintervention than for those who did not (22.5% vs 1.5%; P < .0001). Of patients requiring reoperation, those requiring two or more interventions had an even higher mortality (54% vs 20%; P = .0007). Despite equivalent reoperation rates between specialities (vascular surgeons, 5.2%; others, 5.6%, P = .67), the mortality after reoperation was nearly half for vascular surgeons compared with other specialities (16.2% vs 32.3%; P = .04). The most common reason for reoperation was arterial complications (35.8%) accounting for the largest difference in mortality between vascular surgeons (30.7%) and other specialities (52.0%).ConclusionsPostoperative complications requiring reoperation dramatically increase mortality after AAA repair. Despite similar complication rates, vascular surgeons showed lower mortality rates after reoperation.
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- 2011
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9. Tu1238 Comparing Receipt of Quality Measures in Rheumatoid Arthritis Versus Inflammatory Bowel Disease Among Patients With Regular Primary Care
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Zhanhai Li, Ying-Qi Zhao, David M. Cooley, Christie M. Bartels, Arnold Wald, and Freddy Caldera
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Receipt ,medicine.medical_specialty ,Hepatology ,business.industry ,media_common.quotation_subject ,Gastroenterology ,Primary care ,medicine.disease ,Inflammatory bowel disease ,Rheumatoid arthritis ,Internal medicine ,medicine ,Physical therapy ,Quality (business) ,business ,media_common - Published
- 2015
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10. Patterns of steroid and steroid sparing regimens among older inflammatory bowel disease (IBD) patients with contraindications to tumor necrosis factor antagonists (ANTI-TNFS)
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Maureen A. Smith, Sophia L. Johnson, Jennifer M. Weiss, Carolyn T. Thorpe, Mari Palta, and Christie M. Bartels
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medicine.medical_specialty ,business.industry ,Health Policy ,medicine.medical_treatment ,Public Health, Environmental and Occupational Health ,medicine.disease ,Gastroenterology ,Inflammatory bowel disease ,Steroid ,Steroid sparing ,Internal medicine ,Immunology ,medicine ,Tumor necrosis factor alpha ,business - Published
- 2014
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11. Differences in diagnosis and treatment rates between systolic and diastolic hypertension among young adults
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Jessica R. Schumacher, Christie M. Bartels, Nancy Pandhi, Carolyn T. Thorpe, Maureen A. Smith, and Heather M. Johnson
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medicine.medical_specialty ,business.industry ,Hazard ratio ,Diastolic Hypertension ,Diastole ,Primary care ,Confidence interval ,Internal medicine ,Internal Medicine ,medicine ,Cardiology ,Young adult ,Medical prescription ,Cardiology and Cardiovascular Medicine ,business ,Survival analysis - Abstract
Background: Less than 50% of young adults with hypertension have achieved control. Understanding hypertension diagnosis and treatment patterns in primary care will help tailor young adult hypertension interventions. The objective was to compare the rates of receiving an initial hypertension diagnosis and antihypertensive prescription between young adults with 1) isolated systolic, 2) isolated diastolic, and 3) combined systolic/diastolic hypertension. Methods: This retrospective analysis examined 18-39 year-olds with incident hypertension receiving regular primary care in a large academic group practice from 2008-2011. Eligible patients met JNC7 criteria for a hypertension diagnosis and antihypertensive prescription. The average of the last two blood pressures prior to study entry defined the hypertension type. Patients with a previous hypertension diagnosis or antihypertensive prescription were excluded. Kaplan-Meier survival curves were computed for systolic, diastolic, and combined systolic/diastolic hypertension to evaluate the probability of receiving: 1) a hypertension diagnosis and 2) an antihypertensive prescription, as a function of time since meeting hypertension criteria. Cox proportional hazards regression analysis was used to obtain adjusted hazard ratios and 95% confidence intervals (HR; 95% CI). Results: Among 3,525 young adults, 37% had isolated systolic hypertension, 32% isolated diastolic, and 31% combined systolic/diastolic. At 48 months, 69% with combined systolic/diastolic received an initial diagnosis, compared to 55% (isolated diastolic) and 52% (isolated systolic). At 48 months, 59% with combined systolic/diastolic received an initial antihypertensive prescription, compared to 44% (isolated diastolic) and 30% (isolated systolic). After adjusting for patient and provider factors, young adults with combined systolic/diastolic were 70% more likely (HR: 1.7; 1.5-2.1) to receive a diagnosis compared to isolated systolic. Isolated diastolic (HR: 1.3; 1.1-1.6) and combined systolic/diastolic (HR: 2.4; 2.0-2.9) patients were more likely to receive an antihypertensive prescription compared to isolated systolic patients. Conclusions: Hypertension diagnosis and treatment in young adults was less likely with isolated systolic hypertension. Primary care interventions aimed at diagnosis and treatment variation may improve hypertension control in young adults.
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- 2014
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