18 results
Search Results
2. Cutting the paper chain with EDI
- Author
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Hodgson, Robert
- Published
- 1995
- Full Text
- View/download PDF
3. The influence of electronic health record use on collaboration among medical specialties
- Author
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Janita F.J. Vos, Marjolein van Offenbeek, Albert Boonstra, Arjen Kooistra, Marc A. Seelen, Research programme I&O, Value, Affordability and Sustainability (VALUE), Groningen Kidney Center (GKC), and Groningen Institute for Organ Transplantation (GIOT)
- Subjects
Knowledge management ,020205 medical informatics ,TEAMS ,Interprofessional Relations ,02 engineering and technology ,ORGANIZATION ,Health informatics ,Health administration ,03 medical and health sciences ,0302 clinical medicine ,Documentation ,ROUTINES ,health services administration ,0202 electrical engineering, electronic engineering, information engineering ,Collaborative affordances ,Medicine ,Outpatient clinic ,Humans ,Electronic health records ,030212 general & internal medicine ,Use ,health care economics and organizations ,INFORMATION-TECHNOLOGY ,business.industry ,Health Policy ,Nursing research ,lcsh:Public aspects of medicine ,Information technology ,lcsh:RA1-1270 ,CARE ,DOCUMENTATION ,Collaboration ,Information overload ,Workflow ,INTERDISCIPLINARY ,PAPER ,AFFORDANCE ,business ,Research Article - Abstract
Background One of the main objectives of Electronic Health Records (EHRs) is to enhance collaboration among healthcare professionals. However, our knowledge of how EHRs actually affect collaborative practices is limited. This study examines how an EHR facilitates and constrains collaboration in five outpatient clinics. Methods We conducted an embedded case study at five outpatient clinics of a Dutch hospital that had implemented an organization-wide EHR. Data were collected through interviews with representatives of medical specialties, administration, nursing, and management. Documents were analyzed to contextualize these data. We examined the following collaborative affordances of EHRs: (1) portability, (2) co-located access, (3) shared overviews, (4) mutual awareness, (5) messaging, and (6) orchestrating. Results Our findings demonstrate how an EHR will both facilitate and constrain collaboration among specialties and disciplines. Affordances that were inscribed in the system for collaboration purposes were not fully actualized in the hospital because: (a) The EHR helps health professionals coordinate patient care on an informed basis at any time and in any place but only allows asynchronous patient record use. (b) The comprehensive patient file affords joint clinical decision-making based on shared data, but specialty- and discipline-specific user-interfaces constrain mutual understanding of that data. Moreover, not all relevant information can be easily shared across specialties and outside the hospital. (c) The reduced necessity for face-to-face communication saves time but is experienced as hindering collective responsibility for a smooth workflow. (d) The EHR affords registration at the source and registration of activities through orders, but the heightened administrative burden for physicians and the strict authorization rules on inputting data constrain the flexible, multidisciplinary collaboration. (e) While the EHR affords a complete overview, information overload occurs due to the parallel generation of individually owned notes and the high frequency of asynchronous communication through messages of varying clinical priority. Conclusions For the optimal actualization of EHRs’ collaborative affordances in hospitals, coordinated use of these affordances by health professionals is a prerequisite. Such coordinated use requires organizational, technical, and behavioral adaptations. Suggestions for hospital-wide policies to enhance trust in both the EHR and in its coordinated use for effective collaboration are offered.
- Published
- 2020
4. Personalized recommendation with adaptive mixture of markov models.
- Author
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Yang Liu, Xiangji Huang, and Aijun An
- Subjects
- *
PAPER , *INTERNET , *MARKOV processes , *WEBSITES , *DOCUMENT clustering , *STOCHASTIC processes , *ALGORITHMS , *DATA , *KNOWLEDGE management - Abstract
With more and more information available on the Internet, the task of making personalized recommendations to assist the user's navigation has become increasingly important. Considering there might be millions of users with different backgrounds accessing a Web site everyday, it is infeasible to build a separate recommendation system for each user. To address this problem, clustering techniques can first be employed to discover user groups. Then, user navigation patterns for each group can be discovered, to allow the adaptation of a Web site to the interest of each individual group. In this paper, we propose to model user access sequences as stochastic processes, and a mixture of Markov models based approach is taken to cluster users and to capture the sequential relationships inherent in user access histories. Several important issues that arise in constructing the Markov models are also addressed. The first issue lies in the complexity of the mixture of Markov models. To improve the efficiency of building/maintaining the mixture of Markov models, we develop a lightweight adapt-ive algorithm to update the model parameters without recomputing model parameters from scratch. The second issue concerns the proper selection of training data for building the mixture of Markov models. We investigate two different training data selection strategies and perform extensive experiments to compare their effectiveness on a real dataset that is generated by a Web-based knowledge management system, Livelink. [ABSTRACT FROM AUTHOR]
- Published
- 2007
- Full Text
- View/download PDF
5. Structural analysis for the knowledge management domain.
- Author
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Atzenbeck, Claus and Nürnberg, Peter J.
- Subjects
- *
KNOWLEDGE management , *COMPUTER software , *STRUCTURAL engineering , *LATTICE theory , *COMPUTER systems , *KNOWLEDGE workers , *DATA mining , *MANAGEMENT information systems , *INFORMATION technology , *INFORMATION resources management - Abstract
Structural computing represents a form of hypertext, in which structure is foregrounded in the analysis, design and implementation of systems. Until now, the vast majority of structural computing work has focused on the implementation of frameworks. The applications implemented in these environments are often reimplementations of existing hypertext applications, intended to show the utility of the provided environments in terms of implementation, interoperability, or other metrics. Often, spatial hypertext applications are reimplemented, since they are seen as particularly good tests of structural computing infrastructures. This is because the demonds they pose are quite different from many other types of hypertext applications. However, structural computing researchers have failed to reanalyse and redesign these applications in a structurally-aware way. There are substantial improvements that result from rethinking such applications from a structure-first perspective. In this paper, we present such a reanalysis, and describe its implications for spatial hypertext within structural computing environments. [ABSTRACT FROM AUTHOR]
- Published
- 2006
- Full Text
- View/download PDF
6. A Computerized Cognitive Assessment Method in a Nurse-Led Clinic
- Author
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Yee Ming Wu, Rick Yiu Cho Kwan, Daphne Sze Ki Cheung, Claudia K.Y. Lai, and Louise S. Y. Yap
- Subjects
Adult ,Male ,Paper ,Clinical team ,Organizational Behavior and Human Resource Management ,Nursing (miscellaneous) ,Knowledge management ,Attitude of Health Personnel ,Strategy and Management ,Data management ,education ,MEDLINE ,Pharmaceutical Science ,Health Informatics ,Neuropsychological Tests ,03 medical and health sciences ,Cognition ,0302 clinical medicine ,Drug Discovery ,Humans ,Medicine ,Service user ,030212 general & internal medicine ,Pencil (mathematics) ,Aged ,Marketing ,Pharmacology ,Medical education ,Practice Patterns, Nurses' ,Computers ,business.industry ,Middle Aged ,Nurse-led clinic ,Female ,Cognitive Assessment System ,business ,030217 neurology & neurosurgery - Abstract
This article reports our experience in developing a computerized cognitive assessment method in a nurse-led clinic. The assessment and report-writing time and the accuracy of using a computer as an assessment medium were compared with assessments that use the traditional pencil-and-paper method. The attitudes of professionals and service users toward the computerized approach were also collected. The results found that the computerized approach not only helped to reduce the time spent making assessments and writing reports but also improved the accuracy of the assessment when compared with the pencil-and-paper method. Most of the professionals and service users who were interviewed responded positively toward computerized assessments. The experience gained in this study will also help us to standardize our assessment procedures, promote communication among members of the clinical team, and facilitate data management and clinical research.
- Published
- 2016
7. WHAT DOCUMENTS HAVE EDUCATIONAL VALUE?
- Author
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Moffatt, Maurice P. and Rich, Stephen G.
- Subjects
ARCHIVES ,TEACHING aids ,LIBRARY storage centers ,PAPER ,PICTURE dictionaries ,KNOWLEDGE management - Abstract
The article focuses on the use of documents as educational material to furnish both factual knowledge and understandings of situations and relationships. Anything that is an original record or a photograph thereof or even an accurate reprint thereof, must be classified as a document for the purpose of this study. Significant documents of many varieties provide pertinent knowledge for educational purposes. The term document cannot be restricted to paper with print or handwriting on it. Local libraries and local or county historical societies are the normal repositories of much of the paper documentary material. The values which may be obtained from documentary material are most when the wide range of material is brought together from most diverse sources. Pictorial documents are often strikingly useful. Maps are valuable as documents, especially those that depict past conditions. The study and effective use of the fundamental documents that have molded our destiny has a definite place in our educational programs.
- Published
- 1951
- Full Text
- View/download PDF
8. L'agenda digital: una eina per aprendre a organitzar-se
- Author
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Gil Sancho, Daniel, Universitat Politècnica de Catalunya. Departament d'Enginyeria de Serveis i Sistemes d'Informació, Pastor Collado, Juan Antonio, and Winand, Tomàs
- Subjects
Aplicacions mòbils ,Knowledge management ,school ,digitize ,esdeveniments ,organize ,web ,manage ,Informàtica [Àrees temàtiques de la UPC] ,learn ,calendar ,Súnion ,tasks ,aprendre ,gestionar ,app ,eina ,digitalitzar ,students ,digital ,paper ,Gestió del coneixement ,tool ,escola ,agenda ,organitzar ,alumnes ,iphone ,Mobile apps ,tasques ,android ,events - Published
- 2017
9. Do surveys with paper and electronic devices differ in quality and cost? Experience from the Rufiji Health and demographic surveillance system in Tanzania
- Author
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Amanda Ross, Hildegalda P. Mushi, Oscar Mukasa, Don de Savigny, and Nicolas Maire
- Subjects
Adult ,Male ,Paper ,medicine.medical_specialty ,Knowledge management ,020205 medical informatics ,media_common.quotation_subject ,Data management ,02 engineering and technology ,Data entry ,Tanzania ,Health informatics ,Article ,03 medical and health sciences ,0302 clinical medicine ,0202 electrical engineering, electronic engineering, information engineering ,Electronic Health Records ,Humans ,Medicine ,Quality (business) ,030212 general & internal medicine ,Electronics ,media_common ,biology ,business.industry ,lcsh:Public aspects of medicine ,Health Policy ,Public health ,public health ,Environmental resource management ,Public Health, Environmental and Occupational Health ,lcsh:RA1-1270 ,biology.organism_classification ,Health Surveys ,Data Accuracy ,health and demographic surveillance systems ,Population Surveillance ,Costs and Cost Analysis ,health information systems ,Original Article ,data management ,Demographic surveillance system ,business - Abstract
Background: Data entry at the point of collection using mobile electronic devices may make data-handling processes more efficient and cost-effective, but there is little literature to document and quantify gains, especially for longitudinal surveillance systems. Objective: To examine the potential of mobile electronic devices compared with paper-based tools in health data collection. Methods: Using data from 961 households from the Rufiji Household and Demographic Survey in Tanzania, the quality and costs of data collected on paper forms and electronic devices were compared. We also documented, using qualitative approaches, field workers, whom we called ‘enumerators’, and households’ members on the use of both methods. Existing administrative records were combined with logistics expenditure measured directly from comparison households to approximate annual costs per 1,000 households surveyed. Results: Errors were detected in 17% (166) of households for the paper records and 2% (15) for the electronic records (p
- Published
- 2017
10. Exploring the persistence of paper with the electronic health record
- Author
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Jason J. Saleem, Patricia R. Ebright, Connie Justice, Heather Hagg, Bradley N. Doebbeling, Peter Woodbridge, and Alissa L. Russ
- Subjects
Paper ,Indiana ,Service (systems architecture) ,Knowledge management ,Medical Records Systems, Computerized ,business.industry ,Health information technology ,Workaround ,Health Informatics ,Usability ,Documentation ,Task (project management) ,Health care ,Medicine ,Practice Patterns, Physicians' ,Medical History Taking ,business ,Veterans Affairs - Abstract
Objective Healthcare organizations are increasingly implementing electronic health records (EHRs) and other related health information technology (IT). Even in institutions which have long adopted these computerized systems, employees continue to rely on paper to complete their work. The objective of this study was to explore and understand human-technology integration factors that may be causing employees to rely on paper alternatives to the EHR. Methods We conducted semi-structured interviews with 20 key-informants in a large Veterans Affairs Medical Center (VAMC), with a fully implemented EHR, to understand the use of paper-based alternatives. Participants included clinicians, administrators, and IT specialists across several service areas in the medical center. Results We found 11 distinct categories of paper-based workarounds to the use of the EHR. Paper use related to the following: (1) efficiency; (2) knowledge/skill/ease of use; (3) memory; (4) sensorimotor preferences; (5) awareness; (6) task specificity; (7) task complexity; (8) data organization; (9) longitudinal data processes; (10) trust; and (11) security. We define each of these and provide examples that demonstrate how these categories promoted paper use in spite of a fully implemented EHR. Conclusions In several cases, paper served as an important tool and assisted healthcare employees in their work. In other cases, paper use circumvented the intended EHR design, introduced potential gaps in documentation, and generated possible paths to medical error. We discuss implications of these findings for EHR design and implementation.
- Published
- 2009
11. Cox Communications Deploys Oracle Suite and Oracle Content Management
- Subjects
Cox Enterprises Inc. -- Management ,Cox Communications Inc. -- Management ,Cable television broadcasting industry ,Paper ,Newspaper publishing ,Electronic commerce -- Computer programs ,Knowledge management ,Company business management ,Knowledge management ,Electronic commerce software ,Arts and entertainment industries - Abstract
Cox Communications, a multi-service broadband communications and entertainment company, announced it has significantly reduced its carbon footprint with the help of Oracle E-Business Suite and Oracle Imaging and Process Management, [...]
- Published
- 2010
12. Realizing the potential of empowerment: the impact of a feedback intervention on the performance of complex technology
- Author
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Paul Jackson, Desmond Leach, and Toby D. Wall
- Subjects
Paper ,Change over time ,Technology ,Engineering ,Knowledge management ,media_common.quotation_subject ,Psychology, Industrial ,Physical Therapy, Sports Therapy and Rehabilitation ,Human Factors and Ergonomics ,Efficiency, Organizational ,Feedback regulation ,Feedback ,Operator (computer programming) ,Intervention (counseling) ,Humans ,Staff Development ,Knowledge dissemination ,Empowerment ,media_common ,business.industry ,Data Collection ,Organizational Innovation ,Self Efficacy ,United Kingdom ,Machine utilization ,Risk analysis (engineering) ,Well-being ,Employee Performance Appraisal ,business ,Knowledge of Results, Psychological - Abstract
An empowerment initiative involving enhanced fault-management responsibility for operators of complex technology had not led to expected increases in performance, and investigations suggested that this was due to a lack of appropriate feedback. Thus, a feedback intervention was designed to provide specific, timely feedback on operator-correctable faults. It was hypothesized that the intervention would increase operator self-reliance in operating complex technology and promote system performance. Moreover, given the feedback was continuous from the point of intervention, it was predicted that gains would increase over time. Time series analysis of data on engineer call-outs (self-reliance) and machine utilization (performance) showed clear positive effects of the feedback intervention, with call-outs also showing progressive improvement. Self-report data showed no change over time in motivation, but an increase in knowledge dissemination and a reduction in the likelihood of making expensive mistakes. There were no detrimental effects on operator well being. Implications for theory and practice in the management of complex technology are discussed.
- Published
- 2001
13. Paper- and computer-based workarounds to electronic health record use at three benchmark institutions
- Author
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Mindy E. Flanagan, Alissa L. Russ, Jason J. Saleem, Laura G Millitello, and Bradley N. Doebbeling
- Subjects
Paper ,Data collection ,Knowledge management ,Medical Records Systems, Computerized ,Health information technology ,business.industry ,Workaround ,Health Personnel ,Health Informatics ,Qualitative property ,Usability ,Benchmarking ,Work Simplification ,Research and Applications ,Ambulatory Care Facilities ,United States ,Health care ,Task Performance and Analysis ,Outpatient clinic ,Medicine ,Electronic Health Records ,Humans ,business - Abstract
Background Healthcare professionals develop workarounds rather than using electronic health record (EHR) systems. Understanding the reasons for workarounds is important to facilitate user-centered design and alignment between work context and available health information technology tools. Objective To examine both paper- and computerbased workarounds to the use of EHR systems in three benchmark institutions. Methods Qualitative data were collected in 11 primary care outpatient clinics across three healthcare institutions. Data collection methods included direct observation and opportunistic questions. In total, 120 clinic staff and providers and 118 patients were observed. All data were analyzed using previously developed workaround categories and examined for potential new categories. Additionally, workarounds were coded as either paper- or computer-based. Results Findings corresponded to 10 of 11 workaround categories identified in previous research. All 10 of these categories applied to paper-based workarounds; five categories also applied to computerbased workarounds. One new category, no correct path (eg, a desired option did not exist in the computer interface, precipitating a workaround), was identified for computer-based workarounds. The most consistent reasons for workarounds across the three institutions were efficiency, memory, and awareness. Conclusions Consistent workarounds across institutions suggest common challenges in outpatient clinical settings and failures to accommodate these challenges in EHR design. An examination of workarounds provides insight into how providers adapt to limiting EHR systems. Part of the design process for computer interfaces should include user-centered methods particular to providers and healthcare settings to ensure uptake and usability.
- Published
- 2013
14. Evaluating the impact of hybrid electronic-paper environments upon novice nurse information seeking
- Author
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Louise Lemieux-Charles, Gunther Eysenbach, Elizabeth M. Borycki, and Lynn M. Nagle
- Subjects
Advanced and Specialized Nursing ,Cued recall ,Ontario ,Paper ,Knowledge management ,Novice nurse ,Health professionals ,British Columbia ,Medical Records Systems, Computerized ,Information seeking ,business.industry ,Applied psychology ,MEDLINE ,Health Informatics ,Information needs ,Nursing ,Affect (psychology) ,Risk Assessment ,Access to Information ,Health Information Management ,Medicine ,Humans ,business ,Cognitive load ,Medical Informatics - Abstract
Summary Objective: The purpose of this study was to investigate the effects of hybrid environments (i.e. where part of the patient record is paper-based and part of it is electronic) upon aspects of novice nurse information seeking (i.e. amount of information accessed, choice of key information sources, type of information and use of information seeking tactics). Methods: A within group, laboratory, experimental study was conducted using two simulated environments (i.e. a paper environment and a hybrid environment). Thirty-five novice nurses participated in the study. Results: Findings revealed significant differences between the paper and hybrid environments in terms of their effects upon aspects of novice nurse information seeking. Subjects accessed: 1) less information in the hybrid environment than the paper environment, 2) more non-electronic sources of information were accessed by novice nurses in the hybrid environment, and 3) novice nurses used more passive information seeking tactics in the hybrid environment than the paper environment. Qualitative findings from the cued recall data revealed subjects experienced increased cognitive load in the hybrid environment. Conclusions: Hybrid environments may affect aspects of novice nurse information seeking. Future research should explore the effects of hybrid environments upon the information seeking of other types of health professionals (e.g. physicians, physiotherapists) with differing levels of expertise (i.e. novice, intermediate and expert).
- Published
- 2009
15. Structural analysis for the knowledge management domain
- Author
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Peter J. Nürnberg and Claus Atzenbeck
- Subjects
Paper ,Structure analysis ,Computer science ,Knowledge management ,Interoperability ,Spatial hypertext ,Domain (software engineering) ,law.invention ,World Wide Web ,Spatial structures ,law ,Structural computing ,GUI ,Media Technology ,Information system ,Metaphors ,WildDocs ,Structure (mathematical logic) ,Bindings ,Office work ,Data science ,Computer Science Applications ,Hypertext ,Information Systems - Abstract
Structural computing represents a form of hypertext, in which structure is foregrounded in the analysis, design and implementation of systems. Until now, the vast majority of structural computing work has focused on the implementation of frameworks. The applications implemented in these environments are often reimplementations of existing hypertext applications, intended to show the utility of the provided environments in terms of implementation, interoperability, or other metrics. Often, spatial hypertext applications are reimplemented, since they are seen as particularly good tests of structural computing infrastructures. This is because the demonds they pose are quite different from many other types of hypertext applications. However, structural computing researchers have failed to reanalyse and redesign these applications in a structurally-aware way. There are substantial improvements that result from rethinking such applications from a structure-first perspective. In this paper, we present such a reanalysis, and describe its implications for spatial hypertext within structural computing environments.
- Published
- 2006
16. Exchanging clinical knowledge via Internet
- Author
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Rudolf Hanka and Iain Buchan
- Subjects
Paper ,Knowledge management ,Knowledge representation and reasoning ,Interprofessional Relations ,Knowledge engineering ,Health Informatics ,Clinical decision support system ,Clinical knowledge ,Computer Communication Networks ,User-Computer Interface ,Artificial Intelligence ,Personal knowledge management ,Humans ,Medicine ,Publishing ,business.industry ,Communication ,Decision Support Systems, Clinical ,Mathematical knowledge management ,Hypermedia ,Practice Guidelines as Topic ,Database Management Systems ,Domain knowledge ,The Internet ,business ,Medical Informatics ,Software - Abstract
The need for effective and efficient exchange of clinical knowledge is increasing. Paper based methods for managing clinical knowledge are not meeting the demand for knowledge and this has undoubtedly contributed to the widely reported failures of clinical guidelines. Internet affords both opportunities and dangers for clinical knowledge. Systems such as Wax have demonstrated the importance of intuitive structure in the management of knowledge. We report on a new initiative for the global management of clinical knowledge.
- Published
- 1997
17. Multidisciplinary teamwork: the good, bad, and everything in between
- Author
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J Firth-Cozens
- Subjects
Value (ethics) ,Paper ,Knowledge management ,Quality Assurance, Health Care ,Leadership and Management ,media_common.quotation_subject ,education ,Breast Neoplasms ,Patient Education as Topic ,Multidisciplinary approach ,Surveys and Questionnaires ,Outcome Assessment, Health Care ,Health care ,Medicine ,Humans ,Quality (business) ,skin and connective tissue diseases ,General Nursing ,media_common ,Information Services ,Patient Care Team ,Teamwork ,Hospitals, Public ,business.industry ,Public Health, Environmental and Occupational Health ,Awareness ,Public relations ,United Kingdom ,Variety (cybernetics) ,Group Processes ,Editorial ,Female ,Clinical Competence ,Form of the Good ,business ,Diversity (business) - Abstract
Teams make up the building blocks of health care and every team—from the executive to the coal face—is composed of different professionals, ideally possessing a variety of skills necessary to produce safe and effective care.1 We are constantly reminded of the value of diversity within teams, but the reality is that working together from a variety of perspectives is sometimes difficult to achieve. The paper by Jenkins et al 2 in this issue of Quality in Health Care shows, for example, that, unless roles are well defined and understood, responsibility for giving different types of information to patients could easily result in overload to the patient, differences in messages, and gaps in certain areas. The difficulties of multidisciplinary teamwork are also apparent in differing attitudes towards the way to bring about a good outcome, and even what actually constitutes a good outcome. For example, in teams caring for patients with …
- Published
- 2001
18. Continuing Education: Report on IFLA 1998; Amsterdam, Netherlands
- Author
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Weingand, Darlene E.
- Published
- 1999
- Full Text
- View/download PDF
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