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Acharya A, Kumar N, Singh K, Byrareddy SN. "Mpox in MSM: Tackling Stigma, Minimizing Risk Factors, Exploring Pathogenesis, and Treatment Approaches". Biomed J 2024:100746. [PMID: 38734408 DOI: 10.1016/j.bj.2024.100746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 04/07/2024] [Accepted: 05/05/2024] [Indexed: 05/13/2024] Open
Abstract
Mpox is a zoonotic disease caused by the monkeypox virus (MPV), primarily found in Central and West African countries. The typical presentation of the disease before the 2022 mpox outbreak includes a febrile prodrome 5-13 days post-exposure, accompanied by lymphadenopathy, malaise, headache, and muscle aches. Unexpectedly, during the 2022 outbreak, several cases of atypical presentations of the disease were reported, such as the absence of prodromal symptoms and the presence of genital skin lesions suggestive of sexual transmission. As per the World Health Organization (WHO), as of March 20, 2024, 94,707 cases of mpox were reported worldwide, resulting in 181 deaths (22 in African endemic regions and 159 in non-endemic countries). The United States Centers for Disease Control and Prevention (CDC) reports a total of 32,063 cases (33.85% of total cases globally), with 58 deaths (32.04% of global deaths) due to mpox. Person-to-person transmission of mpox can occur through respiratory droplets and sustained close contact. However, during the 2022 outbreak of mpox, a high incidence of anal and perianal lesions among MSMs indicated sexual transmission of MPV as a major route of transmission. Since MSMs are disproportionately at risk for HIV transmission, this review discusses the risk factors, transmission patterns, pathogenesis, vaccine, and treatment options for mpox among MSM and people living with HIV (PLWH). Furthermore, we provide a brief perspective on the evolution of the MPV in immunocompromised people like PLWH.
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Affiliation(s)
- Arpan Acharya
- Department of Pharmacology and Experimental Neuroscience, College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Narendra Kumar
- Department of Pharmacology and Experimental Neuroscience, College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Kamal Singh
- Department of Veterinary Pathobiology, College of Veterinary Medicine, and Bond Life Sciences Center, University of Missouri, Columbia, Missouri, USA
| | - Siddappa N Byrareddy
- Department of Pharmacology and Experimental Neuroscience, College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA; Department of Genetics, Cell Biology and Anatomy, College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA; Department of Biochemistry and Molecular Biology, College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA.
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Beaulieu N, Bergeron S, Brassard A, Byers ES, Péloquin K. Toward an Integrative Model of Intimacy, Sexual Satisfaction, and Relationship Satisfaction: A Prospective Study in Long-Term Couples. J Sex Res 2023; 60:1100-1112. [PMID: 36205506 DOI: 10.1080/00224499.2022.2129557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Sexual and relationship well-being are strongly intertwined in couple relationships. However, relationship quality is generally examined through relationship satisfaction only, neglecting the importance of sexual satisfaction as an aspect of relationship quality for many couples. Moreover, considering the role of interpersonal processes, such as intimacy, in relationship quality seems essential to better understand couples' optimal functioning. Although the Vulnerability-Stress-Adaptation Model posits bidirectional associations between interpersonal processes and relationship quality, few studies have tested such models. This dyadic study examined the longitudinal associations between the process of intimacy and sexual and relationship satisfaction in 145 long-term mixed-gender/sex couples. Participants completed online questionnaires three times over 13 months. A cross-lagged panel model revealed bidirectional associations between intimacy behaviors and both sexual and relationship satisfaction. Findings suggest that intimacy behaviors could foster both sexual and relationship satisfaction in couples, and that higher sexual and relationship satisfaction could also promote intimacy behaviors over time. These results highlight that satisfaction may not only be an outcome of positive interpersonal processes, but also a facilitator of these interpersonal processes over time. This study underscores the need to consider the complex interplay of interpersonal processes and satisfaction to foster relationship quality in long-term couples over time.
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Dickstein DR, Chen E, Zaorsky NG, Hoffman K, Nguyen P. Do ask, do tell: improving health outcomes for sexual and gender minorities with cancer. JNCI Cancer Spectr 2023; 7:pkad075. [PMID: 37861090 PMCID: PMC10587991 DOI: 10.1093/jncics/pkad075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 09/14/2023] [Accepted: 09/18/2023] [Indexed: 10/21/2023] Open
Affiliation(s)
- Daniel R Dickstein
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Eric Chen
- Department of Radiation Oncology, University Hospitals Seidman Cancer Center, Case Western Reserve University, Cleveland, OH, USA
| | - Nicholas G Zaorsky
- Department of Radiation Oncology, University Hospitals Seidman Cancer Center, Case Western Reserve University, Cleveland, OH, USA
| | - Karen Hoffman
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Paul Nguyen
- Department of Radiation Oncology, Dana-Farber Brigham Cancer Center, Boston, MA, USA
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Comeau D, Johnson C, Bouhamdani N. Review of current 2SLGBTQIA+ inequities in the Canadian health care system. Front Public Health 2023; 11:1183284. [PMID: 37533535 PMCID: PMC10392841 DOI: 10.3389/fpubh.2023.1183284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 07/03/2023] [Indexed: 08/04/2023] Open
Abstract
Gender identity and sexual orientation are determinants of health that can contribute to health inequities. In the 2SLGBTQIA+ community, belonging to a sexual and/or gender minority group leads to a higher risk of negative health outcomes such as depression, anxiety, and cancer, as well as maladaptive behaviors leading to poorer health outcomes such as substance abuse and risky sexual behavior. Empirical evidence suggests that inequities in terms of accessibility to health care, quality of care, inclusivity, and satisfaction of care, are pervasive and entrenched in the health care system. A better understanding of the current Canadian health care context for individuals of the 2SLGBTQIA+ community is imperative to inform public policy and develop sensitive public health interventions to make meaningful headway in reducing inequity. Our search strategy was Canadian-centric and aimed at highlighting the current state of 2SLGBTQIA+ health inequities in Canada. Discrimination, patient care and access to care, education and training of health care professionals, and crucial changes at the systemic and infrastructure levels have been identified as main themes in the literature. Furthermore, we describe health care-related disparities in the 2SLGBTQIA+ community, and present available resources and guidelines that can guide healthcare providers in narrowing the gap in inequities. Herein, the lack of training for both clinical and non-clinical staff has been identified as the most critical issue influencing health care systems. Researchers, educators, and practitioners should invest in health care professional training and future research should evaluate the effectiveness of interventions on staff attitudinal changes toward the 2SLGBTQIA+ community and the impact on patient outcomes.
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Affiliation(s)
- Dominique Comeau
- Vitalité Health Network, Dr. Georges-L.-Dumont University Hospital Center, Research Sector, Moncton, NB, Canada
| | - Claire Johnson
- School of Public Policy Studies, Université de Moncton, Moncton, NB, Canada
| | - Nadia Bouhamdani
- Vitalité Health Network, Dr. Georges-L.-Dumont University Hospital Center, Research Sector, Moncton, NB, Canada
- Medicine and Health Sciences Faculty, Université de Sherbrooke, Sherbrooke, QC, Canada
- Centre de Formation Médicale du Nouveau-Brunswick, Université de Moncton, Moncton, NB, Canada
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Alam P, Marston C. 'Bending' against straightening devices: queer lived experiences of sexuality and sexual health in Bangladesh. BMC Public Health 2023; 23:173. [PMID: 36698108 PMCID: PMC9878820 DOI: 10.1186/s12889-023-15085-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 01/18/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Despite global data around increased health risks among sexual and gender diverse populations, lived experiences of young lesbian, gay, bisexual, transgender, queer or questioning, and others (LGBTQ+) people are often ignored in mainstream health research. This is particularly evident in countries such as Bangladesh where the rights of sexual minorities are not recognised. This article looks at queer lived experiences of sexuality and sexual health within such a context. We use the phenomenological framework of heteronormative 'straightening devices' - mechanisms working to direct people towards heterosexuality, gender conformity, and procreative marriage - to identify 'invisible' structures upholding normative sexual behaviours and see how young people in Bangladesh navigate these in their everyday lives. METHODS This article is based on qualitative data collected in Dhaka, Bangladesh over nine months in 2019 as part of the first author's doctoral research. Using thematic analysis, we draw on experiences of normative sexual expectations from biographical in-depth interviews with 14 purposively sampled LGBTQ + individuals aged 18 to 24. RESULTS Respondents identified heteronormative expectations around gender norms of traditional behaviour and presentation for men and women as well as parental expectations of compulsory heterosexuality through marriage. These straightening devices existed at multiple levels, including individual, interpersonal, community, and societal. The four main themes around straightening devices include marriage norms for women; harassment of feminine-presenting bodies in public spaces; heteronormative healthcare; and consequences of not embodying heteronormativity. CONCLUSION Our study highlighted young people's everyday experiences of having to 'bend' to - and against - heteronormative straightening devices at home, in public spaces, and within institutions such as healthcare in Bangladesh. The exploration of queer experiences provides new insights into context-specific ways in which sexual and gender diverse people understand themselves. Further research using the framework of straightening devices can help public health professionals to identify more 'barriers' confronted by sexual and gender diverse young people.
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Affiliation(s)
- Prima Alam
- Department of Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK.
| | - Cicely Marston
- grid.8991.90000 0004 0425 469XDepartment of Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
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Singh A, Dandona A, Sharma V, Zaidi SZH. Minority Stress in Emotion Suppression and Mental Distress Among Sexual and Gender Minorities: A Systematic Review. Ann Neurosci 2022. [DOI: 10.1177/09727531221120356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: The existing structural framework of defining gender and sexuality based on heteronormative ideology led to the succession of the notions of stigma, prejudice, and hate towards the sexual and gender minority population. The presence of strong scientific evidence for the negative consequences of discriminatory and violent events has directed the association with mental and emotional distress. This study aims to comprehend the role of minority stress in emotional regulation and suppression among the sexual minority population globally using systematic review of literature through elaborate Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Summary: The analyses of the sorted literature premised on the PRISMA guidelines revealed that minority stress mediates the emotion regulation processes among the individuals who witness continuous episodes of discrimination and violence leading to emotional dysregulation and emotion suppression. Studies also reported the dominance of various health-risk behaviors such as alcohol addiction, drug abuse, and other forms of intoxication among sexual minority individuals. Increased instances of anxiety, stress, depression, and suicidal ideations were prominent in the findings of the empirical research suggesting an intricate role of minority stress in advancing the faulty emotion suppression and mental health concerns among the sexual and gender minority population. Key message: Minority stressors among sexual and gender minority individuals mediate emotion suppression and mental distress.
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Affiliation(s)
- Akanksha Singh
- Amity Institute of Behavioral and Allied Sciences (AIBAS), Amity University Lucknow Campus, Chinhut, Lucknow, Uttar Pradesh, India
| | - Anu Dandona
- Amity Institute of Behavioral and Allied Sciences (AIBAS), Amity University Lucknow Campus, Chinhut, Lucknow, Uttar Pradesh, India
| | - Vibha Sharma
- Department of Clinical Psychology, Institute of Human Behavior and Allied Sciences (IHBAS), New Delhi, India
| | - S. Z. H. Zaidi
- Amity Institute of Behavioral and Allied Sciences (AIBAS), Amity University Lucknow Campus, Chinhut, Lucknow, Uttar Pradesh, India
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Orellana L, Alarcón T, Schnettler B. Behavior without beliefs: Profiles of heteronormativity and well-being among heterosexual and non-heterosexual university students in Chile. Front Psychol 2022; 13:988054. [PMID: 36046402 PMCID: PMC9421161 DOI: 10.3389/fpsyg.2022.988054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 07/26/2022] [Indexed: 11/13/2022] Open
Abstract
Heteronormativity comprises essentialist, binary beliefs about sex and gender, and normative behaviors derived from those beliefs. There is scarce literature on how heteronormative attitudes and well-being variables are concurrent among individuals who are heterosexual or gay, lesbian, bisexual, and of other queer sexual identities (LGBQ). The objective of this study was to distinguish profiles of university students based on essentialism and normative behavior, two dimensions of heteronormativity, and to characterize these groups by sexual orientation and gender, perceived social support, physical and mental health, and life satisfaction. A sample of 552 university students in Temuco, Chile, responded to an online questionnaire consisting of sociodemographic questions, the Scale of Heteronormative Attitudes and Beliefs, the Life Satisfaction Scale, the Health-Related Quality of Life Index, and the Multidimensional Scale of Perceived Social Support. We used Latent profile analysis to distinguish profiles based on significant score differences in Essentialism and Normative behavior. We identified four heteronormativity profiles: High heteronormativity (34.85%), with a significant proportion of heterosexuals and men; Low heteronormativity (25.59%), comprising a significant proportion of students who were non-binary, and LGBQ; Heteronormativity focused on normative behavior (20.42%), with a significant proportion students who were men or non-binary, and who were lesbian, gay or bisexual or preferred not to disclose their sexual orientation; and Heteronormativity focused on essentialism (19.14%), with a significant proportion of heterosexuals and women, and individuals who preferred not to disclose their sexual orientation. The four profiles differed in the proportions of students by faculty and area of residence (urban/rural), and by life satisfaction, self-perceived mental health, and perceived social support. These results show that patterns of association between heteronormativity and subjective well-being are heterogeneous among heterosexual and non-heterosexual individuals. Some of these patterns may respond to the COVID-19 pandemic, which has disrupted daily life and social dynamics. These findings expand our understanding of advantageous and disadvantageous conditions associated with maintaining heteronormativity attitudes, particularly among non-heterosexual individuals.
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Affiliation(s)
- Ligia Orellana
- Núcleo de Ciencias Sociales y Humanidades, Universidad de La Frontera, Temuco, Chile
- *Correspondence: Ligia Orellana,
| | - Tatiana Alarcón
- Núcleo de Ciencias Sociales y Humanidades, Universidad de La Frontera, Temuco, Chile
| | - Berta Schnettler
- Núcleo de Ciencias Sociales y Humanidades, Universidad de La Frontera, Temuco, Chile
- Núcleo Científico Tecnológico en Biorecursos (BIOREN-UFRO), Universidad de La Frontera, Temuco, Chile
- Facultad de Ciencias Agropecuarias y Forestales, Universidad de La Frontera, Temuco, Chile
- Facultad de Especialidades Empresariales, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador
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Medina-Martínez J, Saus-Ortega C, Sánchez-Lorente MM, Sosa-Palanca EM, García-Martínez P, Mármol-López MI. Health Inequities in LGBT People and Nursing Interventions to Reduce Them: A Systematic Review. Int J Environ Res Public Health 2021; 18:ijerph182211801. [PMID: 34831556 PMCID: PMC8624572 DOI: 10.3390/ijerph182211801] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/06/2021] [Accepted: 11/09/2021] [Indexed: 11/30/2022]
Abstract
Background: Lesbian, gay, bisexual, and transgender (LGBT) people present poorer mental and physical health results compared to the heterosexual and cisgender population. There are barriers in the healthcare system that increase these health inequities. Objective: To synthesise the available evidence on how nurses can intervene in reducing health inequities in LGBT people, identifying their specific health needs and describing their experiences and perceptions of the barriers they face in the healthcare system. Methods: Systematic review. Between March and April 2021, a bibliographic search was carried out in the Cuiden, LILACS, PubMed, Dialnet, SciELO, Trip Database, and Web of Science databases and metasearch engines. Inclusion criteria: Articles published in the last 5 years that address the specific health needs of LGBT people, their experiences and perceptions, or interventions in this group in which nurses may engage. Results: A total of 16 articles were selected. Health disparities were detected in the LGBT community, which exhibited higher rates of mental health problems, substance abuse, risky sexual behaviours, self-harm, and suicide. These inequalities were related to minority stress, and each of them differently impacted individual populations within the broader LGBT community depending on their sexual orientations and gender identities. The impact of these factors was, in turn, modified by the intersections of race/ethnicity, geographic region, and socioeconomic factors. LGBT people described discriminatory experiences by health professionals, as well as their distrust and fear in this setting. Nurses can carry out interventions such as inclusive education about sex and sexual and gender diversity and bullying and suicide prevention programmes, and can provide gender-affirming and family-centred care. Conclusions: LGBT people experience health inequities and discrimination in the healthcare system. Nurses can implement diverse interventions to reduce these problems and, moreover, these health professionals are obliged to acquire cultural competence regarding LGBT health.
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Affiliation(s)
- Jorge Medina-Martínez
- Nursing School La Fe, Adscript Centre, University of Valencia, 46026 Valencia, Spain; (J.M.-M.); (M.M.S.-L.); (E.M.S.-P.); (P.G.-M.); (M.I.M.-L.)
| | - Carlos Saus-Ortega
- Nursing School La Fe, Adscript Centre, University of Valencia, 46026 Valencia, Spain; (J.M.-M.); (M.M.S.-L.); (E.M.S.-P.); (P.G.-M.); (M.I.M.-L.)
- Research Group GREIACC, Health Research Institute La Fe, 46026 Valencia, Spain
- Correspondence:
| | - María Montserrat Sánchez-Lorente
- Nursing School La Fe, Adscript Centre, University of Valencia, 46026 Valencia, Spain; (J.M.-M.); (M.M.S.-L.); (E.M.S.-P.); (P.G.-M.); (M.I.M.-L.)
- Research Group GREIACC, Health Research Institute La Fe, 46026 Valencia, Spain
| | - Eva María Sosa-Palanca
- Nursing School La Fe, Adscript Centre, University of Valencia, 46026 Valencia, Spain; (J.M.-M.); (M.M.S.-L.); (E.M.S.-P.); (P.G.-M.); (M.I.M.-L.)
- Research Group GREIACC, Health Research Institute La Fe, 46026 Valencia, Spain
| | - Pedro García-Martínez
- Nursing School La Fe, Adscript Centre, University of Valencia, 46026 Valencia, Spain; (J.M.-M.); (M.M.S.-L.); (E.M.S.-P.); (P.G.-M.); (M.I.M.-L.)
- Research Group GREIACC, Health Research Institute La Fe, 46026 Valencia, Spain
| | - María Isabel Mármol-López
- Nursing School La Fe, Adscript Centre, University of Valencia, 46026 Valencia, Spain; (J.M.-M.); (M.M.S.-L.); (E.M.S.-P.); (P.G.-M.); (M.I.M.-L.)
- Research Group GREIACC, Health Research Institute La Fe, 46026 Valencia, Spain
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Arocho R. "I have no idea:" Uncertainty in high school seniors' marital expectations. Popul Res Policy Rev 2020; 40:771-793. [PMID: 34305215 DOI: 10.1007/s11113-020-09614-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Despite changes in marriage's role in young adulthood, youth in the United States report similar or higher expectations to marry than those from decades before, and very few report explicit expectations to not marry. Marital expectations may be one way to understand if the U.S. is indeed experiencing a second demographic transition, and uncertainty in those answers may provide additional information beyond simply yes and no. Using public-use data from 1976 to 2017 from the 12th Grade Monitoring the Future annual cross-sectional surveys, I found that young men and women were more likely to report uncertainty than explicitly expect not to marry, and that boys were generally more uncertain than girls. Slight changes in past decades suggest that boys are becoming more certain regarding marriage, however, and gender differences have diminished over time. Additionally, between 2008 and 2017, I found that boys with the greatest educational prospects were the least likely to report uncertainty about marriage. Uncertainty is common in adolescent marital expectations and should be considered as a possibly informative answer to questions about hypothetical marriages. Results suggest that marriage continues to hold strong meaning in adolescents' ideals.
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Affiliation(s)
- Rachel Arocho
- Department of Behavioral Sciences, Utah Valley University, 800 W University Parkway, Mail Stop 115, Orem, Utah 84058
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