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Toni E, Ayatollahi H. An insight into the use of telemedicine technology for cancer patients during the Covid-19 pandemic: a scoping review. BMC Med Inform Decis Mak 2024; 24:104. [PMID: 38641567 PMCID: PMC11027268 DOI: 10.1186/s12911-024-02507-1] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 04/12/2024] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND The use of telemedicine technology has significantly increased in recent years, particularly during the Covid-19 pandemic. This study aimed to investigate the use of telemedicine technology for cancer patients during the Covid-19 pandemic. METHODS This was a scoping review conducted in 2023. Various databases including PubMed, Web of Science, Scopus, Cochrane Library, Ovid, IEEE Xplore, ProQuest, Embase, and Google Scholar search engine were searched. All quantitative, qualitative, and mixed-method studies published in English between 2020 and 2022 were included. Finally, the needed data were extracted, and the results were synthesized and reported narratively. RESULTS A total of 29 articles were included in this review. The results showed that teleconsultation, televisit, and telerehabilitation were common telemedicine services, and video conferencing and telephone were common technologies used in these studies. In most cases, patients and healthcare providers preferred these services compared to the face-to-face consultations due to their convenience and advantages. Furthermore, the findings revealed that in terms of clinical outcomes, telemedicine could effectively reduce anxiety, pain, sleep disorders, and hospital admission rates. CONCLUSION The findings provided valuable insights into the various telemedicine technologies, services, users' perspectives, and clinical outcomes in cancer patients during the Covid-19 pandemic. Overall, the positive outcomes and users' satisfaction showed that the use of telemedicine technology can be expanded, particularly in cancer care. Future research needs to investigate both clinical and non-clinical effectiveness of using various telemedicine services and technologies for improving cancer care delivery, which can help to develop more successful strategies for implementing this technology.
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Affiliation(s)
- Esmaeel Toni
- Student Research Committee, Iran University of Medical Sciences, Tehran, Iran
| | - Haleh Ayatollahi
- Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran.
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Noun D, Obeid A, Belgaumi A, Sidhom I, Jadiry MA, Al-Saeed R, Khalifa N, Trehan A, Ghanem K, AbdelHafeez H, Rodriguez-Galindo C, Jeha S, Saab R. A regional virtual case discussion forum in pediatric oncology: Experience of the Pediatric Oncology East and Mediterranean Group. Pediatr Blood Cancer 2024; 71:e30838. [PMID: 38149824 DOI: 10.1002/pbc.30838] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 12/08/2023] [Accepted: 12/18/2023] [Indexed: 12/28/2023]
Abstract
BACKGROUND The Pediatric Oncology East and Mediterranean (POEM) group that aims to share expertise among pediatric oncology providers across the Middle East, North Africa, and East Asia region initiated a virtual Case Discussion Forum (CDF) in 2013. METHODS Meeting records from September 2013 till June 2021 were reviewed. Detailed minutes were available starting August 2016; case data were analyzed including diagnoses, purpose of presentation and recommendations. A 38-item survey assessing perception of benefits, challenges, and opportunities of the forum was distributed to members of the POEM group and results analyzed. RESULTS A total of 140 cases were presented from 14 countries. After August 2016, 67 cases were presented, and those were analyzed regarding reasons for discussion, barriers, and recommendations. Details are presented in this report, and the most common challenges identified were related to histopathologic/molecular diagnosis (24%), imaging interpretation (18%), resource limitations (12%), and surgical difficulties (9%). A survey was distributed to all POEM members in 28 countries, and 76 responded. The main benefit reported was the provision of recommendations regarding treatment and evaluation, while the main challenges reported were time zone difference and workload. Recognized opportunities included conducting regionally relevant research studies based on clinical problems identified during discussions, and setting guidelines for resource-adapted treatment regimens. CONCLUSIONS The POEM CDF identified areas for multi-institutional regional studies and led to a twinning project between two centers in the region for improving diagnostic infrastructure. Such forums can identify specific resource limitations in pediatric cancer and direct efforts for targeted capacity building.
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Affiliation(s)
- Dolly Noun
- Children's Cancer Institute, Department of Pediatrics, American University of Beirut Medical Center, Beirut, Lebanon
| | - Anas Obeid
- Children's Cancer Institute, Department of Pediatrics, American University of Beirut Medical Center, Beirut, Lebanon
| | - Asim Belgaumi
- Department of Oncology, Aga Khan University, Karachi, Pakistan
| | - Iman Sidhom
- Pediatric Oncology Department, National Cancer Institute, Cairo University and Children Cancer Hospital Egypt, Cairo, Egypt
| | - Mazin Al Jadiry
- Department of Pediatrics, Oncology Unit, Children Welfare Teaching Hospital, College of Medicine, University of Baghdad, Baghdad, Iraq
| | - Raghad Al-Saeed
- Department of Pediatrics, Oncology Unit, Children Welfare Teaching Hospital, College of Medicine, University of Baghdad, Baghdad, Iraq
| | - Nisreen Khalifa
- Pediatric Hematology Oncology Unit, National Bank of Kuwait Specialized Hospital for Children, Sabah, Kuwait
| | - Amita Trehan
- Pediatric Hematology Oncology Unit, Advanced Pediatrics Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Khaled Ghanem
- BASMA Pediatric Oncology Unit, Al Bayrouni Hospital, Damascus, Syria
| | - Hafeez AbdelHafeez
- Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Carlos Rodriguez-Galindo
- Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Sima Jeha
- Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Raya Saab
- Children's Cancer Institute, Department of Pediatrics, American University of Beirut Medical Center, Beirut, Lebanon
- Department of Pediatrics, Stanford University, Palo Alto, California, USA
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Stanley S, Finucane A, Thompson A, Nwosu AC. How can technology be used to support communication in palliative care beyond the covid-19 pandemic: a mixed-methods national survey of palliative care healthcare professionals. BMC Palliat Care 2024; 23:40. [PMID: 38351101 PMCID: PMC10865684 DOI: 10.1186/s12904-024-01372-z] [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] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 02/01/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Developments in digital health have the potential to create new opportunities for healthcare professionals support delivery of palliative care. Globally, many palliative care professionals used digital health innovations to support communication with staff, patients and caregivers, during COVID-19 pandemic. However, there is limited data about the views of palliative care professionals of using digital health to support communication during the pandemic. We aimed to describe how palliative care professionals used technology to support communication (multidisciplinary team working, education and with patients and family caregivers) during the COVID-19 pandemic. METHOD(S) UK based palliative care healthcare professionals completed an electronic questionnaire to describe their use of digital health, during the COVID-19 pandemic, to support (1) communication within the multidisciplinary team (MDT), (2) education and (3) to support communication with patients and carers. RESULTS Two hundred and thirty-four palliative care professionals participated. Most (n = 227, 97%) described an increase in their use of digital health, to support communication, since the start of the COVID-19 pandemic. We identified benefits and challenges for digital health communication, which we summarised into themes, including 'a new way of working', 'developing a new approach to learning' and 'impacting care'. CONCLUSION(S) Since the pandemic, palliative care professionals have increased their use of digital health to support communication in clinical practice. We have identified facilitators and barriers for future practice. Further work should identify the levels of support needed for organisations to ensure that digital health interventions are meaningfully used to help palliative care professionals effectively communicate with patients, caregivers and staff.
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Affiliation(s)
- Sarah Stanley
- Marie Curie Hospice Liverpool, Liverpool, L25 8QA, United Kingdom.
- Liverpool John Moores University, Liverpool, United Kingdom.
| | - Anne Finucane
- Clinical Psychology, University of Edinburgh, Edinburgh, United Kingdom
- Marie Curie Hospice Edinburgh, Edinburgh, United Kingdom
| | - Anthony Thompson
- St Helens and Knowsley NHS Foundation Trust, Prescot, United Kingdom
| | - Amara Callistus Nwosu
- Marie Curie Hospice Liverpool, Liverpool, L25 8QA, United Kingdom
- Lancaster Medical School, Lancaster University, Lancaster, United Kingdom
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom
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Abdul Rehman M, Naeem U, Rani A, Banatwala UESS, Salman A, Abdullah Khalid M, Ikram A, Tahir E. How well does the virtual format of oncology multidisciplinary team meetings work? An assessment of participants' perspectives and limitations: A scoping review. PLoS One 2023; 18:e0294635. [PMID: 37972143 PMCID: PMC10653537 DOI: 10.1371/journal.pone.0294635] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 11/05/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Virtual multidisciplinary team meetings (VMDTM) provide a standard of care that is not limited by physical distance or social restrictions. And so, when the COVID-19 pandemic imposed irrefutable social restrictions and made in-person meetings impossible, many hospitals switched to the VMDTMs. Although the pandemic might have highlighted the ease of VMDTMs, these virtual meetings have existed over the past decade, albeit less in importance. Despite their recent importance, no review has previously assessed the feasibility of VMDTMs through the eyes of the participants, the barriers participants face, nor their comparison with the in-person format. We undertook this scoping review to map existing literature and assess the perspectives of VMDTM participants. MATERIAL AND METHODS We searched MEDLINE, Embase, CINAHL, and Google Scholar from inception till July 1st, 2023 to select studies that evaluated the perspectives of participants of VMDTMs regarding the core components that make up a VMDMT. Four authors, independently, extracted data from all included studies. Two authors separated data into major themes and sub-themes. RESULTS We identified six core, intrinsic aspects of a VMDTM that are essential to its structure: (1) organization, (2) case discussion and decision-making, (3) teamwork and communication, (4) training and education, (5) technology, and (6) patient-related aspect. VMDTMs have a high overall satisfaction rating amongst participants. The preference, however, is for a hybrid model of multidisciplinary teams. VMDTMs offer support to isolated physicians, help address complex cases, and offer information that may not be available elsewhere. The periodical nature of VMDTMs is appropriate for their consideration as CMEs. Adequate technology is paramount to the sustenance of the format. CONCLUSION VMDTMs are efficient and offer a multidisciplinary consensus without geographical limitations. Despite certain technical and social limitations, VMDTM participants are highly satisfied with the format, although the preference lies with a hybrid model.
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Affiliation(s)
- Muhammad Abdul Rehman
- Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Unaiza Naeem
- Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Anooja Rani
- Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | | | - Afia Salman
- Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Muhammad Abdullah Khalid
- Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Areeba Ikram
- Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Erfa Tahir
- Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
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Virtanen L, Kaihlanen AM, Saukkonen P, Reponen J, Lääveri T, Vehko T, Saastamoinen P, Viitanen J, Heponiemi T. Associations of perceived changes in work due to digitalization and the amount of digital work with job strain among physicians: a national representative sample. BMC Med Inform Decis Mak 2023; 23:252. [PMID: 37940995 PMCID: PMC10631156 DOI: 10.1186/s12911-023-02351-9] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 10/24/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Physicians' work is often stressful. The digitalization of healthcare aims to streamline work, but not all physicians have experienced its realization. We examined associations of perceived changes in work due to digitalization and the amount of digital work with job strain among physicians. The moderating role of the length of work experience was investigated for these associations. METHODS We used representative survey data on Finnish physicians' (N = 4271) experiences of digitalization from 2021. The independent variables included perceptions on statements about work transformations aligned with digitalization goals, and the extent that information systems and teleconsultations were utilized. Stress related to information systems (SRIS), time pressure, and psychological stress were the dependent variables. We analyzed the associations using multivariable linear and logistic regressions. RESULTS Respondents had a mean SRIS score of 3.5 and a mean time pressure score of 3.7 on a scale of 1-5. Psychological stress was experienced by 60%. Perceptions associated with higher SRIS comprised disagreements with statements asserting that digitalization accelerates clinical encounters (b = .23 [95% CI: .16-.30]), facilitates access to patient information (b = .15 [.07-.23]), and supports decision-making (b = .11 [.05-.18]). Disagreement with accelerated clinical encounters (b = .12 [.04-.20]), and agreements with patients' more active role in care (b = .11 [.04-.19]) and interprofessional collaboration (b = .10 [.02-.18]) were opinions associated with greater time pressure. Disagreeing with supported decision-making (OR = 1.26 [1.06-1.48]) and agreeing with patients' active role (OR = 1.19 [1.02-1.40]) were associated with greater psychological stress. However, perceiving improvements in the pace of clinical encounters and access to patient information appeared to alleviate job strain. Additionally, extensive digital work was consistently linked to higher strain. Those respondents who held teleconsultations frequently and had less than 6 years of work experience reported the greatest levels of time pressure. CONCLUSIONS Physicians seem to be strained by frequent teleconsultations and work that does not meet the goals of digitalization. Improving physicians' satisfaction with digitalization through training specific to the stage of career and system development can be crucial for their well-being. Schedules for digital tasks should be planned and allocated to prevent strain related to achieving the digitalization goals.
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Affiliation(s)
- Lotta Virtanen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, P.O.Box 30, 00271, Helsinki, Finland.
| | - Anu-Marja Kaihlanen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, P.O.Box 30, 00271, Helsinki, Finland
| | - Petra Saukkonen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, P.O.Box 30, 00271, Helsinki, Finland
| | - Jarmo Reponen
- Research Unit of Health Sciences and Technology, University of Oulu, P.O.Box 5000, 90014, Oulu, Finland
- Medical Research Center, Oulu University Hospital and University of Oulu, P.O.Box 8000, 90014, Oulu, Finland
| | - Tinja Lääveri
- Department of Infectious Diseases, University of Helsinki and Helsinki University Hospital, P.O.Box 700, 00029, Helsinki, Finland
- Department of Computer Science, Aalto University, P.O.Box 15400, 00076, Espoo, Finland
| | - Tuulikki Vehko
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, P.O.Box 30, 00271, Helsinki, Finland
| | | | - Johanna Viitanen
- Department of Computer Science, Aalto University, P.O.Box 15400, 00076, Espoo, Finland
| | - Tarja Heponiemi
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, P.O.Box 30, 00271, Helsinki, Finland
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Venkataramanan R, Pradhan A, Kumar A, Alajlani M, Arvanitis TN. Role of digital health in coordinating patient care in a hub-and-spoke hierarchy of cancer care facilities: a scoping review. Ecancermedicalscience 2023; 17:1605. [PMID: 37799945 PMCID: PMC10550326 DOI: 10.3332/ecancer.2023.1605] [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: 03/30/2023] [Indexed: 10/07/2023] Open
Abstract
Background Coordinating cancer care is complicated due to the involvement of multiple service providers which often leads to fragmentation. The evolution of digital health has led to the development of technology-enabled models of healthcare delivery. This scoping review provides a comprehensive summary of the use of digital health in coordinating cancer care via hub-and-spoke models. Methods A scoping review of the literature was undertaken using the framework developed by Arksey and O'Malley. Research articles published between 2010 and 2022 were retrieved from four electronic databases (PubMed/MEDLINE, Web of Sciences, Cochrane Reviews and Global Health Library). The preferred reporting items for systematic reviews and meta-analyses extension for the scoping reviews (PRISMA-ScR) checklist were followed to present the findings. Result In total, 311 articles were found of which 7 studies that met the inclusion criteria were included. The use of videoconferencing was predominant across all the studies. The number of spokes varied across the studies ranging from 1 to 63. Three studies aimed to evaluate the impact on access to cancer care among patients, two studies were related to capacity building of the health care workers at the spoke sites, one study was based on a peer review of radiotherapy plans, and one study was related to risk assessment and patient navigation. The introduction of digital health led to reduced travel time and waiting period for patients, and standardisation of radiotherapy plans at spokes. Tele-mentoring intervention aimed at capacity-building resulted in higher confidence and increased knowledge among the spoke learners. Conclusion There is limited evidence for the role of digital health in the hub-and-spoke design. Although all the studies have highlighted the digital components being used to coordinate care, the bottlenecks, Which were overcome during the implementation of the interventions and the impact on cancer outcomes, need to be rigorously analysed.
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Affiliation(s)
- Ramachandran Venkataramanan
- Institute of Digital Healthcare, WMG, University of Warwick, CV4 7AL Coventry, UK
- Strategy and Research Wing, Karkinos Healthcare, Mumbai 400086, India
| | - Akash Pradhan
- Strategy and Research Wing, Karkinos Healthcare, Mumbai 400086, India
| | - Abhishek Kumar
- Strategy and Research Wing, Karkinos Healthcare, Mumbai 400086, India
| | - Mohannad Alajlani
- Institute of Digital Healthcare, WMG, University of Warwick, CV4 7AL Coventry, UK
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Thiagarajan S, Poojari V, Tuljapurkar V, Ghosh-Laskar S, Fatehi K, Babu S, Penumadu P, Patil A, Joshi A, Kumar S, Chaukar D, Kannan R, Pramesh CS. National Cancer Grid Virtual Tumor Boards of Head and Neck Cancers: An Innovative Approach to Multidisciplinary Care. JCO Glob Oncol 2023; 9:e2200348. [PMID: 36706349 PMCID: PMC10166436 DOI: 10.1200/go.22.00348] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
PURPOSE Virtual tumor board (VTB) via videoconference facility involving multiple specialists in the decision making for various tumors is well accepted, especially in high-income countries. Information on virtual tumor boards for head and neck cancers especially from low- and middle-income countries is sparse. In this study, we have audited the findings of the National Cancer Grid VTBs performed for head and neck cancers. METHODS All patients discussed in the head and neck VTBs at our center between December 2016 and February 2022 were included in the study. Details such as the type of institute sending patients for discussion, its location, subsites within the head and neck region, histopathology, treatment setting or question for the VTB, and availability of guidelines for such patient scenarios were assessed. Also, a survey was sent to assess the usefulness of the VTBs. RESULTS A total of 208 patients were discussed in 54 VTB sessions. The most common head and neck sites discussed in the VTBs were the oral cavity (n = 64, 30.7%) followed by skull base/nose and paranasal sinuses/eyelid-orbit tumors (n = 49, 23.5%). Nonsquamous cell carcinoma was the most common histopathology discussed; recurrent cancers/residual diseases were the most common treatment settings (n = 134, 64.4%) for which there were no existing guidelines. Survey results showed that most VTB decisions were implementable, and respondents felt that VTBs were a useful educational tool as well. CONCLUSION Our study affirms the feasibility of VTBs in low- and middle-income countries' health care systems for managing uncommon malignancies and clinical situations, which act as an important educational platform.
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Affiliation(s)
- Shivakumar Thiagarajan
- Department of Head and Neck Oncology, Tata Memorial Centre and Homi Bhabha National Institute (HBNI), Mumbai, India
| | | | - Vidisha Tuljapurkar
- Department of Head and Neck Oncology, Tata Memorial Centre and Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Sarbani Ghosh-Laskar
- Department of Radiation Oncology, Tata Memorial Centre and Homi Bhabha National Institute (HBNI), Mumbai, India
| | | | | | | | - Asawari Patil
- Department of Pathology, Tata Memorial Centre and Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Amit Joshi
- Department of Medical Oncology, Tata Memorial Centre and Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Suman Kumar
- Department of Radiology, Tata Memorial Centre and Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Devendra Chaukar
- Department of Head and Neck Oncology, Tata Memorial Centre and Homi Bhabha National Institute (HBNI), Mumbai, India
| | | | - C S Pramesh
- Tata Memorial Hospital, Surgical Oncology, Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
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