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Sio YY, Chew FT. Risk factors of asthma in the Asian population: a systematic review and meta-analysis. J Physiol Anthropol 2021; 40:22. [PMID: 34886907 PMCID: PMC8662898 DOI: 10.1186/s40101-021-00273-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 11/12/2021] [Indexed: 12/15/2022] Open
Abstract
Background and objective An increasing trend of asthma prevalence was observed in Asia; however, contributions of environmental and host-related risk factors to the development of this disease remain uncertain. This study aimed to perform a systematic review and meta-analysis for asthma-associated risk factors reported in Asia. Methods We systematically searched three public databases (Web of Science, PubMed, and Scopus) in Feb 2021. We only included articles that reported environmental and host-related risk factors associated with asthma in the Asian population. Random-effect meta-analyses were conducted for frequently reported asthma-associated risk factors to provide an overall risk estimate of asthma development. Results Of 4030 records obtained from public databases, 289 articles were selected for review. The most frequently reported asthma-associated risk factor was the family history of allergy-related conditions. The random-effect asthma risk estimates (pooled odds ratio, OR) were 4.66 (95% confidence interval (CI): 3.73–5.82) for the family history of asthma, 3.50 (95% CI: 2.62–4.67) for the family history of atopy, 3.57 (95% CI: 3.03–4.22) for the family history of any allergic diseases, 1.96 (95% CI: 1.47–2.61) for the family history of allergic rhinitis, and 2.75 (95% CI: 1.12–6.76) for the family history of atopic dermatitis. For housing-related factors, including the presence of mold, mold spots, mold odor, cockroach, water damage, and incense burning, the random-effect pooled OR ranged from 1.43 to 1.73. Other risk factors with significant pooled OR for asthma development included male gender (1.30, 95% CI: 1.23–1.38), cigarette smoke exposure (1.44, 95% CI: 1.30–1.60), cigarette smoking (1.66, 95% CI: 1.44–1.90), body mass index (BMI)–related parameters (pooled OR ranged from 1.06 to 2.02), various types of air pollution (NO2, PM10, and O3; pooled OR ranged from 1.03 to 1.22), and pre- and perinatal factors (low birth weight, preterm birth, and cesarean section; pooled OR ranged from 1.14 to 1.32). Conclusions The family history of asthma was the most frequently reported risk factor for asthma development in Asia with the highest risk estimate for asthma development. This suggests a major role of the genetic component in asthma pathogenesis. Further study on asthma genetics is required to improve the current understanding of asthma etiology. Supplementary Information The online version contains supplementary material available at 10.1186/s40101-021-00273-x.
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Affiliation(s)
- Yang Yie Sio
- Allergy and Molecular Immunology Laboratory, Lee Hiok Kwee Functional Genomics Laboratories, Department of Biological Sciences, National University of Singapore, Block S2, Level 5, 14 Science Drive 4, off Lower Kent Ridge Road, 117543, Singapore, Singapore
| | - Fook Tim Chew
- Allergy and Molecular Immunology Laboratory, Lee Hiok Kwee Functional Genomics Laboratories, Department of Biological Sciences, National University of Singapore, Block S2, Level 5, 14 Science Drive 4, off Lower Kent Ridge Road, 117543, Singapore, Singapore.
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Kaushal R, Bhardwaj P, Goel AD, Shekhar S, Kumar P, Goyal JP. Prevalence of Asthma and Sleep-Related Breathing Disorder in School-Going Children. Indian J Community Med 2020; 45:539-542. [PMID: 33623218 PMCID: PMC7877413 DOI: 10.4103/ijcm.ijcm_58_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Accepted: 07/24/2020] [Indexed: 11/12/2022] Open
Abstract
Objective: The main objective of the study was to determine the prevalence of asthma and sleep-related breathing disorder (SRBD) in school-going children. Methods: This school-based, cross-sectional study was conducted among children of age groups of 6–7 and 13–14 years from 31 public and private schools in rural and urban areas of Jodhpur. A pretested and validated questionnaire in Hindi for childhood asthma, International Study of Asthma and Allergies in Childhood questionnaire and 22-item pediatric SRBD scale were used to collect data. Results: A total of 2245 children were screened for asthma and SRBD. The overall prevalence of asthma and SRBD in school children in Jodhpur was 8.0% (95% confidence interval [CI]: 6.9%–9.2%) and 9.5% (95% CI: 8.4–10.8), respectively. Asthma was found to be significantly associated with SRBD in school-going children in Jodhpur (odds ratio: 4.8; 95% CI: 3.3–6.8) on multiple logistic regression analysis. Conclusion: There is a significantly high prevalence of asthma and SRBD with a good association between them in school-going children.
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Affiliation(s)
- Rashmi Kaushal
- School of Public Health, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Pankaj Bhardwaj
- Community and Family Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Akhil Dhanesh Goel
- Community and Family Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Shashank Shekhar
- Obstetrics and Gynecology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Prawin Kumar
- Pediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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Hooper LG, Dieye Y, Ndiaye A, Diallo A, Fan VS, Neuzil KM, Ortiz JR. Estimating pediatric asthma prevalence in rural senegal: A cross-sectional survey. Pediatr Pulmonol 2017; 52:303-309. [PMID: 27551858 DOI: 10.1002/ppul.23545] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 07/12/2016] [Accepted: 07/22/2016] [Indexed: 12/13/2022]
Abstract
RATIONALE In Senegal, the prevalence of childhood asthma and utilization of appropriate asthma therapies is unknown. METHODOLOGY We used the International Study of Asthma and Allergies in Childhood (ISAAC) survey instrument to assess childhood respiratory health in rural Senegal. We interviewed the caregivers of children aged 5 through 8 years of age in the four largest Niakhar villages in August 2012. RESULTS We interviewed 1,103 primary caregivers for 1,513 children, representing 91% of all age-eligible children in the study area. Overall, 206 (14%) children had wheeze at any time in the past, 130 (9%) had wheeze within the past year, and only 41 (3%) reported a clinical diagnosis of asthma. Among children with wheeze within the past year, 81 (62%) had symptoms of severe asthma. Nocturnal cough was reported in 186 (14%) children who denied any history of wheezing illness. Only four (3%) children with wheeze in the past year had ever received bronchodilator therapy. Children with wheeze in the past year were significantly more likely to seek medical care for respiratory symptoms and to be perceived as less healthy than their peers. Children of lower socioeconomic status were significantly more likely to have wheeze. CONCLUSIONS Nearly one in ten children in Niakhar, Senegal had symptoms suggestive of asthma; however, few children have a diagnosis of asthma or use appropriate therapies. This study highlights an opportunity to raise community awareness of asthma in rural Senegal and to increase access to appropriate medical therapies. Pediatr Pulmonol. 2017;52:303-309. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Laura G Hooper
- Department of Medicine, University of Washington, Seattle, Washington
| | | | - Assane Ndiaye
- Institute de Recherche pour le Developpement, Dakar, Senegal
| | - Aldiouma Diallo
- Institute de Recherche pour le Developpement, Dakar, Senegal
| | - Vincent S Fan
- Department of Medicine, University of Washington, Seattle, Washington.,VA Puget Sound Health Care System, Seattle, Washington
| | - Kathleen M Neuzil
- Department of Medicine, University of Washington, Seattle, Washington.,Department of Global Health, University of Washington, Seattle, Washington.,PATH, Seattle, Washington
| | - Justin R Ortiz
- Department of Medicine, University of Washington, Seattle, Washington.,Department of Global Health, University of Washington, Seattle, Washington.,PATH, Seattle, Washington
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Lalu JS, Rakesh PS, Leelamoni K. Prevalence of bronchial asthma and factors associated with it among higher secondary school children in Ernakulam district, Kerala, Southern India. J Family Med Prim Care 2017; 6:311-315. [PMID: 29302539 PMCID: PMC5749078 DOI: 10.4103/2249-4863.220026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Context Bronchial asthma is one of the leading causes of hospitalization and cause of frequent absenteeism among children and adolescents. Studies reporting the prevalence of bronchial asthma among adolescents from India are limited and the available studies report wide geographic variations in the prevalence of bronchial asthma. Aims The current study was aimed to estimate the prevalence of bronchial asthma among higher secondary school children and to identify various factors associated with it in Ernakulam district, Kerala, Southern India. Settings and Design The study was conducted in Ernakulam district, the industrial capital of Kerala. A school-based cross-sectional study was conducted. Subjects and Methods Data were collected from 629 students from 4 randomly selected higher secondary schools using a structured questionnaire. Section on details of respiratory symptoms was adapted from International Union Against Tuberculosis and Lung Disease bronchial symptoms questionnaire. Statistical Analysis Used Descriptive statistics was done with frequencies and percentages and confidence intervals (CIs) were calculated. Univariate and multivariate analysis was done for factors associated with bronchial asthma generating odds ratios (ORs) and 95% CIs. Results A total of 629 students participated in this study. The prevalence of bronchial asthma was estimated to be 9.9% (95% CI = 7.53%-12.27%). Students residing in a rural area (adjusted OR = 1.95, 95% CI = 1.10-3.46) having family history of bronchial asthma (adjusted OR = 2.84, 95% CI = 1.57-5.11) and usual exposure to friend's smoke (adjusted OR = 2.16, 95% CI = 1.17-3.97) were significantly associated with bronchial asthma. Conclusions The prevalence of bronchial asthma was higher among higher secondary school students of Ernakulam district. Considering high prevalence and its contributions to morbidity and mortality, a comprehensive program to tackle the issue of chronic respiratory diseases may be needed. The issue of active and passive smoking at schools exists and need to be resolved.
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Affiliation(s)
- Jishnu Sathees Lalu
- Department of Community Medicine, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - P S Rakesh
- Department of Community Medicine, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - K Leelamoni
- Department of Community Medicine, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
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Mirzaei M, Karimi M, Beheshti S, Mohammadi M. Prevalence of asthma among Middle Eastern children: A systematic review. Med J Islam Repub Iran 2016. [PMID: 28638816 PMCID: PMC5473014 DOI: 10.18869/mjiri.31.9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Background: The prevalence of asthma and allergy has increased during the last decades, especially in children. However, little is known about it in the Middle East region. This systematic review is aimed to estimate the prevalence of asthma among the Middle Eastern children.
Methods: Local and international scientific databases including SID, Iranmedex, Medline and Science Direct were systematically searched for relevant keywords including; asthma, prevalence, children, International Study of Asthma and Allergies in Childhood (ISACC) and the names of Middle Eastern countries for the period of 1996-2011. Papers in Persian and English which met the defined criteria were included into the study. Bibliographies of the extracted articles were also searched. After extraction of data, heterogeneity between studies and publication bias were measured using Egger's-test. Effect size was pooled by the random-effect model. Since significant heterogeneity was found between studies, univariate meta-regression analyses were done to assess the association of variables with the overall results.
Results: Fifty studies in the Middle East examined the prevalence of asthma and allergy in children under the age of 18 years according to the ISAAC criteria and were included. A total number of 289,717 children were examined in the included studies and the prevalence varied from 0.7 % in Isfahan to 22.3 % in Bagdad. The total prevalence of diagnosed asthma was calculated 7.53 % (95% Cl: 6.38-8.75). Prevalence of asthma in the 13-14 years age group was 7.57% (95% Cl: 5.78-9.29) and in 6-7 years age group was 7.43% (95% Cl: 5.75-9.10). The prevalence of asthma among girls, based on random effect model, was 6.30% (95% Cl: 4.97-7.61) and among boys, it was 8.91% (95% Cl: 6.80-11.04).
Conclusion: The prevalence of asthma in the Middle East is lower than most developed countries. However, there is not enough longitudinal data to estimate the trend over time. In order to have more accurate estimates and to provide evidence for proper planning, standard epidemiologic studies should be conducted in countries of the region.
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Affiliation(s)
- Masoud Mirzaei
- Yazd Cardiovascular Research Centre, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mehran Karimi
- Department of Pediatrics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Shima Beheshti
- Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Masoud Mohammadi
- Department of Social Medicine, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Zhu WJ, Ma HX, Cui HY, Lu X, Shao MJ, Li S, Luo YQ, Wang Q, Xu CY, Xu DQ, Liu CH, Chen YZ. Prevalence and Treatment of Children's Asthma in Rural Areas Compared with Urban Areas in Beijing. Chin Med J (Engl) 2015; 128:2273-7. [PMID: 26315071 PMCID: PMC4733796 DOI: 10.4103/0366-6999.163381] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND The prevalence of childhood asthma has been increasing in China. This study aimed to compare the prevalence, diagnosis, and treatment of asthmatic children from urban and rural areas in Beijing, China. METHODS Schools, communities, and kindergartens were randomly selected by cluster random sampling from urban and rural areas in Beijing. Parents were surveyed by the same screening questionnaires. On-the-spot inquiries, physical examinations, medical records, and previous test results were used to diagnose asthmatic children. Information on previous diagnoses, treatments, and control of symptoms was obtained. RESULTS From 7209 children in rural areas and 13,513 children in urban areas who completed screening questionnaires, 587 children were diagnosed as asthma. The prevalence of asthma in rural areas was lower than in urban areas (1.25% vs. 3.68%, χ2 = 100.80, P < 0.001). The diagnosis of asthma in rural areas was lower than in urban areas (48.9% vs. 73.9%, χ2 = 34.6, P < 0.001). Compared with urban asthmatic children (56.5%), only 35.6% of rural asthmatic children received inhaled corticosteroids (P < 0.05). The use of bronchodilators was also lower in rural areas than in urban areas (56.5% vs. 66.4%, χ2 = 14.2, P < 0.01). CONCLUSION The prevalence of asthma in children was lower in rural areas compared with children in the urban area of Beijing. A considerable number of children were not diagnosed and inadequately treated in rural areas.
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Affiliation(s)
- Wen-Jing Zhu
- Center for Asthma Prevention and Education, Capital Institute of Pediatrics, Beijing 100020, China
| | - Hai-Xia Ma
- Department of Pediatrics, Liangxiang Hospital, Fangshan District, Beijing 102401, China
| | - Hui-Ying Cui
- Department of Pediatrics, Tongzhou Maternal and Child Health Hospital, Beijing 101199, China
| | - Xu Lu
- Department of Pediatrics, Tongzhou Maternal and Child Health Hospital, Beijing 101199, China
| | - Ming-Jun Shao
- Center for Asthma Prevention and Education, Capital Institute of Pediatrics, Beijing 100020, China
| | - Shuo Li
- Center for Asthma Prevention and Education, Capital Institute of Pediatrics, Beijing 100020, China
| | - Yan-Qing Luo
- Center for Asthma Prevention and Education, Capital Institute of Pediatrics, Beijing 100020, China
| | - Qiang Wang
- Institute of Environmental Health and Related Product Safety, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Chun-Yu Xu
- Institute of Environmental Health and Related Product Safety, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Dong-Qun Xu
- Institute of Environmental Health and Related Product Safety, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Chuan-He Liu
- Center for Asthma Prevention and Education, Capital Institute of Pediatrics, Beijing 100020, China
| | - Yu-Zhi Chen
- Center for Asthma Prevention and Education, Capital Institute of Pediatrics, Beijing 100020, China
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Kumar GS, Roy G, Subitha L, Sahu SK. Prevalence of bronchial asthma and its associated factors among school children in urban Puducherry, India. J Nat Sci Biol Med 2014; 5:59-62. [PMID: 24678199 PMCID: PMC3961954 DOI: 10.4103/0976-9668.127289] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Bronchial asthma is an important public health problem at the global level. There is paucity of studies on bronchial asthma among school children in Urban India. OBJECTIVE To assess the prevalence and associated factors of bronchial asthma among school children. MATERIALS AND METHODS A cross-sectional study was conducted among 263 children studying in the 8(th), 9(th), and 10(th) standard using the modified International Study on Allergy and Asthma in Childhood questionnaire in Urban Puducherry. Data on associated factors that include family history of asthma, type of fuel used for cooking, placement of kitchen in the house, number of windows in sleeping room, pet animals, smoking among family members, birth order, and smoke outlet were collected. Data were analyzed by univariate analysis and expressed in proportion or percentages. RESULTS Prevalence of ever bronchial asthma was found to be 5.3%, of which 4.2% had current episode of asthma during the last 1-year period. About 72.7% of the current asthmatics had cold or rhinitis and 54.5% each had itching or rashes and nocturnal dry cough. Prevalence is more among the 12-13 years age group (6.5%) compared to the 14-16 years age group (3.6%). Boys (5.4%) and girls (5.2%) had comparable prevalence rates. The prevalence was significantly more among those with a family history of asthma, having smoking habits in any of the family members, and the absence of smoke outlet in the house (P < 0.05). CONCLUSION Bronchial asthma is an important health problem among children in urban Puducherry. Intervention on exposure to passive smoking and provision of smoke outlets may help to reduce the burden of disease at the community level.
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Affiliation(s)
- Ganesh S Kumar
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Gautam Roy
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - L Subitha
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Swaroop Kumar Sahu
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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Grover C, Goel N, Chugh K, Gaur SN, Armour C, van Asperen PP, Moles RJ, Saini B. Medication use in Indian children with asthma: the user's perspective. Respirology 2014; 18:807-13. [PMID: 23489243 DOI: 10.1111/resp.12081] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2012] [Revised: 12/14/2012] [Accepted: 12/20/2012] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVE Despite the high prevalence of asthma in children, there has been limited research into patient perception of medication use, particularly in the developing world. This study therefore aimed to carry out an in-depth exploration of the views of carers and children with asthma on asthma medication use. METHODS Grounded theory approach was used to conduct semistructured qualitative interviews in a purposive convenience sample of parents and children with asthma. The participants were recruited from two specialty hospitals in New Delhi, India. Interviews were tape-recorded, transcribed verbatim and thematically analysed. RESULTS Twenty children (7-12 years old) with asthma and their parent or carer were interviewed in July 2011. Major reported issues included poor parent and child understanding of disease and medications. Fears, misinformed beliefs and lack of self-management skills were apparent. Child self-image, resistance to medication use and lack of responsibility in medication taking were themes that emerged from child interviews. CONCLUSIONS This is one of the first research studies exploring the viewpoint of children with asthma about their medications. Resource constraints dictate a pragmatic paternalistic approach by physicians which, in contrast to patients in westernized nations, seems to be acceptable and satisfactory to Indian patients (carers).
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Exposure to cats: update on risks for sensitization and allergic diseases. Curr Allergy Asthma Rep 2013; 12:413-23. [PMID: 22878928 DOI: 10.1007/s11882-012-0288-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Cats are the pets most commonly implicated in the etiology of asthma and allergic disease. However, systematic reviews have concluded that there is a lack of evidence to support the idea that cat exposure in early life increases the risk of allergic disease. Indeed, it appears most likely that cat exposure is protective against allergic diseases. Recent large prospective studies have shown that living with a cat during childhood, especially during the first year of a child's life, could be protective. However, any advice given to the parents should also incorporate how new acquisition of cats can affect other family members, especially those who are already sensitized. Research is urgently needed to determine whether the suggested impact of acquisition of cats in adult life is modified by the person's childhood pet ownership, to help parents who seek advice on whether or not to get a cat.
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