References of "Ethgen, Olivier"
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See detailDevelopment and validation of the ORACLE score to predict risk of osteoporosis
Richy, F.; Deceulaer, F.; Ethgen, Olivier ULg et al

in Mayo Clinic Proceedings (2004), 79(11), 1402-1408

OBJECTIVE: To develop and validate a composite index, the Osteoporosis Risk Assessment by Composite Linear Estimate (ORACLE), that includes risk factors and ultrasonometric outcomes to screen for ... [more ▼]

OBJECTIVE: To develop and validate a composite index, the Osteoporosis Risk Assessment by Composite Linear Estimate (ORACLE), that includes risk factors and ultrasonometric outcomes to screen for osteoporosis. SUBJECTS AND METHODS: Two cohorts of postmenopausal women aged 45 years and older, participated in the development (n = 407) and the validation (n = 202) of ORACLE. Their bone mineral density was determined by dual energy x-ray absorptiometry and quantitative ultrasonometry (QUS), and their historical and clinical risk factors were assessed (January to June 2003). Logistic regression analysis was used to select significant predictors of bone mineral density, whereas receiver operating characteristic (ROC) analysis was used to assess the discriminatory performance of ORACLE. RESULTS: The final logistic regression model retained 4 biometric or historical variables and 1 ultrasonometric outcome. The ROC areas under the curves (AUCs) for ORACLE were 84% for the prediction of osteoporosis and 78% for low bone mass. A sensitivity of 90% corresponded to a specificity of 50% for identification of women at risk of developing osteoporosis. The corresponding positive and negative predictive values were 86% and 54%, respectively, in the development cohort. In the validation cohort, the AUCs for identification of osteoporosis and low bone mass were 81% and 76% for ORACLE, 69% and 64% for QUS T score, 71% and 68% for QUS ultrasonometric bone profile index, and 76% and 75% for Osteoporosis Self-assessment Tool, respectively. ORACLE had the best discriminatory performance in identifying osteoporosis compared with the other approaches (P < .05). CONCLUSION: ORACLE exhibited the highest discriminatory properties compared with ultrasonography alone or other previously validated risk indices. It may be helpful to enhance the predictive value of QUS. [less ▲]

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See detailTime dependent risk of gastrointestinal complications induced by non-steroidal anti-inflammatory drug use: a consensus statement using a meta-analytic approach
Richy, F.; Bruyère, Olivier ULg; Ethgen, Olivier ULg et al

in Annals of the Rheumatic Diseases (2004), 63(7), 759-766

OBJECTIVES: To provide an updated document assessing the global, NSAID-specific, and time dependent risk of gastrointestinal (GI) complications through meta-analyses of high quality studies. METHODS: An ... [more ▼]

OBJECTIVES: To provide an updated document assessing the global, NSAID-specific, and time dependent risk of gastrointestinal (GI) complications through meta-analyses of high quality studies. METHODS: An exhaustive systematic search was performed. Inclusion criteria were: RCT or controlled study, duration of 5 days at least, inactive control, assessment of minor or major NSAID adverse effects, publication range January 1985 to January 2003. The publications retrieved were assessed during a specifically dedicated WHO meeting including leading experts in all related fields. Statistics were performed conservatively. Meta-regression was performed by regressing NSAID adjusted estimates against study duration categories. RESULTS: Among RCT data, indolic derivates provided a significantly higher risk of GI complications related to NSAID use than for non-users: RR = 2.25 (1.00; 5.08) than did other compounds: naproxen: RR = 1.83 (1.25; 2.68); diclofenac: RR = 1.73 (1.21; 2.46); piroxicam: RR = 1.66 (1.14; 2.44); tenoxicam: RR = 1.43 (0.40; 5.14); meloxicam: RR = 1.24 (0.98; 1.56), and ibuprofen: RR = 1.19 (0.93; 1.54). Indometacin users had a maximum relative risk for complication at 14 days. The other compounds presented a better profile, with a maximum risk at 50 days. Significant additional risk factors included age, dose, and underlying disease. The controlled cohort studies provided higher estimates: RR = 2.22 (1.7; 2.9). Publication bias testing was significant, towards a selective publication of deleterious effects of NSAIDs from small sized studies. CONCLUSION: This meta-analysis characterised the "compound" and "time" aspects of the GI toxicity of non-selective NSAIDs. The risk/benefit ratio of such compounds should thus be carefully and individually evaluated at the start of long term treatment. [less ▲]

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See detailHealth-related quality of life in total hip and total knee arthroplasty - A qualitative and systematic review of the literature
Ethgen, Olivier ULg; Bruyère, Olivier ULg; Richy, Florent et al

in Journal of Bone & Joint Surgery. American Volume (2004), 86(5), 963-974

BACKGROUND: Total hip and total knee arthroplasties are well accepted as reliable and suitable surgical procedures to return patients to function. Health-related quality-of-life instruments have been used ... [more ▼]

BACKGROUND: Total hip and total knee arthroplasties are well accepted as reliable and suitable surgical procedures to return patients to function. Health-related quality-of-life instruments have been used to document outcomes in order to optimize the allocation of resources. The objective of this study was to review the literature regarding the outcomes of total hip and knee arthroplasties as evaluated by health-related quality-of-life instruments. METHODS: The Medline and EMBASE medical literature databases were searched, from January 1980 to June 2003, to identify relevant studies. Studies were eligible for review if they met the following criteria: (1). the language was English or French, (2). at least one well-validated and self-reported health-related quality of life instrument was used, and (3). a prospective cohort study design was used. RESULTS: Of the seventy-four studies selected for the review, thirty-two investigated both total hip and total knee arthroplasties, twenty-six focused on total hip arthroplasty, and sixteen focused on total knee arthroplasty exclusively. The most common diagnosis was osteoarthritis. The duration of follow-up ranged from seven days to seven years, with the majority of studies describing results at six to twelve months. The Short Form-36 and the Western Ontario and McMaster University Osteoarthritis Index, the most frequently used instruments, were employed in forty and twenty-eight studies, respectively. Seventeen studies used a utility index. Overall, total hip and total knee arthroplasties were found to be quite effective in terms of improvement in health-related quality-of-life dimensions, with the occasional exception of the social dimension. Age was not found to be an obstacle to effective surgery, and men seemed to benefit more from the intervention than did women. When improvement was found to be modest, the role of comorbidities was highlighted. Total hip arthroplasty appears to return patients to function to a greater extent than do knee procedures, and primary surgery offers greater improvement than does revision. Patients who had poorer preoperative health-related quality of life were more likely to experience greater improvement. CONCLUSIONS: Health-related quality-of-life data are valuable, can provide relevant health-status information to health professionals, and should be used as a rationale for the implementation of the most adequate standard of care. Additional knowledge and scientific dissemination of surgery outcomes should help to ensure better management of patients undergoing total hip or total knee arthroplasty and to optimize the use of these procedures. [less ▲]

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See detailRisk assessment tools for osteoporosis: scope and limits
Richy, Florent; Gourlay, M.; Ross, P. et al

in Osteoporosis International (2004, May), 15(Suppl.1), 11

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See detailBMD in men: which normative data?
Richy, Florent; Gourlay, M.; Ethgen, Olivier ULg et al

in Osteoporosis International (2004, May), 15(Suppl.1), 54

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See detailDo patients with osteoporotic hip fracture recover their initial health-related quality of life?
Ethgen, Olivier ULg; Tancredi, Annalisa ULg; Jacques, Jessica ULg et al

in Osteoporosis International (2004, May), 15(Suppl.1), 50

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See detailEfficacy of alphacalcidol and calcitriol in primary and corticosteroid-induced osteoporosis: a meta-analysis of their effects on bone mineral density and fracture rate
Richy, F.; Ethgen, Olivier ULg; Bruyère, Olivier ULg et al

in Osteoporosis International (2004), 15(4), 301-310

Vitamin D metabolites alphacalcidol and calcitriol (D-hormones) have been investigated for two decades, but few and conflicting results are available from high-quality randomized controlled trials. Our ... [more ▼]

Vitamin D metabolites alphacalcidol and calcitriol (D-hormones) have been investigated for two decades, but few and conflicting results are available from high-quality randomized controlled trials. Our objectives were to provide an evidence-based update quantitatively summarizing their efficacy on bone mineral density (BMD) and fracture rate. We performed a systematic research of any randomized controlled trial containing relevant data, peer review, data extraction and quality scoring blinded for authors and data sources, and comprehensive meta-analyses of the relevant data. Inclusion criteria were: randomized controlled study, calcitriol or alphacalcidol, BMD or fractures in healthy/osteopenic/osteoporotic patients exposed or not to corticosteroids (CS). Analyses were performed in a conservative fashion using professional dedicated softwares and stratified by outcome, target patients, study quality, and control-group type. Results were expressed as effect size (ES) for bone loss or relative risk (RR) for fracture while allocated to D-hormones vs control. Publication bias and robustness were investigated. Of the trials that were retrieved and subsequently reviewed, 17 papers fitted the inclusion criteria and were assessed. Quality scores ranged from 20 to 100%, the mean (standard deviation) being 72 (22)%. Calcitriol and alphacalcidol were found to have the same efficacy on all outcomes at p>0.13. We globally assessed D-hormones effects in preventing bone loss in patients not exposed to CS, and found positive effect: ES=0.39 (p<0.001). For lumbar spine, this particular effect was 0.43 (p<0.001). D-hormones significantly reduced the overall fracture rates: RR=0.52 (0.46; 0.59) and both vertebral and non-vertebral fractures: RR=0.53 (0.47; 0.60) and RR=0.34 (0.16; 0.71), respectively. No statistical difference in response was observed between results from studies on healthy and osteoporotic patients or depending on the fact that controls were allowed to calcium supplementation. Treatment with D-hormones was evaluated for maintaining spinal bone mass in five trials of patients with CS-induced osteoporosis, and provided ES=0.43 at p<0.001. Only two studies specifically addressed the effects of calcitriol on spinal fracture rate. None of them provided significant results, and the global RR did not reach the significance level as well: RR=0.33 (0.07; 1.51). Our data demonstrated efficacy for DH on bone loss and fracture prevention in patients not exposed to CS and on bone loss in patients exposed to CS, in the light of the most reliable scientific evidence. Their efficacy in reducing the number of fractures in patients exposed to CS remains to be determined. [less ▲]

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See detailSocial support and health-related quality of life in hip and knee osteoarthritis
Ethgen, Olivier ULg; Vanparijs, Philippe ULg; Delhalle, S. et al

in Quality of Life Research (2004), 13(2), 321-330

Objective: To document the association between social support and health-related quality of life (HRQoL) in hip and knee osteoarthritis (OA). Methods: A prospective survey including the SF-36 and the ... [more ▼]

Objective: To document the association between social support and health-related quality of life (HRQoL) in hip and knee osteoarthritis (OA). Methods: A prospective survey including the SF-36 and the Social Support questionnaire (SSQ) was administered to 108 hip and knee OA patients attending an outpatient physical rehabilitation and rheumatology clinic. Multiple regression analysis were performed to study the relation between social support and each dimension of the SF-36, controlling for age, sex, body mass index, number of comorbid conditions, socioeconomic status, site of survey completion and severity of OA which was gauged with the pain dimension of the WOMAC, an OA-specific health status instrument. Results: Greater social companionship transactions were associated with higher physical functioning ( standardized regression coefficients: beta = 0.26, p < 0.01), general health (β = 0.32, p < 0.001), mental health (beta = 0.25, p < 0.01), social functioning (β = 0.20, p < 0.05) and vitality ( b = 0.25, p < 0.05). Satisfaction with problem-oriented emotional support was related to better physical functioning (β = 0.22, p < 0.01), mental health (beta = 0.38, p < 0.001), role-emotional (B = 0.23, p < 0.01), social functioning (beta = 0.19, p < 0.05) and vitality ( b = 0.26, p < 0.01). Conclusion: Social support components significantly account for HRQoL. Health interventions in OA, primary dedicated to pain and physical disability, could be supplemented with social support component to enhance health outcomes. [less ▲]

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See detailDegenerative musculoskeletal disease
Ethgen, Olivier ULg; Reginster, Jean-Yves ULg

in Annals of the Rheumatic Diseases (2004), 63(1), 1-3

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See detailValidation and comparative evaluation of the osteoporosis self-assessment tool (OST) in a Caucasian population from Belgium
Richy, F.; Gourlay, M.; Ross, P. D. et al

in QJM : Monthly Journal of the Association of Physicians (2004), 97(1), 39-46

BACKGROUND: Risk indices have been developed to identify women at risk of low bone mineral density (BMD) who should undergo BMD testing. Aim: To compare the performance of four risk indices in White ... [more ▼]

BACKGROUND: Risk indices have been developed to identify women at risk of low bone mineral density (BMD) who should undergo BMD testing. Aim: To compare the performance of four risk indices in White ambulatory women in Belgium. DESIGN: Epidemiological cross-sectional study. METHODS: Records were analysed for 4035 postmenopausal White women without Paget's disease or advanced osteoarthritis, seen at an out-patient osteoporosis centre between January 1996 and September 1999. Osteoporosis risk index scores were compared to bone density T-scores. The ability of each risk index to identify women with low BMD (T-score < -2.0) or osteoporosis (T < -2.5) was evaluated. RESULTS: Using an Osteoporosis Self-Assessment Tool (OST) score <2 to recommend DXA referral, sensitivity ranged from 85% at the lumbar spine to 97% at the total hip to detect BMD T-scores of <or= -2.5, and specificity ranged from 34% at the total hip to 37% at the femoral neck and lumbar spine. The negative predictive value was high at all skeletal sites (89-99%), demonstrating the usefulness of the OST to identify patients who have normal BMD and should not receive DXA testing. All risk indices performed similarly, although the OST had somewhat better sensitivity and somewhat lower specificity than the other indices at the cut-offs evaluated. Among the 11-12% of women who were classified as highest risk using OST or the Osteoporosis Index of Risk (OSIRIS), 81-85% had low bone mass and 68-74% had osteoporosis. DISCUSSION: The performance of these risk indices among women in Belgium was similar to that reported earlier for other samples in Asian countries, the US, and the Netherlands. The OST and other risk indices are effective and efficient tools to help target high-risk women for DXA testing. [less ▲]

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See detailEvaluation of proposals of Belgian Social Security Institute for reimbursement of bone densitometry tests. Toward a cost-effective strategy for osteoporosis screening?
Ben Sedrine, Wafa ULg; Ethgen, Olivier ULg; Devogelaer, Jean-Pierre et al

in Aging Clinical & Experimental Research (2004), 16(5), 413-419

BACKGROUND AND AIMS: The Belgian Social Security Institute (hereafter INAMI) proposes a list of conditions to be considered as a prerequisite for reimbursement of Bone Mineral Density (BMD) measurements ... [more ▼]

BACKGROUND AND AIMS: The Belgian Social Security Institute (hereafter INAMI) proposes a list of conditions to be considered as a prerequisite for reimbursement of Bone Mineral Density (BMD) measurements. The aim of this paper was to evaluate the diagnostic accuracy of the proposed criteria for identifying osteoporosis, and to gauge how useful they are for more rational application of densitometry tests. METHODS: 3748 Caucasian women aged at least 50 years old were recruited consecutively from an outpatient university center, from the database of which all relevant data corresponding to the INAMI list of clinical factors, as well as patients' age, weight and height, were collected. BMD measurements using dual X-ray absorptiometry were reported at the spine and hip regions. Diagnostic accuracy was evaluated through measures of sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). Additionally, from ROC analysis, benchmark values for age and body mass index were identified and then, used alone and in combination with the INAMI test, were applied to define various screening strategies. For each of them, associated costs per osteoporotic patient detected were estimated. Cost estimates refer only to the costs associated with the densitometric procedure from the perspective of the reimbursement health authorities. RESULTS: Applying INAMI criteria for detecting osteoporosis at any of the considered sites yielded sensitivity of 68.9%, specificity of 50.7%, PPV of 42.9% and NPV of 57.3%. Comparison of incremental costs per patient of the different strategies revealed that, with 67.1 Euros, the option of opening BMD coverage to women on the basis of the INAMI conditions would be more cost-effective than mass screening (90.1 Euros) or applying the age criterion alone (70.2 Euros). However, the BMI condition seems to act as a better indicator of risk than the INAMI criteria in those meeting the age condition (35.4 Euros). CONCLUSIONS: The accuracy of the INAMI proposal turns out to be quite unsatisfactory, and did not adequately cover the population at risk of osteoporosis. From a resource allocation perspective, the best strategy by far would be to recommend using concomitantly INAMI, age and BMI-selective criteria. Some adaptations could enhance the usefulness of the INAMI proposals as a selective approach for BMD referral and reimbursement. [less ▲]

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See detailFrom sample size to effect-size : small study effect investigation (SSEi)
Richy, F.; Ethgen, Olivier ULg; Bruyère, Olivier ULg et al

in Internet Journal of Epidemiology (2004), 1(2),

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See detailAge- and sex-stratified prevalence of physical disabilities and handicap in the general population.
Ethgen, Olivier ULg; Gillain, Daniel ULg; Gillet, Pierre ULg et al

in Aging Clinical & Experimental Research (2004), 16(5), 389-97

BACKGROUND AND AIMS: Our aim was to provide age- and sex-stratified prevalence estimates of physical disabilities and handicap in the general Belgian population. METHODS: A cross-sectional and ... [more ▼]

BACKGROUND AND AIMS: Our aim was to provide age- and sex-stratified prevalence estimates of physical disabilities and handicap in the general Belgian population. METHODS: A cross-sectional and demographically representative health interview survey was conducted nationwide in Belgium in 1997. The 8836 persons aged 15 years and over who answered the health interview were included in this study. Seventeen items from the survey encompassing main activities of daily living (ADL) and confining were analyzed. To provide prevalence estimates as detailed as possible, neither aggregation nor dichotomization were applied. RESULTS: Women consistently reported more disability than men: mobility (p < 0.001), transfer in-out bed (p < 0.001), transfer in-out chair (p < 0.001), dressing (p = 0.004), washing hands and face (p = 0.029), getting to and using toilet (p = 0.003), continence (p < 0.001), seeing (p < 0.001) and mastication (p < 0.001). As expected, there was a marked trend for increased prevalence of disability with increasing age for both sexes. Moderate disability arose mainly from the 25-34 age group for both sexes. For both genders, severe disability appeared mainly at higher ages, particularly for the 65-74 age group. Nevertheless, the data suggest that continence problems for women, mobility and transfer issues for men, as well as mastication problems for both genders, clearly emerge earlier than age 65. Regarding handicap, observed prevalence rates were increasing, in age as was the case for disability, but no differences were found between men or women, except for confinement to house/garden, for which women presented a higher rate in general (p < 0.001) and in the 75-84 age group (p = 0.036) in particular. CONCLUSIONS: This study shows the wide range of disability types in the general population and their association with handicap. While elderly individuals consistently report higher degrees of disability and handicap, attention should also be paid to younger age groups. Disability calls for wide, coherent and relevant medical as well as social responses. [less ▲]

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See detailTime-dependent risk of gastrointestinal complications induced by NSAIDS use: a consensus statement using meta-analytic approach
Richy, Florent; Bruyère, Olivier ULg; Ethgen, Olivier ULg et al

in Osteoporosis International (2003, November), 14(Suppl. 7), 9

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See detailDo utility values and willingness to pay suitably reflect health outcome in hip and knee osteoarthritis? A comparative analysis with the WOMAC index
Ethgen, Olivier ULg; Tancredi, Annalisa ULg; Lejeune, Emmanuelle ULg et al

in Journal of Rheumatology (2003), 30(11), 2452-2459

Objective. To establish whether health utility (time trade-off, TTO) and willingness to pay (WTP) values reflect clinical health outcome as evaluated by the Western Ontario McMaster Universities ... [more ▼]

Objective. To establish whether health utility (time trade-off, TTO) and willingness to pay (WTP) values reflect clinical health outcome as evaluated by the Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) in hip and knee osteoarthritis (OA). Methods. One hundred twenty-eight patients with OA attending a specialized arthritis clinic were interviewed about their socioeconomic characteristics and administered the TTO technique and the WOMAC. Their WTP for 2 hypothetical anti-osteoarthritic drugs was also investigated: the first drug was said to provide a significant improvement in WOMAC dimensions and the second a complete cure of the disease. WTP was elicited by both discrete-choice and bidding game methods. Results. Answer rates were 89.1% for TTO, 98.4% for discrete-choice WTP for both scenarios, and 89.8% and 85.2% for bidding game WTP in the relief and the cure scenario, respectively. The mean TTO utility value was 0.84 (standard deviation 0.20). In discrete-choice, those accepting the bid had higher monthly income (euro 1536.5 vs euro 1060. 1, p < 0.001, for the relief scenario and euro 1449.3 vs euro 1071.6, p < 0.001, for the cure scenario). With the bidding game format, WTP was positively correlated with income in both scenarios (r = 0.56, r = 0.55, p < 0.001). WTP measures differed equally between education and socioeconomic groups with those in favored groups consistently reporting higher WTP (Kruskal-Wallis tests statistics ranging from p < 0.01 to p < 0.001). Except for stiffness, WOMAC dimensions were correlated in the expected direction with TTO values (r = -0.27, p < 0.01 for pain and r = -0.36, r = -0.34, p < 0.001 for physical function and total score, respectively). Conclusion. Whereas they showed good feasibility, WTP measures poorly reflected clinical condition and were mainly related to economic status and ability to pay. TTO was correlated with the WOMAC dimensions and may be considered closer to clinical situations than WTP. However, concern arises regarding the homogeneity of the study sample in terms of clinical severity, which may have precluded the identification of a relationship between WTP and clinical status. [less ▲]

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See detailRisk assessment tools for osteoporosis: scope and limits
Richy, Florent; Gourlay, M.; Ross, P. D. et al

in Osteoporosis International (2003, November), 14(Suppl. 7), 68-69

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See detailRational to use OSIRIS® (osteoporosis index of risk) to prescreen for osteoporosis in the general population
Richy, Florent; Gourlay, M.; Ethgen, Olivier ULg et al

in Osteoporosis International (2003, November), 14(Suppl. 7), 67-68

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See detailPhysical function is the most severely impaired health-related quality of life dimension during the aging process
Ethgen, Olivier ULg; Gosset, Christiane ULg; Richy, Florent et al

in Osteoporosis International (2003, November), 14(Suppl. 7), 65

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See detailImpact of osteoarthritis and chronic back pain on health-related quality of life among patients on NSAIDS
Rabenda, Véronique ULg; Ethgen, Olivier ULg; Belaiche, Jacques ULg et al

in Osteoporosis International (2003, November), 14(Suppl. 7), 89-90

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See detailProspective evaluation of health-related quality of life in total hip and knee arthroplasties
Ethgen, Olivier ULg; Tancredi, Annalisa ULg; Brugneaux, C. et al

in Osteoporosis International (2003, November), 14(Suppl. 7), 66

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