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Introduction: Abdominal aortic aneurysm is a localized widening, located below the renal arteries. The exact etiology is not fully understood. Probably the main role in the formation of abdominal aortic aneurysm plays a correlation between genetic and environmental factors, especially smoking. The disease is primarily diagnosed in older men although in recent years there is an increased prevalence of the disease among women. Untreated abdominal aortic aneurysm increases in size until it ruptures, which often leads to the death of patient. The disease is generally asymptomatic and most of the aneurysms are detected accidentally, eg., during ultrasound examination of the abdominal cavity.Literature search: The PubMed database was searched in order to collect the literature needed to elaborate the aspects of abdominal aortic aneurysm epidemiology. The search was limited to the review of the original publication from the last 10 years.Conclusions: Analysis of the results indicates that the incidence of abdominal aortic aneurysm in Australia is higher than in America and Europe. The total incidence in Western countries is higher than in Asia. AAA incidence in men is higher than in women. Aneurysms having a diameter of 30 to 39 mm were diagnosed more often than aneurysms with a diameter of more than 40 mm.
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Objectives: There are few studies about the association between breathing polluted air and increased risk of cardiovascular diseases and cardiac death in the Middle East. This study aimed to investigate the relation between air pollutants and cardiovascular mortality (based on ICD-10) in Ahvaz. Material and methods: In this ecological study, the data about cardiovascular disease mortality and air pollutants from March 2008 until March 2015 was inquired from the Ahvaz City Authority and the Khuzestan Province Environmental Protection Agency. The quasi-Poisson, second degree polynomial constrained, distributed lag model; using single and cumulative lag structures, adjusted by trend, seasonality, temperature, relative humidity, weekdays and holidays was used for the data analysis purposes. Results: Findings indicated a direct significant relation between an interquartile range (IQR) increase in ozone and cardiovascular deaths among men after 3 days’ lag. There was also a significant relation between an IQR increase in particulate matter below 10 μm and cardiovascular deaths for all people, over 60 years old and under 18 years old after 3 and 13 days’ lags. There was a significant relation between an IQR increase in nitrogen dioxide and carbon monoxide, and cardiovascular deaths in the case of under 18-year-olds (in the lag 11) and over 60-year-olds (in the lag 9), respectively. We finally found a significant association between an IQR increase in sulfur dioxide and cardiovascular deaths in the case of men, under 18-year-olds and from 18- to 60-year-olds in the lag 9, 0, and 11, respectively (p-values < 0.05). Conclusions: It appears that air pollution is significantly associated with cardiovascular deaths in Ahvaz City. Int J Occup Med Environ Health 2018;31(4):459–473
EN
Objectives The aim of this study has been to assess the characteristics of acute poisoning deaths in Poland over a period of time 2009–2013. Material and Methods The analysis was based on the data obtained from the patient records stored in toxicology departments in 6 cities – Łódź, Kraków, Sosnowiec, Gdańsk, Wrocław and Poznań. Toxicological analyses were routinely performed in blood and/or urine. Major toxic substances were classified to one of the following categories: pharmaceuticals, alcohol group poisonings (ethanol and other alcohols), gases, solvents, drugs of abuse, pesticides, metals, mushrooms, others. Cases were analyzed according to the following criteria: year, age and gender of analyzed patients, toxic substance category and type of poisoning. The recorded fatal poisonings were classified according to the International Classification of Diseases. Results The record of 261 deaths were retrospectively reviewed. There were 187 males (71.64%) and 74 females (28.36%) and the male to female ratio was 2.52. Alcohol group poisonings were more frequently responsible for deaths in men compared to all poisonings, 91.1% vs. 71.6%, respectively (p < 0.05), and pharmaceutical agents were more frequently responsible for deaths in women, 47.4% vs. 28.4%, (p < 0.05). Methanol was the most common agent in the alcohol group poisonings, accounting for 43.75% (N = 49), followed by ethylene glycol, 39.29% (N = 44), and ethanol, 16.96% (N = 19). Conclusions Epidemiological profile data from investigation of poisoning deaths in Poland may be very useful for the development of preventive programs. Int J Occup Med Environ Health 2017;30(6):897–908
EN
Objectives To investigate a hypothesized positive association between employment in occupations where heavy lifting is likely to occur, and the risk of ischaemic heart disease (IHD). Material and Methods Male blue-collar workers from Denmark (N = 516 180) were monitored with respect to hospital treatment or death due to IHD, through national registers over the years 2001–2010. Poisson regression was used to estimate relative rates of IHD between “workers in occupations which, according to an expert opinion, are likely to involve heavy lifting” and “other blue-collar workers.” Prevalent cases were excluded from the analysis. Results The rate ratio was estimated at 0.97 (95% confidence interval (CI): 0.94–1.00) for deaths or hospitalizations due to IHD and 1.07 (95% CI: 0.94–1.21) for deaths due to IHD. Conclusions The results do not support the hypothesis that occupational heavy lifting is an important risk factor for IHD.
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Objectives Occupational exposure to asbestos is associated with increased mortality which, however, has not been thoroughly validated in a general population. We have aimed at exploring whether this association may be confirmed within a population-based setting after adjustment for confounders. Furthermore, the impact of tobacco consumption on the association between occupational exposure to asbestos and mortality is assessed. Material and Methods We used data from 2072 (224 exposed) male participants of the Study of Health in Pomerania. Information on exposure to asbestos is based on a selfreport. Median follow-up time was 11.3 years. All-cause mortality and cause-specific mortality of exposed and non-exposed men were compared using mortality rate ratios, Kaplan-Meier analyses and multivariable Cox regression. Results During the follow-up, 52 (23.2%) exposed and 320 (17.3%) non-exposed participants deceased. Exposed subjects had increased hazard ratios (HR) for all-cause mortality (HR=1.48, 95% CI: 1.1–2), benign lung disease mortality (HR=3, 95% CI: 1.18– 7.62) and stomach cancer mortality (HR=4.59, 95% CI: 1.53–13.76). The duration of exposure (per 10 years) was associated with all-cause (HR=1.21, 95% CI: 1.07–1.36) and benign lung disease mortality (HR=1.68, 95% CI: 1.26–2.22). Smokers occupationally exposed to asbestos had the highest risk for all-cause (HR=3.70, 95% CI: 2.19–6.27) and cancer mortality (HR=4.56, 95% CI: 1.99–10.48) as compared to non-asbestos exposed non-smokers. Conclusions Our results confirm associations of occupational exposure to asbestos with all-cause, benign lung disease, and stomach cancer mortality and underline the impact of joint effects of asbestos and smoking on mortality.
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Objectives The role of leisure-time physical activity in reducing all-cause and cardiovascular mortality is well explored. The knowledge on occupational and commuting physical activity continues to be ambiguous and misleading. The aim of the study is to assess the influence of different kinds of physical activity on cardiovascular mortality risk in men. Material and Methods Data analysis on physical activity level and other selected cardiovascular risk factors acquired from 3577 men in the age between 50–80 years who participated in the National Multicenter Health Survey WOBASZ (Wieloośrodkowe Ogólnopolskie Badanie Stanu Zdrowia), Poland (2003–2005) was linked with male mortality in 2004–2009. Data about causes of deaths were obtained from the Central Statistical Office and the Population Electronic Register. Results Among males aged 50–59 years, the strongest risk factor was living in large settlements and provincial capitals as a place of residence and the most protective factor was occupational physical activity. In the age group 60–69 years and 70–80 years, the strongest protective effect was observed for leisure-time physical activity. In men aged between 70–80 years (unlike in the 50–59 years age group), the protective effect of large settlements and provincial capitals as a place of residence was noted. Conclusions Occupational physical activity significantly reduced cardiovascular mortality in men aged 50–69 years, while for leisure-time activity the positive effect was observed in age group 60–69 years and 70–80 years. On the other hand, for the inhabitants of large settlements and provincial capitals, significantly higher risk of cardiovascular mortality in the age group 50–69 years and lower risk in the age group ≥ 70 years was noted, both in comparison with smaller places of residence.
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Objectives There are a few accepted and intensively applied statistical methods used to study associations of ambient air pollution with health conditions. Among the most popular methods applied to assess short term air health effects are case-crossover (using events) and time-series methodologies (using counts). A few other techniques for studying counts of events have been proposed, including the Generalized Linear Mixed Models (GLMM). One suggested GLMM technique uses cluster structures based on natural embedded hierarchies: days are nested in the days of a week (dow), which, in turn, are nested in months and months in years (< dow, month, years >). Material and Methods In this study the authors considered clusters with hierarchical structures in a form of < dow, 14-days, year >, where the 14-days hierarchy determines 7 clusters composed of 2 days (the same days) of a week (2 Mondays, 2 Tuesdays, etc.), in 1 year. In this work the authors proposed hierarchical chained clusters in which 2 days of a week are grouped as follows: (first, second), (second, third), (third, fourth) and so on. Such an approach allows determination of an additional series of the slopes on the clusters (second, third), (fourth, fifth), etc., i.e., estimation of the coefficients for other configurations of air pollutant levels. The authors considered a series of 2 point chained clusters covering a year. In such a construction each cluster has one common data point (day) with another one. Results The authors estimated coefficients (slopes) related to the ambient ozone exposure (mortality) and to 3 selected air pollutants (particulate matter, nitrogen dioxide and ozone) combined into index and considered as health risk exposure (emergency department (ED) visits). The generated results were compared to the estimations obtained from the time-series method and the time-stratified case-crossover method applied to the same data. Conclusions The proposed statistical method, based on the chained hierarchical clusters (< dow, 14-days, year >), generated results with shorter confidence intervals than the other methods.
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Na Śląsku największe straty w liczbie lat życia powstają, biorąc pod uwagę całą badaną populację, z powodu chorób układu krążenia i nowotworów, a w populacji mężczyzn także na skutek zewnętrznych przyczyn zachorowania i zgonów. Mimo iż sytuacja ekonomiczna w badanych trzech województwach pod wieloma względami ksztatuje się korzystniej niż przeciętnie w kraju, wiele spośród obliczonych mierników stanu zdrowia przybiera w tych województwach mniej korzystne wartości niž średnia krajowa. Jedną z przyczyn tego zjawiska može być wysoki stopień uprzemysłowienia badanych województw, czego rezultatem jest m.in. znaczne zanieczyszczenie środowiska naturalnego.
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Celem obecnego opracowania było przekonanie się, w jakim stopniu zmiana formalnych kryteriów mianownictwa wpłynęła na ukształtowanie wewnętrznej struktury przyczyn umieralności. (fragment tekstu)
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W artykule omówiono starzenie się ludności, które w coraz większym stopniu jest wynikiem przemian umieralności. Celem artykułu jest próba opisu starzenia się ludności z punktu widzenia długookresowych przemian umieralności poprzez odwołanie się do obliczonych na podstawie modelowych tablic trwania życia Coale’a i Demeny’ego.
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The impact of long term mortality changes on population ageing. The population ageing which results from changes in mortality has been discussed in the article. The purpose of the article is an attempt to describe the population ageing from the point of view of long term changes in mortality by means of appealing to the different speed in decrease of children, young people, adults and seniors' death probabilities calculated on the basis of the Coale's and Demeny's life expectancy tables as well as determination of the life expectancy extension speed at different stages of human existence. (original abstract)
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W artykule zanalizowano występujący obecnie w Polsce poziom zróżnicowania natężenia zgonów w zależności od stanu cywilnego oraz przedstawiono teoretyczne rozważania wyjaśniające owo zróżnicowanie. Szczególną uwagę zwrócono na pokazanie wpływu stanu cywilnego na nadumieralność mężczyzn i zróżnicowanie natężenia zgonów w przekroju miast i wsi. W opracowaniu oparto się na założeniu, że umieralność w coraz większym stopniu zależna jest od stylu życia jednostki. Istotnym czynnikiem przy wyborze stylu życia jest status rodzinny jednostki, a zwłaszcza jej status matrymonialny. (abstrakt oryginalny)
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The level of death volume diversification depending on martial status in Poland was analyzed, and theoretical considerings, which explains this diversification was presented. The particular attention was taken to show the influence of martial status on excess mortality of man and death volume diversification by the urban and rural areas. This paper was based on the thesis that mortality depends on the lifestyle of the person. The significant factor of chosen lifestyle is family and material status. (original abstract)
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Strajk polskich lekarzy, którzy w latach 1996-2002 protestowali przeciwko niskim wynagrodzeniom oraz złej organizacji systemu służby zdrowia spowodował zaburzenie funkcjonowania ewidencji ludności. "Jedną z form tego strajku było niewypełnienie w karcie zgonu przyczyn zgonu i chorób towarzyszących. Protestujący lekarze ograniczali się do podania danych osobowych, koniecznych do identyfikacji osoby zmarłej, pomijali natomiast informacje dotyczące okoliczności zgonu i historię choroby. Uniemożliwiło to lekarzom orzekającym poznanie wyjściowej przyczyny zgonu i ostateczne jej zatwierdzenie oraz zakodowanie w dokumentacji. W rezultacie dane dotyczące liczby zgonów według przyczyn zebrane w tym okresie i opublikowane w rocznikach demograficznych GUS zawierają braki (...). Celem artykułu jest przedstawienie sposobu oszacowania liczby zgonów według płci, wieku w zakresie wszystkich przyczyn, zgodnie z międzynarodową klasyfikacją chorób i problemów zdrowotnych (...).
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The strike of Polish medical doctors in the years 1996-2002 seriously affected the collection of cause-of-death data in the frame of vital registration system. This article presents a method assessing the total number of deaths by cause under the assumption that the distribution of causes across correctly reported deaths and across deaths without recognized underlying cause was the same within each demographic group (defined by sex, age, place of residence). For each year of strike several variants of assessment were performed; variants differed with regard to the level of detail as for the age and territorial division. The variants gave similar results for territorial characteristics. It means that the scale of protest was not big enough to expose possible regional diversity of mortality by causes. The reconstructed, complete and longitudinal data on deaths by single causes will serve for future analysis of mortality trends and will be used to identify and discuss the possible links between trends in mortality and the political and socio-economic changes that occurred in Poland. (original abstract)
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Pozwolę sobie na stosowanie trójstronnego podejścia. Po pierwsze, dokonam przeglądu danych odnoszących się do osób dożywających ekstremalnie wysokiego wieku w różnych okresach historycznych. Po drugie, odwołam się do ustaleń nauk przyrodniczych co do maksymalnego wieku dla przedstawicieli gatunku ludzkiego. Po trzecie, przedstawię rezultaty szacunków dotyczących maksymalnego trwania życia, wynikające z przyjęcia różnych, matematycznych, modeli opisujących porządek wymierania osób bardzo starych. (fragment tekstu)
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Modeling extreme mortality risk

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The main aim of the paper is presentation some key aspects in modeling extreme mortality risk. We make a review and discuss measures of extreme mortality risk. Besides, we use approach proposed by J.M. Bravo et al. [2012], that is focused on using EVT to model the statistical behaviour of mortality rates over a given high threshold age. Insurers and reinsurers are interested in assessing the risk exposure to extreme mortality risk.
PL
Celem niniejszej pracy jest przedstawienie kluczowych aspektów w modelowaniu ekstremalnego ryzyka umieralności. Przedstawiamy dwa podejścia pomiaru ryzyka. Po pierwsze, dyskutujemy miary ryzyka ekstremalnego, które są wykorzystywane w pomiarze ryzyka umieralności. Po drugie, przedstawiamy podejście zaproponowane przez J.M. Bravo i innych [2012], polegające na wykorzystaniu EVT do modelowania umieralności powyżej pewnego wieku. Oceną ekstremalnego ryzyka umieralności są zainteresowani ubezpieczyciele i reasekuratorzy.
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Rodzina modeli Lee-Cartera

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This paper presents a proposal for the application of selected models of the group of models using the Lee and Carter methodology for forecasting mortality rates. These include the original Lee-Carter, the Lee-Miller (2001) and Booth-Maindonald-Smith (2002) variants, and the more flexible Hyndman-Ullah (2005) and de Jong (2006) extensions. Based on estimates of mortality rates derived from the selected models was verified the ability to use these models to estimate mortality rates in Poland.
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Pomimo że ciągle podkreśla się wagę chorobowości i niesprawności, debaty na temat polityki zdrowotnej zbyt często skupiają się na umieralności. Jedną z przyczyn takiego stanu rzeczy jest brak porównywalnych informacji dotyczących wyników zdrowotnych innych niż zgon, które mogłyby być zestawione z informacją na temat obciążenia przedwczesną umieralnością. W celu obliczenia czasu przeżytego z pewnym stanem zdrowotnym w sposób porównywalny ze standaryzowanym czasem utraconym na skutek przedwczesnej umieralności konieczny jest duży stopień uproszczenia. Celem pracy jest prezentacja lat życia skorygowanych niesprawnością DALY jako miary braku zdrowia oraz jej zastosowanie w szacowaniu obciążenia chorobami. W części empirycznej zaprezentowano zmiany, jakie dokonały się w obciążeniu chorobami populacji Polski między 1990 a 2010 r.
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Despite that morbidity and lack of health is always in concern, the debate on health policy is too often focus on mortality. One of the reasons for this is the lack of comparable information on health outcomes with premature mortality. In order to calculate the time lived with a certain state of health in a way comparable to the standardized time lost due to premature mortality, it is necessary high degree of simplification. The aim of the work is the presentation of life year adjusted with disability DALY as a measure lack of health and its use in estimating the burden of disease. The empirical part presents the changes that have occurred in the Polish population disease burden between 1990 and 2010.
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Wstęp: Samoocena stanu zdrowia stosowana jest w ochronie zdrowia i w konsekwencji wpływa na absencję chorobową populacji pracującej. Celem badania była ocena zależności między zmiennymi społeczno-ekonomicznymi, wybranymi formami zachowań prozdrowotnych a subiektywną oceną stanu zdrowia osób pracujących. Materiał i metody: Badaniem objęto 599 osób – 331 kobiet (55,3%) i 268 mężczyzn (44,7%) w wieku 18–67 lat, pracujących na terenie województwa świętokrzyskiego. Narzędziem badania był kwestionariusz zawierający pytania dotyczące stanu zdrowia i zachowań zdrowotnych w zakresie stylu życia. Przeprowadzono pomiary antropometryczne. W analizie statystycznej wykorzystano test niezależności Chi². W celu oceny wpływu wybranych cech na samoocenę stanu zdrowia badanych zastosowano analizę regresji logistycznej jedno- i wieloczynnikowej. Wyniki: W wieloczynnikowej analizie regresji logistycznej cechami istotnie zwiększającymi szansę bardzo dobrej lub dobrej samooceny stanu zdrowia okazały się: wiek do 39 lat (iloraz szans (odds ratio – OR) = 4,17; 95% przedział ufności (confidence interval – CI): 1,72–10,10; p < 0,002), wykształcenie wyższe (OR = 3,01; 95% CI: 1,04–8,70; p < 0,05) i dbałość o zdrowie (OR = 4,77; 95% CI: 2,81–8,09; p < 0,001). Wnioski: Pracujące osoby z wykształceniem wyższym mają lepszą kontrolę nad własnym zdrowiem i w konsekwencji lepszą jego percepcję. Konieczne jest monitorowanie samooceny stanu zdrowia pracujących jako istotnego wskaźnika oceny stanu zdrowia pracowników i zapotrzebowania na opiekę medyczną. Med. Pr. 2015;66(1):17–28
EN
Background: Self-rated health relates to the use of medical help and, as a consequence, determines sick leave in the population of employees. The aim of the study was to analyze the relationship between socioeconomic variables, selected forms of positive health behaviour and subjective evaluation of health in employees. Material and Methods: Five hundred and 99 subjects were included in the study – 331 females and 268 males, aged 18–67, working in the area of the Świętokrzyskie province. The authors’ survey questionnaire on the selected elements of the state of health and positive health behavior in life style has been used in the study. Anthropometric measures were carried out. A Chi² test for independence was used in the statistical analysis. In order to evaluate the effect of the selected factors on the self-rated health of the studied subjects the researchers have applied single- and multiple-factor logistic regression. Results: In the multiple-factor logistic regression the features contributing to good or excellent self-rated health were the following: age up to 39 (odds ratio – OR = 4.17; 95% confidence interval – CI: 1.72–10.10; p < 0.002), higher education (OR = 3.01; 95% CI: 1.04–8.70; p < 0.05) and care for health (OR = 4.77; 95% CI: 2.81–8.09; p < 0.001). Conclusions: Working people with higher education are characterized by a better control over their own health and, consequently, by a better perception of it. Monitoring self-rated health in a working population is an invaluable indicator in the evaluation of health in employees and the need for medical care. Med Pr 2015;66(1):17–28
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W artykule zwrócono uwagę na trudności interpretacji danych dotyczących kształtowania się umieralności mężczyzn i kobiet ze względu na możliwe błędy weryfikacji wieku osób sędziwych. Nadumieralność mężczyzn traktowana jest w demografii jako pewnik. W pracy pokazano, że wśród osób w bardzo zaawansowanym wieku można znaleźć przykłady wyższej umieralności kobiet. Sytuacja taka występuje również w Polsce. Artykuł przedstawia dwa wyjaśnienia takiego stanu rzeczy: efekt selekcji (do bardzo wysokiego wieku dożywają jedynie najsilniejsi) oraz wpływ zawyżania wieku przy wyrabianiu dokumentów w okresie bezpośrednio powojennym, podkreślając - zwłaszcza w realiach polskich - wpływ tego drugiego wytłumaczenia. (abstrakt oryginalny)
EN
The article focuses on the difficulties in the data interpretation, which concerns forming the women's and men's mortality regarding possible errors in the age verification of the old-age persons. Excess mortality of men is treated in demography as an axiom. In the work was proved, that among veiy old-age people we could find the examples of higher female mortality. This situation occurs also in Poland. The article presents two kinds of explanations: the selection effect (only the strongest ones live to the very old age) and the influence of the age overstating while obtaining the documents in the period directly after the war, stressing - particularly in the Polish reality - the impact of this second explanation. (original abstract)
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Celem artykułu jest prezentacja zróżnicowania przeciętnego trwania życia, współczynników płodności, umieralności niemowląt oraz ogólnych współczynników zgonów między państwami Unii Europejskiej (UE). Posłużą one do wyodrębnienia grup krajów podobnych ze względu na te zmienne. Badanie oparto na informacjach pochodzących z Eurostatu, dotyczących głównie roku 2011. (fragment tekstu)
EN
The aim of the article is to present the diversity of life expectancy, fertility rates, infant mortality and overall mortality rates in the European Union, as well as an attempt to distinguish groups of similar countries due to each of the variables as well as because of all these variables together. The procedure to estimate a synthetic development measure required to carry out the standardization of variables, which in the described case used so-called check-parcel standardization method. (original abstract)
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