Hearing loss is twice as common in Australia’s lowest income groups, our research shows

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Around one in six Australians has some form of hearing loss, ranging from mild to complete hearing loss. That figure is expected to grow to one in four by 2050, due in a large part to the country’s ageing population.

Hearing loss affects communication and social engagement and limits educational and employment opportunities. Effective treatment for hearing loss is available in the form of communication training (for example, lipreading and auditory training), hearing aids and other devices.

But the uptake of treatment is low. In Australia, publicly subsidised hearing care is available predominantly only to children, young people and retirement-age people on a pension. Adults of working age are mostly not eligible for hearing health care under the government’s Hearing Services Program.

Our recent study published in the journal Ear and Hearing showed, for the first time, that working-age Australians from lower socioeconomic backgrounds are at much greater risk of hearing loss than those from higher socioeconomic backgrounds.

We believe the lack of socially subsidised hearing care for adults of working age results in poor detection and care for hearing loss among people from disadvantaged backgrounds. This in turn exacerbates social inequalities.

Population data shows hearing inequality

We analysed a large data set called the Household, Income and Labour Dynamics in Australia (HILDA) survey that collects information on various aspects of people’s lives, including health and hearing loss.

Using a HILDA sub-sample of 10,719 working-age Australians, we evaluated whether self-reported hearing loss was more common among people from lower socioeconomic backgrounds than for those from higher socioeconomic backgrounds between 2008 and 2018.

Relying on self-reported hearing data instead of information from hearing tests is one limitation of our paper. However, self-reported hearing tends to underestimate actual rates of hearing impairment, so the hearing loss rates we reported are likely an underestimate.

We also wanted to find out whether people from lower socioeconomic backgrounds were more likely to develop hearing loss in the long run.

A boy wearing a hearing aid is playing.
Hearing care is publicly subsidised for children.
mady70/Shutterstock

We found people in the lowest income groups were more than twice as likely to have hearing loss than those in the highest income groups. Further, hearing loss was 1.5 times as common among people living in the most deprived neighbourhoods than in the most affluent areas.

For people reporting no hearing loss at the beginning of the study, after 11 years of follow up, those from a more deprived socioeconomic background were much more likely to develop hearing loss. For example, a lack of post secondary education was associated with a more than 1.5 times increased risk of developing hearing loss compared to those who achieved a bachelor’s degree or above.

Overall, men were more likely to have hearing loss than women. As seen in the figure below, this gap is largest for people of low socioeconomic status.

Why are disadvantaged groups more likely to experience hearing loss?

There are several possible reasons hearing loss is more common among people from low socioeconomic backgrounds. Noise exposure is one of the biggest risks for hearing loss and people from low socioeconomic backgrounds may be more likely to be exposed to damaging levels of noise in jobs in mining, construction, manufacturing, and agriculture.

Lifestyle factors which may be more prevalent in lower socioeconomic communities such as smoking, unhealthy diet, and a lack of regular exercise are also related to the risk of hearing loss.

Finally, people with lower incomes may face challenges in accessing timely hearing care, alongside competing health needs, which could lead to missed identification of treatable ear disease.

Why does this disparity in hearing loss matter?

We like to think of Australia as an egalitarian society – the land of the fair go. But nearly half of people in Australia with hearing loss are of working age and mostly ineligible for publicly funded hearing services.

Hearing aids with a private hearing care provider cost from around A$1,000 up to more than $4,000 for higher-end devices. Most people need two hearing aids.

A builder using a grinder machine at a construction site.
Hearing loss might be more common in low income groups because they’re exposed to more noise at work.
Dmitry Kalinovsky/Shutterstock

Lack of access to affordable hearing care for working-age adults on low incomes comes with an economic as well as a social cost.

Previous economic analysis estimated hearing loss was responsible for financial costs of around $20 billion in 2019–20 in Australia. The largest component of these costs was productivity losses (unemployment, under-employment and Jobseeker social security payment costs) among working-age adults.

Providing affordable hearing care for all Australians

Lack of affordable hearing care for working-age adults from lower socioeconomic backgrounds may significantly exacerbate the impact of hearing loss among deprived communities and worsen social inequalities.

Recently, the federal government has been considering extending publicly subsidised hearing services to lower income working age Australians. We believe reforming the current government Hearing Services Program and expanding eligibility to this group could not only promote a more inclusive, fairer and healthier society but may also yield overall cost savings by reducing lost productivity.

All Australians should have access to affordable hearing care to have sufficient functional hearing to achieve their potential in life. That’s the land of the fair go.The Conversation

Mohammad Nure Alam, PhD Candidate in Economics, Macquarie University; Kompal Sinha, Associate Professor, Department of Economics, Macquarie University, and Piers Dawes, Professor, School of Health and Rehabilitation Sciences, The University of Queensland

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • The “Yes I Can” Salad

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Sometimes, we are given to ask ourselves: “Can I produce a healthy and tasty salad out of what I have in?” and today we show how, with a well-stocked pantry, the answer is “yes I can”, regardless of what is (or isn’t) in the fridge.

    You will need

    • 1 can cannellini beans, drained
    • 1 can sardines (if vegetarian/vegan, substitute ½ can chickpeas, drained)
    • 1 can mandarin segments
    • 1 handful pitted black olives, from a jar (or from a can, if you want to keep the “yes I can” theme going)
    • ½ red onion, thinly sliced (this can be from frozen, defrosted—sliced/chopped onion is always a good thing to have in your freezer, by the way; your writer here always has 1–6 lbs of chopped onions in hers, divided into 1lb bags)
    • 1 oz lemon juice
    • 1 tbsp chopped parsley (this can be freeze-dried, but fresh is good if you have it)
    • 1 tbsp extra virgin olive oil
    • 1 tbsp chia seeds
    • 1 tsp miso paste
    • 1 tsp honey (omit if you don’t care for sweetness; substitute with agave nectar if you do like sweetness but don’t want to use honey specifically)
    • 1 tsp red chili flakes

    Method

    (we suggest you read everything at least once before doing anything)

    1) Combine the onion and the lemon juice in a small bowl, massaging gently

    2) Mix (in another bowl) the miso paste with the chili flakes, chia seeds, honey, olive oil, and the spare juice from the can of mandarin segments, and whisk it to make a dressing.

    3) Add the cannellini beans, sardines (break them into bite-size chunks), mandarin segments, olives, and parsley, tossing them thoroughly (but gently) in the dressing.

    4) Top with the sliced onion, discarding the excess lemon juice, and serve:

    Enjoy!

    Want to learn more?

    For those interested in some of the science of what we have going on today:

    Take care!

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  • How gender-affirming care improves trans mental health

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    In recent years, a growing number of states have passed laws restricting or banning gender-affirming care for transgender people, particularly minors. As conversations about gender-affirming care increase, so do false narratives about it, with some opponents falsely suggesting that it’s harmful to mental health.

    Despite widespread attacks against gender-affirming care, research clearly shows that it improves mental health outcomes for transgender people.

    Read on to learn more about what gender-affirming care is, how it benefits mental well-being, and how you can access it.

    What is gender-affirming care?

    Gender-affirming care describes a range of medical interventions that help align people’s bodies with their gender identities. While anyone can seek gender-affirming care in the form of laser hair removal, breast augmentation, erectile dysfunction medication, or hormone therapy, among other treatments, most conversations about gender-affirming care center around transgender people, whose gender identity or gender expression does not conform to their sex assigned at birth.

    Gender-affirming care for trans people varies based on age. For example, some trans adults seek hormone replacement therapy (HRT) or gender-affirming surgeries that help their bodies match their internal sense of gender.

    Trans kids entering adolescence might be prescribed puberty blockers, which temporarily delay the production of hormones that initiate puberty, to give them more time to figure out their gender identities before deciding on next steps. This is the same medication given to cisgender kids—whose gender identities match the sex they were assigned at birth—experiencing early puberty.

    What is gender dysphoria?

    Gender dysphoria describes a feeling of unease that some trans people experience when their perceived gender doesn’t match their gender identity. This can lead to a range of mental health conditions that affect their quality of life

    Some trans people may manage gender dysphoria by wearing gender-affirming clothing, opting for a gender-affirming hairstyle, or asking others to refer to them by a name and pronouns that authentically represent them. Others may need gender-affirming care to feel at home in their bodies.

    Trans people who desire gender-affirming care and have not been able to access it experience psychological distress, including depression, anxiety, self-harm, and suicidal ideation. The Trevor Project’s 2023 U.S. National Survey on the Mental Health of LGBTQ Young People found that roughly half of trans youth “seriously considered attempting suicide in the past year.”

    A grid shows 10 drawings of people in black and white. Seven of the people are highlighted in purple squares. Text on the image reads,

    How does gender-affirming care improve mental health?

    For trans adults, gender-affirming care can alleviate gender dysphoria, which has been shown to improve both short-term and long-term mental health. A 2018 study found that trans adults who do not undergo HRT are four times more likely to experience depression than those who do, although not all trans people desire HRT.

    Extensive research has shown that gender-affirming care also alleviates gender dysphoria and improves mental health outcomes in trans kids, teens, and young adults. A 2022 study found that access to HRT and puberty blockers lowered the odds of depression in trans people between the ages of 13 and 20 by 60 percent and reduced the risk of self-harm and suicidal thoughts by 73 percent.

    Both the Endocrine Society—which aims to advance hormone research—and the American Academy of Pediatrics recommend that trans kids and teens have access to developmentally appropriate gender-affirming care.

    How can I access gender-affirming care?

    If you’re a trans adult seeking gender-affirming care or a guardian of a trans kid or teen who’s seeking gender-affirming care, talk to your health care provider about your options. You can find a trans-affirming provider by searching the World Professional Association for Transgender Health directory or visiting your local LGBTQ+ health center or Planned Parenthood.

    Some gender-affirming care may not be covered by insurance. Learn how to make the most of your coverage from the National Center for Transgender Equality. Find insurance plans available through the Marketplace that cover gender-affirming care in some states through Out2Enroll.

    Some states restrict or ban gender-affirming care. Learn about the laws in your state by visiting the Trans Legislation Tracker.

    Where can trans people and their families find mental health support?

    In addition to working with a trans-affirming therapist, trans people and their families can find mental health support through these free services:

    • PFLAG offers resources for families and friends of LGBTQ+ people. Find a PFLAG chapter near you.
    • The Trevor Project’s hotline has trained counselors who help LGBTQ+ youth in crisis. Call the TrevorLifeline 1-866-488-7386 or text START to 678-678.
    • The Trans Lifeline was created by and for the trans community to support trans people in crisis. You can reach the Trans Lifeline hotline at 1-877-565-8860.

    For more information, talk to your health care provider.

    If you or anyone you know is considering suicide or self-harm or is anxious, depressed, upset, or needs to talk, call the Suicide & Crisis Lifeline at 988 or text the Crisis Text Line at 741-741. For international resources, here is a good place to begin.

    This article first appeared on Public Good News and is republished here under a Creative Commons license.

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  • Early Bird Or Night Owl? Genes vs Environment

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    A Sliding Slope?

    In Tuesday’s newsletter, we asked you how much control you believe we have over our sleep schedule, and got the above-depicted, below-described, set of responses:

    • 45% said “most people can control it; some people with sleep disorders cannot
    • 35% said “our genes predispose us to early/late, but we can slide it a bit
    • 15% said: “going against our hardwired sleep schedules is a road to ruin”
    • 5% said “anyone can adjust their sleep schedule with enough willpower”

    You may be wondering: what’s with those single-digit numbers in the graph there? And the answer is: Tuesday’s email didn’t go out at the usual time due to a scheduling mistake (sorry!), which is probably what affected the number of responses (poll response levels vary, but are usually a lot higher than this).

    Note: yes, this does mean most people who read our newsletter don’t vote. So, not to sound like a politician on the campaign trail, but… Your vote counts! We always love reading your comments when you add those, too—often they provide context that allow us to tailor what we focus on in our articles

    However, those are the responses we got, so here we are!

    What does the science say?

    Anyone can adjust their sleep with enough willpower: True or False?

    False, simply. It’s difficult for most people, but for many people with sleep disorders, it is outright impossible.

    In a battle of narcolepsy vs willpower, for example, no amount of willpower will stop the brain from switching to sleep mode when it thinks it’s time to sleep:

    ❝Narcolepsy is the most common neurological cause of chronic sleepiness. The discovery about 20 years ago that narcolepsy is caused by selective loss of the neurons producing orexins sparked great advances in the field

    [There is also] developing evidence that narcolepsy is an autoimmune disorder that may be caused by a T cell-mediated attack on the orexin neurons and explain how these new perspectives can inform better therapeutic approaches.❞

    ~ Dr. Carrie Mahoney et al. (lightly edited for brevity)

    Source: The neurobiological basis of narcolepsy

    For further reading, especially if this applies to you or a loved one:

    Living with Narcolepsy: Current Management Strategies, Future Prospects, and Overlooked Real-Life Concerns

    Our genes predispose us to early/late, but we can slide it a bit: True or False?

    True! First, about our genes predisposing us:

    Genome-wide association analysis of 89,283 individuals identifies genetic variants associated with self-reporting of being a morning person

    …and also:

    Gene distinguishes early birds from night owls and helps predict time of death

    Now, as for the “can slide it a bit”, this is really just a function of the general categories of “early bird” and “night owl” spanning periods of time that allow for a few hours’ wiggle-room at either side.

    However, it is recommended to make any actual changes more gradually, with the Sleep Foundation going so far as to recommend 30 minutes, or even just 15 minutes, of change per day:

    Sleep Foundation | How to Fix Your Sleep Schedule

    Going against our hardwired sleep schedule is a road to ruin: True or False?

    False, contextually. By this we mean: our “hardwired” sleep schedule is (for most of us), genetically predisposed but not predetermined.

    Also, genetic predispositions are not necessarily always good for us; one would not argue, for example, for avoiding going against a genetic predisposition to addiction.

    Some genetic predispositions are just plain bad for us, and genes can be a bit of a lottery.

    That said, we do recommend getting some insider knowledge (literally), by getting personal genomics tests done, if that’s a viable option for you, so you know what’s really a genetic trait (and what to do with that information) and what’s probably caused by something else (and what to do with that information):

    Genetic Testing: Health Benefits & Methods

    Take care!

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  • Feel-Good Productivity – by Dr. Ali Abdaal

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    “Rise and grind” is not a sustainable way to live. Yet for most of us, there are things we do have to do every day that we don’t necessarily do for fun. So, how to be productive with those things, and not feel like we are constantly compromising and sacrificing our time on this earth for some intrinsically trivial but extrinsically required activity that’ll be forgotten tomorrow?

    And most of us do also have dreams and ambitions (and if you don’t, then what were they before life snatched them away from you?), things to work towards. So there is “carrot” for us as well as “stick”. But how to break the cycle and get more carrot and less stick, while being more productive than before?

    Dr. Abdaal frames this principally in terms of neurology first, psychology next.

    That when we are bored, we simply do not have the neurochemicals required to work well anyway, so addressing that first needs to be a priority. He lays out many ways of doing this, gives lots of practical tips, and brings attention to the ways it’s easy to go wrong (and how to fix those too).

    The writing style isdeceptively relaxed and casual, leading the reader smoothly into understanding of each topic before moving on.

    Bottom line: if you want to get more done while feeling better about it (not a tired wreck), then this is the book for you!

    Click here to check out Feel-Good Productivity, and thrive!

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  • Men have a biological clock too. Here’s what’s more likely when dads are over 50

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    We hear a lot about women’s biological clock and how age affects the chance of pregnancy.

    New research shows men’s fertility is also affected by age. When dads are over 50, the risk of pregnancy complications increases.

    Data from more than 46 million births in the United States between 2011 and 2022 compared fathers in their 30s with fathers in their 50s.

    While taking into account the age of the mother and other factors known to affect pregnancy outcomes, the researchers found every ten-year increase in paternal age was linked to more complications.

    The researchers found that compared to couples where the father was aged 30–39, for couples where the dad was in his 50s, there was a:

    • 16% increased risk of preterm birth
    • 14% increased risk of low birth weight
    • 13% increase in gestational diabetes.

    The older fathers were also twice as likely to have used assisted reproductive technology, including IVF, to conceive than their younger counterparts.

    Steven van Loy/Unsplash

    Dads are getting older

    In this US study, the mean age of all fathers increased from 30.8 years in 2011 to 32.1 years in 2022.

    In that same period, the proportion of men aged 50 years or older fathering a child increased from 1.1% to 1.3%.

    We don’t know the proportion of men over 50 years who father children in Australia, but data shows the average age of fathers has increased.

    In 1975 the median age of Australian dads was 28.6 years. This jumped to 33.7 years in 2022.

    How male age affects getting pregnant

    As we know from media reports of celebrity dads, men produce sperm from puberty throughout life and can father children well into old age.

    However, there is a noticeable decline in sperm quality from about age 40.

    Female partners of older men take longer to achieve pregnancy than those with younger partners.

    A study of the effect of male age on time to pregnancy showed women with male partners aged 45 or older were almost five times more likely to take more than a year to conceive compared to those with partners aged 25 or under. More than three quarters (76.8%) of men under the age of 25 years impregnated their female partners within six months, compared with just over half (52.9%) of men over the age of 45.

    Pooled data from ten studies showed that partners of older men are also more likely to experience miscarriage. Compared to couples where the male was aged 25 to 29 years, paternal age over 45 years increased the risk of miscarriage by 43%.

    Older men are more likely to need IVF

    Outcomes of assisted reproductive technology, such as IVF, are also influenced by the age of the male partner.

    A review of studies in couples using assisted reproductive technologies found paternal age under 40 years reduced the risk of miscarriage by about 25% compared to couples with men aged over 40.

    Having a male under 40 years also almost doubled the chance of a live birth per treatment cycle. With a man over 40, 17.6% of treatment rounds resulted in a live birth, compared to 28.4% when the male was under 40.

    How does male age affect the health outcomes of children?

    As a result of age-related changes in sperm DNA, the children of older fathers have increased risk of a number of conditions. Autism, schizophrenia, bipolar disorders and leukaemia have been linked to the father’s advanced years.

    A review of studies assessing the impact of advanced paternal age reported that children of older fathers have increased rates of psychiatric disease and behavioural impairments.

    But while the increased risk of adverse health outcomes linked to older paternal age is real, the magnitude of the effect is modest. It’s important to remember that an increase in a very small risk is still a small risk and most children of older fathers are born healthy and develop well.

    Improving your health can improve your fertility

    In addition to the effects of older age, some chronic conditions that affect fertility and reproductive outcomes become more common as men get older. They include obesity and diabetes which affect sperm quality by lowering testosterone levels.

    While we can’t change our age, some lifestyle factors that increase the risk of pregnancy complications and reduce fertility, can be tackled. They include:

    Get the facts about the male biological clock

    Research shows men want children as much as women do. And most men want at least two children.

    Yet most men lack knowledge about the limitations of female and male fertility and overestimate the chance of getting pregnant, with and without assisted reproductive technologies.

    We need better public education, starting at school, to improve awareness of the impact of male and female age on reproductive outcomes and help people have healthy babies.

    For men wanting to improve their chance of conceiving, the government-funded sites Healthy Male and Your Fertility are a good place to start. These offer evidence-based and accessible information about reproductive health, and tips to improve your reproductive health and give your children the best start in life.

    Karin Hammarberg, Senior Research Fellow, Global and Women’s Health, School of Public Health & Preventive Medicine, Monash University

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Who Screens The Sunscreens?

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    We Screen The Sunscreens!

    Yesterday, we asked you what your sunscreen policy was, and got a spread of answers. Apparently this one was quite polarizing!

    One subscriber who voted for “Sunscreen is essential to protect us against skin aging and cancer” wrote:

    ❝My mom died of complications from melanoma, so we are vigilant about sun and sunscreen. We are a family of campers and hikers and gardeners—outdoors in all seasons—and we never burn❞

    Our condolences with regard to your mom! Life is so precious, and when something like that happens, it tends to stick with us. We’re glad you and your family are taking care of yourselves.

    Of the subscribers who voted for “I put some on if I think I might otherwise get sunburned”, about half wrote to express uncertainties:

    • uncertainty about how safe it is, and
    • uncertainty about how helpful it is

    …so we’re going to tackle those questions in a moment. But what of those who voted for “Sunscreen is full of harmful chemicals that can cause cancer”?

    Of those, only one wrote a message, which was to say one has to be very careful of what is in the formula.

    Let’s take a look, then…

    Sunscreen is full of harmful chemicals that can cause cancer: True or False?

    False—according to current best science. Research is ongoing!

    There are four main chemicals (found in most sunscreens) that people tend to worry about:

    • Abobenzone
    • Oxybenzone
    • Octocrylene
    • Ecamsule

    Now, these two sound like four brands of rocket fuel, but then, dihydrogen monoxide (DHMO), which is also found in most sunscreens, sounds like a deadly toxin too. That’s water, by the way.

    But what of these four chemicals? Well, as we say, research is ongoing, but we found a study that measured all four, to see how much got into the blood, and what adverse effects, if any, this caused.

    We’ll skip to their conclusion:

    ❝In this preliminary study involving healthy volunteers, application of 4 commercially available sunscreens under maximal use conditions resulted in plasma concentrations that exceeded the threshold established by the FDA for potentially waiving some nonclinical toxicology studies for sunscreens. The systemic absorption of sunscreen ingredients supports the need for further studies to determine the clinical significance of these findings. These results do not indicate that individuals should refrain from the use of sunscreen.❞

    Now, “exceeded the threshold established by the FDA for potentially waiving some nonclinical toxicology studies for sunscreens” sounds alarming, so why did they close with the words “These results do not indicate that individuals should refrain from the use of sunscreen”?

    Let’s skip back up to a line from the results:

    ❝The most common adverse event was rash, which developed in 1 participant with each sunscreen.❞

    This was most probably due to the oxybenzone, which can cause allergic skin reactions in some people.

    Let us take a moment to remember the most common adverse event that occurs from not wearing sunscreen: sunburn!

    You can read the full study here:

    Effect of Sunscreen Application Under Maximal Use Conditions on Plasma Concentration of Sunscreen Active Ingredients—A Randomized Clinical Trial

    None of those ingredients have been found to be carcinogenic, even at the maximal blood plasma concentrations studied, from applications 4x/day to 75% of the body.

    UVA rays, on the other hand, are absolutely very much known to cause cancer, and the effect is cumulative.

    Sunscreen is essential to protect us against skin aging and cancer: True or False?

    True, unequivocally, unless we live indoors and/or otherwise never go about under sunlight.

    “But our ancestors—” lived under the same sun we do, and either used sunscreen or got advanced skin aging and cancer.

    Sunscreen of times past ranged from mud to mineral lotions, but it’s pretty much always existed. Even non-human animals that have skin and don’t have fur or feathers, tend to take mud-baths in sunny parts of the world.

    If you’d like to avoid oxybenzone and other chemicals, though, you might have your reasons. Maybe you’re allergic, or maybe you read that it’s a potential endocrine disruptor with estrogen-like and anti-androgenic properties that you don’t want.

    There are other options, to include physical blockers containing zinc and titanium dioxide, which are generally recognized as safe and effective ingredients.

    If you’re interested, you can even make your own sunscreen that blocks both UVA and UVB rays (UVA is what causes skin cancer; UVB is “milder” and is what causes sunburn):

    How to Make a Safe and Effective Sunscreen from Scratch – medically reviewed by Dr. Debra Rose Wilson, Ph.D., MSN, R.N., IBCLC, AHN-BC, CHT

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