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Management of Post-Operative Pain after Gyneco-Obstetrical Surgery: Practice of Transversus Abdominis Plane Bloc (Tap Block) Echoguide at the Ignace Deen National Hospital

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Open Journal of Anesthesiology 2021年第10期11卷 316-324页

作者： Donamou Joseph Bangoura Almamy Touré Abdoulaye camara Amadou Yalla Traoré Abdourahamane Dine camara M’Mah Lamine camara M’Mah Lamine Dramé Boubacar Atigou camara Mariama Mohamed Orou Yerima Therese Touré Aboubacar Anesthesia-Intensive Care Unit Donka National Hospital Conakry Guinea Anesthesia-Intensive Care Unit National Ignace Deen Hospital Conakry Guinea Medico-Surgical Emergency Department Donka National Hospital Conakry Guinea General and Visceral Surgery Department Ignace Deen National Hospital Conakry Guinea

Objectives: To describe the practice of ultrasound-guided TAP in the management of postoperative pain after gyneco-obstetric surgery. Methods: This was a descriptive prospective study carried out at the Gynecology-Obstetrics department of the Ignace Deen National Hospital over a period of three (03) months from February 01, 2020 to April 31, 2020. Results: In total, we collected 95 patients. These patients had a mean age of 30 ± 9.5 years. The ASA I class was the most represented with 76% of the cases and the cesarean was the most performed intervention. Regarding the assessment of the pain score by the simple verbal scale (SVE) postoperatively at rest, the mean SLE scores at H6 were 0.17 ± 0.38;at H12 of 1.15 ± 0.62;at H24 of 0.84 ± 0.51;at H36 0.45 ± 0.52 and at H48 0.09 ± 0.29. On mobilization, the mean pain scores were 0.77 ± 0.51 at H6, at H12 1.89 ± 0.61;at H24 of 1.53 ± 0.56;at H36 of 1 ± 0.29 and at H48 of 0.82 ± 0.44. The majority of our patients (66.3%) had a mobilization time of less than 24 hours. The mean length of stay was 3.1 ± 1.3 days and most patients (82%) were satisfied with the management of their pain by ultrasound-guided TAP block. Conclusion: Ultrasound-guided TAP is an effective technique for the management of postoperative pain in gyneco-obstetrics surgery. Its integration in a context of multimodal analgesia could improve the management of postoperative pain in gynecological obstetrics.

关键词： Postoperative Pain TAP Block Ultrasound Guidance Gyneco-Obstetrics

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The Reasons for Admission of Elderly Subjects in Intensive Care at the CHU Ignace Deen

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Open Journal of Emergency Medicine 2023年第3期11卷 100-109页

作者： Abdoulaye Touré Amadou Yalla camara Almamy Bangoura Donamou Joseph M’mah Lamine camara Anesthesia-Resuscitation Service University Hospital of Ignace Deen of Conakry Conakry Guinea Medical and Surgical Emergency Department Donka University Hospital Conakry Guinea Anesthesia-Resuscitation Service Donka University Hospital Conakry Guinea

Objective: To determine the reasons for admission of elderly subjects and the prognosis in general intensive care. Patients and Methods: Observational descriptive and analytical study with prospective collection of data over a period of one year from January 1 to December 31, 2021. Patients aged 65 or over were included. Abstract: During the study period, 223 cases were collected out of 587 patients admitted, giving a prevalence of 37.9%. The average age was 74.127.39 ± years with extremes of 65 and 96 years and a male predominance (58.7%). The comorbidities were dominated by arterial hypertension (71.3%). The patients were: transferred from medical and surgical emergencies (75.8%). The average admission time was 48.8 ± 29.8 hours. One hundred and eight patients had a Glasgow score between 3 and 7. The reasons for admission were dominated by vascular causes (51.6%). Strokes of any type accounted for 43.9% of these reasons for admission. The average time for carrying out the biological assessments and imaging was 41.8 ± 27.3 hours with the extremes of 3 and 89 hours, 37.2% had a complete assessment within 24 hours. The average duration of hospitalization was 7.10 ± 8.87 days with extremes of 1 and 72 days. The mortality rate was 71.7%. Conclusion: This study has made it possible to take stock of the reasons for the admission of elderly subjects to intensive care. It appears that vascular causes are the main reasons for admission with heavy comorbidities which results in high mortality.

关键词： Reasons for Admission Elderly Subject Resuscitation

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Factors determining membership in community-based health insurance in West Africa:a scoping review

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Global Health Research and Policy 2022年第1期7卷 44-60页

作者： Kaba Kanko Conde Aboubacar Mariama camara Manar Jallal Mohamed Khalis Saad Zbiri Vincent De Brouwere International School of Public Health Mohammed VI University of Health SciencesBld Mohammed Taïeb NaciriCommune Hay Hassani82403 Casa-blancaMorocco Laboratory of Public Health Health Economics and Health ManagementMohammed VI University of Health SciencesCasablancaMorocco Knowledge for Health Policies Centre CasablancaMorocco Department of Public Health Institute of Tropical MedicineAntwerpBel-gium School of Tropical Medicine and Global Health University of NagasakiNagasakiJapan

Background:In many low-income countries,households bear most of the health care ***-based health insurance(CBHI)schemes have multiplied since the 1990s in West *** have significantly improved their members’access to health ***,a large proportion of users are reluctant to subscribe to a local *** the major factors affecting membership will be useful for improving CBHI *** objective of this research is to obtain a general overview of existing evidence on the determinants of CBHI membership in West ***:A review of studies reporting on the factors determining membership in CBHI schemes in West Africa was conducted using guidelines developed by the Joanna Briggs *** databases were searched(PubMed,ScienceDirect,Global Health database,Embase,EconLit,***,BDPS,Cochrane database and Google Scholar)for relevant articles available by August 15,2022,with no methodological or linguistic restrictions in electronic databases and grey ***:The initial literature search resulted in 1611 studies,and 10 studies were identified by other *** eliminating duplicates,we reviewed the titles of the remaining 1275 studies and excluded 1080 irrelevant studies based on title and 124 studies based on *** the 71 full texts assessed for eligibility,32 additional papers were excluded(not relevant,outside West Africa,poorly described results)and finally 39 studies were included in the *** that negatively affect CBHI membership include advanced age,low education,low household income,poor quality of care,lack of trust in providers and remoteness,rules considered too strict or inappropriate,low trust in administrators and inadequate information ***:This study shows many lessons to be learned from a variety of countries and initiatives that could make CBHI an effective tool for increasing access to quality health care in order to achieve universal health cover

关键词： Community-based health insurance Mutual health organisations Membership Universal health coverage Health financing West Africa

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延边地区32例森林脑炎的临床分析

延边地区32例森林脑炎的临床分析

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作者： camara Siaka 延边大学

学位级别：硕士

[目的]探讨延边地区森林脑炎的临床、脑脊液细胞学及头部MRI特异性及非特异性表现。旨在探讨森林脑炎的防治策略提供依据。[方法]对延边医院2010年5月1日至2011年4月30日收治的32例森林脑炎患者的进行前瞻性研究,包括病人的主要症状、... 详细信息

[目的]探讨延边地区森林脑炎的临床、脑脊液细胞学及头部MRI特异性及非特异性表现。旨在探讨森林脑炎的防治策略提供依据。[方法]对延边医院2010年5月1日至2011年4月30日收治的32例森林脑炎患者的进行前瞻性研究,包括病人的主要症状、体征、实验室、脑脊液检查、影像学检查、电生理检查等。[结果]32例患者均有在温暖季节去森林地区和/或被蜱虫叮咬的经历。32例森林脑炎患者均出现发热,头痛。13例出现意识障碍,脑脊液检查示无色清亮的液体,淋巴细胞300-500个/ml;蛋白质0.6-2g/L;葡萄糖及氯化物正常。影像学检查：MRI示10例为正常、6例可见不规则脑回肿胀、16例存在部分脑白质T2WI高信号。3例发生癫痫发作的患者,进行了脑电图检查,均有异常表现。[结论]延边地区为森林脑炎高发地区,高温季节是疾病高发时期。脑脊液检查以淋巴细胞增多、蛋白增高、糖、氯化物正常为特点。头部MRI检出率较高,但与疾病严重程度并不完全相符。

关键词：森林脑炎延边地区脑脊液细胞学头部MRI

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基于B样条函数的一些逼近曲线的研究

基于B样条函数的一些逼近曲线的研究

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作者： camara AMARA 中南大学

学位级别：硕士

B样条曲线是许多多公式化曲线当中一个有代表性的光滑曲线。这些公式化曲线有多种应用，包括交互式曲线设计。早先研究显示，B样条是一种有效的公式化设置。然而，一个可能的缺点为新手用户在使用B样条时是控制点远离曲线，这使它的操... 详细信息

B样条曲线是许多多公式化曲线当中一个有代表性的光滑曲线。这些公式化曲线有多种应用，包括交互式曲线设计。早先研究显示，B样条是一种有效的公式化设置。然而，一个可能的缺点为新手用户在使用B样条时是控制点远离曲线，这使它的操作不直观。基于最小二乘法，给出了生成全局性逼近给定数据点的逼近曲线的方法．生成的曲线是B样条曲线．论述了利用给定数据点计算调整控制点的计算方法．根据频率的分类间隔和对一张指定的直方图的形状，本文构造了一种满足面积约束的直方图的二次B样条曲线．给出的曲线是一种与直方图相匹配的视觉上中意的二次B样条曲线。

关键词： B样条曲线,全局性逼近,直方图,正常化的B样条,最小二乘法,移动控制点

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Digital Image Watermarking Based on DWT-DCT

Digital Image Watermarking Based on DWT-DCT

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作者： Lancine camara 湖南大学

学位级别：硕士

互联网的发展极大地促进了图片,音频,视频等数字媒体的广泛使用。图像可以被无限制的复制而没有任何质量损失。这样就带来数字图像安全问题。渐渐的,人们在数字图像中嵌入一些信息甚至于秘密信息,这些信息具有增值功能或者涉及到秘密通... 详细信息

互联网的发展极大地促进了图片,音频,视频等数字媒体的广泛使用。图像可以被无限制的复制而没有任何质量损失。这样就带来数字图像安全问题。渐渐的,人们在数字图像中嵌入一些信息甚至于秘密信息,这些信息具有增值功能或者涉及到秘密通信。这样,产生了一种通过在多媒体中直接嵌入一个具有鲁棒性的信号来保护数字媒体的新技术:数字水印。数字水印技术的产生为数字媒体的保护问题提供了一种前途广泛的方式。水印方案的分类作为一种重要的规范,是按照水印嵌入和提取所需的信息分类的:●可见水印的嵌入需要有原始图像和密钥。●半可见水印需要密钥和水印。●不可见水印仅仅需要密钥,这是水印系统最具挑战的技术。水印方案是嵌入可见还是不可见的水印。可见水印用于阻止非授权用户使用图像,易于检测。不可见水印用于识别其宿主数据的拥有者或原始数据。数字水印有如下应用:●版权保护:数字水印技术用于知识产权保护,且是最广泛的应用。●指纹识别:用于跟踪非法复本的来源。●拷贝保护:水印中嵌入的信息可以直接保护数字录音以防拷贝。●广播监控器:将水印信息嵌入商业广告,自动监控系统可以核实其广告是否被正常播放。●数据鉴定:如果原始数据非常重要,脆弱水印可以用于检查数据的真实性。●索引:搜索引擎可以将制作者和评论插入到视频邮件索引,电影索引,新闻索引用于搜索。●医学安全:将病人的名字和相关数据嵌入到医学图像中,是一种有用的安全措施。●数据隐藏:水印技术可以用于秘密信息的传输。传统的信息隐藏办法是加密技术。在数据传送之前,只允许密钥持有者解密数据。但是,这种办法在很大程度上依赖于图像的格式。当图像格式在传送过程中改变,加密信息将会被移除,这种方法就会失效。而且,一旦信息被加密,较难使它重新生成或者重新传送。另一种技术叫做信息隐藏技术,这种技术将多媒体数据作为载体,将秘密信息隐藏在这些多媒体数据中,并且保持多媒体数据本省的形态。但是,这种技术依赖于安全的通信环境,例如点多点通信,这种通信对第三者是非透明的。这种技术对于多种攻击不具有鲁棒性。水印技术由信息隐藏技术发展而来,但是又不同于信息隐藏技术。通过水印嵌入到多媒体中的信息是和其载体的格式相同的。而信息隐藏技术有时嵌入的信息和其载体毫无关系。而且,水印技术更加注重对多种攻击的鲁棒性。●鲁棒性水印技术的基本要求有:●感知性:利用人类视觉特点,确保在典型查看条件下水印不可见。这意味着一幅嵌入水印的图像和未嵌入水印的图像没有视觉上的不同。●鲁棒性:在被压缩攻击之后水印仍然可以被检测到。●容量:水印的容量指隐藏信息的长度或原始信号的有效载荷。●水印的有效载荷:指在特殊的数据流中实际可以存储的信息量。这个要求很大程度上依赖于宿主媒体,应用目的和预期质量。●安全性:水印安全性应基于Kerchhoff的假设,他假设加密数据者应该认为加密算法对非授权者是公开的。这意味着,水印安全可以解释为直接加密,安全领先的原则,它主要在于所选择的嵌入密钥。●特殊性:水印应该是普通的,适用于图像和声音视频等多种媒体。实际上并非如此,在多种应用中,基本的概念可能是相同的,但一种水印并非适应于所有的应用。到目前为止,已经发展有多种水印技术。这些技术将水印嵌入到空间域或频率域。早期的水印技术应用于空间域,在空间域中,将水印信息直接加到图像的像素值中。频率域是用于分析信号数学变换。在一些文章中,已经成功的应用了DWT和DCT。本文中,提出了一种数据隐藏技术,将秘密信息嵌入到512*512大小Lena图像中,并结合DWT和DCT作为我们的水印策略。首先使用小波变换得到4个子带,然后将变换后的HL分成8×8的块,对每个块进行DCT变换。对于水印的嵌入,将0和1水印嵌入到每个块变换块的中频。本文方法经证明可以通过产生高保真水印图像,从而对一些信号处理的攻击,例如JPEG压缩攻击,噪音攻击,几何旋转和中值滤波攻击等具有较好抵抗性。计算原始图像和嵌入水印的图像之间的峰值信噪比(PSNR),从结果辨别不出水印图像。提出不可见,不可感知和鲁棒性结合的,基于DWT-DCT的水印嵌入算法,来在数字图像中嵌入一些信息,提取水印,或者隐藏信息。该水印算法结合DWT和DCT,并且结合现存的各种水印算法中的各种有利因素。实验结果显示本文所提的水印嵌入方法对各种信号处理和压缩攻击均具有较好的鲁棒性。

关键词： Digital image watermarking frequency domain watermarking Discrete Wavelet Transform (DWT) Discrete Cosine Transform (DCT)

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Impacts of the Sahel-Sahara Interface Reforestation on West African Climate: Intra-Annual Variability and Extreme Temperature Events

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Atmospheric and Climate Sciences 2019年第1期9卷 35-61页

作者： Ibrahima Diba Moctar camara Arona Diedhiou Laboratoire d’Océanographie des Sciences de l’Environnement et du Climat (LOSEC) UFR Sciences et Technologies Université A. SECK de Ziguinchor Ziguinchor Sénégal IRD CNRS Grenoble INP IGE Université Grenoble Alpes Grenoble France

The impacts of the reforestation of the Sahel-Sahara interface on the seasonal distribution of the surface temperature and thermal extremes are studied in the Sahel (West African region lying between 11°N and 18°N). We performed a simulation with the standard version of the RegCM4 model followed by another one using the altered version of the same model taking into account an incorporated forest. The impacts of the vegetation change are assessed by analyzing the difference between the two runs. The reforestation may influence strongly the frequency of warm days (TG90P) and very warm days (TX90P) by decreasing it over the reforested zone from March to May (MAM) and the entire Sahel during the June-August (JJA) period. These TG90P and TX90P indices decrease may be due to the strengthening of the atmospheric moisture content over the whole Sahel region and the weakening of the sensible heat flux over the reforested zone. The analysis also shows a decrease of the TN90P indice (warm nights) over the Sahel during the wet season (JJA) which could be partly associated with the strengthening of the evapotranspiration over the whole Sahel domain. The analysis of additional thermal indices shows an increase of the tropical nights over the entire Sahel from December to February (DJF) and during the warm season (MAM). The strengthening of the tropical night is partly associated with an increase of the surface net downward shortwave flux over the reforested zone. When considering the heat waves, an increase (a decrease) of these events is recorded over the southern Sahel during JJA and SON periods (over the whole Sahelian region during DJF), respectively. Changes in latent heat flux appear to be largely responsible for these extreme temperatures change. This work shows that the vegetation change may impact positively some regions like the reforested area by reducing the occurrence of thermal extremes;while other Sahel regions (eastern part of the central Sahel) could suff

关键词： RegCM4 Reforestation Heat Waves Sahel

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钠蒙脱石水化机理模拟研究

钠蒙脱石水化机理模拟研究

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作者： camara Moussa 中国石油大学(华东)

学位级别：硕士

Montmorillonite is a layered swelling clay mineral that has the ability to uptake and release water and chemical species,and to exchange its structural *** properties are benefit in various fields including the study of catalysis,soil mechanics,agronomy,ecology,waste management,drug,borehole *** clay swelling is a goal of large amount of interest from the academia to the *** order to understand and minimize the swelling of Clay minerals,knowledge on Na-montmorillonite（Na-MMT）structure,physical and chemical characteristics and swelling inhibitors are *** study was based on the investigation of the swelling properties of Na-MMT and the impact of the use of inorganic salts on its stability while *** modeling software Material Studio 5.0 was used to build a crystal model,analyze the hydration process and mechanism of *** simulation results showed that the basal spacing of Na-MMT gradually increased with the increase in the adsorbed water molecules between the interlayer ***,two and three water layers were formed when the amount of water molecules reached 48,72,*** studio software was used to calculate the hydration parameters of the cations present into layer *** results obtained from the dynamics simulation at HTHP have shown that,the effects of the hydration degree,the temperature and pressure are more important on the diffusion of water molecules than the cations,and that,the hydration degree of Na-MMT depends on the type of cations present between the *** have also found that,the size,the mass of the cations hydrated affect the diffusion behaviors of the interlayer species,and also that the hydration energy of the interlayer cations does not depend on the hydration degree and the change in temperature and *** the study of the thermodynamics parameters of Na-MMT after addition of inorganic salts,we observed that,the state of Na-MMT became more stable with the add

关键词：钠蒙脱石水化机理溶胀特性热力学参数

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Cerebral Malaria: Epidemiological, Clinical and Prognosis Aspects in the Anesthesia-Resuscitation Department CHU Ignace Deen

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Open Journal of Emergency Medicine 2023年第4期11卷 162-173页

作者： Abdoulaye Touré Amadou Yalla camara Almamy Bangoura M’mah Lamine camara Mohamed Soumah Saramba Nabe Department of Anesthesia-Resuscitation University Hospital of Ignace Deen of Conakry Conakry Guinea Department of Medical and Surgical Emergency Donka University Hospital Conakry Guinea Department of Anesthesia-Resuscitation Donka University Hospital Conakry Guinea

Objective: To describe the epidemiological, clinical, paraclinical and prognostic aspects of cerebral malaria received in the anesthesia-resuscitation department. Methodology: This was a prospective descriptive type study carried out in the anesthesia-resuscitation department over a period of three (03) months (June 01 to August 31, 2022). All patients admitted for cerebral malaria were included. Sociodemographic, clinical and prognostic parameters were studied. Results: We collected 25 cases out of 105 admitted patients (23.8%). The average age was 27.6 ± 9.5 years with extremes of 11 and 50 years. The sex ratio was 0.7 (M/F). Students and housewives were in the majority, i.e. 52% and 24%. Neurological disorders were found on admission in all patients, dominated by impaired consciousness at 100% followed by convulsion (60%), prostration (44%), confusion (36%) associated with deep coma in (68%). Gross hemoglobinuria was present in (84%) of cases. On the blood count, anemia was present in (70%) of the patients followed by thrombocytopenia in more than half of the cases (60%) and transfusion was necessary in 19 cases. P Falciparum malaria was found in all patients (100%), the average parasite density was 60342.8 ± 30425.6 trophozoites/μl with extremes of 9000 to 100000 trophozoites/μl. All our patients were treated with intravenous injectable artesunate. Transfusion was performed in 76% of our patients. Eighty percent of the patients had benefited from dialysis. High oxygen therapy was performed in (92%) of cases. The average duration of hospitalization was 5.74 ± days with extremes of 1 to 17 days. Mortality was 48%. Conclusion: Cerebral malaria can take different clinical forms, the most important of which is cerebral involvement. Prompt initiation of appropriate resuscitation can reduce mortality.

关键词： Cerebral Malaria Mortality Resuscitation

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Peritonitis: Perioperative Care in Surgical Emergencies CHU Ignace Deen

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Open Journal of Anesthesiology 2023年第4期13卷 85-94页

作者： Abdoulaye Touré Amadou Yalla camara Almamy Bangoura M’Mah Lamine camara Marie Paul Sidohon Okou Anesthesia-Resuscitation Service Ignace Deen Hospital Conakry Guinea Department of Medical and Surgical Emergency Donka University Hospital Conakry Guinea Anesthesia-Resuscitation Service Donka University Hospital Conakry Guinea

Objective: Describe the perioperative management of peritonitis in surgical emergencies. Methodology: This was a prospective observational study of the descriptive type over a period of 12 months from January 01 to December 31, 2020 in the surgical emergency room at the CHU Ignace Deen. Included in the study were all patients admitted for peritonitis aged greater than or equal to 18 years. The parameters were epidemiological, clinical and anesthetic. Results: Of the 653 admissions to surgical emergencies in 2020, 185 cases presented with peritonitis, i.e. 29.3%. The average age was 38.6 ± 16.64 years with extremes of 18 and 90 years. The sex ratio was 1.89. The comorbidities were dominated by gastritis and hypertension, i.e. 22%. The patients were classified as ASA 3U (52.4%), ASA2 U (39.5%) and ASA 4 U (8.1%). Preoperative resuscitation was provided only with 100% saline. 25.5% of patients had received a blood transfusion. The response time was less than 48 hours, i.e. 77.6%. General anesthesia was performed for all patients. Ketamine was the most used IV hypnotic (56.3%) combined with 100% halothane. The curares used were suxamethonium at (81.6%), Atracurium (81.6%) and rocuronium at (18.3%). Fentanyl was the only morphine used. Senior anesthesia technicians provided anesthesia in (63.2%). Intraoperative incidents were dominated by hypotension, difficult intubation, cardiac arrest, respectively 10.3%, 8% and 0.5%. The immediate postoperative incidents were arterial hypotension, nausea and desaturation, respectively 52.9%, 80% and 32.4%. Mortality was 3.4%. Conclusion: The perioperative management of peritonitis in the emergency room must be as early as possible in order to reduce morbidity and mortality.

关键词： Surgical Emergencies Peritonitis Anesthesia Perioperative

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