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1

Sleep Apnoea. Plymouth: European Respiratory Society, 2010.

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2

Karmakar, Nemai Chandra, Yang Yang, and Abdur Rahim. Microwave Sleep Apnoea Monitoring. Singapore: Springer Singapore, 2018. http://dx.doi.org/10.1007/978-981-10-6901-7.

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3

Fraser, Andrew K. Obstructive sleep apnoea and allied disorders. Glasgow: Scottish Forum for Public Health Medicine, 1997.

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4

Rees, Karen. Mechanisms of arousal responses from NREM sleep in patients with obstructive sleep apnoea. Salford: University ofSalford, 1995.

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5

Sleep with Buteyko: The only way to stop snoring, sleep apnoea and insomnia. Galway, Ireland: Buteyko Books, 2011.

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6

Nicoll, Deborah J. Prospective evaluation of pulse transit time in the diagnosis and management of the obstructive sleep apnoea/hypopnoea syndrome. Oxford: Oxford Brookes University, 1999.

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7

Pascualy, Ralph A. Snoring and Sleep Apnea. New York: Demos Medical Publishing, 2009.

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8

Carr, Michele M. Pediatric obstructive sleep apnea. Alexandria, VA: American Academy Of Otolaryngology--Head and Neck Surgery Foundation, 2007.

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9

Chilman-Blair, Kim. Medikidz explain sleep apnea. New York: Rosen Central, 2011.

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10

Kiyoshi, Togawa, ed. Sleep apnea and rhonchopathy. Basel: Karger, 1993.

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11

Understanding snoring and sleep apnea. New Haven, CT: Yale University Press, 2004.

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12

name, No. Snoring and obstructive sleep apnea. 3rd ed. Philadelphia, PA: Lippincott Willians & Wilkins, 2003.

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13

Kim, Ki Beom, Reza Movahed, Raman K. Malhotra, and Jeffrey J. Stanley, eds. Management of Obstructive Sleep Apnea. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-54146-0.

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14

McNicholas, W. T., and M. R. Bonsignore, eds. Sleep Apnoea. European Respiratory Society, 2010. http://dx.doi.org/10.1183/1025448x.erm5010.

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15

Craig, Sonya, and Sophie West. Obstructive sleep apnoea. Edited by Patrick Davey and David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0136.

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Obstructive sleep apnoea (OSA) is caused by the repetitive closure of the pharynx during sleep, leading to sleep fragmentation and, often, daytime somnolence. Traditionally, it is defined as either the number of apnoeas (complete cessation of breathing for longer than 10 seconds) or hyponoeas (reduction in air flow by >50%) per hour in an overnight sleep study. However, it must be remembered that this definition is arbitrary, and OSA is better viewed as a spectrum with trivial snoring at one end and severe, almost continuous obstruction at the other. In addition to the sleep-study findings, if the patient is sleepy during the day, as defined by the Epworth Sleepiness Scale, then this condition is termed ‘obstructive sleep apnoea syndrome’. This distinction is important, as patients with this syndrome usually warrant treatment.
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16

Johnson, Jonas T., Jack L. Gluckman, and Mark H. Sanders. Obstructive Sleep Apnoea. Informa Healthcare, 2001.

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17

Johnson, Jonas T., Jack L. Gluckman, and Mark H. Sanders. Obstructive Sleep Apnoea. Taylor & Francis Group, 2003.

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18

Johnson, Jonas T., Jack Gluckman, and Jack Sanders. Obstructive Sleep Apnoea. Taylor & Francis Group, 2001.

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19

Barbé, Ferran, and Jean-Louis Pépin, eds. Obstructive Sleep Apnoea. European Respiratory Society, 2015. http://dx.doi.org/10.1183/2312508x.erm6715.

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20

Pittman, Marcus, and Adrian Williams. Central sleep apnoea. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199657742.003.0005.

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Central sleep apnoea and Cheyne-Stokes respiration are common forms of sleep-disordered breathing, particularly in patients with co-morbidities such as cardiac and renal disease which, however, often do not require specific treatment. Physicians may encounter such patients in their outpatient clinics or as ward referrals in hospital. A typical case is presented to aid the approach to such patients, including how to make an accurate diagnosis, which of the various treatment modalities to use, and what to do if a treatment fails. The evidence for the different interventions is explored, including oxygen, modes of non-invasive positive airway pressure, and drug treatments, with particular attention to groundbreaking studies.
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21

Yang, Yang, Abdur Rahim, and Nemai Chandra Karmakar. Microwave Sleep Apnoea Monitoring. Springer, 2017.

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22

Karmakar, Nemai Chandra. Microwave Sleep Apnoea Monitoring. Springer, 2019.

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23

Eckersley, Jill. Coping with Snoring and Sleep Apnoea. SPCK Publishing, 2010.

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24

Coping With Snoring And Sleep Apnoea. Sheldon Press, 2010.

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25

Eckersley, Jill. Coping with Snoring and Sleep Apnoea. SPCK Publishing, 2010.

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26

Selim, Bernardo, and Kannan Ramar. Beyond positive airway pressure therapy: experimental and non-conventional treatments in sleep apnoea. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0259.

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With decreased adherence to positive airway pressure therapy to treat sleep apnoeas, non-conventional treatments based on new therapeutic targets are emerging. In central sleep apnoea syndrome associated with heart failure, phrenic nerve stimulation and non-conventional pharmacological treatments such as carbonic anhydrase inhibitors, gas therapies, and cardiac devices are novel alternative therapies. In obstructive sleep apnoea, a better understanding of predominant pathophysiological pathways is characterizing diverse clinical phenotypes. For patients with low arousal threshold, sedatives or hypnotics might be effective, whereas for those with unstable ventilatory control, carbonic anhydrase inhibitors or oxygen might improve obstructive sleep apnoea. For patients with upper airway muscle dysfunction, an increase in pharyngeal tone might be beneficial. This chapter describes ‘experimental’ therapies and novel technologies to treat these disorders.
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27

G, Semple S. J., and Royal College of Physicians of London. Working Party on Sleep Apnoea and Related Conditions., eds. Sleep apnoea and related conditions: With recommendations for service provision. London: Royal College of Physicians of London, 1993.

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28

Walder, Dave, and Paul Reading. Narcolepsy: still sleepy on CPAP. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199657742.003.0011.

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Sleep disorders are an increasingly common reason for referral to the respiratory clinic, and our understanding of the different aetiologies is increasing. The commonest sleep disorder is sleep apnoea, but other sleep disorders can cause similar symptoms. Narcolepsy is a neurological disorder that affects the brain’s ability to regulate the normal sleep-wake cycle and often presents with similar symptoms to obstructive sleep apnoea, daytime hypersomnolence, and disturbed night-time sleeping but is largely underdiagnosed. This chapter discusses a patient who presented with symptoms of daytime somnolence and witnessed apnoeas and details the investigations required for a diagnosis of narcolepsy. It covers the more specialized sleep studies required for a clinical diagnosis and the treatment options available for patients with this condition.
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29

J, Chilcott, and Trent Institute for Health Services Research. Working Group on Acute Purchasing., eds. Nasal continuous positive airways pressure in the management of sleep apnoea. Sheffield: Trent Institute for Health Sevices Research, 2000.

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30

Epstein, Lawrence J. Sleep disorders. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780198778240.003.0007.

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Over 70 described sleep disorders disrupt the sleep of an estimated 50–70 million Americans. The disorders present with a broad array of symptoms but result in the individual not getting the health, cognitive, and restorative benefits of a good night’s sleep. The disorders have been categorized into the following categories: insomnia, sleep-related breathing disorders, central disorders of hypersomnolence, circadian rhythm sleep–wake disorders, parasomnias, and sleep-related movement disorders. This chapter reviews each category and provides details on the symptoms, pathophysiology, and treatment of the most common disorder in each category, including insomnia, obstructive sleep apnoea, narcolepsy, restless legs syndrome, and REM sleep behaviour disorder. The presenting complaint is the key to diagnosis, directing subsequent evaluation.
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31

Zaiwalla, Zenobia, and Roo Killick. Sleep disorders. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199688395.003.0035.

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As sleep medicine advances, there is increasing demand on services including neurophysiology to investigate sleep disorders. This chapter classifies the sleep disorders according to the main symptom presenting to the clinician, including excessive daytime sleepiness, insomnia, patients sleeping at the wrong times due to a circadian rhythm disorder, and movements or behaviours in sleep. The clinical presentation of common sleep disorders in each category are outlined, including obstructive sleep apnoea, narcolepsy, restless leg syndrome, periodic leg movements disorder, circadian rhythm disorders, and non-rapid eye movement and rapid eye movement parasomnias. The chapter discusses the overlap of symptoms in different sleep disorders, and the importance of selecting appropriate sleep studies, and recognizes the pitfalls, both clinical and in interpretation of sleep studies. The difficulties in diagnosing narcolepsy and differentiating from other causes of excessive daytime sleepiness, and when to investigate parasomnias is explained.
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32

Mosimann, Urs Peter, and Bradley F. Boeve. Sleep disorders. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199644957.003.0051.

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This book chapter reviews the most common sleep disorders in older adults and their treatment. It begins with a brief review of sleep physiology and then gives an outline on how to take a comprehensive sleep history. Sleep is commonly defined as a periodic temporary loss of consciousness with restorative effects. There are physiological sleep changes related to ageing, but sleep disorders are not part of normal ageing and are often associated with mental or physical disorders, pain and neurodegenerative disease. The most common sleep disorders include insomnia, obstructive sleep apnoea, restless legs syndrome, REM sleep behaviour disorder, excessive daytime somnolence and circadian rhythms disorders. An in depth clinical history, including if possible bed-partner’s information, is the key to diagnosis. Patients need to be informed about the physiological sleep changes and the principles of sleep hygiene. They can benefit from pharmacological and non-pharmacological treatment strategies.
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33

Edwards, Bradley A., and Garun S. Hamilton. Sleep and respiratory disorders. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780198778240.003.0009.

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A number of sleep-related breathing and respiratory disorders impact our ability to achieve a good night’s sleep. Unfortunately, these disorders are becoming increasingly common—a phenomenon that has been linked to the rising obesity rates in society. In this chapter we aim to provide an overview of how some of the most common disorders (particularly obstructive sleep apnoea) contribute to poor sleep, review how these disorders/diseases impact both the individual and society, and discuss some of the key challenges and hurdles that we, as a society, will need to overcome if we are to maximize sleep quality in the community.
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34

Miller, Michelle A. Sleep, inflammation, and disease. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780198778240.003.0012.

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Sleep is a fundamental requirement for living individuals. Sleep disturbances and sleep disorders have extensive effects on the immune system, affecting one’s susceptibility to, and ability to fight off, infections—both bacterial and viral—and the subsequent development of different diseases. This is mediated by the increase in pro-inflammatory cytokines associated with sleep loss and disruption. A number of common conditions, such as obesity, cardiovascular disease, metabolic syndrome, obstructive sleep apnoea syndrome, rheumatoid arthritis, and systemic lupus erythematosus, all share pro-inflammatory mechanisms and the presence of sleep disturbances. Early identification of sleep disorders, and the associated adverse inflammatory and metabolic risk factors, in affected individuals would have a clear clinical benefit.
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35

Dodds, Chris, Chandra M. Kumar, and Frédérique Servin. Cognitive dysfunction and sleep disorders. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198735571.003.0014.

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Cognitive dysfunction is largely a problem in the elderly, but it can occur at any age. The two major presentations, delirium and postoperative cognitive dysfunction (POCD), are compared. Risks for delirium are explored; key points from the patient’s history and possible ways to ameliorate the onset are then reviewed. The presentation of POCD is described, and the lack of our understanding of its causes is highlighted. Known triggers such as centrally active anticholinergic drugs or pain are identified. Current thinking in the inflammatory responses within microglia and astrocytes is summarized. Sleep in the elderly is contrasted with that in younger persons, and the main stages of sleep, SWS and REM, described. The impact and importance of the effects that surgery/anaesthesia has on sleep stages is reviewed. Obstructive sleep apnoea is described, including its effect on the safety of anaesthesia and recovery. Periodic limb movement disorders and early Parkinson disease are described.
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36

Relief from Snoring and Sleep Apnoea: A Step-by-Step Guide to Quiet, Restful Sleep and Better Health Through Changing the Way You Breathe. Penguin Random House, 2012.

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37

Mandal, Swapna, and Joerg Steier. Sleep-disordered breathing in the obese. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199657742.003.0018.

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Sleep-disordered breathing in the obese is not a small problem. Obesity-related sleep-disordered breathing is common and may include sleep apnoea or obesity hypoventilation syndrome. Patients present with symptoms of excessive daytime sleepiness, breathlessness, and, in severe cases, hypercapnic respiratory failure. In recent decades, the prevalence of obesity has increased exponentially. Although not exclusively responsible, obesity is directly linked to the development of sleep-disordered breathing due to high resistance in the upper airway, increased work of breathing, and high neural respiratory drive. Obese patients with sleep disorders are complicated with multiple metabolic, cardiovascular, and orthopaedic co-morbidities, frequently presenting at an advanced stage. This chapter reviews a common clinical presentation of an obese patient with a respiratory condition and the difficulties in their management. The chapter explains the complex underlying pathophysiology and the long-term management of these patients, and shows how sleep-disordered breathing may develop as a consequence of obesity.
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38

Katritsis, Demosthenes G., Bernard J. Gersh, and A. John Camm. Conduction disease in specific conditions. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199685288.003.1501_update_002.

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39

Harder, Louise, and Atul Malhotra. Pathophysiology and therapeutic strategy for sleep disturbance in the ICU. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0225.

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Robust data have shown that sleep disruption and inadequate sleep duration in the general population impact neurocognitive function and produce cardiometabolic sequelae. Despite widespread recognition of the importance of sleep as an essential homeostatic function, there are relatively few data regarding the importance of sleep in critically-ill patients. Obstructive sleep apnoea is a common respiratory condition that is prevalent in the ICU and can be particularly problematic pre-intubation, post-extubation, and in the peri-operative setting. Considerable discussion regarding the impact of sleep versus sedation has occurred, with some insights emerging from improvements in our understanding of basic neurobiology. Sleep disturbance may also have an impact in critically-ill mechanically-ventilated patients by contributing to the development of delirium, which is associated with poor outcomes. However, further data are required to determine the ideal strategy to optimize sleep in the ICU and whether such strategies will in turn improve hard outcomes of critically-ill patients.
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40

The Perils of Sleep Apnea--An Undiagnosed Epidemic: A Layman's Perspective. iUniverse, Inc., 2007.

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41

Roberts, Fred. Ear, nose, and throat surgery. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198719410.003.0026.

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This chapter discusses the anaesthetic management of ear, nose, and throat surgery (otolaryngological surgery). It begins with a discussion of relevant general principles (including the shared airway) and covers airway obstruction and sleep apnoea. Surgical procedures covered include grommet insertion, tonsillectomy, adenoidectomy, myringoplasty, stapedectomy, tympanoplasty, nasal cavity surgery, microlaryngoscopy, tracheostomy, laryngectomy, pharyngectomy (including glossectomy), radical neck dissection, and parotidectomy. It concludes with a series of vignettes of other ear, nose, and throat procedures.
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42

Roberts, Fred. Ear, nose, and throat surgery. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198719410.003.0026_update_001.

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This chapter discusses the anaesthetic management of ear, nose, and throat surgery (otolaryngological surgery). It begins with a discussion of relevant general principles (including the shared airway) and covers airway obstruction and sleep apnoea. Surgical procedures covered include grommet insertion, tonsillectomy, adenoidectomy, myringoplasty, stapedectomy, tympanoplasty, nasal cavity surgery, microlaryngoscopy, tracheostomy, laryngectomy, pharyngectomy (including glossectomy), radical neck dissection, and parotidectomy. It concludes with a series of vignettes of other ear, nose, and throat procedures.
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43

Pack. Sleep Apnea. Marcel Dekker, 2002.

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44

Pack, Allan I., ed. Sleep Apnea. CRC Press, 2002. http://dx.doi.org/10.1201/b14008.

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45

Accardo, Jennifer. Sleep Apnea. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199937837.003.0174.

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Sleep apnea is a common condition involving breathing during sleep, which nonetheless has consequences beyond the scope of either sleep or breathing. Repeated, reversible respiratory obstructions are related to abnormal ventilatory drives and decreased upper airway neuromuscular activation. They result in dysautonomia, sleep fragmentation, and increased cardiovascular risks. Obstructive sleep apnea classically presents with daytime sleepiness and snoring, and its effects on learning, cognition, and mood are pervasive. On a neuropathologic basis, corresponding damage to widespread brain structures is noted. Obstructive sleep apnea is considered treatable, but it is unclear whether its cognitive effects are fully reversible with treatment.
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46

Randerath, W. J., B. M. Sanner, and V. K. Somers, eds. Sleep Apnea. S. Karger AG, 2006. http://dx.doi.org/10.1159/isbn.978-3-318-01299-6.

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47

Bradley, T. Douglas, and John S. Floras, eds. Sleep Apnea. CRC Press, 2000. http://dx.doi.org/10.1201/b15277.

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48

Bradley, T. Douglas, and John S. Floras, eds. Sleep Apnea. CRC Press, 2016. http://dx.doi.org/10.3109/9781420018516.

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49

Pack, Allan I., ed. Sleep Apnea. CRC Press, 2016. http://dx.doi.org/10.3109/9781420020885.

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50

Floras, John S., and T. Douglas Bradley. Sleep Apnea. Taylor & Francis Group, 2019.

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