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Lee Stoner
  • Wellington, Wellington, New Zealand
  • In short, I'm interest in tuning your ticker. More specifically, since joining Massey University in 2011 I have contr... moreedit
Objective: Childhood cardiometabolic disease risk (CMD) has been associated with short sleep duration. Its relationship with other aspects of sleep should also be considered, including social jetlag (SJL) which represents the difference... more
Objective: Childhood cardiometabolic disease risk (CMD) has been associated with short sleep duration. Its relationship with other aspects of sleep should also be considered, including social jetlag (SJL) which represents the difference between a person's social rhythms and circadian clock. This study investigated whether childhood CMD risk is associated with sleep duration, sleep disturbances, and SJL.Study Design: The observational study included 332 children aged 8–10 years (48.5% female). The three independent variables were sleep duration, sleep disturbances, and SJL. SJL was calculated as the variation in hours between the midpoint of sleep during free (weekend) days and work/school days. Eleven cardiometabolic biomarkers were measured, including central blood pressure, lipids, glycated hemoglobin, arterial wave reflection, and glucose. Underlying CMD risk factors were identified using factor analysis.Results: Four underlying CMD risk factors were identified using factor a...
Purpose: To evaluate if sedentary time (ST) is associated with heart rate (HR) and variability (HRV) in adults. Methods: We systematically searched PubMed and Google Scholar through June 2020. Inclusion criteria were observational design,... more
Purpose: To evaluate if sedentary time (ST) is associated with heart rate (HR) and variability (HRV) in adults. Methods: We systematically searched PubMed and Google Scholar through June 2020. Inclusion criteria were observational design, humans, adults, English language, ST as the exposure, resting HR/HRV as the outcome, and (meta-analysis only) availability of the quantitative association with variability. After qualitative synthesis, meta-analysis used inverse variance heterogeneity models to estimate pooled associations. Results: Thirteen and eight articles met the criteria for the systematic review and meta-analysis, respectively. All studies were cross-sectional and few used gold standard ST or HRV assessment methodology. The qualitative synthesis suggested no associations between ST and HR/HRV. The meta-analysis found a significant association between ST and HR (β = 0.24 bpm per hour ST; CI: 0.10, 0.37) that was stronger in males (β = 0.36 bpm per hour ST; CI: 0.19, 0.53). Po...
Over the past decade there have been increasing calls to develop the capacity of United States students to think and act globally (Stearns, 2009). One method of encouraging the civic of global citizenship is through study abroad (Tarrant,... more
Over the past decade there have been increasing calls to develop the capacity of United States students to think and act globally (Stearns, 2009). One method of encouraging the civic of global citizenship is through study abroad (Tarrant, 2010). However, the educational value and legitimacy of study abroad, in particular short-term programs, has been questioned (Tarrant & Lyons, 2012). This review and commentary will endeavor to support short-term study abroad as a creative, engaging, and effective educative practice. Building on a proposed theoretical framework grounding investigations focused on study abroad and global citizenship (Tarrant, 2010), a review of literature will examine Dewey’s (1933, 1938) conceptualization of educative experiences as necessary and valuable components for a learner, and Mezirow’s (1991) transformative learning theory (TLT) in connection with the fundamental role that critical reflection serves in both established perspectives of learning. Of particul...
Introduction: Aortic stiffness offers important insight into vascular aging and cardiovascular disease (CVD) risk. The referent measure of aortic stiffness is carotid-femoral pulse wave velocity (cfPWV). cfPWV can be estimated (ePWV) from... more
Introduction: Aortic stiffness offers important insight into vascular aging and cardiovascular disease (CVD) risk. The referent measure of aortic stiffness is carotid-femoral pulse wave velocity (cfPWV). cfPWV can be estimated (ePWV) from age and mean arterial pressure. Few studies have directly compared the association of ePWV to measured cfPWV, particularly in non-White adults. Moreover, whether ePWV and cfPWV correlate similarly with CVD risk remains unexplored. Aim: (1) To estimate the strength of the agreement between ePWV and cfPWV in both Black and White older adults; and (2) to compare the associations of ePWV and cfPWV with CVD risk factors and determine whether these associations were consistent across races. Methods and Results: We evaluated 4478 [75.2 (SD 5.0) years] Black and White older adults in the Atherosclerosis Risk in Communities (ARIC) Study. cfPWV was measured using an automated pulse waveform analyzer. ePWV was derived from an equation based on age and mean ar...
Public health guidelines for physical activity now include recommendations to break up prolonged sitting with light-intensity activities. Concurrently, interventions to increase standing have emerged, especially within the workplace in... more
Public health guidelines for physical activity now include recommendations to break up prolonged sitting with light-intensity activities. Concurrently, interventions to increase standing have emerged, especially within the workplace in the form of sit–stand or standing workstations. Moreover, in short-duration studies, breaking up prolonged sitting with standing has been associated improved cardiometabolic outcomes. Publicly available estimates of the intensity of standing range from 1.5 to 2.3 metabolic equivalents (METs), neatly classifying standing as a light-intensity activity (>1.5 to <3.0 METs). Further delineation between ‘active’ and ‘passive’ standing has been proposed, with corresponding METs of >2.0 METs and ≤2.0 METs, respectively. However, this study reviews data suggesting that some standing (e.g., while performing deskwork) is substantially below the minimum light intensity activity threshold of 1.5 METs. These data bring into question whether standing should...
This commentary offers discussion on the pros and cons of universal healthcare in the United States. Disadvantages of universal healthcare include significant upfront costs and logistical challenges. On the other hand, universal... more
This commentary offers discussion on the pros and cons of universal healthcare in the United States. Disadvantages of universal healthcare include significant upfront costs and logistical challenges. On the other hand, universal healthcare may lead to a healthier populace, and thus, in the long-term, help to mitigate the economic costs of an unhealthy nation. In particular, substantial health disparities exist in the United States, with low socio–economic status segments of the population subject to decreased access to quality healthcare and increased risk of non-communicable chronic conditions such as obesity and type II diabetes, among other determinants of poor health. While the implementation of universal healthcare would be complicated and challenging, we argue that shifting from a market-based system to a universal healthcare system is necessary. Universal healthcare will better facilitate and encourage sustainable, preventive health practices and be more advantageous for the ...
Sedentary behavior, particularly sitting, is ubiquitous in many contemporary societies. This is a major societal concern considering the evidence for a strong association between sitting behavior and cardiovascular disease morbidity and... more
Sedentary behavior, particularly sitting, is ubiquitous in many contemporary societies. This is a major societal concern considering the evidence for a strong association between sitting behavior and cardiovascular disease morbidity and mortality. Unsurprisingly, leading public health agencies have begun to advocate “reduction” in sitting behavior. Though, the guidelines are typically vague and non-specific. The lack of specific guidelines for prolonged sitting is attributable to the absence of available evidence to facilitate guideline development. To inform policy, well-designed randomized controlled trials are required to test the efficacy of specific and translatable sitting reduction strategies. To guide the design of randomized controlled trials, this review postulates that several gaps in the literature first need to be filled. Following a general discussion of the importance of sitting behavior to contemporary societies, each of the following are discussed: (i) acute sitting...
Type II diabetes mellitus (T2DM) is a metabolic disorder that occurs in the body because of decreased insulin activity and/or insulin secretion. The incidence of T2DM has rapidly increased over recent decades. The relation between... more
Type II diabetes mellitus (T2DM) is a metabolic disorder that occurs in the body because of decreased insulin activity and/or insulin secretion. The incidence of T2DM has rapidly increased over recent decades. The relation between consumption of different types of red meats and risk of T2DM remains uncertain. This meta-analysis was conducted to quantitatively assess the associations of processed red meat (PRM) and unprocessed red meat (URM) consumption with T2DM. We searched PubMed, Embase, Web of Science and The Cochrane Library for English-language cohort studies published before January 2021. Summary relative risks (RR) with 95% confidence interval (CI) were estimated using fixed effects and random effects. Additionally, dose–response relationships were explored using meta-regression. Fifteen studies (N = 682,963 participants, cases = 50,675) were identified. Compared with the lowest intake group, high consumption of PRM and URM increased T2DM risk by 27% (95% CI 1.15–1.40) and 1...
Background: The aortic to femoral arterial stiffness gradient (af-SG) may be a novel measure of arterial health and cardiovascular disease (CVD) risk, but its association with CVD risk factors and CVD status, and whether or not they... more
Background: The aortic to femoral arterial stiffness gradient (af-SG) may be a novel measure of arterial health and cardiovascular disease (CVD) risk, but its association with CVD risk factors and CVD status, and whether or not they differ from the referent measure, carotid-femoral pulse-wave velocity (cfPWV), is not known. Method: Accordingly, we compared the associations of the af-SG and cfPWV with (i) age and traditional CVD risk factors and (ii) CVD status. We evaluated 4183 older-aged (75.2 ± 5.0 years) men and women in the community-based Atherosclerosis Risk in Communities (ARIC) Study. cfPWV and femoral-ankle PWV (faPWV) were measured using an automated cardiovascular screening device. The af-SG was calculated as faPWV divided by cfPWV. Associations of af-SG and cfPWV with age, CVD risk factors (age, BMI, blood pressure, heart rate, glucose and blood lipid levels) and CVD status (hypertension, diabetes, coronary heart disease, heart failure, stroke) were determined using linear and logistic regression analyses. Results: (i) the af-SG and cfPWV demonstrated comparable associations with age and CVD risk factors, except BMI. (ii) a low af-SG was associated with diabetes, coronary heart disease, heart failure and stroke, whilst a high cfPWV was only associated with diabetes. Conclusion: Although future studies are necessary to confirm clinical utility, the af-SG is a promising tool that may provide a unique picture of hemodynamic integration and identification of CVD risk when compared with cfPWV.
Study abroad has shifted from a marginal opportunity to a core strategy of U.S. colleges and universities, considered integral in the mission to globalize the academic environment. Our study explores the effect of studying abroad and... more
Study abroad has shifted from a marginal opportunity to a core strategy of U.S. colleges and universities, considered integral in the mission to globalize the academic environment. Our study explores the effect of studying abroad and studying about sustainability on students’ global perspectives. A total of 291 university students participated in a pretest/posttest design. Results suggest that study abroad can promote cognitive, intrapersonal, and social developmental global perspectives among college students beyond that achieved via on-campus courses. Sustainability course content did not affect global perspectives, however. Findings warrant the conclusion that even short-term study abroad experiences can meet the globalisation goals of institutions of higher education.
Flow-mediated slowing (FMS), defined as the minimum pulse wave velocity (PWVmin) during reactive hyperemia, is potentially a simple, user-objective test for examining endothelial function. The purpose of the current study was to determine... more
Flow-mediated slowing (FMS), defined as the minimum pulse wave velocity (PWVmin) during reactive hyperemia, is potentially a simple, user-objective test for examining endothelial function. The purpose of the current study was to determine the effects of a known endothelial dysfunction protocol on arm PWV and PWVmin. Complete data were successfully collected in 22 out of 23 healthy adults (23.8 years [SD 4.1], 16 F, 22.8 kg/m2 [SD 2.8]). Local endothelial dysfunction was induced by increasing retrograde shear stress in the upper arm, through inflation of a distal (forearm) tourniquet to 75 mmHg, for 30 min. Pre- and post-endothelial dysfunction, PWV was measured followed by simultaneous assessment of PWVmin and flow-mediated dilation (FMD). PWV was measured between the upper arm and wrist using an oscillometric device, and brachial FMD using ultrasound. FMD (%) and PWVmin (m/s) were calculated as the maximum increase in diameter and minimum PWV during reactive hyperemia, respectively...
The increased risk of falls associated with advancing age has increased demand for methods to improve balance and mobility. The primary purpose of the study was to determine whether wearing Aqua Titan-treated stockings could improve... more
The increased risk of falls associated with advancing age has increased demand for methods to improve balance and mobility. The primary purpose of the study was to determine whether wearing Aqua Titan-treated stockings could improve balance and walking performance in an older population; secondary was to elucidate the mechanisms. In a randomized, double-blind crossover, 16 healthy older adults (age, 67.9 ± 4.2 years; BMI, 24.8 ± 3.1 kg/m²) performed two 4-day trials composed of baseline measures and fatiguing exercise on Day 1, with recovery measures at 14, 38 and 62 h post-exercise, wearing Aqua Titan and control stockings. Balance, walking performance, triceps surae stretch reflex, ankle range of motion and gastrocnemius muscle microvascular perfusion, blood flow and oxygen consumption were measured at baseline and during recovery. Aqua Titan had no effect on the microvascular parameters, but increased total ankle range of motion at 38 h (2.4°; 95% CI ± 1.8°) and 62 h (2.7...
Measurement of central hemodynamic parameters, including central systolic blood pressure (cSBP) and arterial wave reflection (augmentation index, AIx), may provide clinicians with important information beyond that provided by peripheral... more
Measurement of central hemodynamic parameters, including central systolic blood pressure (cSBP) and arterial wave reflection (augmentation index, AIx), may provide clinicians with important information beyond that provided by peripheral blood pressure. These parameters can be obtained using oscillometric pulse wave analysis (PWA) devices, which have recently entered the market. Prior to clinical implementation, further study is required to determine measurement precision (reliability), including under conditions which may vary in the clinical setting. PURPOSE: This study sought to examine whether the between-day reliability of oscillometric cSBP and AIx readings: (i) exceed the criterion for acceptable reliability; (ii) are affected by posture (supine, seated) and fasting state. METHODS: Twenty healthy adults (50% F, 27.9 y, 24.2 kg/m2) were tested on six different mornings: three days fasted, three days non-fasted. On each occasion participants were tested in supine and seated postures, resulting in a total of 12 measurements per person, and a total of 240 data points. Oscillometric pressure waveforms were recorded on left upper arm using the SphygmoCor XCEL (AtCor Medical, Sydney, Australia). RESULTS: Repeated measures analysis of variance indicated a non-significant interaction effect (posture X fasting state) for cSBP (P = 0.479) and AIx (P = 0.207). For cSBP there was nonsignificant main effect for fasting state (P = 0.819) but there was a main effect for posture (P = 0.002). Conversely, for AIx there was non-significant main effect for posture (P = 0.537) but there was a large main effect for fasting state (P = <0.001). The criterion intra-class correlation coefficient value of 0.75 was exceeded for both variables when participants were assessed under the combined supine-fasted condition. For cSBP the reliability coefficient (RC) was lowest (best) when supine-fasted (6.8 mmHg) and greatest (worst) when seated-non-fasted (8.6 mmHg). For AIx, the RC was lower for the supine (11.4 11.7 %) compared to seated (14.0 15.2 %) posture. CONCLUSIONS: Findings from this study suggest that oscillometric assessments of central hemodynamic variables: (i) exceed the criterion for acceptable reliability; (ii) are most reliable when participants are evaluated while supine and fasted.
This study assessed the effectiveness of a 6-week, high-intensity, games-based intervention on physiological and anthropometric indices of health, in normal weight (n = 26; 32.5 ± 8.9 kg) and obese (n = 29; 49.3 ± 8.9 kg) children (n = 32... more
This study assessed the effectiveness of a 6-week, high-intensity, games-based intervention on physiological and anthropometric indices of health, in normal weight (n = 26; 32.5 ± 8.9 kg) and obese (n = 29; 49.3 ± 8.9 kg) children (n = 32 boys, 23 girls), aged 8-10 years. Children were randomised into an exercise or control group. The exercise group participated in a twice-weekly, 40 min active games intervention, alongside their usual school physical education classes. The control group did not take part in the intervention. Before and after the intervention, participants completed both a maximal and submaximal graded exercise test. The submaximal exercise test comprised of a 6 min, moderate- and 6 min heavy-intensity bout, interspersed with a 5 min recovery. The exercise group demonstrated improvements in maximal oxygen uptake (51.4 ± 8.5 vs 54.3 ± 9.6 ml · kg(-1) · min(-1)) and peak running speed (11.3 ± 1.6 vs 11.9 ± 1.6 km · h(-1)), and a reduction in the oxygen cost of submaxi...
Objective. To identify modifiable cardio-metabolic and lifestyle risk factors among indigenous populations from Australia (Aboriginal Australians/Torres Strait Islanders), New Zealand (Māori), and the United States (American Indians and... more
Objective. To identify modifiable cardio-metabolic and lifestyle risk factors among indigenous populations from Australia (Aboriginal Australians/Torres Strait Islanders), New Zealand (Māori), and the United States (American Indians and Alaska Natives) that contribute to cardiovascular disease (CVD).Methods. National health surveys were identified where available. Electronic databases identified sources for filling missing data. The most relevant data were identified, organized, and synthesized.Results. Compared to their non-indigenous counterparts, indigenous populations exhibit lower life expectancies and a greater prevalence of CVD. All indigenous populations have higher rates of obesity and diabetes, hypertension is greater for Māori and Aboriginal Australians, and high cholesterol is greater only among American Indians/Alaska Natives. In turn, all indigenous groups exhibit higher rates of smoking and dangerous alcohol behaviour as well as consuming less fruits and vegetables. A...
Preventative measures taken worldwide to decrease the transmission of COVID-19 have had a tremendous impact on youth. Following social restrictions, youth with and without physical disabilities are engaging in less physical activity, more... more
Preventative measures taken worldwide to decrease the transmission of COVID-19 have had a tremendous impact on youth. Following social restrictions, youth with and without physical disabilities are engaging in less physical activity, more increased sedentary behavior, and poor sleep habits. Specifically, youth wheelchair users (YWU) are likely disproportionately affected by COVID- 19 and have a higher risk of contraction due to underlying comorbidities. While we cannot control all of the negative long-term implications of COVID-19 for YWU, participation in positive 24-h activity behaviors can decrease chronic disease risk and the likelihood of long-term complications resulting from infection. This commentary is to extend the discourse on the importance of 24-h activity behaviors by focusing on YWU. Specifically, we discuss the importance of chronic disease prevention, provide a brief overview of 24-h activity behaviors, and outline some of the lessons that can be learned from the CO...
Arterial stiffness is an important marker of vascular damage and a strong predictor of cardiovascular diseases (CVD). Given that pathophysiological processes leading to an increased arterial stiffness begin during childhood, the aim of... more
Arterial stiffness is an important marker of vascular damage and a strong predictor of cardiovascular diseases (CVD). Given that pathophysiological processes leading to an increased arterial stiffness begin during childhood, the aim of this clustered observational study was to determine the relationship between modifiable factors including dietary patterns and indices of aortic arterial stiffness and wave reflection in 9–11-year-old children. Data collection was conducted between April and December 2015 in 17 primary schools in Dunedin, New Zealand. Dietary data were collected using a previously validated food frequency questionnaire and identified using principal component analysis method. Arterial stiffness (carotid-femoral pulse wave velocity, PWV) and central arterial wave reflection (augmentation index, AIx) were measured using the SphygmoCor XCEL system (Atcor Medical, Sydney, Australia). Complete data for PWV and AIx analyses were available for 389 and 337 children, respectiv...
This cross-sectional study determined whether 6-n-propylthiouracil (PROP) taster status moderates the relationship between food consumption patterns and body composition in children. Children were recruited (n = 342, 50% female, 8–10 y)... more
This cross-sectional study determined whether 6-n-propylthiouracil (PROP) taster status moderates the relationship between food consumption patterns and body composition in children. Children were recruited (n = 342, 50% female, 8–10 y) from across New Zealand. Using a food frequency questionnaire, these food consumption patterns were derived: Processed Foods, Fruit and Vegetables, and Breakfast Foods. Body composition variables included: body fat (%), fat mass (kg), fat mass index (FMI, kg/m2), body mass index (kg/m2) and waist to height ratio (W:Ht). Following adjustment for confounders, Processed Foods were positively associated with %fat (p = 0.015), fat mass (p = 0.004) and FMI (p = 0.016). Taste test strips determined PROP status. For Breakfast Foods, there were small negative associations with all body composition variables (p ≤ 0.001 to 0.037). The population sample was also stratified by PROP taster status. For the non-tasters, there were small to moderate negative associat...
To determine which ultrasound-based, single-point arterial stiffness estimate is least dependent on blood pressure (BP) to improve assessment of local vascular function. Ultrasound was used to assess blood flow and diameters at the left... more
To determine which ultrasound-based, single-point arterial stiffness estimate is least dependent on blood pressure (BP) to improve assessment of local vascular function. Ultrasound was used to assess blood flow and diameters at the left brachial artery of 20 healthy adults [55% female, 27.9 years (5.2), 24.2 (2.8) kg/m]. BP of both arms was measured simultaneously. Experimental (left) arm BP was then systematically manipulated by adjusting its position ABOVE (+30°) and BELOW (-30°) heart level in a randomized order following measurement at heart level (0°). The control (right) arm remained at heart level. Six stiffness measurements were calculated: compliance, distensibility, beta-stiffness, and three estimates of pulse wave velocity (PWV) (Bramwell Hill, blood flow, and beta-stiffness). We considered the measurement technique with the least significant change across positions to be the least pressure-dependent. There was a large effect change in mean arterial pressure (np = 0.75, P < 0.001) in the experimental arm when it was ABOVE (Δ-4.4 mmHg) and BELOW (Δ10.4 mmHg) heart level. There was a main effect (P < 0.05) of arm position on all arterial stiffness measures. From least to most pressure-dependent, the arterial stiffness measurements were: PWV (blood flow method), compliance coefficient, beta-stiffness, distensibility coefficient, PWV (Bramwell-Hill method), and PWV (beta-stiffness index method). All single-point measures assessed are pressure-dependent. The PWV (blood flow method) may be the least pressure-dependent single-point measure, and may be the most suitable single-point measure to assess local vascular function.
Abstract We examined whether participation (n= 623 students) in educational travel programs influenced support for environmental policies across different citizen types (justice-oriented, participatory, personally responsible, and... more
Abstract We examined whether participation (n= 623 students) in educational travel programs influenced support for environmental policies across different citizen types (justice-oriented, participatory, personally responsible, and non-citizen). Findings showed that (1) ...
Arterial stiffness (AS) is a key measure in predicting risk for cardiovascular disease (CVD) and related events, independent of other risk factors. Resistance training (RT) has been shown to increase AS in young healthy subjects. However,... more
Arterial stiffness (AS) is a key measure in predicting risk for cardiovascular disease (CVD) and related events, independent of other risk factors. Resistance training (RT) has been shown to increase AS in young healthy subjects. However, the effects of RT on AS in persons with or at risk for CVD remain unclear; this uncertainty is a barrier to RT prescription in this population. Considering RT may be as effective as or superior to aerobic exercise prescription in treating some co-morbidities associated with CVD, it would be helpful to clarify whether RT does lead to clinically meaningful increases (detrimental) in AS in those with CVD or CVD risk factors. The aim of this study was to (1) assess the effects of RT on measures of AS in at-risk populations, and (2) discuss the implications of the findings for clinical exercise physiologists. The electronic databases PubMed, Web of Science, SPORTDiscus, and Google Scholar were searched from inception to February 2018. The reference list...
It is well documented that short sleep duration is associated with excess body weight and poor food intake in children. It has been suggested that sleep timing behaviour may also be an important predictor of weight and other related... more
It is well documented that short sleep duration is associated with excess body weight and poor food intake in children. It has been suggested that sleep timing behaviour may also be an important predictor of weight and other related behaviours, independent of sleep duration; however, there is a lack of research investigating these relationships. The present study investigated sleep timing in association with diet and physical activity levels in 439 children aged 9-11 years old from New Zealand. Sleep and physical activity data were collected using accelerometry, and food choice using a short food-frequency questionnaire. Participants were classified into one of four sleep timing behaviour categories using the median split for sleep-onset and -offset times. Differences between sleep timing groups for weekly consumption frequency of selected food groups, dietary pattern scores and minutes of moderate-to-vigorous physical activity were examined. Children in the late sleep/late wake cat...
Although it is well known that resistance training (RT) is beneficial for patients suffering from a variety of cardiovascular diseases, it remains underutilized as a rehabilitation tool as there is no reliable way to monitor the... more
Although it is well known that resistance training (RT) is beneficial for patients suffering from a variety of cardiovascular diseases, it remains underutilized as a rehabilitation tool as there is no reliable way to monitor the additional stress placed on the central organs. The current study aimed to determine between-day reliability of central haemodynamic indices using oscillometric pulse wave analysis (PWA) during progressive sub-maximal RT. Nineteen healthy young males were tested on 3 different mornings in a fasted state. Central hemodynamic variables including augmentation index (AIx), AIx normalized to a heart rate of 75 beats per minute (AIx@75), central systolic blood pressure (cSBP), forwards (Pf) and backwards (Pb) wave reflection were determined at rest, as well as during leg extension RT at 10, 15 and 20% of maximal volitional contraction (MVC), and following 1 min and 5 min passive recovery. During RT at 10, 15 and 20% MVC, the intraclass correlation coefficient (ICC...

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