In contrast to center-based CR services, which are provided in a medically supervised facility, HBCR relies on remote coaching with indirect exercise supervision and is provided mostly or entirely outside of the traditional center-based setting. 2015;2(1):e000163. The prognostic effect of cardiac rehabilitation in the era of acute revascularisation and statin therapy: A systematic review and meta-analysis of randomized and non-randomized studies – The Cardiac Rehabilitation Outcome Study (CROS). Expert Rev Cardiovasc Ther. 2019 Jul;39(4):208-225. doi: 10.1097/HCR.0000000000000447. Khera A, Baum SJ, Gluckman TJ, Gulati M, Martin SS, Michos ED, Navar AM, Taub PR, Toth PP, Virani SS, Wong ND, Shapiro MD. 2018;21(02):48-52. 4 Piepoli MF, Hoes AW, Agewall S, Albus C, Brotons C, Catapano AL, et al. Knowledge Gaps in Cardiovascular Care of Older Adults: A Scientific Statement from the American Heart Association, American College of Cardiology, and American Geriatrics Society: Executive Summary. The physical rehabilitation of patients with cardiovascular disease (CVD) has been practiced to varying degrees in Europe since the 1970s, although Karoff and colleagues note the recognition that exercise therapy instead of traditional immobilization of cardiac patients was proposed as early as 1885 by German physician Max Oertel. Several systematic reviews have explored quantitative evidence on the potential of digital interventions to support cardiac rehabilitation (CR) and self-management. Previous randomized trials have generated low- to moderate-strength evidence that HBCR and center-based CR can achieve similar improvements in 3- to 12-month clinical outcomes. Home-Based Cardiac Rehabilitation: A Scientific Statement From the American Association of Cardiovascular and Pulmonary Rehabilitation, ... and group-based social support when evidence-based behavioral change techniques are used 103, 104, 105. Eur J Cardiovasc Prev Rehabil. However, important lines of inquiry remain and require attention. Goel K, O'Leary JM, Barker CM, Levack M, Rajagopal V, Makkar RR, Bajwa T, Kleiman N, Linke A, Kereiakes DJ, Waksman R, Allocco DJ, Rizik DG, Reardon MJ, Lindman BR. +41 (0)61 467 85 55 Fax +41 (0)61 467 85 56 e-mail: Editorial office, EMH MediaSchweizerische ÄrztezeitungSwiss Medical ForumSwiss Medical WeeklyPrimary and Hospital CareSwiss Archives of Neurology, Psychiatry and PsychotherapySynapseSwiss Medical Informatics. Carvalho T, Gonzales AI, Sties SW, Carvalho GM. 2010;17(4):410–8. 2020 Sep 29;9(10):3160. doi: 10.3390/jcm9103160. Open Heart. guidelines for cardiac rehabilitation and secondary prevention.Most likely you have knowledge that, people have look numerous times for their favorite books later this best practice guidelines for cardiac rehabilitation and secondary prevention, but end stirring in harmful downloads. Although the CR community still struggles to achieve optimal service delivery, secondary prevention measures have greatly improved over recent decades. Home-Based Cardiac Rehabilitation: A SCIENTIFIC STATEMENT FROM THE AMERICAN ASSOCIATION OF CARDIOVASCULAR AND PULMONARY REHABILITATION, THE AMERICAN HEART ASSOCIATION, AND THE AMERICAN COLLEGE OF CARDIOLOGY . Setting and delivery of preventive car-diology. For Switzerland, no reliable numbers regarding referral of patients to CR services exist. A platform for postgraduate education and scientific work. In the meantime, alternative forms of endurance training, such as ballroom dancing or, for example, exergaming [11, 12] could be considered in order to increase the attractiveness of the services and to contribute to overcoming some of the barriers to participation and long-term adherence. The evidence-based, cardiac rehabilitation program serves patients at 17 community sites across a large region of Ontario and includes weekly visits for six months. This guideline provides evidence-based recommendations and best practice guidance on the management of patients referred for cardiac rehabilitation. 8 Urbinati S, Olivari Z, Gonzini L, Savonitto S, Farina R, Del Pinto M, et al. Intensive Cardiac Rehabilitation program is backed by published clinical evidence. Cardiac rehabilitation (CR) is an evidence-based intervention that uses patient education, health behavior modification, and exercise training to improve secondary prevention outcomes in patients with cardiovascular disease. 14.02.2018 See: emh.ch/en/emh/rights-and-licences/. However, it is estimated that, of eligible patients, only 14 to 35% of heart attack survivors and 31% of patients after coronary artery bypass surgery participate in secondary prevention programmes and that 70% of suitable patients do not receive dedicated interventions for risk factor reduction [7]. Upon programme completion, a final assessment of individual patient needs and demonstration of sustainable health outcomes. Acknowledging the formally shared responsibilities of all professionals involved in a cardiac patient’s care (nurses, general practitioners, intensivists, acute invasive cardiologists and cardiovascular surgeons), the ­European Association for Preventive Cardiology (EACP), the Acute Cardiovascular Care Association (ACCA) and the Council on Cardiovascular Nursing and Allied Professions (CCNAP) started a collaborative project to increase awareness of the various gaps and how possibly to overcome them. Secondary prevention through cardiac rehabilitation: from knowledge to implementation. Background The beneficial effects of cardiac rehabilitation (CR) have been challenged in recent years and there is now a need to investigate whether current CR programmes, delivered in the context of modern cardiology, still benefit patients. The following are key points to remember from this Scientific Statement on home-based cardiac rehabilitation (CR): CR is an evidence-based intervention that utilizes patient education, health behavior modification, and exercise training to improve secondary prevention outcomes in patients with established cardiovascular disease. As the basis for the elaboration of their recommendations, the BACPR used the following definition: CR is the “coordinated sum of activities required to influence ­favourably the underlying cause of cardiovascular disease, as well as to provide the best possible physical, mental and social conditions, so that the patients may, by their own efforts, preserve or resume optimal functioning in their community and through improved health behaviour, slow or reverse progression of disease”. The evidence base supporting cardiac rehabilitation is substantial and overwhelmingly supports its utilization for all qualified patients. In fact, huge varieties in programme components were noticed, such as: – staffing levels and multidisciplinary involvement (e.g., dietetics, physiotherapy, psychology, occupational therapy); – duration and frequency (e.g., 4 to 20 weeks, once or twice weekly); – methods used to change health behaviour (e.g., lectures, cognitive behavioural methods, written materials); – method of delivery (e.g., individual, group-based with “home exercise”, outpatient, self-management at home, home-based and menu-based). This article updates the American Heart Association (AHA) 1994 scientific statement on cardiac rehabilitation. Publication Date: The effect of CR on recurrent myocardial infarction and repeat revascularisation seems to be neutral; however, there is a significant reduction in acute hospital admissions (from 30.7 to 26.1%, NNT 22), which is a key determinant of the intervention’s overall cost-efficacy [2]. Investigators B-. A position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation. HHS 2020 Nov;18(11):777-789. doi: 10.1080/14779072.2020.1816464. Although structured, exercise-based secondary prevention programmes as described above are the most studied modality of secondary prevention interventions in patients after an acute myocardial infarction, programme uptake and adherence proves to be particularly challenging, and innovative strategies to address these problems have been evaluated. A multitude of individual studies and meta-analyses document the beneficial effects of CR programmes in patients with coronary artery disease with or without heart failure. The summary of a thorough review of the literature and the shared analysis of gaps and a proposed plan of action is summarised in figure 1. Additional information can be found here. Among them, the most important are: – Multifactorial individualised telehealth delivery: addresses multiple risk factors and provides individualised assessment and risk factor modification, mostly by telephone contact, – Internet-based delivery: majority of patient–provider contact for risk factor modification via the internet, – Telehealth interventions focusing on exercise, mostly by telephone contact, often including the use of telemonitoring, – Telehealth interventions focusing on recovery: mostly by telephone contact and the intervention content focused on supporting psychosocial recoveryfrom an acute cardiac event such as myocardial infarction or coronary artery bypass graft surgery, – Community- or home-based CR: mostly delivered face-to-face, through either home visits or patient attendance at community centres (for programmes other than traditional CR), – Programmes specific to rural, remote, and culturally and linguistically diverse populations, – Multiple models of care: multifaceted interventions across a number of these categories, – Complementary and alternative medicine interventions. Available literature on barriers to the accessibility of out-patient cardiac rehabilitation services were reviewed. Evidence to be reviewed included clinical practice guidelines available in English or Japanese and existing quality indicators. Lifestyle changes, including healthy food intake, regular physical activity and long-term adherence to optimal cardioprotective medication, are the main pillars of the long-term management of atherosclerotic disease. This program outline guide is based on the best available evidence, and has been developed in consultation with cardiac rehabilitation experts across Australia. Correspondence:Jean-Paul Schmid, MDCardiology, ­Klinik ­BarmelweidCH-5017 Barmelweidjean-paul.schmid[at]barmelweid.ch. Rich MW, Chyun DA, Skolnick AH, Alexander KP, Forman DE, Kitzman DW, Maurer MS, McClurken JB, Resnick BM, Shen WK, Tirschwell DL; American Heart Association Older Populations Committee of the Council on Clinical Cardiology, Council on Cardiovascular and Stroke Nursing, Council on Cardiovascular Surgery and Anesthesia, and Stroke Council; American College of Cardiology; and American Geriatrics Society. Cardiac Rehabilitation Section of the European Association of Cardiovascular P, Rehabilitation. In this, clinical audit of all CR programmes and establishment of ­national datasets are seen as essential as a basis for checking and benchmarking and to ensure that services are being delivered effectively. Abstract. 2012 Nov 20;126(21):2535-43. doi: 10.1161/CIR.0b013e318277728c. Structured cardiac rehabilitation (CR) programmes are recognised as the clinical setting for implementation of such a preventive care strategy [1]. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. It provides recommendations on assessment, health behaviour-change techniques, lifestyle risk factor management, psychosocial health, vocational rehabilitation and medical risk management. Clinical Implications of Physical Function and Resilience in Patients Undergoing Transcatheter Aortic Valve Replacement. Knowledge Gaps in Cardiovascular Care of the Older Adult Population: A Scientific Statement From the American Heart Association, American College of Cardiology, and American Geriatrics Society. Although HBCR has been successfully deployed in the United Kingdom, Canada, and other countries, most US healthcare organizations have little to no experience with such programs. CR has been shown to reduce mortality, hospital readmission rates, healthcare costs and also to improve exercise capacity, quality of life and the … Challenges in secondary prevention after acute myocardial infarction: A call for action. Home-Based Cardiac Rehabilitation: A SCIENTIFIC STATEMENT FROM THE AMERICAN ASSOCIATION OF CARDIOVASCULAR AND PULMONARY REHABILITATION, THE AMERICAN HEART ASSOCIATION, AND THE AMERICAN COLLEGE OF CARDIOLOGY. Cardiovascular Prevention and Rehabilitation in Practice is a comprehensive, practitioner-focused clinical handbook which provides internationally applicable evidence-based standards of good practice. However, although promising, evidence regarding the effectiveness and uptake of existing interventions is mixed. In fact, no benefit for survival, psychosocial status or health related quality of life was shown in that study. [Exercise-based cardiac rehabilitation in COVID-19 times: one small step for health care systems, one giant leap for patients]. New delivery strategies are urgently needed to improve participation. 12 Jaarsma T, Klompstra L, Ben Gal T, Boyne J, Vellone E, Back M, et al. The delivery of six core components (see table 2) by a qualified and competent multidisciplinary team, led by a clinical coordinator. The BLITZ-4 Registry.  |  2016 May 24;133(21):2103-22. doi: 10.1161/CIR.0000000000000380. In the interim, we conclude that HBCR may be a reasonable option for selected clinically stable low- to moderate-risk patients who are eligible for CR but cannot attend a traditional center-based CR program. Participants 10 professionals in cardiac rehabilitation for the consensus panel. Rev Esp Cardiol. Centre-based, multidisciplinary cardiac rehabilitation programmes complying with well-defined minimal requirements are the gold standard for de­livering optimal postinterventional care and achieving secondary preven­-tion goals. Cardiac rehabilitation, telemedicine, telehealth, secondary prevention, cardiovascular. More than 3,600 people participate in the program annually, with 70% acceptance rates and 60% completion rates. No financial support and no other potential conflict of interest ­relevant to this article was reported. 39(4):208-225, July 2019. The scientific evidence for cardiovascular disease prevention and rehabilitation is compelling. Oxford: Oxford University Press; 2015;Part 4:285–293. 2016 Nov;64(11):2185-2192. doi: 10.1111/jgs.14576. Journal of Cardiopulmonary Rehabilitation and Prevention. Cardiovascular Medicine EMH Swiss Medical Publishers Ltd. Farnsburgerstrasse 8 CH-4132 Muttenz Tel. 1 Another German physician, Peter Beckman, … 2019 Jul 9;74(1):133-153. doi: 10.1016/j.jacc.2019.03.008. Cardiovascular rehabilitation, ballroom dancing and sexual dysfunction. In order to offer you a better user experience, we use cookies. For patients who have suffered myo­cardial infarction and/or undergone coronary revascularisation, attending and completing a programme of exercise-based CR is associated with an absolute risk reduction in cardiovascular mortality from 7.6 to 10.4% compared with those who do not take part in a CR programme, with a number needed to treat (NNT) of 37. Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. Furthermore, the CR group was less likely to be physically active at 12 months than the control group. COVID-19 is an emerging, rapidly evolving situation. – Home-based rehabilitation programmes have the potential to increase patient participation by offering greater flexibility and options for activities. Eur J Prev Cardiol. Epub 2012 Oct 22. Intensive Cardiac Rehabilitation is different from the traditional cardiac rehab. 2013;101(6):e107–8. BMJ 2015;351:h5000. CR programs reduce morbidity and mortality rates in adults with ischemic heart disease, heart failure, or cardiac surgery but are significantly underused, with only a minority of eligible … The effective implementation of intensive lifestyle and medical risk factor management together with enabling psychosocial health and wellbeing are … Eur J Heart Fail. Electronic searches of Medline, Embase, CINAHL, science citation … CR programs reduce morbidity and mortality rates in adults with ischemic heart disease, heart failure, or cardiac surgery but are significantly underused, with only a minority of eligible patients participating in CR in the United States. 2 Dalal HM, Doherty P, Taylor RS. 2012;98(8):605–6. However, because it was greatly underpowered (having recruited at best only 23% of the original predefined sample in each trial arm), RAMIT cannot be viewed as a trial of “efficacy”, that is, to demonstrate whether or not CR “works”, but as a pragmatic trial of its effectiveness as provided “in real life” [1].It raised concerns due to considerable ­differences between the centres that recruited patients with respect to content, duration, intensity and volume of the intervention offered to patients. The most critical obstacles, however, are the lack of initial referral and insufficient reimbursement strategies [8]. J Am Heart Assoc. Cardiac rehabilitation (cardiac rehab) is a program of exercise, education and counselling designed to help you recover after a heart attack or other heart conditions.This personalized program will help you regain your strength, prevent your condition from getting worse and reduce your risk of having heart problems in the future. 2016;23(11):NP1-NP96. Epub 2020 Aug 28. Research has shown that cardiac rehabilitation (cardiac rehab) improves cardiac risk factor profile, reduce hospital readmissions and improve quality of life. Starting from simple bedside consultations lasting a few minutes, they have evolved into professionally led multidisciplinary interventions within CR services. 2020 Nov;73(11):969-970. doi: 10.1016/j.recesp.2020.06.040. Published under the copyright license “Attribution – Non-Commercial – NoDerivatives 4.0”. 6 Doherty P, Lewin R. The RAMIT trial, a pragmatic RCT of cardiac rehabilitation versus usual care: what does it tell us? https://doi.org/10.4414/cvm.2018.00545 J Am Geriatr Soc. No commercial reuse without permission. These variations in funding, staffing, content of the programme and referral across CR programmes in England, Wales and Northern Ireland, where the study has been performed, have been judged unjustifiable by the British Association for Cardio­vascular Prevention and Rehabilitation (BACPR), and huge efforts have been made to ensure minimum standards, structure and function of CR programmes. 11. De Cannière H, Smeets CJP, Schoutteten M, Varon C, Morales Tellez JF, Van Hoof C, Huffel SV, Groenendaal W, Vandervoort P. J Clin Med. This site needs JavaScript to work properly. Epub 2019 May 13. Prompt identification, referral and recruitment of eligible patient populations. Lifestyle risk factor management – Physical activity and exercise training – Healthy eating and body composition – Tobacco cessation and relapse prevention, Failure to identify and manage comorbid conditions, Poor communication between physician and others ­involved in a patient’s healthcare provision, Pressure to shorten length of hospital stay, Healthcare systems focused on acute care (hospital-based health systems), Depression, mental disease, substance abuse, Poor awareness on value of preventive measure, Low health literacy / poor awareness on ­value of preventive measure, Poorly designed preventive programmes / lack of quality control. Arq Bras Cardiol. One potential strategy is home-based CR (HBCR). Epub 2020 May 1. Cardiac rehabilitation. 5 Rauch B, Davos CH, Doherty P, Saure D, Metzendorf MI, Salzwedel A, et al. Their conclusions on the current evidence of best practice have been summarised in a position paper, which provides a pragmatic summary of the minimum standards, structure and function of cardiovascular prevention and rehabilitation programmes (http://www.bacpr.com/resources/AC6_BACPRStandards&CoreComponents2017.pdf) (table 1). Please enable it to take advantage of the complete set of features! NLM Methods A systematic review of non-randomised controlled studies was conducted. King M, Bittner V, Josephson R, Lui K, Thomas RJ, Williams MA. 2016;23(18):1994–2006. Short-Term Exercise Progression of Cardiovascular Patients throughout Cardiac Rehabilitation: An Observational Study. For a successful implementation, patients need support by means of a professional multidisciplinary team, which provides the necessary information on the type and severity of their disease, initiates the required behavioural changes, and instructs the patients on how to restart physical activity after an acute coronary event or cardiovascular surgery. Cardiac Rehabilitation Section EAoPCicwtIoMB, Informatics DoMBUoH, the Cochrane M, Endocrine Disorders Group IoGPH-HUDG. J Cardiopulm Rehabil Prev. Accessibility to those services is a major factor in the underutilisation of current programs. Although a most recent meta-analysis of randomised and nonrandomised controlled studies (The Cardiac Rehabilitation Outcome Study [CROS]) confirmed a significant reduction of mortality for CR participants ­after an acute coronary syndrome or after coronary ­artery bypass surgery in prospective or retrospective cohort studies, the single randomised controlled trial available so far (RAMIT: multicentre randomised controlled trial of comprehensive cardiac rehabilitation in patients following acute myocardial infarction) showed a neutral result [5]. In order to achieve the proven effectiveness of CR in routine clinical practice, the definition, implementation and continuous monitoring of accepted minimal standards for CR delivery are constantly reviewed by the BACPR. 10 Völler H, Reibis R, Schwaab B, Schmid JP. Increasing exercise capacity and quality of life of patients with heart failure through Wii gaming: the rationale, design and methodology of the HF-Wii study; a multicentre randomized controlled trial. Early provision of a structured cardiovascular prevention and rehabilitation programme, with a defined ­pathway of care, which meets the ­individual’s goals and is aligned with patient preference and choice. In 1982, Medicare policies provided for coverage of cardiac rehabilitation (CR) for patients recovering from myocardial infarction or coronary artery bypass graft surgery (CABG) or for those with stable angina. 2020 Sep;9(17):e017075. 1 This coverage decision was based primarily on evidence that CR provided safe and effective improvements in functional capacity and quality of life in these patients. As such, evidence-based practice features strongly together with multidisciplinary approaches to the comprehensive delivery of high-quality care. DOI: A recent trial in a cohort of 2,787 patients from 21 centres showed that CARDSS increases the compliance with guideline-recommended therapeutic decisions . 9 Piepoli MF, Corra U, Dendale P, Frederix I, Prescott E, Schmid JP, et al. 1 It provides a review of the recommended components of optimal rehabilitation/secondary prevention programs, ways to deliver these services, recommended future research directions, and the rationale for these recommendations, with emphasis on the exercise … Circulation. This system (cardiac rehabilitation decision support system, CARDSS) actively guides its users through the clinical algorithm, prompting for necessary information and calculating scores of questionnaires. NIH 3 Sagar VA, Davies EJ, Briscoe S, Coats AJ, Dalal HM, Lough F, et al. … Secondary prevention after acute myocardial infarction: drug adherence, treatment goals, and predictors of health lifestyle habits. Keywords: Epub 2016 Sep 27. For individuals with a diagnosis of heart failure, CR may not reduce total mortality, but does impact ­favourably on hospitalisation, with a 25% relative risk reduction in overall hospital admissions and a 39% ­reduction (NNT 18) in acute heart failure related ­episodes [3]. Am J Prev Cardiol. Cardiac rehabilitation programs were first initiated in the ’60s for patients recovering from acute myocardial infarction and then expanded to other cardiac patients - postoperative, myocardiopathies and heart failure patients as well.  |  Cardiac rehabilitation (CR) is a multi-faceted secondary prevention intervention that aims to limit the physiological and psychological effects of cardiovascular disease and to assist in the management of symptoms and a reduction of future cardiovascular risk. evidence-based cardiac rehabilitation program. 2015;22(12):1548–56. Cardiac rehabilitation in Europe: results from the European Cardiac Rehabilitation Inventory Survey. To comply with programme availability, as well as local and national regulations, a certain number of alternative CR models have developed. Eur J Prev Cardiol. Cardiovascular Medicine. Thomas, Randal J.; Beatty, Alexis L.; Beckie, Theresa M.; More. The evidence-based, cardiac rehabilitation program serves patients at 17 community sites across a large region of Ontario and includes weekly visits for six months.  |  Medical director responsibilities for outpatient cardiac rehabilitation/secondary prevention programs: 2012 update: a statement for health care professionals from the American Association of Cardiovascular and Pulmonary Rehabilitation and the American Heart Association. Early initial assessment of individual patient needs which informs the agreed personalised goals that are reviewed regularly. Epub 2020 Sep 14. Eur J Cardiovasc Prev Rehabil. The writing group carried out a systematic review of published studies of HBCR compared with CBCR to assess the comparative effectiveness and potential benefits of HBCR and to explore implementation strategies for developing HBCR programs. They differ from the traditional models of CR, which are generally organised in three phases (e.g., post-intervention on the ward, post-discharge and long-term), involving residential, ambulatory community-, or home-based programmes. 1 Piepoli MF, Corra U, Benzer W, Bjarnason-Wehrens B, Dendale P, Gaita D, McGee H, et al. 7 Bjarnason-Wehrens B, McGee H, Zwisler AD, Piepoli MF, Benzer W, Schmid JP, Det al. To be considered in the future, new forms of CR need to achieve the same level of scientific evidence for improvement in clinical endpoints as the established methods, which constitute the gold standard. • new evidence of ischemia on an exercise test, including thallium scan • new, clinically significant coronary lesions documented by cardiac catheterization . National Campaign for Cardiac Rehabilitation The Evidence Rehab Cardiac Rehab Rehab Cardiac Rehab Rehab. Performance of each indicator was assessed retrospectively using medical records at a university hospital in Japan. USA.gov. Exercise-based rehabilitation for heart failure: systematic review and meta-analysis. 2010;17(1):1–17. It is the process by which cardiac patients recover and readapt to reach and maintain optimal physical, sensory, intellectual, psychological and social functional levels through strategies such that they are provided with the tools to resume their ordinary activities as soon as possi… Regarding the situation in Switzerland, due to the short distances and a dense net of CR programmes, the need for alternative methods of CR delivery seems not to be of major importance. The official ­recognition of each CR programme by the SCPRS is a prerequisite for reimbursement by healthcare provi­ders. 2015;17(7):743–8. Current challenges in cardiac rehabilitation: strategies to overcome social factors and attendance barriers. Cardiac rehabilitation (CR) is an evidence-based intervention that uses patient education, health behavior modification, and exercise training to improve secondary prevention outcomes in patients with cardiovascular disease. Clipboard, Search History, and several other advanced features are temporarily unavailable. Multidisciplinary cardiac rehabilitation (CR) reduces morbidity and mortality and increases quality of life in cardiac patients [2,3,4].Outpatient CR is a comprehensive intervention, in which patients are offered an individualised centre-based programme that may consist of one or more group-based modules or therapies (i.e. For historical, structural or logistical reasons, settings of CR vary in different countries across Europe [7]. 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