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This podcast is written and produced by psychiatry residents at the University of Toronto and is aimed at medical students and residents. Listeners will learn about fundamental and more advanced topics in psychiatry as our resident team explore these topics with world-class psychiatrists at U of T and abroad.

PsychEd: educational psychiatry podcast PsychEd

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    • 4,3 • 3 betyg

This podcast is written and produced by psychiatry residents at the University of Toronto and is aimed at medical students and residents. Listeners will learn about fundamental and more advanced topics in psychiatry as our resident team explore these topics with world-class psychiatrists at U of T and abroad.

    PsychEd Episode 50: The Mental Status Examination

    PsychEd Episode 50: The Mental Status Examination

    Welcome to PsychEd — the psychiatry podcast for medical learners, by medical learners. This episode covers the mental status examination and makes use of practical and fictional examples to delve deeper into the skills and concepts
     
    Learning Objectives:
     
    The learning objectives for this episode are as follows:
    By the end of this episode, the listener will be able to…
    Explain the utility and purpose of the mental status examination in psychiatry
    Describe the major components of the mental status examination and be familiar with some of the common vocabulary used
    Incorporate the mental status in a way that respects patients in presentation, documentation and formulation in clinical practice 
     
    Topics:
    2:37 - Learning objectives
    3:10 - Definition of the MSE
    6:48 - History of the MSE
    9:00 - Limitations of the MSE
    15:37 - Strengths of the MSE
    21:30 - ASEPTIC Mnemonic
    23:04 - Appearance and Behaviour
    37:42 - Speech
    51:51 - Emotion (mood and affect)
    1:03:51 - Perception
    1:08:38 - Thought Form and Content
    1:17:30 - Insight and Judgement
    1:27:40 - Cognition
     
    Hosts: Andreea Chiorean (CC4), Saja Jaberi (IMG), Dr. Weam Seiffien (PGY2), Angad Singh (CC2), Dr. Annie Yu (PGY1), and Dr. Alex Raben, staff psychiatrist.
     
    Guest Experts: Us!
     
    Video clips:
    Speech: 
    Mojo Jojo: https://youtu.be/y4qNWPPlYE4?t=48
    Family guy video: no longer available
     
    Emotion
    Eeyore: https://youtu.be/7xPnUe6Xcbw?t=12
     
    Squidward: https://youtu.be/FjrOWnywPok?t=195
     
    Bubbles: https://youtu.be/rAC4W563Ayk?t=339
     
    Perception
    A Beautiful Mind: https://youtu.be/vNa37tOB4rE
     
    Insight and Judgement
    Simpsons: no longer available
    Mr. Magoo: https://youtu.be/eWEnzLFd4P4?t=201
     
    Cognition
    Still Alice: https://youtu.be/mhiXAJO8kBc?t=67



    Resources:
    MSE template: https://www.therapistaid.com/therapy-worksheet/mental-status-exam
    Emotion wheel: https://feelingswheel.com/
    MSE vocabulary: http://www.columbia.edu/itc/hs/medical/psychmed/1_2004/mental_status_exam.pdf



    References:
    Bell, R. (1977). The Mental Status Examination. 16(5).Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of psychiatric research, 12(3), 189-198.
    Donnelly, J., Rosenberg, M., & Fleeson, W. P. (1970). The evolution of the mental status—past and future. American Journal of Psychiatry, 126(7), 997-1002.
    Norris, D. R., Clark, M. S., & Shipley, S. (2016). The Mental Status Examination. 94(8).
    Norton, J. W., & Corbett, J. J. (2000, February). Visual perceptual abnormalities: hallucinations and illusions. In Seminars in neurology (Vol. 20, No. 01, pp. 0111-0122). Copyright© 2000 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.
    Notes, T. (2020). Comprehensive Medical Reference and Review for the Medical Council of Canada Qualifying Exam (MCCQE) Part I and the United States Medical Licensing Exam (USMLE) Step II 36th ed: Toronto Notes for Medical Students.
    Recupero, P. R. (2010). The Mental Status Examination in the Age of the Internet. The Journal of the American Academy of Psychiatry and the Law, 38(1).
    Robinson D. J. (2002). Mental status exam explained (2nd ed.). Rapid Psychler Press.
    Robinson D. J. (1998). Brain Calipers: a guide to a successful mental status exam. Rapid Psychler Press.
    Ross, C. A., & Leichner, P. (1988). Residents Performance on the Mental Status Examination. The Canadian Journal of Psychiatry, 33(2), 108–111. https://doi.org/10.1177/070674378803300207
    Sadock, B. J., & Sadock, V. A. (2007). Kaplan & Sadock's synopsis of psychiatry: Behavioral sciences/clinical psychiatry (10th ed.). Lippincott Williams & Wilkins Publishers.
    Segal, D. L. (Ed.). (2019). Diagnostic interviewing. Springer.
    Snyderman, D., & Rovner, B. (2009).

    • 1 tim. 49 min
    PsychEd Episode 49: Dementia Assessment with Dr. Lesley Wiesenfeld

    PsychEd Episode 49: Dementia Assessment with Dr. Lesley Wiesenfeld

    Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. In this episode, we’ll explore a topic that we’re sure many listeners are eager to learn about: The Assessment of Major Neurocognitive Disorder, also known as dementia with Dr. Lesley Wiesenfeld who is a Geriatric Psychiatrist and Psychiatrist-in-Chief at Mount Sinai Hospital in Toronto, where she leads the Geriatric Consult Liaison Psychiatry Service. She is also an Associate Professor in the Department of Psychiatry at the University of Toronto.
     
    The learning objectives for this episode are as follows:
     
    Define Major Neurocognitive Disorder (aka Dementia) as per DSM-5 diagnostic criteria
    Identify differential diagnoses for cognitive decline and list differentiating clinical features 
    Outline an approach to the assessment of a patient presenting with cognitive decline, including the role of a comprehensive history, psychometric tools and other investigations [ Relevant PMH/risk factors, ADLs/IADLs to cover on history, psychometric tools such as MMSE, MoCA and tie this back into major cognitive domains when to consider imaging, bloodwork including specialized testing such as ApoE genetic tests] 
    Classify the major subtypes of Neurocognitive Disorders, their epidemiology, and clinical presentations [ Vascular dementia, Alzheimer’s, Frontotemporal, Lewy Body, Parkinson’s,    Mixed dementia - Early onset dementia]
     
    Guest: Dr. Lesley Wiesenfeld ( Lesley.Wiesenfeld@sinaihealthsystem.ca )
     
    Hosts: Dr. Luke Fraccaro (PGY-3), Dr. Mark Fraccaro (PGY-4), Sena Gok (international medical graduate)
     
    Audio editing by: Sena Gok
     
    Show notes by: Sena Gok
     
    Interview Content:
    Introduction: 0:13
    Learning Objectives: 02:35
    Diagnostic criteria of Major Neurocognitive Disorder: 03:20
    Difference between Major and Mild Neurocognitive Disorder: 05:20
    Red Flags of Cognitive Declines: 06:50
    Normal Aging vs Major Neurocognitive Disorder: 10:00
    Clinical Vignette – introduction: 11:35
    Patient Assessment: 16:50
    Past medical/family / Psychosocial history: 21:55
    Clinical Vignette - Assessment: 37:45
    Physical examination: 43:50
    Investigations: 45:53
    Role of genetic testing: 53:24
    Clinical Vignette – Diagnosis: 57:50
     
    References:
     
    American Psychiatric Association. (2022). Neurocognitive Disorders. In Diagnostic and statistical manual of mental disorders (5th ed., text rev.).
     
    Sadock, B. J., Sadock, V. A., Ruiz, P., & Kaplan, H. I. (2015). Neurocognitive Disorders. Kaplan and Sadock’s Synopsis of Psychiatry (11th ed.). Wolters Kluwer
     
    DSM-5-TR Fact Sheets (https://psychiatry.org/psychiatrists/practice/dsm/educational-resources/dsm-5-tr-fact-sheets )
     
    Gauthier S, Patterson C, Chertkow H, Gordon M, Herrmann N, Rockwood K, Rosa-Neto P, Soucy JP. Recommendations of the 4th Canadian Consensus Conference on the Diagnosis and Treatment of Dementia (CCCDTD4). Can Geriatr J. 2012 Dec;15(4):120-6. doi: 10.5770/cgj.15.49. Epub 2012 Dec 4. PMID: 23259025; PMCID: PMC3516356.
     
    Gauthier S, Chertkow H, Theriault J, Chayer C, Ménard MC, Lacombe G, Rosa-Neto P, Ismail Z. CCCDTD5: research diagnostic criteria for Alzheimer's Disease. Alzheimers Dement (N Y). 2020 Aug 25;6(1):e12036. doi: 10.1002/trc2.12036. Erratum in: Alzheimers Dement (N Y). 2022 Feb 03;6(1):e12088. PMID: 32864413; PMCID: PMC7446944.



    CPA Note: The views expressed in this podcast do not necessarily reflect those of the Canadian Psychiatric Association.
     
    For more PsychEd, follow us on Twitter (@psychedpodcast), Facebook (PsychEd Podcast), and Instagram (@psyched.podcast). You can provide feedback by email at psychedpodcast@gmail.com. For more information, visit our website at psychedpodcast.org.

    • 1 tim. 22 min
    PsychEd Episode 48: History of Psychiatry with Dr. David Castle

    PsychEd Episode 48: History of Psychiatry with Dr. David Castle

    Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode delves into the history of psychiatry with Dr David Castle, the inaugural Scientific Director of the Centre for Complex Interventions at the Centre for Addictions and Mental Health and a Professor in the Department of Psychiatry at the University of Toronto. Prior to migrating to Canada in 2021, he spent 15 years as a Professor of Psychiatry at St Vincent’s Hospital and the University of Melbourne in Australia.
     
    The learning objectives for this episode are as follows:
     
    By the end of this episode, you should be able to…
    Gain an appreciation for the historical context of the field of psychiatry Understand how illness categories and treatments have been shaped by this history  Compare and contrast how various past societies viewed and conceptualized mental illness Apply lessons learned from historical practices to appraise current approaches  
    Guest: Dr David Castle
     
    Hosts: Dr Alex Raben (Staff Psychiatrist), Gaurav Sharma (PGY4), Nikhita Singhal (PGY4), Andreea Chiorean (CC4)
     
    Audio editing by: Dr Alex Raben
     
    Show notes by: Dr Nikhita Singhal
     
    Interview Content:
     
    1:45 - Learning Objectives
     
    3:25 - Ancient Times
     
    14:42 - Middles Ages 
     
    23:56 - Renaissance to Enlightenment
     
    34:55 - 19th-20th Centuries
     
    47:55 - 20th-21st Centuries
     
    1:00:48 - Final Thoughts
     
    Resources:
    Shrinks: The Untold Story of Psychiatry (Jeffrey A Lieberman)  
    References:
    The Emotional Foundations of Personality: A Neurobiological and Evolutionary Approach (Kenneth L Davis, Jaak Panksepp) Illustration of Bedlam (William Hogarth) Pinel, médecin en chef de la Salpêtrière en 1795 (Tony Robert-Fleury) Castle, D., Bassett, D., King, J., & Gleason, A. (2013). A primer of clinical psychiatry. Elsevier Health Sciences. de Leon J. DSM-5 and the research domain criteria: 100 years after Jaspers' General psychopathology. Am J Psychiatry. 2014 May;171(5):492-4. https://doi.org/10.1176/appi.ajp.2013.13091218 Eisenberg L. Mindlessness and brainlessness in psychiatry. Br J Psychiatry. 1986 May;148:497-508. https://doi.org/10.1192/bjp.148.5.497 Engel GL. The need for a new medical model: a challenge for biomedicine. Science. 1977 Apr 8;196(4286):129-36. https://doi.org/10.1126/science.847460 Kendell R, Jablensky A. Distinguishing between the validity and utility of psychiatric diagnoses. Am J Psychiatry. 2003 Jan;160(1):4-12. https://doi.org/10.1176/appi.ajp.160.1.4 Robins E, Guze SB. Establishment of diagnostic validity in psychiatric illness: its application to schizophrenia. Am J Psychiatry. 1970 Jan;126(7):983-7. https://doi.org/10.1176/ajp.126.7.983 Rosenhan DL. On being sane in insane places. Science. 1973 Jan 19;179(4070):250-8. https://doi.org/10.1126/science.179.4070.250 Scheff TJ. The labelling theory of mental illness. Am Sociol Rev. 1974 Jun;39(3):444-52. https://doi.org/10.2307/2094300 Szasz T. The myth of mental illness: 50 years later. The Psychiatrist. Cambridge University Press; 2011;35(5):179–182. https://doi.org/10.1192/pb.bp.110.031310  
    CPA Note: The views expressed in this podcast do not necessarily reflect those of the Canadian Psychiatric Association.
     
    For more PsychEd, follow us on Twitter (@psychedpodcast), Facebook (PsychEd Podcast), and Instagram (@psyched.podcast). You can provide feedback by email at psychedpodcast@gmail.com. For more information, visit our website at psychedpodcast.org.

    • 1 tim. 4 min
    PsychEd Episode 47: Understanding the DSM-V-TR with Dr. Michael First

    PsychEd Episode 47: Understanding the DSM-V-TR with Dr. Michael First

    Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. In this episode, we present a focused summary of the latest changes in The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) with our guest expert — Dr. Michael First, a Professor of Clinical Psychiatry at Columbia University, NY. Dr. First is an internationally recognized expert on psychiatric diagnosis and assessment issues, he is the editor and co-chair of the DSM-5 text revision project (DSM-5-TR), the editorial and coding Consultant for the DSM-5, the chief technical and editorial consultant on the World Health Organization ICD-11 revision project and was an external consultant to the NIMH Research Domain Criteria project (RDOC).
     
    The learning objectives for this episode are as follows:
    Understand the rationale for undertaking a DSM-5-TR as well as the revision process itself
     To become familiar with disorder, text and symptom code additions and modifications to the DSM-5-TR
     To understand the purpose and function of the DSM in its current form and be able to contemplate future directions
     
    Guest Expert: Dr. Michael First – staff psychiatrist and professor of clinical psychiatry at Columbia University, USA.
    Produced and hosted by: Dr. Alex Raben (staff psychiatrist) and Saja Jaberi (international medical graduate)
    Audio editing by: Dr. Alex Raben
    Show notes by: Saja Jaberi
    Interview Content:
    2:53 - Learning objectives
    3:34 - Brief description of the DSM and its history
    4:54 – ICD vs. DSM 
    7:43 - Rationale behind the new revision
    11:11 - Characteristics of the DSM-5-TR revision process and the people behind it
    16:54 - Case presentation and Differential Diagnosis
    23:07 - Prolonged Greif disorder
    27:04 - Most important changes to the terminology used in the manual
    39:34 - Pros and cons of the DSM
    44:30 - A brief Comparison to the RDOC Framework
    49:04 – Future Directions of the DSM
     
    References
    American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. 2013.
    American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th Text Revision ed. 2022.
     DSM-5-TR Fact Sheets https://psychiatry.org/psychiatrists/practice/dsm/educational-resources/dsm-5-tr-fact-sheets
     
    CPA Note: The views expressed in this podcast do not necessarily reflect those of the Canadian Psychiatric Association.
     
    For more PsychEd, follow us on Twitter (@psychedpodcast), Facebook (PsychEd Podcast), and Instagram (@psyched.podcast). You can provide feedback by email at psychedpodcast@gmail.com. For more information, visit our website at psychedpodcast.org.

    • 52 min
    PsychEd Episode 46: Antisocial Personality Disorder and Psychopathy with Dr. Donald Lynam

    PsychEd Episode 46: Antisocial Personality Disorder and Psychopathy with Dr. Donald Lynam

    Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. In this episode, we present a broad overview of antisocial personality disorder and psychopathy with our guest expert - Dr. Donald Lynam. Dr. Lynam is a clinical psychologist by training, and professor at Purdue university, where he heads the Purdue's Developmental Psychopathology, Psychopathy and Personality Lab. While there may be some disagreement in the field, Dr. Lynam and I discuss how ASPD and psychopathy are two diagnostic constructs that are attempting to outline the same psychopathology, with the main difference being the degree of severity - for this reason, we use the terms antisocial and psychopathic interchangeably. 
     
    While not necessary, it may be of benefit for listeners to familiarize themselves with the DSM-V criteria for antisocial personality disorder, the psychopathy checklist (PCL), as well as the 5-factor model of personality. References for each are listed below in the references section, however, for a brief overview, one could do a quick google image search for each term (Wikipedia also has a succinct overview of the psychopathy checklist).
     
    The learning objectives for this episode are as follows:
     
    Develop a basic understanding of what is meant by antisocial personality and psychopathy
    Be aware of some of the classic traits and characteristics of antisocial/psychopathic personalities, and the general functions of these behaviors 
    Describe the theoretical basis for the development of antisocial personalities 
     
    Guest Expert: Dr. Donald Lynam - Clinical psychologist, Investigator at Purdue University, Indiana
    Produced and hosted by: Dr. Chase Thompson (PGY5 in Psychiatry)
    Episode guidance and feedback: Dr. Gaurav Sharma (PGY4 in Psychiatry)
     
    Interview Content:
     
    0:50 - Learning objectives
    1:40 - Dr. Lynam discusses his path to his current research interests
    3:40 - Defining the terms antisocial personality disorder, sociopathy, psychopathy
    8:30 - Discussing the possibility of antisocial behaviors without an antisocial personality
    12:07 - Laying out the core features of antisocial individuals 
    18:20 - Antisocial personality from the perspective of the Big 5 personality model
    22:00 - Discussion of the high-functioning psychopathy 
    25:06 - Prevalence of psychopathy
    30:10 - Factors relevant to the development of psychopathy
    39:30 - Prognosis and clinical trajectory 
    44:30 - Comorbid psychopathology 
    46:30 - Functions of antagonism or antisocial behaviours 
    49:30 - Treatment 
     
    References
     
    American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. 2013.
    Broidy LM, Nagin DS, Tremblay RE, Bates JE, Brame B, Dodge KA, Fergusson D, Horwood JL, Loeber R, Laird R, Lynam DR. Developmental trajectories of childhood disruptive behaviors and adolescent delinquency: a six-site, cross-national study. Developmental psychology. 2003 Mar;39(2):222.
    Babiak P, Hare RD, McLaren T. Snakes in suits: When psychopaths go to work. New York: Harper; 2007 May 8.
    Hare RD. The psychopathy checklist–Revised. Toronto, ON. 2003;412.
    Hare RD, Harpur TJ, Hakstian AR, Forth AE, Hart SD, Newman JP. The revised psychopathy checklist: reliability and factor structure. Psychological Assessment: A Journal of Consulting and Clinical Psychology. 1990 Sep;2(3):338.
    Hare RD, Hart SD, Harpur TJ. Psychopathy and the DSM-IV criteria for antisocial personality disorder. Journal of abnormal psychology. 1991 Aug;100(3):391.
    Jones SE, Miller JD, Lynam DR. Personality, antisocial behavior, and aggression: A meta-analytic review. Journal of Criminal Justice. 2011 Jul 1;39(4):329-37.
    Lynam DR. Early identification of chronic offenders: Who is the fledgling psychopath?. Psychological bulletin. 1996 Sep;120(2):209.
    Miller JD, Lynam DR. Psychopathy and the five-factor model of personality: A replication and extension. Journal of personality assessmen

    • 53 min
    PsychEd Episode 45: Perinatal Psychiatry with Dr. Tuong Vi Nguyen

    PsychEd Episode 45: Perinatal Psychiatry with Dr. Tuong Vi Nguyen

    Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers perinatal psychiatry with Dr. Tuong Vi Nguyen, Assistant Professor, Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University and Scientist and Scientist, RI-MUHC, Brain Repair and Integrative Neuroscience (BRaIN) Program, Centre for Outcomes Research and Evaluation. 
     
    The learning objectives for this episode are as follows:
     
    By the end of this episode, you should be able to…
    Define the field of perinatal psychiatry Describe the key issues that should be addressed in pre-conception psychiatric counseling Discuss the management approach for prescribing medications during pregnancy Recognize the prevalence of mood disorders during the perinatal period Recall the diagnostic criteria for postpartum depression Consider the risk factors and explanatory models for postpartum depression Discuss the use of screening tools for postpartum depression Outline the treatment for postpartum depression Describe the clinical presentation of postpartum psychosis and recognize the urgency of this condition List important risk factors for postpartum psychosis Discuss the management for postpartum psychosis  
    Guest: Dr. Tuong Vi Nguyen
     
    Hosts: Nima Nahiddi (PGY4), Audrey Le (PGY1), and Arielle Geist (PGY2) 
     
    Produced by: Nima Nahiddi (PGY4), Audrey Le (PGY1), Rebecca Marsh (PGY2) and Arielle Geist (PGY2) 
     
    Audio editing by: Audrey Le
     
    Show notes by: Arielle Geist 
     
    Interview content:
    Introduction - 00:00 Learning objectives - 00:43 Defining the field of perinatal psychiatry - 01:55 Key issues to address in preconception counseling - 02:50 Management approach for prescribing medications during pregnancy - 07:00 Prevalence of mood disorders during the perinatal period - 12:11 Diagnostic criteria for postpartum depression - 14:05 Differentiating postpartum psychosis from postpartum depression - 16:52 Risk factors and explanatory models for postpartum depression - 18:58 Screening tools for postpartum depression - 20:15 Treatment for postpartum depression - 22:13 Pharmacotherapy - 22:20 Psychotherapy - 27:34 Clinical presentation of postpartum psychosis - 29:07 Risk factors for postpartum psychosis - 30:43 Postpartum psychosis prognosis and impacts on attachment- 32:57 Management of postpartum psychosis -35:30 Closing comments - 38:00  
    Resources:
    Bérard, A., Zhao, J. P., & Sheehy, O. (2017). Antidepressant use during pregnancy and the risk of major congenital malformations in a cohort of depressed pregnant women: an updated analysis of the Quebec Pregnancy Cohort. BMJ open, 7(1), e013372. https://doi.org/10.1136/bmjopen-2016-013372 Boukhris, T., Sheehy, O., Mottron, L., & Bérard, A. (2016). Antidepressant Use During Pregnancy and the Risk of Autism Spectrum Disorder in Children. Jama Pediatrics, 170(2), 117-24. doi: 10.1001/jamapediatrics.2015.3356. Brown, A. S., Gyllenberg, D., Malm, H., McKeague, I. W., Hinkka-Yli-Salomäki, S., Artama, M., Gissler, M., Cheslack-Postava, K., Weissman, M. M., Gingrich, J. A., & Sourander, A. (2016). Association of Selective Serotonin Reuptake Inhibitor Exposure During Pregnancy With Speech, Scholastic, and Motor Disorders in Offspring. JAMA psychiatry, 73(11), 1163–1170. https://doi.org/10.1001/jamapsychiatry.2016.2594 Cohen, J. , Hernández-Díaz, S. , Bateman, B. , Park, Y. , Desai, R. , Gray, K. , Patorno, E. , Mogun, H. & Huybrechts, K. (2017). Placental Complications Associated With Psychostimulant Use in Pregnancy. Obstetrics & Gynecology, 130(6), 1192-1201. doi: 10.1097/AOG.0000000000002362. Huybrechts, K. F., Hernández-Díaz, S., Patorno, E., Desai, R. J., Mogun, H., Dejene, S. Z., Cohen, J. M., Panchaud, A., Cohen, L., & Bateman, B. T. (2016). Antipsychotic Use in Pregnancy and the Risk for Congenital Malformations. JAMA psychiatry, 73(9), 938–946. https://doi.org/10.1001/jamapsychiatry.2016.1520 Huybrechts, K. F., Palmst

    • 40 min

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