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1.

Purpose  

As cancer survival rates improve, there is growing interest in the role of lifestyle in longer-term health and quality of life (QoL). This study examined the prevalence of health-related behaviours, and the associations between health behaviours and QoL, in colorectal cancer survivors.  相似文献   

2.
BackgroundDiet, exercise, and weight management are key in improving outcomes for breast cancer survivors, with international recommendations for cancer survivors relating to these behaviors. However, few behavioral interventions have reported outcomes aligned specifically with these recommendations.ObjectiveTo evaluate a remotely delivered weight loss intervention vs usual care for female breast cancer survivors, on changes in multiple diet and physical activity behaviors.DesignA randomized controlled trial with assessments at study baseline, 6-, 12-, and 18 months (ie, mid-intervention, post-intervention, and non-contact follow-up).Participants/settingParticipants were recruited between October 2012 and December 2014 through hospitals in Brisbane, Australia, and the state-based cancer registry. Eligible participants (women aged 18 to 75 years with body mass index 25 to 45 kg/m2 who were diagnosed with stage I through III breast cancer during previous 2 years) were randomly allocated to intervention (n = 79) or usual care (n = 80).InterventionParticipants randomized to the intervention group received 22 counseling telephone calls targeting diet and physical activity aimed at achieving 5% to 10% weight loss, and optional text messages, over 12 months. Usual care participants received their standard medical care and brief feedback following each assessment, which was similar to that provided to intervention participants with the exception that usual care participants’ results were not compared with national and study recommendations.Main outcome measuresDietary intake (24-hour recalls), physical activity (hip-worn GT3X+ accelerometer [Actigraph]), sitting time (thigh-worn activPAL3 [PAL Technologies Limited), and adherence to World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) recommendations for cancer survivors (0 to 7 score) were measured at each assessment, with data collected between November 2012 and October 2016.Statistical analyses performedIntervention effects were assessed by linear mixed models, accounting for repeated measures and baseline values. Significance was set at P < 0.05.ResultsAt baseline, participants were aged 55 ± 9 years, with a body mass index of 31.4 ± 5.0 kg/m2, 10.7 ± 5.0 months postdiagnosis, and primarily non-minority. At baseline, only 8% (n = 12) of participants met ≥5 out of seven WCRF/AICR recommendations (WCRF/AICR adherence score = 3.8 ± 1.0). At 12 months, significant intervention effects were observed in walking/running (+21 minutes/week; 95% CI 4 to 38) and WCRF/AICR adherence scores (+0.3 points; 95% CI 0.0 to 0.6) only. At 18 months, significant intervention effects were observed for energy intake (–229 kcal/day energy; 95% CI –373 to –84), total fat (–10 g/day; 95% CI –18 to –2), and saturated fat (–5 g/day; 95% CI –9 to –1), and were sustained for WCRF/AICR adherence scores (+0.5 points; 95% CI 0.2 to 0.8).ConclusionsThis remotely delivered weight loss intervention led to sustained improvements in WCRF/AICR adherence scores, and some improvements in diet and physical activity. These findings provide support for the health benefit of programs targeting lifestyle behaviors in line with cancer survivor recommendations, and the potential for dissemination of such programs for women following treatment for early-stage breast cancer.  相似文献   

3.
Statement of problemWhile physical activity is positively associated with more optimal health-related quality of life (HRQoL), less is known about the associations between sedentary behavior and HRQoL. The purpose of this study was to determine associations of total sitting time with HRQoL among older men.MethodsOlder-aged men 55 years of age and older (N = 375) completed a mailed survey that assessed demographic and health information, weekday and weekend sitting time, and HRQoL (RAND-12).ResultsParticipants averaged 9.3 h (SD = 7) of sitting time for weekday and 8.3 h (SD = 5.2) of sitting time for weekend. For weekday, all three adjusted HRQoL models (i.e., physical, mental, and global health) indicated no significant differences in HRQoL across weekday sitting time quartiles (Q) (all p's > .36). For weekend, all three adjusted models indicated significant associations. Differences were observed for Q1 and Q4 (the lowest and highest quartiles, respectively) on physical (Mdiff = 2.3, p = 0.05), mental (Mdiff = 2.9, p < 0.05), and global health (Mdiff = 2.2, p < 0.05). Overall, older men engaged in significantly more total sitting minutes per day on the weekday compared to the weekend (511.6 v. 556.9, p > 0.01).ConclusionOlder men spend the majority of their waking hours engaged in sedentary behaviors. Weekend sitting time was associated with HRQoL when comparing the lowest and highest quartiles.  相似文献   

4.
ObjectivesTo analyze the independent and combined associations of physical activity (PA) and sedentary behavior (SB) with self-rated health (SRH) in a large sample of adolescents.MethodsData from 100,873 students with mean age of 14.3 (±1.1) years were analyzed. SRH, PA and SB were assessed by questionnaires. Age, ethnicity, maternal education, geographical region of country, type of city, industrialized and sugary foods consumption were covariates. Logistic regression models were used to analyze the data according to gender.Results≥300 min/week of PA [OR:1.12 (95%CI:1.04–1.21)] and <4 h of sitting time [OR:1.42 (95%CI:1.32–1.54)] were associated with good SRH among boys, while only lower sitting time was associated with good SRH among girls [OR:1.32 (95%CI:1.23–1.41)]. Physically active and with low sitting time adolescents were more likely to have good SRH [Boys OR:1.57 (95%CI:1.41–1.75); Girls OR:1.32 (95%CI:1.18–1.46)], than inactive and with high sitting time counterparts. However, high sitting time was associated with poor SRH independently of ≥300 min/week of PA.ConclusionPA and sitting time were independently associated with SRH in Brazilian adolescents. Moreover, reaching ≥300 min/week of PA was not sufficient to attenuate the negative association between high sitting time and SRH.  相似文献   

5.
ProblemEvidence is emerging of adverse associations between prolonged sitting at work and physical health, yet little is known about occupational sitting and mental health. This study examined associations between occupational sitting and psychological distress in employed adults, independent of leisure-time physical activity.MethodsA survey of 3367 state government employees (mean age 46.2 years, 71.9% women) was conducted in Tasmania, Australia, during 2010 as part of an evaluation of workplace health and wellbeing programs. The Kessler Psychological Distress Scale (K10) was used to measure psychological distress, and participants reported time spent sitting at work on a typical day. Physical activity was assessed using the International Physical Activity Questionnaire (IPAQ). Ratios of prevalence (PR) for categories of psychological distress were estimated by log multinomial regression separately for men and women, and with adjustment for age, marital status, effort-reward imbalance and leisure-time physical activity.ResultsAverage reported occupational sitting time was 4.8 (Standard Deviation SD = 2.5) hours for men and 4.2 (SD = 2.7) hours for women. Compared to those sitting at work less than 3 h/day, men sitting more than 6 h/day had increased prevalence of moderate psychological distress (adjusted PR = 1.90, 95%CI 1.22, 2.95), and women sitting more than 6 h/day had an increased prevalence of moderate (adjusted PR = 1.25, 95%CI 1.05, 1.49) and high (adjusted PR = 1.76, 95%CI 1.25, 2.47) distress.ConclusionThe current study found an association between occupational sitting and intermediate levels of psychological distress, independent of leisure-time physical activity. Reducing occupational sitting time may have mental health benefits.  相似文献   

6.
Purpose

Pediatric cancer survivors may have lower quality of life (QoL), but most research has assessed outcomes either in treatment or long-term survivorship. We focused on early survivorship (i.e., 3 and 5 years post-diagnosis), examining the impact of CNS-directed treatment on child QoL, as well as sex and age at diagnosis as potential moderators.

Methods

Families of children with cancer (ages 5–17) were recruited at diagnosis or relapse (N?=?336). Survivors completed the PedsQL at 3 (n?=?96) and 5 years (n?=?108), along with mothers (101 and 105, respectively) and fathers (45 and 53, respectively). The impact of CNS treatment, sex, and age at diagnosis on child QoL was examined over both time since diagnosis and time since last treatment using mixed model analyses.

Results

Parent-report of the child’s total QoL was in the normative range and stable between 3 and 5 years when examining time since diagnosis, while child reported QoL improved over time (p?=?0.04). In terms of time since last treatment, mother and child both reported the child’s QoL improved over time (p?=?0.0002 and p?=?0.0006, respectively). Based on parent-report, males with CNS-directed treatment had lower total QoL than females and males who did not receive CNS-directed treatment. Age at diagnosis did not moderate the impact of treatment type on total QoL.

Conclusions

Quality of life (QoL) in early survivorship may be low among males who received CNS-directed treatment. However, this was only evident on parent-report. Interventions to improve child QoL should focus on male survivors who received CNS-directed treatment, as well as females regardless of treatment type.

  相似文献   

7.
ObjectivesLife-space mobility is a measure of the extent and frequency of mobility in older adults reflecting not only physical function, but also cognitive, psychosocial, and environmental factors. This study aimed to (1) develop life-space mobility profiles for nursing home residents; (2) examine independent factors associated with these profiles; and (3) identify health outcomes [ie, mortality, quality of life (QoL) and falls] associated with the life-space mobility profiles at 1 year.DesignProspective cohort study.Setting and ParticipantsTwelve nursing homes including 556 residents, mean age 87.73 ± 7.25 years, 73.0% female.MethodsLife-space mobility was measured using the Nursing Home Life-Space Diameter (NHLSD). Mortality and falls were extracted from residents' records. QoL was measured using the QoL in Alzheimer Disease (QoL-AD) scale.ResultsNHLSD scores ranged from 0 to 50 with a mean score of 27.86 ± 10.12. Resident life-space mobility was mainly centered around their room (94.8%, n = 527) and wing (86.4%, n = 485). One-half of the residents left their wing daily (51.0%, n = 284), and over one-quarter (26.4%, n = 147) ventured outside their nursing home at least weekly. Significant associations (P < .05) with high life-space mobility, identified through multivariable analyses, included lower age [odds ratio (OR) 0.70, 95% confidence interval (CI) 0.51, 0.96]; lower frailty levels (OR 0.67, 95% CI 0.50, 0.86); lower sarcopenia risk (OR 0.72, 95% CI 0.65, 0.79); and a better nutritional status (OR 1.16, 95% CI 1.05, 1.29). High life-space mobility was a predictor (P < .05) of lower mortality, lower falls rate, and higher QoL at 1 year when compared with moderate or low mobility.Conclusions and ImplicationsGiven the independent association between high life-space mobility and lower frailty status, lower sarcopenia risk, and a better nutritional status, physical activity and nutritional interventions may be beneficial in leading to improved life-space use. This requires further investigation. Improved life-space mobility can lead to improved health outcomes, such as lower mortality, lower falls rate, and improved QoL.  相似文献   

8.
Purpose

To obtain insight into employment and insurance outcomes of thyroid cancer survivors and to examine the association between not having employment and other factors including quality of life.

Methods

In this cross-sectional population-based study, long-term thyroid cancer survivors from the Netherlands participated. Clinical data were collected from the cancer registry. Information on employment, insurance, socio-demographic characteristics, long-term side effects, and quality of life was collected with questionnaires.

Results

Of the 223 cancer survivors (response rate 87 %), 71 % were employed. Of the cancer survivors who tried to obtain insurance, 6 % reported problems with obtaining health care insurance, 62 % with life insurance, and 16 % with a mortgage. In a multivariate logistic regression analysis, higher age (OR 1.07, CI 1.02–1.11), higher level of fatigue (OR 1.07, CI 1.01–1.14), and lower educational level (OR 3.22, CI 1.46–7.09) were associated with not having employment. Employment was associated with higher quality of life.

Conclusions

Many thyroid cancer survivors face problems when obtaining a life insurance, and older, fatigued, and lower educated thyroid cancer survivors may be at risk for not having employment.

  相似文献   

9.
Statement of problemStudies exploring relationships between sitting and mental health have been conducted in child and adult, but not pregnant populations. Depression during pregnancy is associated with deleterious outcomes for mothers and children, and shortcomings have been identified in current management strategies. Modifiable lifestyle behaviors may provide more acceptable alternatives to current management strategies if shown to be important. The aim of this study was to explore the relationship between sitting behavior and depressive symptoms in a population of pregnant Australian women.MethodsThis pilot cross-sectional study included 81 pregnant women in Brisbane, Australia. Depressive symptoms were measured using the Hospital Anxiety and Depression Scale (HADS). Sitting behavior was measured using the Australian Women's Activity Survey (AWAS). Several potential covariates were also assessed. Linear regression analyses were used to explore the relationship between sitting and depressive symptoms, whilst controlling for known covariates.ResultsThe model investigating “total sitting time” showed no association with depressive symptoms (F = .77, p = 0.38). The model investigating “planned leisure sitting time” was statistically significant (F = 4.42, p = 0.04): significant contributors to the model variance were HADS anxiety score (p = 0.003) and number of existing children (p = 0.02). “Planned leisure sitting time” showed a statistical trend toward significance (p = 0.06).ConclusionsThis study suggests further investigation of the relationship between sitting, particularly planned leisure sitting, and depression during pregnancy is warranted. Future research should include a larger sample and an objective measure of leisure time sitting.  相似文献   

10.
ObjectiveProlonged sitting is an emerging risk factor for poor health yet few studies have examined awareness of the risks associated with sitting behaviours. This study identifies the population subgroups with the highest levels of unawareness regarding the cardiovascular disease (CVD) risks associated with sitting behaviours.MethodAdults (n = 1256) living in Queensland, Australia completed a telephone-based survey in 2011, analysis conducted in 2013. The survey assessed participant's socio-demographic characteristics, physical activity, sitting behaviours and awareness of CVD risks associated with three sitting behaviours: 1) sitting for prolonged periods, 2), sitting for prolonged periods whilst also engaging in regular physical activity, and 3) breaking up periods of prolonged sitting with short activity breaks. Population sub-groups with the highest levels of unawareness were identified based on socio-demographic and behavioural characteristics using signal detection analysis.ResultsUnawareness ranged from 23.3% to 67.0%. Age was the most important variable in differentiating awareness levels; younger adults had higher levels of unawareness. Body mass index, physical activity, TV viewing, employment status and time spent at work also identified population sub-groups.ConclusionUnawareness of CVD risk for prolonged sitting was moderately high overall. Younger adults had high levels of unawareness on all of the outcomes examined.  相似文献   

11.
12.
This study assessed changes in quality of life (QoL) and cardiorespiratory fitness (CRF) during a diet and physical activity (PA) intervention in breast cancer (BC) survivors and investigated the relation between these changes. The intervention of this single-arm pre-post study involved supervised, 1-hour weekly, diet sessions and 75-minute bi-weekly PA sessions of moderate-to-high intensity. This 12-week intervention targeted overweight/obese women who had recently completed BC treatment. Pre- and post-CRF and QoL measurements were compared using paired t-tests. Linear regression models, including baseline participants’ characteristics and weight change, were used to assess the association between changes in CRF and QoL. The 37 BC survivors who completed the intervention between May 7, 2012 and July 27, 2012 showed significant increases in CRF and QoL. Peak oxygen uptake (mL/kg/min) increased from 19.0 ± 2.8 to 24.0 ± 4.1 while peak workload (watts/kg) increased from 1.3 ± 0.3 to 1.7 ± 0.3. Although statistical significance was not reached, the increase in workload seemed associated with increases in physical, mental, and general health and with a decrease in fatigue. This lifestyle intervention improved BC survivors’ QoL and CRF and suggested possible relationships between CRF and QoL. More research needs to confirm these associations and promote lifestyle interventions aiming at improving BC survivors’ QoL.  相似文献   

13.
ObjectiveSedentary behaviour may be a contributor to weight gain in today's young adult women, who are gaining weight faster than women in their mothers' generation. The aim was to examine the relationships between sitting time and weight in young women.MethodData were from women born in 1973–1978 who completed surveys in 2000, 2003 and 2006 for the Australian Longitudinal Study on Women's Health. Associations between concurrent changes in sitting-time and weight, and prospective associations between these variables, were examined using ANOVA and linear regressions, stratified by BMI-category in 2000 (n = 5562).ResultsAmong overweight and obese women, percentage weight change from 2000 to 2006 was higher in those whose sitting time increased (> 20%) than in those whose sitting time decreased (> 20%) over the same period (p < 0.05). Conversely, percentage change in sitting time was significantly higher in those who gained weight (> 5%) than in those who lost weight (> 5%) (p < 0.05). There were no prospective associations between (change in) sitting time and weight change, or between (change in) weight and change in sitting time.ConclusionThe results confirm associations between concurrent changes in weight and changes in sitting time in overweight and obese women, but no prospective relationships were found.  相似文献   

14.
IntroductionThe primary aim was to examine longitudinal associations between changes in screen-time and mental health outcomes among adolescents.MethodsAdolescents (N = 322, 65.5% females, mean age = 14.4 ± 0.6 years) reported screen-time and mental health at two time points over a school year. Multi-level linear regression analyses were conducted after adjusting for covariates.ResultsChanges in total recreational screen-time (β = −0.09 p = 0.048) and tablet/mobile phone use (β = −0.18, p < 0.001) were negatively associated with physical self-concept. Changes in total recreational screen-time (β = −0.20, p = 0.001) and computer use (β = −0.23, p = 0.003) were negatively associated with psychological well-being. A positive association was found with television/DVD use and psychological difficulties (β = 0.16, p = 0.015). No associations were found for non-recreational screen-time.ConclusionChanges in recreational screen-time were associated with changes in a range of mental health outcomes.  相似文献   

15.
BackgroundChildren with chronic conditions often experience numerous symptoms, but few research studies examine patterns of symptoms and quality of life (QoL) indicators.ObjectiveTo examine if reliable latent classes of children with chronic medical conditions can be identified based on the clustering of symptoms and QoL indicators.MethodsStructured interviews were conducted with children ages 9–21 living with chronic medical conditions (N = 90). Multiple symptoms (e.g., pain, sleep, fatigue, and depression) and QoL indicators (e.g., life satisfaction and social support) were measured. Physical health and emotional, social, and school functioning were measured using the Pediatric Quality of Life Inventory (PedsQL). Latent class analysis was used to classify each child into a latent class whose members report similar patterns of responses.ResultsA three-class solution had the best model fit. Class 1 (high-symptom group; n = 15, 16.7%) reported the most problems with symptoms and the lowest scores on the QoL indicators. Class 2 (moderate-symptom group; n = 39, 43.3%) reported moderate levels of both symptoms and QoL indicators. Class 3 (low-symptom group; n = 36, 40.0%) reported the lowest levels of symptoms and the highest scores on the QoL indicators.ConclusionsThe three latent classes identified in this study were distributed along the severity continuum. All symptoms and QoL indicators appeared to move in the same direction (e.g., worse symptoms with lower QoL). The PedsQL psychosocial health summary score (combining emotional, social, and school functioning scores) discriminated well between children with different levels of disease burden.  相似文献   

16.
BackgroundRecent work has shown that individuals with chronic health conditions and disabilities (CCD) meet the 24-h movement guidelines at lower rates than population norms; however, the evidence base remains limited across different stages of the lifespan and very few studies have examined associations with mental health outcomes.ObjectiveThis study examined 24-h movement guideline adherence among emerging adults with CCD compared to those without and associations between guideline adherence and indicators of mental health.MethodsThis cross-sectional study used data from the 2020 cycle of the Canadian Campus Wellbeing Survey. A total of 17,874 emerging adults enrolled at 20 post-secondary institutions (mean age = 21.6 ± 2.94 years; 65.2% female), including 3336 who identified with a CCD, self-reported their movement behaviors (physical activity, sedentary behaviors, sleep) and completed measures of psychological distress and mental well-being. Logistic regressions models were computed to examine differences in guideline adherence. Propensity score weighted linear regression models were computed to examine associations between guideline adherence and indicators of mental health.ResultsEmerging adults with CCD had significantly lower odds of meeting the 24-h movement guidelines than their peers, and disparities in guideline adherence were most pronounced among those with multimorbidity, developmental, and physical disabilities. Guideline adherence was associated with significantly more favorable scores for psychological distress and mental well-being among those with and without CCD.ConclusionsFindings suggest emerging adults with CCD engage in less healthy movement behavior patterns than their peers, yet they appear to experience similar mental health benefits when they do meet the 24-h movement guidelines.  相似文献   

17.
《The Journal of adolescent health》2007,40(5):462.e9-462.e15
PurposeTo examine social and romantic outcomes among survivors of childhood cancer and comparison peers during the transition from adolescence to emerging adulthood.MethodsFamilies were recruited when the children with cancer were 8–15-years-old and on initial treatment for a malignancy that did not primarily affect the central nervous system (i.e., non-CNS). At that time, each child with cancer was matched to a classmate of similar age, gender, and race for inclusion in a comparison group. For the current follow-up (7.29 years post-diagnosis), 56 survivors, 60 comparison peers, and their parents completed questionnaires after the youth’s 18th birthday. Severity of treatment and late effects were rated by health care providers.ResultsSurvivors and comparison peers were similar on a variety of outcomes, including family background, social self-concept, social competence, family relationships, friendships, and romantic relationships. Mothers reported that survivors engaged in fewer activities than comparison peers. The proportion of participants who lived with their parents, were dating, and expressed plans to marry or have children was similar between groups. Initial treatment intensity, time since diagnosis, and severity of late effects were associated with some indices of social adjustment.ConclusionsThe social and romantic outcomes of survivors of non-CNS cancer were similar to comparison peers during the transition from adolescence to emerging adulthood. Disease and treatment factors had limited associations with outcomes. Clinical interventions to assist social development may not be necessary for all survivors, but additional research is needed to identify subgroups at risk for difficulties.  相似文献   

18.
《Women's health issues》2015,25(6):673-679
BackgroundSedentary behavior is associated with negative health consequences independent of physical activity levels. Evidence suggests the work environment promotes sedentary behavior regardless of sector, and that employees with occupations requiring longer sitting times differ only marginally in leisure sitting time from those with more active occupations. Because physical activity opportunities may be limited across many work settings, leisure sedentary time may be more easily replaced with physical activity. Understanding correlates of leisure sedentary behaviors could inform interventions, specifically for women who are among the least active in America.MethodsFemale employees at two universities completed online surveys (n = 156; mean age, 45.12 [SD = 12.5]; mean BMI, 26.7 kg/m2 [SD = 5.9]; mean work hours/week, 43.7 [SD = 9.4]). Bivariate correlations and two hierarchical regression analyses were conducted to examine personal and behavioral correlates of weekday and weekend leisure sitting time.FindingsFinal regression models revealed that greater weekday leisure sitting time (R2 = 0.307) was related with being older (p = .006), having fewer children (p = .001), self-reporting poorer health (p = .006), and greater weekend sitting time (p < .001). Greater weekend leisure sitting time (R2 = 0.261) was related with greater work-related sitting time (p = .020) and greater weekday leisure sitting time (p < .001). Physical activity was not related with weekday or weekend leisure sitting time.ConclusionsThe most prominent correlates of leisure sitting time were other types of sedentary behaviors. This suggests that sedentary time in one segment of life predicts time spent sitting in other areas of life. Future interventions should target decreasing sedentary behaviors during leisure time specifically, in addition to increasing physical activity behavior.  相似文献   

19.

Background  

Quality of life (QoL) measurements are important in evaluating cancer treatment outcomes. Factors other than cancer and its treatment may have significant effects on QoL and affect assessment of treatments. Baseline data from longitudinal studies of women with endometrial or ovarian cancer or adnexal mass determined at surgery to be benign were analyzed to determine the degree to which QoL is affected by baseline differences in demographic variables and health.  相似文献   

20.
IntroductionPhysical inactivity is a risk factor for cancer morbidity and mortality, but its influence in colorectal cancer (CRC) survivors is understudied. We investigated sociodemographic, physically limiting, and behavioral predictors influencing leisure time physical activity (LTPA) among CRC survivors.MethodsPooled 1997–2010 National Health Interview Survey data (N = 2378) were used to evaluate LTPA compliance in CRC survivors according to Healthy People 2010 recommendations. Univariate and multivariable logistic regression analyses were performed to identify predictors of LTPA compliance among CRC survivors. Independent variables included: age, gender, race/ethnicity, education, health insurance, body mass index (BMI), ≥ 2 chronic conditions limiting physical activity, time since cancer diagnosis, and poverty, marital, smoking and alcohol status.ResultsMultivariable regression models reveal that Hispanics, non-Hispanic Blacks, those with ≥ 2 physically limiting chronic conditions, and current smokers were less likely to comply with LTPA recommendations. CRC survivors who were of “other” race, more than one race, those with some college degree or college degree, and current drinkers were more likely to comply.DiscussionHispanics, non-Hispanic Blacks, those with > 2 physically limiting chronic conditions and current smokers warrant additional efforts to encourage physical activity and to determine the impact of regular physical activity on CRC survivorship.  相似文献   

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