The following annexes can be added as a package of standalone supplementary documents.
➡️Keywords: The MeSH terms for "Guideline for diagnosis of …neonatal and infantile cholestasis’. " on PubMed are: neonate, infantile, cholestasis, guideline
➡️Annex Table 1.
Declaration of Conflict of Interests
The members of the guideline development/ adaptation group and the external review group have no academic, financial, or competing interests to declare and none of them were involved in the development of the original source guideline(s).
Any identified potential COI has been reported below.
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Egyptian Pediatric Clinical Practice Guidelines Committee (EPG) Guideline Adaptation Group (Clinical subgroup) |
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Name |
Affiliation, Area of expertise / Role, Country / Primary location [work] |
Declaration of interests |
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Interest identified |
Management plan & decision |
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None |
Not Applicable |
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None |
Not Applicable |
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Guideline Adaptation Group (Methodology Subgroup) |
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Prof. Ashraf Abdel Baky |
Professor of Pediatrics Ain Shams University, Egypt Founder and Chair of EPG |
None |
Not Applicable |
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Dr. Yasser Sami Amer |
1. Pediatrics Department and Clinical Practice Guidelines and Quality Research Unit, Quality Management Department, King Saud University Medical City, Riyadh, Saudi Arabia; 2. Research Chair for Evidence-Based Health Care and Knowledge Translation, King Saud University, Riyadh, Saudi Arabia; 3. Chair, Adaptation Working Group, Guidelines International Network (GIN), Perth, Scotland 4. Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo (FMRP-USP), Ribeirão Preto, São Paulo, Brazil. |
None |
Not Applicable |
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Dr. Nanis Sulieman |
Associate Professor of Pediatrics Ain Shams University, Egypt |
None |
Not Applicable |
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Dr. Ranin Soliman
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1. Assistant Professor of Evidence-based Practice, School of Life and Medical Sciences, University of Hertfordshire, Egypt. 2. Consultant at WHO/EMRO for the Clinical and Public Heath Guideline Adaptation Project in the EMR. 3. Head of Heath Economics and Value Unit, Children’s Cancer Hospital Egypt. |
None |
Not applicable |
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Dr. Lamis Mohsen Elsholkamy |
Lecturer of Pediatrics, Faculty of Medicine, Modern University for Technology and Information (MTI), Egypt |
None |
Not Applicable |
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Dr. Ahmad Yousef |
Lecturer of Pediatrics, Faculty of Medicine, Modern University for Technology and Information (MTI), Egypt |
None |
Not Applicable |
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Dr. Nahla Gamaleldin |
Lecturer of pediatrics, Faculty of Medicine, Modern University for Technology and Information (MTI), Egypt |
None |
Not Applicable |
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Dr. Mona Saber |
Lecturer of Pediatrics, Faculty of Medicine, Modern University for Technology and Information (MTI), Egypt |
None |
Not Applicable |
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External Review Group |
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None |
Not Applicable |
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None |
Not Applicable |
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None |
Not Applicable |
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External Reviewer for methodology |
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International Peer Reviewers |
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None |
Not Applicable |
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None |
Not Applicable |
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None |
Not Applicable |
Annex Table 2. Guideline documentation; List of Retrieved Guidelines
|
N |
Title |
Database |
English |
Date |
Organization |
Type |
Evidence Based (method used) |
|
1 |
Diagnostic approach to neonatal and infantile cholestasis: A position paper by the SIGENP liver disease working groups |
Google scholar |
Yes |
2022 |
SIGENP liver disease working group; Italy |
Position paper |
Yes, Method: GRADE |
|
2 |
Italian guidelines for the management and treatment of neonatal cholestasis |
Google scholar |
Yes |
2015 |
Italian Society of Neonatology |
Guideline “review” |
Yes Method: Center for Evidence-Based-Medicine |
|
3 |
Efficacy and safety of ursodeoxycholic acid in children with cholestasis |
Google scholar |
Yes |
2023 |
Science and Technology Department of Sichuan Province, China |
A systematic review and meta-analysis |
-Quality of evidence (GRADE)
-Used Cochrane Collaboration risk of bias tool (Rob 2.0) |
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4 |
Early differential diagnosis methods of biliary atresia |
Google scholar |
Yes |
2018 |
Authors, China |
A meta-analysis |
. Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) |
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5 |
Diagnostic Performance of Sonographic Features in Patients with Biliary Atresia |
Google scholar |
Yes |
2016 |
Authors, Korea |
A systematic review and meta-analysis |
. Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) |
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6 |
Systematic review of progressive familial intrahepatic cholestasis |
Google scholar |
Yes |
2019 |
Authors, multinational |
A systematic review and meta-analysis |
Used (PRISMA) guidelines protocol |
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7 |
Systematic Review: The Epidemiology, Natural History, and Burden of Alagille Syndrome |
Google scholar |
Yes |
2018 |
Authors, multinational |
A systematic review |
Used (PRISMA) guidelines protocol |
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8 |
Diagnostic Efficacy of Advanced Ultrasonography Imaging Techniques in Infants with Biliary Atresia (BA) |
Google scholar |
Yes |
2022 |
Authors, China |
A systematic review and meta-analysis |
Used (PRISMA) guidelines protocol Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) |
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9 |
Guideline for the Evaluation of Cholestatic Jaundice in Infants: Joint Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition.2017 |
PubMed |
yes |
2017 |
ESPGHAN; NSPGHAN |
CPG |
Yes Method: GRADE |
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10 |
Outcomes of Alagille syndrome following the Kasai operation: a systematic review and meta-analysis |
PubMed |
yes |
2018 |
Fujishiro et al. |
systematic review |
Used: PRISMA guidelines Protocol |
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11 |
Etiologies of conjugated hyperbilirubinemia in infancy: a systematic review of 1692 Subjects |
PubMed |
yes |
2015 |
Gottesman et al. |
systematic review |
Used: PRISMA guidelines Protocol |
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12 |
The value of preoperative liver biopsy in the diagnosis of extrahepatic biliary atresia: A systematic review and meta-analysis |
PubMed |
yes |
2016 |
Lee et al. |
Systematic review |
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➡️Annex Table 3. Results of the AGREE II assessment of the three source guidelines for
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Guidelines |
Domain 1 Scope& purpose |
Domain 2
Stake hold involve |
Domain 3 Rigor of develop. |
Domain 4 Clarity of present. |
Domain 5 Applicability |
Domain 6
Editorial independence |
Overall |
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1. Guideline for the Evaluation of Cholestatic Jaundice in Infants: Joint Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition |
71% |
47% |
44% |
88% |
44% |
30% |
OA1:77% yes 3, yes with modifications 2, No 0 |
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2. Diagnostic approach to neonatal and infantile cholestasis: A position paper by the SIGENP liver disease working group |
87% |
61% |
66% |
94% |
65% |
25%
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OA 1 :60% OA 2: Yes - 4, Yes with modifications - 0, No - 0 |
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3. Italian guidelines for the management and treatment of neonatal cholestasis |
76% |
39% |
30% |
80% |
28% |
65% |
OA1: 53% OA 2 : Yes - 2, Yes with modifications - 2, No - 1 |
Annex 4. Nurses and Parents Educational Guide in Arabic

بطاقة لون براز الرضع فى بريتش كولومبيا
برنامج كشف رتق القناة الصفراوية (14)
Appendix Table 5. The RIGHT-Ad@pt checklist |
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7 sections, 27 topics, and 34 items |
Assessment |
Page(s)* |
Note(s) |
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BASIC INFORMATION |
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Title/subtitle |
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1 |
Identify the report as an adaptation of practice guideline(s), that is include "guideline adaptation", "adapting", "adapted guideline/recommendation(s)", or similar terminology in the title/subtitle. |
☒ Yes ☐ No ☐ Unclear |
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2 |
Describe the topic/focus/scope of the adapted guideline. |
☒ Yes ☐ No ☐ Unclear |
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Cover/first page |
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3 |
Report the respective dates of publication and the literature search of the adapted guideline. |
☒ Yes ☐ No ☐ Unclear |
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4 |
Describe the developer and country/region of the adapted guideline. |
☒ Yes ☐ No ☐ Unclear |
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Executive summary/abstract |
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5 |
Provide a summary of the recommendations contained in the adapted guideline. |
☒ Yes ☐ No ☐ Unclear |
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Abbreviations and acronyms |
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6 |
Define key terms and provide a list of abbreviations and acronyms (if applicable). |
☒ Yes ☐ No ☐ Unclear |
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Contact information of the guideline adaptation group |
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7 |
Report the contact information of the developer of the adapted guideline. |
☒ Yes ☐ No ☐ Unclear |
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SCOPE |
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Source guideline(s) |
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8 |
Report the name and year of publication of the source guideline(s), provide the citation(s), and whether source authors were contacted. |
☒ Yes ☐ No ☐ Unclear |
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Brief description of the health problem(s) |
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9 |
Provide the basic epidemiological information about the problem (including the associated burden), health systems relevant issues, and note any relevant differences compared to the source guideline(s).
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☒ Yes ☐ No ☐ Unclear |
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Aim(s) and specific objectives |
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10 |
Describe the aim(s) of the adapted guideline and specific objectives, and note any relevant differences compared to the source guideline(s). |
☒ Yes ☐ No ☐ Unclear |
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Target population(s) |
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11 |
Describe the target population(s) and subgroup(s) (if applicable) to which the recommendation(s) is addressed in the adapted guideline, and note any relevant differences compared to the source guideline(s). |
☒ Yes ☐ No ☐ Unclear |
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End-users and settings |
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12 |
Describe the intended target users of the adapted guideline, and note any relevant differences compared to the source guideline(s). |
☒ Yes ☐ No ☐ Unclear |
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13 |
Describe the setting(s) for which the adapted guideline is intended, and note any relevant differences compared to the source guideline(s). |
☒ Yes ☐ No ☐ Unclear |
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RIGOR OF DEVELOPMENT |
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Guideline adaptation group |
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14 |
List all contributors to the guideline adaptation process and describe their selection process and responsibilities. |
☒ Yes ☐ No ☐ Unclear |
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Adaptation framework/methodology |
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15 |
Report which framework or methodology was used in the guideline adaptation process. |
☒ Yes ☐ No ☐ Unclear |
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Source guideline(s) |
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16 |
Describe how the specific source guideline(s) was(were) selected. |
☒ Yes ☐ No ☐ Unclear |
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Key questions |
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17 |
State the key questions of the adapted guideline using a structured format, such as PICO (population, intervention, comparator, and outcome), or another format as appropriate. |
☒ Yes ☐ No ☐ Unclear |
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18 |
Describe how the key questions were developed/modified, and/or prioritized. |
☐ Yes ☒ No ☐ Unclear |
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Source recommendation(s) |
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19 |
Describe how the recommendation(s) from the source guideline(s) was(were) assessed with respect to the evidence considered for the different criteria, the judgements and considerations made by the original panel. |
☐ Yes ☒ No ☐ Unclear |
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Evidence synthesis |
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20 |
Indicate whether the adapted recommendation(s) is/are based on existing evidence from the source guideline(s), and/or additional evidence. |
☐ Yes ☒ No ☐ Unclear |
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21 |
If new research evidence was used, describe how it was identified and assessed. |
☐ Yes ☒ No ☐ Unclear |
NA |
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Assessment of the certainty of the body of evidence and strength of recommendation |
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22 |
Describe the approach used to assess the certainty/quality of the body/ies of evidence and the strength of recommendations in the adapted guideline and note any differences (if applicable) compared to the source guideline(s). |
☐ Yes ☒ No ☐ Unclear |
NA |
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Decision-making processes |
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23 |
Describe the processes used by the guideline adaptation group to make decisions, particularly the formulation of recommendations.
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☒ Yes ☐ No ☐ Unclear |
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RECOMMENDATIONS |
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Recommendations |
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24 |
Report recommendations and indicate whether they were adapted, adopted, or de novo. |
☒ Yes ☐ No ☐ Unclear |
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25 |
Indicate the direction and strength of the recommendations and the certainty/quality of the supporting evidence and note any differences compared to the source recommendations(s) (if applicable). |
☒ Yes ☐ No ☐ Unclear |
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26 |
Present separate recommendations for important subgroups if the evidence suggests important differences in factors influencing recommendations and note any differences compared to the source recommendations(s) (If applicable). |
☒ Yes ☐ No ☐ Unclear |
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Rationale/explanation for recommendations |
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27 |
Describe the criteria/factors that were considered to formulate the recommendations or note any relevant differences compared to the source guideline(s) (if applicable). |
☒ Yes ☐ No ☐ Unclear |
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EXTERNAL REVIEW AND QUALITY ASSURANCE |
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External review |
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28 |
Indicate whether the adapted guideline underwent an independent external review. If yes, describe the process. |
☒ Yes ☐ No ☐ Unclear |
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Organizational approval |
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29 |
Indicate whether the adapted guideline obtained organizational approval. If yes, describe the process. |
☒ Yes ☐ No ☐ Unclear |
SNS & NEBMC |
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FUNDING, DECLARATION, AND MANAGEMENT OF INTEREST |
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Funding source(s) and funder role(s) |
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30 |
Report all sources of funding for the adapted guideline and source guideline(s), and the role of the funders. |
☒ Yes ☐ No ☐ Unclear |
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Declaration and management of interests |
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31 |
Report all conflicts of interest of the adapted and the source guideline(s) panels, and how they were evaluated and managed. |
☒ Yes ☐ No ☐ Unclear |
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OTHER INFORMATION |
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Implementation |
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32 |
Describe the potential barriers and strategies for implementing the recommendations (if applicable). |
☒ Yes ☐ No ☐ Unclear |
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Update |
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33 |
Briefly describe the strategy for updating the adapted guideline (if applicable). |
☒ Yes ☐ No ☐ Unclear |
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Limitations and suggestions for further research |
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34 |
Describe the challenges of the adaptation process, the limitations of the evidence, and provide suggestions for future research. |
☐ Yes ☒ No ☐ Unclear |
-- |
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Gantt chart
