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Dr. Afshin S. Adhami M.D

It may only take one energy drink to harm your blood vessels

Is it safe to consume energy drinks in any quantity?

From students pulling all-nighters to fitness enthusiasts, many people use these boosters, but a new study suggests that a single energy drink could immediately harm blood vessel function.

How do energy drinks affect vascular health? A new study investigates.
According to the National Center for Complementary and Integrative Health (NCCIH), energy drinks are among the most commonly used dietary supplements in the United States.
The NCCIH note, specifically, that men "between the ages of 18 and 34 years consume the most energy drinks," and that "almost one-third of teens between 12 and 17 years drink them regularly."
Because they contain high levels of caffeine, taurine, and other stimulating substances, the safety of energy drinks has always been the subject of intense debate.

For instance, the authors of one study expressed concerns that energy drinks may act as a gateway for illicit drug use. Other research indicates that having too many energy drinks may cause liver damage.
Mostly, however, researchers have been concerned about the impact of energy drinks on cardiovascular health. Reportedly, having more than two such drinks per day may endanger the heart.
Now, specialists from the McGovern Medical School at the University of Texas Health Science Center at Houston are preparing to present evidence that a single energy drink may have serious negative effects on blood vessel function.

Blood vessel health acutely impaired

The study included 44 young, healthy participants. All were medical students in their 20s who did not habitually smoke.
The researchers tested the participants' endothelial (blood vessel) function at baseline, to establish how energy drinks would affect it.
The participants then each had a 24-ounce energy drink. Ninety minutes later, the researchers again performed the endothelial function tests.
At the 90-minute mark, the tests showed that the students had poorer artery flow-mediated dilation than they had before consuming the energy drinks.

Artery flow-mediated dilation indicates blood vessel health. At baseline, it was about 5.1 percent in diameter, on average.

Following energy drink consumption, this measurement fell to 2.8 percent in diameter. The researchers explain that this indicates acute impairment of blood vessel function.
The authors of the study speculate that the impairment of vascular function may result from a combination of substances typically used in energy drinks, including caffeine, taurine, sugar, and herbal stimulants.
The scientists explain that it is still unclear whether energy drinks are safe to consume, and in what quantities. They add:

"As energy drinks are becoming more and more popular, it is important to study the effects of these drinks on those who frequently drink them and better determine what, if any, is a safe consumption pattern."
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Dr. Afshin Shawn Adhami.D
How to control diabetes?
Reduce meat intake
The potential benefits of eating a plant-based diet have expanded once again. A new paper concludes that, for people with diabetes, cutting out animal products improves glucose control and well-being in addition to boosting weight loss.
A new analysis finds more benefits of a plant-based diet.
Over recent years, vegetarianism and veganism have steadily moved from the fringe to the mainstream.
With many hailing it as a more healthful option, researchers seem to be adding to the evidence in favor of a plant-based diet on a weekly basis.
The most recent study to scrutinize the effects of a reduced meat intake considered its impact on people with diabetes.
Specifically, the scientists wanted to understand whether reducing animal-based food intake could help improve both glucose control and overall psychological well-being. To investigate this, they reanalyzed and combined data from existing studies.
Diabetes: Physical and mental
Diabetes needs no introduction. In the United States, it affects an estimated 9.4 percent of the population, with almost 15 percent of the adults in some states having a diabetes diagnosis.
It is possible to moderate the negative impact of type 2 diabetes with medication and lifestyle changes, but, without proper control, there can be severe consequences. For example, diabetes increases the risk of cardiovascular disease, nephropathy (kidney damage), and vision loss.
Aside from the physical impact of diabetes, it can have substantial psychological effects, too. People with diabetes often report lower levels of psychological well-being. The risk of depression among people with type 2 diabetes is almost twice as high as that of the general population.
The psychological aspects of diabetes can create a negative spiral, as depression makes it more difficult for people to eat healthfully, exercise regularly, and follow medication routines. This causes stress, which can make depression worse.
With these findings in mind, the authors delved into existing research that looked at how diet influences psychological well-being in these individuals.
Plant-based diet
There is scientific evidence that eating large quantities of red meat increases the risk of developing type 2 diabetes. Similarly, research has shown that a diet that is rich in vegetables, fruits, nuts, and seeds but low in animal products can reduce the risk of developing this disease.
Consequently, experts now consider a plant-based diet to be the best option for both preventing and controlling diabetes.
In 2018, the American Association of Clinical Endocrinologists and the American College of Endocrinology released new guidelines. They write that people with diabetes "should strive to attain and maintain an optimal weight through a primarily plant-based meal plan."
Although the links between a plant-based diet and the physical impact of diabetes are fairly well-documented, fewer studies record the psychological effects of these dietary changes.
To this end, the researchers carried out a review. In total, they found 11 relevant randomized control trials with a total of 433 participants.
The benefits of eating fewer animal products
The analysis showed that individuals who ate a plant-based or vegan diet experienced significant improvements in their physical and emotional health. Individuals who had depressive symptoms also noted improvements.
Specifically, nerve pain (neuropathy) relating to diabetes improved more in the plant-based groups than in the other experimental groups. Also, fasting glucose levels fell more sharply, which is a sign of improved glucose control.
Similarly, levels of HbA1c — a marker of average blood glucose over recent weeks or months — also dropped for these individuals.
Weight loss improved in the participants who reduced their intake of animal products; in fact, they lost almost twice the amount of weight. Additionally, levels of fat in the blood dropped more quickly in the groups who ate a plant-based or vegan diet.
Fat in the blood and carrying excess weight are both risk factors for cardiovascular disease, so this is an important finding. The authors conclude:
Plant-based diets accompanied by educational interventions can significantly improve psychological health, quality of life, HbA1c levels, and weight, and therefore the management of diabetes."
In six of the studies that the researchers analyzed, individuals who followed the plant-based or vegan diets were able to either stop taking or reduce their medication for diabetes or blood pressure.
These findings support earlier claims of the physical benefits of plant-based diets. However, when it comes to psychological factors, cumulative evidence is, to date, rather scant. This study adds to the existing body of research, but, as the authors note, "The included studies had rather small sample sizes." More work will be necessary.
Research has already shown that limiting meat intake can reduce the risk of developing type 2 diabetes and give people who have diabetes more control over their blood sugar levels. Now, it seems that it might also assist with the psychological aspects of the disease.
Moving toward a more plant-based diet is a simple and cost-effective intervention. If it has a significant impact on both the physical and emotional health of individuals with diabetes, it is an intervention worth investigating thoroughly.
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Dr. Afshin Shawn Adhami M.D

Signs and symptoms of infertility in Women

It is not uncommon for people to experience signs of infertility. This may be stressful, as many people show no direct symptoms of infertility until they try to conceive.

Infertility affects both men and women. According to the Office on Women's Health, about a third of issues with infertility comes from women, and another third starts with men. The final third may be due to a combination of both, other factors, or unknown causes.
In this article, learn about signs of infertility in women, as well as when to see a doctor.

In women, signs of infertility may include:

Not getting pregnant
The primary sign of infertility is not getting pregnant after trying for a certain length of time. A doctor may diagnose infertility if a woman has not become pregnant after 1 year of trying. If the woman is over the age of 35 years old, she may be infertile if she has not become pregnant after 6 months of trying.

A 2018 study found that obesity might negatively affect reproductive health.
Women with obesity have a lower probability of conceiving and are at a higher risk for issues during pregnancy than those without weight issues.

Pain during sex
Pain during sex, or dyspareunia, can be a sign of an underlying health problem that may influence a woman's fertility. Examples of such health issues include infections, endometriosis, and fibroids.

Heavy, long, or painful periods
Heavy periods may indicate an underlying condition affecting fertility.
Some women experience a few days of light flow, while others regularly experience heavy periods and painful cramps.
Women who experience very heavy, painful periods may be showing signs of endometriosis, a condition where tissues usually found in the womb are present elsewhere in the body.
Endometriosis is a risk factor for infertility.
Other symptoms of endometriosis include:
* chronic pelvic pain (not only during menstruation)
* pain during sex
* back pain
* fatigue
* nausea
* irregular periods and spotting
* bowel problems or pain with bowel movements

Dark or pale menstrual blood
If menstrual blood is regularly paler than usual, this may be a cause for concern. Menstrual blood is usually bright red at the beginning of a person's period and may get darker over the following days.
Passing very dark, old blood at the beginning of a period can also be a sign of endometriosis. If a person is experiencing other symptoms, they may wish to speak to a doctor.

Irregular menstrual cycle
The length of a menstrual cycle varies between individuals and over time. However, many people have a regular cycle, meaning that the time between each period is roughly the same.
Having an irregular cycle, including missing periods, can contribute to infertility, as it means a woman may not be regularly ovulating. Ovulation is when the ovary releases an egg.
Irregular ovulation can be due to many issues, including polycystic ovary syndrome (PCOS), obesity, being underweight, and thyroid issues.

Hormone changes
Signs of hormonal changes can be nonspecific, and a person may not notice them or know the underlying cause. A doctor can test for some hormonal issues.
Fluctuations in hormone levels can cause:
* unexplained weight gain
* severe acne
* cold feet and hands
* reduced sex drive or loss of sexual desire
* nipple discharge
* facial hair in females
* thinning hair on the top of the head

Underlying medical conditions
Other contributing factors that may affect fertility in women include:
* damage to the fallopian tubes or ovaries
* premature menopause
* endometriosis
* cancer and cancer treatments

When to see a doctor
Anyone experiencing signs of infertility and who has been trying to conceive for more than a year (or 6 months if older than 35 years of age) may want to speak to a doctor for a thorough diagnosis.
Sometimes there may be simple ways to make lifestyle adjustments to improve fertility, while other underlying causes may require treatment.
Even after an infertility diagnosis, there may still be ways to conceive that people can discuss with their doctor.
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Dr. Afshin Shawn Adhami M.D

Walking may prevent heart failure in senior women

New research examines the effect of walking on two subtypes of heart failure in aging women.

Senior women, walking could do wonders for your hearts.
According to recent estimates, almost 5 million people in the United States have congestive heart failure.
Over half a million cases are diagnosed each year.
Despite its name, "heart failure" does not mean that the heart has stopped working completely, explain the American Heart Association (AHA).
In congestive heart failure, the heart is not pumping blood as well as it should be.

Heart failure occurs in two main ways: either the muscles of the heart weaken, or they become stiff and lose their elasticity.
Although the condition affects people of all ages, it is more prevalent among seniors over the age of 60. The AHA recommend that people at risk avoid smoking, exercise more, and eat heart-healthy foods.
A new study delves deeper into one of these potential strategies for prevention. Researchers from the University of Buffalo in New York set out to investigate how walking affects two heart failure subtypes: reduced ejection fraction heart failure, and preserved ejection fraction heart failure.

Studying walking and heart failure in women
Reduced ejection fraction heart failure occurs when the heart's left side pumps less blood into the body than normal.

Specifically, the normal ejection fraction — which measures how much blood is pumped out of the left ventricle into the body in one heartbeat — is over 55 percent. In reduced ejection heart failure, this rate drops to 40 percent or under.
In preserved ejection fraction heart failure, this rate may be over 50 percent and thus appear to be normal. However, if the heart muscles are too thick or stiff, the initial amount of blood that the ventricles can hold may already be too small for what the body needs.
As LaMonte and team explain, the first form of heart failure has a poorer outlook, whereas the second form is more common in seniors and tends to affect women and ethnic minorities in particular.
The researchers examined the link between physical activity levels as reported by 137,303 people who registered in the Women's Health Initiative, a long-term study of postmenopausal women.
Then, the scientists zoomed in on a subgroup of 35,272 women who lived with either one of the two subtypes of heart failure.

Why walking is 'particularly important'
For each additional 30–45 minutes of daily physical activity, the risk of developing heart failure was reduced by 9 percent for heart failure in general, by 8 percent for preserved ejection fraction heart failure, and by 10 percent for reduced ejection fraction heart failure.
Crucially, while walking and physical activity correlated inversely with heart failure risk, the intensity of the physical activity did not have any effect; this suggests that the amount of activity is what matters.

The finding that walking showed a protective association with heart failure and its subtypes is particularly important in a public health context. This is especially relevant given that walking is by far the most commonly reported physical activity in older adults.

This is the first study to report physical activity levels are related to a lower risk of developing heart failure with reduced ejection fraction in older adults, particularly in women.This is pretty important from a public health standpoint, given the poor prognosis this type of heart failure has once it's present.
Because heart failure is much more common after age 60 and because its treatment is very challenging and costly, the possibility of preventing its development by promoting increased physical activity levels, and specifically walking, in later life could have an important impact on the overall burden of this disease in an aging society.
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Dr. Afshin Shawn Adhami M.D

Top 5 natural antihistamines for allergies

People with allergies may find relief by using natural plant extracts and foods that act as antihistamines.

Antihistamines are substances that block histamine activity in the body. Histamine is a protein that triggers allergy symptoms, such as sneezing, itchy eyes, and a scratchy throat.

Over-the-counter and prescription antihistamine medications are effective for symptom relief, but they can cause side effects, such as drowsiness and nausea. As a result, some people wish to try natural alternatives.

In this article, we describe the five best natural antihistamines, and we take a look at the science behind them.

1. Vitamin C

There are a number of natural antihistamines that may help relieve allergy symptoms.Vitamin C boosts the immune system. It also acts as a natural antihistamine.
According to a 2018 study on vitamin C in the treatment of allergies, oxidative stress plays a key role in allergic diseases. As vitamin C is a powerful antioxidant and anti-inflammatory, it may act as a treatment for allergies.
The researchers observed that high doses of intravenous vitamin C reduced allergy symptoms. They also reported that a deficiency in vitamin C might lead to allergy-related diseases.Another study from 2000 suggests taking 2 grams (g) of vitamin C daily to act as an antihistamine.
The vitamin is present in many fruits and vegetables, including:

bell peppers
cantaloupe melon
citrus fruits
tomatoes and tomato juice
winter squash
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Dr. Afshin Shawn Adhami M.D

Why is important to read a nutrition label

In the U.S., all packaged food and drink products display a Nutrition Facts label. Knowing how to read this label can help people determine the potential impact food or drink may have on their blood glucose levels.
There is often a multitude of information on a Nutrition Facts label, but the three most important numbers are:
* serving size
* total carbohydrates
* calories

We discuss each of these below.
Directly below the Nutrition Facts box, food packaging usually features an ingredients list. If a food product contains any artificial sweeteners or other sugar substitutes, the manufacturer will include them in this list.

Serving size
The first figure to look at on a Nutrition Facts label is the serving size. Manufacturers base all other information on one serving of the food.
For example, a box of crackers may list 10 crackers as one serving. So, if someone eats 20 crackers, they will be consuming twice the calories and carbohydrates stated on the box.
Manufacturers base the serving size on common household measures that are appropriate to the food, such as:
* cups
* tablespoons
* pieces
* slices
* jars

The label will also always include the serving size in grams (g) and the number of servings per container.

On a Nutrition Facts label, the calories figure refers to the total number of calories in one serving. These calories come from all sources, including fat, carbohydrate, protein, and alcohol.
Knowing the total calories consumed each day can be important for people wanting to lose weight or maintain a healthy weight. To lose weight, people need to eat fewer calories than they burn by physical activity and metabolic processes.
Anyone who wishes to lose weight should speak to a doctor or dietician for advice on a diet plan.

Total carbohydrates
The figure for total carbohydrates states the amount of carbohydrate in grams in one serving. This number includes sugar, complex carbohydrate, and fiber.
For people with diabetes, it is critical to consider the total amount of carbohydrate and not just sugar. All types of carbohydrate can affect blood glucose levels.
Some foods may contain little or no sugar but a lot of carbohydrate. By looking at just the amount of sugar on a label, a person may end up underestimating the food's potential impact on their blood glucose.
Food manufacturers will sometimes also use terms such as "net carbs," "impact carbohydrate," or "digestible carbohydrate" on their packaging.
The FDA and the American Diabetes Association do not recognize these terms because they can be misleading about the total carbohydrates in a product.
Manufacturers often calculate these figures by subtracting the quantity of sugar alcohol and fiber from the total carbohydrate. But this method can give the impression that the product has less carbohydrate than it does.
People with diabetes should always look at the total carbohydrate amount when determining whether or not to eat a particular food.
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10 Early signs that you should take a pregnancy test
Many of the early signs of pregnancy can be nonspecific and easily mistaken for other causes. For this reason, it may be difficult to know when or whether to take a pregnancy test.
In this article, we list 10 early signs that can indicate a person should take a pregnancy test.
1. Missed period
The most common reason to take a pregnancy test is a missed period.While there are many reasons why people may miss periods, if a person is sexually active, it may be due to pregnancy.Most pregnancy tests are very accurate when taken after a missed period, but sometimes the hormone levels might not be high enough to trigger a positive result.If a person misses a period and has a negative pregnancy test, they should repeat it after a few days.
2. Breast changes
Sore and swollen breasts are very common in early pregnancy, but they often occur just before a period, as well.Some people also notice that their nipples become larger or slightly darker in early pregnancy.
3. Light bleeding
Some people experience implantation bleeding, which is light bleeding that happens when the embryo attaches to the uterine wall. Implantation bleeding tends to be lighter and shorter than that of a menstrual period.
4. Cramps
Cramps are common just before or during a menstrual period, but some people also get cramps when implantation occurs. A person who experiences cramps around or before their period but does not start bleeding, or has a much lighter period than usual, may want to take a pregnancy test.
5. Nausea and vomiting
Morning sickness, or nausea and vomiting associated with pregnancy, tends to start between the 2nd and 8th week of pregnancy occurring.Nausea does not just happen in the morning — many women feel nauseated all day or into the evening.Feeling nauseated for no apparent reason, especially when combined with other symptoms, may be a sign that a person should take a pregnancy test.
6. Fatigue
Fatigue is a common symptom of early pregnancy if there are no other likely causes, such as stress or lack of sleep. It may be difficult for a person to make it through the day without a nap or the opportunity to rest.
Fatigue during early pregnancy is usually due to changes in the hormone progesterone.
The fatigue usually eases, and pregnant women may find they have more energy starting in the second trimester.
7. Food aversions or cravings
Unusual cravings and food aversions are common in the first trimester, though they sometimes persist through the entire pregnancy.Some people crave non-food items, such as dirt or ice. It is best to see a doctor if experiencing cravings for things that are not food.
8. Changes in bathroom habits
Gastrointestinal symptoms common in early pregnancy include:
Many people also experience frequent urges to urinate and notice increased amounts of urine.
9. Feeling different
Many people report feeling "different" and having an awareness that they are pregnant before taking the test.
Physiological and hormonal changes during pregnancy may cause this "gut feeling".
If a person has a feeling that they might be pregnant, they should take a pregnancy test for confirmation.
10. Missed contraception
People should consider taking a pregnancy test if they are sexually active and have had a birth control mishap within the last month.
While most birth control options are effective in preventing pregnancy, a broken condom or missed birth control pill can increase the risk of conception.
When to see a doctor
People should see a doctor if they get a positive pregnancy test. The doctor can confirm the results of a home pregnancy test with a blood test or schedule an early ultrasound.
If a person is pregnant, it is also vital to start prenatal care or discuss other options as early into the pregnancy as possible.
It is also best to speak to a doctor if a person misses a period, but they are not pregnant. The doctor can help diagnose a possible underlying cause
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Dr. Afshin Shawn Adhami M.D
Chicken allergies
People with a chicken allergy may have an allergic reaction after eating chicken meat, or, sometimes, after their skin comes into contact with chicken feathers.
While fish and seafood are often the primary sources of food allergies, allergies to other types of meat are less common.
Most people with an allergy to chicken will notice mild symptoms and discomfort after eating or touching it. However, some people may develop severe reactions that require medical attention.
Chicken allergies and intolerances
People can have an allergy or intolerance to chicken meat or other chicken products, including feathers or eggs.
An allergy usually involves more generalized symptoms, such as swelling and rashes, while an intolerance involves digestive issues, such as diarrhea.
Another uncommon condition, known as bird-egg syndrome, occurs when a person eats undercooked or raw egg yolks or inhales feathers or particles from a chicken.
Are chicken allergies common?
Allergic reactions to chicken meat are rare. They can affect both adults and children. They are most often seen in adolescents, though may begin around preschool age.An allergy to chicken meat may occur as a primary allergy (a true allergy), or as a secondary allergy caused by cross-reactivity with another allergy, such as an allergy to eggs, though this is rare.
Symptoms of a chicken allergy
A chicken allergy can cause symptoms that range in severity. Since it is a rare condition, it is difficult to say what the most common reactions are.
However, people with chicken meat allergies or intolerance may experience the following symptoms after eating or coming into contact with chicken meat:
* coughing or wheezing
* red, irritated skin
* hives
* an inflamed or swollen throat
* swollen tongue or lips
* sneezing
* nausea or vomiting
* stomach cramps
* diarrhea
* a sore throat
* swollen, watery eyes
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Home remedies to clean your ears
How to clean your ears Methods to avoid Symptoms of earwax blockage? When to See a doctor? Takeaway tips
Earwax is how the body lubricates and protects the ear. People do not usually need to clean out their ears, but sometimes earwax and other debris can build up.
Earwax, or cerumen, leaves the body slowly. Chewing and moving the jaw pushes the earwax from the canal to the outer ear. When the earwax and dead skin it collects reaches the outer ear, it dries up and flakes off.
According to the American Academy of Otolaryngology–Head and Neck Surgery (AAO–HNS), earwax has natural antibacterial properties that may help protect the ear from infections.
Cleaning the ear too often can lead to dry, itchy ears. Using an object, such as a cotton swab, for cleaning the earwax may actually push it back into the ear. Cleaning out earwax that is not causing any symptoms is not usually needed or recommended.
Still, there are times when a person may need to clean their ears if wax or debris has built up to the point that it causes symptoms, such as muffled hearing. In this article, learn how to clean your ears at home.
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Dr. Afshin Shawn Adhami M.D
Poor sleep slows wound healing for type 2 Diabetes patients
Researchers uncovered a connection between poor sleep and wound healing in type 2 diabetes that could pave the way for new treatments.
Diabetes is one of the leading causes of death in the United States.
Type 2 diabetes is the most common form of diabetes, and it impacts the ability of the body to produce insulin, the hormone that regulates blood sugar levels.
One serious complication of diabetes are ulcers that can form from wounds. Feet are one of the most common places of injury. Small wounds that develop on feet can eventually become ulcers.
According to the American Podiatric Medical Association, 14–24 percent of people with diabetes who develop an ulcer end up having a lower limb amputation.
Diabetes in numbers
People with diabetes have medical expenditures approximately two times higher than people who do not have the disease. These numbers highlight the economic weight that diabetes has on society.
Prediabetes is a health condition in which blood sugar levels rise, but the level is not high enough to be diagnosed as type 2 diabetes.
More than 80 million U.S. adults have prediabetes, and the majority of these people are not aware of it because symptoms may not show for years. Prediabetes can lead to type 2 diabetes, heart disease, and stroke.
Poor sleep and wound healing
A new study, published recently in the journal SLEEP, studied the impact of sleep fragmentation on wound healing. The scientists compared obese mice with features of type 2 diabetes with normal-weight mice without type 2 diabetes.
The interrupted sleep pattern caused a significant delay in wound healing in rodents with diabetes. The animals that slept poorly needed around 13 days to reach 50 percent healing, compared with the group without interrupted sleep, which needed around 10 days.
Normal-weight mice achieved 50 percent of wound healing in less than 1 week and complete healing in just 2 weeks.
Researchers observed that type 2 diabetes might lead to poor blood circulation and nerve damage. Because of these complications, the body is more likely to become infected.
Sleep quality affects the immune system and weakens the healing process, so it's easy to see the connection between sleep and wound healing. Studies have shown that sleep is crucial for the immune response.
A lack of sleep can weaken the immune reaction, exposing the body to infection; for instance, shorter sleep durations are linked to a higher risk of developing the common cold.
"This is a public health issue, and we want to contribute to a solution”
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