Tuesday, January 30, 2007

Study: Most diabetics don't exercise


DENVER - Bad news when it comes to diabetics and exercise: Most people with Type 2 diabetes or at risk for it apparently ignore their doctors' advice to be active.

Fewer than 40 percent get exercise, a new study found, and the more in danger the patients are, the less likely they are to be active.

That's despite an earlier study that found nearly three-quarters of diabetics said their doctors had advised them to exercise. The patients who got the strongest warnings to get moving were the least likely to listen, according to research being released Friday.

"People should exercise more, that story is out," said Dr. Elaine Morrato, who led both studies.

"What we're saying is, 'Here's a high-risk population that can benefit from exercise, and they're even less likely to exercise.'"

Without exercise, Type 2 diabetics face complications ranging from nerve damage to high blood pressure.

Morrato, an assistant professor at the University of Colorado Denver with a doctorate in public health and epidemiology, said researchers surveyed more than 22,000 patients for the new survey. Results of the study appear in the February edition of the American Diabetes Association's journal Diabetes Care.

The federal Centers for Disease Control and Prevention estimates more than 20 million Americans have diabetes, about 90 percent of them Type 2, which is linked with obesity.

Dr. Larry Deeb, president of medicine and science at the American Diabetes Association, said by the time patients have Type 2 diabetes or are at risk of getting it, the deck is stacked against them. They may already have problems with mobility as a result of obesity or foot and circulatory disorders that make exercise difficult.

"We have to be careful not to blame the victims," he said. "There's a difference between being unable and being unwilling."

Even for the most disabled, there's hope, said author and fitness expert Charlotte Hayes, but health professionals must do more.

Hayes, who wrote "The I Hate to Exercise Book For People With Diabetes," said telling patients to exercise is different from telling them how.

Every step of exercise is important, she said. For those who can walk, a few steps a day helps. For those who can't, there are alternatives.

"We take a small-steps approach," she said.

The American Diabetes Association recommends people get at least 30 minutes of aerobic exercise, such as brisk walking, five times a week. But the association says for those who can't, there are benefits from even five minutes a day, along with everyday activities such as gardening or walking to work.

Morrato said she doesn't know the answer, only that the results of her study are disappointing.
"It is difficult to be optimistic about addressing the twin epidemics of obesity and diabetes without success in increasing physical activity in the population," her study concludes. "The results of this study provide very pessimistic data."

Deeb, who specializes in pediatrics, said the next generation is off to a better start. Children, he said, are taught nutrition and the benefits of physical activity. Now, families, local governments and school boards need to take action, while doctors need to follow up and find out if at-risk patients know where to get help.

"When you ask a family what they're doing, the answer is all about time. They know what's good for their families, but both parents are working, and sometimes the only time they have is to pick up fast food," he said. "They have to understand, your health depends on it.
"We will not give up," he said. "We can't give up."


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Friday, January 26, 2007

Weight loss improves heart function in obese

NEW YORK (Reuters Health) - A new study shows that people who are obese can reverse some early heart and blood vessel dysfunction by adopting a healthy lifestyle and losing weight. But exercise alone, without weight loss, does not appear to be enough to improve cardiovascular function.

Dr. Chiew Y. Wong of the University of Queensland in Australia and colleagues had 106 obese men and women with no cardiovascular disease complete an eight-week lifestyle intervention program. Sixty-two cut their calorie and fat intake and exercised, while 44 exercised but did not change their diet.

Forty-eight of the study participants lost an average of 4.5 percent of their body weight, while the remaining 58 kept their weight stable or gained weight.

Among those who lost weight, the researchers noted improvements in their arteries' response to changes in blood pressure, as well as a 15 percent improvement in peak VO2, a measure of how well the body uses oxygen during exercise.

The more weight people lost, the greater their improvements in blood vessel function and fitness. People who lost weight also showed some improvement in their left ventricular function.

While the men and women who didn't lose weight did show improvements in peak oxygen uptake -- a measure of how well the body uses oxygen -- no significant changes were seen in their heart or blood vessel function.

This study "supports the argument that increasing cardiorespiratory fitness alone is not sufficient to produce the same cardiovascular benefits," the researchers conclude.

SOURCE: American Journal of Cardiology, December 15, 2006.

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Thursday, January 25, 2007

Obesity cost more than EUR 260 million last year in Finland

In addition to being a major health issue for thoudands of individual Finns, obesity has considerable economic implications for the whole nation and brings costs of 260 million every year.
With some individuals, the public health system is willing to spend as much as EUR 400 for every kilo of weight that they shed.
This is the average cost incurred by the Social Insurance Institution (KELA) when it pays for rehabilitation courses for obese Finns with high blood pressure or other diseases requiring weigh loss.

KELA calculates that the courses lead to an average weight loss of four kilos for the individual, which can be enough to prevent the outbreak of adult-onset diabetes.
"The price might seem high", says Paula Hakala, head researcher at KELA, "but the costs of rehabilitation cannot be considered high, if the person is thus spared diabetes and the complications linked with it." The rehabilitation makes economic sense, even if it merely delays the onset of a disease by a few years.

The annual EUR 800,000 that is spent on rehabilitation of the overweight is only a fraction of the costs imposed on the whole Finnish economy by obesity.
Research professor Markku Pekurinen of the National Research and Development Centre for Welfare and Health (STAKES) calculates that obesity cost the Finnish economy more than EUR 260 million last year in health care and social spending.
The costs of obesity exceed even those caused by smoking.
Pekurinen calculates that 1,200 hospital beds - the equivalent of a relatively large central hospital - are required for the treatment of illnesses linked with excess weight. Obesity is also the cause of 340,000 days of absenteeism from work.
In health care, EUR 188 million was spent on the treatment of obesity - a total of 1.7 per cent of all spending. In the same year EUR 75 million was spent on sick leave and disability pension benefits for diseases linked with obesity, which is about 1.8 per cent of total costs of social benefits.

Fortunately, the percentages are not very high. However, the amount of excess body fat, and diseases linked with it, are constantly increasing, which means that the costs are also likely to rise.
Attempts have been made to keep the costs in check by changing treatment methods. The number of patients hospitalised for diseases caused by obesity declined by 30 per cent from 1997 to 2004. Increasing numbers of those suffering from obesity are treated as outpatients.

Adult-onset diabetes is the most obvious risk factor for the overweight. The frequency of the disease has risen especially with working-aged men. About 65 per cent of cases of adult diabetes are believed to be linked with obesity. Excess body weight is believed to be a factor in one in four strokes and cases of high blood pressure. It is believed to play a role in 12 per cent of injuries to joints.
In 2004 Finnish hospitals treated nearly 5,000 cases of diabetes attributed to obesity. Visits to hospital outpatient clinics in that same year exceeded 15,000.
A year later KELA paid compensation to 110,000 Finns for medicines used for the treatment of diabetes caused by obesity. The number of people receiving the benefit increased by more than 6,000 in a single year.
About one third of health care costs linked with obesity were for the treatment of diabetes.

Calculation of the costs of obesity involves the use of many assumptions.
Pekurinen’s study classifies as obese those people whose body mass index exceeds 28. The index is calculated by dividing a person's weight in kilos by the square of his or her hight in metres.
People of normal weight have a body mass index between 18.5 and 26. Illnesses increase considerably when the index rises over 30.
In Finland, the index for those in the 45-64 age group exceeds 27. With one third of the age group the index is 30 or more.
Pekurinen says that cautious assumptions are used in calculating the costs of obesity, because the results are used as a basis for decision-making in health care, and it is important that the studies not raise unfounded expectations on the impact of different actions.
Professor Aila Rissanen, who studies diseases linked with obesity, feels that the costs of obesity have been clearly underestimated in the calculations.

In addition to direct costs incurred by health care and social services, obesity imposes "productivity costs" on society, in the form of work that is left undone when a person falls ill or dies prematurely.
In addition to a higher rate of absenteeism, an obese person is often less productive when he or she is at work.
"Sleep disorders have a clear correlation with obesity. They affect alertness during the day, and have a clear impact on productivity", Rissanen says. "Most people feel that they are more alert and function better when they have lost weight, or if they exercise more, or both."

There has been no attempt to calculate the total costs of obesity to the national economy in Finland.
Based on foreign assessments, Markku Pekurinen says that the total costs in absenteeism and disability could be many times higher than those incurred by health care.

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Wednesday, January 17, 2007

HMO fitness program may lower health care costs

By Charnicia Huggins

NEW YORK (Reuters Health) - Offering seniors with diabetes the opportunity to participate in a subsidized community-based exercise program may help lower health care costs, if the seniors attend the fitness classes regularly, preliminary study findings suggest.

"These findings warrant additional investigations to determine whether policies to offer and promote a community-based physical activity benefit in older adults with diabetes can reduce health care costs," conclude Dr. Huong Q. Nguyen, of the University of Washington, in Seattle, Washington, and colleagues.

According to previous research, nearly one in five Medicare recipients have diabetes, and diabetes-related health care costs account for about a third of total Medicare expenditures.

The benefits of exercise, particularly important for diabetics, who are at risk of having more functional disability, include reduced health care costs and better physical functioning. Yet, few seniors report participating in regular, moderate-intensity physical activity.

Observational data suggest that health care costs can be greatly reduced among a previously sedentary older adult who engages in moderate physical activity three days a week or more. Nguyen and colleagues investigated whether a physical exercise program offered to seniors as part of their Medicare benefit would also reduce health care costs and utilization.

They analyzed data from an HMO, focusing on 163 seniors, aged 75 years on average, with diabetes who participated in a community-based fitness program that was fully subsidized by the HMO. For comparison, the study also included 364 adults who did not participate in the fitness program.

At follow-up, 12 months later, the researchers found that total health care costs did not differ among the two groups of seniors. However, health care costs among seniors who attended more than the average number of fitness classes per week -- about one -- were roughly 41 percent less than among seniors who attended fewer exercise sessions and among seniors in the comparison group, respectively, Nguyen and colleagues report in Diabetes Care.

"We can not be sure if the exercise actually reduced health care costs or if people who were healthier were able to participate in more exercise classes and therefore had lower health care costs," Nguyen told Reuters Health.

Still, Nguyen added, "in general, any amount of physical activity is beneficial for everyone and it is even more so for people with diabetes and other chronic conditions, regardless of effects on health care costs."

SOURCE: Diabetes Care, January 2007.

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Tuesday, January 16, 2007


TUCSON, Ariz. Jan. 16, 2007 — The largest ALS drug discovery project in
history was launched today as a joint venture by the Muscular Dystrophy
Association (MDA), through its Augie's Quest initiative, and the ALS Therapy
Development Institute.

The three-year, $36 million project will attempt to identify
biochemical targets and find drugs that work on them in ALS (amyotrophic
lateral sclerosis, or Lou Gehrig's disease).

The collaboration will be funded by MDA's Augie's Quest, a
fast-track ALS research program, and by the Institute (formerly the ALS
Therapy Development Foundation). MDA, through Augie's Quest, will grant at
least $6 million a year for the next three years; the Institute will add its
$6 million annual budget to the project. MDA's funding for this
collaboration is above and beyond its existing ALS research expenditures.

"This project represents a declaration of war on ALS, and this
is a war we intend to win by building the best scientific and technologic
army in the world," said Augie Nieto, co-chairman with his wife, Lynne, of
MDA's ALS Division. "Amazing things can happen when you combine the drive to
succeed with money and technology."

Research will take place at the Institute's 16,000-square-foot
lab in Cambridge, Mass. James Heywood, who started the organization in 1999
after his brother

Stephen received an ALS diagnosis, said, "This collaboration
allows for a massive application of cutting-edge technology, combined with
proven drug development techniques. There's no doubt in my mind that
ultimately we're going to be successful."

Stephen Heywood died in November when the ventilator that
allowed him to breathe malfunctioned while he slept.

ALS is a progressive neurological disease that affects the
nerves that send signals to the muscles. It causes paralysis of all
voluntary muscles and ultimately death, usually within three to five years.
The cause is unknown.

"The causes of ALS have been a tragic mystery for too long,"
said MDA National Chairman Jerry Lewis, noting that Lou Gehrig's widow,
Eleanor, held a voluntary leadership position with MDA for many years. "This
project is a giant step toward a solution to that mystery and a cure for

Augie Nieto has been named chairman of the board for the ALS
Therapy Development Institute and Steve Perrin, formerly an executive at the
biotechnology company Biogen Idec, will be its chief scientific officer.
Former Institute vice president of drug discovery Sean Scott will serve as
its president.

About Augie's Quest

Fitness pioneer Augie Nieto started Augie's Quest (www.augiesquest.org) in
conjunction with MDA's ALS Division after his ALS diagnosis in March 2005.
Nieto is co-founder and former president of Life Fitness, and chairman of
Octane Fitness.

About MDA

MDA (www.mda.org) is the world's largest provider of ALS services and funder
of ALS research. Over the years, it has expended almost $200 million in this
effort. It operates 225 neuromuscular disease clinics across the country and
37 ALS-specific research and care centers.

About the ALS Therapy Development Institute

The ALS Therapy Development Institute (www.als.net) is a nonprofit
biotechnology company dedicated to translating research into potential drug
treatments by testing drugs in the SOD1 mouse model of ALS. Since its
inception in 1999, the Institute has become a leader in ALS transgenic mouse
studies, providing a new level of understanding of ALS, as well as related
disorders like Alzheimer's, Parkinson's and Huntington's diseases.

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Monday, January 15, 2007

Early Start Impacts Adolescent Physical Activity Habits

Champaign, IL (PRWeb) January 8, 2007 -- Participation in sports and other forms of vigorous physical activity early in life are important to the maintenance of girls' physical activity during adolescence, according to new research in the Journal of Physical Activity and Health (JPAH).

Researchers from the Arnold School of Public Health at the University of South Carolina at Columbia found that vigorous activity declined from 45.4 percent in eighth grade girls to 34.1 percent in twelfth grade girls. Specifically, decreases in running, bicycling, basketball, soccer, softball and dancing participation were linked to the overall decline in physical activity between the two age groups.

The study is the first to link overall physical activity to specific team sports and individual activities. Researchers also found that motorized transportation tended to replace physically active transportation.

"These findings indicate the importance of early exposure to sports and other forms of physical activity," states Russell Pate, PhD, lead researcher in the study. "Early exposure to sports and other physical activities can increase the likelihood that young people will engage in those activities over time."

Pate points to physical education in schools as a key resource for improving youth activity habits. "Physical education classes offer opportunities for adolescent girls to try new sports and activities, learn activity skills and enjoy physical activity in a safe and controlled environment," he adds. "Our schools can teach girls skills for being active in early adolescence, increasing the likelihood that they will continue to participate in physical activity in late adolescence and into young adulthood."

The new study, which was funded by a grant from the
National Institutes of Health, is published in the January issue of the JPAH, available online today. The JPAH is an interdisciplinary journal published for researchers in fields of chronic disease where physical activity may play a role in prevention, treatment, or rehabilitation. To view more information about the journal, visit www.HumanKinetics.com/JPAH.

Russell R. Pate, PhD, is a professor in the department of exercise science in the Arnold School of Public Health at the University of South Carolina at Columbia. Dr. Pate has 30 years of experience in researching physical activity. In that time he has received 15 years of NIH funding for research in physical activity interventions. He is a member of the FITNESSGRAM® Scientific Advisory Board and has served on the Institute of Medicine's panel for Preventing Childhood Obesity as well as the U.S. Dietary Guidelines Committee. Dr. Pate is a lifelong distance runner with a personal best time of 2:15:20 in the marathon.

For additional resources at http://www.humankinetics.com, enter keywords:
* Active Start for Healthy Kids
* Fitness for Life
* Physical Best
* PE4life

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Friday, January 12, 2007

10 tips to cut cancer risk

By Dr. Sanjay Gupta
Chief Medical Correspondent

The American Cancer Society estimates that more than 560,000 Americans died from cancer-related causes in 2006. Some cancers are preventable, and people can cut their risk by maintaining some positive health steps.

Here are my top 10 tips for avoiding cancer:

1, 2 and 3) Do NOT smoke. If you're one of the more than 40 million American smokers, you need to stop. Smoking is linked to at least three in 10 cancer deaths, according to the American Cancer Society. That's more than 165,000 deaths a year.

4) Stay active. Inactivity and obesity are linked to cancer. Half an hour of exercise a day will significantly help your odds.

5) Eat plenty of fruits and vegetables. The American Cancer Society recommends at least five servings each day. In general, the most colorful fruits and vegetables have the most nutrients.

6) Limit the amount of red meat and processed meats in your diet, and make sure the meat you do eat is lean.

7) Avoid deep-fat frying. Instead, use low-fat cooking methods like roasting, baking, broiling, steaming or poaching. Also, choose low-fat or non-fat milk and yogurt.

8) Limit your alcohol consumption or avoid alcohol altogether.

9) Protect yourself in the sun. Wear sunscreen to limit your exposure to damaging ultraviolet rays.

10) Girls should get the HPV vaccine before they are sexually active to help prevent cervical cancer.

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Thursday, January 11, 2007

Obesity operations jump in United States

WASHINGTON (Reuters) - More than 120,000 obese Americans had some kind of surgery to help them lose weight in 2004, with the biggest increase among middle-aged people, according to a study released on Wednesday.

In 1998, 772 people aged 55 to 64 had gastric bypass, stapling or some similar procedure known as bariatric surgery to help weight loss. But that number ballooned to 15,086 in 2004, according to the Agency for Healthcare Research and Quality.

"Among the reasons for the extremely dramatic increases is that the mortality outcomes from obesity surgery have improved greatly," the agency said in a statement.

"The national death rate for patients hospitalized for bariatric surgery declined 78 percent, from 0.9 percent in 1998 to 0.2 percent in 2004."

Agency director Dr. Carolyn Clancy said the report shows "more Americans are turning to obesity surgery and that an increasing number of younger people are undergoing these procedures."

More than 103,000 of the 2004 operations were on patients aged 18 to 54, the study found, and 349 were performed on youngsters aged 12 to 17.

"As the rate of obesity continues to climb, the health care system needs to be prepared for continued escalation in the rate of this surgery and its potential complications," she said.

The average hospital cost for an obesity surgery patient stay, excluding physician fees, was $10,395 in 2004 as compared with $10,970 in 1998, adjusted for inflation, according to the report, published online at http://www.hcup-us.ahrq.gov/reports/statbriefs/sb23.pdf.

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Monday, January 08, 2007

Girls Most Likely to Gain Weight as Pre-Teens

Report urges interventions before the age of 9 or 10

MONDAY, Jan. 8 (HealthDay News) -- Girls are most likely to gain weight early in adolescence, between the ages of 9 and 12, a new report finds.

And the health consequences of being overweight can be evident in girls as young as 9, all of which points to the need to tailor prevention efforts to ever younger ages.

"We really need to get to kids before age 9 and 10, and this really puts the pressure on elementary school, preschool and whatever societal institutions we have to really focus on young ages," said study co-author Eva Obarzanek, a research nutritionist at the U.S. National Heart, Lung, and Blood Institute.

The study is published in the January issue of the Journal of Pediatrics.

"This shows that obesity and other risk factors for heart disease track from younger to older. This is a wake-up call for policymakers, for schools, for parents," said Arlene Spark, associate professor of nutrition at Hunter College, in New York City. "The success rate for treatment is practically zero. The only thing that we can really hope for is that we can prevent children from becoming overweight and obese."

Dr. Bonita H. Franklin, a clinical assistant professor of pediatrics at New York University School of Medicine, added: "Heart disease is the major cause of mortality in adults in the U.S. This is implying that these factors which are known to make heart disease more likely in adults are already present in young children, so you would presume that there would be an increased health burden and probably shorter life span for this next generation."

The childhood obesity epidemic in the United States continues to worsen. Between 1976 and 1980, 4 percent to 6 percent of children were overweight. By 1999-2002, that number had climbed to 16 percent.

Being overweight, even as a child, increases the likelihood of having risk factors for cardiovascular disease, including higher blood pressure as well as elevated cholesterol, triglyceride and fasting insulin levels.

For this study, more than 2,300 girls aged 9 and 10 were enrolled and followed for at least a decade. Researchers measured their height, weight, blood pressure and cholesterol every year through age 18, then had the teens report their own measures at ages 21 through 23. Roughly half of the girls were white and half were black.

Longitudinal studies, which follow the same individuals for a period of time, are unusual in science because they are so expensive, but yield very valuable data.

"That it's longitudinal is excellent," Spark said.

Rates of overweight among the participants increased through adolescence, from 7 percent to 10 percent in the white girls and 17 percent to 24 percent in the black girls. Girls were 1.6 times more likely to become overweight when they were aged 9 through 12 than later in adolescence. And girls who were overweight during childhood were 11 to 30 times more likely to be obese as young adults.

Being overweight also made girls more likely to have elevated blood pressure and cholesterol levels compared to girls of normal weight.

"We put a biological value to the definition that we use for overweight for children," Obarzanek said. "We attach a health consequence to that cut-off point. In these days of evidence-based medicine, this really is strong evidence."

There were also racial differences, with black girls 1.5 times more likely to become overweight at any given age than white girls. Between ages 9 and 18, the prevalence of overweight was higher among black girls (rising from 17 percent to 24 percent) compared with white girls (rising from 7 percent to 10 percent).

Prevention efforts need to focus both on younger ages and take into account cultural differences, the authors stated.

"This is concerning, but I wouldn't say that it's hopeless," Franklin said. "Efforts to work with preteens would be very important. The younger, the better."

More information

Visit the National Heart, Lung, and Blood Institute's We Can! program for ways to enhance children's activity and nutrition.

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Wednesday, January 03, 2007

Most Americans Want Public Policies to Prevent Obesity

By Steven Reinberg

THURSDAY, Dec. 28 (HealthDay News) -- A large majority of Americans say they
support changes in public policy to stem the rising tide of obesity among
adults, a new survey shows.

"There is a lot of support for employer and health policies aimed at
preventing obesity," said lead researcher Bernard Fuemmeler, an assistant
professor in the department of community and family medicine at Duke
University Medical Center, in Durham, N.C.

"This study provides tangible evidence that people support wide-scale policy
changes that can affect obesity in the U.S.," Fuemmeler added.

The findings appear in the January issue of the American Journal of
Preventive Medicine.

Approximately 60 million American adults are obese, according to the U.S.
Centers for Disease Control and Prevention. In 1998, Americans spent about 9
percent of all medical expenses on problems linked to being overweight or
obese, the
CDC reports.

The new telephone survey of 1,139 adults found that 85 percent supported tax
breaks for employers who made exercise space available to employees.

In addition, 73 percent said they'd support government incentives for
companies that reduced the cost of health insurance for employees who had
healthy lifestyles and shed extra pounds. Seventy-two percent said they
would support government policies requiring insurance companies to cover
obesity treatment and prevention programs.

"There is growing public advocacy for these kinds of policy changes,"
Fuemmeler said. "There is also advocacy in the research community for
large-scale policy changes. With some push, we might be able to get some
changes that would help us better address the obesity epidemic in the

But one expert said it will take more than policy changes to get Americans
to eat better and exercise more.

"The problem is not necessarily that employers need tax incentives," said
Kathryn M. Kolasa, a professor in the department of nutrition services and
patient education at East Carolina University. "The employer can expect to
realize health-care cost savings and can be motivated by that."

However, "It's not clear what will motivate the employees," Kolasa said.

One problem is misinformation about weight loss. "Most individuals that
present for nutrition counseling have significant amounts of misinformation
about food and beverages that prevent them from being successful in weight
loss or weight management," Kolasa said.

"Also, people continue to say that it costs more money to eat healthy, when
it has been demonstrated time and again you can eat healthy at no greater
cost," Kolasa added.

She does believe that changes in policy might make it easier for people to
take advantage of health-promotion programs.

"Just because an insurance company provides a wellness benefit doesn't mean
people will use it," Kolasa said. "I have one patient who was excited to
receive the wellness benefit -- six visits with a certified dietitian during
the year. Her employer let her take time from work for the first visit, but
said subsequent visits would have to be on her time. This same employer
allows employees to take time for doctor visits without penalty," she said.

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