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It indicates that the patient is getting ready for the stimulation and may also occur regardless of a point being stimulated womens health yeast infections discount 10mg female cialis fast delivery, whether with a metal or a laser needle (· chapter 1 pregnancy weight calculator cheap female cialis online visa. In this method the ear areas are "scanned" with the laser pregnancy genetic testing order female cialis 20 mg without prescription, and the resonance points "signal" their location by altering the pulse wave womens health jacksonville purchase female cialis 20 mg online. The ear is a microsystem where all organs and functions of the body are reflected. This method is not only used on the ear to distinguish the points that are relevant for the therapy from the mute points for the purpose of treating a known disorder pattern. The complete laser ear scan requires some practice, but once mastered, it is unsurpassed as an instrument for diagnostic orientation and the verification of a diagnosis. Some of these frequencies may be used intuitively and are entirely sufficient for many indications. Moreover, they are already programmed into most high-quality laser units and can simply be retrieved. Selection of frequency based on the pathology Frequencies can simply be selected based on the pathology. The sick organ or the painful body region are treated and the proper frequency is set. In the other hand he or she holds the switched-off laser pen, which is directed toward the point to be treated. When using the laser needle system, the optic fibers are stuck on the selected skin points. This procedure is repeated for frequency settings which might be suitable for the treatment. Important general frequencies Antioscillatory frequencies according to Bahr Generally speaking, Bahr frequency 5 can be used with any disease as an antioscillatory frequency, as every pathological process causes oscillation at least regionally. Self Heal frequency according to Bahr the Self Heal frequency according to Bahr, which triggers self-healing, is very helpful and can be employed with any disease pattern. The antioscillatory frequency and the Self Heal frequency according to Bahr may always be used and meet the minimum requirements for frequency-modulated laser therapy. Nogier E for inflammations and nerve irritations Nogier E is recommended for the treatment of inflammatory or neuropathic symptoms. Psychological frequencies Nogier F and G Extended diseases and pain are also emotionally stressful. For this reason the psychological frequencies Nogier F and G are indicated in all chronic cases. Meridian frequencies When the path of a meridian is blocked or disrupted, using the pertinent meridian frequencies is effective. Changing frequencies All diseases develop dynamically and are influenced by an adequate therapy. For this reason the patient may respond differently to a frequency during the follow-up sessions than in the initial treatment. Simultaneous use of several frequencies It is generally recommended that the therapist select a frequency for the treatment which is applied to all points to be treated during the entire session. The laser needle system offers the option to modulate any laser diode with a different frequency. Theoretically, twelve different frequencies can therefore be applied with a twelve-channel system. In our experience it makes sense to limit a therapy concept to one and up to a maximum of three frequencies. The information conveyed in this manner is clear and concise, and leads to better results. Therapeutic failure Actual worsening of symptoms after a treatment is usually attributable to overstimulation (· chapter Recommended doses, p. Using therapy-promoting frequencies may lead to overstimulation faster, as stimuli are enhanced disproportionately due to the resonance phenomenon.

Betablockers are also useful in neonatal thyrotoxicosis and in supraventricular arrhythmias due to hyperthyroidism menopause itching purchase female cialis. Propranolol has been used in conjunction with iodine to prepare mildly thyrotoxic patients for surgery but it is preferable to make the patient euthyroid with carbimazole menstrual migraine icd 9 discount female cialis online master card. Most experience is treating thyrotoxicosis has been gained with propanolol but nadolol is also used breast cancer umbrella female cialis 10 mg overnight delivery. Side effects: pruritus breast cancer 2 day atlanta order female cialis 20 mg fast delivery, skin rashes, non-specific gastrointestinal disturbances, headache, mild arthralgia, urticaria, alopecia, drug-induced agranulocytosis, cholestatic hepatitis with jaundice, blood dyscrasias and "drug-fever" reactions. Dose and Administration: Oral: Adult: Initially 20 - 60 mg daily until there is euthyroidism. Drugs used in Endocrine Disorders and Contraceptives Contraindications: breastfeeding. Side effects: hypersensitivity reactions including Coryza - like symptoms, headache, lacrimation, conjunctivitis, pain in salivary glands, laryngitis, bronchitis, rashes; on prolonged treatment depression, insomnia, impotence; goiter in infants of mothers taking iodides. Propranolol Injection, 1mg/ml in 1ml ampoule Tablet, 10mg, 40mg See notes above and section 2. Side effects: nausea, mild gastrointestinal disturbances headache, rashes and pruritus, arthralgia; rarely alopecia, bone marrow suppression, urticaria, leucopoenia; rarely coetaneous viscosities, thrombocytopenia, aplastic anaemia, hepatitis, lupus erythematous - like syndromes. Side effects: (usually with excessive dose) anginal pain, arrhythmias, palpitations, tachycardia, skeletal muscle cramps, diarrhea, vomiting, tremors, restlessness, excitability, insomnia, headache, flushing, sweating, excessive loss of weight and muscular weakness. Dose and Administration: Hypothyroidism: Oral: Adult: initially 50 - 100micrograms daily (25-50 micrograms for: those over 50 years) before breakfast, increased by 25 - 50 micrograms every 3 - 4 weeks until normal metabolism maintained (usual maintenance dose, 100 ­ 200 micrograms daily); where there is cardiac disease, 8. Drugs used in Endocrine Disorders and Contraceptives 291 initially 25 micrograms daily or 50 micrograms on alternate days, adjusted in steps of 25 micrograms every 4 weeks. Congenital hypothyroidism and juvenile myxoedema: Oral: Child: up to 1 month, initially 5 - 10 micrograms/kg daily, adjusted in steps of 25 micrograms every 2 4 weeks, until mild toxic symptoms appear, then reduce dose slightly. Insulin and oral antidiabetic agents Diabetes mellitus is a disorder of carbohydrate metabolism in which the action of insulin is diminished or absent through altered secretion, decreased insulin activity, or a combination of both factors. Although patients may be controlled on diet alone, many require administration of oral antidiabetic drugs or insulin to maintain satisfactory control. The aim of treatment is to achieve the best possible control of plasma glucose concentration and prevent or minimize complications including microvascular complications (retinopathy, albuminuria, neuropathy). Other risk factors such as smoking, hypertension, obesity and hyperlipidaemia should also be addressed. Drugs used in Endocrine Disorders and Contraceptives Management of diabetes mellitus Insulin: Insulin plays a great role in the regulation of carbohydrate, fat and protein metabolism. Insulin may be of beef or pork origin or it may be human insulin produced by gene technology or by modification of porcine insulin. All insulin preparations are to a greater or lesser extent immunogenic in man but immunological resistance to insulin action is uncommon. Insulin of whatever origin is formulated to provide a range of preparations offering: Short duration which have a relatively rapid onset of action, namely soluble insulin, insulin lispro and insulin aspart. Crystalline insulin Zinc suspension For those who require administration of insulin, appropriate combinations of insulin therapy will have to be worked out for the individual patient. Insulin is inactivated by gastro-intestinal enzymes, and must therefore be given by injection; the subcutaneous route is ideal in most circumstances. It is usually injected in to the upper arms, thighs, buttocks, or abdomen; there may be increased absorption from a limb site if the limb is used in strenuous exercise following the injection. Generally subcutaneous insulin injections cause few problems; fat hypertrophy does however occur but can be minimized by rotating · 8. The various types of insulin may also be given intramuscularly when the onset of action is faster than with the subcutaneous route. An even faster onset may be achieved with intravenous administration, but this route is only suitable for fast-acting or soluble insulin. Hypoglycemia: the most frequent complications of insulin therapy is hypoglycemia and patients taking insulin should be educated about its cause, symptoms, and treatment. Most patients can recognize the early warning signs of hypoglycemia and by taking sugar immediately they can prevent more serious symptoms developing.

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If powder or 10x media are purchased it is essential that the water used to reconstitute the powder or dilute the concentrated liquid is free from mineral menstrual flexible cups buy genuine female cialis on line, organic and microbial contaminants women's health issues mayo clinic cheap 10mg female cialis fast delivery. In most cases water prepared by reverse osmosis and resin cartridge purification with a final resistance of 16-18M is suitable breast cancer history generic female cialis 20 mg without a prescription. Once prepared the pH of the medium should be adjusted appropriately women's health clinic fort campbell purchase female cialis 10mg with visa, and then the media filter sterilised before use. The quality, type and concentration of serum can all affect the growth of cells and it is therefore important to screen batches of serum for their ability to support the growth of cells. In addition, there are other tests that may be used to aid the selection of a batch of serum including cloning efficiency, plating efficiency and the preservation of cell characteristics. Serum is also able to increase the buffering capacity of cultures that can be important for slow growing cells or where the seeding density is low. It also helps to protect against mechanical damage which may occur in stirred cultures or whilst using a cell scraper. A further advantage of serum is the wide range of cell types with which it can be used despite the varying requirements of different cultures in terms of growth factors. However, serum is subject to batch-to-batch variation that makes standardisation of production protocols difficult. These risks can be minimised by obtaining serum from a reputable source since suppliers of large quantities of serum perform a battery of quality control tests and supply a certificate of analysis with the serum. Heat inactivation of serum (incubation at 56°C for 30 minutes) can help to reduce the risk of contamination, since some viruses are inactivated by this process, however this process also denatures some proteins and destroys nutrients in the serum with modern production methods for serum, the routine use of heat inactivated serum is not an absolute requirement for cell culture. The use of serum also has a cost implication not only in terms of medium formulation but also in downstream processing. Similarly the focus is on geographical origin, the age of the animals, the breeding and slaughtering conditions, the tissue to be used and the conditions of its processing. Regulatory requirements in Europe stress the importance of justifying the use of material of bovine, caprine or ovine origin in the production of pharmaceutical products. Serum from a reputable supplier should have undergone various quality control tests which will be listed in the product information sheet. Most serum products are cell culture tested including growth promotion, cloning efficiency and plating efficiency tests. Standard tests performed on serum commonly include tests to determine the presence and/or level of the following: Sterility Virus Contamination Mycoplasma Contamination Endotoxin Haemoglobin Total Protein Immunoglobulin Hormone Testing pH (at room temperature) Osmolality 20 The basic principle of successful cryopreservation and resuscitation is a slow freeze and quick thaw. Although the precise requirement may vary with different cell lines as a general guide cells should be cooled at a rate of ­1°C to ­3°C per minute and thawed quickly by incubation in a 37°C water bath for 3-5 minutes. If this and the additional points given below are followed then most cell lines should be cryopreserved successfully. Cultures should be healthy with a viability of >90% and no signs of microbial contamination. Cultures should be in log phase of growth (this can be achieved by using pre-confluent cultures i. Such ultra-low temperatures can only be attained by specialised electric freezers or more usually by immersion in liquid or vapour phase nitrogen. Method Electric (-135oC) Freezer Liquid Phase Nitrogen Advantages · Ease of Maintenance · Steady temperature · Low running costs · Steady ultra-low (-196oC) temperature · Simplicity and mechanical reliability · No risk of crosscontamination from liquid nitrogen · Low temperatures achieved · Simplicity and reliability Disadvantages · Requires liquid nitrogen back-up · Mechanically complex · Storage temperatures high relative to liquid nitrogen · Requires regular supply of liquid nitrogen · High running costs · Risk of cross-contamination via the liquid nitrogen · Requires regular supply of liquid nitrogen · High running costs · Temperature fluctuations between -135oC and -190oC Vapour Phase Nitrogen Storage in liquid phase nitrogen allows the lowest possible storage temperature to be maintained with absolute consistency, but requires the use of large volumes (depth) of liquid nitrogen which is a potential hazard. There have also been documented cases of cross contamination by virus pathogens via the liquid nitrogen medium. For these reasons ultra-low temperature storage is most commonly in vapour phase nitrogen. For vapour phase nitrogen storage, the ampoules are positioned above a shallow reservoir of liquid nitrogen, the depth of which must be carefully maintained. A vertical temperature gradient will exist through the vapour phase, the extremes of which will depend on the liquid levels maintained, the design of the vessel, and the frequency with which it is opened. Temperature variations in the upper regions of a vapour phase storage vessel can be extreme if regular maintenance is not carried out. Modern designs of liquid nitrogen storage vessels are increasingly offering improved vapour phase storage technology.

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Isoniazid +Ethambutol Tablet women's health issues and physical therapy purchase female cialis 10mg with amex, 150mg + 400mg Indications: tuberculosis pregnancy x ray lead apron purchase female cialis 20mg, in combination with other drugs (see notes and tables above) Cautions: see ethambutol and isoniazid Drug interactions: see ethambutol and isoniazid Contraindications: preparation not suitable for use in children; see ethambutol and isoniazid womens health 31 meals in 31 days cheap 20 mg female cialis overnight delivery. Anti-Infective 229 Side effects: see ethambutol and isoniazid Dose and Administration: Tuberculosis menstrual exercises buy female cialis cheap online, continuation phase of 8-month regimen in place of thioacetazone with isoniazid (see notes and tables): Oral: Adult: ethambutol hydrochloride 800mg and isoniazide 300 mg daily. Pyrazinamide Tablet, 500mg Indication: tuberculosis, in combination with other drugs (see notes and tables above) Cautions: hepatic impairment (monitor hepatic function); renal impairment; diabetes mellitus (monitor blood glucose - may change suddenly); increased uric acid level in urine; breast-feeding. Note: - Patients or their carers should be told how to recognize signs of liver disorders and advised to discontinue treatment and seek immediate medical attention if symptoms such as persistent nausea, Vomiting, malaise or jaundice develop. Drug interactions: uricosurics (probenecid, sulfinpyrazone) Side effects: hepatotoxicity including fever, anorexia, hepatomegaly, jaundice, liver failure; nausea, vomiting; arthralgia; gout; sideroblastic anaemia; urticaria; skin flushing. Dose and Administration: Tuberculosis (initial phase of combination therapy; see notes and tables above): Oral: Adult and child 25-mg/kg daily or 35 mg/kg 3 times weekly. Indications: treatment of pulmonary tuberculosis in combination with other agents. Drug interactions: clarithromycin, azithromycin, ciprofloxacin, fluconazole, isoniazid, indinavir, nelfinavir, ritonavir, nevirapine and efavirenz. Side effects: rash, gastrointestinal intolerance (nausea, vomiting, anorexia, abdominal pain and diarrhea), headache, and hematological effects (leucopenia, neutropenia, thrombocytopenia and anemia), hepatotoxicity. Hypersensitivity reactions (flu-like syndrome, chest pain, eosinophilia, bronchospasm, shock) are reported rarely. Dose and Administration: Oral: Adult: Tuberculosis, in combination with other antituberculosis agent: 300 - 450 mg daily. Rifampicin Capsule, 150mg, 300mg, 600mg Syrup, 20mg/5ml Powder for injection (sodium) 300mg, 600mg in vial Indications: tuberculosis, in combination with other drugs (see notes and tables above); leprosy. Cautions: reduce dose in hepatic impairment, liver function tests and blood counts required in liver disorders, elderly, and on prolonged therapy; renal impairment (if dose above 600 mg daily); pregnancy; breastfeeding; porphyria; discolour soft contact lenses. Resumption of rifampicin treatment after a long interval may cause serious immonulogical reactions, resulting in renal impairment, haemolysis, or thrombocytopenia. Patients or their carers should be told how to recognize signs of liver disorders and advised to discontinue treatment and seek immediate medical attention if symptoms such as persistent nausea, vomiting, malaise or jaundice develop. Drug interactions: azathioprine, ciclosporin, contraceptives, dexamethasone, fluconazole, fludrocortisone, glibenclamide, haloperidol, hydrocortisone, indinavir, levonorgestrel, lopinavir, medroxyprogesterone, nelfinavir, nifedipine, norethisterone, phenytoin, prednisolone, guanidine, saquinavir, verapamil, warfarin. Side effects: severe gastrointestinal disturbances including anorexia, nausea, vomiting and diarrhea (antibiotic associated colitis reported); rashes, fever, influenza-like syndrome and respiratory symptoms, collapse, shock, haemolytic anaemia, acute renal failure, and thrombocytopenic purpura-more frequent with intermittent therapy; alterations of liver function jaundice and potentially fatal hepatitis (dose related; do not exceed maximum dose of 600 mg daily); stains body fluid (urine, tears, saliva, and sputum) orange - red. Dose and Administration: Tuberculosis (combination therapy; see notes and tables above): Oral: Adult and Child 10mg/kg daily or 3 times weekly (maximum dose, 600mg daily) Note: - take dose at least 30 minutes before a meal, as absorption is reduced when taken with food. Rifampicin + Isoniazid Tablet, 150mg + 100mg, 300mg + 150mg Capsule, 150mg + 100mg Indications: tuberculosis (see notes and tables above) Cautions: preparation not suitable for use in children; see under rifampicin, and isoniazid 7. Anti-Infective 231 Drug interactions, Contraindications, Side effects; see under rifampicin, and isoniazid Dose and Administration: Tuberculosis, 6 - month regimen (combination therapy; see notes and tables): Oral: Adult: 10mg/kg (rifampicin) and 5mg/kg (isoniazid) daily. Tuberculosis, 6-month regimen (combination therapy; see notes and tables): Oral: Adult 10mg/kg (rifampicin) and 10mg/kg (isoniazid) 3 times a week. Rifampicin + Isoniazid + Pyrazinamide Tablet, 150mg + 75mg + 400mg Indications: tuberculosis, in combination with other drugs (see notes and tables above) Cautions; Side effects, Drug interactions; see Rifampicin, Isoniazid, and Pyrazinamide Contraindications: preparations not suitable for use in children; see rifampicin, isoniazid, and Pyrazinamide. Dose and Administration: Tuberculosis, initial phase of 6 - month treatment regimens (see notes and tables above): Oral: Adult: rifampicin 10mg/kg, isoniazid 5mg/kg, and Pyrazinamide 25 mg/kg daily or rifampicin 10mg/kg, isoniazid 10mg/kg and Pyrazinamide 35mg/kg 3 times a week. Rifampicin + Isoniazid + Pyrazinamide + Ethambutol Tablet, 150mg + 75mg + 400mg + 275mg Indications: tuberculosis (see notes and tables above) Cautions, Side effects, Drug interactions, Contraindications; see rifampicin, isoniazid, Pyrazinamide and Ethambutol. Dose and Administration: Tuberculosis, induction phase of 6-month regimen (see notes and tables above): Oral: Adult: rifampicin 10mg/kg, isoniazid 5mg/kg, Pyrazinamide 25mg/kg, and Ethambutol hydrochloride 15mg/kg daily. Streptomycin Sulphate Powder for injection, 1g, 5g bases in vial Indications: tuberculosis, in combination with other drugs (see notes and tables above) Cautions: children - painful injection, avoid use if possible, renal impairment, infants, and elderly (dosage adjustment), and monitor renal, auditory, and vestibular function, and plasma streptomycin concentrations. Drug interactions: alcuronium, ciclosporin, cisplatin, furosemide, neostigmine, pyridostigmine, suxamethonium, and vecuronium. Side effects: vestibular and auditory damage; nephrotoxicity; hypersensitivity reactions - withdraw treatment; paraesthesia of mouth, rarely, hypomagnesaemia on prolonged therapy; antibiotic associated colitis; also 232 7. Anti-Infective nausea, vomiting, rash; rarely, haemolytic anaemia, aplastic anaemia, agranulocytosis, thrombocytopenia; pain and abscess at injection site. Note: Reconstituted solutions may vary in colour from colourless to yellow and may darken on exposure to light but potency is not affected for 48 hours at room temperature and for up to 14 days when refrigerated. It is transmitted from person to person when bacilli are shed from the nose and skin lesions of infected patients, but most individuals are naturally immune, and symptoms are suppressed.

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For chronic toxicity: 6 vials womens health unc order female cialis 10mg on line, for infants and small children (20kg) menstruation getting shorter buy female cialis in united states online, a single vial may be sufficient minstrel knight buy female cialis 10mg otc. Indications: antidote to gold breast cancer zero stage buy 20 mg female cialis with visa, arsenic, mercury poisoning; adjunct to edetate calcium disodium in lead poisoning; possibly effective for antimony, bismuth, chromium, copper, nickel, tungsten, or zinc. Contraindications: hepatic insufficiency (unless due to arsenic poisoning); iron, cadmium, or selenium poisoning. M: Arsenic, mercury, and gold poisoning: 3mg /kg every 4 - 6 hours for 2 days, then every 12 hours for 7 - 10 days or until recovery (initial dose may be up to 5mg if severe poisoning). Antidotes And Other Substances Used In Poisoning Indications: flumazenil is indicated for the management of benzodiazepine over dose. Cautions: hypersensitivity to benzodiazepines; patients receiving benzodiazepines for prolonged periods; pediatrics, elderly; pregnant and breastfeeding women. Ipecac Syrup, 7% powdered Ipecac Indications: an emetic for emergency use in the treatment of drug overdose and in some cases of poisoning Cautions: children under 1 year of age; heart disease active or impending seizures and in conditions of strychnine poisoning or ingestion of petroleum distillates, such as kerosene, gasoline, coal oil, fuel oil, paint thinner, or cleansing fluid. Drug interactions: activated charcoal, milk or milk products, carbonated beverages, antiemetics. Contraindications: impending coma, severe inebriation, corrosive poisoning with alkali and strong acids, depressed gag reflex, impending shock states. Side effect: diarrhoea, fast or irregular heartbeat, nausea or vomiting, stomach cramps or pain, troubled breathing, unusual tiredness or weakness, aching, and stiffness of muscles, especially those of the neck, arms, and legs. Dose and Administration: Oral:Adult: emetic: 15 to 30ml followed immediately by one glass (240ml) of water. The dosage should be reversed by gastric lavage if emesis does not occur after the second dose. Child: Emetic: Children up to 1 year of age: 5 to 10ml Children 1-12 years of age: 15 ml, preceded or followed by Ѕ-1 full glass (120240ml) of water. The efficacy and safety of late (> 15 hours post ingestion) or prolonged administration (> 16 hours) have not been sufficiently explored. Antidotes And Other Substances Used In Poisoning 461 Dose and Administration: Oral: 2. Side effects: hypertension, precordial pain, dizziness, mental confusion, headache, fever, staining of skin, fecal discoloration, nausea, vomiting, abdominal pain, discoloration of urine, bladder irritation, anemia, diaphoresis. Contraindications: renal insufficiency and pregnancy (in patients with rheumatiod arthritis); patients with previous penicillamine-related aplastic anemia or agranulocytosis; breast-feeding. Side effects: vasculitis, anxiety, agitation, fever, psychiatric disturbances, alopecia, rash, urticaria, wrinkling, anorexia, diarrhea, hematuria, nephrotic syndrome and renal failure. Antidotes And Other Substances Used In Poisoning Adult: 125 - 250mg/day, may increase dose at 1- 3 month intervals up to 1 ­ 1. Child < 12 years: 20mg/kg/day in 2-3 divided doses, round off to the nearest 250 mg dose; maximum 1g/day. Cautions: epilepsy, asthma, diabetes, gangrene, cardiovascular disease, brady cardia. Side effects: bradycardia, palpitations, restlessness, nervousness, hallucinations, seizure, nausea, salivation, diarrhea, stomach pain, frequent urge to urinate, muscle twitching, lacrimations, miosis, dyspnea, bronchospasm, respiratory paralysis, pulmonary edema, diaphoresis. Phytomenadiaone (Vitamin k1) Injection, 10mg/ml in 1ml ampoule Indications: overdose of warfarin and related agents used in rodent poisons. Side effects: shock- like reactions with bronchospasm, cyanosis, tachycardia and vascular collapse. Antidotes And Other Substances Used In Poisoning 463 Protamine Sulphate Injection, 10mg/ml in 5ml ampoule Indications: treatment of heparin overdosage. Cautions: allergic to fish, vasectomised or infertile males, and prior exposure to protamine or protamine containing insulin; porphyria. Side effects: anaphylaxis, transient neutropenia, bradycardia, flushing, systemic hypotension and pulmonary hypertension. Antidotes And Other Substances Used In Poisoning Pralidoxime Chloride Tablet, 500 mg Powder for injection, 1 g in vial Indications: It is used as an adjunct to but not as a substitute for atropine in the treatment of poisoning by certain cholinesterase inhibitors. Its main indication is in poisoning due to organophosphorus pesticides or related compounds. Cautions: It should be used cautionly in patients with impaired renal function (a reduction in dosage may be necessary); myasthenia gravis.

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IMPORTANT RATE NOTES
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