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Whoa!  Lay Off the Vitamins!
Posted: 26 November 2013 09:47 PM   [ Ignore ]   [ # 196 ]
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I don’t think I’ve ever taken a vitamin other than while I was pregnant. I have never given my children vitamins except for the first 6 months or so of their lives while breastfeeding. I’ve never been convinced of the necessity. Even when you speak of (for instance) Vitamin C. When you take the pill, you are only taking a small part of the vitamin C spectrum, same with the other vitamins. As has been mentioned before, you would have to be in pretty poor health to deplete your vitamin stores. Even when people are hospitalized, vitamin supplementation is rare, unless there is a reason you are depleted or unable to absorb them because of some disease process such as Crohns or Hirschprungs Disease, or you are in the ICU for an extended period of time.

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Posted: 26 November 2013 10:55 PM   [ Ignore ]   [ # 197 ]
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macgyver - 26 November 2013 08:53 PM
Lois - 26 November 2013 08:34 PM

I am interested in the latest scientific data that vitamin supplements are not doing us any good and could be doing harm. I have taken vitamin pills on occasion in the past for the same reason many people take them—for “insurance” when I knew I wasn’t eating a perfect diet, which was most ofthe time.  I wonder if anyone knows, perhaps one of the doctors, what we have to eat to get adequate nutrition and all the vitamins we need.  The last time I looked it up I decided that if I ate all the food recommended—3 squares a day—I would weigh 50 pounds more—if I could even get that much food down!  The calories that were recommended were much more than I had been eating.  As it is I eat lightly but sensibly to keep my weight down (though I can’t seem to shed the 20 pounds or so that I am over my ideal weight). I eat two meals a day and neither one is usually “square.” I haven’t taken take any vitamin supplements for years. Am I likely to be deficient?  How can we injest enough nutrition without gaining weight? Or does it not matter that we’re not getting a full complement of vitamins in our food every day?

Lois

You don’t need to get the full daily requirement of vitamins in your diet everyday. It takes a while to deplete your vitamin stores on a nutritionally poor diet. Some days you may get more than you need and others less. It will all even out unless you are going months on some incredibly nutrient poor diet.

Lois the point McKenzie and I have been trying to make here is that most Americans seem to be getting enough vitamins in their existing diets such that supplements don’t seem to offer any health advantage to most of us so you probably don’t have to give a great deal of thought to your diet if your main concern is vitamins. That’s not to say you shouldn’t eat a balanced diet with sufficient servings of fruits,vegetables, grains, nuts etc but you don’t need to be concerned about counting up your vitamin intake.


Thanks, but I am not actually focused on my vitamin intake. I don’t often think about vitamins, I haven’t taken them in years,  I accept the recent scienctific view that supplements are not doing what they claim and that there can be negative consequences. I am one of the many people who did ay one time accept the hype about vitamins and even my doctors sometimes recommended them.  Those of us who are not nutrition professionals are often ill-informed as I was, though I was by no means an extreme case. Until very recently I didn’t hear any nutritional professionals or physicians saying that vitamin supplements are useless. We can’t be blamed for not knowing what we didn’t know and what even professionals were not talking about.

On a different but related subject, do scientists also say now that calcium and iron supplements are of no use except in extreme cases? I’m curious because I have been prescribed both at various times by my physicians (iron when I was pregnant and nursing).  I still take calcium supplements. What’s a layman supposed to do when even her physicians recommend supplements? I read professional level scientific reports and they often give contradictory information. We, the lay public, are often sitting ducks when it comes to medicine. We are manipulated by advertisers and apparently our doctors are, too.


Lois

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Posted: 27 November 2013 05:40 AM   [ Ignore ]   [ # 198 ]
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Lois, McKenzie and I have both been trying to impress upon everyone that supplements are not necessarily bad. There are situations in which someone has a deficit ( ie. Someone with a B12 deficiency because of an inability to absorb it) or is at particular risk for a specific deficit ( patients who has undergone gastric bypass surgery) or has increased need for certain vitamins and minerals ( pregnant women), supplementation is perfectly reasonable. What we are trying to explain is that for the vast majority of people where none of these conditions apply, taking supplements do not offer any benefit and may be harmful.

In regards to your doctors recommendations we all need to keep in m ind that recommendations are based on the current state of knowledge and that fund of knowledge is changing as we learn more. For some time we have recommended that women take calcium supplements because there was some evidence that calcium could slow down the progression of osteoporosis even though it couldnt reverse it. As we have done more studies the benefits of calcium have become a little less certain. To complicate the issue, other studies have shown an association between increased intake of calcium supplements and an increase in cardiovascular disease. Because of the limited benefit and possible side effects of calcium supplementation we have more recently started to rethink this recommendation and I dont personally recommend that my patients use supplements. Oddly, people who have diets which are =higher in calcium dont seem to have the same cardiovascular risk for some reason.

Iron supplements are an example of supplementing patients who have a deficit. Menstruating women lose iron with every period and can become iron deficient. If your doctor finds that you have iron deficiency anemia and the levels are significantly decreased he or she may recommend that you take an iron supplement for a period of time to build your levels up If on the other hand you are not anemic, supplementation would not be appropriate.

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Posted: 27 November 2013 09:34 AM   [ Ignore ]   [ # 199 ]
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macgyver, I think this iron thing might get complicated in pregnant women.  For example, with both my pregnancies, I was Rx pre-natal vitamins and I took them religiously as directed by my Ob-Gyn.  The ironic thing about it though, is with my first pregnancy, I was not anemic, but my son was, from what I remember, born with an iron deficiency and had to take an iron supplement very early in life (his first few months of life).  After that, he hasn’t had many issues, if any, with his iron levels.  With my second pregnancy, I was anemic and my younger son’s iron levels were always fine.  All of this, despite the prenatal vitamins.  To this day, I often wondered why one child had an iron deficiency in his early years of life and the other did not.  Each pregnancy is different and each child born is different, all within the same family from the same mother.  I get that, but what I don’t get is, if a doctor tells a pregnant woman to take prenatal vitamins and she takes one as Rx every day why she’s not anemic and her baby is born anemic, while in another case she is anemic and the baby is born just fine, iron level wise.  Oddly enough, and I don’t think there is a relationship, but the first child developed normally and was born 3 days late and the second one, I had H.E.L.L.P. Syndrome, had to deliver early, and he had PDD-NOS, along with an underdevelped sphinter nerve and kidneys.  I associate the PDD-NOS and the underdevelopment of his urinary tract with being born early and possibly the H.E.L.L.P. Syndrome, not my own iron deficiency because he wasn’t deficient, but I could be wrong. However, I think there is something going on there when one of the two is deficient and the other is not, despite vitamin supplementation.  Whatever the case, I found it very bizarre even after all these years.

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Posted: 06 December 2013 01:26 PM   [ Ignore ]   [ # 200 ]
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I have no intention of resuming the same old arguments here, but since new evidence is coming out all the time on the subject of vitamin supplements, I thought I would post the latest systematic review here for anyone interested.


Autier P., Boniol M., Pizot C., Mullie P. Vitamin D status and ill health: a systematic review. The Lancet Diabetes & Endocrinology, Early Online Publication, 6 December 2013
doi:10.1016/S2213-8587(13)70165-7

This is a nice look at a couple of key issues: The complexities of separating cause and effect, the difference between association and causation, and the importance of the details, such as which specific populations may benefit from a supplement and which may not. The study looked at both observational research and clinical trials. In the observational studies, low Vitamin D levels were associated with a variety of illnesses, and higher levels were associated with better health. This was widely interpreted as suggesting raising Vitamin D levels might improve health and prevent disease.

However, when looking at studies in which Vitamin D was given to some patients and not others, it actually did not improve health or protect against disease for most people. It did reduce overall mortality a little in the elderly, especially women, possibly because of fewer fractures after falls, which is significant risk for death in this population but not so much in younger people.

So why did the observational studies differ from the experimental ones? Well, it appears that lower Vitamin D levels may be caused by illness rather than the other way around. People have lower levels when they are ill, but low levels don’t cause illness and higher levels don’t prevent it most of the time.

So there’s no simple answer as to whether a Vitamin D supplement will prevent illness in any specific indvidual. It seems reasonable it might in elderly people, and it seems pretty unlikely to do anything useful for anyone else. And while no significant risks have been seen yet with unecessary Vitamin D intake, these may appear as more research is done. And even if they don’t, one has to wodner about the billions of dollars spent on supplements that probably aren’t doing anything for most people. As always, life is complicated and full of uncertainty.

HERE is a new story summarizing the paper for those without access to the Lancet.

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Posted: 07 December 2013 05:45 AM   [ Ignore ]   [ # 201 ]
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Fools rush in where angels fear to tread?

What is a vitamin?

From http://en.wikipedia.org/wiki/Vitamin

A vitamin (US /ˈvaɪtəmɪn/ or UK /ˈvɪtəmɪn/) is an organic compound required by an organism as a vital nutrient in limited amounts. An organic chemical compound (or related set of compounds) is called a vitamin when it cannot be synthesized in sufficient quantities by an organism, and must be obtained from the diet. Thus, the term is conditional both on the circumstances and on the particular organism.

Deficiencies:

Well-known human vitamin deficiencies involve thiamine (beriberi), niacin (pellagra), vitamin C (scurvy), and vitamin D (rickets). In much of the developed world, such deficiencies are rare; this is due to (1) an adequate supply of food and (2) the addition of vitamins and minerals to common foods, often called fortification. In addition to these classical vitamin deficiency diseases, some evidence has also suggested links between vitamin deficiency and a number of different disorders.

Bold added by me.

Side-effects:

In large doses, some vitamins have documented side-effects that tend to be more severe with a larger dosage. The likelihood of consuming too much of any vitamin from food is remote, but overdosing (vitamin poisoning) from vitamin supplementation does occur. At high enough dosages, some vitamins cause side-effects such as nausea, diarrhea, and vomiting. When side-effects emerge, recovery is often accomplished by reducing the dosage. The doses of vitamins differ because individual tolerances can vary widely and appear to be related to age and state of health.

Bold added by me.

Should one take multivitamins/mineral (MVM) dietary supplements?

From http://ods.od.nih.gov/factsheets/MVMS-QuickFacts/

MVMs cannot take the place of eating a variety of foods that are important to a healthy diet. Foods provide more than vitamins and minerals. They also have fiber and other ingredients that may have positive health effects. But people who don’t get enough vitamins and minerals from food alone, are on low-calorie diets, have a poor appetite, or avoid certain foods (such as strict vegetarians and vegans) might consider taking an MVM. Health care providers might also recommend MVMs to patients with certain medical problems.

Can MVMs be harmful?

Taking a basic MVM is unlikely to pose any risks to health. But if you consume fortified foods and drinks (such as cereals or beverages with added vitamins and minerals) or take other dietary supplements, make sure that the MVM you take doesn’t cause your intake of any vitamin or mineral to go above the upper safe levels. (Use the Online DRI tool to learn the upper safe level of each nutrient.)

Pay particular attention to the amounts of vitamin A, beta-carotene (which the body can convert to vitamin A), and iron in the MVM.

Bold added by me.

Which kind of MVMS?

Also consider choosing an MVM designed for your age, sex, and other factors (like pregnancy). MVMs for men often contain little or no iron, for example. MVMs for seniors usually provide more calcium and vitamins D and B12 and less iron than MVMs for younger adults. Prenatal MVMs for pregnant women often provide vitamin A as beta-carotene.

Is that all there is to it?

My personal experience was/is daily basic MVMs after about 5 days invariably makes me heavy headed and hyperactive at which point, it is apparently prudent to stop taking it.

OTOH, a tablet in about two weeks seems OK.

Nocebo effect?

From http://en.wikipedia.org/wiki/Nocebo

In medicine, a nocebo (Latin for “I shall harm”) is a harmless substance that creates harmful effects in a patient who takes it. The nocebo effect is the negative reaction experienced by a patient who receives a nocebo.

LOL

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Posted: 07 December 2013 11:35 AM   [ Ignore ]   [ # 202 ]
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This topic has been driven into the ground.  Not interested in continuing.

Occam

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Posted: 09 December 2013 03:04 AM   [ Ignore ]   [ # 203 ]
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Vitamin D?

ABOUT THE AUTHOR(S)
Luz E. Tavera-Mendoza and John H. White worked together in White’s laboratory at McGill University investigating the molecular activities of vitamin D in human cells. They have uncovered aspects of the vitamin’s role in cancer prevention and discovered, with their collaborators, that D regulates certain genes involved in cell responses to microbial invaders. Tavera-Mendoza is now a postdoctoral fellow at Harvard Medical School studying vitamin D and breast cancer. Having witnessed vitamin D’s health-protecting actions firsthand in the lab, both authors take supplements during the parts of the year when sunlight is too weak in the northern cities where they reside to produce adequate amounts in skin. White takes 4,000 international units of D3 daily during those “vitamin D winter” months, and Tavera-Mendoza takes 1,000.

After reviewing multiple studies comparing vitamin D intake and the serum concentrations of 25D produced, Harvard School of Public Health researchers and others concluded last year that the current RDIs are inadequate. They suggested that no less than half of U.S. adults needed to consume at least 1,000 IU of vitamin D3 daily to raise their serum 25D concentrations to the minimum healthy level of 30 ng/ml.
<snip>
Toxic vitamin D overdose through supplementation is certainly possible, although it is generally seen when doses of 40,000 IU or more of D have been taken daily for an extended period. Sunshine-induced vitamin D toxicity has never been observed, however. To put this in perspective, an adult woman with white skin exposed to summer sun while wearing a bikini generates about 10,000 IU of vitamin D in 15 to 20 minutes. Longer exposures do not generate higher amounts of vitamin D, because UVB light also degrades the vitamin, preventing too much of it from building up in the skin.

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Posted: 09 December 2013 06:06 AM   [ Ignore ]   [ # 204 ]
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GdB what you have basically posted here are lab studies and opinion. Not a bit of clinical evidence. Lots and lots of things do something in a test tube or a petri dish full of cells but not in the body. We are not a petri dish. Our bodies are so much more complex that a particular reaction which happens in a dish may not happen in our body at all or may even have the reverse effect. Its not uncommon for brilliant scientists who do this sort of work to come to faulty conclusions and make flawed recommendations (Linus Pauling is the only person to ever win two solo Nobel prizes but the wheels came off his caboose when it came to vitamin C) based on very weak evidence.

The issue with vitamin toxicity is an area where far too many scientists and physicians have blinders on. They work from the assumption that these things are safe until proven unsafe and use studies of short term toxicity to back up their conclusions. They conveniently forget about the fact that cancer for example can take decades to develop. While they are happy to promote the cancer prevention aspects of vitamins shown in a petri dish they overlook the possibility that those drugs might actually cause cancer. Those studies take decades to perform and no one seems to want to wait for the evidence but if you will refer back to the study I cited above about vitamin E and prostate cancer you will see there is good reason for us to heed this warning.

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Posted: 20 December 2013 10:09 AM   [ Ignore ]   [ # 205 ]
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Well, I guess Mac you and I are wrong after all. Here’s an article from the Medical Journal of Australia which conclusively shows the importance of Vitamin D and the dangers of eschewing supplements. With this quality of evidence available, I don’t know how we could ever have been skeptical.

Here’s the abstract:

Abstract


Objective:  Vitamin D has been proposed to have beneficial effects in a wide range of contexts. We investigate the hypothesis that vitamin D deficiency, caused by both aversion to sunlight and unwholesome diet, could also be a significant contributor to the triumph of good over evil in fantasy literature.

Design:  Data on the dietary habits, moral attributes and martial prowess of various inhabitants of Middle Earth were systematically extracted from J R R Tolkien’s novel The hobbit.

Main outcome measures: Goodness and victoriousness of characters were scored with binary scales, and dietary intake and habitual sun exposure were used to calculate a vitamin D score (range, 0–4).

Results:  The vitamin D score was significantly higher among the good and victorious characters (mean, 3.4; SD, 0.5) than the evil and defeated ones (mean, 0.2; SD, 0.4; P < 0.001).

Conclusion:  Further work is needed to see if these pilot results can be extrapolated to other fantastic situations and whether randomised intervention trials need to be imagined.

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Posted: 20 December 2013 02:42 PM   [ Ignore ]   [ # 206 ]
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mckenzievmd - 20 December 2013 10:09 AM

Well, I guess Mac you and I are wrong after all. Here’s an article from the Medical Journal of Australia which conclusively shows the importance of Vitamin D and the dangers of eschewing supplements. With this quality of evidence available, I don’t know how we could ever have been skeptical.

Here’s the abstract:

Abstract


Objective:  Vitamin D has been proposed to have beneficial effects in a wide range of contexts. We investigate the hypothesis that vitamin D deficiency, caused by both aversion to sunlight and unwholesome diet, could also be a significant contributor to the triumph of good over evil in fantasy literature.

Design:  Data on the dietary habits, moral attributes and martial prowess of various inhabitants of Middle Earth were systematically extracted from J R R Tolkien’s novel The hobbit.

Main outcome measures: Goodness and victoriousness of characters were scored with binary scales, and dietary intake and habitual sun exposure were used to calculate a vitamin D score (range, 0–4).

Results:  The vitamin D score was significantly higher among the good and victorious characters (mean, 3.4; SD, 0.5) than the evil and defeated ones (mean, 0.2; SD, 0.4; P < 0.001).

Conclusion:  Further work is needed to see if these pilot results can be extrapolated to other fantastic situations and whether randomised intervention trials need to be imagined.


LOL….LOL… ROFL.  I need to post that in my exam rooms. Where did you find it?

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Posted: 22 December 2013 12:51 PM   [ Ignore ]   [ # 207 ]
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It appeared in the Med J of Australia, and the link is in the previous post. Scientists with a sense of humor—-who knew? wink

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Posted: 01 January 2014 02:34 PM   [ Ignore ]   [ # 208 ]
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I ran into a couple of articles today, and don’t know what to make of them.  Possibly both of you, McKenzie and Macgyver can help me understand them.  LOL
Occam
===
From articles in Science Daily (just the beginning excerpts)
===
Vitamin E May Delay Decline in Mild-To-Moderate Alzheimer’’s Disease
Dec. 31, 2013 —— Difficulty with activities of daily living often affect Alzheimer’s patients,
which is estimated to affect as many as 5.1 million Americans. These issues are among the most
taxing burdens of the disease for caregivers, which total about 5.4 million family members and
friends. New research from the faculty of Icahn School of Medicine at Mount Sinai working with
Veterans Administration Medical Centers suggests that alpha tocepherol, fat-soluble Vitamin E
and antioxidant, may slow functional decline (problems with daily activities such as shopping,
preparing meals, planning, and traveling) in patients with mild-to-moderate Alzheimer’s disease
and decrease caregiver burden.
===
Data from Oregon State University
Most Clinical Studies On Vitamins Flawed by Poor Methodology
Dec. 30, 2013 —— Most large, clinical trials of vitamin supplements, including some that have
concluded they are of no value or even harmful, have a flawed methodology that renders them
largely useless in determining the real value of these micronutrients, a new analysis suggests.

One reference was listed:
Alexander Michels, Balz Frei. Myths, Artifacts, and Fatal Flaws: Identifying Limitations
and Opportunities in Vitamin C Research. Nutrients, 2013; 5 (12): 5161 DOI:
    10.3390/nu5125161

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Posted: 01 January 2014 03:25 PM   [ Ignore ]   [ # 209 ]
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Occam. - 01 January 2014 02:34 PM

I ran into a couple of articles today, and don’t know what to make of them.  Possibly both of you, McKenzie and Macgyver can help me understand them.  LOL
Occam
===
From articles in Science Daily (just the beginning excerpts)
===
Vitamin E May Delay Decline in Mild-To-Moderate Alzheimer’’s Disease
Dec. 31, 2013 —— Difficulty with activities of daily living often affect Alzheimer’s patients,
which is estimated to affect as many as 5.1 million Americans. These issues are among the most
taxing burdens of the disease for caregivers, which total about 5.4 million family members and
friends. New research from the faculty of Icahn School of Medicine at Mount Sinai working with
Veterans Administration Medical Centers suggests that alpha tocepherol, fat-soluble Vitamin E
and antioxidant, may slow functional decline (problems with daily activities such as shopping,
preparing meals, planning, and traveling) in patients with mild-to-moderate Alzheimer’s disease
and decrease caregiver burden.
===
Data from Oregon State University
Most Clinical Studies On Vitamins Flawed by Poor Methodology
Dec. 30, 2013 —— Most large, clinical trials of vitamin supplements, including some that have
concluded they are of no value or even harmful, have a flawed methodology that renders them
largely useless in determining the real value of these micronutrients, a new analysis suggests.

One reference was listed:
Alexander Michels, Balz Frei. Myths, Artifacts, and Fatal Flaws: Identifying Limitations
and Opportunities in Vitamin C Research. Nutrients, 2013; 5 (12): 5161 DOI:
    10.3390/nu5125161

Balz Frei

Balz Frei, Ph.D.


Director and Endowed Chair, Linus Pauling Institute

Joan H. Facey Linus Pauling Institute Professor

Distinguished Professor, Department of Biochemistry and Biophysics

I’d consider his research suspect, given that Pauling was a bit of a nutter when it came to vitamins.

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Posted: 01 January 2014 03:57 PM   [ Ignore ]   [ # 210 ]
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Coldheart Tucker - 01 January 2014 03:25 PM

Balz Frei
I’d consider his research suspect, given that Pauling was a bit of a nutter when it came to vitamins.

Why? Is he Linus Pauling using that Balz Frei name as a pseudonym?
I know nothing of Linus Pauling. Why is he considered a “nutter” when it comes to vitamins?

Does that mean a scientist working under a Ford Foundation Grant or Ford Institute is suspect too because Ford was a bit of a nutter?

Most people regard other scientists research suspect when they don’t agree with it.

Did they ever have a scientist who can disprove that ingesting a multi-vitamin does NOT introduce vitamins into the human body?

Now it’s your turn Tucker. You can retort with the fact that eating 10,000 mgs of vitamin…fill in in the blank…causes cancer.

[ Edited: 01 January 2014 04:04 PM by VYAZMA ]
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