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Type 2 Diabetes Ppt

Type 2 Diabetes Mellitustreatment & Management

Type 2 Diabetes Mellitustreatment & Management

Type 2 Diabetes MellitusTreatment & Management Author: Romesh Khardori, MD, PhD, FACP; Chief Editor: George T Griffing, MD more... The goals in caring for patients with diabetes mellitus are to eliminate symptoms and to prevent, or at least slow, the development of complications. Microvascular (ie, eye and kidney disease) risk reduction is accomplished through control of glycemia and blood pressure; macrovascular (ie, coronary, cerebrovascular, peripheral vascular) risk reduction, through control of lipids and hypertension, smoking cessation, and aspirin therapy; and metabolic and neurologic risk reduction, through control of glycemia. New abridged recommendations for primary care providers The American Diabetes Association has released condensed recommendations for Standards of Medical Care in Diabetes: Abridged for Primary Care Providers , highlighting recommendations most relevant to primary care. The abridged version focusses particularly on the following aspects: Diagnosis and treatment of vascular complications Intensification of insulin therapy in type 2 diabetes The recommendations can be accessed at American Diabetes Association DiabetesPro Professional Resources Online, Clinical Practice Recommendations 2015 . [ 121 ] Type 2 diabetes care is best provided by a multidisciplinary team of health professionals with expertise in diabetes, working in collaboration with the patient and family. [ 2 ] Management includes the following: Appropriate self-monitoring of blood glucose (SMBG) Ideally, blood glucose should be maintained at near-normal levels (preprandial levels of 90-130 mg/dL and hemoglobin A1C [HbA1c] levels < 7%). However, focus on glucose alone does not provide adequate treatment for patients with diabetes mellitus. Treatment involves multiple goals (ie, Continue reading >>

Reference

Reference

This purpose of this talk is to overview the 2017 American Diabetes Association Standards of Medical Care in Diabetes. These Standards comprise all of the current and key clinical practice recommendations of the American Diabetes Association. [SLIDE] 2 Reference American Diabetes Association. Standards of medical care in diabetes—2014. Diabetes Care 2014;37(suppl 1):S1 A few notes on the Standards of Care: The Association funds development of the Standards of Care and all Association position statements out of its general revenues and does not use industry support for these purposes [CLICK] The slides are organized to correspond with sections within the 2017 Standards of Care. As we go through I’ll make note of where we are within the document. [CLICK] Though not every section in the document is represented, these slides do incorporate the most salient points from the Position Statement As with all Association position statements, the Standards of Care are reviewed and approved by the Association’s Board of Directors, which includes health care professionals, scientists, and lay people. [SLIDE] 3 These Standards of Care are revised annually by the ADA’s multidisciplinary Professional Practice Committee (PPC) [CLICK] For the 2017 revision, PPC members systematically searched Medline for human studies related to each subsection and published since 1 January 2016. [CLICK] Recommendations were revised based on new evidence or, in some cases, to clarify the prior recommendations or match the strength of the word to the strength of the evidence [CLICK] A table linking the changes in the recommendations to new evidence can be reviewed at professional.diabetes.org/SOC (Standards of Care) [CLICK] The Association and the Professional Practice Committee Continue reading >>

Diabetes: The Differences Between Types 1 And 2

Diabetes: The Differences Between Types 1 And 2

Diabetes, or diabetes mellitus (DM), is a metabolic disorder in which the body cannot properly store and use sugar. It affects the body's ability to use glucose, a type of sugar found in the blood, as fuel. This happens because the body does not produce enough insulin, or the cells do not correctly respond to insulin to use glucose as energy. Insulin is a type of hormone produced by the pancreas to regulate how blood sugar becomes energy. An imbalance of insulin or resistance to insulin causes diabetes. Diabetes is linked to a higher risk of cardiovascular disease, kidney disease, vision loss, neurological conditions, and damage to blood vessels and organs. There is type 1, type 2, and gestational diabetes. They have different causes and risk factors, and different lines of treatment. This article will compare the similarities and differences of types 1 and 2 diabetes. Gestational diabetes occurs in pregnancy and typically resolves after childbirth. However, having gestational diabetes also increases the risk of developing type 2 diabetes after pregnancy, so patients are often screened for type 2 diabetes at a later date. According to the Centers for Disease Control and Prevention (CDC), 29.1 million people in the United States (U.S.) have diabetes. Type 2 diabetes is much more common than type 1. For every person with type 1 diabetes, 20 will have type 2. Type 2 can be hereditary, but excess weight, a lack of exercise and an unhealthy diet increase At least a third of people in the U.S. will develop type 2 diabetes in their lifetime. Both types can lead to heart attack, stroke, nerve damage, kidney damage, and possible amputation of limbs. Causes In type 1 diabetes, the immune system mistakenly attacks the insulin-producing pancreatic beta cells. These cells are destro Continue reading >>

Type Ii Diabetes

Type Ii Diabetes

Type II Diabetes The Roles of Race, Culture, Genetics, Environment, and Behavior Arleen Brown, MD, PhD Overview Type II diabetes mellitus (T2DM) Definition / Diagnosis Risk factors for T2DM Race/ethnicity, culture, and other demographic characteristics Behavior Environment Genetics Measurable Objectives* List the diagnostic criteria for T2DM Take a family history to understand a patient’s risk of type 2 diabetes mellitus (T2DM) Be able to explain how the following factors contribute to diabetes risk, prevention, management, and outcomes: Race/ethnicity Environment Behavior Genetic factors Use T2DM as a template for other chronic conditions * i.e., what you will be tested on Case 45 year old Latino man with hypertension, hyperlipidemia who presents to clinic with concerns about developing diabetes. He is worried because there are several members of his immediate family, including his mother, who have diabetes. His mother has been struggling with the complications of diabetes and was recently started on dialysis for end-stage renal disease. The patient would like to know if he will also develop diabetes. Additional clinical data: His waist circumference is 35†and his BMI is 27. Introduction Diabetes is a group of metabolic diseases characterized by hyperglycemia resulting from insulin resistance and/or impaired insulin secretion Complications include neuropathy, nephropathy, vascular disease, and retinopathy Classic Symptoms “Polys†– Polyuria, Polydipsia, Polyphagia Unexplained weight loss How is Diabetes Mellitus Diagnosed? Fasting plasma glucose (FPG) >126 mg/dl (7.0 mmol/l) Fasting ==> No caloric intake for at least 8 hours. Random plasma glucose >200 mg/dl (11.1 mmol/l) with classic symptoms of hyperglycemia 2-h plasma glucose >200mg/dl ( Continue reading >>

Type 2 Diabetes And Prediabetes:

Type 2 Diabetes And Prediabetes:

A New Understanding of Cause and Treatment Endocrine Specialists Greenville Health System Objectives for this presentation Understand the “thrifty genotype and thrifty phenotype†hypothesis as to the origin of insulin receptor signaling pathway mutations in patients with type 2 diabetes Review the new hypothesis as to the cause of pre-diabetes and type 2 diabetes Understand why bariatric surgery and extreme diets can reverse type 2 diabetes - Briefly review current research for diagnosis and treatment of type 2 diabetes Types of Diabetes Type 1 diabetes – autoimmune destruction of beta cells in the islets of Langerhans in the pancreas Type 2 diabetes – chronic hyperglycemia resulting from insulin receptor signaling pathway gene mutations LADA (latent autoimmune diabetes of adulthood) Diabetes due to pancreatic destruction (pancreatitis, pancreatic resection) Other genetic causes (Leprechaunism, MODY, etc) Pre-diabetes: Two finger stick glucoses of 100-125 HbA1c 5.7-6.4 Post glucola (2hr) glucose 140-199 Diabetes: Two finger stick fasting glucoses of 126 or higher HbA1c 6.5 or higher Post glucola (2hr) glucose >200 Definition of pre-diabetes and diabetes What causes pre-diabetes and diabetes? Is it obesity? Is it genetics? Is it bad life-style? - 85 percent of diabetics are overweight - but only 30 percent of overweight people have type 2 diabetes and 15 percent of type 2 diabetics have a normal BMI The Paradox… Only two organs need insulin to internalize glucose: Skeletal muscle Fat Skeletal muscle transforms chemical energy (glucose) to mechanical work on a “as needed†basis. Fat provides free fatty acids (FFA) for conversion to ATP in mitochondria during prolonged periods of energy need or during periods of fasting. The key: bot Continue reading >>

Diabetes - Wikipedia

Diabetes - Wikipedia

Not to be confused with Diabetes insipidus . a disease characterized by long-term high blood sugar Universal blue circle symbol for diabetes. [1] Diabetes mellitus (DM), commonly known as diabetes, is a group of metabolic disorders characterized by high blood sugar levels over a prolonged period. [10] Symptoms of high blood sugar include frequent urination , increased thirst , and increased hunger . [2] If left untreated, diabetes can cause many complications . [2] Acute complications can include diabetic ketoacidosis , hyperosmolar hyperglycemic state , or death. [3] Serious long-term complications include cardiovascular disease , stroke , chronic kidney disease , foot ulcers , and damage to the eyes . [2] Diabetes is due to either the pancreas not producing enough insulin , or the cells of the body not responding properly to the insulin produced. [11] There are three main types of diabetes mellitus: [2] Type 1 diabetes results from the pancreas's failure to produce enough insulin due to loss of beta cells . [2] This form was previously referred to as "insulin-dependent diabetes mellitus" (IDDM) or "juvenile diabetes". [2] The cause is unknown. [2] Type 2 diabetes begins with insulin resistance , a condition in which cells fail to respond to insulin properly. [2] As the disease progresses, a lack of insulin may also develop. [12] This form was previously referred to as "non insulin-dependent diabetes mellitus" (NIDDM) or "adult-onset diabetes". [2] The most common cause is a combination of excessive body weight and insufficient exercise . [2] Gestational diabetes is the third main form, and occurs when pregnant women without a previous history of diabetes develop high blood sugar levels. [2] Prevention and treatment involve maintaining a healthy diet , regular physica Continue reading >>

Phd Public Health, Suez Canal University, Egypt

Phd Public Health, Suez Canal University, Egypt

Diabetes mellitus (DM) is a group of diseases characterized by high levels of blood glucose resulting from defects in insulin production, insulin action, or both. The term diabetes mellitus describes a metabolic disorder of multiple aetiology characterized by chronic hyperglycaemia with disturbances of carbohydrate, fat and protein metabolism resulting from defects in insulin secretion, insulin action, or both. The effects of diabetes mellitus include long–term damage, dysfunction and failure of various organs. Diabetes mellitus may present with characteristic symptoms such as thirst, polyuria, blurring of vision, and weight loss. In its most severe forms, ketoacidosis or a non–ketotic hyperosmolar state may develop and lead to stupor, coma and, in absence of effective treatment, death. Often symptoms are not severe, or may be absent, and consequently hyperglycaemia sufficient to cause pathological and functional changes may be present for a long time before the diagnosis is made. The long–term effects of diabetes mellitus include progressive development of the specific complications of retinopathy with potential blindness, nephropathy that may lead to renal failure, and/or neuropathy with risk of foot ulcers, amputation, Charcot joints, and features of autonomic dysfunction, including sexual dysfunction. People with diabetes are at increased risk of cardiovascular, peripheral vascular and cerebrovascular disease. The development of diabetes is projected to reach pandemic proportions over the next10-20 years. International Diabetes Federation (IDF) data indicate that by the year 2025, the number of people affected will reach 333 million –90% of these people will have Type 2 diabetes. In most Western societies, the overall prevalence has reach Continue reading >>

International Diabetes Federation

International Diabetes Federation

Advancing diabetes care, prevention and a cure worldwide Since 1950 Associated with the United Nations Department of Public Information In official relations with the World Health Organization and Pan-American Health Organization IDF championed the UN Resolution on Diabetes (UN Resolution 61/225) What is the IDF? NGO with HQ in Brussels 203 national diabetes associations, 162 countries, over 2 million members Voice of diabetes globally (250 million) In official relations with WHO, UN (DPI) IDF championed the UN Resolution on Diabetes (UN Resolution 61/225) A Federation of 203 national diabetes associations, 162 countries, over 2 million members Voice of diabetes globally (250 million) International Diabetes Federation Since 1950 Associated with the United Nations Department of Public Information In official relations with the World Health Organization and Pan-American Health Organization IDF championed the UN Resolution on Diabetes (UN Resolution 61/225) IDF Programs IDF Clinical Guidelines IDF Atlas (single congruent data source) IDF Centres of Diabetes Education IDF Life for a Child IDF World Diabetes Congresses UN World Diabetes Day Empower, Educate, Energise (Understand diabetes and take control) IDF Programs IDF Programs IDF Clinical Guidelines IDF Atlas (single congruent data source) IDF Centres of Diabetes Education IDF Life for a Child IDF World Diabetes Congresses UN World Diabetes Day Empower, Educate, Energise (Understand diabetes and take control) It was obvious how divided the diabetes organizations were and many were head to head competitors. We created the concept of a “diabetes world†working under the banner of a blue circle representing an Unite for diabetes movement. We have used this slide a lot recently to demonstrate the growing recogniti Continue reading >>

Rebecca Pratt Gregory, Ms, Rd, Cde And Kerri Cavanaugh, Md, Mhs

Rebecca Pratt Gregory, Ms, Rd, Cde And Kerri Cavanaugh, Md, Mhs

Rebecca Pratt Gregory, MS, RD, CDE and Kerri Cavanaugh, MD, MHS Addressing The Role of Nutrition Education and Health Literacy in Diabetes Care * Learning Objectives Review of impact of CDEs and medical nutrition therapy (MNT) on diabetes outcomes Review health literacy & numeracy in diabetes self-care Describe design of new randomized controlled trial to: Examine the value of CDE in diabetes care Examine the role of different approaches to MNT Learn about study results, interpretation and applications to clinical practice * Role of CDEs in Medical Nutrition Therapy in Diabetes Care Diabetes self-management education (DSME) can improve patient knowledge, behavior, and glycemic control Medical Nutrition Therapy is an essential part of DSME Addressing carbohydrates as a nutritional strategy is endorsed by the ADA and the AADE Clinical trials have shown that MNT can improve A1C by 1-2% No studies have compared carbohydrate counting and plate method Facilitating positive behavior as well as transferring knowledge is a priority, but little research in this area exists * Summary of previous literature (bullets) about CDEs (i.e. why do we need to do this study – don’t all already think CDEs are worthwhile??!!) Components of Literacy IOM, Health Literacy, 2004 Defining Health Literacy “…ability to read, write, and speak in English, and compute and solve problems at levels of proficiency necessary to function on the job and in society, to achieve one’s goals, and develop ones knowledge and potential†“ The degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.†***Highlight the functional aspects of ‘health literacyâ� Continue reading >>

Differences Between Type 1 And Type 2

Differences Between Type 1 And Type 2

Tweet Whilst both type 1 and type 2 diabetes are characterised by having higher than normal blood sugar levels, the cause and development of the conditions are different. Confused over which type of diabetes you have? It's not always clear what type of diabetes someone has, despite what many people think. For instance, the typical assumption is that people with type 2 diabetes will be overweight and not inject insulin, while people with type 1 diabetes will be, if anything, underweight. But these perceptions just aren't always true. Around 20% of people with type 2 diabetes are of a healthy weight when diagnosed, and many of them are dependent on insulin. Similarly, people with type 1 diabetes will in some cases be overweight. Because both types of diabetes can be so varied and unpredictable, it's often difficult to know which type of diabetes someone has. It's not safe to assume that an overweight person with high blood glucose levels has type 2 diabetes, because the cause of their condition might in fact be attributable to type 1. In some cases, when the type of diabetes is in doubt, your health team may need to carry out specialised tests to work out which type of diabetes you have. This way, they can recommend the most appropriate treatment for your diabetes. Common differences between type 1 and type 2 diabetes Despite the uncertainty that often surrounds a diagnosis of diabetes, there are a few common characteristics of each diabetes type. Please note that these differences are based on generalisations - exceptions are common. For instance, the perception of type 1 diabetes isn't strictly true: many cases are diagnosed in adulthood. This table should be seen as a rough guide to the differences between type 1 and type 2 diabetes, rather than hard and fast rules. Co Continue reading >>

Type 2 Diabetes Basics

Type 2 Diabetes Basics

1. Type 2 Diabetes What I think you need to Know Nick Thomas 2. • Is an epidemic • Prevalence in UK set to double in next twenty years • Diabetes currently costs 10% Of entire NHS budget • You do the maths………… 3. • Type 2 diabetes is a mixture and Insulin resistance Beta cell dysfunction Diabetes occurs when beta cells can noDiabetes occurs when beta cells can no longer produce enough insulin tolonger produce enough insulin to compensate for insulin resistancecompensate for insulin resistance 4. • Insulin resistance directly linked to Obesity • By the time Diabetes diagnoses Beta cell function has started to deteriorate 5. • Need to diagnose diabetes early (ideally pick up those with high insulin resistance) • Weight loss, decreases insulin resistance, decreases risk of developing diabetes… Simples 6. • Beta cell function started to deteriorate and will deteriorate with time. • Thus management in a stepwise fashion, will require additional management with decreasing endogenous insulin production. • 50% of patients with Type 2 diabetes will require insulin therapy 6 years after diagnosis. 7. Step 1 = Life style (weight loss + diet) Step 2 = Oral hypoglycaemic agents Step 3 = Insulin (start as combination with OGA) 8. ORALORAL HYPOGLYCAEMICHYPOGLYCAEMIC AGENTSAGENTS METFORMIN (1st line) Insulin resistance Hepatic glucose production Insulin release from pancreas Pros:- Weight loss Cons:- Can worsen renal function SULFONYLUREAS (2nd line) Pros:- fast onset of action Cons:- •Weight gain, •risk of hypoglycaemia THIAZOLIDENEDIONES (glitazones) (3rd line) Cons:- weight gain, contraindicated in heart failure Rosiglitazone no longer available due to cardiovascular risk Insulin resistance insulin release glucagon release Gastric digestion Appe Continue reading >>

Targeting The Underlying Pathophysiology Of Type 2 Diabetes

Targeting The Underlying Pathophysiology Of Type 2 Diabetes

Type 2 diabetes Characterized by chronic hyperglycemia Associated with microvascular and macrovascular complications Generally arises from a combination of insulin resistance and ï¢-cell dysfunction Definition, Diagnosis and Classification of Diabetes Mellitus and its Complications. Department of Noncommunicable Disease Surveillance, World Health Organization, Geneva 1999. Available at: Type 2 diabetes is a metabolic disorder with multiple causes, characterized by chronic hyperglycemia with disturbances of carbohydrate, fat and protein metabolism. It generally results from a combination of insulin resistance and loss of ï¢-cell function.1 Insulin resistance places an increased secretory demand upon the ï¢-cell, leading to ï¢-cell dysfunction as the disease progresses.2 In the long term, type 2 diabetes affects a number of organs and is associated with microvascular complications such as retinopathy, nephropathy and neuropathy. In addition, individuals with type 2 diabetes are at increased risk of macrovascular disease.1 Often diagnosis of type 2 diabetes is made after the condition has been present for some years. In fact, more than 50% of individuals have evidence of vascular disease at diagnosis.3 1Definition, Diagnosis and Classification of Diabetes Mellitus and its Complications. Department of Noncommunicable Disease Surveillance, World Health Organization, Geneva 1999. Available at: 2International Diabetes Center (IDC), Minneapolis, 2000. Available at: 3Laakso M. Int J Clin Pract Suppl. 2001; 121:8–12. Continue reading >>

Growing Rates Of Type Ii Diabetes Among Teenagers

Growing Rates Of Type Ii Diabetes Among Teenagers

7% of US population has Diabetes Type II Diabetes Mellitus 90% of Diabetes cases are Type II pancreas produces too little or no insulin glucose builds up in blood stream 1/3 of cases need daily insulin doses required BACKGROUND Type II Diabetes age of onset is decreasing Becoming more common among those 10 to 19 years of age Increase occurring in last 2 decades Increasing obesity in the younger age group Ethnic and cultural backgrounds reflecting sedentary lifestyle BACKGROUND Early-onset Type II Diabetes (similar to the later-onset ) characterized by β-cell failure obesity-induced insulin resistance decline in β-cell function appears to be more rapid than later-onset BACKGROUND 1 out of 3 kids are either overweight or obese PROBLEM Early on-set of Type II Diabetes in children age 10 to 19 Major factors physical inactivity* sedentary lifestyle* obesity/excessive body fat family history of diabetes ethnic background worldwide industrialization - mechanized industry rather than agriculture, craftsmanship, or commerce I changed the age from under 30 to 10-19 to be more specific. I also found a graph to support the 10-19 age range. Also, our solutions of mandatory recess can only be applied to those in school, since we can’t force nonschool student recess. 7 This graph shows that typically, older people develop type II diabetes but children are developing it due to obesity. 8 Early on-set of Type II Diabetes in children and adolescents age 10 to 19 Due to physical activity, sedentary lifestyle, obesity/excessive body fat, family history, and ethnicity background. CONNECTION TO HEALTH EFFECT Type II diabetes can have many complications including... Heart disease and Stroke Kidney Disease Eye complications Foot complications Skin complications Depression IMPACT Continue reading >>

Type 2 Diabetes | Canada| Pdf | Ppt| Case Reports | Symptoms | Treatment

Type 2 Diabetes | Canada| Pdf | Ppt| Case Reports | Symptoms | Treatment

Classically, the 3untranslated region (3UTR) is that region in eukaryotic protein-coding genes from the translation termination codon to the polyA signal. It is transcribed as an integral part of the mRNA encoded by the gene. However, there exists another kind of RNA, which consists of the 3UTR alone, without all other elements in mRNA such as 5UTR and coding region. The importance of independent 3UTR RNA (referred as I3UTR) was prompted by results of artificially introducing such RNA species into malignant mammalian cells. Since 1991, we found that the middle part of the 3UTR of the human nuclear factor for interleukin-6 (NF-IL6) or C/EBP gene exerted tumor suppression effect in vivo. Our subsequent studies showed that transfection of C/EBP 3UTR led to down-regulation of several genes favorable for malignancy and to up-regulation of some genes favorable for phenotypic reversion. Also, it was shown that the sequences near the termini of the C/EBP 3UTR were important for its tumor suppression activity. Then, the C/EBP 3UTR was found to directly inhibit the phosphorylation activity of protein kinase CPKC in SMMC-7721, a hepatocarcinoma cell line. Recently, an AU-rich region in the C/EBP 3UTR was found also to be responsible for its tumor suppression. Recently we have also found evidence that the independent C/EBP 3UTR RNA is actually exists in human tissues, such as fetal liver and heart, pregnant uterus, senescent fibroblasts etc. Through 1990s to 2000s, world scientists found several 3UTR RNAs that functioned as artificial independent RNAs in cancer cells and resulted in tumor suppression. Interestingly, majority of genes for these RNAs have promoter-like structures in their 3UTR regions, although the existence of their transcribed products as independent 3UTR RNAs is Continue reading >>

Clinical Review Of Antidiabetic Drugs: Implications For Type 2 Diabetes Mellitus Management

Clinical Review Of Antidiabetic Drugs: Implications For Type 2 Diabetes Mellitus Management

Go to: Diabetes mellitus (DM) is a complex chronic illness associated with a state of high blood glucose level, or hyperglycemia, occurring from deficiencies in insulin secretion, action, or both. The chronic metabolic imbalance associated with this disease puts patients at high risk for long-term macro- and microvascular complications, which if not provided with high quality care, lead to frequent hospitalization and complications, including elevated risk for cardiovascular diseases (CVDs) (1). The clinical diagnosis of diabetes is reliant on either one of the four plasma glucose (PG) criteria: elevated (i) fasting plasma glucose (FPG) (>126 mg/dL), (ii) 2 h PG during a 75-g oral glucose tolerance test (OGTT) (>200 mg/dL), (iii) random PG (>200 mg/dL) with classic signs and symptoms of hyperglycemia, or (iv) hemoglobin A1C level >6.5%. Recent American Diabetes Association (ADA) guidelines have advocated that no one test may be preferred over another for diagnosis. The recommendation is to test all adults beginning at age 45 years, regardless of body weight, and to test asymptomatic adults of any age who are overweight or obese, present with a diagnostic symptom, and have at least an additional risk factor for development of diabetes. Furthermore, a condition called prediabetes or impaired fasting glucose (IFG), in which the fasting blood glucose is raised more than normal but does not reach the threshold to be considered diabetes (110–126 mg/dL), predisposes patients to diabetes, insulin resistance, and higher risk of cardiovascular (CV) and neurological pathologies (2, 3). Type 2 diabetes mellitus (T2DM) can co-occur with other medical conditions, such as gestational diabetes occurring during the second or third trimester of pregnancy or pancreatic disease associate Continue reading >>

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