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Tracking the next pandemic: Avian Flu Talk

Why the Bird Flu Hasn’t Gone Pandemic Yet

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Amethyst View Drop Down
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    Posted: March 22 2006 at 10:47am

Bird flu can't spread easily in humans: expert

LONDON (Reuters) - Scientists said on Wednesday they may have uncovered why the H5N1 avian flu that is so lethal in birds has not been able to spread easily among humans.

It is because bird flu viruses attach to receptors, or molecules on cells, in different regions of the respiratory system from human influenza viruses.

Receptors act like doorways that allow the virus to enter the cell, multiply and infect other cells. Humans have receptors for avian viruses, including H5N1, but they are found deep within the lungs.

Cells in the upper airway in humans lack the receptors targeted by avian flu viruses, which limit their ability to spread from person to person.

"For the viruses to be transmitted efficiently, they have to multiply in the upper portion of the respiratory system so that they can be transmitted by coughing and sneezing," said Dr Yoshihiro Kawaoka, a virologist at the University of Wisconsin-Madison, who led the research team.

The H5N1 bird flu virus has killed 103 people and infected 184 since late 2003. People infected with the virus, which has spread from Asia to Europe, the Middle East and Africa, have had close contact with diseased birds.

Scientists fear the virus could mutate into a pandemic strain that could become highly infectious and capable of killing many millions of people.

"Our findings provide a rational explanation for why H5N1 viruses rarely infect and spread from human to human, although they can replicate efficiently in the lungs," Kawaoka and his team said in a report in the journal Nature.

MULTIPLE MUTATIONS

Professor John Oxford, a virologist at St Bartholomew's and the Royal London Hospital, Queen Mary's School of Medicine and Dentistry in London, said the research provides a reasonable explanation for the small number of human cases.

"This gives some meaning to the great conundrum at the moment, the fortunate conundrum of why this virus is not going from human to human," Oxford said in an interview

"It looks like a deep scientific study into that and we need more of those studies."

Kawaoka and a team of researchers in Japan infected human tissue with bird flu viruses. Their findings suggest that strains of H5N1 circulating in birds would have to undergo several key genetic changes to become easily transmissible in humans.

"The virus has to mutate to recognize human virus receptors which are in the throat," Kawaoka told Reuters.

"Certainly, multiple mutations need to be accumulated for the H5N1 virus to become a pandemic strain."

Scientists do not know how far the H5N1 has mutated to become a pandemic strain but Kawaoka's findings show the importance of looking for changes in virus recognition of human receptors.

The changes or mutations must occur in the hemagglutinin protein, the "H" in the virus designation, for avian H5N1 viruses to recognize human receptors, according to the researchers.

"Identification of H5N1 viruses with the ability to recognize human receptors would bring us one step closer to a pandemic strain," Kawaoka added.

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: March 22 2006 at 11:29am
Originally posted by Amethyst Amethyst wrote:

Bird flu can't spread easily in humans: expert

LONDON (Reuters) - Scientists said on Wednesday they may have uncovered why the H5N1 avian flu that is so lethal in birds has not been able to spread easily among humans.

Hi Amethyst!
Hope you're feeling better! 
 
Unfortunately, Dr. Nimon noted in a January brief that H5N1 has already exhibited isolated change to maybe challenge that barrier...Dead
 
 
http://www.recombinomics.com/News/01190601/H5N1_Turkey_S227N_E627K.html
 
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: March 22 2006 at 11:40am
This great news, hopfully it can't change.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote corky52 Quote  Post ReplyReply Direct Link To This Post Posted: March 22 2006 at 11:59am
Nothing new here just proof of existing theories and observations.  Description of the steamroller doesn't give you a means to stop it.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: March 22 2006 at 12:08pm
Keep in mind that when you submit something for publication to a scientific or medical journal, it will take minimally 2-3 months at best to get something published.  (Some articles can take upto a year to appear in print)  I wonder when this information was originally submitted to the journal.  This timeframe does not include the prep time needed to get your data together and to write the article so it can be submitted for publication (probably add another month).
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: March 22 2006 at 12:10pm
Your right, I wasn't even considering that, more of the same then. Thumbs Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: March 22 2006 at 12:21pm
A more comprehensive discussion about the receptor sites:
 
Can You Catch Bird Flu from a Human?

Can You Catch Bird Flu from a Human March 22, 2006 11:22AM

Human-to-human transmission of bird flu is highly unlikely, at least for now, experts say. Could genetic changes occur, as experts believe may have happened in the 1918 Spanish flu pandemic? "That's the $64,000 question," said Dr. Arnold S. Monto, a professor of epidemiology at the University of Michigan School of Public Health. "We're all concerned about mutations or any re-assortment that might change the virus."
Two new studies help explain why human-to-human transmission of the bird flu virus has so far not happened -- and might not happen in the future. Both reports found that the H5N1 virus prefers to settle in cells deep within the lungs, rather than in the upper respiratory tract, as happens with human flu strains.

That's important because "most of the coughing and sneezing that transmits flu is going to be from the upper respiratory tract, and not way down in the lower respiratory tract," explains Dr. Arnold S. Monto, a professor of epidemiology at the University of Michigan School of Public Health. "So unless you have relatively close contact, you're not going to have much (bird flu) virus get out."

The findings may also explain why bird flu has proven so lethal whenever it has managed to get a foothold in humans, the experts add.

Since 2003, the H5N1 virus has been found in Asia, Europe, Africa and the Middle East, and has led to the slaughter of tens of millions of domestic fowl. While infection has primarily been limited to birds, the virus has killed 103 people through bird-to-human transmission.

Scientists worry, however, that the germ could mutate into a form that would make human-to-human transmission far easier, raising the specter of a pandemic that could kill millions of people.

One of two studies published this week that looked at that possibility was conducted by researchers working at the University of Wisconsin and the University of Tokyo. They reported their findings in the March 23 issue of Nature.

The team focused on two variants of a receptor molecule lying on the surface of cells that line the nasal/bronchial passages and the lungs. These receptors, called SAalpha2,3Gal and SAalpha2,6Gal (2,3 and 2,6 for short), are the biochemical "hook" flu viruses use to latch onto cells.

Scientists long ago determined that H5N1 strongly prefers the 2,3 form of the molecule. "What this paper was doing was identifying where the locus of these 2,3 receptors are in humans," Monto explains.

The Japanese-American team found that, as expected, H5N1 avian flu is drawn to the 2,3 receptors. Luckily for humans, they also found that 2,3 is most abundant on cells within the alveoli: the most remote, microscopic branches of the lungs' "respiratory tree." H5N1 was much less likely to bind to cells in the upper respiratory tract.

In contrast, common human flu strains prefer to bind with the 2,6 receptor, which is found in plentiful numbers on upper respiratory tract cells. That makes sense, experts say, because every time humans cough or sneeze, droplets from this area are easily expelled into the air, making human-to-human transmission of ordinary seasonal flu possible.

H5N1 colonizes a much deeper, tough-to-access region of the lung -- making infection more difficult to spread and treat in humans, the researchers said.

The finding also helps explain another phenomenon: The fact that many people have tested positive for exposure to H5N1, but have never developed actual infection or illness.

"They didn't have bird flu, but they made antibodies to it," explains Dr. Marc Siegel, a clinical associate professor of medicine at New York University School of Medicine and author of "Bird Flu: Everything You Need to Know About the Next Pandemic."

According to Siegel, it appears that these people may have encountered H5N1, but because the virus failed to reach the lower lung, it never gained a "foothold" for infection.

How, then, to explain the more than 200 documented human cases where people did develop full-blown bird flu?

"I've always assumed it's due to (the patient's) high viral load," Siegel says. In other words, these patients -- most of whom worked every day in close proximity to infected birds -- were so surrounded by H5N1 that it eventually managed to colonize the lower reaches of their lungs.

Once the virus does lodge and flourish in the lower lung, it can quickly prove deadly, Monto says. "It causes pneumonia, a whiting out of the lungs," he says. "In fact, a lower respiratory pathology fits very well with what we are finding" in human cases.

The Japanese/American findings were echoed in another paper, scheduled for release in the March 24 issue of Science, but published early to coincide with the Nature study.

In that study, Dutch researchers at the University of Rotterdam again found that avian flu preferred receptors on cells deep in the lungs, and shunned binding with cells in the upper respiratory tract.

All of this means that human-to-human transmission of H5N1 is highly unlikely, at least for now, experts say.

However, any mutation or series of mutations that caused H5N1 to switch its preference from the 2,3 receptor to the 2,6 receptor could change all that.

Could such genetic changes occur, as experts believe may have happened in the 1918 Spanish flu pandemic?

"That's the $64,000 question," Monto says. "We're all concerned about mutations or any re-assortment that might change the virus."

But Siegel believes the virus would have to undergo a number of complex genetic mutations to move up the respiratory tract. "And even if it does, that's still not an assumption that it's going to cause a severe pandemic," he says.

Still, he and other experts agree that as the virus circulates in millions of migrating birds, vigilance will be key.

"All of this argues for intensified surveillance and attempting to contain, if possible, the disease in poultry," Monto says.

http://www.sci-tech-today.com/story.xhtml?story_id=11200002TI34&page=1
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: March 22 2006 at 12:31pm
Never say never
Sorry siameselady as much as i respect your optimisim and views i wouldn`t hope to much.
 
I agree with you that were not quite at the point to run for cover ( significant h2h)
but my views are this will go h2h  99.8%
if we consider its had almost 10 years in the far east to develop to what we have today then it is reasonable to assume that by this time next year it will be pandemic in wild birds globaly ( if not already as i believe,  more or less )
Then we must also assume that it will be in these wild birds and infecting domestic poultry for at least ten more years.
Factor in the increase in human cases for 06 this year
 
confirmed 40 in 3 months X 4 to give an approx for the year =160 ( being hopefull)
 
2004 = 29            2005 = 61         2006 = 160
 
so lets be optimistic and reduce 2006 down to 120 then we have number of human cases doubling each year.
 
2007 = 240                    2012 = 7680
2008 = 480                    2013 = 15360
2009 = 960                    2014 = 30720
2010 = 1920                  2015 = 61 440
2011 = 3840                  2016 = 122 880
 
Total = 245 520 chances for H5N1 to mutate in favour of a h2h receptor bindings
 
lets not even start to factor in increases in human contact due to global spread or that it might be with us for 20 years not 10 and dont forget this is based on WHO confirmed figures not real life. 
 
Before anyone shouts at me - yes this is being very optimistic imo
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: March 22 2006 at 12:39pm
ummm what has happened to my avaitor si yours was like this yesturday how did you fix it ?
 
anyway sniffles post :
 
i have a problem with :-
That's important because "most of the coughing and sneezing that transmits flu is going to be from the upper respiratory tract, and not way down in the lower respiratory tract," explains Dr. Arnold S. Monto, a professor of epidemiology at the University of Michigan School of Public Health. "So unless you have relatively close contact, you're not going to have much (bird flu) virus get out."
This is except when you get to the stage were your coughing up blood and its pouring from your nose, or when you have just wiped ur a$$ and not washed your hands, just coming out the door of the public toilets could leave you infecting hundreds of people not to mention those dirty teenages working in Mc Donalds..
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Amethyst Quote  Post ReplyReply Direct Link To This Post Posted: March 22 2006 at 1:12pm
Originally posted by Bannor Bannor wrote:

[QUOTE=Amethyst] Hi Amethyst!
Hope you're feeling better! 
 
Unfortunately, Dr. Nimon noted in a January brief that H5N1 has already exhibited isolated change to maybe challenge that barrier...Dead
 
 
 
 
I'm feeling a hundred times better than I felt on Monday.
 
So we don't know if the change is happening yet?  That's what I don't like about this.  There are just too many uncertainties.  Seems like a lot of people are placing their bets on the outcome they most want to happen, rather than what could happen, as if that would make a difference.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Amethyst Quote  Post ReplyReply Direct Link To This Post Posted: March 22 2006 at 1:15pm
Originally posted by Sniffles Sniffles wrote:

Keep in mind that when you submit something for publication to a scientific or medical journal, it will take minimally 2-3 months at best to get something published.  (Some articles can take upto a year to appear in print)  I wonder when this information was originally submitted to the journal.  This timeframe does not include the prep time needed to get your data together and to write the article so it can be submitted for publication (probably add another month).
 
I don't know, but it first appeared online today AFAIK.  But you're right, they should publish the date when the report was actually submitted for publication to keep these things in context.  Tomorrow, they could come out with something that says exactly the opposite.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: March 22 2006 at 1:29pm
When Dr. Niman made his statements about viral changes in January of this year, that probably was about the time the researchers found this receptor difference with human and bird H5N1 infection.  Roughly 3-4 months ago.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: March 22 2006 at 1:45pm
Aren't there computer programs that can predict the likelihood of the pandemic  happening based on the imformation available
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Post Options Post Options   Thanks (0) Thanks(0)   Quote BlackMoon Quote  Post ReplyReply Direct Link To This Post Posted: March 22 2006 at 1:57pm

Well the media is sure playing up this report.  

move on folks... nothing to see here...Ermm
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Amethyst Quote  Post ReplyReply Direct Link To This Post Posted: March 22 2006 at 2:07pm
Originally posted by RBARNES55 RBARNES55 wrote:

Aren't there computer programs that can predict the likelihood of the pandemic  happening based on the imformation available
 
Yeah, I did a quick search in Yahoo and found one:
 
 

CDC releases FluSurge software to predict medical fallout of flu epidemic

Summary:

  • Another influenza pandemic is likely, if not inevitable.1-2 To help public health officials and hospital administrators prepare for the next influenza pandemic, CDC has developed FluSurge 1.0, a specialized spreadsheet-based software that estimates the potential surge in demand for hospital-based health care during a pandemic.
  • For each week of a pandemic, FluSurge calculates the potential demand for hospital beds, intensive care unit beds, and mechanical ventilators.
  • Demand for resources is compared with actual capacity.
  • FluSurge is a companion to the previously released FluAid 2.0, which provides estimates of the total deaths, hospitalizations, and outpatient visits that might occur during an influenza pandemic.
  • Both FluSurge 1.0 and FluAid 2.0, including accompanying manuals, are now available from the National Vaccine Program Office's website at http://www.dhhs.gov/nvpo/pandemics.
  • The software programs and manuals are available free of charge.
  • Influenza pandemic preparedness plan for the United States.
  • Meltzer MI, Cox NJ, Fukuda K. The economic impact of pandemic influenza in the United States: priorities for intervention.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote RICK Quote  Post ReplyReply Direct Link To This Post Posted: March 22 2006 at 2:28pm


Do scientists general communicate by "approving press statements" ? Mmm.   


Published: March 22, 2006

"The avian flu virus would need to accumulate many favorable mutations in its genetic material before it could become a pandemic strain, said Yoshihiro Kawaoka, a virologist at the both the University of Tokyo and the University of Wisconsin."

According to a press statement he approved,
"The finding suggests that scientists and public health agencies worldwide may have more time to prepare for an eventual pandemic."


http://www.nytimes.com/2006/03/22/health/22cnd-flu.html


    
    
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Falcon Quote  Post ReplyReply Direct Link To This Post Posted: March 22 2006 at 4:25pm
how much longer though?  I would suspect if it mingled with a comman virus, then it would be a lot sooner then most people would expect.  So it could tilt either way, but one is coming. We're over due anyways
I look at the stars and wonder what it would be like to touch them.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Amethyst Quote  Post ReplyReply Direct Link To This Post Posted: March 22 2006 at 4:27pm
I don't think anyone knows for sure how much longer.  If they do, they certainly aren't telling the rest of us.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: March 22 2006 at 8:27pm
In my opinion the data just discovered about the virus just makes an observation about it's properties. I does not in any way imply whether this new knowlegde makes it more or less likely that  a pandemic will occur, nor does is any way influence future mutations or recombinations. But the media makes it sound like it makes more difficult to infect humans, because that's what people want to hear.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: March 22 2006 at 9:40pm

WHO urges countries to step up preparations for feared human flu pandemic

AFP

Thursday, March 23, 2006

GENEVA, Switzerland (AFP) - Governments must step up preparations for a feared human flu pandemic which could be launched by a deadly strain of avian influenza, the head of the United Nations (UN) health agency warned yesterday.

"We urge and plead to countries to be prepared," said Dr Lee Jong-wook, director general of the World Health Organisation (WHO).

"Clearly, about 50 countries have concrete plans. All others are scrambling to have a plan. Others claim they have a plan, which is not perfect," Lee told reporters. "We have to take advantage of this window of opportunity," he said.


http://www.jamaicaobserver.com/news/html/20060322T210000-0500_101146_OBS_WHO_URGES_COUNTRIES_TO_STEP_UP_PREPARATIONS_FOR_FEARED_HUMAN_FLU_PANDEMIC_.asp
    

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: March 22 2006 at 11:17pm
WHO is making me dizzy.

"The End Is Com... No Don't Panic, Everthing is.... Oh, Ah.. ."

Now what has happened to make Dr. Lee Jong-wook suddenly feel the need to plead with countries to be prepared? We couldn't get any response from WHO just a few days ago.

(There is an enormous raccoon just outside our front door-  right by my desk. He's moving our heavy, metal cat food dish back and forth across the deck. I think he's unhappy that the dish is empty.)

This experience with Who (and soon with our fed & state gov I'm sure) is just like a appointment with a medical specialist who may or may not be telling you everything about the medical condition that you may or may not have.

You're left driving home saying "What did it mean when he said 'Good Morning' in that tone of voice."

It's not good in the practice of medicine on a small scale or planet wide scale.


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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: March 23 2006 at 4:32am
    (excerpt)

Washington Post
Thursday, March 23, 2006

Human viruses attached to the upper airways, while avian viruses attached to cells deep in the lungs.

"In mice, however, the pattern was reversed. H5N1 attached best to cells in the windpipe, not the lung -- suggesting mice are not the best animal model for research on this strain of virus.

In many of the fatal H5N1 infections, people's lungs were filled with fluid, the result of an out-of-control inflammatory reaction. Kuiken speculated that bird flu's affinity for macrophages -- which can release inflammatory chemicals -- may be part of the reason.


"If I were a clinician, I would like to understand how the virus worked," he said.


http://www.sfgate.com/cgi-bin/article.cgi?file=/c/a/2006/03/23/MNGSDHSJSM1.DTL
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: March 23 2006 at 4:48am


S227N H5N1 In Human Upper and Lower Respiratory Tract

Recombinomics Commentary (excerpt)
March 22, 2006

"In Turkey, the S227N was on a Qinghai strain background, which is different than both the Vietnam or Hong Kong strains used in the lab experiments.

However, the size of the cluster in Turkey suggests that H5N1 was more efficiently transmitted human-to-human, which would be consistent ..."



http://www.recombinomics.com/News/03220602/H5N1_S227N_Upper_Lower.html



    
    
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: March 23 2006 at 5:03am


MARCH 23/2006 - WRIC TV

"Concerns over the Avian Flu and how to fight it are being brought here to Richmond today. About 900 government and health officials from around the state will gather this morning for a summit at the Richmond Convention Center. They will discuss how to prepare for a possible bird flu pandemic."

http://www.wric.com/Global/story.asp?S=4671197
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Post Options Post Options   Thanks (0) Thanks(0)   Quote 7Strong Quote  Post ReplyReply Direct Link To This Post Posted: March 23 2006 at 5:46am

I just have an opinion that I want to throw out there..... 

So with this new information that we have about the virus, do you think it may be a reason there are so many false negatives??  Don't they do throat swabs for the initial tests?  Also if they don't go on to do additional blood tests, wouldn't it also lead to the possibility that there really are more people that are surviving this?  Just wondering what you guys think...
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Post Options Post Options   Thanks (0) Thanks(0)   Quote niman Quote  Post ReplyReply Direct Link To This Post Posted: March 23 2006 at 5:59am
Actually Recombinomics predicted the S227N chnage in October of last year
 
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