Top PDF A REVIEW ON ETIOPATHOGENESIS OF TYPE 2 DIABETES MELLITUS

A REVIEW ON ETIOPATHOGENESIS OF TYPE 2 DIABETES MELLITUS

A REVIEW ON ETIOPATHOGENESIS OF TYPE 2 DIABETES MELLITUS

introduced sulphonylurea derivatives as oral hypoglycemic agents. In 1953, glomerulosis was detected as one of the manifestation of widespread microangiopathy. Presently is recognized as a syndrome characterized by insulin resistance, abnormal insulin secretion, derangement in carbohydrate and lipid metabolism, and is diagnosed by presence of hyperglycemia. The changes in carbohydrate and lipid metabolism are usually consequence of the disease. The altered lipid profile can lead to cardiovascular complications in DM is abundantly documented in literature. DM is a global problem and alarmingly its incidence is on rise in almost all pockets of the world. The estimated number of people in different region is given in table 1 (WHO 1980). Due to increasing obesity, sedentariness and dietary habits in both western and developing countries, the prevalence of T-2DM is growing at an exponential rate. Type-I DM is less common.
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Management of Type 2 Diabetes Mellitus by DPP-IV Inhibition – A Review

Management of Type 2 Diabetes Mellitus by DPP-IV Inhibition – A Review

Diabetes mellitus is one of the most prevalent chronic disorders worldwide. Type 2 diabetes mellitus (T2DM) involves multiple pathophysiological defects, accounting for nearly 85-95% of total reported cases of diabetes mellitus. Different classes of Oral Hypoglycemic Agents (OHA) are now available which target different pathophysiological factors leading to the management of T2DM; however, almost all of them are associated with one or the other kind of side effects. An alternative approach for the treatment of diabetes is based on targeting incretin hormone like Glucagon-like peptide-1(GLP-1). GLP-1 is an insulinotropic gut hormone which enhances meal induced, glucose-dependent insulin secretion (incretin effect) and restores glucose competency to the β -cells of pancreas including the delay of gastric emptying and suppression of appetite. However, the major limiting factor of GLP- 1 is its susceptibility to degradation by dipeptidyl peptidase IV (DPP-IV) enzyme. Also GLP-1 has a short plasma half-life of only 1-2 minutes. Inhibition of DPP-IV enhances the levels of endogenous active GLP-1 and prolongs its half-life, thereby becoming a requisite to identify DPP-IV inhibitors that can act as potential antidiabetic agents. In the wake of disadvantage due to the side effects caused by the synthetic drugs, natural sources of drugs like medicinal plants are in great demand all over the world. A large number of medicinal plants have been identified to have anti diabetic activity over the years. Few such plants have been identified to function as potential DPP IV inhibitors and are discussed in this review along with their synthetic counterparts.
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Combined Training in the Treatment of Type 2 Diabetes Mellitus: A Review

Combined Training in the Treatment of Type 2 Diabetes Mellitus: A Review

This study aimed to review combined training (CT) effects on HbA1c levels in patients with T2DM. Searches were conducted in PubMed via MEDLINE and Google Scholar. Of the 14 selected studies, 11 found reductions in HbA1c le- vels. The interventions that performed both aerobic and resistance training in the same sessions were highlighted. In aerobic training, the best results were in the interventions between 30 and 45 minutes per session, with intensities between 60 and 80% of maximal parameters. In resistance training, the inter- ventions with sets from 8 to 12 repetitions with intensities of 80% and 60% of 1RM respectively, or prescribed by maximal repetitions, were highlighted. We conclude that CT can result in better glycaemic control than AT and RT con- ducted alone.
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A REVIEW ON ANTIOXIDANTS AND OXIDATIVE STRESS IN TYPE-2 DIABETES MELLITUS

A REVIEW ON ANTIOXIDANTS AND OXIDATIVE STRESS IN TYPE-2 DIABETES MELLITUS

Thus the results of clinical trials on T-2DMpatients and for that matter in other diseases such as CVD cancer, aging etc can broadly be divided into four categories: I) beneficial effects II) no effects III) harmful effects and IV) increased mortality. A long drawn study of 23 yr follow up in a cohort in Finland consisting of 2285 men and 2019 women for 4 tocopherols, 4 tocotrienols, 6 carotenoids and ascorbic acid showed that dietary intake of these of antioxidants reduced the risk of T-2DM. Ascorbic acid (500 mg) slightly but non-significantly decreased the risk whereas beta-carotene had no effect. In their final conclusion, they said that neither of these nutrients had any positive or negative effect on the risk of the development of T-2DM. Therefore, despite all the loaded evidence for the involvement of reactive species in the diabetes, the debate continues on three points: a) is it selective in patients or present in all patients but not detectable by available methods, b) is it facultative, that is, it is capable of causing disease but does not necessarily do so in all patients and c) is it obligatory, that is, it universally participates in the genesis of diabetes. Antioxidants have so for not received putative pat in the medicine though FR involvement has lately been given recognition. We would only like to post a caution “Those who fail to read the history are destined to suffer from repetition of the mistakes”. We must therefore tread carefully with accuracy in future.
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Systemic Review: Sexual Dysfunction in Women with type 2 Diabetes Mellitus

Systemic Review: Sexual Dysfunction in Women with type 2 Diabetes Mellitus

dyspareunia. Apart from this, diabetes also has a detrimental impact on the cardiovascular system which leads to diabetic macroangiopathy and diabetic microangiopathy (Doumas et al., 2006; Owiredu et al., 2011). Diabetic macroangiopathy is commonly known to cause the incidence of coronary artery disease and hypertension, whereas diabetic microangiopathy may develop several years after the onset of the disease. In addition to this, hypertension can further aggravate the complications of microangiopathy and macroangiopathy. Thus, there is a great need to control hypertension, which will further lessen the rates of sexual dysfunction (Basson et al., 2000). According to World Health Organization sexual dysfunction refers to a condition in which an individual is not able to participate in sexual intercourse as he/she would wish (American Psychiatric Association, 2013). It is categorized by disorder in the psycho physiological alterationin the sexual cycle of women (Veronelli et al., 2009). Moreover, recently the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)updated a recent definition of sexual dysfunction. It has been grouped into two categories: sexual dysfunction has been put intodyspareunia,veganism and female sexual interest or arousal disorder have been put into the “Genito-pelvic pain/ penetration disorder” category (Khalilzadeh et al., 2015). In general, female sexual dysfunction can be evaluated based on the score of the Female Sexual Function Index (FSFI). A lower score is associated with sexual impairment in diabetic females. Moreover, at the meta-regression, only BMI was found to be significantly associated with the FSFI score. Increase frequency of sexual dysfunction and lower FSFI score in diabetic women are basically interrelated to her body weight. Many studies have already established that the increased prevalence of dysfunction is commonly linked to obesity (Esposito et al., 2005; Martelli et al., 2012; Enzlin et al., 2002; Mezones-Holguin et al., 2008) and metabolic syndrome (Konuru et al., 2017; Pontiroli et al., 2013).
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A REVIEW ON ETIOPATHOGENESIS AND MANAGEMENT OF MADHUMEHA (DIABETES MELLITUS) .......

A REVIEW ON ETIOPATHOGENESIS AND MANAGEMENT OF MADHUMEHA (DIABETES MELLITUS) .......

2.Dhatu Kshaya Janya Madhumeha Sam- prapti: The Kshaya of Gambhira and Sarab- huta Dhatus like Majja, Vasa, Oja and Lasika leads to Vata Prakopa. Vata Dosha gets vi- tiated leading to Ksharana of Sarabhuta Dha- tus through Mutra Pravriti in such a quantity that this Ksharana of Sarabhuta Dhatus itself acts as etiological factor again for Vata Pra- kopa, hence this vicious circle goes on. But due to Ashukaritva of Vata all the stages of Samprapti proceeds so fast that, it leads to Asadhya stage of the disease very quickly 16 3. Aprathikaritha Vatanubandita Madhume- ha Samprapti: This type of Madhumeha is actually not a separate entity but it is the fur- ther stage of Kaphaja or Pittaja Prameha due to Deerga Kalanubandha or this may be called as ignored stage of Prameha due to lack of proper treatment. Kaphaja and Pittaja Prame- ha which are present from quite longer period they do get Anubandha of Vata to chronicity i.e., they get converted into Vataja Prameha 17 4. Avarana Janya Madhumeha Samprapti: Here one sees that Nidana is same as that of Kaphaja Prameha but still the resulting dis- ease is Madhumeha. Guru, Snigdhadi Ahara, Avyayam, Adi Vihara etc. leads to provocation of Kapha and Pitta Dosha in turn increases in quantity of Meda and Mamsa. All these in- creased factors obstruct the Gati of Vata lead- ing to provocation of Vata and this withdraws Oja from the body and takes it towards Basti and leads to Madhumeha, which is Krichra Sadya for treatment.
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<p>Plasma Adipsin as a Biomarker and Its Implication in Type 2 Diabetes Mellitus</p>

<p>Plasma Adipsin as a Biomarker and Its Implication in Type 2 Diabetes Mellitus</p>

The diagnosis of DM has been varied from time to time. However, recurrent or persistent hyperglycemia is used to characterize DM. Different diagnostic parameters were used to assess patients with DM including, fasting plasma glucose (FPG), oral glucose tolerance test (OGTT) and Hemoglobin Alc (HgA1c). 16,17 However, these diag- nostic tools are associated with reduced sensitivity and/or speci fi city to detect diabetes in its early stage. 18 To over- come such problems different newer diagnostic methods were developed by targeting endogenous proteins such as Leptin, TNF-alpha, C-reactive protein (CRP), 19 Netrin, 20 Thioredoxin-interacting protein (TXNIP). 3 But, these novel methods have been also associated with increased cost. 21 Hence, the present review is used to assess the role of Adipsin as a novel diagnostic parameter and its impli- cation in T2DM.
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Alzheimer’s Disease and Type 2 Diabetes Mellitus: Risk Factors and Effectiveness of Antidiabetic Agents in Treatment of Alzheimer’s Disease

Alzheimer’s Disease and Type 2 Diabetes Mellitus: Risk Factors and Effectiveness of Antidiabetic Agents in Treatment of Alzheimer’s Disease

This review article provides the association of diabetes in the pathogenesis of AD. It highlights that management of vascular risk factors may be beneficial for preventing cognitive decline and dementia including Alzheimer’s disease in persons with type 2 DM. There is no definite consensus about the value of any type of diabetic treatment to prevent cognitive impairment in people with Type 2 DM. However recent data suggest that antidiabetic agents such as intranasal insulin, rosiglitazone (RSG), pioglitazone (PGZ), and metformin could have potential benefit to promote cognitive impairment in patients with AD. This knowledge may assist to motivate researchers to make greater efforts on potential new pharmacotherapy for AD patients.
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Measurement of Serum Magnesium in Type 2 Diabetes Mellitus

Measurement of Serum Magnesium in Type 2 Diabetes Mellitus

8. Velayutharaj A, Saraswathi R, Shivakumar R, Saha S, Niranjan G, Ramesh R, et al. Association of serum magnesium with glycemic control and insulin resistance in patients with type 2 diabetes mellitus. International Journal of Current Research and Review. 2016; 8(13):17. 9. Ramadass S, Basu S, Srinivasan A. SERUM magnesium levels as an indicator of status of Diabetes Mellitus type 2. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2015;9(1):42-5.

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Prediabetes and type 2 diabetes mellitus

Prediabetes and type 2 diabetes mellitus

Thorough systematic review of the published literature on exercise testing and training in patients with predia- betes and type 2 diabetes revealed no evidence of any PA-related deaths and a very low incidence of non–life- threatening adverse events. This seems to suggest that nonvigorous (mild to moderate) PA is relatively safe in these individuals, despite their increased baseline risk of microvascular and macrovascular conditions, including CVD, nephropathy, and retinopathy. However, probably because of the perceived risks of exercise in this population, most published randomized control research studies carefully screened out their “high- risk” participants and included only those patients with few comorbidities (and specifically excluded individuals with advanced CVD). Moreover, exercise was generally limited to either mild or moderate intensity, with close clinical supervision. These caveats must be considered when assessing the evidence on the risks of PA for this class of patients.
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The epidemiology of intransient TB-induced hyperglycaemia in previously undiagnosed diabetes mellitus 2 individuals: a protocol for a systematic review and meta-analysis

The epidemiology of intransient TB-induced hyperglycaemia in previously undiagnosed diabetes mellitus 2 individuals: a protocol for a systematic review and meta-analysis

Background: Diabetes mellitus (DM) is burgeoning as a global chronic health condition. Some studies suggest that tuberculosis (TB) can even cause diabetes in those not previously known to be diabetic, which as a corollary can add to the already heavy global DM burden. The World Health Organization (WHO) recommends screening for DM at the start of TB treatment; however, it remains to be elucidated which patients with TB-induced hyperglycaemia are at risk for developing DM and who would benefit from a more regular follow-up. This systematic review will aim to firstly synthesise literature on the irreversibility of TB-induced hyperglycaemia in individuals with previously undiagnosed type 2 diabetes mellitus and secondly to synthesise literature on risk factors for progression from TB- induced hyperglycaemia to overt DM in previously undiagnosed.
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Long-acting preparations of exenatide

Long-acting preparations of exenatide

Abstract: Exenatide has been widely used for the treatment of type 2 diabetes mellitus. However, its short plasma half-life of 2.4 hours has limited its clinical application. The exenatide products on the market, twice-daily Byetta™ and once-weekly Bydureon™ (both Amylin Pharmaceuticals, San Diego, CA, USA), are still not perfect. Many researchers have attempted to prolong the acting time of exenatide by preparing sustained-release dosage forms, modifying its structure, gene therapies, and other means. This review summarizes recent advances in long- acting exenatide preparations.
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Effects of Cognitive Functioning on Diabetes Self-Care in Adults with Type 2 Diabetes Mellitus

Effects of Cognitive Functioning on Diabetes Self-Care in Adults with Type 2 Diabetes Mellitus

Caro-Bautista and colleagues (2014) reviewed the first version of the SDSCA and found the measure to have good content validity, intermediate internal consistency, and poor criterion and test-retest reliability. As with the SMP-T2D, the poor criterion validity was due to limitations in A1C as “Gold Standard” comparison criterion measure (Schmitt et al., 2013). The revised version of the SDSCA was the only DSMB measure to meet all the criteria for recommended use in another review of DSMB measures (Eigenmann et al., 2009). Schmitt and colleagues reported a Cronbach alpha of .63 for the revised version of the SDSCA. The Cronbach alphas for two of the four diet items representing the general diet subscale, and for the exercise, blood glucose testing, and foot care domains ranged from .69 to .88. The two other diet items representing the specific diet subscale had a Cronbach alpha of .15 (Schmitt et al., 2013). As such, the current study only used the two general diet subscale items leading to a final scale of 10 items (8 core [smoking item also omitted] and 2 supplemental). Schmitt and colleagues also reported adequate test-retest reliability. In the present study the SDSCA produced five scores; there is no summary score for the SDSCA.
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ASSOCIATION OF OCT1 GENE POLYMORPHISM WITH GLYCEMIC STATUS AND SERUM METFORMIN LEVELS IN TYPE II DIABETES MELLITUS PATIENTS

ASSOCIATION OF OCT1 GENE POLYMORPHISM WITH GLYCEMIC STATUS AND SERUM METFORMIN LEVELS IN TYPE II DIABETES MELLITUS PATIENTS

(TaqMan SNP genotyping assay): Genomic DNA was extracted from peripheral blood leucocytes using the standard phenol–chloroform method, and the samples were stored at 4°C 31 . PCR primers were designed on the basis of published sequences of OCT1.The primer set(forward primer: 5’-GCCCTGC GGAGGAGCTGAACTATA-3’; reverse primer for: 5’-CCTGTCCCAGGAACTCCCATGTTAC-3’;was designed to amplify the portion of the SLC22A1 gene encoding the SNP. Master mix contained Taq polymerases, dNTP’s , MgCl 2 ,forward primer,

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Etiopathogenesis of type 1 diabetes mellitus: prognostic factors for the evolution of residual β cell function

Etiopathogenesis of type 1 diabetes mellitus: prognostic factors for the evolution of residual β cell function

tion to alleles HLADR4 and DR3. On the other hand, among four common DR2 haplotypes, observed in Cau- casians, DQA1*0102, DQB1*0602, DRB1*1501 are neg- atively associated with type 1 A diabetes and are related in less than 1% of the majority of populations studied, including Asians, Afro-Americans and Mexican-Ameri- cans. This protection seems to have a dominant effect, as the presence of DQB1*0602 protects from diabetes, with rare exceptions, even in the concomitance of alleles of the HLA system of high risk of the disease. In other ethnical groups, the susceptibility for type 1 A diabetes associated with the genes of the HLA system may involve other alle- les. Particularly in Brazil, the latest studies in populations of the Northeast [14] and Southeast [15] show higher fre- quency of antigens DRB1*03 and DRB1*04 in type 1 dia- betes than in normal controls. One of the genes related to the protection is DRB1*11 in both Brazilian populations studied [14,15].
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PIOGLITAZONE AND GLIMEPIRIDE- OVERVIEW

PIOGLITAZONE AND GLIMEPIRIDE- OVERVIEW

After oral administration, Glimepiride is completely (100%) absorbed from the GI tract. Studies with single oral doses in normal subjects and with multiple oral doses in patients with type 2 diabetes mellitus (NIDDM) have shown significant absorption of Glimepiride within 1 hour after administration and peak drug levels (C max ) at 2 to 3 hours. When Glimepiride was given with meals, the mean T max (time to reach C max) was slightly increased (12%) and the mean C max and AUC (area under the curve) were slightly decreased (8% and 9%, respectively). Distribution
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DIABETES MELLITUS, ITS COMPLICATIONS AND MANAGEMENT

DIABETES MELLITUS, ITS COMPLICATIONS AND MANAGEMENT

Residual ß-cell function is necessary for meglitinide analogues to be effective. Repaglinide is licensed as monotherapy in the treatment of patients with type 2 diabetes and may be used in combination with metformin when metformin alone is inadequate. The combination of metformin with repaglinide has been shown to be more effective than repaglinide or metformin monotherapy. It may also be used in combination with thiazolidinediones. It is licensed for use in patients between the ages of 18 and 75 years. It is usually given 15-30 min before meals at a starting dose of 0.5 mg and if a meal is missed, the dose of repaglinide should also be omitted. The maximum single dose is 4 mg with a total daily dose of 16 mg. Nateglinide also can be used in combination with metformin, but it is not yet licensed as monotherapy. Nateglinide should initially be given at a dose of 60 mg three times a day before meals; this can be increase to 120 mg thrice daily and thence to 180 mg thrice daily. Repaglinide and nateglinide should be used cautiously in patients with hepatic insufficiency. They are contraindicated in severe hepatic impairment, pregnancy and breastfeeding. The main adverse effect of meglitinide analogues is hypoglycaemia. Other adverse effects include GIT disturbances, hypersensitivity reactions including pruritus, rashes and urticaria [11]
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Macular choroidal thickness in pregnant women with type 1, type 2 and gestational diabetes mellitus measured by spectral-domain optical coherence tomography

Macular choroidal thickness in pregnant women with type 1, type 2 and gestational diabetes mellitus measured by spectral-domain optical coherence tomography

Patients and methods: This cross-sectional study included 144 eyes of 72 pregnant women in the third trimester divided into four groups: 27 non-diabetic pregnant women; 15 pregnant women with GDM; 16 with type 2 DM and 14 with type 1 DM. CT was measured using optical coherence tomography at ten different locations. We also analyzed possible confounding fac- tors, such as gestational age, glycosylated hemoglobin, time from DM diagnosis, hypertension and severity of diabetic retinopathy.

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Effectiveness of structured teaching programme on self management of type 2 diabetes mellitus among patients with type 2 diabetes mellitus.

Effectiveness of structured teaching programme on self management of type 2 diabetes mellitus among patients with type 2 diabetes mellitus.

India leads the world with largest number of diabetic patients. India is termed as “Diabetes capital of the world”. The rising incidence of diabetes mellitus and its complications are going to pose a grave health care burden on our country. Timely effective interventions or measures and screening tests for complications at the time of diagnosis becomes imperative not only for early detection, but also to prevent progression to end stage disease. Simple interventional strategies like “Eat less, Eat on time and Walk more” can go a long way in preventing these chronic disorders among present as well as in the future generations.
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Current progress in stem cell therapy for type 1 diabetes mellitus

Current progress in stem cell therapy for type 1 diabetes mellitus

skin fibroblasts of patients with T1DM (T1DM-specific iPSCs, DiPSCs). These DiPSCs resembled ESCs in the global gene expression profile and were capable of differ- entiating into pancreatic cell lineages, paving the path of generating T1DM SC-β cells and making autologous stem cell-derived pancreatic progeny transplantation for T1DM possible [32]. In 2015, Millman et al. confirmed that SC-β cells derived from DiPSCs functionally resem- bled adult islet β cells both in vivo and in vitro. GSIS tests showed that under high glucose stimulation (20 mM incubation for 30 min), T1DM and nondiabetic (ND) SC-β cells secreted 2.0 ± 0.4 and 1.9 ± 0.3 mIU of human insulin per 10 3 cells, respectively, and both of these cells functioned similarly to adult primary islets in a previous study. After transplantation into ND immu- nodeficient mice, the engraft function was evaluated by serum human insulin before and 30 min after an injec- tion of glucose. At the early time point (2 weeks after transplantation), most engrafts responded to glucose and released more insulin after glucose injection, and the ra- tio of insulin secretion after glucose stimulation aver- aged 1.4 and 1.5 for T1DM and ND SC-β cells, respectively. The effects of these engrafts on insulin se- cretion were observed for several months. Of note, com- pared to the early time point, after 12–16 weeks, the human insulin content increased approximately 1.5 times after glucose stimulation [33]. It should be ac- knowledged that diversities exist among T1DM patients, and a larger number of specific stem cell lines from T1DM need to be developed for future clinical use. Al- though DiPSCs are an alternative source for cell replace- ment therapy for diabetes, some T1DM-specific stem cell lines have shown low efficiency in generating PDX1 + pancreatic progenitors [34]. Evaluated by flow cytometry, the number of IPCs derived from ND iPSCs (25–50.5%) was comparable to that of the β cells found in human primary islets, whereas the number of IPCs differentiated from T1DM iPSC lines was much lower (15.9%) [35, 36]. Upon a strict differentiation protocol, pancreatic progen- itors derived from T1DM iPSCs showed lower expres- sion of PDX1 than ND iPSCs at a specific differentiation stage. Epigenetic changes resulting from dysmetabolism in T1DM might be responsible for the poor yield of β cells from T1DM iPSCs. Transient demethylation treat- ment of DE cells rescued the expression of PDX1 by inhibiting methyl group deposition on the cytosine resi- dues of DNA and led to the differentiation of DE cells into IPCs [36]. The effect of demethylation on IPC dif- ferentiation has been shown to promote pancreatic pro- genitor induction rather than DE induction [37].
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