Category: 8. Health

The scanner works by using photos to measure fluid levels in the feet and ankles.

Jul 6, 2025

Enjoying a chocolate treat occasionally could actually provide some health benefits, with a study suggesting it may help in lowering “bad” cholesterol levels. Dark chocolate, when combined with another wholesome snack, could help bring down cholesterol levels.

The findings of research featured in the Journal of the American Heart Association indicate that eating dark chocolate along with almonds can result in reduced cholesterol levels in as little as four weeks. This particular pairing was found to specifically target low-density lipoprotein cholesterol (LDL), commonly referred to as the “bad” cholesterol.

While the human body needs a certain amount of cholesterol for optimal functioning, an overabundance of LDL can clog arteries and increase the risk of heart complications.

The study was led by Pennsylvania State University and Tufts University in Boston, involving 48 participants who were overweight or obese, aged between 30 to 70 years.

The aim was to investigate the effects of dark chocolate, cocoa, and almonds on coronary heart disease risk factors, which is one of the top causes of mortality worldwide. The study was conducted over several four-week dietary phases.

Initially, during the first month, the participants refrained from consuming any of the foods under investigation. In the subsequent four weeks, they began adding daily portions of 42.5 grams of almonds to their regular diet.

During the penultimate phase of their research, subjects were asked to eat 43 grams of dark chocolate coupled with 18 grams of cocoa powder. The ultimate trial incorporated a blend of all three snack varieties studied.

The research unveiled that eating almonds solo diminished LDL cholesterol by 7%; an identical effect was witnessed when almonds were teamed with dark chocolate. Moreover, the study indicated that sprinkling these chocolaty delights into an ordinary American diet, without upping overall calories, “may reduce the risk of coronary heart disease”.

The study authors said: “Our results demonstrate that consumption of almonds alone or combined with dark chocolate under controlled‐feeding conditions improves lipid profiles.”

Nevertheless, it is key to recognise that this doesn’t imply one can indulge in massive amounts of almonds and dark chocolate unchecked. It’s vital to exercise moderation due to the calorie-dense nature of these foods.

Penny Kris-Etherton, the lead researcher, made it clear: “It’s important to put this into context. The message is not that people should go out and eat a lot of chocolate and almonds to lower their low-density lipoprotein.

“People are allowed to have about 270 discretionary calories a day, and when foods like almonds, dark chocolate and cocoa are consumed together as a discretionary food, they confer health benefits unlike other discretionary foods such as frosted doughnuts.”

But for those considering swapping almonds for chocolate, Kris-Etherton advises caution. The research indicates that consuming dark chocolate and cocoa alone doesn’t significantly impact heart health.

“Chocolate doesn’t increase cholesterol levels, but it doesn’t decrease cholesterol levels either,” she clarified. However, cocoa beans are held in high regard for their potential health benefits, owing to their content of flavanols – plant-derived antioxidants.

Prior studies have associated these flavanols with cardiovascular perks, including improved flexibility of blood vessels and alleviated blood pressure. For those aiming to lower cholesterol, the NHS endorses a variety of approaches: trimming down on high-fat foods, increasing consumption of fruits, veggies, nuts, seeds, oily fish, olive oil and whole grains, engaging in more physical activity, ditching cigarettes, and reducing alcohol intake.

If you are concerned about your cholesterol levels, it is advisable to seek guidance from a doctor.

Parkinson’s disease is the second most common neurological condition after dementia, with over 150,000 people in Australia living with the condition.

The research team, led by Professor Kay Double from the Brain and Mind Centre, has spent more than a decade studying the biological mechanisms underpinning the condition, with the aim of finding new treatments to slow or stop its progression.

In 2017, the team published a paper in Acta Neuropathologica, identifying for the first time the presence of an abnormal form of a protein – called SOD1 – in the brains of patients diagnosed with Parkinson’s disease.

Normally, the SOD1 protein provides protective benefits to the brain but, in Parkinson’s patients, it becomes faulty, causing the protein to clump and damage brain cells.

The newest study by the same University of Sydney team, published in Acta Neuropathologica Communications,builds on this research. It found that targeting the faulty SOD1 protein with a drug treatment improved the motor function in mice bred to have Parkinson-like symptoms.

Professor Double said: “All the mice we treated saw a dramatic improvement in their motor skills which is a really promising sign it could be effective in treating people who have Parkinson disease too.

“We hoped that by treating this malfunctioning protein, we might be able to improve the Parkinson-like symptoms in the mice we were treating – but even we were astonished by the success of the intervention.”

Methodology

The study involved two groups of mice bred to have Parkinson-like symptoms. One group of mice was treated with a special copper supplement for three months, while the other received a placebo.

Throughout the study, the mice receiving the placebo saw a decline in their motor symptoms. The mice receiving the special copper supplement, however, did not develop movement problems.

Professor Double said: “The results were beyond our expectations and suggest, once further studies are carried out, this treatment approach could slow the progression of Parkinson’s disease in humans.”

What is Parkinson’s disease?

Parkinson’s disease is a degenerative neurological disorder in which dopamine-producing cells in the brain die, leading to a range of symptoms including tremors, muscle stiffness, slow movement and impaired balance.

At present there is no known cure and only limited treatments, although researchers hope understanding the causes of the disease will lead to improved treatments.

Professor Double said: “As our understanding of Parkinson’s disease grows, we are finding that there are many factors contributing to its development and progression in humans – and faulty forms of the SOD1 protein is likely one of them.

“Just as researchers found with HIV, Parkinson’s disease is a complex condition that likely requires multiple interventions. A single treatment may have a small effect when used alone but, when combined with other interventions, contributes to a significant overall improvement in health.”

The researchers’ next step is to identify the best approach to targeting the faulty SOD1 protein in a clinical trial, which could be the start of a new therapy to slow the development of Parkinson’s disease.

KARACHI: A new research study published in The Lancet Regional Health – Southeast Asia highlights the urgent need for a unified national cancer registry in Pakistan to improve cancer surveillance, policymaking and resource allocation.

Titled ‘Cancer Registries in Pakistan: A Scoping Review’, the study was co-authored by experts from the Aga Khan University (AKU), the University of Wisconsin and Shaukat Khanum Memorial Cancer Hospital.

According to these experts, Pakistan faces a substantial cancer burden, with an estimated 185,748 new cancer cases and over 118,631 cancer-related deaths recorded in 2022. Yet, the absence of a national cancer registry means that cancer data collection remains fragmented, inconsistent and incomplete, making it harder to plan and implement effective public health efforts.

“Cancer registries are crucial. They provide population-based data on cancer trends and treatment efficacy, and enable health authorities to monitor disease patterns, guide policymaking, and allocate resources to establish an effective national cancer control programme,” said Dr Zehra Fadoo, Chair of AKU’s department of oncology.

Year 2022 saw over 118,000 cancer-related deaths in country; lack of unified data hampers effective cancer control

The research study identifies 17 cancer registries in Pakistan, with wide variations in scope and geographical coverage. Currently, only 19 of Pakistan’s 129 cities contribute data to at least one registry.

Many registries face operational challenges, limited funding and inconsistent data collection methods. The study has identified strengths and weaknesses of different registries, providing information that can be used to plan for cancer data aggregation and future research studies.

“Building a national cancer registry isn’t something one institution can do alone,” explained Sehar Salim Virani, from AKU’s department of surgery and the University of Wisconsin.

“It will require coordinated action, government leadership, and institutional collaboration. This paper is a first step towards that goal. By mapping what exists, we can now move towards what is needed. It’s time to turn fragmented efforts into a unified national response.”

One of the registries profiled in the study is the Aga Khan University Cancer Registry (AKU-CR), a hospital-based registry established in 2009. AKU-CR has an inbuilt international coding manual that serves as the foundation for measuring the cancer burden at the Aga Khan University Hospital (AKUH) in Pakistan.

The purpose and goal of AKU-CR is to collect, maintain and disseminate the highest quality cancer data that will contribute towards cancer prevention and control — improving diagnoses, patient care, treatment, survival, quality of life and establishing a foundation for research.

So far, using the USA-based CNExT software, the registry has documented over 71,900 cases.

At AKUH, the clinical aspects of the cancer registry are overseen by the AKUH Cancer Committee with trained registrars, ensuring high standards in data quality and clinical relevance.

Pakistan has a National Action Plan for Non-Communicable Diseases, control and health promotion (NAP-NCD), which includes cancer prevention and control.

The Ministry of National Health Services Regulations and Coordination nominated the Pakistan Health Research Council (PHRC) as the focal point for cancer registry in Pakistan, and in 2020, a National Steering Committee was notified, with members from all major cancer registries and data centres. Despite these efforts, challenges remain in achieving complete, consistent and uniform data collection.

“Pakistan has long struggled with adopting national cancer registration,” noted Syed Nabeel Zafar from the department of surgery and the Carbone Cancer Center at the University of Wisconsin.

“With the rising incidence of cancers in Pakistan, a national cancer registry is essential to be able to address this growing problem. While this requires effort and resources, it is not very expensive, and would be very feasible to do in Pakistan,” he said.

Published in Dawn, July 6th, 2025

When it comes to gastrointestinal health, there’s often a focus on eating probiotic-packed foods. However, all of the other foods you eat—including proteins—can influence the composition of the bacteria in your gut microbiome, too. Some are more beneficial than others. Learn about our registered dietitians’ top picks for digestion-friendly protein and keep reading to find out how dietary protein influences your gut health.

1. Yogurt

Yogurt is a concentrated source of protein that comes with beneficial live cultures (aka probiotics), such as Lactobacillus acidophilus. When consumed regularly, dairy products like yogurt may support the bacterial balance in the gut by increasing Lactobacillus bacteria. Enjoy yogurt on its own, add it to smoothies, fruit parfaits or make frozen yogurt cake and frozen yogurt popsicles.

2. Fermented Cheese

Whether you love Cheddar, Swiss or Parmesan, these cheeses are a good source of protein, and aged cheeses in particular may contain probiotics. Shred these cheeses and add them to salads—like this Apple & Cheddar Side Salad with Mustard Vinaigrette—or a wrap, or add pieces of cheese to a Turkey Apple Cheddar Sandwich.

3. Fish

Fish—especially fatty fish like salmon, tuna, mackerel and sardines—are rich in omega-3 fatty acids. These healthy fats have anti-inflammatory properties and can benefit your microbiome by reducing inflammation in the digestive tract. Certain types of fish, such as salmon, also contain vitamin D, an essential nutrient that may influence the type of bacteria in the intestines, as well as protect intestinal lining from inflammation and injury. Kristen White, RDN, CLT, owner of Food Sensitivity Dietitian, says that fish is also generally easier to digest than red meat, which may be beneficial if you experience digestive issues. Check out our Healthy Fish Recipes for easy-to-prep meal ideas.

4. Poultry

Chicken and turkey are excellent sources of lean proteins. They contain amino acids such as glutamine and tryptophan, known to support a healthy microbiome. For example, tryptophan is metabolized by intestinal bacteria that may help make the intestinal lining strong and durable and reduce inflammation, says , Lina Begdache, Ph.D., RDN, a dietitian and assistant professor of Health and Wellness Studies at Binghamton University, State University of New York. In addition, poultry contains B vitamins that play a role in the production of butyrate, which also supports a healthy intestinal barrier.

5. Beans

Beans are a good source of fiber, an important nutrient that helps promote regular digestion and increase healthy bacteria in the GI tract. One cup of canned black beans provides about 17 grams of this important nutrient and 15 grams of protein. Beans are an excellent source of prebiotics, a nutrient that helps gut bacteria flourish, and research shows that eating more beans improves the growth of good bacteria in the GI tract. Check out all of our healthy bean recipes for inspiration.  

Protein and Gut Health

Research reveals that dietary protein may influence the makeup of the microbiome in the gastrointestinal tract, as well as how it functions. The theory is that not all dietary proteins get digested, and as undigested protein arrives in the colon, some bacteria may use the amino acids (building blocks of proteins) as an energy source, producing byproducts called metabolites. These metabolites may then play a role in metabolism and our immune system.

Are you going for plant- or animal-based protein? That makes a difference in this discussion. Animal proteins are complete proteins, meaning they provide all the essential amino acids in proportions needed for health, says White. These amino acids are crucial for a range of bodily functions, including tissue repair and immune system support.

“Animal proteins are generally well-tolerated and easily digested by most people. [Animal proteins] can be particularly beneficial for individuals with digestive issues or sensitivities, as they are less likely to cause gastrointestinal discomfort than some plant-based proteins,” White explains. 

Although animal proteins are complete, some plant-based and vegetarian proteins, like tofu and quinoa, are also complete proteins. You can still get all of the amino acids you need if eating primarily plant-based proteins, like beans and nuts, but it’s important to eat a wide variety of options to meet your needs. Animal proteins are easy to digest for most people, although many plant-based proteins provide other benefits, such as fiber and healthy fats. Eating a wide variety of protein options is recommended to provide a range of nutrients. 

Considerations When Choosing Protein 

• Change up your proteins: Eat a variety of animal- and plant-based proteins for balanced nutrition. Along with the animal proteins on this list, check out these plant-based foods that have more protein than an egg.
• Think about cooking methods: “How these proteins are prepared can significantly impact their effects on gut health,” says White. Both White and Begdache recommend cooking methods such as grilling, baking, poaching and steaming to retain more nutrients and support heart and overall health.
• Go for natural proteins over supplements: Protein powders and shakes have their place, and they can help you meet your protein needs. However, there’s a benefit to choosing food when you can, including a wider array of nutrients. 
• While protein may play a key role in gut health, Begdache advises not to consume protein foods in large amounts without sources of fiber-rich carbohydrates, like fruits, vegetables, whole grains or legumes.
• A high-protein, low-fiber diet may change the gut microbiome by altering the types of metabolites produced by intestinal bacteria. “The healthy microbes that live in the GI tract feed on undigested complex carbohydrates like fiber,” Begdache explains. “High-protein foods, [generally] tend to lack these complex fibers; therefore, their presence in the gut may change the composition of the gut microbiota into a less health-favorable one,” she says. Conversely, a high-fiber diet that includes complex carbohydrate foods may help protect the gut microbiome and reduce inflammation.
• Begdache also indicates that protein digestion in the stomach differs from one person to another. “People with low stomach acid or pancreatic problems may not digest proteins effectively. Consequently, the more undigested proteins enter the colon, the less advantageous these proteins are,” she adds.

Our Expert Take

What you eat—including protein choices—may influence the health and balance of your gut microbiome. Eating a wide variety of protein sources, particularly gut-healthy options like yogurt, fish, poultry, beans and fermented cheese, can help diversify and maintain the concentration of beneficial bacteria in the gut.

A recently published case report in the journal Neurocase describes an unusual and distressing psychiatric condition that developed in a 50-year-old woman shortly after a stroke. With no history of mental illness, she suddenly became consumed by the belief that her husband was unfaithful—an unshakable conviction that ultimately escalated into violence. Doctors diagnosed her with Othello syndrome, a rare form of psychosis involving delusional jealousy. The case sheds light on how specific types of brain damage can dramatically alter perception, emotion, and behavior.

Othello syndrome is a rare psychiatric disorder characterized by the fixed, false belief that a partner is being unfaithful. This belief persists despite clear evidence to the contrary. Named after the jealous protagonist in Shakespeare’s Othello, the condition is a form of delusional jealousy, a subset of psychotic disorders.

While jealousy is a common human emotion, it becomes pathological when it is based on no real evidence, dominates the person’s thoughts, and results in harmful behavior. Othello syndrome has been observed in people with psychiatric disorders, substance use problems, and some neurological conditions. In rare cases, it can emerge after a stroke, particularly when the stroke affects brain regions involved in judgment, emotional regulation, and attention.

The woman described in the case report had lived a stable life with her husband for over 30 years. She had no history of psychiatric illness, substance abuse, or previous strokes. The only known health issue was hypertension, which had not been adequately controlled. One day, while preparing a meal, she experienced a sudden, intense headache followed by confusion and memory problems. These symptoms led her to seek emergency medical care.

Magnetic resonance imaging revealed that she had experienced a rare type of stroke known as a bilateral paramedian thalamic infarct. This type of stroke is caused by a blockage in a unique artery known as the artery of Percheron. Instead of supplying only one side of the brain, this artery provides blood to both sides of a deep brain structure called the thalamus. In her case, the damage was more pronounced on the right side. The thalamus plays a key role in regulating attention, emotion, and the integration of sensory and cognitive information. When this area is damaged, it can have far-reaching effects on a person’s behavior and personality.

During her hospital stay, the woman was sometimes agitated, experienced visual hallucinations, and had trouble moving her eyes vertically—symptoms consistent with damage to the thalamus. After about two weeks, she was discharged from the hospital. Only a few days later, she began accusing her younger sister of having an affair with her husband. The accusations came out of nowhere, as her sister had only come to visit after the hospital stay. The woman told friends and family that her husband’s supposed infidelity was the cause of her illness. Over time, her suspicions shifted. She no longer accused her sister, but now believed her friend’s daughter was involved with her husband.

Her behavior became increasingly erratic. She would try to check her husband’s phone without his knowledge. She stayed up late watching him, sometimes waking him in the middle of the night to accuse him of cheating. These outbursts escalated into two separate violent incidents in which she attacked him with a bladed weapon. Although she later denied these attacks, her jealousy remained intense and unrelenting.

A psychiatric evaluation revealed signs of cognitive decline, such as impaired memory, reduced attention span, and a narrowed focus on her jealous suspicions. On two common cognitive screening tools—the Mini-Mental State Exam and the Montreal Cognitive Assessment—she scored well below the threshold for normal function. The clinicians ruled out other possible causes, such as dementia, drug intoxication, or metabolic disorders. The timing of her symptoms and brain imaging supported the conclusion that her psychiatric symptoms were linked to the stroke. Doctors diagnosed her with Othello syndrome stemming from her thalamic infarct.

She was initially treated with quetiapine, an antipsychotic medication, which appeared to improve her symptoms for a few months. But she relapsed, and her jealous beliefs returned with the same intensity. Her care team then switched her to another antipsychotic, olanzapine, which led to much greater improvement. Over the course of the following year, she continued to take the medication at a reduced dose, with no reappearance of symptoms. She eventually recognized that her past beliefs were false, and she no longer viewed her husband with suspicion.

Although this case is striking, it is not without precedent. Psychotic symptoms can emerge after a stroke, although they are far less common than anxiety or depression. Among people who develop post-stroke psychosis, delusional jealousy is one of the more frequently observed subtypes. The brain regions most commonly associated with these delusions include areas of the right hemisphere, particularly the frontal and parietal lobes, as well as the thalamus.

The thalamus acts as a central relay station in the brain. It connects with both cognitive regions, such as the prefrontal cortex, and emotional areas, such as the limbic system. Damage to the thalamus, particularly on the right side, can disrupt networks responsible for attention, self-monitoring, and emotional processing. This kind of disruption can impair judgment and heighten suspicious thoughts. In this case, the patient’s stroke likely disrupted the normal communication between brain regions responsible for interpreting social cues and regulating emotional responses, paving the way for delusional jealousy.

The researchers emphasized that the patient’s test results showed no signs of underlying dementia or small vessel disease. This helped rule out alternative explanations for her cognitive problems. Instead, the stroke itself appeared to be the primary cause of her psychiatric symptoms. The selective damage to her thalamus seemed to explain not only her delusional thinking but also her memory and attention problems.

This case also illustrates how Othello syndrome can pose a danger not only to mental well-being but to physical safety. The woman’s false beliefs led to violent behavior against a loved one. Because of the risks associated with this syndrome, recognizing the signs early and initiating treatment is essential.

At the same time, the authors of the study acknowledged the limitations of a single case. Case reports cannot establish how common a condition is or how often it is caused by a particular type of brain injury. Nor can they predict how other individuals might respond to the same treatment. Each brain injury is unique, and many factors influence how symptoms develop and change over time.

However, case studies remain a valuable part of medical science. They allow researchers and clinicians to document rare conditions, identify patterns, and generate hypotheses that can later be tested in larger studies. In particular, unusual cases like this one can help draw attention to the diverse ways that brain injury can manifest—not just as physical or cognitive disability, but also as profound changes in personality and behavior.

The study, “Jealousy’s stroke: Othello syndrome following a percheron artery infarct,” and Ghita Hjiej, Maha Abdellaoui, Hajar Khattab, Kamal Haddouali, Salma Bellakhdar, Bouchera El Moutawakil, Mohammed Abdoh Rafai, and Hicham El Otmani.

People often clock thousands of steps a day yet still wonder why the scale or their blood pressure hardly budges. A simple twist on walking, first tested in Japan, may be the missing ingredient.

This “Japanese walking” exercise methodology, called interval walking training (IWT), swaps steady strolling for bursts of brisk movement, then recovery‑paced steps.

Cardiometabolic researcher Kristian Karstoft of the University of Copenhagen’s Center for Healthy Aging has spent more than a decade tracking its effects.

Why pace changes matter

Most walkers cruise at one comfortable speed and never raise their heart rate high enough to stimulate deeper adaptations.

Switching between fast and slow bouts nudges the body to use oxygen more efficiently, a trait measured by VO2peak.

That oxygen boost drives down resting blood pressure and encourages muscles to burn more sugar for fuel. It also keeps a session feeling manageable because the recovery intervals prevent the distress that can accompany continuous hard effort.

Regular shifts in speed even appear to sharpen insulin action, regulating blood sugar swings that set the stage for diabetes.

Scientists call that improvement better glycemic control, a term describing how tightly the body keeps glucose within a healthy range.

How “Japanese walking” works

Japanese physiologists outline a straightforward walking recipe, alternating three minutes at roughly seventy percent of personal maximum effort with three minutes around forty percent. Completing five of these cycles takes about half an hour.

“Additionally, interval walking training is a great way to meet the recommended 150 minutes a week of moderate‑intensity aerobic activity,” noted Sarah F. Eby, the sports medicine specialist at Mass General Brigham and assistant professor at Harvard Medical School.

That schedule, performed on at least five days each week, fits neatly into current public‑health advice to accumulate one hundred fifty minutes of moderate exercise. 

A simple watch or phone app can cue the switches, though early Japanese volunteers used a waist‑worn beeper nicknamed JD Mate. Supportive shoes and a safe sidewalk are the only other requirements.

Proof in older adults

In a seminal five‑month experiment involving adults averaging sixty‑three years old, IWT raised VO2peak ten percent and drove systolic pressure down nine millimeters of mercury compared with either continuous walking or no exercise.

Knee strength climbed as much as seventeen percent, a critical buffer against falls. Body mass index dipped and fasting glucose improved within weeks, suggesting metabolic changes arrive quickly.

What surprised the investigators most was adherence. Ninety‑five percent of more than eight hundred participants kept the habit for the full study window.

Those who logged at least four sessions a week enjoyed the biggest gains, reinforcing the idea that consistency outranks intensity.

The pattern held over nearly two years, although adherence slipped for volunteers starting with higher waistlines.

Benefits of IWT Japanese walking

A Danish trial later pitted IWT against energy‑matched continuous walking in adults living with type 2 diabetes.

Only the interval group shrank abdominal fat and cut twenty‑four‑hour glucose fluctuations, despite similar caloric burn.

“Compared to energy‑expenditure and time‑duration matched continuous walking training, IWT is superior for improving physical fitness, body composition, and glycemic control in individuals with type 2 diabetes,” stated Karstoft.

Follow‑up mechanistic work pointed toward enhanced glucose effectiveness, meaning muscles absorbed sugar without extra insulin. 

Safety and sticking with it

Because walking remains fully aerobic, lactate rarely spikes and the risk of cardiac complications stays low. No serious adverse events surfaced across dozens of trials, even among recent joint‑replacement patients cleared by their surgeons.

Digital prompts can help sustain motivation once novelty fades. Yet data from a Danish smartphone roll‑out show that unsupervised users averaged only nine minutes of fast walking per week after a year, underscoring the value of social or clinical follow‑up.

Coaching, group strolls, or gamified leaderboards may lift engagement, particularly for people carrying extra weight.

Researchers are testing whether regular phone calls paired with step‑count feedback can duplicate laboratory adherence in the real world.

Getting started today

Consult your clinician if you have chronic conditions, then pick a flat route and set a timer for thirty minutes. Begin with one minute brisk, one minute relaxed for fifteen cycles, or even shorter bursts until comfort builds.

“Studies specifically looking at the benefits of interval walking training have found improved physical fitness, muscle strength, and glycemic control,” said Eby.

She advises ramping up gradually so each brisk interval still allows a short phrase before breath runs out.

Track sessions on a calendar; seeing streaks grow is strangely satisfying. Celebrate milestones such as a lower belt notch or an easier climb up the porch steps.

A final word for anyone who thinks walking is too gentle to matter, remember that pace, not mileage, drives adaptation.

The Japanese approach proves that swapping a few calm blocks for a confident stride can steer health markers in the right direction long before you break into a jog.

The study is published in Applied Physiology, Nutrition, and Metabolism.

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