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Old 12 March 2020, 11:30 PM   #1681
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Carnival Corporation Suspends Operation of Princess Cruises for 2 Months Over Coronavirus

https://www.nbcmiami.com/news/local/...virus/2204376/
The economic consequences and the ripples will be immense. And my heart goes out to those who's finances will be harmed. But I do not see how they have a choice. In my opinion it was the right decision.
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Old 12 March 2020, 11:31 PM   #1682
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Old 12 March 2020, 11:32 PM   #1683
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The economic consequences and the ripples will be immense. And my heart goes out to those who's finances will be harmed. But I do not see how they have a choice. In my opinion it was the right decision.
Agreed. The writing is on the wall right now regardless of what people's opinions are on this issue. There will be an economic effect no matter what, so it's best to limit risk and give the impression that your customers matter more than your profits. Lots of pain now or potentially more pain down the road.
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Old 12 March 2020, 11:38 PM   #1684
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I have a question for those more knowledgeable (which is most of you )

How do we determine the difference between a cold and Coronavirus assuming itís mild

Lots of seasonal things around at the moment, seems a grey area.

I guess you can assess your likely risk level but even coming in to contact with one person could be enough?!


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Old 12 March 2020, 11:38 PM   #1685
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The economic consequences and the ripples will be immense. And my heart goes out to those who's finances will be harmed. But I do not see how they have a choice. In my opinion it was the right decision.
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Agreed. The writing is on the wall right now regardless of what people's opinions are on this issue. There will be an economic effect no matter what, so it's best to limit risk and give the impression that your customers matter more than your profits. Lots of pain now or potentially more pain down the road.
Completely agree, there are hot opinions on both sides of the issue

It is not a matter of if a person is sick, if a person gets sick, how bad they are sick or if a person was sick . . .

The economic impact is far ahead of all of that. Saying a person wont get sick ignores the larger issue
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Old 12 March 2020, 11:39 PM   #1686
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Agreed. The writing is on the wall right now regardless of what people's opinions are on this issue. There will be an economic effect no matter what, so it's best to limit risk and give the impression that your customers matter more than your profits. Lots of pain now or potentially more pain down the road.
Agreed.
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Old 12 March 2020, 11:43 PM   #1687
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Yea already discussed in the business news and without polluting the thread there is one very good reason why the UK was left open, to protect certain business interests
Ahh, thank you Brian.
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Old 12 March 2020, 11:44 PM   #1688
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I have a question for those more knowledgeable (which is most of you )

How do we determine the difference between a cold and Coronavirus assuming itís mild

Lots of seasonal things around at the moment, seems a grey area.

I guess you can assess your likely risk level but even coming in to contact with one person could be enough?!


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One of the best differentiators is runny nose and coughing up phlegm. This indicates a common cold, and nasal inflammation is very uncommon as an isolated symptom of COVID-19. On the contrary, COVID-19 will present with fever, malaise (feeling like crap), dry cough. Shortness of breath follows. Severity depends on age and luck of the draw.

Something that isn't making the rounds. "Mild" COVID-19 just means you don't need oxygen support. But it still encompasses a broad range of symptoms ranging from barely anything to fever, cough, weakness, difficulty breathing and could keep you bed-bound for days.

Another thing not making the rounds as much. There is permanent lung damage in survivors that is likely proportional to the severity of symptoms experienced during the acute phase. Permanent scarring and distortion of the architecture of the lung tissue and small airways. This has the potential to leave a lot of people somewhat disabled across the world even when they survive.
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Old 12 March 2020, 11:47 PM   #1689
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Completely agree, there are hot opinions on both sides of the issue
Yes. And the caustic voices are not productive. Regardless of their persuasion.

I note that this thread is one of the few places that people can discuss this thoughtfully. And at least for me, this forum has been good for my mental outlook.

A sincere thanks to the mods for making this venue for civil discussion possible.
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Old 12 March 2020, 11:48 PM   #1690
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Carnival Corporation Suspends Operation of Princess Cruises for 2 Months Over Coronavirus

https://www.nbcmiami.com/news/local/...virus/2204376/


Yes, once Fauci said donít get on a cruise ship in congressional hearing, I donít see any of them operating - just a nail in their risk profile.


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Old 13 March 2020, 12:08 AM   #1691
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the Coronavirus outbreak thread

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Another thing not making the rounds as much. There is permanent lung damage in survivors that is likely proportional to the severity of symptoms experienced during the acute phase. Permanent scarring and distortion of the architecture of the lung tissue and small airways. This has the potential to leave a lot of people somewhat disabled across the world even when they survive.

In my review of the medical info to date, this particular finding wasnít present. I did find impacts to those contracting pneumonia. There are unique markings in the lungs during the progress of COVID-19. But nothing about permanence. For example: https://inside.mountsinai.org/blog/p...w-study-finds/

Anytime one contracts pneumonia, there might be some scarring of the lungs. But that isnít unique to COVID-19.

Could you provide the citations where you found unique COVID-19 histories supporting your info?




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Old 13 March 2020, 12:14 AM   #1692
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Yes. And the caustic voices are not productive. Regardless of their persuasion.

I note that this thread is one of the few places that people can discuss this thoughtfully. And at least for me, this forum has been good for my mental outlook.

A sincere thanks to the mods for making this venue for civil discussion possible.
I agree this has been an interesting thread. It's good not only to hear reasoned arguments and share links, but to get a gauge on what people think out there.

The endless media hype is becoming a little tiresome, and in the US a least, somewhat suspicious. Its good to see level heads prevail.
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Old 13 March 2020, 12:18 AM   #1693
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Old 13 March 2020, 12:19 AM   #1694
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Yes, once Fauci said donít get on a cruise ship in congressional hearing, I donít see any of them operating - just a nail in their risk profile.


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Just hit the news. First two cases in the county where my office is located. Both just came back from a cruise. Health officials are now trying to track.
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Old 13 March 2020, 12:34 AM   #1695
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One of the best differentiators is runny nose and coughing up phlegm. This indicates a common cold, and nasal inflammation is very uncommon as an isolated symptom of COVID-19. On the contrary, COVID-19 will present with fever, malaise (feeling like crap), dry cough. Shortness of breath follows. Severity depends on age and luck of the draw.



Something that isn't making the rounds. "Mild" COVID-19 just means you don't need oxygen support. But it still encompasses a broad range of symptoms ranging from barely anything to fever, cough, weakness, difficulty breathing and could keep you bed-bound for days.



Another thing not making the rounds as much. There is permanent lung damage in survivors that is likely proportional to the severity of symptoms experienced during the acute phase. Permanent scarring and distortion of the architecture of the lung tissue and small airways. This has the potential to leave a lot of people somewhat disabled across the world even when they survive.


Thank you


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Old 13 March 2020, 12:37 AM   #1696
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In my review of the medical info to date, this particular finding wasnít present. I did find impacts to those contracting pneumonia. There are unique markings in the lungs during the progress of COVID-19. But nothing about permanence. For example: https://inside.mountsinai.org/blog/p...w-study-finds/

Anytime one contracts pneumonia, there might be some scarring of the lungs. But that isnít unique to COVID-19.

Could you provide the citations where you found unique COVID-19 histories supporting your info?




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Of course Paul. Here is a link to an article out of China, published in one of the respected journals for practicing radiologists in the US.

https://www.ajronline.org/doi/full/10.2214/AJR.20.22975

"Fibrotic streaks indicated local inflammatory absorption and residual fibrosis, and bronchus distortion suggested that the local inflammation absorbed and retracted the bronchus inside or surrounded it. The pleura were often involved and were characterized by thickening and retraction resulting from the inflammatory reaction."

On imaging, community acquired bacterial pneumonia typically resolves to the point where there is little damage to the underlying supportive structures of the lung tissue and airways. Bacterial pneumonia will fill the alveoli, and the immune system reacts to this, kills the bacteria, and clears the debris. We see this all the time in healthy (and even unhealthy) lungs on follow-up radiographic and CT imaging.

COVID-19 can lead to changes in the interstitium that are usually chronic and fixed. It's probably the inflammatory immune response that causes this rather than the virus itself. We won't know the real extent of permanent lung injury and its clinical relevance for months, and we can't generalize findings from a small study to the world population. But I can say confidently that other diseases that cause lung fibrosis and findings in this study, whether idiopathic or environmental, leave chronic changes that do not heal.
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Old 13 March 2020, 12:39 AM   #1697
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My son-in-law, who is assistant hockey coach at Minnesota, told me today that he thinks the NCAA will cancel the season today. They are scheduled to play Penn State in a Big 10 semifinal game Saturday in an empty arena.
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Old 13 March 2020, 12:43 AM   #1698
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Another thing not making the rounds as much. There is permanent lung damage in survivors that is likely proportional to the severity of symptoms experienced during the acute phase. Permanent scarring and distortion of the architecture of the lung tissue and small airways. This has the potential to leave a lot of people somewhat disabled across the world even when they survive.
This is what concerns me greatly! I have read this too, and I just don't get those that are downplaying this as a bad cold, or seem unconcerned.
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Old 13 March 2020, 12:49 AM   #1699
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Of course Paul. Here is a link to an article out of China, published in one of the respected journals for practicing radiologists in the US.



https://www.ajronline.org/doi/full/10.2214/AJR.20.22975



"Fibrotic streaks indicated local inflammatory absorption and residual fibrosis, and bronchus distortion suggested that the local inflammation absorbed and retracted the bronchus inside or surrounded it. The pleura were often involved and were characterized by thickening and retraction resulting from the inflammatory reaction."



On imaging, community acquired bacterial pneumonia typically resolves to the point where there is little damage to the underlying supportive structures of the lung tissue and airways. Bacterial pneumonia will fill the alveoli, and the immune system reacts to this, kills the bacteria, and clears the debris. We see this all the time in healthy (and even unhealthy) lungs on follow-up radiographic and CT imaging.



COVID-19 can lead to changes in the interstitium that are usually chronic and fixed. It's probably the inflammatory immune response that causes this rather than the virus itself. We won't know the real extent of permanent lung injury and its clinical relevance for months, and we can't generalize findings from a small study to the world population. But I can say confidently that other diseases that cause lung fibrosis and findings in this study, whether idiopathic or environmental, leave chronic changes that do not heal.


Thanks much. That is the Chinese study that the Mt. Sinai radiologists reviewed in the earlier article I posted. This will help with rapid diagnosis via CT scan.

I agree with your conclusion that acute scarring from pneumonia can compromise a patientís lung capacity.

I misunderstood your earlier post - I thought you were saying a unique type of lung damage after COVID-19.

I do note that the new virus does migrate to lower respiratory structures with remarkable speed (like 2 days). This was also a key finding in A-type H1N1 back in 2009-10 timeline.

One must hope SARS-CoV-2 collapses like its predecessor. Isolation efforts can help with that while, at the same time, those efforts slow progress in community spread.


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Old 13 March 2020, 12:58 AM   #1700
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This is what concerns me greatly! I have read this too, and I just don't get those that are downplaying this as a bad cold, or seem unconcerned.


I think you are not alone in your concern. While this doesnít help mitigate your own experiences, the actual incidence of COVID-19 infection resulting in pneumonia is much lower than the number of cases you are hearing about.

Pre-existing immunodeficiency in the patient is a key factor in contracting pneumonia that causes the lung damage.

So for perhaps 80-90% of those who are COVID-19 positive - and in a healthy immunocompetent mode - the experience and symptoms will range from a normal seasonal flu to milder ones.

I think those calling it a cold are like anyone who confuses flu and colds.


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Old 13 March 2020, 01:00 AM   #1701
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Thanks much. That is the Chinese study that the Mt. Sinai radiologists reviewed in the earlier article I posted. This will help with rapid diagnosis via CT scan.

I agree with your conclusion that acute scarring from pneumonia can compromise a patientís lung capacity.

I misunderstood your earlier post - I thought you were saying a unique type of lung damage after COVID-19.

I do note that the new virus does migrate to lower respiratory structures with remarkable speed (like 2 days). This was also a key finding in A-type H1N1 back in 2009-10 timeline.

One must hope SARS-CoV-2 collapses like its predecessor. Isolation efforts can help with that while, at the same time, it slows progress in community spread.


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Glad I could provide some clarification. There are imaging features of COVID-19 that can give us a greater degree of confidence in a diagnosis, but they only gain specificity with time. Early on, less specific. It's a combination of morphology, distribution through the lungs, and change with time.

I think that social distancing will be our best defense. We cannot rely on China's numbers as predictive of our rate of spread unless we take measures similar to China, which of course will not happen. But I think that most western leaders are looking at Northern Italy as an example of what can happen in a democracy with a mobile way of life left unchecked. Even a voluntary partial shut-down of activities that encourage human to human contact will make a dramatic difference.
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Old 13 March 2020, 01:01 AM   #1702
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I’m not sure there’s enough data to reliably know what mild COVID-19 looks like. By definition the bulk of the known cases are not mild because most of them will have sought medical attention. It’s perfectly possible that a truly mild case of COVID-19 is clinically indistinguishable from the various other respiratory viruses doing the rounds.

Edited to add this case report describes a woman with the virus who reported symptoms typical of the kind of RTI we all get from time to time and barely give a second thought to:

https://wwwnc.cdc.gov/eid/article/26/6/20-0452_article

Slight cough, sore throat, runny nose, no fever, normal bloods, normal CXR and able to work during her illness.

She never had fever, shortness of breath, or sputum, and daily lung auscultation was clear, suggesting absence of pneumonia.

I see cases like the one described in the community pretty much every working day and at any point in my career up until now, they’d be getting sent home with no script, no tests and a large dose of reassurance.
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Old 13 March 2020, 01:03 AM   #1703
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I have a question for those more knowledgeable (which is most of you )

How do we determine the difference between a cold and Coronavirus assuming it’s mild

Lots of seasonal things around at the moment, seems a grey area.

I guess you can assess your likely risk level but even coming in to contact with one person could be enough?!


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Wet cough vs dry cough has been said as one of the things to pay attention to. Dry cough (sounding like whooping cough), should trigger a cautionary flag to get a swab test. Better to be safe. Hopefully there is some experts that can chime in on other signs. We also have found out this morning Keizer now has drive though swab so that’s a real blessing for folks here in the Bay Area that haven’t been able to get tested efficiently.
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Old 13 March 2020, 01:22 AM   #1704
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I have a question for the experts here. I am taking this very seriously and trying to be as responsible as I can. I am not particularly worried for myself as I am 41 and in good health but still I'd rather not contract this and put others (or perhaps even myself) in danger. I am fortunate enough to work from home 100% of the time so it is easy for me to essentially quarantine myself. One place I do go is a very lightly-attended gym. There's never more than a handful of people in there at a time and I do not frequently have personal interactions with anyone there. Since this all started I have been hyper-aware to wash my hands multiple times during my workouts and I never, ever touch my face. However, it is obviously an indoor environment and I've read you can get this simply by breathing the same air as someone else. A lot of breathing goes on in a gym.

Not trying to be overly reactionary here, but should I stop going? Other information - my wife at this point is still going to an office everyday and we have two kids under 10 that for now are still in school.
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Old 13 March 2020, 01:33 AM   #1705
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I have a question for the experts here. I am taking this very seriously and trying to be as responsible as I can. I am not particularly worried for myself as I am 41 and in good health but still I'd rather not contract this and put others (or perhaps even myself) in danger. I am fortunate enough to work from home 100% of the time so it is easy for me to essentially quarantine myself. One place I do go is a very lightly-attended gym. There's never more than a handful of people in there at a time and I do not frequently have personal interactions with anyone there. Since this all started I have been hyper-aware to wash my hands multiple times during my workouts and I never, ever touch my face. However, it is obviously an indoor environment and I've read you can get this simply by breathing the same air as someone else. A lot of breathing goes on in a gym.

Not trying to be overly reactionary here, but should I stop going? Other information - my wife at this point is still going to an office everyday and we have two kids under 10 that for now are still in school.
We're in similar situations. I also WFH 100% and have two kiddos in daycare while my wife works full-time in an office.

I'm 36, healthy and go to the gym frequently; I don't intend to stop. Until someone says "don't do that", I will continue to do what we do (including holding my son's birthday party this weekend, flying to Houston for a wedding next weekend, going to Daytona Beach the following weekend...).
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Old 13 March 2020, 01:36 AM   #1706
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I have a question for the experts here. I am taking this very seriously and trying to be as responsible as I can. I am not particularly worried for myself as I am 41 and in good health but still I'd rather not contract this and put others (or perhaps even myself) in danger. I am fortunate enough to work from home 100% of the time so it is easy for me to essentially quarantine myself. One place I do go is a very lightly-attended gym. There's never more than a handful of people in there at a time and I do not frequently have personal interactions with anyone there. Since this all started I have been hyper-aware to wash my hands multiple times during my workouts and I never, ever touch my face. However, it is obviously an indoor environment and I've read you can get this simply by breathing the same air as someone else. A lot of breathing goes on in a gym.

Not trying to be overly reactionary here, but should I stop going? Other information - my wife at this point is still going to an office everyday and we have two kids under 10 that for now are still in school.
Understand your concern, but I would caution you from taking the advice of any "experts" on the Internet. You will get a more qualified answer from your primary care physician and it will be based on someone who has knowledge of your health background.
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Old 13 March 2020, 02:01 AM   #1707
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I have a question for the experts here. I am taking this very seriously and trying to be as responsible as I can. I am not particularly worried for myself as I am 41 and in good health but still I'd rather not contract this and put others (or perhaps even myself) in danger. I am fortunate enough to work from home 100% of the time so it is easy for me to essentially quarantine myself. One place I do go is a very lightly-attended gym. There's never more than a handful of people in there at a time and I do not frequently have personal interactions with anyone there. Since this all started I have been hyper-aware to wash my hands multiple times during my workouts and I never, ever touch my face. However, it is obviously an indoor environment and I've read you can get this simply by breathing the same air as someone else. A lot of breathing goes on in a gym.

Not trying to be overly reactionary here, but should I stop going? Other information - my wife at this point is still going to an office everyday and we have two kids under 10 that for now are still in school.
Hard to say, but the incrementally increased risk of going to the gym with your habits is probably negligible. The higher risk has to do with the interactions your wife and kids will have with others. My wife and I made the decision to take our kids out of school for now and spoke with the principle regarding our decision. My wife stays at home, and I have the ability to mostly work from home if needed, which is fortunate.

On the other hand, maybe you can use this as leverage to install a home gym Unless you need the gym atmosphere to motivate of course.
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Old 13 March 2020, 02:02 AM   #1708
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Old 13 March 2020, 02:05 AM   #1709
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Does anyone know someone first hand with this virus? Had a conversation with them, and gotten first hand accounts of what the symptoms are like?
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Old 13 March 2020, 02:15 AM   #1710
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Does anyone know someone first hand with this virus? Had a conversation with them, and gotten first hand accounts of what the symptoms are like?
https://www.youtube.com/watch?v=G9oqvJ3iXGI
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