Highlights work in Congress to improve quality of care for Alzheimer's patients

Cedar Falls, IA - Today, Congressman Bruce Braley (IA-01) gave a speech at the East Central Iowa Chapter of the National Alzheimer's Association breakfast.  Rep. Braley spoke on the importance of improving quality of care for Alzheimer's patients, and investing in Alzheimer's research and prevention efforts.

"I have seen the effects of Alzheimer's disease, and no family should have to go through the struggles of dealing with this deadly disease," said Rep. Braley. "The simple truth is that by investing in research, care and prevention now, Congress can save lives and save money in the long run.  I will keep fighting to find a cure for Alzheimer's, and to make sure that we're providing the best possible care to those who suffer from this disease."

Congressman Braley is the only member of the Iowa delegation who has cosponsored both H.R. 1897, the Alzheimer's Breakthrough Act, and H.R. 1386, the Health Outcomes, Planning, and Education (HOPE) for Alzheimer's Act.  These bills would expand the federal commitment to prevention and research efforts, and also ensure patients, families and doctors have better information on medical and non-medical services to treat the disease.

In 2010, Congressman Braley helped pass into law language that would identify and measure the best medical practices for treating and caring for individuals with Alzheimer's, and a bill to create a national strategic plan to address the disease.

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Attaluri, Heartland Center for Motility offer advanced GI treatment for the Quad Cities and surrounding areas 

Advanced GI Motility expertise and testing that was previously only available in large, teaching institutions is now available in the Quad Cities and surrounding areas. That's because Gastroenterology Consultants has opened the Heartland Center for Motility that enjoys the expertise and experience of Dr. Ashok Attaluri.

Dr. Attaluri joined the practice in July after several years of honing his training in the specialty at the University of Iowa. The highly published and educated expert in the arena of GI and Motility has now brought that expertise and knowledge to the Quad Cities.

About 20-30% of the U.S. population suffers from one or more of these Functional GI disorders:

Heartburn: Acid Reflux, Non-Acid reflux,  Dysphasia (difficulty swallowing), Non-Cardiac Chest pain, Gastroparesis (abnormal stomach emptying), Irritable Bowel Syndrome, Constipation, diarrhea, Fecal incontinence, Abdominal pain, bloating, gas, fullness, etc.

Often these conditions are the result of an acute GI problem that can be diagnosed and treated by a gastroenterologist using traditional methods such as colonoscopy, upper endoscopy and related tests. However, more often than you may think, the problem can be more complex and related to a much deeper issue such as:

  • Abnormal Motility:  Abnormality in the activity of the GI tract
  • Abnormal Sensation: Sensitivity in the nerves of the GI tract that can cause pain and discomfort
  • Brain-Gut Dysfunction: Disharmony in the way the brain and the GI system communicate

When one or more of these areas are not functioning correctly, patients need advanced testing and expertise.

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Law Expands Options for Schools in Stocking, Administering Epi-Pens

CHICAGO - August 15, 2011. Governor Pat Quinn today signed legislation to increase access to potentially life-saving medicine for children with severe allergies. House Bill 3294, the School Access to Emergency Epinephrine Act, allows schools to stock and utilize epinephrine auto-injectors (often known as 'epi-pens') in the case of life-threatening allergic reactions.

"When a child suffers a severe allergic reaction, every second counts," Governor Quinn said. "With food allergies on the rise, we take action to help children with dangerous allergies. This law allows our schools to be prepared and for school nurses to take the immediate action that could save a child's life."

Sponsored by Rep. Chris Nybo (R-Elmhurst) and Sen. Jeffrey Schoenberg (D-Evanston), the new law allows schools to keep a supply of emergency epinephrine auto-injectors for students. The supply can be used in an emergency if a child forgets their prescribed epi-pen, or when a severe reaction requires a second dose. In addition, the law allows school nurses to administer epi-pens to any child suspected of having an anaphylactic (life-threatening allergic) reaction, regardless of whether the child has been previously diagnosed with an allergy. The law also protects all school personnel from liability when an epi-pen is administered in good faith. It goes into effect immediately. 

A growing percentage of children in the United States are being diagnosed with food allergies. Recent studies suggest that one in 13 children are affected by food allergies. Nearly 40 percent of children with food allergies have a history of severe reaction, and 30 percent are allergic to multiple foods. The most common food allergen is peanuts, followed by milk and shellfish.

Under current law, students with severe allergies may carry their own personally-prescribed epi-pen at school and may allow specific school personnel to administer it in case of emergency. However, before House Bill 3294 was signed into law, schools were prohibited from administering epinephrine auto-injectors to children that had forgotten their epi-pens or to children that had never been diagnosed with a severe allergy. Schools were instead required to dial 911, potentially losing key moments during a life-threatening reaction.

A quarter of anaphylactic reactions amongst children involved individuals that had not been previously diagnosed with a severe allergy. Twenty-five percent of first-time reactions to peanuts or tree nuts among children occurred in a school setting. In instances of epi-pen administrations at schools, 20 percent involved students whose condition was unknown at the time.

"I keep an epi-pen with me because I have severe allergies," Sen. Schoenberg said. "Quite a few children have food allergies, and many have reactions at school if they are unknowingly exposed to an allergen that triggers an attack. Schools should be able to respond quickly and appropriately to increase the child's chance of survival in the case of a serious allergic reaction."

Symptoms of anaphylaxis include difficulty breathing due to swelling and/or spasm in the airways, loss of consciousness, and loss of heartbeat. Anaphylaxis results in the hospitalization of 300,000 children each year. According to the American Academy of Pediatrics, administering an epinephrine auto-injector is the best response to a child having an anaphylactic reaction.

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AMES, Iowa - As consumers check their refrigerators and freezers for recalled fresh and frozen ground turkey products, Iowa State University Extension and Outreach encourages following food safety best practices all the time.

"Food recalls and salmonella outbreaks certainly get people thinking more about food safety," said Catherine Strohbehn, an ISU Extension specialist and professor in hotel, restaurant and institution management. "However, Iowans should always be mindful about food safety when purchasing, storing, preparing and serving food. That's why Iowa State provides consumers, foodservice operators, students and educators with 24/7 access to research-based, unbiased information on food safety and quality at www.iowafoodsafety.org."

On Aug. 3, Cargill initiated a voluntary recall of approximately 36 million pounds of ground turkey products produced at its Springdale, Ark., plant, as reported on the Cargill News Center website. As of Aug. 4, the Centers for Disease Control and Prevention (CDC) reported that 78 people in 26 states had been confirmed with SalmonellaHeidelberg infections and that eating ground turkey was the likely source of this outbreak. One person from Iowa has been affected. CDC provides a summary of the situation at http://www.cdc.gov/salmonella/heidelberg/index.html.

"Symptoms of most salmonella infections are the usual of any foodborne illness ? diarrhea, fever and abdominal cramps manifesting eight to 72 hours after ingesting the contaminated food. Affected individuals also may experience chills, headaches and sustained vomiting. Many of these symptoms are similar to those experienced with the flu, so often people don't realize they have a foodborne illness," Strohbehn said. If symptoms persist, see a doctor.

Cargill has posted a list of recalled ground turkey products at http://www.cargill.com/news-center/news-releases/2011/NA3047807.jsp, Strohbehn noted. Consumers should return opened or unopened packages to the store where purchased for a full refund.

Strohbehn recommends the following general food safety best practices:

Cook foods thoroughly to recommended end point temperatures. For poultry, this is a minimum of 165 F. Use a meat thermometer rather than relying only on cooking times listed on the package, because oven temperature sensors will vary. Looking and touching are not good indicators of doneness ? only a calibrated thermometer can tell for sure.

Keep cold foods cold either by refrigeration (below 41 F) or by freezing. Put cold foods away after shopping first, rather than after canned goods. Don't leave potentially hazardous foods out at room temperature for more than two hours. In summer, don't leave these foods out for more than one hour.

Separate raw from cooked or ready-to-eat foods, and separate clean from soiled ? chefs use the term mise en place, or everything in its place. Be mindful of this concept when working in the kitchen.

Keep it clean. Keep hands clean and keep materials that contact food clean. Clean means washing and rinsing using cleaning cloths and brushes designated for food surfaces only. Consumers may wish to sanitize certain surfaces after cleaning, such as the cutting board. Use a ratio of 1 tablespoon of unscented bleach with 1 gallon of water and allow contact for at least 7 seconds. Let the product air dry.

More information is available from the ISU Extension Food Safety Project website, www.iowafoodsafety.org.

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(Kansas City, Kan., Aug. 9, 2011) - EPA has awarded the Iowa Department of Agriculture and Land Stewardship (IDALS) $30,000 to assist with outreach, education and implementation of the Clean Air Act's Risk Management Program. All fertilizer facilities that handle, process or store more than 10,000 pounds of anhydrous ammonia are subject to EPA's chemical safety requirements. There are approximately 700 agricultural retail anhydrous ammonia facilities in Iowa.

"This grant is designed to prevent releases and protect the health and safety of area residents, and enhance communications with local emergency responders and regulated facilities," said Karl Brooks, regional administrator. "IDALS is receiving this funding to conduct on-site audits, workshops and follow-up safety assessments at agricultural retail anhydrous ammonia facilities in Iowa."

Anhydrous ammonia is generally safe provided handling, storage and maintenance procedures are followed. However, it is toxic and can be a health hazard. Inhaling anhydrous ammonia can cause lung irritation and severe respiratory injuries.

EPA Region 7 receives more accidental release reports for ammonia than for any other chemical.  In addition to releases caused by transportation accidents, human error and equipment failure, a number of releases have been caused by anhydrous ammonia thefts. Anhydrous ammonia is a key ingredient in the illegal production of methamphetamine. When stolen, the toxic gas can be unintentionally released, causing injuries to emergency responders, law enforcement personnel, the public and the criminals themselves.

Retailers were first required to be in compliance with the Risk Management Program in 1999.  EPA then started facility inspections and enforcement of the program, which includes five components: hazard assessment system, management, accident prevention, emergency response and submittal of a risk management plan.

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New Laws Will Increase Coverage of Preventative Care, Patients' Right to Know

CHICAGO - August 9, 2011. Governor Pat Quinn today signed four new laws designed to improve the health of residents throughout Illinois. The new laws will: require insurance coverage of diabetes management education programs; improve dental care for children; increase education on the importance of preventative cardiovascular screenings; and allow patients to access a vast online database of information regarding Illinois' 46,565 physicians and surgeons.

"Preventative care is the key to staying healthy. Cardiovascular checkups, proper diabetes management and good dental health for our kids will save and improve lives by helping people prevent minor health issues from becoming emergencies," Governor Quinn said. "Another key to good health is a great doctor, which is why we're ensuring that all of the important information needed to select a physician is online and available 24 hours a day."

Governor Quinn today signed House Bill 2249, which requires insurance companies to cover education programs to help diabetics maintain their A1C levels within normal ranges. The A1C test measures how well diabetes is managed over time by calculating the percentage of hemoglobin that is coated with sugar. Patients with high A1C levels have poor blood sugar control, which raises the risk for complications. The A1C test has become the industry standard diagnostic test and is considered the most useful diagnostic tool available according to the American Diabetes Association. Sponsored by Rep. JoAnn Osmond (R-Antioch) and Sen. William Haine (D-Alton), this law goes into effect Jan. 1.

"This new legislation will add educational programs to diabetes self-management training to ensure that patients are receiving the full scope of information they need to manage their disease," said Rep. Hernandez, one of the bill's co-sponsors. "Managing the body's glucose levels, or A1C levels, is one more important way for those living with diabetes to reduce complications."

The Governor also took action today to improve access to dental care for low-income children. Effective immediately, Senate Bill 1948 requires the Illinois Department of Healthcare and Family Services (HFS) to work with the dental community to develop and promote "dental homes" for children covered under CHIP, All Kids and Medicaid programs. Under the dental home concept, dentists would collaborate to deliver comprehensive, coordinated and family-centered preventive and restorative oral health care services. The new law builds on a national campaign by the American Academy of Pediatric Dentistry to address the dental needs of children in Head Start programs by creating partnerships with dentists and relevant organizations. The law was sponsored by Sen. William Delgado (D-Chicago) and Rep. Elizabeth Hernandez (D-Cicero).

"This new law will help to address the issue of dental care for children who are part of the All Kids program or other state insurance program that cover our youth," stated Senator Delgado, Chairman of the Senate Public Health Committee.  "Currently, there are very few dentists available in some areas of the state and even fewer who accept patients under the state insurance system."

"Providing a dental home for children goes hand-in-hand with our efforts to promote preventive health care measures for children and families that keep them healthy, instead of just paying the bills after they get sick," HFS Director Julie Hamos said. "Our goal is to improve the oral health of children. Establishing a dental home will help assure that children receive comprehensive dental services - both ongoing preventive services and treatment, if needed."

House Bill 3039 requires insurers to provide annual information regarding the importance and value of early detection and proactive management of cardiovascular disease. According to the American Heart Association, heart disease is the number one killer of women in the United States. Heart attacks, stroke and other cardiovascular diseases kill more women than the next five causes of death combined. Minority women are especially impacted; nearly half of African American women (45 percent) have some form of cardiovascular disease, compared to 32 percent of white women. The new law was sponsored by Rep. Camille Lilly (D-Chicago) and Sen. Kimberly Lightford (D-Chicago) and takes effect immediately; doctors have 60 days to update their information.

"All too often we give more attention to uncommon causes of death and injury like plane crashes and tornadoes, than we do to the foremost cause of death and disability in our country: cardiovascular disease," said Lilly.  "This important legislation will help raise the public's level of awareness about cardiovascular disease and will encourage them to take preventive measures that will enable them to live a longer and healthier life."

House Bill 105, the Patients' Right to Know Act, requires the Illinois Department of Financial and Professional Regulation to make physician profiles available for public inspection, including an online database. The database will compile a wide range of information, including: years in practice, hospital privileges, educational information, disciplinary actions, Medicaid participation, journal articles and translation services offered. Sponsored by Rep. Mary Flowers (D-Chicago) and Sen. William Delgado (D-Chicago), the bill takes effect immediately.

"This is important information, and we wanted to make it as accessible and transparent as possible," Rep. Flowers said. "Today, you can do your banking online, take a virtual tour of a home, and it's important that we bring that technology to bear on one of the most important decisions you can make - who to choose as your doctor."

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WASHINGTON - Sen. Chuck Grassley today urged a key federal agency not to dilute a long-awaited transparency rule that would help disclose financial ties between medical researchers who receive billions of dollars in federal funding and the pharmaceutical industry.

"The public's business ought to be public," Grassley said.  "Transparency is a backstop against research that's compromised by doctors' self-interest, to the detriment of consumers.  Backsliding on transparency would undermine the good work done in recent years to shine a light on these financial relationships."

Grassley wrote to the Office of Management and Budget in response to a media report that the agency is proposing to weaken transparency rules proposed in May 2010 by the Department of Health and Human Services.  According to the article, the Office of Management and Budget is removing the requirement in the proposed rule for a publicly available website that would publish the outside financial interests of researchers funded by taxpayers. 

The Department of Health and Human Services includes the National Institutes of Health (NIH), which is the primary means of federal funding of medical research at universities and large medical centers.  The President's proposed budget for the National Institutes of Health for 2012 is $32 billion, with about 83 percent dedicated for research around the country.

In 2007, Grassley began looking into whether universities have disclosed their professors' outside financial interests and found several cases indicating that more transparency might be helpful, including:

--The chair of the Psychiatry Department at Emory University failed to report hundreds of thousands of dollars in payments from a pharmaceutical company while researching that same company's drugs with an NIH grant.  The Health and Human Services Office of the Inspector General is now investigating the matter.

--The chair of the Psychiatry Department at Stanford University received an NIH grant to study a drug while partially owning a company that was seeking Food and Drug Administration approval of said drug.  He was later removed from the grant.

--Three psychiatrists at Harvard University failed to report almost a million dollars each in outside income while heading up several NIH grants.  Harvard released a report on the matter, and a briefing has been scheduled with Grassley's office.

Also, the Inspector General for the Department of Health and Human Services concluded that the NIH doesn't adequately monitor its outside grants for conflicts of interest.

A law enacted last year through Grassley and Sen. Herb Kohl will require public disclosure of drug company and medical device manufacturer payments to doctors, starting in March 2013. 

The rule proposed for NIH grants would require the research institutions to determine potential conflicts of interest grant by grant, such as whether the doctor owns shares in a company that could cause bias in his or her federally funded research.  The details would have to be posted online for public access. The Office of Management and Budget is proposing to eliminate the online requirement, according to a media article. 

"If the online requirement is gone, it will be much harder for the public to see and use this information," Grassley said. "Without public scrutiny, we'd lose a valuable layer of oversight."

The text of Grassley's letter is available here.

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MILWAUKEE, WI - Traveling can be exciting and a chance to get away from the hustle of the real world, but it also can derail a person's healthy routines.  People may become relaxed with their nutrition selections or think that it's too much effort to exercise.  With numerous opportunities to travel - whether for business, family vacations, or weekend getaways - TOPS Club, Inc. (Take Off Pounds Sensibly), the nonprofit weight-loss support organization, along with the Produce for Better Health Foundation, shares hints to help stay on the wellness track, cut out calories, and feel satisfied.

Eat healthy on the move.
• Bring your own meal for the flight or car ride.  Homemade sandwiches and fresh fruit are a great option.  Not only will you be able to control what you eat, but you will also save time and money.
• Pick up prepackaged fruit and vegetables at the grocery store.  You can also buy peanut butter in a tube or small container to pair with fruit or granola bars.

Be smart with snacks.
• Have a sweet tooth?  Keep dried fruit, which provides disease-fighting antioxidants, handy for snacking instead of candy.  It can also be mixed with nuts and sunflower seeds to create trail mix.
• Pack peppers, celery, or carrots to snack on during a trip.  Resealable containers are perfect for dips, such as ranch dressing, peanut butter, or hummus.
• Frozen grapes make great bite-size snacks and are delicious with low-fat cheese.

Eat out without overdoing it.
• Do your research.  Check out your destination online and look at restaurant menus before the trip.  This will give you an opportunity to find places that serve healthy options.
• Practice eating small portions.  Bring half the meal home or share an entrée with a friend.  Consider choosing two appetizers instead of one entrée.

Give thought to your drinks.
• Switch from soda to low-fat milk, water, or tea with one sugar or a non-nutritive sweetener.
• Opt for tomato juice or vegetable juice on the plane.
• Out for coffee or a smoothie?  Order the smallest size available, request coffee with fat-free or low-fat milk, skip the whipped cream, ask that the smoothie be prepared without added sugar, and look at nutrition facts, if possible.

Watch portions sizes, but don't deprive yourself.
• Use the half-plate rule.  Make fruits and vegetables 50 percent of what you eat at every meal.
• Don't skip your favorite dessert or fried foods.  Eat smaller portions of these foods - just make it a treat, not a regular occurrence. 
• Don't cut out meals.  This may lead to eating too much later in the day.

TOPS Club Inc. (Take Off Pounds Sensibly), the original, nonprofit weight-loss support and wellness education organization, was established more than 63 years ago to champion weight-loss support and success.  Founded and headquartered in Milwaukee, Wisconsin, TOPS promotes successful, affordable weight management with a philosophy that combines healthy eating, regular exercise, wellness information, and support from others at weekly chapter meetings. TOPS has about 170,000 members in nearly 10,000 chapters throughout the United States and Canada.

Visitors are welcome to attend their first TOPS meeting free of charge. To find a local chapter, view www.tops.org or call (800) 932-8677.

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New Law Ensures Injured Student-Athletes Do Not Return to Play Without Medical Clearance and Increases Critical Head Injury Education

CHICAGO - JULY 28, 2011. Governor Pat Quinn today signed comprehensive legislation that will help protect Illinois' student-athletes from concussions and other brain injuries. The new law ensures that athletes who receive a concussion will not be allowed to return to play or practice until they are evaluated and receive written clearance from a licensed health professional. Additionally, the law ensures that student-athletes, their parents and their coaches are able to recognize the signs of a concussion.

"The desire to compete must never trump the safety of our student athletes," Governor Quinn said. "This new law will ensure that student-athletes, parents and coaches recognize the symptoms and understand the risks of concussions, so that they can prevent a more serious, lasting injury."

House Bill 200, sponsored by Illinois House Minority Leader Tom Cross (R-Oswego) and Sen. Kwame Raoul (D-Chicago), requires each school board in Illinois to adopt a concussion policy that complies with Illinois High School Association (IHSA) guidelines. Those guidelines prevent students who are removed from a game or practice due to a possible head injury from returning without being evaluated and cleared by a medical professional. 

The new law also requires all school boards in the state to partner with the IHSA to develop clear guidelines and materials to educate coaches, student athletes and their parents about concussions. In addition, the bill encourages park districts to educate about the dangers of concussions. 

"I am so thankful to the many groups, athletes and parents who came together to help this bill get to the point where it is being signed today by the Governor," said Rep. Cross. "We are hopeful that this new law will raise awareness for our youth in Illinois when it comes to these devastating and sometimes fatal head injuries."

"We have seen too many disturbing stories about the long-term negative impact of concussions," said Sen. Raoul. "From junior football to youth hockey, from girls' basketball or soccer to gymnastics, this new law will help make sure that young athletes are better protected from potentially life-altering head injuries."

CDC research indicates that sports are the second-leading cause of brain injury in young adults 15-24, and that more than 40 percent of high school athletes returned to play before fully recovering from a concussion. Former Chicago Bears guard Kurt Becker, a member of the 1985 championship team and proponent of the legislation, testified before an Illinois House of Representatives' committee on the effects of head injuries that can last a lifetime. Concussion, defined as a type of traumatic brain injury that interferes with normal function of the brain, creates long-term detrimental health effects that are especially harmful for teenagers.

House Bill 200 goes into effect immediately and has already begun to generate results. Chicago Public Schools has distributed concussion awareness materials to all CPS schools and begun to hold meetings with the IHSA to discuss next steps for implementation. 

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New Law Requires Equal Insurance Coverage for Oral Chemotherapy

CHICAGO - July 27, 2011. Governor Pat Quinn today signed legislation to ensure health insurance benefit equality between oral and injectable cancer drugs, allowing cancer patients more affordable treatment options and protecting them from significantly high out-of-pocket costs. House Bill 1825 requires private health insurance plans that provide coverage for oral and intravenous chemotherapy to cover both at the same benefit level.

"Patients battling cancer shouldn't have to forgo potentially life-savings treatments because of costs," Governor Quinn said. "This legislation will provide more affordable coverage options, so that patients can choose the best, most appropriate therapy to fight their cancer."

Historically, chemotherapy drugs have been primarily administered intravenously. Today, many types of chemotherapy can be taken via a liquid, tablet or capsule, a less invasive therapy alternative. Oral chemotherapy is the only appropriate treatment for certain types of cancer, and can also provide an alternative for patients who have trouble responding to other treatments.

Many healthcare benefit plans have not changed to ensure patient access to oral chemotherapy, resulting in some cancer patients facing higher out-of-pocket costs simply because their treatment is dispensed orally rather than intravenously.

The disparity in coverage for oral treatments is also a factor in deployment of "smart drugs" in cancer treatment. Traditional radiation and chemotherapy are effective in killing cancerous cells, but also kill many healthy cells, weakening a patient's immune system. Smart drugs are delivered orally and designed to navigate the bloodstream with precision to stop the growth of cancer cells, often avoiding damage to healthy cells. While these regimens are often more costly up front, they may be able to significantly decrease the amount of therapy time, increase positive outcomes and reduce longer-term costs associated with traditional intravenous treatments.

Illinois joins a number of states that have enacted cancer drug parity laws including Connecticut, Colorado, Indiana, Iowa, Hawaii, Kansas, Minnesota, Oregon, Vermont, the District of Columbia, and New Mexico. Medicare recipients also receive this benefit for identical oral and intravenous chemotherapy drugs.

Sponsored by Rep. Ann Williams (D-Chicago) and Sen. Heather Steans (D-Chicago), HB 1825 passed the General Assembly unanimously and takes effect Jan. 1.

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