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Biology of Aging Final Exam
Terms and concepts
108
Biology
Undergraduate 3
12/05/2007

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Term
Functions of the skeletal system include (5):
Definition

1.  Provide body support

2.  attachment for muscles (movement)

3.  Protection of internal structures (brain, spinal cord, chest and abdominal organs)

4.  Communication (ossicles)

5.  Mineral storage

6.  Blood cell production 

Term
What are osteocytes?
Definition
They are found in chmbers of bone
Term
What are Osteoblasts?
Definition
they form bone from calcium, magnesium, and phosphorous in blood.  Built up around a protein core allowing for flexibility.  Takes Ca+ out of circulation and builds up bones basically.  Once osteoblasts become trapped in the matrix they secrete, they become osteocytes.
Term
What are Osteoclasts?
Definition
They dissolve bone to maintain blood calcium levels and restructure.  This balance is influenced by hormones (estrogen, IGF-1, PTH), nutrients, and weight stress.  Activity of osteoclasts and osteoblasts is regulated by levels of Ca availability as well as signaling molecules in the cells.  These are the target of most new therapies.  Cuts down bone and puts Ca+ back into circulation.
Term
Spongy portion of bone is also known as what?  how is it helpful?
Definition
trabecular.  it allows dispersment of stress on bone.  Mineral deposit.
Term
Compact bone is also known as what?
Definition
Cortical; (dense) casing
Term
What is marrow?
Definition
the storehouse of Ca, P, and Mg.  Built around collagen cores and blood vessels.  The shaft of long bones are tubes filled with marrow.
Term
What happens to the osteoblasts and bone mass as a result of aging?
Definition
The osteoblasts slow their bone output leading to a net decrease in bone mass.  The shift begins in early adulthood, speeds up with loss of hormones. 
Term
Which type of bone is first affected in the aging process?
Definition
Trabecular (spongy) bone
Term
What happens to the cortical bone (compact) when aging?
Definition
Columns in cortical bone become poorly integrated, do not function as well together. 
Term
What happens with protein content with age?
Definition
Protein content of bone decreases with age leading to a more brittle bone.
Term
What is Osteoporosis? How many people are affected by it?  percentage of women?
Definition
The loss of bone and its density - more than 24 million are affected.  80% female.  Affects over 60% of females over the age of 60
Term
What is Type I Osteoporosis?
Definition
Postmenopausal - affects trabecular (spongy) bone more than cortical (compact) bone.  Affects women, thinning of the trabecular.
Term
What is Type II Osteoporosis?
Definition
Senile - affects cortical bone more than trabecular bone.  Affectrs women and men.
Term
Hip fracture and vertebral crush are injuries we see earlier in the aging process. why is this?
Definition
The upper part of the femur and vertebrae are mostly trabecular therefore these bones lose mass earlier and faster.
Term
________ promotes bone production and slows its loss
Definition
estrogen
Term

Postmenopausal hormone replacement therapy and diet also play a big role in ____ __________ and ___________.

 

Definition
bone production, degradation
Term
Calcium uptake depends on _______ _.
Definition
Vitamin D.  It is needed to make calcium binding protien for the intestine.  Vitamin D is made forom cholesterol via sun rays.
Term
Risk Factors for osteoporosis:
Definition

There is a genetic link to bone strength.  Excess protein, sodium, caffeine, alcohol, smoking, or excess fiber in diet (increases calcium excretion), sodas?

Weight bearing exercise slows calcium loss and can increase bone production.  Hip replacement - need to get back up on feet quickly - avoiding falls.

 

Term
What are Biphosphonates?
Definition
drugs to help to build bone.
Term
What do the joints do?
Definition
Allow movement within the rigid bone framework.  Slight movement in certain joints (ribs)
Term
Bones are held together with flexible forms of _________.
Definition
cartilage
Term
Movable joints are lubricated with _________ and cushioned with ________ fluid.
Definition
cartilage, synovial
Term
What is cartilage?
Definition
meshwork of collagen and proteoglycans.
Term
What are some things that happen to the ligaments/tendons, collagen, and joints due to aging?
Definition

1.  Collagen becomes cross-linked (less flexible) and shorter (range of motion) - minimized by stretching

2.  Reduction in blood supply to joints, including vertebrae.

3.  Vertebral disk degeneration or herniation

4.  Arthritis - inflammation of the joint. 

Term
What is Osteoarthritis?  What percentage of people are affected by it?  More in men or women?  What causes this disease?
Definition
Degenerative join disease which is a chronic/progressive disease due to injury, joint overuse, obesity may contribute.  Effects 75% of over 75 years old.  More in women.  In most elderly: In fingers, vertebra, hips, and knees, but few have symptoms degeneration of cartilage portion of joint.  When the cartilage can no longer cushion, the bones begin to degrade.  Also get generation of bone spurst or swellings.  Painful when in vertebra - treament - fused vertebrae.
Term
How can Osteoarthritis be prevented or helped?
Definition
Helped by weight loss, low-impact exercise, anti-inflammatory drugs (cos-2 inhibitors, NSAID's and Steroids), joint replacement.
Term

What is Rheumatoid Arthritis?  Who is more likely to get it men or women?  How many people have it?  

Definition
Inflammatory condition of appendages or back.  ~2.1 million people - about 1% of adults.  Can occur at any age.  Women affected 2x more than men.  Wrists, hands, ankles, feet.  Cause is unknown (possibly viral).  Autoimmune and pannus leads to pain in joints and hence loss in mobility ->more pain->loss in mobility.
Term
Treatment for Rheumatoid Arthritis:
Definition
Anti-inflammatory drugs, exercise.  Anti-inflammatory corticosteroids used for temporary relief in serious cases.  Side effects are general immunosuppressor, demineralization of bones, GI pathology, mood changes, skin frailty, fluid retention, weight gain, weakness, diabetes, cataracts, hypertension.  New therapy attacks B-cells to break this destructive cycle.
Term
What is Autoimmune?
Definition
Where joints come under attack by immune system and synovial fluid and cartilage are degraded, free radicals.
Term
What is Pannus?
Definition
Scar tissue in joints - calcification and fusion
Term
What is gout?
Definition
Build up of uric acid crystals - usually from eating to much meat or internal organs; uric acid build up due to protien breakdown.  Stay well hydrated.
Term
Functions of the Digestive system:
Definition
Sterilize, breakup, taste, digest, absorb food and absorb water and excrete unneeded materials and toxins and excess cholesterol
Term
The _____ make the food small so the digestive enzymes can effectively work.
Definition
teeth
Term
The ______ lubricates the upper GI tract so food can flow. What other two functions does it have?
Definition
saliva, produces enzymes to begin carbohydrate break down to simple sugars and produces bactericidal enzymes.
Term
The _________ takes food (chyme) to stomach by peristaltic movement.  ______ ______ moves food through the rest of the passage.
Definition
esophagus, smooth muscle
Term
List 4 things that the stomach does:
Definition

1.  acidifies food to continue digestion

2.  secretes pepsin to begin protein break down - to amino acids

3.  Stores food and doles it out to the intestine

4.  produces intrinsic factor to aid in vitamin B12 uptake. 

Term
The stomach produces _____ made up of sugars and proteins, to help prevent acid from eating through the stomach (ulcers)
Definition
mucus
Term
What is Intrinsic Factor?
Definition
A way of getting B12 out of the food and into the blood.
Term
The small intestine works with what 3 other organs in order to efficiently break down food and what are their specific jobs?
Definition

1.  Liver - forms the bile, detoxifies and stores toxin and rids bilirubin and detoxifies ammonia (urea).

2.  Pancreas - produces digestive enzymes (insuline and enzymes)

3.  gall bladder - stores bile between meals 

Term
What does bile do?
Definition
Bile are cholesterol products that break up fat masses (like bacon)
Term

Proteins are broken down into _____ ______.

Complex carbohydrates are broken down into _______________. 

Fats are broken down into ____ _____ and ______________. 

Definition

amino acids

monosaccharides

fattyacids and monoglycerides 

Term
The ______ of the lower small intestine absorbs the broken down food (100 sq. m surface).  Sugars, amino acids, vitamins, and salts flow through blood to the liver then to the rest of the body.
Definition
mucosa
Term
Lipids are packaged as ____________ (a lipoprotein similar to but different from LDL and HDL) which are transported to liver through lymph.
Definition
chylomicrons
Term
_______ and ____ must bind to special proteins to be absorbed.
Definition
Calcium and iron
Term
What does the large intestine (colon) specifically do?
Definition
It is shared with billions of bacteria, and it pulls water out of the stool.  Water absorption here controls fecal consistency.  Excess dehydration leads to constipation.  Fiber hodls moisture and fat helps loosen stool.
Term
The slower the transit time the _____ the dryer your stool will be.  The faster the transit time, the ______ your stool will be.
Definition
dryer, wetter
Term
What is about a normal transit time?
Definition
24 hours.
Term
_____ provides bulk and stimulates smooth muscle to movie the stool along faster.  Very important for a healthy stool.
Definition
FIBER yayy mr. hankey
Term
Name the 4 layers of the gastrointestinal lining (from inside-out):
Definition

Mucosa (epithelial) - contains glands that secrete digestive enzymes. Breaks down and is replaced regularly)

Submucosa - provides blood, nervous control and physical support to mucosa

Muscularis - muscles that keep things moving through

Serosa - provides covering, blood and nervous control. (helps reduce friction)

 

Term
Enzymes, acids, and bile are all secreted into the _____ of the GI system.  They are all mixed and moved to the next area by mucles
Definition
lumen
Term
Through the aging process, what happens to the entire lining of the digestive system?
Definition
it entirely thins with age.
Term
In the mouth, what happens with age?
Definition

Some loss of taste buds - many elderly like spicier foods. 

Decrease in saliva production - dehydration. 

Tooth decay/periodontal disease. 

Over half of of those over 65 years have no teeth.  More difficulty healing and more susceptible to infection.

Term
the epiglottis becomes ___ effective, leading to ________ in the lungs.
Definition
less, aspiration
Term
List some things that happen to the esophagus region when aging:
Definition

Poor motor function - uncoordinated movement of food to stomach peristalsis weaker and slower.

Esophageal rings and strictures may develop, blocking food passage.

Reflux - heart burn - sphincter can become damaged and not close well ulceration is a problem

Hiatial Hernias (stomach slipping up through the diaphragm) frequently occurs

GERD - Gastroesophogeal reflux disorder, chronic irritation, can lead to cancer. 

Term
Treatments for acid refux, what is the problem with using these treatments?
Definition

Antacids - neutralize acids

Acid channel blockers.

The problem is that if you block acid prodction, you will have problems breaking down the food you eat. 

Term
List some things that happen with the stomach through aging:
Definition

Wall thinning

Irritation from gastric acid (antacids: neutralizers, H+ production blockers), aspirin (Cox2 Inhibitors help), stress, caffeine, Helicobacter pylori bacteria.

Peptic Ulcers (hole in the lining)

Atrophic Gastritis - thinning, irritation, inflammation

Acute Gastritis - reduced acid -> infections and pain medications. 

Term
What happens to the pancreas, gall bladder, and the liver when aging?
Definition

-Gallstones - (mostly cholesterol) 55% of those over 80, requires minor surgery.

-Blockage of bile duct by gallstones can lead to pancreatitis and jaundice (inflammation of the liver

-Liver size and its enzyme production reduced (not big problem for most)

-less lipid digestion enzymes

-Pancreatic cancer - 4th most common cause of cancer deaths (5%), painful, correlated with smoking, high animal fats, nitrates, coffee, and diabetes. 

-Liver detoxifies alcohol but is also damaged in the process over years leads to Liver Cirrhosis (scarring) - 7th leading cause of death in the USA. 

 

Term
What is Diverticulum?
Definition
when the wall in the large intestine is pushed out due to low fiver in diet.
Term
Aging in the small intestine:
Definition

reduced absorption of key vitamins and minerals including: calcium, iron, zinc, and vitaimn A, D, K, B1, and B12.

Affecting skin, bone, clotting, healing, immune, rbc problems.

Small intestine ulcers (stress, caffeine)

Sometimes can become twisted. 

Term
Aging in the Large Intestine:
Definition

-Poor muscle function leads to longer transit time, drier stools (constipation), damage to mucosal lining.

-Constipation - result of poor liquid intake, longer transit time, inactivity, voluntary retention, low fiber, chronic laxative use.

-Diarrhea - food toxins, drugs, viruses

-Fecal incontinence - loss of sphincter control - surgery, injurty, diabetes, et al.

-Diverticulosis - (out pouches) from refined/processed diet (50% of over 70)

-Diverticulitis - inflammation of diverticula

-Inflammatory Bowel Disease - irritation of rectum

-Benign polyps - raised areas of cells inside colon (like raised moles)

-Colorectal cancer - (starting as benign polyps) easily (yet luckily) detected sphigmoidoscopy, colonoscopy, fecal analysis for blood.  2nd leading cancer in incidence, 3rd leading in fatalities.  Correlated with low fiber, high animal meats fats and sugars.

Hemorrhoids - varicose veins of the anus (itchy to painful) result from constipation and straining during defecation. 

Term
Nutrition refers to:
Definition
intake of foodstuffs
Term
Metabolism refers to:
Definition
biochemical reactions in body, breakdown and synthesis.
Term
What functions in the body to proteins serve? 
Definition
they serve as enzymes, structural, binding, and transport, motility.  Protein can also serve as a fuel
Term
The _______ and _____ _______ serve as first used stores for protein fuel.
Definition
muscles and blood albumin
Term
________ excretion in urine is an indication of muscle breakdown.
Definition
creatine, this type of protein breakdown appears to increase with age.
Term
Why is a high protein diet not recommended?
Definition
Because that increases urea in the blood that puts extra pressure on already stressed elderly kidneys.
Term
What functions do fats serve in our diet?
Definition
Energy storage, insulation, cell membrane, communication
Term
Circulation of lipids and cholesterol through the body:
Definition
Triacylglycerol, a storage lipid, that is circulating in LDL can be released in capillaries by lipoprotein lipase.  Cholesterol is distributed through body from the liver on LDL to tissues.  Cholesterol excess is returned to the liver on HDL.  Liver gets rid of excess cholesterol through bile into gut.  Blood and tissue lipid levels increase steadily with age until middle age then decrease.  Heart uses fat as its primary energy source
Term
What are carbohydrates used for?
Definition
they are used for cell structure, communication, and fuel.  For fuel, carbohydrates are broken down for ATP synthesis
Term
What is the purpose for water in your diet?
Definition
For metabolism, distribution, cleanser, cooling, lubrication, etc.  8 8 ounce glasses of water a day.
Term
Why should we take vitamins?
Definition
They are trace nutrients needed to aid in biochemical reactions and as antioxidants.  You need them when you are old and young.
Term
Why are minerals important?
Definition
They are important as electrolytes, oxygen transport, enzyme cofactors, signaling, structure.  Iron is retained in body, but lost during bleeding and accumulation in liver depleted in many elderly.
Term
Explain the importance of fiber in your diet:
Definition

Fiber loosens stools to aid in transport of excrement - protecting intestines from diverticulosis, constipation, appendicitis, hemorrhoids, colon cancer, hernias, varicose veins, gall stones.

Also provides bulk to diet to reduce calorie intake, also reduces fat, calcium, iron, magnesium and water absorption, flatulence. 

Term
What is malnutrition?
Definition
loss of bone, muscle, endurance, immune response, loss of cognitive function and cardiovascular dysfunction, anemia, obesity, liver cirrhosis, cancer.
Term
What is undernutrition?
Definition
(caloric restriction) has many benefits - some become malnourished though.
Term
Under weight?
Definition
due to disease or lack of interest in eating.  Leads to lack of energy and possible nutrient deficiencies.  Primarily in women.  Older women dont have anyone to eat with, therefore dont eat -> frailty
Term
Why is hypoglycemia?
Definition
Low blood sugar.  High sugar meals lead to sugar "high" then a sugar "low".  If you have problems switching from food sugar to stored sugar (fat) the hypoglycemia makes you tired, irritable, confused, even passed out.
Term
Explain what alcoholism is all about:
Definition
regular consumption of more than moderate levels of alcohol.  Due to body chemistry and/or depression, loneliness, anxiety, boredom.  Leads to severe nutrient deficiencies: protein, B vbitamins, vitamins D and A, folic acid, zinc, magnesium, calcium and direct toxicity from the alcohol - liver, brain, pancreas especially and accidental injurty and fatty deposits (beer gut), fatty heart.
Term
Explain the calorie aspect of drinking alcohol on a regular basis:
Definition

Alcohol can be used as a source of calories (and has been for several millennia).  These are empty calories, that is, few nutrients but many calories.  At high levels it is toxic (in-toxi-cated), mostly to liver, pancreas and brain.  Liver detoxifies alcohol but is also damaged in the process.  Over years leads to Liver Cirrhosis - 7th leading cause of death in the USA.  Scar (connective) tissue build up, blood supply blocked .

Pancreatitis, gallstones, hepatitis, toxic chemicals.  Brain tissue loss, leading to problems with all the things the brain does.  Drug interactions common.   

Term
What is obesity?
Definition
extreme body fat.  Body Mass Index of 30 or higher.  15% of Americans in 1980, 31% in 2000.  BMI 30-25 = overweight, higher accepted body fat for women.  Waist/hip ration >1.0 is also used as a quick measure.  % body fat is a more complicated but useful measure. 
Term
What can obesity lead to? How much does it cost America in health care?
Definition
Can cause diabetes, cardiovascular disease, aggravated arthritis pain.  Inactivity leads to bone and muscle atrophy, weakened immune system.  Obesity estimated to cost America $75 billion per year in health care 1/2 paid by taxpayers.  Our generation = the fatass generation
Term
fat in the _______ is the most susceptible to diabetes.
Definition
muscles
Term
What is diabetes?  What percentage are affected?
Definition
The inability to adequately take sugar out of the blood into cells.  Sugar does not cause diabetes unless it makes you fat.  Normally, high sugar in blood stimulates insulin production then the Insulin turns off glycogen release.  Then it turns on glucose uptkae and glycogen and lipid production.  Over 20% of those over 65 deal with this - 6 times the 1960 level (~12 million, another 5M dont know they have it 180,000 deaths per year).  High risk - obese, women, high muscle triglycerides (fat).  Genetic component: African-American, Hispanic, Native American. 
Term
Type I diabetes?
Definition
patients do not make the insulin that stimulates that uptake
Term
Type II diabetes?
Definition
patients do make insulin but their cells do not respond to it.  They are "insulin resistant"
Term
Symptoms of diabetes:
Definition
frequent urination/ thrist, weight loss, blurred vision, frequent infections, slow healing, "honey urine" can lead to glaucoma.  Causes problems in kidney, eye pressure, cataracts, peripheral nervous system, atherosclerosis, skin (even gangrene)
Term
Treatment for diabetes?
Definition
weight management (calories and exercise), diet management, drugs that stimulate insulin production, insulin sensitivity, starch breakdown, glucose release by liver.
Term
What is gout?
Definition
Build up of uric acid in blood.  The uric acid deposits as sharp (needle) crystals in joints and especially toes when blood levels get too high.  These crystals push against nerves causing great pain (anti-inflammatory).
Term
Causes of gout?
Definition
Genetic - nucleic acid metabolism is altered.  High protein or high fat diet.  Hydration and diet are important in treatment.
Term
What is Atherosclerosis related to?
Definition

High: saturated fat, high cholesterol, smoking

Low: folic acid, antioxidants, exercise 

Term
Increased and Decreased risks of cancer:
Definition

Increased risk: animal fat, red meats, salt, tobacco, white flour, etc.

Decreased risk: plant foods, fruits and vege's, whole grains, etc. 

Term
What are some changes in the male reproductive system as a result of aging?
Definition

Moderate reduction in testosterone level and increase in dihydroxy-testosterone (DHT).

Sperm production may diminish

Sperm ducts may narrow or be blocked preventing sperm flow

Increased voluntary control of orgasmic phase (prolonged) - good change

Declining intensity of ductal muscle contraction - less forceful ejaculation

Declining intensity of pleasureable snesation - not the lack thereof

Longer refractory phase (time before another erection possible) - may be several days 

Term
what is prostate enlargement?  what is the treatment for it?
Definition

(benign prostate hypertrophy) - most men, unknown cause but may result from increased binding of testosterone.  Places increased pressure on urinary system (frequent urination, overflow incontinence, blood in urine) may lead to impotence.  Detected early by "digital" exam.

Treatment - surgery (enlarge ureter), radiation if necessary. 

Term
Percentage affected by prostate cancer, risk factors:
Definition

36% of cancers in men, 3rd leading cause of death from cancer in old men 72 years old is average age of diagnosis.  Detected by prostate specific antigen analysis (unreliable)

Risk factors - obesity, lack of exercise 

Term
Who is testicular cancer more common among?
Definition
young men
Term
What is Impotence (erectile disfunction, ED)?  What causes it?  How can it be fixed?
Definition

inability to obtain/maintain erection.  Atherosclerosis and Fibrosis in the penis slows blood flow slowing or preventing erection and decreasing maximal firmness.  Incidence increases from about 10% at age 40 to 50% at age 80. 

Causes - neural or circulatory (ED a risk factor for heart attack) in nature.   Poor circulation - atherosclerosis, lack of exercise, overeating, diabetes, prostate enlargement.  Drug causes - anti-hypertensives, antihistamines.  Neural - psychological factors, anxiety, depression, dementia, etc.

Prostate surgery clips key nerves.

Drug causes - alcohol, antidepressants, tranquilizers, appetite suppressants, ulcer drugs, etc) "sexual side effects"

Intervention: Prosthetic devices (rigid rods, bands, vacuum, pumps)

Drugs: (injectable meds, Viagra, Cialis, Levitra)

Permanent fixes - Exercise Diet and the Goat Gland man. 

Term
Tell me about menopause, when is the onset?  what is actually happening during menopause?  What medications can you take to make it better?
Definition

Menopause is the cessation of menstruation for 1 year.  The onset is 45-55 years old, average age of 51.  Stage in life referred to as Pre- Peri- or Postmenopausal.  Associated with cessation of ovulation.  Hysterectomy causes eary menopause.

Postmenopausal decline in estrogen production leads to many changes

 

Term
What are the symptoms of menopause?
Definition

Symptoms:  Hot flashes (varying intensity and duration), Sleep disruption and Mood swings, Atrophy of Breast, Uterus, Vagina, Labia, sagging breasts.  Vagina becomes smaller, thinner and less elastic - more fragile.  Production of antibacterial compounds and lubricants diminishes, less acidic.  Increasing the risk of infection in vagina and nearby urethra/bladder.  Increasing the risk of injury during intercourse - commercial lubricants can help a lot.  Dryness can lead to itching.  Frequent sexual intercourse (male ED) and estrogen therapy can slow vaginal changes.  Uterine prolapse - organ attachments relax and uterus sags into vagina

Each of the intercourse phases takes longer - Excitement, Plateau, Orgasm, Resolution. 

Term
What is associated with the decline in estrogen production?
Definition
associated with increased bone loss and increased atherosclerosis.  Women are much more likely to die of their first heart attack and to suffer bone fracture.
Term
What are the positives and negatives of hormone replacement therapy (Estrogen/Progesterone)
Definition

Positives: Reduces hot flashes, vaginal dryness and itching, bone loss.  May improve brain function, and reudce Alzheimer's.

Negatives:  Significant increase in cancers of breast and uterus especially with progesterone.   

Term
___ may have fewer side effects than hormone replacement therapy, but it is less effective.
Definition
Soy
Term
Risk factors for Breast cancer: detections? treatment?
Definition

2nd leading casue of cancer death in women, 10% of women will get this.

Risk factors: Oral contraceptives (estrogen), estrogen replacement therapy, alcoholism, no children (breast feeding), high fat diet, inherited genes (BRCA1+2, HER2.

Detected early by breast self exam (lumps and enlargements), mammogram (x-ray)

Treatment: surgery (lumpectomy, mastectomy), chemotherapy, radiation 

Term
Risk factors for cervical cancer? Percentage affected?
Definition

occurs in about 2-3% of women by age 80.

Risk factors: Having sexual intercourse early after maturation, oral contraceptives, smoking, STDs 

Term
Endometrial (uterus lining) Cancer:
Definition
in about 2% of women by age 80.  Uterine fibroids are benign growts that are very common but can cause some problems with bleeding and pain.
Term
Ovarian Cancer:
Definition
occurs in about 2% of women by age 80. Epithelial tissue in ovaries.  More deadly (50% mortality), (frequently goes undetected until late stage) CA125 blood test has many false negatives, LPA blood test emerging.
Term
Not smoking increases longevity by __-__ years
Definition
13-14
Term
Smoking kills _______ per year in the USA.
Definition
440,000
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