apa psychology essay
Find 2 peer reviewed scholarly articles on brain trauma (or 1 article and 1 minimum 10 minute video). The articles must be written after 2015. The student is to cite each article in APA and write a brief summation of each article. They are also to write WHY they are interested in the articles they chose. 3-4 pages. Some topics could be Brain Trauma and MMA, Brain Trauma and Roller-skating, Brain Trauma and Boxing, Brain Trauma and Hockey, Brain Trauma and firearms, Brain Trauma treatment in South America etc.
You will write this project on the template. Make sure to sign and date the template on the 1st page. This project will be reviewed with safe assign to ensure that there is no plagiarism. Please upload this project to the dropbox. Any projects emailed to me will not be accepted. This project is worth 200 points.
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THIEME
Editorial 3
Interprofessional Research Team Approach Is the Key
to Traumatic Brain Injury Intervention
Ranabir Pal1,
1Department of Community Medicine, MGM Medical College and
Hospital, Kishanganj, Bihar, India
Address for correspondence
Ranabir Pal, MBBS (Hons.), MD,
PhD, DCH, MBA, MNAMS, MNASc,
Department of Community
Medicine, MGM Medical College
and Hospital, Kishanganj,
Bihar 855107, India
(e-mail: ranabirmon@yahoo.co.in).
DOI https://doi.org/
10.1055/s-0040-1701540
ISSN 0976-3147.
©2020 Association for Helping
Neurosurgical Sick People
The spectrum of traumatic brain injury (TBI) has been con-
sidered as global public health menace with important
impacts on cognition, emotional, and psychosocial health,
particularly in post-mild TBI. The “Position Paper: Recom-
mendations of the Colombian Consensus Committee for the
Management of Traumatic Brain Injury in Prehospital, Emer-
gency Department, Surgery, and Intensive Care (Beyond One
Option for Treatment of Traumatic Brain Injury, A Stratified
Protocol [BOOTStraP])” has depicted transparent roadmap.1
The burden of TBI is increasing in the low- and middle-in-
come countries (LMICs) parallel with the explosion of science
and technological inventions and discoveries, as work related
TBI is more than half of reported cases. Though one in five
TBI is reported as major injuries, more frequent victims are
from younger age groups inclusive of prehospital and post-
injury hitches. There is an array of outcomes of morbidity,
mortality, and disability with all forms of damage in and
around head from known and unknown hazards leading to
the overall brunt more than direct and immediate impacts.
There are indeterminate incremental-associated socioeco-
nomic burdens with stress on already overburdened general
health care services, particularly in the LMICs. There is abun-
dant literature on different clinical aspects of the spectrum of
TBI. Yet, we have noted paucity of research studies on holistic
approach on the management of TBI. Also in many places,
even if TBI care facilities are available adequately, there is
reluctance in its use by the primary health care providers
based on ignorance on the transparent limiting steps of dos
and don’ts. As such, there is more need of creating aware-
ness among population in this regard in a concerted manner.
This position paper from Colombian Consensus Committee
is definitely going to help researchers of LMICs to formulate
clinical practice guidelines for their respective countries.2-
4
Understanding and treating of head injuries embrace
internalization that it is a spectrum of sudden, unexpected,
unintended, and violent deleterious consequences affect-
ing head region. The basic pathophysiology and current
evidences indicate that TBI is absolutely preventable and
manageable emergency persisting as the hidden epidemic
of modern society. The discrepancy in the precise descrip-
tion and classification of TBI, along with inconsistency in
data collection in absence of trauma registry in LMICs, has
made the epidemiology of head injury difficult to internal-
ize. Research on TBI had been performed globally for decades
noted that mild TBI or concussion cases are usually managed
by primary care physicians, and severe, as well as fatal, cases
are only recorded by the stakeholders. So, to understand the
growing need, we need to adopt innovative techniques for
TBI managements embedded with the qualitative research
directions in search of well-designed interventions. Thus,
scientifically sound studies, using multipronged approaches
with achievable research questions to test hypotheses and to
produce generalizable futuristic observations, can develop
well- designed interventions. The finding of TBI research
indicated that the perceptions toward interventions could
be influenced to a large extent by knowledge significantly
related with the occupation and education among the gen-
eral population. The proposition that early recognition of
the extent and pattern of TBI can improve scopes for holistic
solutions those are easier said than done. It is important that
health care providers including family practitioners should
be involved and trained in the diagnosis and treatment of
TBI from undergraduate health care capacity building. Sup-
porting TBI patients and their caregivers, empathetically, to
ensure that they understand the limitation of these treat-
ments, remains an important component of TBI management.
TBI is taking tolls despite sincere implementation of effec-
tive protected strategies and establishment of state-of-art
centers of neurosciences manned by experts in the fields.
Real-life internalization on specific TBI risk is revitalized
at every moment with the passing of days in ice-ball phe-
nomenon by encouraging competency-based training with
stress on skill domain in the nonthreatening environment
and rewarding positive performance. Successful TBI control
envisages on futuristic vision and proactivities ranging from
recognition of hazards to the empathetic implementation of
injury surveillance that includes injury registry, mitigation,
plan, and control programs followed by holistic evaluation.
J Neurosci Rural Pract 2020;11:3–4
Published online: 2020-03-03
http://orcid.org/0000-0002-8602-0162
4
Journal of Neurosciences in Rural Practice Vol. 11 No. 1/2020
Editorial
An understanding of the interprofessional (IP) research team
involving experts of all walks of life, viz., physician, injury
care personnel, physical medicine expert, rehabilitation
therapist, social scientists, psychologists, educationists, and
technical and technological experts among others is essen-
tial component of successful TBI control. An ideal clinical
practice guideline with combination of stepwise medical and
surgical managements at the nonneurosurgical centers can
save millions of lives. We need more qualitative researches
in the continuum under leadership of interprofessional team
involving persons from all aspects of life as the call of the day.
Truthfully establishing linkages of the concerned persons of
multiple domain outside the neurosciences community can
solve this mammoth task with multipronged approach.5,6
Funding
None.
Conflict of Interest
None declared.
References
1 Rubiano AM, Vera DS, Montenegro JH, et al. Recommendations
of the Colombian Consensus committee for the management of
traumatic brain injury in prehospital, emergency department,
surgery, and intensive care (beyond one option for treatment of
traumatic brain injury, a stratified protocol [BOOTStraP]). J Neu-
rosci Rural Pract 2020;11(1): 7–22
2 American College of Surgeons Committee on Trauma. ACS
TQIP Best Practice guidelines. Available at: https://www.facs.
org/qualit y-programs/trauma/tqp/center-programs/tqip/
best-practice. Accessed January 15, 2020
3 Cole WR, Bailie JM. Neurocognitive and psychiatric symptoms
following mild traumatic brain injury. In: Laskowitz D, Grant
G, eds. Translational Research in Traumatic Brain Injury. Boca
Raton, FL: CRC Press/Taylor and Francis Group; 2016
4 Dawodu ST. Traumatic brain injury (TBI)—definition,
epidemiology, pathophysiology. Available at: https://emed-
icine.medscape.com/article/326510-overview#a2. Accessed
October 20, 2019
5 Pal R, Agarwal A, Galwankar S, et al. The 2014 Academic Col-
lege of emergency experts in India’s INDO-US joint working
group (JWG) white paper on “developing trauma sciences and
injury care in India” Int J Crit Illn Inj Sci 2014;4(2):114–130
6 Nanclares BVC, Padilla-Zambrano HS, El-Menyar A, et al.
WACEM consensus paper on deep venous thrombosis
after traumatic spinal cord injury. J Emerg Trauma Shock
2019;12(2):150–154
Copyright of Journal of Neurosciences in Rural Practice is the property of Wolters Kluwer
India Pvt Ltd and its content may not be copied or emailed to multiple sites or posted to a
listserv without the copyright holder’s express written permission. However, users may print,
download, or email articles for individual use.
CLINICAL AND TRANSLATIONAL NEUROSCIENCE
COMMENTARY
Advance MR imaging in sports-related concussion
and mild traumatic brain injury – ready for clinical
use? (Commentary on Tremblay et al. 2017)
Sven Haller1,2,3,4
1Affidea CDRC Centre Diagnostique Radiologique de Carouge Clos de la Fonderie 1, 1227 Carouge, Switzerland
2Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden
3Department of Neuroradiology, University Hospital Freiburg, Freiburg, Germany
4Faculty of Medicine, University of Geneva, Geneva, Switzerland
Sports-related concussion – including chronic traumatic encephalopathy in adult professional American football players – has recently
attracted considerable interest, even in the general media. The Hollywood movie entitled ‘Concussion’ is one recent example. Furthermore,
discussion about brain abnormalities as a consequence of sports injuries should also include younger players (Bahrami et al., 2016). It remains
to be explored how traumatic brain injury in the youth may alter the normal trajectory of brain development. In Europe, more attention is paid
to sports-related concussion in the commonly played game of soccer (Koerte et al., 2012; Lipton et al., 2013). Likewise, there is growing
interest in brain abnormalities related to mild traumatic brain injury (MTBI) resulting from minor accidents (e.g. whip-lash injury), particularly
with respect to medico-legal and insurance-related issues. In both sports-related concussion and MTBI, conventional CT and MR imaging
results generally do not reveal clear abnormalities. However, advanced imaging techniques, including diffusion tensor imaging (DTI) (Bahrami
et al., 2016), MR spectroscopy (MRS) (Maugans et al., 2012; Vagnozzi et al., 2013), MR perfusion (Maugans et al., 2012), functional MRI
(Zhou et al., 2012), as well as nuclear medicine techniques such as tau positron emission tomography (Small et al., 2013), may reveal subtle
trauma-related brain abnormalities not evident to the naked eye or through standard imaging.
In ‘Defining a multimodal signature of remote sports concussions’, Tremblay et al. (2017) used DTI and MRS to characterize white matter
changes in aging, retired athletes with a history of sports-related MTBI. Using machine learning approaches, the authors achieved up to 90%
accuracy in identifying former athletes on the basis of their white matter profiles. While this research is certainly promising, there are several
concerns that require strict and careful consideration before such automated classification techniques can be used clinically.
Regional specific pattern of brain abnormalities?
Advanced imaging techniques have been used in the domain of neurodegeneration, particularly in Alzheimer’s dementia and its prodromal
stages, with the same basic aim – to detect subtle brain abnormalities not evident using standard imaging techniques. There is, however, a
fundamental difference between trauma-related and neurodegenerative abnormalities. Neurodegenerative diseases typically share common, dis-
ease-specific patterns of brain changes. For example, Alzheimer’s dementia is characterized by atrophy particularly within the hippocampal
and parietal regions, while behavioral variant fronto-temporal dementia is typically associated with a predominantly fronto-temporal atrophy
(Haller et al., 2013). For post-traumatic changes, we may assume that some traumatic mechanisms are more common than others, and that
trauma-related changes are more or less widespread in the brain. Therefore, trauma-related changes will overlap to a certain degree. However,
the individual trauma-related changes are variable depending on the site, direction and velocity of the impact, and consequently trauma-related
variability is larger than the more stereotypical neurodegeneration-related brain alterations. This implies that several patterns of trauma-related
brain abnormalities should be defined, and the best-suited reference dataset for comparison will depend on the specific trauma of each
individual case.
Progressive or regressive brain abnormalities?
Making the comparison with neurodegenerative diseases again, it is important to highlight that neurodegenerative brain abnormalities are, in
general, progressive. The time point of imaging is consequently of lesser importance, as brain changes will only accumulate during the disease
progress. This situation is different in trauma-related changes. For example, it was believed that trauma-related microbleeds (also known as
hemorrhagic diffuse axonal injuries or shearing injuries) remain more or less constant over years. However, recent evidence suggests that such
lesions may decrease overtime (Liu et al., 2016), grow (Toth et al., 2016) or (temporarily) disappear (Watanabe et al., 2016). Moreover, we
can assume that some regions might show white matter Wallerian-type degeneration after brain trauma, while other areas might develop com-
pensatory increasing connectivity. This suggests that the timing of the imaging, relative to the trauma, might influence the results and should
therefore be carefully considered.
© 2017 Federation of European Neuroscience Societies and John Wiley & Sons Ltd
European Journal of Neuroscience, Vol. 46, pp. 1954–1955, 2017 doi:10.1111/ejn.13643
http://orcid.org/0000-0001-7433-0203
http://orcid.org/0000-0001-7433-0203
http://orcid.org/0000-0001-7433-0203
Group-level vs. single participant analyses
The majority of previous imaging studies have used group-level statistics, that is, comparing a group of patients vs. a group of controls
(Messe et al., 2011; Toth et al., 2012). Such group-level analyses are interesting from a scientific perspective and may reveal brain areas
involved in a given disease or condition. However, such group-level analyses cannot be used for diagnosis of individual patients. The current
investigation ‘Defining a multimodal signature of remote sports concussions’ (2017) elaborated on traditional group-level analyses using
machine learning approaches to differentiate aging athletes with a history of TBI from healthy controls. However, as in most related studies,
the training and testing datasets were derived from the same sample, which can lead to optimistic results (Haller et al., 2014). Ideally, training
and test datasets should be separate, preferably even acquired on different scanners (see below).
Single-center vs. multicenter studies
Most advanced neuroimaging studies in the domain of MTBI and sports-related concussions are single-center studies, typically using only
one scanner with an identical imaging protocol for all participants. Trauma-related changes may be very subtle, and easily within the range of
the normal variability among different MR scanners or sequences. Consequently, to have a clinically useful tool, platform-independent strict
imaging protocols must be established that should ideally be validated using phantom scans – equivalent to the ongoing scanner harmoniza-
tion in the Alzheimer’s disease neuroimaging initiative (ADNI).
Software dependence
Advanced image analysis methods often substantially influence the results, for example, in DTI tractography (Christidi et al., 2016). Moreover,
even within a given software package, there are multiple parameters that can be modified. Similar to the data acquisition discussed above, it is fun-
damental to strictly harmonize and standardize data analysis techniques to obtain reproducible and, as a consequence, clinically applicable results.
Conclusions
In conclusion, advanced imaging and data analysis techniques have the potential to detect subtle alterations in the brain related to MTBI and
sports-related concussion, which are not evident to the naked eye and standard CT or MR imaging. However, to obtain reproducible and clin-
ically applicable results at the individual level, strictly standardized data acquisition including standardized timing and data analyses protocols
is fundamental. These need to be accompanied by large-scale reference datasets controlling for, at least age, gender and education, and ideally
additional information regarding site, direction, and velocity of head impact.
Conflict of interest
No conflicts of interest.
References
Bahrami, N., Sharma, D., Rosenthal, S., Davenport, E.M., Urban, J.E., Wagner, B., Jung, Y., Vaughan, C.G. et al. (2016) Subconcussive head impact exposure
and white matter tract changes over a single season of youth football. Radiology, 281, 919–926.
Christidi, F., Karavasilis, E., Samiotis, K., Bisdas, S. & Papanikolaou, N. (2016) Fiber tracking: a qualitative and quantitative comparison between four different
software tools on the reconstruction of major white matter tracts. Eur. J. Radiol. Open, 3, 153–161.
Haller, S., Garibotto, V., K€ovari, E., Bouras, C., Xekardaki, A., Rodriguez, C., Lazarczyk, M.J., Giannakopoulos, P. et al. (2013) Neuroimaging of dementia in
2013: what radiologists need to know. Eur. Radiol., 12, 3393–3404.
Haller, S., Lovblad, K.O., Giannakopoulos, P. & Van De Ville, D. (2014) Multivariate pattern recognition for diagnosis and prognosis in clinical neuroimaging:
state of the art, current challenges and future trends. Brain Topogr., 27, 329–337.
Koerte, I.K., Ertl-Wagner, B., Reiser, M., Zafonte, R. & Shenton, M.E. (2012) White matter integrity in the brains of professional soccer players without a
symptomatic concussion. JAMA, 308, 1859–1861.
Lipton, M.L., Kim, N., Zimmerman, M.E., Kim, M., Stewart, W.F., Branch, C.A. & Lipton, R.B. (2013) Soccer heading is associated with white matter
microstructural and cognitive abnormalities. Radiology, 268, 850–857.
Liu, W., Soderlund, K., Senseney, J.S., Joy, D., Yeh, P.H., Ollinger, J., Sham, E.B., Liu, T. et al. (2016) Imaging cerebral microhemorrhages in military service
members with chronic traumatic brain injury. Radiology, 278, 536–545.
Maugans, T.A., Farley, C., Altaye, M., Leach, J. & Cecil, K.M. (2012) Pediatric sports-related concussion produces cerebral blood flow alterations. Pediatrics,
129, 28–37.
Messe, A., Caplain, S., Paradot, G., Garrigue, D., Mineo, J.F., Soto Ares, G., Ducreux, D., Vignaud, F. et al. (2011) Diffusion tensor imaging and white matter
lesions at the subacute stage in mild traumatic brain injury with persistent neurobehavioral impairment. Hum. Brain Mapp., 32, 999–1011.
Small, G.W., Kepe, V., Siddarth, P., Ercoli, L.M., Merrill, D.A., Donoghue, N., Bookheimer, S.Y., Martinez, J. et al. (2013) PET scanning of brain tau in
retired national football league players: preliminary findings. Am. J. Geriatr. Psychiat., 21, 138–144.
Toth, A., Kovacs, N., Perlaki, G., Orsi, G., Aradi, M., Komaromy, H., Ezer, E., Bukovics, P. et al. (2012) Multi-modal magnetic resonance imaging in the
acute and sub-acute phase of mild traumatic brain injury: can we see the difference? J. Neurotraum., 30, 2–10.
Toth, A., Kovacs, N., Tamas, V., Kornyei, B., Nagy, M., Horvath, A., Rostas, T., Bogner, P. et al. (2016) Microbleeds may expand acutely after traumatic
brain injury. Neurosci. Lett., 617, 207–212.
Tremblay, S., Iturria-Medina, Y., Mateos-P�erez, J.M., Evans, A.C. & De Beaumont, L. (2017) Defining a multimodal signature of remote sports concussions.
Eur. J. Neurosci., 46, 1956–1967.
Vagnozzi, R., Signoretti, S., Floris, R., Marziali, S., Manara, M., Amorini, A.M., Belli, A., Di Pietro, V. et al. (2013) Decrease in N-acetylaspartate following
concussion may be coupled to decrease in creatine. J Head Trauma Rehab., 28, 284–292.
Watanabe, J., Maruya, J., Kanemaru, Y., Miyauchi, T. & Nishimaki, K. (2016) Transient disappearance of microbleeds in the subacute period based on T2*-
weighted gradient echo imaging in traumatic brain injury. Acta Neurochir., 158, 1247–1250.
Zhou, Y., Milham, M.P., Lui, Y.W., Miles, L., Reaume, J., Sodickson, D.K., Grossman, R.I. & Ge, Y. (2012) Default-mode network disruption in mild trau-
matic brain injury. Radiology, 265, 882–892.
© 2017 Federation of European Neuroscience Societies and John Wiley & Sons Ltd
European Journal of Neuroscience, 46, 1954–1955
Commentary 1955
Copyright of European Journal of Neuroscience is the property of Wiley-Blackwell and its
content may not be copied or emailed to multiple sites or posted to a listserv without the
copyright holder’s express written permission. However, users may print, download, or email
articles for individual use.
PLAGIARISM STATEMENT
By signing my name electronically below, I certify that this assignment/report is my own work, based on my personal study and/or research and that I have acknowledged all material and sources used in its preparation, whether they be books, articles, reports, lecture notes, and any other kind of document, electronic or personal communication. I also certify that this assignment/report has not previously been submitted for assessment in any other class, except where specific permission has been granted from all Professors involved, or at any other time in this class and that I have not copied in part or whole or otherwise plagiarized the work of other students and/or persons.
PRINT NAME DATE
This assignment will not be accepted or graded by your professor without the above signature and date.
pg. 1
PLAGIARISM STATEMENT
By signing my name electronically below, I certify that this assignment/report is my own work, based on my personal study and/or research and that I have acknowledged all material and sources used in its preparation, whether they be books, articles, reports, lecture notes, and any other kind of document, electronic or personal communication. I also certify that this assignment/report has not previously been submitted for assessment in any other class, except where specific permission has been granted from all Professors involved, or at any other time in this class and that I have not copied in part or whole or otherwise plagiarized the work of other students and/or persons.
Jo Anne White 9/16/20
PRINT NAME DATE
This assignment will not be accepted or graded by your professor without the above signature and date.
References
Hunnicutt, G., Lundgren, K., Murray, C., & Olson, L. (2017). The Intersection of Intimate Partner Violence and Traumatic Brain Injury: A Call for Interdisciplinary Research. Journal of Family Violence, 32(5), 471–480.
https://doi.org/10.1007/s10896-016-9854-7
SUMMARY: (In your own words)
An emerging body of research suggests that survivors of intimate partner violence (IPV) are at a high risk for sustaining traumatic brain injury (TBI). However, most scholars and practitioners working on the problem of IPV have not examined how TBI could be related to their familiar subject of study. Concomitantly, little work in the brain injury field has been done to examine TBI in the context of IPV. In this paper, we encourage cross-collaboration among these fields. To that end, we consider the relationship between IPV and TBI; the difficulty in detecting and measuring the IPV-related TBI and ethical concerns that may arise when addressing this issue. Our work emphasizes the need to recognize the complex interplay among psycho-physiological health and socio-cultural contexts. As such, we present a socio-ecological perspective of IPV-related TBI to provide a contextual framework to guide future interdisciplinary research. Finally, we outline directions for future research.
OPINION:
I chose this article due to my past research in domestic violence. I have written several papers on the aforementioned topic and this article goes further and writes about how survivors of intimate partner violence ……………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………
Pritchard, E., Tsindos, T., & Ayton, D. (2019). Practitioner perspectives on the nexus between acquired brain injury and family violence. Health & Social Care in the Community, 27(5), 1283–1294.
https://doi.org/10.1111/hsc.12770
SUMMARY: (In your own words)
Family violence has been highlighted by the World Health Organization as a major public health concern. Although family violence occurs to all genders, a higher prevalence of victims are female. Estimates report around 30% of all women experience intimate partner violence worldwide. Experiencing assault in the family violence context can lead to an acquired brain injury (ABI); however, the connection between these two phenomena has not been well established. The aim of this qualitative study was to explore the extent of, and factors contributing to, ABI and family violence. We conducted 22 semi‐structured interviews and one focus group (n = 4) with practitioners working with family violence victims and/or perpetrators. Thematic data analysis utilised inductive and deductive coding approaches. The Social Determinants of Health Framework was used to guide analysis. Practitioners estimated 30%–40% of the clients on their caseloads had a suspected or diagnosed ABI. They identified that contributing factors were extremely complex. These included acquiring an ABI through assault (past family violence or other criminal act), and transport crashes. Complicating factors of ABI were identified as mental health conditions, alcohol and drug use, and post‐traumatic stress disorder. Additional factors contributing to family violence were recognised as biological (age of parent, twin births, pregnancy, premature births, and children with congenital abnormalities), relationships (intimate partner, father, boyfriend, mother and siblings), previous trauma (family violence), and life stressors (unemployment, financial, and lack of housing). Social determinants of health included cultural (ethnicity, societal attitudes, values, and beliefs) and organisational (legislation and policy) factors which influenced behaviours and outcomes across all sectors. A model of Brain injury Family violence Nexus (BFN) was created to understand the interaction between these phenomena. Utilising the BFN model to understand the interaction can enhance the methods used within health and social services for a more efficacious approach.
OPINION:
I chose this article due to my background as a therapist in Family Therapy. This article highlights ………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………
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