Later On

A blog written for those whose interests more or less match mine.

Archive for October 19th, 2013

What’s weird about the GOP fight against Obamacare…

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And the thing I still can’t get my head around: Republicans are doing everything they can short of throwing themselves bodily under the bus—and figuratively they did that with the shutdown/debt-ceiling debacle—with one goal in mind: to prevent low-income Americans from getting healthcare. That’s it: that’s the goal. And it was presaged in the fact that the Affordable Care Act passed without a single Republican vote. But it did pass, it is the law, and the Supreme Court found it to be so.

I have a very conservative friend who was a minister—he’s now retired—and in a discussion of this, he said that giving the poor healthcare would harm them by making them become dependent on the state and simply want free handouts.

I replied that I knew quite a few people who were working at two or three jobs, often only part-time jobs without benefits, and they have no health insurance or any hope of affording it. They are not sitting back and living on handouts. I have never encountered any of the group he thinks are so numerous, but I do know quite a few who have the mindset that they’re in it for themselves and they will take what they can get and they’re not about to give anything away. That type is depressingly common.

And anyway, as I recall, Jesus didn’t charge for the healings that He did, and He didn’t seem to worry about creating dependency. (Come to think of it, He rather encouraged it: ‘Depend on Me.’) Since my friend knows the New Testament better than I, I suggested he could sort of scan through it in his mind and see where “helping the poor get access to healthcare” would fit in. I don’t think it would be under the “Fight to the death” column.

In ThinkProgress Igor Volsky reports on the fight against healthcare for low-income Americans:

Conservative advocates funded by the billionaire industrialist brothers Charles and David Koch have launched a massive campaign pressuring states to deny health care coverage to lower income Americans through the Medicaid expansion contained in the Affordable Care Act.

The effort, orchestrated by the group Americans for Prosperity, is targeting lawmakers in Virginia tasked with deciding whether the state should accept federal dollars to provide insurance to individuals and families below 133 percent of the federal poverty line ($31,321 in income for a family of four). Volunteers with the organization are distributing flyers through door-to-door canvassing, attending committee hearings, and according to one lawmakers who has become a target of the campaign, intimidating constituents.

As many as 400,000 Virginians could qualify for coverage if the state expands the Medicaid program, but AFP is warning Virginians that the system “will cost Virginia taxpayers billions,” require “future tax hikes and budget cuts to vital services like schools, police and fire departments,” undermine the “doctor-patient relationship,” increase wait times and even endanger lives. “Medicaid patients are almost twice as likely to die during surgery than individuals with private insurance,” the group writes on its website.

Under the Affordable Care Act, the federal government will pick up 100 percent of the cost of growing the program from 2014 to 2016 and states would contribute 10 percent thereafter. Analysis from the Commonwealth Institute for Fiscal Analysis in Richmond finds that “net savings from Medicaid expansion would average about $135 million per year in the upcoming budget cycle” since expanding Medicaid “would allow the state to use federal funds instead of state dollars for these programs that already provide care to the uninsured in Virginia.”

Seventy-six percent of Virginia doctors treat new Medicaid patients, and the “share of doctors accepting new Medicaid patients is nearly the same as the share who are accepting new patients with private insurance or Medicare,” the Institute reports. While Medicaid beneficiaries tend to be less healthy than the general uninsured population, people who do enroll in the program “are 25 percent more likely to report that their health is ‘good’ or ‘excellent.’”

The GOP’s refusal to fully implement the Affordable Care Act will leave more than half of the nation’s uninsured working poor, approximately 8 million people, without access to health insurance. The 26 GOP-controlled states not participating in the law’s Medicaid expansion are home to a disproportionate share of low-income Americans who aren’t poor enough to qualify for the existing Medicaid program and make too much to be eligible for subsidies in the ACA’s insurance marketplaces.

Americans for Prosperity has spent millions “in states around the country, including Arkansas, Florida, Ohio, Louisiana, Michigan and Pennsylvania, to run the kind of aggressive campaign that it is now waging here in Virginia, where much will depend on the governor’s race,” the New York Times notes. Democrat Terry McAuliffe favors expansion, while his Republican opponent, Ken Cuccinelli, does not. The Virginia panel weighing in on the matter will decide the question after the Nov. 5 election.

Written by Leisureguy

19 October 2013 at 2:06 pm

Well stated! NJ Supreme Court decision on gay marriage

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Very nicely said. I never could fathom how allowing gays to marry would have any effect whatsoever on straight marriages, much less somehow “harm” them (especially since this “harm” was always couched in vague and nonspecific terms; for example, that straight marriage will be “undermined”. What? They’re going to tunnel under the houses of straight couples? Really: there’s no there in those arguments, and the NJ Supreme Court states that well. I would bet, though, that the push to not allow gay marriage is simply a barely-disguised effort to bring the US closer to a theocratic state, for the only cogent argument against gay marriage is in the context of religious beliefs, and respect for freedom of religion means allowing each to act in accordance with his/her beliefs insofar as they do not harm, or allow harm to befall, etc.—you know the idea. Those whose beliefs dictate that they not enter a same-sex marriage should, by all means, follow the dictates of their system of belief. And if one’s religion dictates that s/he must pray in the direction of Mecca 5 times a day, by all means do it. But, please, do not try to forbid nonbelievers from forming same-sex marriages if they want, or force nonbelievers to pray 5 times a day toward Mecca. I thought most agreed that keeping out of law the special requirements/dictates of particular religions was a good idea. (And I alluded to this in the earlier post on how some regions have access only to Catholic hospitals—specifically regions with non-Catholics among the population.)

Zack Ford writes at ThinkProgress:

The New Jersey Supreme Court issued an arguably unprecedented decision Friday: though they still plan to hear out a case challenging the state’s ban on same-sex marriage, they are going to allow same-sex couples to begin marrying in the state in the meantime. The lower court’s decision will take effect at 12:01 AM Monday morning.

In an order denying the Christie administration a stay of the lower court’s marriage equality ruling, the Court posited that the U.S. Supreme Court decision overturning the federal Defense of Marriage Act so “changed the landscape” that the harm to same-sex couples being denied federal benefits was too blatant to ignore:

The State has advanced a number of arguments, but none of them overcome this reality: same-sex couples who cannot marry are not treated equally under the law today. The harm to them is real, not abstract or speculative. […]

The State identified certain abstract harms… Weighed against them are immediate and concrete violations of plaintiffs’ right to equal protection under the law. Because plaintiffs cannot marry under State law, they and their children are simply not eligible for a host of federal benefits available to same-sex married couples today. […]

The balance of hardships does not support the motion for a stay.

As ThinkProgress outlined earlier, this outcome is not a final guarantee that the right to marry is a permanent fixture for same-sex couples in New Jersey, but it is incredibly encouraging. Though the Court reserved its right to nullify any marriages that take place until they rule, they have explicitly stated their expectation that the state will lose and marriage equality will prevail.

As of Monday, New Jersey will become the 14th state (plus the District of Columbia and some New Mexico counties) to offer marriage to same-sex couples.

(HT: Kathleen Perrin.)

Written by Leisureguy

19 October 2013 at 1:48 pm

Continuing Salmonella Outbreaks

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One of the ways that the Federal and state governments spend taxpayer money is by making sure our food is safe. (For every American killed by a terrorist, 110 are killed by contaminated food.) I think that’s a good use of government funds, though of course the food industry prefers voluntary guidelines, which they can then ignore, just as Foster Farms is doing. The NY Times has a good editorial:

Months after salmonella-contaminated chicken distributed by a California company sickened people, the dangerous food is still being sold around the country. This disturbing situation is the result of weak federal regulatory powers and the company’s irresponsibility.

The episode is especially dangerous because the seven strains of salmonella bacteria involved in the outbreak are resistant to antibiotics, in some cases to multiple antibiotics. As of Friday, 338 people have been reported as infected by the seven strains in 20 states, with most of the infections in California. No deaths have been reported, but 40 percent of the patients needed to be hospitalized.

Consumers became ill as early as March 1; it was not until late June, however, that the Food Safety and Inspection Service, a unit of the Department of Agriculture, was notified by the Centers for Disease Control and Prevention of a salmonella outbreak in four states. Investigators traced the likely source of the problem to raw chicken products from three Foster Farms facilities in California. On Oct. 7 the F.S.I.S. issued a “public health alert” warning people to handle raw poultry carefully and cook it well. The agency also required Foster Farms to submit plans to prevent persistent salmonella contamination. The company did so and was allowed to keep operating under an enhanced inspection process.

The F.S.I.S. did not ask or order the company to recall any of its products. Instead, the agency told the public to look for numbers on the chicken packaging identifying the three facilities in case they wanted to avoid Foster Farms’ products. Nor did the company recall any products, claiming they were safe if handled and cooked properly. Still, some stores are pulling the chicken from those three plants from their shelves, though many retailers are not, according to consumer advocates.

Aaron Lavallee, a spokesman for F.S.I.S., said that under statutes and case law, the agency cannot compel a recall in the Foster Farms case with the current evidence. Congress should hold hearings to determine if the Agriculture Department and its food safety service need more power to protect the public from potentially serious harm.

Written by Leisureguy

19 October 2013 at 10:53 am

And, speaking of bad healthcare, a Spanish anesthetist infected hundreds with hepatitis C

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Interesting how they proved him to be the culprit, as reported in The Scientist by Chris Palmer:

Something was amiss in the Spanish coastal city of Valencia. A dozen cases of hepatitis C, a potentially fatal blood-borne viral infection that causes cirrhosis of the liver, had turned up within a short time span in early 1998. As more cases popped up over the ensuing weeks, one fact linked virtually all the cases: the patients had at one time or another been admitted to one of two local hospitals.

Valencian public health department officials set up a committee of local scientists and epidemiologists to get a handle on the outbreak. One tool the health department planned to use to identify the source of the infections was a genetic analysis that was just starting to be employed in court cases related to HIV transmission. The forensic tool, based on the principles of molecular phylogenetics, could help infer the most recent common ancestor of virus strains from any two people based on the estimated rate of accumulated viral mutations.

Because of his experience in molecular biology, Fernando González-Candelas, an evolutionary geneticist at the University of Valencia, was tapped to head the health department’s phylogenetic testing. As the investigation expanded, the number of possible cases of infection soared into the hundreds. “We had no idea when we were contacted that it was going to be such a big and complicated problem that it turned out to be,” says González-Candelas. Ultimately, 275 people—almost all of them patients at one or both of two hospitals in Valencia—were determined to be victims of the outbreak, which stretched back to 1988.

When the Valencian provincial court learned of the health department’s scientific committee, it asked to use the findings of the phylogenetic analysis as evidence for a criminal case against Juan Maeso, an anesthetist who worked regularly at the two hospitals (and occasionally at others) and who had administered painkillers intravenously to all of the known hepatitis C patients following surgical procedures.

González-Candelas and his team spent the next 2 years comparing 4,000 sequences of the hepatitis C virus (HCV) genome from 322 patients who had contracted HCV during Maeso’s tenure to more than 100 genome sequences from 28 HCV haplotypes that Maeso carried.

But virus genomes evolve rapidly—about one million times faster than the human genome. “There is a race between the virus and the immune system, with one trying to control the other and the other trying to escape,” says González-Candelas.

This means that viral sequences from the source and even a recently infected individual are almost never identical, according to Anne-Mieke Vandamme, an epidemiological virologist at Katholieke Universiteit Leuven in Belgium who was not involved in the research. However, the rate at which mutations accumulate is relatively constant, so recently infected individuals should have viruses with higher sequence similarity to the source than those infected in the distant past. . .

Continue reading.

Written by Leisureguy

19 October 2013 at 10:49 am

Posted in Evolution, Law, Medical, Science

Catholic Hospitals Grow, and With Them Questions of Care

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Interesting development when a region’s healthcare must follow Catholic doctrine regarding birth control and abortion and assisted suicide in the face of agonizing terminal illness, even for patients who do not share those beliefs. Thus medical treatment needed or desired by the patient may be refused even though the requested procedures do not in any way violate the law or the patient’s own beliefs and faith. Nina Martin reports at ProPublica:

Over the past few years, Washington state’s liberal voters have been on quite a roll. Same-sex marriage? Approved. Assisted suicide? Check. Legalized pot? That too. Strong abortion protections? Those have been in place for decades.

Now, though, the state finds itself in the middle of a trend that hardly anyone there ever saw coming: a wave of mergers and alliances between Catholic hospital chains and secular, taxpayer-supported community hospitals. By the end of this year, the ACLU estimates, nearly half of Washington’s hospital beds could be under Catholic influence or outright control.

Many of the deals have been reached in near secrecy, with minimal scrutiny by regulators. Virtually all involve providers in Western Washington, which voted heavily for same-sex marriage last November and the Death with Dignity Act in 2008. The cultural divide between the region’s residents (Seattle recently edged out San Francisco as the area with the largest proportion of gay couples) and the Catholic Church (whose local archbishop led the effort against marriage equality and is overseeing a Vatican crackdown on independent-minded American nuns) couldn’t be wider. And yet more and more hospitals there — sustained by taxpayers, funded by Medicare, Medicaid, and other government subsidies — could be bound by church restrictions on birth control, sterilization and abortion, fertility treatments, genetic testing, and assisted suicide.

In affected communities, the news is not going over well.

“It’s the perfect storm here,” said Kathy Reim, president of Skagit PFLAG (Parents, Families and Friends of Lesbians and Gays) north of Seattle, where four area hospitals have been in merger talks this year. “We are the only state that has all these rights and privileges available to our citizens. Yet many of our hospital beds are being managed by a system that, for the most part, cannot and will not honor these rights and laws.”

Meanwhile, the deals just keep coming. Earlier this month, . . .

Continue reading.

Written by Leisureguy

19 October 2013 at 10:30 am

2×2 Vegetarian Chili

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No longer subsisting on leftovers (sag paneer and ratatouille), ramen, and ad-hoc meals (granola and yogurt with slivered almonds and maple syrup), last night I finally cooked: a 2-bean, 2-grain chili. It was improvised, naturally.

I had thought to make chili because I had leftover 12-grain and that with beans would complete the protein. But I decided too late to cook beans. So to Grove Market to buy a can of black beans, a small can of diced green chilis, a couple of fresh jalapeños, and a green bell pepper.

Once home, I put probably 3 Tbsp olive oil in the -4-qt sauté pan, then added:

1 ginormous Spanish onion, chopped
good large pinch of salt
many grindings black pepper

When they has sautéed a while, I added:

1/4 c (estimated) garlic cloves, chopped fine
2 jalapeños, chopped fine (with pith and seeds: only the stem removed)
1 green bell pepper, cored and chopped
4 Roma tomatoes (two sort of dried out, but more intense), chopped
about 1 Tbsp fish sauce (last of bottle)
about 2 tsp Tamari sauce
about 2 Tbsp blackstrap molasses
about 2 Tbsp chili powder

Sauté for a few moments, then add:

1 can black beans, drained and rinsed — and it didn’t look like enough beans
Leftover 12 grain, which to my surprise was only about 1/3 to1/2 c
1/3 c sweet vermouth
1.5 c water

I decided the beans and rice needed reinforcements, so I added another bean and another grain:

8 oz red lentils for the beans
1/2 c fregola sarda for the grain (wheat)

I simmered that for 25 minutes. Extremely yummy topped either with shredded mozzarella or ricotta.

Written by Leisureguy

19 October 2013 at 10:26 am

Posted in Food, Recipes & Cooking

Nobel Prize Committee, Meet Your Pals in the Tea Party

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Interesting column by Michael Hirsh in the National Journal:

Who is more irrational: the tea party or the Nobel Prize committee? That’s a pretty close call this week.

Tea party libertarians base much of their view of the world – and their current efforts to blow up Washington – on the simplistic idea that government is always bad and markets are always good. The more freedom, the better for all. The Nobel Prize committee effectively endorsed this concept on Monday by awarding the 2013 prize to the University of Chicago’s Eugene Fama, whose “efficient markets hypothesis” was mocked even by the father of modern free-market economics, Milton Friedman, but which forms a fundamental justification of the world view that tea partiers, many of them unknowingly, live and breathe. That’s the long-since debunked view that markets, especially financial markets, are always rational, so just let ’em rip. No regulation needed. No government needed.

So irrational was the Nobel decision that even the committee second-guessed itself; it simultaneously gave a piece of the 2013 award to Yale’s Robert Shiller, whose life’s work has sought to show that Fama’s theory is “one of the most remarkable errors in the history of economic thought.” (This is perhaps Stockholm’s idea of what Wall Street calls a “hedge.”)

Shiller has developed a field of “behavioral economics” fleshing out John Maynard Keynes’s idea that irrational “animal spirits” drive markets more than policy-makers realize. If we needed any more proof of that, we got it in 2008, when we realized that virtually every Wall Street CEO and the biggest, most sophisticated banks in the world had no clue what they doing and would have destroyed themselves en masse had not the government (yes, the government) stepped in to save them at taxpayer expense.

Why does any of this matter now? Because in spite of the ample evidence before us, we in Washington still live in the free-market fantasy world that Ronald Reagan ushered in, that even President Obama has lamented he has not been able to alter, and which the work of economists such as Fama has propagated. Yes, we know that freer markets are better than “command” economies of the communist ilk. The end of the Cold War proved that as the United States essentially bankrupted the Soviet Union out of existence; even Beijing concedes this, as would the extinct dinosaurs of the Soviet era.

But it’s long past time for the pendulum to swing back to the middle from the extreme conclusion that this means fully free markets always work well. They don’t. The United States is, in truth, not a free-market economy but a “mixed” economy. As the great economist Paul Samuelson once wrote, the end of the Cold War meant only that “victory has been declared in favor of the market-pricing mechanism over the command mechanism of regulatory bureaucracy.” The victor was plainly not pure laissez-faire capitalism but simply a more balanced economy—markets modified by government taxes and government-orchestrated transfers of wealth to limit inequality, and government monetary and fiscal policies to curb recessions and inflation.

The truth is not simple or rational, in other words, and in fact financial markets, most economists have long known, are the least rational of all,contra Fama. Even Milton Friedman didn’t buy Fama’s ideas, one of the late economist’s students, Robert Auerbach, now a professor at the University of Texas at Austin, told me in a 2010 interview. Friedman asked his students: How could it be that all available information is instantly translated into price changes in a completely rational way, as Fama argued in his hugely influential theory, which opened the door to the kind of across-the-board deregulation that led Wall Street to almost destroy the global economy in the mid-2000s? Friedman pointed out that “traders couldn’t make any money if that were true,” Auerbach said.

Ironically, considering that it was tea-party antipathy to Obamacare – to “the government getting involved in health care”—that has put the United States on the precipice of default and economic disaster, some of the best economics work of recent decades has shown that the health care industry is one in which free markets don’t work well. The Nobel-winning economist Joseph Stiglitz, . . .

Continue reading. (UPDATED: Original link was to the National Journal, which placed the article behind a paywall before I could blog it. Link now goes to the author’s blog, where you can find and finish the article.)

Written by Leisureguy

19 October 2013 at 10:23 am

Posted in Business, Science

Sources of some of the problems of the Obamacare website

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Richard Pollock has a good rundown in the Washington Examiner:

Federal officials did not permit testing of the Obamacare healthcare.gov website or issue final system requirements until four to six days before its Oct. 1 launch, according to an individual with direct knowledge of the project.

The individual, who spoke on condition of anonymity, described the troubled Obamacare website project as suffering from top-level management disarray, changing systems requirements and recurring delays.

The root cause of the problems was a pivotal decision by Centers for Medicare and Medicaid Services officials to act as systems integrator, the central coordinator for the entire program. Usually this role is reserved for the prime information technology contractor.

As a result, full testing of the site was delayed until four to six days before the fateful Oct. 1 launch of the health care exchanges, the individual said.

Federal officials were “freezing requirements in time to permit full testing at all levels of the site — integration testing, user testing, performance testing and tuning,” the individual said.

“Normally a system this size would need 4-6 months of testing and performance tuning, not 4-6 days,” the individual said.

The source said there were “ever-changing, conflicting and exceedingly late project directions. The actual system requirements for Oct. 1 were changing up until the week before,” the individual said.

The individual described the project as suffering from a “lack of an end-to-end business and technology vision for the project,” adding that “the hardest part of any technology project is not the technology — it is the business process decisions, what is the system supposed to do and how it will it do it.”

In addition, “The challenge with this project was that the decisions were made very, very late in the project, and no one organization … seemed to know how this complex ecosystem of applications, interfaces, user processes and hardware should all work together.”

Another person, a former employee of CGI Federal — the private-sector contractor hired to build healthcare.gov — said the government’s insistence on being the systems integrator resulted in disastrous consequences for the website.

The former employee said that “requirements came late, CMS dictated the design, especially the sign-up-before-viewing-plans, and there was absolutely not enough time for testing.” . . .

Continue reading.

Written by Leisureguy

19 October 2013 at 10:07 am

Snowden took no files with him to Russia

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Snowden actually seems to have handled his disclosures quite responsibly. In this report by James Risen in the NY Times, he offers some new information and insights, among them:

Mr. Snowden said he gave all of the classified documents he had obtained to journalists he met in Hong Kong, before flying to Moscow, and did not keep any copies for himself. He did not take the files to Russia “because it wouldn’t serve the public interest,” he said.

“What would be the unique value of personally carrying another copy of the materials onward?” he added.

And:

He argued that he had helped American national security by prompting a badly needed public debate about the scope of the intelligence effort. “The secret continuance of these programs represents a far greater danger than their disclosure,” he said. He added that he had been more concerned that Americans had not been told about the N.S.A.’s reach than he was about any specific surveillance operation.

“So long as there’s broad support amongst a people, it can be argued there’s a level of legitimacy even to the most invasive and morally wrong program, as it was an informed and willing decision,” he said. “However, programs that are implemented in secret, out of public oversight, lack that legitimacy, and that’s a problem. It also represents a dangerous normalization of ‘governing in the dark,’ where decisions with enormous public impact occur without any public input.”

And:

Mr. Snowden said he had never considered defecting while in Hong Kong, nor in Russia, where he has been permitted to stay for one year. He said he felt confident that he had kept the documents secure from Chinese spies, and that the N.S.A. knew he had done so. His last target while working as an agency contractor was China, he said, adding that he had had “access to every target, every active operation” mounted by the N.S.A. against the Chinese. “Full lists of them,” he said.

“If that was compromised,” he went on, “N.S.A. would have set the table on fire from slamming it so many times in denouncing the damage it had caused. Yet N.S.A. has not offered a single example of damage from the leaks. They haven’t said boo about it except ‘we think,’ ‘maybe,’ ‘have to assume’ from anonymous and former officials. Not ‘China is going dark.’ Not ‘the Chinese military has shut us out.’ ”

An N.S.A. spokeswoman did not respond Thursday to a request for comment on Mr. Snowden’s assertions.

Read the whole thing.

Written by Leisureguy

19 October 2013 at 9:54 am

Stainless-steel steam juicer

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An ingenious device, and I think would be particularly good for berries, peaches, and the like. Take a look at the video in the post.

Written by Leisureguy

19 October 2013 at 9:42 am

Posted in Daily life, Food

Wonderful shave with Nancy Boy shaving cream

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SOTD 19 Oct 2013

A really fine shave today. Nancy Boy shaving cream (and that’s the Signature fragrance, which is my favorite) is a nonlathering shaving cream, but it’s easiest to apply it with a brush—and, truthfully, if you add a little bit of water and brush vigorously, it does seem to lather. Great stuff, in any event, and very nice to your skin.

My Edwin Jagger lined-chrome razor holds a Gillette 7 O’Clock SharpEdge blade, and it did a fine job—really an excellent shave, and this razor feels quite good in the hand.

The finish was Saint Charles Shave Very V (vetiver), and even as I sit here typing this, I’m enjoying an occasional whiff of the fragrance. Great stuff.

Written by Leisureguy

19 October 2013 at 9:38 am

Posted in Shaving

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