FINAL EXAM 2420-001
Popular in Nutrition and Health Performance
Popular in Psychlogy
This 23 page Study Guide was uploaded by Emma Trokel on Sunday May 1, 2016. The Study Guide belongs to 2420-001 at University of Colorado at Boulder taught by S. Nelson in Spring 2016. Since its upload, it has received 12 views. For similar materials see Nutrition and Health Performance in Psychlogy at University of Colorado at Boulder.
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Date Created: 05/01/16
DiabetesDiabetes Overall Complications if all types of Diabetes ● Heart disease ● Nerve damage ● Kidney damage ● Vision and hearing impairment ● Loss of limbs *Chronic inflammation and systemic stress Type 1 Diabetes Usually seen in kids child onset disease Sugar in the body but the pancreatic cells cannot use the sugar, beta cells don’t let the sugars into the blood supply Largely genetic ● ~510% of the cases ● Autoimmune disease ○ Beta cells unable to function ● Beta cells in the pancreas ● Symptoms ○ Blurry eyes, weight loss, hunger, sweet smelling urine (peeing out all the sugar) Type 2 Can get it at age 40 or higher Being overfat prone to type 2 ● 9095% of cases ● Insulin resistance or insulin deficiency ○ Your beta cells still work, it’s the stress of being over fat ● signs/symptoms ● Risk factors ● Diet and exercise ● Complications Type 1.5 (LADA) Diabetes ● Also known as Slow Onset Diabetes or Latent autoimmune diabetes in adults (LADA) ● Diagnosed in adulthood ● Characteristics of both T1 and T2 ● Often misdiagnosed as T2 ● Autoantibodies ● T2 treatment methods complications similar to those with T1 and T2 ● Not curable ● Adults are most at risk Type 3 Diabetes All involves sugar getting to the brain Lack of insulin or insulin resistance in the brain 80% of all the glucose is being used by the brain Prevents glucose from reaching the brain Problems with growth, development, neural function Brain abnormalities and cognitive impairment similar to those seen in alzheimer’s disease ● Alzheimer’s Disease ○ Brain cells degenerate and die ○ Betaamyloid proteins (sticky proteins and neurons forming into clumps and the messages don’t seem to be going through those clumps ) and tangles from tau proteins ○ Symptoms ● Study on humans ○ Lack of insulin and insulin receptors ○ Similarity to T1 and T2 So is Alzheimer’s Disease a new form or diabetes? ● Lack of insulin has not been proven to be the direct cause of alzheimer’s ● Correlation between lack of insulin and development of lesions New and upcoming issues with diabetes ● Beta cells resotartion with stem cells ○ Fat has a ton of stem cells ● Gene mapping to discover which genes are responsible for diabetes heritability ● Artificial pancreas trial ○ Iphone and tablet Diabetes in Native Americans Today ● 2.8 times higher than in overall US population ● Pima, Havasupai, OjiCree tribes ● 25% of native american males ● 30% of the females ○ Double the total US population that is affected Traditional Pima Indian Diet ● Beans ● Squash ● Maize ● Mule deer, pronghorn, cottontail, jackrabbit,wild turkey ● acorns , pinyon nuts, walnuts, prickly pear, strawberries, grapes, local grasses Genetic Predisposition ● Evolutionary advantage to have activated immune system ○ Lifespan was shorter ○ Injury, infectious diseases were more prevalent ● Native Americans were exposed to repeated epidemic following contact with the Europeans ● May have led to selection of individuals resistant to infectious diseases but prone to diabetes An activated immune system makes you more prone to diabetes and obesity because of the chronic ● IL6= a proinflammatory messenger ○ Involved in glucose and lipid metabolism ○ Circulating levels of IL6 are positively correlated with obesity ○ Baseline IL6 levels are predictive of type 2 diabetes development ● Associated between IL6 promoter polymorphism (G/C) and diabetes ● G allele much more common in diabetics and Native Americans ● All full Pima have GG genotype ● Chronic inflammation leads to development of insulin resistance type 2 ● Inflammation induces the expression of COX2 which is proinflammatory ● Strong association between COX2 gene and development of type 2 diabetes within Pima Indians Wound Healing Wound Healing is Complex ● Requires adequate blood flow for a supply line ● Requires nutrients as building blocks in the repair process Need sufficient ingestion/absorption/metabolic distribution of micro and macronutrients Imbalance due to inadequate supply or excessive demand may lead to an inability to heal wounds When you have burns 5070% of your body are in wound heal state affect the nutrient levels Epidemiology ● Proteinenergy malnutrition (PEM) ○ Inadequate supply ● Hospital patients ○ Excessive demand ● elderly/pressure ulcers ○ Excessive demand ● Addicts drugs/alcohol ○ Inadequate supply ● Patients with diabetes ○ Inadequate supply and excessive demand ● Burn victims ○ ● Trauma war , motor vehicle , sport ○ Nutritional significance of losing teeth not eating things that need biting down which therefore do not get the nutrients from those food sources Meth addiction itch meth mouth turns teeth black Inadequate supply and excessive demand Stages of Wound Healing ● Hematosis ○ Minutes ■ Blood is released into the wound ■ Flush and clean it ■ Fibrinogen converts to fibrin, which starts the clotting cascade ● Inflammation ○ Days ■ Red, inflammed ■ White blood cells travel to the site to fight infection ■ Vasodilation (widening of the blood vessels) ● Proliferation ○ Weeks ■ Wound care may be needed ■ Going from a scab to a scar ■ Tissue perfusion scar formation collagen /granulation ■ Collagen vitamin c scurvy ● Contraction ○ Weeks ■ Wound shrinks by recruiting adjacent tissue and pulling it into the wound ● Remodeling ○ months/years (of constant supply line of nutrition) ■ Scar is transformed to the final mature healed wound ■ Tensile strength approaching undamaged tissue ■ Three years for a scar to completely heal The effect of stress ● Large burns/ critically ill / traumatic injury ● Modification in digestion/absorption/metabolism Hypermetabolism ● The body eats itself to meet the demands of the injury ○ #1 priority survival by preventing infection ● Protein catabolism ○ Eats your muscles ● Nutritional intervention we need to give you additional nutrients (IV tube) Key nutrients in wound healing ● Proteins ○ Needed for white blood cell formation collagen synthesis ● Fats: Omega 3 fatty acids ○ Aid the inflammatory response ○ Enhance the immune function Vitamins ● Vitamin C ○ Free radical scavenger ○ Increases defense against infection ○ Boosting immune function of the body ● Vitamin A ○ Enhances rate of collagen synthesis ● Vitamin E ○ Free radical scavenger ● Vitamin K ○ Needed for clotting factors Minerals ● Zinc ○ Needed for cell mitosis and cell proliferation in wound repair ● Iron ○ Enhances bactericidal activity of white blood cells makes white blood cells more powerful at killing bacteria ○ Hemoglobin oxygen transport to wound Contributing Conditions ● Obesity infection more prone to infection ● Diabetes infection, wound repair issues more prone to infection and don’t heal as well ● Cancer inflammatory response/wound repair (radiation, chemotherapy) problem with wound repair Blood Glucose Levels ● Elevated blood sugar levels ○ 1 arteries less pliable less vendable ○ 2 narrowing of the blood vessels ● This influences the origins of wounds and wound healing Poor Circulation ● Narrowed blood vessels lead to decreased blood flow and oxygen to a wound ● Elevated blood sugar level decreases the function of red blood cells that carry nutrients to the tissue ● This lowers the efficiency of the white blood cells that fight infection. Without sufficient nutrients and oxygen, a wound heals more slowly ● The immune cells do not function properly due to diabetes which raises the risk of infection Diabetic Neuropathy ● Nerve damage can occur and result in loss of sensation in limbs ● Cannot feel a developing blister or infection ● Severity can progress quickly ● Complications with healing Untreated infections ● Untreated infections can result in gangrene, sepsis infection from one local area goes into the entire blood supply, or bone infections ● Diabetes is the #1 reason for limb amputation in the U.S. Hunger in America Who are hungry in America ● The working poor working more than getting paid ● Unemployed / underemployed ● Migrant farm workers no legal rights ● Undocumented workers ● Elderly ● Homeless ● children ● Married ● Clothed ● Housed ● A bit overweight ● Working people are hungry because wages have declined or stagnated for cost of living ● ⅔ of families who are hungry have at least one working adulttypically a full time job ● video Food Insecurity ● 2206 US gov. Changed “hunger” to food insecurity ● Food insecurity: any household where during the previou, people did not have enough to eat ● Food insecurity occurs whenever the availability of nutritionally adequate and safe food, or the ability to acquire acceptable foods in socially acceptable ways, is limited or uncertain Pattern of Malnutrition ● 1 worry about how to get enough food ● 2 stretch resources, more money to other expenses and less to food ● 3. Quality and variety of the diet decreases ● 4 adults eat less and less ● 5 children eat less and less Sample Questions from Food Security Questionnaire ● Light Food Insecurity ○ The food that we bought just didn’t last and we didn’t have any money to get more ○ Was that often, sometimes, or never true for you in the last 12 months? ● Moderate food insecurity ○ In the last 12 months, were you ever hungry but didn’t eat because you couldn’t afford enough food ● Severe food insecurity ○ In the last 12 months, did any of the children ever not eat for a whole day because there wasn’t enough money for food? US programs to address food insecurity ● SNAP food stamp program ● National School Lunch Program ● School Breakfast Program ● Special Milk Program ● WIC ● Food Distribution Program on Indian Reservations The commodities program ● Elderly Nutrition Program ● Summer Food Service Program ● Disaster Feeding Program Private Sources of food/food distribution ● Soup kitchens ● Religious organizations ● Food pantries ● Home delivery of meals The Three step Burden ● Poverty, hunger, and malnutrition ○ Limits access to medical care ○ Discourages education and personal advancement ○ Change in time scale The poverty obesity paradox ● How can hunger and obesity both be issues in America at the same time ● Overconsumption of calories/ malnutrition ● Food quality ● Crop subsidies ● Overeating when food is available ● Physiological changes Why are they overweight? the qualities of calories they are taking in Food Deserts ● Food deserts are defined as urban neighborhoods and rural towns without ready access to fresh healthy and affordable food ● Instead of supermarkets and grocery stores, these communities may have no food access or are served only by fast food restaurants and convenience stores that offer few healthy, affordable food options Effects of hunger ● Malnutrition iron/zinc/antioxidants ● Vegetables only when SNAP $ available / 1st of month ● Stress from unexpected bills ● ADHD or hunger? Inability to focus in school ● Hoarding and stealing ● Eating quickly when food is available Other issues ● Quality of donated foods ● Cost of medications ● Food prep. Time vs. fast food ● Summer food access ● Public transportation Solutions ● Aquaponics ● Community food gardens ● Food co ops ● Sponsorship boxes ● Big store grocery delivery Epigenetics ● Epigenome ○ Proteins and other molecules that regulate expression of genes ■ Turning genes “on” and “off” ○ Inherited or altered ○ Regulation ■ Histones how these are affected are shown or not shown throughout the body ■ Methyl groups BIOACTIVE FOOD COMPONENTS important in turning on or off genes decreases or increases gene synthesis Future generation effects ○ Embryonic development ● Modifying your epigenome ● Health implications ○ Bioactive constituents in whole foods ● Astronaut Scott Kelly/ Mark Kelly The Dutch Hunger Winter ● Germans cut off food supplies to the netherlands in WW2 ● Calories reduced to 5001000 calories per person ● Women who were pregnant during the time (311) ● Altered genetics of all abbies ● More prone to obesity and heart disease than siblings before or after famine ● IGF2 gene Video ● Epigenetics in addition to genetics ● When DNA become attached to each other the genes are turned off ● What happens when genes are switched off? ● Food, stress , the sun contributes to which genes are on and which are off ● Mother breast cancer, than high cholesterol has a sister with no complaints ● People who were born with low birth weight have higher chance of complications ● Happens earlier on but biological indicators effects it later one ● Animal study same genes soy products changes color of fur ● Japan the japanese paradox lower incidence of cancer green tea suppresses cancer statistics chemical in green tea leaf becomes inactive with age green tea removes the methyl groups ● No part of us is older than 7 years ● knowing the DNA is not enough FMT & Human Gut Biota ● Microbiota ○ 100 trillion ○ Vagus Nerve ○ Epithelium ● FMT Facts ○ FECAL MICROBIOTA TRANSPLANTS ○ Bacterial Transfer ○ China ‘Yellow Soup’ 4th C. ○ Low cost low risk ○ Probiotic ○ No side effects ○ 90% success ○ FDA ● Microbiota ○ Behavioral traits ○ Individualized ○ Drugs and toxins ○ B2, B6, B12, K, and folic acid ○ 60% fecal material ○ 13 lbs ○ Dysbiosis The Okinawa Diet ● Okinawa, Japan ○ The highest life expectancy in the world ○ 80% fewer heart attacks than in the US ○ Breast and prostate cancer extremely rare ○ Obesity and smoking very rare ○ BMI of 20 in middle age ○ A series of islands off the coast of Japan ○ Ruyukyu Islands ○ Okinawa, largest island ○ 956 miles from japan ○ More traditional lifestyle and different food choices than japan ● The diet ○ 7 servings of vegetables and whole grains daily 72% ○ Soy (low fat high protein source) and seaweed (lots of iodine) 14% ○ Fish ( great source of protein and omega 3’s) = 11% ○ Meat, poultry, and eggs (cholesterol, bioavailable sources of protein) 3% ● Contributing Factors ○ An overall active lifestyle ○ Martial arts ○ Dance ○ Farming and gardening ○ Other factors ○ Spiritual and religious values connection to something bigger than yourself positive correlation to longevity ○ Status of women high voices are heard ○ Universal health care system ● The meeting of two worlds ○ Highest percentage of people that are 100 in the world ○ They have better health care ○ Public health and nutrition programs ○ Housing and income improvements ○ The american food invasion into okinawa making the younger generations unhealthier than the older generation ● How is it different from the Japanese Diet ○ They consume 1020% fewer calories than japan ○ 300% more fruits and vegetables than japan ○ Staple food a main food that they have in their diet ○ Sweet potatoes(super food) instead of rice as a staple ○ Diet is mostly plant based ● The four Guiding principles ○ 1) regular lifelong physical activity ○ 2) a mostly plant based diet ○ 3) Use of Hara Hachi Bu ○ 4) Knowing the calorie density of foods ● Hara Hachi Bu ○ Stop eating when you’re 80% full ○ Stomach stretch receptors 20 minutes to register ○ If hungry after 20 mins, eat more ● Caloric Density of Foods ○ Breakfast cereal ¾ cup = 32 grams per serving ○ Each serving =110 calories ○ So 110/32 =3.4 = caloric density ○ Featherweights ■ “Eat as much as you want, guilt free” ■ Vegetable soup, unsweetened green tea, asparagus, broccoli, squash, veggies, tofu ○ Lightweights ■ “Eat in moderation” ● Cooked grains quinoa, couscous, rice ● Sushi ● Cooked beans ● Fruit (beware of sugar content) ○ Middleweights ■ “Eat in smaller portions” ■ Hummus ■ Whole wheat bagel carbs and glycemic index ■ Raisins sugar content ○ Heavyweights ■ “The most dangerous, eat sparingly” ■ Cheddar cheese ■ Bacon Sports Supplements and Ergogenic Aids ● Supplements are best treated as ● Ergogenic aid = any external aid that can enhance performance ○ Pre workout , steroids Protein Powders ● Usually milk protein ○ Whey (fast digesting)/ Casein (slow digesting) ○ Processing ■ Concentrate least processed, usually 8090% protein ■ Isolate almost all lactose, fat removed ■ Hydrolysate highly processed: proteins already broken down to peptides (good because they can be absorbed much faster) Why is it Used? ● 1) meet daily protein requirements ○ Athletes: ■ 1.02.0g/kg/day depending on duration, intensity, adaption to training ● 2) Post workout “window” ○ Protein synthesis is increased after training ■ Fast proteins combined with high GI CHO’s result in the largest spikes ○ Milk makes a good post workout drink ■ Milk protein ~ 20% whey ■ Lactose = high GI CHO glycemic index carbohydrates ○ Protein demands are based on how long you’re doing the activity and the intensity Potential Benefits ● People with limited access to quality protein sources ● Convenience ● Athletes requiring high protein and calorie intakes easier to drink calories than eat them ● Liquid may be more palatable after strenuous exercise than whole foods ● Lactose intolerance ● Low calorie, low fat ● elderly , others with issues chewing? Drawbacks ● Less filling than whole proteins ● What is removed during processing? (B vitamins, iron, other vitamins/ minerals ● Concerns over preservatives, sweeteners? ● May make it easier to over consume protein? Creatine ● Others naturally in muscle ○ Creatine phosphate provides energy for activities lasting less than 10 seconds ○ Increases the formation of ATP ● Animal proteins provide creatine in diet ● Supplements are synthetically derived How Creatine Works Definitely: Increases energy stores in muscles for short, intense activities ● Proposed mechanisms for increased growth : ○ 1) Improved endurance for lifting ○ 2) Draws water in muscle cells ■ Increased pressure on walls of cells from water → muscle cell adapt to become stronger Benefits: ● Increased muscle growth ● Improved endurance for short sprints, similar activities ● Improved recovery ● Improved cognitive abilities Drawbacks ● cramps , possibly related to fluid drawn into muscles eliminated with extra hydration ● Hundreds of studies in the last twenty years no other documented problems Anabolic Steroids ● Testosterone natural hormone with wide range of effects throughout body ● Most steroids are synthetic versions of testosterone ● Many forms : pills, injections, skin patches/creams ● Steroids have both anabolic / androgenic effects to varying degrees Anabolic (anabolic = building) ● Increases protein synthesis ● Decreases in protein breakdown ● Stimulate bone marrow ● Increase in muscle size , improved recovery, increase in metabolism Androgenic (masculine characteristics) ● Deepening of voice ● Promote male pattern baldness ● Acne Health concerns ● Effects on the liver ○ Increased chance of hypertension, blood lipid issues ● Suppression of natural testosterone ○ High testosterone levels signal body to stop making its own testosterone ● Gynocomastia ○ Excess testosterone may be converted to estrogen ● Psychological issues? ○ “Roid rage”, aggressive behaviors Who can benefit from Anabolic Steroids (besides strength/power/physique athletes)? ● Traumatic injuries ● Wasting diseases ● Older males Growth hormone ● Naturally occurring peptide hormones ○ Pituitary gland ● HGH = synthetic version ● Complex functions ○ Protein synthesis, glucose production in the liver Benefits ● Athletic performance? ○ Few studies, but surprisingly little benefit shown Milk Alternatives and Meal Replacers Cow’s Milk ● Pros: ○ Good source of protein, Vitamin A, and calcium; most variety in natural vitamins ● Cons: ○ Fat content ● Nutrients from cow milk may be more bioavailable than nondairy alternatives Soy Milk ● What is it? Soaked soybeans and water ● Pros: ○ low in cholesterol, good source of vitamins (A,D,B12, folate, riboflavin), and minerals (Mg, P, K, Ca) ● Cons: ○ Common allergen; possible hormonal effects due to phytoestrogens, often containsGMO’s ● If you have breast cancer, stay away from soy milk Almond Milk ● What is it? Ground Almonds and water ● Pros: ○ Low in calories fat, and cholesterol ○ Good source of fiber, vitamins (A,D,E) and minerals (Ca, Mg, Mn) ● Con’s high in sodium, low in protein, common allergen Rice Milk ● What is it: boiled brown rice and rice starch, water ● Pros: low in saturated fat and cholesterol ● When fortified: good source of vitamins (folate, D, B12) and minerals (Ca, P) ● Cons: very low in protein and fat (essentially all carbohydrate) Coconut Milk ● What is it: coconut meat grated into water ● Pros: low in cholesterol and sodium, good source of manganese and iron, and vitamin B12 ● Cons: very high in saturated fats, little calcium and Vitamin D Hemp Milk ● What is it: hemp seeds soaked and ground into water ● PRos: low in cholesterol, saturated fats ; good source of vitamins (A,E,D,B12,riboflavin), and minerals (Ca, Mg, P) ● Cons: lower quality protein Meal Replacements: Soylent Ambronite and MealSquares Nutrients and Ingredients soylent ● 1 bag (3 meals ) = 2000 calories ● All vitamins and minerals ● Omega 3 from fish oil ● Recipe based on recommendations from institute of medicine ● ingredients : maltodextrin, rice protein, oat flour, vitamin and mineral mix, soy lecithin, salt, sucrose What Soylent Isn’t ● Not certified organic ● Not gluten free ● Not GMO free ● Not allergen free (soy) ● Mostly vegan (fish oil) ● Working on glycemic index ● Has not been evaluated for weight loss Expert Opinions ● Registered Dietitians: ○ No phytochemicals or antioxidants ○ Other currently unknown bioactive food components ○ No variety (sight, smell, texture) ○ Little pleasure ○ Social aspect of food ● Gastroenterologists: ○ flatulence , changes in bowel movements ○ Faster gastric emptying less satiety ○ No fiber variety can impact gut biota Potential problems ● Jaw and teeth function ○ Muscle atrophy, tooth decay ● Gut motility and health ○ GI tract muscle, gut flora ○ Less satiety possibly weight gain? ○ Lack of variety, pleasure, social atmosphere normally associated with food Potential Benefits and Uses ● Convenience, little time to prepare ● Cost effective (estimated 9$ a day ● Sustainable mostly recyclable materials ● Potential use for disaster relief , impoverished communities, food scarcity problems Development ● Romeo stevens: Creator ○ CS student ○ Nutrition research, customer feedback, product development ○ Wanted and easy, default meal option Ingridients ● Emphasis on whole foods, plus some vitamin and mineral powders ● Ingredients: eggs, orange juice, gluten free oats, milk, dark chocolate chips, whey, rice bran, sunflower seeds, dates, vegetable glycerin, moong flour, carrots, coconut oil, tapioca starch Nutritional Breakdown ● 100% of DRI’s for vitamins and minerals ● Special attention to B12 , folate, Vitamin C, and Vitamin D3 ● 1 square = 400 calories (45% carbs, 35% fats, 20% protein) ● 15$/day Characteristics ● Gluten free ● 99% lactose free ● Lacto ovo vegetarian compatible made of egg ● Made from whole foods ● Not FDA certified supplement ● Not vegan ● Possible allergens: egg, milk, tree nut (coconut) Ambronite the healthier approach to soylent Potential Problems and Possible Uses ● Limited sources of fruits and vegetables lack of variety of phytonutrients and antioxidants ● No food source of omega 3 ● Not FDA approved, little research has been done ● Glycemic index??? ALS Amyotrophic lateral sclerosis ● Also known as Lou Gehrig's disease ● Progressive neurological disease ● Effects the motor neurons of the nervous system ● Affects voluntary muscles only swallowing, talking, breathing ● Not involuntary memory, reasoning, vision ● Not currently curable ● Poor diagnosis ● Death within 25 years of diagnosis ● Dr. Steven Hawking famous physicist, cosmologist, astrophysicist ○ Only case on the planet of anyone living this long with ALS 50 + years ● 23 cases/100000 individuals ● More men than women, more after age of 70 ● Cause unknown ● Sporadic ● Familiar ALS genetic link in 10% of cases ● Multifactorial genetic , biological, and environmental ● Two strains ○ 23 years ○ 10 years or longer Symptoms ● Requires destruction of ⅓ of motor neurons before atrophy begins and symptoms are noticeable ● Treatment is on controlling symptoms ● Abnormalities with the neurotransmitter glutamate, so the one drug is riluzole, which is an antiglutamatergic agent Pathophysiology ● Dead neurons are replaced with nonfunctional fibrous cells ● Neurons no longer stimulate muscle action ● Muscle atrophy Clinical Signs ● Asymmetric muscle weakness and atrophy ● Hyperreflexia (hyper stiffening of the muscles) ● Uncontrolled twitching of the muscles ● Increasing paralysis ● Mechanical ventilation ● Nutrition support ● Don’t die of ALS you die of pneumonia muscles of the chest that support breathing become paralyzed Medical Issues ● Drug riluzole 23 months longer ● PEG early ● hypermetabolism where your body starts eating itself because body is not getting a sufficient amount of energy so it resorts to eating itself to get energy ● Muscle spasms ● Depression / anxiety Nutritional issues ● Hypermetabolism eat enough to maintain weight so you don’t break down tissue ● “Unhealthy food preparation” ● Swallowing and choking muscle control ● Dysphagia ( a hard time swallowing ) a long time to eat / isolation ● Unexplained choking laryngospasm ● Swallowing liquids or water ● Dehydration ● Thickening agents/ saliva too thick ● seeds/choking hazards ● Constipation ● PEG vs nasogastric (tube feed you through nasal or stomach) ● CAMs ( supplements ) fish oils, vitamins , CoQ10
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