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Question #: 291

Question: WE ARE ALWAYS CONCERNED THAT THERE WON'T BE ENOUGH VACCINE TO VACCINATE OUR PATIENTS IN THE FALL. WHAT CAN DO ASSURED WE'VE DONE ALL POSSIBLY AVOID THIS TYPE OF SITUATION?

Current Solution

It is never too early to begin planning for the coming fall's influenza vaccination program. The most important thing you can do initially is to place your order for vaccine from your usual source. Some manufacturers often stop taking pre-orders in mid-May. Be sure to include vaccine for pediatric patients needing two doses and also for your facility's healthcare workers as part of your overall campaign.

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Other Possible Solutions to this Question

  • SOME OF MY PATIENTS REFUSE INFLUENZA VACCINATION BECAUSE THEY INSIST "GOT THE FLU" AFTER RECEIVING INJECTABLE VACCINE IN PAST. WHAT CAN I TELL THEM?

    There are several reasons why this misconception persists: (1) Less than 1% of people who are vaccinated with the injectable vaccine develop flu-like symptoms, such as mild fever and muscle aches, after vaccination. These side effects are not the same as having influenza, but people confuse the symptoms. (2) Protective immunity doesn't develop until 1–2 weeks after vaccination. Some people who get vaccinated later in the season (December or later) may get influenza shortly afterward. These late vaccinees develop influenza because they were exposed to someone with the virus before they became immune. It is not the result of the vaccination. (3) To many people "the flu" is any illness with fever and cold symptoms. If they get any viral illness, they may blame it on the flu shot or think they got "the flu" despite being vaccinated. Influenza vaccine only protects against certain influenza viruses, not all viruses. (4) The influenza vaccine is not 100% effective, especially in older persons. For more information on this topic, go to: www.cdc.gov/flu/professionals/vaccination/effectivenessqa.htm

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    SOME OF MY PATIENTS REFUSE INFLUENZA VACCINATION BECAUSE THEY INSIST "GOT THE FLU" AFTER RECEIVING INJECTABLE VACCINE IN PAST. WHAT CAN I TELL THEM?

  • WE HAVE NOTICED THAT CDC RECOMMENDS BEGIN VACCINATING WITH SEASONAL INFLUENZA VACCINE AS EARLY SEPTEMBER OR EVEN EARLIER. DOES PROTECTION FROM DECLINE WANE WITHIN 3 4 MONTHS OF VACCINATION? SHOULD I WAIT UNTIL OCTOBER NOVEMBER TO VACCINATE MY ELDERLY MEDICALLY FRAIL PATIENTS?

    CDC recommends that seasonal influenza vaccine be administered to all age groups as soon as it becomes available. Antibody to seasonal inactivated influenza vaccine declines in the months following vaccination. However, antibody level at a point several months after vaccination does not necessarily correlate with clinical vaccine effectiveness. There are no studies that compare vaccine effectiveness according to the month when the vaccination was given. The authors of a review on antibody declines among the elderly after vaccination reported, "In conclusion, we found no compelling evidence for more rapid decline of the influenza vaccine-induced antibody response in the elderly, compared with young adults, or evidence that seroprotection is lost at 4 months if it has been initially achieved after immunization." (See Skowronski, et al., Rapid Decline of Influenza Vaccine-Induced Antibody in the Elderly: Is it Real, or Is It Relevant? Journal of Infectious Diseases 2008;197:490-502).In addition, there is a lack of evidence for late-season outbreaks among vaccinated persons that can be attributed to waning immunity.

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    WE HAVE NOTICED THAT CDC RECOMMENDS BEGIN VACCINATING WITH SEASONAL INFLUENZA VACCINE AS EARLY SEPTEMBER OR EVEN EARLIER. DOES PROTECTION FROM DECLINE WANE WITHIN 3 4 MONTHS OF VACCINATION? SHOULD I WAIT UNTIL OCTOBER NOVEMBER TO VACCINATE MY ELDERLY MEDICALLY FRAIL PATIENTS?

  • HOW LATE IN THE SEASON CAN I VACCINATE MY PATIENTS WITH INFLUENZA VACCINE?

    Peak influenza activity does not generally occur until February. Providers are encouraged to continue vaccinating patients throughout the influenza season, including into the spring months (e.g., through May), as long as they have vaccine in the refrigerator and unvaccinated patients in their office.

    Because influenza occurs in many areas of the world during April through September, vaccine should be given to travelers who missed vaccination in the preceding fall and winter. Another late season use of vaccine is for children younger than age 9 years who were vaccinated for the first time in the current vaccination season but failed to get their second dose. For each of these situations, vaccine can be given through the month of June since injectable influenza vaccine customarily has a June 30 expiration date.

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    HOW LATE IN THE SEASON CAN I VACCINATE MY PATIENTS WITH INFLUENZA VACCINE?

  • WE ARE PERFORMING DIGITAL X RAY USING A 9 OR 15 MEV LINATRON. THE CAMERA NOT IN DIRECT BEAM PATH. TO SHIELD USED 2.5-INCH THICK TUNGSTEN. NOW FIND HAVE VERY HIGH NEUTRON DOSE WITHIN SHIELDED CONTAINER. WOULD SEEN THIS SAME PROBLEM LEAD TUNGSTEN WORSE? WHAT CAN DO ELIMINATE ACTIVATION CONTAINER? IT BE ENOUGH ADD BORON PLASTIC POWDER COAT

    The linatron is an industrial linear accelerator manufactured by Varian Medical Systems1. In a linatron, the electron beam strikes a target, producing bremsstrahlung which is then collimated with internal collimators and sometimes with external collimators. The target and internal collimator are typically made of some high-Z material such as tungsten. The accelerator head is usually shielded with lead or tungsten. Neutron production will take place in any material struck by an electron or bremsstrahlung beam above a threshold energy (Eth). The minimum threshold for photoneutron production in tungsten and lead is 6.19 MeV and 6.11 MeV, respectively (NCRP 1984). Thus a linatron operating at 9 MV will produce neutrons. The photoneutron spectrum from the accelerator head resembles that of a fission spectrum. The spectrum changes after penetration through the head shielding. Since the linatron is usually operated in a concrete-shielded room, room-scattered neutrons will further soften the spectrum. Neutrons are classified as:

    Thermal: En = 0.025 eV at 20°C; typically En < 0.5 eV (cadmium resonance)
    Intermediate: 0.5 eV Fast: En > 10 keV
    where En is the neutron energy.

    The neutrons observed at the camera location will consist primarily of neutrons leaking directly from the accelerator head, room-scattered neutrons, neutrons produced in the object to be imaged by the primary bremsstrahlung beam, and neutrons scattered from the object to be imaged. Since the camera is not in the direct-beam path, photoneutrons can only be produced in the shielding by leakage photons or photons scattered from the object to be imaged. Since leakage photons are typically only 1 percent or 0.01 percent of the primary beam or even lower, neutron production in the camera shielding from leakage photons can be considered negligible, as can neutrons produced by photons scattered from the object. Therefore changing the shielding from tungsten to lead will not significantly reduce the neutrons at the camera location. The camera can be shielded from neutrons with several inches of a hydrogeneous material such as polyethylene. If thermal neutrons are also of concern, polyethylene doped with 5 percent boron (borated polyethylene) can be used. Boron has a much higher cross-section than polyethylene for thermal neutron capture. Boron interacts with thermal neutrons by undergoing an (n,a) reaction producing 7Li, which then undergoes an isomeric transition by emitting a 0.478 MeV photon or gamma ray. These photons are much lower in energy than the thermal neutron capture gammas (2.2 MeV) from hydrogen in the polyethylene. A sandwich construction of tungsten (or lead), polyethylene, and tungsten (or lead) will work best.

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    WE ARE PERFORMING DIGITAL X RAY USING A 9 OR 15 MEV LINATRON. THE CAMERA NOT IN DIRECT BEAM PATH. TO SHIELD USED 2.5-INCH THICK TUNGSTEN. NOW FIND HAVE VERY HIGH NEUTRON DOSE WITHIN SHIELDED CONTAINER. WOULD SEEN THIS SAME PROBLEM LEAD TUNGSTEN WORSE? WHAT CAN DO ELIMINATE ACTIVATION CONTAINER? IT BE ENOUGH ADD BORON PLASTIC POWDER COAT

  • ARE THERE PRODUCTS AVAILABLE TO THE GENERAL PUBLIC THAT CAN BE PURCHASED PROTECT CELLULAR OR PORTABLE TELEPHONE USERS FROM RADIATION? IF SO, WHERE THESE FOUND?

    There are a number of opportunistic gadgets on the market to allegedly protect the user from hazards of cellular phones. You can search the Internet to find the latest, ranging from antenna shields to whole-body shielding materials. Most experts believe that these devices take advantage of customers' misunderstanding and unfounded fears to sell products with no real value. First of all, cell phones that operate within the guidelines established by national and international safety panels have never been shown to pose a health risk to the user (see answers to other questions on cell phone safety on this website). Secondly, placing any kind of shield over the antenna of a cell phone will in most cases cause it to increase its RF output as it attempts to compensate for signal loss in the shield and maintain a quality phone call. The U.S. Food and Drug Administration published an advisory on cell phones several years ago that said if you are concerned about risks of using a cell phone, then simply use it less. That is still good advice today. Gary Zeman, ScD, CHP Lawrence Berkeley National Laboratory

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    ARE THERE PRODUCTS AVAILABLE TO THE GENERAL PUBLIC THAT CAN BE PURCHASED PROTECT CELLULAR OR PORTABLE TELEPHONE USERS FROM RADIATION? IF SO, WHERE THESE FOUND?

  • MY QUESTION THAT KNOW CANCER CAN BE CAUSED WHEN OUR BODY EXPOSED TO DOSES OF 50 CGY OR HIGHER. WHAT DOES STAND FOR? DO EMIT?

    The term cGy (centigray) is a unit of absorbed dose of ionizing radiation such as x rays or gamma rays. Cell phones do not emit ionizing radiation. They emit nonionizing radiation, namely radiofrequency (RF) energy. Absorption of nonionizing radiation in the body is measured in terms of the specific absorption rate (SAR) in units of watts per kilogram. Both ionizing and nonionizing radiation are forms of electromagnetic energy. The difference is that ionizing radiation has sufficient energy per photon to cause ionization of molecules. Nonionizing radiation does not. It is the ionizing effect of ionizing radiation that has been linked to increased risk of cancer. For more information on cell phones and health check out a Medical College of Wisconsin website. For more information on ionizing versus nonionizing radiation check out a University of Michigan website. Gary Zeman, ScD, CHP Lawrence Berkeley National Laboratory

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    MY QUESTION THAT KNOW CANCER CAN BE CAUSED WHEN OUR BODY EXPOSED TO DOSES OF 50 CGY OR HIGHER. WHAT DOES STAND FOR? DO EMIT?

  • WE'VE HEARD THAT ACIP HAS LIMITED THE USE OF ONE INFLUENZA VACCINE PRODUCTS FOR CHILDREN BEGINNING WITH 2010-11 VACCINATION SEASON. TRUE?

    Yes. You are referring to Afluria, which is manufactured in Australia by CSL Laboratories for the U.S. market. CSL's 2010 Southern Hemisphere influenza vaccine (Fluvax and Fluvax Junior) has been associated with increased post-marketing reports of fever and febrile seizures in children predominantly younger than age 5 years as compared to previous years. For this reason, on August 5, 2010, ACIP recommended that Afluria, 0.5 mL, licensed for use in people age 36 months and older, not be used in children younger than age 9 years. ACIP further recommended that Afluria could be administered to children ages 5 through 8 years who are at high risk for influenza complications if there is no other age-appropriate TIV available, after risks and benefits of using this vaccine in this age group have been discussed with the parent or guardian. The vaccine should not be given to children younger than age 5 years. For detailed information, go to www.cdc.gov/media/pressrel/2010/s100806.htm.

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    WE'VE HEARD THAT ACIP HAS LIMITED THE USE OF ONE INFLUENZA VACCINE PRODUCTS FOR CHILDREN BEGINNING WITH 2010-11 VACCINATION SEASON. TRUE?

  • WHICH OF OUR PEDIATRIC PATIENTS WILL NEED 2 DOSES INFLUENZA VACCINE FOR THE 2011–12 VACCINATION SEASON?

    ACIP's influenza recommendations for children age 6 months through 8 years have changed for the 2011–12 season. According to the new algorithm, certain children need 2 doses of influenza vaccine this influenza season, separated by at least 4 weeks. Here is a summary:

    • Children age 6 months through 8 years who did not receive AT LEAST 1 dose of the 2010–11 vaccine should receive 2 doses, separated by at least 4 weeks, REGARDLESS of their previous influenza vaccination history.
    • Children age 6 months through 8 years whose influenza vaccination status from the previous season is not known should also receive 2 doses at least 4 weeks apart.
    • Children age 6 months through 8 years who received 1 dose of seasonal influenza vaccine during the 2010–11 season need ONLY 1 dose this season. This is because the vaccine strains are the same this season as last season.

    You may find this Immunization Action Coalition handout helpful: www.immunize.org/catg.d/p3093.pdf.

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    WHICH OF OUR PEDIATRIC PATIENTS WILL NEED 2 DOSES INFLUENZA VACCINE FOR THE 2011–12 VACCINATION SEASON?

  • WE'RE GLAD THAT CDC HAS MADE A UNIVERSAL INFLUENZA VACCINATION RECOMMENDATION TO VACCINATE EVERYONE 6 MONTHS AND OLDER. WOULD YOU TELL US HOW THIS CAME ABOUT?

    Prior to the 2010-11 vaccination season, only children ages 6 months through 18 years and adults age 50 years and older were universally recommended for vaccination; recommendations for adults ages 19 through 49 years were targeted to people with specific risk factors, although other adults could be vaccinated if they wanted protection. Collectively, these targeted risk groups made up 85% of the U.S. population. During the 2009 H1N1 outbreak, additional risk groups were identified, such as obese individuals. The recommendation made by ACIP in February 2010 for universal vaccination simplifies previous recommendations, making it easier for healthcare providers to determine whom to vaccinate. The universal recommendation also makes it easier for patients to remember to get vaccinated every year.

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    WE'RE GLAD THAT CDC HAS MADE A UNIVERSAL INFLUENZA VACCINATION RECOMMENDATION TO VACCINATE EVERYONE 6 MONTHS AND OLDER. WOULD YOU TELL US HOW THIS CAME ABOUT?

  • How can we check our 1.5kw spindle. we get a dL error after we start to cut. it spins up fine. We checked IGBTs in the VFD and they're not shorted. We suspect intermittent short INSIDE the spindle. What do you think?

    dL usually stand for a short that is occurring within the spindle or spindle wiring. I would recheck the wiring going from the VFD to the spindle, as well as the terminal on the spindle where there should've been some soldering required. We usually tend to either heat shrink or use electrical tape to cover the terminals so no contact or arching can be present.

    Also depending on the VFD you have please adjust the setting pd008, to the voltage that is required (110V/220V).

    If the issue proceeds please contact use at customerservice@buildyourcnc.com, for further assistance or replacement.

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    How can we check our 1.5kw spindle. we get a dL error after we start to cut. it spins up fine. We checked IGBTs in the VFD and they're not shorted. We suspect intermittent short INSIDE the spindle. What do you think?

  • I have the 2.2KW VFD. I would like to have it controlled through software. What are the Mode parameters that need to be changed that will allow FWD/ REV, START/STOP and RPM control?

    What controller are you using to control the cnc machine (Mach3 usb, parallel breakout board, etc.)?

    The spindle VFD has an input for 0-10 volts to control the speed and can be used with the MAch3 USB or the Pokeys57CNC board. There are also other terminals in the VFD to control the forwared/reverse and start and stop. Mach3 has parameters to control these output and you need to specify which pins are used for these.

    You can also use the TX/RX RS-485 connection on the VFD to have total control using an FTDI USB to serial connector board to connect the computer directly to the VFD.

    How to connect the USB to Serial adapter to the VFD:
    https://www.buildyourcnc.com/FAQ/13790

    FTDI USB to Serial:
    https://www.buildyourcnc.com/item/Interfaces-newbiehack-Interfaces-TTL232R-USB-UART-Serial

    Pokeys57CNC board:
    https://www.buildyourcnc.com/item/electronicsAndMotors-electronic-component-breakout-Mach4-mach3-USB-ethernet-Board

    Mach3 USB board:
    https://www.buildyourcnc.com/item/electronicsAndMotors-electronic-component-breakout-Mach3-USB-Board

    Parallel Breakout board:
    https://www.buildyourcnc.com/item/electronicsAndMotors-parallel-breakout-relay



    Additional Information:
    I do apologize for leaving out the parts list.
    Leadshine MX4660 4-Axis Digital Stepper Motor Driver
    Ethernet SmoothStepper
    YL600-2S-2K20 VFD
    4 Relay control board
    Has anyone had any success getting Mach3 to control the spindle speed and direction?

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    I have the 2.2KW VFD. I would like to have it controlled through software. What are the Mode parameters that need to be changed that will allow FWD/ REV, START/STOP and RPM control?

  • ARE THERE STILL VIDEOS THAT CAN WATCH AS PUT THIS TOGETHER, I'LL BUY THEM IF HAVE TO, VERY FUSTURATED WITH ELECTROCTICS AND WIRING PART.
  • I WIRED MY VFD (2.2KW VERSION) AND TRIED TEST RUNNING THE SPINDLE. CONFIGURED TO YOUR SPECS ON THIS WEBSITE, ONLY ISSUE IS WE GOT AN ERROR CODE. ERR 02, DO YOU KNOW WHAT IS? OR HAVE A LIST OF CODES? THANK

    Can you provide the model number of your VFD?

    Yes, I have the "YL600 - 2S - 2K20"

    It just came with a small booklet that is all in Chinese...

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    I WIRED MY VFD (2.2KW VERSION) AND TRIED TEST RUNNING THE SPINDLE. CONFIGURED TO YOUR SPECS ON THIS WEBSITE, ONLY ISSUE IS WE GOT AN ERROR CODE. ERR 02, DO YOU KNOW WHAT IS? OR HAVE A LIST OF CODES? THANK

  • AM NOT SURE HOW TO SET THE Z AXIS TURN ON/OFF LASER WHEN CREATE CODE. KNOW THAT ITS TYPICALLY Z-AXIS MOVEMENT DOES THIS - BUT YOU DONT SHOW ANYTHING HOOKED UP IN PLACE OF AXIS.

    When the z axis is going down, the laser turns on. When the z axis is going up, it turns off. The z axis directions is only a signal that is either 5v or 0v. That determines the direction. In vectric, you will need to set your machining operations with a very very small depth so the time it takes to get to its final depth is a very short time.

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    AM NOT SURE HOW TO SET THE Z AXIS TURN ON/OFF LASER WHEN CREATE CODE. KNOW THAT ITS TYPICALLY Z-AXIS MOVEMENT DOES THIS - BUT YOU DONT SHOW ANYTHING HOOKED UP IN PLACE OF AXIS.

  • WHAT EFFECTS OF CELL PHONES WILL THERE BE ON YOUNGER PEOPLE OPPOSED TO OLDER PEOPLE? THE AGE OR STATE DEVELOPMENT EFFECT DANGERS A PHONE?

    Physical size of the subject affects the fraction of the total radiofrequency energy that is absorbed in the body. To account for this known effect, the maximum permissible exposure standards for radiofrequency energy were set for the worst-case condition, that is assuming the body size for maximal absorption at a given frequency. Thus the maximum permissible exposure standards are fully protective for bodies of different sizes. For more detailed information, see the answers and the cited references to questions 79, 109, 694, and 893 under the Nonionizing Radiation section of the Health Physics Society Ask The Expert Web page. Gary H. Zeman, ScD, CHP

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    WHAT EFFECTS OF CELL PHONES WILL THERE BE ON YOUNGER PEOPLE OPPOSED TO OLDER PEOPLE? THE AGE OR STATE DEVELOPMENT EFFECT DANGERS A PHONE?

  • I want to order 8 HIWIN Linear Guide Blocks. Is there a cheaper shipping option? $70 is too much for something that weighs less than 5 lbs. I live in the continental US

    Prices on amazon are fixed costs for shipping. The website generally reports high costs for international shipments but we can give you a better quote if you care to email sales@buildyourcnc.com

    Click the link to add information to this solution:
    I want to order 8 HIWIN Linear Guide Blocks. Is there a cheaper shipping option? $70 is too much for something that weighs less than 5 lbs. I live in the continental US

  • LIMIT SWITCHES FOR AXIS. THE PRINT SHOWS THAT YOU CAN WIRE LIMITS EITHER N.O. OR N.C. SO IF THIS IS CORRECT I WOULD NEED TO TELL BOARD IN SOFTWARE HOW LOOK AT THESE LIMITS, I'M GOING GET AN INPUT LOOSE DEPEND ON IT.

    BYCNC Response:
    This is correct. You will need to use a method appropriate for the software you are using. Also remember that NC switches are typically wired in series, while NO switches are normally wired in parallel.

    User Response:
    I am using the cnc planet software for your USB board. Are the limit configurations in this software?

    BYCNC Response:
    Yes, Planet CNC software is compatible with the use of limit switches. Configuration information will depend on your specific application. You can view Planet CNC's information here: http://www.planet-cnc.com/files/CNCUSBController.pdf

    Click the link to add information to this solution:
    LIMIT SWITCHES FOR AXIS. THE PRINT SHOWS THAT YOU CAN WIRE LIMITS EITHER N.O. OR N.C. SO IF THIS IS CORRECT I WOULD NEED TO TELL BOARD IN SOFTWARE HOW LOOK AT THESE LIMITS, I'M GOING GET AN INPUT LOOSE DEPEND ON IT.

  • WHY DO PEOPLE RECEIVED INFLUENZA VACCINE LAST YEAR STILL NEED TO GET VACCINATED THIS WHEN THE VIRUSES HAVEN'T CHANGED?

    Although the strains may sometimes be the same as in the previous year's vaccine, you should NOT use the previous season's vaccine you might still have in your refrigerator. Influenza vaccine distributed in the northern hemisphere expires on June 30 after each season; expired vaccine should NEVER be administered. Secondly, antibody titers that persons might have achieved from the previous year's vaccination will have waned and need to be boosted with a dose of the current year's vaccine.

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    WHY DO PEOPLE RECEIVED INFLUENZA VACCINE LAST YEAR STILL NEED TO GET VACCINATED THIS WHEN THE VIRUSES HAVEN'T CHANGED?

  • IF A CHILD RECEIVES INFLUENZA VACCINE AT AGE 34 OR 35 MONTHS FOR THE FIRST TIME (0.25 ML DOSE) AND THEN RETURNS SECOND DOSE 37 MONTHS, SHOULD WE GIVE ANOTHER 0.25 0.5 THAT INDICATED AGES 3 OLDER?

    The child should always receive the dose appropriate for his or her age at the time of the clinic visit; at age 37 months that would be 0.5 mL.

    Click the link to add information to this solution:
    IF A CHILD RECEIVES INFLUENZA VACCINE AT AGE 34 OR 35 MONTHS FOR THE FIRST TIME (0.25 ML DOSE) AND THEN RETURNS SECOND DOSE 37 MONTHS, SHOULD WE GIVE ANOTHER 0.25 0.5 THAT INDICATED AGES 3 OLDER?

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