Dhanvantari Ayurveda Center  Michael Dick, Ayurvedic Practitioner, Leesburg, Florida    e-mail: md@ayurveda-florida.com

 

     

The Ayurvedist®

                                    Volume V Issue 1                                                                        January 2008  

Health and Science in the News

Text Box: Angel of the Waters Central Park NYC
 

 

 

                                                                                                                   

Inside This Issue

1

Health and Science in the News

2

Stimulating Memory

3

Book Corner--The PIG to Global Warming and Environmentalism

 

 

Happy New Year to all! The Ayurvedist wishes the best to you in the new year.

 

From the People's Pharmacy (Joe and Terry Graedon):

Milk of Magnesia used as an underarm deodorant works surprisingly well.

Dry, splitting, cracking fingertips: try VapoRub externally to the fingers

Foot fungus and foot odor: one's own urine applied topically has been found useful for this purpose by soldiers and civilians alike; others have found vinegar and Listerine half & half for 15' 2x - 3x weekly for few months does the job

For suppressing sexual appetite chaste tree berry in females as it mimics or has progesterone-like effects

Generic Drugs may not be as potent (therapeutic failure) as their brand name equivalent--as least one MD has concluded this fact about oxycodone vs. OxyContin

 

Nutrient and Methyl Mercury Exposure from Consuming Fish1,2--There is controversy about the risks and benefits of consuming fish. Fish consumption provides nutrients, some of which are essential for brain growth and development. All fish, however, contain methyl mercury (MeHg), a known neurotoxicant. The toxic effect of MeHg seems most damaging during brain development, and thus, prenatal exposure is of greatest concern. At present the level of prenatal exposure associated with risk to a child’s neurodevelopment is not known. Balancing the rewards and possible risks of fish consumption presents a dilemma to consumers and regulatory authorities. We review the nutrients in fish that are important in brain development and the current evidence of risk from MeHg at exposure levels achieved by consuming fish. We then review the findings from a large prospective cohort study of a population that consumes fish daily, the Seychelles Child Development Study. The MeHg content of the fish consumed in the Seychelles is similar to that of ocean fish available in industrialized countries, so they represent a sentinel population for any risk from fish consumption. In the Seychelles, evaluations of the children through 9 y of age show no consistent pattern of adverse associations with prenatal MeHg exposure. Recent studies in the Seychelles have focused on nutrients in fish that might influence a child’s development, including long-chain polyunsaturated fatty acids, iodine, iron, and choline. Preliminary findings from this study suggest that the beneficial influence of nutrients from fish may counter any adverse effects of MeHg on the developing nervous system. J. Nutr. 137: 2805–2808, 2007.
 

Low vitamin B-12 status and risk of cognitive decline in older adults1–3--Elevated total homocysteine (tHcy) concentrations have been associated with cognitive impairment, but it is unclear whether low vitamin B-12 or folate status is responsible for cognitive decline. Objective: We examined the associations of cognitive decline with vitamin B-12 and folate status in a longitudinal cohort study performed from 1993 to 2003 in Oxford, United Kingdom. Design: Cognitive function was assessed with the Mini-Mental State Examination on 3 occasions during 10 y and related to serum concentrations of vitamin B-12, holotranscobalamin (holoTC), tHcy, methylmalonic acid (MMA), and folate with the use of linear mixed models in 1648 participants who provided blood in 1995. Results: Cognitive function declined abruptly at younger ages in some participants but remained intact in others until very old age. In multivariate regression analyses after adjustment for established risk factors, concentrations of holoTC (a marker of reduced vitamin B-12 status), tHcy, and MMA predicted cognitive decline, but folate did not. A doubling in holoTC concentrations (from 50 to 100 pmol/L) was associated with a 30% slower rate of cognitive decline ( 0.137 to 0.083), whereas a doubling in tHcy (from 10 to 20 mol/L) or MMA (from 0.25 to 0.50 mol/L) was associated with 50% more rapid cognitive decline ( 0.090 to 0.169) and ( 0.104 to 0.169), respectively. After adjustment for all vitamin markers simultaneously, the associations of cognitive decline with holoTC and MMA remained significant. Conclusions: Low vitamin B-12 status was associated with more rapid cognitive decline. Randomized trials are required to determine the relevance of vitamin B-12 supplementation for prevention of dementia. Am J Clin Nutr 2007;86:1384 –91.

Heavy Metal Contents of Vegetables Grown in Soil, Irrigated with Mixtures of Wastewater and Sewage Sludge in Pakistan, using Ultrasonic-Assisted Pseudodigestion--The success of risk assessment of metal-contaminated soils depends on how precisely one can predict the bioavailability of trace and toxic metals in soil and transfer to the human food chain. A field experiment was carried out from 2004 to 2005 to evaluate the long-term effect of sewage sludge application in agricultural lands where mostly vegetables are grown. The aim of this study was to predict the uptake of Cd, Cu, Cr, Ni, Pb and Zn by different vegetables grown on agricultural soil irrigated for long period with untreated domestic waste water and sewage sludge (SIDWS) as test samples and for comparative purposes, same vegetables grown on agricultural soil irrigated with fresh canal water (SIFW), collected as control samples. A sample preparation method based on ultrasound-assisted pseudo- igestion (UASD) of soil, sewage sludge and vegetable samples in ultrasonic bath was developed. A conventional wet acid digestion method was used for comparison purposes. The EDTA-extractable metal in SIFW and SIDWS was also studied. The extracts and digests were analysed by flame atomic absorption spectrometer/electrothermal atomic absorption  spectrometer (FAAS/ETAAS). Analytical results for six metals and metalloid by UASD in bath and conventional wet digestion methods showed a good agreement, thus indicating the possibility of using low mass and minimum quantity of digesting acid mixture in less time when compared with the conventional digestion method (CDM). The validation of the proposed UASD method was assessed by using certified reference materials BCR 483 and (whole meal flour) BCR 189. Recoveries ranging from 95.5 % to 102.3 % for understudied metals were obtained for different samples (soils and vegetables). The average relative standard deviation of UASD method varied between 2.3 % and 7.9 % for N ¼ 12, depending on the analyte. The vegetables grown in SIDWS showed high level of heavy metals when compared with control samples. This investigation highlights the increased danger of growing vegetables in the agricultural land, continuously irrigated and dressed with waste water and solid sewage sludge. J. Agronomy & Crop Science 193, 218—228 (2007) doi:10.1111/j.1439-037X.2007.00261.x 2007 The Authors Journal compilation 2007 Blackwell Verlag, Berlin ISSN 0931-2250

Fatty acid synthase and the lipogenic phenotype in cancer pathogenesis Javier A. Menendez* and Ruth Lupu--There is a renewed interest in the ultimate role of fatty acid synthase (FASN) — a key lipogenic enzyme catalysing the terminal steps in the de novo biogenesis of fatty acids — in cancer pathogenesis. Tumour-associated FASN, by conferring growth and survival advantages rather than functioning as an anabolic energy-storage pathway, appears to necessarily accompany the natural history of most human cancers. A recent identification of cross-talk between FASN and well-established cancer-controlling networks begins to delineate the oncogenic nature of FASN-driven lipogenesis. FASN, a nearly-universal druggable target in many human carcinomas and their precursor lesions,

Efficacy of folic acid supplementation in stroke prevention: a meta-analysis-- Xiaobin Wang, Xianhui Qin, Hakan Demirtas, Jianping Li, Guangyun Mao, Yong Huo, Ningling Sun, Lisheng Liu, Xiping Xu --Summary Background The efficacy of treatments that lower homocysteine concentrations in reducing the risk of cardiovascular disease remains controversial. Our aim was to do a meta-analysis of relevant randomised trials to assess the efficacy of folic acid supplementation in the prevention of stroke. Methods We collected data from eight randomised trials of folic acid that had stroke reported as one of the endpoints. Relative risk (RR) was used as a measure of the effect of folic acid supplementation on the risk of stroke with a random effect model. The analysis was further stratified by factors that could affect the treatment effects. Findings Folic acid supplementation significantly reduced the risk of stroke by 18% (RR 0·82, 95% CI 0·68–1·00; p=0·045). In the stratified analyses, a greater beneficial effect was seen in those trials with a treatment duration of more than 36 months (0·71, 0·57–0·87; p=0·001), a decrease in the concentration of homocysteine of more than 20% (0·77, 0·63–0·94; p=0·012), no fortification or partly fortified grain (0·75, 0·62–0·91; p=0·003), and no history of stroke (0·75, 0·62–0·90; p=0·002). In the corresponding comparison groups, the estimated RRs were attenuated and insignificant. Interpretation Our findings indicate that folic acid supplementation can effectively reduce the risk of stroke in primary prevention. Lancet 2007; 369: 1876–82

 

A neuroscientist’s guide to lipidomics Daniele Piomelli*, Giuseppe Astarita*and Rao Rapaka--Nature Reviews | Neuroscience volume 8 | October 2007 | 743-- Nerve cells mould the lipid fabric of their membranes to ease vesicle fusion, regulate ion fluxes and create specialized microenvironments that contribute to cellular communication. The chemical diversity of membrane lipids controls protein traffic, facilitates recognition between cells and leads to the production of hundreds of molecules that carry information both within and across cells. With so many roles, it is no wonder that lipids make up half of the human brain in dry weight. The objective of neural lipidomics is to understand how these molecules work together; this difficult task will greatly benefit from technical advances that might enable the testing of emerging hypotheses.

 

Serotonin and the Orchestration of Energy Balance Laurence H. Tecott1,*
1Department of Psychiatry, Center for Neurobiology and Psychiatry, University of California, San Francisco, San Francisco, CA 94158-2324, USA
*Correspondence: larry.tecott@ucsf.edu DOI 10.1016/j.cmet.2007.09.012 --The phylogenetically ancient signaling molecule serotonin is found in all species that possess nervous systems and orchestrates diverse behavioral and physiological processes in the service of energy balance. In some instances, the manner in which serotonin signaling influences these processes appears comparable among invertebrate and vertebrate species. Within mammalian species, central nervous system serotonergic signaling influences both behavioral and physiological determinants of energy balance. Within the gastrointestinal tract, serotonin mediates diverse sensory, motor, and secretory functions. Further examinations of serotonergic influences on peripheral organ systems are likely to uncover novel functions consistent with an apparently pervasive association between serotonergic signaling and physiological substrates of energy balance.

 

Lead in Bottled Waters: Contamination from Glass and Comparison with Pristine Groundwater Williamshotyk * and Michaelkrachler Institute of Environmental Geochemistry, University of Heidelberg, INF 236, D-69120 Heidelberg, Germany --Using clean lab methods and protocols developed for
measuring lead (Pb) in polar snow and ice, we report the abundance of Pb in 125 brands of bottled water from 28 countries. Comparison of six samples of each of three brands of water available in both glass and polyethyelene terephthalate (PET(E)) showed that the waters bottled in glass contained approximately 57, 30, and 26 times more Pb due to leaching from the containers. Excluding the bottled waters in glass, the median Pb concentration in all bottled waters was found to be 8.5 ng/L (n ) 185), with a range from <1 to 761 ng/L Pb. Our study includes 25 brands of bottled water from Canada, and the median Pb concentration in these samples was 15.9 ng/L (n ) 25), with a range from 2.1 to 268 ng/L. For comparison with the bottled waters, pristine groundwater from six artesian flows in southern Ontario, Canada, where some of the bottled waters originate, yielded a median concentration of 5.1 ng/L Pb (n ) 18). The median Pb concentrations reported here for bottled waters from Canada are 32-588 times less than those presented in recently published studies. In fact, all of the waters tested were well below the maximum allowable concentration established by the EU, Health Canada, and the WHO for Pb in drinking water (10 íg/L).


NEEM--Antibacterial, antisecretory and antihemorrhagic activity of Azadirachta indica used to treat cholera and diarrhea in India Prarthana Thakurta a, Poulami Bhowmika, Souryadeep Mukherjee a, Tapas K. Hajra a, Amarendra Patra b, Prasanta K. Baga,∗ a Department of Biochemistry, University of Calcutta, 35 Ballygunge Circular Road, Kolkata 700019, India b Department of Chemistry, University of Calcutta, 92 Acharya Prafulla Chandra Road, Kolkata 700009, India Journal of Ethnopharmacology 111 (2007) 607–612,© 2007 Published by Elsevier Ireland Ltd.--Indigenous uses of Azadirachta indica A. juss (Maliaceae) (locally known as neem) leaves in different parts of India for curing gastrointestinal disorder such as diarrhea and cholera is wide spread. The objective of the present study was to evaluate the antibacterial and antisecretory activity of neem extract against Vibrio cholerae, a causative agent of watery diarrhea such as cholera. The methanol extract of neem leaf was tested for its antibacterial, antisecretory and antihemorrhagic activity against Vibrio cholerae. Azadirachta indica extract had significant antibacterial activity against the multi-drug-resistant Vibrio cholerae of serotypes O1, O139 and non-O1, non-O139. The minimum inhibitory concentration reached by 50% (MIC50) and 90% (MIC90), and minimum bactericidal concentration for the extract were 2.5, >5, and 10 mg/ml, respectively. Neem extract showed antisecretory activity on Vibrio cholerae induced fluid secretion in mouse intestine with inhibition values of 27.7%, 41.1%, 43.3%, 57.0%, and 77.9% at doses of   100, 200, 300, 450 and 1800 mg/kg, respectively. Oral administration of the extract inhibited hemorrhage induced by Vibrio cholerae in mouse intestine at a dose ≥300 mg/kg. The results obtained in this study give some scientific support to the uses of neem employed by the indigenous people in India employed for the treatment of diarrhea and dreadful disease cholera.

 

DNA methylation, insulin resistance, and blood pressure in offspring determined by maternal periconceptional B vitamin and methionine status Kevin D. Sinclair*†, Cinzia Allegrucci‡, Ravinder Singh*, David S. Gardner§, Sonia Sebastian‡, Jayson Bispham‡, Alexandra Thurston‡, John F. Huntley¶, William D. Rees , Christopher A. Maloney , Richard G. Lea§, Jim Craigon*, Tom G. McEvoy**, and Lorraine E. Young†‡ *School of Biosciences and §School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, Leicestershire LE12 5RD, United Kingdom; ‡Department of Tissue Engineering and Modelling, Wolfson Centre for Stem Cells, University of Nottingham, University Park, Nottingham NG7 2RD, United Kingdom; ¶Moredun Research Institute, Pentlands Science Park, Bush Loan, Penicuik EH26 0PZ, United Kingdom; The Rowett Research Institute, Greenburn Road, Bucksburn, Aberdeen AB21 9SB, United Kingdom; and **Scottish Agricultural College, Roslin Biocentre, Roslin, Midlothian EH25 9PS, United Kingdom Edited by R. Michael Roberts, University of Missouri, Columbia, MO, and approved October 15, 2007 (received for review August 2, 2007) A complex combination of adult health-related disorders can originate from developmental events that occur in utero. The periconceptional period may also be programmable. We report on the effects of restricting the supply of specific B vitamins (i.e., B12 and folate) and methionine, within normal physiological ranges, from the periconceptional diet of mature female sheep. We hypothesized this would lead to epigenetic modifications to DNA methylation in the preovulatory oocyte and/or preimplantation embryo, with long-term health implications for offspring. DNA methylation is a key epigenetic contributor to maintenance of gene silencing that relies on a dietary supply of methyl groups. We observed no effects on pregnancy establishment or birth weight, but this modest early dietary intervention led to adult offspring that were both heavier and fatter, elicited altered immune responses to antigenic challenge, were insulin-resistant, and had elevated blood pressure–effects that were most obvious in males. The altered methylation status of 4% of 1,400 CpG islands examined by restriction landmark genome scanning in the fetal liver revealed compelling evidence of a widespread epigenetic mechanism associated with this nutritionally programmed effect. Intriguingly, more than half of the affected loci were specific to males. The data provide the first evidence that clinically relevant reductions in specific dietary inputs to the methionine/folate cycles during the periconceptional period can lead to widespread epigenetic alterations to DNA methylation in offspring, and modify adult health related phenotypes.

 

Stimulating a Peron's Memory

Source: Vd. Mhaiskar

 

While studying MAV in Cambridge, Mass. in the early 90's one of my professors gave a talk on memory and the following factors were mentioned by him. We can assume the these are all attested to by the classical Ayurvedic literature, somewhere, but exactly where, I don't know. From a clinical session perspective these are useful for different purposes depending upon the specifics of the doctor-patient interaction and of course, we will recall some from our school days--repeat, repeat, repeat. On the other hand, it is known that one can improve memory through the agency of pharmaceuticals, e.g. brahmi, mandukaparni, shankhapushpi, bhringaraja, jatamamsi, panna bhasma (emerald ash), gold, and so on. There work to strengthen the nervous tissue directly. Further, western medical practitioners mention neutraceutical such as: L-carnitine, selenium, and others. Modern researchers tells us that using the brain for memory-related tasks enhances memory generally, too. MRI of British cab drivers in London bears testimony to this fact as their brain stem shows undue enlargement. On the negative side, iron deficiency and other minerals may lead to impaired memory. Too much of soy products has been implicated in dementia. And Alzheimer's has had a strong association with excess aluminum in the brain, although the etiological status is still unknown. But when you need results now there are some techniques that be usefully employed. Many of them are useful when taking the history of a case, while others may be needed to get the patient to be able to comply with dosage or other Rx's:

 

1.   Nimitta-grahana: if a name is forgotten try to discover its causative factor (why the name is forgotten). For example, maybe there is trauma associated with that individual which might naturally cause one to try to forget the incident and the persons involved. By exploring the nature of the cause with the patient then the person's name might come back as the cause is made known to or remembered by the patient.

 

2.      Rupa-grahana:  remember form then other memories come;  see a man then the father might be remembered, e.g.

 

3.      Sadrashta: likeness or similarity in value; e.g., goodness, etc. Bringing to mind/attention this value causes one to remember this value about the thing / person to be remembered and then the person is remembered. Asking if their is pain somewhere in the body may cause a person to remember such pain that comes infrequently, e.g.

 

4.      Saviparyaya: opposite values remembered may stimulate memory of the desired object. See 3 above.

 

5.      Sattva, Nubandha: concentrating on something; contemplating for a while; applying mind to something helps the memory to recall the desired information. This technique may be accomplished by a silent break in the dialog to allow for the patient's processing of instructions, etc.

 

6.      Abhyasa: study—again and again; imbibing a quality over and over, saying again and again helps establish something in the mind. Get a patient to repeat instructions so the recall later will come easier.

 

7.  Punah Shrutata: hearing a part again and the whole is remembered—If the first part of a statement is heard that the whole might be recalled. Seeing a part of the object may stimulate recall of the remainder. By telling part of a story (the history of a particular symptom or disease, etc.) the patient completes the details.

 

8.      Jñana yoga: incidentally it comes to me—no effort and yet it comes; the whole is remembered. This is the ideal and shows good health and perhaps advanced consciousness of the person. According to Ayurveda, memory is naturally perfect, complete, etc.

 

Miscellany:

·         Forgetting a good thing is ok but forgetfulness is a bad thing; therefore, remember only good things.

·         To forget may arise from haste.

·         If a person forgets a thing another person may not identify that person correctly, which leads to further prajñaparadha.

·         It is assumed that a person is innocently forgetting.

·         Another person may know correctly but act incorrectly—this is prajñaparadha also.

·         To keep prajña intact we should remember all things—good and bad.

 

 

The Book Corner

The Politically Incorrect Guide to Global Warming and Environmentalism by Christopher C. Horner

Regnery Publishing, Washington, D.C., 2007 pp.303

 

By now, we hope that all of our readers recognize that this Newsletter honors the tradition called science for its unbiased inquiry and attempts to understand our experiences in the creation. One issue that has been on this writer's mind for several years now is that of the environment. Readers of our earlier issues will recall dialogs on disease etiology and disease modeling. One important area of disease causation has been recognized from early antiquity--environmental factors--dust, smoke, lightning, and so on. More recently, modern Ayurvedists have added heavy metals, petro-chemicals, and similar entities to the list of environmental factors of disease causation. One of my clients, a water engineer, educated me on the presence of these entities and of our allopathic drugs in the ground waters all over the globe. With all this in mind, when learning of this book, I took it up and read and studied it for the scientific contributions to understanding man's involvement in planetary contamination, generically, and global warming specifically. Global warming is a survival issue but individual contaminants within this issue may pose health challenges.

 

I thought, as perhaps the rest of you had, that the science of global warming and climate change was "set" and that it was clear that man must do the moral thing and reverse his negligent contribution to all forms of pollution, including CO2, green-house-gases (GHG), and so on. Horner showed chart after chart of data on the science of global warming. First he declared with published data of European, American, and other governments, and scientists that there is no "global warming." There is northern hemispheric warming but no southern hemispheric warming. In other words the term global is used inaccurately. In fact, he cites data indicating that some places are getting cooler so the whole globe in not warming. Then Horner showed pictures advanced by proponents for global warming that show proof of deglaciation around the world, including Mt. Kilimanjaro; but proponents failed to show any cases of the advancing glaciers, thereby giving notice that these issues might be loaded with specious data. Indeed photographic and other data show that the snows on Mt. Kilimanjaro were observed to be retreating as long ago as the 1890's. Scientists say that the moist air which produces weather/snow began avoiding this mountain more than a century ago, and long before manmade CO2 levels were significant.

 

Proponents of global warming have advanced modeled data that purport to explain the posited global warming as a function of CO2 levels in the atmosphere, but are the facts on their side? In other words they claim to have been able to show that the observed climate changes can be predicted by our scientific models. Interestingly, these modeled data ignore significant periods of warming and cooling that have been experienced during the entire last millennium of weather changes experienced globally--the medieval warming (1100 AD - 1300's AD), the little ice age (around the US Revolutionary years), the warming trend of early 20th century countered again by a significant cooling into the 1970's, and so on. Further, one proponent in a highly visible and politically influential position on this topic refused to allow other scientists to see his data, in order to try to replicate his modeling. This is not science in any shape or manner. Further, when scientists compared sun spot activity / solar radiation levels with temperature changes on earth these data almost perfectly matched -- read: the sun is causing earth warming in cyclic patterns. Further, when one analyzes the composition of the GHG's in the atmosphere one learns that methane is a far more abundant and "warming" gas than CO2 (by a factor of about 30 times) and most of it is naturally made (82%), CO2 that is man made accounts for only about 2% of the total CO2, nitrous oxide totals include only about 5% made by man whereas the CFC's are mostly made by man--68%. Interestingly much of the methane is produced by our cattle, which we raise primarily for their meat/protein source. Experts easily agree that if we were to give up this part of our diet we could make a far greater impact on GHG's than by raising SUV efficiency ratings, etc. So the science is clear and the moral imperative is clear--go vegetarian.

 

Numerous other kinds of data are examined, but we shall report on only 4: 1) measured sea level changes, 2) atmospheric temperatures, 3) ocean temperatures, and 4) extreme weather events.

1)When one looks at the GPS data from space we find that the sea levels have increased steadily since the last ice age by about 1.8mm/year and about .1m - .2 m. during the 20th C. Rates have varied over time but we're talking inches of gain for the next century not feet.

2) Temperature change needs a reference point. It's getting colder in the atmosphere than it was in 1998 but it's warmer than it was in 1970, but still cooler than it was during the Medieval Warm Period, etc. Trends need long periods of time from which to be able to draw meaningful conclusions. The data of change are in fractions of a degree per century --about +1.70C for the past century--not in whole degrees per year.

3) Changing oceanic temperatures are reported to be in tiny fractions of a degree and slightly cooling for the past two years.

4) Extreme weather is a predicted/projected pattern of the global warming hypothesis. Hurricanes, tornadoes, floods and the like are what is meant by extreme weather. The models of global warming predicted more severe hurricanes and as you know no significant one was reported for either 2006 or 2007 for the US. Globally there are no changes. Regionally the North Atlantic storms are increasing and Northern Pacific storms are decreasing in frequency. Weather experts on both sides of the matter received criticism--for not predicting enough bad ones before 2006 and then for over-predicting bad events after 2005 and Katrina. The data for floods, tornadoes, etc. have been skewed in the direction of increased numbers from the qualifying criteria: events where property damage or bodily injury were reported. As man increases in population numbers and lives in ever-increasing density then these data will continue to rise regardless of trends in nature, so this category remains inconclusive. But the claims of global warming and increased number of severe hurricanes going together are contradictory, to say the least.

 

Horner's work is chock full of data and references for those who want to check him; his conclusion is that neither science nor proponents have made the case for "global warming" induced by man's activities. There is no period of time which correlates with the projections of increased CO2 levels and warming. As for the proponents read the book and learn of surprising bedfellows in this matter. As for the politics of it, well read the book for that too. The science of man's global polluting activities is pretty good but not really examined as such in this work. One thing Horner and this writer would emphasize: do not practice science by consensus. We can add to this that we should not practice medicine by consensus either.

 

 


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