General Article

Simply 1 in 4 Sufferers Get Rehab After Center Assault, Cardiac Surgical operation

News Picture: Just 1 in 4 Patients Get Rehab After Heart Attack, Cardiac SurgeryVia Amy Norton HealthDay Reporter

MONDAY, June 27, 2022 (HealthDay Information)

Medically supervised workout methods can do middle sufferers numerous excellent, however few other people of colour participate in them — irrespective of revenue, new analysis reveals.

The learn about, of greater than 100,000 U.S. sufferers, discovered that whilst all have been eligible for cardiac rehabilitation, best about one-quarter in fact attended. Enrollment used to be in particular low amongst Asian, Black and Hispanic sufferers, together with the ones with top earning.

Researchers referred to as the chronic disparities “disappointing,” particularly since cardiac rehab could have primary advantages, together with an extended existence.

Cardiac rehab is regarded as a regular of handle sufferers getting better from a middle assault or middle process, and for the ones with positive persistent stipulations reminiscent of middle failure and chest ache led to by way of clogged middle arteries.

Supervised workout is the cornerstone, however methods additionally be offering counseling on vitamin, smoking cessation and the mental facets of middle illness, together with melancholy and nervousness.

But for years, research have proven that few eligible sufferers in fact join in cardiac rehab.

The brand new learn about, printed June 22 within the Magazine of the American Center Affiliation, isn’t any exception.

It discovered that of over 107,000 eligible sufferers, best about 26% attended a minimum of one cardiac rehab consultation. Charges have been particularly low amongst Asian, Black and Hispanic sufferers, who have been any place from 19% to 43% much less more likely to attend than white sufferers have been.

What used to be placing, researchers discovered, used to be that upper revenue didn’t slim that hole. Upper-income other people of all races did join in cardiac rehab extra steadily than lower-income sufferers did.

However even amongst the ones with family earning topping $100,000, racial disparities remained. At that revenue stage, 40% of white sufferers attended, as opposed to 27% to 33% of other people of colour.

“It is disappointing,” stated lead researcher Dr. Jared Magnani, an affiliate professor of cardiology on the College of Pittsburgh.

The learn about can not display why the disparities have been so cussed, however there are probably many causes, Magnani stated.

Sufferers can face a large number of hindrances in attending cardiac rehab — which most often comes to 3 periods per week for 12 weeks. The time dedication on my own, plus the desire for dependable transportation, may also be an excessive amount of for many of us, Magnani identified.

And in some spaces of the rustic, he stated, there is also no cardiac rehab facility inside of an inexpensive riding distance.

Dr. Todd Brown, a heart specialist and affiliate professor on the College of Alabama at Birmingham, agreed that cardiac rehab could be a “large ask” of sufferers.

But even so the logistics, Brown stated, cash may also be a topic even for other people with insurance coverage, as a result of some plans require really extensive copays.

With all the ones hindrances, sufferers want numerous motivation to wait — but they would possibly not at all times perceive the whole advantages of cardiac rehab, stated Brown.

Many sufferers obtain data on it whilst they’re within the sanatorium getting better from a middle assault or cardiac process.

“If you are within the sanatorium, you are being bombarded with data,” Brown stated. “I believe that for many sufferers, it is overwhelming.”

He speculated that conversation may well be one consider racial disparities in cardiac care, too. “Possibly we aren’t handing over the guidelines in a culturally suitable means,” Brown stated.

A key message for sufferers is that cardiac rehab can “allow you to are living longer, really feel higher, and stay you out of the sanatorium,” he stated.

“Numerous sufferers assume it is simply workout and they are able to do it on their very own,” Brown famous. However, he stated, it is the supervision, and the assist with way of life and psychological well being, that makes cardiac rehab efficient.




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Ensuring sufferers perceive some great benefits of cardiac rehab is essential, agreed Dr. Karen Aspry, a member of the American Faculty of Cardiology’s Prevention Cardiac Rehab Workgroup.

However she added that sensible obstacles need to be tackled. A technique may well be to make cardiac rehab facilities extra like a gym, with longer hours and alternatives for other people to workout on their very own quite than in a category, Aspry stated.

As for different answers, Brown stated that home-based cardiac rehab may well be one. All over the pandemic, Medicare regulations have been modified to permit compensation for cardiac rehab delivered on-line.

However that vary isn’t

General Article

New Pointers ‘Bad’ for Some Stroke Sufferers

New Guidelines 'Dangerous' for Some Stroke PatientsVia Cara Murez HealthDay Reporter

THURSDAY, June 23, 2022

After many years the place hundreds of thousands of American citizens who had been in peril for cardiovascular bother had been instructed a day by day low-dose aspirin would guard towards strokes and middle assaults, new tips issued this spring counsel that the tactic isn’t definitely worth the bleeding dangers in the ones over 60.

That is been lots complicated for sufferers who don’t seem to be positive what’s the most secure path ahead.

Diane Manzella, a Southern California resident, is amongst them.

Manzella, now 80, had a brief ischemic assault (TIA), ceaselessly referred to as a “mini stroke,” about two decades in the past. Those assaults generally is a harbinger of a long term main stroke.

Then she had a 2nd TIA final month — after preventing her day by day dose of aspirin a number of months in the past.

Professionals at Cedars-Sinai in Los Angeles have heard from different at a loss for words stroke sufferers in regards to the new tips.

“Each within the health facility environment in addition to our medical institution areas, our sufferers are listening to, seeing the scoop and they’re having members of the family telling them, ‘You want to prevent your aspirin. Hello, it reasons hurt,’ as a result of most of the people does no longer know the adaptation between number one and secondary prevention,” mentioned Dr. Shlee Tune, director of the Complete Stroke Middle at Cedars-Sinai.

The U.S. Preventive Products and services Process Drive made its ultimate suggestions tightening the usage of low-dose aspirin utilization in past due April. Quickly after, the American Middle Affiliation (AHA) famous that the ones adjustments aligned with its 2019 tips.

For now, the suggestions are that folks with a historical past of middle assault, atrial traumatic inflammation, stroke or stenting will have to proceed to take their low-dose aspirin. However for other people and not using a historical past of middle illness or stroke, taking low-dose aspirin isn’t really useful for fighting middle assault or stroke (“number one prevention”), particularly in adults who’ve the next possibility for bleeding.

Positive middle-aged adults would possibly get pleasure from low-dose aspirin remedy, the AHA famous, if they’re at top possibility for middle assault or stroke because of possibility elements equivalent to smoking, hypertension, kind 2 diabetes, top ldl cholesterol or a vital circle of relatives historical past of middle illness. The ones people will have to get explicit remedy recommendation from their medical doctors.

Aspirin nonetheless an choice for some

“The duty power recommends a dialogue with the physician to look if the advantages outweigh the chance. There’s a marginal possibility relief with aspirin within the 40- to 59-year age vary and the doctor or the scientific workforce member must truly be sure that the bleeding possibility does no longer outweigh the possible receive advantages right here,” Tune mentioned.

Aspirin can hurt other people with abdomen ulcers or bleeding problems within the intestine, which is without doubt one of the causes it should not be taken except there may be one more reason to take action, Tune defined.

Medical doctors would possibly display screen for signs equivalent to heartburn or adjustments in stool prior to you decide to make use of aspirin for number one prevention, she mentioned.




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“If a affected person’s physician has really useful low-dose aspirin — or any preventive drugs — the affected person mustn’t discontinue taking it with out discussing it with their doctor,” Tune mentioned in a question-and-answer consultation Cedars-Sinai posted not too long ago to lend a hand sufferers perceive the information.

For the reason that Fifties, medical doctors had been prescribing day by day aspirin to lend a hand save you ordinary middle assaults. Many research have proven that day by day low-dose aspirin or identical medicines can cut back the chance of main vascular occasions like middle assaults and strokes via as much as 25% in comparison to sufferers who don’t take aspirin or aspirin-like medications, mentioned Dr. Lee Schwamm, government vice chair of neurology and director of the Middle for TeleHealth at Massachusetts Basic Medical institution in Boston.

The aspirin technique works via inhibiting activation of platelets, which play a task in clotting, Schwamm mentioned.

Despite the fact that that clotting motion comes in handy after damage to a blood vessel reasons bleeding, platelets too can motive a clot to shape that may block blood go with the flow or destroy off and go back and forth to the mind or middle and motive a stroke or middle assault, Schwamm defined.

Occasional aspirin for ache reduction continues to be a protected choice, and lots of sufferers with arthritis take aspirin

General Article

‘Frailty Checks’ for Older Most cancers Sufferers Would possibly No longer Want Workplace Consult with

News Picture: 'Frailty Exams' for Older Cancer Patients May Not Need Office Visit

WEDNESDAY, June 1, 2022 (HealthDay Information)

Frailty assessments are really useful for older adults who’ve blood most cancers, and new analysis presentations they are able to be achieved nearly, no longer simply in user.

Whilst the screenings are normally performed at a medical institution or physician’s place of job, that turned into a problem throughout the pandemic as a result of folks with blood cancers are at prime possibility of an infection.

A brand new learn about assessing telehealth-based assessments as an opportunity discovered them to be a excellent exchange.

“Doing our 42-item review within the medical institution required a large number of person-to-person touch,” defined learn about writer Dr. Clark DuMontier, of Brigham and Ladies’s Medical institution in Boston.

“We determined to evolve our in-person analysis to a digital structure to forestall pointless viral publicity, however we nonetheless sought after to care for our function efficiency measures of cognition and strolling velocity. Our review is, to our wisdom, the primary in blood cancers to guage each patient-reported and function pieces in combination by way of telehealth,” DuMontier added in a information liberate from the American Society of Hematology.

Frailty exams are really useful for seniors present process systemic remedy, akin to chemotherapy. They incorporate function efficiency measures, in addition to questions like “Do you want lend a hand getting away from bed within the morning?”

The learn about integrated 185 blood most cancers sufferers elderly 73 and older between November 2020 and March 2022 who had digital exams. The analysis workforce when put next their frailty classifications with a bunch of 876 sufferers who have been 75 and older who finished the examination in user.

The investigators then evaluated the digital review’s feasibility and protection in line with what number of contributors effectively finished the analysis. They monitored the sufferers for accidents.

About 81% of the contributors who did the digital checking out finished the take a look at effectively and had no falls or protection occasions throughout the learn about time. They have been additionally discovered to have a quite much less frail standing in comparison to the in-person staff. This might simply be from variation in numerous sufferers and no longer a distinction within the review, the learn about authors mentioned.

The learn about integrated each positives and obstacles. At the plus aspect, immunocompromised sufferers may just steer clear of in-person touch. The researchers additionally may just track affected person growth in the house, the place measurements is also extra correct.

A limitation is that about 46% of the sufferers didn’t have a caregiver or videoconferencing era, either one of which might be had to carry out the gait review.

Someday, the workforce want to make bigger get entry to to era, together with tracking gadgets, in order that extra sufferers can profit from telehealth sources.

“One problem we stumble upon in hematology is that sufferers frequently are available in to peer us when they’re at their absolute best. So, once we see them within the medical institution, they may glance nice, however that still may well be the one day they were given away from bed that week,” DuMontier mentioned. “With the ability to do those assessments nearly permits us to evaluate sufferers in actual time and doubtlessly get extra correct ratings. The use of this review, we will be able to measure frailty the place it issues maximum, of their houses.”

The findings have been printed Would possibly 26 in Blood Advances.

Additional information

The American Most cancers Society has extra on all cancers, together with leukemia.

SOURCE: American Society of Hematology, information liberate, Would possibly 26, 2022

By way of Cara Murez HealthDay Reporter

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General Article

Why Remedy Is helping Some Bronchial asthma Sufferers Extra Than Others

News Picture: Why Treatment Helps Some Asthma Patients More Than Others

WEDNESDAY, June 1, 2022 (HealthDay Information)

New analysis unearths why widespread remedies for bronchial asthma assaults are incessantly useless.

Corticosteroids are used as an emergency remedy right through bronchial asthma assaults to lower airway swelling and inflammation. Whilst efficient in folks with average bronchial asthma, they incessantly fail to assist the ones with critical bronchial asthma.

“Our find out about has exposed a possible mechanism to provide an explanation for why sufferers with critical bronchial asthma are unresponsive to standard remedy,” stated find out about co-author writer Reynold Panettieri Jr., vice chancellor of Medical and Translational Science at Rutgers College in New Brunswick, N.J. “If shall we discover new approaches to remedy that at once have an effect on that mechanism, we could possibly repair a sensitivity to the steroid and reinforce results.”

He and his colleagues discovered that two naturally happening enlargement elements — herbal ingredients that stimulate cellular proliferation — turn on within the airway-lining cells of critical bronchial asthma sufferers after they inhale corticosteroids and block the drugs from operating.

The 2 enlargement elements are fibroblast enlargement issue (FGF) and granulocytic colony forming enlargement issue (G-CSF), in line with findings lately printed within the magazine Science Translational Medication.

“We imagine this reaction explains why sufferers with critical bronchial asthma are unresponsive to such standard remedy,” Panettieri stated in a Rutgers’ information unencumber.

Of the greater than 25 million folks in america with bronchial asthma, an estimated 5% to ten% have critical bronchial asthma, in line with the American Lung Affiliation.

The brand new findings recommend other cell pathways are at paintings within the airway lining cells of sufferers with critical bronchial asthma, specifically the ones considering irritation, researchers stated.

They stated those effects may just level how you can new treatments for folks with critical bronchial asthma.

Checks in mice confirmed that after researchers blocked unencumber of chemical compounds that cause secretion of the 2 enlargement elements, corticosteroids had been ready to opposite airway irritation and in addition avoided tissue scarring. Analysis achieved in animals incessantly produces other ends up in people.

Additional information

There is extra on bronchial asthma on the American Lung Affiliation.

SOURCE: Rutgers College, information unencumber, Would possibly 31, 2022

Via Robert Preidt HealthDay Reporter

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General Article

Opioid Use a Danger for Younger Sufferers Fighting Sarcomas

News Picture: Opioid Use a Hazard for Young Patients Battling Sarcomas

TUESDAY, Might 31, 2022 (HealthDay Information)

When a young person or younger grownup has sarcoma, one of those most cancers within the bones or cushy tissues, a physician will ceaselessly prescribe opioids for the ache.

A brand new find out about discovered that almost 1 / 4 of the ones younger other folks proceed to take opioids after their remedy is finished.

“Those effects spotlight the wish to track younger sufferers with sarcoma for post-treatment opioid use, given the possible unfavorable affects of long-term opioid use, together with misuse and overdose,” mentioned find out about lead creator Melissa Beauchemin, an assistant professor at Columbia College College of Nursing in New York Town.

“Age- and developmentally suitable methods to successfully arrange ache whilst minimizing opioid publicity are urgently wanted,” she mentioned.

Beauchemin famous that teenagers and younger adults are a prone inhabitants as a result of they have got benefitted not up to more youthful and older most cancers sufferers from contemporary advances.

For the brand new find out about, the researchers used a big insurance coverage claims database to investigate data on sufferers elderly 10 to 26 years previous who had now not gained prior opioids and who have been recognized with sarcoma between 2008 and 2016.

Some of the 938 sufferers within the research, 64% gained opioid prescriptions all the way through remedy.

After their most cancers remedy was once achieved, about 14% of sufferers total and 23% of those that used opioids all the way through remedy persisted to make use of opioids. They met the factors for brand spanking new power use, which was once outlined as a minimum of two opioid prescriptions within the 365 days after remedy ended.

The findings have been revealed on-line Might 23 in Most cancers, a magazine of the American Most cancers Society.

Elements related to power opioid use integrated being lined via Medicaid as opposed to industrial insurance coverage; having bone tumors as opposed to cushy tissue tumors; and taking lorazepam, a medicine ceaselessly used to regard anxiousness and drowsing issues.

Sufferers who’ve sarcoma ceaselessly increase broken and fractured bones. They in most cases go through main surgical procedures.

Beauchemin mentioned docs must prioritize secure and early discontinuation of opioids for the ones younger sufferers who require them for ache control.

“Additional, there’s a important want for scientific apply tips to fortify scientific determination making to soundly and successfully arrange ache particularly for teenagers and younger adults with most cancers,” she mentioned in a magazine information liberate.

Additional information

The U.S. Nationwide Institute on Drug Abuse has extra on opioids.

SOURCE: American Most cancers Society, information liberate, Might 23, 2022

By means of Cara Murez HealthDay Reporter

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Lengthy-Time period Middle Irritation Moves 1 in 8 Hospitalized COVID Sufferers

News Picture: Long-Term Heart Inflammation Strikes 1 in 8 Hospitalized COVID Patients

WEDNESDAY, Would possibly 25, 2022 (HealthDay Information)

A yr after being hospitalized with COVID-19, greater than 12% of sufferers have been recognized with center irritation, in step with a brand new find out about of the long-term results of the virus.

For the find out about, researchers in Scotland adopted 159 sufferers hospitalized with COVID-19 between Would possibly 2020 and March 2021. A yr later, many sufferers had ongoing fitness stipulations.

But even so center irritation (myocarditis), irritation around the frame and harm to different organs, together with the kidneys, had been commonplace, in step with the workforce from the College of Glasgow and NHS Better Glasgow and Clyde.

“COVID-19 is a multisystem illness, and our find out about presentations that harm at the center, lungs and kidneys will also be observed after preliminary hospitalization in scans and blood assessments,” mentioned fundamental investigator Colin Berry. He’s a professor of cardiology and imaging on the College of Glasgow.

“Those effects bridge an important wisdom hole between our present figuring out of post-COVID-19 syndromes, comparable to lengthy COVID, and function proof of ongoing illness,” Berry mentioned in a college information free up.

The find out about, dubbed CISCO-19 (for Cardiac Imaging in SARS Coronavirus disease-19), is a part of a Scottish govt effort to spice up figuring out of the coronavirus pandemic.

Individuals had been requested about their very own impressions in their fitness. Additionally they underwent blood assessments, and CT and MRI scans of more than one organs, together with the center, kidneys and lungs. The researchers additionally assessed scientific results, together with survival, medical institution readmission and referral to outpatient clinics.

The investigators discovered that being hospitalized with COVID-19 was once related to poorer health-related high quality of lifestyles, in addition to with anxiousness and melancholy.

The findings additionally confirmed that some sufferers undergo long-term affects as a result of the severity in their COVID-19 signs, fairly than as a result of pre-existing fitness problems.

“The explanations for this are unclear, however it can be {that a} wholesome one who is hospitalized with COVID-19 is more likely to have a worse COVID an infection than any individual with underlying fitness stipulations who’s hospitalized,” Berry urged. “Extra paintings must be performed right here to know the dangers, and in addition on how we will higher fortify sufferers who’ve ongoing fitness results after being hospitalized with COVID-19.”

Inside 450 days of leaving the medical institution, one in seven sufferers had died or been readmitted. In all, two in 3 required outpatient care.

The find out about discovered that lengthy COVID seems to predominantly have an effect on girls. The researchers discovered a hyperlink between being feminine and having myocarditis. That was once then tied with decrease psychological and bodily well-being.

The findings recommend a necessity for targeted use of scientific assessments, new treatment construction and rehabilitation, the find out about authors mentioned. Additionally they spotlight the significance of vaccination to lend a hand save you serious COVID-19.

“This find out about supplies vital perception into the longer-term results of COVID-19 an infection, and can lend a hand tell approaches to remedy going ahead,” mentioned David Crossman, previously Scotland’s leader scientist (fitness).

Whilst the find out about excited about other people hospitalized with COVID-19, different analysis analyzing circumstances no longer requiring hospitalization has reported extra encouraging knowledge on long-term fitness.

The researchers famous that almost all sufferers on this find out about had been unvaccinated as a result of they had been enrolled early within the pandemic. Chance elements for center illness had been commonplace, together with weight problems, hypertension and diabetes.

The record was once revealed on-line Would possibly 23 in Nature Drugs. The find out about is ongoing and can come with follow-up with contributors after 18 months and 5 years.

Additional info

The U.S. Facilities for Illness Keep an eye on and Prevention has extra on COVID.

SOURCE: College of Glasgow, information free up, Would possibly 23, 2022

By means of Cara Murez HealthDay Reporter

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General Article

Scientific Marijuana Would possibly Be offering Protected Ache Reduction for Most cancers Sufferers

News Picture: Medical Marijuana May Offer Safe Pain Relief for Cancer PatientsVia Steven Reinberg HealthDay Reporter

TUESDAY, Would possibly 24, 2022 (HealthDay Information)

Most cancers sufferers who use clinical marijuana revel in much less ache and a greater high quality of lifestyles, Israeli researchers document.

And, their new find out about discovered, those sufferers have been in a position to depend much less on opioid painkillers, with minimum unwanted effects.

“I’m hoping other folks take note of the result of this find out about and use hashish when suitable for sufferers who want it,” stated Dr. Alex Bekker, professor and chairman of the dep. of anesthesiology at Rutgers New Jersey Scientific Faculty, in Newark.

Many docs are nonetheless reluctant to prescribe marijuana for persistent ache, he stated.

“Physicians have a hard time the use of hashish, merely as a result of ancient viewpoint, and it is nonetheless federally no longer licensed,” stated Bekker, who reviewed the find out about findings.

A majority of U.S. states and the District of Columbia have legalized clinical marijuana.

However as a result of it’s nonetheless regarded as unlawful through the government, it hasn’t been licensed through the U.S. Meals and Drug Management, and due to this fact isn’t lined through govt or non-public medical insurance, Bekker defined.

“Articles like this are necessary to influence lawmakers that there is something just right for a affected person and we aren’t the use of it for some ordinary reason why, which is the type of propaganda that is existed for a few years,” he stated.

Ache, despair, nervousness and insomnia all have an effect on sufferers present process most cancers remedy and can result in a deficient analysis, docs say.

“Historically, cancer-related ache is principally handled through opioid analgesics, however maximum oncologists understand opioid remedy as hazardous, so choice treatments are required,” researcher David Meiri stated in a written observation. Meiri is an assistant professor on the Technion Israel Institute of Era, in Haifa.

For the find out about, his group adopted 324 most cancers sufferers who used clinical marijuana over six months. The sufferers skilled an average 20% aid in ache signs, the researchers discovered. Median way part had larger ache aid, part had much less.

Learn about individuals additionally reported different advantages.

Anxiousness ranges dropped through an average 22% and despair severity through 12%. On the similar time, high quality of lifestyles ratings rose through an average 14%. In all, about 60% of individuals reported growth in signs tied to clinical marijuana, the investigators discovered.

After six months of the use of clinical marijuana, just about part stopped all different ache medicine, in step with the researchers.

“Scientific hashish has been advised as a conceivable treatment for urge for food loss; then again, maximum sufferers on this find out about nonetheless misplaced weight,” Meiri stated. “As a considerable portion have been recognized with revolutionary most cancers, a weight decline is predicted with illness development.”

He additionally famous that sexual serve as stepped forward for lots of the males, however worsened for most ladies.

Bekker stated a majority of research display that clinical marijuana improves sufferers’ high quality of lifestyles. As a result of the result of this find out about happened over six months, it’s tough to imagine that they simply constitute a “placebo impact,” he added.

“From what we all know, nearly all of research display growth in high quality of lifestyles,” Bekker stated, noting that marijuana won’t in truth save you the ache of persistent illness but it surely makes dwelling with the ache more uncomplicated.

“Let’s consider you will have persistent ache and you might be observing an enchanting film on TV, for 2 hours you do not take into accounts it, but if the film is over you get started feeling ache once more,” he stated. “Hashish is identical impact. Ache could also be nonetheless there and the aid in ache isn’t dramatic, however sufferers cope higher with the ache. High quality of lifestyles definitely improves with hashish.”




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For some sufferers, then again, marijuana will not be your best choice for ache reduction, he stated. That is very true for the ones with a historical past of psychiatric issues.

The find out about was once printed Would possibly 20 within the magazine Frontiers in Ache Analysis.

Additional info

To be told extra about clinical marijuana, seek advice from the U.S. Nationwide Institute on Drug Abuse.

SOURCES: Alex Bekker, MD, PhD, MS, professor and chair, anesthesiology, Rutgers New Jersey Scientific Faculty, Newark; David Meiri, PhD, MSc, assistant professor, Technion — Israel Institute of Era, Haifa; Frontiers in Ache Analysis, Would possibly 20, 2022

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