Researchers Warn: Don’t Mix Grapefruit, Some Prescriptions

Before you toss that gorgeous grapefruit into your grocery cart, think twice. Canadian researchers say that grapefruit plus some prescription medications can be deadly, or at least cause severe side effects.

Researchers from Ontario’s Lawson Health Research Institute first studied interactions between the fruit and certain prescription medications two decades ago. According to Medical News Today, the number of drugs known to cause heavy-duty side effects when combined with grapefruit has jumped from 17 to 43 between 2008 and 2012. A total of 85 drugs might have some type of interaction. Scientists attribute the big increase to new drugs and formulations.

The Mayo Clinic says in addition to grapefruit, other citrus foods like pomelos and Seville oranges can interfere with certain types of medications even when you ingest them at different times. The interaction occurs when chemicals in the food interfere with enzymes that metabolize certain drugs in the digestive tract. When the medication doesn’t break down properly, it can reach dangerous levels and cause serious side effects.

Among medications likely affected are some anti-anxiety, anti-arrhythmia, antidepressant, antihistamine, anti-retroviral, and anti-seizure drugs. Also on the list are calcium channel blockers, immunosupressants, and statins.

The Canadian researchers found that medications with potential interactions share a trio of traits: they’re administered orally; the enzyme CYP3A4 is tied to their metabolism in the gut; the amount of the medication that reaches the bloodstream unaltered is in the low to mid-range.

Among the most serious side effects are respiratory failure, gastrointestinal bleeding, and renal toxicity. Also possible are bone marrow suppression, acute kidney failure, and even death.

The U.S. Food and Drug Administration (FDA) offers tips for consumers who enjoy grapefruit products. Safety should start by asking a pharmacist or medical provider whether it’s all right to consume grapefruit products while taking a medication. If not, the FDA says it’s wise to also ask if other juices are allowable. Patients can also check the prescription‘s medication guide or sheet for a mention of grapefruit.

The agency suggests it’s prudent to read labels of non-prescription medications and check other juices in the home to see if they contain products made from grapefruit, Seville oranges, or tangelos.

I had to give away a gigantic pink grapefruit a few years ago. As a patient on the same drugs for Crohn’s disease for years, I had become lax about reading patient inserts. As I left my surgeon’s office, he wished me happy holidays, then cautioned me against consuming any alcohol, even in fruitcake, because of one medication. When I mentioned buying the pink grapefruit, he quickly told me it wasn’t allowed either.

The potential interaction from mixing grapefruit and some prescription medications should be a wake-up call for those of us who cavalierly toss product inserts, unread, as soon as we open a prescription.

Vonda J. Sines has published thousands of print and online health and medical articles. She specializes in diseases and other conditions that affect the quality of life.

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'We had the best crop in years': Residents feel pinch after FDA shutters plant

PORTALES, N.M. (AP) — Farmers in a revered peanut-growing region along the New Mexico-Texas border should be celebrating one of the best harvests in recent memory.

Instead, millions of pounds of their prized sweet Valencia peanuts sit in barns at a peanut butter plant shuttered for two months amid a salmonella outbreak that sickened 41 people in 20 states.

Farmers are worried about getting paid for their peanuts, nearly a third the plant's 150 workers have been laid off, and residents wonder what toll an increasingly contentious showdown between the nation's largest organic peanut butter plant and federal regulators could ultimately have on the region's economy.

The tension boiled over when the Food and Drug Administration on Monday said it was suspending Sunland Inc.'s registration to operate because of repeated safety violations, meaning the plant will remain indefinitely shut down as the company appeals the decision. The company had planned to reopen some its operations this week after voluntarily recalling hundreds of products and closing its processing and peanut butter plants in late September and early October.

Many in this flat, dusty and solidly Republican farm town of about 20,000 denounce the FDA's tactics as unfair and unnecessarily heavy-handed — and become defensive about the shutdown of the largest private employer in town.

"We had the best crop in years, and then these (expletives) came in and started this," said resident and local telecomm worker Boyd Evans.

For the first time ever, the FDA is using authority granted under a 2011 food safety law signed by President Barack Obama that allows the agency to shut food operations without a court hearing.

The FDA said inspectors found samples of salmonella in 28 different locations in the plant, in 13 nut butter samples and in one sample of raw peanuts. Inspectors found improper handling of the products, unclean equipment and uncovered trailers of peanuts outside the facility that were exposed to rain and birds. Inspectors also said employees did not have access to hand-washing sinks, and dirty hands had direct contact with ready-to-package peanuts.

The FDA has inspected the plant at least four times over the past five years, each time finding violations. Michael Taylor, the FDA's deputy commissioner for foods, said the agency's inspections after the outbreak found even worse problems than what had been seen there before.

The salmonella outbreak was traced to Trader Joe's peanut butter produced at the plant. Sunland produces products for a number of national grocery and retail chains, and New Mexico Peanut Growers Association President Wayne Baker says the industry generates about $60 million in the region each year.

Valencias are a variety of peanuts that come almost exclusively from eastern New Mexico. Because of their sweet flavor, they are favored for organic and natural peanut butter products because they require few additives.

The peanut is celebrated every year at the town's annual Peanut Valley Festival, and most residents have stories related to peanuts, whether growing up on a peanut farm, helping to haul them to harvest or knowing peanut workers or farmers.

"Peanuts is, like, everything here," said local shopkeeper Brittany Mignard.

The plant's retail store remains open, although its shelves are bare of its own products. The few items remaining include peanut brittle made in Lubbock, Texas. The shelves are stocked with jelly, but no peanut butter.

Baker, who is also a Sunland board member, said the company had never been notified of any past violations. And the company has vehemently denied FDA allegations that it knowingly shipped any potentially tainted products.

Plant officials said they were blindsided by the FDA's suspension on Monday. Just hours before it was announced, the plant had announced plans to start shelling the bumper crop on Tuesday. Plant officials said they had notified the FDA last week of their plans to reopen the processing operations while waiting for approval to resume making peanut butter.

"The FDA is overreaching its power and putting out information that isn't true," Baker said. "We don't understand what is going on. We don't think we are guilty."

FDA officials wouldn't comment on his allegations, saying it was an ongoing investigation.

Food safety expert and Cornell University professor Bob Gravani said given the number of salmonella outbreaks in recent years, he believes the FDA is being heavily scrutinized about why they are not using their rules more frequently or more aggressively.

Putting aside the "he-said, she-said" between the FDA and the company, he said, "I would say suspension is warranted in this case."

This is not the first major outbreak since the FDA gained authority to pull a facility's registration in the 2011 food safety law. An outbreak of listeria in cantaloupe in 2011 is linked to at least 30 deaths and investigators found similar conditions at Jensen Farms in Colorado. Unlike Sunland, however, Jensen Farms did not attempt to restart operations after the recall and FDA investigation. The company later filed for bankruptcy.

Baker said officials have been trying for the past two months to cooperate with the FDA to get the plant reopened.

"That hasn't worked," he said. "But we are not going to give up. We are going to fight this. We have got no choice."

He said officials have begun calling the state's senators and congressman and talking with other agricultural groups about getting help in Washington with an appeal of the FDA action. No hearing has yet been scheduled.

Coburn said about 30 percent of the plant's workers were laid off Monday.

Although peanuts can be stored for a while, Coburn and Baker acknowledged that time is of the essence for getting to work on what Coburn said were "many, many millions" of pounds harvested from this year's crop.

Farmers, Baker acknowledged, are worried about getting paid. But he said Sunland has committed to paying them for their crops.

Under a worst-case scenario, he said, Sunland could sell the peanuts to other producers.

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Associated Press reporter Mary Clare Jalonick in Washington contributed to this report.

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Follow Jeri Clausing on Twitter at http://twitter.com/#!/jericlausing

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Rugby-England add flyhalf Burns to squad for All Blacks’ test

LONDON, Nov 27 (Reuters) – England called up uncapped Gloucester flyhalf Freddie Burns on Tuesday to their squad for Saturday’s test against New Zealand in place of the injured Toby Flood.

Flood sustained ligament damage to a big toe during the 16-15 loss to South Africa at Twickenham last Saturday.

Owen Farrell, whose last start was in the first test in South Africa this year, is set to replace Flood in the starting XV against the world champions.

Lock Courtney Lawes, who missed England’s first three tests of the November series because of a knee injury, has also been included in the 23-man squad. Two other locks, Mouritz Botha and Tom Palmer, have been omitted.

After beating Fiji in their opening match, England have lost to Australia and the Springboks and now face a daunting match against the All Blacks who are unbeaten in 20 tests since the start of their victorious World Cup campaign last year.

“For those in Saturday’s squad the message is clear – last week we went toe to toe with the second best team in the world and felt we should have won,” England head coach Stuart Lancaster said in a statement.

“Now we have a chance to take on the number one side in front of a passionate Twickenham crowd, who have been fantastic throughout the Internationals, and it is a challenge we will meet head on.” (Reporting by John Mehaffey; Editing by Ken Ferris)

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The Wii U sells out in its first week: Evidence of a Nintendo comeback?

The latest console from the videogame pioneer is flying off the shelves. But are the kids really still into Mario and Zelda?

Earlier this year, Nintendo posted its first annual loss in three decades, a grim omen for the pathbreaking videogame maker that introduced the world to classic characters like Mario, Donkey Kong, and Link. The Japanese company has struggled amidst an industry-wide decline in the sales of consoles and games, a trend partly attributed to the ever-growing popularity of tablets and smartphones. Nintendo’s last breakout success was the Wii, released in 2006, and there have been serious doubts that its successor, the Wii U, could sell as many units. However, since the Wii U went on sale in North America on Nov. 18, Nintendo has completely sold out of all 400,000 consoles shipped to retailers. “As soon as the Wii U hits the shelf, it’s selling out,” said Reggie Fils-Aime, the head of Nintendo’s U.S. operations.

The Wii U’s early success is a surprising indication of “strong demand for the company’s next generation of videogame devices,” says Ian Sherr at The Wall Street Journal. And during the week of Nov. 18, Nintendo also sold 300,000 units of the original Wii, as well as more than 500,000 units of its portable DS and 3DS systems, which could reflect a rebound in consumer demand as the economy continues its long slog of a recovery from the Great Recession. Nintendo says it expects to sell 5.5 million Wii U systems by the end of March 2013, the end of its fiscal year.

However, it’s important to remember that “Nintendo has a very dedicated audience that craves almost anything new the company has to offer, not unlike Apple’s fans,” says Nick Wingfield at The New York Times. “The real test of the Wii U’s durability will come when the product is in better supply and more casual gamers, who don’t dream about Mario and Zelda in their sleep, can more easily buy it.” In addition, rivals Sony and Microsoft are expected to unveil their new consoles sometime in 2013, putting extra pressure on Nintendo. 

And perhaps most importantly, Nintendo has to sell games. The Wii U — which retails for $ 299.99, and $ 349.99 for a more powerful model — is being sold at a loss. Nintendo hopes that users will continue to buy games in the years to come, particularly those that aren’t sold on other systems, such as the latest installments in the “Super Mario Bros.” and “Legend of Zelda” franchises. That’s among the keys to Nintendo’s future profitability.

Sources: The Los Angeles Times, The New York Times, USA Today, The Wall Street Journal

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Turkish PM fumes over steamy Ottoman soap opera

ISTANBUL (Reuters) – A hit TV show about the Ottoman Empire‘s longest-reigning Sultan has raised a political storm in Turkey, with Prime Minister Tayyip Erdogan urging legal action over historical inaccuracies and the opposition accusing him of artistic tyranny.

Erdogan tore into the weekly soap opera “Magnificent Century”, which attracts an audience of up to 150 million people in Turkey as well as parts of the Balkans and Middle East, in response to criticism of his government’s foreign policy.

The lavish television production, which grips audiences with tales of power struggles and palace intrigue, is set during the 16th century reign of Suleiman the Magnificent, when Ottoman rulers held sway over an empire straddling three continents.

Bristling at suggestions that Turkey was meddling too much in its neighbors’ affairs, Erdogan recalled Turkey’s heritage, and said Suleiman had been a proud conqueror rather than the indulgent harem-lover portrayed in the show.

“(Critics) ask why are we dealing with the affairs of Iraq, Syria and Gaza,” Erdogan said at the opening of an airport in western Turkey on Sunday.

“They know our fathers and ancestors through ‘Magnificent Century’, but we don’t know such a Suleiman. He spent 30 years on horseback, not in the palace, not what you see in that series.”

Scenes that showed Suleiman with women in the harem have prompted calls from viewers in the mostly Muslim and largely conservative country for the broadcasting regulator (RTUK) to ban the series. But it tops the viewing charts each week.

Erdogan said the director of the series, which has been on air since January 2011, and the owner of the channel that broadcasts it had been warned, but also said he expected the judiciary to act, without elaborating.

Erdogan’s opponents accused him of authoritarianism.

“The prime minister must be jealous of the series’ popularity. He thinks there’s no need for another sultan when he’s in power,” said Muharrem Ince, the deputy chairman of the main opposition Republican People’s Party (CHP).

“Erdogan wants to be the only sultan.”

Elected a decade ago with the strongest majority seen in years, Erdogan has overseen a period of unprecedented prosperity in Turkey. But concerns are growing about his increasingly authoritarian rule.

Hundreds of politicians, academics and journalists are in jail on charges of plotting against the government, while more than 300 army officers were given prison terms in September for conspiring to topple him not long after he swept to power.

Turkey has been increasingly assertive in regional politics, most notably over the crisis in neighboring Syria, where it has led calls for international action and scrambled war planes in a warning to Damascus not to violate its territory.

“I think the prime minister’s aim here is to change the agenda. I can’t think of any other reason to discuss an imaginary television series when there are so many problems in a country,” Nebahat Cehre, who played Suleiman’s mother during the first two seasons, told Turkey’s Birgun newspaper.

(Editing by Nick Tattersall and Jon Hemming)

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Former presidential nominee Dole in hospital: media reports

WASHINGTON (Reuters) – Former Republican presidential nominee Bob Dole has been admitted to Washington’s Walter Reed Army medical center for what an aide called a “routine procedure,” media reports said on Tuesday.

Dole, 89, “self-checked into the hospital for a routine procedure and will be discharged tomorrow,” an aide told NBC News. “He’s doing very well.”

According to Politico, Senate Majority Leader Harry Reid, a Democrat, said on the Senate floor on Tuesday that Dole was hospitalized “because he is infirm. He is sick.”

Reid’s comments came during debate on the U.N. Convention on the Rights of Persons with Disabilities. Dole, who was severely wounded during World War Two, had sent a letter to the Senate urging passage.

Dole, a former Senate majority leader from Kansas, lost the 1996 presidential election to Democratic incumbent Bill Clinton. Dole served as a senator from 1969 to 1996.

(Reporting by Ian Simpson; Editing by Paul Simao)

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W.H. blasts GOP 'obsession' with Rice

Arizona Sen. John McCain, the ranking Republican on the Senate Armed Services Committee—flanked by fellow committee …The White House sharply escalated its attacks Tuesday on Republicans trying to stop Ambassador to the United Nations Susan Rice from succeeding Hillary Rodham Clinton as secretary of state. Press secretary Jay Carney described GOP lawmakers as being gripped by a politically fueled "obsession" with a series of television appearances Rice made shortly after the deadly Sept. 11 attack on the U.S. diplomatic compound in Benghazi, Libya, in which she wrongly suggested the attack had stemmed from a demonstration over an anti-Muslim video rather than a terrorist assault.

Carney's comments came after Rice met privately on Capitol Hill with Republican senators who have said they intend to block her nomination if President Barack Obama chooses her to replace Clinton as the nation's top diplomat. Rice also acknowledged for the first time, in a written statement issued by her office, that her initial public comments on the Benghazi assault were wrong because there had been no protest outside the compound.

Carney said the U.S. still does not know who carried out the assault, which claimed the lives of Ambassador Chris Stevens and three other Americans. But he said GOP focus on Rice's early statements was a politically motivated distraction from efforts to identify those responsible for the killings.

"The questions that remain to be answered have to do with what happened in Benghazi, who was responsible for the deaths of four Americans, including our ambassador, and what steps we need to take to ensure that something like that doesn't happen again." Carney said.

In appearance after appearance, Rice said that American intelligence had pinned the blame on the assault on extremists who took advantage of a demonstration outside the facility.

Tuesday, Rice acknowledged the information initially provided by the intelligence community was wrong.

"Neither I nor anyone else in the administration intended to mislead the American people at any stage in this process, and the administration updated Congress and the American people as our assessments evolved," Rice said.

Rice, accompanied by Acting CIA Director Michael Morell, met with Republican Sens. John McCain of Arizona, Lindsey Graham of South Carolina and Kelly Ayotte of New Hampshire, who have accused Rice (and the Obama administration in general) of misleading the public by tying the assault to the video. Republicans have suggested the administration hoped to blunt the potential political impact of the attack—the first to claim the life of an American ambassador in 30 years—shortly before the presidential election.

"Bottom line: I'm more disturbed now than I was before," Graham told reporters after the meeting. "We are significantly troubled by many of the answers that we got and some that we didn't get," McCain said.

Carney shot back, saying there were "no unanswered questions" about Rice's early televised statements.

"The focus on—some might say obsession on—comments made on Sunday shows seems to me and to many to be misplaced," Carney said. "I know that Sunday shows have vaunted status in Washington, but they have almost nothing to do—in fact zero to do—with what happened in Benghazi."

And neither, to hear Carney tell it, did Rice.

"Ambassador Rice has no responsibility for collecting, analyzing and providing intelligence, nor does she have responsibility as the United States ambassador to the United Nations for diplomatic security around the globe," he said.

So why, then, did the White House anoint Rice the administration point person to answer questions about a possible intelligence failure and consular security? Why not Secretary of State Clinton? Director of National Intelligence James Clapper? Defense Secretary Leon Panetta? National Security Adviser Tom Donilon?

"She is a principal on the president's foreign policy team," Carney said.

He added, "To this day it is the assessment of this administration and of our intelligence community … that they acted at least in part in response to what they saw happening in Cairo and took advantage of that situation."

In other words, according to one well-placed source, the perpetrators of the attack may have concluded that anger at the video gave them the maximum opportunity to get sympathy or support across the Muslim world, and might even inspire copycat attacks. Rice's much-dissected Sept. 16 comments broadly follow those lines.

Obama has fiercely defended Rice, while carefully declining to say whether he has chosen her to succeed Clinton. Another leading contender is the Democratic chairman of the Senate Foreign Relations Committee, John Kerry.

McCain and Graham have pledged to try to filibuster her confirmation, but they are well short of the votes needed to do so.

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HP hit with civil securities lawsuit over Autonomy deal

SAN FRANCISCO (Reuters) – Hewlett-Packard Co was sued on Monday by an investor who claimed the company knew statements about its Autonomy acquisition were misleading and led the stock to fall, according to lawyers representing the plaintiff.

The proposed class action lawsuit was filed in a San Francisco federal court.

HP dropped a bombshell last Tuesday with an $ 8.8 billion write-down on its acquisition of British software firm Autonomy, saying the company inflated sales with improper accounting. Autonomy co-founder Mike Lynch has denied any wrongdoing.

HP bought Autonomy for a hefty $ 11.1 billion last year. HP has said it alerted regulators on both sides of the Atlantic.

The lawsuit, one of the first to be filed by investors on the Autonomy mess, said HP hid the fact it gained control of Autonomy based on financial statements that could not be relied upon. It also said that HP had not revealed to investors that it tried to undo the Autonomy agreement before it closed because of the accounting issues.

(Reporting By Dan Levine and Poornima Gupta; Editing by Gerald E. McCormick and Andre Grenon)

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Actor: CBS comedy ‘Two and a Half Men’ is ‘filth’

NEW YORK (AP) — The teenage actor who plays the half in the hit CBS comedy “Two and a Half Men” says it’s “filth” and through a video posted by a Christian church has urged viewers not to watch it.

Nineteen-year-old Angus T. Jones has been on the show since he was 10 but says he doesn’t want to be on it. He says, “Please stop watching it. Please stop filling your head with filth.”

The video was posted by the Forerunner Christian Church in California, where Jones says he went to meet his spiritual needs.

Show producer Warner Bros. Television has no comment. CBS hasn’t responded to a request for comment left Monday.

The show stars Jon Cryer as Jones’ uptight dad and originally featured Charlie Sheen as his hedonistic philandering uncle, but Sheen was replaced by Ashton Kutcher.

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FDA flexes new muscles, shuts down plant

WASHINGTON (AP) — The Food and Drug Administration halted operations of the country's largest organic peanut butter processor Monday, cracking down on salmonella poisoning for the first time with the new enforcement authority the agency gained in a 2011 food safety law.

FDA officials found salmonella all over Sunland Inc.'s New Mexico processing plant after 41 people in 20 states, most of them children, were sickened by peanut butter manufactured at the Sunland plant and sold at Trader Joe's grocery chain. The FDA suspended Sunland's registration Monday, preventing the company from producing or distributing any food.

The food safety law gave the FDA authority to suspend a company's registration when food manufactured or held there has a "reasonable probability" of causing serious health problems or death. Before the food safety law was enacted early last year, the FDA would have had to go to court to suspend a company's registration.

Sunland had planned to reopen its peanut processing facility on Tuesday and a spokeswoman said before the FDA's announcement Monday that the company hoped to be selling peanut butter again by the end of the year. The spokeswoman didn't have immediate comment on the suspension.

The company now has the right to a hearing and must prove to the agency that its facilities are clean enough to reopen.

Michael Taylor, the FDA's deputy commissioner for foods, said the FDA's ability to suspend a registration like this one is a major step forward for the agency.

"Consumers can be assured that products will not leave this facility until we determine they have implemented preventive measures that are effective to produce safe products," Taylor said.

Sunland Inc. is the nation's largest organic peanut butter processor, though it also produces many non-organic products. The company recalled hundreds of organic and non-organic nuts and nut butters manufactured since 2010 after Trader Joe's Valencia Creamy Peanut Butter was linked to the salmonella illnesses in September.

In addition to Trader Joe's, Sunland sold hundreds of different peanut products to many of the nation's other large grocery chains, including Whole Foods, Safeway, Target and others.

In a monthlong investigation in September and October, after the outbreak linked to processor Sunland and to Trader Joe's, FDA inspectors found samples of salmonella in 28 different locations in the plant, in 13 nut butter samples and in one sample of raw peanuts.

The agency also found improper handling of the products, unclean equipment and uncovered trailers of peanuts outside the facility that were exposed to rain and birds.

The FDA said that over the past three years, the company shipped products even though portions of their lots, or daily production runs, tested positive for salmonella in internal tests. The agency also found that the internal tests failed to find salmonella when it was present.

FDA inspectors found many of the same problems — including employees putting their bare fingers in to empty jars before they were filled, open bags of ingredients, unclean equipment, and many other violations — in a 2007 inspection. Similar problems were recorded by inspectors in 2009, 2010 and 2011, though government officials didn't take any action or release the results of those inspections until after the illnesses were discovered this year.

In a statement earlier this month, Sunland officials denied that they knowingly shipped tainted products.

"At no time in its 24-year history has Sunland, Inc. released for distribution any products that it knew to be potentially contaminated with harmful microorganisms," Sunland president and CEO Jimmie Shearer said in a statement on the company's website. "In every instance where test results indicated the presence of a contaminant, the implicated product was destroyed and not released for distribution."

A separate peanut butter outbreak in 2009 not related to Sunland was linked to hundreds of illnesses and nine deaths.

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Find Mary Clare Jalonick on Twitter at http://twitter.com/mcjalonick

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Online:

FDA updates on Sunland and list of recalled items: http://www.fda.gov/Food/FoodSafety/CORENetwork/ucm320413.htm

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