challenging the concepts of localization and recovery of brain function recbir – research centre...
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CHALLENGING THE CONCEPTS OF LOCALIZATION
AND RECOVERY OF BRAIN FUNCTION
ReCBIR – Research Centre for Brain Injury Rehabilitation
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
UCN - The Unit for Cognitive Neuroscience
Neuroplasticitet og rehabilitering efter hjerneskade – hjerneskadens
mekanismer og behandling
Jesper Mogensen, ProfessorHead of UCN (The Unit for Cognitive Neuroscience), Dep. of
Psychol., University of Copenhagen
Director of ReCBIR (Research Centre for Brain Injury Rehabilitation)
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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Den regionale specialisering af hjernen – funktionel lokalisation
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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FULD FUNKTIONEL GENOPRETNING
TRODS KOMPLET SKADE AF
HJERNESTRUKTURER
(ALLOCENTRISK PLACE LEARNING)
Mogensen et al. Brain Research Bulletin, 2004
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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ELLER
GENOPRETNING?
LOKALISATION
ELLER? …
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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ALGORITHMIC STRATEGIES
ELEMENTARY FUNCTIONS
NEU
RAL
SU
BSTR
ATESBEHAVIOUR X
UNDERLYING COGNITIVE MECHANISMS
AS
A
AS
C
EF
1EF
2EF
3EF
4EF
5EF
6EF
7EF
8EF
9EF10
EF11
EF12
EF13
EF14
EF15
I
II
III
IV VVI
VII
VIII
IX
X
XI
XII
XIII
XIVXV
Brain structure α
Brain structure
β
Brain structure
γ
UN
DER
LYIN
G N
EUR
AL
MEC
HA
NIS
MS
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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BDNF (Brain-Derived Neurotrophic Factor) samt andre trofiske faktorer …
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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TROFISKE FAKTORER
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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SPROUTING
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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MEKANISMER for NEURONDØD
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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BDNF og antidepressiva
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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HVAD PÅVIRKER HJERNENS PLASICITET?
BDNF?
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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BDNF (Brain-Derived Neurotrophic Factor) samt andre trofiske faktorer
ved hjerneskade
Betydning i den akutte fase
Betydning for langsigtet reorganisering
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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SKADER ved BLODPROP
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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MEKANISMER for NEURONSKADE ved TBI
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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BDNF (Brain-Derived Neurotrophic Factor) samt andre trofiske faktorer
ved hjerneskade
Betydning i den akutte fase
Betydning for langsigtet reorganisering
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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Hvordan kan BDNF fremmes ?
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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BDNF og antidepressiva
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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Hvordan kan BDNF fremmes ? – andre muligheder?
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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BDNF ved motorisk aktivitet
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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BDNF
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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Food for Thought …
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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HVAD PÅVIRKER HJERNENS PLASICITET?
Motion?
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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Aktivering/stimulation som terapeutisk metode ved hjerneskade
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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Tidlig eller sen ?
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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SEN !
Men …
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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Aktivering/stimulation som terapeutisk metode ved hjerneskade
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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Påtvunget eller frivillig ?
Stress ?
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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Exercise after stress
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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FRIVILLIG !
Men …
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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Aktivering/stimulation som terapeutisk metode ved hjerneskade
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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Betydningen af stress
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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Støtte til funktionel genopretning og træning – samt måske ”skader” ved
psykiske lidelser
Farmakologi
Aktivering/Stimulering
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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Farmakologisk støttet rehabilitering
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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Farmakologisk støttet rehabilitering
Effekter af Erythropoietin (EPO)
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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EPO og BDNF
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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7 dage 30 dage
Interaktioner
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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EPO og BDNF
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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Glutamat
Betydning i den akutte fase
Betydning for langsigtet reorganisering
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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SKADER ved BLODPROP
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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Glutamat - PIMSD
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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DEN DYNAMISKE HJERNE: HÅB OG UDFORDRINGER
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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Får vi en kopi af det mistede?
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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1. MODIFICATION OF DEGREE OF CONTRIBUTION TO TASK MEDIATION BY INDIVIDUAL STRUCTURES:
Some structures exhibit increased or decreased levels of contribution to task mediation
2. TASK-DEPENDENT AND DISSIMILAR NEURAL SUBSTRATES:
After a given lesion the functional recovery of various cognitive tasks is mediated by unique and dissimilar neural substrates
3. APPLICATION OF NEW COGNITIVE STRATEGIES:
The fully posttraumatically recovered individuals solve the task by applying new strategies that are dissimilar to those applied pretraumatically
PHENOMENA OF POSTTRAUMATIC PHENOMENA OF POSTTRAUMATIC RECOVERYRECOVERY
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
61
ALGORITHMIC STRATEGIES
ELEMENTARY FUNCTIONS
NEU
RAL
SU
BSTR
ATESBEHAVIOUR X
UNDERLYING COGNITIVE MECHANISMS
AS
A
AS
C
EF
1EF
2EF
3EF
4EF
5EF
6EF
7EF
8EF
9EF10
EF11
EF12
EF13
EF14
EF15
I
II
III
IV VVI
VII
VIII
IX
X
XI
XII
XIII
XIVXV
Brain structure α
Brain structure
β
Brain structure
γ
UN
DER
LYIN
G N
EUR
AL
MEC
HA
NIS
MS
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
62
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
63
Får vi en kopi af det mistede?
NEJ!
Men kunne vi få det?
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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Hvordan er de basale netværk dannet oprindeligt?
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
67”Kritiske” perioder under udviklingen
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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CSPGs - stoffer fra gliaceller …
CSPGs – chondroitin sulphate proteoglycans
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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Og så er der låst …
… eller er der?!
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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NEUROGENESE I DEN VOKSNE HJERNE
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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CSPGs
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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Styrkelse af BDNF?
Hæmning af CSPGs?
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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Fordele – og farer
Hæmning af CSPGs?
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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Styrkelse af BDNF?
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
77
Aktivering/stimulation som terapeutisk metode ved hjerneskade
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
78
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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Hvad kan vi gøre for at få den bedste omformning af hjernen?
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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ALGORITHMIC STRATEGIES
ELEMENTARY FUNCTIONS
NEU
RAL
SU
BSTR
ATESBEHAVIOUR X
UNDERLYING COGNITIVE MECHANISMS
AS
A
AS
C
EF
1EF
2EF
3EF
4EF
5EF
6EF
7EF
8EF
9EF10
EF11
EF12
EF13
EF14
EF15
I
II
III
IV VVI
VII
VIII
IX
X
XI
XII
XIII
XIVXV
Brain structure α
Brain structure
β
Brain structure
γ
UN
DER
LYIN
G N
EUR
AL
MEC
HA
NIS
MS
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
81
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
82
GENERALISERING …
af træning?
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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GENERALISERING …
og kan vi få virkeligheden ind i
træningen?
kan vi få træningen ud i virkeligheden?
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
85
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
86
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
87
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
88
Virkeligheden ind i træningen!
Træningen ud i virkeligheden!
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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DEN DYNAMISKE HJERNE: HÅB OG UDFORDRINGER
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
90
I forskning og behandling – lad os gå direkte efter de optimale
løsninger!
UCN - The Unit for Cognitive Neuroscience
ReCBIR – Research Centre for Brain Injury Rehabilitation
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TAK FOR I DAG!
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