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[IPk] Bubble problem survey



We used to get serious bubble problems with the Minimed 511 and 512. It was
one of the main reasons we wanted to switch pumps. Not having the lock
system on the reservoir seemed to be one of the causes as well as really
thin weak o-rings.

We switched to the Cozmo and the bubble problem is more or less eliminated.
Exceptions of course where unavoidable use of cold insulin.

If you are having bubble problems filling from a vial, try a penfill
instead. Insert the needle the same way (inveretd) but use a pen to
*push*the insulin into the reservoir from the penfill rather than
*pull it* in from the reservoir. This creates less pressure. We use penfills
of insulin, which means each 3ml penfill fills a reservoir and we are not
contaminating insulin in a vial.

If you get lots of tiny bubbles near the top when filling the reservoir,
draw some air into the reservoir to form a big bubble. Gently roll the big
bubble around to "catch" the tiny bubbles and then expell the big bubble.

Bubbles are a real nuisance and we have found that once air has been pumped
into a site, the site will soon fail. I think due to insulin oxidising.

Good luck..

Karen Persov. Mum to Sarah age 9, dxd May 98, pumping since 2004

>I wondered if we could do a little informal survey on bubbles - seems that
>I am not alone in having the impression that bubbles may be more common
>with some pumps than others (for whatever reason, maybe shape of
>cartridges) - if this is the case maybe prospective pumpers might want to
>be aware of this when choosing pumps, even though for sure there are plenty
>of users of all the pumps who have no bubble problems.
>I'd be happy to compile a list of people's answers.
>Nanette
>(Cozmo, almost never get bubbles - though having said that, will probably
>have problems all week!!)
>>Subject: Re: [IPk] bubbles bubbles bubbles!!!
>>
>>Hi Seos
>>
>>I, like you, don't actually insert air but it was mentioned by others
>>earlier in the thread and so I assumed this was being done here by Janet.
>>I
>>find that as I withdraw the needle a certain amount of air goes in to
>>maintain the pressure.  I rarely get bubbles.
>>
>>June
>.

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Date: Sat, 3 Jun 2006 16:58:24 EDT
From: email @ redacted
Subject: Re: [IPk] Re: bubbles bubbles bubbles!!!

Hi to everyone. We feel we have tried everything - regarding bubbles.
We  are
also getting marks on  Rachels body where the set has been. We are  chatting
to her dsn on monday morning, prior to leaving for our holiday.[ 5 days  in
skegness at butlins.]Our dsn is leaving in july/ august for another job. She
is
very very supportive , but something is telling me to go back to Rachels old
regime of long acting ,and then short acting before each meal.I just dont
think  its the right time for her at the moment. We also have a little boy
11
months old Jack, who is a handfull day and especially NIGHT.Rachel has
already
accidently pulled the set off whilst playing. I think we will sleep on it
but
probably go back to the injections untill she becomes a little older and our
diabetes team have a little more experience.Janet ,mum to Rachel age 5
pumping  forjust over a month. Good luck to all you pumpers out  there.
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Date: Sat, 3 Jun 2006 14:13:02 -0700
From: email @ redacted
Subject: [IPk] Bubbles etc

I've had a D-Tron plus and now an Accu-Chek Spirit, and very rarely have
bubbles after I've primed. Both pumps use pre-filled cartridges.

HTH

Lesley

Nanette wrote:

I wondered if we could do a little informal survey on bubbles - seems that I
am
not alone in having the impression that bubbles may be more common with some
pumps than others (for whatever reason, maybe shape of cartridges) - if this
is
the case maybe prospective pumpers might want to be aware of this when
choosing
pumps, even though for sure there are plenty of users of all the pumps who
have
no bubble problems.
I'd be happy to compile a list of people's answers.
Nanette
(Cozmo, almost never get bubbles - though having said that, will probably
have
problems all week!!)
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Date: Sat, 3 Jun 2006 15:22:09 -0600
From: email @ redacted
Subject: [IPk] Bleeding

So, I changed my reservoir and infusion set at lunchtime ( couple of
hours ago) and bled profusely from my abdomen when I removed the
canula.  That hasn't happened to me in the 4 months or so that I've
been using the pump.  Is this the start of necrobiosis?  Has anyone
else experienced this?  I presume I'll just have to be a bit more
careful in future.

- --
Tim C.
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Date: Sat, 3 Jun 2006 15:41:54 -0600
From: email @ redacted
Subject: [IPk] Bubbles survey

I use a Medtronic  515.  I see bubbles initially, after drawing in
the insulin, but have found it simple to remove these by moving the
plunger up and down several time and by tapping smartly on the side
of the vial with a fairly heaving pen that I have.  I fully
pressurize the vial before drawing the insulin.  For me, this works
consistently.  I'm amazed that some of you are able to draw insulin
without first pressurizing the insulin vial.  Is it not difficult to
draw back the plunger?

On another topic: I talked with a Medtronic rep earlier in the week
about the continuous blood glucose monitoring.  I think it is their
model 522 and they would be willing to ship one to me at the end of
June.  However, it is not clear that my insurance company would cover
this.  In addition, the cost of the sensors is astonishing-$35 each.
They last only for three days.  The rep said that the insurance
definitely would not cover the sensors.  I suppose there is the
possibility that this will change with time and as the cost
decreases.  Additionally, I suppose one could still use them to help
the learning experience but, for me, the real value would be those up
and down arrows.

Lots of interesting e-mail today!

- --
Tim C.
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Date: Sun, 4 Jun 2006 00:08:08 +0100
From: "June Searle" <email @ redacted>
Subject: Re: [IPk] Re: bubbles bubbles bubbles!!!

Hi Nanette

This survey will be interesting.  I use a 508 and I hardly ever get bubbles.

June

- ----- Original Message -----
From: "Nanette Chana Freedman" <email @ redacted>
To: <email @ redacted>
Sent: Saturday, June 03, 2006 9:22 PM
Subject: [IPk] Re: bubbles bubbles bubbles!!!


>I wondered if we could do a little informal survey on bubbles - seems that
>I am not alone in having the impression that bubbles may be more common
>with some pumps than others (for whatever reason, maybe shape of
>cartridges) - if this is the case maybe prospective pumpers might want to
>be aware of this when choosing pumps, even though for sure there are plenty
>of users of all the pumps who have no bubble problems.
> I'd be happy to compile a list of people's answers.
> Nanette
> (Cozmo, almost never get bubbles - though having said that, will probably
> have problems all week!!)
>> Subject: Re: [IPk] bubbles bubbles bubbles!!!
>>
>> Hi Seos
>>
>> I, like you, don't actually insert air but it was mentioned by others
>> earlier in the thread and so I assumed this was being done here by Janet.
>> I
>> find that as I withdraw the needle a certain amount of air goes in to
>> maintain the pressure.  I rarely get bubbles.
>>
>> June
> .
>
>
> --
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Date: Sun, 04 Jun 2006 00:52:46 +0100
From: Steve Hargreaves <email @ redacted>
Subject: Re: [IPk] Bleeding

Hi Tim

Scary, isn't it. It's only happened to me once - took a couple of weeks
to heal - but been fine since (even though I do tend to leave the sets
in longer than I should).

If it's the first time I wouldn't worry too much. I tend to take any
sign of discomfort as a wake up call to change the set these days
(excessive pain or any itchiness around the site that last more than two
minutes from insertion tends to be a good rule of thumb for me).

You probably hit a capillary or something - I shouldn't be too concerned
at the moment. Chalk it up to experience :o)

Steve


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Date: Sun, 04 Jun 2006 11:53:51 +0000
From: "Vicki Crowley" <email @ redacted>
Subject: Re: [IPk] Bleeding

That's happened to me twice. It's just like when you take a shot and it
bleeds. It bleeds alot I guess cuz it's a bigger needle.

Just part of pumping!


>From: Steve Hargreaves <email @ redacted>
>Reply-To: email @ redacted
>To: email @ redacted
>Subject: Re: [IPk] Bleeding
>Date: Sun, 04 Jun 2006 00:52:46 +0100
>
>Hi Tim
>
>Scary, isn't it. It's only happened to me once - took a couple of weeks to
>heal - but been fine since (even though I do tend to leave the sets in
>longer than I should).
>
>If it's the first time I wouldn't worry too much. I tend to take any sign
>of discomfort as a wake up call to change the set these days (excessive
>pain or any itchiness around the site that last more than two minutes from
>insertion tends to be a good rule of thumb for me).
>
>You probably hit a capillary or something - I shouldn't be too concerned at
>the moment. Chalk it up to experience :o)
>
>Steve
>
>
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>avast! Antivirus: Outbound message clean.
>Virus Database (VPS): 0622-4, 06/02/2006
>Tested on: 6/4/2006 12:52:50 AM
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>http://www.avast.com
>.

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Date: Sun, 4 Jun 2006 04:56:16 -0700
From: email @ redacted
Subject: [IPk] Atovastatin - Long Term Use

Hi All

I would like to know if any of you that have been taking Atovastatin
(Lipitor)
long term, have experienced a gradual loss of normal walking i.e walking as
though you are slightly drunk. Also worsening neuropathic symptoms in the
legs
and feet.

If anybody has any comment to make about this, I would be very grateful.

Julian
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Date: Sun, 4 Jun 2006 13:21:58 +0100
From: "June Searle" <email @ redacted>
Subject: Re: [IPk] Atovastatin - Long Term Use

Hi Julian

By long term, how long do you mean?  I was changed on to Lipitor at
Christmas, last year and have not noticed any side effects that I know of.
My walking is the same and I do have peripheral neuropathy.  When I went to
the doctor last week and mentioned memory problems he said this is a side
effect of Lipitor but my problems go back further so mine is not caused by
that.  Sorry I am really of no help to you.

June

- ----- Original Message -----
From: <email @ redacted>
To: <email @ redacted>
Sent: Sunday, June 04, 2006 12:56 PM
Subject: [IPk] Atovastatin - Long Term Use


> Hi All
>
> I would like to know if any of you that have been taking Atovastatin
> (Lipitor)
> long term, have experienced a gradual loss of normal walking i.e walking
> as
> though you are slightly drunk. Also worsening neuropathic symptoms in the
> legs
> and feet.
>
> If anybody has any comment to make about this, I would be very grateful.
>
> Julian
> .
>
>
> --
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> Checked by AVG Free Edition.
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Date: Sun, 4 Jun 2006 14:33:10 +0100
From: "Jackie Jacombs" <email @ redacted>
Subject: RE: [IPk] Re: bubbles bubbles bubbles!!!

Hi Nanette

We have a Medtronic 712, fill the reservoirs once for every two set changes.
We
keep the opened vial in the fridge (very warm in our house) take the vial
out a
few hours before a set change. Inject air into the vial before filling
up.  I
cant remember the last time we had a bubble problem.

I cant imagine that its down to a pump itself and of course also many people
have a Minimed or Roche/Disetronic pump anyway as they have been to ones
available the longest in the UK and only a few have cozmos or Animas
pumps.  On
the USA CWD parents list the bubble problem seems to effect all different
makes
of pump equally.   I can say I ever notice parent mentioning bubble problems
much on the US parents support list.

Jackie

>
>
> I wondered if we could do a little informal survey on bubbles - seems that
I
> am not alone in having the impression that bubbles may be more common with
> some pumps than others (for whatever reason, maybe shape of cartridges) -
if
> this is the case maybe prospective pumpers might want to be aware of this
> when choosing pumps, even though for sure there are plenty of users of all
> the pumps who have no bubble problems.
> I'd be happy to compile a list of people's answers.
> Nanette
> (Cozmo, almost never get bubbles - though having said that, will probably
> have problems all week!!)
> > Subject: Re: [IPk] bubbles bubbles bubbles!!!
>

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Date: Sun, 4 Jun 2006 11:05:13 +0100
From: Pat Reynolds <email @ redacted>
Subject: Re: [IPk] Re: bubbles bubbles bubbles!!!

Hi Nanette,

I think the old generation of cartridges was much worse than the newer
generation.  The Paradigm does seem to have the most problems of the
latest generation, but I'm not sure whether that's down to simply it
being the commonest pump.

Cheers,

Pat
dm 30+, pumper 5+, currently a Cozmo - very rarely get any bubbles at
all, and very, very rarely have problems with dislodging a bubble - many
more problems with the 508.

In message <00e801c6874b$66e8af20$email @ redacted>, Nanette
Chana Freedman <email @ redacted> writes
>I wondered if we could do a little informal survey on bubbles - seems that
I
>am not alone in having the impression that bubbles may be more common with
>some pumps than others (for whatever reason, maybe shape of cartridges) -
if
>this is the case maybe prospective pumpers might want to be aware of this
>when choosing pumps, even though for sure there are plenty of users of all
>the pumps who have no bubble problems.
>I'd be happy to compile a list of people's answers.
>Nanette
>(Cozmo, almost never get bubbles - though having said that, will probably
>have problems all week!!)
>> Subject: Re: [IPk] bubbles bubbles bubbles!!!
>>
>> Hi Seos
>>
>> I, like you, don't actually insert air but it was mentioned by others
>> earlier in the thread and so I assumed this was being done here by Janet.
>> I
>> find that as I withdraw the needle a certain amount of air goes in to
>> maintain the pressure.  I rarely get bubbles.
>>
>> June
>.

- --
Pat Reynolds
email @ redacted
  "It might look a bit messy now,
                   but just you come back in 500 years time"
  (T. Pratchett)
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Date: Sun, 4 Jun 2006 11:16:07 +0100
From: Pat Reynolds <email @ redacted>
Subject: Re: [IPk] Bleeding

Hi Tim,

This is something that 'just happens' sometimes.  I have had two like
this in 5 years of pumping.  The first was days after hearing about it
for the first time (in my fourth year of pumping).

You will have a nice bruise there.

You probably already know this, but if you got blood on your clothing,
wash it out first in cold water: putting blood into the normal wash
'cooks' it in.

Cheers,

Pat

dm 30+, pumping 5+

In message <a06110402c0a7ad77d685@[192.168.1.100]>, email @ redacted
writes
>So, I changed my reservoir and infusion set at lunchtime ( couple of
>hours ago) and bled profusely from my abdomen when I removed the
>canula.  That hasn't happened to me in the 4 months or so that I've
>been using the pump.  Is this the start of necrobiosis?  Has anyone
>else experienced this?  I presume I'll just have to be a bit more
>careful in future.

- --
Pat Reynolds
email @ redacted
  "It might look a bit messy now,
                   but just you come back in 500 years time"
  (T. Pratchett)
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Date: Sun, 4 Jun 2006 11:14:08 +0100
From: Pat Reynolds <email @ redacted>
Subject: Re: [IPk] Re: bubbles bubbles bubbles!!!

Hi Rachel,

Are the marks where the cannula goes in, or where the sticky stuff was?
If the latter, then there are lots of ways to stop the irritation - ask
your dsn on Monday for some samples of tapes, creams, etc.

On going back to mdi - I would give the pump a chance, first: try a
different pump, to see if you still have bubble problems.  (I think, for
you I'd recommend the Spirit rather than the Paradigm - if I were in the
business of recommending pumps, which I'm not).  Set pulling out: make a
loop of the cannula, and tape through it (or switch to sof-sets, which
give you a toggle to tape down - then when the cannula is pulled, the
set is not pulled.

I say this because, presumably, mdi was not giving Rachel good control.
If she was getting good control on mdi, and you just wanted greater
flexibility, then the pros and cons are about even, I think -
particularly as I imagine that your daughter is not living a very varied
lifestyle at the moment.

Cheers,

Pat

dm 30+, pumper 5+

In message <email @ redacted>, email @ redacted writes
>Hi to everyone. We feel we have tried everything - regarding bubbles.
We  are
>also getting marks on  Rachels body where the set has been. We
are  chatting
>to her dsn on monday morning, prior to leaving for our holiday.[ 5 days  in
> skegness at butlins.]Our dsn is leaving in july/ august for another job.
She
>is
>very very supportive , but something is telling me to go back to Rachels
old
>regime of long acting ,and then short acting before each meal.I just dont
>think  its the right time for her at the moment. We also have a little boy
11
> months old Jack, who is a handfull day and especially NIGHT.Rachel has
already
>accidently pulled the set off whilst playing. I think we will sleep on it
but
>probably go back to the injections untill she becomes a little older and
our
>diabetes team have a little more experience.Janet ,mum to Rachel age 5
>pumping  forjust over a month. Good luck to all you pumpers out  there.
>.

- --
Pat Reynolds
email @ redacted
  "It might look a bit messy now,
                   but just you come back in 500 years time"
  (T. Pratchett)
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Date: Sun, 04 Jun 2006 17:05:18 +0000
From: "Seos Ni Niallain" <email @ redacted>
Subject: RE: [IPk] Bleeding

Tim, I don't know what necrobiosis is but that sounds disturbing.

My site infection is slowly beginning to recede after a week, has been quite
a handful. I ended up not taking the antibiotic but kept it clean and
covered it with mircropore dressing during day. I also took homeopathic
remedy. Tuesday I'm going to try Silhouette instead of Quikset to see if it
makes a difference. Mentioning all this in case you might wish to try that
option if Quikset is source of your problem?

Best

Seos


>From: email @ redacted
>Reply-To: email @ redacted
>To: email @ redacted
>Subject: [IPk] Bleeding
>Date: Sat, 3 Jun 2006 15:22:09 -0600
>
>So, I changed my reservoir and infusion set at lunchtime ( couple of hours
>ago) and bled profusely from my abdomen when I removed the canula.  That
>hasn't happened to me in the 4 months or so that I've been using the pump.
>Is this the start of necrobiosis?  Has anyone else experienced this?  I
>presume I'll just have to be a bit more careful in future.
>
>--
>Tim C.
>.

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Date: Sun, 4 Jun 2006 18:09:21 +0100
From: "LORETTA CASHIN" <email @ redacted>
Subject: Re: [IPk] bubbles bubbles bubbles!!!

To the question of weather you should or should not push air into your
insulin vial, The answer would be to 'VENT' your insulin bottle by using two
needles, One which is attached to your reservoir and the other which is just
free standing to allow air to enter or leave the insulin vial to maintain
the pressure.  Its something I don't do but it is something that can be done
when drawing large volumes into a syringe.
- ----- Original Message -----
From: "Pat Reynolds" <email @ redacted>
To: <email @ redacted>
Sent: Saturday, June 03, 2006 11:26 AM
Subject: Re: [IPk] bubbles bubbles bubbles!!!
>
> Hi Sara,
>
> Do you use a paradigm?  These cartridges seem quite sensitive to torque
> - if you don't move the plunger up and down exactly straight, bubbles
> can occur, as the d-ring seal gets damaged in some way (at least, that's
> what I surmise from others' experiences).  If you continue to have
> problems, get a re-training session, and (particularly if you have
> problems with manual dexterity) talk to your DSN about swapping to a
> pump that has less sensitivity to kack-handedness.
>
> You are right about keeping the pressure lower in the bottle than in the
> cartridge (so that bubbles will want to go back in the bottle.  Also
> right that if you continually put in less air than you take out, it
> becomes harder and harder to get the insulin out at all.  You can stop
> that happening by equalising the pressure after each fill: simply take
> the needle once you've taken it off the cartridge, and push it back into
> the bottle (bottle upright) - there will be a little hiss as the
> pressure re-equalises.
>
> Cheers,
>
> Pat
> dm 30+, pumper 5+, left-handed and clumsy
>
> In message <email @ redacted>, Sara Pumford
> <email @ redacted> writes
>>I have only been on the pump for 10 days and i am already getting probs
>>with
> >bubbles. it seems to be the only thing that is getting to me!! I changed
> >my
> set
>>last night - took ages to make sure there were no bubbles ( even though
>>there
>>were a few champagne ones). On looking at the resevoir this morning there
>>is
>>quite a big bubble stuck to the bottom of the plunger that definately
>>wasn't
>> there last night. Do these bubbles normally disloge or do they stay stuck
>> to
>>the
>>plunger? I have also noticed that at the end of the 3days when i take out
>>the
>>old reservoir there are quite a few bubbles in it. I am thinking of not
>>injecting air into the vial when i start a new bottle but won't the
>>pressure
>> build up inside the vial too much, as I was always taught to do this when
>> i
>>used
>>to use syringes for my monotard years ago.
>>any info would help.
>>thanks
>>Sara Davies
>>Pumping 10 days (minimed 512)
>>.
>
> --
> Pat Reynolds
> email @ redacted
>   "It might look a bit messy now,
>                    but just you come back in 500 years time"
>   (T. Pratchett)
> .
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Date: Sun, 4 Jun 2006 18:22:51 +0100
From: "LORETTA CASHIN" <email @ redacted>
Subject: [IPk] Insulin requirements, Hot weather and Stuff.

Does anybody out there find that hot weather plays havoc with their control.
I am aware that in hot weather insulin is used quicker.  How does anyone
else
cope. Should I think about changing my basal rates for 'HOT WEATHER'. Any
ideas would be great.

Thanks
Loretta.
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Date: Sun, 04 Jun 2006 14:56:01 -0500
From: "Melissa P. Ford" <email @ redacted>
Subject: RE: [IPk] Atovastatin - Long Term Use

Hi Julian,

Actually yes, the phenomenon you describe is documented. These links mention
atorvastatin (there is an R in it, in case you want to type it into google
yourself) specifically:

http://tinyurl.com/ocnmt

http://tinyurl.com/pr4ca

http://www.diabetesmonitor.com/dqa/2005/2005_08_13.htm

As the third link makes clear, it is nigh impossible to know if neuropathy
in someone who has had diabetes for many years is actually related to statin
use. If there's another therapy to try that can reduce your risk for
cardiovascular disease without potentially exacerbating the neuropathy, it's
worth pursuing. And if you are on a statin only because your doctor thought
it sounded like a good idea even though your cholesterol and triglycerides
were fine, for heaven's sake have an argument with your doctor. There is no
clinical evidence to suggest that it does anyone any good to take a statin
unless the lipids are out of order. If your lipids are out of order, work
with your team to find a therapy that is less likely to give you problems.
You might want to ask your doctor if Zetia (aka Ezetrol), chemical name
ezetimbe, could be of any use if your lipids are out of order and a statin
is not good option for you.

Hope this helps,

Melissa
Type 1 13 years; MiniMed pumper 7.5 years; Animas pumper 2 years 5 months

- ----Original Message Follows----
From: email @ redacted
Reply-To: email @ redacted
To: email @ redacted
Subject: [IPk] Atovastatin - Long Term Use
Date: Sun, 4 Jun 2006 04:56:16 -0700


Hi All

I would like to know if any of you that have been taking Atovastatin
(Lipitor)
long term, have experienced a gradual loss of normal walking i.e walking as
though you are slightly drunk. Also worsening neuropathic symptoms in the
legs
and feet.

If anybody has any comment to make about this, I would be very grateful.

Julian
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End of ip-uk-digest V3 #504
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