February 9, 2011


me+ME: Quite good article on ME/CFS by a psychologist


Something else now than the Editorials of Mindy Kitei or how to go about advocating as a patient with ME - though as it happens, it touches on Ms Kitei's first Editorial, that was entitled "No More Psychological Studies - An Editorial" - and the last link is to my own first reaction to it, where you also find links to the original.

The reason these two things are related is a quite good article by University of Hull Professor of Psychology Rhona Johnston called "Mitochondria, not hypochondria" that I reproduce below, with some of my notes, and that you find under the last link.

As it happens, it is by a professor of psychology; it is informed about ME; and it is quite clear, sensible and to the point, and indeed very close to my ow position on ME - and I am a psychologist by degree (M.A.) and am in the 33rd year of having this disease, that with my ex and I started as EBV (Epstein Barr Virus), in our first year of studying psychology, and then never got away - as if stuck somewhere between quite ill with an infection and properly recovering from it.

Also, my interjected notes are both personal and scientific - and the full article without my notes (which you may prefer, e.g. to show to doctors) is under the link that follows, in the title - and I quote in blue, and my remarks are indented and in black:

Public Service Review: Central Government - Issue 21

Mitochondria, not hypochondria

Thursday, January 06, 2011

University of Hull Professor of Psychology Rhona Johnston argues against the widespread belief that ME/chronic fatigue is a psychological condition…

Which in fact is - in my opinion, but I acknowledge a serious personal interest: I am ill, and I don't like to be defamed, insulted, and discriminated by pseudo-science masqueraded as if it were science - both logically, scientifically and morally required by professors of psychology and medicine, wherever they see pseudoscience practised to the detriment of ill people.

But it is rare enough to happen, alas, for which reason professor Johnston is to be highly commended and seriously thanked.

ME/chronic fatigue syndrome (ME/CFS) is a chronic state of profound exhaustion, often accompanied by pain, sleep problems and cognitive dysfunction, and it is made worse by exercise.

Quite so, and on a personal note - that holds for many with ME, but I know the cases of myself and my ex-wife by far the best, and besides these are somewhat stronger, logically and probabilistically, than those of others:

This is precisely what ailed my ex and me from the beginning - January 1979 - and indeed we got from the beginning too much "exercise", since we were first year students of psychology, having both started in September 1978, and we had to do examinations, attend lectures and so called work groups, and related physical moving about of our bodies, which was the problematic thing to do, and quite exhausting.

What is strong evidence in our cases that it was not hypochondria is that we both had resp. given up a good job and remigrated to follow an academic study and had no personal or financial interest whatsoever to pretend we were ill, as also, for us, the problem was not the studying, but the physical moving about - standing, walking, travelling, being present then and there and attending bodily - that was difficult or indeed impossible.

Also, we were quite happy with each other, and were also, at least in the beginning of our studies, when we had not yet learned psychology is only a real science for a small part, quite interested in studying, and we were also, up to January 1979, when the EBV struck, quite healthy and fit.

This is also why during the first two years of our illness we saw quite a few different doctors, often of internal medicine, and were investigated medically rather thorougly repeatedly, with, as we found ten years later, when we at long last learned of the disease ME, in fact by way of a BBC WS program, the for patients with ME normal result that: "we cannot find anything".

But we ourselves remained feeling miserable and ill all the time, indeed in varying extent, mostly varying with how much we were forced to do physically, which caused us many problems and much unpleasantness, that in fact nearly all were  related to (1) having far less energy than healthy people, to a really disabling extent, and (2) having pains of various kinds, and (3) various problems such as years of diarrhea and of night sweats.

Then a fairly brief but important remark relevant to the phrase "cognitive dysfunction":

Both my ex and I eventually got an M.A. in psychology (and I also a B.A. in philosophy), in spite of many difficulties, in my own case not only physical and ME-related, but connected to university-politics, and indeed both of us got very good M.A. degrees.

The reason we succeeded in getting our degrees is that we had then not severe ME and are both uncommonly intelligent, whereas the study of psychology already then was made fit by the university for IQs of 115, and thus was not precisely demanding or indeed a good academic education.

And such "cognitive" difficulties we had we attributed to exhaustion, although this may have been partially mistaken, in that there is more wrong, with concentration, memory for words, spelling and other things, that in my view, if they indeed are a form of "cognitive dysfunction", have a physical explanation, such as hypoperfusion of the brain, or small local damages in connections between neurons.

In any case, here are two concluding remarks relating to the phrase "cognitive dysfunction":

Personally speaking: If my ex or I ever had any "cognitive dysfunction", it did not prevent either of us getting an excellent M.A. degree in the science of psychology, which shows that whatever "cognitive dysfunction" meant in our case and means in the case of others with our type of disease, it did not keep us from doing better than all or almost all in our years in university - for which reason the term "cognitive dysfunction" is inappropriate when applied to my ex and me.

Generally speaking: I am aware many people with ME do have serious problems with cognitive tasks, and indeed so do I, when tested, and so have I when trying to do intricate mathematics. But I reject the term "cognitive dysfunction" for patients with ME that I know of, because, in combination with the pseudoscientists's Jones, Wessely and Bleijenberg's fraudulent, offensive, false, demeaning, degrading, discriminating, defaming, denerate sadistical pseudoscientific rot that we are supposed to be "dysfunctional believers", I rejet this whole terminology as playing into the hands of psychiatric and psycho-therapeutical sadists, frauds or incompetents.

In my local health authority area, individuals with a long-term fatigue problem used to be sent to the immunology department at the regional hospital for diagnosis and treatment, but now they are referred to a psychiatrist. This is a growing trend throughout the UK.

Indeed - and elsewhere, such as in Holland, where it may not so much be a psychiatrist as a clinical psychologist, and are there served the fare of CBT and GET.

The intelligent reader should already here see a fundamental logical - semantical - problem:

If you have a physical problem - exhaustion, diarrhea, night sweats, inability to stand or walk for long without collapsing, all while also doing the usual fare for the academic study course in psychology in the usual tempo (because we had study loans, that required a certain tempo) - it must be medical malpractice to diagnose one as if one has a psychological problem.

These days, getting a diagnosis of chronic fatigue is tantamount to getting a psychiatric diagnosis. This is good for creating work for psychiatrists, but is it good for the individuals concerned?

There is excellent evidence - consult the index of NL 2010, or indeed "101 Good Reasons" or indeed the list of ME-related titles at the end of this text - that being dealt with as if one were a psychiatric patient earns lots of psychatrists lots of money while being very unhealthy persons with ME.

If their condition is a physical illness, they will not receive suitable treatment and so will not make a full recovery.

Quite so - and CBT and GET are decidedly unhealthy for you if you have a physical disease, for the former is psychobabble and mostly bullshit and fraudulence, and the latter is positively harmful and quite sadistic to impose on ill people (see:  On 'exercise as therapy for ME' : The patients' evidence) - though presumably these days consciences of psychiatrists and clinical psychologist disappear whenever their financial interests conflict with honest rational science, or whenever honest diagnosing would make them or their friends and colleagues no money.

The psychiatric view of what they term 'chronic fatigue syndrome' (the term 'fatigue' clearly trivialises the severity of this illness)

Quite so: It is not "fatigue"; it is exhaustion, and that also of a peculiar kind, I did not know before I fell ill with ME.

has gained considerable ground in the UK in recent years, aided by the supposed lack of evidence of physical causes of the condition.

Intelligent readers note again a serious logical problem. Question: Since when is lack of knowledge - ignorance of cause - a positive ground for diagnosis? Answer: Since psychiatry got corrupt, at the KCL and Barts in England, and lately also at the APA in the preparation of the DSM-5: Psychiatrists are redefining and reterming much of the "science" of psychiatry, by inventing out of thin air such diagnoses, terms, and procedures that will assign as many ill persons as possible to - also - have some psychiatric problem ("must learn to cope", "is too concerned with own health", "mother is too concerned about child's health"), for now virtually anything is a psychiatric symptom, by the new DSM-5 the APA hopes to introduce in 2013, to their own great benefit in money and power.

What evidence can psychiatrists adduce to support their assertion that ME/CFS is a purely psychological illness, that is, a form of hypochondria?

None - and the reader can find in Nederlog of the last months and year excellent reasons that there is no rational evidence whatsoever that can "support their assertion that ME/CFS is a purely psychological illness": All they offer are redefinitions, lies, insinuations, methodological malpractices, and pseudoscience to argue that what once was physical - exhaustion, diarrhea, night sweats, inability to stand or walk for long without collapsing - now is psychological that is psychiatric that is hysterical, hypochondric or delusional.

Also, as a psychologist, with 33 years of illness without any help except minimized dole,  I insist that "ME/CFS is" is in no way at all a "psychological illness", that is, neither "purely" or impurely - it is as little "psychological" as an infection or a virus, or indeed as being drunk.

The whole notion that what medical science at present cannot explain "therefore" must be psychiatric is completely irrational stunningly impertinent and at bottom deliberately very offensive very impertinent knowingly sadistic piece of psychiatric fraudulent impertinence, and indeed a step back to the Middle Ages as regards diagnosing and treating ill people.

Psychiatrists argue that individuals with medically unexplained symptoms have 'functional somatic syndromes' – that is, although their symptoms appear to be physical, they are psychological in origin.

Which is to say they diagnose like witchdoctors, like shamans, like the inquisition: Your soul is the culprit - you think the wrong thoughts, therefore you must be ill, and "therefore" you must pay the witchdoctors, shamans, inquisitioners, psychiatrists and clinical psychologists who falsely you accuse you of being mad or a malingerer, great sums of money for the privilege of not being harassed, defamed, discriminated, demeaned, dehumanized, slandered, and offended by their ilk of 'healing professionals'.

It has been argued, on the basis of an analysis of the literature, that having the belief that ME/CFS is a physical illness leads to a poorer prognosis, and that these faulty attributions perpetuate the illness.

It can precisely as cogently be argued and 'proved' with 'evidence based medicine' and 'statistics' that having the belief that one is ill if one is ill "leads to a poorer prognosis" (one usually is right, for the body doesn't lie - and lo and behold: one gets ill: "poorer prognosis" "ergo" psychiatry has once again been confirmed.

Furthermore, that "faulty attributions perpetuate the illness" is the purest crap and bullshit ever since Charcot and Freud misdiagnosed their patients with hysteria, i.e. with "faulty attributions" that in their fraudulent words "perpetuate the illness" - while it lasts, because it is falsely diagnosed and inhumanly treated.

Thus the fact that these individuals believe that they have a physical illness is seen as a further manifestation of their psychological problems.

That's how Wesselytes may present it but "further" is logically incorrect: The ONLY reasons to treat ME/CFS as a psychiatric illness are that (1) psychiatrists say it is a psychiatric illness to make money from ill people - and psychiatry is a field where crap, fraud and bullshit have been rampant with misdiagnoses that only served the financial interests of psychiatrists since its inception and (2) governments and insurances like that or allow that psychiatrists falsely attribute madness to ill people to "cure" them - for money because that is cheaper than real biomedical research or providing help with disabilities other ill people with similar disabilities do get.

However, if those who assert that they have a physical illness do indeed have one, the prognosis for recovery without suitable treatment is clearly going to be poor.

And "if those who assert that they have a physical illness do indeed " not "have one" the prognosis for recovery with CBT or GET is also poor, for these are psychobabble + aerobics anyway, and that hardly cures anything, except the financial problems of psychobabblers and aerobics teachers.

One of the main treatments on offer for the condition is cognitive behavioural therapy (CBT), which has been shown to lead to a significant reduction in fatigue symptoms.

I am sorry but (1) such studies as I have read were very badly designed and methodologically seriously flawed and (2) the whole idea, as argued before, is bullshit from the start: Only dumboes find some relief in psychobabblers and only weakwilled fatsoes have benefit with aerobics.

This finding might be taken as support for the idea that ME/CFS has a psychological cause.

Yes, but by totally irrational reasoning: On the basis that some (pseudo)scientific studies are supposed to show that CBT helps feeling less fatigued it is concluded that the neurological disease "ME/CFS has a psychological cause".

That is crazy talk!

However, there is a higher incidence of depression in those with chronic physical illnesses than in the general population, although in the case of ME/CFS this has been found to be no higher than in, for example, rheumatoid arthritis. Thus CBT may, for a subset of individuals, ameliorate some of the tiredness resulting from a concomitant depression, while not addressing the underlying fatiguing disorder.

OK ... that is a possibility. The real problem is that "ME/CFS" is researched by the pseudoscientific psychiatric frauds as if it is not a physical disease: First they exclude everyone with a real disease, including "ME/CFS", from their studies, in which they only include somehow, in some sense 'fatigued' persons, and then they say that whatever they have found in that group (if their methodology were correct, which it isn't) is true of "ME/CFS".

That's the fallacy of begging the question combined to the sins - deliberate lack of morality, for personal profit - of dishonesty and incompetence.

It is unclear, however, if this is indeed the case, as the authors of these studies use ME/CFS classification criteria that take fatigue as the main symptom. The exclusion of physical symptoms allows the inclusion of individuals who do primarily have a psychiatric disorder.

Precisely. To prove that heart patients have no heart disease, call them hysterics, and "prove" that they are by studying a group of patients who have no disease whatsoever, and then presenting that as 'evidence based medical science' that these heart patients have no heart disease - and then recommend CBT to them, to cure them of their concern with heart disease, and keep the psychiatric brotherhood able to pay their mortgages and the academic education of their brood.

That is what is happening since two decades with ME, and the sickening sadistic frauds and bullshitters - all high income medical doctors of some kind, all conscious frauds - even go so far to speak as if they do this from the goodness of their hearts and while working for "our community of ME patients".

Thus the statistical reduction in fatigue found with CBT may be largely due to the fact that individuals suffering purely from depression are included in these studies.

It may be, at least in part. The so called "studies" are based on psychiatric bullshit to start with, that is, no better 'evidence based' than theology, which is just lies and prejudice to keep priestly and clerical frauds in money and power.

It should also be noted that there is a lack of evidence of long-term benefits of CBT for individuals with an ME/CFS diagnosis.

Quite so - but then this is NOT a reason to "research" this issue: You do NOT need to research by 'evidence based medicine' whether witchcraft works against impotence or whether prayer cures cancer.

The higher proportion of women suffering from ME/CFS is also thought to be evidence that the illness is psychosomatic.

Whereas in fact it is far more rational to assume it is "evidence" hormones are somehow involved.

It is unclear why this should indicate a psychological illness; after all, women are more prone to gallstones as well.

Well... it is easily clarified by the correct observations that the whole theory that declares ME/CFS psychiatric and that insists the latest from of psychiatric psychobabble, that indeed is CBT, is effective (1) is very remunerative for psychiatrists and (2) is all from the same nonsense as Charcot and Freud's diagnosing every woman with problems as "hysteric".

It is noteworthy that when a doctor made a study of viral illnesses in his patients over a 40 year period, of those who subsequently experienced central nervous system pathology, 67.8% were women (of whom a third also experienced ME/CFS) and 32.2% were men (of whom a third also had ME/CFS).

Well... it may be "noteworthy", but not for me without having seen the study.

Thus there was a clear physical basis for the disproportionate number of females suffering from ME/CFS in this study.

Again, I can't agree or disagree without having seen the study. And as I said above: hormones are a good explanation-in-principle. (Not specifically female hormones: Some imbalance - too much or too little - as regards hormones, whether caused by the disease or causing the disease.)

It has also been asserted that ME/CFS is a psychiatric illness because patients have often experienced abuse in childhood.

Also bullshit. Once you have decided that "ME/CFS is a psychiatric illness" and you "research" it by "studying" groups of people with some complaints of "fatigue", any defamation can be insinuated as "evidence based science". (Problems in: Your relation, your children, your education, your religion, your morals - you are just uncommonly weakwilled - a.s.o. a.s.f. in the name of 'evidence based medicine'.)

However, stressors like abuse are known to cause physical ailments. For example, it has been found that child abuse is associated with an increased incidence of ischemic heart disease.

I haven't seen the study or studies.

It has also been shown that individuals having severe chronic stressors in the 12 months prior to being deliberately exposed to a virus were significantly more likely to become ill than those with acute stressors or a low number of stressful life events.

Again, I haven't seen the study or studies. My problem with terms and concepts like "stressors" are not so easily definable for ordinary people in (apparently)  ordinary circumstances.

Also, I have read too much "research" in psychology and medicine to take it serious as if that is the natural thing to do.

A mitochondrial problem?
It is clear that there is little evidence in favour of a psychological explanation of ME/CFS.

Small correction: "there is little" rational methodologically correctly established such "evidence", as e.g. in England alone tens of millions of pounds have been wasted on gathering lots of irrational methodologically incorrectly established pseudo-evidence.

 We therefore need to consider the biomedical evidence for a physical disorder, of which there is a considerable amount.

Quite so - and the question enters that then, if so, why these psychiatrists and psychologists are allowed to defame, discriminate and offend patiens with ME since decades: Since when has anyone the right to say that so-and-so is mad if so-and-so has a legitimate neurological disease according to the World Health Organization - as IS the case with ME since 1969?! How legal is it to exclude such persons one has declared mad from disability benefits? How moral is it to force them to work?

To aid simplicity, the approach taken here is to consider the possibility that individuals with ME/CFS may in the majority of cases have a similar physical problem, but that it may have diverse causes.

I have no problem with it - but it is a no-brainer indeed that something one does not yet fully or indeed partially understand in rational and empirical terms "may have diverse causes": Of course! And see On natural philosophy, philosophy of science, and psychiatry for the relevant rational knowledge.

A recent study has found that 70 out of 71 individuals suffering from chronic fatigue had abnormally low mitochondrial function. Mitochondria are organelles within cells and are the main producers of cellular energy. Mitochondria have to have an intact inner membrane to produce energy via a process called the electron transport chain. There is evidence that a wide range of chemicals impair mitochondrial function, including pesticides, herbicides, PCBs, solvents, toxic metals (such as dental amalgam), plastics, and fluoride. Impairments can also be caused by drugs such as antibiotics, non-steroidal anti-inflammatories and anti-parasite drugs.

Quite. Again, I'd like the study referred, but this is quite along my own favoured eplanation for ME/CFS c.q. what ails me - although I also agree that there are other tenable biomedical explanation that deserve biomedical research.

There are also infections that cause mitochondrial problems, such as mycoplasma. This is a micro-organism that lacks a cell nucleus and a cell wall; it damages the inner membrane of mitochondria, depleting the nutrients in the cells, disrupting the electron transport chain, and causing chromosomal aberrations in the host cell. Studies by Dr Garth Nicolson have shown that individuals with ME/CFS have many bacterial and viral infections; however, a high percentage of them have mycoplasma infections. Thus, over a number of studies, Nicolson and his group have found that between 51% and 68.9% of individuals with a chronic fatigue diagnosis have a mycoplasma infection.

Again, I would have liked references (but space may have been a consideration). In any case, it should be qualified that "between 51% and 68.9% of individuals with a chronic fatigue diagnosis " that they investigated, to be sure.

Most of these studies were carried out in the United States, but the higher figure comes from a Belgian study, in which only 5.6% of controls showed signs of the infection. Nicolson's group has also shown that using a supplement that restores the mitochondrial membrane leads to both a reduction in fatigue and an increase in mitochondrial function in individuals with chronic fatigue.

This then is evidence for their theory that the mitochondria are involved.

Clearly, the infection scenario is a complicated one; susceptibility to mycoplasma and other infections may arise from having an immune system weakened by viruses, and viruses themselves might damage mitochondria. However, getting rid of a mycoplasma infection in those affected will be very beneficial for energy levels, and so reduce stress on the body.

OK: This may explain and help some persons with ME. It is unlikely to be the explanation for all persons with the diagnosis ME, and in my own case and that of my ex wife it seems more likely that it is EBV that our bodies never succeeded in getting rid off, for whatever reason, that may be genetical, i.e. most who get EBV recover from it within some weeks to several months, but a relatively small percentage has genes that do not allow him or her to recover from EBV.

Chronic exposure to stress can in itself damage mitochondria and also impair the functioning of the adrenal glands. Adrenal insufficiency could be a primary cause of ME/CFS in some individuals, as the symptoms are similar to those of Addison's disease. Less extreme debilitating adrenal problems also occur. It has been shown that overworking the stress system leads to problems in keeping a balance between the functioning of the hypothalamic-pituitary-adrenal (HPA) axis and the immune system. If there is an immune challenge, this produces inflammation, and the actions of the HPA axis reduce it by damping down the inflammation. However, if the body has to do this often it becomes overstressed and cannot maintain the balance – this is likely to happen if the body is dealing with a long-term infection like mycoplasma.

What can the NHS do to help individuals with ME/CFS? At the moment, many individuals are offered expensive but harmless CBT.

It is true CBT it "expensive" but it is triply false it is "harmless". First, it is harmfull to waste lots of taxpayers or insurances money on what is useless. Second, CBT is harmful just as Maoism is: It is mostly bullshit, and involves nonsensical assumptions and techniques. Thirdly, it is harmful to make ill people waste time on bullshit and enriching psychobabblers: It causes their state to deteriorate, simply having to go physically to the psychobabbler.

See: 101 Good Reasons : Why it is wrong to provide CBT and GET to ME Patients.  

This technique is now widely used for so many illnesses, including cancer, that it can even be purchased online.

It may be widely used, like astrology is, but that is no "proof: it works as advertised or indeed makes sense all, or is not an extremely expensive way to get some synthetical shows of would be paid sympathy from people who pretend they are qualified to heal the soul or the body.

They are also offered potentially damaging graded exercise regimes.

To offer GET to persons with ME is something that ought to be forbidden as is playing Russian roulette to teenagers: If it builds character or brings money, than at the cost of crippling or mortally dangerous risks.

Exercise can be very beneficial, but not if misinformed practitioners believe their patients to be depressed and persuade them to exercise beyond their reserves of cellular energy. Pacing is excellent and can cost nothing – here, individuals make sure that they keep their activity level within their energy envelope, and so avoid bouts of disabling exhaustion.

In order to help at least some people recover, it would seem a good use of resources for the NHS to screen ME/CFS patients for low mitochondrial function, adrenal problems (not just testing cortisol levels at midday) and mycoplasma infections.

Quite so. And indeed to do the same with persons with "fatigue".

The latter can be treated by antibiotics, which if administered early on could mean that these individuals would avoid having to suffer this debilitating disease for decades, with the consequent weakening of their adrenal glands. Removing this infection is unlikely to lead to an immediate cure for long-term sufferers because of collateral damage to other bodily systems, but there must be a chance that a proportion of individuals will regain their health and lead happier and more productive lives.

So... I am still around and about, but caught in one of the familiar circles - for those with ME, and no doubt for others - too much pain to sleep well; too little sleep to get a bit better. Eventually, one may get out of it it.

P.S. Corrections must wait till later, and links still have to be inserted.

-- Feb 10, 2011: The corrections have been made for the most part and the links inserted, and the piece has been considerably improved - and please note that, if you are interested in the rational grounds for my opinions on ME, psychology, psychiatry, science and scientific method you should follow the links and especially read these

Maybe I should also say that so far this year I have kept up with Recent Changes: Summaries of relevant changes on the site.

As to ME/CFS (that I prefer to call ME):

1. Anthony Komaroff

Ten discoveries about the biology of CFS (pdf)

3. Hillary Johnson

The Why

4. Consensus (many M.D.s) Canadian Consensus Government Report on ME (pdf)
5. Eleanor Stein

Clinical Guidelines for Psychiatrists (pdf)

6. William Clifford The Ethics of Belief
7. Paul Lutus

Is Psychology a Science?

8. Malcolm Hooper Magical Medicine (pdf)

Short descriptions:

1. Ten reasons why ME/CFS is a real disease by a professor of medicine of Harvard.
2. Long essay by a professor emeritus of medical chemistry about maltreatment of ME.
3. Explanation of what's happening around ME by an investigative journalist.
4. Report to Canadian Government on ME, by many medical experts.
5. Advice to psychiatrist by a psychiatrist who understands ME is an organic disease
6. English mathematical genius on one's responsibilities in the matter of one's beliefs:
   "it is wrong always, everywhere, and for anyone, to believe anything upon
     insufficient evidence
7. A space- and computer-scientist takes a look at psychology.
8. Malcolm Hooper puts things together status 2010.

    "Ah me! alas, pain, pain ever, forever!

No change, no pause, no hope! Yet I endure.
I ask the Earth, have not the mountains felt?
I ask yon Heaven, the all-beholding Sun,
Has it not seen? The Sea, in storm or calm,
Heaven's ever-changing Shadow, spread below,
Have its deaf waves not heard my agony?
Ah me! alas, pain, pain ever, forever!
     - (Shelley, "Prometheus Unbound") 

    "It was from this time that I developed my way of judging the Chinese by dividing them into two kinds: one humane and one not. "
     - (Jung Chang)


See also: ME -Documentation and ME - Resources

Maarten Maartensz (M.A. psy, B.A. phi)

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