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Your Teen

Parents Need to Have the “Sex Talk” With Their Kids


Let’s face it, talking to your child about sex isn’t something a parent looks forward to, but a new study says teens who have had a serious conversation about sex with one or both parents are more likely to use condoms or birth control is they are or become sexually active.

“The take home message is that parents do matter, and these conversations do matter,” said Laura Widman, lead author of the new paper and an assistant professor of psychology at North Carolina State University in Raleigh.

While the more information you can present to your child in a way that addresses the health aspects of sexual activity is good, parents don’t have to be experts says Widman, “Just having the conversation is important,” she said. “That’s the good news.”

According to the Centers for Disease Control and Prevention (CDC), nearly half of high school students have had sexual intercourse. Almost 60 percent of high school students surveyed who have had sex said they used a condom when they last had sex, but 14 percent of sexually active teens said they did not use any birth control the last time they had intercourse.

Young people, aged 15 to 24, make up only a fraction of the sexually active population, but they bear a disproportionate burden of sexually transmitted diseases. And while teen pregnancy rates have dropped significantly, there were still 625,000 teen pregnancies in 2010, and nearly half of them –273,000 — gave birth.

Widman noted that results from the study showed that teens who communicated with their parents about were more likely to communicate with their sexual partners and to use condoms.

“We know that being able to communicate with a partner about condom use is one of the best predictors of whether teens use condoms or not,” Dr. Widman said. “So providing kids with the language they need and getting the message across that the subject is not off-limits or taboo can make a difference in their behavior.”

Some parents worry that talking about sex with their child somehow sends a message that they are approving of that behavior. However, studies have found that children who are comfortable talking about sex are actually more likely to delay sexual activity and be older when they first have intercourse.

“Parents fear that if they bring these issues up, they’re signaling that it’s okay to have sex, but that’s completely untrue – we know that parents who bring it up, and bring it up regularly, their kids are least likely to have sex,” said Vincent Guilamo-Ramos, a professor of social work at the Center for Latino Adolescent and Family Health at New York University’s Silver School of Social Work and author of an article about that topic that was published recently in JAMA Pediatrics.

Parents aren’t the only ones uncomfortable talking about sex, so are their kids.  In a 2012, half of the kids surveyed said they were uncomfortable talking to their parents about sex. Only 19 percent of the parents said they were uncomfortable having the “sex talk” with their child.

Children often think that if they ask questions, their parents “will overreact or assume they’re having sex,” said Dr. Guilamo-Ramos, who has developed some pointers on talking with your children.

If you’re wondering how to start that conversation with your child, the Office of Adolescent Health, part of the U.S. Department of Health and Human Services, has these tips:

·      Use current events, pop culture or developments in your social circle to start conversations about sex, healthy relationships and contraception. It’s not a one-time chat, Dr. Guilamo-Ramos said. “Talk to your child on a regular basis.”

·      Take on the tough topics, like birth control and sexual orientation.

·      Pay attention to a teen’s romantic relationships. Teens in intense romantic relationships are more likely to have sex, especially if the partner is a couple of years older than your child.

·      Address your child’s concerns, not just your own. “They want help with the real life pressures they’re experiencing in social situations,” said Dr. Guilamo-Ramos. “Talk with them about what a healthy relationship looks like, and help them come up with strategies and short one-liners that will help them get out of tough situations.”

·      Make sure to talk to your sons, not just your daughters. “Parents’ messages are often more directed to girls than boys,” he said. “And boys aren’t getting the information they need.”

The findings from the North Carolina State University research stem from a large analysis of adolescent health data, based on more than 50 studies involving 25,314 teens over the course of 30 years. The link between parental communication and safer sex practices, while modest overall, is strongest for girls and for teens that talked with their mothers, according to the research, published online in JAMA Pediatrics

As with most studies, the results do not prove a conclusion, only an association. 

Source: Roni Caryn Rabin,


Your Teen

Serious Burns Caused By E-Cigarette Explosions


Many family members have e-cigarettes inside their homes, pockets and purses. As more adults try to quit smoking traditional cigarettes, the use of electronic smoking devices (e-cigarettes) is rapidly increasing.  Several recent studies show that not only are adults experimenting with e-cigarettes, but also teens and preteens are attracted to the candy-flavored gadgets through peer pressure, advertising and celebrity endorsements.

One aspect of e-cigarette use that hasn’t gotten a lot of attention, until now, is that these devices can un-expectantly explode causing severe burns to the face and other areas of the body.

According to a research letter published in the New England Journal of Medicine, electronic-cigarette devices are randomly exploding, burning and injuring people near them when they detonate.

The University of Washington Regional Burn Center in Seattle has treated 22 people for burns and other injuries caused by exploding e-cigarettes since October 2015, lead author Elisha Brownson, M.D., a burn/critical care surgical fellow at the hospital, told HealthDay.

The lithium-ion batteries used in e-cigarettes, Brownson said, cause the explosions. These rechargeable batteries charge a heating coil that brings liquid nicotine and flavorings to the boiling point inside the device, creating an inhalable vapor. Batteries in some of the devices are overheating, causing a fire or an explosion, she said.

The first Seattle case Brownson treated was a man in his 20s using an e-cigarette while driving. The device exploded in his mouth, blowing out several front teeth. She said she has since treated a variety of burns and blast injuries caused by e-cigarettes, including patients with flame burns covering 10 to 15 percent of their total body surface.

"We see a lot of patients who have burns on their thigh and their hands. That's when the device has exploded in their pocket, and they're using their hands to get the device out and away from them," Brownson said. "There also have been a lot of injuries to the hands and face when people have had explosions as they've been using them. Patients tell us they had no idea this could happen. They've had little to no warning that the device is going to explode."

The flame-burn injuries have required extensive wound care and skin grafting, and exposure to the alkali chemicals released from the battery explosion has caused chemical skin burns requiring wound care.

Why do these devices explode? NBC News put the question to Venkat Viswanathan, an assistant professor of mechanical engineering at Carnegie Mellon University in March of 2016.

“The electrolyte inside the battery is basically the equivalent of gasoline, so when these batteries short out, there's a surge of heat that causes this flammable electrolyte to combust and explode."

Well-made lithium-ion cells have a very small risk of failure. But the cheaper cells "have a much greater chance of having a manufacturing defect," which increases the likelihood for failure, Viswanathan said.

The risk goes up if the cells are overcharged or charged too quickly. This can happen if the e-cig comes with a poorly designed charger or the user switches chargers. Well-made lithium-ion batters have fail-safe mechanisms to prevent these problems. Poorly made ones do not. Just because a charger plugs into that e-cig doesn't mean you should use it.

E-cigarettes remain largely unregulated. Until recently, the Food and Drug Administration (FDA) had made little headway in the regulation of e-cigarettes. However, the FDA has recently extended regulatory authority to cover all tobacco products, including e-cigarettes, although the prospects for battery regulation remain unclear. While these explosions were previously thought to be isolated events, the injuries among our 15 patients add to growing evidence that e-cigarettes are a public safety concern that demands increased regulation as well as design changes to improve safety. In the meantime, both e-cigarette users and health care providers need to be aware of the risk of explosion associated with e-cigarettes, the paper’s researchers noted.

Story sources:

Herb Weisbaum,

Daily Dose

College Students and Curfews

1:30 to read

Colleges are out and many students are home for the summer.  But with the return of your child to “the nest” comes a whole new set of issues. Trust me I have been there (more than once).

Your son or daughter has been living in a dorm, apartment, or house....with their own “rules and routines”.  Most college students living away from home have not had to really answer to anyone. If they want to stay up all night, come home at sunrise or sleep all have not been involved. 

But now they are back....hopefully having managed to do well, despite their crazy schedules.  Does this “new normal” of theirs work at your house? It certainly didn’t in ours, especially where both parents were working.

A friend had advised me, “don’t give them a curfew over the summer , they have not had one at college”.  That may be some of the worse advice I have ever gotten!!  When your child is living in your house and you wake up at 2 am and they are not home....well, you assume the worst, right?  Then you try to call them and it goes to voice mail...of course...more worry. After one night like that pacing the floors I knew in my heart of hearts that summer rules, even for college kids are a must!

So, at our house college students (I don’t care how old), need to be respectful of house rules.  Even if they can get up and go to work after 3 hours of sleep, I can’t.  So midnight curfew, just like high school, goes back into place. Nothing good happens after midnight anyway, right?  If they want to stay up in their room or go watch TV in the den, or make a sandwich at 2 am, that is fine by me. I just want to know that they are home and I don’t have to dream about horrible events that are happening when I don’t know where they are.  They always ask, “you don’t know what I am doing when I am at school, so what’s the difference?”  The difference is , “out of sight, out of mind” (sort of).  In my mind I can imagine that they are tucked in their dorm bed at 10 pm.....I always think good thoughts. Those unsettling thoughts only come when they are home.... and that bed is empty.  

Daily Dose

Your Daughter's 1st Pelvic Exam

What to do when it's time for your daughter's 1st pelvis exam.I receive a lot of questions regarding when an adolescent girl should begin having a gynecologic exam.  I read an recent article in the September issue of Pediatrics that reviewed the indications for performing a pelvic exam on an adolescent and when it is appropriate to have a gynecology referral.

The AAP now recommends “the inclusion of the gynecologic examination in the pediatric setting” as the primary care pediatrician is often more familiar to the adolescent than a referral to a gynecologist. In my experience this tends to be the case as my adolescent patients seem to be “more comfortable” (if there is such a thing when discussing gynecology) seeing their own physician that they have developed a rapport with. It is much easier to discuss the “ins and outs” of a pelvic exam with a doctor that has watched you go through puberty and has hopefully educated you along the way about sexuality issues. As with many things in medicine, things change, and this article concludes that it is no longer necessary for most adolescents to undergo a routine pelvic exam.  The first Pap smear is now recommended to be performed at 21 years of age.   Furthermore, an internal exam is no longer required to begin an adolescent on oral contraceptive therapy.  This has just recently become the recommendation. Now that there are screening tests for sexually transmitted infections that can be done without a speculum exam, unless the patient is having symptoms, it is not necessary to perform an internal exam. There are times when an internal speculum exam may be necessary. Some of the indications for this include: abnormal vaginal bleeding, dysmenorrhea (menstrual cramps) which is unrelieved by treatment with non-steroidal medication such as ibuprofen or naprosyn, and persistent vaginal discharge or urinary symptoms in a sexually active adolescent. Of course pregnancy and suspected rape or sexual abuse would also require an internal pelvic examination. The article also discusses indications for a gynecology referral from a pediatrician who may sometimes require the expertise of a gynecologist. If an adolescent have a pelvic mass, a cervical abnormality, acute pelvic pain or the need for an intrauterine device for pregnancy prevention a referral may be necessary.  In this case most pediatricians have their “favorite” gynecologists to use as a referral source, as it is important to find a physician who enjoys adolescents and their special concerns and will take the needed time to explain the procedures that may be involved for further diagnosis or treatment. The article serves to re-emphasizes the special rapport between a pediatrician and an adolescent patient, and acknowledges that most medical gynecologic issues may be managed by the pediatrician in their office as a routine part of preventative care. Ask your pediatrician if they are comfortable addressing adolescent gynecologic issues in advance, so you will know how they will handle these issues that might crop up as your teenage daughter matures. That's your daily dose for today. We'll chat again tomorrow. Send your question or comment to Dr. Sue!

Your Teen

What Is the Most Common and Deadly Cancer Found in Teens?


Do you know the most common and deadly cancer found in teens and young adults? You may be as surprised as I was when I read that a new study shows it is brain cancer.  It’s also not a particular type of brain cancer, but can vary widely as people age.

"For these individuals -- who are finishing school, pursuing their careers and starting and raising young families -- a brain tumor diagnosis is especially cruel and disruptive," said Elizabeth Wilson, president and CEO of the American Brain Tumor Association (ABTA).

"This report enables us for the first time to zero in on the types of tumors occurring at key [age] intervals over a 25-year time span, to help guide critical research investments and strategies for living with a brain tumor that reflect the patient's unique needs," Wilson said in an association news release.

Researchers look at data from 51 separate cancer registries, representing 99.9 percent of the U.S. population in the 15 to 39 year-old-age group.

While 2 types of tumors were the most frequently found in this age group, brain and central nervous system tumors, the report also noted that other types of cancer became more prevalent as people got older.

"What's interesting is the wide variability in the types of brain tumors diagnosed within this age group, which paints a much different picture than what we see in [older] adults or in pediatric patients," said report senior author Jill Barnholtz-Sloan, an associate professor at Case Western's Comprehensive Cancer Center in Cleveland.

"For example, the most common tumor types observed in adults are meningiomas and glioblastomas, but there is much more diversity in the common tumor types observed in the adolescent and young adult population," Barnholtz-Sloan said in the news release.

"You also clearly see a transition from predominantly nonmalignant and low-grade tumors to predominantly high-grade tumors with increasing age," she added.

Nearly 700,000 people in the United States have brain and central nervous system tumors. And more than 10,600 such tumors are diagnosed in teens and young adults each year, with 434 dying of their disease annually, according to the ABTA.

The most common treatment for brain cancer continues to be surgery, radiation and chemotherapy. However, new research is looking into the development of tailored therapeutics involving a combination of targeted agents that use different molecules to reduce gene activity and suppress uncontrolled growth by killing or reducing the production of tumor cells based on their genetic character. Experimental treatment options may include new drugs, gene-therapy and biologic modulators that enhance the body’s overall immune system to recognize and fight cancer cells.

"There are clearly unique characteristics of the 15-39 age group that we need to more comprehensively understand, and the information in the ABTA report starts that important dialogue," Barnholtz-Sloan said.

The ABTA-funded report was recently published in journal Neuro-Oncology.

Story source: Robert Preidt,

Your Teen

Teen Athletes Leading the Nation in Tommy John Surgeries


Teen athletes accounted for more than half of the Tommy John surgeries performed in the U.S. from 2007 to 2011 according to a new study. The surgery is actually an ulnar collateral ligament reconstruction (UCLR) graft procedure in which the ulnar collateral ligament in the elbow is replaced with a tendon from elsewhere in the body. Tommy John was the first Major League baseball pitcher to have the surgery and the nickname has now become common use.

 “Our results showed that 15- to 19-year-olds accounted for 56.7 percent of the Ulnar Collateral Ligament Reconstruction (UCLR) or Tommy John surgeries performed in the US between 2007 to 2011," said lead study author Brandon Erickson, MD, of Rush University Medical Center in Chicago, in a press release. "This is a significant increase over time with an average increase of 9.12 percent per year.”

Once a player has the surgery, he or she needs a good 12 to 15 months of recovery time before they are able to return to a high level of sport activity. Oftentimes, a second surgery may be required as the athlete continues to strain the ligament.

Baseball pitchers are the athletes that most often require the surgery because of the way they pitch; overhanded instead of underhanded. Many believe that the problems start in the teenage years with players who throw harder than ever and don't ever take a month off.

Dr. Erickson and his team looked at a private insurance database to identify patients who received UCLR surgeries throughout the US.

About 4 out of every 100,000 patients who had surgery between 2007 and 2011 had a UCLR surgery. These patients were overwhelmingly male, with 32 percent coming from the 15- to 17-year-old age group and 22 percent coming from the 20- to 24-year-old age group.

These surgeries grew at a rate of 4.2 percent each year between 2007 and 2011. And more than half were performed in the southern region of the US.

Another reason many teen athletes are susceptible to injury is that they play only one sport and play year-round, never giving their immature bodies enough time to rest and repair.

According to Dr. Erickson, more attention should be given to prevention because overuse injuries tend to occur in intensive training and high-performance games.

"The research numbers suggest that more young athletes believe that having an UCLR procedure performed earlier in their career may lead to the big leagues or a scholarship, even though only 1 in 200 kids who play high school baseball will make it to the MLB," Dr. Erickson said. "This paradigm shift needs to be evaluated further to help prevent overuse injuries in kids from the beginning of the season when most issues arise."

Some teens simply play through the pain without considering the possible long-term physical problems that could quickly end the career they worked so hard to attain. It’s up to the adults in their lives to watch over and give them the guidance they need to stay healthy. Parents and coaches need to make sure that their kids and students are following the safety rules established by the sport associations and organizations.

This study was presented at the American Orthopaedic Society for Sports Medicine's annual meeting. Research presented at conferences may not have been peer- reviewed.

Source: Beth Greenwood,





Your Teen

Teens Suffering from FOMA (Fear of Missing Out)


At one time or another, we’ve probably all experienced the feeling that our friends are out having fun, doing interesting things or just simply meeting up, and for some reason, we didn’t know. It’s called the fear of missing out or FOMA. Teenagers are particularly susceptible to FOMA in today’s super charged social media network, according to a new study.

Experts from the Australian Psychological Society (APS) found FOMO elevates anxiety levels of teenagers and may contribute to depression.

It’s not only teens whose stress levels are increasing due to heavy social media use, but adults are also experiencing more anxiety.

The findings, released in the 2015 National Stress and Wellbeing in Australia Survey, measured the levels of stress that Aussies experience and how the use of social media affects their behavior and wellbeing.

Dr. Mubarak Rahamathulla, a senior social work lecturer at Flinders University who led the report, said that levels of anxiety, stress and depression of Aussies who were involved in the study have increased since the beginning of their survey.

The survey included questions on Aussies' experience on social media, as well as a separate survey containing questions about FOMO for teenagers who were aged 13 to 17 years old. More than half of all the teenagers involved in the survey admit that they use social media 15 minutes before bed every night.

Four in ten of the teens said they use social media when they are in the company of others and one in four said they check in on social media while eating breakfast and lunch every day.

The fear of missing out seems to affect teens more that are heavy social media users. About 50 percent of the respondents said they felt the fear of missing out on their friends' inside jokes and events, as well as the chance to show they're having fun on social media.

All this checking in to see what their friends are up to seems to leave some teens feeling like they are living less rewarding lives. For instance, a user may be watching TV at home and decides to casually check and scroll through Facebook. Only, the user sees that his friends have posted photos of them out clubbing and he suddenly feels like he's missing out on something important.

“There is a very strong positive correlation between the hours spent on digital technology and higher stress and depression," said Rahamathulla.

He added that teens today are somehow getting confused between the online world and the real world.

APS member and psychologist Adam Ferrier said that people have always felt the fear of missing out on parties and activities even before the Internet, but social media indeed elevated the FOMO intensely.

Some teens are catching on that too much social media isn’t good for one’s sense of wellbeing. They’ve made the decision to cut back and spend more time with family, doing something they like to do or enjoying a little quiet time alone. But many teens are caught up in the habit of checking on what others are doing and comparing their life to their friends.   

Experts agree that parents need to be aware of how much time their child is spending on social media and watch for symptoms of depression or anxiety. Redirecting their attention or requiring that electronics be turned off after a certain hour at night can help them remember that the real world is a good place to visit and hang out for awhile.

Source: Alyssa Navarro,


Daily Dose

Prescription Drug Abuse

1.30 to read

Several weeks ago, 23 students at Texas Christian University in Ft. Worth Texas were busted for drug use and solicitation.  The newspaper and TV shows have been covering this story with great detail.  While making my morning coffee, a recent update stopped me dead in my tracks. 

I had just been talking with several parents, as well as adolescent patients, about the escalating use of prescription drugs in our community, especially among high school students, and TCU is in our “backyard”. 

This is another “wake up” call! While teens and college students across the country may not be using as many illicit drugs, their new “drugs of choice” are prescription drugs. They deem these drugs to be legal, “safer” as well as easier to obtain. This is alarming on so many different fronts. 

A CDC report in 2009 found that 20% of teens had admitted to having taken a prescription medication, without a prescription. 

In 2010 the Monitoring the Future survey found that prescription drugs were the most commonly used drugs after alcohol, marijuana and tobacco. Lastly, another study among adolescents reported that 7.7% of 12-17 year olds reported misuse of prescription drugs!  Teens unfortunately believe that prescription drugs are “safer” to use than illicit drugs.  Unfortunately, they are dead wrong. 

Looking at another recent headline, the reality of prescription drug abuse continues.  Whitney Houston’s untimely death looks to be most likely secondary to some mixture of prescription drugs. 

The story of Demi Moore’s seizure and hospitalization has rumors swirling of prescription drug abuse (along with “something” else). 

The most commonly abused prescription drugs fall into several categories which include:  painkillers (Vicodan, Percocet, oxycontin), stimulants (used for ADHD such as Adderall, Ritalin), or depressants (used for anxiety and sleep, such as xanax, valium, klonopin). While all of these classes of drugs are safe when used appropriately, when taken illegally and in combination, the side effects can kill you.  Mix any of these with alcohol, as so many teens and young adults are doing, and you may have respiratory depression and then your heart can stop!  A quiet death. 

I hear reports of teens taking pills which were typically obtained from a “friend’s” parents medicine cabinet. Several students in my area have been hospitalized due to the combination of prescription drugs and alcohol.  It is amazing to me how many households have many of the drugs mentioned above just hanging around in their medicine cabinets.  

I have also seen college students who have come home due to a viral illness, such as mono, and they have come in to see me for follow up.  They have brought along narcotics that the student health center had given them for their painful sore throat, or pills to help them sleep while they are sick.  Unbelievably there were a lot of pills prescribed for a fairly short illness and several bottles even had refills!! What are doctors thinking?   

Parents need to LOCK up medications just like the liquor cabinet. When teens come to hang out and they used to “steal” beer from the refrigerator, they are now heading to bathrooms to pocket a bottle of Xanax from a parental medicine cabinet. Scary stuff. 

Talk to your tweens/teens/young adults about the risks surrounding the use of prescription medications when they have not been prescribed. Discuss alcohol and drugs in combination. Show them the headlines in the news. The problem is real.       

That’s your daily dose for today.  We’ll chat again tomorrow.

Your Teen

Websites May Encourage Self-Injury

1.45 to read

The videos may be a focus for communities of youth in which self-injury is encouraged and viewed as normal and exciting, which could potentially increase the risk for self-injury.Some at-risk teens are finding new ways to hurt themselves thanks to a popular website with videos that glorify self-injury.

Young adults and teens may believe that hurting themselves is normal and acceptable after watching videos and other media on Web-sharing sites like YouTube, new research indicates. The findings, published in the journal Pediatrics, warn professionals and parents to be aware of the availability and dangers of such material for at-risk teens and young adults. Deliberate self-injury without the intent of committing suicide is called “non-suicidal self-injury” or NSSI. An estimated 14% to 24% of youth and young adults engage in this destructive behavior, according to the study. NSSI can also include relationship challenges, mental health symptoms, and risk for suicide and death, the study noted. Common forms of self-injury include cutting, burning, picking and embedding objects to cause pain or harm. While other studies have looked at the availability of online information about self-injury, the authors focused on the scope of self-injury in videos uploaded on YouTube and watched by youth. They described their work as the first such study and noted that their findings could be relevant in risk, prevention and managing self-injury. The authors focused on YouTube because, according to the site, since its inception in 2005 “YouTube is the world's most popular online video community, allowing millions of people to discover, watch and share originally-created videos.” Using the site’s search function the researchers looked for the terms “self-harm” and “self-injury,” identifying the site’s top 50 viewed videos containing a live person, and the top 50 viewed videos with words and photos or visual elements. The top 100 items that the study focused on were viewed over 2 million times, according to the analysis, and most – 80% - were available to a general audience. The analysis of the self-injury content found that 53% was delivered in a factual or educational tone, while 51% was delivered in a melancholic tone. Pictures and videos commonly showed explicit demonstrations of the self-harming behavior. Cutting was the most common type of behavior; more than half of the videos did not contain warnings about the graphic nature of the behavior. The average age of uploaders of the self-injury material was 25.39 years, according to the findings, and 95% were female. The authors surmise that the actual average age is probably younger because many YouTube users say they are older in order to access more content. The study concludes that the findings about the volume and nature of self-injury content on YouTube show "an alarming new trend among youth and young adults and a significant issue for researchers and mental health workers." The videos may be a focus for communities of youth in which self-injury is encouraged and viewed as normal and exciting, which could potentially increase the  risk for self-injury. The study warns that health professionals need to be aware of this type and source of content, and to inquire about it when working with youth who practice self-injury because sites like YouTube can reach youth who may not openly discuss their  behavior. Self-harming is not typical behavior for otherwise untroubled teens and young adults, explained Dr. Charles Raison, an Emory University psychiatrist and's mental health expert. It’s an action that kids with psychiatric problems may try. “NSSI is a young person’s affliction…one in ten will kill themselves," he said.   "A lot of people will outgrow the behavior.” Raison said that it’s common for troubled young people to share information about hurting themselves. Treatments can include antidepressants, antipsychotic drugs and psychotherapy.


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Prescription stimulant abuse is on the rise and here's why.

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