November 2015 Briefing - Geriatrics

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Here are what the editors at HealthDay consider to be the most important developments in Geriatrics for November 2015. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

Air Pollution Raises CVD Risks in Women With Diabetes

MONDAY, Nov. 30, 2015 (HealthDay News) -- Long periods of exposure to air pollution -- including dust and car exhaust -- heightens cardiovascular risks for women with diabetes, according to a study published online Nov. 25 in the Journal of the American Heart Association.

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Neurotoxicity Seen With Acyclovir at Recommended Dose in Dialysis

MONDAY, Nov. 30, 2015 (HealthDay News) -- Acyclovir-induced neurotoxicity should be considered for patients with herpes zoster on hemodialysis, according to a case report published online Nov. 21 in the Journal of Dermatology.

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Mortality Rate Increases With Age in Emergency Abdominal Surgery

MONDAY, Nov. 30, 2015 (HealthDay News) -- Emergency major abdominal surgical procedures are associated with high mortality in older adults, with the odds of death increasing with age, according to a review published online Nov. 23 in the Journal of the American Geriatrics Society.

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Nonalcoholic Fatty Liver Disease Predicts MACE in STEMI

MONDAY, Nov. 30, 2015 (HealthDay News) -- For patients without diabetes with ST-segment myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI), nonalcoholic fatty liver disease (FLD) independently predicts impaired myocardial perfusion and adverse in-hospital outcomes, according to a study published in the Dec. 15 issue of The American Journal of Cardiology.

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AAFP Recommends Doctors Explore Use of Social Media

WEDNESDAY, Nov. 25, 2015 (HealthDay News) -- The use of social media channels and associated benefits for physicians are highlighted in a recent article published by the American Academy of Family Physicians (AAFP). And guidelines are provided for physicians wishing to become active in social media.

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C. Difficile Infection Tied to Higher Risk of Post-Op Mortality

WEDNESDAY, Nov. 25, 2015 (HealthDay News) -- Patients at VA hospitals who contracted Clostridium difficile following surgery were five times more likely to die and 12 times more likely to suffer postoperative morbidity, according to findings published online Nov. 25 in JAMA Surgery.

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No Direct Survival Effect for Moderate Drinking in Seniors

WEDNESDAY, Nov. 25, 2015 (HealthDay News) -- For older adults, light-to-moderate drinking does not have a protective effect on mortality after adjustment for health status and physical activity, according to a study published online Nov. 23 in the Journal of the American Geriatrics Society.

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Music Can Help Doctors Develop Relationships With Patients

TUESDAY, Nov. 24 2015 (HealthDay News) -- For one physician, writing songs has improved her self-awareness and strengthened her relationships with patients, according to an article published by the American Medical Association.

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Central Sleep Apnea Predicts Atrial Fibrillation in Older Men

TUESDAY, Nov. 24, 2015 (HealthDay News) -- Central sleep apnea and Cheyne Stokes respiration predict incident atrial fibrillation in older men, according to a study published online Nov. 23 in the American Journal of Respiratory and Critical Care Medicine.

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Confusion Surrounding Osteoarthritis in Primary Care

TUESDAY, Nov. 24, 2015 (HealthDay News) -- There is confusion between patients and doctors about osteoarthritis (OA) and its context within multimorbidity, according to a study published in the November/December issue of the Annals of Family Medicine.

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ACP: Physicians Should Prescribe Generic Meds If Possible

TUESDAY, Nov. 24, 2015 (HealthDay News) -- Physicians should prescribe generic medications whenever possible, keeping in mind that generics have comparable effectiveness to brand name medications and are associated with reduced costs and increased adherence, according to new guidelines published online Nov. 24 in the Annals of Internal Medicine.

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Higher Resting Heart Rate Tied to Higher Risk of Mortality

MONDAY, Nov. 23, 2015 (HealthDay News) -- A higher resting heart rate may indicate higher risk of premature mortality, researchers suggest. The report was published online Nov. 23 in CMAJ, the journal of the Canadian Medical Association.

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Bowel Function Index Valid for Opioid-Induced Constipation

MONDAY, Nov. 23, 2015 (HealthDay News) -- The Bowel Function Index (BFI) is a simple assessment tool for opioid-induced constipation, which is responsive to changes in symptom severity and has a threshold indicating constipation, according to consensus recommendations published online Nov. 19 in Pain Medicine.

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Yoga May Help Maintain Quality of Life for Prostate Cancer Patients

FRIDAY, Nov. 20, 2015 (HealthDay News) -- Yoga may benefit men who are undergoing radiation therapy for prostate cancer, according to a small study. The research was presented at the Society of Integrative Oncology's international conference, held from Nov. 14 to 16 in Boston.

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Bursts of High-Intensity Interval Training Beneficial for Older Men

FRIDAY, Nov. 20, 2015 (HealthDay News) -- A low-volume, high-intensity interval training (HIIT) program is effective for improving muscle power in older sedentary men, according to a letter to the editor published online Nov. 17 in the Journal of the American Geriatrics Society.

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E-Portfolio Developed to Assess Millennial Med Students

THURSDAY, Nov. 19, 2015 (HealthDay News) -- Electronic portfolios are being used to transform medical students' assessments and track progress as students advance through medical training, according to a report published by the American Medical Association (AMA).

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Most IV HTN Meds Ordered for Patients With SBP <180 mm Hg

THURSDAY, Nov. 19, 2015 (HealthDay News) -- Intravenous (IV) antihypertensives are often ordered and administered for patients with asymptomatic uncontrolled blood pressure (BP) levels that are not associated with immediate cardiovascular risk, according to a study published online Nov. 12 in the Journal of Hospital Medicine.

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AAFP: Expected 0.5 Percent Pay Increase Reduced to Zero

WEDNESDAY, Nov. 18, 2015 (HealthDay News) -- A small but promised Medicare pay increase has effectively been reduced to zero for all physician specialties, according to the final 2016 Medicare physician fee schedule and a report published by the American Academy of Family Physicians.

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Burnout Reduces Readiness to Change Teaching Approaches

WEDNESDAY, Nov. 18, 2015 (HealthDay News) -- Occupational burnout appears to reduce clinical faculty members' readiness to change teaching approaches, according to a study published online Nov. 13 in the Journal of Evaluation in Clinical Practice.

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Prostate Cancer Screening, Detection Both Down in U.S.

TUESDAY, Nov. 17, 2015 (HealthDay News) -- Fewer U.S. men are being screened for prostate cancer, and fewer cases of the disease are being diagnosed nationwide. These findings, published in the Nov. 17 issue of the Journal of the American Medical Association, suggest that the U.S. Preventive Services Task Force (USPSTF) recommendations have had an impact.

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Prognostic Biomarkers ID'd in Pulmonary Hypertension

TUESDAY, Nov. 17, 2015 (HealthDay News) -- Biomarkers have been identified for the risk of lung transplantation and death in patients with pulmonary arterial hypertension (PAH), according to a study published online Oct. 26 in the Annals of the American Thoracic Society.

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Reduced Mortality Risk Seen for Coffee Drinkers

TUESDAY, Nov. 17, 2015 (HealthDay News) -- People who drink coffee may live longer than those who don't -- with lower risks of early mortality from cardiovascular disease and neurological conditions such as Parkinson's disease, according to research published online Nov. 16 in Circulation.

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Knee Bracing No Benefit Over Nonoperative Program in Knee OA

TUESDAY, Nov. 17, 2015 (HealthDay News) -- For patients with knee osteoarthritis (OA), knee bracing offers no benefit over a multidisciplinary nonoperative program, according to a study published online Nov. 12 in the International Journal of Rheumatic Diseases.

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Continuation of Antibiotics for UTI Often Inappropriate

TUESDAY, Nov. 17, 2015 (HealthDay News) -- For patients with urinary tract infections (UTIs), initiation of antibiotics in the emergency department is frequently inappropriate, as is continuation of antibiotics after admission, according to a study published online Nov. 12 in the Journal of Hospital Medicine.

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Head Lice infestation Could Cause Iron Deficiency Anemia

TUESDAY, Nov. 17, 2015 (HealthDay News) -- Head lice infestation could cause iron deficiency anemia in the absence of any other cause, according to a case report published online Nov. 5 in BMJ Case Reports.

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Transitional Care Interventions Cut Risk of Readmission in CHF

MONDAY, Nov. 16, 2015 (HealthDay News) -- For patients with congestive heart failure, transitional care interventions (TCIs), especially high-intensity TCIs, are effective for reducing the risks of readmission and emergency department visits, according to a review published in the November/December issue of the Annals of Family Medicine.

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White-Coat, Masked HTN Tied to Target Organ Complications

MONDAY, Nov. 16, 2015 (HealthDay News) -- Both white-coat hypertension (WCH) and masked hypertension (MH) are associated with target organ complications and cardiovascular event risk, according to a study published in the Nov. 17 issue of the Journal of the American College of Cardiology.

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CDC: Adult Smoking Rate Falls to New Low in the United States

FRIDAY, Nov. 13, 2015 (HealthDay News) -- Under 17 percent of adults said they smoked in 2014, down from nearly 21 percent in 2005. And the average number of cigarettes smoked daily fell from nearly 17 to fewer than 14 by 2014. The latest numbers are published in the Nov. 13 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Levodopa Shows Promise Against Macular Degeneration

FRIDAY, Nov. 13, 2015 (HealthDay News) -- Levodopa (L-dopa) might hold potential for preventing or treating macular degeneration, according to a study published online Oct. 30 in The American Journal of Medicine.

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Facilitating Shared Decision-Making Can Cut Antibiotic Use

FRIDAY, Nov. 13, 2015 (HealthDay News) -- For patients with acute respiratory infections (ARIs), interventions that aim to facilitate shared decision-making reduce antibiotic use in primary care, according to a review published online Nov. 12 in The Cochrane Library.

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Intervention Cuts Potentially Inappropriate Meds in Seniors

FRIDAY, Nov. 13, 2015 (HealthDay News) -- An intervention (Optimizing Prescribing for Older People in Primary Care [OPTI-SCRIPT]) can reduce potentially inappropriate prescribing (PIP) in older patients, according to a study published in the November/December issue of the Annals of Family Medicine.

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CDC: Half of Americans With HTN Don't Have BP Under Control

THURSDAY, Nov. 12, 2015 (HealthDay News) -- About 47 percent of individuals with hypertension do not have the condition under control, through either lifestyle changes or medications, according to a November data brief published by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics.

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PCI May Not Improve Survival for Some Heart Disease Patients

THURSDAY, Nov. 12, 2015 (HealthDay News) -- Patients with stable ischemic heart disease who undergo percutaneous coronary intervention (PCI) fare no better than those treated with medication and lifestyle changes alone, according to a report published in the Nov. 12 issue of the New England Journal of Medicine.

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Risk Prediction Equations Created for Diabetes Complications

THURSDAY, Nov. 12, 2015 (HealthDay News) -- New risk prediction equations have been developed and validated to estimate the risk of blindness and lower limb amputation in patients with diabetes, according to a study published online Nov. 11 in The BMJ.

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Reduction in Dizziness, Not Falls, After Routine Cataract Surgery

THURSDAY, Nov. 12, 2015 (HealthDay News) -- Cataract surgery is associated with a reduction in the number of patients with dizziness, but not with a decrease in falls, according to a study published online Nov. 9 in Ophthalmic & Physiological Optics.

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Noon Best Time to Get Vitamin D From Sun for Minimal Cancer Risk

THURSDAY, Nov. 12, 2015 (HealthDay News) -- Variations in ultraviolet (UV) A and B radiation with increasing latitude and during the day impact skin cancer risk, according to a study published online Nov. 6 in the International Journal of Dermatology.

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Leg Strength Linked to Healthier Brain Aging

WEDNESDAY, Nov. 11, 2015 (HealthDay News) -- Leg strength is strongly linked with healthier brain aging, according to research published online Nov. 10 in Gerontology.

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ACP Issues Guidance on 'Concierge' Practices

TUESDAY, Nov. 10, 2015 (HealthDay News) -- Direct patient contracting practices (DPCPs), in which patients pay out of pocket for some or all services provided by the practice, are growing in popularity, according to a position paper published online Nov. 10 in the Annals of Internal Medicine.

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Self-Managing Anticoagulation May Benefit Heart Valve Patients

TUESDAY, Nov. 10, 2015 (HealthDay News) -- Patients with mechanical heart valves may benefit from managing their own oral anticoagulant therapy, according to a study published online Nov. 9 in the Annals of Thoracic Surgery.

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Normal Coronary Angiogram at 65 Predicts Survival

TUESDAY, Nov. 10, 2015 (HealthDay News) -- Patients with normal or near-normal coronary angiogram (CA) results at age 65 years or older have significantly longer survival than the general population, according to a study published in the Nov. 15 issue of The American Journal of Cardiology.

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Expanding Rooming, Discharge Office Protocols Can Save Time

MONDAY, Nov. 9, 2015 (HealthDay News) -- Expanding protocols for rooming and discharge can allow physicians to free up an hour or more of time per day, according to the American Medical Association (AMA).

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Web-Based CBT Program Cuts Suicidal Ideation in Interns

MONDAY, Nov. 9, 2015 (HealthDay News) -- A web-based cognitive behavioral therapy (wCBT) program is effective for preventing suicidal ideation among medical interns, according to a study published online Nov. 4 in JAMA Psychiatry.

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Emotional Intelligence Linked to Self-Management in COPD

FRIDAY, Nov. 6, 2015 (HealthDay News) -- Emotional intelligence, the capacity to understand and manage personal thoughts and feelings, is associated with self-management abilities and quality of life in chronic obstructive pulmonary disease (COPD), according to a study published online Oct. 26 in the Annals of the American Thoracic Society.

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Updated Checklist for Reporting Diagnostic Accuracy Studies

FRIDAY, Nov. 6, 2015 (HealthDay News) -- An updated list of 30 essential items should be included in every report of a diagnostic accuracy study, according to the Standards for Reporting Diagnostic Accuracy Studies (STARD) 2015. These new guidelines have been published in several journals, including Radiology, Clinical Chemistry, and The BMJ.

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Doctors Who Order More Tests Have Fewer Malpractice Claims

THURSDAY, Nov. 5, 2015 (HealthDay News) --The more tests and treatments U.S. doctors order for patients, the less likely they are to be sued for malpractice, according to a study published online Nov. 4 in The BMJ.

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Poll: Americans Want Health Care Costs Kept in Check

THURSDAY, Nov. 5, 2015 (HealthDay News) -- Most Americans now support aggressive regulation to keep health care costs in check -- including price caps on drugs, medical devices, and payments to doctors and hospitals, a new HealthDay/Harris Poll has found.

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Raloxifene Does Not Appear to Boost Cognition in Alzheimer's

THURSDAY, Nov. 5, 2015 (HealthDay News) -- Raloxifene doesn't benefit cognition in women who have mild to moderate dementia due to Alzheimer's disease, according to a small study published online Nov. 4 in Neurology.

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ACP Joins Amicus Curiae Brief to Supreme Court

THURSDAY, Nov. 5, 2015 (HealthDay News) -- The American College of Physicians (ACP) has joined other organizations in an amicus curiae brief to the Supreme Court, urging the court to uphold considerations of race and ethnicity in the medical school admissions process.

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Doctors Should Consider Financial Factors Before Career Change

WEDNESDAY, Nov. 4, 2015 (HealthDay News) -- Financial and other factors should be considered before physicians change career direction, according to a report published in Medical Economics.

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AMA: 6 Steps to Help Ensure Patients Get Preventive Care

WEDNESDAY, Nov. 4, 2015 (HealthDay News) -- Panel management, or population health management, can help physicians provide necessary preventive and chronic care to all patients regardless of their visit frequency, according to a report published by the American Medical Association (AMA).

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Guideline-Concordant Diabetes Care Similar With NPs, PCPs

WEDNESDAY, Nov. 4, 2015 (HealthDay News) -- The rates of processes of diabetes mellitus guideline-concordant care are similar, or slightly lower, for nurse practitioners (NPs) versus primary care physicians (PCPs), according to a study published in the October issue of the Journal of the American Geriatrics Society.

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Prescription Medication Use on the Rise in the United States

WEDNESDAY, Nov. 4, 2015 (HealthDay News) -- More Americans than ever are taking prescription drugs, as well as using more of them, according to research published in the Nov. 3 issue of the Journal of the American Medical Association.

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New Electronic Health Record Regulations Released

TUESDAY, Nov. 3, 2015 (HealthDay News) -- New electronic health record (EHR) regulations modify Stage 2 of the meaningful use program and finalize requirements for Stage 3, according to a report published by the American Medical Association (AMA).

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Benefits, Harms of HTN Drugs Should be Considered for Elderly

TUESDAY, Nov. 3, 2015 (HealthDay News) -- For elderly patients with hypertension, the benefits and risks associated with use of antihypertensive medications should be carefully considered, according to a review published online Oct. 26 in the Journal of Internal Medicine.

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Chronic PPI Exposure Tied to Hyperparathyroidism in Elderly

TUESDAY, Nov. 3, 2015 (HealthDay News) -- Chronic proton pump inhibitor (PPI) exposure is associated with mild hyperparathyroidism in elderly adults, according to a study published in the October issue of the Journal of the American Geriatrics Society.

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Prescribing Drugs 'Off-Label' Can Pose Serious Safety Risks

MONDAY, Nov. 2, 2015 (HealthDay News) -- Off-label drug use puts patients at risk for serious side effects, especially when scientific evidence is lacking, according to a study published online Nov. 2 in JAMA Internal Medicine.

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Competition for Fellowships Broke Records in 2015

MONDAY, Nov. 2, 2015 (HealthDay News) -- According to the American Medical Association (AMA), 2015 was a record-breaking year for fellowship applications.

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Medicare to Cover Advance Care Planning for Older Americans

MONDAY, Nov. 2, 2015 (HealthDay News) -- On Friday, Medicare announced that it will begin reimbursing doctors who work with patients to plan end-of-life care.

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Displaying Prices to Providers Seems to Reduce Order Costs

MONDAY, Nov. 2, 2015 (HealthDay News) -- Displaying order prices to physicians seems to reduce order costs, according to a review published online Oct. 23 in the Journal of Hospital Medicine.

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Fish Oil Supplementation Doesn't Cut Inflammatory Markers

MONDAY, Nov. 2, 2015 (HealthDay News) -- For healthy adults, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) supplementation does not reduce common markers of systemic inflammation, according to a study published online Oct. 26 in the Journal of Internal Medicine.

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Case Study: Bisphosphonate-Linked Osteonecrosis in Diabetes

MONDAY, Nov. 2, 2015 (HealthDay News) -- A case of bisphosphonate-related osteonecrosis of the jaw is described in an elderly patient with diabetes mellitus. The report is published in the October issue of the Journal of the American Geriatrics Society.

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