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Is it OK to drink six pints a day? It's perfect!?

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'It's OK to drink six pints a day': Alcohol expert says up to 13 daily units AREN'T harmful for health
Dr Kari Poikolainen says moderate drinking is better than abstaining
(www.dailymail.co.uk/health/article-2609469/Its-OK-drink-six-pints-day-Alcohol-expert-says-13-daily-units-ARENT-harmful-health.htmlwww.dose.ca/2014/04/21/doctor-says-drinking-bottle-wine-day-ok-time-bust-out-booze)

Zo'n zes Britse 'pints' ondermijnen uw gestel geenszins, ontdekte voormalig alcoholdeskundige van de Wereld Gezondheidsorganisatie (WHO) Kari Poikolainen. De Fin beweert decennia aan onderzoeksresultaten bestudeerd te hebben.
Mannen kunnen volgens The Daily Mail zonder problemen dagelijks 21 glazen weghakken, voor de dames ligt de grens op ongeveer veertien. De levensverwachting van chronische zuipschuiten schijnt zelfs stukken hoger te liggen dan die van geheelonthouders, beweert Poikolainen (http://www.powned.tv/nieuws/tech/2014/04/gezond_34_liter_bier_per_dag.html).


Both the Daily Mail and the Independent reported ... that a bottle of wine a day might not be bad for you. The articles quote a retired Finnish professor, Kari Poikolainen.
Among his reported claims are that moderate drinking is less harmful than being teetotal, and that it’s only after drinking 13 units per day that alcohol is harmful. The Mail claims that UK guidelines are therefore too stringent, as the government currently recommends a maximum of one large glass of wine for women (2-3 units), and slightly more for men (3-4 units), per day.
According to the article, Professor Poikolainen has looked at "decades of evidence" to draw these conclusions. Sadly none of this evidence is mentioned in the article*, and his comments fly in the face of current alcohol guidance from governments and the vast majority of public health scientists.
...
Poikolainen has mentioned, in published research, that drinking is related to mortality in what is known as a J-shaped curve; those who drink a small amount are at lower risk of death and illness than those who drink nothing, but the risk rapidly rises in those who drink a lot. However, this is quite a simplistic finding, and to paraphrase Ben Goldacre, it’s a bit more complicated than that (www.theguardian.com/science/sifting-the-evidence/2014/apr/22/drinking-wine-health-evidence-alcohol-units).


Alcohol heeft effecten op je lichaam
(http://watchfit.com/general-health/how-bad-is-alcohol-for-you/)

Alcohol consumption is a surprisingly complex behaviour. There are no simple answers for complex problems (www.saunalahti.fi/kapoiko/Areview.htm).

In advising individual persons, the best course of action might be to compare carefully the potential benefits and costs of alcohol intake. Protection from CHD by alcohol seems to be especially beneficial for men, for the old and middle‑aged, for patients with CHD, and for healthy individuals with a family history of CHD. On the other hand, abstaining might be the healthiest choice for many patients with certain diseases, such as depression, hypertension, liver cirrhosis, or peptic ulcer, when these are alcohol‑related. Risk of alcohol dependence should also be considered.
Familial alcoholism increases the risk of alcoholism 3 to 4‑fold among the offspring compared with persons without alcoholism in the family. Persons suffering from major depression, anxiety disorder, antisocial disorder, or conduct disorder are also at increased risk. Future alcoholics tend to be heavy drinkers already in adolescence. Of all patients aged 18‑62 years with the diagnosis of alcohol dependence, 97% had started drinking alcoholic beverages before the age of 18 years (Prescott et al., 1999). There are only a few studies that help us to estimate the potential risk of alcoholism among moderate drinkers. Among Swedish male conscripts aged 18‑21 years, the adjusted risk of hospital inpatient admission for alcoholism over a follow up of 15 years was not significantly different between men reporting abstinence from alcohol at the baseline examination lower and those reporting an intake of 1‑100 g of alcohol a week (Andreasson and Allebeck, 1991). In a cohort of adult Californians, both men and women changing from abstinence to moderate drinking had nonsignificantly lower age‑adjusted all‑cause mortality than adults who continued to abstain (Lazarus et al., 1991). In the assessment of risks and benefits, monitoring of blood pressure and other risk factors seems to be advisable. Drinkers should know what moderation means, watch for any harmful effects of alcohol, and avoid intoxication (www.saunalahti.fi/kapoiko/Areview.htm).

Kari Poikolainen heeft ook een boek geschreven: Perfect Drinking (www.perfectdrinking.com/): Perfect Drinking and Its Enemies Paperback – February 21, 2014 (Amazon)


Honing your drinking skills can be more than fun--it also brings about health benefits and thrills the taste buds. Perfect Drinking and its Enemies helps you to perfect your drinking, be it water, coffee, tea, wine, beer, liquor or something else, however, the main focus is on alcoholic beverages, since many common beliefs on the effects of alcohol and alcohol policy are biased. You'll be surprised. Learn how to shun the enemies of perfect drinking. Protect yourself from moral panic, well-meant nannying and patronizing. Know the health risks. Avoid the dangers of alcoholism. Seek to oppose counterproductive alcohol policies. Author Kari Poikolainen is a doctor of medical science and adjunct professor in public health at the University of Helsinki, Finland. His research has focused on the causes and consequences of alcohol intake. He was the Research Director at the Finnish Foundation for Alcohol Studies before he retired to write this book (www.amazon.com/Perfect-Drinking-Enemies-Kari-Poikolainen/dp/1626526788).


Ik kan nergens terugvinden waar de aantallen in de website/krantenartikels op zijn gebaseerd, maar ik vermoed dat het boek wordt bedoeld, gezien de 3 uittreksels/samenvattingen van het boek (www.perfectdrinking.com/excerpts/):

More indulgent than you have been told. Many official and professional groups have published guidelines on the risky levels of drinking. Likewise, recommended levels or safe levels have been presented. These all are guesstimates and underestimates. They are more guided by what is thought to be politically correct than by scientific evidence. As a matter of fact, the risk level of alcohol intake is not easy to estimate....American Cancer Society Study, Cancer Prevention Study II (6). This study found that even in the highest intake group, consuming 72 g/day or more, the risk of death was lower than among lifelong abstainers (www.perfectdrinking.com/wp-content/uploads/sites/4/2014/02/Excerpt1.pdf).

Alcoholism, aka alcohol dependence, aka alcohol addiction, is another fuzzy concept. It escapes rigorous definition. Fuzzy concepts can be useful in everyday communication as approximate signs of direction but do not take us far.
Alcoholism belongs to the class of addictions. The alcoholic is too much attached to drinking. Just like some other people are strongly attached to eating, smoking, coffee, drugs, sex, gambling, shopping, exercise, sunbathing, work, power, some significant other person or something else. One carrot addict is known.
....
I will argue that the biomedical definitions of alcoholism are just old ideas disguised in new jargon. They maintain untenable assumptions on the cause of alcoholism. To find out the causal paths we need to look elsewhere. However, the old ideas stay alive since they serve various vested interests. One of the latter is the powerful alcoholism treatment industry. It promises cure, but there
is no clear evidence (www.perfectdrinking.com/wp-content/uploads/sites/4/2014/02/Excerpt2.pdf).

In 1842, when Abraham Lincoln (1809 ~ 1865) was addressing the temperance folks in Springfield, Illinois, he famously said that:
none seemed to think the injury arose from the use of a bad thing, but from the abuse of a very good thing”  (www.perfectdrinking.com/wp-content/uploads/sites/4/2014/02/Excerpt3.pdf)

Dr. Poikolainen has written a lively, provocative, scientifically sound, very readable book. He pulls no punches when describing the “politics” of reports about alcohol research and the use of the research for public health purposes. The resulting controversy will probably be intense and instructive. The book will be of interest the research community and the general public.
Dr. Arthur L. Klatsky, MD is a Senior Consultant in Cardiology, Kaiser Permanente Medical Care Program, Oakland CA, USA who has studied extensively alcohol-related diseases (www.perfectdrinking.com/endorsements/).

Research in complex systems, like societies, is to a large degree non-experimental and thus highly dependent on assumptions and rational considerations. Kari Poikolainen scrutinizes and reanalyzes popular interpretations of alcohol-related research evidence and points out that the implicit intention of most interpretations is inducing an unbalanced anti-alcohol attitude. The critical reanalyses of the empirical findings of Kari Poikolainen seeks to find a balanced and comprehensive understanding of the role that alcohol actually plays in society and our lives.
– Dr. Alfred Uhl is the head of Addiction Research and Documentation at the Anton-Proksch-Institute (API) and lecturer of research methodology at the Sigmund Freud University, Vienna, Austria (www.perfectdrinking.com/endorsements/).

This book makes a very bold statement. It argues that the public health agenda around alcohol and alcohol problems reliably confuses moral judgment, political correctness and science in more or less equal quantities. In doing so, it stands out from the literature like a defiant banner in a castle under siege. Kari Poikolainen takes on alcohol science, points out the myths and sleight of hand that too often populate the area, and gives a passionate account of the real dangers of drinking alongside a critical examination of the biased science and tactics adduced by the ‘anti-alcohol’ lobby. You may not agree with it; but you need to read it.
– Professor emeritus John B. Davies, Centre for Applied Social Psychology, University of Strathclyde, Glasgow, UK, is the Founding Editor of the journal Addiction Research and Theory, chairperson of the Scottish Government Drug Prevention and Education Working Group and member of the Scottish Government Drug Strategy Commission (www.perfectdrinking.com/endorsements/).

Wie zijn dat toch?

Arthur L. Klatsky, MD, is an adjunct investigator at the Kaiser Permanente Northern California Division of Research and a senior consultant in cardiology (retired July 1999), at Kaiser Permanente Northern California. He has written and lectured extensively on relationships of alcohol consumption to cardiovascular conditions. He has also researched and published articles about coffee, tea, and health (www.dor.kaiser.org/external/Arthur_Klatsky/):

Moderate alcohol intake and cancer: the role of underreporting
Klatsky, A. L.; Udaltsova, N.; Li, Y.; Baer, D.; Tran, H. N.; Friedman, G. D.;
Cancer Causes Control  
Apr 2 2014
Persons reporting light-moderate drinking had increased cancer risk in this cohort. ....We conclude that the apparent increased risk of cancer among light-moderate drinkers may be substantially due to underreporting of intake (www.ncbi.nlm.nih.gov/pubmed/24692102).

Alcohol and cardiovascular mortality common sense and scientific truth
Klatsky, A. L.;
J Am Coll Cardiol   55 (13): 1336-8
Mar 30 2010 (www.ncbi.nlm.nih.gov/pubmed/20338494)

Alcohol and cardiovascular health
Klatsky, A. L.;
Physiol Behav   100 (1): 76-81
Apr 26 2010
The substantial medical risks of heavy alcohol drinking as well as the probable existence of a less harmful or safe drinking limit have been evident for centuries. Modern epidemiology studies suggest lowered risk of morbidity and mortality among lighter drinkers. Thus, defining "heavy" drinking as > or =3 standard drinks per day, the alcohol-mortality relationship is a J-curve with risk highest for heavy drinkers, lowest for light drinkers and intermediate for abstainers. A number of non-cardiovascular and cardiovascular problems contribute to the increased mortality risk of heavier drinkers. The lower risk of light drinkers is due mostly to lower risk of the most common cardiovascular condition, coronary heart disease (CHD). .... A protective hypothesis for CHD is supported by evidence for plausible biological mechanisms attributable to ethyl alcohol. International comparisons and some prospective study data suggest that wine is more protective against CHD than liquor or beer. Possible non-alcohol beneficial components in wine (especially red) support possible extra protection by wine, but a healthier pattern of drinking or more favorable risk traits in wine drinkers may be involved (www.ncbi.nlm.nih.gov/pubmed/20045009).

Arthur L. Klatsky, M.D., and colleagues at the Kaiser Permanente Medical Care Program, Oakland, Calif., analyzed data from 125,580 individuals (55,247 men and 70,333 women) who did not report liver disease when they had baseline examinations, between 1978 and 1985. Participants filled out a questionnaire to provide information about how much alcohol, coffee and tea they drank per day during the past year. ...For each cup of coffee they drank per day, participants were 22 percent less likely to develop alcoholic cirrhosis. Drinking coffee was also associated with a slight reduction in risk for other types of cirrhosis.....Tea drinking was not related to reduced risk in the study, suggesting that it is not caffeine that is responsible for the relationship between coffee and reduced cirrhosis risk. "Previous reports are disparate with respect to whether the apparently protective coffee ingredient is caffeine; in our opinion this issue is quite unresolved," the authors write.
The findings do not suggest that physicians prescribe coffee to prevent alcoholic cirrhosis, the authors continue. "Even if coffee is protective, the primary approach to reduction of alcoholic cirrhosis is avoidance or cessation of heavy alcohol drinking," they conclude.
(Arch Intern Med. 2006;166:1190-1195 (www.eurekalert.org/pub_releases/2006-06/jaaj-cda060806.php).

Moderate Drinking and Reduced Risk of Heart Disease (Alcohol Research & Health Vol. 23, No. 1, 1999)
...the majority of the population consume only moderate amounts of alcohol and are therefore, as a group, at lowest total mortality risk. Persons at higherthan-average CAD risk who drink moderately should not be advised to reduce their alcohol consumption unless they are at special risk for disorders induced or aggravated by alcohol (e.g., liver disease or alcoholism)
(http://pubs.niaaa.nih.gov/publications/arh23-1/15-24.pdf).


Dr. Alfred Uhl, Head of Addiction Prevention Research and Documentation (SucFoDok) at the Anton-Proksch-Institute (API), Vienna; Lecturer at the Sigmund Freud University (SFU), Vienna
Alfred Uhl, PhD is a psychologist and the current head of Addiction Prevention Research and Documentation at the Anton-Proksch-Institute, also teaching at the Sigmund Freud University in Vienna. He is a member of the Federal Austrian Drug Commission, the scientific board of the journal Sucht, the advisory board of the journal Suchttherapie, the editorial advisory board of the journal Drugs and Alcohol Today, and the board of the German Society for Addiction Psychology (DGsps). His research currently focuses on epidemiology, prevention, evaluation, and research methodology. He is the author of over 250 publications in national and international journals and books (www.icap.org/AboutICAP/Research/ResearchAdvisoryGroup/
tabid/558/Default.aspx).

Dr. Alfred Uhl, (www.api.or.at/akis/) (19-7-1954)
Leiter der AlkoholKoordinations- und Informationsstelle (AKIS) des Bundesministeriums für Soziale Sicherheit und Generationen am Anton-Proksch-Institut (API)
seit 2002 Lektor für Forschungsmethoden an der Wirtschaftsuniversität Wien in den letzten Jahren involviert als Sucht-, Präventions- und Evaluationsexperte für das österreichische Bundesministerium für Bildung, Wissenschaft und Kultur (BMBWK), das österreichische Bundesministerium für Gesundheit und Frauen (BMGF), das österreichische Parlament, einigen österreichischen Landtage, das deutsche Bundesministeriums für Gesundheit (BMG), die deutsche Drogen- und Suchtkommission, die deutsche Bundeszentrale für gesundheitliche Aufklärung (BZgA), das Schweizer Bundesamts für Gesundheit (BAG), der Weltgesundheitsorganisation (WHO Kopenhagen), die Pompidougruppe (Europarat, Strassburg) etc.
derzeit Projektleiter für österreichische Forschungsprojekte und Beteiligter an einigen EU Projekten
bis 2006 rund 200 Publikationen und rund 200 Vorträge bei nationalen und internationalen Tagungen (www.bluemonday.at/news/docs/8180_CVUHL_DT.pdf)

Uhl, A.; Bachmayer, S.; Puhm, A.; Kobrna, U.; Musalek, M. (2011):
Handbuch Alkohol - Österreich, Band 2: Einrichtungen 2014 (www.api.or.at/akis/index1.htm).

Uhl, A. (2013): Theorie und Evidenz in der Alkoholforschung und deren Relevanz für die Praxis,
JATROS Neurologie und Psychiatrie, 6, 13, 28-30
Seit der exzessive Alkoholkonsum in der Gesellschaft als wichtiges gesundheitliches Problem erkannt wurde, herrscht unter Experten weitgehender Konsensus darüber, dass Kinder keinen Alkohol konsumieren sollten.... („Kleinkinder sterben schon ab 0,5 Promille Blutalkohol“, BZgA, 2004) bzw. dass diese Alkohol kaum abbauen könnten (Feuerlein 1979). Zu diesem Thema lassen sich zwar kaum empirische Befunde finden, aber die wissenschaftliche Literatur, die es dazu gibt, legt nahe, dass beide Behauptungen falsch sind.
....
Es ist unbestreitbar, dass exzessiver Alkoholkonsum der Mutter beim Fötus massive Schäden auslösen kann, und es erscheint durchaus gerechtfertigt, Frauen während der Schwangerschaft generell vom Alkoholkonsum abzuraten, auch wenn es keine Belege dafür gibt, dass moderater Alkoholkonsum relevante Schäden beim Fötus verursachen kann.
....
Wenn eine stillende Mutter in kurzer Zeit einen Liter Bier oder einen halben Liter Wein trinkt, dann
entsteht – durch den „doppelten Verdünnungseffekt“ (Uhl 2009) – in der Muttermilch bloß ein sehr geringer Alkoholgehalt. Am anschaulichsten ist der Vergleich mit anderen Lebensmitteln. Der natürliche Alkoholgehalt von Apfelsaft, Brot, Bananen und vielen anderen Lebensmitteln übersteigt den Alkoholgehalt dieser Muttermilch um das 2- bis 8-Fache... (www.api.or.at/akis/download.htm).

Prof John Davies
Emeritus Professor
John Davies was Director of the Centre for Applied Social Psychology (CASP) between 1998 and 2011. The main research agendas were public health and human factors.
ROSS, A.J., HEIM, D., FLATLEY, K.J., DAVIES, J.B. & SUDBERY, M. (2005) An exploration of Street Drinking in Drumchapel, Scotland. Health Education Research, 20, 314-322
DAVIES, J.B., McCONNOCHIE, F., ROSS, A.J., HEIM, D. & WALLACE, B. (2004). Evidence for social learning in the self-presentation of alcohol problems. Alcohol & Alcoholism, 39:3, 220-226.
DAVIES, J.B. (2003). What is Addiction? In W. Saunders and S. Helfgott (Eds) Perspectives on Addiction: Understanding the Issues. Taylor and Francis; London (www.strath.ac.uk/humanities/courses/psychology/staff/daviesjohnprof/).

Myth of Addiction
Author:
John B. Davies John Booth Davies
...Current attitudes towards drug misuse in the media, government, and even treatment centres, often exaggerate the pharmacological power of drugs. Their coercive influence is widely believed to be so great that to experiment with a drug is tantamount to addiction. The author argues that such beliefs are largely inaccurate and harmful. Research shows that explanations for drug use vary according to circumstances. Drugs users may explain that they have lost their willpower and capacity for personal decision-making, because this is the explanation expected of them, but most actually use drugs because they want to and because they see no good reason for giving them up. Addicted behaviour is therefore a form of learned helplessness, not an effect caused by narcotic intake (www.kalahari.com/Books/Myth-of-Addiction_p_809739).

An exploration of street drinking in Drumchapel, Scotland Alastair J. Ross, Derek Heim1, Kirsty Flatley, John B. Davies, and Megan Sudbery
Department of Psychology, University of Strathclyde, Glasgow G4 1QE, UK.
Health Education Research (Impact Factor: 1.66). 07/2005; 20(3):314-22. DOI: 10.1093/her/cyg118
(www.researchgate.net/publication/8372441_An_exploration_of_street_drinking_in_Drumchapel_Scotland)

Overestimation of peer drinking: error of judgement or methodological artefact?
Centre for Applied Social Psychology, School of Psychological Sciences and Health, University of Strathclyde, 40 George Street, Glasgow, UK.
Addiction 2011 Jun 7;106(6):1078-84. Epub 2011 Apr 7.
Addiction (Impact Factor: 4.6). 02/2011; 106(6):1078-84. DOI: 10.1111/j.1360-0443.2011.03392.x
Social norms research and related health promotion programmes that seek to reduce the extent of overestimation of peer drinking norms are heavily reliant upon multiple-target drinking questionnaires. The use of such a questionnaire may lead to more distorted or extreme perceptions being reported by pupils compared to single-target versions, which omit self-referent drinking items. By implication, use of multiple-target questionnaires may encourage young people to 'over-overestimate' peer drinking norms (www.researchgate.net/publication/49822357_
Overestimation_of_peer_drinking_error_of_judgement_or_methodological_artefactwww.pubfacts.com/detail/21306598/Overestimation-of-peer-drinking:-error-of-judgement-or-methodological-artefact?).

Alcohol consumption, perceptions of community responses and attitudes to service provision: results from a survey of Indian, Chinese and Pakistani young people in Greater Glasgow, Scotland, UK.
(www.researchgate.net/publication/8621669_Alcohol_consumption_perceptions_of_community_responses_and_attitudes_to_service_provision_results_from_a_survey_of_Indian_Chinese_and_Pakistani_young_people_in_Greater_Glasgow_Scotland_UK)

Reported alcohol consumption, and attitudes of managerial and non-managerial employees, in a study of five industries on Clydeside  JOHN B. DAVIES DOI: http://dx.doi.org/ 160-169 First published online: 1 January 1978 © The British Journal on Alcohol and Alcoholism (http://alcalc.oxfordjournals.org/content/13/4/160)
In a study of five major employers on Clydeside, individual interviews were conducted with 576 employees. During each interview, the respondent filled in two self-completion questionnaires, each employing the same twelve semantic-differential items. In the first questionnaire, respondents described the people who worked at the same level in the firm as themselves. In the second, those in management positions described the lower workforce, and these latter described those in management positions....Results suggested that managers who drank most heavily tended to make the most favourable judgements of the lower workforce, and also rated the lower workforce as not especially tough. On the other hand, a group of abstinent managers made certain unfavourable judgements of the lower workforce, and also made the most extreme ‘toughness’ judgements. If such findings were found to be general, a possible conclusion is that any alcoholism campaign in industry might benefit from the recruitment of at least some heavy-drinking managers, since these seem to be favourably disposed to the lower workforce (http://alcalc.oxfordjournals.org/content/13/4/160).

Bogus science at your expense: Professor John B Davies foresees ‘gas chambers’ (June 14, 2012)
...Today’s post features Professor John B Davies, head of Psychology at Scotland’s Strathclyde University. In 2010, he warned of the overarching socio-political consequences of draconian smoking bans — past and present....Danish journalist and songwriter Klaus Kjellerup found a Danish interview with Dr Davies. ....: “How far do we take this? When do we start saying that we deliberately presenting information in a misleading way to get people to change behavior? When does it begin to become unacceptable?” asks John B. Davies in a video interview on Film Exchange on Alcohol & Drugs.
“Bad science in a good cause is always bad science,” he says.
He also sharply criticized the authorities’ increasing tendency to define smoking as a disease …
Prof. John B. Davies:“I have big problems with the disease concept when talking about cigarette smoking. It all depends on whether one defines smoking as a disease – or whether one defines lung cancer as a disease. For me, a lung disease – while cigarette smoking is a voluntary act. It can cause lung cancer, yes – but to produce voluntary actions such as diseases are absurd.
Cigarette smoking is a voluntary action. Lung cancer is a disease. Activity is something you do – while the disease is something that happens …
I believe that bad science is always bad science. One of my criticisms against the ongoing social marketing campaign (against smoking, Ed.) Is that it is designed to deliberately mislead people, to get them to change their lifestyle. We sing the devil’s tune in campaign purposes. It is in my view, immoral.
The risk of passive smoking is a example, used as a deterrent to smokers: You kill your friends. Because it seems that there is 25% greater risk of cancer from passive smoking than we thought.
… unfortunately, you can deceive people a long way down the road. The question one must ask is: 25% of what? There is only 25% above base rate, so the relative risk is only 1.25 – but it is used as a social marketing message for a good cause (https://churchmousec.wordpress.com/2012/06/14/bogus-science-at-your-expense-professor-john-b-davies-foresees-gas-chambers/).

Dit argument heb ik al vaker gehoord. Dat de wetenschappelijke onderbouwing van meeroken niet 100% aantoonbaar is en dat er een politieke afweging is gemaakt. Op zich niet verkeerd, maar de vraag die Davies -volgens mij terecht- stelt is of het verschuilen achter wetenschap immoreel genoemd kan worden.

Blijkbaar zijn (matig) alcohol drinken, meeroken en verslaving in het algemeen onderwerpen die aansluiten op elkander. Het lijkt er op dat een beetje slecht niet verkeerd is en dat het eigenlijk het overmatig misbruik van iets goeds betreft.




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