Science Does vaping shrink your balls?

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Some time ago, someone sent me this:
twit.jpg

I know, generic ancient Rome/Greek right-wing back-to-nature type stuff, even hates on deodorants:
“Alright Emil, but these are cheap shots. What does the science say? Are there such “studies show” as mentioned?”
twit.jpg

Well, yes, sort of! Challenge accepted. One guy in the replies links to a useful review:


E-cigarettes, a comparatively new phenomenon, are regarded as a safer alternative to conventional cigarettes. They are increasingly popular among adolescents of both sexes, and many smokers use e-cigarettes in their attempts to quit smoking. There is little understanding of the effects of exposure to e-cigarette vapors on human reproductive health, human development, or the functioning of the organs of the male and female reproductive systems. Data on the effects of the exposure were derived mainly from animal studies, and they show that e-cigarettes can affect fertility. Here, we review recent studies on the effects of exposure to e-cigarettes on facets of morphology and function in the male and female reproductive organs. E-cigarettes, even those which are nicotine-free, contain many harmful substances, including endocrine disruptors, which disturb hormonal balance and morphology and the function of the reproductive organs. E-cigarettes cannot be considered a completely healthy alternative to smoking. As is true for smoking, deleterious effects on the human reproductive system from vaping are likely, from the limited evidence to date.

Considering the topic and its importance, it’s strange that this review only has 11 citations at this time. It has some 60+ references, but for simplicity, let’s look at the male effects only. The claim about “studies show” testosterone reductions is true, ish. There is a such rat study. From Tunisia:


Electronic cigarettes (e-cigarettes) are becoming the fashionable alternative to decrease tobacco smoking, although their impact on health has not been fully assessed yet. The present study was designed to compare the impact of e-cigarette refill liquid (e-liquid) without nicotine to e-liquid with nicotine on rat testis. For this purpose, e-liquid with nicotine and e-liquid without nicotine (0.5 mg/kg of body weight) were administered to adult male Wistar rats via the intraperitoneally route during four weeks. Results showed that e-liquid with or without nicotine leads to diminished sperm density and viability, such as a decrease in testicular lactate dehydrogenase activity and testosterone level. Furthermore, quantitative real-time polymerase chain reaction (qRT-PCR) analysis identified a reduction in cytochrome P450 side-chain cleavage (P450 scc) and 17 beta-hydroxysteroid dehydrogenase (17βHSD) mRNA level, two key enzymes of steroidogenesis. Following e-liquid exposure, histopathological examination showed alterations in testis tissue marked by germ cells desquamation, disorganization of the tubular contents of testis and cell deposits in seminiferous tubules. Finally, analysis of oxidative stress status pointed an outbreak of antioxidant enzyme activities such as superoxide dismutase, catalase and gluthatione-S-transferase, as well as an important increase in sulfhydril group content. Taken together, these results indicate that e-liquid per se induces toxicity in Wistar rat testis, similar to e-liquid with nicotine, by disrupting oxidative balance and steroidogenesis.

Sounds scary! What are their methods:

A total of 24 rats were randomized into three groups of eight animals each as follows: Group 1: Control group was injected intraperitoneally with physiological saline (500 ml). Group 2: E-cigarette 0%-treated group received an intraperitoneal injection of electronic cigarette refill liquid without nicotine (less than 10 ml) diluted in physiological saline (500 ml). Group 3: E-cigarette-treated group received an intraperitoneal injection of electronic cigarette refill liquid containing 0.5 mg of nicotine/kg of bw/day (less than 10 ml) diluted in physio- logical saline (500 ml). Rats were treated for four weeks and sacrificed by decapitation 24 h after the last treatment.

Intraperitoneal.. what? Dictionary says “Within the peritoneal cavity (the area that contains the abdominal organs).”. They literally injected rats with vaping liquid. Seems insane and incomparable to human vaping, but authors assure us it is legit:

The dose of e-liquid containing 0.5 mg of nicotine/kg of body weight (bw)/day and the intraperitoneally (i.p.) route were selected on the basis of a previously published report suggesting that daily i.p. administration of 0.5 mg of nicotine/kg of bw is a lower dose than a smoking comparable dose (Matta et al., 2007). Moreover, this dose did not show any sign of toxicity in rats (Higher doses caused paralysis of the back limbs of the animals, diarrheas and increased heart rate). Finally, i.p. route is still largely used to assess nicotine toxicity in rodents (Gerard et al., 2010; Gumustekin et al., 2005; Sener et al., 2005a,b, 2007; Zhang et al., 2015).

The results sure look halfway decent, maybe too good. Here’s for sperm measures:
2c597e4f470ec39099dc97dfdb633e356b1adf14.png
I found it strange that the sperm count is lower in the 0% nicotine group, but maybe this is just due to n=8 per group. Sperm viability shows a 60-70% decline. This kind of result seems crazy, but I would have said the same thing about saunas, perhaps, and look how strong that data is.

Here’s the testosterone one that the Twitter people are on about:
4c3619ab98725f6e5d34a2cf5432d6323d84f94d.png
So here we get it. There is a 50% reduction in one experimental group, the wrong one (0% nicotine), the other group looks like about 25% reduction.

The authors tell us that “Several studies on rodents have reported that nicotine affects sperm function by depressing sperm count and viability (Mosbah et al., 2015; Oyeyipo et al., 2011).”, but they don’t seem to realize that this is not fitting with their finding for the 0% nicotine group. If nicotine had an effect as they cite research to support, the nicotine group should be worse off than the 0% nicotine group.

The same author group then later in 2018 published a very similar paper based on the same rats and the same data (mostly) in a different journal with another lead author. I won’t go into it here because it adds nothing.

Is there something more realistic? Yes, an Italian rat study with actual vapor:


Despite the lack of knowledge of the effects of electronic cigarettes (e-cigarettes, e-cigs) on public health, they have been proposed as a part of smoking cessation efforts. Recently, several basic scientific studies have pointed out how e-cigs can generate carcinogens, such as e-cig liquid thermal degradation by-products, and how the exposure can lead to genomic damage through inhibiting DNA repair or disrupting the redox homeostasis. However, scientific studies have pointed out how e-cigs can generate carcinogens and their release could be avoided setting the device to a low-voltage regimen. To test this feasibility, we show the effects of e-cig vapour generated from a low-voltage device filled with a nicotine-free liquid on rat testicular functions. The chemical analysis revealed the presence of carbonyls, such as formaldehyde, acetaldehyde and acrolein. Rats exposed reported a lower relative testis weight and higher levels of lactate dehydrogenase (LDH) as tissue damage marker, along with an impairment of 3β-hydroxysteroid dehydrogenase (3β-HSD), 17β-hydroxysteroid dehydrogenase (17β-HSD) and glucose-6-phosphate dehydrogenase (G6PDH) as key enzymes in the steroidogenesis pathway. The pro-oxidative environment was confirmed by the higher amount of reactive oxygen species (ROS), the development of lipid peroxidation and protein carbonylation, as well as from the disruption of antioxidant capability. Finally, we observed a higher rate of DNA unwinding in white blood cell line and boosted lipoxygenase (LOX)-linked activity, a tumour promotion marker. Even with the device setting at weak conditions, our results if extrapolated to humans suggest that exposure to e-cig vapours might alter gonads function in male vapers.

Their method:

Fourteen male Sprague-Dawley rats (7 weeks old) were purchased by ENVIGO RMS S.r.l. and housed under standard conditions (12-h light-dark cycle, 22 °C and 60% humidity). Animals had free access to water and chow throughout the experiment. After one-week acclimatization, animals were randomly assigned to the experimental units: control (7 rats) and exposed (7 rats). The exposed group was subjected to the vapour generated from the e-cigarette (see Section 2.2 for details on device settings) for 28 days. The exposure occurred daily for 3 h and it consisted of 11 cycles of two puff (6 s on; 5 s off; 6 s off), followed by 20 min of recovery. At the end of each cycle, the animals were moved to a clean chamber. The levels of O2 , N 2 and CO 2 were monitored by GC/MS to establish safe O 2/N 2 and CO 2/O 2 ratios. Further details on the exposure chamber assessment have been previously reported [5].

So 14 rats this time, 7 per group. Actual vapor, and quite a long time. They didn’t measure testosterone, but they measures testicle sizes:
aa29ec198b3d85c1b331643b1b03f50da3f0a079.png
Both of these comparisons are p < .05, and not < .01, so the p values are bad. Another alternative, they measured some enzymes related to testosterone synthesis:
3b4a044f9217d83ce5d1938dabe38fc4d88b964f.png
I don’t know anything about the chemistry, but maybe some reader can tell us whether they buy this proxy. My hunch is that biology offers so many proxies that one can always find something that shows something somewhere and say its relevant based on some theory of pathway.

And there’s a Polish study:


The results appear to be all over the place and the paper is full of pictures of cells and stuff. I can’t evaluate this.

Enough rats! Is there anything human? Yes:


A global survey showed that one out of eight smokers have attempted e-cigarettes, with most utilisation among young, non-minority individuals1 . Presently, there are no regulations on the use of these products. While detailed studies have been carried out looking at the effects of conventional smoking on sperm quality, no studies to date, have looked at the effects of e-cigarettes on male fertility. In this study, multiple methods have been utilised to distinguish whether e-liquid exposure affects testes function and sperm quality. The ejaculates from 30 men were investigated post gradient centrifugation. Semen samples were split into three groups and cultured with two popular e-liquid flavourings (bubblegum and cinnamon), which have been shown to have a cytotoxic effect on certain cell types2 , and propylene glycol (the base humectant found in all e-liquid solutions). Concentration, motility and progression were analysed and compared with control cultured sperm using Computer Assisted Sperm Analysis software. High concentrations of cinnamon and bubblegum were both statistically significant (P=<0.01) for reducing motility, progression and concentration. In order to assess the effect of e-cigarette inhalation on testes morphology in vivo, adult male C57/BL/6 mice were exposed to e-liquid flavor vapour for four weeks in air controlled cages before undergoing gonadectomy (n=3 for each exposure). The testes were sectioned, TUNEL stained and apoptosis measured using cell counts. Bubblegum flavouring yielded statistically significant results (P=<0.05) as the most damaging exposure causing apoptosis in mouse testes. This study highlights the need for further studies into the harmful effects of electronic cigarettes and provides evidence for the restriction of unregulated flavourings in e-liquids as well as the need for effective regulation internationally.
References:
1. Adkison, S.E., O’Connor, R.J., Bansal-Travers, M., Hyland, A., Borland, R., Yong, H.-H., Cummings, K.M., McNeill, A., Thrasher, J.F., Hammond, D., Fong, G.T. (2013) Electronic nicotine delivery systems: international tobacco control four- country survey. Am J Prev Med 44 (3): 207–215.
2. Bahl, V., Lin, S., Xu, N., Davis, B., Wang, Y., Talbot, P. (2012) Comparison of electronic cigarette refill fluid cytotoxicity using embryonic and adult models. Reprod. Toxicol. 34(4):529–537.

That’s the entire study. I emailed first author to ask about any follow-up. She said that:

Hi Emil,

Thanks for reaching out. I gave this talk at the BFS and the Times reported it. Unfortunately I received a scary amount of abuse online from vapers and vaping companies who said very threatening things. I made the decision not to publish as a result but would be happy to send you ant data from this if I can find it.

Helen

Harassment campaigns work unfortunately.

So there’s two parts of the study. One part where they “cultured” semen with vaping liquid, I think this means they mixed it in a petri dish. I mean, OK, this probably does something bad, but unclear what this would show about typical use. I don’t suppose many people vape with their vaginas after sex. The second part is a n=9 mouse study that also exposed them to vaping gas and measured their testicles. Seems reasonable enough. They say this had an effect in one experimental group, p < .05. Who can say whether this was a fluke or not.

What about something more solid, and with humans? There’s some media articles about vaping and men’s fertility. CNN tells us Vaping doubled the risk of erectile dysfunction in men age 20 and older, study finds. They reference this study:


Methods​

Data from Wave 4 (2016–2018) of the Population Assessment of Tobacco and Health study were analyzed in 2020. Male participants aged ≥20 years who responded to the erectile dysfunction question were included. Multivariable logistic regression models examined the association of ENDS use with erectile dysfunction within the full sample and in a restricted sample (adults aged 20–65 years with no previous cardiovascular disease diagnosis) while adjusting for multiple risk factors.

Results​

The proportion of erectile dysfunction varied from 20.7% (full sample) to 10.2% (restricted sample). The prevalence of current ENDS [Electronic Nicotine Delivery Devices, i.e. e-cigarette] use within the full and restricted samples was 4.8% and 5.6%, respectively, with 2.1% and 2.5%, respectively, reporting daily use. Current daily ENDS users were more likely to report erectile dysfunction than never users in both the full (AOR=2.24, 95% CI=1.50, 3.34) and restricted (AOR=2.41, 95% CI=1.55, 3.74) samples. In the full sample, cardiovascular disease history (versus not present) and age ≥65 years (versus age 20–24 years) were associated with erectile dysfunction (AOR=1.39, 95% CI=1.10, 1.77; AOR= 17.4, 95% CI=12.15, 24.91), whereas physical activity was associated with lower odds of erectile dysfunction in both samples (AOR range=0.44−0.58).

Conclusions​

The use of ENDS seems to be associated with erectile dysfunction independent of age, cardiovascular disease, and other risk factors. While ENDS remain under evaluation for harm reduction and smoking-cessation potential, ENDS users should be informed about the possible association between ENDS use and erectile dysfunction.

So it’s a big observational study. Their results is one giant regression model:
434c5c67da4bf07f2157774fa8e9ddffc6221f2e.png
Phew! Well, some things to look at. The column with OR are the bivariate relationships, i.e., association between erectile dysfunction (ED) and “EDNS” (vaping). So we see that without controls, vaping use is associated with less erectile dysfunction, about half the rate for former and current occasional smokers, p = .08 for daily smokers. I would guess these opposite of expected findings are due to age confounding. After the authors control for 20+ things, the association reverses, so that daily use of vaping is associated with ED with about twice the rate of normal (p <.001), but former and occasional use is not. But if you look later, they also have regular tobacco use which shows no association at all after controls! And neither does “other tobacco products”, which means “past 30‒day use of cigar, cigarillos, pipe, hookah, snus, and smokeless tobacco products”. This doesn’t make any sense together with the various claims of some rat and mice researchers that nicotine itself does stuff. It appears vaping is magical.

Finally, I was able to find a Danish study of smoking and sperm counts:


STUDY DESIGN, SIZE, DURATION
This cross-sectional population-based study included 2008 men with information on cigarette and marijuana use (enrolled between 2012 and 2018), among whom 1221 men also had information on e-cigarette and snuff use (enrolled between 2015 and 2018).
PARTICIPANTS/MATERIALS, SETTING, METHODS
Men (median age 19.0 years) from the general population provided a semen and blood sample and filled out a questionnaire on lifestyle including information on smoking behaviour. Associations between different types of smoking (e-cigarettes, snuff, marijuana and cigarettes) and reproductive hormones (total and free testosterone, sex hormone-binding globulin, LH, oestradiol and ratios of inhibin B/FSH, testosterone/LH and free testosterone/LH) and semen parameters (total sperm count and sperm concentration) were examined using multiple linear regression analyses adjusted for relevant confounders.
MAIN RESULTS AND THE ROLE OF CHANCE
Approximately half of the men (52%) were cigarette smokers, 13% used e-cigarettes, 25% used snuff and 33% used marijuana. Users of e-cigarettes and marijuana were often also cigarette smokers. Compared to non-users, daily e-cigarette users had significantly lower total sperm count (147 million vs 91 million) as did daily cigarette smokers (139 million vs 103 million), in adjusted analyses. Furthermore, significantly higher total and free testosterone levels were seen in cigarette smoking men (6.2% and 4.1% higher total testosterone and 6.2% and 6.2% higher free testosterone in daily smokers and occasional smokers, respectively, compared to non-smoking men), but not among e-cigarette users. Daily users of marijuana had 8.3% higher total testosterone levels compared to non-users. No associations were observed for snuff in relation to markers of testicular function.
LIMITATIONS, REASONS FOR CAUTION
We cannot exclude that our results can be influenced by residual confounding by behavioural factors not adjusted for. The number of daily e-cigarette users was limited and findings should be replicated in other studies.

It’s a study of 2000 Danish men aged 19, who took part due to serving in the army. Of this sample, there were some who used various kinds of nicotine, 25 daily vapers and another 139 occasional vapers. So the authors were able to produce these neat plots. First, testosterone:
d4f3f1083415c6aab928bd00636bb437df8294dd.png
So regular smokers had somewhat higher testosterone levels than non-smokers (p < .01), again contradicting the animal researchers’ results (some of them). Cannabis showed the same pattern (but p = .05). Vaping didn’t show any associations, but with only 25 daily smokers, it can’t be ruled out either, but the effects cannot be large like those seen in the rat studies. Snuff didn’t seem to show any association either.

Results for sperm:
2944edbec82621460ca23872d76e3ed7b62dd5e0.png
Sperm counts were a bit lower for the smokers (p < .01), vapers (p = .01), and not much pattern for the last two groups. It doesn’t appear that vapers are worse than regular smoking wrt. sperm, but this study wasn’t large enough to say for certain. Also, we aren’t that certain that smoking and sperm counts are causal.

Conclusions​

  • I wouldn’t put much trust in the Tunisian rat study, or most other such animal studies.
  • Strange association between erectile dysfunction and vaping, that somehow doesn’t show up for other kinds of nicotine products. Not concerning enough to stop using though IMO.
  • Testosterone associations seem to be positive in actual humans from observational data. It seems easy to do a randomized trial here. Get 200 men, start a random half of them on vaping daily for 3 weeks. Measure all the usual things every week.
  • Sperm count showed about the same negative association with regular smoking as with vaping, so there doesn’t seem to be any particular additional course for concern. As we saw with the heat, these counts are easily reversible.
  • All in all, not much cause for concern, but considering the prevalence of the practice, it should be immediately properly investigated (large RCTs, pre-registration, open data, multiple teams).
 
>push generation of men into eating seed oils because they “trust the science”
>create social perception that vaping is only for faggots that subscribe to the soy lifestyle
>”it’s da propylene glycol and and nicotine that done it not our lifestyles focused on eating industrial byproducts instead of natural foods”
 
Inhaling anything usually isn't the best for you, but I'm always wary when vaping is demonized because there is a lot of money involved in both selling and regulating tobacco itself. Vaping is a major threat to that whole circle of interests because it's an alternative that eats away at profits of both Big Tobacco and the governments that make bank on regulating and taxing tobacco.
 
They literally injected rats with vaping liquid

I mean couldn't they just put vape gasses in a sealed enclose with the rats?
Or train monkey to vape?

1668368264391.png

A global survey showed that one out of eight smokers have attempted e-cigarettes, with most utilisation among young, non-minority individuals
Non-minority?
So they mean China-men and pajeets?
I always hated this habit of people to talk about global affair and situations but then use local demographics vernacular.

I don’t suppose many people vape with their vaginas after sex.

Just wait for the tiktok trend to start...

So regular smokers had somewhat higher testosterone levels than non-smokers

Anyone have a cigarette I can bum?
 
If you vape you're a faggot, end of story.
>but muh seed oils/industrial byproducts and society pushing that stuff
You're still a massive faggot if you vape/smoke/drink any form of alcohol period. And you're even more of a faggot by trying to excuse that shit.
 
Inhaling anything usually isn't the best for you, but I'm always wary when vaping is demonized because there is a lot of money involved in both selling and regulating tobacco itself. Vaping is a major threat to that whole circle of interests because it's an alternative that eats away at profits of both Big Tobacco and the governments that make bank on regulating and taxing tobacco.

You sir are 100% correct. Bit of a PL not going into too much detail, kiwis can take this as Source: Trust me bro if they want. Around 2018 I worked for a vape hardware manufacturer, there's no money in selling E-juice because customers can make that themselves. So I got to have meetings with a lot of the big brands in the vape industry looking to buy hardware and I learned all kinds of inside information. Vaping came in and took a massive market share from big tobacco as they ignored it thinking it wasn't a threat. Until it was.

The first move big tobacco made was to protect their supply chain (Tobacco farms) and pushed this Heat not Burn product into the market. In fact this was forced on some of their customers who sold tobacco and vapes and they were told that they would no longer supply them with cigarettes if they also did not stock heat not burn product as well. HNB product only got some market share in South Korea and Japan. Nobody else gave a fuck, if you want to vape you'll vape, if you want to smoke you'll smoke. HNB was a half way house nobody wanted.

We had representatives come for a visit from one of the Big tobacco companies, my boss thought that they were going to buy product from him and kissed their ass so hard the whole visit, lavish dinners, all night drinking, 5 star hotels and hookers the fucking works. I clocked them right away as just being on a fact finding mission of how our business operated what our manufacturing setup was so they could go off and set up their own manufacturing plant at some point in the future. So they got what they wanted fucked off and we never heard from them again, obviously they got given all the insider information they wanted.

Big tobacco is coming into the vape market but it's going to take them years to set up the supply chain get FDA approvals and whatever else they need. In the mean time they are doing their best to shit on the current vape market with backdoor funded articles like this telling people how bad vaping is. Then surprise! Heres big tobaccos vape that has absolutely none of the problems of the current vape market they have been promoting secretly for years. Our vape won't blow up in your face, it's not full of toxic chemicals and won't shrink your balls.

I've got a specific example of the tactics big tobacco currently use. I was looking for a website for one of the big vape companies at the time, they either didn't actually have a website (Likely just used social media) or they had incredibly shit SEO. But Google did spit out a page that looked like it was theirs vapecompanyname.com, ONE page only. Now reading this page it was actually looking like the company was shitting on it's own product, in a very corporate health conscious way. So I go to the .com domain as there are no links from this page to anywhere else. I find that the domain is owned by some US corporate company that has absolutely nothing at all to do with vaping.

So somebody (BT) had paid to insert a page onto a domain to shit on a vape company. If you go to the domain there are no links at all to this vape page, only Google will find it.

Big Tobacco, salty as fuck running interference until they can enter the market.
 
This is the most bizarre angle of attack on vaping if you assume any level of honesty (har har har), when you can just shit on some of the heating element manufacturers for using alloys in the coils that shed shit that they shouldn't, like Cobalt. That's a worry that goes back way further and the true autists obsess about proper coil materials for a reason.

Apparently that didn't resonate enough, though I did see it pushed years ago now.

It's the most obvious angle of attack but I guess people tune out "china questionable materials bad" after a while, unless you're one of the few weirdos on certain forums which take their health seriously in the vaping sphere.
 
Kudos, OP! I rarely see such a well cited and well reasoned post. It was top notch all around.

I completely agree with your interpretations. One thing I would like to add, regarding frequency of smoking/vaping and testosterone levels. It may be a correlational relationship, rather than a causational one. It could be that people who choose to smoke or vape daily are the same people who have naturally higher testosterone levels. There may even be a behavioral link, people with higher testosterone levels seek out experiences that influence their behavior and reality, such as smoking or vaping and the stimulant effect that nicotine has.

Another thing I would like to add regarding vaping, if you can, buy a brand of vaping liquid that uses synthetic nicotine. It has become well established that vaping nicotine that comes from tobacco has some of the same issues as cigarettes in that the curing and refining process for tobacco, and thus the nicotine extracts, can contain rather unfortunate chemicals that do pose a risk to human health. Synthetic nicotine contains none of those chemicals because it is synthesized in a lab somewhere and must meet chemical purity standards, which tend to be rather stringent. With all that stuff out of the way the only risk that vaping really poses, as far as we know, is nicotine itself. From studies that have been done, in and of itself, nicotine has some potential for issues regarding human health but it is rather limited.. Given the size of the effect of just nicotine on human health I would say that consuming significant quantities of red meat or eating bacon a few times a week, having uncontrolled blood pressure, or dyslipidemia (your blood lipids [cholesterol, etc...] are crap) are probably on the same level of risk, with more than moderate alcohol consumption, distracted driving/speeding, and unprotected sex all being significantly more dangerous.

So, overall, if you are a smoker, vape synthetic nicotine instead, it is substantially less of a health risk. At least give it a try, you have nothing to lose. If you vape, see if you can switch to synthetic nicotine. If you do, given the risk involved, I wouldn't be overly concerned about it from that point forward regarding long term health impacts (this is assuming you get a regular physical and keep your cardiovascular risk factors under control, especially blood pressure). If you are a non-smoker or you don't vape, don't start. If you don't vape, you have no risk, so why add another potential source of health problems to your life? If you decide you absolutely do want to start partaking of nicotine, stick to vaping and particularly synthetic nicotine. Also, follow the advice I mentioned above to the people that already vape about making sure your cardiovascular risk factors are under control.
 
lol, "Carnivore Aurelius"

I swear these goofballs will come up with more and more ridiculous names until they're indistinguishable from the average court docket in Detroit.
 
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