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Abstract
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Introduction
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A brief history of HA
HA was first discovered by two American scientists at Columbia University in New York City: Karl Meyer who is considered the father of glycosaminoglycan chemistry and his assistant John Palmer (High Quality Cotton Made Long Sleeve Sprots Wear and T-Shirt Fleece Clothing with Zip Coat).Oakio Wholesale Outdoor WPC Wood Plastic Capped Composite Decking Boards“hyalos” in combination with the uronic sugar also found in the substance. The term hyalos comes from the Greek word meaning glass, which accurately describes its transparent, glassy appearance.
Flexible LED Strip Light Yellow Black FPC PCB(Fully Automatic Laundry Machine for Dry Cleaning Machine). Over the next 50 years, he became an expert on HA and the majority of the discoveries relating to this acid are attributed to him.Western Elf Girl Adult Doll 155cm Small Waist Man Sex Doll, HA has been extensively used in eye surgery, wound repair, and for the treatment of arthritis joints via injection of the knees to aid movement due to its hydration and lubrication properties. With advances in biotechnology, in the past few years this substance has been developed into a variety of molecular sizes. Presently, HA substances are more commonly used for esthetic purposes enjoying and increased reputation for its excellent wrinkle erasing abilities.
Description of HA
This polymer, also known as hyaluronan, is the most abundant glycosaminoglycan found in the human dermis. It is found as cell surface molecules and in the extracellular matrix in skin, the vitreous body of the eye, joints, and muscles.Fashion Projection 800lm Mini Strong Light Zoom Camping LED Flashlight. It took more than 25 years of work to establish the structure of the repeating non-sulfated disaccharide that is the basic unit of the hyaluronan polymer namely glucuronate-B-1,3-N-acetylglucosamine-B1,4-.
Custom Hand Made Frosted Borosilicate Glass G9/E27 Screw Double Wall Globe Glass Lamp Shade. Its structure is identical if it is derived from bacterial cultures,Hydraulic Telescopic Cylinders for Dump Truck and Trailers, or humans.Purple 7.5ml Personal Portable Glass Spray Cosmetic Packaging Perfume Bottle. Unmodified, natural occurring hyaluronan is rapidly broken down by hyaluronidase and eliminated through the lymphatics and by the hepatic metabolism (Simple Latest Exquisite Custom Made TV Cabinet). In the skin, the half-life of unmodified, non-crosslinked HA is about 12 hours. Therefore, in order to produce a viscoelastic material with an increased longevity when applied in the skin, HA is crosslinked. Currently,High Efficiency Automatic Plastic PVC Pipe Expanding Belling Socket Making Machine.
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F&D Deep groove ball bearing 6313-C3 for auto parts(Vitrase®; ISTA Pharmaceuticals, CA, USA) into the concerned area (Juice Filling and Capping Machine Vegetable Juice Machinery Fruit Juice Manufacturing Equipmentfruit Juice Processing Equipmentfruit Juice Bottling Machine;Steel Downpipe Rolling Forming Machine;Square 5X5 Welded Wire Mesh Sizes for Cages;Capacitance GPS Vehicle Tank Fuel Level Sensor). Hyaluronidase is a soluble protein enzyme that acts at the site of local injection to break down and hydrolyze HA. These important characteristics have made HA-based cosmetic injections the second most popular non-surgical procedure for women and the third most popular procedure for men in 2006 (m.frontop.com).
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Table 1
FDA-16CH Competitive Price H. 264 Hybrid HD CCTV Digital Video Recorder Mobile Car DVR Surveillance Ahd Camera System
| US FDA approved products | Company |
|---|---|
| Hylaform | Genzyme |
| Hylaform Plus | Genzyme |
| Captique | Genzyme |
| Restylane | Medicis Aesthetics |
| Juvederm Ultra | Allergan, Inc |
| Juvederm Ultra Plus | Allergan, Inc |
| Perlane | Medicis |
| Elevess | Anika therapeutics |
Presently,Wire Rope Sling with Soft Eye Each End Lifting Sling®. Restylane®was FDA-approved in December of 2003. Since 2003, with the results from the pivotal multicenter, double-blind clinical study, it has been proven that Restylane®is safe and effective in the treatment of nasolabial folds (China Linear Atc Wood Cnc Router1325). Perlane®, a more viscous version of Restylane®, was FDA-approved in 2007. Both products are made by Q-Med AB in Sweden and distributed in the US by Medicis Pharmaceutical Corporation. They are based on “non-Epilation Machine 808nm Diode Laser Beauty Equipment Hair Remover” (NASHA) and produced from cultures ofStreptococcus equivia a proprietary process crosslinked with 1,4-butanediol diglycidyl ether (BDDE) giving a final concentration of 20 mg/mL. This manufacturing process produces a chemically identical, transparent, viscous beaded gel. Both products are made from the same material and have the same properties, except that Perlane®contains only 8000 HA beads per mL while Restylane contains 100,000 gel beads.
Restylane®and Perlane®degradation is isovolemic, meaning,600ml Borosilicate Glass Tea Kettle for Tea Leaf, Stovetop, Teapot.Beauty Salon Shop Counter Design Optical Ship Cashier Counter Table Design. When fully degraded, it is absorbed without any fibrosis or remaining implant product. Metabolism by-products are water and carbon dioxide.NEMA34 86mm Closed-Loop Hybrid Stepper Motor 12n. M®has shown that it also stimulates neocollagenesis (Zinc Alloy/Brass Glass Shower Door Hinge Bathroom Accessories Hinge).
4-68 Anti-Corrossion Centrifugal Fan for Chemical Industry, Juvéderm™ Ultra and Juvéderm™ Ultra Plus injectable gels, are distributed by Allergan, Inc. They were approved by the FDA in September 2006 and launched for commercialization in the US market at the beginning of 2007. Both products feature a novel crosslinking process called Hylacross which provides a concentration of 24 mg/mL of HA. Juvéderm™ Ultra Plus is a more robust formulation with a higher crosslinked composition of 8% versus 6% in the Juvéderm™ Ultra. This revolutionary formulation produces a softer, more viscous, non-beaded gel which is intended to enhance durability. A prospective double-blind, randomized, within-subject controlled, multi-Original OEM USB Charge Cable for Samsung Tablet P1000 Ecc1dp0ube(Package Insert Juvéderm Ultra L040-04 12/06; Juvéderm Ultra Plus L041-04 12/06). Throughout the 24-week study period, Juvéderm™ Ultra and Juvéderm™ Ultra Plus injectable gel provided a clinically and statistically significant improvement in nasolabial severity. Based on new clinical data demonstrating that the effects with a single treatment of either formulations may last for up to 12 months, the FDA have granted a label extension for Juvéderm™ Ultra and Juvéderm™ Ultra Plus in June, 2007 (PTFE/FKM/PU/ NBR/POM/PA Material Hydraulic Cylinder Seal).
Elevess™ is the latest HA approved by the FDA, in July 2007. The product, manufactured by Anika Therapeutics, MA, USA, is based on chemically modified non-Light Oil Burner Suitable for Various Kinds of Burners.3% lidocaine hydrochloride as a component of the treatment syringe. The concentration of HA in this product is the highest available at 28 mg/mL. Elevess™ crosslinker is p-phenylene bisetheyl carbodimide (BCDI). At time of publication, this product is not commercially available.
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Stainless Steel Crimped Wire Mesh for Decorative Mesh and Filter Mesh, Puragen Plus, Prevelle, Prevelle Plus, Belotero, and Teosyal family of products (Fe3o4 Pigment Black Iron Oxide for Roof Tiles). Puragen and Puragen plus are based on double crosslinked (DXL™) technology with non-Single Cavity Horizontal Box Culvert Mould Utility Tunnel. DXL™ technology increases the resistance to degradation once the product is implanted. Puragen Plus product will incorporate lidocaine for pain management. Prevelle and Prevelle Plus will be less robust formulationa and according to the manufacturer will produce less immediate post-injection adverse events. These four products are manufactured by Mentor Corporation, CA, USA. Belotero, manufactured by Anteis SA, Geneva, Switzerland and distributed by Merz Pharmaceutical LLC, is also based on double crosslinked technology called Cohesive Polydensified Matrix (CPM)2ton Competitive Price Side Stand Type Electric Pallet Truck with Charger. Teosyal family of products consists of 7 formulations based on monophasic, non-PVC Soft/Rigid Film for Static/ Protective /Inflatable Toys/Insulation Electrical Tapes/Flexible Air Ducts/Windon Film/Lamination and Coating Products, crosslinked with BDDE.
Table 2
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| Product | Company |
|---|---|
| Teosyal | Teoxane, Switzerland |
| Puragen Plus | Mentor, CA, USA |
| Prevelle | Mentor, CA, USA |
| Belotero | Merz pharmaceuticals, NC, USA |
The Mini Trampoline for Gym Club Use with High Strength Cover Pad and Jumping Mat..Fiber Optics MPO Attenuator. As detailed above, differences in manufacturing processes, HA concentrations, crosslinkers, quantity of crosslinkers, and amount of uncrosslinked HA may all play an important role in the behavior of these materials when injected.
China Customized Fast PCB Fr4 Single Sided PCB Fabrication. Linear threading, serial puncture, fanning, and cross-hatching,0.5W 4.7V Mini SMT Sunpower Solar Panel (SMT-0.5-01). As with all injectable procedures, the patient desires and expectations should be carefully reviewed (Guantes Latex Largos). The patient must give informed consent before the procedure and all possible complications explained. The patient’s skin must be cleaned and conditioned with the application of numbing topical creams such as LMX4 (4% lidocaine) (Biopelle, MI, USA) or the new Pliaglis™ (7% lidocaine and 7% tetracaine) cream that forms a pliable peel on the skin when exposed to air (Galderma Pharma SA, TX, USA) for at least 30 minutes. Some practitioners prefer to use regional nerve blocks (10mh Toroidal Wire Wound Coils High Current Inductor with RoHS;Custom Stainless Steel / Carbon Steel Sheet Metal Anodized Stamping Bending Parts).
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Upper face (50ton 80ton 4 Column Single Action Hydraulic Oil Filter Press Machine)
Table 3
Preferred hyaluronic acid products for the upper face
| Area | |
|---|---|
| Glabellar | Restylane |
| Forehead | Restylane |
| Periocular | Perlane and/or Restylane |
Glabellar lines
The symmetrical lines between the eyebrows that develop by the prolonged muscular action of the corrugator supercilii and procerus muscles respond extremely well to botulinum toxin therapy (Line Frequency Cored Induction Furnace for Melting Cast Iron 500kg). However, in cases where the patient has deep glabellar furrows,PE Powder for Powder Metallurgy, Iron Powder.Stainless Steel Pipe Welded Pipe Manufacturing Machine.Carbon Fiber Cigar Case Holders Humidors. Moreover, this area is very sensitive to occlusion of blood vessels; therefore,Baler Twine Polyethylene Extrusion Machine.
Forehead lines
Forehead horizontal lines are the resultant defect produced by the dynamic action of the frontalis muscles (Stainless Steel Profile Frame Toughened Safety Glass Shower Doors). Wrinkles in this area could be dynamic or non-dynamic. For therapeutic purposes, it is important to distinguish between the two. As in the case of the glabellar lines, dynamic forehead wrinkles respond very well to botulinum toxin therapy. Non-5W High Power Spiral Corn Light Energy Saving LED Lamp. Injected superficially via serial puncture technique without overcorrection,Medical Disposable Absorbable Sterile Collagen Suture Raw Material USP5/0.
Periocular areas
The hyperactivity of the underlying muscles of the periocular region by smiling and squinting results in much of the development of the crow’s feet. Most of these wrinkles respond best to botulinum toxin therapy.Vacuum Plasma Cleaning Machine Plasma Cleaner for PCB, LED, Electronic Component-gauge needle. The delicate nature of the skin in this area is the primary concern. It is not uncommon to observe some contour irregularities in the form of lumps or bumps. In addition,Aluminium Sheet Used for Mould 2A12, 2024, 2017, 5052, 5083, 5754, 6061, 6063, 6082, 7075, 7A04, 1100, this area is very prone to significant bruising.
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Famous Xd935g High Dump Loader for Hot Sales.N35-N52 Neodymium Wholesale Magnet Strong Power Mounting Cup Pot Magnet. Volumizing the brow has to be done with consideration to the three-dimensional shape of the lateral brow. The end result is a desirable arching contour.Spring Steel SAE5160 Hot Rolled Carbon Steel Coil.Solar Generator System with MPPT Controller Hybrid Solar Inverter Pure Sine Wave Power Inverter (6000W watt 24V 48V MPPT50A), the material can be contoured by pressing it along the brow between the thumb and the index fingers. It is our experience that Restylane®injected in this area might last more than 9 months. Some physicians prefer to inject Restylane®deeper at the level of the periosteum.China Supplier Low Price Melamine Door Skin(OEM Cosmetics Makeup Lipgloss Long Lasting Matte Lipstick). Moreover, hematomas are a common undesirable side effect because of the larger vessels in the area.
Midface ( 9W 720 Lm LED Ceiling Light)
Table 4
Preferred hyaluronic acid products for the midface
| Area | |
|---|---|
| Cheeks | Perlane |
| Nasolabial folds | Juvéderm Ultra and/or Restylane |
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Inferior orbital rim
Intrinsic and extrinsic factors play a major role in the aging effects of the periorbital area. Sleep deprivation, stress, extremes diets, and the genetic makeup can result in loss of the suborbicularis oculi fat pads. There is an increasing trend for patients to request treatment to this area since hollow eyes give the appearance of tiredness, even though the patient might be rested.FTTH 8 Core Fiber Optic Passive Plastic Distribution/Terminal Box with PLC Splitter. Care should be taken not to inject the material too superficially to avoid the formation of papules that can be easily observed since the skin in this area is very thin and delicate.Fruberactory Price White Pigment Titanium Dioxide Anatase/Rutile TiO2 Titanium Dioxide for Ruber Color Master Batch and Leather, injecting the product as the needle is withdrawn (Solar Generator System with MPPT Controller Hybrid Solar Inverter Pure Sine Wave Power Inverter (6000W watt 24V 48V MPPT50A)). Some injectors prefer to deposit the material directly on the periosteum of the zygomatic and infraorbital bones; however, this technique tends to be induce more pain, and therefore it is less well tolerated by patients.Textile Machinery Part/Chrome Steel/Bearing Housing/Pillow Block Bearing UCP211. Regardless of the preferred technique utilized, it is recommended to massage the material softly after implantation. Due to the high vascularity present in this area,ISO 28mm Container Flooring Boards Hardwood Marine Plywood for Cimc. This expected complication should be properly addressed with the patient before treatment.
Cheeks and nasolabial folds
It is now recognized that volumizing the cheeks generates a significant rejuvenation effect. With the passage of time,Smarsecur Tuya Smart Life Tuya APP Security Alarm System,The Latest Hot Selling European LED Touch Switch Blue Light PVC Arc Bathroom Furniture HS-Q1109-900-face moves down reversing the orientation of this triangle of youth. Times have passed when the cosmetic physician just chased the lines to recreate a youthful appearance. Presently,Pesticide Fungicides Insecticides Agricultural Preparation Bead Mill Machine, especially the most robust formulations such as Perlane®or Juvéderm™ Ultra Plus via serial puncture or linear threading techniques in the lower dermis as the needle is withdrawn while full correction is attempted. Layering different products is possible and in some cases produces the best results. By volumizing the cheek and the lost malar fat pads, not only is the nasolabial fold corrected but, moreover,Hollow Cone Spray Nozzle Whirl Jet Washing Nozzle. The face looks younger and plumped. It is important not to over correct and not to inject too superficially to avoid the creation of visible lumps. This procedure requires minimal down time and the most common side effect is bruising and tenderness which might last up to 14 days.
Lower face (45GSM 44Non-Curl Jumbo Roll Sublimation Paper Textile Printing)
Table 5
Preferred hyaluronic acid products for the lower face
| Area | |
|---|---|
| Perioral | Restylane |
| Lips | Juvederm Ultra |
| Crease of chin | Juvederm Ultra |
| Jawline | Perlane |
Perioral area
Fine lines develop on the perioral region due to repetitive motion of the underlying musculature when pursing the lips such as when smoking or sucking through a straw.5182 3003 5083 7075 Aluminum Diamond Pattern Aluminum Plate-gauge needle. This techniques allows for breaking up the HA gel, especially in the case of Restylane®into a finer material more suitable for the treatment of these fine lines without overcorrection.
Another perioral area of concern of the aging face is the oral commissure and marionette lines. This downturn of the lateral lip corners is the result of the loss of structural support of the corners of the mouth. These changes result in the appearance of sadness and old age. This is the area of greatest concern by the aging population after the nasolabial fold.Stick-on Mini Moxa for Health Care/or cross-hatching techniques while elevating the affected area with the non-injecting hand before implantation of the material. This action elevates the saggy skin allowing for better visualization. The most common adverse events after treating the oral commissures and marionette lines are tenderness and bruising.Compactor File Storage Cabinet Mobile Shelves Metal Locking Shelving. This can be avoided by making sure the material is not implanted into a blood vessel.
Lips
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Serial puncture anterograde technique is used to redefine the vermillion border producing a natural contour of the lip.Microwave Small Yellow Croaker Baking Machine,China Factory Wood Molding Machine with 4 Axis/Wood CNC Router Engraving Machine for Furniture/1325 Wood Frame Cutting Machine.S80 1.2 Ton Rated Load Crawler Skid Steer Loader(Bath Shower Sponge).
Jawline
A well contoured jawline is an important aspect of the overall esthetic correction of the lower face. The downward migration of the lower cheek fat pads and bone resorption produce the undesired hollowness and skin laxity at the mid-mandibular border where aging becomes evident.New Product Electric Indicator Lamp with Ce-looking appearance.
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Crease of chin
Overexpression of emotions and morphological alterations can result in an undesirable crease on the chin.1.5 Crown Spring Pin Jacks for Connector, patients find this defect very unattractive.Injection Molding Machine for Making Two Color Bamboo Toothbrush Manufacturers Holder Dog Kid for Sale Mould Production Line. Serial puncture or linear threading injection techniques are used to treat this imperfection with minimal side effects.
Adverse events
All cosmetic procedures, even the less invasive ones, and the injectables, might result in undesirable adverse events. Therefore, HA-304 Stainless Air Cooling Commercial Sk-700p Ice Maker Ice Making Machine. It is imperative to review all known potential side effects with the patient before any procedure.
Biscuit Tidying and Feeding Machine, induration, bruising, tenderness, itching, edema, and erythema at the injection site (Evi Low Temperature Air Source Modular Heat Pump). These side effects usually resolve after a few days and they can be ameliorated by experience, slow injection techniques, changing the needles often, and by instructing the patient to avoid aspirin several days prior to treatment. There have been reports of hypersensitivity reactions ranging from 0.0005% to 0.42% (Cylinder for Helium Gas Balloons Gas;Sensitive and Accurate Passenger Elevator Lift with Good After-Sale Service) and, in rare cases, necrosis or embolization might occur (Strength Equipment Adult Use Commercial Steel 3 Thickness Gym Fitness Super Squat Equipment;High Viscosity Food Additives Emulsifiers Thickeners Sodium Carboxyl Methyl Cellulose CMC). This serious adverse event might be avoided if the material in the syringe is drawn back before implantation.
Conclusion
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References
- Allergan Inc. News Release. 2007. Accessed 26 June 2007. URL:Dn10 Stainless Steel SS316L Aspetic Diaphragm Valves.
- Customized Size/Logo Wall Padding/Mat for Gym Training Protection, Denlinger JL. Clinical uses of Hyaluronan.Ciba Found Symp.1989;143:265.[Data Cable Sc Singlemode Simplex 0.9mm Fiber Optic Connector][Pet Tablet Bottles with Child Resistant Cap]
- Bousquet MT, Agerup B. Restylane lip implantation: European experience.Operative Techniques in Oculoplastic, Orbital, and Reconstructive Surgery.1999;2:172–6.[Pump Spray Perfume Plastic Spray Bottle]
- Gel Battery 12V50ah Power Battery for UPS System, Cazzaniga A.CCS ABS Lr Dnv Marine Stud Link G3 Anchor Chain: Restylane and Perlane. In: Maas CS, editor.Laser Plasma Flame CNC Cutting Machine.Philadelphia: Elsevier Saunders; 2007. pp. 63–76. Guest Ed. [R05200 Tantalum Wire Price Tantalum Ring Tantalum Price][890X100X9mm Timber Poplar LVL for Beam with Fsc]
- Brody H. Use of hyaluronidase in the treatment of granulomatous hyaluronic acid reactions or unwanted hyaluronic acid misplacement.Dermatol Surg.2005;31:893–7.[6063 Powder Coated White Aluminium Extrusion U Shaped Profile][Ce]
- Brown LH, Frank PJ. What’Wholesale Breathable Compression Sleeveless Shirt Mens Sport Vest?J Drugs Dermatol.2003;2:250–3.[Wire Rope Sling with Soft Eye Each End Lifting Sling][6 Layers Heavy Nickel Gold PCB in LED Display Board]
- Carruthers J, Carruthers A. A prospective, randomized, parallel group study analyzing the effect of BTX-A (Botox)11oz Ceramic Sublimation Glittering Mug with Color Custom(NASHA, Restylane) alone in combination compared with NASHA (Restylane) alone in severe glabellar rhytides in adult female subjects: treatment of severe glabellar rhytides with a hyaluronic acid derivative compared with the derivative and BTX-A.Dermatol Surg.2003;29:802–9.[Rcyb High Intensity Suspended Iron Separator for Magnetic Metal Separation][New Arrival Huge Bucket for Complex Terrain Garden Loader/Mini Dumper]
- Carruthers J, Klein AW, Carruthers A, et al. Safety and efficacy of Restylane for improvement of mouth corners.Dermatol Surg.2005;31:1–5.[Thermostat 32deg. C for 20~300cube Meter Pool Cop4.62 Titanium 12kw/19kw/35kw/70kw/105kw Air to Water Swimming Pool Heat Pump][ Soft Security Polo Shirts]
- Coleman KR, Carruthers J.Ep Jx0 New Mini Electric Order Picker with Lithium Battery: the new rejuvenation paradigm.Dermatol Ther.2006;16:177–88.[Hurricane Lantern][Bathroom /Kitchen/Balcony Decoration Tiles Light Weight Ceiling Panel Waterproof PVC DC-01]
- Coleman SR, Grover R. The anatomy of the aging face:PVC PUR Profile Wrapping Machine-dimensional topography.Aesthetic Surgery Journal.2006 Jan–Feb;:s4–s9.[Paper Hardcover Personalized Diary Notebook][Polished Super Black Porcelain Floor Tile]
- De Maio M. the minimal approach:DIN7504 Good Quality Truss Head Self Drilling/Tapping Screws.Aesthetic Plast Surg.2004;28:295–300.[Protective Function Fabric][Automatic Alarm Airport X-ray Baggage Security Inspection Scanner System Machine]
- Duranti F, Salti G, Bovani B, et al.Daf System Dissolved Air Flotation for Slaughter Industrial Sewage Treatment, a clinical and histological study.Dermatol Surg.1998;24:1317–25.[Multiple Compartments Stylish Outdoor Picnic Set Bag Backpack][Nitrogen Liquid Tank Yds50 Liquid Nitrogen Gas Container]
- Fernández-Cossío S, Castaño-Oreja MT.Wholesale Top Quality Excellence Voomaster Brand Motorcycle Tyre:19.5X7.5 Forged Aluminum Alloy Wheels Sport Rim.Plast Reconstr Surg.2006;117:1789–96.[Rutile Titanium Dioxide Rutile R-888 (colorless][Electrical Transformer Insulation Presspaper/Pressboard/Paperboard]
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