Episode 133 Summary 


Mitochondria: What They Are and Their Role - Mitochondria are organelles found in almost all eukaryotic cells. They are responsible for generating energy by burning proteins, fats, and carbohydrates and producing adenosine triphosphate (ATP). This process requires oxygen and enables cells to function properly. Mitochondria evolved from a single bacteria in an endosymbiotic event that granted the original cell an increased energy supply.


Different Types of Mitochondria in Different Cells - Muscle cells require a lot of energy and have a high density of mitochondria in parallel rows along the nucleus. Brain cells have smaller but more numerous mitochondria that are good at generating ATP from ketones. The liver has abundant mitochondria that play a major role in gluconeogenesis. Fat cells have fewer and smaller mitochondria and are used to break down fat and produce heat when required. Red blood cells do not have mitochondria, but they play an important role in delivering oxygen to other cells.


Dysfunction in Mitochondria and Its Health Implications - Dysfunction in mitochondria can contribute to various chronic diseases such as neurodegenerative diseases, cardiovascular diseases, metabolic diseases, and aging. Oxidative stress and other stressors can impact the health of mitochondria, and vice versa.


Improving Mitochondrial Health - One of the first signs of mitochondrial dysfunction is fatigue and reduced energy levels. Strength training and getting enough sleep can improve mitochondrial function. Another way to improve mitochondrial health is by following a carbohydrate-restricted diet. Emerging evidence suggests that carbohydrate restriction can have a positive impact on our mitochondrial health for many reasons. One of which is that it promotes the production of ketones, which are an alternative energy source to glucose that the body can use to fuel the mitochondria. Ketones can also help to increase the number of mitochondria in cells, as they signal to the body to make more of them. Additionally, a carbohydrate-restricted diet can help to reduce the production of advanced glycation end products (AGEs), which can be harmful to mitochondrial health. By allowing the body to use alternative energy sources, such as fat and ketones, a carbohydrate-restricted diet can improve the function of mitochondria and promote overall health. Also important for overall health and mitochondrial function is stress management.

Resource - For more information on a low carbohydrate lifestyle, check out "The Doctors’ Guide to Real Health and Weight Loss," a free resource available for download at www.rlmedicine.com/free


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Show notes:

Episode 133 - Are you sick and tired of being sick and tired?

Dr Mary Barson: (0:11) Hello, my lovely listeners. I'm Dr. Mary Barson.


Dr Lucy Burns: (0:15) And I'm Dr. Lucy Burns. Welcome to this episode of Real Health and Weight Loss. Good morning gorgeous listeners. It's Dr. Lucy here, and I am joined by my most wonderful, fabulous, bestest colleague in the whole world, Dr. Mary Gorgeous Barson. Hello darling, how are you?


Dr Mary Barson: (0:40) Yeah, much better after that. I have to say thank you. Thank you for pumping up my tyres. That was very welcome. Yes.


Dr Lucy Burns: (0:48) Well, you know what? I figured since we're the boss of the podcast, we can, you know, it is incumbent upon me to pump up your tyres. And I'm very happy to do so.


Dr Mary Barson: (1:00) Thank you, you wonderful, beautiful human. If I'm perfectly honest, my tyres could use a bit of pumping as I manage just the normal, everyday ongoing stress of a working mum. Stress management is crucial and feeling loved, a little bit of dopamine, a little bit of oxytocin there has really helped and segueway to today's topic. Having nice, pumped up tyres is a fabulous way for us to move more efficiently through our lives. And today, we are discussing what powers our lives - mitochondria.


Dr Lucy Burns: (1:38) I'm excited about this topic. So lots of people have never heard the phrase mitochondria, or if they did, it was sort of relegated to, you know, Year 11 Biology, you know, when you we talked about crazy things like golgi apparatus and all sorts of endoplasmic reticulum that, you know, have completely exited my brain. However, most people certainly understand tiredness, fatigue, lethargy, and the counter words of energy, vitality, even efficiency. And the things that provide those are, of course, our magnificent mitochondria.

Dr Mary Barson: (2:18) They are. They are.

Dr Lucy Burns: (2:20) Now I'm very excited for you to talk about it, because you, you know, having a biochemistry degree are really a bit of an expert on this important subject.


Dr Mary Barson: (2:31) Yeah, at the risk of sounding like a complete nerd that I am, I have to tell you that I am extremely excited to talk about mitochondria. If you go back probably 20 years, back to a young Mary Barson doing her biochemistry degree at Melbourne University. I remember learning about cell biology, which was what I loved the most. And I ended up majoring in cell biology and learning about the - I'm going to just say long words and then describe what they mean - the endosymbiotic event that resulted in us having mitochondria in all of the more complex life forms having mitochondria and that, that this single event, it happened once, which means that every single plant, animal, fungus, every single eukaryotic organism in this entire planet was evolved from a single cell, a single bacteria that ate another bacteria and then engulfed that bacteria and turned it into its mitochondrial slave. We're all descended from that one cell. And I was like, it was like this watershed moment. I was literally on the edge of my lecture seat. And even now today, I'm like getting emotional thinking about it. I was just like, “Biology is amazing!” And yes, we're toning it down, but about 2.3 billion years ago an aerobic proteobacteria, that is a bacteria that was able to use oxygen, was engulfed and eaten by another cell, and it was enslaved. And that was the first mitochondria and this cell that enslaved this other little bacteria realised that, “Wow! If I get these other bacteria to do some work for me, I can have a lot more energy” and thus mitochondria were born. So yes, we've got lots and lots of little remnants of these little mitochondrial slaves all throughout our body. Each cell has thousands of these mitochondria and they are responsible for making nearly all of our energy and they are the powerhouses of our cells and therefore the powerhouses of our whole life.


Dr Lucy Burns: (4:44) Right. So, let me get this straight. Mitochondria. The history, the formation of mitochondria is actually because one bacteria was an asshole and had decided to eat another bacteria and use it for its own power.


Dr Mary Barson: (5:02) It's true. True. Yeah, there's always two sides to every story though it could be that this enslaved little, you know, aerobic protozoa, the first like mitochondrial ancestor was like, “Hmm it's kind of warm and cool in here and I don't have to go and find my own food. I can, I can make this big cell that ate me do it for me!” So maybe mitochondria have enslaved us? I'm not sure. I'd say that now we're definitely in a symbiotic relationship. I think that's a fair call. Yep.


Dr Lucy Burns: (5:30) All right. Good. Excellent. I was feeling a little worried.


Dr Mary Barson: (5:33) Yeah, that's right.

Dr Lucy Burns: (5:34) Okay. So, every single one of our cells has mitochondria and mitochondria, from what I understand, are like our energy factory, it's where energy is made. 


Dr Mary Barson: (5:47) In effect they're like super duper, biochemically complicated batteries, and I love them. I do.


Dr Lucy Burns: (5:54) Excellent. And every single cell has mitochondria?


Dr Mary Barson: (5:58) Pretty much, there’s a few exceptions. Yes. Yeah.

Dr Lucy Burns: (6:02) Oh, I want to know the exceptions.

Dr Mary Barson: (6:04) Okay, so red blood cells. They don't and yeah, yep. Red blood cells are really just sort of bags of haemoglobin really, and they aren't able to, they’re not able to regenerate themselves. That's why they get made, they sort of get beaten and bashed around our body for three months. And then our spleen catches them and we recycle them into bile, because they can't regenerate. But they are very useful bags of haemoglobin that we need for life. And in fact, you know, they deliver the oxygen to our cells, which is used by the mitochondria. So everything is connected to everything else.


Dr Lucy Burns: (6:38) Okay, so we've got the bags of haemoglobin, aka red blood cells deliver oxygen to most of our other cells. The oxygen is taken into the cell and the mitochondria does something magnificent with it.


Dr Mary Barson: (6:51) Yeah, yeah, that's correct. Yes. So mitochondria, god I love them. They are what we call the powerhouses of ourselves. So their main function is to generate energy in the form of ATP, or adenosine triphosphate, which we use, which our cells use, to do all the things. To do all the things that cells need to do. And it's a beautifully complex, wonderful process. And it's quite, it's quite universal to life, the production of ATP, it's quite fascinating. And we make a lot of ATP. So it's a tiny little molecule, and it's estimated that we generate about, and this is about, our own body weight in ATP every day. So they are busy, these clever, clever little mitochondria, creating cells that allow us to live and allow our bodies to do all the things that they need to do. Yeah go. You had a question?


Dr Lucy Burns: (7:51) So, well, we've got oxygen as one of the ingredients. And what's another ingredient? 


Dr Mary Barson: (7:59) So they burn fuel. So an incredibly simplistic way to look at it is that they can take our macronutrients, and through complicated ways using oxygen, they can turn our components of our protein, or our fat, or the carbohydrates that we eat, or that our body makes and use it to make ATP. And there are different pathways that they use for the protein and amino acids and the fat and the carbs. And depending on which pathway is predominant in your body can affect the health of your mitochondria and therefore the health of your whole body. But that is what they do. So they are able to turn protein, fat and carbs into ATP. They're pretty clever.


Dr Lucy Burns: (8:44) Okay, okay, I've got an analogy.

Dr Mary Barson: (8:46) Mmm hmmm, go for it!

Dr Lucy Burns: (8:48) Well, we all know the woodshed analogy and the fireplace. So you know, I've often spoken about the idea that our body can use two forms of fuel, it can use kindling, which are your carbohydrates, and they burn quickly, and die down quickly. Or we can use logs, which are our fat, which is either fat we've eaten or stored fat. So in fact, mitochondria are in fact, the fireplace. Yes, the fireplace is where all of this happens. And then the smoke that is generated is the ATP. And if we were clever, and I know that there are systems that were done in, you know, back in the olden days, where they would use that fire to sort of boil water and make steam and then get things to move, you know, turbines and cogs and all of that. It's exactly the same.


Dr Mary Barson: (9:35) It is. Yes, yep.


Dr Lucy Burns: (9:36) Great. 


Dr Mary Barson: (9:37) And in some ways, almost literally, like you could see, the biochemical pathways, you know, that are currently flitting before my eyes and the cellular cascades, they're also generated by these ATP cascades where something phosphorylates something else that phosphorylate something else, it’s this cascade of events that then let the cell do the thing that the cell wants to do. And in many ways, there are lots of parallels between the complex machinery of like a steam turbine engine for example? Yep, like at a biochemical level? Yep.


Dr Lucy Burns: (10:07) Yeah. I love that. I love that. I've also got visions of like, that game mouse trap. Where, yes, a little ball rolls down and then something dings and then something else does something and then a net falls down. And then something else. Yes. 

Dr Mary Barson: (10:23) Absolutely. That's right, the cell can, you know, entrap the mouse. And it all starts with, yep, the phosphorylation and burning of an ATP that requires some fuel.


Dr Lucy Burns: (10:32) Excellent. All right. So what we would love therefore, is to have a very, very robust, healthy mitochondria.


Dr Mary Barson: (10:39) We absolutely do, yes, yes. Before we go straight into how we can make our mitochondria healthy, I think it's important to understand that mitochondria do different things in different parts of the body. I think this can be helpful to understand that just as your red blood cells don't have mitochondria, and they're a part of our body, our different tissue types and different cell types have got different numbers and amounts of mitochondria that are different sizes, and that do different things. And I think this is helpful and it’s also extremely interesting to me. So, yeah, muscle tissue that obviously requires lots of energy, one of muscle cells main job is to contract, so that, you know, we can move our bones and our skeleton around, so they have a really high density of mitochondria. And they are arranged in these little parallel rows really clustered around the nucleus. And they have lots and lots of them. Brain tissue also requires a lot of energy. And that the mitochondria, there's lots of mitochondria in our nerve cells. And they've got jobs, such as that they generate ATP from different sources in particular. So the brain cells are quite good at generating ATP from ketones, they particularly like this, this is particularly good. And brain cells have got smaller and more numerous mitochondria than the muscle tissues and you know, they can do clever things like make neurotransmitters and other things.

(12:12) The liver, as always, is the most biochemically interesting part of the body and their mitochondria are no different. So the liver, as you probably know, plays a major role in detoxifying and figuring out a way for us to store our energy. And they have abundant mitochondria that can do lots of cool things like make sugar. The gluconeogenesis is done at the level of the mitochondria. And the bare oxidation of fatty acids is also done by the mitochondria. So they've got lots and lots and lots of these mitochondria. And then also our fat cells. I think it's interesting to know that they have mitochondria, but they are much smaller and fewer in number and they are involved in the process of breaking fat down, and also helping us make heat if we need to. If we're getting really cold, our fat cells will start making heat. And that's actually also done at the level of mitochondria. So I mean, they're pretty cool. And important.


Dr Lucy Burns: (13:15) Indeed, indeed, because in fact, if you have dysfunctional mitochondria, you are well and truly not thriving. Depending on that level of dysfunction, you know, there are some certain genetic conditions that people have dysfunctional mitochondria that are not compatible even with life.


Dr Mary Barson: (13:34) Yeah, that's true. Yes, yeah. And in day to day terms, if we're not as healthy as we can be, if we've got some, you know, we've talked about this in the podcast before, if we've got stress in our body, you've got oxidative stress, that our mitochondria might not be functioning as well as they need to be. They might also be, you know, not the right size in the right organs. And this can contribute to the development and progression of lots of chronic diseases, including neurodegenerative diseases like Alzheimer's and Parkinson's disease, as well as cardiovascular disease like heart disease and strokes. And also metabolic diseases like type two diabetes, and also ageing as well. But there's also a sort of a two way flow where these illnesses can also impact the health of our mitochondria and vice versa. And it's to do with this oxidative stress cycle that we can get into.


Dr Lucy Burns: (14:29) And I think it's really interesting because for a lot of people that first sign they seem to have that maybe your mitochondria aren't as robust as they could be is that they just feel tired. They don't have a lot of energy. And you know, sometimes people think that tiredness, again, like hunger, it's a character flaw, like you know, well, you shouldn't be tired, you just need to suck it up and power on and, you know, deal with it. And it's interesting. Whereas, if you actually think, “Why am I tired? What is causing the fatigue?” And a lot of us have no idea. No idea at all. And in fact, our solution is to then mask it by drinking caffeine, some sort of caffeinated drink


Dr Mary Barson: (15:13) Yeah guilty. I do that to cover up my sleep deprivation caused by a really cute baby. 


Dr Lucy Burns: (15:19) Yeah, yeah, your baby is very cute, but not that cute at 3am.


Dr Mary Barson: (15:24) Yeah. And I am fully aware that caffeine is not an ideal solution. And yet I still drink it.


Dr Lucy Burns: (15:31) I know. And the other thing that people will do, and this is really interesting is eat. And a lot of this is, you know, again, advertising telling you that if you're tired, you need a boost, an energy boost of some sort. And that may involve a Snickers that seems to be a very popular concept that if you’re tired and you're not yourself, have a Snickers, or it'll be an energy drink, like the you know, V or Mother or whatever the those are called, Red Bull, or it'll be something like an iced chocolate milkshake. In particular, they featured heavily in advertising for energy. 

Dr Mary Barson: (16:10) Yes! You know, the wanting the caffeine and wanting the food is a completely understandable response for people when they feel tired, because one of, like a very common reason why we're not metabolically well, and why our mitochondria are not functioning as well as we would like them to is because of insulin resistance. So the woodshed is closed. There's a complex interplay between mitochondrial function and insulin resistance. But one reason why insulin resistance can cause mitochondrial dysfunction is because there is less energy available to the cells, you know, for them to actually go through their ATP production. So the woodshed is closed, and so they need to throw something on that fire.


Dr Lucy Burns: (17:00) Yep. And you know, what, just to add a little more depth to this analogy. In some ways, I'm imagining that if the fireplace is the mitochondria, then if your fireplace is full of manky old ashes, and you've never cleaned it out, then you can't put much fuel in it. And so you're going to run out even more quickly, which is why, again, people often will eat particularly sugary foods to deal with that energy depletion, when in fact, if we go back to the root cause it would be to clean out your fireplace


Dr Mary Barson: (17:37) That's right. This is it, you know, that mitochondrial health, achieving and maintaining mitochondrial health and that lovely, you know, clear metabolism, clean metabolism, that lovely clear fire is really important to the treating of insulin resistance and metabolic disorders. And there are very concrete, very doable, things that we can all do in our everyday life to improve our mitochondria. And you and I, Lucy we’re practical people. And I know that I could nerd out about, you know, endosymbiotic events 2.3 billion years ago, a lot more, and I will if you want me to.

Dr Lucy Burns: (18:19) It’s alright, I’ve got it

Dr Mary Barson: (18:21) Okay, it's possible that we might like to move on to like the practical steps, what can we do to improve mitochondrial health and our health more generally, today?


Dr Lucy Burns: (18:32) Absolutely. So the first thing, obviously, cleaning out your fireplace doesn't happen overnight. So people need to be aware that what you do is unlikely to make any difference on the first day. Like everything, it's going to take a little while. But the basic thing of looking after your, I mean, it's not rocket science. But it really comes back to that basic self care that we talk a lot about. So one of the things we know for sure is helpful is getting enough sleep. Yes. Again, we're robust, resilient humans, we can cope on reduced sleep for short amounts of time, as you have been doing, as all new parents will do with the baby, as all people will do if they're working night shift, or they've got a particularly stressful event, but you cannot survive on reduced sleep year in year out.


Dr Mary Barson: (19:25) That's right. Yeah. And I do, I embrace the idea that there is a seasonality about our lives. You know, there might be one aspect of your life that you're not completely happy with, that isn't working perfectly now. And it might not always be there forever. So certainly having a young baby, I can embrace that. That's a season, you know, and it's not always going to be there and there's lots of things I can do to maximise my health beyond that. And same with shift workers. Although you might not feel that the season of your shift work is going to end anytime soon. There are still lots of levers that you can pull and you don't need to make your health worse by stressing about the fact that you're a shift worker. But your sleep, it's essential. It's biochemically, you know, essential for the repairing and restoring of our cellular processes. And that includes mitochondrial function. So sleep, literally at a cellular level, improves our health and can help treat metabolic disorders and help prevent chronic lifestyle disorders. So sleep is important.


Dr Lucy Burns: (20:27) And for some people, it isn't that they're seasonal things. It's just that they don't go to bed.


Dr Mary Barson: (20:34) Yes, yes. That’s right, yeah. I’m saying that to make me feel better. And it totally works. It makes me feel better. But yes, yes.


Dr Lucy Burns: (20:42) There are other people who just you know, and this is mine, my own challenge, is putting myself to bed. You know, I'm the boss of me and so every now and then my little rebellious side goes, “So I'm gonna stay up till two o'clock watching telly”, and it's very, very unhelpful. And future me is always a bit sad about this. So, you know, we do have a funny little phrase that is, that humans are the only mammals to voluntarily restrict our sleep. No other mammal does it; the dog just sleeps, the cats sleep anywhere. Cows. You know, they're all just asleep in the paddock. It's only us. Too clever for our own good, who invented the electric light and television.


Dr Mary Barson: (21:25) I had a pony. I'm pretty sure the pony slept in the middle of gymkhanas when I was competing. Animals just sleep when they want to.


Dr Lucy Burns: (21:34) Absolutely, absolutely. So we know sleep. We know. So food. Okay. You know, all of you lovelies, you know, we love banging on about insulin resistance. But insulin resistance is again, it's part of that clogging up your fireplace with dirty old ashes.


Dr Mary Barson: (21:52) Yes, yep. And there's emerging evidence that a carbohydrate restricted diet can have a positive impact on our mitochondrial health for many reasons. One is that they're not being bombarded by the AGES and Lucy, they are?


Dr Lucy Burns: (22:06) Advanced Glycated End Products.


Dr Mary Barson: (22:08) Thank you, my friend. If I had more sleep, that would have rolled off my tongue much more easily. And also that mitochondria function well, when they're being powered by fat, and by beta oxidation, which is something that liver mitochondria like to do. So carbohydrate restriction, low carb diets are a really useful way to help your metabolism and help your mitochondria be as healthy as they can be.


Dr Lucy Burns: (22:37) Yeah, which makes sense, you know, without sort of trying to sound like the low carbohydrate lifestyle fixes every single thing. It certainly fixes a whole lot of stuff. And we know that, you know, on a macro level it fixes fatty liver, your fatty liver can be reversed in a very short time. And then at a microscopic level, the mitochondria in your liver are improved.


Dr Mary Barson: (23:01) Yes, yeah. And the shift in metabolism to carbohydrate restriction, if, you know, allows your body to use those alternative energy sources such as fat and ketones. And that actually signals the body to make more mitochondria. So it increases mitochondrial biogenesis, which is a great word, and also can improve the function of the mitochondria. So that shifting metabolism away from primarily burning carbohydrates to burning fats and fuels means healthier mitochondria, and more of them.


Dr Lucy Burns: (23:32) And more energy. Because at the end of the day, that's what we want. We want more energy. I think, you know, if I had $1 for everybody that said they're sick and tired of being sick and tired, I'd be off in the Bahamas on my hammock drinking my low carb cocktails. Because this is it. We are living in a society where we are - we seem to be - despite the abundance of energy dense food, we are energy depleted, and we're tired. And so it's really about accessing that energy rather than just putting it all into the woodshed stored to be never seen again. If you can change the metabolic pathways and improve the health of your mitochondria. Not only will you burn your woodshed and that's always helpful, but you feel great. Like you feel good.


Dr Mary Barson: (24:24) Yes, you do, you do. Another really important part I think of your mitochondrial health and your health in general, is movement. In particular, like all movement is good movement, but movement that increases your muscle strength. So you know, strength training, that has a really positive impact on your insulin resistance and a positive impact on your mitochondria. And again, increases that mitochondrial biogenesis I think raises the number and the health of your mitochondria. It improves your ability to use oxygen. And is, I think, really critical. And I would say, and Lucy, you've said this in your fabulous menopause talk that it's particularly important for women, and particularly important for women in all stages of life, but especially post menopause. Strength training is so important to optimising your health.


Dr Lucy Burns: (25:27) Absolutely. And I know lots of us have been conditioned to think about calories and reducing calories and all of those things because you know, then we will somehow be thinner. But even if we, you know, entertain that thought, for a microsecond, the idea that if you have more mitochondria, and you get more mitochondria by building more muscle cells, and then each cell has more mitochondria in it, basically, that improves your metabolic rate so that you can literally lie around doing nothing, burning more calories.


Dr Mary Barson: (25:59) And who wouldn't want that seriously?


Dr Lucy Burns: (26:01) I know. So exercising to just burn the calories isn't helpful, because our body will counter that with hunger. But exercise that is particularly targeted at building muscle mass is incredibly helpful.


Dr Mary Barson: (26:21) Yes. And its pleiotropic, to use one of my favourite words. It has lots and lots of benefits, especially if you could find something that you enjoy. That's common sense anyway, because you’re unlikely to stick to a strength training regime that you despise. But if you can find something that you enjoy that, you know, maybe also gets you outside, maybe also gets you socialising. It has lots and lots of benefits across your whole life.


Dr Lucy Burns: (26:50) Yeah, absolutely. And again, I think for women who are, you know, sort of my age, in your 50s, we were conditioned to believe that we didn't want to get too big, too big, big, big. You don't want to be big that somehow we're all supposed to be tiny, diminutive, little invisible people. And it's actually time to get strong, strong. Strong is the new black.


Dr Mary Barson: (27:14) I like it. Yes.


Dr Lucy Burns: (27:17) So yeah, and you know, you don't need to worry that you're going to turn into Arnold Schwarzenegger, all you're going to do is to maintain your current muscles, and hopefully build a few more.


Dr Mary Barson: (27:29) Yeah, that's right. And it's good to feel strong. That's what we want. We want energy. We want strength, we want happy, healthy minds and bodies.


Dr Lucy Burns: (27:40) Indeed, indeed. Gorgeous ones. If you're looking for some more information on a low carbohydrate lifestyle, we have a free resource for you. It's called The Doctors’ Guide to Real Health and Weight Loss and you can download it now. The link will be in the show notes or you can go to our website. www.rlmedicine.com/free

Alright gorgeous listeners, that's probably it for us today. That's enough musings from Dr. Mary and Dr. Lucy. We will talk to you all again next week. Have a wonderful, wonderful week.


Dr Mary Barson: (28:19) Goodbye gorgeous listeners.


Dr Lucy Burns: (28:27) So my lovely listeners that ends this episode of Real Health and Weight Loss. I'm Dr. Lucy Burns.


Dr Mary Barson: (28:35) And I'm Dr. Mary Barson. We’re from Real Life Medicine. To contact us, please visit www.rlmedicine.com


Dr Lucy Burns: (28:45) And until next time, thanks for listening. The information shared on the Real Health and Weight Loss podcast, including show notes and links provides general information only. It is not a substitute, nor is it intended to provide individualised medical advice, diagnosis or treatment, nor can it be construed as such. Please consult your doctor for any medical concerns.



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