Guest guest Posted December 17, 2008 Report Share Posted December 17, 2008 Hi , So this means, although not fully proven, it would be a good idea to take vitamin D when I take Urso? Cheers, Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 17, 2008 Report Share Posted December 17, 2008 Dear , who seems to be the expert out there or anyone else, My son Tyler Ostos with PSC and UC has recently had trouble seeing his letters correct. He says he sees them upside down or on top of each other. We saw an optomologist who says he has 20/20 vision and can find nothing wrong with his sight. He does border on ADHD (Hyper trait) and is very bright in addition to all his other medical issues. Ty is on Urso, Remicade infusions and Azacol, Singulair. Any clues? his psychologist says Dyslexia does not normally pop up out of no where. He never had trouble reading before. But, Tyler says it is very frustrating and he is a bit frighteneed. Help???? Stevie Ostos (Mother to Tyler age 11 and McKenna age 6) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 17, 2008 Report Share Posted December 17, 2008 Dear , who seems to be the expert out there or anyone else, My son Tyler Ostos with PSC and UC has recently had trouble seeing his letters correct. He says he sees them upside down or on top of each other. We saw an optomologist who says he has 20/20 vision and can find nothing wrong with his sight. He does border on ADHD (Hyper trait) and is very bright in addition to all his other medical issues. Ty is on Urso, Remicade infusions and Azacol, Singulair. Any clues? his psychologist says Dyslexia does not normally pop up out of no where. He never had trouble reading before. But, Tyler says it is very frustrating and he is a bit frighteneed. Help???? Stevie Ostos (Mother to Tyler age 11 and McKenna age 6) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 17, 2008 Report Share Posted December 17, 2008 Dear , who seems to be the expert out there or anyone else, My son Tyler Ostos with PSC and UC has recently had trouble seeing his letters correct. He says he sees them upside down or on top of each other. We saw an optomologist who says he has 20/20 vision and can find nothing wrong with his sight. He does border on ADHD (Hyper trait) and is very bright in addition to all his other medical issues. Ty is on Urso, Remicade infusions and Azacol, Singulair. Any clues? his psychologist says Dyslexia does not normally pop up out of no where. He never had trouble reading before. But, Tyler says it is very frustrating and he is a bit frighteneed. Help???? Stevie Ostos (Mother to Tyler age 11 and McKenna age 6) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 17, 2008 Report Share Posted December 17, 2008 Dear Stevie; I am by no means an expert (but I did stay at a Holiday Inn last night!) ... sorry, I couldn't resist that attempt at a joke based on a T.V. commercial in the U.S. Seriosly, our son suffered from dyslexia throughout school. He had one-on-one assistance from a reading specialist (a wonderful lady!) who helped him considerably. He also had " accommodations " (extra time for exams). In hindsight we think he may have had an omega-3 deficiency. Our reasoning is as follows: 1. He hardly ever ate fish (the main dietary source of omega-3's). 2. When he went on fish oil supplements, his acne (skin inflammation) improved dramatically, and he now reports markedly improved reading comprehension [he's now in medical school and has to do a great of reading!]. 3. Docosahexaenoic acid (DHA) is a major component of fish oil, and is the main omega-3 fatty acid in the brain. There's growing evidence that DHA has beneficial effects in dyslexia, see for example: J Med Food. 2007 Dec;10(4):662-6. A 5-month open study with long-chain polyunsaturated fatty acids in dyslexia. Lindmark L, Clough P Falsterbo, Sweden. lars.lindmark@... This open pilot study investigated effects of a docosahexaenoic acid (DHA)-rich supplement on learning ability in a group of 20 dyslexic children in Sweden. Children formally diagnosed as dyslexic took eight capsules per day of a long-chain polyunsaturated fatty acid (LC- PUFA) supplement containing high-DHA fish oil and evening primrose oil. Subjective assessments by the children and their parents were completed at baseline and 6, 12, and 20 weeks after supplementation. Quantitative evaluation by word-chain test was completed before and after 4 months of supplementation to measure word decoding (speed of reading) and letter decoding (motoric-perceptual speed). Subjective parent and child assessments showed increasing numbers of positive responders over time in reading speed, general schoolwork, and overall perceived benefit. Significant improvements were observed in reading speed and motor-perceptual velocity. Thirteen of 17 children had a significant improvement on the word-chain test (P < .04). Reading speed improved by 60% from 1.76 +/- 0.29 before the study to 2.82 +/- 0.36 after supplementation (P < .01 by Wilcoxon sign test). Motoric-perceptual velocity improved by 23% from a stanine value of 3.76 +/- 0.42 to 4.65 +/- 0.66 after supplementation (P < .05 by Wilcoxon sign test). Thus LC-PUFA supplementation for 5 months provides positive and clear beneficial effect on variables usually impaired by dyslexia. PMID: 18158838. A recent PSC Partners Seeking a Cure award for best research presented at the 2008 AASLD meeting went to a group that is studying the beneficial effects of DHA in primary sclerosing cholangitis! It improves liver function tests (alkaline phosphatase). My reading indicates that DHA could be serving as an activator of the retinoid X receptor (RXR), which is a master controller of liver bile acid metabolism and transport. I can provide references on this topic if you are interested. I think that DHA-deficiency is a common thread that links autoimmune (autoinflammatory) disease, PSC, reading disorders and depression. If Tyler is not already taking fish oils, please consider talking to Tyler's doctor(s) about this supplement. Best regards, Dave (father of (23); PSC 07/03; UC 08/03) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 17, 2008 Report Share Posted December 17, 2008 , After taking the fish oil (omega 3) does your son still have Dyslexia? Lori A. "Aggressively Pursuing Solutions To Your Real Estate Needs!" First Weber Group Cell: 1507 E. Sunset Drive Waukesha, WI 53189 LoriUSA@... www.Lori.FirstWeber.com To: Sent: Wednesday, December 17, 2008 1:26:04 PMSubject: Re: Ursodiol and vitamin D help keep bile sterile Dear Stevie;I am by no means an expert (but I did stay at a Holiday Inn last night!) ... sorry, I couldn't resist that attempt at a joke based on a T.V. commercial in the U.S. Seriosly, our son suffered from dyslexia throughout school. He had one-on-one assistance from a reading specialist (a wonderful lady!) who helped him considerably. He also had "accommodations" (extra time for exams). In hindsight we think he may have had an omega-3 deficiency. Our reasoning is as follows:1. He hardly ever ate fish (the main dietary source of omega-3's).2. When he went on fish oil supplements, his acne (skin inflammation) improved dramatically, and he now reports markedly improved reading comprehension [he's now in medical school and has to do a great of reading!].3. Docosahexaenoic acid (DHA) is a major component of fish oil, and is the main omega-3 fatty acid in the brain. There's growing evidence that DHA has beneficial effects in dyslexia, see for example:J Med Food. 2007 Dec;10(4):662- 6. A 5-month open study with long-chain polyunsaturated fatty acids in dyslexia.Lindmark L, Clough PFalsterbo, Sweden. lars.lindmark@ telia.comThis open pilot study investigated effects of a docosahexaenoic acid (DHA)-rich supplement on learning ability in a group of 20 dyslexic children in Sweden. Children formally diagnosed as dyslexic took eight capsules per day of a long-chain polyunsaturated fatty acid (LC-PUFA) supplement containing high-DHA fish oil and evening primrose oil. Subjective assessments by the children and their parents were completed at baseline and 6, 12, and 20 weeks after supplementation. Quantitative evaluation by word-chain test was completed before and after 4 months of supplementation to measure word decoding (speed of reading) and letter decoding (motoric-perceptual speed). Subjective parent and child assessments showed increasing numbers of positive responders over time in reading speed, general schoolwork, and overall perceived benefit. Significant improvements were observed in reading speed and motor-perceptual velocity. Thirteen of 17 children had a significant improvement on the word-chain test (P < .04). Reading speed improved by 60% from 1.76 +/- 0.29 before the study to 2.82 +/- 0.36 after supplementation (P < .01 by Wilcoxon sign test). Motoric-perceptual velocity improved by 23% from a stanine value of 3.76 +/- 0.42 to 4.65 +/- 0.66 after supplementation (P < .05 by Wilcoxon sign test). Thus LC-PUFA supplementation for 5 months provides positive and clear beneficial effect on variables usually impaired by dyslexia. PMID: 18158838.A recent PSC Partners Seeking a Cure award for best research presented at the 2008 AASLD meeting went to a group that is studying the beneficial effects of DHA in primary sclerosing cholangitis! It improves liver function tests (alkaline phosphatase) .My reading indicates that DHA could be serving as an activator of the retinoid X receptor (RXR), which is a master controller of liver bile acid metabolism and transport. I can provide references on this topic if you are interested.I think that DHA-deficiency is a common thread that links autoimmune (autoinflammatory) disease, PSC, reading disorders and depression. If Tyler is not already taking fish oils, please consider talking to Tyler's doctor(s) about this supplement.Best regards,Dave (father of (23); PSC 07/03; UC 08/03) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 17, 2008 Report Share Posted December 17, 2008 Hi ; Yes, I think that would be a good idea. Many patients with IBD and PSC develop vitamin deficiencies (including vitamins A, D, E and K). Vitamin D is very important for bone health, protection against colon cancer, protection against autoimmune diseases, and would now seem to have the added benefit of keeping the bile sterile (at least according to the article I posted yesterday): Nutr. Rev. 66 (10 Suppl 2): S182-S194 (2008) Vitamin D: a D-lightful health perspective. Holick MF The Department of Medicine, Section of Endocrinology, Nutrition, and Diabetes, Vitamin D, Skin and Bone Research Laboratory, Boston University Medical Center, Boston, Massachusetts, USA. mfholick@... Sunlight provides most humans with their vitamin D requirement. Adequate vitamin D(3) by synthesis in the skin or from dietary and supplemental sources is essential for bone health throughout life. Vitamin D deficiency is defined as a 25(OH)D concentration <20 ng/mL (50 nmol/L); vitamin D sufficiency as a 25(OH)D >30 ng/mL (75 nmol/L), and insufficiency as 21-29 ng/mL. Vitamin D deficiency and insufficiency has been linked to a wide variety of chronic diseases including common cancers, autoimmune, cardiovascular, and infectious diseases. Healthcare professionals need to be aware of the vitamin D deficiency pandemic. Guidelines for sensible sun exposure and supplemental vitamin D of 800-1000 IU/day are needed. PMID: 18844847. Vitamin A is also very important for your immune system: Ann. N. Y. Acad. Sci. 1143: 170-87 (2008) Retinoic acid in the immune system. Pino-Lagos K, Benson MJ, Noelle RJ Department of Microbiology and Immunology, Dartmouth College, Dartmouth Medical School, Lebanon, NH 03756, USA. On occasion, emerging scientific fields intersect and great discoveries result. In the last decade, the discovery of regulatory T cells (T (reg)) in immunity has revolutionized our understanding of how the immune system is controlled. Intersecting the rapidly emerging field of T(reg) function, has been the discovery that retinoic acid (RA) controls both the homing and differentiation of T(reg). Instantly, the wealth and breadth of knowledge of the molecular basis for RA action, its receptors, and how it controls cellular differentiation can and will be exploited to understand its profound effects on T(reg). Historically, vitamin A deprivation and repletion and RA agonists have been shown to profoundly affect immunity. Now these findings can be interpreted in light of the revelations that RA controls leukocyte homing and T(reg) function. PMID: 19076350. But you have to be very cautious in not " over-dosing " with vitamin A. At high levels is can be toxic to the liver: J. Am. Diet. Assoc. 108: 1536-1537 (2008) Potential liver damage associated with over-the-counter vitamin supplements. Sheth A, Khurana R, Khurana V Department of Gastroenterology, and R. Khurana is clinical fellow, Department of Rheumatology, Louisiana State University Health Sciences Center, Shreveport, LA, USA. The growing popularity and availability of over-the-counter (OTC) health products, including vitamins, raises serious concern about vitamin toxicity. We report a case of cirrhosis in a patient with habitual daily ingestion of an OTC dietary supplement that contained 13,000 microg vitamin A and was associated with marked clinical improvement after discontinuation. This case highlights the potential for liver damage that may be associated with long-term intake of OTC vitamin supplements, and indicates the need for medical supervision of such products. PMID: 18755329. So you should not self-medicate with vitamin A; please see you doctor if you suspect vitamin A deficiency so that he/she can work with you to carefully correct the deficiency. Best regards, Dave (father of (23); PSC 07/03; UC 08/03) > > Hi , > > So this means, although not fully proven, it would be a good idea to > take vitamin D when I take Urso? > > Cheers, > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 17, 2008 Report Share Posted December 17, 2008 Hi Lori; He says that his reading ability and concentration have increased dramatically. Best regards, Dave R. > After taking the fish oil (omega 3) does your son still have Dyslexia? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 17, 2008 Report Share Posted December 17, 2008 Hi Lori; He says that his reading ability and concentration have increased dramatically. Best regards, Dave R. > After taking the fish oil (omega 3) does your son still have Dyslexia? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 20, 2008 Report Share Posted December 20, 2008 To: Sent: Wednesday, December 17, 2008 12:46:32 PMSubject: Re: Re: Ursodiol and vitamin D help keep bile sterile , After taking the fish oil (omega 3) does your son still have Dyslexia? Lori A. "Aggressively Pursuing Solutions To Your Real Estate Needs!" First Weber Group Cell: 1507 E. Sunset Drive Waukesha, WI 53189 LoriUSA@ Yahoo.com www.Lori.FirstWeber .com From: <rhodesdavid1@ comcast.net>To: @ yahoogroups. comSent: Wednesday, December 17, 2008 1:26:04 PMSubject: Re: Ursodiol and vitamin D help keep bile sterile Dear Stevie;I am by no means an expert (but I did stay at a Holiday Inn last night!) ... sorry, I couldn't resist that attempt at a joke based on a T.V. commercial in the U.S. Seriosly, our son suffered from dyslexia throughout school. He had one-on-one assistance from a reading specialist (a wonderful lady!) who helped him considerably. He also had "accommodations" (extra time for exams). In hindsight we think he may have had an omega-3 deficiency. Our reasoning is as follows:1. He hardly ever ate fish (the main dietary source of omega-3's).2. When he went on fish oil supplements, his acne (skin inflammation) improved dramatically, and he now reports markedly improved reading comprehension [he's now in medical school and has to do a great of reading!].3. Docosahexaenoic acid (DHA) is a major component of fish oil, and is the main omega-3 fatty acid in the brain. There's growing evidence that DHA has beneficial effects in dyslexia, see for example:J Med Food. 2007 Dec;10(4):662- 6. A 5-month open study with long-chain polyunsaturated fatty acids in dyslexia.Lindmark L, Clough PFalsterbo, Sweden. lars.lindmark@ telia.comThis open pilot study investigated effects of a docosahexaenoic acid (DHA)-rich supplement on learning ability in a group of 20 dyslexic children in Sweden. Children formally diagnosed as dyslexic took eight capsules per day of a long-chain polyunsaturated fatty acid (LC-PUFA) supplement containing high-DHA fish oil and evening primrose oil. Subjective assessments by the children and their parents were completed at baseline and 6, 12, and 20 weeks after supplementation. Quantitative evaluation by word-chain test was completed before and after 4 months of supplementation to measure word decoding (speed of reading) and letter decoding (motoric-perceptual speed). Subjective parent and child assessments showed increasing numbers of positive responders over time in reading speed, general schoolwork, and overall perceived benefit. Significant improvements were observed in reading speed and motor-perceptual velocity. Thirteen of 17 children had a significant improvement on the word-chain test (P < .04). Reading speed improved by 60% from 1.76 +/- 0.29 before the study to 2.82 +/- 0.36 after supplementation (P < .01 by Wilcoxon sign test). Motoric-perceptual velocity improved by 23% from a stanine value of 3.76 +/- 0.42 to 4.65 +/- 0.66 after supplementation (P < .05 by Wilcoxon sign test). Thus LC-PUFA supplementation for 5 months provides positive and clear beneficial effect on variables usually impaired by dyslexia. PMID: 18158838.A recent PSC Partners Seeking a Cure award for best research presented at the 2008 AASLD meeting went to a group that is studying the beneficial effects of DHA in primary sclerosing cholangitis! It improves liver function tests (alkaline phosphatase) .My reading indicates that DHA could be serving as an activator of the retinoid X receptor (RXR), which is a master controller of liver bile acid metabolism and transport. I can provide references on this topic if you are interested.I think that DHA-deficiency is a common thread that links autoimmune (autoinflammatory) disease, PSC, reading disorders and depression. If Tyler is not already taking fish oils, please consider talking to Tyler's doctor(s) about this supplement.Best regards,Dave (father of (23); PSC 07/03; UC 08/03) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 20, 2008 Report Share Posted December 20, 2008 To: Sent: Wednesday, December 17, 2008 12:46:32 PMSubject: Re: Re: Ursodiol and vitamin D help keep bile sterile , After taking the fish oil (omega 3) does your son still have Dyslexia? Lori A. "Aggressively Pursuing Solutions To Your Real Estate Needs!" First Weber Group Cell: 1507 E. Sunset Drive Waukesha, WI 53189 LoriUSA@ Yahoo.com www.Lori.FirstWeber .com From: <rhodesdavid1@ comcast.net>To: @ yahoogroups. comSent: Wednesday, December 17, 2008 1:26:04 PMSubject: Re: Ursodiol and vitamin D help keep bile sterile Dear Stevie;I am by no means an expert (but I did stay at a Holiday Inn last night!) ... sorry, I couldn't resist that attempt at a joke based on a T.V. commercial in the U.S. Seriosly, our son suffered from dyslexia throughout school. He had one-on-one assistance from a reading specialist (a wonderful lady!) who helped him considerably. He also had "accommodations" (extra time for exams). In hindsight we think he may have had an omega-3 deficiency. Our reasoning is as follows:1. He hardly ever ate fish (the main dietary source of omega-3's).2. When he went on fish oil supplements, his acne (skin inflammation) improved dramatically, and he now reports markedly improved reading comprehension [he's now in medical school and has to do a great of reading!].3. Docosahexaenoic acid (DHA) is a major component of fish oil, and is the main omega-3 fatty acid in the brain. There's growing evidence that DHA has beneficial effects in dyslexia, see for example:J Med Food. 2007 Dec;10(4):662- 6. A 5-month open study with long-chain polyunsaturated fatty acids in dyslexia.Lindmark L, Clough PFalsterbo, Sweden. lars.lindmark@ telia.comThis open pilot study investigated effects of a docosahexaenoic acid (DHA)-rich supplement on learning ability in a group of 20 dyslexic children in Sweden. Children formally diagnosed as dyslexic took eight capsules per day of a long-chain polyunsaturated fatty acid (LC-PUFA) supplement containing high-DHA fish oil and evening primrose oil. Subjective assessments by the children and their parents were completed at baseline and 6, 12, and 20 weeks after supplementation. Quantitative evaluation by word-chain test was completed before and after 4 months of supplementation to measure word decoding (speed of reading) and letter decoding (motoric-perceptual speed). Subjective parent and child assessments showed increasing numbers of positive responders over time in reading speed, general schoolwork, and overall perceived benefit. Significant improvements were observed in reading speed and motor-perceptual velocity. Thirteen of 17 children had a significant improvement on the word-chain test (P < .04). Reading speed improved by 60% from 1.76 +/- 0.29 before the study to 2.82 +/- 0.36 after supplementation (P < .01 by Wilcoxon sign test). Motoric-perceptual velocity improved by 23% from a stanine value of 3.76 +/- 0.42 to 4.65 +/- 0.66 after supplementation (P < .05 by Wilcoxon sign test). Thus LC-PUFA supplementation for 5 months provides positive and clear beneficial effect on variables usually impaired by dyslexia. PMID: 18158838.A recent PSC Partners Seeking a Cure award for best research presented at the 2008 AASLD meeting went to a group that is studying the beneficial effects of DHA in primary sclerosing cholangitis! It improves liver function tests (alkaline phosphatase) .My reading indicates that DHA could be serving as an activator of the retinoid X receptor (RXR), which is a master controller of liver bile acid metabolism and transport. I can provide references on this topic if you are interested.I think that DHA-deficiency is a common thread that links autoimmune (autoinflammatory) disease, PSC, reading disorders and depression. If Tyler is not already taking fish oils, please consider talking to Tyler's doctor(s) about this supplement.Best regards,Dave (father of (23); PSC 07/03; UC 08/03) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 20, 2008 Report Share Posted December 20, 2008 To: Sent: Wednesday, December 17, 2008 12:46:32 PMSubject: Re: Re: Ursodiol and vitamin D help keep bile sterile , After taking the fish oil (omega 3) does your son still have Dyslexia? Lori A. "Aggressively Pursuing Solutions To Your Real Estate Needs!" First Weber Group Cell: 1507 E. Sunset Drive Waukesha, WI 53189 LoriUSA@ Yahoo.com www.Lori.FirstWeber .com From: <rhodesdavid1@ comcast.net>To: @ yahoogroups. comSent: Wednesday, December 17, 2008 1:26:04 PMSubject: Re: Ursodiol and vitamin D help keep bile sterile Dear Stevie;I am by no means an expert (but I did stay at a Holiday Inn last night!) ... sorry, I couldn't resist that attempt at a joke based on a T.V. commercial in the U.S. Seriosly, our son suffered from dyslexia throughout school. He had one-on-one assistance from a reading specialist (a wonderful lady!) who helped him considerably. He also had "accommodations" (extra time for exams). In hindsight we think he may have had an omega-3 deficiency. Our reasoning is as follows:1. He hardly ever ate fish (the main dietary source of omega-3's).2. When he went on fish oil supplements, his acne (skin inflammation) improved dramatically, and he now reports markedly improved reading comprehension [he's now in medical school and has to do a great of reading!].3. Docosahexaenoic acid (DHA) is a major component of fish oil, and is the main omega-3 fatty acid in the brain. There's growing evidence that DHA has beneficial effects in dyslexia, see for example:J Med Food. 2007 Dec;10(4):662- 6. A 5-month open study with long-chain polyunsaturated fatty acids in dyslexia.Lindmark L, Clough PFalsterbo, Sweden. lars.lindmark@ telia.comThis open pilot study investigated effects of a docosahexaenoic acid (DHA)-rich supplement on learning ability in a group of 20 dyslexic children in Sweden. Children formally diagnosed as dyslexic took eight capsules per day of a long-chain polyunsaturated fatty acid (LC-PUFA) supplement containing high-DHA fish oil and evening primrose oil. Subjective assessments by the children and their parents were completed at baseline and 6, 12, and 20 weeks after supplementation. Quantitative evaluation by word-chain test was completed before and after 4 months of supplementation to measure word decoding (speed of reading) and letter decoding (motoric-perceptual speed). Subjective parent and child assessments showed increasing numbers of positive responders over time in reading speed, general schoolwork, and overall perceived benefit. Significant improvements were observed in reading speed and motor-perceptual velocity. Thirteen of 17 children had a significant improvement on the word-chain test (P < .04). Reading speed improved by 60% from 1.76 +/- 0.29 before the study to 2.82 +/- 0.36 after supplementation (P < .01 by Wilcoxon sign test). Motoric-perceptual velocity improved by 23% from a stanine value of 3.76 +/- 0.42 to 4.65 +/- 0.66 after supplementation (P < .05 by Wilcoxon sign test). Thus LC-PUFA supplementation for 5 months provides positive and clear beneficial effect on variables usually impaired by dyslexia. PMID: 18158838.A recent PSC Partners Seeking a Cure award for best research presented at the 2008 AASLD meeting went to a group that is studying the beneficial effects of DHA in primary sclerosing cholangitis! It improves liver function tests (alkaline phosphatase) .My reading indicates that DHA could be serving as an activator of the retinoid X receptor (RXR), which is a master controller of liver bile acid metabolism and transport. I can provide references on this topic if you are interested.I think that DHA-deficiency is a common thread that links autoimmune (autoinflammatory) disease, PSC, reading disorders and depression. If Tyler is not already taking fish oils, please consider talking to Tyler's doctor(s) about this supplement.Best regards,Dave (father of (23); PSC 07/03; UC 08/03) Quote Link to comment Share on other sites More sharing options...
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