Phone: 203-857-7023 Email: NK-FinAid@norwalk.edu. [14] Blood flow, blood transit time, and organ blood volume, can all be calculated with reasonable sensitivity and specificity. Straps and pillows may be used to help you stay in position. CT scans are painless and, with newer machines, take only a few minutes. CT can also be used to image the head in order to locate injuries, tumors, clots leading to stroke, hemorrhage, and other conditions. [150] A 2012 review did not find an association between medical radiation and cancer risk in children noting however the existence of limitations in the evidences over which the review is based. The low doses of radiation used in CT scans have not been shown to cause long-term harm, although at much higher doses, there may be a small increase in your potential risk of cancer. Most reactions are mild and result in a rash or itchiness. This type of test is used to look for possible obstructions in blood vessels, including those in the heart. The sievert unit, in the context of CT scans, does not correspond to the actual radiation dose that the scanned body part absorbs but to another radiation dose of another scenario, the whole body absorbing the other radiation dose and the other radiation dose being of a magnitude, estimated to have the same probability to induce cancer as the CT scan. ACR-SPR practice parameter for imaging pregnant or potentially pregnant adolescents and women with ionizing radiation. Together, we will revitalize Connecticuts economy to bring opportunity and prosperity to every one of our communities. Useful for identifying the internal structures of a solid organ or the walls of hollow structures, such as intestines. The 1979 Nobel Prize in Physiology or Medicine was awarded jointly to South African-American physicist Allan MacLeod Cormack and British electrical engineer Godfrey Hounsfield "for the development of computer-assisted tomography". [189][190] In October 1963, William H. Oldendorf received a U.S. patent for a "radiant energy apparatus for investigating selected areas of interior objects obscured by dense material". However, this technique is susceptible to noise and other factors which can affect the linearity of the voltage to x-ray intensity relationship. Useful for assessing the lung parenchyma. [65], CT scanning has also found an application in transport security (predominantly airport security) where it is currently used in a materials analysis context for explosives detection CTX (explosive-detection device)[66][67][68][69] and is also under consideration for automated baggage/parcel security scanning using computer vision based object recognition algorithms that target the detection of specific threat items based on 3D appearance (e.g. [126] Second, CT scans have greater image resolution, enabling examination of finer details. The attenuation of metallic implants depends on the atomic number of the element used: Titanium usually has an amount of +1000HU, iron steel can completely extinguish the X-ray and is, therefore, responsible for well-known line-artifacts in computed tomograms. Mayo Clinic on Incontinence - Mayo Clinic Press, NEW The Essential Diabetes Book - Mayo Clinic Press, NEW Mayo Clinic on Hearing and Balance - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, Sign up for Email: Get Your Free Resource Coping with Cancer, Multisystem inflammatory syndrome in children (MIS-C), Persistent post-concussive symptoms (Post-concussion syndrome), Pseudotumor cerebri (idiopathic intracranial hypertension), CT scan of brain tissue damaged by stroke, Paraneoplastic syndromes of the nervous system, Spontaneous coronary artery dissection (SCAD), Mayo Clinic installs 1st Quadra PET/CT scanner in North America, AI applied to prediagnostic CTs may help diagnose pancreatic cancer at earlier, more treatable stage, With photon-counting-detector CT, Mayo Clinic at forefront of CT imaging technology. In addition to the use of intravenous contrast, orally administered contrast agents are frequently used when examining the abdomen. [184] These cross-sectional images are made up of small units of pixels or voxels. PCDs have several potential advantages, including improving signal (and contrast) to noise ratios, reducing doses, improving spatial resolution, and through use of several energies, distinguishing multiple contrast agents. After the hearing has been completed, the hearing officer will issue a [163] While there is some variation, most people (99%) received less than 7mSv per year as background radiation. The contrast material blocks X-rays and appears white on images, which can help emphasize blood vessels, intestines or other structures. Each time the x-ray source completes one full rotation, the CT computer uses sophisticated mathematical techniques to construct a two-dimensional image slice of the patient. the unsubscribe link in the e-mail. However, oral alternatives to iodinated contrast exist, such as very dilute (0.51% w/v) barium sulfate suspensions. However, if neither of those can provide the answers needed, or there is an emergency or other time constraint, CT may be an acceptable alternative imaging option. [195], The term "CAT scan" is no longer used because current CT scans enable for multiplanar reconstructions. Educational Neglect in CT DCF Investigations The CT Dept. Varied types of fungus can degrade wood to different degrees, one Belgium research group has been used X-ray CT 3 dimension with sub-micron resolution unveiled fungi can penetrate micropores of 0.6 m[80] under certain conditions. CT scans can also be used for fluid or tissue biopsies, or as part of preparation for surgery or treatment. Typical CT scanners use energy integrating detectors; photons are measured as a voltage on a capacitor which is proportional to the x-rays detected. [30] CT scan often incidentally finds thyroid abnormalities, and so is often the preferred investigation modality for thyroid abnormalities. A CT scan in a pregnant woman poses no known risks to the baby if the area of the body being imaged isnt the abdomen or pelvis. Modern scanners allow the scan data to be reformatted as images in other planes. Over 40% of them lost patches of hair, and prompted the editorial to call for increased CT quality assurance programs. Tell your doctor if you're pregnant. 3. Did the reporter know it was false? The pixel itself is displayed according to the mean attenuation of the tissue(s) that it corresponds to on a scale from +3,071 (most attenuating) to 1,024 (least attenuating) on the Hounsfield scale. Some of the key uses for CT scanning have been flaw detection, failure analysis, metrology, assembly analysis, image-based finite element methods[64] and reverse engineering applications. Password must have 9+ characters; Password must have 1 capital letter; Password must have 1 number; Password must have 1 lower case letter; Password must have 1 special character Artifacts are caused by abrupt transitions between low- and high-density materials, which results in data values that exceed the dynamic range of the processing electronics. At the low doses of radiation used in CT imaging, no negative effects have been observed in humans. Connecticut has several resources available that help residents pay heating and utility expenses. of Children & Families investigates suspected child abuse and neglect. A computed tomography scan (usually abbreviated to CT scan; formerly called computed axial tomography scan or CAT scan) is a medical imaging technique used to obtain detailed internal images of the body. For cross-sectional images used in industry, see, Modern CT scanner (2021), photon-counting CT (Siemens NAEOTOM Alpha), Multiplanar reconstruction and projections, Please expand the section to include this information. File a Complaint File a Complaint The Department of Children and Families takes all complaints seriously. 490 Broad Street Directions New London, CT 06320. Digital geometry processing can generate a three-dimensional image of an object inside the body from a series of two-dimensional radiographic images taken by rotation around a fixed axis. During a head scan, the table may be fitted with a special cradle that holds your head still. Over 256 patients were exposed to radiations for over 18-month period. In response to increased concern by the public and the ongoing progress of best practices, the Alliance for Radiation Safety in Pediatric Imaging was formed within the Society for Pediatric Radiology. Fast imaging reduces motion blurring at high heart rates and potentially allowing for shorter breath-hold time. [30], A CT scan can be used for detecting both acute and chronic changes in the lung parenchyma, the tissue of the lungs. This is a risk that increases with the number of exposures added up over the life of an individual. [185], Pixels in an image obtained by CT scanning are displayed in terms of relative radiodensity. Get Form How to create an eSignature for the dcf 136 2015 2019 form Further details may exist on the, Advanced documentation methods in studying Corinthian black-figure vase painting. Click here to scroll through the image stacks. [7] This type had a major advantage since sweep speeds can be much faster, allowing for less blurry imaging of moving structures, such as the heart and arteries. [210] Photon counting detectors (PCDs) are still affected by noise but it does not change the measured counts of photons. The main limitation of this type of CT is the bulk and inertia of the equipment (X-ray tube assembly and detector array on the opposite side of the circle) which limits the speed at which the equipment can spin. [156][158] If you have an issue with one of our programs and need resolution, we want to make sure it reaches the right person. [36] For this reason, and because no research provides supporting evidence that intensive surveillance gives better outcomes, and because of risks associated with having CT scans, patients should not receive CT screening in excess of those recommended by established guidelines. - Cincinnati Children's Blog", "Difference Between CT Scan and CAT Scan | Difference Between", "Optimal levels of radiation for patients", "Global Initiative on Radiation Safety in Healthcare Settings", "Use of advanced radiology during visits to US emergency departments for injury-related conditions, 19982007", "Global Computed Tomography (CT) Scanners Devices and Equipment Market Report 2020: Major Players are GE Healthcare, Koninklijke Philips, Hitachi, Siemens and Canon Medical Systems ResearchAndMarkets.com", "Vision 20/20: Single photon counting x-ray detectors in medical imaging", "NIH uses photon-counting CT scanner in patients for the first time", "Is it possible to kill the radiation risk issue in computed tomography? Water has an attenuation of 0 Hounsfield units (HU), while air is 1,000HU, cancellous bone is typically +400HU, and cranial bone can reach 2,000HU or more (os temporale) and can cause artifacts. information is beneficial, we may combine your email and website usage information with Connecticut laws continue to ensure that reproductive healthcare remains safe, legal, and accessible for all who need it. Contact a DCF defense attorney before speaking to DCF. CT scan images provide more-detailed information than plain X-rays do. [4], Spinning tube, commonly called spiral CT, or helical CT, is an imaging technique in which an entire X-ray tube is spun around the central axis of the area being scanned. If DCF accepts a referral, a caseworker can appear at your home without warning. National Institute of Biomedical Imaging and Bioengineering (NIBIB). While CT is most prominently used in medical diagnosis, it can also be used to form images of non-living objects. [135], An Australian study of 10.9million people reported that the increased incidence of cancer after CT scan exposure in this cohort was mostly due to irradiation. [149] The International Commission on Radiological Protection estimates that the risk to a fetus being exposed to 10 mGy (a unit of radiation exposure) increases the rate of cancer before 20 years of age from 0.03% to 0.04% (for reference a CT pulmonary angiogram exposes a fetus to 4mGy). A CT scan can show detailed images of any part of the body, including the bones, muscles, organs and blood vessels. [102], Surface rendering is limited technique as it displays only the surfaces that meet a particular threshold density, and which are towards the viewer. [135] However, a lumbar spine x-ray has a similar dose as a head CT.[136] Articles in the media often exaggerate the relative dose of CT by comparing the lowest-dose x-ray techniques (chest x-ray) with the highest-dose CT techniques. Northwestern CT Community College Park Place East, Winsted, CT. For many fragile objects, direct research and observation can be damaging and can degrade the object over time. There is a higher risk of mortality in those who are female, elderly or in poor health, usually secondary to either anaphylaxis or acute kidney injury.[154]. [153], In the United States half of CT scans are contrast CTs using intravenously injected radiocontrast agents. [75], X-ray CT and micro-CT can also be used for the conservation and preservation of objects of cultural heritage. Diagnose muscle and bone disorders, such as bone tumors and fractures, Pinpoint the location of a tumor, infection or blood clot, Guide procedures such as surgery, biopsy and radiation therapy, Detect and monitor diseases and conditions such as cancer, heart disease, lung nodules and liver masses, Monitor the effectiveness of certain treatments, such as cancer treatment, Detect internal injuries and internal bleeding, Take off some or all of your clothing and wear a hospital gown, Remove metal objects, such as a belt, jewelry, dentures and eyeglasses, which might interfere with image results, Refrain from eating or drinking for a few hours before your scan. A CT scan can be used to visualize nearly all parts of the body and is used to diagnose disease or injury as well as to plan medical, surgical or radiation treatment. A radiologist interprets these images and sends a report to your doctor. Living. Attorneys Courts Jurors Media Public Victims Committees / Meetings Directions E-Services Forms Help Jobs However, In volume rendering, transparency, colours and shading are used which makes it easy to present a volume in a single image. [22] Of the above, hypodense (dark) structures can indicate edema and infarction, hyperdense (bright) structures indicate calcifications and haemorrhage and bone trauma can be seen as disjunction in bone windows. As with allx-rays, dense structures within the bodysuch as boneare easily imaged, whereas soft tissues vary in their ability to stop x-rays and therefore may be faint or difficult to see. By using medical images and patient outcomes, clinicians can train machine learning-based technologies to recognize patterns and predict responses. [59][60] With modern dual-energy CT scanners, new areas of use have been established, such as aiding in the diagnosis of gout. Directories Home; Administration - PDF; Adult Probation; Bail Services; Court Service Centers; Court Support Services; Directions; Family Services; Family Support Magistrates; Geographical Areas; Housing; Judges; Judicial Districts; Juvenile Detention; Juvenile Matters - PDF; Juvenile Probation; Law You may have a CT scan at a hospital or imaging center. Although the radiation from a CT scan is unlikely to injure your baby, your doctor may recommend another type of exam, such as ultrasound or MRI, to avoid exposing your baby to radiation. [94], MPR is used almost in every scan. Driven by Trust. Deciding whether and how to treat incidentalomas is complex, radiation exposure is not negligible, and the money for the scans involves opportunity cost. DCF Investigations You dont need to let DCF into your house without having an attorney present! Doctors use the lowest dose of radiation possible to obtain the needed medical information. [77][78] Further examples of use cases in archaeology is imaging the contents of sarcophagi or ceramics.[79]. Shortening of the scanning time to around 1 second, eliminating the strict need for the subject to remain still or be sedated, is one of the main reasons for the large increase in the pediatric population (especially for the diagnosis of appendicitis). [129][130] Virtual colonography is far more accurate than a barium enema for detection of tumors and uses a lower radiation dose. CT stands for computerized tomography and CAT stands for computerized axial tomography. [151], CT scans can be performed with different settings for lower exposure in children with most manufacturers of CT scans as of 2007 having this function built in. [19] An estimated 72million scans were performed in the United States in 2007,[20] accounting for close to half of the total per-capita dose rate from radiologic and nuclear medicine procedures. [159] This occurs in 2 to 7% of people who receive these agents, with greater risk in those who have preexisting kidney failure,[159] preexisting diabetes, or reduced intravascular volume. [23][24][25][26][27][28], Contrast CT is generally the initial study of choice for neck masses in adults. Phone: 860-932-4003 [149] Similar increases have been seen in Europe and Asia. [206] Of the CT scans, six to eleven percent are done in children,[150] an increase of seven to eightfold from 1980. Norwalk Community College 188 Richards Ave, Norwalk, CT. [211][212] PCDs have only recently become feasible in CT scanners due to improvements in detector technologies that can cope with the volume and rate of data required. Radiation-emitting products: Computed tomography (CT). Calibrated automated thrombogram (CT or CAT), a coagulation test. For this reason, contrast agents have been developed that are highly visible in an x-ray or CT scan and are safe to use in patients. Individualize the examination and adjust the radiation dose to the body type and body organ examined. [152], Major manufacturers of CT Scanners Devices and Equipment are:[209], Photon-counting computed tomography is a CT technique currently under development. Oops, something went wrong Please go back to your application home page and start your journey again. Dilute barium sulfate has the advantage that it does not cause allergic-type reactions or kidney failure, but cannot be used in patients with suspected bowel perforation or suspected bowel injury, as leakage of barium sulfate from damaged bowel can cause fatal peritonitis. [106], Although images produced by CT are generally faithful representations of the scanned volume, the technique is susceptible to a number of artifacts, such as the following:[110][111]Chapters 3 and 5, CT scanning has several advantages over traditional two-dimensional medical radiography. However, increased dosage raises the adverse side effects, including the risk of radiation-induced cancer a four-phase abdominal CT gives the same radiation dose as 300 chest X-rays. During a CT scan, you're briefly exposed to ionizing radiation. The multiple X-ray measurements taken from different angles are then processed on a computer using tomographic reconstruction algorithms to produce tomographic (cross-sectional) images (virtual "slices") of a body. (Proceedings)", "Modern imaging of the tracheo-bronchial tree", "Role of curved planar reformations using multidetector spiral CT in diagnosis of pancreatic and peripancreatic diseases", "Three-dimensional Volume Rendering of Spiral CT Data: Theory and Method", "Noninvasive Coronary Imaging Using Electron Beam CT: Surface Rendering Versus Volume Rendering", "Radiation Exposures to Patients from CT: Reality, Public Perception, and Policy", "Radiation Effects on organs of the body (somatic effects)", "Thoracic computed tomography: principles and practice", "Mitigating motion artifacts in FDK based 3D Cone-beam Brain Imaging System using markers", "A Method for Simultaneous Image Reconstruction and Beam Hardening Correction", "An Experimental Survey of Metal Artefact Reduction in Computed Tomography", "Virtual Monochromatic Spectral Imaging with Fast Kilovoltage Switching: Reduction of Metal Artifacts at CT", "Dynamic intensity normalization using eigen flat fields in X-ray imaging", "Virtual colonoscopy for colorectal cancer screening: current status: Wednesday 5 October 2005, 14:0016:00", "Clinical validation of high-resolution fast spin-echo MR colonography after colon distention with air", "Reliability and accuracy of fine-cut computed tomography scans to determine the status of anterior interbody fusions with metallic cages", "Computed tomography an increasing source of radiation exposure", "Medical X-ray Imaging What are the Radiation Risks from CT? This can be something that you are asked to drink before your CT scan, or something that is given through a vein in your arm or inserted into your rectum. In Connecticut, parents must make sure their children go to school or get homeschooled. [87] Hence, the left side of the image is to the patient's right and vice versa, while anterior in the image also is the patient's anterior and vice versa. Some experts note that CT scans are known to be "overused," and "there is distressingly little evidence of better health outcomes associated with the current high rate of scans. This method has many advantages including the ability to rotate the 3D image in space or to view slices in succession, making it easier to find the exact place where a problem may be located. If you were given contrast material, you may receive special instructions. It seems that JavaScript is not working in your browser. A CT scan of the heart may be ordered when various types of heart disease or abnormalities are suspected. These are the dominant type of scanners on the market because they have been manufactured longer and offer a lower cost of production and purchase. CT scans can diagnose possibly life-threatening conditions such as hemorrhage, blood clots, or cancer. [62][63], Industrial CT scanning (industrial computed tomography) is a process which utilizes X-ray equipment to produce 3D representations of components both externally and internally. [187] This is useful to highlight structures such as blood vessels that otherwise would be difficult to delineate from their surroundings. U.S. Department of Health & Human Services, RADx Tech Programmatic or Technical Inquiries, Instrumentation Development and Engineering Application Solutions (IDEAS), NIH Intramural Research Program Training Opportunities, NIH Intramural Research Program Career Opportunities, Diversity, Equity, Inclusion, and Accessibility Programs and Activities, Tissue Engineering and Regenerative Medicine, Design by Biomedical Undergraduate Teams (DEBUT) Challenge. Reproductive Health in Connecticut: Know Your Rights. The main forms of cardiac CT scanning are: To better visualize the anatomy, post-processing of the images is common. A pixel is a two dimensional unit based on the matrix size and the field of view. This process continues until the desired number of slices is collected. This left-right interchange corresponds to the view that physicians generally have in reality when positioned in front of patients. Tell your doctor if you've ever had a reaction to contrast material. [213] Some early research has found the dose reduction potential of photon counting CT for breast imaging to be very promising. [149] The risk for someone who is 40 years old is half that of someone who is 20 years old with substantially less risk in the elderly. Useful for angiographic studies and identification of pulmonary nodules. : the effect of adjusting for multiple primaries", "Answers to Common Questions About the Use and Safety of CT Scans", "No evidence that CT scans, X-rays cause cancer", "Radiation exposure from Chest CT: Issues and Strategies", "Use of Intravenous Iodinated Contrast Media in Patients with Kidney Disease: Consensus Statements from the American College of Radiology and the National Kidney Foundation", "Nuclear energy and health: and the benefits of low-dose radiation hormesis", Doses from Computed Tomography (CT) examinations in the UK 2003 Review, "Dynamics of DNA damage response proteins at DNA breaks: a focus on protein modifications", The Measurement, Reporting, and Management of Radiation Dose in CT, "Absorbed, Equivalent, and Effective Dose ICRPaedia", "The 2007 Recommendations of the International Commission on Radiological Protection", "Radiation and pregnancy: A fact sheet for clinicians", "FDA investigates the safety of brain perfusion CT", "Alignment Solution for CT Image Reconstruction using Fixed Point and Virtual Rotation Axis", "computed tomography Definition from the Merriam-Webster Online Dictionary", "What's the difference between a CAT-Scan and a CT-Scan? CT scanning of the head is also used in CT-guided stereotactic surgery and radiosurgery for treatment of intracranial tumors, arteriovenous malformations, and other surgically treatable conditions using a device known as the N-localizer. [42] More recently CT has played a key role in the fast-evolving field of transcatheter structural heart interventions, more specifically in the transcatheter repair and replacement of heart valves.[43][44][45]. [16], Since its introduction in the 1970s,[17] CT has become an important tool in medical imaging to supplement conventional X-ray imaging and medical ultrasonography. [188], The history of X-ray computed tomography goes back to at least 1917 with the mathematical theory of the Radon transform. [194] It was later known as computed axial tomography (CAT or CT scan) and body section rntgenography. transcatheter structural heart interventions, Computed tomography of the abdomen and pelvis, iterative Sparse Asymptotic Minimum Variance, International Commission on Radiological Protection, Template:Effective dose by medical imaging type, American Society of Radiologic Technologists, American Association of Physicists in Medicine, "The Nobel Prize in Physiology or Medicine 1979", "Electron beam computed tomography: Challenges and opportunities", "Principles and applications of dual source CT", "Radiation dose associated with common computed tomography examinations and the associated lifetime attributable risk of cancer", "Projected cancer risks from computed tomographic scans performed in the United States in 2007", "Dangers of CT Scans and X-Rays Consumer Reports", "Developing Stereotactic Frames for Cranial Treatment", "Thyroid computed tomography imaging: pictorial review of variable pathologies", "Five Things Physicians and Patients Should Question", "Radiation Dose Associated with Common Computed Tomography Examinations and the Associated Lifetime Attributable Risk of Cancer", "Cardiac CT | Radiology Reference Article | Radiopaedia.org", "Complementary role of cardiac CT in the assessment of aortic valve replacement dysfunction", "Computed Tomography for Structural Heart Disease and Interventions", "Coronary Computed Tomography Angiography (CCTA)", "Cardiac 3D Printing and its Future Directions", "Innovative Mitral Valve Treatment with 3D Visualization at Henry Ford", "3D-Imaging of cardiac structures using 3D heart models for planning in heart surgery: a preliminary study", "Cross-sectional Imaging in Crohn Disease", "Transient thermal finite element analysis of CFCCu ITER monoblock using X-ray tomography data", "A model-based 3D multi-slice helical CT reconstruction algorithm for transportation security application", "Implicit Gibbs prior models for tomographic reconstruction", "Innovative data weighting for iterative reconstruction in a helical CT security baggage scanner", "A Classifier based Approach for the Detection of Potential Threats in CT based Baggage Screening", "A Comparison of Classification Approaches for Threat Detection in CT based Baggage Screening", "A Comparison of 3D Interest Point Descriptors with Application to Airport Baggage Object Detection in Complex CT Imagery", "How Next Generation Airport Scanners Are Ending The 100ml Liquid Rule", "Laboratory | About Chikyu | The Deep-sea Scientific Drilling Vessel CHIKYU", "A New Method for Quality Control of Geological Cores by X-Ray Computed Tomography: Application in IODP Expedition 370", "From damage to discovery via virtual unwrapping: Reading the scroll from En-Gedi", "A Letter Sealed for Centuries Has Been ReadWithout Even Opening It", "Unlocking history through automated virtual unfolding of sealed documents imaged by X-ray microtomography", "Advanced Documentation Methods in Studying Corinthian Black-figure Vase Painting", "Three-Dimensional X-Ray Imaging and Analysis of Fungi on and in Wood", "Volume Rendering versus Maximum Intensity Projection in CT Angiography: What Works Best, When, and Why", "Automatic perceptual color map generation for realistic volume visualization", "Use of multi-planar reconstruction (MPR) and 3-dimentional [sic] (3D) CT to assess stability criteria in C2 vertebral fractures", "Technical aspects of CT imaging of the spine", "CT imaging: Where are we going? Imaging for acute ischemic stroke: Stroke, which can have lasting neurological injuries, is also a leading cause of death worldwide. [19] An estimated 72 million scans were performed in the United States in 2007 and more than 80 million in 2015. The radiation dose reported in the gray or mGy unit is proportional to the amount of energy that the irradiated body part is expected to absorb, and the physical effect (such as DNA double strand breaks) on the cells' chemical bonds by X-ray radiation is proportional to that energy. information submitted for this request. A valid e-mail address. While the table moves you into the scanner, detectors and the X-ray tube rotate around you.
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