cord blood elution | umbilical cord blood banking companies

Banking of stem cells from cord blood began in 1994 with the foundation of the New York Blood Centre Cord Blood Bank. The field of umbilical cord blood storage has matured considerably over the last two decades. We continue to learn more about the long-term effects of cryo-preservation on the cells, which has resulted in increased storage times.
Your cells didn’t start out knowing how to come together to form your bones, heart or blood; they begun with more of a blank slate. These completely undifferentiated cells can be found during gestation, or the time the baby is in the womb, and are called embryonic stem cells. These early stage stem cells are master cells that have the potential to become any type of cell in the body.
The choices expectant parents make today go beyond finding out the gender of their baby. They span beyond deciding whether to find out if their child, still in the womb, may potentially have a genetic disorder. Today, many parents must decide whether to store their baby’s umbilical cord blood so it will be available to heal their child if at any point in the child’s lifetime he or she becomes sick.
Stem cells are able to transform into other types of cells in the body to create new growth and development. They are also the building blocks of the immune system. The transformation of these cells provides doctors with a way to treat leukemia and some inherited health disorders.
HSCs can become any type of blood cell or cellular blood component inside the body, including white blood cells and red blood cells. These cells are found in umbilical cord blood and are multipotent, which means they can develop into more than one cell type.
Experts believe that umbilical cord blood is an important source of blood stem cells and expect that its full potential for treatment of blood disorders is yet to be revealed. Other types of stem cell such as induced pluripotent stem cells may prove to be better suited to treating non-blood-related diseases, but this question can only be answered by further research.
When an immediate family member has a disease that requires a stem cell transplant, cord blood from a newborn baby in the family may be the best option. There is a 25% chance, for example, that cord blood will be a perfect match for a sibling, because each child shares one of its two HLA genes with each parent. Occasionally cord blood will be a good match for a parent if, by chance, both parents share some of the six HLA antigens. The baby’s cord blood is less likely to be a good match for more distant relatives. The inventories of unrelated cord blood units in public cord blood banks are more likely to provide appropriate matches for parents and distant relatives, as well as for siblings that do not match.
Cord blood has an abundance of stem cells and immune system cells, and the medical uses of these cells has been expanding at a rapid pace. As these cells help the body re-generate tissues and systems, cord blood is often referred to as a regenerative medicine.
First, the cells are checked to see if they can be used for a transplant. If there are too few cells, the cord blood unit may be used for research to improve the transplant process for future patients or to investigate new therapies using cord blood, or discarded.
Please note: ClinImmune Labs – University of Colorado Cord Blood Bank – CariCord’s activities for New York State residents are limited to collection, processing, and long-term storage of umbilical cord tissue. Possession of a New York State license for such collection, processing, and long-term storage does not indicate approval or endorsement of possible future uses or future suitability of umbilical cord tissue-derived cells.
Your free donation will be part of a program that is saving liv​es and supporting research to discover new uses for cord blood stem cells. Units that meet criteria for storage are made available to anyone, anywhere in the world, who needs a stem cell transplant. 
Osteopetrosis is a genetic disease, so this means that doctors could use a sibling’s cord blood cells to treat Anthony, but they cannot use his own cells because the disease is in every cell in his body. In fact, a majority of the diseases listed in private banking firms’ marketing material as treatable with stem cells are genetic diseases.
Families have the additional option of storing a section of the umbilical cord, which is rich in unique and powerful stem cells that may help repair and heal the body in different ways than stem cells derived from cord blood.
Women typically sign up for cord blood banking between the 28th and 34th week of pregnancy. Some private banks will allow for early or late sign up, but most public storage facilities won’t accept any mother past her 34th week. While most banks don’t officially sign up mothers until a certain time, it’s never too early to research.
Women thinking about donating their child’s cord blood to a public bank must pass certain eligibility requirements. While these vary from bank to bank, the following list shows general health guidelines for mothers wanting to donate.
The first cord blood transplant was performed in Paris on October 6, 1988. Since that time, over 1 million cord blood units have been collected and stored in public and family banks all over the world.
There’s a network of public cord blood banks in the United States that can take your donation. Most public banks are nonprofit organizations, and all public cord blood banks must meet stringent quality standards.
You can check the status of your child’s cord blood unit any time by contacting the public bank. In most cases, the parents won’t have much control over any donated stem cells, so you probably won’t hear much from the storage facility. They may keep you updated if your cells are being used in a patient or clinical trial, but this is up to the bank. By signing the consent form, you are giving the bank full rights to use your child’s cord blood in any patient or clinical trial available.
Some controversial studies suggest that cord blood can help treat diseases other than blood diseases, but often these results cannot be reproduced. Researchers are actively investigating if cord blood might be used to treat various other diseases.
One potentially eligible expense with your Medical FSA that many families are not aware of is umbilical cord blood and tissue banking! Fees for storing umbilical cord blood and tissue to be used for surgery of the child or a family member in the near future (generally within one year) are an eligible medical expense.

The stored blood can’t always be used, even if the person develops a disease later on, because if the disease was caused by a genetic mutation, it would also be in the stem cells. Current research says the stored blood may only be useful for 15 years.
Cord blood stem cells can be used in the treatment nearly 80 diseases today. Click on a category below to see specific diseases. Note: Banking cord blood does not guarantee that treatment will work and only a doctor can determine when it can be used.
Your child’s cord blood will also be tested for contamination. Staff at the lab will test the unit, along with a blood sample from the mother, and check for any possible problems. Contamination may happen in the hospital room or during travel to the lab. If the cells are contaminated, they may still be used in a clinical trial.
After a baby is born, cord blood is left in the umbilical cord and placenta. It is relatively easy to collect, with no risk to the mother or baby. It contains haematopoietic (blood) stem cells: rare cells normally found in the bone marrow.
Parents who wish to donate cord blood are limited by whether there is a public bank that collects donations from the hospital or clinic where their baby will be born. Search our list of public banks in your country. Parents who wish to store cord blood and/or cord tissue for their family can find and compare private banks in your country. Family banks usually offer payment plans or insurance policies to lower the cost of cord blood banking.
Cord Blood Registry® (CBR®) is the world’s largest newborn stem cell company. Founded in 1992, CBR is entrusted by parents with storing samples from more than 600,000 children. CBR is dedicated to advancing the clinical application of cord blood and cord tissue stem cells by partnering with institutions to establish FDA-regulated clinical trials for conditions that have no cure today.
The Leading the Way LifeSaving Ambassadors Club is a recognition program honoring sponsor groups for outstanding performance in reaching or exceeding blood drive collections goals.  CBC presents a Leading the Way plaque to winning sponsors on an annual basis. The award is based on three levels of achievement:
^ a b Thornley, I; et al. (March 2009). “Private cord blood banking: experiences and views of pediatric hematopoietic cell transplantation physicians”. Pediatrics. 123 (3): 1011–7. doi:10.1542/peds.2008-0436. PMC 3120215 . PMID 19255033.
Cord Blood Registry’s Newborn Possibilities Program® serves as a catalyst to advance newborn stem cell medicine and science for families that have been identified with a medical need to potentially use newborn stem cells now or in the near future. NPP offers free cord blood and cord tissue processing and five years of storage to qualifying families. To date, the Newborn Possibilities Program has processed and saved stem cells for nearly 6,000 families.
After your unit arrives at ViaCord’s Processing Lab, specialists will process your baby’s stem cells to maximize cell yield. They are then transferred to a transplant-ready cryobag for storage at or below ≤ -170º C (brrr). 
In New Zealand, a hopeful couple are participating in a study that will use one of their son’s cord blood stem cells to research treatment for another son’s cystic fibrosis. In Chicago, people are using their sibling’s stem cells to successfully treat sickle cell disease. And countless other families have banked their second child’s cord blood after their first child was diagnosed with leukemia. Many of those children are alive and well today thanks to their sibling’s stem cells. Since the first successful cord blood stem cell transplant on a sibling in 1988, over 30,000 cord blood transplants have been performed worldwide.

7 Replies to “cord blood elution | umbilical cord blood banking companies”

  1. Adverse effects are similar to hematopoietic stem cell transplantation, namely graft-versus-host disease if the cord blood is from a genetically different person, and the risk of severe infection while the immune system is reconstituted.[1] There is a lower incidence with cord blood compared with traditional HSCT, despite less stringent HLA match requirements. [1]
    Bone marrow is tissue located in the center of your bones, making healthy blood cells that strengthen your immune system and fight off outside infections. A large amount of cells are located in bone marrow, and doctors frequently use hip bone marrow for most transplants, since the stem cells in this area are the most plentiful.
    ## Payment Plan Disclosures for in-house CBR 12-Month Plan (interest free) – No credit check required. The 12-month plan requires a $15/month administrative fee. The plans may be prepaid in full at any time.
    During the harvesting procedure, doctors use a catheter to draw out blood. The blood moves through a machine, which separates stem cells and allows these cells to be put into storage. This process takes a few hours, and may be repeated over several days in order for doctors to get enough stem cells.
    Georgia Regents University is conducting an FDA-regulated phase I/II clinical trial to assess whether an infusion of autologous stem cells derived from their own cord blood can improve the quality of life for children with cerebral palsy.
    As noted, there are different ways to process cord blood, and although the type of processing method doesn’t always enter the conversation on cord blood banking, it is a big part of the purity of any cord blood collection. Red blood cells can have a negative impact on a cord blood transfusion. In addition, there is a certain number of stem cells that need to be present in order for the cord blood to be effective in disease treatment. Each processing method has the ability to better reduce the number of RBCs and capture more stem cells. Some processing methods like AutoXpress and Sepax are automated to ensure a level of consistency across all collections. HES is preferred by some banks because it was the original processing method used by most banks and it has a proven track record. You can read more about the different cord blood processing methods here.

  2. Our annual storage fee is due every year on the birth date of the child and covers the cost of storage until the following birthday. The fee is fixed upon enrollment for 18 years and will not increase during that span of time. If the stem cells are preserved after the 18th year, preservation may then fall under the new pricing structure.
    CBR was the first family bank accredited by AABB (formerly the American Association of Blood Banks) and the company’s quality standards have been recognized through ISO 9001:2008 certification—the global business standard for quality. The Federal Drug Administration (FDA) has issued cord blood regulations, and the states of California, Illinois, Maryland, New York and New Jersey have mandatory licensing for cord blood banking. The stringent laboratory processes, record keeping, quality control and quality assurance of CBR are designed to meet all federal and state guidelines and regulations.
    As noted, there are different ways to process cord blood, and although the type of processing method doesn’t always enter the conversation on cord blood banking, it is a big part of the purity of any cord blood collection. Red blood cells can have a negative impact on a cord blood transfusion. In addition, there is a certain number of stem cells that need to be present in order for the cord blood to be effective in disease treatment. Each processing method has the ability to better reduce the number of RBCs and capture more stem cells. Some processing methods like AutoXpress and Sepax are automated to ensure a level of consistency across all collections. HES is preferred by some banks because it was the original processing method used by most banks and it has a proven track record. You can read more about the different cord blood processing methods here.
    The first cord blood transplant was performed in Paris on October 6, 1988. Since that time, over 1 million cord blood units have been collected and stored in public and family banks all over the world.
    STEM CELLS are found in cord blood, cord tissue, and placenta tissue. These cells are highly valuable to your baby, the mother, and possibly other family members. When you save these stem cells with Americord®, you ensure that they are securely stored for you and your family’s future needs. Learn more >
    Genes: Segments of DNA that contain instructions for the development of a person’s physical traits and control of the processes in the body. They are the basic units of heredity and can be passed down from parent to offspring.
    There have been several reports suggesting that cord blood may contain other types of stem cells which can produce specialised cells that do not belong to the blood, such as nerve cells. These findings are highly controversial among scientists and are not widely accepted.
    To prevent graft-versus-host disease and help ensure engraftment, the stem cells being transfused need to match the cells of the patient completely or to a certain degree (depending on what is being treated). Cord blood taken from a baby’s umbilical cord is always a perfect match for the baby. In addition, immediate family members are more likely to also be a match for the banked cord blood. Siblings have a 25 percent chance of being a perfect match and a 50 percent chance of being a partial match. Parents, who each provide half the markers used in matching, have a 100% chance of being a partial match. Even aunts, uncles, grandparents and other extended family members have a higher probability of being a match and could possibly benefit from the banked cord blood. Read more reasons why you should bank cord blood.
    So what does CBR do? Your collected sample is shipped to our lab where our lab technicians perform quality tests. We save the cord blood stem cells and let you know when we have securely stored your sample until you need them.

  3. Unlike other banks, CBR uses a seamless cryobag for storage. The seamless construction decreases the potential for breakage that can occur in traditional, seamed-plastic storage bags. Prior to storage, each cryobag is placed in a second overwrap layer of plastic, which is hermetically sealed as an extra precaution against possible cross contamination by current and yet unidentified pathogens that may be discovered in the future. CBR stores the stem cells in vaults, called dewars, specially designed for long-term cryostorage. The cord blood units are suspended above a pool of liquid nitrogen that creates a vapor-phase environment kept at minus 196 degrees Celsius. This keeps the units as cold as liquid nitrogen without immersing them in liquid, which can enable cross-contamination. Cryopreserved cord blood stem cells have proven viable after more than 20 years of storage, and research suggests they should remain viable indefinitely.
    The American Academy of Pediatrics supports efforts to provide information about the potential benefits and limitations of cord blood banking and transplantation so that parents can make an informed decision. In addition, the American College of Obstetricians and Gynecologists recommends that if a patient requests information on umbilical cord blood banking, balanced information should be given. Cord blood education is also supported by legislators at the federal and state levels. In 2005, the National Academy of Sciences published an Institute of Medicine (IoM) report titled “Establishing a National Cord Blood Stem Cell Bank Program”.[15]
    A stem cell has the potential to become one of many different types of cells. Stem cells are unique cells: They have the ability to become many different types of cells, and they can replicate rapidly. Stem cells play a huge part in the body’s healing process, and the introduction of new stem cells has always showed great promise in the treatment of many conditions. It wasn’t until we found out where and how to isolate these cells that we started using them for transplants. Although a person’s own stem cells are always 100 percent compatible, there are risks in using someone else’s stem cells, especially if the donor and recipient are not immediately related. The discovery of certain markers allows us to see how compatible a donor’s and host’s cells will be. The relatively recent discovery of stem cells in the umbilical cord’s blood has proven advantageous over acquiring stem cells from other sources. Researchers are currently conducting clinical trials with stem cells, adding to the growing list of 80 diseases which they can treat.
    In the United States, the Food and Drug Administration regulates any facility that stores cord blood; cord blood intended for use in the person from whom it came is not regulated, but cord blood for use in others is regulated as a drug and as a biologic.[6] Several states also have regulations for cord blood banks.[5]
    Cord blood stem cells can be used in the treatment nearly 80 diseases today. Click on a category below to see specific diseases. Note: Banking cord blood does not guarantee that treatment will work and only a doctor can determine when it can be used.
    What is cord blood and why should we care? Cord blood contains stem cells that have huge potential to help your family. It can only be collected from a newborn’s umbilical cord immediately after birth. They’re unique and can be used to treat life threatening diseases such as anemia and leukemia. We’re just beginning to tap into its potential.
    It depends on who you ask. Although commercial cord blood banks often bill their services as “biological insurance” against future diseases, the blood doesn’t often get used. One study says the chance that a child will use their cord blood over their lifetime is between 1 in 400 and 1 in 200,000.
    Private or family banks store cord blood for autologous use or directed donation for a family member. Private banks charge a yearly fee for storage. Blood stored in a private bank must meet the same standards as blood stored in a public bank. If you have a family member with a disorder that may potentially be treated with stem cells, some private banks will store the cord blood free of charge.

  4. The stored blood can’t always be used, even if the person develops a disease later on, because if the disease was caused by a genetic mutation, it would also be in the stem cells. Current research says the stored blood may only be useful for 15 years.
    This is the time of year when many employers and insurance companies hold open enrollment for insurance plans, for the upcoming year. Along with the usual medical, dental, and life insurance plans, many families also opt to enroll in a Medical Flexible Spending Account (or FSA). This type of account offers tax advantages for eligible healthcare costs throughout the year for you and all your dependents. Your Medical FSA is funded by pre-taxed payroll deductions in the amount you choose and covers a wide range of eligible medical expenses including those that result from the diagnosis, care, treatment, or prevention of disease or illness.
    ^ a b Walther, Mary Margaret (2009). “Chapter 39. Cord Blood Hematopoietic Cell Transplantation”. In Appelbaum, Frederick R.; Forman, Stephen J.; Negrin, Robert S.; Blume, Karl G. Thomas’ hematopoietic cell transplantation stem cell transplantation (4th ed.). Oxford: Wiley-Blackwell. ISBN 9781444303537.
    The Medical Letter On Drugs and Therapeutics also recently addressed aspects of public and private cord blood banks, asking the question: “Does Private Banking Make Sense?” After citing various statistics on the actual uses of privately stored cord blood, they concluded that: “At the present time, private storage of umbilical cord blood is unlikely to be worthwhile. Parents should be encouraged to contribute, when they can, to public cord blood banks instead.” [Access The Medical Letter at http://www.medicalletter.org].
    Remaining in the umbilical cord and placenta is approx. 40–120 milliliters of cord blood. The healthcare provider will extract the cord blood from the umbilical cord at no risk or harm to the baby or mother.
    With public cord blood banks, there’s a greater chance that your cord blood will be put to use because it could be given to any child or adult in need, says William T. Shearer, M.D., Ph.D., professor of Pediatrics and Immunology at Baylor College of Medicine in Houston. Cord blood is donated and is put on a national registry, to be made available for any transplant patient. So if your child should need the cord blood later in life, there’s no guarantee you would be able to get it back.

  5. *Fee schedule subject to change without notice. If a client has received a kit and discontinues services prior to collection, there is no cancelation fee if the kit is returned unused within two weeks from cancelation notice; otherwise, a $150 kit replacement fee will be assessed. †Additional courier service fee applies for Alaska, Hawai’i and Puerto Rico. ††Applies to one-year plan and promotional plan only. After the first year, an annual storage fee will apply. Cryo-Cell guarantees to match any written offer for product determined to be similar at Cryo-Cell’s sole discretion. ** Promotional Plan cannot be combined with any other promotional offers, coupons or financing.
    Started the National Cord Blood Inventory (NCBI). The goal of the NCBI is to collect and store at least 150,000 new cord blood units. These cord blood units are used for patients who need a transplant but do not have a matching donor within their family. To continue to help the success of transplants, the NCBI banks will provide additional cord blood units for research.
    There are some hospitals that have dedicated collections staff who can process mothers at the last minute when they arrive to deliver the baby. However, in the United States that is the exception to the rule.
    In a report to the HRSA Advisory Council, scientists estimated that the chances of a pediatric patient finding a cord blood donor in the existing Be the Match registry are over 90 percent for almost all ethnic groups.
    ^ a b Ballen, KK; Gluckman, E; Broxmeyer, HE (25 July 2013). “Umbilical cord blood transplantation: the first 25 years and beyond”. Blood. 122 (4): 491–8. doi:10.1182/blood-2013-02-453175. PMC 3952633 . PMID 23673863.
    If someone doesn’t have cord blood stored, they will have to rely on stem cells from another source. For that, we can go back to the history of cord blood, which really begins with bone marrow. Bone marrow contains similar although less effective and possibly tainted versions of the same stem cells abundant in cord blood. Scientists performed the first bone marrow stem cell transplant in 1956 between identical twins. It resulted in the complete remission of the one twin’s leukemia.
    Generally not. The reason siblings are more likely to match is because they get half of their HLA markers from each parent. Based on the way parents pass on genes, there is a 25 percent chance that two siblings will be a whole match, a 50 percent chance they will be a half match, and a 25 percent chance that they will not be a match at all. It is very rare for a parent to be a match with their own child, and even more rare for a grandparent to be a match.

  6. In an allogenic transplant, another person’s stem cells are used to treat a child’s disease. This kind of transplant is more likely to be done than an autologous transplant. In an allogenic transplant, the donor can be a relative or be unrelated to the child. For an allogenic transplant to work, there has to be a good match between donor and recipient. A donor is a good match when certain things about his or her cells and the recipient’s cells are alike. If the match is not good, the recipient’s immune system may reject the donated cells. If the cells are rejected, the transplant does not work.
    There are so many things to think about when you have a child. One of them is the blood from your baby’s umbilical cord (which connects the baby to the mother while in the womb). It used to be thrown away at birth, but now, many parents store the blood for the future health of their child. Should you do it?
    We offer standard and premium cord blood processing options. The former has been used in thousands of successful transplants since 1988, and the latter is a superior new processing method that greatly enhances parents’ return on investment. Please visit our processing technology page to learn about our cord blood processing methods.
    Here are 5 Things You Need to Know About Cord Blood Before You Deliver Your Baby according to @TodaysMama #cordblood #cordbloodbanking #cordbloodregistry #newborn #stemcell todaysmama.com/2017/12/5-thin… via @todaysmama
    Cord blood banking is the process of collecting and storing your baby’s umbilical cord blood stem cells for potential medical use. ViaCord also offers parents the option to collect and store stem cells found in the tissue of the umbilical cord.  This is known as cord tissue banking. Our approach to cord blood and cord tissue banking is simple: Apply the most advanced science to deliver the highest-quality stem cell collection and storage process in order to achieve the best results for families. That approach has guided our growth and success for nearly twenty-five years.
    A cord blood bank may be private (i.e. the blood is stored for and the costs paid by donor families) or public (i.e. stored and made available for use by unrelated donors). While public cord blood banking is widely supported, private cord banking is controversial in both the medical and parenting community. Although umbilical cord blood is well-recognized to be useful for treating hematopoietic and genetic disorders, some controversy surrounds the collection and storage of umbilical cord blood by private banks for the baby’s use. Only a small percentage of babies (estimated at between 1 in 1,000 to 1 in 200,000[8]) ever use the umbilical cord blood that is stored. The American Academy of Pediatrics 2007 Policy Statement on Cord Blood Banking stated: “Physicians should be aware of the unsubstantiated claims of private cord blood banks made to future parents that promise to insure infants or family members against serious illnesses in the future by use of the stem cells contained in cord blood.” and “private storage of cord blood as ‘biological insurance’ is unwise” unless there is a family member with a current or potential need to undergo a stem cell transplantation.[8][9] The American Academy of Pediatrics also notes that the odds of using a person’s own cord blood is 1 in 200,000 while the Institute of Medicine says that only 14 such procedures have ever been performed.[10]
    The stem cells from your baby’s cord blood may also be effective in treating certain diseases or conditions of a parent or sibling. Cord blood stem cells have similar ability to treat disease as bone marrow but with significantly less rejection.

  7. There was a time before the 1990s when the umbilical cord and its blood were considered medical waste. Today, parents bank or store their baby’s umbilical cord blood because the stem cells it contains are currently utilized or show promise in the treatment of life-threatening and debilitating diseases.
    Once donated cord blood is listed on the Be the Match registry, doctors can access it to treat patients who need stem cell transplants. Public cord blood banks keep the names of both mothers and babies confidential to protect the privacy of families.
    Cord tissue is rich in a completely different type of stem cell. With over fifty clinical trials currently in progress, researchers agree that banking cord tissue is the future of stem cell banking. Learn more >
    There are several cord blood banks that are accredited by the American Association of Blood Banks. Most offer information on cord blood banking and provide private cord blood banking services. With a little research, you should be able to locate a credible cord blood bank online.
    The proteins stem from three HLA genes, and you inherit one HLA from each parent, or half your HLA markers from your mother and half from your father. This gives siblings a 25 percent chance of being a perfect match, a 50 percent chance of being a partial match and another one-in-four chance of not being a match at all. Unfortunately, about seven out 10 patients who need a transplant don’t have a suitable donor in their family. They can either rely on their own stem cells, isolated before treatment or previously preserved, or try to find a match through a public donor.
    Banked cord blood is most abundant in white blood cells and stem cells. While a lot of attention is paid to the stem cells, there are approximately 10 times more total nucleated cells (TNCs) than stem cells in any cord blood collection. TNCs are basically white blood cells, or leukocytes; they are the cells of the immune system that protect the body. Despite stem cells comprising one-tenth of most collections, cord blood is still considered a rich source of hematopoietic (he-mah-toe-po-ee-tic) stem cells (HSCs). HSCs are often designated by the marker CD34+. Hematopoietic stem cells can become two categories of cells: myeloid and lymphoid cells. Myeloid cells go on to form your red blood cells, platelets, and other cells of the blood. Lymphoid cells go on to become the B cells and T cells and are the basis for the immune system. Cord blood also contains mesenchymal (meh-sen-ki-mal) stem cells (MSCs), but they are much more abundant in cord tissue, which we will discuss in a minute.
    Cord blood is used the same way that hematopoietic stem cell transplantation is used to reconstitute bone marrow following radiation treatment for various blood cancers, and for various forms of anemia.[1][2] Its efficacy is similar as well.[1]

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