Category Archives: Global Health Seattle

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Americans living longer but less healthy lives, UW-led research finds

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Change in leading cause of death in high-income North America 1990-2010

Americans are living longer lives, but we are living out these longer lives with chronic illnesses in large part due to our lifestyle choices, including eating unhealthy diets, failing to exercise, smoking, and using alcohol and drugs, according to research led by researchers at the University of Washington.

In the analysis, the researchers looked the causes of death and disability in 187 countries around the world. The study was led by the University of Washington’s Institute for Health Metrics and Evaluation (IHME) and funded by the Bill & Melinda Gates Foundation.

A live webcast will be held tomorrow, March 5 from 9 am to 10:30 am PST, in which Microsoft founder Bill Gates, UW President Michael Young, and and IHME Director Dr. Chris Murray help launch a new suite of online data visualization tools.

The webcast can be viewed at http://www.healthmetricsandevaluation.org/gbd/live.

Researchers from more than 303 institutions and 50 countries contributed to the project, called the Global Burden of Diseases, Injuries, and Risk Factors Study 2010.

US: a “mixed picture”

Analysis of the US health data revealed a “mixed picture” the researchers said: we are living longer but many of us are not enjoying a healthy old age.

The average life expectancy of American women, for example, increased from 78.6 years in 1990 to 80.5 years in 2010, yet only 69.5 of those 80.5 years were lived in good health.

The picture was the same for American men who in 2010 lived, on average, to be 75.9 years old – up from 71.7 in 1990 – but only 66.2 of those years are healthy.

Most of the illness and death in the US is caused by relatively few conditions. The top causes of death and disability were ischemic heart disease, followed by chronic obstructive pulmonary disease, low back pain, lung cancer, and major depressive disorders.

The analysis also found that the leading causes of death had changed over the past 20 years. Over those two decades,

  • ischemic heart disease, stroke, and lung cancer remained the top three causes of death;
  • chronic obstructive pulmonary disease, lower respiratory infection, and colorectal and breast cancers had moved down;
  • and diseases like diabetes, chronic kidney disease, and Alzheimer’s disease moved up.

US: Lagging behind

The study found that the US also lagged behind many wealthy and middle-income countries with Americans living shorter lives — and shorter healthy lives — than the residents of many other nations.

For example, men in 39 other countries – including Greece, Lebanon, and South Korea – live longer, and men in 30 other countries – such as Costa Rica, New Zealand, and Portugal – enjoy more years of good health.

American women fare about the same; in terms of life expectancy they are ranked 36th in the world, and in terms of healthy life expectancy they are ranked 35th, the analysis found.

We are doing so poorly because of our lifestyle choices:

  • The number one culprit: a diet that puts us at risk for such obesity-related illnesses such as heart disease and diabetes.
  • Number two: smoking, which leads to lung cancer, chronic obstructive pulmonary disorder, heart disease and stroke.

To learn more:

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Chronic illness and disability becoming world’s leading health challenges – UW-led study finds

Globe 125X125By Michael McCarthy

We’re living longer, but many of us are living with chronic illnesses that significantly lower the quality of our lives, according to a new study led by researchers at the University of Washington.

The survey, called the Global Burden of Disease Study, finds that there has been a major change in the causes and impact of poor health over the past decades, with a shift away from early death to chronic illnesses and disability.

The survey found that since 1970 life expectancy has increased by 11.1 years for men and 12.1 years for women and that deaths among children under age 5 have plummeted, except in subSaharan Africa where childhood mortality remains high.

In general, improvement in life expectancy has been steady, but it slowed in the 1990s largely due to deaths from HIV infection in sub-Saharan Africa and alcohol-related deaths in in easter Europe and central Asia.

With our longer life expectancy, the major burden caused by disease is no longer early death but instead chronic illnesses that cause pain and disability, such as arthritis, diabetes and dementia, and psychological disorders, the study concludes.

Change in the leading cause of deaths from 1990 to 2010

Change in the leading cause of deaths from 1990 to 2010 – Click on image for interactive display.

The study was led by University of Washington’s Institute for Health Metrics and Evaluation and funded by the Bill & Melinda Gates Foundation.

“We’re finding that very few people are walking around with perfect health and that, as people age, they accumulate health conditions,” said Dr. Christopher Murray, director of IHME and one of the founders of the Global Burden of Disease.

“At an individual level, this means we should recalibrate what life will be like for us in our 70s and 80s. It also has profound implications for health systems as they set priorities,” Murray said.

Dr. Paul Ramsey, chief executive officer of UW Medicine and dean of the University of Washington School of Medicine, said the study will serve as “a management tool for ministers of health and leaders of health systems to prepare for the specific health challenges coming their way.”

“At a time when world economies are struggling, it is crucial for health systems and global health funders to know where best to allocate resources,” Dr. Ramsey said.

The study found that while heart disease and stroke remained the two greatest causes of death between 1990 and 2010, all the other rankings in the top 10 causes changed.

Diseases such as diabetes, lung cancer, and chronic obstructive pulmonary disease moved up the list, and diarrhea, lower respiratory infections, and tuberculosis moved down, the researchers report.

Explore the changes with this interactive chart.

And while malnutrition used to be a major cause of illness and death, today poor diet and physical inactivity are to blame for soaring rates of obesity, diabetes, heart disease and stroke the study found.

“We have gone from a world 20 years ago where people weren’t getting enough to eat to a world now where too much food and unhealthy food – even in developing countries – is making us sick,” said Dr. Majid Ezzati, Chair in Global Environmental Health at Imperial College London and one of the study’s lead authors.

The study appears in this week’s issue of the medical journal The Lancet.

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Group Health study finds “shared decision making” may reduce medical procedures

Osteoarthritis of the knee

By Ankita Rao

While policymakers debate whether doctors should be paid by the number of services they provide or the outcomes of their treatment, shared decision could have an impact on the ground by reducing demand for medical procedures.

A new Health Affairs report about decision aids, materials given to patients to help educate them about treatment options, shows that they can help hold down costs.

“The decision aids discuss all the available treatment options equally,” said Dr. David Arterburn, an author of the study released Tuesday and investigator at Group Health Cooperative, a non-profit health system in Seattle

For example, in the aids for joint disorders, he said, “Losing weight and increasing physical activity are discussed in detail, as are anti-inflammatory medications, other over the counter medications, and prescription medications for treating osteoarthritis.”

Decision aids can be used for a variety of medical issues, from cardiovascular health to hip replacements. They are delivered in the form of DVDs or printed guides, and are usually provided before a patient visits a specialist.

Researchers conducted randomized trials in Washington state with patients who suffered from knee and hip osteoarthritis, the most common joint disorders in the U.S. They sent aids to 332 patients with hip osteoarthritis and 978 to patients with knee osteoarthritis. The treatments and outcomes were then tracked and compared to a control group that did not receive the aids.

After six months, researchers found that among patients with knee problems who received aids, 38 percent fewer chose to have elective knee replacement surgery than the control group.

Among patients with hip problems, 26 percent fewer opted for hip replacement surgery.

Patients who received aids also had slightly fewer visits to primary care and specialty care doctors.

Overall treatment costs were lower among patients who received aids. For those with hip osteoarthritis, the average total cost of treatment was $13,489 after the use of decision aids, compared to $16,557 for the control group. In the knee osteoarthritis groups those with aids spent $8,041 compared to $10,040 in the control group.

Many states see promise in the shared decision model, and are taking early steps to encourage its use.  Minnesota, for example, outlines the need for a physician to discuss health care options in a shared decision making process in its rules for medical homes.

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Presidential Medal of Freedom

Dr. Bill Foege awarded Medal of Freedom

President Barack Obama today awarded physician and epidemiologist Dr. Bill Foege the Presidential Medal of Freedom, the highest civilian award in the United States, for his work combating infectious disease and promoting public health both at home and abroad.

Foege helped lead the successful campaign to eradicate smallpox in the 1970s. He served as Director of the Centers for Disease Control and Prevention and has helped advance global health through his work with the Carter Center and the Bill & Melinda Gates Foundation.

Dr. Foege is currently a senior fellow in the Gates Foundation’s Global Health Program, Presidential Distinguished Professor of International Health at the Rollins School of Public Health, and affiliate professor of epidemiology at the UW School of Public Health.

Both a building and an endowed chair are named after Foege, the Dr. William H. Foege Genome Sciences and Bioengineering building and the endowed chair of the global health department.

The President’s remarks:

“In the 1960s, more than 2 million people died from smallpox every year.  Just over a decade later, that number was zero — 2 million to zero, thanks, in part, to Dr. Bill Foege.  As a young medical missionary working in Nigeria, Bill helped develop a vaccination strategy that would later be used to eliminate smallpox from the face of the Earth.  And when that war was won, he moved on to other diseases, always trying to figure out what works.  In one remote Nigerian village, after vaccinating 2,000 people in a single day, Bill asked the local chief how he had gotten so many people to show up.  And the chief explained that he had told everyone to come see — to “come to the village and see the tallest man in the world.”   Today, that world owes that really tall man a great debt of gratitude.”

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John Wecker

Pacific Northwest Diabetes Research Institute appoints John Wecker president and CEO.

John Wecker

Pacific Northwest Diabetes Research Institute (PNDRI) announced today that John Wecker, PhD has been appointed president and CEO.

Dr. Wecker was most recently Global Program Leader, Vaccine Access and Delivery at PATH.

PNDRI is an independent non-profit biomedical and clinical research center that focuses on eliminating diabetes and its complications.

The Institute, which has a team of 85 physicians, scientists and technical staff, was founded in Seattle in 1956 by Dr. William Hutchinson, Sr., who also founded the Fred Hutchinson Cancer Research Center.

Before he joined PATH, Dr. Wecker worked for Boehringer Ingelheim, a global pharmaceutical company, where he led pharmaceutical product development teams and championed the company’s efforts to expand access to treatments for HIV/AIDS in the developing world.

During this time he established a program to provide medication for the prevention of mother-child transmission of HIV/AIDS, free of charge to over 120 countries around the world.

Dr. Wecker received his doctorate in Biological Psychology from the University of Rochester, Rochester, NY.

Dr. Wecker succeeds Dr. Jack Faris, who has been serving as acting CEO during the past eighteen months. Dr. Faris will remain part of the PNDRI team as a strategic advisor.

Dr. Wecker will begin at PNDRI on April 23rd.

To learn more:

  • For more information about PNDRI, visit www.pndri.org or call (206) 726-1200.


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PATH names Steve Davis president and CEO

Davis

Seattle’s global health organization PATH announced today that Steve Davis has been appointed president and CEO.

In his new position Davis will oversee PATH’s annual budget of $305 million, a staff of nearly 1,200, and a portfolio of projects based in PATH offices in 22 countries.

PATH projects include the development of an affordable meningitis vaccine, improved screening and treatment for HIV/AIDS and tuberculosis, and low-cost filters for safe drinking water.

Davis comes to PATH  from McKinsey & Company, where he was global director of social innovation.

In that position, Davis led a global team that consults for nongovernmental organizations (NGOs), governments, and the private sector, with a focus on global health and development, research and development, and Asia and Africa.

Previously, Davis was a long-term CEO of Corbis, a global digital media leader, and served as interim CEO of the Infectious Disease Research Institute, a nonprofit biotech working on vaccines, diagnostics, and drug discovery for infectious diseases of poverty.

His previous experiences also include serving as interim director of PATH’s India program, practicing law with K&L Gates, and working on refugee and human rights issues.

Mr. Davis earned his bachelor’s degree from Princeton University, his master’s degree from the University of Washington, and his juris doctor from Columbia University.

Davis will join PATH on June 11 and be based at PATH’s Seattle headquarters.

He succeeds former president and CEO Dr. Christopher J. Elias, who led PATH through significant growth for ten years.

Dr. Elias left PATH in January to become president of the Global Development Program at the Bill & Melinda Gates Foundation.

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Seattle Children’s opens biobank for pregnancy research

Blood, placenta tissue and other specimens will be saved.

A Seattle Children’s project to reduce premature births and still births opens a new facility today to store tissue from pregnant women that researchers from around the world can use to study both normal and abnormal pregnancies.

The biorepository will be run by the medical center’s Global Alliance to Prevent Prematurity and Stillbrith (GAPPS).

Specimens stored at the facility will include maternal blood and urine, cervical vaginal swabs, placenta tissue, and cord blood.

Samples will are collected from the first trimester through the postpartum period.

The specimens will be linked with information about the mothers’ preconception history, course of her current pregnancy, environmental exposures, medical and reproductive history, mental health, nutritional intake, and behaviors.

Participation is voluntary, and the identity of participating mothers is kept confidential with the specimens being identified only by number.

“While pregnancy specimen biobanks have been developed before, this is the first time that specimens paired with information about mothers and their pregnancies have been made widely accessible,” said Dr. Craig Rubens, executive director of GAPPS.

The repository currently has more than 8,000 individual specimens available to scientists, with 800-900 specimens being added each month.

The collection includes contributions from women representing a wide range of racial, ethnic, regional, and socioeconomic backgrounds.

Among the goasl of the GAPPS Repository project are to:

  • Help researchers discover biomarkers and create screening tools to identify women and babies at risk for preterm birth and stillbirth
  • Use those findings to develop diagnostic tests, treatments, and prevention strategies
  • And to support research to identify the causes of poor birth outcomes and the fetal origin of adult diseases in the hope of developing cures.

“Many adult health problems can be traced to fetal development,” Dr. Rubens said. “With these specimens, researchers can begin to understand what causes adverse pregnancy outcomes, and develop novel interventions to prevent them.”

To learn more:

  • Go to the GAPPS Flickr page to see more photos of the repository.
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Gonorrhea bacteria - Photo CDC

New drugs needed to combat drug-resistant gonorrhea, warn scientists

Some cases of gonorrhea in the U.S. may soon be incurable unless new drugs can be found to combat emerging strains that are resistant to existing “last line of defense” antibiotics, scientists warn in an article in this week’s issue of The New England Journal of Medicine.

“It is time to sound the alarm,” said Dr. Judy Wasserheit, vice chair of the Department of Global Health at the University of Washington, who wrote the article with Dr. Gail Bolan of the U.S. Centers for Disease Control and Prevention and Dr. P. Frederick Sparling of the University of North Carolina School of Medicine, Chapel Hill.

Gonorrhea bacteria - Photo CDC

Gonorrhea is a sexually transmitted disease that can infect the genital tract, throat and anus.

There are more than 600,000 cases of gonorrhea a year in the U.S., making it one of the most common reportable infections in the country.

Untreated, gonorrhea can cause a number of serous complications, including infertility, a chronic painful pelvic condition in women called pelvic inflammatory disease, and ectopic pregnancy, a serious complication in which the fetus develops in the fallopian tube instead of the uterus.

In rare cases, the bacteria can travel through the bloodstream and infect joints, heart valves and the brain.

The bacteria that causes gonorrhea, Neisseria gonorrhoeae, has a history of quickly acquiring the ability to resist antibiotics. In the 1940s it became resistant to sulfa drugs, in the 1980s to penicillins and tetracyclines, and by 2007 to flouroquinolones.

Today, treatment with a class of antibiotics called cephalosporins is considered the most reliable option, but resistance to this class of drugs is on the rise both abroad and in the U.S., raising concerns that doctors here will soon begin seeing cases they cannot cure.

Untreatable cases have not yet been reported in the U.S., but they have appeared in Asia and Europe and a worrying number of strains in the U.S. are showing signs of resistance to cephalosporins.

Resistance to one of the cephalosporins has risen 17-fold in the U.S. over the past few years, Dr. Wasserheit and her colleagues write, increasing from just 0.1 percent of cases in 2006 to 1.7 percent in the first part of last year.

Resistance has been increasing even faster in the western U.S., reaching 3.6 percent of all cases last year and 4.7 percent of cases among men who have sex with men.

Although higher doses may overcome the ability of these strains to resist cephalosporins for a time, Dr. Wasserheit and her colleagues write, urgent action is needed now to prevent the spread of these strains and to develop new treatments.

“There is much to do, and the threat of untreatable gonorrhea is emerging rapidly,” they conclude.

 To learn more:

  • Visit the National Library of Medicine’s Medline Plus information page on gonorrhea.
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Hutch hosts lecture series for the public next month

Next month, Fred Hutchinson Cancer Research Center offers its annual “Science for Life” series in which the center’s top researchers will explain the latest science. The promise “a fun and informal atmosphere.”

The talks will be held 7 p.m. to 8:30 p.m. every Thursday of the month.


What’s Stress Got to Do with It? — February 2

Dr. Bonnie McGregor is a behavioral medicine pioneer interested in how psychological factors affect the health of our bodies and our minds. Hear how stress influences our vulnerability to disease, and how stress management techniques can help you reduce your own disease risk.

Stem-cell Therapy: The Hope, the Hype and the Real Potential – February 9

Join Drs. Beverly Torok-Storb, Tony Blau, Phil Horner and Chuck Murry in a discussion of stem-cell research. Learn about the different types of stem cells, common misunderstandings about stem-cell work, clinical therapies being explored and what these researchers envision for the future.

Cancer and Infectious Diseases: Making a Global Impact – February 16

Did you know that nearly a quarter of cancers around the world are infection caused or related? Meet Dr. Corey Casper, the force behind the Hutchinson Center’s research on infection-related cancers in Uganda. By focusing efforts in a country with a higher disease burden, we hope to understand how chronic infections lead to cancer, including why this happens in some of us and not in others.

Influenza: A Study in Evolution – February 23

Soon personal genomic sequences will be cheaper than personal computers. But genomic sequences don’t come with instruction manuals, so revealing what they tell us about evolution and disease remains a challenge. Dr. Jesse Bloom will take us on a journey along the evolutionary path followed by one influenza gene over the last 40 years, and reveal the obstacles and forces that shape genetic change as we attempt to understand evolution at the molecular level.

When:

Thursdays
February 2-23
7-8:30 pm

 Where:

Fred Hutchinson Cancer Research Center
1100 Fairview Ave. N., Seattle
Thomas Building
Pelton Auditorium

To Register go HERE.

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Illustration by Zoran Ozetsky

Inbox: Polyclinic launches clinical research program, VM and Wenatchee Medical Center, PATH & Merck for Mothers

From the LocalHealthGuide inbox:

Polyclinic introduces clinical research department with international HDL study

Seattle’s Polyclinic has launched a clinical research department with a study sponsored by Oxford University. The study, called REVEAL, will test whether new drug Anacetrapib can boost levels of the “good cholesterol” HDL in patients 50 years or older with a history of heart attack, coronary artery disease, or type I or II diabetes. “The only currently available therapy with an effect on HDL is niacin, which raises levels by 20% to 30% but can cause uncomfortable side effects,” the medical group says. Press Release.

Virginia Mason and Wenatchee Valley Medical Center to Begin Cardiac Affiliation

Virginia Mason and Wenatchee Valley Medical Center have formed a “cardiac affiliation” in which physicians from the two medical centers will collaborate on patient care and share best practices. Activities include:

  • Weekly Grand Rounds
  • Consultation on cases requiring technology and techniques not available in Wenatchee
  • Development of cardiology order-sets and clinical protocols
  • Weekly cardiac catheterization conferences and collaborative case reviews
  • Shadowing opportunities
  • Continuing medical education
  • Site visits
  • Community outreach events

To learn more read the full press release.

Merck for Mothers and PATH to collaborate on project to reduce maternal deaths

The pharmaceutical company Merck has awarded a grant to the Seattle global health non-profit PATH to “evaluate more than 30 promising technologies at various stages of development that address the two leading causes of maternal mortality—post-partum hemorrhage and preeclampsia—as well as family planning.”

The initiative is part of Merck’s “Merck for Mothers” program.

“The partnership, valued at $2.5 million and extending through Fall 2012, will integrate private- and public-sector expertise to help evaluate affordable and easy-to-use maternal health technologies that work in resource-poor settings.” Press Release.

PRESS RELEASE MATERIAL

Polyclinic introduces clinical research department with international HDL study

SEATTLE, Wash. – The Polyclinic is participating in a major international clinical research study aimed at raising HDL (good cholesterol) levels. As an entirely new department at The Polyclinic, clinical research opens up an additional arm of medicine for patients and physicians alike. The Polyclinic recognizes clinical research as an enhancement to its mission of providing high-quality, comprehensive, personalized health care.

“Patients who participate in clinical research studies are ultimately contributing to better health care,” said Polyclinic Chief Medical Officer Michael Tronolone, MD, MMM. “It leads to new discoveries that improve quality of life, and also the lives of future generations.”

Having grown significantly since its creation a year ago, the department aims to focus on research studies addressing significant unmet medical needs. Polyclinic physicians welcome the addition of the department, as it increases patients’ options for treatment and their ability to participate in research.

“Not all patients achieve optimum health with currently available medications,” said Dr. Tronolone. “The Polyclinic clinical research department can now play a part in improving outcomes.”

This international HDL study, now enrolling participants, will test whether new drug Anacetrapib can boost HDL levels in patients 50 years or older with a history of heart attack, coronary artery disease, or type I or II diabetes.

The study, entitled REVEAL and sponsored by Oxford University, will include 30,000 individuals worldwide with 180 sites in the United States.

The only currently available therapy with an effect on HDL is niacin, which raises levels by 20% to 30% but can cause uncomfortable side effects.

“Although we have excellent methods of treating heart disease, current therapies have plateaued and further progress is needed,” said Dr. Kier Huehnergarth, Polyclinic

cardiologist and principal investigator for the REVEAL study. “By participating in this research, The Polyclinic hopes to provide patients with even more protection against a future heart attack.”

Patients who qualify for this study will attend five clinic visits in the first year and biannual clinic visits thereafter. They will also receive a stipend for each visit as well as lab tests and study medication at no cost. The study will continue to enroll throughout the next several months.

The Polyclinic clinical research department studies are open to anyone who meets the criteria, regardless of their status as a Polyclinic patient. Other studies currently enrolling are focused on lupus, overactive bladder, nocturia (nighttime urination), and HIV. Each study is administered by a Polyclinic physician who acts as the principal investigator and is assisted by the staff of the research department.

For more information about the REVEAL study and other clinical research studies at The Polyclinic, or to find out if you qualify, visit www.polyclinic.com/clinical-research or call 206-860-5433.

# # #

PRESS RELEASE MATERIAL

Virginia Mason and Wenatchee Valley Medical Center to Begin Cardiac Affiliation

SEATTLE – (Dec. 5, 2011) – Virginia Mason and Wenatchee Valley Medical Center have entered into a new cardiac affiliation. This affiliation represents two outstanding health care organizations, who share similar values, formalizing a relationship to provide the residents of North Central Washington with access to high-quality, efficient and cost-effective health care. This is an opportunity for two like-minded organizations to further dedicate themselves to transforming health care, with a focus on improving the patient experience and value of care.

As part of the arrangement, physicians from Wenatchee Valley Medical Center and Virginia Mason will collaborate on numerous aspects of patient care and share best practices with one another. Some of the activities include:

  • Weekly Grand Rounds
  • Consultation on cases requiring technology and techniques not available in Wenatchee
  • Development of cardiology order-sets and clinical protocols
  • Weekly cardiac catheterization conferences and collaborative case reviews
  • Shadowing opportunities
  • Continuing medical education
  • Site visits
  • Community outreach events

“We look forward to this affiliation with Wenatchee Valley Medical Center, as our patients and providers throughout the state will ultimately benefit from what these exceptional organizations have to offer,” says Sarah Patterson, Virginia Mason executive vice president and chief operating officer. “Virginia Mason has served many eastern Washington patients over the years, and we are excited to build on this service as our partnership with WVMC takes shape.”

“This affiliation is a tremendous opportunity for Wenatchee Valley Medical Center and the patients it serves to have organized access to and interaction with a high quality health care organization that shares our values of patient-centered value-based care,” says Peter Rutherford, MD, CEO and Chairman of Wenatchee Valley Medical Center. “We will be able to learn from each other and improve patient care for all.”

# # #

PRESS RELEASE MATERIAL

Merck for Mothers and PATH Collaborate to Identify Innovations that Save Mothers’ Lives

Alliance is Key Step in Bringing Sustainable, Affordable Technologies to the Mothers Who Need Them Most

Whitehouse Station, N.J. and Seattle, W.A., December 5, 2011 – Merck (NYSE: MRK), known as MSD outside the United States and Canada, awarded a grant to PATH, a global health nonprofit, to identify game-changing technologies with potential to save the lives of women during pregnancy and childbirth in low-resource settings. Spearheaded by top scientists from Merck for Mothers and PATH, this unique alliance will evaluate more than 30 promising technologies at various stages of development that address the two leading causes of maternal mortality—post-partum hemorrhage and preeclampsia—as well as family planning. The partnership, valued at $2.5 million and extending through Fall 2012, will integrate private- and public-sector expertise to help evaluate affordable and easy-to-use maternal health technologies that work in resource-poor settings.

“PATH is excited to collaborate with Merck to make measurable reductions in maternal mortality,” said Dr. Michael J. Free, vice president and senior advisor for technologies, PATH. “Combining our capabilities will allow the most effective technologies to enter the market, without the usual barriers that come from the lack of private-sector incentives. This is an opportunity to advance needed technologies and make a great impact on maternal health around the world.”

“There are many promising, life-saving maternal health innovations that, left to current market forces, would not reach the mothers who need them, when they need them, at a price they can afford,” said Dr. Naveen Rao, who is leading Merck for Mothers. “By collaborating with PATH, which has deep expertise in developing solutions for the world’s greatest health problems, we will help bring important technologies to countries where women are dying at some of the highest rates.  By doing so, we will fulfill a key part of the commitment of Merck for Mothers to advance product development in post-partum hemorrhage, preeclampsia and family planning toward achieving United Nations’ Millennium Development Goal 5.”

Merck for Mothers is a new 10-year, half-billion-dollar initiative to create a world where no woman has to die from preventable complications of pregnancy and childbirth (merckformothers.com).  Drawing on the company’s history of discovering innovative, life-saving medicines and vaccines, Merck for Mothers will apply Merck’s scientific and business expertise—as well as its financial resources and experience in taking on tough global healthcare challenges—to reduce maternal mortality around the world.  As part of its focus, the program will seek to accelerate access to proven solutions; develop game-changing prevention, diagnostic and treatment technologies; and support public awareness, improved policies and broader private-sector engagement in the area of maternal health. The collaboration with PATH is a key step in Merck for Mothers’ rapid development of game-changing technologies in maternal health, and the company will leverage the learnings to build an investment strategy for accelerating the development of these technologies.

Researchers at Merck’s Development Center in Oss, Netherlands and PATH’s Technology Solutions Global Program in Seattle will work together to advance promising technologies in different stages of development, with an initial goal of identifying three to five maternal health breakthroughs in the next 12-18 months. The collaboration will evaluate technologies in the prevention, diagnostic and treatment areas for the different stages of pregnancy and childbirth and compare them across multiple parameters, such as commercialization potential, user and stakeholder acceptability and time to impact.

Potential technologies for assessment include:

• Treatments for the prevention of post-partum hemorrhage to assist women in the third stage of labor.

• Pre-natal preeclampsia screening tool to identify high risk women and significantly increase survival rates.

• Effective family planning interventions that are relatively easy to use to encourage higher adherence.

About Maternal Mortality

In the next decade, it is estimated that as many as three million women may die from complications of pregnancy and childbirth. The majority of these maternal deaths are preventable.

The United Nations’ Millennium Development Goals (MDGs) seek to address the world’s greatest development priorities, with MDG5 focused on reducing the maternal mortality ratio by 75 percent and creating universal access to reproductive health. However, several countries around the world run the risk of failing to meet this goal unless good-quality reproductive health services and well-timed interventions are supplied.

About PATH

PATH is an international nonprofit organization that transforms global health through innovation. PATH takes an entrepreneurial approach to developing and delivering high-impact, low-cost solutions, from lifesaving vaccines and devices to collaborative programs with communities. Through its work in more than 70 countries, PATH and its partners empower people to achieve their full potential. For more information, please visit www.path.org.

About Merck

Today’s Merck is a global healthcare leader working to help the world be well.  Merck is known as MSD outside the United States and Canada.  Through our prescription medicines, vaccines, biologic therapies, and consumer care and animal health products, we work with customers and operate in more than 140 countries to deliver innovative health solutions.  We also demonstrate our commitment to increasing access to healthcare through far-reaching policies, programs and partnerships.  For more information, visit www.merck.com and connect with us on Twitter, Facebook and YouTube.

Forward-Looking Statement

This news release includes “forward-looking statements” within the meaning of the safe harbor provisions of the United States Private Securities Litigation Reform Act of 1995. Such statements may include, but are not limited to, statements about the benefits of the merger between Merck and Schering-Plough, including future financial and operating results, the combined company’s plans, objectives, expectations and intentions and other statements that are not historical facts. Such statements are based upon the current beliefs and expectations of Merck’s management and are subject to significant risks and uncertainties. Actual results may differ from those set forth in the forward-looking statements.

The following factors, among others, could cause actual results to differ from those set forth in the forward-looking statements: the possibility that the expected synergies from the merger of Merck and Schering-Plough will not be realized, or will not be realized within the expected time period; the impact of pharmaceutical industry regulation and healthcare legislation; the risk that the businesses will not be integrated successfully; disruption from the merger making it more difficult to maintain business and operational relationships; Merck’s ability to accurately predict future market conditions; dependence on the effectiveness of Merck’s patents and other protections for innovative products; the risk of new and changing regulation and health policies in the United States and internationally and the exposure to litigation and/or regulatory actions.

Merck undertakes no obligation to publicly update any forward-looking statement, whether as a result of new information, future events or otherwise. Additional factors that could cause results to differ materially from those described in the forward-looking statements can be found in Merck’s 2010 Annual Report on Form 10-K and the company’s other filings with the Securities and Exchange Commission (SEC) available at the SEC’s Internet site (www.sec.gov).

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World AIDS Day

Top 10 myths about HIV vaccine research

By Dr. James Kublin
Executive director of the HIV Vaccine Trials Network

Today, December 1st, is World AIDS Day, and to mark the occasion the HIV Vaccine Trials Network, which is headquartered at Fred Hutchinson Cancer Research Center in Seattle, would like to debunk the top 10 myths about HIV vaccine research.

Myth No. 1: HIV vaccines can give people HIV.

HIV vaccines do not contain HIV and therefore a person cannot get HIV from the HIV vaccine. Some vaccines, like those for typhoid or polio, may contain a weak form of the virus they are protecting against, but this is not the case for HIV vaccines. Scientists make HIV vaccines so that they look like the real virus, but they do not contain any HIV. Think of it like a photocopy: It might look similar, but it isn’t the original. In the past 25 years more than 30,000 volunteers have taken part in HIV vaccine studies worldwide, and no one has been infected with HIV by any of the vaccines tested – because they do not contain HIV.

Myth No. 2: An HIV vaccine already exists.

There is no licensed vaccine against HIV or AIDS, but scientists are getting closer than ever before to developing an effective vaccine against HIV. In 2009, a large-scale vaccine study conducted in Thailand called RV144 showed that a vaccine combination could prevent about 32 percent of new infections. Researchers are starting to understand why this vaccine combination worked and how to improve upon it.

Researchers around the world continue to search for an HIV vaccine that is even more effective. Leading this effort is the HIV Vaccine Trials Network, the largest publicly funded group of HIV vaccine researchers in the world. The HVTN is an international effort to find a safe and effective vaccine to stop the spread of HIV. It is funded by the U. S. National Institutes of Health.

Myth No. 3: Joining an HIV-vaccine study is like being a guinea pig.

Unlike guinea pigs, people can say yes or no to participating in research. All study volunteers must go through a process called informed consent that ensures they understand all of the risks and benefits of being in a study, and those volunteers are reminded that they may leave a study at any time without losing rights or benefits. The HVTN takes great care in making sure people understand the study fully before they decide whether or not join. All HVTN research adheres to U.S. federal regulations on research, as well as the international standards for the countries in which it conducts research.

Myth No. 4: A person must be HIV positive to be in an HIV vaccine study.

Not so. While some research groups are conducting studies of vaccines that might be used in people who are already infected with HIV, the vaccines being tested by the HVTN are preventive vaccines. They must be tested on volunteers who are not infected with HIV.

Myth No. 5: Vaccine researchers want study participants to practice unsafe behaviors so they can see whether the vaccine really works.

Not true. The safety of study participants is the No. 1 priority of HIV vaccine researchers and study site staff. Trained counselors work with study participants to help them develop an individual plan on how to keep from contracting HIV. Participants also are given supplies such as condoms and lubricant as well as instructions on how to use them properly. HIV efficacy trials enroll thousands of participants over several years, and with even with the best counseling some participants will still become infected through their risky behavior. Changing human behavior is never easy; after all, many people still smoke, even though it is widely known that smoking is the major cause of lung cancer. An AIDS epidemic would not exist if prevention was as simple as counseling people to change their risky behavior.

Myth No. 6: Now that there are pills that can prevent HIV infection, an HIV vaccine is no longer necessary.

HIV-negative people who are at high risk can take antiretroviral medication daily to try to lower their chances of becoming infected if they are exposed to the virus. This type of therapy – called PrEP, short for PreExposure Prophylaxis – has been shown to be effective among those at high risk. However, it has not yet been recommended for widespread use. PrEP is unlikely to be an option for everyone because the pills are expensive and are not always covered by insurance, may cause side effects, and not everyone has access to them. Remembering to take a pill every day is also challenging for some people. The most effective way to eliminate a disease is by using an effective vaccine. It was a vaccine that eliminated small pox and has almost eliminated polio. Most likely it will be an HIV vaccine that eliminates HIV from the world. Vaccines are an effective, affordable and practical option.

Myth No. 7: An HIV vaccine is unnecessary because AIDS is easily treated and controlled, just like diabetes.

While treatment for AIDS has dramatically improved over the last 30 years, it is no substitute for prevention. Current HIV medications are very expensive, and there are also many side effects. Sometimes people develop drug resistance and have to change the regimen of pills they take. Access to these drugs for the uninsured in the U.S. and those in the developing world is also very limited.

Myth No. 8: The search for an HIV vaccine has been going on for a long time and it’s just not possible to find one that works.

The science of HIV-vaccine development is challenging, but scientific understanding continues to improve all the time. In just the past two years there have been promising results from the RV144 study in Thailand as well as exciting laboratory work, such as the discovery of new broadly neutralizing antibodies against HIV. HIV is a powerful opponent, but scientists are constantly learning from one another and using advanced technology to fight it. Science has come a long way in the 30 years since AIDS was discovered. In comparing preventive HIV vaccine work to other vaccine development, the time it has taken is not so surprising; the polio vaccine took 47 years to develop.

Myth No. 9: Vaccines cause autism and just aren’t safe.

This is not true. Numerous studies in the past decade have found this claim to be false. The British doctor who originally published the finding about vaccines and autism has since been found to have falsified his data. There is actually no link between childhood vaccination and autism. It is true that vaccines often have side effects, but those are typically temporary (like a sore arm, low fever, muscle aches and pains) and go away after a day or two. The value of protection to vaccinated individuals and to the public has made vaccines one of the top public health measures in history, second only to having a clean water supply.

Myth No. 10: People who aren’t at risk don’t need an HIV vaccine.

A person currently may not be at risk for HIV, but life situations can change along with disease risk. Such a vaccine also may be important for one’s children or other family members and friends. By being knowledgeable about preventive HIV vaccine research, a person can be part of the solution by educating friends and family about the importance of such research and debunking the myths that surround it. Even if a person is not at risk, he or she can be part of the effort to find a vaccine that will hopefully save the lives of millions of people worldwide.

To learn more or find out how to get involved in an HIV vaccine study, please visit www.hvtn.org

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Globe floating in air

PATH’s Elias moves to Gates Foundation

Dr. Christopher Elias, M.D., president and chief executive officer of the Seattle-based global health organization PATH, will move the The Bill & Melinda Gates Foundation to serve as the president of the foundation’s Global Development Program.

Elias joined PATH in 2000, when the organization had a budget of $44 million and a staff of 297 employees. He led the organization through a period of significant growth, and the non-profit now has an annual budget of $295 million and more than 1,100 on staff working on project in more than 70 countries.

In his new position, Dr. Elias focus on developing integrated health-care delivery of interventions for the developing world. In addition, he will oversee the foundation’s Family Health and Vaccine Delivery strategies along with Global Development’s existing work in Agricultural Development, Financial Services for the Poor, Water, Sanitation & Hygiene, and Special Initiatives.

The foundation’s U.S. and Global Libraries Programs will also be combined in this broader portfolio, the foundation said.

“I am deeply honored to be joining the Gates Foundation,” Dr. Elias said in a statement. “I look forward to applying my experience in health and development to help advance the foundation’s ambitious mission.”

Dr. Elias received his M.D, from Creighton University in 1983, and received an MPH in 1990 from the University of Washington, where he was also a fellow in the Robert Wood Johnson Clinical Scholars Program.

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Malaria parasite

Promising malaria vaccine results released at Seattle conference

Malaria parasite

The malaria parasite

A malaria vaccine developed by the pharmaceutical company GSK and Seattle’s PATH has been shown to halve the risk of severe malaria in African children.

Malaria strikes an estimated 225 million people worldwide each year, killing more than 780,000 — most of whom are African children.

Currently, there is no approved vaccine for the prevention of the  disease, which is caused by the parasite Plasmodium falciparum.

The new results, which have been published online in the New England Journal of Medicine, were announced today in Seattle at a Malaria Forum hosted by the Bill & Melinda Gates Foundation, which provided major funding for the trial.

The study, which was conducted in seven countries in sub-Saharan Africa, found that three doses of the vaccine, called RTS,S, reduced the risk of a child developing high fever and chills by 56 percent and of severe malaria by 47 percent.

In the study ,the researchers looked at malaria rates among the first 6,000 children, aged 5 to 17 months, in the 12 months after they had received the third dose of the three-dose vaccine regimen.

All together, a total of 15,460 children are enrolled in the study in two age groups–a younger group, 6 to 12 weeks-old and a slightly older group 5 to 17 months-old.

The trial is ongoing, and results of the vaccine’s efficacy in infants 6 to 12 weeks-old are expected by the end of 2012, but a interim analysis of all of the infants and children enrolled in the trial 6 weeks to 17 months finds that at an average of about one year the vaccine reduced the risk of of severe malaria by a third, 34.8 percent.

In a commentary that accompanied the article, Dr. Nicholas White, professor of Tropical Medicine at Mahidol University in Thailand, writes that if all goes well, the RTS,S vaccine should become available in just over 3 years. “It’s been a long time coming, but it is becoming increasingly clear that we really do have the first effective vaccine against a parasitic disease in humans.”

But, he adds, questions remain: how long, for example, will the vaccine remain protective, how much will the vaccine cost, and, will the recent drop in malaria deaths due to other interventions, such as the increased use of insecticide-treated bed nets, cause a loss of support for expensive anti-malaria initiatives.

“How,” he asks, “will the necessary funding be sustained in the face of a global economic downturn, along with a reduction in political pressure associated with declining mortality form malaria?”

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Pacific Science Center hosts Life Sciences Research Weekend, Nov. 4-6

The Pacific Science Center will host a three-day Life Sciences Research Weekend, November 4th through the 5th, showcasing the research of more than 25 biotech industry and research institutions from around Washington state.

The event, which is geared for children and adults, features interactive, hands-on activities and opportunities to talk with top scientists about their research.

The event, which is cosponsored by the Northwest Association for Biomedical Research, is open to all and free with regular admission.

Organizations interested in setting up an activity table at Pacific Science Center for Life Sciences Research Weekend can register online.

To learn more:

Go to the NWABR website.

Where:

Pacific Science Center

When: 

November 4-6th

Friday: 10 a.m. to 4 p.m.

Saturday and Sunday: 10 a.m. to 5 p.m.

Participating organizations include: 

  • Amgen.
  • Bates Technical College.
  • Benaroya Research Institute.
  • Infectious Disease Research Institute (IDRI).
  • Institute for Systems Biology.
  • Iverson Genetic Diagnostics.
  • North Seattle Community College – SHINE program.
  • Northwest Association for Biomedical Research (NWABR).
  • Pacific Science Center – Science Communication Fellows.
  • Seattle Biomedical Research Institute.
  • Seattle Children’s Research Institute.
  • Shoreline Community College.
  • Swedish Medical Center.
  • The Hope Heart Institute.
  • UW Biochemistry, Computer Science and Engineering Depts.
  • UW Bioengineering Dept. and Biomedical Engineering Society (BMES).
  • UW Medicine, South Lake Union Group (SLUGS).
  • UW Neurobiology & Behavior Community Outreach.
  • WSU Horticulture Dept.

 

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Class helps deaf Bhutanese refugees restart their lives

 

Dhan Biswakarma and his wife, Bee Biswakarma, who live in Kent, are among several deaf Bhutanese refugees who have been learning American Sign Language at Highline Community College. Photo Allison Barrett

By Allison Barrett

Nancy Allen, an American Sign Language (ASL) teacher at Highline Community College, goes through a stack of name cards, holding up each one and looking quizzically at the students.

“Whose is this?” she signs.

A short man in his 50s smiles hesitantly and raises his hand slowly as he sees the card with his name.

“What is your name?” Allen signs.

The man points to his chest, crosses his fingers in the sign for “name” and then slowly shapes his stout, weathered fingers to form: “D-H-A-N. My name is Dhan.”

Sitting next to him, his wife laughs out loud as her turn comes. She stumbles over the signing sequence, but she follows Allen’s lead and carefully signs her name.

“My name is B-E-E. Bee.”

For Bee and Dhan Biswakarma, Bhutanese refugees restarting their lives in Kent, the struggles of resettlement are intensified by the fact that the deaf couple has few means of communicating with the speaking world.

The Biswakarmas are among a number of deaf or hard-of-hearing Bhutanese refugees who have been resettled in King County in the past several years. Last spring’s class at Highline represented the Biswakarmas’ first exposure to a developed language.

“They have gone their whole lives with no formal language, getting by without a lot of communication,” said David Van Hofwegen, the couple’s caseworker from the World Relief Organization.

They have a repertoire of gestures to communicate with family members. But when it comes to sharing their thoughts with the hearing world, they are limited to signing the basics: eat, sleep, sick, house, wife, child.

And family.

In class, Bee has difficulty remembering how to sign her name, but she immediately grasped the expression for family. At home, she makes the sign after pointing to each relative seated on the mismatched jumble of couches and wooden chairs.

Sher Pandey (in baseball cap), his wife, Basu Pandey (to his left), and Man Budhathoki (at right) practice signing at Highline's American Sign Language class last spring. Photo Allison Barrett

Bee, 47, and Dhan, 55, met in a refugee camp along Nepal’s eastern border after each fled Bhutan by foot in 1991.

They were driven out of their home country by policies implemented in the mid-1980s to forcefully integrate the ethnic Nepali inhabitants of southern Bhutan into the monarchy’s vision of a unified national identity.

Southern Bhutanese were required to go to impossible ends to prove citizenship, ordered to stop teaching Nepali in schools and to abandon traditional dress and customs.

They protested and the military cracked down.

Homes were raided at night and dissidents were jailed, said Bal Biswa, a relative who helps to take care of Bee and Dhan.

Dhan and his extended family, including his relatives and caretakers Bal and Pabita Biswa, joined 23 other families to walk out of Bhutan, sleeping in the forest by day and traveling at night.

According to the United Nations High Commission on Refugees, since 1990 almost 100,000 southern Bhutanese have fled the tiny Himalayan kingdom that is often hailed as the “happiest country in the world” and celebrated for its measurement of Gross National Happiness.

Sitting in the Kent apartment that he and Bee share with Bal and Pabitra, Dhan points at Pabitra and then brings his hand above the ground in a gesture that looks like he’s placing it on the head of an invisible child. He pantomimes that he is carrying something.

Pabitra explains that Dahn helped her carry her kids out of Bhutan. She and her husband, Bal, lost two of those young children to a fever that broke out in the squalor of the early encampments.

Bhutan. Map by Shahid Parvez under Creative Commons license.

Little preparation

Bee and Dhan arrived in Seattle early this year, part of the more than 1,800 Bhutanese who have been resettled in Washington state since 2008. They came with their son, 12-year-old Golpal, who is able to hear and lives with other relatives.

The couple had little preparation for life here.

Bee and Dhan were both born deaf, leaving limited options for employment or education. Bhutan had no established sign language until 2003, when the monarchy opened its first school for deaf children.

“You are considered backwater in society,” said Mitra Dhital, a Bhutanese refugee who works as a medical social worker for the Asian Counseling and Referral Services.

In many ways, they are even less independent in America.

Bee and Dhan don’t like to walk the five blocks to a grocery store alone, for fear of getting lost. Sometimes they stroll around the perimeter of the building, but never leave the grounds.

At first they were fearful of going to their ASL class. They were daunted by many things, including the bus ride there, until the World Relief organization provided a volunteer-driven van ride.

Among the eight Bhutanese class members, there is a range of hearing impairment, from Bee, who lives in complete silence, to a man in his mid-30s who has no hearing in one ear and is slowly going deaf in the other.

The number of those who are deaf or hard-of-hearing represent only a small percentage of the Bhutanese refugees here. But caseworkers say it is an unusually large number compared to other refugee groups. No one is certain why.

It is unclear whether that is the result of policies that give the deaf resettlement priority because of their lack of opportunities in the camps, or if the number reflects a high occurrence of deafness within Bhutan.

The World Health Organization estimates that of the 278 million people in the world living with moderate to profound hearing loss, 80 percent live in developing countries. And about half of all cases are preventable, caused in part by illnesses like measles, mumps and rubella that have readily available vaccinations in the developed world.

Ear infections, exacerbated by poor sanitation and hygiene, often went untreated in the refugee camps for Bhutanese, said Dhital.

Allen is adamant that even without a formal language, Bee and Dhan understand each other just fine. “All deaf people have a language,” said Allen.

The challenge for Bee, Dhan and the others in the class is finding a way to interact with the hearing world.

Allen, director of interpretive services at Highline, was approached about starting an ASL class for deaf Bhutanese about a year ago. She had never taught a class tailored to refugees.

Around the same time, Allen ran into a Bhutanese couple in the college’s parking lot, a hearing woman with her deaf husband. The wife, enrolled in English classes at Highline, was in search of a class for her husband.

“The light bulbs started going off,” said Allen. “There are other deaf refugees here. There is a need that is not being met.”

She says her deaf co-teacher, Ricardo Velilla, is the key to the class.

Extremely animated, he can model abstract concepts with ease. He acts out a jaunty stroll down the road, a runaway vehicle and narrowly averted catastrophe. He then runs the palm of one hand up the back of the other in a smooth motion. This is the sign for “almost.”

For a short time, Allen and Velilla had a deaf man from Somalia in their class.

“One day he came in very agitated, making all these wild motions,” said Allen. “Ricardo took one look at him and explained to me, ‘He used to have a driver’s license in his home country but he’s frustrated because he can’t get one here.’ ”

Allen knows lots of other deaf refugees and immigrants could benefit from access to ASL. But for now, the class is only offered once a week.

Until Bee and Dhan acquire enough ASL to communicate ideas to the hearing world, their prospects for employment are dismal.

Van Hofwegen is assisting them with the lengthy and very difficult process of qualifying for federal disability benefits.

The program doesn’t accept international evidence. You have to visit a primary physician for a referral and get screened by certified audiologists and other specialists, a procedure that requires Bee and Dhan, accompanied, to run to appointments all over the county.

Evening sets in, and the Kent apartment is filled with the scent of Nepali dumplings. Golpal and some neighbor boys are engaged in a cutthroat game of marbles on the floor. Bal and Pabitra’s sons are using the bulky computer in the corner, browsing Facebook and watching Bollywood videos on YouTube.

Dhan retreats to the bedroom and returns, carrying a sheet of paper. He takes a seat next to Bee on the couch.

They both lean over the manuscript that is covered in a scrawling alphabet, written in Dhan’s shaky hand, and start to shape their fingers into signs, beginning with the letters of their names.

Allison Barrett, a UW senior, wrote this piece for Health Intersections, the UW Communications Department’s class on global health reporting. She can be reached at allisondbarrett@gmail.com

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