Impact of Tibetan singing bowls massage in the tradition Tsering Ngodrub on the human body

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Study of vibroacoustic tibetan massage effectiveness to reduce anxiety level

Study of vibroacoustic tibetan massage effectiveness


The use of vibroacoustic Tibetan massage to reduce anxiety symptoms (according to the Spielberger test and Tsung’s self-evaluation scale) in 33 investigated patients was positively effective immediately after one session (p <0.05).


vibroacoustic massage, Tibetan singing bowls, psychological rehabilitation, psychocorrection, prevention, anxiety symptoms, reactive anxiety


Development and scientific substantiation of new health-saving technologies that promote the activation of reserve and adaptive capabilities of the organism, correction of the diseases development risk factors, prevention of common somatic diseases complications constitute the main platform for scientific research in the field of restorative medicine (Olenskaya, 2015, Shusharjan, 2013).

At the same time, modern data from epidemiological studies show significant prevalence of anxiety symptoms, both in medical and psychological practice (Neznanov, Martynikhin & Mosolov, 2017).

In our country, the high prevalence of anxiety-depressive disorders was demonstrated by the epidemiological study COMPASS (clinical and epidemiological program for the study of depression in the practice of GPs), the results of which showed that 45.9% of the outpatient department patients were diagnosed with depressive disorders. In most cases, depression is associated with anxiety, so in practice, a doctor has to deal with anxiety-depressive disorder (ADD) in a particular patient.

According to epidemiological data, anxiety disorders are the most common group of psychiatric disorders in the world. For example, in the meta-analysis of epidemiological studies conducted around the world over the past 30 years, the average estimate of anxiety disorders prevalence was higher than that of other psychiatric disorders (including affective disorders and addictions) with a prevalence of 6.7% in the population during the year and 12.9% during life (Peskovets, Evsyukov, 2016). Unfortunately, there are no reliable epidemiological data about the prevalence of anxiety disorders in the Russian Federation. According to the Ministry of Health, in 2013, the number of patients in psychiatric care institutions during the year with neurotic, stress-related and somatoform disorders (the entire chapter F4 of ICD-10) was only 0.3% of the population. It can be assumed that the true prevalence of anxiety disorders in Russia is several dozen times higher than the number of cases recorded by the psychiatric service. However, it is known that inopportune and / or inadequate care for people with anxiety disorders leads to the decrease in the quality of their life and work capacity, development of psychosomatic diseases, unfavorable dynamics of present somatic diseases, which entails serious costs for the public health and economy of the country.

In recent decades, anxiety disorders have been actively studied, a large body of scientific data on their genesis, clinical manifestations and effective therapies has been accumulated, and according to a global survey of psychiatrists conducted by the World Psychiatric Association (WPA) and the World Health Organization (WHO), diagnoses of anxiety disorders are among the most commonly used diagnostic headings by psychiatrists around the world. Moreover, the working group for the preparation of the 11th revision of the International Classification of Diseases (ICD) proposes to single out of the chapter F4 «Neurotic, stress-related and somatoform disorders», existing in ICD-10, an independent chapter «Anxiety and fear-related disorders», which would include generalized anxiety disorder (GAD), panic disorder (PR), agoraphobia, specific phobias and social phobia, and separately an independent chapter «Disorders directly related to stress» (adaptation disorders, post-traumatic stress disorder, etc.) (Shalnova, 2014).

National studies in several countries have shown that mental disorders are widespread and they are a significant cause of disability. Nevertheless, a significant number of specialized medical care lack cases was revealed, even with serious enough disorders. In developed countries, treatment was not provided in 36—50% of serious cases last year, whereas in developing countries the situation was even worse: 76—86% of cases remained untreated. It was proposed to expand treatment services to reduce the incidence and consequences of mental disorders. The problem of «lack of treatment» is so serious that the World Health Report 2001 has issued ten recommendations for its elimination, which include ensuring availability of psychiatric care at the primary care level, psychotropic drugs, and mental health specialist’s professional development. According to the modeling data, the expansion of evidence-based treatment will reduce the prevalence of mental disorders and provide an economic investment return.

According to the World Health Organization (WHO), about 50% of the world’s population suffer from mental disorders at some period of their lives. The results of Psychological Disorders in Primary Care study show that the most common mental disorders in general practice include depression and anxiety disorders. According to experts from WHO (2001), by 2020, depression will take the second place among the causes of disability and mortality of the world population.

According to the literature, the prevalence of anxiety-depressive disorders in the population of economically developed countries in Europe and the US reaches 10% (Jorm, 2017), at least one episode of anxiety disorders is registered in 12—27% of Europe’s population, and in persons with somatic pathology, anxiety-depressive disorders occur 2—3 times more often than in the general population.

Most studies, systematic reviews and meta-analyzes provide consistent evidence that depression is an independent risk factor for developing chronic non-infectious diseases.

In foreign and domestic studies, including official statistics, there is a wide range of data on the prevalence of mental disorders and their subclinical conditions, which is associated with the difficulties of conducting epidemiological studies and the complexity of statistical analysis. In addition, studies revealed insufficient training of therapists, cardiologists and other specialists in the field of somatic diseases in the context of diagnosing mental disorders. According to the literature, in patients observed in outpatient clinics, clinical and subclinical state of anxiety was recorded in 20 to 80% of cases, depression — in 20 to 60% and in 50—80% of cases these conditions are not detected by «somatic» doctors (Shalnova, 2014).

The use of subjective psychometric tests allows to minimize the costs of screening possible mental disorders among the population, while interpreting the results obtained does not require special knowledge from GPs and psychologists.

Literature Review

Such method of restorative medicine, like vibroacoustic therapy — is a relatively new drugless method, using the sound of audible range as a source of mechanical vibrations directly transmitted to the human body. This type of massage, given by contact or non-contact method, with the use of «Tibetan singing bowl» (TSB), has a complex sanative physiological effect on cardiovascular, lymphatic, vegetative systems and on the emotional condition of a person. Vibroacoustic massage with singing bowls (VAMSB) allows to affect individual parts of the body, central and peripheral nervous system, tissues and organ systems separately, according to special technology (Anisimov, Karbysheva, 2012; Anisimov, Karbysheva, Kuzmina, Brilkov, Lomzhina, 2015).

Vibromechanical stimulation, focused on medical-rehabilitation, psycho-corrective and sports-improving purposes, has been used in various ways for more than 80 years.

Periodic oscillatory movements, which cause a kind of shaking sensation in a person, are usually called vibrations. The notion of «vibration» is synonymous with the notion of «mechanical oscillation.» Any living system from cellular organelles (nucleus, chromosomes) to tissue cells (erythrocytes, capillaries) is characterized by the presence of high-frequency mechanical vibrations (ultrasound — hyper sound). This makes it possible to consider vibrational process as one of the main manifestations of life. Experimental facts indicate that mechanical vibrations participated in the creation of biological structures at the beginning of life origin. Vibrational processes accompany life at different stages of its organization. They are a constantly acting factor on our planet and are observed in all spheres. The range of these vibrations extends from infrasound to ultrasound, and their intensity varies from the barely perceptible by a human ear to intensities capable of destroying fortresses. The action of mechanical vibrations under certain conditions is necessary for a living organism, the absence of sound stimuli disturbs nervous activity. For example, variations in the atmospheric acoustic noise of very low frequency are an environmentally significant factor. Infrasound vibrations may be attributed to the main rhythm-setting factors of the environment, since they have seasonal-diurnal, perennial variations (Krikuha, Sergievich, 2015; Paine, 2016; Black; Rodin; Zimmermann, 2017; Cho, 2017).

It is found that there is a direct transformation of the energy of cosmic origin (electro-magnetic radiation) into intense acoustic vibrations of the atmosphere, hydrosphere and lithosphere. These acoustic vibrations may be in different ranges — from audible sounds to acoustic-gravitational waves.

Sound waves, in their turn, may be accompanied by electromagnetic radiation. Due to synergism, one can expect that the combined acoustic and electromagnetic effects on biological objects are much stronger than the effects of each of these phenomena separately.

Vibration sensitivity belongs to the most ancient types of sensitivity. It is obvious, that it was on its basis that the separation of auditory and tactile sensations took place.

Vibration sensitivity is one of the most global forms of reflecting the connections of the human body with the most diverse environmental influences. In poorly hearing and deaf people, vibration sensitivity replaces hearing (Timofeev, 2005, Greenberg, 2014, Sagaidak, Tsikunov, 2016).

Nervous cells, as well as muscular fibers, are able to perceive sound stimulations in the audible range of sound spectrum with frequencies of 200—1000 Hz directly, without the participation of hearing organs. The cells of different human organs, including nervous cells, are sensitive to sound vibrations of a similar frequency, especially in the frequency range to which the human ear is most susceptible.

Disorders of vibration sensitivity depend on the condition of the entire brain cortex. That is why significant fluctuations in sensitivity to the same frequency are observed not only in different persons, but also in the same person studied by different researchers; depending on the time of a day, fatigue, temperature fluctuations, etc. Vibration receptors are present in all tissues of the human body, but they are different in number. Basically, they are located in zones that are evolutionarily the most adapted for perceiving information related to mechanical action: hands, feet soles, etc. Large clusters of vibration receptors are present in larynx area, in oral and nasal areas, in paranasal sinuses.

Massage can be one of vibration form. It is known that vibrating massage can normalize cortical-subcortical relationships, improve the functional condition of endocrine system, and increase the lability of nerve centers. It has a pronounced trophic, analgesic, antispasmodic and anti-inflammatory effect. It accelerates the processes of regeneration and repair, including nervous fibers, contributes to the recovery of work capacity of patients, promotes the normalization of the adaptive-trophic function of the organism. For example, the course of lumbar region vibromassage favorably affects the repair processes of injured sciatic or ulnar nerves (Sagaidak, Shilko, 2010, Barrass, 2016); Gelding, Sun, 2018).

Positive effect of vibromassage in the treatment of patients with neurological manifestations of osteochondrosis was established. Thus, the use of vibration was successful in the treatment of a number of diseases: neurological manifestations of spine osteochondrosis, traumatic injuries of the extremities nerve trunks, infantile cerebral paralysis, gynecological, bronchopulmonary and other diseases.

Positive results with the use of vibration therapy were also obtained in the treatment of endarteritis, scoliosis, vibropuncturing in certain diseases; when using vibration shaking shoes after a stroke for the treatment of blood circulation disorders. The effect of vibration therapy is confirmed by the persistence and duration of the achieved results for a long time.

The effect of vibration on the body is accompanied by certain vasomotor reactions, a change in the bioelectrical activity of the muscles. Positive effect of short-term daily vibration is noted, which is expressed in the increase of muscle strength, improvement of their blood supply, acceleration of wound healing, which persists for several days after the vibration therapy has been stopped.

It was found that vibration procedures affect the entire endocrine system, normalize thyroid gland functioning, causing decrease in serum cholesterol. They stimulated the function of the ovaries: in a number of cases, the recovery of the menstrual-ovarian cycle in middle-aged women with amenorrhea, as well as with menopause that had already occurred, was observed. Endocrine stimulation persisted for many months. The improvement of blood supply in the small pelvis area, metabolism and trophism are also important in the mechanism of this effect; as well as a certain effect on the brain appendage through the central nervous system and increasing of gonadotropic hormones production in connection with this (Dodonov, 2002; Popadyukha, Demidenko, 2016; Bidin, 2016; Goldsby, 2017).

As it was discovered by academician N.I. Arinchin, skeletal muscles are physiological vibrators; vibrations of muscle fibers drive blood in capillary vessels.

The list of diseases, cured by sound vibration massage, counts several dozens and gradually increases. The use of vibroacoustic effects is successful in a variety of pathologies: in the treatment of newborns; in the treatment of burn shock and post-burn hypertrophic scars in children; in complex therapy of compression fractures of the spine; for stimulation of cell regeneration — an element of diabetes complex treatment; for the normalization of cerebral hemodynamics; in the complex treatment of discircular encephalopathy, in the sphere of pediatric urology, in peptic ulcer. The use of vibroacoustic therapy also helps in other diseases: neuritis of facial nerve, osteochondrosis of spine; hepatitis, diseases of the musculoskeletal system, prostatitis, cystitis, essential hypertension, exertional angina, menstruation disorders, cosmetic defects, etc. (Shrestha, 2009; Barrass, 2014; Wu, 2015).

Joint researches of Southern Federal University chronobiology laboratory head, Doctor of Biological Sciences, honored inventor of Russia S.L. Zaguskin with leading specialists in various fields of medicine, conducted for 25 years, allowed us to conclude that the disadvantages of the vibration therapy, physiotherapy conventional methods are connected with the use of permanent impacts or fixed-frequency pulse impacts. In both cases, they are not adequate to the biorhythms of cells, tissues, organs and a whole body sensitivity, to the biorhythms of responses energy, which periods vary constantly. There are no «magic» frequencies for living systems that could give reproducible reactions of the necessary direction. Therefore, conventional physical therapy, as well as drug therapy, cannot guarantee or predict only favorable result for all patients without overdoses and adverse reactions.

One of the ways to improve the treatment results of urological and gynecological diseases, complicated by hypotension and organ atony, is the stimulation of the urogenital system myoneural apparatus by the sound of audible range.

It was found out that the most pronounced effect of smooth muscle contraction occurs when it is exposed to the sound with the frequency in the range from 2 to 3.4 kHz (Radchenko, 2014, Dyachenko, 2016; Sagaidak, 2016; Campbell, Hynynen, Ala-Ruona, 2017). The response of the genitourinary system musculature in the process of sound stimulation is in great dependence on the initial state of motor activity. With hyperkinesia, the frequency of organ contractions decreases, and with hypokinesia it increases, the depth of contractions increases, dyskinesia stops and the organ function is restored.

Note that the organ having smooth muscle tissue, in any case, responds to the applied irritation in such a way that it approaches its normal level of functioning (Humphries, 2010).

There are two types of vibrations in the human body, including the chest: 1) own or spontaneous, associated with the breathing of a man and 2) forced, caused by external vibrational effects. It is possible to attribute to vibrations in the system of breathing, understood in a broad sense, all mechanical vibrations, including one’s own breathing, in which mechanical vibrations of all organs of the chest take place with respiration rate.

The vibration of gas and tissue in the lungs, associated with the movement of gas in the airways, respiratory noise and special breathing maneuvers are considered to be own vibrations. The movement of gas in the respiratory tract is accompanied by the formation of vortices and, under certain conditions, turbulence. The question of transition between laminar and turbulent flows, the role of external vibrations in such transitions is considered (Arend, 2006; Doe, 2013; Gregory, 2017; Jorm, 2017).

Dyachenko A.I. in his work has found out that forced vibrations caused by external mechanical impacts have long been used for diagnostic and therapeutic purposes. Biomechanics of some external vibrations is used in medicine for pulsed oscillometry and other variants of forced oscillations method, as well as for percussion.

It is known that resonance results in the most efficient transfer of energy from the source of vibrations to the body, and therefore it can be the cause of increased sensitivity of the organism to vibrations and acoustic fields, which frequency corresponds to the resonances of the body, its organs or individual cells. At resonance, a relatively weak signal can cause considerable perturbation in the body, therefore it is important to be able to protect the body from the negative influence of intense technogenic physical fields, which frequency falls in resonance with the body’s own vibrations. For the same reason, the selection of the dosed vibration frequency used for treatment should also be made taking into account the phenomena of resonance in organs and tissues (Dyachenko, 2016).

It is proved, in particular, that when the muscle contracts, its volume does not change, but due to the change in its shape, intramuscular pressure increases, which pulls the connective tissue coats of the muscle (endomysium, perimysium, epimysium). In this case, as our studies have shown, their elasticity and resonance frequency increase. In relaxed condition, the frequency of forearm muscles resonance, measured with a vibration force of 0.15 N, does not exceed 30 Hz. At maximum isometric effort, the frequency can increase to 90 Hz or more.

Also, in the dissertation of A.B. Timofeev, it was revealed that the frequency of organs and tissues resonance depends on the amount and pressure of the blood contained in them, intercellular and intracellular fluids, therefore it can be used as an indicator of their functional state, blood filling and water balance (Timofeev, 2005).

The author has shown that one can judge about the relative content of elastic and collagen structures in organs and tissues according to the size of their deformation, at which their resonance frequency reaches 40 Hz, and it is also recognized that the exposure of soft tissues to resonant vibration contributes to the elimination of their posttraumatic edema, pain and reflex muscular contractures, and the effectiveness of the impact can be controlled by the resonance frequency.

In particular, in Anisimov B.N., Karbysheva N.V. Kuzmina O.M., Brilkov D.V., Lomzhina I.B. patent RU 2549667 C1 «Method of the organism biological age correction as prevention of premature aging», sound therapy is used in the format of procedures according to the program of resonance-acoustic vibrations and with the use of resonators (a musical self-sounding instrument made in the form of a bowl and called singing bowls), which ensures the normalization of the functional state of the organism.

The therapeutic effect of the complex is based on the principle that the component acoustic fields produced by a multilayer acoustic resonator interact with the patient’s body. As a result of this influence, the general tonus of the body increases, destructive emotions, habits, programs and settings are eliminated. This harmonizing practice allows you to relax quickly and get rid of blocks and suppressions, from the bustle and chaos of thoughts, contributes to the equilibrium state of the right and left hemispheres work. At the emotional level, there comes relaxation, pacification, harmonization, this is an excellent anti-stress agent. Sound therapy, like a tuning fork, allows you to adjust each organ «correctly», restore its harmonious functioning, it is a necessary «tuner», increasing the effectiveness of each performed procedure.

As the similar patent of Anisimov B.N., Karbysheva N.V. RU 2611947 C1 «The way to restore the working capacity and adaptive capabilities of athletes at the resort stage» describes — one of the music therapy types is PRAV — the program of resonance-acoustic vibrations (PRAV) — the method of biological resonant influence on organs and systems, that provide directional remote (contactless) and drugless restorative effects on the patient’s body, depending on his diseases. The PRAV methodology was approved by the Ministry of Health and Social Development of the Russian Federation (Permission of the Commission for New Medical Technology of the Ministry of Health of the Russian Federation of October 9, 2002, Minutes No. 3, registration certificate N229 / 03031002 / 4633—02 of December 26, 2002).

The programs of resonance-acoustic vibrations are selected by forming musical rhythms for music therapy, restoring the biological potential of the organism, introducing it into the self-regulation mode, which relieves tension, fear, and motivates the feeling of emotional well-being.

The abovementioned mechanisms and principles of health improvement successfully complement and expand the existing traditional rehabilitation possibilities in case of overtraining and allow to naturally combat the causes of prolonged stresses, depressions caused by derange of adaptive-compensatory mechanisms reserves when the goals are not achieved.

From a similar domestic patent RU 2458672 C1 by Anisimov B.N., Karbysheva N.V. «The method of chronic cystitis complex treatment in women at the resort stage» (2012) we know that the «resonance-acoustic vibration program» with the use of TSB is effective when used in the complex treatment of cystitis (the claimed method). It was evaluated based on the analysis of the Hamilton scale and quality of life questionnaire SF-36. In women (34 women were examined) with chronic cystitis, the following symptoms were revealed before treatment: depressive mood, daily mood instabilities, guilt feeling, early and late insomnia, hypochondria. The average value of the Hamilton scale total score was 8.6, which corresponded to the mild degree of depressive symptomatology. According to Hamilton scale for assessing anxiety, anxiety and depressive symptoms, genitourinary symptoms, tension, insomnia were the most pronounced. The anxiety level of the patients averages 8.1 points, which corresponds to the «symptoms of anxiety», i.e. anxiety, combined with other mental disorders. According to the quality of life questionnaire SF-36, the lowest scores were observed on the scales: «general health»; «role functioning due to emotional state»; «life activity». The reduction of these life quality indicators can be explained by the presence of anxiety-depressive disorders in the women surveyed.

In the author’s method of massage by Victor Oguy «Vibroacoustic massage with singing bowls», two main techniques are used: Contact technique («contact dialing») and Noncontact technique («remote-acoustic or sound bath»), in the format of individual, group or pair sessions (procedures) (Waltraut, 2009; Sagaidak, Shilko, 2010; Landry, 2014; Shestaev, 2014; Ross, B., Barat, Fujioka, 2017).


Evaluation of vibroacoustic Tibetan massage method effectiveness for reduction of anxiety symptoms.

Materials and Methods

During the period from January 2018 to March 2018, vibroacoustic massage sessions were given 33 patients (30 women and 3 men) aged 20—55 years (average age 35 ± 6.3 years) who applied to the Clinic of Aesthetic Medicine and a health center «Siberian Center of Singing Bowls» with the aim of improving their psycho-emotional condition and reducing the level of distress. The patients complained of nervousness, anxiety, sleep disorders, feeling of stiffness in the muscles, bad mood, fatigue and irritability.

Health improving massage sessions were conducted according to the author’s method of Victor Oguy «Vibroacoustic massage with singing bowls». The singing bowl is a hemispherical metal instrument with a hemispherical cavity inside having a wall 3 mm thick; with internal diameter of 240 mm; height of the walls 120 mm or more and the outer diameter of the bottom not less than 100 mm produced from the alloy of metals close to the formula of the bell bronze alloy.

A singing bowl has internal bottom surface, inner walls surface, outer bottom surface and outer walls surface. A singing bowl has visually 4 sectors, virtually separated by two conditional lines perpendicular to each other’s axes.

A stick for extracting the vibration from a singing bowl is an object in the form of a pencil 210 mm long, mainly of wood with a thickening (60 mm or more) on one end of a stick made of a rubber band fixed with a nail through the longitudinal axis of a stick.

It is possible to use a stick to produce vibration by friction. Such a stick is a wooden cylinder with suede attached to the outside surface with a handle. The diameter of the cylinder is not less than 40 mm.

VAMSB is the process when a singing bowl is placed on the massaged body, it is held with one hand, and the second hand with the stick produces vibration from the singing bowl by striking the rubber part of the stick against the upper edge of the bowl with a series of strokes with a certain rhythm. After a noticeable reduction in vibration, the singing bowl moves to the next position (shifting by 3/4 the diameter of the singing bowl bottom, which contacts the body of the massaged patient.

When using VAMSB method, a massage therapist follows the basic principles of classical massage: the gradual increase in the massage intensity both during the session and in the course of the method application.

Vibroacoustic massage with singing bowls is given taking into account the direction of lymph flow in the surface layers of the skin. The singing bowl is moved against the lymph current by application method, when SB, moving to the next place, prevents direct contact with the patient’s body. But along the course of the lymph current, SB is moved by sliding method, its bottom or walls contacting the patient’s body.

There are 2 variants of the SB disposing in the process of Tibetan vibroacoustic massage performing: 1 — «giving» SB (inverted upward position of the bowl) when the internal surface of the SB bottom contacts with the body of the massaged patient or the inner surface of the bowl bottom is turned downwards and 2 — «taking» SB in the normal position when the outer part of the SB bottom contacts with the body.

The dosage of VAMSB is administered as follows: 1 — in the rhythm variants, by which vibration is produced; 2 — in the number of rhythm producing cycles at one position of the SB on the patient’s body (from 1 cycle in the first procedure to 3—4 in the following); 3 — in the intensity with which vibration is produced (from 1 to 100% of the potential); 4 — in the number of procedures in the course (from 2 to 4); 5 — in the intervals of procedures in the course (from 1 to 2—3 days between the procedures in the course).

The duration of VAMSB varies from 30—40 minutes with the first procedures, up to 60—70 minutes with subsequent procedures in the course of VAMSB. The duration in minutes will depend on the size of the patient’s body and on the size of the SB bottom contacting with the body: the larger the body size, and the smaller the SB bottom, the longer the procedure will take in minutes.

The procedure of VAMSB implies the impact on the entire body of a person, according to the scheme of VAMSB massage lines.

All patients, before and immediately after the end of the session, as well as in 1 day after the procedure, were evaluated on special scales (Tsung’s anxiety self-evaluation and Spielberger’s test (reactive and personal anxiety) to assess the dynamics of the massage effect.

The results of the research were processed by traditional parametric statistical methods using software: BioStat 2009 and Microsoft Office Excel 2010.


After the vibroacoustic massage session in all the patients anxiety significantly decreased according to Tsung’s scale and Spielberger’s personal anxiety test score (p <0.05).

In one day after the session, there were no significant differences in Tsung’s scale and in Spielberger’s test (on both scales) with the effectiveness of this vibromassage immediately after the session (p> 0.05).

At the same time, significant difference was found between the dynamics of reactive and personal anxiety (p <0.05), as it is shown in Table. 1.

Table 1. Effectiveness of vibroacoustic Tibetan massage
according to Spielberger’s testNote: * — significant difference from the initial level (p <0.05)

This difference according to these two scales is caused, as it seems to us, by the inadequacy of a single time influence on deep psychological and vegetative phenomena of personal anxiety in humans.


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