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Golnesa Gharachedaghi

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Recently GRAM sat down with Golnesa Gharachedaghi, from the television show, Shahs of Sunset. We discuss why she is becoming a part of the growing cannabis industry with her new business, Wusah, and learn about her personal experience using cannabis for symptoms associated with rheumatoid arthritis (RA). 

Many people deal with the pain of RA every day. There are currently 1.5 million Americans suffering,1 many of whom suffer in silence. The joint tenderness and fatigue is sometimes unbearable. RA is an autoimmune inflammatory condition that causes severe pain, stiffness, swelling and redness to the joints.2 RA can affect other tissues of the body as well, including the eyes, lungs, and heart. 

For Golnesa, her symptoms started with her hands. “Up until my diagnosis, the doctors thought what I had was tendonitis from years of being a gymnast. I am sure that was because I started as a gymnast at age 3. Doctors considered it to be normal wear and tear. They began putting steroids into every single tendon in my fingers through injections. The pain eventually found its way to my shoulders. I went to see an orthopedic doctor and he told me I had bursitis.”

The pain then made its way to her knees. Her doctor assumed it was the same issues she was experiencing in her shoulders and began steroid treatment injections to her knees. Finally one doctor had an idea, “The doctor said to me, this has to be something systemic. He sent me to a Rheumatologist. It took two years before I was diagnosed with RA. This was after two years of getting these injections with little to no relief. I remember my fingertips were blue, and I could barely bend my knees. My rings wouldn’t come off my fingers. Two years after injections, finally I understood I had RA in 32 joints in my body.” 

“When having an autoimmune condition, your body can build up an immunity to certain medications after a while. So for me, every medication had a lifespan of about 1 1⁄2 years, and then it just stopped working for me. They tried several pharmaceuticals, so many I can’t remember all of their names. The methotrexate was a mild chemo drug that I had to inject into my stomach once a week in conjunction with all of the pharmaceuticals. That was my booster for everything. There were times I received biweekly transfusions as well.”

It took two years before I was diagnosed with RA.

All of this treatment was still not enough. The inflammation in the tendons of her hands was still too much. “The doctors told me I had too many steroids previously injected into my hand, and the inflammation was so bad, and the tendons were so damaged they had to go in there and scrape it all out.” If trigger finger3 is severe, the finger that is affected can become locked in a bent position. The surgery for trigger finger is called “tenolysis” or “trigger finger release.” Golnesa had this surgery to release the tendon in her hand. 

Rheumatoid arthritis patients suffer not only from pain but also from swelling, redness, stiffness or the joints that are affected may misshapen. For Golnesa, all of her fingers were so stiff she could barely straighten them. Before cannabis she would have to use her teeth to open bottles of water for herself. 

After 8 or 9 years of medications and then finally requiring surgery for trigger finger, she made the life-changing decision to listen to her holistic minded mother. Her mom had been reading a lot about CBD and its benefits. Five years ago, as she began to read about the plant, she felt that it was still just considered cannabis, “You would hear weed or marijuana or pot and would think, so I am just going to get high. I told my mom no, what would it mean if I went back to this drug?“

This was not her first experience with the cannabis plant. Her experience began at a young age, “younger than anyone in my grade, I was about 11.5 the first time I ever smoked pot; my older sister knew it was something that was going to come up, and she wanted my first time to be secured, safe and with her.” She experimented with the plant over the years but discontinued use in 2005. 

Dr. Frankel has treated just under 80 conditions using cannabinoid therapy.

That was until her mother found Dr. Allan Frankel. Dr. Frankel has been a doctor of Internal Medicine for 35 years and is a worldwide authority on dosed cannabis. He is the founder of Greenbridge Medical in Santa Monica, California. The clinic claims that 80% of the people that come to them have had no previous relationship with cannabis. Dr. Frankel has treated just under 80 conditions using cannabinoid therapy. He provides a customized treatment plan to each patient he sees because he understands the varying needs for each patient, and that plant medicine can require some “tuning.” 

Golnesa’s mom made her an appointment with Dr. Frankel. “He really broke it all down for me three and a half years ago. I started with a CBD capsule that was a 5 (CBD):1 (THC) ratio. I was really scared of getting high and that I was going to have a horrible experience, but having the mindset that it was going to help me medically was the significant difference for me. I then went from taking the capsules to buying the flower. As I kept consuming, the THC ratio continued to increase, and after about 8 or 9 months, I noticed my fingers were able to straighten out.” 

Even though she began seeing mild results from cannabis, Golnesa continued with conventional medicine, using mild doses of chemo and going to her rheumatologist regularly. After 11 years of treatments, some of those in conjunction with the use of cannabis, a severe situation led to emergency surgery and the loss of both fallopian tubes. “That somehow put my body into some sort of shock. My rheumatologist said he had never seen my body flare that badly before. They put me back on infusions, but this time they used medications that were safe for pregnancy because at that time I was trying to get pregnant and the body must be rid of methotrexate for at least three months before you can attempt pregnancy.”

Golnesa continued using cannabis and was able to get all of her blood levels where they needed to be so she could try IVF again. During this time of trying to heal her body naturally, she started thinking about how much cannabis improved her quality of life. She started to brainstorm ideas for a product line so she could share this type of healing with others. Two years ago she launched the CBD company, Wusah.5 

I am pleased to tell you she shared with us that she is now pregnant. “I read that CBD vapes were the safest way to consume because its more controlled as far as how much goes into your body while you are pregnant so I was using my Wusah vapes whenever I feel like I am irritable, or like my hands are too much with pain, I would just take a couple puffs. I recently just went three months without consuming. Then, just a few nights ago, I took a few puffs to help with my insomnia”, she tells us about using a CBD vape during her pregnancy. 

“I have been so lucky I have not had any morning sickness, so I have been fine with using CBD only products. Had I been one of those women that did have nausea and they would have wanted to prescribe a medication for that, I would have absolutely just taken a few puffs off of a joint instead.”

Embrace the fact that it is not a drug. Destroy the taboo.

There is currently a lot of controversy surrounding the use of vapes. Vape pens that contain Vitamin E Acetate or MCT oil have caused severe health issues and in some cases, death. In fact, thousands of deaths have now been reported in the US from the use of adulterated products. Golnesa confidently tells us, “unlike all the stuff going on in the outside media, my vapes do not mix with any outside oils, and I don’t dilute it with anything else. We make sure our CBD oil is really good and broad spectrum. It’s hard because of what the media and the government is putting out there, I feel like they are doing it to control the market for a lot of people. I can tell you though, at Wusah, we have no byproducts in our vapes.” 

Vapes are not the only thing she sells. She says her focus is wellness. The Wusah product line includes capsules, oral sprays, a balm, patches, and drops for your water. Her plan is to stick with what internally is the most medicinal and to focus more on symptoms, to help people internally. She says, “Think more like anti-inflammatory, joint pain, and health and wellness.” She wants to put out products that are designed for whatever each individual may need; she feels her cause is to help people internally. 

“To stay current, I read every single day. I read everything. I receive as many cannabis newsletters from as many publications as I possibly can. I go to every possible convention I can in California and in neighboring states. I constantly educate myself on what’s out there. I tend to follow a lot of what Israel is doing since they are so advanced when it comes to cannabis, as well as some of the information coming out of Australia. You really have to dig deep right now because there is a very big dollar sign on this plant.” 

Golnesa is an advocate for people suffering from RA. She has worked with the Arthritis Foundation and Children’s Hospital Los Angeles to help support others, particularly children, who suffer from the disease as well as raise money for research to develop a cure. Most recently, she established a nonprofit foundation, Little Warriors, to support children suffering from a variety of autoimmune diseases. “I would love to be able to advocate publically for the use of cannabis for RA, and I look forward to it.” 

She leaves us with a bit of advice, “My best advice is to educate yourself first, understand all the components of the plant. Read about it. Try it. Ask around. Talk to people. Embrace the fact that it is not a drug. Destroy the taboo. Educate first and foremost. Don’t believe me, do your own research, read the fucking ingredients, know what you are taking. Research and educate yourself, don’t just trust any product because it says it has CBD in it. Once you fully understand the plant, you will then understand why certain products hitting the market can’t be real.”


REFERENCES

1. https://www.arthritis.org/about-arthritis/types/rheumatoid-
arthritis/what-is-rheumat oid-arthritis.php
2. https://www.cdc.gov/arthritis/basics/rheumatoid-arthritis.
html
3. https://www.mayoclinic.org/diseases-conditions/trigger-
finger/symptoms-causes/s yc-20365100
4. https://www.linkedin.com/in/allanfrankel/
5. https://wusah.com/ 

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Keeping Love + Faith Alive

After losing 36 to Covid-19

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What started as a “Shelter in Place” check-in with friends Barbara and Daniel Melvin, grew into this article about a family with extreme losses to COVID-19. Barb first told me they had lost 12 family members and friends from COVID-19 in mid-April. By the end of April, the number had grown to 33. The current count is 40 family and friends lost to COVID-19 as of May 18, 2020.

Daniel and Barbara lived in Detroit before relocating to Naples, Florida, in 2001. Barbara has worked in banking for 30 years and is currently a Vice President at First Florida Integrity Bank. Dan is a multi-talented singer, radio personality, and entrepreneur. They are two of the happiest, kindest, giving, and loving people you could be lucky enough to know.

Together, they have worked to give back to their community through philanthropic endeavors, as well as volunteering on numerous nonprofit boards. They celebrate their mutual birthdays, Sept 6 & 10 by holding an annual event called “Party Hearty for Charity,” formerly known as “Party with a Purpose,” their nonprofit organization., They have raised over $90K in the past six years to help support several nonprofit organizations in SouthWest FL.

Barb says, “The coronavirus is real. I first heard about it in March, but like everyone else, we didn’t understand it, and at that time, we didn’t personally know anyone that was sick from it. Then, as time went on, we started to hear about people that we knew who were dying. My husband and I hated to wake up and look at Facebook because it seemed every time we checked someone close to us or someone we knew had died.”

Barbara tells us, some of the churches in Detroit continued to hold services, after the recommendation not to gather in large numbers. The members met to seek comfort in the face of the pandemic. Barbara believes that was crucial for most of the people she knows who were infected and died.

How could one couple know so many people who have passed from COVID-19? They are an extensive close-knit family, descendants of Tom and Etta Rhoades, born slaves. Tom and Etta’s dreams were to keep their descendants together spiritually, in harmony, and in brotherly love. They have honored their ancestors by gathering each year, for 46 years, for a three-day family reunion. Friday is meet and greet (you would need it with over 200 attending). Saturday is picnic time, complete with a softball game between the North and the South. Sunday, everyone goes to a local church, followed by a family dinner. With all those family members together, not an argument or fight ever. Until 2020, when the pandemic hit the family, and they canceled the family reunion.

Barbara shares with us information on a few of those they have lost. “My aunt, Mary Rhoades, died on April 22, 2020, she was 97 years old. She was in good health, and we were praying she made it to 100.” Several of her siblings had achieved that milestone, and she was reasonably healthy for 97 years of age so that expectation was a real one. “Aunt Mary became infected in early April; two weeks later, she was gone. She went to the hospital in Philadelphia for minor surgery, and we believe she was infected there. What hurts the most is she died alone; no family or friends could visit her.”

“Jason Hargrove was a close friend of ours. He was the bus driver who went on Facebook Live to talk about a woman coughing on his bus without covering her mouth. Two weeks later, he was diagnosed with the coronavirus, and he died shortly thereafter. His death was not in vain as the Detroit Department of Transportation made many changes to enhance the safety of their drivers. Jason was a Deacon at my church.”

Barbara continues, “Another close friend of ours was Larry Griffin. He died on April 16. He sang in my husband’s band called “In Full Effect” when they were performing in Detroit. He continued to sing in a new band called “Serieux,” who performed mostly in Detroit but also in Las Vegas. He had a beautiful voice and some great dance moves. He was so healthy until he caught the virus, and, in weeks, he was gone.”

“It spread so much faster in the churches. Many Pastors we knew caught the virus and were gone. They were older and many had health issues, when the virus attacked them they could not fight it off. These 4 Pastors were all a part of the Church of God In Christ (COGIC). Many had large congregations and were still holding services after the call for social distancing. These great men are a true loss for the COGIC community.”

“On April 23, we lost a very dear friend of mine, Lynn Raimey. I called her my sister as her father was the Pastor of my church in Detroit. Her family took me in and treated me like family when I first moved to Detroit and didn’t know anyone. She had many health issues, so when she was infected by the virus, it killed her very quickly.”

“Although we have lost many family, friends, and associates, we know God is good, and he continues to show us favor even through the midst of this storm. Even though we know of many deaths, we also know of many survivors and to that we are grateful. These people are given a second chance so their test can become their testimony. I know of an entire household, The Washington family of Detroit, who are survivors. Pastor Jamonty, his wife Tamela and their daughter Ariel Washington all recovered and are doing well.”

Barb specifically finds strength in the Beatitudes; “Jesus said in Matthew 5:4, Blessed are they that mourn, for they shall be comforted. It is during these tough times of losing loveda ones that I can refer to scripture to give me the comfort I and my family needs. The question is have you ever suffered? Please know that we all have. But I have come to know through leaning on God and his word, he meets me at my very point of need. As believers, the Bible speaks about plagues and famine and death, and its teachings prepare us for what life has to offer. Oftentimes we don’t understand the current situations, but when we look back, we realize this had to happen.”

As of May 5, 2020, there have been over 72,000 deaths in the United States, and over 257,000 deaths Worldwide. It is critical to find strength either within or in a higher power, focus on the positive, and stay connected.

It is GRAM’s honor to recognize this incredible family.

Blessed are they that mourn, for they shall be comforted.


In Memoriam

Family & Friends Lost to Covid-19 (35 as of 5/5/20)

Mary R. – PA

Jason H. – MI

Rachelle Lynn R. – MI

Rev. O’Neil S. – MI

Gerald H. – MI

Curtis H. – MI

Larry G. – MI

Rosalind C. – MI

Rev. Gerald G. – VA

Skylar H. – MI

Rev. David F. – MI 

Laneeka B. – MI

Ejuan W. – MI

Darnielita B. – MI

Bishop Phillip B. – MI

Bishop Robert S. – MI

Bishop Robert H. – MI

Tatia W. – MI

Rev. Lonie J. – MI

Carrie W. – MI

Helena J. – VA

James J. – VA

Robert J. – VA

Annette W. – NY

Helen L. – MD

Walter H. – DC

Carol T. – DE

Benjamin T. – DC

William B. – KY

Daniel R. – TX

Karen S. – NC

Denise B. – NC

Doris M. – OH

Trina D. – MI

Earl T. – VA

Nathaniel S. – MI

Lonnie L. – MI

Nathaniel S. Sr. – MI

Nathaniel S. Jr. – MI

Angel R. – IL

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Americans for Safe Access + Covid

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Americans for Safe Access (ASA) is a 501(c)(3) nonprofit with the mission of ensuring safe and legal access to cannabis for therapeutic use and research. The organization began in 2002 and has been helping educate people, change laws, and get more research out there about the therapeutic benefits of medical cannabis. “We also care about safety, and we want to make sure patients are using cannabis safely and legally throughout the United States,” explains Debbie Churgai, Interim Director for ASA. 

GRAM sat down with Churgai to discuss how they are handling COVID-19 for patients throughout the U.S. She tells us, “When it first started, patients were really concerned about there being a lack of access to their medicine. So, one of the first things we did was host a stakeholders call. We contacted a bunch of people: patients, industry professionals, medical professionals, legal professionals, and within two hours, 15-20 people were on the phone strategizing. From that phone call, we then created a letter that we sent to Governors, medical cannabis commissions, and health departments urging them to keep medical cannabis businesses as essential, not just the dispensary but also cultivation and manufacturers so that there was no stop in production or supply chain.”

“It also meant, we needed to make sure patients were receiving safe products, that employees were also being kept safe. Then we started thinking about delivery for states that did not have that yet, and the states that did not yet offer telehealth – we wanted to encourage the changing of regulations at least temporarily to help accommodate the patients. As well as things like tax relief and adding additional caregivers, it wasn’t just about keeping businesses open, it was about making sure that patients were being protected and that products and employees were safe.”

In Colorado, we have seen dispensaries adapt to this crisis by adding hand sanitizer at checkout counters, wearing gloves and masks and only allowing one person in the purchasing area at a time. 33 states now have some sort of medical cannabis program.

According to news around the U.S., cannabis is now considered essential. But it wasn’t that way at first. According to Churgai, “Some states seemed to hold back on making any temporary changes in regulations. Within two weeks though, all the other states began implementing the suggestions we recommended.” 

We needed to make sure patients were receiving safe products, that employees were also being kept safe.

“California has reached out more than any other state, I believe that is due to the fact that every single county there is different, from its tax structure to its implementation of the laws. Massachusetts was high with the questions as well because of them deciding to close down their recreational dispensaries for adult use. Now there is an influx of new patients. Now there are new concerns.” 

Each state has a different set of rules and regulations surrounding their medical cannabis programs. “We wanted businesses to all have the same information so we offered a live training on health and safety during COVID-19, that can now be purchased as part of our Patient Focused Certification.1 In the training we provide information such as how to properly put on and take off gloves, how to properly touch things, how to properly sanitize surfaces, and more to make sure that businesses are being as safe as possible during this time.”

“When we realized that we helped assist in making these services essential, we wanted to learn how they actually worked for patients throughout the U.S. We wanted to understand, what do they still need during this time? Are their needs being met as patients? Would they like to see services like telehealth and delivery continue after COVID-19? We realize that we really need to streamline our advocacy efforts at this time, and we felt the survey would be a great way to learn what we can do for patients out there,” Churgai explains.


Help ASA discover what patients need around the United States.

Take the survey here: https://www.safeaccessnow.org/covid-19_survey


COVID-19 Patient Experience Survey asks questions like:

• How do you obtain cannabis?
• Do you feel you are at risk for covid and why?
• Rate your state’s response to the covid crisis.
• How should your state be assisting you more?

Patients are at greater risk for a variety of reasons so ASA is working to ensure that the needs of patients are taken into account. So, in addition to creating this survey, Americans for Safe Access has also created a page on their website dedicated to resources for patients seeking information surrounding COVID-19.2

Churgai says, “Cannabis is real medicine. I have been in this industry for so long, and I am a realist, and I know things will not change overnight. But I do feel the pandemic has highlighted the need for this medicine to be seen as real medicine. At ASA, patients are our priority, we are unbiased, we are not paid to play, and patients will always be our top priority.” You can learn all about Americans for Safe Access by visiting their website: https://www.safeaccessnow.org/


References:
1. http://www.patientfocusedcertification/training/a-la-carte-trainings/
2. https://www.safeaccessnow.org/covid-19

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Trends in Endocrinology + Metabolism

The quest for a healthy
Endo-Cannabinoid System (ECS)
Emphasis on immunoregulation

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The ECS is a disperse system, extending throughout the body; it is in constant interplay with all other organ systems promoting homeostasis in almost every aspect. Despite that, the ECS is still neglected and not included in the curricula of medical schools. For this reason a few introductory notes are in order (Battista et al, 2012). The ECS is the regulator of cognition, mood, nociception, energy metabolism, oxidation, inflammatory processes and a disease modifier as well (Tantimonaco et al, 2014).

The ECS consists of receptors, ligands to these receptors and enzymes that synthesize and degrade these ligands. The number of known endocannabinoid receptors is still growing to more that 55; the two most outstanding receptors are CB1R, mainly distributed throughout the nervous system and responsible for the psychoactivity of cannabis, and CB2R, mainly distributed on immune cells, even those “disguised” as specialized cells within other organs. Other receptors include TRPVx, GPR55, PPaRs etc; all these receptors form dimers between them as well as heterodimers with other types of receptors, like opioid, dopamine, serotonin, adenosine, catecholamine receptors and many others, thereby promoting a universal regulatory interplay throughout the body. The ligands to these receptors are the endocannabinoids (ECs): lipids of the eicosanoid family, derivatives of arachidonic acid (AA); the latter abounds in cell membranes; five of these are well characterized to date, but two are well studied: Anandamide (AEA) and 2-Arachidonoyl-Glycerole (2AG). ECs in the nervous system act in negative feedback loops, more or less like neurotransmitters, but, unlike them, they are synthesized and degraded on demand, and not stored in micro-vesicles. Several formerly unrelated morbid conditions are now recognized as ECS deficiencies, including, among many, migraine, autism, fibromyalgia, irritable bowel syndrome, etc (Russo, 2016).

The endocannabinoid system is involved in immunoregulation through the CB2 receptor and through receptor independent biochemical pathways. The mechanisms of immunoregulation by ECs include modulation of immune response in different cell types, effect on cytokine network and induction of immunoapoptosis; in brief, ECs down-regulate the innate and adaptive immune response in most, but not all, instances. Manipulation of endocannabinoids in vivo may constitute a novel treatment modality against inflammatory disorders.

It is obvious that the health of the ECS is of great importance in many ways, including the facing of a viral infection like COVID-19. A healthy ECS depends on many factors, most importantly from proper nutrition (McPartland et al, 2014).

Dietary ω3 fatty acids seem to act as homeostatic regulators of the ECS, acting in opposite directions if consumed by obese or non-obese individuals. Little change in EC levels are seen in individuals with normal weight, not fed a high ω6 diet.

Dietary ω6 fatty acids are also essential, but should be in a balance to ω3s; suggested balance is ω3:ω6=1:1 to 1:3 for proper ECS signaling and prevention of peroxidation in general. Arachidonic acid is an essential component of the ω6 fatty acids.

Probiotics and prebiotics play a significant part in ECS health, but, for a bizarre reason, they are generally not mentioned: They up-regulate CB2Rs residing on immune cells of the gut; they also modulate CB1Rs, depending on conditions, for instance, they down-regulate CB1Rs in obese individuals and help them gain less or no fat.

Some flavonoids, like kaempferol, genistein, epigallocatechine gallate, and curcumin enhance the ECS; same happens with some anthocyanidins, like cyanidin and delphinidin, although with a different mechanism.

Phthalates, pesticides, additives to pesticides like piperonyl butoxide act as ECS disruptors, meaning that consuming organic food may be a sound protective measure, along with intake of detoxifiers, in case of health problems consistent with ECS deficiency not otherwise explained.

Chronic stress impairs the ECS by decreasing levels of AEA and 2AG, and possibly through changes in CB1R expression too. Stress management may reverse the effects of chronic stress on ECS signaling. Anecdotal reports and common experience suggest that techniques such as meditation, yoga, deep breathing exercises and practicing of sex as well, exhibit mild cannabimimetic effects, thereby balancing the system.

Exercise is also an ECS regulator: Long-term exercise leads to sustained elevations of ECs, and predictable CB1R down-regulation.

Chronic alcohol consumption and binge drinking likely desensitize or down-regulate CB1R and impair EC signaling. Alcohol is not compatible with a healthy ECS.

Nicotine is an ECS deregulator: It induces EC production in some areas of the brain, while decreasing them in others. It should be avoided too.

Caffeine, acutely administered, potentiates CB1R-mediated effects through antagonizing adenosine at the A1 receptor (AA1R). At the undisturbed state, AA1Rs tonically inhibit CB1R activity; Caffeine antagonism on AA1Rs sets CB1Rs free of inhibition, thereby enhancing ECS function, for example by letting 2AG activate CB1Rs. During chronic administration of caffeine, the effects are blurred by individual differences in adaptation. In general, CB1Rs are down-regulated.

Chocolate: Cocoa contains sm-all amounts of at least three N-acyl-ethanolamines with cannabimimetic activity, expressed either directly by activating cannabinoid receptors, or indirectly, by increasing AEA levels (di Tomaso et al, 1996).


Selected Bibliography:

Battista et al, 2012: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3303140/

Tantimonacco et al, 2014: https://pubmed.ncbi.nlm.nih.gov/24526057/

(Russo, 2016): https://pubmed.ncbi.nlm.nih.gov/28861491/

(McPartland et al, 2014): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3951193/

(di Tomaso et al, 1996): https://pubmed.ncbi.nlm.nih.gov/8751435/

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