Planned Parenthood Tape 7 – A Gynecologist’s View

By Tia Will

Disclosure: I have no affiliation, neither personal nor through family or friends with Planned Parenthood nor StemExpress nor any other transport company nor tissue research institution. The following represents my personal perspective on the information provided on the tape as presented by the Center for Medical Progress.

I have followed my previous format of identifying the time on the tape, the speaker, their statement, followed by my interpretation in a separate paragraph marked with an asterisk or a bullet point.

0- 22 seconds

Clip of Dr. Nucatola from the first luncheon tape explaining how the list of cases for any given day are used to determine which cases will yield tissue for research purposes.

*These operative lists are standard for any procedure suite. They allow physicians, nurses, technicians and in the case of tissue transfer, the transporting agents for any purpose (whether transplant, grafting, or research) to coordinate their activities. There is nothing callous, unusual, nefarious or illegal here.

25 seconds – cut away to screen with words:

“ Human Capital”

Episode 3: Planned Parenthood’s Custom Abortions for Superior Product

33 seconds

Holly O’Donnell, (the former phlebotomist for StemExpress) mid-interview with no recording of the prompt question:

“I never did, but I think that I have witnessed some of the other technicians work with the doctors. I remember, I was on my day off and I went on my laptop and it popped up and they were working and I saw a message saying that the doctor had aborted a fully intact fetus, fully intact, and StemExpress was sending it straight to the lab.”

  • From her facial expression, Holly seems to be upset by this. However, from the point of view of the patient, the doctor, the support staff and the receiving tissue researchers this is the best possible outcome. An intact delivery means a less prolonged and painful procedure for the patient with less chance of complications and a faster recovery. For the doctor, it means less time spent and less possibility of complication. For the receiving facility, if it happens to be one that can utilize multiple tissues, it is receiving the specimen in the best possible condition. What has also been omitted, either by Holly or the tape editor is the gestational age of the fetus – which is critical, since an intact delivery is very, very common for some gestational ages and less so for others.

59 seconds

Warning : Some graphic wording which may be disturbing to some.

Cut to mid-interview with Perrin Larton – Procurement Manager Advanced BioScience Resources :

“I have had women come in and go in the OR and come out in 3 minutes, and I’m like ‘what’s going on ?’ and ‘oh, yeah, the fetus was already in the vaginal canal and when we put her in the stirrups, it just fell out”. The male interviewer (confirmed as Mr. Daleiden) then is heard to say “oh wow,” as though this is something unusual or remarkable.

  • While this may appall or surprise those who are unfamiliar with the process of evacuation of a uterus whether for a miscarriage or for an abortion, this is by far the best outcome for the patient since it is a painless extraction of the material from the vagina with no further intervention required. I have done this in less than three minutes too many times to count during spontaneous abortions.

1:11

Cut to interview with Melissa Farrell, Director of Research, Planned Parenthood Gulf Coast in what appears to be her office:

“If we are able to alter our process and obtain intact fetal cadavers, then we can make it part of the budget that any dissections are this, and splitting the specimens into different shipments is this, I mean its all just a matter of line items.”

  • This is a clip from one of the tapes previously reviewed. What has been edited out are her comments making it clear that what she is referring to when she says “line items” is the cost of staff time and equipment for specimen processing which Dr. Nucatola had previously made clear there would be no charge if the Daleiden company were to provide all these functions, not the fetal tissues themselves.

1:38

Cut to mid-interview statement of Holly O’Donnell:

“Usually they want both hemispheres intact with the brainstem, which usually doesn’t happen. They’ll take like an 80% or 75% intact, but you have to contact them to see if that will be ok.”

* It was not clear to me what this limited clip was intended to convey since it seems apparent that researchers will want any tissue that they receive to be in the least disrupted condition possible, taking into account the best interest and care of the patient.

1:51

Warning : The following is quite explicit and may be disturbing to some.

Cut to mid-conversation luncheon with Dr. Nucatola:

“The rate limiting step is the calvarium ….. some people will actually try to change the presentation of the fetus so that it is not vertex, you rarely have enough dilation, unless you have huge dilation to deliver an intact calvarium.”

* While this may sound brutal or like a change in practice that could have harmful consequences, what has not been made clear perhaps due to the editing is that changing the position of a fetus is a common obstetric practice during delivery whether the intent is abortion or delivery of a term or near term baby. This may be done to protect the baby, or to protect the mother, or because the delivering doctor has more experience with one procedure than another and thus feels that delivery by their procedure of greatest expertise is the safest route for all involved. I myself have changed the way a baby is lying in the uterus using US guidance, usually to spare the mother a Cesarean section far too many times to count.

2:56

Cut to Holly mid interview:

She is relating an experience she had at the Alameda PP affiliate.

“I was kind of busy and one of the doctors came in and she looked really frustrated. The medical assistants were with her and I decided to listen and figure out what was going on. The doctor says, ‘If she can’t calm down, then I can’t do the abortion.’ Like…’and I can’t medicate her’… something like that. She was just distraught.”

  • Again, I am not sure what significance this statement is meant to convey. I have had many, many times in my career in which I have had to call off procedures of many different types because the patient was too emotional, distraught, fearful or unable to hold still long enough to perform the procedure in the setting initially felt appropriate. I have even had to abandon efforts to do routine Pap smears in the office because the patient had too much emotional overlay surrounding this simple, less than one minute procedure. It is indeed frustrating to schedule time, staff time, tie up space and equipment for a procedure that you are then unable to complete. This is completely irrelevant to any claim of illegal activity.

3:15

Cut to mid-lab interview with Tram Nguyen – Ambulatory Surgery Center Director, PP Gulf Coast

Mid-sentence: “…the dilation that you have obtained and whether, how, for lack of a better word, how cooperative the patient is during the procedure.”

  • From this interposed clip, one might think that this is unique to these procedures or that the patients are being treated callously. It is true for any procedure that if the patient is “cooperative” the procedure will be safer for them and will entail the possibility of fewer complications. For example, if I am doing a skin biopsy using a scalpel and the patient suddenly moves when I place the knife against her skin, she is likely to sustain a larger or inappropriately placed cut than if she had held still as advised.

3:32

Warning: graphic description which may be disturbing to some.

Cut back to Holly’s description of the distraught patient:

“Finally she calms down, and the doctor went in to perform the abortion, it takes a little while, and I’m in the hallway, I see the jar come out, it goes into the path lab and I can hear them preparing it …… then I hear her say, ‘Holly come over here, this is kind of cool, this is kind of neat’…so I’m over here and I’m flabbergasted. This is the closest to a gestated fetus that I have ever seen. So she takes an instrument and taps the heart, and it starts beating. So I am sitting here looking at this heart beating and I don’t know what to think.”

  • I have a great deal of empathy for Holly in this situation. It is clear that she “does not know what to think.” What is also clear is that she does not appreciate that the beating of a heart in no way defines the viability of the possessor or donor of that heart. Hearts are muscles and can be stimulated either mechanically or electrically to beat regardless of the state of the possessor of the heart, who may in fact be brain dead or functionally dead regardless of the beating of the heart. A heart may beat for a significant amount of time completely outside the body under certain stimuli. What Holly is appalled by here is the act of abortion and its consequences, not the legality of the process.

4:39

Cut to interview of Dr. Ben Van Handel , Executive Director Novogenix Laboratories,LLC

Male interviewer posing as buyer: “Is there still circulation in the heart once you isolate it?”

“There are times when, after the procedure is done, the heart is still beating.”

4:51

Warning: Graphic description of technique which may be disturbing to some.

Cut to Perrin Larton, Procurement Manager

“They induce fetal demise at 18-20 weeks and so they inject digoxin into the fetus.

5:03

Cut to luncheon interview with Dr. Nucatola

“Providers who use digoxin use it for one of two reasons. There are providers who use it so that they have no risk of violating the Federal Abortion Ban. If you induce the demise before the abortion, no one is going to say that you performed a ‘live…..whatever the Federal Government calls it…’ a partial birth abortion.”

5:26

Cut to Mr. Daleiden stating :

“Whenever you are talking about fully intact fetuses in the context of fetal tissue procurement, those are situations where no feticide with a substance like digoxin or potassium chloride or chemical like that can be used to kill the fetus beforehand because that poisons the organs or the tissues in which case that is prima facie evidence of born live fetal cases.”

  • This statement is of questionable accuracy on the facts and of erroneous interpretation with intent to deceive, in my opinion.
  • I do not know if it is true that that no research can be on any tissue post exposure to digoxin and /or potassium chloride. I suspect that the truth is that it limits but does not eliminate any possibility of research utility.
  • What Mr. Daleiden has neglected to mention is that Dr. Nucatola has made it clear in an edited portion of her interview that the choice to use these chemicals is up to the doctor performing the procedure. As a matter of fact, she expressed frustration that doctors were so committed to the procedure that they considered the best practice, that they could not be induced to change even to research the issue in a randomized, controlled fashion.
  1. Thus his claim that this is “prima facie” evidence of live birth at any gestational age is inaccurate. It may occur, or it may not. Nothing in this tape demonstrates which is the case. Nothing in this statement even suggests any illegal activity. If anything, it suggests that doctors may be going out of their way to ensure that they are remaining within federal law.

5:36

Warning : Extremely graphic description of technical procedure on tape.

Cut to Holly mid-interview:

With regard to the beating heart, “I knew why it was happening. It’s happening because the electrical nodes were still firing. And I don’t know if that constitutes that it is technically dead or its alive.” Obvious splicing: “And its face wasn’t very torn up. It had a prominent nose, and eyelids, and its mouth was pronounced and since the fetus was so intact she said, ‘OK it looks like this is a really intact fetus and we can procure a lot from it. We are going to procure brain.’ So something like that means that we are going to have to cut the head open.” She proceeds to provide a very graphic and accurate description of the means of procuring brain tissue. This is accompanied at intervals by a picture of what could be a representative fetus at about 16-20 weeks gestation. The supervising technician asks Holly if she can finish the procedure after showing her how and getting her started. Holly reluctantly agrees to do the procedure although she finds it extremely repugnant, does not want to do it, and regrets her decision almost instantaneously. “And that was the moment I knew that I could not work for the company anymore. Even if that is going to be good, even if it would be the cure for some kind of disease, even if it was, I still wish that I wouldn’t have done it. I don’t want to be that person.” She then gives a graphic description of how she held the fetus and had difficulty getting the body into the container. “It’s really hard knowing that you are the only person that is ever going to hold that baby.” She then describes her imaginings of what this fetus might have become, listing productive jobs in our society. “I imagine things like, I wonder at age three if she would like to color, and things like that, you know. I feel like it’s a waste of life, and like so many people view it as a mistake because it is not. Like getting pregnant, it may be an accident, but it is not a mistake.”

The video ends and this statement is made on a plain black background:

“Hold Planned Parenthood accountable for their illegal sale of baby parts.”

My impressions of this segment are as follows:

  1. This is the most highly edited of the tapes to date. It has brief clips from at least six different settings with no more than a few sentences each from some. There is no context provided in which to interpret many of these statements. Without specific medical knowledge in this area, it would be possible to edit and interpret these interviews to mean almost anything.
  1. Despite the use of graphic and emotionally upsetting images and descriptions, there is not the slightest hint on this tape of any illegal activity.
  1. I have a great deal of empathy for Holly, who naively got herself into a situation which was morally repugnant to her and she should by her own admission have stopped sooner. I am also very, very appreciative and grateful to those who will dedicate their time and efforts to securing these tissues for research purposes in case they “will be used for good and for a cure,” as Holly herself states.
  1. Holly’s limited experience in this field does not allow her to see “the other side of the story.” Her imaginings do not include imagining the terror, pain and hopelessness of this child who might possibly grow up in an abusive household. They do not include the possibility of broken bones or brain damage or near starvation. While she accurately states that it is really hard to know that she is the only one who will ever hold this baby, she has not had the similar experience of being the “only one” to ever hold the extremely premature, pre-viable but spontaneously breathing infant of a teen mother who refused to hold her baby. It was me who cuddled that baby and held her for the few short moments of her life. I can relate to Holly’s pain. I cannot relate to her feeling that her pain and morality should dictate the medical choices of others and the course of their lives. And I certainly cannot relate to the duplicitous, manipulative lies and distortions of the Daleiden group in their efforts to destroy Planned Parenthood.

Author

  • Tia Will

    Tia is a graduate of UCDMC and long time resident of Davis who raised her two now adult children here. She is a local obstetrician gynecologist with special interests in preventive medicine and public health and safety. All articles and posts written by Tia are reflective only of her own opinions and are in no way a reflection of the opinions of her partners or her employer.

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34 comments

    1. TBD “It seems like there is no new violation of the law exposed, just more of the crass, uncouth, unprofessional behavior.” I would make a correction to your statement. There is not only “no new violation of the law exposed” there has been no violation of any law exposed by any of the 7 tapes released to date. I would also like to point out that “crass”, “uncouth”, and “unprofessional” are all in the eye of the beholder. In medicine it is a common event for things to occur that will invoke humor in those of us who deal with these issues on a daily basis but would probably disgust many of you. Some might be offended by my colleagues and I laughing about common occurrences on a labor and delivery unit which are just the occupational hazards of our jobs.  You would probably be surprised and perhaps appalled at just how far and where maternal and fetal excrement can land during an uncomplicated delivery as one example. Many of those on the right who accuse “lefties” of being “PC” are now willing to apply their own standards to the speech of those whose jobs they have no way of understanding.

    2. Robin W

      Thanks for the kind words. At the risk of thoroughly boring everyone, as long as Daleiden keeps putting them out, I will keep analyzing.

      And on another note, I have an update on the ongoing investigations.

      Investigations in Georgia, Indiana, Massachusetts and South Dakota have shown no evidence of sales of fetal tissue.

      Ohio, Arizona, Texas,  and Kansas have all launched investigations despite the fact that no Planned Parenthood affiliate in any of these states has a fetal tissue donation program.

      Governor Bobby Jindahl of Louisiana has ordered an investigation of the Louisiana Planned Parenthood affiliates despite the fact that no Planned Parenthood affiliate in that state provides abortions at their facilities, let alone sells tissue from the non existent procedures.

      The governor’s of Minnesota and Virginia ( both Democrats) have declined to investigate Planned Parenthood as demanded by Republican lawmakers because Planned Parenthood in their states does not participate in tissue donation.

      I challenge any one to tell me on the basis of the above information that this has not been taken up by politicians on the right, many of whom take great pride in their fiscal responsibility and wise use of taxpayer monies, as a very expensive pander to their “pro-life” base, on the flimsiest suggestion that there might be something “crass”, “uncouth” or “unprofessional” going on since it is obvious that you cannot be selling fetal parts that you are not even obtaining or donating.

      1. Western southern Arizona is referring folks to San Diego, because there are so few facilities (for ALL types of medical services) left, and it is a place they can reach in a one day round trip car ride.

  1. The Center for Medical Progress, which has put together this expose, recently won a court decision to release new videos covering StemExpress.

    They immediately put out a 2-minute video, much of it a rehash, with one new snippet where the StemExpress CEO is joking during lunch about shipping complete aborted fetuses. She says they should warn the person who will open the box what they are going to get.

    http://www.mrctv.org/blog/court-removes-injunction-center-medical-progress-immediately-releases-8th-shocking-planned-parenthood-video

    It seems like there is no new violation of the law exposed, just more of the crass, uncouth, unprofessional behavior.

     

    1. TBD

      “I believe you left off the fact that New Hampshire, Louisiana, and Alabama have cut off state funding of Planned Parenthood.”

      You are correct that I had not responded to this. I am not sure why you are putting it forward at all. This issue being discussed with my series of articles was whether or not Planned Parenthood was engaged in any illegal activities.

      I was not addressing whether or not a group of religiously and ideologically driven law makers had decided to take away funding from a group whose activities involved the full range of preventive health care services to men and women who otherwise lack those services because they do not like a tiny portion of those services, and in the case of Louisiana, do not provide abortion at all.

      So I will cede you that. What a victory !  Women having to leave their own state for not only abortions but also for their Pap smears, mammograms, contraceptives ( I bet that will lower the rate of unintended pregnancies and abortions! ). And all because  of the religious beliefs of their leaders. Not the slightest suggestion of any wrong doing of the PP affiliates in their state. What a triumph for democracy and freedom of religion in those states !

      And yes, hpierce, sometimes there is a place for sarcasm.

      1. I believe that Planned Parenthood is the number one abortion provider in the country, somewhere between 300,000 to 400,000 abortions per year. I would not call abortion services at Planned Parenthood a “tiny” portion of the services they provide, that gets into playing word games.

        I’m sure there are many places in Louisiana and elsewhere to obtain contraceptives, Pap smears, and other services. You don’t have to mis-state reality in order to make your point.

        Louisiana – State Facts on Publicly Funded Family Planning Services: “Publicly supported health centers provided contraceptive care to 45,070 women in Louisiana in 2013, including 32,400 women served by Title X–supported centers.6 Health centers in Louisiana served 9,560 teens in 2013 (the latest year for which data are available), including 6,910 by Title X–supported centers. ..”

        http://www.guttmacher.org/statecenter/family-planning/LA.html

         

        Screening for STIs, including chlamydia and gonorrhea, is an integral component of the family planning services provided at safety-net health centers. STI screening results in early detection and treatment of these infections, reducing transmission to partners and helping women and men avoid negative health outcomes that might otherwise follow, such as pelvic inflammatory disease (PID), ectopic pregnancy and infertility. Cervical cancer screening through Pap tests and HPV tests is another basic preventive care service provided at publicly funded family planning visits, along with vaccination for HPV. These services help to prevent cases of cervical cancer, either by detecting abnormal cervical cells and precancer cases before they develop into cancer or by preventing the HPV infection that leads to future health problems. In Louisiana, publicly funded providers helped women and men avoid many such negative health outcomes (see table).8

        BTW, Planned Parenthood still has at least three offices in Louisiana.

        1. I would not call abortion services at Planned Parenthood a “tiny” portion of the services they provide, that gets into playing word games.

          Yes TBD, PP counts an abortion the same as administering birth control or giving a pap smear.  Yes, it’s a much bigger part of their services than PP likes to admit and that’s why as you say it just word games.

  2. Another update. For those who are still considering the validity of the accusations of the Daleiden group I would suggest considering the following as posted in a ThinkProgress article from 8/20/15.

    One of the photos (displayed at the video’s nine-minute mark) isn’t an aborted fetus at all. It’s actually a stillborn fetus prematurely delivered at 19 weeks.

    The woman who took that photo, Alexis (or “Lexi”) Fretz, initially published it on her blog — where she also shared the story of grieving her stillborn son, whom she named Walter Joshua. In a Facebook post, Fretz said that she did not give permission for the Center for Medical Progress to use Walter’s photo, though she does not plan to take legal action against the group.

    This was confirmed by a screen shot of the blog entry from Ms. Fretz .

    To be fair, nowhere on the tape is it claimed that this is an aborted fetus,  however, the implication and attempt at emotional manipulation is clear.

  3. Some readers will undoubtedly think the mom should file legal action, but I admire her for attempting to deal with her grief, and not wasting  time in the courtroom, which is a room that is a reflection of our unfair justice system.

  4. sisterhood

    I agree with you that legal action is not optimal here. What I would like to see is a similarly  mature approach from Mr. Daleiden. I would love to see a formal apology to this woman for the misrepresentation of her photo and an apology to those at Planned Parenthood who he has maligned.  I would also like to see the Daleiden group investigated for the possible illegality of their actions.

    However, I do not seek this as a “punishment” of their group, but rather an invitation to promote their own goals, supposedly an end to abortion, through the alternate means of promotion of sex education and contraception. I am completely aligned with the goal of abortion reduction and would be happy to work with anyone, including Mr. Daleiden who is willing to work on the issue in an honest, transparent manner. I would see this as a very fitting “community service” for any legal transgressions that his group has made.

    1. If we are to treat them equally, then we need to have a thorough investigation of Planned Paenthood for the possible illegality of their actions. I do not see this as punishment for their group, either.

      Second, how about a robust adoption program. I know of many couples who desired to adopt a newborn baby but had to go to China or Eastern Europe.

    1. “Even Hillary Clinton has called these tapes “disturbing”.”

      why even?  she’s running for office and wants to appear moderate plus guard against the possibility that something worse will come out.  she’s not the person i would hang my judgment on here.

  5. TBD

    I have already addressed the issue of how a beating heart is not an indicator of viability. There is no responsible pediatrician who would attempt resuscitation of a 19 week fetus for whom there is zero change of survival outside the womb. The criteria for resuscitation at this point in time is generally accepted to be 24 weeks and in some very highly specialized centers 22 weeks. If you want to call failure to resuscitate a 19 week old fetus infanticide or murder then you are going to have to lock up virtually every delivering obstetrician and every in hospital pediatrician in the country because we have all provided only comfort care if these extremely premature infants attempt to breath, and no intervention at all for only a transient heart beat which is not an indicator of life as I have indicated.

  6. Two updates here.

    The CEO of StemExpress now appears to be changing her story / walking back comments she made on the  recently released video clip where it appears that she is talking about buying / selling complete fetuses. She had referred to “intact cases” and how they should warn the person opening the box back at the StemExpress lab at what they were getting. She is now claiming that “intact cases” meant intact livers. This seems like a strange explanation that doesn’t make sense, especially given prior comments by previous doctors to “intact cases”.

    Second, two committees in Congress in the House of Representatives have opened investigations into Planned Parenthood. One wants to investigate whether abortion procedures were changed in order to obtain tissue donations. The second investigation by Oversight and Reform wants to see if there was any connection to the Obama Administration via Health and Human Services by providing grants to facilitate these sales (my interpretation of a longer explanation). The DA in Houston Texas is also conducting it’s own investigation.

    Planned Parenthood Senior Director of Medical Services Dr. Deborah Nucatola did say that she used partial-birth abortion methods in order to obtain more / better tissue results.

    1. To me it’s obvious from the comments on the videos that the practice of trying to keep the fetuses intact was sometimes being performed by PP even if it impacted the patient.  Sure they have to try and now walk back their comments.  Who would believe that intact livers would cause reactions from clinic workers when they deal with intact organs everyday, now if they opened a box with an intact fetus I can see where a clinic worker might react.

      1. I agree. But there is more to come that contradicts her new assertion.

        So now we know she is lying? I believe in court once a witness tells a lie, lawyers are instructed to question everything they have said.

  7. TBD

    Planned Parenthood Senior Director of Medical Services Dr. Deborah Nucatola did say that she used partial-birth abortion methods in order to obtain more / better tissue results.”

    In truth, this is not what she said. She made clear that the term “partial birth abortion” is what this procedure is called by politicians and the media. We do not use the term “partial birth abortion” in medicine. The tissue sparing techniques used for abortion in the 18-24 week range are very similar to those used to evacuate the uterus when there has been an intrauterine fetal demise in the same gestational age range. Just because I have frequently used these techniques does not mean that I am saying that I have performed “partial birth abortions”. During these procedures, I have also attempted to keep the demised fetus as intact as possible, not because their will be any donation of the fetal tissue, but rather because an intact delivery is less traumatic for the mother.

    The techniques for delivering a fetus intact are not only beneficial to the research recipient of the fetal tissue, but are also frequently beneficial to the woman as I have repeatedly pointed out, and you have repeatedly failed to acknowledge.

  8. It turns out the CEO of StemExpress is a Sacramento State graduate, and allegedly has done some work for or in relation to UC Davis related causes.

  9. https://istandwithpp.org/facts/how-anti-planned-parenthood-videos-were-deceptively-edited/

    “In the last two weeks, five states have concluded investigations into Planned Parenthood – and every one of them has found no wrongdoing.”

    “Collectively, the five videotapes of Planned Parenthood staff have at least 42 splices where content is cut and edited together to make it appear to be a seamless conversation.
    In some cases, these splices completely change the meaning of statements.”

    “CMP edited content out of the alleged “full footage” videos, and heavily edited the short videos so as to misrepresent statements made by Planned Parenthood representatives.”

    1. Can we trust the PR firm and hacks that wrote this, since Planned Parenthood is likely paying them hundreds of thousands of dollars for damage control?

      I recall seeing the Planned Parenthood CEO days after the first tape, and I didn’t believe much that she said.

        1. The big guns don’t work for peanuts, and Planned Parenthood is trying to protect $500M per year in funding from the government.

          BTW, millions of people think Mr. Daleiden has done us a great service.

          1. BTW, millions of people think Mr. Daleiden has done us a great service.

            By lying and committing fraud, and putting forth falsely edited tapes? Then millions of people have no ethical standards, apparently. Or, as someone famous put it, “the end justifies the means.”

        2. TBD:  Planned Parenthood is trying to protect $500M per year in funding from the government.

          BTW, millions of people think Mr. Daleiden has done us a great service.

          I can see how you might have that perspective if you were a person who didn’t need economical gynecological services.

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