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The Crucial Test

WHEN I RETURNED HOME from the library late that night, I was deeply troubled about the implications of these findings, and wondered what course of action I should follow. Should I stop my efforts to publish the article on leukemia in Albany-Troy and concentrate all my energies on this apparently much greater effect of fallout? How could still more convincing evidence best be found? How could scientists and government officials be quickly informed of this discovery so that independent studies to check the findings could be carried out by others as soon as possible?

At that very moment, the French were continuing their atomic tests in the Pacific, while the Chinese were starting to detonate larger-than-ever bombs whose fallout was already drifting over the U.S. If the rise in fetal deaths had truly been caused by fallout, then a simple calculation showed that for each additional megaton of nuclear energy released some 2000 to 4000 infants would be stillborn in the U.S. within a year, and perhaps ten times as many all over the world. And this figure did not even include the many infants who would be born with congenital defects or who would die of cancer and leukemia in the first years of life.

Yet what if my interpretation of the data was wrong? Should I spend many more months or even years gathering more and more detailed data on many additional populations, examining every conceivable alternative explanation for these effects, and only then publish the findings? Clearly this was not just another scientific study, to be handled with more deliberation than urgency. Here, every additional megaton bomb that the French or Chinese tested might mean the loss of thousands of babies, while every additional nuclear weapons system built would increase the certainty that human life would end if these weapons were ever used. The AEC was in the midst of plans to set off another large cratering explosion in Nevada within the next three months in an effort to prove the feasibility of excavating a new Panama Canal by means of hydrogen bombs. Such a test was bound to release large amounts of radioactive debris that would drift all over the United States and northern Europe.

On the other hand, many scientists would surely consider it irresponsible and alarmist to voice concern to the public before all the evidence had been gathered and submitted to the scientific community for detailed consideration. And there would of course be strenuous opposition from all the proponents of nuclear energy for military and peacetime use. Yet by now it was amply clear that I could not expect quick publication of these findings in the widely read scientific journals, such as Science. At best, it might take a year to gather the necessary support and definitively overcome the objections of reviewers.

Ultimately I resolved to take the findings to the public if discussions with colleagues failed to reveal any alternative interpretations of the evidence. Meanwhile, I continued to work at the library, trying to confirm these incredible findings.

One test would be that in a state comparable to New York in economic level and quality of medical care, but where there had been less-intense fallout, the change in the infant mortality decline should have been correspondingly smaller. California, upwind from the Nevada test site, met these criteria, and so I plotted the data for that state. The fetal mortality rate did in fact continue to decline at an undiminished rate during the early 1950s -- while New York State had already begun to show sharp rises -- reaching rates almost half those in New York. Only in 1955 to 1958, after the large hydrogen bomb tests in the Pacific, did California also begin to show a noticeable leveling off in the rate of decline. But at no time did this leveling show the sharp rises observed in New York State that would be expected from the much more intense short-lived radioactivity produced by the relatively small "tactical" weapons tests carried out in Nevada.

But the most crucial test involved the deaths of infants. For some of my colleagues in the field of public health had pointed out that fetal mortality figures, being incompletely reported, are not nearly as reliable as those for infants who are born live but die before the age of one. And when I examined the infant mortality figures for New York City and New York State, I found that they did in fact show the same peaking in 1964 and 1965 as did the fetal deaths. Especially sharp was the increase in deaths among the infants under 28 days old, which are known to reflect most strongly any effects that occurred during embryonic life.

In order to tie these upward changes in fetal and infant mortality to fallout, it would be necessary to make a detailed comparison between the actual measured levels of radioactivity in the food and milk with the mortality rates to see if the rises and falls coincided. Fortunately, data on fallout levels had been made publicly available beginning in 1957 after a struggle between the Public Health Service and the AEC, which wanted to keep them classified. The first area to check would be New York, for which the fetal and infant death rates were already collected. At the outset, I did not know for certain which of the isotopes in the fallout were causing the principal damage. But then I saw that each time the levels of the short-lived isotopes, such as iodine 131 and strontium 89, shot up to their highest peaks, there was a sharp rise in fetal mortality within a year. The first of these sharp general rises occurred after the very large Nevada, Pacific, and Siberian tests in 1957-58, and the second and highest took place following the tests in 1961-62, the high levels of short-lived isotopes in milk peaking in the spring and early summer of 1963.

Thus it appeared that, in the case of infant and fetal mortality, the short-lived isotopes produced especially by the smaller fission bombs were dominant. These isotopes gave off their radioactivity anywhere from ten to a hundred times faster than the long-lived strontium 90 and cesium 137, or than the carbon 14 and tritium produced by the hydrogen bombs. Inside the body, then, they would give the fetus the highest dose in the shortest time. Certainly iodine 131 could be a major source of damage. In a paper just published in January 1968, Merrill Eisenbud, who had been head of the AEC's New York Health and Safety Laboratory at the time of the Troy incident, reported an actual measurement of the iodine in the thyroid of a 12-week-old fetus aborted in New York City in 1962, the peak year of testing. The fetus had received a thyroid dose ten times as large as that being received by the average newborn infant during the same period. Eisenbud gave this peak average thyroid dose for newborns in the city in 1962 as 200 millirads. So the thyroid of the fetus must have been receiving around 2000 millirads, or 2 rads, a truly enormous dose for this crucial organ compared to the 75 millirads it would normally have received from natural background radiation. And this was just the dose to a single organ from a single isotope. The total effect on the developing fetus from the combined concentration of different isotopes in different organs must have been vastly greater. In this connection, Eisenbud also gave monthly figures on strontium 90 in milk for New York City, and these too showed sharp peaks in 1958, 1962, 1963, and 1964, corresponding to the years of greatest increases in fetal deaths.

But what would be the effects of the long-lived strontium on fetal and infant mortality? The intense radioactivity of the short-lived isotopes generally died out within six months to a year, but the strontium, with its half-life of 28 years, would persist in the environment and in the diet, continuing to build up in the bones and genetic material of the exposed people until reaching an equilibrium level where natural metabolic processes would remove it at the same rate as it was being taken in. Studies had shown that this peak level was generally reached some four to five years after continuous intake began. Therefore, it seemed likely that any effects of strontium on infant mortality would parallel this accumulation in the bodies of the parents. If this was so, then after the initial sharp rise caused by the short-lived isotopes there would be a dip, followed by a gradual rise culminating in a second, broader, lower peak extending generally between the third to fifth years. Thereafter, if no additional strontium was added to the diet, there would be a slow decline that would probably accelerate rapidly after a few years as the strontium in the environment was dissipated and diluted by natural processes.

When I discussed the findings with Dr. Barry Commoner, now at Washington University in St. Louis, he suggested that I compare the leveling of the decline in fetal and infant mortality with the measured amounts of strontium 90 on the ground and in the milk for different areas of the United States. It took only a few days to discover that the pattern followed closely the levels of strontium 90 that accumulated in the environment after the onset of hydrogen bomb testing in the early 1950s. Furthermore, the graphs consistently showed two peaks in tandem -- a sharp peak within a year after each test series, when the levels of short-lived isotopes as well as strontium shot up, followed by a second slower rise culminating between three and five years later. The second peaks were especially high, probably because each of the enormous fusion bombs had actually produced hundreds of times as much strontium 90 as one of the earlier atomic fission bombs, even though the hydrogen bombs had been advertised as being much "cleaner." For, as Ralph Lapp and the British physicist Joseph Rotblat had each discovered independently in 1954, in order to get a "bigger bang for a buck" as U.S. Secretary of Defense Charles Wilson put it, Edward Teller and his weapons engineers had surrounded the hydrogen bombs with cheap, abundant uranium 238. As a result, the total explosive force could be doubled at no additional cost, but the levels of strontium 90 in the bones of living creatures were vastly increased.

The final task that remained was to make certain that there existed no other known explanation for the halt in the decline of infant mortality in the United States. Various of my associates in the University of Pittsburgh School of Public Health had said that to the best of their knowledge no other cause had been found. It was suggested that I review the results of an international conference on the problem, held in Washington, D.C., in May of 1965.

The summary of the conference revealed that extensive studies had been made comparing the U.S. with five European countries where there had been much less of a slowing in the infant mortality decline, or none at all. These studies had failed to find any explanation for the sudden worsening of the situation in this country. However, fallout had not even been considered as a possible factor.

According to the report, the U.S. infant mortality problem had become so serious since it was first noticed in 1960 that comparative studies had been undertaken in Scotland, England, Wales, Norway, Denmark, and the Netherlands. The 1965 conference brought together the investigators from each of these countries in an effort to determine "the reasons for the position of the infant mortality rate in the United States."

As the introduction to the report put it:

Two features were noted about the infant mortality rate in the United States in the 1950s: (1) the virtual halt in the rate of decline of infant mortality after a long period of rapid decline, and (2) the unfavorable position of the United States infant mortality compared with that of many other countries. These two points were viewed with concern because health authorities had for many years pointed with pride to the high rate of decrease in infant mortality in the United States.

In his opening remarks, Dr. I. M. Moriyama, chief of the Office of Health Statistics Analysis of the U.S. National Center for Health Statistics, posed the problem as follows:

One of the intriguing questions is why the rate of decline of infant mortality rates for countries such as the United States, England and Wales, and Norway has been checked, whereas the rates for Denmark and the Netherlands have continued to decline without apparent interruption.

But what was more surprising was what Dr. Moriyama added:

Incidentally, the change in mortality conditions was not peculiar to the period of infancy. The rates at other ages also leveled off in the United States, but these changes came several years after the beginning of the deceleration in the infant mortality rate.

This delay in effects on the older population was, of course, consistent with the characteristic established pattern of delay in appearance of radiation-induced cancer and leukemia. And I had found that fetal and infant mortality changed within a year after the exposure took place.

An observation made by Dr. Samuel Shapiro, director of research and statistics of the Health Insurance Plan of Greater New York, seemed to lend further support to the fallout hypothesis. Dr. Shapiro remarked that the birthweight of U.S. infants had mysteriously declined since the early 1950s. This was significant, since a decline in birthweight had been well established as one of the effects of radiation on unborn children in the studies of the Hiroshima and Nagasaki survivors. And extensive laboratory animal studies had long shown that stunting of growth and reduced birthweight were produced by irradiation of the fetus, while similar effects had been observed among human infants accidentally exposed to X-rays prior to birth. Furthermore, a slight reduction in birthweight, such as sometimes appears in infants whose mothers had German measles during pregnancy, was known to greatly increase the likelihood that the infants would die in the first year of life. As it was put later in the report of the conference: "Low-birthweight infants have a much greater chance of dying, and hence contribute significantly to neonatal mortality."

Dr. Shapiro also noted that "the decrease in the rate of decline was more serious in the nonwhite population." The large series of bomb tests that began in Nevada in 1951 would logically have had the greatest effects on the large black populations of the Southern Atlantic and Gulf states. These included the states of heaviest rainfall, over which the fallout from Nevada was blown by the prevailing eastward high-altitude winds, spreading radioactive rain on the crops that formed the staple diet of the sharecroppers and farm laborers of the South. And their children, with the poorer diet, poorer sanitary conditions, and poorer medical care prevalent among the nonwhite populations, would, if they were born slightly weaker and less resistant than normal, have a greatly reduced chance of survival as compared with white children, who are generally far better off in all three respects.

According to the report, it appeared that infant mortality patterns in European countries also fitted the fallout hypothesis. According to Charlotte A. Douglas, a public-health physician from Edinburgh, "In Scotland, there had been impressive declines in maternal, fetal, and infant mortality from 1935 until the early 1950s, when the decline in mortality rates became more gradual. Since then there has been only slight improvement." Thus there was a close coincidence in the times when this leveling trend began in Scotland and the U.S. Similarly, in England and Wales, as reported by Dr. Katherine M. Hirst: "The total infant mortality has declined for years, but it began to level off during the 1950s, as did that of the United States." And again, just as in the U.S., there was a large increase in the number of low-birthweight babies. The same story emerged from the account of Dr. Julie E. Backer for Norway, where the clouds drifting across the North Atlantic would have rained down their fallout most heavily on the coastal mountains rising from the sea.

However, the reports on Denmark and Holland were quite different. In these countries there had been little or no leveling off in the rate of decline. A pattern was beginning to emerge. It was the more northerly countries with the heaviest rainfall that were showing the greatest effects on infant mortality. Even within England, there was a reduction in infant and fetal death rates going southward.

The high-altitude fallout clouds from the Nevada test site, carried across the Atlantic in a northeasterly direction by the prevailing jet-stream wind currents, would have deposited their radioactivity on the northern parts of Europe with much greater intensity than on the southern parts. This pattern was confirmed by the lack of any significant halt in the steady decline in infant mortality in France throughout the early period of Nevada testing. There, the first leveling of the decline did not occur until after the first tests in Algeria in 1960 and the large hydrogen bomb test series in the Pacific in 1961-62. These tests resulted in substantial fallout in France. And the same situation existed in Canada, which had been largely untouched by the fresh fallout from Nevada as it was blown northeastward across the U.S. and on to northern Europe.

An even more striking confirmation of the thesis that these geographical differences in mortality rates were related to fallout was contained in a study by Dr. Bernard Greenberg, a biostatistician at the University of North Carolina, whose work was summarized in the report. Since Sweden had continued to show a much smaller percentage of low-birthweight babies than the U.S., Dr. Greenberg undertook to find out if there was some cultural or genetic difference among people of Scandinavian stock that made their children less susceptible to this condition. Taking the two states of Minnesota and North Dakota, Dr. Greenberg compared the number of low-birthweight babies in counties containing the highest percentage of Scandinavians with the number in counties containing very few Scandinavians. He did indeed find a small difference of about 10 percent, the counties with more Scandinavians showing the smaller number of low-birthweight children. But this percentage was far too small to explain the much larger difference between the U.S. and Sweden. However, he also found something he could not explain at all, namely: All the counties in North Dakota, regardless of the percentage of Scandinavians, showed a much higher incidence of low-birthweight babies than did the counties in Minnesota.

This was odd. But then I remembered an article I had read many years before about fallout in North Dakota. It was entitled "The Mandan Milk Mystery." In the back files of Scientist and Citizen (now called Environment), a magazine then published by the St. Louis Citizens' Group for Nuclear Information, I located the article, written by E. W. Pfeiffer. It described how the Mandan, North Dakota, milk sampling station operated by the AEC had, for some unknown reason, consistently shown the highest concentration of strontium 90 in milk among all the states where such measurements were taken. In fact, in May of 1963, Mandan had shown the highest levels ever recorded anywhere in the United States. The levels were consistently much higher than in nearby states, notably Minnesota.

This, then, was a direct correlation between the amount of strontium 90 in milk and the incidence of low-birthweight babies. It should therefore be possible to find large geographical differences in infant mortality based on differences in fallout levels. The various regions should show rises beginning at different times. These rises should come first in the states in the path of the fallout from the early tests in New Mexico and Nevada -- the southeastern states of heavy rainfall, along the Gulf of Mexico and the Atlantic coast from Forida to about New Jersey. These were the regions over which the high-altitude clouds generally drift from west to east, carried along by the "jet streams," the constant 60- to 120-mile-an-hour winds blowing northeastward at altitudes of 25,000 to 40,000 feet. Only later, after the hydrogen bomb testing began in the Pacific in 1953, should the high-rainfall states in the northern U.S. begin to show an upward trend. For in these tests, which continued up until the test-ban treaty of 1963, the radioactivity was deposited high in the stratosphere, beyond the influence of the prevailing winds, and so it sifted down much more uniformly around the world. But since this high-altitude debris was also eventually brought down mainly by rain and snow, then there should still be clear differences in infant mortality between the wet and dry regions of the U.S.

Searching among the reports published by the U.S. National Center for Health Statistics, I located one that had graphs of infant mortality for every state from 1935 to 1964. And indeed, the southeastern states along the Gulf and Atlantic coasts showed the first sharp leveling during the 1946-50 period following the first test in New Mexico, while the states farther to the north did not show this trend until later in the 1950s when the tests were moved northward to Nevada. And overall, from 1935 to 1964, the least change in the steady decline occurred in the low-rainfall states of the Southwest. In New Mexico, for example, except for a brief halt in the downward trend following the first and only atmospheric test carried out in this state in 1945, the pattern was essentially the same as for France. The decline resumed and showed only a slight degree of slowing until the early 1960s, when the large amount of debris from the South Pacific tests began to raise the levels of radioactivity everywhere.

Furthermore, the lower-income groups -- mainly the nonwhite population -- showed the greater change, so that the effect first became apparent in this group. In fact, in some states, the decline among this group did not just slow or stop. In Arkansas, for instance, the nonwhite infant mortality rate actually began to climb again from a low point of 30 per 1000 live births in 1946 to 39 per 1000 in 1949, gradually rising still further to a high of about 42 after the peak of testing had resulted in the highest levels of radioactivity ever in the diet in 1963. In the face of generally improving living standards, such a trend was very hard to understand any other way.

In sharp contrast, the nonwhite infant mortality rates for dry Arizona and New Mexico kept right on declining. Yet the medical care and general living standards of the Indian populations in these states was not significantly better than for the black population of Arkansas. In New Mexico, the rate for nonwhites in 1952 was close to 100 deaths per 1000 live births. During the ensuing decade of heavy testing, the rate declined continuously to 40 by 1961, just as steady a rate of decline as that for the white population with its much higher living standard.

But the most convincing evidence that it had to be fallout rather than ordinary chemical pollution or any genetic, cultural, medical, or economic factors came from the evidence for Hawaii. Here was an area that originally had roughly the same high infant mortality rate among nonwhites as the southwestern states of the continental United States: about 80 per 1000 births in the early 1930s. It showed a sharp downward trend in the late 1930s that brought the rate to about 28 in 1945. But then this decline suddenly halted, and the rate actually rose during 1946-48, shortly after the Hiroshima and Nagasaki detonations and the first tests at Bikini and Eniwetok, all located directly upwind from Hawaii. The rates for both whites and nonwhites afterward resumed their decline, reaching about 21 by 1951-52. Shortly thereafter, however, they once again not only stopped their decline but actually rose to another peak of 25 between 1957 and 1960, following the large hydrogen bomb tests conducted during 1953-58 in the Pacific. Not until four years after the end of large-scale atmospheric testing in 1962 did Hawaii resume its decline, finally going below 20 in 1966, the lowest rate in its history. The hypothesis that it was the fallout coming down with the rain fitted perfectly: The annual rainfall in Hawaii was among the highest in the world -- some 100 to 200 inches as compared to less than ten for New Mexico and Arizona in the U.S. Southwest.

The worst situation in the continental U.S. existed in Mississippi, a state directly in the path of the fallout from many Nevada tests and with poor medical care and an annual rainfall of 49 inches. There, the nonwhite infant mortality rate had shown a promising decline even throughout the period of the Depression, dropping from 82 per 1000 in 1930 to a low of 40 by 1946, quite close to that for the white population. But instead of declining further, the nonwhite rate leveled off in the early 1950s and then actually started to climb sharply. By 1963 it was back up to 58, an absolute increase of 45 percent in the face of a generally rising standard of living and improved diet and medical care. And once again, just as in Hawaii, the rate renewed its previous decline after the cessation of atmospheric testing, reaching 53 by 1966, the last year for which data were available.

Furthermore, examination of the official fallout measurements showed that the high rainfall areas of the south and east did indeed have two to three times as much strontium 90 in their soil as the dry states of the western mountain region. By plotting the figures for twelve typical rural and urban states on a graph, I was able to ascertain that the upward deviation infant mortality was directly related to the amount of strontium 90 deposited.

The total excess infant mortality for the United States as a whole was truly enormous. Using the calculating methods employed by Dr. I. M. Moriyama, it was possible to estimate what the mortality rates would have been if the decline had not been interrupted. In the fifteen years between 1951 and 1966, the total number of infants in the United States who died in the first year of life exceeded the norm established during the previous fifteen years by 375,000. The infants were not dying to any noticeably greater degree of bone cancer and leukemia, the effects well known to be produced by strontium 90. Instead, they were dying a little more frequently of respiratory diseases, infections, and immaturity, conditions that apparently had nothing to do with the kind of gross effects everyone had been led to expect from radiation, and that would be more noticeable among those who had poorer diets and medical care.

Even more staggering were the figures indicating that for every infant who died in the first year of life there were five to ten who died prior to birth, so that the excess numbers of fetal deaths, spontaneous abortions, and stillbirths must have reached anywhere from two to three million in the United States alone.

In addition, after 1955 there had also been a sudden slowing down in the steady decline of maternal mortality. Between 1937 and 1955 the average rate of decline in the number of women dying from complications of pregnancy and childbirth had been 12.8 percent per year. This rate of decline slowed down drastically to 2.1 percent per year between 1956 and 1962. Even more disturbing, instead of a further decline, there was actually a rise in the number of maternal deaths between 1962 and 1963, the year when fallout reached the highest levels ever recorded and fetal deaths began their sharp rise. Thus in 1963, a total of 1466 women died from complications of pregnancy and childbirth in the United States. The calculations indicated that if the previous downward trend had continued instead of leveling off, close to a thousand of these mothers would not have died in that one year alone. For the whole world combined, the figure would have been ten times as large.

It did not take long to discover that beginning in 1966, some three years after the test-ban treaty was signed, when only the French and Chinese continued testing in the atmosphere, the infant and fetal mortality rates all over the U.S. and Europe suddenly and quite unexpectedly began to decline once more. According to the latest Monthly Report of the U.S. Office of Vital Statistics, the drop in infant mortality that began for the U.S. after 1964, when it had reached a peak of 24.8 per 1000 births, had indeed continued into 1968, reaching 21.7, and it showed no sign of halting. Even Sweden had resumed its decline at the same rapid rate that it had shown prior to the onset of testing. And there, the number of deaths per year had already been so far below that of the U.S. that any further decline seemed extremely unlikely. Here was clear proof that the "irreducible minimum" in infant mortality had not been reached either in Sweden or the United States.

By 1964, the year before the international conference on infant mortality had been held, seventeen other nations in the world had reached a lower level of infant mortality than the United States, according to a report published by Dr. Helen C. Chase of the U.S. Office of Health Statistics Analysis in 1967. These included the Netherlands, 14.8; Norway, 16.4; Finland, 17.0; Iceland, 17.7; Denmark, 18.7; Switzerland, 19.0; New Zealand, 19.1; Australia, 19.1; England and Wales, 19.9; Japan, 20.4; Czechoslovakia, 21.2; Ukraine, 22.0; France, 23.3; Taiwan, 23.9; Scotland, 24.0; and Canada, 24.7. And for the United States in that year the figure had been 24.8, or 68 percent higher than for the Netherlands, when as recently as 1947 the United States actually had a lower infant mortality than that country. Among all these nations, it was the U.S. which was exposed to the most intense fallout from the tests in Nevada and the South Pacific.

Most of these countries had been exposed to other environmental pollutants to the same or even a greater degree than the U.S. Tobacco, food additives, pesticides, and drugs were used throughout the world since World War II. Neither could ordinary air pollution be the principal cause, since unpolluted rural states such as Hawaii and Arkansas showed far greater upward deviations in infant mortality than any of the heavily industrialized urban states in the northeast.

The conclusion was inescapable. There seemed to be no other single factor that could account for such sudden and dramatic changes on a worldwide scale. Only radioactive fallout acting mainly on the early embryo could explain these facts.

After discussing my findings with colleagues in the Federation of American Scientists, it was agreed that they would be made public at a meeting of the Pittsburgh F.A.S. chapter on October 23, 1968. The day before the meeting, I submitted two copies of the report to Science. Because of his interest in the subject, I also sent a copy not intended for publication to Eugene Rabinowitch, editor of the Bulletin of the Atomic Scientists, a journal that had long been concerned with the possible biological effects of fallout.

After delivering my paper at the F.A.S. meeting on the morning of the twenty-third, I was interviewed by Stuart Brown, a reporter from the Pittsburgh television station KDKA. A few hours after the conclusion of the interview, the phone at my office rang. It was Stuart Brown, who said that he had just called Philip Abelson, the editor of Science. Brown thought I ought to know what Abelson had said.

According to Brown, Abelson had told him that my paper had been rejected by an "independent committee." This was a most unusual statement for the editor of a scientific journal to make to the press. According to long-established tenets of professional ethics, such journals are supposed to keep all editorial correspondence completely confidential. Furthermore, the paper I had just presented had been mailed to Science only the night before and thus could not possibly have been reviewed by an "independent committee." Abelson had obviously been referring to the revision of the Troy paper on the rise in leukemia, which contained none of the new data on fetal and infant mortality.

Next, Brown said, Abelson had gone to the files, pulled out my folder, and read statements from the supposedly confidential report of one of the reviewers that my paper was "weak in its scientific methods" and its findings were "sweeping and sensational." And at the end of the conversation, Abelson advised Brown against using any of my findings on the air.

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