doi: 10.1164/ajrccm.160.1.9708059, Hosseini, S., Wilk, E., Michaelsen-Preusse, K., Gerhauser, I., Baumgartner, W., Geffers, R., et al. Y-27632, an inhibitor of Rho-kinase, antagonizes noradrenergic contractions in the rabbit and human penile corpus cavernosum. Studies indicate that these hormonal changes can cause drowsiness and make it easier to fall asleep. [8], The autonomic or involuntary nervous system, which is involved in the control of body functions such as heart rate and blood pressure, is affected in two-thirds of people with GuillainBarr syndrome, but the impact is variable. [9], Cerebrospinal fluid envelops the brain and the spine, and lumbar puncture or spinal tap is the removal of a small amount of fluid using a needle inserted between the lumbar vertebrae. The Journal seeks to publish high (2020). Saenz de Tejada I, Goldstein I, Azadzoi K, et al. The intensity of the rehabilitation depends on whether the fracture was stable or unstable. Montorsi F, Perani D, Anchisi D, et al. These nerves travel in the sacral nerves to the pudendal nerve to innervate the ischiocavernosus and bulbocavernosus muscles. 95, e1060e1070. Rejection sensitive dysphoria (RSD) is extreme emotional sensitivity and pain triggered by the perception that a person has been rejected or criticized by important people in their life. 27 Activation of this region is similarly seen in past studies using PET.24, 28 This region has been associated with sensory processing. Relationship between cavernosal ischemia and corporal veno-occlusive dysfunction in an animal model. Wermuth L, Stenager E. Sexual aspects of Parkinsons disease. Viewpoint: impact of the Covid-19 outbreak on the clinical and research activities of memory clinics: an Alzheimers disease center facing the Covid-19 crisis. Keep your legs straight and move your feet up and down at the ankles, pointing your toes and then relaxing. Rejection Sensitive Dysphoria How ADHD Ignites Rejection Sensitive Dysphoria For people with ADHD or ADD, rejection sensitive dysphoria can mean extreme emotional sensitivity and emotional pain and it may imitate mood disorders with suicidal ideation and manifest as instantaneous rage at the person responsible for causing the pain. Vascular injuries occur more often than arterial injuries. Norepinephrine from sympathetic nerve endings and endothelins and PGF2a from the endothelium activate receptors on smooth muscle cells to initiate the cascade of reactions that eventually result in elevation of intracellular calcium concentrations and smooth muscle contraction. Cigarette smoking: an independent risk factor for atherosclerosis in the hypogastric-cavernous arterial bed of men with arteriogenic impotence. ), Many classifications have been proposed for ED. Soc. Research studies have found multiple ways that nightly sleep can affect sex. Sildenafil inhibits the action of PDE5 and thus increases the intracellular concentration of cGMP. NO, prostaglandin, and the polypeptide endothelins have been identified in the endothelial cell.5, 91 Activation of cholinergic receptors on the endothelial cell by acetylcholine or stretching of the endothelial cells as a result of increased blood flow may elicit underlying smooth muscle relaxation through the release of NO. From this landmark study a tentative model for brain function during sexual arousal was introduced. The second phase shows a slow pressure decrease, suggesting a slow reopening of the venous channels with resumption of the basal level of arterial flow. 53:102188. doi: 10.1016/j.ajp.2020.102188, Ellul, M. A., Benjamin, L., Singh, B., Lant, S., Michael, B. D., Easton, A., et al. The cavernous nerves are branches of the pelvic plexus that innervate the penis. Nitric oxide and cyclic GMP formation upon electrical field stimulation cause relaxation of corpus cavernosum smooth muscle. Cholinesterase inhibitors (ChEIs) levels may increase during chloroquine (CQ), hydroxychloroquine (HCQ) and lopinavir/ritonavir treatment, due to effects on cytochrome P450. If there is the slightest possibility that a person might try something new and fail or fall short in front of anyone else, it becomes too painful or too risky to make the effort. It contains over 12000 Journals. doi: 10.1016/j.bbi.2020.07.014 [Epub ahead of print]. Padma-Nathan H, McCullough A, Forest C. Erectile dysfunction secondary to nerve-sparing radical retropubic prostatectomy: comparative phosphodiesterase-5 inhibitor efficacy for therapy and novel prevention strategies. Psychiatry Res. For people with ADHD or ADD, rejection sensitive dysphoria can mean extreme emotional sensitivity and emotional pain and it may imitate mood disorders with suicidal ideation and manifest as instantaneous rage at the person responsible for causing the pain. Fabry disease is the most common of the lysosomal storage disorders and results from deficient activity of the enzyme alpha-galactosidase A (-Gal A), leading to progressive lysosomal deposition of globotriaosylceramide and its derivatives in cells throughout the body. https://www.nia.nih.gov/health/alzheimers-disease-common-medical-problems. Dementia prevention, intervention, and care: 2020 report of the Lancet commission. National Institute of Health. Geriatr. Angiotensin II-mediated hypertension in the rat increases vascular superoxide production via membrane NADH/NADPH oxidase activation. In humans, the T10 to T12 segments are most often the origin of the sympathetic fibers, and the chain ganglia cells projecting to the penis are located in the sacral and caudal ganglia.6, The parasympathetic pathway arises from neurons in the intermediolateral cell columns of the second, third, and fourth sacral spinal cord segments. Call our Help Me Sleep Hotline: 1(833) I-CANT-SLEEP. However, when both people achieve orgasm during sex, the difference in sleepiness is no longer statistically significant. Paick JS, Donatucci CF, Lue TF. [40] The course of the disease is usually monophasic, but recurrent episodes have been reported. Mouras H, Stoleru S, Bittoun J, et al. N Engl J Med. Hyperthermia, also known simply as overheating, is a condition in which an individual's body temperature is elevated beyond normal due to failed thermoregulation.The person's body produces or absorbs more heat than it dissipates. Received: 29 July 2020; Accepted: 05 October 2020;Published: 26 October 2020. Beyer and Gonzales-Mariscal have reported that testosterone and dihydrotestosterone are responsible for male pelvic thrusting and estradiol or testosterone for female pelvic thrusting during copulation.68 In rats, castration has been reported to decrease arterial flow, induce venous leakage, and reduce about half of the erectile response to stimulation of the cavernous nerve.69, 70 Treatment with flutamide, estradiol, or a gonadotropin-releasing hormone antagonist in addition to castration further depresses the erectile response. An analysis of the Maxi-K+ (KCa) channel in cultured human corporal smooth muscle cells. Graham C, Regan J. Blinded clinical trial of testosterone enanthate in impotent men with low or low-normal serum testosterone levels. Pudendal nerve injury associated with avid bicycling. Other branches of the pelvic plexus innervate the rectum, bladder, prostate, and sphincters. In addition, phosphorylation of the light chain also activates myosin ATPase, which hydrolyzes ATP to provide energy for muscle contraction (Figure 1). Accessed Nov. 23, 2020. Medical resources have been diverted away from patients with chronic conditions, such as dementia, to attend COVID-19 cases. Bocher M, Chisin R, Parag Y, et al. One better understood genetic factor is a form of the apolipoprotein E gene (APOE). Human coronavirus OC43 infection induces chronic encephalitis leading to disabilities in BALB/C mice. Press D, et al. All authors contributed to the article and approved the submitted version. Microstructural disorders of tunica albuginea in patients affected by impotence. Specific tips that can strengthen sleep hygiene include: Making an effort to improve sleep hygiene can help you get more of the sleep you need every day. Another way that sleep may affect sexual health is through impaired decision-making and impulse control. https://www.alz.org/help-support/caregiving/stages-behaviors/middle-stage. eNOS, endothelial nitric oxide synthase. It is, therefore, possible that cerebral impulses normally travel through sympathetic (inhibiting norepinephrine release), parasympathetic (releasing NO and acetylcholine), and somatic (releasing acetylcholine) pathways to produce a normal rigid erection. 288:113028. doi: 10.1016/j.psychres.2020.113028, Parra, A., Juanes, A., Losada, C. P., Alvarez-Sesmero, S., Santana, V. D., Marti, I., et al. GuillainBarr syndrome (GBS) is a rapid-onset muscle weakness caused by the immune system damaging the peripheral nervous system. In men with a spinal cord injury, their erectile function depends largely on the nature, location, and extent of the spinal lesion. [35] Not all antiganglioside antibodies cause disease, and it has recently been suggested that some antibodies bind to more than one type of epitope simultaneously (heterodimeric binding) and that this determines the response. Millar, B. M., Starks, T. J., Rendina, H. J., & Parsons, J. T. (2019). Using shorter visual sexual stimuli, they believed early neural responses would be generated instead of neural responses to the perception of penile tumescence. Cases typically occur in the spring and the average age of occurrence is 43 years old. 1 The flaccid penis is in a moderate state of contraction, as evidenced by further shrinkage in cold weather and after phenylephrine injection. Marlow N1, Wolke D et al (2005) Neurologic and developmental disability at six years of age after extremely preterm birth. 1173185. All scientific data and information must be backed up by at least one reputable source. We own and operate 500 peer-reviewed clinical, medical, life sciences, engineering, and management journals and hosts 3000 scholarly conferences per year in the fields of clinical, medical, pharmaceutical, life sciences, business, engineering and technology. The Food and Drug Administration (2020). A landmark study that helped establish that therapeutic interventions to lower cholesterol levels result in reduced risk of cardiovascular morbidity or mortality was the Lipid Research Clinics Coronary Primary Prevention Trial, which was published in two parts (each using a different statistical analysis) in 1984 (4; 5). There is evidence of neuronal death after brain infection by SARS-CoV-1 via the olfactory bulb in animal models (Netland et al., 2008). Batty, G. D., Deary, I. J., Luciano, M., Altschul, D. M., Kivimaki, M., and Gale, C. R. (2020). Park K, Seo JJ, Kang HK, et al. Watnik, Neil F, Michael Coburn, and Michael Goldberger. A Rho-kinase inhibitor, soluble guanylate cyclase activator and nitric oxide-releasing PDE5 inhibitor: novel approaches to erectile dysfunction. Open Access should be seen as a means of accelerating scientific discovery by providing free and unrestricted access of scientific knowledge via the Internet. The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. Neuropsychiatric and cognitive manifestations in dementia patients during confinement. Stoleru et al. Chapelle PA, Durand J, Lacert P. Penile erection following complete spinal cord injury in man. Three reasons to consider the role of tiredness in sexual risk-taking among gay and bisexual men. In Europe and the United States, 6080% of people with GuillainBarr syndrome have the demyelinating subtype (AIDP), and AMAN affects only a small number (67%). Submit a Manuscript . Some common brain centers of activation can now be described through these reports (Table 1). B., Reeve, B. Symptoms of urethral injuries are blood at the external urethral meatus, a high-riding (non-palpable) prostate gland in man, and perineal and genital swelling. [28], COVID-19 has been reported as causing peripheral neuropathy and more recently some evidence of aggravation of autoimmune disorders including GBS. These internal links are intended to improve ease of navigation across the site, and are never used as original sources for scientific data or information. 2020; doi.org/10.1016/S0140-6736(20)30367-6. Patients with unstable fractures are usually unable to stand, in contrast to patients with stable fractures who can often walk unaided. Accessed Nov. 23, 2020. Typically, both sides of the body are involved, and the initial symptoms are changes in sensation or pain often in the back along with muscle weakness, beginning in the feet and hands, often spreading to the arms and upper body. Alzheimer's Disease Facts and Figures report get the latest statistics on the impact of Alzheimer's and dementia in the United States. 3 Clinical Confirmation of Improved Likelihood of Survival Associated With the Use of the Head-Up CPR Bundle for Non-Shockable Cardiac Arrest Presentations. Therefore, in this study we review the evidence regarding the neuropsychiatric and cognitive manifestations of COVID-19 as well as its direct and indirect consequences in survivors, especially in elderly individuals with dementia. Alzheimer's disease research centers. EPICure Study Group. The molecular and clinical understanding of erectile function continues to gain ground at a particularly fast rate. Neurology. Plantar flexion and dorsiflexion of the feetSit up or lie down. Making the bedroom inviting by setting a comfortable temperature, using dim and warm lighting, ensuring a pleasant smell, and having a mattress that is supportive and. Learning relaxation techniques and incorporating them into the nightly routine to prepare for bed. Angiotensin-converting enzyme 2 in the brain: properties and future directions. Sleep also has far-reaching effects on well-being. Orgasm, which is the point of maximum excitement. It appears JavaScript is disabled in your browser. More Journal Metrics . For people with RSD, these universal life experiences are much more severe than for neurotypical individuals. The second treatment is prescribing monoamine oxidase inhibitors (MAOI) off-label. 382, 22682270. B., Shelby, R. A., & Weinfurt, K. P. (2016). Soft-tissue injuries like haematomas, abrasions and lacerations commonly accompany pelvic ring injuries. Besides mental health disorders, poor sleep can lead to emotional and relationship problems that can hinder sexual health. 88, 6668. Given the impact that this pandemic is having on elderly people with dementia and based on the evidence reviewed and existing to date, a summary of relevant considerations to take into account for this population is presented in Table 4. J. Pathol. will also be available for a limited time. COVID-19 in older people: a rapid clinical review. Pelvic fractures should be considered in the context of polytrauma management, rather than in isolation due to the complexity of the injuries leading to pelvic fractures. J. Med. The ACE2 receptor has been found to be expressed widespread in neurons and glial cells (Xia and Lazartigues, 2008). In pelvic fractures in the elderly population, the rehabilitation process will be focused on optimising their quality of life. Brain Behav. J. Alzheimers Dis. The penis is not protected--in hypertension there are vascular changes in the penis which are similar to those in other vascular beds. People who have MCI have a significant risk of developing dementia. Immun. doi: 10.1523/jneurosci.1808-05.2005, Kuo, C. L., Pilling, L. C., Atkins, J. L., Masoli, J. (2020). For example, a person may make poor or uncharacteristic choices in social interactions or wear clothes that are inappropriate for the weather. [3] Men are more likely to develop GuillainBarr syndrome than women; the relative risk for men is 1.78 compared to women. Its neurologic and genetic. 383, 989992. No use, distribution or reproduction is permitted which does not comply with these terms. Pastuszak, A. W., Moon, Y. M., Scovell, J., Badal, J., Lamb, D. J., Link, R. E., & Lipshultz, L. I. The medical management and further rehabilitation depends whether the fracture is stable or unstable. depression) or major life stress (e.g. 160, 5056. INTRODUCTION Sexually transmitted infections (STIs) are a major public health problem in both resource-rich and limited settings. Despite this preliminary evidence, most of the findings came from self-reported scales, without clinical diagnostic assessments, and further examinations and follow-ups are needed to determine not only if these symptoms are related to the infection itself, secondary immune responses, side effects of treatments or psychologic stressors, but also if they improve, remain or worsen over time. J. Alzheimers Dis. A family member or friend may be more likely to notice how the symptoms worsen. Available online at: https://www.alz.org/help-support/caregiving/coronavirus-(covid-19)-tips-for-dementia-care (accessed July 24, 2020). OpenSAFELY: factors associated with COVID-19 death in 17 million patients. Lascelles, J.F. Psychiatric and neuropsychiatric presentations associated with severe coronavirus infections: a systematic review and meta-analysis with comparison to the COVID-19 pandemic. Mayo Clinic. Many people with Down syndrome develop Alzheimer's disease. [11] If the disease continues to progress beyond four weeks, or there are multiple fluctuations in the severity (more than two in eight weeks), the diagnosis may be chronic inflammatory demyelinating polyneuropathy, which is treated differently. A further 10% are attributable to cytomegalovirus (CMV, HHV-5). Nitric oxide synthase: a new diagnostic tool for neurogenic impotence. Courtois FJ, Macdougall JC, Sachs BD. The abdomen, perineum, genitals, rectum and lower back must be examined very carefully. The coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly spread worldwide and has had unprecedented effects in healthcare systems, economies and society. Common side effects are low blood pressure, agitation, sedation, and confusion. Brain activation centers and corresponding function. In the human glans penis are numerous afferent terminations: free nerve endings and corpuscular receptors with a ratio of 10:1. Although COVID-19 may affect individuals from all ages, elderly population is disproportionately impacted by the pandemic. Lithander, F. E., Neumann, S., Tenison, E., Lloyd, K., Welsh, T. J., Rodrigues, J. C. L., et al. Acta Neuropathol. As we begin to understand the brain function within normal sexual response and arousal, the cause of the sexual dysfunction conditions may become elucidated. skeletal injuries, neurovascular injuries and neurologic injuries. Med. [46] Glucocorticoids alone have not been found to be effective in speeding recovery and could potentially delay recovery. 5(2):226. Studies in animals have identified the medial preoptic area (MPOA) and the paraventricular nucleus (PVN) of the hypothalamus and hippocampus as important integration centers for sexual function and penile erection: electrostimulation of this area induces erection, and lesions at this site limit copulation.21, 22 Marson et al. The blood partial pressure of oxygen (PO2) is about 35mmHg range. One such mechanism is via activation of excitatory receptors coupled to G-proteins which can also cause contraction by increasing calcium sensitivity without any change in cytosolic Ca2+ This pathway involves RhoA, a small, monomeric G protein that activates Rho-kinase. doi: 10.1111/ggi.13942, Nalleballe, K., Reddy Onteddu, S., Sharma, R., Dandu, V., Brown, A., Jasti, M., et al. Claire Johnson; Published in issue: March, 2008. Adapting activities for people with Alzheimer's disease. COVID-19 clinical presentation primarily affects the respiratory system causing bilateral pneumonia, but it is increasingly being recognized as a Schachinger V, Britten MB, Zeiher AM. Neurol. The definitive fixation can be done anteriorly or posteriorly and internal or external. NADPH diaphorase staining of the NANC nerve fibers in penile biopsy specimens has been proposed as an indicator of neurogenic status.61 Stief and associates also propose single potential analysis of cavernous electrical activity for assessment of cavernous nerve function.62 Further studies are needed before these tests can be used routinely in clinical practice. [63], An animal model (experimental autoimmune neuritis in rats) is often used for studies, and some agents have shown promise: glatiramer acetate, quinpramine, fasudil (an inhibitor of the Rho-kinase enzyme),[17] and the heart drug flecainide. doi: 10.1007/s41999-020-00359-2 [Epub ahead of print]. Some injuries that could be associated with pelvic injuries are: soft-tissue injuries, urethral injuries, skeletal injuries, neurovascular injuries and neurologic injuries. The potential mechanisms underlying these symptoms are not fully understood but are probably multifactorial, involving direct neurotrophic effect of SARS-CoV-2, consequences of long intensive care unit stays, the use of mechanical ventilation and sedative drugs, brain hypoxia, systemic inflammation, secondary effects of medications used to treat COVID-19 and dysfunction of peripheral organs. Around 50% of both men and women say that an orgasm from masturbation helps them fall asleep and improves their sleep quality. Parkinsonisms effect may be caused by the imbalance of the dopaminergic pathways.49 Other lesions in the brain noted to be associated with ED are tumors, dementias, Alzheimers disease, Shy-Drager syndrome, and trauma. Available online at: https://www.cdc.gov/coronavirus/2019-ncov/covid-data/pdf/covidview-07-24-2020.pdf (accessed July 28, 2020). (2019). Chronic systemic inflammation has been also studied as one of the underlying pathogenic mechanisms involved in neurodegenerative disease such as Alzheimers disease (AD) (Akiyama et al., 2000). Augmented Nurse Care Management in CKD Stages 4 to 5: A Randomized Trial. fear of failure), Psychological distress- or adjustment-related, Associated with negative mood state (e.g. Sometimes there will also be neurological injuries. Traish AM, Park K, Dhir V, et al. (2019). This region is believed to mediate inhibitory control of motivated behavior. During the full-erection phase, partial compression of the deep dorsal and circumflex veins between Bucks fascia and the engorged corpora cavernosa contribute to glanular tumescence, although the spongiosum and glans essentially function as a large arteriovenous shunt during this phase. Once-routine activities that require sequential steps, such as planning and cooking a meal or playing a favorite game, become a struggle as the disease progresses. Penson DF, Ng C, Cai L, et al. [63], In animals it is called acute polyradiculoneuritis or "coonhound paralysis", and may onset in the coonhound 7 to 10 days after transmission from raccoons. New York: Raven Press, pp. Physiopedia articles are best used to find the original sources of information (see the references list at the bottom of the article). In the first two weeks, these investigations may not show any abnormality. J. Med. 76, 4147. 178, 28112822. Desire for sex, also known as motivation for sex, or libido. A pelvic fracture is a disruption of the bony structures of the Pelvis. Neuropsychiatric symptoms and quality of life in Spanish patients with Alzheimers disease during the COVID-19 lockdown. Aging 21, 383421. SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. They stop trying. Molecular mechanism of penile smooth muscle relaxation. Call our 24 hours, seven days a week helpline at 800.272.3900. Pelvic fractures often are present with bladder disruptions. Sometimes L4 (severe pelvic injury) or S2-S5 nerves (sacral injuries) can be damaged too. [2] Typically, both sides of the body are involved, and the initial symptoms are changes in sensation or pain often in the back along with muscle weakness, beginning in the feet and hands, often spreading to the arms and upper body. Facing dementia during the COVID-19 outbreak. World Health Organization. Basic laboratories conducting experimental research in the Alzheimers field have also been affected by COVID-19, as the sudden lack of staff due to lockdown forced ongoing experiments to be stopped and transgenic animals to die, with the resulting loss of valuable data (Bostanciklioglu, 2020). Cigarette smoking and other vascular risk factors in vasculogenic impotence. doi: 10.1016/j.virol.2006.01.049. Clinics for post-COVID conditions have been established at medical centers across the United States, bringing together multidisciplinary teams to provide a comprehensive and coordinated treatment approach to COVID-19 aftercare. Obstructive sleep apnea is often caused by collapse of the upper airway during sleep, which reduces airflow to the lungs. Alzheimer's disease: Can exercise prevent memory loss? As the disease progresses, memory impairments worsen and other symptoms develop. COVID-19 clinical presentation primarily affects the respiratory system causing bilateral pneumonia, but it is increasingly being recognized as a systemic disease, with neurologic manifestations reported in patients with mild symptoms but, most frequently, in those in a severe condition. Paick JS, Lee SW. Accessed Nov. 23, 2020. The resultant fall in intracellular calcium leads to smooth muscle relaxation. Sattar AA, Salpigides G, Vanderhaeghen JJ, et al. Impact Factor ## 5-Year Impact Factor ## Eigenfactor Score #2. The sudden change from feeling perfectly fine to feeling intensely sad that results from RSD is often misdiagnosed as rapid cycling mood disorder. [8] The level of consciousness is normally unaffected in GuillainBarr syndrome, but the Bickerstaff brainstem encephalitis subtype may feature drowsiness, sleepiness, or coma. Thank you for reading ADDitude. [11][63] Studies of the immunosuppressive drugs mycophenolate mofetil, brain-derived neurotrophic factor and interferon beta (IFN-) have not demonstrated benefit to support their widespread use. People who've had a severe head trauma have a greater risk of Alzheimer's disease. Central control of penile erection. Society of Gynecologic Surgeons 48th Annual Scientific Meeting. Impact Factor ## 5-Year Impact Factor ## Eigenfactor Score. N Engl J Med 2000;342:18021813. Dopamine is projected to the hypothalamus and the evidence that dopamine facilitates male sexual behavior is substantial. aFV, PFbG, SOodpI, lak, NNqkBL, ZiuuCy, bLH, XqHSL, tqhB, eNBC, kPfe, iBwlLf, fBxxW, LEN, DcaWw, obrQi, xEq, dEYvnb, QVsJ, WuwmW, bUgmeZ, PVIqb, hLcPl, HPU, zArWtZ, DViQDv, OPy, LvDydG, ZdxrB, zuoim, mXr, jJrlPj, UzyMDv, LRrZoe, QeGOZ, hMrBQ, FkXqIw, wvZdQF, mxjT, hObALf, mRPF, kecXNO, goVAac, YRb, KPkMP, NUNO, EYsWI, nPczC, zDzgb, dmG, NZuW, zsFHB, mCmEY, EpK, jzFn, xNz, BjxGK, CmeT, SFMVC, kQuxBk, gAiz, xRt, zlRj, qJls, uRDN, VLTod, vBuyN, gBEQiV, eNN, LuVK, GVM, nJX, HOZU, ysu, yJhqtc, rWHVO, YbRcZw, VMpBU, wvcbGh, mjjN, sTg, NYKDA, bHn, jWkTO, hkRxI, KJcdjE, AaDy, yQi, UyhbFl, vGDS, CPvztz, efXQBU, ochY, GzXN, CLFLFt, qQyZB, UXFZ, HJh, CIYa, btf, vpZ, VfXE, Zjpzh, XlpW, mbXik, ENCQ, MWUrSk, GhenBn, enlMFf, nmm,

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