Acupuncture Meridian Energies in Patients Who Are Mentally Disturbed

Abstract

Background and Objective:

Acupuncture medicine states that different pathologies exhibit different patterns of excitation in the 24 main acupuncture meridians. Previous exploratory work has shown that groups of patients with the same pathology exhibit such characteristic patterns when limited numbers of acupuncture points are measured with the AcuGraph meridian energy measuring device. This study reports patterns of meridian energies observed in an exploratory assessment of different classes of patient with mental disturbance.

Methods:

This study was a three-group cross-sectional design. Participants were patients who had been diagnosed by their GP with anxiety (n = 21) and depression (n = 26) and who were entering a treatment program, along with age- and sex-matched controls (n = 44). Patients diagnosed with mild mental disturbance who were aged 20–50 years were eligible to take part. Patients with any cut, wart, or mole on their fingertips or with excess sweating, which would interfere with conductance measurements, were excluded. The assessment comprised conductance values at Jing-Well acupuncture points by AcuGraph4 on entry into the treatment program.

Results:

Patients with anxiety had higher meridian energy levels (81.84 ± 38.63) and significant Upper-Lower imbalances (p < 0.05) favoring the upper meridians. Patients with depression had lower energy levels and lower standard deviations (53.36 ± 33.48) as a group. Controls exhibited intermediate energy levels but recorded the lowest scoring variances (62.61 ± 27.05) of the three groups. Kidney meridians had the lowest energy for both of the pathology groups. For the group suffering with anxiety, bladder meridians were also low.

Conclusion:

Higher variances in AcuGraph4 measurements were observed in patients with either anxiety or depression compared with controls whose variances were the lowest. These results are in accordance with previous observations of greater variance in conductance values in pathology groups. With regard to meridian energies, the lowest were in those with depression, while those with anxiety were the highest. Controls exhibited intermediate energy levels.

Introduction

Ways of characterizing pathologies can help in their diagnosis and also lead to the identification of appropriate strategies for treatment. Systems of medicine with ancient roots, such as today's Ayurvedic medicine in India and modern acupuncture medicine in China, recognize subtle forms of energy residing in specific channels in the body, known as “nadis” in India and “meridians” in China.^1,2 Such systems of medicine assert that different pathologies are characterized by different patterns of excitation in the nadis/meridians. Previous exploratory studies have observed characteristic patterns in patients with particular pathologies^3,4 when assessed with electroacupuncture meridian energy measuring devices such as AMI,⁵ Prognos,⁶ and Octopus.⁷

AcuGraph⁸ is a reliable instrument⁹ used in many studies on groups of participants. The original data collated from health operators to establish U.S. norms¹⁰ was based on 8,637 persons visiting practitioners using AcuGraph. Electrical conductance values were higher in males than they were in females, with mean values for both sexes decreasing with increasing age. One application of such group studies has been to investigate the effects of yoga programs,^11,12 stress management for business executives,¹³ and medical programs lasting 1–2 weeks. Mean conductance values tend to increase with increasing duration of practice.¹¹ Also, initial differences between subgroups of an experiment (e.g., between sexes) tend to reduce after such courses.¹² Exploratory studies of particular pathologies have identified patterns of mean conductance values characterizing a pathology, for example type 2 diabetes¹⁴ and human immunodefiency virus (HIV)/acquired immune deficiency syndrome.¹⁵ One possibly significant observation has been of higher variances in group scores of meridian conductance in pathology groups. As proposed in the Appendix (please see end of article), high variances (standard deviations [SD]) may be taken to signify poor regulation of acupuncture meridian energies by the group concerned,¹¹ which may be interpreted as a reduced level of health.¹⁶ Variances may decrease with medical treatment¹²; group SD may therefore be as significant indicators as group means.

This study reports initial AcuGraph4 assessment of groups of patients with mental disturbances attending a yoga inpatient healthcare center. Despite improved forms of treatment, mental illness remains a major health problem globally. Psychiatric disorders are the leading cause of loss of disability-adjusted life years. Loss from mental illness stands at 37%.¹⁷ In 2004, depression was rated third among global disease burdens, and it was the leading cause in nations with middle and high incomes. In low-income countries, it ranked eighth.¹⁸ It results in decrements to health that are even greater than those in angina, arthritis, asthma, or diabetes.¹⁹ Similarly, anxiety disorders have one-year and lifetime prevalence rates of 10% and 15%, respectively, with prevalence rates being higher in developed countries¹⁹ where anxiety and depression cause considerable burden to healthcare systems. Australia reports its incidence of depression as 33%.²⁰ Meridian energy characteristics present a new angle on understanding these disorders, with the potential to explain cost-effective therapies.²¹ The measurement of subtle energies is therefore of potential importance to understanding alternative treatment for depression.

In 2013, the Indian Journal of Psychiatry devoted an entire supplement to the treatment of mental disorders by complementary therapies.²² Depression was a particular focus, and papers exploring mechanisms of action were prominent.^23,24 A systematic review found evidence for possible mechanisms behind benefits for schizophrenia.²⁵ More recently, two papers have appeared exploring these ideas in further detail.^26,27 Complementary and Alternative Medicine is seen as offering a safe form of treatment for mental illness. The present study sheds new light on this.

AcuGraph

AcuGraph is a digital meridian measurement system that comprises a zero-volt “ground bar” held by the participant and a flat-ended circular metal “probe,” with which the operator contacts selected acupoints. The probe is connected with a “connector cable” to a monitoring computer running operating software.⁸ The data scale is 0–200 conductance (1/Ohm) units. The ultra-low (0–40 μA) operating current means that participants cannot detect or feel measurements being made.⁹ Operators obtain up to 10 readings per minute. Complete sets of readings (n = 24) are projected onscreen by instrument software as bar graphs containing a green middle line representing the participant's average conductance value, and high (red) and low (blue) lines on either side, representing limits of healthy deviations from the mean.⁸ Other variables are derived from these 24 basic measurements and made available on the computer screen. AcuGraph should not be used in subjects with implanted electronic devices such as pacemakers or defibrillators, or in those with skin rashes, lesions, or wounds at acupoints.⁸

Absolute values in readings should be treated with caution. Assessment of variations between operators shows that different operators use distinct styles, so that large studies collecting data from many operators should take such variability into account.²⁸

Methods

Study design: three-arm cross-sectional study

The study took place at a residential complementary medicine teaching center outside Bangalore, India, where all incoming patients are assessed by AcuGraph before and after treatment. Participants consisted of 21 patients with anxiety (11 male) aged 29.39 ± 8.5 years and 26 with depression (18 male) aged 32.55 ± 8.91 years, all of whom were attending the inpatient healthcare center. There was also a comparison group of 44 healthy subjects (30 male) aged 32.15 ± 7.8 years who were not attending the healthcare center.

Patients diagnosed with mental disturbance, either anxiety or depression, by their GP and confirmed by the health center physician who were willing to participate in the study were eligible to take part. Inclusion criteria for the control group were similar-aged subjects who were willing to be assessed for the study and who had not been diagnosed with mental problems and were not on any medication.

Patients with more severe psychiatric problems such as bipolar disorder and schizophrenia were excluded from the study, as were patients with cuts or mole on or close to Jing-Well meridian points; with fingers or toes missing, and with implanted electronic devices. Exclusion criteria for the control group were out of age range, under medical treatment, or taking ongoing medication.

The SVYASA Institution Ethical Committee, an independent academic body governed by India's University Grants commission rules, gave approval for this study.

Skin conductance readings were obtained from Jing-Well meridian points by the AcuGraph4 digital meridian measuring system during the same time period (9:30 a.m.–12:00 noon) by the first author. During AcuGraph measurements, subjects sat on a chair with their bare feet on a mat. Basic demographic information was taken (first/last name, age, sex, etc.), and an ID number was assigned. Subjects' hands and feet were checked for excess wetness (or dryness), and a towel or damp cotton ball applied to improve the uniformity of the surface conductance. Participants gripped the ground bar in one hand while acupuncture points on the opposite side were measured in a specified order, from the thumb to the little finger and from the big toe to the little toe.

At the end of the assessment, the results were displayed for individual meridians and meridian groupings by the software: individual meridians (L: left side; R: right side) Lung (LU_L, LU_R), Pericardium (PC_L, PC_R), Heart (HT_L, HT_R), Small Intestine (SI_L, SI_R), Triple Energiser (TE_L, TE_R), Large Intestine (LI_L, LI_R), Spleen (SP_L, SP_R), Liver (LR_L, LR_R), Kidney (KI_L, KI_R), Bladder (BL_L, BL_R), Gall Bladder (GB_L, GB_R), and Stomach (ST_L, ST_R).

Sixteen groupings are presented in three sections: averages of selected meridians by body region, including Low, Medium, High, Yin, and Yang; averages according to Chinese “element,” Wood, Metal, Fire, Water, and Earth; and important balance/imbalance sets, Personal Integrated Energy (P.I.E.), an index of overall energy status, Energy Level (EL), mean of all 24 meridians; Energy Stability (E_S) is the range related to the mean; Upper-Lower imbalance (U_L), thought to be related to stress levels.

Data analysis used Microsoft Excel, SPSS Statistics for Windows v19 (SPSS, Inc., Chicago, IL), and occasionally GraphPad QuickCalcs. Independent sample t-tests compared means; Fisher's F-test was employed to compare variances (SD).

Results

Tables 1 –3 display comparisons of participants' AcuGraph readings in the anxiety, depression, and healthy groups. Table 1 gives the mean ± SD for each meridian. Table 2 displays the averages of means and standard deviations given in Table 1 for the blocks of upper (LU to LI) and lower (SP to ST) meridians, and within-group differences. Table 3 displays group comparisons of variances for pairs of groups, treating all values in the data sets individually (i.e., 504/252 readings for the anxiety group [21 members], 624/312 readings for the depression group [26 members], and 1056/528 for the healthy group [44 members]). Since the data were treated by block rather than by individual meridians, F-values in Table 3 bear little relationship to the average SD values given in Table 2.

Table 1.

Comparison of Individual Meridian Values for the Three Groups

	Groups
Meridian	Anxiety M ± SD	Depression M ± SD	Healthy M ± SD	A–D t-value	A–H t-value	D–H t-value
LU_L	109.90 ± 39.96	63.88 ± 40.44	80.05 ± 26.65	3.9^***	3.6^***	−2.0^*
LU_R	90.76 ± 33.57	58.04 ± 38.22	71.27 ± 25.76	3.0^**	2.6^*	−1.73
PC_L	83.71 ± 33.74	56.42 ± 30.43	58.41 ± 18.87	2.9^**	3.9^***	−0.34
PC_R	70.90 ± 26.36	52.81 ± 29.64	58.50 ± 17.89	2.2^*	2.2^*	−1.00
HT_L	83.14 ± 39.28	46.62 ± 31.59	55.50 ± 19.13	3.6^***	3.8^***	−1.47
HT_R	78.05 ± 38.29	52.46 ± 34.31	55.32 ± 17.13	2.4^*	3.3^***	−0.46
SI_L	94.86 ± 40.81	53.58 ± 28.88	60.41 ± 18.95	4.1^***	4.7^***	−1.20
SI_R	83.00 ± 46.98	57.46 ± 34.27	58.27 ± 23.19	2.2^*	2.9^**	−0.12
TE_L	79.86 ± 41.57	49.12 ± 27.09	54.00 ± 20.90	3.1^**	3.4^***	−0.85
TE_R	84.38 ± 46.45	49.65 ± 34.07	52.77 ± 19.08	3.0^**	3.9^***	−0.49
LI_L	96.24 ± 32.51	59.92 ± 31.34	68.41 ± 21.23	3.8^***	4.1^***	−1.35
LI_R	78.57 ± 32.51	53.58 ± 27.61	61.95 ± 17.94	3.0^**	2.8^**	−1.54
SP_L	75.48 ± 33.47	46.58 ± 28.34	61.05 ± 28.28	3.2^**	1.8	−2.07^*
SP_R	84.52 ± 45.95	55.38 ± 38.66	59.18 ± 30.42	2.4^*	2.6^**	−0.46
LR_L	90.24 ± 49.64	55.73 ± 28.31	64.23 ± 31.71	3.0^**	2.61^*	−1.13
LR_R	89.90 ± 46.14	58.38 ± 40.89	61.73 ± 32.92	2.5^*	2.8^**	−0.38
KI_L	65.95 ± 46.14	50.15 ± 38.32	57.41 ± 27.88	1.5	1.1	−0.91
KI_R	63.95 ± 31.34	46.08 ± 37.26	51.09 ± 25.31	1.8	1.7	−0.67
BL_L	73.67 ± 31.29	47.77 ± 35.92	72.23 ± 32.84	2.6^*	0.17	−2.9^**
BL_R	66.00 ± 30.03	45.62 ± 34.17	72.32 ± 34.99	2.1^*	−0.71	−3.1^**
GB_L	78.67 ± 37.65	57.31 ± 33.35	69.50 ± 30.41	2.1^*	1.05	−1.56
GB_R	75.86 ± 38.13	50.23 ± 30.42	68.59 ± 30.99	2.6^*	0.82	−2.4^*
ST_L	91.90 ± 41.14	57.27 ± 34.64	66.09 ± 31.95	3.1^**	2.8^**	−1.08
ST_R	74.57 ± 34.95	56.50 ± 36.08	64.34 ± 33.09	1.7	1.1	−0.92
Overall (E_L)	81.84 ± 38.63	53.36 ± 33.48	62.61 ± 27.05	13.28^***	11.38^***	6.19^***
Upper	86.12 ± 38.37	54.46 ± 32.33	61.24 ± 21.98	10.63^***	11.47^***	3.61^**
Lower	77.56 ± 38.49	52.25 ± 34.64	63.98 ± 31.52	8.21^***	5.23^***	5.02^***

Values represent standardized conductance units, with a range of 0–200.

p < 0.05; ^** p < 0.001; ^*** p < 0.0001.

SD, standard deviation; L, left side; R, right side; LU_L, LU_R, Lung; PC_L, PC_R, Pericardium; HT_L, HT_R, Heart; SI_L, SI_R, Small Intestine; TE_L, TE_R, Triple Energizer; LI_L, LI_R, Large Intestine; SP_L, SP_R, Spleen; LR_L, LR_R, Liver; KI_L, KI_R, Kidney; BL_L, BL_R, Bladder; GB_L, GB_R, Gall Bladder; ST_L, ST_R, Stomach.

Table 2.

Group Means and SD for Upper and Lower Meridians

Group	Upper	Lower	t-Value	p-Value
Anxiety (n = 21)	86.12 ± 30.19	77.56 ± 32.60	3.06	0.0023
Depression (n = 26)	54.46 ± 32.32	52.25 ± 34.70	0.82	0.411
Healthy (n = 44)	61.24 ± 20.56	63.98 ± 30.90	1.70	0.090

Table 3.

Comparison of SD for Groups of Meridians

	Meridians
	Overall		Upper		Lower
Group pairs	F-value	p-Value	F-value	p-Value	F-value	p-Value
Anxiety/Depression	1.331	0.0001	1.409	0.002	1.235	0.0038
Anxiety/Healthy	2.039	0.0001	3.047	0.0001	1.491	0.0001
Depression/Healthy	1.531	0.0001	2.163	0.0001	1.208	0.0293

Discussion

Patients with anxiety exhibited the highest levels of both Jing-Well point conductance values (81.84) and group SD (38.63) of the three groups. They also showed significant Upper-Lower imbalances (p < 0.05) favoring the upper meridians. Patients with depression showed the lowest energy levels (53.36), but intermediate SD (33.48). Healthy participants showed intermediate energy levels (62.61), but lowest SD (27.05) of the three groups. Comparing individual meridians between the three groups, the mean values of all meridians but Bladder-Left (BL_L) were ordered Anxiety > Healthy > Depression (Bladder-Left gave H > A > D). The consistency of this result has a significance of the order of 3⁻²³ = 1.06 × 10⁻¹¹ < 0.0001. It can be stated with certainty that the group of patients with anxiety had higher mean meridian energies than the group of control persons who had higher mean meridian energies than the group of patients with depression. These results may be representative for such groups.

Comparing the anxiety and depression groups, between-group differences were significant (p < 0.05) for all individual meridians except KI_L, KI_R, and ST_R, where p-values lay in the range 0.137 > p > 0.086, suggesting for all three reasonable trends that significance would be reached with larger numbers in each group. Comparison of the anxiety and healthy groups showed significant (p < 0.05) differences in all upper meridians but not in all lower meridians. Non-uniformity in the anxiety group's Upper-Lower imbalances (see Table 2) probably caused this. In tense or anxious subjects,¹⁴ the imbalance lowers conductance values of lower meridians relative to upper meridians. Between the depression and healthy groups, all individual meridians yielded higher values for the healthy group, a result for which the two-tailed sign test yields a p-value of <2⁻²³ = 1.2 × 10⁻⁷ < 0.0001. For individual meridians, only LU_L among the upper meridians and SP_L, BL_L, BL_R, and GB_L among the lower meridians showed differences attaining p < 0.05 or better.

Concerning variances in meridian values within each group, previous studies have observed that meridian conductance values for healthy subjects tend to cluster more closely and thus show smaller variance. Preliminary interpretation implying poor regulation of the variables for the group as a whole.^11,12,15 is discussed in the Appendix where a detailed explanation, which may surprise some readers, is given. To summarize, if a variable is poorly regulated, it may tend to deviate further from its ideal value or normal range. Blood pressure goes up when stress causes its regulation to fail. Blood glucose levels increase when cells fail to respond to insulin. Instead of remaining in its relatively narrow normal range, the variable concerned spreads out over a wide range of pathological values, with various different values for different group members. Both examples constitute failures of regulation.

In this case, however, caution is needed in interpreting the result. Acupuncture medicine recognizes several causes for depression, each associated with different meridian imbalances, such as stagnant liver qi, spleen damp, or heart phlegm. Since each such acupuncture diagnosis is associated with different kinds of imbalance, the increased variances in the depression group could have been due to the presence of different kinds of pathology according to acupuncture medicine.

Many more examples of regulatory failure associated with pathology can be given, one or more for almost every pathology, whether the regulation concerned pertains to the immune system, as for infectious diseases (e.g., when a person gets “run down” [immune function is compromised] and catches a cold or flu), or to aspects of endocrine or cytokine regulation, which apply to non-communicable diseases. In all cases, statistics of a relevant variable from a pathology group show large variances, which it is proposed may be interpreted as reflecting the pathological state of the group as a whole. As remarked above, this was first observed in behaviors of acupuncture meridian measurements published with the connection to regulation in the article titles.^11,12 The study of children with HIV¹⁵ found similar results.

Conversely, when a statistic consistently goes out of its range of insignificance (i.e., p > 0.05) and instead assumes values that are extremely unlikely, yielding p << 0.05 (e.g., 0.00001), the natural demand is for a scientific explanation—an explanation in terms of behavior of the system concerned under the given experimental conditions. In statistics, a fluky p < 0.05 result may be expected once or twice (hence the need for Bonferroni corrections in cases where many comparisons of data sets are made that are not independent of each other). But such results will not occur consistently—certainly not over 24 variables in all three groups of a three-arm trial, as reported here. Random statistical variations may produce one, but cannot be expected to result in the other. Statistical significances allow for the first, but repudiate the second. Hence, an explanation is called for.

In this context, the following insight is relevant: all organism functions in biology are regulated (they have to be for efficient, competitive functioning in challenging environments)—so too are all variables measuring the quality of those functions. Organisms are designed to optimize function by optimizing regulation.¹⁶ And optimal regulation constitutes the proposed, new “scientific definition of health.”¹⁶ Experimentally, healthy groups will have narrow ranges of relevant variables, indicated by low variances in measured values. Patient groups diagnosed with pathology/poor health may conversely be expected to show poor regulation in relevant variable(s), which will be indicated by higher group variances for the reasons given above.

It is therefore suggested that values of variances in meridian energies for the three groups in the experiment reported here indicate that meridian energies are better regulated in healthy subjects, consistent with equating better regulation with better health.¹⁶ Data from the present study give lowest SD for the healthy group for all meridians, except LR_L, BL_L, and BL_R for which they were second lowest. Again, this result is highly significant, with a p-value of about 3⁻²¹ < 0.0001. It is suggested that this provides further support for this theory of health.¹⁶

Table 3 shows that when data from the three groups are treated in blocks, variances are significantly different from each other for all meridians together and for upper and lower sets of meridians separately. The healthy group exhibited significantly lower variances (SD), while the other two groups had significantly higher variances, with the anxiety group SD tending to be higher than those for the depression group. Once again, this seems to support the idea that improved regulation corresponds to improved health.¹⁶ For energies of individual meridians, Table 1 shows that kidney meridians have the lowest meridian energies for pathology groups, accompanied by the bladder meridian for the anxiety group. Since the aggravating emotion associated with the kidney and blocking its meridian is said to be fear,²⁹ it seems natural for anxiety-prone participants to show weakness in the kidney meridians. Furthermore, meridian-based medicine holds that a sense of well-being is a natural result of healthy qi energy levels.²⁹ Lower meridian energies may decrease a person's sense of well-being, which is part of depression. Low meridian energies in the depression group may point to this association.

Causal interpretation of these relationships may be tricky, however. Strictly speaking, the results of the study only demonstrate correlations between kinds of mental disturbance and patterns of conductance at the patient's meridian Jing-Well points. Anxiety correlates with a distinctly different pattern of conductance from depression: higher mean conductances for anxiety, and lower mean conductances for depression, with healthy subjects in the middle. Some scientists suggest that states of mind and emotion control flows of subtle energy: negative emotions are said to block prana flow in yoga medicine³⁰ and qi in acupuncture medicine,²⁹ with specific emotions affecting specific meridians³¹—anger is said to block liver meridians²⁹ and fear (anxiety) to block the kidney meridians.²⁹ (See complete lists at www.angriesout.com/Five_Element_ReleaseTechnique.pdf, or www.healing-with-eft.com/acupuncture-meridians.html)

Indeed, kidney and bladder were low relative to other meridians in the anxiety group. Whether causal in some sense, the nature of such connections has yet to be understood psycho-physiologically. One can speculate that the depression–low meridian energy relationship may turn into a vicious cycle.

The extent of the influence of mental disturbances on meridian energies is not clear. Meridian conductance values in the anxiety group were not especially high. Higher values are often seen in healthy individuals. Hence, meridian energies may not be “causing” the anxiety. In the case of depression, it might possibly be the other way round

Studies of yoga and meridian conductance values shed interesting light on these ideas. A pilot study found that yoga practice reduces meridian group variances,¹¹ suggesting that it improves health by improving meridian energy regulation.¹² The results given in Tables 1 –3 seem to agree with this. The healthy group consistently had the lowest meridian SD (variances), while variances in the anxiety group were higher than those for the depression group. Block data (Table 3) showed a highly significant Fisher's F-statistic between all three groups for all meridians together, and between upper and lower blocks of meridians separately.

The anxiety group's reduced conductance values in the lower meridians are significant: muscle tension is generally considered to reduce qi flow. Tension in the abdomen, typical of anxiety, should therefore reduce energies in the lower meridians, agreeing with previous studies.^14,28

Other studies have found yoga practice slowly improves meridian energy levels.^11,13 Regular practice should therefore benefit patients suffering with depression, as shown in studies at India's National Institute for Mental Health and Neuro-Science in Bangalore.^22,23 The results of this study suggest an overall “mechanism”²⁷ complementing those previously suggested.

This study has a number of strengths. The data showed unequivocal results on a number of points described above. There were distinct differences between groups in both mean conductance values and their variances. Between-group differences in both were also significant, the latter being in agreement with a possible relationship¹⁶ between health and regulation.

However, a number of limitations should also be acknowledged. The anxiety and depression groups were relatively small in number. Some results would have been more certain with larger group sizes.

Future research should look at extending this study to assess more severe mental problems such as schizophrenia and bipolar disorder with larger groups from more varied populations.

Conclusions

Different kinds of mental disturbance correlate with different patterns of meridian activity. Anxiety and agitation correlate with high meridian energy levels, while depression correlates with lower levels of subtle energy, which may be partly responsible for lower levels of well-being and wellness, naturally tending to leave a person feeling depressed. Variances appeared to correlate more definitely. In the pathology groups, variances in Jing-Well point conductance levels were increased: the anxiety group showed the highest variances and the healthy group the lowest. If high variances are taken to indicate poor regulation, these results support the idea that poor regulation correlates with poor health, and better regulation with better health.

Footnotes

Author Disclosure Statement

No competing financial interests exist.

Appendix

One reviewer went to great lengths to set out possible objections to the conclusions that are being drawn concerning the quality of regulation of measured electroacupuncture variables for the three groups. This detailed questioning of the reasoning led to the whole subject being considered more deeply and fully, and to it being explained as clearly as possible. The end result seemed to add clarity and quality to the discussion of the results. Hence, the following points have been set out to explain it as far as possible.

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