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Dennis OConnor

Picnic AI - 1 views

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    "Every patient has a story Medicine used to be a one-size fits all model. Disease X meant treatment Y. Doctors made decisions and patients listened.  Clinical trials were our only data source. But those days are over. Medicine has gotten personal.   Today, we know  that every patient has a unique medical story. The best care requires knowing those stories and the next generation of medical discovery requires compiling those stories into structured data sets.   That's why PicnicHealth works directly with patients to gather and manage complete, up-to-date medical records. That's also why with our PicnicAI platform, we go beyond serving patients directly, and partner with the most innovative Life Sciences companies to sponsor PicnicHealth accounts for groups of research volunteers. Only by putting patients in control of their own data will we move beyond fragmented, unstructured medical records for both individual patient benefit today and for the opportunity to meaningfully contribute to tomorrow's medicine."
Dennis OConnor

Milli | Artificial Intelligence Powered Health Coach - 0 views

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    "Meet Milli A self-teaching personalized medical intelligence platform built from real-time analysis of millions of patient/doctor interactions. The Medical Intelligence Platform™ makes it easy to capture, aggregate, and analyze comprehensive patient data with human-augmented Artificial Intelligence. We provide doctors with suggestions for the likely underlying dysfunctions that lead to disease, recommendations for follow up tests, and predictions for which intervention will be most effective for each patient. Our Virtual Health Assistant then provides intervention support to the patient and tracks their adherence and medical outcomes. This closed-loop process enables the platform to systematically learn from every provider/patient medical encounter to learn how to better prevent and reverse disease."
Dennis OConnor

Understanding Medical Research: Your Facebook Friend is Wrong | Coursera - 0 views

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    Recommended by Trish Makowiak: How can you tell if the bold headlines seen on social media are truly touting the next big thing or if the article isn't worth the paper it's printed on? Understanding Medical Studies, will provide you with the tools and skills you need to critically interpret medical studies, and determine for yourself the difference between good and bad science. The course covers study-design, research methods, and statistical interpretation. It also delves into the dark side of medical research by covering fraud, biases, and common misinterpretations of data. Each lesson will highlight case-studies from real-world journal articles. By the end of this course, you'll have the tools you need to determine the trustworthiness of the scientific information you're reading and, of course, whether or not your Facebook friend is wrong. This course was made possible in part by the George M. O'Brien Kidney Center at Yale.
Dennis OConnor

Genome Medical has Partnered with LunaDNA | LunaDNA - 0 views

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    "Our partner, Genome Medical, makes it easy for you to speak with a clinical professional about your DNA information. Interested in DNA testing but don't know where to begin? The experts at Genome Medical can help with that, too. Access your data files directly from your LunaDNA dashboard to support proactive health discussions. Help you better understand your genetic test results or help you determine if testing is right for you Explain your health risks based on your family and personal health history Offer guidance on how you can integrate your results into your health care Assess whether family members should consider genetic testing Within days from scheduling your phone or video appointment, speak with a board-certified genetic counselor who can: Genome Medical's genetic counselors do not analyze raw data from various DNA vendors, such as 23andme and AncestryDNA. However, they can answer any of your specific medical questions and determine if additional genetic testing is right for you and your family. SCHEDULE YOUR SESSIONASK A QUESTION SELF-PAY $99 AS LOW AS $50 With qualified insurance the cost for genetic counseling may be as low as $50 if the consultation is a covered service under your plan. © 2020 LunaPBC. All rights reserved. ABOUT US   LunaDNA was created by the Public Benefit Corporation, LunaPBC™, a team of passionate genomics and technology veterans. 2019 Technology Pioneers World Economic Forum SELF-PAY $99 AS LOW AS $50 With qualified insurance the cost for genetic counseling may be as low as $50 if the consultation is a covered service under your plan. SCHEDULE YOUR SESSIONASK A QUESTION HOW IT WORKSRESOURCES 2020 Most Innovative Companies Fast Company "
Dennis OConnor

FAQs on Diagnostic Testing for SARS-CoV-2 | FDA - 0 views

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    Explanation from DeAunne Denmark, MD, PhD : And just to clarify for all, since all of the testing jargon and landscape can be *extremely* confusing, especially now: The FDA has currently relaxed regulations for COVID diagnostics under "Emergency Use" (EUA). This authorizes, not approves, test kits, machines and devices to run those kits, and all other aspects involved in diagnostic testing. Authorize vs approve are very different animals under FDA. And you will see this repeatedly emphasized on the FDA site. But most often neglected, skipped over, mistaken in the wider press. Many articles and press releases use "approve" which is technically wrong - they mean authorize, or "grant use", or "use will not be objected to by FDA." If you have the stamina, I highly recommended reading as much of this as you can: https://www.fda.gov/medical-devices/emergency-situations-medical-devices/faqs-diagnostic-testing-sars-cov-2 "Validation" is yet an additional aspect that is probably the grayest zone of all, since it is left to each company/testing entity how exactly this is done. Validation can range from excellent to pretty cruddy science and still meet FDA "standards". These will be the devilish details we need to sort out re: collaborating with partners. And will unfortunately likely be a big mess for many outpatient Drs trying to figure out which test to order.
Dennis OConnor

Don't "Flatten the Curve," stop it! - Joscha Bach - Medium - 1 views

  • What all these diagrams have in common:
  • They have no numbers on the axes.
  • They don’t give you an idea how many cases it takes to overwhelm the medical system, and over how many days the epidemic will play out.
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  • They suggest that currently, the medical system can deal with a large fraction (like maybe 2/3, 1/2 or 1/3) of the cases, but if we implement some mitigation measures, we can get the infections per day down to a level we can deal with.
  • They mean to tell you that we can get away without severe lockdowns as we are currently observing them in China and Italy.
  • nstead, we let the infection burn through the entire population, until we have herd immunity (at 40% to 70%), and just space out the infections over a longer timespan.
  • The Curve Is a Lie
  • suggestions are dangerously wrong, and if implemented, will lead to incredible suffering and hardship.
  • Let’s try to understand this by putting some numbers on the axes.
  • California has only 1.8.
  • The US has about 924,100 hospital beds (2.8 per 1000 people)
  • Germany have 8
  • South Korea has 12
  • Based on Chinese data, we can estimate that about 20% of COVID-19 cases are severe and require hospitalization
  • many severe cases will survive if they can be adequately provided for at home
  • by some estimates can be stretched to about a 100,000, and of which about 30,000 may be available
  • mportant is the number of ICU beds
  • oxygen, IVs and isolation
  • About 6% of all cases need a ventilator
  • if hospitals put all existing ventilators to use, we have 160,000 of them
  • CDC has a strategic stockpile of 8900 ventilators
  • number of ventilators as a proximate limit on the medical resources, it means we can take care of up to 170,000 critically ill patients at the same time.
  • Without containment, the virus becomes endemic
  • Let’s assume that 55% of the US population (the middle ground) get infected between March and December, and we are looking at 180 million people.
  • the point of my argument is not that we are doomed, or that 6% of our population has to die, but that we must understand that containment is unavoidable, and should not be postponed, because later containment is going to be less effective and more expensive, and leads to additional deaths.
  • About 20% will develop a severe case and need medical support to survive.
  • Severe cases tend to take about 3–6 weeks to recover
  • 6% may need intubation and/or ventilation
  • Once a person is on the ventilator, it often takes about 4 weeks for them to get out of intensive care again.
  • The “flattening the curve” idea suggests that if we wash our hands and stay at home while being sick aggressively enough, we won’t have to stop the virus from becoming endemic and infecting 40% to 70% of all people, but we can slow the spread of the infection so much that out medical system can deal with the case load. This is how our normally distributed curve looks like when it contains 10.8 million patients, of which no more than 170,000 are ill at the same time:
  • Dampening the infection rate of COVID-19 to a level that is compatible with our medical system means that we would have to spread the epidemic over more than a decade!
  • confident that we will have found effective treatments until the
  • reducing the infectivity of the new corona virus to a manageable level is simply not going to be possible by mitigation, it will require containment.
  • My back-of-the-envelope calculation is not a proper simulation, or a good model of what’s going on either. Don’t cite it as such!
  • Of the 180 million, 80% will be regarded as “mild” cases.
  • Containment works
  • China has demonstrated to us that containment works
  • lockdown of Wuhan did not lead to starvation or riots
  • made it possible to focus more medical resources on the region that needed it most
  • implemented effective containment measures as soon as the first cases emerged.
  • South Korea was tracking its first 30 cases very well, until patient 31 infected over 1000 others on a church congregation.
  • For some reason, Western countries refused to learn the lesson.
  • The US, UK and Germany are not yet at this point: they try to “flatten the curve” by implementing ineffective or half hearted measures that are only meant to slow down the spread of the disease
  • instead of containing it.
  • some countries will stomp out the virus and others will no
  • few months from now
  • almost all travel from red zones into green zones will come to a hal
  • world will turn into red zones and green zones
  • Flattening the curve is not an option for the United States, for the UK or Germany. Don’t tell your friends to flatten the curve. Let’s start containment and stop the curve.
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    "Flattening the curve is not an option for the United States, for the UK or Germany. Don't tell your friends to flatten the curve. Let's start containment and stop the curve." Strong article with data visualizations from a Phd working out of MIT/Harvard.
Dennis OConnor

11 HIPAA and Medical Records Privacy Myths for Patients - 0 views

  • You can be an empowered patient or advocate by knowing the basics of HIPAA and having the confidence to request records from providers. Here are some myths about HIPAA and how they affect you, the patient.
  • Myth: HIPAA Prevents Sharing of Information With Family Members
  • Myth: Only Patients or Caregivers May Get Copies of Health Records
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  • Myth: Employers Are Payers and Can Gain Access to an Employee's Records
  • Myth: HIPAA Laws Prevent Doctors From Exchanging Email With Their Patients
  • Myth: Providers Are Required by Law to Provide All Medical Records to You
  • Myth: Patients Denied Access to Their Records May Sue to Get Copies
  • Myth: HIPAA Laws Cover Privacy and Security for All Medical Records
  • Myth: Providers Are Required to Correct Any Errors Found in Patient Records
  • Myth: Your Health and Medical Records Cannot Affect Your Credit Records
  • Myth: Medical Information Cannot Be Legally Sold or Used for Marketing
  • Myth: HIPAA Can Be Used as an Excuse
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    "You can be an empowered patient or advocate by knowing the basics of HIPAA and having the confidence to request records from providers. Here are some myths about HIPAA and how they affect you, the patient."
Dennis OConnor

Empowered Patient Podcast: When the Patient is a Medical Mystery with Cathy Miller - 0 views

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    "Welcome to the Empowered Patient Podcast with Karen Jagoda.  This show is a window into the latest innovations in digital health and the changing dynamic between doctors and patients. Topics on the show include the emergence of personalized medicine and breakthroughs in genomics advances for aging in place using big data from wearables and sensors transparency in the medical marketplace challenges for connected health entrepreneurs The audience includes researchers, medical professionals, patient advocates, entrepreneurs, patients, caregivers, solution providers, students, journalists, and investors."
Dennis OConnor

The Coming Influenza Pandemic: Lessons From the Past for the Future | The Journal of th... - 0 views

  • in the case of a true pandemic, hospital capacity may well be overwhelmed, and healthcare workers may themselves become ill. 
  • However, the lessons learned within the osteopathic medical profession as a result of the 1917-1918 pandemic could prove useful once again if (or when) a new influenza pandemic occurs.
  • Time to roll up sleeves, vaccinate patients, and hone osteopathic manipulative skills
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  • Obviously, the data collected shortly after the 1917-1918 pandemic must be treated cautiously.
  • In 1918, C.P. McConnell, DO,11 reported that the most effective treatment during the influenza pandemic was begun early in the onset of symptoms (within the first 24 hours) and consisted of carefully applied muscular relaxation and, most importantly, relaxation of the deep and extensive contractions of the deep spinal musculature and mobilization of the spine. These treatments would be repeated two or three times early in the course of the infection, along with traditional supportive measures such as hydration. During later influenza epidemics, such as the 1928-1929 and the 1936-1937 outbreaks, various lymphatic pump treatments and more attention to the cervical and upper thoracic regions were added to this recommended treatment protocol.12 These treatments, individualized to each patient's needs, were apparently the most commonly applied osteopathic medical procedures during the epidemics. 
  • action of these treatments were to diminish somatic inputs from contracted muscles
  • that had further stimulated the already overactive sympathetic system
  • hyperreactivity exacerbated the counterproductive and deadly immune respons
  • OMT) likely enhanced lymphatic drainage and encouraged appropriate immune response
  • we have no controlled data on the effects of OMT on the pandemic influenza
  • Noll et al13 demonstrated that OMT given to elderly patients with pneumonia decreases medication use and hospital stay
  • Whatever the mechanism, these beneficial outcomes have taught us a great deal about how the osteopathic medical profession might handle a coming pandemic.
  • treatments used back then can be used again and do not require patient hospitalization
  • methods can also be taught to family members
  • do not rely on the availability of potent, expensive, and often harmful (especially when one is in a weakened condition) medications.
  • treatments can be delivered by osteopathic medical students under the direction of a physician—a measure that would add significantly to the pool of trained healthcare providers available to assist the public in such an emergency.
  • OMT is meant to improve function, enabling the body itself to better
Dennis OConnor

About AMIA - American Medical Informatics Association ® | AMIA - 0 views

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    "About AMIA - American Medical Informatics Association ® Discovering Health Insights. Accelerating Healthcare Transformation. AMIA ® (American Medical Informatics Association ®) is a community committed to the vision of a world where informatics transforms people's care. Over the last 35 years, the use of informatics has grown exponentially to improve health and to make better healthcare decisions. Today, informatics is the key to accelerating the current goals of healthcare reform. Every day millions of people benefit from informaticians' ability to accelerate healthcare's transformation by collecting, analyzing and applying data directly to care decisions. Data produced throughout health and healthcare is the driving force of informatics and its ability to innovate critical advancements that directly benefit people. AMIA's members are critical to discovering these insights, which is why AMIA is committed to being the professional home for the informaticians of today and the driver of informatics' future."
Dennis OConnor

How to Correct Mistakes in Your Medical Records - 0 views

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    "Types of errors can include: Some typographical spelling errors may or may not require correction. For example, if mesenteric is incorrectly spelled "mesentiric," you might not go through the trouble of having it corrected because there won't be any impact on your health or medical care. Errors in the spelling of your name do require correction because this can prevent your records from being shared properly among different providers, and it can affect payment for services. If your phone number or address is incorrect or outdated, you'll want to make sure it gets corrected immediately. Failure to do so will result in the wrong information being copied into future medical records or an inability for your medical team to contact you if needed. Any inaccurate information about your symptoms, diagnosis, or treatment should be corrected. For example, if your record says that you have temporal tumor instead of a testicular tumor, this is completely different and requires correction. If the record says your appointment was at 2 pm, but you never saw the doctor until 3:30 pm, that may not have any bearing on your future health or billing information needs, and it isn't worth correcting."
Dennis OConnor

The n-of-1 clinical trial: the ultimate strategy for individualizing medicine? - 0 views

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    "N-of-1 or single subject clinical trials consider an individual patient as the sole unit of observation in a study investigating the efficacy or side-effect profiles of different interventions. The ultimate goal of an n-of-1 trial is to determine the optimal or best intervention for an individual patient using objective data-driven criteria. Such trials can leverage study design and statistical techniques associated with standard population-based clinical trials, including randomization, washout and crossover periods, as well as placebo controls. Despite their obvious appeal and wide use in educational settings, n-of-1 trials have been used sparingly in medical and general clinical settings. We briefly review the history, motivation and design of n-of-1 trials and emphasize the great utility of modern wireless medical monitoring devices in their execution. We ultimately argue that n-of-1 trials demand serious attention among the health research and clinical care communities given the contemporary focus on individualized medicine. Keywords: clinical equipoise, early-phase trials, individualized medicine, n-of-1, remote phenotyping, single patient trial, treatment repositioning, wireless health"
Dennis OConnor

UC San Diego School of Medicine - 0 views

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    UC San Diego School of Medicine has long been known as a place where discoveries are made. Today, we are known as a place where discoveries are delivered. UC San Diego School of Medicine, established in 1968, is the region's only medical school. As a top-tier academic medical center, our role is to improve health through innovative research, education and patient care.
Dennis OConnor

Donate to Southwest Catastrophic Injury Fund in honor of Kabir Kadre - 2 views

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    "Thank you for visiting! As you likely know, my name is Kabir Kadre, and I am partnering here with Help Hope Live, a registered 501(c)(3) nonprofit, in part because they provide both tax deductibility and fiscal accountability to those who wish to support the medical costs of my life with Spinal Cord Injury and the resulting quadriplegia and paralysis. Thanks to their efforts, and with your generous support, I am able to offset my substantial medical costs and focus on giving what I can to the world through the gift of my life."
Dennis OConnor

EMPOWEREDPATIENTPODCAST.COM - 0 views

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    Welcome to the Empowered Patient Podcast with Karen Jagoda. This show is a window into the latest innovations in digital health and the changing dynamic between doctors and patients. Topics on the show include the emergence of personalized medicine and breakthroughs in genomics advances for aging in place using big data from wearables and sensors transparency in the medical marketplace challenges for connected health entrepreneurs The audience includes researchers, medical professionals, patient advocates, entrepreneurs, patients, caregivers, solution providers, students, journalists, and investors.
Dennis OConnor

UCSF Emergency COVID-19 Early Detection Research SUPPORT REQUEST - 1 views

shared by Dennis OConnor on 24 Mar 20 - No Cached
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    Click to download the PDF. Oura's primary goal is to help UCSF engage and increase the number of users who have rings and are opting in to early detection efforts. Oura is offering rings at $250 for orders of 1000 rings supporting TemPredict. Immediate impact: Participants are presented every morning with daily personalized insights on heart rate, HRv, respiration, temperature, sleep staging, and activity to empower them to monitor their own health and change their behavior accordingly. This is especially important in medical personnel and high-risk patients. Future impact: UCSF will leverage Oura's backend data to build models that can aid in identifying symptom profiles, pinpointing at risk populations, predicting severity, and validating recovery, containment, and treatment efforts. The data gathered now may be our only chance to measure these changes so we can recognize them and deploy predictive algorithms to minimize the next wave of this outbreak, expected in Fall 2020. We ask all donors to go to OuraRing.com and buy rings for medical personnel so they can join this effort.
Dennis OConnor

Ted J. Kaptchuk | Publications - 0 views

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    "PUBLICATIONS" Ted J. Kaptchuk is Professor of Medicine and Professor of Global Health and Social Medicine at Harvard Medical School and Director of the Harvard-wide Program in Placebo Studies and the Therapeutic Encounter (PiPS) at Beth Israel Deaconess Medical Center in Boston, Massachusetts
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    Keyword: Placebo
Dennis OConnor

Coronavirus Safety GuideAndrew Junkin, MD - Medium - 0 views

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    Coronavirus Safety Guide by Andrew Junkin, MD Beth Israel Deaconess Medical Center Harvard Medical School Boston, MA First published: March 23, 2020 | Last updated: May 3, 2020 This guide is also available in Spanish
Dennis OConnor

COVID-19 FAQ: Andrew Weil Center for Integrative Medicine - 0 views

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    Recommended by Sharon Wampler: "COVID-19 FAQ The information provided on this site is for educational purposes only and is not intended as medical advice. The Andrew Weil Center for Integrative Medicine, is not responsible for individuals who choose to self-diagnose, self-treat, or use the information without consulting with their own health care practitioner. You should never alter your dosage of prescription medications without first consulting with your physician and you should always inform your physician about any dietary supplements you are taking."
Dennis OConnor

A mysterious company's coronavirus papers in top medical journals may be unraveling | S... - 0 views

  • On its face, it was a major finding: Antimalarial drugs touted by the White House as possible COVID-19 treatments looked to be not just ineffective, but downright deadly. A study published on 22 May in The Lancet used hospital records procured by a little-known data analytics company called Surgisphere to conclude that coronavirus patients taking chloroquine or hydroxychloroquine were more likely to show an irregular heart rhythm—a known side effect thought to be rare—and were more likely to die in the hospital. Within days, some large randomized trials of the drugs—the type that might prove or disprove the retrospective study’s analysis—screeched to a halt. Solidarity, the World Health Organization’s (WHO’s) megatrial of potential COVID-19 treatments, paused recruitment into its hydroxychloroquine arm, for example.
  • The study doesn’t properly control for the likelihood that patients getting the experimental drugs were sicker than the controls
  • Other researchers were befuddled by the data themselves. Though 66% of the patients were reportedly treated in North America, the reported doses tended to be higher than the guidelines set by the U.S. Food and Drug Administration, White notes. The authors claim to have included 4402 patients in Africa, 561 of whom died, but it seems unlikely that African hospitals would have detailed electronic health records for so many patients, White says.
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  • This was very, very annoying, that The Lancet were just going to let them write this absurd reply … without addressing any of the other concerns,”
  • 200 clinicians and researchers, that calls for the release of Surgisphere’s hospital-level data, an independent validation of the results
  • But the revision had other problems, Chaccour and his colleagues wrote in their blog post. For example, the mortality rate for patients who received mechanical ventilation but no ivermectin was just 21%, which is strikingly low; a recent case series from New York City area found that 88% of COVID-19 patients who needed ventilation died. Also, the data shown in a figure were wildly different from those reported in the text. (Science also attempted to reach Grainger, but received no reply to an email and call.)
  • Surgisphere’s sparse online presence—the website doesn’t list any of its partner hospitals by name or identify its scientific advisory board, for example—have prompted intense skepticism.
  • wondered in a blog post why Surgisphere’s enormous database doesn’t appear to have been used in peer-reviewed research studies until May.
  • how LinkedIn could list only five Surgisphere employees—all but Desai apparently lacking a scientific or medical background—if the company really provides software to hundreds of hospitals to coordinate the collection of sensitive data from electronic health records.
  • Desai’s spokesperson responded to inquiries about the company by saying it has 11 employees and has been developing its database since 2008.
  • The potential of hydroxychloroquine for treating COVID-19 has become a political flashpoint, and the questions around the Lancet paper have provided new fodder to the drug’s supporters. French microbiologist Didier Raoult, whose own widely criticized studies suggested a benefit from the drug, derided the new study in a video posted today, calling the authors “incompetent.” On social media, some speculated that the paper was part of a conspiracy against hydroxychloroquine.
  • Chaccour says both NEJM and The Lancet should have scrutinized the provenance of Surgisphere’s data more closely before publishing the studies. “Here we are in the middle of a pandemic with hundreds of thousands of deaths, and the two most prestigious medical journals have failed us,” he says.
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    Recommended by Mike Kurisu, DO.
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