Tuesday, January 28, 2020

The Neurobiological Basis of Major Depressive Disorder (MDD)

The Neurobiological Basis of Major Depressive Disorder (MDD) Family name:  Batty Personal Name:  Therese Major depressive disorder (MDD) which is also known as either unipolar depression or major depression is a common yet disabling mental disorder affecting over 400 million people worldwide with a higher incidence in women than men (World Health Organisation, 2012). Depression may be endogenous where there is no discernible cause or reactive whereby the depression is a result of an incidence such as the loss of a parent, loved one or stress. Some of the emotions that individuals may experience with depression are, feelings of sadness, anger, bitterness and resentment, emotions which can last a few days or in some cases, months and have a huge impact on the individuals life. Some individuals suffering from MDD are also more likely to have a substance abuse problem, other mental and physical problems, and are likely to have a greater suicide risk. MDD is a widely researched topic with a sense of urgency to find the exact aetiology and pathophysiology behind the disease so that a more tho rough understanding can be reached and treatment can be uniquely designed for each individual. Researches surmise that various factors are involved such as the chemical changes in the brain, genetic predispositions and environmental factors. The aim of this essay, although not comprehensive enough, is to try and bring together research material from various sources and highlight some key areas around MDD such as a synopsis of the aetiology, pathophysiology, risk factors, treatments and test available today. Aetiology The underlying aetiology (causes) of MDD is so complex with many gaps that it appears that no-one is quite sure what causes depression, however much research done to date into this condition suggests that a combination of factors are involved, such as genetics, an individual’s biochemical environment, personal experiences and psychological factors. According to Dr Michael Miller, a Professor of Psychiatry at Harvard University (2013), several forces interact to bring on depression including faulty mood regulation by the brain, medications, medical problems, genetic vulnerability and stress. In as much as age related brain changes, disease related changes , for example, cerebrovascular disease, Parkinson’s disease, and epilepsy, lead to disruptions in the circuitry of emotion regulation and can cause the onset of depression (Wryobeck, Haines, Wynkoop and Swanson, 2013). Areas of the brain underpinned by major depressive disorders such as the thalamus, the hippocampus and the amygdala (Limbic circuitry) (Figure 1. Miller, 2013 ) include several groups of neurons and white matter. Cell connections, nerve cell growth, and the functioning of nerve circuits in the brain have a major impact on how the brain functions, particularly in the way they communicate with each other. Several different chemicals and hormones working within and outside these nerve cells play a key role, with reduced levels of serotonin and noradrenaline posit to be a huge factor associated with the disease (Miller, 2013). Similarly, Villanueva (2013) through the construct of a survey used to assess the neurobiology of MDD, found that brain-derived neurotrophic factor (BDFN) along with expressions of miRNA’s (involved in neural plasticity), abnormal gastrointestinal signalling peptides and proinflammatory cytokines are all causative factors of major depressive disorder. What proinflammatory cytokines do, is stimulate the hypothalamic-pituitary-adrenal axis, activate secretion of growth hormone and inhibits the thyroid stimulating hormone secretion, all of which are associated with depression. Whereas gut microbiota (flora), specifically leptin, ghrelin and cholecystokinin (signalling peptides), influence the central nervous system including modulation of neurogenesis which can influence brain chemistry and consequently an individual’s behaviour. According to Lopresti, Hood and Drummond (2013), as seen in figure 2 below, a bi-directional relationship is likely to exist between depression and lifestyle factors with key symptoms including changes in appetite, general energy levels, motivation levels and sleep, which in turn affect diet, exercise and sleep thereby creating a cycle of influence. A vicious cycle, all of which point to the necessity of promoting lifestyle changes Figure 2. Potential mechanism of diet, sleep and exercise on major depression. In Lopresti et al. (2013). Another avenue suggested by Dr Miller (2013), is that research has identified that genetics play a role, in that not only do certain genes make individuals more vulnerable to low moods, but it can influence how individuals respond to drug therapy. Likewise, Stanford school of medicine surmise that through its research on the study of identical (100% genetically identical) and non-identical twins (50% genetically identical) and major depression as a heritability factor, heritability shows to be a huge contributor in the development of this disease. Each individual inheriting a unique combination of genes, with a predisposition to certain illnesses (Levinson and Nichols, n.d.). Genes controlling either the production or utilization of serotonin plays and important role in the pathogenesis of depression and in particular with serotonin reuptake due to the fact that depressed individuals have a lower rate of serotonin uptake. In depression of the elderly or late onset depression, genetic s is less common or does not appear to play a role as genetic markers are not present (Halverson, Bhalla, Bhalla and Andrew (2014). In so saying then, non-genetic factors, many of which are not known, also need to be taken into account, as Levinson and Nichols (n.d) suggest, these factors also increase the risk and progression of depression. Pathophysiology Progression of the illness as indicated by Treadway et al.(2014), is linked to biological changes. Due to over-stimulation of steroidal and inflammatory signalling molecules by stress, structural abnormalities within the prefrontal cortex and hippocampus, known for regulating behaviour and endocrine responses to stress, can be damaged. Moreover diet, sleep and exercise not only play a significant role in the development and progression of the illness, it also impacts on the treatment. One research analysis undertaken by Maletic, Robinson, Oakes, Lyengar, Ball and Russell (2001), summarised that MDD involved structural, functional and molecular alterations within the brain. Similarly research conducted by Halverson et al. (2014), speculates that although the underlying pathophysiology of MDD has not been clearly defined, studies show a strong interaction between the neurotransmitter availability and receptor regulation, with emphasis again on serotonin activity disturbances in the cen tral nervous system. Other neurotransmitters such as epinephrine, dopamine, glutamate and brain derived neurotrophic factor (BDNF) are also implicated in depression. Cells within the hypothalamus are responsible for an individual’s emotional state which in turn link to the stress responses. Several studies , in particular Lopresti et al. (2013), show that during stressful times, the hypothalamic – pituitary-adrenal axis (HPA), the neuroendocrine circuit that manages stress in the body, becomes activated. This then leads to the release of epinephrine and glucocorticoids (cortisol) to assist the body in its adaptive response to stress. However, if the body remains under a constant state of stress, excitotoxicity of neurons, particularly in the hippocampus can occur leading to dendrite atrophy and apoptosis of neurons (Wryobeck et al. 2013). Research shows that while cortisol helps the brain to cope with stressful situations, it also damages and kills cells in the hippoca mpus. So it can almost be said that stress excites brain cells to death. Furthermore research shows that individuals experiencing depressive disorders have a smaller hippocampal volume than individuals who do not from depression and that positron emission tomographic (PET) showed a diminished activity in the area of the prefrontal cortex in individuals with depressive disorders. Thereby underlying the functional and structural abnormalities in the brain regions of individuals suffering from depression (Halverson et al. 2014). Most individuals with MDD present with normal appearance however, individuals with more severe symptoms may present with more significant signs such as, poor hygiene, poor grooming and changes in weight. Individuals with MDD have a distorted view of their life whereby negative attitudes make it more difficult to see a positive outcome from a difficult situation. Other symptoms such as psychomotor retardation, agitation or restlessness, suicidal thoughts or atte mpts, social withdrawal and in the elderly somatic complaints may also be evident. These however are only some of the underlying signs and symptoms as individuals vary from one to the next. Risk factors / causal agents It is a widely held view that there is an unambiguous relationship between physical, psychological, environmental, genetic and social factors as well as a dysregulated response to chronic stress as risk factors for depression. Halverson et al. (2014) infer that stress plays a dominant role in depression due to the chemicals involved throughout the body such as adrenaline and cortisol which in abundance, leads to other health complications. With the various types of onset of stress being for example, the loss of a parent prior to the age of 10 years, parent-child relationships, due to poor interaction between the two and child stressors, which can contribute to depression or thought to be associated with both early and late abuse and neglect. In addition, stressful changes in life patterns such as a serious loss, difficult relationships, trauma or financial problems can trigger a depressive episode. Women with a previous history of depression are at higher risk of menopausal depressio n while low testosterone levels in older men also aid in onset of depression (Halverson et al. 2014). Likewise Martin (2014) highlights that women may experience more episodes of depression than men due to hormonal changes such as during premenstrual phases, pregnancy, postpartum and menopause. Coupled with this is the additional stress of work-life balance where women take on the added responsibility of tending to children and or aging parents whilst still trying to forge a career for themselves. Individuals with a family history of depression tend to be at higher risk of developing depressive disorders. Psychosocial risk factors according to Halverson et al. (2014) can include impaired social supports, caregiver burden, loneliness, bereavement and negative life events. Abused substances and pharmacological agents can increase depression risks due to altering brain chemicals. These include pain relievers, sedatives, sleeping pills, cortisone drugs and seizure drugs, to name but a few. Whilst in the elderly, neurodegenerative diseases particularly Alzheimer’s and Parkinson’s, stroke, macular degeneration (vision) and chronic pain can all contribute to higher rates of depression (Martin, 2014). Treatment strategies First and foremost, education plays an important role in the treatment of MDD as individuals may become aware of the signs of relapse thereby allowing them to seek early treatment. Family and support members also need to be educated about the nature of depression and the treatment involved so as to be able to give the support needed, ensure medication compliance and encourage a change in lifestyle such as keeping active (Halverson et al. 2014). Wryobeck et al. (2013), posit that with depression being a multi-factored illness, treatment should encompass a combination of therapies such as psychotherapy, electroconvulsive therapy, lifestyle management, psychosocial therapy and pharmacotherapy. Pharmacotherapy such as anti-depressants being one method affects the neurotransmitters. Selective serotonin re-uptake inhibitors (SSRIs), a new class of antidepressants, which allow for the increase of serotonin by blocking the re-uptake of serotonin into the presynaptic neuron, is according to Clarke and Gordon (2011), used as the first line of treatment. SSRIs allow for autoreceptors to be desensitised or down-regulated, nerve transmission and serotonin levels are normalised and mood is elevated. Figure 3 below, illustrates how the amount of neurotransmitters in individuals with depression are reduced and postsynaptic receptors are increased as a response to these lower levels. The re-uptake of serotonin adding to the decreased amount of neurotransmitters. When treatment of SSRIs take place, serotonin levels increase due to the blocking of the re-uptake and down-regulation of postsynaptic receptors occur (Clarke Gordon, 2011). Figure 3 Action of selective serotonin re-uptake inhibitor drug. In neurobiology of mental illness Clarke Gordon (2011). Psychotherapy can include behaviour therapy, cognitive-behaviour therapy, family therapy, interpersonal therapy, psychodynamic psychotherapy and supportive psychotherapy. Psychosocial therapies according to Halverson et al. (2014) and supported by The American Psychiatric Association (APA) is often a first-line of treatment for mild cases of depression however, in more severe cases this should be combined with antidepressant medication. Other approaches according to Wryobeck et al. (2014) and Halverson et al. (2014), can include electroconvulsive therapy (ECT) which is thought to increase neurogenesis, reversing degeneration and decreased proliferation of nerve cells, regulate neurotransmitters and correct dysregulation of neuropeptides. Stimulation techniques such as vagus nerve stimulation which involves the nerve to be stimulated with electrodes resulting in the assumption that it may alter norepinephrine release and elevating levels of inhibitory GABA. Transcranial magnetic stimulation concentrates magnetic energy over parts of the brain allowing for either an increase or decrease in cortical excitability depending on the frequency. Stimulation over the right frontal lobe apparently reduces the symptoms of depression. Talk therapy as well as exercise are more non-invasive forms for dealing with MDD allowing the individual to develop problem solving skills, coping mechanisms and in some instances to form a suppor t group. Relevant tests To date there are no physical findings that are specific to MDD, instead diagnosis is dependent on the individual’s history and mental state exam. As depression may be linked to an underlying physical problem, both a physical exam as well as thyroid function blood tests can be done. A psychological evaluation is also of benefit to gather information around an individual’s feelings and behaviour pattern. In New Zealand a wide range of tools are available such as the Kessler 10 (K10) for assessing depression, anxiety and general mental health, the patient health questionnaire (PHQ-9) for depression and the GAD-7 for anxiety assessment. According to the Best Practice Advocacy of New Zealand [bpac z](2009) these tools also allow for monitoring the response to an individual’s treatment regime to ensure that optimal health is being met. In conclusion, to date the specific causes of major depressive disorders (MDD) is still unknown, however a substantial amount of research has gone into and still continues in this area with a consensus that depression appears to be a multifactorial and diverse group of disorders involving the chemical reactions and nerve communication in the limbic circuitry of the brain and both genetic and environmental factors. Progression of MDD is linked to biological changes, diet, sleep and exercise. Treatment strategies appear to be multi-factored with underlying assumptions based on individual research results. Education is still an important element focusing on the individual and support structures while more up to date pharmacopeia such as serotonin re-uptake inhibitors, lead the market as the go to drug for antidepressants. Most literature to date however, underlines the need for more research to take place, in particular, within the area of the aetiology / pathophysiology of the disease and likewise specifically structured individual treatment strategies. References Clarke, G. Gordon, C. (2011). Neurobiology of mental illness. In J. Craft, C. Gordon A. Tiziani (Eds.), Understanding pathophysiology (pp. 1177-1180). Chatswood, NSW: Elsevier. Halverson, J. L., Bhalla, R. N., Bhalla, P. M. Andrew, L. B. (2014). Depression. Retrieved from http://emedicine.medscape.com/article/286759. Levinson, D.F. Nichols, W.E. (n.d.). Major depression and genetics. Retrieved from http://depressiongenetics.stanford.edu/mddandgenes.html. Lopresti, A. L., Hood, S. D. Drummond, P. D. (2013). A review of lifestyle factors that contribute to important pathways associated with major depression: Diet, sleep and exercise. Journal of Affective Disorders 148 (2013), 12-27. Maletic, V., Robinson, M., Oakes, T., Lyengar, S., Ball, S. G. Russell, J. (2007). Neurobiology of depression: an integrated view of key findings. International journal of Clinical practice, 61 (12), 2030 – 2040. doi: 10.1111/j.1742-1241 Martin, B. (2014). What are the risk factors for depression? Retrieved from http://psychcentral.com/lib/what-are-the-risk-factors-for-depression. Miller, C. M. (2013). What causes depression. Retrieved from http://www.health.harvard.edu/newsweek/what-causes-depression.htm. The Best Practice Advocacy centre of New Zealand. Assessment of depression in adults in primary care. (2009). Retrieved from www.bpac.org.nz/BPJ/2009/adultdep/assessment.aspx. The world health organisation. (2012). Depression fact sheet. Retrieved from www.who.int/mediacentre/factsheets. Treadway, T. M., Waskom, M. L., Dillon, D. G., Holmes, A. J., Park, M. M., Charavarty, M. M., ‘†¦Ã¢â‚¬â„¢, Pizzagalli, D. A. (2014). Illness progression, recent stress and morphometry of hippocampal subfields and medial prefrontal cortex in major depression. Society of Biological Psychiatry. Retrieved from http://dx.doi.org/10.1016/j.biospych.2014.06.018 Villanueva, R. (2013). Neurobiology of major depressive disorder. Neural Plasticity, volume 2013. doi: 10.1155/2013/873278 Wryobeck, J. M., Haines, M. E., Wynkoop, T. F. Swanson, M. M. (2013). Depressive disorders. In C. Noggle S. Dean (Eds.). The Neuropsychology of psychopathology (pp 201-220). New York, NY: Springer Publishing. List of illustrations Figure 1. Miller, C. M. (2013). What causes depression. Retrieved from http://www.health.harvard.edu/newsweek/what-causes-depression.htm. Figure 2. Lopresti, A. L., Hood, S. D. Drummond, P. D. (2013). A review of lifestyle factors that contribute to important pathways associated with major depression: Diet, sleep and exercise. Journal of Affective Disorders 148 (2013), 12-27. Figure 3. Clarke, G. Gordon, C. (2011). Neurobiology of mental illness. In J. Craft, C. Gordon A. Tiziani (Eds.), Understanding pathophysiology (pp. 1177-1180). Chatswood, NSW: Elsevier.

Monday, January 20, 2020

othello :: essays research papers

Othello   Ã‚  Ã‚  Ã‚  Ã‚  In this speech, Othello lets his mind take over all his self control. A usual cool tempered person Othello is inflicted with rage about the possibility of his wife sleeping with his lieutenant, Cassio. Iago has the ability to cloud the head of Othello with lies about the Desdemona and Cassio causing suffering and tragedy. A tragedy is a serious action or event that always turns out the worst way possible. Iago has setup Othello just enough for Othello to create his own disaster.   Ã‚  Ã‚  Ã‚  Ã‚  The literary devises that William Shakespeare uses in this play help us understand the many themes and symbols in the play. Alliteration is the repetition of the same starting letter to help the line have a smooth sound and good flow. In this play, it isn’t as used as much as some of the recent plays that we have read, but it can still be found. All the minor fights between Desdemona and Othello start a pattern that foreshadows the tragic ending of this story. â€Å"Tis destiny unshunnable, like death† (275). Foreshadowing are sometimes symbols or signs that usually predict events or overcomes in the story. The most prominent symbol is this play includes the image of the handkerchief. The handkerchief shows the love of Othello for Desdemona. Since she dropped and lost the handkerchief she no longer can understand the pain that Othello is enduring. The stress that Othello goes through because of the handkerchief tells of the faith and commitment of De sdemona. These literary devices help us interpret the play as it is meant to be understood.   Ã‚  Ã‚  Ã‚  Ã‚  Several lines in this speech suggest that Othello starts to blame himself. One in which is â€Å"Haply, for I am black/ And have not those soft parts of conversation/ That chamberers have, or for I am declined/ Into the vale of years† (263 – 266). He thinks because he is of a different color that his wife is no longer in love with him. This bring into the subject of interracial marriage. To this day many oppose the marriage of blacks and whites. Not knowing what to think at this point in the play, Othello conjure ups the idea that the being blacks has caused his wife, Desdemona, to cheat on him with a younger, fit soldier. Not knowing that this is false he asks his wife many times if this is true.

Saturday, January 11, 2020

My Journey Through Life Essay

When I started college back in 1994 I thought that this will be the last time that I would start my education at a new school, but life did not happen the way that I thought that it would. In this paper I will describe my past life experiences, and analyze my experiences that have made me the person that I am today using the adult development theories from this class. During this paper I will also state how I will look forward to accomplishing my future goals. I grew up in a small town in Massachusetts. As I child I grew up around my family owned garage. During this period of my life I saw my families get divided by the power of money. My father and uncle inherited the business when my grandfather passed away. Before when my  grandfather was alive everything was great in life, but ever since he passed everything changed. I saw how my uncle who was the eldest take control of the money, and how he treated my father differently than before. During this time of my life it me that money can change any person no matter who they are even if they are related. As a child growing up I played sports all year long. I played football, basketball, and baseball. Since I was the youngest one in my family I followed my older brother around and his friends. My brother is three years older than myself. I would always play sports with his friends, and it made me a better athlete competing against older kids. All I wanted to do since I was a child was to go out and play sports. Growing up my family took many vacations. My fondest times were when we would go camping all around the United States. During these times I got to see all different parts of the country and it helped us bond as a family. Each time we went on vacation my mother and father would never fight. These vacations were my fondest ones just for that reason that we seemed like the perfect family. Then once we got home my parents seemed to be the exact opposite then when we were on vacation. My dad had problems with his brother at the garage and took out his frustration on my mother. This was like night and day from the family that we were on vacation. Growing up my mother was my most influential person in my life. I remember her playing catch with me when my dad was not around. My mother would always attend my sporting events even though she did not understand any of the games that I played. My mother always told me to never let any person tell you that you cannot do anything in life that it is up to yourself what you choose to accomplish. Growing up I played sports all year long. During the course of the year I had my same coaches for many years and they became like father figures to me. They taught me that playing sports was a privilege that had to be earned. They taught that it did not matter how good you were at sports that if you did not have good grades that you were not allowed to play. Playing sports also instilled in me that you have to trust and respect others, because you cannot do everything yourself. As a student in high school I had many different teachers. I had one teacher Mr. Rice who would be very hard on me when I would make a mistake on my assignments. He would always call me out on my mistakes in front of everyone in class to let me know when I was wrong. Once I completed his  class he pulled me aside and told me that I was one of his best students since I learned from my mistakes and never quit. Growing up my parents made me get a job once I turned sixteen. Even though I played sports all year around my parents told me that not everything in life is giving to you. One of my first jobs was a stock boy at our local grocery store. During this time I had to schedule my work, sports, and school work around my work so I would not fall behind. This was a very important lesson in my life that taught me time management along with responsibilities that come along with growing up as a young adult. Once I left college after two years to become an adult I found a job at my brothers company being a micro-electronics technician. This job helped me move out of my parents’ house and become an adult. I learned some of my most valuable lessons in life. This job taught me that I was responsible for every daily activity. I had to provide my own food all the way down to paying each bill to keep a roof over my head. This was a very important lesson in my life that helped prepare myself for next job. After five years of being a micro-electronics technician I moved to Florida and found a job in the quality assurance field. This was one of my most important jobs that would affect my life. As I have grown into an adult and have integrated what I have learned. The â€Å"universal ethical principles state that ideas about right and wrong come from within after a long period of thinking, reasoning, and integrating what we have learned about life† (Witt & Mossler, 2010, CH 3, â€Å"Moral Development†). This job made me realize what I wanted to do in life, and helped me think about what is right and wron g. Before this job the only thing that I cared about was the money. This job gave me satisfaction of what I do on a daily basis. This job did bring me to Florida. I lived in Massachusetts for 26 years until I took my job in the quality field. It was a total culture shook when I moved here. Before this move I was accustomed to my environment in Massachusetts. I realized that things up north move at a faster pace than things in the south. This move was a big culture change for me. This moved helped me grow in many ways than I could have never imagined. I had to learn on how to adapt to different cultures and beliefs that I was not used to. One of the greatest achievements that I have made was moving to Florida and meeting my wife. At the time when I meet her I was unemployed and was running out of money. She brought back hope in my  life and me realize that I have a lot more to offer than just walking around with my head down. Since her belief in me when we got married, I have bought a brand new house, a new truck, and I have more money in my bank account than I have ever before. Meting my wife was one of the best achievements in my life. A few months after getting married to my wife we welcomed our daughter into this world. With her arrival she has taught me many life lessons that I did not have before. She taught me the importance of putting others first. Before her I never thought really about how I could improve upon my life. Since her birth I started to think about finishing my education so I can provide her and my wife with a better life. Going back to school is a very big achievement for me. I would have never thought about going back to school at age thirty eight. But since my daughter was born many of my past thoughts have changed. I realized that I need to set a good example for my daughter. I do not want her growing up thinking why daddy did not finish his degree. By continuing my education this will â€Å"result in employment and wage gains and has a positive influence on continuing education.† (National Center for the Study of Adult Learning and Literacy, B. A. (2002). As a result of continuing my education my employment opportunities will open up as well as my daughter’s thoughts that you can continue education no matter how old you are. In Conclusion, I have discussed some of my life experiences that have made me the person that I am today. I have broken down some of my key experiences using adult development theories from this class. Finally I have presented my future goals and how I plan on achieving them. The experience and knowledge that I have learned throughout this course will help me as I continue in my journey throughout life. Reference National Center for the Study of Adult Learning and Literacy, B. A. (2002). The First Five Years: National Center for the Study of Adult Learning and Literacy, 1996-2001. Retrieved from EBSCOhost. Witt, G. A., & Mossler, R. A. (2010). Adult development and life assessment. Retrieved from https://content.ashford.edu/

Friday, January 3, 2020

Defending Evolution And Its Importance - 1286 Words

Andrew Shin Mr. Coltman Anthro 1 April 23, 2015 Defending Evolution and its Importance The definition of creationism is the belief that the universe and living organisms originated from specific acts of a divine creation, as a biblical account, rather than natural processes such as evolution. Creationism is perhaps one of the biggest roadblocks that divides the educational system; it prevents the teaching of biological evolution because evolution is inconsistent with creationist ideals. Thus many court cases and debates have been devoted to the topic of creationism versus evolution. The problem lies within the creationists’ line of thinking, evolution doesn’t’t undermine creationists ideals. Creationists also lack the understanding of certain evolutionary concepts, which creates a false understanding of how evolution works. Creationists’ misconception does not give them justification to remove the teaching of biological evolution. There’s a substantial amount of evidence to debunk creationists claims as well as evidence to show logic al deductions showing the evolution theory to be most likely true. Evolution should not be removed from the academic curriculum due to creationists’ faulty understanding of evolution, derived from their misguided claims about creation itself. The main argument of creationism is that most of their ideals are just as scientific as any scientific practice, and therefore should be taught over evolution. The problem, in this situation, liesShow MoreRelatedCreation: Scientifically Proven? Essay1537 Words   |  7 Pagesbeliefs throughout the world and it attacks past heritages and religions. Is there not a God and if there was, can it be scientifically proven? With this concept in mind scientist can make a new set of theories in Macroevolution, which is the study of evolution in large portions such as the universe. 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