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  #16   ^
Old Thu, Jul-14-16, 19:58
inflammabl's Avatar
inflammabl inflammabl is offline
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Posts: 2,062
 
Plan: Atkins
Stats: 296/220/205 Male 71 inches
BF:25%?
Progress: 84%
Location: GSP and FLL
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Oh sure. Acetone is the most variable ketone and I have little doubt that adding another source of energy would affect its production and utilization. Also, to a ketone meter, I could easily see it confused by Ethanol, i.e. get a bincorrect reading. Oddly in another thread someone is arguing that alcohol is used before acetone. But then they say that "kicks us out of ketosis" (whatever that means) which means NO acetone produced.... Which way is right? I have no idea and I believe there is a lack of data (but much conjecture) on the topic.

I personally like the spike shown up there. It means there were more ketones after drinking wine, if the meter was right. Does that mean to increase ketosis we should drink more wine? Dunno. Maybe I should go on a wine augmented diet.
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  #17   ^
Old Fri, Jul-15-16, 03:59
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thud123 thud123 is offline
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Posts: 5,160
 
Plan: ~25NC/IF
Stats: 342.2/207/000 Male 182cm
BF:
Progress: 40%
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Very interesting insights and speculation inflammabl, thanks!

~56hrs water fasting... So here are the numbers and I see nothing surprising. I guess the Fasting Blood Glucose is low but hey, I'm fasting and feel fine!

Blood Pressure: 117/75
Pulse: 66
Fasting Blood Glucose: 74 mg/dL
Walmart Pee Strips: ~80 mg/dL
Ketonix Breath Meter: 78 (~7 PPM Acetone)
Weight on Earth: 116.2Kg

That's the highest reading so far. I'll bring the meter into work and get one more at the 72 hr mark for sh!ts and giggles.
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  #18   ^
Old Fri, Jul-15-16, 05:39
Bintang's Avatar
Bintang Bintang is offline
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Posts: 258
 
Plan: MyOwn:CHO<90g/d
Stats: 207/149/150 Male 169 cm
BF:40%/17%/18%
Progress: 102%
Location: Jakarta, Indonesia
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Quote:
Originally Posted by thud123
Ketonix Breath Meter: 78 (~7 PPM Acetone)
After starting to use the ketonix I began wondering how the ketonix readings might relate to total blood ketone levels rather than just to breath acetone (which is the only correlation provided in the ketonix manual) and what a ketonix reading of 100 would mean if such a reading could be obtained.

I didn't manage to find an existing correlation between the ketonix and blood ketones but for what it is worth I have derived one myself using two correlations from the literature for breath acetone vs plasma acetoacetate (AcAc) and for breath acetone vs plasma beta-hydroxybutyrate (b-HBA)– see Figures 3 & 4 in the following reference
"Breath acetone is a reliable indicator of ketosis in adults consuming ketogenic meals" http://ajcn.nutrition.org/content/76/1/65.full

I will spare everyone the mathematics but the procedure I have used is as follows:
1. Convert the ketonix reading (0 to 100) to breath acetone in ppm.
2. Convert the estimated breath acetone in ppm to units of nano-mol/liter
3. Estimate plasma AcAc and plasma b-HBA in mmol/liter from the correlations
4. Add AcAc and b-HBA to get an estimate of total blood ketones in mmol/liter

The results of these calculations are shown in the following chart:


For additional interest I have included in the above chart the blood ketone level thresholds for the start of nutritional ketosis, optimal ketosis and starvation ketosis as per the following Volek and Phinney chart from chapter 10 of their book “The Art & Science of Low Carbohydrate Performance”:

Looks like a ketonix reading of 100 would correspond roughly with the onset of starvation.

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  #19   ^
Old Fri, Jul-15-16, 08:08
GRB5111's Avatar
GRB5111 GRB5111 is offline
Posts: 3,012
 
Plan: Ketogenic (LCHFKD)
Stats: 227/186/185 Male 6' 0"
BF:
Progress: 98%
Location: Herndon, VA
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Quote:
Originally Posted by inflammabl
Oh sure. Acetone is the most variable ketone and I have little doubt that adding another source of energy would affect its production and utilization. Also, to a ketone meter, I could easily see it confused by Ethanol, i.e. get a bincorrect reading. Oddly in another thread someone is arguing that alcohol is used before acetone. But then they say that "kicks us out of ketosis" (whatever that means) which means NO acetone produced.... Which way is right? I have no idea and I believe there is a lack of data (but much conjecture) on the topic.

I personally like the spike shown up there. It means there were more ketones after drinking wine, if the meter was right. Does that mean to increase ketosis we should drink more wine? Dunno. Maybe I should go on a wine augmented diet.

I read a discussion in another blog topic regarding ketosis and breathalyzers. The concern was that in ketosis, the breathalyzer reading could be unusually high, and if coupled with one or two drinks, which normally would keep one under the legal limit, would result in a high reading putting one in a DUI situation. I think it bears testing . . .
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  #20   ^
Old Fri, Jul-15-16, 08:11
GRB5111's Avatar
GRB5111 GRB5111 is offline
Posts: 3,012
 
Plan: Ketogenic (LCHFKD)
Stats: 227/186/185 Male 6' 0"
BF:
Progress: 98%
Location: Herndon, VA
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Bintang - thanks for doing this. Between this and the metrics Thud is posting, it puts Ketonix in context for what is happening with the primary metabolic fuel and the ability to link the Ketonix results to the degree of ketone presence in the blood.
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  #21   ^
Old Fri, Jul-15-16, 09:14
Bintang's Avatar
Bintang Bintang is offline
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Posts: 258
 
Plan: MyOwn:CHO<90g/d
Stats: 207/149/150 Male 169 cm
BF:40%/17%/18%
Progress: 102%
Location: Jakarta, Indonesia
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For those of you who are numerically inclined here is an equation for estimating total blood ketones from the ketonix value:

Blood Ketones (mmol/liter) = EXP(0.6374*Z^0.5 – 4.924)

where Z = the ketonix value (range 0 to 100)

This equation approximates the black curve in the chart below

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  #22   ^
Old Fri, Jul-15-16, 16:51
inflammabl's Avatar
inflammabl inflammabl is offline
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Posts: 2,062
 
Plan: Atkins
Stats: 296/220/205 Male 71 inches
BF:25%?
Progress: 84%
Location: GSP and FLL
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Quote:
Originally Posted by Bintang
After starting to use the ketonix I began wondering how the ketonix readings might relate to total blood ketone levels rather than just to breath acetone (which is the only correlation provided in the ketonix manual) and what a ketonix reading of 100 would mean if such a reading could be obtained.

That's awesome. I suspect that the ketonix was created for hospitals to test for ketoacidosis and that applying it to keto diet monitoring was a mistake. Especially given the fact that Acetone is the last and most variable ketone produced by the body. The mean lags way behind a dietary change and over reacts to small perturbations in lifestyle.

Quote:
I didn't manage to find an existing correlation between the ketonix and blood ketones

You won't find one. There are some good studies that show the blood concentrations of Acetone, acetoacetate and beta-hydroxybutyrate as patients continue a starvartion diet. Funny but when I looked up the ketone names, wiki called acetone "their spontaneous breakdown product". Ha!

Quote:
but for what it is worth I have derived one myself using two correlations from the literature for breath acetone vs plasma acetoacetate (AcAc) and for breath acetone vs plasma beta-hydroxybutyrate (b-HBA)– see Figures 3 & 4 in the following reference
"Breath acetone is a reliable indicator of ketosis in adults consuming ketogenic meals" http://ajcn.nutrition.org/content/76/1/65.full

Good for you.

Quote:
I will spare everyone the mathematics but the procedure I have used is as follows:
1. Convert the ketonix reading (0 to 100) to breath acetone in ppm.
2. Convert the estimated breath acetone in ppm to units of nano-mol/liter
3. Estimate plasma AcAc and plasma b-HBA in mmol/liter from the correlations
4. Add AcAc and b-HBA to get an estimate of total blood ketones in mmol/liter

Spare me not my friend. Two cautions. Concentrations are not conserved. Mass is. So a word to the wise, keep track of mass. Real honest to goodness mass, i.e. grams. Now breath acetone should be converted into a partial pressure which should be maintained across the gas to liquid interface. Someone smart might mention fugacity here. If so, hurt them to the point that they never do that again. Now at that point you should have a liquid concentration, i.e. blood.

The drawback is that I'm not sure if the assumption that the concentration at the surface, where the mass transfer occurs, is in thermodynamics equilibrium. Dunno. Octave is still alive. Maybe he would help. He is the father of this type of analysis and likes to figure out prehistoric concentrations of O2 from the size of dinosaurs.

Quote:
The results of these calculations are shown in the following chart:

Too many dragons there. I would have to see the details. Then again who am I kidding. I would run out of interest before confirming them anyway.

Quote:
For additional interest I have included in the above chart the blood ketone level thresholds for the start of nutritional ketosis, optimal ketosis and starvation ketosis as per the following Volek and Phinney chart from chapter 10 of their book “The Art & Science of Low Carbohydrate Performance”:

Unfortunately I have an opinion on that cartoon. Snoopy should mount it and chase the Red Barron for all it's worth. Here is the paper P&V SAY that cartoon is based on. Not only hasn't that cartoon ever been reviewed, the data needed to draw that cartoon is NOT in the paper. That cartoon is a fraud and needs to be pulled from the internet.
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  #23   ^
Old Fri, Jul-15-16, 21:18
thud123's Avatar
thud123 thud123 is offline
Senior Member
Posts: 5,160
 
Plan: ~25NC/IF
Stats: 342.2/207/000 Male 182cm
BF:
Progress: 40%
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Well damnit! I was all keyed up to get a 72 hour reading at work but forgot my meter there. So it will sit there for the weekend. Perhaps I'll start another experiment next week.

Even how you blow into it is variable I can produce a higher reading by simple breathing near the open mouth piece before putting my lips to it and giving it a good go.

I see the usefulness of this device just to show simple trends if the user has a consistent practice.

Bottom line, this thing is more about entertainment value than research but fugg, it's kind of FUN.
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  #24   ^
Old Fri, Jul-15-16, 21:29
Bintang's Avatar
Bintang Bintang is offline
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Posts: 258
 
Plan: MyOwn:CHO<90g/d
Stats: 207/149/150 Male 169 cm
BF:40%/17%/18%
Progress: 102%
Location: Jakarta, Indonesia
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I am not pretending that any of this is super accurate. It is just indicative and I agree that the P&V chart, which you object to is 'cartoonish' since the vertical axis has no units of measurements. However, the only feature of the chart I am using is the blood ketone threshold values for indicating the start of nutritional ketosis (~0.5 mmol/l), low to high nutritional ketosis range 1.0 to 3.0 mmol/l) and the onset of starvation ketosis (> 3.0 mmol/l)

Converting the ketonix readings to an estimate of blood ketone levels provides a way of understanding a bit better what the ketonix values mean in terms of one's level of ketosis. For example the following screenshot shows the default colour band values of the Ketonix software for the 'nutritional settings' option.


Green range: 40 to 70 (~0.4 to 1.5 mmol/l)
Yellow range: 70 to 90 (~1.5 to 3.1 mmol/l)
Red range: > 90 (~> 3.1 mmol/l)

Based on the above here is my interpretation of the ketonix nutritional settings:
1) If blue you are probably not in ketosis
2) If green you have entered nutritional ketosis
3) If yellow you are well into ketosis and humming along
4) If red you may have been fasting to the point of starvation or you may have just finished intensive exercise.

Last edited by Bintang : Fri, Jul-15-16 at 22:02.
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  #25   ^
Old Sat, Jul-16-16, 08:28
inflammabl's Avatar
inflammabl inflammabl is offline
Senior Member
Posts: 2,062
 
Plan: Atkins
Stats: 296/220/205 Male 71 inches
BF:25%?
Progress: 84%
Location: GSP and FLL
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Quote:
Originally Posted by Bintang
I am not pretending that any of this is super accurate. It is just indicative and I agree that the P&V chart, which you object to is 'cartoonish' since the vertical axis has no units of measurements.

That's what got me curious about that chart, that there was no data points on it and I couldn't quite figure out what the vertical axis might be. The way P&V talk about it, the vertical axis is "good ketosis". That is, the maximum point of optimal ketosis is about 0.5-ish. That then requires a scientific definition of "good ketosis" which is where P&V get suddenly very vague.

So then I tried to figure out what the vertical axis was really. I *thought* it was 1-RQ or maybe 1/RQ. But then what does RQ really mean anyway? RQ is simply a measure of the hydrogen to carbon ratio of the calories we are burning. Attia clued me in on that one with his gibbs free energy blog post. So then what is the chart? On the far right hand side it goes down into ketoacidosis. Does that mean that those in ketoacidosis have a RQ~=1 and high ketones at the same same? I guess..... That kinda makes sense. On the left, there are no ketones and that is bad too I guess.

So that line becomes a baby-bear line. IOW Momma bear's ketones on the left are tooo low. Poppa bear's ketones on the right are tooo high. Baby bear's at 0.5 to 0.8 are juuuuuust right.

If that's too hard for people to understand then some internet hack put a green zone under the point where the line is at a maximum. Just to bring home the point where baby bear is, I guess.

I've used the phrase "I guess" way, way too much and that what really bugs me. IMO, people attribute way too much meaning to that picture.

Quote:
However, the only feature of the chart I am using is the blood ketone threshold values for indicating the start of nutritional ketosis (~0.5 mmol/l), low to high nutritional ketosis range 1.0 to 3.0 mmol/l) and the onset of starvation ketosis (> 3.0 mmol/l)

Converting the ketonix readings to an estimate of blood ketone levels provides a way of understanding a bit better what the ketonix values mean in terms of one's level of ketosis. For example the following screenshot shows the default colour band values of the Ketonix software for the 'nutritional settings' option.


Green range: 40 to 70 (~0.4 to 1.5 mmol/l)
Yellow range: 70 to 90 (~1.5 to 3.1 mmol/l)
Red range: > 90 (~> 3.1 mmol/l)

Based on the above here is my interpretation of the ketonix nutritional settings:
1) If blue you are probably not in ketosis
2) If green you have entered nutritional ketosis
3) If yellow you are well into ketosis and humming along
4) If red you may have been fasting to the point of starvation or you may have just finished intensive exercise.


But you already kind of knew all that without the meter. If your carb intake is near zero then you MUST be burning protein and/or fat (or be dead). You also know, without the meter, that you are not in ketoacidosis. You know you are sitting next to baby bear wherever he is sitting.

So what is the right measure? IMO the scale and only the scale. A few weeks of readings and how you feel over that time is the truth. Some blood ketone, urine ketone or breath ketone meter does not tell me if I am burning body fat. The bathroom scale tells me that.

What the meter does give me is instant gratification which is why hospitals use it with diabetic patients. They need to know if ketones are unreasonably high right away and with a breath meter they don't have to wait for a urine sample.
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  #26   ^
Old Sat, Jul-16-16, 10:37
GRB5111's Avatar
GRB5111 GRB5111 is offline
Posts: 3,012
 
Plan: Ketogenic (LCHFKD)
Stats: 227/186/185 Male 6' 0"
BF:
Progress: 98%
Location: Herndon, VA
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Quote:
Originally Posted by inflammabl
That's awesome. I suspect that the ketonix was created for hospitals to test for ketoacidosis and that applying it to keto diet monitoring was a mistake.

Here you go, inspiration for creating the Ketonix:

https://www.ketonix.com/index.php?o...mid=524&lang=en
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  #27   ^
Old Sat, Jul-16-16, 11:04
inflammabl's Avatar
inflammabl inflammabl is offline
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Posts: 2,062
 
Plan: Atkins
Stats: 296/220/205 Male 71 inches
BF:25%?
Progress: 84%
Location: GSP and FLL
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"My ketones are showing “green” in the mornings and “yellow” in the afternoon, using the Ketonix. When it shows “blue” it’s time to fast, exercise or have more fat!"

Right. So the guy is trying to maintain ketones.... actually only acetone, the most variable ketone. He pooh poohs beta-hydroxybutyrate and acetoacetate. When he wants more acetone, he fasts, exercises or eats more fat. He is not trying to lose weight. He is not trying to get the optimal RQ. None of that. He's just trying to get a lot of acetone.

I agree that the breath meter does a probably good job of measuring acetone as long as it's not fooled by ethanol. What I don't agree with is what that has to do with anything.
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  #28   ^
Old Tue, Jul-19-16, 00:09
Bintang's Avatar
Bintang Bintang is offline
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Posts: 258
 
Plan: MyOwn:CHO<90g/d
Stats: 207/149/150 Male 169 cm
BF:40%/17%/18%
Progress: 102%
Location: Jakarta, Indonesia
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Quote:
Originally Posted by inflammabl
Here is the paper P&V SAY that cartoon is based on.

You have made reference to this paper [The human metabolic response to chronic ketosis without caloric restriction: physical and biochemical adaptation.] multiple times on this forum and it clearly doesn't provide data to support the 'cartoon' which you dislike so much. About all it does show is that the subjects of the experiment (elite cyclists) when in ketosis had resting blood 3-HBA levels of 1.28 mmol/L and post exercise levels of 1.45 to 2.44 mmol/L. These values do not represent total blood ketones because AcAc appears not to have been measured, however they do span the 'dark green range' of the cartoon, which is labelled 'optimal ketone zone' and 'post exercise ketosis'.

Question: Why are you so sure that this is the sole paper on which the 'cartoon' is based? I note that the paper was published in 1983 but P&V did many more years of research after that date and published many additional papers.
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  #29   ^
Old Tue, Jul-19-16, 06:17
inflammabl's Avatar
inflammabl inflammabl is offline
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Posts: 2,062
 
Plan: Atkins
Stats: 296/220/205 Male 71 inches
BF:25%?
Progress: 84%
Location: GSP and FLL
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Oh it's a fact I might be wrong. I'd love to be corrected and then be able to move forward with this low carb theory with more confidence. I just want the data.

Unfortunately P&V provide a web page of references, http://www.artandscienceoflowcarb.com/research/ and the paper I link to is described as "These keto-adapted athletes also demonstrated much higher peak fat oxidation rates than was thought possible" and none of their other papers hit on the subject. That paper is also referenced in their book.

With 100% of my interest I invite you to find a more direct, peer reviewed, source for the assertion about the relationship between resting ketones and RQ.

PS - If you look at their table 2 there is an understandable yet interesting point. The cyclists typically had their ketones go down in the first few minutes of exercise then they shot up. This implies that there is a sequence to fuel sources (as many have said) and low ketones COULD be as a result of mildly increased metabolism.
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  #30   ^
Old Tue, Jul-19-16, 08:47
Bintang's Avatar
Bintang Bintang is offline
Senior Member
Posts: 258
 
Plan: MyOwn:CHO<90g/d
Stats: 207/149/150 Male 169 cm
BF:40%/17%/18%
Progress: 102%
Location: Jakarta, Indonesia
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Quote:
Originally Posted by inflammabl
With 100% of my interest I invite you to find a more direct, peer reviewed, source for the assertion about the relationship between resting ketones and RQ.
Something tells me I will not find it so I think I will spare the effort.

What I have wanted to understand myself for some time is how blood ketone levels respond to different levels of dietary carbohydrate and what is required to get blood ketone levels into the range of 1.25 to 2.75 mmol/L …. assuming this is the desirable ‘optimal ketone zone’ according to P&V's cartoon.

However, I think you are well justified in your skepticism about the P&V cartoon and it’s vagueness about what is ‘good ketosis’. My reason for saying this is based on the experimental results reported in the paper
“Breath acetone is a reliable indicator of ketosis in adults consuming ketogenic meals” http://ajcn.nutrition.org/content/76/1/65.full

The 12 subjects of the experiment reported in this paper were fed extreme ketogenic diets consisting of ~ 4% carbohydrate, ~6% protein and 90% fat (in order to mimic the kind of diet used for treating intractable epilepsy) but over a 12 hour dietary study period total blood ketones (AcAc + b-HBA) ranged from 0.3 to 1.1 mmol/liter (see following charts extracted from Figure 1 of the paper) , which according to the P&V cartoon only corresponds to the start of nutritional ketosis but is not inside the ‘optimal ketone zone’.


Question: How does one get into P&V's 'optimal ketone zone' if an extreme ketogenic diet can only generate total blood ketone levels in the range of 0.3 to 1.1 mmol/liter?

By way of interest I also present the following charts which show my personal ketonix measurements collected over the last 17 days but aggregated within 2 hourly time intervals to show the average trend within a daily period starting around 7:00 am until just after mid-night.


Notes:
1) Blood ketones have been estimated from the ketonix readings using the correlation I explained in earlier posts.
2) My average macros during the 17 day observation period were, total CHO 68g/d, Protein 94g/d Fat 172g/day, energy 2228 kcals/d
3) The dotted vertical lines in the charts indicate average meal times.
4) The meal around 3:30pm is really just a mid-afternoon snack consisting of a small amount of fruit with lot’s of dairy and/or coconut cream. It consistently causes the ketonix readings to spike within about 1 hour.

I'm now tempted to try an extreme ketogenic type diet for a few days in order to see what impact it has on average ketone levels over the daily cycle.

Last edited by Bintang : Tue, Jul-19-16 at 09:05.
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