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Ranu Dhillon

@ranudhillon.bsky.social
378 followers 201 following 31 posts

Global health physician at Harvard working on epidemics & primary health systems Led nat'l & local programs in 10+ countries including India, Nigeria & Rwanda Fmr Special Advisor to President of Guinea on Ebola '14-16 & helped lead its national response

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Ranu Dhillon @ranudhillon.bsky.social · 24/03/2025
We tried to propose a strategy for how to do this in the early going without luck & also overlooked indoor air cleaning which we’ve come to see as the most efficient solution both for Covid & countering future pandemics (which most likely would also be airborne) hbr.org/2020/05/a-pl...
hbr.org
A Plan to Safely Reopen the U.S. Despite Inadequate Testing
The big dilemma in the U.S. is how to reopen the economy when the amount of available testing for Covid-19 is likely to remain inadequate for months. If the lockdown and other social-distancing restri...
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Ranu Dhillon @ranudhillon.bsky.social · 24/03/2025
Dithering on airborne spread without planning ways to reopen more safely (& later overselling vaccines as more definitive than they were) were central failings
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Ranu Dhillon @ranudhillon.bsky.social · 24/03/2025
Lockdowns should’ve been very brief up front to clarify with laser-focus & urgency the mode of transmission & then institute measures to reopen as safely as possible
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Ranu Dhillon @ranudhillon.bsky.social · 21/03/2025
In work led by Ben Pinksy, Grant Higerd-Rusli, Matthew Hernandez & @abraarkaran.bsky.social, in @thelancet.bsky.social, we describe the importance of testing a broader range of people for #H5N1 bird flu in order to check for potentially hidden spread & new routes of transmission t.co/yZeHRcUV65
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Ewen Callaway @ecallaway.bsky.social · 13/03/2025
After 5 years, 150k papers and 17 million genomes, here's what we learned about SARS-CoV-2 and viruses in general. It holds lessons for future pandemics - only if we listen. "We’re in a worse place in terms of pandemic prevention" @eddieholmes.bsky.social told me. www.nature.com/articles/d41...
nature.com
Four ways COVID changed virology: lessons from the most sequenced virus of all time
After 150,000 articles and 17 million genome sequences, what has science taught us about SARS-CoV-2?
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Amy Maxmen, PhD @amymaxmen.bsky.social · 10/03/2025
"I know how lethal Donald Trump’s assault on America’s outbreak preparedness could be. We are sure to regret it," warns @craigspencer.bsky.social @theatlantic.com www.theatlantic.com/ideas/archiv...
theatlantic.com
The Diseases Are Coming
Elon Musk’s slash-and-burn government tear will have lasting effects on global health.
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Melody Schreiber @melodyschreiber.com · 08/03/2025
NEW: As measles cases rise in Texas, pharmacies in some cities are running out of MMR vaccines. The surge in demand comes even as RFK Jr. and the CDC frame vaccination as a "personal" choice — my latest: www.theguardian.com/us-news/2025...
theguardian.com
Texas cities run short of MMR vaccine as measles outbreak drives demand
Pharmacies are struggling with supplies as fatal outbreak expands and health secretary sows disinformation
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Ranu Dhillon @ranudhillon.bsky.social · 07/03/2025
I worry that the study will be politically influenced or outright doctored/falsified to show false results & associations with even bigger/broader ramifications for vaccines bsky.app/profile/ranu...
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Ranu Dhillon @ranudhillon.bsky.social · 07/03/2025
These unanticipated, abrupt & cruel funding cuts will cost lives Ebola outbreaks demand diligent & meticulous tracking of transmission chains Even small lapses can allow spread to escalate dramatically & become hidden in ways that can take months to regain a grip on
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Stephanie Nolen @stephanienolen.bsky.social · 07/03/2025
A leaked recording shows that American officials fear the spread of Ebola in Uganda and beyond, because of the Trump cuts in foreign aid www.nytimes.com/2025/03/06/h...
nytimes.com
As Ebola Spreads in Uganda, Trump Aid Freeze Hinders Effort to Contain It, U.S. Officials Fear (Gift Article)
Two more people are reported dead from the disease, and dozens are in isolation, as the outbreak grows.
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Ranu Dhillon @ranudhillon.bsky.social · 07/03/2025
Exactly - this study would be needless, wasteful & ridiculous, but, even more so, treacherous Given how this admin operates, there is a real risk it will pressure, doctor or falsify results to imply risks & links that are not real & then use that to undermine safe & proven vaccines
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Amy Maxmen, PhD @amymaxmen.bsky.social · 07/03/2025
I only listed a few studies that include 100s of 1000s of children in my story. Here are more from the Autism Science Foundation: autismsciencefoundation.org/autism-and-v...
autismsciencefoundation.org
Autism and Vaccines: Read the Science - Autism Science Foundation
Literature Reviews: Autism and Vaccines Safety of vaccines used for routine immunization in the United States: An updated systematic review and meta-analysishttps://pubmed.ncbi.nlm.nih.gov/34049735Jun...
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Ranu Dhillon @ranudhillon.bsky.social · 07/03/2025
I recently read accounts of the plague & it was jarring just how much it shaped & redefined social order/life in that era Covid had a fraction of that impact but it’s fallout still fuels much of what happens now A more severe pandemic is something we need to be doing more to prevent
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Infectious Diseases @infectiousdz.bsky.social · 06/03/2025
In a measles outbreak, children as young as 6 months can be vaccinated early and then vaccinated again per the regular schedule. This is an extra vaccine and does not count towards the two they should have. publichealth.jhu.edu/2025/what-to...
publichealth.jhu.edu
What to Know About Measles and Vaccines | Johns Hopkins Bloomberg School of Public Health
Experts worry that misinformation and falling vaccination rates could cause measles outbreaks to become more common in the U.S.
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BK. Titanji @boghuma.bsky.social · 06/03/2025
Dr. @gavinyamey.bsky.social & I highlight the serious risks of the U.S. withdrawing from the WHO,both for American & global health security. When the WHO is supported, the world benefits. In the face of rising infectious & chronic disease threats, we need solidarity, not isolation. #GlobalSolidarity
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sri-srikrishna.bsky.social @sri-srikrishna.bsky.social · 04/03/2025
In Nature Medicine, we highlight 8 steps to prevent H5N1 🦅 🐄 🐓 (bird flu) from becoming a pandemic. Free access at rdcu.be/ea153 w/ @ranudhillon.bsky.social @abraarkaran.bsky.social Robert Garry
rdcu.be
Steps to prevent and respond to an H5N1 epidemic in the USA
Nature Medicine - Steps should be taken now to prevent an epidemic of H5N1 in humans and prepare for an outbreak should it occur.
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BK. Titanji @boghuma.bsky.social · 01/03/2025
Cool paper from Florian Kramer & colleagues about a novel feature of circulating H5N1 clade 2.3.4.4. These viruses have a longer stalk in their neuraminidase (NA) enzyme, a key viral protein. This was not seen in past H5N1 strains (2002-2019) Why does it matter?🧪 journals.asm.org/doi/10.1128/...
journals.asm.org
Clade 2.3.4.4b H5N1 neuraminidase has a long stalk, which is in contrast to most highly pathogenic H5N1 viruses circulating between 2002 and 2020 | mBio
While the truncated version of the N1 neuraminidase stalk domain may be associated with increased virulence in poultry, the long version of the stalk domain has been associated with increased transmis...
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Infectious Diseases @infectiousdz.bsky.social · 01/03/2025
Measles in US in 2025 164 cases Alaska, California, Georgia, Kentucky, New Jersey, New Mexico, New York City, Rhode Island, Texas Most children, some too young to be vaccinated 82% under age 20 Vaccination Status Unvaccinated or Unknown: 95% 1 MMR: 3% 2 MMR: 2% www.cdc.gov/measles/data... 🧵
Map is not up to date, RI, NY, WA not updated
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Alexander Tin @alexander-a-tin.bsky.social · 01/03/2025
In case you missed it, from Dr Mike Ryan at today's WHO press conference on those unexplained deaths in DRC "very limited in geography" "strong level of suspicion of a poisoning event related to the poisoning of a water source" tinalexander.github.io/notes/2025/0...
A screenshot of text that reads in part: "Our current assessment of the situation is that what we have is a fairly limited in time and very limited in geography cluster of unusual deaths. It has been proven negative for hemorrhagic fevers. Other samples have been taken, a systematic investigation, looking at all the suspect, even the extremely suspect suspect cases, has been done. And there clearly is, based on onset of symptomatology to death, it looks and appears very much more like a toxic type of event, either from a biologic perspective, like a meningitis or from a chemical exposure. And there have been– there is some indication now from the authorities that there’s a very strong level of suspicion of a poisoning event related to the poisoning of a water source, in relation to that specific village. So that’s under investigation by the appropriate authorities in country. We will continue to investigate. Clearly, and it’s something that, our press officer here at ECA mentioned to me many times, that we are very concerned about these events until we prove that there’s a mixed epidemiology and that many people are dying of malaria and other diseases."
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Linsey Marr @linseymarr.bsky.social · 27/02/2025
Half of Covid-19 patients emitted infectious virus in respiratory particles smaller than 5 microns (>30 min to settle out). Culturability of aerosols was associated with lower neutralizing antibody titers, so immune response matters for transmission potential. www.nature.com/articles/s41...
nature.com
Frequency, kinetics and determinants of viable SARS-CoV-2 in bioaerosols from ambulatory COVID-19 patients infected with the Beta, Delta or Omicron variants - Nature Communications
SARS-CoV-2 can be spread by aerosols. Here the authors show that between 50-60% of ambulatory COVID-19 patients exhale culturable virus and that this is associated with lower neutralizing antibody tit...
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Ranu Dhillon @ranudhillon.bsky.social · 28/02/2025
The tragedy is that, even w/inadequate efforts before this administration, we could still get ahead of H5N1 We recently outlined what a coherent strategy could be (& would now add poultry too) rdcu.be/ea153 None of this of course matters much if political will is opposing & institutions are gutted
rdcu.be
Steps to prevent and respond to an H5N1 epidemic in the USA
Nature Medicine - Steps should be taken now to prevent an epidemic of H5N1 in humans and prepare for an outbreak should it occur.
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Ranu Dhillon @ranudhillon.bsky.social · 27/02/2025
Measles is an outlier in terms of contagiousness & markedly more contagious than even the most contagious Covid variant Some affected areas seem to have pockets with markedly low vax rates It will be difficult to prevent onward spread in these areas without mass catch-up vaccination
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Ranu Dhillon @ranudhillon.bsky.social · 27/02/2025
Thank you for clarifying and sending this along
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Ranu Dhillon @ranudhillon.bsky.social · 27/02/2025
There is expertise & experience in doing this These campaigns have been successful even in places with active war, no roads etc. (Joe Rhatigan & I studied this for the Global Health Delivery Project) (3/3) www.globalhealthdelivery.org/case-collect...
globalhealthdelivery.org
The Measles Initiative
Dhillon R, Rhatigan J. The Measles Initiative. Harvard Business Publishing. 2011.
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Ranu Dhillon @ranudhillon.bsky.social · 27/02/2025
Measles has been reduced globally by mass vaccination campaigns premised on engaging communities on the safety & importance of the vaccine & then vaccinating thousands of kids within a matter of days This is what we need to do in affected & vulnerable US communities now (2/3)
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Ranu Dhillon @ranudhillon.bsky.social · 27/02/2025
The clear response *should* be to urgently engage communities on the need & safety of vaccination Measles is super contagious - the avg infectious person infects ~12-18 people For the most contagious Covid variant, it was ~9-12 Other measures likely won't be enough to stop this outbreak (1/3)
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BK. Titanji @boghuma.bsky.social · 26/02/2025
I commend every parent who is choosing to do the right thing by vaccinating their child as the measles outbreak spreads. There's no shame in changing your mind on a stance you were wrong about. Especially when it concerns protecting children from disease. www.nbcnews.com/health/healt...
nbcnews.com
As Texas measles outbreak grows, parents are choosing to vaccinate kids
At least 124 people, mostly babies, children and teens, have been infected. Eighteen people have been hospitalized.
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Infectious Diseases @infectiousdz.bsky.social · 26/02/2025
Samples have been sent further afield for testing. For now WHO only reports "Metagenomic sequencing and additional investigations are ongoing to determine the cause of illness and deaths in the two health zones".
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Ranu Dhillon @ranudhillon.bsky.social · 26/02/2025
It seems like metagenomic next-gen sequencing akin to what Charles Chiu @ucsfhealth.bsky.social does could help pinpoint the culprit pathogen Has this been tried? If not, an issue of sample preservation & transport? Limits of detection with certain sample types? In 2025, this is a solvable problem
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Abraar Karan, MD, MS, MPH, DTM&H @abraarkaran.bsky.social · 25/02/2025
Our commentary in Nature on immediate steps to combat the #H5N1 bird flu outbreak. @ranudhillon.bsky.social @sri-srikrishna.bsky.social www.nature.com/articles/s41...
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Ranu Dhillon @ranudhillon.bsky.social · 24/02/2025
If H5N1 evolves to spread between people, it could spur a pandemic In @naturemedicine.bsky.social, @sri-srikrishna.bsky.social Robert Garry @abraarkaran.bsky.social & I discuss the mutations it may take for this to happen & what we could do now to stop it & be prepared in case it does rdcu.be/ea153
rdcu.be
Steps to prevent and respond to an H5N1 epidemic in the USA
Nature Medicine - Steps should be taken now to prevent an epidemic of H5N1 in humans and prepare for an outbreak should it occur.
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The Guardian @theguardian.com · 15/02/2025
Extreme weather is our new reality. We must accept it and begin planning | Gaia Vince
theguardian.com
Extreme weather is our new reality. We must accept it and begin planning | Gaia Vince
As wildfires, floods, droughts and record-breaking temperatures have shown, the post-climate change era has arrived. Now we need honesty and action from our leaders
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Helen Branswell 🇨🇦 @helenbranswell.bsky.social · 15/02/2025
#USDA has confirmed that the discovery of #H5N1 #birdflu in Arizona — found through bulk milk testing — does indeed represent a new spillover from wild birds into cows. This is the third time this has been observed to have happened. www.aphis.usda.gov/news/program...
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BK. Titanji @boghuma.bsky.social · 28/01/2025
Many people have asked me how can they best stay informed and protect their health while we navigate the indefinite pause on communications from NIH, CDC, & FDA. Here’s a thread on concrete steps YOU can take to protect yourself & your community. 🧵
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Tom Peacock @peacockflu.bsky.social · 07/01/2025
Really proud to share our preprint describing early adaptation of H5N1 to US dairy cattle, and showing how these mutations enhance the ability of the virus to infect other mammals, such as pigs and humans. With @influenzal.bsky.social @vidhid.bsky.social @drclairesmith.bsky.social and many more!
biorxiv.org
Polymerase mutations underlie adaptation of H5N1 influenza virus to dairy cattle and other mammals.
In early 2024, an unprecedented outbreak of H5N1 high pathogenicity avian influenza was detected in dairy cattle in the USA. The epidemic remains uncontrolled, with spillbacks into poultry, wild birds...
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Gregg Gonsalves @gregggonsalves.bsky.social · 07/12/2024
@stephanienolen.bsky.social is one of the great science and health reporters. This dispatch on mpox in DRC deserves all the awards. www.nytimes.com/2024/12/07/h...
nytimes.com
In Congo, a Medical Mystery Offers Clues to the Mpox Epidemic
In a remote Congolese town, a medical mystery led to the discovery of alarming changes in the mpox virus and, eventually, to a global health emergency.
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Tom Peacock @peacockflu.bsky.social · 07/12/2024
so both receptor binding changes and polymerase changes would be needed to go pandemic (as well as ph stability to allow efficient airborne transmissibility). The cattle viruses already have polymerase changes that are equivalent to E627K though.
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Ranu Dhillon @ranudhillon.bsky.social · 07/12/2024
Even while waiting on the pathogen’s identity, we should quickly discern how it spreads & immediately take steps to stop transmission Biophysical approaches to impede the few potential modes of transmission don’t require the pathogen-specific info needed for biochemical measures (eg, tests, drugs)
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Ranu Dhillon @ranudhillon.bsky.social · 07/12/2024
This is a good but still inadequate & too slow step in the right direction We need to just scale what Colorado’s been doing nationwide & quickly uncover where viral circulation is & use isolation to get it cleared We should’ve done that from the get-go ~9 months ago www.usda.gov/media/press-...
usda.gov
USDA Announces New Federal Order, Begins National Milk Testing Strategy to Address H5N1 in Dairy Herds
WASHINGTON, Dec. 6, 2024 - Today, the U.S. Department of Agriculture’s (USDA) Animal and Plant Health Inspection Service (APHIS) is announcing the start of its National Milk Testing Strategy (NMTS), w...
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Kristian G. Andersen @kgandersen.bsky.social · 06/12/2024
This is an interesting tidbit because it shows that these types of mutations already exist out in "the wild". Does the fact that we found Q226L in a mouse on a farm back in June of this year change the threat picture of H5N1? No, it does not, but we're playing a numbers game. I would rather not.
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Ranu Dhillon @ranudhillon.bsky.social · 06/12/2024
Lots to learn about this deadly mystery disease in DRC Discerning how it is spreading - even if its identity is still being investigated - should be a priority Knowing this could inform immediate steps to slow transmission even while other details are figured out
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Helen Branswell 🇨🇦 @helenbranswell.bsky.social · 02/12/2024
Scientists who have studied #H5N1 #birdflu for years are flummoxed by the lack of severe cases among the 55 human cases the US has confirmed this year. I talked to lots to explore the theories of what's going on. www.statnews.com/2024/12/02/b...
statnews.com
Scientists confront a mystery: Why have U.S. bird flu cases been so mild?
The H5N1 bird flu outbreak in the U.S. has so far been shockingly mild. Researchers have some theories as to why.
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Abraar Karan, MD, MS, MPH, DTM&H @abraarkaran.bsky.social · 27/11/2024
Understanding how transmission occurred is necessary for prevention. Sometimes it may be a very rare pathway that may not occur again & is never elucidated (“freak accident”) but it could also be something we aren’t thinking of with higher risk of recurrence. #H5N1
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Ranu Dhillon @ranudhillon.bsky.social · 24/11/2024
These are a few pragmatic steps we should take now If we continue with the status quo, there’s a chance H5N1 never becomes a bigger threat but, with flu season forthcoming, also a possibility for it to abruptly adapt & immediately launch a global crisis (10/10)
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Ranu Dhillon @ranudhillon.bsky.social · 24/11/2024
(6) Regularly screen those at-risk for H5N1 infection Until we have a better grip on spread, we should also screen at least a subset of people testing + for flu A to discern the presence/frequency of hidden infections All H5N1+ cases should be sequenced (9/10)
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Ranu Dhillon @ranudhillon.bsky.social · 24/11/2024
(5) Track viral circulation & evolution by testing wastewater and sequencing whenever H5N1 is found to gauge for the evolution & accumulation of risky mutations thelancet.com/journals/lan... (8/10)
thelancet.com
Enhancing wastewater testing for H5N1 surveillance
In their editorial, The Lancet Infectious Diseases editors highlight regarding the uptake of H5N1 influenza A testing on farms that: “Testing is largely voluntary, and uptake has been low, so the true...
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Ranu Dhillon @ranudhillon.bsky.social · 24/11/2024
Colorado has shown how this can be done with mandatory serial testing We should do the same nationally or pursue other assured ways to pinpoint H5N1 We’ve proposed local wastewater sequencing as a workaround, though that would be more onerous statnews.com/2024/09/27/h... (7/10)
statnews.com
Sequencing wastewater material may be the key to getting a grip on the H5N1 bird flu outbreak
Opinion: It’s time to take a new approach to monitoring the H5N1 outbreak in dairy cows.
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Ranu Dhillon @ranudhillon.bsky.social · 24/11/2024
(4) Stamp out viral circulation in dairy cows Stopping circulation & spillovers from wild birds is tricky but cows may be a bigger risk for viral evolution given that they're mammals kept in large numbers with close, frequent contact with people science.org/doi/10.1126/... (6/10)
science.org
Stop H5N1 influenza in US cattle now
The relentless march of a highly pathogenic avian influenza virus (HPAIV) strain, known as H5N1, to become an unprecedented panzootic continues unchecked. The leap of H5N1 clade 2.3.4.4b from Eurasia ...
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