Monday 18 May 2009

Disease/Infection News Update 19th May 2008

Talk Medical (http://talk.news-medical.net). Post news from your organization or company, post events you are involved in or feel would be of interest to the wider community, blog to your heart's content on current health issues or simply just share any interesting health stories you may have.

Latest News

Global AIDS coordinator Goosby should serve as 'fierce advocate' for pediatric HIV/AIDS programs, letter to editor Says
"The details of President Obama's new global health initiative have left many concerned that the financing described does not reflect the commitment required to lead the United States' efforts in the global fight against HIV and AIDS," Jennifer Delaney, executive director of Global Action for Children, writes in a New York Times letter to the editor.
http://www.news-medical.net/news/2009/05/18/Global-AIDS-coordinator-Goosby-should-serve-as-fierce-advocate-for-pediatric-HIVAIDS-programs-letter-to-editor-Says.aspx
Sex workers in Pakistan give recommendations on HIV prevention to health officials
Although the recorded HIV prevalence in Pakistan is relatively low, health officials are concerned that a concentrated epidemic of the virus among injection drug users could carry over to commercial sex workers and other high risk groups in the country, IRIN/PlusNews reports.
http://www.news-medical.net/news/2009/05/18/Sex-workers-in-Pakistan-give-recommendations-on-HIV-prevention-to-health-officials.aspx
New HIV/AIDS initiative in Tanzania aims to increase condom availability
Condom vending machines will be unveiled on Monday in Dar es Salaam, Tanzania, as part of a six-year pilot HIV prevention initiative in the country, Tanzania's The Citizen reports.
http://www.news-medical.net/news/2009/05/18/New-HIVAIDS-initiative-in-Tanzania-aims-to-increase-condom-availability.aspx
Denver Post examines efforts to establish needle-exchange programs in Colorado
The Denver Post on Friday examined efforts to establish needle-exchange programs in Colorado to reduce the risk of HIV and hepatitis C among injection drug users.
http://www.news-medical.net/news/2009/05/18/Denver-Post-examines-efforts-to-establish-needle-exchange-programs-in-Colorado.aspx
Vaccine candidate successful in blocking Simian version of HIV
Researchers have successfully blocked SIV, the simian version of HIV, using a new technique that could help lead to the development of an effective HIV/AIDS vaccine, the Children's Hospital of Philadelphia. The team also included scientists from Nationwide Children's Hospital in Columbus, Ohio, and the New England Primate Research Center in Boston.
http://www.news-medical.net/news/2009/05/18/Vaccine-candidate-successful-in-blocking-Simian-version-of-HIV.aspx
Computer simulation captures immune response to flu
Researchers have successfully tested first the first time a computer simulation of major portions of the body's immune reaction to influenza type A, with implications for treatment design and preparation ahead of future pandemics, according to work accepted for publication, and posted online, by the Journal of Virology.
http://www.news-medical.net/news/2009/05/18/Computer-simulation-captures-immune-response-to-flu.aspx
World Health Assembly opens amid concerns about flu pandemic
The 62nd World Health Assembly opened today in Geneva, as officials from 193 member countries began their annual review of the activities of the WHO and set new priorities for the future.
http://www.news-medical.net/news/2009/05/18/World-Health-Assembly-opens-amid-concerns-about-flu-pandemic.aspx
Piecing together the HIV prevention puzzle
"It's an exciting time in HIV prevention research. We will see results from a number of critically important HIV prevention research trials this year, as well as see the start of new trials around the world that will yield important answers in the years to come," said Mitchell Warren, AVAC executive director, at the release of AVAC's 13th annual report of the field.
http://www.news-medical.net/news/2009/05/18/Piecing-together-the-HIV-prevention-puzzle.aspx
Latest news on swine flu - 39 countries now affected
The latest update from the World Health Organization (WHO) # 31, says as of 17th May that 39 countries have now officially reported a total of 8,480 cases of influenza A(H1N1) infection.
http://www.news-medical.net/news/2009/05/17/Latest-news-on-swine-flu-39-countries-now-affected.aspx
Urgent need for stringent TB screening policies among South African healthcare workers
Healthcare workers in South Africa are at a significantly increased risk of developing drug-resistant tuberculosis, or XDR-TB, in a trend which threatens to further exacerbate the already beleaguered healthcare systems in sub-Saharan countries, according to results of a new study.
http://www.news-medical.net/news/2009/05/17/Urgent-need-for-stringent-TB-screening-policies-among-South-African-healthcare-workers.aspx
Influenza A(H1N1) update, 39 countries and 8480 cases
As of 06:00 GMT, 17 May 2009, 39 countries have officially reported 8480 cases of influenza A(H1N1) infection.
http://www.news-medical.net/news/2009/05/17/Influenza-A(H1N1)-update-39-countries-and-8480-cases.aspx
Early retroviral use best for AIDS patients with serious complications
HIV-positive patients who don't seek medical attention until they have a serious AIDS-related condition can reduce their risk of death or other complications by half if they get antiretroviral treatment early on, according to a new multicenter trial led by researchers at the Stanford University School of Medicine.
http://www.news-medical.net/news/2009/05/17/Early-retroviral-use-best-for-AIDS-patients-with-serious-complications.aspx
Early use of antiretroviral treatment improves survival rate of HIV patients
A clinical study, led by researchers from University College Dublin, Ireland, and Stanford University, California, USA, with international collaborators, demonstrates that mortality rates of HIV patients can be almost halved when early antiretroviral (ARV) therapy is added to the treatment of AIDS-related opportunistic infections (OIs) such as pneumonia, meningitis or other serious bacterial infections.
http://www.news-medical.net/news/2009/05/17/Early-use-of-antiretroviral-treatment-improves-survival-rate-of-HIV-patients.aspx
Variation of natural compound cures malaria in mice
Approximately 350 million to 500 million cases of malaria are diagnosed each year mostly in sub-Saharan Africa. While medications to prevent and treat malaria do exist, the demand for new treatments is on the rise, in part, because malaria parasites have developed a resistance to existing medications.
http://www.news-medical.net/news/2009/05/15/Variation-of-natural-compound-cures-malaria-in-mice.aspx
Rates of sexually transmitted infections in Allegheny County, Pa., disproportionately high among blacks, officials say
Health officials in Allegheny County, Pa., on Wednesday held a sexually transmitted infection diversity conference to discuss the disproportionately higher STI rates among blacks and strategies to reduce them, the Pittsburgh Post-Gazette reports.
http://www.news-medical.net/news/2009/05/15/Rates-of-sexually-transmitted-infections-in-Allegheny-County-Pa-disproportionately-high-among-blacks-officials-say.aspx
House, Senate Committees approve bills that include influenza pandemic funds
The Senate Appropriations Committee on Thursday voted unanimously to approve a $91.3 billion defense and foreign aid spending bill that includes President Obama's request for $1.5 billion in emergency funds to fight a potential influenza pandemic, the AP/Winston-Salem Journal reports.
http://www.news-medical.net/news/2009/05/15/House-Senate-Committees-approve-bills-that-include-influenza-pandemic-funds.aspx
Lambda Legal files suit against assisted-living facility for allegedly discriminating against HIV-positive resident
Lambda Legal, a group that represents HIV-positive people, on Tuesday filed a law suit against the Fox Ridge assisted-living facility in North Little Rock, Ark., for allegedly evicting a resident because he is HIV-positive, the Arkansas Democrat-Gazette reports.
http://www.news-medical.net/news/2009/05/15/Lambda-Legal-files-suit-against-assisted-living-facility-for-allegedly-discriminating-against-HIV-positive-resident.aspx
New Jersey Senator proposes plan to avert HIV/AIDS drug copayments
New Jersey state Sen. Joseph Vitale (D) -- chair of the Senate Health, Human Services and Senior Citizens Committee -- earlier this week proposed a plan to temporarily reduce rebate checks to senior citizens earning $100,000 to $150,000 in an effort to alleviate the effects of possible budget cuts on certain populations, the Newark Star-Ledger reports. Vitale's proposal also would avert planned $6 to $15 prescription drug copayments for people living with HIV/AIDS in the state (Livio, Newark Star-Ledger, 5/12).
http://www.news-medical.net/news/2009/05/15/New-Jersey-Senator-proposes-plan-to-avert-HIVAIDS-drug-copayments.aspx
PIH founder Farmer discussing possible appointment to coordinate U.S. global health initiatives, Boston Globe reports
Paul Farmer -- founder of Partners in Health and vice chair of the Department of Global Health and Social Medicine at Harvard Medical School -- said he is in discussions with the State Department about a possible Obama administration appointment to coordinate U.S. global health initiatives, the Boston Globe reports. Farmer made the announcement Monday during a meeting with HMS faculty.
http://www.news-medical.net/news/2009/05/15/PIH-founder-Farmer-discussing-possible-appointment-to-coordinate-US-global-health-initiatives-Boston-Globe-reports.aspx
Obama names New York City Health Commissioner Frieden next CDC Director, New York Times reports
President Obama on Friday named New York City Health Commissioner Thomas Frieden as the next CDC director, the New York Times reports. It has long been expected that Obama would select Frieden, an infectious disease specialist, according to the Times.
http://www.news-medical.net/news/2009/05/15/Obama-names-New-York-City-Health-Commissioner-Frieden-next-CDC-Director-New-York-Times-reports.aspx
Human nose temperature too cold for avian influenza
Avian influenza viruses do not thrive in humans because the temperature inside a person's nose is too low, according to research published today in the journal PLoS Pathogens.
http://www.news-medical.net/news/2009/05/15/Human-nose-temperature-too-cold-for-avian-influenza.aspx
Australian scientist suggests Swine flu an accident in the lab
The suggestion by an Australian virologist that the new flu virus, H1N1 or swine flu, could have been the result of a laboratory accident has been dismissed by Dr. Keiji Fukuda, the deputy director general of the World Health Organization (WHO).
http://www.news-medical.net/news/2009/05/14/Australian-scientist-suggests-Swine-flu-an-accident-in-the-lab.aspx
Swine flu preoccupies world health leaders
It is expected that the upcoming World Health Organisation's (WHO) annual assembly will be dominated this year by the emergence and spread of the new influenza virus H1N1 (swine flu).
http://www.news-medical.net/news/2009/05/14/Swine-flu-preoccupies-world-health-leaders.aspx
Vietnamese HIV/AIDS Department announces funding for prevention efforts
Vietnamese officials announced recently that about 678 billion dong, or about $38.7 million, will be allocated for HIV/AIDS prevention efforts in the country in 2009, the VNA/VietnamPlus.com reports.
http://www.news-medical.net/news/2009/05/14/Vietnamese-HIVAIDS-Department-announces-funding-for-prevention-efforts.aspx
About 20% of surveyed sex workers who use drugs in Irish capital living with HIV, report finds
About one-fifth of commercial sex workers surveyed in Dublin, Ireland, are HIV-positive, while 78% of the surveyed group is living with hepatitis C, according to a report released Tuesday by the National Advisory Committee on Drugs, the Irish Times reports.
http://www.news-medical.net/news/2009/05/14/About-2025-of-surveyed-sex-workers-who-use-drugs-in-Irish-capital-living-with-HIV-report-finds.aspx
Vigils held worldwide to protest jailing of Iranian physicians who addressed HIV/AIDS
Health professionals on Tuesday held vigils in several cities worldwide to protest the imprisonment of Iranian brothers Kamiar and Arash Alaei -- physicians and leading HIV/AIDS advocates in the country -- following the release of Iranian-American journalist Roxana Saberi, the Albany Times Union reports.
http://www.news-medical.net/news/2009/05/14/Vigils-held-worldwide-to-protest-jailing-of-Iranian-physicians-who-addressed-HIVAIDS.aspx
Many Americans support increased domestic funding to address HIV/AIDS, report says
Many Americans support increased funding to address HIV/AIDS in the U.S. according to a report released Wednesday for the National AIDS Coordinating Committee with support from the MAC AIDS Fund, Reuters Health reports.
http://www.news-medical.net/news/2009/05/14/Many-Americans-support-increased-domestic-funding-to-address-HIVAIDS-report-says.aspx
Will the NHS continue to function in an influenza pandemic?
A survey of health care workers has revealed that as many as 85% may stay off work if an influenza pandemic did take hold of the country.
http://www.news-medical.net/news/2009/05/13/Will-the-NHS-continue-to-function-in-an-influenza-pandemic.aspx
Canada 'leading contributor' to global HIV/AIDS efforts, Canadian official says
A recent column in the Victoria Times on Canada's response to HIV/AIDS, written by Times columnist Kate Heartfield, "overlook[ed] the real story here -- that Canada is dedicated to getting results" in treating and preventing HIV/AIDS in Canada and worldwide, Canadian Minister of International Cooperation Beverley Oda writes in an Ottawa Citizen opinion piece.
http://www.news-medical.net/news/2009/05/13/Canada-leading-contributor-to-global-HIVAIDS-efforts-Canadian-official-says.aspx
International Nurses Day chance to improve conditions for health workers in developing countries, opinion piece says
International Nurses Day, which took place on Tuesday, was "an appropriate day ... to consider the challenges faced by health care personnel in developing countries," including those related to HIV/AIDS, Gary Cohen, board director of the U.S. Fund for UNICEF and the CDC Foundation, writes in a NorthJersey.com opinion piece.
http://www.news-medical.net/news/2009/05/13/International-Nurses-Day-chance-to-improve-conditions-for-health-workers-in-developing-countries-opinion-piece-says.aspx
Obama administration 'wants to go slow' on HIV/AIDS efforts, editorial says
"The road to ending AIDS comes with warning sign: Caution -- Politics Ahead. Just ask President Obama, who's getting a crash-course introduction," a San Francisco Chronicle editorial says.
http://www.news-medical.net/news/2009/05/13/Obama-administration-wants-to-go-slow-on-HIVAIDS-efforts-editorial-says.aspx
"Grandmothers 4 Grandmothers" network strong force in HIV/AIDS efforts, HIV advocate Lewis says
The network "Grandmothers 4 Grandmothers" in Regina, Canada -- the local effort of the Stephen Lewis Foundation's network of grandmother organizations called Grandmothers to Grandmothers -- has "emerged as a force to be reckoned with" among the 70,000 Canadians supporting the foundation, the Regina Leader-Post reports.
http://www.news-medical.net/news/2009/05/13/Grandmothers-4-Grandmothers-network-strong-force-in-HIVAIDS-efforts-HIV-advocate-Lewis-says.aspx
South African President Zuma appoints new health minister to replace Hogan
South African President Jacob Zuma on Sunday appointed physician Aaron Motsoaledi as health minister, replacing Health Minister Barbara Hogan, who was appointed to a public enterprises position, London's Guardian reports. Motsoaledi previously served as a provincial education minister. Hogan had been appointed to the post last year to replace former Health Minister Manto Tshabalala-Msimang (Smith, Guardian, 5/10).
http://www.news-medical.net/news/2009/05/13/South-African-President-Zuma-appoints-new-health-minister-to-replace-Hogan.aspx
New York Times examines campaign that promotes HIV awareness, prevention through media
The New York Times recently examined a campaign that aims to promote HIV awareness and prevention through several media outlets.
http://www.news-medical.net/news/2009/05/13/New-York-Times-examines-campaign-that-promotes-HIV-awareness-prevention-through-media.aspx
Scientists develop tool to study a deadly parasite's histone code
In the Japanese art of paper folding, a series of folds can make the same sheet of paper into a ballerina or baby elephant. But try unfolding the baby elephant and making it into a ballerina. It's like trying to make a neuron from a kidney cell. Epigenetics, it turns out, isn't much different from this old Japanese art: Each fold, or epigenetic crease, both limits and permits further potential folds in a way that mirrors how epigenetic changes seal a cell's fate.
http://www.news-medical.net/news/2009/05/13/Scientists-develop-tool-to-study-a-deadly-parasitee28099s-histone-code.aspx
New mathematical model predicts immune response to influenza A virus
Researchers at the University of Rochester have developed a mathematical model to predict immune responses to infection with influenza A viruses, including novel viruses such as the emergent 2009 influenza A (H1N1). This model examines the contributions of specific sets of immune cells in fighting influenza A virus.
http://www.news-medical.net/news/2009/05/13/New-mathematical-model-predicts-immune-response-to-influenza-A-virus.aspx
Influenza pandemic planning needed to ensure that pregnant women and newborns receive priority treatment
Pregnant women and newborns are at greatest risk in a flu epidemic, but more planning must be done to ensure that they receive priority treatment should an outbreak occur, according to a University of Pittsburgh Medical Center (UPMC) and University of Pittsburgh study.
http://www.news-medical.net/news/2009/05/13/Influenza-pandemic-planning-needed-to-ensure-that-pregnant-women-and-newborns-receive-priority-treatment.aspx
Break through in the treatment of bacterial meningitis
It can take just hours after the symptoms appear for someone to die from bacterial meningitis. Now, after years of research, experts at The University of Nottingham have finally discovered how the deadly meningococcal bacteria is able to break through the body's natural defence mechanism and attack the brain.
http://www.news-medical.net/news/2009/05/13/Break-through-in-the-treatment-of-bacterial-meningitis.aspx
The latest news on swine flu
The latest update (# 26) from the World Health Organisation (WHO) reports that as of the 12th of May 2009, 30 countries have officially reported 5,251 cases of influenza A (H1N1) infection.
http://www.news-medical.net/news/2009/05/13/The-latest-news-on-swine-flu.aspx
New York Legislature should approve legislation requiring health workers to offer HIV testing, editorial says
The New York state Legislature "should make it mandatory for health care workers to offer [HIV] testing" as proposed in a New York state bill (A 7757), a Long Island Newsday editorial says (Long Island Newsday, 5/11).
http://www.news-medical.net/news/2009/05/12/New-York-Legislature-should-approve-legislation-requiring-health-workers-to-offer-HIV-testing-editorial-says.aspx
Disabled youth in Botswana call for greater involvement in country's HIV/AIDS efforts
The Botswana Federation of the Disabled recently held a seminar to commemorate the country's "Youth Against HIV/AIDS" month, focusing on the role of disabled young people in efforts to curb the spread of HIV, Botswana's Sunday Standard reports.
http://www.news-medical.net/news/2009/05/12/Disabled-youth-in-Botswana-call-for-greater-involvement-in-countrys-HIVAIDS-efforts.aspx
IRIN/Plus News examines HIV/AIDS services in Zimbabwe following economic crisis
IRIN/Plus News on Monday examined services for people living with HIV/AIDS in Zimbabwe following an economic crisis in the country.
http://www.news-medical.net/news/2009/05/12/IRINPlus-News-examines-HIVAIDS-services-in-Zimbabwe-following-economic-crisis.aspx
HIV cases among young people in Iowa increasing
Health officials announced recently that the number of newly recorded HIV cases among Iowans ages 15 to 24 increased by 45% in 2008 to 16, despite the widespread availability of condoms and other prevention methods, the Iowa Press-Citizen reports.
http://www.news-medical.net/news/2009/05/12/HIV-cases-among-young-people-in-Iowa-increasing.aspx
San Francisco Chronicle examines emergency department HIV testing program
The San Francisco Chronicle on Monday examined an HIV testing program at San Francisco General Hospital's emergency department, which is part of a nationwide CDC program that offers routine testing to all ED patients.
http://www.news-medical.net/news/2009/05/12/San-Francisco-Chronicle-examines-emergency-department-HIV-testing-program.aspx
Simple interventions could contain flu spread – focus on children
Although many have touted strategies from travel avoidance to Tamiflu to halt the spread of H1N1 flu or swine flu, a large body of evidence from the Cochrane Library suggests that concentrating on children's hygiene might be the best way to reduce the spread of respiratory illnesses.
http://www.news-medical.net/news/2009/05/12/Simple-interventions-could-contain-flu-spread-e28093-focus-on-children.aspx
A potentially better way to make flu virus vaccines
A team of Princeton University scientists may have found a better way to make a vaccine against the flu virus.
http://www.news-medical.net/news/2009/05/12/A-potentially-better-way-to-make-flu-virus-vaccines.aspx
Research looks at the human factor in spread of pandemic illness
Industrial engineers Sandra Garrett of Clemson University and Barrett Caldwell of Purdue University have proposed a new system to warn of an impending pandemic by monitoring signals in human behavior. The system could result in using a simple icon on a television screen to warn of future phases of an outbreak of an illness such as the flu
http://www.news-medical.net/news/2009/05/12/Research-looks-at-the-human-factor-in-spread-of-pandemic-illness.aspx
Obama ensures Hispanic community they will be included in H1N1 flu outbreak efforts
In a town hall-style meeting at the White House on Friday, President Obama ensured Hispanic community leaders and advocates that the U.S. will not alienate the group as a result of the recent H1N1 flu outbreak believed to have started in Mexico, the AP/Las Vegas Sun reports. Obama also assured the group that they will receive treatment related to the virus regardless of legal status.
http://www.news-medical.net/news/2009/05/12/Obama-ensures-Hispanic-community-they-will-be-included-in-H1N1-flu-outbreak-efforts.aspx
Stigma, gender violence placing women in Caribbean at increased risk of HIV
Inter Press Service on Thursday examined how an increasing number of women living with HIV/AIDS in the Caribbean face stigma, discrimination and gender-based violence that is linked to the spread of the disease. UNAIDS reports that women overall now account for half of the population living with HIV in the Caribbean, compared with 30% in 1999. Women ages 15 to 24 account for 62% of the entire HIV-positive population in the Caribbean.
http://www.news-medical.net/news/2009/05/12/Stigma-gender-violence-placing-women-in-Caribbean-at-increased-risk-of-HIV.aspx
Botswana announce HIV-prevention project to circumcise 80% of eligible men over five years
Botswana's Ministry of Health is launching a project that aims to circumcise nearly 500,000 men over the next five years in an effort to prevent the spread of HIV, the AFP/Daily Telegraph reports.
http://www.news-medical.net/news/2009/05/12/Botswana-announce-HIV-prevention-project-to-circumcise-8025-of-eligible-men-over-five-years.aspx
Researchers developing pasteurization technique to help HIV-positive women breastfeed
VOA News on Thursday examined a project to help HIV-positive women in developing countries breastfeed their infants and reduce the risk of mother-to-child transmission.
http://www.news-medical.net/news/2009/05/12/Researchers-developing-pasteurization-technique-to-help-HIV-positive-women-breastfeed.aspx
Africa should manufacture its own antiretrovirals, A.U. official says
African countries should produce their own generic antiretroviral drugs in order to continue the fight against HIV/AIDS during the global economic crisis, African Union Commissioner for Social Affairs Bience Gawanas said recently during a conference for health ministers in Ethiopia, Reuters UK reports.
http://www.news-medical.net/news/2009/05/12/Africa-should-manufacture-its-own-antiretrovirals-AU-official-says.aspx
HIV/AIDS advocates express concern about Obama's continuation of needle-exchange funding ban
Although President Obama previously has expressed support for needle-exchange programs as part of HIV/AIDS prevention efforts, advocates recently expressed concern that the administration's 2009-2010 budget proposal intends to continue a funding ban for such programs that dates back to the 1980s, the San Francisco Chronicle reports.
http://www.news-medical.net/news/2009/05/12/HIVAIDS-advocates-express-concern-about-Obamas-continuation-of-needle-exchange-funding-ban.aspx
Researchers screen the smallpox proteome
University of Florida researchers have learned more about how smallpox conducts its deadly business - discoveries that may reveal as much about the human immune system as they do about one of the world's most feared pathogens.
http://www.news-medical.net/news/2009/05/12/Researchers-screen-the-smallpox-proteome.aspx
Early findings about H1N1 pandemic potential
Early findings about the emerging pandemic of a new strain of influenza A (H1N1) in Mexico are published in Science.
http://www.news-medical.net/news/2009/05/12/Early-findings-about-H1N1-pandemic-potential.aspx
Money from Bill and Melinda Gates will help beat Dengue fever in Australia
The University of Queensland (UQ) has won a grant of $100,000 grant from the Bill and Melinda Gates Foundation to fight dengue and other mosquito-borne diseases.
http://www.news-medical.net/news/2009/05/11/49308.aspx
Swine flu could come round again!
The Centres for Disease Protection and Control (CDC) says outbreaks of the new H1N1 swine flu continue to spread across the United States and the swine influenza virus is expected to spread to all 50 states and to cause many infections ranging from mild to severe.
http://www.news-medical.net/news/2009/05/11/49306.aspx
Australian scientists win funds for new research
One bold idea - that's all it takes - such is the creed of a bold initiative fostered by the Bill & Melinda Gates Foundation and once again Bill Gates is putting his hand in his pocket for the good of mankind.
http://www.news-medical.net/news/2009/05/11/49305.aspx
Swine flu now in 29 countries and continuing to spread
The latest update (# 24), from the World Health Organisation on influenza A H1N1 (swine flu) says as of the 10th May 2009, 29 countries have now officially reported cases of human infection.
http://www.news-medical.net/news/2009/05/11/49302.aspx

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Find The Ducklings

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