Should I Exercise with Covid?

Should I Exercise with Covid?

It is hard to believe that we have suffered through an entire year of this COVID-19 pandemic, yet here we are.  Things are improving of course as numbers are down and continue to decline.  The good news about hitting the year mark is that we now know a lot more about the virus and its impacts on health and who is most susceptible to more severe illness.

We have had several questions surrounding COVID-19 and physical activity so I thought this would be a good way to address this issue.  I would like to divide our topic today into 2 categories: 1) Fitness and exercise prior to COVID infection and 2) Exercise after having COVID infection.

Will Exercise Help Prevent COVID-19?

Let’s start with physical fitness and its effects on health, in particular as it relates to COVID-19 infection.  It turns out that the more physically fit and active you are prior to contracting COVID, the less likely you are to suffer from more severe disease or require hospitalization.  I think we could argue that this just makes sense as we know this about fitness and any disease but nevertheless, there is some data that now confirms this.  Here is one example:

“ Although the clinical course of COVID-19 illness varies among athletes, (just as it does among non-athletes), on average, physical fitness appears to mitigate the severity of COVID-19 illness. As an example, in a retrospective study of 246 patients (59±12 years, 42 percent male, 75 percent Black) diagnosed with severe acute respiratory syndrome secondary to COVID-19 illness, hospitalization was found to be inversely related to aerobic fitness [4]. Baseline fitness in peak metabolic equivalents, based on exercise stress testing results obtained within the prior four years, were significantly lower among patients who were hospitalized (6.7±2.8) compared with those not hospitalized (8±2.4) (unadjusted odds ratio [OR] 0.83; 95% CI 0.74-0.92; OR adjusted for major risk factors 0.87; 95% CI 0.76-0.99).”  Source : 

The practical application here is that if you have not had COVID and are looking for things that you can do to mitigate your risk, look no further than an exercise regimen.  Things are more complicated with the pandemic and less access to gyms but that does not mean we should be sedentary. 

Spring is here with warmer temperatures and more sunshine so getting outside should be a given for all of us.  Walking or jogging daily will improve your fitness and well-being.  I will throw in that it will also increase your Vitamin D levels which have also been shown to be inversely related to COVID-19 severity. 

You should also mix in some weight training regularly which you can do at home with little to no equipment or at your local gym. If you need some guidance with that please consult a nutrition and fitness expert.

Should I Exercise with COVID-19?

Turning our attention to exercise after COVID-19 infection I will try to answer the questions of when and how much.  This advice, like that above, is also pretty intuitive.  The research we have points to being able to return to exercise after a week of recovery from symptoms. You want to give your body the time to heal before doing anything too intense or strenuous.

That being said if your symptoms are mild you can certainly get outside and go for a short walk.  Once you have given your body time to rest and recover you should ease yourself back into a routine.  You should expect that you will not be able to go back 100% right away and this is normal and natural and not a cause for concern.

“A concern among recreational and elite athletes during the COVID-19 pandemic is the impact of detraining. Several studies report that community lockdowns to prevent viral spread have had adverse effects on physical fitness. As an example, a retrospective study of Spanish students enrolled in 16 universities, and involving a total of 13,754 valid survey responses, described reduced moderate (-29.5 percent) and vigorous (-18.3 percent) physical activity during confinement and increased sedentary time (+52.7 percent) [9]. Multiple small, observational cohort studies report comparable declines in fitness among adolescents [10-13]. A small case-control study of children reported a substantial decline in the mean maximum oxygen uptake in a post-COVID-19 cohort compared with pre-pandemic controls (39.1 versus 44.7) [10]. Detraining is an important consideration for clinicians to address when providing guidance about return to play [14].”  Source: 

Listen to your body and try to find that balance of pushing hard enough to produce results without pushing too hard to produce injury.  If you are having chest pain or severe shortness of breath you should stop and seek a medical evaluation.  For the majority of you, I expect you to be back to your pre-COVID workouts within a few weeks of recovery.

I hope this helps clarify any questions you may have about COVID and exercise.  As always, if you want to learn more or be evaluated for your personal and individual situation reach out to us for an appointment.

If you are looking for more specific guidance on healthy habits, nutrition or a training regimen let us know and Kathryn Terry, Bianco Primary Care’s  Director of  Nutrition and Fitness will be happy to help you achieve your health and fitness goals.

Now is the time to have a health plan with an affordable Primary Care Doctor who knows you and you can reach when you need them.  In-office, text, phone, email – No insurance required.

How To Handle Nutritional Speed Bumps To Maintain A Healthy Lifestyle

How To Handle Nutritional Speed Bumps To Maintain A Healthy Lifestyle

Fallen off the “new year, new you” wagon already? Have you finished your Whole30, or figured out that your body isn’t meant to run on fats as a primary fuel source? 

Did you finally realize how much time it takes to follow the strict rules of a fad diet and decide we no longer have time for that? Or maybe you just finished a challenge or detox and are looking for a new road map to follow so the scale doesn’t go back the wrong way. 

If you currently find yourself looking for a sustainable plan to optimally fuel yourself for a healthy lifestyle, look no further!


While we are mostly all aware of our self-proclaimed “good habits” and “bad habits,” we still struggle with changing them and breaking them long-term, even when we have good intentions. Fad and crash diets with well laid out road maps seem like an easy answer to breaking old habits, but unfortunately most of the time they do not do anything to transition you from poor, old habits to new, healthier ones. 

Usually cut and dry plans are the quickly successful ones, yet also the plans that only provide short-term success. To sustain your health and wellness goals beyond a 6 week or 60-day challenge, we must turn to true habit change. 

Where To Start

Step 1: Identify the habits that you want to change. And I don’t just mean continue to complain about how you can improve to your gal pal or your mom. I mean actually make a list of nutritional and/or health and wellness habits you would like to change over the next few months. (Yep, you read that right. This is a process and not a quick fix.) 

Step 2: Pick a starting point. Which habit that you change would make the biggest impact initially? Is it reducing your diet coke intake? Or putting up the cell phone before bed? Or is it getting up from your desk more than twice for a bathroom break during your workday? A starting point is personal, and I have a feeling you know what could make a big impact for you if you finally changed it today. 

Step 3: Replace the old habit with a new one. Our habits are rooted deeply in our subconscious. If we try to just toss one out and figure life out without it as we go, we’re gonna struggle! I recommend finding a new, healthier habit to put in the place of the old habit. Drinking 2 extra bottles of water. Establishing a new nighttime routine that includes stretching or mediation. A 7-minute desk movement detox every 2 hours of sitting down at work. 


So now we’ve removed something less healthy and replaced the habit with something more healthy. Sounds like a win to me! However, habit changes are not always going to be easy. You will not change your habits completely overnight.

I do not expect 7/7 perfection when it comes to daily habit changes each week with my clients, and you should not expect that for yourself. There will be days that are less than your new ideal, but those moments are when you have to stay strong and make up your mind to get back at it tomorrow! You have not fallen off the path but merely hit a speed bump. Don’t let that knock you out of the race to having a healthy lifestyle.

Know that your healthy habits should also adapt over your lifetime, particularly as your health and wellness goals change. As your daily routine changes, so should your habits. Each time you find yourself encountering a change or needing to hit a reset, go back to step 1 and look at what you want to change. You will continue to grow into the healthiest version of yourself each time you revisit that step. 

If you need help adapting to some tricky situations like post-pregnancy, menopause, or during a time in your life where you find yourself mostly sedentary during the day, please reach out. I love helping clients use habit changes to reach their goals, and create a good foundation beyond our time with each other. Together we can overcome some temporary speed bumps and get you right back on the road to success.

Kathryn Terry, MS, CPT, PN 1

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A Detox or Small Steps? A Faster Path to Change

A Detox or Small Steps? A Faster Path to Change

I truly love my job. I work with a wide range of clients that vary from anyone learning the basics of the hand portion guide and applying that to habit change, as well as the high-level athlete who needs help fueling optimally around training and competition. 

If you’ve been wondering if you could benefit from working with a nutritionist, my humble answer is “absolutely”. We may all be at different places in our health journey, but each individual could use tweaks or changes, and the occasional refocus in their diet. (I’m right there with you!)

We are constantly hearing of the success so-and-so had on x crash diet or feeling the need to turn back to the old diet that worked for us once upon a time, even though it’s like the bad ex-boyfriend that we know will give us results that won’t last, but for some reason, we keep going back. 

So why waste your time with the old tricks? The miserable detoxes? Listening to the latest social media influencer who has a 6-pack so is obviously educated to give advice? Do you really think you will find the healthiest version of yourself at the end of those rainbows? 

I want to emphasize how sometimes small steps can lead to faster and greater change.

Define what you are looking for

What does the change mean to you? Is it weight loss? Is it greater mental health, or joint longevity? Once your end goal is defined, only then should you pick a route to get there.

I don’t recommend starting some plan just because so-and-so also saw results with it. What were their results? Were those results the same as what you are looking for? Think about reasons why that plan may have worked for them, and why it may or may not work for you.

Crash diets and detoxes are so specific, which I think people crave; however, these specifics/ rules are the main reasons they aren’t sustainable, and ultimately why people fail to maintain their health following their termination.

I have so many clients who request a strict road map when they come in on day one. They say if you tell me exactly what to do, I will do it. But then weeks down the line life changes. And if I gave them a strict road map that doesn’t include “if this, then” statements, that makes it awfully hard for them to succeed. 

As a nutritionist, I believe one of my key roles is to help my clients adapt along with their goals. I provide accountability, but also the ability to make adjustments in their habit change path as we go. 

Building Blocks

Instead of giving my clients new habits after new habits to master every time we meet, sometimes a session calls for a tweak of the habit change in progress. Not every new change is a seamless transition into daily life.

I don’t focus necessarily on breaking “bad” or old habits, but rather building on the foundation that already exists. I aim to use your current routines to your advantage in the process of forming a new habit. By building a new behavior on top of a routine or habit that already existed, the prompt to do a new task is already there. I will help plan out personal ability, or the best way to get the task done from there.

I ask my clients: Is this an easy or a hard task for you to accomplish? If this is an easy task- then motivation doesn’t need to be too high to get it done. However, the harder the task, the more motivation, and commitment I know I need from my client. 

For example, Bob wants to incorporate more cardio in his workout routine and tries to start running after work. The habit doesn’t stick because sometimes when he gets home it is too dark outside and cold this time of year, so he puts the habit off. Instead of putting the habit off, Bob just needs to strategize. 

Firstly, he has the ability to exercise when he arrives home from work because he has time available. However, he does not always have the ability to run outside as he planned. So to most efficiently reach his goal, we also need to access his motivation and make an “if this, then” statement. Bob has been highly motivated to lose weight by his daughter’s wedding in July, so we need to return his focus back there. 

My statement for Bob would be “If I arrive home from work too late to run outside, I will then complete an indoor cardiovascular workout of at least 30 minutes to hit my daily goal.”

The strategizing I just used is based on Dr. BJ Fogg’s Behavior Model, and if you are interested in learning more, you can check it out here. The model has truly helped me and my clients predict potential road bumps, create useful “if this, then” statements, and adapt as we turn tasks into successful habits.

What’s the first step?

So if I’ve got you really contemplating small steps versus a big detox or fad diet, what is the first of these small steps? Well, as I said earlier, it depends on what you are looking for. Pick your end goal. Then work backward, filling in with the building blocks in between. 

If you want help designing personal building blocks for you, please reach out to me. I would love to meet with you, in person or virtually. If you aren’t quite ready for a consultation, call the office and I would be more than happy to answer any questions you may have. 

I do hope my passion for helping my clients create lasting changes is evident here. I would love to help you too. 

Kathryn Terry, MS, CPT, PN 1

Need Help With Proper Nutrition?

We are here to get and keep you healthy. We treat the whole person with affordable, accessible Primary Care, Nutrition, and Fitness guidance. 

How To Keep Your New Year’s Resolution

How To Keep Your New Year’s Resolution

STOP setting your inevitably failing New Year’s resolutions. This year instead, refocus on your why. Take a step back. Think about your long term goals and dreams. (Yes, we are going to get deep.)

Depending on your stage of life, your goals and dreams may look different from many others reading this article. However, at one point or another, we have all taken advantage of the “new year/new me mindset” and have made an effort to achieve a resolution. 

Instead of getting caught up in the resolution mindset of “this is the year I will finally resolve to ‘lose the weight’ or ‘prioritize my sleep,’” let us get more specific by first looking at the big picture. 

Going back to my original thought, what are your goals and dreams? Do you want to have more energy in the office? Retire soon and travel the world? Be able to play on the floor with your grandkids one day? Finally, get rid of that pesky acne? Come off some of your prescription medications? 

Whatever those goals and dreams are, let us now focus on the short term path to reaching those bigger, usually time-consuming goals and far off dreams. 

It is time for us to talk about how. 

Quality and Hopefully, Quantity

You have control over the quality of the life you lead. What you put in your body and how much you move it has been two proven factors time and time again that have the potential to degrade your quality of life. But only if you let it. 

I’m here to remind you that the power is in your hands to choose. The ball is in your court, my friend. Yes, there are environmental factors that make prioritizing more difficult for some versus others, but we all have the power to make an effort, or not. 

Now that you have picked your long term goal or dream to work toward, let’s now create a smaller goal to help you get there. Being as specific as possible here is important. Pick a habit to improve the quantity or quality of that will help you reach your long term goal. 

You can use a SMART goal, if you’d like, to help form your new habit. However, what we are starting here is beyond the SMART goal. In fact, to reach your long-term goal you will most likely need to use several SMART or specific short-term goals. 

Where Do Most New Year’s Resolutions Fail?

I have found through my personal experience, as well as in 5 plus years working with clients, that resolutions are either not specific enough or not long term minded. If we don’t specify with “if this, then that” statements when creating resolutions, we are more likely to crumble under pressure. 

Also, creating something too short term like lose weight before spring break or get my new certification before summer, will come and go with the end date. 

Rather I suggest we create these long-term goals such as “work toward becoming the healthiest version of myself this year.” Short term goals included that we will make more specific are: increase my stretching routine, improve the quality of the vegetables I use in my cooking, and limit my Netflix before bed. Then by setting an amount of time dedicated to reaching that small goal, writing “if this, then” statements, making sure they are realistic, and creating specific ways to measure your progress will all lead you to success. 

The short-term goal list can then continue to build off of each goal, which is exactly what we want. 

No more are the resolutions set to crumble under pressure or be half-satisfied when the deadline approaches and you don’t know how to adapt or did not set further long term goals. 

We can’t accomplish these bigger, long term goals and dreams without using the smaller ones as stepping stones to get us there. Changing habits is one way I help my clients reach their long-term goals. Focus on quality and quantity to start, and let your journey build from there. 

Kathryn Terry, MS, CPT, PN 1

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We are here to get and keep you healthy. We treat the whole person with affordable, accessible Primary Care, Nutrition, and Fitness guidance. 

What You Need to Know About Micronutrients

What You Need to Know About Micronutrients

Ready to talk about another healthy eating strategy that isn’t dieting? ME TOO. Especially with 2021 quickly approaching, and the phrase “I’ll worry about my weight in the new year” already circulating this holiday season. Today I’m going to dive into a topic that is not often a number one priority when I start working with a new client but is important to be aware of and shouldn’t be overlooked. That is micronutrients. 

What are Micronutrients?

Micronutrients are vitamins, minerals, and other compounds such as phytonutrients that we need in appropriate amounts for normal metabolic and physiological processes. If we don’t get enough we won’t function properly and can get sick.

Yes, traditionally we put more emphasis on overall calories and macronutrients (carbs, fats, and proteins), however, some diets and programs focus more on how much than the actual what. When my husband talks to people about nutrition (he obviously became an expert immediately when I became a nutritionist) he shares the Twinkie example. Yes, you could follow the Twinkie diet and use those as your daily needed carbs, most of your calories, and still potentially lose weight- if that was literally all you ate. But, think about what you would be depriving your body of if that’s how you chose to fuel yourself regularly. That’s right, micronutrients.

Deficiency symptoms from missing vitamins in your diet like Vitamin A, E, and B12, can contribute to nagging, chronic health problems. It is time to think about the big picture and use the mindset that not only is food fuel, but also preventative medicine.

Why is it called a Vitamin?

The word vitamin originally comes from the Latin root “vita” or “life.” For the human body, vitamins participate in metabolic processes of growth, digestion, repair, energy transfer, nervous system function, and immunity. An important point to note is that we need them in our diet because we can’t make most vitamins ourselves.

When it comes to digestion and absorption of these nutrients, we categorize Vitamins and minerals as either fat-soluble or water-soluble. These water-soluble micronutrients are passively and actively absorbed in the GI tract (why gut health is so important) and are less likely to be stored because we are constantly taking in and excreting water. For this reason, we need to get these more often. Examples include B vitamins and vitamin C.

Fat-soluble vitamins are mostly passively absorbed in the GI tract and as expected by their name, they travel in the body bound to dietary fat. Meaning, if we don’t eat enough dietary fat, we may not effectively absorb, transport, or use these key vitamins appropriately. Healthy fats have slowly been making a comeback since the Fat-Free craze started back in the 1950s, and we have learned the necessity of them in our diet. Examples of these vitamins include A,D, E, and K.

How can I improve my diet by focusing on Micronutrients?

First off I do want to acknowledge that not every person needs the same micronutrients in the same amounts. There are numerous factors that influence personal vitamin need including biological sex, age, medications, stress, food choices, energy intake, activity levels, and illness or injury. Even beyond that, special considerations need to be kept in mind for plant-based diets, athletes, specific medications, disordered eating, and malabsorption syndromes.

Below I will provide some general recommendations that will benefit a majority of our population. Yes, in an ideal world we get all of our nutrients from the food we eat. However, I believe it is fair to say a majority of us do not achieve our ideal vitamin intake each day on our own. Because of this, we have created a nutritional gap between nutrients consumed in the diet vs nutrients required for optimal health. 

There are numerous reasons behind the nutrient gap: not enough fruits and veggies in the diet, lack of a high-quality multivitamin, digestion issues, and fewer micronutrients available in the soil these days (since farming the same food in the same spots can decrease vitamin availability.)

If we look at these reasons as areas of opportunity and focus on what we can control personally, we will be more likely to succeed. So what do we do with these areas of opportunity? I recommend a change in our dietary focus regarding micronutrients to then drive improvements in everyday health.

Let’s fill in the gaps

Now that we know where our areas of opportunity lie, how can we change our current dietary focus to a healthier one?

Depending on your schedule, foods you typically eat, the number of meals eaten per day, fruits and veggies may not have been your main focus when it comes to nutrition. And now, I’m going to tell you why they should be.

The CDC recommends 1.5- 2 cups of fruit per day and at least 3 cups of vegetables. I don’t feel like that’s asking much honestly, but sadly as of research they conducted in 2017, only 1/10 Americans actually hit both of those totals. That blew my mind.

How do we improve on that? Are more veggies straws and dried apple chips the answer? Sorry but no. More whole food options of fruits and vegetables in the diet is the best place to begin. With my nutrition clients, I try to first focus on adding in more of the good, before necessarily removing the bad. Then sometimes the process takes care of itself.


Like I said earlier, ideally, our micronutrients, like our macronutrients, come from the foods we eat. However, it isn’t always enough. Thanks to years of continued research, we know that certain groups of a greater need can especially benefit from a multivitamin. Those populations include teens, athletes, the elderly, chronic disease patients, and those who take any medications putting them at risk for a nutrient deficiency as a side effect.

Now, know that when I say multivitamin I am mentioning something of high quality. When it comes to effective mineral digestion and absorption the most effective type of supplementary “vitamin” proves to be in capsule form. Not a tablet, and definitely not a gummy. Sorry gummy lovers, but you simply can’t digest, absorb, and put to good use the nutrients from that tasty chewable.

So, how do you know who to trust? I’ll be honest when I say the Costco brand is not always the best option. My number one rule when it comes to supplementation is to make sure the product is 3rd party tested. In the supplement industry, anything from vitamins to protein powders are not regulated by the FDA. This means some cheap companies, and even those you wouldn’t expect can sneak different fillers and ingredients into the product without putting them on the label.

I don’t know how you feel about that, but let’s be honest if I plan to take something every day to supplement my nutritional gap, you best believe I want to know 100% what’s in it.

 So, who do you trust?

One company I have used for over four years now is Thorne. I’ll link our product dispensary here so anyone interested can check it out. I have flagged my favorite products and scientific articles that compile some of the latest research in the industry. They boast 3rd party testing by the National Sports Foundation, which drug tests every professional and college athlete in America for banned substances. If they say my product is clean I definitely trust them.

The supplement industry can be overwhelming and remember my note earlier, your attempts to supplement your nutrition gap are personal to you. Please don’t hesitate to reach out to me with any questions on what options may be best for you and your family.

I do hope that this post inspires you to change your personal fueling strategies, and make addressing your nutritional gap a priority. Optimal vitamin intake specifically will help you boost your health in terms of metabolic growth, digestion, cellular repair, energy transfer, nervous system function, and arguably most importantly right now, immunity.


Kathryn Terry, MS, CPT, PN 1

Need Help With Proper Nutrition?

We are here to get and keep you healthy. We treat the whole person with affordable, accessible Primary Care, Nutrition, and Fitness guidance. 

5 Healthy Habits the Nutritionist is Doing this Holiday Season

5 Healthy Habits the Nutritionist is Doing this Holiday Season

Last week our Office Manager Eileen and our Nutritionist, Kathryn Terry, had a great conversation about health during the holidays. Eileen thought some of Kathryn’s points were important enough to be shared and asked Kathryn to write about 5 habits of her normal routine that she sees as essential for her health, especially during the holiday season. Here is Kathryn’s top 5 below.

1) Sleep

Sleep pops in my mind first because if I do fall short in one of these categories when my schedule is busier, it is sleep. I have learned in more recent years that I have to make it a number one priority as it is my body’s main time to restore and recover from the chaos and stress around me. More stress on the body= more sleep needed. Give yourself an absolute time on both ends of your sleep cycle. An absolute “no later to bed than” and a “will not sleep later than.” Strict bedtime boundaries are important to set when the to-do lists are long as they make us prioritize what has to get done immediately vs what can get done tomorrow, fostering healthy tasking relationship development at the same time. 

A smaller wake-up window is crucial as well. Your body has a specific time for its needed cortisol pop, or “natural delivery of caffeine” in the morning to wake you up. Waking up way before or way after this natural pop often can confuse your body and lead to a decrease in the strength of the initial pop we desire to wake us up. This pop can be crucial to energy supply in the early morning especially and will keep us from walking to the coffee machine like a zombie on repeat. 

2) Stress Outlet

You may initially laugh when I say, “when you are busy, make sure to make time for you too”, but this mindset is important now more than ever. Remember the phrase your grandma said, “Fill your cup up so it can overflow into others”? I believe this to my core and have seen great benefit in finding just a few minutes to dedicate toward restoration and recovery for not only the body and the soul. Bonus points if you enjoy both at the same time. For me, a long run is a good mental fix, and even better if I can talk with a friend along the way. Find something small daily that makes your shoulders relax from your ears, brings a smile to your face, and maybe even a laugh to your lips.

3) Planning Ahead For Meals

My husband makes fun of me sometimes to the extent I plan ahead, but I find great reward in these strategies, especially during the holidays. Whether you are out shopping, running extra holiday errands, or simply stuck in traffic for longer than normal, having some on-the-go snacks in the glove box, purse, diaper bag (but for you, not the baby) fanny pack (I don’t judge here),  can prevent you from making a quick food, instant gratifying decision, you might regret just 10 minutes later.

Planning ahead for food also includes your trips to the grocery store. I do this by printing out a weekly calendar figuring out roughly what meals we want to have each night, and then I make sure my grocery list matches. This helps cut down on our contact with other people in the grocery store and allows you to maximize your time during this specifically chaotic season. Did I mention this will help save money too? I think we can all benefit from that during the holidays…

4) Continuous Learning

Despite a hectic schedule making time to read and educate yourself on topics of interest can keep your mind sharp. Whether you are keeping up with a medical news outlet, slowly pursuing a new certification, or are reading a new post from a certified healthcare professional, just a few minutes a day to continue expanding your knowledge on a subject of your interest will not only expand your knowledge on the subject, but give you the accomplished feeling that learning something new can provide. (And you didn’t have to even get up for this one!)

5) Water

Water intake is one of my first discussion points with all of my nutrition clients, as well as my family and friends when they ask how to optimize their nutrition habits because it is THAT important. The biggest impact water can make during your holiday season (besides keeping you hydrated for normal functions) is aiding in your digestion. Continual water drinking, especially after a meal can aid in nutrient breakdown and transport of nutrients to the rest of your body. The general recommendation is ½ your body weight in ounces per day.

Kathryn Terry, MS, CPT, PN 1

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