Novelties in the world of dietary supplements: innovative health solutions

Chapter 1: Revolution in the world of dietary supplements: on the verge of a new era of healing

1.1. From traditions to innovation: Evolution of the Dad Industry

The industry of biologically active additives (BAD) has come a long and difficult path from simple herbal infusions to high -tech products developed on the basis of advanced scientific research. Initially, dietary supplements were perceived as an addition to traditional medicine, based on knowledge of traditional medicine and herbal medicine. However, with the development of biochemistry, molecular biology and other related disciplines, the approach to the development and use of dietary supplements has changed dramatically.

Today, we are observing the transition from empirical methods to scientifically sound developments. Modern dietary supplements are not just a mixture of plant extracts or vitamins, but carefully designed complexes aimed at specific mechanisms of effects on the body. This transition is due to a number of factors:

  • A growing understanding of human physiology: A deep understanding of the biochemical processes occurring in the body allows you to create dietary supplements that effectively affect metabolism, immunity, hormonal balance and other important systems.
  • Technology development: Modern technologies of extraction, encapsulation, delivery, and other innovative methods allow you to create dietary supplements with increased bioavailability, improved organoleptic properties and prolonged effects.
  • Strict quality and safety requirements: Regulatory authorities in many countries of the world tighten the requirements for the production and sale of dietary supplements, which helps to improve product quality and reduce the risk of side effects.
  • Consumer’s growing interest in a healthy lifestyle: In modern society, there is an increased interest in the prevention of diseases and maintaining health. Bades become an important part of a healthy lifestyle strategy, along with proper nutrition, physical activity and sufficient sleep.

1.2. Key trends and directions of development of the dal

The modern dietary supplement market is characterized by dynamic development and the emergence of new products developed on the basis of advanced scientific research and innovative technologies. Among the most significant trends and areas of development, the following can be distinguished:

  • Personalized nutrition and nutrigenetics: An individual approach to nutrition and the selection of dietary supplements is becoming more and more popular. Nutrigenetics, which studies the influence of genetic factors on the metabolism of nutrients, allows you to develop personalized recommendations for nutrition and intake of dietary supplements, taking into account the individual characteristics of the body. Genetic tests make it possible to identify a predisposition to certain diseases, determine the optimal dosage of vitamins and minerals, as well as evaluate the effectiveness of various diets and dietary supplements.
  • Probiotics and prebiotics of a new generation: The study of a human microbioma opens up new opportunities for maintaining health. Probiotics and prebiotics play an important role in maintaining the balance of intestinal microflora, improving digestion, strengthening immunity and reducing the risk of developing various diseases. New strains of probiotics with improved characteristics appear, as well as prebiotics, selectively stimulating the growth of beneficial bacteria in the intestines. Particular attention is paid to the development of Sinbiotics – combinations of probiotics and prebiotics with a synergistic effect.
  • Adaptogens and nootropics to increase stress resistance and improve cognitive functions: In the modern world, characterized by a high level of stress and information overload, adaptogens and nootropics are becoming increasingly popular. Adaptogens help the body adapt to stress, increase resistance to adverse environmental factors, and improve physical and mental performance. Nootropics improve cognitive functions, such as memory, attention, concentration and learning. Various plant extracts, amino acids, vitamins and other substances are used as adaptogens and nootropes.
  • Liposomal technologies and other innovative delivery systems: Bioavailability is one of the key factors that determine the effectiveness of the dietary supplement. Liposomal technologies and other innovative delivery systems can increase the bioavailability of active ingredients, protect them from destruction in the gastrointestinal tract and deliver directly to target cells. Liposomes are microscopic vesicles consisting of phospholipids that surround the active substance and ensure its effective delivery. Other delivery systems are also developed, such as nanoparticles, microcapsules and transdermal plasters.
  • Plant extracts and phytocomplexes with proven effectiveness: Plant extracts and phytocomplexes continue to be an important part of the database market. However, modern manufacturers pay special attention to the standardization of extracts, ensuring the high quality of raw materials and conducting clinical studies to confirm the efficiency and safety of plant drugs. Innovative extraction methods are used to obtain the most concentrated and pure extracts. Complex phytocomplexes are developed containing several plant extracts that have a synergistic effect.
  • Bades to maintain health of the cardiovascular system: Cardiovascular diseases are one of the main causes of mortality around the world. Therefore, dietary supplements to maintain health of the cardiovascular system are in high demand. This category includes drugs containing omega-3 fatty acids, Q10 coenzyme, B vitamins, antioxidants and other substances that help reduce cholesterol, improve blood circulation, strengthen blood vessels and prevent blood clots.
  • Bades to maintain the health of joints and bones: Diseases of joints and bones are a common problem, especially among the elderly. Bades to maintain the health of joints and bones contain glucosamine, chondroitin, collagen, hyaluronic acid, vitamin D, calcium and other substances that help strengthen the bones, restore cartilage, reduce inflammation and improve joint mobility.
  • Bades to maintain the health of the eyes: Vision is one of the most important senses. Bades to maintain the health of the eyes contain lutein, zeaxantin, vitamin A, vitamin C, vitamin E, zinc and other substances that help protect the eyes from the harmful effects of free radicals, improve vision and prevent the development of age -related eyes, such as cataracts and degeneration of the yellow spot.
  • Bades to improve sleep and fight insomnia: Snown problems are a common problem in modern society. Bades to improve sleep and fight insomnia contain melatonin, valerian, chamomile, lavender and other substances that help relax, reduce anxiety and improve sleep quality.
  • Bades to maintain the health of the skin, hair and nails: The beauty and health of the skin, hair and nails are important for many people. Bades to maintain the health of the skin, hair and nails contain collagen, biotin, zinc, selenium, vitamin C, vitamin E and other substances that help improve skin elasticity, strengthen hair and nails, reduce inflammation and protect the skin from the harmful effects of the environment.

1.3. Regulatory aspects and quality requirements

The regulation of the market of the Dad varies depending on the country. In most countries, dietary supplements are not subject to the same strict test as drugs. However, regulatory authorities establish certain requirements for the quality, safety and labeling of dietary supplements.

In Russia, the regulation of dietary supplements is carried out by the Federal Service for Supervision of the Protection of Consumer Rights and Human Welfare (Rospotrebnadzor). To issue a dietary supplement, it is necessary to receive a certificate of state registration (SGR). The SCR confirms the compliance of the products with the requirements of the security established by the technical regulations of the Customs Union.

Dad manufacturers are required:

  • Follow the requirements for the production, storage and transportation of dietary supplements.
  • Ensure safety and product quality.
  • Provide reliable information about the composition, properties and method of use of dietary supplements.
  • Mark the products in accordance with the requirements of the law.

In recent years, regulatory authorities pay more and more attention to control over the quality and safety of dietary supplements. Manufacturers are conducted, product samples are selected for laboratory tests, falsified and low -quality dietary supplements are detected. Increasing the requirements for the quality and safety of dietary supplements contributes to the formation of consumer trust in this category of products.

Chapter 2: Innovative ingredients and their use in dietary supplements

2.1. Peptides: Revolution in rejuvenation and restoration

Peptides are short chains of amino acids connected by peptide bonds. They play an important role in the regulation of many physiological processes in the body, such as growth, development, immunity, metabolism and tissue regeneration. In recent years, peptides began to be actively used in dietary supplements due to their potential benefits for health and rejuvenation.

The mechanisms of the action of peptides are diverse. Some peptides act as hormones, regulating the activity of certain cells and tissues. Other peptides are antioxidants, protecting the cells from damage to free radicals. Third peptides stimulate the production of collagen, elastin and hyaluronic acid, improving the condition of the skin, hair and joints.

In dietary supplements, various types of peptides obtained from different sources are used. The most common are:

  • Collagen peptides: Collagen is the main structural protein of the skin, bones, cartilage and tendons. Collagen peptides help strengthen the bones, restore cartilage tissue, improve skin elasticity and reduce wrinkles.
  • Elastin peptides: Elastin is another important structural skin protein that ensures its elasticity and elasticity. Elastin peptides help improve skin elasticity and reduce sagging.
  • Hyaluronic acid peptides: Hyaluronic acid is an important component of the skin that moisturizes and holds moisture. Peptides of hyaluronic acid help to improve skin moisture and reduce wrinkles.
  • Carnosine peptides: Carnosine is a dipeptide consisting of amino acids Alanin and Phydin. It has antioxidant and anti -glycation properties, protecting the cells from damage to free radicals and glycing. Carnosine also improves muscle function and endurance.
  • Peptides of the epiphyse: Epiphyse is a gland located in the brain that produces melatonin. Epiphyse peptides help regulate circidous rhythms, improve sleep and increase stress resistance.
  • Timus peptides: Timus is a gland located in the chest, which plays an important role in the immune system. Timus peptides help strengthen immunity and increase resistance to infections.

Clinical studies have shown that peptides can have a positive effect on health. For example, collagen peptides can help reduce joint pain, improve skin elasticity and strengthen the bones. Carnosine peptides can help improve muscle function and endurance. Epiphyse peptides can help improve sleep and increase stress resistance.

Despite the promising research results, additional clinical studies must be carried out to confirm the effectiveness and safety of peptides in dietary supplements. It is also important to consider the individual characteristics of the body and consult a doctor before taking peptides.

2.2. Postbiotics: new era in support of microbioma

Postbiotics are a relatively new class of biologically active substances that are formed in the process of fermentation by probiotics in the intestines. Unlike probiotics (living microorganisms) and prebiotics (food for probiotics), postbiotics are inanimate product of probiotics, such as organic acids (milk, acetic, propionic, butyrate), bacterial lizats, peptidoglycans, polysaccharides and vitamins.

Postbiotics have a wide range of positive effects on health, including:

  • Improving digestion: Postbiotics help improve digestion, reduce bloating and constipation. They can also help improve the absorption of nutrients.
  • Strengthening immunity: Postbiotics strengthen immunity, increase resistance to infections and reduce inflammation. They can also help reduce the risk of allergic reactions.
  • Protection of the intestinal barrier: Postbiotics strengthen the intestinal barrier, preventing the penetration of harmful substances from the intestines into the blood. They can also help reduce the risk of developing high intestinal permeability syndrome.
  • Support for health of the cardiovascular system: Postbiotics can help reduce cholesterol, improve blood circulation and prevent blood clots.
  • Brain health support: Postbiotics can help improve cognitive functions, reduce anxiety and depression.

One of the most studied postbiotics is butyrate. Butyrate is short -chain fatty acid, which is formed in the intestines during fermentation of the dietary fiber with probiotics. Butyrate is the main source of energy for intestinal cells and plays an important role in maintaining the health of the intestinal barrier. It also has anti -inflammatory properties and can help reduce the risk of developing colon cancer.

In dietary supplements, various types of postbiotics are used, including:

  • Bottyra: Butyrate is used to maintain intestinal health, improve digestion and strengthen immunity.
  • Bacterial lizata: Bacterial lizats are destroyed probiotics cells. They contain various biologically active substances that have a positive effect on health.
  • Organic acids: Organic acids, such as lactic, acetic and propionic acids, help improve digestion and suppress the growth of harmful bacteria in the intestines.

Postbiotics are a promising direction in the development of dietary supplements to maintain the health of a microbioma. They have a number of advantages compared to probiotics and prebiotics, including:

  • More stable and resistant to environmental effects: Postbiotics are not living organisms, so they are more stable and resistant to temperature, humidity and acidity of gastric juice.
  • Do not require intestinal colonization: Postbiotics do not need colonization of the intestines to have their effect. They have their effect directly in the lumen of the intestines.
  • Suitable for people with weakened immunity: Postbiotics are suitable for people with weakened immunity, which can be sensitive to probiotics.

Despite the promising research results, additional clinical studies must be carried out to confirm the effectiveness and safety of postbiotics in dietary supplements. It is also important to consider the individual characteristics of the body and consult a doctor before taking postbiotics.

2.3. Exosomas: Nano-bonnels of health and youth

Exosomas are microscopic vesiculas secreted by cells of various types. They contain various biologically active substances, such as proteins, nucleic acids (MRNA, microrm) and lipids. Exosomas play an important role in intercellular communication, transmitting information from one cell to another.

In recent years, exosms have begun to be actively studied in the context of regenerative medicine and cosmetology. They have the potential for the delivery of drugs and other biologically active substances directly to target cells.

The mechanisms of the action of exosos are diverse. They can:

  • Transmit genetic information: Exosomas can transmit MRNA and microrm from one cell to another, changing the expression of genes in a reicipient cell.
  • Deliver proteins: Exosomas can deliver proteins from one cell to another, changing the function of the recipient cell.
  • Stimulate tissue regeneration: Exosomas can stimulate tissue regeneration, contributing to the growth and differentiation of cells.
  • Reduce inflammation: Exosomas can reduce inflammation, suppressing the activity of inflammatory cells.

In dietary supplements, exosomes are used mainly as a delivery system for other biologically active substances, such as peptides, vitamins, antioxidants and plant extracts. Exosomes provide more efficient delivery of active ingredients to target cells, increasing their bioavailability and effectiveness.

Advantages of using exosos in dietary supplements:

  • Increased bioavailability: Exosomas protect active ingredients from destruction in the gastrointestinal tract and provide their effective delivery to target cells.
  • Target Delivery: Exosomas can be modified for the delivery of active ingredients to certain types of cells or tissues.
  • Improved effectiveness: Exosomas can increase the effectiveness of active ingredients due to their more effective delivery and action at the cellular level.
  • Minimum side effects: Exosomas are the natural components of the body, so they are usually well tolerated and do not cause serious side effects.

Clinical studies have shown that exosome can have a positive effect on health. For example, exosms obtained from stem cells can help improve tissue regeneration, reduce inflammation and improve the condition of the skin.

Despite promising research results, additional clinical studies must be carried out to confirm the effectiveness and safety of exosos in dietary supplements. It is also important to take into account the individual characteristics of the body and consult a doctor before taking dietary supplements containing exosome.

Exosive production for dietary supplements is a complex and expensive process. It is necessary to ensure high quality and purity with exosos, as well as confirm their safety and effectiveness.

2.4. Vegetable stem cells: the strength of nature for renewal

Plant stem cells have a unique ability to self -renew and differentiation to various types of cells. They contain a large number of biologically active substances, such as antioxidants, vitamins, minerals and phytonutrients.

In recent years, plant stem cells have begun to be actively used in cosmetology and dietary supplements due to their potential benefits for health and rejuvenation.

The mechanisms of the action of plant stem cells are diverse. They can:

  • Stimulate tissue regeneration: Plant stem cells stimulate tissue regeneration, contributing to the growth and differentiation of cells.
  • Protect cells from damage: Plant stem cells contain a large amount of antioxidants that protect the cells from damage to free radicals.
  • Improve skin condition: Plant stem cells improve the condition of the skin, increasing its elasticity, moisture and elasticity.
  • Reduce inflammation: Plant stem cells reduce inflammation, suppressing the activity of inflammatory cells.

In dietary supplements, various types of plant stem cells obtained from different plants are used. The most common are:

  • Stem cells of apple tree: The stem cells of the apple tree contain a large number of antioxidants and stimulate tissue regeneration.
  • Grapes stem cells: Stem cells of grapes protect cells from damage to free radicals and improve the condition of the skin.
  • Argan stem cells: Argan stem cells stimulate the production of collagen and elastin, increasing the elasticity and elasticity of the skin.
  • Edelweiss stem cells: Edelweiss stem cells reduce inflammation and protect the skin from the harmful effects of the environment.

Clinical studies have shown that plant stem cells can have a positive effect on health. For example, stem cells of apple tree can help improve the condition of the skin and reduce wrinkles.

Despite the promising research results, it is necessary to conduct additional clinical studies to confirm the efficiency and safety of plant stem cells in dietary supplements. It is also important to consider the individual characteristics of the body and consult a doctor before taking dietary supplements containing plant stem cells.

The production of plant stem cells for dietary supplements is a complex and expensive process. It is necessary to ensure the high quality and purity of stem cells, as well as confirm their safety and efficiency.

Chapter 3: Technologies of the future in the production of dietary supplements

3.1. Micro inkapsulation: protection and targeted delivery

Micro inkapsulation is a technology that allows you to enclose active ingredients in microscopic capsules. These capsules protect the ingredients from environmental exposure (oxygen, moisture, light, temperature), and also allow you to control their release in the body.

The advantages of micro -icapsulation in the production of dietary supplements:

  • Destruction Protection: Microcapsules protect active ingredients from destruction in the gastrointestinal tract, increasing their bioavailability.
  • Controlled release: Microcapsules make it possible to control the release of active ingredients, ensuring the prolonged effect of dietary supplements.
  • Masks of taste and smell: Microcapsules can mask the unpleasant taste and smell of active ingredients, improving the organoleptic properties of dietary supplements.
  • Target Delivery: Microcapsules can be developed for targeted delivery of active ingredients to certain areas of the gastrointestinal tract or body tissue.
  • Increased stability: Microinapsulation increases the stability of active ingredients, increasing dietary supplements.

Different methods of micro incapsulation are used in the production of dietary supplements, including:

  • Spraying drying: A solution of active ingredient is sprayed in a stream of hot air, forming microcapsules.
  • Coacery: An active ingredient is the polymer shell by coating.
  • Liposomal encapsulation: Active ingredient consists in liposomes – microscopic vesicles consisting of phospholipids.
  • Extrust: A solution of the active ingredient is pressed through microscopic holes, forming microcapsules.

Microinapsulation is widely used to encapsulate various active ingredients, such as vitamins, minerals, probiotics, plant extracts and oils.

3.2. Nanotechnology: accuracy and effectiveness at the cellular level

Nanotechnologies are technologies working with materials and structures on a nanometer scale (1 nanometer = 1 billionth of a meter). In the production of dietary supplements, nanotechnology is used to create nanoparticles, nanocapsul and other nanomaterials that can improve the delivery and bioavailability of active ingredients.

Advantages of nanotechnologies in the production of dietary supplements:

  • Increased bioavailability: Nanoparticles have a small size, which allows them to easily penetrate through cell membranes and increase the bioavailability of active ingredients.
  • Target Delivery: Nanoparticles can be modified for targeted delivery of active ingredients to certain cells or tissues of the body.
  • Prolonged action: Nanoparticles can provide a prolonged release of active ingredients, increasing the duration of the dietary supplement.
  • Improved solubility: Nanoparticles can improve the solubility of poorly soluble active ingredients, increasing their bioavailability.

Different types of nanomaterials are used in the production of dietary supplements, including:

  • Nanoparticles: Nanoparticles can be made of various materials such as lipids, polymers, metals and ceramics.
  • Nanocapsules: Nanocapsules consist of a shell inside which there is an active ingredient.
  • Nanemulsion: The nanemulsions are oil dispersions in water or water in oil, stabilized by surface-active substances.

Nanotechnologies are used to deliver various active ingredients, such as vitamins, minerals, antioxidants, drugs and genetic material.

Despite promising prospects, it is necessary to carefully study the safety of nanomaterials before using them in dietary supplements. Some nanoparticles can have a toxic effect on the cells of the body.

3.3. 3D printing: personalization and flexibility of production

3D-pricing, also known as additive production, is a technology that allows you to create three-dimensional objects from digital models by sequentially applying layers of the material. In the manufacture of 3D-pricing dietary supplements, it can be used to create personalized dietary supplements, tablets with controlled release and other innovative products.

Advantages of 3D printing in the production of dietary supplements:

  • Personalization: 3D-packet allows you to create dietary supplements adapted to the individual needs of each person, taking into account his genetic characteristics, lifestyle and health status.
  • Flexibility of production: 3D printing allows you to quickly and easily change the shape, size and composition of the dietary supplement, adapting it to various requirements.
  • Controlled release: 3D-packet allows you to create tablets with a controlled release of active ingredients, providing a prolonged effect of dietary supplements.
  • Complex forms: 3D printing allows you to create dietary supplements of complex forms that cannot be made by traditional methods.
  • Reducing waste: 3D printing allows you to reduce the amount of waste in the production of dietary supplements.

Various 3D printing methods are used in the production of dietary supplements, including:

  • Layer Frontation (FDM): The plastic material melts and applies a layer by a layer, forming a three -dimensional object.
  • Stereolithography (SLA): A liquid photopolymer solidizes under the influence of ultraviolet radiation, a layer by a layer, forming a three -dimensional object.
  • Selective laser sintering (SLS): Powder material sins with a laser, a layer by a layer, forming a three -dimensional object.

3D-printing is used to create various types of dietary supplements, such as tablets, capsules, gels and plasters.

Despite promising prospects, 3D printing in the production of dietary supplements is at the initial stage of development. It is necessary to conduct additional studies to optimize the processes of printing, the development of new materials and confirm the safety and efficiency of 3D-printed dietary supplements.

3.4. Bioretors: Effective production of active ingredients

Bioreactors are devices designed to cultivate cells, tissues or microorganisms in controlled conditions. In the production of dietary supplements, bioreactors are used to produce active ingredients, such as enzymes, proteins, polysaccharides and plant extracts.

Advantages of using bioreactors in the production of dietary supplements:

  • High performance: Bioreactors allow you to get a large number of active ingredients in a short time.
  • Controlled conditions: Bioretors provide strict control over the conditions of cultivation, such as temperature, pH, the concentration of oxygen and nutrients, which allows you to get active ingredients of high quality.
  • Environmental friendliness: Bioreactor production is environmentally friendly and does not require the use of a large number of chemicals.
  • Sustainability: Bioreactor production allows you to get active ingredients regardless of the season and climatic conditions.

Different types of bioreactors are used in the production of dietary supplements, including:

  • Mixed bioreactors: Cells are cultivated in suspension, which is mixed to ensure uniform distribution of nutrients and oxygen.
  • Airlift bioreactors: Mixing is carried out using an air or gas flow.
  • Membrane bioreactors: Members are used to separate cells from the nutrient medium and remove metabolism products.

Bireactors are used for the production of various active ingredients, such as enzymes used in digestive dietary supplements, polysaccharides used in immunomodulating dietary supplements and plant extracts used in antioxidant dietary supplements.

Chapter 4: New horizons in clinical research of dietary supplements

4.1. Design of research oriented on microbia

Traditional clinical studies of dietary supplements often do not take into account the effect of intestinal microbioma on the efficiency and safety of the product. However, given the increasing role of a microbioma in human health, it is extremely important to develop new research designs that would take into account this factor.

The basic principles of the design of research of dietary supplements oriented to microbias:

  • Assessment of the composition of the microbioma: Before starting the study, it is necessary to evaluate the composition of the intestinal microbioma in participants using modern methods of molecular biology, such as security 16S RRNA or metagenomic.
  • Stratification of participants: Research participants should be stratified into groups depending on the composition of their microbioma. This will reveal which groups of microbiomas are most susceptible to dietary supplement.
  • Assessment of microbioma changes: During the study, it is necessary to regularly evaluate changes in the composition of the microbioma under the influence of dietary supplement. This will reveal which bacteria are stimulated or suppressed by dietary supplements.
  • Microbioma metabolites rating: It is necessary to evaluate changes in the composition of metabolites produced by a microbioma under the influence of dietary supplement. This will reveal what metabolic tracks are affected by dietary supplements.
  • CHARACTION OF CHANCES OF THE Microbioma with Clinical Results: It is necessary to establish a correlation between the changes in the composition of the microbioma and the clinical results of the study. This will reveal what changes in microbioma most favorably affect health.

In studies of dietary supplements oriented on microbias, you can use different types of designs, including:

  • Cross -design: The study participants receive first dietary supplements, and then a placebo, or vice versa.
  • Parallel design: Research participants are randomly distributed into groups receiving dietary supplements or placebo.
  • Design with one group: All participants in the study receive dietary supplements, and changes in the composition of the microbioma and clinical results are compared with the initial data.

To evaluate changes in microbioma in dietary supplements, various methods are used, including:

  • Sequinization 16s RRNK: Determination of the composition of the bacterial community based on the sequence of the gene 16s RRNA.
  • Metagenomica: Determination of the genetic potential of the microbioma by sequencing of the entire DNA isolated from the sample.
  • Metabolomics: Determination of the composition of metabolites produced by microbioma.
  • Cultivation: The selection and identification of individual bacterial strains from the sample.

Studies of dietary supplements oriented on microbias allow you to get a more complete idea of ​​the mechanism of dietary supplements and identify which groups of people can get the greatest benefits from its use.

4.2. Using artificial intelligence to analyze clinical research data

Artificial intelligence (AI) is becoming an increasingly important tool for analyzing the data of clinical research of dietary supplements. AI can help identify patterns and relationships in large amounts of data, which are difficult to detect with traditional statistical methods.

Advantages of using AI for analyzing clinical research data:

  • Identification of laws and relationships: AI can reveal complex patterns and relationships between various variables, such as the composition of microbioma, genetic characteristics, lifestyle and clinical results.
  • Prediction of efficiency and safety: AI can be used to predict the effectiveness and safety of dietary supplements based on clinical research data.
  • ** Personalization Therapies

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