Are people getting worse in regards to mental health?

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Everyone needs Ozempic, Vit D, and Caplyta? (APA should create a focus group)
Skip the focus group, let's just talk to pharma, pitch it as a combined formulation (Panbetteral) and retire

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Doesn't have to be but how many parents and kids will voluntarily get rid of the automated baby sitter otherwise known as screen-time, and replace it with a healthy diet, exercise, daily mental exercise.....? Very few.

On a related tangent-about 50% of Americans have a vitamin D deficiency. I don't see 1 physician checking Vitamin D levels other than myself.
Insurance doesn't pay for it outside of a handful of specific diagnoses.
 
Even when vitamin D is low, evidence isn’t really strong that supplementing back into “optimal” range confers much of a benefit, if at all.
Yep. Vitamin D, much like HDL, appears to be a marker of health and not something that improves health when corrected with meds.
 
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No I’m not talking about that I mean why is vitamin D a marker for health when all you need to do to increase it is tan?

Spit balling here without any data off the top of my head: could it be that they are the active sort who go out and catch said sunlight on regular basis and therefore are the healthy ones? It’s probably a useful indicator in so far as it may be correlated with other habits and lifestyle choices.
 
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Skip the focus group, let's just talk to pharma, pitch it as a combined formulation (Panbetteral) and retire

My contribution is make it LAI. I’ll take my 25% royalties for life now.
 
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I'm 50. I remember in the late 80s all these warnings came out about excessive sun exposure but the message wasn't getting a fair amount of sunlight and then protection, but pretty much stay out of the sun period. It was backed by the American Dermatological whatever society or or Academy or whatever group. I remember as a kid people spent outdoors all day long as a cultural norm, and people were much more physically active in the outdoors.

Add to this, about the same time the hole in the ozone was a hot topic making fear of sun exposure more so and people were living longer so cancer awareness was up.

The FDA Vitamin D recommended guidelines haven't changed for decades and while I don't know exactly when they were written they were written long before the late 80s and haven't changed.

But the bottom line is whenever these FDA guidelines were written, people's vitamin D levels were likely, as a society, at different levels. They've never been updated.
 
Perfect, we'll call it the COViD therapy and administer it to the general population...wait...
Or maybe instead of all these meds maybe stop being a fatty, watch what you eat, and walk around the block a few times a day. I know the term fatty is derogatory but seriously I got several patients that don't do anything healthy and expect pills to do everything for them. Wake them up, put them to sleep, make them feel good despite that they refuse to exercise or watch what they eat. Someone come up with a PC term for this type of person like someone who decided that Pseudoseizures was offensive so we'll instead call is P-NES as if that doesn't offend anyone.
 
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Or maybe instead of all these meds maybe stop being a fatty, watch what you eat, and walk around the block a few times a day.
How dare you tell people to actively engage in their own health instead of taking a magic pill to fix them. What's next? Telling them they should look at screens less and actually socialize?
 
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How dare you tell people to actively engage in their own health instead of taking a magic pill to fix them. What's next? Telling them they should look at screens less and actually socialize?
Exactly my point, and then the response ranges from "you're right. I got to take care of myself," to "WTF you're my doctor. I expect pills to do everything for me."

Unfortunately the latter end of the spectrum isn't a rare 1% type of patient. But you bring this up and you get a lot of people getting offended. That's where I'm thinking WTF. "How dare you not enable their unhealthy lifestyle?"
 
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Exactly my point, and then the response ranges from "you're right. I got to take care of myself," to "WTF you're my doctor. I expect pills to do everything for me."

Unfortunately the latter end of the spectrum isn't a rare 1% type of patient. But you bring this up and you get a lot of people getting offended. That's where I'm thinking WTF. "How dare you not enable their unhealthy lifestyle?"

It’s an epidemic. Let’s call it “listening to soma.” Huxleyan
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Add to the above screen-time is also like a drug. Yeah it's not a pill, but the effect of being proverbially glued to a screen and watching it hours a day isn't good for our brains or bodies.

We've become the Brave New World whether we like it or not.
 
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Doesn't have to be but how many parents and kids will voluntarily get rid of the automated baby sitter otherwise known as screen-time, and replace it with a healthy diet, exercise, daily mental exercise.....? Very few.

On a related tangent-about 50% of Americans have a vitamin D deficiency. I don't see 1 physician checking Vitamin D levels other than myself.
I check vit d
 
Or maybe instead of all these meds maybe stop being a fatty, watch what you eat, and walk around the block a few times a day. I know the term fatty is derogatory but seriously I got several patients that don't do anything healthy and expect pills to do everything for them. Wake them up, put them to sleep, make them feel good despite that they refuse to exercise or watch what they eat. Someone come up with a PC term for this type of person like someone who decided that Pseudoseizures was offensive so we'll instead call is P-NES as if that doesn't offend anyone.
Again, my prescription of touching grass would be highly beneficial for this patient population. "But going outside won't fix my weight problem." Oh, it will if you do it enough.
 
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Yes. We've become more immature with poor distress tolerance over the subsequent years and generations.
When your brain is wired to respond to threats and no threats are present, it starts to see threats where there are none, resulting in this constant state of distress in many people whose lives are otherwise perfect. These individuals would contend that they have too much stress in their life (though from an objective perspective these threats would seem minor). In truth, they need more stress that is appropriate to retrain their brain as to what actual threats need to be responded to.
 
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When your brain is wired to respond to threats and no threats are present, it starts to see threats where there are none, resulting in this constant state of distress in many people whose lives are otherwise perfect. These individuals would contend that they have too much stress in their life (though from an objective perspective these threats would seem minor). In truth, they need more stress that is appropriate to retrain their brain as to what actual threats need to be responded to.

Let’s not be charitable and give them the evolutionary biological justification. That may be a role in it but by definition so would literally every other person on the planet today compared to their predecessors 100 years ago. Yet the rest of the species manages to move forward. There are plenty of people who are carrying their weight. Let’s not make the pathology normal/baseline/expected imo. Simpler to state that they do not want to do the work because the long term rewards seem so trivial compared to the short term pleasures available at every turn every day in their life. Sure be generous and work with patients wherever they’re at in their journey but like you said if they had perspective with actual stress placed on them they might long for the days when they went to your proverb couch for a struggle session.
 
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Let’s not be charitable and give them the evolutionary biological justification. That may be a role in it but by definition so would literally every other person on the planet today compared to their predecessors 100 years ago. Yet the rest of the species manages to move forward. There are plenty of people who are carrying their weight. Let’s not make the pathology normal/baseline/expected imo. Simpler to state that they do not want to do the work because the long term rewards seem so trivial compared to the short term pleasures available at every turn every day in their life. Sure be generous and work with patients wherever they’re at in their journey but like you said if they had perspective with actual stress placed on them they might long for the days when they went to your proverb couch for a struggle session.
I'm generally kind to my patients. But that's more as a measure of someone who does not believe in free will. I think we respond to the world around us in more or less adapted ways based on our predispositions and experiences, but I think those responses aren't really within our control. Have to change the input to change the output. The input that would make most people normalize back to a more functional baseline would be a modicum of real, honest-to-God struggle
 
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ADHD: I believe it is on the rise and significantly despite that the genepool hasn't changed. ADHD can be subject dependent. If you like what you do-increased dopamine. If you're exercising and being more physically active-increased dopamine. Increased dopamine means less ADHD.

Kids and more screentime-more ADHD

Kids these days have more screentime, work is more data driven then before and it will become more and more data driven as technology advances, and people are sitting on their butts all day long where as before most jobs required people be more physically active.

Of course ADHD is on the rise.

Don't believe me on the subject dependent thing? Get 100 heterosexual men with ADHD. Their job is to be to a bikini beauty model judge. You won't see too many ADHD symptoms in that group of judges as they stare at these physically attractive young women. Tell these same people to do physics and those same men will be suffering big time ADHD sx.

Agreed. I must admit I find it really annoying when I see people talking about their non diagnosed 'ADHD', because they can only really concentrate on things they're really into. Like 90% of your time is probably spent needing to think about and concentrate on stuff you're really not into, that doesn't make it indicative of ADHD. Or the concerned caregivers of children they think might have ADHD, because they're really energetic and they have trouble sitting still. Like WTF, you've just described the average child, how about you take them to the park or something and get them to play and run around. I'm assuming it's because of things like Dr Google and the internet in general, but people's ideas of what ADHD actually is, or what it looks like, have become so skewed in some quarters.

I'm 50. I remember in the late 80s all these warnings came out about excessive sun exposure but the message wasn't getting a fair amount of sunlight and then protection, but pretty much stay out of the sun period. It was backed by the American Dermatological whatever society or or Academy or whatever group. I remember as a kid people spent outdoors all day long as a cultural norm, and people were much more physically active in the outdoors.

Add to this, about the same time the hole in the ozone was a hot topic making fear of sun exposure more so and people were living longer so cancer awareness was up.

The FDA Vitamin D recommended guidelines haven't changed for decades and while I don't know exactly when they were written they were written long before the late 80s and haven't changed.

But the bottom line is whenever these FDA guidelines were written, people's vitamin D levels were likely, as a society, at different levels. They've never been updated.

Australia has one of the highest rates of skin cancer in the world, so of course we needed warnings and information about the danger of too much sun exposure, but the thing is all the warning campaigns worked so well that we've now ended up with an epidemic of people with low vitamin D levels. Now we've got GPs needing to prescribe sun exposure for patients alongside the need for things like mole checks. I think the trouble with our sun safety campaign here is that they didn't actually inform people what was considered safe levels of sun exposure as opposed to just beating people over the head with the idea of, "Sun bad, stay out of sun".

I lost a friend to malignant melanoma, and my goal in terms of my natural complexion has always been "how pale can I be", so its not like I don't agree with the need for sun safety messaging, but when your messaging has lead to other health complications then maybe that message needed to be a little more balanced in the first place.
 
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Again, my prescription of touching grass would be highly beneficial for this patient population. "But going outside won't fix my weight problem." Oh, it will if you do it enough.
Touch grass, eat grass, don’t smoke too much grass
 
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The opioid epidemic is completely out of hand btw. The patients just aren't showing up at the regular psychiatrist office with those issues.. I've been doing some addictions work on a side and we can't keep up with the influx of patients on fentanyl
 
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Metformin, baby Aspirin, antidepressant, GLP-1 agonist, vitamin D levels...

Seems like all of the above will be beneficial even if you don't have the disease it treats, unless you already are exercising, having a healthy diet, and spending a lot of time outdoors.

IMHO health problems are in part because we're sitting on our fat lard-butts all day long doing things our minds aren't genetically programmed to easily grasp such as farm, hunt, build, or cook. The problem will likely get worse as we more and more divorce ourselves from lifestyles our genepool was programmed for success when we were cavemen.
 
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We are doing awesome guys! So much science! So much medicines! Yet our generation failing haha

“In an alarming trend, millennials, born between 1981 and 1996, have become the subject of a paradox: they are facing a faster decline in health compared to older generations despite a heightened awareness of fitness among younger people.

This perplexing phenomenon, initially identified in the United States, is now resonating across major Asian countries, including Korea, Hong Kong and Singapore, countering conventional expectations that the health-savvy younger generation would enjoy increased longevity.

According to a 2020 study by medical insurer Blue Cross Blue Shield in the United States, millennials face an accelerated deterioration in both physical and mental health, with conditions such as hypertension, high cholesterol, depression, and anxiety disorders appearing at an earlier age compared to older generations.”

 
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We are doing awesome guys! So much science! So much medicines! Yet our generation failing haha

“In an alarming trend, millennials, born between 1981 and 1996, have become the subject of a paradox: they are facing a faster decline in health compared to older generations despite a heightened awareness of fitness among younger people.

This perplexing phenomenon, initially identified in the United States, is now resonating across major Asian countries, including Korea, Hong Kong and Singapore, countering conventional expectations that the health-savvy younger generation would enjoy increased longevity.

According to a 2020 study by medical insurer Blue Cross Blue Shield in the United States, millennials face an accelerated deterioration in both physical and mental health, with conditions such as hypertension, high cholesterol, depression, and anxiety disorders appearing at an earlier age compared to older generations.”

I mean…
The diet in the US is absolutely horrible. All food is created for lasting longer and being bigger without adding nutrients. Interesting enough a Coca Cola in France has real sugar while here it has a bunch of weird additives and high fructose corn syrup.
Our diets are horrible, social interaction is minimal even though, for us on psychiatry is luckily higher. But as a millennial I do feel more anxious going outside and making friends than for example my mom or people on her generation.
I feel we are indeed glued to our phones, slowly losing social skills and patience (instant gratification, Amazon anyone).
These are odd times and we weren’t evolutionary speaking, made for this. But as human we evolve into this and maybe one day we will find the new social construct that we will call normal.
 
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Another reason why IMHO we are not happy these days is we aren't engaged in existential threats to our society. If you've read Stephen Jay Gould you'll know what I'm talking about.

Gould introduced the idea, with evidence to back it up, that human psychology is such that it wants to go to war if the society hasn't gone to war for about 1-2 generations. Then when it goes to war and people are killed or come back missing arms and legs, society sobers up, realizes how bad it is, but this sobering effect only lasts 1-2 generations. This in turn emulates what nature did to humanity since pre-history. That is cull our herds as happens with all of the species in nature.

In the meantime if we don't fight an enemy, we end up fighting ourselves. E.g look at partisanship pre 9-11, then literally the day after 9/11 America is united.

Now someone may poke this as my political view. This notion was pushed forward decades ago by several leading minds in the field of psychology, antropology, and sociology. Further there's lots of data backing it up. E.g. a society doesn't go to war for years then viewership in war movies goes up. People tend to be pro-war the first few weeks to months of a war, then after a few months the society is then against war. (E.g. Vietnam, the second Gulf War, the first Gulf War only lasted several weeks and the USA pulled off a victory before the drag in morale effect).

Gould wrote that now that most of our major enemies could destroy us in nuclear war, we'll be trapped into not going through the above cycle that however terrible, is one we want even if we don't know we want it. This in turn will create new problems as we start hating each other. So we can't kill other people in geographic wars so we'll go to killing each other in our communities.

Nixon wrote about this in his book Beyond Peace. Humans go through a cycle of peace then war, then peace then war, and now peace and then what? He grasps Gould's question head on and said yes humanity needs conflict to thrive so how do we make the enemy ignorance, hate, crime, disease, instead of other humans? This will be the great riddle for humanity to solve so we don't destroy ourselves.

IMHO humanity in general is not smart enough to grasp the above, hence we're continuing the cycle, hence the cynicism going on with our society today.

Oh now I'll go listen to a cable news media outlet who is highly profitting off of the above mentality of hating other people. Which news outlet? All of them.
 
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I mean…
The diet in the US is absolutely horrible. All food is created for lasting longer and being bigger without adding nutrients. Interesting enough a Coca Cola in France has real sugar while here it has a bunch of weird additives and high fructose corn syrup.
Our diets are horrible, social interaction is minimal even though, for us on psychiatry is luckily higher. But as a millennial I do feel more anxious going outside and making friends than for example my mom or people on her generation.
I feel we are indeed glued to our phones, slowly losing social skills and patience (instant gratification, Amazon anyone).
These are odd times and we weren’t evolutionary speaking, made for this. But as human we evolve into this and maybe one day we will find the new social construct that we will call normal.

its because its very awkward as an adult to approach someone with the intent of being their friend. Thats why so many adults experience isolation because the world we live in doesnt normalize platonic social interaction. I would say for men its even worse. If a guy approaches me and starts talking to me casually about sports and random stuff im thinking in my head "ok what does he want?". Its almost like a masculinity thing for men too. Outside of residency you also work with people form different generations, in different life stages and it can be harder to connect. I think females its a little less harder but still hard im sure. No one wants to go out and say publicly "hey im super lonely and have no friends, want to hang out?". And then if one person from the opposite gender approaches another, theres always the question of "is this person hitting on me?". I think societal norms couples with the increase in the influence of the internet/social media has caused a lot more social isolation. On a positive note, i have a lot of geri patients, and theres a FB group called "women over 50" that a lot of my people are in, and they have made great connections through there
 
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its because its very awkward as an adult to approach someone with the intent of being their friend. Thats why so many adults experience isolation because the world we live in doesnt normalize platonic social interaction. I would say for men its even worse. If a guy approaches me and starts talking to me casually about sports and random stuff im thinking in my head "ok what does he want?". Its almost like a masculinity thing for men too. Outside of residency you also work with people form different generations, in different life stages and it can be harder to connect. I think females its a little less harder but still hard im sure. No one wants to go out and say publicly "hey im super lonely and have no friends, want to hang out?". And then if one person from the opposite gender approaches another, theres always the question of "is this person hitting on me?". I think societal norms couples with the increase in the influence of the internet/social media has caused a lot more social isolation. On a positive note, i have a lot of geri patients, and theres a FB group called "women over 50" that a lot of my people are in, and they have made great connections through there
There is an unexpected benefit to being married and having progeny as a male, people find you less scary and can talk/connect easier. I've made multiple new friends in the past 1-2 years but all are because we have children around the same age. I worry a lot about what it would be like for any male in his 30's or 40's to be single or not have kids. Associating toxicity with masculinity was a big mistake that will have significant consequences for women as well as men.
 
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its because its very awkward as an adult to approach someone with the intent of being their friend. Thats why so many adults experience isolation because the world we live in doesnt normalize platonic social interaction. I would say for men its even worse. If a guy approaches me and starts talking to me casually about sports and random stuff im thinking in my head "ok what does he want?". Its almost like a masculinity thing for men too. Outside of residency you also work with people form different generations, in different life stages and it can be harder to connect. I think females its a little less harder but still hard im sure. No one wants to go out and say publicly "hey im super lonely and have no friends, want to hang out?". And then if one person from the opposite gender approaches another, theres always the question of "is this person hitting on me?". I think societal norms couples with the increase in the influence of the internet/social media has caused a lot more social isolation. On a positive note, i have a lot of geri patients, and theres a FB group called "women over 50" that a lot of my people are in, and they have made great connections through there
I've taken on changing some hobbies so that I have more opportunities to meet other people (mostly other dudes, nature of the hobby) IRL. Still doesn't lead to a ton of interactions where I think the person might make a good friend (vs acquaintance I see at recurring activity but don't really want to hang out with outside of that activity.) But the few times I've met someone who actually seemed cool, I've done basically that "Hey it was fun (doing activity) with you, it'd be good to keep in touch or hang out some time, what's your number?" Feels like asking someone out on a date because that's basically what you're doing, minus romantic intent, haha. TBH it hasn't led to persistent friendships as of yet, mostly because the other dudes have legitimately very busy lives and don't even engage in (recurring activity) often.
 
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yeah and thats another good point is everyones busy, so its really hard to make time with new friendships. As I get older I get more content with things too where by the time I get home I dont think about socializing, lol

And yea the married with kids people have excuses socialize with other families because sometimes theyre forced into it, lol.

I think of things like "bumble BFF" where people match other people for friends. The idea of me swiping through other guys profiles to see if theyre a friendship match for me just feels weird lol
 
yeah and thats another good point is everyones busy, so its really hard to make time with new friendships. As I get older I get more content with things too where by the time I get home I dont think about socializing, lol

And yea the married with kids people have excuses socialize with other families because sometimes theyre forced into it, lol.

I think of things like "bumble BFF" where people match other people for friends. The idea of me swiping through other guys profiles to see if theyre a friendship match for me just feels weird lol
I think it would be really hard to make a platonic friend without a shared activity.
The pillars of friendship are similarity/familiarity/proximity and those don't exist with someone you've picked out off a website.

I think people with young families socialize with each other a lot because having a family *is* their shared activity. It's not forced or an 'excuse,' it's a set of shared interests/experiences.

I've taken on changing some hobbies so that I have more opportunities to meet other people (mostly other dudes, nature of the hobby) IRL. Still doesn't lead to a ton of interactions where I think the person might make a good friend (vs acquaintance I see at recurring activity but don't really want to hang out with outside of that activity.) But the few times I've met someone who actually seemed cool, I've done basically that "Hey it was fun (doing activity) with you, it'd be good to keep in touch or hang out some time, what's your number?" Feels like asking someone out on a date because that's basically what you're doing, minus romantic intent, haha. TBH it hasn't led to persistent friendships as of yet, mostly because the other dudes have legitimately very busy lives and don't even engage in (recurring activity) often.

This sounds like the right way to go about it. But what's wrong with maintaining a casual friendship based only around that activity? Those can deepen over time but at least IME that doesn't necessarily happen quickly.
 
This sounds like the right way to go about it. But what's wrong with maintaining a casual friendship based only around that activity? Those can deepen over time but at least IME that doesn't necessarily happen quickly.
Nothing at all--I keep regularly engaging in the activity and enjoying the company of most of the people there, even if I wouldn't really hang out with many of them outside of that context (just not much else in common in terms of ways of living aside from the hobby.)
 
There are plenty of people who are carrying their weight. Let’s not make the pathology normal/baseline/expected imo. Simpler to state that they do not want to do the work because the long term rewards seem so trivial compared to the short term pleasures available at every turn every day in their life.
Forgot to respond to this one.
This is an exact reason why I hate psychiatrists who only spend a few minutes with patients unless they're already stabilized or in a triage situation.

Outside of the conventional diagnosis and treat with meds we need to understand their situation. E.g. many people are overworked, but several people are underworked. The concept of Eustress is taught in psychology, but not in our own field. I've seen several nepo-baby trust-fund kids be a victim of not enough stress.

Most of my responses above, and it went-without-saying, but I think our group is smart enough to realize, was written in broad strokes because we're talking about society as a whole, not individual people. IMHO the major problems for several people are from us being divorced from living the way we were genetically programmed to live. That is exercise, healthy diet, some exposure to nature, being reminded of our limitations. (e.g. seeing someone come back from war dead or dismembered has a great way of teaching humility to a society), but I forgot to mention-lack of hope. We had several things decades ago to make us look forward to the future (the economy, the cold war ended, future technology looking good for humanity, but not as many these days. The economy, however good by traditional measures is favoring a very small percent, technology is looking scarier, we have a new type of dangerous world now of terrorism, and 3rd world countries getting a hold of WMDs, Russia destabilized Europe).

If any of you are fans of the Predator-Alien comics, in one of the comics, they explained the reason why these Predators are so into hunting is cause this is their way of staying in touch with themselves. Cause despite that they've advanced into a FTL society, deep down, genetically they're still savages.

Add to this, and this is a side-topic but somewhat related, I speculate the reason why transgenderism skyrocketed in the last decade just wasn't because of social media, but because of microplastics. It's proven that microplastics in the blood bind onto sex hormone receptors. What will that do to a developing child, now that we live in a society where microplastics in our body is now unavoidable and part of our ecosystem?
 
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