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The Buteyko Method and the Importance of Carbon Dioxide

by Dr Alina Vasiljeva and Dr David Nias(more info)

listed in asthma, originally published in issue 93 - October 2003

Introduction

At the end of the 19th century, scientists Bohr and Verigo discovered what seemed a strange law: a decreased level of carbon dioxide in the blood leads to decreased oxygen supply to the cells in the body including the brain, heart, kidneys etc. Carbon dioxide (CO2) was found to be responsible for the bond between oxygen and haemoglobin. If the level of carbon dioxide in the blood is lower than normal, then this leads to difficulties in releasing oxygen from haemoglobin. Hence the Verigo-Bohr law.

The method of Konstantin Buteyko is based on the above law as to how carbon dioxide acts on the body. His drug-free treatment is beginning to spread around the world. Fifty years ago, he found a major cause of bronchial asthma and many other chronic diseases to be a deficiency of carbon dioxide in the alveolus of our lungs, and this, in turn, was found to be caused by deep breathing or hyperventilation.

Why People Hyperventilate

There are many reasons why people over-breath, including anxiety and pollution. Consider also clues provided by the recent increase in cases of asthma. Almost half a century ago, the Institute of Experimental Biology and Medicine of the Academy of Sciences of the USSR made a special study of bronchial asthma. It was found that it can occur as a result of a long lasting discrepancy between the volume of air flow passing through the lungs and the volume of air necessary for metabolism. The development of so-called 'chronic alveolar hyperventilation' was thus seen as a 'deep breathing condition'. Though this term appears literary rather than physiological, it was found in practice, from thousands of cases, that there would not be any asthma without 'deep breathing'. The term 'deep breathing' provides a clue to the development of an entirely new way of treating asthma and, indeed, treating many other diseases as well.

People suffering from asthma have excessive lung ventilation (the condition called 'deep breathing' or hyperventilation) – even when they are relaxed and their breathing cannot be seen or heard. The principle is, "if there is asthma then there is hyperventilation". What's more, bronchial asthma may simply be the body's way of resisting hyperventilation; i.e. the body's defence mechanism against excessive breathing with the aim of stopping the loss of carbon dioxide. Narrowing of respiratory passages is the main cause of attacks of suffocation in asthma. We consider that an asthma attack is the body's way of attempting to reduce the airflow passing through the lungs in order to reduce carbon dioxide loss.

Even 30 years ago, hyperventilation in people was not so common and cases of bronchial asthma were comparatively rare. Researching thoroughly the causes of chronic hyperventilation, we believe that the modern way of life, with low physical (muscular) loading, lack of movement and exercise (hypodynamia), and constant stress, is responsible for the dramatic increase. In other words, a wrong lifestyle is the main cause of hyperventilation in modern humans. Bronchial asthma is some kind of bodily reaction to hypodynamia and that is why different forms of asthma can be successfully treated with the help of physical loading and participation in sport. Buteyko was the first in the world to have argued that a person with asthma is not a disabled person who is hardly able to move because of constant attacks of suffocation. Instead, he claimed that people with asthma who train with his method are now able to live normal active lives.

Buteyko's Discovery

Five clinical trials of the Buteyko method have been conducted in Russia. The results indicated a recovery rate of 80 to 90% for patients with asthma. In the 1990s, the Buteyko method began to spread outside Russia, first to Australia. A clinical trial held in Australia in 1995 for patients with asthma found a significant reduction in the use of broncho-dilators and a reduction in steroids after 12 weeks training with the Buteyko method. These results featured in newspaper articles and the method was then introduced to the UK.

What is the quintessence of Buteyko's discovery? "Breathe less" is his advice because it helps to preserve essential carbon dioxide. Why is breathing so important? Well, imagine for a moment how long we can survive: Without food – 40 days. Without water – a few days. Without breathing – a few minutes. We can live without breathing for only a few minutes, yet we give it very little thought. Sure, we recognize that breathing is the most important and the most changeable function in our body, but it is also the easiest way to make the body ill or healthy.

Konstantin Buteyko proposed a revolutionary theory that, in time, appears to constitute a medical breakthrough:

1. It constitutes a major contribution to medical science in drawing attention to the importance of carbon dioxide for body metabolism and how the lack of it can cause chronic diseases;

2. Buteyko was the first medical professional who discovered, researched and introduced to medical practice the vital importance of normal breathing for humans. You can see normal breathing in a healthy baby. Normal breathing is invisible, through the nose, and is so quiet that you can hardly hear it. With normal breathing the content of carbon dioxide in alveolar air should be 6.5%;

3. Buteyko discovered an association between carbon dioxide levels in the blood in alveoli and the 'control pause'. To find out if you breathe correctly or incorrectly, enough or too much, the simplest method of measuring breathing is by the 'control pause'. This test involves breathing normally then holding your breath for as long as is comfortable. Apart from its use before and during a session, this measure provides an important safeguard against over-training. It can even save lives because, if the control pause decreases as a result of a training session, then this is evidence of over-training. This is important because there have been cases of death in athletes, attributed to over-training. A second measure is the deep ventilation or deep breathing test, which can demonstrate that you are not well because you breathe too much. This deep breathing test is a simple but informative diagnostic test;

4. The Buteyko method gives you the chance to reduce or eliminate symptoms by normalizing your breathing, which can be done simply by decreasing its depth. The method can be described as involving sessions with "a continuous reduction of depth of respiration by relaxation of the diaphragm with a feeling of air hunger".

Application of the method for 50 years has demonstrated its effectiveness. After being treated by the Buteyko method thousands of people have recovered from asthma, hypertension, panic attacks and many other conditions. If it so successful, you may ask, why has the method not spread more widely and more quickly? The answer is that, as with any new technique, there are a lot of obstacles on the way to full recognition. This is a shame for a country like the UK, where one in every eight children suffers from asthma.

What is more is that the method, if applied correctly, allows us to become ideally healthy (Buteyko expression). Health can be built up step by step as the control pause is conquered second by second, until it reaches 60 seconds. Once the control pause is measured as reaching 60 seconds then this indicates that carbon dioxide in alveolar air has reached the desired level of 6.5%. Note that it is the amount of carbon dioxide in alveolar air in the lungs that has to be measured in evaluating the state of health.

In the book Asthma: The Complete Guide, we read that the main Buteyko practitioner in the UK (A Stalmatski) claims that the level of oxygen in the blood of asthmatic patient is high, even during asthmatic attacks.1 However, to quote from Buteyko: "In a mild form of bronchial asthma, hyperventilation leads to a decrease in carbon dioxide in alveolar air and in the blood and little increase of oxygen. More severe asthma attacks will be accompanied by deeper breathing; in severe asthma, ventilation of lungs can be increased four or five times. Increasing ventilation in the lungs washes out carbon dioxide, and so, the carbon dioxide level in alveolar air decreases and oxygen increases. At the same time, the level of carbon dioxide in the blood increases and oxygen decreases and, as a result, the blood supply to tissues worsens and cells will suffer from hypoxia. In this condition patients can die (with a lot of oxygen in their lungs)".[2]

History of Research into Carbon Dioxide

Public opinion tends to think of carbon dioxide as a waste product or even a poison. (It is sometimes confused with carbon monoxide, which is a poison). During the last century, there was a particular interest as to the functional importance of carbon dioxide in the animal and the human body. Physiologists and chemists, such as Albitzkiy, Bohr, Verigo and Henderson, found that carbon dioxide has an important role as a regulator of the processes of metabolism. Buteyko called carbon dioxide "the main hormone of all hormones and the main vitamin of all vitamins". Carbon dioxide may truly be the 'breath of life'.

According to Henderson,[3] "Carbon dioxide had been discovered by Black in 1757, and oxygen had been described by Mayow, Scheele and Priestly. The Italian Physiologist Spalanzani recognized that, in fact, the oxidation does not occur in the lungs: it is in the tissues, to which oxygen is transported by the blood. Then Hoppe-Seyler separated haemoglobin as the means by which the blood transports oxygen.

"Later, in the 19th century, Zuntz, in Berlin, recognized that carbon dioxide, unlike oxygen, is not carried by haemoglobin. He showed that, in the blood, carbon dioxide is combined with bases, chiefly as sodium bicarbonate which plays a part in acid-alkaline balance. All the carbon dioxide is dissolved in the plasma, both in simple solution and that combined with alkali into the bicarbonates.

"Relations of Carbon Dioxide and Oxygen in the Body. Carbon dioxide is, in fact, a more fundamental component of living matter than is oxygen. Life probably existed on earth for millions of years prior to the carboniferous era, in an atmosphere containing a much larger amount of carbon dioxide than at present. There may even have been a time when there was no free oxygen available in the air.

"Another natural misconception is that oxygen and carbon dioxide are so far antagonistic that a gain of one in the blood necessarily involves a corresponding loss of the other. On the contrary, although each tends to raise the pressure and thus promote the diffusion of the other, the two gases are held and transported in the blood by different means; oxygen is carried by the haemoglobin in the corpuscles, while carbon dioxide is combined with alkali in the plasma. A sample of blood may be high in both gases, or low in both gases. Under clinical conditions, low oxygen and low carbon dioxide generally occur together. Therapeutic increase of carbon dioxide, by inhalation of this gas diluted in air, is often an effective means of improving the oxygenation of the blood and tissues".[3]

Do people know that our health depends on the level of carbon dioxide in the body? Why are so many people tired and have head and back ache and are overweight? It is easy to get chronic diseases, but is it possible to cure and prevent them? Are there people who remain healthy? To answer these questions we appeal to ancient wisdom and science (physiology), including space researches and other discoveries. A genuine yogi aims to be absolutely healthy and can typically breathe just once a minute during meditation. People who live in mountains, who walk a lot and have good natural food, often live a long and healthy life. The common factor in such people is the high level of carbon dioxide level in their alveoli.

Henderson and his collaborators showed that under certain experimental conditions the heart tends to develop a partial tetanus or cramp, and that this condition may be overcome by means of carbon dioxide.4 To quote: "The influence of carbon dioxide inhalation has recently been tried on several cases of angina pectoris. This is not an emergency treatment, but a therapy for prolonged application. It is administered for 10 to 15 minutes at a time, two or three times a day. The method of inhalation is essentially like that applied by Henderson, Haggard and Coburn, and by White, after anaesthesia and operation. A special form of apparatus, the H-H inhalator, for the administration of a mixture of oxygen and carbon dioxide to asphyxiated patients was, therefore, devised and has been widely introduced. This treatment has been so successful that many thousands of these inhalators are now in use: several hundred in Metropolitan New York, and a number corresponding to the population in Chicago and other cities. The rescue crews of the fire and police departments, the gas and electric companies, and now also the hospital ambulances, generally have them. At first, a mixture of 5% carbon dioxide in oxygen was used, but 7% has proved to be even more beneficial.

"As the inhalation consists of carbon dioxide in air, instead of in oxygen, its cost, aside from the control apparatus, is small. The effects of this treatment are a distinct improvement in the colour and temperature of the lips and skin, indicating an effect upon the peripheral circulation somewhat like that of amyl nitrate. Arterial pressure and the pulse rate are not increased, although a markedly fuller circulation is evident. The sense of oppression in the chest and the pain referred to the shoulder and arm is considerably decreased; it may cease altogether for some hours after the inhalation. After some weeks of daily inhalations, the capacity to take moderate exercise is markedly increased".[3]

Mechanism for How Carbon Dioxide Acts: Cause of Disease?

To understand the underlying basis of the Buteyko method and related methods (such as the Self-Healer) a short excursion to the root of the problem may help. Lack of carbon dioxide in the body is a cause of many disturbances in the metabolism of cells and tissues, which, in turn, can lead to disease. It was thought before that all metabolic carbon dioxide (produced as a result of body metabolic reactions of oxygenation) is not needed and is perhaps harmful. In 1911, Russian scientist, Professor PM Albitzkiy made an interesting discovery through experiments: not all carbon dioxide eliminates from the body through the lungs to the atmosphere. Some quantity of metabolic carbon dioxide is retained in the body all the time and this is a constant. It was found that four vitally important processes of functioning depend on the level of carbon dioxide in the body:

1. Acid-alkaline balance of the blood. This is one of the factors in the balance of alkali and acid for the maintenance of normal pH of the tissues. Acid-alkaline balance in the body is constant and it is 7.36;

2. Efficiency of oxygen absorption by the body cells according to the Verigo-Bohr law;

3. Tonus of vessels and bronchus increases if there is a lack of carbon dioxide;

4. Optimum processes of energy metabolism (Krebs Cycle).

So, a lack of carbon dioxide is a starting point for different disturbances in the body. If this continues for a long time then it can be responsible for diseases and ageing. Put another way, the mechanism of disease is as follows:

flow of air

Biological Role of Carbon Dioxide in the Buteyko method

To quote from an interview with Buteyko: "CO2 is the main source of nutrition for any living matter on Earth. Plants obtain CO2 from the air and provide the main source of nourishment for animals, while both plants and animals are nourishment for us. The great resource of CO2 in the air was formed in pre-historical times when the amount was about 10%. It has reduced now to a very insignificant amount (about 0.03%). Metabolism in human and animal cells was created during those ancient geological periods when CO2 was at a level of 10% in water and in the air.

It is obvious that (there is) is an optimum concentration of CO2 able to provide normal metabolism in cells. The harmful effect of deep breathing in the body (because of the creation of CO2 deficit) has been demonstrated by many experiments, including the works of a famous physiologist Dr Henderson performed in 1909. With the help of a special device, he made experimental animals breathe deeper and soon they begin to die. According to the Verigo-Bohr effect, we can state that a CO2 deficit caused by deep breathing leads to oxygen starvation in the cells of the body. This state is known as hypoxia and, first of all, it badly affects the nervous system.

"The symptoms that emerge in people who habitually over-breathe may vary greatly. Traditional medicine classifies diseases into many different ones, each with their own name. Symptoms such as broncho-spasm, spasm of heart vessels, increase or decrease in arterial tension, fainting, and convulsions, traditionally are called diseases of bronchial asthma, angina, hypertension, epileptic seizure, etc. Physiological laws can explain the harmful and pernicious effects of deep breathing. They can also substantiate the principle of how to get rid of symptoms by correcting the associated CO2 deficit in the body.

"In my opinion, the main factor (in the cause of deep respiration itself) is popularization of the claimed usefulness of deep breathing. A modern person is taught to breathe deeply even long before their birth, when a pregnant woman is asked to attend ante-natal clinics where deep respiration is recommended. A newborn child is taught to breathe deeply by moving their hands up and down. And it lasts all life long, in the day nursery and kindergarten, at school, and participating in sport. There are some other factors that encourage deep respiration. For example, overfeeding, especially of animal proteins (e.g. fish, chicken, eggs, milk and meat), increases respiration depth. Meat and other animal products increase respiration depth more than vegetables, boiled food more than raw food. The next factor that deepens respiration is laziness and lack of movement and exercise (hypodynamia). Physical exertion (exercise, work) is the main factor for CO2 production, which is necessary for optimal body metabolism. That is why people who stay physically active live longer and are less ill. So hypodynamia or confinement to bed, keeping the horizontal position and sleeping for too long may increase respiration. The recommendation to sleep more does not cure any patient and, what is more, at the end of sleeping somewhere about five o'clock in the morning attacks of asthma, angina, heart attack, stroke, epileptic seizure or paralysis and death may occur. In other words, this time is a dangerous zone for death. Some different emotions, both positive and negative, overheating and stuffy rooms increase respiration depth as well. And, on the contrary, calmness and peace, hardening and cold air decrease respiration depth. Smoking and drinking strong alcohol also lead to deep respiration. Summarizing, I should say that the best way to be healthy is to: breathe less, rest less, sleep less, drink strong drinks less and have less sexual overindulgence. Instead it is better to have more physical exercise, and work until you are sweating (as sweat withdraws many poisons from the body)".5

How to Reduce Hyperventilation and Increase Carbon Dioxide

There are different techniques designed for increasing carbon dioxide levels in the blood ranging from the ancient (e.g. yoga) to the modern (e.g. spacecraft climate). There are people with normal breathing, be they mountain dwellers or Olympic participants or even ordinary people, who have the ability to run every day for two hours at a speed of about 10km per hour. Upon what do carbon dioxide levels in the blood depend?

1. The first mechanism of maintaining metabolic carbon dioxide is its production. The best way to produce it is from physical activity. In working muscles the intensity of metabolism increases so producing more carbon dioxide. This can provide the necessary level of carbon dioxide;

2. The second mechanism is keeping the already produced carbon dioxide through correct breathing. This depends on the amount of carbon dioxide elimination through the lungs to the atmosphere; i.e. the depth and frequency of respiration. The deeper and more often we breathe, the less we keep carbon dioxide in our body. In the atmosphere, air contains 0.03% of carbon dioxide, while in the body there is normally 150 to 200 times more than this. Carbon dioxide in the lungs is 4.5 to 6%, in the blood of alveolus 6.5% and in cells 7%.

The body has a few systems of protection from losing carbon dioxide:
i. Anatomy and physiology of respiratory airways; e.g. the bronchus can become narrow to reduce amount of carbon dioxide lost;
ii. Rapid change in depth and frequency of respiration. This is determined by the respiratory centre in the brain commanding the respiratory muscles to work more or less intensively in order to maintain carbon dioxide levels in the body. Mankind's long experience has shown that it is possible to readapt a respiratory centre to increasing levels of carbon dioxide in the body by a process of training. Elimination of deep respiration can effectively provide this.

Methods of maintaining carbon dioxide level are based on training of the respiratory centre by the creation of a state of hypercapnia (high carbon dioxide level in arterial blood). There are several ways to do this:

1) Elimination of hyperventilation by conscious methods such as yoga, Buteyko (continuous reduction of respiration) and Strelnikova (paradoxical gymnastics);

2) Increasing carbon dioxide production by physical activity; e.g. running at 10km per hour for 40km per week or walking in mountains for two hours a day. And doing it every day;

3) Carbon dioxide baths. By applying a carbon dioxide mixture through the skin it acts in two ways: by widening the capillaries of the skin (so leading to a decrease in high blood pressure) and by entering the blood stream to increase the carbon dioxide level;

4) Breathing a hypercapnic (high carbon dioxide content) air mixture.

The first two are well known as methods for increasing carbon dioxide. The third method was used hundreds of years ago for lung function improvement and for general wellbeing. Carbon dioxide baths can be taken in two ways: through water and the so-called 'dry carbon dioxide bath'. Today these baths are a special treatment in some health spas as an anti-ageing treatment – the method is very effective and pleasant. The fourth method involves inhalation of high content carbon dioxide air with complicated equipment and has been used for over 40 years in the Space programmes for flight preparation of cosmonauts. But a modified device for this is now available, called the Self-Healer.

Restoring Carbon Dioxide Levels with the Self-Healer

Early astronauts could not move some time after landing – just like very old men. And only the specially selected composition of air inside space ships has saved the situation! This system was developed more than 40 years ago by a team led by academician N Agadganyan. The active breathing environment in a spacecraft cabin contains ten times more carbon dioxide than the atmosphere on Earth. It helps to keep carbon dioxide levels in the body of a cosmonaut normal. In 1995, Agadganyan did research with ordinary people. The result was overwhelming: in people older than 50 years, hypocapnia is the usual condition with carbon dioxide levels in the blood being 30 to 50% lower than normal. Figure 1 shows the extent to which carbon dioxide levels tend to decline with age.

Figure 1
Figure 1

Based on the above, and particularly the research imitating space cabin environments by Agadganyan, the Self-Healer device was designed for respiratory system training. Behind this invention are both medical and engineering ideas. To quote from Agadganyan: "has created an accessible instrument; it has helped thousands and in the future will help to make healthy millions of people who are suffering from the diseases of civilisations".

How the Self-Healer Device Works

To find out if you over-breathe or hyperventilate the device includes a procedure for measuring your volume of lung ventilation. A device called the capnometre, which is a bag with a flapper, measures this. The full volume of the bag is 13 litres. For measuring your breathing, breathe normally until the bag is fully inflated. The time it takes to fill it makes it possible to calculate, with the help of a table, the intensity of breathing and then the level of carbon dioxide in your alveolus. Measuring your breathing with the capnometre will indicate your present health condition.

Yoga experts achieve a rate of about two litres per minute. Normally healthy people are around a rate of four litres per minute. But if the time to inflate the capnometre is less then one minute; i. e. if breathing rate is 13 litres or more per minute then your life is in danger!

Breathing with the aid of the Self-Healer during a 20 minute session acts to increase carbon dioxide levels in the body and this stays for a few hours. This is a way of training the respiratory centre to adapt to the increased carbon dioxide level. After a few months training, the respiratory centre readapts automatically to the normal 6.5% level of carbon dioxide. During these months, there is a decrease in the depth of breathing and ventilation of the lungs and the level of carbon dioxide in alveolar air in the lungs gradually becomes normal (6.5%). This in turn improves metabolism in all body cells, leading to spasm relief in all soft muscles (vessels, bronchus, etc) and a boost to immunity generally. The human body can then become healthy and many symptoms of disease will disappear. What is more, cells will become more resistant to hypoxia because a reserve of oxygen supply is built up. The human body becomes increasingly resistant to extreme stress, and to physical and mental exertion. As a result it may be possible to prevent many diseases, such as a heart attack or stroke.

Case Study

Vera, 47 years old, became ill over a period of two years. Her condition was triggered by emotional shock and her symptoms were fatigue, lack of energy, inflammation in the gums and palpitations. Aching in teeth and gums was constant and accompanied by palpitations. "Within a few months irregular and painful periods stopped and, from being an active sports-loving and cheerful person, I soon became useless and hopeless for the family because I was unable to work. Life became too much for me without support and I split from my husband," the patient said. Conventional medicine explained her condition as caused by the menopause. Other diagnoses were Chronic Fatigue Syndrome and Clinical Depression. In fact, she did not get treatment for any of these conditions because she refused antidepressants and counselling did not work. Other than blaming the menopause, the cause of her condition was not found. Seeking a cure for her suffering she consulted Professor Buteyko. He diagnosed chronic infection in her gums and teeth (chronic periodontal disease) as responsible for her condition. Her control pause was measured to be only 8 seconds. Following Buteyko's advice, a couple of teeth were extracted and she had a few months treatment for her remaining teeth by a dentist and a homeopath. At the same time, she started the Buteyko method and tried the various associated treatments, such as carbon dioxide baths. After three months, as her control pause gradually increased, she started exercises such as walking for one to two hours (depending on the control pause result). After seven months, when her control pause reached 40 seconds, her periods started again, this time they were regular and painless. Today she goes swimming and jogging, has joined dance classes and has found new relationships.

References

1. Brostoff J and Gamblin L. Asthma: The Complete Guide. 1999.
2. Buteyko, K.P. (Editor). The Buteyko Method: the experience of implementation in medical practice. (Russian edition). Moscow. 1990.
3. Henderson, Y. Carbon Dioxide. Article in Encyclopedia of Medicine. 1940.
4. Henderson Y. Physiological Regulation of the Acid Base Balance of the Blood and some Related Functions. Physical. Rev. 5: 131. 1925.
5. Vasiljeva, A. and Nias, D. (Editors) The Buteyko Method (English edition). Self-Healing Company. Cyprus. 2002.

Resources

Agadganyan, NA Bodily functions under conditions of hypoxia and hypercapnia. Medicine (Russia). 1986.

Further Information

The Buteyko method has been practised outside of Russia since 1991. An English presentation of the original Buteyko method was specially prepared as a book and published by the Self-Healing Company in Cyprus to help people become more familiar with the genuine method – www.selfhealing.co.uk
To join Buteyko classes contact The Complete Health Care Clinic: Telephone 020 7336 0466.

Comments:

  1. Richard Friedel said..

    Breathing Exercises by Alexandra Strelnikova (as noted in the artickle) were a neat fix for my otherwise everlasting mild asthma.
    1) The emphasis on loud nasal inhales stimulates the heart like many asthma sprays do but the action is natural.
    2) I had trained belly breathing and avoided asthma sprays.
    3) The gymnastics may be Russian but are in no way similar to the Buteyko system which I advocated but seems to be a mere cult. Its exercise fingering the nose is acupressure and not breath therapy.
    I do not believe in the Buteyko method. It is too much of a cult and is not medically accepted


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About Dr Alina Vasiljeva and Dr David Nias

About the Authors Dr Alina Vasiljeva was an anaesthetist and rehabilitation specialist in the Russian Military Hospital. Since moving to the UK, she has been working in pain-stress management, disease prevention and anti-ageing. Dr David Nias is Honorary Senior Lecturer in the Medical School of St Bartholomew's and the Royal London Hospital. He qualified as a chartered clinical psychologist, has conducted research into various aspects of psychology, and has specialized in health psychology and sports psychology. They can be contacted via d.kinias@qmul.ac.uk

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