O Advance Health Medical Center é uma instalação multiespecializada em Tijuana, México. O centro concentra-se em cirurgia plástica, ortopedia e cirurgia bariátrica. Sua configuração cirúrgica inclui três salas de cirurgia e uma endosuite. A clínica também oferece cirurgia de redesignação sexual com mais de 10 anos de experiência. Uma casa de recuperação dedicada apoia os pacientes após a cirurgia.
A equipe médica tem mais de 15 anos de experiência com pacientes internacionais. Especialistas em ortopedia trazem 36 anos de experiência combinada. O Dr. Erik Márquez ganhou o primeiro lugar em uma competição internacional de residentes de cirurgia plástica. Os especialistas são membros da American Society of Plastic Surgeons e da FILACP. A logística com tudo incluído cobre o transporte do Aeroporto de San Diego e a acomodação.
","text_type":"short_description","agency_settings":[{"setting_name":"is_new","setting_value":"0"},{"setting_name":"kids_only","setting_value":"0"}],"procedure_prices":[{"prices":{"price_from":8000,"price_to":10000,"currency":"USD","id":35384},"operation":{"id":671,"name":"Substituição da anca","alias":"hip-replacement"}},{"prices":{"price_from":8000,"price_to":10500,"currency":"USD","id":35382},"operation":{"id":104,"name":"Cirurgia de reparação do manguito rotador","alias":"rotator-cuff-repair-surgery"}}],"reviews":[],"clinic":{"id":1844,"alias":"advance-medical-center","name":"Advance Health Medical Center","short_description":"O Advance Health Medical Center é uma instalação multiespecializada em Tijuana, México. O centro concentra-se em cirurgia plástica, ortopedia e cirurgia bariátrica. Sua configuração cirúrgica inclui três salas de cirurgia e uma endosuite. A clínica também oferece cirurgia de redesignação sexual com mais de 10 anos de experiência. Uma casa de recuperação dedicada apoia os pacientes após a cirurgia.
A equipe médica tem mais de 15 anos de experiência com pacientes internacionais. Especialistas em ortopedia trazem 36 anos de experiência combinada. O Dr. Erik Márquez ganhou o primeiro lugar em uma competição internacional de residentes de cirurgia plástica. Os especialistas são membros da American Society of Plastic Surgeons e da FILACP. A logística com tudo incluído cobre o transporte do Aeroporto de San Diego e a acomodação.
","images":[{"base_url":"clinic/6a75ee5576b31","title":"Modern facade of CORE Medical & Surgical Center in Mexico"},{"base_url":"clinic/6a75ee573bec7","title":"Reception and waiting area at Advance Health Medical Center with modern seating"},{"base_url":"clinic/6a75ee58edce0","title":"Main entrance of Advance Health Medical Center with modern exterior in Mexico"},{"base_url":"clinic/6a75ee5a8ba23","title":"Waiting area at Advance Health Medical Center with modern seating and large windows"}],"flags":[{"name":"is_hide","value":false},{"name":"has_active_agencies","value":false}],"geo":{"country":{"name":"México","id":40,"alias":"mexico","iso_code":"MX"},"city":{"name":"Tijuana","id":396,"alias":"tijuana"},"address":"Calle Diego Rivera 2339-101, Zona Rio, CP 22010, Tijuana, BC, Mexico"},"rating":{"rating":5,"google":4.3,"percent_of_satisfied_clients":98},"statistics":{"number_of_reviews":5,"doctors_number":3},"accreditations":[],"agency_settings":[{"setting_name":"is_new","setting_value":"0"},{"setting_name":"kids_only","setting_value":"0"}]}},{"text":"A Baja Hand Clinic é especializada em condições ortopédicas e da mão, focando na rápida reintegração na vida diária com atendimento ético.
Utilizamos as mais recentes tecnologias de diagnóstico, bem como os procedimentos terapêuticos mais modernos, todos com o objetivo de reintegrar o paciente em sua vida diária no menor tempo possível, sempre sob os princípios da ética profissional, a fim de alcançar uma relação adequada médico-paciente, baseada na verdade e na confiança.
O Advance Health Medical Center é especializado em cuidados ortopédicos com serviços cirúrgicos credenciados e equipe bilíngue.
O ADVANCE HEALTH MEDICAL CENTER é um Centro Cirúrgico de Classe Mundial com uma equipe bilíngue, preparada e treinada para atender qualquer necessidade cirúrgica e médica, proporcionando a melhor qualidade de atenção que você espera. Se suas cólicas menstruais forem causadas por um distúrbio subjacente, como endometriose ou miomas, a cirurgia para corrigir o problema pode ajudar a reduzir seus sintomas.
A CosMed Clinic é uma das instalações médicas mais conhecidas em Tijuana, México. Check-up médico, Medicina estética e cosmetologia, Dermatologia são as especialidades mais fortes. A qualidade dos serviços médicos e tratamentos é confirmada pela Asociación Mexicana de Cirugía Plástica, Estética y Reconstructiva, International Society for Aesthetic Plastic Surgery, The American Society for Aesthetic Plastic Surgery, The American Association for Accreditation of Ambulatory Surgery Facilities International, American Society of Plastic Surgeons, Consejo Mexicano de Cirugía Plástica, Estética y Reconstructiva. Pacientes dos Estados Unidos, Canadá, Reino Unido e outros países escolhem a CosMed Clinic para cuidados de saúde.
","text_type":"short_description","best_texts":{"techniques":"Consulta e planeamento de tratamento individualizado","good_fit_for":"Consulta de ortopedia geral","why_its_ranked":"A clínica é acreditada por vários conselhos cirúrgicos internacionais e possui uma vasta experiência em cirurgia plástica, que pode abranger procedimentos ortopédicos."},"reviews":[],"clinic":{"id":654,"alias":"cosmed-clinic","name":"CosMed Clinic","short_description":"A CosMed Clinic é uma das instalações médicas mais conhecidas em Tijuana, México. Check-up médico, Medicina estética e cosmetologia, Dermatologia são as especialidades mais fortes. A qualidade dos serviços médicos e tratamentos é confirmada pela Asociación Mexicana de Cirugía Plástica, Estética y Reconstructiva, International Society for Aesthetic Plastic Surgery, The American Society for Aesthetic Plastic Surgery, The American Association for Accreditation of Ambulatory Surgery Facilities International, American Society of Plastic Surgeons, Consejo Mexicano de Cirugía Plástica, Estética y Reconstructiva. Pacientes dos Estados Unidos, Canadá, Reino Unido e outros países escolhem a CosMed Clinic para cuidados de saúde.
","images":[{"base_url":"clinic/877ca5fe83d20","title":"Modern reception area at CosMed Clinic with glass accents and lounge seating"},{"base_url":"clinic/f2572936cdaef","title":"CosMed Clinic exterior with modern glass facade and palm trees in Mexico"},{"base_url":"clinic/cf84965c65e0a","title":"Medical staff at CosMed Clinic in modern white uniforms, bright clinic interior"},{"base_url":"clinic/beaeeb7d411a9","title":"CosMed Clinic medical team in formal attire in clinic interior"}],"flags":[{"name":"is_hide","value":false},{"name":"has_active_agencies","value":false}],"geo":{"country":{"name":"México","id":40,"alias":"mexico","iso_code":"MX"},"city":{"name":"Tijuana","id":396,"alias":"tijuana"},"address":"Calle Brasilia #1 Col. El Paraiso Tijuana, Mexico"},"rating":{"rating":0,"google":4.5,"percent_of_satisfied_clients":0},"statistics":{"number_of_reviews":0,"doctors_number":0,"year_foundation":0},"accreditations":[{"logo":"https://s3.eu-central-1.amazonaws.com/bookimed/accreditations/5d88bb3e63a77.jpeg","name":"Associação Mexicana de Cirurgia Plástica, Estética e Reconstrutiva","country_code":"MX"},{"logo":"https://s3.eu-central-1.amazonaws.com/bookimed/accreditations/5d88bd61a3cbb.jpeg","name":"Sociedade Americana de Cirurgiões Plásticos","country_code":"US"},{"logo":"https://s3.eu-central-1.amazonaws.com/bookimed/accreditations/5d88bf21081e8.jpeg","name":"Conselho Mexicano de Cirurgia Plástica, Estética e Reconstrutiva","country_code":"MX"},{"logo":"https://s3.eu-central-1.amazonaws.com/bookimed/accreditations/5db9835a5ab1a.jpeg","name":"Sociedade Internacional de Cirurgia Plástica Estética","country_code":"DE"},{"logo":"https://s3.eu-central-1.amazonaws.com/bookimed/accreditations/5d88c1f95138c.jpeg","name":"A Sociedade Americana de Cirurgia Plástica Estética","country_code":"US"},{"logo":"https://s3.eu-central-1.amazonaws.com/bookimed/accreditations/5d88c2f28fee2.jpeg","name":"A American Association for Accreditation of Ambulatory Surgery Facilities International","country_code":"US"}]}},{"text":"O Hospital Angeles Tijuana transformou a medicina privada no México com mais de 20 anos de experiência. O seu departamento de ortopedia atende viajantes médicos da América do Norte e de outros lugares.
Em pouco mais de duas décadas, o Hospital Angeles transformou radicalmente a prática da medicina privada no México e se tornou um líder em turismo médico. O Angeles Health International é a subsidiária nos EUA do Hospital Angeles que ajuda a coordenar o tratamento de mais viajantes médicos norte-americanos do que qualquer outra rede hospitalar no mundo.
Sua segurança e satisfação são nossas principais preocupações. Nosso hospital e centro cirúrgico de última geração é a primeira instalação do tipo, internacionalmente acreditada, em todo o México. Venha ver o que nos diferencia. Os resultados da cirurgia bariátrica podem variar em cada pessoa. Um programa nutricional segue a cirurgia bariátrica para alcançar os melhores resultados. As fotos dos procedimentos de cirurgia plástica são de ex-pacientes do Dr
Sua segurança e satisfação são nossas principais preocupações. Nosso hospital e centro cirúrgico de última geração é a primeira instalação do tipo, internacionalmente acreditada, em todo o México. Venha ver o que nos diferencia. Os resultados da cirurgia bariátrica podem variar em cada pessoa. Um programa nutricional segue a cirurgia bariátrica para alcançar os melhores resultados. As fotos dos procedimentos de cirurgia plástica são de ex-pacientes do Dr
Narrathrive Sistemas Terapêuticos é uma clínica privada especializada localizada em Tijuana, México.
\n\nA principal especialização do centro médico é a terapia e psicologia. Aqui estão disponíveis terapias online e presenciais para famílias e casais.
\n\nNarrathrive Sistemas Terapêuticos atende crianças e adultos. São cerca de 100 pacientes por ano. A clínica é confiável por pacientes da América Latina, Estados Unidos, Canadá e Austrália.
","text_type":"short_description","best_texts":{"techniques":"Consulta e planeamento de tratamento individualizado","good_fit_for":"Terapia de saúde mental","why_its_ranked":"Especializa-se em tratamentos psicológicos para o controlo da ansiedade. Atende adultos e crianças, com 95 pacientes tratados anualmente."},"agency_settings":[{"setting_name":"is_new","setting_value":"0"},{"setting_name":"kids_only","setting_value":"0"}],"reviews":[],"clinic":{"id":1840,"alias":"narrathrive-sistemas-terapeuticos","name":"Narrathrive Therapeutic Systems ","short_description":"Narrathrive Sistemas Terapêuticos é uma clínica privada especializada localizada em Tijuana, México.
\n\nA principal especialização do centro médico é a terapia e psicologia. Aqui estão disponíveis terapias online e presenciais para famílias e casais.
\n\nNarrathrive Sistemas Terapêuticos atende crianças e adultos. São cerca de 100 pacientes por ano. A clínica é confiável por pacientes da América Latina, Estados Unidos, Canadá e Austrália.
","images":[{"base_url":"clinic/6256aa1333d25","title":"Waiting room at Narrathrive Therapeutic Systems with cozy sofa and ambient lighting"},{"base_url":"clinic/6256a5f82b4e6","title":"Clinic exterior entrance at Narrathrive Therapeutic Systems, modern medical facility"},{"base_url":"clinic/6256aa4068fa5","title":"Comfortable waiting room at Narrathrive Therapeutic Systems with sofa and certificates"}],"flags":[{"name":"is_hide","value":false},{"name":"has_active_agencies","value":false}],"geo":{"country":{"name":"México","id":40,"alias":"mexico","iso_code":"MX"},"city":{"name":"Tijuana","id":396,"alias":"tijuana"},"address":"Av. Saturnino Herrant 12137, Libertad, 22400 Tijuana, B.C., Mexico"},"rating":{"rating":0,"google":5,"percent_of_satisfied_clients":0},"statistics":{"number_of_reviews":0,"doctors_number":0,"year_foundation":2015},"accreditations":[],"agency_settings":[{"setting_name":"is_new","setting_value":"0"},{"setting_name":"kids_only","setting_value":"0"}]}},{"text":"A Muela Dental Tijuana é uma clínica odontológica reconhecida com o prêmio Patient Choice in Dentistry da Bookimed. Conta com uma equipe de oito médicos que atende pacientes em Tijuana, no México.
A Muela Dental Tijuana é uma clínica odontológica reconhecida com o prêmio Patient Choice in Dentistry da Bookimed. Conta com uma equipe de oito médicos que atende pacientes em Tijuana, no México.
O Dr. Jose Luis Aguilar Arceo é um cirurgião ortopédico e de mão certificado com 15 anos de experiência clínica. Ele concentra-se na cirurgia da mão, punho, plexo braquial e nervos periféricos. Concluiu especializações avançadas em ortopedia, cirurgia da mão e microcirurgia, e lesões do plexo braquial e nervos periféricos.
\n\nO Dr. Aguilar Arceo é conhecido pela sua habilidade em procedimentos complexos, como a artroscopia do punho e a cirurgia da mão pediátrica. É membro ativo de organizações profissionais no México e nos Estados Unidos, incluindo a American Society for Surgery of the Hand e a FEMECOT. Dedica-se à excelência e ao crescimento profissional contínuo.
","specialities":[{"id":"sur.016","name":"Orthopedic surgeon ","illness_kind_id":33}],"statistics":{"review_count":0,"review_score":0,"operations_performed_count":0,"awards_count":0}},"clinic":{"id":1844,"alias":"advance-medical-center","name":"Advance Health Medical Center","short_description":"O Advance Health Medical Center é uma instalação multiespecializada em Tijuana, México. O centro concentra-se em cirurgia plástica, ortopedia e cirurgia bariátrica. Sua configuração cirúrgica inclui três salas de cirurgia e uma endosuite. A clínica também oferece cirurgia de redesignação sexual com mais de 10 anos de experiência. Uma casa de recuperação dedicada apoia os pacientes após a cirurgia.
A equipe médica tem mais de 15 anos de experiência com pacientes internacionais. Especialistas em ortopedia trazem 36 anos de experiência combinada. O Dr. Erik Márquez ganhou o primeiro lugar em uma competição internacional de residentes de cirurgia plástica. Os especialistas são membros da American Society of Plastic Surgeons e da FILACP. A logística com tudo incluído cobre o transporte do Aeroporto de San Diego e a acomodação.
","images":[{"base_url":"clinic/6a75ee5576b31","title":"Modern facade of CORE Medical & Surgical Center in Mexico"},{"base_url":"clinic/6a75ee573bec7","title":"Reception and waiting area at Advance Health Medical Center with modern seating"},{"base_url":"clinic/6a75ee58edce0","title":"Main entrance of Advance Health Medical Center with modern exterior in Mexico"},{"base_url":"clinic/6a75ee5a8ba23","title":"Waiting area at Advance Health Medical Center with modern seating and large windows"}],"flags":[{"name":"is_hide","value":false},{"name":"has_active_agencies","value":false}],"geo":{"country":{"name":"México","id":40,"alias":"mexico","iso_code":"MX"},"city":{"name":"Tijuana","id":396,"alias":"tijuana"},"address":"Calle Diego Rivera 2339-101, Zona Rio, CP 22010, Tijuana, BC, Mexico"},"rating":{"rating":5,"google":4.3,"percent_of_satisfied_clients":98},"statistics":{"number_of_reviews":5,"doctors_number":3},"accreditations":[]},"procedure_prices":[{"prices":{"price_from":8000,"price_to":10500,"currency":"USD","id":35382},"operation":{"id":104,"name":"Cirurgia de reparação do manguito rotador","alias":"rotator-cuff-repair-surgery"}},{"prices":{"price_from":8000,"price_to":16000,"currency":"USD","id":35383},"operation":{"id":522,"name":"Substituição do joelho","alias":"knee-replacement"}}]},{"doctor":{"id":6637,"alias":"moises-del-aguila-soto","name":"Moises del Águila Soto","clinic_id":1844,"first_year_working":1990,"created_at":"2023-10-27T04:23:37.287+00:00","short_description":"Moises del Águila Soto é especialista no Advance Health Medical Center e está listado como cirurgião ortopédico certificado pelo Colegio Mexicano de Ortopedia y Traumatología. A clínica apresenta-o como parte de uma equipa de ortopedia com mais de 36 anos de experiência combinada. O seu percurso em ortopedia inclui consultas e planeamento de tratamentos para condições como a síndrome do túnel cárpico e dores musculoesqueléticas envolvendo o joelho, a anca ou a coluna vertebral.","specialities":[{"id":"ort.001","name":"Orthopedist","illness_kind_id":3}],"statistics":{"review_count":0,"review_score":0,"operations_performed_count":0,"awards_count":0}},"clinic":{"id":1844,"alias":"advance-medical-center","name":"Advance Health Medical Center","short_description":"O Advance Health Medical Center é uma instalação multiespecializada em Tijuana, México. O centro concentra-se em cirurgia plástica, ortopedia e cirurgia bariátrica. Sua configuração cirúrgica inclui três salas de cirurgia e uma endosuite. A clínica também oferece cirurgia de redesignação sexual com mais de 10 anos de experiência. Uma casa de recuperação dedicada apoia os pacientes após a cirurgia.
A equipe médica tem mais de 15 anos de experiência com pacientes internacionais. Especialistas em ortopedia trazem 36 anos de experiência combinada. O Dr. Erik Márquez ganhou o primeiro lugar em uma competição internacional de residentes de cirurgia plástica. Os especialistas são membros da American Society of Plastic Surgeons e da FILACP. A logística com tudo incluído cobre o transporte do Aeroporto de San Diego e a acomodação.
","images":[{"base_url":"clinic/6a75ee5576b31","title":"Modern facade of CORE Medical & Surgical Center in Mexico"},{"base_url":"clinic/6a75ee573bec7","title":"Reception and waiting area at Advance Health Medical Center with modern seating"},{"base_url":"clinic/6a75ee58edce0","title":"Main entrance of Advance Health Medical Center with modern exterior in Mexico"},{"base_url":"clinic/6a75ee5a8ba23","title":"Waiting area at Advance Health Medical Center with modern seating and large windows"}],"flags":[{"name":"is_hide","value":false},{"name":"has_active_agencies","value":false}],"geo":{"country":{"name":"México","id":40,"alias":"mexico","iso_code":"MX"},"city":{"name":"Tijuana","id":396,"alias":"tijuana"},"address":"Calle Diego Rivera 2339-101, Zona Rio, CP 22010, Tijuana, BC, Mexico"},"rating":{"rating":5,"google":4.3,"percent_of_satisfied_clients":98},"statistics":{"number_of_reviews":5,"doctors_number":3},"accreditations":[]},"procedure_prices":[{"prices":{"price_from":8000,"price_to":10500,"currency":"USD","id":35382},"operation":{"id":104,"name":"Cirurgia de reparação do manguito rotador","alias":"rotator-cuff-repair-surgery"}},{"prices":{"price_from":8000,"price_to":16000,"currency":"USD","id":35383},"operation":{"id":522,"name":"Substituição do joelho","alias":"knee-replacement"}}]}],"meta":{"total_count":2,"total_pages":1}},"reviews":{"reviews":[{"id":18974,"user":{"id":769150,"name":"Russell Everett Whiteis Jr.","country_code":"US","country_name":{"pt":"Estados Unidos da América","en":"United States of America"}},"ratings":[{"name":"main","value":5},{"name":"relative_price","value":2},{"name":"doctor","value":5},{"name":"personal","value":5},{"name":"comfort","value":5},{"name":"coordination","value":5},{"name":"translation","value":5},{"name":"nps","value":10},{"name":"manager","value":5}],"text":{"pt":"A Dra. Isabella Bernaschina estava muito interessada em ajudar-me verdadeiramente. Foi muito eficiente e tem uma experiência considerável na utilização de células estaminais para muitas doenças diferentes. Acredita no que está a fazer e ela própria já utilizou células estaminais no passado. Além disso, tem um estilo de vida muito saudável e incentiva-o a tirar o máximo partido do tratamento. Pratica simplesmente o que prega e tem um longo historial de utilização de células estaminais e outras modalidades para beneficiar a saúde dos seus pacientes. Fiquei muito satisfeita com os seus métodos e conhecimentos e tenciono voltar a consultá-la se precisar de mais tratamentos. Não podia pedir uma atenção mais dedicada. Ela acompanhou-me após o tratamento para ver como me estava a sentir e pareceu preocupar-se sinceramente com a forma como me senti após o tratamento.","en":"Dr. Isabella Bernaschina was very interested in truly helping me. She was very efficient and she has considerable experience in the use of stem cells for many different conditions. She believes in what she is doing and has used stem cells herself in the past. She also lives a very healthy lifestyle and encourages a healthy lifestyle to gain the most benefit from treatment. She simply practices what she preaches and she has a long history using stem cells and other modalities to benefit the health of her patients. I was very pleased with her methods and knowledge and I plan to see her again if i need further treatment. I could not ask for more dedicated attention. She followed up after treatment to see how i was feeling and seemed to sincerely care about how I felt after treatment."},"order":{"operation":{"id":139,"name":{"pt":"Terapia com Células Estaminais","en":"Stem Cell Therapy"}}},"doctor_info":{"id":7454,"name":"Isabella Bernaschina ","alias":"isabella-bernaschina"},"clinic_info":{"id":5335,"name":"Juventa Regenerative Medicine ","alias":"juventa","flags":[{"name":"has_active_agencies","value":false},{"name":"is_hide","value":false}]},"created_at":"2025-03-03T04:29:43.244+00:00","flags":[{"name":"is_approved","value":true},{"name":"has_client_feedback","value":true},{"name":"is_anonymously","value":false},{"name":"would_recommend","value":true},{"name":"is_notification_sent","value":false},{"name":"coordinator_mentioned","value":true},{"name":"deactivated_clinic","value":false}],"comment_about_bookimed":{"pt":"Foi muito fácil trabalhar com a Bookimed e contactaram-me várias vezes para se certificarem de que eu estava satisfeito com o tratamento programado e com os pormenores da viagem para a clínica a partir dos EUA. Verificaram-me mais do que uma vez e mesmo antes da minha viagem para o México para tratamento. Verificaram a minha viagem e as abominações e pareceram estar sinceramente interessados em saber se eu estava satisfeito com todos os aspectos da viagem e do tratamento.","en":"Bookimed was very easy to work with and checked with me numerous times to be sure i was happy with the treatment scheduled and the details of travel to the clinic from the US. They checked on me more than once and right before my travel to Mexico for treatment. They checked on my travel and abominations and seemed to be sincerely interested if I was satisfied with all aspects of the travel and treatment."},"summary":{"positive":{"pt":"Fiquei muito satisfeito com seus métodos e conhecimentos e pretendo consultá-la novamente se precisar de mais tratamento.","en":"I was very pleased with her methods and knowledge and I plan to see her again if i need further treatment."}}},{"id":24942,"user":{"id":1014987,"name":"Jose Luis Sanchez Ramos","country_code":"MX","country_name":{"pt":"México","en":"Mexico"}},"ratings":[{"name":"main","value":5},{"name":"doctor","value":5},{"name":"personal","value":5},{"name":"comfort","value":5},{"name":"translation","value":5},{"name":"manager","value":0},{"name":"relative_price","value":0}],"text":{"pt":"A minha maior preocupação era não compreender bem a gravidade da lesão. Felizmente, os resultados dos exames de imagem foram muito detalhados e esclareceram tudo. O cirurgião e todo o pessoal da clínica têm sido um grande apoio. A única questão é que os tratamentos para preservar a articulação antes de se proceder à substituição são muito caros, especialmente quando têm de ser realizados periodicamente. Ainda estou na fase inicial de recuperação e a dor é praticamente a mesma, o que é de esperar nesta fase. É um processo. Tenho confiança no caminho que ainda tenho pela frente.","en":"My biggest concern was not fully understanding the extent of the damage. Fortunately, the results of the imaging tests were very detailed and cleared everything up. The surgeon and all the staff at the clinic have been incredibly supportive. The only issue is that the treatments required to preserve the joint before proceeding with replacement are very expensive. I am still in the early stages of recovery and the pain is much the same, which is to be expected at this stage. It is a process. 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