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Artist's commentary
19sacise
Return that life to God!
Pioneer→https://www.pixiv.net/artworks/44745497
Reference to IXA's IXAcise.
There's also a pun with the title name "19sa" (イクサ, Ikusa), as "193" can be read as IXA (イクサ, Ikusa).
Which "19sacise" and "IXAcise" is a pun itself with the english word "Exercise".