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  1. Article ; Online: Publication Rates Vary Across Orthopaedic Subspecialties: A Longitudinal Analysis of AAOS Abstracts.

    Johnson, Mitchell A / Parambath, Andrew / Shah, Neal / Shah, Apurva S

    The Iowa orthopaedic journal

    2024  Volume 43, Issue 2, Page(s) 1–7

    Abstract: Background: Presentation of research at national orthopaedic meetings and subsequent publication are important for both information exchange among surgeons and individual academic advancement. However, the academic landscape and pressures that ... ...

    Abstract Background: Presentation of research at national orthopaedic meetings and subsequent publication are important for both information exchange among surgeons and individual academic advancement. However, the academic landscape and pressures that researchers face may differ greatly across different subspecialties. This study attempts to explore and quantify differences in research presented at national conferences and its implication on ultimate likelihood of publication in peer-reviewed journals.
    Methods: All abstracts from the Annual Meetings of the American Academy of Orthopaedic Surgeons (AAOS) from 2016 and 2017 were reviewed and categorized based on subspecialty focus. Resulting publications were identified using a systematic search of PubMed and Google Scholar databases. Multivariate binary logistic regression modelling was used to assess the predictive value of abstract characteristics on eventual publication.
    Results: A total of 1805 abstracts from the 2016 and 2017 AAOS conferences were reviewed. The overall publication rate of abstracts following the AAOS meetings was 71.6%, with an average time to publication from abstract submission deadline and impact factor of 19.8 months and 2.878, respectively. Statistical differences were observed across subspecialties with respect to publication rate (p<0.001), time to publication (p<0.001), and impact factor (p<0.001). The subspecialty with the highest publication rate, largest impact factor, and shortest average time to publication was Sports Medicine with 83.2%, 3.98, and 17.6 months, respectively; despite lower average sample size (p<0.001) and frequency of multicenter design (p<0.001) compared with other subspecialties. The subspecialty with the lowest publication rate and impact factor was Hand and Wrist with 53.3% and 1.41, respectively. Multivariate logistic regression analysis demonstrates a lower likelihood for internationally authored abstracts (OR: 0.75, p=0.021) and higher likelihood for basic science abstracts (OR: 1.52, p-value=0.023) to reach publication.
    Conclusion: Differences in publication rate across orthopaedic subspecialties were observed with articles in sports medicine more likely to be published, published quickly, and featured in a higher impact factor journals. Understanding these differences, and how they relate to the publication and promotion of novel research, is important for orthopaedic researchers.
    MeSH term(s) Humans ; Logistic Models ; Orthopedics ; Societies, Medical ; Sports Medicine ; United States ; Publishing/trends ; Bibliometrics
    Language English
    Publishing date 2024-01-12
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1204065-4
    ISSN 1555-1377 ; 1541-5457
    ISSN (online) 1555-1377
    ISSN 1541-5457
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Removing or Only Moving a Barrier? Screening Applications with US Medical Licensing Examination Step 2CK Instead of Step 1 May Benefit Women but Not Underrepresented Minorities in Orthopaedics.

    Huffman, William H / Ayotte, Steven R / Johnson, Mitchell A / Cipriano, Cara A

    JB & JS open access

    2023  Volume 8, Issue 2

    Abstract: Most orthopaedic surgery program directors report using a minimum score cutoff for the US Medical Licensing Examination Step 1 examination when evaluating residency applicants. The transition to a Pass/Fail grading system beginning in the 2022-2023 ... ...

    Abstract Most orthopaedic surgery program directors report using a minimum score cutoff for the US Medical Licensing Examination Step 1 examination when evaluating residency applicants. The transition to a Pass/Fail grading system beginning in the 2022-2023 application cycle will alter applicant evaluation in the interview selection process. The impact of this change, particularly on women and underrepresented minority (URM) applicants, remains unclear. This study was designed to evaluate how a shift to screening applications using Step 2 Clinical Knowledge (CK) instead of Step 1 scores could impact selection for residency interviews.
    Methods: We reviewed all 855 Electronic Residency Application Service applications submitted to the University of Pennsylvania's orthopaedic surgery residency program in the 2020-2021 cycle. Applicant age, sex, medical school of graduation, self-identified race, and permanent zip code were evaluated for association with Step 1 and Step 2CK scores using a 2-sample
    Results: Multivariable linear regression revealed both Step 1 and 2CK scores were lower for applicants of URM status (Step 1: p < 0.001; Step 2CK: p < 0.001) and from international medical schools (p = 0.043; p = 0.006). Step 1 scores but not Step 2CK scores were lower for applicants who were women (p < 0.001; p = 0.730), ≥30 years of age (p < 0.001; p = 0.079), and from medical schools outside the top 25 in National Institutes of Health (NIH) funding or
    Conclusions: Conversion of Step 1 grading to Pass/Fail may reduce barriers for groups with lower average Step 1 scores (URM, female, ≥30 years of age, and from institutions with lower NIH funding or
    Level of evidence: Level IV. See Instructions for Authors for a complete description of levels of evidence.
    Language English
    Publishing date 2023-05-30
    Publishing country United States
    Document type Journal Article ; Review
    ISSN 2472-7245
    ISSN (online) 2472-7245
    DOI 10.2106/JBJS.OA.22.00140
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: MRI Predictors of Residual Dysplasia in Developmental Dysplasia of the Hip Following Open and Closed Reduction.

    Johnson, Mitchell A / Gohel, Shivani / Nguyen, Jie C / Sankar, Wudbhav N

    Journal of pediatric orthopedics

    2022  Volume 42, Issue 4, Page(s) 179–185

    Abstract: Background: Following open or closed reduction for children with developmental dysplasia of the hip, there remains a significant risk of residual acetabular dysplasia which can compromise the long-term health of the hip joint. The purpose of this study ... ...

    Abstract Background: Following open or closed reduction for children with developmental dysplasia of the hip, there remains a significant risk of residual acetabular dysplasia which can compromise the long-term health of the hip joint. The purpose of this study was to use postoperative in-spica magnetic resonance imaging (MRI) data to determine factors predictive of residual acetabular dysplasia at short-term follow-up.
    Methods: We retrospectively reviewed 63 hips in 48 patients which underwent closed or open reduction and spica casting for developmental dysplasia of the hip. MRI performed in-spica at ∼3-week follow-up were used to assess 11 validated metrics and 2 subjective factors. Acetabular index (AI) was measured on anteroposterior pelvic radiographs at 2-year postoperative follow-up. Binary logistic regression was then used to identify variables predictive of residual dysplasia, defined as an AI greater than the 90th percentile for age based on historic normative data.
    Results: Average age at surgical reduction was 9.3±3.2 months. 58.7% (37/63) of reductions were open. A total of 43 (68.3%) hips demonstrated residual acetabular dysplasia at 2 years postoperatively based on normative values. In those with persistent dysplasia, patients were on average older at the time of reduction (10.0 mo±3.2 vs. 8.0 mo±2.8, P=0.010) and more likely female (88.4% vs. 60.0%, P=0.010). Patients with residual dysplasia were more likely to have mild subluxation on postoperative MRI (40.0% vs. 10.5%, P=0.022). Hips with a cartilaginous acetabular index (CAI) of >23 degrees were 7.6 times more likely to develop residual dysplasia. Type of reduction (ie, closed vs. open) did not appear to influence the rate of residual dysplasia (P=0.682).
    Conclusion: In this series, the rate of residual dysplasia after surgical reduction was higher than most previous reports, with no appreciable difference between closed and open reductions. Older age, female sex, and a higher CAI were associated with a greater risk of persistent radiographic dysplasia. In particular, hips with a CAI >23 degrees were 7.6 times more likely to be dysplastic at 2-year follow-up.
    Level of evidence: Level III.
    MeSH term(s) Acetabulum/surgery ; Child ; Developmental Dysplasia of the Hip ; Female ; Hip Dislocation, Congenital/diagnostic imaging ; Hip Dislocation, Congenital/pathology ; Hip Dislocation, Congenital/surgery ; Hip Joint/surgery ; Humans ; Infant ; Magnetic Resonance Imaging ; Retrospective Studies ; Treatment Outcome
    Language English
    Publishing date 2022-02-04
    Publishing country United States
    Document type Journal Article
    ZDB-ID 604642-3
    ISSN 1539-2570 ; 0271-6798
    ISSN (online) 1539-2570
    ISSN 0271-6798
    DOI 10.1097/BPO.0000000000002062
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Dissociation of a Femoral Intramedullary Magnetic Lengthening Nail During Routine Hardware Removal: A Case Report.

    Johnson, Mitchell A / Karkenny, Alexa J / Arkader, Alexandre / Davidson, Richard S

    JBJS case connector

    2021  Volume 11, Issue 1

    Abstract: Case: A 15-year-old boy with a right femur length discrepancy secondary to infection underwent hardware removal 1-year status-post right femur osteotomy with placement of an antegrade intramedullary magnetic lengthening nail after successful lengthening ...

    Abstract Case: A 15-year-old boy with a right femur length discrepancy secondary to infection underwent hardware removal 1-year status-post right femur osteotomy with placement of an antegrade intramedullary magnetic lengthening nail after successful lengthening of 4.2 cm. During hardware removal, dissociation between the proximal (outer) and distal (inner) components of the device was observed. The distal component was removed using an endoscopic pituitary rongeur after considering multiple possible techniques.
    Conclusions: In the event of nail disconnection during removal of an intramedullary implant, we recommend use of a long pituitary rongeur to retrieve the distal nail component.
    MeSH term(s) Adolescent ; Bone Nails/adverse effects ; External Fixators ; Femur/surgery ; Humans ; Leg Length Inequality/surgery ; Magnetic Phenomena ; Male ; Osteogenesis, Distraction/methods ; Treatment Outcome
    Language English
    Publishing date 2021-03-08
    Publishing country United States
    Document type Case Reports ; Journal Article
    ISSN 2160-3251
    ISSN (online) 2160-3251
    DOI e20.00950
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Pediatric Orthopedic Trauma Care During the COVID-19 Pandemic: A Survey of the Pediatric Orthopedic Society of North America.

    Johnson, Mitchell A / Ganley, Theodore J / Crawford, Lindsay / Swarup, Ishaan

    HSS journal : the musculoskeletal journal of Hospital for Special Surgery

    2021  Volume 18, Issue 2, Page(s) 205–211

    Abstract: Background: ...

    Abstract Background:
    Language English
    Publishing date 2021-11-15
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2250601-9
    ISSN 1556-3324 ; 1556-3316
    ISSN (online) 1556-3324
    ISSN 1556-3316
    DOI 10.1177/15563316211056022
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Weight gain and gastrostomy tube safety during serial body casting for early onset scoliosis.

    Johnson, Mitchell A / Lott, Carina / Clark, Abigail J / Anari, Jason B / Cahill, Patrick J

    Spine deformity

    2022  Volume 10, Issue 5, Page(s) 1197–1201

    Abstract: Purpose: Serial casting has been shown to improve curve deformity for patients with early-onset scoliosis (EOS). However, despite prior literature demonstrating the importance of weight and nutrition in EOS patients, there is limited information ... ...

    Abstract Purpose: Serial casting has been shown to improve curve deformity for patients with early-onset scoliosis (EOS). However, despite prior literature demonstrating the importance of weight and nutrition in EOS patients, there is limited information regarding complications and weight gain ability for children undergoing serial casting. Additionally, parents of patients undergoing serial casting often have concerns regarding weight gain and patient comfort, which tend to be amplified in patients with gastrostomy tubes (g-tubes). We aim to understand changes in weight, g-tube complications, and cast-related complications in patients being treated with serial casting.
    Methods: A single center retrospective review of all EOS patients less than 6 years old treated with serial casting was performed. Patient weight out of cast throughout their treatment was converted to a percentile based on CDC growth charts. Patients with documented calls regarding cast concerns, complications requiring cast removal, or g-tube procedures were recorded.
    Results: A total of 32 patients treated with serial casting were included with four having g tubes. Overall, the average weight percentile increased from pre-casting to post-casting (27-38%, p < 0.001) with 21 patients showing an increase. Of the 22 patients with a starting weight below the 25th percentile, 14 (64%) demonstrated an increase. Patients with g tubes increased an average of 4.2 kg during casting compared to 3.0 kg in patients without g tubes (p = 0.588). 18 parents registered a cast concern during the treatment and 5 patients required at least one early cast removal. No difference in cast concerns (p = 0.597) or cast removals (p = 0.488) was observed when comparing patients with g tubes to those without. There were no instances of g-tube dysfunction during casting.
    Conclusion: While the average weight percentile for patients initiating serial casting is below average, the majority increased their weight percentile during treatment. Patients with and patients without g tubes were able to maintain or gain weight during casting treatment. While it was common for parents to contact providers with cast concerns, patients with g tubes did not appear to have a greater risk of cast or g tube-related complications.
    Level of evidence: Level IV.
    MeSH term(s) Casts, Surgical/adverse effects ; Child ; Follow-Up Studies ; Gastrostomy/adverse effects ; Humans ; Scoliosis/surgery ; Weight Gain
    Language English
    Publishing date 2022-04-21
    Publishing country England
    Document type Journal Article
    ZDB-ID 2717704-X
    ISSN 2212-1358 ; 2212-134X ; 2212-1358
    ISSN (online) 2212-1358 ; 2212-134X
    ISSN 2212-1358
    DOI 10.1007/s43390-022-00502-y
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Changes in height, weight, and body mass index after posterior spinal fusion in juvenile and adolescent idiopathic scoliosis.

    Johnson, Mitchell A / Cirrincione, Peter M / Zucker, Colson P / Blanco, John S / Widmann, Roger F / Heyer, Jessica H

    Journal of children's orthopaedics

    2023  Volume 17, Issue 4, Page(s) 354–359

    Abstract: Purpose: Posterior spinal fusion for idiopathic scoliosis is known to increase spinal height, but the impacts on weight and resulting body mass index are unknown. This study assesses body mass index, weight, and height percentile changes over time after ...

    Abstract Purpose: Posterior spinal fusion for idiopathic scoliosis is known to increase spinal height, but the impacts on weight and resulting body mass index are unknown. This study assesses body mass index, weight, and height percentile changes over time after posterior spinal fusion for idiopathic scoliosis.
    Methods: Body mass index, weight, and height age- and sex-adjusted percentiles for patients with idiopathic scoliosis undergoing posterior spinal fusion between January 2016 and August 2022 were calculated based on growth charts from the Centers for Disease Control for Disease Control and compared to preoperative values at 2 weeks, 3 months, 6 months, 1 year, and 2 years. The data were analyzed for normality with a Shapiro-Wilk test, and percentiles were compared with the Wilcoxon signed-rank tests.
    Results: On average, 12.1 ± 2.3 levels were fused in 269 patients 14.4 ± 1.9 years, and percentiles for body mass index, weight, and height preoperatively were 55.5 ± 29.4%, 57.5 ± 28.9%, and 54.6 ± 30.4%, respectively. Body mass index and weight percentiles decreased at 2 weeks (-10.7%,
    Conclusion: Despite initial height increase due to deformity correction, acute postoperative weight and body mass index percentile decreases postoperatively normalize by 1-year body mass index percentile. Physicians may benefit from utilizing this information when discussing the postoperative course of posterior spinal fusion with idiopathic scoliosis.
    Level of evidence: 4, Retrospective Case Series.
    Language English
    Publishing date 2023-05-22
    Publishing country England
    Document type Journal Article
    ZDB-ID 2279410-4
    ISSN 1863-2548 ; 1863-2521
    ISSN (online) 1863-2548
    ISSN 1863-2521
    DOI 10.1177/18632521231177041
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  8. Article ; Online: What's New in Pain Management for Pediatric Orthopaedic Surgery.

    Johnson, Mitchell A / Andras, Lindsay M / Andras, Lydia E / Ellington, Matthew D / Upasani, Vidyadhar V / Shah, Apurva S

    Journal of pediatric orthopedics

    2023  Volume 41, Issue 10, Page(s) e923–e928

    Abstract: Background: Improving pain control and decreasing opioid prescription and usage continue to be emphasized across both pediatric and adult populations. The purpose of this review is to provide a comprehensive assessment of recent literature and highlight ...

    Abstract Background: Improving pain control and decreasing opioid prescription and usage continue to be emphasized across both pediatric and adult populations. The purpose of this review is to provide a comprehensive assessment of recent literature and highlight new advancements pertaining to pain control in pediatric orthopaedic surgery.
    Methods: An electronic search of the PubMed database was performed for keywords relating to perioperative pain management of pediatric orthopaedic surgery. Search results were filtered by publication date for articles published between January 1, 2015 and December 1, 2020 and yielded 404 papers.
    Results: A total of 32 papers were selected for review based upon new findings and significant contributions in the following categories: risk factors for increased opioid usage, opioid overprescribing and disposal, nonpharmacologic interventions, nonsteroidal anti-inflammatory drugs, peripheral nerve blocks, spine surgery specific considerations, surgical pathway modifications, and future directions.
    Conclusions: There have been many advances in pain management for pediatric patients following orthopaedic surgery. Rapid recovery surgical care pathways are associated with shorter length of stay and improved pain control in pediatric spine surgery. Opioid overprescribing continues to be common and information regarding safe opioid disposal practices should be routinely provided for pediatric patients undergoing surgery.
    Level of evidence: Level IV-literature review.
    MeSH term(s) Analgesics, Opioid/therapeutic use ; Child ; Humans ; Orthopedic Procedures/adverse effects ; Orthopedics ; Pain Management ; Pain, Postoperative/drug therapy
    Chemical Substances Analgesics, Opioid
    Language English
    Publishing date 2023-09-03
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 604642-3
    ISSN 1539-2570 ; 0271-6798
    ISSN (online) 1539-2570
    ISSN 0271-6798
    DOI 10.1097/BPO.0000000000001956
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Validation of the ACL-RSI Scale in Pediatric and Adolescent Patients.

    Cirrincione, Peter M / Gross, Preston W / Matsuzaki, Yukiko / Johnson, Mitchell A / Nagra, Kiranpreet K / Green, Daniel W / Fabricant, Peter D

    The American journal of sports medicine

    2023  Volume 51, Issue 12, Page(s) 3106–3111

    Abstract: Background: The Anterior Cruciate Ligament-Return to Sport after Injury (ACL-RSI) scale is a 12-item questionnaire assessing psychological readiness to return to sport after anterior cruciate ligament reconstruction. It has been validated for use in ... ...

    Abstract Background: The Anterior Cruciate Ligament-Return to Sport after Injury (ACL-RSI) scale is a 12-item questionnaire assessing psychological readiness to return to sport after anterior cruciate ligament reconstruction. It has been validated for use in adults in multiple languages and in an abbreviated 6-question short form. Additionally, literature has been published using this scale in pediatric and adolescent populations, however it has not yet been validated for use with them.
    Purpose: To validate the ACL-RSI scale for use with pediatric and adolescent patients.
    Study design: Cohort study (Diagnosis); Level of evidence, 2.
    Methods: Scores of 6- and 12-item ACL-RSI scales for patients undergoing return-to-sport readiness testing 6 to 8 months after anterior cruciate ligament reconstruction were analyzed. Convergent validity testing was performed against the International Knee Documentation Committee (IKDC)/Pediatric IKDC score, Single Assessment Numeric Evaluation (SANE) score, and peak torque asymmetry of knee flexion and extension using Spearman correlations. Discriminant validity testing was performed against age (Spearman correlation), body mass index (Spearman correlation), and sex (Mann-Whitney
    Results: A total of 51 patients were included in the final analysis. The mean age at surgery was 15.2 ± 2.2 years, and 51.0% were female. The 6- and 12-item ACL-RSI scales demonstrated a strong significant positive correlation with IKDC/Pediatric IKDC scores (
    Conclusion: The ACL-RSI scale is valid to use with pediatric and adolescent patients. The 6-item scale may be a better choice because it has fewer redundancies and minimizes the risk of questionnaire fatigue.
    MeSH term(s) Adult ; Humans ; Female ; Adolescent ; Child ; Male ; Reproducibility of Results ; Cohort Studies ; Anterior Cruciate Ligament Injuries/diagnosis ; Anterior Cruciate Ligament Injuries/surgery ; Translations ; Sports ; Return to Sport/psychology
    Language English
    Publishing date 2023-08-31
    Publishing country United States
    Document type Journal Article
    ZDB-ID 197482-8
    ISSN 1552-3365 ; 0363-5465
    ISSN (online) 1552-3365
    ISSN 0363-5465
    DOI 10.1177/03635465231191778
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Changes in research quality and surgical trends at the international congress on early-onset scoliosis.

    Johnson, Mitchell A / Lott, Carina / Clark, Abigail J / Flynn, John M / Heyer, Jessica H / Cahill, Patrick J / Anari, Jason B

    Spine deformity

    2023  Volume 11, Issue 3, Page(s) 707–713

    Abstract: Purpose: The founding of the International Congress for Early Onset Scoliosis (ICEOS) and first annual meeting in 2007 represented a significant milestone in advancing the care of patients with EOS. Due to the complexity and rarity of EOS, this annual ... ...

    Abstract Purpose: The founding of the International Congress for Early Onset Scoliosis (ICEOS) and first annual meeting in 2007 represented a significant milestone in advancing the care of patients with EOS. Due to the complexity and rarity of EOS, this annual conference is the premiere venue for physicians, researchers, and advanced practice providers to identify and understand the best treatments for children with EOS. This study examines the trend of various treatment modalities presented at ICEOS and the changes in research quality since its inception.
    Methods: Podium presentations from the 2007 through 2021 ICEOS annual meetings were reviewed to determine the number of study patients, use of a study group, and key features of study design. Treatment strategies being evaluated were recorded and included non-operative treatments (casting/bracing), traditional growing rods (TGR), vertical expandable prosthetic titanium rib (VEPTR), Shilla growth guidance, magnetically controlled growing rods (MCGR), and vertebral body tethering (VBT). Linear regressions were performed to analyze changes in research topic and study group utilization.
    Results: A total of 532 abstracts were reviewed. An average of 97.5 ± 81.3 patients were included per study with a significant increase from 42.3 ± 89.7 in 2007 to 337.6 ± 587.4 in 2021 (r
    Conclusion: The trends in EOS device implantation observed in registry studies align with the trends in research presented at ICEOS including the increased proportion of studies focusing on MCGR and VBT over the past decade. An attempt to increase the quality of research presented at ICEOS through multicenter study groups, increased patient recruitment, and utilization of PROMs has been seen since its inception.
    Level of evidence: V.
    MeSH term(s) Humans ; Child ; Scoliosis/surgery ; Prostheses and Implants ; Spine/surgery ; Orthopedic Procedures/methods ; Vertebral Body
    Language English
    Publishing date 2023-01-06
    Publishing country England
    Document type Multicenter Study ; Journal Article
    ZDB-ID 2717704-X
    ISSN 2212-1358 ; 2212-134X ; 2212-1358
    ISSN (online) 2212-1358 ; 2212-134X
    ISSN 2212-1358
    DOI 10.1007/s43390-023-00643-8
    Database MEDical Literature Analysis and Retrieval System OnLINE

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