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Sociodemographic Disparities in Attention-Deficit/Hyperactivity Disorder Overdiagnosis and Overtreatment During Elementary School. 小学阶段注意缺陷/多动障碍过度诊断和过度治疗的社会人口差异。
IF 3 2区 教育学 Q1 EDUCATION, SPECIAL Pub Date : 2023-09-01 DOI: 10.1177/00222194221099675
Paul L Morgan, Adrienne D Woods, Yangyang Wang

Attention-deficit/hyperactivity disorder (ADHD) overdiagnosis and overtreatment unnecessarily exposes children to potential harm and contributes to provider and community skepticism toward those with moderate or severe symptoms and significant impairments, resulting in less supportive care. Yet, which sociodemographic groups of children are overdiagnosed and overtreated for ADHD is poorly understood. We conducted descriptive and logistic regression analyses of a population-based subsample of 1,070 U.S. elementary schoolchildren who had displayed above-average levels of independently assessed behavioral, academic, or executive functioning the year prior to their initial ADHD diagnoses and who did not have prior diagnostic histories. Among these children, (a) 27% of White children versus 19% of non-White children were later diagnosed with ADHD and (b) 20% of White children versus 14% of non-White children were later using medication. In adjusted analyses, White children are more likely to later be diagnosed (odds ratio [OR] range = 1.70-2.62) and using medication (OR range = 1.70-2.37) among those whose prior behavioral, academic, and executive functioning suggested that they were unlikely to have ADHD.

注意缺陷/多动障碍(ADHD)的过度诊断和过度治疗不必要地使儿童受到潜在伤害,并导致提供者和社区对那些有中度或重度症状和显著损伤的儿童持怀疑态度,导致支持性护理减少。然而,哪些社会人口统计学的儿童群体被过度诊断和过度治疗多动症,人们知之甚少。我们对1070名美国小学生进行了描述性和逻辑回归分析,这些小学生在他们最初的ADHD诊断前一年表现出高于平均水平的独立评估的行为、学业或执行功能,并且没有先前的诊断史。在这些儿童中,(a) 27%的白人儿童和19%的非白人儿童后来被诊断为多动症,(b) 20%的白人儿童和14%的非白人儿童后来使用药物。在调整分析中,白人儿童更有可能在后来被诊断(比值比[OR]范围= 1.70-2.62)并使用药物(比值比[OR]范围= 1.70-2.37),而那些先前的行为、学业和执行功能表明他们不太可能患有多动症的儿童。
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引用次数: 1
Compounding Effects of Domain-General Cognitive Weaknesses and Word Reading Difficulties on Anxiety Symptoms in Youth. 青少年领域性认知缺陷和文字阅读困难对焦虑症状的复合效应。
IF 2.4 2区 教育学 Q1 EDUCATION, SPECIAL Pub Date : 2023-09-01 Epub Date: 2022-06-05 DOI: 10.1177/00222194221098719
Nina J Anderson, Michelle Rozenman, Bruce F Pennington, Erik G Willcutt, Lauren M McGrath

This study examined whether domain-general cognitive weaknesses in processing speed (PS) or executive functioning (EF) moderate the relation between word reading scores and anxiety such that lower word reading scores in combination with lower cognitive scores are associated with higher anxiety symptoms. The sample consisted of 755 youth ages 8-16 who were recruited as part of the Colorado Learning Disabilities Research Center twins study. Lower scores on PS (R2 = .007, p = .014), EF (R2 = .009, p = .006), and word reading (R2 = .006-.008, p = .010-.032) were associated with higher anxiety scores. In addition, the word reading × cognitive interactions were significant such that lower scores on PS (R2 = .010, p = .005) or EF (R2 = .013, p = .010) combined with lower word reading were associated with higher-than-expected anxiety symptoms. Results suggest that weaknesses in PS, EF, and word reading are modestly associated with higher anxiety symptoms, and these anxiety symptoms may be compounded in youth with both PS or EF weaknesses and word reading difficulties. These findings can guide assessment approaches for identifying youth with word reading challenges who may be at increased risk for anxiety.

本研究探讨了处理速度(PS)或执行功能(EF)方面的领域性认知缺陷是否会缓和单词阅读得分与焦虑之间的关系,从而使较低的单词阅读得分加上较低的认知得分与较高的焦虑症状相关联。样本包括 755 名 8-16 岁的青少年,他们是科罗拉多学习障碍研究中心双胞胎研究的一部分。PS(R2 = .007,p = .014)、EF(R2 = .009,p = .006)和单词阅读(R2 = .006-.008,p = .010-.032)得分较低与焦虑得分较高有关。此外,单词阅读 × 认知交互作用也很显著,即 PS 分数较低(R2 = .010,p = .005)或 EF 分数较低(R2 = .013,p = .010),再加上单词阅读较低,都与焦虑症状高于预期有关。结果表明,PS、EF 和单词阅读能力较弱与较高的焦虑症状略有关联,而同时存在 PS 或 EF 弱项和单词阅读困难的青少年的焦虑症状可能会更加严重。这些发现可以指导评估方法,以识别有单词阅读困难、焦虑风险可能增加的青少年。
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引用次数: 0
Executive Functions Training for 7- to 10-Year-Old Students With Mathematics Difficulty: Instant Effects and 6-Month Sustained Effects. 7 ~ 10岁数学困难学生执行功能训练:即时效果和6个月持续效果。
IF 3 2区 教育学 Q1 EDUCATION, SPECIAL Pub Date : 2023-09-01 DOI: 10.1177/00222194221117513
Dan Cai, Jing Zhao, Zhijun Chen, Di Liu

Executive function (EF) training has shown promise for remedying general EF deficiencies faced by students with mathematics difficulty (MD) and for improving their performance. However, latest research also suggests that the instant and sustained effects of EF training remain inconsistent. In this study, 32 Chinese students with MD, age 7 to 10 years, were recruited and randomly divided into two groups: the training group (n = 16, 25 training sessions) and the control group (n = 16). Both groups took a pretest, a posttest, and a follow-up test (after 6 months) on EF, fluid intelligence, and mathematics skills. In the posttest, the training group's performance significantly improved in 2-back, number shifting, letter shifting, calculation fluency, and mathematics problem-solving tasks, but not in Stroop, Flanker, 1-back, numerical operations, and colored progressive matrices tasks. In the follow-up test after 6 months, the effects of training only on the 2-back and letter shifting tasks were sustained. The effect on the numerical operations task appeared; however, the effects on number shifting, calculation fluency, and mathematics problem-solving tasks disappeared. The results of this study show that EF training has instant effects of improving EF and mathematics skills of students with MD, and 6-month sustained effects on some of the improved skills. However, for fluid intelligence, the effects may be very limited.

执行功能(EF)训练对弥补数学困难(MD)学生面临的一般性EF缺陷和提高他们的表现显示出希望。然而,最新的研究也表明,EF训练的即时和持续效果仍然不一致。本研究招募32名年龄在7 ~ 10岁的中国MD学生,随机分为两组:训练组(n = 16, 25次训练)和对照组(n = 16)。两组都进行了EF、流体智力和数学技能的前测、后测和随访测试(6个月后)。在后测中,训练组在2-back、数字移位、字母移位、计算流畅性和数学问题解决任务上的表现显著提高,但在Stroop、Flanker、1-back、数值运算和彩色递进矩阵任务上的表现无显著提高。在6个月后的随访测试中,仅对2-back和字母移位任务的训练效果持续。对数值运算任务的影响;然而,对数字移动、计算流畅性和数学问题解决任务的影响消失了。本研究结果表明,英语学习训练对MD学生的英语学习和数学技能的提高具有立竿见影的效果,并且对某些技能的提高具有6个月的持续效果。然而,对于流动智力来说,这种影响可能非常有限。
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引用次数: 1
Reading and Math Achievement in Children With Dyslexia, Developmental Language Disorder, or Typical Development: Achievement Gaps Persist From Second Through Fourth Grades. 阅读障碍、发展性语言障碍或典型发展儿童的阅读和数学成绩:成绩差距从二年级持续到四年级。
IF 3 2区 教育学 Q1 EDUCATION, SPECIAL Pub Date : 2023-09-01 DOI: 10.1177/00222194221105515
Dawna M Duff, Alison E Hendricks, Lisa Fitton, Suzanne M Adlof

We examined how children (N = 448) with separate or co-occurring developmental language disorder (DLD) and dyslexia performed on school-based measures of academic functioning between second and fourth grades. Children were recruited from 1 school district in the U.S. state of South Carolina via classroom screenings and met common research criteria for DLD and dyslexia. Growth curve models were used to examine the overall form of growth and differences between groups. Children with DLD and/or dyslexia in second grade showed early and persistent deficits on school-administered measures of reading and math. In second grade, children with typical development (TD) scored significantly higher than children with dyslexia-only and DLD-only, who did not differ from each other. Children with DLD+dyslexia scored significantly lower than all other groups. Only small differences in growth rates were observed, and gaps in second grade did not close. Despite lower academic performance, few children (20%-27%) with dyslexia and/or DLD had received specialized support services. Children with DLD-only received services at less than half the rate of dyslexia-only or DLD+dyslexia despite similar impacts on academic performance. Evidence of significant and persistent functional impacts in the context of low rates of support services in these children-especially those with DLD-only-highlights the need to raise awareness of these disorders.

我们研究了患有单独或共同发生的发展性语言障碍(DLD)和阅读障碍的儿童(N = 448)在二年级至四年级之间的学业功能学校测量中的表现。通过课堂筛选从美国南卡罗来纳州的一个学区招募儿童,并符合DLD和阅读障碍的共同研究标准。生长曲线模型用于检验生长的总体形式和组间差异。患有DLD和/或二年级阅读障碍的儿童在学校管理的阅读和数学测试中表现出早期和持续的缺陷。在二年级,典型发育儿童的得分显著高于单纯阅读障碍儿童和单纯阅读障碍儿童,两者之间没有差异。DLD+阅读障碍儿童得分明显低于其他各组。只有很小的增长率差异被观察到,二年级的差距并没有缩小。尽管学习成绩较差,但患有阅读障碍和/或DLD的儿童(20%-27%)很少得到专门的支持服务。尽管对学习成绩的影响相似,但只有阅读障碍的儿童接受服务的比例不到阅读障碍或阅读障碍+阅读障碍的一半。有证据表明,在这些儿童(尤其是那些仅患有dld的儿童)的支持服务率较低的情况下,存在显著和持续的功能影响,这突出了提高对这些疾病认识的必要性。
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引用次数: 10
What Skills Could Distinguish Developmental Dyscalculia and Typically Developing Children: Evidence From a 2-Year Longitudinal Screening. 什么技能可以区分发展性计算障碍和典型发展儿童:来自2年纵向筛查的证据。
IF 3 2区 教育学 Q1 EDUCATION, SPECIAL Pub Date : 2023-07-01 DOI: 10.1177/00222194221099674
Danfeng Li, Xuejing Zhang, Li Zhang

Developmental dyscalculia (DD) is a mathematics learning disorder that affects approximately 5% to 7% of the population. This study aimed to detect the underlying domain-specific and domain-general differences between DD and typically developing (TD) children. We recruited 9-year-old primary school children to form the DD group via a 2-year longitudinal screening process. In total, 75 DD children were screened from 1,657 children after the one-time screening, and 13 DD children were screened from 1,317 children through a consecutive 2-year longitudinal screening. In total, 13 experimental tasks were administered to assess their cognitive abilities to test the domain-specific magnitude representation hypothesis (including symbolic and nonsymbolic magnitude comparisons) and four alternative domain-general hypotheses (including working memory, executive function, attention, and visuospatial processing). The DD group had worse performance than the TD group on the number sense task, finger sense task, shifting task, and one-back task after both one-time and two-time screening. Logistic regressions further indicated the differences on the shifting task and the nonsymbolic magnitude comparison task could distinguish DD and TD children. Our findings suggest that domain-specific nonsymbolic magnitude representation and domain-general executive function both contribute to DD. Thus, both domain-specific and domain-general abilities will be necessary to investigate and to intervene in DD groups in the future.

发展性计算障碍(DD)是一种数学学习障碍,影响了大约5%到7%的人口。本研究旨在检测DD和典型发育(TD)儿童之间潜在的特定领域和一般领域差异。我们招募了9岁的小学生,通过2年的纵向筛选过程组成DD组。在一次性筛查后,总共从1657名儿童中筛查了75名DD儿童,并通过连续2年的纵向筛查从1317名儿童中筛查了13名DD儿童。总共进行了13项实验任务来评估他们的认知能力,以测试特定领域的大小表征假设(包括符号和非符号大小比较)和四个可选的领域一般假设(包括工作记忆、执行功能、注意力和视觉空间处理)。在一次和两次筛选后,DD组在数字感觉任务、手指感觉任务、移位任务和一回任务上的表现都不如TD组。Logistic回归进一步表明,移动任务和非符号量比较任务的差异可以区分DD和TD儿童。我们的研究结果表明,特定领域的非符号量表征和一般领域的执行功能都有助于DD。因此,在未来的DD群体中,研究和干预需要特定领域和一般领域的能力。
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引用次数: 0
A Neuropsychological Profile of Developmental Dyscalculia: The Role of Comorbidity. 发展性计算障碍的神经心理学特征:共病的作用。
IF 3 2区 教育学 Q1 EDUCATION, SPECIAL Pub Date : 2023-07-01 DOI: 10.1177/00222194221102925
Chiara Luoni, Maristella Scorza, Silvia Stefanelli, Barbara Fagiolini, Cristiano Termine
Developmental dyscalculia (DD) has long been thought to be determined by multiple components. Dyscalculia has high comorbidity with other learning and developmental disabilities, including reading and writing disorders, attention deficits, and problems in visual/spatial skills, short memory, and working memory. This study aims to assess prevalence rates for isolated as well as comorbid DD in a sample of Italian-speaking children. In addition, we studied the neuropsychological profile of children with isolated or combined dyscalculia. We tested 380 children (176 males and 204 females) between the ages of 8.17 and 9.33 years using an extensive battery to determine the neuropsychological profile. The assessment included an arithmetic battery and nonverbal intelligence, short-term memory, reading, and writing tests. The results indicated that children with DD more frequently have a reading disorder and writing disorder. They also have a lower nonverbal intelligence quotient (IQ) and obtain significantly lower scores in short-term memory tests and on a visuospatial skills questionnaire. They also had significantly higher scores (indicative of greater attentional difficulties) on the Conners subscale for attentional problems. Children with DD present different cognitive and neuropsychological profiles.
发展性计算障碍(DD)一直被认为是由多种因素决定的。计算障碍与其他学习和发育障碍有很高的合并症,包括读写障碍、注意力缺陷、视觉/空间技能问题、短时记忆和工作记忆。本研究旨在评估意大利语儿童样本中孤立性和共病性DD的患病率。此外,我们还研究了孤立或合并计算障碍儿童的神经心理学特征。我们测试了380名年龄在8.17至9.33岁之间的儿童(176名男性和204名女性),使用广泛的电池来确定神经心理学特征。评估包括算术测试、非语言智力、短期记忆、阅读和写作测试。结果表明,患有DD的儿童更容易出现阅读障碍和写作障碍。他们的非语言智商(IQ)也较低,在短期记忆测试和视觉空间技能问卷中的得分也明显较低。他们在Conners注意力问题量表上的得分也明显更高(表明更大的注意力困难)。DD患儿表现出不同的认知和神经心理特征。
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引用次数: 2
Examining Virtual Manipulatives for Teaching Computations With Fractions to Children With Mathematics Difficulty. 考察虚拟教具对数学困难儿童的分数计算教学。
IF 3 2区 教育学 Q1 EDUCATION, SPECIAL Pub Date : 2023-07-01 DOI: 10.1177/00222194221097710
Rajiv Satsangi, Alexandra R Raines

As digital technology use increases in K-12 education, greater numbers of strategies become available to support students in mathematics. One technology that provides students diverse representations of mathematical concepts is virtual manipulatives. Although instruction featuring representations with physical manipulatives possesses a large body of research, the virtual form lacks comparable study, particularly with young children experiencing mathematics difficulty or identified with a mathematics learning disability. These students often demonstrate challenges learning integral skills such as fractions that subsequently affect their academic success in future years. This study examined the use of virtual manipulatives paired with explicit instruction and a system of least prompts for teaching computations with fractions to three elementary students with mathematics difficulty. A functional relation was found using a single-subject multiple probe design between the treatment condition and students' accuracy performance solving problems. These results and their implications for the field at-large are discussed.

随着K-12教育中数字技术的使用增加,有更多的策略可以用来支持学生的数学学习。一种为学生提供各种数学概念表示的技术是虚拟操作。尽管以物理操作表征为特征的教学拥有大量的研究,但虚拟形式缺乏可比的研究,特别是对于经历数学困难或被认为有数学学习障碍的幼儿。这些学生经常表现出学习分数等综合技能的挑战,这些技能随后会影响他们未来几年的学业成就。本研究以三名有数学困难的小学生为对象,考察了使用虚拟教具配合明确的指导和最小提示系统来教授分数计算。采用单主题多探针设计,发现治疗条件与学生解决问题的准确性表现之间存在函数关系。讨论了这些结果及其对整个领域的影响。
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引用次数: 1
Effects of Professional Development on English Learners' Problem Solving. 专业发展对英语学习者问题解决的影响。
IF 3 2区 教育学 Q1 EDUCATION, SPECIAL Pub Date : 2023-07-01 DOI: 10.1177/00222194221099671
Michael J Orosco, Deborah K Reed

Teacher preparation for problem-solving instruction is essential to meeting the math needs of English learners (ELs) with math learning disabilities (MLD) in U.S. public schools. In investigating this instruction with Hispanic ELs with MLD, this study focused on how professional development supported one special educator's implementation of effective practices for both academic language and problem-solving instruction. The professional development prepared the teacher for instructional and cooperative learning phases that faded prompting as students achieved independence in applying the problem-solving strategy. A multiple-baseline design was used to assess nine third-grade Hispanic ELs with MLD. As compared with the baseline phase, instructional scaffolding increased word problem solving for all the participants. All students' level of probe performance was maintained during follow-up sessions. The results suggest the intervention facilitated improved math problem-solving performance.

教师为解决问题的指导做准备对于满足美国公立学校有数学学习障碍(MLD)的英语学习者(el)的数学需求至关重要。在对患有语言障碍的西班牙裔英语学习者的教学进行调查时,本研究关注的是专业发展如何支持一名特殊教育者在学术语言和问题解决教学方面实施有效的实践。专业发展为教师准备了教学和合作学习阶段,随着学生在应用问题解决策略方面取得独立,这一阶段的提示逐渐消失。采用多基线设计评估9例患有MLD的三年级西班牙裔el。与基线阶段相比,教学脚手架增加了所有参与者解决单词问题的能力。所有学生的探针表现水平在随访期间保持不变。结果表明,干预有助于提高数学解决问题的表现。
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引用次数: 2
Severe Pandemic Learning Loss and the Promise of Remotely Delivered Intervention in Students With Comorbid Reading and Mathematics Learning Difficulty. 严重的流行病学习损失和对阅读和数学学习困难学生进行远程干预的前景。
IF 2.4 2区 教育学 Q1 EDUCATION, SPECIAL Pub Date : 2023-07-01 Epub Date: 2023-05-17 DOI: 10.1177/00222194231170313
Lynn S Fuchs, Pamela M Seethaler, Douglas Fuchs, Daniel Espinas

Analyses were conducted with second graders, drawn from an ongoing multi-cohort randomized controlled trial (RCT), who had been identified for RCT entry based on comorbid reading comprehension and word-problem solving difficulty. To estimate pandemic learning loss, we contrasted fall performance for 3 cohorts: fall of 2019 (pre-pandemic; n = 47), 2020 (early pandemic, when performance was affected by the truncated preceding school year; n = 35), and 2021 (later pandemic, when performance was affected by the truncated 2019 to 2020 school year plus the subsequent year's ongoing interruptions; n = 75). Across the 2 years, declines (standard deviations below expected growth) were approximately 3 times larger than those reported for the general population and for students in high-poverty schools. To estimate the promise of structured remote intervention for addressing such learning loss during extended school closures, we contrasted effects in the RCT's 2018 to 2019 cohort (entirely in-person intervention delivery; n = 66) against the same intervention's effects in the 2020 to 2021 cohort (alternating periods of remote and in-person delivery; n = 29). Large intervention effects were not moderated by pandemic status, suggesting potential for structured remote intervention to address student needs during extended school closures.

对二年级学生进行了分析,他们来自一项正在进行的多队列随机对照试验(RCT),根据共病阅读理解和单词问题解决难度确定了进入RCT的学生。为了估计疫情期间的学习损失,我们对比了3个群体的秋季表现:2019年秋季(疫情前;n=47)、2020年秋季(早期疫情,表现受到前一学年缩短的影响;n=35)和2021年秋季(后期疫情,表现受2019至2020学年缩短以及下一学年持续中断的影响;n=75)。在这两年中,下降幅度(低于预期增长的标准差)大约是普通人群和高贫困学校学生的3倍。为了估计结构化远程干预在学校长期关闭期间解决此类学习损失的前景,我们将RCT 2018年至2019年队列中的效果(完全面对面干预;n=66)与2020年至2021年队列中相同干预的效果(远程和面对面交付的交替期;n=29)进行了对比。大规模的干预效果并没有受到疫情状态的影响,这表明在学校长期关闭期间,有可能进行结构化的远程干预来满足学生的需求。
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引用次数: 0
Examining Interactions Across Instructional Tiers: Do Features of Tier 1 Predict Student Responsiveness to Tier 2 Mathematics Intervention? 检查教学层之间的相互作用:第一层的特征是否预测学生对第二层数学干预的反应?
IF 3 2区 教育学 Q1 EDUCATION, SPECIAL Pub Date : 2023-07-01 DOI: 10.1177/00222194221102644
Marah Sutherland, Taylor Lesner, Derek Kosty, Cayla Lussier, Keith Smolkowski, Jessica Turtura, Christian T Doabler, Ben Clarke

High-quality Tier 1 instruction is frequently conceptualized as the "foundation" for other tiers of intervention within multitiered systems of support (MTSS) models. However, the vast majority of Tier 2 intervention studies do not account for Tier 1 variables when examining intervention effectiveness. The purpose of this study was to examine Tier 1 predictors, or "quality indicators," of differential responsiveness to Tier 2 mathematics intervention. Data were drawn from a large-scale data set where all teachers taught the Early Learning in Mathematics (Tier 1) core program across the academic year, and a subset of students were selected for the ROOTS (Tier 2) mathematics intervention. We examined the following Tier 1 variables: (a) classroom-level mathematics gains, (b) Tier 1 fidelity of implementation, (c) Tier 1 classroom management and instructional support, and (d) class size. Response to Tier 2 intervention was not significantly predicted by any of the Tier 1 variables examined; however, the pattern of Hedges' g effect sizes suggested that students with higher quality of Tier 1 instruction tended to benefit less from the Tier 2 ROOTS intervention. Results are discussed in the context of implications for research and practice.

高质量的第1层指导经常被概念化为多层支持系统(MTSS)模型中其他干预层的“基础”。然而,绝大多数二级干预研究在检查干预效果时没有考虑一级变量。本研究的目的是检验第1层预测因子,或“质量指标”,对第2层数学干预的差异反应。数据来自一个大型数据集,其中所有教师在整个学年中教授数学早期学习(第1层)核心课程,并选择一部分学生进行ROOTS(第2层)数学干预。我们检查了以下第一级变量:(a)课堂水平的数学成绩,(b)第一级实施的保真度,(c)第一级课堂管理和教学支持,以及(d)班级规模。对二级干预的反应没有被任何一级变量显著预测;然而,Hedges的g效应量模式表明,一级教学质量较高的学生往往从二级ROOTS干预中获益较少。结果在研究和实践的意义的背景下进行讨论。
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引用次数: 0
期刊
Journal of Learning Disabilities
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