intervention

干预
  • 文章类型: Journal Article
    研究人员和专业人员越来越关注参与作为明确的干预结果,这促使了思想和实践的范式转变。然而,许多研究都集中在改变特定生活环境和阶段的参与结果。这篇讨论论文认为“参与作为一种手段”在儿科康复和特殊教育干预中,强调其在实现持久成果方面的作用。
    本文使用维恩图方法来考虑三个核心概念之间的关系-参与,干预,和结果-以及它们的交叉点。这篇论文的中心主题围绕着这些概念的交叉点,其中参与是在康复和特殊教育领域实现持久参与成果的一种手段。讨论得到了当代实证工作和最近两次针对干预过程的范围界定评论中确定的文献的支持。
    通过参与干预过程获得持久的参与成果需要创造学习体验,儿童和家庭积极参与每一步:确定参与问题,寻求解释,优先考虑干预目标,选择方法,实施干预措施,并评估过程和结果。
    这种结构化的方法支持专业人员和研究人员培养有障碍儿童持久参与成果所需的技能和能力。
    UNASSIGNED: The increased focus among researchers and professionals on participation as an explicit intervention outcome has prompted a paradigm shift in both thought and practice. However, much research centers on altering participation outcomes in specific life situations and stages. This discussion paper considers \"participation as a means\" in pediatric rehabilitation and special education interventions, emphasizing its role in achieving lasting outcomes.
    UNASSIGNED: This paper uses a Venn diagram approach to consider relations between three core concepts-participation, intervention, and outcomes-and their intersection. The paper\'s central theme revolves around the intersection of these concepts, wherein participation serves as a means to achieve enduring participation outcomes within the realms of rehabilitation and special education. The discussion is supported by contemporary empirical work and from literature identified in two recent scoping reviews focusing on the intervention process.
    UNASSIGNED: Achieving enduring participation outcomes through participation in the intervention process necessitates creating a learning experience, with children and families actively participating in every step: identifying participation issues, seeking explanations, prioritizing intervention goals, selecting methods, implementing interventions, and evaluating the process and outcomes.
    UNASSIGNED: This structured approach supports professionals and researchers to foster the skills and capacity required for lasting participation outcomes for children with impairments.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    生活中的成功与执行功能有关,支持目标导向行为的认知过程的集合。执行功能是与认知控制相关的总称,自我控制,还有更多.执行功能的变化预测了学校教育的并发成功,关系,和行为,以及几年后重要的生活结果。这些发现可能表明,某些人注定要拥有良好的执行功能和成功。然而,环境对执行功能和发展的影响早已得到认可。这一传统的最新研究表明,社会背景影响儿童参与执行功能的力量。这些发现提出了新的解释,为什么个人在执行功能和相关的生活结果方面存在差异,包括跨文化和社会经济地位。这些发现提出了关于如何最好地概念化的基本问题,measure,并支持不同背景下的执行功能。解决现实世界动态和计算机制的未来研究将阐明执行功能如何在世界上出现。
    Success in life is linked to executive functions, a collection of cognitive processes that support goal-directed behaviors. Executive functions is an umbrella term related to cognitive control, self-control, and more. Variations in executive functioning predict concurrent success in schooling, relationships, and behavior, as well as important life outcomes years later. Such findings may suggest that certain individuals are destined for good executive functioning and success. However, environmental influences on executive function and development have long been recognized. Recent research in this tradition demonstrates the power of social contextual influences on children\'s engagement of executive functions. Such findings suggest new interpretations of why individuals differ in executive functioning and associated life outcomes, including across cultures and socioeconomic statuses. These findings raise fundamental questions about how best to conceptualize, measure, and support executive functioning across diverse contexts. Future research addressing real-world dynamics and computational mechanisms will elucidate how executive functioning emerges in the world.
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  • 文章类型: Journal Article
    本研究旨在使用现实主义综合方法来理解和解释背景因素对急性医院实施故意舍入的影响。住院患者的跌倒是急性医院环境中患者安全最常见的问题之一。人们跌倒的原因很复杂。国际准则建议对已识别的风险因素进行多因素评估和有效预防和管理,以减少跌倒次数。有意舍入(IR)是实现这一点的一种方法。IR是一个总称,被理解为一个结构化的过程,护士或护理人员使用标准化的协议对个体患者进行定期检查,以解决定位等问题,疼痛,个人需求和财产的放置。
    这项研究将使用现实主义综合来理解什么是有效的,为谁,在什么情况下,在什么设置。现实主义综合是一种理论驱动的证据综合解释方法。我们打算分析IR作为干预措施,旨在加强医院环境中的病人护理和安全。该综合构成了一项更大的实施研究的一部分,该研究旨在研究减少医院跌倒次数的干预措施。搜索词将包括有意四舍五入,有目的的四舍五入,舒适四舍五入和每小时四舍五入,并将包含超出IR和下降率的搜索词,以避免限制合成。此综合将符合RAMESES(现实主义和元叙事证据综合组)出版物和报告质量标准。
    这些发现将为在急症医院环境中开展IR研究的下一阶段提供信息,解决证据知情因素和IR障碍。结果将通过同行评审的期刊和演示文稿传播。
    UNASSIGNED: This study aims to understand and explain the influence of contextual factors on the implementation of Intentional Rounding in acute hospitals using the realist synthesis methodology.Falls of hospital admitted patients are one of the most frequent concerns for patient safety in the acute hospital environment. The reasons why people fall are complex. International guidelines recommend a multifactorial assessment and effective prevention and management of identified risk factors in order to reduce the number of falls. Intentional Rounding (IR) is one approach for delivering this. IR is an umbrella term, understood as a structured process whereby nurses or care staff carry out regular checks with individual patients using a standardised protocol to address such issues as positioning, pain, personal needs and placement of possessions.
    UNASSIGNED: This study will use realist synthesis to understand what works, for whom, in what circumstances, and in what settings. Realist synthesis is a theory driven interpretive approach to evidence synthesis. It is our intention to analyse IR as an intervention, which aims to enhance patient care and safety in hospital settings. The synthesis forms part of a larger implementation study examining interventions that reduce the number of falls that occur in hospitals. Search terms will include intentional rounding, purposeful rounding, comfort rounding and hourly rounding and will encompass search terms beyond IR and falls rates to avoid limiting the synthesis. This synthesis will conform to the RAMESES (realist and meta-narrative evidence synthesis group) publication and reporting quality standards.
    UNASSIGNED: The findings will inform the next phase of an implementation study on IR in acute hospital settings, to address evidence informed enablers and barriers to IR. The results will be disseminated in a peer-reviewed journal and through presentations.
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  • 文章类型: Journal Article
    UNASSIGNED: This systematic review sought to understand the effectiveness of lived experience mentoring, by people recovered from an eating disorder, with clinical samples currently receiving eating disorder treatment.
    UNASSIGNED: The systematic review was conducted using PsycINFO, MEDLINE, Scopus, and ProQuest Dissertations and Theses Global and reviewing reference lists of included papers. Articles were included if they: (1) were intervention studies that included peer (recovered from an eating disorder) involvement, (2) delivered the intervention to clinical samples (or carers with direct involvement in treatment), (3) were in English, and (4) included quantitative results.
    UNASSIGNED: Eleven studies were included across randomized control trials (RCTs), case series, and a case study; there was variation in quality. Findings varied considerably with some concluding that lived experience mentoring led to significant improvements for mentees, while other studies found no significant differences. Mentor outcomes were often not evaluated. Of those that did assess mentors, there is preliminary evidence for some benefits to participation but also the potential for harm.
    UNASSIGNED: There is a need for further research in this area using high-quality RCTs that address the risk of bias. It is important that lived experience peer mentors are monitored on key outcomes, provided with adequate training and ongoing supervision, and are reimbursed for their involvement.
    UNASSIGNED: This systematic review is the first review to focus on the use of peer mentors recovered from an eating disorder contributing to interventions for people receiving treatment for an eating disorder. All included studies present quantitative results. Given the emerging interest of lived experience mentoring, understanding its effectiveness for both mentees and impacts on mentors continues to be of critical importance. Resumen.
    UNASSIGNED: Esta revisión sistemática buscó comprender la efectividad de la consejería de la experiencia vivida por parte de personas recuperadas de un trastorno de la conducta alimentaria, con muestras clínicas que actualmente reciben tratamiento para el trastorno alimentario.
    UNASSIGNED: La revisión sistemática se realizó utilizando PsycINFO, MEDLINE, Scopus y ProQuest Dissertations, and Theses Global y revisando las listas de referencias de los artículos incluidos. Los artículos se incluyeron si: (1) eran estudios de intervención que incluían la participación de pares (recuperados de un trastorno de la conducta alimentaria), (2) administraban la intervención a muestras clínicas (o cuidadores con participación directa en el tratamiento), (3) estaban en inglés y (4) incluían resultados cuantitativos.
    UNASSIGNED: Se incluyeron once estudios en ensayos controlados aleatorios (ECA), series de casos y un estudio de caso; hubo variación en la calidad. Los hallazgos variaron considerablemente y algunos concluyeron que la consejería de la experiencia vivida condujo a mejoras significativas para los aprendices, mientras que otros estudios no encontraron diferencias significativas. Los resultados del mentor a menudo no se evaluaron. De los que evaluaron a los mentores, hay evidencia preliminar de algunos beneficios de la participación, pero también del potencial de daño.
    UNASSIGNED: Se necesitan estudios de investigación adicionales en esta área que utilicen ECA de alta calidad que aborden el riesgo de sesgo. Es importante que los mentores de pares de la experiencia vivida sean monitoreados en los resultados clave, provistos de capacitación adecuada y supervisión continua, y sean remunerados por su participación.Reprinted from Int J Eat Disord 2023; 56:331-349, with permission from Wiley. Copyright © 2023.
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  • 文章类型: Journal Article
    超越偏见是在布基纳法索引入的干预措施,巴基斯坦和坦桑尼亚,为了减少卫生工作者对年轻人的偏见,未婚和未产妇女寻求计划生育服务。这项研究使用定性方法-基于对参与干预的卫生工作者的访谈,参与干预的医疗机构管理人员,以及国家一级的政策和计划利益相关者-了解干预措施的实施经验。这些结果为寻求实施超越偏见或类似计划的组织或国家提供了见解。并指出在资源较低的环境中,多部分干预措施的其他一些关键实施挑战。干预,使用以人为本的设计方法开发,被视为成功实施的关键,但存在后勤挑战。数字干预是破坏性的,分散了许多人的注意力。此外,非财务奖励干预被认为是复杂的,一些参与者表示,当他们没有得到奖励时感到沮丧。超越偏见没有充分关注“外部设置”,这被认为是一个主要的实施障碍,因为它限制了个人充分实现所需行为改变的能力;例如,空间限制意味着一些卫生设施无法确保为所有客户提供私人服务。存在与成本相关的可扩展性问题,并且存在不确定性(国家内部和国家之间)的背景多样性是否可能限制大规模实施超越偏见。
    Beyond Bias was an intervention introduced in Burkina Faso, Pakistan and Tanzania, with the aim of reducing health worker bias toward young, unmarried and nulliparous women seeking family planning services. This study used qualitative methods - based on interviews with health workers who participated in the intervention, managers at health facilities that participated in the intervention, and policy and program stakeholders at the national level - to understand implementation experiences with the intervention. The results offer insights for organizations or countries seeking to implement Beyond Bias or similar programs, and point to some other key implementation challenges for multi-component interventions in lower-resource settings. The intervention, developed using a human-centered design approach, was seen as key for successful implementation but there were logistical challenges. The digital intervention was disruptive and distracting to many. In addition, the non-financial rewards intervention was perceived as complex, and some participants expressed feeling discouraged when they did not receive a reward. Beyond Bias did not sufficiently attend to the \"outer setting,\" and this was perceived as a major implementation barrier as it limited individuals\' capacity to fully achieve the desired behavior change; for example, space constraints meant that some health facilities could not ensure private services for all clients. There were scalability concerns related to cost, and there is uncertainty whether diversity of contexts (within and across countries) might constrain implementation of Beyond Bias at scale.
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  • 文章类型: Journal Article
    背景:高等教育学生是公共卫生营养干预的重要目标群体。在设计量身定制和上下文相关的干预措施时,参与式和共同创造方法越来越被认为是有前途的,但它们的使用和有效性尚未在这类人群中得到评估。我们系统地审查了旨在改善高等教育环境中饮食质量和/或粮食安全的干预措施,目的是1)确定和描述其参与式和共同创造方法,以及2)比较使用或不使用参与式和共同创造方法的干预措施的有效性。
    方法:我们在PubMed中的搜索,谷歌学者,WebofScience,EMBASE于2023年1月进行,产生了3658条独特记录,其中包括42篇文章(66项干预措施)。在个人水平(纵向评估)或在组水平(重复横断面评估)评估干预措施的有效性。使用五级分类来描述学生和其他合作伙伴在干预设计和实施中的连续参与:无参与(一级),协商,联合制作,共同设计和共同创造(2至5级)。为了综合有效性,在无参与(一级)或有参与(二级至五级)的研究之间进行比较.
    结果:42项研究中有10项(24%)使用了参与式和共同创造方法(2-5级)。使用参与式和共同创造方法的研究报告了5/13(38%)干预组的个人水平结果(即总体饮食质量或食物组摄入量或粮食安全)的积极发现(与13/31或42%没有参与)。使用参与式和共同创造方法的研究报告了4/7(57%)(与没有参与的8/23或35%)的小组级结果(即校园食品商店的食物选择)的积极发现。
    结论:参与式和共同创造方法可能会提高高等教育环境中营养干预的有效性,但证据水平仍然非常有限。在设计时,有必要进行更多的研究来确定最佳的共同创造实践,在高等教育环境中实施和评估营养干预措施。
    背景:PROSPERO注册号CRD42023393004。
    BACKGROUND: Higher education students are an important target group for public health nutrition interventions. When designing tailored and contextually relevant interventions, participatory and co-creation approaches are increasingly recognized as promising but their use and effectiveness has not been assessed in this type of population. We systematically reviewed interventions aiming to improve dietary quality and/or food security in higher education settings with the aims 1) to identify and describe their participatory and co-creation approaches and 2) to compare the effectiveness of interventions using or not using participatory and co-creation approaches.
    METHODS: Our search in PubMed, Google Scholar, Web of Science, EMBASE was performed in January 2023 and yielded 3658 unique records, out of which 42 articles (66 interventions) were included. Effectiveness of interventions was assessed at the individual level (longitudinal evaluations) or at the group level (repeated cross-sectional evaluations). A five-level classification was used to describe a continuum of engagement from students and other partners in the intervention design and implementation: no participation (level one), consultation, co-production, co-design and co-creation (levels two to five). To synthetize effectiveness, comparisons were made between studies without participation (level one) or with participation (levels two-five).
    RESULTS: Ten (24%) out of 42 studies used a participatory and co-creation approach (levels two-five). Studies using a participatory and co-creation approach reported a positive finding on individual-level outcome (i.e. overall diet quality or food group intake or food security) in 5/13 (38%) intervention arms (vs 13/31 or 42% for those without participation). Studies using a participatory and co-creation approach reported a positive finding on group-level outcomes (i.e. food choices in campus food outlets) in 4/7 (57%) (vs 8/23 or 35% in those without participation).
    CONCLUSIONS: Participatory and co-creation approaches may improve the effectiveness of nutrition interventions in higher education settings but the level of evidence remains very limited. More research is warranted to identify best co-creation practices when designing, implementing and evaluating nutritional interventions in the higher education setting.
    BACKGROUND: PROSPERO registration number CRD42023393004.
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  • 文章类型: Case Reports
    弯刀综合征是一种先天性疾病,其特征是部分肺静脉异常回流到下腔静脉(IVC)。成年后的临床表现很少见。管理方法尚未被普遍接受,可能具有挑战性。个性化和多学科的团队决策往往是必要的。我们介绍了一个诊断为复杂先天性心脏病的有症状患者的病例,包括50岁时的弯刀综合征和房间隔缺损。手术修复,涉及使用心包补片在左心房植入弯刀静脉,已执行。尽管进行了手术矫正,呼吸困难持续存在,出现咯血.诊断检查显示重新插入的静脉严重狭窄。通过经皮介入支架植入成功治疗。患者自手术以来一直无症状。弯刀综合征可以在成年期首次诊断,临床表现可能有所不同。诊断检查需要CT血管造影,磁共振扫描,和导管插入在选定的情况下。重新植入的肺静脉(PV)狭窄可以在手术矫正后数年发展,咯血可能作为提示进一步PV成像的警告症状。在有症状的情况下,使用支架进行经皮血管介入治疗是必要的,并且可以带来长期的成功。
    Scimitar syndrome is a congenital disorder characterized by partial anomalous pulmonary venous return to the inferior vena cava (IVC). Clinical manifestation in adulthood is infrequent. The management approach has not been universally accepted and may be challenging. Individually tailored and multidisciplinary team-based decisions are often necessary. We present the case of a symptomatic patient diagnosed with complex congenital heart disease, including scimitar syndrome and atrial septal defect at the age of 50 years. Surgical repair, involving scimitar vein implantation in the left atrium using a pericardial patch, was performed. Despite surgical correction, dyspnea persisted, and hemoptysis developed. A diagnostic workup revealed a critical stenosis of the re-inserted vein. This was successfully treated by percutaneous intervention with stent implantation. The patient has remained asymptomatic since the procedure. Scimitar syndrome can be first diagnosed in adulthood, and clinical manifestations can vary. Diagnostic workup necessitates a CT angiogram, magnetic resonance scan, and catheterization in selected cases. Stenoses of re-implanted pulmonary veins (PVs) can develop years after surgical correction, and hemoptysis may serve as a warning symptom prompting further PV imaging. Percutaneous vascular intervention using a stent is warranted in symptomatic cases and can lead to long-term success.
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  • 文章类型: Journal Article
    儿童的阅读进度通常在正规教育的长时间休息期间减慢,比如暑假。对于有阅读困难或残疾的儿童来说,这种停滞尤其令人担忧。比如诵读困难,因为有可能加剧他们和同龄人之间的技能差距。阅读干预可以防止技能损失,甚至在夏季带来阅读能力的可观提升。将干预反应与大脑变化相关的纵向研究可以揭示对快速学习驱动的大脑可塑性的教育相关见解。目前的工作重点是阅读结果和白质连接,这使得熟练阅读所需的大脑区域之间能够进行交流。我们在夏初和夏末收集了41名一年级或二年级阅读困难儿童的阅读分数和扩散加权图像。儿童被随机分配接受强化阅读干预(n=26;从Lindamood-Bell看到星星,强调拼字流畅)或被推迟到等待名单组(n=15),使我们能够分析白质属性如何在广泛的技能发展和回归轨迹中变化。平均而言,与非干预组相比,干预组的阅读增益更大,他拒绝阅读分数。改善了近端测量的正交处理(而不是其他更多的远端阅读测量)与核心阅读大脑回路(左弓形束和左下纵向束)内的平均扩散率降低以及左皮质脊髓束的分数各向异性增加有关。我们的发现表明,对强化阅读教学的反应主要与与阅读最相关的领域中的白质可塑性有关。
    Children\'s reading progress typically slows during extended breaks in formal education, such as summer vacations. This stagnation can be especially concerning for children with reading difficulties or disabilities, such as dyslexia, because of the potential to exacerbate the skills gap between them and their peers. Reading interventions can prevent skill loss and even lead to appreciable gains in reading ability during the summer. Longitudinal studies relating intervention response to brain changes can reveal educationally relevant insights into rapid learning-driven brain plasticity. The current work focused on reading outcomes and white matter connections, which enable communication among the brain regions required for proficient reading. We collected reading scores and diffusion-weighted images at the beginning and end of summer for 41 children with reading difficulties who had completed either 1st or 2nd grade. Children were randomly assigned to either receive an intensive reading intervention (n = 26; Seeing Stars from Lindamood-Bell which emphasizes orthographic fluency) or be deferred to a wait-list group (n = 15), enabling us to analyze how white matter properties varied across a wide spectrum of skill development and regression trajectories. On average, the intervention group had larger gains in reading compared to the non-intervention group, who declined in reading scores. Improvements on a proximal measure of orthographic processing (but not other more distal reading measures) were associated with decreases in mean diffusivity within core reading brain circuitry (left arcuate fasciculus and left inferior longitudinal fasciculus) and increases in fractional anisotropy in the left corticospinal tract. Our findings suggest that responses to intensive reading instruction are related predominantly to white matter plasticity in tracts most associated with reading.
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  • 文章类型: Journal Article
    背景:关于儿童参与积极交通的报道概述了许多国家的低参与率,尽管有许多相关的心理,物理,和社会健康利益。造成这种现象的主要原因之一是儿童缺乏关于积极旅行(AT)的教育和知识,特别是道路安全。为了解决这个问题,这项研究的目的是评估在线道路安全教育干预措施在儿童及其父母中推广AT的可行性和有效性。
    方法:将多阶段优化策略(MOST)应用于干预开发,实施,和评估,我们设计并评估了4个模块的在线道路安全教育干预措施,样本包括57个亲子二元组,采用23个因子设计,同时进行了定性和定量分析.
    结果:主要干预可行性发现包括对计划内容和设计的积极和关键反馈,以及适度的参与者参与度,这反映在计划保留率和完成率上。关于对儿童的初步干预效果,对于采用"车轮安全和技能"模块的组,观察到道路安全知识得分显著提高.观察到所有干预组的AT知识得分略有改善,但意义不大。在某些群体中,对某些父母AT做法和观念的初步干预有效性得到了显着改善。具有“车轮安全和技能”模块的小组在完成该计划后表现出比未收到该组件的小组高得多的指导选择分数。
    结论:MOST框架使我们能够设计和评估在线道路安全教育干预措施的可行性和初步有效性。已开发的干预措施表明,它有可能提高儿童的道路安全知识以及父母AT做法和观念的某些领域,其中的改进可能归因于“车轮安全和技能”模块的加入,这表明有针对性地关注自行车技能是一个优先领域。讨论了AT编程和实践含义。鼓励未来的研究改进模块,以更好地反映儿童和父母的优先事项,并在更大的样本中测试这些改进的组件。
    9,391(不包括摘要,tables,数字,缩写,和参考资料)。
    BACKGROUND: Reports of children\'s engagement in active transportation outline low participation rates in many countries despite many associated mental, physical, and social health benefits. One of the main contributors to this phenomenon is a cited lack of education and knowledge among children regarding active travel (AT), specifically road safety. To address this issue, the aim of this study was to evaluate the feasibility and effectiveness of an online road safety education intervention to promote AT among children and their parents.
    METHODS: Applying the Multiphase Optimization Strategy (MOST) for intervention development, implementation, and evaluation, we designed and assessed a four-module online road safety education intervention with a sample of 57 parent-child dyads using a 23 factorial design featuring both qualitative and quantitative analyses.
    RESULTS: Main intervention feasibility findings include positive and critical feedback on the program\'s content and design, and moderate participant engagement as reflected by program retention and completion rates. With respect to the preliminary intervention effectiveness on children, a significant improvement in road safety knowledge scores was observed for groups that feature the \"wheeling safety and skills\" module. Slight improvements in AT knowledge scores across all the intervention groups were observed, but were not of significance. Preliminary intervention effectiveness on select parental AT practices and perceptions saw significant improvements in some groups. Groups that featured the \'wheeling safety and skills\' module exhibited significantly higher guided choice scores upon completion of the program than those who did not receive this component.
    CONCLUSIONS: The MOST framework allowed us to design and evaluate the feasibility and preliminary effectiveness of an online road safety education intervention. The developed intervention has demonstrated that it has the potential to improve children\'s road safety knowledge and some areas of parental AT practices and perceptions, to which improvements may be attributed to the inclusion of the \"wheeling safety and skills\" module, suggesting that the targeted focus on cycling skills is a prioritized area. AT programming and practice implications are discussed. Future research is encouraged to refine modules to better reflect the priorities of children and parents and to test these refined components among larger samples.
    UNASSIGNED: 9,391 (excludes abstract, tables, figures, abbreviations, and references).
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